A
TREATISE
ON THE
DISEASES OF FEMALES.
DISORDERS OF MENSTRUATION.
BY JOHN C. PETERS, M. D.
NE W-Y ORK:
WILLIAM RADDE, No. 322 BROADWAY?PHILADELPHIA: RADEMACHER c SHEEK. -BOSTON: OTIS (LAPP.
ST. Louis: J. G. WESSELHOEFT.
LONDON: J. EPPS, 112 GREAT RUSSELL-ST., BLOOMSBURY;
MANCHESTER: TURNER, 41 PICCADILLY.
1854.




Entered according to Act of Congress, in the year 1853, by
WILLIAM RADDE,
In the Clerk's Office of the District Court of the United States for the Southern
District of New-York.
POLYGLOT PBrrINGr OFFPCE,
12 Frankfort-st, N. Y.




HOX(EOPATHIC MEDICINES.
WM. RADDE, 322 Broadway, New York, respectfully informs the Homceopathie
Physicians, and the friends of the System, that he is the sole Agent for the Leipzig
Central Homceopathic Pharmacy, and that he has always on hand a good assortment of the best Homceopathic Medicines, in complete sets or by single vials, in
Tinctures, Dilutions and Triturations; also, Pocket Cases of Medicines; Physicians' and Family Medicine Chests to Laurie's Domestic (60 to 82 Remedies)
-EPP'S (60 Remedies)-HERING'S (60 Remedies to 102). —Small Pocket
Cases at $3, with Family Guide and 27 Remedies -Cases containing 415 vials,
with Tinctures and Triturations for Physicians.-Cases with 260 Vials of Tinctures and Triturations to Jahr's New Manual, or Symptomen-Codex. —Physicians'
Pocket Cases, with 60 Vials of Tinctures and Triturations.-Cases from 200 to
300 Vials, with low and high dilutions of medicated pellets.-Cases from 50 to
80 Vials of low and high dilutions, &c., &c. Homceopathic Chocolate. Refined
Sugar of Milk, pure Globules, &c. Arnica Tincture, the best specific remedy for
bruises, sprains, wounds, &c. Arnica Plaster, the best application for Corns.
Urtica urens and Dr. Reisig's Homwopathic Pain Extractor are the best specific
remedies for Burns. Also, Books, Pamphlets, and Standard Works on the
System, in the English, French, and German languages.
HOM(EOPATHIC BOOKS.
JAHR'S NEW  MANUAL OF HOM(EOPATHIC  PRACTICE; edited, with
Annotations, by A. Gerald Hull, M. D. From the last Paris edition. This
is the fourth American edition of a very celebrated work, written in French
by the eminent Homceopathic Professor Jahr, and it is considered the best
practical compendium of this extraordinary science that has yet been composed. After a very judicious and instructive introduction, the work presents a Table, of the Homceopathic Medicines, with their names in Latin,
English and German; the order in which they are to be studied, with their
most important distinctions, and clinical illustrations of their symptoms and
effects upon the various organs and functions of the human system. The
second volume embraces an elaborate Analysis of the indications in disease,
of the medicines adapted to cure, and a Glossary of the technics used in the
work, arranged so luminously as to form an admirable guide to every medical student The whole system is here displayed with a modesty of pretension, and a scrupulosity in statement, well calculated to bespeak candid
investigation. This laborious work is indispensable to the students and
practitioners of Homceopathy, and highly interesting to medical and scientific men of all classes. Complete Symptomatology and Repertory, 2 vols.
bound, $6.
JAHR'S NEW MANUAL: originally published under the name of SYMPTOMEN-,
CODEX. (Digest of Symptoms.) This work is intended to facilitate a comparison of the parallel symptoms of the various HIomceopathic agents,
thereby enabling the practitionel to discover the characteristic symptoms
of each drug, and to determine with ease and correctness what remedy is
most Homceopathic to the existing group of symptoms. Translated with
important and extensive additions from various sources, by Charles Julius
Hempel, M. D., assisted by James M. Quin, M. D., with revisions and clinical notes by John F. Gray, M. D.; contributions by Drs. A. Gerald Hull,
George W. Cook, and Dr. B. F. Joslin of New-York; and Drs. C. Hering,
J. Jeanes, C. Neidhard, W. Williamson, and J. Kitchen, of Philadelphia;
with a Preface by Constantine Hering, M. D., 2 vols., bound $11
1




William Radde, Publisher, 322 Broadway, New York.
HARTMANN, Dr. FR., DISEASES OF CHILDREN AND THEIR HOM(EOPATHIC TREATMENT. 1853. Bound, $2 00.
1     This is the most complete work ever written on this subject, containing 514 pages.
The learned author's name is a full guarantee for the value of the book to the profession;
therefore every physician and lover of science should possess this treasure.
BOOKS BY THE SAME AUTHOR.
ROKYTANSKY'S PATHOLOGICAL ANATOMY; Translated from the
German with additions on Diagnosis, from Schunlein, Skoda, and others,
by Dr. JOHN C. PETERS. 75 cents.
Opinions of the Press. —" Dr. Rokytansky's book is no more than it professes to be: it is
morbid Anatomy in its densest and most compact form, scarcely ever alleviated by histories,
cases, or hypotheses. It is just such a work as might be expected from its author, who is said
to have written in it the result of his experience gained in the careful examination of over12,000 bodies, and who is possessed of a truly marvellous power of observing and amassing
facts. In the course of our analysis we have said comparatively little of its merits, the best.
evidence of which is found in the length to which our abstracts have been carried without
passing beyond the bounds of what is novel or important. Nor would this fault have been
committted though much more had been borrowed, for no modern volume on morbid Anatomy
contains half so many genuine facts as this; it is alone sufficient to place its author in the.
highest rank of European medical observers."-British and Foreign Medical Revie6w.
Just Published:
RUECKERT, TH. J., A TREATISE ON HEADACHES; with Introduction,
Appendix, Synopsis, Notes, Directions for Doses, and eighty additional cases,.
by JOIIN C. PETERS, M.D.  1853.  Bound.  75 cents.
"Dr. Peters' book owes its existence to the work of Dr. Riickert just alluded to, but it is no
mere translation, indeed it may almost be considered as an original and independent treatise
on Headaches. To a certain extent the author has followed Riickert's arrangement, and given
all his cases and clinical remarks, but Dr. Peters' volume is enriched by more than eighty ad —
ditional cases taken from sources not accessible to RiAckert, to wit, the French, English and
American homceopathic publications. Scattered throughout the work are many useful practical remarks in the form of notes, and at the end is a good synopsis of the indications for the
employment of the different remedies for headache. There is also an excellent introductory
chapter on the nature and causes of headaches, which contains much curious and interesting
information. We may give the reader some notion of the immense amount of original matter
in Dr. Peters' volume, when we state that the number of pages in Riickert's work occupied by
headaches is but 68, whereas Dr. Peters' book contains 173 pages of nearly equal size.
"Dr. Peters promises a second volume, on Apoplexy, encephalitis, and hydrocephalus, still
founded, we presume, on the work of Raiikert; and if he shall follow Riickert through all his
diseases in the manner in which this volume is executed, we shall be forced to admit that the
German original has, like a bishop, gained by translation."-British Journal of Homoeopathy.
RUECKERT ON APOPLEXY AND PALSY. Successful Hommopathie
Cures, collected from  the best homceopatihic periodicals.  Translated and
edited by J. C. PETERS, M. D. With full descriptions of the dose to each
single case. 1853. Bound, 75 cts.
A TREATISE ON THE DISEASES OF FEMALES-commencing with the
Disorders of Menstruation-by JOHN C. PETERS, M. D., with full description
of the dose to each single case. 1853. Bound, 75 cts.
In Press:
A TREATISE ON THE DISEASES OF MARRIED FEMALES, including
the Disorders of Pregnancy, Parturition, and Lactation, by J. C. PETERS, M. D.
Preparing for Press:
A TREATISE ON THE DISEASES OF THE WOMB, OVARIES, ANDI
UTERINE APPENDAGES-by JOHN C. PETERS, M. D.
N. B.-A  Treatise on Diseases of the Eye and Ear, and one on Nervous
Diseases and Mental Derangements, are ready for publication.




AUTHOR'S PREFACE.
DURING the last few years the Diseases of Women have excited unusual attention among homceopathic physicians; the labors of Williamson, Madden, Leadam, Croserio, Loomis, Griesselich, Hering, Hartmann, Marcy and Humphreys need only be alluded to in proof of this.
More than a year ago I had engaged to re-publish and edit Leadam's
work on the Diseases of Females; but several reasons, the most potent
of which was want of time, obliged me to postpone my intentions. A
few months ago, my publisher urged me so strongly to publish that I
did not feel at liberty to decline; and within a week after, the first
instalment of copy was placed in the printer's hands. I have been
enabled to keep pace with the demands of "printer's devils" by the
aid of the extended preparations which were made a year ago, but
especially by the aid of numerous notes upon almost every disease, and
upon the action of almost every remedy, which I have patiently been
accumulating during the course of twelve or fifteen years. The gaps
in my knowledge have been filled up by diligent recourse to the best
works and periodicals, both homceopathic and allopathic-American,
English, French, and German. Among these, the works of Roberton,
Whitehead, Ashwell, Colombat, Churchill, Tilt, Beauvais, Malaise,
Riickert, Henderson, Leadam, Trousseau, Valliex, Ranking, Braithwaite,
the British Journal of Homceopathy, &c., have been most frequently
in my hands. I believe I have always indicated the source from




Vi                         PREFACE.
which I have obtained my materials; but wish to state here, once for
all, that I much prefer merely transcribing the exact words of an author,
to stealing his thoughts and dressing them up in better or worse English
than his own. I had intended to make some severe remarks as to the
course pursued by Leadam and others in this respect, but as I have
frequently availed myself of their pains-taking compilations, I will
leave that unpleasant task to others.
This brochure will be quickly followed by another on the Diseases
of Married Females, and that by a third, upon the Organic Diseases of
the Womb and Ovaries.
3. C. PETERS.
742 BROADWAY, NEW-YOBRK.




9o Ot e    tnemnor
OF
CALEB TICKNOR, A.M., M.D.,
LATE PROFESSOR OF HYGIENE IN THE UNIVERSITY OF THE CITY OF NEW-YORK;
AUTHOR OF
THE PHILOSOPHY OF LIVING; A GUIDE FOR MOTHERS; AN EXPOSITION OF QUACKERY
AND IMPOSTURE IN MEDICINE; A PHILOSOPHY OF MEDICINE.
BORN IN SALISBURY, A. D. 1804.
ietb in  tim3~-otht, Stptembtr, 1840, et. 36.
"Distinguished for his love of study and investigation, sacred regard for truth, his frank and
fearless spirit in the avowal of matured opinions, honorable and gentlemanly deportment,
affectionate and kindly disposition, elevated but humble christian character.
"A man of fine accomplishments, but of finer dispositions; of goodly distinction, but of
better promise; of ardent earthly hopes in this life, but of stronger heavenly hopes in his
death."-REv. ADAM REID.
"Dr. Ticknor was extensively known in this country and in Europe. His'Philosophy of
Living' gave him a reputation wherever the English language is spoken. He was talented,
Industrious and philanthrophic, and devoted to the science of Medicine because it gave him an
opportunity of doing good. He became a thorough convert to Homeopathy, from an honest
conviction that it was a rational system, notwithstanding the ridicule it so often excites. The
idea of profiting by what is usually considered a hallucination of a portion of the civilized
world, never once entered his mind. He was honest in his intentions, and dared to brave the
public sentiment which at one time set with a strong flood against him. We esteemed him for
his integrity and sterling worth and character, and now mourn his early death as an irreparable
loss to the republic of letters, to science, and to humanity."-J. V. C. SMITH, M. D., Ed. Boseto
ied. and Sutrg. Journal.








ON THE
NATURE AND CAUSES
OF
MENSTRUATION.
ON PUBERTY AND FIRST MENSTRUATION.
ON PUBERTY.
Tins period in the female may be defined as that in which
the girl fully commences that general growth and development of all her organs, which renders her a young woman,
and receives those functions which makes her fit to be a wife,
and capable of becoming a mother.
Evidences of the changes which ma-k the advent of puberty, are often detected many months and sometimes years,
before it is fully accomplished; but more commonly, up to
a short time before puberty, we notice only the natural, but
proportionably more rapid growth of the whole body, to such
an extent, that the stature and size of the majority of girls is
nearly attained before the crisis is fully accomplished. But
at the period of puberty, growth and development receive a
still more rapid impulse, and the lank figure and unrestrained
movements of the awkward girl, are changed in the short
space of a few months, into the finished form, reserved manners, and graceful deportment of conscious womanhood.
The age of puberty ought to be distinguished by changes
in the character of the girl, fully as extensive as those of the
physique. The nervous system should show unusual sensibility and susceptibility; the mind should acquire more extended
powers of emotion and passion, and the imagination become
A




2                   MENSTRUATION.
more liveily and animated. The pelvic viscera should become
rapidly developed, and the hips enlarged; the breasts should
become rounded and full, and establish their sympathy with the
womb; the chest, throat and arms should acquire the contour
of a maturer development, and the whole body become more
rounded, full and adipose; the hair should grow more luxuriantly, the skin become fresh and blooming, the voice full and
mellow, and the whole female figure should acquire that elegance of symmetry, the complexion that bloom of health and
beauty, and each feature and action that play of intellect and
emotion, and that indescribable gracefulness of action, which
are to be found united in woman alone.-WHIrrEHEAD.
It is evident that when all these changes are absent, or imperfectly accomplished, that although ordinary dietetic and
hygienic means, aided by common nervines and tonics, &c.,
may help somewhat, still, such is the intricacy and beauty
of the whole natural process, that more subtle and sympathetic means are required. All these external changes and
developments are attended with, or even dependent upon similar internal ones, especially in the ovaries and uterus. The
ovaries in particular become more active. These organs, it
is well known, contain certain bodies called Graafian vesicles, which in their turn enclose the true ova or germs of
future human beings, first accurately described by De Baer,
and hence called ovules of De Baer. Before puberty, the
Graafian vesicles are scarcely visible, but about the tenth
year of life, a whitish or grayish pulpy substance is deposited
in them, and when this changes to a yellow color, from the:
deposit of a yellow, brain-like granular substance, so much
like the ordinary substance of the brain and nerves, as to be
scarcely distinguished from it, then the first signs of puberty
become manifest in the girl; the ovules of De Baer become
more and more developed, and before each monthly period,
one Graafian vesicle commences to increase very greatly in
size, until at the menstrual period it forms a tumor on the
surface of the one or the other ovary, about the size of a small
nut, or medium cherry, having increased in a few days from




PUBERTY.                          3
an infinitesimal body, only one-half, or at the very most three
lines in diameter, to the above dimensions. From this time
forward, at each monthly period, one Graafian vesicle and its
contained De Baer's ovule, successively arrives at maturity,
approaches the surface and lacerates the capsule of the ovary,
is then grasped by the fimbriated extremities of the Fallopian
tubes, and is finally conveyed along to the womb. Simultaneously with this increase of action in the ovaries, the womb
also becomes the seat of greater nervous and vascular activity,
accompanied with congestion of blood to, and pouring out of
the menstrual fluid from its internal surface. The periodical
monthly returns of ovarian activity and congestion, tend to
the growth, development and' expulsion into the womb of
ovules, or germs of future human beings, one of which is sacrificed at each menstrual period, unless conception take place.
The simultaneous periodic activity, and congestion of the
womb tends to the production of the envelopes or membranes
which would enshroud the germ, and if conception take place,
to the proper supply of it with blood and nutriment, or materials for growth. Hence, shortly before, or after the menstrual
flow, is the only period of time when vivification of the
germ can take place; the exceptions to this rule, according to
Raciborski, do not exceed six or seven per cent.*
The rapid development of the Graafian vesicles, from their
rudimentary state to the required menstrual size, causes pressure upon the body of the ovary and its aroused vessels and
nerves, in like manner as the growth and development of a
tooth presses aside and stretches the substance of the gums
in a child, causing comparable local pains, and more or less
distant sympathetic derangement in both processes. Nervousness, restlessness, pain about the groin, or ovary which is
* In almost all cases of recent menstruation in which death took place
accidentally, by sickness, or by hanging, in which menstruation had but just
commenced, the substance of the ovaries, tubes and cornume of the uterus,
quite near the insertion of the tubes, have been found most congested-proving, apparently, that the menstrual excitement and congestion commences in
the ovaries, passes next to the tubes, and then encroaches gradually upon
the uterus, progressing from the neighborhood of the tubes downwards.




4                    MENSTRUATION.
the seat of the process, pains and derangement in the back,
hips, stomach, bowels, headaches, colics, diarrhceas, and even
convulsions may attend the process.
Prior to, and during each catamenial period, the mammre
sympathize with the uterus-the breasts become swollen and
tender, and a degree of irritability in the whole organ exists.
As the menstrual flow sets in, these symptoms disappear, and
the breasts either resume their former state and size,*or they
become slightly diminished, especially as age advances, and
in the unmarried state.
But the advent of puberty is apt to be attended with an
unusual degree of perversion of activity in'both the nervous
and vascular systems, tending obviously to a state of general
excitement and plethora, all of which in due time are relieved
by a flow which nature establishes for the purpose. The manners of the changing girl are perceptibly altered, she is disinclined to pursue her accustomed employment and exercises,
is languid and listless, often reserved and fretful, her appetite
capricious, stomach and bowels disturbed, sleep irregular and
unrefreshing;-pain in the back and head, and weight, fulness, heat, apd some irritation of lower part of abdomen, are
also apt to occur.
But very often these symptons are short and transitory, or
even absent altogether, and the flow sets in more or less scantily or freely, being either at first thin, serous or mucous,
colorless or but slightly colored, and after continuing a few
days, subsides, and health and comfort are speedily restored.
At each succeeding period the flow presents more of the normal red appearance, which it finally acquires in full, after
several repetitions of the process.
But it is not always that puberty advances thus gradually
and progressively, and it would always be well for the mother,
whenever she perceives any of these indications, to lose no
time in preparing her daughter to expect the change which is
the common lot of her sex, so that the first appearance of the
menstrual flow may neither be arrested by the alarm naturally
felt at something hitherto inexperienced, nor by the danger



PUBERTY.                      5
ous applications to which in her ignorance she may imprudently have recourse.
To prove the necessity of this preparatory caution on the
part of the mother, TILT found that out of 100 girls, 25
were unprepared for its appearance; 13 out of the 25 were
much frightened, screamed, or went into hysterics; and 6
out of the 13 thought themselves injured, and attempted to
stop the flow with cold water. Of those much frightened, the
flow was checked by the mental emotion in 7 instances, and
never restored in 3, while the general health of all was seriously impaired. Of the six who washed in cold water, 2 succeeded in effectually stopping the flow, which only reappeared
after several years, and then at irregular intervals, and was
never healthily reestablished.
It will readily happen to all but very thoughtful mothers,
that the first menstruation may make its appearance before her daughter has been forewarned. But when the
monthly flow has once occurred, it is imperatively necessary
that right advice and information should be given to the child;
for many girls view the whole matter with such strong
disgust and levity, that they expose themnselves carelessly or
purposely at the regular term, to cold and wet, or use cold
baths or other means of suppression, finally bringing on disordered menstruation, and permanent ill-health, by thus
trifling with the function, in the same way that a child plays
with a watch, setting the hands backwards and forwards to
amuse and injure themselves. The mother should institute a
monthly regimen-keep an exact account of dates and particulars-prevent all unusual exposure for a few days before the
expected flow, such as to night air, damp linen, thin dresses,
wet feet, cold and acid drinks, balls and entertainments, when
practicable. When the " custom of women " has been fully
and regularly established, such extreme precautions are of
course not only unnecessary, but in many cases unadvisable.
Thoughtless mothers will always allow their daughters to be
taken unawares, but even the most thoughtful may be forestalled. Menstruation may set in for the first time from a




6                   MENSTRUATION.
severe fall, violent jumping, great mental emotion, or an extraordinarily long walk —and in such cases, TILT says there
may be a considerable flow in 30 per cznt., while in 8 per
cent. it may amount to absolute flooding, lasting from 8 to 10
days, and requiring medical treatment. These facts are
important, because they are not in accordance with the general belief, and if duly acquainted with them, the mother,
in such sudden and extreme cases, will not only maintain her
own composure, but impart it to those around her, and reassure her daughter that nothing has happened but what is
not exceedingly uncommon, and easily to be remedied by
rest in the horizontal posture, cool drinks, light covering in
cool and well ventilated apartments, with the aid of a few
drops of Tinct. Cinnamon, &c., until medical advice can be
obtained.
At other times, or rather in other cases, the occurrence of
Menstruation may be long protracted-excessive languor,
drowsiness, violent pain in the head, or along the spine, and
around the lower part of stomach and bowels, may alternate
with rigors and feverish reaction, or with nervous symptoms,
and even spasms; clearly indicating a loss of balance between
the circulatory and nervous systems, which if not timely remedied, may lead to very injurious consequences-to violent congestions, or inflammations; or to scrofulous disease of some
important organ, if there be a hereditary tendency that way;
or to various nervous, spasmodic, or painful affections, when
the nervous system predominates. Aconite and Hyosciamus are the most important remedies here, although Stramonium may be required.
In another class of women, previous to the first appearance
of the menses and during their flow, the venous, biliary or
lymphatic systems may be deranged-the face assumes a sallow, greenish, yellowish or bloated pasty look, the eyes are
dull and sunken, or surrounded by a dark areola, which appearances are present ever afterwards in a greater or less
degree, during every monthly flow, the result of functional
difficulty at the commencement, and generally dependent




FIRST MENSTRUATION.               7
upon and associated with a languid circulation through the
venous and portal systems, and a.low nervous power.-WHITEHEAD. Conium, Pulsatilla, Manganese, Colchicum, &c., will
often be required.
If the changes at puberty be well accomplished, such is the
intensity of vitality, and the impulse given to every nerve and
organ, that the system resists all baneful influences, and sickness and death are less frequent at this period of life than any
other. But on the other hand, original delicacy of constitution, or carelessness, will render this period preeminently
favorable to the propagation of new forms of disease, or to the
development of those latent germs of disorder which have
existed from birth. Hence, the first appearance of the menses should be watched for with some care and anxiety on the
part of the mother.
ON FIRST MENSTRUATION.
Is order to have exact data for any opinions which may be
here advanced, I have with some little labor collected the
largest table of the periods of first Menstruation that has ever
been published, viz., of 29,918 women, observed by Da Boismont, Bennett, Lee, Whitehead, Roberton, Tilt, &c., &c.
1. In one case, in an infant, the flow commenced a few
days after birth, and continued regular at periods of 3 weeks,
till her death at the age of 4 years and some months, at which
time she was developed in size and figure, like a girl of 10 or
11 years.
2. Of these, there is one case in which a child menstruated
at 9 months of age, and continued regular subsequently.
3. Also, one case of a child born with signs of puberty,
who menstruated for the first time at 3 years of age, and continued regular.
1 case menstruated at 4~ years of age.
1 " at 5 years of age.
1  "  ("  7  "      cc




8                    MfENTRUATIOON.
2 cases at 8 years of age.
20  "  "  9  "       "
92  "  "10  "        "
125  "  " from 10 to 11 years.
278  "'t 11 years.
399  "  " from 11 to 12 years.
495  "  " 12 years.
656  "  " from 12 to 13 years.
852  "  " 13 years.
934  "  " from13 to 14 years.
1417  "  " 14 years.
1562  "  " from 14 to 15 years.
1659  "  " 15 years.
2048  "  " from 15 to 16 years.
1634  "  " 16 years.
1792  "  " from 16 to 17 years.
793  "  " 17 years.
1397  "  " from 17 to 18 years.
761  "  " 18 years.
1023  "  " from 18 to 19 years.
326  "  " 19 years.
591  "  " from 19 to 20 years.
170  "  " 20 years.
379  c"  " from 20 to 21 years.
14  "  " 21 years.
148  "  " from 21 to 22 years.
29  "  " 22 years.
90  "  " from 22 to 23 years.
9  "  " 23 years.
36  "  " from 23 to 24 years.
3  "  " 24 years.
15  "  " from 24 to 25 years.
4'  " from 25 to 26 years.
5  "  " from 26 to 27 years.
1  "  " from 29 to 30 years.
But the above table was compiled from cases taken in all
climates, hot, cold, and temperate, and hence is not a sufficient




FIRST MENSTRUATION.               9
guide for the inhabitants of either. Of the 29,918 cases, 766
occurred in hot climates, 6745 in cold, and 15,154 in temperate climates.
At    766 Cases'6745 Cases,  16,154 Cases,    At
YEARS.    HOT.        COLD.       TEMPERATE.   YEARS.
5        0            01                      5
7        0            0             1         7
8        0            0             2         8
9        3            0            16         9
10        9            0            83        10
11       21            1           481        11
12       96            5           783        12
13      159           19          1360        13
14      133          113          2105        14
15      103          372          2675        15
16        55-        738          2869        16
17       39          741          1795        17
18        26         615          1497        18
19       10          540           799        19
20         8         360           393        20
21         2         278           126        21
22         2         114            43        22
23        1           73            22        23
24        2           27            11        24
25         0          12             3        25
26         0           4             2        26
27         0           5             0        27
30        0            1             0        30
Several very important facts may be adduced from the
above table, viz.: the hastening effect of heat, the retarding
effect of cold, and the great number of both precocious and
tardy cases which occur in all climates. Many a consumptive parent is sent to the South merely to die; many a nonmenstruating girl might be sent there to live; many a woman
with profuse Menstruation might be restored to health by a
season spent at the North. The table also corroborates the
well known necessity for warmth of clothing and residence,




10                  MENSTRUATION.
for those with scanty Menstruation, and vice versa. Menstruation occurs in the daughters of the rich, 9 months before it
does in those of the working classes placed in the most comfortable circumstances, and 14 months before its average ap.
pearance in the poorest classes. It should also be borne in
mind that the season of the year at which the girl becomes of
the proper age, has a great influence upon the first appearance, almost as much as hereditary influence; women of the
frozen regions, as the Samoiedes lose but a very small quantity
of blood, and that in the summer season only, while the Greenlanders have scarcely any discharge on account of the cold.
On the other hand, it is quite certain that European women who
migrate to a hotter climate, such as that of the West and East
Indies, often perish in consequence of the excessive menstrual
losses, and their great liability to abortion with haemorrhage.
It is evident from the second table, that the majority of women in hot climates reach the age of puberty and menstruate
between the 12th and 15th years of age; in temperate climates between the 13th and 18th years; and in cold climates
between the 14th and 22d years. We now propose to enter
upon an inquiry into the consequences, or advantages and disadvantages of early or late, MIenstruation-to determine, as far
as possible, when medical aid is required, and when the case
may be left to domestic management or to nature. It is satisfactorily established, that, in every country and climate, the
period of first Menstruation may be retarded in very many
cases much beyond the average age, often without producing
ill-health, or the slightest inconvenience. TILT even goes so
far as to assume that the great art of managing girls, so as to
bring them to the full perfection of womanhood, is to retard
the period of Puberty as much as possible.
MANAGEMENT OF FIRST MENSTRUATION.
It is to be taken for granted that every sensible and thoughtful mother will inform her daughter, when signs of Puberty
and Menstruation present themselves, of what she is to expect.
According to TILT, during the crisis of Puberty, and until




FIRST MENSTRUATION.               11
Puberty is fully confirmed, there should be a general relaxation
from study, which might otherwise too forcibly engross the
mind, and the energies required by the constitution to work
out nature's ends. Even in man, the excess of mental labor is
known to produce constipation, by some prostration of the
nervous energy; would it not then be likely to have the same
effect upon girls —besides tending to check the critical flow
which nature contemplates establishing?  Nay more, even
when puberty is fully confirmed, some days before, and during the time occupied by the monthly function, the head is
very often much affected by pain, vertigo, drowsiness, or dulness; in which case the brain should be less severely taxed
than usual. Those who are occupied in the education of girls
should bear in mind not only this, but also that the same regimen cannot suit all, and that each particular pupil may
require a different amount and quality of mental exertion.
These precautions are particularly necessary for those girls
who have a hereditary, or acquired tendency to sick-headaches; an immense amount of mischief to the head may be
brought about by the combined influence of carelessness of
the mother to institute a proper monthly regimen for her
daughter, and the natural tendency of school teachers to urge
on their scholars as much as possible.
Very particular attention should be paid to the clothing of
young girls about the menstrual period. TILT truly says that
rich or fashionable young ladies suffer almost as much from
insufficient clothing, as the daughters of the absolutely destitute; for poverty and fashion are two inexorable tyrants
which exact the same, or similar things, and bring on the
same diseases. The feet should be more carefully protected,
just before and during the menstrual period; and the upper
part of the chest should be less uncovered than most girls are
inclined to have it when obliged to go to places of nocturnal
amusement.
The mother should take particular care that theflow be not
interrupted, either by carelessness or design.  Of all the
causes of suppression, none is so frequently observed as' the




12                  MENSTRUATION.
application of cold and wet to the feet and legs, particularly
during the flow, or a few days before, or after its appearance.
TILT places much stress upon the effect of draggled clothes in
producing this effect; he says in respect to walking, ladies
may be divided into three classes:
1st. Those who never raise their dress, but walk through
thick and thin, with real or affected indifference to wet and
mud.
2d. Those who raise the dress, but allow the mass of under-clothes to collect all the mud, and beat it up to the middle of the leg.
3d. Those who, without offending the rules of propriety and
good taste, know how to raise both dress and under-clothes,
just sufficiently to protect both.
But suppression occurs almost as frequently from design as
from accident; for many mothers, otherwise judicious, will
not condescend to give the necessary advice to their daughters, many of whom often attempt to check the discharge by
the application of cold water, putting their feet into cold water, &c. They often do this from ignorance, or by the advice
of servants, or sisters but little older than themselves. The
consequence is, that years may elapse before perfect regularity will be established.
The mother should also be watchful that the function be
performed neither Thore or lessfrequently than once a month;
the monthly type is the only type of its healthy performance,
and any marked deviation from this rule, rarely coincides
with perfect health. Many young girls who would otherwise
be quite regular as to time, are exceedingly susceptible to
slight influences, so that walking about with their bare feet
upon the cold floor in winter, while dressing or undressing;
or a walk in the cold air, or a slight chill, will suffice to suppress the discharge instantly. Considerable maternal care,
and even authority, should be exerted in these cases. Such
girls should not be allowed to go to church or school, in rain
or snow storms, much less go to any place of amusement.
Volumes might be filled with illustrations of the pernicious




FIRST MENSTRUATION.                 13
effects of the flow being suddenly checked, either intentionally
pr accidentally. At the monthly period, the uterus, ovaries,
and all the branches of the hypogastric, sciatic, and ovaric
arteries are full; it is full tide with all that system of vessels;
the accompanying nerves are all aroused with the periodical
stimulus. The sudden application of cold Ywill produce a spasmodic closure of the excreting orifices of the womb, and the
uterus and ovaries instantly become the seat of intense engagement, which will react as a disturbing force upon the
whole system, but especially upon any already weakened
organ, be that the head, lungs, stomach, or bowels. If the
application of cold and wet to merely one part of the body, is
capable of producing these bad effects, how much more injurious must be cold bathing at such times, either by the domestic, or professional use of the hydropathic treatment. To
advance, in justification of this practice, that cold does not
always check the flow, is a shallow excuse, founded on but
few exceptional cases, although it is frequently advanced, even
when the menses have become habitually scanty, irregular, or
painful. —TrILT.
The mother should also be careful that the pain should not
be too violent, or long continued. Women expect to suffer
some pain every month, but the pain need not be intense, protracted, or agonizing. If the sufferings are very considerable,
and do not abate with the appearance of the flow, Bellad.,
Stram., Secale, or Cocculus,* may be used, and if these fail,
the medical attendant should be consulted; for, although
the belief prevails, that because the function is a natural one,
all its attendant pains must be endured, so little is this true,
that the frequent occurrence of severe pain is almost proof
positive of carelessness, either upon the part of the mother or
daughter, or both. The severe pains are very generally rheumatic in their nature, and originate and are kept up by the
exciting causes of rheumatism, viz., insufficient clothing of
the person or feet, or thoughtless exposure to cold and wet.
The mother should also be watchful that the flow be not too
* Full directions for the doses of all these remedies will be given subsequently.




14                   BIENSTRUATION.
abundant, or of too long coutinuance.  TILT says there is
another deep-rooted and most dangerous prejudice, which
makes women believe that, however great may be the discharge, if it occur regularly, it is in perfect accordance with
the views of nature. He has frequently drawn a parent's
attention to the debility and ill health following an habitually
too copious flow, and as frequently received the same answer,
" She is always so;" so difficult is it to enforce the conviction
that the fact of a girl being always so, is the very reason for
adopting such measures as should prevent her ever being so.
Tlie monthlyflow must not be accompanied by too much mucous discharge, commonly known by the name of" the whites."
Although the regular establishment of Menstruation is generally and naturally preceded and followed, for a day or two,
by a white discharge, which must be considered a part of its
phenomena, still, if this discharge becomes excessive, or too
long continued, or instead of being white and unaccompanied
with pain, changes to yellow or green, and is attended with
much pain in the back and thighs,-then it becomes a disorder requiring medical interference. Sabina, Copaiba, Bovista, and other remedies, may be required.
The monthlyffunction should not be attended by much hysteria, or severe nervous symptoms. The most frequent of all
nervous symptoms of this function, is a peculiar affection of
the head, not amounting to actual pain, or siok-headache, or
hysterics, but easily aggravated into one or the other of these,
if excessive exertions of body or mind be enforced; it is a dull,
heavy, stupid feeling, with a great tendency to sleep; it varies
from a slight heaviness, to variable shades of severity, which
may become much aggravated by worry or anxiety of mind,
by struggling to learn long and stupid lessons, in order to s/atisfy some exacting school-teacher, or to retain some post of
honor in a class. Girls affected decidedly in, this way, should
be treated with great leniency, and even indulgence, at each
monthly period.
The tendency to diarrhc3a should not be too decided. More
or less tendency to looseness of the bowels is almost natural




REGULAR MENSTRUATION.             15
at the monthly period, but it should not be so excessive as to
diminish the quantity of the flow, much less to take its place.
In 449 cases, collected by BUTLER LANE and TILT, this " catamenial diarrhcea" occurred in 189 instances, so that more
or less of this symptom may be expected in about half of all
cases. If it be excessive, Veratrum, Aloes, or Bryonia may
be required. For dose, see subsequently.
But the most important point of all is, that mothers should
undertake and carry out a system of judicious supervision of
the health, diet, exercise, cldthing, habits, &c., of changing
girls.
REGULAR MENSTRUATION.
1. TIME OF FIRST OCCURRENCE.
From 14 to 16 years of age is by far the most regular and
common time for first menstruation to set in, in temperate
climates. In a table compiled from the cases collected by
WHITEHEAD, DE BOISMONT, LEE, BENNETT, &C., consisting of
8489 cases, more than one half, or 4689, commenced during
these years, viz.:
1417 cases at 14 years.
1658    "    15   "
1614    "    16   ".
In another collection of cases by TILT, of 15,154 young women, no less than 7649 cases, or rather more than one-half,
also commenced to menstruate between their 14th and 15th
years, viz.:
2105 cases at 14 years.
2675    "    15   "
2869    "    16   "
According to WHITEHEAD, this period, from 14 to 16 years
of age, is not only the most regular and common age for Menstruation to commence in temperate climates, but is also
almost necessarily the most favorable; for of 1728 cases occurring during these years, and observed by himself, only
about 324 were attended with unusual, painful, or unfavorable




16                  MENSTRUATION.
symptoms-or only about 19 per cent. The percentage of
irregular, difficult, or unfavorable cases, among the precocious and tardy, is much higher, ranging from 22 to 47 per
cent.
The occurrence of Menstruation one or two years before 14,
or at 13 and 12 years, and also one or two years later than 16,
i. e., at 17 or 18, is not sufficiently uncommon to be regarded as,
decidedly irregular, although the former is rather too early,
and the latter decidedly too late. Of the 23,643 cases in the
two tables above quoted, as many as 8356, or about one-third
set in at the 12th or 13th, or 17th or 18th years, viz.:
1379 cases at 12 years.
2212    "    13   "
2578    "    17   "
2188   c"   18
All cases of Mepstruation occurring for the first time before the 12th year, or after the 18th, must be regarded as very
decidedly precocious, or tardy.
2. TIME OF RECURRENCE.
In regular Menstruation, the flow should return every
lunar month, or every 28 days, counting from the beginning
of one period to the commencement of the next, leaving a
free period of 23 or 24 days, and including a flow of four or five
days' continuance, thus completing the four lunar weeks or 28
days. ROBERTON, of Manchester, thinks that only about 61
women out of every hundredl are thus regular to the true
time of 28 days, calculating from a table of 450 cases. CoNDIE, of Philadelphia, basing his opinion on 784 cases, thinks
that 71 women out of every hundred, have an interval between the cessation of the flow of one period and its recurrence at the next, of 28 days, scarcely ever deviating, and
then only in a few cases, for a single day, or at most two
days, either anticipating or postponing. TILT, from 100 cases,
makes the average of perfectly regular women as high as 77
out of every hundred. ROBERTON, of Manchester, out of 520




REGULAR MENSTRUATION.               17
cases, found 324 who had a regular interval of a lunar
month.
Slight variations from this normal standard must not be
regarded as unnatural, as cases are met with in perfectly
healthy women, in whom the monthly flow occurs with the
utmost regularity, every 25, 26 or 27 days, instead of every
28. WHITEHEAD, in 520 cases, found about 35 women who
were regularly unwell at intervals varying from 20 to 27 days;
but whatever the interval, whether 20 or 25 days, or more, it
had always been the same in the same person.
Again, in 51 cases, WHITEHEAD noticed that, although Menstruation set in every 28 days, still, every 3d or 4th month,
a difference of 3 or more days was observed in the duration
of the discharge, coupled with an increase in quantity.
In 38 other cases, the menses recurred every lunar month
as a rule, but set in every 3d or 4th month from 4 to 7 days
earlier; and these regular deviations were so marked and constant in most instances, as to be expected and anticipated by
preparations for them, at the particular times.
In 14 cases, the interval was only 24 days, but occasionally
l'olonged to 28 days.
One lady menstruated regularly every 28 days, but at the
middle of every 3d month, she had an intercurrent discharge,
lasting from 30 to 40 hours.
In another case, Menstruation generally occurred every 28
days, but every 3d month she missed one period, thus having
a free interval of 2 months, her health never suffering in consequence.
From the frequency of such cases, WHITEHEAD says, some
writers have assumed that the menstrual discharge is augmented periodically and naturally, every 2d, 3d or 4th month.
ARISTOTLE believed that such an increase took place regularly
every 3d month. A knowledge of these variations is of importance, as they are often the occasion of considerable, though
perhaps unnecessary anxiety, and frequently much harm is
done by premature medical or domestic interference, thus
B




