Note 27 — ON THE DISEASES OF PREGNANCY, AND HINTS FOR THEIR PREVENTION AND RELIEF.

There are one or two complaints to which the pregnant female is subject, upon which a few remarks seem advisable. Speaking of headache, Mr. Fox remarks:—

“Headache, independent of accidents, may be a sympathetic affection arising from disorders of the digestive, or other organs. It may be the consequence of a feeble, or disturbed state of the nervous system: or it may be the effect of the vessels of the head being distended with too much blood; or even of a deficiency of blood in the head.

“Where headache arises from a disordered condition of the digestive organs there will generally be an inactive, or irritable, state of the stomach or bowels, which will frequently be accompanied by giddiness, imperfect vision, or by specks floating a short distance from the eyes, by loss of appetite, sickness, acidity of the contents of the stomach, and by flatulence.

“If the stomach be loaded with undigested, or irritating food, it is to be relieved by a gentle emetic. Having drunk a pint of warm chamomile tea, or common tea from one ounce to one ounce and a half of ipecacuanha wine should be taken, after which vomiting will ensue almost immediately, and without any straining, or painful effort. If ipecacuanha wine is not at hand, two or three teaspoonfuls of powdered mustard, mixed in a little water, may be used in its stead.

“In almost every case, it will be found necessary to administer mild aperients every four or five hours, till the bowels are emptied. The aperients may be, rhubarb and Castile soap, of each one drachm, oil of cloves six drops, mixed with a simple syrup, and divided into thirty pills, of which from three to six are to be taken every four or five hours, till the bowels act. Where no disposition to pills exists, from one to two table spoonfuls of compound decoction of aloes may be taken every four or five hours, till the bowels are relieved freely. Where much acidity in the stomach is present, from fifteen to twenty grains of magnesia, combined with six grains of powdered rhubarb, and the same quantity of ginger, may be substituted for the above aperients, and repeated in a similar manner.

“If the pain in the head continues to be severe, after an emetic has operated, or before the aperients begin to act, it will be often greatly mitigated by taking a moderate dose of some opiate; this, however, should not be employed where attacks are frequent, as a habit of taking opiates is productive of much injury.

“There are persons who do not experience relief from opiates, but on the contrary, have the pain aggravated by their use. Strong green tea, or hop tea, will occasionally give relief in mild attacks, or where decided opiates are not productive of benefit.

“Where a feeble, or disturbed state of the nervous system gives rise to headache, aperients are to be taken as recommended above; and stimulants are to be employed, as camphor, ammonia, compound tincture of valerian, æther, &c.

“Four grains of carbonate of ammonia, or fifteen or twenty drops of spirit of hartshorn, are to be mixed in a wineglassful of camphor julep.

“One or two teaspoonfuls of compound tincture of valerian are to be added to a wineglassful of water, or camphor julep.

“From twenty to forty drops of æther are to be mixed in a wineglassful of water or camphor julep.

“Any of the foregoing forms may be taken several times during every twenty-four hours, if necessary.

“If the head is hot, linen wet with vinegar and water, or eau de Cologne and water, is to be repeatedly applied to the temples and forehead; or those parts may be occasionally moistened with æther, the evaporation of which will cause the head to become cool.

“Where reducing the temperature of the head does not diminish the pain, it will be well to try the effect of heat, which may be accomplished in the following manner: pour a little æther into the palm of the hand, and apply it to the forehead, or temples. The heat will be kept up so long as the hand is pressed to the part, and any of the æther remains.

“In severe cases of headache, the patient is to lie perfectly quiet, with the head moderately raised by pillows, and the room is to be darkened.

“If the feet are cold, they should be put into warm water; and if they have a disposition to become chilled again soon, they are to be kept warm by heated flannels, or bottles filled with hot water.

“During an attack of headache, arising from disordered digestive organs, it is essential that the food be very simple, and small in quantity.

