373. “The whites,” during pregnancy, especially during the latter months, and particularly if the lady has had many children, are frequently troublesome, and are, in a measure, owing to the pressure of the womb on the parts below causing irritation. The best way, therefore, to obviate such pressure, is for the patient to lie down a great part of each day either on a bed or on a sofa.
374. She ought to retire early to rest; she should sleep on a horse-hair mattress and in a well-ventilated apartment, and she must not overload her bed with clothes. A thick, heavy quilt at these times, and indeed at all times, is particularly objectionable; the perspiration cannot pass readily through it as through blankets, and thus she is weakened. She ought to live on plain, wholesome, nourishing food; but she must abstain from beer and wine and spirits. The bowels ought to be gently opened by means of a Seidlitz powder, which should occasionally be taken early in the morning.
375. The best application will be, to bathe the parts with warm fuller’s earth and water, in the proportion of a handful of powdered fuller’s earth to half a wash-hand-basinful of warm water; and the internal parts ought, night and morning, to be bathed with it. If the fuller’s earth should not have the desired effect, an alum injection[[70]] ought, every night and morning, by means of an india-rubber vaginal syringe,[[71]] to be syringed up the parts; or fifteen drops of solution of diacetate of lead should be added to a quarter of a pint of lukewarm water, and be used in a similar manner as the alum injection.
376. Cleanliness, in these cases, cannot be too strongly urged. Indeed, every woman, either married or single, ought, unless special circumstances forbid, to use either the bidet or a sitz-bath. If she has not the “whites,” or if she has them only slightly, cold, quite cold water is preferable to tepid. I should advise, then, every lady, both married and single, whether she has the “whites” or not, a regular sitz-bath[[72]] every morning (except during her “poorly times”)—that is to say, I should recommend her to sit every morning in the water (in cold water) for a few seconds, or while she can count a hundred; throwing the while either a small blanket or shawl over her shoulders, but having no other clothing on except slippers on her feet. She should, for the first few mornings, make the water lukewarm; but the sooner she can use it cold—quite cold—the more good it will do her.
377. If the above plan were more generally followed, women of all classes and ages would derive immense benefit from its adoption, and many serious diseases would be warded off. Besides, the use of the sitz-bath, after a time, would be a great comfort and enjoyment.
378. Where a lady suffers severely from the “whites,” she ought to visit the coast. There is nothing in such cases that generally affords so much relief as the bracing effects of sea-air. Of course, if she be pregnant, she ought not to bathe in the sea, but should, every night and morning, bathe the external parts with sea water.
379. When the patient has been much weakened by the “whites,” she will derive benefit from a quinine mixture[[73]]—a dose of which ought to be taken twice or three times a day.
380. Irritation and itching of the external parts.—This is a most troublesome affection, and may occur at any time, but more especially during the latter period of the pregnancy; and as it is a subject that a lady is too delicate and too sensitive to consult a medical man about, I think it well to lay down a few rules for her relief. The misery it entails, if not relieved, is almost past endurance.
381. Well, then, in the first place, let her diet be simple and nourishing; let her avoid stimulants of all kinds. In the next place, and this is a most important item of treatment, let her use a tepid salt and water sitz-bath.[[74]]
382. The way to prepare the bath is to put a large handful of table salt into the sitz-bath, then to add cold water to the depth of three or four inches, and sufficient hot water to make the water tepid or lukewarm. The patient must sit in the bath; her slippered feet being, of course, out of the water, and on the ground, and either a woolen shawl or a small blanket being thrown over her shoulders: which shawl or blanket ought to be the only covering she has on the while. She should remain only for a few seconds, or while she can count, in the winter, fifty, or the summer, a hundred, in the bath. Patients generally derive great comfort and benefit from these salt and water sitz-baths.