The title of this paper is short, but it covers the subject. Though requested to present a paper on obstetrics,that line of work has been nil with me for many years now; but I will endeavor to give a few factors that, back in the days when I did do my bit in ushering into this complex world new faces destined to carry on the continuation of the race, were helpful to me and might prove the same to you. Being eighty-five years old or, as I prefer saying, eighty-five years young with better than sixty years of medical practice behind me, I am thankful still to be capable of carrying on in my chosen profession, today specializing in chronic ailments.
What I will say in this paper will be about things that proved useful to me in my early practice when I helped usher in some of our today’s useful citizens. The remedies used today in homoeopathy in such matters were not so much existent then and so it is my hope that this paper will prove somewhat interesting, as it will be somewhat variant from today’s treatment of such cases.
Being the son of a physician, I was tutored from childhood in things medical. In the early days of my practice people were not so worldly wise in things sexual as are our young generation of today. Counsel was often sought of the physician in matters pertaining to health and otherwise and the physician endeavored to give the best advice he could render. In the case of the expectant mother especial counsel was given to try and make the childbirth an easy and painless one.
Often the expectant mother was schooled to realize the importance of the impending event, being told that motherhood is sacred and that she must conserve her strength. Taking her food for two, she should have a pure and healthy diet–free from all exciting and stimulating elements–chiefly composed of farinaceous substances, fruits and vegetables. The more natural her food the beet.
During the nine months of gestation, the expectant mother should carefully avoid everything that can injure her nervous system, and deprave the new life given to her loving care. She should not injure her own brain and nerves, or the forming nerves of her offspring, with narcotics, tea, alcohol, nor in my mind be subject to even the smoke of tobacco.
Bread, milk, fruit make a perfect diet–brown bread and its equivalents, milk and its products; fruit and its substitutes and similars. No pork or beef or mutton. The finest, most beautiful, most healthful children I have ever seen were nourished on the purest elements of food–before birth and after. Plain, simple, natural food, and especially the most natural food of man, makes the best blood for infant nourishment.
The preparation of childbirth cannot begin too soon. It should begin with the birth of the mother. The one condition of perfect motherhood is perfect health. The very germ of life, formed in the ovary, should be perfectly healthy–perfectly strong–free from any taint of disease. Should be, but how seldom is! The germ may be scrofulous– it may have the taint of any heritable disease. And so many the microscopic sperm cell unit with the germ, to make the new being, which is to live on through the infinite ages. Such work should be well done. The father is responsible for his share of this work of creation, the mother for her longer and more complex duties.
When conception has taken place, her preparation, which should have begun long before, becomes more important. Her work, her peril, her joy, are all before her. She must purify and strengthen her life. Pure, fresh air must be had by night and day, for an added supply of oxygen, and there should be no tight lacing that will hinder the free expansion of the lungs. She should work and exercise in the great outdoors, as women who work have, as a rule, the easiest and most rapid labors. Walk, ride, drive–do whatever invigorates and does not exhaust. Enjoy also society and amusements that promote cheerfulness; but avoid whatever exhausts the strength and lowers the tone of life. All these things we older physicians gave as counsel to our patients.
Pregnancy, as we know, is the state between the periods of conception and delivery. It can only take place after the period of menstruation has commenced, and ceases with the “change of life,” or when the woman ceases to menstruate. There are many things to be guarded against this period, which if not controlled, will exercise an injurious influence on the offspring.
A proper state of mind and feeling must be maintained. Violent anger, jealousy, or terror, nearly always produce unpleasant effects, and abortion is sometimes caused by great mental excitement. A woman who is ill-tempered, passionate and irritable, could hardly be expected to give birth to an infant who would be sweet tempered and gentle. We all know how much the disposition of the parents is shown in the children; and of how great importance is it, then, that the mother, especially, should cultivate a gentle and loving heart, a kind and forgiving spirit, so that her children may grow up an honor, and not a source of unhappiness and misery to her.
