MENSTRUATION AND MENSTRUAL DISORDERS.
THE first appearance of the menses marks an epoch in the life of the
girl which ushers in womanhood. It is the harbinger of the fruitfulness
of the maiden, whose limbs now become rounder, and her hips widen out,
while the breasts increase in size and the entire aspect undergoes
peculiar changes, which all point to the approaching condition of
maturity.
The term is derived from the _Latin_ plural _menses_, meaning month,
from moon, and it is an actual fact that the lunar forces seem to
influence this physiological function, inasmuch as it recurs every four
weeks; most women menstruate during the first quarter, and only a very
few during the new or full moon.
During infancy and childhood, the sexual system of the female is
inactive. The menstruation begins, in a temperate climate, about
the fourteenth or fifteenth year of life, and ceases at the age of
forty-five or a little later.
The climate exerts a marked influence in determinating the first
appearance of menstruation, which is further influenced by the
conditions of life and society in which the child is brought up.
The diversity in the ages at which children menstruate in different
countries cannot be laid to any constitutional peculiarities of the
races. Observation has established that, when children of the same race
and family are brought from a hot to a colder climate, the advent of
the first menstruation changes. These girls menstruate not so young as
their older sisters, but begin about at the same age as those who are
born in the colder climate.
In hot countries, for instance in Africa, the negroes and girls in East
India begin to have their periods at the age of ten to twelve years.
In Sweden and Norway the average age for the first menstruation is
sixteen, while further north, in Lapland, the ages vary from eighteen
to twenty years. Next in order of importance, influencing the menstrual
epoch, are the surroundings and food.
In the same climate there are differences in the ages of children that
are entirely due to these causes. Children who are pampered and who are
nurtured in ease and luxury menstruate earlier than those of the poor
or even of the middle class, who are brought up in habits of industry.
We observe again a difference in the ages between those who are reared
in the country or rural districts and the dwellers in the cities,
whether it be in luxurious apartments or in tenement houses. The former
grow older and stronger than the latter before the _show_ begins.
The temperament also greatly influences the development of the
function; children who are nervous, irritable, and of a sanguineous
temperament, menstruate earlier than those of sedate habits.
The color of the hair and complexion are also indices of the respective
appearance of the menses in the _brunette_ and _blonde_. It has been
observed that the dark-complexioned girls menstruate sooner under
similar conditions than the blondes. Weakly children, who are delicate
from some constitutional habit, or whose organism has suffered from
disturbances of indigestion or suffered severely from teething in early
childhood, menstruate earlier than their stronger and robust sisters.
The quantity of the natural menstrual discharge, as well as the time or
duration, varies greatly in health with different individuals. We first
notice a slimy discharge, which soon becomes tinged with blood, and
after one or two days it is almost of pure blood. The flow generally
lasts three or four days, very seldom only one day, and sometimes a
week to ten days.
The monthly recurrence of the menstrual periods averages thirty years;
in temperate climates it may overreach this figure a little, while in
hot climates it comes much below this average.
It does not follow as a rule that because a woman began to menstruate
quite young, the change of life will take place earlier. This also
depends much upon temperament, habit and mode of life.
Physiologists have established, by carefully-prepared statistics, that
the average period of menstruation for women who began to menstruate
early is thirty-three years, while those who commenced late have an
average of only twenty-seven years.
When a woman is forty-five years of age, we may, however, as a rule,
look for the change of life to set in; if she goes beyond this age, she
may be taken as the exception.
The cavity of the womb is the principal source from which the blood
comes; while the ovaries and tubes are also greatly congested with
blood, the amount that comes from them must be very small.
The blood that comes from the womb is not different from blood coming
from any other source; the changes and peculiarity of the menstrual
show are due to its passage through the vagina, where it becomes
contaminated with vaginal secretions.
It is supplied from the blood-vessels of the womb, oozing through the
mucous membrane of that organ, just as in a case of nosebleed. The
entire womb is more or less swollen, and more especially the mucous
lining, so that it corresponds, in many instances, to an inflammatory
process, and for that very reason, a sudden check of the menstrual flow
will often result in a regular subacute or acute inflammation of the
womb. If the discharge of blood from the uterus is in small quantities
and a gradual, steady flow, it becomes so altered by the secretions in
its passage through the vagina that it does not coagulate, but when
it is poured out more rapidly or in larger quantities, the menstrual
blood coagulates or congeals in the same manner as if it were derived
from other sources.
