Veratrum Album. Great anguish of mind, and self condemnation.
ACCESSORY MEANS. The patient should be placed under the care of firm, but humane and experienced nurse, who can be with her night and day; and unless the symptoms are soon amenable to the remedies the patient should be separated from her family. The diet should be separated from her family. The diet should be digestible and nourishing, including beef-tea, eggs, milk-and- soda-water; and when there is great prostration, brandy or wine. The food should be given regularly, at short intervals. In acute mania a wet-pack or a hot bath is very advantageous.
THE INFANT. If the child is yet unborn, the process of nature cannot be interfered with to any advantage. In Acute Mania, the infant may be allowed the breast again as soon as the symptoms have well subsided. In Melancholia, weaning is at once imperative
66. RETENTION OF URINE AFTER LABOUR.
Retention of urine is not infrequent after parturition, especially after severe and tedious labour. For the treatment the reader is referred to Section 48, p. 161.
ACCESSORY MEANS. The patient should pass water within about eight or twelve hours after delivery, or earlier if necessary; she should do this while in horizontal posture, to prevent flooding, or other serious consequences which might arise from the effort of sitting up to do so. It may be worth while to add, that the pot-de-chamber used by the lying-in patient should be warmed, or the rim protected with flannel. Should there be a kind of paralytic inability to pass urine, the following simple method may be adopted: Let the nurse pass water in the patient’s room, so that the may hear the urine as it passes into the vessel; the sound of the falling stream seems to arouse the dormant nerves of the urinary tract, and their function will generally be quickly restored. Another plan is to apply a cloth wrung out of hot water to the pains, which often removes the difficulty. Should, however, the inability continue, the medical attendant should be informed of the existing retention, so that if necessary he may draw off the urine by means of a character, a measure unattended with pain of exposure. Under any circumstances, the medical attendant should be made acquainted with the actual state of the patient.
67. CONSTIPATIONS AFTER LABOUR
It is a natural conditions for the bowels to remain unmoved for a few days water delivery. It gives rest to the womb, and to the parts in the neighbourhood of the bowel. Instead of injuring, it conserves the strength of the patient, and should on no account be interfered with. In four or five days, however, if the patient has had no evacuation and complains of pain in the bowels, of fulness in the head, one of the following remedies or measures may be adopted.
TREATMENT. Bryonia. Pain in the bowel, s fulness in the head, etc. Two or three doses, at intervals of three or four hours.
Nux Vomica and Sulphur may be given afterwards, if necessary, every four hours, in alternation, for several times.
Collin, Lycopodium, p., Or Plumb. may be required. (See p. 153.)
ACCESSORY MEANS. The moderate use of plain, unstimulating solid food, at suitable intervals after confinement, will furnish the proper impulse to the intestinal
canal, and thus be more likely to facilitate an evacuation than the exclusive use of liquids. When the action of the bowels is arrested by a collection of hardened faeces in the rectum, an enema of chilled water, or of soap-suds, will almost uniformly suffice to afford complete relief.
Castor-oil, aperient pills, etc., are not required. The Author has attended many ladies in their confinements who had previously been under the care of allopathic medical men, and who have assured him that their bowels were never believe after confinement will Castor-oil had been taken; but he has not, either in these or other cases, ever found it necessary to have recourse to any aperient drug. Good management, suitable diet, and, if the symptoms justified it, the occasional administration of a homoeopathic remedy, have in his hands been invariably successful.
68. DIARRHOEA AFTER LABOUR.
This is a much more serious condition than the former, especially if it occur s in the summer or autumn, or when bowel affections are prevailing. An involuntary diarrhoea is especially unfavourable, and should receive prompt and careful attention.
MEDICINAL TREATMENT. Ant. C., Arsenicum, China, Iris., Mercurius, Phosphorus Ac., Pulsatilla
INDICATIONS FOR THE PRINCIPAL REMEDIES.
