) (++)Maladies Des Yeux, Paris, 1847, p.715) Exactly opposite to this is the case quoted by Cazeaux, & & Traite Theorique et Pratique, p.312.) of a young woman whose imperfect vision had compelled her to use spectacles, from childhood, – but whose sight has so much improved immediately after the beginning of her pregnancy that she had no longer need of magnifying glasses. In affections of the eyes, study the following remedies:- Aurum. Objects appear as if divided horizontally. Belladonna. Dim appearance of objects; they appear inverted or double. Calcarea c. All objects appear as if seen through a mist. Causticum. Sudden and frequent loss of sight, with sensation of a film before the eyes. The dimness of vision is greater after every headache. Paralysis of the upper eyelids, so that they hang down. China. She can only distinguish the outlines of distant objects. When reading, the letters appear pale, For other remedies, see Hysteria, Gastric Derangements, &c.
INFLAMMATION OF THE ARTICULATIONS OF THE PELVIS. – This not very common form of inflammation is sometimes seen during pregnancy; but less rarely after parturition. The affection appears spontaneously, with severe, acute and sometimes lancinating pains, in one or several of the pelvic articulations. These pains are necessarily aggravated by pressure; by standing, and by attempts at walking, – which the inflammation may render impossible. In some cases, probably those which were strongly predisposed to suppuration, the inflammation has taken this course, the articular surfaces becoming denuded of cartilage; in two instances, referred to by M. Cazeaux, this affection terminated fatally.
Perfect quiet must of course be observed in such inflammation of parts which are not only immediately engaged in locomotion, but which have to sustain also all the superincumbent weight of the body. The character of the pains themselves, as lancinating or otherwise, together with their conditions of aggravation as to time and circumstances, will readily suggest to the Homoeopathic practitioner the remedy applicable to each particular case, – by the timely exhibition of which not only will much suffering be saved to the unfortunate patient, but the serious and even fatal consequences just referred to as occurring in the Allopathic practice, will undoubtedly be avoided.
RELAXATION OF THE ARTICULATIONS OF THE PELVIS. – In certain constitutions there appears during pregnancy a considerable amount of relaxation of the ligaments which unite the bones of the pelvis, and a consequent mobility of the pelvic articulations. This change occurs in different degrees in different persons; being scarcely perceptible in some, and rendering walking impossible in others.
The precise cause of this affection it may not be easy to designate; although those who suffer in this manner usually appear to possess what is termed a scrofulous constitution. And indeed this temporary relaxation and displacement is in no small degree analogous to the chronic scrofulous disease which goes by the name of Rachitis. The immediate cause of the relaxation is found to consist in a softening of the ligaments, by which the pelvic articulations are usually so firmly bound together. And in this respect this affection differs from the rachitic softening of the bones which so often produces distortion during the period of childhood, – and also from the corresponding softening of the bones in adult years, malacosteon, which occasions so many varieties of pelvic deformity. A certain enlargement of the synovial bursae and corresponding hypersecretion of the synovial fluid, have been noticed in the more aggravated cases of pelvic relaxation.
This spontaneous relaxation and dislocation, from the very first occasions such an amount of instability in standing and insecurity in attempting to walk, as to indicate at once the nature of the difficulty. The pains which accompany the affection, being felt principally from motion, or pressure, – such as standing or walking, – might be incapable of being distinguished form those of inflammation of the articulations, but for this remarkable sense of instability which appears in the incipient stages, and which is subsequently aggravated to exceeding difficulty of standing and impossibility of walking. In such cases the sensation experienced on attempting to stand, is that which so strongly characterizes Belladonna, – as if her whole body would sink down between her thighs.
This relaxation of the pelvic articulations may, – when not too much developed, render delivery less easy and speedy, by destroying the firmness and stability of the point d’appui which the abdominal muscles derive from the bones of the pelvis. But when farther advanced, this relaxation, by somewhat enlarging the pelvic cavities, may facilitate the expulsion of the child’s head, – rendering spontaneous a delivery, which would otherwise have been very difficult on account of the disproportion between the size of the head and the dimensions of the pelvis. After delivery, the relaxation has been known to continue for several months, or even for years or the whole lifetime.
In all cases of relaxation of the pelvic articulations in pregnancy, the most perfect quiet, and even absolute rest should be enjoined, in order to prevent the increase of the difficulty which must result from moving about, and in order to obviate the danger of inflammation arising form undue irritation of tissues already morbidly affected. A careful study should be made of all the indications and symptoms in order to reach the real constitutional dyscrasia which lies at the bottom of the difficulty, and thus at the same times arrest the progress of the present mischief, prevent future trouble, and radically and permanently improve the patient’s health.
