INTRODUCTORY CHAPTER.
1. It may be well—before I enter on the subjects of menstruation, of pregnancy, of labor, and suckling—to offer a few preliminary observations, especially addressed to a Young Wife.
2. My subject is health—the care, the restoration, and the preservation of health—one of the most glorious subjects that can be brought before a human being, and one that should engross much of our time and of our attention, and one that cannot be secured unless it be properly attended to. The human frame is, as every one knows, constantly liable to be out of order; it would be strange, indeed, if a beautiful and complex instrument like the human body were not occasionally out of tune:
“Strange that a harp with a thousand strings
Should keep in tune so long.”
3. The advice I am about to offer to my fair reader is of the greatest importance, and demands her deepest attention. How many wives are there with broken health, with feeble constitutions, and with childless homes! Their number is legion! It is painful to contemplate that, in our country, there are far more unhealthy than healthy wives! There must surely be numerous causes for such a state of things! A woman, born with every perfection, to be full of bodily infirmities! It was ordained by the Almighty that wives should be fruitful and multiply! Surely there must be something wrong in the present system if they do not do so!
4. It will, in the following pages, be my object to point out many of the causes of so much ill health among wives; ill health that sometimes leads to barrenness; and to suggest remedies both for the prevention and for the cure of such causes.
5. It is an astounding and lamentable fact, that one out of eight—that twelve and a half per cent. of all the wives of England are barren, are childless! A large majority of this twelve and a half per cent. might be made fruitful, if a more judicious plan of procedure than is at present pursued were adopted.
6. My anxious endeavors, in the following pages, will be to point out remedies for the evil, and to lay down rules—rules which, I hope, my fair reader will strenuously follow.
7. My theme, then, is Health—the Health of Wives—and the object I shall constantly have in view will be the best means both of preserving it and of restoring it when lost. By making a wife strong, she will not only, in the majority of cases, be made fruitful, but capable of bringing healthy children into the world. This latter inducement is of great importance; for puny children are not only an anxiety to their parents, but a misery to themselves, and a trouble to all around! Besides, it is the children of England that are to be her future men and women—her glory and her greatness! How desirable it is, then, that her children should be hardy and strong!
8. A wife may be likened to a fruit tree, a child to its fruit. We all know that it is as impossible to have fine fruit from an unhealthy tree as to have a fine child from an unhealthy mother. In the one case, the tree either does not bear fruit at all—is barren—or it bears undersized, tasteless fruit,—fruit which often either immaturely drops from the tree, or, if plucked from the tree, is useless; in the other case, the wife either does not bear children—she is barren—or she has frequent miscarriages—“untimely fruit”—or she bears puny, sickly children, who often either drop into an early grave, or, if they live, probably drag out a miserable existence. You may as well expect “to gather grapes of thorns, or figs of thistles,” as healthy children from unhealthy parents!
9. Unhealthy parents, then, as a matter of course have unhealthy children; this is as truly the case as the night follows the day, and should deter both man and woman so circumstanced from marrying. There are numerous other complaints besides scrofula and insanity inherited and propagated by parents. It is a fearful responsibility, both to men and women, if they be not healthy, to marry. The result must, as a matter of course, be misery!
10. If a wife is to be healthy and strong, she must use the means—she must sow before she can reap; health will not come by merely wishing for it! The means are not always at first agreeable; but, like many other things, habit makes them so. Early rising, for instance, is not agreeable to the lazy, and to one fond of her bed; but it is essentially necessary to sound health. Exercise is not agreeable to the indolent; but no woman can be really strong without it. Thorough ablution of the whole body is distasteful and troublesome to one not accustomed to much washing—to one laboring under a kind of hydrophobia; but there is no perfect health without the daily cleansing of the whole skin.
11. But all these processes entail trouble. True: is anything in this world to be done without trouble? and is not the acquisition of precious health worth trouble? Yes, it is worth more than all our other acquisitions put together! Life without health is a burden; life with health is a joy and gladness! Up, then, and arouse yourself, and be doing! No time is to be lost if you wish to be well, to be a mother, and to be a mother of healthy children. The misfortune of it is, many ladies are more than half asleep, and are not aroused to danger till danger stares them in the face; they are not cognizant of ill health slowly creeping upon them, until, in too many cases, the time is gone by for relief, and ill health has become confirmed—has become a part and parcel of themselves; they do not lock the stable until the steed be stolen; they do not use the means until the means are of no avail:
“Our remedies oft in ourselves do lie,
Which we ascribe to Heaven: the fated sky
Gives us free scope; only doth backward pull
Our slow designs, when we ourselves are dull.”[[1]]
12. Idleness is the mother of many diseases; she breeds them, feeds them, and fosters them, and is, moreover, a great enemy to fecundity. Idleness makes people miserable. I have heard a young girl—surrounded with every luxury—bemoan her lot, and complain that she was most unhappy in consequence of not having anything to do, and who wished that she had been a servant, so that she might have been obliged to work for her living. Idleness is certainly the hardest work in the world.
13. It frequently happens that a lady, surrounded with every luxury and every comfort, drags out a miserable existence; she cannot say that she ever, even for a single day, really feels well and strong. This is not to live—
“For life is not to live, but to be well.”[[2]]
14. If a person be in perfect health, the very act of living is itself thorough enjoyment, the greatest this world can ever bestow. How needful it therefore is that all necessary instruction should be imparted to every Young Wife, and that proper means should, in every way, be used to insure health!
15. The judicious spending of the first year of married life is of the greatest importance in the making and in the strengthening of a wife’s constitution, and in preparing her for having a family. How sad it is, then, that it is the first twelve months that is, as a rule, especially chosen to mar and ruin her own health, and to make her childless! The present fashionable system of spending the first few months of married life in a round of visiting, of late hours, and in close and heated rooms, calls loudly for a change. How many valuable lives have been sacrificed to such a custom! How many miscarriages, premature births, and still-born children, have resulted therefrom! How many homes have been made childless—desolate—by it! Time it is that common sense should take the place of such folly! The present system is abominable, is rotten at the core, and is fraught with the greatest danger to human life and human happiness. How often a lady is, during the first year of her wifehood, gadding out night after night,—one evening to a dinner party, the next night to private theatricals, the third to an evening party, the fourth to the theater, the fifth to a ball, the sixth to a concert, until in some cases every night except Sunday night is consumed in this way,—coming home frequently in the small hours of the morning, through damp or fog, or rain or snow, feverish, flushed, and excited—too tired until the morning to sleep, when she should be up, out, and about. When the morning dawns she falls into a heavy, unrefreshing slumber, and wakes not until noon, tired, and unfit for the duties of the day! Night after night—gas, crowded rooms, carbonic acid gas, late hours, wine, and excitement are her portion. As long as such a plan is adopted the preacher preacheth but in vain. Night after night, week after week, month after month, this game is carried on, until at length either an illness or broken health supervenes. Surely these are not the best means to insure health and a family and healthy progeny! The fact is, a wife nowadays is too artificial; she lives on excitement; it is like drinking no wine but champagne, and, like champagne taken in excess, it soon plays sad havoc with her constitution. The pure and exquisite enjoyments of nature are with her too commonplace, tame, low, and vulgar. How little does such a wife know of the domestic happiness so graphically and sweetly described by that poet of the affections, Cowper:
“Fireside enjoyments, home-born happiness,
And all the comforts that the lowly roof
Of undisturb’d retirement, and the hours
Of long uninterrupted evening, know.”
16. A fashionable lady might say, “I cannot give up fashionable amusements; I must enjoy myself as others do; I might as well be out of the world as out of the fashion.” To such a one I reply, “I myself am not a fashionist—it is not in my line; and as in the following pages I have to tell some plain unvarnished truths, my advice to you is, close this book at once and read no more of it, as such a work as this cannot be of the slightest use to you, however it might be to one who values health ‘as a jewel of great price’—as one of her most precious earthly possessions.” Really the subject is assuming such a serious aspect that it behooves a medical man to speak out plainly and unreservedly, and to call things by their right names. Fashion is oftentimes but another name for suicide and for baby-slaughter—for “massacre of the innocents!” God help the poor unfortunate little child whose mother is a votary of fashion, who spends her time in a round and whirl of fashionable life, and leaves her child to the tender mercies of servants, who “gang their ain gait,” and leave their little charge to do the same. Such a mother is more unnatural than a wild beast; for a wild beast, as a rule, is gentle, tender, and attentive to its offspring, scarcely ever for a moment allowing its young to be out of its sight. Truly, fashionable life deadens the feelings and affections. I am quite aware that what I have just now written will, by many fashionable ladies, be pooh-poohed, and be passed by as “the idle wind.” They love their pleasures far above either their own or their children’s health, and will not allow anything, however precious, to interfere with them; but still I have confidence that many of my judicious readers will see the truth and justness of my remarks, and will profit by them.
17. A round of visiting, a succession of rich living, and a want of rest during the first year of a wife’s life, often plays sad havoc with her health, and takes away years from her existence. Moreover, such proceedings often mar the chances of her ever becoming a mother, and then she will have real cause to grieve over her fatuity.
18. A French poet once sung that a house without a child is like a garden without a flower, or like a cage without a bird. The love of offspring is one of the strongest instincts implanted in woman; there is nothing that will compensate for the want of children. A wife yearns for them; they are as necessary to her happiness as the food she eats and as the air she breathes. If this be true—which, I think, cannot be gainsayed—how important is our subject,—one of the most important that can in this world engage one’s attention, requiring deep consideration and earnest study.
19. The first year of a married woman’s life generally determines whether, for the remainder of her existence, she shall be healthy and strong, or shall be delicate and weak; whether she shall be the mother of fine, healthy children, or—if, indeed, she be a mother at all—of sickly, undersized offspring—
“Born but to weep, and destined to sustain
A youth of wretchedness, an age of pain.”[[3]]
If she be not a parent, her mission in life will be only half performed, and she will be robbed of the greatest happiness this world can afford. The delight of a mother, on first calling a child her own, is exquisite, and is beautifully expressed in the following lines—
“He was my ain, and dear to me
As the heather-bell to the honey-bee,
Or the braird to the mountain hare.”[[4]]
20. I should recommend a young wife to remember the momentous mission she has to fulfill; to ponder on the importance of bringing healthy children into the world; to bear in mind the high duties that she owes herself, her husband, her children, and society; to consider well the value of health—“The first wealth is health;”[[5]] and never to forget that “life has its duties ever.”[[6]]
21. A young married lady ought at once to commence to take regular and systematic out-door exercise, which might be done without in the least interfering with her household duties. There are few things more conducive to health than walking exercise; and one advantage of our climate is, that there are but few days in the year in which, at some period of the day, it might not be taken. Walking—I mean a walk, not a stroll—is a glorious exercise; it expands the chest and throws back the shoulders; it strengthens the muscles; it promotes digestion, making a person digest almost any kind of food; it tends to open the bowels, and is better than any aperient pill ever invented; it clears the complexion, giving roses to the cheeks and brilliancy to the eye, and, in point of fact, is one of the greatest beautifiers in the world. It exhilarates the spirits like a glass of champagne, but, unlike champagne, it never leaves a headache behind. If ladies would walk more than they do, there would be fewer lackadaisical, useless, complaining wives than there at present are; and, instead of having a race of puny children, we should have a race of giants. Walking exercise is worthy of all commendation, and is indispensable to content, health, strength, and comeliness. Of course, if a lady be pregnant, walking must then be cautiously pursued; but still, walking in moderation is even then absolutely necessary, and tends to keep off many of the wretchedly depressing symptoms, often, especially in a first pregnancy, accompanying that state. I am quite sure that there is nothing more conducive to health than the wearing out of lots of shoe-leather and that leather is cheaper than physic.
22. Walking is even more necessary in the winter than in the summer. If the day be cold, and the roads be dirty, provided it be dry above, I should advise my fair reader to put on thick boots and a warm shawl, and to brave the weather. Even if there be a little rain and much wind, if she be well wrapped up, neither the rain nor the wind will harm her. A little sprinkling of rain, provided the rules of health be followed, will not give her cold. Much wind will not blow her away. She must, if she wishes to be strong, fight against it; the conflict will bring the color to her cheek and beauty to her eye.
23. Let her exert herself; let her mind conquer any indolence of the body; let her throw off her lethargy—it only requires a little determination; let her be up and doing; for life, both to man and woman, is a battle, and must be fought valiantly.
24. Bear in mind, then, that if a lady is to be healthy, she must take exercise, and that not by fits and starts, but regularly and systematically. A stroll is of little use; she must walk! And let there be no mistake about it, for Nature will have her dues: the muscles require to be tired, and not to be trifled with; the lungs ask for the revivifying air of heaven, and not for the stifling air of a close room; the circulation demands the quickening influence of a brisk walk, and not to be made stagnant by idleness.
25. This world was never made for idleness; everything around and about us tells of action and of progress. Idle people are miserable people; idle people are diseased people; there is no mistake about it. There is no substitute in this world for exercise and for occupation; neither physic nor food will keep people in health; they must be up and doing, and buckle on their armor, and fight, as every one has to fight, the battle of life! Mr. Milne, the master of the North Warwickshire hounds, lately, at a hunt dinner, pithily remarked “that fox-hunting was the best physic for improving a bad constitution.” I am quite sure, with regard to the fair sex, that an abundance of walking exercise and of household occupation is decidedly the best physic for improving a lady’s constitution, more especially if she have, as unfortunately too many of them have, a bad one; indeed, an abundance of walking exercise and of household occupation will frequently convert a bad into a good constitution.
26. Moreover, there is not a greater beautifier in the world than fresh air and exercise; a lady who lives half her time in the open air, in God’s sunshine, and who takes plenty of walking exercise, has generally a clear and beautiful complexion—
“She looks as clear
As morning roses newly washed with dew.”[[7]]
27. Do not let me be misunderstood: I am not advocating that a delicate lady, unaccustomed to exercise, should at once take violent and long-continued exercise; certainly not. Let a delicate lady learn to take exercise, as a young child would learn to walk—by degrees; let her creep, and then go; let her gradually increase her exercise, and let her do nothing either rashly or unadvisedly. If a child attempted to run before he could walk, he would stumble and fall. A delicate lady requires just as much care in the training to take exercise as a child does in the learning to walk; but exercise must be learned and must be practiced, if a lady, or any one else, is to be healthy and strong. Unfortunately, in this our day the importance of exercise as a means of health is but little understood and but rarely practiced; notwithstanding, a lady may rest assured that until a “change comes o’er the spirit of her dreams,” ill health will be her daily and constant companion.
28. A lady should walk early in the morning, and not late in the evening. The dews of evening are dangerous, and are apt to give severe colds, fevers, and other diseases. Dew is more likely to cause cold than rain—
“The dews of the evening most carefully shun—
Those tears of the sky for the loss of the sun.”[[8]]
29. A breath of wind is not allowed to blow on many a fair face. The consequence is, that her cheek becomes sallow, wan, “as wan as clay,” and bloodless, or if it has a color it is the hectic flush, which tells of speedy decay!
30. Sitting over the fire will spoil her complexion, causing it to be muddy, speckled, and sallow. The finest complexion in a lady I ever saw belonged to one who would never go, even in the coldest weather, near the fire: although she was nearly thirty years of age, her cheeks were like roses, and she had the most beautiful red and white I ever beheld; it reminded me of Shakspeare’s matchless description of a complexion:—
“’Tis beauty truly blent, whose red and white
Nature’s own sweet and cunning hand laid on.”
31. Sitting over the fire will make her chilly, nervous, dyspeptic, and dispirited. It will cause her to be more chilly, and thus will make her more susceptible of catching cold; and it will frequently produce chilblains. If she be cold, the sitting over the fire will only warm her for the time, and will make her feel more starved when she leaves it. Crouching over the fire, as many do, is ruination to health and strength and comeliness! Sitting over the fire will make her nervous: the heat from the fire is weakening beyond measure to the nerves. It will disorder and enfeeble her stomach—for nothing debilitates the stomach like great heat—and thus make her dyspeptic; and if she be dyspeptic, she will, she must be dispirited. The one follows the other as surely as the night follows the day.
32. If sitting over the fire be hurtful, sitting with the back to the fire is still more so. The back to the fire often causes both sickness and faintness, injures the spine, and weakens the spinal marrow, and thus debilitates the whole frame.
33. A walk on a clear, frosty morning is as exhilarating to the spirits as the drinking of champagne—with this difference, that on the day following the head is improved by the one, but not always by the other. Simple nature’s pleasures are the most desirable—they leave no sting behind them!
34. There is nothing like a long walk to warm the body and to make the blood course merrily through the blood-vessels. I consider it to be a great misfortune that my fair countrywomen do not use their legs more and their carriages less. “As to exercise, few women care to take it for mere health’s sake. The rich are too apt to think that riding in a close varnish-smelling carriage ought to be a very good substitute for muscular struggles in the open air.”[[9]]
35. Unfortunately this is an age of luxury. Everything is artificial, and disease and weakness, and even barrenness, follow as a matter of course. In proof of my assertion that this is an age of luxury, look at the present sumptuous style of living: carriages rolling about in every direction; dining-tables groaning under the weight of rich dinners, and expensive wines flowing like water; grand dresses sweeping the streets, almost doing away with the necessity for scavengers. I say, advisedly, streets; for green fields are, unfortunately, scarcely ever visited by ladies. We are almost, in extravagance, rivaling ancient Rome just before luxury sapped her strength and laid her in ruins!
36. If a lady has to travel half a mile she must have her carriage. Strange infatuation! Is she not aware that she has hundreds of muscles that want exercising? that she has lungs that require expanding? that she has nerves that demand bracing? that she has blood that needs circulating? And how does she think that the muscles can be exercised, that the lungs can be expanded, that the nerves can be braced, and that the blood can be properly circulated, unless these are all made to perform their proper functions by an abundance of walking exercise? It is utterly impossible!
37. Does she desire to be strong? Then let her take exercise! Does she hope to retain her bloom and her youthful appearance, and still to look charming in the eyes of her husband? Then let her take exercise! Does she wish to banish nervousness and low spirits? Then let her take exercise! There is nothing standing still in Nature: if it were, creation would languish and die. There is a perpetual motion! And so must we be constantly employed (when not asleep), if we are to be healthy and strong! Nature will not be trifled with; these are her laws[[10]]—immutable and unchangeable, and we cannot infringe them with impunity:
“Labor is life! ’Tis the still water faileth;
Idleness ever despaireth, bewaileth;
Keep the watch wound, for the dark night assaileth;
Flowers droop and die in the stillness of noon.
Labor is glory! The flying cloud lightens;
Only the waving wing changes and brightens;
Idle hearts only the dark future frightens;
Play the sweet keys, would’st thou keep them in tune!”
38. If a newly-married woman be delicate, as, unfortunately, too many are, she may be made to bear exercise well, provided she begins by taking a short walk at first—be it ever so short—and by gradually increasing it until she be able to take a tolerably long one. She might find it irksome at the beginning, and might be inclined to give it up in despair; but if she value her health and happiness, let me urge her to persevere, and she may depend upon it that she will be amply rewarded for her trouble.
39. A delicate lady frequently complains of cold feet; she has neither sufficient food nor sufficient exercise to keep them warm. Walking and plenty of nourishment are the best remedies she can use to warm them. If they be cold before retiring to rest—a frequent cause of keeping her awake—let her walk briskly for half an hour, before undressing for the night, about either the hall, or the landing, or a large room.
40. Some ladies declare that they are always cold, their feet especially, which are as cold as ice! The fact is, they not only do not take exercise enough, but they do not take nourishment enough—breakfast especially—to keep them warm. Many ladies really and truly half starve themselves; they consider it to be vulgar to eat much, and to satisfy their appetite! they deem it low to take a long walk: every poor woman can do that! it is much more easy and pleasant to loll back in an easy carriage, and to be rolled along! Truly; but if carriage exercise be more agreeable, is it as healthful? Certainly not: there is very little exercise in riding in a carriage; but every organ, muscle, nerve, and blood-vessel of the body is put into beneficial action by walking. Walking is essential to health; there is no substitute for it; there certainly is no perfect health without it.
41. The reason why my fair countrywomen take so much opening medicine is the want of exercise. How truly it has been said that “physic, for the most part, in nothing else but the substitute of exercise and temperance.”
42. I consider it to be a grievous misfortune for any one—man, woman, or child—who cannot, without the frequent taking of physic, keep their bowels regular. When such is the case there is something wrong, very wrong, about her system and about her proceedings, and the sooner the matter is inquired into and rectified the better. The necessity of a constant swallowing of opening medicine is a proof of chronic ill health, and will in time injure her constitution beyond remedy. I cannot speak too strongly on this subject; I have, in my professional experience, seen so much mischief and misery caused by the frequent swallowing of opening pills, that I should not do my duty if I did not raise my voice against the abominable custom. Why, many ladies make a practice, during the whole of their lives, of taking two or three times a week opening pills! The bowels, they say, will not act without them; but I maintain that if they would resolutely refrain from swallowing them, and adopt the rules of health laid down in these pages, they would be able altogether to dispense with them, to their great benefit and delectation. But then the rules of health require trouble and perseverance—(and what that is worth having does not?)—while the swallowing of a couple of pills might be done quickly, and with very little trouble; but although the frequent taking of pills gives at the time but little trouble, they cause much trouble afterwards! Look, then, at the results of each system, and decide accordingly! It has been said that “gluttony kills more than the sword;” my conviction is, that the constant taking of opening medicine kills more than gluttony and the sword combined! The abuse of aperients is one of the crying evils of the day, and who so proper as a medical man to raise his voice to suppress, or at all events to lessen, the evil?
43. If a lady be costive, and is in consequence inclined to take a dose of physic, let me advise her to take instead a long walk, which will in the majority of cases do her vastly more good; and if requiring repetition, the one is far more agreeable, and the effects are much more likely to be lasting than the other. Exercise, I am quite sure, is, as a rule, in the long run much more effectual and beneficial than opening physic.
44. A newly-married wife ought to be cautious in the taking of horse exercise. As long as she be not pregnant, horse exercise is very beneficial to health, and is a great enjoyment; but the moment symptoms of pregnancy develop themselves, she must instantly give it up, or it will probably cause her to miscarry.
45. Let her breathe the pure air of heaven, rather than the close contaminated air either of an assembly or of a concert-room. The air of an assembly or of a concert-room is contaminated with carbonic acid gas. The gas-lights and the respiration of numbers of persons give off carbonic acid gas, which gas is highly poisonous.
46. The truth of this assertion is patent to every one who will observe the effects that a large assembly, more especially in the evening, when the gas or candles are flaring away, has on the system; the headache, the oppression, the confusion of ideas, the loss of appetite, the tired feeling, followed by a restless night—all tell a tale, and loudly proclaim that either an assembly or a concert-room is not a fit place for a young wife desirous of having a family.
47. Let a young married lady attend well to the ventilation of her house. She may depend upon it that ventilation, thorough ventilation, will prove one of the best friends she has in the world. Let her give directions to her servant to have early every morning every window in the house opened, as the morning air is fresher and sweeter than it is later in the day. “For ventilation, open your windows both at top and bottom. The fresh air rushes in one way, while the foul makes its exit the other. This is letting in your friend and expelling your enemy.”[[11]] This opening of the window, top and bottom, of course applies only to the rooms that are unoccupied:—in an occupied room in hot weather one sash only—the lower, as a rule, is best—ought to be opened. If the upper be lowered when the room is occupied, the cold air is apt to strike on the top of the head, and to give cold.
48. Let her give orders that every chimney in the house be unstopped, and let her see for herself that her orders have been obeyed; for servants, if they have the chance, will stop up chimneys, as they are fully aware that dust and dirt will come down chimneys, and that it will give them a little extra work to do. But the mistress has to see to the health of herself and of her household, which is of far more consequence than either a little dirt or extra work for her servants.
49. She may rest assured that it is utterly impossible for herself and for her family to have perfect health if the chimneys are allowed to be stopped. I assert this fearlessly, for I have paid great attention to the subject. If the chimney be stopped, the apartment must necessarily become contaminated with carbonic acid gas, the refuse of respiration, which is, as I have before stated, a deadly poison.
50. Chimneys, in many country houses, are permanently and hermetically stopped: if we have the ill-fortune to sleep in such rooms, we feel half-suffocated. Sleep, did I say? No! tumble and toss are the right words to express the real meaning; for in such chambers very little sleep do we get,—unless, indeed, we open the windows to let in the air, which, in such an extremity, is the only thing, if we wish to get a wink of sleep, we can do! Stopped-up bedroom chimneys is one and an important reason why some persons do not derive the benefit they otherwise would do of change of air to the country.
51. I unhesitatingly declare that ninety-nine bedrooms out of every hundred are badly ventilated; that in the morning, after they have been slept in, they are full both of impure and of poisoned air. I say, advisedly, impure and poisoned air, for the air becomes foul and deadly if not perpetually changed—if not constantly mixed, both by day and by night, with fresh, pure, external air. Many persons, by breathing the same air over and over again, are literally “poisoned by their own breaths!” This is not an exaggerated statement—alas, it is too true! Let every young wife remember that she requires just as much pure air in the night as in the day; and if she does not have it, her sleep will neither refresh her nor strengthen her, but that she will rise in the morning more weary than on the previous night when she retired to rest.
52. The way to make a house healthy, and to keep off disease, is by thorough ventilation—by allowing a current of air, both by day and by night, to constantly enter and to sweep through the house, and every room of the house. This may be done either by open skylight or by open landing windows, which should always be left open; and by allowing every chamber window to be wide open during the day, and every chamber door to be a little open both by night and by day, having a door-chain on each door during the night to prevent intrusion.
53. Let her, if she can, live in the country. In a town, coal fires—manufactories, many of them unhealthy—confined space—the exhalations from the lungs and from the skin of the inhabitants, numbers of them diseased,—all tend to load the air with impurities. Moreover, if in the town she desire a walk, it is often itself a walk, and a long one too, before she can get into the country—before she can obtain glimpses of green fields and breathe the fresh air; hence walks in the town do but comparatively little good. In the country her lungs are not cheated: they get what they want—a good article, pure air—and the eye and heart are both gladdened with the beauties of nature. I consider the following remark of Dr. Grosvenor, in his excellent Essay on Health, very pertinent. He observes: “Hence it is that one seldom sees in cities, courts, and rich houses, where people eat and drink, and indulge in the pleasure of appetite, that perfect health and athletic soundness and vigor which is commonly seen in the country, in the poor houses and cottages, where nature is their cook and necessity is their caterer, where they have no other doctor but the sun and fresh air, and no other physic but exercise and temperance.”
54. Cold air is frequently looked upon as an enemy, instead of being contemplated as, what it really is to a healthy person, a friend. The effect of cold upon the stomach is well exemplified in a walk in frosty weather, producing an appetite. “Cold air,” says Dr. Cullen, “applied with exercise, is a most powerful tonic with respect to the stomach; and this explains why, for that purpose, no exercise within doors, or in close carriages, is so useful as that in the open air.”
55. Hot and close rooms, soft cushions, and luxurious couches must be eschewed. I have somewhere read, that if a fine, healthy whelp of the bull-dog species were fed upon chicken, rice, and delicacies, and made to lie upon soft cushions, and if, for some months, he were shut up in a close room, when he grew up he would become unhealthy, weak, and spiritless. So it is with a young married woman; the more she indulges, the more unhealthy, weak, and inanimate she becomes—unfit to perform the duties of a wife and the offices of a mother, if, indeed, she be a mother at all!
56. Rich and luxurious ladies are less likely to be blessed with a family than poor and hard-worked women. Here is, to a vengeance, compensation! Compensation usually deals very justly both to man and womankind. For instance, riches and childlessness, poverty and children, laziness and disease, hard work and health, a hard-earned crust and contentment, a gilded chamber and discontent—
“These are ofttimes wedded as a man and wife,
And linked together, hand in hand, through life.”
Riches seldom bring health, content, many children, and happiness; they more frequently cause disease, discontent, childlessness, and misery.[[12]] Riches and indolence are often as closely united as the Siamese twins, disease and death frequently following in their train. “Give me neither poverty nor riches” was a glorious saying of the wisest of men. Rich and luxurious living, then, is very antagonistic to fecundity. This might be one reason why poor curates’ wives and poor Irish women generally have such large families. It has been proved by experience that a diet, principally consisting of milk, buttermilk, and vegetables, is more conducive to fecundity than a diet almost exclusively of meat. In illustration of my argument, the poor Irish, who have usually such enormous families, live almost exclusively on buttermilk and potatoes; they scarcely eat meat from year’s end to year’s end. Riches, if it prevent a lady from having children, is an evil and a curse, rather than a good and a blessing; for, after all, the greatest treasures in this world are “household treasures”—healthy children! If a wife be ever so rich, and she be childless, she is, as a rule, discontented and miserable. Many a married lady would gladly give up half her worldly possessions to be a mother; and well she might—children are far more valuable. I have heard a wife exclaim with Rachel, “Give me a child, or I die.”
57. If a young wife be likely to have a family, let her continue to live heartily and well; but if she have been married a year or two without any prospect of an increase, let her commence to live abstemiously on fresh milk, buttermilk, bread, potatoes, and farinaceous diet, with very little meat, and no stimulants whatever; let her live, indeed, very much either as a poor curate’s wife, or as a poor Irish woman is compelled to live.
58. It is not the poor woman that is cursed with barrenness—she has often more mouths than she can well fill; but the one that frequently labors under that ban is the pampered, the luxurious, the indolent, the fashionable wife; and most assuredly, until she change her system of living to one more consonant with common sense, she will continue to do so. It is grievous to contemplate that oftentimes a lady, with every other temporal good, is deficient of two earthly blessings—health and children; and still more lamentable, when we know that they frequently arise from her own seeking, that they are withheld from her in consequence of her being a votary of fashion. Many of the ladies of the present day, too, if they do bear children, are, from delicacy of constitution, quite unable to suckle them. Should such things be? But why, it might be asked, speak so strongly and make so much fuss about it? Because the disease is become desperate, and delays are dangerous—because children among the higher ranks are become few and far between; and who so proper as a medical man to raise his voice to proclaim the facts, the causes, and the treatment? I respectfully inquire of my fair reader, Is fashion a wife’s mission? If it be not, what is her mission? I myself have an idea—a very ancient and an almost obsolete one—that the mission of a wife is a glorious mission, far removed from fashion and from folly. A fashionable wife, after a fashionable season, is frequently hysterical and excitable, and therefore exhausted; she is more dead than alive, and is obliged to fly to the country and dose herself with quinine to recruit her wasted energies. Is such a wife as this likely to become a joyful mother of children? I trow not. Her time is taken up between pleasure and excitement to make herself ill, and nursing to make herself well, in order that she may, at the earliest possible moment, again return to her fashionable pursuits, which have with her become, like drinking in excess, a necessity. Indeed, a fashionable life is a species of intoxication. Moreover, wine-drinking in excess and a fashionable life are usually joined together. Sad infatuation, destructive alike to human life and human happiness—a road that often leads to misery, disappointment, and death! These are strong expressions, but they are not stronger than the subject imperatively demands—a subject which is becoming of vital importance to the well-being of society, and, in the higher ranks, even to its very existence, and which must, ere long, engross the attention of all who love their country. Fashion is a sapper and miner, and is ever hard at work sapping and undermining the constitutions of its votaries. Something must be done, and that quickly, to defeat its machinations, otherwise evils will, past remedy, be consummated.
59. I consider thorough ablution of the body every morning one of the most important means of health to a young wife; “while the poor, in the matter of washing, are apt to think that they can put off till Saturday what ought to be performed every day, and that they can wind up the week by a good wash with impunity.”[[13]] There is nothing more tonic and invigorating and refreshing than cold ablution. Moreover, it makes one feel clean and sweet and wholesome; and you may depend upon it, that it not only improves our physical constitution, but likewise our moral character, and makes our minds more pure and holy. A dirty man has generally a dirty mind!
60. The ewers and basins in our own country are, for the purposes of thorough ablution, ridiculously small, while on the Continent they are still smaller. They are of pigmy dimensions—the basins being of the size of an ordinary slop-basin, and the ewer holding enough water to wash a finger. How can persons with such appliances be either decently clean, or sweet, or thoroughly healthy? It is utterly impossible. Many people on the Continent have a dread of water—they labor under a species of hydrophobia: hence one reason why the ewers and basins are of such dwarfish proportions.
61. A young wife ought to strip to the waist, and then proceed to wash her face after the manner so well described by Erasmus Wilson in his work on Healthy Skin. He says: “Fill your basin about two-thirds full with fresh water; dip your face in the water, and then your hands. Soap the hands well, and pass the soaped hands with gentle friction over the whole face. Having performed this part of the operation thoroughly, dip the face in the water a second time, and rinse it completely; you may add very much to the luxury of the latter part of the process by having a second basin ready with fresh water to perform a final rinsing.... In washing the face you have three objects to fulfill: to remove the dirt, to give freshness, and to give tone and vigor to the skin.” Now for the remaining process of ablution. Having well rubbed her neck with her soaped hands, she ought thoroughly to bathe her neck, her chest, and arms, by means of a large sponge dipped in cold water—the colder the better. She cannot cleanse her own shoulders, back, and loins with a sponge—she cannot get to them. To obviate this difficulty, she ought to soak a piece of flannel, a yard and a half long and half a yard wide, folded lengthways, in cold water, and throwing it over her shoulders, as she would a skipping-rope, she should for a few times work it from right to left and from left to right, “and up and down, and then athwart,” her loins and back and shoulders. This plan will effectually cleanse parts that she could not otherwise reach, and will be most refreshing and delightful. She should then put both her hands, her forearms, and her arms into the basin of water as far as they will reach, and keep them in for a few seconds, or while she can count fifty. The wet parts should be expeditiously dried. Then, having thrown off her remaining clothes, and merely having her slippers on, she ought to sit for a few seconds, or while in the winter she can count fifty, or while in the summer she can count a hundred, either in a sitz-bath,[[14]] or in a very large wash-hand basin—called a nursery-basin[[15]] (sold for the purpose of giving an infant his morning bath)—containing water to the depth of three or four inches. While sitting either in the bath or in the basin, she ought in the winter time to have either a small blanket or a woolen shawl thrown over her shoulders. If she has any difficulty in getting in and out of the basin, she should place a chair on each side of the basin; she can then, by pressing upon the chairs with her elbows, arms, and hands, readily do so.
62. If a lady be too delicate to take a sitz-bath, or if a sitz-bath should not agree with her, then she ought every morning to use the bidet, and, while sitting over it, she should well sponge the parts with the water, allowing the water for a few seconds to stream over them. Every lady should bear in mind that either the sitz-bath or the bidet, every morning of her life (except under certain circumstances), is absolutely essential to her comfort and her well-being.
63. At first, until she become accustomed to the cold (which she will do in a few days), she ought to use the water tepid, but the sooner she can use cold water, and that plentifully, the better—as it will greatly contribute to her health and strength. But, as I said before, the process ought to be quickly performed, as it is the shock in bracing and in strengthening the system that does so much good.
64. When a lady is very delicate, it may, during the winter, be necessary to put a dash of warm water into the bath, in order to take off the extreme chill; but, as she becomes stronger, she will be able to dispense with the warm water, as the colder the water is, provided she can bear it, the more good it will do her.
65. If her loins or her back are at all weak, the addition either of a large handful of table salt, or of a small handful of bay salt, or of a lump of rock-salt,[[16]] dissolved in the water in the sitz-bath, will be of great service to her.
66. The feet and the legs ought every morning to be bathed—not by standing in the water, but, on the completion of the washing of the other parts of the body, by putting one foot at a time for a few seconds (not minutes) in the basin containing the water (the basin for that purpose being placed on the floor), and well and quickly washing the foot, either with a flannel or with a sponge, and well cleansing with the finger and thumb between each toe, and allowing the water from the sponge or flannel to stream into the basin from the knee downwards. All this, of course, must be done expeditiously; and care ought to be taken, after such ablution, to well dry with a towel between each toe. The washing of the feet as above directed will be a great refreshment, and will be most beneficial to health, and will be a means of warding off colds, of preventing chilblains, and of preserving the feet in a sweet and healthy state. The feet ought to be kept as clean, if not cleaner, than the hands. Parts that are not seen should be kept cleaner than parts that are seen. Filth is apt to gather in covered up places.
67. The moment she has finished her bath she ought quickly to dry herself. I should recommend her to use as a towel the Turkish rubber: it will cause a delightful glow of the whole body.
68. The whole of the body, except the hair of the head, is, by the above method, every morning thoroughly washed. The hair of the head ought occasionally, even with soap and water, to be cleansed, to keep it clean and sweet and wholesome; for nothing is more dirty if it be not well attended to than human hair, and nothing is more repulsive than a dirty head.
69. Brushing of the hair, although beneficial both to the hair and health, will not alone thoroughly cleanse the hair and scalp.
70. Some ladies attempt to clean their hair by simply washing it either with rosemary or with rosewater, or with other washes; but there is no more effectual way of doing it than occasionally by a flannel and soap and water.
71. Bathing in the sea during the season, provided no grease has been previously used, is very good for the hair; it both strengthens the roots and beautifies the color.
72. I should advise my fair reader not to plaster her hair either with grease or with pomade, or with other unknown compounds: many of them are apt to make the head dirty, scurfy, and sore.
73. It might be said that it is utterly impossible for a lady to keep her hair tidy, unless she uses some application to it. If such be the case, either a little best olive oil or scented castor oil, or cocoanut oil, may, by means of an old tooth-brush, be applied to smooth the hair.
74. If the hair should fall off, either a little cocoanut oil or a little scented castor oil, well rubbed every night and morning into the roots, is an excellent dressing. These are simple remedies, and can never do any harm, which is more than can be said of many quack nostrums, which latter often injure the hair irreparably.
75. The best carpet, either for a bath-room or for a dressing-room, is kamptulicon, as the water spilt upon it after the use of a bath or ablution can, by means of a flannel, be readily absorbed; the window ought then to be thrown wide open, and the room will quickly be dried.
76. It would be well for her, when practicable, to have, after she has finished dressing, a quarter of an hour’s walk, either in the garden or in the grounds, in order to insure a reaction, and thus to induce a healthy glow of the circulation, and to give her an appetite for her breakfast. A quarter of an hour’s walk before breakfast is more beneficial to health than an hour’s walk after breakfast.
