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WAWAR
GUNA
VERITAS
UNIVERSITY OF MICHIGAN
SCIENTIA
OF THE
PLURIBUS UND
SQUAERIS PENINSULAM AMOENAM
CIRCUMSPICE
WAT.
紧
​L
"Le Manuel Homœopathique d'Obstetrique, ou
secours que l'Art d'Accouchement peut tirer de
l'Homœopathie," of which the "AID TO MIDWIFERY” is
a translation, is a record of the long and varied expe-
rience of Croserio in this department of practice.
The high reputation of the Author makes unnecessary
any formal recommendation of the work itself, and from
having carefully gone over and compared the present
version with the original, I can safely say that he is
rendered into English with a critical exactness that
does credit to the translator.
E. C. WITHERILL, M. D.,
Prof. of Anatomy in Cleveland
Homœopathic College.
CINCINNATI, Oct. 22, 1852.
HOMEOPATHIC MANUAL
OF
OBSTETRICS:
OR
•
A TREATISE ON THE AID THE ART OF MIDWIFERY MAY
DERIVE FROM HOMEOPATHY.
96681
DOCT. camille
CROSERIO,
MÉDECIN DE L'EMBASSADE DE SARDAIGNE; MEMBRE DE LA SOCIÉTÉ
HAHNEMANNIENNE DE PARIS, ETC., ETC.
FROM THE FRENCH.
BY
M. COTÉ, M. D.
CINCINNATI:
MOORE, ANDERSON, WILSTACH & KEYS,
28 WEST FOURTH STREET.
1853.
Entered, according to Act of Congress, in the year 1852, by
MOORE & ANDERSON,
In the Clerk's Office of the District Court for the District of Ohio.
C. A. MORGAN & CO.,
STEREOTYPERS AND PUBLISHERS,
1
HAMMOND STREET.
TRANSLATOR'S PREFACE,
WE have translated the work which we here offer to
the Members of the Homœopathic school of medicine,
believing that it will supply a want very much felt,
especially by the younger members of our profession,
as there is as yet no work of the kind in the English
homopathic library.
With regard to the translation we can only say, that
we have endeavored to adhere as closely as possible to
the original text, believing that in a work of this kind,
the most literal translation which can be made, consis-
tent with the English idiom, must be the best.
For the rest, we trust to the great name of the author,
to his well-known candor, learning and long experience
to insure it a cordial welcome from that school of medi-
cine, of which he is one of the oldest as well as most
distinguished members.
M. COTÉ, M. D.
PREFACE.
THE title of this work sufficiently indicates that it is
not a treatise upon accouchements which we propose to
offer here to our brethren: the knowledge of the differ-
ent positions of the child and the operations which they
may call for are very well taught by professors of mid-
wifery; this part of medical science has not been influ-
enced by the errors of the imaginary theories which
have but served to lead astray for the last two thousand
years; they are purely physical facts which have been
well studied, ingeniously reduced to rules nearly certain,
and upon which, consequently, we presume our readers
sufficiently instructed. But what they have not been
able to learn, or rather that which they have very badly
learned from these professors, is the hygienic and medi-
cal treatment called for by the derangements of health
often experienced by women during pregnancy, child-
bed, etc., derangements for which the prescriptions of
the old practice are utterly absurd and contrary to the
laws of nature.
(vii)
viii
PREFACE.
A
We propose to exhibit, in so many separate chapters,
the treatment required by the woman during pregnancy,
labor, and lying-in, during lactation and weaning, and
also the treatment of the child.
We shall be as concise and as clear as possible, avoid-
ing all useless theories and displays of learning calcu-
lated rather to obscure than to facilitate a knowledge of
the subject.
If we perform well our task, we shall have rendered
an immense service to society, in contributing to the
strength and vigor of succeeding generations.
In order to understand and utilize this manual, it will
be necessary to be acquainted with the medical princi-
ples of Homœopathy, which must be studied in the
Organon of Homœopathic Medicine, by S. Hahnemann.
:
Vomitings..
Constipation..
Diarrhoea..
Colics
Lumbago
Ischuria....
TREATMENT Of Women during
Pregnancy...
Hygiene of pregnant Women..
Diseases of pregnant Women.. 10
Plethora.
12
12
False Pains
14 Prophylactics applied to chro-
14
15
15
Labor....
16 Hygienic Treatment.
17 Medical Treatment.
Sleeplessness.
Palpitation of the Heart
Syncope
Odontalgia.
Ptyalism....
Pains in the Breasts.
..
..
Coughs
Abortion.
•
··
INDEX.
•
CHAPTER I.
mities....
Dropsy of the Uterus.
PAGE
Longings.
Stitches in the Abdomen......
•
Oppression.
Swelling of the inferior Extre-
•
•
→ D
7
7
•
220
Moral Impressions, Terror,
Obstacles offered by the Child.. 72
Fear, Anger, Joy, and Grief.. 20 Treatment of the Mother after
21
Labor.....
Hemorrhages of the Uterus...
Cramps..
24
Varices and Hemorrhoides.... 24
Fissures in the Skin of the
Abdomen
Mole....
Retention of Urine.
Loss of Urine.
Ephelis.
Convulsions.
25
25
26
37
nic and hereditary Diseases. 47
Medical Treatment
during
•
17
Lipothymy...
18 Cerebral Congestion.
Convulsions....
18
19 Hemorrhages.
20 Obstacles opposed to Delivery
in the Passages through
which the Child proceeds... 69
·
PAGE
41
43
44
44
44
45
Retention of the Placenta..
Hemorrhage of the Uterus..
Convulsions..
Treatment of Women during
Lying-in...
Hygienic Treatment.
Medical Treatment.
49
54
56
58
59
61
65
Prolapsus and Inversion of the
Uterus..
111
75
75
76
79
2883
79
80
38
39 Contusion of the Vulva....... 84
82
*B
(ix)
X
INDEX.
Rupture of the Perineum.
Retention of Urine....
Incontinence of Urine.
Hemorrhoids...
Lochia......
Diminution of the Lochia.... 94
Augmentation of the Lochia..
Secretion of Milk, Lactation,
94
and the Breasts..
··
99
Weaning.
108
Consumption of the Nurse... 109
Abscess of the Breasts... 110
Diseases of the Nipples..
Metritis....
•
Miliaria of Women in Child-
bed....
Enlarged Abdomen..
Falling of the Hair...
Treatment of Infants.
113 Jaundice..
114
Diarrhoea
Puerperal Peritonitis...
119
Spasms of the Chest
Convulsions..
Phlegmasia Alba Dolens..... 124
Constipation
129
•
PAGE
•
•
•
84 Hernia....
136
86 Swelling of the Breasts..
88 Hiccoughs
136
88
Coryza..
137
91 Ophthalmia of the New-born. 137
Constipation..
Wakefulness
137
137
131
131
Continual crying without ap-
preciable cause..
Tetanus
Dentition
Erysipelas
Scald-head
138
Retention of Urine……….
138
Intertrigo or Excoriation.. 138
Aphthæ....
138
139
139
139
139
141
142
144
144
145
145
145
146
147
148
149
151
152
152
152
•
Hygienic Treatment.
132 Measles.
Antipsoric Prophylactics..... 133 Scarlatina.
Asphyxia.
134 Small-pox.
Vaccine..
134 Croup
Ecchymosis on the Surface of
the Cranium…..……….
Deformities, Monstrosities
135 Hooping-cough
Marks.
135 Phthisis Mesenterica.
Cyanosis...
135
Worms
Fevers..
Hardness of the cellular Tissue 136
...
·
•
..
132 Eruptive Diseases.
132 Miliaria..
··
••
··
..
..
...
PAGE
136
··
•
HOMEOPATHIC MANUAL
OF
OBSTETRICS,
OR
AID TO THE ART OF MIDWIFERY.
CHAPTER I.
TREATMENT DURING PREGNANCY.
PREGNANCY, the indispensable function for the preser-
vation of the species, is a normal state and would seem
to require no particular treatment; nevertheless, in this
state important changes take place in the different func-
tions or in the sensibility of the woman, rendering her
susceptible of various and peculiar derangements and
sufferings; art should point out the best precautions
against, and the simplest means of curing these.
HYGIENE OF THE PREGNANT WOMAN.
We need not point out the signs of pregnancy, they
are to be found in every treatise upon midwifery; but
from the moment when by the suppression of the menses,
the swelling or extraordinary hardness, or the prickling
of the breasts, some irregularities of taste, etc., the
woman may suspect the commencement of pregnancy,
she should remove at once every part of her dress which
can produce a compression upon the abdomen, parti-
cularly corsets and every description of belt: the evils
(7)
8
AID TO MIDWIFERY.
caused by the habitual compression of the body during
pregnancy both to the mother and child are incalcula-
ble: such as abortion, diseases of the womb, heart,
lungs, or brain, varices, hydrocephalus of the child,
and the unfavorable positions which, afterward, render
delivery so difficult. All these derangements may
be produced by the obstruction offered to the circula-
tion of the blood through the portal system and the
great arterial trunks and veins of the abdomen, by
the habitual pressure of the dress. Great care should
be taken that this, while adapted to the season, should
be such as to offer no obstruction to the gradual dilata-
tion and free movements of the abdomen.
The necessity of furnishing nourishment to the new
being developing within her, exacts, for the pregnant
woman, a nutriment substantial and easy of digestion,
because the sympathies which unite the stomach to the
uterus, the compression and uneasiness experienced by
the digestive organs in consequence of the extraordinary
increase of the volume of the womb, impairs often the
strength of these organs and renders digestion slow and
difficult.
Meats, boiled or roasted, farinaceous vegetables, the
ripe fruits of the season, in suitable proportion, consti-
tute the best aliment, and pure water the best drink.
Spices, wine, and above all, coffee and tea should be
proscribed with the greatest severity; the nervous sen-
sibility is so much developed in pregnant women that
these drinks are particularly injurious; one must not
suppose themselves obliged to satisfy the desire for hurt-
ful food of many pregnant women; at the same time
they should not be forbidden such as cannot be con-
sidered directly injurious to mother or child.
HYGIENE OF PREGNANT WOMEN.
9
The open air and exercise are also very necessary
during this period; they strengthen the constitution, con-
tribute to preserve health, and effect much more toward
an easy labor than the baths so much recommended by
allopathy. Baths should only be taken for cleanliness;
repeated too often and too much prolonged, they weaken
and are consequently hurtful. Homœopathy should
forbid them especially toward the close of pregnancy.
I should feel as if I were offering an insult to the
intelligence as well as to the humanity of my readers,
by seeking to warn them against the precautionary
bleedings still recommended during pregnancy by some
practitioners: to bleed a pregnant woman is a double
murder, or at least, an attempt at murder, that the laws
should punish, for it often kills the child and sometimes
the mother also.
Pregnancy acts in a perceptible manner upon the
morale of the woman by a great increase of suscepti-
bility; her imagination is more lively, she is more
easily frightened; it is necessary, therefore, to avoid
all violent emotion, as well of pleasure as of pain; to
repress the curiosity, often so great in this state,
when relating to subjects which might impress her too
vividly, the sight of ferocious animals, feats of strength,
etc., as this might prove as injurious to the mother as
to the child; for the same reason she should avoid the
sight of bad wounds, of all monstrosities as well as the
narration of events terrible or exciting.
Ought coition to be permitted to the pregnant woman?
Observation of the laws of nature in general seems to
answer in the negative; physiology supports also this
opinion, and experience has shown that infractions of
this rule have been followed by serious accidents, such
10
AID TO MIDWIFERY.
as metrorrhagia and abortion; however, the contrary
case happens every day. To this we may reply that
wise nature is stronger to preserve than our passions to
destroy; so that, as it is not reasonable to depend entirely
upon nature, when one can aid her by precautions, we
counsel parents, desirous of having children, to remain
separated from the time that they presume pregnancy to
exist, especially when the woman is of a nervous and im-
pressionable temperament, or subject to leucorrhea, or to
too abundant and long-continued or too frequent returns
of the menses.
DISEASES OF PREGNANT WOMEN.
We comprise under this denomination all the affec-
tions which result from the particular state of the uterus.
during gestation up to the moment of labor.
The uterus, which was, so to speak, but an impercep-
tible point in the organization of the woman, acquires,
after conception, an altogether new life, and takes such
a development in all its tissues and in its vital action,
that it attracts, as it were, the whole system into its
sphere and into dependence upon it. In a normal
state, however, all this immense revolution should take
place in the woman without uneasiness and without need
of help from art; often, however, the change in the state
of the uterus does not take place without considerable
suffering in this viscus, or in the organs which have
the most sympathy with it; such as the digestive, respi-
ratory, circulatory, and cerebro-spinal.
From the first weeks, even from the first days of preg-
nancy, the woman experiences uneasiness from the af-
flux of blood to the uterus, and the resistance opposed
by the fibers of this organ to the development necessary
DISEASES OF PREGNANT WOMEN.
11
for its new function: she has a feeling of weight
in the lower part of the abdomen, behind the pubis,
and a sensation of tension, often extremely painful, in
this region; frequent desire to urinate, lassitude in the
limbs, anxiety, palpitation, and a change in her moral
state. The old practice has only the abominable vam-
pirism of bleeding and the relaxing action of tepid baths
to oppose to these sufferings, as if the action of tepid water
could loosen the tissues of the living uterus, as it may
those of the dead body, or as if the bleedings could
draw off the blood which is carried in abundance to the
uterus, for the accomplishment of the function of the
formation of the new being developing within her!—the
most barbarous absurdity ever conceived by a diseased
brain. Hippocrates said that the woman who bled at
the nose would miscarry; but Allopathy, with perfect in-
difference, abstracts now a considerable quantity of blood
from the pregnant woman, without thinking of the con-
sequence that this subtraction must have upon the fruit
that she carries in her bosom, which only lives and
is nourished by the blood of the mother.
If bleeding is a fault in all diseases, it is a crime in
those of pregnant women, because it directly tends to
the destruction of the fœtus: it is necessary then to pro-
scribe always and without exception, sanguineous emis-
sions from the therapeutics of the diseases of pregnant
women, above all in the cases to which we allude,
which are only indispositions that nature ordinarily
cures alone; there are, however, cases more serious, which
might terminate in abortion if not properly treated.
The observation of the simple regimen described in
the commencement of this article, will suffice, ordinarily,
to prevent any accident; if however the suffering con-
12
AID TO MIDWIFERY.
tinues, we have a very efficacious medicine in Nux vom.
30th, one globule in a glass of water, a teaspoonful to
be taken every evening: if the woman is of a lymphatic
temperament, delicate, pale complexion, of a gentle and
timid character, Puls. should be given in the same
manner; Bell. would be preferable if there was at the
same time redness and heat in the face, with a ten-
dency of blood to the head.
PLETHORA.
Often, during the third month of gestation, the wo-
man is attacked with troublesome symptoms of ple-
thora; she experiences a heaviness in the head, vertigo,
particularly in stooping, the face is red and hot, the
limbs heavy and benumbed, especially at night, suffo-
cations, palpitations, sleepiness during the day, and
very heavy sleep at night. All these symptoms are
dissipated by one or two doses of Acon. 30th, taken at
intervals of two or three days; they should be followed
by a dose of Bell. 30th, if the pain and heat in the
head continues; or by Nux vom. if the digestive func-
tions are deranged.
VOMITING.
Pregnant women are almost always, we may say
without exception, troubled more or less with this in-
disposition; with by far the greatest number, it is the
first sign of pregnancy; in the morning from the mo-
ment of rising, they experience a sensation of nausea,
as if about to vomit; during the first days, this nausea
disappears in eating, but afterward continues after, and
even during the repasts; then come later efforts at
vomiting, and then vomiting of slime with or without
VOMITING.
13
effort, and after meals, especially in the morning, vomit-
ing of food. To these sufferings, which render preg-
nancy for the greater part of women so painful, the old
practice has nothing to oppose: what do I say, nothing?
It opposes bleeding!! Poor humanity!! Nux vom.
covers so completely all these primitive symptoms, that
a single dose of the 30th in a glass of water, a tea-
spoonful two or three times a day, takes away ordina-
rily, as if by enchantment, all these discomforts, so that
the woman passes through the remaining part of her
pregnancy without perceiving them. When the vomitings
are, so to speak, continual, when the woman rejects all
or the greater part of her food, when she vomits bile, pure
or mixed with slime, we should give three globules of Ipe-
cac.6th, three times a day until the symptoms are removed.
In a few very rare cases, the vomitings resist these
medicines; in these cases Sepia 30th, in eight teaspoons-
ful of water, one teaspoonful to be taken every morning,
particularly if there is in the vomitings a milky mucus;
if the woman is of a melancholy temperament, if she
is subject to sick headache or any derangement of the
uterus; in this last case, we may have recourse to
Conium in the same manner; this medicine succeeded
very well with me in the case of a lady that I had but
just cured of a scirrhus of the neck of the uterus, after
eighteen months' treatment when she became enceinte;
during her former pregnancies she vomited during the
whole period, in spite of (or in consequence of) the five
or six bleedings bestowed upon her; Nux vom., and
Ipecac., gave but temporary relief, a dose of Conium
cured her completely.
Women subject to vomitings should observe a severe
alimentary regimen, that is to say they should take in
2
14
AID TO MIDWIFERY.
preference meats boiled and roasted, few vegetables, and
abstain from fruits; a few spoonsful of old wine, after
meals may be useful for some.
CONSTIPATION.
Women, in consequence of their sedentary life in cities,
are generally subject to constipation, but this state is
much more habitual during pregnancy; although con-
stipation is much less hurtful than the contrary state, it
can commonly be remedied by a proper diet, by increas-
ing the proportion of vegetables and fruits, or in adding
the use of a glass of pure fresh water after rising in the
morning, and by proper exercise; if these precautions
do not suffice, a small injection (of three ounces) may
be taken every night on going to bed, and the practice
of going to the water-closet every morning should be
strictly observed.
If constipation should produce such effects as heat of
the abdomen, headache, weight in the anus, etc., we
should give Nux vom. 30th, in the evening, and await
its action four or five days. If the effect is not obtained,
we may give Sulph. 30th, in fifteen spoonsful of water,
one every evening. Bryonia 30th, in a glass of water,
a spoonful every two hours, beginning in the morning,
until the effect is experienced, has often succeeded with
me in rebellious constipation.
Puls. would be indicated if the constipation was
caused by rich and indigestible food.
DIARRHŒŒA.
Diarrhoea in pregnant women should not be neglected,
because it easily produces abortion; food light and in
small quantities, and repose should be recommended,
COLIC-
LUMBAGO.
G
15
and according to the symptoms, Puls. if the stools are
slimy, green or watery, preceded by colic, with the
mouth clammy, bitter, without thirst, chills; above all
if the evacuations take place principally at night.
Dulcam. if the diarrhoea has been produced by cold,
if there are mucus or green stools, and colic. If with
liquid stools, yellow or green, or like beaten eggs, the
mouth is bitter, with great thirst, and a desire to vomit;
or bilious vomitings with acute pain in the stomach
and abdomen, tympanites, and dicharge of flatulence, we
should give Cham. If the diarrhoea has become chronic,
Sulph. 30th, in water, one teaspoonful every evening, is
useful in the majority of cases; after this medicine,
Calcarea if the diarrhea continues, particularly if ac-
companied with hunger.
COLIC.
Care must be taken not to confound colic with false
labor-pains, a distinction very easy to make for one who
has seen even but a very little of pregnancy. Cham. will
be sufficient to remove these symptoms, in the majority
of cases, especially if there is flatulency without consti-
pation; if this symptom exists recourse must be had to
Nux vom. If the violence of the colic prevents the
patient from remaining in one place, if she experiences
relief in walking, Colocynthis should be given. In
this species of suffering, the medicines should be given
in a large quantity of water, by teaspoonsfuls at short
intervals, according to the greater or less violence of
the pains.
LUMBAGO.
Pregnant women are very subject to pains in the
back; the backward direction given to the body, the
16
AID TO MIDWIFERY.
efforts made to support the weight of the abdomen, and
maintain the equilibrium, and various other circum-
stances inherent in this state, sufficiently explain these
sufferings. Nux vom. is here the most general spe-
cific; it will be found particularly efficacious if the
woman experiences the most severe pains in turning
in bed. If the lumbago has been caused by an effort
or by fatigue, we should have recourse to Rhus; Arnica
in this last case would be preferable, if the pain should
be felt principally in coughing or in walking.
ISCHURIA.
Women in this state often have difficulty in passing
urine; there is frequent desire, and great pain in uri-
nating, tenesmus vesica without the color of the urine
being changed; Nux vom., in this last case, is a spe-
cific; if the urine escapes involuntarily, with tenesmus,
we should prefer Camphor; if the woman is feeble
and very impressible, of a gentle and timid character,
with the catamenia habitually scanty or irregular, the
difficulty in urinating will give way to Pulsatilla.
Nux vom. is especially indicated when the difficulty in
urinating, or the retention of urine, is produced by the
displacement of the uterus or of the bladder, a displace-
ment caused by the development of the uterus; in
these last cases, however, it is sometimes necessary
to empty the bladder with the catheter to facilitate
the action of the medicines, when this viscus is too
much distended and can no longer contract by itself.
A lady whose pelvis was very narrow in its antero-
posterior diameter, had so much neglected a diffi-
culty of urinating, with which she had been affected
from the fifth month of her pregnancy, that at the
PALPITATION OF THE HEART.
17
seventh month, having been consulted by her, I found
a tumor of the size of a child's head hanging in
front of the pubis, produced by the swelling of the
bladder filled with urine; emission had been impossible
for the last thirty-six hours. I drew off the urine by the
easy introduction of a gum catheter; afterward, in con-
sequence of the species of ventral hernia of the bladder
and the lively nature, and sedentary habits of the
patient, I administered Nux vom. in water for eight
days; the functions of the bladder were re-established,
and accouchement took place without accident.
SLEEPLESSNESS.
T
If, notwithstanding proper regimen, and suitable ex-
exercise, the woman experiences wakefulness, and there
are no sufferings which call for a specific medicine, a
dose of Coffea 6th, on going to bed, will often suffice to
produce sleep, if she has not been habituated to coffee;
in the contrary case, we should obtain greater advan-
tages from Cham. 12th, taken in the same manner. If
sleep has been prevented by night-mare, Sulph. 30th
may be given in the same manner.
>
PALPITATIONS OF THE HEART.
If palpitations are manifested with symptoms of
plethora, we may employ the treatment indicated in
that article (see Plethora) if these symptoms do not
exist; Puls. 30th, suffices ordinarily to disperse these
troublesome symptoms.
In cases where, from the long continuance of the symp-
toms and from other causes, we may presume the
existence of an organic cause, Sulph 30th is the medicine
which has always succeeded the best.
18
AID TO MIDWIFERY.
SYNCOPE.
Sometimes this inconvenience affects the woman from
the instant of conception, without its being possible to
assign any other reason for it; in this case, the absence
of other symptoms, we should be guided in the choice
of the remedy by the physical and moral constitu-
tion of the woman; if she is feeble, melancholy, and
disposed to weep easily, we should give Ignatia³0th; if, on
the contrary, she is lively, gay, and passionate, we should
prefer Cham 12th; if, with this temperament, she is subject
to constipation and leads too sedentary a life, we should
choose Nux vom. 30th; these medicines should be given,
in every case, in a large quantity of water, by small
spoonfuls, in the morning, to prevent too great
action.
If the fainting is the effect of great feebleness pro-
duced by some preceding disease, or by hemorrhages, or
privation of nourishment, we should give China12th, and
two days after Sulph.30th, being guided afterward by the
nature of the symptoms. Sometimes syncope, in preg-
nant women, is the effect of a species of plethora, then
we should employ the means indicated in the article,
Plethora, especially Acon.
Sometimes these faintings are produced by too tight
dressing; in this case they are the punishment of a
serious infraction of the hygienic laws of pregnancy;
after having removed the cause, we should give Acon.
afterward Arnica.
ODONTALGIA.
Many women are tormented with tooth-ache during
pregnancy, sometimes from the time of conception, at
SALIVATION.
19
other times later; this pain continues to the last, with,
or without caries of one or more teeth; these odontalgiæ
should be treated like ordinary tooth-ache, for which we
will point out summarily the principal specifics: if the
pain is sudden and very violent, Coffea; if it is more
violent at night, so as to oblige the patient to get up, or
if the cheek is swollen, Cham.; if it begins in the even-
ing and increases during the night, Puls.; if the pain
is increased by the fresh air, wine, coffee, by cold, and
by any mental labor, and diminished by warmth, a shoot-
ing in the teeth and jaws, extending into the bones of the
face and head, a grinding, pressing, or drawing in a de-
cayed tooth, Nux vom.; if there is determination of blood
to the head, Bell. Sepia is also very useful in tooth-ache
as in many other sympathetic affections of the uterus.
In this case the medicine should be inhaled. Staphy-
sagria succeeds in so great a number of cases of odon-
talgia with caries, that one would do well to have
recourse to it in every case where the first medicine
administered has not removed the pain. In tooth-ache
we may change the medicine at the expiration of an
hour, if that, already administered, has not had the
desired effect.
-
SALIVATION.
This inconvenience attacks women sometimes at the
commencement of pregnancy, and ceases ordinarily of
itself about the third or fourth month; if it becomes
very troublesome in its quantity, the patient may inhale
Merc.; if it is accompanied by nausea and disgust for
food, Puls.; with general cold and weakness, Verat.; if
it resists these medicines, give Sulph., in water, for five
days.
20
AID TO MIDWIFERY.
PAINS IN THE BREASTS.
The fluxion which takes place toward the breasts, to
prepare the mammillary glands for the secretion of milk,
excites always more or less pain in these parts; these
pains become sometimes very acute and almost insup-
portable, especially in women who have compressed the
breast with corsets. Bryonia30th suits cases of prick-
ling without inflammation; but when there is an erysi-
pelatous redness, heat, hardness, etc., we should give
Bell 30th, or Hep. sulph 3rd. (See inflammation of the
breasts.)
LONGINGS.
Desire for improper food or other hurtful substances.
Sulph., generally is the medicine indicated in all the
capricious tastes; nevertheless, if there is an excessive
desire for vinegar, we should try Arnica; for lime and
plaster, Acid nitr.; for brandy, Arsen., Puls., Sulph.,
Lachesis; for charcoal, Coccul. ;for salt, Carbo veget.
PAINS ABOUT THE ABDOMEN.
Toward the fourth month, or later, women often ex-
perience a stitch under the false ribs or in the sides; Nux
vom.30th has always succeeded with me in dissipating
them in a few days. If the woman is of a lymphatic
temperament, we should prefer Puls.
MORAL IMPRESSIONS, TERROR, FEAR,
ANGER, JOY, GRIEF.
The susceptibility, the excessive excitability which
pregnancy produces in the nervous system, compels
women, and those who surround them, to endeavor as
much as possible to screen them from these emotions.
METRORRHAGIA.
21
If, nevertheless, a sudden fright should produce anxi-
ety, suffocation, trembling in the limbs, etc., they should
immediately smell of Opium; if some time has elapsed
since the accident happened, they should smell of Acon.
If these symptoms were the effect of a lively and sudden
joy, they should always smell of Coffea. If they were
the effect of violent anger, Cham.; in the same manner,
Bryonia, if Cham. is not followed by immediate relief;
Nux vom. and Colocynth may also be useful in these
cases; if the impression was sudden and long-continued,
they should smell of Ignatia.
METRORRHAGIA.
