Chapter 18 - Homeopathic Treatment of Diseases
Forms of Medicine for Administration
Selecting and Using Remedies
General Considerations
Diseases of the Ear
Diseases of the Eye and Eyelids
Diseases of the Respiratory Organs
Baldness
Ringworm
Blackheads
Erysipelas
Prickly Heat
Malignant Pustule
Skin Diseases
Diseases of the Digestive Organs
Diseases of Organs of Circulation
Diseases of the GenitoUrinary Organs
Diseases of Infants and Children
Diseases of Women
Surgical Diseases
Diseases of the General System and Miscellaneous Diseases
Diseases of the Nervous System

18.18 Diseases of Women

Diseases of Women.
Chlorosis. Green Sickness.

AT puberty, or the age when the girl becomes a woman, delicate or excessively nervous children, or those living under bad hygienic conditions, or studying too hard, may develop a condition called chlorosis, characterized by impoverishment of the blood; greenish pallor of the skin; palpitation; headache; indigestion; nosebleed; irritability; an appetite for chalk, slate pencils, etc.

Ferrum. Great pallor of the face, with occasional sudden red flushes, with dizziness; palpitation of the heart; neuralgia of the stomach; chilliness; headache; feverishness towards night; absence of the menses, or when the flow is established it is too profuse.

Pulsatilla. Suppression of or scanty menses; girls of a mild, gentle, tearful disposition chilliness; feels uncomfortable in a warm room, better in the open air; tremulousness; may be drawing, tearing, shifting pains, worse at night, with sleeplessness.

Sulphur. Rush of blood to the head, with cold feet; pressive headache in the morning; loss of appetite, with feeling of fullness in the stomach after eating a little; constipation; oppression of the chest; palpitation, especially at night; frequent flushes of heat; night sweats and great prostration and weakness.

Calcarea Carb. Scrofulous cases, with tendency to obesity and enlargement of the glands; morbid craving for chalk, pickles, etc., acidity of the stomach; the girl takes cold easily, and tires readily.
Also Phosphorus in debility following too rapid growth, masturbation or depressing mental influences; great weakness and prostration; palpitation; night sweats. Graphites. Scanty menstruation; dry, harsh, rough skin; constipation; acrid leucorrhea. Consult the remedies under ' St. Vitus' Dance " when there are pronounced nervous symptoms.
A dose of the indicated remedy three times a day. Fresh air, sunshine, exercise, early retiring, simple nourishing food, physical and mental rest, salt water baths, pleasant surroundings, cheerful companionship, normal action of the bowels, proper clothing, and freedom from excitement are essentials in the treatment of these cases.

Inflammation of the Vulva and Vagina.

The, lining membrane of the external genitals called the vulva, is continuous with that of the passage leading to the uterus, known as the vagina. It is a mucous. membrane resembling the lining membrane of the throat, and like the throat subject to inflammation and catarrh, the latter being the result of the former. Inflammation of the vulva or vagina may be due to germs, irritating discharges, lack of cleanliness; worms, masturbation; sexual excesses or to irritation from the urine in diabetes. There is dryness, heat, redness, itching, swelling of the parts, followed by a watery and later by a creamy discharge. The latter is called leucorrhea or the whites.

Aconite. Vulva or vagina dry, hot and sensitive. Belladonna may be given when, in addition to the above symptoms, there is a bearing down feeling as if the organs in the pelvis were being forced from the vulva; swelling of the external genitals; fever and headache; pains worse on motion.

Cantharis. Swelling and irritation of the vulva; violent itching in the vagina; inflammation of the urethra, and difficulty in passing urine.
Also Mercurius cor. Thin, watery, blood tinged discharge; intense inflammation of the external parts. Kreosotum. Soreness, smarting and swelling of the external parts which are hot and hard; itching in the vagina; yellow, offensive, acrid discharge; burning on passing water. Sepia. Great dryness of the vulva and vagina, which are painful to the touch; itching eruption on the vulva, with redness and swelling; much weight and bearing down in the lower abdomen (pelvis); yellow, milky, excoriating discharge, and especially before the menstrual flow. A dose of the indicated remedy every two hours in acute cases, three times a day in chronic. Consult the remedies given under "Leucorrhea."
The cause of the inflammation must be sought and removed. In cases due to gonorrhea, treatment under the care of a competent physician should be at once instituted. Absolute cleanliness is necessary, and in simple inflammation a douche of tepid water one to four times a day, should be followed by a medicated douche. For a raw, excoriated surface, two to four teaspoonfuls of fluid extract of calendula to a pint of tepid water; when there is a profuse secretion, partly mucous, partly purulent, substitute hydrastis; when itching is very trying and there is biting and smarting or an offensive discharge, use ten to thirty drops of kreosotum to a pint of water. The external genitals should be dried and soft pieces of old cotton or linen on which vaseline, calendula or hammamelis cerate had been spread, should be placed between the labia to prevent irritation when walking; or dust on powdered corn starch or calendulated boracic acid if there is no discharge, but only heat and burning. Abstain from sexual intercourse; eat unstimulating food; take daily baths; keep the bowels open, and live out of doors.

Leucorrhea. Whites.
Leucorrhea is a catarrhal discharge from the lining mucous membrane of the vagina, neck or body of the uterus, due to want of cleanliness, sexual excesses, gonorrhea or syphilis, inflammation of tile organs of generation, new growths, general debility, or may occur in the course of other diseases. This discharge may be slight or profuse; thin, glairy, thick, lumpy, or stringy; watery, milky, yellowish, greenish, bloody, or purulent; odorless or very offensive; bland or excoriating and accompanied by heat, burning and intense itching of the genitals. There may be no pain, but lassitude, indigestion, headache, dizziness, faintness, nervousness, or hysteria.

Pulsatilla. Thick, white or creamy discharge, especially in cases of delayed or scanty monthly flow; the external parts swollen, but painless; indigestion; nausea; chilliness; frequent, profuse flow of urine.