Antimonium Crud. Thin, watery, offensive discharges, with marked gastric symptoms, clammy or bitter state of the mouth, white- coated tongue, nausea, heavings, etc.
China. With debility, especially when there has been previous relaxation, loss of blood, profuse lochia, etc.
Iris. Is especially of value in the Diarrhoea which prevails in summer and autumn. The motions are loose, copious, and frequent.
Phosphoric Acid. Obstinate cases, the evacuations being watery, painless, and almost involuntary; also tenesmus, or protrusion of haemorrhoidal tumours, etc.
Pulsatilla. Diarrhoea from the use of too rich, fat food, pastry, or other errors of diet.
ACCESSORY MEANS. Quietude, in a recumbent posture, light, digestible food, cool or cold, in small quantities. See also “Diarrhoea,” in the chapter on the Disorders of Pregnancy.
69. CAUSES OF BAD GETTING-UP AFTER LABOUR.
It is no uncommon thing for a patient otherwise healthy to have ” a bad getting-up after labour”-that is to be a longer time than usual in recovering the general condition, which in some cases it not attained for years. There is general debility, manifesting itself in various ways, notwithstanding a fair amount of rest, food, and stimulants; inability to stand or walk a few steps without feeling ready to drop; bearing-down and discomfort in the pelvis; abundant vaginal discharge, perhaps bloody or muco- purulent, which continues three or four weeks after the birth of the child, and when the lochia ought to have ceased. The most frequent causes are, enlargement, prolapse or displacement or the womb, from taking the erect confinement or Abortion; defective uterine involution, which is the main cause of the displacements that so frequently follow parturition, and the first step to many uterine affections (see next Section), ulceration or bruising of the uterus or its orifices by a severe or protracted labour, or from too violent removal of the placenta; inflammation of the womb, and a typhoid condition due to resorption of a portion of the placenta which is allowed to remain and decompose of the womb. The administration of purgatives and opiates is also a cause of a bad getting-up after labour.
The old practice of starvation during the first few days after delivery is another cause. When, therefore, at the end of four or five weeks after parturition, notwithstanding fair nursing, good food, and stimulants if necessary, the patient continues weak, unable to walk, a nd suffers from backache, and red, matter, or foetid discharge, professional advice should be sought, as grave consequences may result from neglect. A physical examination is generally necessary to discover the true source of mischief. The wife should sleep away from her husband. A cold water abdominal bandage tightly applied, will prove palliative. See “Puerperal Fever,” “The Lochia,” etc.
70. INVOLUTION AND SUBINVOLUTION OF THE WOMB
DEFINITION. Involution is that contractive change which takes place in the womb after the removal of the foetus by abortion or delivery, by which it resumes its ordinary size and attains to its usual compactness of tissues.
Subinvolution is the arrest or retardation of that change; so that the womb remains enlarged and heavy, causing considerable distress and suffering.
PATHOLOGY. The virgin womb is about a couple of inches in length and about an ounce in weight. During pregnancy, and according to the growth of the child, it becomes developed in size and increased in weight. Immediately before the expulsion of a full- grown child, the womb is about fourteen inches long, and weighs at least twentyfive ounces. Immediately after the expulsion, the size and weight are very considerably reduced; the size is less than half what it was before, and the weight is similarly diminished. This change is effected by the contraction of the muscular fibres of the utters, which begins directly after the termination of the labour, which checks the supply, and arrests the circulation, of blood through the organ. With more or less pain the contraction still steadily proceeds. Meanwhile fatty degeneration and disintegration of tissue, and absorption, aid in the restoration of the organ to its normal state. This, if the process goes on with regularity and without interruption, will be attained in the course of five or six weeks, when the compactness of tissue will be regained, and the uterus will measure about there inches in length, and weigh about two ounces. This wonderful contractive and absorptive change is termed involution: if it be incomplete the womb is said to be in a state of imperfect involution, or subinvolution.
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."