Hydrastis. Offensive lochia, with suppressed or scanty urine.
Pulsatilla. Simple scanty discharge.
Sabina. Similar symptoms to those described under Aconitum, minus the febrile ones; also when the red flow continues after it ought to have changed colour.
Secale. Very offensive dark discharge.
ACCESSORY MEANS. In suppression of the lochia, flannels wrung of hot water should be applied to the external pars, and frequently renewed, a second flannel being ready when the first is removed. also, if necessary, injections into the vagina of warm infusion of Camomile flowers. When the discharge is bright, or continues too long, the patient should retain the horizontal posture be kept quiet, and fed with suitable diet.
PREVENTIVES. After a confinement, ablution of the Parts by means of a soft sponge and warm water (containing a little tincture of Calendula a teaspoonful to the half pint, for the first two or three washings), at least twice in every twenty-four hours, the parts being immediately but thoroughly dried, is essential for the health and comfort of the patient, and to prevent the discharge from becoming offensive. The napkins should be frequently changed, and always applied warm, as the application of cold might be followed by an arrest of the lochial discharge. There is no objection in ordinary cases to the patient’s sitting up in the chair the day after delivery, while the bed is made. The daily use of the chair favours the discharge of putrid coagula; and carbolised injections may be employed to aid the evacuation. After the first day the patient may also wash herself, the exertion being helpful rather than otherwise. If the lochia be offensive, the chair should be used more frequently.
62. PUERPERAL CONVULSIONS.
Women are liable to convulsions of variable intensity and character before, during, and after labour; but, happily, the affection is one of very rare occurrence.
CAUSES. The predisposing causes are hereditary tendency, an excitable temperament, or some previous injury or diseases of the head, etc.; and among the exciting causes may be mentioned the irritation produced by a distended rectum or bladder, by the dilation of the orifice of the womb, or by the presence of the child in the maternal passages, etc.
SYMPTOMS. An attack of convulsions may come on suddenly, without any premonitory warning, or it may be preceded by one or more of the following symptoms; Drowsiness, weight, beating, or pain in the head; heat in the scalp, flushing of the face, or redness of the eyes; numbness of the hands; twitching of the muscles of the face and limbs; irregular and slow pulse; ringing in the ears; vertigo; pain and oppression on the region of the heart; restlessness, anxiety, etc. The fully developed convulsions are characterised by unconsciousness; violent spasmodic movements of the muscles of the face, limbs, and drunk; swelling of the face; foaming at the mouth; grinding of the teeth; apparently suspended, or short, hurried respiration; involuntary action of the bladder and bowels; profuse cold, clammy sweat, etc. The convulsions may subside in from two to five minutes, leaving the patient in a state of comatose insensibility, or deep stertorous sleep, from which she may suddenly awake, quite unconscious of what has been the matter, in a quarter of an hour or twenty minutes. No further paroxysms may come on, and the patient may steadily progress towards complete convalescence. Frequently, however, the convulsions recur again and intervals varying from fifteen to thirty minutes, the patient never recovering consciousness from one fit of another.
The alarming character of the symptoms, and the serious nature of the disease, demand al the skill and coolness of the most accomplished physician to meet the requirements of each case, but pending his arrival much previous time may be saved by the intelligent attendant administering one of the following remedies, and carrying out the recommendations of the accessory treatment.
MEDICAL TREATMENT. Aconite, Belladonna, Chamomilla, Coffea, Hyoscyamus, Ignatia, Opium
INDICATIONS FOR THE PRINCIPAL REMEDIES.
Aconitum. The presence of fever, with some premonitory symptoms, would be an indication for this medicine.
Belladonna. This is the most useful and the most frequently indicated remedy, and the only one which need be administered in the majority of cases both during the convulsions and the intervals.
Hyoscyamus. If there be much restlessness or anxiety, and a suspicion of approaching convulsions, Hyoscyamus may be given.
Opium. May be required or remove the dullness and stupor which sometimes remain after the subsidence of the convulsions.
ADMINISTRATION. For the premonitory symptoms, a dose every half- hour, or oftener. During the convulsions, every three or five minutes, the medicine being dropped between the lips or upon the tongue. After the convulsions, every half-hour, hour, or less frequently.,
ACCESSORY MEANS. The character should be moderately darkened, but freely supplied with cool and fresh air. Warm clothing should be applied to the feet the body, and cold lotion or ice to the head. If necessary, delivery should be accomplished by instrumental means, and the bladder and bowels emptied, but these are matters which must be left to the judgment of the medical attendant.
