hope of doing good by purgatives, allow me to suggest to you, the employment of Scudamore's mixture of acetous tincture of colchicum, magnesia, and sulphate of magnesia combined with some aromatic distilled water; you should for this purpose, combine three drachms of acetous tincture of colchicum, one drachm of magnesia, and three drachms of sulphate of magnesia, with four ounces of any aromatic distilled water, as that of mint, cinnamon, or what you will. The dose should be preceded by a moderate portion of blue pill, or calomel, to be taken at bed-time, while the colchicum mixture should be administered the following morning, in wineglassful doses, repeated every second or third hour until the operation is sufficient.

It is important in all those cases where you wish to clear the reproductive organs of any accidental disturbing influence that may arise from irritation of the rectum, dependent upon accumulation of feces or improper excretions there, to move the alimentary passages as preliminary to some more direct treatment. The mere removal of the heat and excitement dependent upon irritation seated in the lower bowel, may be sufficient to set the womb at liberty to perform its menstrual act without pain, or the least distress.

I have already expressed to you my little belief in the power of ) ) ) emmenagogue medicines, without withholding my assent to the opinion that certain medicaments are endowed with the faculty of increasing the determination of the blood, and of the nervous force, toward the pelvic extremity of the body. I have found it safe, convenient and efficacious with this view, to administer for a long series of days, weeks, and even months, portions of the common tincture of Melampodium or black hellebore, and I confidently believe that for different individuals to whom I have prescribed such medicaments, the result has been most fortunate. I have prescribed from fifty to sixty drops of the tincture to be taken thrice daily, with an infusion of some garden herb, as pennyroyal, and, either post hoc vel propter hoc, the patient, who had suffered the greatest distress from dysmenorrhea, has been in different instances entirely relieved of her sufferings. This result I have obtained so many times, that it has become habitual with me to make the prescription where some other indication has not had the precedence of it; such as venesection, purging, leeching, the bougie, etc.

I further believe, that the use of the ferruginous tonics in the cases where the crasis of the blood is so reduced as to warrant them, ought not to be omitted, and, that in a person laboring under dysmenorrhea, and in whom it is right to prescribe the tincture of black hellebore, it will be, in general, right to prescribe Dr. Blaud's pill, of which one may be taken three times a day; or a pill composed of two or three grains of Vallet's mass, thrice daily, or, what, perhaps, is preferable to all the rest, two grains of Quevenne and Micquelard's metallic powder of iron. The patient, under these circumstances, in all the variable and cold seasons, should be compelled, as far as the authority of the physician will go, to wear drawers of woolen flannel.

In the cases of dysmenorrhoea, in which there is pain in the uterine region during the intermenstrual period, and which is greatly aggravated during the menstrual epoch, an examination by the Touch might convince you that the organ is left in a subacutely inflamed state. In your treatment of an obstinate and serious malady of this sort, I should think you would deem it your duty to solicit an opportunity of inspecting the collum uteri, by means of the Récamier speculum. It is not rare to find the interior aspect of the lips, and, indeed, the whole os tincæ, red, turgid, and injected to such a degree, as to render the arterioles et venules visible, as you find them often in the chronic diphtheritis of the pharynx. A general bleeding, or a topical abstraction of blood, by means of leeches, are among the likeliest means to counteract this morbid state of the circulation of the parts, which, as long as it is allowed to persist, might effectually contravene your merely therapeutical efforts. To obtain a cure, bear in mind, also, I pray you, this solid therapeutical truth, namely, the nitrate of silver applied to a superficies, is among the most powerful, and least painful, of the antiphlogistic remedies in your power; and that, in aiding to cure the topical affections of which the uterus complains, it will aid you to rid the patient of constitutional disturbances arising from those lesions.

Many of these dysmenorrheal patients complain of the discharge of shreds of an organized membranous material, which is doubtless the caducous coat of the uterus. If you don't like this term, caducous coat of the uterus, then, I beg you to say that when such a membrane is discharged in dysmenorrhoea, the half organized mass is not, and cannot be the result of coagulation,

but must be a plastic deposit, like the plastic deposit in croup, and like that in phlebitis, in pleuritis, peritonitis, &c., and ipso facto, proves the existence of an inflammatory state, because plastic deposits are not found, except in a condition which deserves to be called an inflammatory condition.

Dr. Dewees regards this excretion as derived from a rheumatic condition of the uterus; you will see his reasoning on the subject, at page 106 of his essays on various subjects, Phil. 1803, and you will find that he was led from à priori reasoning to make use of the guaiac in the cure of the complaint. At page 110 is his formula for the preparation of his celebrated tincture, which is in the following terms:

The volatile spirits of sal ammoniac is to be added, pro re natâ, in the proportion of from one to two drachms, less or more, agreeably to the state of the system.

