IN a normal state of social life, pregnancy would be a condition comparatively exempt from suffering. In consequence, however, of disorders induced by artificial habits, the excessive use of drugs, constitutional diseases, or accidental causes, this condition is too often accompanied by departures from health; some of which we shall describe in the following pages, together with the best means for their prevention and removal. We take them in the following order – those which affect the nervous, the circulatory, digestive, the urinary, and generative systems. According to this arrangement, the first on our list is, –
30. MELANCHOLY, FEAR ETC.
Fear, anger, joy, grief, and other emotional disturbances, operate powerfully upon the heightened susceptibility of the pregnant state, and unless moderated or removed may affect both the mother and child unfavourably. A morbid dread, causing the sufferer to view events through a darkened and disordered medium, is liable to produce trembling of the body, weakness of the limbs, alarming dreams, nightmare, nervous irritability, leading her to despair of life, and even to wish that it were extinct. Injudicious friends often aggravate this morbid state, by recounting accidents and unpropitious results of pregnancy which probably never occurred. Such thoughtlessness cannot be too strongly condemned. The statements are almost always untrue, but they may appear so real to the patient as to operate powerfully on her mind, and thus produce the most serious results.
MEDICAL TREATMENT – Cimicifuga – Melancholic depression, jealousy, nervous weakness, weariness, and restlessness; sleeplessness, or sleep with distressing dreams; pains in the left side, under the breast, in the back, etc.
Ignatia – Inconstant, irresolute, impatient disposition; alternate sadness and gaiety; depression of spirits, the patient frequently weeping without cause; acute sensitiveness; sensation as of a ball rising in the throat, and other hysteric symptoms.
Platina – Extreme depression, even to the fear of death, with anguish about the heart, Hysteria, etc.
Pulsatilla – Weeping mood, headache, heartburn, uneasy feeling at the pit of the stomach, and oppression of the mind by numerous cares.
Aconite, Sepia, Hyoscyamus, Chamomilla, Opi., or Coffea, may also be required in some cases.
ACCESSORY MEANS – Useful occupation, combined with suitable out- of-door recreation or games; cheerful company or books; change of air and scene, or easy journeys to favourite or novel places of interest.
31. FAINTING AND HYSTERICAL FITS
These are not infrequent accompaniments of pregnancy except at the period of quickening, and in weekly and delicate females. The fits are far from being serious except when associated with organic disease of the heart. If they occur towards the end of pregnancy, they may render convalescence after parturition more tedious than it would otherwise be. They are also unpleasant occurrences at the time of labour.
SYMPTOMS – These differ from epileptic fits, as there is no choking noise in the throat, or biting of the tongue. There is a sensation of languor, with disposition to yawn; things appear to turn round; the sight becomes dim, the face pale, and there is a buzzing or ringing in the ears; the patient sighs and becomes partially insensible.
CAUSES – Heightened impressionability of the nervous system from debilitating causes, as Neuralgia, prolonged sleeplessness, Diarrhoea, or other discharges; anger or fright. Tight dresses, crowded and badly ventilated sitting rooms, churches, theatres, ballrooms, etc., are frequent exciting causes. When fainting occurs soon after labour, it may rise from haemorrhage, and requires prompt and skilful treatment (See “Flooding after Delivery.”)
MEDICAL TREATMENT –
Camphor – May be administered during a fit, either by olfaction, or by giving two drops of the strong tincture on a small piece of loaf-sugar.
China – Faintness from exercise, profuse losses of blood. Diarrhoea, perspiration etc.
Digitalis – This alone is sufficient to restore the patient if the fainting be attended with feebleness of the heart.
Iodium – For the constitutional debility, of which the tendency to faint is a symptom.
Moschus may be administered during a fit, either by giving two drops of dilution in a teaspoonful of water, or by olfaction, a bottle of the tincture being held to the nose.
Opium – When fainting has been brought on by fright. Verbascum-Vir., Chamomilla, Ignatia, Pulsatilla, Cimic., etc., are suited to the hysterical fits in certain conditions.