There are women who preserve their menstrual dis-
charges during the first three months of pregnancy, some
still later, without any injury to the mother or child, so
that, should they appear at the regular times, they need
cause no alarm; but when a flow of blood from the
vagina occurs at any other time of pregnancy, or with
great force and abundance, it is always a serious acci-
dent, and calls for the greatest care, because it may
easily be followed by abortion and even endanger the
life of the woman. The woman should go immedi-
ately to bed and take a horizontal posture, which she
should keep, as motionless as possible, until all danger of
a return is over; she should endeavor to preserve perfect
tranquillity of mind, the greatest quiet should be main-
tained around her, and her drinks and food must be
cold: fresh milk, cooled by ice or in a cellar, is an ex-
cellent drink under these circumstances.
4
If the flooding has been caused by a muscular effort in
attempting to lift or carry something, the violent extension
of the arms, a false step, a fall, or a blow upon the abdomen
3
22
AID TO MIDWIFERY.
or back, Arnica12th should be given. If the flow of
blood is abundant, continued and uniform, with pains in
the abdomen, violent efforts and pressure toward the
fundament and uterus, with chills, general coldness, at
the same time heat in the head, lassitude, disposition
to remain in bed, we should give Ipecac.6th. If, with
these symptoms, there are labor-pains, and after a quar-
ter of an hour there is no amelioration, we should give
Cham. When the woman loses a considerable quantity
of dark red blood, with compressive pains in the back,
and pain in the head, particularly in the temples, we
may give Bryonia. China is very precious in serious
cases where there is already weight in the head, vertigo,
confusion of ideas, drowsiness with weakness and dis-
position to faint, coldness in the limbs, paleness of the
face, twitchings about the mouth, contraction of the
eyes, the face and hands blue, twitchings through the
whole body. In these cases of imminent danger, it
may be well to use light frictions upon the abdomen,
and to apply to it napkins wet in cold water tempered
with vinegar. China is also indicated when the blood
flows by gushes, with spasms and pains in the womb,
extending toward the fundament, with increase of the
flow of blood. This medicine is equally applicable
to cases where there are abdominal pains, frequent
desire to urinate, and a painful tension in the lower ab-
domen. It is generally useful in cases where there is a
remaining indisposition in consequence of great loss of
blood. Hyoscyamus30th should be given when there are
pains resembling those of labor, with drawings in the
back and the sacrum, or in the limbs, general heat with
full and accelerated pulse, swelling of the veins on the
back of the hands or in the face, great agitation, exces-
METRORRHAGIA.
23
sive vivacity, trembling in the whole body or numbness
in the limbs, absence of sensibility, dimness of sight,
delirium, jerking of the tendons, or shocks in the
limbs, alternating with rigidity of the joints. Bell 30th
when the blood is neither very clear, nor dark, with
pressure toward the genital parts as if the womb was
coming out; violent pains in the sacrum, as if it was
breaking. Platina30th, when the blood is black, thick,
but not coagulated or in clots, the pain in the sacrum,
not as if it was breaking, but rather a drawing for-
ward toward the groins, and as if the internal parts
were pressed down, at the same time the genital
parts are excessively painful to the touch. Ferrum6th,
when the blood is now black and clotted and then
fluid, with labor-pains, commonly with redness of the
face; after this medicine, China is often useful; if the
blood is very black, clotted and glutinous, we should
give Crocus. Sabina is very useful in the loss of blood
when the blood is of a bright red, with pain in the
back, toward the groins, increasing at intervals or com-
ing in clots. Secale corn., when the blood is black and
liquid, and when the flooding is increased by move-
ment, when the patient is very feeble, with pain and
trembling in the limbs, or when there are cramps.
2
The medicines should be given in these cases, in a
glass of water, of which the patient should take a tea-
spoonful every ten minutes or more rarely according to the
urgency of the case. When the hemorrhage is arrested,
the patient should still keep her bed for five or six days,
in the most perfect quiet, and only afterward take
exercise by little and little and with every necessary
precaution against the return of the accident.
In all cases of violent hemorrhage of the uterus,
24
AID TO MIDWIFERY.
animal magnetism has a very favorable influence; a
few passes made the whole length of the body, will
often suspend the symptoms and give time to oppose an
efficacious remedy to the cause. I must also make
mention of the horse-shoe magnet among the resources
of Homœopathy against metrorrhagia.
CRAMPS.
Pregnant women are often very much troubled at
night and even by day, with cramps in the calves of
the legs and in the feet; Veratrum 30th, in the evening,
on going to bed, succeeds admirably in removing them.
I have often used with advantage, with nervous women,
Nux vom or Coffea, administered in the same manner.
If these means do not succeed, we may give Sulph. 30th,
one globule in a glass of water, of which one teaspoon-
ful may be taken for three or four evenings in suc-
cession, on going to bed.
VARICES AND HEMORRHOIDS.
After the fifth month of pregnancy, the volume and
the weight of the uterus incommodes the circulation in
the ischiatic and portal veins; the veinous branches
which convey the blood in these trunks become stopped
up; their coats are considerably dilated, and form blu-
ish tumors under the skin of the lower limbs, called
varices, or on the margin of the anus, hemorrhoids,
Puls. 30th, repeated every eight days in the morning,
has almost always succeeded with me in dissipating the
acute pain of hemorrhoids in pregnant women; when
there is constipation, or when caused by an abuse of
heating food or coffee, we should give the preference
to Nux vom.; Puls. is also useful in varices, which
-
COUGH. 25
require Sulph 30th, or Silicea or Lycop., of the same dose
in fifteen spoonsful of water, once every morning; the
south pole of the magnet applied for five minutes, I
have found very efficacious. When the woman is
attacked with painful varices, she should avoid all com-
pression such as belts, garters, etc., and not remain
long standing.
FISSURES IN THE SKIN OF THE ABDOMEN
FISSURES IN THE SKIN OF THE ABDOMEN.
The enormous extension that the volume of the
uterus, toward the seventh month, produces in the
integuments, causes a species of laceration of the
skin, into which there pass particles of blood mak-
ing little bluish linear marks over the whole surface
of the abdomen and anterior part of the thighs, which
remain during life. The best means of preventing
these marks is to avoid compressing the abdomen
during the first months of pregnancy, because then the
distensive action of the uterus upon the walls of the ab-
domen, progressing slowly, little by little, their tissue
is gradually extended without breaking the fibres.
Ointments of sweet oil of almond are recommended,
but they are of no use. Light frictions with a tincture
of Arnica diluted with sweet oil of almonds every eight
days from the fifth month, is the best means of prevent-
ing and of dissipating these wounds.
COUGH.
Women are subject, during pregnancy, as at other
times, to colds, which require no peculiar treatment on
account of this state; but they are sometimes attacked
with a dry, nervous and fatiguing cough, which lasts
up to the time of labor if not cured by the proper
26
AID TO MIDWIFERY.
specifics: these coughs are produced by an afflux
of blood toward the lungs, caused by the compression
of the large vessels of the abdomen, by the volume of
the uterus; and the bleedings, recommended by the
Allopathists are very far from removing them. Acon.
30th repeated several times, every other day, followed by
Nux vom., has often succeeded with me in curing this
rebellious cough. If the attacks occur in the evening
or at night, Bell. is preferable to Nux vom.; if the
cough is followed by efforts at vomiting, and vomit-
ing of slime, we should give Ipecac. 6th, repeated every
three or four hours, if it resists and continues with a
tickling in the throat and chest, we give Conium in
the evening, or better still Sepia, which is so appro-
priate to pregnant women. This medicine is indicated
also if the cough is accompanied with expectoration; in
this last case Sepia may be alternated with Pulsatilla.
ABORTION.
We comprise under this title of abortion the expul-
sion of the products of conception before maturity, that
is to say, before the period of nine months, fixed for
accouchement. The distinction made by some physici-
ans between abortion, properly so called, and premature
labor is of no importance from the point of view
of this work, since in these different cases, the phy-
sician proposes to himself the same clinical end; to
prevent the premature expulsion of the products of
conception. Although, in simple premature labor the
consequences are not always so bad, the means re-
commended by art are the same.
Abortion is the most serious accident which can be-
fall a pregnant woman, since she not only loses her
ABORTION.
27
the product of conception, but her own life is endangered.
Its causes are predisposing and accidental. The predis-
posing causes consist in some vice of organization in the
woman, which opposes itself to the sufficient develop-
ment of the volume of the uterus,exacted by the growth
of the fœtus; or in a constitutional, psoric, syphilitic or
sycotic taint, to which may be referred all other dispo-
sitions of the woman that accoucheurs have enumerated
among the predisposing causes of abortion, such as
rigidity of the fibres of the body of the uterus, re-
laxation of those of the neck, tumors in its walls,
polypus, etc.; insufficiency or excess in menstruation,
leucorrhea, the contractibility, or too great sensibility
of the uterus, its inherent or acquired atony, chronic
metritis, dropsy of the uterus, a sanguine or plethoric
temperament, a predisposition to hemorrhages, etc.; all
causes depending upon an alteration in the vital forces,
produced by the presence of one or more of these
taints in the organism; or indeed, by habitual violation
of the laws of hygiene, such as late watching, excess
of all kinds, tight clothes, especially those which press
upon the abdomen, the compression of the uterus and
its contents, etc.
The predisposing causes, inherent in the fœtus itself
or its connections, such as its feebleness, monstrous
conformation, the feeble adherence of the placenta to
the uterus, its adherence upon the neck of the uterus,
the smallness of the cord, hydatids, etc., should all
be referred to the constitutional defects cited above.
The accidental causes of abortion are all those which
may produce abnormal contractions of the uterus, and
thereby the expulsion of its contents, or those which
cause a congestion of blood toward the uterus, or an
28
AID TO MIDWIFERY.
alteration of the vital forces, which no longer permit it
to accomplish its functions. Then the fruit falls before
it is ripe; or these causes act upon the fœtus and its
envelopes, in producing the death of the former, or the
rupture of the latter, in such a manner that the fœtus
becoming a foreign body, is expelled from the body of
the mother by the conservative forces of nature.
To enumerate all the accidental causes of abortion,
would be to cite, so to speak, all the diseases and
all the hygienic agents to which the woman is sub-
jected; thus, acute diseases, especially those which
affect the uterus and the other abdominal viscera;
metritis, peritonitis, diarrhoea, tenesmus; mechanical
causes, such as falls, carriage drives, fatigue, coitus;
psychological agents: anger, grief, and other violent
emotions; the medicines which have a special action
upon the uterus, and which are known under the name
of emmenagogues, abortives, etc. The causes which
act upon the fœtus are in great part also those which
we have just enumerated as acting upon the uterus
and causing through it the death of the fœtus; the
criminal manœuvres practiced in order to procure abor-
tion, either by killing the child, or in procuring the
evacuation of the liquor amnii; thus, purgatives, bleed-
ings, emmenagogues, violent moral affections, falls,
blows upon the abdomen, dyscrasiæ, chronic and acute
diseases of the mother, may also produce the death of
the fœtus, and consequently abortion.
The diagnosis of abortion is exposed in detail in all
the treatises on midwifery.
The prognosis made by the homeopathic physician
ought not to be the same as those of the professors of
midwifery: he plants himself upon the nature of the
ABORTION.
29
causes, and the more efficacious means which he pos-
sesses of preventing them and remedying their con-
sequences, when they cannot be prevented.
The prodromes of abortion produced by dyscrasy
are more difficult to arrest and to prevent; so that
the ulterior development of abortion, whether pro-
duced by an organic defect, or a deterioration of the
tissues of the uterus, or by faults of hygiene, will
be judged according to the greater or less facility
in avoiding them; the nature and the importance of
these accidental causes will also greatly influence the
nature of the prognosis; at the same time, as Homœo-
pathy possesses very powerful, and often certain means of
combating some of these causes, or at least their effects,
the physician should not pronounce abortion certain
until the fœtus shall have already partly passed out of
the uterus: neither the most dreadful hemorrhages,
the discharge of the liquor amnii, nor convulsions
ought to make him lose hope of conducting the preg-
nancy to its term.
As the death of the fœtus cannot be ascertained
by certain signs, the doubtful symptoms of this acci-
dent even should not deprive him of all hope of a
happy result. The insertion of the placenta upon the
orifice of the uterus, which has been considered by
accoucheurs as conducting fatally, through loss of blood,
to abortion or to the death of the mother, is not beyond
the resources of Homœopathy; the annals of science
offer examples of cure of the signs of abortion pro-
duced by this cause. Dr. Bethman, having had a case
of this complication to treat, arrested the hemorrhage
with Sabina repeated at different times, and preg-
nancy took its regular course. The prognosis of
30
AID TO MIDWIFERY.
abortion itself, and its consequences, are much less seri-
ous in the eyes of the homœopathic physician, since he
possesses such powerful means of acting upon the uterus
and its dependencies, either in facilitating the expulsion
of the products of conception when that has become in-
evitable, or in arresting the hemorrhage, or the convul-
sions so often fatal in the hands of the old school, or the
inflammatory and other affections which may follow abor-
tion. In general, abortion produced by a sudden cause,
is more serious and more painful than one produced by a
cause which has been a long time acting upon the organi-
zation of the woman before abortion takes place, because
the neck of the uterus, in the last case, is softened and
dilates more easily to give passage to the fœtus.
How-
ever in such cases, Homœopathy may still avoid much
pain and danger to the woman. The efforts of the
physician in cases of abortion should be directed in
the first place to the end of preventing it, if this be im-
possible, to render its termination as little dangerous
and painful as possible for the mother, and in short to
prevent or remedy all the evil consequences which ac-
company or follow this disease.
It is the first duty of the physician, in the treatment
of abortion, to remove, as far as in his power, all its
predisposing or accidental causes; he must ascertain if
it is to be attributed to faults of hygiene, either in the
mode of dressing, or in the habitation, in the profession
or occupation, or if it be the result of some moral cause,
which he should hasten to remove; and then, by proper
medicines, which we shall indicate below, remedy the
dynamic effects of these causes; next he should inform
himself of the sanitary state of the patient anterior to
pregnancy and during this period; if the patient has
ABORTION.
31
been pregnant before, if she has had other abortions,
and under what circumstances, and especially the habi-
tual state of menstruation. From the information he
obtains he will deduce the nature of the constitution of
the patient and the dynamic, predisposing, and acci-
dental causes of the disease.
If, from previous abortions, an habitually plethoric
state, or one of too great feebleness, an abundant leucor-
rhea, an habitual pain in the uterine region, etc., the
physician infers a predisposition to abortion, he should
without loss of time combat this tendency by a proper
regimen and by the medicines indicated by the state of
the patient.
If she is plethoric, fat, subject to a very abundant
menstruation, to leucorrhea, to soreness of the breasts,
colic, pain in the back, sick headache, congestion of
blood to the head or lungs, to vertigo, we should
have recourse to Calcarea30th, two globules in a glass
of water, a teaspoonful every day in the morning, for a
week, which we may alternate, eight days after, with
the same dose of Bell., in the same manner, to return
afterward to Calcarea.
Doct. Lux reports, in his Zoosiasis, several cases of
success with Camphora spirit., in water, upon cows
which had several times aborted, and which calved
although during the same year many other cows, in
the same village, had abortions.
Among women subject to abortion, the medicine the
most generally used, and which has had the greatest
success in removing the symptoms of abortion, is Sabina.
The patient is made to take a dose for several days,
before each, period of menstruation, until the period of
former abortions is past.
32
AID TO MIDWIFERY.
When the pregnant woman has an abundant leucor-
rhea, is sad, melancholy, feeble, timid, with easy perspira-
tion, and frequent colics, Sepia should be given, alternat-
ed with Pulsatilla, in the same manner as Calcarea and
Belladonna described above. Sulph., if the woman
has been or is subject to pimply eruptions, with itchings,
disposition to constipation and to hemorrhoides; it
should be administered in the same manner as the pre-
ceding: it may be alternated with Nux vom., especially
if the woman experiences, from the commencement of
pregnancy, a bearing down pain in the uterus and fre-
quent desire to urinate.
By means of these medicines, seconded by a proper
regimen we shall prevent miscarriages much more effi-
caciously than by the bleeding, baths, etc., recommended
in these cases by the reigning school. The regimen how-
ever would not be such as it recommends, immobility in
an easy chair, etc.; but the patient should have, every
day, moderate exercise in the open air, on foot, avoiding
fatigue; she should however abstain from carriages and
railroads, so injurious on account of the peculiar side
shake given to the abdomen, and she should also take
great precautions in mounting and descending stairs.
Absolute immobility, in weakening the constitution,
only adds a new cause to the predisposition to the acci-
dent we are so anxious to avoid. The patient should
make use of a substantial nourishment, avoiding taking
too much at a time; she will do well to divide it into
small repasts, regulated according to the rules laid down
by Hahnemann. Abstinence from coffee is here a rigor-
ous necessity, as also abstinence from coitus.
-
When through any of the causes enumerated above,
symptoms of abortion manifest themselves in a pregnant
ABORTION.
33
woman, such as pains in the abdomen pressing down-
ward, or real labor-pains succeed each other with some
regularity, accompanied by marks of blood in the parts,
etc., the woman should keep herself absolutely immov-
able, extended upon her bed, and abstain from warm
drinks or food; avoid, in a word, all that can excite
movement in the abdominal viscera; afterward we must
seek, by the proper medicine, to neutralize the effect of
the accidental cause of the disorder: thus, if the acci-
dent has been caused by a blow upon the abdomen, a
fall, an effort or any other mechanical cause which may
have produced a commotion in the uterus, the best
means will be Arnica12th, in a glass of water, a teaspoon-
ful every two hours. This medicine should be adminis-
tered as soon as possible, after the woman has received
one of those mechanical hurts already cited. If the acci-
dent has been occasioned by an effort in lifting a heavy
weight, a twist in the back, or a false step, we should
give Rhus or Cinnamomum, if the hemorrhage is vio-
lent. If the accident has been produced by a moral
emotion, we should hasten to administer the proper
remedy, to combat its effects, in the manner before indi-
cated. (See Moral Affections.)
When, notwithstanding the medicines directed against
the accidental cause, the danger of abortion is not di-
minished, we should administer a specific adapted to
the present symptoms.
If there has been a violent hemorrhage of red blood,
with colic around the navel, severe pressure upon the
uterus and the rectum, chills, great weakness, paleness
of the face and nausea, we should administer Ipecac.
If the blood is not very red, rather dark, in large
clots, with pains similar to those of labor, in the back
34
AID TO MIDWIFERY.
and abdomen, we should have recourse to Sabina.
When the hemorrhage is arrested for a moment, and
returns afterward with great violence, with expulsive
pains and a dark blood mixed with clots, Puls.
Bell., by the special action it exercises over the ute-
rus, is a precious medicine in premature labor. It is
especially indicated when there are violent, tensive and
compressive pains in the abdomen, with a sensation of
constriction in this region, and a pressure toward the
lower part of the abdomen and the genital parts, as if the
contents were going to fall out; violent pains in the
back, etc.
If there are cutting pains in the abdomen, so violent
as to force cries, extending from the sacrum toward the
sides, and coming on at intervals as in labor, with
desire to go to stool or to urinate, and followed by a flow
of blood which is dark or black and fetid, with clots,
weakness, dimness of sight, ringing in the ears or faint-
ing, we should give Chamomilla.
When the labor-pains are accompanied with convul-
sive movements and rigidity of the limbs, agitation,
increase of vivacity, or numbness of the limbs and
dullness of the senses, dimness of sight, delirium, etc.,
Hyoscyamus will be found an excellent remedy. In the
case of convulsions Ipecacuanha will also be found very
useful and should be preferred if the patient is not en-
tirely insensible, if there are cutting pains around the
navel, etc.
-
In the case of imminent danger of abortion, Sec. corn.
must not be forgotten when the woman is very feeble, of a
cachectic constitution, having a pale face, sallow, very
small pulse, and fear of death, with great loss of dark,
liquid blood, and disposition to convulsive movements.
ABORTION.
35
Nux vom. has succeeded very well with me in the
case of a woman habitually constipated, and whose
catamenia lasted habitually eight days in abundance.
At the end of the sixth month of the second pregnancy
(the first had passed without accident), she was sud-
denly attacked with chills, in the morning, with a
cramp-like pain in the region of the uterus, soon fol-
lowed by pains in the back extending toward the abdo-
men and genital parts, and accompanied by the discharge
of a few drops of blood from the vagina. These symp-
toms lasted for an hour, increasing in severity. When I
arrived, I found upon examination, that the fundus of
the uterus raised up and hardened under the hand at
each pain; although the loss of blood had not been con-
siderable, the patient was very pale, feeble and threat-
ened with fainting; she had not been at stool for five
days; during the preceding night she had permitted her
husband some sexual excesses. I dissolved two globules
of Nux vom. 30th, in a glass of water, and administered
a teaspoonful immediately. At the end of a few
minutes, the violence of the symptoms had much di-
minished, and half an hour after, all danger of abor-
tion had entirely disappeared.
For the other medicines which may be indicated, see
article Metrorrhagia. (The medicines, in cases of threat-
ened abortion, should be given in the smallest possible
doses in large quantities of water, or perhaps better still
by simply smelling.)
Beside the most absolute repose of the body, the
patient should avoid all agitation of mind, much speak-
ing, warm drinks, especially tea and coffee; a rigorous
diet should be observed, which may be relaxed only in
proportion as the threatenings of abortion disappear.
ga
1
36
AID TO MIDWIFERY.
When the symptoms have ceased, it will be prudent
for the patient to retain still the horizontal position, and
perfect quiet for eight days. If she has been very
much enfeebled by loss of blood, we should administer
China 30th, in a spoonful of water.
When we cannot prevent abortion, and when by a
vaginal examination, we have become convinced that
the act of expulsion is already advanced so far as to
leave no hope of arresting it, Homœopathy can still
render great service in facilitating a complete expul-
sion, and in the least dangerous manner; but to avoid
unnecessary repetition we defer these instructions to the
article on labor, the care required by the woman, in the
two cases, being very nearly the same. We should,
however, be forewarned that in an abortion, during the
first six months of pregnancy, care must be taken to
avoid all mechanical modes of accelerating abortion,
rich as we are in dynamic means adapted to these
critical circumstances, means suited specifically to every
cause which can hinder the natural accomplishment of
this function.
We would observe here that the expulsive pains in
abortion, particularly when it happens during the first
four months of pregnancy, are much more painful than
in labor at full term, and are even sometimes so in-
tolerable as to produce convulsions, principally when
the accident is the effect of a sudden and recent cause;
in these cases, Coffea has always been of great service
to me; after a few globules of the 6th attenuation in a
glass of water, administered a teaspoonful every ten
minutes, the patient is more calm and the pains more
supportable.
Another important counsel suggested by experience,
OPPRSSION.
37
C
is never to separate the embryo or fœtus, when expelled
first, without being followed by the after-birth, as its ex-
pulsion is much facilitated by the slight traction exer-
cised by the body of the fœtus upon the cord.
After delivery, repose and quiet are still necessary
for several days, more or less, according to the greater
or less gravity of the circumstances attending the abor-
tion, and the more or less advanced term of pregnancy;
and we should administer for the sufferings of the
patient, in accordance with the prescriptions which will
be found in the article on the treatment after confine-
ment. However, as in abortion, especially if it be the
sudden result of some accident, the uterus always suffers
more in its tissue than after labor at term; it will be
always proper to give a dose of Arnica immediately
after the expulsion of the placenta.
As there is rarely a flow of milk in the breasts, or
but a very feeble afflux in cases of abortion occurring in
the first months of pregnancy; it is also rare that there
is any milk-fever under these circumstances. The phy-
sician cannot then watch too closely such febrile action
as may supervene, for it is ordinarily the effect of an
incipient metritis, which will require the treatment in-
dicated further on in treatment after confinement.
OPPRESSION.
In the first months of pregnancy, the pressure of the
fundus of the uterus upon the parts contained under
the diaphragm, incommode considerably the action of
the stomach; digestion proceeds with difficulty; im-
mediately after meals, the woman is troubled with a
flow of blood to the head, the face becomes red with
anxiety and a feeling of suffocation. Nux vom. 30th, is
4
38
AID TO MIDWIFERY.
the medicine the most appropriate to these sufferings,
and it is rare that it is not followed by a prompt and
durable relief.
If the oppression is permanent, with the face habitu-
ally red, head heavy, vertigo, anxiety, palpitation of
the heart, nightmare, we should give Aconite 24th in a
glass of water, a teaspoonful every four hours, and the
food should be diminished; these means, with exercise
in the open air, will suffice to dissipate this indis-
position.
If the oppression is accompanied with paleness, or
swelling, or a rather bluish color of the face, piping
sounds in the chest, general debility, impossibility of
remaining in bed, oedema of the inferior extremities,
regurgitation of food or water, etc., we should have re-
course to Arsen 30th in water, a teaspoonful every three
hours; this medicine, in some cases, may be alternated
with Ipecac., especially if there is absence of thirst.
If the patient experiences, in breathing, pains in the
chest, which may lead us to presume an inflammatory
point in the lungs, Phosphor. should be given in the
manner indicated for Arsenic.
SWELLING OF THE INFERIOR EXTREMITIES.
Toward the sixth or seventh month of pregnancy, the
woman often experiences a swelling of the feet and legs;
this inconvenience principally affects women who do
not take sufficient exercise, and the correction of this
hygienic fault generally suffices to remove the difficulty.
When the swelling extends to the thighs, so as to render
walking difficult, if there are no other complications,
Bryonia30th in water, a spoonful every evening, has
always been sufficient with me to dissipate it. If, at the
DROPSY OF THE UTERUS.
39
end of a week, the improvement is not very sensible,
we may give Sulph. in the same manner. If the woman
has been subject to eruptions, pimples, or other diseases
of the skin which may have disappeared during gesta-
tion, we should commence the treatment by this last
medicine.
DROPSY OF THE UTERUS.
This disease, which may affect the woman at different
periods of life, is most apt to affect her during the state
of pregnancy. We shall occupy ourselves with this
only, as only this enters within the limits we have
marked out for ourselves.
Authors have admitted two species of dropsy of the
uterus during pregnancy: in the one, the collection of
serum is made between the membranes and the uterus,
and in the other, it is accumulated within the cavity of
the amnion itself. The causes of this disease are the
same as in other dropsies: a lymphatic temperament,
bleedings, too great number of labors, great fatigue, a
sedentary life, privations, living in damp places, moral
affections, and above all, poverty, are the most common.
Autopsies have shown vascular injection, or inflamma-
tory redness of the membranes of the ovum in dropsies
second species, which has caused this disease to be
considered as the result of an inflammation of the
ovum itself.
The diagnosis of dropsy of the uterus is difficult and
even impossible in its commencement. After the first
signs of pregnancy, the abdomen is developed in dispro-
portion to the period of pregnancy, the legs, thighs, face
and hands become oedematous; in shaking the abdo-
men, we feel the shock of a body, either through the
40
AID TO MIDWIFERY.
walls of the abdomen or by the vagina, which can only
be the foetus; the woman experiences great weakness
and all the discomfort which accompanies a too great
volume of the abdomen, difficulty of digestion, and espe-
cially great oppression, which obliges her to pass her
nights in a chair, etc. It is impossible to determine in
advance the seat of the effusion, whether without or
within the amnion.
The prognosis is not serious for the mother, but this
disease is often fatal to the life of the child; particularly
when the dropsy is developed several months before the
term of pregnancy; either the mass of the liquid destroys
the life of the foetus, or the excessive distension of the
uterus induces contractions of its fibres, and provokes
the expulsion of its contents before term, and even
when it takes place at term, the child is always pallid
and very feeble.
