Symptoms. “The menstrual discharge consists of an abundant secretion of mucus mingled with blood. When the expected period is about to come on, the female is affected with a certain degree of discomfort and lassitude, and sense of weight in the pelvis and more or less disinclination to society. These symptoms are in some instances slightly pronounced, in others more troublesome. An unusual discharge of vaginal mucus then begins to take place, which seen becomes yellowish or nearly brown in color, from the admixture of a certain proportion of blood; and by the second or third day the discharge has the appearance of nearly pure blood. The unpleasant sensations which were at first manifested, then usually subside; and the discharge, after continuing for na certain period, begins to grow more scanty. Its color changes from a pure red to a brownish or rusty tinge, until it finally disappears altogether, and the female returns to her ordinary condition..–Dalton.
The original menstruation flux, as it issues from the uterus, is nearly pure blood; but in its passage through the vagina it becomes mingled with the acid, mucous secretion from the vaginal surface, which changes its quality and appearance. The menstrual discharge returns with great regularity in perfectly healthy females; but varies in quantity in different individuals, being quite free in some and scanty in others. Each menstrual period occupies from two or three to five or six days; and the whole amount of the flow may vary from three ounces to eight, according to the temperament and idiosyncrasy of the individual. Some plethoric persons having a very scanty flow; while in others, who seem to have no blood to spare, the discharge in much more free. And in some exceptional cases of persons apparently enjoying good health, the catamenia may differ from the normal standard in every respect. Those irregularities which are properly termed morbid will be considered in a separate chapter. During utero- gestation and lactation the menses are usually wanting; there are however exceptions, some women menstruation with their usual regularity, and while nursing; in many others, the menses return after the first few moments of lactation.
The causes of menstruation, must be identical with those of ovulation–from the intimate connection of these two functions, and from the essential dependence of the former upon the latter. The causes of ovulation must be found in the nerves which supply the ovaries. These form part of the ganglionic system, and are immediately derived from the solar plexus, which is the great centre of vegetative life.
All the actions of the human body may be considered as voluntary, as involuntary, or as partaking of the nature of both these conditions. Thus the bodily actions may be distinctly referred either to the cerebral or voluntary nervous system, to the ganglionic or involuntary nervous system, or to the spinal nervous centre, which is more or less influenced and controlled by each of the others. The involuntary functions, with which alone we are at present concerned, may all be classified as belonging either to the nutrition of the individual, or to reproduction of the species. Thus the ante-pubertal period is almost exclusively devoted to the nutrition of the individual, but not without reference to future reproduction, as is seen in the existence and even extrusion of the premature ova during all this period. During the child-bearing period, the nutrition of the individual is rendered unusually active and vigorous in order that it may subserve the reproduction of the species; and when both cannot be at the same time provided for, it is the former which gives way to the latter. This is seen in case of consumptive women who become enciente; the child flourishes at the expense of the mother, and is born comparatively healthy, while the mother dies from inanition.
Thus menstruation, as dependent upon the action of the ovaries, must find its immediate cause in the ganglionic nerves which supply these organs. And as forming, with ovulation, one of the important processes preparatory to conception, menstruation must finds its final cause in that grand function of reproduction of the species, to the perfect accomplishment of which all the energies of the individual life are devoted.
As we have already explained, menstruation is a function of health, which appears in the order of nature. And in those cases in which it does not take place so easily and so effectually as above described, it is because the young woman herself is not well. From ill-health arise then all the various forms of menstrual disorders; and it is merely as a matter of convenience that we arrange these disorders under the heads of Amenorrhoea, Dysmenorrhoea, and Menorrhagia. And in treating such cases we seek but to obey the call of nature; throw in the proper remedy and the function becomes established or re-established, as the case may be; because we thus cure the patient of some constitutional or other malady, under which he system is laboring. And in this connection, in the following chapter, we shall describe also those forms of actual Uterine Hemorrhage which are understood by the term Metrorrhagia.
