DIRECTIONS FOR SAVING URINE SPECIMENS

Beginning with the second voiding of urine after rising on the morning of the day you are to save the specimen, save all that is pa.s.sed during the following twenty-four hours, including the first voiding on the second morning. Measure carefully the total quant.i.ty pa.s.sed in the twenty-four hours. Shake thoroughly so that all the sediment will be mixed, and immediately after shaking take out eight ounces or thereabouts for delivery to the physician the same forenoon. The following items should be noted, and this memoranda should accompany the specimen:

1. Patient's name.

2. Address.

3. This specimen was taken from a twenty-four hour voiding of urine, which began at .... A.M. ...., and ended at .... A.M. ....

4. The total quant.i.ty voided during this twenty-four hours was ....

pints.

This specimen should reach the laboratory by ten o'clock the same morning.

It is of utmost importance the specimen should be taken to your physician every two weeks, and oftener if conditions indicate it. Take it yourself at the appointed time.

THE BOWELS

Owing to the increasing pressure exerted upon the intestines, most expectant mothers experience a tendency to sluggish bowels and constipation. This unpleasant symptom is usually increased during the later months.

In the first place, a definite time must be selected for bowel action.

It may ofttimes be necessary, and it is far less harmful, to insert a glycerine suppository into the r.e.c.t.u.m, than to get into the enema habit. The injection of a large quant.i.ty of water into the lower bowel will mechanically empty it; but the effects are atonic and depressing as regards future action.

Before we take up the advisability of taking laxatives let us consider what foods will aid in combating constipation. The following list of foods are laxative in their action and will be found helpful in overcoming the constipation so often a.s.sociated with pregnancy:

1. All forms of sugar, especially fruit sugar, honey, syrup, and malt.

All the concentrated fruit juices. Sweet fruits, such as figs, raisins, prunes, fruit jellies, etc.

2. All sour fruits, and fruit acids: Apples, grapes, gooseberries, grape fruit, currants, plums, and tomatoes.

3. Fruit juices, especially from sour fruits: Grape juice, lemonade, fruit soup, etc.

4. All foods high in fat: b.u.t.ter, cream, eggs, eggnog, ripe olives, olive oil, nuts--especially pecans, brazil nuts, and pine nuts.

5. b.u.t.termilk and koumiss.

6. All foods rich in cellulose: Wheat flakes, asparagus, cauliflower, spinach, sweet potatoes, green corn and popcorn, graham flour, oatmeal foods, whole-wheat preparations, bran bread, apples, blackberries, cherries, cranberries, melons, oranges, peaches, pineapples, plums, whortleberries, raw cabbage, celery, greens, lettuce, onions, parsnips, turnips, lima beans, and peanuts.

White bread should be tabooed, and in its place a well-made bran bread should be used. Two recipes for bran bread follow, one sweetened and containing fruit, the other unsweetened:

BRAN BREAD RECIPES

1. Two eggs, beaten separately; three-fourths cup of mola.s.ses, plus one round teaspoon of soda; one cup of sour cream; one cup of sultana seedless raisins; one cup of wheat flour, plus one heaping teaspoon baking powder; two cups of bran; stir well and bake one hour.

2. One cup of cooking mola.s.ses; one teaspoon of soda; one small teaspoon of salt, one pint of sour milk or b.u.t.termilk, one quart of bran, one pint of flour. Stir well, and bake for one hour in a very slow oven. It may be baked in loaf, or in gem pans, as preferred. The bread should be moist and tender, and may be eaten freely, day after day, and is quite sure to have a salutary effect if used persistently.

The drinking of one-half gla.s.s of cold water on rising in the morning often aids in keeping the bowels active. Of the laxative drugs which may be used at such a time, cascara sagrada and senna are among the least harmful. Two recipes of senna preparation follow, and may be tried in obstinate cases:

1. _Senna Prunes._ Place an ounce of senna leaves in a jar and pour over them a quart of boiling water. After allowing them to stand for two hours strain, and to the clear liquid add a pound of well-washed prunes. Let them soak over night. In the morning cook until tender in the same water, sweetening with two tablespoons of brown sugar. Both the fruit and the sirup are laxative. Begin by eating a half-dozen of the prunes with sirup at night, and increase or decrease the amount as may be needed.

