MENSTRUATION. 15 



broken down, and discharged along with more or less blood, 

 constituting the menses, or monthly sickness, which com- 

 monly lasts from three to five days. During this time the, 

 vaginal secretion is also increased, and, mixed with the 

 blood discharged, more or less alters its color and usually 

 destroys its coagulating power. Except during pregnancy 

 and while suckling, menstruation occurs at the above 

 intervals, from puberty up to about the forty-fifth year; 

 the periods then become irregular, and finally the discharges 

 cease; this is an indication that ovulation has come to 

 an end, and the sexual life of the woman is completed. 

 This time, the climacteric or "turn of life," is a critical 

 one; various local disorders are apt to supervene, and even 

 mental derangement. 



Hygiene of Menstruation. During menstruation there 

 is apt to be more or less general discomfort and nervous irri- 

 tability; the woman is not qtiite herself, and those respon- 

 sible for her happiness ought to watch and tend her with 

 special solicitude, forbearance, and tenderness, .and protect 

 her from anxiety and agitation. Any strong emotion, 

 especially of a disagreeable character, is apt to check the 

 flow, and this is always liable to be followed by serious con- 

 sequences. A sudden chill often has the same effect; hence 

 a menstruating woman ought always to be warmly clad, and 

 take more than usual care to avoid draughts or getting wet. 

 At these periods, also, the uterus is enlarged and heavy, and 

 bein^ (as may be seen in Fig. 163) but slightly supported, 

 and that near its lower end, it is especially apt to be dis- 

 placed or distorted; it may tilt forwards or sideways (ver- 

 sions of the uterus), or be bent where the neck and body of 

 the organ meet (flexion). Hence violent exercise at this 

 time should be avoided, though there is no reason why a 

 properly clad woman should not take her usual daily walk. 



Painful menstruation (dysmenorrhwa) may be due to very 

 many causes, but it is only within recent years that physi- 

 cians have come to recognize how often it depends on uterine 

 displacements, and in such cases how readily it may usually 

 be remedied by restoring the organ to its proper position, 

 and supporting it there if necessary. A flexion of the organ 



