CHLOROSIS. 807 



struation or of dysmenorrhcea (Vol. II.). When amenorrhoea occurs, it 

 is almost always because the ovules do not mature ; for, generally, all 

 the other signs which attend ripening and expulsion of the ovum are 

 absent, besides the bleeding. By the laity, and even by some physicians, 

 amenorrhoea is supposed to be a constant symptom of chlorosis, an error 

 which may sometimes be productive of the utmost mischief, by inducing 

 the premature suspension of remedies still urgently required, on ac- 

 count of the presence or appearance of the menses. Indeed, owing to 

 this erroneous idea, that chlorosis is always attended by amenorrhoea, it 

 not unfrequently happens that chlorotic girls, suffering from dysmenor- 

 rhcea or menorrhagia, and complaining of headache and palpitation, are 

 supposed to be " too full-blooded," and are therefore purged and bled. 

 Finally, in many chlorotic patients, besides the irregular menstruation, 

 there is a catarrh of the uterus and vagina (Vol. II., pp. 123, 171). 



The course of chlorosis, unless cut short by proper medication, is 

 almost always slow and tedious. This disease, if not detected, or if 

 treated homceopathically, often lasts for months, and sometimes for 

 many years. It generally terminates in recovery, although, in very 

 young persons, one or more relapses are apt to occur. More rarely, 

 chlorosis passes over into other disorders, such as tuberculosis. It 

 never endangers life, excepting through its complications, particularly 

 the very common one of chronic ulcer of the stomach. The stories 

 about acute febrile chlorosis terminating in death are the result of 

 erroneous diagnosis ; although it is true that unimportant febrile dis- 

 eases, when they attack chlorotic patients, are often accompanied by 

 typhoid symptoms and assume a malignant type. 



TEEATMEJSTT. Attempts to fulfil the causal indication in chlorosis 

 are very seldom followed by benefit, a proof that the causes to which 

 the disease is generally ascribed are not relevant ones. Chlorotic 

 girls are often restored to health in a few weeks, by the fulfilment of 

 the indications from the disease itself, although they had been long 

 and carefully, though fruitlessly, protected from pernicious agencies, 

 had passed months in the country, lived on the best of food, exercised 

 daily, and taken a course of German or Swedish gymnastics without 

 bringing color to their lips and cheeks, relief to their shortness of 

 breath, or improvement to their irritable and fretful temper. The 

 reputation which dietetic treatment enjoys, as a remedy for chlorosis, is 

 mainly attributable to the circumstance that not only does pure oligo- 

 cythaemia bear this name, but it also is given to a great variety of 

 anaemic conditions, in which such treatment is indispensable, while the 

 use of iron is but of secondary importance. Experience teaches daily 

 that brilliant cures of pure chlorosis may be made under the most un- 

 favorable external conditions. 

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