“In headache, from nervous disorders, requiring stimulants, the food may be of a nutritious quality; the quantity, however, should be moderate.

“The foregoing remarks apply to sudden, or severe attacks of headache. When slighter affections of the same nature often occur, strict attention to diet, exercise, and the use of aperients, as recommended in a previous chapter, will greatly tend to mitigate the suffering, and to keep off the complaint altogether.

“Where headache comes on in consequence of fulness of the blood-vessels of the head, it will be indicated by a sense of weight within the skull, drowsiness, giddiness, particularly on stooping, sickness, ringing or other sounds in the ears, and bright flashes, or sparks in the eyes. In these cases, it will generally be necessary to bleed the temples with eight or ten leeches; and if their application to those parts is known to produce swelling of the eyes and face, the leeches may be placed behind the ears. The head is then to be kept cool by applying cold vinegar and water to it; and purgatives are to be administered.

“The diet is to be very simple, animal food is to be avoided, and no stimulants are to be taken.

“Headache may arise from whatever induces debility. It is generally experienced where great loss of blood has taken place, and it may seem singular that the symptoms and sensations of this kind of headache, appear to be the consequence of the vessels of the head having too much blood in them. For instance, there are usually noises resembling the violent beating of a hammer, the rushing of water, the blowing of wind, ringing, &c. It is therefore necessary to notice the condition of the system, to be enabled to decide whether the pain arises from a deficiency, or from an over supply of blood to the head.

“A correct decision should be formed upon this point, by ascertaining whether there is a disposition to fulness of the system, or a state of emptiness of the vessels from great loss of blood, with general debility.

“In the latter case, quietness is most essential: wine and other stimulants, will be necessary; together with a light nutritious diet.

“Opiates also will generally be found requisite, such as have been previously enumerated in this chapter.

“In all cases of headache, mental tranquillity is of much importance; and the patient should not persevere in the pursuit of any occupation which materially increases the pain.

“In this disorder, as well as in many others, accompanied by much irritability, the sleep is often seriously interrupted by slight noises; in most cases, this may be prevented by stopping the ears with small plugs, three quarters of an inch in length, and about one quarter of an inch in diameter. If the plugs be made of white wax, they will generally answer the best, as they admit of being accurately moulded to the form of the openings of the ears. Plugs made of turned wood will sometimes be sufficient.

“If such plans as the foregoing do not soon give relief, medical advice should be had, especially where it is supposed that there is too much blood in the vessels of the head.

“Tenderness and irritability of the external parts sometimes come on to an almost intolerable extent, in consequence of inflammatory action. They are most effectually relieved by bathing the parts occasionally with cold or hot water, or decoction of poppy-heads, or of laurel leaves, and by using a soothing lotion. The soothing lotion may be made of two drachms of acetate of lead, commonly called sugar of lead, and an ounce of laudanum, in seven ounces of water. It may be applied three or four times during every twenty-four hours.

“In these troublesome affections the bowels must be kept rather more active than usual by gentle aperients. The aperients to be, from two to four drachms of Epsom salts. From one to two teaspoonfuls of electuary of senna. From one to two spoonfuls of castor oil. Or from fifteen to thirty grains of magnesia. Any of which may be taken every second night, or every night, as circumstances may require. The diet should be mild, and there must be a total abstinence from spirit, wine, and malt liquor. If these means fail to give the desired relief, it will be advisable to bleed the parts occasionally with six or eight leeches, and to apply poultices of the same kind, and in the same manner, as recommended in another chapter.

“A discharge frequently appears from the passage, which is either white, or slightly tinged with green, or blood; in such cases, the parts are to be washed, or the passage injected with a syringe, twice daily, with tepid milk and water, or a weak solution of alum in water. For the wash or injection, twelve grains of alum may be dissolved in six ounces of water, and about two tablespoonfuls injected at each time.

“Means should be used to secure the regular action of the bowels, by employing mild aperients and injections, as previously recommended.

“More vigorous measures than the above might be productive of much mischief.”