The treatment of dropsy of the uterus partakes of the
difficulty of its diagnosis, especially in its commence-
ment. The old school, which attributes almost all the
diseases of pregnant women to plethora, recommends
venesection, without suspecting, by their want of suc-
cess, its inefficacy and danger. Homœopathy offers us
more effectual means.
After having remedied all remediable hygienic faults,
we should examine all the antecedents of the patient,
and the symptoms other than the enlargement of the
abdomen, and choose the medicine which is most clearly
indicated.
In the beginning, if the disease has been produced
by grief, we should give Ignatia; if it is the effect of
poverty and the want of nourishment, we should admi-
nister China; if the swelling of the abdomen is accom-
SALIVATION.
41
panied with frequent desire to urinate, constipation,
difficulty of digestion, vomiting of food, we may give
Nux vom.; if, with these symptoms, there is a diarrhea,
give Pulsatilla, and Sulph.; if none of these medicines
produce the desired effect, Aconit. may be alternated,
with success, with the medicines just indicated, in the
commencement of the disease.
When a more advanced dropsy of the uterus is accom-
panied by oedema and such a feeling of suffocation that
the patient cannot remain in bed, Arsenic has rendered
me great service. Under its influence, in the case of a
woman in her sixth month of pregnancy, where the
volume of the abdomen forced her to pass her nights in
a chair, with swelling of the extremities, insufficient
and thick urine, etc., the symptoms gradually dimin-
ished, the respiration became more easy, so that she
could pass her nights in bed, and delivery took place at
term of a child, which, although delicate, still lived.
At this period of the disease, Sulph. is still indicated,
and may be alternated with the medicines just cited.
If we could ascertain the effusion to be outside of the
cavity of the ovum, we could easily procure its evacua-
tion, without danger to the mother or child, by intro-
ducing, with care, a gum-elastic catheter between the
membranes and the internal surface of the uterus; but
in the absence of certain signs of this kind of effusion,
we cannot resort to a surgical operation because the
evacuation of the water, contained in the membranes of
the ovum, would be followed by abortion.
MOLE.
The fibrinous mole and the hydatid mole are not
within our scope, being diseases which commonly occur
42
AID TO MIDWIFERY.
out of the state of pregnancy; we shall occupy ourselves
only with that called false conception, a title which in-
dicates the nature of the evil, as the result of a degene-
ration of the ovum, either by the premature death of
the embryo, or by a monstrous development of the
placenta.
The mole cannot be recognized by any characteristic
sign before its expulsion, consequently, the physician
cannot apply his treatment to the restoration of the
ovum to its normal state while it still remains in the
uterus, although one may suspect this degeneration.
The physician can only occupy himself in relieving
the sufferings experienced by the woman; it will be too
late to attempt to remedy an organic vice by medicines,
when the indications lead us to suspect its nature, be-
cause then the disorganization has already taken place,
and is consequently irremediable. In exciting an ex-
pulsion before the uterus feels the need of it, we expose
ourselves to bring on hemorrhages or other accidents,
without even attaining our object. We must await
then its maturity, or until nature herself expels it,
which takes place with pains similar to those of ordi-
nary labor. If the expulsion takes place too slowly,
and is accompanied with hemorrhage, it will be neces-
say to hasten it by the administration of Pulsatilla
or Secale cornutum, according to the rules we shall
give in the article on Labor. The expulsion of the mole
is ordinarily followed by a serious hemorrhage; it is
prudent then not to wait for its entire expulsion before
administering the appropriate medicines for hemorrhage,
and it is still to the two medicines designated above
that we must have recourse, especially to Pulsatilla, if
the woman is frightened at her position and of a mild
RETENTION OF URINE
43
disposition; we should give Secale if she is too feeble
and pale, with a disposition to cramps or convul-
sions.
If in mole, Homœopathy is precious, it is because it
prevents its formation by medicines adapted to the
causes, accidental or predisposing, which produce it, as a
fall or other mechanical injury, a moral affection, great
fright, anger, etc. For the medicines proper to these
cases, see the articles corresponding to its different
causes. If the woman has an unfortunate predisposi-
tion to these deviations, which may be recognized by
her previous history, I believe that Calcarea carb. and
Silicea, alternated every thirteen or fifteen days, would
be found of great service, the first especially, if the
woman is of full habit and subject to abundant cata-
menia.
RETENTION OF URINE.
During pregnancy, women are often incommoded
by frequent desire to urinate, and by pains in urinating.
These inconveniences, the effects of the pressure of the
uterus upon the bladder, particularly in the last months
of pregnancy, hinder them sometimes from sleeping at
night; they may be promptly relieved by Nux vom.;
if however, the woman is of a lymphatic temperament,
and mild disposition, Pulsatilla will be preferable; if
there is a complete retention of urine, with continual
tenesmus and pressure upon the bladder, we should
give Camph., and if that is not sufficient, the two medi-
cines cited above; it being well understood that the
first thing to be done is to ascertain the cause and
remedy it, if the retention depends upon a mechanical
obstacle.
44
AID TO MIDWIFERY.
INCONTINENCE OF URINE.
Sometimes pregnant women cannot retain their urine;
it flows involuntarily upon the least movement, and
annoys them by the sensation of wetness, and by the
irritation it produces in the thighs and genital parts.
This indisposition, caused by the state of pregnancy,
gives way ordinarily to Pulsatilla; if it is accom-
panied by abundant leuchorrhea, it would call for the
administration of Sepia; if the patient has a plethoric
constitution, with a tendency of blood to the head, and
redness of the face, we should give Aconite, and if
this medicine does not suffice, Belladonna.
EPHELIS.
Pregnant women have often the face covered with
yellow spots, as if dirty, without any sensation or other
inconvenience than the disfiguration. Authors recom-
mend for this affection Sepia, especially if it covers the
nose in the form of a saddle. If this medicine is
suited to the general condition of the woman, or to
other particular symptoms, it may be administered very
probably with success; for myself, however, I have in
general met with better success in Sulph. and Lyco-
podium.
CONVULSIONS.
This accident, so much to be dreaded during preg-
nancy, and almost always followed by abortion, when
treated by bleeding, is easily arrested, and without
troublesome consequences, by Bellad., Cham., Hyos.,
Ignatia, and Ipecac. For the choice of these medi-
cines see article Puerperal Convulsions.
FALSE PAINS.
45
"
FALSE PAINS.
At different periods during the last months, especially
at the end of the seventh, or a week before term, the
woman experiences suddenly pains like those of labor.
We recognize by the touch alone that they are not real
pains, for the neck of the uterus remains absolutely
unaffected and soft during their presence. Smelling of
Puls. suffices to relieve in a few minutes the patient
from these sufferings, and to restore things to their
normal state, that is to say, to arrest entirely the pains
if the woman has not arrived at term, or to change the
false pains which fatigue uselessly into veritable labor-
pains, if pregnancy is at term.
Before terminating this article on Treatment during
Pregnancy, it is proper to state that women, in this
state, are extremely impressible, so that in it they pos-
sess a susceptibility to homœopathic medicines which is
not to be compared to that of any other condition of life.
It is necessary, in consequence, to be very reserved in
their administration, and only to give them when they
are really necessary, and then to use always the smallest
doses. As examples of faults committed may serve as
well for instruction, and sometimes better than the most
brilliant success, I will describe in a few words the two
following cases from my register:
In 1838, in the month of April, a young girl of twenty-
one years, tall, strong, and well-made, with black eyes
and hair, came to consult me; she complained of heavi-
ness in the head, giddiness, especially in stooping, and
in rising after stooping; her face was red, the pulse full
and regular; she had no other symptoms except a delay
of eight days in the period of menstruation, which was
5
46
AID TO MIDWIFERY.
always abundant and lasted four or five days: attribut-
ing this indisposition to a plethoric state produced by
the delay in menstruation, and considering all the symp-
toms together, and above all the constitution of the
patient, I thought that a dose of Aconit. would put an
end to this derangement; unhappily I was at that time
under the impression that the high dilutions were not
powerful enough, I put two drops of Aconit.3 in a glass
of water, to be taken by teaspoonful every three hours.
After the tenth teaspoonful, a considerable discharge of
blood took place, with the expulsion of an ovum con-
taining an embryo of five or six weeks. The bad effect
of the medicine needs no comment here. If I had sus-
pected pregnancy, I should have given a much weaker
dose of this medicine, and the morbid phenomena with
which this young person was affected would have been
dissipated without the catastrophe, which occurred so
unexpectedly.
The second case was that of a married woman, in the
eighth month of pregnancy, who had been delivered at
seven months in a previous pregnancy, and for this
reason, had been kept in an easy chair, almost motion-
less, by her physician. She consulted me for constipa-
tion and want of appetite, with thirst, agitation and
sleeplessness at night, and cramps in the calves of the
legs. These symptoms were well adapted to Nux vom.
I put three or four globules of the 30th potency of this
medicine in a glass of water, to be taken by teaspoon-
fuls once every evening on going to bed. From the first
night a favorable effect was experienced, the sleep was
better, and the next day her appetite was improved ;
the medicine, notwithstanding this amelioration, hav-
ing been continued, two days after there came on
PROPHYLACTICS.
47
light pains in the back, with pinchings in the abdo-
men; a few days after the membranes were ruptured
and she was delivered, before the ninth month, of a
healthy child, who fortunately lived. If the medicine
had been suspended after the first effects, as I had di-
rected the patient, it is very probable that this accident
would not have happened; for instead of developing its
primitive effects, such as: "in the morning, in bed, a
kind of effort as if to push out the genital parts; men-
struation four days too soon with cramps in the abdo-
men,” etc., Nux vom. would only have excited a salutary
reaction, that is to say the re-establishment of the func-
tions of the organs of digestion; perhaps even if the
hygienic means observed till then had been continued,
pregnancy would have been conducted to its natural term.
PROPHYLACTICS APPLIED TO CHRONIC AND
HEREDITARY DISEASES.
A distinguished physician has just published a very
interesting memoir upon this subject, in which he recom-
mends giving to the mother, at different periods of preg-
nancy and at long intervals, Sulph.30th and Calc. carb.,
to purify the fœtus from the psoric taint which it may
have inherited from its parents. He cites in support
of this proposition many observations of mothers all of
whose infants had either died at an early age, or had
been attacked with serious scrofulous affections, until
they had been subjected, during pregnancy, to this pre-
servative treatment, after which they brought forth
robust children who had regular and full growth, and
who were even insensible to the vaccine virus and exempt
from the diseases of children. In an experience of
seventeen years of practice in Homœopathy, I have had
48
AID TO MIDWIFERY.
frequent occasions of seeing robust and very healthy
children (susceptible however of the vaccine action) born
of very unhealthy parents, when the mother had been
subjected to the homoeopathic treatment for the indispo-
sitions she had experienced during pregnancy; and I
believe this observation is common to me and a great
number of my brethren. I cannot too much recommend
that the greatest attention should be given to the consti-
tution and to the slightest symptoms of the pregnant
woman, whose health has not been previously good, in
order to administer the medicines proper to her case,
because in this manner, beside the relief to the mother,
we obtain an improvement in the constitution of the
child about to be born, and for whom we prepare a
robust health. It is thus that we shall succeed in re-
generating the human race, as I have said in another
work; but to give medicines to a woman without their
being indicated by actual or commemorative symptoms,
in a condition so impressible as pregnancy, would
be to violate the principles of the doctrine similia
similibus, and would expose one to the danger of
provoking primitive symptoms which might have the
most disastrous consequences, such as uterine hemor-
rhage, and abortion. Thus, if the father has had
venereal diseases badly cured, above all if there still
continued a slight almost imperceptible gleet, we may
presume the mother infected, and give her a high
potency of Merc. sol.; if either of the parents have had
the itch or tetter, of which they still give signs, we
should give the mother Sulph., also of a high potency,
or other antipsorics homœopathic to the actual or com-
memorative symptoms. These are the only circum-
stances under which it is permitted to apply to the
MEDICAL TREATMENT DURING LABOR.
49
mother a preservative treatment for the child she
carries in her bosom. I shall return to this subject in
the article on the Treatment of the newly-born.
MEDICAL TREATMENT DURING LABOR.
Labor being a function by which the product of con-
ception is expelled from the body of the mother, it
would seem that this, like other natural functions,
should be accomplished without foreign aid; and
this indeed, is what happens in a great majority of
cases; if however in a small number of cases this aid is
absolutely necessary, or at least very useful, we owe it
in great part to the refinements of civilization, and the
detestable physical education we give to our daughters;
for who has seen a she-wolf dead beside her offspring,
or an eagle dead upon her eggs? This necessity of aid
is seen already among the females of our domestic
animals; and among our rude peasants, it is much less
frequently necessary than among the inhabitants of
cities; and in cities, less in the middle classes than in
the two extremes; the rich classes, through the effemi-
nacy of their education and habits of life, the poor,
through excess of fatigue and privation. When
Homœopathy shall have become, so to speak, the com-
mon right, that is to say, the doctrine admitted as the
rule of hygiene, and the treatment of diseases, by the
universality of physicians and the public, these neces-
sities will be much diminished; but as these good times.
are still distant from us, and as, supposing the best
conditions, these necessities will sometimes present
themselves, the homoeopathic physician must contribute
as much as possible to remedy them by his gentle
50
AID TO MIDWIFERY.
means, and thus avoid in great part the rude and pain-
ful use of the hand and of instruments.
In order that the expulsion of the fœtus should take
place without accident, it is necessary, the fruit having
arrived at maturity: 1st, That the mouth of the uterus
dilate sufficiently to allow a passage to its contents; 2d,
That the contractions of the muscular fibres of the body
of the uterus, aided by those of the diaphragm and the
muscles of the abdomen, are strong enough to expel it;
3d, That the parts through which the foetus passes have
the necessary dimensions; and 4th, That the size of the
fœtus be in proportion to the capacity of the passage
which it is to traverse, and present to that passage, the
parts of its body which offer diameters in accordance
with it.
We are about to examine successively the relief that
Homœopathy can afford under these different circum-
stances, purposely setting aside all reference to manual
aid, in order to avoid enlarging this little treatise with
instructions, which are to be found in all the works on
midwifery by the professors of the old school.
The opening of the mouth of the uterus takes place
under the action of what are called preparatory pains;
the physician must observe if these occur regularly.
As soon as he is called to a woman who experiences
these pains, he should inform himself of the period of
pregnancy, and if it is not at term, be guided by the
directions given in the preceding article; if the infor-
mation he obtains, and the touch indicate that the wo-
man is at term, and the pains follow each other regularly,
as they are described in the treatises on that subject, he
should respect the effort of nature, for it is a sign that
MEDICAL TREATMENT DURING LABOR.
51
the delivery proceeds regularly. If the pains do not
effect the progress of the fœtus, he should assure him-
self by examination, of their nature, and if he does not
feel during a pain the mouth of the uterus harden and
contract, he must regard them as false pains; and
should then by smelling, or by the taking of a drop of
the solution of a globule of Puls., in a glass of water,
either dissipate them, or change their nature into that
of real ones as we have indicated in the preceding
article. We shall then see either the pains cease com-
pletely during a greater or less number of days, or take
at once a character more active, more regular, augment-
ing and increasing in frequency, until the rupture of
the membranes, if the position of the child is favorable.
When during sufficiently severe and frequent pains,
the membranous sac is not regularly formed, it may be
presumed that the position of the child is unfavorable,
or that the cord is either too short, or is wound round
its neck; and it is then necessary to be assured, by the
touch, of the position of the child, as far as possible
without danger of rupturing the membranes. If we
recognize one of the unfavorable positions, I would
recommend the administration of a dose of Puls.,
before the rupture of the membranes, without leaving
the pains to progress farther. Dr. Bethmann in the
General Homeopathic Gazette, reports an observation
which should encourage us to follow his example. A
woman in labor sent for him, the membranes were not
yet ruptured and the orifice was but slightly opened,
notwithstanding the presence of severe and frequent
pains, and by an examination he recongnized a shoulder
presentation; not wishing to precipitate anything, he
gave a dose of Puls.; some minutes after the woman
52
AID TO MIDWIFERY.
experienced a violent pain with such a sensation of
overturning in the abdomen that she was frightened at
it; then after some time of quiet, the pains recom-
menced regularly, and on a second examination, Beth-
mann was very agreeably surprised to find the head
presenting; the delivery terminated naturally. I be-
lieve I myself obtained, five years ago, upon a lady in
the Rue St. Denis, à similar result by the use of the
same means, and under the same circumstances. The
course that I recommend, under these circumstances, is
conformable to reason; for, the child being entirely in
the cavity of the uterus without having entered in the
pelvis, and being still surrounded with a sufficient
quantity of liquid to facilitate its movements, it will be
very possible that certain contractions of the circular
and longitudinal fibres of the uterus, should give a
sufficient impulse to the body of the child, and in such
a direction as to cause it to take a natural position, and
to which all the parts, containing and contained dis-
pose it.
When the first pains manifest themselves, especially
in primiparæ, the woman is commonly affected with
anxiety and a certain terror; she experiences a kind of
trembling which must not be confounded with that
which takes place at the moment when the pains take
the expulsive character. This terror and distress is
ordinarily dissipated by the calm and assured manner
of the accoucheur, and others around her; but should
they continue, we ought to give a small dose of Aconite
30th, either by smelling, or by dissolving a globule in a
glass of water, and administering a teaspoonful.
It is customary to make women walk during this period
of labor, but I believe that many errors are committed in
MEDICAL TREATMENT DURING LABOR.
53
making this a too general rule; it is necessary in it to
consult the strength of the woman and other circum-
stances; for, with some, walking, instead of accelerating
the pains, stops them entirely.
If notwithstanding the continuation of the pains, the
neck of the uterus remains closed with a hard ridge on
its edges, make the patient smell of Bell 30th, or ad-
minister it internally in the manner described for
Aconit.
Sometimes the mouth of the uterus does not open, as
should be expected from the course of the pains without
its edges showing a hardness and unnatural thickness;
in this case the delay in the opening depends upon a
false position of the head or the presentation of another
part of the fœtus at the superior strait; in this case, it
is a dose of Puls. which must be administered, assuring
ourselves beforehand, as far as possible, of the position, in
order to be prepared to apply manual aid, which may be
necessary immediately after the evacuation of the water.
The formation of the membranous sac is subject to
the same irregularities, and from the same causes which
I have just indicated; and requires the same treatment
from the accoucheur.
Notwithstanding the indication that he may have
been able to obtain by examination through the mem-
branes, with regard to the position of the child, the
accoucheur should not neglect to assure himself farther
upon the opening of the membranes, in order to judge
of what aid he may be called upon to render.
When the rupture of the membranes delays notwith-
standing the employment of Puls., recommended above,
must they be ruptured artificially? I believe that, when
the opening of the mouth of the uterus is large enough,
54
AID TO MIDWIFERY.
in rupturing properly the sac we may abridge in gene-
ral the duration of labor.
In relation to the indications of the treatment drawn
from the known position of the child, we refer, as we
said in the commencement of this work, to the precepts
laid down by modern accoucheurs, premising, however,
that in all the positions of the head and of the inferior
extremities of the fœtus (feet, knees, and breech) deliv-
ery will take place through the force of nature alone, or
aided by the action of the proper homœopathic medi-
cines. Consequently in these cases all idea of manual
or instrumental interference must be abandoned, what-
ever is said on the subject by certain professors of mid-
wifery.
We have said that the expulsion of the products of
conception is effected by the efforts of the muscular
fibres of the uterus, the muscles of the abdomen, and
of the diaphragm of the mother; these efforts manifest
themselves by contractions called labor-pains. During
this period, the woman requires well-directed hygienic
care, in order to facilitate the accomplishment of this
great act.
HYGIENIC TREATMENT.
When a woman at term experiences the first attacks
of pains, she should disembarrass herself of everything
like a string or band which might compress the body,
especially the neck; and occupy an apartment well
aired and not too warm; avoid loading her stomach
with indigestible food, and endeavor to dismiss from
her mind all melancholy ideas and all violent emotion.
Moderate exercise will facilitate the work of nature; but
the woman should be careful during her pains to support
HYGIENIC TREATMENT.
55
herself and to take a convenient position in anticipation
of the effort about to be made; when the water is dis-
charged she must be placed in the position in which she
is to be delivered; the bed properly arranged, with
mattresses sufficiently high to allow the body to take an
inclined position, with the head elevated. The physi-
cian should abstain from farther examination than shall
be necessary to assure himself with regard to the posi-
tion of the child, and to determine as to the time of the
manual operations, called for by the circumstances.
All kinds of odoriferous substances, aromatics, orange-
flower water, cologne, etc., should be removed from a
woman in labor. Pure fresh water sweetened is the
best drink to quench thirst and to cool the mouth.
If the labor lasts too long, a little meat broth or light
porridge may be administered. Wine produces acidity,
and disposes to vomitings and should therefore be
avoided.
The causes which may retard or hinder the expul-
sion of the product of conception depending upon the
repulsive action of the mother are: the slackening or
cessation of the pains, faintings, cerebral congestion,
convulsions and hemorrhage.
When the pains are too feeble and slow, not increas-
ing progressively as they do in a regular labor; if the
child presents one of the extremities of the longitudinal
axis, and if the woman is otherwise well, the physician
should wait, arming himself with patience, in order to
inspire it in the woman; precipitation in this case, may
be the cause of serious danger to the mother. Dr. Ch.,
called to a woman in labor, and finding on his arrival
a total absence of pains, put a smelling bottle to her
56
AID TO MIDWIFERY.
nose, and five minutes after she was delivered, but the
whole perinæum was ruptured to the rectum.
Homœopathists should never lose sight of this ex-
ample, and seek to precipitate a function that nature
performs slowly, by giving medicines when they are not
necessary. If, however, the water has been evacuated
for a long time, and if the woman is growing weaker
without the pains becoming stronger or more frequent,
the best means with which I am acquainted to excite
them, and render them more efficacious, when there are
no other indications to fulfill, is Puls. The effects of
this medicine are prodigious, either on simply causing
it to be smelled or in giving it in water. A single
dose suffices: at the end of ten minutes the pains return
strong, expulsive and regular, augmenting successively
until the end. Sec. corn. is far from equaling this
medicine, in the generality of cases, under these circum-
stances. If, however, the woman is very feeble, with a
disposition to cramps in the legs and feet, and if she has
had already other labors, we should give Sec. corn. 30th,
in a glass of water, a teaspoonful every half hour, until
the pains are developed. We should take good care
not to use the dose of the allopathist, who often poisons
with this heroic medicine, the mother and child at the
same time.
Dr. gave half an ounce of Ergot to a woman in
labor; delivery took place some minutes after, but with
a complete rupture of the perinæum. The child was
born stiff and dead, and the mother, eight or ten days
after committed suicide by throwing herself from a win-
dow. I saw another case of a woman in the Rue Cadet,
who also precipitated herself from a window, eight days
HYGIENIC TREATMENT.
57
after a labor which had been excited by an allo-
pathic dose of Ergot. (Primitive symptom of this
substance.)
When the pains affect the back only, without pro-
gress in the labor, I have always succeeded very well
with Puls.
If the pains are stopped by a moral cause, as bad
news, anger, etc., we should administer the medicine
appropriate to the cause, as we have indicated in the
paragraph on moral affections in pregnant women.
If after having proceeded regularly for some time,
the pains stop suddenly without a known cause, with
heaviness in the head, drowsiness, numbness and
trembling of the limbs, we may give Opium6th, in water
by teaspoonsful every half hour until the cessation
of the symptoms and the return of the pains.
The pains may also be rendered inefficacious by the
too great nervous sensibility of the patient, the violence
of whose sufferings may arrest the complete develop-
ment of the uterine contractions; in these cases the wo-
man cries out, becomes agitated and finds her pains in-
supportable, a dose of Coffea 6th, will moderate this
exaltation of sensibility, and restore the pains to their
regular course. If the alleviation experienced through
this medicine is but of short duration, we may replace
it by Aconite, by smelling. If these insupportable
pains are accompanied by a continual need of going to
stool or by tenesmus vesica with bad humor, impa-
tience, disposition to anger, we should give Nux vom.
If this violence of pain is accompanied with anxiety
and nervous agitation, with shaking in the limbs, in-
quietude, fear, tears and despair, the patient should
smell of Chamomilla; if these means do not produce a
58
AID TO MIDWIFERY.
sensible relief at the end of an hour, Bell. in the same
manner.
Sometimes the pains are suspended by the presence
of an antipathetic person or object; it is very clear that
the first thing to do, in this case, is to remove the
cause, which we should endeavor to discover, before
administering a medicine, should this be judged ne-
cessary.
Fainting is a troublesome and sometimes a very dan-
gerous accident during labor, because it may produce
an unperceived internal hemorrhage, and cause the
death of both the mother and child. When the woman
feels a disposition to faint, if it is the effect of inanition,
we should give a little nourishment: broth, or a spoon-
ful of old wine; if the disposition to fainting does not
depend upon this cause, Nux vom. is the medicine most
often useful, and it will be so much the more so if the
woman is feeble, and subject to diseases of the stomach,
if she has nausea, with paleness of the face, anguish,
trembling; Veratrum will be preferable when the faint-
ings take place on the slightest movement, when she
experiences anguish, depression, or disposition to con-
vulsions with general coldness. If fainting is accom-
panied with violent palpitations of the heart, congestion
of blood to the head, we should give Aconite 30th, in
water, a teaspoonful every hour: if we are aware by
the signs peculiar to it, that an internal hemorrhage has
taken place during fainting, we must have recourse to
the medicines indicated against hemorrhages, which
will excite the contractions of the uterus, terminate
sooner the labor, and prevent the return of the syncope.
Puls. and Sec. corn. answer very well to these indi-
cations; the last especially, if the hemorrhage has
CEREBRAL CONGESTION.
59
already been considerable and continued; in this case it
should be given in water, a teaspoonful every five
minutes, until the expulsion of the contents of the
uterus. In this very dangerous case, the accoucheur
should hold himself ready to terminate the labor by
turning, if the medicines do not show very soon a de-
cisive action.
CEREBRAL CONGESTION.
During the pains of child-birth, the face of the
mother generally becomes red, swollen, the veins of the
neck, forehead and temples swell, the heart and the
arteries beat with violence; but these troubles commonly
disappear with the pains of which they are the effect,
and neither require nor admit of any medicine, but the
care of loosening the clothing about the neck and chest.
Sometimes, however, these symptoms persist in a more
or less active degree, and a long time after the cessa-
tion of the pains, with headache, as if it was too full, or
as if it was about to burst, drowsiness, heaviness in the
head and oppression; these symptoms, if they are not
arrested, terminate sometimes in real cerebral conges-
tion and even in apoplexy. The medicine which has
always succeeded with me without exception in this
case, is Aconite, it being understood that I have never
allowed these accidents to proceed so far as a real cere-
bral congestion and apoplexy. As soon as a woman in
labor complains of pain in the head of the nature I
have just described, with redness of the face between
the pains, or even when redness alone, with puffing of
the face is present, I put a globule of Aconite in a
glass of water, and administer a teaspoonful every hour
or every two hours, according to the effect produced,
60
AID TO MIDWIFERY.
until all danger of congestion has disappeared. I re
peat: this medicine has always succeeded with me; I
give also in the intervals of the medicine, a few mouth-
fuls of fresh water, and I prescribe abstinence from
food. If from being called too late, or from having ne-
glected the premonitory symptoms, cerebral congestion
has taken place, Aconite would then no longer be suffi-
cient; I believe that considering the circumstances, the
violence with which the blood is impelled toward the
brain during the pains, Arnica would be the medicine
which would suit in the majority of cases, especially if
the pulse was full and strong, with symptoms of paraly-
sis, particularly in the left side, loss of consciousness,
involuntary stools and urine, vertigo, etc. After this
medicine comes Bell., when there is giddiness, loss of
consciousness and of speech, with convulsive move-
ments in the limbs and muscles of the face, paralysis,
especially of the right side, paralysis of the tongue,
deglutition difficult or impossible, pupils dilated, face
red and puffed, etc. In the cases where, after vertigo
and weight in the right side of the head, sleeplessness
or frequent sleep, there is manifested a convulsive.
rigidity of the body, with redness, puffiness and heat
of the face, heat of the head with perspiration, redness
of the eyes with the pupils dilated and insensible, res-
piration slow and rattling, convulsive movements and
trembling of the limbs, froth at the mouth, etc., we
should administer Opium. Puls. from the specific
action which it exercises upon the contractions of the
uterus, offers an important consideration for its choice
in the cerebral congestions of women in child-bed,
through the facility it gives to this viscus in expelling
its contents, and extinguishing thus the cause of this
CONVULSIONS.
