the arms are lightly, but securely, fixed against the sides. The
nurse can easily support the body with one hand, and with the other
draw down the lower lid (as shown in the photograph), or otherwise
assist the physician. The doctor sits opposite the nurse, with a
rubber sheet across his knees, and upon this a sterile towel. He
holds the baby’s head gently, but firmly, between his knees, thus
freeing both his hands for necessary manipulations. In the picture
the physician is represented as about to apply a solution of nitrate
of silver with an applicator of sterile absorbent cotton.
“Close at hand is a table on which are a bowl of boracic acid solution
and sterile absorbent cotton for irrigating the eyes; an undine (if
one prefers) for the same purpose; a kidney dish for collecting the
washings; sterile applicators, and small dishes for nitrate of
silver solution and for saline solution (to neutralise): besides
bottles containing solutions of cocaine, atropine, and fluorescein.
Culture tubes, sterile swabs, cover slips, forceps, and a spirit
lamp are ready for bacteriological examinations; and in a glass are
displayed lid retractors, which are usually indispensable to a
thorough examination of the cornea. On the floor is a paper bag,
which, with the contaminated swabs, applicators, etc., is burned on
the completion of the treatment. Other articles may be added as
required; but the important point is, that everything should be at
hand before the examination is begun.
“The physician and the nurse are clothed in surgical gowns; and wear
rubber gloves, which heighten cleanliness, and safety and comfort.
It is to be carefully noted that they both are provided with
protective glasses; for under no circumstances should this
precaution be omitted in treating the purulent ophthalmias.
“The conditions here depicted will not always be possible of
fulfillment, but they represent the ideal for which one should
strive.”
]
It is of interest to nurses that the effort to safeguard the eyes of
babies through preventive treatment and early care was developed
into a national movement by one who also was influential in starting
the training of nurses in this country, Miss Louisa Lee Schuyler.
The lay work for the prevention of blindness, which is now
country-wide, was started by the New York State Committee for
Prevention of Blindness, which was organized by Miss Schuyler in
1908. She was its first Chairman and skillfully directed the work of
the Committee for ten years. During the Civil War Miss Schuyler was
a member of the Sanitary Commission and afterwards was one of the
group which was responsible for starting at Bellevue Hospital, in
New York City (in May, 1873), the first training school for nurses
in this country, planned in accordance with Miss Nightingale’s
standards for the organization and conduct of a school for nurses.
Later, in 1911, the Bellevue School for Midwives was established as
a result of the combined efforts of the Hospital Trustees and Miss
Schuyler’s Committee for Prevention of Blindness, the course of
training being outlined by a sub-committee composed of Miss Lillian
D. Wald, Dr. J. Clifton Edgar and myself. So far as it is possible
to learn this school was the first in this country to be conducted
along the lines of a school for nurses, or after the manner of the
midwife schools in England.
=Syphilis=, which ranks high among the scourges of mankind, is seen
with distressing frequency among young babies. It may be contracted
during uterine life, when it is said to be “inherited,” or it may be
“acquired” after birth by kissing a syphilitic person or coming in
contact with contaminated articles, such as clothing, or nursing
from a diseased breast.
The most conspicuous symptoms are the familiar “snuffles;” the
scaling, fissures or eruption on the soles, palms, buttocks and
about the mouth; shrill, hoarse crying; swollen painful joints;
partial paralysis and a general feebleness and inanition. Some or
all of these symptoms may be present when the baby is born or they
may develop any time within the first two or three months of life.
Babies of syphilitic mothers are often given mercurial inunctions
immediately after birth, even though they have no symptoms of the
disease as it is very likely to be present in a latent form. This is
one reason for the routine inspection of the placenta, since in it
is sometimes found the only indication for treating the baby. An
infant who is known to have syphilis is given mercurial inunctions
or baths, the ointment being rubbed into the groin, axilla, back and
abdomen in rotation on successive days, to prevent irritation of the
skin. The nurse should protect herself with rubber gloves, wash the
area with warm water and soap and thoroughly rub in the ointment.
Sometimes the ointment is put on the inside of the back of the
baby’s binder, by which means he rubs it in himself. The syphilitic
baby should be isolated and should not be put to the breast of an
uninfected woman, but he may nurse from a syphilitic woman without
harm to either her or himself. Good general care, including fresh
air and sunshine are important to the baby suffering from syphilis.
=Thrush= or =Sprue= is a highly communicable disease of the mouth of
new-born babies, due to one of the fungi. It is common among sickly,
undernourished babies and those living in unhygienic surroundings,
but it is seldom seen in healthy babies who are cared for with
absolute cleanliness. The disease is characterized by small raised,
white spots in the baby’s mouth, frequently on the back of the
tongue and inner surface of the cheeks.
Prevention lies in good care and in cleanliness of the mother’s
nipples, or the bottles and nipples for artificially fed babies, and
of all other articles coming in contact with the baby, particularly
his mouth. Some doctors have the baby’s mouth bathed before each
feeding, as a preventive measure, while others feel that a gentle
swabbing once daily is sufficient, if the nipples are kept clean,
since an abrasion of the mucous lining is easily caused and is
favorable to the development of thrush.
Treatment consists in cleanliness and in gently swabbing the spots,
three or four times a day, with sterile cotton wet with an alkaline
solution such as borax (10%), bicarbonate of sodium (6%) and
sometimes with formalin (1%) or a weak solution of permanganate of
potassium.
=Impetigo= and =Pemphigus= are highly infectious skin diseases of
early infancy which are seen more often in hospitals than in
patients’ homes. The treatment of the raised blisters that appear on
different parts of the body is entirely a medical question, but in
caring for the patients suffering from either of these infections
the nurse must take every precaution to avoid extending the trouble
on the skin of the infected baby, himself, and of communicating it
to other babies in the ward. Strict isolation is imperative; gentle
handling and frequent changing of the underclothing to prevent
extending the disease to uninfected areas.
=Vaginitis.= This highly infectious malady is considered troublesome
rather than serious, as a rule, though it may be complicated by
ophthalmia or arthritis. Gonorrheal vaginitis is the commonest form
seen in early infancy and may be due to infection which the baby
acquired during its passage through the birth canal or later from
the mother’s hands or clothing. The symptoms are a vaginal
discharge, which may be thin and serous or thick and yellow and
purulent and it may be scanty in amount or abundant; a reddened,
swollen condition of the vagina and vulva and sometimes redness and
excoriation of the inner surface of the thighs. The nurse’s chief
responsibilities are to be constantly on the alert to detect
evidences of the disease and report them promptly to the doctor, and
to observe strict isolation in caring for the baby while carrying
out the doctor’s orders for douches or suppositories.
COMMON ABNORMALITIES OF THE NEW-BORN
=Icterus= or =Jaundice=, which is so frequently seen in new-born
babies, is occasionally a symptom of some septic condition; of
syphilis or congenital cirrhosis of the liver or obstruction of the
bile ducts, but as a rule it is without any serious significance.
