NAUSEA AND VOMITING – MORNING SICKNESS
THE stomach of course sympathises generally and acutely with the functions of gestation. In every accident, and in every disease, the appetite is affected; and during so mighty a change, we can hardly anticipate the digestive organs would remain unaltered. It is common, during the earlier periods, or until the arrival of the FIFTH MONTH, for nausea and vomiting to be endured every morning.
I have separated the two words, because in some instances, a sensation of nausea or qualmishness is alone present; and this sensation generally departs with breakfast, the appetite for which meal it does not destroy. On the other hand, VOMITION is sometimes violent and distressing, and, so far from its being arrested by feeding, it positively prevents the patient taking any food whatever.
In the generality of cases, however, vomition ceases with the “quickening” of the child; but well-authenticated cases are on record of ladies who have been starved by the continued irritability of the stomach; they have sunk from want of nutriment, the spasm not having ceased by day or by night. Nay, in extraordinary instances, delivery, when the patient has lived to undergo that process, has not terminated the suffering, but vomition is reported to have continued for two months subsequently.
The earliest case of nausea on record, is that of a lady who was led to the hymeneal alter on a Monday, and on the first Saturday of the “honeymoon” she began to sicken. Any earlier notice than this I am unacquainted with; but there can be no reason why the sensation should be even so long delayed.
During these retchings, very frequently nothing is voided; occasionally, a small quantity of water, or mucus, only more or less discoloured, is thrown up; and the patient may, or may not, be relieved by the act.
For these symptoms bleeding is a favourite practice with the Allopathists, notwithstanding that this operation is one of the best-known means of producing abortion; leeches, purgatives, counter-irritants, enemata of asafoetida and turpentine, salines, narcotics, and almost every known process or drug recognised in medicine, are sometimes adopted by the advocates of the general or so-called orthodox doctrine. For my own part, I should hesitate to recommend the mildest of the foregoing measures.
In Homoeopathy, VOMITION is successfully allayed by apparently insignificant doses of either Arsenicum, Ipecacuanha, * Ipecacuanha, in scruple doses, is a well-known emetic. The daily experience of Homoeopathists, however, proves, that in small doses it will allay vomiting.* kreosote, Nux Vomica, or Pulsatilla.
Dr. Simpson, of Edinburgh, was heard to relate a case of chronic vomiting, which has defied every known remedy in the British Pharmacopoeia, until he took the advice of Dr. Arnth, a Homoeopathic physician, and gave half-grain doses Ipecacuanha, which very soon stopped the sickness. As an act of gratitude for this “kind hint,” the great obstetrician of the North undertook the laborious task of compiling the “largest mass” of nonsense ever published against Homoeopathy.
Some of the more enlightened and advanced Allopathists of the present day, have at last deemed it WISE to investigate the leading principles of Homoeopathy, and have embodied in their works numerous and valuable illustrations of the benign efficacy of that mode of practice. Amongst the most prominent of these is Dr. Ringer, Professor of Therapeutics at University College, and one of the physicians to University College, Hospital, London. Few remedies, says that author, are so efficacious in checking some kinds of vomiting as IPECACUANHA. The author in numerous instances has witnessed the efficacy of the wine administered in one-drop doses every hour, or three times a day, according to the urgency of the case, in checking the following kinds of sickness:-
FIRST-It will check the vomiting of pregnancy. This vomiting is not always of the same kind. It occurs only in the morning in some cases, and is excited by the first waking movements. In most instances this from will yield to IPECACUANHA, taken in the way just described. Should it fail, however, relief in many cases follows the administration of the medicine to the patient on WAKING, and some time before any movement is allowed. In other instances, the vomiting occurs not only in the morning, but frequently during the day; recurring whenever food is taken; and may be so severe that no food is retained; while during the intervals of meals, there may be constant NAUSEA, and great LOATHING of all kinds of food. Ipecacuanha may check the nausea and vomiting, with the exception of the attack recurring on the first moving in the morning, when, on on taking a dose IMMEDIATELY on waking, this will also generally cease; but in some very obstinate cases, this early-morning nausea and vomiting continues in spite of the treatment.
SECONDLY-In other instances the early-morning vomiting may be absent, and the attack may occur only on taking food, increasing in severity as the day advances, and becoming most severe in the evening. Should Ipecacuanha, however, as is sometimes the case, fail to check this kind of sickness, then Nux Vomica may be substituted, or taken in alternation, often with marked relief.
In some pregnancies, besides the nausea, sickness, and vomiting, there is much heartburn (Pyrosis), and often considerable flatulence-symptoms which in many cases yield kindly and quickly to Ipecacuanha. But here again, should this remedy fall short of out expectations, Nux Vom. will generally afford relief; and when both are taken, the symptoms yield more surely. It is singular that, while Ipecacuanha will remove, in pregnant patients, even excessive flatulence co-existing with sickness, yet, if the flatulence occurs without sickness, this medicine is generally inoperative; and recourse must, in such cases, be had to Nux vomica, Pulsatilla, the Carbo Vegetabilis, or the Sulpho- carbolate of soda, in five-grain doses, administered immediately after a meal.
