in pregnancy? You have heard a great deal of scrofula—that dreadful
disease. In the long catalogue of maladies to which the human body is
subject, there is not one more fearful, more dreadful than this.
Scrofula is the swine’s disease; and the word is from the Latin
_scrofa_, which means a sow. The swine is, probably, of all living
creatures, the most subject to it. Think, then, of a woman’s eating such
food when she is performing so important an office in God’s government
as that of nourishing within her own body a living child. How much pain,
disease, and suffering may she cause by her improper conduct at this
time; or, on the other hand, how much happiness and physiological
well-being, if she pursues a proper course. “Wisdom’s ways are ways of
pleasantness” to her also as to her child.
If it were not wandering to much from the tenor of my subject, I might
speak of the _cheapness_ of living on vegetable food.
In this country of abundance we do not often see much misery arising
from want of sustenance. Still such things do happen, and now and then
in almost every part. True, our charities are munificent, our country
fertile, our people industrious, and on the whole, benevolent; yet,
there is always room for charity to work in. If we cannot find an object
at home, assuredly we can somewhere; and we ought never to be satisfied
with our course of self-denial, so long as there is one hungry mouth
more in the wide world to fill. I have often thought of these things, I
admit, when I have been eating things which I ought not to have eaten. I
presume you have done the same thing all of you, for the human heart is
as prone to evil as the sparks are to fly upward, or a stone to fall to
the ground.
If I could speak a word to a husband through you, on this important
matter of diet in pregnancy, I would say to him, “Do not, as you love
your wife, tempt her to any excess while she is pregnant. Remember how
you loved her when she consented to give you that which was of
incomparably more importance to you than the whole world besides, her
own faithful, loving heart. Remember, too, how much she is made to
suffer on your account. You can aid her by your example, and by your
sympathy you can uphold her; but the pains, the agonies, and the perils
of childbirth, these all are inevitably hers. I say, therefore, set your
wife a good example yourself. If you do not thus aid her, surely as God
liveth will you be made to suffer for your evil deeds.”
If you should think that I have, in the course of these letters, harped
too much upon the subject of diet, I must ask your indulgence. The
importance of the topic, I am sure you will admit; but as to my method
of treating it, that is another thing. If you consider that I have made
a mistake, that I have taken up too much of your time with that which
you, perhaps, already understand, I hope you will set it down against me
only as a mistake of the head, and not one of the heart, as the
theologians say.
THE DRINK.
It has been a serious question with some, whether man is at all
_naturally_ a drinking animal.
Whatever may be the truth in regard to this question, we all know that
man does drink, and that a good deal, and too often of things which he
ought never to take.
It is admitted, however, that if a person subsists wholly or principally
on farinaceous food and fruits, and avoids stimulants of every kind, and
all other excesses, leading throughout a regular, sober, and temperate
life, he will seldom experience the sensation of thirst, and would then,
consequently, not naturally drink. True, water is one of the most
important of all life agents—one which will keep an animal alive more
than twice as long as he could exist without it; and notwithstanding the
fact that the living body is composed of nearly nine tenths of this
_element_, still, under the circumstances which I have supposed, we do
not wish to drink because our natural thirst is answered by the pure
water that is contained in the food and the fruits we use.
This, then, I consider the better plan: live in a manner so healthful,
so temperate that you will need little drink of any kind.
But if you do at any time need fluid internally, why not act in
accordance with all experience, all good judgment, all reason, and
adhere to the one best of all drinks?
See how the fever patient takes to water; how the animal, and the vermin
that have been poisoned with arsenic. See, too, the faithful cow, the
horse, and the ox, how they satisfy themselves with this best and most
abundant of all beverages when the hot sun comes down them.
I wish that you could all have pure, soft water, both to drink and to
cook with; but you cannot, and then you must do the best you can.
However, if you will leave off all useless, and worse than useless
expenses in your living, you can soon make a cistern and a filter which
will give you an abundance of the best of water—that from the clouds. A
very little expense and trouble will also serve to construct an
ice-house, so that you can have luxury and health combined, although I
wish you to remember that ice should be used sparingly, especially if
you should become very much heated and fatigued.
When I sat down to write this evening, I thought I should say something
on the properties and effects of those almost universally-used articles,
tea and coffee. This much I do say, however, you who are pregnant—you
who are nursing, and, indeed, all and every one, do as I for these
twelve years have done, ESCHEW THEM ALTOGETHER. They are pernicious in a
great many respects. Besides this, I advise you to get my worthy friend
Dr. Alcott’s excellent work on TEA and COFFEE. If you will but read
that, I think you will conclude that it is a great deal better to do as
I have done.
Thanks to Father Mathew, and the noble cause of temperance, there is
little need of saying much now concerning the evils of tippling, which
women were some years ago in the habit of when Dr. Dewees wrote, and
against which he said so much. I need not say to you at this late day,
that it is a great deal better for you to leave off alcohol in all its
forms, and particularly during the period of which we have been
speaking.
