Sometimes the reverse of constipation occurs during pregnancy; namely, diarrhea. This also not unfrequently alternates with constipation. Constipation, however, is the most frequent symptom.
Treatment.—Singular as it may appear, diarrhea should be treated on the same general principles as constipation. Fortify and invigorate the general health, observing at the same time a correct general regimen, and either symptom disappears. In diarrhea, the hip-bath, often repeated, the wet girdle, and cold injections, taken as often as there is any disposition for the bowels to act, are effectual means. The diet should be regulated on the strictest principles. If a diarrhea is very severe, entire abstinence from all nourishment, except water, for a day or two, is a very salutary remedy. Food should then be taken with the same precautions as in nausea and vomiting.
PILES AND HEMORRHOIDS.
Piles and hemorrhoids are more apt to occur in pregnancy than at other times; and when these already exist, they are apt to become worse at this period. Constipation being more apt to occur in pregnancy, and that condition of the system being the one in which these symptoms are most liable to occur when the woman is not pregnant, so also they occur more frequently now than at other times. The constant pressure of the fetus upon the blood-vessels within the pelvis has also an agency in the matter, because every thing that causes sluggishness of circulation tends to bring on piles. So also the more sedentary habits of many females, during the period of pregnancy, are often a cause of this difficulty; but in other cases the opposite extreme is practiced—too much exercise or standing on the feet. Both these extremes may cause piles in pregnancy, or aggravation when they previously existed. Cathartic medicines not unfrequently bring on a “fit of the piles.”
This affection always denotes a wrong state of things in the general health. A really healthy person can never have the piles. Some, however, who are what would be termed tolerably well and strong in general health, experience such symptoms, but such is not the rule. Old cases, particularly, denote derangement of the general system.
When piles come on suddenly, they are often attended with very great pain and suffering to the patient. Not only is the pain great at the part affected, but there is also feverishness, pain, and a very unpleasant feeling in the head, with deep and severe pain in the back.
Treatment.—As to the treatment and general management in this affection, we should of course do the best that may be for the general health. As a general fact, no surgical operation should be allowed upon piles during pregnancy. These operations are often attended with so great pain, that abortion might be the result.
There is nothing in the world that will produce so great relief in piles as fasting. If the fit is severe, live a whole day (or even two, if necessary) upon pure, soft, cold water alone. Give then very lightly of vegetable food. Those who have suffered the agony of this affection, if they will but have patience to try this means, will find the truth of my remarks.
Water applications are also very useful in this disease. Dr. Dewees observes: “The pregnant woman may derive both comfort and advantage from sitting in a demi-bath of cold water, for five or ten minutes at a time, two or three times a day, when the complaint is advancing, or when about to retire; that is, after the severer symptoms have abated, or before they are high.” This advice is partly right and partly not. There is a notion with many that cold water-applications in high inflammation are not good; that they increase the difficulty instead of making it less. Thus in a burn, it is said that after the application of cold water the pain becomes worse. This is not true, although it appears to be so; for so great is the relief afforded by the application, that the pain appears worse, when in fact it is not; but only keep on continuously with the cold water-treatment, and the pain does not return at all. Such at least is the fact in all burns, however severe, when the surface is not destroyed; and the same principle holds good in all high inflammations from whatever cause. Very frequent sitz-baths, or merely washing the part often in cold water, will be found excellent in these severe cases of piles. Cold compresses worn upon the part also afford great relief. Cold injections are also useful. But, as before mentioned, fasting and the regulation of the diet are the great means.