But it should always be considered especially important to PREVENT THE ABORTION. If a woman is prone to miscarry, she ought, as soon as she is pregnant, to lie down a great part of the day; she must keep her mind calm and unruffled, and must live on plain diet; she should retire early to rest, and she must have a separate sleeping apartment. She should avoid taking active physic, but keep her bowels open by diet or by the mildest aperients, or, possibly, daily enemata. Gentle exercise may be taken, alternated with frequent rest. Cold ablutions are proper every morning, but the body should be rubbed afterwards with a coarse towel.
The most usual time for a woman to miscarry is from the eighth to the thirteenth week, but if a woman have a particular time, which to her is the usual period, whenever that time approaches she should be unusually careful. Let her lie down more than she usually does; let her avoid exciting amusements. She might try to keep her bowels open by the external application of castor oil, or by the mildest aperients, or by hot water enemata.
If slight hemorrhage and trifling pains come on, we should seek to arrest the abortion by giving perhaps grain doses of opium every four or five hours. If the hemorrhage is severe, a drachm dose of fluid extract of ergot may be given, and a large draught of cinnamon tea; perhaps a quarter of a grated nutmeg, and, in extreme cases, a spoonful of brandy with it.
But let it be understood that in all such cases a physician should be called as soon as possible; and while waiting for him the patient ought to lie on a hair mattress; a vaginal injection of hot water may be given; she should have but scant clothing upon the bed; her room should be well ventilated, and if she is faint from the loss of blood, a little aromatic ammonia may be given.
CHAPTER III.
PARTURITION.
False pains occur most frequently in a first pregnancy, but most pregnant women have occasional pains, and these become more violent within three weeks of the full time. They may be owing to a disordered stomach, as well as to the action of the uterus; but they usually come on at night, and are liable to be mistaken for labor pains. They are, however, unattended with show; they often change from place to place, perhaps going successively to the hips, loins, lower extremities and abdomen; they come on at irregular intervals, and are at one time violent, at another feeble, and they occasion no dilation of the os uteri; but true pains come on with some regularity, and usually increase in severity. False pains are from various causes, such as fatigue of any kind, especially too long standing, sudden and violent motions of the body, costiveness or diarrhœa, general feverishness, agitation of the mind, or a spasmodic action of the abdominal muscles. It is necessary to adopt the means used for the relief of the pains to the apparent cause, and generally to give an opiate proportioned to the degree of pain, or to repeat in small quantities at proper intervals till the patient shall be composed.
PERIOD OF GESTATION.
The duration of pregnancy is not always absolutely a certain number of days. The usual term is ten lunar months, or nine calendar months and one week. If we could have correct records of all cases we should probably find that half the cases of pregnancy terminated in labor in the fortieth week, but that in a few instances the term was prolonged to the forty-fifth week and that in as many cases women were delivered of fully developed children as early as the thirty-seventh week.
A woman may make her count pretty correctly as follows: She should first note the last day of her being unwell. Let forty weeks from that day be marked in an almanac, and she may expect her labor to come on near that time.
It may happen that a woman who never has her menses while she is suckling, may become pregnant and not have a date to count from; but she ought in that case to reckon from the time that she quickens. Although quickening takes place at various periods, she may then consider herself nearly half gone in her pregnancy, and calculate that in four and a half months she will be delivered.