cloth or gauze, but this cannot be attempted except by a physician.

Usually the simpler methods we have noted will suffice to arrest flowing until medical assistance can be obtained. The most severe flowing is apt to occur directly after childbirth, and this may be best controlled by firm pressure on the lower part of the belly over the womb, grasping it if possible between the thumb and fingers and keeping up steady pressure for half an hour or more regardless of the moderate suffering it may cause the patient (see Childbirth, p. 370).

The bowels should always be kept regular as a means of avoiding flowing. Sexual intercourse is not permissible during periods of excessive hemorrhage from the womb.

LEUCORRHOEA; A DISCHARGE FROM THE FRONT PASSAGE OR VAGINA OF WOMEN.— Leucorrhoea is not a disease in itself, but rather a sign of disorder of the female sexual organs, or of the whole system. When it occurs for a few days before and after the monthly periods, during the change of life, and accompanying pregnancy, it may be regarded as a natural occurrence if not associated with any other trouble suggestive of disorder of the sexual organs or of the body as a whole. as a whole. In the ordinary conditions of health there should, however, be no perceptible discharge from the vagina in women, and if such occurs, with the exceptions just noted, it should be regarded as a symptom of local or general disorder. The dis

charge is not by any means always white, as the common term "whites" would suggest, but yellow, brown, reddish if mixed with blood, or colorless like the white of an egg. It varies greatly in color, consistency, and

amount.

Among general disorders causing a discharge from the front passage are: debility, anæmia (a condition caused by poverty of the blood and accompanied by paleness and weakness), malaria, tuberculosis, and acute diseases, as scarlet fever, measles, diphtheria, and typhoid fever. Exposure to heat, dampness, and emotional excitement may cause leucorrhoea. The discharge is usually white or watery when the trouble follows a disturbance of the general system, and not thick and yellow like matter from a wound.

"Whites" is one of the most frequent symptoms of inflammation of any part of the sexual organs-the womb, tubes, ovaries, and neighboring structures; also of tumors and injuries of these organs, as following tears occasioned by childbirth. It is also produced by faulty positions of the womb, by irritating injections, by too frequent sexual intercourse, etc. In all these conditions of local disease of the sexual organs there are usually present other symptoms, such as pain in the lower part of the abdomen and back or in the front passage, frequency and perhaps pain in urination, and the discharge is more apt to be thick and yellow like that coming from a boil. Such conditions should not be neglected, since sometimes serious disease

may be averted by submitting to treatment at the hands of a competent physician during the early stages of inflammatory disease of the sexual organs. In young children, whites is often due to worms, and should receive local treatment by a medical man. Leucorrhoea is a common disorder of old age, owing to natural changes in the womb, and the discharge is apt to be profuse, watery, and very irritating. In cancer of the womb, on the other hand, the discharge is dirty-colored, has a bad odor, is copious, and often accompanied by flowing. As the result of a continuous discharge pouring out on the skin about the entrance to the front passage or vagina, there are produced much irritation and itching, and often chafing and rawness of these parts.

There is then a simple white or watery discharge from the front passage with no other unhealthy local or general disturbance, in which case it is safe for the patient to try the simple and harmless measures recommended below. There are also the other conditions in which there are symptoms of local inflammation in some part of the sexual apparatus, as pain, disturbances of urination, flowing, and thick discharge like pus which demand immediate attention of a physician; and finally there is a third class of cases where the discharge is caused by some disorder of the general health, for which the patient should also consult a doctor. While the discharge itself causes a drain on the system and weakness, it is more often the case that the

discharge is caused by a general condition of weakness (or local inflammation) than that the general weakness is the result of the discharge.

Treatment. The treatment which we here advise is suitable when the discharge is not associated with other symptoms suggestive of disorder of the sexual organs, as pain, disturbance of urination, flowing, etc., nor with general ill health. The patient should wear a pad of absorbent cotton over the entrance to the front passage, which is held in place by a napkin worn in the ordinary manner. Many women have a prejudice against wearing cloths for a discharge of "whites," apparently convinced that covering increases the discharge; this is not so, and cleanliness is an important agency in cure. The pad should be changed as often as it becomes soiled.

An injection into the front passage of boiled water as hot as the elbow can bear should be made with a fountain syringe, night and morning. The patient should lie on her back with the hips raised upon a pan or receptacle to catch the outflow. It is useless to take douches while sitting up. About six quarts of the plain water should be first injected, and then from a teaspoonful to a tablespoonful of alum should be added to a quart of warm water, and this injected last.

Itching of the external parts is relieved by the injections which remove the cause, the irritating discharge, but if this is not sufficient, a teaspoonful of pure carbolic acid and two ounces of glycerin may be

thoroughly mixed with a pint of hot water, and employed to bathe the itching parts. Sometimes powdering them with starch or using zinc ointment will prove more serviceable.

A discharge from the front passage, beginning suddenly and accompanied by frequent and painful urination and swelling, and soreness of the external parts, is usually extremely suggestive of gonorrhea, a very grave contagious disorder communicated from man through sexual intercourse. It is sometimes seen in little girls who acquire the disease from towels or other objects contaminated with the discharge. Patients with this trouble should stay in bed, use only hot water to bathe the external parts, and take half a teaspoonful of sweet spirit of niter with ten drops of tincture of belladonna three times daily in water for relief of the painful urination. "Whites" is not capable of being communicated from woman to man, except in the case of the discharge due to this disease (gonorrhea). Gonorrhea is the more frequent cause of that inflammation of the womb and tubes, which, if neglected, ultimately requires the removal of these organs by surgical operation. It demands early treatment, therefore, by a skillful physician, as well as the other disorders of the sexual organs or conditions of general ill health which cause whites." The treatment which we have described then, is only useful in "whites" which are due to slight disorders, or until proper medical aid can be procured,