The Ladies Book of Useful Information Part 17

THE SYMPTOMS OF THREATENED ABORTION

vary with the const.i.tution. In the strong and plethoric it is often preceded by s.h.i.+vering and febrile symptoms and by a feeling of weight in the lower bowels. In the weak there is languor, faintness, flaccidity of the b.r.e.a.s.t.s, general depression, and pains in the back and loins. Intermittent pains, and discharge of blood from the pa.s.sage, tell that the process has begun. If miscarriage occurs within the first month or two after conception, the process may be accomplished with so little inconvenience as to escape notice and be mistaken for a menstrual period. More generally, however, the severity of the pain and an unusual clotted discharge of blood render the case evident. The pain, the discharge, and, at the same time, the danger of an abortion, are in proportion to the advancement of the pregnancy.

When a miscarriage goes on, the pains increase in force and frequency, and continue, with discharge of blood, fluid or in clots, until the ovum, or first formation of the child, is expelled; after which both become moderated till they cease altogether and the red flow gives place to a colorless one. It is very important that those in attendance upon the patient should examine every clot that comes away.

If large, tear it in pieces, that they may ascertain whether the contents of the womb are expelled or not, for there is no safety or rest, where miscarriage is progressing, till it has taken place and everything is cast off.

AS SOON AS A FEMALE

experiences threatenings of abortion she ought at once to retire to bed, upon a mattress, and keep perfectly quiet till every symptom has disappeared. Sometimes this simple measure, _promptly adopted_, is sufficient to avert the threatened evil. If there is much feeling of fullness, and the patient is of full habit generally, eight or a dozen leeches may be applied to the lower part of the bowels; if there is fever, saline medicines may be given, such as the common effervescing draft of carbonate of soda and tartaric acid or lemon juice; or, if the bowels are much confined, seidlitz powders, a.s.sisting the action by cold clysters, if necessary. When the pains are severe, particularly in the weak and irritable, twenty or thirty drops of laudanum should be given, and may be repeated in a few hours if the symptoms are not improved. In the case of profuse discharge, the patient should be kept very lightly covered, movement avoided, and every article of food or drink given cold, or iced if possible, provided the vital powers are not excessively reduced. Cloths dipped in cold or iced water should also be applied to the lower part of the body and frequently changed. Acid drinks, with cream of tartar, may be freely given. Ten or fifteen drops of elixir vitriol may be given in a winegla.s.sful of water every two or three hours. Should slight faintness come on, it is better not to interfere with it, but use outward remedies-camphor, cold water, vinegar, etc.-as they maybe salutary. If it reaches to an extent to threaten life, stimulants, as brandy and water, and others, must be had recourse to. Profuse and continued discharge, though it may not threaten life, must occasion a weakness which will take a long time to overcome, and which may ultimately, if not properly attended to, promote the development of other diseases of the womb.

IF THE FLOODING IS PROFUSE

and uncontrolled by the means before mentioned, one grain and a half of sugar of lead may be given every two or three hours, and washed down with a drink of vinegar and water, to which, if there is much pain, add from five to ten drops of laudanum.

Pieces of linen or cotton cloth should be soaked in a strong solution of alum, or a decoction of oak bark; and then well oiled; with this cloth plug the pa.s.sage or birthplace; or, some of this astringent wash may be thrown up with a syringe.

But, during the time and after miscarriage, the general strength must be supported by a strengthening diet, such as soups, meat, etc., avoiding stimulants as much as possible. Nevertheless, in some cases wine or malt liquors may be necessary in convalescence, or when recovering, and if so may be a.s.sisted by tonic or strengthening medicines, such as contain mineral acid. Bark or iron are generally given as the most appropriate remedies. The bowels will, in some cases, require strict attention, as indeed they do throughout, and for this purpose castor oil is a good medicine, or clysters of cold or tepid water are most useful. A teaspoonful of Epsom salts dissolved in half a pint of water, either cold or slightly warmed, to which add fifteen drops of elixir vitriol, forms a most excellent and mild purgative, which should be taken before breakfast. In all cases where the const.i.tution of the woman has a tendency to miscarriage or abortion, a quiet state of mind should be observed, avoiding all violent exertions, particularly lifting heavy weights. These principles of treatment are to be kept in mind in the management of miscarriage:

The first, to prevent it, if possible, by rest, opiates, etc.

The second, to allay pain, moderate the discharge of blood, and to save and support the strength of the patient.