A disposition to fall sometimes greatly troubles the pregnant female. That which arises from sudden attacks of syncope is not referred to here; but rather that want of firm balance in walking, that danger of stumbling, and that general sense of instability, which often prove a constant source of annoyance. The equilibrium of the body in motion, in the natural state, is only preserved by the incessant, although entirely unconscious effort of the muscular apparatus, which as instinctively regulates the movement and position of the body in accordance with the law of gravity, as the muscles of the eye adapt the size of the pupil to the various degrees of light. In persons afflicted with hereditary muscular weakness, – which is but the particular manifestation of some general and constitutional dyscrasia, the constant task of maintaining the proper centre of gravity, – aggravated by the awkward disproportion in size and large addition of weight in front which characterize the advanced stages of pregnancy, – is entirely beyond their strength. Hence the severe myalgic and neuralgic pains, already described, as affecting the abdomen, breasts, back and lower limbs; hence too the difficulty of walking, the unsteadiness of gait, and the danger of falling, with which such persons are afflicted.
A careful collection of all the symptoms of such cases, and an equally careful comparison of them with those belonging to the following remedies, and to others which may occasionally be indicated in the rarer forms of lesion of the locomotive apparatus in pregnancy, will enable the Homoeopathic physician to prescribe the confident hope of affording to these sufferers, both presently and permanently, a hitherto unexpected relief.
AEsculus h. Where the sacro-iliac symphysis is the point of the trouble. She cannot walk, because that part of her back gives out; and it fatigues her so that she must sit down; and she feels better still to lie down.
Aloes. Where a sense of weight and pressure into the pelvis seems to cause the lameness.
Arnica. Where a sensation of soreness as of a bruise prevails. She can hardly move about at all, from the soreness in the symphysis pubis, or in the sacro-iliac symphysis.
Calcarea carb. Will be indicated in leucophlegmatic constitutions; great fatigue on walking even but a short distance, from a general feeling of lameness in the pelvis. Cold, damp feet. Vertigo on ascending. Does not sleep after three A.M. She is clumsy. She stumbles and falls very easily.
Calcarea phosph. She is very much worse after taking a little cold. She is liable to rheumatic pains in all her joints after taking cold.
Magnum. The limbs are affected, and are very tender and sensitive to the touch.
Pulsatilla. She cannot walk so well towards evening. She feels worse when warm in bed. She can hardly find an easy position through the night, owing to the pain in the pelvic articulations.
Rhus tox. A sense of stiffness in the pelvic articulations on first attempting to walk; better after getting warm in walking. At night she must change her position frequently, feeling quite easy for a while after every change, then she must change again.
Silicea. In cases where ulcerations take place with fistulous openings, which are very tender to the touch. If pimples make their appearance around the ulcerations, Hepar may be indicated.
Sulphur. With her pelvic sufferings, she has flushes of heat, weak, fainty spells. She is weak ad faint from about eleven o’clock till noon. Coldness of the feet.
Thuya. The sufferings are greater in the left sacro iliac articulation, the pains running into the left groin. The pain from walking is so insupportable that she must lie down.
The sympathetic nervous disorders that affect young girls in difficult ovulation, are but the prototypes of those affections which occur, during pregnancy, in women of corresponding unhealthy constitutions. Hence, in addition to the more strongly-marked disorders of pregnancy, described in the previous chapter, and in addition to the above-mentioned lesions of the locomotive apparatus, we find disturbances of the nerves of special and of general sense; abnormal conditions of the intellectual faculties, and various depravations of the moral sphere. The more important of these affections will be briefly considered in the order in which we have thus arranged them.
AFFECTIONS OF THE SENSES. – Loss of Hearing. – Davis mentions having seen two cases of the advent of entire deafness during gestation. In the one case the abolition of the sense of hearing came on suddenly during one of the earlier months of gestation, and very gradually returned after delivery; whilst in the other it came on by imperceptible degrees in the seventh and eighth months of pregnancy, and returned suddenly and with painful acuteness on the sixth day after delivery, when the lochia entirely ceased to flow. From Paullini the same author quotes the case of the wife of a citizen who was subject to be seized with an entire loss of hearing about four or five days before she is taken with her labor-pains, – which (deafness) however goes off after her delivery.
Study particularly the following remedies:-
Capsicum. The petrous portion of the ear is much swollen, red and painful.
Causticum. Reverberation of all sounds, even of the patient’s own voice, in the ears.
Graphites. Great dryness in the ears. The deafness is better when riding in a carriage.
Lachesis. The cerumen is too hard; too pale, and insufficient.
Mercurius. Sensation of coldness in the ears continually.