The womb has a great influence through the nervous system, over the whole body, so that when it contains the germ of a human being, it must affect more or less the entire system of the woman. The symptoms which arise from this, constitute the signs of pregnancy. There are, however, many of these symptoms, which are found in other conditions, so that no one sign can be relied upon; and there are also women who are very little disturbed by the pregnant state of excitement and feverishness. The pulse is fuller and quicker; the appetite becomes disturbed; the skin is sallow, and often discolored. The following symptoms are most to be relied upon:.
The first is the stoppage of the menses. This, however, may occur from other causes, so that it cannot be considered a certain sign in itself, but if the health of the female is not affected, it may be considered a strong indication.
Morning sickness taken with other symptoms is of great value. Generally the stomach is irritable, and the woman suffers from nausea and vomiting, which occur particularly in the morning. It commences soon after conception, and generally ceases after the third month. In these cases of nausea I used to recommend one-half cup of clam juice in warm water and this as a rule stopped the nausea. Treated homoeopathically we might use Ipecac, Nux vomica or possibly Pulsatilla. She should eat lots of fruit, especially oranges.
About two months after conception the breasts become more full, with throbbing, and tingling pain in their substance and at the nipples. They increase in size and firmness, and have a peculiar knotty, glandular feeling; the areola, (a colored circle around the nipple) darkens and after some time milk is secreted.
It is well to remember, though, that the breasts may enlarge from other causes; this happens with some women at each menstrual period when the course are suspended, or after they cease, and at such times a milky fluid may be secreted.
Another symptom, the enlargement of the abdomen, taken in connection with others, enables us to tell with considerable certainty the period of pregnancy at the time we make the examination. During the first four months the womb remain in the cavity of the pelvis, or the lower part of the abdomen. Very soon after this, however, it may be felt just above the share bone, or brim of the pelvis. At the fifth month it is about half way between the share bone and navel. At the sixth month it rises as high as the navel which causes it to protrude. During the seventh and eighth months, it fills the whole abdomen, up to the stomach, the intestines being pushed above and behind it.
The first motion felt by the mother of the child is a motion called quickening within her womb, and generally occurs at the fourth month of conception, although some may feel it earlier, and some not until the sixth or seventh month. Some think the child is not alive until this period, which is a very erroneous idea, for it is just as much as living being at the moment of conception, as at any time after that. When quickening is sudden, the woman is apt to get sick, with nausea and sometimes faints entirely away. The sensation at first is like a fluttering, which gradually grows stronger, until she can feel the motions of the different extremities.
Sometimes varicose veins are encountered caused undoubtedly by the pressure of the uterus on the veins within the abdomen, thus preventing a free return of blood to the part. The swelling usually commences at the ankle, and extends upwards towards the thigh, but sometimes not above the knee. The swelling is always less when the patient lies down. This trouble disappears after delivery. Burdock and plaintain leaves bound upon the leg are useful, or an infusion of white oak bark. A weak solution of arnica or hamamelis may be used to advantage. Apply at night before retiring, always rubbing to limb upwards. Other useful homoeopathic remedies sometimes called for according to the symptomatology would be Nux vomica, Pulsatilla, Arsenicum and Carbo veg.
Pregnant women are very liable to piles. Of course we know such are caused by constipation. It is very important that pregnant women be schooled to pay strict attention to their bowels, not allowing either constipation, or diarrhoea; and by attending early to these derangements much trouble can be avoided. Turkey rhubarb was our favorite in such cases. Nux vomica and Sulphur are the principle remedies of today. Give the Nux at night and the Sulphur in the morning. If these do not relieve in a few days, it will be wise to consider Ignatia or other of our homoeopathic remedies.
A sluggish condition of the bowels is one the annoying troubles of pregnancy. There are many circumstances to induce it, and it must be carefully guarded against. A change should generally be made in the diet; eat plenty of ripe sweet fruit, such as apples, prunes, peaches, etc.; take plenty of exercise in the open air. Avoid coffee and all stimulating liquids. It is best not to use violent purgatives, as they are able to produce miscarriage. Nux vomica every morning and night here will most likely prove worthy, and if not Lycopodium or Sulphur may be taken. If the bowels feel painful, Bryonia and Ignatia will often prove beneficial.
