MENSTRUATION

Though this is not a disease, but a healthy function, and as, from various causes, derangement of the function occurs, it is proper that it should be perfectly understood. Menstruation is the term applied to the phenomenon that attends the rupture of what is called the Graafian follicles of the ovaries and the discharge of an ova, or egg. It is a bloody discharge from the female genitals; not differing from ordinary blood, excepting that it does not coagulate, and in its peculiar odor. The blood comes from the capillaries of the womb and vagina.

MENOPHANIA, OR THE FIRST APPEARANCE

of the menses, is usually preceded by a discharge of a fluid whitish matter from the vagina, by nervous excitement, and by vague pains and heaviness in the loins and thighs, numbness of the limbs, and swelling and hardness of the breasts. The first appearance is an evidence of capacity for conception. It generally appears about the age of fourteen, but varies from nine to twenty-four years. In warm climates women begin to menstruate earlier and cease sooner than in temperate regions; in the cold climates the reverse of this holds as a general rule. The manifestations of approaching puberty are seen in the development of the breasts, the expansion of the hips, the rounded contour of the body and limbs, appearance of the purely feminine figure, development of the voice, and the child becomes reserved and exchanges her plays for the pursuits of womanhood.

More or less indisposition and irritability also precede each successive recurrence of the menstrual flux, such as headache, lassitude, uneasiness, pain in back, loins, etc. The periods succeed each other usually about every twenty-eight days, although it may occur every twenty-two, twenty, eighteen, fifteen, or thirty-two, thirty-five, or forty days. The most important element is the regularity of the return. In temperate climates each menstrual period ordinarily continues from three to six days, and the quantity lost from four to eight ounces. The menses continue to flow from the period of puberty till the age of forty-five or fifty. At the time of its natural cessation the flow becomes irregular, and this irregularity is accompanied occasionally by symptoms of dropsy, glandular swellings, etc., constituting the critical period, turn or change of life; yet it does not appear that mortality is increased by it, as vital statistics show that more men die between forty and fifty than women.

DUTY OF EVERY MOTHER

or female in charge of a child in whom age or actual manifestations suggest the approach of puberty to acquaint her with the nature of her visitation and the importance of her conduct in regard to it. She should be taught that it is perfectly natural to all females at a certain period, and that its arrival necessitates caution on her part with regard to exposure to wet or cold. The author has made the acquaintance of the history of many cases of consumption and other diseases which were directly induced by folly and ignorance at the first menstrual flow.

 The child is often kept in extreme ignorance of the liability of womanhood occurring to her at a certain age, and, hence, when she observes a flow of blood escaping from a part, the delicacy attached to the locality makes her reticent with regard to inquiry or exposure; she naturally becomes alarmed, and most likely attempts to stanch the flow by bathing or applying cold water to the part, thus doing incalculable mischief.

This purely feminine physiological function should be well studied and understood by all females. At least, they should know that the phenomenon is a natural one, liable to disorder, and that the best interests of their general health demands care and prudence on their part to maintain regularity, etc., of the flow. Disregard of such a duty will surely entail much misery.

DELAYED AND OBSTRUCTED MENSTRUATION

When the menses do not appear at the time when they may naturally be expected, we call it delayed or obstructed menstruation. It is, however, of great importance to know whether a girl is sufficiently developed to make it necessary for the menses to appear, although she may have reached the proper age. As long as the girl has not increased physically, if she has not become wider across the hips, if her breasts have not become enlarged, and if she experience none of the changes incident to this period, an effort to force nature is positively injurious.



In this case a general treatment will be called for. She should be required to exercise freely in the open air, retire early to bed and rise at an early hour in the morning. She should not be allowed to be closely confined to school, if attending. Her diet should be generous but free from all rich food, which will disorder the stomach. If, however, she is fully developed, and she suffers from time to time from congestions of the head, breast or abdomen, it will be necessary to interfere. The following are symptoms which will generally be found in these cases: Headache, weight, fullness, and throbbing in the center of the cranium and in the back part of the head; pains in the back and loins; cold feet and hands, becoming sometimes very hot; skin harsh and dry; slow pulse, and not infrequently attended with epilepsy.

TREATMENT

It is well for the patient, a few days before the period, to take a warm hip bath or foot bath twice a day, and at night, when retiring, to apply cloths wet in warm water to the lower part of the abdomen.
The bowels should be kept open by some mild catharsis, as castor oil or a pill of aloes. If there is pain and fullness of the head during the discharge, or before it, use the following:

Tincture of aconite leaves,	Two drams;
Tincture of belladonna,	One dram;
Tincture of cantharides,	One dram;
Morphia,	Three grains;
Simple syrup,	Quarter ounce.

Mix. Dose: One teaspoonful three times a day. If the pain is severe it may be taken every two hours.

Between the monthly periods, if the system is weak, the following may be taken:

Precip. carbonate of iron,	Five drams;
Extract of conium,	Two drams;
Balsam Peru,	One dram;
Alcohol,	Four ounces;
Oil wintergreen,	Twenty drops;
Simple syrup,	Eight ounces.

Dose: Two teaspoonfuls three times a day. Shake the mixture before using.