Gynaecia, the third species of Dr. Cullen's menorr-hagia, which he defines, a sanguinary menorrhagia in lying-in women. This discharge arises from the distended vessels, and proceeds till the removal of the distention admits of their contraction. In weak, exhausted constitutions, the discharge often continues for several days, and then only becomes a disease. In healthy habits it continues to flow freely for an hour and more, and the discharge afterwards lessens; in a few days it becomes less red, and then greenish. The redness begins to disappear when the breasts fill with milk. Its quantity is generally less after a miscarriage than when a woman goes her full time; and it sooner stops when a woman gives suck, than when she does not.

The lochia may produce disease when deficient or redundant. The discharge in many women is inconsiderable; but, as this appears constitutional, no inconvenience arises. When exposed to cold, or fever comes on, the discharge often suddenly stops, the belly swells and is sore; a heavy load is felt in the lower part of the abdomen and in the loins; the pulse is full and hard; pain in the head and back; a nausea, sometimes a vomiting, and a difficulty of breathing, come on. Feverish symptoms, particularly rigor, generally precede the suppression of the discharge, rather than follow it, and are the cause, instead of the effect; though the effect so soon follows, that it is often difficult to say which has preceded. Violent passions will sometimes check the lochia, and sudden grief be equally injurious. Errors in diet, and particularly indulgence in spirituous liduors, seems occasionally to bring on a spasmodic stricture,accompanied often with fever. A diarrhoea, or any other copious discharge, will also check the flow, though with less inconvenience. The nearer the period of the suppression is to that of delivery, the greater is the danger; and the occasional returns of the discharge are symptoms of recovery. The lochia sometimes diminish gradually, and sometimes cease at once. A delirium, in many instances, succeeds, occasioning convulsions and death, and if the patient escapes with life, she sometimes continues lunatic.

In general no medicine will force the return; and our chief attention must be directed to procure a relaxation of all the extreme vessels. When the patient is full and plethoric, the pulse full and hard, the face flushed, it has been the practice to bleed copiously, and this has been attended with success, even no fever has come on. It must, however, be done early and boldly, or it will be injurious. As this then is the case, the practitioner should be cautious in what constitutions he makes the attempt.

Emetics are often remedies of importance in this complaint, and should be repeated. To these the relaxing diaphoretics should succeed; and when any organ is overloaded, in consequence of the suppression, a blister applied to the part will be of singular service.

Cathartics are equally necessary, but we should be cautious lest too great a discharge from the bowels prevent a return of the salutary evacuation. It is necessary to relieve too great fulness, and equally proper to avoid irritation; and the infusion of senna with manna, or castor oil, so as to procure two or three motions, will be sufficient. We must then return to the mild relaxing diaphoretics, avoiding great heat, and admitting free air, if not too cold.

In the usual course, the milk is the vicarious discharge of the lochia. This evacuation should therefore be encouraged by warmth to the breast, by glasses; but, above all, by applying a strong, healthy child. If a flow of milk can be determined to these organs, the woman is secure. This, however, is often with difficulty obtained; and we more frequently find, that by removing congestions of every kind, supporting the patient with mild, nourishing food, she gradually covers without a return. We need not add, that the disease is highly dangerous.

The spirits, whatever be the cause, are usually much depressed, and it will be right to cheer our patient in this period of peculiar distress and disappointment, by every favourable representation. In fact, however, the lochia are seldom wholly checked without accession of fever, which, from the time of its attack, is styled puerperal. (See Puerperalis febris.) The idea of checking the discharge by rising too soon, if cold be avoided, is truly ridiculous.

The lochia are sometimes redundant; but this disease must be distinguished from flooding during labour, from an attachment of the placenta to the os uteri, or other causes. The complaint we now speak of is the discharge subsequent to labour; and, in this place, we cannot add to what we have said in the article Haemorrhagic, q. v. As the disease is rapid and violent, so our remedies should be proportionally active and continued. Fainting should not .be obviated; and the practitioner should be particularly cautious that no irritation is kept up from any accumulations in the rectum. Ligatures on the lower extremities are not only useless, but soon become injurious.