Females, whether married or single, appear to be equally subject to this disease. In some cases, marriage appears to cure it; in other cases, it would seem that it caused it.
A change of air, such as leaving a city to reside in the country; or perhaps on the contrary, in some cases where persons remove from the country to the city, the affection ceases.
Effects of Pregnancy.—Pregnancy appears sometimes to break in upon the disease, and cure it; but it is far oftener true, that females who suffer from dysmenorrhea, are incapable of conceiving. Oftener, in this disease, there is a too scanty flow of the menstrual discharge. Sometimes, however, it commences with little or no discharge, but ends in a very copious gushing forth of the menses, which brings entire relief from the pain. “A membranous substance, or small coagulum, is discharged; if it be a membranous substance it will be found of unequal size, sometimes small, at other times large; and sometimes it resembles the cavity from which it has been expelled; at other times it will be broken into many fragments. After the expulsion of this substance, the woman enjoys ease, unless there be a fresh production, in which case it requires for its expulsion fresh contractile exertions of the uterus.” Dr. Denman regarded the secretion of this membranous substance as a mark of barrenness, and says that he never knew a female conceive, in whom it was formed. This rule, doubtless, often holds true, but not always, as observation proves.
Causes.—The causes of this disease are plainly the same, or very similar, to those which operate greatly to deteriorate the general health. “It would perhaps be very difficult,” says Dr. Dewees, “to assign all of its remote causes. The most common are the application of cold during the flow of the menses; taking cold after abortion; and in some instances it follows the beginning of marriage; but in other instances the causes are so hidden as not to be cognizable; the married and single are alike subject to it.”
Treatment.—Immense mischief has been done in this disease by the administration of powerful medicines. A disease so obstinate in its nature as often to call forth the greatest endeavors on the part of the physician to cure it, has been combated, in instances innumerable, by the most potent drugs. Nor are these poor suffering patients backward themselves to swallow any opiate, anodyne, or antispasmodic, however powerful and however harmful it might prove to the general system, if there is any prospect of obtaining present relief.
As this is one of the most painful affections to which human nature is subject, I will enter particularly into a consideration of the means to be employed to cure it. We may divide the treatment into two heads:
1. That which relates to the general health; and,
2. That which relates to the time in which pain is experienced.
As to the first of these considerations, all that I have said or can say in these letters respecting the means and modes of improving the general health and stamina of the system, should here be brought to mind. The second of these indications, however—that of relieving pain—I will endeavor to explain fully.
I must tell you that I have studied and practiced the healing art now a considerable number of years. I have endeavored to learn the truth in this important mission of healing the sick. I now, therefore, solemnly declare to you, that in the whole range of the medical art, so far as I have been able to learn it, I know of nothing that excites in my mind a more lively interest, or a more thankful feeling toward the Author of our being, than the adaptation of cold water as a means of relieving the pain and agony which often attend the menstrual period. There is, if I am a judge in this matter, nothing in the whole range of the materia medica, no, nor in all drug substances combined, that can at all compare with the power of this blessed element to assuage pain. But of this I shall speak more, presently.