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NATIONAL LIBRARY OF MEDICINE
        Bethesda, Maryland

              Gift of
  The National Center for Homeopathy
 
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            LIBRARY
AMERICAN FOUNDATION FOR H"""^PATW 
 
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DISEASES  OF FEMALES.
        LIBRARY
AMERICAN FOUNDATION FOR HOMOEOPATHY 
 
             LIBRARY
AMERICAN FOUNDATION FOR HOMOEOPATHY
THE
HOMCEOPATHIC   TREATMENT
imm d Jemalts,
INFANTS AT  THE BREAST
           3DH,- GI-- H- G-- JAJ&Ti,.





              TRANSLATED FROM THE FRENCH BT


         CHARLES J. HEMPEL,  M. D.


Fellow, and Corresponding Member of the Homoeopathic College of Pennsylvania, Honorary
       Member of the London Hahnemanuian Society, etc., etc., etc.
             NEW YORK:
PUBLISHED  BY WM. RADDE, 300 BROADWAY.

           PHILADELPHIA:
  RADEMACHER & SHEEK, 239 ARCH STREET.
                185 6.
             LIBRARY
AMERICAN FOUNDATION FOR HOMOEOPATHY 
IS5^
       Entered according to  Act of Congress, in  the  year 1856,  by
            RADEMACHER  & SHEEK, and WM. RADDE,
in the Clerk's  Office of the District Court of the United States, in and for the
                    Eastern District of Pennsylvania.
KING & BAIRD, PBS., SANSOM ST. PHILAD'A. 
EDITOR'S  PREFACE.
    This work has enjoyed such a distinguished reception
in Europe by all classes of Homoeopathic practitioners, that
we felt confident a translation of the work into the English
language would be hailed with satisfaction by our American
Homoeopathic brethren.  The work being very complete in
the original, we have not deemed it necessar}^ to encumber
it with  notes of our own.  We have confined  ourselves to
supplying a few omissions concerning doses, principally for
the benefit  of lay practitioners and professional beginners :
we have no doubt that all intelligent friends of our art will
derive pleasure  and  profit from a perusal  of this work to
whose pages all  who are in need of the instruction afforded
by them, may refer with perfect safety and reliance in every
curable case of female disease.

                            CHAELES J. HEMPEL.
Philadelphia, August, 1856. 
 
PREFACE.
  This new work is composed after  the same plan  and
according to the same principles as our Treatise  on  Nervous
Diseases.   We have especially endeavored to  place in the
hands  of our readers a complete Materia Medica of the
affections of the uterine system, such as the limits of our
Homoeopathic Manual did not allow us  to offer.  We have
attempted  to join  it  to  the article on dysmenorrhoea in
general, (§§ 5 to 10); and here the reader will  likewise find
a complete repertory of the  symptoms exhibited by the
female organs of generation and their functions, so that prac-
titioners  will find placed at  their disposal, all the  elements
which the actual condition of our science  offers for  the suc-
cessful treatment and the rapid  cure of  the numerous dis-
eases to which woman is so frequently subject, and the treat-
ment of  which, with the means offered  by the  Old School,
has always remained problematical.
  A perusal  of the Table of Contents, will show the reader
that our  plan embraces  a complete list of  all  the diseases to
which women are subject, both  during the period of nursing,
and at  any  other time, and  we  have  even  added  some
remarks  concerning the cases required by new-born or nurs-
ing infants, whose lives  are so intimately connected with that
of the  mother. Among  these affections, and especially among
the organic lesions peculiar to females, there are some, it is
true, for which Homoeopathy has done little or nothing, and
for which we have consequently been unable  to  indicate any
positive treatment based upon clinical experience;  but being 
viii
PREFACE.
persuaded  that  all these diseases  are no less  accessible  to
internal  treatment than  many others which were  formerly,
before they had been  successfully treated with Homoeopathic
remedies, supposed equally incapable  of being  removed by
internal medicines, we have not omitted a single case without
at least indicating the remedies which seemed to us to deserve
in preference to  others, the attention of the profession  in
regard to its  treatment.
   The usefulness of the pathological, symptomatological and
diagnostic notes, with  which we  have accompanied each article
of our Treatise on Nervous Affections, having been  generally
appreciated, we have  enriched  the  present work with similar
notes, and we have availed ourselves for this purpose not only
of what  the  principal French  authors, such as Velpeau, De-
sormeaux,  Lisfranc, Chailly, Nouvre,  Fabre, etc., have pub-
lished on this subject,  but likewise of what the most celebrated
and recent authors in  Germany have contributed to the study
of these affections.   However, since it  is not the object  of
our work to present a nosographical treatise of these mala-
dies, but only to furnish  therapeutical indications, we  have
often been obliged, without however omitting  any  thing  of
the substance, to content ourselves  with furnishing  a general
statement of the well established facts contained in the works
which we have consulted.
   Among the observations which have been  addressed to us
concerning some of our previous publications, we find  com-
plaints from various quarters that  the dose of the medicine
to be  prescribed, has not been indicated.  In the present
work, we have furnished here and there  a few indications  in
reference to this matter, but rather  with a view of preventing
the employment of too large doses, than for the purpose  of
furnishing general rules which are to be followed blindly.  It
is  impossible  to indicate the  dose in every single case ;  one
must not have the least  idea of  the practice of  medicine  in
order to imagine that every  affection,  notwithstanding its
greater or  less degree of  intensity, has  its particular doses
which cure all the varieties and forms thereof,  no matter  how 
PREFACE.
ix
or under what circumstances.   Nothing varies more than the
doses, and it is more particularly in the administration of the
medicines that the practitioner ought to be the  sole judge of
what is required to be done.  He who does not feel compe-
tent to assume  this responsibility, had better never meddle
with the practice of medicine, for there is no treatise extant
on  this subject, that will give him all  the light he desires.
On the other hand, it  must be conceded that works like the
present, sometimes fall into the hands of new  converts, who
have  as yet little knowledge of homoeopathic medication, or
of  the principles of our art in general, and who nevertheless
feel anxious to use the remedies which are here recommended
for various diseases.   We advise all such beginners to read
elementary works where the  principles of Homoeopathy are
taught, such  as  S. Hahnemann's Organon, or  our  own Ele-
ments of Homoeopathy.   In these  works they will find every
thing  that they require to know concerning doses, and they
will likewise  obtain  a  knowledge of the general rules, which
they may afterwards apply to all particular cases.

                                      G. H.  G. JAHR.
Paris, September, 1855. 
 
TABLE  OF  CONTENTS.
                            Section 1.
 Functional lesions and nervous affections of the uterine system,.........   2

                           ARTICLE I.
 Dysmenorrhea in general,.......................................................   2
                            Section 2.
 General characteristics,...............................................................   2
                            Section 3.
 Causes, course and diagnostic signs,.............................................   3
                            Section 4.
 Treatment, what is to be done during the flow,................................   5
                            Section 5.
 Radical treatment, principal remedies,...........................................   6
                            Section 6.
 Remedies of the second class,..........................................,...........  19
                            Section 7.
 Remedies less frequently indicated,.............................................. 27
                           Section 8.
 Indications derived from the nature of the  menses,..........................  32
                           Section 9.
 Accompanying symptoms in menstrual irregularities,.......................  38
                           Section 10.
 Condition of the parts,...............................................................  52
                          ARTICLE II.
Menstrual colic,.....................................................................  59
                          Section 11.
Nature of the malady,................................................................  59 
x{{                         CONTENTS.




                            Section 12.

                                                         .........  59
Treatment, principal remedies,.....................................



                            Section 13.

                                                    .................  61

Other remedies.......................................................



                            Section 14.

                                                     ................  63

General indications,...................................................





                           ARTICLE III.



Menstrual  irregularis,  anb  alterations of  the  ™"™^  65


       BLOOD,........................................................'"'      ,   ,

Menses too  copious,  premature, too long, scanty, retarded, too short,  ^


       full, etc.,..............................................................



                             Section 15.

                                                      ...............  65
General  observations...........................................



                             Section 16.

                                                      ...............   66
Premature menstruation...................•.......................



                             Section 17.


                                                      ...............  68
 Profuse  menstruation,..............................................



                             Section 18.

                                                     ..................  69
 Menses of excessive duration........................................



                             Section 19.

                                                           ........  71
 Retarded menstruation,...............................................



                              Section 20.


                                                                  73
 Menses too scanty,....................................................................



                              Section 21.


                                                                   74
 Menses too short,.....................................................................



                             Section 22.


  Morbid changes in the  menstrual blood,........................................   75





                             ARTICLE IV.


                                        ......................................  78
  Amenorrhea,....................................



                              Section 23.


  General observations,..................................................................  ' 
                            CONTENTS.                       X1U

                            Section 24.
Symptoms of amenorrhoea,.........................................................  79
                            Section 25.
Causes of amenorrhoea,.........».....................................................  81
                            Section 26.
Course, complications and terminations,.........................................  83
                            Section 27.
Diagnosis and prognosis,.............................................................  84
                            Section 28.
Treatment, principal remedies,.....................................................  85
                            Section 29.
Other remedies,.........................................................................  88
                            Section 30.
Remedies rarely indicated,...........................................................  91
                            Section 31.
Particular indications,...............................................................  92
                            Section 32.
Accompanying symptoms of amenorrhoea,.......................................  97

                            ARTICLE V.
am.2bnia  of young girls,........................................................... h2
                            Section 33.
Symptoms,............................................................................... H*
                            Section 34.
Treatment,............................................................................... 1"

                           ARTICLE VI.
Menospasis, or critical  age,..................................................... 11*
                            Section 35.
                                                               117
Symptoms,.............................................................................
                            Section 36.
                                                               11Q
Treatment............................................................................ "• 
xiv
CONTENTS.
                         ARTICLE VII.
Abnormal changes of the menstrual blood,.............................. 120
                           Section 37.
Symptoms,............................................................................... 120
                           Section 38.
Treatment,............................................................................... 122

                         ARTICLE VIII.
Metrorrhagia,......................................................................... 125
                           Section 39.
Causes,.................................................................................... 125
                           Section 40.
Symptoms and course,............................................................... 126
                           Section 41.
Diagnosis and prognosis,............................................................. 128
                           Section 42.
Treatment,............................................................................... 130
                           Section 43.
Symptomatic indications............................................................. 132

                          ARTICLE IX.
LEUCORRHffiA,........................................................................... 135
                           Section 44.
Symptoms,............................................................................... 135
                           Section 45.
Causes,..................................................................................., 137
                           Section 46.
Diagnosis, prognosis and terminations............................,.............. 138
                           Section 47.
Treatment,............................................................................... 140
                           Section 48.
Particular indications................................................................. 145 
                           CONTENTS.                       XV

                          ARTICLE X.
Uterine  cramps, htsteealgia,................................................... 151
                           Section 49.
Symptoms, causes, treatment,...................................................... 151

                          ARTICLE XI.
Nymphomania........................................................................... 154
        v                  Section 50.
Symptoms,............................................................................... 154
                           Section 51.
Causes, prognosis, treatment........................................................ 156

                          ARTICLE XII.
Chlorosis, green-sickness......................................................... 158
                           Section 52.
Symptoms and course,................................................................ 158
                           Section 53.
Causes, diagnosis and prognosis,................................................... 160
                           Section 54.
Treatment............................................................................... 161
                            Section 55.
Particular indications,................................................................ 167

                          ARTICLE XIII.
Hysteria,................................................................................ 174
                           Section 56.
Remarks,................................................................................. 174

                        SECOND SECTION.
Organic lesions of the uterus and its appendages.............................. 177
                           Section 57.
General  remarks,,.................................................................. 177 
xvi
CONTENTS.
                            ARTICLE I.
Displacements and Deviations of the Uterus,.............................  i7°
                            Section 58.
Falling of the Uterus.................................................................  178
                            Section 59.
Hernia of the Uterus and Ovaries.................................................  189
                            Section 60.
Obliquity, anteversion and retroversion of the Uterus,......................  182
                            Section 61.
Inversion of the Uterus,.............................................................  184
                            Section 62.
Treatment of all displacements,....................................................  186

                            ARTICLE II.
Endometritis or superficial metritis,......................................  189
                            Section 63.
General observations,.................................................................  189
                            Section 64.
Blennorhagia, or acute superficial metritis,..................................  189
                            Section 65.
Uterine catarrh, or superficial chronic metritis,..............................  192
                            Section 66.
Treatment,...............................................................................  193

                            ARTICLE III.
True or parenchymatous  metritis,...........................................  198
                            Section 67.
General observations,................................................................  198
                            Section 68.
Acute metritis,.........................................................................  198
                            Section 69.
Chronic metritis,.......................................................................  201 
                           CONTENTS.                      Xvii

                           Section 70.
Treatment,............... ..............................................................  203

                           Section 71.
Symptomatic details,................................................................. 206

                          ARTICLE IV.
Hydrometra, uterine dropsy,................................................... 212
                           Section 72.
Symptoms,............................................................................. 212

                           Section 73.
Causes, diagnosis, prognosis and treatment,.................................... 213

                          ARTICLE V.
Physometra, tympanitis of the womb,....................................... 217

                           Section 74.
Symptoms, causes and treatment,................................................ 217

                          ARTICLE VI.
Foreign  bodies in the womb,................................................... 219
                           Section 75.
Moles,.................................................................................... 219
                           Section 76.
Hydatids,................................................................................ 221
                           Section 77.
Sanguineous and lymphatic concretions,........................................ 222
                           Section 78.
Uterine polypus,....................................................................... 224
                           Section 79.
Calculi, fibrous bodies in the womb,.............................................. 227

                          ARTICLE  VII.
Schirrus and cancer of  the womb,.......................................... 230
                                1 
XVU1                       CONTENTS.
                            Section 80.
Definition and varieties of cancer,................................................. 230
                            Section 81.
Symptoms and diagnosis of cancer,.............................................. 232
                            Section 82.
Causes, course and terminations,................................................. 234
                            Section 83.
Diagnosis and prognosis,............................................................ 236
                            Section 84.
Treatment,.............................................................................. 238

                          ARTICLE VIII.
Simple Ulcerations of the Womb,............................................. 242
                            Section 85.
Superficial erosions.................................................................... 242
                            Section 86.
Deep-seated ulcerations,............................................................. 243
                            Section 87.
Therapeutic, scorbutic, scrofulous and syphilitic ulcerations,............. 24^
                            Section 88.
Treatment of non-cancerous ulcerations of the womb,...................... 246

                           ARTICLE IX.
Gangrene and  putrescence of the Womb,................................. 249
                            Section 89.
Symptoms and treatment,........................................................... 249

                           ARTICLE X.
Diseases of the Neck of the  Uterus,...................................... 251
                            Section 90.
Inflammations,.......................................................................... 251 
CONTENTS.
xix
                            Section 9i.
Neuralgia, rednesses,  engorgements, eruptions, ulcers and cancers of
      the neck of the womb,....................................................... 252
                           ARTICLE XI.
Ovaritis and  other  affections of the Ovaries,........................ 255
                            Section  92.
Ovaritis,.................................................................................. 255

                            Section  93.
Dropsy of the Ovaries,................................................................ 258
                            Section  94.
Other affections of the Ovaries,.................................................... 260

                           ARTICLE  XII.

Vabinitis,  and other diseases of the Vagina,........................... 261
                            Section  95.
Vaginitis,................................................................................. 261
                            Section  96.
Prolapsus, hernia and flstulse of the vagina,.................................... 265
                            Section  97.
Indurations, contractions, tumors, cysts, polypi,  and cancer of the
      vagina,........................................................................... 269
                            Section  98.
Spasms  and neuralgia of the vagina,............................................. 270

                          ARTICLE  XIII.
Vulvitis and  other affections of the  Vulva,........................... 272
                            Section  99.
Vulvitis, inflammation of the vulva,.............................................. 272
                            Section 100.
Tumors, hernia, oedema, etc., of the vulva...................................... 274
                            Section 101.
Neuralgia, itching, etc., of the vulva,............................................. 276 
XX                         CONTENTS.

                          ARTICLE XIV.
Affections of the breasts and Nipples,.................................... 280
                            Section 102.
General observations,................................................................. 280
                            Section 103.
Inflammations, etc., of the breasts,............................................... 280
                            Section 104.
Tumors, etc., of the mamma,....................................................... 283
                            Section 105.
Schirrus of the breasts,.............................................................. 286
                            Section 106.
Mechanical injuries of the breasts,................................................ 289
                            Section 107.
Neuralgia and neuralgic tumors of the breast,................................. 290
                            Section 108.
Diseases of the nipples,.............................................................. 292
                            Section 109.
Atrophy of the nipples and breasts,.............................................. 295

                         SECTION THIRD.

Functional derangements incidental to pregnancy, confinement........... 297
                            Section 110.
General observations,................................................................. 297

                            ARTICLE  I.
Of  Pregnancy in general,....................................................... 298
                            Section 111.
Symptoms of pregnancy,............................................................ 298
                            Section 112.
Diagnosis of pregnancy.............................................................. 301
                            Section 113.
Hygienic rules during pregnancy,.....................,........................... 303 
                            CONTENTS.                        XXI

                           ARTICLE II.
Diseases of pregnant females...................................................  309
                           Section 114.
General observations,.................................................................  309
                           Section 115.
Digestive derangements,.............................................................  310
                           Section 116.
Derangements of the circulation,...................................................  314
                           Section 117.
Derangements of the respiratory organs,.......................................  318
                           Section 118.
Derangements of the secretory and excretory functions,....................  320
                           Section 119.
Derangements that are painful,....................................................  321
                            Section 120.
Nervous and mental affections,...................................................  323
                            Section 121.
Cutaneous derangements,............................................................  325
                            Section 122.
Local derangements of the sexual organs..........................,.............  326
                            Section 123.
Influence of existing diseases upon pregnancy,...............................  328

                           ARTICLE III.

Miscarriage,.........................................................................  330
                            Section 124.
Symptoms and course,............................................................... 330
                            Section 125.
Causes of miscarriage,................................................................  331
                            Section 126.
Diagnosis and prognosis,.............................................................  333 
xxii                       CONTENTS.
                           Section 127.
                                                      .............  334
Preventive treatment,..................................................
                           Section 128.
                                                                OOD
Active treatment of the precursory symptoms,.................................  '
                           Section 129.
                                                          .......  341
Treatment of the consequences,...........................................

                           ARTICLE IV.
Natural  Confinement, and the  duties  of Physicians  on  such ^
    occasions.......................................................................
                            Section 130.
                                                                34''
Symptoms and course of labor,...................................................
                            Section 131.
                                                                344
Diagnosis and prognosis,.........................................................
                            Section 132.
Hygienic attentions  during confinement,.......................................
                            Section 133.
 Attentions of the  accoucheur during the process of labor,................. 347

                           . ARTICLE V.

 Difficult  labor,.....................................................................
                            Section 134.
 General observations,................................................................. 349
                            Section 135.
 Obstacles inherent in the mother,................................................. 350
                            Section 136.
 Obstacles presented by the fetus,................................................. 351
                            Section 137.
 Accidents to the mother during labor............................................ 352

                            ARTICLE VI.
 Delivery of the Placenta,........................................•............. 3-37 
                            contents.                      xxiii
                            Section 138.
Natural Delivery...................................................,..................  357

                            Section 139.
Complicated delivery,................................................................  358

                           ARTICLE VII.

                            Section 140.
Phenomena after parturition,.......................................................  359

                            Section 141.
Hygienic rules during confinement,...............................................  361

                            Section 142.
Medical attentions during confinement,........................................   363

                           ARTICLE VIII.

Diseases of women during  confinement,....................................  368
                            Section 143.
General observations,.................................................................  3G8
                            Section 144.
Puerperal fevers,.......................... ............................................  369
                            Section 145.
Local derangements of the uterine system,.....................................  374
                            Section 146.
Abdominal affections,.................................................................  375
                            Section 147.
Cerebral affections,....................................................................  377
                            Section 148.
External affections,.................................................................... 378

                           ARTICLE IX.
                            Section  149.
General phenomena of lactation,...................................................  380
                            Section 150.
Hygienic attentions during lactation,............................................  382 
XXIV                      CONTENTS.

                            Section 151.
Medical attentions during nursing,..............................................  384
                            Section 152.
Weaning,  ................................................................................ 389
                            Section 153.
Milk-affections,....................................................................... 390

                            ARTICLE X.
Attentions  to new-born infants and children  at the breast..... 391
                            Section 154.
General observations,...... .......................................................... 391
                            Section 155.
First attentions to the infant,....................................................... 392
                            Section 156.
Diseases of new-born children,..................................................... 394
                            Section 157.
Diseases of infants at the breast,.................................................. 398
                            Section 158.
Ailments during dentition,..........................................................  404
                            Section 159.
Chronic derangements of little children,.........................................  408 
      HOMCEOPATHIC  TREATMENT
                         OP

DISEASES  OF  FEMALES.
FIRST  SECTION.
    FUNCTIONAL LESIONS AND NERVOUS AFFECTIONS OP THE UTERINE
                        SYSTEM.

                      Section  1.

  We  have  divided this work in three  sections: the first
contains functional  and  nervous  derangements peculiar to
females;  the  second, organic lesions of the uterus  and the
other sexual  organs: the third,  affections of females from
the period of conception, to the end of the nursing period. (1)
In this first section, we intend to  treat successively; 1st, of
dysmenorrhoea or retarded and painful  menstruation;  2d, of
menstrual colic; 3d, of the various menstrual irregularities;
4th, of amenorrhoea or menstrual suppression ; 5th, of anaemia
of young girls at the age of pubescence; 6th, of the derange-
ments peculiar to  the climacteric period; 7th, of irregulari-
ties of the menstrual blood; 8th, of metrorrhagia;  9th, of
leucorrhoea;  10th, of hysteralgia; 11th,  of nymphomania;
12th, of chlorosis.

  (1) For the study and the treatment of the diseases of children, we refer
our readers to F. Hartmann's treatise, entitled, " Homoeopathic Treatment
of the Diseases of Children," translated by Charles J. Hempel, M. D., for
sale by W. Radde, 322 Broadway, New York, and Rademacher & Sheek, 239
Arch street, Philadelphia. 
2
DISEASES  OF FEMALES.
   Having treated of hysteria elsewhere in a detailed manner,
we shall content ourselves with referring the  reader  to that
work. (1)

                      ARTICLE I.
                 DYSMENORRHEA IN GENERAL.

                        Section 2.

   General Characteristics.—By dysmenorrhoea, we not only
understand painful  menstruation accompanied by more or
less  extensive derangements of the nervous system, but also
any  abnormal secretion of blood, both as  regards quantity
and  quality.   Dysmenorrhoea being distinguished  from ame-
norrhoea and menorrhagia only by a greater or less degree of
intensity, it will be readily perceived that all that can be said
of the causes, the essential and accessory symptoms, the cha-
racteristic signs and the treatment as amenorrhoea and menor-
rhagia, likewise  applies to a  certain  extent  to  the  various
forms of dysmenorrhoea.  This  is the reason  why we will
give here all  the details applicable to  all possible menstrual
disorders; this will permit us to use more brevity in describing
the other forms, and simply to add that which is peculiar to
each variety.  We may distinguish dysmenorrhoea into three
distinct forms, namely: 1st,  excessive or profuse menstrua-
tion, known  by the term menorrhagia;  2d, scanty menstrua-
tion, known  under  the name of menoschesia; 3d, painful
menstruation, or  dysmenorrhoea, properly speaking.   It is,
however,  of  very rare occurrence in practice, to find the
various forms of dysmenorrhoea as perfectly distinct as they
are here  drawn on paper;  difficult menstruation is  almost
always an accompaniment of menorrhagia and menoschesia;
and, on the other hand, when the catamenia are painful, they
are generally either too profuse or insufficient. Moreover, inas-
much as menorrhagia has almost always the same symptoms and
  (1) Homoeopathic Treatment of Nervous and Mental Diseases; translated
by Charles J. Hempel, M. D.,  and for sale by W. Radde, 322 Broadway,
New York, and Rademacher & Sheek, 239 Arch street, Philadelphia. 
DYSMENORRHEA.
3
results from the same causes as metrorrhagia ; and inasmuch
as menoschesia is, in these respects, nearly related to amenor-
rhoea, we prefer arraying the remarks we may have to offer con-
cerning these  irregularities, under the heads of metrorrhagia
and amenorrhoea, and we shall confine ourselves here to dys-
menorrhoea, properly speaking,  whether characterised  by a
too profuse or too scanty discharge of the menstrual fluid.  In
most  cases the  menstrual secretion  is  difficult, and painful
menstruation is  too scanty ; sometimes the blood is discharged
only in drops, in small quantity, and with remarkable slow-
ness; but even if the quantity is sufficient,  the flow is always
preceded by more or less acute  pains, especially by nervous
colic, which is known by the name of menstrual colic.  These
colics are often  accompanied  by various nervous  and other
accessory symptoms, such  as lassitude  in the extremities,
shiverings, pains in the  lumbar regions, headache, vertigo,
nose-bleed, oppression, labored breathing, cough, haemoptysis,
gastralgia,  nausea, vomiting, weeping,  hysteria, chlorosis.
If the discharge of blood is too scanty, the head feels heavy;
the  face is alternately  red and pale;  there is  rising of
heat to  the  face;  violent but transitory palpitation  of the
heart;  quick, full  and vibratory pulse;  vicarious  haemor-
rhages from  the  nose,  bladder,  bronchial  tubes, or  from
ulcers and other cutaneous lesions; sense of weight at the
epigastric  region;  uterine colicky pains;   labor-pains in
the small of the back, and sub-acute irritation of the uterus.
If the  blood  flows too profusely, the nervous and accessory
symptoms which exist previous to the appearance  of the
menses,  generally cease  in  proportion as  the  menstrual
discharge increases; in  such  cases, the flow may continue
pretty profusely for several days without  causing a  loss of
strength or the  least appearance of illness in the looks of the
patient.
                         Section 3.
   Causes, course and diagnostic signs.—Among the predis-
posing causes of dysmenorrhoea, authors generally mention
onanism, venereal  infection,  amorous excesses, or else the 
4
DISEASES  OF FEMALES.
contrary of these, strict  abstemiousness; but  in many cases
it  is  undoubtedly induced  by  a nervous  constitution,  an
impoverished state of the blood, a  sickly condition of the
system, or general debility resulting from  some former sick-
ness.   Sometimes it  sets in in  consequence of some sudden
emotion, fright, fear, chagrin, wrath, <fcc.;  other  causes  are,
an improper mode of life, deficient exercise, insalubrity of
the air, and the  like.  As regards  the  proximate  cause, it
is almost always  difficult to determine it;  in  some cases the
irregularity has been attributed to chronic inflammations of
the uterus, or to scirrhous and tuberculous degenerations  of
this organ; but in most cases, there is nothing unusual in the
patient's constitution to which  the  disease could positively
be traced.   As regards the  course and termination of this
disease, scanty dysmenorrhoea  generally  ends  in complete
suppression of the menses, with  all the consequences inciden-
tal to  such a condition; profuse dysmenorrhoea  frequently
degenerates  in metrorrhagia; and  if the  menses  are  suc-
ceeded by leucorrhoea, they frequently change to this latter
secretion entirely.   In difficult  menstruation, if the tension
and  swelling of  the uterus are of long  duration,  chronic
inflammation or  schirrus of the uterus may supervene.   In
some cases scanty menses are accompanied by vicarious dis-
charges of blood, such as nose-bleed, bloody  expectorations
from the  chest, vomiting of blood, piles, hematuria, haemor-
rhage  from the  eyes and mouth,  discharge  of blood from
sores, ulcers, or  bloody  sweat;  also, in particular localities
only.  As regards the diagnostic signs, scanty dysmenorrhoea
might  sometimes be  confounded with  superficial  metritis,
which  affection sometimes accompanies dysmenorrhoea, either
as the cause or effect of the disease; but  all  doubt  as to the
precise character of  the  disease is easily removed by a know-
ledge  of  the origin  and causes of the existing  symptoms.
The uterine cramps which precede miscarriage, are sometimes
confounded with  difficult menstruation;  but the discharge of
the water which would soon  supervene in  a case of miscar-
riage, would indicate the precise nature of the flow.  Haemor- 
DYSMENORRHEA.
5
rhoidal  colic can scarcely be mistaken for menstrual colic,
since the  former affection  is  never accompanied by  the
nervous  symptoms that are  always present in the latter;
the absence of all morbid signs in the uterine region would
of course  preclude the possibility of establishing a  wrong
diagnosis.

                        Section 4.

   Treatment; what is to  be done during the flow.—Nothing
is more  difficult  than the treatment of menstrual  disorders,
unless the patient is willing to assist the physician by observ-
ing a careful diet and avoiding every thing that might tend
to keep up the  irregularity.   Frequent walking, muscular
exercise, all sorts of amusements, absence of all violent and
especially unpleasant emotions, such  as  chagrin, vexations,
etc., are  indispensable  requisites to a  restoration  of the
menstrual functions to their normal standard.   As regards
therapeutic means, we have  a sufficient  number in homoeo-
pathy,  each of which, if used in season, may be able to effect
a perfect cure. We have to observe, however, that in habitual
dysmenorrhoea, which  generally results  from constitutional
causes, the accidental treatment has to be distinguished from
the  constitutional.   The former aims at quieting for the time
time being the  distressing   symptoms  inherent  in  difficult
menstruation; whereas the  latter, or the radical treatment,
endeavors to  prevent the return of these  symptoms, and to
restore the regularity of the menstrual discharges.   In this
paragraph we will first point out the principal  means of the
immediate or accidental  treatment,  and in  the  subsequent
paragraphs, we will furnish  a complete  list of the remedies
that have a tendency to regulate  the menstrual secretions;
at  the  close of the article we will furnish an expose of the
leading symptoms by which  the respective  remedies are indi-
cated.   The  most useful medicines  which may have to  be
used for accidents that may  occur  during the menstrual flow,
are,  in general,  Belladonna, Bryonia, Calcarea, Chamomilla, 
6
DISEASES OF  FEMALES.
 Cocculus,  Coffea,  Graphites, Ignatia, Nux  vomica;  among
 these remedies the most efficacious are,
   a. For Menstrual Colic : Belladonna, Chamomilla, Coffea,
 Nux vomica,  Veratrum.   (Compare Sections 11—14.)
   b. For Uterine Cramps :  1. Coffea, Pulsatila, Secale.  2.
 Cocculus, Cuprum, Ignatia.  3. Chamomilla, Veratrum.
   c. For too early Menses : 1. Calcarea,  Chamomilla, Ipe-
 cacuanha, Nux  vomica.  2.  Ignatia,  Platina.   (Compare
 Section 16.)
   d. For late Menses:  1. Cuprum, Kali, Pulsatilla, Sul-
phur.  2. Lachesis, Phosphorus.   (Compare Section 19.)
   e. Too long :  1.  Cuprum, Nux vomica, Platina. 2. China,
 Ignatia.  3.  Aconite, Sulphur.  (Compare Section 18.)
  /. Too profuse :  1.  Belladonna,  Calcarea, Ipecacuanha,
 Nux vomica.  2. Chamomilla, Ignatia, Sulphur.  (Compare
 Section 17.)
   g. Too scanty :  1. Kali, Pulsatilla, Sulphur.  2.  Coccu-
 lus, Lachesia.  3.  Aconite,  Cuprum,   4. Bryonia, Chamo-
 milla, Nux vomica, Veratrum.   (Compare Section 20.)
   h. Too short:  1. Pulsatilla, Sulphur.   2. Phosphorus.
 3.  Lachesis.  4. Platina.  5. Bryonia, Kali, Nux vomica.
 (Compare Section 21.)
   For the details concerning the selection of these remedies,
 we refer the  reader to the following paragraphs:

                        Section 5.

   Radical treatment; principal remedies.—After having indi-
 cated, in the preceding  paragraph, the principal remedies for
 most important symptoms which sometimes supervene in  the
 course of an irregular  menstrual flow, we will now furnish a
 list of all the remedies which correspond to  menstrual irregu-
 larities, and  likewise give all possible indications for their
 rational use, both  in the  treatment of the  accidental symp-
 toms as well as  the germs of  the  disease.   The principal
 remedies  for menstrual  irregularities  in  general  are:  1.
 Calcarea, Graphites, Kali, Kreosotum, Lachesis. Lycopodium, 
DYSMENORRHEA.
7
Magnesia carb., Natrum mur., Nux vom., Phosphorus, Platina,
Pulsatilla, Sepia, Sulphur.   The following  remedies will  be
found particularly efficacious:
   Calcarea, for the following symptoms: Premature menses,
three or four days too soon, or too copious.   Previous to the
catamenia: lascivious dreams, headache, swelling and sensi-
tiveness of the breasts, leucorrhoea,  nervous prostration, and
tendency  to start; nocturnal shivering, and pains in the
bowels.  During the catamenia: rush of blood to the head,
with  heat  in  the head;  pressure at the vertex; nocturnal
agglutination of the lids, with lachrymation in the day-time,
heaviness of the head,  and dizziness;  tearing and boiing
headache, worse during a change in the weather, and after a
sudden and keen emotion;  excoriation;  pain in the  throat
and at  the uvula, when swallowing; toothache, boring in  the
decayed teeth;  inclination to vomit, and ineffectual desire to
go to stool;  vomiting and  nausea;  crainpy pains  in  the
small  of the back,  with  griping pains;  asthmatic  oppres-
sion;  drawing,  with  pressure  and  shooting pains  in  the
abdomen,  with  restlessness even unto  fainting; contractive
pinching  in the  abdomen  when the secretion of  blood is
interrupted; involuntary discharge  of urine during  emotion.
After the catamenia: drawing and shooting in the teeth, day
and night, worse by inclining the head  to  the right or left,
and preventing  sleep.   Mucous leucorrhoea, resembling milk,
also with  itching of the parts; itching of the  parts, with
shootings,  heat, excoriation, pain, and smarting; inflamma-
tion, redness and  swelling of the  vulva;  eruption  on  the
parts;  dampness  and smarting  between the parts  and  the
thighs; pressure in the  vulva;  shooting  in the os  tincae;
sensation of pleasure in the parts.   Symptoms of chlorosis.—
Polypi in  the uterus.
   Graphites.—The menses return tardily, and are too scanty,
do not last long enough, with discharge  of  a thick and black
blood;  uterine  cramps,  cutting  pains,  pressive headache,
nausea, pains in the chest, bronchial or nasal catarrh; great
weakness,  rheumatic  pains  in  the  extremities, oedematous 
8
DISEASES  OF FEMALES.
 swelling of the feet  and legs, herpetic eruptions, toothache,
 with rheumatic pain in the cheek, heaviness in the abdomen,
 dulness of the head, heaviness in the arms and legs, pains in
 the  sides, pressure and heat  in the bowels, fatiguing cough.
 Previous to the menses:  itching in the parts; cutting pains
 at the commencement of the  menses.  During the menses:
 violent headache, especially in the evening, with eructations
 and nausea;   nausea in  the   morning, with  weakness  and
 trembling in  the day-time; pain  in the epigastrium, as  if
 everything would be  torn; bearing-down pains in the abdo-
 men, with  pain in the back and sides, eructations, pricking
 pain in the teeth, and soreness of the parts and between the
 thighs; hoarseness, coryza, with fever; dry cough, with pro-
 fuse perspiration;  swelling of the feet and catarrhal affection
 of the cheek  ; painfulness of the  varices;  obscuration  of
 sight, with  deadness of  the  hands  and formication in the
 anus and lips: pains  in the extremities;  discharge  of blood
 from the anus; cramps in the abdomen;  colic; pains in the
 chest; weakness;  the ulcers  get worse.  After the  menses:
 shiverings,  cutting,  griping  pains,  diarrhoea; leucorrhoea,
 especially before or after the menses,  resembling water or
 white mucus, with weakness in the back and loins, or with
 tension of the bowels; leucorrhoea, day and night:  bearing-
 down on the parts, especially when  standing; smarting in
 the vagina; prickings and vesicles  at the labia ; itching at
 the vulva, especially before the menses, with pimples; sore-
 ness  of the parts and between  the  thighs, with  pimples,
 blotches, and  ulcers; swelling and hardness of  one  of the
 ovaries.
  Kali carbonicum.—The menses are  either too scanty and
too late, or else too copious, too early, and last too long, with
weariness, desire  to  sleep, colic, and toothache;  the  men-
strual blood is acrid,  fetid, and  excoriating.  Before  the
 menses: in the morning, on waking, pleasurable sensation, as
 during an  embrace;  a good   deal  of  heat, with  frequent
 thirst, and restless sleep;  frequent  shivering, with trembling
 of the limbs, crampy sensation in  the abdomen, sour eructa- 
DYSMENORRHEA.
9
tions, rheumatic swelling of the cheek, with prickings, and
swelling of the gums.  During the menses: headache in the
morning,  with heaviness  of the head;  nausea after eating,
with sense of fulness and vomiting;  colic, with foul taste in
the mouth;  rumbling, lassitude, and  drowsiness; wind in the
bowels, with foul taste in the mouth, and bitter, bilious eruc-
tations ; griping colic, with  pressure on the  parts, as if every-
thing would be pressed out;  constipation;  painful sensation
of weight in the loins;  nasal catarrh, with colic,  toothache,
pains  in the  back,  stitches in the ears, restless sleep, and
anxious dreams ;  violent startings in  the whole body ;  dozing
at night,  with anxious  reveries,  and  dizziness on waking.
After the menses:  nocturnal  gastralgia, with sense of coldness
in  the back and  stomach; yellowish,  mucous  leucorrhoea,
with  itching and  smarting  at  the  parts; erythematous sore-
ness, itching and  titillation of the parts, with smarting and
gnawing pimples; tearing  on  the  parts extending up to the
chest;  pricking in  the  labia  majora;  stitches  through the
vulva; pricking  or  excoriation;  pain  in the  vagina  during
an  embrace; aversion to  an  embrace, or  excessive sexual
irritation.
  Kreasotum.—The menses  are  too early, too  copious, and
last too long, with discharge of dark-colored and coagulated
blood, or with violent colic,  and discharge of clear and watery
blood.  Before the  menses: hard bearing; regurgitation of
a whitish and tasteless  froth, or watery vomiting; consider-
able distention of the abdomen;  colic,  with cramp, pains at
the  navel;  followed  by whitish  leucorrhoea;  restless and
nervous excitement.  During the menses: buzzing  in  the
head,  with  pressure from  within  outwards, worse by stoop-
ing ;  hard hearing;  flatulence that  smells like rotten eggs;
retention of  stool and  wind, with discharge  of  coagulated
blood  after the discharge of flatulence; frequent  shivering;
stitch in  the side of the chest, with cutting pains above the
navel; profuse sweat on the back and chest;  report in the
abdomen, followed by diarrhoea.   After the menses:  violent
abdominal cramps, especially in the groin; pressure  on the 
10
DISEASES  OF FEMALES.
parts, as if the menses would reappear;  contractive pains in
the vagina, followed by leucorrhoea;  discharge of a fetid,
acrid, bloody  serum,  with gnawing, tickling  and itching of
the parts;  frequent and violent distress after too copious and
long-lasting catamenia;  whitish  or acrid leucorrhoea, with
itching  and gnawing  at the parts;  serous  leucorrhoea, hav-
ing a foul smell;  discharge of bloody mucus from the vagina;
leucorrhoea, with  debility ; cramp-pains in the external parts;
stitches passing from  the abdomen through the vagina, like
electric shocks; frequent itching in the vagina, with  smart-
ing, heat, excoriating  pain on urinating, swelling,  heat and
hardness of  the  labia;  frequent prolapsus of the womb;
ulcerative pain at the neck of the uterus, during an embrace;
and indurations at the neck;  sexual  desire more  active in
the matin;  burning in the parts, during an embrace ; after
an embrace, the menses appear, with profuse discharge  of a
dark blood,  and  followed by  a  grayish  leucorrhoea,  with
swelling, burning pain, and gnawing itching of  the parts.
  Lachesis.—The menses are too scanty, too short  and late,
with haemorrhoidal pains, nose-bleed, bloody stool,  constipa-
tion, with burning pain and pressure in the bowels, toothache,
leucorrhoea,  and  many other  sufferings,  especially  at  the
critical age, or after the fruitless  exhibition of Sepia.  Before
the menses: headache with vertigo, nose-bleed ; gastralgia with
pressure, spasms  in  the chest  and eructations; nervous dis-
tress ;  leucorrhoea; urine with mucous sediment; colic with
sense of malaise.  During  the menses: Tearing in  the abdo-
men; beating  in  the  head; violent pains at  times in the
loins, at others in the bowels, or lameness in the hips; push-
ing pain from the loins to the  private parts; violent cramps
in the bowels, as  if cut with knives ; viscous and acrid blood.
Leucorrhoea,  especially previous  to  the  menses, profuse,
smarting, mucous, staining  the linen greenish and  stiffening
it, with scanty and  short menses.  Pain  in  the  parts  as if
swollen, with inability to bear contact,  and obliging her to
keep her thighs apart:  cramps that seem to extend  up to the
chest;  swelling of the parts and  cramps in the uterus, with 
DYSMENORRHEA.                  11
sexual excitement,  thrill,  tickling from  the thighs  to the
genital organs, and circular contraction from the uterus  to
the right side of the abdomen and chest, with  heat, uneasi-
ness, tickling under the  skin from the  anus to the sides and
between the shoulder-blades.  Is  often indispensable in dys-
menorrhoea at the critical period, especially when Belladonna
or Sepia have proved inefficient.
   Lycopodium.—The menses  are too  short or too late,  or
else too profuse and too  early, reappearing every six or eight
days;  the menses become suppressed by the least  frit ht.
Before the menses: distention of  the abdomen; heaviness in
the limbs ; cold feet; shivering,  sometimes violent and long-
lasting, with  general  malaise;  fever  after  midnight,  with
restlessness and shivering followed by heat in the face; great
sadness, melancholy, peevish and timorous mood; weeping
and nonsense, as if  she would  lose her  reason; dilatation
of the pupils.  During the menses: violent itching in the
vulva, not allowing her any rest,  with swelling of the parts;
contractive pain in the temples,  as if the forehead would  fly
in pieces; dull headache;  acidity in the mouth,  with coated
tongue; nausea; pain in the sides, in the morning on rising,
hindering  motion; swelling of the feet;  lassitude; fainting
turn at church, while standing, with loss of sight and hearing,
heat  in  the  head, pale face, has to sit  down, dizziness fol-
lowed by tightness of the  head. After the menses: stitches
in the  head.   Leucorrhoea, coming off  by  fits  and starts,
milky or serous (at full-moon);  the  leucorrhoea  is preceded
by cutting colic in the hypogastrium. Pricking in the parts;
violent burning in the vagina during and after an embrace;
bearing-down  in the groin as if the menses would  appear;  ob-
stinate dryness of the vagina-; itching,  burning and gnawing
at the vulva;  pressure from  within  outwards,  above  the
pubis, when stooping ; stitches in the labia when lying down ;
wind passes out of the vagina.
   Magnesia  carbonica.—The   menses  are too early, with
toothache, pain  in the  sides, or bearing-down pain in  the
groin;  the blood is profuse, thick  and  black; profuse and 
12
DISEASES OF FEMALES.
long catamenia, with colic; retarded catamenia, with coagula
and  preceded by  sore  throat;  the menstrual discharge  is
more copious at night than in the day-time; the discharge is
more copious when walking  or standing.   The  menstrual
blood is dark, black, thick, sticky.  Before the menses: canine
hunger and stomachache; nausea and frequent  eructations;
pain in the side, with laming and aching pains, bearing-down
and  contraction; colic  with pressure  on  the parts.  At the
commencement of the menses:  coryza  with  stoppage of the
nose.  During the menses: diarrhceic  stools, with trembling
of the limbs; peevish mood ;  headache with heaviness of the
head and a good deal of heat; bruised pain  at  the vertex;
tearing in  the head and nape of  the neck; pulling in the
forehead as far as  the  occiput,  with  heaviness of the head;
agglutination of the eyelids, in the morning; the eyes are
dull, dry and burning;  burning  rhagades at the lobe of the
ear; pale face;  insipid taste  in  the  mouth, with anorexia;
ptyalism; nausea and desire to vomit; violent colic ; cutting
pain at the navel, eased by emitting wind; violent pressure
in the hypogastrium, interrupting sleep, night and morning;
frequent  sneezing;  drawing  pain in the sides, eased  by
stooping and worse when  stretching one's-self; luxation pain
in the right  shoulder;  pain in the knees, when walking, as
if broken; painful sensitiveness of the feet, even  in bed;
itching at the neck  and  shoulders;  lassitude, sometimes with
sweat or drowsiness; frequent waking in the night;  chilli-
ness and shivering; shivering at night, on waking or when
uncovering one's-self.   After  the menses: pain in the sides
as if broken, towards evening; leucorrhoea.   Watery, acrid,
or else slimy and  whitish leucorrhoea, with pinching  round
the navel or preceded by crampy-colic.  Frequent itching at
the parts.
   Natrum muriaticum.—1. The menses are too scanty, late
and short, with tightness of the head and  determination of
blood to the head, or pain in the bowels as if raw;  tendency
of the menses to become suppressed, especially in young girls
at the age  of pubescence ; 2,  the menses are too early, with 
DYSMENORRHEA.
13
scanty discharge and  headache when coughing,  sneezing or
stooping as if  the  forehead would split; this remedy seems
especially  to agree when  the  menses  are too  early,  with
scanty or profuse discharge; 3, the menses  are more copious,
the blood being black  and flowing day and night, sometimes
with shivering and  frequent yawning; 4, the menses last too
long.  Before  the  menses: attacks of  anxiety, melancholy
irascible mood;  headache ;  qualmishness, with sweetish taste
rising to the throat, and bloody saliva.   During  the menses:
sadness, anxiety and fainting, with cold cheeks and internal
heat; headache; heat in the face, in the evening; lancinat-
ing and tearing toothache in  the open air; heaviness in the
abdomen;  crampy  colic in  the  hypogastrium; burning and
cutting  in the groin, when urinating and during  a meal, in a
sitting  posture; hard  stool;  violent fever  at  night,  with
burning thirst and  complete loss of sleep.  After the menses:
tightness and heaviness of  the  head as  from rush of blood;
aversion to sexual  intercourse,  with dryness  and soreness of
the vagina during  an  embrace.   Profuse, thick, whitish and
transparent leucorrhoea, or  else  acrid, itching,  smarting,
greenish, with contraction in the abdomen or pressure on the
parts,  yellowish face,  mucous  diarrhoea with headache and
colic.   Bearing-down  pressure  towards  the parts, as if pro-
lapses would come on; itching  at the vulva; pimples at the
pubes;   falling  off of  the  hair.  Aversion to sexual  inter-
course ;  after it, irritable and irascible mood.
   Nux Vomica.—The menses are too early and last too long,
preceded by drawing pain in the posterior  cervical muscles.
During  the menses, nausea with  fainting,  especially in the
morning;  lassitude, with goose-flesh  and rheumatic pains in
extremities ; debility,  after every stool, also in the afternoon ;
with headache and  chattering  of teeth, followed by  internal
heat and dryness of the lips ; restlessness, irritable and quarrel-
some mood ; congestion with vertigo and pressive headache;
headache as if the  eyes would start out of their sockets, with
weakness and fever; headache,  as if the brain were ulcerated,
worse when lying; formication  in the fauces, in the evening, 
14
DISEASES  OF FEMALES.
in bed ; nausea with shivering and lassitude ; pressure in the
side of the abdomen,  from  within, outwards ;  distention  of
the abdomen, as if it would burst; crampy colic, with shivering,
lassitude and nausea;  uterine cramps, with pressure in the
hypogastrium, as far as the thighs ; constipation, with inef-
fectual  urging to stool;  frequent and ineffectual urging  to
urinate  ; pain in the sides as if lamed and bruised;  haemor-
rhoidal  pains ; tearing and rheumatic pains in the arms and
thighs.   Fetid leucorrhoea, tinging  the linen  yellow.  Fre-
quent, digging, contractive and clawing uterine cramps, with
more copious discharge  of coagula; pressure  with pushing
towards the parts, especially in the morning in bed, or during
a walk in the open air, with contraction in the hypogastrium ;
congestion  of blood towards the  uterus; irritation of the
uterus,  with heaviness, burning heat, stitches and pressure;
prolapsus of the womb ; hardness and swelling of the os tincae;
swelling of the vagina, like prolapsus, with burning  and ina-
bility to bear contact;  burning in the  parts,  with  sexual
exaltation ;  itching and gnawing eruption at the vulva.
   Phosphorus.—1. The menses are too early, too copious and
last too  long, with  colic  and pain in the sides ; discharge  of
blood between  the menstrual periods.  2. The menses are
too scanty,  preceded by leucorrhoea,  or accompanied by colic,
with cutting pains, as if caused by knives, weeping mood and
vomiting of bile mixed with mucus and food.   3. The menses
are retarded, but in this case too copious, with debility, rings
around the eyes, loss of  flesh and anxiety.  Leucorrhoea  in
the place of the menses.  Before  the menses:  bleeding  of
the ulcers; leucorrhoea, with weeping mood  and  frequent
desire to urinate ;  catarrhal affection of the cheek and swell-
ing  of the gums.   During the  menses:  lameness of the
limbs ;  weakness and weariness, with pain in the back, palpi-
tation,  anxiety,  pain in  the stomach  and violent  nausea,
obliging her to lie down ; pricking,  itching over  the whole
body; frequent shiverings, with coldness  of the hands and
feet; fever in the  afternoon, with  chattering  of the teeth
followed by heat and headache ; tightness of the head, with 
DYSMENORRHEA.
15
prostration  and  drowsiness;  lancinating  headache  in the
forehead, with  desire to remain in bed; vertigo, when walk-
ing ; violent toothache, commencing  during a meal; violent
nausea, obliging her to lie down; nausea when raising herself
in bed, with sour vomiting, oppression,  cold sweat on the
forehead  and vertigo when walking; contractive gastralgia
and pinching in the stomach;  violent colic; pains as if cut
with knives, with pain in the back and vomiting ; fermenta-
tion in the abdomen ; violent pains in the back, as if lamed
and bruised, with jerking in the body, anxiety,  pains  in the
stomach, great weakness and nausea;  blood spitting, palpita-
tion of the heart ; crampy contraction of the limbs.   After
the menses:  weakness, with  rings  around  the eyes,  and
anxiety;  swelling of the gums  or cheek.   Milky, mucous or
acrid, smarting, corrosive and blistering leucorrhoea ;  reddish
leucorrhoea.   Stitches through the pelvis, from the vagina to
the uterus; tearing  pain in the  parts, as  if caused  by  an
ulcer ;  stinging and burning blotches at the border  of the
labia.   Aversion  to sexual intercourse.
   Platina.—The menses are too early, too copious  and  last
too long, with discharge of a black  and viscous  blood, and
preceded  or followed by leucorrhoea.   Before the menses:
labor  pains; cramps at the commencement of the menses.
During the menses: paroxysms of anxiety, with restlessness
and tears; sleeplessness at night; suspicious moods, head-
ache,  frequent attacks of vertigo ; cramp colic, with  pressure
above the vulva; sensitiveness  of the parts, with  pressure
downwards; pressure in the hypogastrium,  with  ill-humor;
colic; pulling in the groin;  constipation or hard  stool;  fre-
quent urging to urinate ; short breath.   After the menses :
weakness or leucorrhoea.    Albuminous  leucorrhoea,  coming
off sometimes after urinating, and at  other times after rising
from a chair.   Pains in the abdomen as if the menses would
come on, with pulling in the groin and hypogastrium, or with
cutting pains and pulling in the head; pressure  on the parts,
through the groin, towards the  sacrum, with urging to stool;
congestion of blood to the uterus;  painful  sensitiveness and 
16
DISEASES OF FEMALES.
pressure at the pubes  and in the parts, with internal  chilli-
ness and  shiverings;  in  the evening, in bed, the painful
pressure  downwards ceases, but comes on again as soon as
she gets up in  the morning.  Hardness of the womb ; cramps
and stitches in the hardened part of the womb.   Excessive
sexual desire,  like nymphomania ;  voluptuous titillation in
the genitals and lower abdomen, with anxious  oppression,
palpitation of  the heart;  pressure in the parts, general  weari-
ness and stitches in the forepart of the head.   Polypi  of the
uterus.
   Pulsatilla.—Retarded menses, especially among  young
girls at the age of pubescence, or among women at the critical
period, with cramp-colic, chilliness, desire to vomit, and other
distresses; the menses flow only  in the day-time; the men-
strual  blood is thick,  viscous, black and coagulated, or else
pale and watery.  Before the menses, goose flesh, with pale
face, yawning  and stretching; weeping mood, sadness, melan-
choly or anxiety ; vertigo, with eructation ; megrim ; mucus on
the stomach;  nausea  and desire to  vomit; sour or mucous
vomiting ; gastralgia;  pains in the liver;  spasmodic colic;
pains in the bowels, with vomiting ; heaviness in the abdomen
like a stone;  pressure on the rectum  as if she had to go  to
stool;  frequent urging to urinate, or  to  go to stool;  leucor-
rhoea; pain in  the sides.   During the menses: shiveriny,
with pale face ; nervousness; headache on one side; obscura-
tion of sight,  worse in a warm room; gastralgia; nocturnal
nausea, with mucus on the stomach;  cramp-colic, with heat;
pressure in the  abdomen  and loins  as from a stone, with
ineffectual urging to stool, and tendency of the limbs to go to
sleep,  when sitting;  stitches in  the  chest  when  breathing ;
stitch  in the  side when  moving  the arm or drawing breath,
also when laughing, almost laming the arm; pain in the side,
removed  by  drawing breath.  Milky,  thick,  mucous  and
 whitish, or else watery, burning,  acrid leucorrhoea, with
 swelling of the vulva;  leucorrhoea before or after the menses
 with colic.  Tractive tension in the hypogastrium, like labor-
 pains ; contractive pains in the left side of the uterus, obliging 
DYSMENORRHEA.
17
her to bend double; pulling pressure in the lower part of the
womb in the morning, with drowsiness; uterine cramps like
labor-pains; incisive pains at the os tincae;  irritation on the
chest: burning stitches in the vagina and labia.
   Sepia.—The menses are too early and too copious, with
stiffness of the limbs, leucorrhoea, cramp-colic and pressure
above the parts, headache, toothache and melancholy.  Men-
strual irregularities at the critical age.  Before the menses :
goose flesh all over, the whole day; violent colic, with fainting;
pressure in  the  abdomen, followed  by soreness at the peri-
naeum and swelling of the vulva;  sensation as if the vulva
were dilated;  burning at  the vulva;  smarting leucorrhoea,
with soreness of the vulva. During the menses:  prostration
in the morning;  lameness and soreness in the extremities;
has to lie down  in  consequence of great uneasiness  in the
body, with pulling  in the limbs and abdomen, borborygmis,
palpitation of the heart, and embarrassed perspiration; great
weakness in  the evening, with obscuration of sight;  sleepless-
ness at night, on account of a tearing  pain in the back, with
shivering and heat, thirst and painful contraction  in  the
chest; melancholy  mood in  the  morning;  violent  frontal
headache, with discharge of hard and  fetid  mucus  from the
nose; nose-bleed, for  three days; toothache, with throbbing
in the gums; pulling in the teeth, as far as the cheek which
swells; crampy colic,  with pressure downwards; tearing in
the tibia.  Acrid, corrosive, yellowish, watery and milky leu-
corrhoea, or else reddish-green, fetid, bloody or purulent, with
stitches in the uterus, itching in the vagina or vulva,  disten-
tion and weight of the abdomen;  a good deal of pain when
walking, pulling  in  the  hypogastrium,  or burning and sore-
ness between  the thighs.   Pains  or painful rigidity in the
region of the uterus;  pressure downwards, as if every thing
would issue  through the vulva, with oppression, cutting colic
and jelly-like leucorrhoea ; prolapsus of the vagina or uterus;
hardness of the neck of the uterus;  heat in the parts and on
the outside; swelling and humid itching and eruption at the
labia minora;  redness  and  excoriation of the  parts  and 
18                DISEASES OF  FEMALES.
between  the thighs; itching of the parts and in the vagina;
stitches in the vagina as far as the navel; contractive pain
in the vagina.— Tendency to miscarriage.
   Sulphur.—Retarded menses, with a good deal of distress,
oppression, constipation and distention of the abdomen ; pre-
mature menses, either too profuse or  too scanty,  with colic
and pains in the sides; menses too profuse, the blood smelling
sour, it  is thick, black, acrid  and excoriates the parts;  the
menses last too long : the menstrual blood is too pale.  Before
the menses:  restlessness and uneasiness;  headache; stinging
toothache in a bad tooth in the morning; pyrosis;  cramp
under the left  hypochondrium ; itching at the vulva ;  leucor-
rhoea; cough in the evening, in bed, obliging her to leave  her
bed, after which  the  cough  ceases;  fulness  on the chest,
obliging  her to draw a  long breath.   During  the menses:
epileptiform convulsions, with violent pains in the lower part
of the bowels, shiverings, coldness of the forehead and hands,
and distortion of the mouth ; drowsiness in the day-time ; rush
of blood to  the head;  frontal headache;  nose-bleed; pres-
sure at the  pit of the stomach; violent cramp-colic  in  the
hypogastrium,  with  cutting  pains,  pinching,  contraction,
shivering in the whole body, and  pain in the  sides; pain in
the epigastrium as if all the bowels were drawn up  by strings
in a ball, so that she is neither able to walk nor to lie down;
violent pains in the loins and bowels, eased by exercise  and
by a more profuse discharge of menstrual blood.  After the
menses:  itching at the nose  for several days;  leucorrhoea,
nose-bleed. Acrid, smarting, excoriating leucorrhoea, or burn-
ing and watery, yellowish or slimy, with cutting  or pinching
pains in the bowels.  Feeling of weakness in the  parts; pres-
sure on the parts ; congestion of blood to the uterus; itching
at the vulva and  in  the  vagina, with  or without pimples;
painless vesicles at the vulva; burning at  the vulva  and in
the vagina, not permitting  her to remain seated;  inflamma-
tion of one of the labia, with burning when urinating; exco-
riated  spots at the vulva and perinaeum; violent  itching of
the  clitoris;  sense  of soreness  in  the vagina during   an
embrace.— Tendency to miscarriage. 
DYSMENORRHEA.                  19
                        Section 6.

   Remedies of the Second Class.—Beside the  above-men-
tioned remedies, the following will likewise be found more or
less indicated by the symptoms: Alumina, Ammonium, Bella-
donna,  Carbo vegetabilis, Causticum, Chamomilla,  China,  Coc-
culus, Conium, Iodium, Magnesia muriatica, Mercurius,  Na-
trum,  Nitri  acidum,  Sabina,  Silicia,  Sulphuris  acidum,
Zincum, more particularly:
   Alumina, for the following symptoms:  The  menses are
too scanty and too pale, or else too  soon and  too short; re-
tarded  menses  also too  short,  only a  discharge of a little
colored water; the menses are too early and too profuse, pre-
ceded by colic.  Before  the menses:  restless sleep, full of
dreams, waking with a headache, heat in the face, excitement
in  the  circulation, palpitation"of the  heart;  colic at stool,
with  pinching, pressure and labor-pains ;  profuse leucorrhoea,
with  trembling, weariness  and  sensation  as  if  the bowels
would fall through the vulva.  During the menses: headache
when the discharge stops;  fluent coryza, with pain at the
forehead and nose; distension of the abdomen, with profuse
discharge; colic with lassitude; diarrhoea with  colic; frequent
urination, with acrid and  excoriating urine;  leucorrhoea.
After the menses: prostration of body and mind, with low-
ness of spirits, and weariness after working or walking ever
so little ; leucorrhoea.  Leucorrhoea, acrid, profuse, like flesh-
water, or transparent mucus, stiffening the linen, or yelloioish,
with  itching at the vulva,  burning and soreness.  Stitch at
the vulva, up to the chest;  throbbing  in  the left  side of the
vagina as if there were an abscess.
   Ammonium.—The menses are too early ; or too feeble  and
short; profuse menses, especially at night, when  sitting or
riding in a  carriage, with  loss of appetite, colic; retarded
menses.   The  menstrual  blood  is  black,  coagulated, with
cramp-colic, hard and  difficult stool; acrid blood, with burn-
ing and soreness of the parts; pale blood. Before the menses:
pale face, colic and pain  in the sides.   During the menses: 
20                DISEASES OF  FEMALES.
prostration of the body, especially the thighs, with yawning,
pain in the sides, toothache  and chilliness;  pale face; tooth-
ache ; violent coryza; violent colic, with pressure, tension and
crackling  between the shoulder blades; tearing in the abdo-
men; pressure downwards, with cutting colic, tearing in  the
back and  parts, and desire to remain  in bed.  Watery dis-
charge from the vagina.  Acrid, profuse, corrosive leucorrhoea,
or else watery and burning.  Swelling, itching and burning
of the vulva ; soreness of the parts and anus, with much pain
when urinating,
   Belladonna.—The menses  are  too profuse, too  early, or
else retarded, and too pale.   Discharge of blood between the
menses.  The menstrual blood is fetid, bright-red, coagulated.
Before the menses: weariness, blur before the  eyes, anno-
rexia and colic.  During  the  menses: tearing pains in  the
limbs, at times in the back, at others in the arms; rush of
blood to the head, with throbbing pain, heat in the head, red
and puffed face,  especially among full-blooded young females;
anguish about the heart, violent thirst; colic, with pressure,
as if everything would  pass through  the vulva, with weight
in the bowels, like  a stone; pains in the  sides, and cramp-
pains in the back; nocturnal sweat on the chest, with fre-
quent  yawning,   shiverings over the back,  and colic ;  leu-
corrhoea, with colic :  stitches in the inner privates ; dryness
of the vagina: prolapsus and hardness of the uterus.
   Carbo  vegetabilis.—The menses  are  too soon  and  too
copious,  or  too  feeble  and  pale;   retarded  menses,  with
acrid, corrosive,  thick and strong-smelling blood.   Before the
menses: violent itching, tetter; itching eruption at the back
of the neck  and between  the shoulder-blades;  headache;
drawing pain from  the hypogastrium to the sides:  colic from
morning till evening; leucorrhoea and smarting at the vulva.
During the menses: headache, with contraction of the eyes ;
toothache; vomiting; colic, especially when the blood ceases
to flow, with pains in the back and lameness in all the bones •
burning in the hands, and soles of the feet; whitish, mucous
thick,  yellowish, or milky  leucorrhoea, or greenish, profuse 
DYSMENORRHEA.
21
and excoriating ;  discharge of bloody mucus from the vagina;
itching  at  the  vulva and anus;  heat and redness  in the
vulva;  burning,  excoriation, and swelling of the parts;
aphthae at the vulva; red, sore spots, resembling little ulcers,
with itching and leucorrhoea.
   Causticum.—Retarded menses ; or  else  too  early and
profuse; the menses are too feeble, do not flow at night; the
menstrual blood  smells badly, and  causes  an  itching of the
parts.   Before  the  menses:  dark melancholy; pains in the
sides  and  anxious  dreams;  drawing colic.   During the
menses: weariness  and  ill-humor; vertigo,  especially  when
stooping; yellow complexion; colic, as  if the  bowels would
be torn, with lameness in  the loins, and discharge of coagu-
lated blood;  cutting pains, with tearing in  the back and  loins,
especially during  emotion;  diarrhoea, with  cutting pains •
pain in the  back;  stitch under the left breast; leucorrhoea
at night, or very profuse and  smelling like the menses  ; leu-
corrhoea,  preceded by cramp-pains, with  much flatulence:
burning in the parts ; soreness of the parts and between the
thighs; aversion  to an embrace.
   Chamomilla.—Menses too copious  and  early, with  dark
and coagulated blood, and followed by  distress; retarded
menses, with anasarca,  swelling  of the bowels, labor-pains,
and  bloating of the pit of the stomach, with  hard, aching
pains in the praecordia.  Before  the  menses:  cramp  pains,
with pulling in  the thighs;  peevishness,  with quarrelsome
and  capricious mood at the  commencement  of the menses.
During the  menses: fainting, with thirst, cold limbs, pale
and hollow face; nausea,  eructations,;and desire to vomit, with
yellowish tongue and bitter mouth; crampy colic,  and  acute
pains in the sides ;  labor-pains ; squeezing and pressing in the
uterus;  greenish  or watery diarrhoea; tearing in  the  veins
of the legs.   After the menses: violent colic,  with sensitive-
ness of  the  abdomen to contact, as  if the parts within were
ulcerated; yellowish, smarting, or watery  and acrid leucor-
rhoea ; pressure on  the parts,  like  labor-pains, with frequent
urging to urinate;  burning, smarting in the vagina. 
22
DISEASES  of females.
   China.—Menses too profuse, like metrorrhagia, with black
 coagula, uterine cramps, cutting colic, and frequent urging to
 urinate, fainting, and convulsions; retarded menses.  Before
 the  menses:  painful pressure on the groin and anus, with
 leucorrhoea.   During the menses:  convulsions, with abdomi-
 nal  cramps,  and spasm of the  chest; rush of blood to the
 head, with throbbing of the carotids, puffed face, protruded
 and weeping eyes, twitching of the eyelids, and loss of con-
 sciousness ; serous or bloody leucorrhoea, with  discharge of a
 fetid or purulent substance, painful  itching, and crampy con-
 tractions in the inner parts; congestion of blood to the womb,
 with  sense of fulness and painful pressure  on the  parts,
 especially when walking.
   Cocculus.—The menses are too early, with  crampy  colic ;
 the menses are too feeble, only  a  few doses being discharged;
 the blood is black and coagulated,  with leucorrhoea between
 the bloody discharges, or with fainting and pressive  colic;
 instead of the menses, a serous leucorrhoea, mixed with blood
 and pus ; retarded menses, preceded by cramp-colic, flatulence,
 paralytic weakness, spasms in the chest, convulsions, nausea,
 unto fainting.  During the menses:  distention of the abdomen,
 with contractive colic, and  contractions in the rectum; hard
 pressure in the abdomen, as from acute stones, with pain, as
 from an internal sore, when touching the  abdomen.  After
 the menses: haemorrhoidal distress;  uterine cramps  from the
 least menstrual irregularity.
  Conium.—The menses  are  too slow, with drawing  pains
 down to the  sacrum,  day and  night; the menses are too
 early, too feeble;  discharge of a  brownish blood in the place
 of the menses.   Before  the menses: tired feeling in  the
 limbs, restlessness, weeping mood, anxiety about every trifle;
 dry  heat in  the  body,  without thirst;  anxious  dreams;
stitches in the hepatic region, especially at night, when lying
and drawing breath ;  pains in the sides.  During the menses:
crampy colic, very painful;  pressure  on the parts, and pulling
in the thighs; contractive pain in the hypogastrium, disap-
 pearing during a walk in the open air; acrid,  smarting, ex- 
DYSMENORRHEA.
23
coriating  leucorrhoea; thick or ivhitish,  milky,  preceded or
accompanied by colic, or followed by lassitude or hoarseness,
with loose cough; itching at the vulva and in  the vagina;
pressure  downwards in the  womb; stitches  in the  parts,
especially in the labia and vagina ; incisive pain between the
labia when urinating; large pimple at the pubes, painful to
contact;  uterine cramps,  with digging,  pinching, smarting,
distention, and stitches up to the left side of the chest.
   Iodium.—Retarded menses, with vertigo and beating of the
heart;  profuse menses,  like  flooding,  especially  at stooh
accompanied by cutting colic, with pain in the sides and back.
Before the  menses;  a good  deal of  distress;  mounting of
heat to the head, with palpitation  of the heart, tension about
the  neck, which swells.  During the menses ;  distress, weak-
ness, pains in the sides.   After the menses ;  beating of the
heart; obstinate, excoriating leucorrhoea;  cramp  colic like
labor-pain, violent pressure in the  hypogastrium, towards the
parts, hardness of the uterus.
   Magnesia muriatica.—Menses too copious and too soon,
 with black coagula ; retarded menses, with pains in the sides,
 pressure  on the groin, and  frequent  yawning.  Before  the
 menses :  leucorrhoea, nervous excitement.   During the men-
 ses: weariness unto fainting, with lameness of the limbs and
 wakefulness in the evening, in bed;  frequent yawning ; pains
 in the sides and thighs; profuse leucorrhoea, watery or thick,
 especially after stool and urinating; leucorrhoea, preceded by
 cramp-colic.  Discharge of  blood previous to the  menses.
 Uterine  cramps, with pains extending to the  thighs,  and fol-
 lowed by leucorrhoea ;  schirrous indurations at the uterus.
   Mercurius.—Profuse menses, with colic; suppressed men-
 ses; discharge  of  blood  between the menses.   Before  the
 menses:  dry heat, excited circulation and rush of blood to the
 head;  itching of the  labia.   During the  menses:  anxiety
 which leaves one no rest;  scorbutic affection, with red tongue
 or covered with red spots, burning,  salt  taste, teeth  on edge
 and pale gums.   Mild and whitish leucorrhoea, or else smart-
 ing, purulent, gnawing, or greenish,  burning,  with  nightly 
24
DISEASES OF FEMALES.
 itching in the parts;  discharge of mucous and purulent flocks
 from the vagina.   Itching pimples  and nodes at the labia;
 swelling of the  labia, with  heat, hardness, shining redness,
 sensitiveness to  the  least contact,  burning, throbbing and
 stinging; inflammatory swelling of  the vagina, with  redness
 and excoriation; falling of  the vagina.
   Natrum  carbonicum.—Menses too late, like  serum, and
 scanty;  menses  too soon,  profuse, and too long, like flooding.
 Before the menses: hardness, with stiffness of the nape of the
 neck ; cutting pains in the hypogastrium.  During the men-
 ses : tearing and stitches  here  and  there; chattering of the
 teeth in the evening; tearing and throbbing headache; nau-
 sea and loathing, with prostration;  painful distention of the
 abdomen, with  diarrhoea,  which  affords  ease;  pains in the
 sides; lameness  and tearing in  the right hip.  Putrid or thick
 yellowish leucorrhoea, especially when urinating or afterwards;
 leucorrhoea  preceded by  cutting pain;  discharge of mucus
 from the vagina, after coit.  Tearing  in the parts; movements
 in the womb as from a fetus; malformation of  the  os tincae;
 soreness of  the parts, and between  the thighs; pressure on
 the parts as if everything would fall  out.
   Nitri acidum.—Menses too  profuse, too soon, or too late,
 with  colic and  headache; suppressed menses.   Before the
 menses:  lameness of the limbs; colic; headache;  cramp-
 colic in  the hypogastrium  and pains  in the sides, at the com-
 mencement of the menses.  During the menses:  weakness,
 so that she is unable  to breathe, and has to lie down ; burn-
 ing of the eyes; headache; swelling of the gums; pressure
 in the hepatic region; distention of the bowels ; cramp-colic,
 as if the hypogastrium would burst, with eructation and con-
 stant desire to move about; pressure on  the  abdomen and
 pains in the sides;  violent labor-pains, with pressure in the
 hypogastrium as far as  the  vagina;  pressure downwards in
 the hypogastrium, with pains in the  sides and pulling in the
thighs and legs; contraction in the abdomen towards the parts •
palpitation,  with anguish,  heat, and  trembling  of the limbs.
After the menses: leucorrhoea. Profuse, mucous, flesh-colored 
DYSMENORRHEA.
25
greenish, brownish, fetid or  foul leucorrhoea.   Itching and
soreness at the vulva;  irritation  and  inflammation of  the
labia; stitches in the vagina;  dry  burning at  the parts;
swelling of one  side of the vagina  and labia, with  burning
itching.
   Sabina.—Menses too profuse and too early, with  coagula
or  discharge of bright red blood, violent colic, labor-pains,
scanty and red urine, dysuria and stranguria, opening of  the
mouth of the  womb, discharge of a mucous liquid from  the
vagina; flow of blood during motion;  menses last too long.
Suppressed menses, in their stead leucorrhoea.  Milky, yel-
lowish,  sanious, foul leucorrhoea, or like pitch, or flesh-colored,
or  with itching  of  the parts.   Tendency to  miscarriage.
Excited sexual desire.  Drawing pains in the lumbar vertebrae,
like labor-pains ;  contractive uterine cramps; heavy pressure
in the hypogastrium,  as if the menses would appear; violent
stitches deep in the vagina.
   Silicea.—The menses are too soon, or too profuse, or  too
scanty; strong smell  of the  menstrual blood.   Before  the
menses; headache  above the eyes;  obstinate  constipation;
diarrhcea ;  icy coldness in the whole body at the commence-
ment of  the  flow.    During the menses;  melancholy and
anxiety in the praecordial region, with  thoughts  of suicide ;
everything  looks pale; burning  and soreness at the vulva,
with eruption  on the inside of the thighs; colic ; nocturnal
pulling between  the  shoulder-blades, she has to bend  back-
wards.  After the menses ; bloody and mucous discharge from
the vagina.   Smarting, acrid, corrosive, or serous and milky
leucorrhoea; leucorrhoea preceded by pinching at the navel.
Itching at the vulva;  labor-pains in the vagina, nausea during
coit.
   Sulphuris acidum.—Retarded menses,  with colic and
pains in the sides ;  menses too copious, too early, and too long.
Before  the menses;  nightmare-like  choking.    During  the
menses ; thirst, stitches in the abdomen and vagina.   After
the menses;  sexual excitement,  or aversion to  intercourse.
Transparent, milky, acrid and burning, or gnawing leucorr- 
26
DISEASES OF FEMALES
hoea; bloody mucous from the  vagina.  Excessive  sexual
desire, with little  enjoyment during coit;  lascivious dreams,
with emission; violent desire for an embrace on waking in the
morning, as if in  the clitoris.
  Zincum.—Retarded menses ; profuse menses, especially at
night and when walking, with  coagula.  Before  the menses:
lassitude, especially in the hands and feet; chilliness ; irasci-
ble  and weeping  mood;  anxiety ; headache in the evening,
like a weight in the forehead, drawing the head back;  opthal-
mia;  sudden  oppression in the  stomach; distention of the
abdomen ; burning  when urinating; itching and stinging of
the parts, with sense of swelling; leucorrhoea; heaviness in
the legs, and pulling about the knees.  After the menses:
discharge of bloody mucous from the vagina.   Mucous, thick
leucorrhoea, preceded by colic, yawning, or after stool.  Sex-
ual desire ; desire for self-gratification ; pressure on the parts
and rectum ;  varices at  the feet.

                        Section 7.

  Remedies t\at are less frequently indicated.—If  none of
the abovementioned remedies  should  be  indicated, we may
sometimes find  a  suitable remedy among  the  following:
3. Aconitum,  Ambra,  Ammonium muriaticum,  Arsenicum,
Baryta,  Berberis,  Borax, Bovista, Bryonia, Cantharis, Carbo
animalis, Ferrum,  Hepar,  Hyoscyamus,  Ignatia,  Moschus,
Nitrum, Petroleum, Rhus toxicodendron,  Ruta, Sarsaparilla,
Secale,  Stannum,  Staphysagria,  Stramonium, Thuja, Vera-
trum.
   Aconitum.—Profuse  menses,  especially among plethoric
females, young girls, like flooding ; suppression occasioned by
fright, or retarded menses among lively girls of a sanguineous
temperament  and leading a  sedentary  life.  Furor at the
commencement of the menses.   Profuse, yellowish and sticky
leucorrhoea.
   Agnus.—Retarded menses, with drawing colic ;  leucor-
rhoea, sterility. 
DYSMENORRHEA.
27
   Ambra.—Menses too early: discharge of blood between
the menses.   During the menses:  varices  at  the left leg,
bluish and painful on pressure.  Thick leucorrhoea at night,
with stinging  in  the vagina, discharge of bluish and whitish
mucus.  Burning in the parts, with discharge of a few drops
of blood after walking or hard stool; sore  pain  and violent
itching of the parts; swelling and soreness of the  labia.
   Ammonium muriaticum.—Menses too early,  with  colic,
during which  the flow is more profuse.  During the menses:
vomiting and  diarrhoea; pressure and  contraction  in the back
and abdomen  ; pain in the back ;  tearing in  the feet.   Albu-
minous, or bluish and slimy leucorrhoea, with pinching about
the navel.
   Arsenicum.—Menses  too  profuse  and  too  early;  sup-
pressed menses, with pain at the coccyx and  in the shoulders.
During the menses: distress, cutting  colic, stitches from  the
pit of the  stomach  to  the hypogastrium,  eructations,  sighs,
weeping.   After the  menses: discharge  of bloody mucus.
Stitches from the hypogastrium to the vagina;  sexual desire
with involuntary  emission.  Acrid, corrosive, thick, yellowish
leucorrhoea;  or coming off in drops, with flatulence from the
vagina.
   Baryra.—Menses too scanty and short, or too profuse and
early.   Before the menses : toothache, leucorrhoea.  During
the menses: colic with pinching and cutting ; lameness in the
loins.  Bloody leucorrhoea, with anxious palpitation, fainting
weakness.  Tearing in the vulva, by fits and starts; aversion
to coit.
   Berberis.—Menses  too feeble, long,  watery,  grayish  or
slimy.   Before the menses: pains in the limbs.   During the
menses:  prostration, peevish mood, loathing of life ;  fainting ;
shiverings; headache;  painful distension of the  abdomen ;
stitch in the  left side as far as the vagina;  pains  in  the
kidneys;  burning  at  the anus;  smarting  in  the vagina;
stitches in the chest; violent pains in the  sacrum and loins,
as if bruised;  tension in the nape  of the neck, shoulders and
arms;  pain in the hip-bones ;  pressure in the thighs and legs. 
28
DISEASES  OF FEMALES.
After the menses:  weariness, stinging and tearing headache.
Suppressed sexual desire, with stitches in  the  parts  during
coit;  the vagina is sensitive to contact;  smarting and burn-
ing,  with  excoriation pain  in  the vagina as far the labia;
pricking in the perinaeum.
  Borax.—Menses  too soon and too profuse, like  flooding.
Before  the menses:  heaviness  on the  chest, morning and
evening, buzzing in the ears.  During the menses: lassitude,
pulsative headache and buzzing  in the ears; colic from the
stomach to the sides  low down, with desire to vomit; crampy
pressure in the groin.   After the menses: gastralgia, with
heaviness  from  the  right  hypochondrium  to  the  shoulder
blade, cramp pain in the  sides, leucorrhoea.  White, albumi-
nous, thick or corrosive leucorrhoea.  Stitches in the  womb ;
pricking at the clitoris, at night.
  Bovista—Menses too scanty or retarded, watery.   Before
the menses: diarrhoea.  During the menses: lassitude, head-
ache, toothache, colic,  soreness at the groin.  After the
menses: leucorrhoea.  Thick, viscous, albuminous leucorrhoea
of a  yellowish-green  color, acrid, corrosive.
  Bryonia.—Suppressed menses, with nose-bleed; menses too
early; too profuse, like  blooding, with dark blood, headache,
pains in the sides.   During the menses: rheumatic pains  in
the limbs ; frequent  shivering ; congestion of the blood to the
head,  with nose-bleed;  burning  gastralgia;  pressure and,
fulness  at the epigastrium; constipation;  leucorrhoea; con-
gestion of the chest with hacking cough.
   Cantharis.—The menses are too early and too copious, with
black blood;  retarded menses.   Before  the  menses: burning
at urinating ; urine  with white sediment.   After the menses :
discharge of bloody mucus.   Burning in the vulva;  violent
itching in the vagina;  pressure towards  the parts ;  sivelling
of the neck of the uterus, with burning in the bladder,  colic
continual  vomiting  and febrile heat.  Inflammation  of the
ovaria.
   Carbo  animalis.—The menses are too early,  with pains  in
the  sides, groin, and with   headache;  delaying  menses. 
DYSMENORRHEA.
29
Before tfy menses: heat with anxiety;  headache; weakness
in the  thighs.  During the menses:  weariness  which inca-
pacitates  her from speaking, with  yawning  and stretching;
distention of the  abdomen; pressure in the  groin, sides and
thighs,  with ineffectual attempts to  raise wind, with shivering
and  yawning.   Burning, smarting, or watery leucorrhoea, or
staining the linen  yellow.
   Coffea.—The menses are too copious, with excessive sexual
desire,  voluptuous itching, and profuse mucous secretion; ex-
tremely distressing menstrual colic, so  painful that they drive
her to despair.
   Ferrum.—Menses too late  and scanty, with  watery and
pale blood; menses too profuse, like flooding, with excited cir-
culation, heat in the face, black coagula, and labor-pains in
the abdomen and sides.   Before the  menses: stinging headache,
with ringing in the ears; rumbling in  the abdomen, with dis-
charge  of long pieces of mucus from the vagina.  During the
menses: violent  cutting pains, with watery blood.  Milky,
smarting  and corrosive leucorrhoea.   Sensitiveness of the
vagina  during an  embrace; falling of  the vagina.
   Hepar.—Menses too late or too  scanty; discharge of blood
between the menses.  Before the menses: contractive head-
ache; distention of the abdomen. During the menses: itching
of the vulva.  Smarting leucorrhoea at the vulva.  Soreness
at the vulva and between the thighs.
   Hyoscyamus.—Menses too late or too early, or profuse-like
flooding, with bright-red blood, delirious talk, cramp-pains.
Before the menses:  hysteric convulsions ; almost constant and
loud laughter; labor-pains  in the  abdomen, with pulling  in
the back  and sides; headache, with nausea and sweat, at the
commencement of the menses.  During the menses: nonsense;
convulsive trembling of the hands and feet; profuse urine and
sweat.  Excited sexual desire; soreness and burning at the
entrance of the  vagina.
   Ignatia.—The  menses are  too early and  too copious; co-
agulated menstrual blood;  the menses are scanty and smell
foul.  During ths menses:  uterine cramps; contractive colic, 
30               DISEASES OF FEMALES.
with headache; heaviness and heat in the head, photophobia,
anguish, palpitation of the heart, and lassitude unto fainting.
Uterine cramps, with cutting  pains, or pressive and contrac-
tive  pains, like labor-pains, with  embarrassed breathing, or
followed by leucorrhoea.
   Ipecacuanha.—The menses are too copious and too early,
like flooding, with  bright-red coagula.   Pressure  towards the
parts and anus.
   Kali jodatum.—The  menses are  too  feeble, or cease en-
tirely. Before the menses: frequent urging to urinate. During
the menses: uterine  cramps  and  painful colic, with violent
squeezing  pain down to the thighs;  frequent yawning; rest-
lessness ;  chilliness, with goose-flesh; uneasiness and  heat in
the head; eructations; rumbling; nausea; pressure at the sto-
mach ; desire to vomit; shuddering over the face and hands.
Clear, watery, corrosive, smarting leucorrhoea.
   Moschus.—The  menses are  too early  and  too  copious.
Violent drawing pains at the commencement of  the menses.
Pulling and pressure on the parts, like labor-pains.  Violent
sexual desires.
   Nitrum.—The menses are too early, too copious, too long,
with  black and coagulated blood.   During the menses:  thirst,
water-brash, colic, with pain in the sides and thighs;  burning
in the right groin when bending forward while sitting; weari-
ness  and  pain in the limbs, with staggering gait.   Light-
colored, white  leucorrhoea, stiffening  the linen, with lameness
of the small of the back.
   Nux Moschata.—The menses are  too late, preceded by
pains in the small of the  back, headache, weariness, pressure
at the stomach, water-brash, pain in  the liver,  thick, dark
blood.  Menses too late, with pressure in the abdomen and
pulling in the limbs.
   Petroleum.—The  menses  are  too  early  and  scanty; the
menses  are too late, with  acrid blood and itching.  Durinq
the menses: weariness and lameness all over; heat in the palms
of the hands and soles of the feet; ringing and buzzing in the
ears; tearing in the thighs; the limbs are  sensitive to con- 
DYSMENORRHEA.
31
tact, here and there.  Albuminous leucorrhoea, with lascivious
dreams.   Aversion to coit; itching in the urethra, when urin-
ating; soreness at the vulva and between the thighs; burning
in the parts, with discharge of blood.
   Phosphori  acidum.—Suppressed menses.   During  the
menses:  hepatic  pains.  After the menses: yellowish leucor-
rhoea, with itching.  Tympanitic distension of the womb.
   Prunus spinosa.—The  menses  are too early  and too
copious,  like  flooding, with  light-colored and watery  blood,
and  pains in  the sides; daily discharge of  blood from the
vagina, between  the menses.  Weakening  leucorrhoea, stain-
ing  the  linen  yellow  and excoriating  the parts.   Painless
throbbing in the parts; tickling in the region of the ovaries.
   Rhus  toxicodendron.—The menses are  too copious and
too early, with  acrid blood, causing  an  itching of the parts,
or with  coagula  and labor-pains.   Drawing labor-pains in
the  womb; stitches in the vagina;  excoriation-pains in the
parts.
   Rut a.—Menses too soon, too copious, or to scanty and short,
followed  by  leucorrhoea.   Corrosive leucorrhoea, after the
menses.
   Sarsaparilla.—Retarded  menses, with frequent urging
to urinate; menses too scanty, with  acrid and burning blood.
Before the menses: itching and humid eruption on the fore-
head; soreness in the right  groin,  and urging  to  urinate,
at the commencement of the courses.   During  the menses:
colic, with pinching in the abdomen; griping in the pit of the
stomach, down to the  sacrum.  Watery leucorrhoea, especially
when walking.
   Secale.—Menses too  profuse and too long, like flooding,
with violent cramps, tingling in the legs, and great weakness;
black, liquid blood, which is discharged only during  a walk.
Leucorrhoea.    Tendency to miscarriage.  Swelling and wens
at the neck of  the uterus; distention of the uterus ; chronic
metritis.
   Stannum.—Menses  too  profuse.   Before the  menses:
anguish,  gloom; pain  at the malar  bones, as from  a blow. 
32
DISEASES OF FEMALES.
 Transparent, mucous, yellowish leucorrhoea.  Pressure in the
 hypogastrium, as if the menses would appear; uterine cramps;
 prolapsus of the vagina during hard stool.
   Staphysagria.—Suppression. Painful sensitiveness of the
 parts, especially when sitting;  cramp-pain in the parts, and
 in the vagina;  itching of the  vulva; blotch on one of the
 labia majora, itching and sore when touched.
   Stramonium.—Menses  like flooding, with  coagula; the
 menstrual blood is watery ;  black blood between the menses.
 During  the menses : the body smells of semen ;  loquacious
 mood ; drawing in the abdomen, thighs and limbs.   After the
 menses:  sighs and moans ; erysipelas of the  left cheek.
   Tartarus.—Profuse and premature menses: watery blood.
 Viscous leucorrhoea, white, slimy.   Nettle-rash at the vulva.
   Thuya.—Menses scanty.  Leucorrhoea.  Mucous discharge
 from the urethra.  Burning, itching and stinging in  the parts,
 especially when  walking; crampy pain down  to  the hypogas-
 trium, especially on rising; pressure and  contraction  when
 sitting;  swelling of the labia, with burning pain when walk-
 ing and touching the parts ; whitish ulcer at  one of the labia,
 with excoriation, pain when touching it; wen at the neck of
 the uterus.
   Veratrum.—Menses premature and profuse.  Before the
 menses:  nose-bleed ; pimples on the labia; vertigo in the day-
 time, with sweat at night.  Diarrhoea, with nausea and  shiv-
 erings at the commencement  of  the menses.   During the
 menses:  tearing headache, with desire to vomit; buzzing in
 the ears ; pains in all the limbs, with much  thirst.   After the
 menses:  Gritting the teeth and bluish color of the face.

                       Section 8.

  Indications  derived from the nature of the  menses.__In
conformity with  what we have  stated in Section 4, we  now
furnish a general list of all the  remedies that have reference
to menstrual irregularities, in order to place before the  eyes
of the practitioner every thing that may serve him as a guide 
DYSMENORRHEA.
33
in the selection of a remedial agent, in case the usual reme-
dies should not avail.

Menses  too  copious:—1. Belladonna,  Calcarea,  Chamo-
         milla, Ferrum, Ipecacuanha, Nux  vomica, Platina,
         Sabina, Secale, Stramonium.
       2. Arsenicum, Bryonia,  Cantharides,  Carbo vegetabilis,
          Coffea,  Crocus, Hyoscyamus, Ignatia, Magnes aus-
         tralis, Mercurius, Natrum muriat., Nitric acid, Nux
         moschata, Phosphorus,  Sepia, Sulphur,  Sulphuric
         acid.
       3. Chelidonium, Cina, Kreosote, Lycopodium, Moschus,
         Ruta, Sambucus, Silicea.
       4. Aconitum, Agaricus,  Ambra, Ammonium  muriati-
         cum, Antimonium, Borax,  Bovista, Carbo  animalis,
          Causticum, Cyclamen, Hepar, Iodium, Laurocerasus,
         Ledum, Magnesia muriat, Muriatic acid, Natrum,
          Nitrum, Phosphoric acid, Pulsatilla, Rhus, Selenium,
          Stannum, Veratrum.
       5. Ammoniacum, Arnica, Baryta, Cannabis, Capsicum,
          Clematis, Cocculus, Colocynthis, Cuprum, Dulcamara,
          Magnesia carb.,  Mezereum,  Opoponax, Plumbum,
          Rhododendron, Sabadilla, Spongia, Strontian, Zincum.
 Menses Too long :-—1. Aconitum, Chininum, Ignatia, Lycopo-
          dium, Natrum muriaticum, Nux  vomica,  Platina,
          Secale,  Silicea, Sulphur.
       2. Baryta,  Bryonia,  Calcarea,  Cantharides,  Coffea,
          Crocus, Cuprum, Ferrum, Kreosotum, Magnes aus-
          tralis, Mercurius, Phosphorus, Rhus, Sabina, Sepia.
       3. Arsenicum, Asarum, Belladonna.  Causticum, Cheli-
          donium,  Dulcamara, Kali, Laurocerasusr Stramo-
          nium,
       4. Agaricus, Belladonna, Borax, Bovista, Cina, Hyos-
          cyamas,  Ledum,  Magnesia   carbonica,   Natrum,
          Nitrum,  Sabadilla,   Stannum,  Sulphuric  acid,
          Zincum.
                            3 
diseases  of females.
Menses premature :—1.  Amhra, Belladonna, Calcarea, Car-
         bo vegetabilis,  Chamomilla,  Ignatia,  Ipecacuanha,
         Natrum  muriaticum,  Nux  vomica, Phosphorus,
         Rhus, Sabina.
       2. Ammoniacum,  Ammonium  muriaticum,  Asarum,
         Bovista,  Cantharides,  Cina,  Cocculus,  Colchicum,
         Crocus, Kali, Kreosotum, Laurocerasus, Magnes aus-
         tralis, Manganum, Platina, Secale, Sepia, Sulphuric
         acid.
       3. Alumina,  Arnica,  Asarum,  Belladonna, Borax,
         Bryonia, Carbo animalis, China,  Colocynthis, Hepar,
         Iodium, Lachesis, Ledum, Magnesia muriatic, Mu-
         riatic acid,   Natrum,  Nitrum,   Nitric  acid,   Nux
         moschata, Phosphoric  acid, Plumbum, Pulsatilla^
         Ruta, Silicea, Spongia, Stannum, Sulphur.
       4. Aconitum,  Arsenicum, Baryta, Cannabis, Causticum,
         Clematis,  Coffea, Conium,  Digitalis,  Dulcamara,
         Ferrum, Graphites,  Helleborus, Hyoscyamus,  Lyco-
         podium,  Magnesia  carbonica, Mezereum,  Natrum
         muriaticum, Petroleum,  Pulsatilla, Rhododendron,
         Ruta,  Spigelia,  Staphysagria, Stramonium,  Stron-
         tiana.

 Menses retarded, delaying :—1. Causticum, Cuprum, Dul-
         camara, Graphites,  Kali, Lycopodium,  Magnesia
         carbonica,  Natrum  muriaticum,  Pulsatilla,  Sepia,
         Silicea, Sulphur.
        2.  Lachesis, Phosphorus.
        3.  Aconitum,  Agnus,  Chelidonium, Cocculus, Drosera,
         Ferrum, Mercurius,  Petroleum, Sabina, Valeriana,
         Zincum.
        4.  Ammoniacum,  Aurum,  Bryonia,  Calcarea,  Cicuta,
           Crocus,  Digitalis,  Hyoscyamus, Magnes  arcticus,
          Magnesia  muriatica, Sabadilla,  Sarsaparilla,  Sta-
         physagria, Stramonium, Strontiana, Veratrum.
        5.  Arnica, Arsenicum, Belladonna,  Borax, Bovista, 
dysmenorrhea.
35
         Cantharis, Carbo animalis, Chamomilla,  China, Col-
         chicum,  Colocynthis,  Helleborus,  Hepar,  Ignatia,
         lodium, Natrum, Nitric acid,  Nux moschata, Nux
         vomica, Phosphoric acid., Rhododendron, Rhus, Ruta,
         Secale, Spigelia,  Sulphuris acidum.

Menses too scanty :—1.  Ammoniacum, Concha}, Dulcamara,
         Graphites, Kali,  Lachesis, Magnesia carbonica, Pul-
         satilla, Sulphur.
       2.  Baryta, Cocculus, Natrum muriaticum, Phosphorus.
       3.  Aconitum, Alumina, Causticum,  Cuprum, Lycopo-
         dium, Magnes arcticus, Mercurius, Ruta, Sabadilla,
         Sarsaparilla, Sepia,  Silicea, Staphysagria.
       4.  Bryonia, Carbo vegetabilis, Cicuta, Colchicum, Digi-
         talis,   Drosera,   Euphrasia,   Ferrum,   Guajacum,
         Ignatia,   Magnesia  muriatic,  Manganum,  Nux
          vomica,  Petroleum,  Thuya,   Valeriana,  Veratrum,
          Zincum.
       5. Agnus, Arnica, Asarum, Aurum, Bovista, Calcarea.
          Carbo animalis,  Chelidonium, Crocus, Hepar, Hyos-
          cyamus,  lodium, Ipecacuanha,  Moschus,  Platina,
          Rhododendron,  Rhus, Sabina, Stramonium, Stron-
          tiana.

 Menses too short :—1.  Ammoniacum, Pulsatilla, Sulphur.
       1. Ammoniacum, Pulsatilla,  Sulphur.
       2. Bryonia, Dulcamara, Phosphorus.
       3. Conium, Graphites, Lachesis,  Mercurius.
       4. Alumina, Euphrasia, Magnesia  carbonica, Natrum
          muriaticum, Platina, Ruta, Sabadilla.
       5.  Baryta, Bovista, Carbo animalis, Colchicum, lodium,
          Ipecacuanha,  Kali,  Lycopodium,  Magnes  arcticus,
         Magnesia  muriatica,  Manganum,  Moschus, Nix
          vomica, Rhododendron, Sarsaparilla, Silicea. 
36
diseases of females.
Menses  suppressed, (menostasia):—1.  Pulsatilla,  Sepia,
         Sulphur.
       2. Bryonia,  Conium,  Dulcamara,  Graphites,  Kali,
         Lycopodium, Silicea.
       3. Aconitum, Ammoniacum, Baryta, Calcarea,  Caus-
         ticum,  Chamomilla,  Cocculus,  Cuprum,  Ferrum,
         Natrum muriaticum,  Phosphorus, Sabadilla,  Sta-
         physagria, Valeriana.
       4. Agnus, Alumina,  Arsenicum, Belladonna, Borax,
         Colocynthis,  Crocus, Hyoscyamus, Ignatia,  Lachesis,
         Magnesia  carbonica, Magnesia muriatic, Mercurius,
         Rhododendron, Ruta, Sarsaparilla, Veratrum,  Zin-
         cum.
       5. Arnica, Aurum, Carbo animalis, Carbo vegetabilis,
         Chelidonium, China,  Colchicum,  Digitalis, Drosera,
         Euphrasia,  Guajacum,  Helleborus, lodium,  Mag-
         nesia   arcticulus,   Manganum,  Nitric  acid,   Nux
         moschata,  Petroleum,  Phosphoric  acidt  Platina,
         Rhus, Secale, Strontiana,  Thuya.

Menstrual blood :—
     Acrid, burning, corrosive, excoriating:—1. Kali, Silicea.
       2. Bovista, Graphites, Sarsaparilla, Sepia.
       3. Ammoniacum, Arsenicum, Cantharis, Nitrum.
       4. Baryta,  Carbo vegetabilis, Hepart Rhus,  Sulphur,
         Sulphuric acid, Zincum.
     Brown .—1. Bryonia.
       2.  Carbo vegetabilis.
       3.  Calcarea, Rhus.
       4.  Conium, Pulsatilla.
     Black,  dark:—1. Chamomilla,   Crocus, Nux vomica,
         Pulsatilla.
       2. Ammoniacum, Antimonium, Kreosotum,  Lachesis,
         Magnesia carbonica, Nitric acid, Sepia.
       4. Arnica, Cantharis, Cuprum, Ignatia, Lycopodium,
         Nux moschata, Phosphoric acid,  Platina, Selenium,
         Stramonium. 
DYSMENORRHEA.
37
  5. Aconitum,  Carbo  vegetabilis,  Cocculus,  Conium,
    Digitalis, Drosera, Ferrum, Graphites, Ledum, Mag-
    nesia muriatic, Nitrum, Phosphorus, Secale.
Coagulated :—1. Chamomilla, Platina, Rhus.
  2. Belladonna, China, Ferrum,  Hyoscyamus, Ignatia,
    Ipecacuanha, Pulsatilla, Sabina, Stramonium.
  3. Arnica,  Cantharis,  Causticum,  Conium,  Crocus,
    Magnesia muriatica,  Mercurius, Nitric acid,  Phos-
    phoric acid, Strontiana.
  4. Bryonia, Carbo animalis, Kreosotum,  Nux vomica-,
    Secale, Sepia.
Dark, see black.
Foul, badly  and smelling:—1. Belladonna, Bryonia.
  2. Carbo animalis, Chamomilla, Crocus, Sabina.
  3. Ignatia, Silicea, Sulphur.
  4. Arsenicum, Carbo  vegetabilis,  Causticum,  China,
     Kali, Mercurius, Phosphorus, Platina, Secale.
Pale, watery:—1.  Belladonna,Dulcamara,Hyoscyamus,
     Sabina.
  2. Carbo vegetabilis, Graphites, Pulsatilla, Sulphur.
  3. Arnica, Calcarea, Ferrum, Ledum, Magnesia aus-
     tralis, Phosphorus, Rhus, Secale.
  4. Anlimonium, Bryonia, Drosera, Ipecacuanha, Lau-
    rocerasus,  Lycopodium,  Mercurius,  Nitrum,  Nitric
    acid, Platina. Sabadilla, Strontiana,  Zincum.
  5. Ammoniacum,  Arsenicum,  Borax, Bovista,  Can-
    tharis, Carbo animalis,  China, Digitalis, Kreosotum,
    Magnesia muriatic, Nitrum, Nux moschata, Sepia,
    Silicea, Stramonium.
Slimy :—1.  Cocculus.
  2. Pulsatilla, Sulphur-is acidum.
SouR-smelling :—Sulphur.
Thick:—1.  Pulsatilla.
  2. Crocus,  Cuprum,  Platina.
  3. Arnica. 
38
DISEASES OF FEMALES.
       4.  Carbo vegetabilis, Fluoricum acidum, Nitrum, Nux
         moschata, Sulphur.
     Viscid :—1.  Crocus.
       2.  Cuprum.
       3.  Secale.
       4.  Magnesia carbonica, Magnesia muriatica.
     Watery, see pale.

                       Section 9.

