SYMPTOMS. In Puerperal Fever there are rigors (shivering fits), followed by an increase of temperature (rising to 105 6 degree); more rapid pulse (ranging from 120 to 160); hurried, short respiration; distressing thirst; sometimes nausea and vomiting; and distention, pain, and great tenderness over the region of the womb, causing the patient to lie on her back, and drawn up her knees to relive the abdomen from muscular pressure, and from the weight of the bed-clothes; suppression of the milk (if it has been secreted at all); also suppressed, or scanty and foetid lochial discharge; there are severe pains in the head, flushed face, glistening eyes, anxious countenance, and sometimes delirium, and, unless the disease is checked, typhoid, or malignant symptoms rapidly supervene. This fever commonly occurs within a few days after childbirth; and it is remarkable that in most cases the patient loses all interest in the faint, and even expresses dislike to it and the husband. Convalescence is often exceedingly slow.
MEDICINAL TREATMENT. Aconite, Arsenicum, Baptisia, Belladonna, Bye., Hyoscyamus, Mercurius, Opium, Phosphorus Ac., Rhus., Verbascum V.
INDICATIONS FOR THE PRINCIPAL REMEDIES.
Aconitum. This remedy should be given as soon as the first indications of fever are noticed. it is usually sufficient in simple Milk Fever, and when there are no symptoms of brain disturbance.
Baptisia. As the indications of fever become more marked this is preferable to Aconite; and when enteric symptoms supervene Rhus should supersede Belladonna
Belladonna. Congestive headache, flushed face, altered pupils, great restlessness, tossing about, mental distress, and other symptoms of approaching delirium or severe disease. If the lochial discharge is not entirely suppressed, but is foetid, this remedy is still very suitable. at the same time Aconite should be continued in alternation with Belladonna, and at brief intervals till professional aid can be obtained.
Bryonia. Distended breasts, oppression, and shooting pain in the chest, etc.
It is not to be expected than a non-professional person will venture to undertake the treatment of such a grave disease as Puerperal Fever, but his intelligent employment of one of the above remedies until the arrival of a physician may be of material importance.
ADMINISTRATION. A dose every half-hour, hour, or two hours, according to the violence of the symptoms.
ACCESSORY MEANS. Frequent small draughts of cold water should be given; this relieves the thirst, and promotes perspirations. Barley, milk, or strong beef-tea between the doses of medicine will help to keep to the patient’s strength; even stimulants may be required; brandy rather than chloroform. Hot water will relieve vomiting; but better still is a grain of Sulph- carbonate of soda 1Dr. G.D. Beebe, of Chicago, says of Sulpho Carbonate of Soda: “During nearly two years I have administered this slat in many hundreds of cases of scarlet fever and diphtheria, as well as reasonable number of cases of erysipelas and puerperal fever, both with a view to the prevention of epidemic contagion and in the treatment of these forms of diseases.
The Sulpho-Carbonate of Soda is readily soluble, and very diffusive when brought within reach of the absorbents. It is odourless, and a taste differing but little from soda. By its administration the blood and tissues of the human body may be thoroughly disinfected without any exciting any toxic effects of the drug. Administered to children breathing an atmosphere loaded with scarlet fever of diphtheritic contagion, it acts as an absolute preventive, with exceptions so rare, and with symptoms so light when any appear, that one is forced to believe that the fault was rather in an efficient dose tan in the agent. Given when either of these diseases has developed an attack, within a few hours the activity of the diseases has ceased, and the remaining symptoms soon fade out into health. Administered to a case of puerperal fever, when one septicaemic chill follow another, with the hot, drenching sweat between, and if not too late in the history of the case, the patient may be assured that not more than one chill will follow its first administration, and the high temperature and icteric hue of the skin will disappear with the most gratifying promptness.
