CAUSES OF MENORRHAGIA.-- I. Diseases of the General System: Plethora; Chlorosis and anæmia; Debility, as from excessive lactation; The exanthemata and typhoid fever; Hæmophilia; Scorbutic, uræmic, and malarial cachexiæ. II. Local Affections, not Uterine: Cerebral, as psychical influences; Cardiac and pulmonary affections, as valvular disease, emphysema, and phthisis; Hepatic diseases, as cirrhosis and the changes produced by residence in tropical climates; Splenic and renal disease; Abdominal tumors and loaded bowels; Peri-uterine inflammations; Ovarian influences. III. Uterine Causes: Subinvolution; Areolar hyperplasia; Endometritis, with fungous growths; Laceration of the cervix, with eversion; Ulceration of the cervix; Displacement of the uterus; Polypi and fibroid tumors; Retention of products of conception; Malignant disease; Congestion. I. Menorrhagia, the result of the first class of causes, but rarely occupies more than a subordinate position. The acute affections, as the exanthemata, do not afford time for more than a single flow, and this has been well termed uterine epistaxis. The condition of plethora is manifest. The cachexiæ are generally well marked and evident. An exception may be made in this regard as to the effect of prolonged residence in malarious locations. There can be no question that menorrhagia is frequently of malarial origin, and even when the patient does not present a cachectic appearance. The disease may be produced by hepatic and splenic derangement, by deteriorated sanguinification, or by depression of nervous force. Menorrhagia is not infrequently a result of Bright's disease; an examination of the urine would determine this point. That the opposite conditions of plethora and anæmia should both cause menorrhagia is not difficult of explanation; in the one there is excess of blood with increased vascular pressure; in the other, a changed condition of the blood favoring transudation, with loss of tone of the vessels.