Mother's Remedies, Thomas Jefferson Ritter [reading well .TXT] 📗

After the womb has been kept in a state of contraction, the room should be rid of all evidences of labor and the woman made comfortable. The buttocks and thighs which have been soiled during the labor should be bathed with warm water and soap and the external genitals sprayed with an antiseptic solution, then dried with sterile gauze or cotton, the dressing applied to the vulva and the temporary bed removed, her night dress pulled down and the patient thus lying in a clean, comfortable bedding. The woman may then have a cup of weak tea, hot milk or broth and be left to rest; but during the first sleep the womb should be carefully watched lest it relax and serious, if not fatal, bleeding occur. In a normal confinement the dressings need not be changed, as a rule, oftener than six times in twenty-four hours, for the first few days. As soon as convenient after the first toilet is finished the physician sterilizes his hands and with the patient on her left side introduces one finger into the rectum and the thumb into the vagina to discover the condition of the perineum. Washing out of the vagina is not necessary as a rule. [OBSTETRICS OR MIDWIFERY 537]

The binder is considered indispensable, and should be made of unbleached muslin and wide enough to extend from the pubic (bone) to the breast-bone, and long enough to go around the patient's body and slightly lap. The binder should be pinned or sewed tightest in the middle, but it should not be so tight as to press upon the womb and crowd it backward or to either side. It acts as a splint to the muscles and assists in resting them to their natural condition.

Rest.—Complete rest of the body and mind is essential to the well being of the lying-in woman. She is better off without any company, and should see no one except her family for the first week or two. Outside visitors should be prohibited. The lying-in room should be kept free from noise and confusion, and the patient should be protected from annoyances of every kind. She should remain lying on her back for a few days and immediately following delivery she should not have a pillow for her head. Sleep is very necessary and desirable, and mild medicines should be given to produce it, if necessary. It is best not to sit up in the bed until the womb shall have had time to become smaller, and has resumed its natural position behind the pubis. Among the upper classes, when it takes the womb longer to regain its normal size, three weeks is a good rule to go by before sitting up in the room, and she should remain in her room until the end of the fourth week. Among healthy women of the laboring class, whose muscular system has not been injured by "culture" and social excesses, the womb and appendages regain their normal proportions more rapidly; but even they should remain in bed two weeks.

AFTER-PAINS.—Women who have borne children frequently suffer from the after-pains, occurring at irregular intervals, for two or three days and they may give rise to much distress. A few drops of spirits of camphor on a lump of sugar will often give relief when they are not severe. Also a drop of tincture of blue cohosh taken every two or three hours is valuable.

THE BLADDER.—If the patient is not able to pass urine it should be drawn once in eight or twelve hours or oftener if required. A No.7 rubber catheter is best. After it has been used, it should be sterilized by boiling and then kept in a bichloride solution (1-2000). It should be washed off with boiled water again before being used to remove the bichloride solution and greased with sterile oil. The parts should be exposed to pass the catheter, the labia separated by the finger and thumb, and the opening of the urethra and surrounding parts bathed clean with an antiseptic solution; unless you are clean decomposing discharges from the vagina may be introduced into the bladder and a cystitis set up. The care of the bladder is very important. It is not so sensitive after the labor and the woman may have urine when she does not think so. Sometimes she passes a little after trying and then thinks there is no more in the bladder. Even the attendants are deceived sometimes. I once had a case where the mother was the nurse. At each visit I inquired as to the amount of urine passed. I was told each time it was sufficient. She suffered severely the second day in the evening. I went to see her and against the protests of the mother I used the catheter and took away an enormous quantity of urine. In such cases the bladder should be emptied slowly to save the woman from shock.

A physician cannot always depend upon the patient's knowledge of her condition even in such matters and sometimes even the nurse is at fault.

[538 MOTHERS' REMEDIES]

THE BOWELS.—There should be a movement of the bowels the second or third day, and a soap and water enema containing a small teaspoonful of spirits of turpentine and one-half ounce of glycerin, will usually be sufficient. Later cascara cordial, castor oil, etc., may be used. Should the breasts be much swollen and painful and fever arise, saline laxatives are needed for two or three days, such as citrate of magnesia, rochelle salts, hunyadi water or seidlitz powder may be given.

Care of the Breasts.—Careful attention should be given them from the first. The nipples should be bathed after labor, with an antiseptic lotion (bichloride, 1-2000), dried and then covered with castor oil, a small square of clean sterile gauze being laid over each to protect the clothing. Bathe the nipples before and after each nursing with a warm saturated solution of boric acid and dry them carefully. The breasts may be supported by a binder, made of a strip of muslin sufficiently wide to extend from above to well below the breasts. If they are heavy and sagging place a layer of cotton at the outer border of each breast and they should be raised toward the middle line, the binder being pinned only tight enough to hold without pressing upon them. The breasts should not be pressed upon by anything. Shoulder straps can be pinned or sewed on the binder if it has a tendency to slip down. Should the breasts be much swollen relief can be obtained by massage with warm olive oil and by the use of a breast pump. The tips of the fingers only should be used in giving massage and the stroke should be light, from the circumference to the center. Roughness and pressure must be avoided.

