Читать книгу The Mother and Her Child - Lena K. Sadler - Страница 78

This whole subject can best be illustrated by relating a story, the actual experience of Mrs. A. This patient came to the office with a history of Bright's disease (albumin and casts in the urine), and chronic appendicitis. While treating her for the kidney condition, preparatory to an operation for the removal of the troublesome appendix—in the very midst of this treatment—she became pregnant, and great indeed was our dismay. We entertained little hope of getting both the mother and child safely through. Frequent examination of urine was instituted, the albumin did not increase and the blood-pressure remained at normal—about 124 mm. She paid weekly or bi-weekly visits to the office and carefully followed the regime outlined. She drank abundantly of water and strictly followed the dietary prescribed. Weeks and months passed uneventful, until we approached the last six weeks of pregnancy, and then we found to our surprise one day that the blood-pressure had made a sudden jump up to 175 mm., while the urine revealed the presence of numerous casts and albumin—in the meantime the albumin had entirely disappeared. There were also other urinary findings which showed that the liver was not doing its share in the work of burning up certain poisons.

In her home we began the following program: Every day we had her placed in a bathtub of hot water, keeping cold cloths upon her brow, face and neck, and then, by increasing the temperature of the bath, we produced a very profuse perspiration. She was taken out of this bath and wrapped in blankets, thus continuing the sweat. All meat, baked beans, and such foods as macaroni and other articles containing a high per cent of protein were largely eliminated from her diet. At times she did not even eat bread. Her chief diet was fruit, vegetables, and simple salads, and yet the albumin and casts continued to increase in the urine and the blood-pressure climbed up to 190 mm.

As we approached the last two weeks of pregnancy, this little woman was taken to the hospital and systematic daily treatment with sweating procedures was begun. Among other things, she had a daily electric light bath. After each of these baths she was wrapped in blankets and the sweating continued for some time. Careful estimations of albumin were made daily and the blood-pressure findings noted three times a day. During the last week of pregnancy she lived on oranges and grapes. Day by day she was watched until the eventful hour arrived. She went into the delivery room and gave birth to a perfectly normal child. The albumin and casts quickly cleared up, the blood-pressure lowered, and today the little woman is a fond mother of a beautiful baby boy.

It is hard to estimate what might have taken place had not her elimination been stimulated. The blood-pressure was our guide. Had the albumin (without casts) appeared in the latter weeks of pregnancy with a blood-pressure of 140 or 150 mm., we would not have become excited, for the reason that in every normal pregnancy there is often present a trace of albumin in the latter weeks; but when the blood-pressure jumped to 170 or 190, then we knew that toxemia—eclampsia—convulsions—were imminent. So we have in recent years, come to look upon the blood-pressure as an exceedingly important factor—as an infallible indicator of approaching trouble—as a red signal light at the precipice or the point of danger; and it not only warns us of the danger, but it tells us about how near the boilers are to the bursting point. The glassy eye, the headache, the full bounding pulse and the blurring of vision, are all symptoms accompanying this high blood-pressure, so that in these enlightened days no practitioner can count himself worthy the name, or in any way fit to carry a pregnant woman through the months of waiting, unless he sees, appreciates, and understands the value of blood-pressure findings in pregnancy.