-From the age or fourteen to the age of forty-five women are subject to a discharge of bloody fluid every four weeks.
The age at which it commences is sometimes earlier and sometimes later than fourteen, and the same may be said of the period of its cessation. The ages named are the average, and any variation from these must not be regarded as meaning disease. The duration of the period during which the flow occurs is about five days, but this again is subject to great variation, as is the interval between the times. Only when the variations are extreme do they constitute disease. Most women feel a sense of fulness and a little restlessness for a few hours before the flow commences. This is relieved when the flow is fully established, and when it is over a feeling of well-being succeeds. This again is the normal progress of the period; but, like everything else connected with it, this is also subject to variation. The slight malaise may be increased to fainting and prostration; the period may be preceded or accompanied or followed by pain in the body or back or distant parts, of all degrees from very trifling up to most agonising. The flow may also vary in its character as well as in its time of duration. Sometimes it lasts for a day and sometimes fourteen days; it may be thin and scarcely coloured, or it may be in clots. Each of these peculiarities as it constitutes disease will be discussed below. When menstruation is natural and healthy all that need be done is to take especial care not to take a chill during the time that it lasts. The clothing must be warm, and all exciting or exhausting pursuits must be as far as possible avoided. Sea-bathing must be particularly avoided. This caution is needful for strong young women, who have such confidence in their strength that they think they can do anything. The most serious consequences have followed this. The affections incidental to the period divide themselves into the following headings:-Appearing Late, Deficient (Scanty, Absent, or Checked), Excessive, and Painful.
Appearing Late.-The late appearance of the menses need cause no alarm if the general health does not suffer. Quack nostrums which are advertised for bringing them on must never be taken. Many a young woman has had her health completely destroyed by having recourse to these. A temperate mode of life, the avoidance of all alcoholic stimulants, coffee and strong or green tea; care in clothing, especially seeing that the feet are kept warm and dry; moderate open-air exercise-these are the best means to preserve the general health and favour the natural functions. It often happens that the state of the general health is the cause of their non-appearance. When, in addition to their absence, there are other bodily ailments, the following medicines will be found useful:-
Medicines.-(Two or three times a day.)
-Suited to patients of a mild and easy disposition. Pain in lower part of abdomen and across the small of the back; giddiness, fulness about the head and eyes; chilliness, cold hands and feet; sour taste in the mouth after eating; nausea and vomiting; loss of appetite, with desire for acids, and palpitation; disinclination for exercise, alternate laughing and crying, sadness, melancholy, painfulness of the head; the symptoms are worse in the afternoon and before midnight; pains frequently change from one place to another; symptoms are better in the open air while exercising.
-After Puls, when the latter has been insufficient, and in all cases which drag, especially if the patient complains of heat in the head, giddiness, and palpitation, short breath, loss of appetite, sickness after eating, loss of flesh, and depression.
-Cold hands and feet; disposition to diarrhoea.
-Delicate women, slightly made, weak chest, lively disposition, and tendency to lung disease; hacking cough with expectoration of blood at the period when the menses might be expected.
Deficient (Scanty, Absent, or Checked).
-In low conditions of health, and in the course of all wasting diseases, the menses are apt to disappear, gradually becoming scantier and paler each month, and at last ceasing altogether. When the health is restored the courses will reappear without any special treatment. In this case the general health is all that needs to be attended to. For the special condition known as Green-sickness or Chlorosis, see ANAEMIA. When the courses cease suddenly whilst the woman is otherwise in a state of health the condition is in itself more serious. The chief causes are exposure to cold, and especially getting cold feet, fatigue, and powerful mental emotions. Usually it is accompanied by constitutional symptoms, and needs proper attention, or serious disease of some kind, such as internal inflammation, will result.
General Treatment.-This is chiefly preventive. Women must be especially careful about the time of the period to avoid chilling and over-fatigue. The feet must be kept warm, and the shoes must be good. Rapid cold sponging in the morning, followed by brisk- rubbing, may be allowed, if the woman is used to a morning cold bath; but there must be no getting into cold water. Sea bathing is especially dangerous. If a chill has been taken, a hot foot- bath must be taken at once, and if that does not suffice to restore warmth to the whole body she must be put into a warm bed, with a hot bottle to the feet, and covered with a good supply of blankets.
Hot drinks must be given at the same time.
Medicines.-(Every hour till reaction sets in. Then at increasing intervals.)
