Treatment.—If it is attended with violent symptoms, as is sometimes the case, it will be necessary to use active measures to cure it. In a majority of cases, however, a few days of abstemious living, alternating now and then with a day of entire fasting, together with plentiful drinking of pure, soft water, and a moderate share of bathing, will suffice to effect a cure. The wet-sheet pack is especially useful in these cases.
LETTER XVIII.
DISORDERS OF PREGNANCY.
Difficulty of Breathing—Pain in the Right Side—Itching of the Genitals—Swellings of the Limbs—Cramps of the lower Extremities—Pain of the Breasts—Hysteria—Physical Hindrances—Exposure to Disease.
Toward the latter months of pregnancy, there is always, necessarily, more or less difficulty. The uterus becomes so large, and fills so much of the abdomen, that the upward and downward motion of the diaphragm, or partition between this and the chest, is greatly impeded. Hence the dyspnœa, or difficulty of breathing. A cough, likewise, not unfrequently attends this symptom, and becomes so severe in some cases as to cause abortion.
Prevention.—Great and protracted exertion, severe fatigue of whatever kind, bodily or mental, ought to be avoided during pregnancy. Running up stairs too quickly, walking too rapidly, and any undue mental excitement, increases this difficulty of breathing. Some mothers are in the habit of taking up heavy children needlessly, and carrying them, which is one of the most certain means of doing harm to themselves. So also, inaction is bad for the breathing. If the individual do not have exercise enough to answer the purposes of health, the system becomes more plethoric or full, and thus also the difficulty is increased. The medium of neither too little nor too much should always be observed. The same also may be said of the diet. And here I remark, that if any pregnant woman will carefully make the experiment, she will find that in the latter months of pregnancy, an exceedingly small allowance of food only, with free water-drinking, bathing, and moderate exercise in the open air, will be sufficient to keep up her strength, and that in a most remarkable manner. Let her not be deluded by the old maxim, that because there are two to support she must take a greater amount of food.
PAIN IN THE RIGHT SIDE.
After gestation has passed the middle of its term, there is experienced often more or less pain in the right side. This does not usually happen until after the beginning of the fifth month of pregnancy. It comes on as a deep-seated pain in the immediate region of the liver; often it is merely a trifling sensation at first, increasing as pregnancy advances. It is not increased by ordinary inspirations, as many internal pains are, although a very full and deep inspiration may augment it in a slight degree. The pain is seldom, almost never, very great; it is constant both day and night, but worse in the latter. The patient can lie on either side, but better on the left. A severe sensation of heat is sometimes experienced at the part where the pain exists. This is sometimes almost constant, at others only occasional, and in still a greater number of instances, nothing of the kind occurs.
Women are more subject to this affection during the first pregnancy than at subsequent times. It may, however, be experienced after a number of children have been borne; this is true more especially in those cases when the child is carried “high up,” as it is called. This comes from the fact, that the pain is caused by the pressure of the upper part of the womb upon the liver, which lies mostly upon the right side.
Treatment.—No material harm can be said to come from this pain, and for this reason no harsh and severe medical treatment should be adopted with a view of removing it. Bleeding is well known to be a common remedy for ordinary pains in the side. But Dr. Dewees, of Philadelphia, whose experience was so great in all matters pertaining to midwifery, remarks of this practice, that so far as he had seen it, not the slightest advantage had arisen from it. “Nor,” observes this candid writer, “has any other treatment which we have advised been any more successful. Leeching, cupping, and blistering, have in turn been employed without benefit. Indeed, we have now ceased to prescribe for this complaint, unless it be attended with some alteration in the circulating system; if this be disturbed, and the pulse tense and frequent, advantage is sometimes experienced from the loss of blood and gentle purging, as this pain may be aggravated by this condition of the system. But in this instance, we prescribe for the general condition of the system, and not for the local affection—as we should have to do most probably as much, were this pain in the side not present.” These are the candid remarks of one whose experience in treating diseases of women was as great, probably, as that of any other man, showing conclusively that ordinary means are of no avail in this difficulty.
Now I can speak confidently in this matter. The water processes are effectual in mitigating this pain much, to say the least. I conclude it is rather a symptom of debility than otherwise. I do not believe it natural. Bathing to support the general strength, and particularly the wet girdle, often rewet, especially in hot weather, so as to keep it at all times cool, and hip-baths, with a good share of friction by the wet hand over the part affected, will be found excellent means. The immediate relief caused by the application of the wet girdle will be often astonishing. Keeping the bowels freely open, as by the habitual use of brown bread, mush, and the like, and injections of cold water, are also of service here.