Chapter III: Part 3

The abundance of petrified coniferous wood in rocks of various ages
has led many botanists to investigate the structure of modern genera
with a view to determining how far anatomical characters may be used
as evidence of generic distinctions. There are a few well-marked types
of wood which serve as convenient standards of comparison, but these
cannot be used except in a few cases to distinguish individual genera.
The genus _Pinus_ serves as an illustration of wood of a distinct type
characterized by the absence of xylem-parenchyma, except such as is
associated with the numerous resin-canals that occur abundantly in the
wood, cortex and medullary rays; the medullary rays are composed of
parenchyma and of horizontal tracheids with irregular ingrowths from
their walls. In a radial section of a pine stem each ray is seen to
consist in the median part of a few rows of parenchymatous cells with
large oval simple pits in their walls, accompanied above and below by
horizontal tracheids with bordered pits. The pits in the radial walls
of the ordinary xylem-tracheids occur in a single row or in a double
row, of which the pits are not in contact, and those of the two rows
are placed on the same level. The medullary rays usually consist of a
single tier of cells, but in the _Pinus_ type of wood broader
medullary rays also occur and are traversed by horizontal
resin-canals. In the wood of _Cypressus_, _Cedrus_, _Abies_ and
several other genera, parenchymatous cells occur in association with
the xylem-tracheids and take the place of the resin-canals of other
types. In the Araucarian type of wood (_Araucaria_ and _Agathis_) the
bordered pits, which occur in two or three rows on the radial walls of
the tracheids, are in mutual contact and polygonal in shape, the pits
of the different rows are alternate and not on the same level; in this
type of wood the annual rings are often much less distinct than in
_Cupressus_, _Pinus_ and other genera. In _Taxus_, _Torreya_
(California and the Far East) and _Cephalotaxus_ the absence of
resin-canals and the presence of spiral thickening-bands on the
tracheids constitute well-marked characteristics. An examination of
the wood of branches, stems and roots of the same species or
individual usually reveals a fairly wide variation in some of the
characters, such as the abundance and size of the medullary rays, the
size and arrangement of pits, the presence of
wood-parenchyma--characters to which undue importance has often been
attached in systematic anatomical work. The phloem consists of
sieve-tubes, with pitted areas on the lateral as well as on the
inclined terminal walls, phloem-parenchyma and, in some genera,
fibres. In the _Abietineae_ the phloem consists of parenchyma and
sieve-tubes only, but in most other forms tangential rows of fibres
occur in regular alternation with the parenchyma and sieve-tubes. The
characteristic companion-cells of Angiosperms are represented by
phloem-parenchyma cells with albuminous contents; other parenchymatous
elements of the bast contain starch or crystals of calcium oxalate.
When tracheids occur in the medullary rays of the xylem these are
replaced in the phloem-region by irregular parenchymatous cells known
as albuminous cells. Resin-canals, which occur abundantly in the
xylem, phloem or cortex, are not found in the wood of the yew.
_Cephalotaxus (Taxeae)_ is also peculiar in having resin-canals in the
pith (cf. _Ginkgo_). One form of _Cephalotaxus_ is characterized by
the presence of short tracheids in the pith, in shape like ordinary
parenchyma, but in the possession of bordered pits and lignified walls
agreeing with ordinary xylem-tracheids; it is probable that these
short tracheids serve as reservoirs for storing rather than for
conducting water. The vascular bundle entering the stem from a leaf
with a single vein passes by a more or less direct course into the
central cylinder of the stem, and does not assume the girdle-like
form characteristic of the cycadean leaf-trace. In species of which
the leaves have more than one vein (e.g. _Araucaria imbricata_, &c.)
the leaf-trace leaves the stele of the stem as a single bundle which
splits up into several strands in its course through the cortex. In
the wood of some conifers, e.g. _Araucaria_, the leaf-traces persist
for a considerable time, perhaps indefinitely, and may be seen in
tangential sections of the wood of old stems. The leaf-trace in the
Coniferales is simple in its course through the stem, differing in
this respect from the double leaf-trace of _Ginkgo_. A detailed
account of the anatomical characters of conifers has been published by
Professor D. P. Penhallow of Montreal and Dr. Gothan of Berlin which
will be found useful for diagnostic purposes. The characters of leaves
most useful for diagnostic purposes are the position of the stomata,
the presence and arrangement of resin-canals, the structure of the
mesophyll and vascular bundles. The presence of hypodermal fibres is
another feature worthy of note, but the occurrence of these elements
is too closely connected with external conditions to be of much
systematic value. A pine needle grown in continuous light differs from
one grown under ordinary conditions in the absence of hypodermal
fibres, in the absence of the characteristic infoldings of the
mesophyll cell-walls, in the smaller size of the resin-canals, &c. The
endodermis in _Pinus_, _Picea_ and many other genera is usually a
well-defined layer of cells enclosing the vascular bundles, and
separated from them by a tissue consisting in part of ordinary
parenchyma and to some extent of isodiametric tracheids; but this
tissue, usually spoken of as the pericycle, is in direct continuity
with other stem-tissues as well as the pericycle. The occurrence of
short tracheids in close proximity to the veins is a characteristic of
coniferous leaves; these elements assume two distinct forms--(1) the
short isodiametric tracheids (transfusion-tracheids) closely
associated with the veins; (2) longer tracheids extending across the
mesophyll at right angles to the veins, and no doubt functioning as
representatives of lateral veins. It has been suggested that
transfusion-tracheids represent, in part at least, the centripetal
xylem, which forms a distinctive feature of cycadean leaf-bundles;
these short tracheids form conspicuous groups laterally attached to
the veins in _Cunninghamia_, abundantly represented in a similar
position in the leaves of _Sequoia_, and scattered through the
so-called pericycle in _Pinus_, _Picea_, &c. It is of interest to note
the occurrence of precisely similar elements in the mesophyll of
_Lepidodendron_ leaves. An anatomical peculiarity in the veins of
_Pinus_ and several other genera is the continuity of the medullary
rays, which extend as continuous plates from one end of the leaf to
the other. The mesophyll of _Pinus_ and _Cedrus_ is characterized by
its homogeneous character and by the presence of infoldings of the
cell-walls. In many leaves, e.g. _Abies_, _Tsuga_, _Larix_, &c., the
mesophyll is heterogeneous, consisting of palisade and spongy
parenchyma. In the leaves of _Araucaria imbricata_, in which
palisade-tissue occurs in both the upper and lower part of the
mesophyll, the resin-canals are placed between the veins; in some
species of _Podocarpus_ (sect. _Nageia_) a canal occurs below each
vein; in _Tsuga_, _Torreya_, _Cephalotaxus_, _Sequoia_, &c., a single
canal occurs below the midrib; in _Larix_, _Abies_, &c., two canals
run through the leaf parallel to the margins. The stomata are
frequently arranged in rows, their position being marked by two white
bands of wax on the leaf-surface.

