The danger from hemorrhages that occur at or near the full period of utero gestation, may often be estimated by the absence or degree of pain, as well as from the quantity of the discharge. Hemorrhages are much more dangerous with sudden than with slow discharges of blood, and women are always in greater danger when they are not accompanied with pain. Puerperal convulsions, whether of the hysteric, epileptiform, or apoplectic variety will always demand and almost always receive the prompt attention of the physician.
While the nurse is waiting for the doctor to arrive she might possibly administer a cathartic, thirty grains of bromide of potash, and an enema, but as a general rule she should not give anything. She might insert a wedge or roll of linen between the teeth to prevent injury to the tongue, and she should remove every thing out of the way, by striking against which, the patient might hurt herself.
PART V.
Ætiology, Symptomotology, Medication, Nursing.
CHAPTER I.
CAUSES OF DISEASE.
The causes of disease are spoken of by authors as predisposing, and exciting. By proximate cause of disease is meant the cause of the symptoms present; this cannot appropriately be dwelt upon here.
By exciting cause is meant the immediate cause of a disease, and the distinction from predisposing cause arises from the fact that when two persons are exposed to something injurious to the health, they may not be equally affected.
It has been said that if twenty persons undergo hardship and exposure from shipwreck, the effect of the wet and cold may be in one to cause catarrh, in another rheumatism, in a third pleurisy, in a fourth opthalmia, in another inflammation of the bowels, and fifteen may escape without any illness at all. A predisposing cause is defined to be anything whatever, which has had such an influence on the body as to have rendered it unusually susceptible to the exciting cause of the particular disease. In most cases the distinction is obvious, but it is sometimes difficult to say of a given cause whether it ought to be ranked among the predisposing or the exciting causes.
Disease is often warded off notwithstanding the presence of the exciting cause, when we ascertain and prevent the predisposing cause of it, and it may sometimes be averted in despite of strong predisposition, if we know and can guard against the agencies by which it is capable of being excited.
When we enumerate causes of disease we see among them many that under ordinary circumstances minister to life, health, and enjoyment; and I can hardly refer at all to the varying circumstances under which they become the medium of pain, disease and death. These circumstances are so various, so many of them are apt to be put in operation at the same time, and so little power have we of excluding them one after the other, so as to ascertain the exact efficiency of each, that our observation respecting their actual effects are open to much fallacy.
We cannot for instance in a given case estimate accurately the effect of impurities in the atmosphere such as organic and inorganic dust, nor the effect of differences in degree of its natural qualities such as extremes of heat and cold, sudden variations of temperature, excessive moisture or dryness, different electric conditions, differences of pressure, a deficiency of light, and the amount of ozone, &c.