The following prescription may be employed: A half gradually increased to one pill is to be taken thrice daily after food.
These pills must always be taken after food, never on an empty stomach.
Further, the full dose is not to be taken all at once. To begin with, let a few of the pills be divided into two, and let a half be taken after meals thrice a day for two or three days, then let a half be taken after two meals and a whole one after the principal meal, and so let the dose be increased till at the end of a week three pills daily are being taken.
It is important also to notice that the use of the pills must not be stopped suddenly but gradu ally, a half pill less being taken for a couple of days, then another half less, and so on till in a week their use is stopped altogether.
Arsenic is apt to disagree with some stomachs. In such cases it may be altogether left out of the pills.
While these directions have been given, it is desirable to say that no unskilled person should attempt to treat such a disorder if skilled advice • it obtainable.
Sudden suppression, as may arise from cold, usually happens in full-blooded people, and is accompanied by severe pain in the back, quick pulse, feverishness, flushed face, headache, &c. Let the patient's feet and legs be placed in a hot mustard bath for half an hour. She sluiuld be then put into a warm bed with warm foot pan, and should have frequent mild warm drinks, following a large dose of opening medi cine, castor-oil, for example. If this is not sufficient, and the case seems urgent, fever being high, place hot mustard poultices over the lower part of the belly, and give 5 to 10 grains of Dover's powder according to age.
Irregularity or Scantiness of the Monthly Discharge, in which the discharge occurs after more than usually long intervals, or at irregular intervals, or in which it occurs regularly but in small quantity, is commonly dependent upon conditions of the general health similar to those producing absence of discharge, and is to be treated on similar lines.
Excessive Monthly Illness fenorrhagia and .3Iet•orrhagia).—The monthly illness may be excessive, because occurring too frequently. Such conditions indicate a depressed condition of general health, and are also associated with disordered states of the womb. They are not uncommon at the period of change of life. The tonic treatment recommended for absence of the illness is likely to prove beneficial.
There are, however, two special forms of excess. One of these is called simply prof use
menstruation, what is meant being that the discharge is too free or lasts for too long a time returning at the regular periods perhaps. The proper term for this is menorrhagia. The other form is not strictly discharge at the monthly periods, but a loss of blood occurring at other than the monthly period, at least discharge of blood from the womb, occurring independent of the monthly period. This it called metro r r hagia.
The first form, that of excessive loss at the period, occurs under various circumstances. II must be observed, however, that there is in absolute quantity of discharge to be regardee as the healthy standard (see p. 621). Eacl woman knows what, under ordinary circum stances, she is accustomed to, and that is hei standard. The excessive loss may depend upoi bad conditions of health, arising from Brighe disease of the kidney, scurvy, consumption, &c Commonly it is a symptom of chronic disease o the womb. It is sometimes the only sympton of fibroid tumour of the womb (p. 660). Ii cancer of the womb, polypus, displacement congestion, and in many other alterations ii structure it is present.
The excessive loss produces a blanched ap pearance of the patient, and according to thy degree of excess is more or less exhausting. The second form is met with under similar conditions, and the first often leads up to and merges into it.
The treatment of both forms is practically identical. The patient should rest in bed as much as possible during the period, under taking no exertion. If the loss of blood is great and threatening, whether during the period or not, she must lie in bed perfectly quiet and lying on her back. Mild but nourishing diet in small quantities should be given often—milk, light soups, &c. The very valuable and most readily obtainable drug is ergot or spurred rye, in the form of the liquid extract. A half to one tea-spoonful is given in water or syrup every third hour as long as necessary. Another useful drug is the tincture of witch-hazel (Haman:die virginica, vol. ii, p. 368), in doses of 5 drops ill water every third or fourth hour. A medical man would, in urgent cases, plug the passage by inserting pledgets of soft cloth, sponge, silk handkerchiefs, &c. In the intervals between the periods good nourishing food, bracing air, moderate exercise, &c., are valuable, as well as the iron tonic advised for absence of the dis charge on the preceding page.