The cause of this suppression is either external or internal. The external cause may be heat or dryness of air, want of sleep, too much work, violent exercise, etc., whereby the substance is so consumed, and the body so exhausted that nothing is left over to be got rid of, as is recorded of the Amazons who, being active and constantly in motion, had their courses very little, if at all. Or it may be brought about by cold which is very frequent, as it vitiates and thickens the blood, and binds up the passages, so that it cannot flow out.
The internal cause is either instrumental or material; in the womb or in the blood. In the womb, it may be in various ways; by humours, and abscesses and ulcers, by the narrowness of the veins and passages, or by the adipose membrane in fat bodies, pressing on the neck of the
matrix, but then they must have hernia, zirthilis, for in men the membrane does not reach so low; by too much cold or heat, the one vitiating the action, and the other consuming the matter through the wrong formation of the uterine parts; by the neck of the womb being turned aside, and sometimes, though rarely, by a membrane or excrescence of the flesh growing at the mouth or neck of the womb. The blood may be in fault in two ways, in quantity and in quality; in quantity, when it is so consumed that no surplus is left over, as in viragoes or virile women, who, through their heat and natural strength, consume it all in their last nourishment; as Hippocrates writes of Prethusa, for when her husband praised her overmuch, her courses were suppressed, her voice changed and she got a beard with a manly face. But I think, rather that these must be Gynophagi, or woman-eaters, rather than women-breeders, because they consume one of the principles of generation, which gives a being to the world, viz., the menstruous blood. The blood may likewise be lost, and the courses checked by nosebleeding, by bleeding piles, by dysentery, commonly called the bloody flux, by many other discharges, and by chronic diseases. Secondly, the matter may be vitiated in quality, and if it be sanguineous, sluggish,
bilious or melancholy, and any of these will cause an obstruction in the veins.
SIGNS.
Signs which manifest the disease are pains in the head, neck, back and loins; weariness of the whole body (but especially of the hips and legs, because the womb is near those parts); palpitation of the heart. The following are particular signs:—If the suppression arises from a cold, the woman becomes heavy, sluggish, pale and has a slow pulse; Venus' combats are neglected, the urine is thick, the blood becomes watery and great in quantity, and the bowels become constipated. If it arises from heat, the signs are just the opposite. If the retention be natural and arises from conception, this may be known by drinking hydromel, i.e., water and honey, after supper, before going to bed, by the effect which it has; for if after taking it, she feels a heating pain about the navel and the lower parts of the abdomen, it is a sign that she has conceived, and that the suppression is natural.
PROGNOSTICS.
The whole body is affected by any disorder of the womb, and especially the heart, the liver
and the brain, and there is a singular sympathy between the womb and those three organs. Firstly, the womb communicates with the heart by the mediation of those arteries which come from the aorta. Hence, when menstruation is suppressed, fainting, swooning, a very low pulse, and shortness of breath will ensue. Secondly, it communicates with the liver by the veins derived from the hollow vein. Obstructions, jaundice, dropsy, induration of the spleen will follow. Thirdly, it communicates with the brain by the nerves and membranes of the back; hence arise epilepsy, madness, fits of melancholy, pains in the back of the head, unaccountable fears and inability to speak. I may, therefore, well agree with Hippocrates that if menstruation be suppressed, many dangerous diseases will follow.