Calcarea Carb. Profuse, milk like, or yellowish discharge; monthly flow too early and profuse; soreness and swelling of the vulva; scrofulous or debilitated women, very sensitive to cold, with constant cold, damp feet; acid stomach.

Hydrastis. Yellow, sticky discharge, often offensive and with shreds of mucus or membrane in it; chronic cases, especially in those having liver or stomach trouble.

Sepia. Pressure and bearing down in the lower abdomen; stinging pains in the ovaries; discharge thick, creamy, yellowish, may be bland or excoriating; leucorrhea especially before the monthly flow, during pregnancy, or at the change of life.

Alumina. Profuse, yellow, acrid, corroding discharge, with burning in the genital organs, the parts being corroded and inflamed; worse before and after the monthly flow; sluggish bowels, and scanty movements, passed with difficulty.
Also Helonias when there is a whitish discharge, with white particles in it; heat, itching and swelling; dragging in the uterus; great debility and prostration; melancholy; especially for nursing mothers or after any great strain on the system. China and Ferrum are both serviceable remedies in leucorrhea in women much debilitated and run down, with impoverished blood and indigestion. A dose of the indicated remedy three times a day.
The general directions under "Inflammation of the Vulva and Vagina" should be followed. In addition to the recommendations for douches, may be mentioned the use of boracic acid, one even tablespoonful to a quart of hot water, or plain cold water. Never use a bulb syringe, but a fountain syringe, and always lie down to take a vaginal douche.

Displacement of the Uterus.

THE uterus swings free in the pelvis, that is, it has no bony attachments, but is supported by ligaments. It is therefore easily tipped or bent out of its normal position, or may sag downward as in " faning of the womb." A few of the commonest causes of displacements are falls or jumping, lifting heavy weights, constipation and straining at stool, excessive exercise, standing constantly, tight clothing, letting the bladder remain full, general debility, tumors and childbearing. Locate treatment under 'the care of a skilled physician should always be instituted in connection with the use of remedies. The latter will be most effective in the early treatment of displacements due to injuries or childbearing, and in recent cases in those who will abstain from sexual intercourse. The general condition of the patient must always be taken into account.

Nux Vom. Sensation of pressing down toward the genitals, especially in the morning; monthly flow dark, and too early and profuse, with nausea, chilliness and attacks of faintness; constipation., indigestion.

Sulphur. The general symptoms are important, such as heat on the top of the head, with cold feet; burning of the soles of the feet, and cramps in the calves of the legs and soles of the feet at night; also thick, dark excoriating monthly flow, too late, too profuse and too brief, with burning in the vagina and stomach.

Sepia. Falling of the womb, with bearing down and strong pressure in the pelvic organs; vagina hot, dry, and painful to the touch; hot flushes; irritability of the bladder; bearing down sensations, better on lying down, worse on sitting up, and especially when walking.

Belladonna. Recent displacements, with great local congestion, and pressure downward as if everything would fall out; back aches as if broken; burning, throbbing, cutting pains in the pelvis; monthly flow too early, and too proof use, or thick, dark and offensive.
Also Ferrum in cases where there is great debility, with impoverished blood; head congested, face fiery red; flatulence and no appetite; feeling of pressure on the chest. A dose of the indicated remedy three times a day.

Inflammation of the Uterus.

THERE are many different names for inflammations of the uterus, depending on the location, and the tissues involved. It is difficult for anyone but a physician to distinguish clearly between the different parts affected, in any event it is the symptoms as a whole that are to be considered and prescribed for. In metritis there is inflammation of the body of the uterus; in endometritis and endocervicitis of the lining membrane of the uterus and neck of the uterus.
These diseases may be acute or chronic, and are caused by infection during or after labor, abortion, or operations; gonorrhea; exposure to wet or cold during menstruation; sexual excesses; the extension of inflammation from nearby organs; uterine tumors, displacements or tuberculosis.
Inflammation of the neck of the uterus may be followed by ulceration; and of the body of the uterus, when occurring in childbed, by puerperal fever and peritonitis. Leucorrhea is a common symptom in endometritis, and treatment is given under that section. Consult also the section on "Childbed Fever" for remedies for acute inflammation of the body of the uterus. In all inflammations Aconite, Belladonna and Veratrum vir. are generally called for.

Nux Vom. A frequently indicated remedy with bruised pain in the neck of the uterus; frequent desire to urinate, with pain, scalding and burning; constipation; frequent and ineffectual urging to stool; much pain in the small of the back; headache, fullness and pressure on the forehead; pain and distention in the abdomen, symptoms worse after 3 P. m.

Sulphur. Chronic cases that get better for awhile under the indicated remedy, then cease to improve; also when there are frequent flushes of heat, passing off in a little perspiration and faintness; heat on the top of the head; feet burn; " cat naps " at night; weak, faint spells frequently during the day; may be yellow, excoriating leucorrhea.

Mercurius Cor. Ulceration of the neck of the womb, especially in cases due to syphilis or gonorrhea; profuse greenish, yellow, or purulent discharge; smarting and itching of the vagina; easy perspiration; much sensitiveness to draughts of air.

Hydrastis, Calcarea carb. and Sepia should be referred to under "Leucorrhea," also secale under "Profuse Flow of Blood from the Uterus." A dose of the indicated remedy three times a day.
Local treatment is generally indispensable in these cases. Good hygiene; rest in bed during the monthly flow; perfect cleanliness; sitz baths; copious hot water vaginal douches (see "Leucorrhea"), simple nourishing food, absolute sexual rest, and perseverance in treatment are essential. During acute attacks of abdominal pain, hot water compresses sprinkled with turpentine, and frequently changed, will give much relief.

Inflammation of the Ovaries.

