LEUCORRHŒA, FLUOR ALBUS, OR THE WHITES

This is the most prevalent of all derangements of the female economy, connected with the uterine system; and from its debilitating effects, induces a train of maladies that tend to embitter personal comfort more than any other human ill. Leucorrhœa consists of a discharge of acrid, or bland, but variously-colored mucus from the vagina, differing in intensity according to the cause and duration. It would be idle to offer the many arguments set up to prove whence it proceeds, or to examine the discussions as to whether it is the produce of the uterine vessels, or the vaginal secretives. That both aid in its formation is doubtless the case (as the employment of the speculum has satisfactorily proved); and equally certain that, according to the amount of irritability existing therein, so depends the quantity and character of the discharge. It exists in the married and single—in the moral and unchaste; and therefore the cause should be cautiously divined, it being evident that other than sexual indulgences establish this annoying and distressing affliction. It may be fairly conceded to be a vitiated secretion, depending upon a weakened state of the local vessels, and, moreover, in particular habits, to be a salutary evacuation. On the other hand, it must not be denied that it is oftentimes, where it occurs to persons living sub judice mariti, the result of sexual intemperance, or disease springing from an indiscriminate indulgence in the same.

However, as my purpose is more with the symptoms and treatment, the following may be received as a summary of what occurs, and what should be done for the removal thereof:—

In addition to the discharge, which at one time is scanty, at another profuse, there are usually severe pains in the loins and lower part of the abdomen: there is a sense of bearing down, as though the womb were descending and even protruding. The general health of the patient is disturbed, loss of appetite, excessive languor, a pale and emaciated look, sleepless nights, dark areola around the eyes, various hysterical and other nervous affections, and numerous disturbances indicating a weakened and impaired state of mind and body. Among other causes beside those alluded to, may be enumerated irregular living, late hours, mental and bodily fatigue, deficient exercise, impure air, and neglect of personal ablution. Among the consequences of a long-continued leucorrhœa, an almost certainty of sterility should not be omitted.

Treatment.—In leucorrhœa, where or where not consecutive to gonorrhœa, depending on loss of tone of the secretive vessels of the internal organs of generation, the chief indication is to impart vigor and restore strength, which it is evident depends much upon an avoidance of those causes that first started the disease.

Although leucorrhœa bears a strong resemblance to gonorrhœa, there are points by which to distinguish the one from the other. In gonorrhœa, the discharge is unceasing, but small in quantity, and is usually accompanied by inflammatory symptoms; whereas in leucorrhœa, the discharge is irregular and copious, often coming away in large lumps.

The treatment of fluor albus is indicated by the degree of severity present. Where the prominent feature is the discharge, the indication is to increase the action of the absorbents by restoring the tone of the diseased surface, and at the same time to strengthen the system. Where the disease is complicated with weakness and relaxation, astringents should be given by the mouth, and also administered in the form of injections. The alkaline solution of copaiba is a very valuable medicament, and may be taken twice or thrice daily. It may also be employed as an injection, by adding one or two ounces to a pint of water, and a teacupful thrown up several times in the day. There are many domestic remedies, which, from their harmless properties, can at least do no injury, if they are not productive of good; as, for instance, a strong decoction of green tea, an infusion of oak bark, or alum-water; or diluted port wine—all to be used as injections, which, if it shall so please the patient, may be tried prior to the annexed:—

[Form 64].
Chalybeate Pills, for Leucorrhœa, or other Female Sexual Weakness.
Take of—
Sulphate of iron1scruple.
Balsam of copaiba and liquorice powder—of each a sufficiency to form the mass, which is to be divided into 40 pills, of which 3 or 4 may be taken three times a day.
Or, take of—
Sulphate of zinc1scruple.
Extract of camomile1drachm.
”gentian1”
Syrup, a sufficiency.
Mix, and form 24 pills. Dose—two twice a day.
[Form 65].
Strengthening Mixture.
Take of—
Infusion of bark7½ounces.
Sulphate of quinine8grains.
Diluted sulphuric acid½drachm.
Syrup of orange-peel2drachms.
Mix. Dose—three tablespoonfuls twice or three times a day.

