Part 11

Nature often seeks her own cure, and a colourless, thin fluid runs from the nipple, which relieves the symptoms.

Cramp, and Pains in the Legs, &c.

Some females, during the latter months of pregnancy, suffer dreadfully from cramp and pain in the legs, and about the sides and lower part of the stomach. This symptom arises from the pressure of the womb upon certain nerves in its neighbourhood, which proceed to the extremities.

If the cramp be seated in the muscles of the legs, a hard, knotty induration is perceivable to the touch, accompanied with great soreness, the latter continuing for a long time after the lump has disappeared. An uneasy position of the muscles is a sufficient cause of irritation, to produce it, and it is frequently removed, by simply rising from the bed or sofa, and walking the room, so as to put the muscles of the leg into action. If this does not succeed, warm friction with the naked hand, or with camphorated oil, generally will.

If spasm affect the sides, or lower part of the stomach, the speediest relief will be obtained from twenty, to five-and-twenty, or thirty drops of laudanum, with a little ether, in distilled peppermint water, or, even at the moment, a little brandy and water; but I generally order, for patients who are at all subject to this affection, the following mixture:—Batley’s sedative solution of opium, one drachm; compound tincture of lavender, half an ounce; distilled peppermint water, six ounces. Two tablespoonfuls to be taken before retiring to rest, if there is the slightest intimation of an approaching attack, and also direct that the feet be put into a mustard foot-bath. During the attack, great benefit will be derived from the external application of hot flannels, moistened with the compound camphor liniment.

Violent movements of the Child.

Before the third month of pregnancy, the child is not sufficiently developed to enable it to move. When a little further advanced in growth, it moves, but so feebly and imperfectly, that the mother is not yet sensible of it. A period, however, soon arrives, when its movements, although at first like the mere fluttering of a bird, acquire a power and force, that enable it to give decided proof of life. It is instantly recognised, the female knows she has quickened, and perhaps the sensation experienced is so sudden, that she faints. After this time the motions of the child increase both in frequency and degree, and are readily perceived by the mother, but after a time the womb accustomed to this action within itself, is less sensible of its effects, and except as a satisfactory evidence of the life of the child, is little regarded.

Sometimes, however, the child is disagreeably active, so violent as not merely to alarm the mother, but occasion much sickness and uneasiness;—sleepless nights; feverish symptoms, &c., and all this to such an extent, as to require medical interference. If this is not thought necessary, relief will be obtained from losing blood, when not otherwise objectionable, to the amount of a few ounces; gentle aperients, and a night draught containing from twenty-five to thirty drops of Batley’s sedative solution of opium. These remedies will afford the greatest relief, and if the symptoms are not altogether removed by them, the female must then endure patiently, recollecting they are a proof that the child is alive and vigorous.

Soreness and Cracking of the Skin of the Abdomen.

It will sometimes happen during the latter months of pregnancy, that the skin covering the abdomen will not yield readily. This produces much uneasiness; the skin becomes tender and fretted, and if there is very great distension, cracks. It forms a source of great discomfort, and renders the female miserable whenever she moves.

It is to be relieved by fomenting the parts with a decoction of poppy-heads; and the frequent use of warm almond oil, applying in the intervals spermaceti ointment, spread very thinly on a piece of soft linen.

Inconvenience from Size.

Many women in the latter months of gestation experience considerable annoyance, and sometimes severe suffering from the great size of the abdomen, and from want of support, when even not so very large. This is a rare occurrence in a first pregnancy, owing to the firmness of the abdominal muscles, but very frequent in subsequent ones. Little women especially suffer from this unpleasant cause, and, in fact, it is so universally the case with all, who have borne children rapidly, that it is highly important for a female to be provided with the means of relieving it.

There is but one remedy with which I am acquainted, but have usually found it answer every purpose. It is wearing during the day-time a well-applied belt, next the skin. It must be sufficiently broad for its upper edge to surround the abdomen above the point of its greatest diameter, and its lower edge to come down to, and be supported by, the hips. It must be drawn tight by a lace-string behind, as circumstances may require, and it must likewise be supported by broad straps passing over the shoulders. This will give the required support to the womb, and when the patient is in an upright position, as much as possible of the weight, of what she externally carries, will be thrown upon, or hang from, her shoulders.

