PATHOLOGY. 
quantity of blood to be taken away mull be regulated by 
the fize and degree of refiftance in the tumour, and by 
t he quantity of watery difcharge (always a meafure of the 
extent of difeafe), regard being paid to the ftrength of 
the patient. At the fame time it muft be recolledted, 
that if, by the lofs of eight or ten ounces of blood by 
cupping, the quantity of the watery difcharge can bedi- 
ininifhed from four ounces to two ounces daily, the pa¬ 
tient will, at the end of a fortnight, poffefs more power 
than if flie had loft four ounces of blood by cupping, and 
the quantity of the watery difcharge had been diininilhed 
to three ounces daily. 
Local bleeding, however, when intemperately em¬ 
ployed, may haften the patient’s diflolution. It ftiould 
not be prefcribed when much cedema of the feet is pre- 
fent, nor during the prevalence of much debility ; in 
faff, it ftiould not, at any time, be carried farther than 
juft to produce the intended effeCt, as there are many 
other auxiliary arts in referve. If the patient ftiould be 
a ftrong woman, and if the difeafe has not been of long 
duration, twelve or fourteen ounces of blood may be 
taken away: if ftie ftiould poffefs lei's ftrength of confti- 
tution, it may be fufficient to order the removal of fix or 
eight ounces only ; and to repeat this once in three weeks 
or a month. The application of leeches to the pudendum 
4 s alfo ferviceable. All general and local ftitnuli are of 
courfe to be avoided ; the diet to be of the mildeft kind, 
as puddings, white fifti, and vegetables. Wine and fex- 
ual connexion to be entirely profcribed. The bowels 
ftiould be (o managed, that one eafy motion be daily pro¬ 
cured ; all draining efforts in evacuating the redhim 
being as injurious in this as in other uterine complaints. 
The fulphate of magnefia in infufion of rofes will be 
found a mild laxative. , 
The enlargement of the tumour may be greatly dimi- 
nifned, and the difcharge confequently leffened, by the 
■ application of cold to the outfide of the pelvis, and by 
the injeflion of cold fluids into the cavity of the vagina. 
Cold water may be applied to the external parts of gene¬ 
ration, to the pubis, and to the loins, by means of a 
fponge ; and this may be done, not once or twice only 
in the twenty-four hours, but feveral times : by keeping 
the parts in this way conftantly chilled, the blood vef- 
fels will be contracted, and the advantages refulting 
from fuch a mode of treatment will foon be made evident, 
in the diminution of the quantity of the difcharge, and 
in the improvement of the conftitutional health. The 
recumbent pofture ought to be infilled upon 5 and, in 
injecting fluids, care ftiould be taken that the fyringe 
does not touch the excrefcence, otherwife blood will 
flow'. A cylindrical fyringe, the diameter of which 
is about three quarters of an inch, the extremity being 
rounded off, may be ufed for this purpofe ; and the pa¬ 
tient ftiould be cautioned not to introduce it farther than 
an inch, or an inch and a half. 
In that aggravated form of the difeafe, where the tu¬ 
mour nearly protrudes, the patient ftiould lie down upon 
the bed with her hips raifed, and a fmall quantity of the 
alfringent fluid ftiould be poured in between the labia, 
with a common butter-boat. When the tumour has ac¬ 
tually protruded, compreffes dipped in an aftringent 
fluid may be applied, or a fponge wetted with it may 
be lightly drawn over the furface. The aftringent injec¬ 
tions recommended, confift of fulphate of zinc and water 
■in various proportions, or alum and water. Solutions 
jof the mineral aftringents in decoClions of aftringent ve¬ 
getables, conftitute applications poffefled of great power: 
fuch as, cort. granat. contuf. gfs. aq. diftillat. -xiij. 
coque per fextam partem horse et cola, dein adde liquori 
colato aluminis 3 'j- Galls, or oak-bark may be fubfti- 
tured for the pomegranate. The efficacy of the latter 
formulas in a great meafure depends upon the tannin. 
