We have placed Menorrhagia among the Apocenoses, because there is reason to suppose that the menstrual discharge is, strictly speaking, a secretion; owing, how ever, to the nature of its symptoms and treatment, we have enumerated it among the fixate,' rhagies, and have given directions for its management in that part of our system. Leucorrheea, which consists in an increased secretion from the mucous glands of the uterus, is cha racterized by the appearance of the discharge; by pain in the loins ; loss of appetite ; general debility ; arta wasting of the flesh. The discharge is sometimes of so acrid a nature as to excoriate the putts on which it lodges, and occasionally it even communicates the same symptoms by contact to a second person.
It is not very easy to ascertain either the exciting or the proximate causes of Leucorrhwa. Whatever stimu lates the parts in an excessive degree has been conceiv ed to give rise to the complaint; but, on the outer hand, it has also been attributed to a variety of circum stances that tend to debilitate the system. Perhaps we ought to ascribe the affection to general debility, com bined with local excitement. The debilitating effect of the complaint is much greater than might have been expected from the quantity of matter discharged, nubeating that the complaint is to be referred chiefly to sonic constitutional action, depending upon the 'elation which the uterine system bears to the other parts of the animal economy. The complaint is often sympathe tic of some structural disease of the uterus, and is then more unfavourable in its prognosis, and often more distressing in its immediate effects ; but when it exists in its simple form, although, as we have remarked above, it is considerably debilitating, and proves a source of much inconvenience, it is seldom to be re garded as dangerous.
The indications of cure are not very obvious, and the effect of remedies is uncertain. The usual method has been to employ tonics and stimulants ; but we are frequently disappointed in our expectations of benefit from them, and, under certain circumstances it would appear, that the opposite plan of treatment is more suc cessful. We occasionally derive advantage from the topical application of astringents, such as solutions of tan, alum, or sulphate of zinc ; but it may be doubted, whether the effect of these substances, as essentially consisting of cold fluids, is not as powerful as any spe cific operation derived from the nature of their ingre dients. Cautharides have lately been recommended in Leucorrhcea, both taken internally, and applied exter nally in the form of blisters, to the parts contiguous to the uterus ; but it may be doubted how far they will be found to correspond with the high character that has been given of them. As there is generally a torpor of the intestines, it is obviously necessary to employ pur gatives; and it is supposed that some particular benefit is obtained from those that are of a stimulating nature, as the resins and extracts, but we are disposed to doubt the correctness of this opinion. Violent exercise of all kinds appears to be injurious ; and we should avoid all those circumstances which excite the circulation without increasing the strength of the system, such as stimulat ing liquors, luxurious diet, and heated apartments.
The second order of the Pareccrises consists of the Epischeses, those diseases in which there is a deficiency of some of the secretions and excretions. The first genus of this order is Obstipatio, an affection which is generally symptomatic of some derangement of the stomach, the liver, or other viscus concerned in the pro cess of digestion, but which may depend upon a torpor of the intestinal canal itself, and which is then to be ob viated by the regular exhibition of purgatives, in the selection of which we must be guided more by the par ticular circumstances of the case, than by any general rules that can be laid down upon the subject. The ope ration of these remedies is always much promoted by an attention to diet, pure air, and exercise.
We have placed Icterus in the same order, although it probably, in some cases, at least, depends rather upon the retention of bile, than a deficknt secretion of it, a de fect which generally happens in consequence of some obstruction in the passages through which the fluid de. scends, in the natural state of the parts, into the duode num. The most remarkable symptoms of Jaundice depend upon the absorption of bile into the circulation after it had been previously sect eted ; upon this depends the peculiar colour of the skin and the cornea, arising front the scrum of the blood being tinged with bile, which is carried into it by the lymphatics of the liver. To the same cause, the bile being actually present in the blond, we may ascribe the bitter taste of the saliva, and the yellow colour which is communicated to the urine, as well as its property of dyeing substances that are im mersed in it. The bile being thus diverted from its na tural course, the deficiency of it in the intestines pro duces a train of symptoms in the digestive organs ; the feces become whitish, or of a clayey appearance, and the bowels torpid ; while the appetite fails, and the whole process of digestion and assimilation is deranged. There is also pain in the region of the liver, and the patient experiences an unusual degree of lassitude and general weakness. In what way the phenomena of Jaundice are connected together, whether a mere obstruction to the passage of the bile from the liver to the intestines is the primary cause of all the other symptoms, whether there is some original defect in the secretion of the bile itself, or some torpor in the digestive organs or their appen dages, may be doubted ; nor, supposing it proved that the disease proceeds front a mechanical cause, are we able to determine how the deficiency of bile in the intestinal canal can produce the effects that we observe on the digestive process. In many cases Jaundice evidently depends upon some disease in the structure of the liver, by which its functions are permanently injured, sometimes by an extraneous body filling up the duct, or pressing upon it ; but there are cases in which, so far as we can judge, it appears to arise from some cause that is more strictly idiopathic, and of a less mechanical nature.