77. If a lady have not been accustomed to a thorough ablution, as just directed, of her whole body, let her, if possible, before commencing, take a trip to the coast, and have a few dips in the sea; after which she might at once go through the processes above advised with safety, comfort, and advantage; but whether she be able to bathe in the sea or not, she must, if she is to be strong and healthy, gradually accustom herself to a daily ablution of the whole of her body. The skin is a breathing apparatus, and unless it be kept clean it cannot properly perform its functions. It might be said, it will take time and trouble daily to cleanse the whole of the skin: it will; but no more than ten minutes, or a quarter of an hour, to go through the whole of the above processes of bathing and of drying the skin. The acquisition of health takes both time and trouble; but nothing worth having in this world is done without it! There is no royal road to health; but although the path at first might be a little rugged and disagreeable, it soon becomes from practice smooth and pleasant!
78. Oh, if my fair reader did but know the value of thorough cold water ablutions, she would not lose a day before giving the plan I have above recommended a trial. It would banish all, or nearly all, her little ailments and nervousness; it would make her dispense with many of her wrappings; it would, in the winter time, keep her from coddling and crudling over the fire; it would cause her to resist cold and disease; it would, if she were inclined to constipation, tend to regulate her bowels; it would strengthen her back and loins; it would make her blooming, healthy, and strong; and it would pave the way, and fit her, in due time, to become a mother, and the mother of fine, hearty children! My reader must not fancy that I have overdrawn the picture; I have painted it from the life. “I only tell what I do know, and declare what I do believe.” Let me urge but a trial, and then my fair inquirer will have cause to be thankful that she had been induced to carry out my views, and I shall rejoice that I have been the means of her doing so. Hear what a physician and a poet, a man of sound sense and of sterling intellect, says of the value of ablution. He speaks of warm ablution, which certainly is, at the beginning of using thorough ablution, the best; but the sooner cold can be substituted for warm the better it will be for the health and strength and spirits of the bather:
“The warm ablution, just enough to clear
The sluices of the skin, enough to keep
The body sacred from indecent soil.
Still to be pure, even did it not conduce
(As much as it does) to health, were greatly worth
Your daily pains; it is this adorns the rich;
The want of it is poverty’s worst foe.
With this external virtue age maintains
A decent grace! without it, youth and charms
Are loathsome.”[[17]]
79. With regard to diet.—Although I have a great objection (which I either have or will particularize) of a young wife taking rich food and many stimulants, yet I am a great advocate for an abundance of good wholesome nourishment.
80. The meager breakfasts of many young wives (eating scarcely anything) is one cause of so much sickness among them, and of so many puny children in the world.
81. Let every young wife, and, indeed, every one else, make a substantial breakfast. It is the foundation meal of the day; it is the first meal after a long—the longest fast. The meager, miserable breakfasts many young wives make is perfectly absurd; no wonder that they are weak, “nervous,” and delicate. A breakfast ought, as a rule, to consist either of eggs or of cold chicken, or of cold game, or of bacon, or of ham, or of cold meat, or of mutton-chops, or of fish, and of plenty of good bread, and not of either hot buttered toast, or of hot rolls swimming in butter; both of which latter articles are like giving the stomach sponge to digest, and making the partaker of such food for the rest of the day feel weak, spiritless, and miserable. If she select coffee for breakfast, let the half consist of good fresh milk; if she prefer cocoa, let it be made of new milk instead of water; if she choose tea, let it be black tea, with plenty of cream in it. Milk and cream are splendid articles of diet. Let her then make a hearty breakfast, and let there be no mistake about it. There is no meal in the day so wretchedly managed, so poor and miserable, and so devoid of nourishment, as an English breakfast. Let every young wife, therefore, look well to the breakfast, that it be good and varied and substantial, or ill health will almost certainly ensue.[[18]]
82. A meager unsubstantial breakfast causes a sinking sensation of the stomach and bowels, and for the remainder of the day a miserable depression of spirits. Robert Browning truly and quaintly remarks that
“A sinking at the lower abdomen
Begins the day with indifferent omen.”
83. It frequently happens that a young wife has no appetite for her breakfast. She may depend upon it, in such a case, there is something wrong about her, and that the sooner it is rectified the better it will be for her health, for her happiness, and for her future prospects. Let her, then, without loss of time seek medical advice, that means may be used to bring back her appetite. The stomach in all probability is at fault; if it be, the want of appetite, the consequent sensation of sinking of the stomach, and the depression of the spirits are all explained; but which, with judicious treatment, may soon be set to rights.
84. If the loss of appetite for breakfast arise from pregnancy—and sometimes it is one of the earliest symptoms—time will rectify it, and the appetite, without the necessity of a particle of medicine, will shortly, with its former zest, return.
85. A young married woman’s diet ought to be substantial, plain, and nourishing. She must frequently vary the kind of food, of meat especially, as also the manner of cooking it. Nature delights in variety of food, of air, and of exercise. If she were fed, for some considerable period, on one kind of meat, she could scarcely digest any other; and in time either a disordered or a diseased stomach would be likely to ensue. I have sometimes heard, with pain and annoyance, a patient advised to live on mutton-chops, and to have no other meat than mutton! Now this is folly in the extreme. Such an unfortunate patient’s stomach, in the course of time, would not be able to digest any other meat, and after awhile would have a difficulty in digesting even mutton-chops, and wretched and ruined health would to a certainty ensue.
86. Three substantial and nourishing meals a day will be sufficient. It is a mistaken notion to imagine that “little and often” is best. The stomach requires rest as much as, or more than, any other part of the body; and how, if food be constantly put into it, can it have rest? There is no part of the body more imposed and put upon than the human stomach:
“To spur beyond
Its wiser will the jaded appetite,—
Is this for pleasure? Learn a juster taste,
And know that temperance is true luxury.”
87. It is a mistaken notion, and injurious to health, for a young wife, or for any one else, to eat, just before retiring to rest, a hearty meat supper:
“Oppress, not nature sinking down to rest
With feasts too late, too solid, or too full.”
88. How often we hear a delicate lady declare that she can only eat one meal a day, and that is a hearty meat supper the last thing at night; and who, moreover, affirms that she can neither sleep at night, nor can she have the slightest appetite for any other meal but her supper, and that she should really starve if she could not have food when she could eat it! The fact is, the oppressed stomach oppresses the brain, and drives away sleep, and appetite, and health. The habit is utterly wrong, and oftentimes demands professional means to correct it.
89. How is it that sometimes a lady who has an excellent appetite is, notwithstanding, almost as thin as a rake? It is not what she eats, but what she digests, that makes her fat. Some people would fatten on bread and water, while others would, on the fat of the land, be as thin as Pharaoh’s lean kine. Our happiness and our longevity much depend on the weakness or on the soundness of our stomachs: it is the stomach, as a rule, that both gauges our happiness and that determines the span of the life of both men and women. How necessary it is, then, that due regard should be paid to such an important organ, and that everything should be done to conduce to the stomach’s welfare,—not by overloading the stomach with rich food; not by a scanty and meager diet; but by adopting a middle course, betwixt and between high living and low living—the juste milieu. We should all of us remember that glorious saying—those immortal words of St. Paul—“Be temperate in all things.”
90. Where a lady is very thin, good fresh milk (if it agree) should form an important item of her diet. Milk is both fattening and nourishing, more so than any other article of food known; but it should never be taken at the same meal (except it be in the form of pudding) with either beer or wine: they are incompatibles, and may cause disarrangement of the stomach and bowels. Milk would often agree with an adult, where it now disagrees, if the admixture of milk with either beer or wine were never allowed.
91. Let me advise my fair reader to take plenty of time over her meals, and to chew her food well; as nothing is more conducive to digestion than thoroughly masticated food. No interruptions should be allowed to interfere with the meals; the mind, at such times, should be kept calm, cheerful, and unruffled, for “unquiet meals make ill digestions.”
92. Many persons bolt their food! When they do, they are drawing bills on their constitutions which must inevitably be paid! The teeth act as a mill to grind and prepare the food for the stomach; if they do not do their proper work, the stomach has double labor to perform, and being unable to do it efficiently, the stomach and the whole body in consequence suffer.
93. The teeth being so essential to health, the greatest care should be taken of them: they should be esteemed among one’s most precious possessions.[[19]]
94. With regard to beverage, there is, as a rule, nothing better for dinner than either toast and water, or, if it be preferred, plain spring water—
“Naught like the simple element dilutes;”[[20]]
and after dinner, one or two glasses of sherry. A lady sometimes, until she has had a glass of wine, cannot eat her dinner; when such be the case, by all means let a glass of wine be taken,—that is to say, let her have it either just before or during dinner, instead of after dinner; or let her have one glass of sherry before or during dinner, and one glass after dinner.
95. A young wife sometimes has a languid circulation, a weak digestion, and constipated bowels; then, a glass of sherry during dinner and another glass after dinner is beneficial; and however much she might dislike wine, she should be induced to take it, as the wine will improve her circulation, will strengthen her digestion, and will tend to open her bowels. But let me urge her never, unless ordered by a medical man, to exceed the two glasses of wine daily.
96. If wine does not agree, and if she require a stimulant, a tumblerful either of home-brewed ale or of Burton bitter ale ought, instead of water, to be taken at dinner. But remember, if she drink either beer or porter, she must take a great deal of out-door exercise; otherwise it will probably make her bilious. If she be inclined to be bilious, wine is superior to either beer or porter.
91. Brandy ought never to be taken by a young wife but as a medicine, and then but rarely, and only in cases of extreme exhaustion. It would be a melancholy and gloomy prospect for her to drink brandy daily; she would, in all probability, in a short time become a confirmed drunkard. There is nothing, when once regularly taken, more fascinating and more desperately dangerous than brandy-drinking. It has caused the destruction of tens of thousands both of men and of women!
98. A wife ought not, if she feel low, to fly on every occasion to wine to raise her spirits, but should try the effects of a walk in the country, and
“Draw physic from the fields in draughts of vital air.”[[21]]
99. An excitable wife is a weakly wife: “excitement is the effect of weakness, not of strength.” Wine in large quantities will not strengthen, but, on the contrary, will decidedly weaken; the more the wine, the greater the debility and the greater the excitement—one follows the other as the night the day. A person who drinks much wine is always in a state of excitement, and is invariably weak, low, and nervous, and frequently barren. Alcoholic stimulants in excess are “a delusion and a snare,” and are one of the most frequent causes of excitement, and therefore both of weakness and of barrenness. Alcohol, pure and undiluted, and in excess, is a poison, and is ranked among the deadly poisons; if a person were to drink at one draught half a pint of undiluted alcohol it would be the last draught he or she would ever, in this world, drink,—it would be as surely fatal as a large dose of either arsenic or strychnine! Brandy, whisky, gin, and wine are composed of alcohol as the principal ingredient; indeed, each and all of them entirely owe their strength to the quantity of alcohol contained therein. Brandy, whisky, gin, and wine, without the alcohol, would, each one of them, be as chip in porridge—perfectly inert. Brandy and wine, the former especially, contain large proportions of alcohol, and both the one and the other, in excess, either prevents a woman from conceiving, and thus makes her barren, or if she do conceive, it poisons the unborn babe within her; and it either makes him puny and delicate, or it downright kills him in the womb, and thus causes a miscarriage. If he survive the poison, and he be born alive, he is usually, when born, delicate and undersized; if such a one be suckled by such a mother, he is subjected, if the mother can nurse him, which in such cases she rarely can, to a second course of poisoning; the mother’s milk is poisoned with the alcohol, and the poor unfortunate little wretch, having to run the gantlet in the womb and out of the womb, pines and dwindles away, until at length he finds a resting-place in the grave! If you wish to make a dog small, give him, when he is a puppy, gin; the alcohol of the gin will readily do it: this is a well-known fact, and is, by dog-fanciers, constantly practiced. If you desire, in like manner, to make a Tom Thumb of a baby, give him the milk of a mother or of a wet-nurse who imbibes, in the form of wine or of brandy or of gin, alcohol in quantities, and the deed is done! Gin-drinking nursing mothers, it is well known, have usually puny children; indeed, the mother drinking the gin is only another way of giving gin to the babe—an indirect instead of a direct route, both leading to the same terminus. Brandy was formerly sold only by the apothecary; brandy is a medicine—a powerful medicine—and ought only to be prescribed as a medicine; that is to say, but seldom, in small and in measured quantities at a time, and only when absolutely necessary: now it is resorted to on every occasion as a panacea for every ill! If taken regularly, and in quantities, as unfortunately it frequently now is, it becomes a desperate poison—a pathway leading to the grave! It is utterly impossible for any person to hold in the mouth, for five minutes at a time, a mouthful of neat brandy without experiencing intense suffering: if it has this fearful effect on the mouth, what effect must this burning fluid, when taken in quantities, have upon the stomach? Injury, most decided injury to the stomach, and, through the stomach, disease and weakness to the remainder of the body! Brandy is a wonderful and powerful agent: brandy has the effect, if taken in excess and for a length of time, of making the liver as hard as a board. Brandy in large quantities, and in the course of time, has the power of making the body marvelously big—as big again; but not with firm muscle and strong sinew, not with good blood and wholesome juices—nothing of the kind; but of filling it full, even to bursting, with water! Brandy has the power of taking away a giant’s strength, and of making him as helpless as a little child! Habitual brandy-drinking poisons the very streams of life! It would take more time and space than I have to spare to tell of the wonderful powers of brandy; but unfortunately, as a rule, its powers are more those of an angel of darkness than those of an angel of light! If the above statements be true (and they cannot be contravened), they show the folly, the utter imbecility, and the danger, both to mother and to babe, of dosing a wife, be she strong or be she delicate, and more especially if she be delicate, with large quantities either of wine or of brandy. Brandy, gin, and whisky act on the human economy very much alike; for, after all, it is the quantity of alcohol contained in each of them that gives them their real strength and danger. I have selected brandy as the type of all of them, as brandy is now the fashionable remedy for all complaints, and, unfortunately, in too many instances the habit of drinking it imperceptibly but rapidly increases, until at length, in many cases, that which was formerly a teaspoonful becomes a tablespoonful, and eventually a wineglassful, with what result I have earnestly endeavored faithfully to portray. Avoid, then, the first step in regular brandy-drinking: it is the first step that ofttimes leads to danger, and eventually to destruction!
100. I am quite convinced that one cause of barrenness among ladies of the present day is excessive wine-drinking. This is an age of stimulants, and the practice is daily increasing. A delicate lady is recommended to take three or four glasses of wine daily. It seems for the moment to do her good, and whenever she feels low she flies to it again. The consequence is, that she almost lives upon wine, and takes but little else besides! Who are the fruitful women? Poor women who cannot afford to drink stimulants; for instance, poor Irish women and poor curates’ wives, who have only, principally, water and milk and buttermilk to drink.
101. There is decidedly, among the higher ranks, more barrenness than formerly, and one cause of it, in my opinion, is the much larger quantity of wine now consumed than in the olden times. Many ladies now drink as many glasses of wine in one day as their grandmothers drank in a week; moreover, the wineglasses of the present day are twice the size of old-fashioned wineglasses; so that half a dozen glasses of wine will almost empty a bottle; and many ladies now actually drink, in the day, half a dozen glasses of wine!
102. In the wine-growing and wine-drinking country of France, barrenness prevails to a fearful extent; it has become there a serious consideration and a State question. Wine is largely consumed in France by ladies as well as by gentlemen. The usual and everyday quantity of wine allowed at dinner at the restaurants of Paris, for each lady, is half a wine quart bottle-full—a similar quantity to that allowed for each gentleman. Where a gentleman and a lady are dining together, and have a bottle of wine between them, it is probable that the former might consume more than his own share of the wine; but whether he does or not, the quantity the lady herself drinks is sadly too much either for her health or for her fruitfulness. I am, moreover, quite convinced that the quantity of wine—sour wine—consumed by French wives is not only very antagonistic to their fertility, but likewise to their complexions.
103. Wine was formerly a luxury, it is now made a necessary of life. Fruitful women, in olden times, were more common than they are now. Riches, and consequently wine, did not then so much abound, but children did much more abound. The richer the person, the fewer the children.
104. Wine is now oftentimes sucked in with a mother’s milk! Do not let me be misunderstood; wine and brandy, in certain cases of extreme exhaustion, are, even for very young children, most valuable remedies; but I will maintain that both wine and brandy require the greatest judgment and skill in administering, and do irreparable mischief unless they are most carefully and judiciously prescribed. Wine ought to be very rarely given to the young; indeed, it should be administered to them with as much care and as seldom as any other dangerous or potent medicine.
105. Statistics prove that wine-bibbing in England is greatly on the increase, and so is barrenness. You might say there is no connection between the two. I maintain that there is a connection, and that, the alcohol contained in the wine (if wine be taken to excess, which unfortunately it now frequently is) is most antagonistic to fruitfulness.
106. It is surprising, nowadays, the quantity of wine some few young single ladies, at parties, can imbibe without being intoxicated; but whether, if such ladies marry, they will make fruitful vines is quite another matter; but of this I am quite sure, that such girls will, as a rule, make delicate, hysterical, and unhealthy wives. The young are peculiarly sensitive to the evil effects of overstimulation. Excessive wine-drinking with them is a canker eating into their very lives. Time it is that these facts were proclaimed through the length and breadth of our land, before mischief be done past remedy.
107. Champagne is a fashionable and favorite beverage at parties, especially at dances. It is a marvel to note how girls will, in quantities, imbibe the dangerous liquid. How cheerful they are after it; how bright their colors; how sparkling their eyes; how voluble their tongues; how brilliant their ideas! But, alas! the effects are very evanescent—dark clouds soon o’ershadow the horizon, and all is changed! How pale, after it, they become; how sallow their complexions; how dim their eyes; how silent their tongues; how depressed their spirits—depression following in an inverse ratio to overstimulation; and if depression, as a matter of course, weakness and disease! Champagne is one of the most fascinating but most desperately dangerous and deceptive drinks a young girl can imbibe, and should be shunned as the plague! Young men who witness their proceedings admire them vastly as partners for the evening, but neither covet nor secure them as partners for life. Can they be blamed? Certainly not! They well know that girls who, at a dance, imbibe freely of the champagne-cup, and who at a dinner party drink, as some few are in the habit of drinking, four or five, or even six, glasses of wine,—that such wives as these, if ever they do become mothers (which is very doubtful), will be mothers of a degenerate race. It is folly blinking the question; it is absolutely necessary that it be looked boldly in the face, and that the evil be remedied before it be too late.
108. There is an immense deal of drinking in England, which, I am quite convinced, is one reason of so few children in families, and of so many women being altogether barren. It is high time that these subjects were looked into, and that the torrent be stemmed, ere it o’erflow its banks, and carry with it a still greater amount of barrenness, of misery, and of destruction.
109. It might be said that the light wines contain but little alcohol, and therefore can cause, even if taken to excess, but slight injurious effects on the constitution. I reply, that even light wines, taken in quantities, conduce to barrenness, and that, as a rule, if a lady once unfortunately takes to drinking too much wine, she is not satisfied with the light wines, but at length flies to stronger wines—to wines usually fortified with brandy, such as either to sherry or to port wine, or even, at last, to brandy itself! I know that I am treading on tender ground, but my duty as a medical man, and as a faithful chronicler of these matters, obliges me to speak out plainly, without fear or without favor, and to point out the deplorable consequences of such practices. I am quite aware that many ladies have great temptations and great inducements to resort to wine to cheer them in their hours of depression and of loneliness; but unless the danger be clearly pointed out and defined, it is utterly impossible to suggest a remedy, and to snatch such patients from certain destruction.
110. I am quite convinced of one thing, namely, that the drinking of much wine—be it light as claret, or be it heavy as port—sadly injures the complexion, and makes it muddy, speckled, broken-out, and toad-like.
111. It is high time that medical men should speak out on the subject, and that with no “uncertain sound,” before mischief be done past remedy, and before our island become as barren of children as France unfortunately now is.
112. If a lady be laboring under debility, she is generally dosed with quantities of wine—the greater the debility the more wine she is made to take, until at length the poor unfortunate creature almost lives upon wine. Her appetite for food is by such means utterly destroyed, and she is for a time kept alive by stimulants; her stomach will at length take nothing else, and she becomes a confirmed invalid, soon dropping into an untimely grave! This is a most grievous, and, unfortunately, in this country, not an uncommon occurrence. Much wine will never make a delicate lady strong—it will increase her weakness, not her strength. Wine in excess does not strengthen, but, on the contrary, produces extreme debility. Let this be borne in mind, and much misery might then be averted.
113. Remember I am not objecting to a lady taking wine in moderation—certainly not; a couple of glasses, for instance, in the day, of either sherry or claret, might do her great good; but I do strongly object to her drinking, as many ladies do, five or six glasses of wine during that time. I will maintain that such a quantity is most detrimental both to her health and to her fecundity.
114. The effect of the use of wine is beneficial; but the effect of the abuse of it is deplorable in the extreme. Wine is an edge-tool, and will, if not carefully handled, assuredly wound most unmercifully. I have not the slightest doubt that the quantity of wine consumed by many ladies is one cause, in this our day, of so much delicacy of constitution. It is a crying evil, and demands speedy redress; and as no more worthy medical champion has appeared in the field to fight the battle of moderate wine-drinking, I myself have boldly come forward to commence the affray, fervently trusting that some earnest men may join me in the conflict. I consider that the advocates for a plentiful supply of alcoholic stimulants are wrong, and that the upholders of total abstinence principles are equally wrong; and that the only path of health and of safety lies between them both—in moderation. A teetotaller and an advocate for a plentiful supply of alcoholic drinks are both very difficult to please; indeed, the one and the other are most intemperate. I am aware that what I have written will be caviled at, and will give great offense to both extreme parties; but I am quite prepared and willing to abide the consequences, and sincerely hope that what I have said will be the means of ventilating the subject, which is sadly needed. It is the violence and obstinacy of the contending parties, each of whom is partly right and partly wrong, that have long ago prevented a settlement of the question at issue, and have consequently been the means of causing much heart-burning, misery, and suffering. The Times once pithily remarked that it would be well if the two combatants were “to mix their liquors.”
115. A young wife ought to rise betimes in the morning, and after she be once awake should never doze. Dozing is both weakening to the body and enervating to the mind. It is a species of dram-drinking; let my fair reader, therefore, shun it with all her might. Let her imitate the example of the Duke of Wellington, who, whenever he turned in bed, made a point of turning out of it; indeed, so determined was that illustrious man not to allow himself to doze after he was once awake, that he had his bed made so small that he could not conveniently turn in it without first of all turning out of it. Let her, as soon as she is married, commence early rising; let her establish the habit, and it will for life cling to her:
“Awake! the morning shines, and the fresh field
Calls us; we lose the prime, to mark how spring
Our tender plants; how blows the citron grove,
What drops the myrrh, and what the balmy reed;
How Nature paints her colors; how the bee
Sits on the bloom.”[[22]]
116. It is wonderful how much may be done betimes in the morning. There is nothing like a good start. It makes for the remainder of the day the occupation easy and pleasant—
“Happy, thrice happy, every one
Who sees his labor well begun,
And not perplexed and multiplied
By idly waiting for time and tide.”[[23]]
117. How glorious, and balmy, and health-giving, is the first breath of the morning, more especially to those living in the country! It is more exhilarating, invigorating, and refreshing than it is all the rest of the day. If you wish to be strong, if you desire to retain your good looks and your youthful appearance, if you are desirous of having a family, rise betimes in the morning; if you are anxious to lay the foundation of a long life, jump out of bed the moment you are awake. Let there be no dallying, no parleying with the enemy, or the battle is lost, and you will never after become an early riser; you will then lose one of the greatest charms and blessings of life, and will, probably, not have the felicity of ever becoming a mother; if you do become one, it will most likely be of puny children. The early risers make the healthy, bright, long-lived wives and mothers. But if a wife is to be an early riser, she must have a little courage and determination; great advantages in this world are never gained without; but what is either man or woman good for if they have not those qualities?
118. An early riser ought always to have something to eat and drink, such as a little bread and butter, and either a cup of tea or a draught of new milk, before she goes out of a morning; this need not interfere with, at the usual hour, her regular breakfast. If she were to take a long walk on an empty stomach, she would for the remainder of the day feel tired and exhausted, and she would then, but most unfairly, fancy that early rising did not agree with her.
119. The early morning is one of the best and most enjoyable portions of the day. There is a perfect charm in nature which early risers alone can appreciate. It is only the early riser that ever sees “the rosy morn,” the blushing of the sky, which is gloriously beautiful! Nature, in the early morning, seems to rejoice and be glad, and to pour out her richest treasures: the birds vie with each other in their sweetest carols; the dew on the grass, like unto myriads of diamonds, glittering and glistening, and glinting in the rays of the sun; occasionally the cobwebs on the shrubs and bushes, like exquisite lace sparkling with gems; the fresh and matchless perfume and fragrance of the earth and flowers;—these, one and all, are gloriously beautiful to behold, and can only be enjoyed to perfection in the early morning, while the majority of people, during the choicest periods of their existence, are sweltering, and dozing, and deteriorating both in body and mind, on beds of down, when they ought to be up, out, and about! Can it be wondered at, when such weakening and enervating practices are so much in vogue—for luxury is the curse of the day—that there are so many barren wives in England? It looks, on the first blush, that many of the customs and practices of the present day were to cause barrenness; for, assuredly, if they had been instituted on purpose, they could not have performed their task more surely and successfully.
120. It might be said that the dews of the morning are dangerous! The dews of the early morning are beneficial to health, while the dews of the evening are detrimental. How truly the poet sings—
“Dew-drops are the gems of morning,
But the tears of mournful eve!”[[24]]
121. Early rising imparts health to the frame, strength to the muscles, and comeliness to the countenance; it clears the brain, and thus brightens the intellect; it is a panacea for many of the ills of life, and, unlike many panaceas, it is both simple and pleasant in its operation; it calms the troubled breast; it gives a zest to the after-employments and pleasures of the day; and makes both man and woman look up from “nature’s works to nature’s God!”
122. Early rising rejuvenizes the constitution: it makes the middle-aged look young, and the old look middle-aged; it is the finest cosmetic in the world, and tints the cheeks with a bloom the painter emulates, but in vain! On the other hand, late rising adds years to the looks, fills the body with aches and pains, and the countenance with crow-feet and wrinkles; gives a yellowness and pimples to the face, and depression to the spirits. Aged looks and ill health invariably follow in the wake of late rising.
123. If a mistress rise early the servants are likely to follow suit: a lazy mistress is almost sure to have lazy servants; the house becomes a sluggard’s dwelling! Do not let me be misunderstood; I do not recommend any unreasonable hours for rising in the morning; I do not advise a wife to rise early for the sake of rising early: there would be neither merit nor sense in it; I wish her to have her full complement of sleep—seven or eight hours; but I do advise her to go to bed early, in order that she might be up every morning at six o’clock in the summer, and at seven o’clock in the winter. I maintain that it is the duty of every wife, unless prevented by illness, to be an early riser. This last reason should have greater weight with her than any other that can possibly be brought forward! All things in this world ought to be done from a sense of duty; duty ought to be a wife’s and every other person’s pole-star!
124. There is a wonderful and glorious object in creation which few, very few, ladies, passing strange though it be, have ever seen—the rising of the sun! The few who have seen it are, probably, those who have turned night into day, who are returning home in the early morning, jaded and tired, after dancing the whole of the previous night. These, of course, cannot enjoy, and most likely do not even see, the magnificent spectacle!
125. I am not advising my fair reader to rise every morning with the rising of the sun—certainly not; but if she be an early riser, she might occasionally indulge herself in beholding the glorious sight!
126. “The top of the morning to you” is a favorite Irish salutation, and is very expressive and complimentary. “The top of the morning”—the early morning, the time when the sun first rises in his majesty and splendor—is the most glorious, and health-giving, and best part of the whole day; when nature and all created beings rejoice and are glad:
“But mighty Nature bounds as from her birth,
The sun is in the heavens, and life on earth;
Flowers in the valley, splendor in the beam,
Health in the gale, and freshness in the stream.”[[25]]
127. Let a young wife, if she be anxious to have a family and healthy progeny, be in bed betimes. It is impossible that she can rise early in the morning unless she retire early at night. “One hour’s sleep before midnight is worth three after.” Sleep before midnight is most essential to health, and if to health, to beauty; hence, sleep before midnight is called beauty-sleep. The finest cosmetic is health!
128. She ought to pay particular attention to the ventilation of her sleeping apartment, and she herself, before leaving the chamber in the morning, ought never to omit to open the windows; and in the summer, if the room be large, she should during the night leave, for about six or eight inches, the window-sash open. If the room be small it will be desirable to have, instead of the window, the door (secured from intrusion by a door-chain) unclosed; and to have, as well, either the skylight or the landing window open. There ought by some means or other, if the inmates of the room are to have sweet and refreshing sleep, to be thorough ventilation of the sleeping apartment. I have no patience to hear some men assert that it is better to sleep in a close room—in a foul room! They might, with equal truth, declare that it is desirable for a healthy person to swallow every night a dose of arsenic in order to prolong his life! Carbonic acid gas is as truly a poison as arsenic! If there be a dressing-room next to the bedroom, it will be well to have the dressing-room window, instead of the bedroom window, open at night. The dressing-room door will regulate the quantity of air to be admitted into the bedroom, opening it either little or much as the weather might be cold or otherwise.[[26]] The idea that it will give cold is erroneous; it will be more likely, by strengthening the system and by carrying off the impurities of the lungs and skin, to prevent cold.
129. Some persons, accustomed all their lives to sleep in a close, foul room—in a room contaminated with carbonic acid gas—cannot sleep in a fresh, well-ventilated chamber, in a chamber with either door or window open: they seem to require the stupefying effects of the carbonic acid gas, and cannot sleep without it! If such be the case, and as sleep is of such vital importance to the human economy, let both window and door be closed, but do not, on any account, let the chimney be stopped, as there must be, in a bedroom, ventilation of some kind or another, or ill health will inevitably ensue.
130. It is madness to sleep in a room without ventilation—it is inhaling poison; for the carbonic acid gas, the refuse of respiration, which the lungs are constantly throwing off, is a poison—a deadly poison—and, of course, if there be no ventilation, a person must breathe this carbonic acid gas mixed with the atmospheric air. Hence the importance, the vital importance, of either an open chimney or of an open window, or of both. The chimney, then, even if the window be closed, ought never to be stopped; and the window, either of the bedroom or of the dressing-room, should not be closed, even in the night, unless the weather be either very wet or bitterly cold. I should strongly recommend my fair reader, and, indeed, every one else, to peruse the good and talented Florence Nightingale’s Notes on Nursing. They ought to be written in letters of gold, and should be indelibly impressed on the memory of every one who has the interest of human life and happiness at heart. Florence Nightingale declares that no one, while in bed, ever catches cold from proper ventilation. I believe her; and I need not say that no one has had more experience and better opportunities of judging about what she writes than this accomplished authoress.
131. I fearlessly assert that no one can sleep sweetly and refreshingly unless there be thorough ventilation of the chamber. She may have, in an unventilated apartment, heavy, drowsy, deathlike sleep, and well she might! She is under the stupefying effects of poison; the carbonic acid gas, which is constantly being evolved from the lungs, and which wants a vent, but cannot obtain it, is, as I have before remarked, a deadly poison! She may as well take every night a stupefying opiate, as breathe nightly a bedroom charged with carbonic acid gas; the one would, in the long run, be as pernicious as the other. To show the power of carbonic acid gas in sending people to sleep, we have only to notice a crowded church of an evening; when, even if the preacher be an eloquent man, the majority of the congregation is fast asleep,—is, in point of fact, under the soporific influence of the carbonic acid gas, the church being at the time full of it. Carbonic acid gas is as certain, if not more certain, to produce a heavy deathlike slumber as either numbing opium or drowsy poppy.
132. I moreover declare that she cannot have sweet refreshing sleep at night unless during the day she take plenty of exercise, and unless she has an abundance of active, useful occupation.
133. Occupation—active, useful occupation—is the best composing medicine in the world; and the misfortune of it is that the wealthy have little or no occupation to cause them to sleep. Pleasure they have in abundance, but little or no real occupation. “The sleep of a laboring man is sweet, whether he eat little or much: but the abundance of the rich will not suffer them to sleep.”[[27]]
134. Sleep is of more consequence to the human economy than food. Nothing should therefore be allowed by a young wife to interfere with sleep. And as the attendance on large assemblies, balls, and concerts sadly, in every way, interfere with sleep, they ought, one and all, to be sedulously avoided.
135. As exercise is very conducive and provocative of sleep—sound, sweet, childlike sleep—exercise must be practiced, and that not by fits and starts, but regularly and systematically. She ought, then, during the day, with exercise and with occupation, to tire herself, and she will then have sweet and refreshing sleep. But some ladies never do tire themselves except with excitement; they do not know what it is to be tired either by a long walk or by household work. They can tire themselves with dancing at a ball; poor fragile creatures can remain up the whole night waltzing, quadrilling, and galloping, but would be shocked at the idea and at the vulgarity of walking a mile at a stretch! Poor creatures, they are to be pitied; and, if they ever marry, so are their husbands. Are such wives as these likely to be mothers, and if they are, are their offspring likely to be strong? Are such wives as these likely to be the mothers of our future warriors, of our future statesmen, and of our other worthies—men of mark, who,
“Departing, leave behind them
Footprints on the sands of time!”
136. Sleep is the choicest gift of God. Sleep is a comforter, a solace, a boon, a nourisher, a friend. Happy, thrice happy, is a wife who can sleep like unto a little child! When she is well, what a comfort is sleep; when she is ill, what a soother of pain is sleep; when she is in trouble, what a precious balm is sleep!
137. Hear what our noblest poet, Shakspeare, says of sleep:
“Sleep that knits up the raveled sleeve of care,
The death of each day’s life, sore labor’s bath,
Balm of hurt minds, great nature’s second course
Chief nourisher in life’s feast.”
138. A luxurious, idle wife cannot sleep; she, night after night, tumbles and tosses on her bed of down. What has she done during the day to tire herself, and thus to induce sleep? Alas, nothing! She in consequence never experiences
“Tired nature’s sweet restorer, balmy sleep.”
For, after all, out-door exercise and useful occupation are the best composing medicines in the world! Encompassed as she is with every luxury—partaking of all the delicacies of the season, of the richest viands, and of the choicest wines—decked out in costly apparel—reclining on the softest cushions—surrounded with exquisite scenery, with troops of friends, and with bevies of servants;—yet, notwithstanding all these apparent advantages, she is oftentimes one of the most debilitated, complaining, “nervous,” hysterical and miserable of mortals. The causes of all these afflictions are—she has nothing to do; she is overwhelmed with prosperity; she is like a fire that is being extinguished in consequence of being overloaded with fuel; she is being killed with overmuch kindness; she is a drone in a hive where all must work if they are to be strong and well, and bright and cheerful; for labor is the lot of all and the law for all, for “God is no respecter of persons.” The remedies for a lady affected as above described are simple and yet efficacious—namely, simplicity of living, and an abundance of out-door exercise and of useful occupation. It would have been to the manifest advantage of many a fair dame if she were obliged to put down her close carriage, and were compelled to walk instead of drive. Riding in close carriages nurse many ailments which walking would banish; a brisk walk is the best tonic and the most reviving medicine in the world, and would prevent the necessity of her swallowing so much nauseous physic. Nature’s simple remedies are oftentimes far superior and far more agreeable than any to be found in the Pharmacopœia. It would have been a blessing to many a rich, indolent, and luxurious lady if she had been born in a lower rank—in one in which she had been compelled to work for her daily bread; if she had been, she would, in many instances, have been far happier and healthier than she now is. Indolence and luxury kill more than hard work and hard fare ever did or ever will kill. Indolence and luxury are slow poisons; they destroy by degrees, but are in the end as certain in their deleterious effects as either arsenic or deadly nightshade—
“Come hither, ye that press your beds of down,
And sleep not; see him sweating o’er his bread
Before he eats it. ’Tis the primal curse,
But softened into mercy—made the pledge
Of cheerful days, and nights without a groan.”
139. I must not forget to speak of the paramount importance in a dwelling of an abundance of light—of daylight. Light is life, light is health, light is a physician! Light is life: the sun gives life as well as light; if it were not for the sun, all creation would wither and die. There is “no vitality or healthful structure without light.”[[28]] Light is health: it strengthens the frame, it cheers the heart, and tints the cheeks with a roseate hue! Light is a physician: it drives away many diseases, as the mists vanish at the approach of the sun; and it cures numerous ailments which drugs alone are unable to relieve.
140. Look at the bloom on the face of a milkmaid! What is it that tints her cheeks? An abundance of light. Behold the pallid, corpselike countenance of a factory girl! What blanches her cheek? The want of light, of air, and of sunshine.
141. A room, then, ought to have large windows in order that the sun might penetrate into every nook and corner of the apartment. A gardener thoroughly appreciates the importance of light to his flowers; he knows, also, that if he wishes to blanch some kinds of vegetables—such as celery and sea-kale—he must keep the light from them; and if my fair reader desires to blanch her own cheeks, she ought to keep the light from them; but, on the other hand, if she be anxious to be healthy and rosy, she must have plenty of light in her dwelling.
142. The want of light stunts the growth, dims the sight, and damps the spirits. Colliers, who a great part of their lives live in the bowels of the earth, are generally stunted; prisoners, confined for years in a dark dungeon, frequently become blind; people who live in dark houses are usually melancholic.
143. Light banishes from rooms foulness, fustiness, mustiness, and smells. Light ought therefore to be freely allowed to enter every house, and be esteemed as the most welcome of visitors. Let me then advise every young wife to admit into her dwelling an abundance of light, of air, and of sunshine.
144. Some ladies, to keep off the sun, to prevent it from fading the furniture, have, in the summer time, all the blinds of the windows of the house down. Hence they save the fading of their furniture, and, instead of which, they fade their own and their children’s cheeks. Many houses, with all their blinds down, look like so many prisons, or as if the inmates were in deep affliction, or as if they were performing penance; for is it not a penance to be deprived of the glorious light of day, which is as exhilarating to the spirits as, and much more beneficial than, a glass of champagne?
