UTERINE HEMORRHAGE.
As intimately connected with the subject of abortion, it is fit that I should here make a few remarks on that form of uterine hemorrhage which is not connected with childbirth.
Case I.—I recollect a case of this kind that occurred with a lady who was, I should think, at least sixty years of age. It was in the month of October, 1846, on a passage from New York to London, in the packet ship Switzerland, Captain E. Knight. The old lady and husband had taken a steerage passage from New York. They were English people, returning after many years’ absence, again to visit their native country.
One day the old gentleman came on deck and told me his wife was very sick of uterine hemorrhage, and that he wished my advice. I told him I would prescribe what I considered to be the best course in such cases, but that I feared his wife would not be willing to follow it. Indeed, I had no idea that she would do so.
However, I gave the advice, which was substantially as follows: First, take old sail-cloth, which was clean, make some pieces into the shape of towels, and one larger, to be used in the form of a child’s diaper; place these cloths, wet, about the abdomen and thighs, and let the patient wear a large one, wet, in the form of a child’s diaper; let her take but little and very light nourishment for two or three days, and be careful and not move about too much; help her out upon deck, when the weather is fine, so that she may enjoy the invigorating effects of the pure air and light. You need not chill her much with the wet cloths, but be exceedingly particular that they do not become too warm; let her wear them the larger portion of the time, until she becomes quite well.
Contrary to my expectations, the old lady followed the course resolutely, and in a very short time was again entirely well. She spoke in great praise of the invigorating effects of the cold cloths; she also drank cold water. We were at sea about three weeks after this, and the old lady’s health continued good until we left the ship.
Case II.—A lady of about the same age, in the winter of 1848–49, living in Jersey City, experienced uterine hemorrhage. She had been overdoing in the way of work. A similar course to that in the above case was followed, and in a few days she also recovered. Rest, alone, in such cases—that is, abstaining from severe labor, and taking but very little exercise, such as can be easily borne, and without fatigue—is alone sufficient for the curing of many of these cases.
Cold hip-baths, of short duration, and often repeated, are always good in attacks of this kind. Indeed, the more coolness generally to the body, the better; but we should not chill the extremities too much—not that it is dangerous to do so, but it is better to avoid it.
In the treatment of hemorrhages, the Indians pursue a very rational mode of treatment. If a severe hemorrhage follow a wound, which is not unfrequently the case, they plunge themselves into cold water, thereby producing a constriction upon the bleeding vessels. We all know by experience the efficacy of cold to arrest bleeding at the nose. We put a piece of ice on the neck, pour cold water down the spine, or even put a cold door-key on the back of the neck, and in most cases epistaxis ceases. All physicians and surgeons—all who at all deserve the name of such—know well the power of cold to arrest hemorrhages—often, too, such as are of the most alarming character. We should make very poor work indeed, in stopping hemorrhages, if we were deprived of cold water. Cold water is worth more—incomparably more for this purpose—than all other remedies under the firmament of heaven combined.
LETTER XVI.
DISORDERS OF PREGNANCY.
Its Febrile Condition—Acute Disease—Sleeplessness—Heart-burn—Constipation—Diarrhea—Piles and Hemorrhoids—Their Treatment.
It is said to have been an aphorism of Hippocrates, the father of medicine, who lived more than two thousand years ago, that pregnant women attacked with acute disease always die. This strong assertion cannot be said to hold good, certainly, at the present day; but yet pregnancy, it must be admitted, exercises, as a general fact, a very unfavorable influence on the system in acute disease. The danger here may be said to be three-fold. First, the system is already in a febrile condition, or one very nearly bordering thereto; second, there is the new disease; and third, this often causes the death of the unborn child, and then the dangers of abortion are superadded to the others. “The life of the child, too,” say authors, “is endangered by the treatment necessary for the cure; especially in the use of harsh purgatives, violent emetics, salivation, and profuse bleedings.” But thanks to a better day, we of the water practice are under no necessity of running such fearful risks. We have not only a more effectual way, but one, when managed by judicious hands, harmless and safe. “It is by the prompt use of mild means, and a persevering attention to small matters,” judiciously observes Dr. Maunsel, “that the patient is to be conducted through the dangers that encompass her.” And he justly adds, “Above all, avoid the dreadful blunder of treating a woman for acute disease without discovering that she is pregnant.”
Pregnancy, as I have remarked, is always attended with more or less excitement of the system, an excitement which bears some resemblance to a state of fever. There is also a greater proneness to fevers, even from slight causes, now than at other times. Hence the necessity of avoiding, as far as possible, all such causes; and hence also, the necessity of exercising the greatest care in regard to diet and drinks. Too much food, and that which is too exciting, will cause more harm in pregnancy than at other times, from the greater tendency to fever. The common belief among women is, that more food is needed during pregnancy than at other times, because the food goes to furnish nourishment for two instead of one, that is, for the mother and the child within her. “It is therefore,” says Dr. Dewees, “constantly recommended to eat and drink heartily; and this she too often does, until the system is goaded to fever; and sometimes to more sudden and greater evils, as convulsions or apoplexy.”
If, instead of full diet, women in pregnancy will but try the plan of eating less food, even of becoming very abstemious, they will most assuredly find that they get along better, suffer less from plethora or fullness, and enjoy greater comfort of body in every respect.