If a woman becomes pregnant, the menses as a rule are suspended during
the child-bearing period, and usually remain absent after the child is
born so long as the woman nurses the child. I have known one woman who
menstruated during her entire pregnancy, and another who had had eight
children and never menstruated in her life, yet she was, and always
had been, in perfectly good health: thus we see, that there is no rule
without exceptions.
An essential part of the menstrual function is that in which the
ova or female germ cells ripen and are expelled from the ovary. The
menstruation is only a reflex or side issue, to a more important part
that is going on in the female generative system; this is termed
_ovulation_, or the ripening and expulsion of the human egg from the
tissues of the ovaries. In the physiological process that operates
in the economy of nature for reproduction, the _ovaries_ are the
principal organs. The other organs are simply accessory, and indeed
many of the lower animals have no other organs than the ovaries for the
perpetuation of their species.
In the human female, the ovaries consist of a tough fibrous tissue,
between whose meshes are little cysts, which are called _Graafian
vesicles_, and these little vesicles serve as the nests in which the
ova or little germ cells mature.
These ova which are imbedded in the Graafian vesicles are so small that
they can only be seen by a high magnifying power.
The activity of the ovaries begins at puberty, and ceases with the
change of life, or menopause.
The approach of the menses is signalized by a certain group of
symptoms, which clearly indicate a congestion of the pelvic organs.
There is generally a drawing sensation in the back and thighs, and a
sensitiveness upon pressure in the regions of the ovaries and the
womb. There is a feeling of lassitude and weakness of the limbs,
sometimes hot flushes changing off with chills, and often a feverish
condition, which will last until the flow is fully established.
Professor Dalton says: “In many birds, for example, the plumage assumes
at this period more varied and brilliant colors; and in the common
fowl the comb or ‘crest’ enlarges, and becomes red vascular. In the
American deer, the coat which, during the first year is mottled with
white, becomes in the second year of a uniform tawny or reddish tinge.
In nearly all species, the limbs become more compact and the body
more rounded; and the whole external appearance is so altered, as to
indicate, that the animal has arrived at the period of puberty, and is
capable for reproduction.”
In the human subject, the child now becomes conscious of the sexual
instinct, however chaste or virtuous her mind, for we must not dull our
intelligence with the idea that the sexual function is unholy; it is
no more so than to say our prayers; so that an additional duty is now
incumbent upon mother or guardian.
The child must be made to know that she must be more reserved and
guarded in her relations with the male sex; that she no longer can
romp or play on the knees of male friends or visitors, and that it is
dangerous and unbecoming to be left alone with them. A little later on,
she must be apprised that she too may become a _mother_, and that that
would be a great disgrace for one so young and not married. The child
thus learns to protect herself against the insidious smiles and snares
of the seducer, for he is ever abroad, and often family friend and
trusted adviser.
There are beings who are men in form only, but at heart are black
villains, and selfish brutes. When the mischief is done, then it is
too late to repent of a mother’s negligence, or to bewail a child’s
disgrace and man’s perfidy; the three combined make one of the most
distressing scenes that it has ever been my misfortune to behold.
Successive crops of eggs ripen, and are discharged by the adult female
at each menstrual period.
I have already said that the ovum is contained in the Graafian vesicle,
in which it grows and matures, as the fruit ripens on a tree, so the
Graafian vesicle gradually ripens for the expulsion of the ovum,
which gradually makes its way to the surface of the ovary. Within the
Graafian vesicle the serous fluid accumulates, so that it ruptures and
discharges its little ovum, which is taken up by the fringed extremity
of the Fallopian tube, and carried along the oviduct into the womb,
from which it escapes into the vagina, and is lost, provided conception
has not taken place.
Investigations have been made as to the number of ova certain mammalia
discharge, and it has been found to correspond with the number of young
that the animal produces at birth. Where a litter consists of from
three to twenty, as in the bitch and the sow, a similar number of eggs
ripen, and are discharged at the period of œstruation.
In the cow or mare, and in the human female, as a rule, only one egg is
discharged at each period of ovulation.
The discharge of ripened ova does, however, occur in exceptional
cases without any sign of the menstrual show, and the person may be
susceptible to conception, so that we may reasonably infer, that
ovulation constitutes the most important function of the menstrual
period.
