[524 MOTHERS' REMEDIES]
Piles.—When these are troublesome the rectum should be emptied by a small dose of salts, and the parts thoroughly washed with warm water, the piles pushed back and local lotions applied (see treatment of piles). Hot fomentations of witch-hazel frequently give great relief to the piles as well as to the varicose veins. Regular movements of the bowels usually will prevent piles. Piles will not usually give rise to much trouble unless constipation exists.
Albumin in the urine. (Albuminuria).—While the urine of about six to ten per cent of all pregnant women contains albumin, the appearance of this symptom should always be regarded with apprehension. Women who are in their first pregnancy are most frequently affected. If the woman has had disease of the kidneys before her pregnancy began this symptom will likely appear in the early months; if it is caused by pressure, etc., it may not appear until after the sixth month, but both acute and chronic. inflammation of the kidneys may develop at any period of pregnancy. Dr. Manton, of Detroit, states, "In the majority of cases, the albuminuria is due to the so-called kidney of pregnancy, in which there is no inflammation, but a fatty infiltration of the epithelial cells associated with anemia of the organ." The urine may also contain casts. Whatever the cause it indicates a condition of insufficiency of the kidney which may lead to serious consequences to the mother and it is also injurious to the (foetus) child. If this symptom develops suddenly the danger to both is greatly increased. For this reason physicians should urge pregnant women to have their urine examined frequently, especially during the later months of pregnancy.
Treatment.—Regulation of the diet; in pronounced cases the diet should consist entirely of milk and the patient should take three or four quarts in twenty-four hours. Meats, pastry and sweets must be prohibited, but vegetables such as squash, spinach, salads may be added to the dietary in ordinary cases. Vichy water may be taken alone or with the milk, and may be taken freely. The bowels should be kept open with citrate of magnesia (one to two teaspoonfuls in water) or epsom salts in peppermint water. Exercise in the open air can be taken in moderation. Warm clothing should be worn and flannel next the skin; exposure to cold and draughts should be carefully avoided. If the more special symptoms appear, such as persistent headache, vertigo, ringing in the ears, black or bright spots floating before the eyes, dimness of vision, an abortion of miscarriage should be induced without delay. Fortunately such cases are rare and with care from the beginning seldom occur. Pregnant women should inform their family physician at the beginning of pregnancy of their condition, and in the great majority of cases serious troubles can be prevented. Physicians expect this information and receive it as a matter of course, and no woman should hesitate to inform her physician either personally or through her husband.
[OBSTETRICS OR MIDWIFERY 525]
Abortion, Miscarriage, Premature Labor. (Accidents of pregnancy).—These three terms indicate a premature expulsion of the products of conception. Let us medically define these terms as follows; Abortion implies expulsion of the foetus before the sixteenth week. Miscarriage, the expulsion between the sixteenth and twenty-eighth weeks. Premature labor designates the time of expulsion as between the twenty-eighth week to within a few weeks before the normal termination of pregnancy. Miscarriage is the term popularly used for the accidental loss of the products of conception. Abortion, in the popular mind, expresses the intentional loss of the products of conception. Abortion in the medical sense, takes place about once in every four or five pregnancies. It occurs more frequently in those who have borne children, occurring generally in the third or fourth pregnancy, or toward the end of the child-bearing period, and it takes place more frequently between the ninth and sixteenth week, when the after- birth is in process of formation; and it is more liable to occur at the time of the month when the normal menstruation would be due. It should be borne in mind also that abortion occurring at this period is quite dangerous to the mother's future health, and also dangerous to life; so that at the first indication of abortion a physician should be called for this trouble, because it needs care, both to prevent it and to assist the woman to a successful ending when it is impossible to prevent it. This is more dangerous to life than confinement at full term, and is apt to leave behind a tendency to recurrence at the same time in the future pregnancies, and also makes the woman liable to inflammatory conditions of the womb.
Causes.—Abortion may be induced by many causes due to the mother, father, and child. Among maternal causes may be mentioned any serious disease, especially fevers, when accompanied by a rash on the skin, such as smallpox, measles, scarlet fever. It is hard for a pregnant woman to go through one of these diseases, without having an abortion. Syphilis, tuberculosis, malaria, organic heart and kidney disease, diabetes, anemia, and systemic poisoning also are causes; nervous disturbances as shock, fright, sorrow, convulsions, chorea; mechanical causes, violent exercise, lifting, blows, falls, coughing, vomiting; local causes, as wrong position of the womb, inflammation of the womb, etc.; all are causes.
Causes. Due to the Father. Paternal.—Syphilis, alcoholism, lead poisoning, excessive venery, extremes of youth or old age.
Foetal Causes.—Disease of the after-birth, other parts, of cord, death of the foetus, placenta pravia, and yet many women are subjected to falls, blows, etc., who carry their child to full term.