18                  MENSTRUATION.
perverting a means which nature had intended to act
beneficially.
The regularity of the recurrence of Menstruation is supposed, by RACIBORSKI, to depend entirely upon the regular
growth, maturation, and periodical discharge of the ova.
That these, like the seeds and eggs of vegetables, insects, and
birds have a certain definite and regular period allowed for
their: formation and ripening. That the development of
Graafian vesicles, or ova, ought to be considered not merely
as the cause of Menstruation, but the essential and most important part of it; and that a woman may regularly develope
her ova and be liable to conceive, even when she may never
have had the outward and visible signs of her catamenia.
GALL, whilst not admitting a sidereal influence, believed
that the discharge would be found generally to take place at
about the same period of time, and that there are certain
weeks in each month in which few or no women are menstruating. He divides the menstrual epochs into two classes,
comprising the first 8 days of the 1st and 2d fortnight, i. e.,
the 1st and 3d weeks of each lunar month. GALL even insists
that those women who, from accidental causes, become unwell
during the 2d and 4th weeks, will soon return under the influence of the general law. However this may be, every physician in large practice will often find a large number of women menstruating about the same time.
3. REGULARITY AS TO DURATION.
The most common and regular length of time for the menstrual flow to continue, is from 4 to 6 days. A flow which
lasts only 3 days or less, must be regarded as rather short,
while one which lasts 7, 8, or 9 days or more, is decidedly too
prolonged, although it may not prove injurious to some individuals.
4. REGULARITY AS TO QUANTITY.
This is much more difficult to determine than one would




REGULAR MENSTRTUATION.             19
suppose. BourITARDAT had one case in which 1 ounce flowed
every 10 hours, by measurement, making about 12 ounces in
120 hours, or 5 days. MEIGs, of Philadelphia, is confident that
many healthy women lose 2 or 3 ounces per day, for from 5 to
7 days, amounting in all to 10 or 15, or even 20. ounces per
term. But these conclusions are undoubtedly much above
the general average. WHITEHEAD, of Manchester, calculates
4, 6, or 9 ounces, as the general average in temperate climates.
BAUDELOCQUE thought that most French women lose only from
3 or 4, to 6 ounces. In Holland, the average is placed at 6
ounces; in Germany, at 6, 8 or 12 ounces; in Spain, at 14 or
15 ounces; in Greece, at 18 or 20 ounces, &c. It is probable
that 6 or 8 ounces is the normal standard-although 4 or 5
ounces per term may not be too little for some persons, nor 10
12, or a few ounces more, too much for others. MIEIs, of
Philadelphia, thinks the quantity may vary normally from a
few ounces to 20, or more. He has repeatedly inquired the
number of changes of napkins required in the whole period of
5 or 7 days, and has often been informed that some women
change-twice, or thrice, or even four times in 24 hours. Now
three changes per day, for 7 days, will give 21 napkins, on each
of which are found at least 2 tablespoonfuls of blood, at which
estimate we shall have the result of 21 ounces for the whole product; and he is confident that many healthy women lose fully
this quantity, as the regular and natural elimination. LooMIs
estimates the normal quantity as low as from 2 to 4 ounces.
5. REGULARITY AS TO QUALITY.
Normal menstrual blood has an acid reaction, while systemYc blood is always alkaline. RETZIUS, of Stockholm, has.
discovered free phosphoric and lactic acids in the menstrual
discharge. It is well known that menstrual blood does not
coagulate like ordinary blood, and it has been demonstrated,,
that the addition of a small quantity of acetic, lactic or phosphoric acid, or of almost apy other acid to natural blood will,
prevent it from coagulating, and approximate it in properties,
and appearance to menstrual blood. The acid seems to act




20                 1MENSTRUATION.
by dissolving the free, or uncombined fibrin contained in systemic blood.
It has long been a mooted point, whether menstrual blood is a
true secretion, or simply an exudation of pure blood. WHITEHEAD decides in favor of the latter supposition; he insists that
true menstrual blood, uncombined with the normally acid
vaginal mucus, is like ordinary blood, and equally capable of
coagulation; but that it is immediately dissolved in the vaginal mucus, being thus enabled to pass off in an uninterrupted
stream. Here is observed, he says, one of those most wise and
merciful provisions of the great Creator and Preserver of all
things, which so frequently strike the physiologist with wonder and admiration. If no such solvent power as that of the
acid vaginal mucus existed, the coagulated part of the menstrual secretion, being, on account of its consistence, necessarily more or less detained within the vaginal canal, would
soon become a mass of dead and putrid animal matter, and
the consequences would be awful in the extreme.
IRREGULAR MENSTRUATION.
In its largest sense, this includes all departures from the
natural standard, whether Menstruation be unusually early or
late in the time of its first appearance; or recurs at too short
or too long intervals of time, viz., as often as every 2 or
3 weeks, or less; or only every 5 or 6 weeks, or more;
or lasts too short a time, viz., less than 3 or 4 days, or
continues too long, viz., as much as 6, 8, 10, or 14 days;, r
more; being attended with too scanty a flow, viz., oriy 1,
2, or more ounces, or with too profuse a discharge, viz.,
more than 8, 10, 12, or 20, or more ounces; or being preceded,
accompanied, or followed by severe pain, distress, or other unusual circumstances. In its more common sense, it refers
merely to those cases in which Menstruation recurs at irregular, and indeterminate periods of time.
Of the 8,489 cases already alluded to, about 20 cases were




IRREGULAR MENSTRUATION.              21
exceedingly and irregularly precocious, Menstruation occurring from a few days, to a few months after birth; or at three
or five years of age, or at eight or nine years. About 50
cases were decidedly and irregularly late in the period of first
occurrence, viz., as late as 21, or 26 years of age.
Of 5,547 cases collected by WHITEHEAD, DE BOISMONT and
BENNETT, no less than 1,742 accomplished the changes of puberty with more or less irregularity, as far as regards suffering,
delay or difficulty, each monthly return being attended with
pain or discomfort of some kind, or with scanty or profuse
discharge, or occurring at irregular intervals of time.
In 1,404 cases, in which particular attention was paid to the
time of the recurrence of Menstruation, by ROBERTON, CONDIE,
and WHITEHEAD, no less than 463 females were found to be
irregular as to time. In 1,045 cases, 96 had returns every
three weeks regularly; 134 women were unwell every 14
days; and 89 were so extremely irregular as to afford no means
of calculating the periods of recurrence, the duration, or quantity of the discharge.
ROBERTON, of Manchester, thinks that only in 61 per cent.
of cases does Menstruation recur regularly and monthly, viz.,
with a free interval of 23 or 24 days, and a flow of 4 or 5
days, completing a period of 4 weeks, or 28 days. He also
thinks that there is another large class of women amounting
to 28 per cent. of the whole number, in whom the natural
term is only 3 weeks; in another and smaller class, embracing about 10 per cent. in number, the returns are irregular and uncertain, but in his opinion not from the effect of
disease, the term varying in length from 4, or 6, or 8, to even
12 weeks. In a fourth, but much smaller class of cases, the
menses return regularly and normally, for the class, as often
as every fortnight, the free interval being only 9 or 10 days,
the flow lasting 4 or 5 days each time, or 8 or 10 days out
of every month.
CONDIE, of Philadelphia, speaks still more decidedly on
these points; he insists that, in about 71 per cent., the interval
between the cessation of the flow and its recurrence amounts




22                   MENSTRUATION.
to 28 days, never deviating, and that in a few cases only, beyond a single day, or 2 days. In about 18 per cent.' he
found that the menses returned at intervals of very nearly 21
AEa;s, but in many cases the flow at each alternate period was;mudi more copious, and lasted for a day or two longer; all
rthese  omnen were in the enjoyment of perfect health, although
sthey feared that the frequent recurrence of the discharge was
ithe result of disease, or was calculated to weaken them. CoNDIE says, that,,after the most minute investigation, he was satis-fied that their fears were unfounded. In about 5 per cent..of CONDIE's cases, the messes returned every 2 weeks; in
about 6 per cent. at very irregular and uncertain periods,,varyinpg from 2 to 8, or 10 weeks, all generally occurring in!feAds of relaxed and excitable constitutions, several being
affected with dyspepsia, hysteria, or leucorrhcea.
WHITEHEAD's general experience has already been quoted
(see p. 17). TILT assumes, that about 77 per cent. of all women are perfectly regular; about 19 per cent. have too frequent returns, viz., as often as every 3 weeks; and that
only about 5 per cent. are exceedingly irregular and uncertain.
In 9 cases out of 359, Menstruation lasted only one day
each time; in 15 cases out of 161, the menses set in every
3 weeks as a rule, but every third or fourth return occurred from 4 to 7 days later; in 14 cases out of 161, the interval was usually 24 days, but occasionally 28 days; in 5
cases the returns happened every 5 or 6 weeks, but occasionally every 4 weeks; in 2 cases Menstruation recurred every
18 days generally, but an interval of a month was interposed
every third dr fourth period; one lady menstruated every 28
days, but at the middle of every third interval, she had an
intercurrent discharge, lasting 30 or 40 hours; finally, in 32
cases out of 161, the returns were so irregular as to afford no
means of calculating either the recurrence, duration, or quantity.
TREATMENT OF IRREGULAR MENSTRUATION.'TrLT insists, that the periods may often be rendered pertfectly regular as to time, by the careful use of Quinine. Vera



PRECOCIOUS MENSTRUATION.               23
trum, Staphysagria, Phosphoric acid, Mercurius acet., and
Nux vomica are supposed to possess the power of restoring
irregular Menstruation to a regular recurrence at the time of
every new moon; if this be so, it would be advisable to pay
particular attention to the administration of these remedies
just before the time of the new moon. Sulphur and Ruta are
regarded as the most homoeopathic remedies for very irregular Menstruation.  Manganum aceticum is also homceopathic
when the menses are apt to recur at unusual periods.
Dose.-The use of these remedies should be commenced at least 2
weeks before the full moon: Of Veratrum, NOACK advises 1 or 2 drop,doses of the 2d, 3d, 6th, or 12th dilution once or twice a day; or from.3 to 5 granules may be given night ai morning; the same doses of
Staphysagria, Nux vomica, and Ruta may be used. One or two grains
per dose of the powder of Phosphoric acid, Mercurius acet., or of Manganumn acet., may be given every 2d night for one week; then every
night for the next three days, and every night and morning for the 3
Adays just preceding the new moon; the 1st, 3d, 6th, or 12th trituration
may be given, or from 3 to 5 granules per dose.
PRECOCIOUS MENSTRUATION.
A precocious puberty is generally observed in girls pos-.sessing the sanguine temperament, and in those who exhibit
a delicate organization of structure. Although the contrary
has been supposed, COLOMBAT justly says that "Observation
proves, that women in whom the nervous temperament predominates, are regulated both sooner and more copiously
than others; and that all the causes which exalt this temperament, such as powerful passions, culture of the arts, and
amusements, light reading, &c., and finally, excitements of all
kinds, far from causing suppression of the menses, do but pre-,cipitate the age of puberty, and increase Menstruation. Besides, in warm climates, womertaare generally endowed with a
sanguine-nervous constitution carried to its maximum, and
IMenstruation is very early, very free, and rarely suppressed;'The earliest period for Menstruation, either in India or'Eng



24                      MENSTRUATION.
land, may be taken at 9 years, although ROBERTON, of Manchester, had one case at 8 years, and cites cases occurring
at Calcutta, at the same age.* The percentage of cases of Menstruation at Calcutta, under 11 years of age, is 10 per cent.;
for England, about 3 per cent.  In Venezuela, first Menstruation sets in,' in a few very rare cases, at 10 years of age;
while only about 10 per cent. occur as early as 11 or 12
years. llindoo women reach puberty nearly two years earlier than in Europe, a far greater proportion menstruating at
12, 13 and 14 years of age, than in England, where it has not
been found that so large a proportion of cases cluster around
any particular age, but ar scattered more equally over the
12th, 13th, 14th, 15th, 16t~ 17th, and even 18th years. PAUL
DUBOIS had a case of precocious Menstruation setting in at 91
years of age, and he places great stress on hereditary influence
in bringing about early or late Menstruation. He also had
two cases in Paris, in which Menstruation occurred in one at
11 years, the other at 12, and both girls were confined with
their first child, one at 13, the other at 14] years of age; and
thinks these cases of premature pregnancy and confinement,
with precocious development of the rest of the body, are by
no means rare.  Menstruation sets in considerably earlier in
cities than in the country. It also occurs in the daughters of
the rich, in those who have every comfort and luxury, everything which enervates and relaxes, and at the same time excites, at least 9 months before it does in those of the working
classes placed in the most comfortable circumstances; and
full 14 months, on the average, before it appears in the poorest classes.
* The number of cases of early Menstruation in temperate climates, and
even in hot climates, is much smaller than is generally supposed, while the
proportion of late cases is much larger in all climates. By reference to the
second table, it will be seen that, even in hot climates, as many commence
Menstruation as late as 19 years of age, as at 9 years; more at 18 years
than at 11; as many at 16 and 17 years, as at 12. While, in temperate climates, more commence to menstruate aslate as 23, than as early as 9 years;
more at 21 years than at 10; nearly as many at 20 as at 11; full as many at
19 as at 12; more at 18 than at 13; more at 16 than at 14.




PRECOCIOUS MENSTRUATION.             25
WHITEHEAD, thinks especial attention is required in the scrofulous; for although Menstruation is apt to set in too early in
them, yet in 226 cases the average time of first Menstruation
was between 15 and 16 years of age; still, signs of puberty
had commenced earlier than usual, but was slow in being fully
accomplished, while regularity as to time and quantity was
sustained with difficulty, so that 86 out of the 226 cases, or 38
per cent., required medical treatment, an average far above
the general one, which is from 18 to 22 per cent. BENNETT
found that only 2 cases out of 5, who menstruated as early
as 10 years, did so regularly and easily; only 7 out of 16, who
commenced at 11 years; only 8 out of 28, who began at 12
years; 14 out of 35, at 13; 14 out of 42, at 14:; also 14 out of
42, at 15; while as many as 20 out of 28, at 16, had, and
continued to have their menses regularly, and easily.
TILT has observed, that those who attain to the age of puberty very early, seldom become perfectly regular before the
age of 18.
Finally, we may refer to some very curious cases of precocious Menstruation. In one well-established case, MIenstruation set in, in an infant, a few days after birth, and continued
to recur at the regular periods; in one case, equally well
authenticated, the periodical discharge commenced at 9
months of age; in another, at 3 years; in one instance, at
5 years; in another, at 7 years; in 3 cases, at 8 years; and in
11 cases, at 9 years.
TREATMENT.-TILT advances it as a general and judicious
rule, that the period of puberty should be delayed as much as
possible, at least to the 14th or 16th year, if practicable.
Among the remedies most homceopathic to precocious ]lenstruation, may be mentioned Phosphorus, Ferrum, Phos. ferri,
Aloes, Cantharides, Stramonium, and Sabina. The frequent
use of hot baths, especially with the addition of mustard; the
indulgence in the use of hot, spiced, and stimulating food, and
drinks; residence in warm climates, or over-heated houses, or
rooms; novel reading, excessive dancing, etc., all tend to produce precocious, frequent, or copious Menstruation. The most




26                      MENSTRUATION.
antipathic remedies are Conium, Baryta, Secale, and Plumbum, especially if aided by the frequent use of cold baths,
scanty clothing, frequent exposure to cold, residence in cold
climates, houses, or rooms, bland diet, abstinence from hot
tea, and coffee, etc.
Dose. —The most homceopathic remedies, viz., Phosphor., Ferrum,
Phos. ferri, Aloe, Cantharides, Stramonium, and Sabina, should be
used in comparatively small doses, viz., 1 or 2 grains per dose, of the
1st, 2d, 3d, or 6th trituration of Ferrum acet., or of Phos. ferri; or 1
or 2 drops per dose, of the 1st, 2d, 3d, or 6th dilution of Phosphor.,
Aloe, Cantharides, Sabina, or of Stramonium, may be given once or
twice a day during the interval, or every 2, 4, or 6 hours during the
flow. Or, from 2 to 5 granules of the most appropriate of these remedies may be given as often as above directed.
In cases in which these remedies fail to afford relief, larger doses of
the strictly antipathic remedies, viz., of Baryta, Conium, Plumbum, and
Secale, may be tried; but none but a physician should presume to undertake the responsibility of their administration.
FREQUENT MENSTRUATION.
In 1,045 cases, WHITEHEAD met with 96 women who had
returns of Menstruation every 3 weeks regularly, and 134
other cases, in which it returned every 14 days.  We have
already seen that ROBERTON supposes, that no less than 28
per cent. of all women have a natural term of only 3 weeks,
while in a much smaller class the menses return regularly and
normally every fortnight, the free interval being only 9 or 10
days. CONDIE assumes that in about 18 per cent. the menses
return at intervals of very nearly 21 days; that in about
5 per cent. they return every two weeks. In 359 other cases,
WHITEHEAD found 36 who were regularly unwell at intervals
varying from 20 to 27 days; but whatever the interval, whether 20, 25, or more days, it had always been the same in the
same person; in 38 other cases out of 161, the menses recurred every lunar month generally, but set in every 3d or
4th term, from  4 to 7 days earlier, and these deviations
were so marked and constant in most instances, as to be expected and anticipated by preparations for these particular




FREQUENT MENSTRUATION.               27
times; in 15 other cases out of 161, the menses set in every
three weeks generally, but every 3d or 4th return happened
from 4 to 7 days later than ordinary; in 14 cases, the interval
was 24 days, but occasionally 28 days. In two cases, the
returns happened every 18 days; one of these patients, however, had a free interval of a month every 3d, or 4th period;
one case menstruated every 28 days as a rule, but at the
middle of every third interval,.she had an intercurrent discharge, lasting from 30 to 40 hours; two cases menstruated
every 14 days, and in one of these the discharge lasted 7 days,
leaving a free interval of only 7 days each term. TILT calculates that nearly 17 per cent. of all women have a regular
interval of only 3 weeks.
It will be seen that ROBERTON and CONDIE insist that these
frequent returns are natural and salutary for some persons.
TILT, on the contrary, assumes that the function should be performed neither more nor less frequently than once a month.
He says, some physiologists and medical writers have inculcated that it might, with equal benefit to the health, occur
every 2, 3, or 4 weeks, and that in fact, all these different types equally fulfil nature's views. But this he believes
to be incorrect. His practice has shown that the monthly is
the only type of its regular performance, and that any deviation from -this rule rarely coincides with good health; most of
the cases which have deviated from this law, he says, may be
traced to an organic, or merely to a nervous derangement of the
ovaries, or of the womb; so much so, that when these diseases
are cured, the menstrual function resumes its most habitual
type. In one-half of the three-weekly cases which fell under
his observation, this frequent recurrencc was explained by the
presence of ovario-uterine disease of an organic nature, or of
chlorosis; in one case which assumed the fortnightly type, the
patient's health was habitually bad. TILT also says, that the
fortnightly, or three-weekly appearance depends sometimes
merely on a disturbance of that nervous force which must preside over this function, as is evident from the fact, that in many
cases in which the irregularity could not be explained by the




28                  MENSTRUATION.
presence of organic ovario-uterine disease, he had been able to
restore the function to its normal type by the use of Sulphate
of Quinine. A strong reason which should induce women to
desire that this function should be brought to its monthly type,
is the additional amount of freedom from infirmity which they
acquire, affording them time, taken from suffering, which
might be devoted to the cultivation of talents, and the acquirement of happiness. Thus, supposing 4 days of every
month to be necessarily given to the performance of this function, then 52 days of inconvenience will have to be endured;
but if Menstruation occur every three weeks, there will be 78
days of suffering; or if every fortnight, there will be no less
than 104 days thus occupied.-TILT.
TREATMENT.-NUX, Sabina, Aconite, Merc. sol., the Magnet, Platina, and Bryonia, have been decided to be homceopathic when the menses tend to return again almost immediately: viz., Flux, when the menses, which have ceased for one
day, return again for some hours. Sabina, when a profuse
menstrual flow is apt to set in about three days after the
menses have ceased, attended with severe labor.like pains,
the blood being partly thin and fluid, partly coagulated, the
urine being scanty and red, with strangury, and a leucorrhoeal
discharge. Aconite, when the menses cease for a day, and
then come on again suddenly, and profusely. Mercurius sol.,
when the menses appear again at the end of 6 days. Application of the Magnet was followed on the next day by the
i-eappearance of the menses, which had ceased for some days,
and continued to flow for 10 days more; in another instance,
the menses, which had ceased to flow for 10 days, came on
again the next day after the application of the Magnet, but
only continued for the usual time. The use of Platina was followed on the same day by Menstruation, which was 6 days too
soon, and instead of continuing only 3 days, as usual, it
persisted for 8 days, attended with a drawing and very
unusual pain in the abdomen. The use of Bryonia is said to
be followed at times by the reappearance of the menses in
the course of a few hours, as much as 8, 14, or even 21 days




FREQUENT MENSTRUATION.             29
days before their regular time. The use of Platina is said to
have been followed on the second day of Menstruation, in a
case in which there was usually no pain, and the flow was
generally quite scanty, by a violent pressure upon the womb,
and incessant discharge, attended with griping in the abdomen, and bearing-down pain in the groins.
When. Menstruation occurs every 3 weeks, Bryonia, Moschus, Cocculus, Pulsat., Sanguinaria canadensis, and Benzoic acid, are regarded as the most homoeopathic remedies.
Brvonia is indicated when the menses set in 8 or 14, or 21
days before their time. Moschus when they come on six days
too soon and are very profuse-merely smelling of this drug is
said to have brough ton Menstruation. Cocculus when it sets
in 7 days too soon, attended with distension of the abdomen, and cutting, contractive pains in the bowvels from every
movement or respiration, and with spasmodic constriction in
the rectum; also when it occurs 8 days too early, attended
with distension of the abdomen, and a pain in the epigastric
region, not only from every movement and step, but also while
sitting, with the feeling as if a sharp stone were pressed into
the hypogastric region, with soreness to touch. Pusaltilla is
said to be indicated in some rare cases, when the menses appear 7 days too soon. Benzoic acid, when the menses occur
8 days too soon and are more copious than usual, but last
only 5 days instead of 6 or 7, the discharge being thick and
clotted. Sanguinaria, when they set in a week too soon, the
discharge being more black than natural.
When Menstruation occurs every 14 days, Ipecac., Bryonia,
Nux vom., Nux juglans, lyosc., Ledum, Prunus spinosa, and
Platina, are regarded as the principal remedies. Ipecac. is
merely said to be indicated when the menses are renewed
every 14 days. Bryonia, when they appear 14 days before
their time.d Nux vomica, when they reappear on the 14th day
again, also Hyosc., Ledum and Prunus spinosa. Nux juglans,
when they set in at the end of a fortnight, with pressing and
drawing pains in the uterus, and abundant loss of blackish
coagulae. Platina, when the menses, which usually come on




30                     MfENSTRUATION.
every 3 weeks, very moderately, reappear at the end of 14
days, and are very profuse.
According to HEMPEL'S Complete Repertory, Sulphuric acid
is indicated when the menses occur too soon, and are too profuse. Sulph ur, under the same circumstances, especially when
they are preceded by chilliness.   Oleum animale, in premature Menstruation, attended with pinching pains and colic.
Nux vomica, when abdominal spasms are present. Kali carb.,
in premature Menstruation, when accompanied with debility
and drowsiness.  Kali bichrom., when premature Menstruation is attended with vertigo, nausea, feverishness, and headache. Graphites, when it occurs too frequently, and is too
thin. Asarum, when it happens too soon, and is long continued. Cantharides, when it recurs too frequently, and is profuse and black. Niccolum, when colic and pain in the small
of the back are present. Kreosote, when frequent Menstruation is succeeded by a discharge of acrid and bad smelling
ichor, causing corrosive itching and smarting of the parts.
Laurocerasus, when menses set in too soon, with a profuse
and painful discharge of fluid blood, and nocturnal tearing
pains in the top of the head. Borax, when there is premature
Menstruation, with colic, nausea, and pain extending from
the stomach, to the small of the back.
Dose.-1 cr 2 drop doses of the 1st, 2d, 3d, or 6th dilution of Aconite, or of Bryonia, or Cantharides, Cocculus, Hyosc., Ipec., Kreos~ote,
Laurocerasus, Ledum, Nux juglans, Nux vomica, Prunus spinosa, Pulsat., Sabina, Sanguinaria, or of Sulphuric acid, may be given once or
twice a day during the interval, and every 2, 4, or 6 hours during the
flow, according to the severity of the symptoms. The lower dilutions,
and stronger doses of Aconite, Bryonia, Cocculus, Ipecac., Kreosote, and
of Sulphuric acid, may be given, than of the other remedies, as some of
these are rather styptic and antipathic in their action.
The 1st, 2d, 3d, or 6th trituration of Benzoic acid, Borax, Graphites,
Kali bichrom., Kali carb., Merc. sol., Niccolum, Oleum animale, Platina,
or of Sulphur, may be used at the same intervals of timid as above directed. Or, from 2 to 5 granules may be given per dose, of the remedy most indicated among those just mentioned, and repeated at the
same intervals of time.




PROFUSE MENSTRUATION.             31
PROFUSE MENSTRUATION, AND MENORRHAGIA.
ASHWELL, in 1,149 cases of uterine disease, met with 79 examples of profuse Menstruation; MADDEN, in 181 cases, had
43 in which the menses were too copious, and 7 with too prolonged a flow.
Formerly, great stress was placed upon the supposed difference between profuse Menstruation and uterine hernorrhage.
Even LooMIs says: "So long as the discharge contains nothing but menstrual fluid, however profuse it may be, it is
still Menstruation, and is the most simple unnatural deviation.
If, however, the discharge be mixed with blood, we have a
more severe form of disease. And if the discharge be pure
blood, unmixed with the catamenial secretion, we have a still
higher grade." If WHITEHEAD'S experiments be reliable, and
there is every reason to suppose that they are so, then there
is no absolute difference between profuse Menstruation and
uterine hemorrhage. (See p. 20.)
Quite a number of varieties of profuse Menstruation have
been described by various authors; the spasmodic and congestive forms, however, have generally been considered the
most important. Latterly, the disease has been considered, by
one class of physicians, as'entirely dependent upon previous
derangement of the ovaries; by another class, as always the
consequence of inflammation and ulceration of the neck of
the womb. ASHWELL places great stress upon the presence
of a soft and flabby condition of the vagina and uterus, with
leucorrhcea, the mouth of the womb being slightly more patulous than usual, but without tenderness or induration. In
long-continued menorrhagia, especially in females over 30 or
40 years of age, the presence of a polypus, or malignant disease of the neck of the womb, should always be suspected and
examined for.
According to ASHWELL, young females are less liable to the
disease than those more advanced in life; still, TILT found
first Menstruation to begin with a considerable flow in 30 per
cent.; while in 8 per cent. it was said to have amounted




32                   MENSTRUATION.
to a flooding, and lasted from 8 to 10 days. The plethoric
and robust are less frequently subjected to these profuse
discharges than females of delicate, susceptible, and feeble
constitutions; still, ASHWELL places some stress upon derangement of the liver, coupled with a costive and loaded condition of the bowels, consequent upon luxurious living, and inattention to the state of the bowels.
I consider it entirely unnecessary to give a dull detail of the
well-known symptoms which accompany profuse Menstruation in general, but will content myself with succinctly describing the most important pathological varieties of the disorder.
1. Ovarian Variety.
As ovarian ovulation is almost always' synchronous with
Menstruation, it is to be supposed that menorrhagia will be
the most common attendant of congestion or inflammation of
the ovaries, especially in irritable and nervous women; these
are said to form the most obstinate and tedious cases. It is also
assumed that there can be no doubt that copious menstrual
losses, with double or inter-menstrual periods, are a frequent
result of ovarian irritation and congestion; profuse Menstruation is the most common result of these disorders; painful
Menstruation is the next in frequency; while the amenorrhoeal
type is a rare affection. CLARus has even described a hbemorrhagic variety of ovaritis. In simple and nervous ovaritis,
besides the pains about the affected ovary, there are remarkable nervous symptoms, which often mislead the physician to
think that he has to deal with hysteria only. But in the haemorrhagic variety, the nervous symptoms are slight, while the
vascular are prominent; the pain and burning in the ovary
are also more violent; there is drawing pain along the round
ligaments, and at times even the labium of the affected side
swells; there is also hlemorrhage from the uterus, which sets
in every 8, or 10, or 14 days, with excessive violence, and
rapidly leads to anaemia and exhaustion, so that the extremities are apt to become cold, the face pale, and the pulse
small, weak, and trembling.




PROFUSE MENSTRUATION.              33
2. Ulcerative Variety.
BENNETT says that profuse, prolonged, and too frequent
Menstruation, is universally considered to be solely the result of
an active or passive state of congestion of the uterus; that
is, when it is not occasioned by malignant disease, or by the
presence of polypi, or uterine tumors.
This, the general opinion of both ancient and modern pathologists, is founded on ignorance; in reality, in the absence of
malignant disease, polypi, or uterine tumors, the quantity of
blood lost during Menstruation is seldom permanently increased so as to constitute hbemorrhage, and the menstrual
periods are seldom materially prolonged and frequent, unless
some chronic, inflammatory, or ulcerative disease of the neck
of the womb exist, provided Menstruation be not finally disappearing. BENNETT asserts roundly, that this assumption, on
his part, is not the result of theory, but of scrupulous observation, and must become equally evident to all practitioners who
will accurately investigate the uterine organs of patients so
affected. Congestion of the womb exists, it is true, in menorrhagia, but it is nearly always the result of inflammation of
the neck of the womb, and assumes an active or passive character, according to the natural constitution of the patient, and
to the amount of reaction produced by the disease on the system at large. If the inflammation of the neck of the womb
be of an active nature, and has not had time through its consequences to debilitate the patient, the bleeding will be considered active, or sthenic; if, on the other hand, the disease
of the neck has existed for a long time, and caused debility
and bloodlessness, then the haemorrhage will be pronounced
asthenic.-BENNETT.
Profuse hkemorrhagic Menstruation may occasionally occur,
however, from mere congestion of the uterus, apart from inflammatory disease, as'is occasionally seen when Menstruation is ceasing. At the same time, it must be understood that
these remarks about the dependence of profuse Menstruation
upon ulceration of the neck of the womb, do not apply to
females with whom profuse Menstruation is a natural condiC




34                  MENSTRUATION.
tion, or to those who experience a haemorrhagic show on particular occasions, as after mental emotions, violent exertion, or,
some other accidental, and temporary cause.
At the change of life, however, when Menstruation is about
to cease definitely, and naturally becomes irregular, profuse
menstruation, amounting to flooding, is not uncommon from
congestion only, without the presence of any local inflammatory, or ulcerative disease. At this period the menses are apt
to disappear for two or more months, and then return again
with excessive abundance. It is very seldom, however, even
at this period of life, that haemorrhagic menstrual fluxes occur
repeatedly, in the absence of polypi, tumors, or malignant
disease, unless there be inflammatory ulceration of the neck
of the womb. In nearly all the instances of very obstinate
flowing at the change of life, which BENNETT meets with, he
finds on examination, that the congestion and hemorrhage
are kept up by inflammatory ulcerative disease. Some of the
very worst instances of, protracted haemorrhage that he has
ever seen, have been cases of this description. What satisfactorily proves to his mind that the inflammatory ulceration
is the cause of the continued hemorrhage is, that as soon as it
is cured, the haemorrhage ceases.
According to BENNETT, inflammatory ulceration of the neck
of the womb is also a common cause of haemorrhage during
pregnancy, and this fact offers an easy and natural explanation of the presumed Menstruation of pregnant females. In
those pregnant females for whom he has been consulted, owing
to the presence of this phenomenon, he has, on examination,
nearly always found, that the blood escaped from an ulceration
of the neck of the womb; such ulcerations being peculiarly
turgid and luxuriant during pregnancy.
3. Climacteric Variety.
ASHWELL thinks that enough attention has not been paid to
this form, although it differs so much from the others, that it
is a matter of surprise to him that its peculiarities should
have been only slightly noticed. He says, it often continues




PROFUSE MENSTRUATION.              35
long, occasionally for several years, and frequently in alarming excess. It is often preceded and followed by large, watery, and leucorrhceal discharges, and pain in the uterine and
lumbar regions is a common accompaniment. Its sympathetic
effects on the brain, lungs, and heart, are occasionally severe,
and when the disease has continued long, there is generally
coldness of the hands and feet, a feeble and quick pulse, and an
anxious, pallid, and sunken countenance. The malady is not
confined to one class of women; the plethoric are not more
prone to it than the debilitated, and irritable; it rarely or
never occurs before 38 or 40 years of age, and sometimes
sets in again after Menstruation has been supposed to have
ceased.
In mild cases, the symptoms already described terminate
after a more or less protracted continuance in the entire cessation of Menstruation; in other and more obstinate examples
the symptoms are so extreme as to excite real apprehension.
The recurrence of the bleedings is uncertain, although, in general, a catamenial period will be partially observed; occasionally the flow continues for many weeks or months, without
any complete cessation, the only appreciable change consisting in a diminished flow; or the discharge may become either
watery, or leucorrhceal, or perhaps slightly, or offensively odorous. In many cases there will, at the expiration of a fortnight, or mid-way in the interval between regular monthly
periods, be a peculiar, acute, bearing-down pain in the lower
part of the uterus, which many patients correctly learn to regard as indicative of a repetition of the menorrhagia. ASHWELL had met with more than several instances, where such
hsemorrhages, alarming in degree, have continued for 12, 18,
24, or 48 months, and have ultimately ceased, good health
being restored.
In the majority of cases, some enlargement of the uterus,
fulness of the neck, and openness of the os, constitute the
whole of the diseased change in the womb.
The only other varieties generally admitted are: Ist. The
acute, or active menorrhagia, occurring in the plethoric and




36                    MENSTRUATION.
robust; 2d. The passive, or chronic form, occurring in delicate, hysterical, and exhausted females. A variety characterized by the dischprge of what is supposed to be blood and
coagulae, in contradistinction to menstrual secretion, has
already been alluded to; there is in reality more difference
in quantity, than quality.
TREATMENT.-It is very important that all cases of profuse
Menstruation, or menorrhagia, should be subjected to careful hygienic, or medical treatment. The patient may do
much for herself, without consulting a physician, if she will
but spare herself as much as possible for a few days before
and during the flow; but moderate exercise, and little labor,
especially lifting, should be permitted; warm drinks, even of
black tea, should be avoided; cold water, or cold, and even
iced tea should be taken; injections of cool or cold water
into the bowels may be used with benefit, especially if the
bowels be costive; tepid, or cool vaginal injections, will often
relieve the congestion of the womb, without risk of suppressing the discharge too suddenly. In more severe cases, the
recumbent posture, with light clothing, are imperatively required.
ACONITE
Is recommended in cases in which there is arterial excitement, or great irritability; CHURCHILL says that M. WEST DE.SOULT has published some facts in favor of Aconite as an emmenagogue. LooMis says, it is indicated when there is simply
-an increased flow of the natural discharge, or if there be no-,thing but blood passed at the menstrual period, especially if:the patient has a yellowish viscous leucorrhcea during the
interval, attended with a general feverish condition.
Dose, — As I regard Acon. as antipathic to arterial excitement, 1 or
2 4rops of the tincture, or of the 1st, 2d, or 3d decimal dilution, may be
given every 2, 4, or 6 hours.
AURTTM
Is recommended by Loomis, if the system has been abused
by Mercury, or if there be a syphilitic taint, and especially if




PROFUSE MENSTRUATION.                37
the neck of the womb be indurated. It perhaps would be no
less suitable to that very much larger class of cases in which
there is a soft and flabby condition of the'vagina and uterus,
with leucorrhcea, the mouth of the womb being slightly more
patulous than usual. CA.RRON DE VILLARDS used the Cyanuret of Gold successfully in amenorrhcea, commencing before
the expected menstrual period; he solved 3 grains in 8 ounces
of alcoholized water, and gave a teaspoonful twice a day,
gradually increasing the dose. The metallic gold- produces a
feeling as if the menses would set in, with labor-like pains in
the abdomen; the muriate facilitates the flow of the menses,
and causes an earlier occurrence, more profuse flow, and
longer continuance of them. VOGT says, if given just before, or
soon after Menstruation, it is very apt to cause uterine haemorrhage. RIECoE says, that it acts powerfully upon the hoemorrhoidal and menstrual flows, while FUNARI, LEGRAND, SOUCHIER, and others, have used it allopathically in amenorrhcea.
If given in full doses, it is apt to induce persistent heat in the
stomach, increase of appetite, fall, strong pulse, general excitement of the nervous system, sleeplessness, restlessness in the
legs, loquacity, redness of the face, starting up from sleep,
vertigo, increased flow of offensive, thick, and sedimentous
urine, or else an abundant discharge of clear and beautiful
amber-colored water, with increased warmth in the vulva,
congestion to the pelvis, excitement of the genital organs, dry
tenesmus, and increased warmth and moisture of the skin.
DOse.-NOACK advises 1 or 2 grains, per dose, of the 1st, 2d, or 3d
triturations, dry upon the tongue, every 3d night during the 1st week
of the interval; every 2d night during the 2d week; every night during the 3d week, and from 1 to 4 times a day during the flow. Or, 2
or 3 globules may be given as often.
ALOE.
This is one of the most homnceopathic remedies to menorrhagia, especially when connected with portal congestion and
haernorrhoids. BRAITHWATrE says, that it acts upon the portal
system may fairly be deduced from the very peculiar state
into which the haemorrhoidal vessels are thrown by the con



38                  MENSTRUATION.
gestions which so rapidly occur after a dose of this drug has
been taken, and also by the condition of the uterine vessels,
which has led to its employment as an emmenagogue. It is
apt to irritate the rectum, giving rise in some instances to
haemorrhoids, and also has a decided tendency to the uterus,
for its influence in promoting Menstruation is by no means
confined to cases in which its action on the neighboring rectum is most conspicuous.-(WooD & BACHE.) CULLEN says,
that it is apt to excite heat and irritation about the rectum,
with tenesmus, and bring on a sanguineous discharge. PEREIRA asserts, that it causes a determination of blood to the
uterus, and fulness of its blood-vessels, especially of its veins,
and thus uterine irritation and menorrhagia are apt to be induced, and increased by it. WEDEKIND and FOTHERGILL say,
that it exerts a specific stimulant action on the venous system
of the abdomen and pelvis, causes increased secretion of bile,
irritation about the rectum, vascular excitement of the sexual
organs, piles, strangury, immoderate flow of the menses, racking pains in the loins, and labor-like pains. SOBERNHEIM says,
that the congestive power of Aloe may go so far as to
cause a flow of blood from the kidneys, uterus, and rectum.
DIERBACH says, in young persons it readily excites febrile
symptoms, with a quick pulse, and troublesome sensation of
warmth in the abdomen. HARNISCH and NOACK say, that it
may cause burning when urinating, violent pain in the kidneys, scanty and hot urine, discharge of blood from the urethra, tenesmus, aching, and heaviness in the pelvis, aching and
burning in the sacral region, erections and pollutions, excitement of the hbemorrhoidal and uterine vessels, and even a
similar action in the whole vascular system, so that the pulse
will become fuller and harder, the mouth dry, with throbbing
and aching in the region of the liver, and congestion of blood
to the head and chest.
Still, EBERLE says: Would not Dr. DEWEES consider Aloe a
very improper allopathic remedy in the menorrhagias of
young, sanguineous, and robust females? He no doubt would,
and why? Because experience has shown that this drug is




PROFUSE MENSTRUATION.                 39
among the most efficient agents for exciting the uterine vessels, and directing the afflux of blood to them. Yet this very
medicine, given in small doses, but frequent ones, deserves to
be accounted the best remedy we possess against those protracted, exhausting, and obstinate haemorrhages from the uterus, which occur in females of nervous, raxed, and phlegmatic halits, about the critical period of life." —EBERLE.
DoSe.-NOACK recommends 1 or 2 drop doses of the pure tincture,
or of the 2d or 3d dilution; or from 3 to 5 granules may be given,
every A, 1, or 2 hours, in severe cases; once or twice a day in sub-acute
attacks.
BELLADONNA.
According to LooMIs, it will be especially indicated if the
erect posture, or walking produces a pressure downwards of
the internal genital organs, attended with shooting pain, particularly if there is a severe throbbing and pressing pain in
the head, with fulness and a sensation of swimming, in the
brain; or if there be prolapsus or induration of the uterus, dryness of the vagina, and the menses return too frequently, and
are made up of clear red blood, and fetid clots. It is very certain, however, that Bellad. does not exert nearly so specific an
action upon the uterine organs as Stramonium, although it has
been recommended from experience, against profuse and premature appearance of the menses, and in menorrhagia, when
accompanied by a painful pressure upon the womb, violent
pain in the small of the back, and the discharge is rather
dark and coagulated.  It has also cured cases of profuse Menstruation brought on by exertion in heavy lifting, when there
was violent pain in the whole abdomen, the discharge being
so copious that bright red blood flowed continuously in a thin
stream, the pulse being full, hard, and frequent. Belladonna
causes such violent congestion to the head and upper parts of
the body, that it may almost be supposed to exert a derivative
effect in congestions to the womb and pelvic organs.
Dose,-It is probable that larger doses of Bellad. are required in
affections of the lower part of the body, than in those of the upper.
NOACK prefers 1 or 2 drop doses of the 1st, 2d, 3d, 6th, or 12th dilu



40                    MENSTRUATION.
tion, repeated every 2, 3, or 4 hours, in sub-acute attacks; every 5, 10,
15, or 30 minutes, in very severe cases. If preferred, from 3 to 6 pellets may be dissolved in a wineglassful of water, and a teaspoonful given
as often as above directed; or 2 or 3 granules may be given dry
upon the tongue. In BEAUVAIS' Clinique, of 106 cases of profuse
Menstruation, only 2 were treated with Bellad.; in both instances the
30th dilution was uped, but the cases progressed in severity until the
expulsion of large clots from the womb brought relief.
BRYONIA.
We have already seen that this remedy is homoeopathic to
frequent Menstruation; it has also been found useful in menorrhagia and abdominal sufferings, brought on by a blow
upon the abdomen, when there was a continual sanguineous
discharge from the vagina, which increased to haemorrhage
every three weeks, attended with burning pains in the stomach, increased by every motion, and becoming intolerable
from the least exertion, attended with paroxysms of anguish and chilliness. It was also useful in a case of profuse
Menstruation, brought on by the excessive use of herb-teas;
after several pounds of blood had been lost, the patient's face
being pale and sunken, her strength gone, pulse variable,
now hard and irritable, then small and weak; attended with
violent burning pain in the small of the back, but commencing at the pit of the stomach; with paroxysmal, violent
pressure in the abdomen, nausea, vertigo; discharge of large
lumps of dark and coagulated blood without pain, while walking, and even while lying down; no appetite, costiveness,
sleeplessness, and frequent chills.
Bryonia is allied to Colchicum in its action, and is homceopathic to profuse Menstruation occurring in rheumatic subjects, and those disposed to rheumatic diarrhcea. KASPAB:
thinks that Bryonia has no affinity for the sexual organs, ex.
cept in so far as the serous envelopes are affected; but it is
undoubtedly homeopathic to profuse Menstruation from a
rheumatic affection of the serous and muscular coats of the
uterus.
)Ose. —NOACK says, 1 or 2 drops of the pure tincture of Bryonia,
or of the 1st, 2d, or 3d dilution, may be given frequently in acute




PROFUSE MENSTRUATION.                   41
cases; once or twice a day in chronic affections; or 2 or 3 granules
may be given dry upon the tongue; or 5 or 6 globules may be solved in
a wineglassful of water, and 1 or 2 teaspoonfuls given as often as above
directed. In BEAUVAIS' 106 cases, Bryonia was only used 5 times;.
the 15th dilution in 2 cases, the 18thin 1, and the 30th in 2 cases; in 4
cases it was only given after the discharge had been moderated by Crocus, China, or some other remedy; in the 5th case, it relieved the most
violent rheumatic and spasmodic affection of the uterus, attended with
profuse discharge of blood.
CARBO ANIMALIS
Cured a case of profuse Menstruation of 16 months' standing, after many other remedies had been used in vain; the
discharges recurred at intervals of 8 or 10 days, being fetid
and putrid, the patient was also affected with a painful hardness in the region of the liver, and with intense pain around
the small of the back, and in the groin.
Dose.-NOAcK says, that 1 or 2 grains may be given dry upon the
tongue, once or twice a day, in chronic attacks; it is rarely used in
acute affections. Or from 2 to 4 granules may be given every night
and morning.
CHAMOMILLA.
This remedy may be regarded as the " Catnip of Homeeopathy."  VOGT classes it among the Excitantia volatilia, or
those remedies which cause a transient arousing of the irritable system. It is supposed to act principally upon those
splanchnic nerves which ramify in the cavities of the abdomen and pelvis; still its action is so gentle that it is decreed
to be rarely useful in severe and obstinate cases. In old-school
practice it has been principally used'against nervous pains,
especially in colics, hysterical spasms, spasmodic affections of
females occurring during Menstruation, or before or after confinement, in spasms of the chest or heart, in hysterical asthma,
slight rheumatic pains and colics. It is regarded as important, if Chamomilla be expected to afford relief in these affections, that they should have just commenced, not be very
severe, and arise from accumulation of wind in the bowels, or
be of a rheumatic or nervous character.




42                   MENSTRUATION.
LooMrS thinks that it is peculiarly adapted to that excessive
sensibility of the nervous system, which precedes and accompanies the flow, in nearly all cases of menorrhagia from irritable uterus. If administered on the first indication of the approach of the menses, either alone or in alternation with Coffea, Nux, or Pulsatilla, it will often mitigate the sufferings
very much, although it will do but little towards removing
any organic change in the uterus, or ovaries. It is best suited
to those cases where the pains are spasmodic and paroxysmal,
resembling labor-pains. It is most useful against the sufferings which precede the commencement of the menstrual flow,
although if there be excessive irritation of all the sexual
organs, with much itching, it may be beneficial during the
flow, especially if there be a profuse discharge of mucus with
the menses. LEADAM thinks Chamomilla is to be preferred
when the discharge of blood is dark, blackish, and coagulated,
occurring in gushes, with pressure upon the womb like laborpains, attended with frequent desire to pass water, and drawing or tearing pains in the thighs and legs; with irritability.
of temper, fainting fits, coldness of the limbs, paleness of the
face, and thirst. It has relieved some cases of menorrhagia
after parturition, even when the patient was almost unconscious from loss of blood, the face and body being cold and
pale, the pulse scarcely perceptible, and the blood flowing violently. Also, cases of metrorrhagic Menstruation, when the
blood flowed continuously, intermixed with large, black coagulae, the whole having a fetid smell; when the pulse was full
but not hard, great weakness being present, with roaring in
the ears, dimness of sight and heaviness of the head, followed
by fainting fits whenever the patient attempted to raise herself;
in some of these cases, Nux may be required for constipation,
and China must be used to remove the subsequent debility.
Although Cham. and' Coffee are said only to relieve slight
and recent cases, yet they have cured one very severe case.
A woman, aged 32, had suffered for 3 jmonths with metrorrhagia, to such an extent that fainting ensued, and the patient
was thought to be dead. On the physician's arrival, he found




PROFUSE MENSTRUATION.                  43
the tapers already lighted, and a number of ladies engaged
in prayer around the bed; her pulse was almost imperceptible, as also the motions of the heart; five or six spoonfuls of
black Coffee were introduced successively into the patient's
mouth, whereby consciousness was restored in a quarter of an
hour. On the following morning, a dose of Chamomilla was
given, which stopped the bleeding and completed the cure.Brit. Jour. Horn., vol. 8, p. 426.
Dose. —In the above cases, the 3d and 4th dilutions were used.
It is, however, such a very mild remedy, that several drops of the pure
tincture may be given every i, 1, 2, or more hours; or the same quantities of the 1st, 2d, or 3d dilution may be used for very sensitive persons. In the very rare cases in which these, or still stronger doses do
not suffice, the higher dilutions may be tried, 2 or 3 globules to be
given dry upon the tongue, as often as above directed. In BEAUvAIS'
106 cases, Cham. was used only 7 times; the Tinct. in 1 case promptly
relieved a hmemorrhage -of 3 weeks' duration; the 4th dilution was
given in 1 case; the 6th in two cases; the 9th in 1; and the 12th in
2 cases, but mostly with equivocal success.
CANTHARIDES.
LooMIs says that this remedy will prove useful when there
is a discharge of black blood, attended with severe pains, especially if there be swelling of the nieck of the womb, accompanied with corrosive leucorrhcea both before and after Menstruation, and by burning pain when urinating. There is a great deal
of old-school experience in favor of the use of Cantharides in
amenorrhcea and scanty Menstruation, but little or none in profuse Menstruation. DEwEEs says, when Madder fails in amenorrhcea, he commences in recent cases with Tincture of Cantharides, in doses of 35 or 40 drops, and rarely increases the
quantity more than 10 or 15 drops beyond the original dose, as
the former moderate (!!) doses have always been found sufficient
by him when the medicine would succeed at all. PEREIRA
says, in consequence of the specific stimulus communicated
to the bladder by Cantharides, it has been supposed that the
same influence might ]be extended to the womb, and thus this
remedy has been employed as a stimulating emmenagogue;
in some cases with apparent benefit, but frequently without




44                   MENSTRUATION.
any obvious effect. Abortion has occasionally happened from
its employment, as PEREIRA himself witnessed in one case.
WooD says, in old cases of menorrhagia, where the uterus is
very feeble and relaxed, remedies calculated to stimulate this
organ directly have been recommended, such as Aloetic preparations, and even Cantharides and Sabina; but these must
be employed with great caution, i. e., in small or khomceopathic doses. A writer in Wood's Quarterly Retrospect says,
in asthenic menorrhagia, Cantharides is a powerful and efficient medicine, and, combined or alternated with Nux vomica, it is capable of relieving the patient in a short time; he
advises the tremendou's doses of from 36 to 60 drops of a mixture of equal parts of Tinct. Cantharides and Tinct. Nux
vomica, to be given 3 times a day in sugar and water; orthe
Cantharides may be given alone; and as soon as the flow
ceases, Ferrum or China are advised to obviate the consequent debility.
DOSe.-NOACK recommends 1 or 2 drop doses of the 1st, 2d, 3d, or
6th dilution, repeated once or twice a day in chronic cases, although
they may be given every i, 1, or 2 hours in more urgent attacks. For
very susceptible persons, from 1 to 3 granules may be given as often as
above directed.
CHINA.
This remedy, according to LEADAM, is useful when the discharge is black and clotted, occurring at intervals, with pressure upon the womb, and jerking movements of the body,
proceeding from depletion rather than spasm, and attended
with painful tension of the abdomen; or when the following
symptoms arise in consequence of great loss of blood: sense
of weight in the head, vertigo, dulness of sensibility, and
drowsiness, the patient being cold and blue; it may also be
given after the attack has passed over, or during the intervals
between the frequent returns of the menses, as part of the
constitutional treatment. It proved useful in one case, in
which there was continual dizziness, with headache over the
whole head, constant glittering before the eyes, humming in
the ears, dryness of the mouth without thirst, pain in the ab



PROFUSE MENSTRUATION.                   45
domen resembling labor pains, extending from  the small of
the back to the bladder,; desire to urinate, with scanty discharge; scanty and hard stools, with much pressing; unusual
debility, sleeplessness, frightful dreams, palpitations of the
heart, and anxiety; constant chilliness, with coldness of the
hands and feet; forgetfulness and anxiety, with fear of dying;
all proceeding from, and attended with continual discharge of
blood and clots from the uterus and vagina.
Dose,-The 16th dilution was used in one case. NOACK advises 1,
2, or several drops, per dose, of the pure Tincture; or the same quantities of the 1st, 2d, or 3d dilution, repeated every i, 1, or 2 hours in
severe cases; every 2, 4, or 6 hours in milder attacks. In some cases,
from 2 to 5 globules may be given as often. In BEAUVAIS' 106 cases,
China was used 17 times, mostly to relieve the subsequent debility after
the hemorrhage had been stopped by other remedies. The 12th dilution was used in 7 cases, relieving the debility about as promptly as if
full doses of Bark had been given; the 2d dilution in 1 case; the Tinct.
in 2 cases; 6th in 1 case; 15th in 2 cases; 16th in 1 case; 9th in 1
case. In 1 instance only did it exert a marked influence upon the flow,
when given in a high dilution.
CALCAREA.
According to LEADAM, it will be found useful when the
menses are too profuse, or too frequent in their recurrence,
and the patient has a scrofulous diathesis.  HAHNEMANN says,
that it will never be given with benefit when there is a deficiency of the menstrual fiowv. It is knore beneficial when
given during the interval, in order to correct that condition
of the uterus and general system upon which the unnatural
state of the menstrual function depends; it may be given
alone, or in alternation with China, Nux and Sulphur.
LooMIS says, that Calcarea is one of the most important remedies in certain conditions of the uterine organs, when attended
by profuse and premature discharge; but it is seldom indicated when there is an irritable uterus. If, however, there be
shooting pains about the mouth of the womb, with aching
pain in the vagina, and a sensation of bearing down, or if
there be a burning pain in the womb, it will be of use to administer a single dose during the interval; he says a single




46                  WMI:NSTRUATION.
dose only, because he has never repeated Calcarea with advantage in cases where the menses returned too soon, or were
too profuse, but, on the contrary, a repetition of the dose has
invariably made the case worse.
But Dr. PATZACK has rendered himself famous by his
methodical use of Calcarea, aided by Nux, China, and Sulphur. He says, it is of great importance to give remedies
during the period intervening between the catamenial discharges, in consequence of which it is generally unnecessary
to act during the flow. Nux vom., China, Sulphur and Calcarea have proved eminently successful in his hands, not
only in regulating the menses, but also in removing the bad
consequences of a too frequent and too copious hkemorrhage,
both in the organs of generation, and in the system generally.
He adopts the following methodical use of these remedies:
on the evening of the 1st day after the cessation of the
menses, he gives a dose of Nux vom.; thirty-six hours afterwards, he administers a dose of Chhna in the morning; in
thirty-six hours more, another dose of Nlix in the evening,
and so on; this alternation of Nux and China, every thirtysix hours, is persisted in during the first half of the intermenstrual period. The treatment of the latter half of the
interval is begun with a dose of Sulphur, followed in 2 days
after by a dose of Calc. carb., after which these two medicines
are continued alternately during the remainder of the latter
half of the interval. PATZMCJK says, that the effect of this
treatment, even in cases of very long standing, was most surprising to him, viz., a speedy restoration of the general health,
and a more regular appearance and duration of the recurring
catamenia. It will of course be seen, that he not only does
not fear, but practically does not meet with the bad consequences from a repetition of the doses of Calcarea, upon
which so much stress'is laid by LooMIs.
PATZACK corroborates his assertions by the recital of several cases:
CASE 1. Baroness C., aged 27, lively and somewhat delicate, had had 5 confinements within 6 years, flowed excessively




PROFUSE MENSTRUATION.               47
each time, and had suffered with piles. As she did not
nurse her last child, the catamenia appeared soon after parturition, very copiously, and continued to do so whenever she
was not pregnant. Ipecac. relieved an attack of flowing; Nux
and China improved her strength and relieved the piles;
afterwards she took Sulphur and Calcarea in alternation, with
such good effect, that the menses were nearly natural at their
next appearance, and she wVas completely cured in a few
months.
CASE 2. ]Baroness R., a sister of the above, also delicate,
had lost much blood 6 years before at a confinement, and
never since had been able to regain her former strength; her
menses had also become not only too copious, but also of too
long duration; she had continued pressing, and gnawing
pains in the regions of the ovaries, but more particularly on
the left side, which were aggravated by any mental or physical
excitement, especially just before Menstruation, to such a degree that they spread over the whole abdomen, in the region
of the bladder, in the lumbar region, and downwards from the
hips, so that it was impossible for her to take any exercise.
Sulphur and Calcarea, continued for 3 months, completely
restored her, with the exception of the pains in the ovaries,
which were finally, and perfectly relieved by Bryonia.
CASE 3. Mrs. A., aged 30, of feeble constitution, had
suffered for years with too copious and firequent Menstruation, to which leucorrhcea had been added for the last year;
and cardialgia, with pressing pains extending to the back, for
the last 5 months. She also had nausea, without actual vom-.
iting, and her bowels were obstinately costive. She was entirely cured in 2 months by the above remedies.
CASE 4. MIrs. Von B., aged 34, had menstruated too copiously ever since the first appearance of the menses, but still
more so since her marriage. As a consequence of such excessive loss of fluids, she had an extraordinary degree of sensibility of the nervous system, so that even trifling causes,
particularly fright and anger, would produce an unusual
degree of excitement in the vascular and nervous systems,




48                     MENSTRUATION.
such as palpitations, trembling, pain in the stomach, headache, the most violent toothache, &c.; she also had great debility, irritability, and low spirits. She too was cured by the
above remedies.
CASE 5. Mrs. W.. aged 40, of vigorous constitution and
large frame, had miscarried several times, been troubled with
too copious and frequent menstrual discharge, great debility,
and frequently returning and most violent cardialgia, for the
last 15 years. Nux did not benefit her much, but after the first
few doses of China, she mended rapidly; Sulphur and Calcarea were then given, and the next Menstruation occurred
later, and lasted only 5 days. She recovered perfectly, and
did not relapse in 24 years.
CASE 6. Mrs. F., aged 35, apparently in vigorous health,
had suffered with excessive general weakness since the birth
of her 5th child; to this was added vertigo, frequently accompanied by violent headache, for which she had been bled
repeatedly; besides this, her menses returned very copiously
every a weeks. She improved much in 4 weeks, and finally
recovered completely, under the use of Nux, China, Sulphur,
and Calcarea.
Dose. —Five chronic cases were cured by Calc. 30, 2 doses every
week; the 3d and 4th dilutions have also effected cures when given
every 2 or 8 days, or at longer intervals. NOACK advises 2, or 3 grain
doses of the 1st, 2d, or 3d dilution, to be given once or twice a day, or
only every 2d, 4th, or 6th day. Or from 3 t'o 5 globules may be
given as often as above directed.
CINNAMON
Is often recommended as honceopathic to hbemorrhage
from the uterus, but its action is generally described as
aromatic, carminative, and astringent, and hence antipathic
to many atonic discharges. DIERBACH says, its continued use
is apt to cause costiveness, and that it is supposed to exert a
specific action on the uterus, while the Tannin which it contains renders it a proper remedy in the treatment of chronic
hemorrhages and blennorrhceas, especially of the genital
organs; it has also been used to increase, and sustain labor



PROFUSE MENSTRUATION.                  49
pains, and is thought to be especially useful in chronic uterine
hsemorrhages.
Dose.-It would seem to be downright folly to use as small doses of
this remedy, as of the Be]llad., Arsen., and other powerful remedies, especially in uterine haemorrhage, to which it is not especially homceopathic. Very powerful and strictly homoeopathic remedies may possibly
be used with success in infinitesmnal doses; but very mild, and non-homceopathic medicines must be used in more massive quantities.  The
quantities recommended ia the old school will probably be the safest,
and most effective in profuse Menstruation.
CROCUS.
According to LEADAM, it is an excellent remedy when there
is an escape of black, lumpy, viscid blood, increased by the
least movement, attended with cutting pains deep in the abdomen, extending to the small of the back; one of its most
characteristic symptoms is the sensation of something alive in
the abdomen, in the form of a ball, most marked when the
flowing is most active. It is thought to be suitable in attacks
of profuse Menstruation which have arisen front dancing, or
taking stimulating drinks during the menstrual period; or
when palpitation, anxiety, and melancholy, jerking and creeping in the limbs, thirst, heavy dreams, and starting on going
to sleep prevail. It has cured cases of chronic metrorrhagia,
When there was an almost constant discharge of dark, tenlacious blood, especially early in the morning, intermingled
with black coagul]e, and alternating with a flow of thin, bloody
water, like flesh water.  When there were free intervals of
only 3 or 4 days, during which there was a heavy pain in the
groins; or when there is almost constant pain in the groin,
and drawing in the small of the back; but little appetite,
which is quickly satisfied; sensation as if there were something alive in the epigastric region; frequent attacks of anxiety, with flushes of heat over the whole body, and prickling
in the skin as if perspiration would break out; when the patient is almost always languid and weary; sleeps but little,
has a livid complexion, and sunken cheeks.  Platina may be
required in alternation, if the menses continue to return every
D




50                  MENSTRUATION.
14 days, rather profusely, with colic and labor-like pressing
downwards in the pelvis, although Crocus will generally moderate the discharge at each menstrual period..Crocus also cured a case of menorrhagia caused by fright;
the patient had for 19 weeks passed large quantities of dark,
fetid, black blood, uninterruptedly, but without pain; around
the umbilicus there was a sensation as if a ball were moving
to and fro; she also had a beating pain in the left side of the
head, especially in the morning, affecting the left eye, the
lids of which were inclined to stick together; the loss of blood
had already caused dimness of vision, dizziness, fainting fits,
complete want of appetite, almost continual nausea, and excessive languor; the limbs felt bruised, and the legs were
slightly swollen; the patient was constantly chilly, slept badly, and was costive; her complexion had become sallow, she
was emaciated, sad, obstinate, and ill-humored. Ipecac. assisted in removing the discharge of blood. Nux removed the
constipation; and Ferrum muriaticum the pains and swelling of the legs.
Crocus also cured a case of menorrhagia occurring every 8
days, at new and full moon, the blood being viscid and blackish. Also another case, from being overheated at the time of
Menstruation; the patient already lay as if lifeless, was unable to open her eyes from excessive weakness; her face and
lips were pale, and she fainted away when she attempted to
move; she had headache, chillineus, discharge of dark and
fetid blood from the vagina, without pain; she felt a sensation as if something alive were in the abdomen, was dizzy,
anxious, and her pulse was quick and scarcely perceptible;
her complexion was anaemic and sallow. China 4, removed
the remaining debility.
Of BEAUvAIS' 106 cases, 18 were cured by Crocus, viz., 1
case that had lasted more than a year, was cured in 3 months,
by the 1st dilution; another, which had continued for 6
months, was relieved in 3 days, by the use of the 1st dilution;
a third, of 4 months' duration, was removed in 11 hours, by the
3d dilution; a fourth, of long duration, by the 1st dilution; a




PROFUSE MENSTRUATION.             51
fifth, which had continued 19 weeks, was successfully removed in 20 days, by the 3d dilution; 4 other cases of from several to 9 days' duration, were cured in about 1 day, by the
Tinct.; a similar case was successfully treated by the 1st dilution; 4 cases, of several days continuance, were cured in from
a few hours to 1 day, by the 3d dilution; one case, of several
hours' duration, in a few hours, by the 2d dilution; another, by
the 4th potency; and one, which had lasted for 2 days, profusely, was cured in 2 days, by the 5th dilution. The higher
potencies do not seem to have been used in a single instance.
The celebrated KoPP says, that in his hands, Crocus has
produced rapid relief in several cases of menorrhagia; sometimes he used the 1st or 2d dilution, at other the pure tincture;
in some instances only a single drop was required in order to
diminish steadily, and finally check, a profuse haemorrhage,
without any subsequent bad consequences. Other patients
took 2 or 3 small doses of Crocus at intervals of 12 or 24
hours.
CASE 20. A young lady always menstruated so profusely,
that she was unable to leave her bed. One drop of Tinct.
Crocus generally relieved her in the course of 1 day. —Kopr.
CASE 21. A lady aged 40, was taken suddenly with violent
pains in the back and stomach, followed by such a violent
haemorrhage, that her life seemed in danger; the blood was
black and often came away in large clots. After 1 dose, of 1
drop Tinct. Crocus, the flow lessened considerably on the
same day; on the 2d day, nothing but colored water was discharged; and on the 3d day she was well. —KoPP.
CASE 22. A young lady, aged 16, menstruated with all the
violence of a metrorrhagia. She took 1 drop of Crocus, 1st
dilution, and a similar dose on the next day; she was cured
by the 2d evening.-KoPP.
CASE 23. A lady, aged 42, after using Bryonia 18, Sabina
12, Platina 2, scruple doses of Ferrum carb., and tablespoon-.
ful doses of infusion of Sabina, with very partial success, was;
cured in a few days by Crocus, Ist and 2d dilution. Nux 18,




502                 MENSTRUATION.
was also given several times, and acted upon the bowels every
time it was administered.-Kopp.
CASE 24. A lady, aged 27, from over exertion on the 10th
day after her confinement, was attacked with violent uterine
hamorrhage. Two doses of Crocus 1st, relieved her entirely
in 24 hours.
CASE 25. A lady, aged 42, whose metrorrhagia, with discharge of black blood and clots, had long resisted antiphlogistic and styptic remedies, was cured by two doses of Crocus.
CASE 26. Sabina is regarded as the best homceopathic remedy, when the flow is of a bright red color; Crocus, when it
is dark, black, and colored. A young woman was taken with
flowing on the 2d day after confinement; the discharge was
said to be bright red in color, and a dose of Sabina 18, was
given without benefit. Then 1 dose of Sabina 3, and one of
Crocus 3, were sent; the former to be given if the discharge
was bright red in color; the latter if the contrary was the
case. The discharge was found to be dark and clotted, and
the Crocus was consequently given; improvement set in, in
the course of half an hour, and a cure was rapidly effected. —
RAU.
CASE 27. A lady, aged 36, had suffered with returns of profuse Menstruation for 6 months; the discharge generally lasted about 15 days; 2 doses of Crocus relieved one attack
promptly; and a repetition of the same treatment, at the
three succeeding monthly periods, cured her entirely.-DuPI'AT.
CASE 28. A lady, in the 4th month of pregnancy, was suddenly seized during the night with pain, attended with flooding to an alarming extent; the blood was of a dark color.
Crocus arrested without altogether stopping the discharge;
Belladonna restrained it still more, and in less than an hour
entirely subdued it. It recurred, however, on the following
night to a considerable extent, but was completely stopped by
the same remedies. The lady then went her full time, and
gave birth to a healthy infant. —DUNsFoRD.




PROFUSE MENSTRUATION.               53
Many other interesting cases are given, but they are too
long for insertion here.
It may be well, however, to quote the opinions of various
authors about the action of Crocus. WooD and BACHE say,
that Crocus was formerly considered highly stimulant and
anti-spasmodic; in small doses it was supposed to moderately
excite different functions, to exhilarate the spirits, relieve pain,
and produce sleep; in large doses it may give rise to headache, dizziness, delirium, and stupor., It was also thought to
act powerfully upon the uterine system, promoting Menstruation, and on the Continent it is still used as a stimulant, and
emmenagogue. PEREIRA says it was formerly considered to
be cordial, aromatic, narcotic, and emmenagogue; BOERHAAVE
regarded it as homceopathic to laughing delirium; BERGIUS
ascribed great mental dejection to its use; BOER1HAAVE and
RIVERIUS have declared, that they have seen immoderate uterine hmmorrhage produced by it, which proved fatal in one
case. It was at one time esteemed as an anti-spasmodic in
asthma, hysteria, and cramp in the stomach, and was used as
an emmenagogue, and to promote uterine contraction and the
lochial discharge; lastly, it has been employed as a stimulant
to the nervous system i; hypochondriasis. NELIGAN says
that Crocus is a stimulant of weak power, exerting a specific influence, by no means well markel, over the uterine
organs, whence it is generally said to be emmenagogue;
on the Continent it bears a high character as a remedy
for the severe lumbar pains, which so frequently precede
or accompany Menstruation. SOBERNHEIM places it among
the pure narcotics, and says that experience has proven it an
excellent analeptic remedy for young children, being slightly
stimulating, while it also relieves pain and spasm, and hence
is often much to be preferred to Opium. It also stands
in a specific relation to the female sexual organs, being apt
to excite a congestive state of the uterine system, while it
also exerts a stimulating, resolving, and fluidizing influence
upon the portal system, which is so intimately connected with
the menstrual function; hence it facilitates the periodical ex



5i4                   MENSTRUATION.
cretion from the uterus, and has obtained a reputation as a
forcing and emmenagogue remedy. It is also supposed to exert a specific curative action upon congestive and spasmodic
affections of the chest, especially in those arising from irregularity of the menstrual function. It is decreed to be a main
remedy in suppression of the menstrual and lochial secretions,
especially when arising from debility and irritability of the
uterine system, and attended with pain and spasms. The
more plethoric the patient is, the more careful the physician
must be in the use of Crocus; but it will afford excellent service when there is torpor of the vascular system in general,
and of the uterus in particular, occurring in females of a sluggish and relaxed habit, more or less leucophlegmatic, and predisposed to mucous discharges, and irregularities of Menstruation; it is most useful when the menses are suppressed, entirely absent, irregular, or scanty and difficult. VOGT thinks
that it resembles Bellad. in its action more than Opium; that
it acts primarily upon the nerves, and next upon the muscular
system, being inclined to cause commotions and congestions
of blood, and excessive hoemorrhages; it may promote the
flow of the menses, and the secretions from the skin, mucous
membranes of the air tubes and genital organs, of the kidneys
and serous membranes. VOGT also recommends it in nervous
and spasmodic affections of the chest and head, when coupled
with irregular Menstruation; in disorders of the portal systems, in suppression or scantiness of Menstruation or lochioe, in
weak and irregular contractions of the uterus during confinement. DIERBACH recommends it as a very powerful sedative,
pain- and spasm-relieving medicine, especially for young
children, in whom it should be used more frequently than Opium; as an anti-spasmodic against hysteria and hypochondria,
in spasmodic colic, and spasmodic affections of the chest;
also in the spasmodic derangement of Menstruation, against
scanty menses, and lochiae, and against insufficient laborpains.
Dose.-The majority of cases were cured by the 1st dilution; the
3d dilution, repeated several times a day, has also been found servicea



PROFUSE MENSTRUATION.                  55
ble. - NOACK recommends drop doses of the pure tincture, or of the 1st,
or 2d dilution, every J, 1, 2, or 3 hours.  STAPF prefers the trituration;-or from 3 to 5 globules may be given per dose.
HYOSCIAMUS.
LEADAM thinks that one of the primary effects of this drug
is uterine hbemorrhage, but it is far less homceopathic to this
disorder than Stramonium. It is said to be indicated when
the menses are profuse, and attended with delirium, the blood
being of a bright red; or by spasms, interrupted by jerks or
startings of single limbs, followed by rigidity of the joints; or
being preceded by hysteric pains, or hysterical laughter,. and
attended with spasmodic pains and trembling of the hands
and feet, or by difficult micturition with pressing, or fainting
fits with convulsive movements; or restlessness, the body being hot, with swelling of the veins, full and quick pulse, dulness of the senses, obscuration of the sight and delirium.
DOSe-NoAACK prefers 1 or 2 drop doses of the 1st, 2d, 3d, or 6th
dilution, to be given at short intervals in severe cases, or only once a
day in milder attacks. Or from 3 to 5 globules may be given per dose,
every i, ~, or 1 hour, in severe cases; every 4, 6, or 8 hours, in less
urgent attacks.
FERRUIM
Is said by LEADAM to be applicable as a homceopathic remedy when the blood is at times fluid, at others black and
clotted, its discharge being attended with labor-pains in the
abdomen and groins, great vascular excitement, heat and redness of the face, fulness and hardness of the pulse.  Chinac
is homceopathic to an almost similar state.
According to RiicKERT, it has cured metrorrhagia occurring
after parturition, with all the above symptoms, and frequent
chills, headache, and vertigo, constipation, and hot urine; also
cases of profuse Menstruation, amounting to hoemorrhage, and
when there was violent erethism of the vascular system.
In old school practice, Iron is recommended in all passive
hemorrhages.  WooD advises it in cases where the system
and uterus are both relaxed, and the bleeding appears to be
sustained by this condition. As the coagulability of the blood




56                 ~.MENSTRUATION.
depends mainly upon the quantity and quality of it contained
fibrin, and Ferrum is well known to diminish the quantity
of fibrin in the blood, it is a matter of course that it will tend
to produce hernorrhage, if it be given too long, or in too large
doses. The Nitrate of Silver exerts, perhaps, the most powerful action of any known remedy, upon the coagulability of
the fibrin, and has been used very successfully against obstinate metrorrhagia.
Dr. LIEDBECK says he has used Iron in the same doses as
recommended by RADEMACHER in severe haemorrhages of the
womb, viz., 30 drops per dose, of the Liquor ferri mur. oxyd.
Ph. Bor., in 8 ounces of distilled water, with the addition of two
drachms of Gum Arabic. Even hbemorrhages from cancer
have diminished more than from any other remedy. The
loss of blood from any cause whatever, even from excoriations and ulcerations of the os uteri and vagina, has either
diminished, or the patient has at least felt stronger and livelier. He has also obtained a perfect cure in some cases,
where there were no indications for the use of Sabina, or Crocus, which, generally, as well as Belladonna, China, and Secale, have been his best remedies.
CASE.-Mrs. B., aged about 40, had always had profuse
Menstruation; since her last confinement, 4 years ago, she
has suffered from almost constant hbemorrhage from the womb,
escaping only about 8 days in every month; she had a great
deal of inflammation of the womb, accompanied with pains
and tenderness of the abdomen; she had been repeatedly
purged, was much weakened, and easily provoked to tears;
the blood was dark, like cherry jelly; the neck of the uterus
was swollen; she was tender in coitus; had a soreness of the
chest, and a feeling of anxiety, with greaf difficulty in ascending a hill, or walking up stairs.
Treatment and Result.-One tablespoonful of the above
mentioned Iron mixture was given every hour; she felt sleepy
after the medicine, had a light pain in the stomach, and some
dark and loose evacuations from the bowels, but still she felt
better, and the bleeding diminished; there was, however,




PROFUSE MENSTRUATION.                   57
soreness about the os coccygis, and some pain and difficulty
in sitting. The uterus was tilted towards the right, and the
right leg was swelled. The bleeding subsided entirely on the
fourth day of the treatment. Ten days after, the patient had
gained in flesh and appearance, and felt quite like another
person; there had been no return of the bleeding. LIEDBECK
exclaims: Could these results have been obtained by hligh dilutions of Iron, or of any other remedy?  He believes not,
and thinks that those who use the high dilutions, would do
well to publish some of their cases.
DOSe.-NOACK prefers 1 or more drops per dose, of the pure tincture, or of the 1st dilution, repeated once or twice a day, in chronic
cases; every 2, 3, or 4 hours, in more urgent attacks.  Or ~ or I grain
doses of the 1st or 2d tritulation, may be given. In very susceptible
persons, 2 or 3 granules may be administered as often as above directed.
Of BEAUVAIS' 106 cases, Ferrum was used in 5, viz.: in one case, in the
3d dilution, to remove swelling of the feet, after the cure of the menorrhagia by Crocus, Ipec., and Nux; in a 2d case, a strong, plethoric woman with haemorrhage, on the 13th day after confinement, was quickly
relieved of pain and haemorrhage, by 2 drops Tinct. Iron, in 4 ounces of
water, given in divided doses; a case of long standing, was cured in 2
days, by Ferrum metallicumrn; a case of 9 days duration, was increased
for 2 hours under the use of Ferrum, 6th dilution, but in 10 hours more
the flow was reduced more than one-half, and ceased entirely on the
next day.
IGNATIA
Is recommended when the menses come away in masses of
coagulated blood, with crampy pains in the womb, like labor pains, and with a tendency to spasms. This remedy,
like Nux, acts most specifically upon the muscular fibres of
the uterus and the motor nerves, and hence is most homceopathic to spasmodic menorrhagia.
Dose.-Ignatia is a powerful remedy, of which 1 or 2 drops may
be given of the 2d, 3d, or 6th dilution, every 1, 2, or 4 hours in some
attacks; or once, or twice a day, or only every 2, 5, or more days, in
chronic cases. In exceptional cases, from 1 to 3 globules may be
given as often as above recommended. In BEAUVAIS' 106 cases, Ignatia
was used only twice, viz., in 1 case in the 6th dilution, in the other
in the 18th. In both cases the flowing had already ceased before the
Ignatia was given to remove spasmodic, dyspeptic, or hemorrhoidal
affections.




