As Recommended by 19th and 20th century Doctors! Courtesy of www.DoctorTreatments.com |
|
and please share with your online friends.
Dysmenorrhaea.It may be stated in general that painful menstruation is caused by one of three conditions: First, a depreciated condition of the constitution originating either in the blood or in the nervous system, and causing a tendency to neuralgia ; second, an unnatural state of the womb; and third, an unnatural condition of the ovaries. In girls dysmenorrhcea is usually due to the first of these causes, less frequently to the second and third ; we should especially look out for chlorosis, or the green sickness, for physical exhaustion, whether due to overwork or over-indulgence in social pleasures, to mental exhaustion from excessive study and emotional excitement. In some cases, too, the pain appears to be due not to any diseased condition, but rather to a tendency of the individual to rheumatism or gout or to malarial influences. It is important to note for the benefit of the physician who may, perhaps, be consulted, whether the pain occurs chiefly before the beginning of the flow and ceases with its appearance, or whether the pain keeps pace with the amount of blood lost, increasing, therefore, during the first day or two of menstruation. It is further desirable to note whether there be any appearance of clotting, or whether particles of reddish appearance, resembling somewhat pieces of flesh, be contained in the discharge ; also whether the pain be felt chiefly in the back or in front, whether it be continuous or be felt at intervals and accompanied with straining- resembling, therefore, the so-called bearing-down pains ; also whether a whitish or yellowish discharge precedes by one or more days the appearance of the proper menstrual flow. Since the causes of painful menstruation are so various, it is evident that the treatment must vary in different individuals. Indeed here, as elsewhere, it must be borne in mind that medical treatment is intended not to destroy a disease, but to assist an individual subject to a disease; that it is, therefore, not the disease, but the patient that is treated. To relieve painful menstruation, we must, therefore, know what causes the pain before attempting to remove it. And since the causes, so numerous and various, can be generally definitely and accurately located only by the special knowledge and skill of the medical adviser, it is impossible to lay down any set of rules for the treatment of painful menstruation. There are certain measures, however, which are decidedly useful in diminishing the pain, and therefore beneficial in nearly all such cases, even though they do not remove the cause nor prevent the recurrence of the pain at the next period. Such girls will be benefited by wearing flannel next to the skin not only during but also between the monthly periods; by taking special care to avoid exposure to cold and wet for several days before the monthly is expected ; by retaining the recumbent posture during at least the first day or two of the flow; by the application of flannels wrung out of hot water to the small of the back and lower part of the abdomen. Sometimes, indeed, a light mustard plaster may be applied to the abdomen with even greater advantage; care being of course taken not to mix in the plaster enough mustard to blister the skin. A bottle of hot water or a hot flat-iron wrapped in flannel may be applied to the small of the back and to the feet if the moisture of the plaster or hot cloth be disagreeable. If the pain still be excessive, a teaspoonful of paregoric or ten drops of laudanum may be administered. Yet it must be remembered that, as a rule, laudanum and other opiates, alcoholic stimulants, whisky slings and other remedies, should be as far as possible avoided; because, since more or less relief follows their employment, the girl will acquire the habit of resorting to them every month, and thus prolonging and rendering permanent the unnatural condition of the sexual organs on which the pain depends. It is advisable to consult a physician at once, if the employment of the hot flannels and other local remedies mentioned be not followed by relief without any resort to medicines. It is a popular impression that such cases are benefited by marriage and maternity; and such is undoubtedly the case in one class of patients suffering from painful menstruation. But marriage, like other remedies, cannot be advantageously prescribed for all. Indeed, many such cases suffer an aggravation of the menstrual difficulty upon the assumption of the duties of the wife and mother. Another disorder of menstruation which may occur, though less frequently, in the maiden as well as in the matron, is an excessive loss of blood during the monthly sickness-a condition termed in medicine menorrhagia. Another condition, often traceable to the same causes, is the appearance of blood in the interval between the regular menstrual periods ; this latter condition is designated metrorrhagia. We may in general divide the causes of profuse menstruation into two classes : first, those associated with the womb itself, and, second, those dependent upon constitutional conditions. Among the