_Of the Retention of the Courses._
The suppression of the menstrual periods, is an interruption of that
accustomed evacuation of blood, which comes from the matrix every month,
and the part affected is the womb.
CAUSE.
The cause of this suppression is either external or internal. The
external cause may be heat or dryness of air, want of sleep, too much
work, violent exercise, etc., whereby the substance is so consumed, and
the body so exhausted that nothing is left over to be got rid of, as is
recorded of the Amazons who, being active and constantly in motion, had
their courses very little, if at all. Or it may be brought about by cold
which is very frequent, as it vitiates and thickens the blood, and binds
up the passages, so that it cannot flow out.
The internal cause is either instrumental or material; in the womb or in
the blood. In the womb, it may be in various ways; by humours, and
abscesses and ulcers, by the narrowness of the veins and passages, or by
the adipose membrane in fat bodies, pressing on the neck of the matrix,
but then they must have hernia, zirthilis, for in men the membrane does
not reach so low; by too much cold or heat, the one vitiating the
action, and the other consuming the matter through the wrong formation
of the uterine parts; by the neck of the womb being turned aside, and
sometimes, though rarely, by a membrane or excrescence of the flesh
growing at the mouth or neck of the womb. The blood may be in fault in
two ways, in quantity and in quality; in quantity, when it is so
consumed that no surplus is left over, as in viragoes or virile women,
who, through their heat and natural strength, consume it all in their
last nourishment; as Hippocrates writes of Prethusa, for when her
husband praised her overmuch, her courses were suppressed, her voice
changed and she got a beard with a manly face. But I think, rather that
these must be _Gynophagi_, or woman-eaters, rather than women-breeders,
because they consume one of the principles of generation, which gives a
being to the world, viz., the menstruous blood. The blood may likewise
be lost, and the courses checked by nosebleeding, by bleeding piles, by
dysentery, commonly called the bloody flux, by many other discharges,
and by chronic diseases. Secondly, the matter may be vitiated in
quality, and if it be sanguineous, sluggish, bilious or melancholy, and
any of these will cause an obstruction in the veins.
SIGNS.
Signs which manifest the disease are pains in the head, neck, back and
loins; weariness of the whole body (but especially of the hips and legs,
because the womb is near those parts); palpitation of the heart. The
following are particular signs:--If the suppression arises from a cold,
the woman becomes heavy, sluggish, pale and has a slow pulse; Venus'
combats are neglected, the urine is thick, the blood becomes watery and
great in quantity, and the bowels become constipated. If it arises from
heat, the signs are just the opposite. If the retention be natural and
arises from conception, this may be known by drinking hydromel, i.e.,
water and honey, after supper, before going to bed, by the effect which
it has; for if after taking it, she feels a heating pain about the navel
and the lower parts of the abdomen, it is a sign that she has conceived,
and that the suppression is natural.
PROGNOSTICS.
The whole body is affected by any disorder of the womb, and especially
the heart, the liver and the brain, and there is a singular sympathy
between the womb and those three organs. Firstly, the womb communicates
with the heart by the mediation of those arteries which come from the
aorta. Hence, when menstruation is suppressed, fainting, swooning, a
very low pulse, and shortness of breath will ensue. Secondly, it
communicates with the liver by the veins derived from the hollow vein.
Obstructions, jaundice, dropsy, induration of the spleen will follow.
Thirdly, it communicates with the brain by the nerves and membranes of
the back; hence arise epilepsy, madness, fits of melancholy, pains in
the back of the head, unaccountable fears and inability to speak. I may,
therefore, well agree with Hippocrates that if menstruation be
suppressed, many dangerous diseases will follow.
CURE.
