The Ladies Book of Useful Information, Anonymous [rocket ebook reader txt] 📗

twelfth week, and toward the seventh month; and the liability is increased at those times which correspond to the menstrual period. When abortion has once taken place it is more likely to occur again, and some have so strong a tendency to it that they never go beyond a certain stage, but then invariably miscarry. THE CAUSE OF ABORTION

may exist in the constitution of the female herself, being the result of weakness and irritability, or of an overfull habit or a diseased condition of the womb; or the fœtus, or child, may die or be deficient in development, when it is cast off like a blighted fruit. Suckling after conception has taken place is not infrequently a cause of miscarriage. Active diseases occurring during pregnancy, such as fevers, severe inflammation, eruptive fevers, etc., are almost certain to occasion the expulsion of the uterine contents. Continued diarrhœa and the action of strong purgative medicines, particularly the aloetic, are dangerous. This is a very good reason for those who are pregnant avoiding all quack aperient medicines; they almost all contain aloes, and may be very injurious. All undue exertion or agitation of body or mind, sudden jerks or jumps, riding on horseback in the early stage, or in a shaking carriage in the latter stages of pregnancy, may any of them bring on miscarriage. To these may be added: exertion of the arms in doing anything on a level above the head; costive bowels and straining consequent therein; sexual indulgence, or, in plain language, too much connection with your husband; and luxurious habits. Those who have once suffered from abortion ought to be extremely careful during succeeding pregnancies, and all ought to bear in mind the possibility of the occurrence.

THE SYMPTOMS OF THREATENED ABORTION

vary with the constitution. In the strong and plethoric it is often preceded by shivering and febrile symptoms and by a feeling of weight in the lower bowels. In the weak there is languor, faintness, flaccidity of the breasts, general depression, and pains in the back and loins. Intermittent pains, and discharge of blood from the passage, tell that the process has begun. If miscarriage occurs within the first month or two after conception, the process may be accomplished with so little inconvenience as to escape notice and be mistaken for a menstrual period. More generally, however, the severity of the pain and an unusual clotted discharge of blood render the case evident. The pain, the discharge, and, at the same time, the danger of an abortion, are in proportion to the advancement of the pregnancy. When a miscarriage goes on, the pains increase in force and frequency, and continue, with discharge of blood, fluid or in clots, until the ovum, or first formation of the child, is expelled; after which both become moderated till they cease altogether and the red flow gives place to a colorless one. It is very important that those in attendance upon the patient should examine every clot that comes away. If large, tear it in pieces, that they may ascertain whether the contents of the womb are expelled or not, for there is no safety or rest, where miscarriage is progressing, till it has taken place and everything is cast off.

AS SOON AS A FEMALE

experiences threatenings of abortion she ought at once to retire to bed, upon a mattress, and keep perfectly quiet till every symptom has disappeared. Sometimes this simple measure, promptly adopted, is sufficient to avert the threatened evil. If there is much feeling of fullness, and the patient is of full habit generally, eight or a dozen leeches may be applied to the lower part of the bowels; if there is fever, saline medicines may be given, such as the common effervescing draft of carbonate of soda and tartaric acid or lemon juice; or, if the bowels are much confined, seidlitz powders, assisting the action by cold clysters, if necessary. When the pains are severe, particularly in the weak and irritable, twenty or thirty drops of laudanum should be given, and may be repeated in a few hours if the symptoms are not improved. In the case of profuse discharge, the patient should be kept very lightly covered, movement avoided, and every article of food or drink given cold, or iced if possible, provided the vital powers are not excessively reduced. Cloths dipped in cold or iced water should also be applied to the lower part of the body and frequently changed. Acid drinks, with cream of tartar, may be freely given. Ten or fifteen drops of elixir vitriol may be given in a wineglassful of water every two or three hours. Should slight faintness come on, it is better not to interfere with it, but use outward remedies—camphor, cold water, vinegar, etc.—as they maybe salutary. If it reaches to an extent to threaten life, stimulants, as brandy and water, and others, must be had recourse to. Profuse and continued discharge, though it may not threaten life, must occasion a weakness which will take a long time to overcome, and which may ultimately, if not properly attended to, promote the development of other diseases of the womb.

IF THE FLOODING IS PROFUSE

and uncontrolled by the means before mentioned, one grain and a half of sugar of lead may be given every two or three hours, and washed down with a drink of vinegar and water, to which, if there is much pain, add from five to ten drops of laudanum.

Pieces of linen or cotton cloth should be soaked in a strong solution of alum, or a decoction of oak bark; and then well oiled; with this cloth plug the passage or birthplace; or, some of this astringent wash may be thrown up with a syringe.