The jaundiced appearance usually begins on the second or third day
and may continue for two or three weeks or it may subside in three
or four days. The depth of the color varies, being very pale in some
cases and almost green in others. When this discoloration of the
skin is unaccompanied by other symptoms, no treatment is given.
=A Cephalhematoma= is a tumor of blood between the periosteum and
the bones of the skull of the new-born baby. It is often due to some
injury sustained during birth and is most frequently seen after
prolonged labors. Cephalhematoma is sometimes confused with a caput
succedaneum, but whereas the caput disappears in a few days the
cephalhematoma may not be entirely absorbed for two or three months.
Although certain conditions sometimes indicate the advisability of
surgical treatment, the nurse’s care consists solely of protecting
the tumor from injury.
=Club foot= is one of the commonest deformities of the extremities
of young babies, occurring once in about every 1000 births. It may
be congenital or caused by injury or it may be due to such diseases
as cerebral paralysis or poliomyelitis. The nurse should watch for
any abnormality in the structure or position of the feet, for the
earlier treatment is started, the better is the prospect of a cure.
=Engorgement of the Breasts.= Not infrequently the breasts of
new-born babies are engorged, in which state they are easily
infected by being rubbed or squeezed. Since the greatest care must
be taken to avoid bruising swollen breasts, they are sometimes
protected by the application of a pad of sterile cotton. Hot
compresses are sometimes applied when there is redness with the
swelling, or a tiny ice-bag, made by tying off the fingers and thumb
of a rubber glove, and partly filling it with finely crushed ice,
after which the wrist is tightly tied.
=Hare Lip.= The fissured lip, which is not infrequently seen in new
babies, may consist merely of a small notch or it may amount to a
deep cleft reaching up into the nostril. It is due to a non-union of
the frontonasal plate with the lateral processes and may occur on
one or both sides, thus forming a single or double hare lip. An
extensive fissure will usually interfere with suckling and the nurse
may need both ingenuity and patience in feeding such a baby, for the
prospect of successful treatment, which is surgical, increases with
the baby’s age and improved nutrition. The longer she can feed the
baby successfully, therefore, the better his chance of recovery.
=Cleft palate=, a common congenital abnormality, consists of a
fissure of the soft, and sometimes of the bony, palate; it may be on
one or both sides and may be continuous with a hare lip. The problem
of feeding the baby with a cleft palate is very grave since the
fissure may make it impossible for him to form the vacuum in the
back of his mouth which is necessary for suckling. He is sometimes
fed with a medicine dropper or by gavage or by means of a special
nipple provided with a flap which fits into the roof of the mouth
and closes the opening into the nasal passages. Even more than in
the care of the baby with a hare lip is it important to nourish the
baby with a cleft palate, and build him up for as long as possible
before he is subjected to the strain and shock of the inevitable
operation.
=Hernia.= Umbilical and inguinal hernias are both seen in young
babies.
=Umbilical hernia= is the commoner type and is not uncommon in thin
babies and those with indigestion and distension and in babies who
cry violently. Such hernias are not regarded as serious if prompt
measures are taken to reduce them as they usually respond very
readily to treatment. But since neglect may have serious
consequences, the nurse should watch for protrusions and report them
promptly. She will often be instructed to reduce the hernia and
apply adhesive strapping, in which case the following observations
by Dr. Griffith will be helpful:
“Usually it is quite sufficient to draw the skin into two folds, one
on each side of the hernia and meeting over it; holding these in
place by straps of adhesive plaster crossing over the navel, or by a
broad horizontal band of adhesive plaster reaching to the lumbar
regions. Another method is the following: A silver quarter of a
dollar is laid upon the adhesive surface of a piece of rubber
plaster about two inches square; over this is placed the broad strap
referred to, with its adhesive surface next to that of the smaller
piece. After reducing the hernia and pressing the sides of the
abdominal walls slightly together the band is applied with the
quarter dollar directly over the position of the navel. My own
preference is for a simple adhesive band without the use of the
coin. The dressing should be worn constantly, changing it from time
to time as the old one loosens. The dressing must, of course, not be
removed during the bath. Several months are required before the
opening is permanently closed. Occasionally the plaster produces a
great deal of cutaneous irritation, especially in the first few
months of life. The employment of zinc oxid plaster tends to avoid
this difficulty.”[17]
=Inguinal hernia= is less common in very young babies but it should
be watched for since it usually may be easily reduced by the use of
a truss, if discovered and treated early, but may be serious if
neglected.
In general, the new baby who is ill, needs the same thoughtful,
gentle, painstaking care that the nurse gives to the well baby, but
these must be shaped to his immediate requirements and the doctor’s
special instructions.
CHAPTER XXIV
A FINAL WORD
It will be well for us now to take a retrospective view of the
various functions of the nurse which are associated with the
phenomena of pregnancy, labor, the puerperium and the beginning of a
new life. As we see these in perspective, our attention is fixed by
a few important principles which stand out from the picture as a
whole in clear and shining relief.
We see, for example, that no matter what else may become vague and
unimportant, be changed or discarded, there remains the conspicuous,
unalterable requirement that the nurse shall do clean work
throughout this entire series of experiences. All maternity patients
and all babies need scrupulously clean care no matter what else they
may have or may lack.
But also must they all be watched throughout these transitional
stages, in order that impending disaster may be apprehended and
warded off. And that this watchfulness be intelligent, the nurse
must of necessity know something of the normal physiological changes
which occur during these momentous periods in the lives of her
patients, lest she fail to detect evidence of abnormality, should it
appear.
Since this invariable cleanliness and close watchfulness are needed
by all patients, whether of high or low degree, and by those in the
care of doctors with widely varied methods, the nurse must be able
to make adaptations to each patient’s environment and temperament
and to the doctor as well, if all of her patients are to be well and
happily nursed. She must be clean, then, and watchful in her work,
and adapt it to every conceivable condition. These features stand
out clear and bold in the perspective. But to make these offices
effective to their utmost, the nurse’s attitude and her care of her
patient must be mellowed by an always deepening sympathy and
understanding. She must endeavor, in each instance, to imagine the
mental experience of the bewildered and timid expectant mother; of
the terrified woman in labor and the discouraged young mother—these
she must appreciate if she is to give of her best. And so, in the
end, the character of the nurse’s work will be influenced, in fact
almost determined, by her awareness of her patient’s needs, mental
and physical, and the earnestness with which she tries to relieve
them. More than this, the nurse whose skill is warmed by a sincere
desire to give of her best will, by virtue of this very desire,
learn something from each patient, and will be steadily enriched and
broadened by her experiences. She will have more to give, and
accordingly will derive increasing satisfaction from her service to
each succeeding mother and baby that she takes into her care.