We have just observed that, in some instances, nux Vomica succeeds when Ipecacuanha fails to afford the expected relief; and this is notably the case when the tongue is coated with a creamy fur; when there is flatulence; when there is much acidity, heartburn; when, in fact, the stomach is generally out of order. In these cases, we shall not be very far wrong in prescribing both the Nux Vomica and Ipecacuanha conjointly, or in alternation.
It must be observed, however, that, in certain instances, Ipecacuanha fails to afford the anticipated relief. In these, it may be the nausea and vomiting is kept up by a displacement of the womb, or by a chronic inflammation of this organ, its cervix, or its os, as long since pointed but by Dr. Henry Bennett. Under these conditions, a line of treatment directed to the removal of these affections should be carried out. Some ladies who, during pregnancy, were untroubled with nausea and vomiting, yet suffer with both these symptoms during the whole or part of the time of suckling. These symptoms usually begin after the first few weeks of suckling, and continue till the child is weaned; and may be so severe, and produce so much exhaustion, as to compel the mother to wean her child prematurely. The nausea and vomiting may be accompanied by great flatulence and other stomach derangements. All these symptoms, also, will invariably yield to the administration of drop-doses of Ipecacuanha, or Nux Vomica, and sometimes to Belladonna.
Similar troubles to those already pointed out afflict some women at each “menstrual epoch,” occurring immediately before, during, or directly after the period. These cases, likewise, will generally yield to Ipecacuanha: if before the period, to kreosote; if during the period, to Arsenicum album; and if after period, to Sepia.
Thus the patient simply has the annoyance removed without the health being destroyed; and she is left all the strength nature has endowed her with, to encounter the season of peril.
WALKING EXERCISE While recommending medicine, however, I should be consciously wrong did I advise a patient so circumstanced to rely alone upon such efficacy. Doctors can do much; but patients can do more. Everybody must have heard gentlemen, previous to dinner, speak of taking an appetising walk. Nothing strengthens the digestive organs so much as frequent exercise in the open air. All the best efforts of science are wasted, if the patient, having strength to perambulate, will remain a prisoner within the house.
Moreover, there is not a greater beautifier in the world than fresh air and exercise. A lady who lives half her time in the open air in God’s sunshine-and who takes plenty of walking exercise, has generally a clear and beautiful complexion-
“She looks as clear As morning roses newly washed with dew.”
Many wives, I am sure, owe their good health to their good legs, and to their good legs, and to their good use of them; and woe betide those ladies who will not exercise their legs as they ought to! Ill-health, general languor, and a jaded frame, are sure to be their allotted portion for life.
So important is this essential to the welfare of pregnancy, that ladies are entreated to combat their own inclinations, and even to do violence to their feelings, rather than forego the benefits which result from frequent exercise.
In order that the slightest promptings for such an amusement may not be thwarted, the patient should be careful how far she gratifies herself by indulgence at the table. A full meal is always followed by disinclination for motion. I know that frequently, during pregnancy, the appetite is apt to become both unnatural and voracious: for such a condition Homoeopathy is prepared to render the best possible assistance.
The sister science pretends not to deal with sensations, the greater portion of the misery of this world; she esteems it not her province to alleviate. She grossly administers only to the body, and regards all that which is essentially existence, and makes the very essence of life, as beyond her duty or her power.
Homoeopathy, on the other hand, looks with a sympathetic and pitying eye upon the mental affliction of her patients: these she studies, and feels convinced she can alleviate.
It is her pride, that where the Allopathist leaves the patient to the tender mercies of CHANCE, declaring himself to be incapable of rendering further assistance, Homoeopathy steps in, takes the sufferer by the hand, and by her discoveries is happy to say she can soothe the anguish of the complaint.
Modern science may at length boast that the well-known appeal of the immortal bard is not made to her in vain:-
“Canst thou not minister to a mind diseased:
Pluck from the memory a rooted sorrow;
Rake out the written troubles of the brain;
And with some sweet oblivious antidote,
Cleanse the stuft bosom of that perilous stuff
Which weighs upon the heart?”
SELECTION OF RESIDENCE
Connected with this subject is that of residence. A valetudinarian evidently cannot walk much on a thick clay, saturated by repeated rains; a dry soil is, where circumstances permit, a choice to be exercised of the highest importance. Nor is it alone sufficient that a lady, at such a period, be taken miles from London. She may be free from the smoke of the metropolis; but if she become the inhabitant of a waste and a solitude, her situation is rather rendered worse than better.
