During the milk-fever the lochial discharge lessens, or ceases entirely, and returns more abundantly as the fever subsides. In quantity this discharge varies in different individuals; some have very little, others have much; in either case no interference is necessary, unless symptoms arise which show that the unusual quantity results from some abnormal state. The lochia have a peculiar odor, differing in individuals, both in character and intensity. The presence of even a small shred of the membranes, which may have become detached and left behind in delivering the placenta, may render the lochial discharge exceedingly offensive. In all cases, the fetid nature of the discharge, or any other deviation from its normal character, will go far to indicate the proper remedy for the general morbid condition, of which this peculiarity is one of the evidences.
Throughout the lying-in period, the condition of the lochia, if abnormal, forms one of the surest and soundest indications for treatment. The selected remedy must always cover the condition here manifested. Every day the physician should inquire of the nurse as to the state of this discharge; and the first abnormal condition should place him on his guard against other serious disturbances which may result. We should always be watchful for the beginning of mischief; but this one of abnormality of the lochia should be especially guarded against, since it is very apt to be overlooked till a late hour. In such cases all the symptoms should be carefully collated and the remedy selected in accordance; but it must always cover the abnormal condition of the lochia.
In the treatment of cases in which there is derangement of the lochial discharges, the following medicines should be carefully studied:
Aconite A suppression of the lochia, or too scanty discharge occurs soon after confinement, with distress in the abdomen, chest, and head, apparently from congestion. Offensive lochia, other symptoms agreeing.
Belladonna Offensive lochia, feeling hot to the parts. Flushed face and injected eyeballs; delirium and frightful visions. Pain in the region of the uterus coming on suddenly and finally leaving as suddenly.
Bryonia Lochia suppressed, and sensation in the head as if it would burst. The least motion aggravates her sufferings. Dryness of the lips, and of the mouth. The lochia may be too profuse, with burning pains in the region of the uterus.
Calc-c.
The lochia last too long in women who menstruate too often and too profusely; in females of a leucophlegmatic temperament.
Chamomilla Suppression of the lochia, followed by diarrhoea, colic, toothache; irritable, impatient disposition; thirsty; one cheek pale, the other red.
Coffea The discharge is too profuse, with an exalted nervous sensibility.
Colocynth Suppression of the lochia, with violent colic, or from anger, or with tympanitic swelling of the abdomen and diarrhoea. Worse from eating or drinking.
Carbo animalis Lochia too long continued, thin, offensive, excoriating, with numbness in the limbs.
Creasote Very offensive lochia, almost ceasing, and excoriating, then it freshness up, and again almost disappears, to freshen up once more, &c.
Crocus The discharge appears in dark strings; sense of motion in the abdomen.
Dulcamara Lochia suppressed by cold or dampness; and the quantity of the milk much diminished.
Hyoscyamus Much delirium and jerking of the muscles; she says she is being drugged or poisoned.
Ignatia Derangements from the abuse of Chamomile tea. In some cases, Nux-v.
Merc-s The discharge is worse at night, with some inflammation of the genital organs.
Nux-v.
The lochia are scanty and offensive in women accustomed to highly seasoned food, coffee and wine. Or the patient has an irritable rectum, calling her to stool frequently.
Opium Suppression of lochia from fright, with sopor.
Platina A little discharge will remain, but it will be black and clotted. The genital organs will be very tender. On account of the excessive sensitiveness she cannot bear the napkins usually applied.
Pulsatilla In cases where the milk has suddenly disappeared from the breasts. The scanty lochial discharge remaining is milky; she is feverish, but has no thirst.
Rhus The lochial discharge lasts too long, is thin and offensive. It has well-nigh exhausted her; it is thin, ichorous and offensive, or it occasionally becomes bloody. Shooting pains up the rectum. Restlessness at night.
Secale-c.
In thin, scrawny women, very offensive and thin lochia; the discharge may be scanty or profuse. It may be painless, or accompanied by prolonged bearing down pains.
Sepia, where the fetid odor is the most characteristic symptom. Offensive lochia, excoriating, with little sharp-shooting pains in the region of the neck of the uterus.
Silicea Pure blood is caused to flow every time the infant nurses.
Stramonium Her mind is full of strange and absurd, but strongly marked ideas.
Sulphur The discharge causes a sensation of weakness, and she has hot flushes, perspiration; heat in the soles of the feet, or her feet feel cold all the time.
See also remedies under Nymphomania, Metrorrhagia, Constipation, and Diarrhoea.
SECRETION OF THE MILK.
This function is one of the most interesting and at the same time one of the most remarkable of the phenomena transpiring during the whole of the lying-in period. While the child is still in utero, the maternal principle and all that pertains to the mother conspire to its nourishment, growth and development there. Suddenly all this is interrupted; the child is expelled from the little world within; the maternal principle misses it, as it were, stands aghast and wonders at its whereabouts. It is without; and in from forty-eight to seventy-two hours, it provides for its sustenance there, from the same source as when it was within, from her own blood. The reaction upon the organism, from this “change of base” from the uterus to the breasts, causes what is called the milk fever. While the child was yet in the uterus, all things conspired and flowed in the bosom of her blood to supply the offspring there: and now all things still conspire and flow in the bosom of her blood to be offered to the offspring, but in the ultimate form of milk, which resembles pure blood more than any other fluid in the body. All this is effected by the “maternal” arousing herself and going out in search of provision for her offspring; and in consequence there results a disturbances in the system, more or less well marked according to the obstacles to be overcome. Hence appear chills, fevers, headaches, and a great variety of pains and sufferings, even intermittent fevers are sometimes developed in consequence of this great physical change.
Some women appear to have milk before the babe is born, or at its birth; but this is not the real milk, since it is devoid of the true milk globules, and is called colostrum. The change already referred to has yet to be made; and presently the real milk comes, bearing in its bosom the true, full and plump milk globules.
The quantity of milk varies greatly; in some women it is quite scanty, but rich in quality; while in others it is poor in quality but abundant in quantity. Every female in a perfectly healthy state will yield nourishment enough for her own babe; and when this is not the case, the remedial agents must be administered to bring about this much to be desired result: for no child can possibly do so well as when supplied with its own maternal ailment laden with all the rich things of its mother’s love and affection. As a general thing all the disturbances incident to the coming of the milk, are less when the child is applied to the breast as soon after delivery as practicable. Much advantage is gained both to the mother and babe by this method, since it serves to lessen the suffering of the one from hunger and of the other from fever.
When the foetus perishes near the full term, the child is still carried for a while, it may be till term. In general, no milk secretes in such cases, certainly not till after the delivery of the dead child.
At no time should the milk flow from the breasts except when drawn. In those cases in which it is constantly flowing spontaneously, remedies should be sought for to cause its retention till needed.
In order to relieve the disorders incident to lactation, we must always rely upon the properly-selected Homoeopathic remedy. No bathing, or even rubbing of the breasts, no undue friction, should be employed, nothing, in fact, should be permitted save the natural action of the child’s mouth. Rubbing the breasts in order to rub out lumps, often bruises the breasts, and lays the foundation for inevitable abscess. The same remarks applies to all mechanical suction other than that of the babe’s mouth or that of some other person. No external application of any sort is admissible.
Aconite should be administered when there is hot, dry skin, much thirst, restlessness, discouragement, anxiety; breasts hard and knotted.
Belladonna The breasts feel heavy, and appear hard and red, the redness often running in radii, flushed face and injected eye-balls; full, bounding pulse; drowsy; throbbing headache; sensitive to noise and light.