No less gratifying is the action of this substance when administered in erysipelas. The rapidly spreading inflammation of the skin stops short, and convalescence begins. The constancy with which these results follow the administration of this admirable antiseptic constitutes a demonstration on the septic character of the disease wellnigh as convincing as the recognition of the parasite under the microscope; and coming, as we do through those clinical observations by a different route, to the same conclusions reached by Pasteur and his co-labourers, the conclusions are both gratifying and suggestive.” dissolved in half a glass of water; a teaspoonful every few hours. Perfect rest and quiet, with absence of all appearance of excitement or alarm in the attendant, are imperatively necessary. Occasional sponging of the body with tepid water is soothing, and if there is much abdominal distention and tenderness, a dry heated brain-poultice, in a bag, is the best local application. Repeated fomentations and lavements of the vagina are valuable; indeed, if the parts were sponged with hot water three or four times a day there would be fewer case of this fever.
The napkins should be frequently examine, and all foul discharge effectually cleansed away, and the room disinfected with Carbolic acid. Indeed, when the discharges are offensive, it is well to inject up the vagina some warm water, to which a few drops of Carbolic acid have been added; or as a more agreeable preparation, Chlorate of potash grs. xij. water x3j; a dessert-spoonful of this to a teacupful of warm water for injection, or to be applied by wetting compresses with the mixture. Dr. Macleod, of Ben Rhydding, states that he saved his own wife from a fatal termination of Puerperal Fever, after the physicians had expressed the opinion that she could not recover, by the injection of three drachms of Condy’s fluid in a wash-hand-basinful of water of 64 degree; followed by a similar operation on the following day with two drachms of the fluid. The temperature of the room should be maintained at about 68 degree, the ventilation through. The nursing of the child should be discontinued with the first active symptoms of fever.
65. PUERPERAL MANIA (Mania Puerperarum)
Gestation, the lying-in period, and nursing, are occasionally complicated by mental derangement, either of a quiet melancholy character, or of a more acute and violent description. The latter is more liable to occur during or immediately after labour, while melancholia, less dangerous to life, but more frequently followed by derangement of the mental faculties, more commonly occurs when the system is drained and exhausted by childbearing, or prolonged suckling.
SYMPTOMS. The symptoms of melancholy-mania are generally preceded by signs of exhaustion. There is also in incipient stage, the mind being wrong, but still able to notice its wandering tendency. The memory becomes weak, the spirits depressed, and various fancies haunt the brain. The patient is abstracted, listless, and silent. A conviction of her husband’s infidelity, or of her own, couple with agonising remorse and contrition, is one of the most common and painful delusions to which this class of patients is a prey; and in numerous instances attempts at suicide result.
Acute mania appears while the patient is sustaining the effects of labour, an occur suddenly and violently. The face may be pale, and the pulse soft and slow. The manner is agitated and excited, the tongue utters violent and often obscene language, and there is generally a tendency to suicide or child-murder. The bowels are constipated; the tongue thickly furred; the secretion of urine and milk nearly arrested, and the skin harsh and dry. There may be either disturbed sleep, or sleeplessness; also a persistent refusal to take food.
CAUSES. This affection scarcely ever occurs except where there is hereditary tendency. The exciting causes are labour, flooding suppression of the lochia, fright, weakness as a result of prolonged nursing, jaundice, or other disease.
MEDICINAL TREATMENT. Arsenicum, Aurum, Belladonna, Cann. I., China, Cim., Hyoscyamus, Ignatia, Platina, Pulsatilla, Stramonium, Verbascum A., Verbascum V.
INDICATIONS FOR THE PRINCIPAL REMEDIES.
Belladonna. Violent delirium from sudden lochial suppression. Staring eyes, hot skin, suppressed urine. etc.
Cannabis Indica. Catalepsy; imagines she is the Queen or the Virgin Mary, etc.
China. Mania following prolonged lactation, or flooding; recurrent headache.
Hyoscyamus. Jealousy; fits of violence; alternating with moroseness, restlessness in sleep, etc.
Ignatia. Persistent silent melancholy; tearfulness; obstinacy.
Stramonium. Violent rage, with constant use of abusive language.
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."