327 
PATHOLOGY, 
Joined, and all fthmflating food and drink denied. Cold 
applications are to be ufed to the loins, abdomen, and 
external organs j and portions of ice (their acute edges 
being rounded off by being held in the hand) may be 
introduced into the vagina, or into the uterus. “Let it 
not, however, be forgotten, (fays Mr. Clarke,) that the 
great remedy for uterine haemorrhage is uterine contrac¬ 
tion ; and every poflible mode of exciting this is to be 
put in pra&ice. The application of a bandage round the 
abdomen has fometimes the power of exciting this con¬ 
traction : but, if the haemorrhage fhould continue pro- 
f'ufe, and if any portion of the hydatids fhould remain 
in the uterus, an attempt fhould be made to remove 
thefe, in order to produce complete contraction of the 
rnufcular fibres. Two or three fingers, or the whole 
hand, covered with pomatum, fhould be carefully intro¬ 
duced into the uterus, and carried up between the fides 
of the uterus and the hydatids, which are to be detached 
from the part to which they adhere by the mofl gentle 
means. The mafs, being now included in the hand of 
the operator, is to be brought out of the uterus, the bur¬ 
geon recollecting always, in the performance of this ope¬ 
ration, that the degree to which the os uteri is dilatable 
without laceration, is in proportion to the fize of the 
whole uterus, both in pregnancy as well as in this dif- 
eafe. So that, fuppofing the uterus in this difeafe to be 
enlarged to the fize of that vifcus in the fixth or feventh 
month of pregnancy, the whole hand of the operator may 
he, if necefl’ary, introduced through the cervix; where¬ 
as, in fmaller dimenfions of the uterus, if any attempt is 
made to introduce the wdiole hand through the cervix, 
however carefully it may be attempted, a laceration of 
it may enfue, and thus the patient may be involved in a 
new danger. The expulfion over, and haemorrhage re- 
lirained, the conftitution mull be invigorated by fuitable 
means, particularly by the cinchona and mineral acids. 
3. Oosing Tumour of the Labium. In this, the difcharge 
arifes from the furface, or rather from the interftices of 
the tumour. The fluid is of a watery nature, and fome¬ 
times very abundant in quantity, being renewed almoft 
immediately after the furface has been dried by a napkin. 
Blood never ifl’ues from the tumour, fo that it has no 
analogy with cauliflower excrefcence. The tumour is 
fometimes fo large as to occupy the whole of the labia, 
extending even to the raons veneris. It feldom projects 
more than a line or two above the plane of the furround¬ 
ing tkin. The colour of the tumour varies little from 
that of the cuticle of the neighbouring parts. In the 
immediate neighbourhood of the tumour cedema is oc- 
caiionally met with, but the tumour is not cedematous ; 
foon after the furface of the tumour has been wdped 
quite dry, a watery fluid begins to ooze from it, and to 
form drops, which, having become large, at length run 
off, and keep the furrounding parts in a ftate of conftant 
humidity; fometimes forenefs and excoriation take place, 
as upon the upper lip when the fecretion from the nof- 
trils is increafed, but the tumour itfelf is feldom ren¬ 
dered more fenfible. 
The fecretion from this tumour correfponds, in appear¬ 
ance, with that from the cauliflower excrefcence. The 
difeafe having begun, it continues to enlarge ; and infu- 
lated patches of it appear in the neighbouring parts, at 
•length running into each other. The complain t feldom 
attacks young women. The principal inconveniences of 
this difeafe are, an itching, fometimes'preternatural fenfe 
•of heat, and a watery difcharge. When excoriations of 
the neighbouring parts are prefent, or an eryfipelatous 
-blufli appears upon them, more advantage will be de¬ 
rived from the internal exhibition of the cinchona in 
Tubftance than from any other medicine; but noimpref- 
flon will be made upon the difeafe itfelf by this valuable 
remedy; and even the fymptoms above mentioned will 
•frequently recur, and call for the employment of other 
remedies. 
