3. MAY PROCEED FROM OTHER CAUSES.--But a ceasing-to-be-unwell may proceed from other causes than that of pregnancy, such as disease or disorder of the womb or of other {271} organs of the body--especially of the lungs--it is not by itself alone entirely to be depended upon; although, as a single sign, it is, especially if the patient be healthy, one of the most reliable of all the other signs of pregnancy.

4. MORNING SICKNESS.--If this does not arise from a disordered stomach, it is a trustworthy sign of pregnancy. A lady who has once had morning-sickness can always for the future distinguish it from each and from every other sickness; it is a peculiar sickness, which no other sickness can simulate. Moreover, it is emphatically a morning-sickness--the patient being, as a rule, for the rest of the day entirely free from sickness or from the feeling of sickness.

[Ill.u.s.tration: Embryo of Twenty Days, Laid Open.

_b_, the Back: _a_ _a_ _a_, Covering, and pinned to Back.]

5. A THIRD SYMPTOM.--A third symptom is shooting, throbbing and lancinating pains in, and enlargement of the b.r.e.a.s.t.s, with soreness of the nipples, occurring about the second month. In some instances, after the first few months, a small quant.i.ty of watery fluid or a little milk, may be squeezed out of them. This latter symptom, in a first pregnancy, is valuable, and can generally be relied on as fairly conclusive of pregnancy. Milk in the breast, however small it may be in quant.i.ty, especially in a first pregnancy, is a reliable sign, indeed, we might say, a certain sign, of pregnancy.

6. A DARK BROWN AREOLA OR MARK around the nipple is one of the distinguishing signs of pregnancy--more especially of a first pregnancy.

Women who have had large families, seldom, even when they are not pregnant, lose this mark entirely; but when they are pregnant it is more intensely dark--the darkest brown--especially if they be brunettes.

7. QUICKENING.--Quickening is one of the most important signs of pregnancy, and one of the most valuable, as at the moment it occurs, as a rule, the motion of the child is first felt, whilst, at the same time, there is a sudden increase in the size of the abdomen. Quickening is a proof that nearly half the time of pregnancy has pa.s.sed. If there be a {272} liability to miscarry, quickening makes matters more safe, as there is less likelihood of a miscarriage after than before it. A lady at this time frequently feels faint or actually faints away; she is often giddy, or sick, or nervous, and in some instances even hysterically; although, in rare cases, some women do not even know the precise time when they quicken.

8. INCREASED SIZE AND HARDNESS OF THE ABDOMEN.--This is very characteristic of pregnancy. When a lady is not pregnant the abdomen is soft and flaccid; when she is pregnant, and after she has quickened, the abdomen; over the region of the womb, is hard and resisting.

[Ill.u.s.tration: Embryo at Thirty Days. _a_, the Head; _b_, the Eyes; _d_, the Neck; _e_, the Chest; _f_, the Abdomen.]

9. EXCITABILITY OF MIND.--Excitability of mind is very common in pregnancy, more especially if the patient be delicate; indeed, excitability is a sign of debility, and requires plenty of good nourishment, but few stimulants.

10. ERUPTIONS ON THE SKIN.--Princ.i.p.ally on the face, neck, or throat, are tell-tales of pregnancy, and to an experienced matron, publish the fact that an acquaintance thus marked is pregnant.

{273}

11. THE FOETAL HEART.--In the fifth month there is a sign which, if detected, furnishes indubitable evidence of conception, and that is the sound of the child's heart. If the ear be placed on the abdomen, over the womb, the beating of the foetal heart can sometimes be heard quite plainly, and by the use of an instrument called the stethoscope, the sounds can be still more plainly heard. This is a very valuable sign, inasmuch as the presence of the child is not only ascertained, but also its position, and whether there are twins or more.

[Ill.u.s.tration: OUR KING.]

{274}

[Ill.u.s.tration]

Diseases of Pregnancy.