In the cure of this, and of all the other following cases, I shall
observe the following order:--The cures will be taken from surgical,
pharmaceutical and diuretical means. The suppression has a plethoric
effect, and must be removed by the evacuation; therefore we begin with
bleeding. In the middle of the menstrual period, open the liver vein,
and two days before, open the saphena in both feet; if the repletion is
not very great apply cupping glasses to the legs and thighs, although
there may be no hope of removing the suppression. As in some women, the
cotyledones are so closed up that nothing but copulation will open them,
yet it will be well to relieve the woman as much as possible by opening
the hemoroid veins by applying a leech. After bleeding let the place be
prepared and made flexible with syrup of stychas, calamint, betony,
hyssop, mugwort, horehound, fumitary, maidenhair. Bathe the parts with
camomiles, pennyroyal, savias, bay-leaves, juniper-berries, rue,
marjoram, feverfew. Take a handful each of nep, maidenhair, succory and
betony leaves and make a decoction, and take three ounces of it, syrup
of maidenhair, mugwort and succory, half an ounce of each. After she
comes out of her bath, let her drink it off. Purge with _Pill agaric,
fleybany, corb, feriae_. In this case, Galen recommends _pilulae of
caberica coloquintida_; for, as they are good for purging the bad
humours, so also they open the passages of the womb, and strengthen it
by their aromatic qualities.
If the stomach be over-loaded, let her take an emetic, yet such a one as
may work both ways, lest if it only works upwards, it should check the
humours too much. Take two drachms of trochisks of agaric, infuse this
in two ounces of oxymel in which dissolve one scruple and a half of
_electuary dissarum_, and half an ounce of _benedic laxit_. Take this as
a purge.
After the humour has been got rid of, proceed to more suitable and
stronger remedies. Take a drachm and a half of trochisk of myrrh; ten
grains of musk with the juice of smallage; make twelve pills and take
six every morning, or after supper, on going to bed. Take half an ounce
of cinnamon, two drachms each of smirutium, or rogos, valerin
aristolochia; two scruples each of astrumone root and saffron; two
drachms of spec. diambia; four scruples of trochisk of myrrh; two
scruples tartari vitriolari; make half into a powder; make lozenges with
mugwort water and sugar, and take one drachm of them every morning; or
mix a drachm of the powder with one drachm of sugar, and take it in
white wine. Take two drachms each of prepared steel and spec. hair; one
scruple each of borax and spec. of myrrh, with savine juice; make it up
into eighty-eight lozenges and take three every other day before dinner.
Take one scruple of castor, half a drachm of wild carrot seed with syrup
of mugwort, and make four pills, take them in the morning fasting, for
three days following, before the usual time of purging. Take five
drachms each of agaric, aristolochia, and juice of horehound; six
drachma each of rhubarb, spikenard, aniseed, guidanum, asafoetida,
mallow-root, gentian, of the three peppers and of liquorice: make an
electuary with honey, and take three drachms for a dose. For phlegmatic
constitutions nothing can be better than the decoction of guaiacum wood
with a little disclaim, taken fasting in the morning, for twelve days
consecutively, without producing sweating.
Treat the lower parts of the body to suffumigating, pessaries, ointments
and injections; for fumigating use cinnamon, nutmeg, the berries of the
bay tree, mugwort, galbanum, molanthium, amber, etc. Make pessaries of
figs and the bruised leaves of dog's mercury, rolled up in lint, and if
a stronger one is required, make one of myrrh, opopanax, ammoniac,
galbanum, sagepanum, mithridate, agaric, coloquintida, tec. Make
injections of a decoction of origane mugwort, dog's mercury, betony, and
eggs; inject into the womb with a female syringe. Take half an ounce
each of oil of almonds, lilies, capers, camomiles; two drachms each of
laudanum and oil of myrrh; make a salve with wax, with which anoint the
place; make injections of fenugreek, camomiles, melilot, dill, marjoram,
pennyroyal, feverfew, juniper berries and calamint; but if the
suppression arises from a lack of matter, then the courses ought not to
be brought on until the spirits be raised and the amount of blood
increased; or if it arises from affections of the womb itself, as dropsy
or inflammation, then particular care must be used; but I will not lay
stress on this here, but will mention the remedies in their order.
If the retention comes from repletion or fullness, if the air be hot and
dry, take moderate exercise before meals, and very light diet and
drinks, and with your food take garden savory--thyme and origane, if it
arises from emptiness and defect of matter: if the weather be moist and
moderately hot, avoid exercise and late hours; let your food be
nourishing and easy of digestion, such as raw eggs, lamb, chickens,
almonds, milk and the like.
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