E58                rMENSTRUATION.
IPECAC.
LEADAM says that it is recommended when there is much
weakness, and the bleeding is of a passive character, attended with cutting pains about the navel, pressing down towards
the uterus and anus, coldness, shivering, paleness of the face,
and heat within the head, the discharge being of a bright red.
According to RiicKERT, Ipec. 1st, one drop per dose, cured
a case of metrorrhagia in the course of a couple of hours,
which had been treated unsuccessfully for 9 months. Also a
case of metrorrhagia in a pregnant female; from over exertion, she was seized with nausea, a feeling of warmth in the
abdomen, and slight dizziness, followed by flow of blood from
the uterus, pain in the small of the back, weakness and heaviness of the legs, and weariness of the body.
AsHWELL recommends Ipecac. in spasmodic menorrhagia,
and gives an illustrative case: A widow, aged 37, of spare
habit, but not weak, had been menorrhagic for several years,
and suffered habitually from dyspepsia. Menstruation had
lasted only 2 days, but for the last 24 hours the parxoysms
of pain and spasm about the womb had been very severe;
much blood had been lost by gushes, and many large
clots had been expelled; the spasms still continued; the pulse
was quick (130) and irritable, but neither full nor hard; she
was chilly and faint; her face pallid and anxious; and she
had had no sleep fiom the commencement of the attack, although there had been long intervals of freedom from pain.
At the commencement of the disease, three years since, she
had been bled and purged with decidedly injurious effects.
Treatment.-One scruple of powdered Ipecac., in 2 ounces
of water, a teaspoonful every i hour, until nausea was produced. In the evening she was considerably relieved, having
taken 6 doses of Ipecac., and being completely nauseated, the
pain occurred at more distant intervals, and the flooding had
nearly ceased; in a few days, the menorrhagia passed entirely
off, and she recovered her usual health. For several successive periods she pursued this plan, and at the end of 6




PROFUSE MENSTRUATION.                 59
months Menstruration was performed so naturally that she
was able to lay aside entirely the use of all medicine. Dr.
OSBORN also found great benefit from the use of Ipecac.
WOOD says that small doses of Ipecac., repeated so as to induce slight nausea, without vomiting, will often have a happy
effect in relieving vascular excitement, and controlling haemorrhage; but vomiting will be attended with some risk of
increased flowing, from the straining and consequent compression of the pelvic viscera which attend the act of vomiting.
VOGT says that it has been much used in haemorrhages, especially in metrorrhagia and spitting of blood. It has been
supposed to possess a peculiar styptic power, and to exert a
specific action upon the female sexual organs, because it exerts a beneficial action upon many spasmodic affections of
women, arising from disorder of the menstrual and sexual
functions. VOGT thinks it most useful when the bleeding
arises from irritation of the nerves, rather than from an
Erethismus vasorum, and is occasioned by abdominal disease,
connected with relaxation of the tissues.
It will be seen that Ipecac. is deemed by some old school
physicians to be most useful in spasmodic haemorrhagia,
and other spasmodic affections; yet its principal action is to
cause a spasmodic action of the stomach and diaphragm in
vomiting; wiile PEREIRA (see Materia Med.) gives several
instances in which it caused spasmodic asthma. VOGT recommends it in spasmodic bleedings from the lungs, although
he admits that it may cause irritation of the air tubes, hoarseness, cough, spitting of blood, and oppression of the chest,
with inflammatory congestion of the air tubes, and congestion
of the lungs. As early as 1846, I published, in the Homceopathic Examiner, new series, vol. 1, p. 407, an essay upon the
spasmodic affections, especially of the lungs, caused by Ipecac.
Dose.-The 1st dilution has been successful in some cases. NOACK
advises 1 or 2 drops of the pure tincture, or of the 1st and 2d dilution,
every ~, 1, or 2 hours in severe cases; every 3, 4, or 6 hours in less
severe attacks; or from 2 to 5 granules may be given as often. In
BEAUVAIs' cases, Ipec. was used only twice, viz., in one case in the




60                   MENSTRUATION.
2d dilution, in the other in the 3d; the second dilution checked in the
course of an hour a profuse flooding after miscarriage. BIGEL was in
the habit of relying upon it, with much confidence.
KREOSOTE.
LEADAM recommends this remedy where there is a discharge of a large quantity of dark blood, followed for some
days by the exudation of a bloody ichor, with a pungent
odor, attended with corrosive itching and smarting of the
parts, succeeded again by flooding, with expulsion of coagulated pieces of blood, accompanied wvith buzzing in the ears,
and pressing pain in the head.
Kreosote has generally been regarded as a styptic remedy, from its power of coagulating the albumen of eggs and of
the blood; concentrated albuminous liquids are immediately
coagulated by it; diluted ones gradually, but fibrin is not
altered by it. PEREIRA makes no mention of any specific
action upon the uterine organs, but says that its influence
upon the urinary organs is sometimes very marked; lMCLEOD
and ELLIOTSON have seen the urine  acquire a blackish
color from its use; occasionally, it increases the quantity
of urine, but in diabetes it sometimes has an opposite effect;
in some instances, it causes micturition and strangury, so that
its action in this respect bears some resemblance to that of
Turpentine. PEREIRA says, that it acts as a most efficient
styptic, partly in consequence of its power of coagulating albuminous liquids, and thereby causing the formation of a
clot, and partly by causing contraction of the bleeding vessels. WooD and BAcnHE say, that it will stop capillary habmorrhage, but possesses no power to arrest bleeding from large
vessels; probably because it merely coagulates the albumen
of the blood, without acting upon the fibrin. From the good
effects which it has often exerted upon indolent, gangrenous,
syphilitic, scrofulous and cancerous ulcers, it may also-prove
useful in ulcerations of the neck of the womb. VOGT says
that Kreosote often increases the secretion of urine, perspiration, and the menses. Still he says that the Aqgua.Binelli,




PROFUSE MENSTRUATION.                61'
which contains impure Kreosote, has often been used with
good effect against bleeding from the nose, blood-spitting,
bleeding from the bowels, kidneys, and uterus.
DOSes —NOACK recommends I or 2 drop doses, of the 1st, 2d, or 3d
dilution, repeated every 2, 4, 6, 8, 12, or 24 hours. It may also be used
-as a vaginal injection, when the discharge is offensive, and there is ulceration of the neck of the womb.
LYCOPODIUM
Is recommended by LooMIs, when there is an irritable condition of the womb, attended with chronic dryness of the vagina, and when the menses appear too early, are too profuse,
and continue too long, being preceded by shivering, sadness,
melancholy, and disposition to weep, or by headache, pain in
the loins, fainting, and vomiting of sour substances, especially
if a yellowish, milky, or reddish corrosive leucorrhcea be present during the interval.
According to VOGT, Lycopodium has frequently been used
as a palliative remedy in spasmodic and:inflammatory affections of the urinary and genital organs, but in large doses,
viz., as much as 20 or 30 grains; from the mildness of its action, it is, however, more frequently used as a dusting powder in excoriations of children, or for enveloping pills to prevent their adhesion. DLERBACEI says, it has been recommended as a quieting and soothing remedy in diseases of children;
especially in colic, also in whooping cough, oppression of the
chest, asthmatic attacks, hysterics, cramp of the stomach, in
dysuria, strangury, and gravel; as an aqua distillati Lycopodii was formerly used against stone and gravel; but it was
prepared from the whole plant, and not merely from the powder. It was once a favorite domestic remedy against pains
in the stomach and bowels in children. Of course it may also
be used in females, when some or any of the above affections
occur in connection with frequent and profuse Menstruation,.
SOBERNHEIM says that in latter times, (i. e., since Hahnemann's
time,) Lycopodium has been again brought forward as an excellent remedy against dysuria, retention of urine, and spasms




62                   MENSTRUATION.
Of the bladder, especially in teething children; the whole
plant has been used successfully against all degrees of ischuria,
even when attended with a suppurative, or calculous condition of the urinary organs. JAHR, from abundant experience,
has found it a sedative and antispasmodic remedy, well calculated to allay morbid nervous sensibility and irritation.
Dose. —NOACK advises 1 or 2 drops, per dose, of the 1st, 2, or 3d
dilution, every 2, 4, 6, 8, 12, or 24 hours, according to the severity of
the symptoms.
MERCURIUS
Is recommended by LoomIs, if there be dry heat with congestion to the head, just before Menstruation; or, if during
it, the tongue be red, with deep colored spots upon it, attended with a burning and salt taste in the mouth; if there be a
purulent and corrosive leucorrhcea, with itching in the parts,or
if there is a sensation of excoriation, with swelling of the vagina, frequent desire to urinate, painful discharge of scanty
urine, of a dark color and offensive smell.
WHITEHEAD thinks, that Mercury may be homceopathic to
precocious Menstruation in scrofulous females; at least he
gives a case in which a girl began to menstruate at 11 years
of age, after taking 20 or 30 pills containing calomel; the result was intense salivation, and she was confined to bed for 6
weeks, during which time Menstruation commenced; her
health was only imperfectly restored at the end of 16 months,
but from the time of its first accession, Menstruation continued to recur at regular intervals, the discharge, however, being
small in quantity, pale, and attended with more or less inconvenience. Between her 13th and 17th years, she was several
times affected with chlorosis, and suffered repeatedly from abscesses in the neck and arm pit, rheumatism of the head and
limbs, nodes upon the legs, and mercurial salt-rheum. She
was in perfect health before she took the Mercury, and neither she or any of her family had previously had any signs of
scrofula; the Mercury was obviously the cause also of the
early appearance of the menses, the other female members of
herfamily having had the change at a much later period of




PROFUSE MENSTRUATLION.                 63
life. She married, and transmitted the scrofulo-mercurial
taint to her children in a decided form.
Dose.-1 or 2 grains per dose, of the 2d, 3d, or 6th dilution. Merc.
corros. should be preferred when there is ulceration of the womb, and
may also be used as a vaginal injection, 2 or 3 times a day. Very susceptible persons may use the globules.
PLATINA.
LooMIS and LEADAM recommend this remedy when the
menses are too early, too profuse, and too long continued,
attended with pressure and bearing down towards the genital
organs, which are very sensitive; and if, in addition to an
irritable uterus, there be induration of the womb, or congestion, especially if the discharge be of thick, dark colored,
but uncoagulated blood; when there is a pressing pain, extending from the small of the back to the groins, a forcing
downwards and outwards, with great excitability and tenderness of the uterus and vagina.
According to RiiCKERT, Platina has been found useful in
cases of violent haemorrhage after miscarriage, the blood coming off in large clots; also when the flowing is attended with
unnatural tenderness and sensitiveness of the genital organs,
with excessive sexual desire. Also in profuse Menstruation,
with discharge of thick, dark, coagulated blood, with pain in
the small of the back, moving down into both groins, and
causing a severe pressing down pain, with excessive tenderness and sensitiveness of the parts involved. It also cured a
case in which there were severe cutting pains in the abdomen,
for several days previous to Menstruation, with heavy pressing down upon the genital organs, and labor-like pains, extending from the small of the back, through the groins, into
the thighs.
Dose.-The 6th and 12th dilutions have been used successfully.
MADDEN found the 3d, 6th, and 12th potencies useful; and applied the
1st and 3d dilution of Platinum Chlor. locally to the uterus and vagina,
in the form of injections; by these means he cured 11 cases out of 15,
of menorrhogia. Of BEAUVAIS' 106 cases, it was used in 4; in 1 case,
in the 2d dilution, with some success; in another case, also in the 2d




64                   MENSTRUATION.
dilution, it cured, in 3 days, a flow which had lasted 4 or 5 weeks;
— there was some aggravation on the 1st day af treatment; a 3d case,
which had continued 3 weeks under allopathic treatment, was cured by
2 doses of Platina; KNORRE found it generally useful in profuse Mens truation.
PULSATILLA.
LJEADAM says, although this is so important a remedy in
ainenorrhcea, it is nevertheless very useful at times in menorrhagia, when the blood is thick and black, or pale and watery,
and flows by fits and starts; or when it is profuse, especially
at the critical age, and attended with headache, noise in the
ears, sadness and melancholy, and great irritation of the
nerves. LooMIs uses almost the same words, but adds, that
it is also indicated when there is an irritable uterus, with
pains in the loins, shiverings, dizziness, tenesmus of the rectum and bladder, scanty red or brown urine, with frequent
desire to urinate, before, during, or after the monthly period,
and a thick, corrosive; burning leucorrhoea. In my opinion,
Pulsatilla is more homceopathic to menorrhagia than to
amenorrhoea (see North American Journal of Homceopathy,
vol. 1, p. 196); VOGT and DIERBACH think that it acts so
powerfully upon the kidney, uterus, and rectum, that suppressed hmemorrhoids and menses reappear during its use.
According to RiiCKERT, it is useful in metrorrhagia when the
flow is not continuous, but ceases at times, in order to return
again with increased violence, much coagulated blood being
evacuated. Also when menorrhagia with false labor-pains,
occur in pregnant females, the blood being blackish and clotted at times, at others liquid, the vagina being contracted
and dry, so that it couldconly be examined with pain and
difficulty; when the patient is exhausted by pain and flowing,
and the pains do not force the uterus to contract. It also relieved a violent flooding after confinement, from adhesion of
the placenta.
DOSe. —MADDEN used the 1st, 3d, 6th, and 12th dilutions of Pulsatilla; the 200th dilution was thought to be useful in 2 cases. NOACK
advises 1 or 2 drops, per dose, of the pure tincture, or of the 1st, 2d, 3d,




PROFUSE MENSTRUATION.                 65
or 6th dilution, to be repeated frequently in some cases, but only once or
twice a day in less urgent attacks; still he prefers the second dilution as
a rule, as he thinks that it has proved more successful in his hands than
any other preparation of this remedy. Delicate and sensitive persons
may take 2 or 3 globules per dose, as often as above recommended In
BEAUVAIS' 106 cases, Pulsat. was used in 5; in one case each, the 18th
and 30th dilutions produced little or no good effect; the 12th seemed
to check the flow, in one case, in 12 minutes; the 15th relieved one
case in i hour, which had continued for 15 days; the 4th dilution was
used in another case.
SABINA,
According to Loomis, is one of the most prominent homceopathic remedies for profuse Menstruation, when it results
from an irritable uterus, especially about the period of the
change of life, and is connected with irregularity as to time;
the discharge being profuse, consisting of clotted or bright
red blood, attended with pains, like those of labor, in the
loins and groins, and contracting pains about the womb, and
by an itching, yellowish, fetid leucorrhoea. It is all the more
indicated if the mouth of the womb be more open than usual,
the lips swollen, and neck tender.  LEADAM thinks it is most
indicated when there is a discharge of black, dark colored, and
clotted blood, with labor-pains in the loins and womb; or
where there are paroxysmal discharges of bright red blood,
increased by motion, especially in women who have frequently suffered from abortion, and who have reached that age
when the change of life should occur. According to RiicKERT,
Sabina cured a case of metrorrhagia which had lasted for 11
weeks, there being a great discharge of black blood, and frequently of large coagulhe; especially, at night, although the
show was often of a bright red; there were violent tearing
pains in the limbs, in the small of the back, and in the abdomen; also a tearing headache, generally on the left side, and
frequently of intolerable severity. Also a severe case with
labor-like pains, moving from the small of the back to the
groins, and excessive urging to urinate. A third case, recurring after a miscarriage, the blood being generally coagulated,
dark, and blackish, or, more rarely, thin and watery; at night
B




66                  MENSTRUATION.
the flow -lessened and was painless; at other times there was
a pressure above the pubis, and a bearing down upon the
womb; also general weakness, emaciation, pallor and vertigo.
Also  chronic case with severe and peculiar pains in the
limbs. And a fifth case, attended with griping pains in the
abdomen, the blood being thin, and the patient very weak.
The Ist, 5th, 8th, and 30th dilutions were all used with good
effect.
According to PEREIRA's experience, it is the most certain
and powerful emmenagogue in the whole Materia Medica;
its emmenagogue power is fully established, the observations
of HoMnE being perhaps the most satisfactory of any on this
subject, confirmed, as they are, by the reports of many other
accurate observers. It has acted so violently upon the kidneys and bladder, that bloody urine has been passed, and coagulated blood found in the bladder. In excessive cases, it
has caused violent and incessant vomiting, excruciating pains 
in the womb, followed by abortion, and dreadful hlemorrhage;
after death, the gall-bladder has been found ruptured, the bile
effused into the abdomen, and the intestines inflamed, and all
this perhaps from a specific action upon the liver, as it causes
an increased secretion of bile, and increase of size of the liver;
hence it is homeoopathic to menorrhagia, when connected with
bilious derangement, and portal congestion. WooD and
BACHE say that it increases most of the secretions, especially
those of the skin and womb, to the latter of which organs it
is supposed to have a peculiar direction, so that it has been
much used in amenorrhoea. In pregnancy it should be given
with much caution, although it has recently been recommended as an effective remedy iucertain forms of menorrhagia, and
is asserted to prove occasionally useful in preventing threatened abortion (see Am. Jour. Med. Sciences, new series, vol.
8, p. 475). DIERBACH says thatit readily causes congestion of
blood to the genital organs, increases the urine, and in large
doses even causes haematuria. He recommends it in chronic
and feverless affections of the womb, in suppression of the
menses, sterility, swelling of the womb, in consequence of




PROFUSE MENSTRUATION.              67
frequent pregnancies, in cramps of the womb, subsequent to
frequent miscarriages, in leucorrheea, chronic huemorrhages
from the uterus, and even in indurations and commencing
cancerous degeneration of this organ; also in blenorrhcoas of
the genital organs of both sexes. VOGT says that it removes
sluggishness, stagnation, and thickness of the vena porta blood,
and increases, in an especial degree, the sanguineous congestion and secretion from the uterus, while, at the same time,
it is the most efficient of all the balsams, in removing sluggishness, relaxation, and atony of the womb. That it excels, in its action upon the female genital organs, all other
gum-resins and balsams is undoubted by all sound practitioners, and it is the more indicated in diseases of these organs,
the more languor there is of their vessels and movements, the
more torpor in the ganglionic system, and the more atony
and relaxation there is in general. He also recommends it
highly against profuse, too frequently returning, and too long
continuing Menstruation, arising from simple atony of the
uterus.
In the American Xour. of Med. Sciences, Oct., 1844, p.
475, we learn that some observations on the employment of
the Juniperus Sabina, in hemorrhage from the uterus, have
been made by M. ARA, from which it would seem to be occasionally a powerful agent in checking these discharges.
Much has been said on the properties of Savin as an emmenagogue; several foreign authors, however, and among them,
WEDEKrND) GiiNTHER, and SANTER, disregard altogether its
tendency to cause uterine hsemorrhage, and, on the contrary,
recommend its use in such cases. M. SANTER says that Sabina,
is one of the most powerful curative means, not only in menorrhagia, but also in those hzemorrhages which threaten abortion, occurring in pregnant women, who, from debility, have
already had several miscarriages. He states that in these
cases he had given the powder of Sabina, in the extraordinary doses of 15 to 20 grains, three times a day, during a
period of 3, 4, or even 5 months, and that he has in this
manner frequently succeeded in arresting the flowing, and




68                 MENSTRUA.ION.
preventing abortion, the infants being born healthy, at the full
period.
The following cases, among others, are mentioned by ARAr:
CASE. —A worker in embroidery, aged 33, had been recently delivered of a child, and since her confinement had had
attacks of menorrhagia at irregular intervals; she was much
debilitated, and her health began to fail. Powdered Savin
was given; in two days the flowing ceased, and did not return again.
CASE 2.-A woman, aged 28, had suffered from menorrhagia, almost continually for eight months; Sabina was given,
and on the 3d day the bleeding was arrested. About six
weeks afterwards, the flow returned, Sabina was again given,
and the bleeding ceased almost immediately.
CASE 3. —A robust lady was attacked with menorrhagia,
after a fatiguing walk; it was neglected, and had already lasted several days; 1 gramme (abott 20 grains) of Savin was
administered in 3 doses, and on the following day the bleeding had ceased, and, although the patient would not remain
in bed, it did not again return.
CASE 4.-A  young married lady was attacked at the
menstrual period with profuse flowing, which had continued
for 8 days; 3 doses of Savin, of 40 centigrammes each, were
given at intervals of 2 hours; on the following day the haemorrhage had almost ceased, and another dose of the medicine
entirely put a stop to it.
The celebrated KorPP has found Sabina useful in active
uterine hmemorrhage, and prides himself not a little upon his
discovery. SANTER expressly confines his use of it to passive
hemorrhages, and all diseases of the uterus depending on
atony, asthenia, debility, defect of contractility, or cohesive
force in uterus.
In Franks' Magazine, we also find Sabina recommended
against profuse Menstruation and menorrhagia, by old school
physicians, in allopathic doses.
CASE 5.-A very poor woman, aged 40, who had had
several children and abortions, suffered with profuse Menstru



PROFUSE MENSTRUATION.             69
ation, lasting from 6 to 8 days;;the blood was almost as black
as coffee, and exceedingly offensive; every time before the
menses set in, her' breath became very offensive, and the
womb was found enlarged to the size of a child's head, and
projected above the pubis; it diminished in size during the
flow; the patient had many hysterical symptoms, and was
pale, and discolored. After an abortion a flowing commenced,
and lasted for 6 weeks, her pulse became small and quick, andfever set in. Twenty-grain doses of Sabina were given, 4
times a day, and quickly restored her; afterwards she always
took a macll (?) dose of Sabina, every night and morning, for
4 days, before the recurrence of Menstruation, with such good
effect, that the menses always sat in without pain or distress,
and were no longer profuse. She recovered her health and
strength entirely.-WEDEnKID.
CASES 6 and 7.-In 2 cases of bleeding from the womb,
in women who were approaching the change of life, and which
had withstood all the ordinary treatment, Sabina was given
successfully in scruple doses, and more, 4 times a day. Hence,
although this remedy is an emmenagogue, it must also be
regarded as among the best styptics against bleeding from the
womb, but only in cases of true atomy and torpidity of the
WOmb.-GUiNTHER.
CASE 8.-A delicate and nervous woman, aged 36, who
had had many children, had also suffered for years with pain in
the kidneys and bladder; after a suppression of 3 months,
Menstruation sat in profusely; blood was discharged in thick,
coagulated pieces, with violent labor-like pains in the back,
but no signs of a fcetus were found. The discharge, which was
at first bright red, then dark and coagulated, had already
lasted profusely for 10 days, and the patient began to have
frequent fainting fits; finally, the flow became brownish and
granular, like decayed cruor, gave forth a horrible stench, like
that of putrid meat, and that so powerfully, that it was difficult to remain in the room.
Treatment.-After many other remedies had failed, 3
drachms of Fol. Sabin. were infused in 4 ounces of water,




To                    MENSTRUATION.
and a tablespoonful given every two hours. The discharge
altered after the 2d dose, and was somewhat increased in
quantity, but in an hour more it began to lessen, the
offensive smell improved, and the pain in the groins ceased.
In the course of 4 days, all offensive odor had disappeared,
and the discharge ceased gradually.
CASE 9.-A lady began to have such profuse Menstruation
that she was obliged to remain in bed for several days each
month, and always lost a large quantity of blood. Appropriate
homceopathic remedies, among which were Sabina, 3d and
6th dilutions, were given without good effect; then 3 drachms of
Fol. Sabin. were infused in 6 ounces of water, and a tablespoonful given every 2 hours, with rapid and permanent benefit.
-KoPp.
Dose.-The 1st, 5th, 8th, and 30th dilutions have each proved successful, or, at least, cases of menorrhagia have subsided under their use.
MADDEN used the 3d and 6th dilutions, of the decimal scale. The
doses must be repeated every i, 1, or 2 hours, in very urgent cases;
2 or 3 times a day in, less severe attacks. Very impressible patients may
take fiom 2, or 3, to 5 granules per dose. In BEAUVAIS 106 cases,
Sabina was used more frequently and successfully than any other remedy, viz., in 16 cases; viz., the 2d dilut. in 1 case; the 3d relieved 1
case in a month, which had already lasted a month; also, another case
in 14 hours, which had continued several hours; the 6th and 7th dilutions each in 1 case; the 8th dilution checked a flow in 2 days, which
had persisted for 14 days; the 12th potency was used in 1 case; the
24th in another; the 30th relieved 1 case in 2 days, which had continued for 11 weeks; finally, a part of a grain of the powder relieved a
a case in 3 days, which had lasted only 1 day.
SECALE.
LEADAM says that Secale is, as might be supposed, a valuable agent in menorrhagia; it is indicated in the congestive
form, when the menses are profuse, especially at the climacteric period; in weak, cachectic, and exhausted individuals,
with cold extremities, pale face, small pulse, and with anxiety
and despondency. He says it should be used in the low attenuations. CHURCHILL says, that Secale will increase if not originate uterine contractions, is known to all, and also that it will




PROFUSE MENSTRUATION.                 71
restrain inordinate discharges from the womb; we should,
however, scarcely expect it to be useful in exciting the menstrual secretion, and it is difficult to determine upon what
principle it does so. (Homeopathy will explain it.)  As to
the fact, we have the evidence of DEWEES, who recommends
its use; of Dr. LococK, who has tried it with success; also
ROCHE, NAUCHE, and PAULY.
Dose.-In uterine haemorrhage this remedy should almost always
be used in massive doses; still, MADDEN gave the 3d, 6th, and 30th dilutions of the decimal scale. It may be given every few minutes in very
urgent cases; every few hours in less severe attacks; and once or twice
a day in chronic states. In BEAUVAIS' cases, it was used in 4.
SULPHUR
Is recommended by Loomis, when there is a painful sensibility of the neck and body of the womb, attended by itching
and a burning sensation in the parts, before the menses set in.
Or, when there is headache, spasmodic colic, pressure on the
part, restlessness, cough, heart-burn, bleeding from the nose,
and yellowish corrosive leucorrhcea, especially if Menstruation recurs too early, and is too profuse, or the blood is too
pale, and has an acid smell. In all chronic cases of long
standing, it will be well to commence the treatment with Sulphur; LooMIs has known a dose or two of Sulphur change
the whole character of the case; in nearly all cases which he
has treated successfully with Sulphur, there has been a quick
pulse, flushed cheek, hot skin, frequent attacks of headache,
high-colored, scanty, and fetid urine, with a greasy pellicle on
its surface, and passed with pain. It is more frequently indicated during the interval, than at the menstrual period.
DSe. — MADDEN used the 3d, 6th, and 12th dilutions.
VERATRUM
Is recommended by LEADAM, when frequent and profuse
Menstruation is attended with diarrhcea, especially when
there is buzzing in the ears, bleeding from the nose, pain in
all the limbs, and great thirst.




72                   MENSTRUATION.
THLAPSI BURSA PASTORIS
Is recommenned by Dr. LANGE, who has noticed the greatest
benefit from this plant, in the menorrhagies of persons of
relaxed constitutions; he has often cured entirely the tendency to excessive discharges at the menstrual periods.
EMMENAGOGUES.
These remedies, of course, are homeeopathic to menorrhagia, in addition to those already mentioned. DIERBACH mentions the Taxus baccata, Laurus nobilis, Ruta graveolens, Buchu, Asarum europmum, and Borax.
He says, that Taxcus baccata has frequently caused fetid
smelling sweats, with itching of the skin and pustular eruptions, flow of mucus and blood from the sexual organs, increasedsecretion of urine, diarrhoea, flow of viscid and acrid
spittle, and attacks of vertigo, with dimness of vision. HIence
it may prove homoeopathic in scrofulous cases, with obstinate
eruptions of the skin and acne, bad-smelling perspirations from
the skin, arm-pits, perinaeum, and feet, with leucorrhcea and
tendency to diarrhoea.
The lcaurus nobilis is most indicated when there is a tendency to abortion.
The Rue is most indicated when there are fetid sweats and
haematuria.
Buchu is most homeopathic when there is a tendency to
profuse secretion of urine, the water being turbid, loaded with
flocculi, and presenting a purulent appearance; also, in dysmenorrhaea, leucorrhea, and chronic menorrhagia, when attended with symptoms of gravel, great irritability of the bladder, with thickening, ulceration, or catarrh of the bladder.
Asarum europceum is one of the most common and active
remedies in the production of abortion.
The emmenagogue action of Borax is said to be undoubted.
Senega is most useful when there is a decided catarrhal
affection of the chest.
Nitre, by stimulating the kidneys, is said to be a decided
emmenagogue. AsHwEtL gave it to a patient whose mother




DELAYED- MENSTRJUATION.             73
placed great confidence in it, in scruple doses, 3 or 4 times
daily, in a wineglass of water; it purged and produced bloody
motions, but on the 3d day there was a copious flow of the
menses, after a suppression of 7 months.
In BEUVAIs' 106 cases, besides the remedies already mentioned, Nux was given in 7 cases, Arsen., Baryt. c., Carb. an.,
Sepia, Silex, and Sulph., each in 1 case.
DELAYED MENSTRUATION.
OF 4,000 cases, WHITEHEAD, of Manchester, met with
499 which were delayed to the 17th year.
393    "    "    "    "    18   "
148    "    "    "    "    19   "
71    "    "    "    "    20   "
20    "    "    "   21st or 26   "
WHITEHEAD found that delayed Menstruation and puberty
exerted a more unfavorable influence than precocity; precocious cases were attended with unfavorable symptoms inabout
20 per cent.; when puberty was delayed to the 17th or 18th
year, as many as 247 cases out of 892, or about 28 per cent.,
presented unfavorable symptoms; while nearly 41 percent.,
or 97 cases out of 239, who menstruated for the first time at
19 years of age, or after, required careful medical attendance, not so much for the absent discharge, as for their general health.
From the table (see page 9,) it will be seen that in cold climates it is almost as natural for women to commence to menstruate as late as 22 years, as at 14 years of age; while very
few, only 19 out of 6745 cases commence as early as 18 years;
only 5 cases out of 6745, at 12 years; and only 1 case out of
6745, at 11 years of age. Hence, protection from cold is very
important for girls suffering with delayed or scanty Menstruation; exposure to warmth, either by means of exceedingly
warm clothing, warm houses, or a residence in a warm climate, necessarily becomes an exceedingly effectual agent in




74                  MENSTRUATION.
the treatment of these cases, although exceedingly precocious
Menstruation is not as common in hot climates as is generally
supposed. In Venezuela the menses set in, only in very rare
cases, as early as 10 years of age.
Only 10 per cent. commence at 11 or 12 years.
As many as 70 per cent. commence from 13 to 15 years.
About 20 per cent. commence as late as 16 to 18 years.
And very rare cases, from 19 to 20 years, or even 21 years.
Still, in the large majority of women in hot climates, the
changes of puberty are accomplished before the 15th year;
in temperate climates, from the 13th to the 18th year; and in
cold climates, from the 14th to the 22d year.
If Menstruation be delayed beyond the usual period, TILT
says, nothing can be plainer than the line of conduct a mother
should adopt in reference to her daughter's health; —if she be
well, however late the first appearance may be delayed, no
physic is required; —if she be ill, medical advice should be
sought. The mother should recollect that puberty occurs at
different periods, according to the country, climate, class of
society, and even the constitution, and in many cases, it is
safely delayed many years beyond the usual time. The knowledge that this may happen, without serious detriment to the
health of the girl, should be sufficient to prevent the infatuation of so many well-intentioned mothers, who, merely because
the " custom of women " has not appeared in their daughters
at the same age as it appeared in themselves, do not hesitate
to administer forcing medicines, without asking the sanction of
a medical opinion.
The following sad history, related by Dr. DEWEES, is, TILT
says, the best case that can be given on this subject.
" I often call to mind, with bitter recollection, the fate of a
most amiable and interesting creature, for whom I was requested to prescribe for the'expected menses, but who had not one
mark that could justify an interference; more especially as she
was in perfectly good health.' She was fifteen; it was time';
and this was all that could be urged by the mother in favor of
an attempt' to bring down the courses.' I relied too much




DELAYED MENSTRUATION.             75
on the good sense of her anxious parent, and fully explained
myself to her, without prescribing for her child. As might
be expected, she determined upon trying a quack medicine,
of some celebrity in similar cases; in a few days her daughter
became feverish, lost her appetite, and suffered from nausea;
she was soon confined to her bed, and by a persistence in the
same treatment, she soon lost an only and a lovely daughter."
The line of conduct to be pursued by the physician when
consulted about a case of retarded or delayed Menstruation,
is equally plain. It should be recollected, and explained,
that many girls do not come to maturity of mind and body
as early as others; if the health of the child be generally good,
her mind and body, however, being rather immature, then the
principal attention should be paid to the development and culture of thephysijue and morale, rather than to a merely onesided regard for the menstrual function. Menstruation should
only be encouraged when both mind and body are prepared for
it, and for the duties, precautions, and feelings, which attend
it; a mere child is not fit to be entrusted with all the attributes, orto have the functions of mature women thrust upon her.
Excessively studious and sedentary habits should be corrected; exercise on foot and in a carriage, riding on horseback, sea bathing, the gamles of battledore, jumping the rope,
rolling the hoop, running, and particularly dancing, are powerful means for obtaining health of body and vigor of mind,
which ought not to be neglected, and which fortunately women seldom object to putting in practice. Living in the
country, for the summer season at least, where the air is pure,
particularly if pleasant company and companions can be added to the charms afforded by diversity of views and landscapes. Pic-nics, riding and boating excursions, evening entertainments, &c., which unite to all the advantages of exercises that of being agreeable to young persons, and producing
the useful stimulus of contact with older and maturer minds
of both sexes, will rapidly and healthily mature a feeble body,
and one-sided, or torpid mind. All these means should be
aided by a carefully selected, nourishing, and rather hearty




76                 MENSTRUATION.
diet; young girls should be methodically and carefully discouraged from acquiring morbid inclinations for sickening and
debilitating trash, miscalled delicacies; for they too soon get
a distaste for all really nourishing and strengthening food.
The medical treatment should be calculated to produce the
same broad and comprehensive changes, which nature designed to do, and which the above hygienic treatment may
fail to accomplish. The physician should recollect that a proportionately more rapid growth and development of the whole
body, more extended powers of mind and imagination, vigor
of form and carriage, and the bloom of health and beauty,
should be accomplished either by nature, or by the medical
and hygienic arts; and that a contemptible and irritating
treatment of a few organs or parts, is but little calculated to
accomplish these great changes.
INFREQUENT MENSTRUATION.
MADDEN, in 181 cases of uterine derangement, met with 9
cases in which Menstruation was infrequent; WHITEHEAD, in
161 cases of irregular Menstruation, found 5 cases in which
the returns generally happened every 5 or 6 weeks, but occasionally there was an interval of only 1 month; one lady generally had her courses monthly, but every 3d time she missed
the period, having a free interval of 2 months, her health
never suffering in consequence. COLOMBAT says, some women
naturally only have their " turns " every 6 weeks, or even only
every 2 months; LINNaEUs saw women in Lapland, whose periodical discharges occurred only once a year; LiSFRANC has
met with women who were regular every 5th or 6th month, or
only every 4th or 6th year; some of these females were habitually disordered, and others enjoyed perfect health. CoLoNBAT thinks that girls of a lymphatic or scrofulous constitution,
are regulated later and with more difficulty than others; while
scrofulous women who are already regulated, often find their
menstrual discharges diminishing little by little, and the retardations constantly becoming more prolonged.




INFREQUENT MENSTRUATION.             77
Although we have seen that many mothers are too anxious
for the first appearance of Menstruation in their daughters,
still, an equally large class are too inattentive to the proper
regulation and periodical occurrence of this function; nothing is more common than to meet with girls who have their
periods at long intervals only, and then unsatisfactorily,
but who do not get medical attendance until some severe accidental disease renders it imperatively necessary that their
health should be attended to. Then the physician is obliged
to contend with the complicated effects of a badly regulated
system, conjoined with acute disease, and the constant liability to relapses, and various unusual occurrences, which are
apt to arise in this state of things.
Treatment of Delayed and Infrequent Zenstruation.
SULPHUR
Is supposed to aot specifically upon the venous system of
the abdomen, lower bowels, and pelvis; ALTSCRUL says, it
causes congestion to the womb, with pressing-down pains, and
tendency to inflammation of the vulva, the menses occurring
either too early or too profusely, or else being suppressed in
consequence of inflammation, o irritation. KNORRE, however,
recommends it when there suppression of the menses, with
congestion of blood to the head; in falling of the womb, leucorrhcea, and inclination to abortion. It has also been decided
to be homceopathic when Menstruation occurs at too late a
period, and too infrequently, attended with constipation and
distension of the abdomen, even when there is a delay of 3
months beyond the usual time.
Dose.-NOACK advises 1 or 2 grains of the 1st or 3d trituration, or
from 1 to 3 drops of a carefuly prepared tinct. of Sulphur, repeated once
or twice a day, or every 2, 4, or 6 days.
NATRUM..NatrUm s8ulph. has been recommended when the menses
are delayed beyond the usual time, being too late in their first




'78                   lMEN STRUATION.
occurrence, infrequent in their recurrence, and scanty, with
constipation. Natrum  muricaticum, when they are simply
too late and scanty. Natrum  is supposed to exert a specific
action upon the neck, the genital organs especially in the
female sex, upon the tissues of the womb, upon the urinary organs, and breast; it has also removed goitre, and
other affections of the cervical glands.  NVatrum carb. acidulum has removed enlarged cervical glands, scrofulous derangement of the stomach and bowels. The Chlorate of
Soda has removed irregularity of Menstruation in scrofulous
females, with enlargements of the glands of the neck. The
Iodide of Soda has removed tumors which have withstood
the use of Iod. mer., and Iod. pot.
Dose.-1 or 2 grains of the 1st, 2d, 3d, or 6th decimal dilution, may
be taken night and morning, or every 2, 3, or 4 days; in appropriate
cases, and in very sensitive persons, from 2 to 5 granules may be taken
per dose.
CHELIDONIUM
Has been recommended when the menses are retarded and
infrequent as to time, but last longer, and are more profuse in
quantity. It has effected cures in women afflicted with obstinate eruptions upon the face, with most extensive and profuse
scrofulous ulcerations, and witl bilious derangement.
Dose.-NoACK advises 1 or 2 drop doses of the pure tincture, repeated oncd or twice a day. The granules may be used in very nervous,
hysterical, and sensitive persons.
SABADILA
Has been used successfully when Menstruation is delayed
and infrequent, and is preceded for several days by a painful
bearing-down; it is most useful in cases in which there is a
frequent inclination to urinate, drawing pains along the spine,
chilliness of the body, with a peculiar feeling of warmth in
abdomen, and a characteristic sensation of excessive debility.
Dose. —1 or 2 drops of the 1st, 2d, or 3d dilution, may be used per
dose; or from 2 to 4 granules.