Pus germs, or the germs of gonorrhea or tuberculosis may cause inflammation of the ovaries which may be acute or chronic. In an acute attack there is fever, rapid pulse, agonizing pain in the region of the ovary, extreme sensitiveness on pressure; and if treatment does not arrest inflammation, pus forms, and life itself is endangered. In chronic inflammation there is constant pain, especially before and after the monthly flow, on having a movement of the bowels, and from any sudden jolt or jar. The monthly flow is profuse, prolonged, and painful, and changes occur in the structure of the ovary.

Aconite. Early in acute cases with fever, restlessness, cutting, darting pains; the abdomen hot and sensitive to touch; painful urging to urinate; especially inflammation following sudden suppression of the monthly flow from cold.

Belladonna. Acute stage; face and head much congested; throbbing in the arteries of the neck and abdomen; severe clutching, clawing, stabbing or throbbing pains in region of the ovaries, especially on the right side, with great local sensitiveness; cannot bear the least jar; high fever and thirst. The leading remedy in acute cases whether mild or severe.

Bryonia. Cases of moderate severity in rheumatic women, with stitching pains, worse on coughing, deep breathing or motion; shooting pains extending to the hips; tongue coated white.

Cantharis. Stitching, pinching pains in the ovaries; difficult urination; frequent urging to pass water; bloody urine; violent pains in the bladder.

Apis. Acute or chronic cases, especially in the right side; burning, stinging pains worse at time of monthly flow; urging to urinate; scanty urine and swelling of the feet.
Also Macrotin in hysterical or rheumatic cases, in the latter when rheumatism seems to shift to the ovaries; shooting pains, with bearing down sensation; irregular, delayed or suppressed monthly flow, great nervousness at that time, and pains under the breasts. Conium. Chronic cases; hardening and enlargement of the ovaries, with cutting pains; soreness and swelling of the breasts before the monthly flow, which is scanty or absent; acrid leucorrhea causing burning; sour stomach and pain in the stomach. Pulsatilla. Suppression of the menstrual flow, with nausea, chilliness, pressure on the bladder and rectum; violent pains making patient cry. A dose of the indicated remedy every hour in acute cases, every three or four hours in chronic. Consult the remedies under "Painful Menstruation," "Profuse Flow of Blood from the Uterus," and "Cessation of Menstruation."
In acute cases while there is fever and much inflammation the diet should be liquid; hot douches should be given frequently; hot hop bag, hot water bag, dry hot bran bag, hot compresses wet with hamamelis and water, frequently changed, may be applied to the abdomen. Rest in bed is essential in all cases, especially during menstruation; the bowels must be kept open, and sexual excitement of any kind avoided.

Painful Menstruation . Dysmenorrhea.

PAINFUL menstruation may be neuralgic or ovarian, or due to inflammation of the uterus, the casting off of the inner membrane or obstruction by small growths, contraction of the passages, congestion from getting the feet cold or wet, mental shock, the result of heavy clothes, lacing and many less frequent causes.

Vibernum, 1 x. Spasmodic dysmenorrhea; excruciating, colicky pains in the lower part of the abdomen, coming on suddenly, preceding the monthly flow, lasting for hours; bearing down and aching, and much nervousness.

Cimicifuga. Severe pains in the back, down thighs and through the hips; hysteric spasms, cramps, and tenderness of the lower part of the abdomen; dysmenorrhea in rheumatic cases.

Caulophylium. Spasmodic dysmenorrhea; bearing down pains normal or scanty flow, in patients subject to rheumatism of the small joints; sympathetic spasms of the bladder, rectum, or bowels.

Belladonna. Paroxysms of severe, dragging, pressing pains in the pelvis from six to twenty four hours before menstruation; the flow bright red, too early and profuse; inflammation of the ovaries; face red and bloated.

Chamomilia. Neuralgic dysmenorrhea, drawing pain from the lower part of the back forward; griping, pinching, labor like pains in the uterus, followed by discharge of large clots of blood; excessive irritability and impatience; frequent desire to urinate.
Also Cocculus in menstrual colic from gas in the intestines; distention of the abdomen; sharp, cramp like pains; headache and nausea as in seasickness; scanty, irregular, painful flow.

Xanthoxylum. The flow too early and profuse, with pains from the ovaries down the front of the thighs; nervous, easily startled, hysterical women; neuralgic dysmenorrhea; headache and full feeling in head. Consult the remedies under "Absence of the Menses," and "Profuse Flow of Blood from the Uterus," especially Pulsatilla.
The indicated remedy should be given every fifteen minutes to one hour while the symptoms are acute during the monthly flow, and three times a day between the periods. Hot applications to the abdomen and spine, and rest, preferably in bed, are indicated. The following are important recommendations: Avoid late !)ours; tea, coffee and alcohol; violent exercise, wet or damp feet; tight, insufficient or too heavy clothing, or thin soled boots; dancing while menstruating; sexual excesses at all times. Eat simple, nourishing food; bathe daily; take moderate out of door exercise; secure good ventilation; be amiable.

Absence or Suppression of the Menses. Amenorrhea.
THE menstrual flow may be suppressed from various causes, the most common ones, perhaps, being getting chilled or wet. Cold baths, sea bathing, acute and chronic diseases, checked perspiration, a sea voyage, mental shock, tuberculosis, hemorrhages, pregnancy, lactation, and sexual excesses, occasion absence of the menses or amenorrhea, as it is called.
The resulting symptoms, in addition to lassitude, general debility, throbbing headache and indigestion, may be pain in the abdomen and small of the back, constipation, nervousness, nausea and lack of appetite. Vicarious menstruation, i.e., hemorrhage from the nose or spitting blood, may occur when the menses are absent.

Pulsatilla. Delayed, suppressed or scanty; hysterical symptoms; nausea and vomiting; palpitation of the heart; loss of appetite; lassitude, chilliness; headache; pain in abdomen or loins. A dose every two hours.

Cimicifuga. Headache, nervousness, sometimes hysteria; pain in left breast and side; rheumatic tendency; neuralgia of the uterus, pains dart from side to side; the flow irregular, delayed or suppressed from mental emotions.

