Chapter XX. Special Remedies for the Non-Surgical Diseases of Woman.
I AM well aware of the fact that the average physician in this country is not well posted in the medical treatment of the diseases peculiar to women. Many cases are sent to specialists to be treated or to have an operation performed. All this takes just so much money out of the pocket of the general practitioner. He should make it his business to know how to cure such cases himself. It is the fad among many doctors to operate on women for about all the ailments they have. Thus it is that our American women are being mutilated, unsexed, degraded to gratify the surgeons' greed for operations.
Our country expects so much of her mothers, for "the hand that rocks the cradle is the hand that rules the world." How can a woman perform the duties of a wife and mother when she has been unsexed? It is no credit to any school of medicine to be obliged to admit that they cannot cure the most common ailments of women without an operation. It is one of the sins that we as a profession are being called to answer for before the "bar of public opinion."
From my book of experience I will try and tell the reader how I treat such cases by medicine.
Girls at puberty, when their menses are delayed, develop headaches, wandering pains, chorea, and sometimes hysteria and epilepsy. There is one remedy indicated in such cases. Caulophyllum in the form of leontin (Lloyd's), given in fifteen drop doses in a little sweetened water once in three hours. A girl may be anemic; she does not "come round" because she has not the blood to spare. We can aid Nature in this crisis by ferrum. When the face and lips are pale, of a bluish color, the face becomes red from the least pain or emotion, we should prescribe three tablets once in three hours of the third decimal trituration of ferrum. If the girl complains of cold hands and feet, and has a dry, rough skin with suppressed menses, or they may be irregular, seven drops of tincture sanguinaria three times a day will cure.
If the menses are delayed by wet feet, in a woman of a mild, gentle disposition Pulsatilla will be found valuable. Add xx. gtts. tincture Pulsatilla to aqua ℥iv. and give teaspoonful doses once an hour. If, with the suppression of the menses, the patient is extremely restless, skin dry and hot, vagina dry and hot, twenty gtts. of the third decimal dilution of tincture aconite in a glass of water—teaspoonful once an hour—will remove the disagreeable symptoms.
In amenorrhea of young girls with aching pains in the hips and loins, a feeling of weight and tension in the loins, tincture polygonum punctatum is the remedy. Add tincture polygonum ʒii. to aqua ℥iv., and give teaspoonful once in three hours. For irregular menstruation with uterine or cervical leucorrhea, that replaces the menses, we need tincture senecio aurens. It is the female "regulator." Add ʒi. of the tincture senecio to ℥vi. of water and give in teaspoonful doses once in three hours. For profuse menstruation, where there is pain extending from the back to the pubes and the blood is partially clotted and partially fluid with a discharge of blood, sometimes, between the periods, sabina is the remedy. Put ten gtts. of tincture sabina in a glass of water and direct your patient to take a teaspoonful once an hour. If the menses are too frequent—come every two weeks and last seven or eight days with profuse, yellowish leucorrhea between the periods—the second decimal trituration of trillum should be administered. Give three tablets four times a day.
In some women the menses are dark colored with many clots; the menses are long continued, a slow, persistent, oozing discharge of blood; the os has a soft, spongy feeling and is somewhat dilated. For such a condition the ustilago maydis is the remedy. Give three tablets of the first decimal trituration three times a day. If the menses are black, viscid, clotted in long black strings and a sensation experienced as if there was something alive in the abdomen, the tincture crocus sativa should be given. Direct your patient to take five gtts. of this remedy in a little water every three hours. For painful menstruation when the patient has intense cramping pains in the uterus, the menses are scanty and a heavy congested feeling in the ovaries, viburnum opulus is an excellent remedy. I have relieved many cases by tincture gelsemium, eights gtts. once in fifteen minutes. The best prescription for the relief of such cases is:
Rx Tincture gelsemium, gtts. xx.
Tincture viburnum Op. ʒii.
Leontin (Lloyd), ʒiii.
Simple syrup, q. s. ℥vi.
Mix. Sig. Teaspoonful once in half an hour until relieved.
To cure such cases I prefer Fl. ext. viburnum prunifolium, xx. gtts. in a half teaspoonful of simple elixir four times a day—to be administered between the periods. Magnesia phosphate is indicated in cramping pains relieved by heat, and when the dysmenorrhea is of a purely neuralgic character. Ten grains of the third decimal trituration should be put in a cup of hot water and two teaspoonfuls given every few minutes. When the pain is of a griping, twisting nature—made worse by bending forward and lying down, relieved by standing on the feet and bending backward, the tincture of dioscorea will relieve. Add Tr. dioscorea ʒi. to aqua ℥iv. and give one teaspoonful once in half an hour. In congestive dysmenorrhea with throbbing headaches, in plethoric girls and women, where the menses are scanty and the pulse hard and tense, we should not forget tincture veratrum viride. Give five gtts. of the first decimal dilution three times a day.