INFREQUENT MENSTRUATION.              79
NUX MOSCIIATA
Is recommended in infrequent and tardy Menstruation,
when preceded by a severe and peculiar tpain in the back,
especially if many hysterical and nervous symptoms be present, such as delirium, vertigo, hysterical loss of sensation,
drowsiness, or transient mental derangement.
Dose. —Same as for Chelidonium.
MERCOtRIALIS PERENNIS
Has been used when there was a delay of 3 days, and the
menses then set in with a sense of anxiety, difficult breathing,
feverish heat over the whole body, followed by swelling and
tenderness of the breasts, headache, and.faintness, especially
if these symptoms occur in girsls who are usually light and
happy, sprightly, gay, and merry, but who become feverish,
surly, fretful, sullen, and depressed, or excited, with dizziness
and drowsiness, heaviness, fulness, heat, and congestion of the
head. It is homceopathic when the menses, which should last
at least 3 days, continue only 1 day, followed by cramps in the
bowels, and headache; also, when the menses are delayed for
1 week; when they last only 4 days, scantily, in females in
whom they generally continue 7 days.
Dose.-Same as given for Sabadilla. (page 78.)
MAGNESIA MURIATICA,
When there is a delay in Menstruation, with violent pain in
the small of the back.
Dose.-The same as recommended for Natrum. (page 78.)
IODINE
Is recommended as homceopathic, when there is a delay in
Menstruation, with dizziness and palpitation; still, ASHWELL
says, that it is occasionally a good emmenagogue, but also,
that there is no remedy of this class, which has so frequently
failed in his hands;' in patients predisposed to struma, or actually suffering from scrofulous enlargements of the glands, it




80                  MENSTRUATION.
exerts an almost specific influence; still COINDET was perhaps
scarcely correct in attributing to this drug such certain and
powerful emmenagogue properties. CHURCHILL says, that Iodinehas been extensively tried in amenorrhoea, and in many
cases successfully; but it may be questioned whether the continued trial has fulfilled the expectation of the physician who
introduced it into practice. COLOMBAT says, that Iodine has
been used successfully in chronic amenorrhoea, by COINDET,
DUMERIL, BRERA of Padua, MAGENDIE, SABLAIROLET, RECAMIER, and TROUSSEAU, as well as by himself. But Dr. MBasoN
does not believe that it possesses any emmenagogue powers,
further than as a stimulant and tonic to the whole body; in
one of his patients, in large doses, it occasioned so much sickness and disorder of the stomach, that the menstrual discharge
was suppressed altogether. It has been supposed to be most
useful in irregular Menstruation, arising from enlargement or
induration of the womb; Dr. THETFORD gave it in a case in
which the uterus was of bony hhrdness, and of so considerable
a size as nearly to fill the whole of the pelvis; yet in six
weeks the disease had given way to the use of Iodine, and
Menstruation was restored. ASHWELL treated successfully 7
cases of hard tumors of the womb, in the average time of from
8 to 16 weeks. LUGOL mentions several instances among his
scrofulous patients, in which it cured obstructed and painful
Menstruation. EAGER found it to act as an excitant on the
genital organs; it augmented the activity of the womb, and
rendered Menstruation more abundant; on the other hand
it has been supposed to be homceopathic to sterility, as
2 cases are detailed by Dr. ROB. H. RIVERS, in which barrenness succeeded its administration.  LOCHER BALBER found
Iodine of use, at times, in those troublesome cases, which occasionally precede the establishment of Menstruation, but if
given in too large doses, he and GOLIs were often obliged to
omit its use, on account of its evil consequences to the lungs,
such as dry cough, and cough with bloody expectoration.
DIERBACH says, that Iodine may cause an atrophic state of the
female breasts, and its influence upon the womb may stand in




INFREQUENT MENSTRUATION.              81
a more or less close connection with this power; hence he can
scarcely regard it as a contradiction, when one observer notices sterility to follow its use, while another finds it to be a
powerful emmenagogue, easily exciting profuse flooding, or
even abortion. In a woman, subject to profuse Menstruation
every 3 weeks, SCHMIDT noticed a violent. flowing fromn the
womb, lasting 4 weeks, produced by the use of Iodine. To
increase the confusion caused by all these contradictory ~tatements it has been pronounced homceopathic against sudden suppression of the flowing menses; also, when they are delayed 8
days, with vertigo and palpitation; against menstrual irregularity; increase of the menstrual flow; premature, copious, and
violent Menstruation. It has relieved a uterine haemnorrhage,
which was increased whenever the bowels were moved,
attended with pains in the stomach, loins, and small of
the back; it proved useful when the menses were preceded
by a rush of blood to the head, palpitation of the heart,
and swelling of the neck; it has also removed all the usual
troublesome precursory symptoms of Menstruation. It is,
perhaps, most hommeopathic when scanty Menstruation is
caused by congestion to the chest, in females inclined to consumption, with pains in the side, dry cough, bloody expectoration, more or less fever, and tightness of the chest, acute
pains in the female breasts, as if they were sore and ulcerated
in their inmost substance, continuing for weeks, and attended
with painfulness and heaviness of both mammee, followed by
considerable emaciation of the whole body, or great diminution in size of the breasts.
Dose. —NOACK advises drop doses of the pure tincture, largely diluted in water, or of the 1st, 2d, 4th, or 6th dilution, once or twice a
day. KNORRE adviseq 1 drop doses of the 1st or 3d dilution. The
granules may be used in very sensitive persons.
FERRUM ACET.,
When delaying menses consist of a scanty discharge of watery blood.
DULCAMARA,
When Menstruation is retarded, with discharge of thin,
F




82                    MENSTRUATION.
watery blood. When the menses are delayed for many days,
even for 25.
DoSe. —Dulcamara is one of the milder remedies, of which NOACK
advises 1 or 2 drops per dose, of the pure tincture, or of the 1st or 2d
dilution, from 1 to 3 times a day. In appropriate cases, the higher
dilutions may be tried, or from 3 to 6 granules may be dissolved in a
wineglassful of water, and 1 teaspoonful taken per dose.
SEPIA,
When the menses are three days too late.
Dose. —Same as for Natrum. (See page 78.)
CIOUTA)
Late Menstruation.
Dose.-Same as for Sabadilla. (See page 78.)
HYOSC. AND IGNAT.,
When " courses" are some days too late.
0ose.-Same as for Cicuta.
PODOPHYLLITUM PELT.,
When menses are retarded and infrequent.
Dose.-Same as for Dulcamara.
NUX VOM.,
When menses do not appear for 6 weeks, and then come on
again at the time of full moon.
Dose.-Same as for Sabadilla.
BELLADONNA,
Increase and delay of Menstruation for 22, 36, or even 48
days.
Dose.-See page 40.
CALCAREA
Cured a case in which Menstruation was often delayed to
the 6th week, but was then very profuse, attended with severe




INFREQUENT MENSTRUATION.            83
colic, frequent headache, dizziness; violent chronic cough, with
pressure upon the chest, as if it were too contracted, causing
her to wake several times at night, with asthma and fearfulness; she had no appetite, was very weak, gloomy, and discontented.
Dose.-Same as recommended from Natrum. (See page 78.)
GRAPHITE
Is homceopathic when the menses are delayed beyond the
proper period of return. It cured a case in which Menstruation was delayed and too scanty, setting in only every 5 weeks,
the patient being dizzy even when sitting, having buzzing in
the ears, tearing pains in the temples, just before the monthly
period, heat in the face, excessive appetite. Menstruation in
this case was attended on the first day by cutting pain and pressure in the abdomen, extending down to the womb, the discharge being scanty; the patient was costive, having a hard
evacuation only every 2 or 3 days; in the evening, while in bed,
she often had a peculiar pain and cramp in the calves of the
legs; in the morning she was so dizzy as often to be on the point
of falling. It also proved useful in another case of scanty and
infrequent M]enstruation, in which the courses set in irregularly, only every 8 or 10 weeks, the discharge being thick and
as black as pitch, being preceded and accompanied by continual headache, by cutting and pressing pains in the lower part
of the stomach, and in the hips. The patient also had pain
in the small of the back; the abdomen, arms, and legs were
bloated, with numbness, tingling, and stinging in them, as if
they would go to sleep; she was chilly, had cold hands and
feet; she had rapidly grown stout, with feeling of heaviness,
weariness, and inactivity; she also had small, round, red, and
itching herpetic eruptions upon the forearms and neck.
Dose,-Same as for Natrum. (See page 78.)
PHOSPHORUS
Is said to be homceopathic when the menses appear too late
by 4 or 8 days, but then are so much the more profuse, last



84                  MENSTRUATION.
ing 8 days, leaving great debility behind, the patient having
dark circles around the eyes, becoming emaciated and anxkous.
Dose. —Same as for Iodine. (See page 81.)
CONIUM AND KALI CARB.
Have been frequently employed with success, when the first
appearance of the menses is retarded.
Dose. —Same as for Bellad. and Natrum.
SCANTY MENSTRUATJON.
WHITEHEAD, in 359 cases, met with a woman of strong and
healthy constitution, whose Menstruation had commenced
regularly for years, on Tuesdays, but the discharge never continued longer than 24 hours; also 8 other females, of different
habits of body and differently occupied, who only menstruated one day each time. In one case, a lady had her turns
every 14 days, but the discharge generally continued only 2
days, and sometimes only a few hours. MADDEN, in 181 cases
of uterine derangement, met with 35 instances of scanty Menstruation. Although LooMIs estimates the natural quantity
of the menstrual flow at from 2 to 4 ounces, still, all cases in
which less than from 4 to 6 ounces are parted with, must be
regarded as decidedly scanty; the same holds true in all
instances in which the flow lasts less than 3 or 4 days, unless
it be unusually copious during that time.
Treatment of Scanty 2en8truation.
BARYTA CARB,)
When the menses are simply scanty.
PULSATILLA.
lEn scanty Menstruation, the discharge ceasing entirely at
night, and returning only in the day time while walking.
Dose,-See page 95.




SCANTY MENSTRUATION.                -85
SARSAPARILLA,
When the discharge is scanty and acrid, causing burning
and excoriation of the inner side of the thighs.
Dose.-Same as for Pulsatilla.
IGNATIA1
When menses are scanty, black and offensive.
Dose- Same as for Nux.
BERBERIS VULGARIS,
When the flow is scanty, also thin, like serum, setting in
with chilliness, aching in the small of the back, and tearing
pains in the whole body.
Dose.-Same as for Pulsatilla.
SABADILLA,
When the usually regular menses become scanty, and occur at irregular periods.
Dose.-Same as for Pulsatilla.
THUYA,
When the monthly flow is diminished and delayed.
Dose.-Same as for Pulsatilla.
DULOAMARA,
Against scanty Menstruation.
DOe, —Same as for Pulsatilla.
Bovista, Croton, Graphite, IKali carb., Lachesis, Magnesia
sulph., Natrum mur., Nux, Petrol., Phos., Sepia, Baryta carb.,
Carb. veg., and Silex, are also recommended.
AQUILEGIA
Is said to be beneficial in many uterine affections, especially
when the menses, although regular as to time, are too scanty
and attended with a dull, painful, nightly increasing pressure
in the right lumbar region.
Dose.-Same as for Pulsatilla.




86                   ME~NSTRUATION.
ATRIPLEX OLIDA
Is said to have cured a case in which the menses were
scanty, and generally consisted of bloody mucus, being preceded by violent lancinations and cuttings, and followed by
leucorrhcea; the patient being pale and livid, having dulness
of the head, constant restlessness and tossing in bed, getting
but little sleep, being troubled with anxious and frightful
dreams; she also had great weakness in the small of the back,
especially in the afternoon, when it was at times so great as
almost to cause her to sink or fall down.
Dose.-Same as for Aquilegia.
CALCAREA5
It is said, may not only be used against profuse, but also
against scanty Menstruation; it is even more frequently appropriate in the latter case.
Dose.-See page 48.
GRAPHITE
Cured a case in which Menstruation had been scanty for 4
years; it was attended with colic, drawing pains in all the
limbs, and by weakness. She had a cramping pain at the
pit of the stomach after every meal, followed by offensive eructations; but little appetite. Baryta relieved the colic; but
Graphite brought the menses on more abundantly. Graphite and Causticuml are said to be useful when the appearance of the menses takes place with pain and difficulty,
the discharge being scanty and soon ceasing.
Dose.-See page 96.
BARYTA CARB,1
When the menses are scanty, and last only 1 day, but set
in 2 days too soon-discharge of a little bloody mucus from
the vagina, with anxious beating of the heart, uneasiness in
the body. According to NEUMANN, Baryta is decidedly homceopathic to torpor of the sexual system.
Dose. —Same as for Calcarea.




SCANTY MENSTRUATION.              87
ALUMINA.
The action of this remedy is very similar to that of Baryta.
It is homeopathic when the menses are scanty and last only 3
days; when they are scanty and pale; when suppressed for
3 months, or only for 1 month, and then set in copiously-preceded for 6 days by a copious flow of menses from the vagina,
attended with trembling lassitude, and feeling as if everything
would fall out-frequent urination during Menstruation, the
urine being acrid-violent headache, which ceased on the appearance of the menses. Profuse and acrid leucorrhcea, with
a burning sensation in the part, but especially in the rectum.
Dose. —Same as for Calcarea.
ASSAF(ETIDA.
PEREIRA. —In J6RG'S experiments it produced irritation of
the sexual organs, while Menstruation appeared before its
usual time, and was attended with uterine pain-it has been
employed in uterine obstructions, such as amenorrhoea and
chlorosis, but CuLLEN very seldom succeeded with it as an emmenagogue-perhaps he might have met with better success
if he had merely used it against that peculiar form of
scanty and painful Menstruation which occurs too soon and frequently. SOBERNHEIM thinks, that it stands in quite a specific
relation to the uterine nervous system, and there is no other
remedy which so readily regulates the altered activities of the
female sexual organs; it effects as much against nervous derangements of the womb, as Bismuth does in the purely nervous affections of the stomach-in menostasia and irregularity
of the menses, owing to a perverse activity of the uterine nervous system, especially in delicate, badly regulated, and spasmodic girls. VOGT recommends it in atony, when attended
with an irritable state of the uterine nerves; in many nervous
and spasmodic affections connected with mentrual disturbances; in painful, suppressed, scanty, and irregular Menstruation, delayed development of puberty, &c. It is most suitable in delicate, atonic, extremely irritable persons, who are
inclined to spasms, have a pale appearance, and disposed to




88                   MENSTRUATION.
leucorrhea. DIERBACH advises it in spasms of the stomach
and bowels, complicated with obstructions in the vena porta
system, and irregularity of Menstruation. Labor-like pains
in the uterus, with bearing-down and cutting pains, recurring
at intervals-when menses set in 10 days too soon, but are
scanty, lasting only 3 days.
Dose —Same as for Chamomilla. (See page 43.)
ABSENT MENSTRUATION.
AMENORRHCEA.
In 1149 cases of uterine disease, ASHWELL met with 126
cases in which Menstruation was absent; in 181 other cases,
MADDEN found 36 cases of the above disorder, i. e., amenorrhoea, with 18 cases of irregular Menstruation, 35 cases of'
scanty discharge, 9 cases of late or delayed Menstruation, and
19 cases in which the flow was too pale in color.
A reference to the tables, (see pages 8 and 9,) will satisfy
any one of the large number of cases which commence Menstruation at a late period, viz., after the 17th or 18th year. It
is true, that in a large proportion of these cases, the patients
suffered more or less in consequence of the delay. Under the
gentle homceopathic treatment, there can he no objection in
commencing the treatment of amenorrhcea es soon as the physician and mother have agreed that the proper time has arrived for the menstrual function to be established. If there
be constitutional debility and delicacy of constitution to contend with, the treatment should be commenced very early, as
these cases are always slower and more difficult of cure than
are most other varieties of amenorrhcea; and, in the naturally
delicate, if Menstruation does not quickly follow the advent of'
puberty, the patient generally suffers for months and years
from the consequences of non-secretion; while COLOMBAT
states, that under old school treatment, amenorrhcea, which
has lasted several years, offers but slight chances of cure. The
treatment in the dominant school is often so severe, that even
the most experienced physicians prefer dilly-dallying witLh




ABSENT MENSTRUATION.               89
their cases in the commencement, and persist in their " masterly inactivity " until the disease becomes firmly established,
and the general health of the patient is materially involved.
Gentle treatment should be commenced with the first signs
of declining health, and even before these appear, if the first
advent of Menstruation be delayed beyond the 16th year.
There are several varieties of Absent Menstruation, or amenorrhcea.
1. When' there is a s8ow and partial development, or entire
absence of puberty.
It is said that retarded Menstruation from absence of puberty, defective organization of the ovaries, or want of maturity in them, may be at once recognized by the general
appearance of the girl; she is but a child, and has the appearance and manners of a child; and it is decidedly wrong
to force or irritate the frail system of an immature creature.
General invigorating management, however, should be instituted, the digestion improved, gymnastic exercises carefully
followed up, fresh air, plain but generous diet, cheerful company, and agreeable variety of occupation and pleasure, should
be supplied.
When there is a deficiency, or disorganization of the whole
of both ovaries, the amenorrhcea will of course prove incurable; but as long as one, or even a portion of one ovary is
sound, Menstruation may be performed more or less imperfectly; while partial, or remedial disease of the whole of both
ovaries should be detected and removed. ASHWEiL says, that
when puberty and Menstruation are delayed from delicacy of
constitution, or from residence in impure air, combined with
sedentary employment, or when the general debility is owing
to rapid growth of the whole body, thus diverting the requisite amount of nervous power and vascular activity from the
ovaries and womb, that the majority of such cases will recover,
under old school treatment, although months and years may'elapse before the cure will be accomplished, during which
time the confidence of the patient and of her friends, in med



90                   MENSTRUATION.
ical skill, will be severely tested. In the N. A. Homoeopathic
Journal, Vol. 1, pp. 181 to 200, I have treated in full of Atrophic ovarian-amenorrhoea; Conium, Plumbum, Baryta, Muriatica, and Bromide of Potash, Camphora, Agnus castus,
were there pointed out as the most homceopathic remedies to
this condition; if these should fail, the Antipathic remedies,
viz., Ferrum, Phosphor., Nux, Electricity, Stramonium, Aloes,
and Cantharides, may be resorted to.
2. Amenorrhoac after puberty is fully established.
Retention of the menses beyond the period indicated naturally by the advanced development of the rest of the system,
may arise
(a) From mere delicacy of the constitution;
(b) From an irritableand hysterical condition;
(c) From chlorosis;
(d) From general plethora, especially when there is an excessively fibrinous state of the blood.
According to ASHWELL and LooMIs, who agree in a remarkable manner, not only in their views, but also in their language, amenorrhcea in plethoric, but otherwise healthy and
robust subjects, is characterized by symptoms of congestion,
or active plethora. There is headache, tension, and weight
about the brain, with a sensation of fulness and throbbing in
the centre of the head, or about the cerebellum, a florid countenance, torpor, lassitude, pain in the back and loins, a full,
and generally a slow pulse, though occasionally, in irritable
females, it is rapid; irregular circulation, evidenced by the
feet and hands being, the one hot and the other cold, or both
at short intervals remarkably hot or cold; the skin is sometimes harsh and dry, at others clammy. These symptoms at
first pass away after the attempt at Menstruation is over, but
subsequently they will persist during the intermenstrual periods, and recur in an aggravated degree as the menstrual
epoch again approaches. This form is generally curable,
though often neglected; and if long neglected, or inefficiently
treated, a cure will not be soon accomplished.




ABSENT MENSTRUATION.
The obstacles in the way of a cure by nature, or medical
art, are:
1. An excess of blood in the whole system.
2. An excesssively fibrinous state of the blood.
3. Congestion of the womb so active, as to prevent the
secretion of the menstrual fluid.
The principal homoeopathic remedies for excess of blood in
the whole system, are, Ferrum, China, Natrum muriaticum,
Bellad., and Stramonium. The principal antipathic remedies,
are, Aconite, Digitalis, Veratrum viride, Carbo vegetabilis
and animalis.
The principal homceopathic remedy, against an excess of
fibrin in the blood, is Argentum nitricum. The best antipathic remedies, are, Ferrum, Phosphor., Kali carb., Calcarea,
Borax, Magnesia carb. and muriatica, Potassoe nitras, and
Causticum.
The principal homceopathic remedies against congestion of
the womb, are, Sabina, Stramonium, Cantharides, Aloes, Crocus, Platina, and the numerous remedies mentioned under the
head of " Profuse Menstruation."
The varieties from debility and nervousness will be alluded
to under the head of treatment.
3. Amenorrhea froo m  distant disease, or visceral irritations,
wtich retain the blood, and prevent itfrom being directed
towards the womb.
According to COLOMBAT, ainenorrhcea, depending upon disease of some organs, may set in at the commencement of such
disease, or more frequently it appears at a rather advanced
period; and it may be assumed as a general rule, that the
menstrual derangement declares itself sooner in proportion to
the degree of sympathy between the disordered organs and
the womb; for example, when the stomach, brain, or heart is
affected, the amenorrhcea is apt to come on at a very early
period, whilst in consumption the complete suspension of the
menses does not occur until the tubercles begin to soften.
Very frequently the menstrual diarrhoea alluded to on page




92                 KMENSTRUATION.
14, becomes so prominent as to render the menses irregular, or
even to suppress them; CHURCHILL has had patients, who,
when their menses became irregular, were very liable to attacks of diarrhoea, with griping pain; BAUDELOCQUE knew a
lady, 45 years old, who had never menstruated, but who had
diarrhoea for 3 days in every month; BRERA, COLOMBAT, and
FOUQUIBR have seen cases in which dysentery sat in every
month for several years, finally causing amenorrhcea. The
simplest form of this variety of amenorrhcea occurs in consequence of the very rapid growth of the rest of the body, which
diverts the nervous power and vascular activity from the ovaries and uterus, to the other and distant organs. COLOMBAT,
in particular, insists that the menstrual flux may be prevented
by all sorts of chronic, congestive, inflammatory, and nervous
affections, and that very frequently a crowd of neuroses and
neuralgias show themselves for the first time, only when Menstruation has become entirely suppressed, and yet they have
caused the suppression, not merely arisen in consequence of
it. With this clue we will be better able to understand the
action of many remedies which have gained a reputation as
emmenagogues, without exerting any specific action upon the
ovaries or womb; they cure the distant irritations, and then
merely allow the blood to return to its regular and periodical
course; thus Bryonia will often remove chronic or periodical
congestions to the chest, and afterwards allow the blood to be
diverted downwards to the ovaries and womb; Bellad., by
curing congestion to the head, homoeopathically, will permit
the regular menstrual congestion and haemorrhage to take
place from the womb; Veratrum, by allaying irritation of the
bowels and curing diarrhcea, will remove the obstacle which
prevented the blood from flowing towards the uterine organs.
Treatment.-In the Hlomceopathic Hospital1 Report, of 54
cases of suppressed, absent, or scanty Menstruation, 36 were
cured, 7 relieved, and 11 uncured, or still under treatment.
In the N. Y. Homceopathic Dispensary Report, for 1851, of
53 cases of suppressed or scanty Menstruation, 14 were cured,
34 relieved, and 5 unknown, or still under treatment. MAD



ABSENT MENSTRUATION.              93
DEN, in 94 cases of absent or scanty Menstruation, had 62
cases cured, or greatly benefitted; 27 cases somewhat benefitted; RiiCKERT reports 30 cases cured; BEAUVAIS, 24 cases;
in all, 255 cases, of which 112 were cured or greatly benefitted; 68 somewhat relieved, and 43 uncured.
In RUiCKERT'S Therapeutics, BEAUVAIS' and MALAIS' Cliniques, HENDERSON, &C., 65 cases of amenorrheea cured by
homoeopathic remedies are reported: of these, 18 were cured
by Puzlsatilla, alone, and 12 by Pulsat., aided by other remedies; 8 cases were cured by Sulphur, alone, and 3 by Sulph.,
aided by other remedies; 6 cases were cured by 3lux vomica,
alone, and 4 cases by Nux, aided by other remedies; Sepia
was used in 7 cases; Graphite was given in 10 cases; Calcarea in 5 cases; Bellad. in 3 cases; Aconite in 3 cases; Bryonia in 4 cases; Cocculus, Iodine, Opium, and Conium, each
in 2 cases; Baryta, Caps., Stramon., Ant. crud., Natrum, Sabina, Coloc., Silex, Arnica, Ferrum, Carb. v., China, Urtica
urens, and Nux moschata, each in 1 case.
PULSATILLA.
This is the favorite homceopathic remedy against amenorrlacea; we have already seen that it was given more or less
successfully, in 26 cases out of 65. Hahnemann recommends
it when the menses are suppressed or delayed, and attended
with cramps in the bowels and womb. KNORRE found it useful when the patient's face was pale, and there was constant
chilliness, even during summer weather and with warm clothing. TIETZE, when amenorrhea was attended with leucorrhoea, dizziness, aching pain in the womb, and difficulty in
urinating. KoPP, when there was great sensitiveness and
weakness of the eyes. RiicKERT, when there was menstrual
colic, cutting pains in the bowels, pressure upon the bladder,
attacks of vertigo, with loss of appetite and taste. TRINKS, in
scanty Menstruation, when attended with menstrual colic.
ALTSCHUL cured several cases with it. MADDEN found it very
serviceable. But DIETZ and HEICHELHEIM, never witnessed
any good effects from it, against absent Menstruation. An




94.: I:NSTRUATION.
overdose of Pulsatilla is apt to cause pain in the stomach,
canine hunger, nausea) and vomiting, slimy stools, frequent
discharge of urine, profuse discharge of offensive sweat, excessive weakness, so that the patient is obliged to keep her
bed, outbreak of a vesicular eruption over various parts of the
body, trembling of the limbs, and peculiar pains in both eyes.
VOGT says, that the most marked and constant of actions, are,
increased flow of urine, and increased secretion of mucus from
the nose and air tubes, and of perspiration. SOBERNHEIM says,
that it acts upon the eyes and skin, mucous membranes, and
urinary organs, in quite a specific manner. DIERBACH says,
it causes offensive perspirations from the feet and arm pits,
vesicular and pustular eruptions, profuse flow of urine, and
that suppressed piles and menses are apt to reappear under
its use; it is also apt to excite an irritation to cough, repeated
sneezing, headache, dizziness, pain, sensitiveness, and dimness of the eyes, also nausea, vomiting, pains in the stomach
and bowels, colic, and slimy diarrhoea. Hence, it would seem
most homzeopathic to amenorrhcea, and suppression from
taking cold, especially if there be a catarrhal affection of the
eyes, nose, and chest, or of the stomach and bowels; or a
rheumatic catarrhal affection of these organs, and of the fib.
rous tissues. It is most homceopathic to amenorrhcea produced by visceral irritations in distant or gans, which retain the
blood in the irritated parts, and prevent it from being directed towards the womb and ovaries. It is especially homceopathic to amenorrhcea from severe one-sided congestions to
the head or eyes, or from severe scrofulo-catarrhal, or rheumatic inflammations of the eyes, nose, or lungs; from severe
influenzas, chronic coryzas, or bronchitis; or from severe acute,
or chronic mucous, or catarrhal irritations of the stomach and
bowels, marked by slimy-coated tongue, nausea, loss of appetite, vomiting of mucus, pain in the stomach and bowels, and
mucous diarrhcea; of from such severe catarrhal affection of
the kidneys, bladder, uterus, and vagina, that the usual menstrual discharge is checked and prevented; finally, it is also




ABSENT MENSTRUATION.                  9.5
homoeopathic to amenorrhcea caused by skin diseases of great
extent and tenacity, such as salt-rheum, acne, &c.
I have a strong suspicion, however, that it is antipathic to
amenorrhea, for STORK has seen it produce increased and copious Menstruation, and even flooding from the womb, attended with the discharge of thick, black blood; and DIERBACHt
says that suppressed piles and menses reappear under its use.
DOe. —The 2d dilution was used successfully in 1 case; the 4th in
3 cases; the 5th in 2 cases; the 6th in 3 cases; the 8th in 1 case; the
12th in 6 cases; and the 15th in 1 case. The very high dilutions do
not seem to be thought worthy of confidence in this disease, as even
Hahnemann advises 1 or 2 drop doses of the 12th dilution. TRINKS
saysj that the 2d dilution is by far the most useful, while ALTSCIUL prefers the 6th in adults. See also page 64.
GRAPHITE.
This remedy was used next most frequently to Pulsatilla,
viz., in 10 cases. In my work on Headaches, page 110, I have
pointed out the close relation of Graphite, or mineral carbon,
to Sepia, or fish carbon, to Carbo vegetabilis, or vegetable carbon, and to Carbo animalis, or animal carbon. There is also a
close relation between some of the actions of all these remedies, and those of Pulsatilla; at least they all act prominently
upon the venous system and skin. Hahnemann found it most
useful when there were frequent flushes of the face, troublesome dryness of the nose, eructations, morning-sickness, heaviness in the bowels, great accumulation of wind, obstinate constipation, painful piles, leucorrhcea, and coldness and falling
asleep of the feet. TRIN1Ks recommends it in scrofulous and
venous constitutions, when there is a great inclination to. perspire, and to chronic eruptions, or to catarrhal affections, or
haemorrhoidal and menstrual congestions to the upper part of
the body. ALTsCHUL says, it is useful when catarrhal affections
are apt to set in about the menstrual period, such as hoarseness, dry cough, evening-headache, and catarrhal fever, attended with pains in the bowels and small of the back, or by toothache, especially if diarrhcea occurs after the menstrual period
has passed by. It has also been used successfully against sup



96                   MENSTRUATION.
pressed, delayed, or irregular Menstruation, when there was
a painful pressure upon the genital organs, persistent aching
pains in the head, swelling of the belly and of the arms and
legs, with heaviness and lassitude. Also, against amenorrheea
and dysmenorrhcea, from portal congestion; GOULLON used it
successfully against amenorrhcea with dropsy of the feet; LoBETHAL against scanty and painful Menstruation, when the
difficult irruption of the menstrual flow finally produces a
scanty discharge, which generally soon ceases again. KNOERR
recommends it from personal experience, against scanty and
infrequent Menstruation, when it occurs irregularly, only
every 8 or 10 weeks, and then lasts but a few days, with a
scanty discharge of thick, black blood. LooMis recommends
it when suppression occurs very soon after the flow commences, attended with cutting pains in the bowels, painful
swelling in the region of the ovaries, a sensation as if everything was forced down towards the genital organs, headache,
nausea, pains in the chest, a Weculiar and characteristic white
laucorrhcea, as liquid as water, especially if the patient be also
troubled with herpetic or erysipelatous eruptions.
DOSe.-The 12th dilution was used in 2 cases; the 30th in 5 cases.
TRINKS recommends 1, 2, or 3 grain doses of the 1st, 2d, or 3d trituration; ALTSCHUL has seen excellent effects from the 2d dilution; LOBETHAL was very successful with the 1st and 2d potencies.
SEPIA.
This remedy is only reported as having been used in 7
cases, although it is given, perhaps, more frequently in chronic
amenorrhoea, than any other homcopathic remedy. Loorms
says, that it is appropriate in chronic amenorrhbea occurring
in weakly females, with a delicate and tender skin, sallow
complexion, and predisposition to melancholy and sadness,
especially if they are also annoyed with a yellowish, or greenish-red, watery leucorrhcea, or a purulent, fetid, and corrosive
discharge. Sepia-patients are subject to frequent attacks of
nasal catarrh, suffer much with nervous debility, and tendency
to weakening perspirations, with headache, nervous toothache,




ABSENT MENSTRUATION.               97
throbbing in the head, dizziness, bearing-down pain in the
womb, pains in the loins and small of the back, and in the
limbs, as if they had been bruised or beaten.
TIETZE recommends it in those amenorrheeas which arise
slowly out of an affection of the assimilation, and the whole
bearing of the patient expresses the presence of an obstinate
and deep-seated affection, the skin being pale, dingy, or sallow, the frame delicate, and the features marked with traces
of frequent suffering. For Sepia to be useful, a dyscrasia
should always be present, attended with obstinate and deepseated nervous derangement. It is almost specific in cases
attended with sutdor hystericus, or a peculiarly sweetish-smelling perspiration of the arm-pits; and soles of the feet.
Dose.-Same as, recommendeda for Graphite.
SULPHUR.
This remedy was used more or less successfully in 11 cases.
It is supposed to be a resolvent remedy which acts principally
upon the skin, liver, mucous membranes of the bowels and
lungs. It acts so beneficially upon the lungs and air tubes,
that GRAVES always adds it to his cough prescriptions, and
even in old:- timies it i obtained the -name of " Balsam of the
Tungs."  SUN DELIN Says, that it operates quite specifically
upon the mucous membrane of the rectum, and thereby promotes critical haemorrhoidal secretions; this action may be
extended to the uterus, for ALTSCHUL says, that its exerts a
specific influence upon the venous vessels of the abdomen,
rectum, and pelvic organs; it causes congestion of blood to
the womb, a pressing-down pain, and inflammation of the
vulva, attended with too easy and too copious a flow of the
menses, so that it probably cures amenorrheea antipathically.
LOOMIs says, that it is most useful in the amenorrhoeas of
lymphatic and bilious females, predisposed to eruptions and
enlargements of the glands; KNORRE recommends it in suppressed Menstruation, when followed by congestion of blood
to the head, especially when there is pain and heaviness in
G




MENSTRUATION.
the occiput, extending down into the nape of the neck; also,
when the patient's face is pale and sickly, with red spots or
blotches upon the cheeks, and livid circles around the eyes;
when the stomach is deranged, and there are sour eructations,
with heaviness, fulness, pressure, and spasms in the stomach
and bowels, loose and slimy stools, with straining, and inclination to piles; also, when there is pain in the loins, itching
of the genital organs, and a yellowish,. corrosive' leucorrhcea.
It is very useful when the suppression is preceded or followed
by irritation or disease of the chest, marked by cough, more
or less pain and soreness, shortness of breath, and expectoration of blood.
It is also particularly suitable in the amenorrhoeas of bilious and rheumatic females, and when suppression is caused
by a check of perspiration, from exposure to a current of air,
or from getting wet, or, washing in cold water.
Dose,-The tincture was used in 2 cases; the 1st trit. in 2; the 30th
dilut. in 2; the 12th in 1 case. TRINKS recommends the 1st or 3d
trituration, or 1 or 2 drop doses of the tincture. ALTSCHUL prefers the
1st or 6th dilution.
CALCAREA
Was given in 5 cases, although HAHNEMANN says it will
never be given with benefit when there is a deficiency of the
menstrual flow. It ought to prove far more homeopathic to
amenorrhcea and diminished secretions from various parts,
than either Pulsat., Graphite, Sepia, or Sulphur, for it not
only diminishes the secretions of the gastro-intestinal mucous
membrane, and thereby occcasions thirst and constipation, but
with the exception of increasing the quantity of urine, when
this is highly acid, it does not, like the other alkalies, promote
the action of the different secreting organs, but rather diminishes it, and has,.in consequence, been classed among the
astringents.
It is thought to be most suitable for persons of a rickety,
scrofulous, or lymphatic constitution, either with delicate
frames from poor nutrition, or else with a great predisposition




ABSENT MENSTRUATION.                  99
to grow large and fat. It will be treated of more fully under
the head of chlorosis.
Dose,-HAHENEMANN found the 6th dilution most useful in robust
persons. ALTSCHUL, who generally prefers the higher potencies, says
that the latest experience of the best homoeopathic physicians has
proved, that the fear of the low dilutions is founded on imagination only.
TRINKS prefers the 1st, 2d, or 3d trituration, or like dilutions of the,Sirit us Calcarece.
EALI CARBONICUM
Is frequently used by homoeopathic physicians against
amenorrhoea, although its principal action is to cause increased activity of the different secreting organs, and of the absorbing vessels and glands; it acts as a liquefacient and solvent,
renders the blood thinner and darker colored, and causes it to
lose its power of spontaneous coagulation when drawn from
the body, and hence predisposes to hiemorrhage, and finally
causes a state precisely similar to that of scurvy. It is one of
the best antipathic remedies against that form of amenorrhcea
which arises from an excessively fibrinous state of the blood,
for it combines with fibrine and albumen, forming soluble compounds, or the so-called Jlbrate and albuminate ofypotash;
gelatine is also readily dissolved by it. Dr. BLAnD, of Beaucaire, supposing that Ferrum does not exert all its curative
properties, unless so modified as to be readily absorbed into
the system, hit upon the plan of combining it with equal
parts of the Kali sub. carbonicum, thinking thus to bring the
Iron into a state of extreme division, rendering it more readily
absorbed, while it acquires greater activity from its chemical
combination. The great probability is, that the Kali modifies
the blood, and diminishes the quantity of fibrin so much as
to predispose the patient to hsemorrhage.
Dose.-Same as for Calcarea.
NUX VOMICA
Was used more or less successfully in 10 cases, although it
has already been decided (see pages 28, 29, and 30) to be homceopathic to profuse Menstruation. It'exerts a most power



100                   MENSTRUATION.
ful antagonistic action in debility of the nervous and muscular systems, and probably will relieve many cases of amenorrhcea attended with such defects. On the other hand, it, like
Secale, is preeminently homceopathic to amenorrhcea from
spasm, or tonic contraction and condensation of the womb,
the muscular coat of this organ being so densely and rigidly
contracted, that no secretion from it can take place. According to LooMIs, it is useful when there is swelling of the womb,
with great tenderness to touch, cramp-like and contracting
pains, burning heat in the organ, and painful pressure towards
the external parts. The action of Nlux is very similar to that
of Electricity. Strychnine, the active principle of Nux vowica, was first used as a remedy against amenorrhcea,, by Dr.
BARDSLEY, of Manchester; out of 12 cases, 10 were cire4d:and
2 relieved. CHURCHILL can add several cases in twhich the
cure was permanent and complete. Although B:'1]SL Y's
cases were of suppressed Menstruation, there is ho re sPflor
doubting its efficacy in simple amenorrhcea. NACEi whas Also
used it successfully. AsHwELL gave it in 4 cases, in d9eipc4
females, without success; CHOLmELEY used it in several;.stances unsuccessfully..,
Dose.-Nux, 10th dilut., in one case restored the menstrual1 flow,
after a cessation of 9 months; in 2 cases, the tincture was given every
night and morning, at first 1 drop was given per dose, then the quarttity was increased by 1 drop every day; the menses appeared on the
4th day in 1 case, on the 8th in the cther. In most cases, the same
doses as recommended for Ignatia, may be given. (See p. 57.)
ELECTRICITY.
To DE HAEN is supposed to belong the credit of first advocating the electric treatment of amenorrhcea, as early as 1758;
he remarks that it always promotes the catamenial discharge. BmcH, in 1779, published his Considerations on the
Efficacy of Electricity in female obstructions, and from this
time down to the present day, the value of this agent has been
more or less recognised. BENERT BOGIN, was the first to use
Galvanism in amenorrhcea; his first case was a girl, aged 18,
and not yet regulated; she was galvinized 6 days, and on the