former are displacements of the womb, or changes in its shape ; inflammation of the inside of this organ, the formation of tumors upon and within it; the retention in the womb of fragments of the afterbirth ; the increased size of this organ after pregnancy, often resulting from getting up prematurely and indulging in work and exercise after delivery. The causes not referable directly to the uterus, and especially frequent in girls as distinguished from married women, are general debility from improper physical and mental training, emotional excitement, etc. As already indicated in the previous pages, domestic remedies must consist in the avoidance of such impropriety of diet, clothing, exercise and habits, and during the menstrual week of maintaining the recumbent posture. A change of air, society and surroundings will frequently, while influencing the general physical and mental health, restore the natural mode of menstruation. Another condition - one which causes mothers much anxiety, often needless during the earlier years of the girl's sexual life - is what is popularly termed suppression of the menstrual flow - the failure, partial or complete, of the monthly sickness to appear at the expected periods. It should be remembered that during the first years the menstrual flow rarely recurs with the same regularity as to time, duration and quantity, which is often manifested in the woman's more mature years ; a girl may skip a period or two without thereby furnishing cause for alarm or interference, unless there be other evidence of deranged functions. The fact that a girl's monthly flow may last but a day or two, may be also quite consistent with perfect health. If, however, the flow be much diminished or entirely disappear in one who has previously menstruated regularly and profusely, and if she at the same time manifest other evidences of imperfect functions - such as headache, nausea, pain in the back, loss of appetite, inability to sleep, and unusual sense of exhaustion - measures may be taken to promote the menstrual discharge. In these cases it will usually be found that the cause is to be sought in the general condition and not in any diseased state of the sexual organs. The treatment will, therefore, naturally be directed to the constitution rather than to the womb. Partial or complete suppression of the monthly flow, technically called amenorrhcea, is frequently found in patients suffering from consumption, chlorosis, and heart disease ; but aside from these unfortunates, this suppression is peculiarly frequent among women who live indolently and luxuriously among the higher classes of society. Therefore, in such cases the menstrual function is but one of the many functions habitually performed but imperfectly; there is no flow of blood from the womb, merely because the woman's body does not produce nor contain blood enough for the purpose. In such cases treatment is directed naturally to the restoration of the general health and to the avoidance of those injurious influences inseparable from persistent devotion to society. If it be possible to restore the color to the cheek and flesh to the body, the menstrual flow wrill usually appear at once in proper quantity and at proper times, without paying any attention to the sexual organs. At times, however, it may be desirable to encourage the menstrual discharge by promoting the flow of blood to the lower abdominal organs-an object which may be accomplished by the application of hot cloths, by a gentle laxative, and by careful friction and gentle kneading of the abdomen and loins, followed by rest and quiet; or a hot hip-bath of fifteen minutes' duration may be used to accomplish the same result. Such are the more usual physical disorders associated with the performance of the menstrual function in the earlier years of womanhood. In discussing them, we have assumed that the child is naturally formed in all particulars, and that no other influences than inherited tendencies and errors of training have been at work in interfering with the proper performance of the menstrual function It should be mentioned, however, that nature exhibits occasionally certain freaks in this, as in other departments of the body - freaks which, because undetected, even unsuspected, may occasion considerable anxiety and difficulty. In some children, who exhibit the other characteristics of fully developed womanhood, menstruation is not observed; indeed, cases are on record in which women have married and borne children without menstruating, the monthly flow having appeared, perhaps, after the birth of one or more children. In other cases there is a mechanical obstruction to the escape of blood from the womb - a membrane which closes completely instead of partially the natural orifice of the parts. In such instances the usual symptoms of the monthly sickness, such as headache, pain in the back and languor, recur at regular intervals, though no blood can of course escape; after a number of months the accumulation of blood in the vagina and womb may be so great as to render each menstrual period extremely painful and even to cause an enlargement of the abdomen, which may give rise to an unjust and cruel suspicion of