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LETTER II.. Of Menstruation.

Midwifery and the Diseases of Women · Joel Shew — chapter 2 of 38 · ~1,645 words · public domain

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OF MENSTRUATION.

Puberty—The Menstrual Discharge—The Marriageable Age.

I am now to write you on a most important subject; I mean that which refers to puberty—the menstrual function, and what we call the marriageable age. I think you will agree with me in thinking that there is no period of the whole life of the female which should give a parent more anxiety and solicitude than the one of which I am now to speak. I trust, therefore, that you will give good attention to all I may say on so important a matter, and learn all that you can about it, from whatever source.

Puberty, or the marriageable age of woman, occurs at a somewhat different age in different parts of the world. In temperate climates, the period of puberty may be reckoned as being at from the twelfth to the sixteenth year. In tropical climates it appears to be considerably earlier, as from eight to twelve; and in the frozen regions later than all, from fifteen to twenty years. It has been said that the Turkish women are capable of becoming mothers at the age of seven or eight years; but of this there is at least room for doubt.

There are other circumstances than those of climate that influence the coming on of the period of puberty. Those that lead habitually an inactive life, a life of leisure and luxury, so called; those who, without sufficiently attending to physical and out-door exercise, practice much the imitative arts, such as painting and music; those who frequent theaters, balls, and parties, late at night; read novels and other works that powerfully excite the imagination and feelings; and especially such as are so unfortunate as to have access to obscene pictures and books, arrive at the season of puberty earlier than others.

So also the use of rich, concentrated, and highly stimulating food and drinks, render the young, of whichever sex, far more precocious, in regard to puberty, than a plain and unstimulating diet. Temperance and frugality, with simplicity of manners, especially if the individual lead a rural, or country life, are always more favorable in reference to the coming on of this important period.

Previously to the period of puberty, the general organization of the male and female progresses very much alike. The tastes and habits, however, vary. The little girl is fond of her doll-babies and play-houses, while the boy exhibits a liking for more manly sports. There is, however, no great difference, up to this time, in the physical frame of the two sexes; but as the period of puberty approaches, there is manifested a great difference in the two beings. In the language of an eloquent writer, Velpeau, “the young girl becomes more timid and reserved, her form becomes rounded, her voice alters but to take on a softer and more harmonious tone, and her bosom is developed; the cellular tissue extends from the front of the breast and the hypogastrium, as from two centers, toward the neck, while at the same time it proceeds to form a soft cushion for the upper part of the limbs. Her eyes, which are at once brilliant and languishing, express commingled desires, fears, and tenderness; the sensations she experiences, and the sense of her own weakness, are the reasons why she no longer dares to approach the companions of her childhood but with a downcast look. On the other hand, the gentle modesty that animates her countenance, and the engaging graces of her demeanor, soon disclose a power, the existence of which she never suspected, and which renders it true to say that the marriageable age in the softer sex is the spring-tide of nature, and the season of the pleasures. But a new function—the catamenial—the absolute compass of good or bad health in woman—is established, with more or less difficulty, in the midst of this great revolution; and by the disorders and accidents which it involves, sometimes dashes with bitterness those happy seasons to which it should naturally serve as a prelude. Such are the changes that go on in the female constitution at one of the most important and critical seasons that can occur in the female’s life.”

The period at which woman may be said truly to arrive at her womanhood, is certainly, in the present state of artificial life, fraught with many dangers to the future health. But, on the other hand, we have proof the most positive and indubitable—the proof of facts—that if young girls are brought up in a simple, judicious manner, and if all their habits—social, moral, physiological, and hygienic—be correct, there can be, as a general law, no danger at the coming on of puberty. With judicious management throughout, the girl will pass through this change with as little difficulty, as little danger and derangement of the general health, as occurs at any other season of her whole life. Although the change is a great one, it is yet within the order of nature, a fact which we should always bear in mind.

The foregoing remarks on puberty lead me necessarily to speak of the menstrual function.

AGE AT WHICH THE MENSES COMMENCE.