Distribution.

The chief home of the Coniferales is in the northern hemisphere, where
certain species occasionally extend into the Arctic circle and
penetrate beyond the northern limit of dicotyledonous trees. Wide
areas are often exclusively occupied by conifers, which give the
landscape a sombre aspect, suggesting a comparison with the forest
vegetation of the Coal period. South of the tree-limit a belt of
conifers stretches across north Europe, Siberia and Canada. In
northern Europe this belt is characterized by such species as _Picea
excelsa_ (spruce), which extends south to the mountains of the
Mediterranean region; _Pinus sylvestris_ (Scottish fir), reaching from
the far north to western Spain, Persia and Asia Minor; _Juniperus
communis_, &c. In north Siberia _Pinus Cembra_ (Cembra or Arolla Pine)
has a wide range; also _Abies sibirica_ (Siberian silver fir), _Larix
sibirica_ and _Juniperus Sabina_ (savin). In the North American area
_Picea alba_, _P. nigra_, _Larix americana_, _Abies balsamea_ (balsam
fir), _Tsuga canadensis_ (hemlock spruce), _Pinus Strobus_ (Weymouth
pine), _Thuja occidentalis_ (white cedar), _Taxus canadensis_ are
characteristic species. In the Mediterranean region occur _Cupressus
sempervirens_, _Pinus Pinea_ (stone pine), species of juniper, _Cedrus
atlantica_, _C. Libani_, _Callitris quadrivalvis_, _Pinus montana_,
&c. Several conifers of economic importance are abundant on the
Atlantic side of North America--_Juniperus virginiana_ (red cedar,
used in the manufacture of lead pencils, and extending as far south as
Florida), _Taxodium distichum_ (swamp cypress), _Pinus rigida_ (pitch
pine), _P. mitis_ (yellow pine), _P. taeda_, _P. palustris_, &c. On
the west side of the American continent conifers play a still more
striking role; among them are _Chamaecyparis nutkaensis_, _Picea
sitchensis_, _Libocedrus decurrens_, _Pseudotsuga Douglasii_ (Douglas
fir), _Sequoia sempervirens_, _S. gigantea_ (the only two surviving
species of this generic type are now confined to a few localities in
California, but were formerly widely spread in Europe and elsewhere),
_Pinus Coulteri_, _P. Lambertiana_, &c. Farther south, a few
representatives of such genera as _Abies_, _Cupressus_, _Pinus_ and
juniper are found in the Mexican Highlands, tropical America and the
West Indies. In the far East conifers are richly represented; among
them occur _Pinus densiflora_, _Cryptomeria japonica_, _Cephalotaxus_,
species of _Abies_, _Larix_, _Thujopsis_, _Sciadopitys verticillata_,
_Pseudolarix Kaempferi_, &c. In the Himalaya occur _Cedrus deodara_,
_Taxus_, species of _Cupressus_, _Pinus excelsa_, _Abies Webbiana_,
&c. The continent of Africa is singularly poor in conifers. _Cedrus
atlantica_, a variety of _Abies Pinsapo_, _Juniperus thurifera_,
_Callitris quadrivalvis_, occur in the north-west region, which may be
regarded as the southern limit of the Mediterranean region. The
greater part of Africa north of the equator is without any
representatives of the conifers; _Juniperus procera_ flourishes in
Somaliland and on the mountains of Abyssinia; a species of
_Podocarpus_ occurs on the Cameroon mountains, and _P. milanjiana_ is
widely distributed in east tropical Africa. _Widdringtonia Whytei_, a
species closely allied to _W. juniperoides_ of the Cedarberg mountains
of Cape Colony, is recorded from Nyassaland and from N.E. Rhodesia;
while a third species, _W. cupressoides_, occurs in Cape Colony.
_Podocarpus elongata_ and _P. Thunbergii_ (yellow wood) form the
principal timber trees in the belt of forest which stretches from the
coast mountains of Cape Colony to the north-east of the Transvaal.
_Libocedrus tetragona_, _Fitzroya patagonica_, _Araucaria
brasiliensis_, _A. imbricata_, _Saxegothaea_ and others are met with
in the Andes and other regions in South America. _Athrotaxis_ and
_Microcachrys_ are characteristic Australian types. _Phyllocladus_
occurs also in New Zealand, and species of _Dacrydium_, _Araucaria_,
_Agathis_ and _Podocarpus_ are represented in Australia, New Zealand
and the Malay regions.

GNETALES.--These are trees or shrubs with simple leaves. The flowers
are dioecious, rarely monoecious, provided with one or two perianths.
The wood is characterized by the presence of vessels in addition to
tracheids. There are no resin-canals. The three existing genera,
usually spoken of as members of the Gnetales, differ from one another
more than is consistent with their inclusion in a single family; we
may therefore better express their diverse characters by regarding
them as types of three separate families--(1) _Ephedroideae_, genus
_Ephedra_; (2) _Welwitschioideae_, genus _Welwitschia_; (3)
_Gnetoideae_, genus _Gnetum_. Our knowledge of the Gnetales leaves
much to be desired, but such facts as we possess would seem to
indicate that this group is of special importance as foreshadowing,
more than any other Gymnosperms, the Angiospermous type. In the more
heterogeneous structure of the wood and in the possession of true
vessels the Gnetales agree closely with the higher flowering plants.
It is of interest to note that the leaves of _Gnetum_, while typically
Dicotyledonous in appearance, possess a Gymnospermous character in the
continuous and plate-like medullary rays of their vascular bundles.
The presence of a perianth is a feature suggestive of an approach to
the floral structure of Angiosperms; the prolongation of the
integument furnishes the flowers with a substitute for a stigma and
style. The genus _Ephedra_, with its prothallus and archegonia, which
are similar to those of other Gymnosperms, may be safely regarded as
the most primitive of the Gnetales. In _Welwitschia_ also the
megaspore is filled with prothallus-tissue, but single egg-cells take
the place of archegonia. In certain species of _Gnetum_ described by
Karsten the megaspore contains a peripheral layer of protoplasm, in
which scattered nuclei represent the female reproductive cells; in
_Gnetum Gnemon_ a similar state of things exists in the upper half of
the megaspore, while the lower half agrees with the megaspore of
_Welwitschia_ in being full of prothallus-tissue, which serves merely
as a reservoir of food. Lotsy has described the occurrence of special
cells at the apex of the prothallus of _Gnetum Gnemon_, which he
regards as imperfect archegonia (fig. 17, C, a); he suggests they may
represent vestigial structures pointing back to some ancestral form
beyond the limits of the present group. The Gnetales probably had a
separate origin from the other Gymnosperms; they carry us nearer to
the Angiosperms, but we have as yet no satisfactory evidence that they
represent a stage in the direct line of Angiospermic evolution. It is
not improbable that the three genera of this ancient phylum survive as
types of a blindly-ending branch of the Gymnosperms; but be that as it
may, it is in the Gnetales more than in any other Gymnosperms that we
find features which help us to obtain a dim prospect of the lines
along which the Angiosperms may have been evolved.