The third, when abortion must take place, to expedite the separation of the ovum and free the contents of the womb. This is generally done by simply occasionally drinking cold water, and in difficult cases, if necessary, by the administration of spurred rye. The dose is a strong infusion or tea given every twenty or thirty minutes until the desired effect is produced, as long as the stomach will bear it.

The health of pregnant females should at all times be an object of great care and interest; and they should be impressed with the conviction that while

BEARING THE FIRST CHILD

they may, by proper care and attention, lay the foundation for their future health and that of their offspring; while by neglect and imprudence in this matter, they may not only enfeeble their const.i.tution, but entail upon their children an inheritance of infirmity and disease.

Miscarriage, or abortion, which includes all cases in which delivery takes place before the sixth month, seldom occurs without being preceded, or accompanied, or followed, by a morbid discharge of blood from the womb, which is commonly known by the name of _flooding_.

Abortion, or miscarriage, takes place with the first pregnancy, and during the first two months; therefore, great care should be observed during this period, as any cause which either destroys the life of the child in the womb or brings on morbid or premature contractions in that organ may induce miscarriage. Coughing severely, or vomiting, a blow or fall, or a misstep leading to an effort to prevent falling, may, and does frequently, result in miscarriage; and this having once occurred, it is, without proper care, exceedingly liable to be the case again at the same period of a subsequent pregnancy. The same result may follow any vivid moral impression; for fright, or mental excitement by pa.s.sion, or witnessing any accident, will be found often to end in miscarriage. In some healthy females, however, it occurs without any other cause than mere fullness of blood. A bleeding from the womb is often in such cases a first symptom of abortion, and should be attended to as early as possible before it goes to any considerable extent. The amount of flooding, in most cases, is in proportion to the early period of pregnancy at which it takes place, for in the latter months there is seldom much blood lost. But there are cases in which pregnant women will lose blood repeatedly from the womb and yet not miscarry, but these are very rare cases.

In most cases, the occurrence of a woman's flooding between the first and fourth months, unless very slight, or quickly relieved, is usually followed by a miscarriage; but as soon as the child and its membranes are both expelled by the contraction of the womb the flooding soon ceases. In many such cases it is often very difficult, and sometimes impossible, to deliver the afterbirth and membranes, which remain and finally pa.s.s off after putrefaction has taken place, resulting in long and offensive discharges from the womb, and which, unless treated by the most skillful management, frequently result in many internal mischiefs of a serious character, such as ulcers, cancers, etc.

In all cases, those who are const.i.tutionally disposed to abortion, or have a tendency to miscarriage, should take great care to preserve a quiet state of mind and to avoid all violent exertion; and all active purgatives should be avoided, and exposure to great heat or cold, during the time of gestation or pregnancy.

When the miscarriage has really taken place, and the ftus, or child, is expelled, together with the contents of the womb, the same precautions should in general be observed as in childbirth.

TO PREVENT MISCARRIAGE,

when it is threatened, or on the appearance of the first symptoms, the patient should lie down and be as quiet as possible; live on very light diet; bowels be kept freely open; and an injection of thirty drops of laudanum should be given in half a pint of slippery elm tea.

Should flooding be present, cold lemonade should be drank freely, and cloths wet with cold or ice water applied to the thighs and lower part of the birthplace, which should be repeated until the flooding is relieved.

MEANS OF PREVENTING ABORTION.

To prevent abortion, women of weak or relaxed habit should use solid food, avoiding great quant.i.ties of tea, coffee, or other weak or watery liquors. They should go soon to bed and rise early, and take frequent exercise, but avoid fatigue. They should occasionally take half a pint of the decoction of lignum-vitae, boiling an ounce of it in a quart of water for five minutes.

If of a full habit, they ought to use a spare diet and chiefly of the vegetable kind, avoiding strong liquors and everything that may tend to heat the body or increase the quant.i.ty of blood; and when the symptoms appear, should take a dram of powdered nitre in a cup of water gruel every five or six hours.

In both cases the patient should sleep on a hard mattress and be kept cool and quiet; the bowels should be kept regular by a pill of white walnut extract or bitterroot.

CHAPTER IX.

MENSTRUATION.

Though this is not a disease, but a healthy function, and as, from various causes, derangement of the function occurs, it is proper that it should be perfectly understood. Menstruation is the term applied to the phenomenon that attends the rupture of what is called the _Graafian follicles_ of the ovaries and the discharge of an ova, or egg. It is a b.l.o.o.d.y discharge from the female genitals; not differing from ordinary blood, excepting that it does not coagulate, and in its peculiar odor. The blood comes from the capillaries of the womb and v.a.g.i.n.a.