145. It is a grievous sin to keep out from a dwelling the glorious sunshine. We have heard of “a trap to catch a sunbeam:” let the open windows be a trap, and a more desirable prize cannot be caught than a sunbeam. Sunbeams, both physical and metaphorical, make a house a paradise upon earth!
146. Let me strongly caution the newly made wife against the evil effects of tight lacing. The waist ought, as a rule, to be from twenty-seven to twenty-nine inches in circumference; if, therefore, she bind and gird herself in until she be only twenty-three inches, and, in some cases, until she be only twenty-one inches, it must be done at the expense of comfort, of health, and happiness. If stays be worn tightly, they press down the contents of the lower part of the belly, which might either prevent a lady from having a family, or might produce a miscarriage.[[29]]
147. Let her dress be loose, and be adapted to the season. She ought not to adopt the fashion of wearing in the morning warm clothes with long sleeves, and in the evening thin dresses with short sleeves. “It is hopeless to battle with fashion in matters of dress; women will never believe that their bonnets, neck-wrappers, or huge petticoats (until they go out of fashion) can have anything to do with headaches, sore throats, or rheumatism; but they ought to know that the more they swathe themselves, the more tender and delicate they are likely to be. If they wish to withstand cold, they should accustom themselves to bear it.”[[30]]
148. If a young wife be delicate, and if her circulation be languid, a flannel vest next the skin, and in the daytime, should, winter and summer, be worn. Scarlet is, in such a case, a favorite color, and may be selected for the purpose.
149. It is important that it should be borne in mind that the wearing of flannel next the skin is more necessary in the summer than in the winter time. A lady in the summer is apt, when hot, either from the weather or from exertion, to get into a draught to cool herself, and not wearing flannel next the skin, she is almost sure at such times to catch a cold. Now, flannel being a bad conductor of heat, keeps the body at a tolerably equal temperature, and thus materially lessens the risk. When it is considered that many of the diseases afflicting humanity arise from colds, the value of wearing flannel next the skin as a preventive is at once apparent.
150. Never was there such a time as the present when dress was so much thought of. Grand dresses now sweep our dirty streets and thoroughfares; rich velvets, silks, and satins are as plentiful as dead leaves in autumn. “There is so much to gaze and stare at in the dress, one’s eyes are quite dazzled and weary, and can hardly pierce through to that which is clothed upon.” Dress is become a crying evil; many ladies clothe themselves in gorgeous apparel at the expense of household comforts, and even of household necessaries:
“We sacrifice to dress, till household joys
And comforts cease. Dress drains our cellars dry,
And keeps our larder lean—puts out our fires,
And introduces hunger, frost, and woe,
Where peace and hospitality might reign.”[[31]]
151. It might be said, What has all this to do with the health of a wife? I reply, much. The customs, habits, and luxuries of the present day are very antagonistic both to health and fecundity.
152. She must not coddle, nor should she muffle up her throat with furs. Boas are the most frequent cause of sore throats and quinsies, and therefore the sooner they are discarded the better. “And this is perfectly true, though few seem to be aware of the fact. Relaxed throats would be rare if cold water was more plentifully used, both externally and internally, and mufflers were laid aside.”[[32]]
153. If my gentle reader will freely use cold water ablutions, she will find that she will not require nearly so much clothing and muffling up. It is those who use so little water who have to wear so much clothing; and the misfortune of it is, the more clothes they wear the more they require. Many young people are wrapped and muffled up in the winter time like old folks, and by coddling they become prematurely old—frightened at a breath of air and at a shower of rain, and shaking in their shoes at an easterly wind! Should such things be?
154. Pleasure, to a certain degree, is as necessary to the health of a young wife, and every one else, as the sun is to the earth—to warm, to cheer, and to invigorate it, and to bring out its verdure. Pleasure, in moderation, rejuvenizes, humanizes, and improves the character, and expands and exercises the good qualities of the mind; but, like the sun, in its intensity it oppresseth drieth up, and withereth. Pleasures kept within due bounds are good, but in excess are utterly subversive of health and happiness. A wife who lives in a whirl of pleasure and excitement is always weakly and “nervous,” and utterly unfitted for her duties and responsibilities.
155. Let the pleasures of a newly-married wife, then, be dictated by reason, and not by fashion. She ought to avoid all recreations of an exciting kind, as depression always follows excitement. I would have her prefer the amusements of the country to those of the town, such as a flower-garden, botany, archery, croquet, bowls,—everything, in fact, that will take her into the open air, and will cause her to appreciate the pure, simple, and exquisite beauties of nature. Croquet I consider to be one of the best games ever invented: it induces a lady to take exercise which perhaps she would not otherwise do; it takes her into the open air, it strengthens her muscles, it expands her chest, it promotes digestion, it circulates her blood, and it gives her an interest in the game which is most beneficial both to mind and body.
156. Oh, that my countrywomen should prefer the contaminated and foul air of ball and of concert-rooms, to the fresh, sweet, and health-giving air of the country!
157. Let me in this place enter my strong protest against a young wife dancing, more especially if she be enceinte. If she be anxious to have a family, it is a most dangerous amusement, as it is a fruitful source of miscarriage; and the misfortune is, that if she once have a miscarriage, she might go on again and again, until her constitution be severely injured, and until all hopes of her ever becoming a mother are at an end.
158. The quiet retirement of her own home ought then to be her greatest pleasure and her most precious privilege. Home is, or ought to be, the kingdom of woman, and she should be the reigning potentate. England is the only place in the world that truly knows what home really means. The French have actually no word in their language to express its meaning:
“That home, the sound we English love so well,
Has been as strange to me as to those nations
That have no word, they tell me, to express it.”[[33]]
159. Cheerfulness, contentment, occupation, and healthy activity of mind cannot be too strongly recommended. A cheerful, happy temper is one of the most valuable attributes a wife can have. The possession of such a virtue not only makes herself, but every one around her, happy. It gilds with sunshine the humblest dwelling, and often converts an indifferent husband into a good one. Contentment is the finest medicine in the world; it not only frequently prevents disease, but, if disease be present, it assists in curing it. Happy is the man who has a contented wife! A peevish, discontented helpmate (helpmate, save the mark!) is always ailing, is never satisfied, and does not know, and does not deserve to know, what real happiness is. She is “a thorn in the flesh.”
160. One of the greatest requisites, then, for a happy home is a cheerful, contented, bright, and merry wife; her face is a perpetual sunshine, her presence is that of an angel; she is happy in herself, and she imparts happiness to all around her. A gentle, loving, confiding, placid, hopeful, and trusting disposition has a great charm for a husband, and ought, by a young wife, to be assiduously cultivated—
“For gentleness, and love, and trust
Prevail o’er angry wave and gust.”[[34]]
161. Every young wife, let her station be ever so exalted, ought to attend to her household duties. Her health, and consequently her happiness, demand the exertion. The want of occupation—healthy, useful occupation—is a fruitful source of discontent, of sin,[[35]] of disease, and barrenness. If a young married lady did but know the importance of occupation—how much misery might be averted, and how much happiness might, by attending to her household duties, be insured—she would appreciate the importance of the advice. Occupation improves the health, drives away ennui, cheers the hearth and home, and, what is most important, if household duties be well looked after, her house becomes a paradise, and she the ministering angel to her husband. But she might say—I cannot always be occupied; it bores me; it is like a common person: I am a lady; I was not made to work; I have neither the strength nor the inclination for it; I feel weak and tired, nervous and spiritless, and must have rest. I reply, in the expressive words of the poet, that—
“Absence of occupation is not rest,—
A mind quite vacant is a mind distress’d.”[[36]]
“If time be heavy on your hands,” are there no household duties to look after, no servants to instruct, no flower-beds to arrange, no school children to teach, no sick-room to visit, no aged people to comfort, no widow nor orphan to relieve?—
“Nor any poor about your lands?
Oh! teach the orphan boy to read,
Or teach the orphan girl to sew—
Pray Heaven for a human heart.”[[37]]
162. To have nothing to do is most wretched, wearisome, and destructive to the mind. The words of Martin Luther on this subject should be written in letters of gold, and ought to be kept in constant remembrance by every man and woman, be they rich or poor, lettered or unlettered, gentle or simple. “The mind,” said he, “is like a mill that cannot stop working; give it something to grind, and it will grind that. If it has nothing to grind, it grinds on yet, but it is itself it grinds and wears away.”
163. A lady in this enlightened age of ours considers it to be horribly low and vulgar to strengthen her loins with exercise and her arms with occupation, although such a plan of procedure is recommended in the Bible by the wisest of men,—“She girdeth her loins with strength, and strengthened her arms.”[[38]]
164. A husband soon becomes tired of grand performances on the piano, of crotchet and worsted work, and of other fiddle-faddle employments; but he can always appreciate a comfortable, clean, well-ordered, bright, cheerful, happy home, and a good dinner. It might be said that a wife is not the proper person to cook her husband’s dinner. True; but a wife should see and know that the cook does her duty; and if she did, perchance, understand how the dinner ought to be cooked, I have yet to learn that the husband would for such knowledge think any the worse of her.
165. A grazing farmer is three or four years in bringing a beast to perfection, fit for human food. Is it not a sin, after so much time and pains, for an idiot of a cook, in the course of one short hour or two, to ruin, by vile cookery, a joint of such meat? Is it not time, then, that a wife herself should know how a joint of meat ought to be cooked, and thus to be able to give instructions accordingly?
166. A boy is brought up to his profession, and is expected to know it thoroughly; how is it that a girl is not brought up to her profession of a wife; and why is it that she is not taught to thoroughly understand all household duties? The daughters of a gentleman’s family in olden time spent an hour or two every morning in the kitchen and in the laundry, and were initiated into the mysteries of pastry and pudding-making, of preserving fruit, of ironing, etc. Their mothers’ and their grandmothers’ receipt-books were at their finger-ends. But now look at the picture; the daughters of a gentleman’s family of the present day consider it very low and horridly vulgar to understand any such matters. It is just as absurd to ask a lady to play on the piano who has never been taught music as to ask a wife to direct her servants to perform duties which she herself knows nothing about. The duties of a wife cannot come either by intuition or by instinct more than music can. Again I say, every lady, before she be married, ought to be thoroughly taught her profession—the duties of a wife; she then would not be at the tender mercies of her servants, many of whom are either unprincipled or inefficient.
167. Do not think that I am overstating the importance of the subject. A good dinner—I mean a well-cooked dinner (which, be it ever so plain, is really a good dinner)—is absolutely essential to the health, to the very existence of yourself and your husband; and how, if it be left to the tender mercies of the present race of cooks, can you have it? High time it is that every wife, let her station be either high or low, should look into the matter herself, and remedy the crying evil of the day. They manage these things better in Sweden. There the young ladies of wealthy families cook—actually themselves cook—the dinners; and instead of their considering it a disgrace, and to be horridly low and vulgar, they look upon it as one of their greatest privileges! And what is the consequence? A badly-cooked dinner is rare, and not, as it frequently is in this country, of frequent occurrence; and “peace and happiness” reign triumphant. It is a pity, too, that we do not take a leaf out of the book of our neighbors the French. Every woman in France is a good cook; good cookery with them is the rule—with us it is the exception. A well-cooked dinner is a blessing to all who partake of it; it promotes digestion, it sweetens the temper, it cheers the hearth and home. There is nothing tries the temper more than an ill-cooked dinner; it makes people dyspeptic, and for a dyspeptic to be sweet-tempered is an utter impossibility. Let me, therefore, advise my fair reader to look well into the matter; either the gloom or the sunshine of a house much depends upon herself and upon her household management. It might be said—What a poor creature a man must be to require so much attention. Truly, if his health be not looked after, if his comforts be not attended to, he is indeed a poor creature!
168. Every young wife should be able—ought to be instructed by her mother or by some competent person—it should be a part of her education—to teach and to train her own servants aright. Unfortunately, in the present day there is too much cant and humbug about the instruction of the lower orders, and domestic servants among the rest. They are instructed in many things that are perfectly useless to them, the knowledge of which only makes them dissatisfied with their lot and tends to make them bad servants. Among other useless subjects taught them are the “ologies.” It would be much more to the purpose if they were thoroughly instructed in all household duties, and “in the three R’s—reading, ’riting, and ’rithmetic,”—in obedience to their mistresses, and in simplicity of demeanor and dress. The servants themselves would be immensely benefited by such lessons.
169. A “blue-stocking” makes, as a rule, a wretched wife; it would be far better for the health of her husband, of herself, and her family, if, instead of cultivating Latin and Greek, she would cultivate her household duties, more especially a thorough knowledge of the culinary department. “A man is, in general, better pleased when he has a good dinner upon his table than when his wife speaks Greek.”[[39]]
170. As soon as a lady marries, the romantic nonsense of school-girls will rapidly vanish, and the stern realities of life will take their place, and she will then know, and sometimes to her grievous cost, that a useful wife will be thought much more of than either an ornamental or a learned one.
171. It is better for a young wife, and for every one else, to have too much than too little occupation. The misfortune of the present day is, that servants are made to do all the work, while the mistress of the house remains idle. Remains idle! Yes; and by remaining idle, remains out of health! Idleness is a curse, and brings misery in its train! How slow the hours crawl on when a person has nothing to do; but how rapidly they fly when she is fully occupied! Besides, idleness is a frequent cause of barrenness. Hard-worked, industrious women are prolific; while idle ladies are frequently childless, or, if they do have a family, their children are puny, and their labors are usually both hard and lingering. We doctors know full well the difference there often is between the labor of a poor hard-worked woman and of a rich, idle lady: in the one case the labor is usually quick and easy; in the other, it is often hard and lingering. Oh, if wives would consider betimes the importance of an abundance of exercise and of occupation, what an immense amount of misery, of pain, of anxiety, and anguish they might avert! Work is a blessed thing; if we do not work we pay the penalty—we suffer “in mind, body, and estate.” An idle man or an idle woman is an object of the deepest pity and commiseration.
172. Longfellow, in his Song of the Blacksmith, beautifully and graphically describes the importance and the value of occupation; and as occupation is as necessary to a woman as to a man, I cannot resist transcribing it:
“Toiling—rejoicing—sorrowing,
Onward through life he goes;
Each morning sees some task begin,
Each evening sees its close;
Something attempted, something done,
Has earned a night’s repose.”
173. Truly may it be said that “occupation earns a night’s repose.” It is the finest composing medicine in the world, and, unlike an opiate, it never gives a headache; it never produces costiveness; and never, by repetition, loses its effect. Sloth and restlessness, even on down, are generally bed-fellows:
“Weariness
Can snore upon the flint, when rusty sloth
Finds the down pillow hard.”
174. The mind, it is well known, exerts great influence over the body in promoting health, and in causing and in curing disease. A delicate woman is always nervous; she is apt to make mountains of molehills; she is usually too prone to fancy herself worse than she really is. I should recommend my gentle reader not to fall into this error, and not to magnify every slight ache or pain. Let her, instead of whining and repining, use the means which are within the reach of all to strengthen her frame; let her give battle to the enemy; let her fight him with the simple weapons indicated in these pages, and the chances are she will come off victorious.
175. There is nothing like occupation, active occupation, to cure slight pains—“constant occupation physics pain”—to drive away little ailments, and the dread of sickness. “The dread of sickness,” says Dr. Grosvenor, “is a distemper of itself, and the next disposition to a many more. What a bondage does this keep some people in! ’Tis an easy transition from the fear and fancy of being sick to sickness indeed. In many cases there is but little difference between those two. There is one so afraid of being ill that he would not stir out of doors, and for want of air and exercise he contracts a distemper that kills him.”
176. What a blessed thing is work! What a precious privilege for a girl to have a mother who is both able and anxious to instruct her daughter, from her girlhood upwards, in all household management and duties! Unfortunately, in this our age girls are not either educated or prepared to be made wives—useful, domesticated wives. Accomplishments they have without number, but of knowledge of the management of an establishment they are as ignorant as the babe unborn. Verily, they and their unfortunate husbands and offspring will in due time pay the penalty of their ignorance and folly! It is, forsooth, unladylike for a girl to eat much; it is unladylike for her to work at all; it is unladylike for her to take a long walk; it is unladylike for her to go into the kitchen; it is unladylike for her to make her own bed; it is unladylike for her to be useful; it is unladylike for her to have a bloom upon her cheek like unto a milkmaid![[40]] All these are said to be horridly low and vulgar, and to be only fit for the common people! Away with such folly! The system of the bringing up of the young ladies of the present day is “rotten to the core.”
177. If a young married lady, without having any actual disease about her, be delicate and nervous, there is no remedy equal in value to change of air—more especially to the sea-coast. The sea breezes, and, if she be not pregnant, sea-bathing, frequently act like magic upon her in restoring her to perfect health. I say, if she be not pregnant; if she be, it would, without first obtaining the express permission of a medical man, be highly improper for her to bathe.
178. A walk on the mountains is delightful to the feelings and beneficial to the health. In selecting a sea-side resort, it is always, where it be practicable, to have mountain-air as well as the sea breeze. The mounting of high hills, if a lady be pregnant, would not be desirable, as the exertion would be too great, and, if she be predisposed, might bring on a miscarriage; but the climbing of hills and mountains, if she be not enceinte, is most advantageous to health, strengthening the frame, and exhilarating to the spirits. Indeed, we may compare the exhilaration it produces to the drinking of champagne, with this difference,—it is much more beneficial to health than champagne, and does not leave, the next morning, as champagne sometimes does, either a disagreeable taste in the mouth or headache behind,—
“Oh, there is a sweetness in the mountain-air,
And life, that bloated ease can never hope to share!”[[41]]
179. Bugs and fleas.—This is a very commonplace subject, but like most commonplace subjects is one necessary to be known, as these pests of society sometimes destroy the peace, comfort, and enjoyment of a person when away from home. Many ladies who travel from home are made miserable and wretched by having to sleep in strange beds—in beds infested either with bugs or with fleas. Now, it will be well for such ladies never to go any distance from home without having four things in their trunks with them, namely: (1) A box of matches, in order, at any moment of the night, to strike a light, both to discover and frighten the enemies away. (2) A box of night-lights. Bugs never bite when there is a light in the room. It would therefore be well, in an infested room, and until fresh lodgings can be procured, to keep a night-light burning all night. (3) A packet of “La Poudre Insecticide,” manufactured in France, but which may be procured in England: a preparation which, although perfectly harmless to the human economy, is utterly destructive to fleas. (4) A 4 oz. bottle of oil of turpentine, a little of which, in case of a discovery of bugs in the bed, should be sprinkled between the sheets and on the pillow. The oil of turpentine will, until fresh lodgings can be procured, keep the bugs at a respectful distance. Care should be observed while sprinkling the sheets with the turpentine not to have (on account of its inflammability) a lighted candle too near the bed. I know, from experience, that bugs and fleas are, when ladies are away from home, a source of torment and annoyance, and am therefore fully persuaded of the value and importance of the above advice.
180. If it be not practicable for her to visit the sea-coast, let her be in the fresh air—in the country air. Let her mornings be spent out of doors; and if she cannot inhale the sea breezes, let her inhale the morning breezes—
“The skies, the air, the morning’s breezy call
Alike are free, and full of health to all.”[[42]]
181. Cheerfulness and evenness of temper ought, by a young wife, to be especially cultivated. There is nothing that promotes digestion, and thus good health, more than a cheerful, placid temper. We know that the converse is very detrimental to that process; that violent passion takes away the appetite, deranges the stomach, and frequently disorders the bowels. Hence it is that those who attain great ages are usually of an even, cheerful temper. “Our passions are compared to the winds in the air, which, when gentle and moderate, let them fill the sail, and they will carry the ship on smoothly to the desired port; but when violent, unmanageable, and boisterous, it grows to a storm, and threatens the ruin and destruction of all.”[[43]]
182. A young wife is apt to take too much opening medicine; the more she takes, the more she requires. Hence she irritates the nerves of the stomach and bowels, and injures herself beyond measure. If the bowels are costive, and variety of food, and of fruit, and of other articles of diet, which I either have or will recommend in these pages, together with an abundance of air, and of exercise, and of occupation, will not open, then let her give herself an enema; which she can, without the slightest pain or annoyance, and with very little trouble, readily do, provided she has a proper apparatus for the purpose, namely, a “self-injecting enema apparatus,”—one made purposely for the patient, either to administer it to herself, or to be administered to her by another person. A pint of cold water is as good an enema as can be used, and which, if the first should not operate, ought in a few minutes to be repeated. The clyster does nothing more than wash the bowels out, removing any offending matter, and any depression of spirits arising therefrom, and neither interfering with the stomach nor with the digestion.
183. Until she become accustomed to the cold, she might for the first few mornings slightly warm the water; but gradually she should reduce the temperature of it until she use it quite cold. A cold water is more bracing and strengthening to the bowels, and more efficacious in action, than a warm water enema.
184. It will, during pregnancy and after a confinement, be safer to use a tepid than a cold water enema.
185. No family ought to be without a good enema apparatus, to fly to in any emergency. Many valuable lives have been saved by means of it, and having it always in good order and at hand.
186. By adopting the dictates of reason and of common sense, many of the nervous, useless, lackadaisical, fine ladies will be unknown; and we shall have instead blooming wives, who will in due time become the mothers of hardy, healthy, happy children.
187. In the foregoing pages the burden of my song has been health—the preservation of health—the most precious of God’s gifts, and one that is frittered and fooled away as though it were but of little value. Health ought to be the first consideration of all, and of every young wife especially, as, when she is married, her life, her health is not altogether her own, but her husband’s and her family’s. Oh! it is a glorious gift, a precious boon, to be in the enjoyment of perfect health, and is worth a little care and striving for.
188. In concluding the first division of my subject, let me entreat my fair reader to ponder well on what I have already said; let her remember that she has a glorious mission; let her thoroughly understand that if good habits and good rules be not formed and followed during the first year of her wifehood, they are not at all likely to be instituted afterwards. The first year, then, is the golden opportunity to sow the seeds of usefulness; to make herself healthy and strong, and to cause her to be a blessing, a solace, and a comfort to her husband, her children, and all around her.
189. Menstruation, during a period of about thirty years, plays a momentous part in the female economy; indeed, unless it be in every way properly and duly performed, it is neither possible that such a lady can be well, nor is it at all probable that she will conceive. I therefore purpose devoting an especial chapter to its due and careful consideration.
PART I.
MENSTRUATION.
190. There are two most important epochs in the life of a woman—namely (1) the commencement, and (2) the close of menstruation. Each is apt, unless carefully watched and prevented, to bring in its train many serious diseases. Moreover, unless menstruation be healthfully and properly performed, conception, as a rule, is not likely to take place: hence the importance of our subject.
191. Menstruation—the appearance of the catamenia or the menses—is then one of the most important epochs in a girl’s life. It is the boundary line, the landmark, between childhood and womanhood; it is the threshold, so to speak, of a woman’s life. Her body now develops and expands, and her mental capacity enlarges and improves. She then ceases to be a child, and she becomes a woman. She is now for the first time, as a rule, able to conceive.
192. Although puberty has at this time commenced, it cannot be said that she is at her full perfection; it takes eight or ten years more to complete her organization, which will bring her to the age of twenty-three or twenty-five years; which perhaps are the best ages for a woman, if she have both the chance and the inclination, to marry.
193. If she marry when very young, marriage weakens her system, and prevents a full development of the body. Besides, if she marry when she be only eighteen or nineteen, the bones of the pelvis—the bones of the lower part of the belly—are not at that time sufficiently developed; are not properly shaped for the purpose of labor; do not allow of sufficient space for the head of the child to readily pass, as though she were of the riper age of twenty-three or twenty-five. She might have in consequence a severe and dangerous confinement. If she marry late in life, say after she be thirty, the soft parts engaged in parturition are more rigid and more tense, and thus become less capable of dilatation, which might cause, for the first time, a hard and tedious labor. Again, when she marries late in life, she might not live to see her children grow up to be men and women. Moreover, as a rule, “the offspring of those that are very young or very old lasts not.” Everything, therefore, points out that the age above indicated—namely, somewhere between twenty and thirty—is the most safe and suitable time for a woman to marry.
194. Menstruation generally comes on once every month—that is to say, every twenty-eight days; usually to the very day, and frequently to the hour. Some ladies, instead of being “regular” every month, are “regular” every three weeks.
195. Each menstruation continues from three to five days; in some for a week; and in others for a longer period. It is estimated that, during each menstruation, from four to six ounces is, on an average, the quantity discharged.
196. A lady seldom conceives unless she be “regular,” although there are cases on record where women have conceived who have never been “unwell;” but such cases are extremely rare.
197. Menstruation in this country usually commences at the ages of from thirteen to sixteen, sometimes earlier; occasionally as early as eleven or twelve; at other times later, and not until a girl be seventeen or eighteen years of age. Menstruation in large towns is supposed to commence at an earlier period than in the country, and earlier in luxurious than in simple life.[[44]]
198. Menstruation continues for thirty, and sometimes even for thirty-five years; and, while it lasts, is a sign that a lady is liable to become pregnant—unless, indeed, menstruation should be protracted much beyond the usual period of time. As a rule, then, when a woman “ceases to be unwell,” she ceases to have a family; therefore, as menstruation usually leaves her at forty-five, it is seldom, after that age, that she has a child.
199. I have known ladies become mothers when they have been upwards of fifty years of age. I myself delivered a woman in her fifty-first year of a fine healthy child. She had a kind and easy labor, and was the mother of a large family, the youngest being at the time twelve years old.[[45]] “Dr. Carpenter, of Durham, tells us that he has attended in their confinements several women whose ages were fifty. ‘I well recollect a case occurring in my father’s practice in 1839, where a woman became a widow at forty-nine years of age. Shortly afterwards she married her second husband, and within twelve months of this time gave birth to her first child. These cases belong to the working classes. But I know of two others, where gentlewomen became mothers at fifty-one with her first child, the other with her eighth. I can say nothing of how they menstruated, but I know of a virgin in whom the catamenia appeared regularly and undiminished up to and at the end of sixty.’ Dr. Powell says that he last year attended a woman in her fifty-second year; and Mr. Heckford, that he attended a woman who stated her age to be at least fifty. Mr. Clarke, of Mold, states that he has attended several women whose ages were upwards of forty-four, and that he lately delivered a woman of her first child at forty-eight. Mr. Bloxham, of Portsmouth, delivered at fifty-two, in her first confinement, a woman who had been married thirty-five years.”[[46]]
200. In very warm climates, such as in Abyssinia and in India, girls menstruate when very young—at ten or eleven years old; indeed, they are sometimes mothers at those ages.[[47]] But when it commences early, it leaves early; so that they are old women at thirty. “Physically, we know that there is a very large latitude of difference in the periods of human maturity, not merely between individual and individual, but also between nation and nation—differences so great that in some southern regions of Asia we hear of matrons at the age of twelve.”[[48]] Dr. Montgomery[[49]] brings forward some interesting cases of early maturity. He says: “Bruce mentions that in Abyssinia he has frequently seen mothers of eleven years of age; and Dunlop witnessed the same in Bengal. Dr. Goodeve, Professor of Midwifery at Calcutta, in reply to a query on the subject, said: ‘The earliest age at which I have known a Hindu woman bear a child is ten years, but I have heard of one at nine.’”
201. In cold climates, such as Russia, women begin to menstruate late in life, frequently not until they are between twenty and thirty years old; and, as it lasts on them thirty or thirty-five years, it is not an unusual occurrence for them to bear children at a very advanced age—even so late as sixty. They are frequently not “regular” oftener than three or four times a year, and when it does occur the menstrual discharge is generally sparing in quantity.
202. The menstrual fluid is not exactly blood, although, both in appearance and in properties, it much resembles it; yet it never in the healthy state clots as blood does. It is a secretion from the womb, and, when healthy, ought to be of a bright-red color, in appearance very much like blood from a recently cut finger.[[50]]
203. The menstrual fluid ought not, as before observed, to clot. If it does, a lady, during menstruation, suffers intense pain; moreover, she seldom conceives until the clotting has ceased. Application must therefore, in such a case, be made to a medical man, who will soon relieve the above painful symptoms, and, by doing so, will probably pave the way to her becoming pregnant.
204. Menstruation ceases entirely in pregnancy, during suckling, and usually both in diseased and in disordered states of the womb. It also ceases in cases of extreme debility, and in severe illness, especially in consumption; indeed, in the latter disease—consumption—it is one of the most unfavorable of the symptoms.
205. It has been asserted, and by men of great experience, that sometimes a woman menstruates during pregnancy. In this assertion I cannot agree; it appears utterly impossible that she should be able to do so. The moment she conceives, the neck of the womb becomes plugged up by means of mucus; it is, in fact, hermetically sealed. There certainly is sometimes a slight red discharge, looking very much like menstrual fluid, and coming on at her monthly periods; but being usually very sparing in quantity, and lasting only a day or so, and sometimes only for an hour or two; but this discharge does not come from the cavity of, but from some small vessels at, the mouth of the womb, and is not menstrual fluid at all, but a few drops of real blood. If this discharge came from the cavity of the womb, it would probably lead to a miscarriage. My old respected and talented teacher, the late Dr. D. D. Davis,[[51]] declared that it would be quite impossible during pregnancy for menstruation to occur. He considered that the discharge which was taken for menstruation arose from the rupture of some small vessels about the mouth of the womb.
206. Some ladies, though comparatively few, menstruate during suckling; when they do, it may be considered not the rule, but the exception. It is said, in such instances, that they are more likely to conceive. Many persons have an idea that when a woman, during lactation, menstruates, the milk is both sweeter and purer. Such is an error. Menstruation during suckling is more likely to weaken the mother, and consequently to deteriorate the milk. It therefore behooves a parent never to take a wet nurse who menstruates during the period of suckling.
207. A lady sometimes suffers severe pains both just before and during her “poorly” times. When such be the case, she seldom conceives until the pain be removed. She ought therefore to apply to a medical man, as relief may soon be obtained. When she is freed from the pain, she will, in all probability, in due time become enceinte.
208. If a married woman have painful menstruation, even if she become pregnant, she is more likely, in the early stage, to miscarry. This is an important consideration, and requires the attention of a doctor.
209. If a single lady, who is about to be married, have painful menstruation, it is incumbent on either her mother or a female friend to consult, two or three months before the marriage takes place, an experienced medical man, on her case; if this be not done, she will most likely, after marriage, either labor under ill health, or be afflicted with barrenness, or, if she do conceive, be prone to miscarry.
210. The menstrual discharge, as before remarked, ought, if healthy, to be of the color of blood—of fresh, unclotted blood. If it be either too pale (and it sometimes is almost colorless), or, on the other hand, if it be both dark and thick (it is occasionally as dark, and sometimes nearly as thick, as treacle), there will be but scant hopes of a lady conceiving. A medical man ought, therefore, at once to be consulted, who will in the generality of cases, be able to remedy the defect. The chances are, that as soon as the defect be remedied, she will become pregnant.
211. Menstruation at another time is too sparing; this is a frequent cause of a want of family. Luckily a doctor is, in the majority of cases, able to remedy the defect, and by doing so will probably be the means of bringing the womb into a healthy state, and thus predispose her to become a mother.
212. A married lady is very subject to the “whites;” the more there will be of the “whites” the less there will usually be of the menstrual discharge;—so that in a bad case of the “whites” menstruation might entirely cease, until proper means be used both to restrain the one and to bring back the other. Indeed, as a rule, if the menstrual discharge, by proper treatment, be healthily established and restored, the “whites” will often cease of themselves. Deficient menstruation is a frequent cause of the “whites,” and the consequent failure of a family; and as deficient menstruation is usually curable, a medical man ought, in all such cases, to be consulted.
213. Menstruation at other times is either too profuse or too long continued. Either the one or the other is a frequent source of barrenness, and is also weakening to the constitution, and thus tends to bring a lady into a bad state of health. This, like the former cases, by judicious management may generally be rectified; and being rectified, will in all probability result in the wife becoming a mother.
214. When a lady is neither pregnant nor “regular,” she ought immediately to apply to a doctor, as she may depend upon it there is something wrong about her, and that she is not likely to become enceinte[[52]] until menstruation be properly established. As soon as menstruation be duly and healthily established, pregnancy will most likely, in due time, ensue.
215. When a lady is said to be “regular,” it is understood that she is “regular” as to quality, and quantity, and time. If she be only “regular” as to the time, and the quantity be either deficient or in excess, or if she be “regular” as to the time, and the quality be bad, either too pale or too dark; or if she be “regular” as to the quality and quantity, and be irregular as to the time, she cannot be well; and the sooner means are adopted to rectify the evil, the better it will be for her health and happiness.
216. There is among young wives, of the higher ranks, of the present time, an immense deal of hysteria; indeed it is, among them, in one form or another, the most frequent complaint of the day. Can it be wondered at? Certainly not. The fashionable system of spending married life, such as late hours, close rooms, excitement, rounds of visiting, luxurious living, is quite enough to account for its prevalence. The menstrual functions in a case of this kind are not duly performed; she is either too much or too little “unwell;” menstruation occurs either too soon, or too late, or at irregular periods. I need scarcely say that such a one, until a different order of things be instituted, and until proper and efficient means be used to restore healthy menstruation, is not likely to conceive; or, if she did conceive, she would most likely either miscarry, or, if she did go her time, bring forth a puny, delicate child. A fashionable wife and happy mother are incompatibilities! Oh, it is sad to contemplate the numerous victims that are sacrificed yearly on the shrine of fashion! The grievous part of the business is, that fashion is not usually amenable to reason and common sense; argument, entreaty, ridicule, are each and all alike in turn powerless in the matter. Be that as it might, I am determined boldly to proclaim the truth, and to make plain the awful danger of a wife becoming a votary of fashion.
217. Many a lady, either from suppressed or from deficient menstruation, who is now chlorotic, hysterical, and dyspeptic, weak and nervous, looking wretchedly, and whose very life is a burden, may, by applying to a medical man, be restored to health and strength.
218. As soon as a lady “ceases to be after the manner of women”—that is to say, as soon as she ceases to menstruate—it is said that she has “a change of life;” and if she does not take care, she will soon have “a change of health” to boot, which, in all probability, will be for the worse.
219. After a period of about thirty years’ continuation of menstruation, a woman ceases to menstruate; that is to say, when she is about forty-four or forty-five years of age, and, occasionally, as late in life as when she is forty-eight years of age, she has “change of life,” or, as it is sometimes called, a “turn of years.” Now, before this takes place, she oftentimes becomes very “irregular;” at one time she is “regular” before her proper period; at another time either before or after; so that it becomes a dodging time with her, as it is so styled. In a case of this kind menstruation is sometimes very profuse; at another it is very sparing; occasionally it is light colored, almost colorless; sometimes it is as red as from a cut finger; while now and then it is as black as ink.
220. When “change of life” is about, and during the time, and for some time afterwards, a lady labors under, at times, great flushings of heat; she, as it were, blushes all over; she goes very hot and red, almost scarlet; then perspires; and afterwards becomes cold and chilly. These flushings occur at very irregular periods; they might come on once or twice a day, at other times only once or twice a week, and occasionally only at what would have been her “poorly times.” These flushings might be looked upon as rather favorable symptoms, and as an effort of nature to relieve itself through the skin. These flushings are occasionally, although rarely, attended with hysterical symptoms. A little appropriate medicine is for these flushings desirable. A lady while laboring under these heats is generally both very much annoyed and distressed; but she ought to comfort herself with the knowledge that they are in all probability doing her good service, and that they might be warding off, from some internal organ of her body, serious mischief.
221. “Change of life” is one of the most important periods of a lady’s existence, and generally determines whether, for the rest of her days, she shall either be healthy or otherwise; it therefore imperatively behooves her to pay attention to the subject, and in all cases when it is about taking place to consult a medical man, who will, in the majority of cases, be of great benefit to her, as he will be able to ward off many important and serious diseases to which she would otherwise be liable. When “change of life” ends favorably, which, if properly managed, it most likely will do, she may improve in constitution, and may really enjoy better health and spirits, and more comfort, then she has done for many previous years. A lady who has during the whole of her wifehood eschewed fashionable society, and who has lived simply, plainly, and sensibly, and who has taken plenty of out-door exercise, will, during the autumn and winter of life, reap her reward by enjoying what is the greatest earthly blessing—health!
PART II.
PREGNANCY.
SIGNS OF PREGNANCY.
222. The first sign that leads a lady to suspect that she is pregnant is her ceasing to be unwell. This, provided she has just before been in good health, is a strong symptom of pregnancy; but still there must be others to corroborate it.
223. The next symptom is morning sickness. This is one of the earliest symptoms of pregnancy; as it sometimes occurs a few days, and indeed generally not later than a fortnight or three weeks, after conception. Morning sickness is frequently distressing, oftentimes amounting to vomiting, and causing a loathing of breakfast. This sign usually disappears after the first three or four months. Morning sickness is not always present in pregnancy; but, nevertheless, it is a frequent accompaniment; and many who have had families place more reliance on this than on any other symptom.
224. A third symptom is shooting, throbbing, and lancinating pains, and enlargement of the breasts, with soreness of the nipples, occurring about the second month; and in some instances, after the first few months, a small quantity of watery fluid, or a little milk, may be squeezed out of them. This latter symptom, in a first pregnancy, is valuable, and can generally be relied on as conclusive that the female is pregnant. It is not so valuable in an after pregnancy, as a little milk might, even should she not be pregnant, remain in the breasts for some months after she has weaned her child.
225. The veins of the breast look more blue, and are consequently more conspicuous than usual, giving the bosom a mottled appearance. The breasts themselves are firmer and more knotty to the touch. The nipples, in the majority of cases, look more healthy than customary, and are somewhat elevated and enlarged; there is generally a slight moisture upon their surface, sufficient in some instances to mark the linen.
226. A dark-brown areola or disk may usually be noticed around the nipple,[[53]] the change of color commencing about the second month. The tint at first is light brown, which gradually deepens in intensity, until, toward the end of pregnancy, the color may be very dark. Dr. Montgomery, who has paid great attention to the subject, observes: “During the progress of the next two or three months the changes in the areola are in general perfected, or nearly so, and then it presents the following characters: a circle around the nipple, whose color varies in intensity according to the particular complexion of the individual, being usually much darker in persons with black hair, dark eyes, and sallow skin, than in those of fair hair, light-colored eyes, and delicate complexion. The area of this circle varies in diameter from an inch to an inch and a half, and increases in most persons as pregnancy advances, as does also the depth of color.” The dark areola is somewhat swollen. “There is,” says Dr. Montgomery, “a puffy turgescence, not only of the nipple, but of the whole surrounding disk.”