61
>
dreaded accident, especially when the woman has lost
consciousness, with the face puffed and of a bluish red,
when there is loss of movement, violent palpitation of
the heart, pulse almost extinct and stertorous respiration.
In these cases, the medicines are introduced by force
into the mouth, by opening the jaws with a lever.
The advice we give for cerebral congestion is equally
applicable to apoplexy, this being only one degree more
advanced, and upon the living, difficult to distinguish
from cerebral congestion on account of the analogy in
their symptoms, and the identity of the organ affected.
CONVULSIONS,
Is another very serious and alarming accident that
the homœopathic accoucheur may always prevent with
a little attention and knowledge of the resources placed
at his disposal by Hahnemann.
<
We have said that nervous and timid women are
seized with a trembling through fear on the first ap-
pearance of the pains; but when the pains take an ex-
pulsive character, when the head begins to engage in
the superior strait, a trembling of another nature is
felt even in the most courageous women; this trembling
is a nervous state, a species of light convulsion excited
by the distension of the pelvis and the violence of the
uterine contractions; in courageous and well constituted
patients, these spasms soon calm, and the labor proceeds
and is accomplished without farther ill effects; but with
nervous and timid women, these spasmodic dispositions
continue and are ready to recommence at every new
pain; they increase in intensity with the increase of
pain, and if anything occurs to impede for a moment
the progress of labor, either through the violence of
6
62
AID TO MIDWIFERY.
the last pains, or a cerebral congestion such as we have
described in the preceding paragraph, or through a
moral affection, violent convulsions manifest themselves
with loss of consciousness and delirium which are soon
followed by the death of both mother and child, if we
do not succeed in promptly removing this unfavorable
condition. For more than forty years that I have
practiced midwifery, among women of all conditions,
and of all ages, even to a child not yet thirteen years
of age, never have I seen spasms arrive at this serious
stage, even before I possessed the resources of Homœo-
pathy. Nervous, hysterical women, subject to what we
call nervous attacks, are very impressible, and the calm
and decided air of a robust man has a very tranquiliz-
ing influence upon them. When being with a woman
in labor, while always preserving a calm air I have ob-
served her eyes become brilliant, her speech short and
rude, I have taken care by a few concise words to bring
her back to reality, and to make her feel the necessity
of the pains and the absence of danger; then I have
given a glass of fresh water sweetened, with a little
orange-flower water; tranquillity was soon restored, and
the danger of convulsions past; but, I repeat, these
means must be used upon the first appearance of the
indications of spasms.
Lately, in the case of a person who is very dear to
me, this moral remedy alone was sufficient to arrest at
their commencement, the symptoms of spasms which
had already begun to alarm those around her: her
speech was short and interrupted, upon odd and in-
coherent subjects, her eyes brilliant, with grinding of
the teeth, etc.; a few severe, but at the same time affec-
tionate words restored her in an instant to calmness and
CONVULSIONS.
63
reason. But how much more powerful are we when we
can add to this moral influence the aid of Aconite,
Cham., Coffea, Bell., Hyoscyamus, Stramonium, etc.
What we have said of the means to be employed for
the relief of pains too sharp, and insupportable to
nervous women, is applicable also to this article. If
the face of the woman continues red during the inter-
vals of the pains, if the eyes become brilliant and
ardent, with headache, short speech, etc., the homœo-
pathic physician, beside the moral means indicated
above, will still have at his disposal a very efficient
means of arresting this disposition to convulsions, in
Aconite, smelled after every pain or administered in
water, and repeated every quarter of an hour until the
head becomes more free. Coffea, Cham., and Bell.,
will be preferable when the symptoms indicated in the
preceding paragraph present themselves, which I pass
here in silence in order to avoid repeating what has
already been said there. By these means one may be
sure of preventing the development of real convul-
sions.
Should we be called to a woman who is already in
convulsions, either because an intelligent use has not
been made of the means above indicated, or when this
condition has been suddenly developed by a moral
cause, we should administer, immediately, the medicine
adapted to the nature of the moral affection as exposed
in the article on that subject, and in the Treatment of
Pregnant Women; we should especially give Ignatia,
if the affection is sad in its nature; Cham., if the emo-
tion be one of anger, and Opium if one of fright.
These medicines will probably arrest this very danger-
ous disorder; if however, after some minutes, there is
64
AID TO MIDWIFERY.
not a sensible amelioration, or if the convulsions have
not been produced by a moral canse, we should have re-
course to Ilyoscyamus, Belladonna, Lachesis, Stra-
monium, or to the three medicines before mentioned
according to the symptoms presented by the patient.
Hyoscyamus. If the face is bluish and puffed, the
eyes protruded, if there are convulsive movements of
the whole body, excessive anguish, involuntary urine,
or great drowsiness, with snoring, delirium, and in the
intervals of convulsions, agitation, disposition to laugh
at everything.
Belladonna. Flow of blood to the head with vertigo.
face dark red, puffed and burning or very pale, eyes
convulsed or fixed, pupils dilated, involuntary emission
of excrements, spasmodic constriction of the chest, con-
vulsive and jerking movements in the superior extremi-
ties, a sensation of stiffness and prickling in those parts,
convulsive movements of the mouth, eyes and face;
opisthotonos, return of the convulsions at the slightest
touch or at the least contradiction, loss of consciousness,
in the intervals of the attacks, sleeplessness with agita-
tion or profound sleep, coma, with distortion of the face,
sudden waking with cries, anguish, fear, and fright-
ful visions.
-
Chamomilla. Great desire to stretch the limbs, convul-
sive movements of the limbs, eyes, eyelids, and tongue,
convulsive shocks during sleep, face red and puffed, or
red on one side and pale on the other, skin dry and
burning with great thirst, warm perspiration on the face
and head, respiration rapid, anxious and rattling, great
impatience and disposition to anger.
Ignatia. Convulsive movement of the limbs, eyes,
eyelids, and face, confusion in the head, face puffed, pale
18
I'*'
HEMORRHAGE.
65
or very red, or redness of one cheek and paleness of
the other, or alternate redness and paleness, attacks of
suffocation, frequent yawning, loss of consciousness.
Lachesis. Convulsions with cries, cold feet, vertigo,
cephalalgia, paleness of the face, palpitations, drowsi-
ness, etc.
Opium. Opisthotonos or violent movements of the
limbs, cries, attacks of suffocation, loss of consciousness,
profound sleep, coma.
Stramonium. Opisthotonos or convulsive movements
of the limbs, especially in the upper parts of the body,
sardonic laugh, stammering or loss of speech, face pale,
stupid or red and puffed, loss of consciousness and
sensibility, cries, frightful visions, laughing, shuddering,
singing, attempts to escape and fly; return of the
attacks upon being touched and at the sight of bright
objects.
F
If the convulsions have been caused by a mechanical
injury, she should smell of Arnica, before passing to
the other medicines indicated by the symptoms, which
should be given if this medicine does not suffice to
arrest them.
HEMORRHAGE.
Hemorrhage may take place during labor, either by
the insertion of the placenta upon the neck of the ute-
rus, which is the most common, by a rupture of the
umbilical vein or arteries, by a rupture or other lesion
of the womb, or by the separation of a portion of the
placenta caused by a serious obstacle to labor, as a bad
position of the fœtus, a defect in the pelvis, or some
violent moral impression, as anger or terror, or by me-
chanical lesion.
66
AID TO MIDWIFERY.
THE HEMORRHAGE INTERNAL OR EXTERNAL.
External hemorrhage is easy to be recognized and
characterizes itself; but internal hemorrhage reaches
sometimes a dangerous extent before it is recognized, if
the accoucheur does not give a very assiduous attention
to the sufferings of the woman. It may take place in
the interior of the membranes (and when occurring from
rupture of the vessels of the cord this is always the case),
or between the membranes and the internal surface of
the uterus, and some cause, such as the head of the
child, or a clot adhering to the orifice of the uterus
prevents the blood from flowing out, and causes it to
accumulate in the uterus.
Among the numerous causes of the detachment of the
placenta (falls, contusions, congestions of the uterus)
the most common is the situation of the placenta upon
the neck of the uterus; hemorrhage produced by this
cause is easy to recognize: toward the sixth or seventh
month of pregnancy, it is manifested without apprecia-
ble cause, slight at first, and stopping either spontane-
ously or by the aid of art; it afterward returns, and
increases successively in intensity and duration up to
the moment of delivery: it acquires sometimes, from its
first appearance, such an intensity, as to threaten the
life of the patient.
During labor, this cause of hemorrhage is recognized
principally by the abundance of the flow of blood,
greater during the uterine contractions, the contrary
taking place when the hemorrhage is produced by other
causes. If we make an examination, we find the lips
of the orifice thicker and softer than common, and the
orifice itself occupied, totally or in part, according as
HEMORRHAGE.
67
the implantation of the placenta is complete or partial,
by a flabby and spongy body very easy to be recognized
as the uterine surface of the placenta.
In internal hemorrhage, beside the general symptoms
of hemorrhage without the blood escaping externally,
the woman often experiences a sensation of weight and
of painful tension in the region of the womb; we see
this organ sensibly augment in volume; if the flooding
takes place in the interior of the membranes, the in-
crease of volume continues in a uniform manner; but
if it takes place out of the membranes and occupies
only a portion of the uterine cavity, the development
of the uterus occurs in an unequal manner, and the ex-
ternal surface of the organ is, as it were, parted into
two distinct hemispheres.
-
The course to be pursued in these cases by the ac-
coucheur requires great sang-froid and prudence: as, in
hemorrhage during labor, there is always a material
division of tissues, Arnica should be employed upon
the appearance of the first symptoms: it is especially
indicated in the implantation of the placenta upon the
neck; I have used it with success in the case of a woman
who had experienced the symptoms of this aberration
from the laws of conception from the fifth month; this
medicine of the 24th dynamisation, two globules in a
glass of water, a teaspoonful every quarter of an hour,
from the time of the appearance of the hemorrhage,
which returned three times before labor and afterward
more formidably during labor itself, sufficed to conduct
pregnancy to its term and procure a fortunate labor for
the mother and child.
If this medicine does not succeed as promptly as in
the case I have named, the principal indication and the
68
AID TO MIDWIFERY.
most urgent one to fulfill in order to arrest the hemor-
rhage completely and in a durable manner, is to procure
the evacuation of the uterus, that this organ may con-
tract and close the open mouths of the vessels which
give out the blood, after being assured that there is no
mechanical obstacle to labor, such as the size or posi-
tion of the child, or the dimensions of the pelvis, which
would require manual operations. Puls. is the anchor
of safety which fulfills the principal indication, that of
hastening the termination of labor and of stopping the
effusion of blood, when the hemorrhage is either exter-
nal or has taken place in the interior of the uterus.
It is to be well understood that I presume the attentive
and intelligent accoucheur to have combated before-
hand by the appropriate medicines indicated above, the
symptoms of plethora and of immoderate afflux of blood
toward the head and toward the uterus during preg-
nancy and the first part of labor, which means
ordinarily suffice to prevent the accident of which we
speak.
If after the administration of Puls. in water, a tea-
spoonful every five or ten minutes, according to the
greater or less gravity of the hemorrhage, brisk and
efficacious pains do not soon manifest themselves, and
the life of the mother is threatened, it will be necessary
to proceed to artificial delivery by turning or the forceps.
If the hemorrhage is accompanied by convulsions or
delirium we should have recourse to Hyos. For the
other medicines which may be employed, according to
circumstances, before resorting to extreme means, if
there is time to await their action, the indications of
them will be found in the paragraph hemorrhage in the
article on Treatment of Women after Accouchement,
HEMORRHAGE.
69
The obstacles which may oppose delivery in the
passage through which the child is to make its exit
consist in those deformities of the pelvis which narrow
its diameters, or in bony tumors which produce the
same effect, in the tumors developed in the body, neck
or mouth of the uterus, or in the membranes of the
vagina, or at the vulva, and in a congenial or accidental
contraction of the vagina or of the vulva.
The accoucheur should assure himself as soon as pos-
sible, during pregnancy, but above all during labor, if
he has not done it before, of the state of the pelvis, and
of the passages which the child must traverse, in order
to judge if the delivery can take place naturally, or if
some obstacles will call for the aid of art, either to re-
move them before the epoch of labor or during that act,
or to overcome them in the case where they cannot be
removed, or to prepare for the cæsarian operation, if he
finds these obstacles invincible.
A deformity of, or tumors in, the pelvis leaving two
inches and a half in the narrowest diameter, requires
only from the physician that he should sustain the ex-
pulsive force of the woman by the means indicated
above, because the delivery may take place without
manual operations. In the case of a woman twenty-
six years of age, in her first labor, in whom the sacro
pubic diameter of the superior strait did not offer more
than two and a half inches, I had the patience to wait for
seventy-two hours the natural efforts of the labor. The
head being in the first position, at the end of the second
day, it began to engage in the superior strait; at the
end of the third day, the pains slackened very much,
the woman became very feeble, was pale, exhausted,
and had lost all hope; I put Sec. corn. 30th, in a glass
-
7
70
AID TO MIDWIFERY.
of water, and gave her a teaspoonful at four o'clock in
the evening: some minutes after, she fell asleep, and
slept very quietly for three quarters of an hour; when
awakened by a violent pain, she made a courageous
effort, and, two hours after, gave birth to a child, pale
and in a state of asphyxia, but which was recalled to
life by proper care; the recovery of the mother pro-
ceeded in a regular manner.
The narrowness of the pelvis below the capacity in-
dicated, belongs to the domain of manual surgery, with
which we cannot occupy ourselves here, either in case
of a decision for artificial abortion, in order to save the
mother, or for awaiting the maturity of pregnancy in
the hope of saving the child and the mother by the aid
of the cæsarian operation.
The tumors of the soft parts should be treated during
pregnancy, if they are recognized, in a manner appro-
priate to their nature; during labor, we should endea-
vor to put them aside from the passage; if we do not
succeed, we should administer the proper medicines to
facilitate the uterine contractions, in order to aid them
to overcome the obstacle which opposes them. If this
obstacle is a vaginal hernia, a dose of Nux vom. will
probably effect its reduction and render all other treat-
ment superfluous. Prolapse of the umbilical cord will
also require the employment of Puls., if we do not
succeed in maintaining it in the uterus.
When the narrowness of the vagina is congenital and
without induration or other morbid organic alteration,
the efforts of nature commonly suffice to vanquish the
obstacle it presents to delivery. Madame P. in her
first labor at twenty-seven years of age, arrived at term,
her vulva and her vagina would hardly admit a quill;
HEMORRHAGE.
71
she had always had dysmenorrhoea; the pains lasted
twenty-nine hours, when she gave birth to a very small
but healthy child. Since that time menstruation takes
place more casily, and her health is much improved.
If the narrowness of the vagina is produced by a
tumor in its walls, or in the surrounding tissues, these
should be appropriately treated, and as much as pos-
sible before the period of labor.
What I have said of the obstacles in the vagina, is
equally applicable to the treatment of that offered by
the narrowness of the vulva; that offered by the pre-
sence of a too thick and resisting hymen, will be re-
moved either by gradual distension, or by an incision
made before the term of pregnancy, in order to prevent
the rupture of this membrane during the passage of the
head, which might cause that of the perinæum.
In in-
flammations with swelling of the vulva and of the vagina,
I have always succeeded with Merc. sol. of the inter-
mediate dynamisations, repeated every six hours, ac-
cording to the gravity of the disease; Thuja is also
useful in some cases.
Sometimes, especially in primiparæ, the vulva,
although normal in structure offers an almost insur-
mountable obstacle to labor in the intense pain caused
by its distension, which arrests the expulsive efforts, and
threatens to produce convulsions. Butter, and other
greasy substances with which it is customary in this case
to cover the parts, and the efforts of the finger introduced
into the vulva, only serve to satisfy the prejudices of the
assistants; a dose of Coffea 6th, in a glass of water, a
teaspoonful every ten minutes, will calm these pains
and give time to the tissues to prepare themselves for
the distension necessary to the passage of the child.
72
AID TO MIDWIFERY.
To preserve under these circumstances, the perinæum
from rupture by the passage of the head, it is prudent
to sustain it with the hand, not applied directly to the
distended skin of the part, but in trying, with the ends
of the fingers and the palm of the thumb applied upon
the folds of each thigh, to bring the skin of these parts
toward the perinæum, in order to relax it as much
as possible and facilitate its distension; a pressure
made upon these parts, at this moment weakens the re-
sistance of its fibres and facilitates its rupture.
The obstacles to delivery offered by the child, are very
little within the reach of medicine. False positions if
they have not been changed by the treatment recom-
mended in the commencement of this article, require
manual operations. The too great size of the head,
hydrocephalus and other deformities, also require manual
operations, if the accoucheur does not judge that the
aid of the dynamic action of Puls. or of Ergot, ad-
ministered according to the rules prescribed above, can
enable nature to overcome the obstacles and expel the
fœtus without interference.
-
In case of the shortness of the umbilical cord, we find
in Homœopathy the means of saving ourselves the
necessity of manual operations to terminate labor, and
thus avoid the dangers to which these operations expose
the mother and child. As soon as, by rational signs,
such as the slowness with which the head advances
during the uterine contraction, the prompt retraction as
soon as the impulsive effort is past, the sudden suspen-
sion of contraction at the instant when it should ap-
parently attain its highest degree, and a sensation of
drawing in the abdomen during the pains, as if some-
thing were being torn away, with anxiety, we may
HEMORRHAGE.
73
infer the existence of this obstacle to the progress of
labor, we should administer Puls. in the manner indi-
cated, and the labor will thus be sufficiently accelerated
to prevent all accident for the child as well as for the
mother.
I have not spoken of the death of the child as a com-
plication in labor requiring the aid of art, because really
it is not one; this condition may however require the
help of remedies. Commonly the labor is slower, and
the pains are less efficacious the longer the period since
the death of the foetus, because the softness and flacci-
dity of its body offers less resistance to the expulsive
efforts; and in the case of death of long standing the
mother suffers under a certain feebleness and anxiety
which seem to render her incapable of accomplishing
delivery.
A dose of China18th in a glass of water, a spoonful
every three or four hours, will dissipate this condition;
afterward if the pains are still insufficient, we may give
Sec. corn. or Puls. according to the rules above.
Doct. Kollenbach, of Berlin, affirms that he has never
obtained any effect from the employment of Puls. or
even of Secale when he has administered them to excite
the expulsive contractions of the uterus during labor;
this so positive assertion on the part of an honorable
colleague would have made me doubt myself, and not-
withstanding fifteen years' experience always followed
by the same result, I should have hesitated to recom-
mend so decidedly this remedy under these circum-
stances. I should have feared that I had not well
observed my cases, and have waited new experiences;
but, seeing the doses used by this practitioner, I am no
longer astonished at the difference in our results; Doct.
74
AID TO MIDWIFERY.
Kollenbach commonly used of the mother tincture, and
never above the 3d dilution, from three to five drops at
a time he has given five drops of the mother tincture
of Puls. to a woman in labor; the woman experienced
nothing but great uneasiness without any increase of
the pains! This effect of a dose truly poisonous will
cause no astonishment, if we consider the excessive sus-
ceptibility of the constitution of the woman at this time,
and that the augmentation of the expulsive pains is a
reactive effect of nature; how then shall this reaction
take place with so enormous a dose upon a vital force
exhausted, so to speak, through the pains and other
circumstances of labor? Nature, outraged, confused by
this mass of poison, can no longer re-act regularly;
beside, the crude drugs exercise a violent general action
upon the whole organism which hinders it, so to speak,
from perceiving the particular affinities with the different
organs.
In this manner the observations of the Berlin physi-
cian and their contradiction to my own are explained;
and this contradiction furnishes a new proof of the
necessity of employing the high dynamisations in the
circumstances under consideration: for if I have only
proposed the numbers under 30, it is that I may not
shock the ideas generally accepted by the homœopathic
public, for I am convinced that the 200th and above
would be here much more in their place than the dilu-
lutions ordinarily recommended in this work, committed
as they were in great part to writing before I had recog-
nized the advantages of the high preparations. In fact,
women in labor are endowed with an excessive sensi-
bility, so great indeed that the slightest odor may affect
them violently; the professor Ant. Dubois, in order to
TREATMENT AFTER LABOR.
75
dissuade accoucheurs from carrying perfumes about
them, reports in his treatise on midwifery that one day on
approaching a woman in labor who was very well other-
wise, she immediately fainted, and he perceived that
this accident was owing to a violet that he had in his
button-hole, which, covered with shame, he hastened to
hide before those present perceived it. To a sensibility
so exquisite is it not proper to address agents as pene-
trating, as attenuated as possible? Is it not to deny the
spirit of the doctrine of Hahnemann to subject it to the
action of the excessive dose of five drops of mother
tincture of Pulsatilla?
TREATMENT OF THE MOTHER AFTER LABOR.
Retention of the Placenta.
The after-birth, composed of the placenta and the
membranes of the ovum, is ordinarily expelled a short
time after the expulsion of the foetus, sometimes with
it; after the birth of the child, the mother experiences
some moments of perfect calm, afterward pains are felt
in the lower part of the abdomen and in the back; they
are frequently repeated, and if, after a time, we intro-
duce the finger following the cord, we feel the soft mass
of the placenta in the excavation of the pelvis; it may
then be extracted without any difficulty by making
slight traction upon the cord; if we feel any resistance,
we must await its expulsion by the successive contrac-
tions of the uterus. If sometime after the birth of the
child, the pains necessary for the expulsion of the after-
birth do not manifest themselves, we should excite them
by a dose of Puls. administered in the manner indi-
cated above; this medicine will render useless the trac-
76
AID TO MIDWIFERY.
tions operated upon the cord and the introduction of the
hand into the uterus to detach such portions of the pla-
centa as may be adherent or inclosed in the sinus of
this organ by the irregular contractions of its muscular
fibres.
If the woman is by nature or by the circumstances of
a preceding labor, very feeble, we should prepare Sec.
Corn. and administer in the same manner.
UTERINE HEMORRHAGE,
Is the most dangerous accident to which woman is
subject after labor. After the birth of the child, during
and after the expulsion of the after-birth, a greater or
less quantity of blood is expelled through the genital
parts; the accoucheur should never lose sight of this
excretion, in order to be assured that it does not exceed
the normal quantity; if he finds it too abundant, he
should immediately ascertain its cause that he may em-
ploy in time the proper means for arresting it. If the
hemorrhage is produced by the adherence of the pla-
centa, or by atony of the uterus and the absence of the
contractions of this viscus necessary to close the
mouths of the vessels which open upon its internal sur-
face, after the separation of the placenta, we should
have recourse to Puls. or to Sec. corn., according to the
rules just given for the retarded expulsion of the pla-
centa; in this case, as in all those where there is a con-
tinued loss of the vital fluids, it will be necessary to
repeat the doses very frequently (every five or ten
minutes) until the hemorrhage diminishes, and to
lengthen the intervals afterward in proportion to the
improvement. The same medicines are indicated when
a clot in the mouth of the uterus prevents the occlusion
TREATMENT AFTER LABOR.
77
and contraction of the body of the uterus which is
necessary to arrest efficaciously the flowing of the blood.
It is unnecessary for me to state that a very danger-
ous hemorrhage may take place and accumulate in
the cavity of the uterus, without the blood flowing
from the vulva, in consequence of the presence of a clot
or a portion of the placenta, which plugs up its mouth.
This modification of the accident under consideration
belongs also to the domain of the medicines which exert
a special action upon the muscular fibres of the uterus,
and at the same time correspond to hemorrhage, at the
head of which we find still the two medicines, before
named, Puls. and Secale, for which one should, accord-
ing to the symptoms, sometimes substitute Sabina, Bel-
ladonna, or Nux Vom.
-
Hemorrhage sometimes comes on after labor in a most
formidable manner, all at once, with a continued effu-
sion of red liquid blood, in this case Ipecac. is the
medicine indicated, especially if the hemorrhage is
accompanied with cuttings in the umbilical region with
pressure toward the uterus and the rectum, chills, heat
in the head, great feebleness, paleness of the face, nausea.
We should give the solution of the 6th in a glass of
water by teaspoonfuls every three or five minutes.
Sabina is also very useful in hemorrhages, after labor,
when the blood is clotted, with pains in the abdomen
and back resembling those of labor.
Crocus is indicated here as in epistaxis, when the
blood is black, like tar, and mixed with clots; and more-
over if the woman feels movements in the abdomen as
if there was as a ball or something alive there, with
the face yellow, earthy, sight confused with frequent
attacks of fainting.
78
AID TO MIDWIFERY.
If the blood is dark red or black and fetid, mixed
with clots, coming by sudden efforts, with expulsive
pains in the abdomen, violent thirst, coldness of the
limbs, paleness of the face, or redness of one cheek and
paleness of the other, and attacks of fainting, we should
prescribe Cham.
Belladonna is preferable when there are violent com-
pressive and tensive pains in the abdomen with a sensa-
tion of constriction or of compression in this region, and
a sort of pressure upon the genital parts as if everything
were going to be forced out, with pain in the back as if
the sacrum were broken.
Sometimes the hemorrhage is accompanied by convul-
sive movements and even by real convulsions; then,
beside Ipecac., Hyos. also offers us precious aid. It is
indicated when the hemorrhage is accompanied by great
agitation, extraordinary vivacity, general trembling, or
with a numbness of the limbs, dullness of the senses,
obscuration of the sight, delirium, subsultus tendinum,
or convulsive shocks in the limbs alternating with teta-
nic stiffness, general heat, with full and frequent pulse;
swelling of the veins of the hands and face.
In metrorrhagia, with over-excitement of the arterial
system, cephalalgia, vertigo, deep redness of the face,
pulse full and hard; if the blood flows in abundance,
partly liquid and partly in black clots, with pains in the
back and expulsive pains in the abdomen, Ferrum will
be employed with success.
If the loss of blood has been already considerable
either from not being early enough treated, or in conse-
quence of the failure of the means employed to arrest
it, so that the patient has become very feeble, we should
have recourse to China18th in water, frequently repeated,
TREATMENT AFTER LABOR.
79
as we have indicated for Ipecac., even in extreme cases,
where the symptoms indicate the approaching extinction
of life, such as dizziness of the head, loss of conscious-
ness, drowsiness, faintness, coldness of the limbs, pale-
ness of the face, or bluish tint of the face and hands,
with convulsive shocks.
Our venerated master attached great importance to
magnetic passes, in violent hemorrhages, as a palliative
means of arresting the loss of the nutrient fluid and
obtaining time to administer the proper specific, and for
this to produce reaction.
I have obtained very beautiful results from the appli-
cation of these means in making two or three slow
passes the whole length of the body from the head to
the feet.
