A Book of Medical Discourses, in Two Parts

by Rebecca Lee Crumpler

When a woman is expected to be sick, if a physician has not been engaged as one should have been, no time should be lost in seeking quietly to notify one. It is just as important that a doctor should be in attendance before the birth of a poor woman’s child as that he should be present before the birth of the child of wealth. And it should be considered inhuman in any physician to purposely absent him or herself until after the birth of the child. With a little benevolence and perseverance, the most humble in life can be provided with bedstead and bedding, upon which should be fixed securely pads of cotton batting, or woollen cloths. Also there should be provided clean apparel for a change of under-garments, should such change be needful. The chemise and gown should be well taken up so as to be kept dry; as wet or soiled bedding or apparel in time of labor is a frequent cause of severe chills. For the same reason, should instruments or vessels be warmed before inserting, in the case of instrumental labors. The surrounding atmosphere should be comfortable, never too warm or too cold. When there is no physician present, and a child is so fortunate as to “born itself,” surely some one can be found to assist it to survive the task. After cautiously looking under cover to see that the infant’s face is clear from contact of any parts or particles, patience will aid in determining how best to complete a well-begun job.

BORN WITH A CAUL.

It is no uncommon thing, in hasty labor, for the bag of water to break and remain close around the face and neck of the child. This is done by the quick, rolling motion in coming into the world. The force of the descent breaks the thin skin or bag, and the same force packs the face into it; so that it remains over the face, partly around the neck, and sometimes over the head as well. Were it not removed, the child must suffocate. This circumstance at a birth has given rise to the sayings, “Born with a caul,” “Born with a veil,” etc. The proper way to remove this bag or membrane is, from over the head down, as lifting it may pull open the eyes; thereby bringing the eyeball in contact with the fluid or the chalk-like substance, thus laying the foundation for sore eyes. After twenty minutes or more, beating having ceased in the cord,—which may be known by pressing closely between the fingers that part nearest the belly of the child,—it should be tied by means of a flat knot, with lamp wicking, or many strands of white spool cotton, about a finger’s length from the belly. In case of twins, there should be a second tie the same length from the first, and the cord cut between the two ties. There have been times when women depended largely upon each other, in their helpless hours of confinement; it may be so again, but with a far greater chance of successful results.

CHAPTER IV.
THE BETTER MODE OF WASHING THE NEW-BORN.

Washing is the name given to the old method. Cleansing is the proper one for the new.