Those who suffer much from this cause, ought also to lie down upon a couch or bed, for two or three hours every day; this will give great relief to the muscles.

Being Unwell during Pregnancy.

A female may be pregnant, and yet be unwell for one period or more while in that condition. Indeed, it may take place every month to the time of quickening, and has even continued in some rare cases up to the time of delivery.

Now, although this can scarcely be called one of the diseases of pregnancy—for it, ordinarily, in no way, interferes with the health—still, as while the discharge is actually present it predisposes to miscarriage, it is necessary to give one or two hints of caution.

Any female, then, thus circumstanced should manage herself with great care immediately before the appearance, during the existence—and directly after the cessation of the discharge. She should observe the most perfect quiet of body and mind—keeping upon the sofa while it lasts, and carefully abstaining from any stimulating or indigestible article of food, and if any symptoms of pain, uneasiness, or threatening miscarriage come on, immediately seek medical advice.

A case, showing the necessity of carefulness under such circumstances, occurred to me some time since, and its relation is all that I need add upon this point.

A lady, resident in Gloucestershire, missing one period, suspected herself of being pregnant, but being unwell on the following month, supposed herself mistaken. She had occasion, however, to come to London on the second day of her being unwell—Monday. On the Wednesday following she suffered considerable uneasiness from the exertion attendant upon the journey, and on Friday while from her hotel was obliged to return home in haste, and before night, miscarried.

Here then is a case in point—first proving, what some persons deny, that a female may be unwell and yet be pregnant, for she could not perceive the slightest difference in the appearance of the discharge from what ordinarily took place, and it was exact as to the time of its return—and next, showing how necessary is great caution, and the most perfect quiet, since undoubtedly this lady would not have miscarried, if her journey had only been delayed another week.

Jaundice sometimes occurs in the early or latter parts of the pregnancy—certain affections also of disordered functions of the heart, producing palpitation—a troublesome cough, accompanied with considerable pain in the head, sudden attacks of difficulty of breathing, and distressing inconvenience from irritable bladder.

These, and many other slight affections, may manifest themselves during gestation, but of those I say nothing. It would be advancing beyond the bounds by which I thought it right to limit myself, and departing from the object proposed.

I have finished what was purposed, and presented the married female with that information for direction and relief, in those little ailments and discomforts which frequently arise during pregnancy, for which she does not think it necessary to consult her medical adviser, and yet from which she will not unfrequently go on suffering for weeks, rather than speak of them.

PREVENTION TO CONCEPTION.

We have seen from the preceding pages, that in addition to what may be termed diseases ordinarily attendant upon a state of pregnancy, there are others in which to become pregnant is to hazard the health, and often the life of the woman, involving a peremptory necessity either for instrumental or Cæsarean operation, premature delivery or miscarriage. Apart from its agonizing torture, the danger of the Cæsarean operation is imminent to a frightful extent. Premature delivery is often attended with success, but the offspring being prematurely born, if they survive, rarely attain maturity, and even then mostly during their short existence very sickly. Miscarriage, although attended with but little danger when skilfully effected and properly conducted, can only be considered as an alternative; only a choice of evils. But thanks to the indefatigable researches of the learned and humane M.M. Desomeaux for his great discovery by which pregnancy can be prevented. By this discovery every woman can have in her own power the means of prevention.

The imperative, and self-evident necessity that, in some cases, pregnancy should not take place, cannot, for a moment, be doubted, in view that it is within the knowledge of every medical man, who makes his profession subserve the amelioration of the suffering to which the female is subject—knowledge, too, acquired within the sphere of his daily practice—that there are women who should not become pregnant, for with them pregnancy is peril to life. And even when life is spared, the birth of every child snatches many years from the life of the mother, hurrying her, with a constitution shattered, and health destroyed, to a premature grave.