INFLAMMATION OF THE BREAST, Abscess; Broken Breast.—This usually results from germs. The breast inflames, the milk tubes are choked and distended, there may be fever. There is sometimes severe local pain, hard swelling and an abscess forms and if this breaks it is called broken breast.

[OBSTETRICS OR MIDWIFERY 539]

Treatment, Preventive.—Support breast with a binder. The milk should not be allowed to accumulate and cake. The breasts and nipples should be kept clean and dry. Breast pump should be used if necessary to get out the surplus milk. If the lumps continue and are painful, put cold applications to the breast. Have child nurse at the other breast. If it continues and will suppurate, apply moist heat, such as fomentations or poultices, and then open thoroughly. Poke root makes a splendid poultice for caked breasts. I have great faith in it. At the same time I give of the tincture one drop doses every hour. It is a splendid remedy and the poultice and remedy frequently stop the trouble. Inflammation of the breasts sometimes occurs in babies, generally in the first weeks. The swelling can be reduced by mild rubbing with warm carbolized oil used every day. Do not rub hard enough to hurt the baby. After the rubbing, absorbent cotton with carbolized oil should be applied and cover all with a thick layer of cotton held on with adhesives. If the breasts form pus they must be opened.

MOTHERS' REMEDIES. 1. Sore Breasts, a Never-Failing Remedy for.—"Take a pint of raw linseed oil and four ounces tincture of camphor, mix and apply a cloth saturated in the liniment to the affected parts, taking care that the whole surface of the inflamed parts is covered with the liniment. When the breasts become swollen or painfully inflamed, apply the liniment often to prevent gathering." Even if they have gathered it is an excellent outward application. It allays pain, is extremely soothing and seldom fails to effect a cure.

2. Swollen Breasts, an Herb Treatment for.—"Chamomile flowers one ounce, marshmallow roots one ounce, bruise and boil in one quart of water down to a pint. Foment the breast with this liquor as hot as can be borne; and then place the flowers and roots in a cloth and apply as a poultice."

3. Sore Breasts, a Hot Poultice for.—"Apply hot pancakes made of sour milk, saleratus and wheat flour, large enough to cover affected parts. Keep them changed often enough, so they will not be cold. This is an excellent remedy to steam out the inflammation." This is an old tried remedy and one to be relied upon. The steaming relieves the swelling and inflammation and gives relief quickly.

4. Caked Breasts, Fresh Hops for.—"Fry one pint of fresh hops in a half cup of lard until the lard is a rich brown, then strain, set away to cool and use as a salve."

5. Sore Breasts, a Poultice of Peach Leaves for.—"Take enough peach tree leaves to mix well with meal and water to the consistency of a poultice." This poultice should be applied hot, but should only be used in cases where the breast has matter or pus in it.

MOTHERS' REMEDIES.—l. Sore Nipples, a Good Wash for.—"Brandy and water mixed together and put on the nipples will harden them but should be washed off before the child nurses. If they are cracked, apply glycerin with starch, or arnica ointment."

2. Sore Nipples, Good Family Ointment for.—"Four ounces of white wax, one ounce bayberry wax, three ounces of spermaceti, one pint olive oil. Mix briskly over a slow fire, taking care to stir it briskly until cool." This is an excellent ointment for mothers when troubled with sore nipples; it moistens the skin and forms a coating. It is good for dry, scurvy, chapped hands, blotches on the face and all sores which require a mild ointment, but should be assisted with internal remedies when the case requires it.

[540 MOTHERS' REMEDIES]

The Lochia.—By this term is meant the discharges from the womb and soft parts after labor. They are mixed with blood at first and contain dark clots, mucus, shreds of the after-birth and pieces of the membrane. They become paler in color from the end of the third to the sixth day. After this the color is yellow, greenish and contains pus and fatty cells, with a little blood. This discharge varies in different women. In those who menstruate freely and do not nurse they are usually copious; when decomposed, they smell badly and the odor is penetrating. The flow may cease entirely between the second and sixth week. It is increased by exertions at about the time the patient begins to move about.

Diet.—This should consist at first of liquid, unstimulating food, given in small quantities and frequently. If the baby does not nurse, the liquids should be restricted. Some women on the first day can take milk, milk toast, or if desired, dry or buttered toast with coffee, tea, weak cocoa, according to the patient's taste. Water may be given if desired. On the second and third days, simple soups or any of the following may be added to the dietary: Meat broths, beef tea, soft boiled or poached eggs, raw or stewed oysters (no vinegar or spices) and some simple dessert, such as boiled custard or junket. During the next few days, chicken (white meat), scraped beef or mutton in small quantities, baked potato, rice and cereals may be given and by the end of the week a gradual return to the ordinary diet may be made. Should there be any tendency to constipation, the bowels should be opened by a simple enema (as before stated) or glycerin enema, etc.; or by one or more doses, 2 drams, of the compound licorice powder repeated in three or four hours, if necessary; or a half ounce of castor oil, or a half glass of hunyadi water. Cooked fruits for the constipation may also be given.

Bleeding After Delivery, Post-Partum Hemorrhage.—Bleeding