Now if there is no hemorrhage to compel artificial interference, we may still wait the action of the remedies for twenty-four or thirty-six hours. If these still fail, the hands should be introduced as previously directed; and the attempt carefully made to insinuate the fingers between the placenta and the uterus; until the placenta is, if possible, entirely separated from the urine surface, See Fig. 136, when it should be carefully scooped out, the hand following.
Should there be hemorrhage, which may result from partial adhesion, which we cannot control, we must not wait till out patient is hopelessly sacrificed; but, after relying upon the selected remedy as long as we may feel safe in doing so, introduce the hand, and detach and deliver the placenta in the manner just described.
Should there be no hemorrhage, or none beyond our control, and the spasmodic action continue, we should wait for days rather than make artificial interference; for it is much safer to wait on the remedies than to the spasm and deliver by such violence. But by judicious selection of the Homoeopathic remedy we may be able to control all hemorrhages and all cases of retained placenta, without resorting to mechanical interference, excepting in those very rare instances of actual growth of the placenta upon the uterus.
For haemorrhages which occur during or subsequent to the delivery of the after-birth, see previous section on Haemorrhages, and treat as there directed. The greatest and most implicit confidence may be re-
Fig. 136.
The mode of breaking up the adhesions of the placenta.
posed in this mode of treatment. My experience has been very large, but not a case has ever occurred in all my practice, during a period of over twenty-two years, where I have ever resorted to mechanical interference of any kind; and I have never lost a case from hemorrhage.
When some portions of the placenta are retained and cannot be removed, we must treat the symptoms as they arise, and thereby warm off any danger that may accrue from putrid absorption.
When any difficulty appears in relation to the delivery of the placenta, we should always examine through the abdominal walls, in order to ascertain whether the uterus presents its regular globular form; or whether there may not be a depression in its fundus, showing a tendency to inversion; for it sometimes occurs that a complete inversion takes place in this manner.
If a tendency in this direction be discovered, and if remedy cannot be found which will cause a return of the uterus to its natural condition, the hand must be introduced for this purpose. If there be discovered already a complete inversion with placenta attached, the placenta should first be peeled off, and the uterus returned by pressing it upwards and doubling its walls upon themselves in the opposite direction from that which resulted in the inversion itself. If the uterus be perceived to be but partially inverted, its restoration should be instituted upon the same principle, inversely as it appears, fist, if necessary, peeling off the adherent placenta.
LACTATION. THE INFLUENCE OF PREGNANCY UPON LACTATION.
The only injurious effect of pregnancy upon the milk of the nursing mother is of render it less nutritious. Every thing in nature conspires to the care of the new order of things within the womb, and the purest essences of the blood go these; consequently the nursling must suffer of want of that nourishment which would otherwise be devoted to its support; it feeds, as it were, upon the husks, and of course it becomes sickly and loses flesh.
It is best to make preparation for nursing, so that the nipples shall not be troublesome by becoming tender, cracked, or ulcerated. If they become tender or painful during pregnancy, some such remedy as Graphites, Lycopodium, Petroleum, Pulsatilla, Sepia, Silicea, or Sulphur, or some other (see Diseases of Pregnancy) will cure them, so that no trouble will be experienced during the nursing period. All these troubles of sore nipples arise from dyscrasia, developed by pregnancy and nursing; hence they are especially curable even whilst nursing.
Agaricus. If the patient be troubled with chilblains, which itch and burn very much, and are red; or if the nipple itches and burns much and looks red.
Arnica. When in the first days of nursing the nipples only feel sore, as if bruised. It is often indicated; and often cures in a few days when early applied.
Calcarea c. An ulcer appears on the nipple discharging pus; the patient is otherwise a subject for this remedy.
Chamomilla. The nipples are much inflamed and are very tender. She can hardly endure the pain of nursing. She feels irritable and cross, with impatience.
Castor equorum. In neglected cases, where the nipple is nearly ulcerated off. It only hangs as it were by small strings.
Croton. t. Every time the child draws at the nipple, a pain runs through to the scapula of that side. The pain is excruciating.
Graphites. The nipple seems to have little vesicles on it; at least it oozes out a thick, glutinous fluid, which forms a crust that is removed by nursing, when the same formation again occurs, and so on.
Lycopodium. The nipple bleeds very much and is very sore.
Mercurius. The nipple feels very raw and sore. She has sensitive gums; sore teeth; enlarged cervical glands; and other mercurial symptoms.
Pulsatilla. In mild, tearful patients; who weep at every nursing. The pain from nursing often extends into the chest, up into the neck, down the back; and often changes from place to place.
Sepia. The nipples crack very much across the crown, in various places; deep cracks.
Silicea. The nipple ulcerates very easily and is very sore and tender.
Sulphur. After nursing, the nipple smarts and burns very much. It chaps badly about the base and bleeds. Constitutional symptoms will sometimes determine the selection of this remedy, in order to cure the nipples.
The proper mode of administering the remedy is to give one dose dry on the tongue, and to tongue, and to dissolve a few globules of the same remedy in water, or water and brandy, and apply the solution to the nipple immediately after nursing. In this manner all sore nipples may be cured more speedily and certainly than by ant other means.
The child should be put to the breast soon after being born. After being washed and dressed, it may be allowed to sleep for awhile, but when it awakens it should be put to the breast, and not otherwise fed, unless it is not satisfied with the breast. In this case it may be fed with milk, or cream and water, two parts the latter to one of the former. The child should be educated to regular periods of nursing; it should not be put to the breast or fed every time it cries let it be turned over, or change its position, and be patted and quieted, will the period has expired, say two hours, two and a half, or three hours, some definite period of interval should be decided upon, and most rigorously adhered to. If the mother has sufficient nourishment for her babe no other need be added, provided, she be sufficiently strong and healthy for the occasion.
If form any cause it becomes necessary that the child should depend in part or entirely upon other nourishment, that should be provided which most nearly resembles the mother’s milk. Cream diluted with water is the best. After five or six months, when the child requires more nourishing food, one of the most suitable articles is readily prepared as follows; take a quantity of flour, tie it very tightly in a bag or cloth, then dip it quickly into water just to moisten the surface, and then roll it in dry fluor, then dip it in again, and so on till it is quite thickly coated with a sort of paste; now put this into boiling water and let it boil for four or five hours. The contents of the bag will then be thoroughly cooked, when it may be grated and made into pap as required for use; for this latter propose water to milk may be employed. A small pinch of salt and perhaps a little sugar will be useful. Wheat bread thoroughly baked, dried in the oven, reduced to a powder, and made into a pap is also very useful. As the child gets more and more teeth, its diet may be more and more varied and liberal; but until its first dentition is accompanied, a meat diet should be as much as possible avoided.
Sometimes children will not take milk; then cocoa, made as ordinarily for table, use, and an equal quantity of milk added, with a little bread, forms a very acceptable article of diet, both healthy and nutritious.
AGALACTIA-FAILURE OF LACTATION.
When the mother has not a sufficient quantity of nourishment for her infant, the deficit is often owing to some unnatural state of her own system; and the proper Homoeopathic remedy should be sought to change that condition, so that a natural supply may be afforded. The habit of forcing a supply by means or porter, or other similar stimulant, is alike injurious to the mother and to the child. It is an Allopathic remedy. The two-hundredth, or even some higher potency of the proper remedy will develop a healthy condition, and consequently a good supply of milk. Where there is a scarcity of milk from any cause, study the following medicines:
