Sabina – Paroxysmal discharge of bright-red blood, with bearing- down pains in the lower part of the abdomen, especially in women who have had frequent abortions, or who are approaching the climacteric period. It is eminently useful during the flow, but in may cases it is advantageously administered in the intervals as well, especially in cases in which there is irritation of the bladder or rectum.
Secale – This is a valuable agent in haemorrhage from the uterus, occurring in weak, cachectic, and exhausted women, with cold extremities, pale face, and small pulse, especially, in women whose systems have been debilitated by a long residence in hot climates. Like Sabina, it may be given both during and after the discharge.
Sulphur – This medicine is sometimes useful when given in the inter-menstrual periods to patients with unhealthy skins and scrofulous symptoms, the blood being black and clotted.
OTHER MEDICINES THAT MAY BE SOMETIMES REQUIRED.
– Acon, and Belladonna The former when there is severe congestive headache flushed face, throbbing temples, confusion, sensitiveness to light and sound etc.; and the latter when there is feverishness, palpitation, throbbing in the uterus, etc.
ADMINISTRATION – When the discharge amounts to flooding, the dose should be repeated every ten, fifteen, or twenty minutes, until flooding ceases. In less urgent cases every two, three, or four hours, as long as necessary.
ACCESSORY TREATMENT – The patient should spare herself, and maintain the recumbent posture a good deal for a few days before, and especially during the discharge; household duties, particularly lifting, or reaching anything high, should be avoided; also warm beverages, even of black tea, and excessive eating and the use of stimulating food and beverages. Cold water is the most suitable drink; injections of cold, or even iced water up the bowel are useful, especially if the patient is costive or troubled with piles; cool vaginal injections, with a female syringe, or the application of hot-water spinal-bags of the small-of-the-back for half an hour at a time, tend to relieve a congested state of the womb. In very severe cases, cold wet cloths suddenly applied over the abdomen so as to produce a shock, light covering, and the horizontal posture, are absolutely necessary; the hips should be as high or higher than the shoulders, so as to relieve the uterus of the column of blood, and the patient be kept cool, quiet, and free from excitement. So long as the tendency to menorrhagia continues, every kind of excitement should be restricted or avoided altogether.
PLUGGING THE VAGINA – Sometimes it may be necessary to plug the vagina. A sponge or handkerchief will do; but common cotton wadding, with the backing on it, makes the best plug. Whatever is used should freely smeared with glycerine, and have attached to it a piece of tape or twine to facilitate removal. Care should be taken to fill up and distend the vagina with the plug, otherwise the object of using it will be defeated by the oozing out of the blood at the sides. The plug should not remain more than twenty-four hours; if necessary it may be replaced by another. See also “Accessory Means” under “Flooding after Labour”
PREVENTIVE MEASURES – If an impoverised state of the blood is the cause of profuse menstruation, the defect must be remedied by nutritious and unstimulating diet, pure air, out-of-door exercise, etc. Residence in a tropical climate, or in a malarious or unhealthy locality, must be changed. An elevated place, sheltered from the north-east winds, on a sandy or chalk soil, is of great importance. Severe and persistent cases are much benefited by a temporary residence on the coast. Sea- bathing and the sponge bath, taken under favorable conditions, followed by good friction for several minutes by means of a bath- sheet or large towel, are of great service by correcting the defective activity of the cutaneous surface which so often co- exists with Menorrhagia. The cold sitz-bath is especially valuable; the water should be sufficient to cover the pelvis, while the feet and legs should be covered with hot flannel, placed against a foot-warmer or immersed in foot-pain of hot water. The exact temperature of the bath 55* to 65*), and the length of time the patient should sit in it (five to fifteen minutes), should be modified by the season of the year. The bath should be taken at bedtime, and on leaving it the patient should be dried quickly, and immediately retire to bed. Weakly patients should have assistance in their ablutions. Worry and domestic cares should, as far as possible, be avoided; the influence of these causes is very potent, and if not removed or greatly modified may neutralise all our best directed efforts.
14. – PAINFUL MENSTRUATION – MENSTRUAL COLIC (Dysmenorrhoea).
DEFINITION – The term Dysmenorrhoea is used to designate the condition in which menstruation is performed with difficulty and pain. The pain, the essential element, is of various degrees of intensity, and, like all uterine and ovarian pain, is chiefly felt at the bottom of the back and within the lower part of the abdomen. The menstrual discharge is generally scanty and imperfect; it may, however, be profuse, or in some cases the function may otherwise be healthily performed.
VARIETIES – Several forms of Dysmenorrhoea have been described. (1) The inflammatory, or congestive form occurs in plethoric patients or strong passions, who are fond of the pleasures of the table and of the gaieties of life; it is accompanied by the discharge of flocks of fibrin and false membrane from the interior of the uterus. This has been called membranous Dysmenorrhoea, hypertrophied portions of the mucous lining of the uterus being discharged. In this form the pain in greater on the left side, shooting along the edge of the false ribs, up to the shoulder, then down to ovary. “This is the most intractable and troublesome from of the disease. In a large majority of cases it follows abortion. Most women who have it have had an abortion in the early months or years of their married life, either accidental or induced. When this abortion took place, the lining membrane of the womb was peeled off, or exfoliated, and subsequently, with each return of the menses, a similar loss of this structure is sustained. The altered membrane may come away as a complete cast of the uterine cavity, but is usually thrown off in strings of shreds. Besides being a very painful form of the complaint, the woman sometimes suffering as much in real labour to get rid of these shreds or casts, it almost always results in barrenness. In many cases abortion depends upon this disposition of the lining membrane of the womb to detach itself at started periods (Ludlam). (2) Neuralgic Dysmenorrhoea, which occurs in the feeble and anemic, as after nursing, flooding, prolonged diarrhoea etc. This variety occurs in delicate girls of feeble constitution, or in women of full habit but inactive life or in those who are poorly fed and overworked. The flow is scanty, the pain paroxysmal, but not entirely absent, less when warm, aggravated by cold. (3) Spasmodic Dysmenorrhoea, from indigestion, nervous irritability, exhaustion, etc. In this form the suffering is in the back and the lower portion of the abdomen. (4) Obstructive or congenital Dysmenorrhoea, in which the pain is caused by the excessive flexure or insufficient calibre of the canal or passage which should convey the blood from the womb, producing partial and temporary retention of the menses. This variety also includes mechanical Dysmenorrhoea from Polypi, Cancer, fibroid or other tumors of the womb, which compress or distort the canal, or otherwise impede the exit of the menstrual fluid. The phenomenon may be thus explained to the non-medical reader :- Naturally the cavity of the unimpregnated healthy womb will only contain a very small quantity of fluid, and as soon as the menstrual blood accumulates, unless it finds free exist, it will distend the uterus, and thus give rise to pain, greater or less according to the sensibility of the patient and the amount of resistance.
SYMPTOMS – Severe bearing down pains in the uterine region, resembling the pains of labour, and occurring in paroxysms; aching in the small-of-the-back, loins, pelvis, and sometimes extending to the limbs; headache, flushed cheeks, hurried breathing, palpitation; cutting and pressing pains in the abdomen. The pain often increases in severity as the period approaches, becoming so intense that the patient cannot move about, but is compelled to lie down, and even roll about in agony. The pain sometimes precedes the flow several hours, or even days, and continues for a longer or shorter period, and may cause or continue when discharge is established. At other times the pain continues till a membranous substance is expelled, when a healthy discharge takes place, or it may entirely cease. In some cases, the breasts, the counterparts of the female generative organs, become extremely sensitive and painful. Patient subject to Dysmenorrhoea are generally troubled with confined bowels, frequent headaches, from congestion in the inter-monthly period, and are often sterile from abortion which occurs at the menstrual cycle.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."