Читать книгу Mother, Nurse and Infant - S. P. Sackett - Страница 8

Table of Contents

Pregnancy is not a disease. Many women enjoy better health during its continuance than any other time, and in general the pregnant woman is not quite as much exposed to contagious and other diseases. But there are certain disorders incident to pregnancy, of which it is necessary to speak.

Morning sickness, when it is only troublesome during the early part of the day, is generally borne without much complaint, or much medical care. Before taking any medicine for it, I advise that the lady try such simple means as the following: Let her take a cup of coffee or milk, and eat a few crackers or a biscuit, after washing her hands and face, and before rising in the morning; then let her remain in bed for about fifteen minutes, then dress quickly and take a short walk. If the sickness continues, let her eat freely of pop corn, and she may eat of this occasionally during the day, or whenever she is suffering from sickness, and let her partake of other food also during the day. Persistent sickness and vomiting indicates a disordered condition of the digestive apparatus, and requires appropriate remedies. Use successively the following: Formula 85, 104, 81, 107.

Vomiting is sometimes so persistent and severe that the stomach can retain nothing, or but very little food. Of course, such cases demand the aid of a physician, and his efforts to give relief may be effectual, when the medicine here directed fails.

Costiveness is another complaint to which pregnant women are liable. This is hurtful in its consequences, being not uncommonly the cause of fever, tenesmus, pain in the bowels, and abortion. Care must be taken to obviate costiveness by the use of such food as will have a laxative effect. The use of graham bread, oatmeal gruel, raisins, figs, grapes, roasted apples, baked pears, brown bread, cracked wheat, stewed prunes, and other varieties of farinaceous food and fruit, may obviate the necessity of taking opening medicines (F. 108, or milk of magnesia.) An enema is an excellent remedy, and every lady should have a good enema apparatus, by which she can administer an injection to herself, and if she suffer from constipation, she should take an enema twice or three times a week, and the early morning is the best time. The clyster may be warm water, or castile soap and water, of the temperature of new milk. It may be well to give occasionally an aperient to insure a thorough clearance of the whole bowels, and castor oil, salad oil, citrate of magnesia, seidlitz powder, stewed rhubarb, or an electuary of figs may be given. I sometimes direct that the woman should take every day a small dose of oil, in a cup of water gruel or oatmeal gruel.

Severe pain in the bowels and rectum is sometimes caused by a column of hard and indurated feces, which remain for a number of days in the rectum and colon. Not only pain but inflammation, and other serious ills, may result if such a condition is neglected. If taking injections does not suffice to give relief, manual assistance is necessary. The nurse should learn the art of removing them if necessary; she should use a convenient instrument, carefully conducting it into the anus, or she may thrust her finger into the vagina to break the hard mass, and assist in its expulsion, then she should wash it out with repeated clysters.

For abdominal pains that are caused by its distention, and by the weight of the enlarged uterus, the woman should wear a bandage, or an abdominal supporter, adjusted to fit the abdomen, and made with proper straps and buckles to accommodate the increasing size of the abdomen. To relieve the pain, the abdominal walls may be rubbed with equal parts of sweet oil and laudanum.

Troublesome HEMORRHOIDS may be caused by constipation, and also by the congestion in the parts, and by the pressure made on the vessels of the part by the enlarged uterus. It is proper sometimes to use emollient fomentations and cataplasms. Relief may often be given by making firm and gentle pressure between the finger and thumb of each distinct tumor, till they are all compressed and returned within the anus.

In cases of BLEEDING PILES, blood comes away each time the patient has a stool. The patient ought to be as quick as possible in relieving the bowels, and should not at such times sit one moment longer than is absolutely necessary. If the piles are inflamed and painful, foment them three times a day, and for half an hour each time, with hot water containing a little carbolic acid—a one per cent. solution. Apply it by means of a sponge. Extract witch hazel may be used also, and relief may often be obtained by sitting over the steam of hot water for fifteen or twenty minutes. Simply put hot water in a close vessel, and sit over it. Sometimes the woman cannot sit in an ordinary chair, and she should sit either on an air cushion, or a water cushion half filled with water, placed on the chair. (F. 107.)

Diarrhœa is a less frequent attendant of pregnancy than constipation, and the latter is sometimes the cause of the former; in such cases an aperient is required. (F. 109.) Should the complaint remain after the operation of the laxative, opiates are proper, mixed with some mild astringent medicine, aromatics, antacids, etc. (F. 69, 74, 79, 80, 95.)

Tenesmus, and also diarrhœa, are common attendants on abortion, of which they are, indeed, sometimes the cause. Ipecac in half grain doses, with powdered opium, and given every six hours; or frequently repeated doses of opium may be needed. (F. 91, 92.) A flannel bag filled with hot table salt, and applied near the part affected, may give great relief to pain.

Heartburn is a common and often a distressing symptom of pregnancy. I would prescribe in such cases an abstemious diet, pepsin, ingluvin, and other medicine to help digestion; antacids and laxatives. (F. 71, 72, 74.) Calcined magnesia is good; prepared chalk is harmful.

It is not necessary for me to dwell upon the few ailments that occasionally afflict pregnant women that I have not yet referred to—a few words must suffice. If a woman who is pregnant is apt to be FAINT, or to FAINT AWAY, I advise that she be laid down—that she lie flat on her back, with a pillow under her head—that tight articles of dress be loosened—windows raised—water should be sprinkled on her face, a few drops of aromatic ammonia may be administered, and perhaps smelling salts or hartshorn held to the nose. If it is simply fainting, it is not dangerous.

A nervous pregnant woman is sometimes subject to PALPITATION OF THE HEART, especially when lying down. A small dose of aromatic ammonia will generally give relief.

If CRAMPS of the legs or thighs are troublesome, take F. 92, and tie a handkerchief around the limb, above the part affected, and let it remain a few minutes, and use friction. If cramp attacks the bowels or back, a hot bag of salt, or a stone bottle filled with hot water and wrapped in flannel, may be pressed against the part, and something similar should be placed to the sole of the feet.

If PRURITIS PUDENDI—irritation and itching of the external parts—are troublesome, use F. 195, 217, 220, and take frequently a tepid salt and water sitz bath, remaining but a short time in the bath. If the parts are hot and inflamed, and covered with an eruption, use either of the following lotions: F. 217, 195.