CRAMPS

Cramps are sharp, exceedingly painful muscular spasms occurring in the muscles of the calf of the leg, the toes, etc. The expectant mother in the later months of pregnancy awkwardly turns in bed, is suddenly awakened and without a moment's warning, is seized with a most excruciating pain in her leg or toe. The most effectual treatment for these cramps is quickly to apply a very cold object to the cramping muscle. Extremes of either heat or cold usually relieve as well as the vigorous grasping or kneading of the muscle. A hot foot bath on going to bed will often prevent an attack. A long walk in the latter months of pregnancy should invariably be followed by a short hot bath or a foot bath. Many attacks may be avoided by this procedure.

SWELLINGS

All swellings should be taken seriously by the pregnant mother to this extent, that she save a twenty-four hour specimen of urine and that she personally take it to her physician, with a report of her "swellings." This symptom may or may not indicate kidney complications. The blood-pressure together with chemical and microscopical analysis of the urine will determine the cause.

Slight swelling of the feet is often physiological and is due to pressure of the heavily weighted uterus upon the returning veins of the legs. The progress of the veinous blood is somewhat impeded, hence the accumulation of lymph in the tissues of the legs, ankles, and feet.

Never allow yourself to guess as to the cause of swellings, always take urine to the physician and allow him definitely to ascertain the true cause. All tight bands of the waist and knee garters must be discarded at this time. The same general treatment suggested for varicose veins holds here.

GOITRE

The enlargement of the thyroid gland—goitre—is physiological during pregnancy, and is believed to be caused by the throwing into the maternal blood stream of special protein substances derived from the fetus. As just stated, this is more or less physiological, will usually pass away after the babe is born, and, therefore, need give the mother no particular concern. Tight neck bands should be replaced by low, comfortable ones. The bowels should move freely every day, and water drinking be increased as well as sweating of the skin encouraged by a short, hot bath, followed by the dry blanket pack, while the head is kept cool by compresses wrung from cold water. In this manner the elimination of these poisons is increased through both the skin and the kidneys.