Few diseases of women cause so much pain and suffering as this disease. Skene in his splendid work “Diseases of Women,” classifies dysmenorrhoea in five special forms, “the inflammatory, membranous, neurotic, obstructive and ovarian.” All of these are more or less painful and some of them exceedingly so. Each form has been accurately described by many authors in the numerous works on the “Diseases of Women.” Each writer has painted his word picture of misery and suffering with all his power of pen, yet none, I believe, has overdrawn this picture of suffering too strongly.
We have no space to devote to a description of the different forms above mentioned, with their manifold array of symptoms, for such is not the object of this treatise. In the end, all the literature that has been written upon the subject, has not satisfied the majority of practitioners. We feel that the true etiology of the disease has not yet been reached; the true cause is yet unrevealed. Why should the disease manifest itself in so many forms, with hardly two cases of the same form resembling each other? We must look elsewhere for causes, other than the causes specified in the works under which this disease is classified. One form is attributed to congestion, another to neuralgia, another to obstructions, another to the membranes, and still others to malformations of the organs, or to the various pathological states and conditions of the system.
It is true in some forms we do have pathological conditions present that cause great suffering at times, but the majority of cases are functional or neurotic, behind which lies some constitutional dyscrasia. Speaking of the cause of membranous dysmenorrhoea, the same author (Skene) says, “Discarding the current views regarding membranous dysmenorrhoea–that is, that it is due to inflammation, or else to the result of gestation-one is left without any very rational view to offer regarding its cause. While it is not, perhaps, the part of wisdom to discredit the views on any question in medicine until one has something more to offer, still, if the causes assigned can be readily shown to be incorrect, it is infinitely better and safer to be entirely in ignorance of the cause of things than to attribute them to wrong causes.” How true this is, but it is only occasionally that some one rises up as a doubter, and throwing to the winds the doctrines of the day begins to investigate for himself, choosing rather to be numbered with the minority and find the truth, than to be numbered with the majority and follow the traditions of men. The world today would materialize all cause, for nothing else, seems to satisfy the mind of the materialist. How happy and satisfied the pathologist is when he can locate the cause in some one particular corner or part of the body, in a muscle, in an organ, in a nerve center, in some ganglion, or even in a nerve ending.
When Hahnemann says, “Disease is a disturbance of the life force,” it means nothing to many of us, because we know so little about this life force that vivifies and animates the human body. It is necessary to understand the Hahnemannian life force theory, and the laws that govern it before we can understand anything clearly and distinctly about disease. We must also know something about the chronic miasms, before we can understand the true cause and the multiple changes in the phenomena of disease. One will attribute the cause of dysmenorrhoea to a rheumatic diathesis and another to Syphilis; still another to the strumous diathesis; this later is the tubercular, of course. Others have attributed it to external causes, and in a sense they are right, but when we come to study disease carefully from the standpoint of the chronic miasms, a different light is thrown upon cause and effect. We see disease in its true light, we can understand a dysmenorrhoea that is due to Psora, pseudo-Psora, Sycosis, or to Syphilis, or to any of the combinations of these great central disturbers of life. We are soon able to classify and to place each form of dysmenorrhoea, each individual case where it belongs, calling it, as the case may be, Psoric, pseudo-Psoric, Sycotic, of syphilitic. The writer has given the subject much study and thought, and in practice has seen wonderful results from prescribing the Homoeopathic remedy in dysmenorrhoea, both from the palliative methods and from the anti-miasmatics. It is of the latter that we wish to speak further.
We notice the tubercular forms of dysmenorrhoea more prominently than any of the others. The reason is that we meet it so frequently in practice, and having considerable knowledge of the tubercular diathesis we readily associate the two together. We see the rise and fall of the latent tubercular expression in the organism. No greater field exists for miasmatic action than in the reproductive organs and sexual functions of women. Today we meet in a great number of women some form of dysmenorrhoea. The whole organism is more or less disturbed during menstruation. Often from the crown of the head to the sole of the foot they are disturbed and manifest some from of suffering, all due to the presence of the tubercular element. “No function is ever perverted in a normal healthy organism,” and should not be accompanied with pain and suffering. Pain is always a signal of disease; its meaning denotes a penalty, a fine, or a punishment. A woman should have no suffering at the menstrual period; there should be but a simple consciousness of its presence, a little lagging of the forces of life, a pause, as it were, for the preparation. Indeed, we should have no more than a simple consciousness of the presence and action of any organ, yet we find in the menstrual function of women, who are affected with a sycotic or tubercular taint, every degree of suffering, even to the anguish of death, as the organs attempt to perform their periodical work. The sexual organs of the women of today are the great centers of disease, and especially is this true of the sycotic miasm, whose destructive and disturbing action has become an alarming factor to our best pathologists and ablest therapeutists. Often when therapeutic measures have failed, the surgeon has to be called in to remove a part or even all of the reproductive organs of women. Many times the surgeon’s knife is resorted to, simply because, as a therapeutist, he was not familiar with the effect of the sycotic poison (miasm) upon the reproductive tract. His therapeutic knowledge did not reach that far, thus in the end, he demonstrated his ignorance of the disease by removing the organ.
Thus did Pasteur say, when the silk worms of France became diseased, “Kill the silk worm.” So they say, “kill everything that is diseased; remove every organ that is diseased.” We had better become acquainted with these diseases, and recognize their destructive death-dealing principles, so that we may be able to analyze them and meet them on a therapeutic plane, and cure them with therapeutic measures.