Dr. Dewees is justly to be regarded as one of the most eminent practitioners of midwifery in his day, and no American physician has acquired a wider-spread reputation, either at home or abroad, than he. His opinions are entitled to respect, and I refer you to his article on dysmenorrhoea, which every student ought to read; in that article you will find his directions for the administration of the volatile tincture of guaiac, with an account of the flattering results obtained from its employment.

I do not consider myself as treating his memory with any disrespect, when I suggest to you that it is rarely the nature of rheumatism to produce plastic secretions upon surfaces, and that in none but the most violent examples of rheumatic inflammation, do we find plastic secretions, even about the articulations.

Be careful, in all cases, about your patient's diet, about her occupations, and about her whole conduct; think always what you have to do, and how it is best to be done.

I think, gentlemen, I shall have nothing further to say to you at present, of dysmenorrhoea. I am

Very truly,

Your obedient servant,
C. D. M.

LETTER XXXV.

GENTLEMEN: In this letter I shall speak to you on the "change of life," as it is commonly called, or that state of the female in which she finally loses the power of menstruation, ceasing from that time forth to be subject to the mensual evacuation of blood.

If I have been correct in the opinion I have entertained, and which in former letters I have expressed, as to the causes of menstruation, then I shall have little to do in making you acquainted with the causes of the cessation of the menstrua, or change of life. For it is obvious, that if women menstruate because of the monthly ovulation and deposit, they cease to menstruate because the monthly ovulation has ceased to be a Biotic function.

I have all along insisted that the power of germ production is a climax of life-force-one that is only attained when the body has attained its full and mature development, maintained as long as that body retains its healthful vigor and force, and lost often upon the smallest change of the health, and given up definitively when the powers of life, having been exerted during the prime and maturity of the forces, begin to fail, and the possessor to decline towards the last term of existence, which is stated to be at three score and ten years.

There is something melancholy in the conviction that must attend the final cessation of the menses, of a decadence of the constitution. The subject of such a conviction is compelled to admit that that she has now become-what? an old woman. Henceforth, what has she to expect save gray hairs, wrinkles, the gradual decay of those physical or personal attractions, which heretofore have commanded the flattering homage of society-the slow augmentation of the burdens of existence--when the grasshopper becomes a burden-when the keepers of the house shall tremble, and they that look out of the windows shall become dim. The pearls of the mouth are become tarnished-the hay-like odor of the breath is gone-the rose has vanished from the cheek, and the lily is no longer the' vain rival of the forehead or the neck. The dance is preposterous, and the throat no longer emulates the voice

reason.

of the nightingale. All these are melancholy convictions, and not even the fine arguments of Tully, in his Treatise on Old Age, can drive away the painful truth or make the wrong the better To be sure, religion can bring its consolations, its hopes, and its triumphs;-for religion can make us triumph over death and the grave, robbing them of their sting and their victory. Still, human we are, and we shall be human while the clogs of mortality still hinder and bind us.

What hope, then, has the woman who has come to the period of the change of life? Have you any comfort for her? Yes! She is no longer exposed to the direful risk and pain of childbearing. She thanks God for that, and takes comfort in the thought. She is no longer to be the subject of the monthly trouble, which, while it lasted, and still held up her claim to be numbered amongst the young, yet was often connected with sensations of ill health-which annoyed her by its failure-its procrastination-its anticipation-its violence-its protractedness, and its pain. She has become fatigued with it, and tired of it. She had lost her color, and grown thin, for it exhausted and irritated her, but now that she has laid it aside for ever, her constitution no longer teased and taxed with the necessity, takes a new start of life and vigor; she begins to acquire a certain embonpoint, and, as Colombat beautifully depicts it, she seems to recover somewhat of the beauty, and grace, and attractions of an earlier date. Many women, in fact, do find that the health is greatly improved by the dispensation. The complexion recovers its former tint, and new deposits of fat give roundness to the limbs, and efface the wrinkled traces impressed upon the features by care, and watching, and exhaustion; so that, though the loss of the catamenia brings with it the melancholy conviction that she is becoming old, there is a compensating conviction in the apparently renewed health and comfort that follows the change. A few short years, however, renew, but in a gradual manner, the evidences of the decline of life.

But the sort of moral impressions of which I have spoken, and which, doubtless, are painful, are not the only evils to which the female is exposed at the change of life. I am sure that you will have no difficulty to conceive, that an organ, or rather a collection of organs, that have been for thirty years concerned in the production of germs and in the performance of the great offices of