A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Science
A system of practical medicine. By American authors. Vol. 4 : $b Diseases of the genito-urinary and cutaneous systems. Medical ophthalmology, and otology
Medicine -- Practice
Before considering more direct measures for establishing menstruation
it may be well to recall to mind the two elements of the
function--ovulation and the uterine flow. The first, the prime factor,
we can not influence by any medicines nor by any mode of treatment
except, perhaps, by electricity. Observation of animals shows that mere
proximity of the male influences it plainly, but this only indicates a
line along which we cannot prescribe. An opinion may, however, be asked
in regard to the propriety or advisability of marriage for a woman who
has never menstruated. In such case no advice should be given until
after a thorough local examination, and its tenor will then be in
accord with the condition of the organs. With such atresia or absence
of organs as not to permit sexual intercourse marriage should be
positively negatived. In such cases as those of partially-developed or
absent uterus the facts should be laid before the parties interested
and the decision referred to them. In the former class of cases some
hopes of improvement may be entertained.
The second factor of menstruation, the flow, we can influence by such
measures as cause a more or less intense pelvic congestion. The ovaries
sharing in this congestion, it is not impossible that ovulation is in
some {190} degree also promoted, but it can be only to a minor degree
and when the ovaries are in a favorable condition. The uterus is the
principal organ to be affected, and to it the most of these measures
are addressed.
Direct treatment for the establishment of menstruation should be first
of a character rather to solicit than to force the flow. These measures
act best where, the general health having been restored, the flow does
not appear, but the premonitory symptoms are present. Rest in bed,
warmth to the pelvic region by poultices or other means, and hot
drinks, are to be prescribed; among the latter infusions of pennyroyal,
some of the mints, tansy, and cotton-root have a high domestic
reputation and should be preferred. Hot pediluvia or hot sitz-baths,
prolonged to twenty or thirty minutes, may be taken at bedtime. These
may be rendered sufficiently stimulating to irritate the skin by the
addition of mustard. More active measures are stimulating enemata and
vaginal injections--for the former ten grains of aloes in mucilage, and
for the latter liquor ammonia in milk, fluidrachm j-pint j, gradually
increasing the strength to production of slight leucorrhoea. Both these
have the endorsement of high authority.
Such measures should be used or plied more assiduously about the
period, when that is known. During the interval a tonic course is
almost always required, and a powerful local influence can be exerted
by cold sitz-baths of brief duration, say one or two minutes, once
daily, followed by vigorous rubbing with a coarse towel or a
flesh-brush.
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