2. _Senna with prunes and figs._ This recipe does not call for cooking. Take a pound of dried figs and a pound of dried prunes, wash well. Remove the stones from the prunes and if very dry soak for an hour. Then put both fruits through the meat chopper, adding two ounces of finely powdered senna leaves. Stir into this mixture two tablespoons of mola.s.ses to bind it together, the result being a thick paste. Begin by eating at bedtime an amount equal to the size of an egg, and increase or decrease as may be necessary. Keep the paste tightly covered in a gla.s.s jar in a cool place. If the senna is distasteful a smaller quant.i.ty may be used at first.

CARE OF THE b.r.e.a.s.t.s

The b.r.e.a.s.t.s are usually neglected during the months of pregnancy, and as a result complications occur after the baby comes which cause no end of discomfort to the mother. If, during the pregnancy, the b.r.e.a.s.t.s are washed daily with liquid soap and cold water, and rubbed increasingly until all sensitiveness has disappeared, they may be toughened to the extent that no pain whatsoever is experienced by the mother when the babe begins to nurse. During the last month of pregnancy a solution of tannin upon a piece of cotton may be applied after the usual vigorous bathing. If the nipples are retracted they should be ma.s.saged until visible results are attained.

THE MENTAL STATE

Keep the mind occupied with normal, useful, and healthy thoughts.

Listen to no tales of woe. Stay away from the neighborhood auntie dolefuls. Keep yourself happy and free from all worry, care, and anxiety.

"Put no faith in fables of cravings, markings, signs, or superst.i.tions. They are all unfounded vagaries of ignorant old women and will not bear investigation."

Don't take drugs for worry and sleeplessness. Take a bath.

The secret of deliverance from worrying is self-control. Minimize your difficulties. Cultivate faith and trust.

The conditions which favor sound sleep are: Quiet, mental peace, pure blood, good digestion, fresh air (the colder the better), physical weariness (but not fatigue), mental weariness (but not worry).

When tempted to borrow trouble, when hara.s.sed by fict.i.tious worries, remember the old man who had pa.s.sed through many troubles, most of which never happened. Train the mind to think positive thoughts.

Replace worry-thought with an opposite thought which will occupy the mind and enthuse the soul. Drive out fear-thought by exercising faith-thought. Cultivate the art of living with yourself as you are, and with the world as it is. Learn the art of living easily. a.s.sociate with children and learn how to forget the vexing trifles of everyday life.

There is something decidedly wrong with one's nerves when everybody is constantly "getting on them." They are either highly diseased or abnormally sensitive. Every woman is a slave to every other that annoys her.

Fear is capable of so disarranging the circulation as to contribute to the elevation of blood-pressure--which will be more fully considered in a later chapter.

CHAPTER V

COMPLICATIONS OF PREGNANCY

It is the purpose of this chapter to take up the various complications which may appear in the course of an otherwise normal pregnancy, and offer advice appropriate for their management.

MORNING SICKNESS

About one-half of the expectant mothers that come under our care and observation, experience varying degrees of nausea or "morning sickness." This troublesome symptom makes its appearance usually about the fourth week of pregnancy and lasts from six to eight weeks.

On attempting to rise from the bed, there is an uncomfortably warm feeling in the stomach followed by a welling up into the throat of a warmish, brackish tasting liquid which causes the patient to hasten to rid herself of it; or, as she rides on the train, on the street cars, in a carriage or automobile, she frequently senses the same unpleasant and nauseating symptoms during the second and third months of pregnancy. Normally, this uncomfortable symptom quite disappears by the end of the third month. A number of remedies have been suggested for it, but that which seems to help one, gives little or no relief to another; we therefore mention a variety of remedies which may be tried.