incontinence. It is scarcely necessary to state that a watchful mother could and would early detect the unnatural formation by simple inspection of the genital organs. This discovery should be made early, not only for the satisfaction of the knowledge acquired, but also because the condition can be at once and very simply relieved without any danger to the girl, if but few menstrual periods have transpired; while on the other hand, after some years, when the accumulation of blood has become excessive, the operation necessary to secure the natural performance of the function may have far more serious consequences for her than could have ensued in the first or second year of menstruation. It sometimes happens, too, that while a girl is otherwise well and perfectly developed, one or more of her sexual organs fail to undergo the change natural at the period of puberty, and remain in the undeveloped condition natural to the child; indeed it may happen that some of these organs are entirely absent-have been left out of the child's body in the making, just as an individual is sometimes born without the usual number of fingers, or even without arms. It is scarcely necessary to observe that such an individual can never hope to perform the duties of the wife and mother. If indeed the ovaries only be lacking she may become a wife, although she will never exhibit the peculiarities of outline and figure, of heart and mind characteristic of the complete woman ; she is, and must remain a sexless being. If the sexual organs be all present the girl may ultimately become a woman even at the advanced age of 24 or 25 years - there being merely a delay, and not an arrest of development. In such cases it may be possible to hasten the change by exposure to those very influences, such as emotional excitement, which are known to concentrate the bodily energies upon sexual organs; possibly something can be done also with medicine and electricity. The most efficient agent is doubtless marriage, which is, under the circumstances, of course scarcely a legitimate and honorable means, and one usually impracticable. On the other hand, sexual development occurs sometimes at a remarkable early age. Thus instances are on record in which the peculiar physical changes, including the monthly discharge of blood, began at five, at three and at two years ; indeed two cases have been recently reported in which menstruation began with the life of the infant. That the sexual development actually occurs in such precocious children is shown by the fact that girls have become mothers at nine, even at seven, years of age. It might be interesting, but is scarcely necessary to enumerate the various deviations from the usual type of menstruation which have been observed in individual cases ; such, for instance, as those in which the loss of blood occurs from the nose instead of from the womb. Yet it is necessary to call attention to the fact that tumors connected with the ovaries or the womb are occasionally developed during puberty, and that such tumors may give rise to excessive and irregular menstruation, or may even cause a complete suppression of the courses. Numerous instances have been observed in which a sudden cessation of menstruation, followed in a few months by enlargement of the abdomen, has been construed, notwithstanding the unfortunate girl's tearful denials, as evidence of pregnancy ; and although in the majority of such cases - tearful denials included - the suspicion is well founded, yet the possibility should be borne in mind that suppression of the courses, enlargement of the abdomen, and other symptoms usually produced by pregnancy may be also caused by a tumor of the abdomen - that in any doubtful case the girl should have the benefit of the doubt and be submitted to medical examination before an ineffaceable stain be allowed to deface her fair name. We have thus sketched the care and attention which may be properly bestowed upon the girl's body during the trying period of puberty. Yet it is understood that a not less important duty of a mother during these same years is a training of the moral nature. This department does not belong, of course, essentially to the medical adviser, nor will it be discussed in these pages. Yet one suggestion should be made by the physician, since he is often called upon to treat cases arising from defects of the moral training. At this time of the girl's life there is an imperative necessity for the most intimate and intelligent sympathy between mother and daughter. At no other time in the life of the human female has she such pressing need for guidance, support, encouragement and affectionate solicitude ; at no other time is she so completely dependent for sympathy and tenderness upon members of her own sex. She is entering a to her, unknown and unexplored realm. She is assuming duties and powers which she would often gladly escape ; she is bewildered, perhaps overwhelmed, by new emotions and desires which she is unable, often unwilling, to direct and control. The various circumstances which thus increase her need for sympathy and affection constitute at the same time a barrier between her and her male relaatives. In these, her new trials and troubles, she