Part 61

2. Leucorrhea, Glycerin for.--"One part glycerin to six parts water is a very soothing lotion when there is much tenderness, pain or heat in the vagina. A teaspoonful of tartaric acid in a pint of warm water is a specific, in some cases, acting like magic. Whatever lotion is employed, always use it warm. After cleansing with soap suds, the medicated lotion of not less than two ounces should be injected."

3. Leucorrhea, Common Tea for.--"A very simple remedy that every woman has in the home is a decoction of common tea; used as an injection twice daily is very beneficial." The tea has an astringent action and the tannin contained in the tea leaves is very effective. This remedy is a harmless one, and every woman suffering with this disagreeable disease should give this remedy a trial.

4. Leucorrhea, Witch-hazel for.--"Cleanse the parts well with clear warm water, then inject two quarts of warm water in which has been dropped a tablespoonful of witch-hazel." This is a very good remedy and sure to give relief.

5. Leucorrhea, White Oak Bark for.--"White oak bark one ounce, water one pint. This makes a very good injection and will be found very effective,"

6. Leucorrhea, a Good Herb Remedy for.--"Inject into the vagina with a female syringe, a tea of bistort or beth root, and cranesbill, night and morning and take the following night and morning in wineglassful doses.

White Pond Lily Root. 2 ounces Unicorn Root 2 ounces Wahoo Root 1 ounce Golden Seal 1 ounce Cinnamon 1 ounce

Add three pints of water, simmer to one quart, pour boiling hot upon one ounce of grated nutmeg, one-half ounce ginger, powdered, one half pound of granulated sugar. Exercise in the open air and nourishing food are indispensable."

7. Leucorrhea, Common Vinegar for.--"Two tablespoonfuls vinegar in two quarts of water (warm or hot), used as a douche at bedtime, until cured," This will cure some mild cases and has an astringent action.

8. Leucorrhea, an Easily Prepared Remedy for.--"Red oak bark tea used with syringe; follow with hot water." Steep the red oak bark and make a tea of it, using about two or three teaspoonfuls of the bark to a pint of hot water. This acts as an astringent and the red oak bark contains a good deal of tannin which is very beneficial in cases of this kind.

9. Leucorrhea, Home-Made Suppositories for.--"Take a small piece of medicated cotton, and saturate in pure glycerin and insert in the vagina at night, after a warm salt injection has been taken to thoroughly cleanse the parts." So many women of today are careless about taking injections, at least once or twice a week. Many of these diseases could be avoided in the beginning by women being more cleanly. This saturated cotton acts as a suppository absorbing the mattery secretion and in that way relieves the congestion.

[512 MOTHERS' REMEDIES]

10. Leucorrhea, a Good Home Remedy for.--"Cleanse the parts affected with warm water with a little castile or ivory soap in it, by means of an injection. Then inject a full syringe of the mixture, made by dropping a tablespoonful of extract of witch-hazel (Pond's is best) into warm water; repeat each night until cured." The injection of soap and water is one of the essential things to do for leucorrhea, as it cleanses the parts thoroughly and the witch-hazel is very soothing and healing.

11. Leucorrhea, a New York Doctor's Remedy for.--"Fluid extract of Oregon grape root (sometimes called mild grape) mixed with a simple syrup and given in teaspoonful doses, three times a day, is recommended by Dr. W. W. Myers, as a curative for leucorrhea."

PHYSICIANS' TREATMENT.--First is to do away, if possible, with local disease, like inflammations, tear of the cervix, etc. The general system should be built up with tonics. The same treatment as for anemia and chlorosis will be usual for this trouble. Refer to those diseases.

Local.--The vagina should be kept as clean as possible with the hot water injections. To the hot water many simple remedies can be added with much benefit.

1. One ounce of white oak bark in a pint of boiling water makes a good injection for this trouble. Before any medicine is used the vagina should always be washed out by an injection of warm water. Then follow with the indicated injection and retain it as long as possible.

2. Tannic acid and glycerin, equal parts, one ounce to two quarts of warm water, is a good injection.

3. Lloyd's Golden Seal is splendid, used in the proportion of four teaspoonsful to a pint of warm water.

4. This combination gives good service:--

Sulphate of Zinc 1 dram Sulphate of Alum 1 dram Glycerin 6 ounces

Put a tablespoonful to each quart of warm water and use as injection.

It is well to remember the injections must be given in large quantities, and used in a fountain syringe. A gallon can be used at one time.

5. Witch-hazel in warm water makes an excellent injection in many cases. It can be used in the proportion of one-fifth water of witch-hazel to four-fifths of warm water.

6. Many other simple remedies may be named, Cranesbill is one. Vaginal cones are now made for leucorrhea. These are used about every third night and a thorough injection taken the next day. There are many varieties, most of them are good and can be bought at any drug store.

