Mrs. P., aged twenty-nine, brunette, second confinement,, in labor eighteen hours. She was markedly nervous and fretful. Had prolonged labor with the previous child. One dose of Chamomilla increased the dilation from the size of a dime to that of a silver dollar (5 cm.) in one and one-half hours. The nervousness left and she worked hard with the pains. An ampule of pituitrin was later given which seemed unusually slow in acting, but the delivery was made in about one-half hour.
Mrs. G., aged eighteen, blonde, primipara. Had pains two days, was nervous, fretful, anxious, pulse 86 irregular and skipping. At her fifth month vomiting of pregnancy started ; then later she was in bed six weeks with a condition diagnosed as nephritis. At 7.56 A.M. she was given one dose of Chamomilla ; in five minutes she drew a long breath much like a sigh, then started to move and talk more freely. She progressed gradually to delivery at 3.40 P.M. The writer handled only the delivery and after-care. Following delivery she developed septic endometritis from which she recovered after taking homoeopathic remedies.
Now what do the textbooks give us as indications for Chamomilla at the delivery table ? The general action of this drug on the body is on the mental and emotional phases. This is an important point. It tends to indicate that the symptoms we find in our patient are expressions of a part of the body other than the musculature of the uterus and the nerves supplying it.
Mental symptoms are : Whining restlessness, impatience, extreme sensitivity to every pain. The patient is nervous, strung up, hyperesthetic about examinations, decidedly snappish, sensitive and irritable.
Indicating symptoms during labor are : Pains begin in the back and travel down the thigh (the inner side of the thigh), nervous excitement is great. Labor is especially painful. The patients are cross and declare they will not stand the pain. The pain is in the small of the back. Labor pain is spasmodic, pains seem to press upward, there is an expression from the patient that the pain is intolerable and unendurable.
The nipples may be inflamed ; they are tender to touch.
Sleep-The undercurrent of fear is even shown by these patients in their sleep by their moaning, weeping and wailing during sleep. The dreams shoe anxiety and fright.
The physician in charge can recognize the action of Chamomilla both objectively and subjectively. Among the objective changes, the first change usually noticed is sometimes a sigh, the patient involuntarily takes a deep breath. Usually the patients, instead of jumping or moving around in the bed, is twitching and squirming. In one case that I was observing, I wanted to check my own observations so I said to the nurse, “She dose not seem as nervous and jumpy as she was. What do you think about it ?”
After observing for two or three minutes she said she thought so too. Next you may notice that where she had been complaining of her plight or possibly moaning and keeping her mouth open, she will close the mouth tight and bear down with the pains. Also the type of conversation that had had been scolding or, as the textbooks speak of it, whining restlessness, will change to more determined words and be less continuous because she seems to want to spend her time helping those pains.
The subjective changes are accompanied by objective changes : the cervix that was so sensitive that it caused the patient to scream or jump when your finger touched it, will become more soft and thin and painless. In a few of these cases it seemed, before the Chamomilla was given, that the cervix drew up into a spasm, a strictura cervicis, became firm and hard to touch and almost as thick and long as though there were no effacement at all. Effacement will be rapid and dilatation complete in a relatively short time. Chamomilla does not stop the labor pains but seems to permit them to work in the correct channels. Dystocia is brought to a minimum.
These patients do not want to be examined but when the examiners finger reached the cervix, the patient moves and objects. You press lightly on the cervix and they object again. If you pull on the edge of the cervix with the tip of the finger, they cry out quick and may even scream. You relax your pressure and ask them what the trouble is and they say, “That hurts.” The patients are very few whose minds allow them to become “decidedly snappish,” or even “irritable” in their remarks. But when this does happen you have a specific indication for his this remedy.
Now a little bit about the psychology of our patient. What part does fear play on the minds and nerves of these cases ? The provers found that the guiding symptoms of Chamomilla are mental and emotional and also that fear is one of the basic indications. It would seem that fear plays a large part in the attitude of the expectant mother towards pregnancy and childbirth. The primipara, of course, has never felt delivery pains but has heard stories of their severity. Some of them have come from her girl friends and some from her sisters who just want to impress her during a moment of playful sport.
This kind of discussion is almost sure to be marked by gross exaggeration of the facts regardless of how seriously their on her future mental attitude is going to be. This reminds me of a story that has been circulated in my neighborhood which illustrates this point. It occurred in another doctors practice so I am passing it along but not as an absolute fact. A young lady became pregnant and her sisters told her, in a sportive mood, that when a child was delivered it was taken out through a cut made in the abdomen.
The expectant mother tucked the idea back in the memory cells and quietly proceeded to do her daily duties while the fetus developed to maturity. The doctor was ready for delivery and gave an anesthetic. On waking the mother said “Have you cut me open ?” “No”, said the doctor. She said, “When are you going to cut me open ?” The doctor said, “We are not going to, the baby is delivered now.” She said, “How did it come if you did not cut me open ?” It was not until then that she learned the facts. My heart goes out in sympathy to those who are so grossly deceived in their teaching on such important subjects.
There are many other sources of chagrin and fear. They young woman who is pregnant and has the idea that pregnancy is something to be shunned and ashamed of. She avoids meeting her customary friends and this deprives her of companionship. She avoids going out on the street for fear the neighbors will see and talk behind closed doors. If she must go to the store, an attempt is made to hide the enlargement by arranging the clothing.
And so one could go on and on. Fear, chagrin, mental reaction are not only predominant in the mind but almost an obsession. Along this same line I have a lot of respect for the doctors wife who said she felt like pinning an American flag to the projecting abdomen as she walked down the street.
Of course it is natural to avoid pain. Even the little boy avoids going to the dentist because he knows the drill in that tooth is going to hurt. A pregnant woman has nine months of anticipation of pains which her mind is keyed to know as severe and agonizing. Sometimes it is the primipara who presents the greater problem for this homoeopathic prescription but by no means always. Just as an estimate I should say that the multipara would give the higher ratio by about 75 to 25 per cent.
