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Diseases of Pregnancy.There is therefore sometimes room for doubt as to just where the line should be drawn ; some uncertainty in determining what cases demand treatment, and in which ones no interference is required. This is especially true of those derangements manifested by the digestive organs. The morning sickness, already referred to, which is exhibited by almost all women to a greater or less extent in the early months of pregnancy, becomes at times the source of serious difficulty, and even apprehension. So long as the general health is not impaired thereby, it is certainly best not to attempt any interference with medicines. There is, indeed, a prevalent impression among the laity that morning sickness conduces to the success of the process ; an impression embodied by midwives in the saying that a sick pregnancy is a safe one. Yet at times this symptom becomes so violent that the woman's general health is evidently injured ; in such cases the sickness occurs not merely in the morning, but after every attempt to take food, no matter how bland and unirritating. In some of these cases it seems incomprehensible how the body can be sustained by the very slight amount of nourishment retained in the stomach. The most violent of these cases usually occur in first pregnancies Sometimes, too, the simple loss of food is aggravated by the violence of the effort occasioned in emptying the stomach - a violence which often causes anxiety, lest the womb also should be excited to expel its contents and abortion be the consequence. At other times the vomiting is very easily accomplished. In but few of these cases is there any notable emaciation or any interference with the development of the fætus; the usual history is, that after some weeks or months of constant distress, the vomiting ceases as suddenly and inexplicably as it began. At other times, however, there occur emaciation, pain in the stomach, the matters vomited are often mixed with bile, the breath is fetid, and the result is spontaneous abortion, unless this mode of relief be proposed and executed by the medical attendant. Treatment.- The remedies which have been proposed for the relief of the vomiting of pregnancy are innumerable - a fact which in itself indicates that none of them can be always relied upon. Indeed, it can scarcely be otherwise ; for the vomiting in this case is dependent not upon any disease of the digestive organs, but upon the presence of the fætus in the womb ; and so long as this condition remain all attempts to regulate the digestive organs by remedies addressed directly to them are likely to be attended with only partial success. Yet it is fortunate that only partial success is required, since if the vomiting can be restricted within certain limits there will be no interference with the pregnancy. It is best to begin by a regulation of the diet; by avoiding irritating food ; by confining the diet to liquid articles of food, at least in the morning. Indeed, it sometimes happens that the vomiting can be very largely relieved by the simple device of taking the breakfast in bed and not rising for an hour or two after breakfasting. In some cases milk and lime water, barley water, soups and broths are retained on the stomach, though everything else be rejected ; occasionally eggs will be well borne, though this is the exception ; sometimes while all warm or hot articles are rejected at once, cold food will be well borne. In short, no rules for diet can be laid down ; the stomach is at this time extremely capricious, and we can ascertain what will suit it best only by trial in each particular case ; but it is desirable to make such trial with various articles of diet before resorting to medicines. As to the remedies themselves, there is the same uncertainty of effect; sometimes a glass of mineral water taken before rising seems to secure the desired result ; or pieces of ice held in the mouth until melted ; brandy and soda, a whisky sling, or a glass of champagne have each, in individual cases, prevented vomiting. The alcoholic beverages are especially valuable for this purpose in those cases in which there is considerable weakness and emaciation. A happy result will sometimes be secured fry an effervescent draught, which is also desirable for the purpose of securing regular movements of the bowels. One of the most convenient of these draughts is made by dissolving in water one or two teaspoonfuls of the effervescent citrate of magnesia. If the vomiting do not yield to the use of these simple measures, it is desirable to secure the advice of the medical attendant, since most obstinate cases, which have resisted all changes of diet, and even a great variety of remedies, often yield to applications made directly to the mouth of the womb-a measure which must be, of course, referred to. the physician. A not infrequent annoyance of pregnancy is constipation. This habit, for it is oftentimes nothing more than a habit, is especially injurious during pregnancy, and great pains should be taken to avoid it. This