SUPPRESSION OF THE MENSES.
Description.
In this disease there is a partial or total obstruction of the menses in women from other causes than pregnancy and old age. The menses should be regular as to the quantity and quality; that this discharge should observe the monthly period, is essential to health. When it is obstructed, nature makes her efforts to obtain for it some other outlet; if these efforts of nature fail, the consequence may be, fever, pulmonic diseases, spasmodic affections, hysteria, epilepsy, mania, apoplexy, green sickness, according to the general habit and disposition of the patient. Any interruption occurring after the menses have once been established in their regular course, except when occasioned by conception, is always to be considered as a case of suppression. A constriction of the extreme vessels, arising from accidental events, such as cold, anxiety of mind, fear, inactivity of body, irregularities of diet, putting on damp clothes, the frequent use of acids and other sedatives, &c., is the cause which evidently produces a suppression of the menses. This shows the necessity for certain cautions and attentions during the discharge. In some few cases it appears as a symptom of other diseases, and particularly of general debility in the system, showing a want of due action of the vessels. When the menses have been suppressed for any considerable length of time, it not unfrequently happens that the blood which should have passed off by the uterus, being determined more copiously and forcibly to other parts, gives rise to hemorrhages; hence it is frequently poured out from the nose, stomach, lungs, and other parts, in such cases. At first, however, febrile or inflammatory symptoms appear, the pulse is hard and frequent, the skin hot, and there is a severe pain in the head, back, and loins. Besides, the patient is likewise much troubled with costiveness, colic pains, and dyspeptic and hysteric symptoms.
Treatment.
It will be necessary, in the treatment of this disease, to remove urgent symptoms if they are present. If the patient is in severe pain, give the diaphoretic powders,[[3]] and at the same time let a strong infusion of garden thyme and pennyroyal be freely given. Immerse the feet in warm lye water, and rub well with coarse flannel. If relief is not obtained in the course of an hour, or in a very short time, a strong decoction of bitter herbs should be thrown into a proper vessel, and the patient steamed fifteen or twenty times, as long as she is able to bear, or until perspiration is produced; immediately after which let her be put in bed, covered warm, and the herbs be enclosed in flannel or muslin, and applied to the lower part of the abdomen or belly. This process will almost immediately relieve the urgent symptoms. After this our next object will be, to regulate the menstrual discharge, by a proper course of strengthening medicine; that recommended under the head of chlorosis, or a retention of the menses, may be taken with advantage. Inasmuch as both proceed from debility, it is evident that it must be removed in order to effect a cure; and, therefore, that medicine and treatment which strengthen and invigorate the system, will invariably benefit the patient. The skin, stomach, and intestines, all seem concerned in the production of this disease, and hence our attention should be directed to a restoration of their proper offices: the stomach and bowels should be cleansed and stimulated to a healthy action; perspiration must be promoted, and, in short, every secretion and excretion of the system. If the stomach is in a morbid condition, let an emetic be occasionally given, and afterwards a dose of mandrake; both of which may be repeated as occasion requires. The patient may then take the following tonic bitters: Take prickly ash bark, two ounces; wild cherry tree bark, two ounces; Seneca snake-root, one ounce; tansy, one ounce; gum socotrine aloes, half an ounce; devil’s bit, two ounces: pulverize; to every two ounces of the powder add half a pint of boiling water and one quart of Holland gin, and half a wineglassful taken three or four times a day. This may be continued while it agrees with the patient, or as long as benefit is derived. About once a month there will generally be felt more or less symptoms preceding a catamenial discharge; considerable pain will be felt through the lower part of the abdomen, hips, and loins, showing that there is a strong effort or struggle of nature to return the menses. Our principal object, when this occurs, should be, to aid her salutary efforts, as directed in the Retention of the Menses. The patient should sit over the steam of bitter herbs for ten or fifteen minutes, retaining the steam by means of a blanket, to concentrate it upon the lower part of the body; at the same time the feet may be bathed, and tansy tea freely drunk. The abdomen should also be fomented, as before directed. It will not be necessary, however, to use these means, except there is an obvious indication to return the menses.[[4]]
It must be recollected that when the patient labors under some other disease, there is such debility that there is not superfluous blood sufficient to keep up the menstrual discharge; and in this case our attention must be directed to the primary affection, without any regard to such symptoms; it is also very necessary to bear in mind the fact, that the menses are often suppressed from pregnancy. By a proper attention, we can always discriminate between a suppression of the menses and pregnancy; and the principal diagnostic symptom is, that in the former complaint there is a pain or affection of the head, attended with dizziness.