  Accompanying symptoms in menstrual irregularities—The
ailments which precede, accompany or follow the catamenia,
being of  the utmost importance to the  proper selection of a
remedy, we  here furnish a detailed list  of all  the indications
resulting from such symptoms.

            a GENERAL MENSTRUAL AILMENTS.
At the  Period,  in general:—1. Bryonia,  Calcarea carb.,
         Cocculus,  Graphites, Nux  vom., Pulsatilla, Sepia,
         Sulphur.
       2.  Belladonna,  Coffea, Ignatia, Platina, Secale, Vera-
         trum.
       3.  Aconitum, Ammonium  carb., Ammonium  mur.,
          Carbo vegetab., Causticum, Cuprum met, Kali carb.,
         Kreosotum, Lachesis, Lycopodium, Magnesia carb.,
         Magnesia mur., Mercurius viv., Natrum mur., Nux
         mosch., Petroleum,  Silicea, Zincum met.
      4.  Baryta carb.,  Borax, Chamomilla,  Chelidonium, Co-
         nium, Phosphoric acid., Sabina, Stramonium.
Before:—1.  Calcarea carb.,  Cuprum met, Lycopodium,
         Mercurius viv., Pulsatilla, Sepia, Sulphur, Vera-
         trum.
       2. Ammonium carb., Baryta  carb.,  Carbo veget. Coc-
         culus, Conium, Kreosotum, Natrum mur., Phospho-
         rus, Phosphori acid., Platina. 
DYSMENORRHEA.
39
       3. Alumina, Asarum,  Causticum, Chamomilla, Fer-
         rum met,  Graphites, Hyoscyamus,  Jodium, Kali
         carb., Lachesis, Magnesia carb., Manganum,  Nux
         mosch., Silicea, Stannum.
       4. Ammonium   mur.,  Belladonna,   Borax, Bovista,
        Bryonia, Cantharis, Carbo anim.,  China, Cina,  Cof-
        fea, Crocus, Dulcamara,  Hepar,  Ignatia, Ipecacu-
         anha, Magnesia mur., Mezereum, Moschus, Muriatic
         acid, Natrum carb., Nitrum, Nux vomica, Petroleum,
         Rhus toxic, Ruta, Sabadilla, Sarsaparilla, Spigelia,
         Spongia, Staphysayria, Sulphuric  acid.,  Valeriana,
         Zincum met.
At the Commencement :—1. Hyoscyamus.
       2. Aconitum,  Causticum,  Chamomilla,  Lycopodium,
         Phosphorus, Platina, Pulsatilla, Sepia.
       3. Bryonia, Coffea,  Graphites,  Jodium,  Ipecacuanha,
         Magnesia carb., Natrum muriat.
       4. Asarum, Belladonna, Cocculus, Ignatia, Magnesia
         mur., Mercurius vivus, Moschus, Nitric acid., Ruta,
         Sarsaparilla,  Silicea, Staphysagria.
During :—1. Ammonium carb.,  Chamomilla, Graphites, Hy-
         oscyamus, Kali carb., Kreosotum, Pulsatilla, Sepia.
       2. Ammonium  muriat, Calcarea carb., Carbo veget.,
          Cocculus,  Coffea,  Conium, Ignatia,  Lycopodium,
         Magnesia carb., Magnesia mur., Nux vomica, Phos-
         phorus, Sulphur.
       3. Belladonna,  Borax, Bovista,  Carbo anim.,  Causti-
         cum,  China,  Cuprum met., Lachesis, Natrum carb.,
         Sabina, Silicea, Veratrum, Zincum.
       4. Aconitum, Alumina, Ambra,  Arsenicum, Asarum,
         Baryta carb., Bryonia, Cannabis,  Cantharis, Capsi-
         cum,   Chelidonium,  Crocus,  Ferrum  met,  Hepar,
         Jodium, Laurocerasus, Mercurius viv.,  Moschus, Mu-
         riatic acid., Natrum mur., Nitrum, Nitri acid., Nux
         mosch., Petroleum, Phosphoric acid., Platina, Rhodo- 
40               diseases of females.
         dendron, Rhus tox., Sarsaparilla, Secale, Selenium,
         Spongia,  Stannum,  Stramonium, Strontiana, Sul-
         phuris acid.
Following :—1. Borax, Graphites, Kreosotum, Nux vom.
       2. Lycopodium, Natrum mur., Phosphorus, Phosphori
         acid., Platina, Stramonium.
       3.  Alumina, Calcarea carb., Conium, Kali carb., Mag-
         nesia carb., Mercurius viv.,  Ruta, Sepia.
       4.  Ammonium  carb.,  Bovista,  Bryonia,  Cantharis,
         Carbo anim.,  Carbo  veget,  China,  Cuprum  met,
         Jodium, Lachesis,  Pulsatilla, Rhus tox., Silicea,
         Sulphur, Sulphuris acid., Veratrum.
    PARTICULAR AILMENTS AT THE MENSTRUAL PERIOD.
Abdomen Distended :—Alumina, Hepar, Kreosotum,  Zin-
         cum.
    Before the menses:—Kreosotum.
    During the menses :—1. Zincum.
       2.  Alumina, Hepar.
    Affected  with  Cramps:—1.  Cocculus, Ignatia, Pulsa-
         tilla, Sulphur.
       2.  Chamomilla, Conium, Sepia.
       3.  Cuprum, China,  Graphites, Nux vom., Platina.
       4.  Carbo veget, Hyoscyamus, Kali, Magnesia muriati-
         ca, Natrum muriaticum, Nitri acidum, Zincum.
    Before the menses:—1.  Chamomilla, Cocculus, Pulsa-
         tilla, Sulphur.
       2.  Carbo veget, Hyoscyamus, Kali.
    During the menses:—1. Ignatia, Platina.
       2.  Cocculus,  Conicum,  China,  Graphites,  Pulsatilla,
         Sepia, Sulphur, Zincum.
      3.  Cuprum, Magnesia muriat, Natrum muriat Nitric
         acid., Nux vom.
    Pain in,  colic:—1. Belladonna, Calcarea, Chamomilla
          Cocculus, Nux vom., Pulsatilla, Sulphur. 
DYSMENORRHEA.
41
       2. Aconitum, Graphites, Ignatia, Phosphorus, Platina,
          Secale, Sepia, Veratrum.
        3.  Alumina, Ammonium,  Ammonium  muriat., Ba-
          ryta,  China,  Conium,  Crocus, Cuprum, Lachesis,
          Silicea, Zincum.
        4.  Carbo veg.,  Causticum, Kreosotum, Laurocerasus,
          Lycopodium, Magnesia carbon., Mercurius, Nitrum,
          Natrum, Sarsaparilla, Stannum, Stramonium, Sul-
         phuric acid.
     Before  the menses:—1.  Baryta,  Belladonna, Calcarea,
          Chamomilla, Platina, Pulsatilla.
          2.  Alumina,  Ammonium,  Causticum,  Graphites,
         Lachesis, Lycopodium, Nitrum, Phosphorus, Sepia.
     During  the menses:—1. Alumina, Ammonium, Bella-
         donna,  Calcarea, Chamomilla, Graphites, Lachesis,
         Phosphorus, Platina, Pulsatilla, Sepia.
         2.  Agnus,  Ammonium  muriat,  China,  Cocculus,
          Conium, Crocus, Ignatia, Nux vom., Secale,  Silicea,
         Zincum.
       3.  Carbo veget, Causticum, Coffea, Kreosotum,  Lauro-
         cerasus, Lycopodium, Magnesia carb., Mercurius,
         Natrum, Sarsaparilla, Stannum, Stramonium, Sul-
         phur, Sulphuric acid.
     Following the menses '.—Lachesis, Pulsatilla,  Veratrum.
     Heavy -.—Pulsatilla.
Acid Mouth, during menses:— Lycopodium.
Anguish:—1.  Mercurius.
       2. Cocculus, Stannum.
       3. Belladonna, Ignatia, Phosphorus.
     Before the menses:—Cocculus, Mercurius, Stannum.
     During the menses '.—Belladonna, Ignatia, Mercurius.
     Following the menses :—Phosphorus.
Appetite lost, before the menses :—Belladonna.
Back, pains in :—Ammonium,  Phosphorus. 
42               DISEASES OF FEMALES.
       2. Ammonium muriat, Arsenicum, Belladonna, Caus-
         ticum, Lycopodium, Spongia.
    Before the menses :—Phosphorus, Spongia.
    During the menses :—1. Ammonium, Phosphorus.
       2. Ammonium muriat, Arsenicum, Belladonna, Caus-
         ticum, Lycopodium.
     Sweat on:—Kreosotum.
Breasts Painful:—1.  Conium.
       2.  Calcarea, Conium, Sanguinaria.
     Before the menses:—Conium.
    Swollen:—Calcarea.
Breathing Impeded:—Cocculus.
       2.  Graphites, Lachesis, Pulsatilla, Sepia, Sulphur.
Bruised feeling all over:—Ambra, Conium, Lachesis, Spon-
         gia,  Stramonium.
Buzzing in the ears -.—Borax, Ferrum, Kreosotum, Veratrum.
     Before the menses :—Ferrum.
     During the menses:—Borax, Kreosotum,  Veratrum.
 Catarrh,  bronchiale, during the menses:—Graphites.
 Cheeks swollen:—Graphites, Phosphorus, Sepia.
 Chest affected with Cramps :—1. Cocculus, Lachesis, China
     Before the menses:—Cocculus.
     During the menses:—China.
 Chest, pains in :—1. Graphites, Pulsatilla.
       2. Kreosotum, Lachesis, Phosphorus.
     Sweat on :—Belladonna, Kreosotum.
 Cold  in head :—Graphites.
 Colic, see Abdomen, pain in.
 Constipation :—Kreosotum.
 Convulsions :—1. Chamomilla, Cocculus, Cuprum, Ignatia.
        2.  Aconitum, Coffea, Lachesis, Pulsatilla.
        3.  Bryonia,  China,  Conium,  Graphites, Hyoscyamus
          Kreosotum, Magnesia muriatica, Natrum muriati-
           cum, Nux vom. 
DYSMENORRHEA.
43
Coryza, cold in head :—Graphites.
Cough :—Graphites, sulphur.
Cramps, uterine:—1. Chamomilla, China, Cocculus, Cuprum,
         Hyoscyamus, Ignatia.
       2.  Aconitum, Coffea, Lachesis, Pulsatilla.
       3.  Bryonia, Conium,  Graphites, Kreosotum,  Magnesia
         muriatic, Natrum muriatic, Nux vomica.
Delirium :—Hyoscyamus, Lycopodium.
Diarrhea :—1. Graphites, Silicea,  Veratrum.
       2.  Alumina, Ammonium,  Causticum, Magnesia  car-
         bonica.
Dreams,  many:—Alumina,  Calcarea,  Causticum,  Conium,
         Kali.
Emotions, disturbed :—Cocculus, Lycopodium, Natrum  mu-
         riatic, Pulsatilla.
       2.  Aconitum, Ammonium,  Causticum,  Chamomilla,
         Hyoscyamus, Sepia, Stannum, Stramonium, Vera-
         trum.
Epilepsy :—Sulphur.
Epistaxis, see Nose-bleed.
Eructations:—1. Lachesis, Pulsatilla.
       2.  Graphites, Kali,  Kreosotum,  Magnesia carbonica,
         Nitri acidum.      <
Eruptions at vulva:—Kali.
Eyes with Rings :—Phosphorus.
     Convulsed :—Graphites, Lycopodium.
     Fatigued:—Calcarea, Magnesia carbonica, Mercurius,
         Pulsatilla, Silicea,  Sulphur.
     Spasms:—China.
Face Blueish :— Veratrum.
     Puffed:—China.
     Hot :—Alumina.
     Yellowish :— Causticum, Natrum muriaticum.
     Pale :—1. Pulsatilla.
      2. Manganum carbonica, Manganum muriatica. 
44
diseases of females.
Fainting :—Ignatius, Nux vomica.
Feet Painful :—Pulsatilla.
     Swollen -.—Graphites, Lycopodium.
     Fever :—Phosphorus.
     Flatulence:—1.  Cocculus.
       2. Kreosotum.
Furor, at the commencement of the menses:—Aconitum.
Gastric Derangements:—1. Nux vomica, Pulsatilla.
       2. Ammonium, Carbo vegitabilis, Lycopodium, Vera-
         trum.
       3. Magnesia carbonica, Sulphur.
       4. Capsicum, Hyoscyamus, Phosphorus.
Groins Painful :—Argentum nitricum.
Hemoptysis :—Phosphorus.
Hemorrhoids :—1. Pulsatilla.
       2. Lachesis.
       3. Cocculus, Phosphorus.
     Before the menses :—Lachesis,  Phosphorus.
     Following the menses:—Cocculus, Pulsatilla.
     Fluent:—Ammonium muriatic, Graphites.
Head, heat of:—Calcarea,  Conium, Ignatia.
     Before the menses:—Conium, Calcarea, Ignatia.
     During the menses:—1.  Calcarea, Causticum.,
     Congestion of:—1. Mercthius.
         2. China,  Conium, lodium, Phosphorus, Veratrum.
         3. Kali, Magnesia carbonica, Sulphur.
     Before the menses :—Mercurius.
     During the  menses:—Calcarea, Causticum, China,  Co-
         nium, lodium, Mercurius,  Phosphorus,  Sulphur,
         Veratrum.
Headache :—1.  Carbo, Kreosote, Lachesis, Lycopodium, Na-
         trum muriaticum, Sulphur.
       2. Calcarea,  Cuprum,  Nux vomica,  Platina.
       3. Alumina,  Graphites, Ignatia, Kali, Magnesia car-
        bonica,  Magnesia  muriatica, Natrum, Phosphorus,
        Pulsatilla,  Sepia, Veratrum. 
DYSMENORRHEA.
45
       4. Ammonium muriaticum, Borax, Bovista, Bromine,
         Ferrum, Hepar, Hyoscyamus, lodium, Kali bichromi-
         cum, Laurocerasus, Mercurius, Nitrum, Nux mos-
         chata.
     Before the menses:—1. Carbo vegetabilis, Cuprum,  La-
         chesis, Sulphur.
       2. Alumina, Bromine, Calcarea, Ferrum, Hepar, Jo-
         dium. Mercurius, Natrum, Natrum muriaticum,
         Nux moschata, Pulsatilla, Silicea,  Veratrum.
     During the menses :—1. Carbo vegetabilis, Kreosotum, La-
         chesis, Lycopodium, Nux vomica, Platina, Sulphur.
       2. Calcarea,  Cuprum, Graphites,  Ignatia, Kali, Mag-
         nesia  carbonica, Magnesia muriatica, Phosphorus,
         Sepia.
       3. Ammonium muriaticum, Borax,  Carbo  animalis,
         Graphites, Hyoscyamus, Natrum, Pulsatilla, Vera-
         trum.
     Following the menses -.^Lycopodium, Pulsatilla.
 Hearing Hard :—Kreosotum.
 Heart, palpitation of:—1. Jodium, Spongia.
       2. Alumina, Ignatia, Nitri acidum, Phosphorus, Sepia.
 Heat, feverish:—Carbo animalis, Mercurius, Nitri acidum,
         Nux vomica, Sepia, Sulphur.
 Hoarseness :—Graphites.
 Hunger, canine, before the menses:—Magnesia carbonica.
 Irritable  mood, before the menses:—Kreosotum, Natrum
         muriaticum.
Itching at parts :—1. Graphites, Sulphur.
         2. Hepar, Lycopodium, Petroleum, Zincum.
Lassitude.
    Before the menses:—1. Cocculus.
       2. Ignatia,  Nux vomica, Phosphorus.
       3. Alumina.
    During the menses:— Calcarea,  Causticum,  Graphites, 
4(.               diseases of females.

         lodium, Magnesia carbonica, Magnesia muriat, Nux
         vomica, Phosphorus.
     Following the menses:—1. Platina.
       2. Alumina, lodium, Phosphorus.
Laughter, convulsive -.—Hjoscyamus.
Legs weary -.—Kreosotum. Sulphur, Zincum.
     Painful -.—Ambra, Chamomilla, Conium, Lachesis, Spon-
         gia, Stramonium.
     Heavy:—Baryta, Lycopodium, Pulsatilla, Zincum.
     Varicose:—Ambra, Pulsatilla.
Leucorrh<ea:—1.  Alumina,  Calcarea,  Cocculus,  Conium,
         Mercurius, Pulsatilla, Sepia.
       2.  Ammonium, Carbo animalis, Carbo vegetabilis, China,
          Graphites, Kali, Kreosotum,  Lycopodium, Magne-
         sia  muriatica, Mezereum, Natrum muriaticum, Nux
         vomica,  Petroleum,  Phosphorus,   Sabina, Silicea,
         Stannum, Stdphur, Zincum.
       3.  Aconitum, Agnus, Ambra, Anacardium, Arsenicum,
         Borax, Cannabis, Drosera, Hepar, Jodium,  Lachesis,
         Nitri acidum, Ruta,  Sulphuric acid.
       4. Argentum nitricum, Belladonna,  Coffea,  Nitrum,
         Phosphoric acidum, Plumbum, Thuja, Viola tricolor.
     Before the menses :—1.  Calcarea, Lachesis.
       2. Baryta, Carbo  vegetabilis, China, Phosphorus.
       3. Alumina, Graphites, Kreosotum,  Pulsatilla,  Ruta,
          Sepia, Sulphur, Zincum.
      During the menses :—1.  Alumina.
       2. China,  Cocculus,  Graphites,  Lachesis, Pulsatilla,
          Zincum.
      Following  the menses :—1.  Alumina, Pulsatilla, Ruta,
          Sabina.
       2. Bovista,  Cocculus,  Graphites, Kreosotum, Mercurius,
          Nitri acidum, Phosphoric acidum, Silicea, Sulphur.
 Limbs Painful :—1.  Conium, Phosphorus, Sepia. 
DYSMENORRHEA.
47
      2. Alumina, Arsenicum, Bryonia, Cantharis,  Crocus,
        Graphites, Magnesia carbonica, Spongia, Veratrum.
    Before the menses :—Alumina.
    During  the menses:—Alumina, Arsenicum, Cantharis,
         Crocus, Magnesia carbonica, Natrum.
Hips Swollen :—Phosphorus.
Liver, Pains in:—1.  Pulsatilla.
      2. Conium, Nux moschata, Phosphoric acid.
    Before the menses :—1.  Pulsatilla.
      2. Conium, Nux moschata.
    During the menses:—Phosphori acidum, Pulsatilla.
Loquacity :—Stramonium.
Melancholy, sad:—1. Lycopodium, Natrum muriaticum.
      2. Ammonium, Causticum,  Sepia, Stannum.
    Before  the menses:—1. Lycopodium, Natrum muriati-
         cum.
       2.  Causticum, Stannum.
    During the menses :—Ammonium, Natrum muriaticum,
         Sepia.
Metralgia, uterine cramps:—China, Hyoscyamus.
Miliary Eruption :—Dulcamara.
Mucus  on stomach:—1. Nux moschata, Pulsatilla.
       2.  Nux moschata.
Nausea, see Vomit.
Nightmare, during the menses:—Sulphuris acidum.
Nose-itching, after the menses:—Sulphur.
     Bleeding -.—Lachesis, Sulphur, Veratrum.
Pains in the parts:—1. China.
        2. Belladonna, Conium, Nitric acidum, Platina, Pul-
         satilla, Silicea.
     Before the menses:—China, Platina.
     Following the menses:—China, Kreosotum.
 Palpitation of Heart, see Heart. 
48
DISEASES OF FEMALES.
Photophobia, see Eyes.
Pressure on Parts:—1. Ammonium, Platina.
      2. Belladonna, China, Moschus, Nux  moschata, Sepia.
    Before the menses :—Platina.
    During the menses:—1. Ammonium, Conium, Lachesis.
      2. Belladonna, Moschus, Nitri acidum, Platina, Sepia.
    Following the menses :—Cliina.
Pyrosis, before the menses:—Sulphur.
Redness of the Parts :—1.  Mercurius, Nux vomica, Sepia.
      2. Aconitum, Belladonna, Calcarea, Carbo vegetabilis,
         Sulphur.
Restless :—Platina, Sulphur.
Rush of Blood :—1. Alumina.
      2. Mercurius.
      3. Cuprum.
Salt taste in Mouth:—Mercurius.
Semen,  body swells of:—Stramonium.
Shivering :—1.  Pulsatilla.
       2. Phosphorus.
       3. Calcarea,  Graphites,  Kali,  Lycopodium,  Nux
         vomica, Veratrum.
       4. Belladonna, Carbo animalis, Kreosotum,  Magne-
         sia carbonica, Natrum.
     Before the  menses:—Lycopodium,  Pulsatilla,  Vera-
         trum.
     Following the menses:—Graphites, Nux vomica,Pulsa-
         tilla.
 Sighing :—Stramonium.
 Sight blurred -.—Belladonna, Silicea.
     Pale  :—Silicea.
 Sleep  Restless -.—Alumina,  Kali, Natrum  muriaticum,
         Sepia. 
                     dysmenorrhea.                 49

  Small of Back, Pains in:—1. Calcarea, Lachesis, Pulsa-
          tilla.
        2. Ammonium, Magnesia  carbonica,  Natrum,  Ni-
          trum, Sulphur.
        3. Ammonium  muriaticum, Asarum,  Baryta,  Bro-
          mine,  Carbo  vegetabilis,  Hyoscyamus, Magnesia
          muriaticum, Phosphorus,  Sarsaparilla.
        4. Argentum nitricum,   Graphites,  lodium,  Kali,
          Kreosotum, Lycopodium,  Nitri acidum, Nux  mos-
          chata, Nux vomica, Platina, Sepia, Sulphuric acid.
      Before the  Menses :—1. Ammonium, Bromine, Hyos-
          cyamus, Lachesis, Magnesia carbonica, Nux mos-
          chata, Pulsatilla.
      During the Menses :—1.  Calcarea, Lachesis.
        2. Ammonium, Natrum,  Pulsatilla, Sulphur.
        3. Ammonium muriat, Asarum, Carbo  vegetabilis,
          Lycopodium, Magnesia carbonica,  Magnesia  mu-
          riatica, Phosphorus,  Sarsaparilla.
      Following the Menses :—1.  Pulsatilla.
        2. Borax.
 Sorenesss at the parts and between the thighs:—1. Kali.
        2. Bovista.
        3. Graphites, Sepia, Silicea.          '
     Before menses :—Graphites, Kali, Silicea.
     During menses :—Kali, Sepia.
 Spitting of Blood :—Phosphorus.
 Start,  tendency to:—Calcarea.
 Stinging in the parts:—Sulphuris acidum.
 Stitch  in side:—Pulsatilla.
 Stomach, pains in, gastralgia :—1.  Lachesis, Pulsatilla.
      2.  Nux moschata, Sulphur.
    Before menses :—Lachesis, Pulsatilla.
    During menses :—Borax, Sarsaparilla.
Stupor  :—China.
                           4 
50               DISEASES  OF FEMALES.

Sweat:—1.  Belladonna, Graphites,  Veratrum-
      2. Hyoscyamus.
      3. Kreosotum.
    Night -.—Belladonna, Graphites,  Veratrum.

Tearing in the parts -.—Phosphorus.
Teeth, set on edge :—Mercurius.
    Pain in :—1.  Calcarea,  Carbo vegetabilis, Chamomilla.
      2. Lachesis, Magnesia carbonica, Sepia.
      3. Ammonium, Graphites, Kali, Laurocerasus.
      4. Natrum muriaticum, Nitri acidum, Phosphorus,
        Sulphur, Sulphuric acid.
    Gritting the:— Veratrum.
Tenesmus :—Pulsatilla.
Thirst :—1. Kali.
      2. Belladonna, Sulphuris acidum, Veratrum.
    Before the menses :—Kali.
    During the  menses :—Kali, Belladonna,Sulphuris acid.,
         Veratrum.
Tongue, dry :—Mercurius.

Ulcers worse :—Graphites, Phosphorus.
Urinate, urging to, frequent:—Phosphorus, Pulsatilla, Sar-
         saparilla.
    Flow of urine :—Hyoscyamus.

Varices :—Ambra.
Vertigo :—
    Before  the  menses:—!. Lachesis, Pulsatilla,  Vera-
         trum.
       2.  Calcarea, Phosphorus.
     During the menses :—1. Pulsatilla.
       2.  Calcarea, Veratrum.
       3.  Causticum, Phosphorus, Veratrum.
     Following the menses : —Lachesis, Pulsatilla. 
DYSMENORRHEA.
51
 Vomit, desire to, nausea:—1. Pulsatilla.
       2. Carbo vegetabilis, Lycopodium, Nux vomica, Vera-
         trum.
       3. Capsicum, Cocculus.
       4. Calcarea,  Graphites,  Hyoscyamus,  Phosphorus,
         Sulphur.
     Before the menses:—1. Cocculus.
       2. Magnesia carbonica, Pulsatilla.
     During the menses:—1.  Carbo vegetabilis, Lycopodium,
         Nux vomica, Pulsatilla, Veratrum.
       2. Borax, Calcarea, Graphites, Hyoscyamus,  Phos-
         phorus, Sulphur.
     Following the menses :—
 Vomiting:—1. Ammonium muriaticum,  Carbo vegetabilis,
         Pulsatilla.
       2. Kali, Kreosotum, Lycopodium, Phosphorus.
     Before the menses:—Kreosotum, Pulsatilla.
     During the menses :—1. Ammonium muriaticum, Carbo
         vegetabilis, Pulsatilla.
       2. Ammonium,  Kali, Lycopodium, Phosphorus.
     Following the menses :—Borax, Pulsatilla.
Weeping mood:—Conium,  Lycopodium, Phosphorus, Pla-
         tina, Zincum.
     Before the menses:—Conium, Lycopodium, Phosphorus.
     During the menses  :—Lycopodium, Platina, Zincum.
Womb painful, see Metralgia:
Yawning, frequent:—Belladonna, Pulsatilla. 
r.9
diseases of females.
                     Section 10.'
  Condition  of the parts.-ln treating menstrual irregulari-
ties, it is of the utmost importance to take the condit.on of
the sexual organs into due  consideration.  Here follow  the
principal indications which the present condition of science has
furnished us for this chapter :—
Aphthe at the parts -.—Carbo vegetabilis.
Burning at the  parts, (vulva) :-l.  Carbo vegetabilis,  Sul-
        pliur.
      2. Ammonium, Calcarea, Cantharis.
      3. Ambra,  Bryonia,  Carbo  animalis,  Causticum,
         Chamomilla,  Hyoscyamus,  Kali,  Laurocerasus,
         Lycopodium, Magnes australis, Mercurius, Meze-
         reum, Nitri acidum,  Nux vomica,  Petroleum,
         Thuja.
     In  vagina:—Chamomilla,  Hyoscyamus, Lycopodium,
         Sulphur, Thuja.
 Congestion of the parts:—1.  Belladonna.
       2.  China, Hepar, Nux vomica, Secale, Sulphur.
       3.  Bryonia, Mercurius, Platina.
       4.  Crocus, Sabina, Sulphur.
 Contractive pain in the parts:—1. Nux vomica.
       2.  Ignatia, Sabina, Sepia,  Thuja.
 Cramps in uterus :—1. Cocculus, Ignatia.
       2. Cicuta, Conium, Graphites, Magnesia muriaticum,
          Nux vomica, Pulsatilla.
       3. Bryonia, Natrum  muriaticum, Platina,  Sepia,
          Stannum.
       4. Argentum  nitricum,   Belladonna,  Chamomilla,
          Eyoscyamus, Kreosotum, Thuja.
 Deformity of uterine orifice :—Natrum.
 Digging in the vulva:—Conium.
 Distension of  the womb:—Lycopodium, Magnes arcticus,
          Phosphorus.
 Dryness of vagina -.—Belladonna, Lycopodium. 
                    DYSMENORRHEA.                 53

Eruptions at the parts :—1. Mercurius, Sepia.
       2. Dulcamara, Graphites, Petroleum, Sulphur.
       3. Angustura, Calcarea, Bryonia, Causticum, Conium,
         Kali, Nux vomica, Tartarus.
       4. Mercurius, Phosphorus, Staphysagria.
    Pimples at the parts :—1. Graphites, Mercurius.
       2. Angustura, Conium, Kali, Natrum  muriaticum,
         Tartarus.
    Herpes at the parts :—1.  Dulcamara, Petroleum.
       2. Causticum.
    Nodes at the parts -.— Calcarea, Mercurius,  Phosphorus.
    Pustules at the parts :—Bryonia, Mercurius.

Fulness in the parts:—Graphites, Staphysagria, Sulphur.
    Heat at the vulva:—China.

Herpes at the parts:—Carbo vegetabilis, Kreosotum, Mer-
         curius, Nux vomica,  Sepia.
Hysteric ball in uterus :—1. Dulcamara, Petroleum.
       2. Causticum, (compare eruptions,) Lachesis,  Plum-
         bum.

Induration of the womb:—1. Belladonna, Carbo  animalis,
         Sepia.
       2. Aurum,  China,  Magnesia  muriatica, Staphy-
         sagria.
       3. Clematis, Cocculus,  Conium, Rhus.
Inflammation of the labia :—1.  Mercurius,  Sepia.
       2. Nux vomica.
       3. Calcarea.
       4. Aconitum, Belladonna, Nitri acidum, Sulphur.
Inflammation of the womb :—1. Nux vomica.
       2. Aconitum, Belladonna, Chamomilla.
       3. Coffea, Lachesis,  Mercurius,  Platina, Rhus,  Se-
         cale.
       4. Bryonia, Cantharis, China, Ignatia, Pulsatilla. 
54               diseases of  females.

Ixch^g at the parts -.-Calcarea Carboveg^^^
         Natrum muriaticum, Sepia, Silicea,  Sulphur.
       2. Angara, Coffea, Kali, Kreosotum, PJ^na
       3. Ambra, Ammonium, Lachesis, Lycopodium, Mer-
         curius.

Gnawing at the parts -.-Kali, Lycopodium.

Labia irritated :—l.  Calcarea, Conium, Sepia, Silicea.
       2 Mercurius, Nux vomica, Thuja.
       3 ' Ammonium, Bryonia,  Graphites, Carbo  vegetabilis,
         Dulcamara,  Hepar, Lycopodium, Natrum,   Nitn
         acidum,  Phosphorus, Pidsatilla.
Labor-pains, like :—1.  Pulsatilla.
       2. Chamomilla, Coffea, Secale.
       3. Arnica, Belladonna, Nux moschata, Nux vomica.
       4. Calcarea,  Cina,  lodium,  Kali, Kreosotum, Opium,
         Sulphuris  acidum.
 Leucorrhcm :—1.  Alumina,  Calcarea,  Cocculus,  Conium,
         Mercurius,  Pulsatilla, Sepia.
       2. Ammonium,   Carbo  animalis,  Carbo  vegetabilis,
          China,  Graphites, Kali,  Kreosotum,  Lycopodium,
          Magnesia  carbonica, Magnesia muriatica, Mezereum,
         Natrum muriaticum, Nux vomica, Petroleum, Phos-
         phorus,  Sabina, Silicea, Stannum, Zincum.
        3. Aconitum, Agnus, Ambra, Anacardium, Arsenicum,
          Borax, Cannabis, Drosera, Hepar, lodium, Lachesis,
          Nitri acidum,  Ruta, Sulphuris acidum.
        4.  Argentum nitricum, Belladonna,  Bovista,  Coffea,
          Manganum, Phosphori  acidum,  Plumbum, Thuja,
          Viola tricolor.

  Moles :— Cantharis.

  Nodes of the  Vulva :—Calcarea, Mercurius,  Phosphorus.
      Neck of the Womb :—Kreosotum. 
DYSMENORRHEA.                 55
Ovariairritated:—1. Belladonna, Cantharis, China, Lachesis,
         Mercurius.
       2.  Conium, Dulcamara, Platina, Sabina, Staphysagria,
         Thuja.
       3.  Aconitum,  Ambra, Antimonium, Arsenicum, Asa,
         Aurum,  Carbo animalis,  Lycopodium,  Mezereum,
         Secale, Sepia.
       4.  Carbo vegetabilis,  Colocynthis,  Graphites, Ignatia,
         Nitri acidum, Nux vomica, Sulphur,  Zincum.

Pain at the neck of the womb, when touched:—China, Fer-
         rum,  Kreosotum.
     At os tineas, incisive:—Pulsatilla.
Pimples at the parts, (see Eruptions:)—1.  Graphites, Mercu-
         rius.
       2. Conium, Kali, Natrum muriaticum, Tartarus.
Polypi in the womb:—1. Calcarea.
       2. Staphysagria,  Sepia.
       3. Nitri acidum, Thuja.
Pressure on the parts:—1. Belladonna, Chamomilla, China,
          Natrum, Sulphur.
       2.  Calcarea,  Chininum, Platina.
       3. Ipecacuanha,  Magnesia carbonica,  Moschus, Nux
          vomica.
       4. Asa, Cina, Crocus, Graphites, Natrum muriaticum,
          Sepia, Thuja, Zincum.
Pulling in the parts:—1.  Pulsatilla.
       2. Moschus, Rhus, Sabina.
       3. Lycopodium.
Pustules at the parts:—Bryonia, Mercurius.

Roughness, heat at the  parts:—1.  Kali.
       2. Calcarea, Carbo vegetabilis,  Conium, Natrum muri-
          aticum, Sepia, Silicea, Sulphur.
       3. Ammonium, Lycopodium, Nitri acidum.
       4. Graphites, Kreosotum Staphysagria. 
5(3               diseases of  females.

Sensitiveness of the parts:—1. China.
       2. Mercurius, Nux vomica, Staphysagria.
       3. Coffea, Platina, Sepia, Zincum.
     Of the neck of the womb :—China.
Sexual Appetite increased:—1. Belladonna, Platina, Vera-
         trum.
       2. China, Coffea.
       3. Cantharis, Cina, Gratiola, Lachesis, Moschus, Nux
         vomica, Sulphuris acidum.
     Decreased -.—Baryta, Belladonna, Kali, Natrum muria-
         ticum, Petroleum.
     In intercourse, painful:—Ferrum, Kreosotum.
     Repugnant:—Kali, Natrum muriaticum, Petroleum.

Soreness of  the  parts, and of  the surrounding parts:—1.
         Carbo vegetabilis, Graphites, Sepia, Sulphur.
       2. Ammonium, Hepar,  Lycopodium.
       3. Ambra, Nitri acidum, Petroleum, Rhododendron,
         Thuja.
       4. Arsenicum, Aurum,  Coffea, lodium,  Kreosotum,
         Phosphorus.
     Pain as from :—1.  Ambra, Ferrum, Rhus,  Thuja.
       2. Chamomilla,  Kali, Kreosotum, Staphysagria.
Sterility:—1. Borax, Calcarea, Cannabis, Mercurius, Phos-
         phorus.
       2. Ammonium, Causticum, Conium, Graphites, Natrum
         muriat., Sulphuris acidum.
       3. Agnus, Ferrum, Natrum, Ruta.
       4. Cicuta,  Crocus, Dulcamara, Hyoscyamus, Platina,
         Sepia.
Stinging in the parts:—1. Lycopodium, Sepia.
      2.  Kali,  Kreosotum, Nitri acidum, Phosphorus, Pul-
         satilla, Sabina.
       3. Alumina, Arsenicum, Belladonna, Calcarea, Coni-
         um,   Graphites, Mercurius,  Rhus,   Staphysagria,
         Thuja. 
DYSMENORRHEA.                  57
Swelling of the parts:—1.  Nux vomica.
       2. Belladonna, Mercurius,  Sepia.
       3. Ammonium, Bryonia,  Cantharis, Carbo veget., La-
         chesis, Secale, Thuja.
    of the labia majora :—1.  Carbo veget, Mercurius, Sepia
         2. Ammonium, Bryonia, Lachesis, Secale, Thuja.
    of the uterus :—1. Nux vomica.
       2. Belladonna, Sepia.
       3. Angustura,  Cantharis, Mercurius, Secale, Thuja.
    of the ovaria:—Graphites, Lachesis.
    of the Vagina:—Kali bichromicum, Mercurius.

Throbbing in the parts:—Alumina, Mercurius.

Ulcers at the vulva:—1.  Sepia.
       2. Nitri acidum,  Thuja.
       3. Graphites.
    at the neck of the womb :—1. Nitri acidum, Thuja.
         Arsenicum, Belladonna,  China, Cocculus, Mercurius,
         Sepia.
Uterus  irritated:—1. Belladonna,  Conium,  Nux  vomica,
         Platina, Pulsatilla, Secale, Sepia, Sulphur.
       2.  Chamomilla, Cocculus, Graphites, Hyoscyamus, Ig-
         natia, Kreosotum, Magnesia muriat, Sabina.
       3. Bryonia,  Carbo animalis, Crocus, Ferrum, Moschus,
         Natrum   muriat,  Nux moschata,  Opium,  Rhus,
         Stannum,  Thuja, Veratrum.
      4. Arnica, Calcarea, China, Coffea, Ipecacuanha, Phos-
         phori acidum.

Vagina  irritated:—1.  Conium,  Mercurius,  Sepia, Sul-
         phur.
       2. Belladonna, Conium, Ferrum, Kali, Lycopodium,
         Nux vomica.
       3. Arsenicum, Cantharis,  China, Nitri acidum, Phos-
         porus, Pulsatilla, Rhus, Staphysagria, Thuja. 
58               DISEASES  OF FEMALES.

      4. Alumina,  Capsicum,  Carbo  vegetabilis,  Chamo-
        milla, Graphites, Hyoscyamus, Kreosotum, Platina,
        Sabina, Silicea, Stannum.
Varices, at the parts -.—Calcarea, Carbo vegetabilis, Lycopo-
        dium, Nux vomica, Zincum,
Vesicles,  at the parts:—1.  Graphites.
      2. Staphysagria, Sulphur.
Vulva irritated:—1. Calcarea,  Conium, Natrum muriati-
        cum, Sepia, Silicea.
      2. Mercurius, Nux vomica, Thuja.
      3. Ammonium, Bryonia,  Graphites, Kali,  Kreoso-
        tum, Staphysagria, Sulphur.
      4. Agaricus,  Alumina,  Ambra,  Cantharis,  Carbo
        vegetabilis, Dulcamara,  Hepar, Lycopodium, Mag-
        nesia carbonica, Natrum, Nitri acidum, Phosphorus,
        Pulsatilla.
Wind from  the vagina:—Bromine, Lycopodium, Sangui-
        naria. 
MENSTRUAL COLIC.
59
ARTICLE  II.
                  MENSTRUAL COLIC.

                       Section 11.

  Nature of the malady.—Menstrual colic is generally one of
the most marked symptoms of dysmenorrhoea.  Its seat seems
to be the uterus;  it is either inflammatory or purely nervous
in its character;  often it resembles labor-pain, and only comes
on at intervals; at other times it is continuous, and is  princi-
pally felt  in  the  loins,  hips and lower  limbs.  It generally
precedes the menstrual discharge by a few hours or days, and
ceases as soon as the blood has begun to flow properly;  in
other cases it only makes its appearance after the courses have
commenced to flow, which are sometimes interrupted in conse-
quence of the colic, for a longer or shorter period.  This colic
is often accompanied by the expulsion of a kind of false mem-
brane,  after which the blood re-commences  to flow.  Some-
times, if the blood is arrested by the colic, the breasts swell,
become more sensitive,  and even painful.  Few  women  are
entirely free from these pains;  some remain subject to them
as long as  the menstrual  functions last.  The most frequent
and exciting  causes of this colic are, a cold, especially when
caused  by exposure of the feet  to  dampness; errors in  the
mode of living, or the vicious and imprudent use  of drugs
during the menstrual flow.

                       Section 12.

   Treatment.—The best remedies for these pains are,  during
the flow, Belladonna, Calcarea, Chamomilla,  Cocculus,  Coffea,
Nux vomica, Pulsatilla, Sulphur—particularly: 
00
DISEASES OF FEMALES.
  Belladonna.—For pains in the abdomen, as if the parts
were clutched; pains in the sides, with pulling all along the
thighs;  weight  and pressure on the parts, as  if everything
would fall through ; the pains come on  before the appearance
of the courses, with determination  of blood to the head, blue
before  the eyes, frightful fancies and  rage; red and puffed
face, pains in the sides, violent thirst.
  Calcarea.—Abdominal  colic,  with  leucorrhoea;  cramp-
pains in the sides ; colic, with shivering; swelling and pain-
fulness of the breasts ;  polypi of the womb; rush of blood to
the head, with  vertigo and stupefaction ;  loss of  appetite;
embarrassed respiration ;  toothache ;  nausea or vomiting.
  Chamomilla.—Violent colic, consequent upon profuse and
premature menses, with sensitiveness  of the abdomen, as if
ulcerated ; labor-pains; painful pressure in the sides, down to
the abdomen and private  parts; violent  abdominal cramps,
with greenish or watery diarrhoea, nausea, eructations, yellow
coating of the tongue,  bitter mouth; dark, coagulated blood ;
fainting  turns,  with thirst, coldness of the  limbs, pale and
haggard face.
  Cocculus.—Abdominal  cramps, colic with  pressure, pres-
sure on  the chest, with  restlessness,  sighs; suppression or
scanty menses, with black coagula; flatulence, nausea unto
fainting;  paralytic weakness, with oppression, cramps in  the
chest, anxiety,  convulsive movements of the limbs ; flesh-col-
ored leucorrhoea, with  bloody and purulent serum  instead of
the menses.
   Coffea.—Distressing and maddening  colic;  fulness  and
pressure  in the  abdomen, as if it  would burst; abdominal
cramps ascending to the chest; nervousness, with restlessness,
cries, and twisting of the whole body ; profuse menstrual dis-
charge,  with serous mucus,  voluptuous  itching of the parts
and excessive sexual excitement.
   Nux vomica.— Uterine cramps, -with painful pressure in the
hypogastrium,  down to  the  thighs ; lameness in the sides ;
 distention of the bowels; constipation, with ineffectual urging
 to  stool; frequent urging to  urinate, with tenesmus of the 
MENSTRUAL COLIC.
61
bladder; the menses axe premature and last too long, reappear-
ing  several  times  after having  seemed to cease;  irascible
mood.
  Pulsatilla—Colic, abdominal spasms, retarded menses ;
discharge of black  coagula, or of a pale and  serous blood;
hepatic pains, gastralgia, pains in the sides, nausea and desire
to vomit, or sour and slimy vomiting ; megrim, vertigo ; shiv-
ering, with pale face ; leucorrhoea, weeping mood, anxiety, sad-
ness and melancholy;  weight in the bowels as from a stone;
violent pressure  in  the lower bowels, with pulling down  the
thighs; numbness of the legs when  sitting;  violent pressure
on the rectum, like urging to stool.
   Sulphur.—Colic and abdominal cramps, rush of blood to
the head, nose-bleed, toothache, water-brash, gastralgia, itching
of the parts, dyspnoea, cough, premature and profuse menses,
with pale blood.
   Dose.—These  different  remedies  may be  administered as
follows:—Dissolve  from six to eight globules, or one or  two
drops, of the attenuated medicine in solution, in about ten or
twelve table spoonfuls of water, and give the patient a table-
spoonfal of this solution  every half hour, or every  hour or
two hours, until the pain  ceases; the frequency of the  dose
depends upon the intensity or the frequency of the paroxysms.


                        Section 13.

   Other Remedies.—If the above-mentioned remedies should
prove insufficient,  we may  administer Aconitum, Bryonia,
 Graphites,  Ignatia,  Phosphorus,  Secale, Sepia,  Platina,
 Veratrum.
   Aconitum.—Distressing colic, with congestion of the  head
 and  chest; palpitation of  'the  heart; pressive,  throbbing
 or stinging headache;  red cheeks ; full and hard pulse; fever-
 ish heat, with thirst; irascible  mood; vertigo  or  fainting
 turns on  raising herself in bed;  is most suitable to plethoric
 young girls, who lead a sedentary life.
   Bryonia___Colic, with leucorrhoea, or rheumatic  pains in 
1)2
DISEASES OF FEMALES.
 the limbs;  pressive or burning gastralgia; pressure and ful-
 ness in the pit of the  stomach; congestion of the  chest  and
 head, with short cough or nose-bleed ;  constipation  ; coldness,
 frequent  shivering.
   Cuprum.—Abdominal cramps, ascending to the stomach
 and  chest,  with vomiting, convulsions, cries,  suppression or
 scanty menses.
   Graphites.—Cutting and crampy colic, with scanty and
 short menses; discharge of a thick  and black blood, or else
 pale and serous ;  nausea, pains in the chest, bronchial or nasal
 catarrh; weakness, rheumatic pains in the limbs; oedema of
 the  feet and legs.
   Ignatia.—Contractive cramp-colic,  with premature  and
 profuse menses; discharge of black blood mixed with coagula;
 oppressive headache;  photophobia; anxiety,  palpitation  of
 the heart, and fainting turns.
   Phosphorus.—Colic, as if the bowels were cut with knives,
 with pains in the sides,  vomiting  of bile, mucus  and food;
 the menses  at first delay, then become too profuse and  flow
 too long, with weakness,  rings around  the eyes,  loss of flesh,
 restlessness; stinging headache, lameness of the limbs,  pal-
 pitation of the heart, spitting of blood, shivering, swelling of
 the gums and  cheek.
   Platina.—Cramp-colic, with painful pressure on the geni-
 tal parts: the menses are premature, last too long, and are
 too profuse, with black and slimy blood; leucorrhoea before or
 after the menses; frequent urging to urinate;  constipation,
 hard  stool; anorexia; vertigo;  anguish, weeping,  restless-
 ness ; sleeplessness ; suspicious mood.
   Secale CORNUTUM.-Tearing and cutting colic, with pro-
 fuse  and  long menstrual flow; cold limbs, pale  face, cold
 sweat, weakness, small and almost suppressed  pulse; violent
 twisting of the body;  cries, rolling on the ground.
   SEPiA.-Cramp-colic, pressure on the parts,  scanty or pro-
fuse menses; leucorrhoea, headache, lameness of the limbs
toothache, melancholy.                                   '
  VERATRUM.-Colic, with  nausea,  vomiting, hysteric  dis- 
MENSTRUAL COLIC.
63
 tress ;  labor-pains in the sides and hypogastrium; colic with
 diarrhoea after the menses ; headache before the menses ;  icy
 cold hands,  feet and  nose; weakness,  fainting turns;  pale
 and earthy face; sense of  constriction in the throat; sexual
 excitement.
   Dose.—These medicines  are  administered  in  the same
 manner as prescribed for the remedies of the previous para-
 graph, at the end of the list.

                       Section  14.

   General Indications.—Beside  the remedies  mentioned in
 the two preceding paragraphs, we may have to resort to, 3,
 Alumina, Ammonium,  Ammonium  muriaticum,  Baryta,
 China,  Conium, Cocculus, Cuprum, Lachesis, Silicea, Zincum,
 4, Carbo vegetabilis, Causticum, Kreosotum, Laurocerasus, Lyco-
podium, Magnesia carbonica, Mercurius, Natrum, Nitrum, Sar-
 saparilla, Stannum, Stramonium, Sulphur, Sulphuric acid.

 When  the  colic sets  in before the  menses:—1.  Bella-
         donna,  Calcarea, Chamomilla, Platina, Pulsatilla.
        3. Alumina,  Ammonium, Baryta,  Causticum, Gra-
         phites,  Lachesis, Lycopodium, Nitrum, Phosphorus,
         Sepia.
     With the menses:—1. Belladonna, Calcarea, Chamomilla,
         Graphites, Phosphorus, Pulsatilla, Sepia, Sulphur.
       2. Cocculus, Coffea,  Ignatia, Nux vom., Secale.
       3. Agnus, Alumina, Ammonium, Ammonium muriat,
          China, Conium, Crocus,  Silicea, Zincum.
       4. Carbo veget, Kreosotum, Laurocerasus, Lycopodium,
         Magnesia carbon., Mercurius, Sarsaparilla, Stannum,
         Stramonium, Sulphuris acidum.
     After the menses:—Lachesis, Pulsatilla, Veratrum.
 Moreover, if the menses are too long :—1. Nux vomica,
         Platina, Secale.
       2. Bryonia, Calcarea, Coffea, Ignatia, Phosphorus,
         Sepia. 
64
DISEASES OF FEMALES.
     Too profuse:-!.  Belladonna,  Calcarea, Nux vomica,
         Platina, S<cale.
       2.  Chamomilla,  Coffea,  Ignatia, Phosphorus,  Sepia.
       3.  Aconite, Bryonia, China,  Crocus, Mercurius,  Pulsa-
         tilla, Veratrum.
     Premature:— Calcarea, Chamomilla, Cocculus, Ignatia,
         Nux vom., Phosphorus, Platina, Sepia,  Sulphur.
     Retarded:—1. Graphites,  Pulsatilla,  Sepia,  Sulphur
       2.  Aconite, Calcarea, Cocculus, Phosphorus, Veratrum.
     Scanty:—1. Graphites, Pulsatilla, Sulphur.
       2.  Aconite, Cocculus, Phosphorus, Sepia.
     Short:—1. Pulsatilla,  Sulphur.
       2.  Graphites,  Phosphorus, Platina.
    Suppressed:—1. Pulsatilla, Sepia, Sulphur.
       2.  Aconite,  Belladonna,  Bryonia,  Calcarea,  Chamo-
         milla, Cocculus, Ignatia, Phosphorus, Veratrum.
Blood, coagulated:—1. Belladonna,  Chamomilla, Ignatia,
         Platina, Pulsatilla.
       2. Bryonia, Nux vomica,  Secale, Sepia, Pulsatilla.
    Black, dark :—1.  Chamomilla, Nux vomica, Pulsatilla.
       2. Belladonna, Bryonia,  Sepia, Sulphur.
    Pale, watery:—1. Belladonna,  Graphites,  Pulsatilla,
         Sulphur.
       2. Bryonia, Calcarea,  Phosphorus, Platina, Secale.

  For  further information see  the Article DYSMENOR-
RHEA, Sections 5, 6, 7, 8,  9, 10. 
MENSTRUAL IRREGULARITIES AND ALTERATIONS.   65
ARTICLE  III.
MENSTRUAL IRREGULARITIES,  AND  ALTERATIONS
             OF THE MENSTRUAL BLOOD.

WHEN THE MENSES  ARE TOO  COPIOUS, PREMATURE, TOO LONG,  SCANTY,
               RETARDED, TOO SHORT, FULL. ETC.

                      Section 15.

  General Observations.—Besides  the various  ailments
which may  occur  before, after, or during the menses, and
which constitute in their totality what we have termed dys-
menorrhea, of  which  a more particular  description has
been furnished in  Sections 2-10, the menstrual flow itself is
liable to irregularities, setting  in before or after the regular
period, and  being either  too copious  or too scanty,  too short
or too long.  The  blood is likewise susceptible of morbid
changes,  as regards  color,  consistence,  smell,  etc.  These
irregularities may be unaccompanied by  any other distress
or irregularity in the menstrual functions; most frequently,
however, they are the first cause of dysmenorrhoea and many
other menstrual  ailments.  For this reason we shall furnish
a more detailed  account  of these various sufferings than we
have been able to do under the  head  of Dysmenorrhoea, Sec-
tion  3.   We  shall treat in succession,  1st, of premature
menstruation ; 2nd, profuse menstruation ; 3d, menstruation
of excessive duration;  4th, retarded menstruation; 5th, scanty
menstruation; 6th, menstruation  of insufficient duration;
7th,  of the various alterations of the menstrual blood.
                           5 
66
DISEASES OF FEMALES.
                      Section 16.

  Premature  Menstruation.—The best remedies are  in
general,
  1. Ambra, Calcarea, Carbo vegetabilis, Chamomilla,  Igna-
tia, Ipecacuanha, Natrum muriaticum,  Nux vomica,  Phos-
phorus, Rhus, Sabina.
  2. Ammonium, Ammonium muriaticum, Asarum, Bovista,
Cantharis, Cina,  Cocculus, Colchicum, Crocus, Kali, Kreosotum,
Leurocerasus, Magnes auslralis, Manganum,  Platina, Secale,
Sepia, Sulphuris acidum.
  3. Alumina,  Arnica, Asafcetida, Belladonna, Borax,  Bryo-
nia, Carbo animalis, China, Colocynthis, Hepar, lodium, Lachesis,
Ledum, Magnesia muriatica, Muriatis  acidum, Natrum, Nitri
acidum. Nux moschata, Phosphori acidum, Plumbum, Pulsa-
tilla, Ruta, Silicea, Spongia, Stannum, Sulphur.
  With the following particular indications :—
   Ambra.—Painful varices  at the legs; thick leucorrhoea,
with stitches in the vagina and discharges of pieces of bluish
and whitish mucus;  burning in the parts ; excoriation-pains,
violent itching  and  swelling of the labia.
   Belladonna.—Premature and profuse menses with bright-
red, foul-smelling, and coagulating blood; colic, as  if every
thing would  fall through the vagina;  throbbing headache;
red and puffed  face; blur before the eyes ;  sweat  on the chest,
 at night,  with thirst.
    Calcarea.—Premature  and profuse menses, with cutting
 in the bowels, toothache, leucorrhoea, swelling  of the veins;
 before  the  menses,  headache, colic, shuddering, leucorrhoea
 and swelling of the breasts with sensitiveness.
    Carbo Vegetabilis.—Premature and profuse menses, pre-
 ceded by eruptions and itching of the skin, headache or colic;
 cutting colic when  the flow stops,  with backache, lameness in
 the limbs, toothache, vomiting, headache.
    Chamomilla.—Profuse menses, with drawing cramp-colic
 from  the  sides to  the abdomen;  dark coagula; thirst; cold
 limbs, fainting. 
     MENSTRUAL IRREGULARITIES AND ALTERATIONS.   67

  Ignatia.—Menses every fortnight, with compressive cramp-
pain, hardness and distention of the abdomen ; hysteric symp-
toms ; nausea with fainting;  shuddering all over, with pale
face;  sight  feeble and blurred;  intolerance of light  and
noise.
  Ipecacuanha.—The menses set in too soon without  any
known cause, they  are too copious,  the blood is bright-
red and coagulates readily; weakness, restlessness and aver-
sion to food.
  Natrum muriaticum.—Menses  too  copious and too long,
preceded  by irritability, melancholy and restlessness, with
headache; during the menses; headache, desire to remain in
bed, toothache, cramp-colic and nightly fever.
  Nux  vomica.—Profuse menses, with  abdominal cramps;
menses every fortnight; during the menses ; vomiting, head-
ache above the eyes,  dry heat and weakness.
  Phosphorus.—Profuse  menses, with pains in the sides,
colic, swelling of the gums and  cheek; during the menses;
cutting in the bowels, backache, spitting of blood, palpitation
of the heart and fermentation in the bowels.
  Rhus toxicodendron.—Profuse discharge of blood, with
coagula ; labor-pains ;  excoriation-pains in the vagina.
  Sabina.—Profuse menses, with discharge of coagula ; colic,
labor-pains, scanty and red urine, mucous discharge from  the
vagina.
  Moreover, if the menses break out again before their time
in consequence of a violent emotion, give Platina.
  If in consequence of an  exertion, give Arnica and Rhus.
  If without any known cause, Ipecacuanha.
  For more precise information, see Dysmenorrhoea, Sections
5-10.
  Dose.—Of these different medicines give from four to  six
globules dry on the tongue, or one or two drops of the atten-
uated tincture in a teaspoonful of  water or on a little sugar,
a few days after the menses  cease to flow, and repeat  the
dose every  week until the next menstrual period  is about
to set in. 
63
DISEASES OF FEMALES.
                       Section 17.

  Profuse menstruation.—The principal remedies  are:—
  1. Belladonna, Calcarea. Chamomilla, China, Ferrum, Ipe-
cacuanha, Nux vomica, Platina, Sabina, Secale, Stramonium.
  2. Arsenicum, Bryonia,  Cantharis, Carbo vegetabilis. Coffea,
Crocus,  Hyoscyamus,  Ignatia,  Magnes australis,  Mercurius,
Natrum muriaticum, Nitri acidum, Nux moschata, Phosphorus,
Sepia, Sulphur, Sulphuris acidum.
  3. Aconitum, Agaricus,  Ambra, Ammonium muriaticum,
Antimonium, Borax,  Bovista,  Carbo  animalis,  Causticum,
Chelidonium, Cina,  Cyclamen,  Hepar, lodium,  Kreosotum,
Laurocerasus, Ledum, Lycopodium, Moschus, Muriatis acidum,
Natrum, Nitrum, Phosphori acidum, Pulsatilla, Rhus, Ruta,
Sambucus, Selenium, Silicea, Stannum, Veratrum.   With the
following particular indications :
  Belladonna.—Profuse and premature menses, with violent
bearing-down  in  the  genital  organs;  bright-red,  offensive
discharge,  readily  coagulating; pulsative headache  in the
temples; red and puffed face; pains in the sides.
  Calcarea.—Cutting colic, toothache and leucorrhoea dur-
ing the menses; swelling and sensitiveness  of the renal region
before  the appearance of the menses; headache,  colic  and
shuddering ;  lascivious dreams;  dyspnoea.
  Chamomilla.—Discharge of  a  dark-red or black blood,
offensive, occasionally mixed with coagula; labor-pains, thirst,
cold extremities, pale face,  weakness unto fainting, blurr be-
fore the eyes, buzzing in the ears.
   China.—Watery and pale blood, or coagula now and then,
with uterine cramps, frequent urging to urinate  and painful
 distention of the bowels ;  laziness; weakness  and disposition
 to  sweat;  confusion  in the head  and buzzing in the ears:
 swelling of the legs.
   Ferrum.—Profuse discharge of blood which  is partially
 thin, and partially  black and  coagulated, with  labor-pains ;
 vascular excitement,  headache, vertigo,  glowing redness  of
 the face, full and hard pulse. 
     menstrual irregularities and alterations.   63

  Ipecacuanha.—Copious and uninterrupted discharge of a
liquid and  bright-red blood, with  cutting  in  the  umbilical
region, pressure on the womb and rectum, shivering, coldness,
heat of the head, weakness, pale face, nausea and constant
desire to lie down.
  Nux vomica.—Menses premature and too long, with ver-
tigo, constipation,  nausea and weakness, cramp-colic frontal
headache, aggravation of the symptoms  in the  morning.
  Platina.—Thick  and dark blood, with painful drawing in
the sides down to the groin, as if the abdominal viscera were
drawn down; excessive sexual excitement.
  Sabina.—Discharge of dark blood, mixed  with  coagula,
accompanied by  colic and labor-pains; weakness,  rheumatic
pains in the limbs and head.
  Secale cornutum.—Suitable to feeble, worn-out, cachectic
females,  with coldness of the  extremities, pulse full, leaden
countenance, small pulse, uneasiness and fear of death.
  Stramonium.—Profuse discharge of black blood, with large
coagula; during the menses, drawing pains in  the abdomen,
thighs and  limbs; talkative; the body smells of semen.
  For further information concerning remedies and  their  in-
dications, see Dysmenorrhoea, Sections 5-10.
  Dose.—The same as indicated at the end of Section 17.

                       Section 18.

  Menses  of excessive  duration.—The principal remedies
are:—
  1. Aconitum,  China, Cuprum, Ignatia,  Lycopodium, Na-
trum muriaticum, Nux vomica, Platina,  Secale,  Sulphur.
  2. Baryta, Bryonia, Calcarea,  Cantharis, Coffea,  Crocus,
Ferrum, Kreosotum, Magnes australis, Mercurius, Phosphorus,
Rhus, Sabina, Sepia.
  3. Arsenicum, Asarum, Belladonna,  Causticum,  Chelido-
nium, Dulcamara, Kali, Laurocerasus, Stramonium.
  With the following indications:
  Aconitum.—Congestion of the head and heart, with sting- 
70               DISEASES OF FEMALES.

ing pains, full and hard pulse; blurred and bright-red blood,
coagulating readily; moral and nervous excitements ; feverish
heat with red  cheeks, or weakness,  fainting turns and  pale
face when raising herself from a recumbent posture.
  China.—Weakness, with pale face, rings around the eyes,
blur before them, ringing in the ears; labor-pains;  swollen
feet; sleeplessness or restless sleep, with  nightly headache ;
nervousness and irritable mood.
  Cuprum.—The menses are too  profuse, with abdominal
cramps, congestion of the head, pressive headache at the ver-
tex, red face and eyes, frequent nausea with vomiting, palpi-
tation of the  heart.
  Ignatia.—The menses last too long, followed by hysterical
symptoms, with discharge of coagula.  During the menses :
abdominal spasms, headache with heaviness  and  heat  in  the
head, photophobia, contractive colic, anguish,  palpitation of
the heart, and weakness unto fainting.
  Lycopodium.—Profuse menses, reappearing  several times,
even after having ceased to flow;  before the menses: shud-
dering,  malaise,   sadness, lowness  of spirits,  apprehensive
mood;  during the menses:  sour taste in the mouth, nausea.
  Natrum muriaticum.—Menses last too long, with profuse
discharge, headache, sadness, abdominal cramps, shivering,
frequent yawning.
  Nux  vomica.—Premature  menses ; they last too  lono-,
reappear several  times after having  ceased to flow, with ute-
rine cramps, frontal  headache, vertigo, constipation, nausea,
dyspepsia, and irritable mood.
  Platina.—Profuse menses, with  pressure  on the parts,
thick and black or else slimy and sticky blood,  sexual excite-
ment, also of the parts.
  Secale.—Profuse  menses,  with  violent  cramps ; all  the
symptoms are worse during and before the menses; tingling
in the  legs, weakness; nocturnal cramps  in the calves and
soles of the feet.
  Sulphur.—When the  foregoing  remedies are insufficient, 
     MENSTRUAL IRREGULARITIES  AND  ALTERATIONS.   71

with discharge of an acrid, black and corrosive blood ;  erup-
tions and tetter on the skin here and there.
  For further details see Sections 5-10.
  Dose.—The same as at the close of  Section 17.

                       Section 19.
  Retarded Menstruation.—The principal remedies  are:
   1.  Causticum,   Cuprum,   Dulcamara,  Graphites,  Kali,
lachesis, Lycopodium,  Magnesia carbonica, Natrum muriati-
cum, Phosphorus, Pulsatilla,  Sepia, Silicea, Sulphur.
   2. Aconitum, Agnus, Chelidonium, Cocculus, Drosera, Fer-
rum, Mercurius,  Petroleum, Sabina, Valeriana, Zincum.
   3. Ammonium, Aurum, Bryonia, Calcarea, Cicuta, Crocus,
Digitalis. Hyoscyamus, Magnes arcticus, Magnesia muriatica,
Saba&lla,  Sarsaparilla,  Staphysagria,  Stramonium,  Stron-
tiana, Veratrum.
  With the following particular indications :
  Causticum.—The menses  are too scanty, flowing only in
the day-time; melancholy, gloomy mood, pains in  the sides
before  the  menses;  yellow complexion, abdominal colic and
vertigo  during the menses.
  Cuprum.—Abdominal spasms or general convulsions, with
cries; congestion of the head; headache  at the vertex  ; face
and eyes red, or else pale, with rings around the eyes ; fre-
quent nausea  with  vomiting; palpitation of  the  heart, and
cramps  in the chest.
  Dulcamara.—The menstrual blood is pale,  and the flow
is too short; tetter at the  labia; miliaria  before the menses.
  Graphites.—Delaying  menses, too scanty, with abdominal
colic, weight in the  abdomen  and dulness  of the head; heavi-
ness of  the arms and legs; abdominal cramps, pains  in the
chest, weakness, discharge of blood from  the anus, pains in
the  limbs, during the menses.
  Kali carbonicum.—Pressure towards  the parts ; soreness
and redness around  the parts  and between the thighs; a good
deal of heat, with thirst, and  restless nights; the menstrual
blood is acrid and fetid. 
diseases of females.
  Lachesis.—Colic in the back, at the commencement of the
menses, with  abdominal cramps and throbbing headache;
scanty flow, with nose-bleed, and distress.
  Magnesia carbonica.—Delaying menses, with sore throat,
canine hunger, pains in the stomach, nausea before the men-
ses, which flow only at night.
  Natrum muriaticum.—Menses  too late and scanty, with
rush of blood  to  the head; melancholy, anxiety, headache,
qualmishness, blood-spitting, before the menses.
  Phosphorus.—Leucorrhoea, frequent  urging to urinate,
weeping, before the menses; shivering, weariness, fever, sting-
ing headache, and spitting of blood, during  the menses ;  suit-
able to persons with delicate constitutions  and inclining  to
pulmonary diseases.
  Pulsatilla.—Menses at times delaying, at others prema-
ture, with black blood mixed with mucous, or pale  and serous
blood; nausea and vomiting, shivering, pale face, stitching
colic  extending  to the parts;  semi-lateral headache,  with
drawing pains extending to the face, ears and teeth ; tendency
to diarrhoea, leucorrhoea.
  Sepia.—Delaying menses, with fainting turn, violent colic,
shuddering all over, burning in the vulva,  soreness and swel-
ling of the parts, leucorrhoea and pressure  in the abdomen,
before  the menses ;  uterine cramps  and rheumatic pains in
the limbs  during the menses; yellow border across the  nose
and cheeks.
  Silicea.—Delaying menses,  with  diarrhoea,  or  painful
pressure above the  eyes, before  the menses; scanty menses ;
strong  smell of the menstrual blood.
  Sulphur.—When the other remedies fail, with headache
before, during and after the menses;  loss of  flesh; heat  in
the head; weakness  after eating.
  For  further details, see Sections 5-10.
  Dose.—The same  as has been indicated at the end of Sec-
tion 17. 
      menstrual irregularities and alterations.   73

                       Section 20.

   The menses are too scanty.—Principal remedies :
   1.  Ammonium,  Conium,  Dulcamara,  Graphites,  Kali,
Lachesis, Pulsatilla, Sepia, Sulphur.
   2. Baryta,  Cocculus, Magnesia carbon., Natrum muriati-
cum, Phosphorus.
   3. Aconitum, Alumina, Causticum,  Cuprum, Lycopodium
Magnes arcticus,  Mercurius,  Ruta, Sabadilla, Sarsaparilla,
Sepia, Silicea. Staphysagria.
   With the following  particular  indications:
  Ammonium.—Menses too short, with pressure on the parts,
backache, cramp-colic, toothache, violent pains in the  sides,
pale face, coryza and  shivering.
   Conium.—Scanty  and  premature  menses, preceded by
painful  sensitiveness  of the  breasts.   During the menses:
painful abdominal cramps, bearing down on  the parts, and
pulling in the thighs.
   Dulcamara.—The  menses are too short and scanty, with
pale and serous blood; tetter  at the vulva.
   Graphites.—Pale  blood, with violent  headache, nausea in
the morning, labor-pains, painfulness of the varices, rheumatic
pains in  the limbs, uterine spasms, pains in the chest, weak-
ness, the ulcers are worse.
   Kali Carbonicum.—Short and scanty menses, with drop-
sical symptoms, pale blood, soreness of the parts, abdominal
colic, nausea, flatulence, etc.
   Lachesis.—Short and  scanty menses, especially after the
ineffectual use of  Sepia, toothache which is worse in  propor-
tion as the menses flow scantily,  colic, leucorrhoea, cramps  in
the bowels.
   Pulsatilla.—Delaying and short menses, gastralgic pains,
black and thick blood, or  else pale and watery, flowing only
at times;  shivering, pale  face, sadness, melancholy, weeping
mood; burning cramps in the bowels, leucorrhoea.
   Sepia.—Scanty  and delaying  menses, with  toothache,
swelling  of the cheeks, fainting  weakness,  blur  before the 
74
diseases of  females.
eyes;  lameness, rheumatic pains, abdominal  cramps, with
pressure on the parts.
  Sulphur.—When the other remedies fail, and  the follow-
ing symptoms occur: Pale blood, drowsiness in the day-time,
abdominal cramps, convulsions, pains in the sides and bowels,
itching of the parts.
  For further details, see Sections 5-10, and Amenorrhoea.
  Dose__The same as at the close of Section 17.

                       Section 21.
  Menses which are too short__Principal remedies:
  1. Ammonium,  Baryta,  Conium, Dulcamara,  Graphites,
Lachesis, Pulsatilla, Sulphur.
  2. Alumina,  Cuprum, Magnesia carbonica, Mercurius, Na-
trum muriaticum, Platina, Ruta, Sabadilla.
  3. Bryonia, Bovista,  Carbo animalis, Colchicum, lodium,
Ipecacuanha, Kali,  Lycopodium, Magnes arcticus,  Maejnesia
muriatica, Manganum, Moschus, Nux  vomica, Rhodendron,
Sarsaparilla, Silicea.
  With the following particular indications :
  Ammonium—Menses too scanty and too pale, with colic,
toothache and pains in the sides.
  Baryta—Menses too short and too  scanty, with leucor-
rhoea, swelling of the gums and toothache.
  Conium.—Scanty menses and short, with painful pulling
from the back to the sacrum; painful uterine spasms.
  Dulcamara.—Menses short and  delaying, with pale and
watery blood; scanty menses.
  Graphites.—Menses short and scanty, with  pale blood,
pains in the sides,  shivering, colic and diarrhoea  after  the
menses.
 ^ Lachesis—Short and scanty menses, with distress, espe-
cially at the critical age;  abdominal cramps,  during  the
menses.
  Pulsatilla.—Menses short, scanty and delaying, with thick
and black, or else pale and serous blood, leucorrhoea, shiver-
ing, pale face and weeping mood. 
      menstrual irregularities  and  alterations.    75

   Sulphur—Menses too short, pale and scanty, with head-
 ache, itching at the vulva, colic, corrosive leucorrhoea.
   For further details see Sections 5-10.
   Dose.—The same as at the close  of Section 17.


                        Section 22.

   Morbid Changes in the Menstrual Blood.—The  nor-
 mal menstrual  blood is  red, liquid, a little sticky, almost
 resembling arterial blood ; according to some authors, it should
 not coagulate, whereas others look upon  the presence of co-
 agula in the menstrual fluid as something quite natural.   As
 a general rule the menstrual blood, as regards color, quantity,
 intensity of the flow, differs  a good  deal  from one period  to
 the other.  It  is successively  very red,  less red, pale  like
 water, black, thick, viscous or fluid.   Sometimes those changes
 can be traced to distinct causes, such as a keen disappoint-
 ment, after which the flow becomes either more scanty or more
 copious, or  the  color of the blood changes; in spasmodic
 affections the blood is paler; in scrofulous persons it is scanty,
 paler, less consistent, or  else thick and black.  Among chlo-
 rotic  individuals it  is almost always  watery, pale, causing
 scarcely a yellow stain.  In syphilitic affections it is like-
 wise very often discolored and  pale.  In  eruptive, scorbutic,
 typhoid affections, the blood is sometimes  blackish and fetid.
 If the blood is retained in the uterus for some time, it becomes
 black, thin, inodorous.  In cancerous or  herpetic affections,
 the menstrual blood has been known  to  possess deleterious
 characters, and to communicate  by intercourse non-syphilitic
 discharges from  the urethra.  But in most cases it is impos-
sible to account for the changes which take place in the men-
strual blood. t Hence these  changes  seem of very little avail
in  establishing a general  dignosis; but they help to point out
the remedy which is  most adapted to some peculiar menstrual
irregularity.   Here follow the various therapeutic indications
which we are enabled to offer in  reference  to this subject: 
76
diseases of females.
Blood acrid, burning, excoriating, smarting:—1. Kali, Silicea.
       2. Bovista, Graphites, Sarsaparilla, Sepia.
       3. Ammonium, Arsenicum, Cantharis, Nitrum.
       4. Baryta,  Carbo veget, Hepar, Rhus, Sulphur, Sul-
        phuris acidum, Zincum.
     Black, dark:—1.  Chamomilla,  Crocus,  Nux  vomica,
         Pulsatilla.
       2.  Ammonium,  Antimonium,  Kreosotum,  Lachesis^
         Magnesia carbon., Nitri acidum, Sepia.
       3. Aurum, Belladonna, Bryonia, China, Sulphuris.
       4. Arnica,  Cantharis, Cuprum, Ignatia, Lycopodium,
       Nux moschata, Phosphorus acidum, Platina, Selenium,
         Stramonium.
       5. Aconite,  Carbo veget,  Cocculus, Conium, Digitalis,
         Drosera, Ferrum, Graphites, Ledum, Magnesia mu-
         riatica, Nitrum, Phosphorus, Secale.

     Coagulated :—1.  Chamomilla, Platina, Rhus.
       2.  Belladonna, China, Ferrum, Hyoscyamus, Ignatia,
         Ipecacuanha, Pulsatilla, Sabina, Stramonium.
       3. Arnica,  Cantharis,  Causticum,   Crocus, Magnesia
         muriat., Mercurius, Nitrum, Nitri acidum, Phosphori
         acidum, Strontiana.
       4.  Bryonia, Carbo animalis, Kreosotum, Nux vomica,
         Secale, Sepjia.

     Fetid :—1. Belladonna, Bryonia.
       2.   Carlo animalis, Chamomilla, Crocus, Sabina.
       3.  Ignatia, Silicia, Sulphur.
       4.  Arsenicum, Carbo veget, Causticum,  China, Kali,
         Mercurius, Phosphorus, Platina, Secale.

     Pale, watery:—1. Belladonna, Dulcamara,  Ilyoscya-
         mus, Sabina.
       2.   Carbo veget, Graphites, Pulsatilla, Sulphur.
       3.  Arnica, Calcarea, Ferrum, Ledum, Magnesaustralis,
         Phosphorus, Rhus, Secale. 
   menstrual irregularities  and  alterations.   77

     4.  Antimonium, Bryonia, Drosera, Ipecacuanha, Lau-
       rocerasus,  Lycopodium,  Mercurius,  Nitrum,  Nitri
       acidum, Platina, Sabadilla, Strontiana, Zincum.
     5.  Ammonium, Arsenicum, Borax, Bovista,  Cantharis,
       Carbo animalis,  China, Digitalis, Kreosotum, Mag-
       nesia, Nux moschata, Sepia, Silicea,  Stramonium.
  Slimy:—1.  Cocculus.
     2. Pulsatilla, Sulphuric acidum.
  Lour :—Su Iphur.
  Thick:—1. Pulsatilla.
     2.  Crocus,  Cuprum, Platina.
     3. Arnica.
     4.  Carbo veget,  Nitrum, Nux moschata, Sulphur.
  Viscous :—1. Crocus.
     2.  Cuprum.
     3. Secale.
     4. Magnesia  Carbon., Magnesia muriatica.
For further details see Sections 5-10. 
DISEASES of  females.
ARTICLE  IV
                    AMENORRHEA.

                      Section 23.

  General Observations.—By amenorrhoea we understand,
in common with other authors, a menstrual suppression, which
may occur between  the periods of pregnancy  and nursing,
from the age  of pubescence  to the critical  age at a  later
period.  According  to the functions of the organs which pre-
side over the process of menstruation, a suppression may be
owing to two distinct circumstances, namely:
  1st. Deficient  exhalation  or secretion, in which case the
menstrual blood is not furnished or secreted by the  exhalants.
  2d.  Deficient excretion, in which case  the  blood is indeed
regularly secreted, but its discharge  from the womb  is pre-
vented by some cause or other.
  Either of these cases may occur from the period when the
first menses were to appear; or else it may only occur as  an
accidental derangement in females who had already menstru-
ated.  With reference to these conditions we distinguish:
  1. Primitive amenorrhoea, also termed menstrual retention
or anaemia, such as  occurs in young girls at the age of pube-
scence and afterwards.
  2. Secondary  amenorrhoea, or  menstrual  suppression, as
may set in suddenly in consequence of some accident or mor-
bid cause, or else developing itself gradually, and causing a
more  or less complete suspension of the menstrual  flow in
females  who had already menstruated.
  But howsoever distinct these various conditions may be in a
physiological aspect, pathologically and symptomatically they 
amenorrhoea.                     79
are so nearly related to each other that  they cannot well be
treated separately without plunging into endless repetitions.
Whatever may be the nature of amenorrhoea in a given case,
and independently of its  primary or secondary origin, the
symptoms, so far from being the same in every case, may pre-
sent, on the  contrary, an endless variety, and the same symp-
toms may occur in one form as well as in another.
   This shows that the symptoms ought to be presented  inde-
pendently of the various  forms of amenorrhoea where  they
occur, so much more as these symptoms may be classed under
two distinct categories, namely : such as denote inflammation,
and such as  denote weakness ;  upon which distinction several
authors have founded the division of amenorrhoea in
   a, Sthenic amenorrhoea, with inflammatory symptoms; and
   b, Asthenic amenorrhoea, with  symptoms  of debility or
ansemia.
   We will treat of these various forms in the following order :
   1st.  Of the symptoms of amenorrhoea generally.
   2nd. Of the causes of amenorrhoea.
   3rd. Course and complications.
   4th. Diagnosis and prognosis.
   5th. Treatment of the  various forms of amenorrhoea.

                      Section 24.

   Symptoms of Amenorrhea.—What strikes us most in the
condition of females attacked with amenorrhoea, is the sthenic,
asthenic  or purely local character of the symptoms, denoting
either general hypersemia or ansemia, or a local engorgement;
so far  as a  rational treatment of  amenorrhoea is concerned,
these differences are of the utmost importance.  Sthenic or
inflammatory amenorrhoea, which is peculiar to sanguineous
constitutions, attacks more particularly young girls of a rose-
colored and  warm skin, with tendency  to perspire, swelling of
the sub-cutaneous veins,  etc.   The most  frequent  uterine
symptoms in such  cases  are:  distress in  the  hypogastrium
and the umbilical region, extending sometimes to the sides
and at other times to the vagina and thighs, and consisting 
80
diseases of females.
either of a simple  heaviness or of  violent, cutting or boring
colic, with  uterine cutting pains,  swelling of the abdomen,
tumefaction of the labia  majora and  minora, heat  in  the
vagina,  with discharge  of mucus; loss of appetite, nausea,
eructations, vomiting, constipation, dysuria, swelling of the
breasts, with or without secretion of  milk, dyspnoea, palpita-
tion, febrile movements, general lassitude, pain in the limbs
or joints, redness of the face,  congested  state of the eyes,
headache, vertigo, buzzing in the ears,  drowsiness, or sleep
disturbed by dreams; pains in the stomach, diarrhoea, faint-
ing turns, neuralgic pains in  the breasts or thighs, etc.   In
primary amenorrhoea, the symptoms of abdominal congestion
generally disappear,  one after  another, in  a few  days, and
return again with increased  intensity  at the next  period ;
whereas, in secondary amenorrhoea, when the menses are sup-
pressed  by  some sudden cause,  a real metritis may develope
itself, together with many other symptoms, such as—general
anasarca, partial  dropsy, mental  derangement,  hysteria,
paralysis, epilepsy, convulsions, tonic spasms, aphonia, loss of
memory, etc.  In asthenic amenorrhoea, which most generally
occurs in lymphatic young girls, that have not yet menstru-
ated, the symptoms of uterine congestion are almost wanting  ;
but there occur, on the other hand, a  good many symptoms of
constitutional derangement, such as discoloration of the skin,
flabby and  bloated flesh, dull and  languid look, headache in
the back part of the head, buzzing in the ears, small and fre-
quent pulse, lassitude, aversion  to  exercise, taste  for strange
things to eat,  nausea,  vomiting,  chlorotic symptoms.   In
amenorrhoea caused by obstructions in  the passage from  the
uterus and  through  the vagina, we have, besides the above-
mentioned  sympathetic  symptoms of  sthenic  amenorrhoea,
which may all be present again, several local symptoms, such
as  an enlargement, increasing from  below  upwards, and
extending from the pubes to the umbilicus; at each successive
period it grows larger and larger, so that it sometimes simu-
lates pregnancy, especially if the breasts swell at the same
time.  When the blood accumulates in  large quantity in  the 
 
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amenorrhea.
81
 uterus, it gradually compresses the rectum, bladder, the sacral
 plexus, the sciatic  nerves, impeding  stool and  the  urinary
 emission, and  causing  a tingling in  the  lower  extremities,
 pains in the groins, colic, uterine cramps, sensitiveness of the
 hypogastrium, and a variety of other  sympathetic symptoms,
 resembling those of sthenic amenorrhoea.

                        Section 25.

   Causes of  Amenorrhea.—We  have  stated above that
 menstrual suppression  may  arise,  first:  from  deficient se-
 cretion of blood in the womb; and secondly, from retention
 of  the secreted blood in the cavity  of the uterus,  or in the
 vagina.   In the former case, ^here the  menstrual blood is
 not secreted in sufficient quantity to be  expelled from the
 womb, the causes of this deficiency generally exist anteriorly
 to  the period  of pubescence,  and  are inherent  in the  con-
 stitution  of the girl.   These causes are:—first: a nervous
 constitution;   second, a  robust  or  plethoric constitution;
 third,  a  weakly or cachectic  constitution;  fourth,  a lym-
 phatic, flabby  constitution,  with white skin and  tendency
 to  grow  fleshy.   Among  the direct causes we  have to
 notice, atrophy of the uterus or ovark,  deficient develop-
 ment,  functional weakness, or entire absence of the  uterus.
 Primary amenorrhoea is sometimes owing to organic  affections
 and visceral lesions in other parts of  the body, such  as pul-
 monary phthisis, chlorosis, scrofula,  etc.  Hence we see that
 the causes which prevent the first appearance of the menses,
 in young  girls, are  generally of  a constitutional character,
 and predispose the person for such a difficulty.  This remark
 likewise,  applies to secondary or  accidental  amenorrhoea,
 which  develops itself gradually, slowly, or incompletely, for
 the same  causes which prevent the first menstrual flow in
young girls, afterwards operate to gradually arrest the menses
after they have made their appearance.   It  is different in
sudden menstrual suppressions; here occasional causes play
the chief part.   Among them we distinguish in the first place
low dwellings, badly lighted, cold, wet  and insalubrious; ex-
                            6 
82
diseases of females.
treme changes of temperature; the requirements of fashion
and gallantry, in consequence of which, dashing women some-
times expose themselves half covered to the air, and at other
times load themselves with unnecessary garments.  The im-
proper use of corsets, cold baths, washes, astringent injections,
stimulating food or insufficient nourishment, may likewise oc-
casion the suppression.  Changes of locality and occupation,
and  the functions to which females may have to attend, are
likewise exciting causes.
  A sedentary mode of life, like that of the seamstress, nun,
etc., or  excessive exercise, like that of dancers, singers, ser-
vants, etc., induce amenorrhoea as readily as a change from
the country to a large city, admission to an hospital, a board-
ing-school or convent, a fatiguing journey, standing  behind
the counter, or any other radical  change in the condition of
young  girls.   Complete abstemiousness or  sexual  excesses,
may likewise occasion amenorrhoea.  Exposure to cold air
when sweating, cold drinks or washes, ice-cream, loss of blood,
sudden  acute  diseases,  intense  pain, odors, considerable
changes in one's  mode  of life, fatigue, emetics,  purgatives,
abuse of drugs either in domestic practice or under treatment;
all  such causes may likewise induce menstrual suppression.
The same may be said of  sudden emotions, such as  anger,
sudden joy, fright, etc.  In some cases  amenorrhoea is only a
symptomatic and sympathetic condition, caused by some other
affection, such as pulmonary tubercles, chronic laryngitis, epi-
lepsy, chlorosis, carcinoma, arthritis,  diseases of the  womb,
ovaries, brain, heart, stomach, lungs, breasts, etc.  As regards
amenorrhoea from deficient excretion, it  is always produced by
mechanical difficulties which  prevent  the  free discharge of
blood, such as malformation of the parts, closing of the vulva,
obstruction of the mouth of the womb  by mucous secretions,
membranes across the vagina,  etc. 
amenorrhea.
83
                       Section 26.

  Course, Complications and Terminations.—Considered
in itself, amenorrhoea runs a continuous course, except that,
in the sthenic variety, when the suppression  took  place sud-
denly, there occurs about the  period when the menses ought
to appear, an aggravation of all the general and local symp-
toms.  As regards the duration of amenorrhoea, it is exceed-
ingly variable ; accidental  amenorrhoea may  last but a very
short time, whereas primary amenorrhoea, and such as is de-
pending upon some other organic affections,  may run a very
long course.  As regards complications, we find almost every
form of disease mentioned by the various authors as resulting
from the gradual or sudden suppression of  the menses.  Such
are  pulmonary phthisis,  asthma,  chlorosis, heart-disease,
cancer, pains in the stomach, dyspepsia,  piles, megrim, hys-
teria,  hypochondria, various  moral and  mental  affections,
chorea, convulsions, nervous diseases, lesions of the  lymphatic
system, phlegmasia}, disorganizations, rheumatisms,  gout, vari-
ous eruptions and ulcerations, herpes, styes, erysipelas, cuta-
neous  diseases, ophthalmia, toothache, catarrhal discharges,
hsemorrhages from other organs.   However,  although many
of these diseases are undoubtedly caused by amenorrhoea, yet
it is well known at this day that they, on the  contrary, cause
the  suppression.   Such  are all  chronic  affections, such  as
phthisis, cancer, plethora, chlorosis,  anaemia, general weak-
ness, heart-disease, chronic rheumatism, gout, paralysis, etc.
But it is different as regards the mucous discharges, vicarious
haemorrhages, inflammatory congestions, leucorrhoea,  mucous
diarrhoea,  otorrhcoa, bronchial catarrh, blind  or fluent piles,
ophthalmia,  otitis, stomachitis, megrim and the other forms
of neuralgia or neurosis  that  develope themselves  as conse-
quences of sudden amenorrhoea.   These  symptoms  are real
complications of amenorrhoea, and disappear again  as soon  as
the discharge returns, whereas,  in all cases  where amenorrhoea
is a symptom of some other disease, the flow can only be re-
stored by removing the disease which causes the suppression. 
84
DISEASES  OF FEMALES.
                       Section 27.

  Diagnosis and prognosis.—The existence of amenorrhoea
is known by the evidence of the fact; but what we have par-
ticularly to ascertain is, whether the suppression arises from
the retention of  the menstrual  blood, or from deficient secre-
tion of this fluid in the womb.   Retention often simulates
pregnancy; but when the menses have been suppressed for
several months, the absence  of  the uterine souffle,  and of the
beating of the foetal heart, will enable us to establish a correct
diagnosis.  It is likewise easy to know whether amenorrhoea
is caused by an imperforate hymen, a simple inspection of the
vulva being sufficient to convince ourselves of this fact.   If
the obstacle to the discharge of  the menstrual blood is situated
higher up in the vagina, we  have to institute a fuller explo-
ration of the parts, which is  unfortunately not always practi-
cable ; the touch through the rectum, or the introduction of a
probe  into the vagina,  are  sometimes sufficient to obtain a
good diagnosis.   If no mechanical difficulty  whatever opposes
the passage of the blood from  the womb,  the amenorrhoea is
evidently caused by deficient secretion, in  which case we have
to determine whether the disorder arises from a simple delay,
or from constitutional weakness, or from some  other peculiar
irregularity or morbid condition.  In diagnosing this difficulty,
the physician may be guided by the age of the patient, influ-
ences of climate, her mode of life, poverty  or wealth, educa-
tion, etc.  In Paris, the first menses generally appear at the
age of fourteen ; in the country they generally appear later;
in  capitals  and  manufacturing towns at an earlier period.
Young girls who are exposed to misery and starvation, men-
struate later than those of the middle  classes; the young
ladies of wealth and fashion menstruate soonest.   This  shows
that, without a careful examination of all the  surrounding
circumstances, we may mistake a natural delay for an actual
suppression.  At the critical period a most natural cessation
 of the menstrual flow  may likewise be mistaken for amenor-
rhcea.   If there is reason to apprehend the  existence  of preg- 
AMENORRHEA.
85
 nancy, we had  better, in case of doubt, wait some months
 before we make up any  diagnosis, until the beating of the
 foetal heart can be heard.  Lastly, in order to decide whether
 amenorrhoea is  symptomatic or idiopathic,—-in  other  words,
 whether it is caused  by, or results from the concomitant affec-
 tions, it will be sufficient,  in  most cases,  to ascertain whether
 the suppression has preceded or followed the alteration of the
 general health,  or whether in case of primary  amenorrhoea,
 the young girl is suffering from one of those affections which
 generally induce absence of the menstrual secretion, such as:
 chlorosis, phthisis,  scrofula, diseases of  the uterus, etc.   As
 regards prognosis, it differs a good deal, and depends entirely
 upon the causes of the irregularity.  As a general rule sthenic
 amenorrhoea yields  more speedily to  remedial agents than
 asthenic  amenorrhoea, and a  sudden  suppression is often
 removed very easily.   A mechanical retention of the  menses
 is not at all dangerous when caused by an  imperforate hymen ;
 but if such  a retention should be caused by adhesion of the
 parietes of the vagina  or uterus, it may lead to fatal results.

                       Section 28.

   Treatment,  principal remedies:—It is  of  particular
 importance,  in  the  treatment of amenorrhoea,  to ascertain
 whether the  absence of the menstrual  discharge is owino- to
 constitutional or accidental causes, in other words, whether it
 is an idiopathic or sypmtomatic condition.   In the latter case,
 it becomes absolutely necessary to treat the disease of which
 amenorrhoea is a symptom.   In the present instance we shall,
 therefore,  treat  only of  idiopathic amenorrhoea, especially
 when caused  by some  accidental circumstance; as regards
primary absence  of the menstrual flow,  it will  be treated
 of in detail in the next  article, under the  head of amcenia of
young girls.   However  we  shall here give  all  the phenomenal
indications which  may  possibly occur  in  amenorrhoea; and
likewise in order  to  meet those cases  where the  diagnosis
might be more or less doubtful.   The principal  remedies for
amenorrhoea  are: 
86
DISEASES OF FEMALES.
  1. Conium,  Dulcamara,   Graphites,  Kali,  Lycopodium,
Pulsatilla, Sepia, Silicea, Sulphur.
  2. Aconitum, Ammonium, Baryta, Bryonia, Calcarea, Caus-
ticum,  Chamomilla,  Cocculus,  Cuprum,  Ferrum,   Natrum
muriaticum, Phosphorus, Sabadilla, Valeriana.
  3. Alumina, Arsenicum, Belladonna, Borax, China, lodium,
Mercurius, Natrum, Nux moschata, Opium, Platina, Sabina,
Staphysagria, Veratrum, Zincum.
  4. Agnus,  Arnica,  Aurum,  Carbo animalis,  Carbo  veget,
Colchicum, Colocynthis, Crocus, Digitalis, Drosera, Euphrasia,
Guajacum, Ilelleborus, Hyoscyamus, Ignatia, Lachesis, Mag-
nesia carbon.,  Magnesia muriat,  Manganum, Nitri acidum,
Petroleum, Phosphoric acidum, Rhododendron, Rhus,  Ruta,
Sarsaparilla, Secale, Stramonium, Strontiana.
  With the following  particular indications:
  Conium.—Chlorotic symptoms and hysteria;  the breasts
are flabby and shrivelled, or else hard and painful; nervous
prostration, weakness with  involuntary  laughing and weep-
ing ; exhaustion after the shortest walk ; anxiety and sadness ;
abdominal and uterine cramps, with distention of the bowels, and
lancinating pains; hardness of the neck of the uterus; stinging
in  the parts ;  itching of the vulva; leucorrhoea with uterine
cramps or colic; painful pimples at the pubes; abstemiousness.
   Dulcamara.—Suppression in consequence of a cold, or in
females affected with  tetter at the parts or on other parts of
skin;  the breasts are engorged and  hard; scrofulous consti-
tution, with  glandular engorgements; warts on the hands;
 disposition to cold in  the head and other  mucous discharges;
 tendency to urticaria ; frequent sore throat.
   Graphites.—Occasional show of the menses, but they are
 too pale  and  short,  with  abdominal  cutting  pains, uterine
 cramps,   hysteric spasms,  rheumatic  pains in  the  limbs;
 oedema  of  the  feet  and  hands;  tetter or  erysipelatous
 affections; hysteric headache;  nausea;  pains in  the chest;
 weakness ; leucorrhoea, sterility, piles, chlorosis.
    Kali carbonicum.—One of our best remedies, for primary
 or  secondary a nenorrhoea, especially  when the  following 
AMENORRHEA.
87
symptoms are present; dyspnoea, palpitation of the heart;
frequent erysipelatous eruptions ;  alternate paleness and red-
ness of the face; febrile heat, with thirst and restless sleep;
abdominal  cramps, with sour  eructations; swelling  of  the
cheek, with stinging and swelling of the gums;  leucorrhoea;
smarting redness and soreness of the parts and  between  the
thighs ;  irritation  of the vagina  during  coit;  disposition to
pulmonary phthisis ; organic disease  of the heart.
   Lycopodium.—Chlorotic  symptoms,  sadness,  weeping ;
hysteric headache ; sour mouth and vomiting ; swelling of the
feet;  headache with pain  in  the sides  and colic; frequent
fainting turns ; leucorrhoea; swelling and pressure in the pit
of the stomach ; drawing and tensive pains in the abdomen ;
the menses  are  suppressed by  the  least fright;  frequent
shivering; milky  leucorrhoea;  burning in the vagina during
an embrace;  bearing-down on the  groin;  dryness of the
vagina ; passage of wind from the vagina.
   Pulsatilla.—One of our best remedies for amenorrhoea,
when  caused by exposure to dampness and cold, or by getting
the feet wet, with  the following symptoms; semilateral head-
ache,  with stitches  through the face and teeth ; pale complex-
ion ; vertigo with buzzing in the ears ; stinging and wandering
toothache; frequent cold in the head;  dyspnoea and oppres-
sion after the least emotion; palpitation of the  heart;  cold-
ness of  the hands  and  feet;  mucous  diarrhoea; leucorrhoea;
stomach ache, with nausea  and vomiting; continual shudder-
ing with yawning and stretching ;  swelling of the feet; gentle
disposition,  with tendency to sadness ; freckles in the face.
   Sepia.—Almost as important a remedy for amenorrhoea as
Pulsatilla, especially when  accompanied  by leucorrhoea or by
the following symptoms; hysteric headache or  megrim, fre-
quently ;  toothache, with sensitiveness of the nerves; delicate
constitution ; delicate, white and tender  skin ; pale complex-
ion, or  yellowish  spots  in  the  face;  nervous weakness, with
disposition to perspire;  alternate shuddering and heat; melan-
choly, sad mood, weeping; frequent cold in the head ; lameness
and soreness of the limbs; frequent colic and pain in the sides. 
88
DISEASES  OF FEMALES.
   Silicea.—Melancholy, anguish in the  epigastrium,  with
 thought of suicide;  soreness and  redness of the parts;  blur
 before the eyes, diarrhoea; weak chest,  with pthisicky dispo-
 sition, pressive  headache above the  eyes;  constipation,  hard
 stool; smarting, acrid, corrosive leucorrhoea, with abdominal
 colic and cutting pains;  itching of the  vulva.
   Sulphur.—Pressive  and  tensive headache, especially  at
 the  occiput; congestion of  the  head,  with  throbbing  and
 buzzing in the brain ; pale and sickly face, with red spots on
 the cheeks and rings around the eyes; excessive appetite,  with
 loss  of flesh; pressure, fulness and  weight in the stomach,
 hypochondria and abdomen ;  piles  ; mucous diarrhoea, or else
 constipation, with  ineffectual  urging to stool;  leucorrhoea,
 with itching of  the parts; hysteria and chlorotic symptoms ;
 dyspnoea; tendency to take  cold; weariness  after talking;
 irascible mood,  or sad and weeping disposition.
  Dose.—Give from four to six globules dry on  the tongue,
 or one or two drops of the attenuated tincture on sugar, or in
 a spoonful of water, the morning after the day when  the
 menses should have  made  their appearance, and repeat  this
 dose every week until the flow sets in.  In acute cases of
 sudden suppression, one or two drops of the attenuated remedy
may be mixed  in ten table-spoonfuls of water, and a table-
spoonful of this solution may be given every five or six hours,
until the discharge returns.   If it  does not return in a day or
two,  discontinue  the medicine, and  resume it again a few days
before  the next  period.

                      Section 29.
   Other Remedies.—To  the above-mentioned remedies,
which will be found sufficient  in most cases, we will subjoin  a
few more, which will  likewise be found indicated by the symp-
 toms in some cases:
  Aconitum.—Frequent congestion of the head or chest,
with stitching or throbbing pains,  and beating of the heart;
pressive headache;  red face; pulse full  and hard; frequent
 attacks of heat, with  thirst; irascible  mood; fainting  and 
AMENORRHEA.
89
 vertigo on raising  one's  head in a recumbent posture; the
 symptoms are aggravated by motion and heat,  eased by cold.
 Is particularly suitable to plethoric young girls  of a sanguine
 temperament, and leading a sedentary life.
    Ammonium carbonicum— Pains  in the sides, toothache
 and  shivering;  pale face, frequent  coryza,  violent tearing
 colic;  cutting colic, with pressure on the parts ;  profuse, acrid
 and corrosive leucorrhoea ;  soreness of the parts and between
 the thighs ; scrofulous symptoms, impetiginous eruptions, with
 swelling of the glands and earache;  scorbutic symptoms.
    Baryta.—Toothache, with  swelling of  the  gums;  colic,
 with heaviness of the limbs; scrofulous symptoms;  retarded
 development  and growth, in young girls; weakness, leucor-
 rhoea, pains in the breasts.
   Bryonia.—Vascular excitement, frequent congestion of the
 head or chest,  with nose-bleed and dry cough; frequent cold-
 ness and shuddering, sometimes alternating with dry heat;
 constipation ;  pressive gastralgia or colic.
   Calcarea.—Frequent  congestion  of  the head, with ver-
 tigo;  burning pains  in the forehead,  or pulsative headache;
 buzzing in the ears; painful pressure in the hypochondria,
 even the pressure of the clothes is unpleasant to bear;  colic
 and cutting in  the bowels, down  to the thighs,  especially at
 the time when the menses  should appear;  fatigue and heavi-
 ness in  the whole body, especially the legs.
   Causticum.—In cases where Ammonium seems indicated,
 but has no effect; hysteric  symptoms, cutting colic; uterine
 cramps; yellowish complexion ; gloomy melancholy, vertigo ;
 backache;  stinging in the breasts; profuse leucorrhoea, with
 colic; soreness of the parts; aversion to intercourse.
   Chamomilla.—Suppression in consequence of suppressed
sweat;  cramp-colic,  peevish mood, quarrelsome,  irascible;
yellowish  complexion,  redness of one  cheek and paleness of
the other;  cramps in the stomach, with dyspnoea and wind ;
diarrhoea, with colic and cutting pains;  fainting  turns;  nau-
sea, desire to vomit, with yellowish tongue and bitter mouth;
distress  in the sides. 
90
DISEA3ES OF  FEMALES.
  Cocculus.—Leucorrhoea  in the place of the menses, with
abdominal cramps, hysteric  symptoms, pressure on the chest,
oppression, uneasiness and anguish, with sadness and frequent
sicrhs:  weakness, so that she is almost unable to speak; ner-
vous symptoms;  discharge of a few drops of black blood.
  Cuprum.—Congestion of  the  head; feverish  headache  on
the top of the head; redness of the face and eyes, or else full
face with rings around the eyes;  frequent nausea and vomit-
ing; abdominal cramps; convulsions  and cries; palpitation of
the heart and cramps in the chest.
  Ferrum.—Weariness and weakness with trembling, loss of
flesh and desire to remain seated or lying;  congestion of the
head, with pulsative headache; buzzing  and pricking in the
brain;  pale and leaden face, with margins around the eyes, or
red face and eyes; pressure in  the shoulder and head ;  oede-
matous swelling of the face, hands and feet; lassitude in the
legs and other  chlorotic symptoms.
  Natrum muriaticum__Chlorotic, phthisicky, or scrofulous
symptoms ; pimples and itching at the vulva; falling off of the
hair; congestion  of the head, headache; irascible mood; un-
easiness and melancholy; stinging and tearing in the teeth;
cramp-colic; blood-spitting; nocturnal fever with thirst and
sleeplessness; aversion to intercourse ; leucorrhoea.
  Phosphorus.—Suppression in young persons who generally
menstruate pretty copiously, with leucorrhoea ; frequent desire
to urinate; weeping mood;  toothache; abdominal colic; vio-
lent backache; spitting of blood; lameness of the limbs ; con-
gestion of the chest and head; vicarious hemorrhage from
the anus, urethra or other organs.
   Sabadilla.—Sometimes  useful in cases where Pulsatilla,
Sepia or  Sulphur  seem indicated, but  do not produce any
effect.
  Valeriana.—Suitable to nervous or hysteric females who
have drank much chamomile-tea.
   Dose.—The same as at the close of Section 28. 
AMENORRHEA.
91
                       Section 30.

  Remedies that are  rarely indicated.—If none of the
previously-named remedies suffice, we may have recourse to
the following:
  Alumina, if Calcarea seems indicated, but remains ineffec-
tual ;  restless  sleep, with dreams  and headache, heat in the
face, palpitation of the heart on waking; leucorrhoea with
weakness; uterine cramps.
  Arsenicum.—Prostration ; pale face with margins around
the eyes; desire for acids, coffee, b'andy; sexual excitement;
corrosive leucorrhoea; fainting turns.
  Belladonna, suitable to plethoric girls, with congestion of
the head and chest; throbbing headache;  heat in  the head;
red and bloated face; numbness  of the legs when sitting;
anguish about the heart; burning thirst; cramp-pains in the
sides and back.
  Borax.—Suppression in females who generally menstruate
sufficiently; weight  on  the chest, dyspnoea, buzzing in the
ears, throbbing in the head, etc.
   China.—Pale face, rings around the eyes, pressive head-
ache at night;  pressure at the stomach  after eating;  dys-
pepsia ; loss of flesh; weakness;  restless sleep, with anxious
and fatiguing dreams ;  abdominal  and pulmonary spasms;
nymphomania ; nervousness.
  Iodium.—Frequent  palpitation of the heart;  pale  face,
alternating sometimes with redness; out of breath on going
up  stairs; weariness in the legs, chlorotic symptoms.
   Mercurius.—Congestion of the  head,  with dry heat and
vascular excitement; leucorrhoea; oedematous swelling of the
hands, feet and face; pale face ;  sickly look; weakness and
trembling after the least  work; sad  or  peevish; contrary
mood.
   Natrum  carbonicum.—Frequent  headache; hysteric  or
 chlorotic  symptoms; disposition to  sadness, with apathy;
 physical and  mental weakness, with heaviness in  the limbs,
 aversion to motion; irascible mood. 
92
diseases of females.
   Nux moschata.—Suppression, with spasms and other hys-
 teric  symptoms, tending to sleep  and fainting; prostration
 after  the least effort; mucus on the stomach; fitful mood.
   Opium.—Suppression with congestion of the head which
 feels  heavy; red and hot face; drowsiness; convulsive twitch-
 ings.
   Platina.—Sudden suppressions in females who  are  ordi-
 narily regular, with spasmodic colic; constipation ; hard stool;
 anguish ; uneasiness ; weeping.
   Sabina.—Sudden  suppression, followed  by  a  thick  and
 fetid leucorrhoea.
   Staphysagria.—Sensitiveness of the parts,  with cramp-
 pains; itching  of  the  parts; blotches and  vesicles at the
 labia.
   Veratrum.—Amenorrhoea,  with  nervous  headache  and
 hysteric  ailments; pale,  leaden  face, frequent nausea  with
 vomiting and cold hands,  feet and nose; weakness, fainting
 turns, sexual excitement.
   For further  information and  details, see Sections 5-10,
 and the following:
   Dose.—The same as  at the close of Section 28.

                      Section 31.

   Particular  Indications.—We here subjoin a few parti-
cular  indications regarding the different forms of Amenorhoea,
and the ailments which sometimes accompany the  cessation
of the menstrual flow.

      a. FOR THE DIFFERENT SPECIES  OF AMENORRHEA.

