It is evident enough, I think, that under such circumstances, some powerful and decided means must be resorted to; otherwise the disease might proceed so rapidly as to destroy the patient’s life, and that too, possibly, within twenty-four hours.
We commenced the treatment by giving her a thorough ablution in water, a little tepid at first. She was then placed in a heavy linen sheet but moderately wrung from cold water, and packed loosely, with but little covering. The object of these applications was gradually to cool the system; to bring down the pulse, as soon as might be, to its natural standard; to arrest the inflammation that was already going on in the abdomen; and to quell the pains. The wet sheet was changed every twenty to thirty minutes. Gradually the pulse became less frequent, and the pains less, till midnight, when we had succeeded in bringing the pulse permanently down to 80, and the pains were quite gone. The wet sheet was then folded each way, making it four double, and placed about the patient’s body, from the arms downward; in this she was to sleep the remainder of the night, having just covering enough to keep her comfortable. But if she should become wakeful from pain or feverishness, the husband was to renew it, that is, rewet it in cold water, and as often as necessary. Once or twice only it was changed before morning.
The reader who is at all acquainted with the danger and the fearfulness of this most awful disease, may form some idea of the anxiety I felt when I first found this patient with the attack upon her. He may judge, too, something of my feelings, when, by midnight, I had succeeded in bringing the pulse down to 80, and quelling all fever and pain.
The next morning the patient appeared in all respects well, but somewhat weak, and not a little blanched. She got along afterward in all respects perfectly well.
In a very short time—I do not now remember in how many days after the birth—she commenced walking out carefully, and riding in the city to improve her strength, with a view of returning home as soon as circumstances might warrant.
When her infant was nineteen days old, feeling in all respects strong and well—as much so, perhaps, as ever in her life—she proceeded, in company with a female attendant, on her journey homeward, about three hundred miles.
I should remark that this patient was always of weak, nervous, and delicate constitution. She had had a miscarriage three years before this confinement, which weakened her a good deal. During this second pregnancy she adopted the water-treatment under my directions, but was obliged to use, both for bathing and drinking as well as other purposes, very hard, limy water—a circumstance considerably against her. She experienced numerous little ailments, but on the whole got along very well.
Case XIII.—Nov. 8, 1850.—A lady residing in the city of Brooklyn, of small stature, tolerably good constitution, nervous temperament, and I should judge about twenty-five or six years of age, gave birth to her third child near midnight of the above date. Having suffered a good deal at her last preceding confinement, particularly with after-pains, she had resolved at this time to adopt the water-treatment.
Very soon after the birth, the placenta having been expelled soon after the child, the most fearful after-pains commenced, precisely in the same way the patient had suffered before; and she had doubtless, as many have, experienced incomparably more pain after the birth of the child than before it. This is all unnatural and wrong, and would not be, if human beings had from the first always obeyed the physical laws. But is there no method by which these pains—terrible and persistent as they often are—may be prevented? Certainly, if the experience of thousands may be taken as a guide. No drugs can do it. Suppose we give strong opiates, as some few of the more stupid practitioners may yet sometimes do, we may allay the pains somewhat for the time. But who does not know that the pains are in the end made worse? And what havoc does such treatment make with the nervous system? But, fortunately, physicians have, as a general thing, abandoned this practice.
In this case we helped the patient into the wash-tub, having the back elevated two or three inches by a block of wood, she sitting in it with the feet outside, and there being a couple of pails of tepid water in it. She was rubbed for a long time—say fifteen or twenty minutes—until all pain was removed. A large, heavy sheet was then folded both ways, making it four double, and laid upon the bed; on this she was placed, after which it was folded about her, reaching from the arms to the knees. The application caused a good deal of shivering, but as I told her, the more shivering the less pain, she bore it patiently. She was covered, so as to make her in a reasonable time comfortable, and there was, I believe, moderately warm applications made to the feet.