When the dyspnœa arises from a full habit the patient must live low, keep the body regularly bathed and rubbed, and the bowels freely open by an occasional seidlitz powder, or dose of Epsom Salts. If the difficulty becomes at any time suddenly great and alarming, the feet should be placed immediately in hot water, while the patient is upright; a mustard plaster should also be put upon the chest, and an opening injection of starch and Castor Oil administered as soon as possible. The usual practice in such cases is to bleed from the arm, to the extent of eight or ten ounces, and in case no other means give relief, this may be tried.
COUGH.
Like the previous affection cough is most usually produced during pregnancy by sympathetic irritation. It may arise, however from a partial congestion, or inflammation of the lungs or bronchial tubes, produced by a too great determination of blood to them. In the merely nervous cough, there is no expectoration, nor any soreness or pain in the chest, and it will frequently disappear for several days together. No particular attention need be bestowed upon this cough, unless it become so violent as to threaten abortion. In that case a pill, containing one grain of opium, may be taken, or from ten to fifteen drops of laudanum, whenever the attack is severe. Barley water, or gum arabic water, may also be freely drunk, with a large spoonful of Syrup of Poppies added to each pint. A small dose of Hive Syrup, or Paregoric, will also be found sometimes better than anything else. An enema of Starch and Laudanum, as formerly described, will also relieve, in some cases, better than anything taken by the mouth. The body should be kept warm, particularly the feet, and a mustard poultice may be placed over the chest, if the straining at any time becomes too great. Some patients experience relief from an assafœtida pill, or a little musk, and others from a small dram of cordial, or wine.
If there be expectoration, with fever, and tenderness in the chest, or sharp pains when a long breath is drawn, there is reason to fear inflammation of the lungs, or bronchitis. In this case all the above means, except the wine and stimulants, may also be used only more freely, and the mustard poultice must be kept on till it makes a blister. The patient must live low, her feet must be frequently bathed in hot water, and her bowels regularly opened either with saline purgatives or enemas. All that is requisite is to keep the inflammation from extending till after delivery, when it usually subsides without any further trouble. As soon as the womb is emptied, its pressure upon the abdominal aorta ceases, and the blood can then flow freely to the lower extremities, and thus the lungs become relieved and the inflammation goes down.
PALPITATION OF THE HEART.
This is also a frequent accompaniment of pregnancy, and one that is likely to cause alarm sometimes, from its violence. Unless dependant upon organic disease of the heart however, it is in general only a nervous affection, and passes away with delivery. We may always reasonably suppose it to be nervous when it occurs only during pregnancy, and particularly if it is irregular in its frequency and violence. I have known females who were always attacked with it about the same period, and who could therefore always tell when it was coming on, and sometimes even how long it would last. It will sometimes come on during sleep, and so forcibly as to waken the patient instantly. At other times while awake, it will commence so suddenly that she will sink down as if struck by a powerful blow.
The only directions that can be given for alleviating it are, to keep as quiet as possible, use the bath regularly, avoid constipation, and live rather low, particularly if the patient be of a full habit. Exercise should also be taken regularly in the open air, but not of a violent kind. She should also sleep with the head on a high pillow, and never eat late suppers, nor take any food that disagrees with the stomach.
All kinds of stimulants, such as wine, coffee and spices, should be abstained from, and all powerful emotions carefully guarded against. During an attack a few drops of Laudanum, or an Opium pill may be taken, and the feet placed in hot water. An Assafœtida pill is sometimes good, or a little Ether. Bleeding is generally practised in extreme cases, but there is often considerable danger in it.
A too full habit is often the exciting cause of the palpitation, as may be seen by the patient being always liable on the slightest exertion to flushed face, dimness of sight, ringing in the ears, swelling of the limbs, and puffiness of the gums, sometimes to such an extent that the mouth will taste of blood. Such persons should carefully observe a moderate unstimulating and simple diet, and never allow the bowels to remain constipated more than a single day. They should also rub and wash the skin well, and study calmness and quiet.