cannot make confidants of father and brothers as has been her previous habit, for however tender their regard, she feels instinctively that they can have no intelligent appreciation of her situation ; she must seek solace and counsel from woman, and of all women, most naturally of her mother. Yet the experience of physicians sometimes reveals the fact that the mother's advice and assistance have been very tardily and even grudgingly bestowed ; that the entire matter has been ignored so far as possible, perhaps even until the girl has been terrified by the sudden appearance of her first menstrual flow ; that she has been taught to regard her sexual functions as an evidence of total depravity, a part of the original curse in the garden ; something to be* ashamed of, repressed, neglected, and not infrequently in such cases the girl's knowledge of the powers and possibilities of her future sexual life have been derived, in large part at least, from her playmates and school companions. In very brief conversation with the child the physician readily perceives whether her information has been derived from her mother or from other sources, for in the latter case there is apparent a false delicacy, a furtive air, a tacit impression that the whole subject belongs in the realm of forbidden fruit. The child plainly betrays by her manner a consciousness of guilt in knowing anything about the subject at all, indeed often affects an ignorance of matters which she evidently understands. It may be perhaps true in the abstract that the girl should be kept in ignorance of the sexual relation ; of the significance of those changes which she is now experiencing ; yet it is quite sure, as a matter of fact, that she will not remain in this state of ignorance. For it is practically certain that the information will be obtained through either legitimate or illegitimate channels, and it is surely far better that she should hear the truth from her mother; that she should be impressed with a solemn sense of the dignity, responsibility and yet danger to body and soul inseparable from her sexual powers that she should be taught the conscientious discharge of her new duties - that she should be instructed to regard these as the crown and glory of her womanhood. This plan is certainly far better physically, mentally and morally than that she should learn from girls as ill-instructed as herself that the prime object and use of her sexual powers is sensual gratification ; that marriage is on the same moral plane as licensed prostitution ; that maternity is the unwelcome though inevitable result of the sexual instinct; for if the girl entertain such ideas she will certainly not confide in her mother that implicit trust so essential to her own safety. She will brood and dream in private over the great mystery thus revealed. This unfortunate and mistaken impression is but too often strengthened by the mother's neglect to introduce the subject-a neglect prompted either by false delicacy or by the erroneous belief that the girl is as yet but a child and can't comprehend such matters ; a silence which may be interpreted by the girl as a tacit confirmation of her suspicion. We would not be understood as insisting that the girl of 14 or 15 should be instructed in all that pertains to the sexual relations. We would merely express our conviction that in order to secure the complete confidence of her daughter, the mother must impart, and that, too, early in puberty, at least some of the elementary truths as to the meaning of sexual development. Let her not beguile herself into the belief that the matter may be better postponed until the child has acquired more experience and discretion ; let her remember that the question is merely whether the information shall be conveyed in the delicate spirit and pure motive of the mother or clothed with the degrading influences of doubtful jest and innuendo. The details of the communication must be of course left to the mother's tact and discretion. Were mothers generally in the habit of early instructing their daughters as to the significance of puberty, it would be scarcely necessary for us to allude to a topic which, under present circumstances, cannot be conscientiously ignored-indulgence in secret bad habits. Probably every mother who reads this line recoils in disgust at the idea of associating her own daughter's name with such a possibility ; for every mother believes, naturally, that her child is too pure in soul and body ever to conceive or practice a habit so loathsome ; but be not too sure. A part of this fond belief is doubtless justified - probably very few children have ever conceived the idea or the possibility of such practices ; and were the habit limited to the few precocious enough to discover them independently, and to practice them voluntarily, it would scarcely be necessary for us to mention this repulsive subject. But the fact is, that the child rarely escapes a knowledge of this subject, communicated by the precept and example of older playmates, servants and even nurses. In many cases the girl or boy is instructed to perform such unnatural acts at a time when she or he is mentally incapable of comprehending their significance, and