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.
Parturition, it is well known, is a natural process, and cannot therefore be considered a disease; nevertheless it often lays the foundation of many distressing complaints, and is now and then attended suddenly even with fatal consequences.
A woman sometimes appears safely put to bed after an easy and natural labour; she has suffered no unusual loss of blood; the womb, on the application of the hand, is found well contracted, and the patient appears in a fair way to do well: but notwithstanding these favorable appearances, and perhaps even during the congratulations of her friends upon the termination of her sufferings, she complains of a degree of faintness, attended with a sensation of sinking: this is followed by restlessness, with an anxious, depressed countenance, and occasionally by pain and a feeling of tightness at the pit of the stomach; and expressions of alarm for her approaching dissolution are not unfrequently repeated. Shortly afterwards the restlessness increases, the countenance becomes more dejected and ghastly, the pulse gradually fails, the breathing becomes difficult, and if these symptoms are not speedily relieved, death will quickly follow. The cause of this sudden loss of life is supposed to be the sudden removal of pressure from the walls of the abdomen, and its contents; as the same result has frequently happened in tapping for Dropsy; and the same means that will prevent mischief in the one case, will equally prevent it in the other.
As soon as the woman is delivered, a broad bandage-formed of a small sheet, or a long kitchen towel-should be passed round her, and pinned on tightly; placing under it, and over the womb, a soft pad: a petticoat rolled up will answer the purpose. This should remain on for at least forty-eight hours. As soon as the bandage is put on, the patient should have about 30 drops of Laudanum, when, if not disturbed, she will usually get a few hours sleep. All stimulants should at this time be strictly prohibited, a little warm gruel, if the patient wishes for anything, being the only thing allowed. It is wonderful the difference there is in women's constitutions, and how little concern some women give themselves about an event that will confine others to the house for a month. I recollect the second midwifery case I ever attended. There was a fair-partly pleasure and partly cattle-in the village in which I was then residing, about thirty miles from London. I had previously attended the wife of the owner of a ginger-bread stall, who was confined in the canvas tent on the fair ground, the night before the opening of the fair; and was sitting down to dinner,when a messenger came in a great hurry, to say the wife of the owner of a caravan of wild beasts, who was exhibiting at the fair.was suddenly taken in labour. Following the messenger,I found the patient at one of the village inns, where they made her as comfortable as such sudden circumstances would allow. She was confined between four and five o'clock on Friday morning; on Saturday she sat up for an hour; on Sunday she was up all day; on Monday she was up doing needle-work; and on Tuesday morning at seven o'clock, she left the place by stage to follow her husband; he and his caravan having proceeded to another fair at some distance.
The most usual complaints which occur after delivery, are:
These usually come on shortly after delivery, and with some women prove very severe. The quicker the labour has been, the slighter will they prove in general. Women with their first child are seldom much troubled with after-pains; but, as the womb is thought to contract less readily after each future labour, so they are are more liable to suffer from them in. any succeeding delivery than in the first.
When after-pains prove so troublesome as to deprive the patient of her rest, it will be necessary to have recourse to opiates combined with other antispasmodics. She may take the following, which may be repeated in six or seven hours if necessary.
Tincture of Castor..............................One Dram.
If this is not sufficient, the patient may take about fifteen grains of Hydrate of Chloral. Heated flannels or bladders filled with warm water may be applied over the abdomen. A tight bandage being kept on all the time.
This is apt to prevail after delivery, and should always be removed by some gentle laxative, such as Castor Oil or the Lenitive Electuary. Or an injection of warm water or warm thin gruel may be given.
In all women a certain degree of flooding takes place after delivery, produced by the removal of the placenta, which thereby lays bare the mouths of the blood-vessels in the inside of the womb; and this commonly continues until the womb contracts to such a size as to close them up again. The discharge for the first four or five days consists usually of florid blood, after which time it assumes a mucous appearance, and so ceases gradually.
In weak and relaxed habits, where the application of a bandage has been neglected, it sometimes happens, that instead of saturating a cloth now and then, as is natural to all women, the blood gushes out with such rapidity and violence as to run quickly through all the bed-clothes,and even to soak through the bed itself; in which case the patient will be reduced to a state of great debility, if the flooding is not soon restrained. To effect this the bandage must be applied at once; and the mixture (Aromatic Sulphuric Acid) recommended under the head of Abortion may be taken; and the patient must be kept cool.
Where a suppression of the lochia ensues before the accustomed period, the discharge ought to be brought back again, if possible, by the application of warm fomentations to the parts. Should these means prove ineffectual, the bowels must be opened with some gentle laxative.
About the third or fourth day after delivery, the breasts generally become turgid and painful from the secretion of milk which then takes place in them. When this is moderate and free, no inconvenience will be experienced; but when copious, and secreted faster than the child can suck it away, or there is any obstruction in the milk-vessels from an exposure to cold, the breast will then become hard, swelled and painful, and a small fever will arise, accompanied by nausea, restlessness, pains in the head and back, and a considerable degree of thirst.
To prevent any consequences of this kind, it will always be advisable to apply the child to the breasts at a very early period after delivery. By delaying to do so immediately after the secretion of milk commences, the breasts are not only apt to become much enlarged and distended, but the nipples are often so drawn in that the child cannot lay hold of them without the greatest difficulty.
Where the mother's health will not admit of her suckling the child, or any other thing happens to prevent it, she should be careful to have her breast drawn three or four times a day by some other person; and with the view of preventing a copious secretion of milk, she should use a very spare diet, keep her bowels perfectly open with laxative medicines, and abstain as much as possible-from all liquids.
If any degree of fever arises, besides confining the patient to a spare diet, and keeping the bowels open, she may take the following:
Antimonial "Wine...............................Six Drams.
Solution of Acetate of Ammonia............One Ounce.
Sweet Spirit of Nitre...........................Half an Ounce.
Syrup..............................................Half an Ounce.
Water, sufficient to make......................Half a Pint.
A tablespoonful every three or four hours.
From exposure to cold, and neglecting to put the child at an early period to the breasts, or to get them drawn by some other person, the breasts are very apt to become inflamed, swelled, and hardened.
The best way to reduce the inflammation and disperse the swelling, which should be done as soon as possible, is to apply linen rags dipped in the following cold lotion to the breast, (taking care not to cover the nipple, and changing them as often as they become warm.
Powdered Muriate of Ammonia (Sal Ammoniac)............................One Ounce.
The patient at the same time taking the Fever mixture prescribed above. The breasts should be drawn several times a day, particularly the one affected, either by the child or by some person who understands the operation. When they are so much swelled as not to allow of laying hold of the nipple, the proper instruments made for that purpose should be employed.
If the swelling should show a determination to gather and break, (which it will not do, if the means ordered above are adopted in time), then it must be assisted to do so by poultices and warm fomentation. As soon as the gathering is ripe it should be opened, and the sore dressed with Spermaceti Ointment, or Turner's Cerate.
From the constant state of moisture in which these parts are kept by those who give suck, the nipples are very apt to become tender, get inflamed, and become chapped. The best application is, finely powdered Borax or finely powdered Chalk mixed with Honey: a dram of Borax or Chalk to an ounce of Honey. This may be applied to the nipple three or four times a day; but should always be washed off with warm water, each time before the child is put to the breast. Or the artificial teats may be used.
If the tenderness of the nipple arises from the heated or feverish-state of the patient, she had better take a little cooling medicine