In Greece and other hot countries, it is said that the menses appear usually at nine or ten years of age. In the more temperate climates generally, as in Great Britain and our own country, the average age at which menstruation commences is from fourteen to fifteen years.

Habits of life, also, have something to do with the evolution of this function. “The early or late appearance of the menses,” says Dr. Denman, “may depend upon the climate, the constitution, the delicacy and hardness of life, and upon the manners of those with whom young women converse.” High living, the use of stimulating food and drinks, living in populous cities, the habit of frequenting balls and theaters, and of being taught early in the habits of civic life, have all, doubtless, a considerable effect in rendering girls precocious as to menstruation. In Paris, girls are occasionally observed to become regular at ten, eleven, and twelve years. Velpeau knew one that menstruated at nine and a half years; another at ten and a half; and one young woman who at fourteen was as tall and robust as the majority of women at twenty, and had been entirely in a state of puberty since she was eight and a half years old.

On the other hand, a country life and occupation, simplicity of manners, and frugal regimen, appear to be circumstances which procrastinate, to a greater or less extent, the coming on of the menstrual function. It is said that with the North American Indians this epoch does not commence until from the eighteenth to the twentieth year.

A table showing the ages at which the menses appeared in 450 cases, as quoted by Dr. Maunsel, of Dublin, as having been given by Mr. Robertson in the Edinburgh Medical and Surgical Journal, is as follows:

10 first menstruated at 11 years 19 „ 12 „ 53 „ 13 „ 85 „ 14 „ 97 „ 15 „ 76 „ 16 „ 57 „ 17 „ 26 „ 18 „ 23 „ 19 „ 4 „ 20 „ ——— 450 total.

According to this table, it will be seen that with the largest number, namely, 97, menstruation commenced at the age of fifteen; and nearly as many at sixteen as fourteen; so that we are to regard the average age in such a climate as Great Britain, Germany, France, and the United States, as being from fourteen to fifteen years.

Dr. Meigs, of Philadelphia, gives a table on the authority of Drs. Boismont, of Paris, and Lee, of London, showing the ages at which 1,781 women began to menstruate, in France and England, as follows:

110 first menstruat. at 11 years 144 „ 12 „ 256 „ 13 „ 860 „ 14 „ 366 „ 15 „ 284 „ 16 „ 144 „ 18 „ 72 „ 19 „ 40 „ 20 „ ———— 1776 total.

At what age the remaining five first menstruated, the table does not show. On the whole, its results may be regarded as very similar to those of Mr. Robertson’s table, before given.

Dr. Guy, of London, gives a table of the ages at which menstruation commenced of 5,062 cases, 2,905 being of England, 1,825 of France, 332 of Germany; the total numbers being as follow:

1 first menstruat. at 5 years 1 „ 7 „ 2 „ 8 „ 15 „ 9 „ 48 „ 10 „ 263 „ 11 „ 368 „ 12 „ 554 „ 13 „ 839 „ 14 „ 926 „ 15 „ 751 „ 16 „ 574 „ 17 „ 379 „ 18 „ 173 „ 19 „ 111 „ 20 „ 29 „ 21 „ 14 „ 22 „ 10 „ 23 „ 4 „ 24 „

There is one topic connected with this subject which I cannot here enlarge upon, but which I will simply refer to by quoting the remarks of a certain author who has given much attention to the subject.

Dr. Ray, author of a work on the “Medical Jurisprudence of Insanity,” observes, “that the evolution of the sexual functions is very often attended by more or less constitutional disturbance, especially in the female sex, is now a well-established physiological truth. The shock seems to be felt chiefly by the nervous system, which experiences almost every form of irritation, varying in severity from the slightest hysteric symptoms to tetanus, St. Vitus’ dance, and epilepsy.” “And when we bear in mind, also, that general mania is sometimes produced by this great physiological change,” continues this author, “it cannot be deemed an extraordinary fact that partial mania, that partial acts, inciting to acts of incendiarism or murder, should be one of its effects.”

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