What is the cause of this pain??

For a long time I have felt a pain in my right side, and my husband persuaded me to have my body examined, to make sure whether the cause of this pain is the appendix — for he felt the very same pain a year ago from an inflamed appendix — or whether my trouble is of that kind?

The woman speaking to me was twenty years of age. I looked at her with interest and asked her to explain her problem to me further; and I asked her whether the pain was continuous, or came from time to time. She answered:

— It comes at a certain period, but it is enough to wear me out!

— Has anything happened to you that has prevented pregnancy? Or have you yourself tried to postpone it?

— No, doctor, I have never experienced pregnancy, and I long to have a child!

— Then have you tried to cut off the course of the pain with any treatment?

— No; the pain comes and goes without cause or treatment, and I pass through this torment every month.

— So it has a fixed time?

— Not exactly by the monthly reckoning, but it occurs between the two menstrual periods.

— And what of the menstrual cycle? Does it come every twenty-eight days?

— Yes!

— How would you describe this pain to me?

— It is continuous for forty-eight hours, on one side; a pain I would not call severe, and yet it is thoroughly troublesome. Then, before it begins, I feel light prickings three days earlier, which I take as a warning of what is to follow!

— And do you notice any bleeding during this time?

— No! That has happened only once or twice!

— And when was your last menstrual period?

— Ten days ago, and this morning I began to feel the