One word more. The maternity nurse almost inevitably becomes deeply
attached to her baby patient, whether he is sick or well, and she is
eager to protect him and safeguard him as long as possible. She may
continue to serve him, even after he has passed from her trained
hands, if she will teach his mother how to take care of him, should
she be inexperienced, particularly if the young mother is to have
full charge of her baby after the nurse leaves, or is to have only
the assistance of a partly trained nursery maid. In such a case the
nurse may often perform her most valuable and enduring service to
the baby by gradually teaching his mother how to prepare the milk
with cleanliness and accuracy, if he must be bottle-fed; how to give
his bath deftly and comfortably, and impressing upon her the
importance of fresh air and of regularity in the baby’s daily
routine. All of these things, and also how to do the thousand and
one other things that seem so trivial and yet mean so much to the
baby’s immediate health and future well being.
The first day after the nurse leaves, and the first few after that
are often very dark ones for the inexperienced young mother, and if
she is alone they are likely to be filled with fear and misgivings.
The nurse may rob these days of much of their discouragement by
anticipating them; trying to imagine the young mother’s possible
perplexities and then teaching her how to meet them. This teaching
is perhaps not a part of the nurse’s professional obligation but it
is one of the privileges, one of the gratifying by-paths of nursing
that she may take for the sheer joy of it.
Not infrequently the young mother is so filled with awe over
possessing anything so wonderful as her own baby that she is afraid
to handle the exquisite little body; is fearful of harming it; and
because of her timidity and inexperience she fails to give him the
care that he needs, and that she wants to give. On the other hand,
all too many young mothers have a blind confidence that the mere act
of having a baby vests one, in some instinctive way, with the
requisite knowledge and skill to care for it, and in this belief
they are supported by a legion of women friends and relatives.
It would be difficult to imagine a single factor that works more
destruction among babies than this one of ignorant motherhood. And
the damage is equally great whether the ignorance arises from
timidity or from overweening confidence.
“Is it not preposterous,” says Herbert Spencer, “that the fate of a
new generation should be left to the chance of unreasoning custom,
impulse, fancy, joined with the suggestions of ignorant nurses and
the prejudiced counsel of grandmothers? To tens of thousands that
are killed, add hundreds of thousands that survive with feeble
constitutions, and millions that grow up with constitutions not so
strong as they should be, and you have some idea of the curse
inflicted on their offspring by parents ignorant of the laws of
life.”
The nurse is in the most effective position possible, to help in
dispelling maternal ignorance, during the long days of pleasant
intimacy which she and the young mother spend together in devotion
to the baby. And by helping the inexperienced young mother to give
skilful care to her baby, with all of the gentleness and tenderness
that a mother can lavish, the nurse will not only serve the baby;
she also will awaken for many a young woman, an interest that will
be ever fresh and absorbing, and point the way to unexpected joys
and delights in her motherhood.
“Can there be any higher work than this?
Can any woman wish for a more womanly work?”
INDEX
Abdomen, changes in, during pregnancy, 102
enlargement of, during pregnancy, 98
Abdominal binders, in pregnancy, 122
in puerperium, 349
Abdominal palpation, 226
Abdominal pedicle, 76
Abdominal supporters, in pregnancy, 122
Abdominal wall, in puerperium, 321
Abnormalities of newborn, 540
Abortion, 165, 166
attempted, 151
causes of, 166
complete, 170
early signs of, 142
incomplete, 170
induced, 309, and _see_ Induced abortions
missed, 170
prevention of, 168
symptoms of, 167
therapeutics, 171
threatened, 170
treatment of, 170
complete, 170
incomplete, 170
threatened, 170
Abscesses, in breast, 344
Accidental hemorrhage, 178
Accidents of pregnancy, 164
Accouchement forcé, 309, 313
Acidosis, 525
Acute yellow atrophy of liver, during pregnancy, 207
Advice for mothers, 427
After-birth, _see_ Placenta
After-care, immediate, of patient, 281
After-pains, 318
Air, fresh, during pregnancy, 129
Albumen in urine, tests for, 118
Alcohol, during pregnancy, 127
Amenorrhea, 56
Amnion, 70
development of, 70
Amniotic fluid, 71
Analgesia, nitrous oxid gas, 291
Anatomy of pelvis and genitalia, 19
Anesthesia, à la reine, 288
chloroform, 287, 288
complete, 292, 293
ether, 289, 290
light, 288
nitrous oxid gas, 291
obstetrical, 286, 288
scopolamin and morphin, 292
unfavorable signs in, 294
Animal foods, allowed during pregnancy, 128
Ante-partum hemorrhage, 174
Areola, 43
Artificial feeding of baby, 489
Attitude of fetus, in utero, 217
Auscultation of fetal heart, 231
Axis-traction forceps, 301
Baby, and _see_ Infant, and New-born
basket for, while travelling, 507
care of, by visiting nurse, 437
during summer, 514
immediate, 265
while travelling, 507
feeding, 486, and _see_ Baby’s food
artificial, 489
breast, 486
giving bottle to, 495
method of holding, for eye examination, 537
nutrition of, 368
preparations for, 162
supplies for, 428
sore eyes of, 533
toilet tray for, 417
Baby’s food, articles used in preparing, 492
commercial, 503
ingredients of, 498
proprietary, 504
Baby basket, for travelling, 507
Ballottement, 100
Barley water, preparation of, 505
Bartholin’s glands, 40
Bath, bran, preparation of, 517
in puerperium, 329
soda, preparation of, 517
starch, preparation of, 517
Bathing, during pregnancy, 119
Baudelocque’s diameter, 25, 27
Bed exercise, in puerperium, 349
Bed, position in during puerperium, 326
preparation of for labor, 248
Beef juice, preparation of, 506
Beri-beri, 376
Binders, abdominal, during pregnancy, 122
in puerperium, 349
for breast, 123, 345, 347
Birth, changes in fetal circulation at, 84, 87
Bladder, 37
care of in puerperium, 332
Blastodermic vesicle, 65, 66
Bleeding, _see_ Hemorrhage
Bones, changes in, during pregnancy, 104
Bottle, giving of to baby, 495
Bowels, care of in pregnancy, 120
care of, in puerperium, 331
of fetus, 88
Bradycardia, puerperal, 322
Bran bath, preparation of, 517
Bread, allowed during pregnancy, 128
Breast, and _see_ Lactation, and Nursing
abscess in, 344
anatomy of, 41, 42
binders, in pregnancy, 123
in puerperium, 345, 347
caked, 344
care of, during pregnancy, 131
in puerperium, 339
changes in, in pregnancy, 96, 103
drying up of, 366
feeding, 486, and _see_ Nursing, Lactation
contraindications, 357
infusion under, 202
stripping, 348
supporting, in puerperium, 343
supports for, in puerperium, 343, 345
Breast tray, 417
Breath, shortness of, during pregnancy, 140
Breech extraction, 298
Bregma, 89
Broad ligament, 33, 38
Broths, preparation of, 506
Cæsarean section, 305
conservative, 307
extra-peritoneal, 307
indications for, 306
radical, 307
Caked breasts, 344
Cane sugar, 498
Canned milk, 504
Caput succedaneum, differentiated from cephalhematoma, 541
Cardiovascular system, changes in pregnancy, 103
Care of baby, by visiting nurses, 437
in traveling, 507
during summer, 514
immediate, 265
of mother, by visiting nurses, 437
Carriage, in pregnancy, 105
Catheterization, 333
Cephalhematoma, 541
Cereals allowed during pregnancy, 128
Certified milk, 490
Cervix, changes in pregnancy, 99, 102
during labor, 234
Champetier de Ribes’ bag, 311
Childbirth, deaths in, 112, 405
Chloasma, 97, 105
Chloroform anesthesia, 287, 288
Chorion, 68
development of, 68
frondosum, 70
læve, 70
primitive, 67
villi, 68, 70
Circulation, fetal, 84, 85
changes in at birth, 84, 87
Cleft palate, in new-born, 542
Climacteric, 56
Clinic assistant, duties of, 431
Clinic equipment, 432
Clitoris, 40
Clothes, during pregnancy, 121
Club foot, in new-born, 541
Coccyx, 20
Colic in infants, 528
Colonic irrigations in eclampsia, 195
Colostrum, 103
Commercial baby foods, 503
Complete abortion, 170
Complicated labors, 295
Complications of pregnancy, 164
early signs of, 141, 143
of puerperium, 391
Concealed hemorrhage, 178
Conception, 62
Condensed milk, 504
Confinement, to calculate date of, 93, 94
Constipation, during pregnancy, 120
in infants, 529
Contracted pelvis, measurements in, 29
Convulsions, in infants, 531
Cord, umbilical, 76
development of, 61
ligation of, 272
prolapsed, 285
Corpus luteum, 49
false, 49
of menstruation, 49
of pregnancy, 49
verum, 49
Corsets, during pregnancy, 121
front-lace, 122
maternity, 122
Cow’s milk compared with mother’s milk, 491
Cramps in legs, during pregnancy, 140
Cravings, during pregnancy, 127
Cul-de-sac of Douglas, 36, 39
Dämmerschlaf, 292
Date of confinement, to calculate, 93, 94
Deaths in childbirth, 112, 405
Decidua basalis, 66
gravidatis, 65
reflexa, 66
serotina, 66
vera, 66
Deficiency diseases, 372, 378
Delivery, dressings required for, 159
patient draped for, 262
preparation of dressings for, 155, 158
of equipment for, 155
of room for, 155
requirements of mother for, 158
of physician for, 161
room ready for, 258, 259
Detachment of placenta, 241
Desserts allowed in pregnancy, 128
Development of cord, 61
of embryo, 61, 76, 78, 80
of fetus, 61, 76, 78, 80
of membranes, 61
of ovum, 61
of placenta, 61, 72
Diameters of fetal head, 90, 91
of pelvis, 25, 26, 27, 28
Diarrhea, during pregnancy, 136
Diarrheal diseases of infants, 518
Diastasis of rectus muscles, 102
Diet during pregnancy, 125, 128
during puerperium, 329
of nursing mother, 363
Digestive tract, changes in during pregnancy, 104
during puerperium, 321
Discoloration of skin during pregnancy, 97
Discomforts during pregnancy, 134
Discus proligerus, 48
Distress during pregnancy, 136
Douches, vaginal, in puerperium, 338
Douglas, cul-de-sac of, 36, 39
Dressings, post-partum, 336
required for delivery, 155, 158, 159
Dried milk, 505
Drugs excreted in milk, 331
Dry labor, 235
Dry pack, hot, in eclampsia, 197
Ductless glands, changes in during pregnancy, 105
Duncan’s mechanism of placental separation, 239, 242
Dysmenorrhea, 56
Eclampsia, 190
colonic irrigations in, 195
frequency of, 190
mortality of, 191
nursing care in, 193
symptoms of, 191
treatment of, 193
Ectoderm, structures derived from, 67
Elevated Sims’ position, 139
Embryo, 67, 68
development of, 61, 76, 78, 80
Embryonic area, 66
development, 67
Emotional changes during pregnancy, 105
Endometrium, 32
pre-menstrual swelling of, 49
Enema, to give to infant, 530
Engagement of presenting part, 224
Engorgement of breasts, in newborn, 541
Entoderm, structures derived from, 67
Episiotomy, 298
Equipment, preparation of for delivery, 158
Esbach’s test for albumen in urine, 118
Ether anesthesia, 289, 290
Evaporated milk, 504
Examination of eye, method of holding baby for, 537
of urine, in pregnancy, 117
rectal, during pregnancy, 231
vaginal, in labor, 248, 252
in pregnancy, 230
Excretions during pregnancy, 117
Exercise, bed, during puerperium, 349
for nursing mother, 364
in pregnancy, 129
Expectant mother, 109
mental hygiene of, 145
Extra-uterine pregnancy, 82
Face presentation, positions in, 223
Fallopian tubes, anatomy of, 33
Fallopian tubes, changes in during pregnancy, 102
fimbriæ of, 34
Fat soluble A. vitamines, 371, 377
Feeder, for premature babies, 513
Feeding, 486
artificial, 489
breast, 486
mixed, 503
percentage, 499, 500, 501
Feet, swelling of during pregnancy, 137
varicose veins of during pregnancy, 138
Fertilization, 62
Fetal circulation, 84, 85
changes in at birth, 84, 87
Fetal head, 88, 90
circumference of, 91
diameters of, 90, 91
fontanelles of, 89, 90
rotation of during birth, 236
sutures of, 89
Fetal heart, auscultation of, 231
Fetal heart beat, sign of pregnancy, 99
Fetal mortality, 112
Fetus, 68
at term, 80, 218
attitude of in uterus, 217
bowels of, 88
development of, 61, 76, 78, 80
growth of, 84
head of, 88, 90, and _see_ Fetal head
kidneys of, 88
maturation of, time required for, 68
movements of, as sign of pregnancy, 99
palpation of, 224
as sign of pregnancy, 99
physiology of, 84
position of, 217
presentation of, 217, 220
presenting part of, 220
Fimbria ovarica, 34
Flatulence during pregnancy, 136
Follicle, primordial, 47
Fontanelles of fetal head, 89, 90
Foods for baby, commercial, 503
proprietary, 504
Forceps, 300
axis-traction, 301
high, 303
indications for, 301, 302
low, 303
Simpson’s, 301
Tarnier’s, 301
Fornix of vagina, 35
Fossa navicularis, 40
Fourchette, 40
Frank hemorrhage, 178
