This section is from the book "Smith's Family Physician", by William Henry Smith. See also: Natural Physician's Healing Therapies: Proven Remedies that Medical Doctors Don't Know.
Floodings are more or less dangerous according to the stage of pregnancy in which they happen. The farther a woman is advanced therein, the greater will bo the risk, especially if unaccompanied by labour pains, as the mouths of the vessels which pour out the discharge are much enlarged during the Last stage of pregnancy, and of course a vast quantity will be discharged in a short space of time. Although miscarriages before the fifth month are seldom attended with immediate danger, the loss of blood being usually small, they nevertheless frequently lay the foundation for many grievous ailments. Some women are sometimes visited by habitual miscarriages, which are sometimes repeated for several successive pregnancies, and more frequently take place about the third month than at any other time.
The danger of abortion is to be estimated by considering the previous state of health and habit of the patient, the violence of the discharge of blood, the duration of the complaint, the difficulty of checking it, the disposition to expulsion which accompanies it, the period of gestation at which it is threatened, the frequency of its occurrence, and its combination with spasmodic affections and convulsions. The most dangerous abortions are those which are procured by substances of an irritating nature taken internally, and by attempts to excite the womb, or by puncturing the membranes.
A woman who is subject to habitual abortions ought to avoid anything that is likely to prove an exciting cause. If of a full, plethoric habit of body, she should keep her bowels well open; use a spare diet, with but little meat; take no stimulants; sleep upon a mattrass instead of a feather bed; and avoid all agitations of mind, severe exercise and violent efforts of any kind; and should take regular but gentle exercise.
In women of a weak, lax habit, a nutritive and generous diet, moderate exercise in a carriage, cold bathing when the weather will allow of it, and tonic medicines, will be necessary. Until the pregnancy is advanced beyond the usual time of abortion, it would be advisable that the woman should sleep alone. In some cases it may even be necessary that the patient should keep her room for some time, and confine herself to bed or to a sofa, till the critical time is past.
In those cases of habitual abortions accompanied with spasmodic pains in the womb, or a disposition to convulsions, Opium in Half-grain doses or Laudanum in doses of fifteen or twenty drops; or Bromide . of Potash or Hydrate of Chloral in ten or fifteen grain doses, may be taken once or twice a day.
Where the patient is troubled with nausea or vomiting she may take small effervescing draughts of Bi-carbonate of Soda (10 grains) and Tartaric Acid (8 grains) and repeat them several times a day. An abortion being threatened in consequence of some slight separation of the placenta from the womb, may frequently be stopped by immediately adopting proper steps, and the woman be enabled to go on her full time.
On the first appearance of the flooding, the woman should be confined to her bed, and be placed with her hips somewhat more elevated than her head, keeping her at the same time perfectly cool and extremely quiet, debarring her of all food of a heating, stimulating nature, giving her cold liquors to drink, sharpened with some agreeable acid, and applying linen cloths wetted in vinegar and water to the loins and private parts. The patient may also take the following mixture:
Aromatic Sulphuric Acid...................Two Drams.
Compound Tincture of Cardamoms.......Half an Ounce.
Compound Infusion of Roses or Mint tea, sufficient to make half a pint. Two tablespoonfuls every two or three hours.
At the same time ten grains of Bromide of Potash may be taken two or three times a day, about an hour after taking the Acid mixture , or one dram of Laudanum may be added to the bottle of mixture.
At the same time astringent injections may be thrown up the vagina by means of a female syringe. The following is the best combination for that purpose:
Tannic Acid, or Gallic Acid..................Two Drams.
Warm water.....................................Half a Pint.
This will be sufficient for twice. The water must be merely warm; not hot.
Or pieces of soft flannel may be soaked in the solution, and the vagina may be plugged with them. These must be introduced with the finger, piece after piece, till the vagina is well filled. A bandage must then be placed in such a way as to prevent the plugs from giving way,
If the pulse is full, hard, and frequent, many practitioners have been in the habit of extracting blood from the arm: but this is seldom necessary.
Where sickness or great feebleness attends an abortion, the patient is to be kept at rest with the head low, and she may take a few drops of Spt. Sal Volatile in a little water; or, in very urgent cases, she may take a little wine or diluted brandy, but these must not be given too often.
In all cases where a considerable flooding has begun, but particularly at an advanced stage of pregnancy, the first thing of importance to be inquired into and ascertained is its cause, and this can hardly be done too early, for as long as the accoucheur allows himself to act without this piece of essential information, his practice must necessarily be uncertain, and the life of his patient in danger.
If on examination, the placenta is found in the right place, it is probable, or at least it is possible, that the flooding may subside permanently by the aid of a horizontal posture, a low diet, the application of cold, and a use of the other means before noticed; but, if, on the contrary, the placenta be placed over the mouth of the womb, however these remedies may afford a temporary relief we may be assured that the discharge will return; for the next time that a dilatation of the womb takes place, which must be sooner or later, a fresh portion of the placenta will become detached and other bleeding vessels unavoidably be opened. If therefore on examination, the placenta is discovered over the mouth of the womb, or very near thereto, even should there have been only one considerable discharge, the patient should be watched with the greatest diligence, and delivered as soon as the parts are sufficiently dilatable to allow of the introduction of the hand without improper force.
It sometimes happens in abortions, that the whole ovum does not come away at once, but only the foetus, and that either a part or the whole of the secundines remain behind. These by long retention, give rise to an offensive discharge from the vagina, and a feverish state accompanied with hysterical affections. In such cases, it will be advisable to keep the parts clean, by injecting an infusion of Chamomile Flowers (to which a dram of Tannic Acid to the pint may be added); to keep the bowels open with gentle laxatives or clysters of warm water; to support the strength with tonic medicines, such as the Citrate of Iron and Quinine; and by light nourishment, with small portions of wine, frequently repeated. At the same time we must procure rest or allay irritation by means of opiates or sedatives.
After every abortion the woman should be confined to bed for a few days, as getting up too soon is apt to produce a debilitating discharge.
In some cases of severe uterine hemorrhage after delivery, where the patients became nearly exhausted, fatal syncope has been prevented by the transfusion of blood from another person into their veins, thus replacing what was lost; and the life of the women has been thus preserved.