Bromides and milk diet, bran or alkaline baths give good results, and local applications of sedative lotions and ointments containing menthol, carbolic acid or cocaine (cautiously) will aid. The woman in some instances becomes almost frantic, and tears at the vulva with her nails until it bleeds.
The iodine treatment of Hensler is simple and often effective. If no skin changes are visible and but little leucorrhœa, the vulva is thoroughly prepared as for a vaginal operation, dried and painted with a 10 per cent solution of tincture of iodine. Generally one application suffices, but when the leucorrhœa is bad, it may be necessary to repeat the treatment on the third and fifth day thereafter. Between treatments, the vulvar surfaces and even the vaginal walls (by insufflation) are kept dry with zinc oxide powder. If all measures fail and exhaustion is imminent, emptying the uterus may be advisable.
Herpes is an inflammatory, superficial eruption, characterized by red patches, blisters, or pustules. It is accompanied by burning, itching, and nervous depression. The origin is probably toxic and the termination may be fatal. Milk diet, soothing lotions, and, if necessary, abortion, constitute the means of treatment.
Areas of pigmentation (the chloasmata) are not amenable to treatment. They usually disappear after labor.
Albuminuria of Pregnancy.—Albuminuria is so common as to be almost physiological when the amount of albumin is small. When the amount of albumin in the urine is large, it may be due to pre-existing disease, which is first discovered when the urinalysis is made during pregnancy. (Chronic nephritis?).
If it makes its debut during gestation and continues as a mere trace without casts, it is spoken of as the albuminuria of pregnancy, but the patient must be watched with great care, since the albuminuria may be a premonitory sign of eclampsia.
Albuminuria and eclampsia must be considered together, because, while the two conditions may exist separately, they are most frequently associated, and it is believed that they have a common causation. It is true that most cases of albuminuria terminate favorably, yet the higher the albumin content, the greater the danger of eclampsia.
Albumin appears in the urine in from three to five per cent of all pregnancies. It is more common in the latter half of gestation and the attacks differ greatly in severity.
Symptoms.—In the early stages the urine shows an abundant, pale fluid of low specific gravity.
The seriousness of the case is generally indicated by the amount of albumin, although this is not a reliable guide as to the danger of eclampsia. Casts and red and white blood corpuscles are occasionally found. The output of urea usually remains normal, but diminution usually occurs in connection with eclampsia. Anæmia and anasarca are common, but it is a hopeful clinical sign that the cases of extensive edema rarely develop eclampsia.