227. A fourth symptom is quickening. This generally occurs about the completion of the fourth calendar month; frequently a week or two before the end of that period; at other times a week or two later. A lady sometimes quickens as early as the third month, while others, although rarely, quicken as late as the fifth, and, in very rare cases, the sixth month.
228. It will therefore be seen that there is an uncertainty as to the period of quickening, although, as I before remarked, the usual period occurs either on, or more frequently a week or two before, the completion of the fourth calendar month of pregnancy.
229. A lady at this time frequently either feels faint, or actually faints away; she is often either giddy, or sick, or nervous, and in some instances even hysterical. Although, in rare cases, some women do not even know the precise time when they quicken.
230. The sensation of “quickening” is said by many ladies to resemble the fluttering of a bird. “Quickening” arises from the ascent of the womb higher into the belly, as, from its increased size, there is not room for it below. The old-fashioned idea was that the child was not alive until a woman had quickened. This is a mistaken notion, as he is alive, or “quick,” from the very commencement of his formation.
231. Hence the heinous and damnable sin of a single woman, in the early months of pregnancy, using means to promote abortion: it is as much murder as though the child were at his full time, or as though he were butchered when he was actually born!
232. An attempt, then, to procure abortion is a crime of the deepest dye, viz., a heinous murder! It is attended, moreover, with fearful consequences to the mother’s own health; it may either cause her immediate death, or it may so grievously injure her constitution that she might never recover from the shock. If these fearful consequences ensue, she ought not to be pitied: she richly deserves them all. Our profession is a noble one, and every qualified member of it would scorn and detest the very idea either of promoting or of procuring an abortion; but there are unqualified villains who practice the damnable art. Transportation, if not hanging, ought to be their doom. The seducers, who often assist and abet them in their nefarious practices, should share their punishment.
233. Flatulence has sometimes misled a young wife to fancy that she has quickened; but, in determining whether she be pregnant, she ought never to be satisfied with one symptom alone; if she be, she will be frequently misled. The following are a few of the symptoms that will distinguish the one from the other: in flatulence, the patient is small one hour and large the next; while in pregnancy the enlargement is persistent, and daily and gradually increases. In flatulence, on pressing the bowels firmly, a rumbling of wind may be heard, which will move about at will; while the enlargement of the womb in pregnancy is solid, resistant, and stationary. In flatulence, on tapping—percussing—the belly there will be a hollow sound elicited as from a drum; while in pregnancy it will be a dull, heavy sound, as from thrumming on a table. In flatulence, if the points of the fingers be firmly pressed into the belly, the wind will wobble about; in pregnancy they will be resisted as by a wall of flesh.
234. The fifth symptom is, immediately after the quickening, increased size and hardness of the belly. An accumulation of fat covering the belly has sometimes led a lady to suspect that she is pregnant; but the soft and doughy feeling of the fat is very different to the hardness, solidity, and resistance of pressure of pregnancy.
235. The sixth symptom is pouting or protrusion of the navel. This symptom does not occur until some time after a lady has quickened; indeed, for the first two months of pregnancy the navel is drawn in and depressed. As the pregnancy advances, the navel gradually comes more forward. “The navel, according to the progress of the pregnancy, is constantly emerging, till it comes to an even surface with the integuments of the abdomen [belly]; and to this circumstance much regard is to be paid in cases of doubtful pregnancy.”[[54]]
236. Sleepiness, heartburn, increased flow of saliva, toothache, loss of appetite, longings, excitability of mind, a pinched appearance of countenance, liver or sulphur-colored patches on the skin, and likes and dislikes in eating,—either the one or the other of these symptoms frequently accompany pregnancy; but, as they might arise from other causes, they are not to be relied on further than this—that if they attend the more certain signs of pregnancy, such as cessation of being “regular,” morning sickness, pains and enlargement of and milk in the breasts, the gradually darkening brown areola or mark around the nipple, etc., they will then make assurance doubly sure, and a lady may know for certain that she is pregnant.[[55]]
CLOTHING.
237. A lady who is pregnant ought on no account to wear tight dresses, as the child should have plenty of room. She ought to be, as enceinte signifies, incincta, or unbound. Let the clothes be adapted to the gradual development both of the belly and the breasts. She must, whatever she may usually do, wear her stays loose. If there be bones in the stays, let them be removed. Tight lacing is injurious both to the mother and to the child, and frequently causes the former to miscarry; at another time it has produced a crossbirth; and sometimes it has so pressed in the nipples as to prevent a proper development of them, so that where a lady has gone her time, she has been unable to suckle her infant, the attempt often causing a gathered bosom. These are great misfortunes, and entail great misery both on the mother and the child (if it has not already killed him), and ought to be a caution and a warning to every lady for the future.
238. The feet and legs during pregnancy are very apt to swell and to be painful, and the veins of the legs to be largely distended. The garters ought at such times to be worn slack, as tight garters are highly injurious, and, if the veins be very much distended, it will be necessary for her to wear a properly-adjusted elastic silk stocking, made purposely to fit her foot and leg, and which a medical man will himself procure for her.
ABLUTION.
239. A warm bath in pregnancy is too relaxing. A tepid bath once a week is beneficial. Sponging the whole of the body every morning with lukewarm water may with safety and advantage be adopted, gradually reducing the temperature of the water until it be used quite cold. The skin should, with moderately coarse towels, be quickly but thoroughly dried.
240. Either the bidet or sitz-bath[[56]] ought every morning to be used. The patient should first sponge herself, and then finish up by sitting for a few seconds, or while, in the winter, she can count fifty, or while, in the summer, she can count a hundred, in the water. It is better not to be long in it; it is a slight shock that is required, which, where the sitz-bath agrees, is immediately followed by an agreeable glow of the whole body. If she sits in the water for a long time she becomes chilled and tired, and is very likely to catch cold. She ought, until she become accustomed to the cold, to have a dash of warm water added; but the sooner she can use quite cold water the better. While sitting in the bath she should throw either a woolen shawl or a small blanket over her shoulders. She will find the greatest comfort and benefit from adopting the above recommendation. Instead of giving, it will prevent cold, and it will be one of the means of warding off a miscarriage, and of keeping her in good health.
241. A shower-bath in pregnancy gives too great a shock, and might induce a miscarriage. I should not recommend, for a lady who is pregnant, sea-bathing; nevertheless, if she be delicate, and if she be prone to miscarry, change of air to the coast (provided it be not too far away from home), and inhaling the sea breezes, may brace her, and ward off the tendency. But although sea-bathing be not desirable, sponging the body with sea water may be of great service to her.
AIR AND EXERCISE.
242. A young wife, in her first pregnancy, usually takes too long walks. This is a common cause of flooding, of miscarriage, and of bearing down of the womb. As soon, therefore, as a lady has the slightest suspicion that she is enceinte, she must be careful in the taking of exercise.
243. Although long walks are injurious, she ought not to run into an opposite extreme; short, gentle, and frequent walks during the whole period of pregnancy cannot be too strongly recommended; indeed, a lady who is enceinte ought to live half her time in the open air. Fresh air and exercise prevent many of the unpleasant symptoms attendant on that state; they keep her in health; they tend to open her bowels; and they relieve that sensation of faintness and depression so common and distressing in early pregnancy.
244. Exercise, fresh air, and occupation are then essentially necessary in pregnancy. If they be neglected, hard and tedious labors are likely to ensue. One, and an important, reason of the easy and quick labors and rapid “gettings about” of poor women, is the abundance of exercise and of occupation which they are both daily and hourly obliged to get through. Why, many a poor woman thinks but little of a confinement, while a rich one is full of anxiety about the result. Let the rich lady adopt the poor woman’s industrious and abstemious habits, and labor need not then be looked forward to, as it frequently now is, either with dread or with apprehension.
245. Stooping, lifting of heavy weights, and overreaching ought to be carefully avoided. Running, horse exercise, and dancing are likewise dangerous—they frequently induce a miscarriage.
246. Indolence is most injurious in pregnancy. A lady who, during the greater part of the day, lolls either on the sofa or on an easy-chair, and who seldom walks out, has a much more lingering and painful labor than one who takes moderate and regular open-air exercise, and who attends to her household duties.
247. An active life is, then, the principal reason why the wives of the poor have such quick and easy labors, and such good recoveries; why their babies are so rosy, healthy, and strong; notwithstanding the privations and hardships and poverty of the parents.
248. Bear in mind, then, that a lively, active woman has an easier and quicker labor, and a finer race of children, than one who is lethargic and indolent. Idleness brings misery, anguish, and suffering in its train, and particularly affects pregnant ladies. Oh, that these words would have due weight, then this book will not have been written in vain. The hardest work in the world is having nothing to do! “Idle people have the most labor;” this is particularly true in pregnancy; a lady will, when labor actually sets in, find to her cost that idleness has given her most labor. “Idleness is the badge of gentry, the bane of body and mind, the nurse of Naughtiness, the step-mother of Discipline, the chief author of all Mischief, one of the seven deadly sins, the cushion upon which the Devil chiefly reposes, and a great cause not only of Melancholy, but of many other diseases, for the mind is naturally active; and, if it be not occupied about some honest business, it rushes into Mischief or sinks into Melancholy.”[[57]]
249. A lady sometimes looks upon pregnancy more as a disease than as a natural process; hence she treats herself as though she was a regular invalid, and, unfortunately, she too often makes herself really one by improper and by foolish indulgences.
VENTILATION—DRAINAGE.
250. Let a lady look well to the ventilation of her house; let her take care that every chimney be unstopped, and during the daytime that every window in every unoccupied room be thrown open.
251. Where there is a skylight at the top of the house, it is well to have it made to open and to shut, so that in the daytime it may, winter and summer, be always open; and in the summer time it may, day and night, be left unclosed. Nothing so thoroughly ventilates and purifies a house as an open skylight.
252. If a lady did but know the importance—the vital importance—of ventilation, she would see that the above directions were carried out to the very letter. My firm belief is that if more attention were paid to ventilation—to thorough ventilation—child-bed fever would be an almost unknown disease.
253. The cooping-up system is abominable; it engenders all manner of infectious and of loathsome diseases, and not only engenders them, but feeds them, and thus keeps them alive. There is nothing wonderful in all this, if we consider but for one moment that the exhalations from the lungs are poisonous! That is to say, that the lungs give off carbonic acid gas (a deadly poison), which, if it be not allowed to escape out of the room, must over and over again be breathed. That if the perspiration of the body (which in twenty-four hours amounts to two or three pounds) be not permitted to escape out of the apartment, must become fetid—repugnant to the nose, sickening to the stomach, and injurious to the health. Oh, how often the nose is a sentinel, and warns its owner of approaching danger!
254. Truly the nose is a sentinel! The Almighty has sent bad smells for our benefit to warn us of danger. If it were not for an unpleasant smell, we should be constantly running into destruction. How often we hear of an ignorant person using disinfectants and fumigations to deprive drains and other horrid places of their odors, as though, if the place could be robbed of its smell, it could be robbed of its danger! Strange infatuation! No; the frequent flushings of drains, the removal of nuisances, cleanliness, a good scrubbing of soap and water, sunshine, and the air and winds of heaven, are the best disinfectants in the world. A celebrated and eccentric lecturer on surgery,[[58]] in addressing his class, made the following quaint and sensible remark: “Fumigations, gentlemen, are of essential importance; they make so abominable a stink that they compel you to open the windows and admit fresh air.”
255. It is doubtless, then, admirably appointed that, we are able to detect “the well-defined and several stinks;” for the danger is not in them,—to destroy the smell is not to destroy the danger; certainly not! The right way to do away with the danger is to remove the cause, and the effect will cease; flushing a sewer is far more efficacious than disinfecting one; soap and water and the scrubbing-brush, and sunshine and thorough ventilation, each and all are far more beneficial than either permanganate of potash, or chloride of zinc, or chloride of lime. People nowadays think too much of disinfectants and too little of removal of causes; they think too much of artificial, and too little of natural means. It is a sad mistake to lean so much on, and to trust so much to, man’s inventions!
256. What is wanted, nowadays, is a little less theory and a great deal more common sense. A rat, for instance, is, in theory, grossly maligned; he is considered to be very destructive, an enemy to man, and one that ought to be destroyed—every man’s hand being against him. Now, a rat is, by common sense, well known to be, in its proper place—that is to say, in sewers and in drains—destructive only to man’s enemies—to the organic matter that breeds fevers, cholera, diphtheria, etc.; the rat eats the pabulum or food which would otherwise convert towns into hot-beds of terrible diseases. That which is a rat’s food is often a man’s poison; hence a rat is one of the best friends that a man has, and ought, in his proper place, to be in every way protected; the rat, in drains, is the very best of scavengers; in a sewer he is invaluable; in a house he is most injurious; a rat in a sewer is worth gallons of disinfectants, and will, in purifying a sewer, beat all man’s inventions hollow; the maligned rat, therefore, turns out, if weighed by common sense, to be not only one of the most useful of animals, but of public benefactors! The rat’s element, then, is the sewer; he is the king of the sewer, and should there reign supreme, and ought not to be poisoned by horrid disinfectants.
257. If a lady, while on an errand of mercy, should in the morning go into a poor person’s bedroom after he, she, or they (for oftentimes the room is crowded to suffocation) have during the night been sleeping, and where a breath of air is not allowed to enter—the chimney and every crevice having been stopped up—and where too much attention has not been paid to personal cleanliness, she will experience a faintness, an oppression, a sickness, a headache, a terribly fetid smell; indeed, she is in a poisoned chamber! It is an odor sui generis, which must be smelt to be remembered, and will then never be forgotten! Pity the poor who live in such styes—not fit for pigs! For pigs, styes are ventilated. But take warning, ye well-to-do in the world, and look well to your ventilation, or beware of the consequences. “If,” says an able writer on fever in the last century, “any person will take the trouble to stand in the sun and look at his own shadow on a white plastered wall, he will easily perceive that his whole body is a smoking dunghill, with a vapor exhaling from every part of it. This vapor is subtle, acrid, and offensive to the smell; if retained in the body it becomes morbid, but if reabsorbed, highly deleterious. If a number of persons, therefore, are long confined in any close place not properly ventilated, so as to inspire and swallow with their spittle the vapors of each other, they must soon feel its bad effects.”[[59]]
258. Not only should a lady look well to the ventilation of her house, but either she or her husband ought to ascertain that the drains are in good and perfect order, and that the privies are frequently emptied of their contents. Bad drainage and overflowing privies are fruitful sources of child-bed fever, of gastric fever, of scarlatina, of diphtheria, of cholera, and of a host of other infections and contagious and dangerous diseases. It is an abominable practice to allow dirt to fester near human habitations; more especially as dirt, when mixed with earth, is really so valuable in fertilizing the soil. Lord Palmerston wisely says that “dirt is only matter in the wrong place.”
259. A lady ought to look well to the purity of her pump-water, and to ascertain that no drain either enters or percolates, or contaminates in any way whatever, the spring; if it should do so, disease, such as either cholera, or diarrhœa, or dysentery, or diphtheria, or scarlet fever, or gastric fever, will, one or the other, as a matter of course, ensue. If there be the slightest danger or risk of drain contamination, whenever it be practicable, let the drain be taken up and be examined, and let the defect be carefully rectified. When it be impracticable to have the drain taken up and examined, then let the pump-water, before drinking it, be always previously boiled. The boiling of the water, as experience teaches, has the power either of destroying or of making innocuous the specific organic fecal life poison, which propagates in drain contamination the diseases above enumerated.
NECESSITY OF OCCASIONAL REST.
260. A lady who is pregnant ought, for half an hour each time, to lie one or two hours every day on the sofa. This, if there be either a bearing down of the womb, or if there be a predisposition to a miscarriage, will be particularly necessary. I should recommend this plan to be adopted throughout the whole period of the pregnancy: in the early months, to prevent a miscarriage, and, in the latter months, on account of the increased weight and size of the womb.
261. There is, occasionally, during the latter months, a difficulty in lying down; the patient feeling as though, every time she makes the attempt, she should be suffocated. When such be the case, she ought to rest herself upon the sofa, and be propped up with cushions, as I consider rest at different periods of the day necessary and beneficial. If there be any difficulty in lying down at night, a bed-rest, well covered with pillows, will be found a great comfort.
DIETARY.
262. An abstemious diet, during the early period of pregnancy, is essential, as the habit of body, at that time, is usually feverish and inflammatory. I should therefore recommend abstinence from beer, porter, and spirits. Let me, in this place, urge a lady, during her pregnancy, not to touch spirits, such as either brandy or gin; they will only inflame her blood, and will poison and make puny her unborn babe; they will only give her false spirits, and will depress her in an increased ratio as soon as the effects of the brandy or of the gin have passed away. She ought to eat meat only but once a day. Rich soups and highly-seasoned stews and dishes are injurious.
263. A lady who is enceinte may depend upon it that the less stimulants she takes at these times the better it will be both for herself and for her infant; the more kind will be her labor and her “getting about,” and the more vigorous and healthy will be her child.
264. It is a mistaken notion that she requires more nourishment during early pregnancy than at any other time; she, if anything, requires less. It has often been asserted that a lady who is pregnant ought to eat very heartily, as she has two to provide for. When it is taken into account that during pregnancy she “ceases to be unwell,” and therefore that there is no drain on that score; and when it is also considered how small the ovum containing the embryo is, not being larger for the first two or three months than a hen’s egg, it will be seen how futile is the assertion. A wife, therefore, in early pregnancy, does not require more than at another time; if anything, she requires less. Again: during pregnancy, especially in the early stages, she is more or less sick, feverish, and irritable, and a superabundance of food would only add fuel to the fire, and would increase her sickness, fever, and irritability. Moreover, she frequently suffers from heartburn and from indigestion. Can anything be more absurd, when such is the case, than to overload a stomach already loaded with food which it is not able to digest? No, let nature in this, as in everything else, be her guide, and she will not then go far wrong! When she is further advanced in her pregnancy,—that is to say, when she has quickened,—her appetite generally improves, and she is much better in health than she was before; indeed, after she has quickened, she is frequently in better health than she ever has been. The appetite is now increased. Nature points out that she requires more nourishment than she did at first; for this reason, the fœtus is now rapidly growing in size, and consequently requires more support from the mother. Let the food, therefore, of a pregnant woman be now increased in quantity, but let it be both light and nourishing. Occasionally, at this time, she has taken a dislike to meat; if she has, she ought not to be forced to eat it, but should have instead, poultry, game, fish, chicken-broth, beef-tea, new milk, farinaceous food, such as rice, sago, batter puddings, and, above all, if she has a craving for it, good sound, ripe fruit.
265. Roasted apples, ripe pears, raspberries, strawberries, grapes, tamarinds, figs, Muscatel raisins, stewed rhubarb, stewed pears, stewed prunes, the inside of ripe gooseberries, and the juice of oranges, are, during pregnancy, particularly beneficial; they both quench the thirst and tend to open the bowels.
266. The food of a pregnant woman cannot be too plain; high-seasoned dishes ought, therefore, to be avoided. Although the food be plain, it must be frequently varied. She should ring the changes upon butcher’s meat, poultry, game, and fish. It is a mistaken notion, that people ought to eat the same food over and over again, one day as another. The stomach requires variety, or disease, as a matter of course, will ensue.
267. Light puddings, such as either rice, or batter, or suet-pudding, or fruit puddings, provided the paste be plain, may be taken with advantage. Rich pastry is highly objectionable.
268. If she be plethoric, abstinence is still more necessary, or she might have a tedious labor, or might suffer severely. The old-fashioned treatment was to bleed a pregnant patient if she were of a full habit of body. A more absurd plan could not be adopted! Bleeding would, by causing more blood to be made, only increase the mischief; but certainly it would be blood of an inferior quality, watery and poor. The best way to diminish the quantity of blood is to moderate the amount of food, to lessen the supplies.
SLEEP.
269. The bedroom of a pregnant lady ought, if practicable, to be large and airy. Particular attention must be paid to the ventilation. The chimney should on no account be stopped. The door and the windows ought in the daytime to be thrown wide open, and the bedclothes should be thrown back, that the air might, before the approach of night, well ventilate them.
270. It is a mistaken practice for a pregnant woman, or for any one else, to sleep with closely-drawn curtains. Pure air and a frequent change of air are quite as necessary—if not more so—during the night as during the day: and how can it be pure, and how can it be changed, if curtains are closely drawn around the bed? Impossible. The roof of the bedstead ought not to be covered with bed furniture; it should be open to the ceiling, in order to prevent any obstruction to a free circulation of air.
271. The bed must not be loaded with clothes, more especially with a thick coverlet. If the weather be cold, let an extra blanket be put on the bed, as the perspiration can permeate through a blanket when it cannot through a thick coverlet.
272. A lady who is pregnant is sometimes restless at night—she feels oppressed and hot. The best remedies are:—(1) Scant clothing on the bed. (2) The lower sash of the window, during the summer months, to be left open to the extent of six or eight inches, and during the winter months, to the extent of two or three inches; provided the room be large, the bed be neither near nor under the window, and the weather be not intensely cold. If any or all of these latter circumstances occur, then (3) the window to be closed and the door to be left ajar (the landing or the skylight window at the top of the house being left open all night, and the door being secured from intrusion by means of a door-chain.) (4) Attention to be paid, if the bowels be costive—but not otherwise—to a gentle action of the bowels by castor oil. (5) An abstemious diet, avoiding stimulants of all kinds. (6) Gentle walking exercise. (7) Sponging the body every morning—in the winter with tepid water, and in the summer with cold water. (8) Cooling fruits in the summer are in such a case very grateful and refreshing. (See paragraph 264.)
273. A pregnant woman sometimes experiences an inability to lie down, the attempt occasionally producing a feeling of suffocation and of faintness. She ought, under such circumstances, to lie on a bed-rest, which must, by means of pillows, be made comfortable; and she should take, every night at bedtime, a teaspoonful of sal-volatile in a wineglassful of water.
274. Pains at night, during the latter end of the time, are usually frequent, so as to make an inexperienced lady fancy that her labor was commencing. Little need be done; for unless the pains be violent, nature ought not to be interfered with. If they be violent, application should be made to a medical man.
275. A pregnant lady must retire early to rest. She ought to be in bed every night by ten o’clock, and should make a point of being up in good time in the morning, that she may have a thorough ablution, a stroll in the garden, and an early breakfast; and that she may afterwards take a short walk either in the country or in the grounds while the air is pure and invigorating. But how often, more especially when a lady is first married, is an opposite plan adopted! The importance of bringing a healthy child into the world, if not for her own and her husband’s sake, should induce a wife to attend to the above remarks.
276. Although some ladies, during pregnancy, are very restless, others are very sleepy, so that they can scarcely, even in the day, keep their eyes open! Fresh air, exercise, and occupation are the best remedies for keeping them awake.
MEDICINE.
277. A young wife is usually averse to consult a medical man concerning several trifling ailments, which are nevertheless, in many cases, both annoying and distressing. I have therefore deemed it well to give a brief account of such slight ailments, and to prescribe a few safe and simple remedies for them. I say safe and simple, for active medicines require skillful handling, and therefore ought not—unless in certain emergencies—to be used except by a doctor himself.
278. I wish it, then, to be distinctly understood that in all serious attacks, and in slight ailments if not quickly relieved, a medical man ought to be called in.
279. A costive state of the bowels is common in pregnancy; a mild aperient is therefore occasionally necessary. The mildest must be selected, as a strong purgative is highly improper, and even dangerous. Calomel and all other preparations of mercury are to be especially avoided, as a mercurial medicine is apt to weaken the system and sometimes even to produce a miscarriage.
280. An abstemious diet, where the bowels are costive, is more than usually desirable, for if the bowels be torpid, a quantity of food will only clog and make them more sluggish. Besides, when labor comes on, a loaded state of the bowels will add much to a lady’s sufferings as well as to her annoyance.
281. The best aperients are castor oil, salad oil, compound rhubarb pills, honey, stewed prunes, stewed rhubarb, Muscatel raisins, figs, grapes, roasted apples, Normandy pippins, oatmeal and milk gruel, coffee, brown bread and treacle, raw sugar (as a sweetener of the food), Du Barry’s Arabica Revalenta.
282. Castor oil, in pregnancy, is a valuable aperient. Frequent and small are preferable to occasional and large doses. If the bowels be constipated (but certainly not otherwise), castor oil ought to be taken regularly twice a week. The best time for administering it is early in the morning. The dose is from a teaspoonful to a dessertspoonful.
283. The best ways of administering it are the following: Let a wineglass be well rinsed out with water, so that the sides may be well wetted; then, let the wineglass be half filled with cold water, fresh from the pump. Let the necessary quantity of oil be now carefully poured into the center of the wineglass, taking care that it does not touch the sides; and if the patient will, thus prepared, drink it off at one draught, she will scarcely taste it. Another way of taking it is, swimming on warm new milk. A third and a good method is, floating on warm coffee; the coffee ought, in the usual way, to be previously sweetened and mixed with cream. There are two advantages in giving castor oil on coffee: (1) it is a pleasant way of giving it—the oil is scarcely tasted; and (2) the coffee itself, more especially if it be sweetened with raw sugar, acts as an aperient; less castor oil, in consequence, being required; indeed, with many patients the coffee, sweetened with raw sugar, alone is a sufficient aperient. A fourth and an agreeable way of administering it is on orange-juice—swimming on the juice of one orange.
284. Some ladies are in the habit of taking it on brandy and water; but the spirit is apt to dissolve a portion of the oil, which afterwards rises in the throat.
285. If salad oil be preferred, the dose ought to be as much again as of castor oil; and the patient should, during the day she takes it, eat either a fig or two, or a dozen or fifteen of stewed prunes, or of stewed French plums, as salad oil is much milder in its effects than castor oil.
286. Where a lady cannot take oil, one or two compound rhubarb pills may be taken at bedtime; or a Seidlitz powder early in the morning, occasionally; or a quarter of an ounce of tasteless salts—phosphate of soda—may be dissolved in lieu of table salt, in a cupful either of soup, or of broth, or of beef-tea, and be occasionally taken at luncheon.
287. When the motions are hard, and when the bowels are easily acted upon, two, or three, or four pills made of Castile soap will frequently answer the purpose; and if they will, are far better than any ordinary aperient. The following is a good form:
Take of—Castile Soap, five scruples;
Oil of Caraway, six drops:
To make twenty-four pills. Two, or three, or four to be taken at bedtime, occasionally.[[60]]
288. A teaspoonful of honey, either eaten at breakfast, or dissolved in a cup of tea, will frequently comfortably and effectually open the bowels, and will supersede the necessity of taking aperient medicine.
289. A basin of thick Derbyshire oatmeal gruel, made either with new milk or with cream and water, with a little salt, makes an excellent luncheon or supper for a pregnant lady; it is both nourishing and aperient, and will often entirely supersede the necessity of giving opening medicine. If she prefers sugar to salt, let raw sugar be substituted for the salt. The occasional substitution of coffee for tea at breakfast usually acts beneficially on the bowels.
290. Let me again urge the importance of a lady, during the whole period of pregnancy, being particular as to the state of her bowels, as costiveness is a fruitful cause of painful, of tedious, and of hard labors. It is my firm conviction that if a patient who suffers from constipation were to attend more to the regularity of her bowels, difficult cases of labor would rarely occur, more especially if the simple rules of health were adopted, such as: attention to diet—the patient partaking of a variety of food, and allowing the farinaceous, such as oatmeal and the vegetable and fruit element, to preponderate; the taking of exercise in the open air; attending to her household duties; avoiding excitement, late hours, and all fashionable amusements.
291. Many a pregnant lady does not leave the house—she is a fixture. Can it, then, be wondered at that costiveness so frequently prevails? Exercise in the fresh air, and occupation, and household duties are the best opening medicines in the world. An aperient, let it be ever so judiciously chosen, is apt, after the effect is over, to bind up the bowels, and thus to increase the evil. Now, nature’s medicines,—exercise in the open air, occupation, and household duties,—on the contrary, not only at the time open the bowels, but keep up a proper action for the future: hence their inestimable superiority.
292. Where a lady cannot take medicine, or where it does not agree with her, a good remedy for constipation in pregnancy is the external application of castor oil—castor oil as a liniment—to the bowels The bowels should be well rubbed every night and morning with the castor oil. This, if it succeed, will be an agreeable and safe method of opening the bowels.
293. Another excellent remedy for the costiveness of pregnancy is an enema, either of warm water or of Castile soap and water, which the patient, by means of a self-injecting enema apparatus, may administer to herself. The quantity of warm water to be used is from half a pint to a pint; the proper heat is the temperature of new milk; the time for administering it is early in the morning, twice or three times a week. The advantages of clysters are, they never disorder the stomach—they do not interfere with the digestion—they do not irritate the bowels—they are given with the greatest facility by the patient herself—and they do not cause the slightest pain. If an enema be used to open the bowels, it may be well to occasionally give one of the aperients recommended above, in order, if there be costiveness, to insure a thorough clearance of the whole of the bowels.
294. If the bowels should be opened once every day, it would be the height of folly for a pregnant lady to take either castor oil or any other aperient. She ought then to leave her bowels undisturbed, as the less medicine she takes the better. If the bowels be daily and properly opened, aperients of any sort whatever would be highly injurious to her. The plan in this, as in all other cases, is to leave well alone, and never to give physic for the sake of giving it.
295. Diarrhœa.—Although the bowels in pregnancy are generally costive, they are sometimes in an opposite state, and are relaxed. Now, this relaxation is frequently owing to their having been too much constipated, and nature is trying to relieve itself by purging. Such being the case, a patient ought to be careful how, by the taking of chalk and of astringents, she interferes with the relaxation.
296. The fact is, that in all probability there is something in the bowels that wants coming away, and nature is trying all she can to afford relief. Sometimes, provided she is not unnecessarily interfered with, she succeeds; at others, it is advisable to give a mild aperient to help nature in bringing it away.
297. When such be the case, a gentle aperient, such as either castor oil or rhubarb and magnesia, ought to be chosen. If castor oil, a teaspoonful or a dessertspoonful, swimming on a little new milk, will generally answer the purpose. If rhubarb and magnesia be the medicine selected, then a few doses of the following mixture will usually set all to rights:
Take of—Powdered Turkey Rhubarb, half a drachm;
Carbonate of Magnesia, one drachm;
Essence of Ginger, one drachm;
Compound Tincture of Cardamoms, half an ounce;
Peppermint Water, five ounces and a half:
Two tablespoonfuls of the mixture to be taken three times a day, first shaking the bottle.
298. The diet ought to be simple, plain, and nourishing, and should consist of beef-tea, of chicken-broth, of arrow-root, and of well-made and well-boiled oatmeal gruel. Meat, for a few days, ought not to be eaten; and stimulants of all kinds must be avoided.
299. If the diarrhœa be attended with pain in the bowels, a flannel bag filled with hot table salt, and then applied to the part affected, will afford great relief. A hot-water bag, too, in a case of this kind, is a great comfort.[[61]] The patient ought, as soon as the diarrhœa has disappeared, gradually to return to her usual diet, provided it be plain, wholesome, and nourishing. She should pay particular attention to keeping her feet warm and dry; and, if she be much subject to diarrhœa, she ought to wear around her bowels, and next to her skin, a broad flannel belly-band.
300. Heartburn is a common and often a distressing symptom of pregnancy. The acid producing the heartburn is frequently much increased by an overloaded stomach. The patient labors under the mistaken notion that, as she has two to sustain, she requires more food during this than at any other time; she consequently is induced to take more than her appetite demands, and more than her stomach can digest;—hence heartburn, indigestion, etc. are caused, and her unborn babe, as well as herself, is thereby weakened.
301. An abstemious diet ought to be strictly observed. Great attention should be paid to the quality of the food; greens, pastry, hot buttered toast, melted butter, and everything that is rich and gross, ought to be carefully avoided.
302. Either a teaspoonful of Henry’s magnesia, or half a teaspoonful of carbonate of soda—the former to be preferred if there be constipation—should occasionally be taken in a wineglassful of warm water. If these do not relieve—the above directions as to diet having been strictly attended to—the following mixture ought to be tried:
Take of—Sesquicarbonate of Ammonia, half a drachm;
Bicarbonate of Soda, a drachm and a half;
Water, eight ounces:
To make a mixture. Two tablespoonfuls to be taken twice or three times a day, until relief be obtained.
Chalk is sometimes given in heartburn, but as it produces costiveness, it ought not in such a case to be used.
303. Piles are a common attendant upon pregnancy. They are small, soft, spongy, dark-red tumors, about the size either of a bean or of a cherry—they are sometimes as large as a walnut—and are either within or around the fundament; they are then, according to their situation, called either internal or external piles—they may be either blind or bleeding. If the latter, blood may be seen to exude from them, and blood will come away every time the patient has a stool; hence the patient ought to be as quick as possible over relieving her bowels, and should not at such times sit one moment longer than is absolutely necessary.
304. When the pile or piles are very large, they sometimes, more especially when she has a motion, drag down a portion of the bowel, which adds much to her sufferings.
305. If the bowel should protrude, it ought, by means of the patient’s index finger, to be immediately and carefully returned, taking care, in order that it may not scratch the bowel, that the nail be cut close.
306. Piles are very painful and are exceedingly sore, and cause great annoyance, and frequently continue, notwithstanding proper and judicious treatment, during the whole period of pregnancy.
307. A patient is predisposed to piles from the womb pressing upon the blood-vessels of the fundament. They are excited into action by her neglecting to keep her bowels gently opened, or by diarrhœa, or from her taking too strong purgatives, especially pills containing either aloes or colocynth, or both.
308. If the piles be inflamed and painful, they ought, by means of a sponge, to be well fomented three times a day, and for half an hour each time, with hot chamomile and poppy-head tea;[[62]] and at bedtime a hot white-bread poultice should be applied.
309. Every time after and before the patient has a motion, she had better well anoint the piles and the fundament with the following ointment:
Take of—Camphor (powdered by means of a few drops of
Spirits of Wine), half a drachm;
Prepared Lard, two ounces:
Mix, to make an ointment.
310. If there be great irritation and intense pain, let some very hot water be put into a close stool, and let the patient sit over it. “In piles attended with great irritation and pain, much relief is often obtained by sitting over the steam of hot water for fifteen or twenty minutes, and immediately applying a warm bread-and-milk poultice. These measures should be repeated five or six times a day (Greeves).”[[63]]
311. If the heat be not great, and the pain be not intense, the following ointment will be found efficacious:
Take of—Powdered Opium, one scruple;
Camphor (powdered by means of a few drops of
Spirits of Wine), half a drachm;
Powdered Galls, one drachm;
Spermaceti Ointment, three drachms:
Mix.—The ointment to be applied to the piles three times a day.[[64]] Or the compound Gall Ointment (B.P.) may, in the same manner, be applied.
312. If the heat and the pain be great, the following liniment will be found useful:
Take of—French Brandy,
Glycerin, of each, half an ounce:
Mix.—The liniment to be frequently applied, by means of a camel’s-hair pencil, to the piles, first shaking the bottle.
313. The bowels ought to be kept gently and regularly opened, either by taking every morning one or two teaspoonfuls of compound confection of senna, or by a dose of the following electuary:
Take of—Sublimed Sulphur, half an ounce;
Powdered Ginger, half a drachm;
Cream of Tartar, half an ounce;
Confection of Senna, one ounce;
Simple Syrup, a sufficient quantity:
To make an electuary. One or two teaspoonfuls to be taken early every morning.
314. Magnesia and milk of sulphur is an excellent remedy for piles:
Take of—Carbonate of Magnesia,
Milk of sulphur, of each, three drachms;
Mix.—To make nine powders. One to be taken early every, or every other morning, mixed in half a teaspoonful of new milk.
315. Remember, in these cases, it is necessary to keep the motions in a softened state, as hard lumps of stool would, in passing, give intense pain.
316. If the confection of senna and the other remedies do not act sufficiently, it may be well to give, once or twice a week, a teaspoonful or a dessertspoonful of castor oil.
317. In piles, if they are not much inflamed, and provided there be constipation, a pint of tepid water, administered early every morning as an enema, will be found serviceable. Care and gentleness ought, of course, to be observed in introducing the enema pipe (but which only requires ordinary care), in order not to press unduly on the surrounding piles.
318. The patient ought to lie down frequently in the day. She will derive great comfort from sitting either on an air-cushion or on a water-cushion about half filled with water, placed on the chair; for sometimes she is unable to sit on an ordinary seat.
319. In piles, the patient ought to live on a plain, nourishing, simple diet, but should avoid all stimulants; any food or beverage that will inflame the blood will likewise inflame the piles.
320. Piles in pregnancy are frequently troublesome, and sometimes resist all treatment until the patient is confined, when they generally get well of themselves; but still the remedies recommended above will usually afford great relief, even if they do not effect a cure.
321. Swollen legs from enlarged veins (varicose veins).—The veins are frequently much enlarged and distended, causing the legs to be greatly swollen and very painful, preventing the patient from taking proper walking exercise. Swollen legs are owing to the pressure of the womb upon the blood-vessels above. Women who have had large families are more liable to varicose veins than others. If a lady marry late in life, or if she be very heavy in her pregnancy—carrying the child low down—she is more likely to have the veins to distend.
322. The best plan will be for her to wear an elastic silk stocking,[[65]] which ought to be made on purpose for her, in order that it may properly fit the leg and foot. It will draw on like a common stocking. She ought to wear a gauze stocking next the skin, and the elastic stocking over it, as the gauze stocking can then, from time to time, be washed, as can likewise the foot and leg. Moreover, the gauze stocking will be more comfortable next the skin than the elastic stocking.
323. If the varicose veins should be very painful, she had better apply to a medical man, as it may be necessary, in such a case, to have them enveloped in mild plasters, and then rolled.
324. If the feet and legs be cold as well as swollen, a domette[[66]] bandage, two inches and a half wide and eight yards long, nicely applied to each leg, from the toes to the knee, will be found a great comfort. One great advantage that domette has over calico is that it will keep in its place for days, while calico will be loose in an hour or two.
