The next thing is to allay the irritability of the stomach, which is to be accomplished by the means already pointed out—the effervescing draught of soda, magnesia, chamomile tea, &c.; but in connexion with this, two or three grains of the purified extract of aloes, with an equal quantity of the extract of henbane, must be taken two or three times a week, at bedtime. This will keep the tongue still clean, and the bowels in order.
After a little time, the sickness having subsided, tonic medicines may be used: and a fourth part of the following mixture, taken three times a day, will, under the present circumstances, be the best means of restoring the tone of the stomach and bowels: sulphate of quinine, six grains; diluted sulphuric acid, half a drachm; infusion of columba, five ounces and a half; simple syrup, half an ounce.
Having pointed out the means for mitigating sickness in the early months, there only remains one additional suggestion to make, and it is, that all the remedies for relief detailed may, in some cases, fail. The sickness continues most obstinate; every time the female takes food, or even sometimes when abstaining from it, she vomits; and at last, from this excessive irritability and long-continued violent action of the stomach, symptoms threatening miscarriage will manifest themselves.[[20]] There is generally in such a case, pain and a sensation of tension about the pit of the stomach, increased after every attack of sickness. If symptoms of miscarriage are not present, the application of nine or twelve leeches to the stomach, and pieces of soft linen rag well soaked with laudanum, constantly applied and renewed, will give the most decided relief. If, however, there is pain in the loins and hips, increasing in frequency and power, becoming at last slightly bearing down, I strongly advise the patient to consult her medical adviser, as the loss of a little blood from the arm, perfect rest in the recumbent position, and other directions which he alone can give, will, in such a case, be absolutely necessary, and I may add, if perseveringly acted up to by the patient herself, be certainly followed by success.
Secondly, of sickness coming on at the conclusion of pregnancy.
This arises from the distended state of the womb affecting mechanically, by its pressure, the coats of the stomach, and certain parts of its neighborhood.
This form of vomiting but rarely occurs; for do not let me be supposed to refer to the sickness which sometimes immediately precedes, and generally accompanies, the early part of labour. I am speaking of that irritability of the stomach which may arise about the sixth, seventh, or eighth month, and from which the female has been entirely free during the previous months of gestation, and now producing vomiting of an exceedingly troublesome form.
A lady suffering from sickness thus late in pregnancy, ought to seek medical advice at once. From this cause, if severe, premature labour might be brought on, and judicious medical treatment is always decidedly necessary to mitigate this form of sickness. The patient must lose a little blood, she must keep strictly to her sofa, and the bowels ought to be gently acted upon by small doses of Cheltenham or Epsom salts. A grain of the extract of opium may be given to allay the irritability at night, and cloths dipped in laudanum frequently applied to the pit of the stomach.
In all forms of sickness arising from pregnancy as its cause, the diet must be light, mild, and nutritious, taken in moderate quantities of three or four meals a day. It should consist of mild animal food, boiled or roasted. Chicken, white game boiled, mutton or beef roasted, are the viands most nutritious and easily digested. Stale pure bread untoasted, or pilot bread, mealy potatoes, or well-boiled rice, in moderate quantities, may be taken with animal food for dinner. A glass of port wine with warm water at the conclusion of the meal, is the best kind of beverage.
Advantage has often been derived from always taking brown bread, and Jamaica sugar in the morning’s coffee. The healthy operation of the bowels has thus been promoted; although a system of regular exercise by walking, apportioned to the strength, and not continued so long as to fatigue, will generally effect this purpose, while at the same time it gives tone to the general health. Fatigue of body is sedulously to be avoided. Slow and moderate walks, exercise in an open carriage (if the patient has sufficient strength), should be taken daily between breakfast and dinner; always avoiding to sit down to the latter meal tired, and, therefore, probably, with a blunted appetite.[[21]]