does not imply that purgatives should be employed; indeed purgatives should be banished so far as possible /during pregnancy. It will be rarely necessary to employ any other means than simple regulation of the diet, regularity in taking air and exercise and in attending to nature's calls. The diet for this purpose should include ripe fruits and fresh vegetables, brown bread, oatmeal and the like ; if these measures be inefficient, enemas or the " cascara cordial " may be employed. An uncommon annoyance of the pregnant state is diarrhea; if severe or obstinate it should be checked, but otherwise does not require especial interference. In most cases no medicine is required ; by confining herself to milk, barley water, arrow root and rice for a day or two the patient will usually be relieved. At other times the cause is evidently indulgence in irritating food, some of which has remained in the bowels ; in these cases a tablespoonful of castor oil will usually remove the irritating matters, and thus quiet the diarrhea. A number of symptoms which occasion considerable annoyance and oftentimes anxiety, occur in the latter part of pregnancy, as the result of the pressure of the enlarged womb upon the veins. It is a familiar fact, that pressure upon the veins causes a swelling of those parts of the body below the point of pressure, as occurs in the end of the finger when a string is tied around the hand or the wrist. In the same way the pregnant womb presses upon the veins which pass into the body from the legs, and may thus cause a swelling of the lower limbs, usually beginning in the feet. This swelling is naturally greatest in the evening, after the woman has been all day erect', and has usually disappeared more or less when she rises in the morning. If no other symptoms occur to indicate interference with the general health, this swelling need occasion no anxiety, and usually requires no treatment if the woman will remain as quiet as possible, and avoid walking and standing. If, however, there be a swelling not only of the feet but also of the hands ; and if such swelling be accompanied by headache and disturbances of vision, especially if the pain be at the back of the head, and if, at the same time, there occur unusual feelings of languor and debility, there is cause for careful attention, for in these cases there is frequently more or less disorder of the kidney, which may occasion trouble before or subsequent to confinement; indeed, it is usually desirable to call the attention of the medical adviser at once to this condition, since serious mishap may be thereby averted. Another result of this pressure is the enlargement of the veins of the leg usually just behind and below the knee, resulting in the condition called varicose veins. This condition is especially liable to occur in women who have previously borne children ; sometimes the varicose veins disappear after confinement, since the cause - the enlargement of the womb-is now removed. Yet after two or three confinements this enlarged or varicose condition of the veins is usually permanent. If this enlargement of the veins cause pain, it will be advisable to support the skin. This may be accomplished most simply by applying an ordinary bandage, but most effectually by the use of an elastic stocking. This garment should be made to order by a surgical instrument maker, since if not accurately fitted it may do more harm than good. It is hardly necessary to add that the pain and annoyance can be greatly diminished if the patient will retain the recumbent posture or keep the feet elevated on a chair when sitting. During pregnancy women not infrequently suffer from enlargement of the veins in the lower part of the bowel, known as haemorrhoids, or piles. This condition occurs with especial frequency in those who suffer from constipation. It occurs indeed rarely if a movement of the bowels be secured every day. It is desirable, therefore, to avoid hæmerrhoids, by securing regular movements of the bowels. Sometimes, however, this does not suffice ; the haemorrhoids persist and occasion the loss of considerable blood at stool. In these cases there is also usually severe pain. Treatment.-Since haemorrhoids which originate during pregnancy usually disappear spontaneously after confinement, the object of treatment consists merely in the adoption of such measures as will make the patient comfortable until the end of pregnancy. An operation is not required, and may indeed be positively dangerous. The first object is, as has already been stated, to secure regular movements of the bowels, which may be accomplished by small doses of cascara cordial, or by injections of warm water every night. If complete relief be not thus obtained, an ointment made of tannin and opium may be applied to the part after each movement of the bowels. But first, if you want to come back to this web site again, just add it to your bookmarks or favorites now! Then you'll find it easy! Also, please consider sharing our helpful website with your online friends.
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