What Women Should Know/Chapter 15

Falling or Displacement of the Womb.—Falling of the womb is a complaint to which women of all ages, both married and single, are subject. It may prostrate a young girl who has just reached maturity; it may make the life of the wife and mother wretched; or it may attack a woman past the childbearing age and render the remainder of her existence a weariness, if not a torture.

Description of the Womb.—The womb, uterus or matrix is situated within the pelvis, between the bladder in front and the rectum at the back. It bears a resemblance both in size and shape to a moderately large pear. The cervix or neck of the womb is small, and gradually enlarges to the fundus or upper part. Out of this part proceed the Fallopian tubes, two passages or ducts about three inches in length at the ends of which are the ovaries. It is through the Fallopian tubes that the ovaries pass during the monthly sicknesses. The womb is held in its place by broad ligaments extending to each side. When these ligaments weaken from any cause and give way, the womb, being no longer held in place, falls into some improper position.

​Various Displacements of the Womb.—The womb may incline too far forward, when it is called ante-version; or backward, when it is called retroversion. It may incline to either side, or it may descend low down in the vagina. Again, it is subject to in version, and may come into full view outside the vaginal passage.

Causes of Falling of the Womb.—One of the most frequent causes of prolapsus uteri is an improper mode of dress. Tight lacing, with the bones of the stays pressing upon the abdomen, can hardly fail to more or less derange the uterine system. The weight of heavy skirts suspended from the hips, and necessarily bringing great strain upon the abdominal muscles and viscera, is another certain cause. Too hard physical labor, by bringing too great a strain upon the muscles of the back, chest and abdomen, is another prolific source of suffering in this direction. On the other hand, a too idle, luxurious life tends to relax the muscles of those parts. A fall or sudden exertion may bring on the indications of this disease in one who has hitherto been free from it. Constipation, with the consequent pressure upon the uterus of the distended rectum, and the straining at stool, is certain, if long continued, to produce falling of the womb. An over-distended bladder, occasioned by long retention of urine, will produce the same result. A difficult or ill-conducted delivery is one of the most frequent causes; so, also, a too greatly hastened convalescence. Though I do not believe it is absolutely ​necessary to remain for a long period in bed after delivery, especially if the woman feels able to get up; still, no woman should ever return to the full care of her household in less than one month, and, in cases or extreme weakness and debility, a still longer period of exemption from hard labor is necessary. It requires one month at least to restore all the disturbed organs to their proper places, reduce the womb to its proper size, and bring strength and vigor back to the muscles.

Symptoms of Falling of the Womb.—The physical and mental symptoms attendant upon displacement of the womb are numerous and varied. Some are common to all sufferers from the complaint; others, though frequently encountered, are not always experienced. There will be a heavy, dragging sensation in the lower part of the abdomen and about the hips and loins; pain and weakness in the small of the back, sometimes so great as to prevent an upright position; weariness and difficulty in walking; painful menstruation; leucorrhœa or whites; a tired feeling amounting to actual pain at the back of the neck, as though the head had been long bent in an unnatural position; a dragging sensation at the root of the tongue, as though all the organs of the chest were hanging by their weight upon it; sometimes a frequent desire to make water without the ability, and a pressure upon the rectum producing feelings resembling a slight tenesmus. The sufferer is only comfortable in a recumbent posture. She is affected by low or variable spirits; will be of an uneven temper; and if ​of a nervous organization, easily excited and as easily depressed. Hysteria, in some one of its many forms, may develop itself.

Mode of Treatment of Falling of the Womb.—Falling of the womb is not difficult to cure if treated in season. Unfortunately, many women suffer for a long time without having a suspicion what is the matter with them.

First of all, the stays should be discarded and the clothing loosened about the waist. The skirts must be few and light, and worn with suspenders or waists to relieve the hips, abdomen and back of pressure and weight. Second, if the remodeling of the clothing does not abate the bad symptoms, the womb must be restored to and held in its proper place by the use of a pessary. This must be first adjusted in the vaginal passage by a physician, who should see that it fits properly. The patient must learn to put it in and take it out herself, as it should be frequently removed and replaced. Third, some tonic is required to strengthen the system and bring it up to the proper degree of health. Diet and exercise may do much toward this, but medicine is also required. Iron in some form is frequently prescribed, and is, no doubt, beneficial; of the muriated tincture of iron twenty drops is a dose, taken in a little water. In taking this medicine it should not be allowed to touch the teeth more than can be avoided. Huxham's Tincture of Bark I have found excellent, and I would recommend it in preference to iron.