_Ephedra._--This genus is the only member of the Gnetales represented
in Europe. Its species, which are characteristic of warm temperate
latitudes, are usually much-branched shrubs. The finer branches are
green, and bear a close resemblance to the stems of Equisetum and to
the slender twigs of _Casuarina_; the surface of the long internodes
is marked by fine longitudinal ribs, and at the nodes are borne pairs
of inconspicuous scale-leaves. The flowers are small, and borne on
axillary shoots. A single male flower consists of an axis enclosed at
the base by an inconspicuous perianth formed of two concrescent leaves
and terminating in two, or as many as eight, shortly stalked or
sessile anthers. The female flower is enveloped in a closely fitting
sac-like investment, which must be regarded as a perianth; within this
is an orthotropous ovule surrounded by a single integument prolonged
upwards as a beak-like micropyle. The flower may be described as a bud
bearing a pair of leaves which become fused and constitute a perianth,
the apex of the shoot forming an ovule. In function the perianth may
be compared with a unilocular ovary containing a single ovule; the
projecting integument, which at the time of pollination secretes a
drop of liquid, serves the same purpose as the style and stigma of an
angiosperm. The megaspore is filled with tissue as in typical
Gymnosperms, and from some of the superficial cells 3 to 5 archegonia
are developed, characterized by long multicellular necks. The
archegonia are separated from one another, as in _Pinus_, by some of
the prothallus-tissue, and the cells next the egg-cells (tapetal
layer) contribute food-material to their development. After
fertilization, some of the uppermost bracts below each flower become
red and fleshy; the perianth develops into a woody shell, while the
integument remains membranous. In some species of _Ephedra_, e.g. _E.
altissima_, the fertilized eggs grow into tubular proembryos, from the
tip of each of which embryos begin to be developed, but one only comes
to maturity. In _Ephedra helvetica_, as described by Jaccard, no
proembryo or suspensor is formed; but the most vigorous fertilized
egg, after undergoing several divisions, becomes attached to a tissue,
termed the columella, which serves the purpose of a primary suspensor;
the columella appears to be formed by the lignification of certain
cells in the central region of the embryo-sac. At a later stage some
of the cells in the upper (micropylar) end of the embryo divide and
undergo considerable elongation, serving the purpose of a secondary
suspensor. The secondary wood of _Ephedra_ consists of tracheids,
vessels and parenchyma; the vessels are characterized by their wide
lumen and by the large simple or slightly-bordered pits on their
oblique end-walls.

A, Female Flower. a, Imperfect Archegonia.
n, Nucellus. e, Partially developed Megaspore.
pc, Pollen-chamber. F, Fertile half.
i, Integument. S, Sterile half.
p', Inner Perianth. pt, Pollen-tube.
p", Outer Perianth. z, Zygote.
B, C, Megaspore. z', Prothallus.
a, Imperfect Archegonia.
e, Partially developed Megaspore.
F, Fertile half.
S, Sterile half.
pt, Pollen-tube.
z, Zygote.
z', Prothallus.]

_Gnetum._--This genus is represented by several species, most of which
are climbing plants, both in tropical America and in warm regions of
the Old World. The leaves, which are borne in pairs at the tumid
nodes, are oval in form and have a Dicotyledonous type of venation.
The male and female inflorescences have the form of simple or
paniculate spikes. The spike of an inflorescence bears whorls of
flowers at each node in the axils of concrescent bracts accompanied by
numerous sterile hairs (paraphyses); in a male inflorescence numerous
flowers occur at each node, while in a female inflorescence the number
of flowers at each node is much smaller. A male flower consists of a
single angular perianth, through the open apex of which the
flower-axis projects as a slender column terminating in two anthers.
The female flowers, which are more complex in structure, are of two
types, complete and incomplete; the latter occur in association with
male flowers in a male inflorescence. A complete female flower
consists of a nucellus (fig. 17, A, n), surrounded by a single
integument (fig. 17, A, i), prolonged upwards as a narrow tube and
succeeded by an inner and an outer perianth (fig. 17, A, p' and p").
The whole flower may be looked upon as an adventitious bud bearing two
pairs of leaves; each pair becomes concrescent and forms a perianth,
the apex of the shoot being converted into an orthotropous ovule. The
incomplete female flowers are characterized by the almost complete
suppression of the inner perianth. Several embryo-sacs (megaspores)
are present in the nucellus of a young ovule, but one only attains
full size, the smaller and partially developed megaspores (fig. 17, B
and C, e) being usually found in close association with the surviving
and fully-grown megaspore. In _Gnetum Gnemon_, as described by Lotsy,
a mature embryo-sac contains in the upper part a large central vacuole
and a peripheral layer of protoplasm, including several nuclei, which
take the place of the archegonia of _Ephedra_; the lower part of the
embryo-sac, separated from the upper by a constriction, is full of
parenchyma. The upper part of the megaspore may be spoken of as the
fertile half (fig. 17, B and C, F) and the lower part, which serves
only as food-reservoir for the growing embryo, may be termed the
sterile half (fig. 17, B and C, S). (Coulter, _Bot. Gazette_, xlvi.,
1908, regards this tissue as belonging to the nucellus.) At the time
of pollination the long tubular integument secretes a drop of fluid
at its apex, which holds the pollen-grains, brought by the wind, or
possibly to some extent by insect agency, and by evaporation these are
drawn on to the top of the nucellus, where partial disorganization of
the cells has given rise to an irregular pollen-chamber (fig. 17, A,
pc). The pollen-tube, containing two generative and one vegetative
nucleus, pierces the wall of the megaspore and then becomes swollen
(fig. 17, B and C, pt); finally the two generative nuclei pass out of
the tube and fuse with two of the nuclei in the fertile half of the
megaspore. As the result of fertilization, the fertilized nuclei of
the megaspore become surrounded by a cell-wall, and constitute
zygotes, which may attach themselves either to the wall of the
megaspore or to the end of a pollen-tube (fig. 17, C, z and z'); they
then grow into long tubes or proembryos, which make their way towards
the prothallus (C, z'), and eventually embryos are formed from the
ends of the proembryo tubes. One embryo only comes to maturity. The
embryo of _Gnetum_ forms an out-growth from the hypocotyl, which
serves as a feeder and draws nourishment from the prothallus. The
fleshy outer portion of the seed is formed from the outer perianth,
the woody shell being derived from the inner perianth. The climbing
species of _Gnetum_ are characterized by the production of several
concentric cylinders of secondary wood and bast, the additional
cambium-rings being products of the pericycle, as in _Cycas_ and
_Macrozamia_. The structure of the wood agrees in the main with that
of _Ephedra_.