Amenorrhea,  primary, from the  period of pubescence :—
      1. Pulsatilla, Sulphur.
      2. Causticum,  Graphites, Kali
      3. Conium, Ferrum, Magnesia carbon,, Natrum muriat.
       • Petroleum, Sabina, Sepia.
      4. Agnus, Ammonium,  Chelidon., Cocculus, Digitalis,
         Dulcamara, Silicea, Veratrum. 
AMENORRHEA.
93
       5. Aconite, Aurum, Bryonia, Calcarea, Cicuta, Crocus,
          Cuprum, Drosera, Guajacum, Hyoscyamus, Lachesis,
         Magnesia muriat, Mercurius, Phosphorus, Sabadilla,
         Sarsaparilla,  Spigelia,  Staphysagria, Stramonium,
         Strontiana, Veratrum, Zincum.
     From excessive vitality, with sthenic or inflammatory
       character:—1. Aconite, Belladonna,Bryonia, Calcarea,
         Nux vomica,  Opium, Platina, Sabina, Sulphur.
       2.  Chamomilla, Ipecacuanha, Crocus, Mercurius, Na-
         trum muriaticum, Phosphorus.
     From constitutional weakness, with asthenic charac-
       ter:—!. Arsenicum, China, Conium, Graphites, lodium,
         Natrum, Pulsatilla, Sepia, Sulphur.
       2. Ammonium,  Baryta,  Calcarea,  Cocculus, Dulca-
         mara, Ferrum, Kali, Magnesia carbon.
       3. Alumina,  Causticum,  Cuprum, Lycopodium, Mer-
         curius, Sabadilla, Silicea, Staphysagria, Veratrum.
Amenorrhea Symptomatic.
    With cerebral  symptoms :—Ammonium, Belladonna,
        Bryonia, Causticum, Cuprum, Mercurius, Nux vomica,
         Opium, Sepia, Sulphur,  Zincum.
    Chlorosis :—1. Belladonna,  Calcarea, Cocculus,  Ferrum,
        Lycopodium,  Nitri acidum,  Platina, Pulsatilla,
        Sulphur.
      2. China,  Conium,  Helleborus,  Kali,  Nux vomica,
        Phosphorus, Plumbum, Sepia, Spigelia.
      3. Arsenicum, Digitalis, Graphites, Mercurius, Phos-
        phoricum acidum, Staphysagria, Valeriana.
      4. Baryta, Carbo animalis, Carbo vegetabilis, Causticum,
        Ignatia,   Oleander,   Sabina,   Sulphuris   acidum,
        Zincum.
    With  heart affections:—1. Calcarea, Kali,  Natrum
        muriaticum,  Pulsatilla, Spigelia, Sulp>hur.
      2. Aconitum, Arsenicum, Aurum, lodium, Lycopodium,
        Phosphorus,  Sepia, Veratrum, Zincum. 
94                DISEASES OF  FEMALES.
    3.  Belladonna,  Carbo vegetabilis, Causticum,  Chamo-
       milla, Cliinn,  Cuprum,  Graphites,  Mercurius, Na-
       trum, Nitri acidum, Nux  moschata, Nux  vomica,
      Platina,  Sabina, Secale, Sulphuris acidum.
With epilepsy :—1. Belladonna, Calcarea,  Cuprum, Hyos-
       cyamus,  Sulphur.
    2.  Arsenicum Chamomilla,   Cocculus, Kali, Lachesis,
       Lycopodium  Natrum  muriaticum,  Nitri  acidum,
      Nux vomica, Sepia, Silicea.
    3.  Conium, Magnesia carbonica, Opium, Platina, Rhus,
       Secale, Stramonium.
  With GASTRIC affections :—1.  Arsenicum, Bryonia, Cal-
       carea, Nux vomica, Pliosphorus, Pulsatilla, Sulpjhur,
       Veratrum.
    2.  Aconitum,  China,  Cocculus, Kali,  Lycopodium,
      Natrum muriaticum, Rhus,  Sepia, Silicea.
    3.  Alumina,  Barj/ta, Belladonna,  Carbo  vegetabilis,
       Chamomilla, Conium,  Cuprum, Ferrum, Graphites,
      Hyoscyamus, lodium, Mercurius, Platina, Plumbum,
      Sabadilla,  Sabina,  Secale,  Staphysagria, Sulphuris
      acidum,  Valeriana, Zincum.
  With  gout,   symptoms of:—1.  Belladonna, Bryonia,
      Kali, Mrcurius, Rhus, Sabina, Staphysagria.
    2. Agnus, Baryta,  Calcarea, Causticum, China, Coccu-
       lus, Ferrum, Graphites, Hyoscyamus, Natrum muria-
      ticum  Phosphorus,  Pulsatilla,   Sepia,  Sulphur,
      Zincum.
    3.  Alumina,  Carbo  vegetabilis,  Chamomilla,  Dulca-
      mara, lodium,  Lycopodium,  Nux moschata, Nux
      vomica, Sabadilla, Secale, Silicea.
  Chronic larynystis:—1.  lodium,  Nux  vomica, Phos-
     phorus, Pulsatilla.
    2. Aconitum, Belladonna,  Carbo vegetabilis,  Causticum,
       Chamomilla,  Lachesis, Rhus, Sabadilla, Sulphur,
      Vera tr u m, Zincum. 
AMENORRHEA.
95
   3. Alumina, Ammonium, Arsenicum, Calcarea,  China,
     Cocculus,  Conicwn,  Graphites, Hyoscyamus,  Kali,
     Magnesia muriatica, Mercurius, Natrum muriatioum,
     Phosphori acidum, Sabina, Sepia.

MAMMiE, affection of:—1.  Bryonia, Chamomilla, Conium,
     Phosphorus, Silicea.
  2. Arsenicum, Belladonna, Calcarea, Graphites, Pulsa-
     tilla, Sulphur.
   3. lodium,  Lycopodium,  Mercurius,  Nitri acidum,
    Rhus, Sabina, Sepia.
Uterus:—1. Belladonna,   Chamomilla,  Kali,  Platina,
     Pulsatilla, Sabina, Sepia.
   2. Carbo  animalis,   Conium,  Crocus,  Ferrum, Nux
     vomica, Opium,  Rhus, Secale, Sulphur.
   3. Calcarea,  China,  Cocculus,  Graphites, Hyoscyamus,
     Kreosotum, Magnesia muriatica, Natrum muriaticum.
Ovaria:—1.  Staphysagria.
  2. Carbo animalis, China, Lachesis, Lycopodium,'Secede,
     Sepia, Zincum.
  3. Aconitum,  Carbo  vegetabilis,  Graphites, Mercurius,
     Nitri acidum, Nux vomica, Sulphur, Thuja.
Pulmonary:—1.  Calcarea, China, Conium, Kali, Lycopo-
     dium, Phosphorus, Sepia,  Silicea.
  2. Ferrum, Kreosotum, Mercurius, Natrum,  Phosphoric
     acid, Rhus, Staphysagria,
   3. Arsenicum, Cocculus, Pulsatilla, Sabina, Sulphur.
Schirrous or cancerous of uterus,  or  breasts:—1.  Carbo
     animalis, Grapltites, Kreosotum.
   2. Arsenicum, Belladonna,  China, Cocculus, Conium,
     Dulcamara,  Mercurius,  Nitri acid,  Sepia, Silicea,
     Staphysagria,  Thuja.
Secondary:—1. Pulsatilla, Sepia, Sulphur.
   2. Aconitum, Bryonia, Conium, Dulcamara, Graphites,
     Kali, Lycopodium, Silicea. 
96               DISEASES OF FEMALES.

      3. Ammonium, Arsenicum, Baryta, Belladonna, Cal
        carta,   Chamomilla,   Cocculus,  Cuprum,  Ferrum,
        Natrum muriaticum, Phosphorus.
      4. Alumina, Bm-ax, Bovista,  China, Mercurius, Nux
        moschata, Opium, Platina,  Sabadilla, Sabina, Sta-
        physagria,   Stramonium,   Valeriana,   Veratrum,
        Zincum.
    By some emotion:—1. Aconitum,  Coffea, Lycopodium.
      2. Opium, Platina,  Veratrum.
    By  exposure, a cold :—1. Aconitum.
      2. Nux moschata, Pulsatilla.
      8. Belladonna, Dulcamara, Sepia, Sulphur.
    By exposure to dampness, wet feet, etc. :—1. Pulsatilla.
      2. Nux moschata.
      3. Calcarea.
Amenorrhea, secondary.
    Of  young girls who  generally menstruate COPIOUSLY :—
      1. Aconitum, Belladonna, Bryonia,  Calcarea, Nux
        vomica, Opium, Platina, Sabina, Sulphur.
      2. Chamomilla, Crocus, Mercurius, Natrum muriati-
        cum,  Phosphorus.
    Of  feeble, cachectic females:—1. Arsenicum,  China,
         Conium, Graphites, lodium, Natrum, Pulsatilla,
        Sepia, Sulphur.
      2. Ammonium, Baryta,  Cocculus,  Dulcamara, Fer-
        rum, Kali, Magnesia carbonica.
      3. Alumina,  Causticum,  Cuprum, Lycopodium, Mer-
        curius, Sabadilla, Silicea,  Staphysagria.
    Slow and gradual:—1. Ammonium,Conium, Dulcamara,
         Graphites, Kali, Lachesis, Magnesia carbon., Pul-
         satilla, Sulphur.
      2. Baryta, Cocculus, Natrum muriaticum,  Phospho-
        rus.
      3. Arnica, Alumina, Cuprum, Lycopodium, Mercu-
        rius,  Ruta, Sabadilla, Sepia, Silicea,  Staphysagria. 
AMENORRHEA.
97
        4. Bryonia,  Carbo  vegetabilis,   Cicuta,  Colchicum,
          Digitalis, Ferrum, Ignatia, Magnesia  muriatic,
          Nux vomica, Thuja, Valeriana,  Veratrum, Zincum.
    (See  above:  Symptomatic  Amenorrhoea,  and  Primary
 Amenorrhoea.)

                        Section 32.

   B.  Accompanying Symptoms of  Amenorrhea. —By
 these  symptoms we mean all such  ailments  as  may follow
 menstrual suppression or  primary absence of the menstrual
 flow, as a necessary consequence of such irregularities, not as
 having  been instrumental in  producing  such  suppression.
 Here follows a list of the principal of such ailments, together
 with their remedies.

 Alienation, mental derangement:—1. Belladonna, Hyoscy-
          amus,  Lachesis,  Nux  vomica,  Opium,  Pulsatilla,
          Stramonium, Veratrum.
       2. Arsenicum, Calcarea,  Crocus, Cuprum,  Mercurius,
         Platina, Rhus, Silicea,  Sulphur.
       3. Aconitum, Lycopodium, Nux  moschata, Sepia.
 Anasarca, general:—1.  Arsenicum,  China, Kali.
       2.  Graphites, Helleborus,  Lycopodium, Sulphur.
       3.  Bryonia,  Dulcamara, Ferrum, Phosphorus,  Sepia.
       4.  Aconitum, Belladonna, lodium, Pulsatilla, Sabina.
 Aphonia, loss of voice -.—Baryta, Belladonna,  Causticum,
         Sulphur.
       2.  Carbo veget, Mercurius, Phosphorus.
       3. Lachesis,  Natrum  muriat,  Platina,  Pulsatilla,
         Veratrum.
Appetite, lost:—1. Arsenicum,  Bryonia, China, Mercurius,
         Nux vomica, Pulsatilla, Sulphur.
      2.  Aconitum, Ammonium, Belladonna,  Calcarea, La-
         chesis, Lycopodium, Natrum muriat, Platina, Rhus,
         Sepia, Silicea.
      3.  Baryta,  Cocculus, Conium, lodium, Nux moschata,
         Opium, Veratrum.
                          7 
98
DISEASES OF FEMALES.
Articulations, pains in the:—1. Belladonna, Bryonia, Kali,
         Mercurius, Pulsatilla, Rhus, Sabina, Staphysagria.
       2. Agnus, Baryta, Calcarea,  Causticum,  China, Coc-
         culus, Ferrum,  Graphites,  Hyoscyamus,  Natrum,
         Natrum muriat, Phosphorus, Pulsatilla, Sepia, Sul-
        phur, Zincum.
       3. Alumina, Carbo  veget,  Chamomilla,  Dulcamara,
         lodium, Lycopodium,  Nux moschata,  Nux vomica,
         Sabadilla, Secale, Silicea.
Ascites :—Arsenicum,  China, Belladonna,^Kali, Sulphur.
       2. Aconitum, Bryonia, Dulcamara, lodium, Mercurius,
         Sepia.
       3. Cuprum, Lycopodium, Pulsatilla.
Asthma :—Aconitum, Arsenicum,  Belladonna, Bryonia, Cu-
        prum, Ferrum, Nux vomica, Phosphorus, Pulsatilla,
         Sulphur.
       2. Ammonium,  Carbo  veget, Hyoscyamus, Kali, La-
         chesis, Stramonium, Zincum.
       3. Calcarea, Chamomilla, Cocculus, Dulcamara, Opium,
         Silicea, Veratrum.
Bronchitis :—1.  Graphites.
       2. Aconitum, Belladonna,  Bryonia, Chamomilla, Mer-
         curius, Nux vomica, Pulsatilla, Rhus, Sulphur.
       3. Arsenicum, China, Dulcamara, Hyoscyamus, Lache-
         sis, Phosphorus.
       4. Calcarea, Sepia, Silicia, Staphysagria,  Veratrum.
Buzzing in Ears :—1. Belladonna, Graphites, Nux vomica,
         Pulsatilla, Sulphur.
       2. Bryonia, Calcarea, Conium, Kali, Lachesis, Lyco-
         podium,  Mercurius, Natrum muriat, Platina, Sepia.
       3. Aconitum, Ammonium, Aurum,  Cocculus, Dulca-
         mara, lodium, Magnesia carbonica, Nitri acidum,
         Petroleum, Phosphorus, Sabadilla, Silicea,  Veratrum.
 Cephalalgia congestive: — 1. Aconitum, Belladonna, Bryo-
         nia, Lachesis, Mercurius, Nux  moschata, Opium,
         Pulsatilla, Sulphur. 
AMENORRHEA.
99
      2.  Alumina,  Chamomilla,  China,  Dulcamara, Kali,
        Lycopodium, Nitri acidum,  Phosphorus, Sepia,
        Silicea.
      3.  Calcarea,  Crocus, Natrum, Natrum muriaticum,
         Veratrum.
    Hysteric :—1. Cocculus, Magnesia carbon., Phosphorus,
        Platina, Sepia, Valeriana,  Veratrum.
      2.  Aurum, Hepar, Ignatia, Magnesia  muriat., Nitri
        acidum.
      3.  Chamomilla, Rhus, Ruta.
    Nervous, megrim:—1. Calcarea, China, Colocynthis, Pul-
        satilla, Sanguinaria, Sepia.
      2.  Bryonia, Ignatia, Nux vomica,  Rhus, Veratrum.
      3.  Aconitum, Arnica, Arsenicum, Belladonna, Cham-
        omilla, Nitri acidum, Silicea,  Sulphur.
Chlorosis :—1. Belladonna, Calcarea,  Cocculus,  Ferrum,
        Lycopodium, Nitri acidum,  Platina, Pulsatilla,
        Sulphur.
      2.  China, Conium,  Helleborus,  Kali,  Nux  vomica,
        Phosphorus, Plumbum, Sepia, Spigelia.
      3.  Arsenicum, Digitalis, Graphites, Mercurius, Phos-
        phori acid., Staphysagria, Valeriana.
      4.  Baryta, Carbo animalis, Carbo vegetabilis, Ignatia,
         Oleander, Sabina, Sulphuris acid., Zincum.
Chorea:—1.  Belladonna, Causticum,  Cuprum,  Ignatia,
        Nux vomica.
      2.  Hyoscyamus, Stramonium, Zincum.
      3.  Arsenicum, China, Dulcamara, lodium, Pulsatilla,
        Sepia, Silicea.
      4.  Rhus, Sabina, Sulphur.
Colic, intestinal:—1. Belladonna, Calcarea, Chamomilla, Coc-
         culus, Nux vomica, Pulsatilla, Sulphur.
      2. Aconitum, Graphites, Ignatia, Phosphorus, Pla-
         tina, Secale, Sepia, Veratrum.
      3. Alumina,  Ammonium,  Baryta,  China,  Conium,
         Crocus, Cuprum, Lachesis,  Silicea, Zincum. 
100
diseases of  females.
    Uterine; cramps  in  uterus:—1.  Chamomilla,  China,
         Cocculus,  Cuprum, Hyoscyamus, Ignatia.
      2. Aconitum, Coffea, Lachesis, Pulsatilla.
      3. Bryonia,  Conium,  Graphites,  Kreosotum, Mag-
        nesia muriatica, Natrum muriat., Nux vomica.
Congestions of Brain :--1. Aconitum, Belladonna, Bryonia,
        Mercurius, Nux vomica, Opium,  Pulsatilla, Sul-
        ph ur.
      2. Alumina,  Chamomilla,  China,  Dulcamara, Kali,
        Lycopodium,  Nitri  acidum,  Phosphorus,  Sepia,
        Silicea,
      3. Calcarea, Crocus, Natrum muriat., Veratrum.
    CnEST:—1. Aconitum, Belladonna, Nux vomica, Phos-
        phorus, Sulphur.
      2. Aurum,  China, Mercurius.
      3. Ammonium, Carbo  vegetabilis,  Cocculus, Ferrum,
        lodium, Nitri acidum, Pulsatilla, Rhus, Sepia.
Constipation, costiveness :—1. Bryonia, Calcarea, Cocculus,
        Lycopodium, Nux vomica, Opium, Silicea, Staphy-
        sagria, Sulphur.
      2. Alumina, Belladonna, Carbo vegetabilis, Conium,
        Dulcamara,  Graphites,  Kali,  Mercurius, Nitri
        acidum, Phosphorus, Platina, Sabadilla, Sarsapa-
        rilla, Sepia, Sulphuris acidum, Veratrum, Zincum.
      3. Aconitum, Ammonium, Antimonium, Arsenicum,
         Baryta,  China,  Colchicum, Colocynthis, lodium,
        Lachesis,  Magnesia carbon., Magnesia  muriat,
        Natrum  muriat, Pulsatilla,  Rhus, Sabina, Stra-
         monium.
Convulsions, general:—1. Belladonna, Chamomilla,  Cu-
         prum, Hyoscyamus, Opium, Sepia, Stramonium.
       2. Arsenicum, Bryonia,  Calcarea, Causticum, Coni-
         um, Ignatia, Kali, Lycopodium, Mercurius, Na-
         trum muriat, Platina, Secale, Silicea, Strontiana,
         Sulphur. 
AMENORRHEA.
101
       3.  Alumina, Carbo vegetabilis, Dulcamara,  lodium,
         Magnesia carbonica, Manganum,  Natrum, Petro-
         leum, Phosphorus, Phosphori  acidum, Rhododen-
         dron, Rhus, Veratrum.
Diarrhea:—1. Chamomilla, China, Mercurius, Phosphorus
         Phosphoriacid.,Pulsatilla,Rhus, Sulphur, Veratrum.
       2.  Aconite,  Arsenicum, Bryonia,  Calcarea,  Conium,
        Digitalis, Hyoscyamus,  Lachesis, Nitri acid., Sepia,
         Silicea,
       3.  Alumina, Antimonium, Baryta, Belladonna, Carbo
         veget, Cocculus, Cohcynthis, Cuprum, Drosera, Dulca-
         mara, Ferrum,  Graphites,  Ignatia, lodium, Lycopo-
         dium, Nux moschata, Nux vomica, Opium, Petro-
         leum, Sabadilla, Sabina, Secale, Staphysagria, Vale-
         riana, Zincum.
Dyspnea, oppressed breathing :—Bryonia, Nux vomica, Pul-
         satilla, Sulphur.
       2. Arnica,  Calcarea, Carbo veget,  Mercurius, Natrum,
         Rhus, Sepia, Silicea.
       3. Ammonium, Arsenicum, Baryta, Belladonna,  Co-
        nium, Drosera,  Ferrum,  Graphites, Hyoscyamus,
         Ignatia,  Kali,  Lycopodium, Phosphorus,^Staphysa-
         gria, Veratrum.
Dyspepsia: — 1. Aconite,  Arsenicum,  Belladonna,  Bryonia,
         Cuprum,  Nux   vomica,   Phosphorus,  Pulsatilla,
         Sepia, Sulphur,  Veratrum.
       2.  Calcarea, Carbo veget., Chamomilla,  Cocculus, Igna-
         tia,  Kali, Lycopodium,  Opium, Platina, Rhus,
         Zincum.
       3. Arnica,  Aurum,  Conium, Ferrum, Hepar, Mercu-
         rius, Nux moschata, Sabadilla, Silicea, Staphysagria.
DYSURIA,  difficulty of urinating:—1. Aconite, Belladonna,
         Dulcamara,  Mercurius, Nux  vomica,  Pulsatilla,
         Sulphur.
       2.  Arsenicum,  Baryta,  Causticum, Graphites, Kali,
         Nux moschata, Phosphorus, Rhus, Sabina, Staphys-
         agria. 
102
diseases of females.
       3. Arnica, Aurum, Cohcynthis, Digitalis, Hepar, Phos-
        phori acidum, Ruta, Sarscqxtrilla.
Ecchymosis:—1.  Arsenicum, Bryonia, Rhus.
       2.  Belladonna,  Nux  vomica,   Phosphorus,  Secale,
         Silicea.
       3. Arnica, Hyoscyamus, Stramonium, Sulphuris acid.
Epilepsy:—1. Belladonna, Calcarea, Cuprum, Hyoscyamus,
         Sulphur.
       2. Arsenicum,  Chamomilla, Cocculus, Kali,  Lachesis,
         Lycopodium, Nitri acidum, Nux vomica, Sepia.
       3.  Conium, Opium, Platina, Rhus, Secale, Stramo-
         nium.
Epistaxis:—1. Bryonia, Lycopodium.
       2.  Aconite, Belladonna,  China,  Mercurius, Nux vom.,
        Phosphorus, Pulsatilla, Rhus, Sulphur.
       3. Arnica, Crocus, Ferrum, Kreosotum, Nitri acidum,
         Sabina, Secale.
       4. Ammonium, Arsenicum, Baryta, Calcarea,  Carbo
         veget, Drosera, Dulcamara, Sepia, Silicea.
Eructations:—1. Belladonna,  Bryonia,  Cocculus  Conium,
         Mercurius,  Nux vomica,  Phosphorus,  Pulsatilla,
         Sepia, Sulphur, Veratrum.
       2. Alumina, Baryta, Calcarea, China, Graphites, Kali,
        Lycopodium,  Natrum,   Rhus,  Sabadilla, Silicea,
         Staphysagria,  Valeriana.
       3.  Antimonium,  Arsenicum, Carbo animalis,  Carbo
        veget., Dulcamara, Ferrum, Ignatia, Ruta, Sulphuris
         acidum, Zincum.
Eruptions, cutaneous :—Arsenicum, Calcarea, Lycopodium,
       Rhus,  Sepia, Silicea Sulphur.
       2.  Aconite,  Ammonium,  Baryta  Bryonia,  Conium,
         Dulcamara  Graphites, Kali,  Mercurius,  Natrum
         muriat, Pulsatilla, Staphysagria.
       3. Antimonium, Carbo  vegetabilis,  Chamomilla, Helle-
         borus, Ignatia,  Natrum, Nitri acidum, Nux vomica,
         Petroleum,  Sulphuris acidum,  Veratrum,  Zincum.
Erysipelas :—1. Aconitum, Belladonna,  Graphites, Mercu
         rius, Rhus. 
AMENORRHEA.
103
      2. Ammonium, Arsenicum, Bryonia, Ccdcarea, lodium,
         Lycopodium, Phosphorus, Sulphur.
      3. Arnica, Baryta,  Carbo animalis, Carbo vegetabilis,
         Hepar, Hyoscyamus, Natrum, Petroleum, Pulsatilla,
         Silicea, Stramonium.
Eyes injected, red:—
    Bleeding :—1. Belladonna, Nux vomica.
      2. Calcarea, Carbo vegetabilis,  Chamomilla.
      3. Arnica, Cuprum, Ruta.
Face, pale:—1. Arsenicum,  China,  Pulsatilla, Sepia,.Sul-
         phur.
      2. Bryonia, Cocculus, Conium, Cuprum, Ferrum, Kali,
         Lycopodium,  Nux  vomica,  Phosphorus,   Platina,
         Rhus, Secale, Silicea, Veratrum.
      3. Ammonium, Antimonium,  Belladonna,  Calcarea,
         Chamomilla,  Helleborus, Ignatia, Magnesia muriat,
         Nitri acidum, Petroleum, Phosphori acidum, Sabi-
         na, Staphysagria,  Zincum.
    Red:—1. Aconitum, Belladonna, Bryonia, Chamomilla,
         China, Nux vomica, Opium.
      2.  Cocculus, Ferrum,  Hyoscyamus, Ignatia, Lycopo-
         dium, Mercurius,  Platina, Pulsatilla,  Rhus, Saba-
         dilla, Stramonium,  Sulphur, Valeriana,  Veratrum.
      3. Ammonium, Arsenicum, Baryta, Calcarea, Conium,
         Cuprum, Dulcamara, Kali, Natrum,  Phosphorus,
         Sepia, Silicea, Staphysagria.
Fainting:—1. Aconitum,  Chamomilla, China, Nux vomica,
         Sep>ia, Stramonium.
      2.  Arsenicum,  Bryonia, Cocculus, Ferrum,  Hyoscya-
         mus, Nux  moschata,  Opium,  Phosphorus, Silicea,
          Veratrum.
       3.  Belladonna,  Calcarea, Carbo vegetabilis, Cohcynthis,
         Digitalis, Ignatia, Kali, Mercurius, Pulsatilla, Rhus,
         Sabadilla, Sulphur.
FEVER :—1. Aconitum, Belladonna, Bryonia, Mercurius, Nux
         vomica, Phosphorus, Pulsatilla, Rhus. 
104
DISEASES OF FEMALES.
       2. Aurum, Chamomilla, Kali, Sulphur, Veratrum.
       3. China, Cocculus, Nitri acidum, Opium, Phosphorus,
         Secale, Sepia.
Gastralgia,  pain  in  stomach:—Belladonna, Calcarea,  Coc-
         culus, Nux vomica, Pulsatilla, Sulphur.
       2. Ammonium, Bryonia, Chamomilla, China, Conium,
         Graphites,  Lachesis, Lycopodium,  Nux moschata,
         Phosphorus, Sepia, Silicea.
       3. Carbo animalis,   Carbo vegetabilis, Cuprum, Digi-
         talis, Ferrum, Hyoscyamus, Ignatia, Kali, Magnesia
         carbonica, Natrum muriaticum, Petrol um, Staphys-
         agria.
    Gums, swollen :—1. Aconitum,  Belladonna,  Calcarea,
         Causticum,  China,  Nux  vomica,  Staphysagria,
        Sulphur.
      2. Chamomilla, Graphites,  Rhus, Sepia.
      3. Ammonium,  Baryta,   Nitri  acid.,  Phosphorus,
        Silicea.
   Bleeding:—1.  Calcarea, Mercurius, Sulphur.
      2. Arsenicum,  Carbo  vegetabilis,   lodium,  Silicea,
        Zincum.
      3. Carbo animalis, Magnesia  muriatica, Nux  vomica
        Phosphorus, Sepia, Staphysagria.
   Gout :—1. Belladonna, Bryonia, Kali, Mercurius, Rhus,
        Sabina, Staphysagria.
      2. Agnus, Baryta, Calcarea, China, Cocculus, Ferrum,
        Graphites, Hyoscyamus,  Natrum, Phosphorus, Pul-
        satilla, Sepia, Sulphur, Zincum.
      3.  Alumina,  Carbo  vegetabilis,  Chamomilla,  Dulca-
       mara, lodium, Lycopodium, Nux vomica, Sabadilla
        Secale Silicea.
   ILematemesis :—1. Ferrum,  Phosphorus.
      2.  Aconitum,  China, Nux vomica,  Pulsatilla,  Sepia,
       Sulphur.
      3.  Arnica, Arsenicum, Belladonna,  Calcarea,  Causti-
        cum,  Chamomilla,  Cuprum,  Hyoscyamus,  Ipecacu-
       anha,  Mercurius, Nitri acidum, Rhus, Silicea. 
AMENORRHEA.
105
  Hematuria:—1.  Pulsatilla, Sepia.
   2. Dulcamara, Zincum,
   3. Aconitum, CaUarea,  Mercurius, Phosphorus, Sul-
     phur,
  Haemoptysis :—1.  Ferrum, Phosphorus, Pulsatilla, Sul-
     phur.
   2. Aconitum, Arsenicum, Belladonna, Bryonia, Calcarea,
      China, Mercurius, Rhus, Sabina, Sepia, Zincum.
   3. Ammonium,  Arnica,   Conium,  Crocus,  Cuprum,
     Drosera, Hepar, Hyoscyamus, Ipecacuanha,  Kali,
     Natrum muriaticum, Nitri acidum, Nux moschata,
     Nux vomica,  Opium, Sabadilla,  Silicea, Sulphuris
     acidum.
 Haemorrhoids:—1.  Arsenicum,  Calcarea,  Nux vomica,
     Pulsatilla, Sulphur.
   2. Ammonium,  Graphites, Kali, Lycopodium, Phos-
    phorus.
   3. Antimonium,  Carbo vegetabilis, Cohcynthis,  Nitri
     acidum,
   4. Alumina, Cuprum,  Ferrum.

 Hypochondria:—1. Nux vomica, Sepia, Sulphur.
   2. China, Natrum.
   3. Belladonna, Chamomilla,   Conium, Lachesis,  Na-
    trum muriaticum, Phosphorus, Phosphori acidum,
     Pulsatilla, Staphysagria, Veratrum, Zincum.

 Hysteria:—1. Conium,  Nux moschata,  Nux  vomica,
     Pulsatilla, Sulphur.
   2. Belladonna,  Calcarea,  Cocculus,  Platina,  Sepia,
    Silicea.
   3. Agnus,  Aurum,  Bryonia,  Chamomilla,  China,
    Hyoscyamus,  Ignatia, lodium, Magnesia muriatica,
    Nitri acidum, Phosphorus, Plumbum, Staphysagria,
     Stramonium, Valeriana, Veratrum.

Leucorrhea:—1.  Calcarea,   Cocculus,   Conium,  Mer-
     curius, Pulsatilla, Sepia, 
106
diseases of females.
  2.  Alumina,  Ammonium,  China,  Graphites,  Kali,
    Lycopodium,  Natrum  muriaticum,   Nux  vomica,
    Phosp>horus, Sabina, Silicea, Sulphur, Zincum.
  3. Aconitum,  Agnus,  Arsenicum,  Carbo animalis,
     Carbo  vegetabilis,  Drosera,  lodium,   Kreosotum,
    Lachesis,  Magnesia carbonica,  Magnesia muriatica,
    Nitri acidum, Petroleum.
Jaundice:—1.  Aconitum,  China, Mercurius, Sulphur.
  2. Chamomilla, Nux vomica.
  3. Arsenicum, Belladonna, Calcarea,  Cuprum,  Pul-
    satilla,  Rhus.
  4. Aurum,   Bryonia,  Carbo   vegetabilis,  Cocculus,
     Conium,   Digitalis, Hepar,   lodium.   Magnesia
    muriatica, Nitri acidum, Opium, Phosphorus, Secale,
    Sepia,  Veratrum.
Indolence, aversion  to motion:—1. Aconitum, Arseni-
    cum, Nux vomica, Sepia.
  2. Baryta,  Cocculus, Lycopodium.
  3. Alumina,  Belladonna,  Bryonia,  Digitalis, Dulca-
     mara,  Ignatia, Mercurius, Phosphorus, Zincum.
Mammae diseased:—1. Bryonia,  Chamomilla,  Conium,
     Phosphorus, Silicea.
  2. Arsenicum, Belladonna, Calcarea, Graphites, Pul-
    satilla,  Sulphur.
  3. lodium,  Mercurius, Nitri acidum,  Rhus,  Sabina,
    Sepia.
Mania furor:—1. Belladonna, Veratrum.
  2. Arsenicum, Hyoscyamus, Mercurius, Opium,  Stra-
    monium.
  3. Baryta,    Cocculus,  Colchicum,  Crocus, Cuprum,
     Kali, Lachesis, Phosphorus, Sabadilla, Secale.
Metritis,  etc.:—1. Belladonna,  Nux vomica,  Pulsa-
     tilla, Sabina,  Sepia.
  2. Chamomilla, China,  Cocculus, Conium,  Platina,
     Secale, Sulphur. 
amenorrhea.                  107
   3.  Calcarea,  Carbo animalis,  Crocus,  Ferrum,  Gra-
    phites,  Hyoscyamus,  Kali,  Kreosotum,  Magnesia
    muriatica,  Opium.
Melancholia:—1. Arsenicum, Pulsatilla.
   2.  Causticum,   Graphites,   Natrum,  Nux  vomica,
    Platina, Rhus, Sepia, Silicea, Sulphur, Veratrum.
   3.  Aurum, Belladonna, Calcarea,  Cocculus,  Cuprum,
    Helleborus,  Hyoscyamus,  Ignatia,  Lachesis,  Mer-
     curius, Phosphorus,  Phosphori  acidum, Stramo-
     nium, Zincum.
Memory weakened or lost:—1. Lachesis, Nux moschata,
    Staphysagria, Sulphur.
   2.  Arsenicum,  Belladonna,  Bryonia,  Opium,  Rhus,
    Sepia, Silicea, Veratrum.
   3.  Alumina, Baryta,  Calcarea,  Conium,  Graphites,
    Helleborus, Hepar, Hyoscyamus, Ignatia, Kreosotum,
    Zincum.
Nausea:—1. Chamomilla,   Nux  nomica,  Pulsatilla,
    Rhus, Sepia, Silicea, Sulphur, Veratrum.
  2. Aconitum,  Arsenicum, Belladonna,  Bryonia,  Cal-
    carea, China,  Cocculus, Conium, Cuprum, Graphites,
    Kali, Mercurius, Natrum muriaticum, Phosphorus,
    Sabadilla, Sepia, Valeriana.
  3. Agnus, Ammonium, Antimonium, Carbo vegetabilis,
    Digitalis,  Dulcamara, Ipecacuanha, Magnesia mu-
    riatic,  Nitri acidum, Phosphori acidum,  Staphys-
    agria, Sulphuris acidum.
Neurosis :—1.  Belladonna,  Cuprum, Hyosyamus, Opi-
    um, Stramonium.
  2. Arsenicum,  Calcarea, Conium,  Ignatia,  Mercurius,
    Platina, Silicea, Sulphur.
Nymphomania:—1.  Phosphorus, Platina,  Veratrum.
   2.  Belladonna,  China, Hyoscyamus, Mercurius, Nux
    vomica,  Pulsatilla, Stramonium, Sulphur,
Odontalgia:—1.  Bryonia, Chamomilla,  China, Natrum,
    Sepia, Staphysagria, Zincum. 
108
DISEASES of females.
       2. Belladonna,  Kali, Nux  moschata,  Nux  vomica,
         Phosphorus, Pulsatilla, Rhus.
       3. Alumina,  Ammonium, Baryta,   Calcarea,  Carbo
         vegetabilis,  Hyoscyamus, Kreosotum, Magnesia  mu-
         riatica, Platina, Sabadilla,  Sabina Sulpitur.
 Opthalmia.—1. Aconitum, Belladonna,  Calcarea, Chamo-
          milla,  Mercurius, Nux vomica, Phosphorus, Pulsa-
          tilla, Rhus, Sepia, Sulphur.
       2. Arsenicum, China, Dulcamara, Graphites, Silicea,
          Valeriana.
       3. Antimonium, Arnica, Digitalis, Ferrum, Hyoscya-
         mus, Ignatia, Nitri  acidum, Phosphori acidum,
         Staphysagria, Veratrum.
 Otalgia, ear-ache: —  1. Belladonna,  Chamomilla, Mercu-
         rius, Pulsatilla, Sulphur.
       2. China, Dulcamara, Nux vomica, Platina.
       3. Antimonium, Arnica, Bryonia, Calcarea.

 Pains in the limbs or joints :—1. Aconitum,  Bryonia, Mer-
         curius, Nux vomica, Pulsatilla.
       2. Arnica, Belladonna,  Carbo vegetabilis, Chamo-
         milla, China,  Phosphorus,  Sulphur, Veratrum.
       3.  Arsenicum, Ferrum, Ignatia, Nux moschata, Rho-
         dodendron, Sepia.
 Palpitation of the heart :—l.  Aconitum,  Calcarea, China,
         lodium, Mercurius, Phosphorus, Pulsatilla, Sepia,
         Sulphur.
       2. Arsenicum, Belladonna, Bryonia, Cuprum,  Kali,
         Natrum, Nux vomica, Rhus, Silicea,  Veratrum,
         Zincum.
       3. Alumina, Ammonium, Antimonium,  Arnica, Au-
         rum,  Baryta,  Carbo vegetabilis, Chamomilla, Digi-
         talis,  Ferrum,  Graphites, Ignatia, Nux moschata,
         Phosphori acid., Platina, Sabina, Secale.
Paralysis of various parts:—1. Belladonna, Cocculus, Dul-
         camara, Pulsatilla, Secale,  Silicea. 
AMENORRHEA.
109
       2.  Aconitum,  Calcarea,   Causticum,  Nux  vomica,
         Phosphorus, Sepia, Sulphur, Zincum.
       3.  Alumina, Arsenicum, Baryta, Conium, Graphites,
         Hyoscyamus, Kali, Mercurius, Nitri acidum, Nux
         moschata, Ruta, Stramonium.
Rheumatism :—1. Aconitum, Bryonia, Mercurius, Nux vom-
         ica, Pulsatilla.
       2. Arnica, Belladonna,  Carbo vegetabilis,  Chamo-
         milla, China,  Lachesis, Phosphorus, Rhus, Sul-
        phur, Veratrum.
       3. Antimonium, Arsenicum, Ferrum, Ignatia, Nux
         moschata, Rhododendron, Sarsaparilla, Sepia.
Sciatica:—1. Pulsatilla, Sepia.
       2. Belladonna, Bryonia,  Calcarea, Chamomilla, Ly-
         copodium, Nux vomica.
       3. Arsenicum, Graphites, Mercurius, Rhus, Staphy-
         sagria, Sulphur.
Stools bloody, discharge of blood from  anus:—1. Ammo-
        nium, Arsenicum,  Mercurius, Phosphorus, Sepia,
         Sulphur.
       2. Belladonna, Calcarea,  Conium,  Nux vomica, Pul-
         satilla.
       3. Ammonium, Carbo vegetabilis,  Cuprum, Ferrum,
        Kali, Platina, Sabina,  Valeriana, Zincum.
Sleep, restless :—1. Arsenicum, Baryta,  China, Silicea,
        Sulphur.
      2. Alumina, Belladonna,  Bryonia,  Calcarea, Chamo-
        milla, Ferrum,  Kali,  Nux vomica, Phosphorus,
        Pulsatilla, Sabadilla, Sabina, Sepia.
       3. Aconitum, Aurum,  Cohcynthis,  Conium,  Dulca-
        mara, Ignatia, Mercurius,  Nitri  acidum, Ruta,
        Secale, Staphysagria, Valeriana, Veratrum.
Somnolence :—1. Nux vomica, Phosphorus, Pulsatilla.
       2. Aconitum, Arsenicum, Belladonna, Bryonia, Cal-
        carea, Conium,  Kali, Nux moschata, Opium, Sepia,
        Sulphur, Veratrum. 
110
DISEASES OF  FEMALES.
      3. Alumina, Antimonium, Baryta,  China, Cocculus,
         Cuprum, Hyoscyamus, Lachesis, Mercurius, Phos-
        phori acidum, Rhus, Secale, Silicea, Staphysagria,
         Stramonium, Zincum.
Sweat, bloody:—1.  Calcarea, Lycopodium, Nux vomica.
      2. Arnica, Chamomilla, China, Lachesis, Nux mos-
         chata.
Ulcerations:—1. Arsenicum, Lycopodium, Mercurius, Pul-
         satilla, Silicea, Sulphur,
      2. Belladonna, Bryonia, Calcarea, Conium, Phospho-
         rus, Sepia, Staphysagria.
      3. Aconitum, Baryta,  Carbo  vegetabilis, Causticum,
         Chamomilla,  China,  Graphites,  Natrum,  Nitri
         acidum, Phosphori acidum, Sabina, Secale.
Ulcers bleeding a good deal:—1. Arsenicum,  Graphites,
         Phosphorus.
      2. Kali, Lachesis, Lycopodium,  Mercurius, Pulsa-
         tilla,  Silicea, Sulphur.
      3. Belladonna,  Carbo  vegetabilis, Conium,   lodium,
         Sabina, Secale, Sepia, Zincum.
Vagina, irritated :—1.  Calcarea, Kali, Sepia.
      2. Belladonna, China,  Ferrum, Lycopodium, Mercu-
         rius,  Nux vomica, Pulsatilla, Sulphur.
      3. Arsenicum, Cocculus,  Conium, Graphites, Lycopo-
         dium, Platina, Sabina, Secale,  Staphysagria.
Vertigo :—1. Belladonna, Calcarea, Phosphorus, Pulsatilla.
      2. Aconitum, Bryonia, Causticum, Nux vomica, Pul-
         satilla,  Sepia, Silicea, Sulphur, Valeriana, Vera-
         trum, Zincum.
      3. Arnica, Chamomilla, Cocculus, Cuprum, Ferrum,
         Graphites, Kali, Mercurius, Natrum, Nux mos-
         chata, Opium, Phosphori acidum,  Rhus,  Secale,
         Staphysagria, Stramonium.

Vesicles, bloody:—1.  Arsenicum, Secale.
      2. Aurum, Bryonia, Sulphur. 
AMENORROHEA.
Ill
Vomiting:—1. Arsenicum, Bryonia, Chamomilla, Cuprum,
         Ferrum, Nux vomica, Pulsatilla, Silicea, Sulphur,
         Veratrum.
       2. Belladonna, Calcarea, China, Phosphorus, Secale,
         Sepia.
       3. Aconitum,  Antimonium,  Drosera,  Dulcamara,
         Graphites,  Hyoscyamus,  Ignatia,  Ipecacuanha,
         Lycopodium, Mercurius, Opium, Stramonium.
Vulva swollen, inflamed :—1.  Mercurius, Nux vom., Sepia.
       2. Aconitum,  Ammonium,  Belladonna,  Bryonia,
         Calcarea, Nitri acidum, Secale, Sulphur.

Wounds bleeding a good deal:—1. Lachesis, Phosphorus.
       2. Mercurius, Pulsatilla, Sulphur.
       3. Carbo vegetabilis, Natrum muriaticum, Phosphori
         acidum, Rhus, Sulphuris acidum, Zincum.

  For  further  details see: Indications and accompanying
symptoms of Dysmenorrhoea, Section 10.
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112
diseases of females.
ARTICLE  V.
              AM^ENIA OF YOUNG GIRLS

AT THE AGE OF PUBESCENCE, AND AILMENTS WHICH SOMETIMES ACCOMPANY
             THE FIRST APPEARANCE OF THE MENSES.

                       Section 33.

   Symptoms.—In the chapter on amenorrhoea, we have said
all that we have to say concerning the causes, symptoms, and
the various  forms of primary amenorrhoea, occurring at the
age of pubescence, and consisting in a non-appearance of the
first menstrual discharge.  We  shall therefore  dispense with
any further remarks  on this point, so much more as it is
exceedingly difficult to determine whether the  delay in the
appearance of the first menses is not rather a natural occur-
rence than  a  morbid condition of the organism.   There are
cases, however, where symptoms develope themselves which
are evidently  caused by the retarded appearance of  the first
menses, and which almost always disappear again as soon  as
the menstrual functions have fairly begun, and continue regu-
larly  to take place at the right period. It is to this condition,
and  to its  treatment, that we will  here devote a few lines.
We have likewise stated  that  the  age when  the first menses
appear is not the same in different persons, and that it depends
upon  differences of constitution, climate, education, mode  of
life,  condition in society, national usages, etc. All  that
remains for  us to do, is, therefore, simply to treat  of the acci-
dents which sometimes accompany the appearance of  the first
menses.  The  most frequent ailment, at the commencement
of menstruation in young girls, is menstrual colic, which may 
                AM.ENIA OF YOUNG  GIRLS.             113

 either take place in the  bowels or in the womb.   Sometimes
 it is so trifling that  it is scarcely noticed by the patient; at
 others so violent that the patient  utters  cries, and becomes
 convulsed.   It may last a few days only, or several months,
 and even years, always recurring  at the period when the
 menses set in.  In some cases this  colic is complicated with
 pains in the sides and in the sciatic nerve.  The most impor-
 tant ailments are the general concomitant  symptoms.   Many
 young girls, at this  period, are affected with  more or  less
 headache, either continually or at intervals, in one side  of the
 head only or in the whole head.  In others, the mental  and
 moral faculties become altered, being  either duller or keener
 than usual;  sometimes even a furious mania or  inclination to
 suicide setting in.    The  appetite  is  sometimes morbidly
 excited and altered, the  patients manifesting a desire for coal,
 clay, chalk,  sand, etc.,  or  for acid things, green  fruit,  etc.
 Deafness is likewise met with, and,  in  some females, attacks
 of catalepsy, hysteria, epilepsy, and other nervous and spas-
 modic affections.   The circulation is likewise deranged.   We
 meet with vertigo, drowsiness, general heaviness, redness of
 and  ascension of  heat to the face, dyspnoea, palpitation of
 the heart, and other symptoms that seem to point to some
 organic affection of  the heart.  We likewise meet with opthal-
 mia  and  other affections of the eyes, which are sometimes
 very obstinate ; or with  vicarious haemorrhages from different
 organs, such  as gums, nose, lips, and even from the uterus,
 from which latter organ  a bloody discharge sometimes  takes
 place every eight days, or every two, five or six weeks, until
 the menstrual discharge becomes quite regular.   The pulse
 of these young females  is generally fuller, more developed,
 and  febrile movements  are frequently present.   They  may
 co-exist with colic and pains in the sides, and give rise to a
 slight form of metritis.  In other young girls we meet with
 leucophlegmasia,  general dropsy,  or  partial oedema.   We
 ought likewise to mention a dry, nervous  cough, which  con-
tinues  all the time, and is  very fatiguing, and which might
give  rise to the belief that  there  are tubercles in the lungs,
                            8 
114
DISEASES OF FEMALES.
but which is generally  of little consequence, although it is
undoubtedly true that pulmonary and  laryngeal  phthisis de-
velopes itself very frequently at the age of pubescence. ' The
digestive functions are likewise disturbed; besides morbid
and strange  changes in the appetite for particular things, the
patients are attacked with  nausea, vomiting, gastralgia, and
especially with a  species of tympanitis, that is  sometimes
characterized by an intermittent type.   The skin is likewise
the seat  of  a variety of morbid appearances: vesicles, pus-
tules and blotches  break out in large  numbers, especially in
the face.  Not unfrequently copious  sweats  break out, with
rapid and excessive emaciation, weakness, lameness  and dis-
tress in the  limbs, and  all  the other  symptoms which some-
times set in  with amenorrhoea, and which have been described
in the preceding article.

                       Section  34.

   Treatment.—However efficacious  our  remedies for any
form  of menstrual disorder may  be, they will be  found  of
little  avail, unless  we institute a mode of life suitable to the
condition  of the  patient.  Unfortunately  this is not always
possible.  The requirements of fashion, of society, and even
of coquetry, are so imperious, and the character of our young
ladies is so frivolous, and their mothers are so condescending,
that it is really wonderful that the number of our fashionable
victims is not much  larger than it really  is.   Sometimes we
see them lightly  clad, exposing  themselves  to the keenest
winds and to all sorts of atmospheric  inclemencies ; at others
they  are loaded with a heap of unnecessary garments required
by fashion;  then they will  drink  ice-water  at  the  very
moment when they are heated by  the exciting dance, or they
will cool themselves by sitting in a cold current of air; is it
to  be wondered under these  circumstances, that pulmonary
phthisis should attack  so many girls, even at the age of six-
 teen  or twenty,  or that, at  any rate, their nerves  should
become shattered, and the  menstrual functions should never 
AM.ENIA OF YOUNG GIRLS.
115
assume a regular development?  And to cap the climax of
folly,  the  young  girls are frequently  deluged with strong
drinks, beer, wine, and  even brandy, in  the vain hope that
these stimulating beverages will restore the strength that had
been wasted  by fashionable  excesses.   And what are we to
say of the premature use of corsets, of the abuse  of cold
bathing, of stimulating food,  and of the dainty luxuries which
the capricious taste of our young  ladies cannot do without ?
These are  some of the causes which delay the first  appear-
ance of the menses, and induce the whole train of symptoms
that sometimes accompany this  state of anaemia,   Hence, if
we wish  to  afford relief to our  patient, we have in the first
place to  regulate her diet and general habits.  Next to  thi3
precaution we may derive benefit from the use of the follow-
ing remedies:
   1.  Causticum,  Graphites, Kali, Pulsatilla, Sulphur.
   2. Arsenicum,   Belladonna,  Bryonia,  Cocculus,  Conium,
Ferrum, Lachesis, Lycopodium,  Magnesia carbonica, Natrum
muriaticum, Petroleum, Phosphorus,Sabina, Sepia, Veratrum.
   3. Agnus,  Ammonia, Chelidon.,  Digitalis,  Dulcamara,
Silicea,  Valeriana.
   4. Aconite, Aurum,  Calcarea,  Cicuta,  Crocus, Drosera,
Guajacum, Hyoscyamus,  Magnesia muriatic,  Mercurius,
Sabadilla,  Sassafras,  Spigelia,  Staphysagria, Stramonium,
Strontia, Zincum.
   With the following particular indications :
   Causticum.—If the patient is very melancholy, with hys-
teric symptoms, etc.  (See this remedy under Amenorrhoea.)
   Graphites.—When there are herpetic  and other symp-
toms  on the skin,  the patient is  sad,  chlorotic,  etc.  (See
Amenorrhoea.)
   Kali.—Tendency to pulmonary phthisis, dyspepsia, palpi-
tation  of the heart, etc.   (See Amenorrhoea.)
  Pulsatilla.—Suitable to young  girls of gentle disposi-
tion, with pains in the sides,  colic, vertigo, congestion of  the
head,  megrim,  pale face, buzzing in the  ears,  dyspepsia,
depression  of spirits, frequent palpitation of the heart, etc. 
 Hi]              DISEASES OF FEMALES.

   Sulphur.-When  none of the  other  remedies helps, the
 patient is disposed to religious reveries, etc.
   Arsenicum.—Pale and  bloated face  in the  morning on
 rising, with  swelling  of the feet in the evening;  sensation  of
 heat in the body, followed by great weakness.
   Belladonna.—Vertigo when standing, redness of the eyes
 and face, photophobia, nose-bleed.
   Bryonia.—Frequent nose-bleed, stinging pain  in the head,
 congestion  of the chest, gastralgia.
   Cocculus.—Nervous symptoms, sadness,  contractive and
 pinching colic  in the hypogastrium,  oppression,  hysteric
 spasms.
   Conium.—Hysteric or  chlorotic spasms, hard  and painful
 breasts, nervous  weakness, and  prostration after  the least
 walk.
   Cuprum.—Convulsions of the  limbs  and  spasms  of the
 internal organs; cramps in the calves, nausea and vomiting.
   Ferrum.—Chlorotic  symptoms,  emaciation,  aversion  to
 motion, frequent congestion of the head.
   Lachesis.—Dyspnoea and frequent attacks of  suffocation ;
 nose-bleed; the symptoms are worse after sleeping.
   Lycopodium.—Chlorotic symptoms; the nose-bleed yields
neither to Lachesis nor to Bryonia.
  Magnesia  carbonica.—Intestinal  colic,  uterine cramps,
acidity and vomiting.
  Natrum  muriaticum.—Hysteric  symptoms, sadness, con-
stant weeping.
   Petroleum.—Scrofulous symptoms, breaking out on the
skin.
   Phosphorus—Irritable to delicate girls, disposed to pul-
monary phthisis, with short and dry cough, dyspepsia,  rheu-
 matic pains.
   Sabina.—Irritable to robust, plethoric girls, with frequent
nose-bleed,  uterine colic, etc.
   Sepia.—Sometimes after Pulsatilla, when this medicine is
ineffectual,  with yellow spots in the face,  and a yellow streak
 across  tho nose. 
MENOSPASIS OR  CRITICAL  AGE.          H7
  Veratrum.—Continual  coldness of the hands and feet,
with disposition to diarrhoea.
  For further  information and  details,  see  Amenorrhoea,
Sections 23-32.
  Dose.—Give a dose of the appropriate remedy every three
or four days, morning and  evening, the dose may consist of
six globules, dry on the tongue, or of one or two drops of the
attenuated solution on sugar, or in a spoonful of water.
-»-*■
ARTICLE VI.
           MENOSPASIS, OR CRITICAL AGE,
AND AILMENTS WHICH ARE INCIDENTAL TO A CESSATION OF THE MENSTRUAL
                  FUNCTIONS AT THAT PERIOD.

                       Section 35.

  Symptoms.—The age when menstruation ceases entirely, is
not the same with  all women.   At an average it  is between
forty and  fifty, generally forty-five or six  in France, and
somewhat later  in cold, but earlier in warm climates.  In
females with weak constitutions the menses may likewise
cease to  flow  at an earlier period.  This cessation is not,
however,  depending upon the earlier  or retarded appearance
of the first menses; it seems  agreed that, the more children
a woman has had,  the longer the menstrual  flow is  disposed
to continue.   If  nothing untoward occurs,  the intervals
between  the menstrual periods become  more and more pro-
longed, until the menses cease  entirely.  In many cases this
change takes place without any unpleasant sensations or local
disorders.  The most frequent  and the least dangerous symp-
tom is an irregular return of the menstrual flow, every week, 
118
diseases of females.
or every two  or  three weeks, or every two, three, four or six
months, and being more or  less irregular as regards quantity
or quality  of the menstrual blood.   Serious  and  alarming
haemorrhages frequently set in, especially among plethoric and
nervous women, or such as have indulged  in sexual excesses.
Sometimes  these haemorrhages  alternate with  whitish  or
yellowish leucorrhoea, which often  has  a fetid smell, is acrid
and extremely copious.  This leucorrhoea  may continue long
after the menstrual discharge has  entirely ceased to appear.
At this period we likewise meet not unfrequently with colic,
uterine  cramps,  pain3 in  the sides, weight  in  the loins, or
distressing  itching of the parts.  In some  cases the abdomen
swells as during  pregnancy, with  sympathetic development
of the breasts, until the swelling suddenly disappears after the
expulsion of  a mole, or after the emission of a quantity of
gas,  or  after an  haemorrhage, or  a  profuse  discharge  of
serum.  With reference to  the general symptoms, we notice
sometimes congestions of the head, haemoptysis, bloody urine,
piles, nose-bleed,  and other vicarious haemorrhages; pulmo-
nary phthisis likewise takes a fresh  development, and  fre-
quently terminates  fatally.  In other  cases we  meet with
diarrhoea, weakness of the stomach, flatulence, vomiting  and
other derangements  of the  digestive  canal, which are some-
times accompanied by consumption  and profuse sweats.  Some
women complain at this period of  attacks of  rheumatism of
the shoulder or  thigh,  or  of a considerable swelling of the
joints; others experience  attacks  of hysteria,  hypochondria
and  even  nymphomania;  others  again  are  attacked  with
various eruptions, such as tetter at the genital organs, acne
rosacea or  erysipelas.   The most distressing maladies which
break  out  at this  period  and often  terminate fatally,  are
ulcers and  polypi of the uterus, and carcinoma of this organ
and  of the  breasts.  These various ailments do not always set
in; in many females the critical change takes place so slowly
and  gradually, that  they  are not aware of any particular
transformation which the organic  life is undergoing.  Their
health becomes more vigorous and durable than before. 
MENOSPASIS OR CRITICAL AGE.
119
                       Section  36.

  Treatment.—If no important difficulties set in, we ought
not to prescribe remedies for every little distress that may
show itself in conjunction with the critical change.   It is of
more importance to attend to a proper and simple diet, which
should consist  in  plain  and nourishing food, without being
either  stimulating  or  heating.   Coffee,  tea, strong spices,
and domestic drugs, and decoctions, are never more hurtful
than at this period.  An exclusively sedentary life  and too
much exercise  are alike hurtful.  Every day  the  patient
should take exercise in the open   air.  Keen and  windy
weather and over-heated apartments  are to be avoided.   The
patient should be clad agreeably to the  states of the  weather,
temperature, season.  So far as  remedies are concerned by
means of  which the various  ailments incidental to a critical
suppression of the menses are combated, they  are the same
as those which have been recommended for Amenorrhoea,
Section 34, except that,  according to the symptoms, we may
have to accord  a preference to :  1. Pulsatilla, Lachesis : 2.
Bryonia,  Cocculus, Ignatia, Sepia,  Sulphur,  these  reme-
dies  being peculiarly adapted to the ailments incidental to
the critical period.   For further details We refer the  reader
to the articles Amenorrhoea, and Metrorrhagia,  Cancer of
the womb, Diseases of  the breasts, Leucorrhoea, etc., which
will be found in subsequent parts of  this work. 
120
DISEASES OF  FEMALES.
ARTICLE  VII.
 ABNORMAL CHANGES  OF  THE MENSTRUAL BLOOD.

                      Section  37.

   Symptoms.—A noteworthy  symptom,  which  not unfre-
quently occurs during amenorrhoea and  menstrual irregulari-
ties, is haemorrhage or congestion, which often occurs in place
 of the menses and seems to supply the  deficiency in the nor-
mal secretion.   Such an  haemorrhage may take place from
any orifice of the body.   In young girls it mostly occurs in
the superior organs, whereas, at the critical age,  it generally
takes place from the lower organs.  In plethoric and nervous
females, such haemorrhages are more frequent than  in young
girls or lymphatic individuals.   They likewise attack more
readily the  organs which are naturally predisposed for this
kind of derangement—for instance, organs where  haemor-
rhages had taken place previously, or which had been more or
less affected during the menstrual flow.   Thus, haemorrhages
may take place from the socket of a tooth, if a female should
have it pulled at the  critical period; nasal haemorrhage  may
set in in consequence  of  violent sneezing;  vomiting of blood
in consequence  of violent straining, etc.   These  vicarious
haemorrhages may either  be preceded by local symptoms in
the region where they are to take place, or by general symp-
toms  resembling those which used to occur  previous to the
appearance of the menses ; sometimes they set in without any
precursory symptoms.  Ordinarily they  occur one or two days
before the  menses generally set  in, and they either last as
long as these habitually lasted,  or else they continue a few
days longer, or  break out after the  period for the menstrual 
     ABNORMAL  CHANGES OF THE MENSTRUAL BLOOD.   121

 appearance is  past.  If  haemorrhage takes  place while the
 menses are flowing, this flow is generally very scanty, whereas
 an abnormal haemorrhage is copious  and prolonged.   These
 various  vicarious haemorrhages  are  very apt to take place
 repeatedly from the same  organ, until the critical change  is
 completed; though  it sometimes occurs  that haemorrhages
 from different  organs take place in  the  same patient.  °In
 some, milk flows  from the breasts, or  a serous liquid from the
 ear ; whereas,  in others again, there  is no haemorrhage, but
 simply  a congested condition of the  organ.   As we stated
 above, these haemorrhages may occur from any orifice or tis-
 sue of the body; but the tissue which  is most frequently
 affected, is  the mucous membrane, giving rise to nose-bleed,
 spitting  or vomiting  of  blood,  bloody stool, piles,  bloody
 urine, hemorrhage from  the mucous lining, conjunctiva  or
 corner of the eye, or from the mouth, gums and teeth.  Not
 unfrequently such haemorrhages occur from the external inte-
 guments of the body, from former sores, cicatrices, or from
 recent wounds, cuts, excoriations, flea-bites, or other  injuries
 of the  external parts.   They likewise  take  place from  the
 sound skin, in  the arm-pits, breasts, cheeks, tips  of the fin-
 gers, etc.  As  regards duration, the haemorrhage may consist
 in a simple show  of blood for a few hours, or it may continue
 for six or eight days, and even  longer; sometimes a  simple
 effervescence and congestion of  the  parts may  take place,
 without  any sanguineous  secretion.   If  once existing, the
 haemorrhage is  very apt to occur again at the next catamenia,
 unless cured by a rational treatment.  These vicarious changes
 do not  seem to be very dangerous; even  haemorrhages from
 important and vital organs, such as the lungs, may continue
 for a long time without producing organic alterations; the
 same remark applies to haemorrhages from the mouth or rec-
 tum ; haemorrhages from  the stomach, bladder, and  smaller
intestines, do not seem, however, to be without danger if they
last  too  long;  haemorrhages from the  bladder often cause
great debility. 
122
DISEASES OF  FEMALES.
                      Section 38.

   Treatment.—Although most  authors look upon these
vicarious haemorrhages as something useful and desirable, and
advise even to favor them by various  means, yet we  have no
hesitation in laying down an opposite  principle of practice.
It is true that, in retention or primary absence of the men-
strual discharge in the case of plethoric females, the  ailments
arising from such a condition generally disappear as soon  as a
vicarious haemorrhage from some other part of the  body, or
from the  uterus, takes place, and  it would be the height of
absurdity to undertake  to suppress such  an haemorrhage by
the revulsive  means of the old school.  But our school  pos-
sesses remedies which not only tend to arrest the haemorrhage
but likewise to restore the menstrual discharge, and it is  per-
fectly proper to administer one of these remedies, agreeably
to the existing indications.   By this means we avoid all  risk
of improper interference  with drugs, especially if  we  first
content  ourselves with a  minute dose—a  few globules of the
15th to the 30th  attenuation—and  do not repeat  the dose
until we are sure that the remedy has been well chosen.   In
this way the haemorrhage will gradually cease  and give  way
to a normal  restoration  of  the menstrual flow.  The  best
remedies for these various haemorrhages are :
  For haemorrhage from the  Conjunctiva or simple  Conges-
tion of the Eyes :—
      1. Belladonna, Calcarea, Chamomilla, Lachesis, Nux
        vomica, Ruta.
      2. Aconitum, Bryonia, China, Mercurius, Phospho-
         rus, Sepia.
      3. Arnica, Arsenicum, Graphites, Pulsatilla, Silicea,
         Sulphur.
  For nasal haemorrhage, epistaxis :__
      1. Bryonia, Lachesis, Lycopodium.
      2. Aconitum, Belladonna, China,  Mercurius,  Nux
        vomica, Phosphorus, Pulsatilla,  Rhus, Sulphur. 
  ABNORMAL CHANGES OF THE MENSTRUAL  BLOOD.  123

     3. Arnica,  Crocus, Ferrum, Nitri acidum,  Sabina,
       Secale.
     4. Ammonium, Arsenica, Baryta,  Calcarea,  Carbo
       vegetabilis, Drosera,  Dulcamara, Sepia, Silicea.
For haemorrhage from the mouth, gums or teeth :—
     1. Ccdcarea, Mercurius, Sulphur.
     2. Arsenicum,  Carbo   vegetabilis,  lodium,  Silicea,
       Zincum.
     Carbo animalis, Magnesia muriat., Natrum muriat,
       Nux vomica, Phosphorus, Sepia, Staphysagria.
For pulmonary haemorrhage :—
     1. Ferrum, Phosphorus, Pulsatilla, Sulphur.
     2. Aconitum, Arsenicum, Belladonna, Bryonia, Cal-
       carea, China, Lycopodium, Mercurius, Rhus, Sa-
       bina, Secale, Sepia,  Zincum.
     3. Ammonium,  Arnica,  Conium, Crocus, Cuprum,
       Drosera,  Dulcamara, Hepar, Hyoscyamus, Ipeca-
       cuanha, Kali, Natrum muriat, Nitri acidum, Nux
       moschata, Nux vomica, Opium, Sabadilla, Silicea,
       Sulphuric acid.
For vomiting of blood :—
     1. Ferrum,  Phosphorus.
     2. Aconitum,  China, Nux vomica, Pulsatilla, Sepia,
      Su Iphur.
     3. Arnica, Arsenicum,  Belladonna, Calcarea,  Chamo-
      milla, Cuprum, Drosera, Hyoscyamus, Ipecacuanha,
      Lycopodium, Mercurius, Nitri acidum, Rhus, Silicea.
For haemorrhage from the intestines, anus :—
     1. Ammoniacum,  Carbo vegetabilis,  Mercurius,  Phos-
       phorus, Sepia.
     2. Conium,  Lachesis.
     3. Calcarea, Platina, Pulsatilla, Sabina, Stramonium,
       Valeriana, Zincum.
For  piles :—1. Aconitum, Belladonna, Phosphorus.
     2. Calcarea, China, Mercurius, Pulsatilla, Sepia, Sul-
       phur. 
124              diseases of  females.

         3. Ammoniacum, Carbo vegetabilis,  Cuprum,  Fer-
        rum, Kali, Lachesis, Nitri acidum.
  For hematuria:—1.  Pulsatilla, Sepia.
      2. Dulcamara, Lycopodium,  Zincum.
      3. Aconitum,  Calcarea,  Mercurius, Phosphorus,  Sul-
        phur.

  In order to select the right remedy for one or the other of
these various  kinds of haemorrhage, we  ought of course  to
consider  all  the other symptoms which  may  have been de-
veloped  in the  sick organism, and  likewise the character of
the amenorrhoea or dysmenorrhoea,  with which  the patient is
affected.   AVe refer  the reader to  the articles Amenorrhoea
and  Dysmenorrhea, Sections  9-10  and 28-32, where we
have furnished  the necessary indications as  completely  as
possible. 
metrorrhagia.
125
ARTICLE   VIII.
                    METRORRHAGIA;

          OR, FLOODING BETWEEN THE MENSTRUAL PERIODS.

                       Section  39.

   Causes.—By metrorrhagia we understand every discharge
of blood from the uterine  vessels, which either exceeds the
natural limit of the Catamenia, or else takes place abnormally
at a period when the menses are not expected.   The condi-
tion of the uterus having much to do with the character of
these haemorrhages,  it is of importance to inquire into the
state of this organ, both during pregnancy and at other pe-
riods ;  but inasmuch as the former condition will be treated
of in a special chapter, we here confine ourselves  to a con-
sideration of haemorrhages from the unimpregnated uterus.
Sometimes such an  haemorrhage  is no more than increased
menstruation; at other times, however, it is a morbid dis-
charge of blood occurring between the menstrual periods.  In
the former of these two cases,  excessive  menstruation, the
blood may flow too long, too profusely, too frequently, or it
may flow continually.   The causes which may determine such
an haemorrhage, are the same as those which tend to exercise
the normal menstrual  flow; most  frequently, however, such
metrorrhagia occurs either during the first menstrual periods,
or at the critical age, although it  may likewise occur at any
period  between these two extremes.  AVomen who have been
guilty of sexual excesses, of onanism, or who have increased
the sensitiveness of the uterus  by any other cause, or who
have borne many children, are  particularly liable to this de-
rangoment.  In many cases metrorrhagia  is induced  by a 
 12t>              diseases  of females.

 stimulating diet, abuse of spirits, coffee, drugs, warm baths ;
 also by fatigue, excessive walking, riding on horseback, stand-
 ing erect, or by compression  of the body by means of corsets,
 tight dresses, or  by exciting the  parts by lascivious novels,
 thoughts  or conversations, or finally by the use of abortive
 means.  According  to  some authors atmospheric  influences
 have something to do with metrorrhagia; women who inhabit
 high districts, and are less exposed  to atmospheric pressure,
 are less subject to metrorrhagia than  persons  who live more
 near the level of the sea. The most frequent determining
 causes of  metrorrhagia,  are:  excessive sexual  intercourse,
 sudden emotions, such as  fright, anger, intense joy ; violent
 exercise, such as:  running, leaping,  dancing, riding in a car-
 riage or on horseback ; violent commotion of the body, falling
 upon the feet or nates, blows on the abdomen or  pelvis ; strain-
 ing in  consequence of coughing, sneezing, vomiting; irritating
 or  warm injections in the  vagina, cauterization  of the neck of
 the uterus, application of  leeches to  the uterus, use of pessa-
 ries, warm sitz-baths, sinapisms  to the lower limbs, etc.  In
 many cases metrorrhagia  is  only a symptom, for instance,
 when it depends upon diseases of the uterus, chronic metritis,
 hydatids or moles in  the uterus, polypi, carcinomatous ulcera-
 tion, displacement of the womb, etc.  Bilious affections, worms
 in  the  intestines or other  inflammatory or  gastric irritations
 may occasion uterine haemorrhage.  Beside these  active hae-
 morrhages, there are others which might be regarded as pas-
 sive; these occur  in  women  of feeble, cachectic or scorbutic
 constitutions, in consequence of a weakening  mood  of  life,
 depressing passions, long sickness, excessive nursing of infants
 at the breast, etc.

                       Section 40.
  Symptoms  and  Course.—Uterine haemorrhage may take
place as soon  as the cause begins to operate, or  in a few days
only.   In the latter case,  precursory symptoms generally in-
dicate a congestion towards the uterus; but in either case the
haemorrhage may set in with  so much violence, that the life 
metrorrhagia.
127
of the  patient  may be endangered thereby.  Accidental
haemorrhage occurs much less frequently than an haemorrhage
which is occasioned by predisposing causes, and sets in gradu-
ally  by a successive increase of the quantity, duration and
frequency of the menstrual periods.  The precursory symp-
toms of metrorrhagia are sometimes a  simple malaise with
slight colic,  whereas, at other times, the symptoms  are much
more marked, such as : swelling of the breasts, tension in the
hypochondria, heaviness, heat and pain in the sacral and hy-
pogastric regions; constipation, general lassitude, febrile pulse,
pale face, cold extremities, shuddering, heat  and itching of
the parts ; after  the first  appearance of blood these symptoms
first seem to abate; but,  if the flow  becomes a little more co-
pious, a fainting sensation is experienced in the region of the
stomach, with paleness of the face and lips, feeble pulse, blur
before the eyes, buzzing in the ears, weakness  of hearing,
embarrassed and  stertorous  breathing;  death.   In nervous
females most of these symptoms may develope themselves be-
fore the haemorrhage has become very profuse; most cases are
accompanied by a violent headache, especially in the occipital
region, which sometimes  continues even after the cessation of
the haemorrhage.   If the haemorrhage,  although  feeble in it-
self, continues too long or occurs too frequently, the digestive
functions  become deranged, the patient  becomes excessively
weak, pale, with rings around the eyes, oedema of the feet and
legs, nervous  distress, and collection of  serum in the perito-
neal and pleural cavities.  These latter  symptoms  generally
only set in after the haemorrhage from the active had changed
to the passive form, in which case the blood is pale, serous or
blackish.  The course of metrorrhagia varies a great deal; as
a general rule, the more  copious the flow, the  less it will last.
In young girls, at the age of pubescence, the metrorrhagia is
but trifling,  and frequently consists only in  a sero-sanguineous
discharge which only lasts a few days, and is generally ac-
companied by a sensation of heat and swelling in the vagina
and vulva, and followed by debility, paleness of the face, rings
around  the eyes, flabbiness of the flesh, lassitude in the limbs. 
1v>3              DISEASES  OF FEMALES.

At  the critical period metrorrhagia generally  lasts longer.
Somtimes it sets in suddenly like a flood; at other times the
blood flowes scantily; in most cases the flow stops in a few days,
and recommences again after an interval of two or more days.
Chronic  metrorrhagia may  continue for several  years; tne
discharge of blood is generally little, and either continues all
the time  or at short intervals,  during which  the patients are
generally troubled with leucorrhoea.

                       Section 41.
   Diagnosis and Prognosis___Metrorrhagia cannot possibly
be mistaken for the menstrual  discharge; but the quantity of
the discharge, its duration and weakness caused  by it, may
serve to  render our  diagnosis  still more certain.   Moreover,
the blood in metrorrhagia is  always more coagulable than the
menstrual blood,  and which  sometimes comes off in large co-
agula in  consequence of the  accumulation of the blood in the
vagina;  it is only in cases of  chronic cachexia or of exhaustion
by previous haemorrhages, that the  blood may have become
very thin and destitute of fibrin or cruor.  It is particularly
important to know the character of the  metrorrhagia, whether
it is idiopathic or symptomatic, depending  upon  other pre-
existing  diseases  of the uterus or other organs.   In this case
the diagnosis can only be established  after an attentive ex-
amination  of the other organs, and particularly of the uterus
and its  appendages.   In order to distinguish between active
 and passive metrorrhagia, we  have to bear  in mind that  the
 passive form is almost always chronic; but it attacks princi-
 pally lymphatic constitutions and such as had been weakened
 by previous causes; that it  is  not accompanied by any sign of
 reaction, and that  the blood is watery and impoverished,
 whereas active metrorrhagia  is  almost always  preceded or
 accompanied by symptoms  of general or local reaction, runs
 a rapid course, attacks principally  robust  women of strong
 constitutions, and the blood is highly coagulable.   The prog-
 nosis depends upon the  age, constitution and strength of the
 patient, upon the  causes which  have produced  the disease, 
METRORRHAGIA.
129
upon the quantity of the blood which is discharged and upon
the length of time that the disease has lasted; in the case of
girls at the age of pubescence, as well as in the case of women
at the  critical period, metrorrhagia is scarcely ever a serious
disease; nor  is it any more so in the case of robust women,
when the accident is  owing to some sudden cause, and the
discharge is not  excessive; but profuse, rapid metrorrhagia
which is accompanied by sudden prostration, is  always  dan-
gerous  and may  terminate fatally; chronic  metrorrhagia is
likewise more or less dangerous, especially if it  has occurred
more than once and the constitution has been deeply affected
in consequence; in the case of lymphatic, nervous or debili-
tated females, such haemorrhages are particularly dangerous.
If the metrorrhagia is occasioned by the presence of a polypus,
moles,  ulcer or uterine cancer, or by chronic metritis or any
other  morbid condition of the uterus, the prognosis always
depends upon the primary disease,  and  the haemorrhage  can-
not be radically cured unless the disease is cured likewise.

                       Section 42.

   Treatment.—The first thing to be done in any kind of
metrorrhagia is to regulate the diet  and regimen of the pa-
tient, and to  remove all  influences  that tend to keep up  the
haemorrhage.  The patient should at once be placed in an
horizontal position, the pelvis being slightly raised by means
of a pillow placed underneath; hair-mattrasses or spring-beds
should be preferred to feather beds which are too soft and too
warm; the patient should be covered  only slightly, and be
kept in a  cool  rather  than  a warm room; care, however,
should  be taken to keep the extremities warm;  at the  same
time the patient's mind should be kept perfectly quiet, and
all disturbing emotions should be carefully avoided ; all mental
exertions of any kind  should  be avoided; these precautions
having been taken, we may  administer one of the following
remedies:—
                             9 
130              DISEASES  OF FEMALES.

       1. Belladonna,  Calcarea,  China, Ferrum, Ipecacuanha-,
         Nux vomica, Sabina.
       2. Arnica, Bryonia, Chamomilla, Crocus, Hyoscyamus
         Lycopodium. Mercurius, Nitri acidum, Phosp>horus
         Platina, Pulsatilla,   Secale,  Sepia, Stramonium
         Sulphur.
       3. Aconitum,  Antimonium,,   Arsenicum,   Cantharis
         Carbo vegetabilis,  Coffea, lodium,  Nux moschata
         Silicea, Sulj)huris acid.
      4. Arnica, Borax,  Capsicum,  Carbo  animalis, Cina
         Cocculus,  Cuprum,  Ignatia,  Kreosotum,  Natrum
         Plumbum, Rhus, Ruta, Sambucus,  Zincum.
    Giving particularly for acute metrorrhagia:—
      1. Belladonna, Chamomilla, Crocus, Ipecacuanha, Pla-
         tina, Sabina.
      1. Aconitum,  Arsenicum,  Calcarea, Cannabis, China,
         '""//'«,  Hyoscyamus,  Kreosotum, Mercurius,  Nux
         moschata, Nux vomica, Phosphorus,  Secale.
    For chronic metrorrhagia :—
      1. Belladonna, Calcarea, Nux vomica, Platina, Sabina,
        Secale, Stramonium.
      2. Arsenica, Bryonia, Carbo vegetabilis, China, Kreoso-
        tum, Nitri acidum,  Phosphorus, Sejria,  Sulphuric
        acid.
      3. Ambra, Ammonium,   Acid muriaticum,  Borax,
        Bovista,  Carbo animalis, Hepar, lodium,  Ledum,
        Lycopodium,  Natrum,  Nitrum,  Phosphori  acid.,
        Pulsatilla, Selenium, Silicea, Stannum, Sulphur.
    For acute metrorrhagia:—
      1. Aconitum, Belladonna, Chamomilla, Platina, Rhus,
        Sabina.
      2. Arnica. Bryonia, Calcarea,  Carbo vegetabilis, Fer-
        rum, Hyoscyamus, Ignatia, Ipecacuanha, Nux vomi-
        ca, Phosphorus, Pulsatilla, Sepia, Silicea,  Veratrum.
      3. Cantharis,  Carbo  animalis,  Causticum,  Conium,
         Crocus, Kreosotum, Mercurius, Nitri acidum, Stron-
        tiana. 
METRORRHAGIA.
131
      For passive metrorrhagia :—
        1.  Calcarea, China, Ferrum, Hyoscyamus, Ipecacuanha,
          Pulsatilla, Secale, Sidphn/r.
        2.  Arnica,  Carbo  vegetabilis,  Crocus, Lachesis,  Nitri
          acidum,  Nux  moschata, Nux vomica, Phosphori
          acidum, Pulsatilla,  Veratrum.

   For hemorrhage of girls at the age op pubescence:—
        1.  Calcarea, Ferrum, Sabina.
        2.  Bryonia, Crocus, Hyoscyamus, Mercurius, Phospho-
          rus, Pulsatilla,  Sepia, Stramonium, Sulphur.
        3.  Aconitum,  Cocculus, Cuprum, Silicea, Zincum.
      For haemorrhage at the critical age:—
        1.  Belladonna, Calcarea, Pulsatilla, Secale.
        2.  Antimonium, Bryonia, Conium, Ignatia, Sepia, Sul-
         phur.
        3.  China, Ferrum,  Conium, Ipecacuanha, Nux vomica,
          Sabina.

      For haemorrhage  caused by a violent emotion:—
        1. Platina.
       2. Aconitum,   Bryonia,  Chamomilla,  Coffea,   Nux
         vomica.
       3. Belladonna,  China,  Cocculus,  Crocus,  Ferrum, Hy-
         oscyamus, Mercurius, Phosphorus,  Pulsatilla, Sepia,
         Stramonium, Sulphur.

     For haemorrhage  produced by concussion, a blow, fall,
         etc.:—
       1. Arnica, Pulsatilla.
       2. Bryonia, Phosphorus, Rhus, Ruta, Sulphur.
       3. Calcarea, Chamomilla, Crocus, Hyoscyamus, Mercu-
         rius, Nux vomica, Phosphori acid., Silicea.

  For symptomatic metrorrhagia, depending upon some prior
affection of the uterus and its appendages, we refer the reader
to the articles on, uterus, foreign bodies in  the  uterus,
ulcers, carcinoma, etc. 
132
DISEASES OF FEMALES.
                       Section 43.

   Symptomatic indications  of the above mentioned  reme-
 dies.
   Belladonna—If the blood is neither too light-colored nor
 too  dark, with  violent dragging and  tensive pains  in the
 abdomen, sense of  constriction  or pressing asunder; painful
 pressure on the parts  as  if everything would issue from the
 vulva;  pains in the small of the  back as  if the sacrum were
 broken; red face with headache, vertigo, throbbing  of the
 carotids, and great vascular excitement.
   Calcarea—Especially in the case of plethoric girls of full
 habit, with pains in the small  of the back, profuse discharge
 of a bright-red blood, abdominal colic, congestion of the
 head.
   CniNA.—AArhen the blood is  discharged at intervals, with
 uterine  cramps,  colic, frequent desire to urinate  and painful
 tension  in the abdomen ; or, if much blood has already been
 lost,   even in the most serious cases, with  heaviness of the
 head, vertigo, dulness of the senses, coldness of the extremi-
 ties,   pale face, fainting  turns,  convulsive starting of  the
 body.
   Ferrum.—Profuse discharge  of thin blood which is partly
 black and coagulated, with  pains in the  small of the  back
 and  labor-pains; vascular excitement, vertigo, glowing red-
 ness   of the face, full and hard pulse;  or pale and watery
 blood, with pale face, weakness,  fainting turn, rapid prostra-
 tion  although the quantity of blood lost is not large.
  Ipecacuanha—Profuse and continual discharge of  a thin
 and  bright-red  blood, with cutting pains  in  the umbilical
 region,  pressure on the uterus  and  rectum; shivering and
 coldness of the  body, heat  of the head,  fainting weakness,
pale  face, nausea, desire to remain in bed.
  Nux vomica—For  chronic metrorrhagia when  the haemor-
rhage returns from the least  cause,  with  scanty discharge,
bearing-down colic, pains in the small of the back as if broken,
painful  weight  and tightness  in  the  hypochondria, frequent 
METRORRHAGIA.
133
urging to urinate, constipation with ineffectual desire to go to
stool; irritable and angry mood.
   Sabina.—Discharge of a dark blood mixed with coagula,
accompanied by  abdominal  pains,  and  labor-pains  in  the
small of the back; weakness, rheumatic pains  in  the  limbs
and head; irritation of the  womb,  increased sexual desire,
increase of the  discharge  from the  least emotion, red urine,
painful urination, mucous discharge from  the vagina.
   Arnica.—The haemorrhage is caused  by a strain, a false
step, a concussion,  with discharge of bright-red blood mixed
with coagula;  nausea in  the pit of the  stomach, warmth
about the head and cold extremities.
   Bryonia—Often after Crocus, if this remedy has not been
sufficient, with profuse discharge of  a dark-red blood, violent
dragging pains in  the  small of the  back; distensive pain in
the temples, pressure in the abdomen, nausea, vertigo, fainting
turn.
   Chamomilla.—Discharge of a dark-red or black  blood,
badly smelling and mixed with coagula; the discharges take
place at intervals,  colic like labor-pain;  violent thirst, cold
extremities, pale  face,  fainting weakness, blur before the eyes
and buzzing in the  ears.
   Cinnamomum—For metrorrhagia  in consequence of a false
step, effort, strain,  fall or  other concussion, if arnica proves
ineffectual and the sexual desire is very much excited.
   Crocus.—Black and viscous blood, mixed with coagula, after
the  ineffectual use  of  Chamomilla,  China or Ferrum, with
movements in the abdomen as from a ball  or fetus;  yellowish
or livid complexion, great weakness,  sadness, uneasiness.
   Hyoscyamus.—Labor-pains, with  dragging  pains  in the
loins, small of the back and limbs; heat all over, with full and
hurried pulse; swelling of the veins of the hands and  feet;
restlessness, intense liveliness of disposition, trembling;  or,
numbness of the extremities, dulness of the senses, blur before
the  eyes,  delirium, twisting  of  the  tendons, and convulsive
shaking of  the limbs  alternating with tetanic  stiffness  of
the body. 
131              DISEASES  OF FEMALES.

  LYCOPODIVM-After Calcarea,  especially suitable to  girls
and women of gentle disposition, in chronic metrorrhagia with
scanty discharge,  compressive headache, nausea, violent pains
in the small of the back, weakness.
  Mercurius.—Metrorrhagia at the critical age, with vas-
cular excitement, congestion of the  head, swelling of the
labia, violent colic, painful swelling of the breasts, itching of
the  vulva.
  Nitri acidum.—Chronic  metrorrhagia  from  the  least
cause, and  even without  any perceptible cause, itching and
soreness of the vulva; heat and dryness  of the parts;  colic
and headache; weakness.
  Phosphorus.—Frequent  metrorrhagia with  profuse dis-
charge, colic,  toothache, sexual excitement,  shivering, cold
extremities, palpitation of the heart, lameness  of the ex-
tremities.
  Platina.—Thick  and dark-colored blood, with  drawing
pains down to the groin, sensation as if  the  internal organs
were drawn down, excitement of the parts  and of the sexual
instinct.
  Pulsatilla.—Occasional flow, recurring after  an interval
with renewed violence, or black blood mixed with  coagula,
accompanied by labor-pains; also suitable to women at the
critical age.
  Secale  cornutum—Adapted to  exhausted  and cachectic
females, with cobl extremities, pale or livid  face, small and
almost suppressed pulse, uneasiness and dread of death.
  Sepia.—Induration of the  neck of the uterus, with  spas-
modic colic,  painful pressure on  the  parts  with  stitches
through the parts.
  Stramonium.—Profuse discharge  of  black  blood mixed
with coagula;  drawing pains in the limbs, thighs and abdomen,
talkative mood, lascivious thoughts and  smell  of the whole
body as of semen.
  Sulphur—In  chronic metrorrhagia, with discharge of  a
thick,  black,  acrid and corrosive blood;  or  frequent scanty 
LEUC0RRHC3A.
135
discharges of blood; almost every day, ceasing only at short
intervals.
  For further  indications, see the articles Dysmenorrhoea,
Sections 5-10;  Menstrual Irregularities, Sections 16-21, and
Morbid Changes of the Menstrual Blood, Section 22.
  Dose.—Dissolve six globules,  or one or two drops of  the
liquid  preparation in  ten table-spoonfuls of water, and give
the patient a table-spoonful of this solution every ten minutes,
or every half hour or hour, until the haemorrhage is arrested ;
in passive or chronic metrorrhagia the medicine may be given
morning and evening, or three or four times a day, according
to the gravity of the case.
ARTICLE IX.
                     LEUCORRHCEA.

                       Section  44.

  Symptoms.—AVe understand  by leucorrhoea, a catarrhal
discharge from the mucous membrane of the vagina, or of the
uterus and  its appendages, without  regard to color.   This
discharge which may be more or less copious, often constitutes
the only symptom; in most cases it is white or colorless, scarcely
leaving any stains upon the linen, but  stiffening it and coming
off under friction in the  shape of a  fine powder  or of little
scales.  At  other times it has a slightly yellow or greenish
yellow tinge;  as regards consistence,  it varies from that of a
thin  serum to  the consistence of milk  or cream, or even of an
albuminous  or viscous  fluid.   The quantity of the discharge
varies likewise; at times it is a mere exudation, at  others the
discharge is  so copious that the woman has to wear  a bandage
as during the catamenial  flow-  There are even  cases where 
 \l))              DISEASES  OF FEMALES.

 the leucorrhocal discharge resembles a perfect flooding.   In
 idiopathic or catarrhal  leucorrhoea, the  liquid discharge is
 what is  termed mild, and does not irritate or excoriate the
 parts : but when the leucorrhocal discharge is merely a symp-
 tom indicative of violent  phlegmasia, or depending  upon or-
 ganic lesions of the uterus or its  appendages, the discharge
 becomes acrid, corrosive, fetid, brownish or greenish, and
 finally assumes  a malignant color  and quantity.   In most
 cases the leucorrhocal discharge proceeds both from the va-
 gina  and from  the uterine cavity ; the discharge from  the
 vagina is generally thin, white, of the consistence of milk or
 cream : the discharge from the uterine cavity, on the contrary,
 is thicker, more viscid,  albuminous, flocculent, and  has an
 alkaline  reaction, whereas the  vaginal  secretion is always
 acid.  If the  discharge proceeds both from the  vagina and
 uterus, the two are always found mixed up together.   Asa
 general rule, the leucorrhceal  discharge is more copious at the
 time of  the menses than at any other period; in other cases
 the discharge continues all  the  time,  although  varying  in
 quantity.  It may even  occur before the first menses have
made their  appearance, especially in the  case of fair, lym-
phatic or scrofulous girls ; sometimes this leucorrhoea ceases
as soon as menstruation  has  set in,  whereas,  in other cases,
the first menses  are delayed by the leucorrhceal discharge.
According to some authors the leucorrhoea  intermits during
the menses ; but this assertion is not  borne out by experience.
In some females the leucorrhceal discharge sets  in several days
or a week before the menses,  and ceases as soon  as these set
in ; in other cases the leucorrhoea only shows  itself after the
cessation of  the menstrual discharge;  sometimes, again, a
leucorrhceal discharge takes place instead of the menses which
remain absent.  If the leucorrhoea is but slight and not too
frequent, the general health of the female is not much affected
by  it, except some general debility and  a gnawing at the
stomach; but, if the discharge becomes more copious or con-
tinues all the time, the patient experiences pains and a heavi-
ness in the epigastrium, paroxysms of factitious hunger with 
LEUCORRHOEA.
137
fainting, nausea and vomiting, irregular and capricious appe-
tite, sometimes with desire for strange things not belonging
to the class of ailments; digestion becomes slow and difficult,
and is often followed in its  train by headache, vertigo, lazi-
ness  and slowness of  motion, pains  in the limbs, especially
between  the  shoulder-blades.  After a season  the patient
grows thin, with pale, thin or bloated face, livid or discolored
skin, dull eyes surrounded by margins, languid looks, inability
to perform the least exercise without  being attacked with pal-
pitation of the heart or losing her breath; the intellectual and
moral faculties  are weakened.  Cases of  this kind, where
leucorrhoea produces such a perfect  state of  exhaustion, are
indeed rare, although  some of these symptoms  are always
more or less complained of by women of an enfeebled consti-
tution, whenever the leucorrhceal discharge is at  all unusu-
ally copious and lasting.

                        Section 45.

  Causes.—In  most cases leucorrhoea is  the result of an
hereditary  predisposition, especially in the case of fair women
with  a cachectic,  feeble,  lymphatic or lymphatico-nervous
constitution, soft flesh and pale skin.  No age is exempt from
this affection ; it has been noticed even in children of eight,
six, four and two years old;  but it occurs more characteristi-
cally between the age of fifteen and forty-five.  In cold and
damp regions, leucorrhoea is quite common ; women who move
from the country to a large city, are very often attacked with
leucorrhoea; recently-built houses, or houses situated in nar-
row and  deep valleys or in marshy and damp districts, like-
wise engender a predisposition to leucorrhoea.   Some authors
speak of epidemic leucorrhoea, which they pretend broke out
in spring and fall-seasons  that were  colder and wetter than
usual.   According to some observers  a predisposition for leu-
corrhoea  is likewise induced by insufficient clothing, exposure
of the neck and  shoulders to the cold air, compression of the
body by corsets, abuse  of warm baths,  warm  injections, and 
 133              diseases  of females.

 washes, etc.   Feculent food, fish, crabs  and oysters, watery
 or acid fruits, milk, new beer, cider, hard water, the excessive
 use of tea and coffee, abuse of  purgatives or cmmenagogues,
 are likewise supposed to pave the way for leucorrhoea;  let us
 not forget to mention among  the causes of this disease depres-
 sing  passions,  chagrin, grief,  etc.  As  regards the various
 modes of  life and professions, we are not yet sufficiently pos-
 sessed of  facts in order to enable us to measure the influence
 which they exercise over  this disorder;  but onanism, exces-
 sive sexual intercourse, foreign  bodies in the vagina, such as
 r essaries, sponges, etc., are undoubtedly  productive of leucor-
 rheca.  In some cases leucorrhoea, results  from  some prior
 disease, such as scrofula, chlorosis, vaginitis, displacements of
 the womb, menstrual irregularities, confinement, miscarriage,
 pregnancy, dentition, chronic gastritis, intestinal worms, con-
 stipation and even pulmonary phthisis.   A most frequent or,
 at any rate, a very frequent cause of leucorrhoea is a certain
 metastasis developing itself in  consequence  of a sudden sup-
 pression of the perspiration, habitual sweat of the feet, piles,
 diarrhea, milky secretion, suppurations of long standing,
 ulcer  or issue, and even of a  cold  in the head, bronchial  ex-
 pectoration or  vomiting.  To this category likewise belong
 retrocessions of the gout, of an  eruption,  an old tetter or any
 other exanthem.

                       Section 46.

  Diagnosis,  prognosis, and  terminations.—Leucorrhoea
 may be easily confounded with  catarrhal inflammation of the
 vagina or uterus.   In order to prevent such a mistake, all that
 we have to do is to bear in mind that,  in catarrhal inflamma-
 tions  of the vagina and uterus,  symptoms of local  inflamma-
 tions  are  always present, such as pain, heat, tension of the
 affected parts, aggravation of the  symptoms  by walking  or by
 any other fatiguing exercise; and that the discharge, which,
 in simple leucorrhoea, is mild and white, in catarrhal inflam-
mations on the  contrary, is yellow, greenish  and more or less 
LEUC0RRHC3A.
139
acrid and corrosive.   Moreover, the mucous membrane of the
vagina, which,  in  simple  leucorrhoea, preserves  its natural
aspect, in a case of inflammation  looks more or less red, in-
jected,  swollen.   Discharges resulting from the presence of
polypus, engorgements of the neck of the uterus, cancers and
ulcerations, are  readily distinguished from the white and mu-
cous  secretions  occurring in simple leucorrhoea;  they are,
according  to  circumstances, purulent,  colored, bloody, fetid,
etc.;  the other  local symptoms and an  examination  of  the
organs will banish  all doubt.  Much greater is the difficulty
of distinguishing a  non-contiguous leucorrhoea from a venereal
discharge caused by the presence of chancrea or gonorrhoea.
If gonorrhoea is present,  the mucous lining of the vagina is
always more or less inflamed; and, if the leucorrhoea, is caused
by chancres, they  can easily be discovered by a careful  ex-
ploration of the  parts.  It behooves  us  moreover to distin-
guish between active or  sthenic and  passive or asthenic leu-
corrhoea ; the former which is owing to an acute irritation of
the mucous lining,  occurs  in robust women in consequence of
onanism or sexual abuses, or from some other irritating cause;
whereas the latter results from weakness  of the parts, and is
met with in feeble, cachectic or lymphatic women, in whom
it is caused by debilitating influences.  As regards prognosis,
leucorrhoea  is scarcely ever in itself a serious disease; it is
only when  it becomes excessive and permanent, that it may
weaken the constitution  and pave the way for  serious mala-
dies.   Leucorrhoea  is  a  very tedious malady and  difficult  to
cure,  unless we  make  an exception in favor of intermittent
leucorrhoea, and of that  which is induced by gastric or other
local irritations.   If depending upon some deep-seated organic
disorder, or kept up by  an unnatural mode of living, mental
excitement, etc., the disease is  exceedingly obstinate; the
older the patient, the more enfeebled and  the more lymphatic
her disposition,  the more  difficult  the cure.  If leucorrhoea
continues after the  period when the menses have permanently
ceased  to flow, it becomes  a very serious  disorder.   In some
cases, on the contrary,  for instance  in  girls at the age  of 
110
DISEASES OF FEMALES.
pubescence, the  leucorrhceal  discharge disappears almost of
itself; in other women it ceases after their first confinement,
or during pregnancy, or even after their first cohabitation. A
change of locality from a damp to a dry region of country
sometimes effects a cure; in other cases a cure is wrought by
the breaking out of a sweat, a catarrh, a  diarrhoea, vomiting,
bronchial irritation,  ptyalism or haemorrhage.  Lastly, it is
here as in other affections, the prognosis depends a good deal
upon  the treatment; under  allceopathic  treatment a number
of cases  remain unimproved, whereas, under homoeopathic
treatment, the most obstinate and apparently incurable cases
sometimes disappear  as if by magic.


                       Section 47.

  Treatment.—Preventive and even hygienic means are just
as important in the treatment of leucorrhoea as in that of ame-
norrhoea or  any other menstrual irregularity.   It is absolutely
necessary to the cure of leucorrhoea  that the patient should
live in a dry and open country, away from stagnant water, in
a healthy habitation; that she should be properly clad, fed;
and that  coffee, tea, injections, warm  baths, cathartics and all
other  disturbing causes by the presence of  which the discharge
might be  kept up, should be carefully removed.  Having at-
tended to the  regimen, the following remedies will  be found
efficient in arresting  the disorder:—

       1. Pulsatilla, Sepia,  Alumina, Calcarea, Kreosotum,
         Mercurius.
       2. Ammonium, Bovista, Carbo vegetabilis, China, Coccu-
         lus, Conium, Ferrum, Graphites, Phosphorus, Sabi-
         na, Silicea,  Sulphur.
       3. Arsenicum, Borax,  Cantharis, Carbo animalis, Cha-
         momdla, lodium, Kali, Mezereum,  Natrum,  Nitri
         acidum, Phosphori  acidum, Ruta,  Stannum, Sul-
         phuris acid. 
LEUC0RRHC3A.
141
       4.  Aconitum, Agnus, Ambra,  Anacardium,  Baryta,
         Belladonna,  Bryonia,  Cannabis,  Coffea,  Drosera,
         Guajacum, Hepar, Ignatia,  Manganum, Nitrum,
         Nux  moschata,  Nux vomica, Petroleum, Platina,
         Plumbum, Ranunculus, Sarsaparilla,  Secale,  Se-
         nega,  Squilla, Strontiana, Viola tricolor, Zincum.

  AVith the following particular indications.
  Alumina, for leucorrhoea before or after the menses; fre-
quent, acrid and profuse leucorrhoea, with heat and soreness
of the parts, and relief  from the use of cold washes ; discharge
of a flesh colored liquid,  after the  menses or  between the
menstrual periods, especially at  night, or in the afternoon,
when walking or sitting;  transparent, mucous leucorrhoea,
stiffening the linen; watery, yellowish and mucous leucorrhoea ;
itching at the vulva in  consequence of the  discharge.
  Calcarea.—Leucorrhoea before  the menses;  mucous  or
milky leucorrhoea, at intervals  and when  urinating;  leucor-
rhoea with heat and itching of the vulva.
  Kreasotum.—Whitish leucorrhoea,  preceded by pains in
the small of the back, with heat  in the face  ; white leucorrhoea,
smelling like rye; acrid, yellowish-white leucorrhoea causing
red spots, with  itching at the  vulva;  yellowish leucorrhoea,
with weakness of the legs; flesh-colored leucorrhoea, having a
foul  smell; discharge of  blood  and mucous from the vagina,
in the morning on rising; mild or acrid  leucorrhoea, always
with great weakness.
  Mercurius.—Mild  or acrid  leucorrhoea, whitish, purulent
and  corrosive leucorrhoea; greenish leucorrhoea, especially in
the evening, with itching of the parts at night; discharge of
mucous and purulent flocks from the vagina.
  Pulsatilla.—Watery,  acrid  and  burning  leucorrhoea;
milky leucorrhoea, sometimes without smell, and at times with
swelling of  the vulva, flowing  especially  after  the menses ;
mucous, thick  and white leucorrhoea,  especially  when lying
down, or before and  during  the menses,  with  abdominal
cramps. 
142
diseases of females.
   Sepia.—Leucorrhoea with stinging in the womb, pulling in
 the abdomen, itching in the vagina and at the vulva, or dis-
 tention  and  heaviness of  the  abdomen, leucorrhoea  after
 urinating or after making an effort to vomit, acrid leucorrhoea,
 with pain when walking;  leucorrhoea with discharge of fetid
 mucous  flocks; yellowish, watery  leucorrhoea;  mucous leu-
 corrhoea;  milky leucorrhoea,  only  in  the  day-time,  with
 burning pain and soreness  of the parts; puriform or muco-
 sanguineous leucorrhoea; discharge of a  reddish-green liquid
 from the vagina during pregnancy.
   Moreover :
   Ammonium.—Acrid, corrosive  leucorrhoea;  watery dis-
 charge from the uterus; burning, watery  leucorrhoea.
   Bovista.—Leucorrhoea  after the menses; viscid,  albu-
 minous leucorrhoea, or greenish, acrid, corrosive.
   Carbo-vegetabilis. — Leucorrhoea before  the  menses;
 watery, white leucorrhoea; corrosive, greenish leucorrhoea.
   Causticum.—Leucorrhoea at  night; leucorrhoea preceded
 by abdominal cramps, with emission of flatulence, pulling and
 lameness of the  small of the back, and painful flatulence  in
 the bowels.
   China.—Leucorrhoea before the menses, with painful  pres-
 sure on  the groin and anus;  bloody leucorrhoea, and discharge
 of small black coagula of fetid, purulent matter, with distres-
 sing itching and painful contraction in the inner organs.
   Cocculus.—Leucorrhoea instead of the menses or between
 the periods; flesh-colored  leucorrhoea,  with discharge  of a
 purulent and  sanious liquid;  discharge  of  bloody mucous
 during pregnancy.
   Conium.— Acrid, gnawing, corrosive  leucorrhoea; acrid,
burning, mucous leucorrhoea; thick, milky, leucorrhoea  with
labor-pains.   Before the discharge, pinching  colic, or lame-
ness in the small of the back.  Afterwards, lassitude and
hoarseness with cough and expectoration.
  Ferrum— Milky, gnawing and  corrosive leucorrhoea, also
before the menses, with discharge of mucous shreds from the
vagina. 
LEUCORRHEA.
143
   Graphites.—AVhite mucous leucorrhoea, also  with  weak-
 ness in the small of the back ; thin, light-coloured leucorrhoea
 with distention of the abdomen.
   Lycopodium.—Leucorrhoea  at intervals; also preceded by
 cutting colic; rose-coloured leucorrhoea before full-moon.
   Phosphorus.—Mucous  leucorrhoea;  acrid and blistering
 leucorrhoea; viscid leucorrhoea in the place  of the menses.
   Sabina.—Leucorrhoea with amenorrhoea; itching and milky
 leucorrhoea; jelly-like, yellowish, ichorous and fetid leucor-
 rhoea, with flesh-coloured discharge every fortnight.
   Silicea—Smarting leucorrhoea,  especially  after  eating
 acids;  watery leucorrhoea, after  urinating, or  after colic
 around the navel.
   Sulphur—Leucorrhoea before the  menses;  leucorrhoea
preceded by cutting colic or pinching around the navel, watery
 or yellowish; corrosive leucorrhoea, burning or smarting like
 salt.
   Also:
   Arsenicum.—Leucorrhoea when standing; acrid, corrosive,
 thick and yellowish leucorrhoea.
   Borax.—Albuminous leucorrhoea,  with sensation  as if hot
 water were running down  the  thighs;  corrosive  leucorrhoea,
 also like starch.
   Cantharis.—Acrid, burning leucorrhoea;  discharge  of
 bloody mucus after the menses.
   Carbo animalis—Yellowish, burning leucorrhoea.
   Chamomilla—Yellowish, smarting leucorrhoea; acrid and
watery discharge from the vagina after a meal.
  Iodium.—Chronic  leucorrhoea, flowing particularly at the
period of the menses, with  soreness of the thighs.
  Kali carbonicum.—Yellowish  leucorrhoea, also with itch-
ing of the parts.
  Magnesia carbonica.—Chronic leucorrhoea; also particu-
larly when walking or sitting, preceded  by uterine cramps.
  Magnesia  muriatica.—Leucorrhoea after stool  or  after
urinating, also preceded by uterine cramps; leucorrhoea be-
tween  the periods, followed by  bloody discharge. 
144
DISEASES OF FEMALES.
   Mezereum.—Chronic malignant leucorrhoea.
   Natrum carbonicum—Leucorrhoea preceded by colic and
cutting pain in the bowels; putrid leucorrhoea.
   Natrum muriaticum.—Leucorrhoea preceded by cramps,
contraction in the abdomen;  acrid leucorrhoea, with yellowish
compression; yellowish leucorrhoea, especially when walking;
profuse mucous,  white and transparent  leucorrhoea; leucor-
rhoea with headache, colic, mucous diarrhoea.
   Nitri acidum.—Mucous,  filamentous, flesh-colored leucor-
rhoea; mucous and greenish leucorrhoea after the menses;
fetid, brownish leucorrhoea.
  Phosphori acidum.—Yellowish, and purulent leucorrhoea
after the menses.
   ]Iota.—Acrid, gnawing leucorrhoea, after the menses.
  Stannum.—Yellowish,  debilitating leucorrhoea.
  Sulphuris acidum__Painless leucorrhoea;  acrid burning
leucorrhoea; bloody mucus from the vagina.
  Also:
  Aconitum.—Profuse, yellowish, viscid leucorrhoea; bloody
leucorrhoea.
  Ambra.—Chronic leucorrhoea;  thick,  mucous leucorrhoea,
preceded by stitches in the vagina; discharge of blueish mucus
from the vagina.
  Ammonia muriaticum.—Leucorrhoea with distention of the
abdomen ; brownish leucorrhoea after urinating.
  Anacardium.—Itching leucorrhoea, with soreness of the
parts.
  Antimonium crudum.—Acrid, stinging water  from the
vagina.
  Baryta—Mucous  leucorrhoea, with  palpitation  of the
heart, fainting weakness.
  Belladonna.—Leucorrhoea with  colic, alternating some-
times with metrorrhagia.
  Capsicum.—Fetid leucorrhoea.
  Coffea.—Profuse discharge of mucus from the vagina,
with frequent discharge of blood, itching and  excitement of
the parts. 
LEUCORRHOEA.
145
  Copaiva.—Bloody and mucous leucorrhoea; thick, purulent
leucorrhoea, with constant pressure on the vagina.
  Drosera.—Leucorrhoea, with colic like labor-pains, during
the suppression of the menses.
  Hepar  sulphuris.—Leucorrhoea with  smarting  of the
vulva.
  Ignatia.—Puriform, acrid, gnawing leucorrhoea, preceded
by uterine  cramps.
  Lachesis.—Leucorrhoea  before  the  menses, a greenish
mucus, with scanty and short menses.
  Nitrum.—AVhite leucorrhoea, with lameness in the  small of
the back.
  Nux vomica.—Fetid, yellowish or mucous leucorrhoea.
  Petroleum.—Leucorrhoea with voluptuous dreams.
  Platina.—Albuminous leucorrhoea, only in  the day-time.
   Sarsaparilla__Mucous leucorrhoea when walking.
   Tabacum.—Flesh-coloured  leucorrhoea,  a fortnight after
the menses.
   Tartarus emeticus__Viscid,  white, mucous leucorrhoea.
   Zincum.—Mucous leucorrhoea, especially after stool; leu-
corrhoea preceded by cutting in  the bowels,  gnawing,  or
pinching in the epigastrium; thick  leucorrhoea, morning and
evening, before and during the menses.
   Dose.—Of  the appropriate  remedy give the patient six
globules or one or two drops  of the attenuated remedy  on
sugar or in a spoonful of water, morning and evening.