As tiiis principle lias the power of coagulating albumen, 
io as to form an infoluble precipitate, it becomes necef- 
flary to prepare the patient for a circumftance which may 
otherwife occafion great alarm in her mind, the appear¬ 
ance of thin, whitiffi, or afti-coloured, flakes, which w ill 
come away from time to time. Thefe are frequently 
thought to be portions of the body, and the agitation of 
the patient’s mind has been very confiderable, until it 
has been quieted by fome explanation. Where irritable 
vagina exifts, a mixture of decoCtion of oak-bark and 
linfeed tea, forms a lefs irritating lotion. 
In many cafes, where the conftitution has fuffered, 
the powers of nature require to be recruited, and we 
muft employ fome light tonic. The muriatic and ful- 
phuric acids are appropriate medicines. Sulphate of 
zinc, in fuch dofes as do not excite vomiting, and com¬ 
bined with an effential oil to reconcile the ftomach to 
its ufe, is recommended as occafionally ufeful. Say as 
follows : Sulphate of zinc, gr. xv. extrafl of hop, gj. 
oil of cinnamon, gt. iij. Iff. in pi 1 . xv. one to be taken 
every night. 
In fome inftances the refources of the medical art fail, 
and then the ligature holds out a profpeCt of relief, which 
has naw and then been realized. True it is, that the 
fungus may, and probably will, he regenerated 5 but a 
confiderable time, may elapfe before a tumour of large 
fize forms; and in the interim, by the removal of the fe- 
creting furface, the difcharge will be reftrained, and 
time will be afforded for the powers of the patient to re¬ 
cruit. 
2. Hydatids of the uterus are connected with the ute¬ 
rus and with each other by fmall filaments and by por¬ 
tions of fubftances partly bloody and partly gelatinous. 
A fnnilar fubftance is attached to the internal part of the 
uterus, from which the footftalks of the hydatids grow. 
The number of thefe hydatids increafing, the cavity of 
the uterus enlarges ; and, when the organ has attained 
a large fize, it contracts upon its contents. When the 
pelvis can no longer contain the enlarged uterus, that 
vifcus rifes into the cavity of the abdomen, and may be 
felt as a circumfcribed tumour through the parietes. 
The function of menftruation is ufually interrupted. 
In the examination of a patient labouring under hy¬ 
datids of the uterus, the body of this vifcus will be 
found enlarged, and fuddenly bulging out from the 
upper part of the cervix. All thefe fymptoms attend 
other enlarged (fates of the uterus; but there remains to 
be mentioned one other fymptom which ferves to diltin- 
guifti this difeafe from all others, and from pregnancy, 
—and this fymptom is the difcharge of an almoft-colour- 
lefs watery fluid. This watery difcharge is to be diftin- 
guift'.ed from that which attends the cauliflower-excref- 
cence, by the irregularity and fuddennefs of its appear¬ 
ance and ceflation ; being produced by a rupture of one 
or more of the coats of thefe hydatids, in confequence of 
the occalional contraction of the uterus upon them, or of 
any fudden violence, as in the act of coughing or l'neez- 
ing ; whereas the difcharge from the cauliflower-excref- 
cence, being a fecretion from its furface, is conftantly 
efcaping. The fluid watery difcharge may be diftinguilh- 
ed from thofe fplafhes of urine which fometimes come 
away from pregnant women, by being wholly inodorous. 
Sooner or later a parturient nifus takes place : the os 
uteri opens; the hydatids are expelled by periodical 
pains j and then, for the firft time, danger prefents itfeif 
in the form of a frightful haemorrhage. The reafon of 
this laft is obvious. The placenta covers only a limited 
fpace of the internal furface of the uterus, whereas the 
hydatids fpring from every portion of the cavity. No 
means of curing or arrefling the progrefs of this difeafe 
have hitherto been difcovered. The patient is to be ap- 
prifed of the nature of the complaint, and the event is to 
be patiently waited for, treating occafional fymptoms as 
they arife. When the time arrives at which the uterus 
ftruggles to unload itfeif of its contents, then all the (kill 
and energy of the practitioner will be neceffary to control 
the haemorrhage,and fultain the powers of the conftitution. 
Perfect quietude in the horizontal pofture (hould be en¬ 
joined, 