CONVULSIONS.
This accident rarely happens after labor, although it
may take place before or after delivery.
The too lively emotion of pleasure in being a mother,
acting upon a brain already over excited by the impul-
sion given to the blood toward the head, in the last
efforts of labor, or the too abundant loss of blood in a
nervous woman, or a painful moral impression, may
cause convulsive movements and even real convulsions,
which 10ws with what attention the state of the wo-
man should be studied in all the periods of labor. We
refer, f the medical treatment required, to the counsels
we ha given, in the paragraph Convulsions, article,
Treat sent of Women During Labor.
:
TREATMENT OF WOMEN IN CHILD-BED.
7 omen in child-bed, are exposed to much more
de ger than in all the other periods of the function of
80
AID TO MIDWIFERY.
reproduction, and in every ten mothers who pay with
their life the creation of a new member of the human
family, nine die during this period. In fact, the great
nervous susceptibility, developed during pregnancy, the
fatigues of this period, the efforts, the very great suffer-
ing, the agonies of labor, the loss of blood she experi-
ences must render her constitution very impressible;
and the revolutions her whole being experiences in the
return of the great mass of the uterus to its normal
state of vacuity, the secretion of milk, the emotions
caused by the state of the new being to which she has
given birth, are serious causes of disturbance in her
economy, rendering her so susceptible to morbid causes,
that the least of these causes may develop a serious and
too often mortal disease. Happily Homœopathy, by its
teachings, is a real providence, especially for women
under these circumstances of her life.
The care required during this period, consists in a
hygiene adapted to the state of the woman, and in the
medical treatment called for by the numerous accidents
which are often the result of this state.
HYGIENIC TREATMENT.
After delivery, the patient should be washed, and
carried to her bed, she should be comfortably covered,
but not warmly enough to excite perspiration. The
breasts should be no more warmly covered than the
rest of the body, but should be carefully protected from
currents of air and from all contact with cold bodies.
It will be well to put two or three drops of Arnica into
the bowl of tepid water, with which the genital parts
should be frequently bathed, instead of the too relax-
-
HYGIENIC TREATMENT.
81
ing mallow water, or irritating warm wine, recom-
mended by some accoucheurs.
As the woman is very much fatigued and very im-
pressible, the most perfect silence and the greatest
possible quiet should be preserved in the apartment,
avoiding also a too bright light.
The temperature of the apartment should be main-
tained at sixty-five degrees Fahrenheit. The room
should be well aired every day, taking the necessary
precautions to prevent the patient from taking cold.
All kinds of odors should be banished with the greatest
severity.
The prejudice which hinders the patient from sleep-
ing is contrary to every law of reason. The woman in
her state of fatigue and exhaustion, can do nothing
better than sleep; only the nurse should take care to assure
herself often that the flow of blood is not too abundant.
The nourishment to be taken by the patient, will de-
pend upon whether she proposes to fulfill entirely the
office of mother by giving the breast to the child or not.
In the first case, an hour after delivery, she may take
meat broth, and repeat it some hours after; afterward,
according to her appetite, she may partake several times
a day of porridge, until the milk fever, after which the
nourishment should be insensibly augmented, passing
to solid food, according to her requirements as nurse,
and to the state of her stomach. If on the contrary,
the patient either cannot or wishes not to nurse, she
should be kept upon broth, or at least very light por-
ridges, until the breasts are sufficiently cleared of the
milk which obstructs them, and from the danger which
its accumulation might produce.
The best drink for a woman in child-bed is sweetened
82
AID TO MIDWIFERY.
water slightly tepid; it may be sweetened with some
simple sirup, or liquorice root. Sweetened water answers
to all the indications for which the allopathists recom-
mend their barley-water, etc. It provokes perspiration,
and the flow of urine, and facilitates digestion, which
all the diet-drinks derange.
Under no other circumstances in life is a moral calm
more necessary than in child-bed.
We should endeavor to maintain the mild moisture
to which the woman is disposed during lying-in, but
not encourage abundant perspiration.
The patient should preserve a horizontal position for
eight or nine days; and those who are feeble will do
well to remain four or six weeks without walking.
MEDICAL TREATMENT.
The circumstances demanding the attention of the
physician are, 1st, The lesions suffered by the genital
parts, in the passage of the child; 2d, The phenomena
produced by the return of the body of the uterus to its
natural state; 3d, The secretion of milk and its con-
sequences, and the state of the breasts when the mother
does not nurse; and 4th, The restoration of the strength,
exhausted by the fatigues and losses sustained.
Among the accidents produced by the passage of the
child, is prolapsus and inversion of the uterus, the con-
tusion and consecutive inflammation of the vulva, the
rupture of the perinæum, the retention and incontinence
of urine, and hemorrhoidal tumors.
PROLAPSUS AND INVERSION OF THE UTERUS.
This accident ordinarily so serious in its consequences
to the woman, is much less so when treated homœo-
PROLAPSUS AND INVERSION OF THE UTERUS.
83
pathically. Either when it owes its origin to the violent
efforts and rapidity of the labor, so that the uterus pro-
trudes through the vulva after the expulsion of the foetus,
or is the result of imprudent pulling, for the extraction
of the placenta, or where abnormal contractions bring
on the prolapsus of the uterus and its inversion, we
should proceed immediately to its reduction as soon as
we shall have recognized the nature of the tumor pro-
truding through the vulva; simple prolapsus of the uterus
is easy to recognize by anatomical recollections of the
form of this organ; its inversion might be confounded
with a polypus, were it not for the absence of the ring
formed by the neck of the uterus around the peduncle
of the polypus.
After the reduction is effected according to the prin-
ciples of art, the woman should remain in bed on her
back for four or six weeks, according to the gravity of
the case, with the pelvis a little more elevated than the
rest of the body, and of a solution of Nux vom. 30th, in
a glass of water we should give a teaspoonful immedi-
ately, and repeat this dose every six hours for eight
days, if the particular symptoms do not contra-indicate
this medicine, or demand another more urgently; in
these cases, we should return to the use of Nux vom.,
as soon as the phenomena which required its suspen-
sion shall have ceased. It is rare that this medicine is
not alone sufficient to the cure, and the restoration of
the ligaments of the uterus to their normal condition.
However, if, after fifteen days, in rising the woman
feels a certain heaviness in the region of the uterus, we
should give Sepia 30th, in eight spoonsful of water, one
every morning, to return again eight days after to
Nux vom.
84
AID TO MIDWIFERY.
All efforts in the evacuation of the fæces must be
avoided, and if this function is performed with diffi-
culty, notwithstanding the action of Nux vom., we
should give an injection of water every time the patient
feels the need of going to stool. It being well under-
stood that all bandages, and pessaries of whatever form
or substance, must be banished, because, beside inter-
fering with the action of the medicines, they cause a
mechanical irritation injurious to the diseased parts so
impressible, and so much disposed to inflammation.
The local treatment, after the reduction, should be
limited to the hygienic care indicated above.
CONTUSION OF THE VULVA.
This lesion is ordinarily removed without the aid of
art; however, a few drops of the tincture of Arnica, in
the water used for bathing these parts, will greatly
facilitate its cure and prevent consecutive inflammation.
This inflammation, if developed by the cause alluded
to above or through any other, may be efficaciously
combated with Merc. sol. 30th, in water, a teaspoonful
every three or six hours, without any local emollient
application, which would only increase the afflux of
blood to the inflamed part; if this medicine does not
entirely remove the evil, we should administer a dose
of Thuja 30th, in the same manner. Aconite would not
be indicated unless the extent and gravity of the inflam-
mation produced a high fever with chills.
RUPTURE OF THE PERINEUM,
Is a terrible accident, which, when she has no other
resources for aid than those offered by the surgery of
the old school, threatens the woman with a disgusting
RUPTURE OF THE PERINÆUM.
85
infirmity for the rest of her life; happily, thanks to
Hahnemann, Homoeopathy offers a much more effica-
cious means of cure in the skillful use of Arnica. As
soon as we have discovered this accident, we should
hasten to cleanse the patient and put her in bed; the
parts should then be washed with water in which we
have put some drops of Arnica; afterward we should
bring together the edges of the wound and cover them
with a thick and large compress of lint saturated with
pure tincture of Arnica, and maintain the union of the
edges of the wound by thick compresses, wet with the
arnica lotion; over these should be crossed two bandages,
which, starting from, and securely attached to, a large
body bandage firmly inclosing the pelvis, descend
behind and under the two thighs, tending to bring them
together, and crossing opposite the perinæum, remount
and are attached to the body bandage, each in front of
the opposite groin; the woman should be kept lying
motionless on the side which is most agreeable to her.
During the first days we should renew the dressing
very frequently, to facilitate the flowing of the lochia;
the following days it will suffice to renew them every
time the woman is obliged to urinate. I recommend
the saturation of the compress in the pure tincture of
Arnica because the abundant flowing of liquids from
the uterus dilutes it very soon, and consequently renders
its action less sensible; when the lochia shall have di-
minished, we may mix the tincture with an equal quan-
tity of water.
This dressing and these precautions should be con-
tinued for six weeks in order that the cicatrice may have
time to consolidate. It will be prudent during the first
week to assist this local treatment by the internal admi-
8
86
AID TO MIDWIFERY.
nistration of Arnica, if other and more urgent indica-
tions do not present themselves. The woman should be
kept upon a strict diet, and drink as little as possible, to
avoid the frequent occasion of renewing the dressing
after urinating or going to stool. I recommend with
confidence this course of treatment, because it succeeded
perfectly with me in the case of a woman (passage St.
Marie, 2, Faubourg Saint Germain).
At the moment of the passage of the head through
the vulva, the cot-bed (lit de sangle), being too feeble,
gave way, the woman fell with a shock, and on raising
her I found the perinæum ruptured up to the edges of
the anus, with a considerable loss of blood. I imme-
diately gave two drops of Arnica 12th, afterward, after
having delivered her and put her to bed, I applied the
dressing that I have described, and at the end of six
weeks the cure was complete; the vulva indeed
remained a little large, but the perinæum was restored
and all the functions were regularly performed. Com-
pare the gentleness of these means and their results
with the sutures and other means of the reigning school
and their results, and see if Homœopathy is not a pro-
vidence for women in labor!
RETENTION OF URINE.
The pressure of the head upon the urethra and neck
of the bladder during its sojourn in the pelvis, and even
during its passage, produces a contusion of these parts
which sometimes hinders the passage of urine, and pro-
duces its retention after labor. Arnica would seem to
be the specific for this accident, evidently produced by a
mechanical lesion; experience has proved to me that it
is not so. My dear daughter, after a very fortunate
RETENTION OF URINE.
87
+
labor, inasmuch as being her first, her severe pains
lasted only one hour, remained twenty-four hours with-
out urinating. As she had acquired at boarding-school
the habit of retaining her urine, in consequence of which
this delay often happened to her, I did not attach much
importance to it in this case; nevertheless as the genital
parts were painful, I had her bathed with water lightly
charged with tincture of Arnica in the manner before
indicated. After forty-eight hours no urine having
been passed notwithstanding the applications I had
recommended, and the region of the bladder being volu-
minous without however the patient feeling the need of
urinating, I introduced a gum-elastic catheter with great
facility through which flowed a considerable quantity
of urine of natural quality.
Arnica 12th in water, a teaspoonful every three hours,
did not preserve me from the disagreeable necessity of
introducing the catheter during two days. The third
day I gave Bell.300 in the same manner, and the same
evening even the emission took place spontaneously and
continued afterward without interruption. This fact
proves that the circumstances, among others the occa-
sional cause, should only be considered after the proper
symptoms, in the picture of a disease, for the choice of
a medicine; for Arnica has indeed tenesmus vesicæ,
but not retention of urine in its pathogenesis, while in
that of Bell. the retention of urine is clear and repeated
in several groups of symptoms. Thus this medicine
should be considered as a specific under these circum-
stances, in which the uterine system, with which it has
so great an affinity, is over-excited at the same time that
the bladder cannot exercise its functions.
-
88
AID TO MIDWIFERY.
INCONTINENCE OF URINE.
The same cause which produces the retention of urine
in a woman newly delivered, may produce its inconti-
nence if it lasts longer or is exercised with more vio-
lence. A prolonged or violent pressure upon the neck
of the bladder may paralyze it and render it incapable
of retaining the urine. Arnica, in this case should be
an efficacious medicine, because beside being adapted
to the cause, it offers in its pathogenesis the involuntary
flow of urine. After this medicine administered in the
manner described above, if the inconvenience has not
entirely disappeared, we should have recourse to Bell.,
of which we should repeat the dose every twelve or
fourteen hours if necessary. If the disease has become
chronic and does not yield to these two medicines, we
should give Sepia or Sulph. These medicines, in this
case, should be given in a single dose, and only once,
awaiting the action for several days; they may be alter-
nated every eight or fifteen days.
HEMORRHOIDS.
Sometimes immediately after labor, through the pro-
longed distension of the anus by the head of the child,
or the breech resting at the inferior strait, the hemor-
rhoidal vessels receive such a development that all the
functions of the parts in this region become deranged,
the flow of the lochia and the evacuation of the urine
and fæces is suspended, in addition to which the sharp
pains and the agitation they cause deprive the patient
of all rest.
*
Homœopathy possesses in Puls. a very efficacious
means of appeasing this disorder. A small and delicate
AFTER-PAINS.
89
woman, delivered two hours before of her fourth child,
after a long and painful labor, had a mass of hemor-
rhoids of the thickness of the thumb, surrounding the
anus; she had frequent desire to urinate without the
power to do so; the flowing of the lochia was arrested ;
severe pains and agitation with fever prevented repose.
I gave Puls.30th in a glass of water, a teaspoonful every
two hours. Ten minutes after the first spoonful, the
pains were appeased, and an abundant evacuation of
urine took place without suffering; the lochia returned
at the same time, and without renewing the dose the
hemorrhoids subsided and the recovery afterward took
its regular course.
The return of the uterus to its normal state of vacuity
can only take place through the successive contractions
of its muscular coats and the expulsion of the abundant
fluids impregnating them, and the blood and mucus
contained in its cavity. These contractions, more or
less painful, constitute what are called after-pains, and
the evacuation of blood and other fluids contained in
the uterus after the expulsion of the placenta, with the
subsequent secretions from its internal surface, con-
stitute what is called the lochia. We are about to
examine in what manner these two functions may be
deranged and indicate the homoeopathic means of cor-
recting their aberrations.
AFTER-PAINS.
Doct. Gross and other homoeopathists have recom-
mended the administration of a globule of Arnica im-
mediately after delivery for the purpose of preventing
the after-pains, considering them, without doubt, as the
effect of mechanical lesions of the organs of generation
90
AID TO MIDWIFERY.
through the efforts of labor; but these pains, as we have
just seen, do not recognize this cause; they are the
effect of a natural and indispensable function with which
it would be very injurious to interfere, since in checking
them we should hinder the return of the uterus to its
normal state and permit the loss of blood to continue;
beside Arnica has no appreciable action upon the after-
pains; and, by that which it possesses upon the vascu-
lar system, it might produce injurious effects.
I counsel the physician, then, to abstain in ordinary
cases from this practice of attempting to prevent the
after-pains, reserving it for those cases where the long
retention of the head at the inferior strait produces pre-
sumable lesions of these parts. If the after-pains are
moderate we should abandon them to nature, as an evil,
as inevitable as the pains of labor. When through their
violence or frequency they prevent sleep, Coffea or
Cham. will soon calm them and enable the patient to
obtain the repose which is so necessary.
Coffea is preferable for very nervous women who can-
not, or who do not know how to support pain, or if there
is wakefulness, or if the patient has taken too much
chamomile tea. Chamomilla, on the contrary, should
be given when the woman is habituated to coffee, if she
is of a very lively temper, and if there is an extraordi-
nary thirst.
If the pains press toward the rectum, with desire to
go to stool, she should smell Nux vom., if she is of an
active and decided character; if ou the contrary, she is
gentle and timid, with a predominance of the veinous
system, she should smell of Pulsatilla.
We should enjoin the most absolute repose and the
most perfect quiet around the patient.
LOCHIA.
91
LOCHIA.
After delivery the open mouths of the vessels of the
uterus discharge a greater or less quantity of blood
until the uterine contractions, gradually diminish their
capacity and finally entirely close them, and the mucous
membrane, at first enormously distended, secretes an
abundance of mucus which diminishes in proportion as
the membrane returns to its ordinary extent and the
uterus to its natural dimensions; these various excre-
tions of blood and mucus constitute the lochia.
This excretion should attract the attention of the
accoucheur, because it may be considered, so to speak,
as the thermometer for determining the state of the most
interesting viscus of the lying-in woman, the uterus.
Should not the study of these alterations, strictly
speaking, be separated from those of the diseases of this
organ; we will follow however the custom of the pro-
fessors of accouchement who make always a separate
article on the alterations of the lochia; alterations which,
beside, may take place without any other perceptible de-
rangements of the genital organs. The lochia may be
altered in their quantity or in their nature.
It is impossible to determine the exact quantity to
which the lochia should attain; experience only and the
state of the patient should guide us in this appreciation;
the flow which is hardly sufficient, in the case of a
robust and plethoric woman, would be excessive and
morbid in the case of one feeble and nervous. In
general, the lochia gradually diminish, and cease entire-
ly some days before the return of the monthly periods,
or immediately after these. In the case of women who
nurse, they cease ordinarily fifteen days or three weeks
after labor.
92
AID TO MIDWIFERY.
The diminution or the suppression of the lochia is
commonly the symptom of another affection; for it is diffi-
cult to conceive of the alteration of a secretion without
a derangement in the state of the secreting organ; it is
then under these circumstances, to this organ that the
attention of the physician should be particularly direct-
ed. It happens, however, sometimes that the dimuni-
tion or suppression of the lochia takes place so promptly
that it may be considered as idiopathic, and become in
itself the cause of more serious disease if not remedied
in time. These cases occur, when in consequence of
a sudden moral affection, a cold or other hygienic error
suddenly impressing the woman, a spasmodic contrac-
tion of the orifices of the vessels of the internal surface
of the uterus takes place, and the secretion is diminished
or suspended.
The diagnosis of this derangement is established by
the fact itself; but it is very important to the treatment
we prescribe, if we expect a prompt cure, that it be
made in reference to the exciting cause.
The choice of the remedy should also be influenced
by the nature of the lochia; it would be different if
they were still formed of pure blood, or if this liquid
had entirely disappeared at the epoch of the accident.
The suppression caused by a moral impression should
be combated by the medicine appropriate to this cause
which we have indicated in the article, Treatment of
Women During Pregnancy. I will only remark here
that Aconite offers more reasons for being preferred when
the suppression takes place soon after labor, when the
flow is still sanguineous and the woman experiences
pain in the abdomen with anxiety, and a disposition to
congestion to the chest, abdomen or head.
LOCHIA.
93
If the suppression of the lochia is produced by a
chill, we should also have recourse to Aconite, if it is
accompanied by fever, heat in the face and other prin-
cipal symptoms proper to this medicine. If it is ac-
companied by diarrhoea with colic, with some nervous
pain in the head, teeth, etc., febrile heat, we shall obtain
good results from Cham. Coffea, Nux vom., Dulcam.,
Bryon., and Puls., would also be indicated if there
are the characteristic symptoms of these medicines.
If the suppression does not cease under the action of
the medicines appropriate to its cause, and if other
morbid symptoms do not develop themselves, which
very often happens, especially when it takes place some-
time after labor, it is better to leave it to nature, be-
cause in this case it can have no injurous influence
upon the re-establishment of the patient. If on the
contrary, this accident is accompanied or followed by
more or less serious affections, we must be guided by
the symptoms accompanying them in the choice of
a medicine.
If the suppression is accompanied by symptoms
which make us fear an inflammation of the viscera of
the abdomen, we should have recourse to Aconite, to
Bell., or to Merc., according to the indications we shall
give in the articles Puerperal Peritonitis and Metritis.
If the suppression is accompanied with violent colics or
tympanites and diarrhoea, we should give Colocynth.
If the milk disappears from the breasts, we should give
Puls. If there are violent pains in the head, redness
of the face, frightful visions, delirium, we should choose
Bell., or Hyoscyamus. This last will be preferable if
the loss of consciousness is complete.
If symptoms of nymphomania manifest themselves,
9
94
AID TO MIDWIFERY.
we shall find a valuable resource in Platina. Several
other medicines, such as Nux vom., Sec corn., etc.,
may be called for under the different circumstances
which accompany, or are caused by the accident under
consideration; but I do not wish to abridge here what
I shall be obliged to say more completely in the dif-
ferent articles on the diseases of women in child-bed
which will be found farther on.
DIMINUTION OF THE LOCHIA.
We have said that it was impossible to determine the
quantity of this secretion at the different periods of
lying-in, the experience of the physician and the habits
of the woman, are the best guides in directing its ap-
preciation. What we have said upon the suppression
of the lochia may also serve as a rule for remedying its
diminution, when its presence causes us to fear danger
for the woman.
AUGMENTATION OF THE LOCHIA.
We would observe that the augmentation of the
lochia differs according to the nature of the discharge:
if it is still sanguineous, or if it has already become
mucous, and according as it has taken place at a period
more or less distant from the labor. We must also have
regard to the cause which has produced it. The most
common causes of this kind of derangement of the
lochia, are a moral impression, a chill, an imprudence
in rising or walking too soon, the abuse of liquor,
sudorific drinks, too great heat of the chamber, or of
the covering of the bed, coitus, etc. As for the moral
causes, I will not repeat what I have several times said
with regard to them, of the importance of combating
LOCHIA.
95
their effects, as soon as possible, by medicines appro-
priate to the nature of each of these causes previously
indicated.
If there has been a chill, we should have recourse,
according to the nature of the symptoms which accom-
pany the augmentation of the lochia, to Aconite or
Nux vom.
We should administer the first if the patient
has a full pulse, face red, head heavy and full, and
other symptoms belonging to this medicine; we should
prefer Nux vom., if the pulse is hard with paleness of
the face, pains in the back and weight in the anus,
chills, alternating with heat, etc. If the accident has
been caused by fatigue, the most absolute repose and a
very small dose of Arnica 30th, will ordinarily suffice to
remove it. It is sometimes produced by the abuse of
warm drinks, alcoholic or spiced, or of very warm
sudorifics, or of coffee or chamomile; we know the
marvelous effects of Nux vom. in combating the effects
of spirituous drinks, it will be found also very effica-
cious in this case on account of its affinity with the
sexual organs. If however, the augmentation of the
lochia, produced by this cause, is accompanied by great
agitation and an exalted nervous sensibility, Coffea
would be preferable at first, to be followed by the medi-
cine aforenamed. If Coffea does not suffice, Lachesis
and many other medicines have been recommended,
but I believe the two designated above, will suffice in
these cases. If there has been an abuse of spiced drinks,
these same medicines will be also useful, and according
to circumstances, China. The routine of the nurses
and midwives, consists in the frequent use of the infu-
sion of Chamomile for women in child-bed; nothing
can be more injurious and dangerous than this practice.
96
AID TO MIDWIFERY.
The most serious accidents, and, in particular, the one
which now occupies us, uterine discharges, abdominal
inflammations, convulsions, etc., are too often its conse-
quences. This drink should be forbidden to women in
child-bed, because it has too direct an action upon an
organ which has so much need of skillful management,
the uterus. The medicines, in this case are Nux vom.
and Ignatia, and still Coffea, if the patient is not
habituated to its use. If the increase of the lochia is
the effect of too great heat in the apartment or of the
coverings, feather beds, etc., more rational hygienic
treatment will generally suffice to arrest them. If not-
withstanding this treatment it persist, we should have
recourse to the medicines indicated by the symptoms,
as we shall hereafter sketch them.
The symptoms which should direct us in the choice.
of the medicine in the morbid augmentation of the
lochia, are drawn from the nature of the discharge,
from its quantity and from the phenomena which ac-
company it. If the discharge is sanguineous, it is
difficult to distinguish it from uterine hemorrhage,
otherwise than by its quantity; in this case, for the medi-
cine to employ, we refer to the rules given in the para-
graph Metrorrhagia. We would however observe
that, in this particular case, when the sanguineous
discharge continues too long without being very abund-
ant, and exhausts the patient by its duration, with
derangement of the digestive functions, etc., we have
obtained very happy effects from the employment of
Calcarea 30th, in a glass of water, a teaspoonful every
evening: at the end of a few days, the discharge re-
sumes its normal state, the appetite returns and health
is re-established as if by enchantment.
LOCHIA.
97
When the augmentation consists only in a more
abundant mucous discharge, the medicine I have just
designated is also often efficacious, if there are suffer-
ings in the abdomen, swelling, and flatulence, pains,
difficult digestion, disposition to diarrhoea, diminution
of the milk in the breasts of those who nurse, etc.;
Puls. will be often indicated in this indisposition when
the discharge is thick, mucous, with pains in the
loins, and a sad and mild humor. Sepia has much
analogy with Puls., in this case; it should be employed
if this does not suffice to moderate the discharge, or
indeed if the liquid excreted is serous or milky, if it is
sour and if it excoriates the genital parts, if the woman
has a hardness of the neck of the uterus, and above all
if the temper is sad, morose and peevish. Merc. should
be given when we remark a dispositon to abdominal in-
flammations or of the genital parts, and if the discharge
is more abundant at night. If the very abundant dis-
charge enfeebles the woman, and is not corrected by the
means indicated, we should give a dose of Sulph. 30th,
and some days after return to the other medicines, ac-
cording to the nature of the symptoms.
Sec. con. will prove a very precious resource in case
the woman is very much enfeebled.
Under these circumstances we should order for the
patient a substantial nourishment composed of meat-
soups and of roasted meats in moderate quantities; her
apartment should be often and thoroughly aired.
The lochia may be altered in their nature, which is
always the effect of a derangement of the mucous
membrane of the uterus or of the vagina, and does not
consequently need to be studied apart. However, as
sometimes these alterations are the only, symptoms
⠀⠀:
98
AID TO MIDWIFERY.
offered by the derangement of the secreting organ, we
will give summarily the indications proper to the greater
part of these alterations.
The lochia sometimes assume again a sanguinolent
nature. If the quantity is not too abundant, this alter-
ation will not require any medicine; in the contrary
case, we should have recourse to Calcarea or to Sepia,
according to the precepts above, or to Conium, if the
discharge corrodes the parts. Sometimes the lochia
become suddenly black, almost like ink, which gene-
rally frightens the woman and inexperienced persons;
this color, if it is not accompanied by a very decided
putrid odor, deserves no attention on the part of the
physician, it is the effect of the dissolution of the mem-
brana caduca or of some fragment of placenta, or some
clots of blood remaining in the uterus; and the lochia
recover their natural color as soon as those fragments
are entirely removed by the uterine secretion. If the
lochia take an appearance of suppuration, it is still
Sepia which will be found most commonly useful;
Merc. and China might, as we have said above, be
indicated under some circumstances. The lochia some-
times emit an almost insupportable odor of putrefaction;
if this odor is not the effect of the negligence of the
hygienic care enjoined, it should attract the attention
of the physician, because it is the indication of a bad
pathological state of the uterus, for which he should
administer a remedy; if, however, notwithstanding this
character of the discharge, the uterus and the other
organs of the abdomen offer no particular symptoms,
we should still remove this odor which must be so dis-
agreeable to the patient.
The medicines most successful with me for this end
Judy
SECRETION OF MILK, LACTATION, ETC.
99
are Sepia, and above all, Creosote, the 30th dynamiza-
tion, one globule in a glass of water, a teaspoonful
morning and evening. It being well understood that
the greatest cleanliness is indispensable.
