MIDWIFERY 
All medicines called emmenagogues are 
stimulating; we must never use strong 
stimuli where the constitution is yet weak, 
or we shall only exhaust the system, and 
where there is a tendency to plethora, we 
shall produce hiemoptoe : these then must 
not be begun upon till the constitution is 
amended. Some employ hellehore, which 
has sometimes certainly evinced great power, 
for which reason we may give forty drops 
of the tincture, though most commonly the 
menses will return without giving any thing. 
Madder is recommended from its supposed 
deobstruent quality. Instances of its won- 
derful powers are related in Dr. Homes’s 
practice. Now and then electricity has 
been useful, when the patient all but men- 
struates. Friction of the lower extremities 
is good as exercise. Issues have been re- 
commended ; dancing, air, and exercise, 
are the real, the natural, and only effectual 
remedies. It is merely necessary to deter- 
mine to the part ; we w ell know that a 
mother directly as she takes the child in her 
arms, feels the draught of tlie milk come 
into her breast, even before the child is put 
to it. 
Profuse Menstruation. We now proceed 
to consider the opposite stale to obstructed 
menstruation, which is profuse menstruation, 
or menorrhagia; this is where it returns too 
often, though there may not be too much 
lost in each time ; or, it may be, there is 
twice the quantity lost at the regular time : 
in short, in whatever manner the secretion 
is increased, so as to weaken the constitu- 
tion, it is called menorrhagia. Whether 
there be too much or too little tone in the 
vessels, they may be inactive ; allowing their 
contents to escape as they do in petechial 
fever, both into the cellular membrane and 
into the urine. 
Profuse menstruation may depend on in- 
creased action of the heart and arteries ; or 
on too much food, drink, or stimuli in any 
shape. And the symptoms which appear 
in the constitution from such causes, will be 
just those of plethora ; stuffing of the chest, 
heat and thirst, concurring with this pro- 
fuse menstruation ; and the same treat- 
ment of the constitution will remove it : 
this is the simplest sort of menorrhagia, and 
requires least discussion. We must prohi- 
bit the use of animal food, and keep the 
bowels in a state of purging with Epsom 
salts. What we want is not a violent 
purging, but a gentle increased action of the 
bowels ; by this we pall the appetite, which 
js another object gained i and it does not 
allow the food to remain so long in the 
stomach, while part of the circulating fluids 
is evacuated by the increased secretion we 
have produced into the intestines. If this 
treatment be not sufficient, it will be ne- 
cessary to apply those local remedies pre- 
scribed in floodings. 
The next state of increased menstruation 
is, from relaxation of the system. This 
will sometimes arise from increased action, 
which we have said will oecasionally dege- 
nerate into a weakened state ; for the effect 
of great action is the production of great 
weakness. Wliere there is a weak pulse, 
flabbiness of the muscles, and all the symp- 
toms of weakness and relaxation of vessels, 
a very small force of action in the heart will 
be equal to the forcing of blood through an 
open vessel. All the strengthening medi- 
cines as well as astringents will be ne- 
cessary here ; alum and bitters : and where 
there is nothing of a vibrating feel in the 
pulse, steel may be given. But, sometimes, 
when the profuse discharge depends on re- 
laxation of vessels, steel will increase the 
discharge ; yet, where there is no fever, it 
is one of the best remedies. Next come 
the cold bath, and moderate exercise in a 
pure air. In regard to steel, it must be 
given very gradually at first, as in the mi- 
neral waters which are so famous. The 
stomach wall frequently not bear it less di- 
luted. It is very beneficial to recommend 
patients to some mineral spring in the coun- 
try, even from a secondary desire to get 
them out of town, where they may rise 
early, and enjoy the benefit of a country air. 
The patient goes with hope and expectation 
of relief ; her mind is amused, and her 
health repaired by drinking the water, 
though in the water there should be no vir- 
tue at all. 
The next sort of menorrhagia does not 
depend on general, but local weakness ; 
arising from the woman having borne a 
great number of children, and the weakened 
state of the uterus. This effect is some- 
times dependant on excessive venery ; 
hence we account for the violent attacks of 
menorrhagia prostitutes are very subject to. 
It may arise from blows on the abdomen. 
Tills is a more unmanageable case than the 
others ; because the weakness is local, and 
any strengthening remedies applied, con- 
stitutionally increase the strength of both 
parts at the same time ; so that Siere still is 
the same difference between the system 
and the uterus in point of tone, because 
they are both equally raised ; injecting cold 