MENSTRUAL DISORDERS.
These are designated by different terms, not because each name
signifies a particular disease, but simply an indefinite symptom of
a diseased condition. In other cases menstrual disorder may produce
symptoms that are common to widely different diseases. In other
words, the phrase menstrual disorder, without being qualified as to
its particular cause, means, from a practical standpoint nothing upon
which a treatment can be intelligently based. Not any more than a cough
which is simply an irritation of the bronchial nerves, and may be due
to a bronchitis or pneumonia, or it may not be due to any pulmonary
affection at all, as, for instance, in the case where an aneurismal
tumor presses on the bronchial nerves, and excites severe paroxysms of
coughing. A great many menstrual disorders are due, not to any disease
of the generative organs, but to an affection of the nervous system.
Menstruation may be precocious in some girls, and if the discharge is
not accompanied with the usual symptoms of backache and some of the
other symptoms that characterize the normal appearance of the menses,
or if the girl is otherwise not fully developed, and has in this
climate not reached her twelfth or fourteenth year, it constitutes a
sign of a disease. If, however, the show recurs at certain intervals,
it is not to be considered with the same degree of apprehension that it
would be if it recurred at irregular intervals.
The sanguineous discharge which shows itself at the genitals during an
acute attack of an infectious disease, has no relation whatever with
the menstrual function; this may take place in children at any early
age.
We often see girls who are not yet thirteen, who still wear short
clothes and go to school, that menstruate regularly, but with this
precocious menstruation there is also a corresponding development of
the body which gives them a womanly appearance. Such girls should not
be permitted to expose themselves to the inclemency of the weather,
because they are much more liable to take cold, which may result in
inflammations, than girls in whom the menses have not appeared.
Girls of a scrofulous taint or other hereditary habits of constitution,
often begin to menstruate prematurely; outdoor exercise and cod liver
oil with cold sponging on retiring at night are the proper resources
for building them up.
AMENORRHŒA.
This term is employed for the purpose of designating an absence of the
menstrual flow in persons who are old enough to menstruate, and in whom
there is no physiological reason for its suppression, such as being too
young, after the change of life, or during pregnancy and while nursing
the child on the breasts.
We find this disorder of the natural function of menstruation more
among the women of the rich and affluent whose lives are spent in
indolence and luxury; this is to be ascribed to lack of sufficient
exercise to stimulate the nervous and sanguineous systems to the
performance of their healthy functions.
The amenorrhœa, or a retarded menstruation in young girls, is oftener
the result of a general debility than of a disease of either the womb
or ovaries. We have here again about the same causes playing their
pernicious role as in precocious menstruation in weakly children;
that is, that the same causes produce directly opposite results. The
scrofulous and hereditary taints always interfere with the proper and
healthy development of the system; in amenorrhœa they appear to be a
hindrance to the formation and growth of the red blood corpuscles.
In some girls the suppression of the courses appears to be a wise
conservative provision of nature, because the girls are already
so weak and bloodless that even the loss of a very small amount
would only increase the anæmia, so that in these cases it is not so
much a question of “bringing on the courses” as of building up the
constitution, and enriching the blood in order to bring about the
desired result.
Chlorosis, or the green sickness, is not simply an anæmia or a
bloodlessness, but a physiological incapacity of the system to prepare
the required blood cells for the sanguineous fluid, and this is,
indeed, the most frequent cause of the disorder under consideration.
Chlorosis is a disease that is peculiar to the female sex, beginning as
a rule at the age of approaching puberty, between the fourteenth and
twentieth year, so that there appears to be a physiological relation
between the blood genesis on the one hand, and the development of
womanhood on the other.
In some cases we can trace the impoverished condition of the blood
to unhealthy dwellings, impure air, want of exercise, improper diet,
nervousness, the reading of exciting, amorous novels, and the practice
of masturbation or self-abuse. On the contrary, the disease is often
developed under the most moral and exacting discipline and hygienic
surroundings.
I have known girls who lived in the country, enjoyed horseback riding,
ate nutritious and wholesome food, and whose solitary moments were
beyond suspicion, yet at the age of puberty they commenced to fade in
color, and fail in strength, gradually growing paler and weaker, until
they became chlorotic and bloodless. This can only be explained on the
theory that the period in which nature was preparing the system for the
purposes she had in view, caused a shock to the nervous system, which
so disarranged the functions that the _sanguineous_ system did not
respond to the growth of the _generative_ system.
