I may, however, dismiss this whole matter of sleeplessness in pregnancy, by saying, that those who bathe daily, exercise judiciously, and, when possible, in the open air, drink only pure soft water (and all can have this from the clouds), partake only of plain and unstimulating food, and sleep upon hard beds and pillows, in cool, fresh air, will rarely, if ever, be troubled with want of sleep.
One other thing, however; it sometimes seems necessary for persons in pregnancy to get a “nap” during the day. Those who have great cares, and many in our country have, often find it extremely difficult to get through the long, hot days of summer without sleep. Now, in such cases, if the woman can go by herself, and be wholly undisturbed, and feel entirely free from every care, and thus get a good half hour or an hour’s sleep, she will be much refreshed thereby. It is necessary to observe that the clothing should be removed as at night. Persons often wonder how it is that they feel worse after sleeping than before. When one lies down, if the clothing be left on, too much heat is retained about the surface, and thus debility, instead of refreshment, is experienced. This day-sleeping should be done with the stomach empty, as at three or more hours after a meal, and not in the afternoon, as that would be liable to cause wakefulness at night. It is truly surprising how much, under favorable circumstances, a short sleep even will refresh the powers of life.
HEART-BURN.
This is not unfrequently one of the first unpleasant symptoms that women experience after becoming pregnant. It sometimes becomes very distressing, and difficult to manage according to the ordinary modes. “It is generally,” says Dr. Dewees, “very distressing and very difficult to subdue.” He had known large and repeated doses of the alkalies given with scarcely any temporary alleviation, and much less, permanent benefit.
The great cause of heart-burn in pregnancy, as well as in other cases, is acidity of the stomach; and acidity of the stomach comes from improper food. Very seldom, indeed, can a pregnant woman be troubled with heart-burn, acidity of the stomach, or vomiting, if the dietetic and other habits be regulated according to principle. Pregnant women, in this country of abundance, generally eat a great deal too much food. They have also too little exercise in the open air. Some, indeed, have too much exercise, as in doing household work; but more are injured by doing too little than too much. But in this country ninety-nine of the one hundred eat too much food while in the pregnant state.
Treatment.—To cure the heart-burn, let the woman, when she first experiences it, at once desist in the quantity of food. If she rises in the morning and finds the symptom upon her, she may be certain that digestion has gone on badly the day previous, and that the stomach contains portions of the undigested aliment which has passed into the acetous fermentation, and thus causing the difficulty she experiences. What is to be done in such a case? Will the introduction of another portion of food into the already disordered stomach make matters any the better? Certainly not, except for a short time. When the stomach is goaded on by a new meal, the individual may feel the better for half an hour; but, other things being equal, it in the end only makes the matter worse. Fasting a meal or two, with water-drinking for its tonic effect, is the best possible means. The stomach, thus, has time to regain its vigor, and food taken in moderation, subsequently, will then be found to agree perfectly well. It will here also surprise any one to learn how small an amount of food is really necessary, with water-drinking, to sustain the strength.
If the heart-burn is very troublesome, it will be found of great relief for the patient to vomit by means of water. This, in most cases, will take place very easily by drinking, in quick succession, a number of tumblers of soft water, about blood-warm temperature. This, with a little help, as by putting the finger in the throat, will be found sufficient; and if, in any case, the vomiting does not take place, the water yet does much good by means of diluting the offending matters in the stomach. Thus, suppose there is one ounce of acid matters in the gastric cavity, and that ten ounces of pure water are introduced therein, the offending mass is weakened tenfold; so that even if vomiting does not take place, great relief is experienced. I would not have any one make too great an effort to produce vomiting, especially in pregnancy, for hard vomiting might cause abortion. There is, however, no danger except the vomiting caused by drug substances. Water-vomiting is easier than can be imagined by those who have tried only the old modes.
Soda and other alkalies, taken so often to ease heart-burn, do more harm than good in the end. The wet girdle, worn occasionally about the abdomen, and managed so as to produce a cooling effect, will be found of great service in invigorating the stomach, thus tending to prevent heart-burn, acidity, and the like. So, also, the general ablutions, which ought never, for a single day, to be omitted during pregnancy, as we may say, too, of other times.
In heart-burn, arising from whatever cause, it is a very common custom, both with the profession and the people, to give alkalies, as magnesia and chalk. Dr. Dewees, I remarked, had known large and repeated doses given, with scarcely any temporary alleviation, much less permanent benefit. It is of little effect, certainly, to continue giving these articles, when at the same time the dietetic habits are such as are certain of keeping up the difficulty. This would hold true even if the articles administered were perfectly neutral in their effects as to harm, which can never be the case. All drug substances, however much good they do, at the same time cause a certain amount of harm. The articles, magnesia and chalk, the ones generally resorted to in this difficulty, are moreover often impure. This is particularly true of the latter article.
Dr. Dewees mentions a case in which the lady’s health was utterly destroyed by her enormous use of chalk. “I formerly attended a lady, with several children,” says he, “who was in the habit of eating chalk during the whole term of pregnancy; she used it in such excessive quantities as to render the bowels almost useless. I have often known her without an evacuation for ten or twelve days together, and then it was only procured by enemata (injections); and the dejections were literally chalk. Her calculation, I well remember, was three half-pecks for each pregnancy; she became as white nearly as the substance itself; and it eventually destroyed her, by so deranging her stomach that it would retain nothing upon it.” I repeat, that these alkaline substances always and inevitably do more harm than good; and the part of wisdom is to do without them.