How to proceed: A soft, white, all-wool blanket, about two yards square, should be always in readiness when a birth is expected. Not necessarily new, but pure, never having been used about fever patients, or about the dead. A metallic slop-pail with cover, that all secundine particles may be put out of sight; the same serving as a vessel for the woman to sit over. As soon as the babe is freed from the mother, it should be wrapped in the blanket and laid aside in a comfortable place. After the mother’s safety is assured of, prepare thus to clean and dress the babe: Secure a comfortable position, with plenty of light and ventilation, as far from the confinement bed as possible. Have a stand or covered chair, upon which to place the half of a small teacupful of fresh hog’s lard or sweet oil. If in a cold room, warm the grease by setting the cup in hot water for a few minutes. Have a piece of soft, all-wool flannel, about the size of your pocket-handkerchief, another piece half as large, and two pieces of soft linen or cotton about as large as your hand. A piece of lamp wicking or several strands of white spool cotton, to be used in re-tying, in case of bleeding from the cut end of the cord. The infant may then be brought forth, held on the lap, or laid on two chairs. As many babes have open eyes as soon born, it is best to dip a small piece of the soft linen or cotton in the grease, and wipe the inner edges of the lids first of all, as the drying on of the chalky substance or other matter with which the child’s face may have had contact, while coming into the world, may, as I have before said, be the first cause of sore or inflamed eyes. Then proceed with the small piece of flannel, well saturated with oil, to clean the face, ears, nose,—avoiding the eyes,—neck, chest, under the arms and between the fingers. Wipe dry with the clean, large piece of flannel. Those parts can then be covered with a part of the blanket, and the lower extremities cleaned with care. Should there be dried blood from the cut end of the cord, moisten with warm water, and wipe it off. Then proceed to clean and examine well all the private parts. When done, cut a hole in the piece of cotton, linen or batting, as it may suit, about the size of your hand, through which slip the cord, fold it closely, but flat and smooth, and lay it over to the left side of the belly, that it may not intercept the circulation of the liver, which is situated on the right side. Then secure it with an all-wool flannel band. The band should be made so as to include a shirt with long sleeves. It should extend from over the teats down below the hips. There never would be swelling of the breasts of infants if the bands were purposely made wide. The natural office of the mamma in girl-children, has been destroyed by repeated pressing of the teats with the mistaken purpose of “getting out the milk.” Narrow bands are worthless. If they shrink they should be pieced out or replaced with new. The band securely placed,—a flannel roller, plain slip and napkin, is all that is required for the first dressing. It often happens that, after “washing” and dressing by present methods, blood oozes from the cut end of the cord. Seldom does this happen by the new method,—I should say, my method. Sometimes the fault is in the manner of tying, or from imperfection of the cord itself. In any case the cord should be re-tied, or the bleeding otherwise stopped, and the infant kept warm till medical aid can be summoned. To return to first dressing: After the wraps have been drawn up over the feet, the head should be thoroughly greased and cleaned, taking care not to press the bones in the least. Pressure upon the head at birth may be the means of stupidity, or even idiocy, during life. The baby’s mouth should then be swabbed out with a clean, wet cloth, and the little one laid down in quiet. Babies usually sleep during the procedure, as does the mother, she waking only to find her babe by her side, “all warm, sweet and clean,” and “mamma didn’t even hear it cry once.” One trial of this method is convincing of its benefits. If soap is used with grease, it acts the same as suds into which new cotton cloth is put. No good laundress will meet with such an accident, if possible to avoid it. And surely no careful nurse will allow her little charge to suffer by having to stop and change the water. Moreover, in the absence of soap, there is no liability to chapped skin, glandular sores, sore eyes, ears, and crusty scalp. Especially should the scalp be well cleaned, and kept so; as it not only adds to the tidy appearance of the child, but favors an even, healthy growth of the hair bulbs. The foundation for a love of cleanliness can best be laid in infancy. There are many adults who desire good hair, yet do not or will not know that combing the hair daily, and keeping the scalp clean and cool, promotes a healthy growth of the hair.

CHAPTER V.
NECESSITY OF AGREEABLE AND SOOTHING SURROUNDINGS.

No Bay Rum, perfume, puff powders or other unnatural substances should be tolerated about young infants. But after the patients have been made comfortable, all soiled clothing or slops should be quietly removed. All loud talking or laughing should be strictly prohibited. To insure this, no sly jokes should be indulged in by any one present; for by so doing convulsions of an alarming nature may be brought on. Judging from the actions of some women, when around a confinement bed, it is not at all unlikely that many cases of internal convulsions, both of mother and child, are the results of inward or suppressed laughter soon after delivery, and before the womb has had time to get in place, or when the babe is nursing.

Infants should be accustomed to a change of apparel as soon as possible. It is an error to suppose that a child should be kept hot, and tucked down in soiled wrappings till after the navel drops off. After twenty-four hours it can be wiped with clean warm water, close around the navel. The napkins, too, should be changed and washed out just as often as soiled. Also there should be clean day wraps and night slips in constant readiness during the child’s helpless period. Heavy or wadded coverlets should be discarded, even in the coldest weather, for the reason that they are heavier than woollen, retain the moisture from breaths, are not so easily washed as woollen blankets, nor are they so warm. The science of our nature teaches us that woollen is the best covering during the hours of sleep. For instance, the pores of our skin permit the escape of all gases not necessary for the renewal of the tissues of the body; in like manner woollen goods permit the odors to escape from our bodies.

The face of an infant should never be covered when asleep, especially when in the bed with adults; it induces lung difficulties. The blood must pass through the heart and lungs, uninterrupted, day and night, in order to supply all parts of the body. The hours for sleep are intended for the repair of worn material, while at the same time the useless matter is passing off in breath or perspiration. I believe that all infants should be supplied with a light covering for the head day and night, until the hair grows out. The old style lace cap, for instance, deserves a conspicuous place among the relics of health preservers. Later on, the hair becomes the only proper covering for the head day or night. By all means, a child should be closely watched, and its wraps changed and adapted to atmospherical changes. If infants are too tightly wrapped, or are allowed to get too hot, they generally make it known by writhing or whining in their sleep.