of the head, are frequently felt. A watchful care should be kept, lest a real plethoric state supervene. A most careful regulation of the bowels is indispensable, as they are the great safety valve, and should be used as such without fear. Exercise in the open air, abstinence from fermented liquors of all kinds, and moderation in diet, are necessary at this period; and it may be needful, sometimes, to have recourse to medical treatment: the application of leeches, or the use of diaphoretics, and of drastic and saline purgatives, so as to unload the hepatic vessels, or produce a serous discharge from the surface of the intestines, may be highly useful. But these means should not be adopted without proper authority, for it is easy to pass the boundary line, and induce debility. On the other hand, if the cessation of the catamenia be abnormal, it will be in one of two ways; either they will too suddenly cease to appear, or they will linger too long, recurring too frequently, or copiously, or both. In the first instance the too sudden or rapid disappearance of the catamenia,-the dangers to be apprehended are simply of a plethoric character, and demand merely the vigilant observation and care of the physician; but the second case is more difficult to manage. On the one hand, the too frequent or the violent discharges often induce very great

debility, paleness, and exhaustion, leaving no time for recovering the loss of blood, and recruiting the general powers. Yet occasionally these outbursts are preceded by such symptoms of plethora as might tempt the unwary into dangerous interference. I speak of this condition as purely a functional derangement, not connected with any diseased condition of the uterus; for it is manifest that if any such diseased condition exist, it demands the attention of the physician, and therefore whenever the suspicion of such disease does exist, the question should be at once determined by examination. When, however, we have simply to deal with a discharge of blood, copious and continuous, or frequently recurring, we should have recourse to all proper means to diminish and arrest the flow. It is a prevailing and dangerous error to leave everything to nature, merely to remain at rest and wait the gradual cessation of the flow. It often becomes merely a passive hæmorrhage, and demands a skilful and careful treatment to mitigate the discharge and remove its debilitating effects. It is a sad thing to see females at this period of life thin, pale, exsanguine, walking about the mere shadows of their former selves, and every now and then confined to their beds for a week or more, from which they are at first scarcely able to rise; and to know

that they are suffering all this, and perhaps laying the foundation for serious disease, from a mistaken notion," that it is best not to interfere, that nature should be allowed to take her course.' I do not know of a greater evil than this, nor one of more frequent occurrence. When nature has dealt kindly with a female, and the catamenia have disappeared without any important derangement of health, she then enters on a new phasis of existence; her constitution gradually approaches to the type of the male in the manner described in Part I, (page 41.) Yet in many women, although the catamenia never reappear, there will often occur, at indefinite periods, even for several years, various signs of fulness and plethoric feelings in the head and loins, and flushings in the face and chest, which demand the use of salines, purgatives, and perhaps some trifling abstraction of blood by cupping or leeches; and this, particularly in the most strong and healthful women, will occur again and again, until the period when age decidedly sets in. The period of the “ Change of Life" should not be made to signify the period of the disappearance of the catamenia only, but should mean the whole time from the first irregularity in the flow to the cessation of all plethoric feelings, in a word, to the unmistakeable commencement of age; and during the

whole of this period, the woman should carefully watch her own condition-bearing in mind, that various organic diseases are then most likely to commence, that the latent seeds of hereditary evil are the most likely to become developed, and altogether, that she is passing along a way beset with dangers; but that prudence and watchfulness will assuredly guide her safely through the road.

CHAPTER III.

DISEASES OF AGE.

In every period of life, the due performance of all the functions of the frame constitutes health, and any failure or derangement in their action constitutes disease. If there be no change in the structure or organisation of any part, the disease is merely functional, and the healthful action being restored, all is well again; but if there be any positive structural change in any part of the body, the disease is of a more serious and intractable character,-it is then organic, and it is rarely that such organic changes can be removed or the disease be absolutely cured.' When organic changes in any part have occurred, the utmost care of the individual, the utmost skill of the physician, is generally confined to an endeavour to

Perhaps, there cannot really be any functional change, but as the result of some organic change, although such change may not be evident. Future observers, aided by the powers of the microscope, may teach us what slight changes of structure occasion those derangements which we usually call-functional ; but it will be readily understood that by the term-organic changes, as here used, visible changes of structure are intended.