Calcarea Carb. Delayed menstruation in scrofulous girls, who are fleshy, lack muscle. have a fair complexion, perspire easily about the head, have cold, damp feet, and are of a consumptive tendency.

Aconite. This is an invaluable remedy for sudden suppression of the menstrual flow from a chill, fright or vexation, with congestion of the head or chest, anxiety and great restlessness, especially in full blooded young women.
Also Ferrum. Delayed appearance of first menses, with debility, languor, palpitation, indigestion, leucorrhea, sickly complexion, puffiness of the face or ankles. Graphites. Delayed or tardy menstruation with scanty, pale flow; constipation; tendency to skin eruptions. Belladonna. In very full blooded persons, with pressure and throbbing in the head; much bearing down in the lower abdomen; nosebleed.
A dose of the indicated remedy every two or three hours during menstruation or when the menses are due; three times a day in the interval between periods. Consult the recommendations under "Painful Menstruation." Build up the general health if there is debility with nourishing food, milk, cocoa, malt extracts, cod liver oil, an outdoor life, and otherwise good hygiene. Hot foot baths or hot sitz baths are recommended, also mental as well as physical rest. In delayed appearance of the menses in young girls, leave them alone as long as they seem perfectly well, and let them live out of doors and hygienically. Never hesitate to consult a physician when there is ill health, Change of climate is often beneficial, also electricity.

Profuse Flow of Blood from the Uterus. Menorrhagia and Metrorrhagia.

THE first of these long names is applied to too profuse flow of blood at the monthly periods; the second, to discharge of blood between the menstrual periods. Common causes of metrorrhagia are tumors and growths of the uterus, retention of the placenta after abortion, inflammations of the uterus; and of menorrhagia, general debility, heart disease, other diseases such as malaria or congestion of the liver, and incipient tuberculosis.
The remedy, whatever the cause, must be chosen in accordance with the majority of the symptoms; and whatever remedies are used, the most important part of the treatment is the removal of the cause of the condition whenever possible.

Calcarea Carb. Too early and profuse menstruation, lasting too long, in scrofulous women, or where there is poor nutrition, and much debility; milk like leucorrhea, with itching and burning; feet feel cold and damp; profuse monthly flow in nursing women. Calcarea Phos. May be substituted, for young girls having frequent attacks of headache, and too frequent and too profuse menses.

Trillium. "Bleeders" who menstruate every fortnight, the flow lasting six or seven days, blood bright red at first, then pale; yellowish leucorrhea during the interval.

Nux Vomica. Too soon, too long and too profuse; stops for a day or two, then returns; irritability; nausea in the morning, With chilliness, attacks of faintness, and pressure towards the genitals; sedentary habits.

Belladonna. Much congestion; blood bright red; pressive pains in the abdomen; face flushed and bloated; flow too early and profuse.

China. Excessive flow, followed by much exhaustion, headache and ringing in the ears; heaviness of the head; weak pulse; fainting; twitching of the muscles; cold extremities; after great loss of blood.

Crocus. Dark, stringy blood in black clots, worse from least motion; earthy yellow face; debility and palpitation; especially in young women.

Ipecac. After labor or miscarriage; continuous flow of bright red blood; the patient is cold and pale; also when monthly flow is too early, profuse and of bright red blood, which clots readily.
Also Secale in hemorrhage from uterus following abortions or labor, when the uterus does not contract; uninterrupted flow of dark blood; worse from motion; also in inflammation of the uterus with profuse flow. A dose of the indicated remedy every two hours, or every fifteen minutes in hemorrhage following labor or abortions.
A careful examination of the uterus should be made by a skillful physician, that the cause of the trouble may be removed if possible. Surgical interference may be necessary. Rest in bed should be taken at the monthly periods when the flow is profuse. Live hygienically, and take a generous, nourishing diet including milk and eggs. A hot water bag to the spine is recommended. Six quart douches at a temperature of 115' may be taken twice a day; to the last quart a tablespoonful of powdered alum may be added. All local treatment, however, is best undertaken under a physician's direction. Sleep on a firm mattress, with light coverings; take a daily cold salt water sponge, avoid overexertion, lifting anything heavy, tight clothing, excessive emotion, especially worry.

Cessation of Menstruation .Climacteric.
BETWEEN the ages of forty and fifty, most frequently about the age of forty-five the menstrual flow occurs less often and diminishes in amount, finally ceasing altogether. This is the normal, physiological change in women denoting the close of that period of her life during which she, should be able to bear children.
A profound readjustment of the nervous system takes place which goes on even after menstruation ceases. When the process is not normal, many complications may develop, such as cancer, inflammation of the uterus, fibroid and other tumors, derangements of the nervous system, obesity, etc.
It is very advantageous for a woman to be under the observation of a good physician during the change of life. Under the best of conditions there are many annoying symptoms which homoeopathic remedies will greatly relieve; these symptoms are mentioned below.

Cimicifuga. Restless and unhappy state of mind; the patient feels grieved and troubled, is irritable and cannot sleep; sinking sensation in the stomach; pain in left side; fullness and dull aching in top of head.

Lachesis. Hot "flushes;" burning sensation on top of head; profuse flowing; fainting spells; vertigo; flatulence; may be pain and tenderness in left ovary; patient nervous, anxious, and talkative.

Sanguinaria. Change of life in women who flow profusely; vertigo, rush of blood to the head, with buzzing in the ears, and flushes of heat; headache in paroxysms, beginning in the back of the head, passing over the right eye; headache with nausea and chilliness, sometimes bilious vomiting; better in the open air, from lying down and from sleeping; acrid, bad smelling leucorrhea.

Sepia. Palpitation of the heart, in evening, in bed with beating of all the arteries, also during digestion; flushes of heat at night as well as in daytime; much prostration and faintness in the morning during menses; pain in the small of the back when walking; irritability; darting pains in head from left eye backward; derangements of the liver and stomach; liver spots on the skin and yellow saddle across the nose.