ADMINISTRATION – During a fit, a dose every ten or fifteen minutes; afterwards, every four or eight hours.
ACCESSORY MEANS – During a hysteric fit, cold water may be dashed on the face. For a simple fainting fit, the patient should be laid down, with the head and shoulders slight raised, abundance of air admitted to the room, and quiet maintained. Camphor, Eau-de-Cologne, Moschus, salts of Ammonia, etc., may be applied to the nostrils. If the extremities are cold, artificial warmth may be necessary. The exciting cause must, as far as possible, removed; when this is a tight dress, or a too hot or badly ventilated room, removal of the cause is generally sufficient. If fainting arises from constitutional conditions, professional treatment is necessary.
32. – HEADACHE, DIZZINESS, ETC.
These are sometimes most distressing concomitants of pregnancy. There are acute digestion, with throbbing, dimness of sight, confusion of ideas and great heat of the head and face, with dizziness, intolerance of light and sound, etc. Or the face may be pale, cool, and the eyes heavy and languid. There may also a feeling of weight on the top of the head or the back of the neck, palpitation, nervous tremblings a disposition to fall forward, variable or diminished appetite, gastric derangements, etc.
MEDICAL TREATMENT :-
Aconitum – Giddiness on rising from recumbent posture, heavy, oppressive pains on the top of the head of in the forehead, redness of the eyes, dry burning skin, hard frequent pulse, scanty urine, etc. Especially suitable for florid patients of nervous temperament.
Belladonna – Violent congestive headaches, with staggering, buzzing in the ears, throbbing of the arteries of the temples and neck, scarlet redness of the face, sparks before the eyes, pains in the orbits, double vision, confusion of ideas, intolerance of light etc. The symptoms are worse in the morning, and there is disinclination to move.
Bryonia – Beating in the forehead, giddiness sense of weight and fulness, as if the brain would press through the forehead on stooping. This headache is often accompanied by indigestion, constipation, sometimes bleeding from the nose, rheumatic pains, etc.
Cimicifuga – Nervous, hysterical headache; pulsative; severe aching pain in the eyeballs; pressure in the occipital region from within outwards; absence of gastric disturbance.
Gelsemium – Headache with feverishness; giddiness, heavy eyelids, temporary blindness, heat of the face and body; intermittent pulse; strong palpitation; oppression of the chest.
Glonoine – Throbbing of the arteries of the head; dizziness; sensation of a tight band around the head; full rapid pulse; cursing, jerking, maddening pulse; hot, injected eyes, with flashes of light.
Nux Vomica – Congestive headache waking the patient early in the morning, worse after eating, aching as if the head would split, stupefaction, etc., often associated with constipation, nausea, etc., sometimes commencing with dazzling of the light and increased by coughing or stooping. Nux Vom. is especially suited to headache from over-eating, or too late eating at night, from alcoholic beverages, or from sedentary habits.
Pulsatilla, Ignatia, Ipecac., Iris., Cocc., Sepia, Platina, etc., may also be considered.
ACCESSORY MEANS – In congestive headache the feet should be kept warm, and when cold, hot applications should be made to them. In headache from gastric derangements, free vomiting often given relief; to promote which, if necessary, a tumbler of warm water with a teaspoonful of mustard mixed in it may be taken. In neuralgic headache hot dry flannels around the head, or a handkerchief tied tightly, is often palliative. If the feet are cold, a hot brick or bottle should be applied.
PREVENTIVE TREATMENT – Early hours, to obviate as far as possible the use of artificial light, heated rooms, etc.; the cold bath, with plenty of friction, in a well-ventilated room, every morning on rising; regular daily open-air recreation; domestic duties and anxieties should only be permitted to exercise a moderate influence, the patient aiming to live a tranquil and agreeable life; regularity or moderation in eating and drinking, avoiding eating in a hurry, taking suppers, stimulating food and drinks, especially spirits, strong tea, coffee., etc. The regular function of the bowels should be promoted by observing the directions in the Section on “Constipation.”
