One of the principal constitutional characteristics of the female, is
menstruation, or the monthly evacuations peculiar to the sex.
This important operation generally takes place about the age of twelve
or thirteen; but varies through the world, either in degree or
frequency, both from constitution and climate.
Women in the higher ranks of life, and those of a delicate, nervous
constitution, are subject to sickness, headache, and pains in the back
and loins, during periodical evacuation. Those of the lower rank, inured
to exercise and labor, and strangers to those refinements which
debilitate the system, and interrupt the functions essential to the
preservation of health, are seldom observed to suffer at these times,
unless from general indisposition, or a diseased state of the womb.
After the discharge has become established it recurs periodically while
in health; and its recurrence is so regular, that it can be calculated
with great exactness. The usual period of its visitations is from
twenty-seven to thirty days. As to the time of its continuance, this is
various in different women; but it seldom continues longer than six
days, or less than three, and does not cease suddenly, but in a gradual
manner.
Its approach is generally preceded by certain feelings of oppression or
deviation from the ordinary state of health, which warn the individual
of what is to happen. There is, in particular, a sensation of fulness
about the lower part of the belly, and a relaxation about the uterine
system which can scarcely be overlooked by the most heedless. The
appetite becomes delicate, the limbs tremble and feel weak, the face
becomes pale, and there is a peculiar dark streak or shade under the
eyes; sometimes great restlessness, slight fever, headache, heavy and
dull pain in the small of the back and bottom of the belly, swelled and
hardened breasts, &c. All of which are sometimes instantly relieved by a
trifling discharge from the vagina, and this not necessarily colored. It
must at the same time be admitted, that in some few constitutions these
feelings are so inconsiderable as to be little attended to; so that the
woman mixes in society as usual without any apparent inconvenience.
The period at which the menses make their appearance, is various; it is
much influenced by constitution, climate and mode of life. As a general
rule, it takes place at puberty, or at that period at which the female
is capable of propagating her species; and this period varies as climate
may differ. They constantly, however, keep pace with the development of
the body; where this is rapid, they will appear proportionably earlier;
where this process is slower, they will appear later: but whenever the
menses appear as regular evacuations, they mark the period of puberty:
thus, in hot countries, women commence to menstruate at eight or nine
years of age, and are not unfrequently mothers at ten.[1]
In the more northern regions, as in Lapland, &c., this evacuation is
generally delayed until the female has attained her eighteenth or
nineteenth year: in the temperate latitudes the average period will be
found from the fourteenth to the sixteenth year. A difference, will,
nevertheless, be found in the women who may reside in cities, and in
those who dwell in the country of each respective portion of the globe.
It may also be observed, that in cold countries, women continue to
menstruate for a longer period than in warm; and as a general rule, it
will be found they are obnoxious to this discharge double the period
that elapses before it commences. Thus, women who have not this
discharge until eighteen, will be found to have it until beyond fifty;
those who commence at fourteen or fifteen, will leave off at forty-five;
those who begin so early as eight or nine, will have it cease at
twenty-five or six.[2]
On the appearance of the menses, or monthly turns, nature seems to
perfect her work, both as regards development and proportion: it is the
period of the most perfect beauty of which the female is susceptible; it
is the one at which the moral changes are not less remarkable than the
physical; it is a moment, of all others, the most replete with
consequences to the inexperienced and confiding female.
At this period a great variety of interesting and curious phenomena
present themselves: the voice is found to change; the neck and throat to
increase in size, and to become more symmetrical; the mammæ to swell;
the nipple to protrude; the chest to expand; the eyes to acquire
intelligence, and increase of brilliancy; in a word, a new being,
almost, is created.
The quantity of fluid expended at a menstruous period differs in
different individuals; with girls who precociously menstruate, the
quantity is in general smaller, and the returns less regular. Climate
exerts an influence upon the quantity discharged, as well as upon the
periods at which this evacuation shall commence. Thus, in the equatorial
and more northern regions, it is less than in the more temperate
climates.
It is of importance for women to know that occasional irregularities are
not always the consequences of disease. Constitutions vary as much in
respect to the regular returns of this discharge, as they do with regard
to their first appearance or final cessation. Those in whom the change
occurs very early from vigor of constitution, require little to be done
for them; but in weak and delicate habits, the non-appearance of this
evacuation is too often considered as the cause, whereas it ought to be
viewed as the effect, of the state of the habit unpropitious to its
taking place. And, according to family practice, under this false
impression, warm teas and forcing medicines are employed at the approach
of this disease, which have often done much harm.
Nature is not so defective in her own judgment as to require
auxiliaries. Care should be taken to improve the general state of the
health, by attention to diet, moderate exercise, change of air, &c.
In some instances the menstrual discharge does not make its appearance
before the age of seventeen or eighteen, and, nevertheless, health is
not in the least affected. The mere want of evacuation at the ordinary
time, therefore, is not to be considered as morbid, unless the system be
evidently deranged thereby. In many cases, however, symptoms of disease
appear which are evidently connected with the defect of the menses, and
go off upon its discharge. The treatment, in such cases, must be
regulated by the particular circumstances and constitution of the
individual. There is no remedy adapted to every case of this kind; but
an open state of the bowels, and a due regulation of the diet, together
with moderate exercise, are useful in every instance of this complaint.
Warm clothing, too, particularly about the lower extremities, is of most
essential benefit. The occasional use of the warm bath is pleasant and
beneficial, especially if the skin be dry and warm. As the health
improves, the cold bath will prove an auxiliary, if, after using it, the
patient feels a glow of heat and a greater degree of liveliness. When
the means ordinarily employed have failed, marriage, or a change of
climate, has produced the wished-for effect.
In some instances the evacuation is impeded by a mechanical cause, that
is an obstruction of the passage to the womb. This occasionally is met
with, and the chief obstacle to its speedy removal is the difficulty of
ascertaining its existence. The operation by which it is completely
remedied, is not more painful nor formidable than blood-letting.
Fortunately, in most cases, the evacuation takes place in due time, and
the constitution sustains no material or permanent injury. It is,
however, in every instance, proper to pay particular attention to the
system during the continuance of the evacuation.
The stomach and bowels, at this period, are very easily disordered, and
therefore, everything which is heavy or indigestible, ought to be
avoided. Some are hurt by eating fruits or vegetables; others by taking
fermented liquor. In this respect experience must enable each individual
to judge for herself. Exposure to cold, particularly getting the feet
wet, is hurtful, as it tends suddenly to obstruct the discharge. The
same effect is likewise produced by violent passions of the mind, which
are also, at this time, peculiarly apt to excite spasmodic affections,
or hysterical fits.
It is, in general, a very proper rule not to administer any very active
medicines, at this time, unless some violent symptom absolutely requires
them. Opiates, for instance, are, in many cases, necessary to allay
spasmodic affections, or abate pain; and they are, in such
circumstances, uniformly safe. They give speedy relief to hysterical
feeling or suffocation, or to spasm of the stomach or bowels.
Dancing, exposure to much heat, or making any great or fatiguing
exertion, are improper. These causes may increase, to an improper
degree, the quantity of the evacuation, and in certain circumstances may
give a disposition to a falling down of the womb.