Let us ever remember that labor is a natural process for the woman, therefore the less mechanical interference the better for the patient. Here homoeopathy stands out alone as the greatest of all medical gifts the Creator has given to the parturient woman. It carries her through from the preparatory stage to the final outcome in a safe, speedy and highly efficient manner unknown to any other method of treatment, medical or otherwise. It provides and embraces remedies for the preparatory stage, the process of labor, and for every detail after the labor is passed.
THE PREPARATORY STAGE.
In the preparatory stage, aside from remedies to restore her normal health, it provides such remedies as Caul., Cimic., and Puls. to relieve that bane of all pregnant women, rheumatism of the womb, thereby strengthening and adding tone to the weakened muscles of the womb, thus enabling the muscles to assume their proper functions and right the position of the child in the uterus, and thereby bring about a normal presentation at birth and ease the pains during that period. Those remedies are easily distinguished from each other.
During labor homoeopathy presents us with a host of remedies with which to relax the parts, ease the pains and relieve the rheumatism of both the womb, os and pelvis, amongst which stand out prominently: Caul., whose pains may be true or false, weak, even ceasing, short, spasmodic and irregular; Cimic., whose pains are weak from cramp in the hip, or cease are felt in the groin, and may extend to the heart or groin, causing fainting, and she is apt to shudder during the first stage of labor; and Puls., where the pains cease or become ineffectual or weak, or may alternate with haemorrhage, or cause fainting, with the usual aggravation from heat and craving for fresh air. If the os is thick and tense, we have Gels.,the pains distressing, spasmodic, extending up and down the back; or if the os is thin and tense we have Bell., whose pains come and go suddenly. I have known cases to come through under Bell. without a tear when the os was thin as writing paper.
My greatest assistant during labor was towels wrung out of water as hot as could possibly be borne and applied directly over the vulva during the pains, asking the patient to bear down steadily at the same time, but not with too much force, thereby allowing the parts to thoroughly relax and yield, all the time impressing upon the patient the dangers that may arise from too much force and rapidity and that complete repairs cannot always be assured, and that it is better to bear the pains a little longer now than to have to go through life a chronic invalid. That always worked.
Under strict homoeopathy instruments are very rarely, if ever, needed; that I have proven. In all my career of fifty years. I have never either owned or applied a pair of delivery forceps, nor did I ever refuse any case offered me. I have never lost a child, and with but one exception have I ever had any evil after effects following labor, and that one exception was in a woman who apparently was syphilitic, whose womb burst at the fundus just as the child emerged; the womb and placenta were found to be in black shreds.
AFTER LABOR After labor homoeopathy furnishes us a host of remedies covering every conceivable state. A German lady taught me how to successfully deliver the placenta by using steady traction on the cord and at the same time having the patient blow on the back of her hand, allowing no air to escape from her mouth. For the retained placenta we have most excellent remedies in Sabina, Caul., Apis, Sec. and Pyrog.
No other remedy being indicated, I have invariably given a dose of Arn. 30 or 200, and I feel that it has not only been a great comfort to the patient,but that it has also accounted for the freedom from evil after-effects that otherwise might have followed the ordeal. Again, later, no other remedy indicated, I have given a dose of Nux 30 or 200 to right the peristalsis of the bowels.
Should haemorrhage occur, either during or after labor, Ipecac, Sabina, Bell. and China stand out prominently. It is my opinion that patients properly treated before labor should be almost perfectly immune to haemorrhage, convulsions, metritis, mania and septic states.
Bell. and Sabina both have a flow of bright red blood mixed with clots; the blood of Bell. feels hot to the parts, while Sabina has the characteristic pain from the sacrum to the pubis; Erig. has haemorrhage in connection with urinary troubles; Ham. has haemorrhage coming away in gushes with great soreness of the veins of the parts; Ipecac has bright red gushes, with the characteristic nausea; Sec. has a dark offensive haemorrhage, often with convulsions, together with the characteristic aversion to heat and covering; China has a discharge of dark blood, copious, often passive in character, thin and mixed with clots, with great weakness.
In treating the parturient woman we must ever remember we are working on natural law, and that natural law is fixed and permanent, therefore must individualize the remedies whose direct primary pathogenesis are fixed and permanent, rather than the patient whose systematic reactions to the fixed drugs primary action differs with the individual on whom the drug is proven. Drugs and disease seem to work from different angles. The drug produces a basic picture whose indications are not changed by the systemic reaction of the patient to that basic picture, while on the other hand the disease produces a basic picture that changes the indication for the remedy with the systems reaction to that basic disease picture. Thus in reality we prescribe neither for the patient nor her disease, but for the basic drug picture. TOLEDO, OHIO.