LETTER XII.
DISORDERS OF PREGNANCY.
Nausea and Vomiting—Means of Prevention, and Cure.
There are a variety of physiological troubles that are connected with
pregnancy. True, women do not all experience these, any or all of them;
but inasmuch as you are liable to these affections, it is my duty to
speak of them. In doing so, I shall class all of these abnormal symptoms
under the general head of “disorders,” because I believe that in a truly
natural, or, in other words, healthful state of the system, none of
these ailments would be experienced.
Nausea and vomiting, as most of you know, and not a few of you by
experience—are, in the present state of society, frequent attendants of
pregnancy.
These symptoms occur, for the most part, during the earlier months of
gestation. They may, however, continue through the whole period, and in
some cases they cease and then return again toward the latter part of
it.
Most frequently morning-sickness commences from two to three weeks after
the beginning of pregnancy. It may, however, come on the very day of, or
next after conception, and some women have been able to discover this
circumstance by the occurrence of the vomiting which follows it.
This sickness of the stomach is most apt to occur in the morning. Hence
it has been called “morning-sickness,” from the fact that it is most apt
to take place at this period of the day. This is in part, doubtless,
owing to the circumstance of the woman’s getting up at this time, and
not to any thing necessarily connected with that part of the twenty-four
hours. If she reclines, the sickness leaves her for the most part, but
again appears if she attempts to rise.
The matter thrown up from the stomach varies in character in different
cases. Much here depends upon the dietetic habits of the individual and
the state of the health. It is more commonly a sort of tough, sour
mucus; but sometimes there is vomited an extremely acid, thin water,
which in some cases is strong enough to excoriate the mouth and set the
teeth on edge. Sometimes, too, bile is thrown up with the other matters.
The appetite is apt to become very variable in these cases; often,
indeed, there appears to be none at all; at other times the most
singular and even disgusting articles are craved for, and not
unfrequently that kind of food which we would suppose the worst for the
patient proves to be the best, that is, so far as retaining it on the
stomach is concerned.
It may appear a strange doctrine to you, that in general those who
suffer from nausea, vomiting, and the other more common accompaniments
of pregnancy, get along better than those who experience none of these
symptoms. “If vomiting should not be violent, and occur only in the
early part of the day, though very troublesome,” observes Dr. Denman,
“it is so far from being detrimental, that it is generally found to be
serviceable, by exciting a more vigorous action of the uterus, and by
bringing the stomach into a better state.”
Some have been afraid that vomiting would cause abortion; and such an
occurrence might happen, if this symptom were brought on in a violent
manner, as by the administration of powerful drugs. But the vomiting
which comes on in consequence of the stomach-sickness, instead of
causing premature delivery, appears to be a safeguard against such an
occurrence. In other words, those who experience nausea and vomiting,
are not so liable to miscarry as those who have none of these symptoms.
If we could but take into our minds the whole scope of nature, and if we
were able to trace, like the Infinite Mind, causes and effects, we
should, doubtless, much oftener than we now are, be struck with the
evident goodness of the Creator, even in the physical sufferings which
He has made it our lot to endure. What is the office of nausea and
vomiting in these cases? It is possible, under bad management, for these
symptoms to become actually alarming in their extent. But what, it is
well for us to inquire, is the design of these occurrences, so common
during the period of gestation? Plainly, to restrain the woman from the
gratification of a voracious and wayward appetite, the indulgence of
which could but be of material detriment to both mother and child.
How is it in sea-sickness? Do we not find that people who go to sea are
generally benefited in health thereby, and that none are so much
benefited as those who are made sick? And how are they thus benefited? I
answer, by the abstinence and fasting which they are compelled to
practice. Almost all persons—all, I will say—have more or less of
impurity in their bodies, so badly have we treated ourselves, and so
badly do we live. Hence it is that in sea-sickness, and in the vomiting
that occurs in pregnancy, benefit is received; the body is made to
purify itself by its own inherent power.
If every pregnant woman could have nausea enough, no doctor would ever
think of bleeding her; it would prevent all that plethora and fullness
of the system which, under such circumstances, have led good and honest
men, as well as women, to believe it is often best to abstract blood.
But you ask me, are these symptoms really natural, and intrinsically
best for the system in pregnancy? I answer, they are not. I believe it
possible so to live that a woman pregnant need not have them any more
than any one else. In sea-sickness how is it? The sailors—they who are
kept up regularly in the open air every four hours at farthest—never
have it to any extent worth speaking of. The first time they go to sea
they are apt to be sick, like other people; but in a day or two it is
all gone—they work it off.
So, too, in the sickness of pregnancy. We never hear of the Indian women
having it. They, likewise, are active in their habits, live plainly, and
go often into the open air.