Then there is another class of cases, where girls menstruate before
they are old enough, and without their bodies showing any visible
evidence of developed womanhood, who belong to the most obstinate cases
for successful treatment.
The relative diminution of the red blood cells to the healthy standard
is in some cases truly alarming. In the average healthy blood, there
are, in one thousand parts of blood, one hundred and thirty parts of
red blood cells; this falls to sixty, and even forty parts in the
thousand in the chlorotic patient.
It is one of the peculiarities of this disease, that while the muscular
tissue wastes away, the fatty tissue is not only preserved, but it
sometime increases, so that in a family of several girls, the chlorotic
girl is considered the ‘_most fleshy_,’ but as fat is not flesh, the
appearance is deceptive.
When we stop to think a moment, that the _red blood corpuscles_
are the messengers which absorb the oxygen in the lungs during the
respiratory movements, and carry it to the different organs and tissues
of the body, without which all tissue change would cease. And that the
same red blood cells must return again to the lungs for exhaling the
carbonic acid, one of the waste products of tissue growth, then the
diminution of the red blood cells in the proportion above given, must
affect the entire system very injuriously.
This is indeed the case; the natural respiratory movements are
insufficient on the slightest exertion, so that patients tell us that
when they walk a little fast, go up the stairs, or even sweep the room,
they feel a shortness of breath.
There are other symptoms that point to carbonic acid poisoning, which
it will be interesting to review. A great majority of these symptoms
are to be found in every case of chlorosis. The muscles become weak at
first, because their nutrition is interfered with, and they waste away,
and secondly they become irritable from the poisonous presence of the
carbonic acid, and so are often very painful. The patients are easily
tired out; some, indeed, feel tired all the time, getting up in the
morning as worn out as when they retired at night.
The nervous system suffers as much, because the principal nerve
food is oxygen, and if there is no blood, there can be no oxygen; a
starved nerve is a painful nerve. We find neuralgias, affecting the
different parts of the body, the rule; when these are located in the
external muscles, they are easily recognized, but when located in the
deep organs, as the ovaries or the womb, they are generally mistaken
for something else. The nerves of these individuals being in such an
irritable state, it is natural to infer, that hysteria is often to
be found as one of the complications, so that habitual sadness, and
abnormal longings after chalk, lead pencils, and other indigestible
articles are prominent symptoms.
The circulatory system suffers derangements that are characteristic
of chlorosis. Palpitation of the heart is a prominent symptom; this
is partly due to the irritation of the carbonic acid on the cardiac
nerves, and partly to sensitiveness of the patient, owing to a
morbidly-increased sensibility of the whole body. Chlorotic patients
blush up at times, only to be followed by a green paleness that
is peculiar to the disease. Pain in the region of the heart, and
disturbances of the digestion, are sometimes prominent symptoms. There
is no feeling of hunger; eating is not so much from hunger, but more
from a sense of duty to keep up the strength. A heavy or full feeling
is often experienced after a meal, and a sourish eructation will give
relief to the oppression, because the walls of the stomach are relaxed
and in sympathy with the general debility.
But in all cases of chlorosis the sexual functions are the seat of
the greatest disturbance; amenorrhœa or the suppression of the menses
is the most prominent symptom. The ovaries no longer seem to expel
ripened ova, for there are no indications that point to their activity,
because there is not only an absence of the show, but also an absence
of the other signs that were noted when we considered menstruation and
ovulation.
There are a great many other diseases of which amenorrhœa is a
prominent symptom; these will be referred to when separate diseases
become the subject of special inquiry.
The treatment of amenorrhœa is, indeed, in the great majority of
cases, the treatment of chlorosis, and that should be conducted on
common-sense principles. If the child has vicious practices, they must
be corrected, and everything else that has been mentioned as a cause
must be abandoned. Children who were once robust and strong require
electrical treatment, while those who were naturally weak require
nourishing food and tonics. If there is in the entire pharmacopœa a
remedy that deserves the name of a specific, it is to that one which I
suggest in amenorrhœa due to chlorosis or anæmia. Iron preparations are
very numerous; every physician has his favorite prescription; some are
to be praised more for their elegance and flavor than for any virtue
that they possess. If in these cases any positive and decided result is
to follow the administration of iron, it must be given in such a mild
form that it can be taken in great quantities without irritating the
stomach or interfering with digestion. If the contents of the whole
alimentary canal are saturated or impregnated with the ferruginous
medicine, there will be astonishing curative effects.
