PRACTICE OF PHYSIC. 



may be considered as immoderate, which is preceded and fol- 

 lowed by a leucorrhoea. 



DCCCCLXXVI. I treat of menorrhagia here as an active 

 haemorrhagy, because I consider menstruation, in its natural 

 state, to be always of that kind ; and although there should be 

 cases of menorrhagia which might be considered as purely 

 passive, it appears to me that they cannot be so properly treat- 

 ed of in any other place. 



DCCCCLXXLVII. The menorrhagia (DCCCCLXVIII. 

 et seq.) has for its proximate cause, either the haemorrhagic ef- 

 fort of the uterine vessels preternaturally increased, or a 

 preternatural laxity of the extremities of the uterine r.rtevies, 

 the haemorrhagic effort remaining as in the natural state. 



DCCCCLXXVIII. The remote causes of the menorrhagia 

 may be, 



First, Those which increase the plethoric state of the uterine 

 vessels ; such as a full and nourishing diet, much strong 

 liquor, and frequent intoxication. 



" Menorrhagia is very often to be referred to the usual causes 

 of the plethoric state, full diet, a sedentary life, or too much 

 warmth. But particularly the indolent or sedentary life will 

 have this effect, and may cause the disease either by general 

 or by partial plethora. For by diminishing the perspiration, it 

 disposes to an accumulation of the fluids in the internal vessels, 

 and as in the male sex it produces a plethoric state of the vena 

 portarum, so it will in the female favour congestion in the uterine 

 system. With regard to the warmth, we might suppose that to 

 be compensated by the perspiration which it supports, but it is 

 not so in fact; and it produces a laxity or flaccidity in the system. 



" I have hardly known any instance of drunkenness in 

 females, which did not produce this disease, remarkable for the 

 frequency of its periods, and the unusual quantity. Nay, in 

 most instances where I have had occasion to know the menstrual 

 flux continuing beyond its usual period, beyond the age of 

 fifty, it was owing to the frequent and too free use of spirituous 

 liquors : and I have had instances where the menstrual flux 

 had ceased about the fiftieth year, and was again renewed, con- 

 tinuing till after the sixtieth, merely from this cause, so far as 

 I could discern at least." 



