In no instance which has come under my knowledge, where the hemorrhage was in consequence of a laxity of the uterine vessels, have these pills failed in producing the desired effect.
In those cases where the hemorrhage is profuse, or of long continuance, and resists the means already pointed out, it will be proper to inject into the uterus from a gill to half a pint of a strong decoction of oak bark, in which one or two drachms of alum have been dissolved, or as much of the saturated solution of alum in water, in order to constringe and strengthen the vessels of the womb. This may be repeated twice or thrice a day, according to circumstances.
When symptoms of an increased action in the vessels of the womb are observable, the tincture of foxglove, in doses of twenty drops every four hours, constitutes the best remedy.
When there is reason to suppose the hemorrhage proceeds from a scirrhous or ulcerated state of the womb, all that can be done, is to afford temporary relief by giving opium in large doses. Indeed, opiates may be given with advantage in every case where there is considerable pain or anxiety, and the patient much exhausted. Under these circumstances, from one to two teaspoonfuls of laudanum, or from two to four grains of opium, according to the urgency of the case, will be useful not only in giving a check to the discharge, but also in preserving the strength, and abating nervous irritation. In most cases it is preferable to give opium in the form of injections to allay the spasmodic pains of the womb; and, when administered in this way, clysters of thin starch or gruel, in each of which two teaspoonfuls of laudanum are added, should be given every two hours until relief be obtained. (See Abortion and Flooding.)
Regimen.
The diet, at the time of excessive discharge, must be light and cool. The drink must always be cold, as ice-water, lemonade, or tamarind beverage. Port wine, in such cases, is too frequently resorted to, which uniformly does harm by increasing the circulation.
Prevention.
To prevent a recurrence of the attack in those who are subject to it, the patient must necessarily avoid the causes by which it has been produced.
When it is evident that the discharge is in consequence of a full habit, it will be proper to reduce the system by living sparingly, by keeping the bowels rather in a laxative state, and by rising early, and taking through the day regular but frequent exercise; and, after the plethora is removed, by strengthening the vessels which have been over-distended, by the use of the cold bath.
In a greater number of cases, however, we meet with a delicate constitution and spare habit, with pale countenance: this state requires the use of sea bathing or the shower bath, and the vessels of the womb are particularly strengthened by pouring cold water daily on the back and loins.