An obstruction of the menses is often the effect of other maladies. When this is the case, instead of giving medicines to force that discharge, which might be dangerous, we ought by all means to endeavour to restore the patient’s health and strength. When that is effected, the other will return of course.
But the menstrual flux may be too great as well as too small. When this happens, the patient becomes weak, the colour pale, the appetite and digestion are bad, and œdematous swellings of the feet, dropsies, and consumptions often ensue. This frequently happens to women about the age of forty-five or fifty, and is very difficult to cure. It may proceed from a sedentary life; a full diet, consisting chiefly of salted, high-seasoned, or acrid food; the use of spirituous liquors; excessive fatigue; relaxation; a dissolved state of the blood; violent passions of the mind, &c.
The treatment of this disease must be varied according to its cause. When it is occasioned by any error in the patient’s regimen, an opposite course to that which induced the disorder must be pursued, and such medicines taken as have a tendency to restrain the flux, and counteract the morbid affections of the system from whence it proceeds.
To restrain the flux, the patient should be kept quiet and easy both in body and mind. If it be very violent, she ought to lie in bed with her head low; to live upon a cool and slender diet, as veal or chicken broths with bread; and to drink decoctions of nettle-roots, or the greater comfrey. If these be not sufficient to stop the flux, stronger astringents may be used, as Japan earth, allum, elixir of vitriol, the Peruvian bark, &c.[[179]]
The uterine flux may offend in quality as well as in quantity. What is usually called the fluor albus, or whites, is a very common disease, and proves extremely hurtful to delicate women. This discharge, however, is not always white, but sometimes pale, yellow, green, or of a blackish colour; sometimes it is sharp and corrosive, sometimes foul and fœtid, &c. It is attended with a pale complexion, pain in the back, loss of appetite, swelling of the feet, and other signs of debility. It generally proceeds from a relaxed state of the body, arising from indolence, the excessive use of tea, coffee, or other weak and watery diet.
To remove this disease, the patient must take as much exercise as she can bear without fatigue. Her food should be solid and nourishing, but of easy digestion; and her drink rather generous, as red port or claret, mixed with Pyrmont, Bristol, or lime-water. Tea and coffee are to be avoided. I have often known strong broths have an exceeding good effect, and sometimes a milk diet alone will perform a cure. The patient ought not to lie too long a-bed. When medicine is necessary, we know none preferable to the Peruvian bark, which in this case ought always to be taken in substance. In warm weather, the cold bath will be of considerable service.
That period of life at which the menses cease to flow, is likewise very critical to the sex. The stoppage of any customary evacuation, however small, is sufficient to disorder the whole frame, and often to destroy life itself. Hence it comes to pass, that so many women either fall into chronic disorders, or die about this time. Such of them, however, as survive it, without contracting any chronic disease, often become more healthy and hardy than they were before, and enjoy strength and vigour to a very great age.
If the menses cease all of a sudden, in women of a full habit, they ought to abate somewhat of their usual quantity of food, especially of the more nourishing kind, as flesh, eggs, &c. They ought likewise to take sufficient exercise, and to keep the body open. This may be done by taking, once or twice a-week, a little rhubarb, or an infusion of hiera picra in wine or brandy.
It often happens that women of a gross habit, at this period of life, have ulcerous sores break out about their ancles, or in other parts of the body. Such ulcers ought to be considered as critical, and should either be suffered to continue open, or have artificial drains substituted in their stead. Women who will have such sores dried up, are often soon after carried off by acute diseases, or fall into those of a chronic nature.