even physically incapable of experiencing any pleasurable emotion in connection therewith ; the child is, therefore, not only ignorant of the physical wrong, but is also quite innocent of any intention, or even consciousness of moral impurity. Although Miss Catherine Beecher long ago sounded the note of warning to parents, and although this warning has been often repeated, and confirmed in popular publications by medical men, yet parents are not yet fully awakened to the widespread prevalence of this habit among the youth of both sexes. It may be safely said that wherever children between twelve and sixteen years of age^ habitually congregate, there the habit is more or less rife; in every school, especially in the boarding-schools, where the children are withdrawn to a large extent from the ennobling influences of personal contact with their parents; in every crowd of boys, or even girls, there will be found one or more individuals who are not content to be themselves addicted to this habit, but are sure to impart a knowledge of it to their companions, many of whom, unconscious of any wrong, are easily induced to imitate. Indeed, almost every physician could mention cases in which the innocent child has been instructed in this vice by the servants in her father's house, perhaps even by her own governess. The effects, physical and moral, of indulgence in this habit, though greatly exaggerated and distorted in the circulars and books with which the country is flooded by patent medicine venders and other quacks, are nevertheless dire enough. Among them we may enumerate loss of appetite and of flesh, bodily and mental weakness, nervousness, and disorders of the sexual and urinary organs. Yet, perhaps, the most disastrous is the moral effect, for this unnatural and premature excitement of the sexual desire must necessarily direct the child's thoughts and inclinations into improper channels, and may well dispose the girl to become an unreluctant victim to profligate arts in subsequent years. In one of the saddest cases in the writer's experience, the possibilities just expressed have been realized. A girl had, at the very beginning of puberty, been taught the habit by a companion, and became a slave to the passions thus nurtured, and finally a victim to one who knew how to arouse these passions to which she was herself enslaved ; and when, at nineteen, she became an outcast from society, she vainly lamented that no one had ever warned her at that early age of innocence and ignorance against the disastrous moral tendencies of her secret habit. Nowhere have we better illustration of the value of prevention as compared with cure; for this habit, once acquired, it seems at times impossible to break. In some cases it has been found necessary to resort even to mechanical restraints, such as tying the hands. Yet if it be discovered that the child is addicted to this unfortunate habit, a cure would best be effected, in most cases, certainly not by severe censure and harsh reproof, but by kind sympathy and affectionate encouragement. Oftentimes, doubtless, these measures, directed by a mother's tact, will suffice. It should also be observed that there be no local physical causes which can keep up an irritation of the sexual organs ; for it is a fact that, in exceptional cases, the habit is maintained, perhaps even generated by local disease of the womb or of the skin of these parts ; by worms in the lower bowel, and by imperfect attention to cleanliness. So, too, the inclination thereto may be diminished by hard beds, light covering at night, regular evacuation of the bowels and bladder, especially late in the evening ; sometimes, also, ablutions with cold water, shortly before retiring, may be beneficial. If these simple measures, combined with the judicious advice and restraint of the parents, fail to abolish the habit, a physician should be at once consulted ; for this a matter too serious to be neglected or to be hidden. Far better than the attempt to cure the habit, however, is the prevention thereof, which can be accomplished very readily if the mother possess the entire confidence of her daughter. If the girl be taught to converse with her mother as freely upon her sexual functions as about the action of the bowels, it is rarely possible the child could acquire or attempt to conceal such habits. It is not, of course, necessary under such circumstances, to warn the child particularly against these habits in such terms as may excite an unnatural curiosity for further knowledge, but merely to instruct her in a general way that any handling of these parts is injurious and degrading. In this connection it should be observed that while such habits are usually acquired during or after puberty, yet cases have been observed - in boys more frequently, it is true, than in girls-in which children, at an age usually incapable of sexual excitement, yes, even infants in arms, have habitually performed such acts, accomplished by movements of the thighs and contortions of the body ; and the acquisition of the habit is not infrequent among children who present as yet no sign of sexual development. A condition often found in girls, though not by any means confined to them, is