                       Section  48.

   Particular indications__We  shall  here give only the
symptomatic indications  that refer exclusively  to idiopathic
leucorrhoea, depending upon a catarrhal state of the vagina
and uterus. AVe shall say nothing of symptomatic leucorrhoea,
depending  upon organic diseases of the uterus and its  append-
ages, such as,  polypi, ulcerations, scirrhus, cancer, etc.; for
in all such cases of leucorrhoea, it is these diseases that have
to form the main object of the treatment.  For  the treatment
                            10 
140               DISEASES OF  FEMALES.

of these affections we refer the reader to the chapters where
they have  been treated  with  full details.   Here follow  the
symptomatic  indications  of idiopathic leucorrhoea, or leucor-
rhoea resulting from a simple, catarrhal or inflammatory con-
dition of the vaginal and  uterine mucous  membrane:—
For  copious  leucorrikea:—1.  Ammonium, Graphites, La-
         chesis, Natrum muriaticum.
       2. Aconitum,  Alumina,  Carbo vegetabilis, Causticum,
        Magnesia muriatica,  Phosphorus, Phosphoric  acid,
         S'pia, Silicea.
     Obstinate :—1.  Alumina,  Borax,   Odcarca,  lodium,
         Kreosotum, Mercurius,  Mezereum, Pulsatilla, Sepia,
       2.  Carbo vegetabilis, China,  Cocculus,  Conium, Fer-
         rum,  Graphites, Lycopodium,  Phosphorus, Sabina,
         Silic'-a,  Sulp)hur.
     Simple:—1.  Odcarca, Pulsatilla, Sepia.
       2. Ammoniacum,  Borax,  Graphites, Silicea, Stannum,
         Sulphur.
       3. Arsenicum,  Carbo  vegetabilis,  Ferrum,  Natrum,
         Nitrum, Nitri acidum, Nux vomica, Sabina, Zincum.
       4. Ambra,  Belladonna,  Bryonia, Cantharis,   Carbo
         animalis,  Cocculus, Conium,  Ferrum, Guaiacum,
         Mercurius, Phosphorus,  Plumbum, Senega, Sulphu-
         ris acid.
     Inflammatory, with  vaginitis or catarrhal metritis:—
       1. Alumina, Ferrum, Mercurius, P/iosjjhorus.
       2. Arsenicum, Bovista, Carbo  vegetabilis, Conium,  Jo-
         dium, Sepia, Silicea.
       3. Ammoniacum,  Chamomilla, Ignatia, Lycopodium,
         Pulsatilla, Ruta, Sulphuris acidum.
       4. Antimonium,  Calcarea, Cannabis, Cantharis,  Carbo
         animalis, China, Hepar, Kali, Nitri acidum, Thaja.
     Sthenic or  active:—1.  Calcarea, Carbo vegetabilis, Fer-
         rum, Mercurius, Phosphorus, Pulsatilla, Sepia, Sili-
         cea, Sulpjhu.r.
       2. Arsenicum, Chamomilla,  Cocculus, Coffea, lodium,
         Phosphorus, Sabina. 
LEUCORRHOEA.                  147
     Asthenic or passive:—I.China, Cocculus,Ferrum, Pul-
         satilla, Sulphur.
       2.  Arsenicum,  Carbo vegetabilis, Conium,  Graphites,
         Kali, Natrum, Phosphorus, Sepia, Stannum.
For leucorrhoea before the menses:—1. Calcarea, Lachesis.
       2.  Baryta,  Carbo vegetabilis, China, Phosphorus.
       3.  Graphites, Pulsatilla, Ruta, Sepia, Sulphur, Zin-
         cum.
     During the menses:—1. Alumina.
       2.  China,  Cocculus,  Graphites,  Lachesis,  Pulsatilla,
         Zincum.
     Following the menses:—1. Alumina, Pulsatilla, Ruta,
         Sabina.
       2.  Bovista, Cocculus, Graphites, Kreosotum,  Mercurius,
         Nitri acidum, Silicea, Sulphur.
     In place of the menses :—1.  Calcarea, Conium, Mercu-
         rius, Pulsatilla, Sepia.
       2.  Alumina,  China, Graphites,  Kali, Natrum, Nux
         vomica, Phosphorus, Sabina, Silicea,  Sulphur, Zin-
         cum.
       3.  Aconitum, Agnus, Arsenicum,  Carbo animalis, Carbo
         vegetabilis,  Drosera, lodium, Lachesis,  Magnesia car-
         bonica, Nitri acidum, Petroleum,
  With reference to the character  of  the leucorrhoeal  dis-
charge :—
Leucorrhoea, albuminous':—Borax,  Bovista, Platina.
     Bloody :—1.  China, Cocculus.
       2. Arsenicum, Nitri acidum.
       3. Lycopodium, Sepia, Silicea, Sulphuris acid.
       4. Alumina,  Calcarea,  Cantharis, Conium, Tartarus.
    Blueish :—Ambra.
     Burning:—1.  Calcarea, Pulsatilla.
       2.  Conium,  Kreosotum.
       3.  Cantharis,  Carbo animalis, Kali, Sulphuric acid.
       4. Arsenicum, Borax. 
148              DISEASES  of females.
LEL'CORr.n'EA, brownish :—Cocculus, Nitri acidum.
    Corrosive, acrid:—1. Alumina, Ferrum,  Mercurius,
         Phosphorus.
      2. Arsenica, Carbo vegetabilis, Conium, lodium, Sepia,
         Silicea,
      3. Ammoniacum, Chamomilla,  Ignatia,  Lycopodium,
         Pulsatilla, Ruta, Sulphur.
      4. Borax, Calcarea, Cantharis, Carbo animalis, China,
         Hepar. Kali, Lachesis, Magnesia, Natrum muriati-
         cum, Nitri acidum, Thuja.
    Fetid :—1. Kreosotum, Sabina.
      2. Natrum, Nux vomica,
      !>. Cluna, Nitri acidum,  Sepia.
      4. Capsic ion, Sabina.
    Flesh-colored :—1. Cocculus.
      2. Alumina,  Calcarea,  Lycopodium,  Nitri acidum,
        Phosphorus, Sabina, Sepia, Silicea.
      3.  Baryta, Carbo vegetabilis, China,  Conium, Tartarus.
   Greenish.—1. Sepia.
      2.  Bovista, Mercurius.
      3.   Carbo vegetabilis, Nitri acidum, Pulsatilla.
   Itching :—1.  Calcarea.
      2. Alumina, Mercurius.
      3. Sabina, Sepia.
     4.  Arsenicum, Chamomilla,  China,  Conium, Ferrum,
        Kali, Phosphorus, Silicea, Sulphur.
   Milky:—1. Oikarea, Pulsatilla.
     2.  Silicea.
     3.   Carbo vegetabilis, Ferrum, Sulphur.
     4.  Conium, Lycopodium,  Natrum muriaticum,  Phos-
       phorus, Sabina, Sepia.
   Mucous:—1. Borax, Pulsatilla.
     2.  Graphites, Natrum, Stannum, Sulphur
     3.  Alumina, Ambra, Bovista, Carbo  vegetabilis, Coni-
       um, Mercurius, Nitri acidum, Nux vomica, Sabina,
       rs'.p,a, Zuicum.                                 ' 
                  LEUC0RRHC3A.                   149

  4. Arsenicum, Belladonna,  Bryonia, Cantharis, Carlo
     animalis,  China,  Ferrum,  Guajacum, Phosphorus,
     Senega, Thuja.

Purulent :—1.  Cocculus, Mercurius, Sabina.
  2.  China, Sepia.
  3.  Copaiva, Nitri acidum.
Reddish:—1. Cocculus.
  2.  Calcarea, Nitri acidum, Phosphorus, Sabina, Sepia,
     Silicea.
  3. Baryta,  Carbo vegetabilis, China, Tartarus.
Thick:—1. Pulsatilla.
  2. Sabina.
  3. Arsenica, Zincum.
  4.  Ambra,  Borax, Bovista,  Carbo vegetabilis,  Conium,
     Sepia.
Viscid :—1. Borax, Stannum.
  2. Bovista,  Sabina.
  3. Aconitum, Phosphorus,  Tartarus.
Watery:—1.  Graphites, Pulsatilla, Sepia.
  2. Alumina, Carbo animalis, Carbo vegetabilis, Silicea,
     Sulphur.
  3. Chamomilla, China, Kreosotum, Mercurius, Nitrum,
     Tartarus.

White :—1. Calcarea, Pulsatilla.
  2. Silicea.
  3. Carbo vegetabilis, Ferrum, Mercurius, Sulphur.
  4. Borax, Conium,  Graphites,  Nitrum, Phosphorus,
     Sabina, Sepia, Sulphur, Sulphuris acidum.
Yellowish :—Sepia.
  2. Kreosotum, Sabina.
  3. Carbo animalis, Carbo vegetabilis, Chamomilla, Nux
    vomica.
  4. Aconitum, Alumina, Mercurius, Stannum, Sulphur. 
150
diseases of females.
With reference to the existing causes:—
    After C0TT:—Natrum.
    At intervals:— Calcarea,  Silicea,
    At full-moon:—Lycopodium.
    During a walk :—Strontiana.
    Motion :—Magnesia carbonica.
    At night:—Ambra, Natrum muriaticum.
    After stool:—Zincum.
    AA'hen  urinating or after:—1. Carbo vegetabilis, Silicea.
       2. Calcarea.
Leucorrhoea in the secondary symptoms in general :—
       1. Kreosotum, Mercurius, Sepia,
       2. Alumina,  Calcarea,  Cocculus,  Kali, Lycopodium.
         Pulsatilla, Silicea.
       3. Arsenica,  Carbo animalis,  Ferrum, Magnesia, Na-
         trum, Phosphorus, Sulphur, Sulphuris acidum, Zin-
         cum.
       4. Ambra, Ammoniacum, Antimonium, Baryta, Bella-
         donna, Borax, Bovista, Cannabis, Cantharis,  Carbo
         vegetabilis, Causticum,  Chamomilla, China, Copaiva,
         Drosera, Graphites, Ilpar,  lodium, Nitrum,  Nitri
         acidum, Phosphori acidum, Platina,  Ruta, Sabina,
         Secale,  Stannum, Thuja.
     With, distention of abdomen:—Graphites, Sepia.
     AVith cephalgia:—Natrum muriaticum.
Leucorrhoea with colic :—1. Magnesia muriatica.
       2. Ignatia, Lycopodium, Magnesia carbonica,.
       3.  Causticum,  Conium,   Drosera, Pulsatilla,  Sepia,
         Silicea, Sulphur, Zincum'.
       4. Alumina, Ammonia  muriatica, Belladonna,  Kali,
         Mercurius, Natrum, Natrum muriaticum.
     With  uterine cramps:—1.  Magnesia muriatica.
       2. Caustkum,  Ignatia, Magnes. carb., Natrum muriat.
     AATith DIArr>hc3A :—Natrum muriaticum. 
hysteralgia.
151
Stinging in the parts:—Sepia.
With yellow face :—1. Natrum muriaticum.
  2. China, Ferrum, Sepia.
Pale:—1.  Pulsatilla.
  2. Arsenicum, Sepia.
  3. Graphites, Kreosotum, Natrum muriaticum.
AVith weakness:—1.  Kreosotum.
  2. Alumina, Baryta.
With  pains in small of back :—1. Magnesia muria-
  tica.
  2. Causticum, Kreosotum.
  3. Baryta, Conium, Graphites, Kali, Nitrum.
AVith voluptuous dreams:—Petrohum.
With trembling.:—Alumina.
ARTICLE  X.
          UTERINE  CRAMPS, HYSTERALGIA.

                       Section 49.

  Symptoms,  causes, treatment.—The  pains which  are
known under the name of uterine cramps, or hysteralgia, are
a real neuralgia of the uterus, and are both idiopathic, or
existing independently of any organic affection of the uterus,
and symptomatic, or depending upon some organic lesion of
the womb.   This neuralgia is generally characterized by in-
tense, acute, lancinating or tearing pains, which are generally
irregular, intermittent, recurring at more or less regular and
well-marked intervals, and being principally seated in  the
hypogastrium, whence the pain radiates to the groins, exter-
nal pudendum  and anal region.   Hysteralgia  only occurs 
 1.V2              diseases of females.

 during the age when women menstruate, and attacks particu-
 larly nervous and irritable women, in whom it may be excited
 by any thing that has a tendency to exalt the sensitiveness
 of the uterus.   Sometimes the disease  accompanies the men-
 strual functions and, in such a case, manifest itself some time
 previous  to  the menses setting in.  The  best  remedies for
 this affection are:
   1.  Causticum, Cocculus, Conium, Ignatia, Magnesia muria-
 ticum, Nux vomica.
   2. Belladonna, Baryta, Chamomilla, Hyoscyamus, Natrum
 muriaticum,  Platina, Spia, Stannum.
   AVith the following particular indications:—
   Causticum.—For uterine cramps, with pains in the hypo-
 gastrium, or  in  the stomach, chest or small of the  back,
 obliging her to bend double ; fulness, pressure in the abdomen
 as if it would burst; constant but  ineffectual desire to raise
 wind ;  violent increase  of the pain after taking the least nou-
 rishment, or  after raising herself and tightening her clothes
 round  the hypogastrium; relieved by external heat.
   Cocculus.—Painful  pressure in  the uterus, with  pressure
 on  the chest, restlessness, sighs, flatulence, fainting nausea,
 oppression and cramps of the chest; anxiety and starting of
 limbs;  suppression of  the menses,  or  leucorrhoea  in  their
 stead.
   Conium.— Uterine cramps with  digging in  the vulva, dis-
 tention of the abdomen and stitches  extending  to the right
 side of the chest; pinching and squeezing in the  uterus.
  Ignatia—Uterine cramps  with  cutting stitches, labor-
 pains ;  compressive hysteralgia, followed by puriform leucor-
 rhoea,  or accompanied  by  dyspnoea; relieved  by  external
 pressure  or lying on  the back.
  Magnesia muriatica.— Uterine  cramps, with  pains ex-
 tending to the thighs And followed by leucorrhoea.
  Ki'X vomica.— Contractive  hysteralgia, with  digging and
clutching  pains, especially during the menses, with increase
of the  menstrual  discharge and passage of coagula; painful 
hysteralgia.
153
pressure in  the parts, especially in the morning in bed, or
during a walk in the open air, with painful contraction in the
hypogastrium.
  Dose.—Dissolve  in  globules or one or two  drops of  the
attenuated preparation in ten  table-spoonfuls of water, and
give the patient a  table-spoonful  every half hour,  or every
hour or two hours until the pain is removed.
  Also  the following remedies:—
  Belladonna, for:—Clutching pains in the hypogastrium,
with pains  in the small of the back and drawing pains down
the thighs;  heaviness  and pressure on  the parts; the pains
are especially felt before the menses, with congestion of  the
head.
  Bryonia.—Uterine cramps, with pinching and uneasiness
in the abdomen, as  if the menses would make their appear-
ance ; burning  pains in the uterus;  pressure and fulness in
the pit  of the stomach.
   Chamomilla.—Uterine  cramps, with  pulling  sensation
down to the thighs; pressure in the uterus  like labor-pains,
with frequent urging to urinate.
   Hyoscyamus__Uterine cramps, with pains like labor-pains,
especially before the menses, and with pulling  in  the loins
and small of the back.
   Natrum  muriatIcum.—Uterine cramps, especially at the
period of the menses, with burning, and cutting pains in  the
groins.
   Sabina.—Lancinating uterine cramps, or pulling  and cut-
ting in  the hypogastrium or groin, as if the menses tvould make
their appearance, with pressure on  the parts, groin and  small
of the back, and tenesmus at the anus.
   Sepia.— Uterine pains, like painful rigidity, or pressure on
the parts, as if every thing  would issue through the vulva,
with cutting pains and jelly-like leucorrhoea.
   Stannum.—Uterine cramps,  with pressure in the  hypogas-
trium and uterus, as if the menses  would make their appear-
ance.
  Dose.—The  same as page  145. 
154              diseases  of females.
ARTICLE  XI.
                   NYMPHOMANIA.

                      Section 50.

  Symptoms.—Authors  are  exceedingly divided in opinion
concerning the character of this affection, which consists in an
excessive excitement of  the  sexual desire  in  females; some
confound it  entirely with erotalgia or erotomania, which is
simply a platonic aberration of the mind, whereas nympho-
mania is a disease characterized by physical symptoms ; some
again do not look upon it3 as a disease, but only as  an exces-
sive development of a perfectly natural instinct; others again
regard it simply as a surexcitation of the sexual organs.  Our
own opinion  is, that nymphomania is a  real disease, charac-
terized  by a violent desire for sexual union, which  is  mani-
fested  by improper expressions and signs, with or without
physical excitement of the parts,  but  which is distinguished
from  erotomania  by this, that, in the  latter condition, the
patient desires an  absolute physical and spiritual union with
the sole object of her love, without any expressed  desire for
the material  act, which  always remains  subordinate  to the
higher desire; whereas a woman affected with nymphomania,
desires  sexual intercourse with any person indiscriminately.
In erotomania the desire is of a spiritual, in nymphomania of
a physical nature.  Most authors who  have treated of this
disease, have distinguished three periods.   In  the first  period,
no external  symptom reveals as yet the invasion of the dis-
ease,  for the patients are still able to  conceal  the obscene
ideas with  which their  imaginations  are  filled.  Soon, how-
ever,  relapsing into their amorous reveries  in  spite of all 
NYMPHOMANIA.
155
efforts to the contrary, the patients lose courage, seek solitary
places,  and  finally  abandon  themselves  to their  unbridled
fancies and desires, and sometimes even go so far as to gratify
their passion by self-pollution.  At this period we frequently
observe a marked turgescence about the breasts  and parts,
with itching, tension, and a more or less copious leucorrhoea.
In the second period, the patients abandon themselves with-
out any restraint  to their passions,  and seize every opportu-
nity of talking about amorous enjoyments; they lose all sense
of modesty, inviting the men  near them to have sexual inter-
course with them; at the same time the patients try to inflame
their  desires by all sort of means, reading  lascivious novels,
conversation, voluptuous  songs, stimulating diet,  touch.  In
the third period the disease presents a truly sorrowful aspect
of human misery; the female is totally insane ; she invites the
first man  she sees to have  intimacies with her;  she throws
herself upon him, exciting him by words, improper attitudes,
and, if he resists, she becomes raving,  and  tears and strikes
whatever is within her reach.  The  most timid girl becomes
like a mad prostitute; modesty gives place to wild  lust, and
the horribly excited fancy  frequently leads patients to self-
abuse.  At this period other symptoms generally manifest
themselves, such as convulsive movements, or burning thirst,
dry and burning mouth;  discharge of a thick froth  from  the
mouth; fetid breath ; spasms of the throat, with hydrophobia,
sleeplessness, restless sleep, with  distressing, heavy and las-
civious dreams.   Sometimes the attacks are followed by a sort
of prostration which it is of the utmost importance to arrest.
Towards the close of the disease, the patients generally fall
into a sort of  slow fever, with  colliquative diarrhoea and
general consumption, and thus they die with all the symptoms
of a most violent  acute or chronic malady; sometimes they
succumb even during  a violent spasmodic  paroxysm of the
disease, although such an occurrence happens very rarely. 
l.V.
diseases of females.
Section  51.
  Cause*  prognosis, TREATMENT.-Nymphomania  rarely
ever breaks out before the age of pubescence, or after some
critical period,  although young girls as well as old women
have in isolated cases, been attacked with it.  According to
some'authors, it is most frequently met with among women
with strong muscles, rich  and black hair,  black, lively and
larcre  eyes, an  expressive and animated countenance, well-
formed, full and  large  breasts,  round  hips, a slender and
straight waist, large mouth, red  and thick lips, white, round
and properly arranged  teeth; in some cases, however,  the
disease has been met with among  females of a totally different
character.  The disease has been observed in  young widows
of an  ardent temperament, and who are suddenly deprived of
the sexual pleasures which had been their delight;  or  it like-
wise attacks  married  women  whom  their feeble  and sickly
husbands could not satisfy.   On  the  other hand, excessive
sexual intercourse and onanism likewise lead to the disease.
In  other  cases, nymphomania seems to arise from  itching
eruptions at the vulva, such as lichen, erythema, etc.,  in con-
sequence of which the patients have to rub the parts  all the
time,  by  which means  the sensitiveness of these organs is
much increased; a similar effect  appears to have resulted from
the presence of ascarides in the  rectum or anus.  Sometimes
the affection  seems to be owing to organic diseases of  the va-
gina, vulva, uterus or  its appendages. Feather beds, sleeping
too long in  the  morning, stimulating food or drink, coffee,
liquor, chocolate; certain kinds of fish,  truffles,  cinnamon,
 vanilla, etc.;  balls, theatres,  novel-reading, a violent and un-
requited  passion, bad  examples, and other influences  that
 excite and inflame  the  imagination, may lead to  the devel-
 opment of this horrible  disorder.  As regards ywognosis, it is
 always favorable as long as the  third stage has not yet set in.
 A  good deal depends upon the treatment.   Under old school
 treatment many cases have been pronounced incurable, which
 have yielded perfectly to homoeopathic treatment.  The best 
NYMPHOMANIA.
157
 remedies for this disease, according to our provings  and to
 positive clinical experience, are:

        1. Phosphorus, Platina.
        2. Hyoscyamus, Stramonium,  Veratrum.
        3. Belladonna, Cantharis, Natrum muriaticum, Nux
         vomica, Pulsatilla.
       4.  China, Mercurius, Sulphur, Zincum.
       5. Agnus, Majoran.

   Especially when the following conditions occur:

 During confinement :—1. Platina, Belladonna, Pulsatilla.
       2. Sulphur,  Veratrum, Zincum.
 With physical Weakness of the organs:
        Agnus,  Calcar.,  Conium,  Graphites, Hyoscyamus,
         Lachesis, Moschus,  Natrum mur., Opium,  Sepia,
         Stramonium, Sulphur.
 With Leucorrhosa:—1.  Calcarea, Mercurius, Pulsatilla,
         Sepia.
        2. Carbo vegetabilis, China, Conium, Graphites, Natrum
         mur., Nux vomica, Phosphorus, Sulphur, Zincum.
        3.  Agnus, Lachesis, Nitric acid, Silicea.
 AVith lascivious furor :—1. Hyoscyamus, Stramonia,  Vera-
         trum.
        2.  Belladonna, Cantharis, Mercurius, Nux vomica,
         Phosphorus, Platina, Pulsatilla, Zincum.
 During Pregnancy: — Belladonna, Platina, Stramonium,
         Veratrum, Lachesis, Mercurius, Pulsatilla.
 With want of Modesty :—1. Hyoscyamus, Stramonium, Ver-
        atrum.
       2. Belladonna, Nux vomica, Opium, Phosphorus.
After Onanism:—1. Nux vomica, Sulphur.
       2. Calcarea,  Carbo  vegetabilis,  China,  Mercurius,
        Natrum mur., Phosphorus, Platina, Pulsatilla.
With desire for Onanism:—Sulphur. 
15S              diseases  of females.

AVith Itching  at the vulva :-l.  Calcarea, Carbo vegetabilis,
         Conium, Natrum mur., Sepia, Silicea, Sulphur.
       2.  Lmhesis, Mercurius, Nitric acid, Platina.
At the time of the Menses:—1. Stramonium.
      2. Hyoscyamus, Veratrum.
       3.  Platina, Pulsatilla, Sepia.
AVith  Spiritual excitation without the physical:—
      1. Calcarea,  Carbo vegetabilis, China, Phosphorus.
       2.  Cantharis,  Graphites,  Lachesis,  Natrum  mur.,
         Pulsatilla, Sepia, Stramonium, Veratrum.
       3. Conium, Ignatius, Majoran, Moschus,Nitric acid,
         Zincum.
AVith excitement of the parts, turgescence of the vulva, etc:
       1. Platina.
       2. Cantharis,  Natrum mur.,  Nux vomica, Phospho-
         rus,  Pulsatilla.
   3.  Graphites, Nitric acid., Opium, Silicea.
                    ARTICLE  XII.



            CHLOROSIS, GREEN-SICKNESS.

                      Section  52.

  Symptoms and course.—Chlorosis, which seems  to  be a
disease peculiar  to  females, although it has also been ob-
served in  males,* is characterized by discoloration and pale-
ness of the skin, and more particularly of the face,  habitual
weakness, derangement of the digestive functions, embarrassed
respiration, and  frequently by the presence  of  amenorrhoea
or dysmenorrhoea.  The group of  symptoms which is generally
* See Uzac, on Chlorosis in Males.  Paris: 1853.  In quarto. 
chlorosis.
159
present  in  this  affection,  is  the  following:  yellowish  or
greenish paleness of the face, with bloatedness of the part, white
lips, livid and swollen eyelids after  sleeping; sad expression
of the eyes and excessive whiteness  of the conjunctiva;  dry-
ness, or dull leaden or earthy color of the skin; flabbiness of
the flesh, oedema of  the  feet;  diminished appetite, or loss of
appetite, dyspepsia,  desire for hearty food or for things which
cannot be  eaten,  such  as  chalk,  coal, etc.;  constipation,
nausea, vomiting; small  and frequent  pulse; palpitation  of
the heart; dyspnoea, especially when going  up stairs or when
ascending an eminence ; spontaneous attacks of weariness even
unto  fainting; laziness,  aversion to  movement;  desire to be
alone; sadness, sighs, frequent weeping;  menstrual irregu-
larities or suppression;  the menstrual  discharge is scanty,
pale and serous;  aggravation of the symptoms  at each men-
strual period, with gastralgia, fainting, melancholy, foreboding,
melancholy thoughts.  If the disease continues, other symp-
toms develop themselves, such as headache at the occiput,
painful distension of the abdomen, organic affections in vari-
ous  parts, hectic fever.   Frequently the disease  announces
itself by sadness and indolence, followed  by  digestive de-
rangements, discoloration of the skin, and all the other symp-
toms.  In some cases the disease sets in with gastric  derange-
ment, or mucous inflammation of the stomach and bowels.  At
length incurable and fatal affections  may develop themselves
as consequences  of  this  disease.  Pathological  anatomy has
so far been unable to reveal  any disorganizations that might
be looked upon as peculiar  to this  malady, unless  we may
accept the statement of some authors that bodies  have been
found destitute of blood ;  for as to the other organic  changes,
such  as  serous effusions in the various cavities, pulmonary
tubercles, organic lesions of  the heart, liver, spleen, ovaries,
etc., they do not belong to the  chlorosis proper,  but ought  to
be traced to affections that have developed themselves during
the course of chlorosis, sometimes even in consequence of an
improper management of the disease.   Some authors regard
chlorosis as a symptom of amenorrhoea, and not by any means 
ir,o
DISEASES OF FEMALES.
as a disease  by itself.   It is true,  in  many cases, chlorosis
only sets in after amenorrhoea has taken place;  but there arc
also cases where chlorosis precedes the menstrual suppression,
and where it exists without either amenorrhoea or dysmenor-
rhoea being present, so that it would seem as though chlorosis
and amenorrhoea, so far from holding towards each other the
relation of  cause and effect, are, on the contrary, the effects
of one and the same cause, which may perhaps be a deranged
condition of the functions of digestion and reproduction.


                      Section 53.

   Causes,  diagnosis and prognosis.—According to some
authors, the proximate cause of chlorosis is an inertia of the
genital  organs.   This  opinion  will appear  somewhat well
founded, if we consider that chlorosis generally takes place at
the period of  pubescence, and if the menstrual  functions are
either delayed or otherwise irregular.   It has, however, been
mot with in both widows and married women in consequence
of excesses.   Predisposing causes  seem to be:  a lymphatic
temperament; a feeble constitution; the influence of a  cold
and damp dwelling or temperature;  indigestible or not suf-
ficiently  nourishing food;  abuse of watery, cold  or warm
beverages, (tea, coffee, decoctions, etc.;) warm baths; wines of
bad quality, abuse of spirits; excessive sleeping  or watching;
sedentary habits, onanism,  and other debilitating causes.   As
exciting  causes  we  may likewise mention:  disturbing emo-
tions, ennui,  imprisonment, unhappy  or  disappointed love,
abstemiousness ; accidental and prolonged menstrual suppres-
sion; debilitating,  acute  and chronic maladies.   It is  not
always easy to distinguish between chlorosis and other affec-
tions where paleness  is  a prominent  symptom.   Such, for
instance, as anaemia, which resembles chlorosis  as  far as the
color of the skin is  concerned;  but the other symptoms and
the causes which produce each malady,  will enable  us to dis-
tinguish  one  from the other.   AVhatever  resemblance these
two maladies may bear to each other, as far  as the discolora- 
CHLOROSIS.
161
tion of the skin, of the conjunctiva, lips, mucous membrane
of the mouth, and various other symptoms which both diseases
have in common, are concerned, the derangement of the vis-
ceral  functions is  much more marked in chlorosis than in
anaemia;  moreover, we observe in chlorosis  cerebral disturb-
ances, melancholy, headache, pains in the stomach, and strange
tastes  which are entirely  wanting in anaemia.  It  is much
more  easy to confound  chlorosis  with  certain organic affec-
tions of the heart, so much more as dyspnoea, violent palpita-
tion of the heart, various abnormal sounds, serous  effusions,
etc., are frequently present in  chlorosis; what will enable us,
however,  to establish a correct  diagnosis,  is this,  that, in
chlorosis, all these signs are always irregular and changing ;
whereas, in organic diseases of the heart, they are more fixed
and always permanent.  We hardly need allude to  the  dis-
tinction between chlorosis  and jaundice, since the color of the
skin in these two diseases is not at all the same.  As regards
the  other  organic lesions  which may  occasion anaemia, such
as:  pulmonary tubercles, cancer,  disorganizations of the sto-
mach,  etc., these diseases are so well marked, that they cannot
well be mistaken for idiopathic anaemia;  moreover,  the pale-
ness of the skin which exists in these diseases, is neither as
universal nor as clear as in chlorosis.   As far as prognosis is
concerned, it depends upon  the fact whether  the disease is
recent and uncomplicated or  old and complicated.   In  the
former case it is  without  any danger, and  a cure  is easily
effected,  if we but use a rational treatment.   In the second
case, the disease is  always  a serious, and  often incurable ma-
lady, proportionate  to the importance of the organic affections
upon which it depends.

                       Section 54.
  Treatment.—What we  have said under Amenorrhoea con-
cerning the necessity of a proper regime, is likewise and most
emphatically applicable  to the treatment  of chlorosis, more
particularly since these two classes of patients have tastes and
desires entirely opposed to their health.   The appetite is
                            11 
1(32              DISEASES OF  FEMALES.

sometimes  so  depraved that things which  are absolutely not
fit to eat. are craved by such patients;  exercise in the open
air which is absolutely indispensable to the restoration of their
health, and ahvavs docs them a deal  of  good, is generally
needed bv  such patients.   Nevertheless the physician has to
require of them that they take sufficient exercise,  and he has
to gradually bring them back to the use  of nutritive beve-
rages and  solid food, without, however, opposing them in a
rude and  positive  manner;  for the strange  fancies  which
these patients sometimes manifest for  things which  do not
belong to the class  of aliments, are natural indications rather
than unmeaning caprices.   As long as  these patients do not
exhibit a desire for things  that are absolutely injurious either
to the constitution  or  to the treatment, it is advisable to let
them indulge their fancies, and  so  gradually prevail  upon
them, by gentle means  and appropriate medical treatment, to
 resume  a  natural and  rational  diet.   Any thing that has  a
 tendency to excite  the  sexual organs,  heating beverages and
 solid food, influences that  work  upon the imagination and ex-
 cite  the passions, novel-reading,  dancing-parties,  theatres,
 habits of  indolence, etc.,  should  be carefully removed from
 and avoided  by  the patient.  A well-regulated physical and
 mental exercise,  quiet,  and a simple diet, are the  best preven-
 tives and likewise indispensable to a successful treatment.  As
 regards treatment,  we are willing to  admit with  the other
 school, that iron is a very useful remedy, but not in  the enor-
 mous doses in which it is prescribed by allceopathic physicians;
 for we are persuaded that the good effects of iron in this disease,
 do  not result from its chemical, but from  its  dynamic action,
 and that  if the  desired result cannot  be obtained by homoeo-
 pathic  doses, massive  doses  will be of no avail either.   In
 homoeopathic practice  iron, however, is not the  only remedy
 for chlorosis; we have other remedies which experience has
 shown to  be, if  not superior, at least  equal to,  iron in chlo-
 rosis ; they are:
 i  1. Pulsatilla, Sulphur,  Calcarea,  Belladonna,  Cocculus,
  Lycopodium, Nitri acid. 
CHLOROSIS,
163
  2. China, Conium,  Helleborus, Kali, Natrum muriaticum,
Nux vomica, Phosphorus, Platina, Plumbum, Sepia, Spigelia.
  3. Arsenicum, Digitalis, Graphites,  Mercurius, Phosphori
acid., Stapdiysagria, Valeriana.
  4. Baryta,  Carbo animalis,  Carbo vegetabilis, Causticum,
Ignatia, Ohander,  Sabina, Sulphuris acidum, Zincum.
  AVith the following  particular  indications:—
  Belladonna.—For frequent  pressure  on the genital or-
gans, with or without  leucorrhoea; jerking shocks in the vagi-
na; heat in the vulva; fulness and pressure in the abdomen;
scanty and painful menses,  preceded by colic; weariness ;
anorexia; frequent paroxysms of anguish;  numbness of the
legs when sitting;  lymphatic  temperament with blue eyes and
fair hair.
  Calcarea.—In  many cases,  after  Sulphur,  and  particu-
larly for  the  following symptoms;  amenorrhoea, with con-
gestive headache,  vertigo,  gastralgia  with  fulness  in  the
hypochondria ; weariness and heaviness in the body ; leucor-
rhoea,  anorexia, dyspnoea and  frequent palpitation; nausea
and vomiting; nervous prostration, with desire to be magne-
tized ;  frequent shuddering and chilliness; weary after the
least effort; melancholy and inclined to weep ; desire  for wine
and dainties, with  aversion to flesh;  obstinate constipation.
  Cocculus.—Particularly after abuse of coffee and chamo-
mile-tea, or for frequent cramps in the bowels;  suppressed or
scanty and irregular menses;  leucorrhoea;  paralytic weak-
ness ;  dyspnoea, cramps  in the chest; sadness, uneasiness,
anguish, sight; sensitiveness to the open air; whether cold or
warm; frequent yawning; fainting nausea; gastralgia.
  Ferrum.—In obstinate cases, when every other remedy
seems to fail, especially when the following symptoms occur:
complete suppression; constant desire to lie or sit; oedema of
the face, hands and feet, with bloat around the eyes ;  weari-
ness in the legs or after  the least exercise in the open air ;
want of vital heat; uneasiness with  throbbing in the epigas-
trium ; gastralgia  or vomiting after the least  meal;  dyspnoea
as from contraction of the chest. 
164              diseases of  females.

  Lycopodium.—Especially after the favorable action of Cal-
carea, or for complete suppression, sensitiveness to the open
air, vascular excitement or sensation as if the blood were colder
and ceased to circulate ; tendency of the limbs  to go to sleep ;
lassitude with trembling ; fainting turn; continual drowsiness ;
chilliness : melancholy, averse to company; falling off of the
hair; desire for sweets;  constipation;  dryness of the  vagina.
  Nitri acidum.—Nourishment after Calcarea, especially
suitable to girls with  choleric  temperament, brown or black
hair or  eyes, or when the following symptoms are present:
hysteria, nervous prostration after  the least pain; sadness,
tendency to start, aversion  to meat,  desire for  chalk, lime,
clay; difficult  digestion, with nausea,  lassitude, drowsiness
after eating ; short and panting breathing ; palpitation of the
heart when going up stairs.
  Pulsatilla.—Especially after abuse of Ferrum, or for sup-
pression, frequent leucorrhoea, megrim, hysteric distress ; buz-
zing in the ears, weariness and heaviness of the legs ; dyspnoea,
loss of breath after  an exertion; frequent palpitation of the
heart; cold hands and  feet; pressure and heaviness in the
abdomen; gastralgia, nausea, vomiting ; chilliness and shiver-
ing, with yawning and stretching; oedema of the feet, melan-
choly mood, weeping,  dread of  dying; marked desire for
spirits or spicy  things, stimulants; gentle, timid disposition.
  Sulphur.—In most cases, after Pulsatilla,  or at the com-
mencement  of the treatment, for abdominal  cramps, leucor-
rhoea, nervous debility, fainting,  sensitiveness to the open air,
tendency of the  limbs to go to sleep ; aversion to washing; con-
stant drowsiness in the day-time; frequent shivering, coldness;
melancholy, weeping mood, raw and burning eructations ; dif-
ficult  digestion, with pressure and  fulness in the  stomach;
constipation, with hard  stool; dyspnoea  and sense of  weight
in the chest; frequent congestion of the chest.
  Dose.—Of the appropriate remedy give five or six globules
dry on the tongue, or one or two drops of the attenuated pre-
paration on sugar or in a spoonful of water every morning or 
chlorosis.
165
evening; or, after an improvement has set in, every two or
three days.
  Also:
  China.—For abdominal or pulmonary cramps, leucorrhoea ;
nocturnal, pressive headache ; weakness, lassitude and heavi-
ness of the  legs;  restless sleep, with anxious and fatiguing
dreams; nervousness, with sensitiveness to noise; dyspepsia,
pressive gastralgia especially after eating; hysteric ailments ;
watery, leucophlegmatic infiltration;  distress in the limbs
which feel as if broken ; lowness of spirits and hypochondria ;
listless, apathetic; desire for dainties, wine, acids; frequent
palpitation of the heart.
   Conium.—Hysteric ailments ; flabby and withered breasts ;
nervousness with involuntary weeping; anxiety,  tendency to
start; leucorrhoea; abdominal cramp3 with  distention of  the
abdomen and stitches  in  the parts; hysteric cramps  in  the
throat; aversion  to bread ;  desire  for  acids;  nausea after
eating ; palpitation of the heart after drinking.
   Kali carbonicum.—Amenorrhoea, palpitation of the heart;
oedema; fainting turns; aversion to open air; dry skin ; desire
for sweets;  nausea, vomiting, constipation.
   Natrum muriaticum.—Hysteria, sadness, weeping; weak-
ness of mind and body, aversion to movement; desire for bitter
things, leucorrhoea, palpitation, irregular beating of the heart.
  Nux vomica.—Menses not quite suppressed, but irregular,
preceded by pains in the nape of the neck and back;  nausea
with fainting, especially in the morning; fatigue with aversion
to movement;   constipation,  with frequent but  ineffectual
urging to go to stool; frequent urging to urinate, with tenes-
mus of the  bladder;  congestion  of the head with pressive
headache ; irascible mood, or dedression of spirits.
  Phosphorus.—Scanty  menses, preceded  by  leucorrhoea
with weeping mood ; frequent colic with pains in  the small of
the back and vomiting; weakness, nervous  prostration and
fainting turns;  violent beating of the heart; dyspnoea, oppres-
sion  ; spitting of blood ; hysteric symptoms.
  Platina.—Uterine cramps, with pressure in the hypogas- 
166
diseases of females.
 trium and on  the  parts; loss of  appetite, constipation, ver-
 tigo; deathly anguish, with dread of dying; suspicious and
 proud disposition.
   Plumbum.—Leucorrhoea; painful breasts;  frequent cramps
 in  the  abdomen, paralytic weakness ;  constipation;  hysteric
 spasms; flabby muscles; oedema;  constant shivering; nausea
 and vomiting.
   Sepia.—Suppression of the menses ; frequent leucorrhoea ;
 hysteric or nervous headache; general weakness  and dispo-
 sition to perspire;  frequent shiverings, alternating with heat;
 melancholy and weeping; catarrhal discharges from the nose,
 ears, bronchial passages, etc.;  frequent colic  and pains in the
 small of the  back;  tendency  of the limbs to  go to  sleep;
 heaviness of the body, aversion to motion;  sensitiveness to
 the  open air;  fainting spell; depression of spirits.
   Spigelia.—AATeariness after walking ever so little; yellow-
 ish margin around the eyes;  sensitiveness of the pit of the
 stomach to the least contact;  catarrhal, mucous  discharges;
 oedema; dyspnoea;  violent palpitation of the heart; irregu-
 lar beating of the heart and abnormal sounds in the cardiac
 region.
  Dose.—The  same as on page 164.
   Also:
   Aksenicum.—For prostration that does not allow one to
 walk; frequent fainting turns;  marked desire for acids, coffee
 or brandy; excessive desire for coit; eorrosive  leucorrhoea;
 nausea and vomiting.
  Digitalis.—AVeakness  and  frequent fainting turns;  oede-
 ma ; frequent drowsiness in the day-time; small, feeble, very
 shw  pulse, accelerated  by the least movement; frequent
 attacks of anguish, with weeping mood  and  dread of the
 future ; marked desire for bitter food and sour drinks ; nau-
 sea and vomiting in the morning; sense of weakness in the
 pit of the stomach, as if  the patient would die ; audible pal-
pitations of the  heart, with  anguish  and  contraction in the
 chest.
  GRAPHITES.-When the menses  appear  sometimes, but are 
CHLOROSIS.
167
too pale, and do  not  last long enough; hysteric headache ;
frequent nausea; pains  in  the chest;  abdominal cramps;
hysteric spasms;  mucous leucorrhoea and sterility ; bronchial
or nasal catarrh ; oedema.
   Mercurius.—Frequent leucorrhoea, oedema of the hands,
feet and face;  weakness with rush of blood after  the  least
effort; irritable mood ;  sad, melancholy, contrary.
   Phosphori  acidum.—Leucorrhoea,  with tympanitis of the
womb ;  nervous prostration ;  constant drowsiness; sadness,
with  fear about  one's health; marked desire  for juicy and
refreshing things ; pressure at the stomach after eating.
   Staphysagria.—Lassitude, as  if  the  limbs were lame,
especially after an effort;  drowsiness  in  the  day-time, with
yawning and stretching; hypochondriac mood, sadness ;  fears
about her health  ; frequent sweating ;  marked desire for wine
and spirits ; painful sensitiveness of the sexual organs.
   Valeriana.—Chlorosis  complicated- with  hysteria,  with
excessive nervousness.
   Dose.—The same as on page 164.

                       Section  55.
   Particular  Indications.—Here  follows  a list  of the
principal indications regarding the use of the remedies which
have been recommended for chlorosis.   These indications refer
both  to the causes which induce chlorosis, and to the princi-
pal symptoms  of this malady.   AVe have arranged them  in
alphabetical order, as follows, referring the reader, for further
details,  to the  article on Dysmenorrhoea, Sections 5-10.
Abdomen, pain in, colic:—1. Belladonna, Nux vomica,  Pul-
         satilla.
       2. Arsenicum, Carbo vegetabilis, China, Cocculus, Igna-
         tia, Lycopodium, Mercurius, Phosphorus, Sulphur.
       3.  Calcarea, Nitri acidum, Platina.
       4.  Causticum, Ferrum, Staphysagria, Zincum.
     Distended :—1.  Arsenicum, Belladonna, Calcarea, Carbo
         vegetabilis, China, Graphites, Mercurius, Phosphorus,
         Sepia, Sulphur. 
 Ills              diseases  of females.

       2. Causticum, Conium, Digitalis, Lycopodium.
       3. Kali, Natrum muriat, Nux vomica, Pulsatilla,
          Valeriana.
       4. Carbo animalis,  Ferrum, Ignatia,  Nitri acidum,
         Platina,  Plumbum, Sabina, Spigelia.
 Abstemiousness, sexual, as a cause:—1.  Conium.
       2. Calcarea, Cocculus, Sulphur.
       3. Nux vomica, Phosphorus, Sepia, Staphysagria.
 Appetite, gone:—1.  China, Nux vomica, Sepia.
       2. Arsenicum, Belladonna, Cocculus, Conium, Ignatia,
         Lycopodium,  Mercurius,  Platina,  Pulsatilla, Sul-
         phur.
       3. Digitalis, Forum, Nitri acidum, Sulphuris  acid.
       4. Carbo animalis, Carbo vegetabilis, Graphites, Kali,
         Plumbum, Sabina, Spigelia.
 Beverages, spirituous (cause):—1. Nux vomica.
       2. Arsenicum,  Belladonna, Calcarea,   China,  Helle-
         borus, Ignatia, Lycopodium, Pulsatilla.
       3. Carbo vegetabilis,  Cocculus.
       4. Carbo animalis, Conium, Sulphur, Suljdiuris acid.
Cephalalgia:—1.  Belladonna,  Calcarea, China,  Ignatia,
         Mercurius, Nux vomica,  Pulsatilla, Sepia, Sulphur.
       2. Arsenicum, Carbo vegetabilis, Cocculus, Lycopodium,
         Platina.
       3. Conium,  Ferrum,  Graphites, Kali, Phosphorus.
Coffee,  abuse of (cause):—1.  Causticum,   fgnatia, Nux
       vomica.
       2. Cocculus, Mercurius, Pulsatilla, Sulphur.
       3. Belladonna, Carbo vegetabilis, Platina,  Sepia.
       4. Arsenicum, Nitri acidum, Sulphuris acidum.
Cold and dampness (cause) :—1.  Calcarea.
       2. Mercurius, Sulphur.
       3. Carbo animalis, Carbo vegetabilis, China,  Ferrum
         Attn acidum, Pulsatilla, Staphysagria, Zincum.
       4. Belladonna, Conium, Kali, Nux vomica, Phosphorus
         kepia. 
CHLOROSIS.
169
 Constipation :—1. Calcarea,  Cocculus, Nux vomica, Plum-
         bum, Sulphur.
       2. Belladonna,  Carbo vegetabilis,  Conium, Graphites,
          Kali,  Mercurius,  Phosphorus,  Platina,  Sepia,
          Zincum.
       3. Arsenicum,  China,  Natrum  muriat,  Pulsatilla,
         Sabina.
       4. Carbo animalis, Digitalis, Ferrum, Ignatia,  Spigelia.
 Dampness, see Cold.
 Desires, strange, for
     Bitter things :—Digitalis, Natrum muriaticum.
     Brandy :—1.  Arsenicum, Nux vomica, Sepia,  Sulphur.
       2. Spigelia,  Staphysagria.
       3. China, Pulsatilla.
     Coffee :—Arsenicum, China, Conium.
     Coal :—Cicuta, Conium.
     Chalk, clay,  etc.:—Nitri acidum, Nux vomica.
     Cooling things :—1. Cocculus, Pulsatilla.
       2. Phosphorus,  Valeriana.
       3. Carbo animalis.
     Herrings :—Nitri acidum.
     Juicy things :—Phosphori acidum.
     Piquant things:—Pulsatilla.
     Salt things :—1.  Calcarea, Conium.
       2. Causticum, Nitri acidum.
       3. Carbo vegetabilis, Phosphorus.
     Spirituous drinks :—1. Calcarea, Staphysagria,
       2. Arsenicum,  Mercurius,  Nux vomica,  Pulsatilla,
         Sulphur.
       3. China, Sepia, Spigelia.
     Sourcrout :—Carbo animalis, Chamomilla.
     Sour things :—1.  Arsenicum, Phosphorus, Sulphur.
       2. Digitalis, Ignatia,  Kali, Sepia.
       3.  Carbo animalis, China,  Conium, Sabina,
Desire for Sweets :—1.  China, Kali, Lycopodium.
       2. Sulphur.
       3. Calcarea,  Carbo vegetabilis, Nux vomica. 
170              DISEASES OF FEMALES.

Dyspepsia, digestion difficult :—l.  Calcarea, China,  Mercu-
         rius, Nux vomica, Pulsatilla, Suljdiur.
       2.  Carbo vegetabilis, Natrum muriaticum, Sepia.
       3.  Arsenicum, Belladonna, Conium, Ferrum, Graphites,
         Ignatia, Kali, Lycopodium,  Phosphorus, Staphys-
         agria.
Dyspngsa, breathing oppressed :—1. Arsenicum, Belladonna,
         Carbo vegetabilis, Ignatia,  Nux vomica, Phosphorus,
         Pulsatilla, Sipia, Sulphur.
       2.  Calcarea,  China, Cocculus, Kali,  Lycopodium, Pla-
         tina, Spigelia, Zincum.
       3.  Carbo  animalis,  Conium, Ferrum, Mercurius, Sta-
         physagria.
       4.  Digitalis,  Graphites, Nitri acidum, Phosphori aci-
         dum, Plumbum,,Sabina, Sulphuris acid.,  Valeriana-
Exercise in the open air,  aversion to:
     As symptom:—1. Calcarea, Cocculus, Kali, Nux vomica.
       2.  Belladonna,1 China, Conium, Ignatia, Sepia, Spigelia,
         Sulphur, Valeriana.
       3.  Arsenica, Carbo animalis,  Mercurius, Nitri acidum,
         Plumbum, Staphysagria.
       4.  Carbo vegetabilis, Digitalis, Graphites, Phosphorus,
         Platina, Pulsatilla, Sabina.
Face, blueish:—1.  Conium, Digitalis.
       2.  Arsenicum, Belladonna, Ignatia.
       3.  Iticnpodium, Staphysagria.
       4.  Mercurius, Phosphorus, Pulsatilla.
     Round the eyes:—1.  Arsenicum, China.
       2.  Cocculus,  Ignatia, Phosphori acid., Staphysagria.
       3.  Ferrum, Nux vomica, Phosphorus, Sabina, Sepia,
         Sulphur.
       4.  Calcarea,  Graphites, Kali, Mercurius, Spigelia.
     Pale:—1.  Arsenicum,  China,  Phosphori acid., Sepia,
         Su Iphur.
       2.  Cocculus,  Conium, Ferrum, Kali, Lycopodium, Nux
         vomica, Phosphorus, Platina, Pulsatilla,  Spigelia. 
CHLOROSIS.
171
       3. Belladonna,  Calcarea,  Carbo animalis,  Digitalis,
         Helleborus, Ignatia, Nitri acidum, Plumbum, Sabina,
         Staphysagria, Zincum.
       4. Carbo vegetabilis, Graphites, Mercurius.
    Earthy:—1. China, Ferrum, Mercurius.
       2. Arsenicum,  Ignatia, Nitri  acidum, Nux  vomica,
         Phosphorus.
       3. Sepia.
       4. Plumbum, Zincum.
    Greenish :—1. Arsenicum, Carbo vegetabilis.
    Yellowish :—1. Conium, Ferrum, Nux vomica, Plum-
         bum, Sepia, Sulphur.
       2. Carbo vegetabilis, China, Digitalis, Mercurius, Nitri
         acidum, Phosphorus.
       3. Arsenicum,  Belladonna,  Calcarea, Ignatia,  Kalii
         Pulsatilla, Spigelia.
       4. Causticum, Cocculus, Graphites, Helleborus, Natrum
         muriaticum, Sulpihuris acid.
    Bound the mouth :—1.  Sepia.
       2. Nux vomica.
    The nose :—1. Sepia, Nux vomica.
    At the temples:—Causticum.
    Eyes:—1. Nitri acidum, Spigelia.
       2. Nux vomica.
Fainting, frequent:—1.  China, Nux vomica, Sepia.
       2. Arsenicum,   Cocculus,  Ferrum,  Phosphorus,  Spi-
         gelia.
       3. Belladonna,  Calcarea,  Carbo vegetabilis, Ignatia,
         Kali, Mercurius, Plumbum, Pulsatilla, Sulphur.
       4. Causticum,  Conium, Graphites,  Helleborus,  Nitri
         acidum, Staphysagria,  Valeriana,
FLESn, flabby (symptom):—1.  Calcarea, Cocculus.
       2. Conium, Mercurius, Sulphur.
       3. China, Digitalis, Ferrum, Pulsatilla.
       4.  Graphites, Kali, Plumbum, Sulphuris acidum.
Heart affected:—1.  Calcarea, Pulsatilla,  Spigelia,  Sul-
         phur. 
172              DISEASES  OF FEMALES.

       2.  Lycopodium. Phosphorus, S<-pia, Zincum.
       3. Arsenicum,  Belladonna,  Carbo  vegetabilis,  China,
         Cocculus,  Digitalis,  Graphites,  Kali,  Mercurius,
         Nitri acidum, Nux vomica, Sabina.
       4.  Carbo animalis, Conium, Ferrum, Helleborus, Igna-
         tia, Plumbum, Staphysagria, Valeriana.
     Palpitation of:—1.  Calcarea, Cldna, Mercurius, Phos-
        phorus, Pulsatilla, Sejna, Spigelia, Sulphur.
       2. Arsenicum, Belladonna, Carbo vegetabilis, Ignatia,
         Kali, Nitri acidum, Nux vomica, Zincum.
       3.  Carbo animalis,  Cocculus,  Digitalis, Ferrum, Gra-
        phites, Platina, Plumbum, Sabina, Sulphuris acid.
       4.  (hnium, Staphysagria,  Valeriana.
Indolence, aversion to motion :—1.  Arsenicum, Nux vomica.
       2.  Cocculus, Digitalis, Natrum muriaticum.
       3. Belhdonna, Mercurius, Phosphorus, Pulsatilla, Se-
        pia, Zincum.
       4. Calcarea, Carbo animalis,  Carbo  vegetabilis, China,
         Conium, Kali,  Nitri acidum, Sulphur.
Infiltrations, oedematous:—1.  Arsenicum, China, Pulsa-
        tilla,  Sulphur.
       2. Belladonna, Lycopodium, Mercurius, Sabina.
       3.  Conium, Ferrum, Kali, Nitri acidum, Phosphorus,
        Plumbum, Sepia.
     Iron-preparations, abuse of (cause):—1.  China, Pul-
        satilla.
       2. Arsenicum, Belladonna, Mercurius.
     Leucorrhea (symptom) :—l.  Calcarea, Mercurius, Pul-
        satilla, Sepia.
       2. Carbo vegetabilis, China,  Cocculus, Conium, Fer-
        rum,  Graphites, Phosphorus, Sabina, Sulphur.
       3. Arsenicum, Carbo  animalis, Kali, Nitri  acidum,
        Phosphori acid., Sulphuris acid.
       4. Belladonna, Ignatia, Nux vomica,  Platina, Plum-
        bum,  Zincum.
    Love,  unhappy (cause) -.-Causticum,  Ignatia,  Kali
        Au.x  vomica, Phosphori  acid.,  Sepia, Staphysagria. 
CHLOROSIS.
173
Nausea :—1.  Nux vomica, Pulsatilla, Sulphur.
  2. Arsenicum, Belladonna, Calcarea, Carbo vegetabilis,
     China, Cocculus,  Conium, Digitalis, Kali, Mercu-
     rius,  Nitri acidum, Phosphorus, Sepia.
  3. Ignatia,  Phosphori acid., Platina, Plumbum, Spi-
     gelia, Staphysagria.
  4. Ferrum, Sabina, Zincum.
Onanism  (cause):—1.  Calcarea,  China,  Conium,  Nux
     vomica, Phosphori acid., Sepia,  Staphysagria, Sul-
     phur.
  2. Carbo vegetabilis, Kali,  Lycopodium, Mercurius,
     Phosphorus, Pulsatilla, Spigelia.
  3. Arsenicum, Ferrum, Ignatia, Plumbum,
Sadness, melancholy:—1.  Cocculus, Ignatia.
  2. Belladonna, Graphites, Lycopodium, Platina, Pul-
     satilla.
   3. Calcarea, China, Conium, Nux  vomica, Sepia, Sta-
     physagria,  Sulphur.
   4. Carbo animalis, Causticum, Digitalis, Helleborus,
     Kali, Mercurius,  Phosphorus, Phosphori acid., Spi-
     gelia.
 Sighing, frequent:—1. Belladonna,  Ignatia, Nux vom.
   2. China,  Cocculus, Digitalis, Graphites, Kali, Mer-
     curius, Nitri acidum, Plumbum, Pulsatilla,  Sepia.
 Solitude, desire of:—1. Belladonna, Ignatia,  China.
   2. Carbo animalis,  Conium, Digitalis, Graphites, Nux
     vomica, Sepia.
 Weeping,  frequent:—1.   Causticum,  Platina, Pulsa-
     tilla, Sulphur.
   2. Belladonna, Odcarea,  Graphites, Ignatia, Natrum
     muriaticum, Sepia, Staphysagria.
   3. Arsenicum, Carbo animalis, Carbo vegetabilis,  China,
     Kali, Nitric acid, Nux vomica,  Plumbum, Sulphu-
     ris acid.
   4. Cocculus,  Conium, Digitalis, Mercurius, Phospho-
     rus,  Zincum. 
174
DISEASES OF FEMALES.
ARTICLE   XIII.
                      HYSTERIA.

                       Section 56.

   Remark:—AVe have spoken of this affection in detail some-
 where else,* so  that  all we  have to do here, is  to point out
 the place where this  article  may be  found  by those who are
 unacquainted with our work on " Nervous Diseases."  However,
 in order not to leave a gap in our series, we will here mention
 very briefly the principal remedies for this affection, referring
 the reader  for the details to the work in  question.  These
 remedies are :
   1.  Aurum,  Conium,  Ignatia,  Moschus,  Nux  moschata,
 Nux vomica, Pulsatilla,  Sulphur.
   2. Asarum, Belladonna, Calcarea,  Causticum,  Cicuta, Coc-
 culus, Magnesia muriatica, Natrum muriaticum,  Nitric acid,
 Platina, Sepia, Silicea, Stramonium,  Vahriana, Viola odorata.
   3. Aconitum, Agaricus, Agnus, Bryonia, Chininum, Coffea,
 Hepar, Lachesis, Mercurius, Phosphorus, Plumbum, Stannum,
 Veratrum, Zincum.
   4. Arsenicum, Cannabis, Chamomilla, Hyoscyamus, Opium,
 Phosphori acid., Staphysagria.
   5. Capsicum,  Carbo vegetabilis, Cuprum,  Digitalis, Dulca-
 mara, lodium, Ipecacuanha, Lycopodium, Rhus, Squilla,  Sul-
phuris acid.,  Tartarus, Thuja.
   With the  following particular  indications:
 For general convulsions:—1. Belladonna, Cicuta, Conium,
         Ipecacuanha, Moschus,  Stramonium,  Veratrum.'
  * On the Homoeopathic Treatment of Nervous and Menstrual Diseases,
 translated  by Charles J. Hempel, M. D., and published by W. Radde, 332
 Broadway, New York. 
HYSTERIA.
175
      2. Calcarea, Causticum, Conium,  Cuprum,  Platina,
         Sulphur.
      4. Bryonia,  Coffea, Opium, Pulsatilla, Secale, Sepia.
For the  local or partial symptoms in  the moral sphere:—
         Calcarea, Conium, Ignatia, Platina, Asa foetida,
         Nux moschata, Nux vomica, Pulsatilla, Sepia, Sul-
         phur, Silicea.
    Headache : — Aurum,   Ignatia,  Platina,  Moschus,
         Sepia, Belladonna, Cocculus, Valeriana, Veratrum,
         Bryonia, Hepar, Nitri acidum,  Phosjdwrus.
    Throat:—Belladonna, Ignatia, Nux  vomica, Stramo-
         nium,  Sulphur,  Cocculus, Conium, Chamomilla,
         Nitri acidum, Pulsatilla, Sepia.
    Stomach : —Ignatia, Chamomilla,  Cocculus, Nux vom.
    Bowels:—Ignatia, Cocculus,  Ipecacuanha, Nux vomi-
         ca, Moschus, Stannum,  Valeriana,  Arsenicum,
         Belladonna, Stramonium, Sulphur, Veratrum.
    Urinary organs :—Asa foetida, Pulsatilla, Sepia, Bel-
         ladonna, Hepar, Nux vomica,  Zincum.
    Uterus:—Cocculus, Ignatia,  Cicuta, Conium,  Nux
         vomica, Pulsatilla,  Natrum muriaticum, Platina,
         Sepia, Stannum, Stramonium, Hyoscyamus, Phos-
         phorus.
    Larynx :—Belladonna,   Coffea,  Cuprum,  Moschata,
         Phosphorus, Natrum muriaticum, Platina, Hepar,
         Hyoscyamus, Pulsatilla,  Sulphur,  Veratrum.
    Bronchia :—Belladonna, Ignatia,  31oschus, Nux vomi-
        ca, Phosphorus,  Pulsatilla, Aconitum, Coffea, Cu-
         prum.
    Lungs:—Ignatia, Moschus,  Nux vomica,  Aconitum,
         Belladonna, Coffea,  Nux moschata, Pulsatilla,
         Stramonium,  Aurum, Conium,  Cuprum,  Ipecacu-
         anha, Phosphorus, Stannum. 
176              diseases of females.

    Heart -.—Aconitum, Pulsatilla, Chamomilla, Cocculus,
         Nux vomica, Veratrum, Arsenicum,  Kali, Nitri
         acidum.
  However summary these few details may be, we trust that
they will be found sufficient in every case where the different
maladies treated of in this volume, are complicated with hys-
teric symptoms ; as regards  the treatment of hysteria in its
fulness, we again refer the  reader to our work on Nervous
Diseases. 
SECOND  SECTION.
     ORGANIC LESIONS OF THE UTERUS AND ITS
                      APPENDAGES.

                       Section 57.

   General Remark.—Organic affections of the uterus being
 infinitely more important than those of the remaining sexual
 organs, we  shall first treat of each uterine affection in parti-
 cular, leaving out only such details as belong  exclusively to
 operative surgery, and we shall afterwards briefly and  sum-
 marily advert to the treatment of the diseases affecting the
 remaining organs.  In the present Section, we shall treat
 successively of 1st, the displacement of the uterus; 2d, of endo-
 metritis; 3d, of metritis; 4th, of uterine dropsy ; 5th, of physo-
 metry; 6th, of tumors, excrescences and foreign bodies in the
 uterus; 7th, of schirrous and cancer of the uterus; 8th, of non-
 cancerous ulcerations; 9th, of gangrene of the uterus; 10th, of
 affections of the neck of the uterus; 11th, of ovaritis and other
 organic lesions of the ovaries;  12th, of vaginitis and other
 affections of the vagina;  13th, of vulvitis and other affections
of the vulva;  14th,  of affections of  the breasts and  nipples.
AVe shall only present the internal treatment to be pursued in
these affections, and we shall leave out every thing that ex-
clusively concerns the surgical treatment of these affections  ;
at the  same  time we  mean to show that a judicious homoeopa-
thic treatment is capable in many cases of superseding  the
employment of surgical  means in organic affections  of  the
sexual organs.
                           12 
178
diseases of females.
ARTICLE  I.
DISPLACEMENTS AND DEVIATIONS OF THE UTERUS.

    FALLING, HERNIA, OBLIQUITY AND INVERSION  OF THIS ORGAN.

                      Section 58.

  Falling  of  the  uterus.—By falling of the uterus we
understand  the displacement  of  the uterus downward,  of
which we generally distinguish three degrees ; the first, called
relaxation of the uterus, being simply a slight descension of the
organ ; the second, being a falling of the uterus to the fundus
of the pelvis; and the third, consisting in an actual protrusion
of the uterus outside  of the vulva.  The first degree is rarely
accompanied by any ailments worthy the interference of art,
and is very frequently present in the case of women who have
had  several children.   Some practitioners only admit two
degrees of this affection, 1st, an  incomplete or partial de-
scension of the  uterus, and 2nd, an  actual protrusion of the
organ.  In descending, the uterus carries along with it  the
superior portion of the vagina; the os tincae either bears on
the upper portion of the os cocyx or presents near the orifice
of the vagina;  the fundus of the womb is generally inclined
laterally; the  Fallopian  tubes are almost in a vertical posi-
tion, and the small intestines occupy the place of the womb.
In complete prolapsus, the vagina  is sometimes turned upon
itself either partially or totally, forming the  external surface
of a tumor which, at its lower portion, exhibits the orifice of
the uterus, and sometimes assumes the appearance of the skin.
Enclosed in this species of sae, the fundus of the bladder and
the anterior wall  of  the  rectum are sometimes  carried alonor 
displacements  of the uterus.         179
with the womb.  Sometimes the small intestines even descend
into the upper  part  of the  external tumor  which has been
known,  in  some instances, to go  down  to  the knee.  Pro-
lapsus may take place both during and between the periods of
pregnancy, or when the uterus is either in health or attacked
with disease.  The most frequent diseases of the uterus are:
acute or chronic inflammation, schirrus or cancer, polypi and
fibrous tumors.   The organs which accompany the prolapsed
uterus, have likewise  been seen diseased, especially the bladder,
where calculi have been discovered.   The symptoms of falling
at the first degree, are  : pulling in the loins and groin ; pains
in the small of the back; sense of pressure in the  rectum, and
constriction of the anus,  sensation  as  if  something would
issue  from  the  vulva, dysuria and even  retention of urine,
inflammation and swelling of the uterus,  leucorrhoea, pulling
in the stomach  and  more  or less considerable disgestive de-
rangements.  At the second stage all these symptoms become
more marked;  the urine  which  comes in contact with  the
surface of the tumor, frequently causes a violent inflammation
and excoriation of the vaginal mucous membrane, followed by
partial  or total  gangrenous  sloughing.   The predisposing
causes seem to be  a  lymphatic constitution, chronic  leucor-
rhoea, confinement,  a large  pelvis, emaciation, frequent con-
stipation, and the presence of tumors bearing upon the uterus;
it is more frequently met with in women who have had several
children, although we  likewise find it in unmarried  females
and even young girls.  Exciting causes are: violent exertions,
falling upon the nates  or knees,  violent shaking when riding
in a carriage, long  standing or walking,  pressure upon  the
abdomen,  pulling at the womb  in consequence of large  ex-
crescences.   As regards  diagnosis,  the  disease is   clearly
revealed by an  examination of the parts which exhibit a pear-
shaped tumor with the  larger portion upwards and the orifice
of the womb  downwards.  This  kind of  prolapsus must  not
be confounded with falling of the vagina or elongation of the
neck  of the womb ; in falling of the  vagina  the shape of the
tumor differs from that of the prolapsed uterus, and the os 
130              diseases  of females.

tincae is  distinctly  felt at  the  bottom  of the  cylindrical
cavitv which  forms  the  arc  of the tumor.   As regards  he
elongated neck, its shape is less cylindrical  than that  of  the
womb, and if  the finger be introduced in the uterine cavity,
the os tine* is  found  to be  much nearer the vaginal onnce
than ordinarily.  As to prognosis, it depends entirely upon
the nature of the causes and upon the duration of the disease,
upon the  condition of the parts and the constitutional volume
of the  patients; prolapsus depending upon malformation of
the pelvis, is of course incurable; recent  prolapsus, or such as
results from some accidental  cause, is cured the most easily;
the diseased condition of the prolapsed  parts aggravates the
weakness  and  may  portend the  most  distressing  results,
although patients have  got  well even  after  the sloughing
of the°gangrened womb.  It is supposed by uninformed per-
sons that pregnancy is favorable to the cure of prolapsus,  but
nothing is more ill-founded.   In the fourth  or fifth month the
uterus indeed resumes its  natural  height, but after confine-
ment the uterus prolapses  again, and successive pregnancies
make the weakness worse and worse.   The  treatment of this
affection will be described hereafter, when the other  organic
lesions are treated of.

                      Section 59.

   Hernia of the uterus and ovaries.—By hernia of the
uterus or hysterocele, we understand the  passage of this organ
into the  crural canal, which may take  place  both with  the
prcgnated and unimpregnated uterus.  If unimpregnated, the
displaced uterus forms a hard tumor; the os tincae is raised,
turned towards the sacrum or enclosed in the hernial sac; the
vagina is stretched, turned from above downwards, and curved
forwards towards one or the  other groin.  During pregnancy
hernia generally takes place in consequence of some  violent
effort; first we observe a rather small tumor in the hypogas-
trium or  towards the groins, which increases gradually and
soon reveals its true character by the movements of the fetus.
This kind of  hernia is occasioned by the weakness and relax- 
displacements of the uterus.         181
ation of the uterine ligaments, contusion of the abdominal
muscles, abscesses in the groin, etc.; generally it sets in in con-
sequence of a violent effort.   Recent hernia of this kind, of
little extent, and without adhesions, can easily be reduced by
moderate pressure to be made after the patient is first placed
in a suitable position; but, if such hernia takes place during
pregnancy, confinement is scarcely ever possible without an
operation.   Beside hernia of the womb, we sometimes, though
very rarely, come across hernia of the ovary.  Ovarian hernia
may be crural, inguinal, ischiatic, umbilical, or even vaginal,
according as the ovary becomes engaged in  one or  the  other
of these parts.  Very young girls are more particularly sub-
ject to this  disease, though no age is exempt from it.   The
most frequent predisposing causes  seem to be, among full-
grown persons: ascites, emaciation succeeding obesity, immo-
derate use of fat or oily substances, relaxing beverages,  damp
climates; among children, an insufficient development of the
pelvis, the particular form  and situation of  the ovaries, etc.
The exciting causes are the same as those which induce any
other kind of hernia;  among children they are, in particular,
cries and badly-applied bandages.  The accompanying symp-
toms are  almost  all  of a  purely local nature; there  is no
derangement of the digestive organs, no colic, no constipation
or vomiting, no functional or material lesion  of any  other
organ, or even of the  uterus.  As regards  the  tumor itself,
the skin is not  altered, it is circumscribed, has the volume and
shape  of  a pigeon-egg, resisting,  more  or less  uneven, and
always the seat of a more or less acute pain, especially  when
pressed upon;  the pain extending in the  pelvis  and towards
the uterus.   At the time of the menses, this tumor becomes
considerably larger, and  decreases again after the period.
This hernia never  disappears of itself, and it is  always more
or less difficult  to  effect reduction by taxis.   It is  generally
difficult to diagnose this hernia;  if reducible, it  sometimes
resembles epiplocele, except that, in this kind of hernia, the
tumor is much less circumscribed, never  painful to pressure,
and  the pulling pains are felt rather in  the epigastrium than 
182
diseases of females.
in the hypogastrium.  If the hernia is not reducible, it might
be confounded with a lymphatic ganglion ; but such a tumor
is likewise scarcely ever  painful, and  the gland is always
moveable and scarcely ever isolated, nor is it  exactly located
opposite a hernial  orifice; the most difficult cases are  those
where the hernia is complicated with hydatids or schirrous
degenerations.   In such cases  a  diagnosis may sometimes be
facilitated by observing the influence which the movements of
the neck of the uterus have upon the tumor, inasmuch  as no
trace of this influence exists in any of the other kinds of her-
nia with  which ovarian  hernia might be  confounded.   This
hernia is  never serious unless it becomes strangulated, in
which case, as in the other kinds of hernia, gangrene is to
be apprehended unless reduction is speedily effected.

                       Section 60.

   Obliquity,  anteversion  and retroversion  of  the
uterus.—By these terms we  understand the various  devia-
tions of  the uterus from the normal line; obliquity, properly
speaking, being an accident peculiar to  pregnancy, we shall
revert to it when speaking of the accidents which may com-
plicate  utero-gestation; so  that, in the  present instance, we
shall only treat of anteversion  and retroversion.  These names
are applied to  uterine  displacements where  the longitudinal
axis of the uterus assumes an horizontal direction in the pel-
vis, in which case we term the displacement anteversion when
the fundus of  the uterus is  turned forward, behind  the os
pubis, and retroversion,  when the fundus of the uterus is
 directed toward the hollow of the sacrum.  Either of these
 displacements may take place during and between the periods
 of pregnancy; anteversion,  however,  occurs more particu-
 larly when the uterus is empty, and retroversion during preg-
 nancy.  For this reason we shall likewise  treat of retroversion
 when we come to speak of pregnancy, and shall  here  simply
  deal with  anteversion.   This defect  is very much analogous
  to falling of the uterus, of which it is, so to say, only a variety.
  It is generally produced by the same causes, such as:  relaxa- 
displacements  of the  uterus.         183
tion  of the  ligaments  of  the  uterus, excessive width  of  the
pelvis combined with narrowness of the lower strait, a  fall
upon the feet, knees or nates;  violent shaking when riding in
a carriage, or similar concussions; the affection may also  be
owing to certain organic lesions, fibrous or  other  tumors in
the anterior wall of the uterus, or tumors situated behind  the
body of this organ.  Some look upon an engorgement of  the
anterior wall of the uterus as the only cause of the antever-
sion ;  but, according to recent observations, this engorgement
which is indeed always present, is rather the effect than  the
cause of the anteversion.  The symptoms  of this affection
are:  sense of embarrassment and heaviness in the pelvis, es-
pecially at the  extremity of the rectum, with more  or  less
frequent tenesmus, frequent urging to urinate,  pulling  in  the
groin which sometimes extends to the  thighs; pains  in  the
small of  the back, and aggravation of the pain by standing,
walking or riding in a  carriage.   Sometimes the  bowels  are
completely bound and the urine  cannot be voided.  Soon all
these symptoms become  complicated with symptoms of ute-
rine inflammation, with pains in the  pelvis  and small  of  the
back, leucorrhoea which is  sometimes bloody, irregular menses
which are at times too  copious, at others too scanty, more or
less  fever having  a  remittent or continuous type, deranged
digestion, emaciation and loss of strength, and in the event of
continued inflammation, organic degenerations of the uterus.
On the other hand, at the period of menostasis, all the symp-
toms  of an  anteversion sometimes disappear quite suddenly
after the complete cessation of the  menses and  the loss of
uterine vitality.  The  most certain  diagnostic sign of this
defect is derived from the  touch.  On inserting the finger into
the vagina while the woman is standing  erect,  we  soon meet
a solid  body engaged in  the  upper  portion of the vagina,
which being round in front and thinner  behind, will soon be
recognized as the displaced uterus, which can at once  be re-
stored to its natural position by hooking the  os  tincae with
the finger and bringing this part of the uterus forward.   As
regards prognosis, the difficulty is proportionate to the clevel- 
184              DISEASES OF FEMALES.
opment of the organic affection and to the symptoms described
above;  sometimes anteversion becomes a cause of sterility.
The treatment will be  found described at the close  of this
article.

                       Section 61.
  Inversion of the Uterus.—AVe understand by this defect,
the complete turning of the uterus inside out, in the manner
of a glove, stocking or  hat, the internal becoming the external
surface.   We generally distinguish  three degrees  of this
affection, namely: 1, Simple depression, where the fundus of
the uterus is only a little depressed. 2, Incomplete inversion,
when the fundus of the uterus has come down to the orifice,
and has even penetrated into the vagina.  3,  Complete inver-
sion, when the uterus is completely turned inside  out, and is
suspended  in the vagina, close to the vulva.   These  various
degrees of inversion may take place after confinement, or at
any other period  entirely removed  from  this event.   AVhen
occurring after confinement, a description of the treatment to
be pursued will be furnished  in  the  article  devoted to the
accidents  and ailments incidental to confinement;  here we
have only to do with the other degrees.  The symptoms which
characterize this  affection  generally differ somewhat  accord-
ing as the inversion is  more or less complete, or takes place
suddenly or gradually, under  circumstances which are more
or less serious. Incomplete inversion  sometimes   announces
itself simply by  a more  or  less copious menorrhagia, or  a
simple leucorrhceic discharge when the  accident occurs inde-
pendently of parturition.  Other symptoms gradually develop
themselves,  such  as  pullings and twitchings  in  the groin,
pains in the small of  the back, a sensation of distention and
heaviness in the pelvis.  If the inversion is  not  reduced in
season, the inverted part in the vagina may become strangu-
lated, and the fundus of the uterus may tear, whence inflam-
mation, and subsequent  gangrene, and  lastly  death, may
result;  or, if the inflammation should be less intense, a sim-
ple adhesion of such portions of  the peritoneal coat of the 
DISPLACEMENTS  OF THE  UTERUS.         185
uterus as are brought in contact with each other, may be the
consequence.  In complete inversion, all the above-mentioned
symptoms  become much  more marked, with tearing pains,
violent pullings,  syncope,  convulsions, and  an haemorrhage
which  may soon terminate fatally.   Even if the patient's life
is not destroyed by haemorrhage  or  gangrene, the  womb,
hanging out of the vulva, irritated by the contact with urine,
air and clothes, remains  almost always in a  permanent state
of chronic  inflammation, and becomes covered with more or
less serious ulcerations.  The causes of inversion, not induced
by parturition, are most of  them analogous to the  traction
and the pressure made on the uterus during parturition.  For
instance, inversion  may be caused  by extensive polypi, by
uterine dropsies, by  effusions of blood in the  uterine  cavity,
which  tends  to  thin the walls of  this organ, to weaken its
energies, and, by suddenly escaping from the uterine cavity,
to drag the uterus after it.   As regards the diagnosis, we be-
come advised of a simple depression, and of an imcomplete
inversion of the uterus, by the touch revealing the existing
condition  of the  womb, and, in complete inversion,  by  the
aspect and shape of  the tumor within the vagina and outside
of the vulva.  Considering all that we have said here, and in
Section 58, of falling  of the  womb, and of the shape and
character of these tumors, it seems almost impossible to  con-
found an inverted womb with any of the other tumors occur-
ring  in the vagina, or protruding from the vulva.  The prog-
nosis is always dubious, for the inversion may soon terminate
fatally, unless repaired in season.  The  sooner the inversion
takes place after confinement, the  greater the danger;  the
further removed  from the  period  of confinement,  the  less
dangerous  the  accident becomes.   Reduction immediately
after inversion is not so very difficult;  the longer  reduction
is delayed,  the more  difficult it becomes.  Some authors speak
of old cases of inversion, that became reduced spontaneously
in consequence of some sudden concussion of the female body.
If inversion  is caused by a polypus, the womb resumes of 
186
DISEASES of females.
itself its original position, after the removal of the weight
that drew it down.

                      Section 62.
  Treatment of all Displacements.—In order to avoid
frequent repetitions, we have condensed the treatment of the
various  forms of displacements into one  paragraph.  Our
business is not to point out the surgical means that it may be
necessary to  resort  to in these affections, but  to  show the
internal treatment, which will sometimes enable us to do with-
out surgical  operations, or,  at  any  rate, which  will wonder-
fully  facilitate the use of instruments.   Thanks to Hahne-
mann, these internal means are furnished by homoeopathy.
A few globules of the proper remedy will sometimes do more
for  the patient, in such affections, than  all the  appliances of
surgery.  Of course, the  necessary external means should
not be neglected, for no  cure can be affected without them.
Whatever may be the nature of the  displacement, the patient
should always be placed on her  back, in a horizontal position,
and, as  a general rule, should be kept in  this  position  until
health is totally  restored.   In  recent and  complicated cases
of  inflammation, strangulation, gangrene  or  haemorrhage,
some remedy which will facilitate  the reduction  should at
once be administered, particularly Nux vomica, Sepia, Igna-
tia, or one of the remedies mentioned below; after which the
patient  should be left undisturbed by  work or mental  excite-
ment.   In  most cases, such treatment may be sufficient to
effect a reduction without any surgical means. Even in severe
cases of inflammation, haemorrhage  or strangulation, a  well
chosen remedy, corresponding to all the symptoms of the  case,
will be  found sufficient  to  effect a cure, without  the inter-
ference   of the  surgeon.   If  the  displacement  is of  long
standing, and the patient has to attend to her business, it will
not always be  found possible  to effect a  cure without well
applied  bandages, provided they are adapted to the case before
us,  and  constructed by an intelligent maker; for a badly made
or  improperly applied bandage may  do as  much harm as  a 
displacements of the  uterus.        187
well made and properly applied bandage may do good.  The
principal remedies which are to be administered internally, in
the various displacements, are:
       1. Belladonna, Ignatia,  Mercurius, Nux  vomica,
         Sepia, Sulphur.
       2. Ferrum, Kreosotum, Stannum.
       3. Aconitum, Aurum, Cocculus, Cohcynthis,  Lyco-
         podium, Natrum muriat, Nitri acidum.
       4. Cantharides,  Dulcamara,  Graphites, Nux mos-
         chata, Silicea, Thuja,  Veratrum.

For falling of the womb :—1. Nux vomica, Platina, Thuja.
       2. Belladonna, Sepia.
       3. Aurum, Calcarea, Kreosotum, Mercurius.
       4. Ferrum, Nux moschata, Stannum.

    Of the vagina :—1.  Mercurius, Sepia.
       2. Ferrum, Ammonium.
       3. Belladonna, Nux vomica.
       4. Aurum, Calcarea, Ferrum, Nux moschata.

For hernia  of the womb :—1. Nux vomica, Sulphur.
       2. Aurum, Cocculus, Silicea, Veratrum.
       3. Chamomilla,  Cohcynthis, Nitri acidum, Opium,
         Phosphorus, Rhus, Staphysagria.
       4. Aconitum,   Carbo animalis,  China, Pulsatilla,
         Thuja,  Zincum.

For anteversion:—1. Nux vomica, Platina.
       2. Belladonna, Sepia.
       3. Aurum, Calcarea, Ferrum, Mercurius, Vux vom,,
         Stannum.
For inversion:—1.  Belladonna, Nux vomica.
       2. Calcarea, Mercurius, Stannum.
       3. Aurum, Ferrum, Nux moschata.

For strangulation of the parts:—1. Aconitum, Sulphur.
       2. Lachesis, Opium.
       3. Arsenicum,  Vux vomica, Belladonna,  Veratrum. 
188
diseases of females.
For gangrene :—1. Arsenicum, Belladonna.
       2. Cantharides, Kreosotum, Lachesis, Sulphur.
For  hemorrhage:—1.  Belladonna, Ferrum,  Mercurius,
         JSiux vomica, Sepia, Sulphur.
       2. Aconitum,  Calcarea,  China,  Lycopodium, Nitri
         acidum.
       3. Phosphorus, Zincum.
For inflammation :—1.  Aconitum, Belladonna, Mercurius,
         Nux vomica, Sepia, Sulphur, Sulphuris acidum.
For leucorrhoea :—1. Belladonna,  Mercurius,  Sepia, Sul-
         phur.
       2. Ferrum,  Kreosotum, Nux vomica, Stannum.
       3. Cocculus, Nitri acidum.

  Dose.—For chronic cases  give three or four  globules, or
one or  two drops of the attenuated preparation on sugar or in
a spoonful of water every morning and evening,  and in acute
cases dissolve  this  dose  in ten tablespoonfuls of water, and
give a  tablespoonful  every five minutes, or every half hour,
hour, or two  and three  hours, according to the  gravity and
intensity of the case. 
endometritis.
189
ARTICLE II.
     ENDOMETRITIS,  OR SUPERFICIAL METRITIS.

                      Section 63.

  General observation.—We understand by endometritis,
or superficial metritis, an  inflammation of the uterine lining
membrane.  Some authors have confounded it with metritis
or parenchymatous  inflammation  of  this  organ;  but the
ancients have always described it as a separate malady under
the name of blennorrhagia of the uterus or uterine catarrh.
This inflammation  may either  be acute  or  chronic, each  of
which presents symptoms  which it may be well to distinguish.
In the  following paragraphs  we shall  treat,. 1st, of  acute
endometritis or blennorrhagia of the uterus, and 2nd,  of
chronic endometritis or uterine catarrh, giving the symtoma-
tology, etiology and diagnosis of each disease.  As regards
the treatment of these two affections, it has so many points of
contact that we shall unite in one paragraph  all we have  to
say on the subject.   The treatment will be indicated after the
pathology of these two  affections.

                      Section  64.

  Blennorrhagia, or acute superficial  metritis.—This
affection is  a  superficial  phlegmasia of the internal lining
membrane of the uterus, and is characterised by acute, inflam-
matory leucorrhoea.  The irritation may either be  confined
to the uterus, or may be  accompanied with inflammation  of
the vaginal mucous  membrane.   At first  the symptoms with
which the disease sets in,  are: a  more or less marked febrile
movement,  with  malaise, spontaneous lassitude,  headache, 
190
diseases of females.
though these symptoms only exist in the severer forms of this
inflammation,  but are almost always absent in the  lighter
ones.   These precursory symptoms generally last  from four
to six days, at the termination of which period a heavy pain
is generally experienced  above the pubes extending  to the
loins, perinaeum, groin  and  thighs, with heat, itching and
smarting at the genital organs, difficult, painful and smarting
micturition.   In  many  cases  the inflammation invades the
external parts; they become sensitive, moist, red and swollen;
at the same time the mouth of the uterus becomes more open,
softer, moister, warmer  and more painful than  usual.  The
catarrhal discharge generally sets  in  as  soon as the uterus
begins to show signs of sensitiveness; at first it is serous and
bloody, but it soon becomes thick,  yellowish or  greenish,
ropy, fluid or purulent;  after drying up, it  leaves  yellow or
greenish stains on  the linen, and stiffens it as if it had been
starched; afterwards the discharge sometimes becomes whiter,
milky and mixed with transparent pieces of thick mucus.  If
this change in  the discharge  sets in, the inflammatory condi-
tion is almost entirely dispersed, which may take place at the
end of thirty-six or forty days or even sooner, when the dis-
charge becomes chronic,  or reappears again at the time of the
menses, after sexual excesses, overeating or drinking, or even
without any apparent cause.   As  a general rule,  the  more
acute the inflammation,  the thicker and darker the discharge.
The  discharge always  has  an  alkaline  reaction, whereas
vaginal secretions always react like acids.   Examined by the
microscope,  the discharge looks  homogeneous, thick,  con-
taining globules resembling those that float in  pus  or healthy
mucus.   As regards the  course of this affection, we may dis-
tinguish four periods.  The first period sets in with a rather
slight itching at the vulva, in the interior of the vagina and
sometimes in  the uterus, with sense of heat in the  uterus,
pains in the small of the back and in the back, increase of
the sexual  desire  and frequent urging to urinate.  In the
second period, which sets in  about the third or fourth day, a
serous discharge takes place which is at first scanty, but soon 
endometritis.
191
becomes more profuse, assumes a greenish or yellowish, rather
dark appearance, and is accompanied with increased burning
at urination.  In the third period, which generally commences
about the ninth day, the inflammation becomes less intense,
is still very copious, thickens, becomes more and more whitish,
and then decreases, with diminution of the flow of urine.  In
the fourth period, when the disease inclines to become chronic,
the discharge disappears and reappears again repeatedly, and
frequently without any known  cause.   The causes of this
affection are  frequently the  same as those that give rise to
vaginitis ; in many cases the uterine blennorrhagia is  nothing
more than a development of a pre-existing vaginal irritation.
Most frequently this  phlegmasia becomes developed  at  the
menstrual periods, especially when the normal menstrual  dis-
charge  is  either  insufficient  or  remains  entirely  absent.
Another cause of this disease are long  and painful  confine-
ments,  miscarriages, the presence of polypi or hydatids in the
uterus, engorgements, indurations or other organic lesions of
this organ, and more  particularly sexual  abuses, onanism,
irritating injections  and  any  other  irritating  causes.  As
regards DIAGNOSIS; an inflammatory catarrhal discharge can
easily be distinguished from a simple and mild  leucorrhoea;
it  will likewise be an  easy matter to  distinguish  between
 acute blennorrhagia  and a parenchymatous inflammation of
the uterus,  inasmuch as there is scarcely any or very little
 discharge in the latter disease, and the body of  the uterus is
moreover enlarged, which is  not the case in uterine catarrh;
 as regards symptomatic discharges of the uterus, such as take
place in  cancer, engorgements,  etc., all  doubts  will  likewise
be removed by the touch or  by an exploration of the parts.
 The  greatest difficulty  will be  found in distinguishing  this
 discharge from  syphilis;  in such  a case all absence  of other
 syphilitic signs, and a history of the case, will  enable us to
 decide.  The prognosis of  acute  blennorrhagia  is never
 serious ; when not complicated, in healthy and otherwise  well
 formed women, it  generally terminates in  resolution.   In
 vicious, lymphatic, scrofulous or herpetic  constitutions, or 
192
DISEASES OF FEMALES.
when other disorganizations of the uterus are present,  or
when the exciting  cause  continues to  operate, the disease
inclines more  than  any other to pass into the chronic form,
and becomes exceedingly obstinate  even under treatment.

                       Section 65.
  Uterine catarrh or superficial  chronic metritis.—
In most cases, or perhaps  in  all cases, this affection is only
the consequence of  an acute  blenorrhagia of the uterus,  so
that even where it appears to be a primary  disease, it may
always be supposed  that it  has been preceded by an acute
stage which has passed over without having  been observed.
The symptoms by which  this affection  manifests itself, are:
dull pains in the hypogastrium  aggravated by pressure, with
pulling in the  loins, groin, thighs, frequent urging to urinate
and painful urination.  These  pains  are accompanied by a
leucorrhceal discharge of a  dirty-white or yellowish  color,
more or less consistent, having a sickening and insipid  smell,
an alkaline reaction and being more or less profuse.  If pro-
ceeding from the neck of the uterus, it is more abundant and
more tenacious than that which is  secreted from the body of
the  uterus.  In most  cases  the disease is accompanied  by
digestive  derangements, bulimia alternating with  anorexia,
pains in the stomach, nausea, vomiting of ropy mucus in the
morning.   These symptoms, especially the discharge, become
generally worse immediately before or after the menses, under
the influence of a stimulating diet, or in consequence of sexual
excesses, onanism,  etc.  In  some  women, this affection in-
creases the sexual desire;  in  others, this desire is diminished,
and even gives place to positive repugnance.—Chronic catarrh
of the uterus  being  the  result of an  acute blennorrhagia
which  had probably passed unnoticed, the exciting or predis-
posing causes  of catarrh are the same as those of acute blen-
norrhagia.  The diagnosis is obtained by the touch and  by
an exploration of the  affected  parts; the mucous membrane
of the neck is generally red and inflamed and at the uterine
orifice we discover  traces of the matter that is  discharged 
ENDOMETRITIS.
193
 from the vagina; the orifice is open and the parts composing
 it are soft and swollen.—The prognosis is not serious except
 where a continuance of this affection has given rise to uterine
 disorganizations; sometimes the disease terminates spontane-
 ously in resolution; in  other  cases it disappears  and gives
 rise to some other affection; still more frequently it continues
 for years unless it is removed by rational and truly efficacious
 treatment.

                       Section 66.

   Treatment.—The best means for acute as well as chronic
 blennorrhagia, are:
       1.  Alumina, Calcarea,  Kreosotum,  Mercurius, Pul-
         satilla, Sepia.
       2.  Ammonium, Bovista, Carbo vegetabilis, China, Coc-
         culus, Ferrum,  Graphites, Lycopodium, Phospho-
         rus, Sabina, Silicea, Sulphur.
       3.  Arsenicum, Borax,  Cantharides,  Carbo  animalis,
         lodium, Kali, Magnesia  carbonica, Mezereum, Na-
         trum, Natrum muriatica, Nitri acidum, Phosphori
         acidum, Platina, Stannum,  Veratrum, Sulphuris
         acidum.
       4. Belladonna, Coffea, Lachesis, Nux vomica, Zincum.
AVith the following particular indications :
In  the  first  period :—1. Pulsatilla, Mercurius,  Sepia,
         Kreosotum.
       2.  China, Cocculus,  Ferrum,  Phosphorus, Platina,
         Sabina.
In the second period :—1. Mercurius,  Pulsatilla, Sabina,
         Sepia.
       2. Alumina, Calcarea, China,  Cocculus, Kreosotum,
         Lycopodium, Natrum, Nitri acidum.
In chronic catarrh, or in the third or fourth period of acute
         blenorrhagia :—1. Alumina, Calcarea, Mercurius,
         Pulsatilla, Sepia.
                           13  ■ 
194
DISEASES OF FEMALES.
       2. Ammonium,  Carbo  vegetabilis,  China,  Cocculus,
         Ferrum, Graphites, Lycopodium, Phosp>horus, Sa-
         bina, Silicea, Sulphur.
  And particularly:
For sexual appetite increased:—1. Belladonna,  Platina,
         Veratrum.
       2. China, Coffea.
       3. Arsenicum, Cantharis, Kreosotum, Lachesis, Nux
         vomica, Sulphuris acidum, Zincum.
Abdomen painful :—1. Belladonna, Carbo vegetabilis, Lyco-
         podium, Magnesia muriat.
       2. Causticum, Conium, Drosera, Ignatia, Pulsatilla,
         Sepia, Silicea, Sulphur, Zincum.
       3. Alumina, Ammonium muriat,  Belladonna, Gra-
         phites, Kali, Mercurius, Natrum, Natrum muriat.
Desire, sexual, less:—Belladonna, Kali, Natrum muriat.
Discharge, acrid :—1. Alumina, Ferrum, Mercurius, Phos-
         phorus.
       2. Arsenicum,  Bovista, Carbo  vegetabilis, Conium,
         lodium, Sepia, Silicea.
       3. Ammonium,  Chamomilla,  Ignatia,  Kreosotum,
         Lycopodium, Pulsatilla, Ruta, Sulphur,  Sulphuris
         acidum.
       4. Antimonium, Calcarea, Cannabis, Cantharis, Car-
         bo animalis,  China,  Hepar,  Kali, Magnesia  car-
         bonica,  Magnesia  muriatica,   Mezerewn, Nitri
         acidum, Phosphori acidum, Thuja.
    Bloody:—China, Cocculus.
       2. Kreosotum, Nitri acidum.
       3. Arsenicum, Lycopodium, Sepia,  Silicea,  Sulphuris
         acidum.
       4. Alumina,  Antimonium,  Cantharis, Carbo  veget,
         Conium, Magnesia muriatica.
    Brown :—Nitri acidum.
    Burning :—1.  Calcarea, Pulsatilla.
       2. Conium, Kreosotum. 
endometritis.
195
   3. Ammonium, Cantharis, Carbo animalis, Kali, Sul-
     phuris acidum.
   4. Arsenicum, Borax.
 Corrosive, see acrid.
 Fetid :—1. Kreosotum, Sabina.
   2. Natrum.
   3. China, Nitri acidum, Nux vomica, Sepia.
 Greenish :—1. Sepia.
   2. Bovista, Mercurius.
   3. Carbo vegetabilis, Pulsatilla.
 Itching:—1.  Calcarea.
   2. Alumina, Kreosotum, Mercurius.
   3. Sabina, Sepia.
   4. Arsenicum, China, Ferrum, Kali, Phosphori acid.
 Milky :—1. Calcarea, Pulsatilla.
   2. Ammonium, Silicea.
   3. Carbo vegetabilis, Ferrum, Sulphur.
   4. Conium,   Graphites,  Kreosotum,  Lycopodium,
     Phosphorus, Sabina, Sepia,  Sulphuris acidum.
 Purulent :—1. Cocculus, Mercurius, Sabina.
   2. China, Kreosotum, Sepia.
   3. Calcarea,  Ignatia.
 Thick :—1. Pulsatilla.
   2. Sabina.
   3. Arsenicum, Carbo vegetabilis, Natrum, Natrum
     muriatica,  Zincum.
   4. Ambra, Bovista, Sepia.
Viscid :—1. Borax, Stramonium.
 ■  2. Bovista, Sabina.
   3. Aconitum, Phosphorus, Phosphori acidum.
Watery, serous :—1.  Graphites.
  2. Ammonium, Pulsatilla, Sepia.
  3. Antimonium, Carbo  animalis, Carbo  vegetabilis,
     Chamomilla, China, Kreosotum, Magnesia carbon.,
    Magnesia  muriat, Mercurius,  Nitrum, Silicea,
     Sulphur. 
196
DISEASES OF FEMALES.
     Yellowish:—1.  Sepia.
       2. Kreosotum, Lycopodium, Sabina.
       3. Aconitum, Carbo animalis, Carbo vegetabilis,  Cha-
         momilla, Nux vomica.
       4. Alumina, Arsenicum,  Bovista, Kali, Phosphori
         acidum, Sulphur.
Menses suppressed :—1. Conium,  Graphites, Kali, Pulsa-
         tilla, Silicea, Sulphur.
       2. Aconitum,  Calcarea, Chamomilla,  Cocculus, Fer-
         rum, Phosphorus,  Sepia.
       3. Arsenicum,  China, Lachesis, Magnesia carbonica,
         Mercurius, Nitri acidum, Platina, Sabina, Zincum.
     Too scanty :—1.  Ammonium, Conium, Graphites, Kali,
         Pulsatilla, Sulphur.
       2. Alumina, Cocculus,  Lachesis, Lycopodium, Mer-
         curius, Phosphorus, Silicea.
       3. Aconitum, Ferrum, Sabina, Sepia.
Pains in small of back :—1. Magnesia muriatica.
       2. Baryta, Conium,  Graphites, Kali, Kreosotum.
Vagina affected :—1. Calcarea, Kali, Sepia.
       2. Belladonna,  Cantharis,  China,  Kreosotum, Fer-
         rum, Lycopodium, Mercurius, Nux  vomica, Pulsa-
         tilla, Thuja.
       3. Arsenicum,  Carbo vegetabilis, Cocculus,  Conium,
         Graphites, Natrum  muriaticum, Nitri  acidum,
         Phosphorus, Platina, Sabina.
       4. Borax,  Carbo animalis, Magnesia  muriatica, Na-
         trum, Silicea, Sulphuris acidum, Zincum.
Vulva affected, Labia swollen:—1.  Sepia.
       2. Carbo vegetabilis,  Mercurius, Nux vomica.
       3. Aconitum, Belladonna, Calcarea, Conium,  Natrum
         muriat, Nitri acidum, Silicea, Sulphur, Thuja.
       4. Ammonium, Graphites, Kali, Kreosotum,  Nitri
         acidum, Pulsatilla.
Womb, painfulness  of:—1.  Belladonna,   Conium,   Nux
         vomica, Platina, Pulsatilla, Sepia, Sulphur. 
ENDOMETRITIS.
197
       2.  Chamomilla,  Cocculus,  Graphites,  Kreosotum,
         Magnesia carbon., Magnesia muriat, Sabina.
       3.  Carbo animalis, China, Ferrum, Kali, Natrum
         muriaticum.
Worse before the menses :—1.  Calcarea, Lachesis.
       2.  Baryta,  Carbo vegetabilis, China, Phosphorus.
       3.  Kreosotum, Pulsatilla.
       4.  Alumina, Graphites, Ruta,  Sepia,  Sulphur, Zin-
         cum.
     During  the menses:—1. Alumina.
       2.  China, Cocculus, Graphites, Lachesis, Pulsatilla,
         Zincum.
     Following the menses :—1.  Alumina.
       2.  Pulsatilla, Ruta, Sabina.
       3.  Cocculus,  Kreosotum,  Mercurius, Nitri acidum,
         Silicea, Sulphur.
       4.  Bovista, Graphites, Magnesia carbonica, Phosphori
         acidum.
  For further  information concerning  the use of the  above-
mentioned drugs, see the articles on dysmenorrhoea and  leu-
corrhoea.

  Dose.—In acute cases dissolve six globules,  or one or two
drops of the liquid  attenuation in ten table-spoonfuls of water,
and  give  the patient a table-spoonful  of this solution every
two hours', in  chronic cases give a few globules every night
before retiring, dry on the tongue or dissolved  in a spoonful
of water. 
198
DISEASES OF FEMALES.
ARTICLE  III.
       TRUE OR PARENCHYMATOUS METRITIS.

                       Section 67.

