Heartburn is the result of eating improper food, or a failure to digest the food taken. Starchy foods should be avoided. Meats and fats should be taken sparingly. Avoid also the et ceteras of the table, as pickles, sauces, relishes, gravies, mustard, vinegar, etc. Good results follow dry meals,—meals taken without liquids of any kind. Live on a simple, easily digested, properly cooked diet. Chew the food thoroughly, take plenty of time and be cheerful.
Constipation During Pregnancy.—Most women are as a rule more or less constipated during pregnancy. It is caused by failure to take the proper amount of outdoor exercise, to take enough water daily, to live on the proper diet, to live hygienically, or because of wrong methods of dress. It is most important that the bowels should move thoroughly every day. Pregnancy no doubt aggravates constipation by diminishing intestinal activity. Consequently there is a greater need for activity on the part of the woman, and open air exercise is the best way
to accomplish this. She should eat fruits, fresh vegetables, brown or Graham bread, or bran muffins, figs, stewed prunes, and any article of diet which she knows from experience works upon her bowel. She should drink water freely; a glass of hot water sipped slowly on arising every morning or one-half hour before meals, is good. Mineral waters, Pluto, Apenta, Hunyadi, or one teaspoonful of sodium phosphate, or the same quantity of imported Carlsbad salts in a glass of hot water one-half hour before breakfast, answers admirably. If the salts cannot be taken a three- or five-grain, chocolate-coated, cascara sagrada tablet, may be taken before retiring, but other cathartics should not be taken unless the physician prescribes them. Rectal injections should be avoided as a cure of constipation during pregnancy. They are very apt to irritate the womb and if taken at a time when the child is active, they may annoy it enough to cause violent movement on its part, and these movements may cause a miscarriage. See article on "Constipation in Women."
Varicose Veins, Cramps, and Neuralgia of the Limbs.—When cramps or painful neuralgia occur repeatedly in one or both legs, some remedial measures should be tried. Inasmuch as the cause of this condition is a mechanical one, it would suggest a mechanical remedy. The baby habitually seeks for the most comfortable position, and having found it stays there until conditions render it uncomfortable. He does not consult you in the matter, but he may be subjecting you to untold misery and pain. The child may rest on the mother's nerves or blood-vessels as they enter her body from her lower limbs. If the pressure is sufficient, it can interfere quite seriously with the return blood supply, because veins which carry back to the heart the venous or used blood, are vessels with thin, soft, compressible walls, while arteries which carry blood away from the heart cannot be compressed easily, because their walls are hard and tense. The condition therefore is that more blood is being sent into the limb than is being allowed to return; in this way are produced varicose veins. If these varicose veins burst or rupture we have ulcers, which
may quickly heal, or they may refuse to heal, and become chronic. A dropsical condition of the leg may follow, and because of interference with the circulation of the blood we get cramps and neuralgias. How can we remedy this painful condition?
Sometimes we don't succeed, but at least we can try. So long as the cause exists, it is self-evident that rubbing the limb with any external application, will not give any permanent relief, though it is well to try. When rubbing, to relieve cramps at night, always rub upward. It is not a condition that calls for medicine of any kind, while hot baths and hot applications will only make the trouble worse. The remedy that promises the quickest and longest relief is for the patient to assume the knee-chest position for fifteen minutes, three times a day, till relief is permanently established. The patient rests on her knees in bed, and bends forward until her chest rests on the bed also. The incline of the body in this position is reversed; hips are highest, the head lowest. The baby will seek a more comfortable position and this new position may relieve the pressure and cure the condition. Doing this three times daily for fifteen minutes gives relief to the leg by reestablishing a normal blood circulation, and very soon the baby finds a new position that does not interfere with its mother's blood supply, and the cramps, and neuralgia and dropsy, and maybe the varicose veins will soon show improvement. Wearing the proper kind of abdominal support may help, as explained on page [77]. If the varicose veins are bad, it is desirable to wear silk rubber stockings or to bandage the limbs.
Insomnia During Pregnancy.—Insomnia or sleeplessness is sometimes a vexatious complication during pregnancy. It seldom if ever becomes of sufficient importance or seriousness to interfere with the pregnancy or the health of the patient. Nevertheless, a period of sleeplessness lasting for two or three weeks is not a pleasant experience to a pregnant woman. It is most often met with during the latter half of pregnancy.
There can be no question that every case of insomnia has definite cause, and can be relieved if we can find the
cause. The only way to find it is to systematically take up the consideration of each case, and this is best done by the physician. He must have patience and tact; you must answer each question truthfully and fully. Your diet, personal conduct, exercise, condition of bowels, mental environment, domestic atmosphere, everything, in fact, which has any relation to you or your nerves, must be inspected with a magnifying glass. Some little circumstance, easily overlooked, of seemingly no importance, may be the cause of the trouble. You may need more outdoor exercise, or you may need less outdoor exercise. You may need more diversion, more variety, or you may need less. You may need a sincere, honest, tactful, patient confidant and friend, or you may need to be saved from your friends. You may be exhausting your vitality and fraying your nerves by social exigencies,—those empty occupations which fill the lives of so many fussy, loquacious females,—echoless, wasted, babbling moments, of supreme important to the social bubbles who ceaselessly chase them but of no more interest to humanity than the wasted evening zephyrs that play tag with the sand eddies on the surface of the dead and silent desert. You may have wandered from the narrow limitations of the diet allowable in pregnancy, or you may be the victim of an objectionably sincere relation who pesters you with solicitous inquiries of a needless character. Whatever it is, rectify it. A good plan to follow on general principles is to take a brisk evening walk with your husband just before bedtime, and at least two hours after the evening meal. Follow this with a sitz bath as soon as you return from the walk.
A sitz bath is a bath taken in the sitting position with the water reaching to the waist line. It should last about fifteen minutes and the water should be comfortably hot. It is sometimes found that this form of bath creates too much activity on the part of the child and defeats the purpose in view. This is apt to be the case in very thin women when the abdomen is not covered by a sufficient layer of fatty tissue. These women will find it advisable to take, in place of the sitz bath, a sponge bath in a warm room, using the water rather cool than hot but in