DR. KAPLOWE: Dr. Pulford, it can be readily seen, must have had many years of training in obstetrical work, because it takes many, many cases before one can come to the conclusion about the efficacy of methods such as the blowing on the back of the hand to facilitate the expulsion of the after-birth or the application of the heat to the parts while the patient gently bears down to ease the pains of labor.
I will speak of a few drugs that I have used myself and, therefore, about which I have had practical experience. I think Dr. Yingling speaks in his book, The Accoucheurs Manual, in those conditions in which there was the greatest danger to life, will the homoeopathic remedy act with the greatest speed and efficacy.
Of course, haemorrhage is perhaps the greatest danger of life in such a condition. I believe it was Dr. Roberts who spoke to me about a woman who was haemorrhaging so violently after birth that he thought she would die.
Then she gave the clue, a severe pain shooting from the sacrum to the pubis, and Sabina (it might have been the 200th potency) stopped that almost instantaneously. I believe, Dr. Pulford, that was your experience, too.
I remember my experience with Sabina, also. I was called to see a woman in labor, by another physician who claimed he could not handle the case because he was busy at the time. When I got there I found that she had ruptured her membranes about a week previously. I first was inclined to think the doctor was panning something off onto me that he did not care to handle. He was an allopathic physician, by the way. She had been having fairly strong, contractions for about twelve or fourteen hours, if I remember correctly, but there was apparently no progress. The cervix was entirely closed. She did give me the clue, the pain shooting from the sacrum to the pubis. I gave Sabina. This was at two oclock in the morning. At five oclock I was home. I delivered her in her home.
I remember another patient who after delivery could not urinate for twenty-four hours, but the characteristic feature was the fact she had no desire to urinate. Opium 1M., and in about an hour she presented us with a quart of urine.
There are two other outstanding remedies. One is Caulophyllum, which I have used. The pains sometimes are false labor pains with a bearing down in the hypogastrium. They get nowhere, sometimes coming a weak or two before the due date of birth.
Then when true labor sets in, the pains are not organized. They are not systematized. They are not localized, shall I say. The patient gets nowhere. The pains fly from one part to another, in the lower abdomen, over the bladder, in the groin or down the thighs. The patient is weak and exhausted.
Gelsemium has a different type of exhaustion. She has no more will power to use the little force of strength that is left. But a characteristic of Gelsemium is that the pains, instead of bearing downward, shoot upwards to the back, and there many times, whether the os be rigid or whether it be relaxed, an easy labor will be brought about.
DR. ALMFELT: I want to relate an incident in my early obstetrical practice out in Wisconsin some years ago. We had no hospital service for this class of patients in those days. They were taken care of at home, with very little help at that. The postpartum haemorrhage is a serious problem and requires quick thinking and action on the part of the physician. I remember one case in which the patient had nearly bled to death before I got to her bedside.
The baby had been born for an hour or more and although a neighbour woman had cut the cord and tied the babys end, the mothers had been left open with the placenta still in the uterus. After delivering the placenta manually there was still no response or contraction. Suddenly the patient threw down her bedclothes, threw up her arms and wanted air, yet she was cold ice and pulseless. There are classical symptoms for Secale in just such conditions. I gave her a powder of the 200th potency on her tongue, and in less than two minutes she turned on her side, went to sleep and that was the end of the haemorrhage and her life was saved.
DR. PULFORD: There is no doubt that occasionally things will happen in confinement, but there is one thing that is absolutely necessary to the obstetrical business and that is: you should understand distinctly what constitutes the totality of the symptoms in order that you shall prescribe not for symptoms but for the drug picture. You are working on natural law. Natural law is fixed. A drug, no matter on how many persons it is proven, will have a basic picture that will never change. But in every drug proving, the systems reaction to that natural drug picture changes and gives you a different phase.
If you are going to prescribe for the drug picture, other than the basic one, you will have to take all of the symptoms in or you are not prescribing according to your convictions.
In confinement, early in the game I learned that process, and by studying carefully Guernsey, who was the greatest prescriber that was ever known in any school, and Bell on Diarrhoea, to learn how they prescribed, that gave me the insight into this game.
For every man who is going to study obstetrics and is going to practice obstetrics, the thing for him to do is to learn what constitutes the symptom totality in every drug he is going to use. If he doesnt, he is going to fail.