Chapter 11 - Female Diseases
Introduction to Female Diseases
Inflammation of the Neck of the Womb
Inflammation of the Ovaries
Whites
Absence of the Menses
Profuse Menstruation
Painful Menstruation
Green Sickness
Cessation of the Menses
Hysteria
Polypus of the Womb
Uterine Hydatids
Inflammation of the Womb
Falling of the Womb
Falling Over of the Womb
Tumors of the Womb
Cancer of the Womb
Ovarian Tumors
Inflammation of the Fallopian Tubes
Inflammation of the Vagina
Itching of the External Parts
Tubal Pregnancy
Sterility
Midwifery
Miscarriage
Abortion
Prevention of Pregnancy
Labor
Antiseptic Dressings
Milk Leg
Child Bed Fever
Puerperal Convulsions
Hemorrhage
Nursing Sore Mouth
Broken Breast
Sore Nipples
Sex of Child, How to Regulate Before Birth

11.24 Midwifery

Midwifery.

A STOPPAGE, of her courses is most commonly the first notice a woman has of her being in the family way. This is perceived about three weeks after conception, when she begins to experience other feelings peculiar to the situation. These feelings are nausea and vomiting, or a decided languor, in the morning; swelled and sometimes painful breasts; the areola, or colored rings around the nipples, darker than usual; pain in the lower part of the back; and, occasionally, a good deal of spitting of a frothy, cotton like, substance.
These symptoms are more or less severe in different cases, and under different circumstances, according to the state of the patient's bowels and her habits of exercise. Ordinarily, she suffers most during the second and third months, on account of
Sinking Down of the Womb, which, from soon after the period of conception, is gradually increasing in size and weight. As it grow larger and heavier, it sinks lower in the cavity of the pelvis, until about the fourth month, when, becoming so large that it cannot longer be accommodated within the narrow limits of this unyielding box of bones, it is obliged to mount higher to find room in the ampler and more distensible belly. This low position of the womb in the early months of pregnancy occasions many disagreeable sensations, as pain in the lower part of the back and sickness at the stomach.
The Costiveness, too, from which women suffer so much at this time, is often caused, in part at least, by the pressure of the enlarged womb upon the lower bowel. Costiveness, thus induced, at length becomes itself a cause of serious mischief. The lower bowel, filled and enlarged with its hardened contents, reacts upon the womb, crowding it still lower in its narrow quarters, and greatly increasing its excitability. The enlarged bowel and womb combined make constant pressure, sometimes upon the urethra, or water pipe, causing pain and difficulty in making water, and always upon the ascending veins, checking the return of blood, and producing congestion in the lower bowel, manifested by troublesome piles.

Treatment of Pregnancy. When the pregnant woman first recognizes her situation, she should determine to "observe moderation in all things." Let her avoid violent and sudden exertion, and move about more calmly and evenly than usual. By this is not meant that she should give up her customary occupation; but that she should pursue it with becoming carefulness, resolved in no case to hazard over exertion, and rather leaning to the side of indolence. This would not be real indolence, for she is doing a great work internally, and should not unduly withdraw her energies to external affairs.
Let her not be too much in the erect position. If of delicate constitution, and not in vigorous health, she should make it a point to lie down several times during the day. The standing position, continued for a long time, especially if it be under circumstances to induce fatigue, greatly favors the descent of the womb, while a frequent rest in a horizontal position may enable it to keep its place.

An Objection. It may be objected by some, that a large majority of the mothers in the world are working women, and obliged to contribute by their industry to the support of their families; and that they cannot afford, therefore, to lie still, and mind directions.
To this it may be answered, that it is a great advantage to understand the best way, so as to have the privilege of at least aiming at it. Much is accomplished, in all circumstances, by aiming at doing the best thing; and few women are so situated that they could not so favor themselves as to obey the laws of health a little more perfectly, if they thoroughly understood them. All can better afford to avoid sickness, than to be sick. Many occupations, also, unless money tempt to excessive application, become, when steadily followed, comparatively easy and unexciting. Thus, most people can go through their usual round of duties, because they have got wed to it. Indeed, there is nothing but indolence itself, to which we may not become accustomed. The difference between the laboring and the privileged classes is more imaginary than real. All must work . None can escape the primeval decree “In the sweat of thy face shalt thou eat bread."
Many women, when they find themselves in the family way, win observe no caution, but work all the harder, and even use other means for the purpose of bringing on abortion, and preventing an increase of children. This unnatural and wicked, but too prevalent, disposition, results sometimes from a fear of the pains of child birth, sometimes from a desire to avoid the necessary care and confinement connected with raising children, but most often from a wish to escape the expenses which the prevailing fashions and customs of society connect with a large family. The cost of a shattered nervous system, and of a body weakened and poisoned by powerful drugs, is not considered, because not understood! Hence the success of those quack advertisements, impudently professing to cure female diseases, but whose chief object is disclosed by the insertion of the hypocritical caution ,, Be careful not to take this medicine during pregnancy, as it will be sure to produce abortion."
It seems as if the world would never learn that God loves children, although since, Abraham’s day be has said so much about them in his Word, although His Son, sent into the world on purpose to show the disposition of the Father, took them up in his arms, and blessed them, and although He has implanted a most wonderful love of them in the soul of man.