   General Observations.—After long and  serious reflec-
tions we have  been induced to reserve the name of metritis
for an inflammation of the tissue of the uterus ; for whatever
opinions modern  authors may express on the subject, in  the
so-called superficial metritis, it is only the mucous lining that
is inflamed; but  just as palpable a mistake it would be  to
designate by the term carditis an inflammation of the external
or internal membrane of the heart, which would  constitute
either pericarditis or endocarditis, just as false it would be to
call metritis an inflammation of the lining membrane of this
organ.  By metritis we  understand an inflammation  of  the
uterine substance  itself.  But, in order to avoid all confusion
resulting from the fact that our learned professors have ranged
all kinds of uterine inflammation under the name of metritis,
we will designate an inflammation of the uterine tissue by  the
adjective tune or parenchymatous metritis.  The acute form
of this disease generally occurs only during confinement; the
chronic form is frequently met with  in the unimpregnated
uterus, in which case the neck of the uterus is most frequently
the seat of the disease.  Hence result tolerably characteristic
differences  between the acute and chronic forms of metritis
which  we will  describe in the following paragraphs in  this
order; 1st, acute metritis ; 2d, chronic metritis,  to be followed
by the treatment of both of these affections.

                      Section 68.

  Acute Metritis.—The symptoms of this affection differ 
parenchymatous metritis.
199
according as the neck alone, or  the neck and body of the
uterus are affected.  An acute inflammation of the neck of
the uterus generally sets in after  the first embrace or in con-
sequence of  severe labor.  In  the former case the neck is a
little  swollen, warm and very  sensitive  to  contact;  in  the
latter case, the pain deep in the vagina is more or less acute;
there is a discharge of blood or of bloody mucus, and an ex-
amination shows that the neck  i3  swollen  and sometimes
covered  with  cracks  having more or less  depth.   Febrile
symptoms are generally  absent, and the affection is without
danger;  in  most cases a cure  takes  place without the inter-
ference of art, although this acute form sometimes passes into
the chronic  stage.  AVhen the whole body of the uterus be-
comes inflamed, other symptoms develop themselves beside
those which we have described above.   General metritis com-
mences most frequently with a more  or less acute pain in the
hypogastrium ; if the peritoneum should be involved, this pain
is felt in all the parts of the  abdomen.   It  is a continuous,
fixed pain, aggravated by pressure, cough, deep inspirations.
At the same  time a sense of heaviness,  heat and tension is
felt in the hypogastrium.  An examination shows that the
neck  is  soft, swollen, painful to contact and warmer than the
vagina.   Sometimes the uterus  forms a round tumor above
the pubes which, being deep-seated, is more easily discovered
by the touch than by sight.  Frequently a species of tenes-
mus of the rectum and  dysuria with painful urination super-
venes.  The loins,  the  groins  and  the  thighs  are equally
affected  by  pains consisting for  the  most part in painful
twitchings and pullings.  Most patients complain  moreover
of headache, especially in the frontal region, with vanishing
of  sight and  hearing, vomiting,  partial  sweat, pains in the
small of  the back, lassitude, fainting  turns, profound changes
in the features, pale face, etc.   Fever is not wanting; it con-
sists in a violent chill which lasts  a long time, and is followed
by heat with a torpid character.   The pulse is hurried, the
skin  dry and  warm, the  urine red.  In  fatal  cases  we have
afterwards meteorism, singultus, delirium, coldness of the ex- 
200
diseases of females.
 tremities and  discharge of fetid  matter from  the vagina.
 Sometimes the affection  involves the neighboring organs, the
 peritoneum, ovaries, fallopian tubes, etc., which may happen
 even in the mildest cases.   As to the causes of this disease,
 it is rarely ever noticed before  the age of pubescence, and
 after the critical period; it occurs quite frequently during
 confinement, but rarely  during pregnancy.  Exciting causes
 are:  serious wounds, compression, ligatures,  cauterizations,
 commotions of the uterus in consequence of too much  vehe-
 mence during intercourse, sudden suppression of  the menses,
 vaginal injections, mechanical or  external irritations, tetter
 at the parts, ascarides in the anus or vagina, violent  straining
 at stool, etc.  The diagnosis of acute metritis is sometimes
 rather obscure; but  an  attentive exploration of the sexual
 parts may help us establish  it, especially when the inflamma-
 tion is confined  to the neck  ; but if both the uterus and the
 peritoneum  are  invaded, metritis can readily be  diagnosed ;
 for, in simple peritonitis, the symptoms of metritis are always
 absent; whence we may infer that, whenever the symptoms
 of peritonitis  and  metritis  co-exist,  the inflammation  was
 originally a case of genuine metritis.  As regards the course
 and termination of acute metritis, it may terminate in death
 even on the  third or second  day  after the disease had set in,
 but which generally  happens within  seven days, or within
 two, three or  four  weeks after  the invasion of the disease.
 Sometimes the inflammation terminates in gangrene, in con-
 sequence of which the dead uterus has been known to become
 detached from the body, expelled through the vagina,  and
 the patient  nevertheless to  survive such a terrible  accident.
Metritis however does not always terminate fatally or lead to
 disastrous results.   Cases which happen  between the periods
 of pregnancy, and which do not  involve the peritoneum or
the whole womb, generally  terminate happily, within a  few
weeks, or after  three or  four days,  especially under  homoeo-
pathic treatment.   Metritis setting in  during  pregnancy
 often leads  to the destruction of the fetus and even to the
 death of the mother.  Among the consequences of acute me- 
parenchymatous metritis.
201
 tritis, we have to note an obstruction of the Fallopian tubes
 as occurring  quite frequently, in consequence of which ste-
 rility of course  result.   The prognosis  of course  depends
 upon the extent of the inflammation, upon its intensity and
 upon existing complications.  Inflammations occurring during
 pregnancy or immediately after confinement, are always more
 dangerous than those which occur at other periods.

                       Section  69.

   Chronic metritis.—This affection occurs much more  fre-
 quently than acute metritis.  It may set in in consequence of
 an acute inflammation  or as a primary disease, and may either
 affect the whole of the uterus or the neck only.   The primary
 disease seems to be principally owing to  sexual excesses, to
 onanism, the use of pessaries, or to some herpetic or rheumatic
 metastasis;  often it sets  in without any apparent cause; it
 occurs most frequently  between the twentieth and the fortieth
 year.  The  characteristic symptoms of this disease are: dull
 and heavy pain in the  hypogastrium, extending to the  loins,
 groin, thighs and sometimes to  the breasts, the pain being
 aggravated  by  long standing, walking or by sexual excesses;
 sometimes the pain is accompanied by a discharge of opaque,
 milky, inodorous  mucus from the vagina,  and  sometimes by
 haemorrhages with paleness of the face, weakness, emaciation.
 With some  exceptions  most women preserve  their  volume,
 good looks and even strength.  The os tincae  appears more
 elongated than in its normal state; the neck is very soft, its
 surface is smooth and the orifice generally closed; touch always
 causes a more  or less acute pain, or aggravates  the pain gene-
 rally experienced by the patient.  When the disease is  con-
 fined to  the neck, the womb  preserves  its  mobility  and
 ordinary weight; but when the body of the uterus is involved,
 this organ always seems heavier when attempted to be raised
 by the finger introduced into the vagina, and it  is less move-
 able on examining  the hypogastrium, or on introducing  the
finger in  the rectum, we sometimes discover a  round tumor
in the region of the womb, which  is easily recognised as  the 
202
DISEASES of females.
uterus by the various movements imparted to it by the explor-
ing finger.  The menstrual discharge is generally painful and
difficult,  though not necessarily  suppressed.—This affection
generally runs a slow  course;  it  may  continue for years
without  any noticeable change in the  symptoms or without
any local changes; often the disease may terminate favorably,
in which case the swelling of the womb diminishes gradually
and the symptoms which the patient experienced disappear,
or become reduced to some obscure and not very embarrassing
sensations in the hypogastrium;  in some cases the trouble
remains unchanged for an  indefinite period.  It is a mistake
to suppose that cancerous ulcerations and  degenerations can
result from chronic metritis; this is about as true  as it is that
tubercular phthisis can result from some neglected catarrh of
the lungs.  Cancerous and schirrous degenerations are idio-
pathic  affections  resulting from  pre-existing germs  in  the
diseased organ; this germ may indeed be developed but can-
not be created by succeeding or continuous inflammations  or
catarrhs; on the contrary, its presence is very frequently the
only pathological cause of these repeated catarrhal inflamma-
tions.  Uterine catarrh is  readily diagnosed;  it  cannot well
be confounded with cancer or polypus  of the womb, both of
which diseases are characterized  by  symptoms  which  are
wanting in catarrh.   In cancer the affected part is hard, un-
even, and the  seat  of  lancinating pains; there is a reddish
discharge, frequent  flooding, and the face of the patient  has
the straw-colored complexion which we observe in all cancer-
ous diseases.   In a case of polypus, if  it  has not yet  grown
outside of the uterine orifice, the neck will be found open, and
the expulsive pains which frequently accompany the repeated
haemorrhages,  may at least lead us to suspect the  presence of
polypus.   The prognosis of  chronic uteritis may be inferred
from what we have said of the course  of the disease;  if no
cancerous diathesis or polypi are present, the affection is not
as serious as one would suppose;  simple cases  yield more or
less promptly to homoeopathic treatment. 
parenchymatous metritis.           203
                       Section 70.

  Treatment.—The principal  remedies for acute or chronic
parenchymatous metritis are :
       1.  Pulsatilla, Sepia, Belladonna, Chamomilla, Kali,
         Platina, Sabina.
       2.  Bryonia, Carbo animalis, Conium, Crocus, Ferrum,
          Graphites, Kreosotum, Mercurius, Nux vomica, Opi-
         um, Rhus, Secale, Sulphur.
       3.  Aconitum, Arnica, Calcarea,  China,  Cocculus, Cof-
         fea, Cohcynthis, Hyoscyamus, Ignatia,  Ipecacuanha,
         Magnesia muriatica, Natrum, Natrum muriaticum,
          Phosphoric acid,  Thuja,.
       4. Arsenicum,  Cantharis, Lachesis, Lycopodium, Mag-
          nesia  carb.,  Phosphorus,  Stramonium, Sulphuris
          acid.,  Veratrum, Zincum.
   AVith the following particular indications :
 For acute metritis :—1. Mercurius, Belladonna.
       2. Aconitum, Chamomilla, Coffea, Nux vomica.
       3. Bryonia,  Cantharis,  China, Cocculus Ignatia, Lache-
          sis, Platina, Pulsatilla, Rhus, Sabina, Secale, Sepia.
       4. Arnica, Arsenicum,  Cocculus, Crocus, Ferrum, Hy-
          oscyamus, Stramonium, Sulphur,  Veratrum.
 For CHRONIC metritis:—1. Belladonna, Calcarea, China, Coc-
          culus, Conium, Kali, Kreosotum, Nux vomica, Pla-
          tina, Pulsatilla,  Sabina, Secale, Sepia.
       2. Bryonia,  Ferrum, Graphites,  Lycopodium, Magne-
          sia carbonica, Magnesia  muriatica,  Natrum, Na-
          trum muriaticum, Phosphorus, Zincum.
 And with these complications :
      AVith gangrene :—1. Sabina, Secale.
       2. Arsenicum,  Belladonna, Lachesis, Silicea.
        3. Aconitum, Conium, Mercurius, Plumbum, Sulphur,
          Sulphuris acid.
      Hiccough :—1.  Nux vomica.
        2. Ammonium muriaticum Hyoscyamus, Ignatia.
        3. Belladonna, Pulsatilla, Veratrum. 
204
DISEASES of females.
       4. Aconitum,  Cocculus, Lycopodium, Magnesia  muria-
         ticum,, Mercurius, Natrum,  Staphysagria, Stramo-
         nium, Sulphur.
    Leucorrhea :—1. Cakarea, Kreosotum, Mercurius, Pul-
         satilla, Sepia.
       2. Ammonium,  Carbo  vegetabilis,  China,  Cocculus,
         Conium, Ferrum, Graphites, Lycopodium, Phospho-
         rus, Sabina, Sepia, Sulphur.
       3. Arsenicum, Cantharis, Carbo animalis, Chamomilla,
         Magnesia  carbonica,  Natrum  muriaticum,  Phos-
         phori acid., Sulphuris acidum.
Complications with  frequent  metrorrhagia :—1. Belladon-
         na,  Calcarea, China, Ferrum, Nux  vomica, Sabina.
       2. Bryonia, Chamomilla, Crocus, Lycopodium,  Mercu-
         rius, Nitri acidum, Phosphorus, Pulsatilla,  Secale,
         Sepia, Stramonium, Sulphur.
       3. Aconitum,  Cantharis, Coffea, Platina, Silicea, Sul-
         phuris acidum.
    Menses suppressed:—1.  Conium, Graphites, Kali, Ly-
         copodium, Pulsatilla,  Sulphur.
       2. Aconitum,  Calcarea, Chamomilla,  Cocculus, Ferrum,
         Phosphorus, Sepia, Staphysagria.
       3. Arsenicum, Bryonia,  Cohcynthis, Cocculus,  Crocus,
         Ignatia, Mercurius, Stramonium, Veratrum.
    Painful:—1. Belladonna, Bryonia, Chamomilla, Nux
         vomica, Platina, Pulsatilla, Secale,  Sepia, Sulphur.
       3. Calcarea,  Cocculus, Coffea, Graphites, Ignatia, Phos-
         phorus,  Veratrum.
       3. Ammonium, Carbo vegetabilis, Kreosotum, Lachesis,
         Magnesia muriaticum, Mercurius, Zincum.
    Ovaritis:—1.  Cantharis, Staphysagria,  Thuja.
       2. Carbo animalis, China, Conium,  Lachesis, Lycopo-
         dium, Secale, Sepia, Zincum.
       3. Aconitum,  Carbo vegetabilis, Cohcynthis, Graphites,
         Ignatia, Mercurius, Nitri acidum, Nux vomica, Sul-
         phur. 
parenchymatous metritis.
205
    Peritonitis :—1. Aconitum, Belladonna, Bryonia, Hy-
         oscyamus, Nux vomica.
       2.  Chamomilla, Coffea, Cohcynthis, Rhus, Sulphur.
:       3.  Cohcynthis, Mercurius, Pulsatilla, Veratrum.
    Polypus, probable in persons who had  been so affected
         before:—1.  Calcarea, Conium, Phosphorus,  Sta-
         physagria.
       2.  Lycopodium, Mercurius, Silicia, Thuja.
       3.  Belladonna,  Graphites, Hepar, Mezereum, Natrum
         muriaticum,  Nitri  acidum, Phosphori acid.,  Sul-
         phur., Sulphuric acid.
       4.  Ambra,  Pulsatilla.
    Schirrus or cancer, in persons with this  diathesis:—
       1.  Graphites, Kreosotum.
       2.  Carbo animalis.
       3.  Arsenicum, Belladonna,  China, Clematia, Mercu-
         rius, Sepia, Silicea, Sulphur.
       4.  Calcarea, Lachesis, Phosphorus, Sabina, Staphysa-
         gria, Thuja.
     Vomiting, frequent:—1. Nux vomica.
       2.  Conium, Ipecacuanha, Pulsatilla.
       3.  Arsenicum, Ferrum, Natrum muriaticum, Sepia.
       4.  Aconitum, Kreosotum, Lachesis, Magnesia muriati-
         ca, Phosphorus,  Veratrum.

And when the affection breaks out:
    After confinement:—1. Nux vomica.
       2.  Aconitum, Belladonna,  Bryonia, Chamomilla, Cof-
         fea,  Cohcynthis,  Rhus.
       3.  Arnica, Arsenicum,  Hyoscyamus, Ipecacuanha, La-
         chesis, Mercurius, Platina, Pulsatilla,  Secale, Stra-
         monium,  Veratrum.

     Retrogressed eruptions:—1.  Bryonia, Graphitis, Ipe-
         cacuanha, Phosphori acid.
       2.  Belladonna,  Chamomilla,  Lycopodium,  Natrum
          Pulsatilla, Rhus, Sepia, Staphysagria. 
206
diseases of  females.
       3.  Aconitum, Alumina, Ambra, Arsenicum,  Carbo ve-
         getabilis,  Causticum, Dulcamara, Hepar, Kali, La-
         chesis, Mercurius, Phosphorus, Silicea, Stramonium,
         Thuja, Veratrum.
     Excesses, sexual, or after onanism :—1. Nux vomica,
         Sepia.
       2.  Calcarea, Phosphori acid., Staphysagria.
       3.  Carbo vegetabilis, China,  Conium, Kali, Mercurius,
         Phosphorus, Pulsatilla, Silicea.
       4. Arsenicum, Ferrum, Ignatia, Lycopodium, Natrum
         muriaticum, Sulphur.
     Irritation, by pessaries,  etc.:—1. Arnica,  Conium,
         Hepar, Nux vomica,  Pulsatilla, Rhus, Sulphuris
         acidum.
       2.  Chamomilla, Lachesis, Phosphorus, Ruta, Staphy-
         sagria, Sulphur.
       3.  Bryonia,  Calcarea,  China, Hyoscyamus, Kali, ]Kre-
         osotum, Lycopodium, Mercurius, Natrum,  Natrum
         muriaticum, Nitri acidum, Platina, Secale.
     Rheumatism,  metastatic:—1. Aconitum, Belladonna,
         Bryonia,   Chamomilla,  Mercurius,  Nux vomica,
         Phosphorus, Pulsatilla, Rhus.
       2. Arsenicum,  Carbo vegetabilis, China, Ferrum, Igna-
         tia, Lachesis, Lycopodium, Sepia,  Sulphur, Thuja,
         Veratrum.
       3.  Cantharis, Cohcynthis, Kreosotum,  Mezcreum,  Nitri
         acidum.

                      Section 71.

  Symptomatic details—In all cases of metritis, no matter
of what kind, we may administer the following remedies when
indicated by the symptoms :
  Aconitum—For acute  metritis, at the commencement of
the  treatment, especially if the disease was caused  by fright
during confinement or menstruation,  or for the following
symptoms: inflammatory fever with  dry and burning heat, 
parenchymatous metritis.
207
violent thirst with desire for cold drinks, red and warm face,
short, oppressed breathing and sighing ;  distention of the ab-
domen, with sensitiveness to contact and cutting pains through
the whole abdomen.
  Belladonna—Often after Aconitum, especially when the
abdomen  is  distended,  with lancinating, digging  pains, or
violent cramp-colic, as if part of the intestines  were seized
with nails ; painful pressure on the genital organs as if every
thing would issue through the parts ; sensitiveness of the ab-
domen to contact;  shivering in  some  parts, with heat in
others ; heat about the head and eyes, with redness of the face ;
pressive headache, with throbbing  of the carotids ; spasmodic
dysphagia; sleeplessness, with  uneasiness and tossing of the
limbs ; sopor, furious delirium ;  suppression  of  the menses,
or metrorrhagia with discharge of  foul blood; lancing pain in
the hips, permitting  neither contact nor motion; pains in the
small of the back as  if the sacrum  were broken.
   Bryonia.—Distention of the abdomen and excessive sensi-
tiveness  to the least contact or motion;  constipation ; lanci-
nating pains in the abdomen aggravated by pressure; violent
fever, with burning  heat through the whole body; burning
thirst for cold beverages; irascible mood, with apprehensions,
dread of the  future and uneasiness about her condition.
   Carbo animalis—In  some cases of  chronic metritis, for:
painful pressure in the loins, groins and thighs, with ineffec-
tual urging to  raise  wind; shivering and gaping; lassitude
which scarcely permits  her to remain up ;  distention of the
abdomen; leucorrhoea which tinges the linen yellow; lassitude
in the thighs.
  Chamomilla.—In  acute  metritis when  caused by severe
disappointment, fit of anger, during the catamenia or after
confinement, with discharge of a black blood, mixed with coag-
ulated blood; distention and sensitiveness of the abdomen to
contact;  colic like labor-pains ; heat all over, with red face and
thirst; nocturnal exacerbation, followed by sweat;  restless-
ness ; impatience, nervousness.
   Coffea—In acute metritis, for nervousness,  with sensi- 
208
diseases of females.
 tiveness to contact, or metritis is caused by excessive joy that
 had induced menstrual suppression.
   Colocynthis.—Sometimes after Chamomilla, in acute me-
 tritis resulting from suppression of  the  menses or lochia in
 consequence of a violent indignation, or for: delirium alter-
 nating with sopor; heat about  the head, red face, glistening
 eyes; dry heat; hard,  full and  hurried  pulse; cutting in
 the  bowels as with knives, with shiverings,  tearing pains
 along the thighs ; crampy colic as if the bowels were clutched,
 or were squeezed between stones.
   Conium.—In chronic metritis,  with or without ovaritis.or
 peritonitis, especially for the following symptoms : distended
 abdomen, with digging above the pubes, and stitches extend-
 ing to the side of the chest;  clutching, squeezing in the womb;
 painful pressure downwards, with pulling in the thighs; sup-
 pressed or scanty menses ;  paralytic weakness in the small of
 the back; bloody or milky  leucorrhoea;  vomiting, hiccough ;
 excessive sensitiveness of the abdomen to the least contact.
   Crocus.—For profuse flooding, with discharge of a viscid
 blood mixed with black coagula ;  heaviness  and pressure in
 the groin and hypogastrium, as if  the  menses would make
 their appearance ;  violent stitches as with knives in the sexual
 organs,   extending  into  the abdomen; movements  in the
 bowels as from a foetus.
  Ferrum.—In chronic metritis, with great pain during an
 embrace; colic like labor-pains ; suppressed or scanty menses ;
lancinating headache ;  milky and corrosive leucorrhoea.
  Graphites.—In chronic metritis, with or without ovaritis,
especially for  painful pressure on  the  parts, especially after
long standing;  eruptions,  fetters,  excoriations or  ulcera-
tions at the vulva;  pains in the small of the back not per-
mitting  her to move ;  weariness in  the  hypogastrium, with
dulness in the  head ; eructations and nausea, with lassitude;
sense of  heat at the hypogastrium; leucorrhoea ; suppressed
or scanty menses.
  Kali carbonicum.—In chronic metritis, especially for aver-
sion  to sexual intercourse or else  excessive irritation of the 
parenchymatous metritis.
209
sexual instinct;  painfulness of the parts during intercourse,
with tearing and stitches in the womb; erythema and excoria-
tions  at the vulva;  menses suppressed or scanty; menstrual
blood corrosive  and fetid; abdominal cutting pains or pres-
sure in the hypogastrium as if everything would issue below ;
frequent eructations and vomiting.
  Kreosotum.—In  chronic  metritis, with  stitches through
the vagina and uterus like electric  shocks;  sore pain at the
neck  of the uterus during intercourse, especially in the morn-
ing ;  indurations at the  neck, increased sexual desire; leu-
corrhoea which stains the linen grey;  swelling of the puden-
dum ;  violent cramp-pains in the  groin;  violent  pressure
downwards like labor-pains ;  nausea, vomiting.
  Lycopodium.—In chronic metritis, with tearing stitches in
the parts;  burning pain  during and after intercourse; pull-
ing and pressure in the groin, as if the menses would appear ;
dryness  of the vagina ; pressure from within outwards, above
the pubes,  when stooping; frequent passage of wind from the
vagina;  suppressed menses ; heaviness  of the legs; melan-
choly, sadness, lowness of spirits, peevishness.
  Mercurius.—In acute metritis,  especially when the  pains
in the womb are lancinating, boring or pressing; slight fever,
not much heat, but shivering and frequent sweating.
  Nux vomica.—In most cases  of acute  metritis, with or
without peritonitis,  when  the fever is not very  high, or after
the fever had abated under the use of Aconite or Belladonna ;
also in many cases of chronic metritis, more particularly for
the following symptoms :  pressive  pains in the hypogastrium,
aggravated  by pressure  and contact; violent  pains in the
small of the back ; swelling of the uterine orifice, with  pains
as if  bruised,  and stitches in the lower abdomen; heaviness
and burning in the hypogastrium  and  in  the parts; sup-
pressed menses, or else too profuse, with  violent pains in the
small  of the back, dysuria  and burning urine; tearing or
cramp-pains in the thighs and legs, with numbness of  these
parts; pulsative  or pressive headache,  with  vertigo, blur
before the eyes, buzzing  in the ears and fainting turn; con-
                            14 
210
DISEASES of  females.
stipation or hard stool;  in  the  morning the symptoms are
worse.
   Opium.—sometimes in acute  metritis,  with meteonsm,
hiccough, delirium, cold extremities, discharge of fetid matter,
or else violent pains like labor-pains, with spasmodic con-
traction of the abdomen.
   Platina.—In acute metritis, especially after confinement,
with increased sexual  desire, voluptuous  tingling in the
womb and external pudendum; painful pressure at the hypo-
gastrium and  on the parts, with shuddering and coldness ;
hardness of the womb; profuse  discharge  of  a  thick  and
black blood; sensitiveness of  the parts ; headache, restless-
ness and weeping.
   Pulsatilla.—For pulling,  tension and contraction in the
hypogastrium, as if the menses would make their appearance,
with desire to vomit; cutting pain in  the  uterine  orifice;
shiverings with yawning and stretching;  weight in the hypo-
gastrium as from a stone ;  pressure at the rectum, with tenes-
mus ; colic and vomiting, also  with discharge of mucus from
the vagina; pressure at  the sacrum and hypogastrium, with
numbness of  the limbs;  pale  face ; semi-lateral  headache ;
scanty or suppressed menses.
   Rhus toxicodendron.—In  acute metritis, especially after
confinement, or after a sudden  suppression of the  menses,  or
if  cerebral or typhoid symptoms become developed from the
commencement of the disease,  or if the symptoms are made
worse by the least disappointment; pulling  in  the hypogas-
trium, as if labor would set in ; excoriation-pain in the vagina
when touching it.
  Sabina.—In acute or chronic metritis, especially after mis-
carriage  or confinement,  with  increased sexual desire; con-
tractive pain in the uterus ; pressive  heaviness in the hypo-
gastrium, as  if the menses  would make their  appearance;
violent stitches at  the bottom of the  vagina;  metrorrhagia,
with discharge of coagula ; inflamed urine, with painful uri-
nation ; discharge of a mucous liquid from the vagina.
  Secale Cornutum.—Often in the most acute cases of me- 
parenchymatous metritis.
211
tritis, with tendency  to gangrene or putrescence ;  metritis
caused by suppression of the lochia or menses;  distention of
the uterus ; metrorrhagia, with tingling in the legs, debility,
and discharge of  a thin and black blood.
   Sepia.—In chronic metritis, especially for the following
symptoms:—Painful rigidity in the hypogastrium and uterine
region ; choking pressure downwards, as if everything would
pass through the vagina, with  abdominal cutting pain and
jelly-like  leucorrhoea; hardness  of the  neck of the  womb ;
falling of the uterus ; itching, erythematous redness and exco-
riations at the vulva ; suppressed or  scanty menses ;  stitches
in the womb, with  distention  and heaviness;  nausea and
vomiting.
   Sulphur.—When the other  remedies, which have been
named for acute and  chronic metritis, have proved fruitless,
especially for the following symptoms :—Excoriation-pain at
the bottom of the vagina, during an embrace; suppressed or
scanty menses ;  flooding between the periods, almost every
day; violent pains in the hypogastrium, with heat, shivering
and epileptiform  convulsions ;  violent  colic and pains in the
small of the  back, with  distention of the abdomen ;  uterine
cramp-pains ; itching, inflammation, swelling and excoriation
of the labia.
   For further details concerning the use of the other reme-
dies, see Dysmenorrhoea,  Sections  5-10, and Amenorrhoea,
Sections 23-32.
   Dose.—In acute cases, dissolve six globules, or one or two
drops of the  liquid attenuation, in ten  table-spoonfuls of wa-
ter, and give a table-spoonful every two  or three hours.  In
chronic cases, give this dose twice a day, morning and evening. 
212              diseases of  females.
ARTICLE  IV.
        HYDROMETRA,  OR UTERINE DROPSY.

                      Section  72.

r  Symptoms.—Most authors distinguish three kinds of hydro-
metra  or  dropsy  of the uterus,  namely : 1, uterine ascites,
where the liquid is contained within the cavity of the uterus ;
2, hydatids  in  the  womb;  and 3, hydrometra of pregnant
women, which developes itself during pregnancy.  Having to
treat of the two last named varieties in the articles on For-
eign bodies in the  womb, and Ailments during pregnancy, we
have here only to  treat of  the first form, ascites.   The symp-
toms of this disease differ  according as the  disease is persis-
tent or periodical, that  is to say, according as the fluid con-
tained in the womb remains there until the patient either gets
better or dies, or according as it escapes at certain intervals
from  the uterine  orifice.   In the former  case, the patient
complains of pains in the lumbar region and in the hypogas-
trium, progressive swelling of the abdomen, menstrual sup-
pression;  sometimes swelling of the breasts,  and discharge
from the breasts of  a certain quantity of milky lymph, so that
the symptoms are  often  mistaken for those  of pregnancy.
This condition may last one, two or  more months, and even
years.   The swelling of the  abdomen increases from  below
upwards, and the accumulation of the secreted fluid gives rise
to  a  round, circumscribed, soft,  fluctuating,  more or less
voluminous tumor, yielding a dull sound to percussion.   This
dropsy may terminate  in  the spontaneous  discharge  of the
fluid,  in  consequence  of  a contusion,  fall, hurried motion,
effort  when coughing, sneezing, or  in  consequence  of any
% 
hydrometra.
213
other concussion of the body.  In  this case,  uterine  pains
soon set in, the uterine  orifice becomes dilated, and  the fluid
either escapes gradually or  all at once, after which  the cure
is sometimes  completed.   In other cases, the fluid in the ute-
rine cavity sometimes distends the womb to a certain extent,
and occasions a sort of swelling of  the abdomen ; but from
time to time, and more particularly at the period of  the men-
ses, or in consequence of some concussion, sometimes, without
any appreciable cause, the neck of the uterus becomes dilated,
so that  the fluid which is enclosed in the uterine cavity is able
to pass out, which does  not prevent, however, the collection
of another quantity of  serum, that  is  expelled again, in its
turn, after a certain period.   This variety is termed, by some
authors, periodical  ascites of the womb, and is  distinguished
from the former variety by this, that, in the former variety,
the secretion of the fluid ceases after its expulsion ;  whereas,
in  the  periodical variety,  the secretion continues  after the
expulsion.   In  either of these  two  varieties, it is  only the
external symptoms  that are either permanent or  variable ;
whereas, the pathological  condition—namely, the  abnormal
secretion—remains the same in either case.  In either variety
the abnormal secretion  remains permanent until  the definite
cessation of the disease  by a radical cure, or by death.  AArhen-
ever a considerable quantity of fluid is secreted in the uterine
cavity,  or whenever this secretion is accompanied  by other
organic lesions  of the womb, the  patient experiences  pains,
a sense of heaviness in  the loins, groins, and in the hypogas-
trium, with difficulty of urinating or  going to stool, infiltration
of  the eyelids and straw-colored complexion.

                        Section 73.

   Causes, diagnosis, prognosis, and treatment.—Hydro-
metra never  sets in  before the menstrual functions have com-
menced, or  after  they have entirely  ceased.   It  is  almost
always the result of a tubercular, schirrous or hydatic degene-
ration  of  the  walls of  the uterus, but  it may also exist in- 
214              diseases  of females.
dependency of these  alterations.  Sometimes it sets in, in
consequence of blows in the hypogastric region, or  of a mis-
carriage, suppression of leucorrhoea  or  of the  lochia, or it
may be induced by any other cause that  may induce inflam-
mation  of  the  uterine  mucous  membrane.  As  regards
diagnosis,  hydrometra  might  be  most  readily confounded
with pregnancy; but the absence of all the real signs  of
pregnancy, such as the movements of the foetus, the sounds
of the foetal heart, etc., will soon clear all doubt regarding it.
As regards dropsies  of  the  nervous cysts, of the  Fallopian
tubes or of the ovaries,  they can  scarcely be  mistaken  for
dropsy of the womb; for in all these  affections  the  womb
remains unaltered, and the swelling is located on the right or
left of the median line.   Sometimes the  accumulation of  the
menstrual blood, in amenorrhoea, may occasion a more or less
considerable  swelling of the abdomen;  but,  such  a swelling
corresponds more  particularly to  the menstrual period, in-
creasing at such a period and decreasing again afterwards.
Finally,  in  physometra  the  abdominal  swelling  sometimes
reaches a considerable volume, but there is always resonnance
in such a tumor, and an absence of fluctuation;  these  two
characteristic signs are wanting in hydrometra.   The PROG-
NOSIS is not very unfavorable unless there  are deep-seated
organic alterations of the uterus, and when the  affection only
depends upon chronic inflammation, a polypus, mucous con-
cretions or spasmodic closing of the neck of the uterus; but,
if the disease is occasioned by cancerous  or schirrous degene-
rations, or by any other disorganizations of the uterus,  it
becomes exceedingly serious.   The  treatment  should be
determined with reference to the cause of the disease, although
the following remedies will be found generally sufficient:
       1.  Arsenicum, Belladonna,  China, Helleborus, Mer-
         curius, Sulphur.
       2. Bryonia,  Calcarea, Conium, Ferrum, lodium, Kali,
         Lachesis,  Lycopodium, Pulsatilla,  Ruta, Sabina,
         Sepia. 
hydrometra.
215
      3. Aconitum, Ambra, Arnica,  Cantharis, Duhamara,
         Hyoscyamus, Nux vomica, Opium, Plumbum, Secale,
         Veratrum.
      4. Ammonium, Antimonium, Aurum, Carbo vegetabilis,
         Cocculus, Hepar, Ignatia, Ledum, Nitri acid., Phos-
        phorus, Phosphoric acid,  Silicea, Stannum, Stramo-
         nium.
And in particular:
After a miscarriage :—1.  Belladonna, Sabina, Secale, Sepia.
      2.  Bryonia,  Cakarea, China, Ferrum, Kali, Pulsatilla,
         Sulphur.
      3.  Arnica,  Cantharides,   Hyoscyamus,   Lycopodium,
         Nitri acid., Nux vomica, Phosphorus,  Rhus, Silicea.
     Blows on the hypogastrium:—1. Arnica,  Conium, Pul-
         satilla, Rhus.
      2. Bryonia, lodium, Lachesis,  Phosphorus, Ruta, Sul-
         phur.
       3. Calcarea, Cantharides, Carbo vegetabilis, Dulcamara,
         Kali, Lycopodium,  Mercurius,  Nitri acid., Nux
         vomica, Silicea  Veratrum.
     With hydatids :—1.  Cantharides, Mercurius.
     Inflammation of the mucous lining (endometritis):—
       1. Mercurius, Pulsatilla, Sepia.
       2. Ammonia,  Cakarea, China, Conium,  Ferrum, Lyco-
         podium, Sabina, Sulphur.
       3. Arsenicum, Cantharides, Kali, Nitri acid., Phos-
         phorus,  Veratrum.
     Suppressed  leucorrhoea:—1. Bryonia,   China,  Nux
         vomica, Pulsatilla, Sulphur.
       2. Aconitum,  Ammoniacum,  Arsenicum, Belladonna,
         Lachesis.
       3. Calcarea, Carbo  vegetabilis,  Conium, Nitri acid.,
         Phosphorus, Sepia.
     Suppression  of lochia :—1. Belladonna, Nux vomica,
         Pulsatilla,  Secak.
      2. Hyoscyamus Veratrum. 
216
diseases of females.
     Polypi:—1. Calcarea,  Conium, Phosphorus,  Staphysa-
         gria.
         2. Lycopodium, Mercurius,  Silicea, Thuya.
       3. Belladonna,  Graphites,  Hepar, Mezereum,  Nitric
         acid, Phosphori acid., Pulsatilla, Sulphur.
   Suppressed menses :—1. Conium, Kali, Lycopodium, Pul-
         satilla, Sulphur.
       2. Ammonium, Dulcamara, Ferrum, Graphites, Hyos-
         cyamus, Ignatia,  Lachesis, Mercurius, Phosphorus,
         Sepia,  Silicea, Veratrum.
     Schirrous  or   cancerous   affections:—1.   Graphites,
         Kreosotum.
       2. Arsenicum,  Belladonna,  Carbo animalis,  China,
         Mercurius, Sepia, Sulphur.
       8.  Calcarea, Lachesis, Phosphorus, Sabina.
   For further details concerning  the use of  these remedies
see Dysmenorrhoea,  Amenorrhoea,  Leucorrhoea, Endometritis
and Metritis.
   Dose.—Dissolve six globules, or one  or two drops of the
liquid  attenuation  in ten tablespoonfuls  of water,  and give
the patient a  tablespoonful  of this solution  every three or
four hours, or even more frequently in  urgent cases. 
physometra.                   217
ARTICLE V.
     PHYSOMETRA, TYMPANITIS OF THE WOMB.

                       Section 74.

  Symptoms,  causes and treatment.—This affection con-
sists in a distension of the uterus, caused by gas which accu-
mulates in the cavity  of the  uterus without being able to
escape from it.   The distended uterus  forms a round, more
or less extensive tumor  in the  hypogastric region, according
as more or less gas is accumulated.  If this affection  sets in
immediately after confinement, the swelling may sometimes
attain  to a size equal to that  before confinement, and other
symptoms may develop themselves with it, such as coma,  tur-
gescence of the face and head, loss of consciousness,  and
other cerebral symptoms.   If  the distension of the uterus is
at all  considerable,  there is an embarrassment and  tension
about the hypogastrium; the  uterine pains extend  to  the
loins, groin and thighs, and even to the epigastrium; in many
cases the menses cease.   Sometimes a little  fever is present,
with evening exacerbations; shivering,  thirst, loss of appe-
tite,  scanty and  difficult stool, frequent  urging to vomit,
dyspnoea, laziness, aversion to physical  exercise, swelling of
the breasts and discharge of a milky fluid from the nipples.
All these symptoms disappear after the  escape of the  gas
through the vagina, which takes place  at irregular  periods
and sometimes with a loud explosion.  As regards the causes
of this  affection, it is most frequently owing  to the decompo-
sition of coagula or of the placenta  after  confinement, or
even of the dead foetus in the uterus.   In some cases, how- 
218
DISEASES OF  FEMALES.
ever, gas accumulates within the uterine  cavity, to such an
extent  that the abdomen acquires  the  same  dimensions as
during pregnancy.   The diagnosis of physometra  is readily
obtained;  the elasticity of the tumor and its resonance when
percussed, will remove all doubt as soon as we have become
satisfied that the womb and  not the intestines  are the seat of
the affection.  The prognosis is not serious; the disease is
not dangerous in itself, and only becomes so when it results
from the putrefaction of a  foetus, of the placenta, or from
the presence of  some other primary trouble.  As  regards
treatment, if the  expulsion of the gas should be  prevented
by some mechanical cause, this should be of course removed;
for which purpose the finger is generally the best instrument.
If medicines are required, the following are the best remedies:
       1. Phosphori acid.    £,dfft (
       2. Belladonna, China, Cocculus, Hyoscyamus, Lyco-
        podium, Magnesia carb., Nux moschata, Sepia.
       3.  Carbo vegetabilis,  Chamomilla, Graphites, Ignatia,
         Kali,  Nux vomica, Phosphorus, Pulsatilla,  Sta-
        physagria,  Veratrum.
       4. Arnica,  Calcarea, Cohcynthis,  Conium,  Nitri
         acid., Platina, Plumbum, Sulphur.
  Dose.—One or two drops of the liquid  attenuation, or six
globules dry on the tongue,  morning and evening. 
FOREIGN BODIES  IN THE WOMB.          219
ARTICLE VI.
           FOREIGN BODIES IN THE WOMB.

MOLES, HYDATIDS, SANGUINEOUS CONCRETIONS, MEMBRANEOUS FORMATIONS,
               POLYPI AND OTHER EXCRESCENCES.

                       Section 75.

   Moles.—We unite in this article  all the foreign  bodies
which are found in the uterus, and  which  may require some
peculiar treatment.   As regards moles, authors are not at all
agreed about the  definition and meaning of this term.  Ac-
cording to ancient  authors, a mole is a shapeless and inert
mass of flesh  caused in the womb,  in consequence  of an
imperfect conception.  Afterwards all sorts of confused ideas
were attached to this term,  until  modern  authors  finally
agreed to  admit  three kinds of moles: 1st,  the fleshy mole.
resulting from  false conception ; 2d, the hydatic mole, being
a heap of hydatids;  and  3d, the sanguineous mole, which is
a sanguineous concretion in the womb.  We shall here treat
only of the mole resulting from false conception, and defer a
description of  the other  kinds to  the next two paragraphs.
The fleshy mole  seems sometimes  to be  an hypertrophied
placenta,  containing within its cavity a  foetus which often
continues to grow even  after all life is extinguished.  These
fleshy moles always result from false  conception,  and should
not be confounded  with  the fibrous  concretions  which  are
sometimes  found  even among unmarried girls, and of which
we shall  treat  by and by when speaking  of  polypi.  These
masses of  hypertrophied  placenta  frequently exist  in  the
womb simultaneously with a foetus, although in most  cases
the development of the foetus is not only interfered with, but 
220
DISEASES OF  FEMALES.
the foetus is destroyed.  Sometimes the placental hypertro-
phy only commences after the expulsion of the foetus in con-
sequence of some cause.  As regards diagnosis, it is exceed-
ingly  difficult  to establish it  correctly.  At  the  onset the
swelling  may be confounded  with  pregnancy.  Even  after
the contents of the womb are changed,  the  signs of preg-
nancy still continue ; only the movements of the foetus are not
perceived, and the development  of the womb does not con-
tinue its regular course;  everything seems to point to the
presence of a foreign body in the uterus;  but it is impossible
to tell  whether it is an hypertrophied placenta or a slowly-
formed  coagulum  in  the uterine  cavity.  Even after the
body has protruded through the uterine orifice, the uncer-
tainty is not always removed by an ocular inspection of the
body.   The expulsion  of these bodies always takes  place  by
means of contractile efforts on the  part of the uterus, with
pains  and phenomena  similar to those of confinement, and
resembling a case of miscarriage  after the death of the foetus.
In most  cases, it is preceded  and accompanied by a more or
less profuse uterine haemorrhage, which  is often very rebel-
lious to old school  treatment,  especially when the  uterus is
not entirely freed from the presence of the foreign body.  As
regards treatment, the best means to favor the expulsion of
the womb, are:
       1.  Pulsatilla, Secale or Cantharis.
       2.  Calcarea, Silicea.
       3.  Belladonna, Kali, Opium, Platina.
       4.  Chamomilla, Cocculus,  Nux vomica,  Sabina, Sepia.
       5. Arnica,  Carbo veget,  Graphites, Ignatia, Magne-
         sia muriat.,  Natrum,  Natrum muriaticum,  Nux
         moschata, Ruta, Sulphur.
And for Uterine Hemorrhage  :
       1. Belladonna, Platina, Sabina.
       2.  China, Ferrum.
       3. Arnica,  Chamomilla, Crocus.
       4. Bryonia, Hyoscyamus, Ipecacuanha.
  Dose.—The same  as at the end of Section  74, and if 
foreign bodies  in the  womb.          221
haemorrhage or other acute symptoms occur, mix one or two
drops of the liquid attenuation in ten tablespoonfuls of water,
and give the patient a spoonful every few minutes or every hour
or  few hours,  according as  the symptoms are more or less
acute or dangerous.
   For other details see Metrorrhagia, Pregnancy and Con-
finement

                       Section 76.

   Hydatids.—Like  moles, hydatids are rather a disease of
the foetus than of the womb.  They are a sort of hollow
moles, caused by changes of the  ovum.  These  formations
may become exceedingly numerous, and have been known to
exceed several thousand; fecund women  are generally the
most  subject to such alterations.   Such hydatids sometimes
induce  all the signs  of  true  pregnancy: increase  of the
volume of  the abdomen, menstrual  suppression, frequent
nausea, sadness without any apparent motive.  This condition
may last from one to twelve and even fifteen months.  Dur-
ing the expulsion of the hydatids, acute uterine pains,  like
labor-pains, are experienced, and  copious haemorrhages fre-
quently set  in, which  are followed by great weakness,  and
are accompanied  by the expulsion of hydatids  through the
vagina.  These  masses are  often lobular on the outside,
granular  like a full-grown  placenta,  and the lining mem-
branes in the interior of these formations, often  contain
quantities of these vesicles which we term hydatids, from the
size of an almond to that of a little grain of sand.   Some-
times even the remnants or  origin of the  umbilical cord, or
some  other appendage of the ovum, is distinctly recognized
in one or the other  group of these vesicles.  Beside these
hydatids or  hollow moles, there  are  others formed by small
vesiclar acephalocysts, but differing  from the preceding va-
riety  less  than might  be supposed.  These  vesicular hyda-
tids, the animal nature of which is contested by some authors,
exist under two distinct forms.   Sometimes they are attached
to several  partial  stems, which are  ingrafted upon one larger 
222
diseases of  females.
 common pedicle,  thus  constituting a  variety  known  as
 grape-shaped moles.   Sometimes these vesicles, in the cavity
 which contains them, are free from  the  vascular  pedicles
 through which those  of the preceding species receive  their
 nourishment.  Either species  may  give rise to  false  preg-
 nancy,  known  under  the  name of  hydatid  dropsy.  These
 moles induce  an  alternate  occurrence  of  small, red and
 watery  losses,  commencing in  most women from the second
 month,  and continuing  at longer  or shorter intervals  until
 the period of parturition,  which generally takes place  from
 the second to the tenth  month.  Their expulsion is very apt
 to take  place when they are isolated, and it may be followed
 by all the symptoms setting in after confinement, such lochia,
 milk fever, and even metro-peritonitis.   The  causes of this
 affection are not much known; some authors think, however,
 that an excessive use of vegetable  and  unwholesome  food,
 and living  in a damp and unwholesome dwelling may cause
 the disease. Like the hollow moles, hydatids may take place
 in married  women, and like the former, seem a disease of the
 first product of gestation, though some  authors  pretend  to
 have seen them likewise in unmarried women, whose purity
 could not be suspected.  As  regards the treatment of this
 disease,  the following remedies  may be  used to combat it:
       1. Calcarea, Sulphur, Silicea, Mercurius.
       2. Aconite, Arsenicum, China, Ferrum,  Graphites.
       3. Belladonna,   Hyoscyamus,  Kali, Lycopodium,
         Sabina, Sepia.
  Dose—The same as  at the end of the preceding para-
 graph.

                      Section 77.

  Sanguineous and lymphatic concretions.—Beside the
moles of which we have treated, there are  other bodies  of a
widely different nature, but which are often confounded  with
moles.  These are the sanguineous and lymphatic concretions
formed in the womb. The sanguineous concretions are a species
of coagula,  which might be compared to the polypous concre-
% 
FOREIGN BODIES IN THE  WOMB.         223
tions  in  the  heart  and larger vessels, although the coagula
in the womb are generally more consistent and show some
signs  of  organization;  often  they  are  surrounded by a
fibrinous  layer  of a  greyish-white  color  which  envelops
them  like a membrane  and increases this organized appear-
ance ; but in dissecting them carefully, this appearance dis-
appears, and no cavity with smooth walls is  found in their
interior,  as is the case with  fleshy moles.  These concretions
may  acquire a considerable volume,  and may exist  in  the
womb together with a  large  mass of liquid  or coagulated
blood.  The  formation  of these coagula  takes place most
frequently in women who menstruate profusely and are subject
to uterine haemorrhages; they are  likewise met with pretty
frequently in women who were recently confined and whose
lochia do not flow regularly ; even  young  unmarried females
are attacked by such disorders.   AVhen such concretions take
place, the menses cease; afterwards, after a lapse of from one
to two or three months, an haemorrhage  takes place which
increases little by little, with labor-pains; the foreign body is
expelled and the haemorrhage diminishes gradually,  under-
going the same changes  as  the lochial discharge.   In other
cases  the expulsion  does not take place so promptly, and  the
haemorrhage  may last longer and be followed by all the con-
sequences of a serious flooding.  The  foreign  body  may also
become decomposed, giving rise to a sanious and putrid dis-
charge, the absorption of which into the organism sometimes
increases the gravity of the case.  Lymphatic concretions
are membraneous bodies  of integumentous consistence and a
dirty-white color, resembling the membranes in croup.  They
are formed in the uterine cavity and are afterwards expelled,
either shaped as a sac, or as a bursa,  the external surface of
which is studded with filaments,  and  the internal  surface is
smooth and moistened with a serous liquid; they form patches
of various shapes, some  of  them  having  even been shaped
exactly like the neck of the womb.   Sometimes  these patches
are expelled  together with  menstrual blood.   These  forma-
tions  seem to arise from a certain degree of inflammation or 
224
diseases of  females.
exuding  irritation  of the  uterine mucous membrane ;  they
affect more particularly women whose menses flow scantily
and induce pain.  In most cases these formations are acci-
dental, and never  occur again; sometimes  they are  repro-
duced at  longer or  shorter  intervals.   Their presence in, and
expulsion from the  womb, are generally accompained by the
same symptoms as sanguineous concretions.  The best reme-
dies for these two kinds of concretions are:
       1. Nitri acid., Phosphori acid., Strontiana.
       2. Bryonia, Carbo animalis, Kreosotum, Nux vomica,
         Secale, Sepia.
    For lymphatic concretions :—1. Suphuris acid.
       2. Ammonium, Borax,  Bromine,   lodium,   Nux
         vomica, Spongia,  Sulphur.
       3. Alumina, China, Hepar, Nitric acid.
       4. Arsenica, Euphorbium, Kreosotum, Lachesis  Tart.
  For further details concerning the use of the remedies, see
Dysmenorrhoea,  Amenorrhoea,  Metrorrhagia, Confinement,
Pregnancy, etc.
  Dose.—The same as at the close of the last paragraph.

                      Section 78.

  Uterine polypus.—Such  polypi  are   fleshy,  spongy,
fibrous and other excrescences developing themselves in the
sub-mucous cellular tissue of the womb.  We distingush five
varieties, namely:
  1st. Vesicular polypi—Composed of a soft, homogeneous
tissue, and containing a liquid which is discharged when the
polypus is torn.
  2d. Sarcomatous  or Fleshy Polypi.—Almost the same
as fibrous bodies in the womb, except that the polypi grow
out on the side of the  uterine  mucous membrane, whereas the
fibrous bodies  grow  out of the peritoneal surface.
  3d. Cartilaginous,  osseous and stony polypi,—Which
are simply successive  transformations of the former.
  4th.  Spongy,  fungous  polypi.—Soft, red, looking like 
FOREIGN BODIES IN THE  WOMB.          225
tomatoes, frequently of  a  livid color, bleeding a good deal,
sometimes  like  haemorrhage,  with tendency  to change to
cancer or to reappear.
  5th. Granular polypi.—Not very large, developed along
the surface in the shape of whitish, grayish, or  rose-colored
granules with very thin  pedicles, resembling cauliflowers or
syphilitic vegetations for which some  authors  really take
them.
  All these polypi, some of which appear even in a mixed form,
may occupy the most diversified portions of  the womb, and
differ vastly as regards insertion, shape, volume and duration.
By growing  thinner and  longer either  in the body or stem,
or by inverting  the fundus of the womb, the uterine  polypi
may even descend into the neck of the womb,  and pass even
into the vagina.  All these polypi may grow without causing
any sense of embarrassment in  the sexual organs;  whereas,
at other  times, their appearance may be preceded for  a long
period by a  whitish, yellowish  or greenish, purulent or puri-
form leucorrhoea, or by haemorrhages or reddish discharges.
In  this case, such symptoms  are accompanied by a sense of
embarrassment, weight  and  pain in the hypogastrium, when
walking; hysteric symptoms, such as heat in the face,  sensa-
tion of a ball ascending to the throat,  chest or abdomen, etc.
All these symptoms  may  be caused by the smallest  polypus,
the presence of which may render walking or riding  in a car-
riage exceedingly painful, or  even impossible,  cause great
sensitiveness during sexual intercourse, disturb sleep,  diges-
tion and the other principal functions.  If remaining  enclosed
within the uterine cavity,  the  uterus may become dilated to
such an extent that it may simulate pregnancy; it presses upon
the rectum and bladder,  causing frequent urgings to  evacuate
these parts,  colic pains  in the small of the back, pullings in
the groin, swelling of the feet,  legs, thighs, and varices  on the
legs.   At last all these symptoms grow worse, the  limbs
become dropsical, ascites  sets in,  and a hectic  fever  termi-
dates the sufferings of the patient by death.   In some cases
all  these symptoms remain  stationary;  but sooner  or later,
                           15 
226
DISEASES OF  FEMALES.
 in consequence of some favorable cause, the  polypus escapes
 from the womb, and protrudes at the vulva where it becomes
 irritated, inflamed, and then ulcerates in consequence of the
 friction of the clothes  and the  contact of  the  urine, until
 finally hectic fever sets is, and the patient dies likewise.   At
 other times  the polypi become transformed  into encephaloid
 cancers, before issuing from the womb, they suppurate and
 ulcerate, with  ichorous,  bloody  and very fetid discharges,
 which generally cause a number of very serious accidents.  In
 other cases the polypi become gangrenous, with all the symp-
 toms which characterise this affection.  As regards the diag-
 nosis of polypi, it  is exceedingly obscure as  long  as these
 excrescences  remain enclosed in the uterus,  and the neck
 remains closed; but what may distinguish them from preg-
 nancy with which they might be confounded, is  the absence of
 the characteristic signs of  pregnancy,  and  the slower deve-
 lopment of the  uterine symptoms.  Prolapsus or inversion of
 the womb cannot  be mistaken for polypus,  if the parts are
 carefully examined,  more particularly if the womb should be
 found to have remained in its place.   The prognosis depends
 upon the age,  shape, seat  and nature of these excrescences.
 At  first they are not very serious, unless debilitating hoemor-
rhages should set in.  Polypi enclosed  in the uterine cavity,
 are more serious  than those that have protruded; but the
 most to be dreaded are such as have  degenerated into cancer-
 ous or gangrenous tumors.  As regards treatment, neither
ligature nor  excision need  ever be resorted  to under proper
 homoeopathic treatment; well chosen homoeopathic remedies
 always secure the  expulsion of polypi without instruments
 being resorted to.   We would recommend the use of a single
 dose, which should be allowed to act for three or four weeks.
 No  polypus comes off before the end of  the seventh or  eighth
 week, and, if we give the remedy every day  or several times
 a week, the organism becomes used to the drug long  before
 the polypus has been  touched by the medical  action to the
 foundation ;  or  else, so many accessory  symptoms set in that
we are obliged to abandon the use of the remedy before it 
FOREIGN BODIES  IN THE WOMB.         227
has had time to act.   We have cured several polypi with two
globules  of Calcerea  30,  which we allowed to act  for ten
weeks  without repeating  it.  The best remedies to bring
about the expulsion of polypi, are :
       1. Cakarea.
       2. Conium, Phosphorus,  Staphysagria.
       3. Aurum, Hepar, Lycopodium, Mercurius, Mezereum,
         Sepia, Silicea,  Thuja.
       4. Belladonna, Graphites, Natrum muriat, Nitri aci-
         dum, Phosphori acid.,  Sulphuris acid.
And in particular for fleshy polypi:—1.  Calcarea.
       2. Staphysagria, Thuja.
       3. Lycopodium, Mercurius,  Nitri acid., Phosphorus.
For fungous polypi:—1.  Cakarea.
       2. Lycopodium.  Mercurius,  Nitri acidum,  Staphysa-
         gria, Thuja.
       4. Phosphorus, Sepia, Silicea, Sulphur.
For  granular  polypi: — 1. Nitri acidum, Staphysagria-
          Thuja.
       2. Calcarea, Lycopodium.
For frequent Haemorrhages :—1. Calcarea.
       2. Belladonna, Lycopodium, Mercurius,  Nitri acid.,
         Phosphorus,  Pulsatilla, Sepia, Sulphur.
       3. Silicea, Sulphuris acid.

                       Section 79.

  Calculi, or Fibrous Bodies of the Womb__These bodies
are in structure analogous to the fibrous tissue ; they are more
or less globular, and  are seated  in the tissue of the uterus.
These tumors may either grow out from the external surface
of the womb on the side of the peritoneum, or from the inter-
nal mucous membrane.  In this latter case, these tumors form
the fibrous polypi, of which  we  made mention in the former
paragraph.  As a general rule,  they may be seated either in
the fibrous tissue  of the uterus, or between this tissue and the
peritoneal covering, or  between  this tissue  and the mucous 
228
diseases of fbmales.
membrane.  The volume of these bodies differs considerably.
Some are no bigger than  a little pea; others  are of the size
of a hazelnut, a  chestnut, or  a hen's egg;  others again  are
bigger than  a fist;  some  even have been known  to weigh
thirty pounds.  When they are very numerous, they disfigure
the body of the uterus completely, and if they attain  to  the
size of a man's head, they dilate the uterine cavity  in every
direction.   The structure of these  tumors is likewise exceed-
ingly varied:  some are like fleshy bodies, others fibrocarti-
laginous, others  osseous.    It  may be that  these differences
simply denote the various periods, of development which these
tumors  have to  pass through before  they reach  their  full
growth.  When fleshy, these  tumors are so  much paler  the
denser they are, and when they are soft, like muscular sub-
stance, they are  red ;  when cut into, it is seen that they are
formed  of bundles of muscular fibres,  which are interlaced
here and there in  an  inextricable manner.   Sometimes por-
tions of the same fibrous body are still red  and pretty soft,
while other portions have already become whitish, gray,  and
much harder.  These denser portions are the first to assume
a fibro-cartilaginous consistence, and, if  ossification sets in,
it is here that the process of ossification first  commences in a
number of points, whence  it spreads until the whole tumor
has  become ossified, after  which  it is  hard  and heavy.   It
frequently occurs that fibrous bodies, in  the various stages, are
found  in  the same uterus, or  bodies, portions of which  are
still fleshy while other portions are  already ossified.   They
do  not seem  to grow before  the age of thirty years,  and
unmarried women  seem more subject  to them than married
females.  Moreover, the  more children a woman  has had, the
less is  she  liable to such tumors.   As a general  rule, they
are found quite frequently; on five women who are examined
after death, one  generally is found to have  had one or more
of such tumors in the womb.   When these  tumors are seated
in  the uterine  tissue, and project  towards the abdominal
cavity, they are  sometimes seen near the os tincae, occupying
the  body of the  uterus or the  thickness of  the neck.  In the 
foreign bodies in the  womb.         229
former case they are easily recognized by the touch; but this
is not so easy when they are seated within the tissue  of the
uterus.  Bodies which are seated near the peritoneal surface
remain sometimes unknown for a long time, especially if they
are small and pedunculated; but after they have acquired a
considerable volume, they may  be known  by an  external
examination of the hypogastrium.   As regards tumors with
pedicles and projecting  on the side of the uterine cavity, we
refer the reader to what has been  said in  the preceding para-
graph about fleshy polypi, which are nothing else than fibrous
bodies with pedicles.  The prognosis is not very serious in
itself, but in some cases these  tumors may act like foreign
bodies, and induce all  sorts of serious ailments, and even
death.  They  may interfere with  the menses, cause leucor-
rhoea, haemorrhages, obstruct the  development  of the  fetus,
compress the rectum and bladder.   For the treatment, see
the remedies for  fibrous polypi  mentioned in the preceding
paragraph. 
230
DISEASES  OF FEMALES.
ARTICLE VII.
       SCHIRRUS AND CANCER OF  THE WOMB.*

                       Section 80.

  Definition and varieties of Cancer—Most authors now
understand by cancer of the uterus, every affection which, at
the same time as it changes the tissue of the uterus, naturally
tends to spread all around, and to destroy itself by ulceration
in the centre.  Latterly, these  ulcerations have been a good
deal divided and subdivided,  though some of them seem only
different conditions of  one and the same changes.   Be this as
it may, here  are  the different varieties admitted by modern
authors.
   1.  Schirrous or tuberous  cancer,  consisting in a general
or  partial  indurated swelling  of  the uterus, with change of
tissue that  is not susceptible  of reduction, and must necessa-
rily extend and ulcerate, unless we succeed in removing the
affection of the tissues.  To  this variety belongs the creeping
cancer of Dupareque,  which  sometimes commences in the va-
gina, with  elongated, uneven, indurated and irregular  eleva-
tions, not very extensive at first, and gradually spreading
from a limited point over  the whole vagina, with tendency to
invade the  neck of  the uterus, and to change to a cancerous
ulcer.
   2.  Fungous cancer, fungus  hematodes,  or  hypersar-
COSIC cancer, being a swelling  that spreads like a mushroom
  * For a complete study of this subject, we refer the reader to " Trails
Pratique des Maladies Canccreuaes et  des affections curables confonderes avee le
cancer,'1'' by Dr. H. Zebert, Paris, 1851 ; and to a discussion in the Academy
of Medicine (Bulletin of the Academy, Paris, 18&4, Vol. xx.) 
SCHIRRUS AND CANCER OF THE WOMB.      231
over the surface of the neck, of lobular or granular appear-
ance, in some cases soft, and in others hard and firm ; of a
brownish or violet color ; secreting a reddish, serous, puriform
or ropy fluid ; discharging a black blood, in some cases con-
tinually ;  termination in sphacelus or cancerous ulceration.
   3d. Bloody cancer, or cancerous engorgement of the womb,
characterised by violet-colored, but uniform swelling of a por-
tion  of the  uterus,  and especially of the neck, where this
 variety is  often  seated  without  spreading   any  further;
remarkable softness  of the tissue, increasing in proportion as
the tumor  is  nearer the uterine orifice; marked crepitating
noise when compressing the tumor ;  incessant discharge of a
black and  granulated blood, mixed with more or less exten-
sive  coagula; oozing  out  of  a milky, whitish fluid, which
becomes afterwards  mixed with a cerebriform matter, and
with  fetid substances; marked tendency to spread towards
 the body of the uterus.
   4th. Cerebriform  or  encephaloid cancer, medullary
 cancer, characterised  by the presence of this substance with
 which  the tumor  is  either  infiltrated, or  which  is found
 agglomerated in the cancerous engorgements; fetid, puriform
 or purulent discharge;  discharge of  putrid  flocks; uneven
 surface of the ulcer; the degeneration of the tissue is some-
 times limited  to the environs of  the ulcer,  sometimes  it
 spreads over  the whole womb; a white liquid of the consist-
 ence of cream may be squeezed out of the  tumor.
   5th. Ulcerated, open or confirmed cancer, or the cancer
 of the ancients properly speaking, being schirrous, fungous, san-
guineous or medullary engorgements transformed into a corrod-
 ing or spreading ulcer.  This cancer may likewise be a primary
 ulcer.  In such a case it generally commences at the neck of
 the uterus, in the shape of a superficial ulcer,  (the superficial
 cancer of  some authors)  upon a  basis  of inconsiderable
 elevation,  but very  hard, with an irregularly circumscribed,
 unevenly   granulated surface,  the whole  having a grayish
 color.  In the  cases where the  cancerous ulceration forms
 only the last stage of preceding changes,  the ulcer destroys 
232
DISEASES OF FEMALES.
successively the engorged  parts; but  where the  cancerous
affection commences with ulceration,  the sore parts become
indurated,  the  ulceration  spreading  more  and more, and
changing to an open ulcer, in proportion as the hardness keeps
spreading.
  As regards the lardaceous cancer of some authors, it only
seems to form a variety of the schirrous cancer which becomes
soft and ulcerated.
  Cancers  composed of a mixture of  various tissues, do not
constitute a separate variety: there may be ever so many
modifications of this kind arising from  peculiar combinations
of the above-mentioned forms.

                      Section 81.

  Symptoms and diagnosis  of cancer.—The first invasion
of the disease  is often  over-looked by the physician  and the
patient who scarcely thinks of the ailments she had experi-
enced  for  a long time  already.   An examination   of the
parts would show considerable  disease even at  this  period.
The first symptoms generally are : menstrual irregularities,
a temporary increase of the menstrual flow, leuchorrhoea,
which is either continual  or lasts only for a short time, white
or yellowish, sometimes changing to a reddish color after inter-
course or after any other local irritation ; sense of  weight  at
the hypogastrium, with pressure on the rectum, or the  urinary
organs; stool and emission  of urine sometimes more  painful,
and always more or less  difficult;  disagreeble sensation dur-
ing intercourse; occasional transitory shooting stitches, espe-
cially at the period of the menses, or after physical or moral
excitement; transitory pullings in the loins  or groin ; hyste-
rical ailments; haemorrhoidal distress; alternate distension
and caving in of the abdomen, etc.  Sometimes  we discover
even at this period,  slight swellings or indurations of the
womb, occupying rather the neck  than the body of the womb,
with a sort of  irregularity in  the  shape of the neck.   These
symptoms may remain unchanged  for a long time;  but  as
soon as cancer has openly set in, the neck and even the body 
SCHIRRUS AND CANCER  OF THE WOMB.      233
of the uterus,  and likewise the lips of the os tincae  are
swollen,  hard,  knotty, lobed, and more or less red,  but
smooth  and not sore,  covered with a bloody mucus or with
pure blood, painful to  pressure, and sometimes accompanied
with engorgement  of  the  ovaries.   In some cases  there is
only a  single  clearly  circumscribed  tumor,  the seat  and
extent of which may be discovered by an examination through
the rectum ; in most cases  there are several  tumors, or even
if the  entire uterus should be invaded, a group  of several
rounded  inequalities at the surface.  These  tumors  might
sometimes be  confounded  with fibrous bodies,  if the other
signs that accompany the cancer, did not render such  a mis-
take impossible.  As soon  as  the cancer has  broken out, the
pains, which until  recently had been transitory,  become per-
manent, with acute lancinating pains  like needles or knives
thrust through  the part; the loss of blood becomes more fre-
quent and sometimes  habitual, and a fetid serous or bloody
leucorrhoea sets in, which  becomes  fouler the more the ulce-
ration  progresses,  being   sometimes mixed  up  with  small
flocks of putrid matter, of a brownish color, and frequently
having  an  excessively pungent odor,  or also with  little
coagula of blackish blood.   If the  menses have  continued so
far,  they often increase to  a flooding;  in women, where they
have stopped,  they act as if  they would reappear;  others
discharge constantly a profuse watery liquid without smell, or
having  an insipid, sickening odor;  stiffening the linen some-
what, and leaving grayish stains after  dying;  at the men-
strual period this liquid becomes rose-colored.  This  serous
discharge generally indicates  that  the ulceration  has  either
commenced or is imminent.  Pain now succeeds  pain ;  loins,
small of the back,  hypogastrium,  iliac  region, even the nates
down to the thighs become the scat of contusive tearing, or
distensive pains,  sometimes mingled with smarting  pains or
acute stitches in the neck of the uterus, and  sometimes  pre-
venting sleep to such a degree that  the  patients dare not
give themselves up to it.   In spite of  these sufferings, the
cerebral functions remain  frequently  intact even until the 
234
DISEASES OF FEMALES.
moment of death.   AAThat is most remarkable is, that  these
cancers do not always prevent conception; women affected
with enormous cancers, have been known to go their full term
and to give birth  to children who, however, did not survive;
in most cases the  children were putrified.  As regards  con-
stitutional symptoms, uterine  cancer  seems to  influence  the
general well-being  less  than  other cancers; as long as it
remains at the first stage, and  is confined to a single point in
the uterus, the  constitution does not suffer,  and the appetite
remains unimpaired.  Cases  have  been  known where  the
patients retained a certain freshness and rotundity even after
the cancer had progressed quite considerably.  Other women,
on the contrary, experience an intolerable malaise from  the
commencement of the  disease.  The  appetite  is gone, they
become melancholy, are attacked  with pains in various parts
of the  body, sudden  and  transitory swellings, and  they
become so restless that they cannot remain an  instant in the
same position.  Fever generally  does not set in until  the
cancer has arrived at its last stage; it is a hectic fever with
several exacerbations every day.    When  the third stage is
reached, a general constitutional  derangement  sets in.  The
process of nutrition becomes slower; the skin assumes a pale,
yellowish, earthy color,  sometimes  with  bluish streaks  over
the face;  a general emaciation sets in, a flabbiness and thin-
ness of all the tissues;  the flesh becomes soft, the  muscles
lose  their tone ; the appetite is entirely gone ; the bowels are
completely bound,  the stools are brown and hard; the  horri-
ble pains which the patients experience, and the loss of sleep,
exhaust the remainder of their strength,  and they gradually
go into decline and perish.

                       Section 82.

  Causes, course and terminations.—The etiology of can-
cer of the womb  is not  near  so well known  as  is generally
supposed.   It is true, as has been asserted by some authors
that physical as well as  vital  derangements of  the uterus
may be more or less instrumental  in ushering in this disease • 
          SCHIRRUS AND CANCER  OF THE WOMB.      235

but how often do not  such  causes  exist without resulting in
cancer, and, on  the  other hand, how often do not cancerous
affections  develop themselves without any appreciable cause ?
AVhere a  cancerous germ exists, physical or moral commo-
tions of the system may contribute  to develop it;  but a germ
must pre exist in order that a cancerous disease may become
developed, and such a germ cannot be created by any  of  the
above-mentioned causes.  In our judgment, the true cause of
cancer, is a cancerous diathesis which, if once existing, may
afterwards be developed  by all  sorts of  moral or  physical
influences that have a tendency to irritate the uterus.   Cancer
may happen at any period of life, from the age of twenty to
the  most  advanced old age.  It occurs most  frequently be-
tween  the ages of forty and  fifty, less  frequently between
thirty  and forty, and  least frequently before twenty-five and
after seventy.  The critical age is generally the period when
cancer develops itself  more  openly  and rapidly;  but the first
origin  of this affection generally dates  much  farther  back.
According to  some  authors  celibacy,  or sexual excesses,
onanism,  frequent miscarriages,  or uterine  haemorrhages,
repeated  menstrual  irregularities, or even syphilis, are some
of the exciting  causes of cancer.  It is very probable, that
frequent or chronic uterine  inflammations  or discharges may
develop a cancerous  germ,  in which case everything that
tends to foster or create  such diseases, may be looked upon
as capable of producing cancer.  This disease runs a very
uncertain  course, and its  duration  is inversely proportionate
to its intensity.   Generally it  lasts  from twelve to  eighteen
months.   It  may terminate fatally  in  five or six  months,
or after five or six years.   Some patients, especially such as
have suffered agonizing distress, die without having lost any
of their stoutness; others die of peritonitis, a violent haemor-
rhage; chronic fever, or in consequence of convulsions caused
by the  intense pain.  If the disease continues uninterruptedly,
the symptoms get worse and worse; the appetite is lost; fre-
quent vomitings of bile and  mucus set in ;  the patient is trou-
bled with  rumbling in the bowels, eructations, violent flatulent 
236
DISEASES OF FEMALES.
colic, obstinate constipation or excessive diarrhoea; afterwards
aphthae break out in  the mouth ;  the  patients become ema-
ciated even so as to resemble skeletons ; in other patients, the
lower limbs become infiltrated; sometimes the  whole  body
looks somewhat bloated, the  strength  gets lost, the patients
are scarcely able to remain up for  a few hours, and the ulce-
rative process gets worse and worse until  death  takes place.
After death,  the organs adjoining'the uterus, are generally
found  intact,  especially if  only a part  of  the organ has
been affected ; but if the uterus had grown much larger, the
fatty tissue near  the neck sometimes becomes more volumi-
nous, denser, and covered with little ulcers and foul and fun-
gous vegetations.   Sometimes the disease  extends to the rec-
tum and bladder, portions of which  become  schirrous, and
are even destroyed by cancerous ulceration.  The vagina may
also become involved in the general affection, and even the peri-
toneum may become the seat of a chronic inflammation with effu-
sion of an ichorous pus.   As regards the more distant organs,
scarcely any other derangements are discovered in them than
are found in persons who have died  with any other deep-seated
diseases of the viscera accompanied by general marasmus.

                       Section 83.

  Diagnosis and prognosis.—Although from our descrip-
tion of the disease,  it might seem  easy to infer its  existence
whereas the disease is really present,  yet there is probably
no disease that has been as frequently misapprehended where
it was really present, or as frequently supposed to be present
where it really did not  exist.   A chronic but uncomplicated
inflammation  of the uterus may be mistaken for cancer;  so
may certain  forms  of  leucorrhoea,  various  other uterine
degenerations, simple ulcerations and other affections, unless
we  take great  care  to direct  our attention to the totality of
the morbid phenomena.
  In chronic  metritis we likewise find the  volume of  the
uterus enlarged, or  at any rate of some  of  its parts, some-
times with intolerable pains, heaviness at the bottom of the 
SCHIRRUS AND CANCER  OF THE WOMB.      237
vagina, pains in the small of the back, and painful pullings in
the loins and hypogastrium; but these pains generally mani-
fest themselves only when pressure  is made upon the uterus,
the inflamed  and swollen  portion of which remains soft, the
neck remaining either smooth  and even,  or at most exhibit-
ing only some small indurations about two lines deep.  Sim-
ple ulcerations  are distinguished from cancer by the manner
in which they commence, by the matter which they secrete,
by the  absence of all schirrous characteristics  in the parts
where the  ulcers are seated, and by the course which they
pursue in  their development.   Fibrous bodies are  sometimes
more difficult  to  distinguish;   but whatever  may  be  the
character of the swelling  to which these  tumors  give rise,
and however hard these tumors  may  be, they  always re-
main indolent, and frequently  project from the neck of the
uterus, or from the uterine orifice, where they can  be readily
found out by the touch.  As regards polypi, it  is more
difficult  to  diagnose  them  correctly,  especially when  they
originate in  a pure degeneration  of the uterine  substance,
or when they  are contained  in  the  uterine cavity, where
they often  determine haemorrhages,  discharges of  various
kinds, and sometimes even ulcerations  of the os tincae, which
may  simulate  a cancerous  ulcer.  However,  the  smoother,
softer condition of the os  tincae,  the  more or less  marked
opening of the uterine orifice, and  the absence of  all indura-
tion, may lead us to  establish our  diagnosis  even  before the
polypus  bad  passed out of  the neck of the womb, or before
the orifice  of the neck should have become sufficiently dilated
to enable  us to recognise  the polypus by the touch.  As
regards the discharges, we have to pay particular attention to
them, in order not  to fall  under the most serious mistakes.
A most profuse and malignant  leucorrhoea may  exist without
there being  any trace of  cancer,  and there  may  even be
prickings in  the womb and  vagina, profuse menstruation, an
uneven surface in the orifice of the womb, and other symp-
toms resembling those of  cancer.   In such cases the  true
condition of the parts is frequently not recognized,  except 
238
DISEASES OF FEMALES.
after long and  patient observations; however, the fetid and
ichorous discharges of cancer do not generally set in until the
disease has advanced so far, that it is no longer possible to mis-
take it for something else, after an examination by the touch ;
so that, in spite of the apparently malignant nature  of the dis-
charge, we may always be sure not to have a cancer before
us as  lon<* as none of the  disorders characteristic  of cancer,
are recognized by the touch.
  The prognosis  of cancer  is  always highly dubious  under
any treatment; the more  inveterate and extensive the can-
cerous ulceration, the less hope  there is of a cure.   Schirrous
cancers  seem to be the most difficult  to cure, no matter at
what stage of their growth, whereas fungous and  medullary
cancers seem often more  than any other variety, disposed to
yield  to  a rational treatment.  It seems  as  though all the
cases  of cancers that have been set down as cured, could not
possibly imply  an  error of diagnosis.   It  seems to us that  a
cure may  be possible,  although it  must always be extremely
difficult.

                       Section 84.

  Treatment.—Homoeopathy  repudiates  all cauterizations
and  external   applications to cancerous sores,  because all
these  ordinary means to  which surgeons  have been in  the
habit  of resorting,  are more injurious than useful.  On the
other hand, we have no  positive  remedies for this disease,
especially when it has reached the last stage;  nevertheless
partial relief has been obtained in slightly, and even some-
times in desperate cases, by the use of  some well  chosen
remedy.   The  best remedies which analogy and  experience
seem  to point to as most adapted to uterine cancer, are:
       1.  Graphites, Kreosotum, Sepia.
       2.  Arsenicum, Silicea,  Sulphur, Mercurius.
       3.  Aurum,  Belladonna, Carbo animalis, China, La-
          chesis, Lycopodium, Mercurius.
       4.  Cicuta,  Cocculus,  Conium,  Dulcamara, lodium,
          Magnesia, Mercurius, Nitri acid.,  Staphysagria,
          Thuja. 
         SCHIRRUS AND CANCER OF THE WOMB.      239

       5. Calcarea, Carbo veget., Phosphorus, Rhus, Sabina.
  And particularly:—
For  Schirrous  cancer,  before ulceration:—1. Carbo  ani-
         malis, Sepia.
       2. Aurum, Belladonna, China, Staphysagria.
       3.  Calcarea, Carbo veget., Clematis, Cocculus, Conium,
         Lycopodium, Phosphorus, Rhus.
For fungous cancer:—1. Graphites.
       2. Arsenicum, Carbo  animalis, Kreosotum, Lycopo-
         dium,  Sepia,   Staphysagria, Thuja, Belladonna,
         Carbo veget., Lachesis, Mercurius, Nitri acidum,
         Phosphorus, Sabina, Silicea, Sulphur.
       3.  Aurum, Calcarea, Cocculus,  Conium.
For bloody cancer :—1.  Belladonna, Carbo animalii, China,
         Graphites, Kreosotum, Sepia.
       2. Aurum, Carbo veget, Lachesis, Mercurius, Silicea,
         Sulphur.
       3. Arsenicum, Cicuta, Cocculus, Conium, Phosphorus,
         Sabina.
       4.  Calcarea, Dulcamara, lodium, Lycopodium, Mag-
         nesia muriat, Nitri acid., Staphysagria, Thuja,
For  medullary cancer:—1. Belladonna,  Phosphorus, Sili-
         cea, Sulphur.
       2.  Arsenicum,  Carbo  animalis,  China,  Graphites,
         Kreosotum, Mercurius, Sepia.
       3.  Aurum, Cicuta,  Clematis, Cocculus,  Conium, Dul-
         camara, lodium,  Magnesia muriat, Nitri acidum,
         Staphysagria,  Thuja.
       4.  Calcarea, Carbo veget, Rhus, Sabina.
For  ulcerative cancer:—Graphites, Kreosotum.
       2.  Arsenicum, Belladonna,  Carbo animalis,  China,
         Lycopodium, Mercurius, Sepia, Silicea.
       3.  Aurum. Calcarea,  Carbo veget, Lachesis,  Phos-
         phorus, Sabina, Staphysagria, Thuja.
       4.  Cicuta, Cocculus, Conium,  Dulcamara, lodium,
         Magnesia muriat, Nitri acidum, Rhus tox. 
240              diseases  of females.
  With the following particular indications :
  Arsenicum.—For open cancer, with burning  and agoni-
zing pains, secretion of fetid, brownish or blackish ichor.
  Aurum.—At the onset, when the indurations  are still of
a schirrous nature, with falling of the womb and pressure on
the fundus of the bladder.
  Belladonna.—For frequent haemorrhages from the womb,
painful pressure on the parts, violent pains in the small of
the back and nervous  excitement.
  Carbo  animalis.—For  schirrous cancer,  with pressive
pains in  the  loins, groins and thighs, with distention of the
abdomen, flatulence, frequent eructations and desire to vomit.
   China.—Sometimes at the commencement of the affection,
when the indurations first commence, with  ichorous leucor-
rhoea, dysmenorrhoea, etc.
   Clematis.—Sometimes for softened schirrus, with corrosive
leucorrhoea and lancinating pains.
   Conium.—For intolerable lancinating pains, with frequent
nausea, vomiting, odd fancies for various things  to eat, and
other symptoms similar to such as occur during pregnancy.
   Graphites.—A powerful remedy in open cancer, especially
for warmth and painfulness of the vagina, engorgement of
lymphatic vessels and mucous follicles, hardness of the neck of
the womb, which is swollen covered with fungous excrescences;
heaviness of the abdomen, with exacerbation of the pains and
fainting when standing; retarded  and  painful menses, with
 discharge  of black,  coagulated and fetid  blood;  stitches
 through the thighs and  hypogastrium  like electric shocks ;
 burning pains, constipation, earthy complexion, sadness and
 restlessness.
   Kreosotum.—For swelling of the labia, with  itching in
 the vagina;  stitches  through the thighs, like electric jerks;
 dark, coagulated menstrual discharges, followed  by an icho-
 rous and corrosive discharge; painful pressure on the parts.
    Lachesis.—Sometimes  after Kreosotum, at the critical
 age, for frequent  haemorrhages;   stitches  as with knives,
 sickly and distressed looks. 
          SCHIRRUS AND CANCER  OF THE WOMB.      241

  Lycopodium. — For  open  cancer with  tearing  stitches,
burning pains in the vagina after intercourse ; warmth and
dryness of the vagina, bloody leucorrhoea.
  Mercurius bromatus.—For itching,  erythematous  red-
ness and swelling of the labia, with  inflammatory egorgement
of the vagina; serous, purulent and greenish leucorrhoea.
   Sepia.—For  soft  schirrus, with painful pressure  down-
wards, burning  heat in the parts, eructions on the inside of
the labia, soreness and redness of the vulva; lancinating jerks
from the fundus of the vagina to the umbilicus ;  frequent
bloody discharges between the periods, especially after inter-
course ; putrid leucorrhoea.
   Silicea.—For open  cancer, with bloody discharges from
the  vagina,  especially after the menses, or fetid, brownish
purulent, ichorous leucorrhoea.
   Sulphur.—In most cases at  the onset, especially in open
cancer,  with violent, burning pain  in  the vagina; painful
soreness during  intercourse;  constant bloody discharges or
else foul, corrosive, ichorous leucorrhoea.
   For further details see Dysmenorrhoea, Metrorrhagia, Leu-
corrhoea, Metritis, Endometritis, etc.
   Dose.—One  or  two drops of the liquid attenuation on
sugar or in a little water, or six globules dry on the tongue,
morning and evening.
16 
242
DISEASES OF FEMALES.
ARTICLE VIII.
           simple ulcerations of the womb.

                       Section 85.

  Symptoms.—Superficial  erosions. — Simple  and non-
cancerous ulcerations of the uterus scarcely affect any other
part than the neck, so that it would seem as though we ought
not to have mentioned them  until we treat of the diseases of
the neck of the womb.   But inasmuch  as these  ulcerations
have often been confounded with cancer, we  have deemed it
advisable to give them a place immediately after the chapter
on cancerous ulcerations.  Simple  ulcerations are  of various
kinds ; some are quite superficial, consisting of single erosions ;
others,  being more  penetrating,  form  true  ulcers  without
however becoming malignant.   Moreover,  several  authors
distinguished herpetic,  scrofulous  and scorbutic ulcerations,
not  to mention  syphilitic ulcers, which may likewise invade
the neck of the uterus.   In this paragraph we will first treat
of simple erosions, in the  following paragraphs we will treat
of other ulcerations, mentioning their symptoms, causes  and
diagnosis ; in the last paragraph of this article will be found
a  description of the treatment.   Superficial erosions  are
commonly seated at the lower extremity of  the neck, at  the
os  tincae, most frequently on the posterior  lip.   The most
simple of these ulcerations constitute red patches which  are
sometimes so superficial that they  cannot even  be  recognised
by the touch, unless the area or edges of the ulcer should be
slightly  raised and the existence of the erosion should be re-
vealed  by this  tumefaction  of the  affected  part.  In most
cases the neck is swollen,  and a tenacious, transparent or 
           SIMPLE ULCERATIONS OF  THE WOMB.       243

whitish mucus is discharged from the orifice; sometimes the
mucus is like pus or resembles an old catarrhal discharge from
the nose and generally hides the os  tincae over which  it is
spread.    Sometimes  these  erosions  exist for  a long  time
without the patient being aware of it; some only complain of
a little  embarrassment  and  pain in the  pelvis, accompanied
by a very slight leucorrhceal discbarge assuming  a slightly
reddish  or bloody color after intercourse which is scarcely ever
painful.   Other patients experience a sense of burning heat,
a painful itching  at  the bottom of the vagina, pretty acute
pains in the small of the  back, and sometimes intolerable
pains during intercourse ; and a profuse discharge of white
mucus takes place from the vagina  being mixed with a  good
deal of  blood after coit.  The causes of these erosions are
very  often  sexual  excesses, be  it  in  consequeuce of  the
excitement which  they cause in the organ, or of the friction
which the sexual  act may  cause in  the  os  tincae.    Other
causes are: frequent  and deep seated digestive derangements,
or a general sinking of health.  In other women such erosions
seem to be caused by the pressure or  friction which the neck
of the  uterus  exercises against the  walls of the  vagina, in
cases of deviation of  the uterus from  the normal line;  some-
times they owe their existence to  an acrid and  corrosive
leucorrhoea, to a gonorrhceal discharge, to  acute or chronic
inflammatory catarrh of the uterus or  vagina.  As regards
the course of  such erosions, they have often been known to
induce fungous or varicose  tumors, especially in cases  where
these erosions  showed a tendency to  bleed profusely;  a cir-
cumstance which, in  some cases, may render the  prognosis
much more dubious than it  may seem.  In other cases, such
erosions have  been succeeded or accompanied by ovarian
engorgements.   The  treatment will be given in  the  last
paragraph of this article.

                       Section. 86

   Deep-seated   ulceration^.— These ulcerations  which
sometimes penetrate  the  substance of the  uterine  neck to 
244
DISEASES OF FEMALES.
considerable depth, are almost always seated on the inside of
the os tincae, most frequently on  the  posterior lip; but very
often they develop  themselves in the fissures occasioned in
the neck by parturition.  In some cases they ascend pretty
high up  in the neck, and even extend  into the body of the
uterus.   If  these  ulcerations  are divided  by cracks  and
marked by little tubercular elevations, they may assume the
appearance of cancerous  ulcerations.   Leucorrhoea is not
necessarily present; but they give rise  to  frequent haemor-
rhages or an almost continual bloody  discharge; the general
health is not often affected by them.  If no proper treatment
is pursued, the disease  may continue  for months.   Some
authors  think that these  ulcerations may degenerate into
cancer ; this is a mistake, for simple ulcers  always terminate
in cicatrization, and if cancer becomes developed in the  end
it is because a cancerous germ  existed from the commence-
ment.   As regards causes, these ulcers seem for  the most
part to result from an inflammation of the  vagina or from an
acute or  chronic uterine catarrh, during the course of which
they become frequently developed, with simultaneous engorge-
ment of  the  uterus or its  neck.   The  same  causes which
produce  chronic metritis or vaginitis,  may likewise  cause
these ulcerations, especially if the catarrhal discharge should
have become  suppressed without the  inflammatory condition
of the womb or its neck having disappeared.  The DIAGNOSIS
is not very difficult except when the ulcer is  deep-seated,
bleeding  and of a fungous character,  which might lead one
to confound it with cancer.   We may  guard against such an
error by remembering that in cancer, the tissue of the neck
is either much softer or much  harder,  bleeds  more readily
and is  more livid than  in  veinal  ulcerations ;  moreover the
lancinations are more frequent and more  marked, and  the
secretions are  fouler and have a more  unhealthy look.   A
simple ulcer is moreover much more  easily controlled and
cured than an  ulcer having  a cancerous  character.   For the
treatment we refer the reader to the  last paragraph of this
article. 
           simple  ulcerations of the womb.       245


                       Section 87.

  Herpetic, scorbutic, scrofulous and syphilitic ulcera-
tions.—We have not much to offer concerning these different
varieties of ulcerations, which are of the same nature, when
attacking the neck  of the uterus, as when breaking out on
the skin, or on any portion of the lining  membrane in other
cavities.  Herpetic  ulcers generally arise from  some  pre-
existing herpetic eruption on the neck of  the uterus.  These
eruptions consist most frequently  in red tips, or in trans-
parent vesicles on the neck, which is more or less swollen,
and which secrete a more or less copious quantity of mucus.
In most cases these eruptions are accompanied by an herpetic
eruption on the skin; and if this eruption disappears, it will
be  generally found  that leucorrhoea breaks out after  it, or
that  an existing leucorrhoea becomes more  profuse.  Fre-
quently the  neck is more swollen,  more  puffed, and  looks
more angry'than  it does  in  simple 'erosions.   Scrofulous
ulcerations are characterised by a tuberculous matter which
they  secrete, and these tubercles sometimes form roughnesses
that  may give rise to the suspicion  of a cancer having de-
veloped itself.   The destruction caused by these ulcers, may
be  quite  extensive, involving even  the  whole  neck of the
uterus,  even down to the lower portion of the vagina; they
generally follow the course of hot or cold  abscesses, forming
tumors  where fluctuation  is felt, as in softened cancer, or in
a suppurating gland.  In almost all cases, these  ulcerations
are complicated with engorgements of the body of the uterus,
whence the tubercular process may spread onward, inflaming
the peritoneum and causing effusions in the peritoneal cavi-
ties.  These scrofulous ulcerations  are so rare, that scarcely
one is found in a hundred.  As regards the so-called scorbutic
ulcerations, it is more  than  probable that they are mercurial
ulcerations arising  from the abuse of mercury, when given
for syphilis, similar to the ulcers which are frequently seen
at the prepuce and  scrotum, after the use of excessive doses
of mercury, although the regular doctors deny that mercury 
246
DISEASES OF FEMALES.
has anything to do with such sores, which they attribute to
some  other  morbid diathesis.   As  regards syphilitic  ulcers,
it is an  established fact, that chancre may break out on the
neck of the uterus.   Some  authors  relate cases  of chancre
contracted by intercourse with  women who were supposed to
be affected  with uterine cancer; if we consider  the  uncer-
tainty which prevailed in the diagnosis of cancer  at the time
when these cases took place, we need not make a great effort
of the  imagination in order  to  believe that these pretended
cases  of uterine cancer were cases  of true chancre.  As a
general rule, it is very difficult  to establish a  sure diagnosis
of these syphilitic  ulcerations,  unless we choose to  resort to
the inoculation of  the syphilitic virus on  some other  part of
the body, in consequence of which the sufferings and dangers
of the patient would  be increased.  Nevertheless, however
difficult it may be to diagnose simple syphilitic erosions, there
are cases  of fully developed chancre, which  cannot be mis-
taken for  any other kind of ulcer.

                       Section  88.

  Treatment  of  non-cancerous  ulcerations  of the
womb.—In  the  treatment of these ulcers, which should  be
exclusively  internal,   all external  applications should  be
avoided, as  was  likewise recommended for cancer, and the
remedies should be seleete 1 in conformity with the symptoms
furnished  by the aspect and  nature  of the ulcers,  and by the
constitutional symptoms of the  patient.   The main remedies
for such ulcerations, are:
       1.  Nitri acidum, Thuja.
       2.  Arsenicum, Belladonna,  China, Cicuta, Cocculus
         Mercurius,  Pulsatilla, Sepia, Silicea, Sulphur.
       3.  Calcarea, Carbo vegetabilis, Conium, Nitri acidum
         Phosphorus, Phosphori acidum, Staphysagria.
       3.  Aurum, Carb. animalis,  Causticum, Chomomilla
          Graphites,  Kreosotum,   Mercurius,  Petroleum
         Ruta, Sabina, Secale. 
          SIMPLE ULCERATIONS OF THE WOMB.       247

      4. Antimonium, Argentum nitricum, Clematis, Hepar,
         Kali, Muriatis acidum, Nux vomica, Petroleum.
  And in particular:

For superficial erosions :—1. Arsenicum, Lachesis.
       2.  Carbo vegetabilis,  Lycopodium, Mercurius,  Nitri
         acidum, Phosphorus,  Pulsatilla,  Secale,  Silicea,
         Sulphur, Thuja.
       3. Ammonium, Belladonna, Causticum, China, Kreo-
         sotum, Petroleum, Phosphori acidum, Sepia.

For  deep-seated  ulcerations :—1.  Belladonna,  Calcarea,
         Nitri acidum, Pulsatilla, Silicea.
       2. Aurum, Conium,  Graphites, Kreosotum, Lycopo-
         dium, Mercurius, Sulphur.
       3. Antimonium, Asafoetida, Carbo vegetabilis, Hepar,
         Lachesis, Muriatic acidum, Petroleum, Phosphori
         acidum, Rhus, Ruta, Sepia.
       4.  Causticum, Clematis, Kreosotum, Natrum muriat,
         Phosphorus, Sabina, Staphysagria, Thuja.

For herpetic ulcerations:—Calcarea, Graphites, Lycopodium,
         Mercurius, Sepia, Silicea, Sulphur.
       2. Arsenicum, Clematis, Conium, Dulcamara, Rhus,
         Staphysagria, Zincum.
       3. Belladonna, Cicuta. Coccidus,  Hepar, Magnesia,
         carbonica, Natrum muriat, Petroleum, Pulsatilla,
         Thuja,  Veratrum.

For scorbutic ulcerations:—1. Arsenicum, Carbo animalis,
         Carbo vegetabilis, Lachesis, Mercurius,  Staphysa-
         gria, Sulphur.
       2. Ammonium, Ammonium muriat.,  Clematis,  Co-
        nium, Hepar, Phosphorus, Pulsatilla, Sepia, Silicea,
         Thuja.
       3. Alumina, Ambrosia, Causticum, lodium, Kreoso-
         tum, Natrum muriat., Nitri acidun, Nux vomica,
         Ruta. 
248
diseases of females.
       4.  Belladonna,  Calcarea,  Cantharis,  China,  Gra-
         phites, Lycopodium,  Phosphori  acidum, Sabina,
         Zincum.

For Scrofulous ulcerations :—1.  Arsenicum,  Belladonna,
         Calcarea, Carbo vegetabilis, Lycopodium,  Silicea,
         Sulphur.
       2.  Aurum,  Graphites, Hepar, Lachesis, Phosphorus.
       3.  Carbo animalis,  Clematis, Conium, Dulcamara,
         lodium, Mercurius, Nitri acidum, Phosphori acid.,
         Sepia, Thuja.
       4.  Alumina, Ammonium,  Cantharis, Kali, Kreoso-
         tum, Mezereum, Pulsatilla, Sulphuris acidum.

For syphilitic ulcerations:—1. Mercurius.
       2.  Nitri acidum, Thuja.
       3.  Aurum,  Carbo vegetabilis, Kali, lodium, Lachesis.
         Nux jug Ians.
       4.  Carbo animalis,  Clematis, Lycopodium,  Phospho-
         rus, Phosphori acidum, Sepia, Staphysagria.
  For further details see the articles : Leucorrhoea, Endome-
tritis, Metritis, Metrorrhagia, and Dysmenorrhea ; the symp-
toms by which these affections  are characterized,  frequently
accompany the above described ulcerations, which  can often
only be cured by attending to the  complaint of which the
ulcers are mere symptoms.  This remark applies more parti.
cularly to uterine catarrh,  which is often  the  fundamental
cause of the ulcerated condition of the neck of the womb.
  Dose.—Give one or two drops of the liquid attenuation, or
six globules dry on the tongue,  morning  and evening. 
gangrene and putrescence of the womb.   249
ARTICLE   IX.
   GANGRENE AND  PUTRESCENCE  OF THE WOMB.

                       Section 89.

  Symptoms and treatment.—Gangrene or putrefaction of
the uterus, is a disease which sometimes supervenes as one of
the frightful  terminations of acute metritis, and particularly
of malignant epidemic puerperal metritis. According to Boer,
it first attacks the neck of the uterus, whence  it extends  to
the more  remote parts; the uterus  increases in volume; its
walls become thickened and spongy ; the tissue of the organ
becomes soft and friable  between the fingers, looking some-
times  like decayed  fruit,  either pale  or  dark-colored and
blackish;  the internal  surface is generally softer than the
other parts, sometimes ulcerated and covered with a layer of
viscid, putrid, blackish and  fetid substance; often  we find
beneath this layer the tissue of the uterus altered to the depth
of 2, 3, and even 6 lines.   During the patient's life-time it is
often very difficult to recognise this affection, especially, when
the entire surface of the uterus has not been invaded, or when
it only exists  here and there, and occasions a  few scattered
eschars.   However,  inasmuch as the affection always com-
mences at the neck,  and  its presence is at all suspected, we
may recognize it by  the touch.  It is only in the most serious
cases, where the whole surface of the uterus is invaded,  that
the disease will develop all its characteristic symptoms ;  in
such a case, the pains in the hypogastrium which existed until
then, disappear; a brownish  liquid  of  a fetid odor, is dis-
charged from the vulva:  a diarrhoea of a  cadaverous smell
sets in, and  a cold and clammy sweat breaks out  either  over 
250
DISEASES OF FEMALES.
the whole body or only on some parts ;  the pulse becomes
frequent,  small  and intermittent; the features are deeply
altered, the extremities become  colder, and the patient sinks
into syncope  or a prolonged coma, with or without delirium.
If the disease is not arrested by proper treatment, death
almost always sets in a few days after these dangerous symp-
toms have made  their appearance.  This  affection  is  almost
always occasioned by a violent metritis, or it sets in in conse-
quence of tedious and difficult labor.  However, it may like-
wise set in in women  who went through their confinement
without any untoward symptoms.  We likewise meet with it
in  epidemic puerperal fever; but nothing has yet  occurred
that might lead  us to assert that this disease is contagious.
   The  treatment of this disease is always very difficult,
even in homoeopathy, although we do sometimes obtain some
success.   The principal remedy is undoubtedly Secale cor-
NUTUM, which may be tried  even in the most unpromising
cases; not, however, in large  doses, such as are recommended
by Hartmann, but, on the contrary, in the 30th to the 200th
potency, six globules in half  a tumblerful of water, of which
the patient may take  a teaspoonful every hour.  Next to
Secale, we may try Arsenicum  and Kreosotum, also Carbo
vegetabilis, which may be useful as long  as the organic reac-
tion has not entirely ceased.   Experience will teach us whether
Phosphorus, Carbo vegetabilis, Nitri acidum, Sabina,  Squilla,
Belladonna,  may effect any good in this  disease. 
diseases of the  neck  of the uterus.     251
ARTICLE X.
      DISEASES OF THE NECK OF  THE UTERUS.

                      Section 90.

  Inflammations.—Inflammations of the neck of the womb
are induced by the same causes as those of metritis generally.
AVe distinguish three forms of  such  inflammations, namely:
1st,  acute; 2d, chronic;  3d,  granular.—The  two former
may, like metritis, affect  only the mucous  membrane, (catar-
rhal inflammation,)  or  the parenchyma,  (parenchymatous
inflammation.)   The catarrhal form  is scarcely ever present
without uterine  catarrh,  of which it is only an extension;
parenchymatous inflammation, on the contrary, is very often
limited to  the neck of the uterus, or even to one of the lips
of the os  tincae, which  is, in such  a  case, harder, longer,
thicker  and redder than  its fellow.   Either variety inclines,
to pass from the acute to  the chronic stage, and the parenchy-
matous form is very apt to develope ulceration.  In granular
inflammation, we find the os tincae surrounded by small vege-
tations,  generally of the size of  a millet-seed, whitish, soft,
pretty numerous, and secreting  from their  interstices the
blood which exudes, after contact, sexual  intercourse or pres-
sure at stool.   At other  times  the granulations are hard,  of
the size of peas, and pediculated.  In many cases this  in-
flammation seems idiopathic, consequent upon  menstruation,
fatigue, long standing,  constipation,  and such like  causes.
It is  also  present in induration of  the neck  of  the womb,
fibrous tumors of the womb, herpes, or syph lis.  If entirely
idiopathic,  the inflammation is not dangerous;  but if compli-
cated with  other affections, the prognosis  is more doubtful. 
252
DISEASES OF  FEMALES.
  As regards  treatment, the  catarrhal variety is  treated
exactly like Endometritis, described in Sections 63—1>6.
  The principal remedies for parenchymatous inflammation
of the neck, are: China,  Belladonna, Sepia, Platina, Na-
trum, Thuja, Nitri acidum, Mercurius, Conium,  Kreosotum,
Graphites.
  For idiopathic granular  inflammation, we  give, Nitri
acidum, Thuja, Staphysagria.  If of a syphilitic character,
Cinnabaris, Nitri acidum, Thuja, Mercurius, Lycopodium.
If accompanying indurations or fibrous tumors of the womb,
see these affections and their treatment, Sections  78,  79.
  Dose.—One or two drops of the liquid attenuation in ten
tablespoonfuls  of water, a tablespoonful every three  or four
hours.

                       Section 91.
  Neuralgias,  rednesses,   engorgements,   eruptions,
ULCERS AND CANCERS OF THE NECK  OF THE WOMB.—Having
mentioned ulcerations and cancer of the womb, in Sections 80
—88, and the other derangements which we have just named,
resembling a good deal those which have been treated in the
preceding paragraph, we  have  but little  to say  concerning
the affections which form the subject  of this paragraph.
  Neuralgia of. the neck of the womb exists  often indepen-
dently of any other lesion of this organ or of the body of the
uterus;  the patients complain  of pains  that are seated high
up  in the vagina,  without any alteration being perceptible
even after the  most minute investigation.   Contact is always
painful, and sexual intercourse often produces such an  agoniz-
ing distress, that the patients would rather bear any other
torture.  The  best remedies for this condition are :
      1. China.
      2. Kali, Ferrum,  Causticum, Natrum muriaticum,
         Kreosotum, Sepia, Belladonna.
  The rednesses of the neck of the womb consist in red or
rose-colored patches on or near  the neck, breaking out at the
time  of, or after the  menses, or in  consequence of sexual 
        DISEASES OF THE NECK OF THE UTERUS.     253

excitement.   They are likewise seen on the posterior lip of the
neck, in women who flood copiously, and where they seem
induced by the contact of the secreted fluid.   Other of  these
efflorescences resemble herpes, and are often accompanied by
a simple engorgement of the neck.  According to some prac-
titioners, all  such efflorescences  manifest a predisposition to
ulcerations, and  old-school  physicians at once advise to cau-
terize the  parts.  We do not look upon  these efflorescences
as any thing  serious, and, if they coexist with engorgements
of the neck, we  have to treat them altogether  and not the
spots alone.
   Engorgements  of the  neck of the womb  may  either be
simple or  complicated.  They are termed complicated when
they are united to inflammations, ulcerations, degenerations,
or any other  organic  lesions  of the  womb or neck of the
uterus.  If existing without any of these affections, they are
termed simple.  In this  instance we  have only to do  with
simple  engorgements;  the other kinds  will  be  found men-
tioned in  the chapters where the affections  to which  those
engorgements are united, are treated  of.  Generally we dis-
tinguish three kinds  of  simple engorgements :  congestive,
hard and oedematous.   The congestive engorgement most fre-
quently extends  over the whole  neck  and may vary from a
simple catarrh to a state of turgescence, where the accumu-
lated blood imparts to the tissue of the neck  the appearance
of an engorged spleen.  The neck is in such a case softened,
larger and darker-colored, with sense of  heaviness in the
pelvis, pullings in the groin, and generally copious menstrua-
tion,  sometimes  amounting to  haemorrhage.  The  hard en-
gorgement can hardly be  distinguished  from schirrus, and
may easily degenerate into  cancer;  like schirrus, it exists
with or without roughnesses.   The oedematous engorgement
is rarely ever found except after confinement, and  seems to
be induced by the violent treatment which the neck of the
womb has to  suffer.  As regards treatment, the congestive
engorgement yields very generally to Belladonna or Platina,
beside which  we may have  to employ  Sepia,  Mercurius, 
254
DISEASES OF  FEMALES.
Ammonium, Conium,  China, Crocus, Sabina, Sulphur.  Ihe
best remedies for the hard or indurated engorgement, which
it  is  much  more  difficult to disperse,  are:  Belladonna,
Sepia, Carbo animalis, Aurum, China, Magnesia muriatica,
Angustura,   Staphysagria,  Clematis,  Conium,  Cocculus.
For  oedematous  engorgements,  we  recommend:  Arnica,
China, Lycopodium, Sepia.
   As regards the eruptions on the neck  of the womb,  some
authors speak of phlyctsense and herpetic efflorescences, which,
according to their statement, degenerate in ulcers.  AVe have
not had an opportunity of treating such affections.  How-
ever,  the reader may consult the article Ulcerations, Sections
85—88, and our previous remarks  in this paragraph, about
efflorescences or rednesses of the neck of  the womb. 
OVERITIS and ovaries.
255
ARTICLE  XL
     OVARITIS AND OTHER AFFECTIONS OF THE
                       OVARIES.

