This view of the subject will explain equally the pathology and practice in all their varieties. When the changes, which successively take place in the determinations to the different parts, commence, a great degree of irritability occurs, and sometimes considerable debility. This is particularly the case with the changes in organs so peculiarly irritable as those connected with generation. At this period, in young women, we find a pallid languor, want of appetite, terrors, tremors, and even convulsions. Where the constitution is more robust and plethoric, violent pains, flushings in the face, and even feverish attacks. In the first instance, the determination is unequal to the task, in the second, some obstruction occurs in the exhalents; and, like every other impediment to the free circulation, excites a vis a tergo to overcome it. Similar symptoms follow obstruction, joined with the inconveniences which arise from the stoppage of an habitual discharge, added to those which result from the altered determination, which is the consequence.

Menses deficientes, the amenorrhoea of Dr. Cullen, including also, with less accuracy, the dys-menorrhoea, difficilis menstruatio of authors, constitute a disease divided into the amansio and suppressio men-sium. The difficult menstruation may be a variety of the latter, as the discharge is temporarily suppressed.

The emansio mensium consists of a retention of the discharge at the period when it should take place, independent of pregnancy. To constitute a disease it must be attended with pain, uneasiness, or a disturbance of the functions, for, whatever time may be fixed as the usual one, this period is protracted in some constitutions, without inconvenience. Much depends on the climate, the mode of life, the structure of the body, and the peculiarities of the constitution. Thus in a warm climate the period may be accelerated to the age of ten or eleven, and, in a cold one, retarded to eighteen: a girl, indulged in all the luxuries of modern fashionable life, and the sedentary seamstress, or the laborious peasant, experience equal prematurity, or retarded expansion: a full bosomed plethoric girl and a thin attenuated one, with small delicate limbs and a torpid circulation, are respectively in the same circumstances. Somewhat depends also upon structure. In the case recorded in the Edinburgh Journal, where the menses never appeared, the ovaria were wanting. In similar circumstances, the form, the manners, and general appearance, resemble that of a man; so that, when we see the masculine manner and growth, it is highly probable that the menses, if they appear at all, will be scanty, and impregnation improbable, as the female structure is in some important respect defective.

When the discharge does not take place, the whole system becomes languid, the complexion pale, the mucous secretions are defective: and, in consequence, the foeculent discharges are impeded, and the nose is dry. The appetite is bad, or fanciful, often requiring substances not alimentary, though not, as has been said, always antacid, nor in such circumstances does acid abound in the stomach. The mind is whimsical and variable, the voluntary muscles convulsed; the sleep disturbed, the urine pale. In fact, the animal functions are almost wholly suspended, and the vital ones feebly carried on, for the pulse is low and quick, the breathing laborious, consumption, or palsy, seems to impend, and the patient appears to sink rapidly to the grave. In the worst stages of these complaints, a little mucous or serous discharge, perhaps somewhat coloured, changes the scene, and gives some appearance of returning health: it recurs at distant and irregular intervals, attended, each time, with some amendment of all the symptoms, till at last, colour, appetite, spirits, etc. return; and the palid, chlorotic girl becomes a blooming, healthy young woman.

While we are ignorant of the first principles by which nature acts, we know not the impediments to her action. We recognize, in the case before us, either a want of energy, or some resistance in the exhalent arteries; each attended by an apparent sinking of the more active powers. If we observe the progress, the change at last appears to take place from the vessels yielding, in consequence of debility, rather than from increased impetus, for the first appearances, the serous or mucous discharges are complaints, which, at future periods, arise from debility only. The change, though imperfectly taking place, is attended with beneficial consequences; and the powers of nature, thus reanimated, gain additional force, to complete the more perfect state. The regular return, however, is not yet observed, for this is the consequence of habit.

In this weak state young women often continue for many years; but we know not that the complaint has ever been fatal, for, if the discharge does not take place, they recover some share of strength and activity. The complaint is often taken for consumption, and many remedies of a secret kind have acquired credit from the efforts of nature alone. Many old women's remedies have, on the same ground, been highly praised; and the numerous female pills, so often advertised, have appeared to succeed, when nature has done the work. We mean not to deny that this often happens in regular practice, but the foundation of the plans in this disease, we shall proceed to explain.

The most obvious idea in these circumstances is to give strength and activity to the circulating system: another, though a subordinate one, is to relax cither a supposed constriction, or to stimulate, topically, the; neighbouring vessels.

To give strength and activity to the circulation is attempted generally by tonics and stimulants. Such, however, of the former as combine astringency are supposed to be injurious. The simple bitters are, therefore, often employed, particularly the camomile flowers, and the columbo root. The myrrh is a medicine of a more doubtful nature; and, as a narcotic bitter, may appear to combine a sedative power. It seems, very certainly, to lessen hectic exacerbations. Whether it has a peculiar power in promoting the menstrual discharge we dare not say. We never have observed such power, but have suspected, in hectics, where there is a tendency to haemorrhage from the lungs, that it has contributed to promote haemoptysis: it may, therefore, have a similar effect. Astringents have been accused of checking the discharge, and we believe with reason. They have been certainly injurious when employed too freely in critical menstruations, and in puerperal profluvia.