1. COSTIVE STATE OF THE BOWELS.--A costive state of the bowels is common in pregnancy; a mild laxative is therefore occasionally necessary. The mildest must be selected, as a strong purgative is highly improper, and even dangerous. Calomel and all other preparations of mercury are to be especially avoided, as a mercurial medicine is apt to weaken the system, and sometimes even to produce a miscarriage. Let me again urge the importance of a lady, during the whole period of pregnancy, being particular as to the state of her bowels, as costiveness is a fruitful cause of painful, tedious and hard labors.

2. LAXATIVES.--The best laxatives are castor oil, salad oil, compound rhubarb pills, honey, stewed prunes, stewed rhubarb, Muscatel raisins, figs, grapes, roasted apples, baked pears, stewed Normandy pippins, coffee, brown-bread and treacle. Scotch oatmeal made with new milk or water, or with equal parts of milk and water.

3. PILLS.--When the motions are hard, and when the bowels are easily acted upon, two, or three, or four pills made of Castile soap will frequently answer the purpose; and if they will, are far better than any other ordinary laxative. The following is a good form. Take of:

Castile Soap, five scruples; Oil of Caraway, six drops;

To make twenty-four pills. Two, or three, or four to be taken at bedtime, occasionally.

4. HONEY.--A teaspoonful of honey, either eaten at breakfast or dissolved in a cup of tea, will frequently, comfortably and effectually, open the bowels, and will supersede the necessity of taking laxative medicine.

5. NATURE'S MEDICINES.--Now, Nature's medicines--exercise in the open air, occupation, and household duties--on the contrary, not only at the time open the bowels, but keep up a proper action for the future; hence their inestimable superiority. {275}

6. WARM WATER INJECTIONS.--An excellent remedy for costiveness of pregnancy is an enema, either of warm water, or of Castile soap and water, which the patient, by means of a self-injecting enema-apparatus, may administer to herself. The quant.i.ty of warm water to be used, is from half a pint to a pint; the proper heat is the temperature of new milk; the time for administering it is early in the morning, twice or three times a week.

7. MUSCULAR PAINS OF THE ABDOMEN.--The best remedy is an abdominal belt constructed for pregnancy, and adjusted with proper straps and buckles to accomodate the gradually increasing size of the womb. This plan often affords great comfort and relief; indeed, such a belt is indispensably necessary.

8. DIARRHOEA.--Although the bowels in pregnancy are generally costive, they are sometimes in an opposite state, and are relaxed. Now, this relaxation is frequently owing to there having been prolonged constipation, and Nature is trying to relieve herself by purging. Do not check it, but allow it to have its course, and take a little rhubarb or magnesia. The diet should be simple, plain, and nourishing, and should consist of beef tea, chicken broth, arrowroot, and of well-made and well-boiled oatmeal gruel. Butcher's meat, for a few days, should not be eaten; and stimulants of all kinds must be avoided.

9. FIDGETS.--A pregnant lady sometimes suffers severely from "fidgets"; it generally affects her feet and legs, especially at night, so as to entirely destroy her sleep; she cannot lie still; she every few minutes moves, tosses and tumbles about--first on one side, then on the other. The causes of "fidgets" are a heated state of the blood; an irritable condition of the nervous system, prevailing at that particular time; and want of occupation.

The treatment of "fidgets" consists of: sleeping in a well-ventilated apartment, with either window or door open; a thorough ablution of the whole body every morning, and a good washing with tepid water of the face, neck, chest, arms and hands every night; shunning hot and close rooms; taking plenty of out-door exercise; living on a bland, nourishing, but not rich diet; avoiding meat at night, and subst.i.tuting in lieu thereof, either a cupful of arrow-root made with milk, or of well-boiled oatmeal gruel.

10. EXERCISE.--If a lady, during the night, have the "fidgets," she should get out of bed; take a short walk up and down the room, being well protected by a dressing-gown; empty her bladder; turn her pillow, so as to have {276} the cold side next the head; and then lie down again; and the chances are that she will now fall asleep. If during the day she have the "fidgets," a ride in an open carriage; or a stroll in the garden, or in the fields; or a little housewifery, will do her good, and there is nothing like fresh air, exercise, and occupation to drive away "the fidgets."