a discharge commonly known as " the whites," and technically called leucorrhaea. In married women, this discharge is usually a symptom of disease of the womb, and it will be referred to in considering the diseases of that organ. In girls, on the other hand, leucorrhcea often occurs without any disease of the womb, the discharge proceeding entirely from the vagina. Although most common after puberty, yet it is not rare to find this same condition in girls from eight to fifteen years of age. Inasmuch as this same symptom accompanies also a certain contagious disease, there sometimes arises a suspicion that the girl has, whether voluntarily or not, been brought in contact with some one suffering from this disease, and physicians are sometimes consulted by anxious mothers as to the possibility that their children have been tampered with by others. If such be really the case, there will usually be other and unmistakable evidence ; the fact of the discharge alone does not warrant any suspicion of contact with others. In girls from eight to eighteen, the discharge, though usually white, has sometimes a tinge of yellow, or even green ; is sometimes so slight as merely to attract notice by stains upon the linen, at other times so profuse as to occasion great annoyance. There is usually no pain, though sometimes a slight burning sensation is felt, particularly just before and aftei the menstrual period; the monthly flow is itself often irregular, both as to quantity and time; the general health is usually somewhat impaired; the individual is pale and languid-suffers from constipation, irregular and ill-defined pains in different parts of the body, especially the loins, loss of appetite and sleep. Causes.-Leucorrhcea, as it occurs in girls, is usually not a symptom of disease of the womb, but indicates merely a relaxed condition of the vagina, dependent most always upon an impairment of the general health. It is especially frequent in those children whom we are accustomed to call scrofulous-those with pale, waxy skins, prone to enlargements in the neck, the children of delicate parents. Such children often have more or less discharge from various mucous membranes; they have red, watery eyes, and oftentimes excessive secretion from the nose. In such children the discharge from the vagina is to be regarded in the same light and treated largely in the same way ; that is, by efforts to improve the general health, by proper attention to diet, air, exercise, etc. In other cases, leucorrhcea is the direct result of improper habits of life, and is especially frequent in the girls of large cities who receive less than the proper quantity of fresh air and sunshine, live in hot and ill-ventilated rooms, and wear clothing which, whatever its design may be, does not protect the person from cold and wet. The general use of woolen underclothing and stockings, and of thick shoes, would go far toward eradicating leucorrhcea from girls. Yet sometimes the cause is to be found, not in the direct violation of ordinary rules of health, but in excessive mental strain, whether of the intellect or of the emotions. Leucorrhcea is especially frequent among the so-called nervous girls. It is not infrequently also a symptom of chlorosis. Treatment.-The treatment of leucorrhcea must usually begins with an investigation of the girl's habits of body and mind and of her general health ; for, in most instances, the discharge ceases without any local treatment, if proper care be exercised to 'secure nourishing food, warm clothing, appropriate physical and mental exercise. Locally, it rarely becomes necessary in the leucorrhcea of girls - and of them we are now speaking-to do more than secure simple cleanliness, though it must be borne in mind that reliance must not be placed upon local treatment to the neglect of those general rules of health and hygiene already indicated. If the discharge be merely white or glairy, like the white of an egg, it will be usually sufficient to employ, morning and night, a simple injection of lukewarm water, a quart of which may be slowly injected by means of a Davidson syringe ; if, after several days, the discharge still continues, two tablespoonfuls of alum may be mixed with the water before injecting. Regular movements of the bowels should also be secured, though only a gentle laxative may be employed. A warm hip bath, followed by vigorous friction of the skin with a coarse towel, will also be found beneficial. After the discharge has ceased, the injection should be continued for two or three weeks, to prevent a return of the difficulty. Another complaint often manifested by girls during puberty, though by no means monopolized by them, is hysteria, popularly known as hysterics. While in many cases there is undoubtedly a physical basis for this disease in some derangement of the sexual organs, yet in a very large number of instances hysteria is a purely mental disorder, the result of a lack of balance between the emotions and the will. The cases occurring during puberty usually fall in this latter category; there is ordinarily no disease of the womb or ovaries, but merely a development of the emotional nature in advance of the judgment and discretion ; it is