SICKNESS AND VOMITING.
Nausea, or sickness, with or without vomiting, is one of the most frequent and troublesome accompaniments of pregnancy. It is so general, in fact, as to be looked upon as one of the earliest and most reliable signs of that state. It is undoubtedly caused, in the earlier stages, simply by the intimate sympathy which exists between the stomach and womb, and which causes one of those organs to be temporarily deranged whenever the other is in any unusual condition. In the latter months it is also produced by the enlarged womb pressing on the lower part of the stomach, as it rises in the abdomen. In many diseases of the womb, particularly in enlargements, and tumors, the stomach will become deranged in precisely the same manner as during pregnancy, and the patient is frequently deceived thereby as to her real condition.
In most cases the sickness does not begin till about the second month, and it seldom lasts beyond the third or fourth. There are some however, with whom it commences almost immediately after fecundation, and others with whom it lasts till the very commencement of labor. I have even known persons who always experienced the nausea at the very moment of conception, and who were thus aware when that event took place. With some persons the trouble occurs only during certain parts of the day, most usually in the morning, while with others it comes on irregularly, or even endures constantly. In most cases it is not very severe, and causes but little distress; occasionally however, it is very serious, and may even lead to fatal results, in spite of all that can be done. Abortion is frequently brought on by it; and so are faintings, and spitting of blood. Many women however, will vomit with violence, during almost the whole period, without either accident or evil effect. The treatment must vary according to the cause of the derangement, its violence, and the effect it produces. In regard to diet but little can be said that will be found generally applicable. Mild and light food is generally recommended, but is not always the best, for some females can only keep on their stomachs the most indigestible articles. Perhaps nothing more can be said, with propriety, than that the patient should take whatever she can retain, particularly if she has become weak from want of nourishment, which is often the case. Some females can only keep down a little broth, or tea, or sweetened water, while others find solid food the best, or fruits. I have known many able to take Gum Arabic, either solid or dissolved in water, and retain it, when nothing else could be borne. This is nourishing, and may often keep up the strength till the sickness abates.
There are many remedies that will sometimes relieve, though frequently they are of no use whatever. A little wine or brandy, or orange flower water;—a few drops of laudanum, or ether, or essence of peppermint, may be tried. One or two ipecac, or cayenne, or camphor lozenges, will sometimes be efficacious, and so will a little Port wine and Peruvian bark, or a seidlitz powder, or even common soda water. A tea-spoonful of powdered charcoal succeeds occasionally, or some very strong bitters, or a cordial, such as a wine-glassful of curacoa. A plaster of opium may also be placed over the stomach, or one of meal wet with laudanum. A mustard poultice over the stomach, will frequently relieve when everything else fails;—sometimes it is more effective however, when placed on the spine, opposite the stomach. As a general rule the bowels should be kept free, either with injections or with mild purgatives, as castor oil, or manna. Regular bathing will often act as a complete preventive or cure, and the vomiting may be frequently stopped by simply dashing cold water over the stomach. Some practitioners recommend emetics, and bleeding if the patient be of a full plethoric habit. Leeches and cups have also been used over the stomach, and sometimes with good effect. Ether and chloroform have also been inhaled, and have operated favorably in a few instances. Plentiful draughts of cold water, or swallowing bits of ice will likewise afford relief to some.
In several instances the vomiting has been so violent, and the patient has suffered so much, and become so exhausted from want of nourishment, that it has been absolutely necessary, after all other means have failed, to cause miscarriage, as the only means of saving the patient's life.
Whenever the trouble can be borne, Patience is the grand specific. The sufferer must recollect that it will surely cease with delivery, and most probably before.
PTYALISM, OR EXCESSIVE SALIVATION.
Some pregnant females will secrete an immense amount of saliva for weeks and months in succession, as if they had been salivated. I have never known a case in which this discharge caused any evil, even when very great, though it is often troublesome. It would probably not be judicious to stop it, even if we could do so, as long as it does no harm, though it may be advisable at times to moderate it. The only treatment proper to effect this is, to keep the bowels free and the body well bathed, and to gargle the mouth with mint or balm teas, or canella water, or a little syrup of poppies.
This discharge, like the vomiting, arises from the sympathetic action of the uterus, and it generally ceases about the fourth month, though with some it will last the whole time.