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.