​Falling of the Womb Sometimes Incurable.—Where falling of the womb comes on after the turn of life, the use of a pessary may not effect a cure, but it is, after all, the only means of relief. The ligaments which support the womb have then become weakened, and will never regain their strength.

Abdominal Supporter.—Those who are still in the first stages of this disease may check its progress by the use of a bandage or abdominal supporter, a diagram of which is given below. Those also in whom the disease has been found incurable will derive comfort from its use.

This bandage should be thirty-one inches across the top and thirty-six inches across the bottom. It should be seven inches in length on the front edges, nine inches from top to bottom of the back and three inches at the side seams. (It will, of course, be understood that the measurements here given are only designed to indicate the relative proportions of the bandage. In practice, the actual measurements must be made in reference to the size of the person who is to wear the bandage.)

This bandage should be made of two thicknesses of duck, and be fastened in front by lacing with a strong cord. The dotted lines indicate the shape and position ​of pieces of stiff leather which are to be stitched in. If the womb makes its appearance outside the vagina, there should be buttons at the places indicated, and straps crossing each other fastened from front to back, for the purpose of holding in place a cushion which will press upon the orifice of the vagina and prevent the descent of the womb. The bandage should be put on well down over the hips.

This bandage may be worn by a woman just recovering from confinement until she has acquired her customary health and strength.

Bad Effects of Constant Use of Bandage.—Those who have little or no hope of cure of their troubles may wear this bandage all the time if it affords them any relief. But young women, and those in the first stages of the disease, had best make only occasional use of it, putting it on perhaps when they feel more than ordinarily uncomfortable, or when they are about to make any extra exertion. This bandage will not cure falling of the womb. It will alleviate the suffering from it, but the disease still remains; and if the bandage is worn constantly, it is sure to aggravate the complaint. By its constant use, the muscles of the abdomen, being no longer obliged to act in their natural capacity, become, in course of time, hopelessly debilitated.

Patent Braces and Abdominal Supporters.—Let every woman suffering from "female weakness" scrupulously avoid the use of braces and abdominal supporters made of horn and metal, which ​are so widely advertised and for which so much is promised. The metal of which they are made becomes heated by contact with the body, and renders their constant use even more disastrous in its results than that of the cloth bandage.

Pregnancy Sometimes a Cure for Affections of the Womb.—Sometimes pregnancy alone will work a cure for affections of the womb, and a woman who has suffered before she became a mother will, if she pass through parturition safely and propitiously, and does not injudiciously hasten her convalescence, find herself afterward completely restored to health without any medical treatment whatever.

Ulceration of the Womb.—If a woman is sensible of soreness and a dull pain in the locality where she supposes her womb to be, accompanied perhaps with whites and many of the symptoms of prolapsus uteri; if, in case she is married, cohabitation is attended with more or less suffering, ulceration of the womb may be reasonably suspected. This requires the attention of a physician, who can only ascertain the true state of the case by the use of the speculum. If attended to in time, it is easily cured.

Leucorrhœa, or Whites.—Leucorrhoea, or whites, also called fluor albus, is a discharge peculiar to delicate women who are suffering from some form of "female weakness." It is the result of an inflammation of the inner surface of the womb, and is regarded by most authorities as a disease in itself, and treated as such. Yet I am inclined to believe that it is not a ​separate and distinct disease—only a symptom of some other disease. That it is almost invariably present in all forms of female weaknesses is admitted; and when there is no actual disease recognized, I think whites may be regarded as an indication that there is more. or less weakness and disorder, which, if unattended to, will result in disease.

Whether, however, the whites are considered as cause or effect in the category of female troubles, the remedies suggested will be equally efficacious. Extreme cleanliness of the parts of generation—by the means of baths and injections—is imperatively called for. An injection of green tea may be used with much benefit. Four or five grains of sugar of lead in three or four tablespoonfuls of rain water will also be found excellent in mild cases. White vitriol in about the same proportions is also used to advantage. So is also a decoction of oak bark or of nutgalls. In conjunction with these washes, strengthening medicine should be used.

Young girls approaching puberty are frequently subject to whites. In their cases this symptom needs no medical treatment whatever, as it simply indicates the approach of menstruation. When that is fully established, it will disappear.

Diseases of the Rectum and Anus.—Though men as well as women are subject to diseases of the rectum and anus, the latter are especially liable to them. The weight of the womb bearing upon these parts during pregnancy will frequently cause them. ​Ignorance or carelessness during delivery and subsequent confinement will often produce them. The principal disorders of these organs are piles, fissure of the anus and fistula. Of the latter I shall say nothing, as it is so serious a trouble that it absolutely requires the attention of a physician.