                      Section 92.

  Ovaritis.—Ovaritis,  like  any other  inflammation, may
either be acute or chronic.  Acute ovaritis is most generally
caused by pregnancy and confinement; but it may likewise
result from retrocession of gonorrhoea, in which case we term
it blennorrhagic ovaritis.   The acute  ovaritis, which is con-
sequent upon  pregnancy or confinement, is frequently  a sort
of latent disease, characterized by a violent fever, which con-
tinues for several days, without causing any derangement in
the  secretion  of milk or the  lochial discharge;   no local
symptom, exploration of the abdomen, touch, etc., indicate
the presence  of the organic  disorder ; but all  at once the
patient  becomes delirious, comatose  and death  ensues.   In
other cases the local affection is revealed by  a sense  of
heaviness  in the groins  and small of the back,  the lochial
discharge  becomes  less;  other symptoms  set in,  such as:
hysteric ailments, nausea, mucus  on the  stomach, vomiting,
convulsions even; the emission of urine and the passage of
stool become painful.  The pain sometimes extends down to
the thigh on the affected side, which becomes stiff and numb;
the pain is increased by suddenly  raising herself when lying
down, or by bearing-down at stool. At the  same time we dis-
cover on one,  and sometimes  on both sides of the  uterus a
tumor, which is more or less  painful when  pressed upon, and
where sometimes a throbbing  or fluctuation is perceived.   In
ihe first stage  of the disease, the ovary is a  little harder than 
256              diseases of females.
generally, but scarcely any larger;  in  the  second stage its
volume  becomes  double  and even  quadruple  that  of the
natural  size, sometimes larger than  a hen's-egg;  the  organ
becomes rounded, soft, friable or infiltrated with  serum; in
the third stage the serum is  changed to pus, which is either
infiltrated in  the tissue or deposited in mass in the interior
and softened organ;  in ihe fourth stage, the whole or part of
the ovary becomes soft or even completely dissolved. Arrived
at this  point,  the ovarian  abscess generally breaks and the
contents become scattered in the peritoneal cavity, or in the
bladder  or rectum;  at  other times they  pass  off  by the
vagina,  or the abscess  burrows onwards to the crural arch or
presents itself at the inguinal ring.   The  affection may like-
wise terminate in softening  of  the  ovary,  or, according to
some  authors, in gangrene.  A  frequent  termination of the
disease is induration of the ovary.   In any event, ovaritis is
always  a dangerous  disease; it may  terminate  fatally in
three  or four  days ; suppuration generally sets in about the
fifteenth day,  and resolution, if  it take place at all, between
the eighth or twelfth day, or  even sooner,  if a rational treat-
ment  be pursued.   Resolution is undoubtedly the most for-
tunate result; but even  if an abscess  should already have
formed, help  is sometimes possible.   Beside pregnancy and
confinement,  other  causes of this   disease are:  traumatic
lesions,  blows on  the hypogastrium,  vehement  exercise of
the sexual act, onanism,  menstrual  suppressions, drugs used
to effect miscarriage, etc.
   Chronic  ovaritis  scarcely  differs from  the  acute form,
except that it is slower.   Sometimes it follows acute inflam-
mation ;  but it may likewise develop  itself imperceptibly and
terminate in  softening, induration or other degenerations of
the ovary.  As long  as suppuration  has not set in, it is diffi-
cult to recognise the disease, and we may barely suspect its
presence, when  a sensitive and painful,   but  not stinging
tumor forms in the ovarian  region, which becomes from time
to time the seat of a new inflammation.   If suppuration sets
in,  the   affection  sometimes  assumes  the form of ovarian 
OVARITIS  AND OVARIES.
257
dropsy; we discover in the tumors a partial fluctuation, with
hardness in various points; or in other words, the hardness
is less uniform, but  likewise less evident  than in ovarian
dropsy, with pains and sensitiveness from  the commencement
of the formation of the tumor, whereas in  ovarian dropsy, the
tumor forms and fluctuation is perceived before the pain is
felt.   We have  already stated  that the most frequent termi-
nations of  this inflammation are softening, induration  and
other degenerations of the ovary.   Prostitutes and young girls
addicted to secret vices, seem principally  exposed to this dis-
ease ;  often, however, it originates in moral causes, which
render the cure very difficult.
   Gonorrhoeal ovaritis  corresponds in women to the gonor-
rhoeal orchitis of men ;  it is a metastasis of the inflammatory
process of the urethral mucous membrane  of the ovary, where
it develops itself as an acute disease.
   The principal remedies for acute and chronic ovaritis are:
        1. Belladonna.
        2. Mercurius, Lachesis.
        3. Conium, Platina.
        4. Sabina, Dulcamara, China.
        5. Staphysagria,  Ambra, Antimonium, Arsenicum,
          Aconitum, Cantharis.
  In acute ovaritis Aconite will be found  very serviceable as
long as the  fever is high;  but  inasmuch as Aconite has not
any specific effect upon the ovary, we had better not stop to
trouble ourselves about the fever, but at once give Belladonna,
which maybe alternated every three hours with Mercurius, if
the pain is very violent.   Mercurius is an excellent remedy,
if suppuration  may be  apprehended;  if it  should  have set
in already, Lachesis is the best remedy.  In a case of acute
ovaritis supervening  during chronic  inflammation  of  this
organ, and where the face had already become hippocratic
and the pulse filiform,  Conium brought  about  a  cure.   In
some cases where the pain is  excessive, and the sexual sys-
tem is very  much excited, Cantharis will be  found highly
useful.
                            17 
258
diseases of females.
  In  chronic ovaritis,  besides the remedies named, we may
derive benefit from Platina, Lachesis, Staphysagria, Sabina,
Bryonia, Rhus, Arsenicum,   Cohcynthis,  Ignatia,  China,
Nux vomica, Phosphori acid., and other remedies have like-
wise been  recommended for   ovaritis.  But  these remedies
have no specific relation to  the ovaries, and can only be used
as intercurrent remedies for accidental symptoms, for instance:
Ignatia, Staphysagria, Phosphori acid., where the affection
is fed by moral causes, disappointments, grief, etc.; Staphy-
sagria, Phosphori acid., China, when it is  caused by onan-
ism; Bryonia, Arsenicum, Rhus and other  remedies, when
the peculiar character of the pain indicates these drugs.
  Blennorrhagic ovaritis  generally  yields to the remedies
that were specifically required by the original disease, such
as Mercurius, Aurum, Nitri  acid., Thuja, Pulsatilla.

                       Section  93.
  Dropsy  of the ovaries.—At  the commencement nothing
seems more obscure than this affection, which consists in the
formation  of a  sac or  cyst containing  a liquid.   The  only
sign that betokens its  existence, is a tumor, the growth of
which gradually impedes the functions of the adjoining organs;
but this tumor  may exist  for a long time without any pain,
menstrual irregularities, or other changes in the condition of
the patient.  It is only after a period, when the abdomen
becomes very much  distended,  that dyspnoea,  a  sense of
weight  and gastric derangements set in.   The size of  the
tumor may vary from that of a  hen's  egg to a tumor of six
feet and more in circumference.   At first it is seated in the
region of the ovary, but afterwards  it may descend into the
inferior portions of the pelvis or occupy the middle  of the
abdominal cavity.  The liquid it encloses, is of different kinds,
sometimes  transparent  or  colorless,  at other times milky or
purulent,  gelatinous,  lemon or coffee-colored, or  like honey,
vinous sediment, tallow, oil,  etc.  If developed to a certain
degree, ovarian dropsy may easily he confounded with ascites;
the diagnosis is aided by the fact that the ovarian tumor is 
OVARITIS  AND  OVARIES.
259
always  round,  irregular and  not  level at the upper surface,
and that the bowels and the  stomach are situated above the
tumor;  percussion yields a much duller sound than in ascites;
finally,  the commencement of the  trouble in one side, its pri-
mitive limits, the undiminished quantity of the urine, the pre-
servation of the general  health, the absence of the horizontal
level when the patient sits down, and the natural shape of
the  sides when she is  lying on  her back; the tympanitic
sound of the bowels on the sides of the tumor, where the dul-
ness of sound seems circumscribed by curvilinear outlines, are
so many signs which distinguish in a positive manner ovarian
dropsy  from ascites.   Moreover the  tumor is always move-
able, and if the patients turn suddenly from one side to the
other, they  experience a sensation as if a round and cold body
were falling from side to side.  Internal exploration shows
the  uterus more or less pushed to the opposite side.   The
cause of this disease, and the influences that lead to it, are
almost  unknown;  according  to  some authors   the  disease
scarcely ever sets in before the age of forty or fifty, and mar-
ried women are more  subject to it than  unmarried; we have
seen  cases of  ovarian  dropsy at twenty and at thirty years,
and in young girls  of acknowledged purity.   Ovarian dropsy,
though  sometimes  incurable, is not very serious; it develops
itself slowly, and the  general health does  not suffer much.
Such tumors have existed for thirty and more years in  some
cases, and yet the patients lived up to eighty and even  more
years.  According  to  most authors,  the average duration of
the disease from the commencement to its fatal issue, is from
six to twelve years; death taking place either in consequence
of the compression  of  the thoracic organs,  or of  the rupture
of the tumor and  effusion into  the peritoneal cavity, which
almost always causes sudden and malignant peritonitis.
  As regards treatment, the old-school looks upon this dis-
ease as  incurable, and rebelling against all possible remedies.
Alloeopathic practioners resort to puncture, incision, and extir-
pation as their only means of cure.  So far homoeopathy has
not been much more  successful  in  the treatment of  this 
260
DISEASES OF FEMALES.
malady;  there are cases, however, where Arsenicum, Lyco-
podium, Sepia, lodium, and Platina, seem to have affected
an improvement, and these remedies might, perhaps, effect a
cure if used in time -.—Mercurius, Phosphori acid., Graphites,
China, Staphysagria, Thuja, have also been recommended.

                      Section 94.

  Various other affections of the ovaries : hydatids,
CYSTS, CALCULI, FIBROUS BODIES,  TUBERCLES,  CANCER, her-
nia.—All we do is to mention these affections, the treatment
of which is the same as that which has been  recommended
for similar diseases of the womb.   In  order  not to leave any
gap in our work, we will mention some remedies that seem to
us to deserve particular attention when these  diseases affect
ovaries :
For Hydatids :—Cantharis, Mercurius.
     Fibrous bodies:— Calcarea,  Platina,  Staphysagria,
         Thuja.
     Ovarian cancer t—Graphites, Arsenicum, Kreosotum,
     Hernia:— Nux vom., Silicea, Conium, Magnesia muriat.,
 Cocculus, Sulphur, Sulphuris acidum. 
diseases of the  vagina.            261
ARTICLE  XII.
VAGINITIS AND OTHER DISEASES OF THE VAGINA.

                      Section 95.

  Vaginitis.—This  inflammation is likewise either acute or
chronic.  Both forms only affect the mucous membrane of
the vagina  to whieh  they remain  confined during the whole
course of the disease, and are characterised  by more or less
copious blennorrhoea  or leucorrhoea, with  swelling and  more
or less marked heat of the vaginal mucous membrane. Acute
vaginitis, generally commences with itching  and painful ten-
sion extending from the vulva through the vagina, and which,
together with  the heat and  swelling, increases for  the  first
five or six days.  The walls of the vagina close in upon each
other, and  are very painful when a finger is  introduced; the
emission of urine is  more painful  and frequent;  there is a
sense of weight on the anus, and the pains are worse during
stool; walking is impeded, especially if the inflammation ex-
tends as far as the vulva.   The intensity of the pains varies
according to circumstances, from a simple malaise to intense
agony, without these pains being at all proportionate to the
perceptible signs of the inflammation.  At the onset, the mu-
cous membrane is  generally drier than in the normal condi-
tion ; but soon a quantity of serous  fluid of a light color is
secreted and discharged  by the vulva.  Gradually this fluid
becomes creamy, yellowish or  greenish,  sometimes bloody;
its  quantity varies, from  a hardly perceptible  discharge to a
flow equal to the catamenial discharge.  In all cases of simple
vaginitis, this discharge  is almost transparent, with  round
globules floating in it, such  as are found in pus and mucus; 
262
DISEASES OF FEMALES.
but, if vaginitis is caused by impure coit, the discharge con-
tains moreover small animalculae.  The mucous lining is
generally more or less intensely and more or less uniformly
red, with or without puffiness of the affected portions.   In a
few rare cases, the inflammation penetrates  to the subjacent
tissues, becoming phlegmonous, with acute  and continuous
pains, febrile motions and other accessory symptoms such as
headache, weight in the stomach, nausea, vomiting, etc.; even
abscesses may form in the substance of the vaginal  walls,
which may break either at the  perinaeum or at the labia ma-
jora.   The course  of  acute vaginitis varies; generally the
acute symptoms decrease after eight or ten days,  after  which
the discharge becomes less copious, and  finally ceases alto-
gether, provided  the inflammation does  not become chronic.
In most cases chronic vaginitis which differs  from acute vagi-
nitis only in  the intensity of  its  symptoms and its slower
course, is only a  sequel of the  acute form, although  it may,
however, be a chronic  inflammation  from the first, with  all
the signs of such  a form.
  According to the condition of the mucous membrane, both
the acute and chronic variety may assume a good many modi-
fications.   We distinguish in this respect:—
  1. ^Erysipelatous and  erythematous vaginitis, where there
is  scarcely any discharge, but where the  vagina exhibits  in-
tensely-red, painful, more or less extensive patches, somewhat
raised and causing a sense of pain  and smarting.
  2. Papulous vaginitis, where the vagina  and the  neck of
the womb are covered with papulae or follicles that are more
or less developed, and present themselves in the shape of small
spots of the size of  a pin's head, or in the shape of granula-
tions that resemble fleshy  granulations, and may form real
vegetations.
  3. Vesicular vaginitis, caused by a spreading of the eczema
from the vulva to the vagina and which may produce a true
herpes phlyctenoides in the deep-seated  parts of  the vagina,
and on the neck of the womb.
  4. Pustulous vaginitis, where real pustules are developed 
DISEASES OF THE VAGINA.            263
in the vagina, in persons affected  with impetiginous erup-
tions.
  5.  Glandular  vaginitis,  where  the  follicles alone seem
affected, but where the mucous membrane exhibits no trace of
change, and where  the  secretion alone seems  altered, more
copious and of a yellowish-white or grayish color.
  The causes of these different forms of vaginitis are exceed-
ingly varied, and  it is  difficult to trace them.  Women of a
flabby and lymphatic  constitution,  or such as are  tainted
with  scrofula, chronic,  cutaneous eruptions,  etc.,  seem par-
ticularly liable to  such inflammations ; no age is exempt from
them, even children after the second teething are more or less
attacked  by these irritations;  among  adults they  are quite
frequent; among  old persons they become rarer, although the
critical period when most women are troubled with itching at
the vulva, predisposes for these diseases in consequence of the
more or less inflammatory irritation which this  itching causes
in the vagina.  Among other women there seems  to  exist a
particular predisposition for all sorts of catarrhal inflamma-
tions, especially  for  inflammations of the vagina.   Beside
these causes, we have to note  as exciting causes the friction,
contusions, irritations of the vagina, caused by  foreign bodies
(pessaries,  etc.),  excessive  intercourse, onanism,  injections
(except  pure water), fatiguing walking, and recto-anul asca-
rides, which get  into the vagina.  Infection by impure coit,
likewise, with individuals affected with  gonorrhoea, may like-
wise  induce a virulent vaginitis, of  which we  shall treat
by-and-by.
   Virulent vaginitis, also termed blennorrhagic or gonorrhceal
vaginitis, has all  the anatomical characteristics of acute  or
chronic  simple vaginitis, except  its  origin and  contagious
character.   In all  other respects,  it resembles so  closely a
simple vaginitis that, unless the origin of the disease were
known,  it would  be difficult  to distinguish the  virulent from
the other variety.  Some characteristic signs seem, however,
peculiar  to  this  form   of vaginitis, which we  shall describe
more particularly when speaking of the diagnosis. 
264
DISEASES  OF FEMALES.
   The diagnosis of simple vaginitis, is not difficult as far  as
 the disease is concerned;  a careful exploration of the vagina,
 and, in some cases the simple touch, are sufficient to reveal to
 us the condition of the parts, either by the swelling which is
 seen, or by the painfulness and the heat which are ascertained
 by the touch; but these signs are not sufficient when we have
 to determine whether the inflammation is  simple  or  gonor-
 rhoeal.   The physician has to be guided in such a case by the
 accompanying circumstances,  the  time which  had  elapsed
 between the period of the infection, and the period when the
 disease first showed itself, and  perhaps by the nature of the
 secretions, where,  according  to some  authors, nothing but
 mucous vesicles  and purulent globules are formed, when the
 inflammation is  simple, but where little animakuloz {trichomo-
 nas of the vagina) are discovered if the inflammation is  caused
 by the gonorrhceal virus.
   In regard  to  prognosis, it is not  at all dangerous in the
 simple or acute form, if the patients have a good constitution
 and  the disease  owes its origin  to accidental causes;  resolu-
 tion  is obtained promptly and without  any trouble.   But, if
 constitutional influences have slowly determined the disease,
it is  much more obstinate.  This is  likewise the case when
the patients are  affected with cutaneous eruptions.  Virulent
vaginitis is likewise easily cured, if it  is a  first attack, and
the patient is of a sound  constitution; but if she  should be
predisposed  for  catarrhal discharges, or have  a lymphatic
 consitution, and be subject to  cutaneous  disorders, or if she
should have been attacked before, the disease is much more
difficult to cure, and  inclines  to become  chronic, or,  at any
rate, to assume  the form  of  a simple but obstinate chronic
vaginitis.
   The treatment of vaginitis is generally the same as that
which we have recommended  for Leucorrhoea, Sections, 44—
48, to which we  refer the reader.  We will give a few  indica-
tions that are more particularly applicable to vaginitis.  The
best  remedies in general are: 
DISEASES OF THE VAGINA.
265
       1. Mercurius, Sepia, Pulsatilla, Sulphur.
       2. Nitri acidum,  Thuja, China, Kreosotum,  Lyco-
        podium, Sabina.
       3. Alumina,  Ammoniacum,   Causticum,  Conium,
         Petroleum, Phosphorus, Silicea, Stannum.
And in particular:
For acute vaginitis :—1.  Mercurius, Sepia.
       2. Sulphur, Pulsatilla.
       3. China, Nitri acidum, Thuja, Sabina, Mezereum.
For  chronic vaginitis:—1. Sepia, Pulsatilla, Conium, Sul-
         phur, Mercurius, Sabina.
       2. Calcarea, Alumina,  Ammonium,  Conium,  Gra-
         phites, Kali, Petroleum,  Nux vomica,  Silicea,
         Stannum, Zincum.
       3. Arsenicum,  Cannabis,  Carbo  veg.,  Magnesia,
         Magnesia muriatica.
For erythematous vaginitis:—Mercurius, Belladonna, Ly-
       copodium, Nux vomica, Kali, Alumina, Kreosotum.
For  vesicular  vaginitis:—Mercurius,  Petroleum, Dulca-
       mara, Phosphoricum acidum,  Thuja, Nitri acidum,
       Sulphur.
For virulent vaginitis :—Cannabis, Mercurius, Nitri acid.,
       Thuja, Sulphur, Sepia, Alumina.
  Dose.—One or two  drops of the liquid attenuation in ten
tablespoonfuls of water, a  tablespoonful  of which solution is
to be given  every four or six hours.

                     Section 96.

  Prolapsus, hernia and fistula  of  the vagina.—By
prolapsus of  the vagina, we understand  a protrusion of the
internal membrane of the vagina within the vaginal canal, or
even between the labia of the vulva, caused not by hernia of
the bladder or rectum, nor  by falling of  the womb, but by a
puffing-up of the inner lining membrane.  The prolapsus may
be complete or incomplete, partial  or  general, according as 
266
DISEASES OF FEMALES.
the tumor projects from the vulva or is  confined to the in-
terior of the vagina, and that it extends either over the whole
of the vagina or  only over a portion of this canal.   The
symptoms of this  prolapsus vary, as far  as  intensity is con-
cerned, according to the extent of the falling, and the inflam-
matory state of the tumor, and are generally: sense of weight
at the orifice of the vagina; more or less prominent tumor,
which is round when the prolapsus is only partial and  looks
like a circular pad when the prolapsus extends  all around;
impeded walk, difficulty of remaining  seated; tenesmus of the
bladder, dysuria;  constipation, discharge of puriform mucus.
If the prolapsus is complete, the action of the urine upon the
tumor renders  the inflammation  sometimes  very acute, with
soreness, intense pain,  and tension in the tumor as far as the
loins; the  swelling of the  part   may also produce a sort of
strangulation, that may result   in  gangrene.   Among  the
predisposing causes of this affection, we may number all the
influences that may produce a relaxation and weakness of the
tissues,  such as: a lymphatic constitution, a cachectic condi-
tion, arising from bad nourishment  or any other weakening
cause, abuse of warm baths and relaxing beverages, inveterate
and copious  fluor albus, menorrhagia and  frequent  confine-
ments or miscarriages.  Existing causes are: violent friction
with the hands or instruments during parturition; excessive
intercourse; onanism; effort to lift heavy loads; constipa-
tion; concussions  caused  by leaping,  falling,  immoderate
laughter,  cough  and  vomiting.   Sometimes  the falling is
caused  by chronic inflammation of the mucous membrane of
the vagina.  The diagnosis is  founded  upon  the  existing
symptoms and upon the shape of the tumor, which has  trans-
versal rugae  in partial prolapsus; whereas, in complete pro-
lapsus,  the tumor  is  cylindrical, with circular  rugae.  The
base of the tumor is united  to the internal  membrane of the
vulva, although this is likewise,  sometimes, surrounded with
a cul-de-sac  that  is not very deep.   Complete prolapsus of
the  vagina  cannot always  readily  be  distinguished  from
prolapsus of the womb.  The prognosis is generally very 
DISEASES  OF THE VAGINA.            267
simple; prolapsus of long  standing  is sometimes very obsti-
nate.    Complete  prolapsus  is most difficult to cure.   In
some  cases a cure  has  been effected by means of accidental
inflammations, which were  excited in the vagina by foreign
bodies, such as a pessary, for example.  Cases are mentioned
where pregnancy is said to have effected a cure, or  at least a
marked improvement.   For  the  treatment, we  refer the
reader to  the end of this article, where  the particular indica-
tions  are given.
  From falling of the vagina we have to distinguish hernia,
that  is descensions  where other  organs  are engaged in a
tumor in  the interior  of the vagina or passing out at the
vulva.  We distinguish three kinds: 1st, vaginal hernia, or
incomplete hernia of  the vulva, which  is  nothing  else than
intestinal  hernia, where a portion of bowel is contained in the
hernial sac; 2d, vaginal cystocele, where the bladder is en-
gaged in  the hernial  sac; 3d, vaginal rectocele, where the
rectum passes into the vagina and protrudes from the vulva.
The description and treatment of these secondary descensions
of  the  vagina,  belongs  rather to the  pathology and thera-
peutics of hernia, than  to those of the sexual organs;  for
this reason we only make a passing  allusion to these difficul-
ties here,  and shall describe  the treatment at the end of this
paragraph.
  Vaginal fistula  are lesions of continuity, produced by
accidental wounds or  by abscesses developed in the vaginal
walls, in consequence of which a communication is established
between the vagina  and urethra, or between  the vagina and
bladder (urethro-vaginal fistulse), or between the vagina and
rectum (recto-vaginal fistulse), or between some other portion
of the intestines and the vagina (intestino-vaginal fistulse), or
between the vagina and  the peritoneal  cavity (peritoneo-
vaginalfistulse), or, finally,   between the  vagina  and some
accidental cavity,  resulting from the opening of an abscess,
or of some cyst  that has developed itself in some neighboring
organ, and has discharged  its contents into the vagina.
  These various lesions require the interference of the sur- 
268              diseases of females.
gical art, and we should  not  have mentioned  any of them
here, if it were not proven by experience, that a well chosen
remedy may sometimes  enable nature to effect  the  spon-
taneous reduction of a displaced  organ, of hernia, and the
cicatrisation of  a fistula.  We have, therefore,  deemed it
proper to indicate the principal remedies by means of  which
these  lesions may be cured  internally, without  any other
surgical means  than  such manual assistance as is absolutely
necessary.
I. For falling of the vagina:—1.  Mercurius, Sepia.
       2.  Ferrum, Stannum.
       3. Belladonna, Nux vomica.
       4.  Calcarea, Ferrum, Kreosotum, Nux moschata.

II. For vaginal hernia:—1. Nux vomica, Sulphur, Sul-
         phuris acid.
       2.  Ammonium muriaticum, Aurum,  Cocculus, Lyco-
         podium, Magnesia, Silicea,  Veratrum.
       3.  Chamomilla, Clematis,  Cohcynthis, Nitri acidum,
         Opium, Petroleum, Phosphorus, Rhus, Staphysa-
         gria.
       4.  Aconitum,  Alumina,  Carbo animalis,  China,  La-
         chesis, Magnesia carb., Thuja,  Zincum.

III. For vaginal fistula :—1. Pulsatilla, Silicea, Lycopo-
         dium,  Calcarea,
       2.  Sulphur,  Asarum,  Carbo  vegetabilis, Belladonna,
         Nitri acid., Conium.
       3.  Thuja, Petroleum, Causticum, Antimonium), Aurum,
         Thuja, Sepia, Lachesis.

Moreover:—
For strangulation of the parts:—1. Aconitum, Sulphur.
       2.  Lachesis, Opium, Sulphuris acid.
       3.  Arsenicum, Nux vomica, Belladonna, Veratrum.

     Inflammation :—Aconitum, Mercurius, Belladonna, Sul-
         phur, Nux  vomica, Sepia, Sulphuris acid. 
diseases  of the vagina.
269
    Ulcerations :—Mercurius,  Hepar,  Lachesis,  Silicea,
         Sulphur, Chamomilla, Pulsatilla, Nitri acid, Thuja,
         Asarum, Phosphorus.
    Gangrene:—Arsenicum,  Sulphuris  acid., Belladonna,
         Calcarea, Sulphur, Lachesis, Kreosotum.
  It is a matter of course that, if vaginal fistula is caused by
some other disease, cancer, syphilis, etc., we have to remove
this affection and  select our remedies accordingly.

                       Section  97.
  Indurations, contractions, tumors, cysts, polypi, ul-
cers and cancers of the vagina :—Inasmuch as these affec-
tions do not differ from similar  affections of the womb, except
by their  locality,  we shall here simply mention the charac-
teristic  symptoms which these affections  develope  in the
vagina, and,  for the rest, refer  the reader  to what we said of
the nature and origin of these diseases in  our chapters  of
uterine disorganizations.
  Like the neck  and body of  the womb, the vagina may  be
affected with simple indurations which are neither schirrous
nor syphilitic.  They are engorgements or thickenings of the
mucous membrane, which generally come on  slowly and im-
perceptibly, commencing at circumscribed points  rather high
up in the vagina, and even round the neck of  the  uterus.
The effect of such indurations always is to contract the vagina
more or  less, to render it more rigid, less dilatable, and  to
render the introduction of foreign bodies difficult and painful.
In most cases there is not discharge, although there are cases
where a profuse leucorrhceal  discharge takes  place from the
commencement.  Almost always the patients complain of pain
at the outset, of smarting, itching, and increase of heat, and,
in proportion as  the affection develops  itself, the vagina be-
comes contracted and sometimes entirely obliterated.   AAThat
distinguishes these simple thickenings  from  schirrous indu-
rations is this, that they do not present to the finger those
roughnesses which characterize schirrus;  that  they are less
consistent than schirrus, and never ulcerate.   The most fre- 
270
diseases of females.
quent causes of these indurations, which are most frequently
met with towards the fortieth year, are:—onanism, effect of
hard bodies, such as pessaries, friction by coit, or irritations
caused by acrid humors, etc.  As regards  the treatment of
these indurations, we recommend the following  remedies:—
Petroleum,  Clematis,  , Pulsatilla,  Sulphur,   Belladonna,
China, Magnesia muriat., Conium, Lycopodium, Sepia.
   As regards the various tumors which occur in the vagina,
they are:—1, bloody tumors,  of which we  shall say a few
words  when we come  to describe the ailments incident to
pregnancy;  2,  serous cysts, resembling hydrocele; 3, fatty
tumors^ or lipoma;  4,  fibrous  tumors; 5, polypi and  non.
syphilitic ulcerated vegetations.  The  treatment  of these
lesions is the same as that of similar lesions in other parts of
the body, namely purely medicinal and internal.   The follow-
ing remedies are the best for these affections:—
   I. For  bloody tumors :—Mercurius, Sepia, Sulphur, Bel-
ladonna.
   II. For  serous  cysts :—Pulsatilla,   Graphites, Lycopo-
dium, Silicea, Sulphur, Rododendron.
   III.  For fibrous tumors :—Calcarea, Staphysagria, Thuja,
Lycopodium, Mercurius, Nitri acidum, Phosphorus.
   IV.  For polypi:—Calcarea, Conium, Phosphorus, Platina,
Staphysagria, Lycopodium,  Nitri acidum, Mercurius.
   V. For granular vegetations:—Nitri  acidum, Staphysa-
gria, Thuja, Cakerea, Lycopodium.
   For  the treatment of simple and cancerous ulcerations of
the vagina, we refer the reader to Sections  79-87, where these
affections of the uterus are fully described, together with an
indication of their treatment.

                       Section 98.
   Spasms and neuralgia of the vagina.—These two kinds
of affections, which  are  quite frequent,  generally  get well
without the interference of art; however, cases which require
the use of medicines, may occur, and we have deemed it  ne 
diseases of the vagina.
271
cessary, on this account, to offer  some remarks  concerning
them.  By spasm of the vagina, we understand a convulsive
stricture of the vagina, which may be so intense  as to com-
pletely obliterate the  canal.   Sometimes this stricture is a
symptom of vaginitis, but in other cases it exists idiopathically
as a purely nervous disease, in which case the constriction of
the vagina is exceedingly painful, intermittent, without red-
ness, heat or swelling.   Often this  spasm sets in during con-
finement; some nervous women are  attacked  by it  at  the
moment of intercourse, but it ceases as soon as  the vagina
secretes the seminal mucus; it may also be  induced  by moral
causes; nervous and passionate women are more particularly
liable to it.  The best remedies for it, are:—Nux vomica,
Ignatia, Cocculus, Belladonna, Pulsatilla, Platina, Mercu-
rius.
   Neuralgia of the  vagina often consists in a  simple sen-
sitiveness of  this organ, but it may likewise be characterized
by acute, lancing, burning, tearing pains, or even by intoler-
able itching.  Touch is likewise painful, and most women who
are attacked with this weakness, show great  aversion to sexual
intercourse.  Sometimes  they fancy that they are suffering
with some serious disease, and that ulcers or cancer will break
out; but on exploring the vagina we find it simple  and idiopa-
thic neuralgia,  neither inflammation nor any other abnormal
symptom.   Such neuralgia may likewise be caused by some
uterine affection, of which we have to assure ourselves  by all
means.   Simple and idiopathic neuralgia is often  caused  by
exhaustion consequent upon sexual intercourse, by cold injec-
tions and by other influences.  The principal remedies are:—
Belladonna, Conium,  Ignatia,  Valeriana, Sepia,  Hyoscya-
mus, Chamomilla, Asafcetida.
   Dose.—One or two drops  of  the  liquid attenuation in a
tumblerful of water, of which a tablespoonful is  to be given
every few hours. 
272              DISEASES OF  FEMALES.
ARTICLE   XIII.
VULVITIS AND  OTHER AFFECTIONS OF THE  VULVA.

                      Section  99.

  Vulvitis, inflammation of the vulva__Like any other
inflammation, an inflammation of the vulva may be acute or
chronic.  In acute vulvitis  the labia are more or less red on
their mucous surface;  there is intense heat and a distressing
itching, with painful sensitiveness which does not even allow
of the least contact; the swelling  may be so intense as to close
the vulva completely.   In some cases the nymphae  are alone
inflamed and swollen,  so as to protrude between  the labia
majora; generally, however, the  inflammation invades simul-
taneously the labia majora, nymphae and clitoris, causing a
permanent  erection of this organ, and thereby exciting more
or less marked lascivious desires ; sometimes the inflammation
spreads to the pubic region and to  the inguinal glands.  At
the onset of the disease, the  mucous membrane  is dry  and
shining, but soon it secretes  an  opaque, white or  yellowish
mucous of  a sickening smell, and  excoriating acridity.   In
some cases, a submucous inflammation  sets in which causes
burning or stinging  pains, and  may become very extensive.
Acute  vulvitis scarcely ever lasts  longer than eight or  ten
days, and the most frequent termination is a gradual disper-
sion of all  the  symptoms;  in some cases the inflammation
terminates  in  suppuration, and  even  in  gangrene.   In  the
latter case, the  affected parts become cold,  the pains cease,
and the vulva exhibits  a violet-colored, dark or livid border.
But these  cases scarcely ever happen except after  violent
contusions or hard labor, or  in consequence of improper treat- 
AFFECTIONS OF THE  VULVA.
273
ment.   The most general predisposing causes, are:—obesity,
approach  of the  menstrual period,  pregnancy, prolonged
standing, walking, dentition, piles, cutaneous affections of the
vulva, uncleanliness,  abuse of washes, foot-stoves,  onanism,
etc.   Among the exciting causes, we have to note,  irritating
action of certain uterine  and vaginal discharges, repeated
frictions of the parts, sexual excesses, irritating injections,
lacerations, various manipulations during labor, etc.   Some-
times this affection results  from metastasis in parotitis, otor-
rhoea, etc.
   Chronic vulvitis  has the  same characteristic signs as the
acute form, except that the symptoms are more marked.  In
most cases it is  developed out of acute vulvitis, but  it may
likewise set in from the  first  as a chronic disease, especially
in lymphatic persons.   Often there is  neither redness nor
heat in the chronic form, but the parts are generally  pain-
ful and slightly swollen, more or less hard and itching.
   The best remedies for acute vulvitis are : Mercurius, Sepia,
Nux vomica, Belladonna,  Conium,  Nitri  acid.,  Sulphur,
Aconite.
   If the inflammation had  been  caused by mechanical  influ-
ences, (blows,  manipulations, contusions, etc.,) we give Ar-
nica, or Cicuta, Conium, Pulsatilla, Chamomilla.
   If  phlegmonous,  give:—Belladonna, Mercurius, Sepia,
Nux vomica, Sulphur.
   For suppuration :—Mercurius,  Pulsatilla, Sulphur,  Si-
licea.
   For Gangrene:—Arsenicum, Pulsatilla, Silicea,  China.
   For chronic  vulvitis :—Sepia, Sulphur, Conium,  Mer-
curius, Nitri acid.
   If vulvitis depends upon existing  uterine or vaginal dis-
charges, these  have  to  be cured,  of course; for which we
refer the reader to the article on Leucorrhoea.
   Dose.—The  same as at the close of the last paragraph.
                            18 
274
diseases of females.
                      Section 100.

  Tumors, hernia,  (edema, fistula, cysts, hypertrophy,
varices, polypi and cancer of the vulva.—The treatment
of these  affections does not differ in the  least from that of
similar affections of other parts  of the sexual organs.   Our
remarks bearing upon the vulva in particular will necessarily
be very short.
  Bloody tumors of the vulva are more or less extensive, of
a violet-colored, bluish or brownish appearance, generally
without pain, but occasioning a tolerably violent tension, and
impeding the walk more or less.  They  may develop them-
selves spontaneously, but  in most  cases they are induced by
blows,  a fall, contusions, frictions during  labor or at any
other period, also during pregnancy.  The principal reme-
dies for these tumors are: Arnica, Sepia, Nux vomica, Mer-
curius, Conium, Zincum.
   Hernia of the vulva is very rare; it commences like vagi-
nal hernia, and develops itself in the substance of the labia
majora, where  they can easily be  distinguished from vaginal
hernia by the direction they take, and from  a cyst or an abscess
in the  labia by the absence of fluctuation,  by the general cha-
racters of every kind of  hernia,  and by the disappearance of
the tumor in the horizontal posture.  The principal remedies
which will facilitate the reduction of hernia, are: Nux vomica,
Sulphur, Cocculus, Sulphuris acidum.   (See also Vaginal
Hernia, Section 96.)
   (Edema of the vulva may result from vulvitis, or it may
come on spontaneously in consequence of the  impeded circu-
lation  in the pelvic extremities,  as takes  place during preg-
nancy.  What distinguishes this swelling from any other,  is
its softness, which causes it  to retain a depression from the
pressure of the finger;  its decrease in the horizontal and its
increase in  the  vertical position. The  principal  remedies
are: Mercurius, Sulphur, Sepia, Arnica.
   Abscessess  of the  vulva  always result  from vulvitis, or 
AFFECTIONS OF THE  VULVA.            275
during pregnancy.  If badly managed, they may give rise to
vulvo-rectal fistulse, especially if  the  abscess  is  seated near
the fourchette  or the corresponding portion of  the vagina.
In regard to treatment, the best thing to be  done is to pre-
vent them, by dispersing the primary inflammations by appro-
priate  remedies,  such  as:  Mercurius, Sepia,  Belladonna,
Lachesis.   After suppuration has sefc in, with or without fis-
tula, we often still obtain a cure by giving:  Mercurius, Sili-
cea, Lachesis, Phosphorus, Sulphur,  and particularly: Sili-
cea, Calcarea, Phosphorus,  Sutyhur, if fistula has set in.
   Cysts of  the vulva are frequently met with,  especially in
prostitutes.   They  generally develope themselves on one of
the labia, on the left rather than  on the right.   At first they
are scarcely noticed at the orifice of the vagina, but they may
continue to grow until  they have reached the size of a nut,
and even of a  fist.  Most frequently they are filled with a
colorless liquid or a thick, yellowish  substance; other cysts
are stertomatous, filled  with fatty matter.   When the former
cysts break, which  seldom  takes  place spontaneously, their
orifice remains open and continues  to secrete moisture, which
may irritate the parts and cause inflammations and abscesses.
Under  homoeopathic  treatment we scarcely ever need have
recourse to surgical  means; the internal treatment will  be
found  sufficient to  effect  the dispersion of the  cysts.  The
best remedies are:
       1. Calcarea, Nitri acidum.
       2. Baryta,  Sul[jhur, Sabina.
       3. Graphites, Silicea, Hepar.
       4. Kali, Spongia, Antimonium, Agaricus.
   Hypertrophy of the labia majorum, if  supervening during
pregnancy,  often yields to Sepia; in  other cases we may
have to  give :  Carbo vegetabilis,  Sepia.   If  the disease  is
caused by leucorrhoea, we have to  cure this affection by the
remedies indicated for leucorrhoea.
   Varices and erectile tumors of the vulva likewise yield
in  most cases  to internal  treatment which may always  be 
276
DISEASES of  females.
 tried before we  resort to surgical  means.  The  principal
 remedies are:
   1.  For varices :—Pulsatilla, Arnica, Carbo veget., Lyco-
 podium, Ferrum, Arsenicum,  Causticum, Sulphur, Gra-
 phites, Zincum.
   2.  For erectile tumors :—Carbo animalis,  Arsenicum,
 Carbo veget, Platina, Thuja, Silicea, Phosphorus,  Sulphur,
 Nitri acidum, Lycopodium, Kreosotum.
   And  if these  tumors  bleed  a  good deal:—Phosphorus,
 Carbo veget, Arnica, Lachesis, Pulsatilla,  Kreosotum, Sul-
 phur.
   If they become inflamed :—Pulsatilla, Asenicum, Arnica,
 Sulphur, Lycopodium, Spigelia, Silicea, Kreosotum.
  If they become ulcerated :—Pulsatilla, Lycopodium, Ar-
 senicum, Silicea, Lachesis, Sulphur.
   Polypi, ulcers and cancer  of  the vulva are treated in
 the same manner as polypi, etc., of the womb.  (See Sections
 79-87.

                      Section 101.

   Neuralgia, itching, eruptions, worms  and lice of the
 vulva.—We have so little to say of these affections, that we
 have  considered it useless to accord a special paragraph to
 each of them.
  Neuralgia of the vulva has the  same signs as that of the
vagina, often the  two coalesce.   The remedies are likewise
the same, viz.: Belladonna,  Conium, Ignatia, Valeriana,
Sepia, Hyoscyamus, Chamomilla, Asarum.
  Itching of the vulva, which often  arises  from some erup-
tion (lichen,  prurigo, eczema,  etc.,) may also exist  indepen-
dently of these eruptions.  As an independent  disease, we
seldom meet with it  among young  girls,  or among women
below thirty-six years old, but very often in older  females,
especially after the critical age.  It seems induced by habit-
ual congestion towards  these parts, by a sedentary  life, late
rising from  bed, or  by  continued exercise.  It is especially 
affections of  the vulva.
277
met with among women who do not keep  the sexual parts
very clean.  Often a proper regimen is sufficient to remove
this itching.  If these means are not sufficient, we may give:
Conium, Carbo veg., Natrum muriaticum,  Sepia, Sulphur,
Calcarea.
  Among the cutaneous  diseases of  the vulva,  we dis-
tinguish : 1st, erythema, which causes  efflorescences and ex-
coriations of the vulva; it  is  apt  to co-exist with acrid and
corrosive leucorrhoea, or is  frequently found in  fat females;
2d, erysipelas, which  frequently  invades the labia majora,
nymphae and clitoris; the affected parts, which  are hot, red
and swollen, soon  become oedematous, and even covered with
gangrenous sloughs; 3d, herpes,  which  has the same cha-
racteristic  signs  as herpes  praeputialis, and  whose vesicles
leave behind them superficial excoriations, which soon become
covered with crusts and heal within eight or ten days, which
is not the case with the syphilitic eruptions with which they
might sometimes  be confounded;  4th, eczema,  likewise ac-
companied  by  excoriations and  intolerable  pains,  painful
emissions of urine, pain during coit, and  vaginal dischage,
having an insipid smell; 5th, lichen, characterized by papulae,
occupying an erythematous base  ; they cause an intolerable
itching, which increases towards  evening  or at night,  and
which, after  scratching, is  followed  by  excoriations that
secrete a bloody serum, and then become covered with crusts ;
6th, prurigo, characterized by papulae that are larger  and
paler  than lichen,  occupying the mons veneris, the labia
majora and the mucous membrane of  the  vulva; often this
prurigo  is accompanied by vaginitis,  with a more  or  less
copious  and irritating discharge.   All these eruptions often
cause  an intolerable itching, which leads patients to commit
onanism; prurigo especially causes a  tormenting desire for
sexual intercourse.  The best remedies
For all these eruptions, are:—Sepia, Mercurius,  Duka-
     mara, Graphites, Petroleum,  Sulphur, Angustura, Kali,
     Causticum, Bryonia, Conium, Tartari,  Natrum muriati-
     cum. 
278
diseases of females.
For erythema and excoriation:—Carbo vegetabilis, Causticum,
     Graphites, Sulphur,  Sepia, Ammonium, Ambra,  Lyco-
     podium, Mercurius, Hepar sulph., Nitri acidum, Thuja.
For  erysipelas:—Belladonna, Hepar,  Pulsatilla,  Lachesis,
     Mercurius, Rhus, Euphorbiwm.
For  herpes:—Nitri acidum, Mercurius, Dulcamara,  Phos-
     phoricum acidum,  Petroleum, Sepia.
For  eczema:—Graphites,  Sulphur,   Sepia,  Staphysagria,
     Aconitum.
For  lichen :—Aconitum, Sulphur, Dulcamara, Lycopodium,
     Cocculus,   Natrum   muriaticum,   Cicuta,   Muriaticum
     acidum.
For  prurigo :—Aconitum, Nitri acidum, Sepia, Mercurius,
     Arsenicum, Sulphur, Mezereum.
  Moreover, if the  itching is too  troublesome, or seems in-
tolerable, and neither Aconitum or Sulphur is  of any avail,
we may have the parts rubbed with sweet oil, or with brandy,
especially if the itching comes on at night.  This may afford
relief.   Washes of camphorated alcohol mixed with water, or
starch-flour applied to the parts, may likewise prove servicea-
ble.   Sometimes the internal use  of Mercurius, Sulphur or
Carbo veg., may do good, especially if  the  trouble comes  on
at night;  the itching which comes on at night, after getting
heated in bed, often yields  to Pulsatilla;  that which is ac-
companied  by burning and smarting, to Hepar, and, if blood
oozes out after scratching, we  may give Mercurius or Sul-
phur, we refer the reader to our work on Cutaneous Diseases,
Paris, 1850.*
  Syphilitic affections of the vulva are : chancres, flat tuber-
cles  and venereal vegetations.   Chancres generally occupy
the internal surface of the  labia majora or nymphae;  they
are  almost always  more  superficial  than in the male, and
sometimes disappear with  an incredible rapidity, leaving be-
hind them an indurated spot, which is  exceedingly  obstinate
  * Translated by Charles J. Hempel,  M. D., and published by W. Radde,
322, Broadway, New York. 
affections of  the vulva.
279
against treatment, especially after the  absurd cauterizations
of the old school had previously been resorted to in the treat-
ment.  Flat condylomata are always a secondary symptom of
syphilis.   They increase prodigiously  by a want  of cleanli-
ness, so that they are sometimes found in unclean individuals,
scattered  in  large  numbers, on  the external  and internal
surface  of the labia, whence they often spread towards  the
perinaeum, as far as the anus and thighs.  Cleanliness some-
times causes  them  to  disappear, but they always incline to
return as  long as  the general syphilis  is  not cured.  Syphi-
litic vegetations of the  pudendum  are  the same as those of
the male prepuce.   They are even more frequent in females,
and are more inclined  to penetrate into the female urethra.
They are  met with more particularly in young women and in
lymphatic and fair-complexioned females.  As regards treat-
ment, chancres generally yield to the continued use of Mer-
curius, second or  third trituration.  The same may be said
of flat condylomata; vegetations require  principally:  Nitri
acid., Thuja, Lycopodium, Sarsaparilla.
   The vulva is often  the seat of  ascarides, which crawl in
from  the  lower part of the rectum, and  cause such violent
itchings  in the vulva  and such a  violent desire for  sexual
intercourse, that  a real nymphomania may be  the  result.
The best remedies for this affection are: Nux vomica, Aconi-
tum, Ignatia, Urtica  urens, Ferrum, Sulphur, Silicea, Cal-
carea. AVashes of diluted camphorated alcohol are sometimes
very useful.
   Lice are generally found  among the hair growing around
the parts, whence they often crawl  up to the  armpits, eye-
lids and lashes.   The best and most harmless remedy is snuff
mixed with oil or  butter, with which the  parts should  be
rubbed.   Two or  three frictions at an interval of twenty-four
hours between each, are abundantly sufficient; in most cases
one friction will answer.  Mercurial frictions  are often in-
jurious to the health, and do not effect any  more than snuff.
Essence  of bergamotte likewise  destroys these insects very
speedily,  and has  moreover  the  advantage  of  having  a 
280
DISEASES OF FEMALES.
pleasant odor and of not staining the linen; this agent has,
however, the  inconvenience of causing a good deal of heat
and smarting, for twenty-four hours or more, without however
inducing any further trouble.   Lastly, the essence of turpen-
tine destroys  these insects as speedily as tobacco, but has a
rather unpleasant smell, and causes a burning and smarting
on the skin.
                    ARTICLE XIV.

    AFFECTIONS  OF THE BREASTS AND NIPPLES.

                      Section 102.

  General observations__Having to speak of the anoma-
lies of the  secretion of milk in the chapter on Lactation or
Nursing (Chapter III., Article 9,) we shall here treat only of
such diseases of the breasts and nipples as may occur at other
periods than those  of pregnancy or nursing.  In this article
we have only to treat of inflammations, divers tumors, cancer,
neuralgia, and  injuries of the breasts, and of general affec-
tions of the nipples.

                     Section 103.

  Inflammations, catarrhal  affections  and abscesses
of the breasts.—Inflammations of the breasts present three
distinct forms according to  the anatomical seat  of the  dis-
ease :—
  1. Inflammation of the mamma  proper, or of the adipose
layer, resembling inflammatory erysipelatous, with  swelling,
pain, heat,  and a more or less intense redness of the part;
the fever is proportionate to the extent of the inflammation.
The causes of this  inflammation are sometimes external,  and
at times internal.  It may be caused by erysipelas, erythema,
eczema, porrigo, and by any other cutaneous affection of the 
        AFFECTIONS OF THE BREASTS AND NIPPLES.    281

 chest, or by the rubbing  of the corsets, a blister, burn, etc.;
 in all these cases the inflammation develops itself from with-
 out  inwards.   Inflammation may likewise be incidental to a
 pre-existing disease of the secretory tissue, such as milky and
 other engorgements, in which  case the inflammatory process
 travels from within outwards.
   2. Deep-seated inflammation of the breast, generally with
 inflammatory fever, and  a good deal of swelling extending
 under the arm, the breast being tense, smooth, round, and
 traversed by full veins.   This inflammation may be induced
 by the same  causes  as  the preceding;  it may likewise be
 caused by a disease of the chest, such as pleurisy, organic
 disease of the  lungs, thoracic effusions, fracture of  a rib,
 caries, etc.   Sometimes  it arises  even spontaneously, or  in
 consequence of  unknown  internal causes, or as a sequel of a
 general febrile disease.
   3. Inflammation of the mammary gland, attacking prin-
 cipally women who were recently  confined, wet-nurses,  and
 being caused by a catarrhal irritation of the lactiferous parts
 of the breasts, or by external violence, such as blows, a fall,
 contusions, etc.   AVhat distinguishes  this inflammation from
 the former is, that the pains and swelling are scattered through
 the substance of the breast which is  not very much  swollen,
 but where we may discover with the finger a few painful indu-
 rations.   Sometimes this  variety is complicated with the one
 or the other mentioned previously.
  These inflammations almost always pursue the same course;
 that of the mammary gland is  rather slower than the course
pursued  by the other varieties; but  all three  may terminate
in resolution, induration  or  suppuration.   If left to them-
selves, or under Old-School treatment,  these inflammations
generally terminate in suppuration, by  forming abscesses,
which it is more or  less difficult to heal.
  These abscesses of the breasts, which are always the result
of a previous inflammation, may be as varied,  as  far as their
locality is concerned, as the inflammations themselves;  but
the internal treatment of these abscesses is not  affected by 
282
DISEASES OF FEMALES.
their divisions into classes.   It may be observed, however,
that whereas simple inflammatory abscesses of the mammary
tissue are easily cured by proper treatment, abscesses of the
mammary gland are quite obstinate.  The presence of these
abscesses is ascertained by the symptoms which have preceded
their  development, by the existing fluctuation  and by the
other external signs of abscesses in general.  All these ab-
scesses show a great tendency to spread and to cause ulcera-
tion of the adjoining parts,  or  to  develope  fistula? of every
variety, and difficult to cure.
   Such fistula? may be simple sinuous canals continuing after
the breaking of the abscess,  or canals one extremity of which
terminates at the surface of the breast, and the other commu-
nicates  with  a milky duct.  These latter  fistulae, the real
galactophorous fistulse, generally have a very narrow cutaneous
orifice from which exudes a greater or less quantity of a sero-
purulent or milky fluid.   These fistulae of course  are only met
with among wet-nurses and  women that  were recently con-
fined.
   These affections can always be cured by the internal  means
furnished by homoeopathy.   In acute inflammation, no matter
where seated, Belladonna is always the principal  remedy,
especially if there be hard  swelling, lancinating or tearing
pains, and erysipelatous  redness  which  radiates from the
center towards the periphery.   Sometimes  this  remedy may
be alternated  with Bryonia, which  is ever preferable in  in-
flammation of the mammary gland, in the case of wet-nurses
or recently-confined women, if the breasts are rigid,  hard,
with tensive pains, and burning heat externally.
   If  Belladonna and Bryonia,  do not succeed  in scattering
the hardness  and pains  in  the  breasts, or  the  erysipelatous
redness, we may  give Mercurius.
   If the formation of an  abscess had to be feared, Mercurius,
Hepar, Lachesis and Belladonna, may be given.   Mercurius,
often favors the breaking of the  abscess, if pus has formed
and resolution is no longer possible.
   If the abscess is formed, give Silicea, Phosphorus and Sid- 
       AFFECTIONS OF THE  BREASTS AND NIPPLES.    283

phn:   Silicea and Phosphorus are suitable even in the most
dangerous cases, no matter where the abscess may be seated
or what its nature may be.
   For induration after inflammation, we give:—
       1. Carbo  animalis,  Conium, Silicea.
       2. Chamomilla, Belladonna, Phosphorus,  Graphites.
       3. Sepia,  Clematis,  Arnica,  Nitri acidum.
       4. Mercurius, Lycopodium,  Pulsatilla, Calcarea.
  For inflammations caused by contusions or external violence,
we give  Belladonna, Mercurius Bryonia, Silicea, Phospho-
rus, Lachesis; and if these remedies are not sufficient, Co-
nium,  Carbo animalis, Arnica.
   Dose of all these remedies.—One or two drops of the
liquid  attenuation morning and night in  chronic  cases; in
acute cases mix one drop in ten table-spoonfuls of water, and
give a table-spoonful of this solution every three or four
hours.

                      Section  104.

   Tumors, cysts, hydatids, lipoma and hypertrophy of
the mamma.—AVe shall  have to treat  here of the following
affections:—Simple engorgements, milky and buttery tumors,
cysts, fibrous, cartilaginous and osseous tumors.  Milky en-
gorgements will be treated in the Third Chapter, where we
speak of the ailments incidental to nursing.
   Simple engorgements or catarrhal irritations of tite
mammae,  are transitory swellings of the breast, such as are
sometimes seen after a sudden  suppression of the menses.
These engorgements often arise with a wonderful suddenness,
so that, in one night, the breasts sometimes swell up to double
or treble their normal size,  and cause a good deal of trouble.
But  this  condition, howsoever dangerous it may seem,  is not
serious, and generally ceases again as  soon  as the menses
either reappear or the number of  days during which  they
ought to  have been flowing, is passed.  Hence the treatment
should  simply aim  at restoring  the menses, if  they do not 
284
DISEASES OF FEMALES.
reappear of themselves.   For this  purpose we  give princi-
pally:  Pulsatilla, Bryonia, Conium, Sulphur, Lycopodium.
  Milky or buttery  tumors always result from an infiltration
of milk between the lobules or excretory canals of the gland,
which may be the effect of a  simple trunsudation or of some
rupture.   When these tumors are punctured while recent, a
pure milk spirts out, which, if allowed to stand for  a couple
of hours,  becomes covered with a layer of grease.  In old
tumors, the milk changes to a  creamy, buttery, or cheesy
substance.   In  most cases, these tumors form shortly after
confinement, or at least during the period of nursing ; and at
this period, might give rise to a  belief, owing  to  the fluctua-
tion which is perceived in them, that suppuration is taking
place,  were it not that all signs of inflammation are  abso-
lutely wanting.   If the milk does not flow out  either through
a spontaneously or  artificially made opening, the tumor be-
comes an indurated  cyst, which may continue for years with-
out any great embarrassment to the patient.  The best reme-
dies for this affection  are: Belladonna, Bryonia, or Mercu-
rius, by the use of which a dispersion of the  tumor  may
always be attempted in recent cases; as regards old tumors
of this kind, we do not know whether they can  be  removed
by internal treatment.   However, if sarcomatous cysts will
gradually disappear under the action of the natural forces of
the organism, assisted by internal treatment, why should not
such indurated milky cysts likewise yield to similar influences ?
At any rate, we may assist the process  of  natural dispersion
by the use of Calcarea, Graphites, Sulphur, Baryta, Hepar,
Nitri acidum.
  The mammary cysts, properly speaking, differ as regards
contents.   We  distinguish, 1st, hydatic or  serous cysts, with
fluctuation,  and  affecting, without  any  particular  cause,
women of all ages  and constitutions; 2d, sero-sanguineous
cysts, filled with a black or reddish fluid, having  some resem-
blance to menstrual blood, and forming a knotty tumor where
globular, elastic, and fluctuating masses are discovered ; 3d
sero-mucous cysts, containing a  gray or yellowish substance, 
       AFFECTIONS OF THE BREASTS AND NIPPLES.    285

and exhibiting  tumors  resembling glandular indurations.
The two last-mentioned cysts often result from blows or con-
tusions,  or  from any other external violence.  These  cysts
are  not  dangerous;  however, hydatic cysts, if left to them-
selves, may grow to  an unlimited  extent, and finally consti-
tute a dangerous disease; as regards the first-named variety,
it sometimes  disappears spontaneously.  In treating  these
cysts, we may derive benefit, in the treatment of  hydatic
cysts, from the use  of: 1,  Pulsatilla, Graphites, Rhododen-
dron, Sulphur,  Silicia, Arnica, Lycopodium, Nux vomica,
2, for sero-sanguineous cysts :  Arnica, Conium, Sulphuris
acidum,  Lachesis.   3, for sero-mucous  cysts,  perhaps:
Conium.  Encysted  hydatids, which must not be confounded
with the  hydatic cysts of  Velpeau that we have described just
now, are encysted tumors  with cavities, containing acepha-
logist worms ; according  to Cooper, they may be recognised
by a fluctuation in the centre of the tumor, by the induration
of the tissues that envelope the cyst, and by an absence of
pain to pressure.  We are not acquainted with any remedy
that has been used for these cysts with  success, but we will
suggest: Sulphur, Mercurius, Arsenicum, Cantharis.
   Lipoma of the breast is  a partial  hypertrophy of the adi-
pose tissue, a fatty  tumor, having all the characteristics of
lipomas in other parts of the body, and forming in the breast
a lobular, well circumscribed, pendulous, and even sometimes
pediculated  tumor.   Sometimes the lipoma is  not a definitely-
circumscribed tumor, but  is intermediate between general and
partial hypertrophy  of the  adipose tissue.   The best medi-
cines for these tumors are : Baryta, Calcarea, lodium, Anti-
monium, Sulphur, Lycopodium.
   Hypertrophy of  the breast very seldom  results  from an
excessive development of the adipose  tissue  of  the mamma;
in most cases, this hypertrophy only affects  a portion of the
adipose substance, thus constituting tumors which we  have
described before, under the name of lipoma.   There are two
other kinds  of hypertrophy which are much  more frequent;
they are :—glandular and  celluh-fibrous hypertrophy.   The 
286
DISEASES OF FEMALES.
former variety, which is almost always a characteristic of, and
results in, pendulous breasts and which consists  in  an exces-
sive development of the parenchyma of the mamma, is very
frequently met with in America, England and Germany; it
is especially observed from the age of pubescence to the age
of thirty or thirty-five, and may not only lead to an enormous
increase of the breasts, with excessively distressing malforma-
tions, but may likewise terminate in death.  In celluh-fibrous
hypertrophy, which almost always results from inflammation
and subsequent induration, only one breast generally becomes
swollen, and  tumours may  form which are very  much like
schirrus, and cases of which have undoubtedly been reported
to the world  as cured under the supposition that they were
schirrous tumors.   We shall say something concerning the
diagnosis of these tumors in our paragraph on  Cancer.  As
regards treatment, we recommend for glandular  hyper-
trophy:—Iodine,  Mercurius,. Natrum,  Spongia,  Calcarea,
Natrum muriaticum, Ambra.  For cellulo-fibrous  hyper-
trophy:— Conium, Carbo  animalis, Clematis, Silicea, Phos-
phorus.
  For a description and the treatment of fibrous, cartilagi-
nous and osseous tumors, which are more less  frequently met
with in the mammae than in the womb, we refer the reader to
our remarks  on  this subject, to Sections 75-79, where these
tumors  of the womb are treated of.

                      Section 105.

  Schirrus  and cancer of the breasts.—Cancer of the
breasts  is much  more frequent  than is generally supposed.
It occurs most frequently between the ages of thirty and fifty
years, and especially at  the critical period, although the dis-
ease has likewise been observed  between  the ages of  twenty
and thirty.   In  many cases the disease seems to have  been
induced by external injuries, blows, contusions,  etc.  Some-
times  the  disease sets in  immediately after the  injury is
received; at other times at the end of  three, four and twelve 
       AFFECTIONS OF THE BREASTS AND NIPPLES.    287

months.  Very often the affection  commences with a little
induration  that does not seem natural, but which  does not
cause any inconvenience or derange the general health.  This
hardness increases more and more, from the size of a small
nut to that of a hen's egg; its surface becomes rough, and the
edges of the tumor adhere to the skin and even to the mus-
cular substance.   At the same time painful stitches are felt
in the tumor, especially  towards evening and at night; the
axillary glands become enlarged and painful; the mammary
tumor grows more rapidly; the general health becomes altered;
a general emaciation takes place;  the complexion becomes
straw-colored ;  her appetite decreases, or becomes queer and
irregular.   The tumor which had become sensitive to contact,
begins to protrude; the skin  that covers the  tumor, becomes
reddish, livid; the veins in the tumor become more and more
apparent;  the  nipple  retreats more and  more, and finally
sinks in altogether, and at the reddest part a little crack takes
place, from which some serum escapes.  This is the  beginning
of the ulcerated cancer; the edges of the fissure recede from
each other,  become thickened,  everted, and  the  cancerous
ulcer soon becomes covered with reddish vegetations and the
seat  of an  ichorous and often very fetid  suppuration, with
lancinating,  smarting, burning,  aching or  itching pains.
From this  moment the disease affects the whole constitution,
and the general symptoms of a cancerous cachexia develope
themselves with more or less intensity; the whole body assumes
a wax-colored  aspect; the patients experience an extreme
anxiety and malaise; they are tormented by  febrile motions,
restless; a dry and frequent cough sets in,  and in proportion
as the constitutional disorder increases, the local disease be-
comes worse.  Soon the whole breast is invaded, the pectoral
muscles  are destroyed, the ribs  are laid bare;  under the in-
teguments deep excavations are perceived, and the angular
and sinuous surface of  the sore, covered  with gray-colored
and fetid pus, exhibits the most hideous aspect.   At the same
time the general symptoms continue to grow worse; the ema-
ciation becomes excessive;  an almost constant oppression of 
288
DISEASES  OF FEMALES.
breathing torments  the  patient,  together  with the racking
cough; the aversion to food becomes intolerable ; a distressing
constipation sometimes alternates with colliquative diarrhoea;
and finally the patient perishes, exhausted by hectic fever and
agonizing distress.
   Open or  ulcerated cancer is easily diagnosed;  as long as
the tumor has not advanced  beyond the schirrous stage, the
diagnosis is  quite difficult; for there is no distinctive sign by
which  schirrus  is  distinguished  from the  other tumors of
which mention was made in the preceding  paragraph.   This
is  particularly  so at the onset of the  disease.  At a later
period, the livid redness of the skin covering the tumor, the
veins that traverse it, and which become from day to day more
apparent; the adhesions which the tumor forms with the skin
and  muscles, are, indeed,  characteristic signs which belong
almost exclusively  to schirrus; but before schirrus arrives
at this stage, there is scarcely any difference  between schir-
rus and other tumors of the breast.   As far as the lancinating
pains and the  enlargement of the axillary glands  are con-
cerned, other tumors of the breast  are likewise accompanied
by such signs.  As regards relapses after an operation, they
simply show the uselessness of such surgical  proceedings in
the management  of cancerous tumors.   The occasional suc-
cess  obtained in the extirpations of ordinary tumors  from the
breast, does not justify a similar operation in the case of cancer.
In almost every case the other breast soon begins to enlarge,
sometimes after the lapse  of six or eight months,  and this
new  cancer,  which develops itself after  the operation, pro-
gresses  towards a  fatal termination with  a  most frightful
rapidity.
  As far as  the treatment of mammary tumors is concerned,
every conscientious  homoeopathic or alloeopathic  physician
should oppose their extirpation with the knife, as long  as the
character of the tumor is not known beyond all possibility of
doubt, and more particularly in all cases of schirrous tumors.
Even though we should feel convinced that the tumor cannot
be cured by internal treatment, yet nothing  is lost by not 
        AFFECTIONS OF  THE  BREASTS  AND NIPPLES.   289

 resorting to the operation;  on the contrary, just so long as
 we postpone the operation, the life of the patient will be pro-
 longed.   The  celebrated Doctor Walther, Professor of Sur-
 gery in the University of Bonn, told us in one of his lectures:
 "i am so fully convinced of the uselessness of operations in
 cancerous affections,  and  of the impossibility  of preventing
 relapses,  that I have given up all attempts  to extirpate cancer
 with the knife,  except in  cases of  open cancer, where I resort to
 the operation simply in order to free the patient for some months
 at least, from such a horrible sorer  If extirpations with the
 knife  are pernicious, leeches, blisters,  and  ointments with
 which scirrhous tumors used to be treated by old  school
 physicians,  are no  less so;  more than one  scirrhus which
 had only just  commenced  to show itself,  has been rapidly
 converted into an open sore by the application of such  exter-
 nal means.   The only true method of treating cancer, is by
 internal specific remedies.
   The principal remedies for the dispersion of schirrus, and
 which sometimes have  effected  cures,  are: Conium, Cicuta,
 Carbo animalis, Clematis,  Silicea,  Phosphorus, Rhus,  and,
 perhaps, also,  Mercurius bromatus.
   In open cancer we may use:  Arsenicum, Silicea, Clematis,
 Graphites,  Kreosotum,   Conium,  Cicuta, Belladonna, Hepar,
 Lachesis.
   Dose:—One or two  drops of the  liquid attenuation, in a
 tumblerful of water, of  which solution a tablespoonful may
 be given every four  or six hours.

                       Section  106.

  Mechanical injuries of the breast.—In this paragraph
we mean to treat of external injuries, (blows, contusions, etc.,)
wounds, and such like  accidents.  Every  body knows that
such lesions may be attended by dangerous  consequences.
But here, too,  the  application of leeches,  ointments, etc., is
exceedingly pernicious.   The only proper application is cold
water mixed with  the  tincture of Arnica, 10  drops of the
                            19 
290
DISEASES OF FEMALES.
tincture in a tumblerful of water.  Linen compresses mois-
tened with this solution are to be applied to contusions, blows
and to wounds with solution of continuity.   At the same time
we may give internally six globules of Arnica 15, dissolved
in 6  tablespoonfuls of water, of which  a  teaspoonful should
be given every three hours.   In old wounds Arnica is scarcely
advisable.  In  such  cases we  have to use Conium, Silicea,
Phosphorus, Hepar,  Mercurius, Sulphur, Pulsatilla, Cicuta,
two or three globules of 15th to 30th attenuation, dry on the
tongue  every three  or four days, changing the remedy if,
after the  fourth dose, no sign of improvement  has become
manifest.   Moreover, we may  use more particularly:
In simple contusions :—Arnica, Conium, Sulphuris acidum,
     Ruta, Pulsatilla, Hepar, Euphrasia,  Sulphur, Cicuta,
     lodium.
For ecchymoses -.—Arnica, Sulphuris acid.,  Conium, Ruta,
     Sulphur,  Hepar, Pulsatilla,  Rhus,  Bryonia, Dulca-
     mara, Lachesis, Nux vomica, Euphrasia, Chamomilla,
      China, Plumbum.
When the wound bleeds a good deal:—Phosphorus, Lachesis,
     Arnica, Sulphur, Carbo vegetabilis, Sulphuris acid., Pul-
     satilla, Mercurius, Hepar, Phosphori acid.
 When  the wound  is  inflamed :—Mercurius,  Chamomilla,
      Pulsatilla, Aconite, Silicea, Arnica, Sulphur, Rhus, Gra-
     phites, Hepar, Sulphuris acid.
 When there is suppuration :—Mercurius,  Sulphur, Chamo-
      milla, Pulsatilla, Hepar, Belladonna, Silicea, Lachesis,
      China, Asafoetida, Plumbum.

                       Section 107.

   Neuralgia and  neuralgic  tumors of  the breast:—
 This affection  is characterised by keen pains, with or without
 swelling.  In  either case  the pain is, if not  the only symp-
 tom, but the predominant symptom of the morbid  condition,
 and these pains are sometimes  so acute,  that women would 
       AFFECTIONS OF THE BREASTS AND NIPPLES.    291

rather have their breasts  amputated than bear such pains
any longer.   The pains are generally stinging or lancinating
pains, recurring or exacerbating at longer or shorter inter-
vals.   In most cases these pains are seated in the breasts
themselves; at other times they seem  to proceed from the
uterus.   They may exist without swelling, though sometimes,
even  if the  breasts  are  not  swollen, they are  fuller, more
rigid  and more sensitive to pressure than usual.  In  case of
swelling, an induration of the mammary gland  is perceived,
which feels knotty without having much increased in volume,
or without the least trace of engorgement or inflammation
being present.   Women of twenty-five  to forty are princi-
pally subject to  this disease, although young girls affected
with dysmenia may likewise be subject to it.   This affection is
not serious in itself,  and  often disappears again without leav-
ing any trace behind.  In other cases the induration of the
mamma consists in an agglomeration of nodosities or granules
scattered around the gland,  and causing  acute lancinating
pains which are the source of much distress to those who are
affected with them.   This variety is peculiar to females who
are near the critical period, and who often feel very  uneasy
in consequence of such swellings, although there is no cause
for serious apprehensions.  In the former variety the  nodosi-
ties are so little developed that they are scarcely perceived.
In this case the pains are radiating, accompanied with a little
heat and numbness of the breast.  Finally in other cases, we
observe small rounded lenticular tumors, from  the size of a
coffee-bean to that of a lima-bean.
  In  regard to the course  of  these neuralgic tumors, we
generally see the breast  enlarge, if the gland is  affected by
the pain; several  lobes of the gland become extremely  painful
to the touch, and the pain which is thus excited, sometimes
lasts for some hours.   The lancinating  and throbbing pains
sometimes extend from  the  breast to  the  shoulder, axilla,
elbow and even fingers, or hip on the side of the body cor-
responding to the diseased breast.  The patient  is absolutely
unable to sleep on the affected side; sometimes she is even 
292
diseases of females.
unable to lie on this side;  in  some cases the weight of the
breast, in the bed, is sufficient to cause intolerable pains which
are sometimes so distressing that they excite vomiting.   At
the approach of the menses the pains generally get worse,
and are somewhat relieved during the menstrual  flow.   These
sufferings  may continue for weeks  and even years, without
any perceptible diminution; but the disease does not at all
incline to  degenerate into malignant tumors.
  As regards treatment,  we have as yet no perfectly posi-
tive clinical experience.   From analogy, and from experience
in similar neuralgic affections, we are led to recommend  the
following remedies:—
       1.  Graphites, Chamomilla, Aconitum, Spigelia, Mercu-
         rius, Arnica, Bryonia,  Veratrum, Nux vomica.
       2.  Cocculus, Pulsatilla, Zincum, Phosphorus.  China.

And in particular:—
     For vodosities:—Graphites, Conium, Chamomilla,  Car-
         bo animalis,  Clematis, Silicea, Graphites, Baryta,
         Belladonna, Bryonia, Sulphur.
     For  LANCINATING  pains :—Graphites,  Sepia,  Conium
          Carbo animalis,  Aconitum,  Spigelia, Mezereum,
         Phosphorus, Zincum,  China,  Cocculus,  Veratrum,
          Verbascum, Belladonna.
     Sensitiveness to  touch  :—Alumina,  Graphites, Pulsa-
         tilla, Sulphur, Nux  vomica, Sabina, Senega, Rhodo-
         dendron, Strontiana.

                       Section 108.

   Diseases of the nipples.—The most frequent affections
of  the nipples, are:—cracks  and fissures,  excoriations, in-
flammations, abscesses and exanthemata.  Excoriations are
frequently met with in the  case of nursing females who some-
times  suffer so much from  such excoriations, that they have
to give up nursing.  AVomen who nurse for the first time, are
  articularly liable to this difficulty, especially when the nipple 
       AFFECTIONS OF THE BREASTS AND NIPPLES.    293

is  short, hard and covered with a fine and delicate skin, or
when they are of a lymphatic temperament.  These excoria-
tions often give rise  to cracks or fissures, which are princi-
pally seated round the base of the nipple, or in the nipple
itself, or even in the  areola round the nipple.  In proportion
as they increase, they become more painful, deeper and fre-
quently discharge a copious quantity of blood.
  The inflammations of the nipple are almost always limited
to the areola, and are scarcely ever met with except as a
sequel of the cracks  and  fissures consequent upon nursing.
These  inflammations  may  sometimes give rise to  abscesses
which  are of the same nature as  abscesses in other parts of
the body, and which are sometimes  present  in considerable
numbers, and scarcely ever attain to the volume of a  hen's
egg-
   Among the  exanthemata  of  the nipples, we sometimes
distinguish eczema, impetigo, pityriasis, or a species of pso-
riasis or even syphilitic eczema.
   As regards treatment,  we shall  revert to it hereafter, at
least as far as inflammations,  cracks  and  abscesses are con-
cerned, in speaking of the ailments incidental to nursing.
All  we shall do here, is to indicate most generally the prin-
cipal remedies for this affection; they are :—

       Pulsatilla, Chamomilla,  Ignatia,  Lycopodium,   Gra-
         phites, Sulphur, Arnica, Mercurius, Silicea,  Sepia,
          Calcarea, Bryonia, Sabina, Bismuth, Rhabarbarum.

And in particular:—
     For simple inflammations:—Chamomilla,Ignatia, Sili-
         cea, Calcarea, Phosphorus, Sulphur.
     For excessive sensitiveness:—Graphites, Zincum, Rha-
         barbarum, Manganum.
     For excoriations:—Arnica, Sulphur, Ignatia, Chamo-
         milla, Pulsatilla, Calcarea, Graphites, Silicea,  Lyco-
         podium,  Causticum, Mercurius, Sepia, Nux vomica,
         Manganum. 
294              DISEASES OF FEMALES.
    For cracks and fissures:—Sulphur, Graphites,  Caus-
         ticum, Pulsatilla, Chamomilla, Mercurius, Silicea.
    For abscesses :—Silicea, Hepar, Phosphorus, Mercurius,
         Chamomilla, Kreosotum.
Afterwards:—
    For exanthemata of the nipples and breasts in general:—
      1. Sepia, Lycopodium, Phosphorus,  Plumbum, Carbo
         vegetabilis, Sulphur, Cocculus Ipecacuanha.
      2. Bryonia, Belladonna, Hepar, Lachesis, Staphysa-
         gria, Silicea, Rhus, Strontiana.
      3. Mercurius, Arsenicum,  Calcarea, Bovista,  Coni-
         um, Belladonna, Alumina, Ammonium muriati-
         cum, Mezereum, Nitri acidum.
In particular:—
    For spots in general:—Sepia,  Phosphorus,  Cocculus,
         Carbo vegetabilis, Ipecacuanha.
      2. Belladonna, Sulphur, Arsenicum, Ledum, Nitri
         acidum, Lachesis, Arsenicum, Ammonium muriati-
         cum, Mezereum, Manganum, Squilla.
    For brown spots:—Sepia, Carbo vegetabilis, Sulphur,
        Lycopodium.
    For hepatic spots:—Lycopodium, Sulphur, Carbo vege-
         tabilis, Sepia, Phosphorus, Arsenicum,
    For yellow spots:—Sepia, Lycopodium, Phosphorus,
        Sulphur, Arsenicum.
    For red spots:—Ledum, Sabadilla, Belladonna, Ipeca-
        cuanha, Phosphorus,  Cocculus,  Lachesis, Meze-
        reum, Magnesia.
    For pityriasis -.—Petroleum,  Causticum,  Dulcamara,
        Staphysagria, Phosphorus, Arsenicum.
    For scabs and crusts :—Lycopodium,  Petroleum, Caus-
        ticum, Arsenicum, Dulcamara, Staphysagria.
    For itching:—Sulphur, Alumina, Petroleum, Conium.
  Dose—The same as at the close of Section 105. 
      affections of the breasts and nipples.    295

                      Section 109.

  Atrophy of  the nipples and breasts.—Atrophy of the
nipples is not a very rare disease; in many women, in conse-
quence of some malformation, or of the pressure of the dress,
the nipple is short, flat, atrophied, so that, instead of project-
ing, a depression exists in its place.   According to our expe-
rience, Sarsaparilla has the best effect on this difficulty.
  We will  add to this a few remarks concerning  atrophy of
the breasts, owing  to  which they either  remain undeveloped
at the age  of pubescence or decrease in  volume, after having
acquired their full development.  Either the adipose tissue or
the glands, or the whole breast, may  become atrophied in
either  way, from  deficient  nutrition which  may induce a
general atrophy, or  simply from some  morbid state of the
breasts exclusively.  This latter case sometimes arises from
abuse of lodium or Mercurius, or from  pre-existing diseases
of the breasts, inflammations, neuralgia, suppressed eruptions,
deprivation of nursing in mothers, or from uterine affections
and other  influences.   Whatever may  be the cause of this
affection, whenever the  atrophy does not depend upon consti-
tutional  atrophy or marasmus, but  develops itself in  young
girls of otherwise good health, and where, to judge from their
general constitutional development, the mammae should be
well developed, the following remedies sometimes are of great
use in restoring a normal condition  of the parts:—
       lodium, Conium, Nitri acidum, Nux moschata, Phos-
         phorus, Hepar, Silicea, Cocculus, Ignatia, Coffea,
          Calcarea, Nux vomica, Nitri acidum, Secale, Phos-
         phori acid., China, Sulphur, Bryonia.
 And in particular:—
     If caused by abuse of iodine:—Hepar, Phosphorus,
          Sulphur, Arsenicum, China.
     Of  mercury:—Nitri acidum, China, Phosphori  acid.,
          Hepar, lodium, Sulphur. 
296              DISEASES OF FEMALES.

    After  sexual excesses:—Bryonia,  Phosphori acid,
         Calcarea, Sulphur, Sepia,  Ignatia,  China, Nux
         vomica.
    Inflammations of the breasts:—Phosphorus, Silicea,
         Conium, lodium.
    Deprivation of  NURSING:—Phosphorus, Nux vomica,
         Secale.
    Suppressed  eruptions:—Calcarea, Sulphur, Arseni-
         cum.
    With neuralgia:—Cocculus, Coffea, Ignatia.
  If the mammae develope  themselves too slowly at the  age
of pubescence, we recommend, Nux moschata, Conium.
  Dose.—The same as at the close of Section 105. 
derangements incidental to pregnancy.   297
SECTION THIRD.
    FUNCTIONAL DERANGEMENTS INCIDENTAL TO
          PREGNANCY, CONFINEMENTS, ETC.

                      Section 110.

   General observations.—In this  Section we shall have to
treat of the following subjects:—Pregnancy, Parturition,
Confinement, Nursing and Weaning  ; and we shall describe
the ailments and diseases which may  be incidental to each of
these conditions.  Pregnancy being,  so to say, the basis from
which all the other  functions of maternity emanate, we shall
consider it more in detail, not  only as a physiological state,
but  likewise with regard to the  ailments,  be  they light or
serious, which may set in as  a sequel  of pregnancy. Our aim
shall be to enable the reader to distinguish clearly between
the really serious and the unimportant ailments incidental to
pregnancy.   Miscarriage being a most serious accident which
may be followed by all  the  unpleasant consequences of  real
labor, we shall devote a separate article to it  immediately
after the diseases of pregnant females.  We shall likewise
consecrate a few paragraphs to  the management of new-born
infants, and of infants at the breast, which is a subject of the
highest importance to those who are going  to  assume the
duties of mothers.   Hence, we shall have to treat  in this Sec-
tion of the following subjects :—1, pregnancy; 2, diseases of
pregnant women; 3, miscarriage; 4, regular labor; 5, pro-
tracted  or difficult labor ; 6, regular confinement; 7, diseases
during  confinement; 8, nursing ; 9,  weaning and metastasis 
298
diseases of females.
of the milky secretion; 10, management of infants.  In  all
these  articles  we shall  of  course  confine ourselves  to the
strictly medicinal work of the attending physician ; the duties
of the accoucheur' as an operator are sufficiently well and
fully expounded in every obstetrical treatise.
                     ARTICLE   I.

            OF PREGNANCY IN GENERAL.

                      Section 111.

  Symptoms of pregnancy.—We shall not enter into details
concerning the changes which the uterus undergoes during
pregnancy;  for these changes only occupy an inferior part
in the work which we have proposed to ourselves to accom-
plish.  These changes have  reference to the volume, shape,
situation and direction, and likewise to the tissue and pro-
perties of the uterus.  During intercourse the uterus becomes
erect, together with the other genital organs, and, if concep-
tion  takes place, this turgescence  continues,  the volume of
the uterus increases  more and  more, both in consequence of
the thickening of its  walls and of the dilatation of its cavity;
the more  it expands at the fundus, the  more contracted it
becomes at the  orifice, so that, after a while, this orifice is no
longer a linear and  transversal slit, but  changes  to an oval
opening.  After the uterus has grown to a certain size, it
assumes a spheroidal shape, and at its lower extremity the
neck forms a sort of appendage, until, at full term, the uterus
forms a complete ovoid, or egg-shaped body, the neck having
become obliterated and being known  only by the rim of its
orifice.  In  the first pregnancy the lips of the neck sometimes
become very thin; but among women who have had several
children,  they  are often very much swollen and infiltrated,
and are sometimes divided into several tubercles by means of 
PREGNANCY IN GENERAL.
299
fissures,  that  have more or less  depth.   This  increase  of
volume and weight of the uterus during pregnancy, obliges
it to descend in the pelvic cavity; but from the third to the
fourth month, it becomes too voluminous to be contained in
this  narrow space; it then rises gradually, so that, at the
end of pregnancy, the os tincae is raised so  high, and pushed
so far backwards, that it can scarcely be  reached with the
finger; at  the  same time the uterus  inclines  to  one of the
sides of the abdomen, more to the right than the left.   The
uterine tissue likewise undergoes  remarkable  changes; the
serous tissue expands, the mucous follicles  become more  de-
veloped,  their secretion  increases, the menses cease to  flow
after  conception,  although  the change  in the  circulation,
which  formerly resulted in  the  catamenial discharge,  con-
tinues  to be noticed at  every period by  the modifications
experienced in the condition  of the pulse and of the general
well-being  of the woman.  At  the same time the current of
blood is determined towards the uterus ; the uterine circula-
tion becomes more  excited, the  uterine temperature is in-
creased,  nutrition  is more active, and the  organ becomes so
sensitive that the female perceives the least  movements of
the  fetus,  which  are  always  more  or  less  painful.   The
changes  in the constitution of the uterus, are accompanied by
changes  in the adjoining  organs.  The uterus, both in its
ascent and descent, drags along with it the superior extremity
of the vagina ;  the bladder is more or less  pushed backward,
and the urethra is elongated and drawn out in consequence;
the lesser  intestines which are pressed to one side  of the
abdomen, most frequently to the  left, push before them the
transverse  colon,  the  stomach and  liver; the  diaphragm
becomes  more concave, and  the thoracic cavity being dimin-
ished from below upwards, the lungs have of course less space
to breathe.   At the same time, the anterior wall of the abdo-
men becomes quite prominent; the opening of  the umbilical
ring becoming enlarged, it allows a portion of bowel and of
the epiploon to slip through,  which  explains the umbilical
enlargement perceived  in the third or fourth month of preg- 
300
DISEASES OF FEMALES.
nancy;  the  subcutaneous veins expand, and the skin,  espe-
cially on the lower portion of the abdomen, exhibits brownish
or bluish ridges forming parallel curves and remaining even
after confinement in the shape of fine veins of a shiny white
color, like cicatrices.
   Besides  these  local  symptoms,  the whole  constitution
becomes more or less affected owing to the mechanical or
sympathetic action of the uterus upon the  other organs.
The stomach in particular  is first and principally affected by
pregnancy.  Some women experience  even from the moment
of  conception a  loathing of  food, meat; they are  seized
with nausea, slime  on the stomach,  vomiting ; these  symp-
toms  generally disappear again about  the  third or fourth
month, and  are then  followed by an increased appetite, and
by better digestion; about the end of pregnancy they some-
times re-appear.   In other cases these gastric affections only
show themselves  in the last half of pregnancy, whereas the
functions of the stomach are perfectly natural during the first
months; according  to some  authors  this  peculiarity only
takes place when girls are borne, whereas, in the case of boys,
the gastric  disorders  show themselves from the first.   The
biliary  secretion  seems to decrease; the  current  of blood
seems to incline towards the upper parts of the body, whereas
the circulation in the abdominal viscera and lower extremities
is impeded ; hence come varices, oedema of the legs and sexual
organs;  the pulse of pregnant women is generally  more fre-
quent, more animated, and sometimes  fuller and harder than
that of other women.  The  breathing  is  generally  embar-
rassed and hurried during the first months of pregnancy, and
sometimes an  obstinate cough sets  in.   AAre have said before
that the menses cease to flow after  conception has  taken
place;  some women, however, continue to menstruate during
the first months, and even  to the  end of pregnancy; but
these are rare  exceptions.  Defecation is generally  impeded;
most pregnant women are troubled with obstinate  constipa-
tion.  Others  are attacked with diarrhoea;  but this  diarrhoea
occurs most  frequently during the last months of pregnancy, 
PREGNANCY IN  GENERAL.
301
and, if-the patient has not vomited any during the first months,
this diarrhoea is supposed to be indicative  of the birth of a
daughter.  At  the  beginning of pregnancy  we  sometimes
notice copious ptyalism, and, at  the end,  many women expe-
rience  frequent  urging  to urinate.  As regards the breasts,
they sometimes feel  a change from the moment of conception ;
but all women very soon experience a tension, stinging  and
pricking in the breasts; afterwards the breasts gradually
increase in volume ;  the nipple  becomes more prominent and
darker, so does the  areola around the base of the nipple ; the
veins of the mamma become more apparent; the mammary
gland  secretes viscid lymph, and afterwards genuine milk,
which  is  discharged through  the  nipple.   The cutaneous
action does not  seem increased; sometimes pregnant women
are affected with brownish  or  yellowish  spots,  especially in
the face ;  some women grow quite fat during their pregnancy.
Locomotion is  likewise  influenced  by pregnancy;  walking
and standing become painful; the  increase of weight in the
pelvis compels the female to throw back her shoulders a good
deal, in order to preserve her equilibrium.   As regards intel-
lect and the sentient brain, they have been supposed to be
influenced by pregnancy more than is really the case;  all we
know for certain is, that pregnancy increases the sensitive-
ness of  the nervous system,  and induces a predisposition for
nervous diseases.

                      Section 112.

  Diagnosis of pregnancy.—Nothing is more easy than to
recognize pregnancy after it has arrived at a certain stage,
and particularly after the movements of the fetus have been
felt; but it is exceedingly difficult to be sure of the existence
of pregnancy before this period, or to  know whether concep-
tion has taken place.  As regards the signs of conception, it
may be said that none of those  which have been presented as
such, have been  sufficiently verified  by  experience to be fully
believed in.   Among these signs some authors have recorded
the following:  a voluptuous sensation  even superior to  that 
302              diseases of females.
of coit; the retention of the seminal fluid after the act;  a
vermicular and painful movement in the iliac, umbilical and
hypogastric regions ; a sense of heaviness or swelling in the
region of the womb;  general spasm with shuddering, nausea,
and vomiting; sometime  after conception, spasmodic disten-
sion of the abdomen, anxiety, sadness, depression of spirits,
pallor, languid looks, a certain diminution of the  freshness of
the eyelids and the features, and a bluish margin around the
eyes.   There are other signs no more certain than the above,
such as aversion  to intercourse or  even to the most cherished
person, a peculiar odor of the breath, and especially a slight
swelling of the skin of the neck, which sign was considered
by the ancients as infallible.
  The only certain signs of the presence of pregnancy, are
the movements of the fetus and certain changes  in the  deve-
lopment of the womb.  Such are  the  closing of the  uterine
orifice, without hardness or any  morbid sign ; the circular
shape of ^this orifice  in women who  have not yet had any
children ;  the dilatation of the body of the uterus  posteriorly;
the increased weight of this organ when  raising it with the
finger, etc.  But all these  signs may exist when the uterine
enlargement is due to other  causes than pregnancy; unless
the presumed period of pregnancy corresponds to the degree
of dilatation and  the  uterine development takes place in
regular progression from the body of the womb downwards
towards the neck; to which the absence of any other morbid
symptom may  be added as a confirmatory sign of pregnancy.
Beside these perceptible  symptoms,  there are others termed
rational  which  are  suggested by the reason.   These are:
1st, Menstrual suppression,  an  almost  certain  sign  when
this suppression takes place without any appreciable cause in
a woman  of good health, nor is followed by any unpleasant
consequences,  except such  as are incidental to  pregnancy;
but this suppression is not always  present, and again, women
who  have never  menstruated, may become pregnant.   An
increased volume of the  abdomen, if accompanied by  men-
strual suppression, may, indeed,  be a presumptive sign of 
pregnancy in general.
303
pregnancy, but we ought not to forget that many other causes
may likewise lead to abdominal enlargements; in pregnancy,
however, the abdomen becomes  progressively enlarged from
below upwards; in front the abdomen projects in a marked
manner, whereas the sides are flattened; but what is more
important is that, in proportion as the volume of the abdo-
men increases, the umbilical fossa gradually fills up, and the
navel actually protrudes towards the third or fourth month.
The signs about the breasts and nipples are likewise observed
between  the periods of pregnancy,  after menstrual suppres-
sion and in many other uterine affections.   The signs obtained
from the pulse are  less reliable than any  other. In some
women the  skin  becomes of a duller white; their  eyelids
become soft, livid, and rings are formed round their eyes;
the lustre of the eyes becomes less and the look is more lan-
guid ;  there is  aversion to exercise, sexual intercourse and
work; the  patients  become capricious,  morose; they are
seized with fancies for the  strangest things, and the memory
is sometimes weakened,  These  signs, however, may likewise
exist in many other diseases.  In order to makeup our minds
whether pregnancy exists, we have to put all the perceptible
and rational signs together, and draw our  conclusions accord-
ingly ; but,  in order to establish our diagnosis upon a firm
basis, we have  to depend upon the movements of the fetus,
and upon  the  signs furnished by auscultation, by the  appli-
cation of the stethoscope to the abdomen,   By this means we
discover two kinds of pulsations in the abdomen, those which
belong to  the  fetal heart, and  which are double and more
frequent than those of the pulse of the  mother; the other
pulsations are isochronous with the  pulse of the mother, and
accompanied by a blowing sound.  As soon as we hear these
 double pulsations we may rest  assured that pregnancy has
 taken place.

                      Section  113.

   Hygienic rules during pregnancy.—Pregnancy is not
 in itself a pathological state.   On the contrary, it is a per- 
304
diseases  of females.
 fectly normal state which would not require any sort of par-
 ticular care, if the marked changes which this condition induces
 in the sensibility and in the different functions of the female,
 did  not  predispose her for a variety of derangements which
 may either be avoided by a proper mode of life, or cured by
 the  application of suitable remedies.  In the article where we
 shall treat of the different diseases which  pregnancy may in-
 duce, we shall indicate the simplest and most efficient means
 of removing them ; in the present instance  where we con-
 sider pregnancy only in its  physiological aspect, we have
 simply to mention the hygienic means which will prevent the
 advent of such ailments and  preserve to pregnancy its  cha-
 racter as a strictly physiological function.
   Among these means we number above all things a pure air
 free from excessive  heat  or  cold, dampnes or dryness; but
 this  is very difficult to attain, and yet the privation of fresh
 air,  or air of a normal temperature causes more suffering to
 pregnant women than is generally supposed.   As soon  as a
 woman has reason to believe that  she is pregnant, she ought
 to dress  according to  the season,  not expose  herself to dis-
 turbing  atmospheric influences, avoid.all  sudden changes of
 temperature, and not sacrifice herself to the exigencies of
 fashion or social gallantry.   She  ought  to consider  it her
 highest duty to devote herself physically and mentally to the
 little being to whom she is to give  birth, in order to secure to
 its physical, moral  and intellectual  development  the most
 favorable constitutional disposition.
  At the same time she ought to dress loosely, without com-
 pressing the abdomen or chest, which might injure the growth
 of the  nipples, or impede still more the action of  the  lungs.
 Pregnant women  should  abandon  corsets  and  belts;  undue
 pressure upon the waist by such means is exceedingly injuri
 ous.   Busks  do  not,  as is generally  supposed, prevent the
fetus from ascending too much, but they keep the uterus in
an obilique position, which may afterwards become an exceed-
ingly active cause of prolapsus.  Corsets and  belts, by their
habitual  compression,  impede the  portal  circulation,  which 
pregnancy in  general.
305
may cause incalculable inconveniences to the  mother  and
child, such  as miscarriage, uterine  affections, heart-disease,
pulmonary or cerebral affections, false positions of the fetus,
varices, etc.   Such improper modes of dressing may perhaps
also be a remote cause of hydrocephalus by inducing an ab-
normal development of the head.
   The habitual  sensitiveness of the  digestive organs during
pregnancy, and  the wants  of the fetal  being, show that the
nourishment of pregnant females should be easily digestible,
wholesome and sufficiently  nourishing.  Aliments that do not
possess these properties, should be excluded from the table of
pregnant women.   In most cases women are rightly guided
by their desires for particular kinds of food; if a few of them
have to be restrained, there is no doubt that, generally speak-
ing, the woman  may be  allowed to  indulge  her appetite.
Sometimes these desires are natural indications, especially if
they continue in spite of the patient's own wish.   The most
suitable food for pregnant women is meat boiled or roasted,
beef,  mutton, venison, and in general meats furnished by the
mammalia, whatever may have been said to the contrary by
Old School experimenters.   White meat, such as veal, poultry,
fish, etc., is  generally much more difficult to digest; this  is
shown by the diarrhoea and the digestive derangement they
cause, if persons unused to this  kind of nourishment live on
such articles of  diet for some days in succession.   Farinace-
ous and vegetable diet, ripe fruits of the season, if eaten in
moderate quantities, not between meals, but by way of des-
sert, likewise constitute an agreeable and useful  diet.   As a
beverage nothing is better  than fresh water, or if the water
of the place where the patients reside is not good, water united
with  about  one-fifth claret.   Pure  wine, alcoholic liquors,
spices, coffee  and  tea should  be prohibited in  most cases.
Coffee not only injures the mother, but  also the child, predis-
poses her for haemorrhage, difficult labor, toothache during
pregnancy, and while nursing the infant; it is  the cause of a
good many difficulties which infants experience during denti-
tion, and  develops  a nervous state of the system which may
                            20 
306
diseases of females.
remain for life.  Chamomile-tea, of  which such  enormous
quantities are used by pregnant women, is as hurtful as coffee.
As a general rule, warm drinks and decoctions are more hurt-
ful than  useful, owing to the debilitating and relaxing action
which they exercise upon the digestive organs.  Ice-beverages
should likewise be avoided;  they have been known to cause
miscarriages;  in cases of gastralgia or vomiting, where such
drinks are sometimes resorted  to as sedatives,  they have to
be taken in small quantities  as if they were medicines.
   Bodily exercise, especially in the open air, on foot,  and
moderately enjoyed, so as not to cause any weariness, is like-
wise necessary during  pregnancy;  it prevents  the develope-
ment of many diseases  to which this condition predisposes the
female, and is frequently a means of curing them and securing
an easy confinement.  But  as useful  moderate walking may
be to pregnant females, as  injurious riding in a carriage, or
on horseback, dancing,  etc.,  may  prove to them in  conse-
quence of the violent shaking which the body undergoes,  and
which may induce haemorrhage and miscarriage.  Keeping
late hours at  night is likewise hurtful during  pregnancy;
 women in this condition should sleep a little longer than usual.
 The use of warm baths which  are so generally recommended
 by Old School physicians and nurses, is an improper practice,
 such bathing should only be resorted  to for purposes of clean-
 liness, and the patient should not remain in her  bath longer
 than from five to ten minutes ; if used too frequently  and too
 long, they weaken the constitution and cause a good deal of
 trouble to feeble, lymphatic women, or such as are disposed to
 oedema or uterine haemorrhage.  It is particularly towards the
 end of pregnancy that warm  baths are hurtful and therefore
 condemnable.  Foot and hip-baths should likewise be strictly
 forbidden; they facilitate or even cause uterine haemorrhages
 and miscarriages.
    Some women unfortunately continue  to entertain the per-
 nicious  Old School error,  that sanguineous depletions in
 the first months of pregnancy tend to prevent the phenomena
 of plethora which  sometimes trouble females from the  third 
pregnancy in  general.
307
month of pregnancy.  This is a great mistake; for the sup-
posed plethora exists only in appearance; no pregnant woman
ever has one drop of blood too much; all the blood she has,
is necessary to  her for the development of her infant, and
blood-letting  will invariably  injure the constitution of  the
little being.   Dr. Croserio-- said some time ago:—"Bleeding
a pregnant woman is a double attempt of homicide which the
laws should prevent;  both  the mother and  child may be de-
stroyed by  this practice."  AVhat has been  said of blood-
letting, may likewise be said of the emetics  and cathartics
which  alloeopathic  physicians  prescribe for the gastric de-
rangements and the constipation of pregnant females.  AVhat-
ever tends  to weaken  the  organs  and the  constitution is
prejudicial to the health of the mother and child, and should
be avoided as a wrong.
  We have said above that the sensibility of pregnant women
is increased, that their imagination is more lively, and that
they are more liable to start as if  in affright.   This suscepti-
bility is  sometimes so excessive, that a mere odor,  the sight
of some  repulsive object, the  least fright, a fit of anger,  an
unexpected  joy, a moderate  pain  may produce convulsions,
haemorrhages, miscarriages and other serious accidents.  Phi-
losophical physicians do no longer admit the theory that the
image of such things as were strongly desired by the mothers,
becomes  impressed upon the fetus.   AVe know of but one case
where this happened;  it is the case of  a young female who
was frightened at a ball by a black mark, and who from this
instant, became  so  keenly impressed  with the idea that her
child would  be injured by her  fright, that, at the end of six
months, she gave birth  to a child whose face was as black as
that of a negro.   AVe  have  no disposition  to  draw any in-
ference  from  this isolated  fact;  but it certainly shows the
propriety of guarding the mother against all impressions that
tend to disturb or impress her  nervous system  or imagination
in an unfavorable  manner.   All  violent  emotions, be they
agreeable or otherwise;  the sight of wild animals, of athletic 
308
diseases of females.
exhibitions,  monstra, serious wounds, or  the narration of
frightful events should be kept away from them altogether.
   As regards sexual intercourse, it  is rather forbidden
than allowed by most practitioners.  If enjoyed too frequently,
especially by newly-married persons, it may undoubtedly be-
come a cause of miscarriage.   It should be abstained from by
women who  have miscarried, or where a miscarriage  may be
apprehended, or by women of a nervous and  sensitive  tem-
perament, who are subject to leucorrhoea, to profuse menstrua-
tion, or to menses that last either too long or are too frequent.
Nature  will sometimes  indicate the  true course to follow.
Some women, especially such as have not had any children,
experience immediately after conception such  an aversion to
sexual intercourse, that they would  not consent to it even if
they loved their husbands ever so much.   This should always
be respected as a sacred indication of nature.  Generally,  such
an aversion lasts until the fourth or fifth month of pregnancy.
Intercourse during the last months of pregnancy has never
been known to be injurious;  some authors  pretend  that it
secures an easy confinement. 
diseases of pregnant  females.         309
ARTICLE II,
          DISEASES OF PREGNANT FEMALES.

                       Section 114.

   General Observations.—The diseases peculiar  to preg-
 nancy are nothing else than  the divers physiological pheno-
 mena, depending upon  it carried  to an intense degree of
 exhaltation.  Several authors have classified these  diseases
 according to the period of  pregnancy when they manifest
 themselves; but inasmuch as several of these affections may
 occur at any time of life, this classification, which is not with-
 out  its advantages, seems nevertheless to present practical
 difficulties which prevent us  from adopting  it  in  this work.
 Other authors classify these diseases agreeably to the physio-
 logical functions involved in the disturbance,  and it is this
 arrangement which, with some slight modifications suggested
 by the plan of our work, we shall likewise adopt  in its general
 features.   AVe shall therefore treat successively: 1st, of the
 derangements of the digestive organs ;  2d, of the derangements
 of the circulatory system ; 2d, derangements of the  respira-
 tory organs; ith, derangements of the secretory functions;
 5th,  derangements causing pain ; 6th, convulsions and mental
 derangements;  1th, cutaneous derangements; 8th, derange-
 ments  of the uterus and its  appendages; 9th, influence of
pregnancy upon existing diseases.  Before treating of each
 of these  disorders specially, it seems proper that we should
 offer a few remarks concerning the administration of reme-
 dies during  pregnancy.   It is supposed by many women, that
 any kind of medicine taken during pregnancy, exposes them
to the  danger of miscarrying.  This  is undoubtedly true  as
regards alloeopathic medication, or  even the  use of  massive
doses of homoeopathic tinctures or first attenuations, of which 
310
diseases of  females.
they order whole drops dissolved in a few ounces of water, to
be taken in table-spoonful  doses.  Aconite, Calcarea, Sepia
or Sabina,  administered in  this manner, have often caused a
good deal of harm during pregnancy.  We should  never give
more  than two or three globules either  dry on  the  tongue
every day, or  even  every two or three days, or dissolved in
about ten table-spoonfuls of water,  a  tea-spoonful of which
solution should be given every two or three hours even in the
most acute and rapidly progressing cases.  Discite moniti.