11. HEARTBURN.--Heartburn is a common and often a distressing symptom of pregnancy. The acid producing the heartburn is frequently much increased by an overloaded stomach. An abstemious diet ought to be strictly observed.

Great attention should be paid to the quality of the food. Greens, pastry, hot b.u.t.tered toast, melted b.u.t.ter, and everything that is rich and gross, ought to be carefully avoided. Either a teaspoonful of heavy calcined magnesia, or half a teaspoonful of carbonate of soda--the former to be preferred if there be constipation--should occasionally be taken in a wine-gla.s.sful of warm water. If these do not relieve--the above directions as to diet having been strictly attended to--the following mixture ought to be tried. Take of:

Carbonate of Ammonia, half a drachm; Bicarbonate of Soda, a drachm and a half; Water, eight ounces;

To make a mixture: Two tablespoonfuls to be taken twice or three times a day, until relief be obtained.

12. WIND IN THE STOMACH AND BOWELS.--This is a frequent reason why a pregnant lady cannot sleep at night. The two most frequent causes of flatulence are, first, the want of walking exercise during the day, and second, the eating of a hearty meal just before going to bed at night. The remedies are, of course, in each instance, self-evident.

13. SWOLLEN LEGS FROM ENLARGED VEINS (VARICOSE VEINS.)--The veins are frequently much enlarged and distended, causing the legs to be greatly swollen and very painful, preventing the patient from taking proper walking exercise. Swollen legs are owing to the pressure of the womb upon the blood-vessels above. Women who have had large families are more liable than others to varicose veins. If a lady marry late in life, or if she be very heavy in pregnancy--carrying the child low down--she is more likely to have distention of the veins. The best plan will be for her to wear during the day an elastic stocking, which ought to be made on purpose for her, in order that it may properly fit the leg and foot.

14. STRETCHING OF THE SKIN OF THE ABDOMEN.--This is frequently, in a first pregnancy, distressing, from the {277} soreness it causes. The best remedy is to rub the abdomen, every night and morning, with warm camphorated oil, and to wear a belt during the day and a broad flannel bandage at night, both of which should be put on moderately but comfortably tight. The belt must be secured in its situation by means of properly adjusted straps.

15. BEFORE THE APPROACH OF LABOR.--The patient, before the approach of labor, ought to take particular care to have the bowels gently opened, as during that state a costive state greatly increases her sufferings, and lengthens the period of her labor. A gentle action is all that is necessary; a violent one would do more harm than good.

16. SWOLLEN AND PAINFUL b.r.e.a.s.t.s.--The b.r.e.a.s.t.s are, at times, during pregnancy, much swollen and very painful and, now and then, they cause the patient great uneasiness as she fancies that she is going to have either some dreadful tumor or a gathering of the bosom. There need, in such a case, be no apprehension. The swelling and the pain are the consequences of the pregnancy, and will in due time subside without any unpleasant result.

For treatment she cannot do better than rub them well, every night and morning, with equal parts of Eau de Cologne and olive oil, and wear a piece of new flannel over them; taking care to cover the nipples with soft linen, as the friction of the flannel might irritate them.

17. BOWEL COMPLAINTS.--Bowel complaints, during pregnancy, are not unfrequent. A dose either of rhubarb and magnesia, or of castor oil, are the best remedies, and are generally, in the way of medicine, all that is necessary.

17. CRAMPS.--Cramps of the legs and of the thighs during the latter period, and especially at night, are apt to attend pregnancy, and are caused by the womb pressing upon the nerves which extend to the lower extremities.

Treatment.--Tightly tie a handkerchief, folded like a neckerchief, round the limb a little above the part affected, and let it remain on for a few minutes. Friction by means of the hand either with opodeldoc or with laudanum, taking care not to drink the lotion by mistake, will also give relief.

[Ill.u.s.tration: A PRECIOUS FLOWER.]