_Welwitschia (Tumboa)._--This is by far the most remarkable member of
the Gnetales, both as regards habit and the form of its flowers. In a
supplement to the systematic work of Engler and Prantl the well-known
name _Welwitschia_, instituted by Hooker in 1864 in honour of
Welwitsch, the discoverer of the plant, is superseded by that of
_Tumboa_, originally suggested by Welwitsch. The genus is confined to
certain localities in Damaraland and adjoining territory on the west
coast of tropical South Africa. A well-grown plant projects less than
a foot above the surface of the ground; the stem, which may have a
circumference of more than 12 ft., terminates in a depressed crown
resembling a circular table with a median groove across the centre and
prominent broad ridges concentric with the margin. The thick tuberous
stem becomes rapidly narrower, and passes gradually downwards into a
tap-root. A pair of small strap-shaped leaves succeed the two
cotyledons of the seedling, and persist as the only leaves during the
life of the plant; they retain the power of growth in their basal
portion, which is sunk in a narrow groove near the edge of the crown,
and the tough lamina, 6 ft. in length, becomes split into narrow
strap-shaped or thong-like strips which trail on the ground. Numerous
circular pits occur on the concentric ridges of the depressed and
wrinkled crown, marking the position of former inflorescences borne in
the leaf-axil at different stages in the growth of the plant. An
inflorescence has the form of a dichotomously-branched cyme bearing
small erect cones; those containing the female flowers attain the size
of a fir-cone, and are scarlet in colour. Each cone consists of an
axis, on which numerous broad and thin bracts are arranged in regular
rows; in the axil of each bract occurs a single flower; a male flower
is enclosed by two opposite pairs of leaves, forming a perianth
surrounding a central sterile ovule encircled by a ring of stamens
united below, but free distally as short filaments, each of which
terminates in a trilocular anther. The integument of the sterile ovule
is prolonged above the nucellus as a spirally-twisted tube expanded at
its apex into a flat stigma-like organ. A complete and functional
female flower consists of a single ovule with two integuments, the
inner of which is prolonged into a narrow tubular micropyle, like that
in the flower of _Gnetum_. The megaspore of _Welwitschia_ is filled
with a prothallus-tissue before fertilization, and some of the
prothallus-cells function as egg-cells; these grow upwards as long
tubes into the apical region of the nucellus, where they come into
contact with the pollen-tubes. After the egg-cells have been
fertilized by the non-motile male cells they grow into tubular
proembryos, producing terminal embryos. The stem is traversed by
numerous collateral bundles, which have a limited growth, and are
constantly replaced by new bundles developed from strands of secondary
meristem. One of the best-known anatomical characteristics of the
genus is the occurrence of numerous spindle-shaped or branched fibres
with enormously-thickened walls studded with crystals of calcium
oxalate. Additional information has been published by Professor
Pearson of Cape Town based on material collected in Damaraland in 1904
and 1906-1907. In 1906 he gave an account of the early stages of
development of the male and female organs and, among other interesting
statements in regard to the general biology of _Welwitschia_, he
expressed the opinion that, as Hooker suspected, the ovules are
pollinated by insect-agency. In a later paper Pearson considerably
extended our knowledge of the reproduction and gametophyte of this
genus.

