PILES AND HEMORRHOIDS.
Piles and hemorrhoids are more apt to occur in pregnancy than at other times; and when these already exist, they are apt to become worse at this period. Constipation being more apt to occur in pregnancy, and that condition of the system being the one in which these symptoms are most liable to occur when the woman is not pregnant, so also they occur more frequently now than at other times. The constant pressure of the fetus upon the blood-vessels within the pelvis has also an agency in the matter, because every thing that causes sluggishness of circulation tends to bring on piles. So also the more sedentary habits of many females, during the period of pregnancy, are often a cause of this difficulty; but in other cases the opposite extreme is practiced—too much exercise or standing on the feet. Both these extremes may cause piles in pregnancy, or aggravation when they previously existed. Cathartic medicines not unfrequently bring on a “fit of the piles.”
This affection always denotes a wrong state of things in the general health. A really healthy person can never have the piles. Some, however, who are what would be termed tolerably well and strong in general health, experience such symptoms, but such is not the rule. Old cases, particularly, denote derangement of the general system.
When piles come on suddenly, they are often attended with very great pain and suffering to the patient. Not only is the pain great at the part affected, but there is also feverishness, pain, and a very unpleasant feeling in the head, with deep and severe pain in the back.
Treatment.—As to the treatment and general management in this affection, we should of course do the best that may be for the general health. As a general fact, no surgical operation should be allowed upon piles during pregnancy. These operations are often attended with so great pain, that abortion might be the result.
There is nothing in the world that will produce so great relief in piles as fasting. If the fit is severe, live a whole day (or even two, if necessary) upon pure, soft, cold water alone. Give then very lightly of vegetable food. Those who have suffered the agony of this affection, if they will but have patience to try this means, will find the truth of my remarks.
Water applications are also very useful in this disease. Dr. Dewees observes: “The pregnant woman may derive both comfort and advantage from sitting in a demi-bath of cold water, for five or ten minutes at a time, two or three times a day, when the complaint is advancing, or when about to retire; that is, after the severer symptoms have abated, or before they are high.” This advice is partly right and partly not. There is a notion with many that cold water-applications in high inflammation are not good; that they increase the difficulty instead of making it less. Thus in a burn, it is said that after the application of cold water the pain becomes worse. This is not true, although it appears to be so; for so great is the relief afforded by the application, that the pain appears worse, when in fact it is not; but only keep on continuously with the cold water-treatment, and the pain does not return at all. Such at least is the fact in all burns, however severe, when the surface is not destroyed; and the same principle holds good in all high inflammations from whatever cause. Very frequent sitz-baths, or merely washing the part often in cold water, will be found excellent in these severe cases of piles. Cold compresses worn upon the part also afford great relief. Cold injections are also useful. But, as before mentioned, fasting and the regulation of the diet are the great means.
LETTER XVII.
DISORDERS OF PREGNANCY.
Headache: the Nervous and the Plethoric kinds—Stye in the Eye—Salivation—Hemorrhage from the Stomach—Cramp of the Stomach—Toothache—Jaundice.
Headache is one of the most common of all the disorders of pregnancy. It may occur at any part of the period; in the early months, it is supposed that nervous headache is most apt to occur; in the latter, headache arises more frequently from plethora. In such cases there may be throbbing of the temples, suffusion of the eyes, ringing in the ears, indistinct vision, and flashes of light passing before the eyes. If the headache gets to be very severe—splitting, as we may say—there is danger of either apoplexy or puerperal convulsions. But these things, be it remembered, do not come upon those who live moderately and temperately, lead an active, industrious, and regular life, go often into the open air, and practice daily ablutions.
That form of headache in pregnancy which occurs often, and is not a sick or nervous headache, so-called, is regarded by authors generally as being a very serious affair.
Treatment.—Dr. Maunsel says of the nervous form of this disease: “This, especially if it take the form of hemicrania (that in which the pain is confined to one half of the head), is one of the most unmanageable of all the diseases of pregnancy.”
According to the old practice, prompt and decided measures must be taken in these cases, especially if the affection is of that form arising from a general fullness of the system.
“If the state of the system indicates bleeding,” says Dr. Maunsel, “it will commonly do good; local should be preferred to general bleeding. If bleeding is not indicated, we should at first attend to the secretions; when these are corrected, antispasmodics and anodynes come in well. Hyosciamus and camphor, a grain of each, is a good remedy; also the volatile tincture of valerian. The external application of some anodyne extract, as stramonium, belladonna, or cicuta, may be tried, but with caution, lest they produce the poisonous effects of the drug.”
Dr. Churchill remarks: “These nervous headaches may usually be relieved by antispasmodic medicines, or diffusible stimuli, such as valerian, hartshorn, etc.
“Eau de Cologne applied to the forehead, or a blister behind the ears, is often useful.
“A brisk purgative should also be given occasionally.
“A much more active treatment will be necessary when there are any symptoms of plethora, or vascular excitement about the head, both for the relief of the pain and for the purpose of anticipating evil consequences. Blood should be taken from the arm, in quantity according to the strength of the patient and the relief afforded; and this should be repeated, or leeches applied to the temples, if necessary. We are not to rest satisfied that enough has been done until the pain is relieved, and the arterial system reduced to the ordinary standard.
“After a certain amount of good effect has been produced, great benefit will often result from the application of a blister to the nape of the neck.”
Now compare with the above practice of bleeding and dosing, secundum artem, the true and rational one.
In nineteen cases out of twenty, the nervous headache comes from either tea or coffee drinking, or the use of improper food. Only remove the causes, then, and the difficulty vanishes. Strange to say, however, there are many women who have either so little confidence in what any one can say to them, or so little control over themselves, they will not even make the experiment. Should one who has been cured tell them the fact, they will not yet believe; nor would they if one should rise from the dead. Such persons—those who have the truth set before them, and yet will not act—are welcome to all their tea and coffee, their fine food, their bleeding and dosing, and their sick headache.