325. Stretching of the skin of the belly is frequently, especially in a first pregnancy, distressing, from the soreness it causes. The best remedy is to rub the bowels, every night and morning, with warm camphorated oil, and to apply a broad flannel belt, which should be put on moderately but comfortably tight. The belt ought to be secured in its situation by means of properly adjusted tapes.
326. If the skin of the belly, from the violent stretching, be cracked, the patient had better dress the part affected, every night and morning, with equal parts of simple cerate and of lard—lard without salt—well mixed together, spread on lint; which ought to be kept in its place by means of a broad bandage, similar to the one used in confinements, and which is described in a subsequent paragraph (Bandage after Confinements).
321. Pendulous belly.—A lady sometimes, from being at these times unusually large, suffers severely; so much so, that she cannot, without experiencing great inconvenience, move about. This, where a patient is stout, and where she has had a large family of children, is more likely to occur, and especially if she has neglected proper bandaging after her previous confinements.
328. She ought in such a case to procure, from a surgical-instrument-maker, an elastic abdominal belt, made purposely for pendulous bellies, which will, without unduly pressing on the belly, be a support. It is a good plan to have the belt made either to lace behind or with straps and buckles, in order to accommodate the belly to its gradually increasing size.
329. If the patient be delicate, and if she has a languid circulation, she ought, instead of the elastic belt, to apply a broad flannel belly-band, which should go twice around the bowels, and must be put on moderately and comfortably tight.
330. The patient, before the approach of labor, ought to take particular care to have the bowels gently opened, as during that time a costive state of them greatly increases her sufferings, and lengthens the period of her labor. I say a gentle action is all that is necessary; a violent one would do more harm than good.
331. Toothache is a frequent complaint of pregnancy; and I wish to caution my gentle reader not to have, during the time she is enceinte, a tooth extracted; miscarriage or premature labor has frequently followed the extraction of a tooth.
332. If the tooth be decayed, the hollow ought to be filled with cotton wool, soaked either in oil of cloves, or in equal parts of oil of cloves and of chloroform, and which should be frequently renewed; or with what I have found an excellent remedy, a little alum dissolved in chloroform.[[67]] A bit of cotton wool placed in the ear of the affected side will oftentimes relieve the toothache arising from a decayed tooth. This simple remedy ought always to be tried before resorting to more active treatment. If the above remedies do not relieve, soak a small ball of cotton wool in chloroform, and insert it inside the ear, and let it remain there until the pain be relieved; let it be from time to time renewed. I have frequently found in toothache the above plan most efficacious, and to afford relief when other means have failed.
333. Creasote (spirits of tar) is sometimes applied, but of all remedies it is the worst for the purpose. I have known it, when thus used, severely injure and decay the whole of the remaining teeth: one case in particular I remember, of a gentleman who, by the frequent use of creasote, for the relief of toothache, lost the whole of his teeth!
334. If the teeth be not decayed, especially if the stomach be disordered, let an aperient be taken. The state of the bowels ought always to be attended to, as toothache is frequently relieved, and when the tooth is not decayed, cured by a dose of opening medicine. Let the sides of the face be well fomented with hot chamomile and poppy-head tea, and let a piece of crumb of bread (but not crumbed bread) be soaked for five minutes in boiling milk, and be frequently placed inside the mouth, between the cheek and gum; and let a large hot bread poultice be applied at bedtime to the outside of the face.
335. If the above does not have the desired effect, a piece of brown paper, the size of the palm of the hand, soaked in brandy, and then well peppered with black pepper, should be applied outside the cheek, over the part affected, and kept on for several hours. It ought from time to time to be renewed. This simple and old-fashioned remedy will sometimes afford great relief. It is in these cases preferable to a mustard poultice, as it is less painful, and neither blisters nor injures the skin.
336. If the pepper plaster does not afford relief, a ginger plaster should be tried:
Take of—Powdered Ginger,
Flour, of each one tablespoonful;
Water, a sufficient quantity:
To be well mixed together, adding the water drop by drop (stirring it the while) until it be of the consistence of paste. Let it be applied at bedtime, on linen rag, outside the cheek, and let it remain on all night, or until the pain be relieved.
337. If the tooth be not decayed, and if the pain of the face be more of a neuralgic (tic-douloureux) character, the following pills will frequently afford great relief:
Take of—Sulphate of Quinine, twenty-four grains;
Powdered Extract of Liquorice, six grains;
Treacle, a sufficient quantity:
To make twelve pills. One to be taken three times a day.
338. The teeth, in pregnancy, are very apt to decay: I have known several patients, each of whom has lost a tooth with every child!
339. Morning sickness.—It is said to be “morning,” as in these cases, unless the stomach be disordered, it seldom occurs during any other part of the day. Morning sickness may be distinguished from the sickness of a disordered stomach by the former occurring only early in the morning, on the first sitting up in bed, the patient during the remainder of the day feeling quite free from sickness, and generally being able to eat and relish her food as though nothing ailed her.
340. Morning sickness begins with a sensation of nausea early in the morning, and as soon as she rises from bed she feels sick and retches; and sometimes, but not always, vomits a little sour, watery, glairy fluid; and occasionally, if she has eaten heartily at supper the night previously, the contents of the stomach are ejected. She then feels all right again, and is usually ready for her breakfast, which she eats with her usual relish. Many ladies have better appetites during pregnancy than at any other period of their lives.
341. The sickness of a disordered stomach unaccompanied with pregnancy may be distinguished from morning sickness by the former continuing during the whole day, by the appetite remaining bad after the morning has passed, by a disagreeable taste in the mouth, and by the tongue being generally furred. Moreover, in such a case there is usually much flatulence. The patient not only feels but looks bilious.
342. If the stomach be disordered during pregnancy, there will, of course, be a complication of the symptoms, and the morning sickness may become both day and night sickness. Proper means ought then to be employed to rectify the disordered stomach, and the patient will soon have only the morning sickness to contend against; which latter, after she has quickened, will generally leave of its own accord.
343. Morning sickness is frequently a distressing, although not a dangerous complaint. It is only distressing while it lasts, for after the stomach is unloaded, the appetite generally returns, and the patient usually feels, until the next morning, quite well again, when she has to go through the same process as before.
344. It occurs both in the early and in the latter months of pregnancy; more especially during the former, up to the period of quickening, at which time it usually ceases. Morning sickness is frequently the first harbinger of pregnancy, and is looked upon by many ladies who have had children as a sure and certain sign. Morning sickness does not always occur in pregnancy; some women, at such times, are neither sick nor sorry.
345. A good way to relieve it is by taking, before rising in the morning, a cup of strong coffee. If this should not have the desired effect, she ought to try an effervescing draught:
Take of—Bicarbonate of Potash, one drachm and a half;
Water, eight ounces:
Two Tablespoonfuls of this mixture to be taken with one of lemon-juice every hour, while effervescing, until relief be obtained.
346. A glass of champagne, taken the overnight, I have sometimes found to be the best remedy, and, if it has the desired effect, it certainly is the most agreeable.
347. I have known, too, cider, where other things have failed, to succeed in abating morning sickness.
348. Sometimes, until the whole contents of the stomach be brought up, she does not obtain relief from her sickness. She had better, when such is the case, drink plentifully of warm water, in order to encourage free vomiting. Such a plan, of course, is only advisable when the morning sickness is obstinate, and when the treatment recommended above has failed to afford relief.
349. The morning sickness, during the early months, is caused by sympathy between the stomach and the womb; and during the latter months by pressure of the upper part of the womb against the stomach. As we cannot remove the sympathy and the pressure, we cannot always relieve the sickness; the patient, therefore, is sometimes obliged to bear with the annoyance.
350. The bowels ought to be kept gently opened, either by a Seidlitz powder taken early in the morning, or by one or two compound rhubarb pills at bedtime, or by the following mixture:
Take of—Carbonate of Magnesia, two drachms;
Sulphate of Magnesia, one ounce;
Peppermint water, seven ounces:
A wineglassful of this mixture to be taken early in the morning, occasionally, first shaking the bottle.
351. Great attention ought in such a case to be paid to the diet; it should be moderate in quantity, and simple in quality. Rich dishes, highly-seasoned soups and melted butter must be avoided. Hearty meat suppers ought not on any account to be allowed. There is nothing better, if anything be taken at night, than either a teacupful of nicely-made and well-boiled oatmeal gruel, or of arrow-root, or of Arabica Revalenta. Any of the above may be made either with water, or with new milk, or with cream and water.
352. It is an old saying, and, I believe as a rule, a true one, “that sick pregnancies are safe,” more especially if the sickness leaves, which it generally does, after she has quickened. The above remarks, of course, do not include obstinate, inveterate vomiting, occasionally occurring in the latter period of pregnancy, and which not only takes place in the morning, but during the whole of the day and of the night, and for weeks together, sometimes bringing a patient to the brink of the grave. Such a case, fortunately, is extremely rare. Another old and generally true saying is, “that females who have sick pregnancies seldom miscarry.”
353. Means to harden the nipples.—A mother, especially with her first child, sometimes suffers severely from sore nipples. Such suffering may frequently be prevented, if for six weeks or two months before her confinement, she were to bathe her nipples, every night and morning, for five minutes each time, either with eau de Cologne, or with brandy and water, equal parts of each. The better plan will be to have the brandy and water in a small bottle ready for use, and putting a little each time into a teacup, using it fresh and fresh. A soft piece of fine old linen rag should be used for the purpose of bathing. All pressure ought to be taken from the nipples; if the stays, therefore, unduly press them, either let them be enlarged or let them be entirely removed. The nipples themselves ought to be covered with a soft linen rag, as the friction of a flannel vest would be apt to irritate them. Let me recommend every pregnant lady, more especially in her first pregnancy, to adopt either the one or the other of the above plans to harden the nipples; it might avert much misery, as sore nipples are painful and distressing; and prevention at all times is better than cure.
354. The breasts are, at times, during pregnancy, much swollen and very painful; and, now and then, they cause the patient great uneasiness, as she fancies that she is going to have either some dreadful tumor or a gathering of the bosom. There need, in such a case, be no apprehension. The swelling and the pain are the consequences of the pregnancy, and will in due time subside without any unpleasant result. The fact is, great changes are taking place in the breasts; they are developing themselves, and are preparing for the important functions they will have to perform the moment the labor is completed.
355. Treatment.—She cannot do better than, every night and morning, to well rub them with equal parts of eau de Cologne and of olive oil, and to wear a piece of new flannel over them; taking care to cover the nipples with soft linen, as the friction of the flannel may irritate them. The liniment encourages a little milky fluid to ooze out of the nipple, which will afford relief.
356. If stays be worn, the patient should wear them slack, in order to allow the bosoms plenty of room to develop themselves. The bones of the stays ought all to be removed, or serious consequences might ensue.
357. Bowel complaints, during pregnancy, are not unfrequent. A dose either of rhubarb and magnesia, or of castor oil, are the best remedies, and are generally, in the way of medicine, all that is necessary.
358. The diet at such times ought to be simple, small in quantity, and nourishing. Farinaceous food, such as rice, tapioca, sago, Du Barry’s Arabica Revalenta, and arrow-root, are particularly beneficial. Green vegetables and fruits, especially stone fruits and uncooked fruits, ought to be avoided.
359. The surface of the body—the bowels and feet particularly—ought to be kept warm. If a lady suffer habitually from relaxation of the bowels, let her, by all means, wear a flannel vest next the skin.
360. The bladder.—The patient during pregnancy is liable to various affections of the bladder. There is sometimes a sluggishness of that organ, and she has little or no inclination to make water. There is, at another time, a great irritability of the bladder, and she is constantly wanting to pass urine; while, in a third case, more especially toward the latter period of the time, she can scarcely hold her water at all,—the slightest bodily exertion, such as walking, stooping, coughing, sneezing, etc., causing it to come away involuntarily; and even in some cases, where she is perfectly still, it dribbles away without her having any power to prevent its doing so.
361. A sluggish state of the bladder is best remedied by gentle exercise, and by the patient attempting, whether she want or not, to make water at least every four hours.
362. Irritability of the bladder.—The patient ought, during the day, to drink freely of the following beverage:
Take of—Best Gum Arabic, one ounce;
Pearl Barley, one ounce;
Water, one pint and a half:
Boil for a quarter of an hour, then strain, and sweeten either with sugar candy or lump sugar.
363. The bowels ought to be gently opened with small doses of castor oil. The patient must abstain from beer, wine, or spirits, and should live on a mild, bland, nourishing diet.
364. Where the patient cannot hold her water there is not a great deal to be done, as the pregnant womb by pressing on the bladder prevents much present relief. The comfort is, as soon as the labor is over, it will cure itself. She ought frequently in the day to lie down either on a horse-hair mattress or on a couch. She should drink but a moderate quantity of liquid, and if she has a cough (for a cough greatly increases this inability to hold the water), she ought to take the following mixture:
Take of—Compound Tincture of Camphor, half an ounce;
Compound Spirits of Lavender, half a drachm;
Oxymel of Squills, six drachms;
Water, six ounces and a half:
Two tablespoonfuls of this mixture to be taken three times a day.
365. Fainting.—A delicate woman, when she is enceinte, is apt either to feel faint or to actually faint away. When it is considered the enormous changes that, during pregnancy, take place, and the great pressure there is upon the nerves and the blood-vessels, it is not at all surprising that she should do so. There is one consolation, that although fainting at such times is disagreeable, it is not at all dangerous, unless the patient be really laboring under a disease of the heart.
366. Treatment.—If the patient feel faint, she ought immediately to lie down flat upon her back, without a pillow under her head; that is to say, her head should be on a level with her body. The stays and any tight articles of dress—if she has been foolish enough to wear either tight stays or tight clothes—ought to be loosened; the windows should be thrown wide open; water ought to be sprinkled on her face; and sal-volatile—a teaspoonful in a wineglassful of water, or a glass of wine ought to be administered. Smelling-salts must be applied to the nostrils. The attendants—there should only be one or two present—should not crowd around her, as she ought to have plenty of room to breathe.
367. She must, in the intervals, live on a good, light, generous diet. She should keep early hours, and ought to sleep in a well-ventilated apartment. The following strengthening medicine will be found serviceable:
Take of—Sulphate of Quinine, twelve grains;
Diluted Sulphuric Acid, half a drachm;
Syrup of Orange-peel, half an ounce;
Water, seven ounces and a half:
Two tablespoonfuls of the mixture to be taken three times a day.
If she be delicate, a change either to the country, or, if the railway journey be not very long, to the coast, will be desirable.
368. A nervous patient during this period is subject to palpitation of the heart. This palpitation, provided it occur only during pregnancy, is not dangerous; it need therefore cause no alarm. It is occasioned by the pressure of the pregnant womb upon the large blood-vessels, which induces a temporary derangement of the heart’s action. This palpitation is generally worse at night, when the patient is lying down. There is, at these times, from the position, greater pressure on the blood-vessels. Moreover, when she is lying down, the midriff, in consequence of the increased size of the belly, is pressed upward, and hence the heart has not its accustomed room to work in, and palpitation is in consequence the result.
369. The best remedies will be either half a teaspoonful of compound spirits of lavender or a teaspoonful of sal-volatile in a wineglassful of camphor julep,[[68]] or a combination of lavender and of sal-volatile:
Take of—Compound Spirits of Lavender, one drachm;
Sal-Volatile, eleven drachms:
Mix.—A teaspoonful of the drops to be taken occasionally in a wineglassful of water.
370. These medicines ought to lie on a table by the bedside of the patient, in order that they may, if necessary, be administered at once. Brandy is in these cases sometimes given, but it is a dangerous remedy to administer every time there is palpitation; while the lavender and the sal-volatile are perfectly safe medicines, and can never do the slightest harm.
371. Mental emotion, fatigue, late hours, and close rooms ought to be guarded against. Gentle out-door exercise, and cheerful but not boisterous company are desirable.
372. Cramps of the legs and of the thighs during the latter period, and especially at night, are apt to attend pregnancy, and are caused by the womb pressing upon the nerves which extend to the lower extremities. Treatment.—Tightly tie a handkerchief folded like a neckerchief round the limb a little above the part affected, and let it remain on for a few minutes. Friction by means of the hand either with opodeldoc or with laudanum (taking care not to drink it by mistake) will also give relief. Cramp sometimes attacks either the bowels or the back of a pregnant woman; when such is the case, let a bag of hot salt, or a hot-water bag,[[69]] or a tin stomach warmer filled with hot water and covered with flannel, or a stone bottle containing hot water, wrapped in flannel, be applied over the part affected; and let either a stone bottle of hot water or a hot brick, which should be incased in flannel, be placed to the soles of the feet. If the cramp of the bowels, of the back, or of the thighs be very severe, the following mixture will be serviceable:
Take of—Compound Tincture of Camphor, one ounce;
Dill Water, five ounces:
A wineglassful of this mixture to be taken at bedtime occasionally, and to be repeated, if necessary, in four hours.
373. “The whites,” during pregnancy, especially during the latter months, and particularly if the lady has had many children, are frequently troublesome, and are, in a measure, owing to the pressure of the womb on the parts below causing irritation. The best way, therefore, to obviate such pressure, is for the patient to lie down a great part of each day either on a bed or on a sofa.
374. She ought to retire early to rest; she should sleep on a horse-hair mattress and in a well-ventilated apartment, and she must not overload her bed with clothes. A thick, heavy quilt at these times, and indeed at all times, is particularly objectionable; the perspiration cannot pass readily through it as through blankets, and thus she is weakened. She ought to live on plain, wholesome, nourishing food; but she must abstain from beer and wine and spirits. The bowels ought to be gently opened by means of a Seidlitz powder, which should occasionally be taken early in the morning.
375. The best application will be, to bathe the parts with warm fuller’s earth and water, in the proportion of a handful of powdered fuller’s earth to half a wash-hand-basinful of warm water; and the internal parts ought, night and morning, to be bathed with it. If the fuller’s earth should not have the desired effect, an alum injection[[70]] ought, every night and morning, by means of an india-rubber vaginal syringe,[[71]] to be syringed up the parts; or fifteen drops of solution of diacetate of lead should be added to a quarter of a pint of lukewarm water, and be used in a similar manner as the alum injection.
376. Cleanliness, in these cases, cannot be too strongly urged. Indeed, every woman, either married or single, ought, unless special circumstances forbid, to use either the bidet or a sitz-bath. If she has not the “whites,” or if she has them only slightly, cold, quite cold water is preferable to tepid. I should advise, then, every lady, both married and single, whether she has the “whites” or not, a regular sitz-bath[[72]] every morning (except during her “poorly times”)—that is to say, I should recommend her to sit every morning in the water (in cold water) for a few seconds, or while she can count a hundred; throwing the while either a small blanket or shawl over her shoulders, but having no other clothing on except slippers on her feet. She should, for the first few mornings, make the water lukewarm; but the sooner she can use it cold—quite cold—the more good it will do her.
377. If the above plan were more generally followed, women of all classes and ages would derive immense benefit from its adoption, and many serious diseases would be warded off. Besides, the use of the sitz-bath, after a time, would be a great comfort and enjoyment.
378. Where a lady suffers severely from the “whites,” she ought to visit the coast. There is nothing in such cases that generally affords so much relief as the bracing effects of sea-air. Of course, if she be pregnant, she ought not to bathe in the sea, but should, every night and morning, bathe the external parts with sea water.
379. When the patient has been much weakened by the “whites,” she will derive benefit from a quinine mixture[[73]]—a dose of which ought to be taken twice or three times a day.
380. Irritation and itching of the external parts.—This is a most troublesome affection, and may occur at any time, but more especially during the latter period of the pregnancy; and as it is a subject that a lady is too delicate and too sensitive to consult a medical man about, I think it well to lay down a few rules for her relief. The misery it entails, if not relieved, is almost past endurance.
381. Well, then, in the first place, let her diet be simple and nourishing; let her avoid stimulants of all kinds. In the next place, and this is a most important item of treatment, let her use a tepid salt and water sitz-bath.[[74]]
382. The way to prepare the bath is to put a large handful of table salt into the sitz-bath, then to add cold water to the depth of three or four inches, and sufficient hot water to make the water tepid or lukewarm. The patient must sit in the bath; her slippered feet being, of course, out of the water, and on the ground, and either a woolen shawl or a small blanket being thrown over her shoulders: which shawl or blanket ought to be the only covering she has on the while. She should remain only for a few seconds, or while she can count, in the winter, fifty, or the summer, a hundred, in the bath. Patients generally derive great comfort and benefit from these salt and water sitz-baths.
383. If the itching, during the daytime, continue, the following lotion ought to be used:
Take of—Solution of Diacetate of Lead, one drachm;
Rectified Spirits of Wine, one drachm;
Distilled Water, one pint:
To make a lotion. The parts affected to be bathed three or four times a day with the lotion. Or the parts may be bathed two or three times a day with equal parts of vinegar and water.
384. The external parts, and the passage to the womb (the vagina), in these cases, are not only irritable and itching, but are sometimes hot and inflamed, and are covered either with small pimples, or with a whitish exudation of the nature of aphtha (thrush), somewhat similar to the thrush on the mouth of an infant; then the addition of glycerin to the lotion is a great improvement, and usually gives immense relief. Either of the following is a good lotion for the purpose:
Take of—Biborate of Soda, eight drachms;
Glycerin five ounces;
Distilled Water, ten ounces:
To make a lotion. The part affected to be bathed every four hours with the lotion, first shaking the bottle.
Or,
Take of—Solution of Diacetate of Lead,
Rectified Spirits of Wine, of each, one drachm;
Glycerin, five ounces;
Rose Water, ten ounces and a half:
To make a lotion. To be used in the same manner as the preceding one.
MISCARRIAGE.
385. If a premature expulsion of the child occur before the end of the seventh month, it is called either a miscarriage or an abortion; if between the seventh month and before the full period of nine months, a premature labor.
386. There is a proneness for a young wife to miscarry, and woe betide her, if she once establish the habit! for it, unfortunately, often becomes a habit. A miscarriage is a serious calamity, and should be considered in that light; not only to the mother herself, whose constitution frequent miscarriages might seriously injure, and eventually ruin; but it might rob the wife of one of her greatest earthly privileges, the inestimable pleasure and delight of being a mother!
387. Now, as a miscarriage may generally be prevented, it behooves a wife to look well into the matter, and to study the subject thoroughly for herself, in order to guard against her first miscarriage; for the first miscarriage is the one that frequently leads to a series. How necessary it is that the above important fact should be borne in mind! How much misery might be averted; as, then, means would, by avoiding the usual causes, be taken to ward off such an awful calamity. I am quite convinced that in the majority of cases, miscarriages may be prevented.
388. Hence the importance of a popular work of this kind, to point out dangers, to give judicious advice, that a wife may read, ponder over, and “inwardly digest,” and that she may see the folly of the present practices that wives—young wives especially—usually indulge in, and thus, that she may avoid the rocks they split on, which make a shipwreck of their most cherished hopes and treasures.
389. Let it then be thoroughly understood,—first, that a miscarriage is very weakening—more weakening than a labor; and, secondly, that if a lady has once miscarried, she is more likely to miscarry again and again; until, at length, her constitution is broken, and the chances of her having a child become small indeed!
390. Causes.—A slight cause will frequently occasion the separation of the child from the mother, and the consequent death and expulsion of the fœtus; hence the readiness with which a lady sometimes miscarries. The following are the most common causes of a young wife miscarrying: Taking long walks; riding on horseback; or over rough roads in a carriage; a long railway journey; overexerting herself, and sitting up late at night. Her mind, just after marriage, is frequently too much excited by large parties, by balls, and concerts.
391. The following are, moreover, frequent causes of a miscarriage: Falls; all violent emotions of the mind, passion, fright, etc.; fatigue; overreaching; sudden shocks; taking a wrong step either in ascending or in descending stairs; falling down stairs; lifting heavy weights; violent drastic purgatives; calomel; obstinate constipation; debility of constitution; consumptive habit of body; fashionable amusements; dancing; late hours; tight lacing; indeed, anything and everything that injuriously affects either the mind or the body.
392. The old maxim that “prevention is better than cure” is well exemplified in the case of a miscarriage. Let me, then, appeal strongly to my fair reader to do all that she can, by avoiding the usual causes of a miscarriage which I have above enumerated, to prevent such a catastrophe. A miscarriage is no trifling matter; it is one of the most grievous accidents that can occur to a wife, and is truly a catastrophe.
393. Threatening or warning symptoms of a miscarriage.—A lady about to miscarry usually, for one or two days, experiences a feeling of lassitude, of debility, of malaise, and depression of spirits; she feels as though she were going to be taken “poorly;” she complains of weakness and of uneasiness about the loins, the hips, the thighs, and the lower part of the belly. This is an important stage of the case, and one in which a judicious medical man may, almost to a certainty, be able to stave off a miscarriage.
394. More serious, but still only threatening symptoms of a miscarriage.—If the above symptoms are allowed to proceed, unchecked and untended, she will, after a day or two, have a slight show of blood; this show may soon increase to a flooding, which will shortly become clotted. Then, perhaps, she begins for the first time to dread a miscarriage! There may at this time be but little pain, and the miscarriage might, with judicious treatment, be even now warded off. At all events, if the miscarriage cannot be prevented, the ill effects to her constitution may, with care, be palliated, and means may be used to prevent a future miscarriage.
395. Decided symptoms of a miscarriage.—If the miscarriage be still proceeding, a new train of symptoms develop themselves; pains begin to come on, at first slight, irregular, and of a “grinding” nature, but which soon become more severe, regular, and “bearing down.” Indeed, the case is now a labor in miniature; it becomes le commencement de la fin; the patient is sure to miscarry, as the child is now dead, and separated from its connection with the mother.
396. The most usual time for a lady to miscarry is from the eighth to the twelfth week. It is not, of course, confined to this period, as during the whole time of pregnancy there is a chance of a premature expulsion of the contents of the womb. A miscarriage before the fourth month is at the time attended with little danger; although, if neglected, it may forever injure the constitution.
397. There is, in every miscarriage, more or less of flooding, which is the most important symptom. After the fourth month it is accompanied with more risk; as the further a lady is advanced in her pregnancy, the greater is the danger of increased flooding; notwithstanding, under judicious treatment, there is every chance of her doing well.
398. A medical man ought in such a case always to be sent for. There is as much care required in a miscarriage as, or more than, in a labor.
399. If bearing down, expulsive pains—similar to labor pains—should accompany the flooding; if the flooding increase, and if large clots come away; if the breasts become smaller and softer; if there be coldness, and heaviness, and diminution in the size of the belly; if the motion of the child (the patient having quickened) cannot be felt; if there be “the impression of a heavy mass rolling about the uterus [womb], or the falling of the uterine tumor from side to side in the abdomen [belly] as the patient changes her position;”[[75]] and if there be an unpleasant discharge, she may rest assured that the child is dead, and that it is separated from all connection with her, and that the miscarriage must proceed, it being only a question of time. Of course, in such a case—if she has not already done so—she ought immediately to send for a medical man. A miscarriage sometimes begins and ends in a few days—five or six; it at other times continues a fortnight, and even in some cases three weeks.
400. Treatment.—If a patient has the slightest “show,” she ought immediately to confine herself either to a sofa or she should keep in bed. A soft feather bed must be avoided; it both enervates the body and predisposes to a miscarriage. There is nothing better for her to sleep on than a horse-hair mattress. She either ought to lie flat upon her back or should lie upon her side, as it is quite absurd for her merely to rest her legs and feet, as it is the back and the belly, not the feet and the legs, that require rest.
401. Let her put herself on a low diet, such as on arrow-root, tapioca, sago, gruel, chicken-broth, tea, toast and water, and lemonade; and whatever she does drink ought, during the time of the miscarriage, to be cold. Grapes, at these times, are cooling and refreshing.
402. The temperature of the bedroom should be kept cool; and, if it be summer, the window ought to be thrown open; aperient medicines must be avoided; and if the flooding be violent, cold water should be applied externally to the parts.
403. Let me strongly urge upon the patient the vast importance of preserving any and every substance that might come away, in order that it may be carefully examined by the medical man.
404. It is utterly impossible for a doctor to declare positively that a lady has miscarried, and that all has properly come away, if he have not had an opportunity of examining the substances for himself. How often has a lady declared to her medical man that she has miscarried, when she has only parted with clots of blood! Clots sometimes put on strange appearances, and require a practiced and professional eye to decide at all times upon what they really are.
405. The same care is required after a miscarriage as after a labor; indeed, a patient requires to be treated much in the same manner—that is to say, she ought for a few days to keep her bed, and should live upon the diet I have recommended after a confinement, avoiding for the first few days stimulants of all kinds. Many women date their ill state of health to a neglected miscarriage; it therefore behooves a lady to guard against such a catastrophe.
406. A patient prone to miscarry, ought, before she become pregnant again, to use every means to brace and strengthen her system. The best plan that she can adopt will be TO LEAVE HER HUSBAND FOR SEVERAL MONTHS, and go to some healthy spot; neither to a fashionable watering-place nor to a friend’s house, where much company is kept, but to some quiet country place; if to a healthy farm-house so much the better.
407. Early hours are quite indispensable. She ought to lie on a horse-hair mattress, and should have but scant clothing on the bed. She must sleep in a well-ventilated apartment. Her diet should be light and nourishing. Gentle exercise ought to be taken, which should alternate with frequent rest.
408. Cold ablutions ought every morning to be used, and the body should be afterward dried with a coarse cloth. If it be winter, let the water be made tepid and let its temperature be gradually lowered until it be used quite cold. A shower-bath is, in these cases, serviceable; it braces and invigorates the system, and is one of the best tonics that she can use.
409. If she be already pregnant it would not be admissible, as the shock of the shower-bath would be too great, and may bring on a miscarriage; but still she ought to continue the cold ablutions.
410. A lady who is prone to miscarry, ought, as soon as she is pregnant, to lie down a great part of every day; she must keep her mind calm and unruffled; she should live on a plain diet; she ought to avoid wine and spirits and beer; she should retire early to rest, and she must have a separate sleeping apartment. She ought as much as possible to abstain from taking opening medicine; and if she be actually obliged to take an aperient—for the bowels must not be allowed to be constipated—she should select the mildest (such as either castor oil or lenitive electuary or syrup of senna), and even of these she ought not to take a larger dose than is absolutely necessary, as a free action of the bowels is a frequent cause of a miscarriage.
411. The external application of castor oil as a liniment, and as recommended at page [144], is a good and safe remedy for a patient prone to miscarry; and if sufficiently active, is far preferable to the mildest aperient. Another great advantage of the external application of castor oil is, it does not afterward produce constipation as the internal administration of castor oil is apt to do. If the external application of castor oil in the manner advised at page [144] should not have the desired effect, then an enema—a clyster of warm water, a pint—ought, in the morning, two or three times a week to be administered.
412. Gentle walking exercise daily is desirable: long walks and horseback exercise ought to be sedulously avoided. A trip to the coast, provided the railway journey be not very long, would be likely to prevent a miscarriage; although I would not, on any account, recommend such a patient either to bathe or to sail on the water, as the shock of the former would be too great, and the motion of the vessel and the sea-sickness would be likely to bring on what we are anxious to avoid.
413. As the usual period for miscarrying approaches (for it frequently comes on at one particular time), let the patient be more than usually careful; let her lie down the greatest part of the day; let her mind be kept calm and unruffled; let all fashionable society and every exciting amusement be eschewed; let both the sitting and the sleeping apartments be kept cool and well ventilated; let the bowels (if they be costive) be opened by an enema (if the external application of castor oil, as before recommended, be not sufficient); let the diet be simple and yet be nourishing; let all stimulants, such as beer, wine, and spirits, be at this time avoided; and if there be the slightest symptoms of an approaching miscarriage, such as pains in the loins, in the hips, or in the lower belly, or if there be the slightest show of blood, let a medical man be instantly sent for, as he may, at an early period, be able to ward off the threatened mishap.
FALSE LABOR PAINS.
414. A lady, especially in her first pregnancy, is sometimes troubled with spurious labor pains; these pains usually come on at night, and are frequently owing to a disordered stomach. They affect the belly, the back, and the loins; and occasionally they extend down the hips and the thighs. They attack first one place and then another; they come on at irregular intervals; at one time they are violent, at another they are feeble. The pains, instead of being grinding or bearing down, are more of a colicky nature.
415. Now, as these false pains more frequently occur in a first pregnancy, and as they are often more violent two or three weeks toward the completion of the full time, and as they usually come on either at night or in the night, it behooves both the patient and the monthly nurse to be cognizant of the fact, in order that they may not make a false alarm and summon the doctor before he is wanted, and when he cannot be of the slightest benefit to the patient.
416. It is sometimes stated that a woman has been in labor two or three weeks before the child was born! Such is not the fact. The case in question is one probably of false pains ending in true pains.
417. How, then, is the patient to know that the pains are false and not true labor pains? False labor pains come on three or four weeks before the full time; true labor pains at the completion of the full time; false pains are unattended with “show;” true pains generally commence the labor with “show;” false pains are generally migratory—changing from place to place—first attacking the loins, then the hips, then the lower portions, and even other portions of the belly—first one part, then another; true pains generally begin in the back; false pains commence as spasmodic pains; true pains as “grinding” pains; false pains come on at uncertain periods, at one time a quarter of an hour elapsing, at others, an hour or two hours between each pain; at one time the pain is sharp, at another trifling; true pains come on with tolerable regularity, and gradually increase in severity.
418. But remember—the most valuable distinguishing symptom is the absence of “show” in false labor pains, and the presence of “show” in true labor pains. It might be said that “show” does not always usher in the commencement of labor. Granted; but such cases are exceedingly rare, and may be considered as the exception and not the rule.
419. Treatment.—A dose of castor oil is generally all that is necessary; but if the pains still continue, the patient ought to be abstemious, abstaining for a day or two from beer and from wine, and rubbing the bowels every night at bedtime either with camphorated oil, previously warmed, or with laudanum (taking care not to drink it by mistake). Either hot salt, in a flannel bag, or a hot-water bag applied every night at bedtime to the bowels, frequently affords great relief.
420. If the pains be not readily relieved she ought to send for a medical man. A little appropriate medicine will soon have the desired effect.
421. These false labor pains might go on either for days, or even for weeks, and at length may terminate in real labor pains.
PERIOD OF GESTATION—“THE COUNT.”
422. The period of gestation is usually[[76]] two hundred and eighty days—forty weeks—ten lunar or nine calendar months.
423. It will be well for a lady, in making her “count,” to commence her “reckoning” about three days after the last day of her being “unwell.” The reason we fix on a woman conceiving a few days after she has “ceased to be unwell” is that she is more apt to do so soon after menstruation than at any other time.[[77]]
424. A good plan to make the “reckoning” is as follows: Let forty weeks and a few days, from the time specified above, be marked on an almanac, and a lady will seldom be far from her calculation. Suppose, for instance, the last day of her “ceasing to be unwell” was on January the 15th, she may expect to be confined very near October 23d.
425. Another plan, and one recommended by Dr. Tanner, to make the “count,” is the following: “To effect this readily, we cannot do better than follow the plan of most German obstetricians, who learn the probable day of delivery thus: the date of the last menstruation being given, they calculate three months backward and add seven days. For example, suppose the 20th January to be the last day of the last menstrual period, labor will be due about the 27th October—i.e. on the 280th day.”[[78]]
BEING OUT IN THE RECKONING.
426. A lady, sometimes, by becoming pregnant while she is suckling, is put out of her reckoning; not being unwell at such time, she consequently does not know how to “count.” She ought, in a case of this kind, to reckon from the time that she quickens—that is to say, she must then consider herself nearly half-gone in her pregnancy, and to be within a fortnight of half her time; or, to speak more accurately, as soon as she has quickened, we have reason to believe that she has gone about one hundred and twenty-four days: she has therefore about one hundred and fifty-six more days to complete the period of her pregnancy. Suppose, for instance, that she first quickened on May the 17th, she may expect to be confined somewhere near October the 23d. She must bear in mind, however, that she can never make so correct a “count” from quickening (quickening takes place at such various periods) as from the last day of her being “unwell.”
427. A lady is occasionally thrown out of her reckoning by the appearance, the first month after she is enceinte, of a little “show.” This discharge does not come from the womb, as that organ is hermetically sealed; but from the upper part of the vagina, the passage to the womb, and from the mouth of the womb, and may be known from the regular menstrual fluid by its being much smaller in quantity, by its clotting, and by its lasting generally but a few hours. This discharge, therefore, ought not to be reckoned in the “count,” but the one before must be the guide, and the plan should be adopted as recommended in page [186], paragraph 423.
“IS IT A BOY OR A GIRL?”
428. It has frequently been asked, “Can a medical man tell, before the child is born, whether it will be a boy or girl?” Dr. F. J. W. Packman, of Wimborne, answers in the affirmative. “Queen bees lay female eggs first, and male eggs afterward. In the human female, conception in the first half of the time between menstrual periods produces female offspring, and male in the latter. When a female has gone beyond the time she calculated upon, it will generally turn out to be a boy.”[[79]] It is well to say generally, as the foregoing remarks are not invariably to be depended upon, as I have had cases to prove. Notwithstanding, I believe that there is a good deal of truth in Mr. Packman’s statement.
MONTHLY NURSE.
