Of the complaints which befal women in a pregnant state, the most
troublesome are a redundance of crudities, continued vomiting,
salivation, heartburn, and loathing of food; it will therefore be proper
to give directions regarding them. The most suitable remedies are,
exercise on foot, food not too sweet, wines which are yellow, fragrant,
and about five years old, and moderate drink. All these things are
proper for the cure of crudities and vomiting. For medicines, you may
give the plant of knot-grass, boiled in water, for drink; and likewise
dill, and the Pontic-root, called Rha, in the dialect of its native
country. These things may be taken at a meal, or before it. Externally,
the flowers of the wild vine, those of the wild or domestic pomegranate,
the leaves of the alsanders (_smyrnium_), and the seed of the fennel,
may be mixed together according to pleasure, along with dates and old
wine, and applied to the præcordium in the form of a cataplasm. Heartburn
may be alleviated by drinking warm water, by gentle exercise on foot,
and by covering the hypochondrium with soft wool. In the case of those
who have an aversion to food, whet their appetite with a variety of
articles of a savory nature, and also give dry starch. This last is
particularly serviceable to those who long to eat earth, as is the case
in the complaint called Pica, which occurs most frequently about the
third month after conception; because the fœtus being then weak, cannot
consume all the aliment which is brought to the uterus, and hence various
superfluities are collected in the stomach; and therefore they have a
desire for complicated and improper articles, such as extinguished coals,
Cimolian earth, and many more such things. On that account, the affection
has got its appellation, either from the variety of colours which the
bird Pica possesses, or from its being subject to this complaint. Labour
and long journeys will also contribute to restore a desire for wholesome
food. But she who has accustomed herself to live in an indolent manner,
will not be able, when she proves with child, to bear exercise all at
once. To those who loathe food, it may be of service to take acrid
substances, and particularly mustard. For swellings of the feet, it may
be proper to bind over them the herb anthyllis, soaked in vinegar; or to
lay the leaves of a cabbage over them, and to anoint them with Cimolian
earth mixed with vinegar, or with alum and vinegar. It is likewise of
use to sprinkle the feet with a decoction of the Median apples, called
citrons.
* * * * *
COMMENTARY. We shall commence by giving a short account of ancient
opinions on a curious subject not touched upon by our author,—we mean, on
the influence of the imagination in pregnant women on the fœtus.
Hippocrates says, that when pregnant women long to eat coals and
earth, the likeness of these things appears on the head of the child.
(De Superfœt. c. 8.) Galen likewise believed in the influence of the
imagination of pregnant women on the fœtus _in utero_. (Ad Pison.)
Soranus also was a firm believer, and gives instances in women and in the
inferior animals of the force of imagination at the time of impregnation.
(lib. vii.) This belief was very ancient, for it appears to be
countenanced by the Jewish historian. (See Genesis, xxx, 37-9.) Traces of
this opinion may be found in Hesiod; and distinct allusion to it is made
in the ‘Cynegetics’ of Oppian. (i, 327.) The story in the ‘Æthiopics’ of
Heliodorus respecting Chariclea, the white daughter of the black king and
queen of the Æthiopians, bespeaks the prevalence of the belief at the
time when this celebrated romance was written. Andreas Laurentius gives
an interesting statement of ancient and modern opinions on this subject.
(De Mirab. Strum. Sanit.)
The bird _pica_ is mentioned by name (κίττα) in the ‘Aves’ of
Aristophanes. (See also Schol. in Aristoph. in Pac. 496, and Vesp. 348;
Aristotle, Hist. An. vii, 4; and Pliny, Hist. Nat. x, 41.) Harduin
concludes, from Pliny’s account of it, that it was the magpie. But we
are rather inclined to follow Schneider in referring it to the jay, or
_corvus glandarius_.
On the disease, see Galen (Hyg.; de Causis Sympt. i, 7); Aëtius (xvi,
10); Theophanes Nonnus (c. 213); Moschion (de Morb. Mulier. c. 27);
Eros (apud Gynæcia), Alexander Aphrodisiensis (Problem. ii, 73);
Pseudo-Dioscorides (Euporist. ii, 16); Soranus (viii); Leo (vi, 14);
Rhases (Contin. xi); Avicenna (iii, 21, 2); Haly Abbas (Theor. vi, 17);
Serapion (Tr. iii, 22); Alsaharavius (Pract. xxv, 2, 8.) It appears to be
the malacia of Pliny (Hist. Nat. xxiii, 56, ed. Hard.)
