Midwifery and the diseases of women

by Joel Shew

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.

EFFECTS OF WATER-TREATMENT.

There is one remarkable fact concerning the effects of water-treatment, as affecting menstruation, which should here be spoken of. Where a vigorous course of hydropathy is practiced for chronic disease, the menstrual function, in some cases, ceases for months, and even a whole year or more. I had first to learn this fact for myself, no other practitioner ever having promulgated the doctrine, so far as I know. And it is a remarkable fact, that in such cases no injury arises from the circumstance; but the individual’s health grows, month by month, in all respects better. No inconvenience is experienced from the suppression, nor need the slightest alarm be felt. The probable reason why menstruation thus ceases is, that a vigorous action of the skin is caused by the water process; elimination, or the throwing off of the waste, morbid, and impure matters, is made to go on so rapidly and vigorously, that there is no need of the purification of menstruation at the time. This doctrine, however, is conjecture and mere speculation, and one that does not appear to be susceptible of positive proof. That the occurrence does takes place, and that women have, at the same time, been remarkably benefited in health; cured, as we may say, of long-standing and most obstinate chronic diseases, we know to be a fact.

But whenever retention of the menses occurs, and is not caused by pregnancy, or by the age of the individual, at which the function ceases naturally, or by a course of water-treatment, we are to suspect some derangement of the general health. This is a natural function, and if we find it ceasing when it ought to go on, we may safely conclude, that the efforts of nature are by some means thwarted; otherwise she would do her work.

CHLOROSIS.

Retention of the menses is very often attended with what is technically termed chlorosis.

The word chlorosis signifies a greenish, or greenish-yellow hue of the skin, and might, therefore, be applied to certain affections belonging to both sexes; but the term is “generally confined to that modification of amenorrhea, which is attended by a dingy-pale, or greenish color of the skin.” Chlorosis also goes often under the name of green sickness.

In this disease there is “heaviness, listlessness of motion, on the least exercise palpitations of the heart, pains in the loins, back, and hips, flatulency and acidity in the stomach and bowels, a preternatural appetite for chalk, lime, and various other absorbents, together with many dyspeptic symptoms.” In the progress of the disease the face and lips become pale, and after a time assume a more yellow hue; there is great general debility, flaccidity of the muscles, and not unfrequently, swelling of the feet and lower limbs; there is, in short, a great variety of symptoms, varying more or less, endlessly, as we may say, in different cases, and such as denote a very depraved state of the constitution generally.

This disease is sometimes cured spontaneously. The simple force of nature, acting also, perhaps, in consequence of favorable circumstances as to air, exercise, diet, clothing, occupation, etc., is often sufficient to effect a cure. Menstruation is brought on, and thus the individual becomes well; but in other cases the affection is of a very obstinate nature, and leads to disease of some important organ, as the womb, bowels, lungs, etc., and ends at last in death.