                      Section  115.

  Digestive derangements.—The  diseases which belong to
this category, are,  anorexia and strange tastes; vomiting
(nausea, mucus on  the  stomach);  colic,  constipation, diar-
rhoea.  We shall say sometimes  about each of these various
conditions,  and at the same  time mention the  treatment to be
pursued in  each.
  Anorexia  and strange  tastes  are extremely frequent
during the first  months of  pregnancy; they generally cease
of themselves towards the fourth  or fifth month, and are  fol-
lowed by a better appetite and by easier digestion than usual.
Either of these derangements will sometimes yield to a small
dose of Sulphur; if this remedy should not suffice, we may
prescribe:—
For desire for  sour things:—Aconitum, Arnica, Pulsatilla,
         China, Arsenicum, Veratrum.
    Bitter :—Digitalis, Natrum muriaticum.
    Coffee:—Arsenica, Bryonia,  Carbo  veget., Conium,
         Aurum.
    Chalk, clay:—Nitri acidum,  Nux vomica,  Calcarea,
         Hepar, Ignatia.
    Charcoal:—Cicuta, Conium.
    Sourcrout:—Carbo vegetabilis, Chamomilla.
    Brandy : — Lachesis,  Sulphur,  Hepar,  Arsenicum,
         China. 
diseases of pregnant females.        311
   Dainties :—China, Ipecacuanha,  Calcarea,  Natrum,
        Petroleum, Rhus.
    Cold  food:—Sulphuris  acid.,  Veratrum,  Pulsatilla,
        Ignatia, Tartarus.
    Fat :—Nux vomica, Nitri acidum.
    Herrings :—Nitri acidum.
    Piquant things :—Pulsatilla.
    Cooling :—Pulsatilla, Rhabarbarum,  Cocculus,  Caus-
      ,  ticum.
    Salt:—Conium,  Calcarea,  Causticum, Nitri acidum,
         Carbo vegetabilis, Phosphorus.
    Sweets:—China, Lycopodium, Sulphur, Calcarea Car-
        bo vegetabilis, Nux vomica, Kali.
    Smoked meat:—Causticum.
    Wine:—Calcarea, Staphysagria, Aconitum, Bryonia,
        Hepar, Lachesis, Sulphur.
For aversion* to  food:—Pulsatilla, Arnica, Nux vomica,
        Bryonia, Ipecacuanha, China.
    To  broth:—Rhus,  Chamomilla,  Arnica,  Graphites,
         Arsenica, Belladonna.
    Water  :—Belladonna, Stramonium, Nux vomica, Bry-
         onia, Natrum muriat., Lycopodium, China, Caus-
         ticum, Sulphuris acid.
    Milk -.—Sepia, Calcarea, Pulsatilla, Guaiacum, Bryo-
         nia, Silicea,  Sulphur.
    Bread :—Natrum muriat, Conium, Sepia, Lycopodium,
         Pulsatilla, Nux vomica, Sulphur.
    Solids -.—Ferrum, Angustura, Mercurius,  Staphysa-
         gria.
    Meat -.—Sulphur, Sepia, Calcarea, Rhus, Carbo veget,
         Muriatic acid, Silicea, Petroleum.
   Vomiting, nausea,  mucus  on the stomach, are likewise
very common in pregnancy, and they sometimes increase to a
real disease.  As a general rule, they cease  after the third or 
312
diseases of females.
fourth month of pregnancy,  but  sometimes they  continue
longer, or recur periodically during the whole course of preg-
nancy, or they discontinue at the end of  the fourth month,
and reappear again at the close of pregnancy.   Most fre-
quently the patients are attacked in the morning, and vomit
a viscid or slimy fluid; at other times they break out after a
meal, and in this case, the food is rejected by the vomiting;
in other cases again, the women reject every thing  they take
into the stomach, be it solid or liquid food.   In most cases,
the best remedy for this trouble is Nux vomica, especially if
the vomiting takes place in the morning, and the patients
only vomit a viscid liquid; or Ipecacuanha, especially if the
vomiting continues all the time, and the patient rejects every
thing she takes into her stomach, both solids and fluids, with
or without bile or mucus.  If neither of these remedies should
prove sufficient, we may often derive benefit from Pulsatilla,
especially if the vomiting comes on in the evening or at night;
Ferrum, if the patients, a few hours  after eating, suddenly
vomit up the food  taken into the stomach; Sepia, especially
for vomiting of milky mucus, the patients  are sad, subject to
hemicrania, leucorrhoea or uterine derangements ; or Conium,
suitable to patients affected with  engorgements or induration
of the neck of the womb or breasts.  In a case where no other
remedy seemed of any avail, two globules of Sulphur, dry on
the tongue, has removed the whole trouble  in twenty-four
hours.  Petroleum, Arsenicum,  Natrum  muriaticum,  may
likewise be useful.
   Colic is as frequent in pregnancy as anorexia and vomit-
ing ; generally the trouble consists in  abdominal spasms that
set in during the first months of pregnancy, and which ought
not to be confounded with the false labor-pains of which  men-
tion will be made hereafter. The best remedy for these colics,
in  most  cases, is:  Chamomilla (two globules  dry on the
tongue,) especially when there is much wind in the bowels
that cannot be passed, and anguish and pressure in the pit of
the stomach; or Nux vomica, if Chamomilla is not  sufficient,
and  if the bowels  are very costive; or Belladonna, if the 
diseases  of pregnant females.        313
 bowels feel a pain as if clutched with nails or crushed between
 stones ; or Cohcynthis, if the pains are extreme, not allowing
 the patient any rest, and feeling better by walking.  Pulsa-
 tilla, Sepia, Bryonia,  Arnica, may likewise be tried.
   Constipation troubles pregnant women, especially towards
 the end of pregnancy;  if continuing too  long, the appetite
 gets lost, digestion becomes difficult, and the patients become
 restless and do not sleep well;  not to mention the danger of
 haemorrhage and miscarriage to which  the straining at stool
 occasioned  by the expulsion of  hard  and large fecal  messes,
 give rise.  Constipation of pregnant women should be attended
 to with great care by the practitioner.  But cathartics, even
 ever so mild, are the very worst means to remove the difficulty.
 Often a change of  diet, a little more vegetables or  fruit, a
 little more exercise in  the open  air, or a good drink of  fresh
 water, after  rising  in  the morning, and two or  three  times
 during  the day, are sufficient to bring about  a cure.  If these
 dietetic measures  are not  sufficient, we may resort to Nux
 vomica, two globules  dry on the  tongue,  which should be
 allowed to act for three or four  days in succession, especially
 when the patient's  complain of dull headache, heat in the
 abdomen, pressure towards the anus, with frequent but inef-
 fectual  urging to go to stool, and congestion of the head with
 red face.   If Nux  is not sufficient, we  may have recourse to
 Sulphur, one dose, or to Bryonia, likewise one dose.  If none
 of these remedies help, Sepia is often extremely  useful.   In
 obstinate cases we may give Lycopodium and Alumina ; injec-
 tions are only serviceable, if the constipation has lasted two
 or three days, with  frequent urging to stool, but inability to
 expel the faeces on account of their hardness or size.  In such
 a case, we may resort to  an injection of tepid water, in which
 a little castile-soap  had been  dissolved.  It would be wrong
to take  injections every day; this would fatigue and irritate
the bowels and anus.
  Diarrhoea is an untoward symptom in pregnant women, not
so much in itself, as because it may bring  on miscarriage.
The best remedy for this  trouble is Chamomilla, which should 
314               diseases of females.
be given first, especially if the  patient complains  of violent
colic, with yellow, greenish stools, or resembling stirred eggs;
or Pulsatilla, if the stools  are  greenish or watery, preceded
by  colic, with slimy,  bitter mouth, chilliness,  loss of thirst,
nocturnal stools; or Dulcamara,  when the diarrhoea results
from a cold, with colic, slimy, greenish stools; if these reme-
dies do not suffice, we may give Sulphur, followed by Calca-
rea, or Sepia.   We may also  try Antimony, Phosphorus,
Petroleum, Hyoscyamus.

                      Section 116.
   Derangements of  the circulation.—The morbid condi-
tions of which we shall have to  treat in this Chapter, are :—
Plethora, abdominal,  congestions,  palpitations of  the  heart,
syncope, haemorrhage, piles, varices, oedema of the legs.
   Plethora is present in  every case  of pregnancy, so that
several physicians have regarded it as the principal, if not the
only cause of all the accidents  to which pregnancy may give
rise, and have  recommended blood-letting as the  sovereign
remedy for this condition.   AAre have stated before that  this
plethora of pregnant  women is only an  apparent  symptom.
What  is supposed to  be owing to a general increase of the
volume of blood, is caused by a certain embarrassment  in the
circulation.   These phenomena of supposed plethora generally
set in about the sixth or seventh month of pregnancy.  With
a  full  and hard pulse, females suffer with  heaviness of the
head, somnolence, vertigo when stooping, a sense of fulness
and embarrassment in the limbs, sometimes slight nose-bleed,
congestion in the pelvic vessels, and sometimes pains in the
gums.   These symptoms may continue for a good while with-
out  the general health being disturbed; but sometimes con-
gestions or haemorrhages  take place,  the most frightful of
which  are  cerebral  haemorrhage and   metrorrhagia.  The
adoption of a suitable regimen, such as we have indicated in
the previous Chapter, is generally sufficient to prevent every
unpleasant accident and  to scatter all these symptoms little
by little.   But if these symptoms should nevertheless become 
            diseases of pregnant  females.         315

too fatiguing, or  should cause any apprehension in the pa-
tient's mind, a dose of Aconitum, six globules dissolved in
half a tumblerful  of water, and a tea-spoonful of this solution
administered every three hours, will remove the unpleasant
condition more promptly, more safely and more radically than
all  the blood-lettings in the world could do.   After Aconite
a dose of Belladonna may be given, two globules dry on the
tongue, if two or three days  after the administration of the
Aconite, the patient still feels some  heat  and pain in the
head; or a  dose of Nux vomica may be given, if the digestive
functions are deranged, or the bowels  are constipated.
   Abdominal and uterine congestions, generally develope
themselves   in the first weeks and even days of pregnancy.
The patient experiences a more or less painful tension, and  a
sense of weight in the hypogastrium,  behind the pubes,  with
frequent urging  to urinate, lassitute  in the limbs, anguish,
palpitation and depression, and uneasiness of spirits.   These
symptoms sometimes disappear of themselves, by adopting  a
suitable regimen, but in some cases they may have to be acted
upon  by medicinal means, lest they  should  lead to miscar-
riage.  The best  medicine is Belladonna, especially if the
face be red and warm, with congestion of the head, sensation
as if  the weight  felt in  the bowels would press through the
parts; or Nux vomica, if Belladonna  is not sufficient,  with
frequent desire  to urinate, and  ineffectual  urging to go  to
stool.   Pulsatilla is  suitable to women of  a delicate and
feeble constitution, with  disposition to leucorrhoea and other
mucous discharges, occasional shiverings, pale face and soft
features.
   Palpitation  of the  heart  is generally an  accompani-
ment of general plethora;  Aconite is the  best remedy for
this symptom.  If unaccompanied by symptoms  of  general
plethora, Pulsatilla may be  given for palpitation, if Aconite
remains without  effect.   Beside these two remedies we may
also  give  Lycopodium,  Sulphur,  Sepia,   China, Spigelia,
Natrum mur.
   Fainting fits often  assail pregnant women without any 
316
diseases of  females.
known cause from the moment of conception;  in some cases
they are caused by  dresses that are too tight around  the
waist; sometimes they depend upon a certain general or par-
tial plethora,  or they may result from  a general  debility
occasioned by haemorrhage, deficient nourishment,  or some
previous sickness.   The best remedies  for these  fainting
turns,  when happening  without any  known  cause,  are,
Ignatia, two globules dry on the tongue, especially in  the
case of hysteric or sad and melancholy women; Chamomilla,
suitable to women of an  irritable temperament; Nux vomica,
suitable to women of an  irascible disposition; if the  fainting
depends upon a general plethora,  Aconitum, Belladonna,
Bryonia ;  if caused by tight clothes impeding the circulation,
Aconitum, Opium, Bryonia, Arnica ;  if caused by debili-
tating losses,  China,  Carbo vegetabilis,  Veratrum, Nux
vomica, Sulphur.
   The various kinds  of hemorrhage occur quite frequently
during pregnancy, from  the nose  (epistaxis,) lungs (haemopty-
sis, blood-spitting,) stomach, (haematemesis, vomiting of blood,)
uterus (metrorrhagia, flooding.)   This last is the most danger-
ous, both because it may lead to miscarriage and to the mother's
death.  Having treated these accidents in detail, together with
the remedies to be used for them (Sections 39 and 43,)  we shall
here simply mention  the medicines that  are most suitable for
flooding during pregnancy: Crocus, Platina, Sabina, Bella-
donna, Chamomilla, Bryonia, China, Hyoscyamus, and more
particularly, if miscarriage is to be apprehended;  Sabina,
Chamomilla,  Crocus,  Kreosotum,  Platina,  Secale; if the
flooding is caused by a strain, wrong  step, blow on the abdo-
men or small of the  back:  Arnica, Bryonia, Ruta. How-
ever, not  every loss  of  blood from the womb  during preg-
nancy need cause apprehension.   As long as the blood only
flows as during the menses,  we can easily arrest the haemor-
rhage by Belladonna, Ipecacuanha,  China, Sabina; and if
the inflammation should  become  suddenly acute and  danger-
ous,  give  Ipecacuanha.   Nose-bleed during pregnancy  is
often relieved by Aconitum, Arnica, China, Bryonia, Conium, 
diseases of pregnant  females.         317
Belladonna.  For blood-spitting, if not caused by disease,
but resulting from a simple  determination of blood to the
lungs,  we  give  Aconitum, Arnica,  Ferrum, Ipecacuanha,
Chamomilla, Phosphorus, Sulphuris acidum.  For vomiting
of blood : Ipecacuanha,  Arnica, Ferrum, Sulphur,  Aco-
nitum.   Sec  the article,  Metrorrhagia,  (Sections 39-43,)
where detailed symptomatic indications of every remedy may
be found.  As  regards  dose, six globules may be dissolved
in half a tumblerful of water, and a teaspoonful of this solu-
tion may be given every fifteen minutes or half hour, or even
less  frequently,  according as  the  danger is  more or less
imminent.
  Piles  of pregnant women seem  to  originate in habitual
constipation rather  than in impeded circulation of the pelvic
vessels.  These  engorgements  of the  haemorrhoidal  veins
cause sometimes such violent pains, that the patients wish to
be freed  from their trouble at any price.  It would not be
advisable,  however, to combat these piles by external appli-
cations ;  the  true treatment is  to give  a  dose of Pulsatilla
internally, two  globules dry on  the tongue,  which may be
repeated every four or six days if necessary.  If Pulsatilla is
not sufficient, we may  give  Nux vomica, especially  if the
bowels are always bound, or the patient has used much  coffee,
wine or other heating beverages: Arsenicum,  Carbo  veget,
Chamomilla,  Natrum muriat, are likewise excellent reme-
dies for piles.
  Varices which  are bluish enlargements of the subcutane-
ous veins,  and  are  sometimes found at the vulva and thighs,
are caused in consequence of the circulation  of the  pelvic
veins being impeded by  the volume and weight of the uterus,
and by the pressure of this organ  upon the veins of the pelvis
and abdomen.   Often one side  is alone affected, or at any
rate more than the other.   The varices generally cease after
confinement; but as long as they continue, they are hurtful
by the pain which they cause and by the  impediment which
they occasion during exercise.  Sometimes they  rupture and
give rise  to  serious haemorrhage.  Old  school physicians 
318
diseases of  females.
employ blood-letting as a remedy for varices; but the remedy
is worse than the disease.  The most efficacious homoeopathic
remedy for varices is Pulsatilla,  or we may try Carbo veget.,
Lycopodium, or Silicea.  According to Croserio the  South
pole, of the magnet applied for a few minutes is very effica-
cious.   For rupture  of the varices  and subsequent haemor-
rhage may be recommended: Arnica, Carbo veget, Lachesis,
Phosphorus.   It is necessary to a cure,  that the  patients
should not stand too  long at a  time, and that all compression
by tight lacing, tight garters and the like should be avoided.
  (Edema of pregnant women is caused by the same influ-
ences as varices, to which a peculiar constitutional predispo-
sition  and an improper mode  of life may be  added.   This
trouble generally sets in about the sixth or seventh month of
pregnancy, especially if the patients lead a sedentary life, or
have  a lymphatic constitution.  Sometimes  retrocession of
some cutaneous  disease may  cause  the swelling. At times
the swelling extends to the lower abdomen,  giving the  pelvic
extremities enormous dimensions.  If the oedema is not very
considerable, it  disappears over  night, and  a  little  walking
generally  removes it entirely.   But if the thighs are involved
these hygienic means are no longer sufficient;  we then have
to give Bryonia, six globules in half a tumblerful of water, a
teaspoonful morning and night,  and if Bryonia is not suffi-
cient, Sulphur, two globules dry on the tongue, a dose  every
other day, three doses at most.  Arnica is sometimes useful.
For  oedema of the vulva, if occasioned by the same causes,
we have to give Sepia, Mercurius, and  Nux vomica.

                      Section 117.

  Derangements of the respiratory organs.—These are
oppression or dyspnoea  and cough.
  Dyspnoea which is  caused by the crowding upwards of the
diaphragm in the last months of pregnancy, generally affects
women of  small  size,  and in whom  the uterus has acquired
very large dimensions.   If the  thorax is badly shaped, or the
lungs and heart are  diseased,  the dyspnoea may sometimes 
            diseases  of pregnant females.        319

reach a very high degree.   In every case  it is rather trou-
blesome and accompanied by digestive derangements.  It is
generally  after a meal that females are attacked by the dis-
tress  for breath, with  anguish, congestions of the head, red
face.   The  best  remedy is undoubtedly  Nux vomica; two
globules dry on the tongue will  often dissipate the trouble.
In some cases China, is an  excellent remedy, especially if
flatulence and distention of the abdomen after  eating,  are
present; or Aconitum,  a  few globules  dissolved in half a
tumblerful of water, in  teaspoonful doses every  three to  six
hours, in cases of plethora,  with palpitation of the heart, red
face,  vertigo and anguish ;  or Arsenicum, for great weakness,
swelling of the legs,  pale  and  puffed face,  or  yellow and
greenish face; or Pulsatilla for  difficult digestion, with pale
face,  bitter  taste in the  mouth after eating, frequent mucus
on  the stomach, and  chilliness; or Ipecacuanha,  for desire
to vomit,  with pale or bluish red face,  disposition  to faint.
If  old  pulmonary  disorganizations  are present,  give Phos-
phorus, Sulphur, Kali,  Lachesis.
   Cough is not always a necessary accessary of pregnancy;
it may be caused by a cold or some other exposure indepen-
 dently of pregnancy.  There is a  cough,  however, which
 results from the compression  of  the larger vessels and conse-
 quent determination of blood to the lungs.   This cough is
 dry,  frequent, fatiguing, and continues to the end of preg-
 nancy.  It often leads to a sudden  spirting out of the urine,
 and  may cause haemorrhages  and  miscarriage.  The best
 remedy for this cough is  Aconitum in  half a tumblerful of
 water,  in  teaspoonful doses  every  three  or  four  hours; or
 Sepia, if aconitum should  not be sufficient; or Belladonna,
 if  the  cough should  set in in  the evening or  night; Nux
 vomica, if the cough happens  in  the morning or after a meal,
 with pain, as if bruised in the  hypochondria or head, when
 coughing;  Ipecacuanha or Pulsatilla,  if the cough excites
 vomiting;  Conium or Dulcamara, if the cough is accompa-
 nied by obstinate tickling in the throat and chest;  or Natrum
 muriat,  (Causticum  or Phosphorus,) if  the cough comes on 
320              DISEASES OF FEMALES.

involuntarily, and sudden  spirting  out  of the  urine.  If an
ordinary catarrhal cough  should set in, it has to be treated
like any other catarrh.

                      Section 118.
  Derangements of the secretory and excretory func-
tions.—Having spoken of constipation and diarrhoea,  and
likewise of vomiting of pregnant women, we have to treat  now
of ptyalism, derangements of the urinary functions, such as
dysuria, stranguria, ischuria, and  incontinence of urine.
  Ptyalism of pregnant females proceeds from the same cause
as vomiting. It incommodes them very much, and is incurable
by Old School treatment.  Generally it  ceases of itself, about
the end of the  fourth or fifth month of pregnancy.  The  best
remedy for it  is Sulphur, ov Mercurius-, if Sulphur  is  not
sufficient or the ptyalism is very profuse.  If accompanied by
nausea and aversion to food, Pulsatilla  and  Ipecacuanha are
very useful; or  Veratrum and Arsenicum, if the patients are
very feeble and chilly.
  Dysuria  and stranguria  are  equally  frequent among
pregnant females, in consequence of the  pressure of the uterus
upon the bladder and urethra, and likewise in consequence of
the irritation of the  mucous lining caused by this pressure.
Hence  a frequent urging to urinate, sometimes without result
or with frequent emissions of a few drops of burning urine  and
tenesmus of the bladder.   The best medicine for  this trouble
is Pulsatilla, or Nux vomica, if Pulsatilla  is not sufficient,
and  dysuria is caused by displacement of the  uterus.   In
some  cases  Cocculus, Phosphori  acid., Sulphur, and even
Aconitum may  be of great use.
  In complete retention  of urine, it may sometimes be ne-
cessary to depend upon the catheter before administering the
suitable remedy.  Previously, however, we may try Camphor,
or Nux vomica, or Pulsatilla ;  however, if the  retention  has
already continued for twenty-four  hours, and  the remedies
have no effect, the catheter should be resorted to, after which
we may give Nux vomica or Pulsatilla. 
diseases of pregnant  females.        321
  Incontinence of urine  during  pregnancy,  consists  in  a
frequent desire to urinate, which is sometimes so violent that
a few drops of urine will escape before the patient is able to
reach the vessel.   Sometimes the vulva and thighs are very
much irritated by the continual  dribbling of the urine.  The
principal remedy for this difficulty is Pulsatilla, or Sepia,  if
Pulsatilla is not sufficient.   Sometimes we may give Aconi-
tum, Belladonna, Natri muriat., or Causticum.
  All the remedies mentioned in this paragraph may be given
as follows:—Dissolve six globules, or one drop of the liquid
attenuation  in half  a tumblerful of water, and give  the pa-
tients a dessertspoonful of  this solution every three  or four
hours.

                       Section 119.

   Derangements that are painful.—We  unite  in this
paragraph all those  derangements, the principal symptom  of
which is pain, except colic, of which we have spoken before.
Here we treat of toothache, pains in the breasts, pains in the
small of the back, painful stitches  in the abdomen, false pains
and cramps in the calves.
   Toothache  occurs  quite  frequently  among  pregnant
females; some women lose a tooth during every pregnancy.
This toothache lasts sometimes from the moment of  concep-
tion to the end of pregnancy, and often  is very troublesome
indeed.  The best remedy for it  is Sepia, two globules dry
on  the  tongue, or Chamomilla, if the pain  proceeds from a
single carious tooth; Pulsatilla, if a whole side of the jaw is
affected, or the pain  shifts about; Coffea, if the pain is violent,
comes on in paroxysms, and the patient cries  out with  pain ;
Nux vomica, if the  pain proceeds from  a decayed tooth  to
the  facial bones, and gets worse  by wine, coffee and mental
work; Aconitum, Belladonna  or Hyoscyamus, for violent
congestion about the head ; Staphysagria for toothache, in
carious teeth, if neither Chamomilla nor Nux vomica helps.
The specific  remedy affords instantaneous relief, if  two glo-
bules are given dry on the tongue ; if no improvement follows
                            21 
322
diseases of females.
 in a couple of hours, another remedy will have to be chosen ;
 it would be useless to give a second dose of the same remedy.
   Pains in the breasts generally come on in the first weeks
 of pregnancy, owing to the rapid development of the mam-
 mary gland, the copious afflux of fluids to this  organ, and the
 tension that results from it.   But the patients sometimes feel
 a good deal of pain in the last months of  pregnancy; caused
 by excessive distension of the breasts and cracking of the
 skin.  The best remedy for this  condition, for which alloeo-
 paths bleed their patients, is Bryonia, especially if the ten-
 sion is very painful; or Belladonna, if there is erysipelatous
 or inflammatory redness.  For distensive pains, Secale, Au-
 ricular, Nux vomica, Sepia, are excellent remedies.
   Painful stitches during pregnancy are principally felt
 in the lower part of the  thorax, false ribs, in  one side or in
 the inguinal region; they seem to be induced by the pulling
 of the muscular  fibres caused by the extreme tension of the
 abdominal  integuments.  These pains are  confined to narrow
 localities;  they do not hinder respiration, but  often become
 more acute by pressure, motion, and by various positions of
 the body, and sometimes do not cease until after confinement.
 The best remedies for these pains, are:—Nux vomica, Bella-
 donna, Bryonia, Arnica, Pulsatilla.
  The pains in the small of the  back during pregnancy,
 may be owing to various causes, such  as  the  pulling of the
 large ligaments, compression of the  lumbar nerves, engorge-
 ment of the pelvic or uterine vessels, excessive distension of
 the uterus, and weariness of the spinal  muscles.  When the
 pains are caused by the pulling of  the large ligaments and the
 compression of the  lumbar nerves, they increase by walking
 and  standing, but decreased in a recumbent position; when
 the vessels  are full, a sense of fulness and weight in the hypo-
gastrium and pelvis is experienced; the pains caused  by a
 distension of the uterus, are characterized by a sensitiveness
in  the  region where  the pains are felt, and  the pains which
are caused  by weariness of the muscles, are distinguished by
their locality and by an exacerbation of the pains when pres- 
diseases of pregnant females.        323
 sing upon the muscles.  The chief remedies for these pains
 are,  Nux vomica,  when there are symptoms of abdominal
 plethora; Belladonna, or Pulsatilla, or Nux vomica, when
 there is great sensitiveness, hardness and tension in the ute-
 rine region;  Rhus or Arnica, if the pain is caused by mus-
 cular fatigue  or by a strain.
   False pains come on at various periods during the  last
 months of pregnancy, especially at the end of the seventh
 month, or eight or ten days before confinement.  The pains
 set in suddenly as if labor would come on, but when  exploring
 the uterus with the finger, the neck  is found closed and  soft
 during the whole of these pains.   The best remedy for false
 pains is generally Pulsatilla, two globules dry on the tongue,
 or Coffea and  Nux vomica, if Pulsatilla is not sufficient.   In
 some  cases Chamomilla, Belladonna, Nux  moschata,  Hyos-
 cyamus, Sepia, may prove useful.
   Cramps in the calves and feet often torment pregnant
 women day and night, and fatigue them by depriving them
 of sleep and rest.   The best remedy for this  trouble is  Vera-
 trum, two globules dry on the tongue, or Sulphur, or Coh-
 cynthis, if Veratrum does not help.   Sometimes we may give
 with success,  Camphor, Secale, Chamomilla,  Sepia,  Cuprum,
 Calcarea, Lycopodium.

                      Section  120.

   Nervous and mental  affections.—In this paragraph we
 have to mention sleeplessness of pregnant women, convulsions,
fear of death, which sometimes haunts them in a very fatiguing
 manner, and moral emotions.
   Sleeplessness  may be in  a great measure removed by a
 suitable regimen, and by regular exercise in the open air.   If
 the want of sleep should continue without any other ailments,
 a dose of Coffea or Belladonna will often bring back  sleep.
 If night-mare  should occur, we may  give Aconitum or Sul-
phur, two globules dry on the tongue.
   We shall return to convulsions when speaking of confine-
 ment and labor, at which period convulsions occur much more 
324
diseases of  females.
 frequently than  during pregnancy.   If  convulsions occur
 during pregnancy, they are always dangerous, and may result
 in miscarriage.  Belladonna, six globules in half a tumblerful
 of water, a dessertspoonful every three hours,  will remove
 the  danger in most cases.  If Belladonna  should remain
 powerless, we may resort to Chamomilla or Ignatia, or even
 Hyoscyamus or Ipecacuanha.  In other cases we might give
 Cicuta,  Cocculus, Platina,  Moschus,  Stramonium, Vera-
 trum.
   The best  remedy for fear of death which so often haunts
 pregnant women, is  Aconitum.  Recent critics have under-
 taken to show that the symptoms  540 of Hahnemann's
 Materia Medica;  moaning, ivith apprehension of impending
 death, {from  two  to  twelve hours); 541, apprehensions lest
 some misfortune should happen to him; 538, apprehension
 of impending death (Richard); are false, and that they should
 be blotted out from our collection of symptoms.  But we have
 more faith in the numerous practical experiments of the large
 majority of  homoeopathic practitioners than  in the baseless
 criticisms of a  few neophytes, and the experience of all the
 best practitioners of our school shows that  whenever dread
 of death is a symptom in mental or nervous diseases, Aconi-
 tum is a specific remedy for such affections.   AVe shall there-
 fore insist upon recommending Aconitum as a  specific remedy
 for fear of death during pregnancy, unless the totality of the
 symptoms should indicate a different drug.
   As regards moral  emotions, we have a good many reme-
 dies  by means of which their unpleasant effects may be safely
 and  gently prevented or removed.  For the effects of fright
 or fear, Opium will always  be found efficacious, if  the
 remedy can be employed immediately, or  if  there be trem-
 bling, anguish and dyspnoea, with red face  and congestion
 of the  head or chest;  or  Aconitum,  if Opium  does  not
 help, if  there is  beating of the  heart, pale face,  fainting
fits ;  or Veratrum, if there be  diarrhoea with general cold-
ness  of the body, after an attack of  fear; or Belladonna
if  the fright  causes convulsions, heat of   the head, red 
            diseases of pregnant females.         325

 and sweaty  face;  or  Hyoscyamus, if  Belladonna is not
 sufficient  to stop the convulsions;  or Platina, if fright is
 followed by uterine haemorrhage.   For  the consequences of
 grief, Ignatia, especially when there is much sadness, pains
 in  the stomach, headache, vomiting and vertigo ; or Phos-
 phori acid., or Staphysagria, if Ignatia  is not sufficient; for
 violent anger, Chamomilla, especially when there is dyspnoea,
 weight about the heart, bilious symptoms with bitter vomiting,
 or  yellowish, greenish diarrhoea; or Nux vomica, if Chamo-
 milla is not sufficient; or Bryonia, if the patient feels chilly
 all over, with irascible mood;  or Staphysagria or Cohcynthis,
 when  anger  and indignation go  together, with a sense of
 horror of what causes the anger; for excessive and sudden
 joy, Coffea, or Aconitum, if Coffea is  not sufficient.   We
 always give two globules dry on the tongue, of any of these
 remedies; the dose should not be repeated until the symptoms
 get worse again.

                       Section 121.

   Cutaneous derangements.—These are freckles and crack-
 ing of the skin of the abdomen.
   Freckles are generally seated in the face; they are  dirty-
 yellow or yellowish-brown spots.  The best  remedy is Sepia,
 when the spots occupy the upper part of the face, forehead or
 nose, where they form a sort of saddle across the nose; in
 other cases, Sulphur is  the best remedy, or Lycopodium or
 Antimony.
  Cracking of the skin of  the  abdomen.—A  little blood
 becomes effused into these cracks which generally occur  about
 the seventh month of pregnancy, in  consequence of  the dis
 tension of the abdomen by  the uterus.   AVe do not like to
 recommend Arnica washes for this trouble, for the drug is too
readily absorbed by the  torn  skin, and might produce medi-
 cinal symptoms;  we prefer frictions with almond-oil, and we
recommend pregnant women to keep the abdomen perfectly
free and easy,  in order not to interfere with the gradual ex-
pansion of the integuments. 
326
diseases of females.
                      Section 122.
  Local derangements  of the sexual organs.—These
local  diseases  are:  acute  metritis, hydrometra, moles, false
pregnancy  and tumors of the vulva.
  Metritis of pregnant women  is so little known, that we
cannot  say any thing about it here.   If, however, the womb
should become inflamed during pregnancy, we have to treat
the inflammation precisely as any  other metritis, see Sections
63-71.
  Hydrometra or uterine dropsy differs  from this disease
when supervening in the  unimpregnated womb, in  such a
marked manner that we will describe it here more minutely.
The affection  arises  from an excessive abundance  of  the
amniotic fluid, whence metritis develops itself in some cases,
and which leaves even traces of inflammation in the placenta
and ovum.   In other cases this dropsy seems to come on after
an inflammatory action in the uterus.  It may befal women
of any age, temperament or condition of life; sometimes it
coincides with  twin-pregnancy; at other times it has been
seen to come on after a blow on the epigastrium.  The symp-
toms of this increase are too rapid a growth of the uterus, a
dull pain in the hypogastric region, and a more or less marked
sense of weight in the pelvis, sometimes with swelling of the
legs, thighs, face and hands, weakness, difficult  digestion, op-
pression, often obliging the patients to spend the night on a
seat.  The  signs which distinguish hydrometra of pregnant
women from common uterine dropsy, are those of pregnancy
having preceded the state  of dropsy  or coexisted with   it ;
moreover the balloting of the fetus that can be perceived in
most cases.   The prognosis, though not serious for the mother,
is always unfavorable to the fetus which always perishes if the
amniotic liquid  escapes through the uterine orifice.  It is not
always easy to  treat  this affection, especially on account of
the obscurity of the symptoms at the onset of the disease, and
afterwards on account of their limited number, and the absence
of particular indications; nevertheless, if the disease is well 
DISEASES OF  PREGNANT  FEMALES.        327
marked, we may always commence  the treatment with Sul-
phur, six  globules in half  a  tumblerful of water, a dessert-
spoonful of which solution should be given three times a day ;
or with Arsenicum, if there be a marked  dyspnoea, swelling
of the legs, face and thighs.  Sometimes we may give  China
with success, especially if the patients have been weakened by
loss of blood or deficient nourishment; or Nux vomica, if there
be constipation, frequent urging to urinate, difficult digestion
and vomiting of food.
  Fleshy moles which  must not be confounded with false
pregnancy, where a germ is always wanting, are an affection
of pregnant women consisting in a degeneration of the product
of conception.  Unfortunately this condition cannot be recog-
nized  by  any characteristic sign  before the expulsion of the
mole; and, if some signs should lead us to suspect the presence
of a mole, the expulsion is generally close at hand and cannot
be prevented.  We have  indicated Section 75, the best  reme-
dies to facilitate expulsion if it should go on too slowly ;  hence
we refer the  reader to this  passage.
   False  pregnancy which has nothing in  common with preg-
nancy but the name, is a  species of hydatic hydrometra, occa-
sioned by acephalocyst worms in the womb that may simulate
an  incipient pregnancy most perfectly.   AATe refer our readers
to Section 76, where we have given a full description of this
affection and of its treatment.  The treatment of such  disor-
ders as may set in after the expulsion of moles, such as lochia,
milk-fever, or even metroperitonitis, is the  same as that  which
we have indicated in the-paragraphs concerning the ailments
that  may complicate labor and confinement.   Sections 130-
135.
   The TUMORS OF TnE VULVA which occur during pregnancy.
are the phlegmonous swelling and oedema of this organ.  For
a description of these diseases and of their  treatment, we refer
the reader to Sections 99-101.  The best remedies for  in-
flammation of the vulva during pregnancy, are Sepia and
Mercurius, and for csdsma of  the vulva,  Bryonia, Sulphur,
Mercurius, Sepia. 
328
DISEASES OF FEMALES.
                      Section  123.
  Influence of existing diseases upon pregnancy.—We
have to examine in this paragraph: 1st, the influence which
diseases exercise over pregnancy ; 2d, the influence which preg-
nancy exercises over diseases; 3d, the treatment to be followed
in case unpleasant consequences should result from either.
  As regards the influence Which diseases exercise over
pregnancy, it  is generally admitted,  that acute epidemic or
other diseases when befalling a pregnant female, easily  lead
to miscarriage,  and often result fatally; but this termination
may be owing to the heroic treatment  pursued by old school
physicians rather than to the disease itself.  We have treated
measles, variola, scarlatina, dysentery, etc., supervening  dur-
ing pregnancy, without having ever had a fatal result to deplore.
Chronic diseases scarcely ever modify  the  course of preg-
nancy ; consumptive persons, or  women affected with aneu-
risms or dropsy, or with other chronic diseases, generally go
their  full term.   So do  women  affected with abdominal
tumors, nervous diseases, mental derangements, and other
affections of the same sort; syphilis, however, will often  pro-
duce miscarriage, after destruction of  the fetus.
  The influence of pregnancy over diseases is likewise
well known.  In some cases  certain epidemic diseases seem
to spare pregnant women,  whereas  other epidemic diseases
seem to attack them more readily and  more dangerously than
other  persons.   It seems certain that  the  high functional
vitality of otherwise healthy pregnant  women preserves them
from, rather than  exposes them to,  acute diseases;  whereas
weakly females  become more liable  to the invasion of acute
diseases than previous to pregnancy.   On the  other hand,
pregnancy sometimes slackens the course of chronic maladies
and even suspends the development  of the symptoms.  This
is especially applicable to pulmonary phthisis; although there
are likewise  cases of  pregnancy where consumption was  has-
tened onward to a fatal issue.   Generally, however, consump-
tions that seemed to be arrested during pregnancy, break out 
            diseases of pregnant  females.         329

again with a redoubled fury after confinement; and tubercles
which had remained in  a state of crudity previous to preg-
nancy, sometimes  become  inflamed  and ulcerated immedi-
ately after  confinement.  Old ovarian  tumors  and other
tumors of the sexual organs  sometimes disappear entirely
under the influence of pregnancy.  In Section 58, about dis-
placements of the uterus, we have said all that we have to say
concerning the  pretended  curative influence  of  pregnancy
over prolapsus of the womb.  Mania and dementia are some-
times favorably affected by pregnancy;  but  as far as a radi-
cal cure of these  affections  goes, it cannot be effected by
pregnancy except  where these affections depend  upon acci-
dental disorders of the menstrual functions, or upon certain
uterine disorders of the same sort.
   Diseases which  supervene  during pregnancy, have to be
treated in the same manner as if  they occurred at any other
period.   As  regards  chronic  diseases,  the  period  of preg-
nancy is exceedingly favorable to their treatment, inasmuch
as the female organism is never  more sensitive to the action
of the drugs than during pregnancy, it is at this time  that
the  germs of disease are  most  easily  extinguished  in the
human body.  Both the mother and the child which she bears
in her womb, are  benefitted by a wisely directed treatment.
We recommend with others, and  with Croserio in particular,
the administration of two globules of Sulphur, which are to
be allowed to act for  six weeks, after which a dose of Calca-
rea is to be  given, and to be allowed to act for the same
period;  a strict homoeopathic regimen is to be pursued all
the while.  Mothers that had always given birth to poorly
looking  children, bore perfectly  healthy and robust children
under the invigorating influence  of such a treatment.   Sul-
phur and Calcarea,  however,  are not  the  only  remedies
adapted  to  this condition; other remedies will  very often
have to be chosen.  The rule is to select them in accordance
with  the perceptible  symptoms;  in order  to enable the mo-
ther to bear healthy children, it will  very often be sufficient
to treat  her  for the ailments that may successively develop 
330
DISEASES OF  FEMALES.
themselves during pregnancy.  By invigorating the constitu-
tion of the  mother, we benefit the child she is to give birth
to ; hence the mother should be  watched  during the whole
period of pregnancy, not only with a view of regulating her
diet, but likewise in order to remove  the  unpleasant symp-
toms,  weaknesses, pains, etc., that may set  in previous to her
confinement.
ARTICLE  III.
                    MISCARRIAGE.

                      Section 124.

  Symptoms and course.—By miscarriage is understood the
expulsion of the fetus from  the womb before it is able to live
separately from the mother.  This accident may take place
at any period during pregnancy, but it occurs much more fre-
quently during the first three months, and especially during
the  third.  In the two first months, the ovum which is yet
very small, is often expelled without pain or any considerable
flooding.  The patients often fancy that they have  simply
been  laboring under  temporary  suppression,  followed by
increased flooding, whereas in reality there was a miscarriage.
The pains and the flooding which accompany the miscarriage,
increase in proportion  as the  pregnancy is more advanced,
and the flooding which accompanies the miscarriage, is often
much more violent than  the loss  of blood that occurs  after
confinement at full term.  The other symptoms vary accord-
ing to the causes that have given rise to the miscarriage.  If
resulting from chronic weaknesses, the accompanying symp-
toms generally are:  loss of appetite, thirst and nausea ; shud- 
MISCARRIAGE.
331
dering followed by heat; pains in the small of the back, las-
situde, fainting turns, palpitation of the heart, coldness of the
extremities, depression of spirits, prostration, pallor, livid
and  bloated eyelids, dull eyes; foul breath;  sense of weak-
ness in the abdomen, cold  feeling towards the pubes, weight
on the anus and vulva, flabbiness of the  breasts with serous
discharge from the  nipples ;  ichorous  and bloody discharge
from the  vagina, followed by discharge of a thin  and  gru-
raous blood,  slackening and  sudden  cessation of  the fetal
movements, sinking-in  of the hypogastrium,  increased fre-
quency of the uterine  pains ; progressive  dilatation  of the
uterine orifice and membranes ;  lastly  expulsion of the amni-
otic  liquor and of the  fetus, followed after some  time by
expulsion of the placenta.   Miscarriage which is induced by
accidental causes, is frequently preceded  by pains in the
small of the back, weight in this region, sense of heavy pres-
sure on the lower portion of the vagina, with general malaise,
gastralgia and shivering.  These symptoms  are often from
the first  accompanied by a little show  of blood, followed by
discharge of  a sero-sanguineous liquid,  which increases to
flooding some time previous to the miscarriage taking place.
In  other  cases the  accidental cause  immediately  excites a
copious haemorrhage; frequent and lancinating pains in the
jibdomen  from the umbilicus  to the vulva set in, the uterus
becomes   the  seat of expulsive  efforts, and the  fetus is dis-
charged.   Haemorrhage may cease after the expulsion, or
may continue sometime after.  If miscarriage takes place at
;.n advanced  period of pregnancy, it is accompanied by simi-
lar phenomena as confinement  at full term,  such  as lochia,
secretion  of milk, and milk-fever.

                      Section 125.

   Causes of  miscarriage.—These are predisposing and ex-
citing causes.
   The predisposing causes are partially peculiar to the mother,
and  partially to the  fetus.  Those that are  peculiar to the
mother consist either in a vicious conformation of the organs 
332
DISEASES  OF FEMALES.
of the mother opposing a sufficient expansion  of the uterus
and consequently preventing the  growth of the fetus, or in
some constitutional taint which affects both the womb and its
contents.   Among such causes we may enumerate the exces-
sive rigidity of the fibres of the uterus, or else  an  excessive
degree of contractility and sensibility of this organ ; weakness
or laxity of  the  neck of the  uterus;  atony of the uterus
caused by  copious leucorrhoea or by  previous unfavorable
confinements; chronic metritis, scirrhus, carcinoma, various
tumors, polypi, dropsy  of  the womb, presence of several
fetuses.  Among the general constitutional causes we have a
sanguine temperament, plethora, piles, profuse and irregular
menstruation;  great  weakness>  extreme  sensitiveness,  ca-
chexia, syphilis, hysteria, scurvy and other chronic maladies,
an hereditary disposition, tendency to miscarriage induced by
previous miscarriages even accidental.   Prolonged watching,
deficient  food, misery,  tight dresses, may also become predis-
posing causes of miscarriage.  Sometimes a peculiar epidemic
condition  of the atmosphere  may favor miscarriage.   The
predisposing  causes inherent in the fetus are weakness, mon-
Btrous development and  disease;  feeble adhesion of the
placenta, placental presentation at the uterine orifice, various
organic defects (scirrhus, hydatids, aneurisms, varices, etc.,)
hypertrophy  or atrophy; excessive  shortness,  length, thin-
ness, hypertrophy or atrophy or other defects of the umbilical
cord;  thinness of the membranes of the ovum; dispropor-
tionate quantity of amniotic liquor.
  The exciting causes are so numerous that they can scarcely
be enumerated.   The most common of  these are uterine dis-
eases,  acute  diseases, fevers;  diarrhoea, dysentery,  colic,
constipation, urinary diseases,  moral emotions, acute pains,
strong odors, sexual intercourse, shocks, violent  emotions,
dancing,  riding in a carriage or on horseback, laughter, cries,
coughing; vomiting ; falling, blows on the abdomen and small
of the back;  abuse of cathartics, emmenagogues, blood-letting
(especially  from  a vein  of  the feet,)  foot-baths, etc.  It is
particularly towards the  menstrual period that these  causes 
MISCARRIAGE.
333
are most to be dreaded.  They affect the fetus and its appen-
dages as much as the uterus, either by destroying the former
and thus compelling its expulsion, or  by exciting the uterus
into expulsory movements before the full term and while  the
fetus was alive.  Abortive means, such as bleeding at  the
feet, drastics, emmenagogues,  puncturing  the membranes of
the ovum, are  likewise to be numbered among the exciting
causes.   These criminal measures do not always lead to  the
desired  result, especially if the patients are of sound health,
so that  intentional miscarriages are much less frequent than
those which are the result of accident.   These exciting causes
are scarcely ever sufficient to produce miscarriage, if there is
not  a  predisposition  that favors their action.   Even  the
mechanical means which are resorted to for the purpose of
puncturing the membranes, frequently lead to serious injuries
of the womb without producing expulsion of the fetus.

                      Section 126.

   Diagnosis  and prognosis.—In diagnosing miscarriage it
is not sufficient that the general character  of the pathological
process that we are called upon to treat, should be recognized;
we have to determine how far  the  danger  has become  immi-
nent, and what causes have  led to it.   As  regards  the
causes,  most  of them are easily ascertained, or are revealed
without any obscurity  by the general state and constitution
of  the  patient, particularly  to the homoeopathic physician
who is in the habit of observing every symptom.  As regards
the imminence of the danger,  we may suppose that a miscar-
riage is to be apprehended, if, after the operation of one of
the above mentioned exciting causes, some of  the precursory
symptoms of miscarriage make their appearance, and if these
symptoms should  be  accompanied by labor pains, softening
and gradual  dilatations  of the uterine orifice, protrusion of
the membranes  during the pains, discharge of the amniotic
fluid, we may consider the process of miscarriage as having
actually commenced.   The prognosis depends upon  the  fact
whether miscarriage has actually set in, or whether we have 
334
DISEASES  OF FEMALES.
only the precursory symptoms to contend against.  Many
accoucheurs regard actual miscarriage as much more serious
than confinement at full term.  This may indeed be  true, if
the accident was  caused by violence, intentional or uninten-
tional.  In  such  a case the danger is  proportionate to the
unexpected suddenness of the attack.   If the accident takes
place spontaneously  and  without any  apparent cause,  it is
often painless and unattended by unpleasant  consequences;
but relapses are apt to take place in such  cases, and  their
frequent recurrence may finally develop many inconveniences,
such as menstrual irregularities,  chronic metritis,  hysteria,
etc.   The prognosis  also  depends upon the accessory symp-
toms.  If violent flooding takes place, the danger is  of course
considerable.  Convulsions,  diarrhoea,   dysentery, acute  in-
flammations, fevers, eruptive diseases, likewise complicate the
trouble, and render the prognosis  more doubtful.  If we  have
only the precursory symptoms to combat, the prognosis under
homoeopathic treatment  is of course much more  favorable
than under  old-school  treatment.  Nevertheless, in spite of
the excellent means which our school possesses to prevent or
arrest miscarriage, this is not very easy, if some internal dys-
crasia, uterine disorganization, vicious mode of living, etc., is
the cause of the disorder; the nature and seriousness of the
exciting cause likewise  determines in a  measure the chances
of a favorable issue;  the intensity of the accompanying symp-
toms which are more immediately traceable to  the  accident,
is  likewise  to be considered.  But whatever may  seem the
amount of the danger, the homoeopathic physician  need not
despair until the miscarriage has actually taken place. Even
where  the most violent flooding or convulsions had already
set in, or in placental presentation, or after the discharge of
the amniotic fluid, the use of homoeopathic means has often
prevented the occurrence of miscarriage.

                      Section 127.
   Preventive  treatment.—The main point  is to prevent
the miscarriage, especially where there  is a  predisposition for 
MISCARRIAGE.
335
such mishaps.   To this  end we  have to acquaint ourselves
with the hygienic conditions of our patient, and to remove all
the  predisposing  and exciting causes  which, in  her  case,
might lead to miscarriage. We have said above (Section 113)
every thing that we had to say concerning the mode of life to
be pursued during pregnancy, clothing, dwelling, exercise,
food, etc.   In respect to these things  every necessary pre-
caution has to  be observed by females disposed to miscarry;
they should take moderate  exercise in the open air, especi-
ally  walking;  their food  should  be plain  and substantial;
coffee,  tea, drugs of every description, herb-teas, decoctions,
warm baths, etc., should be strictly avoided, and the mind
should be kept  easy.   Riding on  horseback  or in a carriage
is likewise hurtful.  Such old-school  means as  sleeping in
extension-chairs, are  likewise condemnable, for the reason
that the  constitution  of the patient  is weakened in  conse-
quence, and the disposition to miscarry is increased  rather
than diminished.
   After regulating  the  hygienic  conditions of the patient,
and  removing the predisposing and exciting  causes, we have
to examine the sanitary condition of  the patient generally,
inquire into her previous sicknesses, the character of her ca-
tamenia, her most common indispositions, and then institute
a treatment in  conformity to  the  information which we have
obtained.    Some beginners  in  homoeopathy  imagine  that
there are  medicines which  prevent miscarriage absolutely, in
any  constitution, and  they prescribe  a whole string of such
medicines, simply because the repertories recommend them as
efficacious.  This  species of  treatment is  a great mistake.
The  best  means of preventing miscarriage is to invigorate
the patient's constitution, to  cure her of  all constitutional
weaknesses, and the medicines which affect this  object best,
will likewise  prove the best  preventive medicines  as  far as
miscarriage is concerned.  It is evident that we cannot men-
tion  a remedy for every  individual  case  of  constitutional
suffering  that may  occur among pregnant women, for the
symptoms  by which such  weaknesses  are characterised are 
336
DISEASES  of females.
too numerous.   Nevertheless  the  following remedies will in
general prove  efficacious  against  the chronic  ailments of
women predisposed to miscarriage:

       1.  Calcarea,  Camphora, Sabina, Sepia, Pulsatilla,
         Sulphur, Carbo veg., Ferrum.
       2. Asarum, Camphora, Cocculus, Hyoscyamus, Nux v.,
         Plumbum, Ruta, Silicea.
  And in particular:
   Calcarea, in the case  of  plethoric women of full habit,
with profuse and premature menstruation, disposed to leucor-
rhoea, painfulness  of the breast, colic, pains in the small of
the back, frequent congestions of the head  and the chest,
vertigo, varices of the genital  organs, etc.
   Camphora, suitable  to females of a feeble constitution,
subject to leucorrhoea, colds on the chest or in the head, or
catarrhal  discharges generally, with pale,  loose and  cold
skin, sensitiveness to open or cold  air; indifference to  sexual
intercourse, little enjoyment during intercourse, etc.
   Sabina, suitable to plethoric women with profuse and long-
lasting menses, or where the patients had been in the habit
of miscarrying in the third month.  If this medicine is  indi-
cated,  the patient  may take three globules dry on the tongue,
a  dose every forty-eight hours, during  the week  preceding
the period when the menses ought to have set in ; this treat-
ment has to be repeated until  after the time when the previous
miscarriages took  place.
   Sepia, suitable  to feeble, soft constitutions with a delicate
and sensitive skin, dingy color of  the skin, "brownish or yel-
lowish spots in the face, slender waist; disposition to  leucor-
rhoea,  with soreness,  eruptions and  itching of  the  parts;
menses generally too  scanty or  premature, with sadness,
weeping, headache or toothache; frequent attacks of megrim ;
tendency to perspire; frequent colic; disposition to cold in
the head and bronchial  catarrh.
   Pulsatilla, for the same conditions as Sepia, or in alter-
nation with Sepia, and  preferable to  this agent if the patient 
miscarriage.
337
is  chilly, averse to drinking, disposed  to bilious diarrhoea,
derangements of the  stomach,  with pale face, gentle dis-
position.
   Sulphur, often at  the onset, before Calcarea or Sabina;
the menses are premature, profuse; or after  Pulsatilla  or
Sepia, when the menses are scanty and retarded, with leu-
corrhoea, itching, burning and soreness of the parts; eruptions
or tetter on the skin;  disposition  to piles, bronchial catarrh
or other mucous discharges;  weariness, nervous debility, loss
of appetite;  frequent headach with pressive pain and conges-
tion of blood about the head.
   Carbo vegetabilis, in some cases when  the menses  are
too pale and too scanty, or too  copious and  premature, with
varices at the parts, frequent pains in  the small of the back
and headaches, spasmodic colic, etc.
   Ferrum, suitable to chlorotic  patients with leucorrhoea and
amenorrhoea ;  or suitable to plethoric females, with vascular
excitement, red face,  full  and strong pulse, premature and
copious menses.
   Lycopodium, profuse and long catamenia, with itching,
burning and varices  of  the  parts; dryness  of the vagina;
disposition to melancholy and tears; leucorrhoea, headache,
pains in the small of the back, fainting  turns.
   Moreover:—
   Asarum, suitable to females who are subject to megrim;
menses too early and  long, with discharge of black blood and
pains  in the small of  the back; nervous  sensitiveness, espe-
cially  of the hearing.
   Cannabis, suitable  to females who had been  affected with
virulent gonorrhoea; sensitive disposition; weariness after the
least exertion;  hysteric ailments; scrofulous  constitution;
disposed to constipation, etc.
   Cocculus, difficult  menstruation, with colic and uterine
cramps; weakness and frequent hysterics; aversion to open
air; scrofulous engorgements; gentle and phlegmatic disposi-
tion ; sad.
   Hyoscyamus, copious menses with hysteric ailments ; dis-
                            22 
338
diseases of females.
posed to have boils;  brownish spots and  freckles all over;
jealous, quarrelsome and talkative.
   Nux moschata, suitable  to hysteric females who are dis-
posed to fainting turns, convulsions or uterine cramps; irre-
gular menses, with pains in the small of the back and discharge
of a thick and  dark  blood; sensitiveness  to the  open, cold
and damp air; cold and dry skin ;  no perspiration; changing
mood; disposed  to feel chilly, with pale face.
   Plumbum, suitable  to patients who are fond of sexual inter-
course, with yellowish or blueish color of the skin, and brown-
ish spots on the body ; habitual constipation; dryness  and
falling off of the hair ; pale  face; chlorotic  symptoms, etc.
   Ruta, suitable for  irregular catamenia  either too profuse
or too scanty, preceded or followed by acrid leucorrhoea.
   Silicea, when the  catamenia are generally too early and
profuse, with disposition to corrosive leucorrhoea.
  Predisposing causes arising from chronic metritis, leucor-
rhoea, scirrhus, carcinomatous tumors, polypi, etc., have to'be
met by treating these diseases in the manner indicated in pre-
vious paragraphs.
   But whatever pathological condition we may have to act
upon in order  to prevent miscarriage, it is  always well to be
very cautious in not  giving too  much medicine.   A  single
dose of two or three globules dry on the tongue is sufficient
at a time; and  this dose should not be repeated without a
positive indication by the symptoms.

                      Section 128.

   Active treatment of the precursory  symptoms.—If, in
spite of  our preventive measures, miscarriage will threaten,
and precursory symptoms of it develop themselves, such as
pains from the umbilicus to the  genital organs, or real labor-
pains coming on in regular succession  and accompanied by
discharge of blood or bloody mucus, we have at once to give
a remedy corresponding to these symptoms and to the excit-
ing cause.   The patient should  be kept  perfectly quiet in her
bed,  avoid warm drinks and warm solid food, or  any thing 
miscarriage.
339
that may excite the abdominal viscera.  The best remedies
for this purpose are:—1. Arnica, Ipecacuanha, Sabina, Bel-
ladonna,  Chamomilla,  Hyoscyamus,  Secale,  Nux vomica,
Bryonia, Pulsatilla, Rhus,  Cinnamon.   2.  Chamomilla,
China,  Cinnamon,  Cocculus, Crocus, Nux vomica, Platina,
Ruta.  And more particularly,
   Arnica, when, after  a blow on the stomach, fall, or after
violent  movements,  labor-pains with discharge of blood or
bloody mucus have  set in.
   Ipecacuanha, for acute haemorrhage with continuous flow
of bright red blood,  colic, cutting pains at the umbilicus, vio-
lent pressure on the womb  and rectum, nausea, weakness,
pale  face, shuddering,  or even convulsions without  loss of
consciousness.   If Ipecacuanha does not help, we may give
Platina or  Cina.
   Sabina, if the precursory symptoms of miscarriage show
 themselves  during  the first months  of pregnancy, especially
 in the third; but,  also at any other period, and particularly
 when the following symptoms occur:—discharge  of dark-
 colored coagulated  blood; pressive  and  drawing pains  from
 the small of the back to the sexual parts; soft and flat abdo-
 men ; continual urging to stool, with diarrhoea, nausea  and
 vomiting; fever, with shuddering and heat.
   Belladonna, for pressive and  tensive pains in the whole
 abdomen, with sense of constriction  or distension,  lumbar
 pains as if the sacrum would  break; pressure downwards in
 the abdomen and private parts, as  if every thing would fall
 through.
   Chamomilla, for discharge of dark or black and foul blood,
 with coagula; violent cutting colic from the small of the back
 to the hypogastrium, with frequent desire to go to stool or to
 urinate ; sense of heaviness in the abdomen;  frequent yawn-
 ing; shivering and shuddering;  restlessness and convulsive
 movements.
   Hyoscyamus,  for convulsions,  restlessness, loss of con-
 sciousness, stupefaction, vanishing of sight and hearing, deli-
 rium, etc. 
340
diseases of  females.
  Secale cornutum, when the uterus is organically diseased,
or for  deficient vitality of the womb; suitable  to feeble, ex-
hausted, cachectic females, with disposition to passive haemor-
rhage or convulsions;  pale  and earthy complexion;  pulse
small and almost extinguished; fear of death;  profuse dis-
charge of black and thin blood.
  Nux vomica, for obstinate constipation with violent cramp-
pains, congestion of the womb, suitable  to women  who have
abused coffee or alcohol;  scanty flow of blood, but accompa-
nied with great weakness and pale face.
  Bryonia, if Nux is not sufficient for the violent pains, con-
stipation, congestion of the head, dry mouth and thirst.
  Pulsatilla, for intermittent haemorrhage, recurring every
now and  then with redoubled violence, accompanied with ex-
pulsive pains and discharge of a dark blood with coagula.
  Rhus, when the attack is caused by violent efforts such as
lifting a weight, or by a strain of the side or a false step.
  Cinnamonum, if Rhus  is not sufficient, or if the  effort is
followed  by profuse flooding.
  As a general rule we may give—
For violent hemorrhage :—Ipecacuanha, Arnica, Sabina,
         Pulsatilla, Cinnamon.
     Continuous:—Ipecacuanha, Sabina,  Arnica,  Cinna-
         mon.
     Intermittent :—Pulsatilla.
     AVith bright-red blood:—Ipecacuanha, Arnica.
     Dark-red:—Sabina,  Chamomilla, Secale.
     Convulsions: —Ipecacuanha,  Hyoscyamus,  Chamomilla,
         Platina, Cinnamon, Secale.
     Blows on the abdomen:—Arnica.
     A strain:—Rhus, Cinnamon.
   The dose should be six  globules in half a  tumblerful of
water, of which  solution  a dessertspoonful may be  adminis-
tered every two or three hours. 
MISCARRIAGE.
341
                      Section 129.

  Treatment of the consequences.—If the accident cannot
be prevented, and the physician is called after the expulsion
of the fetus has already commenced, we will have to treat the
patient in the same manner as if actual confinement had taken
place.   We refer the reader in this respect to Sections 130-
133.  If the accident should  occur previous to the seventh
month of pregnancy, we should abstain as much as possible
from interfering by manual manipulations with the  natural
process.  If  the fetus should be expelled, we have to hold it
in a manner that will prevent  the tearing of the cord.  For,
if the placenta should remain  in  the womb, after the expul-
sion of the fetus, it may still continue  to grow and give rise
to the symptoms  of false  pregnancy, or to  fleshy  moles.
Moreover, the expulsive pains in miscarriage are always more
violent and protracted than in natural confinement, so as to
frequently occasion convulsive  movements.   In this case,
manual interference would be of no use.  A dose of  Coffea,
Pulsatilla, or Secale (three globules dry on the tongue) will
facilitate the expulsion of the fetus, if it cannot be avoided.
   After the  miscarriage, we proceed in  the same manner as
after  confinement and labor.   Sections 130-153. 
342              diseases of females.
ARTICLE IV.
   of natural confinement and of the duties of the
              physician on SUCH OCCASIONS.

                      Section 130.

   Symptoms and  course of  labor.—At  the  approach of
the natural term  the  organs  of generation  become moist,
the uterus descends sometimes a fortnight before confinement,
the epigastrium becomes disembarrassed, the breathing easier,
the digestive functions  less difficult;  on the other  hand, a
sense of weight in the lower portion of the pelvis, a  sense of
numbness in the uterus and frequent urging to urinate often
set in, until labor commences.  First the patient feels short,
transitory and slight pains in the hypogastrium, during which
the uterine tumor becomes harder, whereas  the orifice which
had been somewhat dilated, contracts and becomes more rigid
all around, and mueus is discharged from the vagina.  Soon
the pains become  sharper, occur  more  frequently  and last
longer, every pain  sometimes being  ushered  in  by a sort of
internal trembling or even a slight chill.  At the same time
the pulse becomes hard, frequent, raised; the heat of the body
increases,  the face becomes redder, the lips and tongue  be-
come  dry; the patient feels  thirsty, restless,  sick at  the
stomach,  and even vomits; the orifice of the  womb opens and
dilates, the borders of  the orifice become stretched and thin-
ner ; the  membranes  pass into the orifice in the shape of a
spherical  segment, the dimensions of which augment  at each
pain; the abdominal muscles contract; at last the pains cease,
and all these symptoms disappear except the dilatation of  the
orifice which increases more and more until the uterine cavity
forms a continuous canal with the vagina, the superior portion 
              natural confinement.               343

of which becomes dilated correspondingly to the neck of  the
womb.  After the dilatation of the uterine orifice is completed,
the first part of the process of labor is accomplished, and the
second part commences with the same symptoms as the former,
only more intensely; the restlessness of the patient increases
sometimes  even to delirium; the pains become more acute,
more frequent, but are followed by a period of more complete
repose during which the patient shows a disposition to sleep*
At the same time the patient experiences in the lower portion
of the pelvis a sense of heaviness, a sort of tenesmus, which
determines  the contraction of the abdominal muscles and of
the diaphragm ; the amniotic  fluid which is pushed downwards
by these contractions,  forces the inferior portion of the mem-
branes which break and allow the fluid to escape, sometimes
with so much force that the patient utters a cry of surprise.
After the expulsion of the fluid, the head of the fetus presents
at the orifice which becomes stopped up in consequence, so as
to prevent any further escape of the amniotic liquid.  At each
new pain the head of  the fetus descends a little lower in the
vagina,  protrudes  through  the orifice, and passes into the
vagina which dilates accordingly, and  at the same time, be-
comes elongated, the vulva opening a little at the same time;
the labia majora and  minora are stretched out into one fold,
the mons veneris sinks  in,  the perinaeum becomes distended
and thinner; the anus protrudes, dilates and the faecal matter
which the rectum happened to contain, escape;  the urine is
likewise expelled spontaneously.   The  more labor advances,
the more the efforts of the  patient increase; the  patient  is
seized with a convulsive trembling, and the pains extort cries
from her.  Lastly, a most violent expulsive pain presses the
 head out of the vulva; this is followed by a moment of  rest,
 then a new and less violent  pain  takes  place,  which propels
 the body of the infant out  of the vulva, and with it the re-
 mainder of the amniotic fluid.  Labor being over, a delicious
 calm is  experienced by the mother after these excessive exer-
 tions and pains; and  she enjoys the sweet thought of having
 given birth to  a new being  that is to be the pride and joy of 
344               diseases of  females.
her earthly existence.   After this calm has lasted for a while,
the phenomena of placental delivery begin to develop them-
selves;  of this mechanism we shall treat by and by, after
having  described the attentions which  it  behooves the ac-
coucheur to bestow upon the mother both during natural  and
praeternatural labor.

                      Section  131.

  Diagnosis  and prognosis.—The object of diagnosis in
confinement is to find out whether labor has really set in, or
how long  it  may  possibly  be  before  it  does set  in;  and
secondly, whether  the existing conditions justify a favorable
prognosis.  As  regards  the beginning  of labor,  we have
hardly a right to say  that labor  has actually set in before the
neck of the womb  is  entirely effaced, no matter how far  the
orijfice  of the  womb may otherwise be  dilated; if  the com-
plete disappearance of the uterine neck is  accompanied with
regularly increasing  pains,  a progressive dilatation of the
uterine orifice and tension of the membranes during the pains,
discharge of mucus from the vulva: we may rest assured  that
labor has actually set in.   In regard to the pains we have to
distinguish false from real pains.  Real pains are those which
depend upon  uterine contraction during  which the  uterine
orifice  becomes  more and  more dilated; the false pains  are
entirely foreign to  the process  of  labor, and  are generally
located in some part adjoining the  uterus; often these pains
are inflammatory or  spasmodic  colicky pains,  not  accompa-
nied by any other sign of labor, and leaving a sense of pain
during the intermission, provided there be such a period.  As
regards the conditions of a spontaneous termination of natural
labor, they are revealed  to us  by the position of the fetus,
and by  an exploration of  the straits through which the child
has to  pass.   The canal through which the fetus is  transmit-
ted into the outer world, must have the necessary dimensions ;
the fetus has to pass through  this  canal  in  such a manner
that the various dimensions of the  fetus are in  exact co-
adaptation  to  the various diameters of the straits; the orifice 
NATURAL CONFINEMENT.
345
of the uterus has to be  sufficiently dilated  to allow the fetus
to pass;  and lastly, the muscular contractions of the women
have to be strong enough-^o effect the expulsion of the fetus.
Having ascertained these various points, we can easily deter-
mine how long the process  of labor may last.  The prognosis
depends upon the constitution of the patient, the strength she
possesses,  the  shape of the pelvis, the  softness or hardness,
the thinness or thickness of the uterine  orifice, the dampness
or dryness, flexibility or rigidity of the genital organs,  the
probable  size of the child, and  the position in which it pre-
sents ; the intensity  of the uterine contractions, and their
effect upon the progress in the expulsion of the fetus, like-
wise the number and character of her previous confinements.
Most of these'signs are  ascertained  by the touch, which  has
to be resorted to  as  soon  as the first  signs of labor have
become apparent.

                      Section 132.
  Hygienic  attentions during  confinement.—The  first
care of the accoucheur should be to enable the patient to keep
up her strength,  and to prevent the untoward consequences
of such external influences as might effect her unpleasantly ;
next,  he  has to assist  and watch nature, in  order to bring
about a favorable  termination of the process of labor.   In
this paragraph we will treat of the hygienic conditions of the
patient, and in the  next  paragraph we will describe the par-
ticular medicinal measures  which the physicians may have to
adopt to help his patient through.
  The hygienic regulations constitute one of the most impor-
tant  points in  obstetric  therapeutics; many unpleasant  ail-
ments may be prevented by wise precautions.  The  external
conditions must be adapted to the patient's wants in order to
enable  her to  have an easy confinement.  As  soon as  she
experiences the first  pains, she ought  to remove every spe-
cies of clothing that  feels  tight on  the body,  and especially
around the neck, in order to be freed from every embarrass-
ment that might be disagreeable to  her, and might  impede 
346
DISEASES  OF FEMALES.
the liberty of respiration and of the  circulation of the blood.
The air  that she inhales, should be  pure and of moderate
temperature; neither too warm, lest the patient  should be-
come restless and the circulation should become excited; nor
too cold, lest she  should  take  cold  to  her great  detriment.
The woman's strength should be kept up by nourishment of
easy digestion, which  is taken  in small quantity; but pure
wine, stimulants or icy beverages  should be strictly prohi-
bited;  pure water or water with sugar are the best drinks for
our patient; and  if the  patient  should  be so weak  as to
require something strengthening, we may resort for this pur-
pose to broths  or  soups.  In order to prevent the involun-
tary emission of urine, or the involuntary evacuation of faecal
matter, or, on the other hand, the  excessive accumulation of
faeces in the rectum,  the patient should be advised to go to
stool as  long as the labor is not too far advanced to render
this impossible; in case of constipation  with difficulty of
evacuating the  bowels, we  may administer an injection of
tepid water.   Whatever has  a tendency to excite  the patient
or  to depress her spirits, should be kept away from her; per-
fumes, strong  odors,  noises, loud  conversation, etc., should
likewise  be  removed as hurtful.  A little walking about in
the room facilitates the process of labor; but  during the
pains the patient should lean against something,  and take  a
position  that will prevent all  useless  straining.   After the
discharge of the amniotic fluid, the patient should be fixed in
the position in which  she is  to be confined, upon a bed pre-
pared expressly for this purpose, where the head is somewhat
elevated, and the body gently inclined.  The bed should be
sufficiently provided with pieces of linen to receive the blood
which  is discharged from the vulva; the  covering of the
patient  should be  adapted  to the season.  The head and
shoulders should be gently raised, the thighs flexed upon the
abdomen, and  the legs upon the thighs,  the knees being at
the same time  spread apart from one another.   All mechani-
cal means to dilate the organs of generation preparatory to
labor,  are  absolutely condemnable; they irritate the parts 
NATURAL CONFINEMENT.
347
and are moreover useless;  for nature is amply able to achieve
this work.  The finger should not be introduced in the vagina
any more frequently than is  absolutely necessary to discover
the position of the child, and  to ascertain whether any manual
interference  is required.   Hip-baths, tepid injections, fumi-
gations,  etc., are  likewise  condemnable; if  any medicinal
assistance  is  to be tendered, the  following paragraph  will
explain more fully what is to be done.

                      Section 133.

  Attentions of the accoucheur during the process of
labor.—Having devoted the  following paragraph to the details
concerning praeternatural labor, we shall here simply confine
ourselves to the means by which labor  can  be  facilitated, or
else restored in case it should have been arrested.   The ac-
coucheur should therefore keep an eye upon  the  muscular
contractions  that have to  bring about  the  expulsion of the
fetus; 2, the dilatation of the uterine orifice and of the canal
through which the fetus has to pass ; 3, the more or less favor-
able positions of the fetus.
  We have alluded above to  the false pains  during which the
uterine orifice remains closed, whereas it dilates and becomes
rigid  during  the real labor-pains.  Hence, if a  pregnant
woman  begins to feel pain, the physician has to inquire  into
the period of her pregnancy, and if it should appear that the
patient  has gone her full term, the  pains should not be inter-
fered with.  But if, in spite of the full term, the pains do not
progress, and the  uterine orifice does not become rigid or
contracted during the pains, we may administer three globules
of Pulsatilla dry on the tongue, or a similar dose of Coffea,
or Nux vom., or Belladonna, or perhaps Chamomilla, or Nux
mos.; the pains will either cease or else progress in  regular
order.
  Sometimes  the pains continue properly and regularly; but
the uterine orifice remains closed; this may  be owing to a
wrong position of the  fetus,  or to an excess of resistance on
the part of the neck.   If the neck does not resist sufficiently, 
348
DISEASES  OF FEMALES.
or does not become thinner, a dose of Pulsatilla may remedy
the defect; for Pulsatilla seems to be endowed with a faculty
of changing the wrong position of the fetus as  long as it is
still floating in the amniotic fluid.  If the neck should remain
closed and a hard rim should be felt all around  the orifice,
three globules of Belladonna dry on the tongue  will  bring
about the regular evolution of the process of labor.
   In other cases the orifice dilates regularly during the  pains,
but the watery tumor does not seem  disposed to make its ap-
pearance.  This may likewise be owing to a false position of
the fetus, which may be remedied by a dose of Pulsatilla.
   Sometimes every thing goes on  favorably, pains, muscular
contractions, progressive dilatation of the uterine orifice and
of the whole canal through which the child has to  pass, and
the watery tumor seems to present properly;  but the  pains
are too violent, and the patient fancies  that she cannot bear
them any longer.  In this case, three globules of  Coffea, dry
on the tongue, will afford great relief, especially if the patient
is very nervous and sensitive, restless and utters  loud  cries;
or we may give a dose of Nux vom., when there is frequent
urging to stool or to void the urine, with irascible  and  impa-
tient mood; or Chamomilla when the pains are accompanied
by anguish, with twitching of the limbs,  fear, weeping, dis-
consolate and vehement mood; or Belladonna if none of the
other medicines help.
   In spite of the most favorable course  of the process of
labor, the patients are sometimes seized with a dread of death,
inexpressible anguish and terror; especially primiparae  who
are attacked in this way as soon as the pains commence; no
reasoning, no encouragement, no assurance on the part  of the
accoucher succeed in dispelling this symptom.   A single dose
of Aconite (three globules dry on the tongue) will do all that
is required.
  There  are other symptoms which sometimes intervene dur-
ing the course of labor  and require the interference of the
accoucheur: such symptoms are: absence of labor-pains, faint-
ing, cerebral  congestions, convulsions, haemorrhage, etc.;  we 
difficult or  protracted labor.        349
have united all these accidents  by which the regular process
of labor is sometimes  interrupted or interfered with, in a
special chapter under the heading of difficult and protracted
labor.
ARTICLE  V.
        OF difficult or protracted  labor.

                       Section 134.

   General  observations.—Labor may be protracted by:
1st, obstacles  existing in the  passage through  which the
child has to pass ; 2d, obstacles  offered by the  fetus; 3d,
accidents that  may  happen to the  mother  during labor.
Several of these obstacles are of the domain of instrumental
labor, and we shall content ourselves with simply mentioning
them here, inasmuch as we have only to deal with the medicinal
treatment which the condition of the patient may require.*
Several conditions, however, which it was  supposed required
the  interference of operative  obstetrics,  can  be remedied
much better by internal homoeopathic treatment,  so that the
domain of medicinal obstetrics is much more  extended now-a-
days than it was  formerly.  Hereafter we shall explain the
various accidents  that appertain to each of the above men-
tioned categories, and at the same time  furnish a  description
of the treatment required by each.
  *See  the Practical  Treatise on  Obstetrics by Chailly.Honore\  Member of
the Imperial Academy of Medicine, Professor of Obstetrics, former head of
the Obstetrical Clinique of the College of Medicine in Paris.  Third edition,
considerably increased.  Paris,  1853,  one Vol. in 8vo.,  1050 pages, with
275 wood cuts. 
350
DISEASES of females.
                      Section 135.

  Obstacles inherent in the mother.—These  obstacles
are: deformities of the pelvis, tumors  in the body or the
appendages of the uterus, tumors of the vulva and vagina, con-
tractions of the vagina and vulva.   Evidently some of  these
affections cannot be removed during the process  of labor, and
the accoucheur, as soon as he is called for a pregnant female,
has to explore the condition of the passage in order to deter-
mine  whether any interference of art is required for  their
removal previous to the period when labor will set in.
  The deformities of the pelvis are all of  them inaccessi-
ble to the ministering agency of art;  but as long as there is
barely space sufficient to admit the passage of the child's
head  (two inches and  a half,)  the accoucheur should not de-
spair.  A dose of Secale, two globules second attenuation, in
half a tumblerful of water, a dessertspoonful at  a dose,  taken
each time that the pains seem to flag, or a  similar dose of
Pulsatilla, will sometimes conquer every difficulty, and  bring
about a  happy termination  of labor.  Osseous excrescences
and tumors in the orifice or neck of the womb, or membranes
in the vagina or vulva are  likewise incurable  by medicine.
Deformities which prevent the passage of the fetus, belong to
the domain of operative obstetrics, and need  not be  men-
tioned here.
  It is different with tumors in the soft parts, neck  of the
womb, vagina or vulva.  Most of them can be treated during
pregnancy, provided their formation is known in season, and
the proper treatment can be pursued.   But even if they can-
not be removed by treatment, they do not necessarily prevent
the regular process of labor, for they may be pushed out of
the way of the fetus by a suitable management of the  parts,
or the uterine contractions may be strengthened by a dose of
Secale or Pulsatilla,  sufficiently to enable the  fetus to over-
come the obstacles alluded to.   Nux vomica may be given in
case of vaginal hernia.  If labor is interfered with by falling 
           difficult or  protracted  labor.        351

or protrusion of the umbilical cord, Pulsatilla will be  found
very useful.
  As regards contraction or stricture of the vagina, this
condition may either be congenital or accidental. If congenital,
without any other organic defect, labor is not prevented by it,
and the parts dilate gradually so as to admit the passage of the
fetus.  But if this dilatation should proceed too  slowly or be too
painful, a few doses of Coffea, Secale, Pulsatilla or Nux vom.,
will remedy this trouble.  But if the  stricture is  accidental,
owing to some tumor, we should treat it during pregnancy by
appropriate remedies.  Inflammatory swellings of the vulva
and vagina generally yield to a few doses of Mercurius, Sepia,
or Thuja.   If the excessive tenderness of the vulva or vagina
should prevent the  dilatation of these parts on account of the
acute pains excited by this process, which sometimes render
the danger of convulsions imminent, a few doses of Coffea or
Nux vomica, will sometimes prove an efficient remedy.

                       Section 136.

   Obstacles presented by the fetus.—These are: false
positions, excessive  size  of the head, shortness of the umbilical
cord, death of the Infant.
   We have stated that, if these positions can be known while
the fetus is still enveloped in its membranes in the interior of
the uterus, a dose of  Pulsatilla will often  be sufficient to
change them.  But if they are found out too  late, or Pulsa-
tilla remains without effect, we have  to  resort to the  opera-
tions which are fully described in obstetric  treatises for  such
occasions.
   As regards the excessive  size of the head, some homoeo-
paths advise the employment of Pulsatilla or  Secale, in  very
small doses, in order to obtain the natural expulsion of the
fetus in spite of this inconvenience.  We have  no  clinical
observations concerning this phenomena except one, which is
the case of a mother who, on three successive  occasions, gave
birth to children with such enormous  heads  that instrumental
delivery had to be  resorted to in every case; during her 
352
DISEASES of females.
fourth pregnancy, I gave her Calcarea, Sulphur and Silicea,
and the child was brought  to  life without any instrumental
interference whatever.
   The shortness of the  cord is not necessarily a danger-
ous obstacle to delivery, provided the physician is made aware
of  it  in  season.  If the  head should not  descend  with a
promptitude proportionate to the force of the uterine contrac-
tions, which often cease at the very moment when they should
be the most powerful, and if the  patient feels at every pain
as if  the  bowels  would  be  torn out, we may be certain that
the cord  is too  short.   A  dose  of  Pulsatilla  or Secale, a
dessertspoonful of a solution of six globules in half a tumbler-
ful of water, to be given at  every contraction, will assist the
efforts of  nature  and bring about a favorable termination of
labor.
   The death of the fetus does not prevent its expulsion,
but renders the  labor often less effective, the  more so the
longer the fetus had been dead.  Pulsatilla and Secale will
likewise be of great use to the patient.

                      Section 137.
   Accidents  that  may happen to  the mother during
labor.  These accidents by which the process of labor may
be more or less  retarded,   are: absence or cessation of the
pains, fainting, cerebral congestion, convulsions, haemorrhage.
   Absence  of pains may depend upon constitutional weak-
ness, or upon transitory causes, such  as passion, contrarieties,
etc.   Secale, Pulsatilla or  Opium, in small doses will always
prove useful.
   Secale  is  particularly suitable  to feeble  and  cachectic
women, or to such as have become exhausted by haemorrhage.
Pulsatilla, when the pains set in slowly in females of good
constitution; or when the  pains only affect the small of the
back without benefitting the labor; in one word, when  the
absence of pains seems  to  be caused  by inactivity of the
uterus rather than by a general weakness of the  constitution.
Opium is suitable for robust  women, the pains cease suddenly 
           difficult or  protracted labor.        353

in consequence of a fright or  some  other violent emotion,
with congestion of the head, red and  puffed face,  coma, etc.
If the pains do not cease entirely, or are not entirely wanting,
but are only slow and  feeble,  and do not progress regularly,
without  any  known  cause, and  in  the  case  of otherwise
healthy patients, the best thing to be done is, not to give any
medicine, but to wait  patiently.   However, if  after the  dis-
charge  of the amniotic  fluid,  the  pains  should  still remain
feeble and slow, we  may give  a dose of Pulsatilla.  If the
pains should have become suspended by some accidental cause,
such as an unpleasant impression, the presence of a disagree-
ble person, strong odors, etc., all that is generally required is
to remove these obstacles,  after which the labor  will resume
its natural course.
   Fainting is  an unpleasant symptom  during  labor, espe-
cially if it occurs at every pain ;  such an accident seriously
threatens the patient's  life.   In most cases it is induced by
an extreme dilatation of the uterus, but it may also be caused
by deficient nourishment, previous haemorrhage or other sick-
 ness, nervous debility, etc.  The  best remedies for this trou-
ble are : Nux vomica, Aconitum,  Veratrum, Ignatia, Pulsa-,
 tilla,  Secale.  Nux  vomica,  in  the case of feeble women,
 with nausea, pains  in the stomach,  anguish, trembling,  pale
 face, etc.  Aconitum,  for congestion of blood  to the head,
violent palpitation of the  heart,  alternate paleness and red-
 ness of the  face.  Veratrum, if the patient is very weak,
with coldness of the whole body and extremities, the attack
comes on after the slightest effort, with anguish or convulsive
 movements.   Ignatia,  especially  for hysteric women,  of a
 delicate constitution.   Pulsatilla,  if  the  attack  depends
upon an excessive distension of the womb, with inactive pains,
 signs of internal haemorrhage.  Secale, if Pulsatilla is insuf-
 ficient, or at the onset in the case of feeble  and exhausted
 women.
   Congestions of the  head which  occur during labor, may
 become very serious and degenerate into real cerebral conges-
 tions or apoplexy.  The best  remedies are:  Aconitum, Pul-
                             23 
354
diseases  of females.
satilla,  Opium, Belladonna, Arnica.  Aconitum, for head-
ache, as if the head would split, with drowsiness, heaviness of
the head, oppression, red and puffed face even during the in-
termission.  Pulsatilla, for  sopor,  absence of muscular
contraction, blueish-red face, violent palpitation of the heart,
loss of pulse and stertorous breathing.  Opium for heaviness
of the head, vertigo followed  by drowsiness,  red,  hot  and
bloated face, hot and sweaty head, red eyes with dilated and
insensible pupils,  slow  and rattling  breathing, convulsive
rigidity of the body, twitching and trembling of the limbs,
froth  at the mouth.  Belladonna, vertigo with the loss of
consciousness  and speech, twitching of the limbs and facial
muscles, paralysis of the right side of the tongue, dysphagia,
dilated  pupils, red  and puffed face.  Arnica, for  full  and
strong pulse, symptoms  of paralysis of the left  side, loss of
consciousness, dizziness, involuntary stool and urine.   Dis-
solve in all these cases three globules in half a tumblerful of
water,  and give the patient a dessertspoonful of this  solution
every two or three hours according to circumstances.
  Convulsions  are a most  dangerous accident if occurring
during labor; if  increasing  in intensity by any  cause what-
ever, they become complicated with loss of consciousness and
delirium,  and are soon  followed by the death of the mother
and child.   Nervous, timorous and  sensitive women are- most
liable to such accidents, and  such  patients require to be
watched with great care, in order that  the  attack  may be
arrested at  the very onset.   Encouraging advice will do a
good  deal towards quieting the patient; if medicines should
be required, we  may use Aconitum,  Coffea,  Belladonna,
Chamomilla, Opium or Ignatia, which will often arrest the
attack at once.  But even if the physician should not arrive
until the  most violent convulsions  have broken  out, he will
still  be  able to  afford  relief  by  an appropriate  remedy,
especially by Aconitum, at the onset, if the face  remains
red  between  the  paroxysms,  with  headache,  glistening
and  sparkling eyes, impatience,  restlessness, shortness of
speech, etc.   Coffea, if Aconite  does  not  quiet  the  pa- 
difficult or protracted labor.
355
tient at the  beginning of  the  attack, especially suitable to
sensitive women.  Chamomilla, sometimes after  Coffea or
Aconitum, if  these remedies do  not arrest the  convulsions
at the commencement, or  if they  set in in consequence of
a fit of anger, with convulsive twitching  during sleep, red-
ness of the face on  one, and paleness on the other side, hot
sweat  about  the head and  the  face, convulsive  motion of
the  eyes, lids  and   tongue,  restlessness,  irritable  mood.
Belladonna, congestion of the head, red and puffed or pale
face, dilated pupils, convulsive  twitching of the corners of the
mouth, eyes and facial muscles,  the  attack is excited by the
least contact  or disappointment, with comatose sleep or  sleep-
lessness between the  attacks.   Ignatia, when the attack is
caused by grief or chagrin, with throwing back of  the head,
alternate paleness and redness of the face, or redness of one
and paleness  of the other cheek, frequent yawning, twitching
 of  the limbs, eye-lids  and  facial muscles.   Opium, when the
 attack is  caused by fright, with  violent motion of  the  limbs,
 deep,  comatose sleep, cries,  choking  turns.  Hyoscyamus,
 blueish and bloated face, protruded  eyes, convulsive jerking
 of the whole body, comatose  drowsiness, delirious, tertorous
 breathing, or sleeplessness with anguish and  restlessness.—
 Stramonium, risus   sardonicus, gaping or loss  of speech,
 smiling  face, or  frightful visions, cries,  moaning, desire  to
 escape; the  attacks are excited by touch or by the sight of
 shining objects.—Dissolve three  globules of 12th to 18th
 attenuation, in half a  tumblerful of water, and give a dessert-
 spoonful  of this solution at every attack;  if no improvement
 takes place  after the second or  third dose, select another
 remedy.
    Hemorrhage during labor may be external or internal.
 External haemorrhage is  readily  perceived,  but internal
 haemorrhage sometimes attains  to a very high degree of in-
 tensity before its existence is known.   It is  generally occa-
 sioned 1st, by the insertion of the placenta over  the uterine
 orifice;  2d,  by the tearing of the placenta;  3d, tearing or
 some other injury of  the uterus; 4th, rupture of the umbilical 
356
diseases  of females.
vein or arteries ; in any of these cases the blood may remain
enclosed within the[uterine cavity or be discharged externally.
If it  remains within the cavity, the  patient experiences a
sensation of heaviness or tension in the uterine region, which
swells perceptibly, whatever be the cause of such an haemor-
rhage, it is always a most formidable occurrence, and may
terminate fatally.   However, success may crown our  efforts
to assist the patient; whatever be the kind of  haemorrhage
that we have  to combat,  three globules of Arnica in  half a
tumblerful  of  water, a dessertspoonful every fifteen or thirty
minutes, will  generally remove  all  immediate danger.   If
Arnica does not help soon, Pulsatilla will speedily bring about
a  suppression  of  the  haemorrhage  and  evacuation of the
uterine  cavity from all foreign contents.   For other remedies
we refer the reader to Metrorrhagia, (Sections 39,  43.) 
delivery of the placenta.
357
ARTICLE   VI.
            delivery of the placenta.

                      Section  138.

  Natural Delivery.—The  delivery of the placenta ter-
minates the process of labor.   First, the placenta is detached
from the womb by means of the uterine contractions during
the expulsion of the fetus, on that the placenta is sometimes
found completely detached and resting upon the neck of the
uterus, as soon as the fetus is expelled.  The presence of the
detached placenta in the womb causes  new contractions which
are similar to, but weaker and longer  than labor-pains.   The
neck of the uterus  dilates, and the placenta passes into the
vagina and rests upon the rectum.  The final expulsion  takes
place by means of contractions of the  diaphragm and of the
abdominal  muscles,  and by the pressure which the abdominal
viscera exercises upon  the placenta.   Sometimes this expul-
sion takes place immediately after the birth  of the fetus : at
other  times there is an interval of fifteen minutes or several
hours.   As a  general  rule, delivery  of  the placenta takes
place more promptly in robust than in feeble and exhausted
women.   In most  cases  the placenta comes down  into the
vagina without the assistance of the  accoucheur;  in  other
cases it has to be extracted  by the accoucheur.   Care should
be had not to  tear the placenta  by unseasonable tractions;
such injuries  might give rise to  violent haemorrhage.  If
resistance is met with in gently pulling the cord, we have to
wait until the placenta is entirely detached.   Should this take
place  too  slowly, we may give a small dose of Pulsatilla or
Secale, three globules in half a tumblerful of water, a dessert- 
358
diseases of  females.
spoonful every fifteen  minutes;  this would  induce stronger
and  more successful contractions, and bring about a speedy
delivery without any accidents.

                      Section  139.

   Difficult or complicated delivery.—In the preceding
paragraph we have mentioned inertia of the uterus which may
retard delivery; here we  have  to speak of adhesions of the
placenta, haemorrhages, convulsions and fainting turns,  by
which placental delivery is sometimes complicated in a serious
manner.
   Placental  adhesions may give rise  to  violent  uterine
haemorrhages and  inflammations, if the placenta  remains in
the uterus, or is only partially detached ; for this reason some
accoucheurs advise to  remove the  placenta on any account,
even in pieces rather than to leave  it  in the uterus.   Under
homoeopathic treatment a  few globules of Pulsatilla or Secale
will be sufficient to detach the placenta, or, if necessary, Bel-
ladonna and Placenta  may be administered.
   Uterine  hemorrhages during or after placental delivery
may be caused by adhesions of the placenta, inertia of the
uterus,  insufficient uterine contractions leaving the mouths of
the bleeding vessels open.  Such haemorrhage may likewise
be internal  or external.  Pulsatilla and Secale  will  remove
the difficulty,  or we may have to  give Platina, Cocculus,
China,  Ipecacuanha, Chamomilla,  Crocus, Ferrum, Sabina,
Belladonna.  Platina, flooding, voluptuous  tingling  in the
inner parts, with painful  pressure in  the small  of the back
and lower abdomen, as  if the menses would appear.  Crocus,
black and viscid blood, with movements in  the abdomen, as of
a living fetus.  China, thin, impoverished blood, weakness
by previous losses.  Ipecacuanha, flooding every now and
then, with discharge of a red and thin blood.   Chamomilla,
dark-red blood.  Ferrum,  profuse flooding  with red blood
mixed with  black coagula, vascular excitement, and burning
redness of the face.   Sabina,  bright-red blood, with pains
like labor-pains.  Belladonna, bearing-down upon the parts 
                regular confinement.              359

as if  every thing would  fall  through.   See Metrorrhagia,
(Sections 39-43.)
  Convulsions which occur during or after delivery of the
placenta, have to be treated like those occurring during labor,
(Section 137.)
  For fainting, we refer the reader to fainting during labor,
(Section 137.)
ARTICLE  VII.
    OF REGULAR CONFINEMENT AND ATTENTIONS
          REQUIRED IN THE  SICK-CHAMBER.

                      Section  140.

   Phenomena after parturition.—After the expulsion of
the fetus and  the placenta, the uterine contractions still con-
tinue more or less until the uterus has resumed the conditions
which it had before conception.   This generally takes place
in from twelve to fifteen days.  The effect of these contrac-
tions is to expel the coagula or fluids which may have remained
within the cavity or parenchyma of the uterus.  These con-
tractions or after-pains generally commence immediately after
delivery of the placenta, soon reach their highest degree of
intensity, and  cease with  the  appearance of  the milk-fever.
Their intensity is sometimes  proportionate to the  number of
confinements, and primiparae  are generally free from them.
After an easy confinement they are likewise more severe than
after  tedious  labor.   They are  readily distinguished  from
other pains by this, that they recur  at regular intervals and
are always followed by the expulsion of a coagulum  or of a
quantity of fluid. 
360              diseases of females.
  Together with  the after-pains the lochial discharge takes
place, which is an expulsion of the fluids, blood  and mucus
that impregnated the walls of the uterus.  The lochia gene-
rally commence shortly after the placental  delivery; first a
pure blood is discharged for twelve or fifteen hours; gradually
this loses its  consistence  and dark color, and changes to a
sanguineous serum, until the milk-fever sets in, during which
the lochial discharge is generally interrupted, but after the
termination of which the lochia resume their flow as a yellow-
ish-white more or less thickish'liquid.  Hence we term them
sanguineous, serous, milky, etc.   The smell of the lochia is
first insipid, but afterwards it becomes peculiarly fetid.  They
flow from two to four weeks, and among women who do not
nurse their infants, they generally flow until the menses have
resumed their course.   In this case the lochia are generally
more  copious.
   In  consequence of these continued contractions and expul-
sions  of fluids, the uterus  gradually resumes its natural form
and  size.   The uterine orifice which had remained dilated
some  time after confinement, contracts again upon itself, but
remains a little larger, and the lips show the cicatrices of the
fissures which  the passage  of the child had occasioned.  The
vagina becomes  shorter, contracts  again to a  certain point,
the rugae reappear, and it resumes its original form but not as
perfectly as the uterus.  The vulva and  the abdominal walls
likewise experience the same changes, except that they retain
the streaks which had  formed during pregnancy, and which
look like white veins traversing the abdominal  walls.
   At the same time the physiological  condition of the woman
undergoes a series of remarkable changes.  The pulse which,
shortly after the labor was contracted and frequent, becomes
soft and large; the woman is feeble and  prostrate, she feels
weary in her whole body, is exceedingly sensitive to impres-
sions, and a mild moisture breaks out upon the  skin, which
sometimes changes to a  profuse sweet, having a sourish smell
and causing a stinging sensation on the skin.  At the end of
two days, the milk-fever sets in; the breasts swell and become 
regular confinement.
361
indurated, and towards  the close of the fever, the distension
of these parts  reaches  the  highest degree.  After this, the
breasts become smaller,  the secretion of milk goes on continu-
ously and regularly during the period of nursing ; but it de-
creases little by little if the woman does not nurse her infant.

                       Section 141.

   Hygienic rules during  confinement.—A strict  and
well regulated regimen during confinement may keep off a
good many  unpleasant  accidents.   The  first thing to be  at-
tended to after parturition,  is the  comfort and cleanliness of
the patient.   The parts should be bathed with tepid water to
which a few drops of the tincture of Arnica may be added,
especially if the parts have  been violently  contused and torn
during labor.  After this we change the  linen and other gar-
ments of the patient, taking  care  to  dry and  warm every
article of clothing thoroughly before using it; lastly, we put
her  in a fresh bed, with her head sufficiently raised, and neck
and arms covered so as to  enable her to keep them  outside
of the bed-cover  without being exposed  to  the  danger of
taking cold. As  regards the bandage  which is put on  the
patient by most accoucheurs in order to prevent the determi-
nation of fluids  to the uterus and consequent inflammations of
this organ or of the abdominal viscera, all we  have to say is
that inasmuch  as  the bandage keeps shifting all the  time, it
might just  as  well be omitted.  The air of  the sick-room
ought to be neither too warm nor too cold, (about 52° F.) so
as neither to give rise to  any excessive sweating nor to check
the  gentle cutaneous moisture which is so useful to women in
confinement; ventilation  should  not be neglected, but  care
must be had not  to expose  the patient to  the direct contact
of the air;  exposure to strong light or  to loud noise should
likewise be  avoided.  The patient  should be kept perfectly
clean; the  parts have  to be  bathed very frequently; every
day the linen should be changed likewise.  The food should
be of easy  digestion, moderate in quantity, not stimulating;
a little soup three times a  day until the milk fever sets  in ; 
362
DISEASES  of females.
during this fever, the patient may take some broth ; gradually
the quantity of nourishment may be increased until the usual
mode of life can be permitted again without any danger to the
patient.   Wine, coffee, tea,  stimulating drinks  which  are
supposed to promote the secretion of milk, should be avoided as
injurious; most of these preparations predispose for fevers, and
give rise  to copious sweats and even inflammations ; the abuse
of chamomile tea, which is unfortunately so universal and so
inveterate, occasions flooding, inflammation of the abdominal
viscera, convulsions, etc,;  coffee not  only deranges  the  ner-
vous system of the mother, and excites the circulatory organs,
but likewise prepares the way for a difficult digestion and for
all the ailments inherent in this trouble.  Water, either pure
or  with  a little sugar or  a few drops of claret, is  the  best
beverage for women in confinement.   Fomentations  of warm
vapors to the sexual parts for the purpose of removing the
dysuria  by which the patients are so often troubled, or  the
use of cathartics  in order to  keep the bowels open, should
likewise  be avoided, inasmuch as we possess excellent means
to obtain these results, without resorting to any of the above
contrivances.   In order to prevent uterine prolapsus which is
apt to be occasioned by the laxity of the parts and the weak-
ness of the ligaments, the patient should  keep quiet until the
parts are restored to  their former strength.   The patients
should certainly be kept in bed for nine or ten days at least.
 Sleep is an excellent restorer of strength in the case of  con-
fined women.   The old school resorts to opium to procure it;
in homoeopathy we have other and better means of which we
 shall  treat by and by.   The most  precious thing for  such
 patients is internal tranquillity; hence, their senses, imagina-
 tion or  feelings should be left undisturbed;  frequent visits
 and social gatherings around her  bed would fatigue her, and
 should never be permitted during the first ten days.—Lastly,
 is  it necessary to  remind  the  young mother of  the  duty
 imposed upon her,  of nursing her  infant?  Nursing is too
 intimately  interwoven  with  the  whole organism of  the
 mother  to  be neglected without injury to both mother and 
regular  confinement.
363
child.  Only if the mother is too feeble, or the milk is want-
ing, other means of feeding the infant, may be resorted to.

                      Section 142.

