Chapter VII: Of the Retention of the Menses

The suppression of the terms is an interception of that accustomed evacuation of blood which every month comes from the matrix, proceeding from the instrument or matter vitiated. The part affected is the womb, and that of itself or by consent.

_Cause._—The cause of this suppression is either external or internal. The external cause may be heat, or dryness of air, immoderate watching, great labour, vehement motion, &c. whereby the matter is so consumed and the body so exhausted, that there is not a surplus remaining to be expelled. Or it may be caused by cold, making the blood vicious and gross, condensing and binding up the passages, that it cannot flow forth.

The internal cause is either instrumental or material, in the womb or in the blood. In the womb it may be divers ways; by imposthumes, humours, ulcers, by the narrowness of the veins and passages, or by the omentum, in fat bodies, pressing the neck of the matrix, but then they must have hernia, zirthilis, for in mankind the caul reacheth not so low; by overmuch cold or heat, the one vitiating the action, the other consuming the matter by an evil composition of the uterine parts, by the neck of the womb being turned aside, and sometimes, though rarely, by a membrane or excrescence of the flesh growing about the mouth or neck of the womb. The blood may be in fault two ways, in quantity or quality: in quantity, when it is so consumed that there is not a superplus left, as in viragos, or virile women, who, through their heat and strength of nature, digest and consume all in their last nourishment. The blood likewise may be consumed, and consequently the terms staid, by bleeding at the nose, by a flux of the hemorrhoids, by a dysentery, or bloody flux, by many other evacuations, and by continual and chronical diseases. Secondly, the matter may be vicious in quality; and suppose it to be sanguineous, phlegmatical, bilious, or melancholic; every one of these, if they offend in grossness, will cause an obstruction in the veins.

_Signs._—Pains in the head, neck, back, and loins; weariness of the whole body, (but especially of the hips and legs, trembling of the heart.) If the suppression proceed from cold, she is heavy, sluggish, of a pale colour, and has a slow pulse; the urine curdles, the blood becomes waterish and much in quantity, and the excrements are retained. If of heat, the signs are contrary to those now recited. If the retention come of conception, this may be known by drinking of water and honey, after supper, going to bed, by the effect which it worketh; for if, after taking of it, she feels a beating pain upon the stomach, and the lower part of the belly, it is a sign she hath conceived, and that the suppression is natural; if not, then it is vicious, and ought medicinally to be taken away.

_Prognostics._—With the evil quality of the womb, the whole body stands charged, but especially the heart, the liver, and the brain; and betwixt the womb and these three principal parts there is a singular concert: First, the womb communicates to the heart by those arteries which come from the aorta. Hence, the terms being suppressed, will ensue faintings, swoonings, intermission of pulse, cessation of breath. Secondly, it communicates to the liver by the veins derived from the hollow vein. Hence will follow obstructions, jaundice, dropsies, hardness of spleen. Thirdly, it communicates to the brain by the nervous membrane of the back: hence will arise epilepsies, frenzies, melancholy passion, pain in the after parts of the head, fearfulness, and inability of speaking. Hippocrates says, if the months be suppressed, many dangerous diseases will follow.

_Cure._—The suppression is a plethoric effect, and must be taken away by evacuation; and therefore we begin with the phlebotomy. In the midst of the menstrual period open the liver vein; and for the reservation of the humour, two days before the evacuation, open the saphena in both feet; if the repletion be not great, apply cupping-glasses to the legs and thighs, although there should be no hopes of removing the suppression. As in some the cotiledones are so closed, it will be convenient, as much as may be, to ease nature of her burden, by opening the hemorrhoid veins with a leech. After bleeding, let the humours be prepared and made flexible with syrup of calamint, betony, hyssop, mugwort, horehound, fumitory, maiden-hair. Bathe with camomile, pennyroyal, savin, bay-leaves, juniper-berries, rue, marjoram, feverfew. Take of the leaves of maiden-hair, succory, and betony, of each a handful, make a decoction; take thereof three ounces. Syrup of maiden-hair, mugwort, and succory; mix of each half an ounce. After she comes out of the bath, let her drink it off. Purge with pill de agarice, fley-bang, corb, feriæ. Galen commends pilulæ de caberica, coloquintida; as they purge the humour of offending, and open the womb, and strengthen the faculty by their aromatical quality.

If the stomach be overcharged, let her take a vomit, such a one as may work both ways, lest working only upward, it should too much turn back the humour.

After the humour hath been purged, proceed to more proper and forcible remedies. Take of troschisk of myrrh one drachm and a half; of musk ten grains with the juice of smallage; make twelve pills; take six every morning, or after supper going to bed. Take of cinnamon half an ounce, smirutium, valerian aristolochia, of each two drachms; roots of astrumone, drachm saffron, of each two scruples; spec. diambia, two drachms; troschisk of myrrh, four scruples; make half into a powder; with mugwort water and sugar a sufficient quantity, make lozenges, take one drachm of them every morning; or mingle one drachm of the powder with one drachm of the sugar, and take it in white wine. Take of prepared steel, spec. hair, of each two drachms; borax, spec. of myrrh, of each one scruple, with the juice of savin; make it up with the lozenges, and take three every other day before dinner. Take of castor one scruple, wild carrot seed half a drachm, with syrup of mugwort, make four pills; take them in a morning fasting, for three days together, before the wonted time of the purgation. Take of juice of horehound, of each five drachms; rhubarb, spikenard, aniseed, galbanum, asafœtida, marrow root, gentian, with honey, make an electuary, take of it three drachms for a dose. In phlegmatic bodies nothing can be better given than the decoction of the wood guiacum, taken in the morning fasting, and so for twelve days together, without provoking of sweat.

Administer to the lower parts by suffumigations, pessaries, unctions, injections: make suffumigations of cinnamon, nutmeg, cloves, bay berries, mugwort, galbanum, molanthium, amber, &c. Make pessaries of figs, and the leaves of mercury bruised, and rolled up with lint. Make injections of the decoction of origane, mugwort, betony, and eggs; inject it into the womb by an instrument for that purpose. Take of oil of almonds, lilies, capers, camomile, of each an ounce; laudani, oil of myrrh, of each two drachms; with wax make an unguent, with which let the place be anointed; make infusions of fenugreek, camomile, melilot, dill, marjoram, pennyroyal, feverfew, juniper-berries, and calamint; but if the suppression comes by a defect of matter, then ought not the menses to be provoked until the spirits be animated, and the blood again increased; or, by proper effects of the womb, as dropsies, inflammations, &c. then must particular care be used.

If the retention comes from repulsion or fulness, if the air be hot or dry, use moderate exercise before meals, and your meat and drink attenuating; use with your meat garden savory, thyme, origane, and cyche peason: if from emptiness or defect of matter, if the air be moist and moderately hot, shun exercise and watching; let your meat be nourishing and of light digestion, as raw eggs, lamb, chickens, almonds, milk.