I have often observed chlorotic cases who have made the rounds of the
different iron springs, and who have taken the numerous and various
fancy elixirs, without the slightest perceptible effect, bloom up,
after being fed, so to speak, on some harmless iron preparation, which
was astonishing to themselves and surprising to their friends. The
following is my favorite prescription for chlorosis or anæmia:
NO. I.
Take: Powd. Carb. of iron, sacch. (Germ.) 1 ounce
Powd. Aloes. 20 grains
Powd. Tragacanth. 20 grains
Mix with sufficient water to make into a hard mass and divide into one
hundred and fifty pills, and roll in powdered cinnamon.
Take three pills three times a day and after three days increase to
four pills at one dose three times a day, then after another three days
increase to five pills as many times a day as before; if these doses
are not at first borne, begin with less, and if there is no costiveness
or tendency thereto, omit the aloes.
If there is reason to believe that the impoverishment of the blood is
partly or wholly due to scorfulous taints, then it is advisable to take
fresh, pure cod liver oil in conjunction with the iron pills; three
boxes of pills are, as a rule, necessary to effect a cure.
It happens quite often in chlorosis or anæmia that there is a
distressing dyspepsia or indigestion with loss of appetite. In these
cases I would first advise to put the stomach in order; this is done
by first avoiding all indigestible food, such as cakes, pies, and
puddings, and taking the following medicine:
NO. II.
Take: Bicarbonate of soda 2 drams
Subcarbonate of bismuth 2 drams
Tr. of nux vom. 2 drams
Fluid ex. of rhubarb 3 drams
Simple syrup 1 ounce
Peppermint water sufficient to make 8 ounces
Take a tablespoonful three times a day, and if the bowels move freely
take less.
Hygiene in the treatment of every disease is to be an important factor;
all vicious habits must be abandoned.
DYSMENORRHŒA.
Difficult or painful menstruation is the definition of the above word;
all painful menstrual disorders that take place either before or during
the menstrual flow come under this designation.
The seat of the pain, when of a colicky nature, is in the uterus; when
a continuously dull ache is in the small of the back, it is located in
the nervous plexus in the small of the back. The pain is very often
in the ovaries and in that portion of the peritoneal membrane which
folds over all the pelvic organs and extends on the sides of the womb,
constituting the broad ligaments; when the pain is confined to these
structures, it is principally felt below the stomach and over the lower
part of the bowels.
Painful menstruation is a prominent symptom of a great many diseases,
and it often strains the ingenuity of the most clever specialist to
trace the symptoms to their real cause.
Obstructive dysmenorrhœa, as its name implies, is due to some hindrance
or obstacle to the escape of blood from the cavity of the womb. The
obstruction may exist in the neck of the womb, at its mouth, or in
the vagina. When the obstruction is in the neck of the womb, it may
be congenital or date from birth. The constriction or narrowness may
be due to an acquired inflammation of the lining membrane of the neck
of the womb. Every inflammation causes a swelling of the tissues, and
if the inflammation continues, the swelling becomes permanent and a
_stricture_ is the result.
Such strictures are often the result of the applications of strong
_caustics_ and meddlesome tampering by the ignorant specialist and
abortionist. The application of the _electrical current_ by means
of the uterine electrode is the most modern and effectual method of
treating these cases successfully.
Flexion of the womb is understood to be a condition in which the uterus
is flexed or bent upon itself at a sharp angle, just as a rubber hose
that is bent sharply on itself becomes compressed at the kink so as to
shut off the flow, in this manner the flow of blood from the cavity of
the womb is partly shut off, and the obstruction is the cause of the
painful menstruation.
In some women who have flexion or a bent womb there is no obstruction,
because the probe passes the canal freely; in these cases dysmenorrhœa
must be traced to some other cause. If it is clearly established that
flexion is the cause of the obstruction, the most successful treatment
is the electrical current. I have often had cases where little mucous
growths no larger than a small marble, grew in the canal and obstructed
the free escape of blood; after these were removed, the dysmenorrhœa
ceased at once.
