The Four Epochs of Woman's Life; A Study in Hygiene

by Anna M. Galbraith

Regularity in this, as in all other habits of life, is most essential, and the individual should go to the toilet at the same hour every day, even if there is no inclination to have a bowel movement, and thus the habit will be established; the most convenient time is directly after breakfast.

Medical Treatment.— But if all these means have failed, medicines must be resorted to. Cold water is a better laxative than hot; to a glassful of cold water add from one teaspoonful to one tablespoonful of the effervescing granules of the phosphate of soda, and take this the first thing on rising in the morning. This preparation of soda is particularly useful because it acts slightly on the liver. Other laxatives are: a seidlitz powder dissolved in a glass of cold water on rising; a wineglass or more of Hunyadi Janos, also taken on rising. Any of these may be taken with safety by pregnant women. For children the simplest laxative is one teaspoonful of Husband's milk of magnesia, to be taken in one glass of water on rising.

Enemas.— Perhaps one of the most common methods used by the laity for the relief of constipation is the rectal injection, or enema. Enemas habitually given to unload the bowels are productive of much harm by overdistending the rectum, so that in time the rectum fails to react to the normal stimulus— namely, the presence of the feces— as it otherwise would. But by some means or other the bowels must be well moved once every twenty-four hours. And it is much better to use an enema than to go to bed without a bowel movement. If the woman is going around, so that she can give the enema to herself, the most effective way to take it is in the knee-chest position or an approximation to this. Either a fountain or bulb syringe may be used for this purpose; a quart of water at a temperature of 110° F. should be prepared by making it into a suds with castile soap, or one tablespoonful of glycerin may be added to one pint of water. The nozle to be used is the smallest one that comes with the syringe, the so-called infant's nozle; this is quite large enough, and its insertion is not nearly so painful as the larger ones; the nozle must be well greased with vaselin. When everything is ready, the patient gets down on her knees with the shoulders near the floor, having first loosened all of her bands and taken off her corsets; the nozle is introduced as far as it will go into the rectum, and if a bulb syringe is used the water must be very gradually squeezed into the rectum, otherwise it will not retain so much; or if the fountain syringe is used, it must not be hung too high. So soon as the patient feels that she has taken all that she can retain, she should lie down on the left side, and retain the water as long as possible, as it is thus rendered more effective. An enema so taken will be very much more effective than one taken in the ordinary manner of sitting on the toilet. In the method just described more water can be used and it will be longer retained; it can be felt to go up along the course of the large bowel, and it will often be found very effective when the ordinary enema fails. This enema will often be found to be a very valuable aid in curing an obstinate chronic diarrhea, which is kept up by particles of feces remaining in the folds of the large intestine. If the patient is confined to bed, she should lie on the left side, with a heavy towel folded under her to prevent the bed from becoming wet; when the nurse withdraws the nozle she should make pressure on the anus with the towel, to help the patient to retain the water as long as possible. But should the patient have gone so long without a bowel movement that all these means fail, it will be necessary to precede the water enema with one of oil; or still more effective is the following combination: take one teaspoonful of the spirits of turpentine, the yolk of one egg, and two tablespoonfuls of olive oil, and beat well together, and add to these one pint of water at a temperature of 110° F. Constipation, however, of so obstinate a character as this demands a physician's attention.

Diarrhea.— A diarrhea may be acute or chronic; the treatment is essentially different. For an acute attack accompanied by frequent stools and severe abdominal pain the first thing to do is to go to bed. If there is nausea, drink a glass of water as hot as can be taken, at once; for the diet, a glass of scalded milk, not boiled but just allowed to come to the boiling-point, every two hours; and nothing else should be taken until the diarrhea is well in check. If the pain is severe, a spice plaster over the abdomen will be found to be very comforting. It is made as follows: take of powdered allspice, cinnamon, cloves, and ginger each two tablespoonfuls, and two teaspoonfuls of cayenne pepper; mix well together in a bowl; then quilt in a piece of flannel large enough to cover the abdomen; when ready for use, dip in hot whisky and apply as hot as the patient can bear; cover over with a large napkin, as the plaster produces a deep stain which does not wash out; keep on as long as necessary. If the rest in bed and the milk diet kept up for twenty-four hours do not suffice to cure the diarrhea, it is not wise to take any risks, but send for your doctor at once. Or if there should be any blood in the stools, do not wait for anything, but send for the doctor without delay.

For a chronic diarrhea an enema given in the knee-chest position, as already described, will often be found a most efficient remedy. In diarrheas the use of fruits and vegetables should be avoided; the best diet after the milk is bread well toasted through, toast-water, soft-boiled eggs, beefsteak, oyster stew, and clam broth.

Vaginal Douche.— To be of service except for mere cleansing purposes the douche must be taken in the horizontal position, either on a couch or, if it is not cold, on the floor. Of course, this position necessitates the use of a douche-pan. The douche-pan is best of agate-ware, oblong in shape, and with a broad strip which comes under the nates. On lying down to take the douche the nates must come down well over the pan and the clothing must be pushed well up to prevent the water from seeping up the back. To make the woman more comfortable there should be a pillow under the head, and she must have a shawl or some light woolen material to throw over her while taking the douche to prevent chilling; thus doing more harm than good.

There are two forms of syringes on the market: the bag or fountain syringe, which is hung up sufficiently high— about three feet above the patient— to cause the water to flow; and the bulb syringe, in which the bulb has to be constantly squeezed by the hand, which is tiresome to many women, but this is a much more convenient form to have in traveling. During pregnancy the fountain syringe only should be used, and it should be hung as low as will enable the water to flow. For a woman who has never taken douches it is well to begin with a temperature of 110° F., gradually increasing the temperature to 118° or 120°; this is as high as the woman should attempt to go, for a higher temperature would burn her, leaving the vulva so sensitive that she would only be able to take cool douches for a long time after this; a bath thermometer should be used in all cases to test the temperature, so that the woman knows exactly what she is doing.

In cases of inflammation of the uterus or its adnexa four quarts of water should be used, and the douche should be taken in the horizontal position. The water thus acts as a hot poultice about the uterus, and the woman will find on rising that some water flows out from the vagina. Ordinarily plain hot water is all that is necessary to use, but where the discharge is acrid and scalding, the plain hot-water douche should be followed by a warm douche containing one teaspoonful of borax to a pint of water. The best time for taking a douche is at night just before retiring; there is also less danger of taking cold when the douche is taken at this time.

The scalding sensations at the vulva may be due to the acidity of the urine, in which case it will be increased just after urination; or it may be due to an acrid discharge from the vagina. A little observation on the part of the patient will enable her to distinguish which is the real cause. If there is any trouble with the urine, it should be carefully examined at once, as some congestion or inflammation of the kidneys is not infrequently present, which if attended to might be cured, and which if allowed to run on unattended to, may develop into a serious form of Bright's disease.

The genitals should be washed with soap and water night and morning. Women who do not suffer from leuchorrhea need not take a vaginal douche more than once a week; after the menstrual flow the vaginal injection is advised to remove the detritus of the flow.