SECRETION OF THE MILK,
OF THE MILK, LACTATION AND
THE BREASTS.
The breasts augment in volume and in hardness from
the first days of pregnancy, and this continues until
toward the end. They discharge sooner or later a
serous liquid, the first rudiment of the future milk
Great care should be taken to avoid all compres-
sion upon these important organs, especially in the
region of the nipple, in order that it may develop freely
and be easily seized by the child; if, notwithstanding
this precaution, the nipple remains undeveloped, it will
be necessary to procure its development by the mechani-
cal means taught by accoucheurs. Twenty-four hours
after labor, the woman experiences pricklings in the
breasts, which swell and harden so as to occupy the
whole anterior surface of the chest and even the arm-
pits, and incommode the respiration; the woman feels
as it were a heavy weight upon the chest which suffo-
cates her. These phenomena are accompanied by a
general febrile disturbance called milk-fever. This
fever commences ordinarily on the second or third day
after labor by headache, pains in the back, chill alter-
nating with heat, soon followed by dry burning heat,
redness of the face, pain in the front part and sensation
of fullness of the head as if it would burst, pulse full,
hard, thirst, tongue white, suppression of the lochia.
We must be careful not to confound this state with
puerperal peritonitis from which, even at the commence-
100
AID TO MIDWIFERY.
ment, it is distinguished by the slight duration of the
chill, and especially by the abdomen not being painful
to the touch.
Six or twelve hours after the commencement of the
fever, profuse perspiration commences, the breasts begin
to relax, milk flows spontaneously, the lochia become
again sanguinolent and everything returns to its normal
state.
In the regular course of the milk-fever, if the suffer-
ing is not too violent, it is better to give no medicine,
and to content ones-self by administering simple and
tepid drinks, according to the desire of the patient; she
should be kept moderately covered, avoiding currents
of air and the fatigue of importunate visits, because this
fever constitutes a critical movement of nature to effect
the lacteal secretion, and the complete disgorgement of
the uterus with which we should be careful not to inter-
fere by medical influences, especially if we take care to
give the child the breast as soon as the milk begins to
flow. This precaution is the best means of preventing
the discomfort arising from the milk-fever. In the case
of women who do not nurse, this fever is much more
violent, and homoeopathy may be very useful in mode-
rating it and diminishing the suffering. When the
pulse is strong, full, with a violent headach, we should
administer Aconite 24th, two globules in a glass of water,
a teaspoonful every two hours; in this manner we
diminish the vascular orgasm and a salutary perspira-
tion is sooner established; if the too great flow of milk,
produces, by the excessive enlargement of the breasts,
a sensation of oppression upon the chest, we should give
Bryonia 30th, a globule in water, a teaspoonful every
three hours. Some minutes after the first spoonful the
Mчou
-
SECRETION OF MILK, LACTATION, ETC.
101
patient already experiences relief, and breathes more
freely.
This medicine has always sufficed with me to remedy
the too great accumulation of milk in the breasts, and
to procure a desirable termination to the fever. How-
ever, if under unfavorable circumstances an afflux of
blood to the head, during the fever, is accompanied by
very violent pain in this part, with partial delirium, the
eyes brilliant, etc., which give us cause to fear a cerebral
inflammation, after two or three doses of Acon. we should
give Bell 30th in the manner indicated for Bryonia, until
the cerebral symptoms are overcome; then we should dis-
continue all medicine, if the state of the breasts do not
demand the medicine we have indicated as appropriate
to them. If the labor has been severe, with lesions of
the genital parts, and if we have neglected in this case
to give Arnica immediately after labor, as we have pre-
scribed in its place, a dose of this medicine, alternated
with Aconite, may be usefully administered to diminish
the reaction of the lesion of the genital parts upon the
arterial system, and to moderate the fever.
The question with accoucheurs, whether it is proper
to present the breast to the child before the milk-fever,
cannot be one with a homœopathist accustomed to study
and to follow the designs of nature. For the reasons
already given we recommend placing the child at the
breast as soon as the mother feels the milk flowing into
them; this means ordinarily succeeds in preventing the
engorgements of the breasts and other accidents pro-
duced by the accumulation of the milk, if the nurse is
careful to protect her breasts from cold and other exter-
nal injuries.
102
AID TO MIDWIFERY.
But things are not so easily managed in the case of
the mother who does not nurse; after the cessation of the
fever, the milk continues to flow and accumulates in the
breasts; and may become the cause of engorgement or
of inflammation of the breasts; the physician must
prevent this afflux by the deprivation of nutritive food
for the necessary time, and by warm drinks to facilitate
perspiration.
When these means do not suffice to prevent the afflux
of milk to the breasts, if there are no contra-indications,
I should administer Puls.30th, two globules in eight
spoonsful of water, a spoonful every morning; at the
end of a few days the fullness of the breasts diminishes,
and the milk ordinarily disappears before the medicine.
is all taken. It is however possible that in very lym-
phatic persons this medicine would not alone suffice to
suppress the flow of milk to the breast.
Doct. James Lembke reports, in the twenty-seventh
volume of the General Homœopathic Gazette, an obsti-
nate case of secretion of milk during pregnancy, which
only yielded to a dose of Lycopod.
Calc. carb. has been employed with success in very
obstinate cases of this kind. (See Weaning.)
The secretion of milk does not always take place as
regularly as we have just described; sometimes, instead
of enlarging and causing pricklings to the patient, the
breasts remain soft and pliant for several days, and the
function of lactation is thus hindered. The physician.
should then inform himself of the probable cause of
this accident, which will be sometimes found to consist
in a deficiency of nourishment, especially in the case of
women who have been several days in labor, during
SECRETION OF MILK, LACTATION, ETC.
103
which they do not commonly take food. This want is
easy to remedy by means of well-chosen and substantial
nourishment.
Doct. Jahr reports, in his clinical advice, the case of
a failure of the secretion in consequence of a plethoric
state with a very violent milk fever, and recommends
to remedy it Aconite, Bryonia, and Cham., or Bell.,
or Merc.
This case has never presented itself to my
observation; but, if it should occur, the medicines re-
commended ought to produce a happy result. The
most frequent cause of the failure of milk, when it is
not owing to a want of nourishment, is a lymphatic
constitution, a feebleness of the arterial system or of the
vital force, general constitutional weakness, or some
debilitating moral affections, such as long-continued
sorrow, bad health during pregnancy, etc.
The most efficacious remedy, and one which has
never failed me in the numerous cases in which I have
employed it, is Agnus castus; three globules of the 12th
dynamisation in a glass of water, a teaspoonful every
three hours, until the secretion is established. If
the woman proposes to nurse, we should not wait more
than thirty-six hours before giving her this medicine, if
in this space of time she has not felt pricklings in her
breasts, the precursor of the secretion, because, in wait-
ing longer, the child might suffer by a too long delay
in suckling. This medicine, I have also employed with
success, when in the course of lactation, the milk di-
minishes in the breasts, or disappears without any ap-
preciable cause; we should however, always choose our
medicine with reference to the cause when we can re-
cognize it; thus if it was anger, we should give Chamo-
milla; if grief, Ignatia; if jealousy in love, Hyoscya-
104
AID TO MIDWIFERY.
mus or Phos. acid; if by a chill, Dulcamara, etc.
Puls. and Calc. by that alternate effect which so many
homœopathic medicines possess of succeeding in quite
opposite diseases, have also been recommended under
these circumstances, and the annals of science afford
many observations in which their administration has
produced favorable results in the diminution or suppres-
sion of the milk.
Dr. Kallenbach, of Berlin, having remarked in an
allopathic journal that when they employed for a long
time asafoetida plasters upon the epigastrium of hysteri-
cal women, there resulted sometimes a swelling of the
breasts, which discharged a milky liquid, thought that
this medicine might be employed with advantage in the
suppression of the milk of nurses, and to convince
himself, he administered it in four cases which he re-
ports. I give them here to the reader in order that he
may judge for himself of the reality of this presumed
virtue in asafoetida.
1st. Madame G., aged thirty-four years, very robust,
had never been able to nurse her children, because
between the eighth and fourteenth day her milk disap-
peared. In April 1845, happily delivered for the
seventh time, the secretion of milk was very well estab-
lished on the fourth day, but from the fourteenth day
the milk commenced to diminish, and on the sixteenth
it had entirely disappeared. M. Kallenbach prescribed
Tinct. Asafoetida, a drop in a drachm of alcohol to be
taken three times a day, five drops, upon a piece of sugar.
The second day after the commencement of the use of
this preparation, the secretion of the milk was fully
re-established, and, three days after the child com-
menced suckling; its excrements emitted the odor of the
•
SECRETION OF MILK, LACTATION, ETC.
105
medicine. Notwithstanding that, he continued it for
eight days, and the secretion of milk lasted three weeks
and a half, after which the use of the asafoetida became
again necessary, and as the nurse disliked the bad taste
of this medicine, he replaced the first preparation by
the third attenuation of Hahnemann, which still had a
distinct odor of asafoetida; the effect was also effica-
cious. In the eighth and the thirteenth week, a relapse
called anew for the remedy; at last in the eighteenth
week in consequence of violent grief, the milk disap-
peared altogether, and could no more be recalled by any
means. M. Kallenbach remarks, that although suffi-
ciently large, the mammary glands possessed but very
little sensibility.
2d. Madame K., strong and vigorous, aged twenty-
one years, in her first labor, remarked, six weeks after
confinement, a sensible diminution of her milk. M.
Kallenbach ordered Tinct. Asafetida 3ª, and after four
days, the secretion of milk had again become abundant,
he continued every eight days five drops upon a lump
of sugar, and at the ninth month the nursing was con-
tinued with success.
3d. Madame S., aged thirty-four years, of a some-
what feeble constitution, had already nursed three
children although with insufficient milk, since after eight
weeks, she was obliged to add the sucking bottle. De-
livered for the fourth time on the seventeenth of Septem-
ber, she complained on the seventeenth of November
of such a diminution of milk, that she had been obliged
to feed the child for three weeks. M. Kallenbach pre-
scribed Asafoetidas, three times a day without success;
after the employment of this medicine, eight days with-
out effect, he prescribed the first dilution, three times a
106
AID TO MIDWIFERY.
day as before, with striking success. Eight days after,
the secretion being completely re-established, he dis-
continued the medicine. The twenty-eighth of Decem-
ber, having remarked a new diminution of milk, the
patient took the third dilution of the medicine, three
times a day, five drops: and every eight days a similar
dose. The effect upon the nurse was complete, she was
able to dispense with the bottle, although she made no
change in her habitual nourishment, so that the aug-
mentation of the milk could be attributed to no other
cause than the action of the medicine.
4th. In this case, the medicine remained entirely
without effect, because the woman, attacked with peri-
tonitis the fourth day after labor, could only be cured
after four weeks, and at that time the breasts were
entirely softened; notwithstanding every effort, he could
not recall the milk.
Dr. J. Lembke, before mentioned, reports in the same
journal, volume 37, Page 355, an observation in which
asafoetida remained entirely without effect, although he
administered it two, three, and four times a day, for a
long time, after he had in vain employed for the same
purpose Bell. 6th and Cal. carb. 20th, from the time of
labor. Bell. 4th appeared at last to have a better result.
I am not astonished at the uncertainty and want of
success with a medicine which required to be given in
such large doses, to obtain an augmentation of a secre-
tion of milk; beside, the short duration of its action.
proves that it acts only as a palliative, and by an anti-
pathic virtue. We should leave it then to the allopath-
ists, we who have surer, more durable and more gentle
means. How does it happen that M. Kallenbach did
not think of the injury he might do to the child, by so
1
SECRETION OF MILK, LACTATION, ETC.
107
large a dose of so powerful a substance given for so
long a time to the nurse?
The milk may also be altered in its quality, may
become too serous to suffice for the nourishment of the
child, or acquire certain qualities imperceptible to exter-
nal observation, but which renders it unpalatable to the
child. In the first case I have used Sulph. 30th with ad-
vantage, in a spoonful of water, and, eight days after,
Calc. carb. in the same manner, if Sulph. did not suffice
to give the milk more body. We should, however,
have regard to the constitution of the nurse, and to the
causes of this defect in the lacteal secretion. In the
second case, that is to say, when the milk is refused by
the child, Merc. viv., recommended by our authors, has
succeeded with me several times in correcting this ano-
maly in the milk. I put two globules of the 30th in a
glass of water, and administered a teaspoonful every
four hours. After the second teaspoonful, the child com-
monly took the breast with avidity.
Is the milk of the nurse, who has her catamenia, hurt-
ful to the child? This opinion is a prejudice resembling
that with regard to the milk of the woman at the com-
mencement of pregnancy; under these two circumstances
the milk is only rendered less substantial, and conse-
quently, less nourishing; it would be an imprudence in
the physician who should endeavor, by means of medi-
cine, to remedy a defect in the milk through these causes,
as he would be acting against the wise intentions of
nature, which the homoeopathist should always take for
a rule in guiding his choice of medicine; in these cases
he should content himself with having the nurse feed
the child, in order to replace the nourishment which no
longer exists in sufficient quantity in the milk.
108
AID TO MIDWIFERY.
WEANING.
We have nothing to add to what physiology and all
the treatises upon accouchements teach upon the proper
time for weaning; it is a complex problem which can
only be solved by the state of the nurse and that of the
child. A new pregnancy, the presence of the menses,
with a diminution of milk, a state of exhaustion mani-
fested by distressing pains in the stomach, especially
while the child nurses, or immediately after, anorexia,
faintings, etc., will make weaning necessary for the sake
of the mother; nature refuses to continue this function
longer.
On the part of the child; nature teaches that it should
have the breast, until by the acquisition of teeth it is in
a condition to take other nourishment; so, that if the
nurse is in good health, it would be preferable to delay
the weaning until after the appearance of the canine
teeth. I should even prefer to delay it until after the
appearance of the first two molars, because the breast
is a great resource in the diseases with which these little
creatures may be affected at this early period of their
lives. When the milk has almost disappeared from the
breast, and the child uselessly fatigues itself during suck-
ling, it becomes necessary to wean, because this fatigue
might injure the stomach of the child. It is well under-
stood that additional nourishment should be given to the
child, as it appears to be needed by the quality or
quantity of the milk.
When the nurse has decided to wean, she should pre-
pare for it, by gradually giving the breast at longer
intervals, and diminishing the quantity of her food;
after pursuing this course for several days, she should
cease entirely to give the breast, and keep her bed for a
CONSUMPTION OF THE NURSE.
109
day or two, upon a very light diet, with watery, tepid
drinks; and if she still feels, in spite of these precau-
tions, the milk flowing into her breasts, she should take
Puls. in water, a teaspoonful every morning for eight
days, she should cover the breasts lightly with a muslin
handkerchief several times doubled. The habit of
smothering them under cotton batting is contrary to the
end proposed, and may have very sad results, the least
of which is the disappearance forever of these precious
ornaments. If Puls. does not suffice we may give
Calcarea in the same manner.
CONSUMPTION OF THE NURSE.
This disease in the nurse may depend upon causes
inherent in her constitution, such as the development
of pulmonary tubercles, excited by nursing, etc. This
species of consumption does not enter within the limits
we have traced for ourselves, because, in order to treat
of all the diseases to which women are liable in the
different periods of the function of reproduction, it
would be necessary to make a complete treatise upon
therapeutics; the diseases we propose to study are those
which are exclusively dependent upon the different
states of women during the performance of this func-
tion. Thus, the consumption with which we shall
occupy ourselves, is that which is produced by the ex-
haustion caused by a too prolonged, and too abundant
secretion of milk, or by too strong a suction on the part
of the child. The premonitory symptoms of this are
dejection, general feebleness, invincible sadness and in-
clination to weep without cause; an empty, hollow feel-
ing in the stomach, anorexia, or bulimia, great thirst,
tearing pains in the anterior part of the chest, extend-
-
10
110
AID TO MIDWIFERY.
ing under the shoulder-blades to the back; these suffer-
ings are aggravated during, and after suckling the child.
If we do not remedy this state, there are soon added
pains and fever in the afternoon, redness of the cheeks,
night-sweats, and all the symptoms of a consumption.
The first means to employ, in this case, is to wean
the child immediately if the nursing has already con-
tinued long enough, or if the disease has received a
certain development. If it is observed from the com-
mencement, a dose of China 30th, suffices to repair the
disorder, and restore the nurse to a condition to con-
tinue her function; in cases more advanced, where
weaning has become indispensable, China is still the
medicine with which we should commence the treat-
ment, and, if it does not suffice, we should give Calcarea
and afterward Lycopodium; by these means, we shall
prevent an alteration of the parenchyma of the lungs,
and re-establish the functions of the alimentary canal.
We may assist the action of these medicines by a good
restorative regimen, fresh air, and exercise.
ABSCESS OF THE BREASTS.
A current of air upon the breasts, or a sudden cold
applied to the hands, or an accumulation of milk
through some fault in suckling the child, or because the
papillary orifices of the milk-vessels are obstructed, or
mechanical violence, produces sometimes a very painful
inflammatory swelling of the breasts, with an excessive
tendency to suppuration. If, on the first appearance of
pains, or other symptoms, in the breast after a chill,
before the swelling has acquired a certain develop-
ment, we immediately administer Aconite in water, a
teaspoonful every two hours, the child continuing to
ABSCESS OF THE BREASTS.
111
nurse, we shall probably stifle this disease in the germ;
but if the accumulation of milk is already considerable
and the tumor voluminous, red, with beatings, and lan-
cinating pains, burning, tensive pain, we should give
Bryon 30th in water, a teaspoonful every three hours,
until the entire dissipation of the swelling.
If the tumor of the breast, under the preceding con-
ditions, is accompanied by shining erysipelatous redness,
we should give Bell. in the same manner; and if after
twelve hours, there is no amelioration, we should alter-
nate these two medicines every three hours; in case
this is insufficient we should have recourse to Merc., espe-
cially if slight chills indicate the approaching formation
of pus.
Hepar sulph. is indicated when Mercury shall have
diminished the inflammatory character of the tumor, if
it still shows signs of commencing suppuration. Some
physicians recommend continuing this medicine or to
let the dose act, if we give it only once, until after
the opening of the abscess, if it does not procure its
soluction.
This practice has been often followed with success,
under our own eyes; but since I have seen the marve-
lous effects of Phos. in abscess of the breasts, I have
employed no other medicine, when there have been evi-
dent signs of suppuration. This medicine, administered
under these circumstances, at the 30th dynamisation,
one globule in water, a teaspoonful every six hours,
promptly calms the pains, procures the opening of the
abscess and its cure, without leaving any visible trace
of the cicatrice upon the breast.
I could cite many cases of these prodigious cures ;
but in order not to repeat the same facts, I will report
112
AID TO MIDWIFERY.
only that of a woman with her first child (Madame G.
de T.) who on the thirtieth day after labor, had the
right breast of the size of a large child's head, with
redness and excruciating, lancinating pains which had
deprived her of sleep for eight days, when I saw her for
the first time; her physician had promised her to come
with a surgeon to lance the breast on the morrow; the
left breast was also a little swollen, red and somewhat
painful. The patient, of a very gentle character, and a
constitution lymphatico-nervous, offered no other nota-
ble morbid symptoms, and she had always enjoyed good
health. I put one globule of Phos.30th upon her tongue
at five o'clock in the evening; a quarter of an hour
afterward the pain was much alleviated; at six o'clock
she fell into a profound sleep which lasted until mid-
night; on her awakening she was in another world:
her bed was inundated with perspiration and suppura-
tion;
her right breast was almost reduced to its ordinary
size, and the left was altogether restored; the next day
she gave the left side to the child, and six days after the
so much diseased breast offered not even the vestiges
of a cicatrice,
S
The efficacy of Phos., in abscesses, shows itself quite as
remarkably in the cure of the rebellious fistulæ of these
organs, resulting from allopathic treatment, as also in
the hardness of the mammary glands remaining after
the opening of the abscess by the knife. The homoeo-
pathic physician ought not to open these abscesses with
a cutting instrument, because, occupying a part where
there is nothing to fear from the effusion of pus, he can
await its spontaneous opening from the specific adminis-
tered, which has the advantage of avoiding the pain,
the emotion, and a disagreeable consecutive cicatrice;
DISEASES OF THE NIPPLES.
113
and facilitating the complete resolution of the obstruc-
tions of the mammary gland, and also prevent the
serious degenerations which sometimes follow these
accidents.
In the fistulous opening of the breasts Silicea is
sometimes indicated, if the openings discharge only
serous matter, especially if the patient offers other
symptoms belonging to this medicine.
The local treatment of this affection should be limited
to sustaining the breast by a suspensory or other suita-
ble bandage, to prevent the pain caused by its weight,
and to keep it clean by bathing in tepid water when the
abscess shall be open. I recommend especially absti-
nence from the application of cataplasms or other warm
applications, in this kind of tumor; they only produce
a more considerable afflux of liquids, aggravate the
disease, hasten the suppuration, interfere with the favor-
able action of the medicine employed, and facilitate the
engorgements which often remain in the breasts after an
abscess treated according to the laws of Allopathy.
DISEASES OF THE NIPPLES.
The nipples should have a certain prominence, in
order that the child may seize them to suckle.
We should give attention to this in cases of women
in their first pregnancy; and when they are not suffi-
ciently prominent recommend the use of artificial means
for their development. The nipples should be washed
from time to time in brandy to harden the skin, in order
that it may not be too easily broken by the efforts of
suction.
Notwithstanding these attentions, in the commence-
ment of nursing, the nipples often become excoriated
114
AID TO MIDWIFERY.
and covered with cracks which renders suction very
painful and sometimes intolerable. The old school is
reduced to empirical local means, most frequently, alto-
gether powerless against this affection, which is often
the cause of abscess of the breast, and even of the impos-
sibility of continuing to nurse. The application to the
nipples, as soon as this inconvenience is experienced,
of lotions of a very weak tincture of Arnica each time
after giving the child the breast, commonly cures it in
a few days. If this does not succeed we may give
Sulph.30th which ordinarily suffices. Sometimes I have
been obliged to give, eight days after, Graphit. 30th or
Calc., and afterward Lycopod. When we apply Arni-
ca lotions to the nipples they should be washed with
tepid water before giving them to the child.
>
In case of simple inflammation of the nipples, with-
out excoriation, we should give Cham.12th, if the patient
is not habituated to an infusion of this plant. In the
contrary case we should give Ignatia 30th.
I can affirm that the dynamic means, indicated above,
have always sufficed with me to cure cracks in the nip-
ples, and that since I have possessed them, I have had
no more need to have recourse to the balsams recom-
mended by the old women.
METRITIS.
•
Puerperal metritis being often the effect of the sup-
pression of the lochia or the retrocession of the milk, I
believe it is in accordance with the clinical study of
these two functions to give it place here in the order of
succession of the diseases of women in child-bed; these
derangements are often confounded reciprocally in their
causes and in their effects; a sudden suppression of the
METRITIS.
115
lochia, if it is not promptly arrested, is often followed
by metritis, and metritis almost always produces either
the suppression of the lochia, or their augmentation, to
such an extent as to become a genuine metrorrhagia.
We may say almost the same of the secretion of the
milk; and by the cure of the disease of the uterus alone
we may sometimes re-establish these two functions.
I have said, from the commencement of this work,
that I did not propose to write a compleet treatise upon
midwifery and the diseases of women and children, that
I did not think it useful to report here what is already
exposed with method and exactitude in the books of the
schools; my object was only to supply what is not
found in those treatises, the means of repairing in the
surest, most prompt and gentle manner, the disorders.
and diseases which may present themselves in the cir-
cumstances under consideration. I shall abstain then
from giving the history and the signs of metritis, which
I suppose known to my readers; I will beg them only
to remember that it is generally the effect of a violation
of hygiene in the food, or of cold drinks taken too soon
after labor, a current of air, a moral affection, of
coition, of mechanical lesions during labor, or by crimi-
nal means for the expulsion of the fœtus, or the sup-
pression of the lochia, etc.; that its principal symptoms
are a continual, violent, burning or lancinating pain in
the region of the uterus, with a peculiar sensation of
weight in the abdomen; the pain extends successively
over the whole abdomen, which swells and becomes
painful to the touch; the interior of the vagina is very
hot, burning to the touch; the neck of the uterus
swollen; the lochia and the milk suppressed, or there
appears suddenly an intense hemorrhage; the stools.
116
AID TO MIDWIFERY.
and the urine are suppressed or rare; the pulse is very
frequent, without being developed; the skin is hot and
dry, with physical and moral uneasiness, fear of death
and frequent attacks of fainting, or an extraordinary
tendency to this symptom.
The prognosis will always be very favorable when the
inflammation has not attained the peritoneum for there
is no disease more easy to treat than this, of which all
the symptoms are found perfectly expressed in Nux
vom.; thus, although in our country the fauteuils a ac-
couchements are no longer known except in the his-
tory of the art, and that, consequently, the chilling of
the genital parts caused by this apparatus, to which Dr.
Hartmann attributes so great an influence in the pro-
duction of metritis, is no longer to be feared, this medi-
cine is as efficacious in our hands as upon the numerous
patients treated by this learned physician.
The symptoms which call for this medicine are, in
general, those which we have enumerated above.
However, sometimes, other medicines are necessary to
cure this disease; if the metritis commences by violent
chills, followed by excessive heat, with full pulse and
red face, frontal pulsative cephalalgia, or as if the skull
was too full and would split, and, above all, if the dis-
ease was first caused by a fright or by a chill, we should
give Aconite, for six or eight hours, a teaspoonful of its
solution in water every hour, and pass afterward to
Nux vom.
Bell. would suit especially those cases where the
metritis is developed in consequence of the retention of
the placenta; and Hartmann recommends it where there
is a sensation of dragging and weight in the lower ab-
domen, which becomes often a kind of bearing down,
METRITIS.
117
with lancinating pains and burning above the pubis,
and a sensation in the sacrum as if it were crushed, lan-
cinating pains especially in the hip joints, which render
the least movement or pain insupportable; but especially
if the lochia is arrested, or if this discharge has a fetid
odor, if it is of an acrid nature, with a sensation of
burning and fullness in the vagina; according to the
same author, Merc. sol. is the medicine which has the
most analogy with the preceding in this disease, particu-
larly when the pain is lancinating, compressive or pierce-
ing; and we may add when with heat not very intense
there is abundant perspiration or chills. Chamomilla
will be indicated when the metritis is the effect of anger,
when there is augmentation of the secretion of the
lochia, or the change of this secretion into a species
of metrorrhagia of a black and coagulated blood.
When these symptoms present themselves after the
abuse of an infusion of Chamomile, we should have
recourse to Nux vom., Ignat., or Puls., according to the
symptoms belonging to these medicines. When the de-
velopment of the metritis is the result of great and
unexpected joy, we should give Coffea, as for all
the moral and physical causes, we should have recourse,
against them, to the specifics indicated above. The
treatment of metritis sometimes demands Bryon. or
Rhus tox., especially in the case of women subject to
rheumatism; the first, when there is an engorgement of
the breasts, obstinate constipation, fever of a synochal
nature; and Rhus when symptoms of a nervous or
typhoid fever manifest themselves.
Sometimes, in the case of very scrofulous or other-
wise psoric subjects, the metritis has a tendency to de-
generate into gangrene, which is manifested by a total
-
11
118
AID TO MIDWIFERY.
collapse of the forces, facies hippocratica, cold sweats,
etc. In this case, Sec. corn. offers a precious resource,
it should be given alternately with China, while we
sustain the strength of the patient by some drops of
generous Alicante, Malaga, or other wine. Arsenic
offers another resource in this degeneration of metritis;
it is indicated when there are burning pains in the
uterus and its vicinity, excessive feebleness, skin covered
with a cold sweat, excessive moral anguish, thirst,
liquid diarrhoea, etc.
