Midwifery and the diseases of women

by Joel Shew

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.