429. It is an important, a most important, consideration to choose a nurse rightly and well.
430. A monthly nurse ought to be middle-aged. If she be young, she is apt to be thoughtless and giggling; if she be old, she may be deaf and stupid, and may think too much of her trouble. She should have calmness and self-possession. She must be gentle, kind, good-tempered, and obliging, but firm withal, and she should have a cheerful countenance. “Some seem by nature to have a vocation for nursing; others not. Again, nursing has its separate branches; some have the light step, the pleasant voice, the cheering smile, the dextrous hand, the gentle touch; others are gifted in cookery for the sick.”[[80]] The former good qualities are essential to a monthly nurse, and if she can combine the latter—that is to say, “if she is gifted in cookery for the sick”—she will, as a monthly nurse, be invaluable. Unless a woman have the gift of nursing, she will never make a nurse. “Dr. Thynne held that sick-nurses, like poets, were born, not made.”[[81]]
431. She ought neither to be a tattler, nor a tale-bearer, nor a “croaker,” nor a “potterer.” A tattler is an abomination; a clacking tongue is most wearisome and injurious to the patient. A tale-bearer is to be especially avoided; if she tell tales of her former ladies, my fair reader may depend upon it that her turn will come.[[82]] But of all nurses to be shunned as the plague is the “croaker,” one that discourses of the dismal and of the dreadful cases that have occurred in her experience, many of which, in all probability, she herself was the cause of. She is a very upas-tree in a house. A “potterer” should be banished from the lying-in room; she is a perpetual worry—a perpetual blister! She is a nurse without method, without system, and without smartness. She potters at this and potters at that, and worries the patient beyond measure. She dreams, and drawls, and “potters.” It is better to have a brusque and noisy nurse than a pottering one—the latter individual is far more irritating to the patient’s nerves, and is aggravating beyond endurance. “There is one kind of nurse that is not uncommon in hospitals [and in lying-in rooms], and that gives more trouble and worry than all the others together, viz., the ‘pottering’ nurse. Of all nuisances, defend us from a potterer.... The woman always has the very best intentions in the world, but is totally devoid of method and smartness. You never know when she has begun anything, and you certainly will never know when she has finished it. She never does finish it, but she sometimes leaves off.... She seems incapable of taking in a complete and accurate idea of anything, and even while you are speaking to her it is easy to see that her attention cannot be concentrated, and that her mind is flying about among half a dozen subjects. If she is in the least hurried, she loses what little intellect she ordinarily possesses, moans feebly in a sotto voce monotone, fetches the wrong articles, does the wrong thing at the wrong time, and is always in the way.”[[83]]
432. Some monthly nurses have a knack of setting the servants at loggerheads, and of poisoning the minds of their mistresses toward them. They are regular mischief-makers, and frequently cause old and faithful domestics to leave their situations. It will be seen, therefore, that it is a momentous undertaking to choose a monthly nurse rightly and well.
433. Fortunately for ladies the class of nurses is wonderfully improved, and the race of Sairey Gamp and Betsey Prig is nearly at an end.
434. She ought to be either a married woman or a widow. A single woman cannot so well enter into the feelings of a lying-in patient, and has not had the necessary experience. Moreover, a single woman, as a rule, is not so handy with an infant (more especially in putting him for the first time to the breast) as a married woman.
435. She must be sober, temperate, and healthy, and free from deafness and from any defect of vision. She should have a gentle voice and manner, but yet be neither melancholy nor hippish. She ought to be fond of children, and must neither mind her trouble nor being disturbed at night. She should be a light sleeper. “Scrupulous attention to cleanliness, freshness, and neatness” in her own person, and toward the lady and the infant, are most important requisites.
436. A fine lady-nurse that requires to be constantly waited upon by a servant is not the one that I would recommend. A nurse should be willing to wait upon herself, upon her mistress, and upon the baby with alacrity, with cheerfulness, and without assistance, or she is not suitable for her situation.
437. As the nurse, if she does her duty, devotes her time, her talent, and her best energies to the lady and infant, a mistress ought to be most liberal in the payment of a monthly nurse. A good one is cheap at almost any price, while a bad one, though she come for nothing, is dear indeed. A cheap nurse is frequently the ruin of the patient’s and of the baby’s health, and of the peace of a household.
438. The monthly nurse ought to be engaged early in the pregnancy, as a good nurse is caught up soon, and is full of engagements. This is most important advice. A lady frequently has to put up with an indifferent nurse from neglecting to engage her betimes. The medical man at the eleventh hour is frequently besought to perform an impossibility—to select a good nurse; and which he could readily have done if time had been given him to make the selection. Some of my best nurses are engaged by my patients as early as two or three months after the latter have conceived, in order to make sure of having their favorite nurses. My patients are quite right; a good nurse is quite of as much importance to her well-doing as a good doctor; indeed, a bad nurse oftentimes makes a good doctor’s efforts perfectly nugatory.
439. It is always desirable, whenever it be possible, that the doctor in attendance should himself select the monthly nurse, as she will then be used to his ways, and he will know her antecedents—whether she be sober, temperate, and kind, and that she understands her business, and whether she be in the habit of attending and of following out his directions, for frequently a nurse is self-opinionated, and fancies that she knows far better than the medical man. Such a nurse is to be scrupulously avoided. There cannot be two masters in a lying-in room; if there be, the unfortunate patient will inevitably be the sufferer. A doctor’s directions must be carried out to the very letter. It rests with the patient to select a judicious medical man, who, although he will be obeyed, will be kind and considerate to the nurse.
440. A monthly nurse ought to be in the house a week or ten days before the commencement of the labor, in order that there may be neither bustle nor excitement, and no hurrying to and fro at the last moment to find her; and that she may have everything prepared, and the linen well aired for the coming event.
441. She must never be allowed, unless ordered by the medical man, to give either the patient or the baby a particle of medicine. A quacking monthly nurse is an abomination. An infant who is everlastingly being drugged by a nurse is sure to be puny and delicate.
442. A monthly nurse ought to understand the manner of putting on and of tightening the bandage after a confinement. This, every night and morning, she must do. The doctor generally does it the first time himself, viz., immediately after the labor. It requires a little knack, and if the nurse be at all awkward in the matter, the medical man will only be too happy to show her the way, for he is quite aware the support, the comfort, and the advantage it will be to his patient, and he will be glad to know that the nurse herself will be able to continue putting it on properly for some weeks—for at least three weeks—after the lying-in.
443. If nurses better understood the proper method of bandaging patients after their labors, there would not be so many ladies with pendulous bellies and with ungainly figures. It is a common remark that a lady’s figure is spoiled in consequence of her having had so many children. This, provided efficient bandaging after every confinement had been properly resorted to, ought not to be. But then, if a monthly nurse is to do those things properly, she ought to be properly trained, and many of them have little or no training; hence the importance of choosing one who thoroughly knows and will conscientiously do her duty.
444. A monthly nurse who thoroughly understands her business will always have the lying-in room tidy, cheerful, and well ventilated. She will not allow dirty linen to accumulate in the drawers, in corners, and under the bed; nor will she allow any chamber utensil to remain for one moment in the room after it has been used. If it be winter, she will take care that the fire in the grate never goes out, and that it is never very large, and that the room is kept as nearly as possible at one temperature—namely, at 60° Fahrenheit. She will use her authority as a nurse, and keep the other children from frequently running into the room, and from exciting and disturbing her mistress; and she will make a point of taking charge of the baby, and of keeping him quiet while the mother, during the day, is having her necessary sleep.
445. A good monthly nurse fully comprehends and thoroughly appreciates the importance of bathing the external parts concerned in parturition every night and morning, and sometimes even oftener, for at least two or three weeks after a confinement. And if the medical man deem it necessary, she ought to understand the proper manner of using a vaginal syringe. If the nurse be self-opinionated, and tries to persuade her mistress not to have proper ablution—that such ablution will give cold—she is both ignorant and prejudiced, and quite unfit for a monthly nurse; and my advice is, that a lady ought on no account to engage such a person a second time.
446. In another part of this work I have entered fully on the vital importance of ablution after a confinement, and I need not say more than again to urge my fair reader to see that the monthly nurse properly carries it out, and that, if there be any objections made to it by the nurse, the medical man be appealed to in the matter, and that his judgment be final. Assured I am that every doctor who understands his profession will agree with me, that the regular ablution of the parts after a labor is absolutely indispensable. The nurse, of course, will take care to guard the bed from being wet, and will not expose the patient unnecessarily during the process; she will be quick over it, and she will have in readiness soft, warm, dry towels to speedily dry the parts that have been bathed. The above is most important advice, and I hope that my fair inquirer will engage a monthly nurse that will do her duty in the matter.
447. Before concluding a list of some of the duties of a monthly nurse, there are four more pieces of advice I wish to give both to a wife and to a monthly nurse herself, which are these: (1) Never to allow a nurse, until she be ordered by the doctor, to give either brandy, or wine, or porter, or ale to the patient. (2) I should recommend every respectable monthly nurse to carry about with her an india-rubber vaginal syringe. One of the best for the purpose is Higginson’s syringe,[[84]] which is one constructed to act either as an enema apparatus, or, by placing the vaginal pipe over the enema pipe, as a vaginal syringe. She will thus be armed at all points, and will be ready for any emergency. It is an admirable invention, and cannot be too well known. (3) I should advise a monthly nurse while on duty, whatever she may do at other times, to doff her crinoline. A woman nursing a baby with a stuck-out crinoline is an absurdity, and if it were not injurious both to the mother and to the infant (as the nurse in crinoline cannot do her duty either to the one or to the other) she would be a laughable object. A new-born baby pillowed in steel! (4) I should recommend every monthly nurse, while in the lying-in room, to wear either list slippers or the rubber slippers, as creaking shoes are very irritating to a patient. “Nurses at these times should wear slippers and not shoes. The best slippers in sick-rooms are those manufactured by the North British Rubber Company, Edinburgh: they enable nurses to walk in them about the room without causing the slightest noise; indeed, they may be called ‘the noiseless slipper’—a great desideratum in such cases, more especially in all head affections of children. If the above slippers cannot readily be obtained, then list slippers—soles and all being made of list—will answer the purpose equally as well.”[[85]]
PART III.
LABOR.
THE PRECURSORY SYMPTOMS OF LABOR.
448. A day or two before the labor commences, the patient usually feels better than she has done for a long time; she is light and comfortable; she is smaller, and the child is lower down; she is more cheerful, breathes more freely, and is more inclined to take exercise, and to attend to her household duties.
449. A few days, sometimes a few hours, before labor commences, the child “falls,” as it is called, that is to say, there is a subsidence—a dropping—of the womb lower down the belly. This is the reason why she feels lighter and more comfortable, and more inclined to take exercise, and why she can breathe more freely.
450. The only inconvenience of the subsidence of the womb is that the womb presses on the bladder, and sometimes causes an irritability of that organ, inducing a frequent desire to make water.
451. The subsidence—the dropping—of the womb may then be considered one of the earliest of the precursory symptoms of the labor, and as the herald of the coming event.
452. She has, at length, slight pains, and then she has a “show,” as it is called; which is the coming away of a mucous plug, which, during pregnancy, had hermetically sealed the mouth of the womb. The “show” is generally tinged with a little blood. When a “show” takes place, she may rest assured that labor has actually commenced. One of the early symptoms of labor is a frequent desire to relieve the bladder.
453. She has now “grinding pains,” coming on at uncertain periods; sometimes once during two hours, at other times every hour or half hour. These “grinding pains” ought not to be interfered with; at this stage, therefore, it is useless to send for a doctor; yet the monthly nurse should be in the house, to make preparations for the coming event. Although, at this early period, it is not necessary to send for the medical man, nevertheless, it is well to let him know that his services might shortly be required, in order that he might be in the way, or that he might leave word where he might quickly be found.
454. These “grinding pains” gradually assume more regularity in their character, return at shorter intervals, and become more severe. About this time, shivering, in the majority of cases, is apt to occur, so as to make the teeth chatter again. Shivering during labor is not an unfavorable symptom; it proves, indeed, that the patient is in real earnest, and that she is making progress.
455. She ought not, on any account, unless it be ordered by the medical man, to take brandy as a remedy for the shivering. A cup either of hot tea or of hot gruel will be the best remedy for the shivering; and an extra blanket or two should be thrown over her, which ought to be well tucked around her, in order to thoroughly exclude the air from the body. The extra clothing should, as soon as she is warm and perspiring, be gradually removed, as she ought not to be kept very hot, or it will weaken her, and will thus retard her labor.
456. Sickness frequently comes on in the beginning of the labor, and may continue during the whole process. She is not only sick, but she actually vomits, and she can keep little or nothing on her stomach.
457. Now, sickness in labor is rather a favorable symptom, and is usually indicative of a kind and easy confinement. There is an old saying that “sick labors are safe.” Although they may be safe, they are decidedly disagreeable!
458. In such a case there is little or nothing to be done, as the less an irritable stomach is meddled with the better. The sickness will probably leave as soon as the labor is over. Brandy, unless prescribed by the medical man, ought not to be given.
459. She must not, on any account, force down—as her female friends or as a “pottering” old nurse may advise to—“grinding pains:” if she do, it will rather retard than forward her labor.
460. She had better, during this stage, either walk about or sit down, and not confine herself to bed; indeed, there is no necessity for her, unless she particularly desire it, to remain in her chamber.
461. If, at the commencement of the labor, the “waters should break,” even if there be no pain, the medical man ought immediately to be sent for; as, in such a case, it is necessary that he should know the exact presentation of the child.
462. After an uncertain length of time, the character of the pains alters. From being “grinding,” they become “bearing down,” and are now more regular and frequent, and the skin becomes both hot and perspiring. These may be considered the true labor pains. The patient ought to bear in mind then that “the true labor pains are situated in the back and loins; they come on at regular intervals, rise gradually up to a certain pitch of intensity, and abate as gradually; it is a dull, heavy, deep sort of pain, producing occasionally a low moan from the patient; not sharp or twinging, which would elicit a very different expression of suffering from her.”[[86]]
463. As soon as the pains assume a “bearing down” character, the medical man ought to be in attendance; if he be sent for during the early stage, when the pains are of a “grinding” character, and when they come on “few and far between,” and at uncertain intervals (unless, as before stated, “the waters should break” early), he can do no good; for if he attempt in the early stage to force on the labor, he might do irreparable mischief.
464. Cramps of the legs and of the thighs are a frequent, although not a constant, attendant on labor. These cramps come on more especially if the patient be kept for a lengthened period in one position; hence the importance of allowing her, during the first and the second stages of labor, to move about the room.
465. Cramps are generally worse during the third or last stage of labor, and then, if they occur at all, they usually accompany each pain. The poor patient, in such a case, has not only to bear the labor pains but the cramp pains! Now, there is no danger in these cramps; it is rather a sign that the child is making rapid progress, as he is pressing upon the nerves which supply the thighs.
466. The nurse ought to well rub, with her warm hand, the cramped parts; and, if the labor be not too far advanced, it would be well for the patient to change her position, and to sit on a chair, or, if she feel inclined, to walk about the room; there being of course an attendant, one on each side, to support her the while. If either a pain or a cramp should come on while she is thus moving about, let her instantly take hold of the bedpost for support.
467. I observe, in a subsequent paragraph, that in a case of labor, a four-post mahogany bedstead without a foot-board is preferable to either a brass or an iron bedstead. It will now be seen that this was one of my reasons for advising the old-fashioned bedstead; as the support of a bedpost is oftentimes a relief and a comfort. The new-fashioned mahogany bedsteads made with fixed foot-board, and both the iron and brass bedsteads with railings at the foot, are each and all, during the progress of labor, very inconvenient; as the patient, with either of these kinds of bedsteads, is not able to plant her feet firmly against the bedpost—the foot-board of the former and the railings of the latter being in the way of her doing so. The man who invented these new-fangled bedsteads was an ignoramus in such matters.
468. Labor—and truly it may be called “labor”[[87]]—is a natural process, and therefore ought not unnecessarily to be interfered with, or woe betide the unfortunate patient.
469. I firmly believe that a woman would stand a much better chance of getting well over her confinement without assistance, than if she had been hurried with assistance.
470. In a natural labor very little assistance is needed, and the doctor is only required in the room occasionally, to ascertain that things are going on rightly. Those ladies do best, both at the time and afterward, whose labors are the least interfered with. Bear this in mind, and let it be legibly written on your memory. This advice, of course, only holds good in natural confinements.
471. Meddlesome midwifery cannot be too strongly reprobated. The duty of a doctor is to watch the progress of a labor, in order that, if there be anything wrong, he may rectify it; but if the labor be going on well, he has no business to interfere, and he need not be much in the lying-in room, although he should be in an adjoining apartment.
472. These remarks are made to set a lady right with regard to the proper offices of an obstetrician; as sometimes she has an idea that a medical man is able, by constantly “taking a pain,” to greatly expedite a natural labor. Now, this is a mistaken and mischievous, although a popular notion.
473. The frequent “taking of a pain” is very injurious and most unnatural. It irritates and inflames the passages, and frequently retards the labor.
474. The occasional, but only the occasional, “taking of a pain” is absolutely necessary to enable the medical man to note the state of the parts, and the progress of the labor; but the frequent “taking of a pain” is very objectionable and most reprehensible.
475. As a rule, then, it is neither necessary nor desirable for a medical man to be much in a lying-in room. Really, in a natural labor, it is surprising how very little his presence is required. After he has once ascertained the nature of the case, which it is absolutely necessary that he should do, and has found all going on “right and straight,” it is better, much better, that he retire in the daytime to the drawing-room, in the night season to a bedroom, and thus to allow nature time and full scope to take her own course without hurry and without interference, without let and without hindrance. Nature hates hurry and resents interference.
476. The above advice, for many reasons, is particularly useful. In the first place, nature is not unnecessarily interfered with. Secondly, it allows a patient, from time to time, to empty her bladder and bowels,—which, by giving more room to the adjacent parts, greatly assists and expedites the progress of the labor. Thirdly, if the doctor is not present he is not called upon to be frequently “taking a pain,” which she may request him to do, as she fancies it does her good and relieves her sufferings; but which frequent taking of a pain in reality does her harm, and retards the progress of the labor. No; a doctor ought not to be much in a lying-in room. Although it may be necessary that he be near at hand, within call, to render assistance toward the last, I emphatically declare that in an ordinary confinement—that is to say, in what is called a natural labor—the only time, as a rule, that the presence of the doctor can be useful, is just before the child is born; although he ought to be in readiness, and should therefore be in the house some little time before the event takes place. Let the above most important advice be strongly impressed upon your memory. Oh! if a patient did but know what a blessed thing is patience, and, in an ordinary labor, the importance of non-interference!
477. Bear in mind, then, that in every well-formed woman, and in every ordinary confinement, nature is perfectly competent to bring, without the assistance of man, a child into the world, and that it is only an ignorant person who would, in a natural case of labor, interfere to assist nature.[[88]] Assist nature! Can any thing be more absurd? As though God in his wisdom, in performing one of his greatest wonders and processes, required the assistance of man! It might with as much truth be said that in every case of the process of healthy digestion it is necessary for a doctor to assist the stomach in the process of digesting the food! No; it is high time that such fallacies were exploded, and that common sense should take the place of such folly. A natural labor, then, ought never to be either hurried or interfered with, or frightful consequences might, and in all probability will, ensue. Let every lying-in woman bear in mind that the more patient she is, the more kind and the more speedy will be her labor and her “getting about.” Let her, moreover, remember, then, that labor is a natural process—that all the “grinding” pains she has are doing her good service, are dilating, softening, and relaxing the parts, and preparing for the final or “bearing down” pains; let her further bear in mind that these pains must not, on any account whatever, be interfered with either by the doctor, by the nurse, or by herself. These pains are sent for a wise purpose, and they ought to be borne with patience and resignation, and she will in due time be rewarded for all her sufferings and anxieties by having a living child. Oh, how often have I heard an ignorant nurse desire her mistress to bear down to a “grinding” pain, as though it could do the slightest good! No, it only robs her of her strength and interferes with the process and progress of the labor. Away with such folly, and let nature assert her rights and her glorious prerogative! It might be thought that I am tedious and prolix in insisting on non-interference in a natural labor, but the subject is of paramount importance, and cannot be too strongly dwelt upon, and cannot be too often brought, and that energetically, before the notice of a lying-in woman.
478. Fortunately for ladies, there is great talent in the midwifery department, which would prevent—however anxious a patient may be to get out of her trouble—any improper interference.[[89]]
479. I say improper interference. A case sometimes, although rarely, occurs, in which it might be necessary for the medical man to properly interfere and to help the labor; then the patient must leave herself entirely in the hands of her doctor—to act as he thinks best, and who may find it necessary to use promptness and decision, and thus to save her an amount of unnecessary lingering pain, risk, and anxiety. But these cases, fortunately, are exceptions—rare exceptions—and not the rule.
480. It is, then, absolutely necessary, in some few cases, that a medical man should act promptly and decisively; delay in such emergencies would be dangerous:
“If it were done when ’tis done, then ’twere well
It were done quickly.”
481. There are times, and times without number, when a medical man is called upon to do but little or nothing; and there are others—few and far between—when it is imperatively necessary that he should do a great deal. He ought at all times to be, as gentle as a lamb, but should, in certain contingencies, be as fearless as a lion!
482. Should the husband be present during the labor? Certainly not; but as soon as the labor is over, and all the soiled clothes have been put out of the way, let him instantly see his wife for a few minutes, to whisper in her ear words of affection, of gratitude, and consolation.
483. The first confinement is generally twice the length of time of an after one, and usually the more children a lady has had, the quicker is the labor; but this is by no means always the case, as some of the after labors may be the tedious, while the early confinements may be the quick ones.
484. It ought to be borne in mind, too, that tedious labors are oftentimes natural labors, and that they only require time and patience from all concerned to bring them to a successful issue.
485. It may be said that a first labor, as a rule, lasts six hours, while an after labor probably lasts but three. This space of time, of course, does not usually include the commencement of labor pains, but the time that a lady may be actually said to be in real labor. If we are to reckon from the commencement of the labor, we ought to double the above numbers—that is to say, we should make the average duration of a first labor twelve; of an after labor, six hours.
486. When a lady marries late in life—for instance, after she has passed the age of thirty—her first labor is usually much more lingering, painful, and tedious, demanding a great stock of patience from the patient, from the doctor, and from the friends; notwithstanding which, if she be not hurried and be not much interfered with, both she and the baby generally do remarkably well. Supposing a lady marries late in life, it is only the first confinement that is usually hard and lingering; the after labors are as easy as though she had married when young.
487. Slow labors are not necessarily dangerous; on the contrary, a patient frequently has a better and more rapid recovery, provided there has been no interference, after a tedious than after a quick confinement—proving beyond doubt that nature hates hurry and interference. It is an old saying, and, I believe, a true one, that a lying-in woman must have pain either before or after a labor; and it certainly is far preferable that she should have the pain and suffering before than after the labor is over.
488. It is well for a patient to know that, as a rule, after a first confinement she never has after pains. This is some consolation, and is a kind of compensation for her usually suffering more with her first child.
489. The after pains generally increase in intensity with every additional child. This only bears out, in some measure, what I before advanced, namely, that the pain is less severe and of shorter duration before each succeeding labor, and that the pain is greater and of longer duration after each succeeding one.
490. The after pains are intended by nature to contract—to reduce—the womb somewhat to its non-pregnant size, and to assist clots in coming away, and therefore ought not to be needlessly interfered with. A judicious medical man will, however, if the pains be very severe, prescribe medicine to moderate—not to stop—them. A doctor fortunately possesses valuable remedies to alleviate the after pains.
491. Nature—beneficent nature—ofttimes works in secret, and is doing good service by preparing for the coming event, unknown to all around. In the very earliest stages of labor pain is not a necessary attendant.
492. Although pain and suffering are the usual concomitants of childbirth, there are, nevertheless, well-authenticated cases on record of painless parturition.[[90]]
493. A natural labor may be divided into three stages. The first, the premonitory stage, comprising the “falling” or subsidence of the womb, and the “show.” The second, the dilating stage, which is known by the pains being of a “grinding” nature, and in which the mouth of the womb gradually opens or dilates until it is sufficiently large to admit the exit of the head of the child, when it becomes the third, the completing stage, which is now indicated by the pains being of a “bearing down” expulsive character.
494. Now, in the first or premonitory stage, which is much the longest of the three stages, it is neither necessary nor desirable that the patient should be confined to her room; on the contrary, it is better for her to be moving about the house, and to be attending to her household duties.
495. In the second or dilating stage, it will be necessary that she should be confined to her room, but not to her bed. If the drawing-room be near at hand, she ought occasionally to walk to it, and if a pain should come on the while, lie on the sofa. In this stage it is not at all desirable that she should keep her bed, or even lie much on it. She is better up and about, and walking about the room.
496. In the first and the second stages she must not, on any account, strain or bear down to the pains, as many ignorant nurses advise, as, by robbing her of her strength, it would only retard the labor. Besides, while the mouth of the womb is dilating, bearing down cannot be of the slightest earthly use—the womb is not in a fit state to expel its contents. If by bearing down she could (but which fortunately she cannot) cause the expulsion of the child, it would, at this stage, be attended with frightful consequences—no less than the rupture of the womb! Therefore, for the future, let not a lady be persuaded, either by any ignorant nurse or by any officious friend, to bear down until the last or the complete stage, when a gentle bearing down will assist the pains to expel the child.
491. In the third or completing stage, of course it is necessary that she should lie on a bed, and that she should, as above advised, bear gently down to the pains. The bearing down pains will indicate to her when to bear down.
498. If, toward the last, she be in great pain, and if she feel inclined to do so, let her cry out,[[91]] and it will relieve her. A foolish nurse will tell her that if she make a noise, it will do her harm. Away with such folly, and have nothing to do with such simpletons!
499. Even in the last stage, she ought never to bear down unless the pain be actually upon her; it will do her great harm if she does. In bearing down, the plan is to hold the breath, and strain down as though she were straining to have a stool.
500. By a patient adopting the rules just indicated, much weariness might be avoided; cramp, from her not being kept long in one position, might be warded off; the labor, from her being amused by change of room and scene, might be expedited; and thus the confinement might be deprived of much of its monotony and misery.
501. Nurses sometimes divide a labor into two kinds—a “back labor,” and a “belly labor.” The latter is not a very elegant, although it might be an expressive, term. Now, in a “back labor,” the patient will derive comfort by having her back held by the nurse. This ought not to be done by the bare hand, but let the following plan be adopted: Let a pillow be placed next to the back, and then the nurse should apply firm pressure, the pillow intervening between the back and the nurse’s hand or hands. If the above method be followed, the back will not be injured, which it otherwise would be by the pressure of the hard hand of the nurse. Where the bare hand alone has been applied, I have known the back to continue sore and stiff for days.
502. During the latter stage of labor, the patient ought always to beep her eyelids closed, or the straining might cause an attack of inflammation of the eyes, or, at all events, might make them bloodshot.
503. Let a large room, if practicable, be selected for the labor, and let it be airy and well ventilated; and, if it be summer, take care that the chimney be not stopped. If the weather be intensely hot, there is no objection to the window being from time to time a little opened.
504. The old-fashioned four-post mahogany bedstead is the most convenient for a confinement, and is far preferable either to brass or to iron. The reasons are obvious: in the first place, the patient can, in the last stage of labor, press her feet against the bedpost, which is often a great comfort, relief, and assistance to her. And secondly, while she is walking about the room, and “a pain” suddenly comes on, she can, by holding the bedpost, support herself.
505. If there be a straw mattress and a horse-hair mattress, besides the bed, let the straw mattress be removed; as a high bed is inconvenient, not only to the patient, but to the doctor.
PREPARATIONS FOR LABOR.
506. I should strongly urge a patient not to put everything off to the last. She must take care to have in readiness a good pair of scissors and a skein of whity-brown thread. And she ought to have in the house a small pot of fresh lard—that is to say, unsalted lard,[[92]] that it may be at hand in case it is wanted. Let everything necessary both for herself and the babe be well aired and ready for immediate use, and be placed in such order that all things may, without hurry or bustle, at a moment’s notice, be found.
507. Another preparation for labor, and a most important one, is, attending to the state of the bowels. If they are at all costive, the moment there is the slightest premonitory symptom of labor, she ought to take either a teaspoonful or a dessertspoonful (according to the nature of her bowels, whether she be easily moved or otherwise) of castor oil. If she object to taking the oil, then let her have an enema of warm water, a pint, administered. By adopting either of the above plans she will derive the greatest comfort and advantage. It will prevent her delicacy from being shocked by having her bowels opened, without her being able to prevent them, during the last stage of labor; and it will, by giving the adjacent parts more room, much expedite the confinement and lessen her sufferings.
508. The next thing to be attended to is the way in which she ought to be dressed for the occasion. I would recommend her to put on her clean night-gown, which, in order to keep it clean and unsoiled, should be smoothly and carefully rolled up about her waist; then she ought to wear over it a short bed-gown reaching to the hips, and have on a flannel petticoat to meet it, and then she should put on a dressing-gown over all. If it be winter, the dressing-gown had better either be composed of flannel or be lined with that material. The stays must not be worn, as they would interfere with the progress of the labor.
509. The valances of the bed, and the carpet, and the curtains at the foot of the bed, had better all be removed; they are only in the way, and may get soiled and spoiled.
510. “The guarding of the bed.”—This is done in the following way: Cover the right side of the bed (as the patient will have to lie on her left side), with a large piece—a yard and a half square—of waterproof cloth, or bed-sheeting, as it is sometimes called, which is sold for the purpose;[[93]] over this, folded sheets ought to be placed. If a waterproof cloth cannot be procured, an oil-cloth table-cover will answer the purpose. Either of the above plans will effectually protect the bed from injury.
511. The lying-in room should be kept not hot, but comfortably warm; if the temperature of the room be high, the patient will become irritable, feverish, and restless.
512. Every now and then, in order to change the air, let the door of the room be left ajar; and if, in the early periods of the labor, she should retire for awhile to the drawing-room, let the lying-in room window be thrown wide open, so as to thoroughly ventilate the apartment, and to make it fresh and sweet on her return. If the weather be very warm, the lower sash of the window may for a few inches be opened. It is wonderful how refreshing to the spirits, and how strengthening to the frame, a well-ventilated room is to a lying-in patient.
513. Many attendants are not only unnecessary but injurious. They excite and flurry the patient, they cause noise and confusion, and rob the air of its purity. One lady friend besides the doctor and the monthly nurse is all that is needed.
514. In making the selection of a friend, care should be taken that she is the mother of a family, that she is kind-hearted and self-possessed, and of a cheerful turn of mind. At these times all “chatterers,” “croakers,” and “potterers” ought to be carefully excluded from the lying-in room. No conversation of a depressing character should for one moment be allowed. Nurses and friends who are in the habit of telling of bad cases that have occurred in their experience must be avoided as the plague. If nurses have had bad cases, many of them have probably been of their own making; such nurses, therefore, ought on every account to be shunned.
515. During the progress of the labor, boisterous and noisy conversation ought never to be permitted; it only irritates and excites the patient. Although boisterous merriment is bad, yet at such times quiet, cheerful, and agreeable conversation is beneficial.
516. A mother on these occasions is often present; but of all persons she is the most unsuitable, as, from her maternal anxiety, she tends rather to depress than to cheer her daughter. Though the mother ought not to be in the room, it is, if practicable, desirable that she should be in the house. The patient, in the generality of cases, derives comfort from the knowledge of her mother being so near at hand.
517. Another preparation for labor is to soothe her mind by telling her of the usual safety of confinements, and by assuring her that, in the generality of instances, it is a natural process; and that all she has to do is to keep up her spirits, to adhere strictly to the rules of her doctor, and she will do well.
518. Tell her that “sweet is pleasure after pain;”[[94]] tell her, too, of the exquisite happiness and joy she will feel as soon as the labor is over, as perhaps the greatest thrill of delight a woman ever experiences in this world is when her babe is first born. She, as if by magic, forgets all the sorrow and suffering she has endured. “A woman when she is in travail hath sorrow, because her hour is come; but as soon as she is delivered of the child, she remembereth no more the anguish, for joy that a man is born into the world.”[[95]] Keble, in the Christian Year, well observes:
“Mysterious to all thought,
A mother’s prime of bliss,
When to her eager lips is brought
Her infant’s thrilling kiss.”
Rogers, too, in referring to this interesting event, sweetly sings:
“The hour arrives, the moment wished and feared;
The child is born, by many a pang endeared!
And now the mother’s ear has caught his cry—
Oh! grant the cherub to her asking eye!
He comes—she clasps him; to her bosom pressed,
He drinks the balm of life, and drops to rest.”
519. The doctor, too, will be able to administer comfort to her when he has “tried a pain” or has “taken a pain,” as it is called, and when he can assure her that it “is all right and straight”—that is to say, that the child is presenting in the most favorable position, and that everything is progressing satisfactorily. He will, moreover, be able to inform her of the probable duration of the labor.
520. Let me in this place urge upon the patient the importance of her allowing the medical man to inquire fully into her state. She may depend upon it that this inquiry will be conducted in the most delicate manner. If there be anything wrong in the labor, it is in the early stage, and before the “waters have broken,” that the most good can be done. If a proper examination be not allowed to the medical man whenever he deems it right and proper (and a judicious doctor will do it as seldom as he can), her life, and perhaps that of her child, might pay the penalty of such false delicacy.
521. French brandy, in case it is wanted, ought always to be in the house; but let me impress upon the minds of the attendants the importance of withholding it, unless it be ordered by the doctor, from a lying-in woman. Numbers have fallen victims to brandy being indiscriminately given. I am of opinion that the great caution which is now adopted in giving spirits to women in labor is one reason, among others, of the great safety of the confinements of the present day, compared with those of former times.
522. The best beverage for a patient during labor is either a cup of warm tea, or of gruel, or of arrow-root. It is folly in the extreme, during the progress of labor, to force her to eat: her stomach recoils from it, as at these times there is generally a loathing of food, and if we will, as we always ought to, take the appetite as our guide, we shall never go far wrong.
523. A patient during labor ought frequently to make water; by doing so she will add materially to her ease and comfort, and it will give the adjacent parts more room, and will thus expedite the labor. I wish to call attention to this point, as many ladies, especially with their first children, have, from false delicacy, suffered severely from not attending to it; one of the ill effects of which is inability after the labor is over to make water without the assistance of the doctor, who might in an extreme case deem it necessary to introduce a catheter into the bladder, and thus to draw the water off.
524. I recommended, in a previous paragraph, that the doctor ought to have either the drawing-room or a bedroom to retire to, in order that the patient may, during the progress of the labor, be left very much to herself, and that thus she may have full opportunities, whenever she feels the slightest inclination to do so, of thoroughly emptying either her bladder or her bowels. Now, this advice is of very great importance, and if it were, more than it is, attended to, would cause a great diminution of misery, of annoyance, and suffering. I have given the subject great attention; as I have had large experience in midwifery practice; I therefore speak “like one having authority,” and if my advice in this particular be followed, this book will not have been written in vain.
525. If the patient, twelve hours after the labor, and having tried two or three times during that time, is unable to make water, the medical man ought to be made acquainted with it, or serious consequences might ensue.
CHLOROFORM IN HARD AND IN LINGERING LABOR.
526. Mothers and doctors are indebted to Dr.—now Sir James—Simpson for the introduction of chloroform, one of the greatest and most valuable discoveries ever conferred on suffering humanity.
527. Sulphuric ether was formerly used to cause insensibility to pain; but it is far inferior to chloroform, and is now, in this country, very seldom employed; while the inhalation of chloroform, especially in cases of hard and of lingering labor, is every day becoming more general, and will do so still more extensively as its value is better understood, and when, in well-selected cases, its comparative freedom from danger is sufficiently appreciated.
528. Chloroform, then, is a great boon in midwifery practice; indeed, we may say with Dr. Kidd,[[96]] that in labor cases “it has proved to be almost a greater boon than in the experimental and gigantic operations of the surgeon.” It may be administered in labor by a medical man with perfect safety. I have given it in numerous instances, and have always been satisfied with the result.
529. The inhalation of chloroform causes either partial or complete unconsciousness, and freedom from pain either for a longer or for a shorter time, according to the will of the operator. In other words, the effects might with perfect safety be continued either for a few minutes, or from time to time for several hours; indeed, if given in proper cases, and by a judicious medical man, with immense benefit.
530. Chloroform is more applicable and useful in a labor—more especially in a first labor—when it is lingering, when the pains are very severe, and when, notwithstanding the pain, it is making but little progress,—then chloroform is a priceless boon.
531. Chloroform, too, is very beneficial when the patient is of a nervous temperament, and when she looks forward with dread and apprehension to each labor pain.
532. It might be asked,—Would you give chloroform in every case of labor, be it ever so easy and quick? Certainly not: it is neither advisable nor expedient, in an ordinary, easy, quick labor, to administer it.
533. The cases in which it is desirable to give chloroform are all lingering, hard, and severe ordinary labors. In such I would gladly use it. But before administering it, I would, as a rule, wait for at least six hours from the commencement of the labor.
534. Oh, the delightful and magical effects of it in the cases here described! the lying-in room, from being in a state of gloom, despondency, and misery, is instantly transformed, by its means, into one of cheerfulness, hope, and happiness!
535. When once a lying-in woman has experienced the good effects of chloroform in assuaging her agony, she importunately, at every recurrence of “the pain,” urges her medical man to give her more! In all her subsequent confinements, having once tasted the good effects of chloroform, she does not dread them. I have frequently heard a lady declare that, now (if her labor be either hard or lingering) she can have chloroform, she looks forward to the period of childbirth with confidence and hope.
536. It might be asked,—Does the inhalation of chloroform retard the patient’s “getting about”? I emphatically declare that it does not do so. Those who have had chloroform have always, in my practice, had as good and as speedy recoveries as those who have not inhaled it.
537. One important consideration in the giving of chloroform in labor is, that a patient has seldom, if ever, while under the effects of it, been known to die; which is more than can be said when it has been administered in surgical operations, in the extraction of teeth, etc. “I know there is not one well-attested death from chloroform in midwifery in all our journals.”[[97]]
538. One reason why it may be so safe to give chloroform in labor is, that in the practice of midwifery a medical man does not deem it needful to put his patient under the extreme influence of it. He administers just enough to ease her pain, but not sufficient to rob her of total consciousness; while in a surgical operation the surgeon may consider it necessary to put his patient under the full influence of chloroform: hence the safety in the one, and the danger in the other case. “It is quite possible to afford immense relief, to ‘render the pains quite bearable,’ as a patient of mine observed, by a dose which does not procure sleep or impair the mental condition of the patient, and which all our experience would show is absolutely free from danger.”[[98]]
539. There is another advantage in chloroform,—the child, when he is born, is usually both lively and strong, and is not at all affected by the mother having had chloroform administered to her. This is a most important consideration.
540. The doctor, too, as I before remarked, is deeply indebted to Sir J. Simpson for this great boon: formerly he dreaded a tedious and hard labor; now he does not do so, as he is fully aware that chloroform will rob such a lying-in of much of its terror and most of its pain and suffering, and will in all probability materially shorten the duration of the confinement.
