_Description._
Besides the two deviations from the usual course of nature already
mentioned, there sometimes occurs a third, viz. where menstruation,
although not wholly suppressed, is nevertheless somewhat difficult, and
accompanied with severe pains in the back, loins, and bottom of the
belly. This disease is owing to a weak action of the vessels of the
uterus, or spasm of its extreme vessels, and is to be obviated by
tonics, warm bathing, both local and general, together with the use of
anodynes, which should be employed as soon as the symptoms which denote
its approach are apparent. This complaint is a common, and generally an
extremely harassing, affection. It may occur at every period during the
menstruation stage of life; but it appears to be most common between the
twentieth and thirtieth years of age, and in subjects of an irritable
and sanguineous temperament. In many instances severe pains are
experienced in the back, loins, and lower part of the abdomen for five
or six hours previous to the appearance of the menses. This, however,
soon ceases, and an immediate aggravation of the torturing pain follows.
Sometimes the catamenia begin to flow moderately, with little or no
previous pains; but in an hour or two, they become suddenly arrested, at
the same time that violent pains come on in the hips, side, loins, back,
and thighs, with a distressing sensation of forcing or bearing down.
Occasionally a very slight menstrual discharge continues uninterruptedly
for three or four days, accompanied throughout with extremely severe
pains in the abdomen; and in some rare instances the catamenial
evacuation, although attended with great suffering, is sufficiently
copious and prolonged in its course, and may even exceed the regular
duration and quantity of an ordinary healthy menstruation.
_Treatment._
Since it is well known that a derangement in the uterine functions must
generally proceed from a check of perspiration, astringing the minute
ends of the uterine vessels, or in some manner deranging their
functions, causing debility, &c., it will appear clear that our first
attention must be directed to the skin. Cold appears to be the cause of
the disease, and heat seems to remove it; therefore, when these periods
of distress occur, let the patient sit over a strong decoction of bitter
herbs, such as tansy, hoarhound, wormwood, catnip and hops, while a
blanket is thrown round the waist of the patient to confine the steam to
the lower parts. After the diseased person has been thus steamed and the
feet bathed, let her be put into a bed, warmly covered, and diluent
drinks given, such as tansy, thyme, pennyroyal, &c. At the same time let
fomentations of the same herbs, enclosed in a flannel bag, be applied to
the abdomen, as before directed. This will produce perspiration and
afford immediate relief; and when these distressing symptoms are
removed, and the patient becomes comfortable, a course of treatment must
be adopted to prevent a recurrence of these symptoms, or to produce a
natural flow of the catamenial discharge; and similar to that
recommended under the preceding complaints. Herbs may be freely drunk.
A writer on this subject thus remarks, “This case of painful
menstruation deserves particular attention, because it impairs the
health of patients by its present effects, and seems to render them less
prolific in future. Dr. Fothergill has afforded relief to several by the
following process: Let the patient have near her a few pills, consisting
of opium, gr. i. each, made soft with a little of any kind of conserve.
She is to take one of these pills the moment the pain attending this
discharge comes on. A pill may be taken every hour till the pain ceases:
more than two will seldom be required; yet they must be taken in
quantities sufficient to mitigate the pain. Let the patient keep either
in or upon the bed, or at least in a recumbent posture, drink moderately
of any diluting liquor, as herb teas, weak whey, or thin broth. When the
time is past, a course of chalybeate bitters, in small doses, may be
continued, till within a few days of the return; and the bowels should
be kept open with some proper laxative. This excruciating pain seems to
be spasmodic, and to proceed from the extreme irritability of the
uterine system.” The _diaphoretic powders_ will be found very useful.
Diet and exercise are important. A hot brick or salt, enclosed in
flannel wet with vinegar, and applied to the bowels, soon relieves the
pain.