In congestion of the os uteri, with the abdomen sensitive to external touch, with burning and stinging pains, a feeling of fullness as if everything was pressing toward the vulva, tincture belladonna is the remedy. Add twenty gtts. of third decimal dilution to a glass of water and give teaspoonful once an hour. In congestion of the os uteri with stitching pains, extending from the vagina to the umbilicus, a profuse leucorrhea of a fetid odor, sensation of a ball or weight in the rectum, flashes of heat, stomach feels empty, urine reddish, and very offensive and adheres to the bottom of the vessel, sepia is the remedy indicated. Prescribe three tablets of the sixth decimal trituration four times a day. In ulceration of the os uteri with a discharge like pus I have always obtained good results from three drop doses of tincture belladonna given once in three hours. With the belladonna I have given in alternation three drop doses of Fowler's Solution once in three hours. Locally I use Micajah's Uterine Wafers, inserting one every other night between the menstrual periods.
For leucorrhea I depend upon hamamelin first decimal trituration, giving three tablets four times a day. In leucorrhea, where the discharge is milky white and non-irritating kali mur. should be given. I prescribe three tablets of the third decimal trituration once in two hours. When the uterus and its appendages feel as if they were being dragged out of the body, with a leucorrhea that comes on every few days in torrents of thick, yellowish discharge, the third decimal trituration of secale cornutum is the remedy. Give three tablets three times a day.
For pruritus of the vagina there is one prescription which I have used for years that has never failed to stop the itching of these parts. It is the following:
Rx Powdered borax, ʒiv.
Fl. ext. hydrastis, ℥ii.
Mix. Sig. Bathe the parts four times a day.
Internally we have one remedy especially indicated when there is a yellow leucorrhea, itching of the parts covered with hair, and bruised, painful feeling in the ovaries. It is fagopyrum esculentum. Three tablets of the third decimal trituration should be taken once in two hours.
In prolapsus uteri when there is a dragging sensation in the lower part of the abdomen, the back feels as if it were broken and pains extend along the outer side of the thighs; the patient talks about "her womb," is conscious that she has one and it is sore and tender, and there is a tendency to melancholia, helonias dioica is specially indicated. Give tincture helonias in ten drop doses three times a day. If there is pressure and bearing down as if everything would protrude from the pelvis, she feels as if she must sit close and cross her legs to prevent it, and there is a yellow saddle across the nose and cheeks, sepia is the remedy. Prescribe three tablets of sepia sixth decimal trituration four times a day.
In displacements of the uterus with bearing down feeling, frequent desire to urinate, cannot walk on rough ground, only flows when she moves about, tincture lilium tigrinum should be used. Give in five drop doses three times a day. Locally I like the uterine wafers as mentioned above. In all the years of my practice I have never used pessaries, outside or inside, supporters, or had any operation performed upon any of my patients, yet I have never failed to cure the worst cases of prolapsus with the above treatment. In many cases of displacement of the uterus where pessaries, or supporters, are used the real cause of the prolapsus is because of the enlargement of the uterus. It is heavy and it drops from its own weight. From this it is evident how silly it is to try to keep it in its natural position by any mechanical support. When you can reduce the enlargement of the uterus you remove the cause and the position becomes normal. When there is an enlargement and a heavy bearing down feeling fraxinus americanus is the remedy. Direct ten drops of the tincture to be taken three times a day. Many cases of enlargement of the uterus are called fibroid tumors of the uterus.
In metritis I have always depended upon tincture gelsemium and tincture macrotys, twenty drops of each in a glass of water. Teaspoonful every hour. Externally I use bags of hops and wormwood moistened with hot vinegar and changed every half hour. In chronic metritis with thickening of the cervical canal, menses too soon, yellowish leucorrhea, dragging sensations in the pelvic organs use third decimal trituration of aurum muriaticum, giving three grains one hour after each meal.
In acute salpingitis where there is acute, sharp, lancinating pain on the affected side, with tenderness on pressure aggravated by motion, I have depended upon ferri phos. third decimal trituration and kali mur., third decimal trituration, of each five grains in a cup of hot water, giving two teaspoonfuls every half hour. Apply locally bags of hops and wormwood moistened with hot vinegar and change every half hour. I saved a doctor's wife from a surgical operation by this treatment and cured her in a week's time.