The homœopathic physician should never lose sight
of the fact that all puerperal diseases recognize psora
as their first or predisposing cause; and should not, con-
sequently, hesitate to give a dose of Sulph., when the
medicines best indicated by the symptoms remain with-
out effect, or produce but incomplete results. This
medicine sometimes also perfectly completes the cure.
The hygienic treatment of metritis consists in a strict
diet, if the patient does not nurse, and in very light
food if she does; tepid watery drinks, and an absolute
repose of body and mind.
-
-
The application upon the region of the uterus of a
warm, soft, and thin poultice, made of rice flour, in
facilitating the establishment of perspiration, is a means
of which the homeopathist should not fear to avail
himself, because in the alleviation of local pains, he
facilitates the salutary effects produced by the appro-
priate specific medicines, administered internally. Warm
baths, so much praised by Allopathy, are far from
offering the same advantages; they give great pain
through the necessity of moving the patient, and weaken
her; consequently their employment requires great pru-
dence on the part of the physician. In the case of
PUERPERAL PERITONITIS.
119
women who nurse, we should present the child to the
breast as soon as there are signs of milk in those organs;
this secretion and the suction effect a useful revulsion to
the disease of the womb, without the milk being in-
jurious to the child, as is believed by the vulgar.
PUERPERAL PERITONITIS.
Before the valuable labors of Laennec and Pinel, peri-
tonitis, metritis, of which we have just given a descrip-
tion, meningitis and phlebitis or phlegmasia alba dolens
of women in labor, were all confounded under the name
of puerperal fever. These authors have demonstrated
the error of this amalgamation, and, like them, and all
the nosologists who have followed them, we propose
to make separate articles of the different affections
which sometimes attack women in child-bed, in order
to exhibit in a methodical manner the immense re-
sources possessed by Homoeopathy against these dif
ferent species of affections.
What I have just said upon the causes of metritis
may also be applied to peritonitis; its symptoms have a
much more rapid development; and the prognosis! it
is in this terrible disease that the statistics are so brilli-
ant for Homœopathy; the old school considers puerperal
peritonitis as always mortal, while the termination of
these cases under homoeopathic treatment does not show
a fatal result in a tenth part.
The characteristic symptoms are: a severe burning,
lancinating and continued pain at some point in the ab-
domen, which goes on extending until it occupies the
whole abdomen; a long chill followed by dry and burn-
ing heat; a wan pale face; great anxiety; fear of death;
excessive sensibility of the abdomen to the slightest
120
AID TO MIDWIFERY.
touch, even of the chemise; swelling, distension, first with
a clear, afterward with a dull sound; vomitings, liquid
diarrhoea, suppression of the lochia, falling of the breasts,
etc. (see the treatises upon this subject). It terminates
by resolution or by suppuration, rarely by gangrene.
The treatment of puerperal peritonitis, requires close
attention on the part of the physician; he should above
all watch that he may recognize it upon its first appear-
ance, for its cure is so much the more sure and easy as it
is treated sooner after its commencement. It is for this
that I have counseled the physician never, so to speak,
to lose sight of the woman during the first days of her
lying-in. It is to this assiduous surveillance, without
doubt, that I owe never having seen a peritonitis, or a
genuine metritis develop itself among the great number
of women that I have assisted, even before being in
possession of the treasures of Homœopathy.
But, if notwithstanding this surveillance, or in con-
sequence of having neglected it, the phenomena of peri-
tonitis declared themselves, phenomena so easy to
recognize, it is rare that a few doses of Aconite will not
be found very useful, and even indispensable.
The great sensibility developed in the parts affected,
announced by the violence of the pains, calls with
certainty for this medicine. The violence of the fever,
with dry and burning heat, great thirst, burning red-
ness of the face, swelling and sensibility of the abdo-
men to the touch, and very severe pains in the abdomen,
bitter, greenish vomiting, etc., indicate this medicine.
We should put three globules of the 30th attenuation in
a glass of water, a teaspoonful to be taken every hour,
or every half hour, if the symptoms are rapidly aggra-
vated, and continued for six, eight, or twelve hours.
PUERPERAL PERITONITIS.
121
Afterward, if the disease is subdued, we may diminish
the doses, but continue the medicine until the cure is
complete. If, after six or twelve hours, notwithstanding
the diminution in violence of the fever, the abdominal
symptoms continue, we should choose between Bell.
and Bryon., that one which applies best to the actual
state of the disease.
Dr. Ruckert, in his treatise Elements d'une thera-
peutique Homœopathique future special, reports five
observations, in which Bell. cured peritonitis. The
characteristic symptoms of these cases were violent
cramp-like pains, as if a portion of the intestines was
crushed between two stones, with swelling of the abdo-
men; or severe pain and bearing down toward the
genital parts, as if the internal organs would be
forced out; excessive sensibility of the abdomen to the
touch; chills in some parts, with heat in others at the
same time; or burning heat especially in the head and
face, with redness of the face and of the eyes; compres-
sive pain in the forehead, with beating of the carotid
arteries; mouth dry, tongue red, thirst; wakefulness
with agitation, or soporous sleep, with furious delirium
or other cerebral symptoms; lochia insufficient, watery
or fetid; or metrorrhagia with a discharge of red fetid
blood; the breasts swollen and inflamed, or flaccid and
without milk; constipation, or diarrhoea.
Bryonia is indicated when the abdomen is equally
swollen, very sensitive to the touch, and when the
slightest movement considerably aggravates the pain,
with constipation; burning heat over the whole body;
ardent thirst, and desire for cold drinks; irritable
humor; disposition to anger, or to anxiety and fear re-
specting the future and her recovery. Cham. suits
122
AID TO MIDWIFERY.
$
when the breasts are flaccid and empty of milk, when
there is a whitish diarrhea; tympanitis, abdomen very
sensitive to the touch, pains in the abdomen like those
of labor; general heat with redness of the face and great
thirst; aggravation at night followed by sweats; great
agitation, impatience and nervous irritability; and
principally when the peritonitis is caused by anger.
Colocynth produced a marvelous effect with me in a
case of the most desperate character; the disease dated
for three days under a fruitless allopathic treatment;
the abdomen was enormous, the pains insupportable;
diarrhoea with colic as soon as she took a little drink.
Colocynth 30th, three globules in a glass of water, a tea-
spoonful every hour. The amelioration commenced
after the second spoonful; the colic diminished, the
abdomen became less sensitive, a half hour of sleep
procured a considerable abatement of all the other
symptoms; twenty-four hours afterward the patient was
convalescent.
Merc. sol. is a precious medicine for puerperal peri-
tonitis, either when the disease is still in its inflamma-
tory period, or when there are already symptoms of
effusion in the peritoneum; it is especially indicated
when, with the general symptoms of the disease, the
face is wan, earthy; burning, inextinguishable thirst,
afflux of saliva in the mouth; burning and lancinating
pains in the abdomen with tenesmus without effect,
or with mucous and bloody stools; urine dark and
very fetid; general debilitating perspiration, without
relief, and marked aggravation of the symptoms at
night. Beside this medicine, in the very serious cases
where one has not been able to prevent the effusion in
the peritoneum, Arsen. may be very useful, as also Carb.
PUERPERAL PERITONITIS.
123
veg., Asa., China, Bell., and Sulph., according to the
symptoms belonging to these medicines, for which, in
order not to prolong this article, we refer to the materia
medica.
Nux vom. is indicated when the lochia having been
suddenly arrested by a contradiction, or a cold, or hav-
ing been changed by these causes into a species of
hemorrhagia, with a sensation of weight and burning
in the genital parts and in the abdomen, there exist vio-
lent pains in the loins, with constipation, difficulty, and
burning in urinating, etc. But this medicine does not
offer the peculiar characteristics of peritonitis, which
are the swelling, the tension, and the excessive sensi-
bility of the abdomen; it should rather be reserved for
metritis, as we have indicated in that article.
Rhus is a medicine almost indispensable when, from
the commencement of the disease, the nervous system is
profoundly affected, when the least contradiction aggra-
vates the symptoms, when the white lochia begins to
become bloody with evacuation of clots of blood, and
when the fever has a nervous or typhoid character.
The hygienic treatment required by puerperal perito-
nitis are; the most absolute possible repose of body and
mind, all noise near the patient should be prevented,
the chamber very dimly lighted and a temperature not
too warm; the air being frequently changed.
As the stomach can support nothing, after depriving
the patient of all nourishment, we should content our-
selves with slaking the thirst by a few drops of cold
water, and if the vomitings are too pertinacious, with
little pieces of ice.
and
Bathing and all applications upon the abdomen
should be reiected on account of its great sensibility, of
124
AID TO MIDWIFERY.
which every movement aggravates the pain to such a
degree as to produce fainting. Tepid applications to the
genital parts, in case of suppression of the lochia, or
small injections in case of constipation, are the only
external means to be employed. What we have said
in the article Metritis upon the suckling of the child is
also applicable to peritonitis.
PHLEGMASIA ALBA DOLENS.
This affection has also been comprised, by authors,
among the different forms of suffering offered by puer-
peral fever; the works of the anatomical physicians of
the beginning of the present century have assigned to
it its true character of phlebitis of the veins of the pelvis
and of the inferior extremity; it is ordinarily the conse-
quence of the inflammation and suppuration of the
uterus, of the peritoneum, or of the ovaries, but it is
sometimes developed idiopathically without this cause,
as I have seen it by the effect of cold upon the limbs.
too soon after labor.
In accordance with the plan I have proposed for my-
self in this work, I shall neither give the etiology nor
the pathology of this disease, which is so easy to be
recognized by the white color, and the hot, smooth swelling
of the limb, the painful resistance to the pressure of the
finger, and the absence of the pit made by that pressure.
I shall pass at once to its treatment.
When the phlebitis is the effect of suppurations occur-
ing in the pelvis and re-absorbed by the veins of the
extremities, the physician should direct all his attention
to this cause and combat it by the means indicated in
the articles Metritis and Peritonitis. The medicines.
designated by the materia medica and the experience
PHLEGMASIA ALBA DOLENS.
125
of homœopathists for the phlegmasia of which we
speak, are: Arn., Bell., Bryon., and Puls., to which
it will sometimes be necessary to add Acon., Rhus,
Nux vom., Cham., and Sulph.
Arnica: if during labor the head had remained long
in the pelvis, or if through some unskillful management
we have reason to suspect a mechanical lesion of the
vessels, and at the same time, if the tensive pains in the
hips and thighs indicate a development of phlebitis,
this medicine may be followed by a prompt cure, as is
proved by a case reported in the first volume, p. 50, of
the General Homœopathic Gazette.
Bryonia and Belladonna appear above all prefer-
able according to their symptomatology. Bryonia:
Drawings in the hips and the extremities; lancination
from the hips to the feet, sometimes with general per-
spiration and impossibility of supporting the touch
and movement; dragging like those preceding the ap-
pearance of the menses; tensive, painful stiffness;
swelling of the leg without redness, etc. Belladonna:
Pain, as if bruised, in the inferior extremity with tear-
ing pains in the joints, weight in the thighs; drawings
in the left thigh, pressure in the right; lancinations as
if with a knife, etc. This medicine possesses, beside, a
great homœopathicity with the diseases of the pelvis in
woman. Puls., beside its great sympathy with the dis-
eases of the organs of generation in woman, has a spe-
cial action upon the veins, announced by the swelling
of their trunks in the hands and limbs in a great num
ber of their symptoms, and consequently it has a special
action in phlebitis, and particularly in puerperal phle-
bitis, when it is accompanied with a suppression of the
lochia. The special indications for either of these
126
AID TO MIDWIFERY.
medicines, as well as for those aforenamed, will be known
by the symptoms peculiar to each, as found in the
materia medica.
And as, during eighteen years' experience in Homœo-
pathy, I have met with no case of this kind in my
practice, I will supply the want of experience on my own
part by that of an accoucheur who has made the most
successful application of Homoeopathy in the art of
midwifery, by transcribing the following observation,
reported by this physician in the third volume of the
Annales de la Clinique Homœopathique of Hartlaub
and Trinks.
"A woman of twenty years of age was delivered on
the 6th of March, 1825, for the first time, of a strong
and healthy little girl. Doct. Bettmann was very little
acquainted with this woman, he knew however that she
was of a delicate constitution with great irritability and
mobility, physical as well as moral. The attendants
assured him that the lochia and the secretion of milk
had taken their regular course, although the woman,
from the seventh day of the same month, complained
of slight darting pains in the left hip, to which was
joined a feeling of tension in the whole left extremity.
"No cause could be discovered for these sufferings,
the patient having experienced no inconvenience during
pregnancy, excepting some derangements in the appetite
and difficulty in the evacuation of the fæces.
"On the eighth of March, the pain became more
severe, and at the same time, movement more difficult,
and the patient felt a little swelling in the upper part of
the limb.
"The ninth of March passed in an augmentation of
swelling and pain under the application of dry heat.
PHLEGMASIA ALBA DOLENS.
127
During the night Doct. Bettmann was called on account
of the violence of the pains: he found the patient ex-
tended in her bed, incapable of any movement; she
screamed if any one approached to touch the lower half
of her body or the diseased extremity. Her look was
anxious and unquiet, great thirst, and the pulse rather
hard than full, gave a hundred and twenty pulsations a
minute. The painful extremity was a little swollen,
and although not at all inflamed, it was so sensitive,
that she could not endure the slightest touch, especially
upon the thigh. She had made several efforts to take
a more comfortable position in the bed with the assist-
ance of two strong persons, but they had been obliged
every time to stop, the moment they made the slightest
movement of the parts in the vicinity of the pelvis.
She had passed two nights without sleep, and for the
last few hours her respiration began to be short and
anxious, she said with tears that she should die, because
her mother had died the second day after labor with
the same symptoms. She experienced a crawling alter-
nately in the two limbs, and she thought that the right
was as much affected and paralyzed as the left; this ex-
tremity was as sensitive to the touch and movement as
the other.
C
66
Homœopathy was then less advanced than at this
time, and the author well remembers how the blood
mounted to his head when he became fully aware of the
nature of this disease. After having studied several
medicines, he administered a small dose of the 15th
dynamisation of Belladonna; his success confirmed
the truth of the homœopathic law; for, when the author
visited the patient, eight hours after the administration
of the Belladonna she related to him with great joy
128
AID TO MIDWIFERY.
that, not only had she slept several hours, but that she
had actually again become mistress of her legs, and
could separate them. While in repose, she felt no more
pain; but she could not yet bear the touch; the thirst
was diminished; she felt above all in a much better
state of mind and free from anxiety. The evening of
the same day she was in a condition, with suitable aid,
to descend from her bed and have a natural stool.
"On the eleventh of March, the extremity could be
touched without producing pain; the patient could walk
in her chamber with a little assistance. The patient
now remembers that the left extremity was a little
swollen during the last months of pregnancy. She
assures us that she now only feels a slight lancinating
pain in the left inferior extremity while walking. The
lochia and the milk which had somewhat diminished
for the last two days, are now perfectly regular.
"At his visit on the twelfth, Doct. Bettmann found
his patient sitting up in bed, nursing the child; this
operation concluded, she descended alone from the bed,
walked about the apartment, freely exercising the
limbs without aid. This cure continued perfect during
the three weeks that Doctor Bettmann visited the
patient.
"A second case, reported by the same author, relates
to a disease which had been maltreated by all the
abominations of the old school, without any other
result than the great weakening and exhaustion of the
patient.
"The appetite and sleep were gone, the patient had
great thirst and violent tearing pains in the internal
parts of the right inferior extremity, which was a little
swollen without remarkable heat, and very sensitive to
CONSTIPATION.
129
the touch. The places which had been injured by the
blisters and tart. emet. ointments were very sensitive,
caused burning pains, had a lead color and a very dis-
agreeable odor; the secretion of milk, which had con-
tinued, was insufficient for the nourishment of the child,
which caused the mother great anxiety.
"A dose of Acon.24th, three globules, procured an
amelioration after some hours, and after a dose of Rhus
tox 30th, two globules, given the next day, the patient
could, twenty-four hours after, sit upon the side of her
bed for five minutes with a proper support, and the
second day, she could turn herself freely in bed; after
three days she walked about her chamber drawing the
limb after her. The amelioration continued from day
to day, and after the administration of Nux vom., Ars.,
Bell., during the three following weeks, the patient at-
tended to her domestic affairs without inconvenience."
CONSTIPATION.
Nature, in her wisdom, has suspended the alvine
evacutions for the first six or eight days after labor, in
order to allow the parts bruised by the act of parturi-
tion, the time to recover; the nurses, midwives, and
even the accoucheurs, who are no more learned than
the midwives in this, become very anxious on account
of this state, and endeavor to remedy it by injections,
when their imbecility does not extend to the giving
castor oil; it is a routine exceedingly hurtful and dan-
gerous; if after eight days the patient has not a natural
evacuation, we should give Bryon. 50th, in three spoons-
ful of water, every two hours, commencing on waking
in the morning: after the first stool we should discon-
tinue the medicine.
130
AID TO MIDWIFERY.
If the woman experiences a desire to go to stool without
the power of evacuating, as if she was hindered by a
constriction of the rectum; if she has hemorrhoidal
tumors; if there is a want of appetite with rumbling in
the bowels, etc., we should give the preference to Nux
vom., a spoonful every evening, until it has produced
the desired effect.
Opium. If the woman feels as it were a heavy
weight in the anus, without urgent inclination to stool,
head heavy, we should give Opium 6th, in the morning
in a spoonful of water; if there is not a stool during
the day we may give, in the evening, Nux vom. as has
been indicated.
Sulph. will be preferable in the case of a woman
habitually constipated, and especially after Nux vom.,
if this has not been sufficient to remedy the evil; some-
times without other morbid symptoms, the stools seem
arrested by the hardness of the mass in the rectum; an
injection of warm water suffices then and furnishes the
best remedy, because in any case, but principally in
case of women in labor, medicine should never be given
unless necessary.
Diarrhoea is much more dangerous to women in
child-bed; it deranges the uterine and lacteal secretions;
and we cannot too soon administer a remedy for it.
We should ascertain the cause, and if it has been pro-
duced by an error in the regimen, Puls. 30th, in water,
would be a specific; if it is accompanied by very decided
gastric symptoms, such as a bitter and clammy mouth,
tongue covered with a thick white coating, nausea,
sickness of the stomach, etc., we should give Antim.,
if the discharge is liquid and like beaten eggs, with
colic, Rheum.; Dulcam. if produced by a cold; Hyoscy-
ENLARGED ABDOMEN.
131
amus has been useful when, with watery or mucous
stools the patient is very much enfeebled.
MILIARIA OF WOMEN IN CHILD-BED.
It is the effect of excessive perspiration; in following
the counsels of Homœopathy we may almost always
avoid it. This indisposition generally disappears of
itself in a day or two; if however, it becomes annoying
by the itching it causes, or by its duration, we may
give Bryon. 30th, in water.
ENLARGED ABDOMEN.
After delivery, the abdomen has sometimes a ten-
dency to remain large, and when there have been
several consecutive pregnancies, the abdomen remains
prominent, and sometimes falls over the upper part of
the thighs. Sepia 30th, repeated after fifteen or twenty
days, much diminishes or removes this indisposition.
Notwithstanding the specific action of this medicine,
sometimes it does not afford any relief, and it will then
be necessary to group all the accessory symptoms, and
choose the antipsoric medicine which shall the best suit
them in these cases, we shall often find the indication
for Calc. carb., and sometimes for Silicea; but what-
ever medicine be chosen, it should be left to act at least
five or six weeks, and administered at a very high
dynamisation. Its action should be seconded by proper
exercise on foot, a plain alimentary regimen and slight
compression of the abdomen; it is only however after
lying in, that we can be permitted to attempt the cure
of this difficulty, either by medicines or by hygienic
means. Much as moderate compression may be useful
at this time, in so much is it hurtful applied during
132
AID TO MIDWIFERY.
lying-in as recommended by accoucheurs, to prevent this
inconvenience; for in this last case, it produces a quite
contrary effect, in attracting a more considerable afflux
toward the abdomen and uterus.
FALLING O F THE HAIR.
Notwithstanding the hygienic precautions, which
Homœopathy, like the old school, recommends during
child-bed, it happens too often that young women lose
a great part of this precious ornament after a labor;
this loss is ordinarily the effect of too abundant per-
spiration unskillfully excited and treated during child-
bed, especially of the head, by too warm envelopes of
this part; consequently the avoidance of this abuse will
generally suffice to prevent it. If however, an abun-
dant fall of the hair takes place, either through the
cause mentioned or any other, it will be first necessary
to ascertain the cause and the symptoms accompanying
it, and oppose it by the corresponding homoeopathic
medicine; we shall generally find it in Sulph., Calc.,
Natrum Muriat., and Lycopod., or Hepar Sulph. and
Silicea. If the loss has been very considerable, China
should be tried before Sulph., and Calc.
TREATMENT OF INFANTS.
T
-
Hygienic Treatment.
The treatment recommended by modern accoucheurs
for the newly-born child are altogether rational; we con-
sequently refer to their works, except for the practice
of allowing a little blood to escape after having cut the
umbilical cord, and for the use of chicory sirups.
Since the child no longer receives blood from the um-
bilical vein, it should not be allowed to lose any from
ANTIPSORIC PROPHYLACTICS
133
the arteries. We should never forget that blood is the
principal support of life.
I would here caution nurses against the mania of the
accoucheurs and midwives, for giving a warm bath
every day to the infant in washing it; this practice, im-
ported from England, is entirely contrary to the views
of nature; the skin, so porous, so spongy at this age, ab-
sorbs too great a quantity of water, and disposes the
child to a predominance of the lymphatic and scrofu-
lous temperament; this bad habit has certainly some-
thing to do with the enormous proportion of tubercles
among the English, since these tuberculous affections
are the last expression of the lymphatic constitution.
The child should be washed in tepid water in cold
weather, and with cold in summer; and when it shall
have passed its first dentition be washed always in cold
water.
ANTIPSORIC PROPHYLACTICS.
It is here treating of the hygiene of the newly-born
that it is proper to introduce the subject of the prophy-
lactics proposed by Dr. Gastier for the child, in order
to preserve it from the development of the psoric taint
which it may have inherited from its parents. With-
out entering into theoretic discussions, which would be
out of place in this elementary work, I would affirm
that my personal experience entirely agrees with that
of Dr. Gastier; I recommend then, as soon as possible
after birth, putting one or two globules of the 200th dy-
namisation of Sulph. in the mouth of the child, and to
repeat this dose four or five weeks after, if no morbid
phenomena demand another medicine; toward the third
month, we may give the same dose of Calcarea, which
12
134
AID TO MIDWIFERY.
has the advantage of facilitating in a singular manner,
the development of dentition. I have never seen any
bad effects from the application of these recommenda-
tions, and I have always seen, on the contrary, the
children who had been subjected to them developed in
a strong and healthy manner both morally and physi-
cally. My experience does not confirm the opinion of
Dr. Gastier with regard to the inactivity of vaccine upon
these subjects; the vaccine took perfectly upon all those
children who had at the same time experienced good
effects from the prophylactics prescribed.
2
ASPHYXIA.
There are two varieties of this affection, asphyxia
apoplectica and asphyxia syncoptica; the homœopathic
treatment should differ in accordance with these dif-
ferent forms; in the first case, Acon. 18th
upon the
tongue of the child; afterward, if at the end of a
quarter of an hour there is no improvement, Tart.
emet. 12th in the same manner; if the child is purple, we
should give Opium. In the second case, which occurs
when the mother has lost much blood, or has had other
serious diseases during her pregnancy, or when the
labor has been very long or before term, China 12th will
be found useful, it being well understood that the um-
bilical cord should be preserved intact as long as there
are pulsations, and all other palliative means, recom-
mended in this case, administered to recall the infant to
life.
ECCHYMOSIS ON THE SURFACE OF THE CRANIUM.
One or two lotions of the pure tincture of Arnica
suffice to dissipate them, whether they manifest them-
CYANOSIS
135
selves at the time of labor or some time after, whether
they are produced by the sojourn of the head in the
pelvis, or by the action of the blades of the forceps.
DEFORMITIES, MONSTROSITIES.
We recommend, in all deformities, a few doses of
Sulph.30th and of Calc. 30th, alternated at long intervals,
as soon as possible after birth. Many deformities may
be corrected in this way, for, as deformities are the
effect of a deviation in the action of the vital forces in
the formation of the organs, in bringing back this force
to its normal state, we may obtain a resolution of the
vicious forms which they have produced. If the de-
formity implicates the osseous system, after these medi-
cines we may give Silicea, but at very long intervals
and at very high dynamisations.
G
MARKS.
The different blemishes which appear on the peri-
phery of the body of the new-born, are the products of
a defect of the organic tissues of the skin and ordinarily
of the excessive development of the capillary vessels.
The same medicines recommended in the preceding
article will also be found very useful here, and so much
the more useful as they are administered nearer to the
epoch of birth; clinical observations testify that Calc.
carb. is the medicine which has had the happiest results
of all those which have been tried in this species of
organic defect.
CYANOSIS.
Children remain blue, because the ductus arteriosus
continues open, and the veinous blood is not conse-
quently forced to pass through the lungs and be there
136
AID TO MIDWIFERY.
changed into arterial blood: here Sulph., and especially
Calcarea ought to be administered as soon as possible;
afterward Digitalis should be alternated with Calcarea,
at an interval of two or three months, and at the 200th
dynamisation.
CONGENITAL HERNIE,
Whether inguinal or umbilical, are cured in a few
weeks by Sulph.30th. If in a fortnight the tumor still
protrudes, we should give Nux vom. 30th, and eight days
after, still another dose of Sulph.
INDURATION OF THE CELLULAR TISSUE.
This disease, which carries off so many new-born
infants in the foundling hospitals, will ordinarily yield
with sufficient facility to a few doses of Acon.3d, afterward
Bryon. 30th, and if the disease still resists, give Sulph.,
and return afterward to Acon.
SWELLING OF THE BREASTS.
It is commonly the effect of improper pressure upon
these parts; Arnica 12th will reduce it if there is yet no
redness; if the contrary, we should give Cham.; or
Bryon., and Bell., if it has an erysipelous character.
If the inflammation is active, we should precede these
medicines by Acon.; if there is an abscess, give Hep.,
three globules a day, and finish the cure by Silicea 30th,
HIC COUGHS.
The child should be warmed against the breast of
the nurse and take sweetened water by drops; if these
means do not suffice it should smell Bell.
CORYZA, ETC.
137
CORYZA.
The stoppage of the nose prevents respiration in
suckling. If oiling the nose with some greasy substance
does not give relief, the child should smell Nux vom.
If twenty four hours after there is still no relief, we
should give Sambucus nig. 30th. If there is a serous
discharge from the nose, Cham.; if the coryza is aggra-
vated in the evening, Carb. veget.; if it returns every
time the child is exposed to the cold air we should give
Dulcamara.
OPHTHALMIA OF THE NEW-BORN.
This disease, so rebellious in the hands of Allopathy,
yields very readily to Acon.; twelve hours after we
should give Dulcam. If the disease has already made
great progress, we should give first, Tinct. Sulph. 30th
and afterward Calcarea 30th
"
CONSTIPATION.
If it does not depend upon the too heating food of
the nurse, we should give the child Bryon. 30th or the
same dose of Nux vom. If these medicines do not
suffice, we may give Opium; if the constipation returns.
often, a dose of Sulph. Dr. Rummel found Alumina
very efficacious in cases of constipation in infants.