33. TOOTHACHE OR FACEACHE
The toothache of pregnancy is a Neuralgia, from which some women begin to suffer soon after conception, and even recognise their condition by this symptom. It is, however, liable to happen at any period during pregnancy. The pain may attack one or more decayed or not quite sound teeth, or it may extend along the jaw without affecting any tooth in particular. It is sometimes so intense as to render the patient temporarily delirious. Extraction of teeth is seldom advisable, as homoeopathic treatment will generally remove the pain. A qualified dentist, indeed usually refuses to remove them for this cause, where it exists alone. Besides, patients of nervous sensibility, or who have a tendency to Miscarriage are in a danger of abortion from the fear of shock of extraction.
Aconitum – Toothache from exposure to cold or wet, with throbbing of the gums and cheek, febrile symptoms, and aggravation of the pains by stimulants.
Belladonna – Toothache with determination to the head, and great nervous irritability; the pains increases at night, are throbbing or piercing, and often occur in alternation with intense headache.
Chamomilla – Faceache with swelling, irritability, heat redness, especially of one side of the face, flushes, palpitation and sensitiveness to external impression, the pain being worse on taking warm food or drink, and at night.
Coffea – Extreme sensitiveness to pain, sleeplessness, flushed face, great restlessness; the pain is relieved by cold water, and may be accompanied by palpitation, recurring every night.
Kreosotum – Toothache from decayed teeth; it not only relieves the pain, but also tends to arrest the progress of the decay.
Magnesia Carb. – Toothache in sound teeth; pain intolerable during repose.
Mercurius – Pain in decayed teeth, extending into the head; toothache from cold with swelling of the gums; threatened gumboils. This remedy has been, perhaps, more frequently and successfully used in domestic practice than any other.
ADDITIONAL REMEDIES which may be used both during the attacks, and also during the intervals – Bryonia, Calc-C., Cim., Nux V., Pulsatilla, Sepia, Staphysagria
ADMINISTRATION – A dose every fifteen, thirty, or sixty minutes, according to the severity of the attack.
ACCESSORY MEANS – Avoidance of cold and damp. Improvement of the general health, especially of the digestive organs, should be promoted by the use of whole-some food, pure, air, out-of-door exercise, bathing, and regular, early habits.
34 PALPITATION OF THE HEART
Weakly nervous ladies often suffer from attacks of palpitation. By some it is experienced immediately after conception, by others at the period of the quickening by others, again, towards the end of pregnancy.
CAUSES – Increased sensibility and irritability of the nervous system, consequent on pregnancy; in the later months, plethora may act as a predisposing cause; the movements of the foetus, indigestion, the excessive use of tea, and coffee, mental emotions, etc., may also excite palpitation.
MEDICINAL TREATMENT –
Aconitum – When the palpitation is connected with a plethoric condition, or derangement of any of the important organs of the body, or is brought on by fright or excitement.
Belladonna – Is useful in cases very similar to the ones calling for Aconite Headache, with redness of the face and dimness of vision, would indicate this remedy.
Cactus Grand – Nervous palpitation without recent or chronic, especially with a sensation of fulness at the heart, suffocation, and general plethora; heart appears to whirl round, or to be tightly grasped.
Digitalis – Great irritability in the heart’s action, sometimes rapid, sometimes almost entirely suspended; inability to walk or lie down; great distress.
Moschus – Nervous palpitation, with a tendency to faint.
Natrum Mur. – Palpitation after a meal, or on lying down at night.
Nux vomica – This medicine is of great value when the palpitation is apparently due to indigestion. It is especially indicated in patients of a dark complexion and irritable disposition.
Pulsatilla – Like the preceding medicine, Pulsatilla is useful in cases arising from indigestion, but in fair-haired women, of mild, easy disposition.
ADDITIONAL REMEDIES – Camph., Chamomilla, Cin., Coffea, Ignatia, Sepia, Verbascum V.
ADMINISTRATION – A dose every thirty or sixty minutes during an attack; in the intervals, thrice daily.
ACCESSORY MEANS – Derangements of the digestive organs, mental anxiety, excitement, heated rooms and confinement within doors, should be guarded against.