a result of the methods of education, mental and moral training, and peculiar social influences to which the girl has been exposed. It is often noticed that hysterical women have been irritable, capricious and overindulged children ; and a hysterical convulsion or " fit " is oftentimes to be regarded as merely the woman's way of expressing the feelings conveyed by children and men in angry words, boisterous behavior and sulkiness. This is so generally understood that people are not usually inclined to bestow upon hysterical females the same amount of sympathy and solicitude which would seem to be demanded by the violence and dangerous character of the fits; it is considered that the hysterical convulsion is merely an evidence of bad temper, cunningly expressed in a way to demand an attention and sympathy which could not be secured by the temper without the fit. While such is doubtless the true explanation of many hysterical convulsions, yet we may not, in justice to many unfortunate women, class all cases in this same category ; for oftentimes it is absolutely certain that there is no intention to deceive or to abuse our confidence by enlisting our sympathies against our judgment. Indeed, instances have been known - though rare ones, it is true - in which a woman has had a hysterical convulsion when alone; and nervous women have often been observed to exhibit the same appearances under the influence of sudden and uncontrollable, but genuine emotions. The conduct of a woman during a hysterical attack varies so extremely that no comprehensive description can be given. At times there is merely an immoderate indulgence in an emotion which is, under the circumstances, perfectly natural and legitimate, such as an excess of tears or of hilarity. At other times there occurs the sequence of events popularly associated with the idea of hysteria-a rapid and sudden change from laughter to tears, and conversely. Then again there may be associated convulsive movements of the body and limbs, accompanied with screams. In the fully developed hysterical convulsion there are certain characteristic features ; they usually occur during a certain depression of spirits or bodily discomfort, especially at or near the menstrual epoch. The patient often experiences headache, perhaps cramps and numbness in the limbs, sometimes a feeling described like that of a ball rolling around in the abdomen and chest, which often rises into the throat accompanied by a feeling of choking. This latter symptom, a very frequent sensation in genuine epilepsy, may also be simulated in the disease under discussion. The breathing usually becomes hurried and irregular, there is palpitation of the heart and pronounced flushing, often alternating with pallor, of the face. About this time the patient usually falls, screams, pulls her hair, and undergoes a variety of bodily contortions ; the arms are thrown aimlessly about, the knees often drawn violently up to the abdomen and as violently extended ; occasionally nausea and vomiting ensue The general appearance of the patient, the disheveled hair, staring eyes, bodily writhings, interference with circulation and respiration, constitute a startling picture, one well calculated to distress and alarm the uninitiated, especially those who may have a personal and affectionate interest in the patient's welfare ; yet it may be said once for all that there is not the slightest element of danger, that the complete recovery of the patient is merely a question of time- a few minutes or perhaps several hours. Causes*-The causes of hysteria have been already indicated. In some cases, especially in married women, there will be found a diseased condition either of the womb or of the ovaries, the relief of which will be followed by a disappearance of the hysteria. Yet in the majority of cases, especially of those which occur during puberty, the fault lies, not with the sexual organs, but in the training of the moral and emotional nature ; sometimes indeed its development can be traced to extreme emotional excitement- fear, anger, disappointment of the affections, religious fervor; and since maternity is the natural culmination of a woman's life, it is not surprising that hysteria should be especially prevalent among those females whose sexual and maternal feelings find no natural gratification, and who at the same time have no other object in life which may divert their attention. It is an interesting fact, and one which has practical importance in the training of girls, that hysteria is eminently " catching, " that is to say, that the appearance of one case of hysterics is almost invariably followed by the same trouble in females who are intimately associated with the original victim ; and this is especially true of girls during the accomplishment of puberty. It is a familiar fact that boarding-schools and colleges for girls are sometimes swept by hysteria as if by an epidemic, so that comparatively few of the pupils between 13 and 18 years escape entirely this affliction. It is in such cases - which are really merely examples of the innate tendency of the human mind to mimicry - that the purely emotional nature of hysteria is manifested ; for in these instances the