THE CHANGE OF LIFE IN WOMEN and the ILLS AND AILINGS INCIDENT THERETO by J. COMPTON BURNETT, M.D.
It stands in evil repute does the change of life in women; and when a more than usually curious patient enquires of us the nature of this or that, and we reply, “Oh, it is the change of life!” a more or less sufficient reason is thereby supposedly given, and the women is heard resignedly to exclaim, “Ah, I suppose I must except trouble at my time of life!” But why should poor woman except trouble at the change of life? That she does, a a matter of fact, often suffer at and after that time of life is all too evident; but again, Why?
Surely the thing can be accounted for, and measures taken to prevent, cure or palliate said sufferings.
Girls are more forward than boys at a given early age up to the looming of the menses, as any of us can see in our own families; but no sooner does menstruation begin than the superiority of the girl over the boy is at and end. The boy slowly gains upon her and becomes more aggressive, and the girl more retiring..
The explanation of this lies close at hand, -the girl’s digestion and assimilation are so arranged that she shall for some thirty years or so of her life’s course, from puberty to menopause, make blood enough for her own maintenance and activities plus what should or might be needed for gestation and lactation, the menstruation being primarily a means of maintaining her equipoise by throwing overboard at stated times a given not called for blood supply, prepared by the time of each ovulation as a possibly needed food reserve, which throwing overboard of said supercargo does not occur if impregnation of the ovule take place. It is this menstrual arrangement which must be kept in view if we are to understand the change of life and its sequels, and indeed if we are understand women’s diseases at all any period.
The resignation of many women to their various sufferings is to me often absolutely astonishing, and many times have I enquired of my professors, of books, of myself, and finally of old mother Nature, what this change really is. It is not a little instructive to work out clinical problems for one’s self, just as they really are, without the godfathership of schoolmen, who often seem to me to stand between truth and one’s mental vision; we very commonly learn our professor’s teachings only, and never see the things themselves.
Unobscured by Preconceptions
The importance of the change of life in the practice of medical men, notably in those who see much of diseases of women, needs no demonstration. The change of life is very commonly regarded as something positive that, so to speak, attacks the woman’s health, “I suppose it is all the ‘change’,” one hears very constantly.
Now, what is this “change of life” that causes so much misery to so many women?
I am treating a lady for haemorrhoids that bleed furiously here and there, causing alarming symptoms of faintness, so that tonics and stimulants are in constant requisition.
“My family doctor says I must undergo an operation for the piles, or I shall never get well, but I think myself it is all the change.”
I saw a lady yesterday for rheumatoid arthritis and lumbago; she is fifty one years age, and the ends of her finger bones are getting knobby, and the erstwhile elegant little hand, with tapering fingers, is becoming “full of horrid knobs,”…… said she, “I suppose it’s due to the change of life; you know I have turned fifty, and those things have left me.”
And continuing – “And these horrid flushes: my family doctor has given me no end of things for it, and Dr. Jones gave me Lachesis and you gave me Urtica, but nothing has done me the least bit of good.”
If we are to understand what a CHANGE of life signifies we must first have a clear notion of what that LIFE really is, that in its “Change” is so surest. Life in general, as common to both man and woman, I am here not dealing with, but with its modification as manifested in the female, and specifically with that part of her life which is called THE CHANGE, which change consists in the cessation of the monthly period, and with this leaving off of the menses seemingly begin the ills and ailings incident thereto. Not that they really begin in the individuals at the menopause they were for the most part there before only that at this time of life the manifestations change form.
In order to get clear idea of the subject are considering, we must first have a just conception of what the menstruation that here leaves off really is, so let us dwell a little on the subject.
We need not go far afield to get at the bottom of this function in its main essentials. The normal woman, as we all know, ovulates in certain known cycles in order to supply the ovule necessary for continuing the race, but as the ovule seeking spermatozoon may not be in the way, and in obedience to its own life-history, the ovule appears at intervals. Should the ovule meet at the proper trysting place, and there marry the spermatozoon, we have normal impregnation.
We have here nothing more to do with the ovule, the product of each menstruation; but we must see what good the menstrual flow itself may be, apart from being the medium of the ovule. The flow itself stands before our minds thus:- Suppose the monthly period were a mere ovulation and nothing more, how would matters stand? The woman would have nothing wherewith to nourish the impregnated ovule; with each ovulation there is a menstrual flow of the vital fluid; and if there be no impregnation, the flow is, as we have seen, cast away as waste, purely and simply: with the ovulation and for the contingency of an impregnated ovule, comes the flow.
After impregnation the period ceases. Why? Because the nourishment it contains is needed within the economy of the mother for feeding and building up the child, AND FOR STRENGTHENING the woman for the work of parturition, and then for suckling. The expansion and consolidation of the woman during gestation is very striking and remarkable, and for this extra growth food is required, and this can only come from her own blood.
Thus the normal woman’s digestion is equal to producing blood enough for himself, together with a monthly surplus, which goes to waste if the ovule meet with no spermatozoon; but if it does, and due fructification result, the woman’s organism simply goes on as usual, only the monthly surplus is here not cast away as waste, but is retained and used for building up the new being until it is born, and then during lactation there no monthly flow, as it is diverted into the breasts in the form of milk, to nourish the babe during the early months of its life till its teeth grow, and then in due course the breasts become dry, the female organism reverts to active menstrual life, and goes over the same ground again and again within its known limitations. But that is not all!
The Menses Constitute a Means of Purification for the Organism.
The monthly flow, however, subserves a further use, viz., that of purifying the woman’s blood and through it her organism; and here we must pause and fix upon our minds the importance of this monthly loss as a means of purifying the entire individual for the time being, for herein lies the central idea of this work.
With the monthly period the woman throws away her disease elements and products, her monthly period is a monthly purification.
Has any one ever seen normally menstruating woman in an acute attack of gout of the classic variety? I never have; clearly the gout is cast out menstrually. And so we observe that menstrually active women have- apart from their own peculiar ailings- by far fever diseases than the corresponding man. So much is this the case, that women commonly live longer than men, and this I attribute top their power of monthly purification, to a very large extent.
In my opinion it is very rare for a woman to die of childbearing, through deaths in childbed are not uncommon; at any rate I have rarely known a woman die “of” childbed: in childbed, yes.
Assuming that there is no danger of blood poisoning from the accoucher of nurse, or from food, air, or water, or what not, and assuming that the woman is well built, and that she have no CONSTITUTIONAL TAINT, then there is practically no danger in child- bearing.
Deaths in childbed are very largely due to pre-existing disease proclivities in the parturient person, and these are generally expressed by inflammation and haemorrhage. The most common causes of childbed mortality are certainly inflammation and haemorrhage.
Haemorrhage is, most usually, due either to a consumptive taint of the individual expressed in the pelvic parts, or to other locally expressed disease, and is no necessary part of child- bearing. That is to say, child-bearing is, in the normal and under healthy conditions, a healthy thing, fraught with absolutely no danger whatever to the parturient person, all danger is from the abnormal. A distinguished lady journalist wrote not long since that a women ” descended into the valley of the shadow of death in order to bear a child!”