19. THE WHITES.--The whites during pregnancy, especially during the latter months, and particularly if the lady have had many children, are frequently troublesome, and are, in a measure, occasioned by the pressure of the womb on the parts below, causing irritation. The best way, therefore, to obviate such pressure is for the patient to lie down a great part of each day either on a bed or a sofa. She ought to retire early to rest; she should sleep on a hard {279} mattress and in a well-ventilated apartment, and should not overload her bed with clothes. A thick, heavy quilt at these times, and indeed at all times, is particularly objectionable; the perspiration cannot pa.s.s readily through it as through blankets, and thus she is weakened. She ought to live on plain, wholesome, nourishing food; and she must abstain from beer and wine and spirits. The bowels ought to be gently opened by means of a Seidlitz powder, which should occasionally be taken early in the morning.

20. IRRITATION AND ITCHING OF THE EXTERNAL PARTS.--This a most troublesome affection, and may occur at any time, but more especially during the latter period of the pregnancy. Let her diet be simple and nourishing; let her avoid stimulants of all kinds. Let her take a sitz-bath of warm water, considerably salted. Let her sit in the bath with the body thoroughly covered.

21. HOT AND INFLAMED.--The external parts, and the pa.s.sage to the womb (v.a.g.i.n.a), in these cases, are not only irritable and itching, but are sometimes hot and inflamed, and are covered either with small pimples, or with a whitish exudation of the nature of aphtha (thrush), somewhat similar to the thrush on the mouth of an infant; then, the addition of glycerine to the lotion is a great improvement and usually gives much relief.

22. [3]BILIOUSNESS is defined by some one as piggishness. Generally it may be regarded as _overfed_. The elements of the bile are in the blood in excess of the power of the liver to eliminate them. This may be caused either from the superabundance of the materials from which the bile is made or by inaction of the organ itself. Being thus retained the system is _clogged_. It is the result of either too much food in quant.i.ty or too rich in quality. Especially is it caused by the excessive use of _fats and sweets_. The simplest remedy is the best. A plain, light diet with plenty of acid fruits, avoiding fats and sweets, will ameliorate or remove it.

Don't force the appet.i.te. Let hunger demand food. In the morning the sensitiveness of the stomach may be relieved by taking before rising a cup of hot water, hot milk, hot lemonade, rice or barley water, selecting according to preference. For this purpose many find coffee made from browned wheat or corn the best drink. Depend for a time upon liquid food that can be taken up by absorbents. The juice of lemons and other acid fruits is usually grateful, and {280} a.s.sists in a.s.similating any excess in nutriment. These may be diluted according to taste. With many, an egg lemonade proves relishing and acceptable.

23. DERANGED APPEt.i.tE.--Where the appet.i.te fails, let the patient go without eating for a little while, say for two or three meals. If, however, the strength begins to go, try the offering of some unexpected delicacy; or give small quant.i.ties of nourishing food, as directed in case of morning sickness.

24. PILES.--For cases of significance consult a physician. As with constipation, so with piles, its frequent result, fruit diet, exercise, and sitz-bath regimen will do much to prevent the trouble. Frequent local applications of a cold compress, and even of ice, and tepid water injections, are of great service. Walking or standing aggravate this complaint. Lying down alleviates it. Dr. Shaw says, "There is nothing in the world that will produce so great relief in piles as fasting. If the fit is severe, live a whole day, or even two, if necessary, upon pure soft cold water alone. Give then very lightly of vegetable food."

25. TOOTHACHE.--There is a sort of proverb that a woman loses one tooth every time she has a child. Neuralgic toothache during pregnancy is, at any rate, extremely common, and often has to be endured. It is generally thought not best to have teeth extracted during pregnancy, as the shock to the nervous system has sometimes caused miscarriage. To wash out the mouth morning and night with cold or lukewarm water and salt is often of use. If the teeth are decayed, consult a good dentist in the early stages of pregnancy, and have the offending teeth properly dressed. Good dentists, in the present state of the science, extract very few teeth, but save them.