AUTHORITIES.--General: Bentham and Hooker, _Genera Plantarum_ (London,
1862-1883); Engler and Prantl, _Die naturlichen Pflanzenfamilien_
(Leipzig, 1889 and 1897); Strasburger, _Die Coniferen und Gnetaceen_
(Jena, 1872); _Die Angiospermen und die Gymnospermen_ (Jena, 1879);
_Histologische Beitrage_, iv. (Jena, 1892); Coulter and Chamberlain,
_Morphology of Spermatophytes_ (New York, 1901); Rendle, _The
Classification of Flowering Plants_, vol. i. (Cambridge, 1904); "The
Origin of Gymnosperms" (A discussion at the Linnean Society; _New
Phytologist_, vol. v., 1906). Cycadales: Mettenius, "Beitrage zur
Anatomie der Cycadeen," _Abh. k. sachs_. _Ges. Wiss._ (1860); Treub,
"Recherches sur les Cycadees," _Ann. Bot. Jard. Buitenzorg_, ii.
(1884); Solms-Laubach, "Die Sprossfolge der Stangeria, &c.," _Bot.
Zeit._ xlviii. (1896); Worsdell, "Anatomy of Macrozamia," _Ann. Bot._
x. (1896) (also papers by the same author, _Ann. Bot._, 1898, _Trans.
Linn. Soc._ v., 1900); Scott, "The Anatomical Characters presented by
the Peduncle of Cycadaceae," Ann. Bot. xi. (1897); Lang, "Studies in
the Development and Morphology of Cycadean Sporangia, No. I.," Ann.
Bot. xi. (1897); No. II., _Ann. Bot._ xiv. (1900); Webber,
"Development of the Antherozoids of Zamia," Bot. Gaz. (1897); Ikeno,
"Untersuchungen uber die Entwickelung, &c., bei Cycas revoluta,"
_Journ. Coll. Sci. Japan_, xii. (1898); Wieland, "American Fossil
Cycads," Carnegie Institution Publication (1906); Stopes, "Beitrage
zur Kenntnis der Fortpflanzungsorgane der Cycadeen," _Flora_ (1904);
Caldwell, "Microcycas Calocoma," _Bot. Gaz._ xliv., 1907 (also papers
on this and other Cycads in the _Bot. Gaz._, 1907-1909); Matte,
_Recherches sur l'appareil libero-ligneux des Cycadacees_ (Caen,
1904). Ginkgoales: Hirase, "Etudes sur la fecondation, &c., de Ginkgo
biloba," _Journ. Coll. Sci. Japan_, xii. (1898); Seward and Gowan,
"Ginkgo biloba," _Ann. Bot._ xiv. (1900) (with bibliography); Ikeno,
"Contribution a l'etude de la fecondation chez le Ginkgo biloba,"
_Ann. Sci. Nat._ xiii. (1901); Sprecher, _Le Ginkgo biloba_ (Geneva,
1907). Coniferales: "Report of the Conifer Conference" (1891) _Journ.
R. Hort. Soc._ xiv. (1892); Beissner, _Handbuch der Nadelholzkunde_
(Berlin, 1891); Masters, "Comparative Morphology of the Coniferae,"
_Journ. Linn. Soc._ xxvii. (1891); ibid. (1896), &c.; Penhallow, "The
Generic Characters of the North American Taxaceae and Coniferae,"
_Proc. and Trans. R. Soc. Canada_, ii. (1896); Blackman,
"Fertilization in Pinus sylvestris," _Phil. Trans._ (1898) (with
bibliography); Worsdell, "Structure of the Female Flowers in
Conifers," _Ann. Bot._ xiv. (1900) (with bibliography); ibid. (1899);
Veitch, _Manual of the Coniferae_ (London, 1900); Penhallow, "Anatomy
of North American Coniferales," _American Naturalist_ (1904); Engler
and Pilger, _Das Pflanzenreich, Taxaceae_ (1903); Seward and Ford,
"The Araucarieae, recent and extinct," _Phil. Trans. R. Soc._ (1906)
(with bibliography); Lawson, "Sequoia sempervirens," _Annals of
Botany_ (1904); Robertson, "Torreya Californica," _New Phytologist_
(1904); Coker, "Gametophyte and Embryo of Taxodium," _Bot. Gazette_
(1903); E. C. Jeffrey, "The Comparative Anatomy and Phylogeny of the
Coniferales, part i. The Genus Sequoia," _Mem. Boston Nat. Hist. Soc._
v. No. 10 (1903); Gothan, "Zur Anatomie lebender und fossiler
Gymnospermen-Holzer," _K. Preuss. Geol. Landes._ (Berlin, 1905) (for
more recent papers, see _Ann. Bot., New Phytologist_, and _Bot.
Gazette_, 1906-1909). Gnetales: Hooker, "On Welwitschia mirabilis."
_Trans. Linn. Soc._ xxiv. (1864); Bower, "Germination, &., in Gnetum,"
_Journ. Mic. Sci._ xxii. (1882); ibid. (1881); Jaccard, "Recherches
embryologiques sur _l'Ephedra helvetica_," _Diss. Inaug. Lausanne_
(1894); Karsten, "Zur Entwickelungsgeschichte der Gattung Gnetum,"
_Cohn's Beitrage_, vi. (1893); Lotsy, "Contributions to the
Life-History of the genus Gnetum," _Ann. Bot. Jard. Buitenzorg_, xvi.
(1899); Land, "Ephedra trifurca," _Bot. Gazette_ (1904); Pearson,
"Some observations on Welwitschia mirabilis," _Phil. Trans. R. Soc._
(1906); Pearson, "Further Observations on Welwitschia," _Phil. Trans.
R. Soc._ vol. 200 (1909). (A. C. Se.)

GYMNOSTOMACEAE, an order of Ciliate Infusoria (q.v.), characterized by a closed mouth, which only opens to swallow food actively, and body cilia forming a general or partial investment (rarely represented by a girdle of membranellae), but not differentiated in different regions. With the Aspirotrochaceae (q.v.) it formed the Holotricha of Stein.

GYMPIE, a mining town of March county, Queensland, Australia, 107 m. N. of Brisbane, and 61 m. S. of Maryborough by rail. Pop. (1901) 11,959. Numerous gold mines are worked in the district, which also abounds in copper, silver, antimony, cinnabar, bismuth and nickel. Extensive undeveloped coal-beds lie 40 m. N. at Miva. Gympie became a municipality in 1880.

GYNAECEUM (Gr. [Greek: gynaikeion], from [Greek: gyne], woman), that part in a Greek house which was specially reserved for the women, in contradistinction to the "andron," the men's quarters; in the larger houses there was an open court with peristyles round, and as a rule all the rooms were on the same level; in smaller houses the servants were placed in an upper storey, and this seems to have been the case to a certain extent in the Homeric house of the Odyssey. "Gynaeconitis" is the term given by Procopius to the space reserved for women in the Eastern Church, and this separation of the sexes was maintained in the early Christian churches where there were separate entrances and accommodation for the men and women, the latter being placed in the triforium gallery, or, in its absence, either on one side of the church, the men being on the other, or occasionally in the aisles, the nave being occupied by the men.

GYNAECOLOGY (from Gr. [Greek: gyne, gynaikos], a woman, and [Greek: logos], discourse), the name given to that branch of medicine which concerns the pathology and treatment of affections peculiar to the female sex.