[Form 66].
Astringent Pills for Leucorrhœa.
Take of—
Extract of Peruvian bark1drachm.
Gum kino1”
Alum½”
Nutmeg1scruple.
Syrup, sufficient to form the mass. Divide into 36 pills.
Dose—three pills three times a day, to be followed by a teacupful of lime-water.
[Form 67].
Astringent Pills.
Take of—
Alum30grains.
Catechu1drachm.
Opium5grains.
Mix to form 30 pills. Dose—three twice a day. Useful in chronic gonorrhœa and leucorrhœa.
[Form 68].
Astringent Pills for obstinate Gleet, or Leucorrhœa.
Take of—
Gum kino1part.
Canadian turpentine4parts.
Powder of tormentilla, as much as may be necessary to form a mass. Divide the same into pills of 5 grains each, and take from three to half a dozen of them night and morning. Continue them for a week or fortnight. A very useful remedy.
[Form 69].
Astringent Injections for Leucorrhœa or Gonorrhœa.
Take of—
The compound solution of alum½oz. to 1 oz.
Water1quart.
Mix.
Injections may be used two or three times a day. If found to irritate, they should be diluted with water. Appropriate syringes are to be had; but the best are those formed by the Enema apparatus.

[Form 70].
Astringent Injection.
Take of—
Sugar of lead1scruple.
Water1quart.
Mix.
Or, take of—
Catechu1drachm.
Myrrh1”
Lime-water½pint.
Mix.
Or, take of—
Nitrate of silver1scr. to 1 dr.
Water1quart.
Mix and strain. This lotion is much, and very effectively, used by the profession.
Or, take of—
Sulphate of zinc½to 1 drachm.
Water1quart.
Mix.
See Forms [11] and [12].

The remaining diseases peculiar to the female pelvic viscera and their outlet, are hæmorrhoids, irritability and inflammation of the bladder, disordered uterine functions, urethritis, or inflammation of the urinary passage, and, lastly, internal and external irritation or excoriation. But as these fall within the province of every family practitioner, to the consultation of whom no morbid delicacy should prevent a patient, having such in their confidence, from resorting, I shall conclude this section by appending sundry prescriptions, in order that, should prudence not direct the sick one or her friends to call in the advised assistance, help may not be entirely withheld, and in order that, if the aid offered be not the means of supplying the loss of a more proficient and skilful director, it may at least be found mitigatory of these interruptions of health and comfort:—

[Form 71].
Pills to promote the flow of the Menstrual Secretion.
Take of—
Aloetic pills, with myrrh1drachm.
Compound iron pill1”
Mix to form 24 pills. Take two twice a day.

Or, take of—
Compound galbanum pills1drachm.
Socotrine aloes1”
Mix to form 24 pills. Dose—two twice a day.
[Form 72].
Injection for the retention of the Uterine Periodical Secretion.
Take of—
Liquor of ammonia10drops.
Milk½pint.
To be used morning and evening. This is a remedy that has been used by many medical men with very great success.
There are no means so importantly serviceable as the frequent use of the warm and vapor bath.
[Form 73].
Stimulating Drops to restore the Menstrual flow.
Take of—
Compound tincture of aloes1½oz.
Tincture of black hellebore1drachm.
”castor1”
”Lyttæ30drops.
Mix. Dose—a teaspoonful in water three times a day.
[Form 74].
To relieve entire suppression.
Take of—
Compound galbanum pills1drachm.
Sulphate of iron1”
Extract of savin10grains.
Of black hellebore20”
Syrup sufficient to form 36 pills. Dose—three twice a day.
All these medicines must be given with great caution.
[Form 75].
To check an immoderate flow of the Menstrual secretion.
Take of—
Infusion of roses8oz.
Tincture of opium30drops.
Mix. Dose—three tablespoonfuls three times a day.

Or, take of the tincture of ergot of rye, a teaspoonful in water twice a day.
Or, take of the sesqui-chloride tincture of iron, 20 to 30 drops in water, three times a day.
[Form 76].
For painful Menstruation.
Add to a portion of gruel, upon going to bed, 15 or 20 drops of laudanum. This quantity may also be taken in the morning, and repeated several days; the bowels in the meantime to be relieved by castor oil.
The warm hip bath, in these cases, is invaluable.
Or, take of—
The extract of stramonium½gr.
Spanish soap5grs.
Mix to form a pill to be taken twice a day.
[Form 77].
To allay external irritation.—Sedative application.
Take of—
Oil of almonds6ounces.
Spermaceti½”
White wax[11]½”
Rose-water3”
Orange-flower water10”
Dissolve the wax in the oil, then add the waters, and constantly stir till cold. This is an admirable application for irritation or excoriation of the external parts. It is commonly known as “cold cream.”
[Form 78].
To heal Excoriations.—Mild drying ointment.[12]
Take of—
The oxide of zinc1drachm.
Ointment of spermaceti1ounce.
Mix.

[Form 79].
For obstinate Excoriations.
Take of—
Ointment of nitrate of mercury½ounce.
Superacetate of lead1scruple.
Spermaceti ointment, or cold cream1ounce.
Mix.