Other obstructions may be due to a stricture of the vagina or some
deformity of the hymen; a very slight surgical operation will
permanently relieve both of these hindrances.
There is a much larger proportion of cases that suffer from painful
menstruation in whom the uterine organs are perfectly healthy, but who
are systematically injured by dishonest or hungry specialists, by being
subjected to _local treatments_. I have had cases of this nature fall
into my hands very often. They had made the rounds of the specialists
and had been made the innocent prey of avaricious professional
competition, so that it is of the greatest importance to distinguish
this class of cases from those in which the pelvic organs are the seat
of the difficulty.
Nervous and congestive dysmenorrhœas are particularly adapted for the
hygiene of home treatment. Nervous or neuralgic dysmenorrhœa is very
often overlooked, and treated as a local lesion of the womb.
The psychical exaggeration which many women experience at the approach
of the menses is abnormally heightened in dysmenorrhœa. The pains in
the back, in the hips, and in the lower part of the abdomen disturb
the normal operations of the mind. The irritation of the nerves of the
womb is often reflected to distant organs, and pain is felt in remote
regions. Some women suffer only just a day or two preceding the flow,
while others suffer severely during the entire period, so that they are
forced to keep to their bed the greater part of the time.
Professor William Goodell, one of the most profound and original female
specialists in America, has this to say in a recent publication: “I
have learned to unlearn the idea— and that was the hardest task of
all—that uterine symptoms are not always present in cases of uterine
disease; or that, when present, they necessarily come from uterine
disease. The nerves are mighty mimers, the greatest of mimics, and
they cheat us by their realistic personations of organic disease and
especially of uterine disease. Hence it is that even seemingly urgent
uterine symptoms may be merely nerve counterfeits of uterine disease.
I have, therefore, long since given up the belief, which, with many,
amounts to a creed, that the womb is at the bottom of every female
ailment.
“Nerve strain, or nerve exhaustion, comes largely from the frets, the
griefs, the worries, the carks and cares of life. Yet although the
imagination undoubtedly affects it, it is not a mere whim or imaginary
disease, as all healthy women and physicians think; but it is the
veriest of realities. When some flippant talker or some slipshod
thinker scoffs at nervousness as a sham disorder, I say to him: ‘Can
the bribe of a principality keep you from blushing when you are
ashamed, or from blanching when you are afraid?’ Under the flitting
sense of shame or of fear these vasomotor disturbances are momentarily
beyond your control; and so they are in the nervous woman, whose vital
organs are, as it were—not transiently but—perpetually blushing and
blanching under deficient brain-control over the lower nerve centers.
“Strangely enough, the most common symptoms of nerve disorder in women
are the very ones which tradition and dogmatic empiricism attribute to
womb disease.
“They are, in the order of their frequency, great weariness and more or
less of wakefulness and inability to walk any distance, a bearing-down
feeling, headache, nape-ache and backache, scant, or _painful_, or
delayed, or suppressed menstruation, cold feet, and irritable bladder,
general spinal and pelvic soreness, and pain in one ovary, usually
the left, or in both ovaries. The sense of exhaustion is a remarkable
one; the woman is always tired, she passes the day tired, and she goes
to bed tired, and she wakes up tired, often, indeed, more tired than
when she fell asleep. She sighs a great deal, she has low spirits, and
her arms and legs become numb so frequently that she fears palsy or
paralysis.
“There are many other symptoms of nerve strain, but since they are not
so distinctly uterine, and, therefore, not so misleading, I shall not
enumerate them. Now, let a nervous woman with some of the foregoing
group of symptoms recount them to a female friend, and she will be
told that she has womb disease. Let her consult a physician and ten to
one he will think the same thing and diligently hunt for some uterine
lesion. If one be found, no matter how trifling, he will attach to it
undue importance, and treat it heroically as the offending organ. If no
visible disease of the external organs be discoverable, he will lay
the blame to the invisible endometrium, or on the unseeable ovaries,
and continue the local treatment. In any event, whatever the inlook or
the outlook, a local treatment is bound to be the issue.”
