292. Where a lady cannot take medicine, or where it does not agree with her, a good remedy for constipation in pregnancy is the external application of castor oil—castor oil as a liniment—to the bowels The bowels should be well rubbed every night and morning with the castor oil. This, if it succeed, will be an agreeable and safe method of opening the bowels.
293. Another excellent remedy for the costiveness of pregnancy is an enema, either of warm water or of Castile soap and water, which the patient, by means of a self-injecting enema apparatus, may administer to herself. The quantity of warm water to be used is from half a pint to a pint; the proper heat is the temperature of new milk; the time for administering it is early in the morning, twice or three times a week. The advantages of clysters are, they never disorder the stomach—they do not interfere with the digestion—they do not irritate the bowels—they are given with the greatest facility by the patient herself—and they do not cause the slightest pain. If an enema be used to open the bowels, it may be well to occasionally give one of the aperients recommended above, in order, if there be costiveness, to insure a thorough clearance of the whole of the bowels.
294. If the bowels should be opened once every day, it would be the height of folly for a pregnant lady to take either castor oil or any other aperient. She ought then to leave her bowels undisturbed, as the less medicine she takes the better. If the bowels be daily and properly opened, aperients of any sort whatever would be highly injurious to her. The plan in this, as in all other cases, is to leave well alone, and never to give physic for the sake of giving it.
295. Diarrhœa.—Although the bowels in pregnancy are generally costive, they are sometimes in an opposite state, and are relaxed. Now, this relaxation is frequently owing to their having been too much constipated, and nature is trying to relieve itself by purging. Such being the case, a patient ought to be careful how, by the taking of chalk and of astringents, she interferes with the relaxation.
296. The fact is, that in all probability there is something in the bowels that wants coming away, and nature is trying all she can to afford relief. Sometimes, provided she is not unnecessarily interfered with, she succeeds; at others, it is advisable to give a mild aperient to help nature in bringing it away.
297. When such be the case, a gentle aperient, such as either castor oil or rhubarb and magnesia, ought to be chosen. If castor oil, a teaspoonful or a dessertspoonful, swimming on a little new milk, will generally answer the purpose. If rhubarb and magnesia be the medicine selected, then a few doses of the following mixture will usually set all to rights:
Take of—Powdered Turkey Rhubarb, half a drachm;
Carbonate of Magnesia, one drachm;
Essence of Ginger, one drachm;
Compound Tincture of Cardamoms, half an ounce;