417. How, then, is the patient to know that the pains are false and not true labor pains? False labor pains come on three or four weeks before the full time; true labor pains at the completion of the full time; false pains are unattended with “show;” true pains generally commence the labor with “show;” false pains are generally migratory—changing from place to place—first attacking the loins, then the hips, then the lower portions, and even other portions of the belly—first one part, then another; true pains generally begin in the back; false pains commence as spasmodic pains; true pains as “grinding” pains; false pains come on at uncertain periods, at one time a quarter of an hour elapsing, at others, an hour or two hours between each pain; at one time the pain is sharp, at another trifling; true pains come on with tolerable regularity, and gradually increase in severity.
418. But remember—the most valuable distinguishing symptom is the absence of “show” in false labor pains, and the presence of “show” in true labor pains. It might be said that “show” does not always usher in the commencement of labor. Granted; but such cases are exceedingly rare, and may be considered as the exception and not the rule.
419. Treatment.—A dose of castor oil is generally all that is necessary; but if the pains still continue, the patient ought to be abstemious, abstaining for a day or two from beer and from wine, and rubbing the bowels every night at bedtime either with camphorated oil, previously warmed, or with laudanum (taking care not to drink it by mistake). Either hot salt, in a flannel bag, or a hot-water bag applied every night at bedtime to the bowels, frequently affords great relief.
420. If the pains be not readily relieved she ought to send for a medical man. A little appropriate medicine will soon have the desired effect.
421. These false labor pains might go on either for days, or even for weeks, and at length may terminate in real labor pains.
PERIOD OF GESTATION—“THE COUNT.”
422. The period of gestation is usually[[76]] two hundred and eighty days—forty weeks—ten lunar or nine calendar months.
423. It will be well for a lady, in making her “count,” to commence her “reckoning” about three days after the last day of her being “unwell.” The reason we fix on a woman conceiving a few days after she has “ceased to be unwell” is that she is more apt to do so soon after menstruation than at any other time.[[77]]
424. A good plan to make the “reckoning” is as follows: Let forty weeks and a few days, from the time specified above, be marked on an almanac, and a lady will seldom be far from her calculation. Suppose, for instance, the last day of her “ceasing to be unwell” was on January the 15th, she may expect to be confined very near October 23d.
425. Another plan, and one recommended by Dr. Tanner, to make the “count,” is the following: “To effect this readily, we cannot do better than follow the plan of most German obstetricians, who learn the probable day of delivery thus: the date of the last menstruation being given, they calculate three months backward and add seven days. For example, suppose the 20th January to be the last day of the last menstrual period, labor will be due about the 27th October—i.e. on the 280th day.”[[78]]