Plain Facts for Old and Young

by John Harvey Kellogg

It is of the greatest importance that careful attention should be given to the proper establishment of the menstrual function at the outset of a woman's life of sexual activity. The first two years will be quite likely to have a deciding influence respecting her health during her whole future life. If a woman can get through the first two years after puberty without acquiring any serious uterine or ovarian disease, she will stand a good chance of enjoying a good degree of sexual health during the balance of her life. The foundation of a great share of the many thousands of cases of uterine disease is laid during this period.

At this early period the daughter is usually too young to appreciate the importance of observing slight deviations from the standard of health, even if she were able to recognize them. Hence it is a duty which no mother should neglect, to inquire into the exact frequency of the periods, the amount and character of the discharge, and other points necessary to ascertain whether or not there is any deviation from the natural condition of health. If there is pain, it is a certain evidence of something seriously wrong. If there is irregularity in any particular, it is a matter well deserving of serious attention.

[Menorrhagia.]—This condition is that in which there is a too profuse discharge of blood. The system is weakened by the loss, and, so much so, in many cases, that the individual does not recover her accustomed strength before the occurrence of the next period, when she becomes weakened still more. By a continuance of this periodical loss, the person may be reduced to a state of almost utter helplessness. A deathly pallor of the countenance, extreme emaciation, loss of strength, and general debility mark the effects of the constant drain upon the system. Thousands of young women continue to suffer in this way year after year, until their constitutions are almost hopelessly wrecked, being deterred by false notions of modesty or delicacy from consulting a proper medical adviser and finding relief.

The observance of a few simple precautions, and the application of proper remedies, will check the unnatural loss in most of these cases very promptly. In the first place, absolute rest, chiefly in a supine position, must be observed not only during the menstrual period, but for a few days previous to its commencement. If this does not restrain the flow, then cool and even cold compresses may be applied to the lower part of the abdomen and to the small of the back. In severe cases no harm will come from the use of an ice-compress, made by inclosing pounded ice between the folds of a towel. Great care must be taken to make the hands, arms, feet, and limbs thoroughly warm by the application of warm bottles and woolen blankets. These measures will scarcely fail to accomplish the desired end, if employed thoroughly and judiciously. It may be well to add just here that the popular fear of using cold in such cases is groundless. No harm can come so long as the extremities are kept warm, and the circulation well balanced. The patient must not be made chilly, however. It is also of importance that the patient be kept mentally quiet as well as physically so.

Much good will result from these simple measures at the time of the period; but a radical cure can only be effected by removing the cause of the difficulty. The patient's general health must be improved, and local congestion must be removed. This will be accomplished by attention to general hygiene, gentle exercise out-of-doors between the periods, abundance of good food, tonic baths and other necessary treatment if there is derangement of the digestive organs, and daily hip baths with a local douche. The hip bath should be taken in water of a temperature of 92° at the beginning. After five minutes the temperature may be lowered 5°. After five minutes more, it may be lowered a few degrees more. By taking a warm foot bath at 95° or 100° at the same time, quite a cool bath may be endured without chilling. The bath should be continued 15 minutes to 30 minutes, according to the strength of the patient. A shorter bath than this will do little good, as the sedative effect will not be obtained.

The douche may be taken at the same time with the bath, or before, as is most convenient. The fountain or syphon syringe should be employed, and the water used should range from 95° to 105°, as best suits the sensations of the patient, being cooled a little toward the last. In general, the hot douche, of a temperature from 100° to 115°, or even 120°, is not only more agreeable, but much more beneficial.

By these simple remedies alone we have successfully treated scores of cases of this sort. In some cases other remedies may be required, and in nearly all, accessory remedies can be employed to advantage; but the measures described are the main features of the most successful mode of treatment.

[Dysmenorrhoea.]—This condition is that in which there is more or less pain and difficulty in connection with the menstrual process. The causes are various, as congestion of the uterus, malformation, and displacement or distortion of the organ. Some of these conditions require the attention of a skilled physician to remedy; but all will be palliated more or less by a course of treatment similar to that described for the previous condition. A warm sitz or hip bath just at the beginning of the period will often give almost magical relief. The application of fomentations over the lower part of the abdomen, and the corresponding portion of the spine, or of hot bags, bottles, etc., in the same localities, is a measure of great utility. The patient should be covered warm in bed, should keep quiet, and great care should be used to keep the extremities well warmed. The use of electricity is a very valuable aid in numerous cases, but this requires the services of a physician, who should always be employed in severe cases when within reach.

In many cases of this form of disease the suffering is so great that the constant dread of its periodical repetition becomes a source of great unhappiness, and casts a gloom over the life of an individual who would otherwise be as happy as could be desired.

[Amenorrhoea and Chlorosis.]—These are serious disorders which require prompt and vigorous attention. They depend less frequently on disorder of the sexual organs themselves than upon some disorder of the general system. They usually demand the attention of a competent physician, and require a more accurate description of their nature and of proper modes of treatment than we have space to give here.