One of the most important things to observe in these cases is, not to
eat too much, or at wrong times. A great many patients of this kind make
sad work with themselves by eating all sorts of things for which they
have a relish, and at all hours of the day, just as the fit happens to
take them. We know full well how important it is to eat regularly when
we are in health. How much more so, then, must it be when we are ill! If
you have nausea, or if you have not, but no appetite, drink some pure
cold water, and wait; the appetite will come.
It is really surprising to see on how small a portion of food a patient
can subsist for many days.
The laboring classes—those who are compelled to work hard, whether they
would or not, and who are obliged, in consequence of the iron hand of
poverty being upon them, to live on plain, homely fare—they are not
troubled with nausea and vomiting, as the idlers and the luxurious are.
You will naturally expect me to speak of the professional treatment for
these troubles; and in regard to this, I remark, there are a great many
things to be taken into the account. You cannot well know too much in
regard to all the means of improving the general health.
The nausea is the most distressing part of morning-sickness, as it also
is of sea-sickness. In the former, as in the latter, it is one of the
most comforting things that can be done—the _most_ comforting, rather—to
take a good draught of pure, soft water, at about the blood temperature.
If enough is taken it causes vomiting, which at once brings relief; but
if the stomach should not thus be excited to an inverted action, the
water will yet do good, as it tends to “settle the stomach,” and this of
itself brings a good deal of relief, although not so much as actual
vomiting would do.
Some may tell you that vomiting is dangerous in pregnancy—that it is
liable to cause abortion. So it is, as I have before said, if it is
rendered very violent by the giving of powerful drugs. But any thing
like a reasonable emetic, even of the drug kind, is comparatively safe
in this respect; so much so, that the most experienced and most honest
physicians are not now afraid to vomit a pregnant patient, if they
consider it important to resort to that measure. Emetics of the drug
kind have even been used, and apparently with good success, as a cure of
the nausea of which I have been speaking.
But do not understand me as recommending vomiting, even by water, the
best and mildest of all emetics, except in cases of urgency, and when it
can be made to take place without great straining or effort. As a
general thing it is far better to fast.
I do not know of any thing in which physicians have been more puzzled
than in the treatment of these symptoms. They have left nothing in the
_materia medica_ untried. The result is, however, that no plan has yet
been fixed upon as being a legitimate one, or one that can be depended
upon with any tolerable chance of success. Patients have sometimes died
of the exhaustion caused by the vomiting, as has been supposed; but I am
more inclined to think they have far oftener been drugged to death. It
is mostly in the hospitals that these deaths have occurred, and there,
as you know, there is great temptation for experimenting. Young
physicians are there allowed to make experiments; and there the older
ones are also too much tempted to do as they would not wish to be done
by.
Physicians have been so much thwarted in these cases, that they have
often recommended bringing on premature delivery, fearing that the
patient would be destroyed if they did not resort to this dreadful
expedient. Most of them, I have no doubt, have acted honestly in these
dreadful emergencies. It is to their credit that they seldom, if ever,
have resorted to premature delivery without first having counsel on the
subject.
I have already hinted that exercise and activity are great helps in
keeping off those troubles that so often occur with the pregnant. I
would repeat, BE ACTIVE. Do not let a day, a half day, nor even an hour
pass over without your doing something. BE ACTIVE, REGULARLY, HABITUALLY
ACTIVE. Let this be your motto, and your practice, too.
I must tell you also that water-treatment is a most useful help. Take
the rubbing wet-sheet when you feel so badly, and see how great a change
it will work. Wear the wet girdle, and take the cold hip-bath, not too
long at a time, if necessary. I do not know that I can recommend eating
ice, as some have done; yet it has sometimes appeared to act very
favorably, and great quantities have been used by some in this way,
without any apparent harm.
The cold water injections are much to be recommended in cases of
costiveness, which often occurs in connection with the vomiting.
LETTER XIII.
DISORDERS OF PREGNANCY.
Fainting—Its Causes—Symptoms—Results—Treatment.
Fainting sometimes happens in pregnancy, even with those who are not
subject to it at other times. It is more apt to occur at or about the
time of quickening. Some persons are very subject to it, from very
slight causes, during the whole period of pregnancy; others experience
it only occasionally; and some have it repeatedly, and some
periodically. It is more commonly the weakly and delicate who are thus
attacked; but some healthy females are subject to it. It happens with
some every month periodically, with others every week, and in some cases
every two or three days, or even oftener.