Gelsemium. Headache with rush of blood to the head; heaviness, fullness and dizziness; dimness of sight; drowsiness; bruised feeling and throbbing in the head; may be nausea and vomiting; uterine neuralgia.
Also Amyl Nitrite for the hot flushes not relieved by Lachesis; much throbbing in the ears, intense fullness in the head, choking, constricted feeling in the throat. Coffee or Passiflora are indicated in cases where there is marked nervous excitement, with sleeplessness owing to great activity of the mind, and alertness of all the senses. A dose of the indicated remedy three times a day.
Every effort should be made to favor the normal action of the principal organs of the body, the skin, stomach, liver, bowels, kidneys, heart, etc. Frequent warm baths are highly beneficial; much fresh air and moderate exercise are necessary; a simple, rather abstemious diet is recommended; loose clothing; no excitement; early hour,; restraint of all passions, and the avoidance of stimulants.
Any noticeable increase in the frequency or amount of the menstrual flow is good and sufficient reason for immediately consulting a physician; malignant or other disease may be present, and if so, it is of the highest importance that early treatment be instituted. It cannot be too strongly emphasized that the time for a woman to prepare for a normal climacteric is through all her menstrual life, especially by avoiding wet or damp feet, excitement and overexertion during the monthly flow, and by pure and temperate living at all times.

Labor. Parturition. Morning Sickness and Other Ailments.

AMONG the derangements of the system during pregnancy, none is more common than nausea and vomiting, or morning sickness so called, because these symptoms appear most frequently on first rising in the morning. With some women this difficulty lasts but a few weeks; in others, for several months. The distress may be slight or severe, sometimes threatening life itself, as in the form known as "Pernicious Vomiting."

Arsenicum. Vomiting after eating or drinking, with faintness and excessive prostration; much thirst for small quantities of water, vomiting as soon as taken; very pale, white look; uneasiness and restlessness.

Cocculus. Intense nausea; scarcely able to get up in the morning; yellow coated tongue, with aversion to food; worse from driving or being on the water.

Nux Vom. Sickness every morning; bitter, sour risings; vomiting of sour mucus and food; excessive nausea with feeling as if vomiting would relieve; great depression of spirits; constipation; neuralgia of the stomach, with cramp like pains.

Ipecac. Constant nausea, never any let up; vomiting of bilious matter, undigested food, and large quantities of mucus; disgust for food; empty retching; pinching pains in the pit of the stomach; diarrhea; neuralgia of the stomach with nausea.

Pulsatilla. Especially when vomiting comes on in the evening or night; capricious appetite, longing for beer, acids, wine, etc.; nothing tastes good; absence of thirst; loss of taste, or bitter, fatty, sour or saltish taste; eructations.

Sepia. Feeling of emptiness in the pit of the stomach; aversion to meat; nausea in the morning; bitter, selfish taste in the mouth; constipation; eructations tasting like bad eggs; disgust for all kinds of food; vomiting of food and bile.

Cuprum. Violent vomiting of frothy mucus, sometimes green, relieved by drinking cold water; intense coppery taste; profuse salivation.

Phosphorus. Sour eructations and sour vomiting; very weak feeling in the abdomen; constipation, with narrow, long, hard, dry feces, or profuse watery diarrhea; patient sleepy all the time.
Also Sulphur. Profuse salivation, the taste of which causes nausea and vomiting; flashes of heat; cold feet; "cat naps" at night; aversion to meat; feels full after eating a little; ravenous hunger or complete loss of appetite. Colchicum. Excessive nausea caused by the smell of food; extreme aversion to the odor or mention of food.
A dose of the indicated remedy may be given three or four times a day. It will be noticed that these remedies cover the annoying symptoms of aversion to food, neuralgia of the stomach, acidity, constipation, diarrhea, and the excessive secretion of saliva. Other ailments of pregnancy, such as sleeplessness, debility, neuralgia, headache, leucorrhea, itching of the skin, varicose veins, hysteria, etc., have been discussed at length previously, and should be consulted for the treatment. Additional remedies for the other conditions will be found under the appropriate headings such as "Constipation ... .. Diarrhea ... .. Indigestion, " etc.
Careful regulation of the diet; bathing and exercise; the avoidance of worry, excitement, sexual intercourse, tight clothing and late hours form essential parts of the treatment.

False Pains.
As pregnancy nears its close, many women are troubled with false labor pains which often mislead them into thinking that labor has begun, or is about to begin. The strain on the abdominal muscles and other tissues may cause them, or rheumatism or irritation elsewhere as constipation, indigestion, etc. False pains are generally constant, and when they are not, return at irregular intervals; may be feeble one time, and strong another, then feeble again. True labor pains occur at regular intervals, increase in strength, and cause the uterus to contract forcibly,

Caulophylium. A most helpful remedy for spasmodic pains in various portions of the abdomen below the stomach; irregular pains, flying in all directions.

Cimicifuga. Especially in hysterical women or those subject to rheumatism; pains in the lower abdomen shooting from side to side; nausea; sleeplessness.

Nux Vom .Pains in those used to rich or highly spiced food, stimulants, or a life lacking sufficient exercise; constipation; pain in the back preventing turning over in bed, and making the sufferer get up and walk about; worse about 4 A. M.
Also Atropia for neuralgic pains, appearing and ceasing suddenly; worse from the slightest jar, back feels as if it would break. Pulsatilla. Pain in the ovaries, especially at night; a close, warm room feels very oppressive; patient wants to walk about after sitting a short time, and craves cool air. A dose of the indicated remedy every one or two hours.

Hot fomentations of hamamelis to the abdomen are very soothing, also belladonna or hamamelis cerate gently rubbed into the abdominal muscles. Lying down in a perfectly quiet room is beneficial to nervous patients. Noise, confusion and excitement should be avoided.