A woman, at such times, requires to live in a cheerful spot, and is benefited by having too many than too few companions; because a person doomed to solitary confinement is always oppressed by DESPONDENCY. The noise of frequent visitors is certainly not to be commended; but there is a happy medium equally removed from racket and from dullness, which the good sense of my readers will readily realise.
SELECTION OF DIET
I have mentioned diet; and it is well in this place to say, that the lightest and most nutritious substances, taken in small but frequent quantities, should at this season be selected as articles of food. All meats, hardened or dried by the methods common in England, of ROASTING or BOILING, should be avoided. Cookery, to preserve the nutriment in the “viand,” should occupy at least DOUBLE the time generally allowed in this country. By such means-that is, by SLOW ROASTING or BOILING-the fibres are softened, and the juices preserved; whereas excessive heat may hasten, but will render HARD and INDIGESTIBLE, the food submitted to such process.
Servants may not like to see cooking long about; few articles can be properly prepared for the table under THREE or FOUR hours. Mutton roasted at a distance from the fire, or exposed to heat for the time mentioned, is altogether different from the burnt and dried-up joints served at the majority of English tables. Nor can I do better, while on this subject, than refer the reader to the excellent article on slow roasting and slow boiling, in Miss Acton’s Modern Cookery Book.
Every person who has been upon the continent can appreciate the difference between the English and the French method of stewing meat. There is not, for a lady out of health, a more wholesome and digestible little dish than a mutton-chop, deprived of all its fat, and placed in a small saucepan with a table- spoonful of water. No more seasoning should be allowed than a little pepper and salt; and in this condition, the lid being on the saucepan, it should simmer for at least TWO HOURS AND A HALF. At the end of that time it will be tender and surrounded with its own gravy. Or-
A lamb cutlet dressed in the same way, merely adding an additional spoonful of water, and fifteen or twenty minutes less time in stewing.
Another good and nourishing little dish, rendered by its mode of preparation suitable to the most delicate stomach, and well adapted for invalids, is to boil a nice young pullet till three-parts done, take off the skin, and cut off the meat when cold; then pound it to a paste in a marble mortar, adding to it a little of the liquor, if required; season with salt; a slice of lemon-peel, and one grate of nutmeg. Boil it gently till it gains the consistency of thick gruel; and drink it while warm.
Another important point connected with this part of the subject is the period of rest required after meal.
Raw, ripe fruits, such as grapes and strawberries, require little absolute rest.
Cooked fruits require a period of from half an hour to one hour.
Milk, and dishes prepared with milk, boiled or baked, require a period of one and a half to two hours.
Eggs, if plainly boiled-namely, about two minutes and a half-require a period of about an hour.
Dishes prepared with eggs, such as rice, vermicelli pudding or custard, require a period of about an hour and a half’s rest.
Animal Food.-Broiled meat requires a period of about two hours.
Roast meat, about two hours and a half.
Boiled meat, about three hours.
Fried fish, about an hour and a half.
Boiled fish, about two hours.
Roasted fowl, about three hours.
Boiled fowl, about three hours.
Game, about two hours, or less.
Meat broths, about the same period.
Farinaceous articles, about an hour.
Vegetables, about an hour and a half.
Next to the nature and quantity of the food, is the manner in which the patient partakes of her meals.
1. The appetite should be trained to return at stated periods by exact punctuality of meal hours.
2. The lady should come to meals calmly, and without being hurried or excited. She should eat slowly, without interruption, and without being irritated or excited by conversation, or the occurrence of any very pleasant or disagreeable news.
3. The food should be eaten, and the meal quite finished, before the patient partakes of any liquid. This should at all times be moderate in quantity.
PAINS, OR CRAMP OF THE STOMACH
Other distressing symptoms are acute pains, described either as a dragging at the back, a falling through, or giving way. These doubtless are occasioned by the sudden diversion of all the powers of vitality of one organ during gestation. That organ not only increases in size, but also enlarges its substance. Arteries, veins, absorbents, and nerves-structures which for the most part are of fixed formation, being appended to this viscus- suddenly become of much larger development. Other parts must therefore suffer, not only by the deprivation of their natural nutriment, but by the sudden growth of so large a body in the small cavity of a lady’s abdomen.
For dragging pains, however, Homoeopathy is prepared; and while the Allopathist stands confounded, she is fully armed for her relief.
The general practitioner listens to the tales told him about cramps in the stomach, smiles, and assures the lady she must bear, as well as she can, the pangs which are inseparable from her condition. He modestly accepts the fee for talking nonsense, and retires inflamed by the consciousness of having done his duty. He believes no earthly science can do more; but would he only fall back on “Nature’s grand law,” he would find that such agonies are to be successfully encountered by such remedies as Aconite, Belladonna, Nux Vomica, or Pulsatilla, in unappreciable doses.
