on. A slight pain or at least a feeling of discomfort is
present in most cases of menstruation. But in many cases the pain is
so severe, so _excruciating_, that the sufferer, girl or woman, is
incapacitated for any work, and must go to bed for a day or two. In
some cases the pain is so severe as to necessitate the use of
morphine, and as it is a very bad thing to have to give morphine every
three or four weeks, every endeavor should be made to find out the
cause of the trouble and to remove it. It is a mistake, however, to
think that all or even most cases of dysmenorrhea are due to some
local trouble, that is, to an inflammation of the ovaries, or a
displacement of the womb. Many cases of dysmenorrhea are of _nervous_
origin; the cause resides in the central nervous system, and not in
the genital organs themselves. It is, therefore, not advisable to
undertake any local treatment, unless a competent physician has made a
thorough examination and has decided that local treatment is
advisable.

As to the percentage of dysmenorrhea, a recent statistical examination
of 4,000 women showed that dysmenorrhea of some degree was present in
over one-half, namely, 52 per cent.

CHAPTER EIGHT

THE HYGIENE OF MENSTRUATION

Lack of Cleanliness During Menstrual Period--Superstitious
Beliefs--Hygiene of Menstruation.

The hygiene of menstruation can be expressed in two words: cleanliness
and rest. Common sense would suggest these two measures, and as far as
rest is concerned, many women do rest or take it easy while they are
unwell. Some are forced to do it, because, if they don't, their
dysmenorrhea is worse and the amount of blood they lose is
considerably increased. The same cannot be said of cleanliness. Due
undoubtedly to the superstitious opinions about menstruation, which
came over to us from the ages-of-long-ago, menstruation is still
considered a _noli-me-tangere_, and women are afraid to bathe, to
douche or even to wash during the periods. And if there is any period
when a woman needs a douche it is during menstruation. Any leucorrhea
that a woman may be suffering from becomes aggravated around the
periods; the menstrual blood of some women has a decided odor, and if
no cleansing douche is taken during four or five days, some of the
blood decomposes and acquires a decidedly offensive odor, which can be
noticed at some distance and to which some men and women are very
susceptible. There are some women who neve