ABSENT MENSTRUATION.              101
7th Menstruation sat in, and was soon followed by a perfect
recovery of health. BOGIN cured several other cases. SCARPA
also insisted particularly upon the emmenagogi'e properties
of Electricity.  ROGNETTA was not very successful with it,
but found it more useful when applied to the hypogastrium
and back, than when conveyed directly to the womb through
the vagina. RAYER cured a suppression of several months'
standing, at the 3d sitting. He also used Electricity in a
female, subject to serious attacks of vomiting of blood, followed by amenorrhoea, which had been uselessly treated by various remedies, for 8 months; electro-magnetism was applied,
once a day, for 10 or 15 minutes, strong enough to produce
painless contractions; after the 5th sitting, the menses reappie*a Qscantily, for 1 day only, but the vomiting of blood did
O.t0ccuur afterwards; Electricity was used again the next
Won.th, for.several days previous to the expected period, and.the menses then sat in more copiously, and the patient gradu1fly recovered.
1  Lately, GOLDING BIRD has distinguished himself by his sucwqssful use of electricity in amenorrhcea; in 1843, he reported
24,.C4s:treated by it; the youngest patient being 15 years
old,? the oldest 25, all unmarried.
Of these, 4 were chlorotic,
6 slightly so,
12 not at all so,
2 complicated with hysteria..Of these, the remedy succeeded in all except the four chlorotic girls.
BIRD says: " In electricity, we possess the only direct emmenagogue which the experience of our profession has furnished us with. I do not think I have ever known it fail to
excite Menstruation where the womb was capable of performing this function. Disappointments, however, will almost certainly result at times, if we have recourse to electricity merely
because a girl does not menstruate; and we must never lose
sight of the fact, that, after all, the large majority of cases of
amenorrhcea depend upon an anaemic, or bloodless condition




102                  MENSTRUATION.
of the patient, who does not menstruate simply because she
has no blood to spare. Nothing can be more ridiculous than
applying Electricity, or any other local irritant or stimulant, to
the womb, when chlorosis exists; the first great indication
will be to restore the general health; give Iron to make up
for the previous deficiency of that element in the blood, [or
give Kali carbonicum, or some other remedy, to reduce the
excess of fibrin which prevents the hsemorrhage; or give
Graphite, Sepia, or Sulphur, to remove the peculiar dyscrasias
against which they are so specific; or use Nux vomica, to
restore the tone of the digestive system, and remove excessive
debility and irritability of the nervous and fibrous systems,]
and then, and not before, think of stimulating the womb. It
is true that, in a large proportion of cases, the menses will ap
pear as soon as the chlorosis, [hyperinosis, dyscrasia, or general debility] is cured, and, of course, in such cases, there will
be no need of the employment of Electricity; but still a large
number will occur, in which, even after the complete relief
of the chlorotic, ansemic [dyscratic, fibrinous, or debilitated]
condition, the womb will remain torpid and refuse to act. In
such cases, a few shocks of Electricity, transmitted through
the pelvis, seldom, if ever, fail in effecting Menstruation. I
have repeatedly known the menses, although previously absent for months, to appear almost immediately after the use of
Electricity; and in more than one case the discharge actually
appeared within a few minutes. About a dozen shocks should
be transmitted through the pelvis, one director being placed
over the lumbo-sacral xegion, the other just above the pubes,
[or alternately over each ovarian region.]
Dr. McDONNELL says, that the practitioner often meets with
instances where females have suffered for months, or even
years, from complete arrest of Menstruation, or from its being
secreted scantily, and with difficulty and pain, or where the
discharge comes on irregularly, being abundant and without
pain at one time, whilst at the next period the patient may
suffer exceedingly, scarcely any discharge being present; in
another class of cases, severe dysmenorrhcea, or painful Men



ABSENT MENSTRUATION.              103
struation may have existed for years before the physician is
consulted. There are not, perhaps, any diseases in which the
ordinary [allopathic] courses of treatment are more unsuccessful; for long before we are consulted, the usual effects of such
derangements have become well marked upon the system;
-the constitution has become reduced and debilitated, and the
ordinary features of chlorosis and hysteria have become well
established. In other instances, the constitutional symptoms
may have preceded the uterine derangements, and it often happens that the disease becomes more and more confirmed, and
little or no benefit being derived from the advice of the regular
[allopathic] physician, the patient resorts to quack medicines
and nostrums, and after a waste of time, money, and health, a
physician is again applied to. It is under such circumstances,
and in such cases, that electro-galvanism acts with the greatest success, inducing a return of Menstruation when arrested,
or producing an easy and abundant secretion, when the function has been scantily and painfully performed, perhaps for
many years previously; and this change is soon followed by
an amelioration of all the distressing symptoms under which
the patient has labored.
McDONNELL applies one button to the os pubis, the otheris
passed slowly along the spine, from the occiput to the os coccygis, four or five times, and then is kept applied to the sacrum for 5 or 6 minutes, and the Electricity is thus passed in an
uninterrupted current through the uterus. It is by no means
necessary to put the patient to great torture by increasing the
strength of the shocks, as more benefit will be derived from
an uninterrupted and steady transmission of a moderate quantity of electro-galvaiism, than by occasional shocks of great
intensity. The author reports several cases, which place the
efficacy of electro-galvanism, in various uterine derangements,
in a very favorable light.
The internal use of electrical remedies, such as Zinc and
Cuprum, Zinc.and Argentum, Zinc and Platina, 1 dose of
each, to be given at an interval of i or i hour, then allowing




104                    MENSTRUATION.
an intermission of 4 or 6 hours, and again repeating them  im
the same way, may he used with great benefit, in connection with the external application of Electricity.
SECALE
Acts specifically upon the nerves and muscles of the womb,
almost in the same manner as Nux vomica and Electricity
act upon the nerves and muscles in general. Although it
is but rarely recommended in homceopathic works, it ought to
prove one of the very best: homceopathic remedies against
painful, scanty, and suppressed Menstruation.  It has been
frequently used in the old school, notwithstanding its homceopathicity; CHURCHILL says: that Ergot of Rye will increase, if
not originate, uterine contractions, is known to all, and also,
that it will restrain inordinate discharges from the womb; we
should, however, scarcely expect it to be useful in-exciting the
menstrual secretion, and it is difficult [easy] to determine
upon what principle it: des so. As to the fact, we have the
evidence of DEWEES, *vho recommends its use; of Dr. LoCOCK, who has tried it with success'; and of ROCHE, NAUCHE,
and PAULY.
Dose.-In scanty or suppressed Menstruation, Secale should be
given in quite small, or homoeopathic doses; it often fails in the hands
of old school physicians, because they administer it in 5 or 10 grain
doses,several times a day. In profuse Menstruation, however, in which
it is antipathic, it should be given in full doses. I have been to the
habit of relying upon it, almost exclusively, in menorrhagia, and have
rarely or never known it to fail. In suppressed or scanty Menstruation,
the Ist, 2d, or 3d dilution may be given once or:twice a day, during the
interval, and every 4, 6, or 8 hours, during the menstrual period. Or,
from 2 to 4 granules may be administered as often as above directed.
BRYONIA
Was used in 4 cases, although it has already been decided
to be homoeopathic to profuse and frequent Menstruation.
(See pages 28, 29, and 40.) It is probably homceopathic to
amenorrhcea, when the menses are delayed or suppressed by
the counter-irritant action of rheumatism of the chest, joints,




ABSENT MENSTRUATION.             105
or limbs; and homceopathic to profuse Menstruation from
rheumatism of the womb or ovaries.
Dose, —See pages 40 and 41.
BELLADONNA
Was used in 3 cases, although it also has been said to be
homeoopathic to profuse Menstruation. See page 39.
Dose.-See pages 39 and 40.
ACONITE
Was also used in 3 cases; it, too, has been recommended
as an emmenagogue. See page 36.
Dose,-See page 36.
OPIUM
Was only used in 2 cases, although it is decidedly one of
the most homoeopathic remedies to scanty, suppressed, or absent Menstruation, although PEREIRA says that the menses,
lochia, nmd secretion of milk, are not checked by it, and that
its use in the female is not likely to be attended with suppression or retention of the uterine or mammary secretions.
It is most homoeopathic when amenorrhcea is attended with
congestion of blood to the head, obstinate constipation, and
scanty urine.
Dose.-Same as for Aconite.
CONIUM
Is also one of the most, undoubted homceopathic remedies
for amenorrhcea. DIERBACH says, that it exerts an especially
depressing action upon the genital organs, preventing pollutions, relieving satyriasis and nymphomania, and repressing
ordinary sexual inclination to such a degree, that in olden
times the Hierophantes and priests of Cybele, were obliged
to use Conium juice internally, and also to wash themselves
with it, in order to'keep down all lustful emotions. ANDRY,
ANDREE, and GREDING, assert that it causes suppression; Lm



106                  MENSTRUATION.
ryus. knew it to cause impotence in one instance; lHAHNEM
MANN says, that it causes suppression of the menses, with pains
in the back and sacrum, also scanty menstrual flow, and barrenness. It also exerts an equally depressing effect upon the
breasts and testicles, to that which it induces in the womb
and ovaries; DoscoRDEs says, it suppresses the milk in women,
and prevents the development of the breasts in virgins, and
causes a wasting away of the testes in boys. PLINY gives a
similar account of its action, and says that it reduces all
tumors. AVICENNA praises it as a remedy for tumors of the
breasts and testicles, while, more recently, PEREIRA has heard
of 2 cases in which it caused atrophy of the female breasts.
It is homoeopathic to amenorrhcea from atrophy and torpor of
the ovaries and womb.
Dose. —Same as for Belladonna.
EARYTA
Was used in 1 case only, although it is almost as homceopathic. to amenorrhcea, as Secale or Conium; it produces atrophy of the womb, ovaries, and breasts, and diminishes the
sexual feeling more decidedly than any other remedy.
Dose.-Same as for Calcarea. See page 48.
KREOSOTE.
My friend, Dr. BOLLES, cured 1 case of amenorrhcea, of 1
years' standing, with Kreosote 30.
EMMENAGOGUES.
In those cases of amenorrhcea in which strictly homceopathic remedies fail to effect a cure, or else, as they frequently
do, restore the general health without bringing on the menstrual flow, it may be allowable to use moderate doses of emmenagogue remedies. If WHITEHEAD'S opinion is correct,
that Menstruation is merely a flow of blood from the womb
and its appendages, and not a peculiar secretion, then there




ABSENT MENSTRUATION.             107
are many remedies well calculated to favor the excretion. Of
these:
SABINA
Is the most certain and powerful. (See page 65.)
Stramonium, Ferrum, Aloes, Cantharides, Crocus, Borax,
Ruta, Nux vomica, Potash, and others, are well-tried and efficient remedies. As the same blood vessels and nerves furnish branches to the bladder, kidneys, womb, ovaries, and rectum, some German physicians have hit upon the idea of giving Aloes, which acts specifically upon the rectum; Sabina,
which operates especially upon the womb; and Cantharides,
which effects the bladder so decidedly, in order to draw down
the blood from the upper parts of the body, to all of the pelvic viscera. But this treatment will fail entirely, unless anaemia has been previously removed by the use of Ferrum or
Manganum; excess of fibrin by means of Kali carb., Kali
nit.; deficiency of nervous energy, by Phospor. or Nux; deepseated dyscrasias, by Sepia, Graphite, Carbo animalis, etc.
In some cases all these remedies will fail, and even the
most bigotted theoretical physician will at times be glad to
resort to some empirical remedy.
PRUNUS LAUROCERASUS.
Dr. KASTNER, first tried the efficacy of this drug upon a
strong, plethoric girl, aged 16, in whom the symptoms of
Menstruation had appeared a year before, but latterly had
almost entirely ceased. She suffered at times, however, with
considerable distress, such as congestion to the head and
chest, and also violent colics; these symptoms becoming much
increased, Dr. K. tried many of the usual remedies, but without effect; he at length became acquainted with the use of
this bark, and 6 days before the next periodic return of the
symptoms, she was ordered to use it daily. On the expected
day the usual disagreeable symptoms came on, viz., loss of
appetite, rumbling in the bowels, frequent desire to pass
water, with a burning sensation during micturition, dragging
sensation in the pelvis, with rush of blood to the head; two




108                  MENSTRUATION.
days thereafter a mucous discharge appeared from the vagina,
and on the third day a diarrhcea, along with the menstrual
flow, which continued moderately for 4 days. The next period
was 2 days too late, and the next again 3 days too early, but
after this she became quite regular.
Two other similar cases were treated with an equally favorable issue; and lastly, a case of suppression, in a girl, aged
18, in whom, after using the medicine for two separate periods of 8 days each, the discharge was reestablished.
CHENOPODIUM OLIDUM.
Dr. HOLToN has had frequent opportunities of watching
the curative action of this remedy, and is perfectly convinced
that it is a very safe and important medicine in many cases
in which Menstruation is not duly performed; he generally
gave it for a fortnight previous to the expected menstrual
period, and repeats the same treatment if the first course of it
does not effect a cure. It will cire cases in which restoration
of the general health is not followed by Menstruation, and the
womb itself requires assistance.
MAMMARY IRRITATION.
Dr. CORMACK says, that warmth und stimulants applied to
the breasts often act powerfully as emmenagogues; in the
ordinary treatment of amenorrhcea, the first indications of the
womb being roused from its torpor are turgescence and tingling of the breasts; phenomena which also usually precede
natural Menstruation. It is equally true, though not so familiarly understood, that measures which act directly and primarily upon the breasts, such as warm clothing to the breasts,
and the application of ordinary or stimulating poultices, not
only cause them to swell and throb, but likewise stimulate the
ovaries and cause the menses to flow. The practice of applying leeches to the breats in amenorrhcea, owes its efficacy to
the fomentations used, and the irritation of the bites.
Drs. CoRMAcK and PATTERSON give 1 case, in a woman, aged




SUPPRESSED MENSTRUATION.           109
24, in whom the menses had been suppressed for 21 years,
cured in 2 days by the application of a large mustard poultice to one breast. Also, another case, in a girl, aged 19, with
suppression for 5 months, cured in 3 days by a mustard poultice to one half of one breast.
The emmenagogue effects ascribed to the application of the
leaves of the Castor oil plant, by Drs. MCNILUAx and TYLER:
Smrri, can easily be understood, when we remember their.
irritating character, and the consequences which have been
found to follow irritation of the breasts by other stimulants. A
good deal may be effected by the mere application of warm
poultices.
SUPPRESSED MENSTRUATION.
Two great varieties are generally admitted, viz., Sudden or
Aczute suppression, and Gradual or Chronic;-temrporary
suppression also deserves attention.
Sometimes the suppression is very simple and temporary in
lit nature, and merely requires time to remove it. TILT says,
thit mothers should be made aware of the fact, that without
Any detriment to a girl's health, Menstruation may be sup]pressed by any great change of abode, or circumstances; that
-when a girl leaves the country and goes to school in town, the
flow will be very likely to stop for 3 or 6 months, and then
proceed regularly, even without medical treatment; and vice
Versa, when a girl is accustomed to a town residence, she will
be apt to have a cessation for a short time, if she passes the
summer in the country, although the suppression may not
come on until she returns to the city again.
TILT says that this fact is so little known by women, that
he was scarcely surprised at being informed by Dr. JULIUS, of
Richmond, that in a school which he attended professionally,
where the number of boarders generally averaged from 80 to
90 girls, this retard or delay in the regular appearance of
]Menstruation, occurred so frequently soon after the arrival of
the girls, that the lady presiding over the establishment, felt




110                 MENSTRUATION.
convinced that it depended on the unwholesomeness of the
situation, and she intended to urge the removal of the institution to another locality, had not Dr. JuLIUS succeeded,
with some difficulty, in convincing her of the real state of the
case.
That this temporary su2ppression depends on change only,
and not on a change from agreeable to less agreeable circumstances, is proved by the fact, that when the courses have proceeded regularly in town, they sometimes stop for several
months when a girl returns to her home in the country. —-TILT.
The suppression probably depends upon the same causes
which so friequently induce obstinate constipation, when a
change from city to country, or vice versa, has been made,
coupled with a more or less great change in diet, water, hours
of eating, &c., all aided by the powerful excitement to the
brain and nervous system, induced by the novelty of the new
mode of life. This view is corroborated by the similar effects
of a sea voyage, especially upon those who are not familiar
with the beauties and terrors of the sea, and are unaccustomed
to the motion of a vessel. Menstruation is almost always
arrested and suppressed during a sea voyage, and seldom
recommences until several months after an arrival in a strange
land. This is observed to take place as frequently with ladies
arriving in India, after a long sea voyage, as it is with the
poor Irish emigrant to America.
COLoMBAT asserts, that suppression, which occurs in the year
following the first appearance of the menses, is rarely of much
importance, as it is scarcely ever due to a seriously morbid
state of the womb. TILT has noticed that those girls who
attain to puberty very early, are seldom quite regular before
the age of 18, and says, if these facts were to be carefully
instilled into the mother's mind, there would be much less
mischief done by the injudicious administration of forcing
medicines to promote the return of what, in fact, ought not to
have appeared so soon.
Suppressed Menstruation may be produced by moral, phky
sical, unknown causes, or by those symptomatic of some dis



SUPPRESSED MENSTRUATION.           11
order of distant organs, or acute irritation of any part of the
body.
BRIERRE DE BOISMONT, in 190 cases of suppression, found it
produced by
Moral causes in...  92 instances.
Physical "...  68 
Unkown  "...  30    "
190
Among the moral causes may be mentioned anger, disappointed love, jealousy, excessive joy, sudden reception of bad
news, fright, extreme fear, or sudden disappointment. From
the report of BAUDELOCQUE, we learn that 62 women were
attacked with haemorrhage or suppressions on the occasion of
the explosion of the powder magazine of Grenelle; HUssON
witnessed a case in which menstrual suppression had been
caused at several different times by the mental shock, at hearing loud claps of thunder; COLOMBAT observed in July, 1830,
that the report arising from the platoon-firing and cannon
shot, produced the same effect on several women; ROSTAN
had a patient whose " monthlies " became suddenly suppressed on learning that a seton was to be applied to her chest;
one of CoLomBsAT's relatives, whose Menstruation was ordinarily very regular and abundant, was attacked with sudden
suppression, in consequence of a frightful dream and kind of
night-mare; CHURCHIL says, that almost all the women who
are sent up to the Richmond Penitentiary, labor under suppression of the menses, in consequence of the mental agitation
and distress they have undergone; Goocu relates, that a patient of his consulted him long after the entry of the Cossacks
into Paris, for suppression, which was solely produced by the
alarm she then suffered. The influence of the brain and nervous system in producing suppression, is perhaps more generally acknowledged, and more adroitly treated by homceopathic physicians than by any others; they regard it as far more
important to allay the derangement of the nervous system,
and then to allow the blood and vital energies to be directed




112                 MENSTRUATION.
to their proper channels by nature, than to attemipt to force
Menstruation.
Aconite, Lycopod., Kali c., Coffea, Opium, or Veratrum,
will be suitable when suppression is caused by fright, or sudden mental emotion.
Aecon., Bell., Coloc., Ignatia, Platina, Puls., or Sta'h., are
recommended when it is caused by mortification of mind, or
contradiction.
Bryonia, Cham., or Colocynth, when caused by a fit of
passion.
Coffea, or Opium, if by excessive joy.
Ignatia, Hyos., Phos. ac., or iellebore, if produced by disappointed love, etc.
Among the physical causes of suppression, the application
of cold is the most common and dangerous; such as sudden
exposure to cold and damp air, immersion of the feet and
hands in cold water, cold hip-baths, sitting upon the grass, or
ground, use of ice cream or very cold drinks, when the body
is over-heated, or the leaving off of an accustomed garment;
PULTE says, that he has foundthe wearing of thin-soled shoes
to be the most fruitful source of the decay of female beauty,
and the decline of female health; the injury of tight lacing,
although considerable, is nothing in comparison with the fatal
habit of appearing in all kinds of weather in thin-soled shoes
and gossamer stockings. There is a very large class of young
girls who are apt to have " a check " from the slightest chill or
exposure during the monthly period, yet they will obstinately
persist in trudging out in snow or rain storms, to church, or
school, or to places of amusement, or will loiter in cold rooms
while dressing or undressing, or will walk about in their bare
or stocking feet, etc. Happily or unhappily, the effect of several of these causes may be diminished by the frequency of
their occurrence, so that bathing women go into the sea, during Menstruation, with perfect impunity, and the habitual
exposure to the casualties of life, necessarily diminishes their
injurious impression. It would be a useless task for a physician to attempt to reform the evening dresses of ladies; TILT




SUPPRESSED MENSTRUATION.:13
truly says, that rich young ladies suffer as much from insufficient clothing as the daughters of the destitute; for poverty
and fashion are two inexorable tyrants, which exact the same
things and often bring on the same diseases; enough has been
said against the exposure of the upper part of the chest, and the
"diaphanous attire" of young ladies; they at least do not yet
fully rival the belles of Axim, on the coast of Africa, it being
a positive fact, that some of the Axim girls wear merely the
bustle, without so much as the shadow of a garment. The
Axim mothers, however, have a reason for wearing a tournure
which does not exist elsewhere, for their little children ride
astride of the maternal " tarb Roshe," which thus becomes useful, as well as ornamental.-BRIDGE.
Among other physical causes of suppression may be mentioned, the use of purgatives or emetics about the time of
Menstruation, large doses of chincona, the action of strong
odors, particularly, according to HALLER'S assertion, of the
herb Pennyroyal; DE BOISMONT says, that Copaiba and Cubebs are very apt to produce amenorrhea; Opium, Plumbum, and Secale, would be likely to produce the same effects,
also many of the styptic remedies, and those employed in the
old school against menorrhagia.
Accordingto ASHwELL, sudden suppression in stout, plethoric, and ruddy females, will be followed by active congestion, if not by inflammation; the patient immediately feels
a sensation of heat, weight, and pain in the pelvis, more or less
violent uterine colic, and a disagreeable fulness and tension
in the groins, and loins, and upper part of the thighs; the
abdomen and breasts become enlarged; there is an indescribable feeling of malaise and lassitude; extreme loathing, nausea, vomiting, headache, dizziness, noises in the ears, oppression of the chest, frequent palpitations, and in many, a burning pain while urinating. Suppression, accompanied by such
symptoms, is far more immediately dangerous than any of the
other derangements of Menstruation.
Treatment.-LooMIs recommends Aconite when the pulse
is rapid, or full and sluggish; a rush of blood to the head, proHt




114                  MENSTRUATION.
ducing pain; giddiness and drowsiness, with flushing of the
face; weight in the loins, especially if there be heat, thirst,
and a general feverish state.
Dose. —See page 36.
BELLADONNA
May be given, if the head be'hot, the face alternately pale
or flushed, the limbs cold, and there be shiverings alternating
with heat, and attended with confusion of the head; or if
there be dizziness, trembling of the hands, sparkling before the
eyes, with aching pains in the eyeballs and sockets; shooting
pains about the womb and ovaries, with heat and dryness of
the vagina.
Dose, —See page 40.
BRYONIA
Is recommended when there is congestion to the head or
chest, with vertigo, bleeding of the nose, stitches in the sides
of the chest, and dry cough, attended with constipation, severe
pressing pain in the stomach, or by colic and irritability of
temper.
Dose,-See page 40.
NUX VOMICA
May be givenrwhen there is swelling of the womb, with
great tenderness to touch, cramp-like and spasmodic pains
in the womb, with burning heat in, and painful pressure
towards, the external parts.
Dose.-Same as Ignatia. (See page 57.)
OPIUM
May be useful in recent cases, when there is great heaviness of the head, dizziness, lethargy, and drowsiness, or excessive desire to sleep without the ability to accomplish it, the
pulse being full and slow; especially if there also be obstinate
constipation, and retention of urine.
Dose.-Same as Crocus. (See page 55.)




SUPPRESSED MENSTRUATION.           115
When suppression occurs in delicate and spare women,
who are highly nervous and irritable, inflammation may occur;
but in the majority of such attacks, the pain and other symptoms are not inflammatory, although it is sometimes difficult
to distinguish the aggravated neuralgia and spasm of the different abdominal organs, and of the womb and its appendages,
from real inflammation. In these cases, the pain is rarely
fixed, but attacks first one organ, then another, changing its
locality without the use of remedies; it is often remarkable,
how quickly the pain may be transferred from the womb to
the head, from the head to the chest or heart, or again from
these parts to the bowels; the patient is also apt to have hysteric, or fainting fits.
Treatment.-Pulsattilla may be given when the prominent
symptoms are languor, pain across the small of the back and
lower part of the bowels, palpitation, nausea, vomiting, sensation of fulness in the head and eyes, and disposition to general
coldness, especially if there be alternate crying and laughter,
or sadness and melancholy; the pains being particularly
inclined to shift their location rapidly and repeatedly.
Dose.-See pages 64 and 95.
COCCULUS
Is indicated, when there is great derangement of the nervous system, violent cramps in the bowelsand'womb, the
patient being very weak, and agitated, with sighing and
moaning.
Dose.-Same as Ignatia. (See page 57.)
VERATRUM
Is indicated, if the suppression be the result of fear, fright,
or vexation, attended with, or followed by anger, especially
if hysterical affections set in, or nervous headache, the face
being pale and earthy, the hands, feet, and face cold, followed
by extreme debility and fainting, or nausea and vomiting,
with acidity, or by diarrhcea.
Dose.- Same as Bryonia. (See page 41.)




116                 MENSTRUATION.
NUX MOSCHATA
Is said to be adapted to acute suppression, when caused by
a chill from being in the water, or exposure to cold and damp
air, especially when it occurs in persons of a nervous and mobile constitution, and is attended with spasms or other nervous affections, or by great drowsiness, or inclination to faint,
with sense of great fatigue and exhaustion, and pain in the
loins.
Dose. —Same as Chamomilla. (See page 43.)
CUPRUM
Is indicated when there is a pressing pain on the top of the
head, rush of blood to the head and face, with i'edness of the
face and eyes, or else paleness of the face with livid circles
around the eyes, nausea and vomiting, cramps of the stomach
and bowels, convulsive movements of the limbs, spasms of the
chest, and palpitation of the heart..Dose. —Same as Ignatia. (See page 57.)
CHRONIC SUPPRESSION.'This disease will be treated of fully under the head of
Amenorrheea, oabsent Menstruation.
VICARIOUS MENSTRUATION.
COLOMBAT says, among the most curious phenomena following suppression of the menses, should be ranked the haemorrhages and other vicarious discharges. They take place more
frequently from the mucous membranes, especially of the
lungs, stomach, and bowels, than from other parts, although
they have been met with from almost every region of the
body. Thus, GARDIEN observed a girl who, after suppression
of Menstruation, had a periodical discharge of blood: 1st,
for 6 months from small ulcers on the legs; 2d, for a year,




VACARIOUS MENSTRUATION.          11'
from ulcers upon the arms; 3d, for 6 months, from the opening of a felon on the left thumb; 4th, for 2 years, from ulcers
at the angle of the eye, in consequence of erysipelas of the
face; 5th, for 5 months, from the navel, where another erysipelas had made its appearance; 6th, for 4 months from
the inner side of the left ancle; 7th, and finally, for 2 months,
from the left ear. In this case, when the blood ceased to
flow from a given point, the patient was seized with attacks
of bleeding from the nose or lungs, preceded by convulsions,
headache, and dizziness.
Dr. CHATELAIN had a patient, who, in consequence of derangement of Menstruation, had discharges of blood success —
ively from the arm-pit, nipple, left flank, back, pit of the stomach, and the thigh.
BEGIrN had a young person, whose fore-finger of the left
hand, swelled, and was covered with an acute herpetic eruption, from the surface of which blood flowed at a certaine
period every month. The eruption and the discharge, which.
only lasted 3 or 4 days each time, were accompanied by a
disagreeable itching. Three years after, the womb returned
to its natural functions, and the health of the patient was
reestablished.
RoussEAU states, that a woman had suppression in consequence of the shock from the extraction of a molar tooth, and
a discharge, which was renewed every month, was established
from the socket of this tooth. RAYMOND, also, speaks of a
woman who had a bleeding once a month from the socket
of a tooth which she had lost; the discharge of blood,
which lasted 3 days, amounted to 3 ounces per day, or 9
ounces per term. PECHLIN had a case of vicarious Menstruation from an ulcer on the foot; KERC1RENG cites the case of
a girl who was periodically regulated from a wound in the
right hand.  MERCATUS had a woman with suppression,
whose cheeks became of a very deep red color every month.
— COLOMBAT.
LEADAM had a young lady under his care, who was subject
to oozing of blood from the upper surface of all the toes, a few




118                 MENSTRUATION.
days before Menstruation, which was always scanty. Also,
a young married woman, who had never been pregnant, and
whose Menstruation was very irregular, who, every 3 or 5
weeks, first had serum, then blood, ooze out of the right nipple. And a third patient, with attacks of bleeding of the
lungs for a year or two, with suppression of the menses, who
had, before the occurrence of the blood-spitting, an oozing of
blood from the scalp, just above the forehead; this was repeated 2 or 3 times, and so alarmed her friends, that they ran off
with her to a physician, with the blood trickling down her
forehead.
The general impression of the profession seems to be, that
no serious results follow these bleedings, even when delicate
organs are the seat of it; on the contrary, they are said to
prevent in a great measure the occurrence of those severe and
fatal diseases, which sometimes follow upon amenorrhaea.
Sooner or later, the womb resumes its functions, and this disagreeable succedaneum subsides.
Loomns, with mingled gravity and modesty, asks what are
the causes of this disorder? He says, suppression of Menstruation cannot be the cause, because suppression is not always
followed by Vicarious Menstruation. He, again, boldly assumes, that plethora or congestion cannot be the cause, because
these are met with in thousands of cases, without any vicarious discharge. And finally concludes, that it is better to
say that we " do not know the why "!! But, as Menstruation is a simple but periodical haemorrhage from the womb,
it is not at all strange, when it is suppressed, that we should
meet with periodical discharges from any part more irritated
than the uterus. Thus, according to STAHL, an indigestion or
pulmonary catarrh, occurring during Menstruation, will sEnffice to provoke the flow of blood towards the stomach or
lungs. We also find that bleeding from the nose, stomach,
lungs, and bladder, are the most common forms' of vicarious
haemorrhage, just as they are the most frequent varieties of
accidental haemorrhage. Again, in young females, the vicarious bleeding generally takes place from the nose, stomach,




cmHLoosI3.                  119
or chest; later in life, the hemorrhoidal vessels and bladder
are apt to be the seat of the flux. We have already seen (see
page 91,) that irritations of distant organs invite and provoke
the flow of blood from the womb to the irritated part, and
thus frequently cause suppression; the irritation may be great
enough to produce a discharge of blood; and, finally, the
periodicity of Menstruation will impress a periodical character upon the vicarious bleedings, in the same way that it impresses a regular type upon the headaches, colics, and what
not, which so frequently attend Menstruation.
Treatment.- LEADS recommends Ferruvm as the homeeopathic remedy for most of these cases; 1Millefolium may often
prove useful. He cured one case of vicarious bleeding from
the nipple, with Lycopodium.
LoOMIs suggests Ferrum, Mur., Lachesis, and Lycopod.,
when the bleeding is from the skin.
If from the nose, Bryon., Puls., Sepia.
If from the eyes, Bell., Carb. v., Cham., or Nux vom.
If from the ears, Bryon., Cicuta, Graph., Merc., Petrol.,
Puls., Rhus.
If from the mouth and gums, Arnica, Bell., Cham., Ferrum
our., Kreosot, Ledum, and Lycopodium.
If from the lungs, he suggests 30 remedies, all of which
have some little reputation against simple bleeding from the
lungs.
If from the stomach, one or the other of 16 remedies, which
are commonly recommended for Haematemesis.
If from the bladder, 14 of the most common remedies for
hsematuria.
CHLOROSIS.
GREEN SICKNESS.
Several entirely different disorders may be combined with
and mistaken for simple chlorosis, viz.:
1st. Anaemia, or deficiency of blood;
2d. Hydraemia, or watery condition of the blood;




120                 MENSTRUATION.
3d. Leucocythemia, or excess of white cells in the blood.BENNETT.
It is'exceedingly difficult to separate chlorosis distinctly
from these other affections; in fact, as already stated, several
of them often occur in varying degrees of combination.
In 1149 cases of uterine disease, ASHWELL met with 89 examples of chlorosis, and TILT asserts that the frequency of
chlorosis is greater than is generally believed; for although
physicians are only consulted for it in extreme cases, two-'thirds of all women residing in large towns are more or less
tinged with this complaint.
According to COLOMBAT, no disease inspires more tender
interest, or more touching compassion, than the state of paleness, suffering, and languor, observed in a young chlorotic
girl; like some delicate plant deprived of the beneficent rays
of the sun, she is a flower which withers and droops away,
even before its blossoming.
The approach of chlorosis is marked by a state of habitual inertia and melancholy (Ignatia); the patient becomes
sombre and taciturn, weeps without cause, and sighs involuntarily (Puls., Aurum); the face may become bloated, and the
expression, as it were, veiled (Arsen. Plumbum); the eyes are
sad and languishing; the eyelids, which may be swollen, especially in the morning, are encircled by blackish rings, contrasting strongly with the pearly color of the whites of the
eyes, and the pallor of the lips; the skin, particularly of the
extremities, is dry and cool; the pulse frequent, rather large,
and easily compressed; the breathing difficult; digestion
deranged; the alvine dejections become white and hard
(Plumbum), but sometimes are fluid; palpitations, and creeping chilly turns, make their appearance, while debility, lassitude, a desire for sleep, or rather for repose, augment from
day to day. —CoLoMBAT.
The patient feels a frequent inclination to make deep and very
strong inspirations, which is increased by walking, ascending,
or even by very slight exercise, and finally, by any mental
emotion; the impulse of the heart is stronger, and the carotid




CHLOROSIS.                   121
arteries, which beat with great force, are the seat of certain
peculiar and unnatural sounds. Sometimes we have the simple or double bellows sound.; at others, a prolonged vibration,
and a kind of humming, like that produced by a hummingtop.
As the disease progresses, the functions of the stomach become deranged; the strangest and most depraved appetites
may manifest themselves, and it is not uncommen for chlorotic patients to prefer the most sapid substances, such as salt,
vinegar, or green fruits, while they often seek with avidity
indigestible substances, such as charcoal, chalk, plaster, earth,
ashes, spiders, flies, and other equally disgusting objects. The
appetite may gradually diminish, or be increased beyond
measure, while the ingestion of food is followed by a sense of
weight at the pit of the stomach, and sometimes by vomiting.
The tongue is generally large, and covered with a mucous
coat; acid regurgitations, and frequent nausea, occur, especially in the morning; a feeling of heat and weight in the pit
of the stomach, and sometimes nervous pains in the course of
the gullet, and extending through to the shoulders, make their
appearance. Finally, the patients experience alternations of
constipation and watery diarrhoea, the passages being white,
while the urine is small in quantity, pale, and limpid, as in
by many nervous affections.-CoLosBAT.
The nervous system participates in the general languor of
all the functions; the patient becomes sad, melancholic, and
indifferent to all enjoyment; she seeks solitude, sighs involuntarily, and weeps without cause; she is often tormented with
sinister ideas; her temper is capricious, odd, and irascible;
for her, all thought and hope of happiness is gone, and in her
despair she often speaks of suicide; her nights are disturbed
broken slumbers and frightful dreams.-CoLoMBAT.
Various nervous symptoms may be added, such as noises in
the ears, dizziness, partial loss of sight, tremors of the limbs,
neuralgic pains in the head, neck, or teeth, peculiar palpitations in the pit of the stomach, and hysterical symptoms.
When the progress of the disease is not arrested, the symp



122                  MENSTRUATION.
toms become more and more aggravated; the head becomes
the seat of severe pain, felt especially in the back of it; the
skin assumes a greenish or earthy hue; the stomach and bowels become hard and tumid, thirst sets in; the difficulty of
breathing, faintness, and palpitations, are increased; diarrhoea and hectic fever gradually creep in; daily aggravations
occur, and emaciation makes rapid progress. Finally, the
presence of'slight general dropsy, extreme debility, invincible
repugnance to all kinds of exertion, marked alteration of the
features, and a pale violet color of the lips, forebode approaching death, which comes at last without shock and without
pain.
The disease is supposed to depend upon one or more of
three or four causes, viz:
1st. Debility of the digestive organs.
2d. Weakness of the genital organs, with amenorrhoea from
debility.
3d. Debility of the circulatory system, with a depraved
state of the blood.
4th. General debility of the nervous system, especially of
the nerves which preside over the circulation, digestion, nutrition, and genital functions.
COLOMBAT decides that atony of the digestive organs ought
not to be considered as the starting-point of the disease, as
chlorosis sometimes precedes the derangement of the digestive organs, and even the stomach at times retains its natural
condition. He also asserts, that debility of the ovaries and
womb, with absence of Menstruation, cannot be regarded as
the primary cause of the chlorotic condition, for this sometimes
makes its appearance in well-regulated girls, who do not cease
to be so throughout the disease; it has also been observed in
women who menstruate abundantly and perfectly, and in
pregnant females. But it is very true, that a profuse leucorrhceal discharge often takes the place of Menstruation; that
the menses generally fail, or become suppressed; and even
when they persist and last longer than usual, the excreted fluid
is apt to be pale and watery, to separate upon the napkin into




CHLOROSI.                   123
two distinct portions, and form spots which lose all their color by
drying. He also rejects the theory which supposes the chlorotic condition to depend upon debility of the blood and bloodvessels, producing a depraved state of the composition of the
blood, marked by excess of serum, and of the white particles
of the blood, including the fibrin, and a deficiency of coloring
matter, blood globules, Iron, and even of Manganese, which latteris now regarded as a natural and invariable ingredient of the
blood. However this may be, the alterations in the composition of the blood are among the earliest and most characteristic features of the disease. Thus, in 8 cases of slight chlorosis, observed by ANDRAL, the water of the blood was increased from the natural standard of 17 9  to 1_80'; while in
18 confirmed cases of the disease, the water was increased to,-~05, and in a few cases even to T8}-W}, giving rise to a serous
plethora of great importance, i. e., to the so-called ilyperhydrcemia, which is attended with signs of blood-fulness, and
turgor lymphaticus, the blood actually being in excessive
quantity,although it is watery, pale, and thin.
Again, the natural quantity of fibrin in healthy blood, is 3
parts in 1000, while in chorosis it often rises to 3_ 6  o or to
130 50  and even to 5. 3o and as the coagulability of the blood
depends in a great measure upon the quantity and quality of
the contained fibrin, we can readily see that hsemorrhage will
not be apt to take place in chlorosis.
The coloring matter and blood globules are greatly diminished; in ANDRAL'S 8 cases of slight chlorosis, the blood globules were diminished from  the natural standard of o'-q7- to?o-6%, while in the 18 severe and confirmed cases, they were
further lessened to an average of T~]~, and in exceptional
cases they were decreased to T4 -  and even to  30,, forming
a class of clases in which the amount of blood globules fell so
far below the natural standard, that we can scarcely comprehend how life could still have been maintained.
Finally, according to LEcANv, from  l    to l-TLz of Iron
are found in the blood of healthy females, while only from
TW3W to To-w are present in that of chlorotic persons.




