12 September 1874 • New York, N.Y. (MS facsimile: CU-MARK, UCCL 01127)
olc Ⓐemendation
It was a hard journey. Livy has taken all the care she could, since we have arrived. She has not been down stairs yet. Still, she began to flow this morning, had no appetite for breakfast, & is nauseated all the time. She is lying down all day, & Clara Spaulding will foment her tonight. She has her girdles on.
Now no doubt “treatment” is necessary again.1explanatory note If so, will you write & tell a reliable lady physician here to come to the hotel & administer it? We are most comfortably housed, here, & Livy shall not budge a peg till she is safe, if it be a year.
Many thanks for your letter. We send our kindest regards to all of you.2explanatory note
In Talks to My Patients, Gleason recommended treatment for “menorrhagia, or profuse menstruation”:
Vaginal injections, taken while in the sitz bath, and an enema for the bowels of half a pint of cool water, to be retained as one lies down, are valuable where there is a tendency to flooding.
A girdle, made of two thicknesses of linen (not very heavy), about one-third of a yard wide and long enough to pin about the hips and around over the abdomen, wet, with two thicknesses of heavy dry cotton over it, and all fitted comfortably over the hips and pinned over the stomach and bowels, will, if changed as often as it gets warm and dry, keep down the tendency to heat in the pelvic region, and be very grateful to the patient. In the absence of nicely-fitting girdles, towels, one wet and the other dry, may be substituted, and worn in comfort.
When the monthly period commences it is usually safe to take sitz baths, the first day at ninety-five degrees; the second day at ninety degrees; the third day at eighty-five degrees, and so on, gradually reducing the temperature as heretofore directed, and using the vaginal injection in the bath.
The first day, if there be great pain, it may be necessary to take a sitz bath at one hundred and five degrees, with the usual vaginal injection, and then adopt the range of temperature before indicated.
Sometimes the hot sitz bath fails, and then fomentations over the region of the pain, from half an hour to an hour, hot as can possibly be borne, will prove effective.
Let the food be nourishing, but not stimulating. Let the head direct the hands in useful labor, or if the time be employed in reading, let it be historic and scientific, rather than the ideal and emotional, which reacts unfavorably on the uterus.
Intense love of music, and excessive devotion to the same, often induces too early and too profuse menstruation. (Gleason, 32, 36–37)
Gleason’s letter has not been found. The recipients of the Clemenses’ regards are identified in 10 June 74 to OC and MEC, n. 1.click to open link
MS facsimile, Mark Twain Papers, The Bancroft Library, University of California, Berkeley (CU-MARK).
L6 , 231–232.