For sudden suppression from taking cold, as by wetting the feet, there being headache, more or less fever, the pulse frequent and variable, pains in the small of the back and cramp like pains in the pelvic region, give, in alternation, Aconite and Pulsatilla, as often as every fifteen or twenty minutes in a violent case, and at longer intervals as the patient begins to get easy. Putting the feet into hot water, or taking a hot Sitz bath is very useful. If the patient is sick at the stomach, as is often the case, give lukewarm water freely and let her vomit; after which let her drink freely of water as hot as it can be safely swallowed, adding milk and sugar to make it palatable. The good effects that are often attributed to and experienced from the use of various hot teas in this affection, are, in my opinion, attributable more to the hot fluid alone than to any specific medicinal virtue in the substance of which tea is made. At all events, very hot drink with nothing but water, milk and sugar, is equally efficacious, and my medicine (a few grains of sugar of milk) put into the hot water, seasoned as above, has often obtained great credit, when the hot water was alone worthy. Rubbing the loins and abdomen briskly downwards with the hands of a healthy and vigorous nurse, will often excite the menstrual flow after a sudden suppression. If the head is hot, the face full and red, and the arteries of the neck and temples beat violently, give Bell. with Pulsatilla, and if the lungs are oppressed, use also Bryonia, giving the three in rotation. If, after the menstrual flow begins, there is still much pain in the pelvic region, give Caulophyllin, which will immediately afford relief.
Apis mel. is very servicable in suppressed menses of several days, or even weeks duration, where there is fever, redness of the face, and pain in the head, and pains in the hips extending to the limbs, especially if there is any tendency to bloating of the abdomen and swelling of the limbs or feet. It acts promptly and efficiently.
If the suppression has been caused by sudden fright or any strong mental emotion, Veratrum should be given in connection with the two former medicines. Should there be great fullness of the vessels of the head, or bleeding at the nose, Bryonia with Pulsatilla are to be used. Bell. is also useful in this case if the pain in the head is throbbing, especially if any delirium is present.
For suppression in young females, of several months duration, I have used, with much success, Podophyllin and Macrotin, one at night, the other in the morning, giving them for two or three weeks before the proper time for a return, and a day or two prior to the time, give also Pulsatilla, and give the three in rotation, a dose every six hours.
This practice has been successful with me in cases of long standing and apparently obstinate character. Where there is other disease, as an affection of the liver, lungs or stomach, this must be treated and cured, or the menses will not probably return. Great care should be exercised to keep the patient's feet and limbs warm, as upon this may depend her future health.
Dysmenorrhœa.—Painful Menstruation.
For this disorder, I know of no one remedy so valuable as the Caulophyllin, but Pulsatilla in many cases is efficacious, and as they do not prevent each other's action, I prescribe them in alternation, giving a dose every half hour, for a short time during the paroxysm, or until the pain abates to some extent, then every hour.
If there is pain in the head, sickness at the stomach, a kind of sick headache, as is often the case, with painful menstruation, Macrotin should be used with the others; Ipecac is the Specific for an excessive flow of the menses with great pain, especially if the stomach is nauseated. It should be given as low as the first dilution, and the tincture, in water, in the proportion of thirty drops to half a pint, injected into the vagina quite warm.
The application of extract of Belladonna to the neck of the uterus will often produce immediate and perfect relief. After the patient is relieved from the painful paroxysm, she should be treated so as to prevent a return of the pains at the next monthly period. Pulsatilla, Caulophyllin and Podophyllin are the three medicines that are most certain to effect this object. They are to be given, one medicine each day, a dose at night for three weeks, then morning, noon and night, until the time for the return of the menses, when they should be used oftener if there is pain. If the patient is inclined to be costive, Nux should be given at night for a few days before the menstrual period, in place of Pulsatilla.