Emmenologia : an inaugural address to the Edinburgh Obstetrical Society / by Alexander Russell Simpson.

  • Simpson, Alexander Russell, Sir, 1835-1916.
Date:
1876
Catalogue details

Licence: Public Domain Mark

Credit: Emmenologia : an inaugural address to the Edinburgh Obstetrical Society / by Alexander Russell Simpson. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    8/20 (page 6)
    NATURE OF THE DISCHARGE. Some physiologists note three stages in the flow. 1st, a stage of Invasion; 2d, a stage of Persistence; and 3d, a stage of Decline. In the first brief stage of Invasion, the discharged fluid is pale and scanty, not unlike the discharge that escapes from the genitals of some of the lower animals at the period of rut, and usually having a peculiar odour, more marked in some individuals than in others. It is like a leucorrhceal mucous discharge faintly tinged with blood, and contains many epithelial cells derived from the different mucous membranes lining the genital canals and their follicles, quantities of mucous corpuscles or wandering cells, and a few red blood-globules. This prelimi- nary pale discharge has not lasted long when it is followed by the bright red discharge which continues through the several days' stage of Persistence. The fluid that now escapes presents all the pecu- liarities of blood drawn from a wounded surface, except that it has little tendency to coagulate. But it is known that the admixture of a small proportion of pus or mucus to fresh-drawn blood pre- vents coagulation. And when we examine the menstrual dis- charge chemically and microscopically, it is found to consist mainly of blood mixed with cells and fragments of epithelium from the walls of the vagina and vaginal portion of the cervix, cylindrical epithelium from the canal of the cervix and from the cavity of the uterus and the uterine follicles, many rounded nucleated cells like pus and mucous globules, and compound granular corpuscles. In the third stage of Decline or Cessation, the fluid gets less in quan- tity, becomes first darker, less arterial in colour, then pale and turbid, and then more clear, till it returns to the condition in which it was before the Invasion. During the day or two of the Decline, the fluid is found to contain chiefly mucus and pus, with many cells in various stages of fatty disintegration. QUANTITY. The amount of blood that thus escapes, it is difficult to esti- mate. The statement that we .may count an ounce for each cloth that the patient wears during a period, must be received with considerable qualification. The sense of comfort and propriety in different women differs too widely to render such a standard available, and to estimate the loss of blood at an ounce per diaper would certainly give an exaggeration in the ordinary run of cases. The difficulty of determining this point has led writers to give quite different statements as to what we are to consider as the normal loss—some giving it at 2 or 3 oz.; others at double that amount, or more. There is certainly such considerable diversity in different women as to make it 'impossible to say that every woman who loses 7 or 8 oz. of menstrual blood is menstruating too freely, or that one who loses less than 2 oz. is amenorrhceic; and in dealing with individual cases, the important point to be