After Pains.
WHEN the child is delivered the uterus should, and generally does, contract promptly. By this means the afterbirth and clots are expelled, hemorrhage is prevented, and the return of the uterus to its usual size hastened. Sometimes the contractions of the uterus causes much pain, and there is also always some soreness of other muscles concerned in the expulsion of the child. These after conditions are greatly relieved by the appropriate remedy. After pains do not cause a rise of temperature, rapid pulse, and distention and tenderness of the abdomen, thus distinguishing them from inflammation of the peritoneum which does.

Arnica. Unless some other remedy is plainly indicated Amica should be given immediately after labor to prevent pains, and relieve the sore, bruised feeling in the muscles. A drop of the tincture in a teaspoonful of water every half hour to one or two hours.

Caulophyllum . Especially suitable after protracted and exhausting labor, with spasmodic pains across the lower part of the abdomen extending into the groins. Give as above, but should not be administered in cases where there is much flow of blood,

Pulsatilla. After pains too long, or too violent, or cause faintness, pains worse towards evening, in mild, tearful women; symptoms better if the room is cool. A dose every one or two hours.

Nux Vom. Aching pains which cause frequent desire for movement of the bowels, with feeling of something in the rectum; soreness in the uterus so that there is a dread of being moved or touched for any purpose; irritability; patient wants to be well covered and have the room warm. Give as above.
Also Belladonna when the pains are of a severe, forcing character as if everything would be forced out of the vagina; pains that come and go suddenly; the least jar of the bed distresses patient greatly. A dose every half hour to one or two hours. Gelseinium is also highly recommended.
In case clots are retained in the uterus, pressure with the hand over that organ will favor their expulsion. Hot applications of arnica in water are soothing. Half a teaspoonful of calendula tincture to half a pint of hot water injected in that passage, and sterile gauze wet with the same may be applied to the vulva.

Difficult Urination.
AFTER labor there may be retention of urine or difficulty in urinating. The tendency to this condition can be lessened by encouraging a woman to make water as of ten as she has the slightest inclination before labor. The bladder will then not require to be emptied for several hours, during which the normal control of it may be regained.

Hyoscyamus. Nervousness and irritability; desire to urinate, but bladder seems to be paralyzed.

Belladonna. Retention of urine, or great difficulty in passing even a small quantity of urine; sensitiveness of the bladder to pressure, and pain on being jarred or moved.
Other remedies may be consulted under "Retention of Urine." A dose of the indicated remedy every half hour.
While it may be necessary to draw off the urine by a catheter, this should be avoided if possible. Pouring warm water over the genitals may start the flow of urine, or the sound of water running from a faucet or poured from a pitcher may stimulate the action of the bladder. A woman should make one or two attempts at least to urinate within the first six or eight hours after delivery, as a greatly distended bladder renders evacuation of its contents more difficult.

Sore Nipples.
FRICTION of the child's mouth in nursing, the softening action of the milk on the skin, or exposure to cold while the nipples are moist or warm not infrequently causes soreness, abrasions, cracks or at least sensitiveness of the nipples. These conditions should receive prompt attention otherwise ulceration may result, and even abscesses form.

Agaricus. Much itching and burning of the nipples which look very red; especially for women with the above symptoms who are subject to chilblains.

Graphites The nipples seem to have little vesicles on them which ooze a thick, glutinous fluid, forming a crust, or are painful, inflamed, cracked.

Mercurius Viv. The nipples feel very raw and sore; the glands in the neck are enlarged; the gums sensitive, and the teeth sore.

Phytolacca. Sore and fissured nipples, with intense suffering on patting the child to the breast; pain seems to start from the nipple and radiate over the whole body.
Also in the very first days of nursing give Arnica if the nipples feet sore and bruised. Calcarea Carb. Ulceration of the nipples, and discharge of pus, especially in fair, fleshy women, who perspire easily. ,Sepia. Deep, very sore cracks and cracks across the crown of the nipples. A dose of the indicated remedy every two hours.
Prevention is an essential part of treatment, and proper care of the nipples during the last months of pregnancy will do much to save subsequent discomfort. Pressure of the corsets or clothing must be avoided; during the last month or two apply frequently alcohol and water equal parts, with ten per cent. of alum added; draw out flat nipples daily.
During nursing wash the child's mouth with boracic acid solution; wash the nipples with calendula and water after every nursing, and dry thoroughly. When there are slight cracks, apply hydrastis powder or a solution of alum or tannin; excoriations may be painted with compound tincture of benzoin; deep cracks touched with one to five per cent. nitrate of silver, then covered with a film of absorbent cotton sealed with collodion. Always wash off any preparation before giving the child the breast. A rubber shield may be used to protect the nipples.

Inflammation of the Breast. Broken Breasts.
Mastitis.
INFLAMMATION of the breasts is commoner in blondes than brunettes, and occurs in five to six per cent. of nursing women. "Poor health" is a predisposing cause, also congestion of the milk glands, and excoriations of the surface allowing infection by bacteria or germs. The inflammation may be superficial or involve the deeper structures of the breast. In severe cases chill, high temperature, and pain are marked symptoms, as well as heat, tenderness, pain, swelling, hardness and even suppuration in the affected breast.

Bryonia. Breasts heavy, hot, hard and painful, but not very red; breasts gorged with milk; stitching, drawing pains; patient feels sick on sitting up even in bed; great thirst for large quantities of water; lips rough and dry; constipation, with dry, burnt looking stools.

Belladonna. Heavy, swollen, hot and painful breasts, with red streaks running like the spokes of a wheel from a central point; tearing pains; fever; waking suddenly or starting up in sleep.

Phytolacca. Chill; fever; marked hardness and sensitiveness of the breast from the beginning; nipples tender; caked breast; hard, painful lumps in the breasts; pain during nursing extending from the breast throughout the body.

