In certain cases of persistently recurring attacks, due to tumours, and threatening life, a surgeon might recommend removal of the ovaries, or other operative interference.
Painful Monthly Illness Painful menstruation is exceedingly common, and many women who suffer severely at each period seek no advi& nor relief, because they believe a certain amount of pain is a natural accompaniment of the illness. This is not so. Any actual pain is a departure from the proper state of affairs, and ought not to be endured, if it can be got rid of.
The causes of the pain are numerous, just as the cause of every other menstrual trouble may depend on a variety of circumstances. in one set of cases the cause is a mechanical one, and consists in some obstacle to the easy flow of the discharge, undue expulsive efforts of the womb being thereby occasioned. Thus the canal lead ing from the womb may be very small or Con traded, the womb may be displaced and bent, so that the canal is encroached on, or at one point blocked by the bending, clots may form readily, and stop the way or require specially violent-efforts to expel them, or the way may be barred by a tumour. All these instances come under this class of cases as mechanical causes of painful menstruation. Another set of classes often occurs in which the pain is of a congestive or inflammatory sort, and iu others shreds of membrane and casts of the womb are expelled. In a fourth set the pain is more neuralgic in character, not seeming to depend Cu any special condition of the womb, while the pain in some cases arises from the ovaries. The commonest cause of painful menstruation is some mechanical obstruction to the flow of the discharge, due either to narrowing of some part of the canal of the womb, or to some displacement. The occurrence of any clots or shreds of membrane will certainly increase the pain by the difficulty of their passage along the narrowed canal.
The symptoms of this variety are very in tense pain, sometimes agonizing, leading in some cases to fainting, hysterical attacks, or even delirium. The pain often begins before the discharge, and is relieved when any quantity passes, as it sometimes does, in gushes. It begins deep iu the belly, but radiates to the groin, thighs, and back. Headache and vomiting are common, and there is often tenderness over the womb and ovaries. The pain may persist throughout the illness. Morover, the obstacle to the flow tends to produce a congested con dition of the womb.
The cases dependent upon congestion have similar symptoms.
Those accompanied by discharge of shreds of the membrane are recognized by the presence of the membranous fragments, and the pain is most intense just before the passage of the membrane, after which it is relieved. When the pain is more ovarian than belonging to the womb, it usually begins a few days or a week before the discharge appears, and may cease with its appearance. It is felt in the situation of the ovaries (see Fig. 113, p. 241), in the groin, and commonly on the left side, and there is tenderness over this position. Vomiting and hysterical attacks are common in it. Probably there are few cases really neuralgic in character, those classed thus being likely due to some obscure condition of the ovaries.
Treatment.—The general treatment of pain ful menstruation consists in rest in bed during the attack, and the employment of hot applica tions, hot-water bottles, hot fomentations, &c. Great relief will be experienced, in many cases, by the patient taking a hot bath, lasting for twenty to thirty minutes, before going to bed, on one or two nights before the illness is ex pected. The pain will be relieved by some preparation of opium or other similar soothing drug. The following pill is good for that purpose: - Morphia, .. grain.
Extract of Indian Hemp, ird Extract of Hyoscyamus, .
Extract of Gentian, ............ 1 „ Make into one pill.
Two or three of these may be taken at inter vals of two or three hours after each pill.
Instead of this a dose of 10 to 15 drops of laudanum, with 5 drops of tincture of bella donna, may be used.
If the pain is felt over the ovaries, 20 grains bromide of potassium, dissolved in water, may be tried every three hours.
- While such a remedy is often necessary, the danger attending the use of any preparation of opium must be strongly pointed out. The desire for the drug becomes strong, and it is used more frequently iu ever-increasing quantities. Many women contract a fatal opium habit from Using it at such periods. In such a time of suffering, also, stimulants are sought, and relief is obtained from them. The craving for them grows just like the craving for morphia. Thus too many women have become the slaves to opium or whisky, which was originally taken for the relief of urgent suffering.