Fresh air during pregnancy, 129
Front-lace corset, 122
Fruits allowed during pregnancy, 128
Funis, 76
Gastro-enteritis, acute, 519
nursing care in, 519
symptoms of, 519
treatment of, 519
Gavage, 524
Genitalia, anatomy of, 19
external, 39
internal, 30
Germinal spot, 48
vesicle, 47
Gonorrhea complicating pregnancy, 212
Gonorrheal vaginitis in infants, 540
Graafian follicle, 34, 48
Gymnastics during pregnancy, 130
Harelip in newborn, 541
Head, fetal, 88, 90
circumference of, 91
diameters of, 90, 91
fontanelles of, 89, 90
rotation of during birth, 236
sutures of, 89
Health, general, during pregnancy, 106
Heart, fetal, auscultation of, 231
lesions of complicating pregnancy, 209
Heart beat, fetal, sign of pregnancy, 99
Heart burn, during pregnancy, 135
Heat and acetic acid test for albumen in urine, 118
Hebotomy, 303
Hemorrhage, accidental, 178
ante-partum, 174
concealed, 178
during pregnancy, 143
during puerperium, 391
frank, 178
post-partum, 286, 391
causes of, 391
treatment of, 392
Hemorrhoids during pregnancy, 140
Hernia, in newborn, 542
inguinal, 543
umbilical, 542
Hot dry pack in eclampsia, 197
Hygiene, of nursing mother, 363
of pregnancy, 116
Hysterotomy, vaginal, 305
Icterus, in newborn, 540
Ignorance, dangers of, 546
Ilium, 19
Impetigo, 540
Impregnation, 62
Inanition, 518
Incomplete abortion, 170
Indian binder for breasts, 347
Induced abortion, 309
indications, 309
methods, 310
Infancy, abnormalities of, 518
disorders of, 518
infection in, 533
Infant, and _see_ Newborn
colic in, 528
constipation in, 529
convulsions in, 531
diarrheal diseases of, 518
enema for, 530
gonorrheal vaginitis in, 540
syphilis in, 538
vaginitis in, 540
vomiting in, 532
wasting diseases in, 518
Infantile scurvy, 374
Infection, in infancy, 533
puerperal, 393
nursing care in, 399
prevention of, 399
symptoms of, 396
treatment of, 399
Infusion, of orange peel, preparation of, 506
saline, in eclampsia, 200
under breast, 202
Inguinal hernia, in newborn, 543
Injection of salines, in eclampsia, 200
Innominate bones, 19
Instructions to patients, 427
Intestinal irrigations, 522
Invalidism, due to lack of obstetrical care, 112
Involution of uterus, 317
Irrigations, colonic, in eclampsia, 195
intestinal, 522
Ischium, 20
Itching of skin, during pregnancy, 141
Jaundice, in newborn, 540
Kidneys, during pregnancy, 117
of fetus, 88
Labia majora, 39
minora, 40
Labor, cause of, 232
cervix during, 234
complicated, 295
course of, 232
definition of, 232
dry, 235
duration of, 233
first stage of, 23
nurses duties during, 245, 256
mechanism of, 232
nurses duties in, 243
during first stage, 245, 256
during second stage, 256
during third stage, 278
when doctor is delayed, 283
onset of, 232
pains of, 232
premature, 172
causes of, 172
induced, 309, 310
treatment, 173
preparation for, 248
of bed, 248
of room, 248
signs of, 232
second stage of, 236
nurses duties during, 256
stages of, 232
symptoms of, 232
third stage of, 240
nurses duties during, 278
vaginal examination in, 252
when to call physician, 247
Lactation, 320, 342
Lactose, 498
Lacerations, perineal, 296
repair of, 297
Lavage, 524
Layette, details of, 162
recommended by Maternal Centre Association, 416
Leg, cramps in during pregnancy, 140
Leg, milk, 400
Leg straps, to improvise, 296
Leggings, for delivery or operation, 304
Ligaments, broad, 33, 38
ovarian, 34, 38
round, 38
uterine, 38
Ligation of cord, 272
Linea nigra, 197
Lineæ albicantes, 102
Liquor amnii, 71
folliculi, 48
Liver, acute yellow atrophy of during pregnancy, 207
Lochia, 319
alba, 319
rubra, 319
serosa, 319
Longitudinal presentations, 221
Loss of weight during puerperium, 319
Lutein, 49
Malnutrition, 369, 387, 518
Maltose, 498
Mania, puerperal, 400
Marasmus, 518
Marital relations during pregnancy, 133
Masque de femmes enceintes, 105
Massage during pregnancy, 130
Mastitis, 345
Maternal mortality, 112
Maternity Centre Association, 410
baby’s supplies, 428
clinical equipment, 432
clinical routine, 429
doctor’s duties, 431
duties of clinical assistants, 431
forms and routines used by, 423
instructions to patients, 427
mother’s supplies, 428
nurse’s duties, 429
nursing visits, 424
orders for nurses, 434
post-natal follow up, 435
records, 427, 431
requirements, 432
Maternity Centre Nurse, 413
Maternity Centre orders for nurses, 434
ante-partum, 434
post-natal, 435
post-partum, 435
Maternity corsets, 122
Maternity Protective Committee of the Woman’s City Club, 411
Maternity records, 427, 431
Maternity Service Association of Physicians and Hospital
Superintendents, 411
Maternity service for rural communities, 422
Maternity nursing, visiting, in Montreal, 445
Maternity work of Visiting Nurses Society of Philadelphia, 439
delivery routine, 441
equipment for bags, 439
routine after delivery, 442
routine in home, 440
routine technique, 439
Maturation of fetus, time required for, 68
Mauriceau’s maneuver, 299
Measurements, in contracted pelvis, 29
Meatus urinarius, 37
Membrana granulosa, 48
Membrane, vitelline, 47
Membranes, development of, 61
examination of, 280
Menopause, 56
Menorrhagia, 56
Menstrual cycle, 50
Menstruation, 50
cessation of, sign of pregnancy, 96
corpus luteum of, 49
difficulties of, 54
during puerperium, 320
modifications of, 56
painful, 54
relation to ovulation, 55
vicarious, 56
Mesoderm, structures derived from, 67
Mental changes during pregnancy, 105
hygiene during pregnancy, 145
Micturition, frequent, as sign of pregnancy, 97
Migration of ovum, 61
Milk, canned, 504
certified, 490
condensed, 504
cow’s compared with mother’s, 491
dried, 505
drugs excreted in, 331
drying up of, 366
evaporated, 504
mixtures, formulas for, 500, 501, 503
mother’s compared with cow’s, 491
pasteurized, 494
powders, 505
preparation of for baby, 494
reconstructed, 505
top, 499
whole, 499
Milk leg, 400
Miscarriage, 165
early signs of, 142
Missed abortion, 170
Mixed feeding, 503
Mons Veneris, 39
Montgomery, tubercles of, 43
Morning sickness, 97, 135, 142, 181
Mortality, fetal, 112
maternal, 112
Morula, 64, 65
Mother, advice for, 427
care of by visiting nurses, 437
expectant, 109
mental hygiene of, 145
milk of compared with that of cow, 491
nursing, 357
bowels of, 364
diet of, 363
exercises for, 364
hygiene of, 363
recreation for, 365
rest for, 364
Mother, nutrition of, 368
requirements of for delivery, 158
supplies for, 428
