Full Title: The Works of John Fothergill, M.D. . . . with some Account of his Life by John Coakley Lettsom. London: Printed for Charles Dilly, in the Puultry, M.DCC.LXXXIV. [1784]
OF THE MANAGEMENT PROPER
AT THE
CESSATION OF THE MENSES
To the Medical Society in London.
Gentlemen,
THERE is a period in the life of Females to which, for the most part, they are taught to look with some degree of anxiety; as a period on which depends their enjoying a good or bad state of health during the residue of their lives.
The various and absurd opinions relative to the ceasing of the mentrual discharge, and its consequences, propagated through successive ages, have tended to embitter the hours of many a sensible women. Nor have these mistaken notions been confined to them only; they have occupied the minds of such who ought to have been better informed: some practitioners, in other respects able and judicious, if they have not favoured these erroneous and terrifying notions, seem not to have endeavoured to correct them, with the diligence and humanity which an object like this requires.
The design of this essay is to contribute my mite towards so necessary a purpose; to assist in removing these groundless apprehensions, and to substitute a reasonable confidence, that, with very little aid, Nature is sufficient to provide for her own security on this occasion.
You must forget for a moment that I am submitting these remarks to the judgment of a Society, every member of which, perhaps, is as capable of this work, and some much better than myself. I am writing to many sensible young men in the profession of physic, who, though they may have applied themselves to the general study and practice of our profession with diligence and success, may not yet, perhaps, know where to look for such information on this subject as may be sufficient to satisfy themselves and their patients, what managment is proper when the Menses are about to cease.
To propose a regimen that shall suit all the different cases that may occur, would require a volume. To give some general direction is all I intend, without entering into a minute description of the commencement, progress, and termination of the Menses. I must suppose every thing of this kind is already known, and that the single question is, What conduct, what management is necessary to be observed, when the Menses are about to cease, by the patient who consults her physician on the occasion? We are now sensible that the menstrual discharge is not, what it was too long and too generally believed be by many of the sex, an evacuation of peccant matter and morbid humour, sometimes acrimonious and malignant, whose retention, from its noxious qualities, never fails to be extremely injurious to the constitution. What opinion the ancients entertained concerning it, I need not repeat to you: that its malignancy was such as to affect even inanimate bodies. But these fables are wholly disbelieved, except by some of those who ought to be undeceived in a matter that so much concerns them.
It is now well known, and the sex cannot be too generally apprized of it, that the menstrual discharge possesses no such injurious or malignant properties; that it is solely a redundancy of that pure vital blood, which animates the whole frame of a healthy person; and that its retention is by no means attended, in general, with effects that are not as easily removed as any disorder to which they are subject.
That some acrimonious morbid humours may be discharged together with the Menses, when any such exist, is not improbable. So it happens likewise to men subject to piles, or other preternatural excretions.
Women who have unhappily imbibed that prejedice, are naturally alarmed at the consequences they apprehend must ensue from such a change in their constitution; and the more strongly they are preposessed with a belief, that by this channel has been regularly discharged whatever had a tendency to produce diseases, the more they are terrified with apprehensions of some of the worst complaints: and, indeed, it is not seldom that, by such anxiety, they bring on disorders that are not easily removed, attributing them to the cause we are speaking of, whilst they principally originate from anxiety.
For the most part, the menstrual discharge, as has been mentioned, proceeds from a redundancy of good and healthy blood; this redundancy is formed for the most necessary purposes; continues whilst this necessity subsists; and ceases when, according to the constitution of the female frame, it is no longer required.
The powers communicated to the human system, generally expressed by the term Nature, are such as spontaneously bring about this cessation. The provision for the Mesnes ceases, and extra quantity of blood is not generated, and the vessels provided for its regular discharge by degrees collapse; and in general all this proceeds without any the least interruption to the health of the subject in which this alteration happens. Here it might not be improper to mention at what time this alteration first begins, and the general period of its cessation. These circumstances, however, may be found elsewhere so amply treated of, as to render it as unnecessary as it is foreign to my present design.
There are great numbers of women in whom the menstrual discharge ceases, without their perceiving any alteration in their usual health. There are some who, from being invalids during a part of the season which is appropriated to menstruation, find themselves by degrees recovering health and vigour, to which they have been strangers during that period, when this discharge leaves them entirely. Very tender, delicate, relaxed habits, subject to copious discharges, are often much benefited by the cessation. All, however, are not so fortunate. Some alterations frequently supervene, that render assistance necessary. . . .
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