SEXUAL WEAKNESS
This complaint, commonly called fluor albus, or whites, to which women are peculiarly subject, must form an important object of attention, since it is always attended with disagreeable symptoms; and, when aggravated, soon spoils the beauty of a fine face, weakens the digestive powers, produces a general bad habit, and occasions sterility.
Symptoms.
An irregular discharge from the passage leading to the womb, of a fluid, which, in different women, varies much in colour, being of a white, green, yellow, or brown hue. In the beginning it is, however, most usually white and pellucid, and, in progress of the complaint, acquires the various discolourations and different degrees of acrimony, whence proceed a slight smarting on making water. Besides the discharge, the patient is frequently afflicted with severe and constant pains in the back and loins, indigestion, paleness of the face, chilliness, and languor. In process of time, every symptom becomes highly aggravated, the feet and ankles swell, palpitations, and a difficulty of respiration are experienced, the menstrual discharge is rendered irregular, the urine is turbid, the mind is dejected, and either consumption or dropsy supervenes, and terminates a miserable existence.
In some languid habits, the fluor albus returns periodically, instead of the proper menstrual evacuation, until the patient’s constitution is duly invigorated.
Causes.
It may be produced by any cause which either weakens or irritates the womb and its appendages. It may arise from general debility of the constitution, but it is especially caused by circumstances impairing the power of the womb itself, as, for instance, a severe labour, a miscarriage, or profuse menstruation.
In some instances it appears to depend on a full and irritable habit of body, and, in other cases, of local irritation, such as disorders of the womb, or of the urinary organs, or a collection in the gut, of the small thready worms called ascarides.
Upon the high authority of Dr. Hamilton, this disease is most frequently first brought on by some imprudence in respect to diet and clothing, or exposure to cold or fatigue, or neglect of the bowels about the time when menstruation begins.
Treatment.
In the treatment of this complaint regard must be had to the apparent cause, and to the state of the patient. The discharge is too often considered by the sex as the effects of general weakness in their habit, and, therefore, they are led to the indiscriminate use of heating medicines, as port wine, balsam copaibæ, &c., without paying attention to the habit of the body, or cause of the disease.
A milk diet, change of air, and the partial cold bath, as sponging the loins and thighs with cold water every morning, with attention to cleanliness and proper exercise, are often sufficient to arrest the disease, if early adopted.
In addition to this plan of treatment, if the patient be of a full habit, a disposition to fever from slight causes, attended with a sense of heat about the passage to the womb, it will be necessary to have recourse to the lancet, cooling cathartics, and febrifuge medicines, and to inject, several times a day, flax-seed tea or milk and water, into the passage of the womb. In the great majority of cases, the complaint arises from general debility or laxity of the vessels of the parts, and in such cases the indications of cure are to increase the vital heat, promote the digestion, and restrain the preternatural discharge. In order to which, recourse must be had to such of the tonic medicines as will be found to agree best with the patient. Of these, the bark and elixir vitriol, the tonic powders or pills, the rust or tincture of steel, and lime-water have usually been employed, and often with good effects. In some instances, however, I have known these medicines to fail, when the nitric acid, diluted, in doses of a wineglassful, three or four times a day, wonderfully succeeded.
Previously to the exhibition of tonic medicines, it is advisable to give a dose of ipecacuanha or antimonial wine. Gentle emetics are supposed to be of singular utility in this complaint, not only by cleansing the stomach and bowels, and making a revulsion of the humors from the inferior part of the body, but likewise by their exciting all the powers of the constitution to a more vigorous action.
The bowels must be kept in a regular state by conjoining a few grains of rhubarb with some of the tonic medicines, or by taking occasionally, at bedtime, one of the aloetic, or aperient or diaphoretic pills; or, in the morning, a teaspoonful of Epsom salts dissolved in a tumbler of water.
If there be a fulness of the stomach after eating, the tincture of rhubarb in small doses will excite digestion. In obstinate cases, it is often expedient to produce a change in the system, by giving a grain or two of calomel, or one of the mercurial pills at bedtime, until the gums become slightly affected, and then the cure may be completed by strengthening medicines, together with the shower bath.
Besides tonics, stimulating medicines, such as commonly determine to the urinary passages, have very frequently been employed with great benefit. Of these, rosin in doses of ten grains in the yolk of an egg, or a spoonful of molasses, or balsam copaibæ in doses of a teaspoonful, or tincture of cantharides in doses of twenty or thirty drops in some mucilaginous drink, and taken three or four times a day, will be found most salutary.
These means strike at the cause of the complaint; but if it do not remove the effect very soon, we are not to trust to them alone. For once a morbid secretion being excited, it is very apt to continue, although the exciting cause cease to operate.
On this account, we ought, without delay, to have recourse to astringent injections, such as a strong decoction of red oak bark, with the addition of a little alum or a solution of alum in water. Half an ounce of the former to be dissolved in a bottle of water; which should be thrown into the vagina by means of a female syringe, two or three times a day. The celebrated Dr. Burns says, after many trials, he satisfied himself, that although assistance may be derived from internal medicines and the cold bath, yet the chief dependence is to be placed on astringent applications to the seat of the discharge; and these, where there is no fulness of the general system, nor any affection of the womb itself, are perfectly safe, and seldom fail in producing a cure.
It will be prudent, when this disease occurs as an early symptom of pregnancy, not to check the discharge suddenly, lest miscarriage be the consequence; but it may be moderated by injections of water, with the addition of a little vinegar, or an infusion of green tea. Neither should the discharge be suddenly suppressed when it has been of long standing, and acquired a considerable degree of acrimony, with an offensive smell. For if it be unseasonably checked, the belly swells, and a train of the most disagreeable symptoms occurs. In such cases, soap suds, or an infusion of chamomile flowers or hops, should be frequently thrown up the vagina; and, as soon as the blood is freed of its impurities, by suitable medicines, and has recovered, in some measure, its soft and balmy quality of which it has been deprived, the astringent injections may be employed with perfect safety.
The application of a blister to the sacrum, has, in some obstinate cases, been attended with advantage.
When the fluor albus proceeds from worms, purgatives and bitter clysters are the proper remedies.
Pain in the back and loins is often mitigated by the application of a large adhesive or strengthening plaster, and by avoiding a standing posture of long continuance, much walking, dancing, or any other violent exertion.
Women should carefully avoid all the remote causes of the disease: they should pay diligent attention to cleanliness, by washing the parts frequently with cold water; and when there are excoriations, milk and water, or lead water, may be employed as a wash.
Regimen.
The diet should be light, cordial, and nourishing, consisting of isinglass dissolved in milk by boiling it, jellies, custards, rice, milk, soft-boiled eggs, gelatinous broths, and light meats, together with a prudent use of genuine wine, particularly claret or port.
Women, affected with this disease, should by no means indulge in the use of tea and other warm slops of a relaxing nature; but should lie on a mattress in preference to a feather bed; and they should rise early, and take such daily exercise as their strength will admit, particularly on horseback. When there is much languor, with chilliness, friction with the flesh-brush, and wearing flannel next the skin, must not be omitted.