Movements of fetus a sign of pregnancy, 99
Multipara, definition of term, 219
Multiple pregnancy, 82
Nausea, during pregnancy, 134
Nephritic toxemia, during pregnancy, 203
nursing care of, 205
symptoms of, 204
treatment of, 205
Neurotic vomiting during pregnancy, 183
Newborn baby and _see_ Infant
abnormalities of, 540
bathing of, 463
behavior of, 459
bowels, training of, 482
cephalhematoma in, 541
characteristics of, 451
chest, 455
cleft palate in, 542
clothes for, 472
club foot in, 541
cord, 458
dressing of, 469
crying of, 484
development of, 452
diapers for, 475
ear pulling, prevention of, 483
engorgement of breasts in, 541
exercise for, 480
fontanelles, 455
fresh air for, 477
growth of, 453
harelip in, 541
head, 455
height of, 455
hernia in, 542, 543
icterus in, 540
inguinal hernia in, 543
jaundice in, 540
nursing care of, 461
resuscitation of, 273
ruminating, prevention of, 484
schedule for, 462
size of, 452
skin of, 459
sore eyes in, 533
stools of, 456
tears of, 459
teeth of, 455
thumb-sucking, prevention of, 482
training of, 482
umbilical hernia in, 542
urine of, 456
weight of, 452, 453
Newborn baby, weight chart, 454
Nipples, 41
care of, during pregnancy, 132
care of, in puerperium, 340, 342
cracked, care of, 342
flat, 132
retracted, 132
toughening, 132
Nipple shields, 340, 341, 342
Nitrous oxid gas anesthesia, 291
Nullipara, definition of term, 219
Nurses’ bag, contents of, 434
Nurses’ duties, in clinic, 429
during labor, 243
first stage, 245, 256
second stage, 256
third stage, 278
maternity centre orders for, 434
ante-partum, 434
post-natal, 435
post-partum, 435
Plunkett, 408
requirements of for delivery, 161
visiting, care of mother and baby by, 437
work of in prenatal case, 112
Nursing mother, 357
bowels of, 364
diet of, 363
exercise for, 364
hygiene of, 363
recreation for, 365
rest for, 364
Nursing of baby, _see_ Lactation and Nursing mother
frequency of, 361
methods of, 358
Nursing care in puerperium, 323, 326
Nursing visits, 424
Nutrition, 369
of baby, 368
of mother, 368
Oatmeal water, preparation of, 506
Obstetrical anesthesia, 286, 288
operations, 295
Oöcyte, 47
Operating table, to make, 295
Operations, destructive, 309
obstetrical, 295
Ophthalmia neonatorum, 533
nursing care of, 535
symptoms of, 534
prevention of, 534
treatment of, 535
Orange juice, preparation of, 505
Organized prenatal work, 405
Organs of reproduction, female, 30
Ossa innominata, 19
Ova, 34, 47
Ovarian ligament, 34, 38
Ovaries, 34
changes in during pregnancy, 102
Ovulation, 47
relation to menstruation, 55
Ovum, 47, 68
development of, 61
migration of, 61
segmentation of, 64, 65
Pack, to give, 521, 522
Palpation of fetus, 224
sign of pregnancy, 99
Pasteurized milk, 494
Pellagra, 380
Pelvic cavity, 22
Pelvic examination in puerperium, 329
Pelvimetry, 19, 25, and _see_ Diameters of pelvis
Pelvis, anatomy of, 19
brim of, 22
contracted, measurements of, 29
diameters of, 25, and _see_ Diameters of pelvis
false, 23
female, 19, 21, 30
inferior strait, 23
inlet, 22
male, 21, 30
measurements of, 25
normal female, 19, 30
outlet of, 23
rachitic, 30
true, 23
Pemphigus, 540
Percentage feeding, 499, 500, 501
Perineal dressings, in puerperium, 336
lacerations, 296
repair of, 297
Perineum, anatomy of, 40
care of in puerperium, 335
Peritoneum, 34
Pernicious vomiting of pregnancy, 134, 181
classification, 182
Phlegmasia alba dolens, 400
Physician, requirements of for delivery, 161
when to call in labor cases, 247
Physiology, 45
Pigmentation, in pregnancy, 103, 105
Placenta, 68, 72
delivery of, 279
detachment of, 241
development of, 61, 72
examination of, 280
function of, 73
origin of, 72
Placenta, separation of, 239, 279
mechanism of, 239, 241, 242
premature, 178
size of, 75
weight of, 75
Placenta prævia, 174
causes of, 176
central, 176
complete, 176
frequency of, 174
incomplete, 176
marginal, 176
mortality in, 174
partial, 176
symptoms of, 176
treatment of, 177
Plunkett nurses, 408
Poncho, Sutton’s, 479
Position of fetus, 217
definition of, 221
Position, elevated Sims, 139
right angled, 138
Positions, in face presentations, 223
in transverse presentations, 223
in vertex presentations, 222
Post-natal follow-up, routine for, 435
Post-natal work of Maternity Centre nurses, 419
Post-partum care by visiting nurses, 437
dressings, 336
hemorrhage, 286, 391
causes of, 391
treatment of, 392
Potato water, preparation of, 505
Pouting umbilicus, 103
Powders, milk, 505
Pre-eclamptic toxemia, 187
prevention of, 188
nursing care in, 189
symptoms of, 187
treatment of, 189
Pregnancy, abdominal binders during, 122
abdominal changes in, 98, 102
abdominal enlargement, sign of, 98
accidents of, 164
acute yellow atrophy of liver during, 207
alcohol during, 127
bathing during, 119
bones, changes in during, 104
bowels, care of during, 120
breasts, care of during, 131
changes in a sign of, 96
changes in during, 96, 103
breast-binders during, 123
cardio-vascular system, changes in during, 103
carriage in, 105
cervix, changes in during, 99, 102
softening, a sign of, 99
cessation of menstruation, a sign of, 96
clothes, during, 121
complications of, 164
early signs of, 141, 143
constipation during, 120
corpus luteum of, 49
corsets during, 121
cramps in legs during, 140
cravings during, 127
diarrhea during, 136
diet during, 125, 128
digestive tract, changes in during, 104
discoloration of skin, as sign of, 97
discomfort during, 134
distress during, 136
ductless glands, changes in during, 105
duration of, 93
emotional changes during, 105
excretions during, 129
exercise during, 129
extra-uterine, 82
fallopian tubes, changes in during, 102
fetal heart beat, a sign of, 99
fetal movements a sign of, 99
flatulence during, 136
fresh air during, 129
gonorrhea complicating, 212
gymnastics during, 130
health, general, during pregnancy, 106
heartburn during, 135
heart lesions complicating, 209
hemorrhage during, 143
hemorrhoids during, 140
hygiene of, 116
itching of skin during, 141
kidneys in, 117
marital relations during, 133
massage during, 130
mental changes during, 105
mental hygiene during, 145
micturition, frequent as sign of, 97
morning sickness during, 97, 135, 142, 181
multiple, 82
nausea during, 134
nephritic toxemia in, 203
neurotic vomiting in, 147
nipples, care of during, 132
flat, 132
retracted, 132
ovaries, changes in during, 102
palpation of fetus, sign of, 99