A nutritious diet, and a moderate allowance of wine, 
'■Vox.. XIX. No. 1306. 
fhould be prefcribed. External applications may miti¬ 
gate, but never cure, the complaint. Common ftarch- 
powder, repeatedly fprinkled over the parts till it cakes 
upon them, is a very efficient remedy ; but it will be ne- 
ceffary to keep the patient in the horizontal pofture dur¬ 
ing its life ; a pofition indeed which has a beneficial in¬ 
fluence in itfelf. A mixture of ftarch-powder and cupri 
fulphas, very finely levigated, has been found ferviceable; 
or a folution of cupri fulphas, or of argentum nitratum, 
may be ufed. A folution of gum arabic in decoCtum 
quercus may be tried. Cold water is alfo a valuable re¬ 
medy, and there are no cafes in which it will not afford 
much temporary comfort. Perhaps the raoll effectual 
applications are of a fpirituous nature. Strong new 
port-wine has afforded great relief; and, when this has 
failed, brandy or arquebufade may be employed, or even 
alcohol. The complaint, upon the whole, is very rare. 
Genus III. Blenorrhcea, [from (STiEH'a, mucus, and psw, 
to flow.] Muculent difcharge from the urethra or vagina; 
generally with local irritation, and dyfury; not difap- 
pearing during menftruation. (Gonorrhoea, Sauv. and 
Cullen.) Three fpecies. 
t. Blenorrhcea fimplex, (Gonorrhoea pura, Sauv. and 
Cull.) Simple increafed fecretion from the mucous glands 
of the urethra. 
That a mucous fecretion may arife from the meatus 
urinatus of the female without fpecific venom, is well 
known ; and hence, were not cafes on record to prove 
the faff, we fhould dill infer the jaoffibility of a gonor¬ 
rhoea exifting without copulation. We may remark, 
however, that this is perhaps one of the rareft difeafes 
we are fubjeCt to. It would of courfe require the very 
Ample means of plentiful dilution and mild purgatives. 
2. Blenorrhcea luodes, (Gonorrhoea impura, Cull.) 
Clap. Muculer.t difcharge from the -urethra or vagina 
intermixed with fpecific venom; burning pain in mictu¬ 
rition; produced by impure coition ; infectious. 
We (hall enter into no fpeculatior.s as to the nature of 
clap, whether it be lues, owing its character to the pe¬ 
culiar ItruCture it occupies, or whether it be a diltinCt 
difeafe. At all events, its appearance and its cure are 
quite different; and, whether the mucous membrane is 
unfavourable to the abforption of the virus, or whether 
the virus of clap is not capable of affeCting'the conftitu¬ 
tion at large, fecondary fymptoms do not follow this dif¬ 
eafe. It conies on from forty-eight hours to four days 
after copulation ; and is ufually preceded by tingling and 
itching of the penis. The above definition embraces 
all the characters of Blenorrhcea in men. In wo¬ 
men the difeafe is apt to be confounded with fome forms 
of I.eucorrhoea communis. We nuift diftinguifh the dif¬ 
eafes chiefly by confidering the life and habits of the 
patient, and whether any caufe has been prefent which 
was likely to bring on Leucorrhcea. The Leucorrhcea, 
*as Dr. Good obferves in his definition, flops during men- 
•ftruation, which is not the cafe in Blenorrhcea. It is alfo 
faid, that in women the early ftage of Blenorrhcea luodes 
is marked by an unufual defire for fexual intercourfe, 
and an itching of the labia. Pain in micturition, fo 
common in clap, is feldom felt in Leucorrhcea. The 
nature of Blenorrhcea is this. A peculiar ltimulus, act¬ 
ing on the fecernents of the mucous membrane of the 
vagina or urethra, excites them to an aCtion which eli¬ 
cits from the blood the fame material as this ftimulus it¬ 
felf confifted of. This difeafed ftate of the fecernents 
induces an inflammatory affeCtion of the blood-vefl'els of 
the fame part, which inflammation teems to be actually 
neceflary to keep up the difeafed fecretion. Gonorrhoea 
therefore is cured in two ways. Firft, by reducing the 
inflammation, when we thall merely have fecretion from 
laxity of veflels to contend with. Secondly, by inducing 
a ftimulus of fo oppofite a kind in the difeafed fecernents, 
that they at once lofe the property of fecreting morbid 
matter. With the firft view,cold applications to theexter- 
4 - P nal 