The nervous variety of painful menstruation is frequently due to
impoverishment of the blood, which, as we have learned, is often the
direct cause of irritable nerves. The same treatment as for chlorosis
will give the desired relief: the treatment with iron pills. If the
stomach is deranged from dyspeptic disorders, then my dyspeptic
mixture, No. II, is to be given. But there are cases that are purely
neuralgic without any apparently serious lesion of the blood; cases in
which the neuralgia of the womb or ovaries is probably due to exposure
to cold or some other indiscretion; here the following recipe will
effect a cure in the course of several months:
NO. III.
Take: Fluid ex. of black cohosh ½ ounce
Fluid ex. of ergot ½ ounce
Tr. of guaiacum ammoniated 3 ounces
Glycerine 2 ounces
Mix. Take a teaspoonful in a tumblerful of milk three times a day,
between meals.
Congestive dysmenorrhœa is oftener in the nature of an acute or sudden
attack, except when it is due to a chronic inflammation of the lining
membrane of the womb. It is often brought on by a sudden or inadvertent
exposure, just at the time when the menses should make their regular
appearance.
Persons of a plethoric habit and those who have been the subjects
of inflammations either of the womb or in the tissues surrounding
the womb, are more liable to this form of dysmenorrhœa than others.
It will often be ushered in with a chill, followed soon with fever.
There is headache, the skin becomes dry and hot, and often there is
considerable irritability of the bladder, straining of the rectum
and diarrhœa. Unless the pain is due to an obstinate displacement, it
yields to proper treatment. For the straining and irritable bladder a
hot sitz-bath should be employed for ten to fifteen minutes. In the
absence of a suitable vessel for a sitz-bath an ordinary bathtub can
be used by filling it six or eight inches with water, at a temperature
of 104°F., and while sitting in the bath allow the boiling water to
run slowly into it, so as to keep the temperature up. These sitz-baths
should be taken several times a day, and after each bath the patient
should rub herself thoroughly dry and wear flannel next to the skin.
The extremities and feet should also be kept warm by wearing woolen
hose.
Towels wrung out of hot water should be carefully folded and applied to
the lower region of the abdomen and then covered over with a thickly
folded flannel cloth so as to retain the heat and moisture; when the
towel has cooled off repeat the dipping in hot water.
The Femina vaginal capsules are of inestimable value in this class
of diseases. They relieve congestion of the womb by allaying the
irritation. The best time to use one is just before retiring, and after
taking a sitz-bath, or a vaginal injection of hot water, or both.
Persons who are of a costive habit should pay particular attention
that, about the time their monthlies come around, their bowels act
freely, and to accomplish this purpose the Femina laxative tablets
should be taken, one each night for several nights before the courses
are expected.
MENORRHAGIA AND METRORRHAGIA.
By _menorrhagia_ is meant, as the composition of the term implies,
an excessive flow of blood at the regular monthly period; by
_metrorrhagia_, a flow of blood from the womb at any time irrespective
of the regular menstrual periods. Neither of these forms can be called
a disease, as they are solely the symptoms of several kinds of uterine
affections. In the course of our investigations, we will find that one
of the most prominent and common symptoms of different womb diseases is
_hemorrhage_ of the womb.
If the hemorrhage is the result of general debility from protracted
nursing, the child must be weaned, and recipe No. I, with a nourishing
diet, will effect a cure.
Hemorrhage may be due to the presence of a fungoid inflammation,
tumors, or affections of the mouth or neck of the womb, or congestion
of the ovaries.
It is very often due to a “bad getting up” from confinement, where the
womb has never returned to its original size. Sometimes it is due to a
portion of the afterbirth that was retained in the cavity of the womb.
It is also a symptom of cancer. As I have already said, it may be the
symptom of so many different diseases that the proper course to pursue
is to find an _honest_ and competent physician to make a thorough
examination, for the purpose of deciphering the real cause, and when
that is discovered, it is as a rule, an easy matter to remove it and
thus afford the patient permanent relief.
There is no remedy which on the whole is so effectual in controlling
hemorrhage, no matter from what cause, as:
NO. IV.
Take: Fluid ex. of ergot 1 ounce
Dose: a teaspoonful in a little water every four hours until the flow
ceases, or until a physician is consulted to diagnose the case. In
pregnancy, the administration of ergot is not admissible; cold water
compresses are also useful in checking uterine hemorrhage, and the
utmost quietude should be observed.
Nervous exhaustion from protracted confinement, or mental worry from
the loss of a child or the death of a friend, may also cause uterine
hemorrhage. The ergot is useful in these cases, with a change of air
and scenery.