But, during the time and after miscarriage, the general strength must be supported by a strengthening diet, such as soups, meat, etc., avoiding stimulants as much as possible. Nevertheless, in some cases wine or malt liquors may be necessary in convalescence, or when recovering, and if so may be assisted by tonic or strengthening medicines, such as contain mineral acid. Bark or iron are generally given as the most appropriate remedies. The bowels will, in some cases, require strict attention, as indeed they do throughout, and for this purpose castor oil is a good medicine, or clysters of cold or tepid water are most useful. A teaspoonful of Epsom salts dissolved in half a pint of water, either cold or slightly warmed, to which add fifteen drops of elixir vitriol, forms a most excellent and mild purgative, which should be taken before breakfast. In all cases where the constitution of the woman has a tendency to miscarriage or abortion, a quiet state of mind should be observed, avoiding all violent exertions, particularly lifting heavy weights. These principles of treatment are to be kept in mind in the management of miscarriage:

The first, to prevent it, if possible, by rest, opiates, etc.

The second, to allay pain, moderate the discharge of blood, and to save and support the strength of the patient.

The third, when abortion must take place, to expedite the separation of the ovum and free the contents of the womb. This is generally done by simply occasionally drinking cold water, and in difficult cases, if necessary, by the administration of spurred rye. The dose is a strong infusion or tea given every twenty or thirty minutes until the desired effect is produced, as long as the stomach will bear it.

The health of pregnant females should at all times be an object of great care and interest; and they should be impressed with the conviction that while

BEARING THE FIRST CHILD

they may, by proper care and attention, lay the foundation for their future health and that of their offspring; while by neglect and imprudence in this matter, they may not only enfeeble their constitution, but entail upon their children an inheritance of infirmity and disease.

Miscarriage, or abortion, which includes all cases in which delivery takes place before the sixth month, seldom occurs without being preceded, or accompanied, or followed, by a morbid discharge of blood from the womb, which is commonly known by the name of flooding. Abortion, or miscarriage, takes place with the first pregnancy, and during the first two months; therefore, great care should be observed during this period, as any cause which either destroys the life of the child in the womb or brings on morbid or premature contractions in that organ may induce miscarriage. Coughing severely, or vomiting, a blow or fall, or a misstep leading to an effort to prevent falling, may, and does frequently, result in miscarriage; and this having once occurred, it is, without proper care, exceedingly liable to be the case again at the same period of a subsequent pregnancy. The same result may follow any vivid moral impression; for fright, or mental excitement by passion, or witnessing any accident, will be found often to end in miscarriage. In some healthy females, however, it occurs without any other cause than mere fullness of blood. A bleeding from the womb is often in such cases a first symptom of abortion, and should be attended to as early as possible before it goes to any considerable extent. The amount of flooding, in most cases, is in proportion to the early period of pregnancy at which it takes place, for in the latter months there is seldom much blood lost. But there are cases in which pregnant women will lose blood repeatedly from the womb and yet not miscarry, but these are very rare cases.

In most cases, the occurrence of a woman's flooding between the first and fourth months, unless very slight, or quickly relieved, is usually followed by a miscarriage; but as soon as the child and its membranes are both expelled by the contraction of the womb the flooding soon ceases. In many such cases it is often very difficult, and sometimes impossible, to deliver the afterbirth and membranes, which remain and finally pass off after putrefaction has taken place, resulting in long and offensive discharges from the womb, and which, unless treated by the most skillful management, frequently result in many internal mischiefs of a serious character, such as ulcers, cancers, etc.

In all cases, those who are constitutionally disposed to abortion, or have a tendency to miscarriage, should take great care to preserve a quiet state of mind and to avoid all violent exertion; and all active purgatives should be avoided, and exposure to great heat or cold, during the time of gestation or pregnancy.

When the miscarriage has really taken place, and the fœtus, or child, is expelled, together with the contents of the womb, the same precautions should in general be observed as in childbirth.

TO PREVENT MISCARRIAGE,

when it is threatened, or on the appearance of the first symptoms, the patient should lie down and be as quiet as possible; live on very light diet; bowels be kept freely open; and an injection of thirty drops of laudanum should be given in half a pint of slippery elm tea. Should flooding be present, cold lemonade should be drank freely, and cloths wet with cold or ice water applied to the thighs and lower part of the birthplace, which should be repeated until the flooding is relieved.

MEANS OF PREVENTING ABORTION.

To prevent abortion, women of weak or relaxed habit should use solid food, avoiding great quantities of tea, coffee, or other weak or watery liquors. They should go soon to bed and rise early, and take frequent exercise, but avoid fatigue. They should occasionally take half a pint of the decoction of lignum-vitæ, boiling an ounce of it in a quart of water for five minutes.

If of a full habit, they ought to use a spare diet and chiefly of the vegetable kind, avoiding strong liquors and everything that may tend to heat the body or increase the quantity of blood; and when the