_Causes._—Fainting in pregnancy is often excited by the first movements
of the child, even while they are weak, and by subsequent ones when
strong. It is sometimes a consequence of palpitation, or derangement of
the heart’s action and of the circulation. Too great exercise of either
mind or body, want of exercise and employment, violent mental emotions,
running too quickly up stairs, want of sleep, offensive sights and
odors, overeating, and too great heat in the apartment—each of these may
bring on fainting in pregnancy. Dr. Campbell observes, “As in the gravid
(pregnant) state, fainting seizes individuals so suddenly, and that,
too, while they are in perfect health, it is difficult, more especially
in the early months, to account for it, since the uterus at this period
cannot, from its bulk, produce any interruption or irregularity in the
circulation of the heart or larger vessels. The womb, however, may
influence the heart in another, viz., through the medium of the nerves,
whereby irregularity of its action, as often happens from a similar
cause on other occasions, is produced; this inordinate action may lead
to some irregular distribution of the blood in the cerebral vessels, and
hence fainting.”
_Symptoms._—The patient experiences a feeling of langour, weariness, and
weakness, and there is a frequent inclination to yawn or sigh; the sight
becomes dim; surrounding objects appear to turn round; specks float
before the eyes; there is a ringing or buzzing in the ears; the face
becomes pale, and thus the patient becomes faint and insensible. The
premonitory symptoms, if any appear, are sometimes so rapid in their
course, that the patient is unable to call attention to them.
During the fit there is no pulsation at the wrists; the heart beats but
faintly; breathing is nearly suspended; the muscles lose their power,
and a cold sweat breaks out over the surface. But there is no convulsive
motions of the limbs, nor any frothing at the mouth, in a case of simple
fainting.
This condition of things may last only a few minutes, or for several
hours. When the fit begins to pass off, respiration becomes more
distinct, the patient utters a few long-drawn sighs, the heart begins to
act with more energy, the pulse at the wrist becomes more perceptible,
some color appears in the face, and the consciousness is again restored.
In some cases consciousness is not entirely lost, and in some it is long
before it is fully regained.
“There is a species of syncope,” says Dr. Burns, “that I have oftener
than once found to prove fatal in the early stage of pregnancy,
dependent, I apprehend, on organic affections of the uterus; that viscus
being enlarged, or otherwise diseased, though, perhaps, so slightly, as
not previously to give rise to any troublesome, far less, pathognomonic
symptoms. Although I have met with this fatal termination most
frequently in the early stage, yet I have also seen it take place so
late as the sixth month of pregnancy.”
Cases of organic disease of the heart, however, are rare, so that you
ought not to think, at every little fainting spell you may experience,
that you have a disease of this organ. If in the syncope there is
convulsive motion of the limbs, distortion of the features, and frothing
at the mouth, it is only a hysterical spasm.
If fainting happens most toward the close of pregnancy, it is to be
regarded with more suspicion, according to the opinions of some authors;
not so much, however, for the immediate consequences, as for its effect
upon the convalescence after parturition.
This symptom sometimes occurs in consequence of an internal hemorrhage,
in which case it is generally never prolonged, accompanied with fullness
and tension of the abdomen, dull pain and weight in the pelvic region,
permanent blanching of the surface, and after a short time a discharge
of blood from the vagina.
_Results._—In fainting, the circulation becomes for the time almost
suspended. When, therefore, we consider the dependence of the fetus upon
the maternal circulation, we cannot suppose that its frequent recurrence
is wholly innocuous to the child. Occasional fits of syncope, however,
appear to do no harm to the fetus; and yet it is always best to avoid
the occurrence as much as possible. It has been known to cause abortion
when it has been often repeated.
_Treatment._—The patient should, during the fit, be placed in the most
comfortable posture, the recumbent being the best, the head at the same
time being laid rather low, and, if possible, where a current of cool or
cold air can be made to blow over it, particularly upon the face;
sprinkling cold water in the face, and washing and rubbing the face and
hands in cold water are useful measures. In some cases it would be also
advisable, or rather necessary, to wash and rub the whole surface.
A full injection of tepid water will aid materially in bringing about
consciousness and circulation in these cases.
This water-treatment is incomparably better than that which is usually
adopted, such as giving the patient wine, brandy, spirits, carbonate of
ammonia, etc.
It generally happens that people themselves, without the aid of the
physician, have to manage cases of syncope. This they can readily enough
do as a general thing; but if it should prove at all persistent or
troublesome, they should lose no time in getting the best medical advice
they can obtain.
_Prevention._—Every thing should be done that may be to restore the
general health. Oftener by far than otherwise, fainting is purely a
symptom of debility. This fact of itself suggests the measures that
should be adopted in order to ward off the attacks.
LETTER XIV.
DISORDERS OF PREGNANCY.
Abortion—Its Nature and Ill Effects—Its Causes—Means of Prevention.
Abortions are evidently not in the order of nature. We see in the animal
kingdom that, as a general fact, gestation everywhere goes on to its
full and normal period; that abortions are very rarely indeed seen; but
when we come to consider the animal man, we find a different state of
things. With man, and man only, abortions are frequent.