pernicious vomiting of, 134, 181
physiology of, 93, 100
pigmentation in, 105
positive signs of, 99
premature termination of, 165
early signs of, 142
presumptive signs of, 96
pressure symptoms during, 137
probable signs of, 98
pulmonary tuberculosis complicating, 209
psychoses during, 147
pyelitis complicating, 212
quadruplet, 82
quickening, as sign of, 98, 99
to calculate date of confinement from, 94
quintuplet, 82
rectal examination in, 231
respiratory organs, changes in during, 104
rest during, 130
sextuplet, 82
shoes during, 124
shortness of breath during, 140
signs of, 93
positive, 99
presumptive, 96
probable, 98
skin, care of during, 118
changes in during, 104
itching of during, 141
stretching of during, 141
sleep during, 130
spurious, 96
stocking supporters during, 124
supporters, abdominal, during, 122
stocking, during, 124
swelling of feet during, 137
symptoms of, 93
syphilis, complicating, 207
teeth in, 104, 133
temperature of body in, 105
thyroidism, complicating, 210
toxemias of, 142, 179
early signs of, 142
travelling during, 133
triplet, 82
twin, 82
umbilicus, changes in during, 103
urinary apparatus, changes in during, 104
urine in, 117
tests for, 118
uterus, changes in during, 101, 83
sign of, 98, 99
vagina, changes in during, 102
vaginal discharge during, 140
examination in, 230
varicose veins during, 138
vomiting during, 134, 181
Premature baby, 508
bed for, 512
care of, 509
feeder for, 513
feeding of, 510, 513
heat required for, 511, 512
size of, 508
Premature labor, 172, 165
causes of, 172
early signs of, 142
induced, 309, 310
indications for, 310
methods, 311
treatment of, 173
Premature separation of normally implanted placenta, 178
causes of, 178
symptoms of, 178
treatment of, 179
Premature termination of pregnancy, 165
early signs of, 142
Premenstrual swelling of endometrium, 49
Prenatal care, 111
work of nurse in, 112
Prenatal work, organized, 405
Prenatal visits, routine for, 423
Preparations for delivery, 155, 158
Presentation of fetus, 217
definition of, 220
face, 223
longitudinal, 221
transverse, 221, 223
vertex, 222
Presenting part, definition of, 220
engagement of, 224
Pressure symptoms during pregnancy, 137
Prickly heat, 516
Primigravida, definition of, 219
Primipara, definition of, 219
Primordial follicle, 47
Prolapsed cord, 285
Proprietary baby foods, 504
Protein milk, preparation of, 506
Pseudocyesis, 96
Psychoses during pregnancy, 147
Puberty, 45
Pubiotomy, 304
Pubis, 20
Pudendal crease, 39
Puerperium, 317
abdominal binder, in, 349
abdominal wall in, 321
bath in, 329
bed exercise in, 349
bladder, care of during, 332
bowels, care of during, 331
bradycardia during, 322
breasts, binder for, 345, 347
care of during, 339
supports for during, 343, 345
complications in, 391
diet in, 329
digestive tract during, 321
douches, vaginal during, 338
hemorrhages during, 391
infection in, 393
nursing care of, 399
symptoms of, 396
treatment of, 399
loss of weight during, 319
mania during, 400
menstruation during, 320
nipples, care of during, 340
nursing care in, 323, 326
pelvic examination in, 329
perineal dressings in, 336
perineum, care of during, 335
physiology of, 317
pulse during, 322, 335
position in bed during, 326
respiration in, 335
sitting up in, 328
skin in, 322
temperature in, 321, 335
urine in, 322
uterus, changes in during, 317
height of during, 327, 328
Pulmonary tuberculosis complicating pregnancy, 209
Pulse, in puerperium, 322, 335
Pyelitis complicating pregnancy, 212
Quadruplet pregnancy, 82
Quickening, as sign of pregnancy, 98, 99
to calculate date of confinement from, 94
Quintuplet pregnancy, 82
Rachitic pelvis, 30
Reconstructed milk, 505
Records, maternity, 427, 431
Recreation, for nursing mother, 365
Rectal examinations, during pregnancy, 231
Rectum, 37
Reflex vomiting during pregnancy, 182
Reproduction, organs of, 30
Respiration, in puerperium, 335
Respiratory organs, changes in during pregnancy, 104
Rest, during pregnancy, 130
for nursing mother, 364
Resuscitation of newborn baby, 273
Richardson Y binder, 345, 347
Rickets, 381
symptoms of, 382
treatment of, 385
Right angled position, 138
Room for delivery, preparation of, 155, 258, 259
Rotation of fetal head during birth, 236
Round ligaments, 38
Routine for prenatal visits, 423
Rubber gloves, sterilization of, 253
Ruminating cap, 485
Rumination, prevention of, 484
Ruptured uterus, 307
causes of, 308
frequency of, 308
symptoms of, 308
treatment of, 308
Sacro-coccygeal joint, 20
Sacro-iliac joints, 20
Sacro-vertebral joint, 22
Sacrum, 20
Saline infusion, in eclampsia, 200
Schenck’s theory of sex determination, 63
Schultze’s mechanism of placental separation, 239, 241
Scopolamin and morphin anesthesia, 292
Scorbutus, 373
Scurvy, 373
infantile, 374
Segmentation of ovum, 64, 65
Separation of placenta, 239, 279
mechanism of, 239, 241, 242
Sex, determination of, theories of, 63
Sextuplet pregnancy, 82
Shoes, during pregnancy, 124
Shortness of breath, during pregnancy, 140
“Show,” 235
Sims’ elevated position, 139
Simpson’s forceps, 301
Sinciput, 89
Sitting up, during puerperium, 328
Skin, care of in pregnancy, 118
changes in, during pregnancy, 97, 104
discoloration of as a sign of pregnancy, 97
in puerperium, 322
itching of, during pregnancy, 141
stretching of, during pregnancy, 141
Sleep, during pregnancy, 130
Society for the Health of Mothers and Children, 408
Soda bath, preparation of, 517
Soups, allowed during pregnancy, 128
Spermatozoa, 61, 62
Sphincter ani, 37
Spinach, preparation of, 505
Sprue, 539
Spurious pregnancy, 96
Starch bath, preparation of, 517
Stocking supporters during pregnancy, 124
Stretching of skin, during pregnancy, 141
Striæ, 97, 102
gravidarium, 102
Stripping of breast, 348
Subcutaneous injection of salines in eclampsia, 200
Sucking of thumb, prevention of, 482
Sugar, 498
Summer, care of baby during, 514
complaint, 519
diarrhea, 519
Supplies for baby, 428
for mother, 428
Supporter, abdominal, during pregnancy, 122
Supports for breasts, in puerperium, 343, 345
Sutton’s poncho, 479
Sutures of fetal head, 89
Swelling of feet during pregnancy, 137
Symphysiotomy, 305
Syphilis, complicating pregnancy, 207
in infants, 538
Tarnier’s forceps, 301
Teeth, care of during pregnancy, 133
in pregnancy, 104, 133
Temperature, in pregnancy, 105
in puerperium, 335
Tests for albumen in urine, 118