A Greek philosopher wrote that woman was "an animal with a pain in her side and constipated bowels." For that pain in her side, just under the left breast, give macrotin, first decimal trituration. Dose, three tablets once in three hours.
Vaginismus of the newly married woman may make trouble in the family unless it can be remedied. I have used an ointment of hydrochlorate cocaine, five grains to the ounce of vaseline, the ointment to be applied to the inside of the vagina before retiring. In women who are thin, rigid and spare, with dark hair, platinum, sixth decimal trituration, is the remedy; give three tablets once in two hours. In congestion of the ovary, swollen and indurated, distress relieved from starting of the flow, menses scanty, black, and offensive, the sixth decimal dilution of lachesis is the remedy. Add ten drops to half a glass of water and give two teaspoonfuls once an hour. When from ovarian irritation we have burning, stinging pains and soreness in the ovary which is large and sensitive, tincture apis mel. will give relief. Place twenty drops in a glass of water and give one teaspoonful every hour. Pain in the right ovary, running down the right thigh, calls for podophyllin. Prescribe three tablets once in two hours of the sixth decimal trituration.
In nymphomania where the sexual desire is easily excited, the least touch of the sexual organs causes violent sexual excitement—menses are irregular with large clots, murex purpurea, sixth decimal dilution, is the needed remedy. Add twenty drops to a glass of water and give a teaspoonful once in two hours.
Sterility. Out of five hundred and five cases of sterility three hundred and forty-three had uterine displacements, or about two-thirds of the whole. There are three forms, prolapsus uteri, anteflexion or retroflexion. Study the symptoms of each case carefully and give the remedy indicated. Don't depend upon pessaries to cure such cases. The Almighty never intended that a woman should be harnessed up like a horse.
There are cases where the natural position during intercourse is not the proper one to induce conception. In cases of retroversion, if the position of husband and wife are reversed during intercourse conception is more apt to occur. In anteflexion I have known cases where conception has taken place when the parties concerned had intercourse in the standing position.
Induration of the cervix uteri is another cause of sterility; conception cannot take place because the ovum slips out of the uterus before it is fertilized. We have one remedy which we can depend upon in such cases, Aurum Muriaticum Nat. (double chloride of gold and sodium). Give three grains of the third decimal trituration one hour after each meal. It will soften the indurations, increase the strength and appetite and, in two or three months, will often produce the result desired and the woman will be "in the way women like to be who love their lords." As a local application I like ichthyol and glycerine, equal parts, to be applied by means of a tampon pressed up against the os uteri. This tampon should be renewed once in twelve hours. In women with acrid leucorrhea, soreness, abrasions of the os uteri and vagina—there is membranous dysmenorrhea—borax is the remedy, administer in doses of three grains three times a day. Locally apply boracic acid on a sponge to which a narrow ribbon or string is attached. Roll the sponge in fine powdered boracic acid after it has been moistened in glycerine. Place the sponge in the vagina, push it up tight against the os uteria and allow it to remain for twenty-four hours, when it should be removed and a fresh one inserted. The borax has often produced conception and the labors after its use are easy. In vaginitis the leucorrhea is often of an abnormal acid condition, which is fatal to the life of the spermatazoa, thus preventing the desired conception. We may overcome this difficulty by placing a tampon moistened with the following prescription in the vagina:
Rx Bi-carbonate sodium, grs. xx.
Glycerine, ℥j. Mix.
Tie a string to the tampon and place it in position the latter part of the afternoon allowing it to remain in situ until the next morning. Let the removal be followed by intercourse and conception may take place.
There may be an abnormal irritability of the clitoris, causing an excessive secretion of the cervical glands. This may lead and often does lead to masturbation. When the genitalia are excessively sensitive, cannot bear to be touched, will almost go into spasms with the examination, platina is the remedy. Give three tablets of the sixth decimal trituration once in two hours.
Frigidity, the absence of the sexual desire, is another cause of sterility. The more passionate a woman is the more likely she is to conceive. Women who are worn out by worry or hard work sometimes lose their sexual passion. In such cases give the Fld. Ext. saw palmetto, twenty drops in a little water after each meal. It seems to vitalize and invigorate the whole system, restore the sexual desire, and conception may take place in a short time.
When married people want to have children they should remember to have intercourse on the last day of the menstrual period or on the third, fifth, or seventh day after the period has ceased. Diabetes, ulceration of the os uteri, fibroid tumors, and enlargements of the uterus should all be considered as causes of sterility, and must be treated by the indicated remedies.