The water processes, practiced in a manner suited to the exigencies of the case, cannot be too highly recommended or too much praised, as a means of purification and cure in this offensive and troublesome malady.
Suppression of the Discharge.—Women, in general, very much fear a sudden cessation of the lochia, and for the reason that it is generally well understood that this occurrence is attended with circumstances of an unfavorable character. But while patients should, on the one hand, always be careful and considerate in matters pertaining to health, they should, on the other, not become at once frightened at every little cessation of the discharge. As I have before said, it may cease of itself spontaneously, and without harm to the system, within a few hours after birth. Dr. Good, indeed, tells us “that in some women who have healthy labors, there is no lochial discharge whatever, the blood-vessels of the uterus contracting suddenly and closely as soon as the red blood ceases to flow.” This celebrated author points out an example of this kind that occurred to Professor Frank, even after a third natural delivery; the patient, moreover, having been from a girl as destitute of menstruation as afterward of lochia; yet her health was in no respect interfered with.
Diagnosis and Treatment.—If thus, on examination, we find that there is no increase in the frequency of the pulse, or other unfavorable symptoms, no fear whatever need be entertained. If the patient has taken cold, causing an inflammation of the womb, an accident which may be known by sensations of chilliness along the spine, accompanied, perhaps, with general rigors, by the roundness, hardness, and tenderness of the womb, which may be easily felt through the abdominal coverings; and, if added to all these symptoms, there is great heat of the skin and frequency of the pulse, rising to 110°, 120°, 130°, or even more; then we may know that the suppression is a morbid one—one, too, which if not promptly treated, may soon end in death.
Patients, under such circumstances, have great fears of cold; they bundle themselves up, and heat their systems in all manner of ways, as if their physical salvation depended wholly upon such a course. But the truth is, the mischief has been already done; once there is a severe inflammation or fever upon a patient, it is impossible for her to take another cold until the previous one has been cured.
This fact, then, indicates clearly what the proper treatment of such cases should be; we must treat them on the same general principles of all other inflammations; and as soon as the fever and inflammation are sufficiently removed by means of ablutions, wet compresses, injections, water-drinking, and, if necessary, the packing wet-sheet, the discharge—if any such be at all necessary—must follow as inevitably as a stone falls to the ground. Thus it is, then, that under certain circumstances, a cold may give fever and inflammation; while under other circumstances, cold cures these symptoms. These operations of nature, simple and beautiful as they are, must prove highly interesting to every reflecting mind; and they show, moreover, the goodness, benevolence, and design of the Creator, in furnishing us everywhere, so abundantly, a remedy so powerful and safe as pure, cold water.
In all those diseases following delivery, the excellent Dr. Good observes, “That cleanliness and purity of air are of the utmost importance,” and “that, without these, no plan whatever can succeed; and with them, no other plan is often wanted.” “They are, moreover,” he continues, “of as much moment to the infant as to the mother. It is a striking fact that, in the space of four years, ending in 1784, there died in the lying-in-hospital of Dublin—at that time a badly-ventilated house—2944 children out of 7650; though after the ventilation was improved, the deaths within a like period, and from a like number amounted to not more than 279.”
LETTER XXXIV.
OF CHILDBED FEVER.
Milk Fever as distinguished from Puerperal Fever—The great Danger of Childbed Fever—Its Symptoms and Nature—Modes of Treatment—Is it a Contagious Disease?
In the course of two or three days usually after the birth of the child, the woman experiences more or less febrile excitement of the system. This is what is termed milk fever, it being connected with the coming on of the lacteal secretion. The attack sometimes amounts to a “smart febrile fit, preceded by shivering, and going off with a perspiration.” It is not dangerous, seldom lasts over twenty-four hours, and during the time of its appearance the breasts are full, hard, and painful, which distinguishes this from more dangerous fevers.
Puerperal or childbed fever is a very different thing from the foregoing, and is reckoned by physicians as being one of the most fearful of maladies.