Gynaecology may be said to be one of the most ancient branches of medicine. The papyrus of Ebers, which is one of the oldest known works on medicine and dates from 1550 B.C., contains references to diseases of women, and it is recorded that specialism in this branch was known amongst Egyptian medical practitioners. The Vedas contain a list of therapeutic agents used in the treatment of gynaecological diseases. The treatises on gynaecology formerly attributed to Hippocrates (460 B.C.) are now said to be spurious, but the wording of the famous oath shows that he was at least familiar with the use of gynaecological instruments. Diocles Carystius, of the Alexandrian school (4th century B.C.), practised this branch, and Praxagoras of Cos, who lived shortly after, opened the abdomen by laparotomy. While the Alexandrine school represented Greek medicine, Greeks began to practise in Rome, and in the first years of the Christian era gynaecologists were much in demand (Haser). A speculum for gynaecological purposes has been found in the ruins of Pompeii, and votive offerings of anatomical parts found in the temples show that various gynaecological malformations were known to the ancients. Writers who have treated of this branch are Celsus (50 B.C.-A.D. 7) and Soranus of Ephesus (A.D. 98-138), who refers in his works to the fact that the Roman midwives frequently called to their aid practitioners who made a special study of diseases of women. These midwives attended the simpler gynaecological ailments. This was no innovation, as in Athens, as mentioned by Hyginus, we find one Agnodice, a midwife, disguising herself in man's attire so that she might attend lectures on medicine and diseases of women. After instruction she practised as a gynaecologist. This being contrary to Athenian law she was prosecuted, but was saved by the wives of some of the chief men testifying on her behalf. Besides Agnodice we have Sotira, who wrote a work on menstruation which is preserved in the library at Florence, while Aspasia is mentioned by Aetius as the author of several chapters of his work. It is evident that during the Roman period much of the gynaecological work was in the hands of women. Martial alludes to the "_feminae medicae_" in his epigram on Leda. These women must not be confounded with the midwives who on monuments are always described as "obstetrices." Galen devotes the sixth chapter of his work _De locis affectis_ to gynaecological ailments. During the Byzantine period may be mentioned the work of Oribasius (A.D. 325) and Moschion (2nd century A.D.) who wrote a book in Latin for the use of matrons and midwives ignorant of Greek.

In modern times James Parsons (1705-1770) published his _Elenchus gynaicopathologicus et obstetricarius_, and in 1755 Charles Perry published his _Mechanical account and explication of the hysterical passion and of all other nervous disorders incident to the sex, with an appendix on cancers_. In the early part of the 19th century fresh interest in diseases of women awakened. Joseph Recamier (1774-1852) by his writings and teachings advocated the use of the speculum and sound. This was followed in 1840 by the writings of Simpson in England and Huguier in France. In 1845 John Hughes Bennett published his great work on inflammation of the uterus, and in 1850 Tilt published his book on ovarian inflammation. The credit of being the first to perform the operation of ovariotomy is now credited to McDowell of Kentucky in 1809, and to Robert Lawson Tait (1845-1899) in 1883 the first operation for ruptured ectopic gestation.

_Menstruation._--Normal menstruation comprises the escape of from 4 to
6 oz. of blood together with mucus from the uterus at intervals of
twenty-eight days (more or less). The flow begins at the age of
puberty, the average age of which in England is between fourteen and
sixteen years. It ceases between forty-five and fifty years of age,
and this is called the menopause or climacteric period, commonly
spoken of as "the change of life." Both the age of puberty and that of
the menopause may supervene earlier or later according to local
conditions. At both times the menstrual flow may be replaced by
haemorrhage from distant organs (epistaxis, haematemesis,
haemoptysis); this is called _vicarious menstruation_. Menstruation is
usually but not necessarily coincident with ovulation. The usual
disorders of menstruation are: (1) _amenorrhoea_ (absence of flow),
(2) _dysmenorrhoea_ (painful flow), (3) _menorrhagia_ (excessive
flow), (4) _metrorrhagia_ (excessive and irregular flow). Amenorrhoea
may arise from physiological causes, such as pregnancy, lactation, the
menopause; constitutional causes, such as phthisis, anaemia and
chlorosis, febrile disorders, some chronic intoxications, such as
morphinomania, and some forms of cerebral disease; local causes, which
include malformations or absence of one or more of the genital parts,
such as absence of ovaries, uterus or vagina, atresia of vagina,
imperforate cervix, disease of the ovaries, or sometimes imperforate
hymen. The treatment of amenorrhoea must be directed towards the
cause. In anaemia and phthisis menstruation often returns after
improvement in the general condition, with good food and good sanitary
conditions, an outdoor life and the administration of iron or other
tonics. In local conditions of imperforate hymen, imperforate cervix
or ovarian disease, surgical interference is necessary. Amenorrhoea is
permanent when due to absence of the genital parts. The causes of
dysmenorrhoea are classified as follows: (1) ovarian, due to disease
of the ovaries or Fallopian tubes; (2) obstructive, due to some
obstacle to the flow, as stenosis, flexions and malpositions of the
uterus, or malformations; (3) congestive, due to subinvolution,
chronic inflammation of the uterus or its lining membrane, fibroid
growths and polypi of the uterus, cardiac or hepatic disease; (4)
neuralgic; (5) membranous. The foremost place in the treatment of
dysmenorrhoea must be given to aperients and purgatives administered a
day or two before the period is expected. By this means congestion is
reduced. Hot baths are useful, and various drugs such as hyoscyanus,
cannabis indica, phenalgin, ammonol or phenacetin have been
prescribed. Medicinal treatment is, however, only palliative, and
flexions and malpositions of the uterus must be corrected, stenosis
treated by dilatation, fibroid growths if present removed, and
endometritis when present treated by local applications or curetting
according to its severity. Menorrhagia signifies excessive bleeding at
the menstrual periods. Constitutional causes are purpura, haemophilia,
excessive food and alcoholic drinks and warm climates; while local
causes are congestion and displacements of the uterus, endometritis,
subinvolution, retention of the products of conception, new growths in
the uterus such as mucous and fibroid polypi, malignant growths,
tubo-ovarian inflammation and some ovarian tumours. Metrorrhagia is a
discharge of blood from the uterus, independent of menstruation. It
always arises from disease of the uterus or its appendages. Local
causes are polypi, retention of the products of conception, extra
uterine gestation, haemorrhages in connexion with pregnancy, and new
growths in the uterus. In the treatment of both menorrhagia and
metrorrhagia the local condition must be carefully ascertained. When
pregnancy has been excluded, and constitutional causes treated,
efforts should be made to relieve congestion. Uterine haemostatics, as
ergot, ergotin, tincture of hydrastis or hamamelis, are of use,
together with rest in bed. Fibroid polypi and other new growths must
be removed. Irregular bleeding in women over forty years of age is
frequently a sign of early malignant disease, and should on no account
be neglected.

