M. M. Venesection in small quantity. A cathartic. Then opium, a grain every night. Steel. Bark. A blister. Topical aspersion with cold water, or cold vinegar.
[12]. Dysmenorrhagia. A difficulty of menstruation attended with pain. In this complaint the torpor of the uterine vessels, which precedes menstruation, is by sympathy accompanied with a torpor of the lumbar membranes, and consequent pain; and frequently with cold extremities, and general debility. The small quantity and difficulty of the discharge is owing to arterial inactivity, as in chlorosis. Whence it happens, that chalybeate medicines are of efficacy both to stop or prevent too great menstruation, and to promote or increase deficient menstruation; as the former is owing to inirritability of the veins, and the latter of the arteries of the uterus. See Article [IV. 2. 6]. in the Materia Medica.
M. M. Opium, steel, pediluvium. Warm bath.
[13]. Lochia nimia. Too great discharge after delivery. In that unnatural practice of some hasty accoucheurs of introducing the hand into the uterus immediately after the delivery of the child, and forcibly bringing away the placenta, it frequently happens, that a part of it is left behind; and the uterus, not having power to exclude so small a portion of it, is prevented from complete contraction, and a great hæmorrhage ensues. In this circumstance a bandage with a thick compress on the lower part of the belly, by appressing the sides of the uterus on the remaining part of the placenta, is likely to check the hæmorrhage, like the application of a pledget of any soft substance on a bleeding vessel.
In other cases the lochia continues too long, or in too great quantity, owing to the deficiency of venous absorption.
M. M. An enema. An opiate. A blister. Slight chalybeates. Peruvian bark. Clothes dipped in cold vinegar and applied externally. Bandages on the limbs to keep more blood in them for a time have been recommended.
[14]. Abortio spontanea. Some delicate ladies are perpetually liable to spontaneous abortion, before the third, or after the seventh, month of gestation. From some of these patients I have learnt, that they have awakened with a slight degree of difficult respiration, so as to induce them to rise hastily up in bed; and have hence suspected, that this was a tendency to a kind of asthma, owing to a deficient absorption of blood in the extremities of the pulmonary or bronchial veins; and have concluded from thence, that there was generally a deficiency of venous absorption; and that this was the occasion of their frequent abortion. Which is further countenanced, where a great sanguinary discharge precedes or follows the exclusion of the fetus.
M. M. Opium, bark, chalybeates in small quantity. Change to a warmer climate. I have directed with success in four cases half a grain of opium twice a day for a fortnight, and then a whole grain twice a day during the whole gestation. One of these patients took besides twenty grains of Peruvian bark for several weeks. By these means being exactly and regularly persisted in, a new habit became established, and the usual miscarriages were prevented.
Miscarriages more frequently happen from eruptive fevers, and from rheumatic ones, than from other inflammatory diseases. I saw a most violent pleurisy and hepatitis cured by repeated venesection about a week or ten days before parturition; yet another lady whom I attended, miscarried at the end of the chicken pox, with which her children were at the same time affected. Miscarriages towards the termination of the small pox are very frequent, yet there have been a few instances of children, who have been born with the eruption on them. The blood in the small pox will not inoculate that disease, if taken before the commencement of the secondary fever; as shewn in Sect. XXXIII. 2. 10. because the contagious matter is not yet formed, but after it has been oxygenated through the cuticle in the pustules, it becomes contagious; and if it be then absorbed, as in the secondary fever, the blood of the mother may become contagious, and infect the child. The same mode of reasoning is applicable to the chicken pox. See Class [IV. 3. 1. 7].
[15]. Scorbutus. Sea-scurvy is caused by salt diet, the perpetual stimulus of which debilitates the venous and absorbent systems. Hence the blood is imperfectly taken up by the veins from the capillaries, whence brown and black spots appear upon the skin without fever. The limbs become livid and edematous, and lastly ulcers are produced from deficient absorption. See Sect. XXXIII. 3. 2. and Class [II. 1. 4. 13]. For an account of the scurvy of the lungs, see Sect. XXVII. 2.