541. Chloroform ought never to be administered, either to a labor patient or to any one else, except by a medical man. This advice admits of no exception. And chloroform should never be given unless it be either in a lingering or in a hard labor. As I have before advised, in a natural, easy, everyday labor, nature ought not to be interfered with, but should be allowed to run its own course. Patience, gentleness, and non-interference are the best and the chief requisites required in the majority of labor cases.
HINTS TO ATTENDANTS IN CASE THE DOCTOR IS UNAVOIDABLY ABSENT.
542. It frequently happens that after the first confinement the labor is so rapid that the child is born before the doctor has time to reach the patient.
543. It is consequently highly desirable—nay, imperatively necessary—for the interest and for the well-doing both of the mother and of the baby, that either the nurse or the lady friend should, in such an emergency, know what to do and what NOT to do. I therefore, in the few following paragraphs, purpose, in the simplest and clearest language I can command, to enlighten them on the subject.
544. In the first place, let the attendants be both calm and self-possessed, and let there be no noise, no scuffling, no excitement, no whispering, and no talking, and let the patient be made to thoroughly understand that there is not the slightest danger; as the principal danger will be in causing unnecessary fears both as to herself and her child. Tens of thousands are annually delivered in England, and everywhere else, without the slightest assistance from a doctor,[[99]]—he not being at hand or not being in time; and yet both mother and child almost invariably do well. Let her be informed of this fact—for it is a fact—and it will be a comfort to her and will assuage her fears. The medical man, as soon as he arrives, will soon make all right and straight.
545. In the mean time let the following directions be followed: Supposing a child to be born before the medical man arrives, the nurse ought then to ascertain whether a coil of navel-string be around the neck of the infant; if it be, it must be instantly liberated, or he might be strangled. Care should be taken that he has sufficient room to breathe, that there be not a “membrane” over his mouth;[[100]] and that his face be not buried in the clothes. Any mucus about the mouth of the babe ought, with a soft napkin, to be wiped away, or it might impede the breathing.
546. Every infant, the moment he comes into the world, ought to cry; if he does not naturally, he should be made to do so by smacking his buttocks until he does cry. He will then be safe:
“We came crying hither.
Thou know’st, the first time we smell the air
We waul and cry.”[[101]]
547. If the doctor has not arrived, cheerfulness, quietness, and presence of mind must be observed by all around; otherwise, the patient may become excited and alarmed, and dangerous consequences might ensue.
548. If the infant should be born apparently dead, a few smart blows must be given on the buttocks and on the back; a smelling-bottle ought to be applied to the nostrils, or rag should be singed under the nose, taking care that the burning tinder does not touch the skin; and cold water must be freely sprinkled on the face. The navel-string, as long as there is pulsation in it, ought not to be tied.
549. The limbs, the back, and the chest of the child ought to be well rubbed with the warm hand. The face should not be smothered up in the clothes. If pulsation has ceased in the navel-string (the above rules having been strictly followed, and having failed), let the navel-string be tied and divided,[[102]] and then let the child be plunged into warm water—98° Fahr. If the sudden plunge does not rouse respiration into action, let him be taken out of the warm bath, as the keeping him for any length of time in the water will be of no avail.
550. If these simple means should not quickly succeed, although they generally will, Dr. Marshall Hall’s Ready Method ought in the following manner to be tried: “Place the infant on his face; turn the body gently but completely on the side and a little beyond, and then on the face, alternately; repeating these measures deliberately, efficiently, and perseveringly, fifteen times in the minute only.”
551. Another plan of restoring suspended animation is by artificial respiration, which should be employed in the following manner: Let the nurse (in the absence of the doctor) squeeze, with her left hand, the child’s nose, to prevent any passage of air through the nostrils; then let her apply her mouth to the child’s mouth, and breathe into it, in order to inflate the lungs; as soon as they are inflated, the air ought, with the right hand, to be pressed out again, so as to imitate natural breathing. Again and again, for several minutes, and for about fifteen times a minute, should the above process be repeated; and the operator will frequently be rewarded by hearing a convulsive sob, which will be the harbinger of renewed life.
552. Until animation be restored, the navel-string, provided there be pulsation in it, ought not to be tied. If it be tied before the child has breathed, and before he has cried, he will have but a slight chance of recovery. While the navel-string is left entire, provided there be still pulsation in it, the infant has the advantage of the mother’s circulation and support.
553. If Dr. Marshall Hall’s Ready Method and if artificial respiration should not succeed, he must be immersed up to his neck in a warm bath of 98° Fahrenheit. A plentiful supply of warm water ought always to be in readiness, more especially if the labor be either hard or lingering.
554. Should the child have been born for some time before the doctor has arrived, it may be necessary to tie and to divide the navel-string. The manner of performing it is as follows: A ligature, composed of four or five whity-brown threads, nearly a foot in length and with a knot at each end, ought, by a double knot, to be tightly tied, at about two inches from the body of the child, around the navel-string. A second ligature must, in a similar manner, be applied about three inches from the first, and the navel-string should be carefully divided midway between the two ligatures. Of course, if the medical man should shortly be expected, any interference would not be advisable, as such matters ought always to be left entirely to him.
555. The after birth must never be brought away by the nurse: if the doctor has not yet arrived, it should be allowed to come away (which, if left alone in the generality of cases, it generally will) of its own accord. The only treatment that the nurse ought in such a case to adopt is, that she apply, by means of her right hand, firm pressure over the region of the womb: this will have the effect of encouraging the contraction of the womb, of throwing off the after birth, and of preventing violent flooding.
556. If the after birth does not soon come away, say in an hour, or if there be flooding, another medical man ought to be sent for; but on no account should the nurse be allowed to interfere with it further than by applying firm pressure over the region of the womb, and not touching the navel-string at all; as I have known dangerous, and in some cases even fatal, consequences to ensue from such meddling.
REST AFTER DELIVERY.
557. A lady ought never to be disturbed for at least an hour after the delivery; if she be, violent flooding might be produced. The doctor, of course, will make her comfortable by removing the soiled napkins, and by applying clean ones in their place.
558. Her head ought to be made easy; she must still lie on her side; indeed, for the first hour let her remain nearly in the same position as that in which she was confined—with this only difference, that if her feet have been pressing against the bedpost, they should be removed from that position.
CLOTHING AFTER LABOR.
559. She ought, after the lapse of an hour or two, to be moved from one side of the bed to the other. It ought to be done in the most tender and cautious manner. She must not, on any account whatever, be allowed to sit erect in the bed. While being moved, she herself should be passive—that is to say, she ought to use no exertion, no effort, but should, by two attendants, be removed from side to side; one must take hold of her shoulders, the other of her hips.
560. A patient, after delivery, usually feels shivering and starved; it will therefore be necessary to throw additional clothing, such as a blanket or two, over her, which ought to envelop the body, and should be well tucked around her; but the nurse ought to be careful not to overload her with clothes, or it might produce flooding, fainting, etc.; as soon, therefore, as she is warmer, let the extra clothing be gradually removed. If the feet be cold, let them be wrapped in a warm flannel petticoat, over which a pillow should be placed.
561. A frequent change of linen after confinement is desirable. Nothing is more conducive to health than cleanliness. Great care should be taken to have the sheets and linen well aired.
REFRESHMENT.
562. A cup of cool, black tea, directly after a patient is confined, ought to be given. I say cool, not cold, as cold tea might chill her. Hot tea would be improper, as it might induce flooding.
563. As soon as she is settled in bed, there is nothing better than a small basin of warm gruel.
564. Brandy ought never, unless ordered by the medical man, to be given after a confinement. Warm beer is also objectionable; indeed, stimulants of all kinds must, unless advised by the doctor, be carefully avoided, as they would only produce fever, and probably inflammation. Caudle is now seldom given; but still, some old-fashioned people are fond of recommending it after a labor. Caudle ought to be banished the lying-in room; it caused in former times the death of thousands.
BANDAGE AFTER A CONFINEMENT.
565. (1) This consists of thick linen, similar to sheeting, about a yard and a half long, and sufficiently broad to comfortably support the belly. It ought to be put on moderately tight; and should be retightened every night and morning, or oftener, if it become slack. (2) Salmon’s Obstetric Binder is admirably adapted to give support after a confinement, and may be obtained of any respectable surgical-instrument-maker.
566. If there be not either a proper bandage or binder at hand—(3) a yard and a half of unbleached calico, folded double, will answer the purpose. The best pins to fasten the bandages are the patent safety nursery-pins. The binder requires no pins.
567. A support to the belly after labor is important: in the first place, it is a great comfort; in the second, it induces the belly to return to its original size; and lastly, it prevents flooding. Those ladies, more especially if they have had large families, who have neglected proper bandaging after their confinements, frequently suffer from enlarged and pendulous bellies, which give them an unwieldy and ungainly appearance.
POSITION.
568. The way of placing the patient in bed.—She ought not, immediately after a labor, under any pretext or pretense whatever, to be allowed to raise herself in bed. If she be dressed, as recommended at paragraph 508, her soiled linen may readily be removed; and she may be drawn up by two assistants—one being at the shoulders and the other at the legs—to the proper place, as she herself must not be allowed to use the slightest exertion.
569. Inattention to the above recommendation has caused violent flooding, fainting, bearing down of the womb, etc., and in some cases even fatal consequences.
THE LYING-IN ROOM.
570. The room to be kept cool and well ventilated.—A nurse is too apt, after the confinement is over, to keep a large fire. Nothing is more injurious than to have the temperature of a lying-in room high. A little fire, provided the weather be cold, to dress the baby by, and to encourage a circulation of the air, is desirable. A fire-guard ought to be attached to the grate of the lying-in room. The door must occasionally be left ajar, in order to change the air of the apartment; a lying-in woman requires pure air as much as any other person; but how frequently does the nurse fancy that it is dangerous for her to breathe it!
571. After the affair is over, the blinds ought to be put down, and the window curtains should be drawn, in order to induce the patient to have a sleep, and thus to rest herself after her hard work. Perfect stillness must reign both in the room and in the house.
572. It is really surprising, in this present enlightened age, how much misconception and prejudice there still is among the attendants of a lying-in room; they fancy labor to be a disease, instead of being what it really is—a natural process; and that old-fashioned notions, and not common sense, ought to guide them.
573. The patient should, after the labor, be strictly prohibited from talking; and noisy conversation ought not to be allowed; indeed, she cannot be kept too quiet, as she may then be induced to fall into a sweet sleep, which would recruit her wasted strength. As soon as the baby is washed and dressed, and the mother is made comfortable in bed, the nurse ought alone to remain; let every one else be banished the lying-in room. Visitors should on no account, until the medical man gives permission, be allowed to see the patient.
THE BLADDER.
574. Ought a patient to go to sleep before she has made water?—There is not the least danger in her doing so (although some old-fashioned person might tell her that there is); nevertheless, before she goes to sleep, if she have the slightest inclination she should respond to it, as it would make her feel more comfortable and sleep more sweetly.
575. Let me urge the importance of the patient, immediately after childbirth, making water while she is in a lying position. I have known violent flooding to arise from a lying-in woman being allowed, soon after delivery, to sit up while passing her water.
576. The “female slipper”[[103]] (previously warmed by dipping it in very hot water and then quickly drying it) ought, at these times, and for some days after a confinement, to be used. It is admirably adapted for the purpose, as it takes up but little room and is conveniently shaped, and readily slips under the patient, and enables her to make water comfortably, she being perfectly passive the while. It should be passed under her in front, and not at the side of the body.
577. If there be any difficulty in her making water, the medical man must, through the nurse, be immediately informed of it. False delicacy ought never to stand in the way of this advice. It should be borne in mind that, after either a very lingering or a severe labor, there is frequently retention of urine,—that is to say, that although the bladder may be full of water, the patient is, without assistance, unable to make it.
578. After the patient, while lying down, trying several times to pass her water, and after, allowing twelve or fifteen hours to elapse, and not being able to do so, it will be well for her to try the following method: Let the pot de chambre be well warmed, let the rim be covered with flannel, let her, supported the while by the nurse, kneel on the bed, her shoulders being covered with a warm shawl; then let her, with the pot de chambre properly placed between her knees on the bed, try to make water, and the chances are that she will now succeed.
579. If she does not, twenty-four hours having elapsed, the doctor must be informed of the fact; and it will then be necessary, absolutely necessary, for him, by means of a catheter, to draw off the water. It might be well to state that the passing of a catheter is unattended with either the slightest danger or pain; and that it is done without exposing her, and thus without shocking her modesty.
THE BOWELS.
580. The bowels are usually costive after a confinement. This confined state of the bowels after labor is doubtless a wise provision of nature, in order to give repose to the surrounding parts—especially to the womb; it is well, therefore, not to interfere with them, but to let them have perfect rest for three days. Sometimes before the expiration of the third day the bowels are relieved, either without medicine or merely by the taking of a cupful of warm coffee. If such be the case, all well and good; as it is much better that the bowels should be relieved without medicine than by medicine; but if, having taken the coffee, at the end of the third day they are not opened, then early on the following—the fourth—morning, a dose of castor oil should be given in the manner recommended at paragraph 281. Either a teaspoonful or a dessertspoonful, according to the constitution of the patient, will be a proper dose. If, in the course of twelve hours, it should not have the desired effect, it must be repeated. The old-fashioned custom was to give castor oil on the morning after the confinement; this, as I have before proved, was a mistaken plan.
581. After a lying-in, and when the bowels are not opened either naturally or by the taking of a cupful of warm coffee, if medicine be given by the mouth, castor oil is the best medicine, as it does not irritate either the patient’s bowels, or, through the mother’s milk, gripe the infant. Aperient pills, as they most of them contain either colocynth or aloes, or both, frequently give great pain to the babe, and purge him much more than they do the mother herself; aperient pills, therefore, after a confinement ought never to be taken.
582. If the patient object to the taking of castor oil, let the nurse, by means of an enema apparatus, administer an enema. This is an excellent, indeed the best, method of opening the bowels, as it neither interferes with the appetite nor with the digestion; it does away with the nauseousness of castor oil, and does not, in the administration, give the slightest pain. If the first enema should not have the desired effect, let one be given every quarter of an hour until relief be obtained. One of the best for the purpose is the following:
Take of—Olive oil, two tablespoonfuls;
Table salt, two tablespoonfuls;
Warm oatmeal gruel, one pint;
To make a clyster.
Another capital enema for the purpose is one made of Castile soap dissolved in warm water.
583. If the patient object both to the taking of the castor oil and to the administration of an enema, then the following draught will be found useful; it will act kindly, and will neither gripe the mother nor the child:
Take of—Concentrated Essence of Senna, half an ounce;
Syrup of Ginger, one drachm;
Distilled Water, seven drachms:
To make a draught. To be taken early in the morning.
If in twelve hours the above draught should not have the desired effect (although, if the essence of senna be good, it usually does long before that time), let the draught be repeated. If the bowels be easily moved, half of the above draught is generally sufficient; if it be not so in twelve hours, the remainder should be taken. But let every lying-in woman bear in mind that as soon as her bowels will act, either naturally or by the taking of a cupful of warm coffee, without an aperient, not a particle of opening medicine should be taken.
584. But, after all that can be said on the subject, there is no better method in the world for opening a lying-in patient’s bowels, when costive, than (if the cup of coffee be not sufficiently powerful) by giving her an enema, as advised in a previous paragraph. An enema is safe, speedy, painless, and effectual, and does not induce costiveness afterward, which castor oil, and all other aperients, if repeatedly taken, most assuredly will.
585. An enema, then, is an admirable method of opening costive bowels, both during suckling and during pregnancy, and deserves to be more universally followed than it now is; fortunately, the plan just recommended is making rapid progress, and shortly will, with ladies at such times, entirely supersede the necessity of administering aperients by the mouth.
586. Aperients, after a confinement, were in olden times, as a matter of course, repeatedly given both to the mother and to the babe, to their utter disgust and to their serious detriment! This was only one of the numerous mistakes and follies that formerly prevailed in the lying-in room. Unfortunately, in those days a confinement was looked upon as a disease, and to be physicked accordingly. A better state of things is happily now dawning.
587. When the patient’s bowels, for the first few days after the confinement, require to be opened, she ought to use either the French bed-pan or the bed-pan of the Liverpool Northern Hospital. Either the one or the other of these pans is a great improvement on the old-fashioned bed-pans, as they will readily slip under the patient, and will enable her, while lying down and while she is perfectly passive in bed, to have her bowels relieved, which at these times is very desirable. The French bed-pan or the bed-pan of the Liverpool Northern Hospital is admirably adapted for a lying-in room; indeed, no lying-in room ought to be without either the one or the other of these useful inventions. “A flannel cap for the toe-part, held on by strings round the heel, will afford considerable comfort to the patient.”[[104]]
“CLEANSINGS”—ABLUTIONS.
588. The “Cleansings.”—This watery discharge occurs directly after a lying-in, and lasts either a week or a fortnight, and sometimes even longer. It is, at first, of a reddish color; this gradually changes to a brownish hue, and afterward to a greenish shade; hence the name of “green waters.” It has in some cases a disagreeable odor. A moderate discharge is necessary; but when it is profuse, it weakens the patient.
589. Some ignorant nurses object to have the parts bathed after delivery; they have the impression that such a proceeding would give cold. Now, warm fomentation twice a day, and even oftener, either if the discharge or if the state of the parts requires it, is absolutely indispensable to health, to cleanliness, and comfort. Ablutions, indeed, at this time are far more necessary than at any other period of a woman’s existence.
590. There is nothing better for the purpose than a soft sponge and warm water, unless the parts be very sore; if they be, a warm fomentation, two or three times a day, of marshmallows and chamomile,[[105]] will afford great relief, or the parts may be bathed with warm oatmeal gruel, of course without salt. In these cases, too, I have found warm barm (yeast) and water a great comfort, and which will soon take away the soreness. The parts ought, after each fomentation, to be well but quickly dried with warm, dry, soft towels.
591. If the internal parts be very sore, it may be necessary, two or three times a day, to syringe them out, by means of an india-rubber vaginal syringe,[[106]] with either of the above remedies. Hence the importance of having a good monthly nurse, of having one who thoroughly understands her business.
592. Let the above rules be strictly followed. Let no prejudices and no old-fashioned notions, either of the nurse or of any female friend, stand in the way of the above advice. Ablution of the parts, then, after a confinement, and that frequently, is absolutely required, or evil results will, as a matter of course, ensue.
REST AND QUIETUDE.
593. A horizontal—a level—position for either ten days or a fortnight after a labor is important. A lady frequently fancies that if she supports her legs, it is all that is necessary. Now, this is absurd; it is the womb and not the legs that requires rest; and the only way to obtain it is by lying flat either on a bed or on a sofa: for the first five or six days, day and night, on a bed, and then for the next five or six days she ought to be removed for a short period of the day either to another bed or to a sofa; which other bed or sofa should be wheeled to the side of the bed, and she must be placed on it by two assistants, one taking hold of her shoulders and the other of her hips, and thus lifting her on the bed or sofa, she herself being perfectly passive, and not being allowed to sit erect the while. She ought, during the time she is on the sofa, to maintain the level position.
594. She ought, after the first nine days, to sit up for an hour; she should gradually prolong the time of the sitting; but still she must, for the first fortnight, lie down a great part of every day. She should, after the first week, lie either on a sofa or on a horse-hair mattress.
595. The above plan may appear irksome, but my experience tells me that it is necessary, absolutely necessary. The benefit the patient will ultimately reap from it will amply repay the temporary annoyance of so much rest. Where the above rules have not been adopted, I have known flooding, bearing down of the womb, and even “falling” of the womb, frequent miscarriages, and ultimately ruin of the constitution, to ensue.
596. “Falling of the womb” is a disagreeable complaint, and the misfortune of it is, that every additional child increases the infirmity. Now, all this might, in the majority of cases, have been prevented, if the recumbent posture for ten days or a fortnight after delivery had been strictly adopted.
597. If a patient labor under a “falling of the womb,” she ought to apply to a medical man, who will provide her with a proper support, called a pessary, which will prevent the womb from “falling down,” and will effectually keep it in its proper place.
598. It is only a medical man, accustomed to these matters, who can select a pessary suitable for each individual case. A proper kind of, and duly-adjusted, pessary is a great comfort to a patient, and will enable her both to take her proper exercise and to follow her ordinary employments; indeed, if a suitable pessary be used, it is so comfortable that the patient often forgets that she is wearing one at all. Those pessaries ought only to be employed that can be removed every night, as there is not the least necessity for a patient to sleep in one, as the womb does not usually come down when the patient is lying down. Moreover, a pessary ought to be kept perfectly clean, and unless it be daily removed it is utterly impossible to keep it so. It is a great comfort and advantage to a patient to be able both to introduce and to remove the pessary herself, which, if a proper kind be employed, she can, when once taught, readily do.
599. If “falling of the womb” be early and properly treated, there is a good chance of a patient being perfectly cured, and thus of being able to dispense with a pessary altogether.
DIETARY.
600. For the first day the diet should consist of nicely made and well-boiled gruel, arrow-root and milk, bread and milk, tea, dry toast and butter, or bread and butter; taking care not to overload the stomach with too much fluid. Therefore, either a cupful of gruel, or of arrow-root, or of tea, at a time, should not be exceeded, otherwise the patient will feel oppressed; she will be liable to violent perspiration, and there will be a too abundant secretion of milk.
601. For the next—the second day.—Breakfast,—either dry toast and butter, or bread and butter, and black tea. Luncheon,—either a breakfast-cupful of strong beef-tea,[[107]] or of bread and milk, or of arrow-root made with good fresh milk. Dinner,—either chicken or game, mashed potatoes, and bread. Tea, the same as for breakfast. Supper,—a breakfast-cupful of well-boiled and well-made gruel, made either with water or with fresh milk, or with water with a tablespoonful of cream added to it.
602. If beef-tea and arrow-root and milk be distasteful to the patient, or if they do not agree, then for luncheon let her have either a light egg pudding or a little rice pudding instead of either the beef-tea or the arrow-root.
603. On the third and fourth days.—Similar diet to the second day, with this difference, that for her dinner the patient should have mutton—either a mutton-chop or a cut out of a joint of mutton, instead of the chicken or game. The diet ought gradually to be improved, so that at the end of four days she should return to her usual diet, provided it be plain, wholesome, and nourishing.
604. The above, for the generality of cases, is the scale of dietary; but of course every lying-in woman ought not to be treated alike. If she be weak and delicate, she may from the beginning require good nourishment, and instead of giving her gruel, it may, from the very commencement, be necessary to prescribe good strong beef-tea, veal-and-milk broth,[[108]] chicken-broth, mutton-chops, grilled chicken, game, the yelk and the white of an egg beaten up together in half a teacupful of good fresh milk, etc. Common sense ought to guide us in the treatment of a lying-in as of every other patient. We cannot treat people by rule and compass; we must be guided by circumstances; we can only lay down general rules. There is no universal guide, then, to be followed in the dietary of a lying-in woman; each case may and will demand separate treatment; a delicate woman, as I have just remarked, may, from the very first day, require generous living; while, on the other hand, a strong, robust, inflammatory patient may, for the first few days, require only simple bland nourishment, without a particle of stimulants. “And hence the true secret of success rests in the use of common sense and discretion—common sense to read nature aright, and discretion in making a right use of what the dictates of nature prescribe.”[[109]]
BEVERAGE.
605. For the first week, either toast and water, or barley-water and milk,[[110]] with the chill taken off, is the best beverage. Wine, spirits, and beer, during this time, unless the patient be weak and exhausted, or unless ordered by the medical man, ought not to be given. All liquids given during this period should be administered by means of a feeding-cup; this plan I strongly recommend, as it is both a comfort and a benefit to the patient; it prevents her from sitting up in bed every time she has to take fluids, and it keeps her perfectly still and quiet, which, for the first week after confinement, is very desirable.
606. When she is weak, and faint, and low, it may, as early as the first or second day, be necessary to give a stimulant, such as either a tumblerful of home-brewed ale or a glass or two of wine daily; but, as I before remarked, in the generality of cases, either toast and water, or barley-water and milk, for the first week after a confinement, is the best beverage.
607. After a week, either a tumblerful of mild home-brewed ale or of London or Dublin porter, where it agrees, should be taken at dinner; but if ale or porter be given, wine ought not to be allowed. It would be well to keep either to ale or to porter, as may best agree with the patient, and not to mix them, nor to take porter at one meal and ale at another.
608. Barreled, in this case, is superior to bottled porter, as it contains less fixed air. On the whole, however, I should prefer home-brewed ale to porter. Either old, or very new, or very strong ale, ought not, at this time, to be given.
609. Great care is required in the summer, as the warm weather is apt to turn the beer acid. Such beer would not only disagree with the mother, but would disorder the milk, and thus the infant. A nursing mother sometimes endeavors to correct sour porter or beer by putting soda in it. This plan is objectionable, as the constant taking of soda is weakening to the stomach and impoverishing to the blood. Moreover, it is impossible, by any artificial expedient, to make either tart beer or porter sound and wholesome, and fit for a nursing mother. If beer or porter be sour, it is not fit to drink, and ought either to be thrown away or should be given to the pigs.
610. Sometimes neither wine nor malt liquor agrees; then, either new milk and water, or equal parts of fresh milk and barley-water, will generally be found the best beverage. If milk should also disagree, either barley-water, or toast and water, ought to be substituted.
CHANGE OF ROOM.
611. The period at which a lying-in woman should leave her room will, of course, depend upon the season, and upon the state of her health. She may, after the first fourteen days, usually change the chamber for the drawing-room, provided it be close at hand; if it be not, she ought, during the day, to remove—be either wheeled or carried in a chair—from one bedroom to another, as change of apartment will then be desirable. The windows, during her absence from the room, ought to be thrown wide open; and the bedclothes, in order that they may be well ventilated, should be thrown back. She should, at the end of three weeks, take her meals with the family; but even then she ought occasionally, during the day, to lie on the sofa to rest her back.
EXERCISE IN THE OPEN AIR.
612. The period at which a lady, after her confinement, ought to take exercise in the open air, will, of course, depend upon the season, and upon the state of the wind and weather. In the winter, not until the expiration of a month, and not even then unless the weather be fine for the season. Carriage exercise will at first be the most suitable. In the summer she may, at the end of three weeks, take an airing in a carriage, provided the weather be fine, and the wind be neither in an easterly nor in a northeasterly direction. At the expiration of the month she may, provided the season and weather will allow, go out of doors regularly, and gradually resume her household duties and employments.
PART IV.
SUCKLING.
THE DUTIES OF A NURSING MOTHER
613. A mother ought not, unless she intend to devote herself to her baby, to undertake to suckle him. She must make up her mind to forego the so-called pleasures of fashionable life. There ought, in a case of this kind, to be no half-and-half measures; she should either give up her helpless babe to the tender mercies of a wet-nurse, or she must devote her whole time and energy to his welfare—to the greatest treasure that God hath given her.
614. If a mother be blessed with health and strength, it is most unnatural and very cruel for her not to suckle her child—
“Connubial fair! whom no fond transport warms
To lull your infant in maternal arms;
Who, blessed in vain with tumid bosoms, hear
His tender wailings with unfeeling ear;
The soothing kiss and milky rill deny
To the sweet pouting lip and glistening eye!
Ah! what avails the cradle’s damask roof,
The eider bolster, and embroidered woof!
Oft hears the gilded couch unpitied plains,
And many a tear the tasseled cushion stains!
No voice so sweet attunes his cares to rest,
So soft no pillow as his mother’s breast!—
Thus charmed to sweet repose, when twilight hours
Shed their soft influence on celestial bowers,
The cherub Innocence, with smile divine,
Shuts his white wings, and sleeps on beauty’s shrine.”[[111]]
615. Oh, if a mother did but know the joy that suckling her infant imparts, she would never for one moment contemplate having a wet-nurse to rob her of that joy—
“The starting beverage meets the thirsty lip;
’Tis joy to yield it, and ’tis joy to sip.”[[112]]
616. Lamentable, indeed, must it be, if any unavoidable obstacle should prevent a mother from nursing her own child!
THE BREAST.
617. As soon as the patient has recovered from the fatigue of the labor—that is to say, in about four or six hours—attention ought to be paid, more especially in a first confinement, to the bosoms.
618. In a first confinement, there is, until the third day, but very little milk; although there is usually on that day, and for two or three days afterward, a great deal of swelling, of hardness, of distention, and of uneasiness of the breasts, in consequence of which, in a first confinement, both care and attention are needed.
619. If there be milk in the breast, which may be readily ascertained by squeezing the nipple between the finger and the thumb, the infant should, at first, be applied—not frequently, as some do, but at considerable intervals, say until the milk be properly secreted—every four hours; when the milk flows, the child ought to be applied more frequently, but still at stated times.
620. To wash away any viscid mucus from the nipple, or any stale perspiration from the bosom, let the breasts and the nipples, before applying the baby, be first sponged with a little warm water, and then be dried with a warm, dry, soft napkin; for some infants are so particular that unless the breasts and the nipples be perfectly free from mucus and from perspiration, they will not suck. If after the above cleansing process there be any difficulty in making him take the bosom, smear a little cream on the nipple, and then immediately apply him to it.
621. If the breasts be full, hard, knotty, and painful, which they generally are two or three days after a first confinement, let them be well but tenderly rubbed every four hours, either with the best olive oil (a little of which should, before using it, be previously warmed, by putting a little of the oil in a teacup on the hob by the fire) or with equal parts of olive oil and of eau de Cologne, which should be well shaken up in a bottle every time before it be used.
622. On the third day, more especially after a first confinement, the breasts are apt to become very much swollen, painful, and distended. If such be the case, it might be necessary, for a few days, to have them drawn, once or twice daily, by a woman who makes it her business, and who is usually called either a breast-drawer, or, in vulgar parlance, a suck-pap. A clean, sober, healthy, respectable woman ought to be selected. There is, in nearly every large town, one generally to be found who is at the head of her profession. Such a one should be chosen.
623. If the bosoms be more than usually large and painful, in addition to assiduously using the above liniment, apply to the breasts, in the intervals, young cabbage-leaves, which should be renewed after each rubbing. Before applying them, the “veins” of the leaves, with a sharp knife, must be cut smooth, level with the leaf. It will require several, as the whole of the breast ought to be covered. The cabbage-leaves will be found both cooling and comfortable. Each bosom should then be nicely supported with a soft folded silk handkerchief, going under each breast and suspending it; each handkerchief should then be tied at the back of the neck, thus acting as a kind of sling.
624. The patient ought not, while the breasts are full and uncomfortable, to drink much fluid, as it would only encourage a larger secretion of milk.
625. When the milk is at “its height,” as it is called, she ought every morning, for a couple of mornings, to take a little cooling medicine—a Seidlitz powder—and, every four hours, the following effervescing mixture:
Take of—Bicarbonate of Potash, one drachm and a half;
Distilled Water, eight ounces:
To make a mixture. Two tablespoonfuls to be taken, with two tablespoonfuls of the Acid Mixture, every four hours, while effervescing.
Take of—Citric Acid, three drachms;
Distilled Water, eight ounces:
Mix.—The Acid Mixture.
The best way of taking the above effervescing medicine is to put two tablespoonfuls of the first mixture into a tumbler, and two tablespoonfuls of the acid mixture into a wineglass, then to add the latter to the former, and it will bubble up like soda-water; she should instantly drink it off while effervescing.
626. In two or three days, under the above management, the size of the bosoms will decrease, all pain will cease, and the infant will take the breast with ease and comfort.
627. Second and succeeding confinements.—If the breasts are tolerably comfortable (which in the second and in succeeding confinements they probably will be), let nothing be done to them except, as soon as the milk comes, at regular intervals applying the child alternately to each of them. Many a bosom has been made uncomfortable, irritable, swollen, and even sometimes gathered, by the nurse’s interference and meddling. Meddlesome midwifery is bad, and I am quite sure that meddlesome breast-tending is equally so. A nurse, in her wisdom, fancies that by rubbing, by pressing, by squeezing, by fingering, by liniment, and by drawing, she does great good, while in reality, in the majority of cases, by such interference she does great harm.
628. The child will, in second and in succeeding confinements, as a rule, be the best and the only doctor the bosoms require. I am quite convinced that, in a general way, nurses interfere too much, and that the bosoms in consequence suffer. It is, of course, the doctor’s and not the nurse’s province in such matters, to direct the treatment; while it is the nurse’s duty to fully carry out the doctor’s instructions.
629. There is nothing, in my opinion, that so truly tells whether a nurse be a good one or otherwise, as the way she manages the breasts; a good nurse is judicious, and obeys the medical man’s orders to the very letter; while, on the other hand, a bad nurse acts on her own judgment, and is always quacking, interfering, and fussing with the breasts, and doing on the sly what she dare not do openly: such conceited, meddlesome nurses are to be studiously avoided; they often cause, from their meddlesome ways, the breasts to gather.
630. Let the above advice be borne in mind, and much trouble, misery, and annoyance might be averted. Nature, in the majority of cases, manages these things much better than any nurse possibly can do, and does not, as a rule, require helping. The breasts are sadly too much interfered and messed with by nurses, and by nurses who are, in other respects, tolerably good ones.
STATED TIMES FOR SUCKLING.
631. A mother ought to suckle her baby at stated times. It is a bad habit to give him the bosom every time he cries, regardless of the cause; for be it what it may—over-feeding, griping, “wind,” or acidity—she is apt to consider the breast a panacea for all his sufferings. “A mother generally suckles her infant too often—having him almost constantly at the bosom. This practice is injurious both to parent and to child. For the first month he should be suckled about every hour and a half; for the second month, every two hours; gradually, as he becomes older, increasing the distance of time between, until at length he has the breast about every four hours. If he were suckled at stated periods he would only look for it at those times, and be satisfied.”[[113]]
632. A mother frequently allows her babe to be at the bosom a great part of every night. Now, this plan is hurtful both to her and to him; it weakens her, and thus enfeebles him; it robs them both of their sleep; and generates bad habits, which it will be difficult to break through; it often gives the mother a sore nipple and the child a sore mouth.
633. It is surprising how soon an infant, at a very early age, may, by judicious management, be brought into good habits; it only requires, at first, a little determination and perseverance: therefore a nursing mother ought at once to commence by giving the child the breast at stated periods, and she should rigidly adhere to the times above recommended.
634. A mother should not, directly after taking a long walk, and while her skin is in a state of violent perspiration, give her baby the bosom; the milk being at that time in a heated state, will disorder the child’s bowels, or it may originate in him some skin disease, and one which it might be difficult to cure. She ought, therefore, before she gives him the breast, to wait until the surface of her body be moderately cool. Let her be careful the while not to sit in draughts.
CLOTHING.
635. A nursing mother ought to have her dress, more especially her stays, made loose and comfortable.
636. A gathered breast sometimes arises from the bones of the stays pressing into the bosom; I should, therefore, recommend her to have the bones removed.
637. If a lady be not in the habit of wearing a flannel waistcoat, she ought at least to have her bosoms covered with flannel, taking care that there be a piece of soft linen over the nipples.
638. I should advise a nursing mother to provide herself with a waterproof nursing apron, which may be procured either at any baby-linen establishment or at an india-rubber warehouse.
DIETARY.
639. A nursing mother ought to live plainly; her diet should be both light and nourishing. It is a mistaken notion that at these times she requires extra good living. She ought never to be forced to eat more than her appetite demands; if she be, either indigestion, or heartburn, or sickness, or costiveness, or a bowel complaint will ensue. It is a folly at any time to force the appetite. If she be not hungry, compelling her to eat will do her more harm than good. A medical man, in such a case, ought to be consulted.
640. The best meats are mutton and beef; veal and pork may, for a change, be eaten. Salted meats are hard of digestion; if boiled beef, therefore, be eaten, it ought to be only slightly salted. It is better, in winter, to have the boiled beef unsalted; it is then, especially if it be the rump, deliciously tender. Salt, of course, must be eaten with the unsalted meat. High-seasoned dishes are injurious; they inflame the blood, and thus they disorder the milk.
641. Some persons consider that there is no care required in the selection of the food, and that a nursing mother may eat anything, be it ever so gross and unwholesome; but, if we appeal to reason and to facts, we shall be borne out in saying that great care is required. It is well known that cow’s milk very much partakes of the properties of the food on which the animal lives. Thus, if a cow feed on swedes, the milk and the butter will have a turnipy flavor. This, beyond a doubt, decides that the milk does partake of the qualities of the food on which she feeds. The same reasoning holds good in the human species, and proves the absurdity of a nursing mother being allowed to eat anything, be it ever so gross, indigestible, or unwholesome. Again, either a dose of purgative medicine given to her, or greens taken by her at dinner, will sometimes purge the baby as violently, or even more so, than it will herself.
642. Even the milk of a healthy wet-nurse acts differently, and less beneficially, upon the child than the mother’s own milk. The ages of the mother and of the wet-nurse, the ages of her own and the latter’s infant, the constitutions of the one and of the other, the adaptability of a mother’s milk for her own particular child—all tend to make a foster-mother not so desirable a nurse as the mother herself. Again, a mother cannot at all times get to the antecedents of a wet-nurse; and, if she can, they will not always bear investigation.
643. With regard to the ages of the mother and of the wet-nurse—for instance, as a wet-nurse’s milk is generally a few weeks older than the mother’s own milk, the wet-nurse’s milk may, and frequently does, produce costiveness of the bowels of her foster-child; while, on the other hand, the mother’s own milk, being in age just adapted to her babe’s, may and generally does keep her own infant’s bowels regular. The milk, according to the age of the child, alters in properties and qualities to suit the age, constitution, and acquirements of her baby—adapting itself, so to speak, to his progressive development. Hence the importance of a mother, if possible, suckling her own child.
644. A babe who is suckled by a mother who lives grossly is more prone to disease, particularly to skin and to inflammatory complaints, and to disease which is more difficult to subdue.