Nitric acid. Much swelling of the internal ear; it is nearly closed, and sometimes there is much pain within it.
Phosphorus. Difficulty in distinguishing the human voice.
Pulsatilla. Sensation as if the ears were stopped up.
Silicea. partial relief is obtained by blowing the nose.
Sulphur. Aggravation for a while after eating, or blowing the nose.
Compare also, Calcarea c.; Petroleum; Hepar; Staphysagria, & c.
The eyes sometimes become the seat of a still more painful affection in pregnancy. Dr. Bezard* (*Journ. de Medorrhinum, par Leroux, xxxiii., p.72) relates the case of a lady who, in the fifth month of her ninth pregnancy, was suddenly and without any known cause seized with a deep-seated pain in her right eye. There was no external sign of disease, except that there was no secretion of tears; there was however a sensation of strong pulsation at the bottom of the orbit, accompanied by acute and frequently repeated lancinating pains, by appearances of rapidly- darting specks before the eyes, and by errors of the vision. Pain of the forehead and at the root of the nose, together with a sense of weight and oppression about those parts aggravated the patient’s distress. In a short time the rays of light ceased to irritate the retina, the eye became insensible to the contact of the finger; and the patient could intently stare at the sun without producing any painful excitement. Inability to sleep accompanied this local affection for several weeks. The delivery was happily accomplished; in the course of some days subsequently the lady found that she could perceive light with the eye which she considered as lost to her, and after some days she could clearly distinguish objects with it. She gradually improved in this respect for eighteen months, when she became enceinte for the tenth time. At about the fifth month, at the same time as in the former pregnancy, she was seized with similar but much more intensely severe pains in the same eye. In this pregnancy the difficulty extended to the left eye also, which after delivery in great measure recovered its functions; but the right eye remained permanently insensible to light.
According to Beer, Plus ( Plus Lawrence on The Eye, p. 612.) amblyopia or amaurosis, accompanied with nausea or with vomiting which cannot be quieted, sometimes occurs early in pregnancy, and ceases after parturition. He saw a young Jewess, who, in her first three pregnancies, which followed in quick succession, began to grow blind in the early period, and became quite amaurotic in the third or fourth month. On the first two occasions she continued blind until after parturition; and the third time her sight never returned. Desmarres also mentions pregnancy among the indirect causes of amaurosis(++) (++)Maladies Des Yeux, Paris, 1847, p.715) Exactly opposite to this is the case quoted by Cazeaux, & & Traite Theorique et Pratique, p.312.) of a young woman whose imperfect vision had compelled her to use spectacles, from childhood, – but whose sight has so much improved immediately after the beginning of her pregnancy that she had no longer need of magnifying glasses.
In affections of the eyes, study the following remedies:-
Aurum. Objects appear as if divided horizontally.
Belladonna. Dim appearance of objects; they appear inverted or double.
Calcarea c. All objects appear as if seen through a mist.
Causticum. Sudden and frequent loss of sight, with sensation of a film before the eyes. The dimness of vision is greater after every headache. Paralysis of the upper eyelids, so that they hang down.
China. She can only distinguish the outlines of distant objects. When reading, the letters appear pale, and surrounded with a white border. She sees better after sleeping.
Cicuta v. The letters seem to move about when she is reading.
Cina. She can see more clearly for a while, after rubbing the eyes.
Hyoscyamus. Frequent spasms of the eyelids. Strabismus. All objects appear of a red color; or larger than they are.
Natrum mur. Frequent spasmodic closing of the eyelids.
Nux v. Heaviness and contraction of the lids.
Phosphorus. All objects appear to be covered with a gray veil.
Pulsatilla. Sensation as if the eyes were covered with a mist, or as if the dimness could be removed by rubbing something off from the eyes.
Sulphur. Dimness of vision and gas, or lamp lights appear to be surrounded by a halo.
Compare also Cyclamen e., Drosera, Mercurius, Ruta, Sepia, Veratrum & c.
HEADACHE. – This forms one of the most common and painful affections of pregnancy. It may arise in part from sedentary habits especially in the more advanced stages of pregnancy; and for similar reasons it may be both complicated with and aggravated by constipation. In persons who are usually subject to headache, the condition of pregnancy may serve to increase the difficulty. The cephalalgia of pregnancy may attack those of an anaemic habit and nervous temperament; or it may appear in connection with a plethoric condition, – indicated by flushing of the face, and giddiness aggravated by stooping. Or again the headache may accompany nausea and other gastric disturbances, with paleness of the countenance and general debility.
