PATHOLOGY. 323 
black hellebore, to each dofe of the above mixture, will 
aid their effeft. Emmenagogues may be done without 
in molt cafes ; and they are of little ufe, unltfs the dyf- 
peptic treatment precedes or accompanies their adminif- 
tration. 
The two following fpecies of mif-menftruation, and 
the treatment of fupprefiion of the menfes, we fnall dif- 
cufs together, becaufe, as we (hall prefently (how, a few 
fimple principles will better accord with our praftical 
information as to their treatment, than any artificial de¬ 
tails drawn from external appearance. 
2. Paramenia-difficilis, laborious menftruation : cata¬ 
menia protruded with great local pain, and efpecially in 
the loins ; part of the fluid coaguiable. 
3. Paramenia fuperflun, excefiive menftruation : cata¬ 
menia excefiive, and accompanied with hemorrhage from 
the menftrual vefl'els. Two varieties. 
a. Crebra; excefiive from a too frequent recurrence. 
( 3 . Profufa, profufe menftruation ; (JJJue. of blood, Matth. 
ix. 20.) Exceffive from too large a flow at the proper pe¬ 
riods. 
Of that fpecies of mifmenftruation which is charaffer- 
ized by a more frequent return of the complaint than 
natural, we can afford no fatisfa£fory pathology, becaufe 
we are unacquainted with the caufe which brings on the 
catamenia even during health, and confequently cannot 
be fuppofed to know thecaufe of its more frequent occur¬ 
rence. The improvement of the general health will be 
generally attended with the cure of this malady. As to 
fupprefled, painful, and profufe, menftruation ; the firftis 
fometimes, and the two laft frequently, attended with 
fymptoms which characterize a certain degree of periodi¬ 
cal inflammation in the parts affeCled. This is peculi¬ 
arly the cafe in thefe coagulating difcharges which are 
met with in painful menftruation, and which for the mod 
part are of lymphatic conftruftion, and accurately coin¬ 
cide with the furface from which they are exuded. The 
latter fad is not however perceived, unlefs the coagula 
are placed in water, where they gradually difplay a pla¬ 
cental ora tubular form, evidently correfponding with 
fome portion of the uterus. Again ; profufe menftrua¬ 
tion is fometimes attended with a quick and full pulfe, 
and more efpecially when an aClual hemorrhage takes 
place. In each of thefe cafes it will be neceflary to de¬ 
plete the fyftem in a moderate degree ; in fupprefiion of 
the menfes, by leeching, ajid to excite the relaxation by 
a warm hip-bath and briflc cathartics ; in painful men- 
llruation, it may in fome cafes be allowed to take blood 
more generally; and, in addition to the warm bath, &c. 
opiates fhould be given in fomewhat ample dofes. When 
the uterine difcharges become profufe, the very nature of 
the complaint itfelf forbids the ufe of bleeding; but ne- 
verthelefs, by low living and by the exhibition of digi¬ 
talis or plumbi fuperacetatis, we mull in fome meafure 
imitate the praflice laid down with reference to phlogofis 
of the mucous membrane, or aftive hemorrhage. 
In the greater proportion of cafes,.the profufe and the 
impeded action of the menftruatingorgans will be found 
connected with debility of the uterine fecernents, and of 
the body generally; and will require a ftimulating treat¬ 
ment. The diet mull be regulated fo as toenfure gene¬ 
ral vigour of the conftitution, and the bowels and chy- 
lopoietic vifcera in general excited to fecretion. At the 
time proper for the menfes to come on, the ufual means 
of warm bathing of the lower extremities, emmenagogues, 
and, laltly, electricity pafled through the womb, will 
enfure the accefiion of the flux; while narcotics and af- 
tringents, as opium and fulphuric acid, &c. with reft, 
will generally be fuccefsful in reftraining an excefiive 
puffwe difeharge. 
4. Paramenia erroris, vicarious menftruation : catame¬ 
nia transferred to, and excreted at, remote organs. 
Vicarious menftruation is curable only by iiich reme¬ 
dies as excite and irritate the uterine fecernents. This 
Vol. XIX. No. 1306. 
difeafe offers curious examples of that procefs called 
metaftalis. Dr. Good enumerates many varieties; viz. 
a. Ex oculis fluens. Dodonai Obf. cap. xv. Boerh. 
