Many females do themselves much harm by taking what they call opening medicines, the action of which is often more injurious than the constipation itself. All drastic purgatives, such as aloes, gamboge, colocynth, and jalap should be carefully avoided, as they not only make the costiveness worse after their action is over, but they also frequently produce inflammation, and even abortion, by the violent straining they cause. The best medicines, when they are really needed, are manna, seidlitz powders, or castor oil. Enemas are better however, as a general rule, such as those of thin starch, or molasses and water, to which may be added a little castor oil. The grand aim should be, in all such cases, to stimulate the bowels to an increased action without medicines, by a properly regulated diet! Salads may be eaten when they do not cause derangement of the stomach, and ripe or stewed fruits, particularly figs, dates and prunes. Soups are also good, except they contain rice, or vermicelli, or maccaroni. Bran bread should be eaten regularly, and not white. The only meats should be veal or poultry. As a drink lemonade is excellent, with a little cream of tartar, or tamarind tea, or barley water sweetened with honey. With some patients a cup of coffee, or a glass of beer will always relieve the bowels, especially if a glass of water is also drank after it. I have known persons neglect the bowels so long that they have become completely impacted, by the hard fæces, and could be relieved only by instruments. It is very important to attend to this affection in time, and to persevere with the means of permanent relief regularly.
DYSENTERY AND DIARRHŒA.
It is frequently the case that pregnant females, instead of being constipated are afflicted with severe diarrhœa. This may arise from inflammation, and is then attended by fever, and extreme tenderness and soreness of the bowels. Most usually however it is entirely nervous, and arises from the sympathetic irritation of the womb. There is then no tenderness or soreness, no fever, no derangements of the appetite, nor in fact any other symptom of any consequence. If it remains long unchecked blood will be discharged, from the extreme irritation of the intestines, and it is then called dysentery. This is nearly always accompanied by fever and general irritation. Sometimes there will be a constant and painful desire felt to move the bowels, but with little power to do so, and at the same time a burning heat and unpleasant sensation at the fundus. This is called tenesmus, and the straining from it has frequently produced abortion.
If the diarrhœa is not excessive, and the female does not lose her appetite, or strength, it is better let alone, particularly if she be of a full habit, and disposed to fever. If thought desirable to check it a little, this may usually be done by a change in the diet. Rice milk, sago, tapioca, and arrow-root may be taken, white bread may be used, and not much fluid drunk. If such means are insufficient an injection may be thrown up the rectum in the morning, of thin starch, with a tea-spoonful of laudanum. The abdomen may also be well fomented, and a dose of Tincture of Rhubarb taken occasionally. If the tenesmus is very troublesome, an injection of tepid water may be used, and the female should sit occasionally over the steam of hot water: in extremely painful cases a few leeches may be used round the fundament, and a hot flaxseed poultice placed over the abdomen. A warm bath is also an excellent remedy with many. When the diarrhœa still continues notwithstanding the above remedies, resort should be had to tonics and opiates. The patient should take Port wine and Peruvian bark, or some Gentian wine, and use injections of Starch and Laudanum regularly. Cammomile tea may also be freely drunk, and an opium pill may be taken at night. Above all, the patient must endeavor to avoid all mental agitation. When dysentery sets in, every effort should be made to subdue it as early as possible. Half a pint of rice milk, with ten or fifteen drops of laudanum may be taken two or three times a day, and an injection may also be used night and morning of flaxseed, with fifteen or twenty drops of laudanum. M. Colombat recommends the following recipe as seldom failing to cure. Take the whites of six eggs and beat them up in a quart of water; then use one-third as a drink, and the rest as an injection. A neat spoonful should be drunk every ten minutes, and an injection used every two hours, but not more than one small syringeful at a time. A tea-spoonful of syrup of poppies, with some loaf sugar, may also be added to every spoonful that is drunk. Eggs, jellies, and rich soups, with meat and wine, if there be no inflammation, may be taken regularly, in addition to the articles already mentioned.
DYSPNŒA, OR DIFFICULTY OF BREATHING.
There are but few pregnant females who do not complain more or less of difficulty of breathing, and this difficulty may arise from different causes. In the earlier months it is caused by sympathetic irritation only, the same as difficulty of swallowing. In the latter months it is caused by the enlarged womb filling up the abdomen so much that the lungs in the chest are pressed upon and have not sufficient room to play freely. It may also be caused by a plethoric or too full habit, the lungs then being in reality congested.
The temporary difficulty of breathing which is felt in the early months, from nervous sympathy, needs scarcely any kind of treatment, as it passes off naturally in a short time. In severe attacks the same remedies may be used as for difficulty of swallowing before referred to.
That which arises in the latter months, from pressure of the womb, can frequently be relieved only by the patient remaining as long as possible in certain favorable positions. I have known many who could never sleep except when propped nearly upright, by means of pillows and cushions, as immediately they assumed the recumbent position the upward pressure became so great they were nearly suffocated. In such cases the patient should be careful never to eat or drink to excess, nor take anything likely to produce wind, because the least increase in the size of the abdomen adds to the difficulty. The bowels should also be kept free, and nothing tight or heavy in the way of clothing should be worn.
This difficulty is most frequently seen in those who have contracted chests, and in those who have been accustomed to wear corsets and tight dresses. A deformed pelvis may also give rise to it by forcing the womb above its usual position. Many females both create and increase this difficulty by binding themselves tighter than usual during pregnancy, under the mistaken idea that it enables them to support their burden so much easier.