By ACONITE, when there is a feeling of congestion experienced in the womb and other abdominal organs, with a full and frequent pulse.
By BELLADONNA, when there is a gnawing pressure or spasmodic tension in the abdomen, obliging the patient to bend backwards to seek relief.
By NUX VOMICA, when the pains were aching or crampy, and worse after food, or attended with nausea, flatulency, and constipation.
And by PULSATILLA, when the pains are of a stitching or crampy nature, attended with nausea, and even vomiting of food.
CARDIALGIA – PYROSIS – HEARTBURN
Another distressing sign of pregnancy is intense heartburn. occasionally, the secretion is of comparatively a bland nature; but in other instances it is peculiarly acrid. The stomach being loaded with this fluid, finds relief by vomition; but so pungent has been the fluid, that its passage has deprived the fauces of their protecting membrane; or not being thrown off, has even eaten through the very walls of the stomach.
For such a condition, Homoeopathy will administer Calcarea Carb., Arsenicum, Carbo Veg., Nux Vom., or Pulsatilla
Calcarea Carb,. when the symptoms are-
1. A slimy, insipid taste, slimy coating on the tongue.
2. A burning sensation in the stomach, acrid eructations, sometimes sour, at other times alkaline in taste; a feeling of pressure over the stomach, with vomiting of food and mucus.
The symptoms indicative for Arsenicum are characterised by a foul, bitter, or sour taste, a hot, burning sensation in the oesophagus and pharynx, eructation of sour acrid fluid, nausea, retching, and vomiting of slimy or stringy mucus tinged with blood; pain in the stomach, oppressive anxiety, trembling and coldness of the extremities; a small, irregular, and frequent pulse, with a peculiar anxiety of countenance.
Phosphorus, Pulsatilla, Nitric and Hydrochloric Acids are likewise valuable remedies in certain forms of Gastralgia: the former did good service in a case of the kind which came under my notice some months since: the two latter should be taken a brief period before meals.
There is not a more fatal error than that which tempts the lady to watch her bowels too attentively. A certain degree of constipation is in some patients natural to their condition, and therefore should not be too speedily interfered with; however, for the evacuation to be absent for the period of days or weeks, is essentially wrong and dangerous.
It is well known that, under the absorbing influence of gestation, a strange torpor often afflicts the lower intestines. The colon and rectum become loaded with dry and hardened faeces; and to such an extent have they been distended as to materially interfere with the process of labour, or to provoke even Peritonitis after the child has been born. Therefore, the lady in such a condition is entreated, for her own sake and that of her offspring, to encourage the habit on which the safety of both so much depends.
There is a moment when nature seeks relief; this should NEVER be neglected. Should, however, nature fail in her efforts, one of the following medicines, administered in accordance with the totality of the symptoms, will invariably succeed in giving the desired relief, viz. Alumina, Bryonia, Nux Vom., Opium. or Podophyllum Peltatum.
Alumina-When constipation appears to arise from an apparent absence of peristaltic action in the bowels, with hard, dry, and pale faeces.
Bryon.-When the same condition occurs in warm weather, particularly in persons prone to rheumatism, with a sensation of pressure in the stomach, bladder, or perineum; faeces hard, large, and devoid of mucus.
Nux Vom.-is a sovereign remedy when the cause may be traced to a want of power in the intestine to expel its contents; a kind of paralysis, with a sensation as if more had to be expelled, as if from constriction of the rectum, the faecal mass pale and lumpy in consistence.
Opium claims a priority in constipation when there exists a sensation as if the anus were firmly closed; a feeling of heavy weight in the lower part of the abdomen; the faeces hard, small, and round, like balls, either blackish or deeply discoloured.
Podoph. P.-When congestion of the liver exists, with a deficiency of bile in the intestines. In obstinate cases of constipation, and when urgent symptoms demand relief, i sometimes prescribe a “Lavement,” consisting of 10 or 12 ounces of warm soap and water (soapsuds); but to those who object to such an operation, a teaspoonful of castor-oil, or the same quantity of “Lenitive Electuary,” prepared according to the formula of the official Pharmacopoeia of this country, will frequently yield the desired result. In addition to such simple measures, a lady so circumstanced is advised to augment the proportion of vegetables and fruit, to drink a tumblerful of cold water night and morning, and to take moderate exercise in the open air.
FASTIDIOUS TASTE – LONGINGS
The stomach, during gestation, is capable of influencing the imagination; therefore we have many and strange stories of what formerly were termed “Ladies’ Longings’. For such caprices regular medicine has no antidote. She can drag and tear the health to tatters, but with the mind it is her belief she has no business to meddle. She therefore leaves such fancies alone; and though unfortunate ladies have drunk vinegar and brandy to excess, or have eaten coals, cinders, common salt, or chalk, until their bowels became clogged, the doctor did nothing to relieve his client. She of course perished, having no strength when the season of labour arrived.