Change of Life in Women; Its Ills and Ailings
Of course we do not except to find any virus-disease from without as peculiar to the Change of Life. The English name – change of life – is singularly appropriate:it is what its name implies and nothing more. The woman who is really in sound health – i.e., of good constitution – is quite a swell at and after the change as before.
A good constitution does not then become bad. It is, as it were, sleeping dogs that then wake up to bark and bite; hence it is that we must early look to the principle of heredity to get correct and helpful views of the troubles that be set a woman at the change, notably where they have lain more or less latent prior thereto. Manifestations of gout and rheumatism are most common.
Goutiness – Arthritism
Like begets like, which no one can gainsay; but as two beget one, we have a third entity whose qualities are not absolutely apparent. When we learn to read, and come across a new word, we spell it; so it is with the hereditariness of disease. I have occupied myself a good deal with this question, and hope to say my say thereon in due course.Here I must confine myself to its bearings on the subject matter of this book.
The offspring of a gouty parent must be gouty more or less, unless indeed the one of the twain completely neutralizes the other, which is conceivable, but not probable. The girl that comes of a gouty father will teethe goutily; she will menstruate goutily; and at and after the change of life her ills and ailings will be gouty.
Many times I have remembered this point in the troubles of dentition with much advantage. Even in using the Repertory it throws a valuable side-light on the case, and helps. My two big guns in gouty menopause are – Bursa Pastoris 0 and Pulsatilla 0.The similitude is very small; the dose must therefore be material, a few drops of the tincture; and on the treatment of gout I may fairly refer to my own monograph on the subject, Gout and its Cure. Boericke & Tafel, Philadelphia, 1895. in which what I know of gout may be found. Bursa Pastoris 0, ten drops in a teaspoonful of warm water at bedtime, is a very frequently indicated remedy in gouty ladies at the change of life. The gouty diathesis must be treated on its own merits in a woman just the same as in a man.
Note on Bursa Pastoris
In my judgment, as I have elsewhere stated, the Shepherd’s Purse in pronouncedly a uterine medicine. It is a very notable remedy in uterine sterility – pregnancy frequently occurring during its use. A gentleman was under my professional care for frequent nocturnal micturition of a gouty character, and I ordered him Bursa Pastoris 0, ten drops in water at bedtime. On April 8th he wrote me that he could not take such a large dose, as it caused him “aching and fullness in the head, worse in the morning.” At my request he resumed the medicine (Bursa ) in four -drop doses.
June 10th. – On this day he bought the medicine back himself to me in the original half-ounce bottle, still two-thirds full of the tincture, complaining very much of its ” nasty rotten drain smell,” and saying he could not take any more of it, for says he, ” it flushes my face so much that I cannot take it; I only took three drops this morning, and just see how it has flushed my face.”
This symptom being pathogenetic, we thus get another remedy for the flushes, and it would be additionally indicated in gouty individuals, for Bursa pastoris often produces a notable output of gravel.
And, referring again to the Flushes, our apotherapeutists score one in the palliative treatment of this trouble; thus we read in the British Medical Journal of April 24, 1897, a note by Dr. Fosbery, of Bournemouth, as follows :-
“Severe Climacteric Flushings Successfully Treated by Ovarian Extract
“As medication by various glands is still on its trial, except perhaps, that of the Typhoid in Myxoedema, individual experiences, if recorded, will help in estimating rightly its value, and in indicating the class in which treatment may be used with benefit. It is with this object I record the following case :-
“Miss C., aged fifty-two for more than three years suffered from severe menorrhagia, and during part of that time from metrorrhagia also. The latter was relieved by the removal of a pedunculated polypus growing from the cervix. The menorrhagia, however, continued, the periods occurring about every three weeks, and lasting a fortnight or even three weeks. The bleeding was very severe, and not influenced much by drugs, though Ergot (both by mouth and hypodermically), Hydrastis, Liquor Ferri Perchloridi, Potassium Bromide, Hazeline, Arsenic and Thyroid Gland were tried. During the last two periods, however, Calcium Chloride in scruple doses, three times a day, seemed to have a good effect, but this might have been due to the natural close of menstruation. Frequent plugging of the vagina, sometimes twice a day, was the only means of controlling the haemorrhage, with iced injections on removal of the plugs. Hot douches were not so effectual as the cold.