CLASS V. GENETICA. ORDER I. CENOTICA. Diseases affecting the Fluids. MORBID DISCHARGES; OR EXCESS, DEFICIENCY OR THIS order, the name of which is derived from Galen, and has been explained already, is designed to include a considerable number of diseases which have hitherto been scattered over every part of a nosological classification, but which are related to each other, as being morbid discharges dependent upon a morbid condition of one or more of the sexual organs. The term employed might have been MEDORRHETICA but that medorrhoea, as a genus, has been already employed by Professor Frank, of Paris, in a somewhat different, and, as it appears to the author, peculiarly indistinct sense; as combining, under a single generic name, what seems to be a medley of diseases with no other connexion than locality, or contiguity of organs, as mucous piles, fistula in ano, leucorrhoea, clap, gleet, syphilis, phimosis, paraphimosis, and what was formerly called hernia humoralis, by him named epidydimitis, the orchitis of the present system. The genera under this order are five, and may be thus expressed : CLASS V. Scope of the order. ORDER I. GENUS I. PARAMENIA. Mismenstruation. MORBID EVACUATION OR DEFICIENCY OF THE GEN. I. Origin of generic term. Catamenia incorrectly regarded as blood: since it has hardly any property in common with it. How distinguished by J. Hunter. By Cruikshank. Further illustrated. PARAMENIA is a Greek term derived from magà "male" and “mensis." The genus is here limited to such diseases as relate to the menstrual flux, or the vessels from which it issues. This fluid is incorrectly regarded as blood, by Cullen, Leake, Richerand, and other physiologists: for, in truth, it has hardly any common property with blood, except that of being a liquid of a red colour. It is chiefly distinguished by its not being coagulable; and hence, when coagula are found in it, as in laborious and profuse menstruation, serum or blood is intermixed with it, and extruded either from atonic relaxation or entonic action of the menstrual vessels. "It is", observes Mr. John Hunter, "neither similar to blood taken from a vein of the same person, nor to that which is extravasated by accident in any other part of the body; but is a species of blood, changed, separated, or thrown off from the common mass by an action of the vessels of the uterus similar to that of secretion; by which action the blood loses the principle of coagulation, and, I suppose, life." Mr. Cruikshank supposes it to be thrown forth from the mouths of the exhaling arteries of the uterus, enlarged periodically for this purpose; and his view of the subject seems to be Paramenia. confirmed by a singular case of prolapse, both of the uterus .GEN. I. and vagina, given by Mr. Hill, of Dumfries, in the Edin- Mismenburgh Medical Commentaries. In this case, the os tincæ struation. appeared like a nipple projecting below the retroverted vagina, which assumed the form of a bag. The patient, at times, laboured under leucorrhoea: but it was observed that, when she menstruated, the discharge flowed entirely from the projecting nipple of the prolapse; while the leucorrhoea proceeded from the surrounding bag alone*. confusion to this dis in Sauvages As this distinction has not been sufficiently attended to Nosological either by nosologists or physiologists, many of the discases from not occurring in the present arrangement under paramenia, attending have been placed by other writers under a genus named tinction. menorrhagia, which, properly speaking, should import hemorrhage (a morbid flow of blood alone) from the menstrual vessels. And we have here, therefore, not only a wrong doctrine but the formation of an improper genus; for menorrhagia or uterine hemorrhage is, correctly speaking, only a species of the genus HEMORRHAGIA, and will particularly be so found in the present system, in which it occurs in and Cullen. Class 111. Order IV. This remark applies directly to Sauvages; and quite as much so to Cullen, who, in his attempt to simplify, has carried the confusion even further than Sauvages. Few diseases, perhaps, of the uterus, or uterine passage can be more distinct from each other than vicarious menstruation, lochial discharge, and sanious ichor; yet all these, with several others equally unallied, are arranged by Sauvages under the genus menorrhagia, though not one of them belongs to it. While Cullen not only copies nearly the whole of these maladies with the names Sauvages has assigned them, but adds to the generic list leucorrhoea or whites, abortion, and the mucous fluid, secreted in the beginning of labour from the glandulæ Nabothi at the orifice of the womb, and hence vulgarly denominated its show, or appearance. Menstruation may be diseased from obstruction, severe pain in its secretion, excess of discharge, transfer to some Vol. iv. p. 91. GEN. I. Paramenia. Mismenstruation. Specific divisions of other organ, or cessation; thus offering us the five following species, accompanied with distinct symptoms: 1. PARAMENIA OBSTRUC OBSTRUCTED MENSTRUA TIONIS. GEN. I. SPECIES I. PARAMENIA OBSTRUCTIONIS. Obstructed Menstruation. CATAMENIAL SECRETION OBSTRUCTED IN ITS COURSE; THIS species by many writers called menostatio, appears under the two following varieties: a Emansio. Retention of the menses. & Suppressio. menses. The secretion obstructed on its accession or first appearance. The feet and ancles edematous at night; the eyes and face in the morning. The secretion obstructed in its regular periods of recurrence. Head-ache, dyspnoea, palpitation of the heart. GEN. I. SPEC. I. a P. ob Emansio. In order to explain the FIRST of these VARIETIES, or RETENTION OF THE MENSES, by Professor Frank quaintly denominated amenorrhoea* tiruncularum, it is necessary structionis to observe that when the growth of the animal frame is completed, or nearly so, the quantity of blood and senso- the menses. rial power which have hitherto been employed in providing Physiology. for such growth, constitutes an excess, and must produce plethora by being diffused generally, or congestion by being accumulated locally. Professor Monro contended for the former effect; Dr. Cullen, with apparently more reason, for the latter. And this last turn it seems to take for the wisest of purposes; I mean in order to prepare for a future race by perfecting that system of organs which is immediately concerned in the process of generation; and which, during the general growth of the body, has remained dormant and inert, to be developed and perfected alone when every other part of the frame has made a considerable advance towards maturity, and there is, so to speak, more leisure and materials for so important a work. We shall have occasion to touch upon this subject more at large when we come to treat of the genus CHLOROSIS: for the present it will be sufficient to observe that this accumulation of nervous and sanguineous fluid seems first to show itself among men in the testes and among women in the ovaria; and that from the ovaria it spreads to all those organs that are connected with them either by sympathy or unity of intention, chiefly to the uterus and the mammæ; exciting in the uterus a new action and secretion, which se- and with cretion, in order to relieve the organ from the congestion it is hereby undergoing, is thrown off periodically, and by lunar intervals, in the form of a blood-like discharge, although Menstrual discharge. when minutely examined, the discharge, as already stated, is found to consist, not of genuine blood, but of a fluid possessing peculiar properties. These properties we have already enlarged upon, and have shown in what they differ from those of proper blood: and it is upon this point that the physiology of Dr. Cullen is strikingly erroneous; for ⚫ De Cur. Hom. Morb. Epit. Tom, v1. Lib. vi. Part 1. Svo. Vienna, 1821. Sexual organization when perfected, by what means: what result. Its charac- ter. view of Cullen. |