MANAGEMENT AT THE CHANGE OF LIFE.
The explanation I have already given will indicate to you the nature of the general management which should be employed at the period of the cessation of the menstrual function.
I have said it should be regarded as a natural change in the system. The best local and general treatment that can be adopted, therefore, will be that which is calculated to fortify and invigorate the general health. Every thing in diet, exercise, bathing, the daily occupation, and the moral and mental habits of the individual, should be, as far as possible, regulated according to physiological principles, and the laws of health.
Especially let not fear excite in you any unnecessary alarm respecting this period. Trust nature, and do by her properly, and she will do safely, faithfully, and efficiently her own work.
Those methods of dosing and drugging the system which have by many been practiced on such occasions, are, as a general fact, pernicious, doing a great deal of harm. Those especially who take powerful, and so-called expulsive medicines, with the view of forcing nature to continue the menstrual discharge, render themselves liable to serious injury. It is easy thus, by, as it were, a single misstep, to seal the inevitable doom of life-long ill health.
Doctor Dewees, in speaking of the great advantages of a well-regulated regimen in securing the woman against injuries which may arise from the irregularities of the menstrual discharge at this period of life, judiciously observes, “that a well-ordered course of exercise in the open air in well-selected weather, and great simplicity of diet, is of the utmost importance to the female, and should never be neglected, if it be possible to indulge in them.”
By these means, the nervous, muscular, vascular, and lymphatic systems are all preserved more certainly in equilibrium with each other, since they are the best calculated to insure a reciprocation of their respective offices, and, consequently, to maintain that condition of the system termed health. Hence the justness of the remark, that the women who live in the country, and exercise freely in the open air; who have fulfilled their duties scrupulously as mothers, by suckling their children agreeably to the views of nature; who do not goad their systems by over-stimulating food and drinks; who do not relax their bodies by too long indulgence in bed, have but little suffering at this period.
The advantages of a suitable degree of care in regard to exercise, diet, and all those habits that tend to the promotion of the general health, will likewise appear evident when we take into consideration the manner in which the system is sometimes found to suffer at this period.
During that part of the woman’s life in which menstruation occurs, the constitution is under the necessity, so to say, of forming not only a sufficiency of blood for its own support, but a superfluous quantity for the purposes of menstruation. Now it must be the order of nature, that in a healthy and well-balanced constitution, enough blood only will be elaborated for the normal purposes of the economy; but if too great an amount is formed after the menses cease, there will be no outlet for it, and as a consequence, there will be, perhaps, fullness and congestion of the head, and other symptoms of plethora.
For this reason, physicians have often thought it necessary to abstract blood, and to use other depletive means. But I am led here to remark, how very much better, under such circumstances, it would be to employ fasting, or, at least, a proper degree of abstinence, and the other measures calculated to keep off too great fullness of the body. Nothing in the world is easier—provided a woman has sufficient control over herself, and perseverance—than to vary to any desirable extent, the quantity of blood in the system; and all physicians agree that it is far better to regulate these matters by diet, and other hygienic measures, than to have to resort to bleeding and cathartics, provided that it can be done.
The practical deductions to be drawn from these remarks then, is, that if, at the change of life, the woman feels any of the symptoms of plethora and too great fullness in her system, she should adopt all good rules in regard to the improvement of the general health, and she should be especially guarded in reference to the amount and quality of food taken. In so far as she attends to all these matters, will she be more than doubly rewarded for her patience, her perseverance, and her self denial.
In conclusion, I remark, that if any one of you who is about arriving at the turn of life, feels that you are growing old, that you will be less attractive to those about you, and that you will enjoy less of the social pleasures of life after this change has taken place, there is yet a comfort for you, even in this world. You will now no longer be subject to those monthly troubles which, for these thirty years, have been your lot. All the annoyance, the irregularity, the tardiness, the suppression, and the pain—these all are now gone from you, no more to return. No doubt you may feel sad as the sighing wind reminds you in the autumn that we can be young but once. We all feel sad at times when we think how age is creeping upon us. But may I not say to you, there is yet that which can make us triumph over all of these things, yea, over death and the grave.
LETTER V.
OF MENSTRUATION.
Tardy and Suppressed Menstruation—Chlorosis—Sudden Check of the Menses.