Costiveness and Piles. Let the pregnant woman use all proper means to keep her bowels in order. She will thus greatly diminish the distressing nausea, and may entirely prevent the accession of piles. To accomplish this object, the saline aperients (7), (5), or, occasionally, other mild cathartics (10), (12),(14), maybe used. But more important than either or all of these is the frequent use of a good self injecting family syringe. An injection of half a pint of cold water every morning will do much towards regulating the bowels, and preventing or curing piles.

Nausea. If, as sometimes happens, there should be persistent nausea after the first three months, it will need to be combated by mild tonics and stimulants, as chamomile tea, or clove tea (58), (114), and by seeking a kind of diet which will be agreeable both to the palate and the stomach. Ten grains of ingluvin after each meal and on arising, oftentimes prevent vomiting. Stretching the neck of the womb moderately, and replacing a retroverted womb, are foremost in importance of treatment when structural causes demand such interference.
A tablet containing 2 grains of oxalate of cerium, 2 grains of sub nitrate of bismuth, and 1 12 of a grain of cocaine is very useful it taken three or four times a day. These tablets may be bought under the title of nausea tablets if made by a reliable chemist.

The Nipples. During the last month, particular attention should be paid to the nipples. Untold misery often results to the young mother from sore nipples; and it is well worth her while to use every precaution against them. The nipples are, of course, in an excitable state during the whole period of gestation, and at length frequently become irritable and tender. Let them be daily bathed, for three or four weeks before confinement, with some astringent and cooling lotion, as oak bark decoction, borax water, alum water, or a solution of tannin (200), (201), (202), (203).
Nothing is better than the daily application of weak alcohol and water.
The object of treatment, in this case, is to toughen them and render them less susceptible, so that they may not be made tender by the subsequent application of the child's lips.
When a woman is peculiarly liable to this trouble, the further precaution of having them gently drawn by some friend, every day, during this last month, would be of great service.
At all events, let no pains be spared to guard against this evil ; for sore nipples make sore breasts, and sore breasts make broken breasts; and broken breasts are terrible things. They make the mother sick; and ff the mother is sick, the child is sure to be sick; and all bands soon get sick and worried, and the whole business of having children, and taking care of them, is deprived of its peculiar joys and consolations, and brought into undeserved disrepute. Whereas, under wise and prudent management, there is something delightful to the young mother in yielding sustenance to her dependent offspring. For, when her nipples and breasts are in a healthy state, she can say with the poet, as 94 The starting beverage meets its thirsty lip, 'Tis joy to yield it, as 't is joy to sip."

Swathing. In advanced pregnancy, much assistance in supporting the burden is sometimes derived from swathing the bowels. Healthy and vigorous women, however, need no such assistance; it is chiefly applicable to cases of debility, either constitutional, or resulting from neglect, or from over exertion during former pregnancies.
Cramp in the Stomach is sometimes very severe, and if allowed to continue, may kill the child. The best remedies are warm carminatives (114), (115), or anodynes, etc. (121), (122), or antispasmodics (90), (94).

Headaches. These may be relieved by antispasmodics, etc. (90), (94), or anodynes (121).

Palpitation of the Heart may prove very distressing to delicate women. The remedies are the antispasmodics, with rest. Some. times tonics are useful, such as the muriated citrate of iron (73). The bowels should be carefully regulated.

Fainting, which occurs before or at the time of quickening, is sometimes very troublesome. The proper treatment is the avoidance of fatigue, and, during the fainting fit, the recumbent posture, cool air, application of cold water to the face, and ammonia to the nose.

Cough is sometimes present. It is caused by the upward pressure of the diaphragm against the lungs, by which they are irritated and convulsed. The remedies may be selected from the cough preparations among the prescriptions.

Heartburn may be relieved by 10 gr. doses of bicarbonate of soda taken in water after meals. Ten grains will be equal in amount to that quantity which may be scooped up on a five cent piece.

Varicose Veins. These cannot be removed during pregnancy; but they may be relieved by great care of the bowels, and by wearing tight bandages, or elastic stockings.

Swelling of Lower Limbs is caused by pressure of the enlarged womb upon the veins; and may be relieved by care of the bowels, and diuretics (130).

Itching of the Genitals may be much relieved by borax, camphor, etc. A four per cent solution of cocaine, painted on, gives most relief, and is most curative.

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