Piles.—Married women are especially subject to piles, though men are by no means exempt. If means are not early taken for their cure, they may become fixed in their character, and torment one for a lifetime. In a previous chapter I have described their symptoms and treatment. A severe delivery without proper protection of the anus is one of the most frequent causes of piles. Then the common use of castor oil and other purgative medicines during confinement can hardly fail to increase the tendency toward piles. At that period all the parts in the neighborhood of the generative organs partake more or less of the weakness and debility of those organs, and are consequently exceedingly liable to affections. The woman after her confinement, if she suffers any pain or difficulty in this region, should be on her feet as little as possible, though a certain amount of fresh air and exercise is necessary to bring her system up to that state which shall render it less susceptible to disease. Frequent bathing of the affected parts in cold water should also be resorted to for the same purpose.

Remedies for Piles.—An ointment made by simmering the bruised leaves of the Datura stramonium or Jamestown weed in lard or fresh butter and adding ​a little laudanum to it will, if applied to the affected parts, often afford speedy relief. Steaming over bitter herbs, or a sitz-bath in a hot tea of these herbs or of raspberry leaves, will relax the parts, allay irritability and reduce inflammation. The sufferer should always make use of a suppository either obtained at a druggist's or cut from mutton suet, before having a movement of her bowels.

Fissure of the Anus.—This is a trouble differing from, yet similar in its causes and treatment to, piles. It is the result of constipation combined with tenderness, weakness and semi-inaction of the rectum and muscles of the anus. The bowel is inclined to protrude the same as in piles, and the membrane which lines it tears or cracks. This fissure becomes irritated and inflamed from the frequent passage of the fœces over it. If constipation continues, the fissure is constantly enlarged by the consequent strain and stretching. The muscle surrounding the anus, called the sphincter muscle, becomes subject to spasmodic contractions causing the most intense pain. In severe cases these contractions, with the attendant pain, will continue for a large portion of the time. The woman cannot remain on her feet more than a moment at a time, nor can she keep any position long. Walking especially aggravates the misery.

Symptoms of Fissure of the Anus.—Fissure of the anus, unlike piles, disposes the sufferer from it to desire a hard seat rather than a soft one. In case of fissure, during the passage of the fœces a sharp, tear ​ing sensation is experienced in the anus, and severe pain follows the stool. During this pain, in trying to pass the finger up into the rectum, the muscles will be found tightly and rigidly drawn, so that the finger cannot be forced through.

Treatment of Fissure of the Anus.—The constipated state of the bowels must be remedied at once; for unless that is done, all attempts at cure are useless. A diet of brown bread and fruit—apples cooked and uncooked—with an abstinence from meat and pastry, and all articles of a stimulating or binding nature, will bring the bowels to a proper state quickly and effectually. The usual method of medical treatment is to partially sever the sphincter muscle in order to prevent the contractions and relieve the pain. In severe cases this may be necessary; but if a fissure receives proper attention in its early stages, I think the use of the knife may be dispensed with. Let the parts be kept scrupulously clean by careful bathings in warm, water after every passage of the bowels, in order that no acrid matter may remain to irritate the fissure. Sitting over a vessel containing hot herb or raspberry leaf tea so full that the hot tea shall touch the affected part will give great immediate relief and help toward effecting a cure. Suppositories may also be used before each stool to cool and lubricate the rectum or lower bowel and reduce the chances of irritation and tendency to inflammation. Frequent cold baths will be advisable to bring back the parts to a state of health and strength. Whether ​the sphincter muscle is severed or not, this course of treatment is equally necessary. Carriage-riding will be found of the utmost benefit in this trouble, as it gives the required exercise without necessitating the sufferer to be upon her feet. Anointing the affected part with a mixture of glycerine and tannin will speedily cure the fissure. After that the stramonium ointment recommended in piles will afford relief from the pain and soreness.

The Menopause or Change of Life.—In a woman's life there comes a time when she is released by nature from the functional duties of motherhood. This period occurs somewhere between the fortieth and fiftieth years; rarely either later or earlier. The ovaries no longer produce ova, and the menstrual flow ceases. There is a change in the woman's appearance, and frequently in her health.