Aconite 3 -After a chill or fright; the special indications are, congestion of blood to the head and face; redness of the face; giddiness, nausea, faintness; throbbing or shooting pains in the head, sometimes attended with stupor or delirium, feverishness, restlessness, hot, dry skin. If Aconite is taken at once when a chill has been taken, all the effects will be warded off.
-If Aconite has not been taken at first, Pulsatilla is the chief remedy. It is especially useful after exposure to cold and and damp, the chief indications being headache, chiefly on one side, with pains extending to the face, ears, and teeth; palpitation; feeling of suffocation; flushes of heat; nausea and vomiting; pressure at the lower abdomen; frequent desire to pass water; whites. It is especially suitable for person of mild, easy disposition, with a tendency to shed tears, and melancholy.
-In nervous headache; hysterical affections; frequent nausea and vomiting; pale, earthy colour of the face; coldness of the hands, feet, or nose; great weakness, with fainting fits.
-In nervous headache; hysterical affection; frequent nausea and vomiting; pale, earthy colour of the face; coldness of the hands, feet, or nose; great weakness, with fainting fits.
Nat. mur. 6.
-In debilitated, anaemic subjects, chills, cold feet, tendency to constipation.
-Pain in the loins; paralysis and weakness in the limbs; irritability of temper or disposition to melancholy; pressing headache, at the back or over the eyes; heat and throbbing in the head; confusion, giddiness; dim vision; dark circles round the eyes; voracious appetite; sour stomach; sour and burning eructations; heaviness in the abdomen; constipation, with tendency to piles.
Excessive.-Under this heading are classed cases in which the flow is too copious though the period is not prolonged; those in which it is too copious, and the period also prolonged, and those in which the periods recur too frequently, whether the flow is too copious or the time too prolonged or not. The effect of a woman losing too much every month is, as might be expected, the inducing of a state of languor which is hardly recovered from during the intervals. It is generally accompanied by pains in the back and body, and in the interval there is apt to be leucorrhoea.
General Treatment.-This will consist in care of the general health both during the interval and during the period. Warm clothing and generous, unstimulating diet are essential; cold sponge-bath in the morning during the intervals, followed by brisk rubbing with a rough towel, if reaction can be obtained. During the period the patient should lie down as much as possible.
Medicines.-(Three times a day during the interval; every two hours during the period.)
-When the period is always before its time and too copious. In chilly subjects; pale, cold, clammy hands and feet.
Nat. mur. 6.
-Profuse flow; in anaemic subjects with earthy complexion, tendency to constipation; chilly.
-Profuse discharge or bright red blood; when there is nausea.
-Dark, clotted, stringy, very copious, too early.
-Too profuse, too early; flow commencing and leaving again; pain in body.
-Accompanied with great debility; flow excessive and lasting a long time; debility afterwards.
-Most women feel a certain amount of discomfort at some part of other of the period, but in the majority it is not of such a degree as to constitute disease. Only when it is so serious as to interfere with the discharge of the usual duties does it need special attention. The pain is experienced severely in the lower abdomen, in the loins, lower part of the back, and in the limbs. It is of various characters-colicky, spasmodic, grinding, pressing, dragging, or bearing down. General Treatment.-Painful menstruation, or Dysmenorrhoea, as it is called, is often an expression of a low state of general health, just as neuralgia is, and often means over-work and under-feeding. When these conditions are remedied the affection disappears, and the period is passed through without difficulty. When attention to the general health is not sufficient to remedy the evil, recourse must be had to medicines.
Medicines.-(Every hour during the attack, or oftener if the pains are very severe; two or three times a day during the interval.)
-Violent, writhing pains in the body and back. One of the most useful of all medicines in the disease.
-Pressure from the small of the back towards the front of the abdomen and downward; colic, with tenderness of the lower part of the body when touched; discharge of dark-coloured, clotted blood.
-Heaviness, as if from a stone in the lower abdomen; violent pressure in lower part of abdomen and small of back, attended with sensation of numbness extending down the thighs felt most when sitting; pressure in lower bowel, with frequent ineffectual calls to stool; frequent desire to pass water.
-Writhing pains in the body, accompanied by nausea; pains in back and loins, as if dislocated; feeling as if bruised in bones of pubis; frequent desire to pass water.
-Colicky pain, with nausea and headache; cold sweat on forehead in the paroxysm; cold feet, hands, nose, great prostration, fainting.
Cessation of. See CHANGE OF LIFE.