disease can be usually entirely eradicated by simply stimulating the girl's will to combat her emotions. Sometimes a rather harsh stimulus is especially efficient. It is related of a French physician who was called to one of the Parisian convents, where most of the young lady pupils had recently become hysterical, that having assembled the interesting patients he heated a number of irons red-hot before their eyes and with a bland smile informed them that the first girl who had hysterics would be cauterized down the spine. He had no use for his irons. A case of hysteria, which does not yield readily to social and moral influences which can be brought to bear in the home circle, should be brought to the notice of the physician ; for there are no rules to be laid down as to the administration of medicine. If drugs are required-the exception rather than the rule - it will be desirable to know the cause of the hysteria, since this is really a symptom, and not a disease. Among the numerous eminent medical writers who have publicly urged the considerations set forth in the preceding pages, no one, perhaps, is more worthy of attention than Dr. William Goodell, of Philadelphia, who closed a recent address on the subject in the following pertinent words: " I am old-fashioned enough to believe that the chief end of woman is to be married, to have a home of her own, and to give birth to healthy children ; and that woman, as woman, has no moral right to do anything that will unfit her for this end. Whatever does damage to her, does damage to those born to her; and her disabilities are their disabilities - disabilities far-reaching and never-ending. A woman has undoubtedly the right to remain single all her life ; but as a late writer forcibly observes, if she considers herself a candidate for love and marriage she has no moral right to touch any employment that will in any degree unfit her for domestic life and all the responsibilities that go with marriage. Now, while in the abstract this is undoubtedly true, yet I fear that it could be carried out only in the new Atlantis, or in some other equally ideal community. But while a physician cannot undertake to create a fancy republic where hygeia shall reign supreme and where every rule of good health and of good morals shall be observed, he can work efficiently toward the redemption of woman. He can discourage women from taking those industrial employments which tend to impair their health and to unfit them for the duties and functions of woman. Of this class are all those occupations which oblige the worker to be on her feet, and especially during her monthly periods. Should a dire necessity drive them to such work, he can so influence public opinion as to compel their employers to give them the daily or the monthly rest which they may need. " Nor can women as a class sustain, without injury, the same amount of brain work as men. Where can a robust schoolmistress be found ? Or how rare is it for a highly intellectual woman to be a healthy one ? Then again, compare the health of the boys with that of the girls at our public schools. Women, from their own sensations and feelings, call themselves * unwell ' during the monthly flow. They are, by their own showing, literally unwell, and are, therefore, at that time, as unfit for severe brain-work as for fatiguing body work. The curriculum of studies in our female schools should, therefore, be lengthened out and graded to the physical needs of our girls - our nascent women. Out of school hours there should be very little study; while * unwell ' their brains should not be overtaxed and their bodies overworked. Mothers should be taught how to preside over the physical education of their daughters - how to pilot their frail bodies safely through the shoals and quicksands of girlhood. The clothing should be thick and warm and supported, not from the waist but by the shoulders ; their shoes stout and roomy ; their chests unconfined by corsets ; their brains not overtaxed. Candies, doughnuts and hot biscuits must be struck out from their path ; such trash has made our dentists world-renowned. Habits of regularity in sleep, as well as in the evacuations, should be scrupulously enforced. Overwork in a constrained position, especially that at the sewing machine, must be forbidden. Let them daily take sunshine and exercise in the open air. But on the other hand let them during their monthly sickness, avoid picnics, sleighrides, dancing parties, and other like imprudences. " The risks from the suppression of the flow should be vividly pointed out, else they could hardly be persuaded to forego pleasures which at such times are fruitful sources of mischief. Mothers should therefore diligently supervise the menstrual week of their daughters, and at that time forbid all overwork of brain and of body. Would that all women could be taught to look upon the law of periodicity in their nature not as an affront to womanhood, not as the mark of a curse, but as a dower of health and of beauty, if respected - as the leaven of lifelong invalidism, when abused." But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! Also, please consider sharing our helpful website with your online friends.
|