284 PRACTICE OF PHYSIC. 



DCCCCLXXX. The treatment and cure of the menorrhagia 

 must be different, according to the different causes of the dis- 

 ease. 



In all cases, the first attention ought to be given to avoiding 

 the remote causes, whenever that can be done ; and by that 

 means the disease may be often entirely avoided. " The cure 

 is difficult, as you will easily see, where the disease depends 

 upon an original conformation, or even on an acquired laxity of 

 the uterine system or in the extremities of the uterine vessels. 

 But as I have reason to believe, that the system of the uterus 

 is very often independent of the rest of the system ; so this 

 affection is often to be considered as purely topical, and at the 

 same time in a part which is beyond the reach of direct appli- 

 cation, and little affected by general remedies." 



When the remote causes cannot be avoided, or when the 

 avoiding them has been neglected, and therefore a copious mens- 

 truation has come on, it should be moderated as much as pos- 

 sible, by abstaining from all exercise either at the coming on, 

 or during the continuance of the menstruation ; by avoiding 

 even an erect posture as much as possible ; by shuning external 

 heat, and therefore warm chambers and soft beds ; by using a 

 light and cool diet ; by taking cold drink, at least as far as for- 

 mer habits will allow ; by avoiding venery ; by obviating cos- 

 tiveness, or removing it by laxatives that give little stimulus. 

 " A low diet is a fundamental part of the cure : it might be 

 observed, that as we have referred the disease to a local affec- 

 tion, to a laxity of the extreme vessels of the uterus, a low diet 

 will have less effect : but even in passive hasmorrhagies, which 

 depend on the laxity of the vessels, the natural impetus of the 

 blood is too much for the firmness of these vessels, and certainly 

 every increase of that impetus will readily affect them. Nothing 

 is more necessary in the very case of laxity, than to take down, 

 if possible, the impetus of the blood, by observing a strict, low, 

 and cooling diet." 



The sex are commonly negligent, either in avoiding the re- 

 mote causes, or in moderating the first beginnings of this dis- 

 ease. It is by such neglect that it so frequently becomes vio- 

 lent, and of difficult cure ; and the frequent repetition of a co- 

 pious menstruation may be considered as a cause of great laxity 



