More than ten years ago, and while I was yet a student in medicine, and had never heard of the water-cure as practiced by the great Priessnitz, I was in the habit of revolving these matters in my mind. It occurred to me often, that if the Roman women, and the Indian women of different nations, could reap so great a benefit as appeared to be derived from ablutions performed soon after childbirth, that our own females too, weakly although they are many of them, could gain similar advantages from pursuing a like course. It was thus that I was led, as far back as 1843, to strike out a course of treatment for myself in these cases, having no medical authority or precedent to go by. The result of this treatment is now, fortunately, getting to be pretty well understood, and the merits of the new method appreciated in almost all parts of our country. In Europe they are altogether behind us in the improvement to which I allude.
I need not here go into any lengthy details concerning the methods of bathing that are proper to be adopted in the parturient state. The numerous cases which I have given will serve as a sufficient guide, I trust, to all of you who are concerned. I may remark, however, in general terms, that there is no need of doing any violence in the way of a bath; and those who have not access to the personal advice and superintendence of a physician who understands the practice, may always act safely by washing the patient in her bed. Thus, if a blanket or some other extra article is placed beneath her, she may easily be washed over the whole surface, piecemeal, a practice which, though it is neither so thorough nor useful in most cases, as it would be to go at once into the tub, is yet a good one, and productive of great comfort.
The Binder, Compresses, etc.—As to the use of the wet bandage, the compresses, etc., a few words will here be in place. If a dry bandage is ever needed as a support, the wet one is much to be preferred to it. As a general thing, however, we put no bandage upon the woman soon after the birth, as will be seen by reference to the cases given in this work; we wish to change and rewet the application frequently, and for this reason the simple compresses are the most convenient. But when the patient is to sit up or walk about, the wet girdle, if properly arranged with tapes to secure it, and made pretty tight at the lower part of the abdomen, affords a good deal of support. The wet bandage does not slip upward and get out of place near so readily as the dry one.
It will naturally occur to you, whether the going without the old-fashioned belly-bandage will not be likely to prove injurious to the woman’s form. The sum and substance of this whole matter is just this: whatever tends to weaken the constitution in general, and the abdominal muscles in particular, must have a tendency to produce laxity of the fibers, thus rendering the part more pendulous. On the other hand, whatever tends to strengthen the system and to give tone to its fibers, must have a contrary effect. Now, the dry belly-band, even when it is so arranged as to keep its place—which it generally is not—is too apt to become heating, and, of course, a source of debility under such circumstances. For this reason it is plain that a cold wet girdle is altogether better than a dry one. Nor should this even be left on too long a time without changing and rewetting it. This should be done, as a general thing, every three or four hours at farthest, and in warm weather oftener.
The Repose.—Some have feared to allow the woman to go to sleep for some hours after delivery, fearing that she might be taken in hemorrhage as a consequence. It is possible that a patient under such circumstances may wake suddenly with a flooding upon her, particularly if she be too warmly covered up in bed. But by all of the best authorities it is regarded that the sooner the woman sleeps after she has passed through the agony of labor the better. Sleep is, indeed, no less “nature’s sweet restorer” under such circumstances than at other times; and it would be most cruel to deny a patient this privilege, when it would be so grateful and refreshing to her.
Sitting up soon after the Birth.—I have proved satisfactorily to myself, that there is great error abroad in this country generally in regard to the parturient woman rising soon after the labor is past. It appears to be the belief of physicians generally in this country, that it is highly dangerous for a woman to sit up before some days after accouchement. The common saying concerning the ninth day you have all of you heard.
Velpeau, of Paris, who is higher authority by far than any old-school man in this country, says: “After this first sleep—that is to say, after the lapse of two or three hours—the patient should sit up in bed, and take a little broth; this position seems to rest her, and allows the lochia which had accumulated in the vagina to flow readily off.” That is the point: it serves to REST her; that is, when a woman is tired of lying down, both common sense and instinct declare that she should change her position; in other words, sit up. This very same thing I have taught strenuously for these seven or eight years, as many of you know; and just now, while I am writing, I find that Velpeau long ago recommended the same thing.
Walking About.—Precisely the same principle holds good in regard to walking and all other modes of exercise as in sitting up. A little and often should be the rule. The cases which I shall give you will form a sufficient guide on this point.
I have known a great many more persons to be injured by inactivity, remaining too much in bed and in overheated rooms, than by walking about too much and too soon.
The Food and Drink.—I have but a word here to say on this subject. The patient should begin directly after birth with the same kinds of food and drink which she intends to use during the period of nursing. If she is to eat fruit, which I consider good for her, she should take it from the first. Prudence should, of course, be exercised in regard to quantity as well as quality of food under these circumstances.