The treatment will usually be very simple, since the indications can hardly fail to be plain. When the disorder appears in connection with constipation, -increasing in severity upon each occasion till the bowels are moved, -and seems also to result in some measure from the sedentary mode of life to which so many women addict themselves even when not enceinte, exercise in the open air should be strongly advised, to be taken in the manner best suited to the circumstances of the patient. Among the most important and frequently indicated remedies may be mentioned: Aconite; Belladonna; Bryonia; Nux v.; Pulsatilla; Sepia and Sulphur. But there are numerous other which may required by the particular and accompanying symptoms of individual cases.
NEURALGIA. – Facial neuralgia in pregnancy differs, but little from headache in its causes and requisite mode of treatment, – except that while like headache it may arise in connection with constipation, it is otherwise more apt to occur in persons of a pale, anaemic or nervous temperament, than in those of a ruddy, plethoric habit of body. According to Tyler Smith, “facial neuralgia from uterine irritation, is a very common affection of pregnancy. It generally affects the dental nerves, particularly those of the upper jaw. In many subjects acute caries of the teeth occurs; in some child-bearing women, a tooth or two is lost in each pregnancy. In neuralgia of the face, in pregnant women, without disease of the teeth, the same author says a generous diet is called for, and he advises also wine and porter. (*Braithwaite’s Retrospect, xxxiii., p.252) The latter articles we think can hardly ever be needed in this country, unless perhaps temporarily, in cases of great privation from suitable nourishing food, – in such instances a little wine may aid in restoring the system from its enfeebled condition and thus enable it the more readily to avail itself of a wholesome and nutritious diet. Great care must be taken in cases of severe neuralgia in pregnancy, – cases which may constitute a true spinal neuralgia, – lest from loss of sleep, inability to assimilate suitable food, and the depressing influence of long-continued suffering, the system may become so much reduced as to induce abortion and even fatal marasmus.
In headache and neuralgia, study among others the following remedies:-
Aconite. In headache or neuralgia, accompanied by vertigo on rising up in bed. Crampy sensation in the root of the nose. Sensation as if the whole brain would press out at the forehead. She fears to be in a place of excitement or confusion.
Belladonna. Flushed face and injected eyeballs. Cannot bear noise or bright light. She seems to be in a stunned or stupid condition.
Bryonia. A splitting headache; she wishes to keep very still. Dryness of the lips and mouth.
Calcarea c. Headache with an unusual accumulation of dandruff on the scalp.
Cocculus. Her head feels worse after eating or drinking.
Coffea. Intense pain, -the head feeling contracted or too small.
Magnes. c. Much worse from talking or mental exertion. She feels sad and disconsolate.
Nux v. Headache in the forehead, with large, difficult stools. Especially suited to persons addicted to highly-seasoned food; much coffee; wines; sedentary life; keeping late hours, & c.
Pulsatilla. In mild, tearful women. Semilateral headache.
Platina. The pain causes weeping. Objects appear smaller than they really are.
Sepia. Headache with an aversion to all food; sensation of great emptiness in the pit of the stomach.
Sulphur. Heat on the top of the head; flashes of heat all over; cold feet; fainty spells.
Veratrum a. Headache causing delirium, dementia and cold sweat on the forehead.
ODONTALGIA frequently appears in connection with pregnancy, – being in fact only a particular form of neuralgia, – and in many cases it forms the earliest symptom from the presence of which the pregnant state is suspected. Leadam, (*Diseases of Females, p.102) strongly advises against extracting the teeth in such cases, since abortion has been known to follow the operation. Tyler Smith states that they ought only to be extracted with caution under such circumstances. But those having in their hands the Homoeopathic remedies and blest with even a moderate amount of skill in administering them, will never be tempted to resort to a practice at once barbarous and dangerous. Still it must be borne in mind that neither local applications nor remedies selected with reference to the teeth alone will suffice, in many cases, to remove an affection which it is at once painful, sympathetic and constitutional, – that is connected with some individual idiosyncrasy. Here, as in all other cases of disease, the remedy must be selected in accordance with the totality of all the symptoms.
In odontalgia or toothache, study the following among other remedies.
Alumina. Drawing toothache, extending to other parts, as down to the larynx, neck, shoulder, & c.
Belladonna. Pains as if ulcerated; worse after lying down at night; or in the cold air. The pain causes moaning and weeping.
Calcarea c. The pain is aggravated by the slightest change, – as from a current air, cold or warm; drinking any thing cold or warm; noise; excitement of the mind, & c.
Hyoscyamus. Violent tearing and pulsating pain, – causing spasmodic jerks of the fingers, hands, arms, facial muscles, eyelids, spasms in the throat, & c.
Magnesia c. Insupportable pains during repose; she must get up and walk about.
Mezereum. Pain extending to the bones of the face and temples; particularly where they run along the let malar bone to the temple.