124                 MIENSTRUATION.
The quantity of Manganese in the blood in health and in
this disease has not yet been determined.
This will, perhaps, be the most proper place to point out
the difference between Anvemia, Hydreamia, and Leucocythemia.
AN"_MIA.
Deficiency of Blood.
The analogy between anaemia and chlorosis is so great, that
ANDRAL regards them as one and the same disease. Among
the symptoms common to both, are: paleness and discoloration of the skin, whites of the eyes, lips, and mucous membrane of the mouth; shrinking and disappearance of the subcutaneous veins; muscular debility; fainting from the slightest exertion; dropsical swellings; derangement of the stomach and bowels; and similar sounds in the heart and arteries. But the progress of chlorosis is generally slow; it occurs almost exclusively in women at the period of puberty,
and often takes its rise without known cause. Anaemia, or
simple deficiency of blood, generally commences rather suddenly, and is usually owing to spontaneous or secondary losses
of blood; in short, in anaemia, we have simple diminution of
the mass of the blood, while in chlorosis there is also a change
in the chemical composition of that fluid.
Chiam is the principal homeopathic remedy.
HYDRAEMIA,
Or, Watery Condition of the Blood.
This causes a peculiar kind of plethora or fulness of blood;
although the patient is pale, languid, and dyspeptic, yet
she has many of the symptoms which belong to plethora,
such as dizziness, dazzling of the eyes, ringing in the ears,
headache, difficulty of breathing, palpitations of the heart,
throbbing of the arteries, flushing of the face, and drowsiness.
The apparent superabundance of the blood is nothing more
than an increase of the serous or watery parts of the blood,
which fluid is actually impoverished and deprived of its nu



CHLOROsI.                   125
tritive qualities. Even BOERHAAVE regarded some cases of
chlorosis as the result of an excess of serous blood; he says:
the fluids are in excess over the solids, and their motion is
retarded, because the-mass to be moved is augmented, while
the moving force is diminished; the body soon becomes inactive; the young girl becomes swelled and grows pale; for, to
speak truly, she does not lose the red portion of her blood,
but acquires more of the white than is necessary in proportion to the red.-BERNER, BUCHNER, and BEN, have maintained the same view.
Arsenicum, Hellebore, Graphite, and Marsh Marigold, are
the principal homceopathic remedies.
LEUCOCYTHEMIA,
Or, White Cell Blood.
The blood contains colored or red globules, and colorless
globules, corpuscules, or cells.'BENNErr has given the name
Leucocythemia, or white cell blood, to a peculiar form of disorder, very much resembling anaemia and chlorosis, and in
which these white or colorless globules exist in great excess
in the blood. He thinks that the blood globules, especially
the white ones, are formed in the lymphatic glands; in short,
that the lymphatic glands secrete the blood corpuscules in the
same manner as the testes secrete the semen and spermatazoa, the female breasts the globules of milk, or the salivary or.gastric glands form the cells of the- saliva or gastric juice.
He repeats, that the blood corpuscles are originally formed in
the lymphatic glandular system, and that the great majority
of them, on joining the circulation, become colored by the addition of Iron, and by exposure to the oxygen in the lufigs,
and assumes that, in certain diseases and enlargements of the
lymphatic glands, their cell elements are multiplied to an
unusual extent, and find their way into the blood, causing a
great increase in their white or colorless cells. This is Leucocythemia. The easiest way to detect the disease is, to
obtain a drop of blood by pricking the finger of the patient
with a needle, and then examining it under the microscope;




126                  MIENSTRUATION.
the yellow and colorless corpuscules are at first seen rolling
confusedly together, and the excessive number of the latter is
atonce perceived; sometimes they are. five times as numerous as in health.
This disease is very important, as it is rebellious to all allopathic treatment; BENNETT says, in no one instance has the
condition of the blood been observed to undergo any marked
improvement after the excess of white cells has been discovered in it.
Leucocythemia resembles chlorosis in some marked particulars:
1st. The fibrin is in excess, 7 times out of 9, varying from
~3'~ to -1w o 0, while the natural standardard is only loW.
2. The serum or water is in excess, varying from.8-  to
Wo-8, while the natural and healthy quantity is only g7'.
8. The blood globules are diminished from  the natural
standard of   2'I to Ioo, or even to,,7 and, in some few
cases to T1 40
The distinctive characters of the disease, are: enlargement
of the spleen, and disease of the lymphatic glands; in 19
cases of leucocythemia, the spleen was found to be more or
less enlarged in 16; in the same 19 cases, the lymphatic glands
were more or less diseased in 11.
It is probable, however, that disease or disorder of the
spleen also exists in chlorosis, and even that this may be the
prinapal cause of the alteration in the blood; at least, ECKER
and BECLARD have come to the conclusion that the blood globules are incessantly disintegrated or destroyed in the spleen.
They base their opinion upon the following facts:
1st. The blood returned by the splenic vein, prior to its
junction with the vena porta, contains a smaller proportion
of blood globules than arterial blood, and even all kinds of
venous blood; thus, the blood of the splenic vein contains
only  Y2~  of globules and fibrin, while that of the external
jugular has as much as TJJ-, the mammary artery -4,M   and
the vena porta as much as 2 2'.I  The deficiency of globules
in the splenic vein can only be accounted for by the supposi



CHLOROSIS.                  127
tion that the blood globules are destroyed or disintegrated in
the spleen.
2d. The quantity of albumen in the splenic vein is much
greater than in any other blood-vessel; there are only T  o in
the blood of the vena porta,'I 9 in that of the external jugular, -, in that of the mammary artery, and as much as
-2 4 in the blood of the splenic vein. BECLARD very justly
concludes that the disappearance of the blood globules in the
spleen can be conceived of with difficulty, without their principal element (albumen) being thus found to be present in
excess in the splenic vein.'These facts render it very probable that excessive action of
the spleen causes the diminution of the blood globules, and
consequent pallor of the surface, in chlorosis, leucocythemia,
and even in the paludal cachexia of fever and ague; all allied
diseases. This supposition, that the spleen is involved in
chlorosis, will account for the frequency, obstinacy, and
severity of the chlorotic and hysterical pain in the left side,
just under the left breast. Leucocythemia, then, would differ
from chlorosis, principally in the additional disease of the lymphatic glands and system, which attend the former disease.
The principal homceopathic remedy against simple chlorosis is Plumbum; against leucocythemia, are, Natrum muriaticum, Iodine, Iodides of Iron and Lead, and Conium, or
Belladonna.
Treatment.-TILT says, that chlorotic patients are notoriously fond of ease, and all they want is to be allowed to remain
in -a state of muscular quietude; but this desire must no more
be listened to, than that of travellers yielding to the soporific
effects of intense cold; for the habitually cold skin of chlorotic
patients causes a half-poisoned state of the blood, by the retention of what should be excreted, and the imperfect oxygenation it undergoes; with this vitiated, and lympathic, and
venous blood, the internal organs are overloaded [especially
the spleen]. They should, therefore, be urged and enforced
to exert themselves, so that the blood may circulate more
rapidly, and thereby absorb that due quantity of oxygen




128                 MENSTRUATION.
which is necessary to impart to it those vital properties which
excite all the organs to perform their proper functions. The
limbs and body should be rubbed briskly once or twice a day,
in order to solicit the blood to the surface; Dr. HOLLAND recommends the exercise of respiration, to invigorate the system
and improve the blood, by a more perfect oxygenation of it,
for, in chlorosis, the chest in general is scarcely seen to rise, and
breathing must be very imperfectly performed. The use of
an inhaling-tube is entirely unnecessary; the patient need
only take long, and full, and deep breaths for several minutes,
or 10 minutes in succession, several times a day. Reading
aloud and: singing are excellent exercises for the lungs.
PLUMBUM.
This is undoubtedly the most homceopathic remedy for
chlorosis. To Dr. F. C. WINTER, of LUNENBURG, is due the
credit of introducing this remedy into homceopathic practice.
A.DRAL says, that the prolonged use of lead induces the same
conditions of the blood as those we see in chlorosis; an interesting case, reported by T.NQUEREL, shows how deceptively the
disease produced by lead simulates chlorosis: A man, aged
21, of strong constitution, came under treatment for chlorosis,
and great palpitation of the heart, following exposure to lead
for 18 months. WnNTER used it with success in cases of chlorosis marked by difficulty of breathing, constipation, dropsy
of the feet,, and unusual debility, in which the ordinary means,
both homeoopathic and allopathic had been tried without benefit; the obstinate, and almost invincible constipation, led him
to use Plumbum, which proved of great service, not only in
this, but against almost all the other concomitants of chlorosis.
DRYSDALE has also used it, with marked benefit, in cases of
chlorosis, after the more active state of disorder of the digestive organs has -been subdued by other medicines, and the
chief, or only symptoms which remain are: difficulty of
breathing, obstinate constipation, muscular debility, and
scanty or suppressed Menstruation.
According to WINTER, Plumbum is homeopathic when the




CHLOROSIS.                   129
patient has a peculiar, pale, often waxy, greenish-yellow complexion, with a yellowish tinge of the whites of the eyes; when
the eyes are deeply sunken and surrounded by dark, or blue circles; when the pulse is frequent, small, and soft; the patient
being very dispirited, anxious, and despairing; also very feeble, with bewildering confusion and pain in the head; when
the lips, gums, and inside of the mouth, are very pale, or
bluish-gray, in color; when there is a want of appetite, or
desire only for particular things; thirst, with burning in the
stomach; eructations, nausea, vomiting, aching in the
stomach, cramps in the bowels, obstinate constipation, alternating with diarrhcea; diminished secretion of urine; laborious or sighing respiration, with more or less oppression and
tightness of the chest, with anxiety and palpitation of the
heart; pains in the back, loins, and limbs, with great weariness and languor; coldness of the body, dropsy of the feet,
and frequently a general and uniform dropsical swelling of
the whole body.
It has also proved useful when there are intense headaches,
noises in the ears, suppressed, scanty, or irregular Menstruation, with insurmountable indolence, great drowsiness, frequent yawning, great debility, softness and flaccidity of the
muscles, and trembling of the limbs, sadness, love of solitude,
absence of mind, and melancholy, the patient being shy, depressed, and indifferent to all things.
WINTER used it, with surprisingly good effects, in 7 cases.
NATRUM MURIATICUM.
According to PIORRY, this remedy, given in doses of from 4
to 8 drachms, effects very rapidly what no other succedaneum of Quinine, that he has tried, ever does, viz., a diminution
of the size of the spleen. PIORRY promptly cured 6 out of 8
cases in which he tried it. Bathing with salt and water over
the region of the spleen, or wearing a salt-bag there, or the
use of warm or cold salt water baths, may also be useful. It
may also prove useful in scrofulous cases, and in true leucoI




130                  MENSTRUATION.
cythemia. (See DUNSFORD'S 15 cases of scrofula, cured by a
trituration of sea salt: Brit. Jour. of Hoom., vol. 3, p. 37.)
PULSATILLA
Is the most homceopathic remedy when the blood becomes
deprived of many of its red globules, not by disease of the
spleen or lymphatic glands, but by simple or scrofulous irritation of the mucous membranes and follicles of the stomach,
bowels, air-tubes, or of other organs.
It has been recommended in many disorders of females,
when attended with chills, or a persistent coldness, especially
of the limbs, even when the temperature of the atmosphere is
warm; under these circumstances, it will prove useful in chlorosis, menstrual colics, and in cramps of the stomach and
bowels.
FLEISCHIANN gave it with success to a girl, aged 17, who
had not yet menstruated, but was feeble, with a pale and
puffed countenance; complained of fatigue of the whole body,
especially of the legs and feet; whose appetite was diminished,
tongue,furred, taste in the mouth bad, with frequent eructations; breathing short and oppressed, especially after exercise,
with strong pulsations of the heart, and distinct 6ruit de
diable in the carotid arteries, the pulse being feeble and slow.
She improved after 14 days' use of Pulsatilla, 4th decimal
dilution, and seemed well in a month.
GUERARD gave it to a girl, aged 14, not yet menstruated,
who was slightly chlorotic, had emaciated, was troubled with
colics and constipation, nausea, loss of appetite, coated tongue,
slight fever every evening, and with cramps in the feet and legs.
Pulsat 30 was followed by an erysipelatous eruption upon
the legs, and by Menstruation at the end of fifteen days, when
she soon recovered her natural color and health. Pulsatilla
18 was also given by Dr. GUERARD, to a chlorotic young lady,
aged 24, who was pale, sallow, and languishing, with uncer-,tain and irregular Menstruation, troublesome bloating of the
stomach and bowels, burning in those parts, and in the throat,
vomiting after each meal, preceded by acrid risings. Bellad.




CHLOROSIS.                  131
30, allayed the vomitings, and Pulsat. 18 then removed the rest
of the complaint, so that she recovered her healthy color and
strength, became free from acidity, and her digestion was good.
IIENDERISON treated a lady, aged 27, of pretty full habit, with
sallow complexion, whose menses had first been scanty and
irregular for 6 months, then totally suppressed for 3 months,
but finally had appeared scantily about a month before; she
had taken Iron for 5 months without improvement, was rarely
free from headache for more than a day or two, was very feeble, especially on attempting to walk, subject to difficulty of
breathing and palpitation from the most ordinary exertion,
and even while at rest; her lips were very pallid. She then
spent 9 months in the country without medical treatment,
and improved but little in health; the menses appeared only
for 1 day at a time, at long intervals, and very scantily; she
was last unwell about 9 weeks ago, scantily for the whole of
1 day, and a part of 2 others; her difficulty of breathing and
palpitation were worse; the headaches recurred every 2 or 3
days; she slept badly, had very little appetite; her feet swelled at night; there was evident pulsation of the carotids, and
a strong continuous chlorotic murmur in the right side of the
neck; bowels regular.
Treatment.-Pulsatilla 12, twice a day; in 4 days she became unwell, and continued so for 3 days, with more discharge
than she had had for 2 years, with some improvement to her
general health. At the end of a month, China 12, and Graphite 30, morning and evening, were given, followed in 1 day
by Menstruation more profuse than for years, and her headache left her, strength and appetite improved; but her breathing and color remained as before. Ferrum 18, and Graphite
20, morning and evening, at the end of 2 weeks more, when
she still continued free from headache and was able to employ
herself actively within doors. Then, Pulsatilla 6 was given,
twice a day, with still greater improvement, so that she menstruated 4 entire days, with abundant secretion, and dyspncea
and palpitations finally lessened. Fifteen days after she commenced the use of Graphite 12, twice a day, for 20 days,




132                 MENSTRUATION..
when Pulsat. 6, twice a day, completed the cure. She was
under treatment 5 months in all.
Dose.-See pages 64 and 95.
FERRUM.
This is the most decided and useful antipathic remedy, yet
KNORRE says, that he has used it successfully in chlorosis,
with vertigo, painful aching in the head and stomach, loss of
appetite, sluggish bowels, paleness of the face and whole of
the body, also of the lips and tongue; the menses being very
scanty and resembling serum; emaciation, excessive weakness, especially of the knees; swelling and bloating of the face,
hands, and especially of the feet; frequent chills and constant
coldness; weak pulse.
The allopathic experience with the use of Iron is abundant
and conclusive; most physicians agree in stating that a cure
of chlorosis may generally be effected with it, in from 2 to 6
weeks; it has a peculiar power of increasing the richness and
redness of the blood, and produces the effects which are most
wanted in this disease, viz., an augmentation of the proportion
of red corpuscules, and a diminution of the quantity of fibrine.
The use of some preparation of Iron is the more required, as
there is a positive deficiency of Iron in the blood in chlorosis.
Thus, BECQUEREL and RODIER, in 1000 grammes of calcined
healthy blood, found j a gramme of Iron; this 1000 grammes
of healthy blood contained 141 grammes of blood globules.
On the other hand, the proportionate quantity of Iron in 31
cases of chlorosis was also ~ of a gramme; but then there
were only 91 grammes to the 1000 of blood globules, whence
it has been assumed that the deficiency of red globules stands
in a close relation and proportion to the diminished quantity
of Iron in chlorosis.
In scrofulous cases and in chlorotic Hyperhydrcemia, when
there is considerable fulness of the system and a diminished
proportion of blood globules, from retention in the blood of its
watery parts, owing more to a deficient excretion from the skin
and kidneys, than to an absolute diminution of the globules, the




CHLOROSIS.                   133
Iodide of Iron has been found serviceable, as it seems to promote the secretions more than any other preparation of Iron,
and sometimes acts as a diuretic. It is also useful when there
are enlargements of the glands and tonsils; and is said to
have brought on Menstruation when other preparations of
Iron have been used for a considerable time without effect.
WILLIAMS, from many comparative trials, thinks the Iodide
the most speedily useful preparation; he has cured chlorosis
with it in 3 weeks, and replaced extreme pallor with the rosy
hue of health.
The young practitioner may easily be deceived in reading
the glowing accounts of allopathic physicians, of the effects
of Iron in chlorosis, into the belief that it is only requisite to
-give Iron in these cases, in order to effect a prompt and certain cure. But PETREQUIN has observed many cases of chlorosis, which have resisted Iron as obstinately as does the anaemia connected with cancer, or organic disease; other cases,
again, after deriving a certain amount of benefit from'Iron,
remain stationary; and others again appear cured by it, but
the cure is not permanent. The remedy required in these
cases, according to PETREQUIN, is Manganese; he has proved
that Manganese is a normal constituent of animal and vegetable tissues, and believes that, wherever Iron exists in appreciable quantity, Manganese co-exists with it. Hence he infers that Iron alone will not succeed in some blood-diseases,
but requires the aid of Manganese.
Dose. —See page 57.
CARBON.
It is unnecessary to enter into a dull detail of the great homceopathicity of the carbonaceous remedies, viz., Sepia, Graphite, Carbo animalis, and Carb. vegetabilis, to chlorosis. In
homoeopathic practice, the remedies which act upon the carbon of the body, and the venous system are most relied upon
in chlorosis; in allopathic practice, those remedies which act
upon the oxygen and the arterial system are the favorites. In
proof, however, of the homceopathicity of the carbonaceous




134                  MENSTRUATION.
remedies, we add the following: chlorotic anaemia affected
universally the workmen in a coal-pit near Valenciennes, but
only those who worked in a particular gallery or pit; all
who had ever been in it suffered, although, perhaps not for 3
or 4 months after the exposure; the gallery was strongly impregnated with sulphuretted hydrogen, and carbonic acid.
They had symptoms resembling those of menstrual colic in
females, and abdominal congestion; viz: severe colics, tightness of the chest, palpitations, debility, and prostration; the
colic pains lasted for 10 or 12 days, then the skin became
blanched and sallow, the pulse quick and feeble; profuse
sweats and great weakness finally set in. The illness often
lasted for several months, and even for a year; and the colics
sometimes returned frequently.
SABINA
Is the specific homceopathic remedy against menorrhagicchlorosis, although Dr. WATZKE has used it successfully
against chlorosis with amenorrhcea.
CASE 1. A girl, of strong constitution, aged 17, had had
suppressed Menstruation and chlorosis, for 6 months; she suffered with violent giddiness, especially in the morning, and
from exertion, so that she sometimes fell down; pressing pain
in the forehead, singing in the ears, greenislh-yellow acrid leucorrhcea, shortness of breath, palpitations of the heart, great
tendency to perspire, heaviness and painful weariness of the
limbs; her skin was pale, and appearance leucophlegmatic;
she had a great desire for sour things, and for burnt coffee.;Treatment.-Pulsatilla was given for 3 weeks without benefit, then 1 drop 01. Sabina in a drachm of sugar, was given
in 1 or 2 grain doses, with rapid relief.
CASE 2. A girl, aged 16, not yet menstruated, had suffered for 3 years with headache; cachectic appearance, with
dark circles around the eyes, toothache, tendency to nausea and
vomiting, heartburn, dragging and griping pains in the abdo



CHLOROSIS.                  135
men, pressure downwards upon the genitalia, shortness of
breath, palpitations, oppressive pain in the chest, w eight in
the legs, with pain in the thighs when walking, dragging and
tearing pains in the limbs, particularly at night, debility,
great drowsiness, and laziness.
Treatment.-Puls., Sepia, Kali, Ferrum, and Silex were
given for 2 months without benefit; she then recovered under
the use of Sabina, as directed for Case 1.
Dose. —See page 70.
CHINA
Is also homceopathic to aneamia and chlorosis from excessive
lactation and Menstruation, although WATZKE gave it with
success in
CASE 1. An unmarried lady, aged 30, of strong constitution and phlegmatic temperament, had complained for several months with oppression and heaviness of the head, loss of
appetite, tightness and distension of the belly, pain in the
sides, short and difficult breathing, pressure upon the chest,
frequent palpitations, swelling of the legs up to the knees,
great weakness, so that she could only walk with great difficulty; the menses were scanty and pale; she had some leucorrhoea; the patient, who had previously always been in
good health, with a blooming complexion, had become pallid
and bloated, and she, who had formerly been sprightly and
good-humored, had become very cross and lachrymose.
Treatment.-The alternate use of Ferrum and Helleb. nig.,
1st dilution, followed by China, 3d dilut., permanently restored the patient in 9 or 10 weeks.
CASE 2. Miss A., aged 21, of delicate frame, menstruated at 16, accompanied with intolerable headaches, for which
she was repeatedly and profusely leeched; finally, all the
signs of confirmed chlorosis set in.
Treatment.-Ferr., Puls., Coccul., Hep., Ignat., and Nux
were given without benefit, for 2 months; then she was cured




136                 MENSTRUATION.
in 2 months by China 3, and she remained well for at least 3
years afterwards.
Dose.-See page 45.
DIFFICULT AND PAINFUL MENSTRUATION.
DYSMENORRHCEA.
In 300 cases of uterine disease, BENNETT met with 123
instances of painful Menstruation. MADDEN, in 180 cases,
with 34; AsHIWELL, in 810 cases, found only 10 with dysmenorrhcea, 19 with irritable uterus, and 74 with hysteria.
Several varieties of the disease are described by authors,
viz.:
1. From stricture or narrowness of the canal of the neck of
the womb.
2. Spasmodic stricture of the sphincter at the os internum,
which is formed by a strong band of the circular muscular
fibres of the cervix, and destined to close the uterus during
the latter stages of pregnancy.
3. From croupous or dysenteric inflammation of the internal surface of the womb, leading to the formation of false
membranes, which are expelled with great pain and difficulty.
4. From simple or rheumatic inflammation of the womb,
especially of its neck.
5. From a nervous and spasmodic action of the muscular
fibres of the womb. And,
6. From congestion of the womb.
Of BENNETT'S 123 cases of painful Menstruation, 2 commenced at 10 years of age; 8 at 11 years; 17 at 12 years;
also, 17 cases at 13 years; 22 at 14 years; 20 cases at 15
years; only 9 cases at 16; 11 at 17 years; 8 at 18 years;
5 at 19; and 1 at 20. Hence it would seem as if painful
Mlenstruation is more frequently connected with an early appearance of the menses, than with a delayed. COLOMBAT even
asserts, that the subjects of dysmenorrhcea are generally of a
nervous or bilious temperament, of ardent feelings, and greatly addicted to coitus, although constitutions precisely the op —




DIFFICULT AND PAINFUL MENSTRUATION.      137
posite of these are not exempt from  it; and during an
attack of the disease, they generally feel a sensation of heat
in the neck of the womb, a kind of pruritus of the vagina, and
spasmodic constriction of the vulva. It is but right to add
that COLOMBAT often seems to take a blackguardly pleasure in
making similar assertions, which are generally unfounded.
1. Dysmenorrhcea from  Stricture, or Narrowness of the
Canal of the Neck of the Womb.
Dr. MACKINTOSH was the first to draw attention to this form
of the disorder; as early as 1823, after having frequently met
with much difficulty and embarrassment in the treatment of
some cases of dysmenorrhcea, he thought that he perceived the
signs of stricture of the canal of the neck of the womb, and
imagined that dilating it with the bougie might prove a method of relieving the pain of the patient. In the course of a few
years, from 1826 to 1832, he met with 20 cases of dysmenorrhcea, which he treated in this way, 18 of them with the most
marked success, and only 2 without benefit; 10 of the 18
were barren married women, of whom, 7 afterwards became
with child; 8 were unmarried, or widows.
In some of these cases, the stricture is very great, the aperture of the mouth of the womb being so small as scarcely to
admit a hog's bristle, others being just large enough for the
introduction of a small silver probe. Dr. MEIGS cannot boast
of success equal to that of MACKINTOSH, but the treatment has
certainly been productive of advantage in several instances,
especially in the persons of 2 married ladies, who were not
only relieved of their painful Menstruation, but, though they
never before had been pregnant, soon became with child.
RIGBY has, however, given the best description of obstruc'
tive dysmenorrhoea. He says, that the chief feature of this
species of the disorder is, that the pain precedes the discharge; it varies in different individuals, sometimes coming
on but a few hours before Menstruation; at other times, the
patient may begin to suffer for days or even a week before
the menstrual flow commences.  These differences probably




138                   MENSTRUATION.
depend on the slowness or rapidity with which the secretion
comes on, and somewhat upon the amount of irritability which
the womb manifests on becoming distended with the menstrual fluid. Hence, when the secretion flows fast, and the
uterus resents the accumulation within its cavity, there will
probably be a sharp, but short attack of pain, for the rapid
distension of the uterus, and its contractions, will cause severe
suffering, while they will quickly produce the requisite
amount of dilatation which will allow the fluid to pass out of
the womb, and thus relieve the pain. In mild cases, a moderate amount of distension is sufficient to effect the necessary
degree of dilatation of the mouth of the womb, and the accumulated fluid is discharged, with complete relief to the patient;
but where the obstruction is greater, and produces greater
resistance, the accumulation goes on, the pain becomes more
severe, and then, as the womb is roused to contract upon the
retained fluid, the patient will experience exacerbations of
intense suffering, similar to the severe pain which is often
seen in bad cases of abortion and early miscarriage, until after
a long and agonizing struggle, the obstruction is surmounted,
and the discharge takes place.-RIGBY.
In cases of obstructive dysmenorrhzea of this severe character, the uterine system, as well as the general health, is apt
to stffer considerably; the wonlb becomes enlarged by this
periodical distension, so that the ordinary internal measurement of its cavity may increase from 2-1 inches to 3, or even
more; and this enlarged cavity will often not clear itself entirely of the menstrual fluid, more or less of which is apt to be
retained; after a time, the thinner portions are absorbed,
leaving what remains, of a dark, thick, molasses, or tar-like
consistence, which may only be evacuated at the next monthly period. IHence it is, that in passing the sound, or dilating
the'neck of the womb, a quantity of dark, brown, and slimy
fluid frequently besmears the instrument, and the patient
has a discharge of a similar character for a day or two afterwards, with much relief. The stomach, liver, and bowels are
apt to become deranged, with more or less hemorrhoidal con



DIFFICULT AND PAINFUL MENSTRUATION.        139
gestion and loaded urine, and the tongue soon displays that
dry, rough, short-napped, brownish fur, which so invariably
attends uterine irritation.-RIGB3Y.
Obstructive dysmenorrhcea seldom continues for any length
of time, without producing more or less ovarian irritation.
The ovaries are well known to present a considerable degree
of irritation and congestion at these times, even in a state of
health; but, under such circumstances as those above mentioned, the congestion assumes more the character of inflammation, with great aggravation of the patient's sufferings
There is severe pain in the groin, above Poupart's ligament,
darting down the thigh; the part is very tender on pressure,
and frequently feels to the patient as if swelled; finally,
chronic inflammation of the ovary may be set up, and then
is not unfrequently attended with severe menorrhagia.
RIGBY also says, that there is no doubt, that a large number of cases of obstructive dysmenorrhcea are due to an originally contracted state of the mouth of the womb, or of the
canal of the neck of the womb, and accordingly we find, that
in many or most of these cases, the patient has suffered at her
menstrual pe-iods, from their first commencement. In some
cases, the pain and difficulty do not come on until some years
after the first establishment of Menstruation, and in others,
not until after marriage; in these cases, the principal part of
the pain is owing to a congested or swollen state of the lining
membrane, obstructing still farther an orifice or canal, which,
though originally contracted, had nevertheless at one time
allowed the discharge of the menstrual fluid without any peculiar difficulty. RIGBY also. thinks that there can be but
little doubt that dysmenorrhcea, in females with rheumaticgouty constitutions, arises from a similarly congested, swollen,
and irritated state of the mucous membrane lining the mouth
and canal of the neck of the womb.
BENNETT says, that extreme dysmenorrhcea, from congenital contraction of the neck of the womb, is of rare occurrence,
but admits that dilatation is sometimries the only means we
have of remedying an extreme amount of suffering at the




140                 MENSTRUATION.
menstrual period. He gives the case of a young female, aged
22, who had suffered in the most excruciating manner at
every menstrual period since the menses first appeared at the
age of 18; the pain always continued without intermission,
throughout the 3 days and nights that Menstruation lasted,
and was of so severe a character, that she never closed her
eyes, and was confined to bed the whole time. She had been
almost constantly under medical treatment, without the least
relief from antispasmodics, anodynes, or sedatives; even large
doses of Opium were given without the slightest benefit.
Mechanical Treatment.- Dilatation was effected to a considerable extent in the course of 3 weeks, preceding the next
menstrual period, by means of small sponge tents; the very
next Menstruation was more abundant than usual, and she
was entirely free from pain; the next period was also free from
pain and she remained well. MEIGS prefers the use of a flexible block-tin bougie; if the instrument be somewhat curved,
its apex will enter without difficulty, and should be passed
slowly upwards to the distance of 1 to 2 inches, and allowed
to remain for a minute or two, and then withdrawn, to be followed by one of a larger size. If the instrument "be too large,
the patient will complain of a sense of aching in the womb;
it is undesirable to cause any pain. This mode of treatment
is evidently proper in some cases; the cause of the pain is
evident and should be removed, for the cavity of a non-pregnant healthy womb will not contain more than 10 or 12 drops
of fluid, and as soon as the menstrual secretion commences
from the lining membrane of the womb, unless the blood finds
free exit, it will distend the the uterus and give rise to great;
pain; as soon as the obstruction is overcome, the blood will
escape freely and the pain ceases. RIGBY prefers the use of a
peculiar dilator, the blades being made of well-tempered steel,
and opened after being introduced into the canal of the cervix, and allowed to remain so for about a minute, thus rapidly
effecting a considerable degree of dilatation, often with very
striking relief, even when used but a short time before a menstrual period, the discharge appearing freely, with but little
pain.




DIFFICULT AND PAINFUL MENSTRUATION.      141
2. From Congestion.
BENNETT says, in those females in whom the womb is naturally predisposed to congestion, and in whom Menstruation
is very abundant, and often preceded and followed by a white
lencorrhceal discharge, Menstruation is apt to be painful,
either for the first day, or throughout the entire period. In
such women, the dysmenorrhcea is evidently functional, and
the result of the distension caused by the excessive congestion, combined perhaps with a peculiar susceptibility of the
uterine nerves.
WHITEHEAD has paid most attention to congestive dysmenorrhcea; he says, it consists essentially in a state of vascular
hypertrophy of the womb and its appendages, and is associated, to a greater or less exteit, with a similar condition of the
portal circulation generally. The whole, or a considerable
portion of the womb is found to be large and weighty, attended with some prolapsus; the neck of the womb is tumid, occasionally excoriated, or presenting a granular surface, and generally less firm than natural; some retroversion or anteversion
is apt to be present, causing frequent desire to empty the
bladder, or pain and difficulty in evacuating the bowels, while
it increases the pain of Menstruation by narrowing the canal
of the neck of the womb, owing to the bent state of the part
in this displacement. The walls of the vagina are apt to be
relaxed, and the vulva may be swollen and marked with venous distension; the upper part of the thighs may also be
marked by enlarged veins, and piles may be present. This form
is more frequent in the married than in the virgin state, and
it often exists in the barren, and in those who have experienced frequent abortions.
Bellad., Stramon., Sabina, and Borax are the principal
remedies.
3. From Spasmodic Contraction.
This may arise from a spasmodic contraction of the whole
of the womb, or merely of that kind of muscular sphincter,




142                  MENSTRUATION.
which exists at the os internumn, formed by a strong band of
the circular muscular fibres of the neck of the womb. In
some cases, this may merely be a nervous or muscular affection, but very fiequently the spasm is caused by congestive,
inflammatory, or rheumnatic irritation of these parts.
[Nux, Ignatia and Secale are the principal homeeopathic
remedies.
4. JFom kl~ammnation and Ulcewation of the Neck of the
FWomb.
BENNETT is, of course, the enthusiastic advocate for the frequency of this form  of the disorder. He says it generally
exists when Menstruation which was originally easy, or but
slightly painful, finally becomes -extremely so; such a change
does not take place without a cause, and that cause is, generally speaking, inflammation and ulceration of the neck of
the womb; dysmenorrhcea being one of the most prominent
and most ordinary symptoms of that disease. This remark,
he insists, applies to to the virgin as well as to the married
female, and is of extreme importance, as affording a key to
those extreme cases of dysmenorrhcea, accompanied by spinal irritation and hysterical convulsions, which appear to
resist every form of allopathic treatment, and are alike distressing to the patient, her friends, and medical attendant.
Since he has ascertained this fact, nearly all the cases of extreme dysmenorrhcea in the unmarried female, that have come
under his notice, have proved to be of this description, and,
however impracticable before, have yielded as soon as proper
treatment has been adopted. These cases, he says, are easily
distinguished from those caused by contraction of the neck of
the womb; for in the latter, the patient is free from pain,
except at the menstrual period, but when there is inflammation and ulceration, there is not the same immunity from pain
during the interval.
The principal honmceopathic remedies are Arsenicum, Aurum muriaticum, Borax, used both locally and internally, and
the Chloride of Platina..




DIFFICULT AND PAINFUL MENSTRUATION.      143
5. From  Ovarian ITritation.
LooMIs adopts TILT'S ovarian theory of many uterine diseases, and of dysmenorrhcea among the rest, with considerable enthusiasm. The subject is now so hackneyed, that I merely refer to it here, in order to point out the most homceopathic remedies, when the ovaries are decidedly involved.
Argentum nitriceum  is indicated when the menses are profuse and painful, with pains especially in the small of the
back, groin, and ovaries.
Granatumn, when Menstruation lasts but a short time, is
profuse, with colic, and pressing pains in the small of the
back, groins and ovaries.
Borax, when the menses are attended with spasmodic and
lancinating pains in the groins and ovaries.
ITcai hydriodicum, when there are aching pains in both
groins and ovaries, and small of the back.
Cantharides, Graphite, and Staphysagria also deserve attention, when the ovaries are disordered.
6. Pseudo-membranous Variety.
This has generally been regarded as owing to a peculiar or
croupous inflammation of the lining membrane of the womb;
but PoucHET states, that in all females, even in virgins, a
delicate decidual membrane or cast is formed in the cavity of
the womb at every Menstruation, and is thrown off about the
10th day. If this be so, the deciduous pseudo-membranes of
dysmenorrhcea may be considered as merely an exaggeration
of a natural condition, which, however, may be still further
increased by the superaddition of croupous inflammation.
BENNETT, of course, believes, or rather assumes, that the formation of these membranes coincides almost invariably with
the present or past existence of uterine inflammation; he,
doubtless, can see further into a mill-stone, or the womb, than
anybody else, but that does not prevent him from being as
absolutely ignorant of the appearances of inflammation as
was BROUSSAIS. Still, he has grace enough to admit that the
removal of the inflammatory disease does not always free the




144                  MENSTRUATION.
patient from the liability to the formation of pseudo-membranous casts.
The presence of these false membranes aggravates the patient's distress considerably; their expulsion is always preceded by an increase of the uterine pains, and not unfrequently
by tormina similar to labor-pains, which are evidently occasioned by the violent efforts of the womb to get rid of the
membranes and casts formed in its cavity; that the difficulty
of expulsion is partly the cause of the severe contractions and
pains, is proved by the fact that they have repeatedly been
relieved by dilating the canal of the mouth of the womb
during the interval of Menstruation, and this in females who
still continued to expel false membranes, even after all visible
disease of the womb had disappeared.
T.reatment.-It is evident that mechanical and general
treatment will not remove this peculiar disorder; as we know
of no hom eopathic remedies for pseudo-membranous irritation,
or croupous inflammation of the uterus in particular, it may
be allowable to use the true croup remedies; thus, we will
at least use remedies which are homeopathic to the nature of
the disease, even if they have no specific relation to the locality. Bromine, Bichromate of Potash, Ammonium causticum,
and Cantharides may be used with much prospect of success,
especially as the latter also act specifically upon the uterine
organs.
In the cases reported by BEAUVAIS, Pulsatilla alone cured
3 cases; Puls. and Nux, 1 case; Puls. and Cocc., 1 case;
Puls. and Sulph., also 1 case; Cocculus alone, 2 cases; Coccul.
and Puls., 1 case; Graphite and Lycopod., 1 case; Graph.
and Baryt. c., 1 case; Nux was used in 3 cases; Veratrum,
Secale, Calcarea, Lachesis, Ignat., Conium, Platina, and
Crocus, each in 1 case; Sulphur in 2 cases.
ACONITE.
LooMIs recommends this remedy when the dysmenorrhcea
arises from an inflammatory condition of the womb or ovaries,
with violent fever, dry and burning heat of skin, excessive




DIFFICULT AND PAINFUL MENSTRUATION.      145
thirst for cold drinks, redness and heat of the face; distension
of the abdomen, with tenderness to touch. It may also be
suitable in alternation with Colchium, Bryonia, or Guaiacum,
where painful Menstruation arises from a rheumatic affection
of the womb.
Dose.-See page 36.
AMMONIUM CARBONICUM
Is also recommended by LOOMIS as most adapted to the
inflammatory variety; the Ammonium causticum, we have
already seen, is homceopathic to the pseudo-membranous form.
It is said to be most indicated when painful Menstruation is
attended with swelling, itching, and burning of the sexual organs, or excoriation of these parts, especially when the menses
occur too soon, and are too copious, dark in color, and acrid;
or if there be pain in the loins and colic, with pressing-down
pain, &c. COLOMBAT recommends the Acetate of Ammonia;
he says that it produces a rapid sedative action upon the
womb, and relieves the painful tormina which attends the
discharge; but if too much of it be given, it is apt to cause
scanty Menstruation.
Dose. —Same as for Iodine and Phosphor. (See page 81.)
BELLADONNA
Is said by Loomis to be indicated in the inflammatory variety, although it may prove useful in some cases of the neuralgic form; it is, however, best suited to the congestive and
spasmodic varieties. In fact, he proceeds to recommend it,
when there is congestive enlargement of the womb, or falling
of that organ,?with menstrual colic and spasms, with labor-like
pains. It is not generally known, that the so-called bearingdown pains are often merely a tenesmus of the os and cervix
uteri; it is in these cases that Bellad. is so useful. HIOLMEs,
of Mississippi, thinks that Bellad., if rightly used, never fails
to relieve the pain of dysmenorrhoea, and render Menstruation
regular, free, and healthy; he thinks that it acts specifically
upon the womb, relieves its pains andspasms, increases the.3




146                  MENSTRUATION.
flow, dilates the canal of the neck, and thus permits coagulae
and membranes to pass without the least inconvenience to
the patient; but he uses 3 grain doses of the extract.
Dose.-See page 40.;'
BRYONIA
Is a valuable adjunct in the rheumatic variety, especially
if the symptoms of rheumatism of the womb be well marked,
in'addition to rheumatic pains about the head or chest, with
short, dry cough, and frequent bleeding from the nose, or
rheumatic pains and swellings of one or more joints or limbs.
Dose.-See page 41.
CALCAREA
Is recommended when the breasts are apt to be swollen
and painful during Menstruation, with headache, colic, cramplike pains in the region of the kidneys, acidity of the stomach,
high-colored and acid urine, with chronic inflammation and
swelling of the womb.
Dose. —See page 48.
BORAX
Has long been used in Germany to produce uterine contractions, and to facilitate the excretion of the lochia and
menstrual fluid; it is the principal remedy against that aphthous and granular affection of the mouth and neck of the
womb, which has led to so much abuse of the speculum and
digital examination by BENNETT and others. BENNETT has
lately found out that it is homceopathic and curative to membranous dysmenorrhcea. He gives the case of a woman, aged
26, subject for two years, since marriage, to painful ]Menstruation; the menses were regular as to time, but usually lasted
a week, and were attended with such great suffering that she
had always been compelled to lie down for the greater part of
that time; the discharges were generally very dark in color,
and mixed with clots of blood and numerous flakes of whitish
membrane; in the intervals, there was more or less leucorrhcea,




DIFFICULT AND PAINFUL MENSTRUATION.      147
with dull aching pain in the lower part of the back; her
tongue was redder than natural; pulse 96, and sharp. She
had never conceived, and had been subjected to a great
variety of treatment, with very little advantage. After taking
the Biborate of Soda for 20 days, Menstruation occurred with
very little pain, and was unmixed with either shreds or flakes;
during the whole period she had been able to pursue her
usual avocations, and had enjoyed a degree of comfort to which
she had been a stranger for years; the next month she also
menstruated without material suffering, the aching in her
back had also disappeared, together with a chronic cough,
which had persisted for several months.
It is thought to be especially adapted when there is slight
fever, pain in the loins, and the expulsion of shreds and flakes
of lymph.
Dose.-Same as for Calcarea. (See page 48.)
CROCUS)
Coffea, and Chamomilla, are admirable palliatives when
frequent and profuse Menstruation is attended with great
pain.
Dose.-See pages 43 and 55.
COCCULUS
Is generally regarded as the principal homceopathic remedy
against menstrual spasms and colic; LooMIs thinks it is more
appropriate in the neuralgic than the inflammatory variety;
but it, like Nux and Ignatia, is probably more homceopathic
to the spasmodic form than any other. It is especially indicated when there is menstrual colic with cramps in the womb,
early and profuse Menstruation with much pain, and followed
by a sanious leucorrhcea during the interval. The indications
for Nux and Ignatia are too well known to require repetition
here.
Dose —See page 57.