_Diseases of the External Genital Organs._--The vulva comprises
several organs and structures grouped together for convenience of
description (see REPRODUCTIVE SYSTEM). The affections to which these
structures are liable may be classified as follows: (1) Injuries to
the vulva, either accidental or occurring during parturition; these
are generally rupture of the perinaeum. (2) _Vulvitis._ Simple
Vulvitis is due to want of cleanliness, or irritating discharges, and
in children may result from threadworms. The symptoms are heat,
itching and throbbing, and the parts are red and swollen. The
treatment consists of rest, thorough cleanliness and fomentations.
Infective vulvitis is nearly always due to gonorrhoea. The symptoms
are the same as in simple vulvitis, with the addition of mucopurulent
yellow discharge and scalding pain on micturition; if neglected,
extension of the disease may result. The treatment consists of rest in
bed, warm medicated baths several times a day or fomentations of
boracic acid. The parts must be kept thoroughly clean and discharges
swabbed away. Diphtheritic vulvitis occasionally occurs, and
erysipelas of the vulva may follow wounds, but since the use of
antiseptics is rarely seen. (3) Vascular disturbances may occur in the
vulva, including varix, haematoma, oedema and gangrene; the treatment
is the same as for the same disease in other parts. (4) The vulva is
likely to be affected by a number of cutaneous affections, the most
important being erythema, eczema, herpes, lichen, tubercle,
elephantiasis, vulvitis pruriginosa, syphilis and kraurosis. These
affections present the same characters as in other parts of the body.
_Kraurosis vulvae_, first described by Lawson Tait in 1875, is an
atrophic change accompanied by pain and a yellowish discharge; the
cause is unknown. Pruritis vulvae is due to parasites, or to
irritating discharges, as leucorrhoea, and is frequent in diabetic
subjects. The hymen may be occasionally imperforate and require
incision. Cysts and painful carunculae may occur on the clitoris. Any
part of the vulva may be the seat of new growths, simple or malignant.

_Diseases of the Vagina._--(1) Malformations. The vagina may be absent
in whole or in part or may present a septum. Stenosis of the vagina
may be a barrier to menstruation. (2) Displacements of the vagina; (a)
cystocele, which is a hernia of the bladder into the vagina; (b)
rectocele, a hernia of the rectum into the vagina. The cause of these
conditions is relaxation of the tissues due to parturition. The
palliative treatment consists in keeping up the parts by the insertion
of a pessary; when this fails operative interference is called for.
(3) Fistulae may form between the vagina and bladder or vagina and
rectum; they are generally caused by injuries during parturition or
the late stages of carcinoma. Persistent fistulae require operative
treatment. The vagina normally secretes a thin opalescent acid fluid
derived from the lymph serum and the shedding of squamous epithelium.
This fluid normally contains the vagina bacillus. In pathological
conditions of the vagina this secretion undergoes changes. For
practical purposes three varieties of _vaginitis_ may be described:
(a) simple catarrhal vaginitis is due to the same causes as simple
vulvitis, and occasionally in children is important from a
medico-legal aspect when it is complicated by vulvitis. The symptoms
are heat and discomfort with copious mucopurulent discharge. The only
treatment required is rest, with vaginal douches of warm unirritating
lotions such as boracic acid or subacetate of lead. (b) Gonorrhoeal
vaginitis is most common in adults. The patient complains of pain and
burning, pain on passing water and discharge which is generally green
or yellow. The results of untreated gonorrhoeal vaginitis are serious
and far-reaching. The disease may spread up the genital passages,
causing endometritis, salpingitis and septic peritonitis, or may
extend into the bladder, causing cystitis. Strict rest should be
enjoined, douches of carbolic acid (1 in 40) or of perchloride of
mercury (1 in 2000) should be ordered morning and evening, the vagina
being packed with tampons of iodoform gauze. Saline purgatives and
alkaline diuretics should be given, (c) Chronic vaginitis (leucorrhoea
or "the whites") may follow acute conditions and persist indefinitely.
The vagina is rarely the seat of tumours, but cysts are common.

_Diseases of the Uterus._--The uterus undergoes important changes
during life, chiefly at puberty and at the menopause. At puberty it
assumes the pear shape characteristic of the mature uterus. At the
menopause it shares in the general atrophy of the reproductive organs.
It is subject to various disorders and misplacements. (a)
_Displacements of the Uterus._--The normal position of the uterus,
when the bladder is empty, is that of anteversion. We have therefore
to consider the following conditions as pathological: anteflexion,
retroflexion, retroversion, inversion, prolapse and procidentia.
Slight anteflexion or bending forwards is normal; when exaggerated it
gives rise to dysmenorrhoea, sterility and reflex nervous phenomena.
This condition is usually congenital and is often associated with
under-development of the uterus, from which the sterility results. The
treatment is by dilatation of the canal or by a plastic operation.
Retroflexion is a bending over of the uterus backwards, and occurs as
a complication of retroversion (or displacement backwards). The causes
are (1) any cause tending to make the fundus or upper part of the
uterus extra heavy, such as tumours or congestion, (2) loss of tone of
the uterine walls, (3) adhesions formed after cellulitis, (4) violent
muscular efforts, (5) weakening of the uterine supports from
parturition. The symptoms are dysmenorrhoea, pain on defaecation and
constipation from the pressure of the fundus on the rectum; the
patient is often sterile. The treatment is the replacing of the uterus
in position, where it can be kept by the insertion of a pessary;
failing this, operative treatment may be required. Retroversion when
pathological is rarer than retroflexion. It may be the result of
injury or is associated with pregnancy or a fibroid. The symptoms are
those of retroflexion with feeling of pain and weight in the pelvis
and desire to micturate followed by retention of urine due to the
pressure of the cervix against the base of the bladder. The uterus
must be skilfully replaced in position; when pessaries fail to keep it
there the operation of hysteropexy gives excellent results.

Inversion occurs when the uterus is turned inside out. It is only
possible when the cavity is dilated, either after pregnancy or by a
polypus. The greater number of cases follow delivery and are acute.
Chronic inversions are generally due to the weight of a polypus. The
symptoms are menorrhagia, metrorrhagia and bladder troubles; on
examination a tumour-like mass occupies the vagina. Reduction of the
condition is often difficult, particularly when the condition has
lasted for a long time. The tumour which has caused the inversion must
be excised. Prolapse and procidentia are different degrees of the same
variety of displacement. When the uterus lies in the vagina it is
spoken of as prolapse, when it protrudes through the vulva it is
procidentia. The causes are directly due to increased intra-abdominal
pressure, increased weight of the uterus by fibroids, violent
straining, chronic cough and weakening of the supporting structures of
the pelvic floor, such as laceration of the vagina and perinaeum.
Traction on the uterus from below (as a cervical tumour) may be a
cause; advanced age, laborious occupations and frequent pregnancies
are indirect causes. The symptoms are a "bearing down" feeling, pain
and fatigue in walking, trouble with micturition and defaecation. The
condition is generally obvious on examination. As a rule the uterus is
easy to replace in position. A rubber ring pessary will often serve to
keep it there. If the perinaeum is very much torn it may be necessary
to repair it. Various operations for retaining the uterus in position
are described. (b) _Enlargements of the Uterus_ (hypertrophy or
hyperplasia). This condition may sometimes involve the uterus as a
whole or may be most marked in the body or in the cervix. It follows
chronic congestion or inflammatory prolapse, or any condition
interfering with the circulation. The symptoms comprise local
discomfort and sometimes dysmenorrhoea, leucorrhoea or menorrhagia.
When the elongation occurs in the cervical portion the only possible
treatment is amputation of the cervix. Atrophy of the uterus is normal
after the menopause. It may follow the removal of the tubes and
ovaries. Some constitutional diseases produce the same result, as
tuberculosis, chlorosis, chronic morphinism and certain diseases of
the central nervous system.