Best Years of a Woman's Life.—When she has lived carefully and judiciously during her previous life—when she has passed through the years of her motherhood wisely and well, preserving her health and husbanding her strength—this period should be approached without apprehension. Once safely passed, the years that follow it ought to be considered the most precious and useful of a woman's life. At forty-five a man is in his prime. At the same age so ought also to be a woman, with vigorous health, intellect cultivated and energies unimpaired. She ought not to expect to be called away by death for long years to come, and these years should be full of active work. ​The woman is now released from home duties. There is no longer a baby to cry, or little ones to cling to her and keep her a willing or unwilling prisoner within home bounds. The years of motherhood, if she has improved them rightly, have been years of deep and earnest thought and of valuable experience. They have been the school of her life, and she is now called upon to make use of the knowledge she has acquired. She may go out into the world; she may confine herself to society or the church; or she may not go beyond the limits of her own home-circle; but wherever she is, she should be an active worker and a wise and prudent counselor.

Wasted Old Age.—If, on the other hand, the girl's entrance into woman's estate was signalized by pain and suffering; if child-bearing has been torture and motherhood weariness; if in the spirit of self-sacrifice she has considered the wishes or even the comfort of her family before her own imperative physical and mental needs, and has thus been spendthrift of the vitality and energy of a lifetime during the years of wifehood and motherhood—then she may well approach the critical period of the change of life with fear and trembling. Nature is an inexorable creditor, and will demand payment of all debts incurred to the last penny. In this case she can only look forward to a premature old age; a time in which she must sit for long years in the chimney-corner, knitting perhaps, or dandling a grandchild; growing weak and querulous; the gossip of the neighborhood ​her only intellectual food, its scandal her greatest excitement. She can look forward to an early approach of second childhood, and know that, unless her children possess more than an ordinary amount of filial affection, she will sink at last into an unwept grave because "she had so long outlived the period of her usefulness." The picture is a gloomy but a true one in many cases.

As the sufferings and perils of approaching puberty and maternity are the undoubted results either of organic deficiencies or of some violation of natural law, so these same causes will operate to make the second great change in the life of a woman painful and dangerous.

Symptoms of Change of Life.—When the period of the change of life is at hand, the menstrual flow may suddenly cease and never again appear; or it may become irregular, going and coming at greater intervals of time. It may be more scant than usual, or it may come on with flooding. The woman may experience the symptoms of pregnancy, and for some months believe herself in that condition. She may be subject to flushes of heat followed by chilliness; palpitation of the heart, pains in the back and loins, even symptoms of hysteria. It may be well for the woman to place herself under the care of a physician, but there is little to be feared. Even the flooding need not be checked unless it be too profuse. It is only an effort of nature to avert the evils which result from plethora. Sometimes, instead of flooding, there is frequent bleeding at the nose, or even spit​ting of blood. These result from the same cause, and one in no wise dangerous.

The nervous and mental systems may become deranged in sympathy with the physical changes going on. Serenity of mind and patience should be striven for, and there should be no giving way to morbid apprehensions.

Treatment for the Disorders incident to Change of Life.—The reader will probably smile when I give my own invariable prescription for all the ills which female flesh is heir to—namely: careful diet, exercise in the open air, and occupation. If the woman is of full habit, she should at once subject herself to the plainest and most sparing diet—a diet differing little from that to be used during pregnancy. She should abstain from meat, from rich food of all kinds, and especially from wine, beer and other stimulants. On the other hand, if her system is debilitated, her food should be nourishing in character, and tonics may be used with advantage.

A spice plaster on the pit of the stomach may relieve unpleasant sensations, or "goneness," there; and a teaspoonful of aromatic spirits of ammonia diluted in water and taken internally will probably restore equilibrium to the nervous system. The pains in the back and loins can be allayed by applications of hot mustard water, or laudanum and water.

Certain diseases are more liable to develop themselves at this period than at any other. A woman who has been careless and injudicious in regard to ​her health, and who has worked too early and too hard during motherhood, need not be surprised if she finds herself a victim without apparent cause to prolapsus uteri. The muscles and ligaments of the womb, if they have been overstrained, relax entirely at this period, and prompt medical assistance can alone prevent her from being a sufferer to the end of her life.

Cancers and tumors of the uterus and breast are more liable now to develop themselves. Where their existence is suspected, medical advice ought at once to be sought, as they can sometimes be arrested or removed in their early stages. However, these affections are not so common that women need give way to fears until there are actual indications of their presence.

Fraught as this period of life seems to be with danger and difficulty to women, it is, after all, more so in seeming than in reality. Statistics of mortality prove that more men than women die between the ages of forty and fifty. So that the period of change may safely be regarded only as a few months of inconvenience at worst. At best, and according to the intentions of nature, it may signify nothing at all save the opening of the doors of life into improved and thoroughly established health, with in no wise decreased faculties for enjoyment, and with enlarged opportunities for usefulness.