Hepar Sulph .When pus forms; sharp stitching pains; breast very sensitive to touch; faintness from pain; free perspiration without relief.

Mercurius Viv. Breasts swollen, hard and painful; feel sore and raw; the milk is poor, and baby refuses to nurse; soreness of the teeth, gums and tongue.
Also Phosphorus in inflammation with night sweats; breasts red in spots or streaks, with hard lumps; small openings with watery, offensive, ichorous discharge. Silicea. Ulcers that constantly discharge and refuse to heal; the substance of the breast seems to be discharged with the matter formed. A dose of the indicated remedy every one to three hours.
As soon as hardness appears or any sign of swelling or heaviness the breast should be supported by a bandage. Too much milk may be withdrawn by the breast pump or massage; hardness relieved by massaging with olive oil, stroking toward the nipple. Hot fomentations of flannel wet in phytolacca tincture and hot water, a drachm to a pint, or antiphlogistine warm, will relieve inflammation. To prevent engorgement of one breast, the child should nurse from both. The general health must receive attention.

Milk Fever.
WITHIN the first two or three days after labor the secretion of milk in the breasts is established, and often with some constitutional symptoms such as feverishness, increase in the pulse rate, general sense of discomfort, more or less distention of the breasts. This condition is known as milk fever, and quickly subsides in normal cases with the free flow of the milk.
Aconite may be given in the beginning for the feverishness, or Bryonia when the milk is secreted slowly, and the breasts seem much engorged, with a tendency to inflame. As a rule no other remedies will be required, but Pulsatilla, Asafoetida, Belladonna, or Calcarea Carb., may be called for, the indications for these remedies being given under "Scanty or Excessive Secretion of Milk."

Scanty or Excessive Secretion of Milk.
Too little milk may be due to excessive nervousness, grief or fright, or to poor nutrition of the mother. Attempts to increase the flow of milk should not include the resort to alcoholic stimulants, but should be directed to improving the general health by an abundance of simple, nourishing food, especially milk, and by good hygiene, plenty of sleep, fresh air, etc.
Too much milk may be due to excessive activity of the digestive functions in robust women of great vitality, or may equally occur, in "run down" women. In the latter case the milk is poor, thin, and will not nourish the child. Excessive lactation often occurs when nursing is prolonged unduly, and when conception takes place while a woman is still nursing her baby. Headache, vertigo, insomnia, debility, emaciation, etc., result.

Calcarea Carb. Poor milk, although profuse in quantity in fair, fleshy or flabby women; also scanty milk supply in women of the same type, inclined to too frequent and profuse menstruation, and with cold, damp extremities.

Pulsatilla. Often called for when there is too little milk in mild, tearful women apparently in good health, or when the milk is profuse, thin and watery; feverishness but no thirst; fatty, rich food disagrees; the patient craves cool air.

Belladonna. Scanty milk supply; breasts large and heavy; headache; eyes red; face flushed; no sound sleep, but a half waking, half sleeping condition.

Sulphur. Excessive secretion of milk in poorly nourished, low-spirited women, who complain of frequent weak faint spells.
Also China. Scanty milk in women who have lost much blood, or who are greatly debilitated, with flatulence, indigestion, dizziness, and ringing in the ears. Asafoetida. Excessive sensibility and nervousness; sometimes hysteria; lack of milk, although breasts are enlarged, and veins distended. A dose of the indicated remedy every three hours.
As has already been said, the general nutrition must be improved when there is a scanty milk supply; a strong decoction of the castor oil plant, applied warm to the breasts seems to stimulate the secretion of the milk. Excessive secretion of milk also calls for attention to the general health. When the milk is of poor quality the child must have a wet nurse or be weaned. A moderately firm bandage put on over absorbent cotton, should be applied to the affected breast to secure compression and give support.

Bleeding After Labor. Postpartum Hemorrhage.
WHILE it may be reasonably assumed that the average woman in labor will have the attendance of a physician, it is by no means uncommon for a woman to give birth to a child without having medical aid. Serious hemorrhage following labor is fortunately not the rule, but the exception, nevertheless when such an emergency arises the attendant must be prepared to act promptly and effectively.
The local treatment recommended is of the greatest importance, but. should be supplemented by internal medication which will pre vent a recurrence of excessive flowing.

Ipecac, 3 x. Constant flow of bright red blood; cutting pains about the navel; constant nausea and vomiting; the patient feels cold; is very pale; gasps for breath; complains of dizziness and headache; every effort to vomit causes blood to flow with a gush. The leading remedy.

China. The uterus does not contract; flow not so bright as that calling for ipecac, but very profuse; also paroxysmal discharge of clots of dark blood; coldness and blueness of the skin; yawning; faintness; dizziness; ringing in the ears.

Secale. Hemorrhage of dark blood in debilitated women; slightest motion aggravates the flow; strong contractions of the uterus, every gush of blood being preceded by a contraction or by bearing down pains; patient prostrated, and takes little note of her condition.

Sabina. Dark blood, with blackish clots, mixed with watery blood; painless loss of blood after miscarriage or normal labor; pain in small of back extending round to the lower part of the abdomen; uterus does not contract. To be thought of when ipecac is not indicated.
See also Trillium and Belladonna under " Profuse Flow of Blood from the Uterus." A dose of the indicated remedy every ten minutes to one hour.
The bone above the external genitals is called the pubic bone or the pubes. Above this will be felt the uterus, and by placing the hand on it after labor, muscular contractions should be felt. When the uterus is relaxed, however, and bleeding is going on, grasp it firmly with the right hand, with a sort of kneading pressure. This will aid it to contract and expel blood clots, etc. Dip the hand first in cold water if there is time. If there are clots in the vagina, gently insert the other hand and remove them. The following directions should also be followed: remove pillows from under the patient's head; lift up the foot of the bed two or three inches and rest it in chairs; put cloths wrung out in ice water over the abdomen and change them frequently; if bleeding persists, push a lump of ice the size of a hen's egg well up in the vagina, or if ice is not at hand, fill a bulb syringe with vinegar and inject it into the vagina, or give a copious hot douche, two or three quarts with a fountain syringe, temperature 115' to 120', determined by a bath thermometer. Putting the child to the breast frequently stimulates contraction of the uterus. Perchloride of iron, one ounce to ten ounces of water, may be used as a final resource, to be given after the hot water douche.