(c) _Injuries and Diseases resultant from Pregnancy._--The most
frequent of these injuries is laceration of the cervix uteri, which is
frequent in precipitate labour. Once the cervix is torn the raw
surfaces become covered by granulations and later by cicatricial
tissue, but as a rule they do not unite. The torn lips may become
unhealthy, and the congestion and oedema spread to the body of the
uterus. A lacerated cervix does not usually give rise to symptoms;
these depend on the accompanying endometritis, and include
leucorrhoea, aching and a feeling of weight. Lacerations are to be
felt digitally. As lacerations predispose to abortion the operation of
trachelorraphy or repair of the cervix is indicated. Perforation of
the uterus may occur from the use of the sound in diseased conditions
of the uterine walls. Superinvolution means premature atrophy
following parturition. Subinvolution is a condition in which the
uterus fails to return to its normal size and remains enlarged.
Retention of the products of conception may cause irregular
haemorrhages and may lead to a diagnosis of tumour. The uterus should
be carefully explored.

(d) _Inflammations Acute and Chronic._--The mucous membrane lining the
cervical canal and body of the uterus is called the endometrium. Acute
inflammation or endometritis may attack it. The chief causes are
sepsis following labour or abortion, extension of a gonorrhoeal
vaginitis, or gangrene or infection of a uterine myoma. The puerperal
endometritis following labour is an avoidable disease due to lack of
scrupulous aseptic precautions.

Gonorrhoeal endometritis is an acute form associated with copious
purulent discharge and well-marked constitutional disturbance. The
temperature ranges from 99 deg. to 105 deg. F., associated with pelvic
pain, and rigors are not uncommon. The tendency is to recovery with
more or less protracted convalescence. The most serious complications
are extension of the disease and later sterility. Rest in bed and
intrauterine irrigation, followed by the introduction of iodoform
pencils into the uterine cavity, should be resorted to, while pain is
relieved by hot fomentations and sitz baths. Chronic endometritis may
be the sequela of the acute form, or may be septic in origin, or the
result of chronic congestion, acute retroflection or subinvolution
following delivery or abortion. The varieties are glandular,
interstitial, haemorrhagic and senile. The symptoms are disturbance of
the menstrual function, headache, pain and pelvic discomfort, and more
or less profuse thick leucorrhoeal discharge. The treatment consists
in attention to the general health, with suitable laxatives and local
injections, and in obstinate cases curettage is the most effectual
measure. The disease is frequently associated with adenomatous disease
of the cervix, formerly called erosion. In this disease there is a new
formation of glandular elements, which enlarge and multiply, forming a
soft velvety areola dotted with pink spots. This was formerly
erroneously termed ulceration. The cause is unknown. It occurs in
virgins as well as in mothers, but it often accompanies lacerations of
the cervix. The symptoms are indefinite pain and leucorrhoea. The
condition is visible on inspection with a speculum. The treatment is
swabbing with iodized phenol or curettage. The body of the uterus may
also be the seat of adenomatous disease. Tuberculosis may attack the
uterus; this usually forms part of a general tuberculosis.

(e) _New Growths in the Uterus._--The uterus is the most common seat
of new growths. From the researches of von Gurlt, compiled from the
Vienna Hospital _Reports_, embracing 15,880 cases of tumour, females
exceed males in the proportion of seven to three, and of this large
majority uterine growths account for 25%. When we consider its
periodic monthly engorgements and the alternate hypertrophy and
involution it undergoes in connexion with pregnancy, we can anticipate
the special proneness of the uterus to new growths. Tumours of the
uterus are divided into benign and malignant. The benign tumours known
as fibroids or myomata are very common. They are stated by Bayle to
occur in 20% of women over 35 years of age, but happily in a great
number of cases they are small and give rise to no symptoms. They are
definitely associated with the period of sexual activity and occur
more frequently in married women than in single, in the proportion of
two to one (Winckel). It is doubtful if they ever originate after the
menopause. Indeed if uncomplicated by changes in them they share in
the general atrophy of the sexual organs which then takes place. They
are divided according to their position in the tissues into
intramural, subserous and submucous (the last when it has a pedicle
forms a polypus), or as to the part of the uterus in which they
develop into fibroids of the cervix and fibroids of the body.
Intramural and submucous fibroids give rise to haemorrhage. The menses
may be so increased that the patient is scarcely ever free from
haemorrhage. The pressure of the growth may cause dysmenorrhoea, or
pressure on the bladder and rectum may cause dysuria, retention or
rectal tenesmus. The uterus may be displaced by the weight of the
tumour. Secondary changes take place in fibroids, such as mucous
degeneration, fatty metamorphosis, calcification, septic infection
(sloughing fibroid) and malignant (sarcomatous) degeneration.

The modes in which fibroids imperil life are haemorrhage (the
commonest of all), septic infection, which is one of the most
dangerous, impaction when it fits the true pelvis so tightly that the
tumour cannot rise, twisting of the pedicle by rotation, leading to
sloughing and intestinal and urinary obstruction. When fibroids are
complicated by pregnancy, impaction and consequent abortion may take
place, or a cervical myoma may offer a mechanical obstacle to delivery
or lead to serious post partem haemorrhage. In the treatment of
fibroids various drugs (ergot, hamamelis, hydrastis canadensis) may be
tried to control the haemorrhage, and repose and the injection of hot
water (120 deg. F.) are sometimes successful, together with electrical
treatment. Surgical measures are needed, however, in severe recurrent
haemorrhage, intestinal obstruction, sloughing and the co-existence of
pregnancy. An endeavour must be made if possible to enucleate the
fibroid, or hysterectomy (removal of the uterus) may be required. The
operation of removal of the ovaries to precipitate the menopause has
fallen into disuse.