645. Do not let me be misunderstood: I am not advocating that a mother should be fussily particular—by no means. Let her take a variety of food, both animal and vegetable; let her from day to day vary her diet; let her ring the changes on boiled and stewed, on grilled and roast meats; on mutton and lamb and beef; on chicken and game and fish; on vegetables, potatoes, and turnips; on broccoli and cauliflower, on asparagus and peas (provided they are young and well boiled), and French beans. “The maxim of the greatest importance in reference to the materials of human food is, mixture and variety—a maxim founded, as has been stated, upon man’s omnivorous nature. Animal and vegetable substances, soups and solid meat, fish, flesh, and fowl, in combination or succession, ought, if due advantage is to be taken of the health-sustaining element in food, to form the dietary of every household.”[[114]]
646. But what I object to a nursing mother taking are—gross meats, such as goose and duck; highly-salted beef; shell-fish, such as lobster and crab; rich dishes; highly-seasoned soup; pastry, unless it be plain; and cabbages and greens and pickles, if found to disagree with the baby; and any other article of food which is either rich, or gross, or indigestible, and which, from experience, she has found to disagree either with herself or with her child. It will be seen, therefore, from the above catalogue, that my restrictions as to diet are limited, and are, I hope, founded both on reason and on common sense.
647. A moderate quantity—say a tumblerful—either of fresh mild ale or of porter will generally be found the best beverage both for dinner and for supper. There is much more nourishment in either ale—home-brewed—or in porter, than in wine; therefore, for a nursing mother, either ale or porter is far preferable to wine. Wine, if taken at all, ought to be used very sparingly, and then not at the same meal with the porter or ale. In the higher ranks of life, where a lady is in the habit of drinking wine, it is necessary to continue it, although the quantity should not be increased, and ought never to exceed a couple of glasses—dry sherry being the best wine for the purpose.
648. A nursing mother is subject to thirst. When such be the case, she ought not to fly either to beer or to wine to quench it; this will only add fuel to the fire. The best beverages will be either toast and water, milk and water, barley-water, barley-water and new milk (in equal proportions), or black tea, either hot or cold. Cold black tea is a good quencher of thirst.
649. A lady who is nursing is at times liable to fits of depression. Let me strongly urge the importance of her abstaining from wine and from all other stimulants as a remedy; they would only raise for a time her spirits, and then would depress them in an increased ratio. Either a drive in the country, or a short walk, or a cup of tea, or a chat with a friend, would be the best medicine. The diet should be good and nourishing; plenty of bread and plenty of meat should be her staple food, in addition to which Du Barry’s Arabica Revalenta, made either with fresh milk or with cream and water, is, in these cases, most useful and sustaining. The best time for taking it is either for luncheon or for supper. A lady subject to depression should bear in mind that she requires nourishment, not stimulants,—that much wine and spirits might cheer her for the moment, but will assuredly depress her afterward. Depression always follows overstimulation; wine and spirits therefore, in such a case, if taken largely, are false and hollow friends. It is necessary to bear the above facts in mind, as there are many advocates who strongly recommend, in a case of this kind, a large consumption of wine and brandy. Such men are, at the present moment, doing an immense deal of mischief; they are, in point of fact, inducing and encouraging drunkenness.
650. Spirits—brandy, rum, gin, and whisky—are, during suckling, injurious; I may even say that they are insidious poisons to the parent, and, indirectly, to the child.
651. When an infant is laboring under an inflammatory complaint, a nursing mother ought not to take stimulants, such as either ale or wine. In a case of this kind, toast and water will, for her dinner, be the best beverage, gruel for her supper, and black tea—not coffee, as it would be too stimulating—both for her breakfast and tea.
FRESH AIR AND EXERCISE.
652. Out-door exercise during suckling cannot be too strongly insisted upon; it is the finest medicine both for babe and mother. Whenever the weather will admit, it must be taken. It is utterly impossible for a nursing mother to make good milk, unless she do take an abundance of exercise and breathe plenty of fresh air.
653. Whatever improves the health of the mother, of course at the same time benefits the child: there is nothing more conducive to health than an abundance of out-door exercise. It often happens that a mother who is nursing seldom leaves her house; she is a regular fixture; the consequence is, both she and her babe are usually delicate and prone to sickness.
654. A mother ought not, immediately after taking exercise, to nurse her infant, but wait for half an hour. Nor should she take violent exercise, as it would be likely to disorder the milk.
655. Carriage exercise, if the weather be hot and sultry, is preferable to walking; if that be not practicable, she ought to have the windows thrown wide open, and should walk about the hall, the landings, and the rooms, as she would by such means avoid the intense heat of the sun. Although carriage exercise during intensely hot weather is preferable to walking exercise, yet, notwithstanding, walking must, during some portion of the day, be practiced. There is no substitute, as far as health is concerned, for walking. Many ailments that ladies now labor under could be walked away; and really it would be a pleasant physic—far more agreeable than pills and potions!
THE POSITION OF A MOTHER DURING SUCKLING.
656. Good habits are as easily formed as bad ones. A mother, when in bed, ought always to suckle her child while she is lying down. The sitting up in bed, during such times, is a fruitful source of inflammation and of gathering of the breasts. Of course, during the day the sitting-up position is the best. Let me caution her not to nurse her baby in a half-sitting and half-lying posture; it will spoil her figure, disturb her repose, and weaken her back.
THE TEMPER.
657. Passion is injurious to the mother’s milk, and consequently to the child. Sudden joy and grief frequently disorder the infant’s bowels, producing griping, looseness, etc.; hence, a mother who has a mild, placid temper generally makes an excellent nurse, on which account it is a fortunate circumstance that she is frequently better-tempered during suckling than at any other period of her life; indeed, she usually, at such times, experiences great joy and gladness.
658. The happiest period of a woman’s existence is, as a rule, when she first becomes a mother. “The pleasure of the young mother in her babe is said to be more exquisite than any other earthly bliss.”[[115]]
659. It is an old and, I believe, a true saying, that the child inherits the temper of his mother or of his wet-nurse. This may be owing to the following reasons: If the mother or the wet-nurse be good-tempered, the milk will be more likely to be wholesome, which will, of course, make him more healthy, and consequently better-tempered.
660. While, on the other hand, if the mother or the nurse be of an irritable, cross temper, the milk will suffer, and will thus cause disarrangement to his system; and hence ill health and ill temper will be likely to ensue. We all know the influence that good or bad health has on the temper.
661. An important reason, then, why a nursing mother is often better-tempered than she is at other times is, she is in better health, her stomach is in a healthier state:
“A good digestion turneth all to health.”[[116]]
There is an old and a true saying, “that it is the stomach that makes the man,” and if the man, the woman:
“Your stomach makes your fabric roll,
Just as the bias rules the bowl.”[[117]]
662. Hear what Shakspeare says of the functions of the stomach. The stomach is supposed to speak (and does it not frequently speak, and in very unmistakable language, if we will but only listen to its voice?):
“True is it, my incorporate friends, quoth he,
That I receive the general food at first
Which you do live upon: and fit it is;
Because I am the store-house and the shop
Of the whole body: But if you do remember,
I send it through the rivers of your blood,
Even to the court, the heart,—to the seat o’ the brain;
And, through the cranks and offices of man,
The strongest nerves, and small inferior veins,
From me receive that natural competency
Whereby they live: And though that all at once,
You, my good friends, though all at once cannot
See what I do deliver out to each;
Yet I can make my audit up, that all
From me do back receive the flour of all,
And leave me but the bran.”
Coriolanus, act i. sc. 1.
OCCUPATION.
663. I strongly recommend a nursing mother to attend to her household duties. She is never so happy, nor so well, as when her mind is moderately occupied at something useful. She never looks so charming as when she is attending to her household duties—
“For nothing lovelier can be found
In woman, than to study household good.”[[118]]
664. I do not mean by occupation the frequenting of balls, of routs, or of parties: a nursing mother has no business to be at such places; she ought to devote herself to her infant and to her household, and she will then experience the greatest happiness this world can afford.
665. One reason why the poor make so much better nursing mothers than the rich is the former having so much occupation; while the latter, having no real work to do, the health becomes injured, and in consequence the functions of the breasts suffer; indeed, many a fashionable lady has no milk at all, and is therefore compelled to delegate to a wet-nurse one of her greatest privileges and enjoyments.
666. What would not some rich mother give for the splendid supply of milk—of healthy, nourishing, life-giving milk—of the poor woman who has to labor for her daily bread!
667. What is the reason that wealthy ladies so frequently require wet-nurses? The want of occupation! And from whom do they obtain the supply of wet-nurses? From the poor women who have no lack of occupation, as they have to labor for their daily food, and have in consequence the riches of health, though poor in this world’s goods—
“For health is riches to the poor.”[[119]]
Bear this in mind, ye wealthy, and indolent, and pampered ladies, and alter your plans of life, or take the consequences, and still let the poor women have the healthy, the chubby, the rosy, the laughing children; and you, ye rich ones, have the unhealthy, the skinny, the sallow, the dismal little old men and women who are constantly under the doctor’s care, and who have to struggle for their very existence! “Employment, which Galen calls ‘nature’s physician,’ is so essential to human happiness, that Indolence is justly considered as the mother of Misery.”[[120]]
668. Occupation, then—bustling occupation, real downright work, either in the form of out-door exercise, or of attending to her household duties—a lady, if she desire to have a good breast of milk, ought to take; if, in point of fact, she wishes to have healthy children. For the Almighty is no respecter of persons. And he has ordained that work shall be the lot of man and of woman too! It is a blessed thing to be obliged to work. If we do not work, we have all to pay a heavy penalty, in the form of loss of both health and happiness. “For work is the grand cure of all the maladies and miseries that ever beset mankind—honest work, which you intend getting done.”[[121]]
669. A mother who is listless and idle, lolling either the greater part of every day in an easy-chair, or reclining on a sofa in a room where a breath of air is not allowed to enter, usually makes a miserable and a wretched nurse. She is nervous, dyspeptic, and emaciated; having but little milk, and that little of a bad quality, her baby is puny, pallid, and unhealthy, and frequently drops into an untimely grave. Occupation, then, with fresh air and exercise, is indispensable to a mother who is suckling.
AILMENTS, Etc.
670. The Nipple.—A good nipple is important both to the comfort of the mother and to the well-doing of the child.
671. One, among many, of the ill effects of stays and of corsets is the pushing-in of the nipples; sore nipples, and consequent suffering, are the result. Moreover, a mother thus circumstanced may be quite unable to suckle her infant; and then she will be severely punished for her ignorance and folly; she will be compelled to forego the pleasure of nursing her own children, and she will be obliged to delegate to hirelings her greatest privilege! Ladies who never wear stays have much better nipples, and more fully-developed bosoms; hence such mothers are more likely to make better nurses to their babies. There is no doubt that the pressure of the stays on the bosom tends both to waste away the gland of the breast (where the milk is secreted), and to cause the nipple either to dwindle or to be pushed in, and thus to sadly interfere with its functions. I should strongly advise every mother who has daughters old enough to profit by it, to bear this fact in mind, and thus to prevent mischief when mischief might be prevented, by not allowing them, when young, to wear stays.
672. Treatment of very small and drawn-in nipples.—The baby ought to suck through the intervention of an india-rubber teat fastened on a boxwood shield, or through an india-rubber teat and shield, made entirely of india-rubber.[[122]] The india-rubber teat must, before it is used, be softened by dipping it in warm but not in hot water. I have known many mothers able to suckle their children with this contrivance who otherwise would have been obliged either to have weaned them, or to have procured the assistance of a wet-nurse. The above aid, in the generality of instances, will enable the infant to suck with ease. After this has for a time been used, the nipples will be so improved as to render the continuance of it unnecessary. Of course I do not advise the use of an india-rubber teat until a fair trial has been given by applying the babe at once to the nipple; but if he cannot draw out the nipple, then, rather than wean him, or than employ a wet-nurse, let the teat be tried.
673. Remember, as soon as the nipple be sufficiently drawn out, which in all probability it will in a few days, the teat ought to be dispensed with. In such a case, when the infant is not at the breast, Dr. Wansbrough’s Metallic Nipple Shields should be worn. Small and bad nipples have, by the wearing of these shields, frequently been drawn out and made good ones; the dress will suffice to keep them in their places.
674. Sore nipples.—If a lady, during the latter few months of her pregnancy, were to adopt the plan recommended at page [162], paragraph 353, sore nipples, during the period of suckling, would not be so prevalent as they now are.
675. A sore nipple is frequently produced by the injudicious custom of allowing the child to have the nipple almost constantly in his mouth. Stated periods for suckling, as recommended at paragraph 631, ought to be strictly adopted. Another frequent cause of a sore nipple is from the babe having the thrush. It is a folly to attempt to cure the nipple without at the same time curing the mouth of the infant.
676. Treatment.—One of the best remedies for a sore nipple is the following powder:
Take of—Biborate of Soda, one drachm;
Powdered Starch, seven drachms:
Mix,—A pinch of the powder to be frequently applied to the nipple.
677. Dr. A. Todd Thomson’s—my old preceptor—remedy for sore nipple is a very good one; it is as follows:
Take of—Finely-powdered Gum Arabic, half an ounce;
Powdered Alum, five grains:
To be well mixed together in a mortar to make a powder, of which a pinch should either be sprinkled over the nipple, or it may be applied to the part by means of a camel’s-hair brush every time directly after the child has done sucking. Let the brush, covered with the dry powder, gently sweep over the sore nipple.
As there is nothing in either of the above powders injurious to the infant, the powder, before applying him to the breast, ought not to be wiped off; indeed, either the one or the other of the powders (the former one especially, as it contains borax) is likely to be of service in preventing or in curing the sore mouth of the child.
678. If the above powders should not have the desired effect (efficacious though they usually are), “a liniment composed of equal parts of glycerin and of brandy” (say a vial containing two drachms of each) ought to be tried, which must be shaken up just before using. It should, by means of a camel’s-hair brush, every time directly after the baby has been suckled, be painted on the nipple. A piece of either old soft cambric or lawn, about the size of the palm of the hand, snipped around to make it fit, ought then to be moistened in the glycerin and the brandy, and should be applied to each of the sore nipples, and worn (until they are cured) whenever the child is not at the breast. These applications will be found of much service and of great comfort, and will act as nipple shields, protecting and healing the nipples. A soft sponge of warm water may be gently applied to the nipple just before putting the child to the bosom.
679. If the above remedies should not succeed in curing the sore nipple, then she ought to try Dr. Wansbrough’s Metallic Nipple Shield (as recommended previously for small and drawn-in nipples), and should, whenever the babe is not sucking, constantly wear it on the nipple. It is very cooling and healing, and keeps off all pressure from the clothes. It will frequently cure a sore nipple when other remedies have failed. The shield may be procured of any respectable surgical-instrument-maker.
680. Cracked and fissured nipples.—Sometimes the nipple is sore from having either cracks or fissures upon it. These cracks or fissures may attack any part of the nipple, but are very apt to form where the nipple joins the breast; and, when very severe, an ignorant nurse, who is always fond of dealing in the marvelous, declares that the child has nearly bitten the nipple off! Treatment.—Now, the best remedy for a cracked and fissured nipple is for the infant, until the cracks and fissures are cured, to suck through the intervention of an india-rubber teat and shield; and every time, directly after the babe has been put to the nipple, to apply to the parts affected either neat brandy or the glycerin and brandy liniment, as I have before recommended. When the child is not at the breast, Dr. Wansbrough’s Nipple Shields should be worn; the dress will keep them in their places.
681. Another cause of a sore nipple is from the mother, after the babe has been sucking, putting up the nipple wet. She, therefore, ought always to dry the nipple—not by rubbing it, but by dabbing it with either a soft cambric or lawn handkerchief, or with a piece of soft linen rag (one or other of which ought always to be at hand), every time directly after the infant has done sucking, and just before applying either of the above powders or liniment to the nipple.
682. When the nipple is very sore, a mother, whenever the child is put to the bosom, suffers intense pain. This being the case, she had better suckle him through the intervention of an india-rubber teat, properly fastened on a shield, as before recommended. See page [276], paragraph 672. But she ought never to use an india-rubber teat unless it be absolutely necessary—that is to say, if the nipple be only slightly sore, she should not, on any account, apply it; but there are cases where the nipple is so very sore that a mother would have to give up nursing if the shield and teat were not used; these, and very small and drawn-in-nipples, are the only cases in which an india-rubber teat and shield is admissible.
683. A nursing mother is sometimes annoyed by the milk flowing constantly away, making her wet and uncomfortable. All she can do under such circumstances is to wear nipple-glasses, and to apply a piece of flannel to the bosom, which will prevent the milk from chilling her, and will thus do away with the danger of her catching cold, etc.
684. The breast.—A mother ought, before applying the infant to the bosom, to carefully ascertain if there be milk. This may readily be done by squeezing the nipple between the finger and the thumb. If there be no milk, she must wait until the milk be secreted, or serious consequences both to her and to him might ensue: to the former, inflammation and gathering of the bosom, and sore nipples; to the latter, thrush, diarrhœa, and eruptions on the skin.[[123]]
685. If there be a supply of milk in the breast, and if still the child will not suck, the medical man’s attention ought to be drawn to the fact, in order that he may ascertain whether the child be tongue-tied; if he be, the mystery is explained, and a trifling, painless operation will soon make all right.
686. If the bosoms be full and uneasy, they ought, three or four times a day, to be well although tenderly rubbed with olive oil and eau de Cologne (equal parts of each, mixed in a vial). Some nurses rub with their fingers only. Now, such rubbing does harm. The proper way to apply friction is to pour a small quantity of the oil and eau de Cologne—first shaking the bottle—into the palm of the hand, the hand being warm, and then to well rub the breasts, taking care to use the whole of the inside of the hand.
687. After the bosoms have been well rubbed, each ought to be nicely supported with a large, soft, folded silk handkerchief; each handkerchief must pass under each breast and over the shoulders, and should be tied at the back of the neck, thus acting as a sling.
688. If the bosoms be very uncomfortable, young cabbage-leaves (with the “veins” of each leaf cut level to the leaf) ought, after each application of the oil and eau de Cologne, to be applied; or a large warm white-bread-and-milk and olive oil poultice ought to be used, which must be renewed three or four times a day. The way to make the poultice is as follows: A thick round of bread should be cut from a white loaf; the crust should be removed, the crumb ought to be cut into pieces about an inch square, upon which boiling-hot new milk should be poured; it ought to be covered over for ten minutes; then the milk should be drained off, and the olive oil—previously warmed by placing a little in a teacup on the hob—should be beaten up by means of a fork with the moistened bread until it be of the consistence of a soft poultice. It ought to be applied to the bosom as hot as it can comfortably be borne.
689. Gathered breast.—A gathered bosom, or “bad breast” as it is sometimes called, is more likely to occur after a first confinement and during the first month. Great care, therefore, ought to be taken to avoid such a misfortune. A gathered breast is frequently owing to the carelessness of a mother in not covering her bosoms during the time she is suckling. Too much attention cannot be paid to keeping the breasts comfortably warm. This, during the act of nursing, should be done by throwing either a shawl or a square of flannel over the neck, shoulders, and bosoms.
690. Another cause of a gathered breast arises from a mother sitting up in bed to suckle her baby. An infant ought to be accustomed to take the bosom while he is lying down; if this habit be not at first instituted, it will be difficult to adopt it afterward. Good habits may be taught a child from the very earliest period of his existence.
691. A sore nipple is another fruitful cause of a gathered breast. A mother, in consequence of the suffering it produces, dreads putting the baby to it; she therefore keeps him almost entirely to the other bosom. The result is, the breast with the sore nipple becomes distended with milk, which, being unrelieved, ends in inflammation, and subsequently in gathering.
692. The fruitless attempt of an infant, to procure milk when there is very little or none secreted is another and a frequent cause of a gathered bosom. Dr. Ballard, in his valuable little work before quoted, considers this to be the principal cause of a gathered breast; and, as the subject is of immense importance, I cannot do better than give it in his own words, more especially as he has the merit of originating and of bringing the subject prominently before his professional brethren. He says: “This (mammary abscess or gathered breast) is another form of disease entirely referable to the cause under consideration [fruitless sucking]. In the case last related, the formation of mammary abscess [gathered breast] was only just prevented by arresting any further irritation of the breast by suckling; and since I have kept careful notes of my cases, I have observed that in all instances of abscess there has been abundant evidence of a demand being made upon the gland for a supply of milk beyond that which it had the power of secreting. If the child only has been kept to the breast, then it has suffered with disordered bowels; but in the majority of cases an additional irritation has been applied; the commonly-received doctrine that a turgid breast is necessarily overloaded with milk, leads mothers and nurses to the use of breast-pumps, exhausted bottles, or even the application of the powerful sucking powers of the nurse herself, to relieve the breasts of their supposed excess; and it is this extraordinary irritation which, in the majority of cases, determines the formation of an abscess [gathering]. Sometimes these measures are adopted to remove the milk when a woman is not going to suckle, and then an abscess not unfrequently is established. I have previously alluded to the mistake into which mothers and nurses are led by the appearance of a swollen breast; it is not evidence that the gland can secrete freely, and it is in this turgid state that the excessive irritation tells most severely. This hyperæmic [plethoric] condition seems to be a step toward inflammation, and the irritation supplies that which is wanting to complete the process. If a woman will only remove the child from the breast directly the act of sucking produces pain, she may be pretty sure to avoid abscess. So long as the milk can be obtained there is no pain.” The above most valuable advice deserves great attention, and ought to be strictly followed.
693. How is a patient to know that she is about to have a gathered bosom?—There are two forms of gathered breast; one being of vast and the other of trifling importance. The first, the serious one, consists of gathering of the structure of the gland of the breast itself; the latter, merely of the superficial part of the bosom, and ought to be treated in the same manner as any other external gathering, with warm poultices.
694. In the mild or superficial kind of gathered bosom, the mother may still persevere in suckling her child, as the secreting portion of the breast is not at all implicated in the gathering; but in the severe form, she ought not, on any account whatever, to be allowed to do so, but should instantly wean her child from the affected side. The healthy breast she may still continue to nurse from.
695. The important form of a gathered breast I will now describe: A severe gathered bosom is always ushered in with a shivering fit. Let this fact be impressed deeply upon my reader’s mind. This shivering is either accompanied or followed by sharp lancinating pains of the bosom. The breast now greatly enlarges, becomes hot, and is very painful. The milk in the affected bosom either lessens or entirely disappears. If the child be applied to the breast (which he ought not to be), it gives the mother intense pain. She is now feverish and ill; she loses her strength and appetite, and is very thirsty.
696. A medical man must, at the very onset of the shivering fit, be sent for; and he will, in the generality of instances, be able to prevent such a painful and distressing occurrence as a gathered breast. If twelve hours be allowed to elapse after the shivering has taken place, the chances are that the gathering cannot altogether be prevented; although even then it may, by judicious treatment, be materially lessened and ameliorated.
697. We sometimes hear of a poor woman suffering dreadfully for months, and of her having a dozen or twenty holes in her bosom! This is generally owing to the doctor not having been sent for immediately after the shivering; I therefore cannot too strongly insist, under such circumstances, upon a mother obtaining prompt assistance, not only to obviate present suffering, but, at the same time, to prevent the function of the breast from being injured, which it inevitably, more or less, will be, if the important form of gathering be allowed to take place.
698. When a nursing mother feels faint, she ought immediately to lie down and to take a little nourishment; either a crust of bread and a draught of ale or of porter, or a glass of wine, or a cup of tea with the yelk of an egg beaten up in it, either of which will answer the purpose extremely well. Brandy, or any other spirit, I would not recommend, as it will only cause, as soon as the immediate effects of the brandy are gone off, a greater depression to ensue; not only so, but the frequent taking of brandy might become a habit—a necessity which would be a calamity deeply to be deplored!
699. A mother is sometimes faint from suckling her child too often, she having him almost constantly at the bosom. So long, of course, as she continues this foolish practice, she must expect to suffer from faintness.
700. Aperients, etc. during suckling.—Strong purgatives, during this period, are highly improper, as they are apt to give pain to the infant as well as to injure the mother. If it be absolutely necessary to give an aperient, the mildest, such as a dose of castor oil, should be chosen.
701. If she cannot take oil, then she should apply it externally to the bowels as a liniment, as recommended at page [144].
702. An enema, either of warm water, or of gruel, oil, and table salt,[[124]] applied by means of a good self-injecting enema apparatus, is in such a case an excellent—indeed, the very best—method of opening the bowels, as it neither interferes with the digestion of the mother nor of the child.
703. The less opening medicine, whatever be the kind, a mother who is suckling takes, the better will it be both for herself and for her babe. Even castor oil, the least objectionable, during suckling, of aperients, if she once begin to take it regularly, the bowels will not act without it, and a wretched state of things is established. No, if the bowels will not act, an enema is by far the best remedy; you can never do any harm, either to the mother or to the babe, by the administration of an enema; it will neither induce future constipation, nor will it interfere with the digestion of the mother, nor with the bowels, nor with the health of the infant.
704. When a lady who is nursing is habitually costive, she ought to eat brown instead of white-bread. This will, in the majority of cases, enable her to do without an aperient. The brown bread may be made by mixing one part of bran and three parts of fine wheaten flour together, and then making it in the usual way into bread. Treacle instead of butter on the brown bread increases its efficacy as an aperient.
705. Either stewed prunes or stewed French plums are an excellent remedy to prevent constipation. The patient ought to eat, every morning, a dozen or fifteen of them. The best way to stew either prunes or French plums is the following: Put a pound, either of prunes or of French plums, and two tablespoonfuls of raw sugar, into a brown jar; cover them with water, put them into a slow oven, and stew them for three or four hours. Both stewed rhubarb and stewed pears often act as mild or gentle aperients. Muscatel raisins, eaten at dessert, will oftentimes, without medicine, relieve the bowels.
706. A Bee-master in The Times, or, as he is usually called, The Times Bee-master, has satisfactorily proved that honey—pure honey—is most wholesome and beneficial to the human economy. He recommends it to be occasionally eaten in lieu of butter for breakfast. Butter, in some localities, and in some seasons of the year, is far from good and wholesome.
707. The Germans are in the habit of eating for breakfast and for tea a variety of fruit jams instead of butter with their bread. Now, if the bowels be costive, jam is an excellent substitute for butter. The Scotch, too, scarcely ever sit down either to breakfast or tea without there being a pot of marmalade on the tables. English ladies, in this matter, may well take a leaf out of the books of the Germans and of the Scotch.
708. A basinful of gruel, made either with Robinson’s Patent Groats, or with the Derbyshire oatmeal, sweetened with brown sugar, every night for supper will often supersede the necessity of giving opening medicine. A tumblerful of cold spring water—cold from the pump—taken early every morning, sometimes effectually relieves the bowels. Coffee ought to be substituted for tea for breakfast, as coffee frequently acts as an aperient, more especially if the coffee be sweetened with brown sugar. A glass of sherry should be taken every day during dinner, as, if the bowels be sluggish, it sometimes stimulates them to action. I should strongly recommend a patient, in such a case, to eat a great variety of food, and to let the vegetable element predominate. Much meat encourages constipation. Fruit—Muscatel raisins especially—farinaceous food, coffee, and a variety of vegetables, each and all incite the bowels to do their duty.
709. Although a nursing mother ought, more especially if she be costive, to take a variety of well-cooked vegetables—such as potatoes, asparagus, broccoli, cauliflower, French beans, stewed celery, and turnips; she should avoid eating greens, cabbages, and pickles, as they would be likely to affect the baby, and might cause him to suffer from gripings, pain, and “looseness” of the bowels.
710. The “wet compress” is another excellent method of opening the bowels. The way of applying it is as follows: Fold a large napkin a few thicknesses until it is about half a foot square; then dip it in cold water and place it over the bowels; over which apply either oilskin or gutta-percha skin, which should be, in order to exclude the air, considerably larger than the folded napkin. It should be kept in its place by means of either a bolster-case or a broad bandage, and must be applied at bedtime, and ought to remain on for three or four hours, or until the bowels be opened.
711. Let me again—for it cannot be too urgently insisted upon—strongly advise a nursing mother to use every means in the way of diet, etc., to supersede the necessity of the taking of opening medicine, as the repetition of aperients injures, and that severely, both mother and child. Moreover, the more opening medicine a person swallows, the more she requires; so that if she once get into the habit of regularly taking aperients, the bowels will not act without them. What a miserable existence, to be always swallowing physic!
712. If a lady, then, during the period of suckling, were to take systematic exercise in the open air; to bustle about the house and to attend to her household duties; if she were to drink, the moment she awakes in the morning, a tumbler of cold water, and every day during dinner a glass of sherry; if she were to substitute brown bread for white bread, and coffee for tea at breakfast, and brown for white sugar; if she were to vary her food, both animal and vegetable, and partake plentifully of sound ripe fruit; if she were to use an abundance of cold water to her skin; if she were, occasionally, at bedtime, to apply a “wet compress” to her bowels, and to visit the water-closet daily at one hour; if she were—even if the bowels were not opened for four or five days—not to take an aperient of any kind whatever, and avoid quacking herself with physic; in short, if she would adopt the above safe and simple remedies, which are in the reach of all, she would not suffer so much from costiveness, which is frequently the bane, the misery, and the curse of her existence! But then, to get the bowels into a proper and healthy state, it would take both time and trouble; and how readily can a couple of pills be swallowed, and how quickly they act, and how soon they have to be repeated; until at length the bowels will not act at all unless goaded into action, and the pills become a necessity! Oh, the folly and the mischief of such a system!
WEANING.
713. There is an old saying, “that a woman should carry her child nine months, and should suckle him nine months.” It is well known that the first part of the old adage is correct, and experience has proved the latter to be equally so. If a babe be weaned before he be nine months, he loses that muscular strength which the breast-milk alone can give; if he be suckled after he be nine months, he becomes flabby, weak, and delicate. “It is generally recognized that the healthiest children are those weaned at nine months complete. Prolonged nursing hurts both child and mother; in the child, causing a tendency to brain disease, probably through disordered digestion and nutrition; in the mother, causing a strong tendency to deafness and blindness. It is a very singular fact, to which it is desirable that attention were paid, that in those districts of Scotland—viz., the Highland and insular—where the mothers suckle their infants from fourteen to eighteen months, deaf-dumbness and blindness prevail to a very much larger extent among the people than in districts where nine or ten months is the usual limit of the nursing period.”[[125]]
714. The time, then, when an infant ought to be weaned.—“This, of course, must depend upon the strength of the child, and upon the health of the mother: nine months on an average is the proper time. If she be delicate, it may be found necessary to wean him at six months; or if he be weak, or laboring under any disease, it may be well to continue suckling him for twelve months; but after that time the breast will do him more harm than good, and will, moreover, injure the mother’s health.”[[126]]
715. If he be suckled after he be twelve months old, he is generally pale, flabby, unhealthy, and rickety; and the mother is usually nervous, emaciated, and hysterical. A child who is suckled beyond the proper time, more especially if there be any predisposition, sometimes dies either of water on the brain, or of consumption of the lungs, or of mesenteric disease.
716. The manner in which a mother ought to act when she weans her child.—“She must, as the word signifies, do it gradually—that is to say, she should by degrees give him less and less of the breast, and more and more of artificial food; she ought, at length, only to suckle him at night; and lastly, it would be well for the mother either to send him away, or to leave him at home, and for a few days to go away herself.”[[127]]
717. “A good plan is for the nurse to have in the bed a half-pint bottle of new milk, which, to prevent it from turning sour, has been previously boiled, so as to give a little to the child in lieu of the breast. The warmth of the body will keep the milk of a proper temperature; and will supersede the use of lamps, of candle-frames, and other troublesome contrivances.”[[128]]
718. If the mother be not able to leave home herself, or to send her child from home, she ought then to let the child sleep in another room, with some responsible person—I say responsible person, for a baby must not be left to the tender mercies of a giggling, thoughtless young girl.
719. If the mother, during the daytime, cannot resist having her child in the room with her, then I should advise her to make a paste of aloes—that is to say, let her mix a little powdered aloes with a few drops of water, until it be of the consistence of paste—and let her smear it on the nipple every time just before putting him to the breast; this will be quite enough for him; and one or two aloe applications to the nipple will make him take a disgust to the bosom, and thus the weaning will be accomplished. A mother need not be afraid that the aloes will injure her baby; the minute quantity he will swallow will do no harm; for the moment he tastes it, the aloes being extremely bitter, he will splutter it out of his mouth.
720. Another application for the nipple, to effect weaning, is wormwood. There are two ways of applying it, either (1) by sprinkling a very small pinch of powdered wormwood on the nipple; or (2) by bathing the nipple with a small quantity of wormwood tea just before applying the babe to it—either the one or the other of these plans will make him take a dislike to the breast, and thus the weaning will be accomplished. Wormwood is excessively bitter and disagreeable, and a slight quantity of it on the nipple will cause an infant to turn away from it with loathing and disgust—the wormwood, the minute quantity he will taste, will not at all injure him. Wormwood was in Shakspeare’s time used for the purpose of weaning:
“And she was wean’d,—I never shall forget it—
Of all the days of the year upon that day:
For I had then laid wormwood to my dug [breast],
Sitting in the sun under the dove-house wall,
My lord and you were then at Mantua:
Nay, I do bear a brain: but, as I said,
When it did taste the wormwood on the nipple
Of my dug, and felt it bitter, pretty fool!
To see it tetchy, and fall out with the dug.”[[129]]
721. The best way of “drying up the milk” is to apply to each breast soap plaster (emplastrum saponis), spread on soft pieces of wash-leather, the shape and size of the top of a hat, with a round hole the size of a shilling in the middle of each to admit the nipple, and with a slit from the center to the circumference of each plaster to make a better fit. These plasters ought to be spread by a chemist.
722. When the child is once weaned, the breasts ought not to be drawn, as the drawing of them would cause them to secrete larger quantities of milk; if, therefore, the bosoms be ever so full or uncomfortable, a mother ought to leave them alone; she should wait patiently, and the milk will gradually diminish, and will at length disappear.
723. The drawing of the bosoms, during weaning, either by means of a breast-pump, or by the mouth, or by other like contrivances, has frequently caused gathered breasts. If not drawn, they scarcely, if ever, gather.
724. The foregoing plan of “drying up the milk” will generally in five or six days assuage the milk away; but if, at the end of three days, the bosoms still continue full and uncomfortable, the plasters should be removed, and the breasts ought, every four hours, to be well but tenderly rubbed with equal parts of olive oil and of eau de Cologne; the nurse supporting the bosom, during such friction, with her other hand.
725. Let me impress the above important advice on a nursing mother’s mind; it might save a great deal of after-suffering and misery.
726. It might be well to state that, after the child has been weaned, the milk does not always entirely leave the breast, not even for weeks, and, in some cases, not even for months; it is not of the slightest consequence, and requires no treatment to get rid of it.
727. A mother ought, during the period of weaning, to live abstemiously, and should drink as little as possible. In many cases, it is necessary to give, every morning, for two or three mornings, a few doses of mild aperient medicine, such as either a Seidlitz powder, or a teaspoonful of Henry’s magnesia and a teaspoonful of Epsom salts in half a tumbler of warm water.
728. Symptoms denoting the necessity of weaning.—A mother sometimes cannot suckle her child; the attempt bringing on a train of symptoms somewhat similar to the following: singing in the ears; dimness of sight; aching of the eyeballs; throbbing in the head; nervousness; hysterics; tremblings; faintness; loss of appetite and of flesh; fluttering and palpitation of the heart; feelings of great exhaustion; indigestion; costiveness; sinking sensations of the stomach; pains in the left side; great weakness and dragging pains of the loins, which are usually increased whenever the infant is put to the bosom; pallor of the countenance; shortness of breath; swelling of the ankles.
729. Of course, every mother who is suffering from suckling does not have the whole of the above long catalogue of symptoms! But if she has three or four of the more serious of them, she ought not to disobey the warnings, but should discontinue nursing; although it may be necessary, if the babe himself be not old enough to wean, to obtain a healthy wet-nurse to take her place.
730. Remember, then, that if the above warning symptoms be disregarded, dangerous consequences, both to parent and child, might be the result. It might either throw the mother into a consumption, or it might bring on heart disease; and, in consequence of his not being able to obtain sufficient or proper nourishment, it might cause the infant to dwindle and pine away, and, eventually, to die of water on the brain.
731. Soon after nine months’ nursing, “the monthly courses” generally return. This is another warning that the babe ought immediately to be weaned, as the milk will lessen both in quantity and in nourishment, and the child in consequence will become delicate and puny, and every day he is suckled will lose, instead of gain, ground. I have known many children, from protracted suckling, smaller at twelve months than they were at nine months; and well they might be, as, after nine months, the mother’s milk usually does them harm instead of doing them good, and thus causes them to dwindle away.
732. At another time, although the above train of symptoms does not occur, and notwithstanding she may be in perfect health, a mother may not be able to suckle her baby. Such a one usually has very small breasts, and but little milk in them, and if she endeavor to nurse her infant, it produces a violent aching of the bosom. Should she disregard these warnings, and should still persevere, it might produce inflammation of the breast, which will probably end in a gathering.
733. An obstinate sore nipple is sometimes a symptom denoting the necessity of weaning.—When the nipples are, and, notwithstanding judicious treatment, persistently for some time continue, very sore, it is often an indication that a lady ought to wean her baby. Long-continued, obstinate sore nipples frequently occur in a delicate woman, and speak, in language unmistakable, that the child, as far as the mother herself is concerned, must be weaned. Of course, if the infant be not old enough to wean, when practicable a wet-nurse ought to take the mother’s place. If the above advice were more frequently followed than it is, gathered breasts, much suffering, and broken health would not so frequently prevail as they now do.
734. If a mother be predisposed to consumption; if she has had spitting of blood; if she be subject to violent palpitation of the heart; if she be laboring under great debility and extreme delicacy of constitution; if she has any of the above complaints or symptoms, she ought not on any account to suckle her child, but should by all means procure a healthy wet-nurse.
735. Occasionally a mother suckles her infant when she is pregnant. This is highly improper, as it not only injures her own health, and may bring on a miscarriage, but it is also prejudicial to the baby, and may produce a delicacy of constitution from which he might never recover.
In conclusion, I fervently hope that this little book will, through God’s blessing, be to my fair reader, during the whole period of her wifehood, a friend in her need, a guide in her difficulties, and a silent but trusty counselor in all things pertaining to her health. I sincerely trust that it will give her as much pleasure in the reading of these pages as it has given me in the writing of them.