ChildBed Fever. Puerperal Fever. THE introduction of septic germs into the wounds of the birth canal during or after labor causes a dangerous condition known as puerperal fever. The hands of the physician or nurse, unclean instruments or cloths most frequently convey this infection. The disease is described at length earlier in the book. The most conspicuous early symptoms are chill, free perspiration, rapid pulse of 100 to 140; rise of temperature, 102 to 104 degrees; often bad smelling lochia, as the discharge from the uterus is called, and pain in and tenderness of lower abdomen.

Aconite. Chill, followed by high fever, with hot, dry skin; quick, hard pulse; mouth and tongue dry; great thirst; may be vomiting; urine scanty, red and hot; cutting, burning, shooting pains in the lower abdomen, which is hot to the touch, and very sensitive to slightest pressure.

Veratrum Vir. Give early when there is nausea and violent vomiting, with empty retching; much congestion of the head; full, hard pulse; may be substituted for Aconite.

Belladonna. Intense congestion; rush of blood to the face and head; painful retching and vomiting; abdomen so sore, sensitive and painful the weight of the bedclothes cannot be borne or the slightest jar or motion; vaginal discharge suppressed; painful bearing down in the pelvis; eyes red; throbbing headache and delirium.

Bryonia. Peritonitis, with stitching, cutting pains in abdomen, worse from slightest motion; lochia suppressed; great thirst; cutting pains in the stomach, with distention, and sensitiveness to pressure.

Arsenicum .Sudden sinking of strength; cold, clammy perspiration; constant thirst and vomiting; diarrhea; burning pain in the abdomen; great anguish and restlessness; rapid prostration. A dose every half hour.

Veratrum Album. Serious cases, sudden and rapid in their development and with threatened collapse and speedy death; violent vomiting and diarrhea; suppressed lochia; icy cold extremities; face pale, sunken, cold perspiration. A dose every fifteen minutes to one hour.
Consult the remedies in the section on "Inflammation of the Uterus." A dose of the indicated remedy every one or two hours unless otherwise specified. The local treatment is outlined'on page 409, but these cases require the service of a competent physician whenever obtainable.

Suppression of the Lochia.
THE lochia are the genital discharges which follow labor, axe more or less bloody for four or five days, and contain shreds of tissue, then become more watery, and finally creamy like an ordinary vaginal discharge. The lochia last from two to four weeks in normal cases. From some disturbance of the system the lochia may be suppressed, or become offensive, with general symptoms showing that an abnormal condition exists. Prompt treatment is desirable, also when the discharge continues so long as to affect the general health.

Aconite. Suppression of the lochia, or a too scanty discharge, occurring soon after confinement, with distress in the abdomen, chest and head; feverishness, with thirst; much uneasiness, anxiety, and restlessness; suppression from fright.

Belladonna. Offensive lochia which feel hot in passing; flushed face; pain in the uterus, and great sensitiveness to touch or any jar; drowsiness, but no sound sleep; bad dreams; may be delirium.

Bryonia. Suppression of the lochia, with sensation as if the head would burst; worse from the slightest motion; thirst for large quantities of water at a time; mouth and lips very dry.

Nux Vom. Scanty and offensive lochia in women accustomed to highly seasoned food, coffee and wine, with constipation; irritability of the bladder.

Pulsatilla. Scanty or suppressed lochia with failure of milk in the breasts; feverishness, but no thirst.
Also Calcarea carb. when the lochial discharge is milky, and lasts too long in women who ordinarily menstruate profusely.

Rhus Tox. Thin, offensive, ichorous, persistent lochia causing much exhaustion; shooting pains up the rectum; much restlessness at night. Cimicifuga. Suppression of the lochia from cold or emotion.

Colocynth. Suppression from anger; suppression with violent colic.
A dose of the indicated remedy every three hours. The vagina should be cleansed twice or three times a day by hot water douche, see section on 11 Leucorrhea."

Milk Leg. Phlegmasia Alba Dolens.
Two or more weeks after delivery, there may be pain and swelling in one of the lower limbs preceded by a chill. The cause may be an extension of the inflammation from around the uterus through the lymphatics, or some clot in the pelvic veins. Whatever the cause, which is not always discoverable, the limb becomes swollen, tense, hard, white, glistening, and the veins distended like hard, irregular cords, with frequently a lumpy feel. An abscess or gangrene may follow.

Aconite.Fever; high temperature; rapid pulse; restlessness; much thirst.

Belladonna.Cutting pains, or sharp, shooting pains, aggravated by the least jar or motion; fever with burning thirst; throbbing of the arteries in the neck; eyes bloodshot.

Pulsatilia.Pale swelling in the foot and limb; supp~ession of milk; no thirst; bad taste in the mouth, especially after sleeping; the sufferer craves fresh, cool air.

Hamamells. Inflammation of the veins about the uterus, extending to the veins of the leg.
Also Arsenicum when there is much pale swelling; burning pains; great restlessness, every motion causing a feeling of exhaustion; thirst for frequent sips of cold water. A dose of the indicated remedy every one or two hours.
The leg should be kept at rest in a horizontal position, and elevated on cushions so as to be slightly higher than the thigh. Hot applications of hamamelis and water should be made, covered with absorbent cotton and oiled silk, or apply ichthyol and glycerin, 1 to 4, twice a day. Not until inflammation has wholly subsided should massage be given or a bandage or elastic stocking used. The latter is then advisable until all swelling has disappeared. Keep the bowels open, and drink plenty of soft water.

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