35 – VARICOSE VEINS
DEFINITION – This frequent accompaniment of pregnancy consists of a dilatation of the veins, especially of the lower limbs, and sometimes of the vagina, so that the veins stand out like knotted cords, with more or less swelling of the adjacent parts, and often rendering sufficient walking exercise impossible.
SYMPTOMS – The enlarged veins are most frequent on the leg below the knee, but the veins of the thigh are also liable to be involved, and in some cases those of the labia majora, vagina, and even of the os uteri. Both limbs may be equally affected, but when the womb is more inclined to one side then the other, the corresponding limb will be most affected. Sometimes the foot becomes quite purple from the congestion of the minute vessels, an the veins in the thigh and leg acquire an enormous size. The veins get larger when the patient is much on her feet, or allows the limb to hang down, but diminish during the rest in the horizontal posture.
CAUSES – Pressure of the enlarged womb upon the iliac and inferior cava, and so obstructing the return of blood from the parts below. It is most frequent when the uterus is too low, when the person is very heavy, and in those who have borne many children. As the derangement is caused by the pressure consequent on pregnancy, after delivery the veins soon regain their former size.
MEDICINAL TREATMENT – Aconite, Arsenicum, Belladonna, Fluor., Ac., Hamamelis, Lycopodium, Nux V., Pulsatilla, Silicea, Sulphur
INDICATIONS FOR THE PRINCIPAL REMEDIES
Aconitum – This medicine has no specific action upon varicosis, but is often indicated when inflammation has been set upon the veins, as an intercurrent remedy.
Hamamelis – In severe cases, and when bleeding is threatened. A dose every eight or twelve hours. The local use of this remedy is also sometimes necessary. Generally, Hamamelis is the best remedy.
Nux vomica – Varices, with enlargement of the abdomen, haemorrhoids. Constipation and frequent bearing down pains.
Pulsatilla – Painful and inflamed veins of a bluish colour, causing swelling of the limbs, in patients having the Pulsatilla temperament.
ACCESSORY MEANS – The limb should be bandaged from the toes to a little above the knee, or to the hip if the disease extends above the knee; beneath this bandage compresses of linen should be laid over the enlarged veins, and kept wet with a Hamamelis lotion (one part of the strong tincture to four of water)l or the affected portion may be bathed with the lotion morning an night. All ligatures, such as garters, must be removed. Rest in the recumbent posture, or the limb raised as much possible, is necessary. Sometimes an elastic stocking, made to measure, and drawn on like an ordinary stocking, before rising in the morning, is requisite.
36. SWELLING OF THE LOWER EXTREMITIES (OEdema)
In advanced pregnancy women often suffer from a puffy swelling of the ankles, and sometimes of the thighs, or even of the external genital parts. Change of posture has great influence upon the swelling of the legs; in the morning it is but slightly perceptible, but during the day it increases, and towards night it is at greatest degree.
Apis Mellifica – Rapid and extreme swelling, with urinary difficulties.
Arsenicum – OEdema with much debility, weakness, and prostration; feeble and irregular pulse, and coldness of the extremities.
China – Dropsical swellings from exhaustive discharges, haemorrhages, diarrhoea, etc.
Ferrum – OEdema depending on an anaemic or chlorotic condition.
Sulphur – When the patient has been subject to affections of the skin, which have disappeared during the pregnancy.
ADMINISTRATION – A dose three or four times daily.
ACCESSORY MEANS – The recumbent posture will often lessen the inconvenience; and when the patient sits she should do so as much as possible with the legs raised. Standing is more unfavourable than a moderate degree of walking exercise.
37. – PAINS IN THE BACK AND LOINS
Many women suffer from pains in the lower part of the back during pregnancy. The pains are usually aching, heavy dragging, or pressing as if caused by a weight. They are often severe during the night than during the day.
MEDICAL TREATMENT –
Arnica – Is indicated if the pain can be traced to fatigue or over-exertion.
Bryonia – May be employed if the patient be subject to rheumatism.
Nux V. – Is an excellent remedy in cases attended with flatulence, constipation, and piles the pains being worse in bed.
