370 DYSTOCIA. 



tially, from the middle stage of the most natural labor, and notwith- 

 standing there is no hemorrhage. Besides, an anatomical disposi- 

 tion that has no real existence is relied on here, the ovum is merely 

 struck (plaque) on the inner face of the womb, and not intimately 

 united to it; the placenta and organ of gestation communicate with 

 each other only by means of pores, and not by means of large vas- 

 cular mouths. 



862. The efficient cause of flooding seems to me to be analogous 

 to those of all other hemorrhagies, to that of epistaxis, for instance. 

 The sanguine exhalation takes place in the womb as it does in the 

 nose, under the influence of a local congestion, an affluxion, a pe- 

 culiar state of irritation, of the molimen hemorrhagicum so much 

 talked of by Stahl. When this affluxion, or molimen, exists to a 

 certam degree, the blood transudes with greater or less force, and 

 from a more or less extensive surface, as happens during the pre- 

 sence of the menses; only, it requires a stronger impulsion, because, 

 during pregnancy, the ovum that it is compelled to detach in order 

 to effect a passage, necessarily presents a certain degree of resistance 

 to it; moreover, it seems to me, that in respect to its intimate me- 

 chanism, an uterine hemorrhage that does not depend upon any trau- 

 matic lesion, is always the same, at whatever period and in whatever 

 condition it may occur, as well during gestation as during and after 

 parturition. 



The idea which I now set forth, and which is nearly similar to that 

 which has already been taught by Costa, M. Desormeaux, Madame 

 Lachapelle and M. Duges, merits the most serious attention, and 

 ought to have great influence on the therapeutics of flooding, and 

 upon some other points of tokological science. 



The determining causes are as numerous as they are diversified; 

 they may be referred to a general state of the woman, to a peculiar 

 state of the sexual organs, and to external accidents. 



863. General state. StoU, Finke and other observers have re- 

 marked that during the prevalence of certain epidemics, all the 

 bilious affections were accompanied with metrorrhagy; it has been 

 stated that verminose diseases, various lesions of the alimentary 

 canal, and all those indispositions that are accompanied with sympa- 

 thetic reaction upon the womb, are capable of giving rise to it. 

 Fatigue, frequent attendance at balls, plays, whole nights passed 

 without sleep, an exciting regimen, heating liquors, purgatives, the 

 warm bath, substances used to produce abortion, moral commotions; 

 in fine, whatever tends to render the menstrual flux more abundant 

 and more precocious, is also capable of giving rise to the flooding; 

 to these causes may be added an ulcer, a polypus at the neck of the 