63. MILK FEVER-PUERPERAL EPHEMERA
When the breasts are first called upon to perform this function, there is sometimes a little circulatory disturbance which is called the “Milk Fever.” This is a normal process, and ordinary requires nothing but the early application of the child. In severe cases there is speedy accession of more serious symptoms, which frequently run on into the formidable diseases called Puerperal, or Childbed Fever. (See next Section.)
Usually Milk fever is of short duration, consisting of one or two paroxysms, which occur a few days after childbirth, and attended with diminution of the milk and lochia, but with no local functional or structural disturbance.
It appears about a week after delivery, rarely sooner, sometimes later; prevails in low, humid, marshy districts where the population is sparse, or near stagnant ditches and pools i hence it is malarious in its character.
SYMPTOMS. Chill, rigors, increased temperature and perspiration; pain in the head, back, and limbs. Pricking sensations of milk, urine, and lochia are suspended. The secretions of milk, urine, and lochia are suspended. The eyes are sunken; the fingers blue; the pulse is feeble and somewhat hurried.
When perspiration breaks out freely, the other secretions are re-established, the patient improves, and the fever passes away.
MEDICINAL TREATMENT. Aconite, Belladonna, Bryonia, China, Coffea, Acid phosphoricum., Rhus, Ver-V.
INDICATIONS FOR THE PRINCIPAL REMEDIES.
Aconitum may be safely had recourse to when much fever is present, especially at the commencement.
Belladonna should prove useful when, with swelling and pain of the breasts, there is some cerebral disturbance.
Bryonia. On the subsidence of the febrile symptoms, should there be oppressed and laborious breathing, headache, and constipation.
Acid phosphoricum. Should there remain profuse perspiration after the fever has abated.
Pulsatilla. This medicine is an excellent one for promoting the establishment of the secretion of milk, especially when the febrile symptoms are attended with considerable muscular rheumatic pains.
ACCESSORY MEANS. The patient’s chamber should be kept cool and well aired. All mental excitement or worry should be avoided. The diet should be light, such as gruel, arrowroot, barley-water, sago, etc., and taken in small quantities at a time. So long as the fever lasts the child should not be put to the breasts, but they should be drawn gently by the nurse, either with a breast- pump or otherwise, if full and uneasy.
64. PUERPERAL FEVER
This is a continued fever occurring in childbirth, sometimes following neglected Milk Fever, sometimes appearing as an independent affection. It is distinguished from Milk Fever i n that it is usually attended with peritoneal inflammation, uterine phlebitis, or other local functional and structural disturbances. According to the best authorities, this fever is very fatal, Dr. Ferguson being of of opinion that, “with all the resources which medicine at present offers, we shall find that one case in every three die die”; and that “to save two out of three may be termed good practice.” When the disease proves fatal, death usually occurs in from one to eight days. The disease is infectious, and has often appeared as an epidemic, attacking any women who happened to be confined at the time. It is, therefore, no small matter that we have in our Materia Medica-which, of course, Dr. Ferguson and his colleagues ignore remedies which prescribed according to the law of similars, and given in the early stage, are often sufficient to cure this disease.
CAUSES. Instrumental or difficult labour; foetid lochia; 1M. D’Espine, in a thorough investigation of post-partum inflammations, came to the conclusion that blood-poisoning from foetid lochia is the origin of Peritonitis, the so-called Milk Fever, and other inflammations and congestions liable to occur after accouchement. Febrile action in the first week after delivery almost always depends on absorption of lochia through slight abrasions or lacerations of the utero-vaginal canal. It may continue for some weeks, should the uterus not be firmly contracted, or should the lochia be foetid. In the latter case ulcerations through which absorption takes place, may almost always be found either on the cervix or in the vagina. neglect of cleanliness; decomposing fragments of retained placenta; violent emotional disturbances; contracted, or personal transmission of the poison from one patient to another by doctors and nurses. Other animal poisons, as that from Erysipelas, Scarlatina, Typhus, and from the post-mortem or dissecting-room, are capable of exciting Puerperal Fever, as conveyed by the persons and dresses of the attendants of the patient, even after the exercise of great caution. The disease derives great importance, both from its extreme danger and its frightfully contagious character.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.
Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."