Moschion defines the Pica to be an appetite for unusual food, which
happens to pregnant women at some irregular period; being attended with
a collection of depraved humours and nausea. It occurs, he says, most
commonly in the second month, but sometimes earlier, and sometimes later.
He recommends a restricted diet at first, then wine, dry astringent food,
cataplasms of a repellent nature, and bodily motion.
Soranus treats of Pica in very similar terms to those of Moschion.
But the account of the disease given by Galen and Aëtius is the fullest.
They derive the name either from the bird, as mentioned above, or from
ivy (κίττος), because, as ivy entwines itself about various plants, so
does this appetite in pregnant women fasten upon a variety of improper
articles of food. It is attended with languor of the stomach, nausea,
and loathing of food, bringing on vomiting of bile or phlegm, anxiety,
and pains in the stomach. All these symptoms arise, they say, from a
sanguineous plethora, brought on by a suppression of the menstrual
discharge. They, therefore, recommend a restricted diet, and moderate
exercise when the woman was accustomed to it. When the humour which
infests the stomach is of an acid, acrid, or saltish nature, they
direct draughts of tepid water, to encourage vomiting; they forbid all
sweet things; and recommend an old sub-astringent wine. When there is a
loathing of food, they advise us to tempt the appetite with a variety
of savory things. To those who have a desire for eating earth, they
particularly recommend starch. When the fluid which is vomited is of a
thick and viscid nature, they recommend pickles, radishes, and oxymel,
for an emetic. They also particularly direct astringent cataplasms and
plasters to be applied to the præcordia.
As the practice of the other authorities is conducted upon similar
principles, we shall mention them very succinctly. For the depraved
appetite which longs for earth, Serapion recommends aromatic spices,
such as cardamon, cubebs, and the like. For the continued vomiting,
Alsaharavius directs plasters, containing the oil of spikenard, mastich,
quinces, wormwood, and the like, or a vessel filled with hot water, to be
applied over the stomach, pomegranate seeds to be held in the mouth; and
that the patient should take gentle exercise, and abstain from all sweet
things.
Alexander Aphrodisiensis accounts for the disease in much the same way as
Galen and Aëtius. He says that, when the menstrual fluid is suppressed, a
determination of it takes place to the stomach, until the fœtus becomes
as large as to consume it.
Pliny strongly commends citrons for the cure of the disease.
For the œdematous swellings of the feet and legs, most of the other
authorities concur with our author in recommending astringent
applications. The anthyllis, mentioned by him, is supposed by Sprengel to
have been the _cressa cretica_. (R. H. Hist. p. 164.)
We shall conclude our commentary on this Section with an outline of
the directions given by Aspasia for the management of pregnant women.
Women who have conceived are to be guarded from frights, sorrow, and all
violent mental perturbation. They are to avoid gestation in carriages,
severe exercise, inordinate breathing and blows about the loins; also the
lifting of heavy loads, dancing, and sitting on hard seats. Likewise all
acrid and flatulent food, strong clysters, and too much or too little
food and drink are to be avoided. All discharges of blood, whether from
the nose or hemorrhoids, are dangerous in the pregnant state. Moderate
and wholesome food, gestation in a sedan, gentle walking, soft friction,
and the exercise of spinning are proper. About the eighth month,
which is the most critical period of pregnancy, the diet is to be more
contracted, and the exercise increased. If the bowels are constipated
owing to compression of the rectum, by the enlarged uterus, laxative
food is to be given, such as ptisan and mallows. In the ninth month the
regimen is to be of a relaxing nature, and for this purpose the tepid
bath is to be frequently taken, for it has a great effect in rendering
parturition easy. (Apud Aëtium, xvi, 12.)
Our author borrows part of this chapter from Oribasius, and abridges the
rest from Galen and Aëtius.