The menstrual anomalies of tubercular patients are often pictures of dreadful sufferings from that dreaded miasm pseudo- psora. The flow is always accompanied with exhaustion and weariness. It comes too soon, is too copious and too prolonged, often assuming the form of hemorrhage. The patient feels badly a week before the menses appear and a week afterwards. The menstrual period is accompanied with severe backache, gastric disturbances, neuralgia, headaches, ovarian neuralgia, even diarrhoea and febrile states. Such is the picture of a tubercular case of dysmenorrhoea, with all its exaggerated conditions of function, and all its sufferings and phenomena of that exhausting and death-dealing principle, the tubercular element.
The menstruation of the sycotic patient is not prolonged like the pseudo-psoric one, and is seldom as copious. If it is profuse it is not so exhausting, nor so heavy a drain upon the sufferer. It may be very profuse for twenty-four hours or even a little longer, but it does not continue as in the case of pseudo-psoric for a whole week. (The flow of the sycotic patient has more of a spasmodic nature about it.) The tubercular have dark circles about the eyes, are hollow-eyed, pale, a worn-out, exhausted look; loss of appetite, nausea, vomiting, and diarrhoea are not infrequently present. Hysterical symptoms may arise in these cases in any degree of severity, indeed they are the most difficult cases of the kind we have to treat. The flow is at times pale, watery, and long lasting, as is seen in Calcarea carb. Kali carb and that class of remedies. Again it is profuse even to exhaustion, and of a bright-red color, inducing anaemia in young women whose ages range from seventeen to twenty-four. Occasionally the complexion becomes pale or assumes an ashen or yellowish hue. The menses are not infrequently followed with leucorrhoeas, palpitation of the heart, and loss of vitality generally; later on great weakness, flushing of the face, dry tickling cough, vertigo, hoarseness, and finally you have a well developed case of tuberculosis that might have been arrested earlier in life through a careful analysis of the case and a remedy selected on the pseudo-psoric symptoms.
The mental symptoms alone of these patients often furnish us with data enough upon which to base our pseudo-psoric remedy. These patients are sad, gloomy, full of fanciful notions, foreboding, are fearful, extremely sensitive, nervous and irritable. Sometimes they may pass through the menstrual period with but little suffering, but it is followed with prosopalgia of a prolonged and distressing nature. I have said little of the neuralgias, the many reflex symptoms, and untold sufferings of these patients. Usually in a marked case where the tubercular element is present, we have retroflexions and all sorts of malpositions of the uterus. Their sufferings date from an early period following puberty, within a year or two at least. In Sycosis, the neuralgias are displaced by the rheumatic element. In fact about all the pains of Sycosis are rheumatic. We have muscular rheumatism prevailing in many cases. Of course we have many pains that are similar to pseudo-psora, but on close analysis the rheumatic element can be traced back to the cause. Often they have muscular rheumatism at intermenstrual periods, lumbago or stiffness of the muscles of the neck and aching in the limbs. We have aching of the limbs in the tubercular, but it is accompanied with great weariness, with pelvic congestion so severe that they are unable to stand on their feet any length of time. In Sycosis the uterine pains are spasmodic, colicky, often extending over the whole abdomen, and generally felt in the membranes of the ovaries and tubes.
The remedies called for in sycotic dysmenorrhoea are Colocynthis, Chamomilla, Colchicum, Cyclamen, Rhus tox, Bovista, Actea racemosa, Phytolacca, Sepia, Lachesis, Medorrhinum, Nat. sulph, Caulophyllum, Gelsemium, Dulcamara and occasionally Pulsatilla, Arsenicum alb, Lycopodium, Nux vomica, Croton tiglium, Asarum, Viburnum opulus. These are a few of the sycotic remedies, but there are many others that we will call your attention to in giving the indication for the remedies. The miasmatic element will be mentioned under each remedy. The flow frequently comes in gushes with much pain, and is, as a rule, dark and clotted, as we have already mentioned. The menses of a tubercular patient seldom clot, they are more apt to be thin and watery or bright red and copious. The odor of the tubercular menses is like blood, while the sycotic is musty, or it has a fish-brine or stale fish odor. It is often irritating, corrosive, excoriating, producing pruritis at some period of the flow, generally at the close. The pruritis is a biting, smarting, itching sensation, and the discharge quite often excoriates, and produces an erythema of the parts with which it comes in contact. Often we find some form of salpingitis even to complete destruction of the ovarian tubes, or we may find any of the lesions mentioned in the beginning of their work.
When we have the tubercular element combined wit the sycotic we have the worst form of dysmenorrhoea to deal with. There is no worse combination outside of a malignancy than where dysmenorrhoea is based upon a tubercular basis with a sycotic addition to magnify all its phases. Usually in a typical sycotic patient, whether acquired or hereditary, there is some form of irritation of the bladder about the time of the appearance of or during the menses. The urine either passes frequently or in small quantities, or it is copious and frequent with more or less pain or irritation of the neck of the bladder. The menses are almost always dark, clotted, and difficult to wash out. Menstrual colic is frequent with ovarian pains and there is tenderness of the breasts during the flow.
Enough has been said to give the reader some idea of a case of sycotic dysmenorrhoea, and a fuller expression of it will be brought out as the indications for the remedies are given. The treatment should be continued until the patient menstruates normally or nearly so, which may take from three months to a year, and in some cases even two years. Prescriptions made during the inter-menstrual period are the most efficacious, as the acute expression has quieted down and the latent expression is shown more clearly, and upon this symptomatology it is better to base your prescription.