Emmenagogues are remedies which restore and regulate the normal menstrual flow when it is absent or deficient or irregular.

Ecbolics are remedies which cause the expulsion of the contents of the uterus.

In menstruation both ovaries and uterus become congested. An ovum is discharged, and a flow of blood occurs from the uterus. Diminution or absence of the menstrual flow may be occasioned either by general or local conditions : thus great debility or anaemia may cause it, and it is very frequent indeed in the anaemia and debility which are consequent on the occurrence of slight consolidation in the lungs.

A local cause may be deficient determination of blood to the ovaries and uterus, although no general anaemia exists.

The remedies employed for these two conditions are termed indirect emmenagogues. To correct anaemia, iron, manganese, and cod-liver oil may be employed.

In order to determine more blood to the uterus, warm footbaths, warm hip-baths, mustard hip-baths, mustard stupes or poultices to the thighs and lower part of the abdomen, and leeches to the inside of the thighs or to the genitals, and aloetic purgatives, may be employed.

It might at first seem from theoretical considerations that foot-baths could hardly have any action on the uterus, but warm foot-baths cause great dilatation of the arteries in the legs, and it is probable that this dilatation extends up the iliacs, so that more blood may be sent to the genitals as well. But in addition to this, it is not at all improbable that a close nervous connection exists between the vascular supply of the uterus and of the feet, for not only does the warm foot-bath tend greatly to restore, but cold and wet feet are amongst the most powerful agents in checking, menstruation.

Other substances, which seem to have a direct stimulating action upon the womb itself, are called direct emmenagogues. It is not easy to see at present how they act; we know, however, that when given in large doses they cause contraction of the womb, and thus act as ecbolics. The chief emmenagogues are: Indirect Emmenagogues.

Baths

Hot foot.

Hot hip.

Mustard.

Leeches

To genitals.

To thighs.

Mustard

Baths.

Poultices.

Stupes.

Purgatives, as aloes. Iron.

Manganese. Cod-liver oil. Strychnine.

Direct Emmenagogues.

Ergot.

Digitalis.

Savin.

Quinine.

Asafoetida.

Myrrh.

Guaiacum.

Cantharides.

Borax.

Rue.

Hydrastis.1

1 Fellner, 'Die physiolog. Wirkung einiger Praparate des Hydrastis Canadensis. Wien. med. Jahrbiicher, 1885.