Diarrhoea does not occur so often during pregnancy as constipation, but is much more injurious, as it rapidly weakens the patient if not checked. Sometimes there is simply looseness of the bowels, where the movements are more frequent than usual; but the appetite remains good and the general health is not affected. Such cases may be controlled simply by regulating the diet. The diarrhoea which is to be feared, is when the discharges are dark-colored, liquid, and very offensive; the breath is bad, and there is a disagreeable taste in the mouth; little or no appetite. The principle remedies here are Chamomilla, Pulsatilla, Dulcamara and Nux vomica used according to symptoms presented.
In cases of dyspepsia, heartburn, or sour stomach sometimes a slice of lemon, sugared and kept in the mouth will relieve, or one drop of sulphuric acid in a tumbler of water. If these do not relieve try Nux vomica and Pulsatilla in alternation.
Females during the early months of pregnancy are frequently attacked with fainting and hysteric fits.
The patient should be placed in cold air and cold water dashed over the face, and ammonia held to the nostrils. When the paroxysm is over, give a dose of Coffea or Chamomilla. When the attack is caused by anger give Chamomilla; by fear Veratrum; for nervous persons, Ignatia, Coffea, or Chamomilla.
Should there be incontinence of urine (enuresis) we must not forget Pulsatilla, Sepia, or Causticum. On the other hand when there is difficult urination (strangury), which is often an exceedingly troublesome complaint, caused by pressure of the enlarged uterus upon the bladder, I have often scalded a little parsley and given the decoction or tea, a few teaspoonfuls at a time quite often to allow proper urination to take place. Apple water also will do the trick. Among our homoeopathic remedies Pulsatilla is the principal remedy. The administration half- hourly of a few doses of Gelsemium in almost any potency will nine times out of ten render the catheter unnecessary in cases of retention of urine after confinement.
Mention should probably be made here that the nipples during and after pregnancy are liable to become cracked and inflamed, and this happens especially after the child begins to nurse, therefore, for several weeks previous to delivery the breasts should frequently be bathed in cold water, and rubbed down with coarse towels. Sometimes bathing the nipples and breasts with brandy twice a day for several weeks previous to confinement will be found beneficial. Or using a decoction of green tea or a decoction of oak bark, or pomegranate. Should there be tenderness or soreness, bathe the nipples and breasts frequently in a weak solution of arnica.
I don’t intend going into a discussion of labor and delivery as my intention here is to treat factors which will aid the mother over the confinement period.
Often the secretion of milk may be suddenly suppressed from various causes, such as exposure to cold and dampness, mental emotions, errors in eating. Here hop tea or a glass of beer will bring milk, and a little thuja ointment rubbed on the breast will reduce the hardness of the breast and aid the milk to flow.
If, on the other hand, there is an excessive secretion of milk, which sometimes happens, causing distention of the breast and sometimes inflammation, debility, headache and other nervous disorders, Calcarea carb. or Phosphorus will generally afford relief.
If the nipples become sore after the child has left the breast, the nipples should be washed with cold water to which has been added a few drops of arnica and they should then be thoroughly dried and the milk squeezed out of them, and covered with powdered starch.
My advice to expectant mothers has always been to be careful in raising the arms high as in hanging clothes and the like during pregnancy as it is likely to lead to a miscarriage.
By taking red raspberry tea each day for three or four months before confinement all aching pains around the pelvis will be done away with and an easy delivery will result. I have never had to use forceps in my life. Always remember red raspberry tea, a light diet, with broths and soups, short walks daily and frequent rests, and delivery will be easy. It is a wise act for the mother to remain in bed for nine of twelve days following the delivery to rest up and become normal.
If the mother becomes fainty with shortness of breath give Crataegus in small doses. If chilly I would give Millefolium (Yarrow) which will open the circulation more freely.
Lastly, I would like to mention that if the mother while carrying the child longed for various foods which it was impossible for her to obtain, the child will become restless and yearning after birth. In such cases I have used a washed sweet pickle for the child to suck on. If this failed, I would use the raw rind off a piece of pork in the same manner and have never known it to fail in such cases. The child has suffered because the mother has not received what she wanted while carrying the child.
MT. CLEMENS, MICH.