Secale – Bearing down sensations in the lower part of the abdomen, with pain in the back.
Sepia – Useful when the patient has been long subject to menstrual derangements, or has a sallow, unhealthy looking sin, and is subject to piles.
ACCESSORY TREATMENTS – Sponging the loins with hot water for a few minutes before going to bed is sometimes of great efficacy, especially in cases associated with rheumatism or over-fatigue. In almost all cases a wellfitting thin flannel bandage is desirable.
38 – SLEEPLESSNESS
Sleeplessness is a prominent and annoying symptom in some women in all stages of pregnancy.
MEDICINAL TREATMENT –
Aconitum – The presence of any febrile symptoms would indicate the employment of this medicine.
Cimicifuga – Restlessness, inability to lie still.
Coffea – When the sleeplessness occurs in the early part of the night.
Ignatia – Nervousness; cannot get rid of thoughts.
Nux vomica – Sleeplessness chiefly in the morning, with flatulence and constipation.
Veratrum Album – If the sleeplessness be caused by cramps.
ACCESSORY TREATMENT – When the sleeplessness occurs in the early part of the night the patient should sponge her face and neck with hot water, or, if this fail, she should apply a cold-water compress, without macintosh covering, to the nape of the neck, just before going to bed. Similar measures may be adopted if the sleeplessness manifests itself in the early morning.
39 – MORNING SICKNESS
In the early months of pregnancy, most women experience more or less of this : occasionally nausea or vomiting, or both, are very troublesome and persistent symptoms, and give rise to serious concern as to the patient’s health, especially in the pregnancy of delicate women.
SYMPTOMS – The first intimation of it generally occurs on rising from bed. Before getting up the patient may feel as well as usual, but while dressing will be overtaken by nausea, followed by retching, and perhaps by vomiting. Or it may not occur until some little time after leaving the apartment, or not until after breakfast, which may be eaten with zest. In some cases sickness is not felt till the evening, when its habitual return indicates one of the forms of displacement (prolapse or retroversion) of the womb incident to pregnancy. Morning Sickness may begin almost immediately after conception, of which it is often one of the earliest symptoms; but more frequently it does not commence until after the lapse of two or three weeks, and then continues more or less constantly and severely for three or four weeks, and in some instances till near the time of quickening, or even until confinement. In some rare instances it does not occur before the last weeks of pregnancy, and is then apt to be severe; in other cases it is altogether absent during the whole period of gestation.
CAUSE – The increased action of the nerve force employed in digestion to furnish material for enlarged growth, carried to so high a degree as to disturb the equilibrium of the digestive and assimilative forces. It is most common amongst the wealthy and inactive. Moderate Morning Sickness is no doubt salutary diminishing that tendency to plethora or too great fulness in the system which often attends pregnancy. Uterine displacements are known to produce Morning Sickness, and it is more than possible that the slight prolapsus of the womb which is incident to the first months of gestation may help to account for it (Ludlam). When sickness is invariably brought on, or intensified during the latter part of the day or in the evening after the patient has been upon her feet, it is due to displacement or prolapse; this is proved by the prompt relief that follows the replacement of the organ on the patient’s taking the horizontal posture. Obstinate and long-continued nausea or vomiting is generally caused by congestion, ulceration, or displacement, or it may arise from hyperaesthesia of the nervous system, and require professional treatment. Nausea and sickness occurring towards night are more serious and obstinate for the reasons already mentioned.
MEDICINAL TREATMENT – Ant. C., Arsenicum, Cocc., Conn., Cup-S., Ipecac., Kal-B., Kreosotum, Lycopodium, Nux V., Petrol., Pulsatilla, Tabac., VerbascumA.
LEADING INDICATIONS FOR THE PRINCIPAL REMEDIES
Arsenicum – Vomiting after eating or drinking; persistent vomiting, with extreme weakness and emaciation.
Ipecacuanha – Great uneasiness about the stomach; vomiting of undigested food, bile or phlegm; relaxed bowels. Often sufficient in mild, uncomplicated cases.