The task is more difficult when the discharge is immoderate; for female prejudice demands our active interference to check it, but this is always injurious. Young practitioners are commonly alert to show their skill; but it is wiser to rest, and to observe with care. In general, we have seldom known a more healthy old age than in those where the menses have disappeared with these profuse evacuations. If the woman has confidence in her medical attendant, she will remain at rest, in free air, lightly clothed, without exciting the circulation by aliment too rich, or drinks too stimulating; keeping, with anxious care, the bowels free by the most cooling laxatives. This conduct should, we think, be pursued, even when the debility is considerable; nor should even opiates be interposed, except the pain is violent. In such cases, powerful astringents are highly injurious, and we have more than once seen apoplectic attacks from their imprudent use. In a few instances we have found it necessary to regulate the discharge, but seldom with advantage, and have had reason to suspect scirrhosities of the uterus, ulcers and cancers from the imprudent use of styptics. If called on, it is necessary to attempt relief in some way; and we have generally found, that, though no haemorr-hagic effort is perceivable, we have done more service by cooling and sedative medicines than by bitters and astringents. Bitters may indeed be frequently allowed, and they will please, because an astringency is supposed to accompany every medicine of this kind.

The maenorrhagia, menses immodicae; or an excessive menstrual discharge, independent of the pregnant or puerperal state, is truly an haemorrhage, and may be either active or passive. The active haemorrha-gia arises from cold, from blows or shocks, and almost exclusively occurs in strong robust habits. The passive maenorrhagia arises from debility of the vessels, too fluid blood, from frequent miscarriages or labours, which occasion local debility. There is, however, an intermediate kind, viz. the excessive discharges, which occur in the indolent and luxurious females of polished life. In these the vessels yield to excessive fulness, in part from debility, but generally with the assistance of some haemorrhagic effort. In the first variety bleeding is sometimes necessary, though, as usual, a suspicious and uncertain remedy. It must, however, be often used, to prevent immediate bad consequences; but, in general, rest, in a cool free air, with nitre and camphor, very generally with opium, often in large and repeated doses, interposing cooling saline purgatives, will relieve the complaint. The treatment of the second variety differs in no respect from that of other passive haemorrhages; but the third often baffles our best endeavours. It is difficult to induce the patient to avoid the principal causes, indolence and luxury; and to constringe distended vessels is the surest means of increasing their debility. If, however, she be obedient, lessening considerably the quantity and quality of her aliment, using, at the same time, free exercise in the open air, she will soon find a degree of languor and debility superior to what she before experienced; and it will be difficult to persuade her to continue a disagreeable plan, when her feelings tell her that increased weakness is the consequence. The fact is, that the diminution of the fluids lessens the tension of the vessels; and, as in the paracentesis, and numerous other cases, the diminution of tension produces faintness, and sometimes even convulsions. It will require, then, no little confidence in the physician, and no common resolution to persevere; yet, with perseverance, relief is certain. To steer between opposing prejudices and the best means of relief is difficult; nor do we know what rules to offer. The disposition of the patient must be consulted, and every address employed to lessen the powers of the aliment; to increase the discharge of the bowels by cooling laxatives; to lessen the activity of the circulation by opiates and refrigerants, while by every artifice bodily exercise is promoted. In the summer, sea bathing, and in the proper season, Cheltenham, and other saline chalybeate waters, may be advised, as change of scene will lead to more frequent exercise in the open air. The fashionable physician, who is contented with receiving his daily fee, while he humours the fancies of his patient by some useless placebo, has the best chance of gaining credit in these rases; as usual, not by assisting, but by pleasing. Yet some political advice will not be without its advantage. Women look to the period of the access and departure of the catamenia, as well as the monthly recurrence, as times of peculiar delicacy. They are unwilling to take any medicine unless it be consistent with their present circumstances, and are apt to attribute any disappointment to the medicine that they may have been prevailed on to employ. The discharge is, however, an occurrence which we cannot always produce, and which we can seldom prevent, or supply by any vicarious evacuation. In general it requires no peculiar care; but, while popular prejudices exist against the use of any medicine at this time, a prudent physician will forbear to press it, unless absolutely necessary. If it be so, the inconvenience, whatever it may be, must be met, and every bad effect may be obviated by caution. Even a copious bleeding will often not stop the discharge; purgatives will assist it; and opium, though it may occasionally retard, will be ultimately injurious. When, however, the discharge is fully established, and has continued twenty-four or forty-eight hours, the danger of checking it, even in female apprehension, is inconsiderable.

See Medical Observations and Inquiries, vol. v. p. 160; Hoffman's Medicinae Rationalis Systema; Hal-ler's Physiology; Cullen's First Lines, vol. iii. p. 9. 32; Hamilton's Midwifery, edit. 4th, p. 134; Edinburgh Medical Commentaries, vol. v. p. 119; London Medical Journal, vol. v. p. 183. The works professedly on this subject are, however, unsatisfactory and erroneous. The various authors on midwifery, particularly Dr. Hamilton, in his Elements, afford the best assistance.