The menses are intended to relieve the womb of a quantity of blood sent to that organ each time an egg is matured and cast off. This blood is put to other uses in case the egg is fecundated, as it is called, that is, put into condition to become a new human being; otherwise it flow off, and at times it does not escape by the usual channel, but, instead, leaves the system through the nose, lungs, or some other outlet, giving rise to a discover known as vicarious menstruation. The patient feels as if the menses were about to appear, but they do not flow, or flow very scantily, while at the same time nose-bleed, or vomiting or spitting of blood does occur. Such losses of blood do not always indicate that the organ through which the blood flows is diseased, although it does indicate a tendency that way by reason of weakness of that organ, and it makes care for the health and rest during the menses imperative. Bryonia is the best medicine in such a condition, and should be given dissolved in water, in doses of a teaspoonful every hour to two hours while the periods lasts, and in tablespoonful doses twice daily during the interval between the periods. If this medicine be not sufficient to effect a cure, the case may easily be of such gravity as to require professional treatment.
Menstruation in health should be painless as well as regular. When it is otherwise we have the disorder known as dysmenorrhoea, meaning painful or difficult menstruation. This condition may depend upon several causes, and manifests itself by many symptoms. Sometimes deformities, displacements, or obstructions in the womb itself are the cause, sometimes nervous or other diseases, sometimes it is due to cold or to imprudence or exhaustion. The pain may be a colic, a backache, headache, a “bearing-down,” or something else, local or general, may be accompanied by the discharge of a membrane from the womb, or by scanty, profuse, intermittent, or variable flow. Such a catalogue of causes and effects makes it evident enough that a full plan of treatment for difficult menstruation can have no place in a work like the present; still some suggestions can be made.
The first thing to advise when there is pain with the menses is lying down so long as it continues. Lie on side, face, or back, as is most agreeable, but horizontal, and with the head rather low. The next thing to be thought of, especially if there be backache, is the hot foment–as hot as can be borne.
In preparing foments it is absolutely essential that a good thermometer be used, and one that will register as high as the boiling-point of water. First, place a rubber sheet or waterproof over the bed to protect it. Then have at hand a piece of flannel or old blanket, large enough to make a pretty solid roll eighteen inches long and three to four inches in diameter when rolled up. The patient must be entirely undressed. Water of exactly 115*F. should be brought to the bedside–not 115*F. by guess, but by the thermometer. The flannel is to be dipped into this water, wrung out, not too dry but so it will not drip, rolled up, and while the patient sits up in bed it is to be applied along the length of the backbone. This is to be done as quickly as possible, and the patient is then to lie back upon the flannel the nurse holding it in position while she does so, and then covering her with a sheet and blanket. The patient should lie quietly for ten minutes, and then the pail should be again brought, but this time containing water of 120*F., again exactly measured by the thermometer. Into this the cloth should be dipped, wrung out, and applied for another period of ten minutes precisely as before. After this interval the cloth should be wrung out for the third time; but now from water of exactly 125*F. Then it should be reapplied for another period of ten minutes, making the whole treatment last for half an hour. When this last period is over, water of 100*F. should be brought, and with this the back should be sponged off quickly, dried, and the patient allowed to lie quietly or to get up if she be well enough.
A foment should be given, as just described, twice a day, either before breakfast and supper or before the midday meal and bedtime, never sooner than two hours and a half after a meal. The cloths may feel pretty hot at first contact, but the skin soon becomes accustomed to them, and the patient finds the moist heat very soothing–a statement that will not hold true of dry heat, as applied by hot water bottles, sand-bags, and the like.
If the foments be well borne at the temperatures given, the next day each cloth may be made five degrees hotter, making the first 120*F., the second 125*F., and the third 130*F., and the next day they may be raised again to 125*, 130*, and 135*F., respectively, the “wash off” remaining at 100*. Hotter than this it is not often necessary to go for a young person, although still greater heat given in this way would not in the least scald or burn the skin, and the hotter the cloths can be borne the more serviceable they are in relieving pain. It is sometimes a troublesome matter for the nurse to wring out these very hot cloths. It may be done, however, by using a clothes-wringer, or by wrapping the wet cloth in a dry towel, or even by simply dipping the hands in cold water just before grasping the hot cloth.