  Medical  attentions  during  confinement.—These at-
tentions  consist in 1st,  repairing the injuries  which the
parts may have suffered after confinement, such as contusions
of the vulva, rupture  of the perineum ! prolapsus of the
womb, piles, contusions of the neck of the bladder and of the
urethra,  etc. ; 2d, in attending to the after-pains,  lochia and,
if the patients do not nurse their  infants, to the secretion of
milk ; 3d, in restoring the exhausted strength of the patient,
we shall treat of each  of these subjects, uniting in the next
article all that we have to say concerning the accidents which
may  occur  during confinement,  such  as  puerperal fever,
metritis,  phlegmasia alba, miliaria, etc.
  In regard to contusions of  the vulva, we have already
said, (Section 141,) that the parts may be bathed with tepid
water, in which a  few drops  of the tincture of Arnica are
mixed.   If  inflammatory symptoms should have developed
themselves, Mercurius, Belladonna or  Thuja, may  be  given
internally.   If an abscess should have formed, Mercurius will
favor its coming to a  head,  unless Belladonna or  Lachesis
should have brought about its dispersion.
  Rupture of the perineum is not near as  terrible an
accident  under homoeopathic  treatment as it is under the old
school management.  As soon as  the  accident is known we
should bathe the parts with Arnica-water, brings the  edges
the wound in  contact, and apply a pad of lint  thoroughly
soaked with pure Arnica.  Over  this  pad thick  compresses
moistened with Arnica-water  may be applied, over which two
bands  are to  cross each other,  proceeding from   a  large
bandage  around the pelvis and coming  down to  the thighs,
which bands cross each other  opposite the perinaeum and are
fastened to  the main  bandage, one on  each side  near the
crroin, in such  a manner  as to hold the edges of  the wound
necessarily juxtaposed.   The  patient should be kept  quiet, in 
364
diseases  of females.
bed, on one  side, and  the  bandage  should be  frequently
changed during the first days, in order to facilitate the lochial
discharge;  afterwards,  after the lochia  are decreased,  the
bandage need only be renewed if the patient  wants to urinate.
Croserio advises the use of the strong tincture of Arnica,  which
is sufficiently diluted by the water that is discharged from the
uterus in tolerably  copious  quantity  and  is imbibed by the
compresses; but  as  soon as the lochial discharge decreases,
Arnica-water may be resorted to.  By continuing this treat-
ment for some six weeks with care, the wound will be  found
healed perfectly.
  Prolapsus  and inversion of the uterus, accidents that
happen pretty frequently after tedious  labor, are  likewise
readily cured  by internal homoeopathic treatment save such
manual operations as are absolutely indispensable to replace
the womb  in  its natural position.   The patient should be
kept quiet  as  we  stated in  Section 62, and a  small dose of
Nux vomica, or Sepia,  in case Nux should not help, may be
given, three globules of 30th attenuation, in  half a tumblerful
of water, in dessertspoonful  doses, morning and evening, this
treatment will help,  provided the patient is  kept on her back
as  long  as she feels  a weight in the uterine region  when
rising.  If neither  Nux nor Sepia should  be  indicated, we
may have to resort  to Thuja or Platina.
   Contusions of the  neck of the bladder and of  the
urethra, caused by the pressure which the  head of the child
in the pelvis makes  upon these parts,  sometimes cause  reten-
tion or incontinence of urine during confinement.  Either of
these difficulties yields to Belladonna in  small doses.   If in-
sufficient we may give for retention, Pulsatilla; for incon-
tinence  OF urine,  Sepia or Sulphur.
   Piles  yield most generally to Pulsatilla,  three globules of
12th attenuation in half a tumblerful of water, a dessertspoon-
ful of which  solution should be  given  every three or four
hours.
   After pains, though resulting from the necessary contrac-
tions of the uterus  after parturition by means of which  this 
REGULAR  confinement.
365
organ returns to its normal  condition,  may be modified, in
case the pain should be too acute, by a small dose of Coffea,
especially in the case of nervous women who are sensitive to
pain and deprived of their usual sleep.   If Coffea should not
suffice, Nux vomica may be resorted to, especially if the pains
bear upon the rectum  or bladder, with frequent desire to
evacuate  the bowels or  bladder ; or Chamomilla, in the case
of women who have drank a good deal of coffee, and if Nux
does not  afford any relief; Pulsatilla, if fragments of the
placenta have remained in the uterus.
   The lochia may either be too  scanty or too profuse, or
altered in their quality.  If too scanty or suppressed, and if
this condition does not depend upon  any other cause, Aco-
nitum will restore them, if they were still red, and a cold or
sudden  emotion caused  the  suppression; or  Chamomilla, if
the suppression is followed by diarrhoea and colic, or by head-
ache, toothache or other aches.   If the suppression is symp-
tomatic, arising from metritis, peritonitis, enteritis, or from
some other disease, or if inflammatory symptoms threaten to
develop  themselves in  consequence of the suppression, the
remedies  which have been prescribed for these affections, will
have to be  indicated; we  may likewise give Aconitum, if
there are symptoms  of inflammatory  fever ;  Cohcynthis, if
the abdomen is distended; Belladonna,Hyoscyamus or Stra-
monium,  if the brain is deranged, with frightful visions, deli-
rium, etc. ;  Platina or Zincum, if the symptoms of nympho-
mania set in.
   As  regards excessive lochia, we have  to  distinguish
between the  periods when  the excessive flow takes place.   If
it takes place while the lochia  are still  red, we have to pre-
scribe the remedies that have been indicated for metrorrhagia
or for excessive menstruation, such as, Platina, China, Cal-
carea, Rhus, or Secale, unless the symptoms should indicate
Bryonia,  Crocus,  Hepar,  Conium,  or Bromium.   If  the
white or mucous lochia  are excessive, this symptom indicates
an irritation in the lining membrane of the uterus, and has to
be treated like leucorrhoea, with Pulsatilla, Sepia, Sulphur 
366
diseases of females.
or Calcarea.  If the red lochia continue too long, Calcarea or
China will hasten their transformation into mucous discharges.
If the excess of red  lochia depends upon wrong diet, a change
of diet will remove  the difficulty;  if this should not be the
case,  we may give  Coffea, Ignatia or Nux vomica, if the
patient have used much Chamomile tea; Arnica or China, if
the difficulty arises from excessive bodily exertions;  Nux
vomica, if the patient  has indulged in coffee, or alcoholic or
heating beverages and aliments.
  Altered lochia, black, purulent, etc., indicate an irrita-
tion of  the uterine  lining membrane,  and require no other
treatment  beside the  general  uterine  affection.  In  some
cases  some special remedy may be indicated, such as Calcarea
or Sepia, if the mucous lochia become  again bloody; Sepia,
Mercurius or China, if they become purulent; Carbo animalis,
Belladonna,  Secale, Kreosotum or Sepia, if  they have  a
putrid smell.  Black  lochia, which generally arise from the
decomposition of  patches of  membrane or bloody coagula in
the uterus, do not require any treatment, unless there should
be  a  peculiar foul  smell or other symptoms denoting putre-
faction or gangrene of the uterus.
  Milk-fever, which generally commences on the second or
third  day after confinement,  does not require any treatment,
especially if the woman nurses her infant, and the milk can
be drawn out as soon as it commences to flow.  If the woman
does not nurse her infant, the fever may become complicated
with other ailments which it is  necessary to prevent.   For
this purpose we  use Aconitum, Bryonia  or  Belladonna;
Aconitum, if there  be much fever with marked heat, full and
strong pulse,  violent headache  and a  good deal of thirst.
Belladonna, if symptoms of cerebral inflammation set in,
with stupefying headache,  more  or less marked delirium,
glistening eyes, red and hot or else very paleface; Bryonia,
if the breasts become too much distended by the milk, with
painful oppression of the chest; or Pulsatilla, if after the
cessation of the fever and the adoption of a somewhat  more
nutritive diet, the milk still continues to increase in the breast. 
REGULAR  CONFINEMENT.             367
If the milk should continue to flow out in spite of Pulsatilla,
we may give Calcarea or Lycopodium.   The  accessory ail-
ments which may occur during lactation, will be described in
Sections 149-153, in a continuous series.
  As regards  the  restoration  of  strength after con-
finement, no particular treatment is required for such a pur-
pose ; if no serious derangement has taken place, the strength
will speedily return by means of a good diet and rest; and if
existing diseases prevent the restoration of strength, these
have to be treated with suitable remedies.  If the patient
should  have become  exhausted  by flooding or by excessive
sweats, we may give her six globules of China dissolved in
half a tumblerful of water, a dessertspoonful  of which solu-
tion is  to be given every twelve hours; or Calcarea, Kali,
 Sulphur, Nuxv omica, Phosphori acidum, Veratrum.   If the
 weakness  should  cause  excessive  sweating, we  may give
  Carbo  vegetabilis,  Aconitum, Arsenicum. Sambucus.  The
  falling off of the hair which sometimes  cannot be pre-
  vented  after confinement even by the  greatest care, soon
  ceases after using Sulphur or Calcarea, three globules dry on
  the tongue, which are to be allowed to act for four or five
  weeks.  If these remedies do not help,  we may try Natrum
  muriaticum, Lycopodium, Hepar or Silicea.   Another incon-
  venience which sometimes befals women who have had seve-
  ral children,  is an  enlargement of the abdomen, vulgarly
  termed pot-bellied; this defect requires to  be treated with
  Sepia,  Cohcynthis, three globules every week. 
368
diseases of females.
ARTICLE  VIII.
    DISEASES OF WOMEN DURING CONFINEMENT.

                      Section 143.

   General  observations.—The peculiar  sensitiveness  to
 external impressions which child-birth excites in the organism
 of the young mother, exposes her more at this than at any
 other period  to the action of the epidemic type of disease or
 to other disturbing influences which develop diseases charac-
 terised by symptoms peculiar to the changed condition of the
 system.  Such diseases  are inflammatory  affections which
 principally invade the  parts  that have suffered most during
 the process of labor and  during pregnancy.  Hence the fre-
 quency of metritis, peritonitis, ovaritis, enteritis  and  other
 similar -affections during confinement; even the thoracic organs
 and the brain are frequently attacked with inflammatory dis-
 eases.   These affections  generally run  a rapid course, and
 show a tendency to terminate in  suppuration or effusions of
 purulent serum; in most cases these inflammations are accom-
 panied  by suppression of the milk and lochia, thus compli-
 cating the existing inflammation  by other  affections.   The
 arrest of perspiration likewise, becomes the frequent cause of
 acute or chronic rheumatism which may attack the articula-
 tions of the pelvic  bones; or such  a suppression of the perspi-
 ration may cause an inflammation  of the pelvic veins known
 under the name of  phlegmasia and alba dolens, or  an inflam-
 mation of the ganglious and lymphatic vessels of the extremi-
 ties.  To these diseases we have to add some neuroses, such
 as hysteria and mania, and the so-called milk-affections.  In
 the following chapters  we will  treat of: — 1st,  puerperal
fevers; 2d, local diseases of the uterine tissue ;  3d, abdominal 
DURING CONFINEMENT.
369
 affections ; 4th, cerebral affections ; 5th, external diseases of
 women in  confinement, omitting for the present the affections
 of the milk which will be treated in the chapter on lactation.

                       Section 144.

   Puerperal fevers.—The  affections  of  this class, with
 marked febrile  symptoms,  are:—puerperal  peritonitis, ute-
 rine  phlebitis and adynamic fevers  during  confinement.
 Acute metritis and phlegmasia alba dolens  do not belong to
 this category, inasmuch as neither of these affections has  the
 characteristic signs of a puerperal  inflammation.  In this Ar-
 ticle we will describe the symptoms of each  of these fevers,
 and then proceed to indicate their causes  and treatment.
   Puerperal peritonitis is  the most frequent  and one of
 the most dangerous of puerperal fevers.  It generally develops
 itself the first eight days after parturition, and it is sometimes
 preceded by a general malaise with a slight diarrhoea.   Most
 frequently, however, it comes on suddenly, with vague shiver-
 ings or a violent chill, followed by heat, more or less frequent
 paroxysms of vomiting, and an acute stinging pain, increased
 by pressure, touch, straining when vomiting, or  at stool,  or
 when voiding  the urine, or by the least motion in bed.  The
 pain is at first  confined  to the hypogastrium and remains
 most violent in this region, even if the pain should extend  to
 other part3 of the  abdomen.  At the same  time  the lochia
 become less, or  are entirely suppressed;  the breasts do not
 expand, or they sink in after having been filled with milk; the
 secretion of milk either does not come on  or stops;  the abdo-
 men acquires  in a  few days a considerable volume in conse-
 quence of the effusion that takes place in this cavity, and/we
 generally perceive there the same fluctuation as in ascites.
 In ordinary cases, puerperal peritonitis does not last very long,
 and if it terminates successfully, the volume  of the abdomen
 decreases as rapidly as it had increased previously; the lochia
reappear, the breasts swell, and the secretion of milk some-
times resumes its course.
  Uterine phlebitis is much more serious,  but fortunately
                           24 
370
DISEASES  OF FEMALES
much less frequent  than puerperal peritonitis.   It generally
commences about twenty-four hours after parturition with a
more or less acute pain  in the region of the womb, accompa-
nied or followed by violent shiverings, with suppression of the
lochia, quick pulse,  headache or slight delirium,  sense of dis-
tress all over,  and  sometimes nausea and  vomiting.   These
symptoms  are  sometimes  followed  by heat  and  muscular
twitches in the  face and extremities, hurried and feeble pulse,
anxious and hurried breathing, intense thirst, brown and dry
tongue.  Sometimes effusions of pus take place  in the lungs,
pleural cavities, cellular tissue, etc.   Under Old-School treat-
ment, this frightful disease generally terminates fatally.
   Adynamic fever, which  is the most serious  fever  that
befals  women  during  confinement, generally  sets in on the
second or  third day after parturition, and the  danger is  so
much greater  the  nearer to this period the invasion of the
disease takes place.  Sometimes the fever  commences like a
simple puerperal  peritonitis, but soon after cerebral symptoms
supervene, the  sight becomes obscured, sparks are seen before
the eyes, and a buzzing in the ears  is felt; the muscles and
lower extremities begin to twitch, delirium, twitching of the
tendons and picking at flocks set in.  At  the same time the
mouth becomes dry, the tongue becomes covered with  a thick
 and, brownish  coating, the features  become altered, the nose
looks pointed,  the breathing is hurried, sighing  and moaning,
 and the patient is tormented by an unquenchable thirst.   In
 some cases petechiae,  miliaria alba, convulsions and furibond
 delirium supervene.  Towards the close,  the  face becomes
 excessively pale, the look becomes fixed and fierce, the mouth
 exhales a stream of hot and foul air;  colliquative, clammy
 sweats  break  out; a watery, greenish-brown, foul-smelling
 diarrhoea sets in,  and death finally takes  place by paralysis
 of the abdominal  or  cerebral nerves, or by gangrene of  the
 affected parts.
    The  most frequent causes of these fevers  are:—violent
 irritations of the uterus by tedious and hard labor; manual or
 instrumental operations for  turning or destroying the child; 
DURING CONFINEMENT.
371
 astringent injections,  sudden suppression of the  lochia and
 milk by any physical or moral  cause, exposure to cold air,
 violent emotions such as  fright, joy,  anger,  etc.  Dietetic
 transgressions, excessive eating  on the part of women who
 do not nurse their own children, heating or stimulating food,
 purgatives, chamomile-tea, infusions of juniper-berries, irrita-
 tions of the urinary passages by diuretics, etc., may likewise
 be considered as exciting  causes of this fever.  In lying-in
 hospitals the disease sometimes becomes epidemic without any
 apparent cause.  It is as an epidemic disease that  the fever
 exhibits the dangerous character  of cerebral typhus described
 above.
   These  fevers can  sometimes be prevented by proper diet
 and a careful removal  of all disturbing influences either phy-
 sical or moral.   But if the disease  has  set in in spite of our
 precautions, we often succeed in breaking the fever, if we give
 at  the very onset of  the disease Aconitum, six globules  of
 eighteenth attenuation, in half a tumblerful of water, of which
 solution a dessert-spoonful should be given every three hours
 until the disease is conquered,  especially if  the following
 symptoms are present:—excessive dry  and  burning  heat,
 glowing  redness of the face,  bilious vomiting, unquenchable
 thirst, excessive sensitiveness  to pain,  disconsolate anguish
 with restlessness and moaning, and especially dread of death,
 warm baths, etc., should of course  be avoided.  Pure water
 should be the patient's only drink, and a strict diet should be
 enjoined.   If we should be called too late for Aconitum, or
if Aconitum should prove ineffectual after twenty-four, or, in
very  acute  cases,  after twelve hours, we have to resort to
Belladonna, Mercurius, Nux vomica, Bryonia, Rhus, Cha-
momilla, Cocculus, Hyoscyamus,  Platina, Arsenicum, Carbo
vegetabilis, Sulphur, Pulsatilla, Arnica, Opium.
  And particularly:—
In  simple puerperal peritonitis:—Mercurius,  Bryonia,
          Chamomilla, Belladonna,  Sulphur,  Hyoscyamus,
         Platina, Nux vomica, Cohcynthis, etc. 
372
DISEASES OF FEMALES
In uterine phlebitis :—Belladonna, Mercurius,  Arseni-
         cum,  Rhus,  Bryonia, Pulsatilla,  Arnica,  Nux
         vomica, etc.
In adynamic fever :—Belladonna, Bryonia, Rhus, Mercu-
         rius,  Hyoscyamus,  Arsenicum,  Carbo vegetabilis,
         Sulphur, etc.
  But  independently of names, the homoeopathic physician
will have to be guided in the  selection of his  remedy by the
following symptomatic indications:
  Belladonna, for distension of the abdomen with  tympa-
nitic resonance on percussion, stinging and digging pains, or
as if the bowels were grasped by claws or nails ; violent pres-
sure towards the genital  organs, as if every  thing would be
pressed out there; sensitiveness of the abdomen to contact;
partial shuddering, with burning heat of the head and face,
redness of the face and eyes, frontal headache with pressure,
throbbing of the carotids; dry mouth, with  thirst  and red
tongue; dysphagia and spasms in the fauces ;  cerebral symp-
toms such  as furibond delirium and comatose sleep, or com-
plete loss of sleep; also,  scanty watery or  mucous lachia; or
uterine haemorrhage with discharge of coagulated and fetid
blood;  empty  and flabby breasts or else swollen  and  in-
flamed.
   Mercurius, in many  cases where Belladonna is  not suf-
ficient, or in alternation with Belladonna, especially when the
cerebral symptoms are less marked than the symptoms of the
abdomen, or when signs of effusion are developed, with lanci-
nating, pressive and boring pains ; constant moaning; exces-
sive sensitiveness of the  abdominal integuments to the least
touch and motion ; burning and unquenchable thirst; altered,
yellowish  or earthy countenance;  profuse ptyalism; mucous
and bloody stool with tenesmus ; dark and fetid urine; sweat
all over, profuse and weakening, with nocturnal aggravation
of all the  symptoms.
   Nux vomica, sudden suppression of the  lochia, with weight
and burning in the abdomen and  sexual organs; or profuse
lochia, with violent pains in the small of the back ; strangury 
DURING CONFINEMENT.
373
and burning urine ;  constipation, nausea  and vomiting; red
face; rheumatic and crampy pains in the thighs and legs, with
numbness of these parts ; pressive headache with vertigo, buz-
zing in the ears, fainting turns and Vanishing of sight; espe-
cially suitable to women  who have indulged  in  spirits and
chamomile-tea.
   Bryonia, sometimes after  Aconitum, if this is not  suffi-
cient, or at the onset for  the  following symptoms; sensitive-
ness  of  the abdomen to  the least  touch  or motion, with
constipation; lancinating pains  in  the  abdomen, worse  by
pressure;  violent fever, with burning heat all over, burning
thirst and  desire for cold drinks, irritable, irascible  mood,
with dread of the future, and  concern about her sickness.
   Rhus, sometimes  indispensable if cerebral or  typhoid
symptoms exist  from the  first, with aggravation by the least
unpleasantness, return of bloody lochia in the place of mucus,
 discharge of coagula.
   Chamomilla, flabby and empty breasts with whitish diar-
 rhoea,  scanty  lochia, distention  and sensitiveness  of  the
 abdomen to touch ; colic  like labor-pains ;  heat all over with
 red face  and  thirst;  nocturnal aggravation of  the pains,
 followed by sweat: restlessness, impatience and nervousness ;
 the disease was caused by anger or exposure of the body to
 cold.
   Colocynthis, if Chamomilla is insufficient in cases where
 the disease was caused by a fit  of anger, especially for  the
 following  symptoms: violent pains in the abdomen, dry  and
 burning heat, diarrhoea and colic after the least drink ; hard,
 full and hurried  pulse;   hot head and  red  face; delirium
 alternating with comatose sleep ; symptoms of cerebral para-
 lysis, with the lower jaw  depressed.
   Hyoscyamus, if Belladonna is insufficient for  the cerebral
 and typhoid symptoms, with frightful visions or 'loss of con-
 sciousness, frequent  discharge of coagulated blood, convul-
 sions and spasms in the throat.
   Platina, excited  sexual instinct, signs of nymphomania
 with voluptuous crawling in the parts;  painful  pressure at 
374
DISEASES OF FEMALES
the hypogastrium and on the parts, like labor-pains; discharge"
of a thick and black blood ;  sensitiveness of the parts ;  head-
ache, restlessness and weeping ; especially suitable to women
of a proud disposition.
   Arsenicum, if Mercurius is insufficient in cases where
effusion in the peritoneum has taken place, with great weak-
ness ; pale, earthy  and altered  countenance,  frequent desire
for cold drinks, of which the patient  only takes a little at a
time.
   Carbo  vegetabilis, sometimes in the last  extremity, if
neither Arsenicum nor Mercurius help in cases of effusion.
   Sulphur,  suitable to women who  are  subject to chronic
eruptions, or when the following symptoms  occur:  violent
colic, excessive distension of the abdomen and pains in the
small of  the back;  suppression or  decrease of the lochia;
tenesmus of the rectum  and bladder ;  violent pains in the
hypogastrium, with heat, shivering and epileptiform convul-
sions.
   Of all these remedies dissolve three globules of 6th or  12th
attenuation, in  half  a tumblerful of water, and give the pa-
tient a dessert-spoonful of this solution every  three hours.

                      Section 145.

  Local   derangements  of  the  uterine  system.—The
most frequent of these affections during  confinement  are ;
acute metritis, ovaritis, uterine  haemorrhage and gangrene of
the uterus.  To what has been said concerning these affections
in other parts of this work, we have to add the following:
  Puerperal metritis generally requires the same treat.
ment as   parenchymatous  metritis,   Sections  70-71.   The
disease is  most frequently induced by the following causes  :
dietetic transgressions, cold  drinking soon after confinement,
exposure to a draught of air, moral emotions, premature re-
sumption of sexual intercourse, violent exercise and mechanical
injury during confinement, astringent injections, suppression
of the lochia, and any physical or moral cause by  which such
a suppression  may be induced.   If no peritonitis is as yet 
during confinement.
375
developed, three  globules of  Nux vomica, 18th attenuation,
dry on the tongue, will generally prove sufficient to arrest
the disease.   If other affections  should complicate the dis-
ease, or if Nux should not be sufficient, we may give the fol-
lowing remedies : Belladonna, Bryonia, Chamomilla, Rhus,
Cohcynthis, Aconitum, or:  Hyoscyamus,  Mercurius,  Pla-
tina, Pulsatilla, Secale, Arsenicum, Stramonium, Veratrum,
Arnica, Lachesis.—For special indications concerning the use
of these remedies, we refer the reader to Sections 70-71.
   Puerperal  ovaritis does not  differ from acute ovaritis,
described Section 92, with the  treatment.  During confine-
ment the  disease  may  be  treated  most  successfully  with
Belladonna, Platina, Mercurius, Sabina.
   Uterine hemorrhage during confinement requires  to be
treated like  haemorrhage  during  labor, Section 139.   If
resulting from  general  debility, China  is  an  excellent
remedy.   In other cases Sabina, Platina, or  Crocus  will
prove efficient.   See,  also,  the remedies mentioned Section
139, and Metrorrhagia, Sections 42-43.
   Gangrene or putrescence  of the uterus, is the most
dreadful accident that  can occur during confinement, and is
often not perceived until it  is too late to do any good.   For
the symptoms and treatment of this disease, we refer our
readers to  Section 89.
   Prolapsus  and inversion  of  the womb, have  been
spoken of in detail, Section  142.

                       Section 146.

   Abdominal affections.—The abdominal  affections that
may take place during confinement, are : deep-seated enteritis,
superficial enteritis or  diarrhoea, and constipation.
   Deep-seated or phlegmonous enteritis, does not  occur
very frequently as a  sequel of confinement;  if it should,
however, we may give  three globules of Aconitum, in half a
tumblerful of water, a  dessert-spoonful  of  which solution
should  be administered every three hours  until  the  fever
ceases ;  or, if Aconitum should not prove sufficient, we may 
376              diseases of females
give Belladonna, Bryonia, Nux vomica, or Cohcynthis  If
peritonitis  should supervene, we have  to  use  the remedies
recommended  for puerperal  peritonitis,  Section  144.—For
colic during confinement we give :  Chamomilla, Bryonia ;
or, Belladonna,  Hyoscyamus, Pulsatilla, Sepia,  Veratrum,
Arnica, Lachesis, Nux vomica.
  Superficial enteritis or diarrhoea during confinement
is less to be dreaded for its inherent intensity  than for the
derangement it causes in the milky secretion.  If the patient
has  not indulged too  freely  in  chamomile  tea, the best
remedy for this trouble is Chamomilla, especially when there is
colic, watery, greenish  or  yellowish stools, the latter looking
like stirred eggs.   Women  who have used  much  chamomile
tea or who have  deranged their  stomachs by overeating,
should take Pulsatilla.   If  the stools  are papescent, fer-
mented, having  a marked sour  smell, we give rhubarb.
Sometimes Antimonium will help, especially when there are
gastric symptoms, white-coated  tongue, nausea, eructations,
sticky mouth, etc., or Dulcamara, if the diarrhoea is caused
by a cold ;  or Hyoscyamus for  painless, watery and mucous
stools.
  Constipation occurring  the first week after  confinement,
is a sign that the patient is getting better and stronger, and
should therefore  be left undisturbed by treatment.  If the
constipation should continue beyond this space of time,  a few
globules of Bryonia may be given one evening and another
dose the next.   If Bryonia  should  not help, we may give
Nux vomica, six  globules in half a tumblerful of  water, and
a dessert-spoonful of  this  solution  every evening until the
patient is quite easy; Nux is  particularly indicated by  piles,
distension of the  abdomen and loss of appetite ; or Opium for
inertia of the bowels, with  complete  absence to all urging to
stool; or Sulphur if none of the other remedies help; in
some cases  Platina may be useful.  If  the constipation is
owing to the hardness  and size of the excrements, an  injec-
tion of tepid water may remove  the difficulty. 
DURING confinement.
377
                      Section  147.

  Cerebral affections.—These affections during confine-
ment, are : puerperal meningitis and mental derangement.
  Puerperal meningitis is never an idiopathic disease, but
only occurs as a distressing accessory of  one  of the above-
mentioned puerperal fevers.  It is characterised by the usual
cerebral symptoms, such as furibond delirium, sopor, twitch-
ing of the tendons  and muscles, grasping at  flocks, loss of
sight, sparks before the eyes, buzzing in the ears, dry mouth,
brown-coated  tongue,  etc.,  and  generally violent  headache
and vertigo.   The  best remedies for  these symptoms  are:
Aconite, Belladonna, Bryonia, Rhus,  Cohcynthis,  Sulphur,
etc.;  for the particular indications concerning the use of
these remedies we refer the reader to Section 144.
  Mental derangement generally commences already dur-
ing pregnancy; the patient is sad, has sinister forebodings
and shows a good deal of restlessness without any appreciable
cause.  The face is generally pale;  she complains of pain in
the  uterine  region;  the pulse  is small,  feeble, contracted.
The real dementia generally develops itself during  confine-
ment and the period of  nursing.  The patient is altogether
irrational,  has  frequent  hallucinations  during  which  the
patient  sees  her child  consumed by  fire or  drowned;  the
strangest fancies sometimes chase each other with the  most
wonderful rapidity.   In some cases the  dementia is compli-
cated with furious  mania, nymphomania,  etc.;  whereas in
other cases we  observe  a  deep, taciturn  melancholy;  some-
times there is complete dementia.   The most frequent causes
of  this derangement are: a cold, fright,  domestic trouble or
other unpleasant  emotions,  sudden weaning,  suppression of
the lochia and milky secretion.  This  derangement may last
from one to six  months, and may have frequent relapses.  If
not radically cured, the patients sometimes remain for ever
 subject to hysterical or other convulsions, or  to fixed  ideas,
 melancholy or attacks of dementia with or without paralysis.
 This affection is rather easily cured by Aconite, Aurum, Bel- 
378
diseases of  females
ladonna, Pulsatilla, Platina, Sulphur,  Veratrum, Stramo-
nium, Zincum.  Aconitum is indicated by fear of death, and
if the derangement was caused by fright; Aurum, anguish
with thoughts of suicide, weakness of memory and intellect;
Belladonna, restless and uneasy nights, fear of ghosts, fright
with desire to escape or to hide herself, paroxysms of rage and
fury; Pulsatilla, sad  thoughts, weeping  mood, taciturn
disposition, the patient remains in one corner, embraces  her
knees and gesticulates like a crazy person, acid stomach, gas-
tralgia ; Platina, excessive sexual  desires, with voluptuous
crawling in the parts;  Sulphur, disposition  to meditate  on
religious subjects, with despair of salvation ; forgets the names
and words she wants to use; Veratrum  for religious melan-
choly or nymphomania with desire  to embrace every body;
Stramonium  for nymphomania,  with obscene  gestures  and
language,  the  body smells like  that of a goat; Zincum  for
nymphomania or melancholy during confinement,  with fear
of  thieves, demons and other frightful figures;  Hyoscyamus
for nymphomania with furor, loss of modesty, desire to un-
cover one's self, etc.
   Dissolve  any of these remedies in half  a tumblerful of
water, 6 globules of 6th  or 12th attenuation,  and give a  des-
sertspoonful of this solution every three hours.

                      Section 148.

   External affections.—These are phlegmasia alba dolens
and miliaria.
   Phlegmasia  alba dolens is considered by many authors
a  symptom of  puerperal fever, and is  characterised  by a
white, smooth and hot swelling, sometimes affecting one limb
only, and consisting in an inflammation of the veins of these
extremities or of the veins of the pelvis.   It  is a  species of
external  phlebitis  having the  same  characteristic signs as
uterine phlebitis and depending upon similar influences which,
however,  produce different symptoms owing to  the difference
in  the tissues and organs  affected.  Phlegmasia generally
runs a slow course and  exists  without  fever; but in some 
DURING CONFINEMENT.
379
cases it may give rise to acute inflammations and even termi-
nate in gangrene.   If treated improperly, the trouble may
last from six to nine months, and even if the  disease termi-
nates favorably at the  end of this  period, the  affected limb
preserves for a long time afterwards a  great weakness and
sensitiveness  to contact  and motion.  Bleeding is  a highly
improper proceeding in this  disease, and although the homoeo-
pathic treatment is not free  from danger, yet if the remedies
are well chosen, a cure is generally effected by Aconitum, if
the phlegmasia has an  acute character, with  violent inflam-
matory fever, heat all over and violent pains;—Arnica, if
the phlegmasia sets in after tedious labor, violent manipula-
tions or mechanical injuries  of the vessels ;—Bryonia, draw-
ing or lancinating pains from the hip to the foot, with copious
sweat and excessive sensitiveness to touch or motion; pulling
in  the abdomen and  legs  as if the menses would appear 5
painful rigidity and tension  and  pale  swelling of the leg ;—
Belladonna,  stitches as with knives;  heaviness in the thighs,
hypogastrium and sexual parts;  creeping in  the limbs, with
paralytic weakness; violent fever with burning thirst, violent
pains disturbing  her sleep, and  not permitting either motion
or  contact;—Pulsatilla,  if Belladonna or  Bryonia have
effected  no improvement.  We  may also recommend Rhus,
Sulphur, Nux vomica, Arsenicum.
   Miliaria  during confinement is  not very dangerous in
itself, but may become so by improper treatment with sodori-
fics, purgatives, warm infusions  and other debilitating decoc-
tions  and herb-teas.    Too much  covering  in  bed or  an
 excessive temperature in the sick chamber  excites copious
 sweats and consequently such an  eruption as the  one here
 mentioned.   By avoiding every thing that might excite such
 sweats,  and  by simply  preserving a little  gentle moisture
 upon the skin, the miliaria  generally disappears of itself in a
 day  or  two.  Should it  nevertheless  prove  obstinate and
 troublesome, we may give Bryonia, three globules dry on the
 tongue, which may be allowed to act for twenty-four hours. 
380
DISEASES OF  FEMALES
ARTICLE  IX.
OF LACTATION AND OF THE ATTENTIONS REQUIRED
                 BY THIS FUNCTION.

                      Section  149.

   General phenomena.—The  secretion of milk continues
during the whole period of pregnancy; the breasts become
harder and larger, discharging sooner or later a serous fluid
which is the first appearance of the future milk, and imme-
diately after confinement,  becomes changed into a yellowish
liquid of a sweetish taste, and known under the name of colos-
trum.   Forty-eight hours  after  parturition, the  breasts swell
and  harden in a marked  manner; the patient experiences
slight chills followed by heat of the skin, and in  few hours,
by a profuse perspiration; the  face becomes  red and ani-
mated ;  there  is headache, loss of appetite,  white-coated
tongue,  suppression or diminution of the lochia  and hurried
pulse.   This fever which must  not be confounded with puer-
peral fever, is the milk-fever which, from a slight  fever of
some twelve hours duration, may increase to an inflammatory
fever of some  three or four days.  It  can be distinguished
from puerperal peritonitis by the fact that the abdomen is
never painful  to  pressure.  At  the close  of  the fever,  the
breasts  which had  become very much  distended, become
softer, the  milk  flows out  spontaneously, the lochia return,
and the  mother whose condition  has again become normal, is
able  to nurse her infant.
   The secretion of milk, if once established, goes  on unin-
terruptedly ; but various circumstances may induce an exces-
sive secretion of  milk, with a tingling and stinging sensation 
LACTATION.
381
in the breasts, the milk sometimes  spirting out from  the
nipples  with considerable force.   This will sometimes  take
place as soon as the child is held  near the breast, or even at
the mere sight or thought of a child.  This rush of milk may
likewise take place without its cause being known; but it
almost always takes place as soon as  the child commences to
nurse.  The act  of nursing is an indispensable excitant by
means of which the secretion  of milk is kept up.  In women
who from one cause or another do not nurse their little ones,
the milk  soon  dries up, whereas by  nursing the child, the
secretion  of milk may sometimes continue for several years.
It appears,  moreover, that it is an infant's mouth that has to
draw out the milk;  for  if the milk be drawn by an adult or
by some mechanical  contrivance,  the breasts are indeed
emptied,  but the secretion  soon ceases.  By the act of  nurs-
ing infants  have been able to excite a flow of milk for months
even in females who were still far remote from  the period of
confinement, or in women of sixty years old, or even in young
girls and  males.  Nevertheless  there are cases where the
secretion of milk ceases even if the nursing be steadily con-
 tinued.   Some wet-nurses have been able to have children at
 the breasts for seven years and longer, but there are likewise
 cases where the  milk ceased to flow at the end of a month in
 spite of nursing.
    As regards the milk itself, it may vary both  in quantity
 and  quality.  The quantity  especially varies a good deal in
 different women.  Some have milk  enough to nurse several
 children at once, whereas others have scarcely milk enough
 for one.  In some cases scarcely any milk  is secreted.   As a
 general  rule, after a first confinement, less milk is secreted
 than after subsequent confinements;  on the other hand,  there
 are women with large breasts who secrete  less  milk at every
 subsequent confinement, until the secretion ceases altogether
 after the third  or fourth.    As  regards  quality, the milk of
 some women is too watery to serve as nourishment;  in  other
 women,  the chemical constituents of the  milk are altered, im-
 parting  to the  milk a  saltish  or bitter  taste, beside  other 
382
DISEASES  of females
alterations not perceptible to external observers, but sufficient
to excite an aversion in the child.  Even good and healthy
milk will sometimes' vary in its nutritive properties, being in
the course of twenty-four hours more or less creamy and con-
sistent.   It is generally supposed that lymphatic women have
more milk, but more serous and less nourishing than others.
Moreover, the more actively the secretion of milk is going on
in consequence of excitable influences, the thicker and fatter
does the milk become.   There is probably no secretion which
is more influenced by the  general causes that affect health
and  nutrition, than the secretion of milk.  The  nature  and
quantity of the food which is used by the mother, affect  the
milk; the odour,  taste and color, and even  the medicinal
properties of the substances which the mother takes into her
stomach, impart similar conditions to the milk; chagrin, fright,
anger and other moral emotions suddenly alter both the quan-
tity and quality of the milk, so as to cause the most serious
accidents in the  child that nurses it.   The diseases by which
the nursing mother happens to be attacked, likewise affect the
milk. If the catamenia reappear during the period of nursing,
or the mother should  again become  pregnant, the  quantity
and  consistence  of the  milk are likewise lessened; in most
cases pregnancy stops  the secretion of milk, or  alters  the
milk to  such a degree that the child  is  unwilling to nurse or
is made sick by the milk.  It seldom  happens that pregnancy
leaves the milk unchanged.

                      Section 150.
  Hygienic attentions during lactation.—It is  of great
importance that  nothing should occur which might impede or
arrest the secretion of  milk, or alter and  diminish the nutri-
tive  qualities of  this  fluid.  It follows from  what  we have
stated in the preceding paragraph concerning the influence
of food  on the qualities of the milk, that the mother has to be
very particular in the choice of her nourishment  in  order to
impart to the milk such properties as  will make it a wholesome
and nutritive agent.  Plain and wholesome food is generally 
LACTATION.
383
sufficient to effect  this result, and if this should not be the
case, there is undoubtedly  something wrong  in the mother's
constitution, which has to be removed by  treatment.  The
means which are ordinarily recommended by nurses and even
by  accoucheurs  under  these  circumstances, are pernicious,
Buch  as quantities of coffee, anis, caroway and other drugs.
The medicinal qualities which  these things impart to the milk,
exercise an unpleasant influence  over  the child; a difficult
dentition, nervousness, colic, sleeplessness, crying and tossing
about, are generally the effects  upon the child, of the coffee
which so many nursing mothers use in  such large quantities.
Tea likewise disposes people to become nervous ; many young
girls  would have stronger nerves if their mothers had used
less tea during their nursing time.  The same remark applies
 to  all the other herb-teas and  decoctions which are so fre-
 quently recommended by Old School practitioners, but which
 every mother who is anxious  to bring up healthy and robust
 children, should avoid.  The poor little beings suffer enough,
 forsooth, without  being tormented by such improper manage-
 ment.  As regards the alcoholic and other stimulating bever-
 ages  which  are used by  so  many  nursing  mothers, by the
 recommendation  of nurses, we are of opinion that  the use
 of these things is a  crime,  inasmuch as both the physical
 and  intellectual faculties of  the child are impaired thereby.
 We  cannot forbear raising  our voice against  the horrible
 custom of some nurses to use drugs for every little trouble
 they may experience;  they seem to forget that they inflict
 incalculable injury upon their nurslings by such indiscretions.
 A nurse should never take any medicine without the advice
 of a physician, even under homoeopathic treatment; nor should
 the  physician prescribe any thing without considering the con-
 dition of the infant and the probable effect which the medicine
 may have upon it.
    In the preceding paragraph  we have likewise spoken of the
 influences which moral  emotions may exercise  upon  the
 quality of the milk and the health  of the infant.  It may not
 be possible for nursing mothers to avoid all opportunities of 
384
DISEASES  OF FEMALES
 getting  angry or sad; but  it is  certainly possible  to avoid
 every violent and  artificial excitement, such  as  theatres,
 novel-reading, or even any other exciting amusement or seri-
 ous business.  It is not only the diet that should be attended
 to,  but  the  condition of the breasts and of the secretion of
 milk should  never be lost sight of.   How many women render
 themselves diseased for life by exposure to  draughts of air
 or other causes while they are nursing their children.  The
 breasts  and every other part  of  the body should be kept in
 an uniform  temperature ;  too much heat around the breasts,
 or exposure  to cold  is injurious to the milk.
   The   homoeopathic regimen prescribed by  Hahnemann
 in his Organon*is more particularly applicable  to  nursing
 females.   A mother who avoids salt and young meat, strong
 spices,  sausage meat, acids and  heating  substances, herb-
 teas, drugs,  except such as are necessary on given occasions;
 in one word,  everything  that might  injure  the  body and
 spirit of the child,  and who  contents  herself in the place
 of all this with plain and healthy nourishment, will have
 the  satisfaction of raising  a  healthy  and vigorous  off-
 spring.    A  true mother will  be  willing to conform to our
 demands; she will  be willing to sacrifice her coffee and tea,
 her social dissipations and  theatres,  for the  benefit of her
 child. As long as the mother is not yet aware of her preg-
 nancy, such  excitements may seem pardonable;  but as soon
 as the child is born,  and its sweet smile has greeted the young
 mother's  eyes, she cannot, if she is a true mother,  find our
 rules too  strict, or  the privations which we recommend, too
 fatiguing.
                      Section 151.
   Medical attentions during nursing.—The accidents or
 morbid conditions that may'require the  attention  of the phy-
 sician during the period of nursing, are : agalactia, or loss of
 milk; dysgalactia, or bad milk ; galactirrhcea, or involuntary
flow of milk ; diseases of the  nipples; diseases  of the  breasts,
and phthisis of the nurse.   We shall speak of each of these
conditions in succession. 
lactation.
385
  Agalactia or loss  of milk, may be total or partial, pri-
mary or accidental,  according as the milk fails entirely or is
not secreted in sufficient quantity, and according as the milk
fails from  the beginning, or the secretion decreases or stops
in consequence of some accidental cause.  The most frequent
causes of agalactia are deficient nourishment, a constitutional
weakness caused by debilitating moral affections, sickly preg-
nancy or other chronic affections,  and finally, the bad condi-
tion of the' breasts,  their atrophy,  organic disorders or insuf-
ficient development.  If this condition is owing to a temporary
want of food, the best means  to restore the proper secretion
of milk is to give the patient suitable nourishment as often as
she requires it.   If  the trouble is  caused by constitutional
debility,  the best  remedies  are: Agnus, Calcarea, Causti-
cum, Pulsatilla, Rhus; Agnus,  especially deserves a pre-
ference, unless  the  symptoms indicate some  other remedy;
for nodosities  in the breast we have to give, Dulcamara,
Agnus, Belladonna, Chamomilla, Rhus,  and if no appreci-
able cause can be discovered, we may prescribe :  Dulcamara,
Agnus, Zincum, Calcarea.  In case of accidental suppres-
sion of milk, we will always find  the following remedies effi-
cacious, according to  circumstances: Belladonna, Bryonia,
Pulsatilla, Dulcamara,  or Calcarea, Chamomilla,  Coffea,
Mercurius,  Aconitum, Rhus, Sulphur;  and more particu-
larly, if the suppression is induced by a cold; Dulcamara, or
Pulsatilla, Belladonna,  Chamomilla, or  Aconitum, Mercu-
rius,  Sulphur; after  a fit of grief: Ignatia, Causticum,
Phosphori acidum ; after a fit of anger :  Chamomilla, Bry-
onia ;  after a fright  : Aconitum, Belladonna,  Opium, Cof-
fea;  after  amorous  jealousy: Hyoscyamus, Pulsatilla,
Lachesis,  Causticum; after a sudden joy:  Coffea.
   Dysgalactia, or bad milk takes place if, in spite of a suffi-
cient supply of milk, the  child refuses  to  take  the  breast
either because  the  milk is too bad, or the child finds it  too
troublesome  to  draw  it out.   We have spoken above of  the
various changes that  the milk may undergo in its nutritive
and other qualities.  The  best remedies for bad milk are:
                            25 
386
diseases of females.
Sulphur, Mercurius, China, or Borax, Silicea, China, or Pul-
satilla, Rhabarbarum, Carbo  animalis, Lachesis, Nux vom.,
Sambucus ;  and more particularly, if the milk is too serous,
not sufficiently nutritive, and if the child does not thrive
from it:  China or Sulphur, or Cina, Mercurius ; if the milk
coagulates readily: Borax or Lachesis;  if it turns sour
readily: Rhabarbarum, Pulsatilla;  if the  child REFUSES
to take the breast, without any appreciable cause: Mer-
curius,  Cina,  Silicea; if the  child vomits  after nursing:
Silicea, Cina, Mercurius.   If the milk should be secreted in
sufficient quantity, but cannot  be  readily drawn out by the
child, there  is generally too  much action  in the lactiferous
tubes, and a state of plethora bordering upon inflammation,
owing to which the excretory canals are, so to say, stopped up
by a species of partial orgasm.  This condition,  which  is
often  met with  in the case of plethoric young females over-
flowing  with health, yields to  Aconitum, Bryonia, Chamo.
milla, Belladonna, Mercurius.
  Galactirrhoha, or involuntary flow of milk,  takes place
when  the milk is secreted in  excessive quantity,  and the
breast  is unable to retain  it.  If this loss should  continue
and become excessive, it must necessarily be injurious to the
health  of the mother,  and may even  induce a considerable
degree of emaciation and  loss  of strength.  In most cases
this condition yields  to the following remedies: Pulsatilla,
or Calcarea, or Belladonna, Borax, Bryonia, Rhus, or China,
Conium, Phosphorus,  Stramonium.   Sometimes the milk,
though secreted in excessive quantity, nevertheless remains in
the breast in spite of nursing.   The  mammae swell, become
painful and knotty,  the knots forming strings from the breasts
as far as the armpits.  For this trouble, Bryonia or Calcarea,
if Bryonia should not suffice, will prove an excellent remedy;
sometimes  Belladonna,  Phosphorus,  Pulsatilla,  may  be
useful.
   The diseases of the nipples which may prevent nursing,
are deficient development and soreness of the nipples.  We
refer the reader to what we have said  concerning these affec- 
LACTATION.
387
tions, Sections 108-109.  If the nipples are not sufficiently
prominent, the child being unable to take hold of them, of
course, cannot nurse.  If such a difficulty exists, it has to be
attended to even  during pregnancy.   The  simplest way to
remedy this defect is to draw the nipple out by applying to it
a small vial or the bowl of an earthen pipe, after having pre-
viously expelled the air  from either, by holding the flame of
a piece of burning paper or spirit-lamp over it.   The  nipple
having been drawn out, a little cup of soft India rubber cloth
may be tied over  it, in order to prevent its being chafed  by
the pressure or friction of the clothes.  In order to prevent
the soreness of the nipples, the patient will  do well to bathe
them even  during her pregnancy with a little brandy;  this
strengthens the skin, and diminishes its liability to tear.  If
this means should not prove sufficient, and the nipples should
become sore, they may be bathed with a solution of a drop of
 Arnica-tincture in  100  drops of water; if this remedy is
 applied at once, a cure will soon follow.  If Arnica does not
 help, Chamomilla, or Ignatia, and sometimes Pulsatilla will
 prove efficient, if the nipples are simply inflamed  without
 being either raw or cracked.   If  they are cracked or excori-
 ated, Sulphur, or, perhaps,  Graphites, Calcarea, or Lycopo-
 dium will be found sufficient.
   The diseases of the nipples with which nurses  may be
 attacked, are: phlegmonous inflammation  and abscesses  of
 the nipples.   We refer the reader to Section  103.  These
 accidents generally result from a cold, accumulation of milk,
 stoppage of the  lactiferous vessels  or from  a blow upon  the
 breasts.  If the  physician is called as soon as the  disease
 shows itself, with  a little inflammation and swelling, Aconitum
 will sometimes prove sufficient to arrest the disorder.   But, if
 the inflammatory  swelling is well developed, the best remedy
 will  be  Belladonna,  especially if  there is erysipelatous red-
 ness ; or Bryonia if Belladonna is not sufficient, and if the
 tumor is very red, with  lancinating or tensive pains.  If an
 abscess should threaten, the best remedy is Mercurius, espe-
 cially if it  can be used as soon as the first signs of suppura- 
388
diseases  of females.
tion are perceived;  but if the pus is already formed, and the
suppurative process has become  quite evident, Phosphorus
will be found the best remedy.  If  fistulous ulcers develop
themselves, Silicea is the best  remedy.  All these remedies
should be  administered as follows:  6 globules in half a tum-
blerful of water,  a  dessertspoonful  of which solution is to be
given every three  hours.  If  the  suppuration should have
become  chronic,  or should Have  been going on for months
before the  physician is called, the same  medicines may be
administered, except that the above-mentioned dose should be
given every morning  only, or even  3 globules dry on the
tongue  every three or  four days  at  most.   With my late
friend Croserio,  I  repudiate with  all  my  might the use of
poultices  in  these tumors.  Poultices  promote  the suppura-
tion and the formation of chronic engorgements which occur
so frequently under old school treatment.
   Phthisis of nurses, when  induced either by  a too profuse
flow of  milk, or  by excessively prolonged nursing, is gene-
rally  ushered in by great weakness,  depression of spirits,
constant desire to weep ; after  a while the patient experiences
acute drawing pains in the forepart of the chest and  in the
back, between the shoulder-blades, with loss of appetite or else
canine hunger, burning  at the stomach, in the fauces, chest,
or sense of emptiness at the pit of the  stomach, violent thirst
and exacerbation of all the pains  during  and  after nursing;
afterwards a hectic fever sets  in, which is sometimes accom-
panied by paroxysms of hypochondria  or hysteria, and, if the
disease is not arrested, the emaciation and prostration may
rapidly lead to death.   The first thing to be done, as soon as
the first symptoms  of consumption  make their appearance, is
to wean the child.  In most cases the secretion of milk ceases
shortly after weaning, and the health of the patient is restored
again shortly after,  especially if  a substantial  and easily
digested nourishment  is resorted to.  Exercise in the open
air should not be neglected.  If this change of  regimen is not
sufficient,  a few small doses of  China, 6 globules of the 15th
attenuation in half a tumblerful of water, a dessertspoonful 
LACTATION.                    389
morning and  evening, will  soon bring  about a favorable
change, so much so that the patient  is sometimes enabled to
resume  her nursing.   If  the  disease is  too far advanced to
yield to the action of China,  Calcarea, Sulphur, or Lycopo-
dium will render good service.  In cramps of the stomach
which sometimes set in after exhausting nursing, China may
be given, and, if this does not help,  Carbo vegetabilis.

                       Section 152.

   Weaning.—If nothing occurs to force the mother to wean
 her infant, the best period for weaning is the  time when the
 child has cut its first teeth,  and is able to  digest the  new
 nourishment for the use of which the organs of the child have
 gradually  been prepared.  Few women, however, can await
 this period:  the reappearance of the menses, the diminution
 of milk,  a new pregnancy, marked debility and  other acci-
 dents of this kind, may compel her, and often do compel her,
 to wean her child sooner  than she would wish.  The nearer to
 the period when the first dentition is accomplished, the better
 for the child to be weaned.  In any  case, as soon as the
 milk commences to give out,  or if the  breast remains empty
 even after the child makes an effort to draw milk, it is  time
 to wean the child,  both on the mother's account as well as for
 the sake of the child's own health.   The  child should not be
 weaned suddenly,  but gradually by lengthening  the intervals
 between  the hours when the child is put to the breast.   It is
 likewise proper to gradually diminish the period during which
 the child is kept at  the  breast.  If the  period  for weaning
 the child altogether, has finally arrived,  it  may be  well  for
 the mother to keep her bed for a day or two, and to use no-
 thing  but gruels  or  light broths for  her nourishment.  By
 this means the secretion of milk will soon cease; a  dose of
 Pulsatilla or Calcarea may sometimes be necessary to facili-
 tate this result.  As regards the engorgements of the breasts
  which sometimes  take place after weaning,  they have  to be
  treated like the engorgements of which mention was made in
  the preceding paragraph. 
390
diseases of females.
                      Section 153.

  Milk-affections. — We  cannot  conclude  this  chapter
without alluding to  those pretended metastases or displace-
ments of the milk to which a good many affections of mothers
who have weaned their children are attributed by ignorant
persons.   Nevertheless, like the sudden  suppression of the
menses or lochia, so may the sudden suppression of the milky
secretion give rise to many troublesome and  even  dangerous
symptoms.  If the sudden suppression  of the milk in conse-
quence of a fright or  of some other emotion, should be fol-
lowed by acute inflammation of some viscus or some acute
eruption,  we  may safely infer that the suppression is the
cause of this  acute disorder.   Whether such a suppression
may likewise be followed by chronic disorders, remains yet to
be decided.  Nor do we exactly know  what these  disorders
are.  But inasmuch as the  other suppressions  may  lead to
functional derangements in  almost  any organ, it is fair to
suppose that the suppression of milk may be followed by
similar affections, and that these affections may, by improper
management or neglect, become more  or less chronic.  As
far as homoeopathic  treatment is concerned,  this pathological
distinction is  of very  little consequence.   By selecting  a
remedy  in accordance with  the existing symptoms,  we not
only pursue the right  treatment, but  likewise cure the dis-
ease.  If  it should  be certain, however, that an  existing
affection was caused by sudden suppression  of the  milk, the
following remedies may deserve a preference over any other:
Belladonna, Pulsatilla, Agnus, Rhus, Bryonia,  Calcarea,
Sulphur,  Dulcamara,  Mercurius,  Lachesis, Lycopodium,
Sepia,  Cina, Zincum.

  And in particular:

  In metastasis to the abdominal viscera : Pulsatilla, Rhus,
Belladonna, Bryonia,  Sulphur.
  In metastasis to the chest: Bryonia,  Calcarea, Bella-
donna, Sulphur, Lycopodium. Lachesis, Rhus, Pulsatilla. 
attentions to new-born  infants.       391
  In metastasis to TnE brain:  Belladonna, Rhus, Bryonia,
Zincum, Lachesis, Mercurius, Sulphur, Pulsatilla, Cina.
  In  metastasis to  the  skin: Sulphur,  Calcarea, Dulca-
mara, Causticum, Rhus.
  Of these remedies dissolve 6  globules of  the 12th attenua-
tion in about half a tumblerful  of water, and give the patient
a dessertspoonful of this solution every 3 hours.
ARTICLE X.
   ATTENTIONS TO NEW-BORN INFANTS  AND  TO
              CHILDREN AT THE BREAST.

                      Section 154.

   General observations.—The object and narrow limits of
this work do not permit us to enter upon long details con-
cerning the diseases to which little children  are subject, and
still less concerning the diseases  of children generally.  In
order to do justice  to  this subject, a separate volume would
have to be written, perfectly distinct from the  present work
which is exclusively devoted to diseases of women.  However,
inasmuch as the life  of  new-born children is intimately con-
nected with that of their mother, we will offer a few remarks
about the attentions to be bestowed upon infants at the breast
until the first  dentition is accomplished.   This period com-
prises  four distinct  intervals, namely:  1st, the  moment of
birth; 2d,  the first few days of their existence;  3d, the period
of nursing;  4th, the period  of dentition.  Each of these
periods is liable to peculiar ailments and derangements, which
we shall describe as they occur according to the order of these
periods  corresponding as  they do  to similar periods in the 
392
diseases  of females.
life of the mother, namely: 1, labor; 2, confinement; 3, nurs-
ing; 4, weaning.  If the same  ailments should occur in more
than one of these periods, we shall allot them  to the period
when they occur most frequently.

                      Section 155.

   First attentions to the infant.—The first thing to be
done after the  child is born, is to place it so as to enable it
to breathe freely, and not to deliver the placenta until the
pulsations in the cord have either ceased or become consider-
ably weaker.  If the cord is twisted  round the neck or round
any other part of the child's body, the parts are disembar-
rassed, after which the child is placed on one side with its
face turned away from the vulva, by this means  the mucus
which may be in the mouth, will flow out without causing any
trouble, and the blood discharged from the vulva will be pre-
vented from obstructing  the nostrils of  the  infant.  After
tying the cord a few inches from its attachment to the infant,
previous  to which operation we have to ascertain whether a
portion of  bowel  has not  slipped into the cord, we sever the
cord between the ligature and the placenta.  The cord having
been tied, all the impurities which may be found in the child's
mouth and nostrils, are removed by means of a soft piece of
linen, the  child's body is  carefully washed with tepid water,
the navel is dressed, a bandage is applied round the abdomen,
and the child is comfortably and warmly dressed, so as neither
to interfere with  the breathing nor the circulation,  nor with
the free motion of its limbs.  We do not approve of washing
the child's body with brandy or alcohol, which some accouchers
recommend for the purpose of dissolving the fatty matter with
which the newborn infant is  often  covered; alcohol does not
act upon this substance, and, moreover, irritates the delicate
skin of the child.   It is much better to use sweet oil or cream
for this purpose.
  After dressing the child, it may be laid close to the mother
who may  commence nursing it after  ten or twelve hours.
The first milk which is drawn from the mother's breast, called 
attentions to new-born infants.       393
colostrum,  is not very nutritive,  and will help to expel the
meconium  if this  substance should have  remained  in the
bowels.   No mother should deprive her infant of the nourish-
ment which nature seems to have destined  for it, except in
case of absolute necessity.  No  animal  refuses to nurse its
young; it  is only  among  the  human species that we  find
mothers  cruel  enough  to  deprive  a newborn infant of  its
natural food.   If  this is done from wilful neglect or indiffer-
ence, mothers often pay dearly for such violations of nature's
laws.  If compelled by weakness to renounce the pleasure of
nursing their infants, a nurse should be  obtained whose milk
is as nearly as possible like that of the mother; if the milk is
too old, it  becomes so  strong  and fat that the child cannot
assimilate  it, in consequence of  which the  tender being lan-
guishes, and gradually perishes.  If no  nurse that has suita-
able milk for the baby, can be had, it should be fed on  fresh
cow's milk mixed with one-third tepid water, and sweetened
with a little loaf sugar ; a few teaspoonfuls of this milk may
be fed every now and then,  increasing the  quantity and  the
consistence of  this nourishment  in proportion as the infant
grows stronger.   Nursing  bottles  should never  be used for
this purpose.  Whatever care  we may bestow upon them, it
is impossible  to keep them  clean.   Nor can the  instrument
with which they are  stopped, and which is  in imitation  of a
nipple, be washed with sufficient care to prevent some parti-
cles of the  milk  from penetrating the  pores in the ivory.
This milk  turns sour, of which we may convince ourselves by
the  smell; and it  is this  sour milk which  frequently causes
aphthae.   The silver nursing spoons which are used in Ger-
many, are much better  than our nursing bottles.  They are
shaped like bottles with long necks, and can be opened  and
closed at pleasure.  Being accessible in every part, they can
 be kept perfectly clean and  polished,  and the  infant can
 drink out  of them  with the most perfect ease.
   In  order to keep the  infant clean,  it  should be washed
 every day in tepid or cold water,  according to the season.
 After the first teething, cold  water may be  used altogether. 
394
diseases  of females.
It is a  bad habit to put the infant into a tepid bath every
day.  Such a proceeding is highly favorable to the develop-
ment of a lymphatic constitution, and, moreover, weakens the
child, and renders it unnecessarily sensitive  to changes in
the weather or temperature.   It is not to be wondered that
in England where the use of tepid baths is quite prevalent, a
number  of individuals  should be  affected with tubercular
diseases.

                      Section  156.
   Diseases of new-born children.—The arrival of a new
being in this world of misery and strife is not always exempt
from difficulties and pains.   Tears  and  cries mark its first
entry into life.   The first cries of  a child which are caused
by the irritating effect of the air upon the lungs, need not
alarm any one; on the contrary, they show that the child is
born with a healthy and  strong constitution,  and it is right
and  proper that  young mothers  should be delighted to hear
these first cries  of  their little  ones.  Sometimes,  however,
these joyful scenes are closed by sorrow.   Respiration, which
is an indispensable condition of life,  is sometimes wanting,
and  all the other functions remain suspended ; the child seems
asphyxiated.  In  other cases the child is alive, but its head
is ecchymosed or swollen, or  its skin is blue, yellow or indu-
rated, and sometimes the child  is born with malformations.
All these conditions may require the immediate attention of
the  practitioner.  We  will  describe  the treatment  which
sometimes has to be instituted in the case of children, under
the following heads: apoplexy, asphyxia,  cyanosis, jaundice,
ecchymoses and swelling  of  the  head, cellular  indurations,
swelling of the breasts, congenital malformations, and hernia.
   The apoplectic condition in which children sometimes  are
born, is caused by long and painful labor; the surface of  the
body seems swollen; the  face and the whole body are of a
violet,  or  rather  blackish-blue  color; the  muscles do   not
move;  the limbs preserve their  flexibility and  the body its
heat; the pulsations of the cord, pulse and even those of  the 
ATTENTIONS TO  NEW-BORN  INFANTS.       395
heart are either imperceptible or at any rate very feeble, and
the breathing does not take place.   In such cases alloeopathic
accouchers are  in the habit of promptly severing the cord and
letting a few teaspoonfuls  of blood flow from it.   Instead of
resorting  to such a  proceeding  and  depriving these  little
beings of the blood which constitutes the principal support of
their feeble existence, we have it in our power to remove the
difficulty by the exhibition of Aconitum,  Tartar emetic, or
Opium.   A single pellet of Aconitum, 18th attenuation, dry
on the tongue,  sometimes changes this unfavorable condition
visibly ; if no improvement should take place after ten or fif-
teen minutes, we may have recourse to Tartar emetic, which
will generally help.   If the body of the child is violet-colored,
Opium will sometimes prove efficient.  This apoplectic con-
dition must  not be  confounded with asphyxia;  for this last
named condition requires  a treatment different  from the one
required by apoplexy.
   Asphyxia of  new-born  infants generally occurs  among
feeble children, or  among such as have been  weakened by
tedious labor, or  by flooding during pregnancy, or by other
affections with  which the  mother  had been attacked during
the period of utero-gestation.  In  these children the circula-
tion is neither  arrested nor impeded, but the breathing and
the muscular movements are wanting, the  skin  is extremely
pale, the flesh  is flabby and soft, and  the child  almost looks
like a corpse.  In such a case the umbilical cord  should be left
undivided as long as we discover pulsations in the cord, and the
mucus which is in the nostrils should be removed by means of
a little linen rag; afterwards we place three pellets of China
18th, on the child's tongue, wrap  it in warm flannel, and rub
the chest and  hands with  a similar material.   If the child
does not commence to breathe soon, or if the pulsations cease
entirely, the cord may be  severed  after  tying it; this being
done, we  place the child in a warm bath in order to  preserve
the temperature of the body, and we endeavor to  excite mus-
cular action by gentle strokes on the limbs  and chest.   If
 China does not  bring on any change within  ten or  fifteen 
396
DISEASES  OF FEMALES.
minutes, a similar dose  of  Tartarus emeticus may be given,
which maybe alternated with China every fifteen minutes;
if no change takes place in two hours, we may give Lachesis.
At the same time a young person in good health  may place
her mouth close over the mouth of the  infant,  and endeavor
to blow air into  the child's lungs, during which operation the
nostrils  of the  child have to be closed with the fingers.  In-
sufflation of the lungs is best accomplished by means  of the
laryngeal tube which, passing as it does into the larynx, pre-
vents the air from being  blown into the  oesophagus  and
distending the stomach, which would increase the compression
of the  lungs.   These  insufflations,  however, do not always
respond to the object we seek to attain;  sometimes the best
means to excite action in the muscles of the  thorax, is to
sprinkle the chest with  cold water, especially the left side; or
to blow a little  brandy and  water out of one's own  mouth
against the anterior wall of the child's thorax.   It often hap-
pens that respiration commences immediately after resorting
to the  sprinkling.   We should not give up too soon  in our
efforts  to restore  animation.  Sometimes it  takes several
hours to accomplish this result; but even, if all our endeavors
should prove fruitless, the child ought nevertheless to be kept
warm for some time, for in more cases than one,  animation
set  in spontaneously after all the efforts of art seemed to have
proved  fruitless.  As soon  as we perceive the  first signs of
life, our efforts to restore animation should be discontinued;
nor should the child be left in the warm bath after it has
commenced to cry and to breathe freely.
  Cyanosis of new-born infants results from a mixture of the
arterial and venous blood caused by an imperfect  closure  of
the foramen ovale,  on which account the blood of the right
ventricle, instead of passing into the lungs and there being
arterialised, passes  directly into the left ventricle whence it is
propelled into the general circulation.   We may try Sulphur,
 Calcarea or Digitalis for the purpose  of  removing this mal-
formation, small doses should be given at long  intervals.
  Icterus of new-born children is often caused by exposure 
attentions to new-born infants.       397
to cold at the time of birth, resulting from the carelessness
of nurses;  sometimes it is owing to the retention of the me-
conium in the bowels.  This trouble is not serious;  in most
cases it gets well of itself without any treatment;  if, how-
ever, this should not be the case, and the skin should at  the
same time be dry and hot, we may give  three globules of
Aconitum, 12th attenuation, in half a tumblerful of water,
of which solution a dessertspoonful should be given twice  a
day.
   The induration OF the cellular tissue is almost always
a very serious difficulty, which  attacks children during  the
first ten  day3 after their birth.  It generally commences at
the lower extremities or cheeks, when it soon extends to  the
abdomen and  chest.  The skin which covers  the  diseased
parts is  slightly rose-colored or purple, violet, livid.  If the
disease runs a rapid course, the temperature of  the body de-
creases rapidly, the pulse is scarcely perceptible, the breath-
ing becomes more and more labored, the child's cries diminish
and gradually cease altogether, the face becomes livid,  and
the little ones die as of suffocation, generally on the third day.
Sometimes the disease is more  chronic, and passes off again
from the fourth to  the eighth  day; but these  cases are ex-
ceedingly  rare,  and under  the old treatment most children
die in a few days.   Under homoeopathic treatment this  dis-
ease is  readily  cured by  Aconitum, 18th  attenuation, six
globules in half a  tumblerful  of  water, a  dessertspoonful  of
which solution may be given every three  or four hours.   If
there should be no improvement after  a few doses  of Aconi-
tum, we may give Bryonia  in  a similar manner.  If the
disease  grows  obstinate, three globules of Sulphur, dry on
 the tongue, may be administered once only as an intercurrent
remedy.
   The  ecchymoses and swelling of the head with which
 children are sometimes  born,  are  caused by the instruments
 which had been applied  during delivery, or by the contusions
 which the head receives in passing through the straits.  They
 generally  disappear after bathing the  head with a mixture of 
398
diseases of females.
ten drops of tincture of Arnica in half a tumblerful of water;
if  any swelling should remain after applying the Arnica, we
may give Rhus, three globules dry on the tongue.  This will
remove the difficulty; but if ulcers should form, give Silicea
the same as Rhus.
   Swelling of  the breasts in new-born  children often
results from pressing the breasts after birth, which is a habit
with a great many nurses.  If the swelling is not inflamed, a
single dose of Arnica will remove it; if it is red, give Bella-
donna, three globules dry on the tongue;  if suppuration is to
be feared, we may give Mercurius or Hepar, or even Silicea
if  suppuration should have  set it.  For scirrhous induration
of the breasts Chamomilla is the specific remedy.
   Umbilical or inguinal  hernia of new-born infants often
yields to Nux vomica and Sulphur, three globules alternately
every week, dry on the tongue.  If no better in six weeks,
give Cocculus, or Aurum, or Veratrum, Lachesis, Sulphuris
acidum.
   Malformations, congenital excrescences, tumors, etc.,
sometimes  disappear of themselves as the child grows older;
hence operations  should not  be performed  too soon.   In
many cases three globules of Sulphur, dry on the tongue,
will prove useful; in five or six weeks we may give a similar
dose of Calcarea.   These two remedies are  likewise excellent
for n^evi materni, unless we should  have to give Carbo vege-
tabilis, Platina, Sepia,  Thuja, Zincum.  If the skull-bones
should slip one  over  the other, as  is often  the case after
instrumental labor, and should remain in  this situation, mak-
ing the child look old, emaciated, with flabby muscles, Opium
will sometimes remove these symptoms.

                      Section 157.
   Diseases of infants at  the breast.—After children have
passed through the first  moments of their existence, and draw
their sustenance regularly from  the  breast  of their mother,
they are still exposed to many derangements incidental to
their condition.   These  are: hiccough, stoppage of the nose, 
attentions to new-born infants.       399
asthma, cardiospasm,  sleeplessness, cries,  colic,  diarrhoea,
constipation, falling of the rectum, retention of urine, erythe-
ma,  aphthae,  ophthalmia,  erysipelas  and  rash.   In  this
paragraph we will treat successively of each  of these affec-
tions, reserving for the last  paragraph all that has to be said
concerning  dentition and  the  disorders  inherent  in  this
period.
  Hiccough is sometimes very troublesome to little children,
without however  being a serious  complaint.  It generally
passes off shortly after the infant gets warm again in  its
mother's bosom, and takes a few teaspoonfuls of fresh water.
If the attack should take  place frequently, a few globules of
Aconitum, or Nux vomica, or Pulsatilla, dry on  the tongue,
will  soon  stop it.
   Stoppage of the nose often  renders it impossible for  in-
fants to nurse.  Sometimes  rubbing a little  goose-grease  on
the  nose will  cure the  trouble; if not, we  may give  Nux
vomica, or Sambucus if Nux is insufficient.  If mucus should
flow from the nose, we may give Chamomilla; or Carbo vege-
tabilis, if the trouble gets worse toward evening; or Dulcamara
if the aggravation takes place in the open air.
   Cardiospasm or liver-grown, is a  sudden bloating  and
hardness of the  pit of  the  stomach and hypochondria, with
sense of suffocation ; the children are restless, cry, toss about,
draw their thighs up, and are out of breath.   Chamomilla is
specific for this trouble.
   Asthma of infants, which  is sometimes mistaken by  the
uninformed for croup, consists in a sort of spasm of the chest
which arrests the breathing,  and imparts a violent  color to
the  face;  the children  wake  suddenly, with  anxiety, hollow
 and  dry  cough, and plaintive cries.  A few magnetic passes
quiet the child;  if not, two globules of  Ipecacuanha may be
given dry on the tongue,  or Sambucus, both of which are spe-
 cific remedies for this condition.
   Sleeplessness of infants  is generally owing to a vicious
regimen on the part of the mother, the use of coffee, chamomile
or°other  teas, heating food, etc., or the child does  not lie well, 
400
diseases  of females.
is  bandaged too tightly, etc.  If, after  the removal of these
causes, the sleeplessness still continue, a pellet of Coffea may
be given dry on the tongue, or, if insufficient, a dose of Cha-
momilla, especially if the child is troubled with flatulence ; or
Opium  may be given if the blood  goes  to the head and the
face is  very red.  For simple wakefulness without nervous-
ness, we try Ranunculus, bulbosus.
   Crying  without a  cause  probably  never occurs.   If a
child cries, it feels uncomfortable, a pin  pricks it, or the skin
itches, etc.  We should make every effort to discover the true
cause of the trouble; but if, after removing it as well  as  we
know, the crying still continues, we may give  for crying from
anger :—Aconitum, Chamomilla or Arnica ; from fright :
Opium, Belladonna, Ignatia;  for crying followed by con-
vulsions, with rigidity of the body,  raising of the abdomen,
and throwing the head back: Chamomilla ; if the children are
restless with a burning skin:  Coffea or Aconitum; if the
face  is red:  Aconitum or Belladonna; if they cry and
cannot be quieted :  Belladonna, Aconitum,  or Coffea; if
they become furious, and kick and demean themselves: Tar-
tar emetic; if  the crying is caused by ear-ache, colic, etc.,
give the remedies indicated for these affections.
   Colic is  easily recognized  by the twisting of  the  child,
emission of flatulence, drawing up  of the legs,  crying, etc.,
Chamomilla is a specific remedy for this trouble, especially if
there is greenish and watery diarrhoea, with constant crying,
distension of the abdomen, starting of the limbs and cold feet;
or China may be given, if the colic occurs  towards evening,
with hardness of  the  abdomen, absence of stool  or whitish
stool,  or resembling stirred eggs.   Pulsatilla for  flatulence,
rumbling, frequent shuddering, pale face and  no thirst.   Ipe-
cacuanha, for  fermented diarrhoea having a  foul  smell, and
the children uttering violent and piercing cries.
   Diarrhoea  of  infants generally yields to a  few doses of
Ipecacuanha, eighteenth attenuation, three globules in half
a tumblerful  of water,  a dessert-spoonful of  which  solution
should be given every three hours.   If  this should not help, 
ATTENTIONS TO  NEW BORN INFANTS.       401
we may give Rhabarbarum, if the evacuations and the child's
whole body smell sour;  Chamomilla, if the child cries a good
deal, draws up its legs, with distension of the bowels and fre-
quent emission of flatulence; Antimonium, if  the tongue is
coated white or  yellow; Dulcamara, if the diarrhoea arises
from a cold  or from exposure to cold air; Bryonia, if caused
by summer-heat; Belladonna, if the evacuations are greenish,
the child sleeps a good  deal, but  the sleep is  restless, with
pale face; Arsenicum or Secale, if the child is very feeble;
Sulphur, Calcarea or Nux moschata, in obstinate cases where
nothing else will  help.
  Constipation  of little children  is often caused by heating
food, and yields to a change of diet. If medicine is required,
Bryonia, Nux vomica, Opium, will be found sufficient.  Give
one or two pellets dry on the tongue, and again in twenty-four
hours, changing the medicine, if no improvement takes place
after the second dose.   For chronic constipation we may give
three pellets of Sulphur or  Alumina, every three or four
days, dry on the  tongue; if no evacuation should take place
within twenty-four hours, we may resort to injections of tepid
milk and water.
  Falling  of the  rectum in the case  of little children,
occurs quite frequently,  generally after long  lasting diarrhoea
or violent straining at  stool  when the faeces are  hard and
large.   The  best medicines  are  Ignatia or  Nux vomica.
These medicines  may be given at  the time when the trouble
takes place; sometimes  they act on the spot, and the rectum
returns  to its normal position without any manual assistance.
  Retention of urine, generally yields to Pulsatilla, or
Nux vomica;  if  these medicines are  not sufficient, we may
give Aconitum,  or the child may smell of the tincture of
Camphor.
  Excoriations, soreness,  intertrigo, are  very trouble-
some to little children; generally they are seated in the groin
between the genital organs and the thighs, but often they in-
vade the parts between the nates, the genital organs and the
axilla.   The best remedy is Sulphur, two globules dry on the
                            26 
402
diseases of females.
 tongue, which generally effect an improvement in a few days;
 if not  sufficient, we  may  give Chamomilla, especially if the
 children cry a good deal and seem ill-natured; or Carbo vege-
 tabilis, if Chamomilla renders the symptoms worse; or Mer-
 curius,  if  the  child looks yellow, the excoriation extends
 behind the  ears, with redness of the sore places.   Semetimes
 Graphites renders good service;  Lycopodium is seldom indi-
 cated.  The soreness behind the ears requires Sulphur, Cal-
 carea or Graphites.
   Erysipelas  of infants  generally proves  fatal  unless
 checked.   It is always seated on  the abdomen,  spreading
 from the navel over the abdomen to the genital parts, and the
 inner surface of the  thighs.  The affected parts  are  warm,
 hard and  painful  to the  touch, the  urine stains the linen
 "Yellow and  reddish; the fever  is generally high, with frequent
 pulse, dry and hot skin; and coated tongue.  This erysipelas
 generally yields to Belladonna, 18th  attenuation, three pel-
 lets  in  half a tumblerful  of  water, a dessertspoonful every
.three hours; if Belladonna does not help, we may give  Rhus.
   Rash of  infants  is  generally caused by excessive covering,
.and passes  off again  after the cause is removed;  if not, we
fmay  give  Aconitum if there is fever, with dry skin  and
frequent pulse; or Ipecacuanha, if diarrhoea is present; or
Bryonia, if there is constipation and distension of the bowels.
   Fever of little children, unless caused by teething, is gene-
rally a  sign that some  other  acute affection is approaching,
such as inflammation  of some  organ, or an  eruptive disease.
But in many cases these diseases may be prevented by attend-
ing to the precursory symptoms.   If the child is hot, restless,
with quick  and strong pulse, dissolve three pellets of Aconi-
tum,  18th   attenuation, in half a  tumblerful of water,  and
give a dessertspoonful  of  this solution every few hours until
the fever ceases, or until other symptoms develop themselves,
pointing to some  other remedy.   In  most cases,  the fever
will cease in about twenty-four  hours,  or, at any rate, the
disease will  run  a much milder course,  provided it was impos-
sible to  arrest it. 
           attentions to new born infants.       403

   Aphtha are small white  specks  in  the mucous lining  of
the mouth, which spread, and form irregular and thin patches
that either remain distinct or run intoeach other.  If remain-
ing  distinct, the disease is not very serious, and the inflam-
mation runs its course in one or two weeks; but  if these
patches unite, the whole mouth becomes lined with a creamy
crust that thickens  from day to day; this  crust soon turns
yellow; the inflammation spreads to the digestive organs, and
the  little patient becomes weaker  and weaker,  and finally
dies.  The most frequent causes of this affection are: suck-
ing  when  the  breast is empty; too  substantial food; obi
milk ;  want of cleanliness ; the use of  ordinary sugar-tits,  or
nursing-bottles that  are not kept clean.  The best remedy for
this affection is  Sulphuris acidum, six pellets of third attenu-
ation in half a tumblerful of water,  in dessertspoonful dosea
every  three hours; if this remedy is not  sufficient, we may
give Mercurius; or Sulphur, if Mercurius does not help.
Borax may be given, if the urine smells  like cat's urine,  or
if no other medicine helps.
   Ophthalmia of infants is characterized  by  an enormous
swelling of the  lids  with accumulation of a purulent matter
between the eyeball  and the lower lids; it principally occurs
among children of a bad constitution and who are not kept
clean.   The best remedy for this affection is Aconitum, 6th
attenution, 6 globules  in half a tumblerful of water,  in des-
sertspoonful doses every three hours; if the affection is more
'chronic, we may give Sulphur.  In some cases  the favorable
action of Aconitum  is very appropriately succeeded by Dul-
camara, Mercurius,  Chamomilla, Belladonna,  or by Pulsa-
tilla, and  after Sulphur we may give Calcarea,  Lycopodium,
Silicea, Arsenicum.
   Otalgia and otitis of infants, (earache and inflammation
of the  ears) generally announce  themselves by cries, restless-
ness, starting during sleep, fever ; the child continually grasps
at the ear, and  is very uneasy.  The best remedies are:  1.
 Chamomilla.   2. Pulsatilla. Belladonna, Mercurius or Sid- 
404
diseases of females.
phur.   And if there is discharge, we give Pulsatilla, Mercu-
rius or  Sulphur.
   Convulsions of  children are generally frightful  to those
who are unacquainted with medicine, but  they scarcely ever
fail to yield to homoeopathic treatment.  In many cases these
convulsions cease by rubbing the upper lip of the child, under
the nose, with a finger  moistened with the tincture  of Cam-
phor.  If this is not sufficient, and the paroxysms return, we
may give Ignatia, Belladonna,  Chamomilla,  Coffea, Ipeca-
cuanha, Mercurius, Opium, Sulphur.
   Ignatia is indicated, if the attack comes on without  any
apparent cause, especially every other day at  the same hour,
or if worms or teething  seem  to be the cause of it;  Bella-
donna,  if the convulsions are  accompanied by cerebral symp-
toms, such as vertigo,  sparks before the eyes,  loss of con-
sciousness,  etc.;  Chamomilla, if  the convulsions affect the
arms, legs, and head, the  eyes are half closed;  one cheek is
red, the other pale; Coffea, suitable to feeble children,
when the convulsions are not accompanied by other symp-
toms; Ipecacuanha, if the  children are oppressed on the
chest, with eructations, vomiting or diarrhoea,  tetanic rigidity
of the whole  body ;  Mercurius, if the abdomen  is hard  and
distended, with eructations, water in the mouth, fever, pros-
tration  after  every  attack;  Opium, if, after a fright,  the
body trembles, the arms and legs are thrown about, the child
cries without  consciousness,  with stupor,  distension of  the
abdomen, retention of stool and urine; Sulphur, if the con-
vulsions recur constantly in spite of treatment.
   The  presence of  worms is often suspected  where other
causes induce derangements.   If worms are really present,
we may give  alternately Sulphur and  Cina,  two pellets dry
on the  tongue, every week.   In case of fever, Aconitum or
Mercurius  will soon dispel it.

                      Section 158.
   Ailments  during dentition.—The process of dentition,
which generally commences  a few months after birth, deve- 
           attentions to new  born  infants.       405

lops various ailments which generally disappear again after
this period, but which may become  so  violent  as to require
the interference of a physician.   These  are, affections of the
gums, nervous excitement, fever, convulsions, diarrhoea, cough,
and general  derangements.  We shall treat of  each of these
affections in particular.
   The affections of the gums are  generally the first visible
signs of dentition.   The gums become  swollen, hot, painful
and whitish at the borders; they itch; the child's mouth is
hot, and there is a constant flow of saliva from the mouth; the
child has difficulty in nursing,  and crowds everything into it*
mouth  in  order  to bite.   If this condition does not last too
long, it does not require  any treatment; otherwise,  if the
 gums remain swollen  and  the  teeth  do  not break through, or
 if the teething takes place in an irregular manner, three pel-
 lets of  Sulphur, 30th attenuation,  may be given dry on the
 tongue, and in about a week  a  dose of Calcarea ; if neces-
 sary, another dose of Calcarea may be  given in a week.  By
 this mode of treatment the necessity of lancing the gums will
 always be avoided.
    The  nervous irritation caused by the teething is some-
 times exceedingly  troublesome.  The child does not sleep, is
 restless, capricious, laughs or  weeps about  trifles.  The best
 remedies for these symptoms  are Aconitum or Coffea, espe-
 cially if the child's  cheeks are  alternately red and pale; or
 Chamomilla if one cheek is red, the other pale, with starting
 in the limbs; or Nux  vomica, if there  is constipation and
 nervous hacking cough, and if Aconitum  and Coffea remain
 without effect, sometimes Belladonna or Borax are indicated.
    The fever  of  dentition  generally yields to Aconitum,
 six pellets  in half a tumblerful of  water, in dessertspoonful
 doses  every three hours ;  we  may also  give Chamomilla,
 Belladonna, Coffea, Nux vomica or Silicea.  Chamomilla,
 if the child is restless at night, with  continual tossing, marked
 thirst, short  breathing with anxiety and moanining, oppres-
 sion on the chest, warm head with sweat of the hair and
 scalp,  redness of one cheek and paleness of the other, start- 
406
diseases  of females.
ing of the limb3 ;  Belladonna, if Chamomilla is not sufficient,
eyes and skin are red, a  good deal of  thirst, disposition to
start, anguish, dry cough like whooping-cough;  Coffea, if
the fever is accompanied by nervousness, with  cries, weeping,
disconsolate restlessness, Aconitum  having  been given with-
out effect; Nux  vomica,  for  constipation,  nervous, hacking
cough,  aggravation  towards  morning;  Silicea, suitable to
scrofulous children, if  the fever will not yield to any medi-
cine, the child's body is  burning hot, face  red and bloated,
distension of the abdomen, swelling and hardness of the cer-
vical glands, which feel like dry peas.
   Convulsions  caused by teething are  sometimes prevented
by a small dose of Chamomilla,  18th  attenuation, three
pellets dry on  the tongue,  if the medicine can be administered
in time, as soon as diarrhoea, paleness of the face, dulness of
the eyes, loss of appetite,  prostration which  induces the child
to lay its head upon the shoulder of the  nurse, are perceived.
If Chamomilla is not sufficient, we may give Ignatia, Bella-
donna,  Cina, Tartarus, Calcarea, Stramonium or Sulphur.—
Ignatia is suitable if Chamomilla proves insufficient during the
precursory stage, especially if the convulsions resemble  epi-
lepsy, or break out at once without any precursory symptoms;
Belladonna, if Ignatia is insufficient, and if the child is drowsy
between the  attacks,  with involuntary  emission  of urine
during  sleep,  waking as  if in affright,  with  restless looks,
dilated  pupils, immovable eyes, burning hands and head;
Cina, suitable for children who wet  their beds, have  worms,
or who have a cough like whooping-cough, or if  the convulsions
resemble  epilepsy;  Tartarus,  if  the  children cough  and
gape a good deal  between the attacks, with drowsiness,  con-
vulsive  movements of  the facial  muscles, continual  crying,
anxiety in the features, greenish diarrhoea  ; Calcarea, espe-
cially suitable for fat and lymphathic children, if  no other
medicine helps;   Stannum, for epileptiform convulsions, for
which Ignatia or  Cina remains powerless; Sulphur, as an
intercurrent remedy, if the convulsions recur in spite of tem-
porary palliation  produced by other remedies; if  the brain 
attentions to new  born  infants.
407
should be affected between  the attacks, as may be inferred
from such symptoms  as these:  glazed and dull eyes, drowsi-
ness, sleeplessness, desire to bury the head into the pillow or
to roll it about constantly, pale or animated face, or if the
children bite the glass when drinking, we may  give Bella-
donna  and  Cina,  or  sometimes Hyoscyamus,  Cuprum,
Sulphur, Calcarea.
   Constipation may aggravate the condition of the child, it
should be wet by Bryonia, Nux vomica, Magnesia muriatica.
   Diarrhcea during dentition  should never be stopped sud-
denly, for it  frequently acts as  a natural outlet for the  cere-
bral irritation which sometimes takes place during this period;
but if the diarrhoea lasts too long, we may treat it with  Mer-
curius, Sulphur, Ipecacuanha.
   The cough which frequently  affects children during denti-
tion, is very much like whooping-cough.  It is  hollow, dry
and  more or less  spasmodic.   The best  medicines for this
cough   are  Cina,  Chamomilla, Nux  vomica, Belladonna,
Ipecacuanha.
   There are various  derangements which  attack  children
during dentition, and which may be arranged as follows : 1st,
Strophulus, consisting  of red, prominent, more or less  in-
flamed patches, scattered over the  forearms, the back of the
band, but especially over the cheeks, and sometimes inter-
mingled with  erythematous  patches.   2d,  Impetiginous
eczema, or scald-head, consisting of inflamed vesicles which
sometimes resemble impetigo-pustules and form yellowish and
soft  crusts that sometimes  discharge a profuse  quantity of
purulent mucus;  3d, Milk-crusts, (impetigo larvalis,) re-
sembling the  former eruption, except that it is seated in the
face, these two eruptions are often accompanied with swelling
of the glands of  the neck and back of the  neck.  Strophulus
generally disappears  without medicine;  but  if the blotches
become troublesome, we may give Sulphur  or  Mercurius,
or sometimes  Chamomilla, Cina, Rhus, Graphites or Caus-
ticum.   The  best  remedy for  milk-crust  or  scald-head,  is
Rhus,  18th attenuation, six  globules in half a tumblerful of 
408
diseases of females.
water, a dessertspoonful morning and  evening.   If  there
should be no improvement within six or eight days, three
pellets of Sulphur may be  given  dry  on the  tongue, and  if
no change  takes place  within a  week, Rhus may again be
given for a week, to be followed by a second dose of Sulphur;
and,  if  things remain  unchanged, we  may  give  Calcarea,
three pellets dry on the tongue, which  may be  allowed to
act  one, two  or more weeks.   In  some cases Mercurius,
Staphysagria, Arsenicum,  may be given.  Other medicines,
such  as  Viola  tricolor, Aconitum, Chamomilla, Dulcamara,
etc.,  scarcely ever do any good, unless  they are indicated very
particularly by the symptoms.    Cicuta, Baryta, Lycopo-
dium, Graphites, Sarsaparilla, are likewise rarely indicated.
If the cervical glands are swollen and the crusts itch a good
deal, Ammonium carbonicum, will be found very useful.

                       Section  159.

   Chronic derangements  of   little  children.—Little
children  are subject to  various chronic derangements, which
sometimes  affect them  immediately after birth.  The  prin-
cipal are:  large head,  retarded  closing  of  the fontanelles,
deviations  of  the spinal column, muscular weakness, which
prevents children  from learning to  walk, large abdomen,
spontaneous limping, stammering and wetting the bed.
  A large head often arises from an excessive development
of the brain.   This  may facilitate in  one respect the growth
of the mind, but, on the other hand,  predisposes children to
acute hydrocephalent.   Hence it is of importance that this
excessive development of the brain should be arrested as soon
as possible.  We accomplish this result by means of Sulphur,
Calcarea, Silicea, Mercurius, of  which three  pellets may be
taken dry on the tongue, allowing each  dose  of the selected
remedy to act three or more weeks, as long as the good effect
continues.
  Retarded closing of the fontanelles,  arises from the
fact that the process of ossification from the centre to the
circumference of the skull-bones takes place too slowly.  This 
attentions to  new born infants.       409
same  defect affects also  other bones  of the body, so  that
children  in whom the fontanelles remain open, often labor
under deviations of the spinal column, curvatures, etc., arising
to excessive  softness of  the  osseous substance.  The best
remedies for this difficulty are:   Sulphur, Calcarea, Silicea,
Mercurius, to be administered as before, under large heads.
  Deviations of the spine arises, as was  stated  above,
from  deficient ossification, owing to which the bones  do not
offer sufficient resistance to the  muscle, and hence, deviate
from their true direction.  These deviations of the bones are
likewise  successfully treated  by the same  remedies  which
we  have proposed for retarted  closing of  the  fontanelles,
namely : Sulphur, Calcarea, Pulsatilla, Silicea.  And some-
times we may use with  success:  Mercurius,  Lycopodium,
Rhus, Staphysagria, Ammoniacum, Hepar,  Phosphorus,
Plumbum.
  Muscular debility which incapacitates children from learn-
ing to walk, generally depends  upon the presence of some
scrofulous taint which likewises causes the slow development
of the osseous system. Hence Sulphur, Calcarea, Silicea, are
likewise  eminently serviceable in the difficulty.  Sometimes
Belladonna,  Causticum  or Pinus silvestris may be  given
with advantage.
  Abdominal enlargement is likewise a sign of scrofulous
diathesis.  It is a  tuberculous  affection of the mercuteric
ganglia,  with swelling and hardness of the abdomen, emacia-
tion and general derangement of  the functions of nutrition,
with or without diarrhoea.  This  serious malady often  yields
to a dose of Sulphur, 18th attenuation, three pellets  dry on
the tongue, to be permitted to act three, four or more weeks,
and to be followed by  a similar dose  of  Calcarea,  if Sul-
phur  should  be insufficient.   If  there  should be  diarrhoea
and debility, Arsenicum, 30th attenuation may be given, six
pellets in half a tumblerful of water, a dessertspoonful of this
solution, morning and evening for a week.  After Arsenicum
we  give Nux vomica, 30th attenuation, three pellets dry on the
tongue, and in about a week after we give Sulphur, as above. 
410              diseases of females.
  In  Spontaneous  luxation of the femur,  one limb is
shorter than the other, and the children limp.   This defect is
likewise owing to  a scrofulous taint which induces an inflam-
mation and subsequent ulceration of the articular surfaces.
This disease which, if it lasts any length of time, causes incu-
rable  disorganizations  in  the joints,  is  a most  obstinate
malady ; sometimes  however  we  succeed in arresting and
removing the inflammation.   The best  remedies are Sulphur
and  Calcarea, to be  administered as for abdominal enlarge-
ment.  If  the inflammatory  symptoms  are  not  yet fully
developed,  and the child simply limps without complaining of
pains in the thigh, it  is  best  to use  Mercurius and Bella-
donna alternately, first three pellets of Mercurius dry on the
tongue, and in  two or three days a similar  dose of  Bella-
donna, continuing this  alternate  use for  a fortnight, unless
the improvement  produced by one of these remedies, should
indicate its  exclusive use without the  other.   If  these two
remedies cease to do  any good, Rhus, 18th attenuation, three
pellets every  four days, may be given, until an  improve-
ment is perceived,  after  which we may  discontinue the use of
medicine until the  improvement ceases  to  progress, after
which Sulphur may be given as above ; this medicine should
likewise be prescribed, if Rhus effects no improvement within
a week.
  Stammering should  be attended to as soon as the first
signs of it are perceived.  Sometimes we  cure  it  by making
the child draw  a long breath  and hold it as long as possible;
during the  expiration  they should be  made to pronounce a
few words-.   This  exercise should be continued for several
months  with great patience and kindness.  A dose of Bella-
donna, three pellets dry on the tongue, every  few days, or a
dose of  Mercurius may be  given from the commencement.
Platina, Sulphur, Euphrasia,  Bovista, are likewise  useful.
  Wetting the bed, is a very troublesome and  distressing
weakness with  which many children  are afflicted.   The best
remedies for this weakness are : Belladonna  or Cina, three
pellets dry  on the tongue  every three or four days ;  first we 
          attentions to new born infants.       411

give Belladonna, and if this remedy affects no improvement
within a week, two doses of Cina.   If this does not help, three
pellets of  Sulphur dry on the tongue:  or Sepia, three glob-
ules every eight days, for four weeks, if  Sulphur is insuffi-
cient.  If none  of  these remedies  help, we may resort to
Silicea, 30th attenuation, three  pellets dry on  the  tongue,
every week, until the patient is better. 
 
            ALPHABETICAL  INDEX

                          OF THE

SUBJECTS  TREATED  OF  IN  THIS  VOLUME.
                           A.

Abscesses of the breasts,.....................................280
         of the vulva,........................................274
Adhesions of the placenta,....................................358
Adynamic fever,.............................................3 <0
After-pains,.................................................364
Age, critical,................................................*■*■'
Ailments during dentition,....................................404
Amaenia of young girls,...................................112-117
Amenorrhoea,............................................18-111
           causes of,........................................°*-
           course, complications and terminations,.............83
           diagnosis and prognosis,...........................84
           treatment,.......................................°5
           particular indications,.............................92
           accompanying symptoms...........................J'
Anteversion of the uterus,....................................^
Apoplexy of new-born infants,.................................*9
Atrophy of the breast,....................................
       of the nipples,....................................3Q2
Attentions to the infants,...............................

                           B.
       ,  .                               ..............189
Blennorrhagia,..............................               2g0
Breasts, abscesses of the,.........................         "
       atrophy of the.................................. 
414
INDEX.
Breasts, cancer of the.........................................286
        cysts of the..........................................283
        hydatids of the.......................................283
        hypertrophy  of the,...................................283
        inflammation of the,...................................280
        injuries of the,........................................289
        lipoma of the,........................................283
        neuralgia of the,......................................290
        neuralgic tumors of the,...............................290
        schirrus of the,.......................................286
        tumors of  the,........................................283

                                C.

Calculi of the ovaries,........................................260
       in the womb,..........................................227
Cancer of the breast,.........................................286
       of the ovaries..........................................260
       of the vagina,.........................................269
       of the womb,..........................................230
       of the neck of the womb,...............................252
Catarrh, uterine,.............................................192
Chlorosis....................................................158
Chronic derangements of little children,.........................408
Colic of pregnant females,.....................................312
Concretions in the womb,.....................................222
Confinement, see Labor,
            hygienic, rules during,...............................361
            medical  attentions during,.........................363
Constipation during confinement,..............................376
            of pregnant  females,..............................313
Contractions of the vagina,....................................269
Contusions  of the neck  of the bladder and  urethra  during
          confinement,.......................................364
Cough of pregnant females,....................................319
Cracking of the skin  during pregnancy,.........................325
Cramps during  pregnancy,....................................322
       uterine,.......................•.......................151
Critical age,.................................................117
Cysts of the breasts,.........................................283
      of the ovaries,..........................................260
      of the vagina,..........................................269
      of the vulva,...........................................274 
INDEX.
415
                               D.

Death during pregnancy, fear of,...............................324
Debility during confinement,..................................367
Delivery of the placenta,......................................357
                      difficult.................................358
Dentition, ailments during,....................................404
Diarrhoea during  confinement,.................................376
         of pregnant females,..................................313
Diseases of new-born infants,..................................394
         asphyxia............................................395
         asthma,.............................................399
         cardiopasum,.....................••..................399
         crying,..............................................400
         colic,...............................................400
         cyanosis,............................................396
         diarrhoea,............................................400
         ecchymosis,.........................................3.7
         hernia,..............................................39°
         hiccough,...........................................3"
         icterus,.............................................396
         induration of the cellular tissue,........................397
                                                              qqq
         liver-grown,..........................................° **
         malformations........................................OJO
                                                              qqq
         sleeplessness,........................................***
         swelling of the head,..................................397
                       breasts,..............................■398
         stoppage of the  nose,.................................3"
  Digestive derangements of pregnant females,....................310
  Dropsy of the ovaries,......................................
         uterine,..............................................  "1
  Dysmenorrhoea in general,.................................• •
  Dyspnoea of pregnant females,.............................
  Dysuria of pregnant females...............................
                               E.
                                                .............189
Endometritis,...............................                  232
Engorgements of the neck of the womb,......................^
Enteritis during confinement...............................o^
Eruptions of the neck of the womb,............................-
          of the vulva............................. 
416
INDEX.
                                F.

Fainting fits of pregnant females,..............................315
Falling off of the hair during confinement.......................367
        of the uterus..........................................17g
Fear of death during pregnancy,...............................324
Fever, adynamic,.............................................370
      puerperal,.............................................369
Fibrous bodies of the ovaries,..................................260
        bodies in the womb,..................................227
Fistulse of the vagina,........................................265
Flooding between the menses,.................................125
Freckles during pregnancy,...................................325

                                G.

Gangrene of the womb,.......................................249
Green-sickness,..............................................158

                               H.

Haemorrhage during pregnancy,...............................316
Hair, falling off of the,  during confinement,......................367
Hernia of the ovaries,........................................260
        of the uterus and ovaries...............................180
        of the vagina,........................................265
        of the vulva..........................................274
Hydatids of the breasts,......................................283
         of the ovaries........................................260
         in the womb,........................................221
Hydrometra,................................................212
            during pregnancy,.................................326
Hypertrophy of the breasts,...................................283
            of the labia vulvae,...............................275
Hysteralgia,.................................................151
Hysteria,...................................................174

                                I.

Indurations of the vagina,.....................................269
Inflammation of the bowels, see Enteritis,
              of the breasts,...................................280
             of the neck of the uterus,........................251
             of the nipples,..................................293
             of the ovaries,.....................................255
             of the vagina....................................261 
INDEX.
417
Inflammation of the vulva,....................................272
Injuries of the breasts,.........................................289
Inversion of the uterus,.......................................184
Itching of the vulva,.........................................276

                                J.

Jaundice, see Icterus.

                                L.

Labor,......................................................342
       course and symptoms of,.................................342
       diagnosis and prognosis,.................................344
       hygienic attentions during confinement,...................345
       attentions of the accoucheur during the progress of,........347
       difficult or protracted,..................................349
                           causes,.............................349
       inherent in the mother and foetus,....................3r)0, 352
       accidents to the mother during,.............................352
       fainting during,........................................353
       congestions of the head during,..............................353
       convulsions during,......................................354
       haemorrhage during,....................................355
Lactation,......................................................;-380
Leucorrhoea,..............................................13i>, 151
Lice of the vulva,..............................................279
Lipoma of the breasts,........................................~e°
Lochia,.....................................................365

                                M.

Mammae, see Breasts.
Meningitis during confinement, puerperal,.......................3^
Menospasis, or critical age,.....................................l^'
Menses, too copious,.................................................
             long,...............................................33
            .  °                                ...............34
       premature,.............................
       retarded,...............................................
                                                ...............do
       too scanty,...........................
       too short...........................................
       suppressed,.........................................       "*
Menstrual ailments, general,......................................'^ ^
                   particular,...............................  '
                   condition of the parts,....................°*> d0
                                27 
418
INDEX.
 Menstrual blood, acrid,........................................36
                brown,.........................................36
                black,........................................36
                burning, see acrid.
                coagulated,....................................37
                dark, see black.
                excoriating, see acrid.
                foul,..........................................37
                morbid changes in,...........................75,120
                pale,..........................................37
                slimy,........................................37
                sour-smelling,.................................37
                thick,.........................................37
                viscid,...........................................38
                watery, see pale.
 Menstrual colic,..............................................59, 64
           irregularities,.....................................65, 78
 Menstruation, profuse..........................................68
             excessive duration of,..............................69
             premature.........................................66
             retarded,.........................................71
             scanty,..............................................73
             short,...............................................74
 Mental derangement during confinement,........................377
 Metritis, acute,................................................198
         chronic,.............................................201
         puerperal,...........................................374
         during pregnancy,......................................326
         superficial,..........................................189
         acute superficial,.....................................189
         superficial chronic,...................................192
         true, or parenchymatous,...............................198
 Metrorrhagia,...............................................125
Miliaria,..........................................................379
Milk affections,...............................................390
    fever,.....................................................3 6
         secretion  of,.....................................380, 388
Miscarriage,.............................................330, 342
Moles  during pregnancy, fleshy,...............................327
      in the  womb,..........................................219 
INDEX.
419
                               N.

Nausea of pregnant females,.....................................311
Neuralgia of the breasts,.....................................290
         of the neck of the womb,...............................252
         of the vagina,.......................................270
         of the vulva,...........................................276
New-born infants, diseases of,.................................394
Nipples, atrophy of the,......................'................295
        inflammation of the,...................................293
Nursing,....................................................384
Nymphomania,..............................................lf>4

                               0.

Obliquity  of the uterus,.........................................182
(Edema of pregnant females,......................................318
        of the vulva,.........................................274
Ovaries, calculi of the,...........................................260
        cancer of the,.........................................260
        cysts of the,.........................................260
        dropsy of the,.......................................258
        fibrous bodies of the,.................................260
        hernia of the,.........................................260
        hydatids of the,.......................................260
        inflammation of the,...................................255
        tubercles of the,.......................................260
Ovaritis,.....................................................255
        puerperal,..........................................375

                               P.

Palpitation of the heart, of pregnant females,....................315
Peritonitis, puerperal,..........................................369
Phlebitis,  uterine,............................................369
Phlegmasia, alba dolens,......................................378
Phthisis of nurses,...........................................387
Physometra.................................................217
Piles, during confinement,.....................................364
       during pregnancy,......................................317
Placenta,  delivery of the,......................................357
           difficult delivery of the,............................358
           adhesions of the....................................358
           haemorrhage, during delivery of the...................358
Polypi of the vagina..........................................269 
420
INDEX.
 Polypus in  the womb,........................................224
 Pregnancy, diagnosis of,......................................301
           false,....................,.........................327
           hygienic rules during..................................303
           influence of, upon existing diseases,..................328
           pains during,.......................................321
           symptoms of,......................................298
 Prolapsus of the vagina,..........................................265
 Ptyalism of pregnant females,..................................320
 Puerperal fever,................................................369
           meningitis during confinement,......................377
           metritis,...........................................374
           ovaritis,..............................................375
          peritonitis,..........................................369
 Putrescence of the womb,.....................................249

                                R.     *

 Rednesses of the  neck of the womb,............................ 252
 Retention of urine during pregnancy,...........................320
 Retroversion of the uterus,....................................182

                                S.

 Schirrus of the breast,........................................286
        of the womb,..........................................230
 Sleeplessness during pregnancy................................322
 Sore nipples during nursing,....................................387
 Soreness of the nipples, see Inflammations.
 Spasms of the vagina,........................................270
 Syphilitic affections of the vulva,..............................278

                                T.

 Teething, see Dentition,
 Toothache during pregnancy,..................................321
 Treatment of uterine displacements,............................186
 Tubercles of the  ovaries,......................................260
 Tumors of the breast,.........................................283
        of the breast, neuralgia,................................290
        of the vagina,....................•....................269
        of the  vulva,.........................................274
        erectile,   "  .........................................275
        of the vulva during  pregnancy,..........................327
Tympanitis of the womb,......................................217 
                            INDEX.                         421

                               u.

Ulceration of the womb,..................................242 248
Ulcers of the vagina,.........................................269
      of the neck of the womb,................................252
Uterine catarrh,.............................................. 192
        cramps,...............................................151
        displacements, treatment of,............................186
        dropsy,..............................................212
        haemorrhage during confinement,........................375
        phlebitis..............................................369
Uterus, see Womb,

                               V.

Vagina, cancer of the,........................................269
        contractions of the....................................269
        cysts of the,.........................................269
        fistulae of the vagina,.................................265
        hernia of the,........................................265
        indurations of the,....................................269
        inflammation of the,..................................261
        neuralgia of the,......................................270
        polypi of the,........................................267
        prolapsus of the,.....................................265
        spasms of the,.......................................270
        tumors of the,...........................................269
        ulcers of the,...........................................269
Vaginitis,......................................................261
Varices during pregnancy,....................................317
        of the vulva,............................................275
Vomiting of pregnant females,................................311
Vulva, abscesses of the,.......................................274
       cysts of the,...........................................274
       eruptions of the,.......................................277
       hernia of the,.........................................274
       hypertrophy of the labia,...............................275
       inflammation of the,....................................272
       itching of the,........................................276
       lice of the,............................................279
       neuralgia of  the,......................................276
       oedema of the,........................................274
       syphilitic affections of the,..............................278
       tumors of the..........................................274 
422
INDEX.
Vulva, tumors, erectile, of the...................................275
       varices of the,.............................................275
Vulvitis,..............._...................................272

                               W.

Weaning.....................................................388
Womb, anteversion of the,....................................182
        cancer of the,.........................................230
        cancer of the neck of the,..............................252
        engorgements of the neck of the,....................... .252
        eruptions of the neck of the,............................252
        falling of the,.........................................178
        gangrene of the,......................................249
        gangrene of the, during confinement,....................375
        and ovaries, hernia of the................................180
        inflammation of the neck of the,.........................251
        inversion of the,......................................184
        neuralgia of the neck of the,............................252
        obliquity of the,.......................................182
        prolapsus of the, during confinement,....................364
        putrescence of the,....................................249
        rednesses of the neck of the,...........................252
        retroversion of the,....................................182
        schirrus of the.........................................230
        tympanitis  of the,.....................................217
        ulceration of the,.................................242, 248
        ulcers of the neck of the,...............................252 
 
 

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