Theca folliculi, 48
Therapeutic abortion, 171
Threatened abortion, 170
Thrush, 539
Thumb sucking, to prevent, 482
Thyroidism complicating pregnancy, 210
Toilet tray, baby’s, 417
Tomato juice, to prepare, 506
Top milk, 499
Toxemia, nephritic, 203
nursing care in, 205
symptoms of, 204
treatment of, 205
pre-eclamptic, 187
nursing care of, 189
prevention of, 188
symptoms of, 187
treatment of, 189
Toxemias of pregnancy, 142, 179
early signs of, 142
Toxemic vomiting, during pregnancy, 184
Transverse presentations, 221
positions in, 223
Travelling, baby basket for, 507
care of baby in, 507
during pregnancy, 133
Triplet pregnancy, 82
Tubercles of Montgomery, 43
Tuberculosis, pulmonary, complicating pregnancy, 209
Twilight sleep, 292
Twin pregnancy, 82
Umbilicus, changes in during pregnancy, 103
pouting, 103
Umbilical cord, 76, and _see_ Cord
Umbilical hernia, in newborn, 542
Ureters, 37
Urethra, 37
Urinary apparatus, changes in during pregnancy, 104
Urine, albumen in, to test for, 118
in pregnancy, 117
examination of, 117
in puerperium, 322
to obtain specimen of from baby, 526, 527
Uterus, anatomy of, 30
blood supply of, 32
body of, 32
cervix of, 32, 33,
changes in during pregnancy, 83, 98, 101
as sign of pregnancy, 98
changes in during puerperium, 317
contractions of as sign of pregnancy, 99
cornua of, 33
external os, 33
fundus, 32
height of in puerperium, 327, 328
internal os, 33
involution of, 317
ligaments of, 33, 38
multiparous, 32
ruptured, 307, and _see_ Ruptured uterus
virgin, 32
Vagina, changes in during pregnancy, 102
fornix of, 35
Vaginal discharge during pregnancy, 140
douches during puerperium, 338
examination in labor, 248, 252
in pregnancy, 230
hysterotomy, 305
opening, 40
Vaginitis, in infants, 540
Varicose veins during pregnancy, 138
Vegetables allowed during pregnancy, 128
Venesection in eclampsia, 200
Version, 299
cephalic, 299
combined, 300
external, 300
indications, 299
internal, 300
podalic, 300
Vertex presentations, positions in, 222
Vestibule, 40
Vicarious menstruation, 56
Villi, chorionic, 68, 70
Visiting nurses, care of mother and baby by, 437
Vitamines, 371
fat soluble A., 371, 377
water soluble B., 371, 377
water soluble C., 371, 373
Vitelline membrane, 47
Vomiting during pregnancy, 134, 181
pernicious, 134, 181
neurotic, 147, 183
reflex, 182
toxemic, 184
Vomiting in infants, 532
Voorhees’ bag, 312
Vulva, 39
cleansing of, 249
varicose veins of during pregnancy, 139
Wassermann’s reaction, in obstetrics, 208, 209
Wasting diseases of infants, 518
Water soluble B., 371, 377
Water soluble C., 371, 373
Weaning, 365
Weight, loss of, during puerperium, 319
Weight of newborn baby, 452, 453
chart, 454
Whey, preparation of, 506
Whole milk, 499
Woman’s Municipal League, 409
Xerophthalmia, 377
-----
Footnote 1:
In the generally contracted pelves, all of the external measurements
are shorter than normal, the diagonal conjugate being 11.5 cm., or
less. In simple flat pelves, on the other hand, the external
measurements are normal, but the diagonal conjugate is 11 cm., or
less.
If the distance between the tuber-ischii is only 8 cm., or less, the
patient has some kind of a funnel pelvis; simple, if the inlet
measurements are normal, but if they also are shortened, the pelvis is
described as a generally contracted funnel.
The rachitic pelves present certain characteristic features, one
being less difference between the inter-spinous and inter-crestal
measurements than is found in a normal pelvis. Another, that the
distance between the tuber-ischii is always of normal length and may
even be greater than normal. The peculiar deformity of the sacrum,
however, is the most characteristic abnormality of the rachitic
pelves. The concavity from above downward is markedly increased, in
some cases almost forming an angle, while the horizontal concavity is
nearly or quite obliterated. The commonest type of a rachitic pelvis
is one in which all of the inlet measurements are shortened, the
inter-tuberous distance normal, and the sacrum characteristically
deformed. This is called the generally contracted, rachitic pelvis. In
the flat rachitic pelvis all of the inlet measurements are normal,
except the diagonal conjugate, which may be shortened to 11 cm., or
less, and the sacrum presents the deformity described above.
Footnote 2:
The Prospective Mother, by J. Morris Slemons.
Footnote 3:
“Obstetrics,” by J. Whitridge Williams.
Footnote 4:
“The Practice of Obstetrics,” by J. Clifton Edgar.
Footnote 5:
“The Value of the Wassermann Reaction in Obstetrics, Based upon the
Study of 4,547 Consecutive Cases.” Johns Hopkins Hospital Bulletin,
Oct., ’20. “The Significance of Syphilis in Prenatal Care and in the
Causation of Infant Death.” Johns Hopkins Hospital Bulletin, May,
1921.
Footnote 6:
Routine preparation of hands at Johns Hopkins Hospital.
Footnote 7:
Written especially for this book.
Footnote 8:
From _puer_, child, and _parere_, to bring forth.
Footnote 9:
“The Practice of Obstetrics,” by J. Clifton Edgar.
Footnote 10:
Alfred F. Hess, M.D., and Lester J. Unger, _American Journal of
Diseases of Children_, April, 1919.
Footnote 11:
Alfred F. Hess, M.D., _The Journal of the American Medical
Association_, Sept. 21, 1918.
Footnote 12:
“The Nursing Mother as a Factor of Safety in the Nutrition of the
Young.” E. V. McCollum and N. Simmonds, _The American Journal of
Physiology_, June, 1918.
Footnote 13:
“The Life of Pasteur,” by Vallery Radot.
Footnote 14:
The Committee consisted of Drs. J. Clifton Edgar, Ralph Lobenstein and
Philip Van Ingen.
Footnote 15:
“Obstetrics,” by J. Whitridge Williams.
Footnote 16:
“Acidosis,” by John Howland, M.D., and W. McKim Marriott, M.D.,
_Pennsylvania Medical Journal_, April, 1918.
Footnote 17:
“The Diseases of Infants and Children,” by J. P. Crozer Griffith,
M.D.
------------------------------------------------------------------------
TRANSCRIBER’S NOTES
1. p. 88, changed “this is spite of” to “this is in spite of”.
2. Silently corrected typographical errors and variations in
spelling.
3. Retained anachronistic, non-standard, and uncertain spellings as
printed.
4. Footnotes have been re-indexed using numbers and collected
together at the end of the last chapter.
5. Enclosed italics font in _underscores_.
End of Project Gutenberg's Obstetrical Nursing, by Carolyn Conant Van Blarcom