374 DYSTOCIA. 



even convulsive movements appear in succession, and sometimes 

 with frightful rapidity. 



In external floodings, the precursory symptoms are succeeded by 

 a discharge of blood from the external organs, and this characteristic 

 is too evident for it to be needful to indicate any others; neverthe- 

 less, it has appeared to be difficult to some persons, not to con- 

 found, at times, a real flooding with a simple monorrhagia. Bau- 

 delocque did all in his power to clear up this point of diagnosis: 

 according to him, menstruation occurring during pregnancy differs 

 from metrorrhagia, properly so called, in respect that it takes place 

 without any pain, without effort, without any notable disorder of the 

 health, without any antecedent molimen; in respect that the fluid 

 which escapes is serous, very slighdy colored, and does not coagu- 

 late; in that it is very small in quantity, terminates in two, three, or 

 four days, appears at the ordinary epochs of the menstrual flux, and 

 that far from debilitating, it is, on the contrary, followed by an im- 

 proved state of health, and greater freedom in the exercise of the 

 functions; while the very opposite circumstances are observed in a 

 real hemorrhagy. But, in looking a little closer at the subject, it is 

 soon found that these characteristics are for the most part quite illu- 

 sory. In the first place, it is a fact that, in many women the menses 

 are frequently preceded by the same symptoms as the most danger- 

 ous floodings, and that the blood of the menses, far from being fluid 

 and colorless in all cases, is on the contrary sometimes charged with 

 cruor and very coagulable; besides, flooding is not always accom- 

 panied or announced by the general signs heretofore indicated; it 

 may be very moderate in the beginning, and formed of serous blood, 

 or blood charged with fibrine, and coincide with one of the catamenial 

 epochs; indeed, as the mechanism of menstruation is the same with 

 that of metrorrhagia, I do not see that it is possible to distinguish 

 the one from the other by any special signs. Moreover, this diffe- 

 rential diagnosis leads to nothing; while the flow is slight, the pre- 

 cautions prescribed by art are incapable of interfering injuriously 

 with the menstrual function; and as soon as the blood escapes in 

 sufiicient quantity to require more active interference, it would be 

 almost ridiculous any further to seek to discriminate between menor- 

 rhagia and metrorrhagia. 



870. In internal flooding, admitted by Mauriceau, De la Motte, 

 Levret, Baudelocque and Merriman, who have related cases of it, the 

 blood tends to accumulate between the placenta, or membranes, and 

 the corresponding part of the womb; a lenticular coagulum might in 

 such case form with variable rapidity, depressing the ovum in au 



