SECT. I.—ON THE COMPLAINTS OF PREGNANT WOMEN, AND THEIR DIET.
Of the complaints which befal women in a pregnant state, the most troublesome are a redundance of crudities, continued vomiting, salivation, heartburn, and loathing of food; it will therefore be proper to give directions regarding them. The most suitable remedies are, exercise on foot, food not too sweet, wines which are yellow, fragrant, and about five years old, and moderate drink. All these things are proper for the cure of crudities and vomiting. For medicines, you may give the plant of knot-grass, boiled in water, for drink; and likewise dill, and the Pontic-root, called Rha, in the dialect of its native country. These things may be taken at a meal, or before it. Externally, the flowers of the wild vine, those of the wild or domestic pomegranate, the leaves of the alsanders (smyrnium), and the seed of the fennel, may be mixed together according to pleasure, along with dates and old wine, and applied to the præcordium in the form of a cataplasm. Heartburn may be alleviated by drinking warm water, by gentle exercise on foot, and by covering the hypochondrium with soft wool. In the case of those who have an aversion to food, whet their appetite with a variety of articles of a savory nature, and also give dry starch. This last is particularly serviceable to those who long to eat earth, as is the case in the complaint called Pica, which occurs most frequently about the third month after conception; because the fœtus being then weak, cannot consume all the aliment which is brought to the uterus, and hence various superfluities are collected in the stomach; and therefore they have a desire for complicated and improper articles, such as extinguished coals, Cimolian earth, and many more such things. On that account, the affection has got its appellation, either from the variety of colours which the bird Pica possesses, or from its being subject to this complaint. Labour and long journeys will also contribute to restore a desire for wholesome food. But she who has accustomed herself to live in an indolent manner, will not be able, when she proves with child, to bear exercise all at once. To those who loathe food, it may be of service to take acrid substances, and particularly mustard. For swellings of the feet, it may be proper to bind over them the herb anthyllis, soaked in vinegar; or to lay the leaves of a cabbage over them, and to anoint them with Cimolian earth mixed with vinegar, or with alum and vinegar. It is likewise of use to sprinkle the feet with a decoction of the Median apples, called citrons.
Commentary. We shall commence by giving a short account of ancient opinions on a curious subject not touched upon by our author,—we mean, on the influence of the imagination in pregnant women on the fœtus.
Hippocrates says, that when pregnant women long to eat coals and earth, the likeness of these things appears on the head of the child. (De Superfœt. c. 8.) Galen likewise believed in the influence of the imagination of pregnant women on the fœtus in utero. (Ad Pison.) Soranus also was a firm believer, and gives instances in women and in the inferior animals of the force of imagination at the time of impregnation. (lib. vii.) This belief was very ancient, for it appears to be countenanced by the Jewish historian. (See Genesis, xxx, 37-9.) Traces of this opinion may be found in Hesiod; and distinct allusion to it is made in the ‘Cynegetics’ of Oppian. (i, 327.) The story in the ‘Æthiopics’ of Heliodorus respecting Chariclea, the white daughter of the black king and queen of the Æthiopians, bespeaks the prevalence of the belief at the time when this celebrated romance was written. Andreas Laurentius gives an interesting statement of ancient and modern opinions on this subject. (De Mirab. Strum. Sanit.)
The bird pica is mentioned by name (κίττα) in the ‘Aves’ of Aristophanes. (See also Schol. in Aristoph. in Pac. 496, and Vesp. 348; Aristotle, Hist. An. vii, 4; and Pliny, Hist. Nat. x, 41.) Harduin concludes, from Pliny’s account of it, that it was the magpie. But we are rather inclined to follow Schneider in referring it to the jay, or corvus glandarius.