One of the most important of all subjects connected with the health of females, is that of disordered menstruation.
You will find, as you read medical works on Females, the word amenorrhœa, which signifies a partial or total obstruction of the menses in women, from other causes than pregnancy and old age. You will find, also, the words menorrhagia, signifying an immoderate flow of this discharge, and dysmenorrhea, meaning difficult or painful menstruation.
Before proceeding to speak of obstructed menstruation, I ought to make some remarks upon the too tardy appearance of this discharge.
As I have before observed, the catamenia usually appear at from the fourteenth to the fifteenth years of age. Now, when there is a failure on the part of nature to bring about this state of things, there is not unfrequently a great deal of anxiety experienced on the part of mothers and those most intimately concerned. If, likewise, the girl at this time is attacked with any particular ailment, it is almost sure to be attributed to this cause. Too often, under these circumstances, she is also subjected to various modes of medical treatment, with the view of forcing nature into that sort of work which it is believed she ought to do, but will not. Now, the effect of such a course can be only harmful, as a general fact. To aid nature, it should be remembered that we must increase her powers, and not diminish them, as is almost necessarily the case if a course of drug-medication is practiced.
Please notice, then, that I wish to persuade you that this plan of drugging the system for tardy menstruation is a most unwise and unnatural one. Attend well to nature, and nature will take care of herself. Let me give you a few words from an honest, good man, Dr. Dewees, who years ago went to his long home. He says:
“Our exertions in favor of such patients, should tend to the invigoration of the system in general, and the development of the uterine system in particular. The first should be attempted—First: By the establishment of a regular course of exercise; such as riding on horseback, when practicable; walking in proper weather; skipping the rope within doors, when the weather will not permit exercise abroad; dancing moderately, and with strict regard not to become overheated, and cooling too suddenly. Secondly: By proper attention to dress; wearing flannel next the skin in cold weather, and properly protecting the feet and legs against cold; carefully avoiding damp and wet places, and partial streams of cold air, especially when warm. Thirdly: By a diet of easily-digested substances, both of the vegetable and animal kind; avoiding all stimulating drinks, such as wine, spirits, or beer, etc., under the specious pretext of their being strengthening.”
I give you these words, not that I would altogether agree with every idea advanced, but because of the general worth and correctness of the remarks, and the high authority from which they come. I do not believe it best for any one to wear flannel next to the skin, but I do believe in guarding the body sufficiently against cold, a thing which young ladies too often neglect. Dancing, too, as a general rule, cannot be regulated in the way it should be; and as for animal food, it is not necessary, to say the least.
I do not wish to appear to be fault-finding with your sex; but I must say, in all frankness, that some have taken an unreasonable course in regard to bringing on the courses, when they are tardy. The following case happened to a physician of eminence: The girl was a most amiable and interesting creature, for whom he was requested to prescribe for the expected menses, but who had not one mark which would justify an interference, and especially as she was in perfectly good health. She was fifteen, it is true; and this was all that could be urged by the mother in favor of an attempt to “bring down her courses.” He relied too much upon the good sense of her anxious parent, and freely explained himself to her. She left him apparently satisfied with his reasoning, and he heard nothing of the poor child for six months; but at the end of this time he was suddenly summoned to attend her, as she was said to be alarmingly ill.
When he saw her, she was throwing up blood in considerable quantities from the lungs; she died a few days after from the excess of this discharge. The distracted mother told him, that though she appeared satisfied with what he had said when she left him, she was convinced he was wrong, and that her daughter’s health required the immediate establishment of the menstrual evacuation. With this view, she determined upon the trial of a medicine of much celebrity in similar cases, vended by a quack. She procured it, and gave it according to direction; in a few days her daughter became feverish, lost her appetite, and frequently vomited; her strength failed, and after a short time she was confined to her bed. She called upon the “doctor,” and made known to him the condition of her daughter; he encouraged her to persevere, and told her that the fever, etc., was an effort nature was making for the end proposed. She persevered, fatally persevered, for in a few days she lost her lovely and only daughter. The medicine given in this case proved, on examination, to be the oil of savin (juniperas sabina), a most active poison, and one which, in the smallest doses, has been known to produce disastrous results.