Aph. 
p. Ex naribus. Parai. xxv. 12. Braffavol. Aph. 
xxxiii. 
y. Ex alveolo dentis. It onffei de Horn, primord. c. 2S. 
S. Ex auribus. Braffavol. Aph. xxv. feft. 4. 
£. Ex mammarum papillis. Amat. Cent. ii. cur. 21. 
£. Ex vomitu. Jlipp. de Morb. Mul. Aretai, lib. ii. 
». Per inteftina. Galen, in Aph. xxxv. f. v. 
S. Ex podice. Parai, lib. xxiii. cap. 12. 
1. Per urinam. Braffavol. Aph. xxx. f. v. 
x. Ex umbilico. Nicolai Florent. Serm. ii. c. 8. 
A. Ex digito. Me.rcat. de mulier affeft, lib. i. c. 7. 
(x. Ex cute. Iluller. comment. 667. p. 87. See alfo 
Cruikfhank on Abforb. 4.10. p. 54.. Phil.Tranf. vol. xiv. 
121. Richerand’s Elem. de Phyliol. Aph. clxxi. 
5. Paramenia ceffationis: catamenial flux irregular at 
the term of its natural ceffation ; occalionally accompa¬ 
nied with fymptoms of dropfy, glandular tumours, or 
fpurious pregnancy. 
The ceffation of the menfes is, from the unufual quan¬ 
tity of fluids thrown into the general circulation, often at¬ 
tended with a variety of acute and chronic inflammations. 
Thefe are bell: obviated by occafional bleedings and pur¬ 
gatives. When they make their appearance, counter- 
irritants, as fetons, See. are highly ufeful. On this ac¬ 
count we are diretted not to heal ulcers and breakings- 
out in the lower limbs at this period of life. The ute¬ 
rine difeharge generally flops at about the forty-fifth year; 
but it has fometimes continued to a very late period of 
life. To the age of 71; Holde/reund, Erzahlungen, n. 4. 
To the age of 80 ; Bourgeois, Hebammenb. part. ii. cap. 
6. To the age of 90 ; Hagendorm, cent. ii. obf. 84. See, 
for various cafes, Pelargus, Med. Jarh. iii. 347, and fol¬ 
lowing. 
Genus II. Leucorrhaa, [from Xvjy. 0;, white, and 
to flow.] Fluor albus, or whites. Generic charadlers— 
Mucous difeharge from the vagina, commonly wuthout 
infedfion ; difappearing during menftruation. 
The difcharges from the female organs of women have 
been for the molt p.art indiferiminately treated of under 
the term rohites. The impropriety of this fweeping defig- 
nation is evident from the variety of difeafes of which a 
difeharge of this kind may be a fymptom. The common 
caufes of difcharges from the vagina are the fame as thofe 
of mucous phlogofes in general; viz. cold debilitating the 
fundiions of the (kin, mechanical irritation (hence the oc¬ 
currence of leucorrhcea from excefiive copulation), difeafed 
fecretions poured over the furface of the vagina, as when 
the uterus is difeafed, or diftant irritation. The vagina 
is alfo expofed to increafe of its mucous difeharge from 
relaxation of its mufcular coat; for this, of courfe, allows 
a greater afflux of blood to pafs to the mucous membrane, 
and hence more copious fecretion follows. The difeharge 
has in fo many inftances been traced to this laft fource, 
that mod people confider whites as the refult of weaknefs, 
and preferibe ftimulating medicines without caution. 
It fflould be remembered, however, that all mucous mem¬ 
branes are liable to fimilar kinds of difeafed aflion ; and 
that inflammation is perhaps of all others the mod com¬ 
mon affedtion they are fubjedt to. 
The diftindlion which has been made by Dr. Clarke of 
the different varieties of this difeafe are taken from the 
appearance of the difeharge. It appears that a tranfpa- 
rent or a white mucous difeharge is the refult of inflam¬ 
mation of the mucous membrane in the vagina, uterus, 
meatus urinarium, or bladder; and that a more purulent 
difeharge has its origin from the fame fource in more 
violent cafes. On the other hand, we find the purulent 
difeharge, efpecially when mixed with blood, a fymptom 
of the corroding or the carcinomatous ulcers of the cer- 
4 0 vix 