148                 MENSTRUATION.
PHOSPHORUS
Is most homeopathic when there is excessive ovarian and
sexual irritation, with inflammation of the ovaries and neck
of the womb, the menses being profuse, and long continued,
preceded by an acrid leucorrhbea, and accompanied with colic
and cutting pains in the bowels, back-ache, and pains extending from the vagina up into the womb. Platina is recommended under nearly the same circumstances.
Dose. —See page 81.
PULSATILLA
Is used very frequently in dysmenorrhcea, especially when the
menses are scanty or suppressed, the patient being rheumatic,
or subject to a leucorrhoea of a corrosive and burning nature,
and thick like cream.
Dose.-See page 93.
SECALE
Is decidedly the most homceopathic remedy in spasmodic
dysmenorrhcea; it has been very rarely used, however, especially by those who pride themselves much more upon giving
infinitessimal doses of some inert remedy, than upon always
giving the most homoeopathic remedy.
Dose,-See page 104.
SEPIA AND SULPHUR
Have been used in dyscratic and rheumatic cases.
Dose.-See pages 97 aild 98.
UNNATURAL OR DEPRAVED MENSTRUATION.
I apply this rather rude name to that class of cases in which
there is a decided alteration in the color, consistence, and
odor of the menstrual secretion.
In 181 cases of uterine disease, MADDEN met with 19 in



LAST MENSTRUATION.              149
stances in which the menses were too pale, and 8 in which
they were too dark.
Dulcamara is said to be indicated when Menstruation is
retarded, and the discharge is watery; Ferrum acet., when
menses are delayed, with a scanty discharge of watery blood;
Sulphur, when the menstrual discharge is too pale; Stramo~nium, when it is watery; Pulsatilla, when pale and watery.
China is said to be homceopathic when there is a discharge
of clots of black blood; Ignatia, when menses are black,
scanty, and fetid; Yux juglans, when premature Menstruation is attended with pressing pain in the womb, and expulsion of blackish coagulhe; Cantharides, when menses are too
profuse, early, and dark; Pulsatilla, when the blood is viscid,
thick, clotted, and black; Ignatia, when lumps of coagulated
blood are expelled; Conium, when the discharge is brownish
in color; Ammon. carb., when it is black.
Sulphur has been recommended when menses are profuse,
with an acrid smell; Bellad., in profuse Menstruation, when
the blood smells badly; Ignatia, when menses are scanty,
black, and fetid; Sarsaparilla, when they are scanty and
acrid, so as to excoriate the inner side of the thighs: Kreosote,
when menses occur too soon, with a discharge of acrid-smelling, bloody ichor; Phosphor, when the menstrual discharge
has an offensive odor; Suzljhur, when it is thick and acrid;
Rhus tox., when the menstrual blood is so acrid as to cause a
severe smarting pain in the vulva; KEali carb., when it is
acrid and pungent, making the thighs sore; Carb. veg., when
it is acrid and corrosive.
LAST MENSTRUATION.
CHANGE OF LIFE.
The most common time for the cessation of the menses and
change of life is between the 40th and 50th years; but, like
the first appearance, so:the cessation of Menstruation varies
in different females, and is in subordination to the tempera



150                  MENSTRUATION.
ment, constitution, climate, and habit of life of the' female;
as a general rule, however, there is a certain relation between
the periods of the first and last Menstruations, for the cessation occurs at a later period in proportion as the first appearance was less precocious.
BRIERE DE BOISMONT, in 183 cases, found two instances in
which Menstruation ceased at 21 years of age; 1 case each
at the 24th, 26th, 27th, 28th and 29th years of age; 3 cases
at 31 years; 2 at 32 years; 4 at 34; 6 at 35;;  at 36; 4 at
-37; 7at38; 1at39; 18 at 40 years; 10 at 41; 7 at 42; 4
at43; 13 at 44; 13 at 45; 9 at46; 13 at 47; 8 at48; 7 at
49; 12 at 50; 4 at 51; 8 at 52; 2 at 53; 5 at 54; 2 each at
55, 56 and 57 years; and 1 at the 60th year of age. Hence,
of 183, in 7 it occurred between the 55th and 60th year of
age; in 31 cases between the 50th and 55th years; in 50
cases between 45 and 50; in 52 cases between the 40th and
45th year; in 25 cases, from the 35th to 40th year; in 9
cases from the 30th to 35th year; in 7 cases from the 20th
to the 30th year.
ROBERTON in 77 females, found 1 case to cease Menstruation at 35 years; 4 at 40 years; 1 each at 42 and 43; 3 at
44; 4 at 45; 3 at 47; 10 at 48; 7 at 49; 26 at 50; 2 at 51;
7 at 52; 2 each at 53 and 54; 1 at 57T- 2 at 60; and 1 at
70 years of age.
ROBERTON also gives 13 instances of late Menstruation in
HIindoo women, viz.: 2 cases still menstruated at 56 years
of age; and 1 case each at 57, 58, 59, 60, 63, 64, 65, 67, 68,
and 80 years of age.
In 2 HIindoo women, who commenced to menstruate at 11
years, menses ceased at 37 and 42. Of 6 women who commenced at 12 years, 2 ceased at 38, and 1 each at 40, 46, 49
and 52 years. Of 15 females who commenced at 13 years
of age, 1 ceased at 40; 2 at 41; 1 each at 43, 45, 46 and 47;
4 at 48; 1 each at 50, 52 and 54. Of 18 cases which commenced at 14 years of age, 1 each ceased at 34 and 37, 40
and 41 years; 2 at 42; 1 at 43; 2 at 44; 1 at 47; 4 at 50;
1 each at 51, 54 and 58 years. Of 5 cases which cqmmenced




LAST MENSTRUATION.                151
at 15 years, 1 ceased at 30; 1 at 40; 2 at 41; and 1 at 45.
Of 2 cases which commenced at 16 years, 1 ceased at 45, the
other at 46. Of 4 cases commencing at 17, 1 each ceased at
41, 43, 44 and 48 years. Of 2 cases commencing'at 18, 1
ceased at 46, the other at 47.
BENNETT met with 2 females who commenced their menstrual life at 11 years, one of whom ceased menstruating at
47 years, the other between 40 and 50; 1 who began at 13
was still regular at 47; 1 at 14 ceased at 44; of 3 at 15, 1
each ceased at 48, 49 and 54 years; 1 at 16 ceased at 50; 5
at 18 ceased, 1 each at 41, 45 and 48, and 2 at 50 years; 2 at
19 years ceased, 1 at 44, the other at 50; of 2 at 20, 1 ceased
at 50, the other at 53. On the other hand, BENNErrTT met with
1 case which commenced Menstruation at 11 years, and was
still menstruating at 50; of 3 at 12 years, 1 each was still
regular at 47 and 49, and the other at 56; of 7 beginning at
13 years, 3 were still menstruating at 47 years; and 1 each at
45, 50 and 52 years; of 2 commencing at 14, 1 was still
regular at 45, and the other at 48; of 4 cases at 15, 2 were
still regular at 47, and 1 each at 45 and 48; 1 case at 17
was still regular at 49; and 2 cases at 18 still menstruated at
46 and 51 years.
ROBERTON assumes that Menstruation always continues as
late as the power:of conception, and gives a table of 10,000
pregnant women, 436 of whom were over 40 years of age,
viz.: 101 in their 41st year; 113 in their 42d; 70 in the
43d; 58 in the 44th; 43 in the 45th; 12 in the 46th; 13 in
the 47th; 8 in the 48th; 6 in the 49th; 9 in the 50th; 1
each in their 52d, 53d, and 54th years. He also met with
3 women who had children at advanced ages, one in her 50th,
another in the 51st, and the 3d in her 53d year; in all of
whom Menstruation continued up to the period of conception.
COLOMBAT mentions some curious cases of late pregnancy and
Menstruation, viz., 1 case in which a woman was delivered
in her 62d year; another in her 67th. HALLER mentions a
woman still regular at 70, and brought to bed with child at
that age. COLOMBAT saw a female who was very regular, and




152                 MENSTRUATION.
confined at 61 years of age; another who commenced Menstruation at 18, and continued regular up to the 73d year;
while ORFILA gives the case of a woman who became pregnant with her first child at the age of 47, then had 7 children,
the last when she was 60, remained regular until she was 99,
and died at the age of 114.
Menstruation ceases abruptly in some women; gradually
in others. TILT thinks that it terminates gradually in about
39 per cent.; by a succession of floodings in 19 per cent.; by
a terminal flooding in 14 per cent.; by alternations of slight
and considerable discharges in 10 per cent.; by a sudden
stoppage in 18 per cent.
The gradual termination is the most frequent, and is, of
course, attended with the least disturbance of health. A terminal flooding is often mistaken for miscarriage, and the sudden stoppage of the function deserves more attention than it
has received, because it happens more frequently than is commonly supposed at an early period of life, and then is often
mistaken for accidental suppression, and treated as such. Sudden cessation is also not unfrequently mistaken for pregnancy,
especially if there is some amount of swelling of the abdomen
and breasts, with secretion of milk, and other sympathetic
disturbance, of which time only can show the fallacy.-TILT.
Sudden cessation often takes place thus: the person having
arrived at the usual age, the expected Menstruation is prevented by cold, fright, or some illness; these accidents would
have been followed, earlier in life, by a return of Menstruation after their removal; but it is not so now; nature seizes
this opportunity to put and end to the function altogether,
and many patients are thus dealt with, without experiencing
any inconvenience. In gradual extinction,one period is missed,
and then there is a return; a longer time elapses, and there is,
perhaps, an excessive flow; afterwards, some months may pass
away without any reappearance; then there may be a scanty
secretion, followed perhaps by flooding; and finally the secretion becomes so scanty and so slightly bloody as scarcely to
attract notice, and then disappears forever. — AsHWELL.




LAST MENSTRUATION.              153
After a long period of cessation, the flow may reappear and
return regularly for months and years, without, however. always indicating a return of procreative power. In some
women, after cessation, the stock of vital productivity is fairly
exhausted; but in most there is a superabundant nervous
energy, or an excess of blood; for that supply, which was formerly sufficient for the maintenance of both mother and
offspring, can now only be expended on the woman's frame.
TILT also thinks that it is an important point to be remembered by women, that in proportion as their sufferings were
protracted previous to the healthy establishment of Menstruation, so may they, in general, expect its cessation to be attended with a corresponding period and intensity of suffering.
But it must not also be inferred, that those who have suffered
little or none at its establishment, have no illness to expect, and
therefore need take no precautions. Another fact, equally
interesting and important to be known, is, that, in general,
those diseases which precede the first appearance of Menstruation may possibly precede its cessation. Thus, ALBERT
has observed some skin diseases to appear twice only in life,
viz.: before the first appearance of Menstruation, and again
at its cessation. SIR HENRY MARSH noticed, that women, in
whom the establishment of puberty had been preceded by
repeated nose-bleedings, experienced the same accident as a
prominent symptom of cessation. TILT has several times seen
both first and last Menstruation preceded in the same person
by an abundant eruption of boils, frequently by continued diarrhcea, and still oftener by a great amount of pseudo-narcotism and hysteria.
TILT also regards it as another indication useful to women,
that, whenever irregular Menstruation is attended with a
sinking feeling at the pit of the stomach, with flushes of heat
and perspirations, even though their age may only be between
30 and 40, it is a warning of the commencement of the change
of life. The usual concomitants of Menstruation are variously
affected in different cases; in 64 cases out of 100, the patients
generally had headache, sick headache, hysteria or pseudo



154:                 MENSTRUATION.
narcotism, at each menstrual period; and these symptoms
were aggravated in 36 per cent. at the change of life; they
remain unchanged in 18 per cent., were diminished in 10
per cent.
TILT often refers to a train of symptoms, which he terms
pseudo-narcotism; in the young girl, just before Menstruation,
it consists of headache, dizziness, heaviness, dulness of intellect,
tendency to sleep, &c. With a wonderful uniformity of language, changing girls will speak of a heaviness in the head,
stupid feeling, stupid headache, feeling heavy for sleep; of being
drowsy; of the possibility of sleeping anywhere, while at work,
or standing; of feeling lost or bewildered; of losing their wits
or memory for a time; of dimness of the eyes, or momentary
loss of sight; of falling down while stooping; of involuntarily
dropping any article which they may have in their hands; of
forgetting, when sent on an errand, what they were sent for,
and then being obliged to stand still and make an effort to
recollect. Similar signs of pseudo-narcotism are apt to appear
at the change of life; some women acquire an habitual giddiness, an uncertain and tottering gait, a vacancy of feature,
a dull and drowsy expression of the eye. The more ordinary
symptoms are: a great tendency to sleep, an uneasy sensation
of weight in the head, a feeling as if a cloud or cobweb required to be brushed from the brain, disinclination for any
exertion, and a diminution in the powers of memory, and of
the mind. Some become exceedingly depressed and melancholic, sit in an indolent posture, look gloomy, hardly speak
at all, and live under the impression that some evil is about to
befall them; they are apt to be suspicious and undecided in
all their movements.-TILT.
The same author also places much stress upon the feelings
of sinking or depression at the pit of the stomach, not an'actual
pain, but an irritating and tormenting sense of a want of support, or of emptiness; these feelings are associated with hot
flushes, burning heats, and, in fact, are the harbingers of
flushes and suffusions of the cheeks; on the subsidence of the




LAST MENSTRUATION.               155
heats, the skin breaks out into perspirations, either gentle or
drenching, sometimes hot, at others cold and clammy.
TILT met with these sensations of faintness, exhaustion, and
sinking at the pit of the stomach, in 26 cases out of 100;
With heats and flushes in    38         cc
" perspirations in        30  "       c
"  sweats                 16   "      "
These flushes and perspirations are the means by which
nature relieves the system of the fluids, which used to be discharged every month; the heats, flushes, and gentle perspirations often prevent internal disease; in about 16 per cent.,
the sweats, by their amount, form a disease of themselves,
without relieving the patient as well as a more moderate exhalation; these heats, flushes, and perspirations have been
known to continue to appear several times a day for 10 or 16
years after the cessation of Menstruation. TILT has known the
perspirations to become so profuse that the drops accumulated as fast as they were wiped off the face, and the clothes.
were always wet; and when in bed the sufferer was afraid of
turning, for fear that she should be chilled by the damp cold
in the immediate vicinity of the body.
After cessation, it is not uncommon to have a continuance,
or even an augmentation of the pains, by which Menstruation
was usually attended, and the patients need not fancy fromn
this circumstance alone that serious disease is impending.
These pains are, in a large proportion of cases, merely nervous, and doubtless are meant to warn women that a certain
degree of prudence is necessary while they last.
Pains in the back existed in          70 per cent.;
" I    "I    were increased in    46    "
IC   C"   remained the same in  17
11"   "    were lessened in       7    "
Pains in the lower part of the body, of a bearing-down
character, were present in 51 per cent.; which were increased
in 30, remained unchanged in 10, and were lessened in 9.
Flooding occurred in 27 cases out of 100 about the time of
the change of life; this symptom, which at other times would




156                  MENSTRUATION.
be considered pernicious, is not so alarming at this period,
and need not be interfered with, unless it is too much for the
patient's strength; but if these profuse flows occur too often,
or are too abundant, and last very long, the woman should
not allow her health to be completely ruined by this constant
drain, but should apply for relief.
At the change of life, the blood, instead of being directed
to the skin, as shown by the flushes and perspirations, or to
the womb, as proved by the occurrence of floodings, or profuse
leucorrhcea, may be turned towards the internal surface of the
body, the stomach, liver, or bowels. BUTLER LANE says, it is
very common to find severe biliary derangement at, or about
the change of life; the patient is apt to have a bitter, oily
taste in the mouth, a sensation of burning in the throat,
frontal headache, nausea, and even vomiting, high-colored
urine, bilious passages, furred tongue, and bilious tint of the
skin. Diarrhiea is apt to come on, either irregularly, or quite
regularly every month. Piles are also apt to come on, for the
firdt time, about the change of life, or to be increased if they
have already been present. Still, diarrhoea is much less frequent at the time of cessation, than as a symptom of regularly
established Menstruation. TILT met with it in only 8 per
cent. in the former case, while it occurred in 88 instances out
of 161 regularly menstruating women; in those cases in which
it was present, it preceded the menstrual flow in 45 cases,
accompanied it in 31, both preceded and attended it in 10,
and in 2 cases it followed the monthly flow for 2 days. As a
general rule, however, when diarrhoea has habitually accompanied Menstruation, there is at the change of life a gradual
diminution of both discharges, the cessation of one marking
the termination of the other.
On the other hand, CORFE, of the Middlesex Hospital, thinks
that there is no organ in the female economy which so readily
partakes of disturbance from uterine irregularities, as the
liver; and the instances are not few, where protracted bleeding from the womb at the change of life, which has resisted
all other treatment, will yield to remedies directed to the




LAST MENSTRUATION.               157
liver. In such cases, the womb takes on a vicarious action
for the liver; and so long as this organ is allowed to remain in
its torpid condition, so long will the womb continue to pour
out an undue quantity, or an altered quality, of dark, venous
fluid, and the patient becomes enfeebled, harassed, and distressed; piles, also, are not unfrequently induced. But, oftentimes, no sooner do the remedies tell upon' the hepatic
branches of the portal system, than the uterine portion of the
same system becomes relieved from its congested state, and
the uterine discharge is quickly subdued. The alvine evacuations are usually offensive, fetid, and so dark, that CoRFE has
known them to partake of the character of the motions of a
patient with malaena for several days together; and he is inclined to think that it is from the fact that physicians so rarely
look at these excretions themselves, that many cases of this
disorder are misunderstood, and therefore mismanaged.
Whenever the urine ceases to deposit lithates, and becomes
of a pale canary color, and the evacuations from the bowels
present a healthy appearance, and cease to emit a penetrating
fetor, then there will be a corresponding amelioration in the
state of the patient; her spirits will become more buoyant, her
mind less distressed, her appetite more equable, and her
whole frame less heavy and weary..Treatment.-AsHwELL says, that no more serious mistake
can be made than to attribute any of the symptoms of this
period to debility rather than to repletion, without the most
accurate inquiry. Let it be remembered that an accustomed
evacuation is about to cease, or has finally disappeared, and
that hence the probability is that the system is oppressed,
and that the weakness is apparent, rather than real. If, for
instance, because there is languor and inactivity, a slow pulse,
torpid bowels, and depression of mind, stimulants and generous
diet be allowed, some important organ will be sure to suffer.
A light and nutritious, but not a full diet, should be allowed,
with little or no wine, and no malt liquors. Owing to the distressing sensations commonly felt at this time, small quantities
of spirits are sometimes prescribed, and are always gladly




158                  MENSTRUATION.
taken by the patient; but their good effects are only temporary, while their permanent influence is most mischievous.
Veal, pork, salt meat, fried and boiled fish, tea, pastry, and
made dishes, or ragouts, wine, bottled beer, or any liquid
containing free acid, or gaseous matter, seem to aggravate
the disorder in a marked degree. Beef, mutton, roast or
boiled, boiled fish, fresh game, or cocoa, form the best diet;
and CORFE is quite enthusiastic about the benefits to be derived from taking halfa dozen oysters, without any other food or
additions, such as pepper, vinegar, &c., or even bread, upon
an empty stomach, as for luncheon, for instance; their alkalescent character often removes the morbid acidity of the
stomach, and restores its tone and vigor.
In  accordance with these views, LEADAM  recommends
Aconite as the most soothing of all medicines at the climacteric
period, especially if the patient be robust or plethoric, and if
there be any evidence of local or general increased action.
PULTE recommnends Pulsatilla and Lachesis as the most important remedies.
When there is great nervous irritability, Aconite, Coffea,
Ignatia, and Pulsatilla are recommended.
If there be congestion of the head or abdomen, with fulness,
tension and pressure internally, attended with lumbar and
sacral pains, LEADAM suggests the use of Belladona, to be followed in some cases by Hepar. sulph., and Sulphur. TILT has
hit upon the use of Sulphur during the climacteric period; he
says, that it owes its chief value, in diseases of cessation, not
to its laxative properties, but to another action, much more
difficult to understand, and which has long rendered it so valuable both in hemorrhoidal affections, where there is an undue
action of the intestinal capillaries, and in affections of the skin,
marked by a morbid activity of the cutaneous capillaries.
Whether Sulphur cures by acting on the nerves, or on the
blood-vessels, or by modifying the composition of the blood
itself, TILT finds it difficult to decide, but it certainly cures
many of the affections of changing women.  It forms




LAST MENSTRUATION.               159
part of many popular remedies for the infirmities of old age;
it has been recommended by HUFELAND, and is lauded by Dr.
Day, in his work " On the Diseases of Old Age "; but its
utility is not generally known, except to the homceopathist,
in many of the derangements of the menstrual function, at
whatever period of life they may occur, and particularly at
the change of life, where, if required, its action may be continued with impunity for months and yeais. It is particularly
serviceable against bilious derangements, piles, sweats, and
flushings.
If there be a burning sensation in the head, with bleeding
from the nose, Crocus and Carb. veg. may be required.
If there has been menorrhagia from congestion of the womb,
and great debility has ensued, the remedies for profuse Menstruation (see pages 36 to 73) should be used, among which,
Aurum, Aloe, Chamomilla, China, Calcarea, Crocus, Ferrum,
Kreosote, Platina, Sabina, Secale, and Sulphur, deserve most
attention.
If nervous faintness and exhaustion are present, Valerian,
Veratrum, Nitric acid, Kali carb., and Moschus are recommended by LEADAM.
Cocculus is also recommended as of use in the spasmodic
attacks, seated either in the uterus or ovaries, especially when
attended with bilious vomiting, or nausea.
Ruta is supposed to be particularly useful against the pains
in the small of the back, sacrum, and os coccygis.
Nux, Pulsat., and Bryon. are the chief remedies against
the dyspeptic symptoms.
Aloe is one of the best remedies against long continued
flowing, and against bleeding piles. TILT says, he has never
seen haetnorrhoidal affections caused by the frequent use of
Aloes, but he has seen them relieved by it, and his experience
is corroborated by that of GIACOMINI, AVICENNA, STAHL, and
CULLEN. I have made frequent and successful use of Aloes
and Iron, against profuse and long continued flowing, and
against bleeding piles.




160                 MENSTRUATION.
The profuse perspirations and flushings may be treated by
Aconite, Opium, Sulphur, Arnica, &c.
Sudden suppression should be met by the remedies for the
suppression of the menses, (see pages 112 to 116).
Arsenicumrn and China are the best remedies against chills
and sweats.
Sabina and Bovista, against profuse leucorrhena.
Sabina, Cuprum, and Phosphor., against the tendency to
chronic bilious derangement.




IND EX.
A.                                                  PAGE.
PAGE. Aloe in Last Menstruation....... 159
Absent Menstruation...... 88 to 109  Aquilegia in Scanty Menstruation,  85
".." from absence of    Atriplex olida  "        "         86
puberty,....  89  Assafcetida     "        "         87."..      after puberty,.  90      "    Dose of,............  88
cc "        "    from disease in  Alumina in Scanty Menstruation,  87
distant organs, 91  Ammonium carbonicum  in Pain("      "    statistics of, 92 & 93    ful and Difficult Menstruation, 145
"    Pulsatilla in,..  93  Anaemia..................... 124
"'      " c   Graphite in,..  95  Average time of First Menstrua"'    "    Sepia in,.....  96    tion,......................  10
CC      "    Sulphur in,... 97  Average time of Last Menstrua4"      "    Calcarea in,...  98    tion....................... 150
S' t    "    Kali carb. in,.. 99  Average time of Last Menstruacc      "    Nux vomica in, 100    tion compared with that of First
" Electricity in,           Menstruation............... 151
100 to 104
44 "4 Secale in,......  104                        B.
es   "    Bryonia in,... 104  Belladonna in Profuse Menstrua"    Bellad. in,.... 105                tion..........  39
" Aconite in,..... 105'" Frequent    "           82
"    Opium in,.... 105         "       Absent       "    105
"t   " c   Conium in,.... 105            "       Suppressed   "    114
"'        " Baryta in,.... 106           "       Painful      "    145
(" "    Kreosote in,.. 106              "       Doses of,40
a4      Ad   Emmenag~ogues         Bryonia in Profuse Menstruation,  40
in......... 107      4"    Absent          "       104
"    Laurocerasus in, 107      "     Painful        "      146:' c"   Chenopodium in, 108'    Doses of.......... 41
"    Mammary irri-  Baryta carb. in Scanty Menstruation,
tation in,... 108                             84 & 86
Aconite in Profuse Menstruation,  36      "   "   Absent    "          106
It     Absent    9"          105       "   "  Doses of,..........  86
Suppressed "          113  Borax in Pseudo-membranous Dys"      Difficult and Painful         menorrhoa,................. 146
Menstruation,..... 144
"   Doses of........... 36, 105
Aurum in Profuse Menstruation,.  37
"   Doses of,..............  37  Carbo animalis in Profuse MenAloe in Profuse Menstruation,...  38                   struation,.....  41
Doseso a 3i "  dose of.       41
"   Doses of,..............  39.      dose of,........ 41.... in Chlorosis..... 133
Aloe in Piles,................. 159
Eg




162                                HDEX.
PAGE.                                   PAGE.
Chamomilla in Profuse Menstrua-         Delayed Menstruation, statistics of, 73
tion,.........  41         " " management
"     Dose of,........... 43                              of,.....  75
Cantharides in Profuse Menstrua-             "        "        treatment
tion.........  43                             of,..77 to 84
t"        Precocious, Men-        Difficult and Painful Menstruastruation,.....  25    tion.................. 136 to 148
"'    Dose of...........  44  Difficult and Painful MenstruaChina in Profuse Menstruation,..  44    tion from obstruction,........ 137
"    Chlorosis,............ 135  Difficult and Painful Menstrua"  Dose of,................  45    tion from congestion,........ 141
Calcarea in Profuse Menstruation,  45  Difficult and Painful Menstrua-'i      Infrequent    "         82    tion from spasm............. 141
it      Scanty         "t       86  Difficult and Painful Menstrua"'      Absent         "        98    tion from inflammation and ulcc      Painful " 146    ceration,..................  142
"    Doses of..............  48  Difficult and Painful MenstruaCinnamon in Profuse Menstruation, 48    tion from ovarian irritation,.. 143
Crocus in Profuse Menstruation,.  49  Difficult and Painful Menstrua"      Painful       "         147    tion from  pseudo-membranous
"   Doses of,...............  55    variety....                       143
Chelidonium  in Infrequent Men-         Dulcamara in Infrequent Menstrustruation,..................  7 8                    ation..........  81
Chenopodium in Absent Menstru-                 "      Scanty   Menstruaation....................... 108                     tion............   85
Conium in Infrequent Menstruation, 84          "   Dose of,............  82
" Absent              "       105  Diarrhcea, menstrual,...... 15 & 156
"  Doses of,.............. 106
Cocculus in Suppressed Menstruation.............. 115  Emmenagogues,.......... 72 & 107
Painful Menstruation, 147  Electricity in Absent Menstruar" Last " 159    tion,...................... 100
"   Doses of............. 115
Cuprum in Suppressed Menstruation........................ 116  First Menstruation...........  to 15
Chlorosis,..............17 to 136                 "  in hot climates,  9 & 24
"    state of blood in,..... 123    "        "  in cold climates,      9
"' state of spleen in...... 124    "         "  in temperate climates, 9
"    treatment of,... 127 to 136    "         "  management of,
"    Plumbum in......... 128                                     10 to 15
C6nception...................   3  Frequent Menstruation...... 26 to 30
"     late power of....... 151.... "    treatment of,  28
Climacteric  variety  of Profuse        Ferrum in Profuse Menstruation,   55
Menstruation,...............  34          "     Infrequent    "          81
"  Doses of..............   57
D.                        i "   Chlorosis,........... 132
Delayed Menstruation,.........   6  Flooding in First Menstruation,..       6
Ad 4"9                   73 to 76       "       Last       "          155




INDEX.                                 163
G.                                                     PAGE.
PAGE. Infrequent Menstruation, Sepia in, 82
Graafian vesicles,..........   3     i"           "    Cicuta in,.  82
Graphite in Infrequent Menstrua-             cc"                  osc. in,  82
tion,........ 83,"                      "  Ignatia in, 82
Scanty Menstruation,  86                     "    Podophyl"      Absent,        "        95                            lum in,   82
"    Doses of,                 96'           "    Nux vom.
in.....  82
I"I          "    Belladonna
Hydroemia................... 124                                in.....  82
Heats and Flushes in Last Men-                            "    Calcareain, 82
struation,................... 155                     "    Graphitein, 83
Hyosciamus in Profuse Menstrua-                                Gr  Phosphorus
tion.........   55                           in         8
"       Infrequent  Men-                Conium in, 84
struation,..     82          "            "    Kali carb. in, 84
"    Doses of,..........  55
K.
Kreosote in Profuse Menstruation,  60
Ignatia in Profuse Menstruation,  57         "      Absent,    "           106'"     Infrequent,   "          82
Doses of, 5..............        Kali carb. in Infrequent MenstruI.............."ation............  84
Ipecac. in Profuse Menstruation,.  58                 At    t.. t.. i o
"   " D oAbsent Menstruation, 99
"4  Dose of,...............  59.... 5    Dose of,............  99
Iodine in Infrequent Menstruation,'79
" Dose of...............  81                          L.
Irregular Menstruation...... 20 to 23
Infrequent Menstruation......'76  Liver, derangement of, in First
Infrequent Mesrato....              6Menstruation.........   6
treatment
of,..'7'7 to 84    "   derangement of, in Last
Sulphur in,  7             Menstruation........  156
"    Natrum in, 77  Lycopodium in Profuse MenstruaChelidoni-                      tion.............  61
"     Dose of...........  62
"    Sabadlla in,  78  Laurocerasus in Absent MenstruSab8dilla in, 78
chaNux mos-        ation,.................   10
chata in,   9  Last Menstruation........ 149 to 160
"   "    Mercurialis  Late Menstruation,............  16
perennis, 79    "  power of conception....... 151
"    Magnesia    Leucocythemia................ 125
mur. in,'79
Iodine in,
79 to 81  Menstruation in Infants.........   7
c"          "c   Ferrum            Management of first Menstruaacet in,.  81    tion,.......................  10
c"          "    Dulcamara         Menstruation in Scrofulous perin,.....  81    sons,.......................  25




164                                INDEX.
PAG1E                                  PAGe.
Mercurius in Profuse Menstrua-         Profuse Menstruation, China in,..  44
jion..............  62         "       Calcarea in, 45 to 48
"     Dose.of,............  63             "       Cases of,... 46 to 48
Mercurialis Perennis in infrequent               "      Cinnamon in,..  48
Menstruation,...............   9             "       Crocus in,.. 49 to 55
Magnesia in infrequent Menstrua-                 "      Cases  treated
tion..........7.........  79                          with Crocus,.  51
Mammary  Irritation  in  absent                  "      Hyosciamus in,  55
Menstruation............... 108 " Ferrum in,.....  55
t"     Ignatia in,.....  57
N.                            ic      Ipecac. in......  58
Natural quantity of Menstruation,  19            "      Kreosote in,.    59
"   quality         "          19            "       Lycopodium  in,  61
Natrum in Infrequent  "            77            "      Mercurius in,...  62
s"     Chlorosis............ 129            "       Platina in.....63
Nux moschata in Infrequent Men-                  "      Pulsatilla in,...  64
struation,....  79           "       Sabina in,.. 65 to 70
("       Suppressed Men-                 "      Cases treated
struation.................. 116                        with Sabina,.  68
Nux vomica in Infrequent Men-                    "      Secale in..... 70
struation.....  82            "      Sulphur in,....  71
"t      Absent Menstru-                  "       Veratrum in,...  71
tion,......... 100             "      Thlapsi Bursa'"       Suppressd  Men-                          Pastoris in,...  72
struation,..... 114            "      Emmenagoguesin 73
c".Iodine in.......  81
0.                    Platina in Profuse Menstruation,.  63
Ovaries, functions of..........   2  Pulsatilla in  "           it        64
Ovarian variety of Profuse Men- " Chlorosis,..... 130
struation....................  32        "       Scanty Menstruation,  84
Opium  in Suppressed Menstrua-              "       Painful      "        148
tion,....................... 105         "       Absent      "          93
"    Dose of,..........  64
P.                   Podophyllum in Infrequent MenPains attending last Menstruation, 155    struation...................  82
Puberty.....................   1  Phosphorus in Infrequent MenPrecocious Menstruation,... 23 to 26                      struation......  83
Profuse "... 31 to 73 " Painful MenstruPseudo-narcotism in last Menstru-                         ation........ 148
ation,......................   154
Profuse Menstruation, Aconite in,  36
Aurum  in.....   37 Regular Menstruation...... 15 to 20
Aloe in38  "    recurrence of MenstruaAloe in,.......  38
tion.    16
Belladonna in,  39             duration of Menstruation  18
Bryonia in,...   40
"e  Carbo animalismn 41   "    quantity of      "         19
("      Chamomilla in,.  41                     s.
Cantharides in,.  43  Scanty Menstruation,....84 to 88




INDEX.                               165
PAGIR                                  PAGQL
Scanty Menstruation, Baryta carb.      Suppressed Menstruation, chronic,
in,....84 & 86.        "  from  moral."..            Pulsat. in,.  84                          causes,.. 111...  Sarsaparilla              "            "  from physical
in.......  85                         causes,.. 112.... Ignatia in,.  85                          "      "    treatment."..         Berberis vul-                                of,.... 113
garis in,.  85.      "     Aconite.'..         Sabadilla in, 85                             in,... 113."..          Thuya in,.  85          "           "      Bellad.."..            Dulcamara                                     in..'. 114
in,......  85              "      "     Bryonia.'..         Aquilegia in, 85                             in,... 114
Atriplex oli-           "           "      Nux v.
da in,....  86                             in,... 114."..         Calcarea in,  86         "           "      Opium.".. Graphite in, 86                               in,... 114.".. Alumina in,  87..        "      Cocculus.. it            Assafoetida                                   in,... 115
in......  87  "                          Veratr.
Sepia in Infrequent Menstruation,  82                             in,... 115
"   Absent            "        96         it "lux m.
"   Dose of...............  97                                in,... 116
Sulphur in Profuse Menstruation,  71         "            "      Cuprum
"9     Infrequent    "          77                             in,... 116
"t     Absent          "       97
cc     Last           it       158
L Dose of1.......             98  Tabular Statement of First MenDose of,............... 98
Sudden Cessation of Menstruation, 152    struation,.................   8
Gradual    "               "      152  Three-weekly Menstruation,....  21
Unnatural and Depraved  "         148
Sarsaparilla in Scanty  "  85  Treatment of Irregular MenstruaSabadilla       cc                 85                    tion............  23
"aai  8Precocious    "       25
Sabina in Profuse          "       65
"    Absent              1" 04
Painful.                148                    u.
Suppression from Fright.......          Ulcerative  Variety  of Profuse
"   Dose  of,........... 5    Menstruation............... 33
Suppressed Menstruation,..109 to 116
" Last                 "    15V
"   sudden,.. 113                     v..;..    temporary, 109  Vicarious Menstruation,.... 116 to 119




CATALOGUE OF HOMCEOPATHIC BOOKS.
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HOM(EOPATHIC TREATMENT OF DISEASES OF THE SEXUAL SYSTEM, being a complete Repertory of all the symptoms occurring in the
Sexual Systems of the Male and Female. Adapted to the use of physicians
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HEMPEL'S B(ENNINGHAUSEN for Homceopathic Physicians; to be used at
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