For a medicine, the mother tincture of Viburn. op. is most generally useful, especially if there be cramps and colic-like pains through the bowels. It must be taken in doses of ten drops, mixed with about a tablespoonful of hot water, and this dose is to be repeated every two hours until the patient is relieved. If improvement follow the administration of this drug in this manner, it would be advisable to continue its us for the whole interval before the next period, but in smaller doses. Take five drops of the tincture morning and evening, mixing the dose with a tablespoonful of hot water. Another useful medicine is Gelsemium, if there be headache, dizziness, blurred vision, drooping eyelids, large quantities of urine, spasmodic pains, and also where a membrane is discharged from the womb. The dose will be five drops of the mother tincture in a tablespoonful of hot water, repeated once every two hours. This drug may also be continued till the next period if it prove helpful, but in the interval use only two drops to the tablespoonful of hot water, a dose morning and evening. Cocculus is often a useful remedy where the pains are like colic, worse by every touch and motion, and by cold, with a fitful flow of the menses. The patient is usually very nervous. Dissolve twelve globules of the medicine in half a glass of water, and give a tablespoonful every two hours. The same dose may be continued morning and evening till the next period. If difficult menstruation be associated with obstruction or pain in the bowels, a full injection of warm water containing a little castile soap is to be advised.
Very profuse or long-lasting menstruation, or a similar flow of blood from the womb between the menstrual periods, will demand treatment, as the loss of the vital fluid may be so great as even to threaten life itself. Abnormal growths in the womb, congestions of that organ induced, perhaps, by masturbation, or by imprudences of various sorts, bad conditions of the blood itself or of the blood-vessels, are among the causes of such bleeding, and several of these will demand professional treatment for their cure.
Rest on the back must be the main reliance in domestic treatment. If there be pain in the back give foments as described above. If enough blood have been lost o really weaken the patient and induce paleness of the face and faintness, China is the medicine. Dissolve twelve globules in half a glass of water, and give a tablespoonful every hour or two hours as needed. Of course, in this condition a physician will have been called. If the blood lost be bright red, and the patient complain of nausea, Ipecac. should be given as directed for China. If the periods be regularly too profuse and long-lasting, especially if they begin a little too early, and the patient be pale, fat, flabby, rather dull, and subject to cold feet, use Calcarea carb. between the periods for some months, dissolving twelve globules in half a glass of water, and giving a tablespoonful dose, morning and night.
The serious and sudden gushes of blood from the womb known as flooding, to which women are liable during pregnancy, abortion, or miscarriage, after labor, and at the change of life, require the attendance of a physician as soon as that can be obtained, and in the meantime such prompt measures as those at hand can apply. Lay the patient down flat in the nearest convenient place- on the floor is as good a place as any– and slightly elevate the hips by a pillow, cushion, or shawl rolled up. Apply a napkin, towel, sponge or anything soft to stop the flow of blood, and if possible without disturbing the patient too much, get the clothing off sufficiently to apply ice to the backbone. This can best be done by using small pieces of ice inclosed in a rubber ice-bag, but any other plan will answer. Neither cold water nor snow will substitute the ice satisfactorily, and the application should be to the lower part of the spine. Mix twelve globules of Sabina in half a glass of water, and give teaspoonful doses every ten or fifteen minutes, if necessary, till the bleeding ceases or the doctor arrives. Be very careful about disturbing the patient, even for the sake of undressing or getting her to bed. If she must be moved let it be in the horizontal position, unless several hours have passed without bleeding. Great care must be taken for days after such an accident, lest a strain, a jar, an exertion, or some excitement result in renewed flooding.
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,