On the disease, see Galen (Hyg.; de Causis Sympt. i, 7); Aëtius (xvi, 10); Theophanes Nonnus (c. 213); Moschion (de Morb. Mulier. c. 27); Eros (apud Gynæcia), Alexander Aphrodisiensis (Problem. ii, 73); Pseudo-Dioscorides (Euporist. ii, 16); Soranus (viii); Leo (vi, 14); Rhases (Contin. xi); Avicenna (iii, 21, 2); Haly Abbas (Theor. vi, 17); Serapion (Tr. iii, 22); Alsaharavius (Pract. xxv, 2, 8.) It appears to be the malacia of Pliny (Hist. Nat. xxiii, 56, ed. Hard.)
Moschion defines the Pica to be an appetite for unusual food, which happens to pregnant women at some irregular period; being attended with a collection of depraved humours and nausea. It occurs, he says, most commonly in the second month, but sometimes earlier, and sometimes later. He recommends a restricted diet at first, then wine, dry astringent food, cataplasms of a repellent nature, and bodily motion.
Soranus treats of Pica in very similar terms to those of Moschion.
But the account of the disease given by Galen and Aëtius is the fullest. They derive the name either from the bird, as mentioned above, or from ivy (κίττος), because, as ivy entwines itself about various plants, so does this appetite in pregnant women fasten upon a variety of improper articles of food. It is attended with languor of the stomach, nausea, and loathing of food, bringing on vomiting of bile or phlegm, anxiety, and pains in the stomach. All these symptoms arise, they say, from a sanguineous plethora, brought on by a suppression of the menstrual discharge. They, therefore, recommend a restricted diet, and moderate exercise when the woman was accustomed to it. When the humour which infests the stomach is of an acid, acrid, or saltish nature, they direct draughts of tepid water, to encourage vomiting; they forbid all sweet things; and recommend an old sub-astringent wine. When there is a loathing of food, they advise us to tempt the appetite with a variety of savory things. To those who have a desire for eating earth, they particularly recommend starch. When the fluid which is vomited is of a thick and viscid nature, they recommend pickles, radishes, and oxymel, for an emetic. They also particularly direct astringent cataplasms and plasters to be applied to the præcordia.
As the practice of the other authorities is conducted upon similar principles, we shall mention them very succinctly. For the depraved appetite which longs for earth, Serapion recommends aromatic spices, such as cardamon, cubebs, and the like. For the continued vomiting, Alsaharavius directs plasters, containing the oil of spikenard, mastich, quinces, wormwood, and the like, or a vessel filled with hot water, to be applied over the stomach, pomegranate seeds to be held in the mouth; and that the patient should take gentle exercise, and abstain from all sweet things.
Alexander Aphrodisiensis accounts for the disease in much the same way as Galen and Aëtius. He says that, when the menstrual fluid is suppressed, a determination of it takes place to the stomach, until the fœtus becomes as large as to consume it.
Pliny strongly commends citrons for the cure of the disease.
For the œdematous swellings of the feet and legs, most of the other authorities concur with our author in recommending astringent applications. The anthyllis, mentioned by him, is supposed by Sprengel to have been the cressa cretica. (R. H. Hist. p. 164.)
We shall conclude our commentary on this Section with an outline of the directions given by Aspasia for the management of pregnant women. Women who have conceived are to be guarded from frights, sorrow, and all violent mental perturbation. They are to avoid gestation in carriages, severe exercise, inordinate breathing and blows about the loins; also the lifting of heavy loads, dancing, and sitting on hard seats. Likewise all acrid and flatulent food, strong clysters, and too much or too little food and drink are to be avoided. All discharges of blood, whether from the nose or hemorrhoids, are dangerous in the pregnant state. Moderate and wholesome food, gestation in a sedan, gentle walking, soft friction, and the exercise of spinning are proper. About the eighth month, which is the most critical period of pregnancy, the diet is to be more contracted, and the exercise increased. If the bowels are constipated owing to compression of the rectum, by the enlarged uterus, laxative food is to be given, such as ptisan and mallows. In the ninth month the regimen is to be of a relaxing nature, and for this purpose the tepid bath is to be frequently taken, for it has a great effect in rendering parturition easy. (Apud Aëtium, xvi, 12.)
Our author borrows part of this chapter from Oribasius, and abridges the rest from Galen and Aëtius.