286 PRACTICE OF PHYSIC. 



shall appear that some degree of irritation concurs, opiates may 

 be employed to moderate the discharge; but in using these 

 much caution is requisite. " In the menorrhagia which happens 

 to women who are not pregnant, I have not found opium of 

 service : but, in the cases of abortion and of child-bearing, the 

 haemorrhagy very often depends upon spasmodic affections ; in 

 quieting of which, opium may be highly useful. M.M. 



If, notwithstanding these measures having been taken, the 

 discharge shall prove very large, astringents, both external and 

 internal, may be employed. In such cases, may small doses of 

 emetics be of service? 



" The only astringent which has any pretensions to efficacy 

 is alum. It may be of service in menorrhagia and other uterine 

 haemorrhagies, which often depend upon a laxity of the vessels of 

 the uterus ; and we have often found it to be so. It should be given 

 at first in small doses, as it is ready to irritate the stomach, and 

 in several instances I have found it rejected by vomiting ; and 

 what is more extraordinary, I have known large doses of it 

 operate as a purgative. In urgent cases, however, the doses 

 must be frequently repeated and increased, for it has been only 

 from large quantities given that its effects have appeared to be 

 considerable. We begin by giving it in doses of five grains, 

 but have gone the length of a scruple, and have given such a 

 dose several times a day. M.M. 



DCCCCLXXXIII. When the menorrhagia depends on the 

 laxity of the uterine vessels, it will be proper, in the intervals 

 of menstruation, to employ tonic remedies, as cold bathing and 

 chalybeates. The exercises of gestation also may be very use- 

 ful, both for strengthening the whole system, and for taking off 

 the determination of the blood to the internal parts. 



" I have no doubt that many cases of this increased evacua- 

 tion depend upon a general flaccidity or loss of tone in the sys- 

 tem, and so far they may be obviated by tonic remedies ; but 

 it will require some nicety to discern when their application is 

 proper, and when the disease depends on a degree of phlogis- 

 tic diathesis, in which case, all such means of increasing the 

 tone would likewise increase the disease. 



" Some physicians are pleased with the singular proposition, 

 that chalybeates and the bark are equally fitted to an excessive 