WAKEFULNESS.
Is often the effect of the moral affections, or of the
bad regimen of the nurse, which it will be first neces-
sary to correct. If the wakefulness persists we should
give Coffea; if the child suffers at the same time with
wind or colics, we should give Cham.; Opium will suit
if the face of the child is red.
138
AID TO MIDWIFERY.
CONTINUAL CRYING OF INFANTS WITHOUT APPRE-
CIABLE CAUSE.
It is very rare that a child cries without suffering,
either in its ears, abdomen, or head; consequently if a
crying child has, at the same time, the body burning
and the face red, we should give Acon. 30th, repeating
it four or six hours after; if this state continues, if the
cries are violent with agitation that nothing can calm,
we may give Coffea or Cham.
-
RETENTION OF URINE.
The child should smell of Camph., and afterward we
may give several doses of Acon.; these medicines com-
monly suffice to bring back the secretion to its natural
state; Puls., or if there is constipation, Nux vom. are
also useful in this disease of infants.
G
INTERTRIGO OR EXCORIATION.
Allopathy has no remedy for this inconvenience
which is often very painful and deprives the child of
all repose; Sulph, 30th has rarely failed with me to
effect good results; in three or four days the skin would
be entirely cicatrized; if it is a crying, troublesome
child, we should give Cham.; if these means do not
succeed, at the end of eight or ten days, Graph 30th, or
Lycopod. of the same attenuation.
APHTHÆ.
Acid sulph., a drop in a glass of water, a teaspoonful
every three or four hours, is the most appropriate speci-
fic; Merc. 12th is also a specific, especially when there is
much saliva in the mouth; if the disease is not cured in
five or six days after the taking of Merc., we may give
JAUNDICE—DIARRHŒA, ETC.
139
Tinct. Sulph. 30th. Borax has succeeded with me when
all the other medicines had failed.
JAUNDICE.
Ordinarily disappears of itself; when it is very in-
tense, and the child burning, we should give Acon 30th
in a glass of water, a teaspoonful every three or six
hours until the cure is completed.
DIARRHEA.
Ipecac., repeated every three or four hours is the
specific most generally useful in this affection of infants,
especially if the stools are watery, green or frothy; if
the child cries much, with flatulence and distension of
the abdomen, we should give Cham.; if the diarrhoea
is renewed on every exposure to the fresh air Dulcam.;
when it is produced by the great heat of summer, with
great thirst, Bryon.; if the tongue is covered with a
thick coat, white or yellow, we should give Antim.; if
the child becomes very feeble and pale, Arsen.: it being
well understood that the nurse must abstain from fruits
and all relaxing food.
SPASMS OF THE CHEST,
Or sudden suffocation of the new-born. It cannot
breathe, becomes pale; we give Ipecac., which we should
repeat according to the necessity of the case; if this
medicine does not suffice the child should smell several
times of Samb. nig.
CONVULSIONS.
When we know the cause of convulsions, we should
administer the medicine appropriate to this cause.
In
140
AID TO MIDWIFERY.
general, we should not give medicines during an attack
of convulsions; however if they are very severe, the
child may smell of Camph., which always instantly
calms them; we should give the medicine indicated
some time after the attack, or toward its close, when
the case is urgent; if after taking it there is an aggra-
vation, we should await its effect: if the first dose does.
not produce a prompt and sensible effect, we should
give a second as soon as a second attack manifests it-
self. If the following attacks diminish in severity, we
should wait while the amelioration continues and give
afterward another medicine if the attacks change their
character. The principal medicines against convulsions
in infants are Ignatia, Coffea, Cham. In the case of
feeble and sickly children, who have often convulsions
without other accidents, we should give Coffea.
When there are jerkings in the limbs, and frequent
attacks of heat, with light sleep and awakening with
fright, violent cries and trembling of the whole body;
when we do not know the cause of the convulsions,
Cham.; when they return every day at the same hour
and are followed by sweats and heat, or return every
two days a little sooner or later, we should give Ignatia,
which we should repeat after the following attack. In
this last case Merc. is often indicated.
When with jerkings in the arms and legs, the head is
turned from one side to the other, when the child lies
stretched with the eyes half open, without conscious-
ness, one cheek red and the other pale, moans much,
and wishes to suck all the time we may give Cham.,
repeating it two or three times.
If with convulsions, there is short breathing, nausea,
efforts at vomiting, or vomiting and diarrhoea, if the
TETANUS.
141
child stretches itself spasmodically before, during, and
after the attack, we should give Ipecac., which we
should repeat until there is an amelioration.
When with a trembling of the whole body, the child
strikes with his hands and feet, screams during the
attack, when he lies extended without consciousness, or
when with the belly swollen for a long time there are
no stools or urine; when the nurse has been frightened
or angry (in this last case we should give afterward
Cham.), and the convulsion depends upon this cause,
we should give Opium, repeated until the symptoms
are alleviated.
When the belly being swollen, there are no other
symptoms which indicate the preceding medicine, but
when there are eructations and a flow of saliva from
the mouth, fever and great debility after the attacks,
we should give Merc. If this medicine does not prove
useful, or if the child beside these symptoms rubs his
nose or has passed worms we should give Cina.
TETANUS.
In warm climates, this terrible disease carries off a
great many children; but with the aid of homœopathy
it is easy to rescue these little beings from this fatal
destiny. Doct. Hartmann states that he has always
had the most perfect success in administering imme-
diately a few globules of Camph. 3d rubbed on the gums
of the child, making it smell at the same time of spirits
of Camph. held under its nose; if these means bring
no relief at the end of ten minutes or a quarter of an
hour, we should give Bell. 3ª, two globules. The child
should be enveloped in flannel and the chamber
suitably warmed.
13
142
AID TO MIDWIFERY.
DENTITION,
Is too often accompanied by sufferings which give
occasion for the empirical medicines of the allopathists
to destroy forever the health of the child by Calomel
and leeches: Homœopathy is a great resource during
this painful period of life.
When the teeth pierce the gums with difficulty, the
gums remaining a long time swollen, white and painful,
we should give Calc.30th, repeated every eight days for
three or four weeks; if any accident should happen, the
child should smell of Camph.
When the child is very much agitated, now crying,
and then too gay, with a little fever, we should give
Coffea, repeating it for three or four days; when if the
symptoms do not disappear, we may give Acon., and
if these derangements still persist, Cham.; if there is
violent fever, heat, thirst, if the child cries often and
thrusts his hands into his mouth, if he is frightened in
his sleep, we should also give these medicines Acon.
and Cham., taking care not to pass to a second medi-
cine until after the action of the first is exhausted;
if there is a slight dry cough with constipation, we
should give Nux vom. rather than Cham., which suits
especially diarrhoea. This last medicine is particularly
indicated when the child has at the same time, a dry
cough like hooping-cough, restlessness at night, sucking
often, with burning heat, redness of the skin and eyes,
anguish, difficult, short, quick and loud respiration,
trembling and twitchings in some of the limbs, or a
great number of these symptoms. If in these cases
Cham. does not suffice, we should give Bell 30th
If there are signs of approaching convulsions, if the
child has a diarrhoea, paleness of the face, eyes dull,
DENTITION.
143
little appetite; if he wishes always to be carried and
lays his head upon the shoulder of the person who car-
ries him, Cham. may prevent their development. If
the symptoms which we have indicated for Ignatia (see
convulsions) exist, this medicine would also be effi-
cacious.
If the convulsions are already developed, the child
should smell Ignatia in holding the cork of the bottle
under the nose, during inspiration; if there is a second
similar attack the same means should be repeated, and
if then they do not cease we should give Cham., in
water, a teaspoonful after every attack. Bell. will suit
in the case of the failure of Ignatia and Cham., and it
should be preferred when the child after an attack falls
into a lethargic sleep which lasts during the whole inter-
val of calm; if he awakes suddenly as by a fright,
looks anxiously around him, with the pupils dilated,
and the eyes motionless as if he was frightened at some-
thing; when there is rigidity of the whole body, burn-
ing heat in the forehead and hands, passes his urine in
the bed (in these cases we may also recommend Cina);
this last medicine, Cina, will suit especially when the
passing of urine in the bed is often repeated even in the
intervals of the attacks, if he has a dry cough like hoop-
ing-cough to which are added spasms in the chest and
convulsions; if the child thrusts the fingers in the nose.
We should avoid the use of lancets upon the gums,
or of files or other instruments upon the teeth, excepting
when they are developed in abnormal places or in such a
bad direction that we cannot hope they will ever become
straight by the consecutive development of the jaw:
only in this case should we have recourse to the manual
treatment of the dentist. Brushes are very injurious to
144
AID TO MIDWIFERY.
the tender gums; we should content ourselves with
having the child's mouth washed with tepid water.
ERYSIPELAS.
Young infants are often attacked with an erysipelas
which extends successively over every part of the body
several times, until death puts an end to their sufferings;
it is thus at least that things passed before Hahnemann
presented the world with his experiments upon Bell.
and Rhus, which are its specifics; Bell.30th should be
given in water, a teaspoonful every hour, or it may be
smelled, and twenty-four hours after Rhus taken in the
same manner; they may be alternated thus until the
cure is effected. If the fever is violent, the treatment
should be commenced by the smelling of Acon.
SCALD-HEAD.
This disease, which commonly attacks children of a
lymphatic constitution at the epoch of dentition, may
easily be prevented by the early employment of anti-
psorics, as I have indicated in the article Prophylactics;
if these means have been neglected and the scald-head
developed, the most specific means, which I have seve-
ral times proved in following the indication of Hart-
mann, is Viola tricolor 3, three globules in a glass of
water, a teaspoonful morning and evening; sometimes
however this medicine does not suffice or is not indi-
cated by the symptoms of the disease; if the skin is red
and swollen and the child is very much agitated, we
should commence the cure with Acon. and pass after-
ward to Viola tricolor; if the eruption covers a great
part of the body, with itching and wakefulness, we
should give Sulph.; if the child suffers much with his
MEASLES.
145
teeth and is wakeful at night, Cham., and if that does
not suffice, some days after, Calc. carb.; if the eruption
eats into the flesh with a discharge of acrid humor,
Rhus tox.; if the humor discharged is of a yellowish
color, Staphys.
All these medicines should be administered at a high
attenuation and at long intervals of from one to four
weeks; we should take care that the nurse takes animal
food or the child meat broths.
ERUPTIVE DISEASES.
Among nursing infants these diseases are not com-
monly dangerous: if there is much fever Acon.30th may
be given in water; at the end of twenty-four hours if
there is no amelioration, we should administer the spe-
cific for the particular nature of the eruption. The
most important of these are miliaria, measles, scarla-
tina, and small-pox.
MILIARIA.
This eruption is of very little importance in very
young children; it is commonly the effect of too warm
covering, and is dissipated by removing the cause. If
however it is accompanied by dry heat, frequent pulse,
drowsiness and hot mouth we should give Acon., in a
glass of water, a teaspoonful every three or four hours.
If there is a diarrhoea, Ipecac.; if the belly is swollen.
with constipation, Bryon. in the manner indicated for
Aconite.
MEASLES.
Nature alone commonly cures this disease in children
at the breast. If the disease is in the house and the
146
AID TO MIDWIFERY.
"
child is exposed to take it, it would be prudent to give
every two days a teaspoonful of a solution of Puls 30th
two globules in a glass of water, as a preservative
means which I have often seen answer perfectly this
end.
•
Puls. is the specific for measles. As soon as we per-
ceive the redness of the eyes, flowing coryza, the hoarse-
ness and other symptoms indicating the appearance of
this disease, Puls. will arrest its development; it is
also indicated in more advanced periods of the disease;
either when the eruption is complete or only in its
development; the diarrhoea which often accompanies
this disease is only another indication for this medicine,
and then its effects are, so to speak, instantaneous.
If the eruption does not appear on the surface freely,
and if the little patient experiences difficulty in breath-
ing, we should give Ipecac. Bryon. also facilitates
the eruption in measles when there is much agitation,
thirst and a violent, loud and hollow cough. Acon. is
sometimes indicated during the febrile period when the
face is very red, with drowsiness, great thirst and
anguish. The patient should be confined to a low diet
until the fever has ceased, take warm drinks, avoid the
cold air, and particularly a chill in changing the linen,
this change being made as seldom as possible.
SCARLATINA.
Bell. is its specific when it is smooth and the finger
leaves a white mark when pressed upon the red part of
the skin. When the skin is covered with little pimples
and the finger leaves no white mark, it is a false scar-
latina and Bell. will have no effect upon it; we should
continue Acon., and if there is much agitation alter-
SMALL-POX.
147
nate a few doses of Coffea with those of Acon., which
should be repeated every twelve hours.
SMALL-POX.
When the fever is violent before the eruption, we
should give Acon.18th, in water; if there is a violent
headache, Bell.; if the eruption is developed with dif-
ficulty, if there is excessive anxiety, thirst, burning of
the skin, vomitings, we should give Arsen.30th, in water,
a teaspoonful every two hours.
In the period of suppuration, Merc.12th is very useful
in moderating the fever and accelerating the formation
of the scabs, and preventing the erosion of the pus into
the derma. If the pustules are very abundant with
much suppuration, when the desiccation commences, we
should give Sulph.
Vaccinia 30th, repeated two days in succession, has
entirely stopped, in the hands of Doct. Gross and other
homœopathic physicians, the progress of the disease.
The recent experiments of our venerable and inde-
fatigable Bœninghausen have procured us a new specific
for this disease, through the exact knowledge he pos-
sesses of the materia medica pura: in fact Thuja has,
in its symptoms of the skin, pimples precisely similar
to those of the small-pox. This ingenious physician
put two globules of the 200th attenuation of Thuja
upon the tongue of a patient affected with confluent
small-pox, and, four days after, fever pimples, scabs,
and pits even had entirely disappeared, and the patient
was perfectly well. In some rare cases, he has been
obliged to give, on the second day, a second dose of the
same medicine, and the result has always been the
148
AID TO MIDWIFERY.
same. Since I have been acquainted with his experi-
ences I have had one case of small-pox serious in its
symptoms, although the pustules were distinct on the
second day of the eruption. I gave Thuja, two
globules of the 300th, according to the indication of Dr.
Bohninghausen, and, the sixth day, the patient went
out entirely cured; in the place of the pimples, there
only remained a little red point of the size of a pin's
head; I could hardly believe my eyes.
VACCINE.
After the experiments I have just cited upon the effect
of Thuja in small-pox, should we not adopt the opinion
already expressed by Hahnemann on the subject of the
suppression of the use of vaccine, in view of the danger
there is of inoculating at the same time the virus in-
herent to the subject from whom we take it, and of the
facility Homoeopathy already offered, in his time, for
curing natural small-pox? This facility being much
augmented by new homœopathic discoveries, small-pox
will become a much more innocent disease than those
we are in danger of contracting by vaccination. If the
statistics published by some political journals, in which
it is stated, that while fewer childern die since the use
of vaccine, the average duration of the life of adults is
much abridged, are true, there should be no hesitation.
in adopting the suppression of the vaccine; but, as our
new experiments are not yet sufficiently numerous, and
that, beside, the individual not vaccinated, might con-
tract the small-pox during voyages, or in countries
where there are no homoeopathic physicians to treat it
properly, I think that, until Homœopathy has become
CROUP.
149
universal, it is prudent to continue to vaccinate children.
It is always prudent to give a dose of Sulph. after the
desiccation of the scab.
CROUP.
Croup is commonly preceded by the ordinary symp-
toms of a cold; the child is complaining, grows hoarse,
has a little dry cough, and a little fever, especially in
the evening; he desires to sleep; the sleep is agitated;
afterward the child is awakened in the night by exces-
sive suffocation; he puts his hand to the larynx as if he
would pull away something which is strangling him;
he has a violent cough, hollow, sonorous, whistling,
with a noise similar to the cry of a young cock; the
respiration is whistling or rattling, or sighing; he rises
up upon his seat; his face is very red and puffed; very
high fever, pulse very frequent and strong; impatient;
he throws his head back in order to breathe; these
attacks are followed by a few moments of quiet and
drowsiness, and afterward return more and more vio-
lently and more and more frequently, until the larynx
being almost entirely stopped, the symptoms of asphyxia
manifest themselves, and the child dies of suffocation.
In examining the bottom of the throat of the child,
we see spots more or less white, adhering to the
velum palati or to the tonsils, which is the commence-
ment of the false membrane which extends into the
air passages; this symptom is considered as charac-
teristic of the croup, to distinguish it from spasmodic
angina which presents all the appearance without
offering the same danger. The distinction between
these two diseases is very important to the allopathist,
150
AID TO MIDWIFERY.
that he may not martyrize the child by the violent and
cruel means which he employs in the case of real croup,
for a disease which commonly disappears of itself; but
for Homœopathy, this distinction is of less consequence,
since the gentle and simple means which suffice to cure
the croup, accelerates also the cure of spasmodic
angina.
The first medicine to employ when the croup declares
itself, is Acon.; put three globules of the 18th attenua-
tion in a half glass of water, and administer a tea-
spoonful every five minutes; lengthening the intervals
when the violence of the febrile symptoms abate. Four
or five hours after the commencement of the use of this
medicine, the force of the fever is diminished, the face
is not so red; we may then give Spongia 30th also in
half a glass of water, a teaspoonful every half hour;
increasing the intervals between the doses in proportion
as the violence of the cough and suffocation diminish.
Ordinarily, after a few doses of Acon. the child goes
to sleep, and falls into a profuse perspiration, which we
should take good care not to interrupt; he awakes after
an hour or two with a cough which is much less violent;
the violence of the disease is subdued. When after
twenty-four or thirty-six hours of the use of Spongia,
the cough remains hollow, we should give Hepar sulph.;
some physicians recommend giving Spongia and Hep.,
alternately every two hours. Sambucus is indicated
when notwithstanding the diminution of the cough, the
suffocation continues. In this disease the greatest care
should be taken to avoid chills; the child's linen should
not be changed until the cure is complete, in order to
avoid the relapses which are so liable to occur.
HOOPING-COUGH.
151
HOOPING-COUGH
Generally commences with a common cold; and a
few days after, the attacks peculiar to this disease are
developed the child experiences an uneasiness, gap-
ing, sneezings, a tickling in the larynx; he becomes
silent, sad for some minutes, then the fit of coughing
commences; it consists in a series of short, interrupted
expirations, with inability to make a sufficient inspira-
tion; these expirations are followed by a strong and
loud, or sighing inspiration, or with a cry similar to
the braying of an ass, and afterward by a series of little
expirations, alternately four, six, and eight times in one,
or several minutes; the longer the attack lasts the more
the child is suffocated, he endeavors to rest his hands.
or his head upon something, his body is leaned forward,
he stamps with his feet, he is as it were beside himself;
his face becomes violet-red; sometimes the blood starts
from his nose and mouth; finally the attack commonly
finishes by the rejection from the mouth of more or less
abundant quantities of mucus and food; the child then
returns to his habitual state.
During the catarrhal period, we should be guided in
the choice of medicines by what has been said in the
article Coryza. When the cough assumes its peculiar
spasmodic character, we should give a globule of Dro-
sera, to repeat it five or eight days after; commonly two
or three doses will suffice.
When the child is stiff and without consciousness
during the attack, Cuper. finds a special application.
By repeating every day Aconite in the morning, I cured
a recent hooping-cough in an active and plethoric child.
Cinn. when the child has a strong appetite, when he
152
AID TO MIDWIFERY.
puts his finger often to his nose, or if there are convul-
sions. Conium has succeeded with me when the attacks
of coughing took place in the night. When the con-
vulsive attacks are dissipated the remaining cough may
be combated with Ipecac., or other medicines appro-
priate to its nature. (See Coryza.)
ATROPHY.
-
Hard and indolent swelling of the abdomen in in-
fants, with excessive emaciation of the body, earthy
color of the skin, commonly accompanied with diar-
rhoea; Sulph. alone often suffices for its cure. If, after
a month or two, the amelioration is not considerable we
may give Calcarea. If the diarrhoea is very frequent,
with burning in the anus and excessive debility, we
should commence with Arsenic, and keep the child on
a light regimen of meat broth.
WORMS.
When the child passes worms, either lumbrici or as-
carides, Cinn. 12th will ordinarily remove the attendant
symptoms; in case of need, we give Sulph 30th. These
medicines should be repeated at five or eight days,
interval.
FEVERS.
All, or almost all the fevers which attack very young
children are cured, or at least ameliorated by Acon. 24th
in water, a teaspoonful every two hours, or at a little
shorter, or a little longer interval, according to their vio-
lence; we shall always then do well to give, in these
cases, this medicine, if particular symptoms mentioned
in the preceding paragraphs do not indicate some other.
Maou
FEVERS.
153
However, as the diseases of this early age progress very
rapidly, it will be always prudent, when they are some-
what serious, to study their symptoms, and apply the
remedy the most homœopathic; for a great part of the
phlegmasiæ, or almost all, may attack children, and it
would be necessary to write a complete treatise on medi-
cine and surgery, to explain the treatment of all these
diseases, which is very far from my intentions. I con-
clude therefore, here, my work, happy if my experience
may assist our young brethren and midwives, in giving
all the relief which this so interesting a class of the
human family, the subject of this treatise, has a right
to expect from the true art of healing.
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SERVICE AFLOAT AND ASHORE: By LIEUT. RAPHAEL
SEMMES, U. S. N.
"UNLIKE most similar works, this has no one hero, unless the natural
partiality manifested for General Worth, may be considered as giving
him a more marked elevation. It is neither adorned nor disfigured with
vulgar anecdotes, to gratify a morbid love of the marvelous. The
author writes right on: like a man who seeks to tell the truth. He crit-
icises freely, whatever, high or low, his Sailor's eye deems worthy
of comment. The intelligent reader will be pleased with the frankness
and independence of the writer."-Newark Daily Advertiser.
"He was early engaged in the blockade of the Mexican ports, and
narrowly escaped death while in command of the Somers; afterward,
through fortuitous circumstances, he became a participant in, and
observer of, nearly all the stirring incidents in General Scott's triumph-
ant march to the Capital. * * * Lieut. Semmes possesses the fac-
ulty of describing comprehensively, intricate occurrences, and seizes
upon the prominent points of a field of battle, and presents them in such
a manner that we are, as it were eye witnesses of the scene. We have
rarely read a work, put forward with so little pretension, so intrinsi-
cally valuable.”—Mobile Daily Advertiser.
"THIS is an elegant volume in every respect. *
The work
is written with great spirit, taste and ability. We have seen no work
which has given us such vivid impressions of Mexican scenery and char-
acter, or the events of General Scott's campaign. *** He has thrown
around the country, the people, and the expedition, a flood of illumina-
tion from the historians of the Spanish march and conquests over the
same regions. * * The whole book inspires and sustains an inter-
est of which the reader can form no opinion, unless he goes through,
which he will not fail to do, if he begins."-Southern Press.
"CALM, deliberate, and intelligent, as he is, he cannot entirely con-
ceal his personal preferences. He has, notwithstanding, furnished the
very best book which that war has called forth, and, with remarkable in-
telligence and skill, has interwoven the events of the war with saga-
cious observations on the country and people."-Phil. Presbyterian.
"A beautiful and very interesting volume, which, from the glances
we have had time to give it, appears to be written with much ability,
and to afford the reader a great deal of valuable information in regard
to the war, the country, and the people.”—Balt. American.
"A most interesting addition to the literature of a war, odious in its
origin, as it was triumphant in its progress, and happy in its conse-
quences."-Puritan Recorder.
"It is written with a spirit and life that commend it to perusal."-
N. Y. Observer.
"AN accomplished writer as well as gallant officer."-Philadelphia
Observer.
Ir is difficult, after having commenced i's perusal, to lay it aside
before finishing it."-Norfolk Daily News.
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lishers; for scarcely any one of the sciences has a larger number of terms with which
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dent of divine Providence."-N. Y. Independent.
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ers, and the taste and skill of the typographer."-Boston Post.
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Jike this, from a city that had scarcely an existence fifty years ago, got up in a style
of elegance, that ranks it beside the finest issues of the publishing houses of Boston
and New York. This fact, however, is but the smallest element of interest that attaches
to the volume. It is one of those noble contributions to natural science, in its relation
to revealed religion, which in the writings of Hugh Miller, King, Brewster, and others
have conferred new luster on the honored name of Scotland.
The concluding
chapter is a sublime questioning of Geology, as to the testimony she gives to a Creator,
somewhat after the manner of the Scholia, to Newton's Principia, and is one of the
noblest portions of the work."-Richmond, Va., Watchman and Observer.
That
"THE science of Geology is attracting more and more attention.
which was once a gigantic chaos, has become developed into a system beautifully sym-
metrical, and infinitely grand.”—Mercantile Courier.
MOORE & ANDERSON'S PUBLICATIONS.
SERVICE AFLOAT AND ASHORE during the Mexican
War: By LIEUT. RAPHAEL SEMMES, U. S. N., late Flag-
Lieutenant of the Home Squadron, and Aid-de-camp of
Major-General Worth, in the battles of the Valley of Mexico.
1 vol. 8vo, $1.75. Illustrated with numerous lithographs,
in beautiful style, by Onken, and an official map.
He has given to the public a very attractive work upon Mexico
itself, as well as upon the Mexican war."-Charleston (S. C.) Standard.
"
HIS original descriptions are drawn with great felicity. He is a
lively and spirited narrator. His battle sketches are extremely vivid,
and produce a deep impression on the imagination. His pictures of
social and domestic life in Mexico are apparently true to nature, and
present the attractions of a romance-criticises the military operations
in a decided partisan spirit, but with evident ability."-N. Y. Tribune.
"He is bold, capable, and courageous. He can wield a pen or a
sword with admirable force and dexterity. * * * As a writer, Lieut
Semmes is clear and cogent. The first forty pages of the volume are
occupied with a description of Mexico, its government and people; and
we know of no description of the kind, which brings the condition of
things in that unhappy country so distinctly before the mind of the
reader. The whole volume, as a work of intellect, is worthy of a high
place in the department to which it belongs."-Louisville Journal.
* *
"IN remarking upon the various battles and military movements, it
indulges neither in indiscriminate praise nor indiscriminate censure.
It lauds everybody for something, but none for everything.
General Scott is often and highly praised for his surpassing abilities—
for what he did do in the cause of his country; yet, Lieut. Semmes asserts
that the battle of Churubusco, and its consequent slaughter, was entirely
unnecessary, and brings forward arguments to sustain his assertion.-
He also declares, and brings evidence to the truth of the declaration,
that General Scott understood nothing of the real use or strength of the
Molinos del Rey, which were so bloodily defended by the Mexicans, and
that time and again our successes were owing to the personal ability
and valor of subordinates, and not to the much-vaunted foresight and
science of the commander-in-chief. With all this, there is no virulence
or indiscriminate fault-finding. Lieut. Semmes' book differs from all
that have preceded it, and must attract attention. We say, "God defend
the right," but let us know what right is, and give honor to whom honor
is due."-Boston Post.
"SAILORS are said to be persons of strong prejudices. And it is no
small praise to the author, to say that we have never read a history evi-
dently so fairly written, with regard to the merits of the numerous
claimants of military glory. * * We shall take our sailor and
soldier out of the ranks, and see what he has to tell of a more amusing
nature than battle fields.
*
* After sailing about the Gulf, and
*
S
*
cruising from Vera Cruz to Mexico and back again with our author, we
have arrived at the conclusion that he is as pleasant a companion as one
might desire upon a similar journey, and so commend him to the favor
of the reading public.”—Literary World.

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