Let the girl be taught that every menstrual period is a new evidence of her capacity to hand down to another generation, not merely her life, but her disposition, her mental power or weakness, her ambition, her faults, and shortcomings; that it is a reminder that she is responsible to posterity for her habits, and daily behavior, and that the important relations of her sexual life to every other part of her being, show that she should never fail to consider whatever she does in the light of its possible influence upon her children. Women, as a rule, are not properly prepared for the simpler, and more easily understood duties of child-bearing and nursing. Generally, a woman is thought to be a pretty good mother if she get her children up to their tenth year without making them, or allowing them to become, nuisances to her neighbors. But rare enough are the mothers who can claim to have successfully coped with their duties toward children in their teens, and why should not this constantly recurring flow be considered as nature’s way of reminding them of their life- work, in preparing for which they cannot by any possibility spend too much time or thought? Any young girl who is taught so to look upon her menstruation and sexual organs will be in very little danger of sacrificing her health and strength to the momentary, unsatisfactory, and degrading pleasure of masturbation, or of falling a victim to vice in any form.
Menstruation, or the monthly flow of blood from the womb, usually begins somewhere between the twelfth and the sixteenth year, and continues for about thirty years, during which time its only healthy interruptions are those occasioned by pregnancy and nursing. The periods in health are regular, except for a time near the beginning, and again near the close of the reproductive portion of a woman’s life, which is that portion during which menstruation continues. But regularity with respects to the periods does not mean the same thing for every woman: for with some, two weeks is the usual interval, with others, six, while still others experience a regular return of the “courses” at almost any time between those limits. In other words, every woman is a “law unto herself,” and what is regularity for her must be determined by observing the usual interval at which this function is repeated by her body under ordinary circumstances. Health simply requires its regular performance, not its repetition at any stated time. And the same thing is true with regard to the duration of the flow. With some it is two days, with others, ten; some lose a tablespoonful of blood, others, half a pint. As an average, however, it may be said that menstruation returns once is twenty-eight days, and lasts five days.
The Derangements of Menstruation consist of irregularities in the quantity, quality, duration, or frequency of the flow, and of various symptoms associated with the function. More or less irregularity is to be expected at the establishment of the flow, and two very important things should be remembered by those who are in charge of a girl during this epoch: First, no amount of irregularity in the periods or of delay in the appearance of the flow will warrant medical interference, unless there are other symptoms indicating deranged health; and, second, the establishment of this flow is an important effort of the body, requiring all the nervous energy that can be spared from absolutely essential vital processes, and for this reason, as little as possible should be required of the girl’s mind and muscles, till the new function is thoroughly well established, and proceeding regularly and painlessly.
When a girl nears her “teens,” or comes to about the age at which her mother began to menstruate, she should be watched with extra care, and any disturbance of health should be met by prompt measures. If nature be engaged in establishing menstruation, more or less indefinite pain, languor, loss of appetite, and disinclination for society and regular employments are to be expected, and should be the signal for laying aside studies, work, and every taxing employment. Let the dictates and even the caprices of appetite have much weight in the selection of food, so long as no attempt to eat positively indigestible articles is made. If breakfast be not wanted, do not urge it–the patient has other work on hand in the body more important for the present than the digestion of food, and there is no danger of starvation before the appearance of the sense of hunger. But hold in check the ambition of the girl herself, or of her teachers, which would ignore the demands of the body for the sake of accomplishing a certain amount of study or other work in a certain time.
During the actual continuance of the first period the girl ought to lie down, and if there be any pain or disturbance of general health at subsequent periods, the same rule should be observed till the flow is well established. The relationship of this function to the whole mental, moral, and physical life of the woman is so very important that too much care can hardly be bestowed upon the girl during its establishment. All the little ailments and whims which at another time might better be repressed and ignored, should now be considered in their possible relation to derangements which, if allowed to become seated at this crisis, may result in permanent ill-health and disability. It is far better to allow nature even a year or two of entire freedom from ordinary demands at this time, that she may perfect the body and its functions on the sound basis of health, than it is to crowd studies, piano-practice, and other taxing employment at the cost of a life of invalidism. Usually between the periods the girl will feel as well as usual, and it will be sufficient to keep her at rest on the back while the flow actually continues. But if her ill-feelings demand attention at other times they should not be neglected.
If the first menses do not appear at the time they are expected, but other symptoms of general disturbance of health are present, the case demands investigation. Possibly the membrane that closes in the vagina in many (not all) women is without an opening for the escape of the blood. This is a condition that can only be discovered by local examination, and the person who should thus examine is, of course, the mother. A “maidenhead” without an opening is not difficult of recognition, and the cure for it is a surgical operation. Possibly the obstruction may be more serious and deeper, or there may be, in very rare cases, no vagina at all. Such things demand a surgeon’s attention, and if present where menstruation is attempted by the womb, will occasion heaviness, fulness, and swelling in the lower part of the abdomen, backache, nausea, swelling and tenderness of the breasts, constipation, and other symptoms requiring careful professional treatment.
When backache, “bearing-down” pains, headache, and lassitude indicate that nature is endeavoring to bring about the monthly flow, but nothing is seen of such flow, and no obstruction can be discovered, a warm foot-bath may be tried as a stimulant to the function. Let the water be at 110*F.–measured by the thermometer, and not guessed at-deep enough to come up well on the ankles, let it contain two teaspoonful of ground mustard, and let the patient sit quietly with her feet in the bath for full thirty minutes. The bath and lower part of the body should be covered by a sheet or blanket to keep in the heat and guard against draughts. Such a bath may be advised for a similar purpose at any time of life; but cold bathing of any kind should always be entirely omitted during menstruation, no matter how well and strong the patient may think herself. Baths, of whatever character, should never be taken within less than two and a half hours after a meal, and a good time for a warm foot-bath, such as just described, is immediately before retiring.
If a medicine be required for delayed or suppressed menstrual flow, either at its first establishment or later in life, Sil, or Pulsatilla will be most likely to be indicated. Silicea should be given in tablespoonful doses, morning and night, using a solution of twelve globules in half a glass of water, when the patient complains of a hot head, with pain and dizziness, backache, sweating feet, has a tendency to boils, and itching or soreness about the sexual organs. Pulsatilla should be given in similar doses, four times a day, to a patient who complains of chilliness, want of appetite, especial aversion to fat foods, pains that are constantly changing both locality and character, and who is better in the open air although, perhaps, not anxious to get out of doors. This medicine is often of service where the failure of the menses to appear can be traced to wetting the feet or to cold. Sometimes failure of the menses to appear in those who are fat and flabby, who sweat much about the head, have cold feet, are pale and lack vitality, may be corrected by giving Calcarea carb. dissolved in water, a tablespoonful four times daily.
Member New York State and County Homoeopathic Medical Societies ;
Formerly Staff-Physician to the College and Wilson Mission
Dispensaries ; Fellow of the N. Y. Academy of Anthropology ; Member American Historical Association,