MENOPHANIA, OR THE FIRST APPEARANCE

of the menses, is usually preceded by a discharge of a fluid whitish matter from the v.a.g.i.n.a, by nervous excitement, and by vague pains and heaviness in the loins and thighs, numbness of the limbs, and swelling and hardness of the b.r.e.a.s.t.s. The first appearance is an evidence of capacity for conception. It generally appears about the age of fourteen, but varies from nine to twenty-four years. In warm climates women begin to menstruate earlier and cease sooner than in temperate regions; in the cold climates the reverse of this holds as a general rule. The manifestations of approaching p.u.b.erty are seen in the development of the b.r.e.a.s.t.s, the expansion of the hips, the rounded contour of the body and limbs, appearance of the purely feminine figure, development of the voice, and the child becomes reserved and exchanges her plays for the pursuits of womanhood.

More or less indisposition and irritability also precede each successive recurrence of the menstrual flux, such as headache, la.s.situde, uneasiness, pain in back, loins, etc. The periods succeed each other usually about every twenty-eight days, although it may occur every twenty-two, twenty, eighteen, fifteen, or thirty-two, thirty-five, or forty days. The most important element is the regularity of the return. In temperate climates each menstrual period ordinarily continues from three to six days, and the quant.i.ty lost from four to eight ounces. The menses continue to flow from the period of p.u.b.erty till the age of forty-five or fifty. At the time of its natural cessation the flow becomes irregular, and this irregularity is accompanied occasionally by symptoms of dropsy, glandular swellings, etc., const.i.tuting the _critical period_, _turn_ or _change of life_; yet it does not appear that mortality is increased by it, as vital statistics show that more men die between forty and fifty than women.

It should be the

DUTY OF EVERY MOTHER

or female in charge of a child in whom age or actual manifestations suggest the approach of p.u.b.erty to acquaint her with the nature of her visitation and the importance of her conduct in regard to it. She should be taught that it is perfectly natural to all females at a certain period, and that its arrival necessitates caution on her part with regard to exposure to wet or cold. The author has made the acquaintance of the history of many cases of consumption and other diseases which were directly induced by folly and ignorance at the first menstrual flow. The child is often kept in extreme ignorance of the liability of womanhood occurring to her at a certain age, and, hence, when she observes a flow of blood escaping from a part, the delicacy attached to the locality makes her reticent with regard to inquiry or exposure; she naturally becomes alarmed, and most likely attempts to stanch the flow by bathing or applying cold water to the part, thus doing incalculable mischief.

This purely feminine physiological function should be well studied and understood by all females. At least, they should know that the phenomenon is a natural one, liable to disorder, and that the best interests of their general health demands care and prudence on their part to maintain regularity, etc., of the flow. Disregard of such a duty will surely entail much misery.

DELAYED AND OBSTRUCTED MENSTRUATION.

When the menses do not appear at the time when they may naturally be expected, we call it delayed or obstructed menstruation. It is, however, of great importance to know whether a girl is sufficiently developed to make it necessary for the menses to appear, although she may have reached the proper age. As long as the girl has not increased physically, if she has not become wider across the hips, if her b.r.e.a.s.t.s have not become enlarged, and if she experience none of the changes incident to this period, an effort to force nature is positively injurious. In this case a general treatment will be called for. She should be required to exercise freely in the open air, retire early to bed and rise at an early hour in the morning. She should not be allowed to be closely confined to school, if attending. Her diet should be generous but free from all rich food, which will disorder the stomach. If, however, she is fully developed, and she suffers from time to time from congestions of the head, breast or abdomen, it will be necessary to interfere. The following are symptoms which will generally be found in these cases: Headache, weight, fullness, and throbbing in the center of the cranium and in the back part of the head; pains in the back and loins; cold feet and hands, becoming sometimes very hot; skin harsh and dry; slow pulse, and not infrequently attended with epilepsy.

TREATMENT.

It is well for the patient, a few days before the period, to take a warm hip bath or foot bath twice a day, and at night, when retiring, to apply cloths wet in warm water to the lower part of the abdomen.

The bowels should be kept open by some mild catharsis, as castor oil or a pill of aloes. If there is pain and fullness of the head during the discharge, or before it, use the following:

Tincture of aconite leaves, Two drams; Tincture of belladonna, One dram; Tincture of cantharides, One dram; Morphia, Three grains; Simple syrup, Quarter ounce.

Mix. Dose: One teaspoonful three times a day. If the pain is severe it may be taken every two hours.