[WOMAN'S DEPARTMENT 513]

MENOPAUSE. (Change of Life). The active menstrual life lasts on an average for thirty years and ends between forty and fifty years of age. The courts have recognized the age of fifty-three years as the limit that a woman can become pregnant.

The onset of the change of life, may be sudden or gradual. The organs shrink and waste. The womb shrinks and part of its muscular tissue disappears and its walls become thin, soft and relaxed. The ovaries become small and harder. The vagina shortens and also becomes narrower. Sudden mental shock, wasting disease or change of climate, may cause a sudden appearance of the change of life.

Symptoms.--Many women hardly notice any change, as it comes on gradually. Other women have all kinds of bodily and mental symptoms, and some are afraid of becoming insane. The heart palpitates readily, feelings of heat and cold, flushes of heat of the face, followed by sudden sweating. Rush of blood to the head so quickly sometimes as to make the patient lose temporary consciousness. The spirits are very much depressed, sleeplessness is common in some women.

MOTHERS' REMEDIES. 1. Change of Life, a Useful Herb Remedy for.-- "Motherwort is one of the most useful herbs to relieve obstructed menstrual flow. There is no better herb for cleansing the womb and removing obstructions in the female at change of life. Dose: A wineglassful of the decoction three times a day."

2. Change of Life, excessive Flowing. An Old Tried Remedy for.--"One ounce of nutmeg, grated, one pint Jamaica rum. Mix well and shake before taking. Dose :--One teaspoonful three times a day as long as necessary." I tried this remedy upon the advice of a physician at the time of "change of life" and was very soon relieved, so I heartily recommend it.

3. Change of Life. Good Advice From an Experienced Mother.--"The first and most important point to consider is the general health of the patient. If the general health can be sustained there will be no danger attending this critical period of life. Therefore whatever form of disease may manifest itself the one object should be to seek a remedy in time. Take special pains to preserve general good health and take care not to overwork, take plenty of outdoor exercise and keep up a regular action of the bowels. Purify the blood with tonics if necessary."

PHYSICIANS' TREATMENT.--Exercise, fresh air, with freedom from worry, anxiety and care. Many women at this time of life need much encouragement, and cheerful company is a good tonic. Prominent annoying symptoms should be met with the proper medicine. Irregular bleeding of the womb at this time or after should lead to an examination as to its origin.

[514 MOTHERS' REMEDIES]

CYSTOCELE--Cystocele is simply a tumor formed by the bladder pressing into the walls of the vagina. The bladder descends into the pelvis on account of relaxation or destruction of its normal support. The anterior wall of the vagina yields.

Causes.--Tear of the perineum allows the bottom of the pelvis to relax. Undue relaxation of the ligaments of the bladder and of the floor of the pelvis, with over distention of the bladder, are responsible for the majority of the cases.

Symptoms.--Weight and dragging feeling. A tumor can be felt in the vagina. It decreases when the bladder is emptied.

Treatment.--Supports are suitable in some cases (Skene's pessary). An operation is necessary in many cases.

RECTOCELE.--The muscle that holds up the lower end of the rectum is relaxed or torn and this deprives the lower end of the rectum of its support so that during expulsion of the feces forward distention of the anterior wall of the rectum into the vagina results. The posterior wall of the vagina is carried before the advancing anterior rectal wall, and appears at the entrance of the vagina as a bulging tumor which is increased in size with every effort of the rectum to cast out the feces.

Causes.--Hard child-birth (labor) and the long time the head of the child was resting on the perineum. This resulted in an overstretching or tear of the muscle that holds up the lower end of the bowel and the parts were necessarily weakened.

Symptoms.--It is hard to entirely empty the rectum because of the presence of the tumor. This is soft, rounded, increasing and decreasing in size and disappears upon pressure.

Treatment.--Keep, if possible, the tumor from getting larger, regulate the bowels.

An operation may be necessary to restore the parts to their normal condition. A physician must be consulted.

[OBSTETRICS OR MIDWIFERY 515]

OBSTETRICS OR MIDWIFERY

Small bodies are contained in the ovaries. These are called eggs or ova. The human egg is about 1/125 of an inch in diameter. This egg enlarges and one or more escape from the ovaries, usually about the time of the monthly sickness, and are caught by the ends of the Fallopian tube, enter its canal and are carried into the womb. After they have arrived in the womb they are, as a rule, cast off with the secretion and leave the body. If in the course of its travel from the ovaries, through the tube to the womb, the female ovum or egg meets with the male elements, fertilization or impregnation may take place. If then it is not cast off it generally lodges in the womb and pregnancy has begun. The male and female elements are usually supposed to meet in the outer portion of the Fallopian tubes, fertilization then taking place; but this can occur any place from the ovary to the womb. When the fertilized egg enters the womb it is usually arrested in the folds of the womb membrane nearest the opening of the tube and at once attaches itself to the womb wall. The folds by which it is surrounded then grow forward and their edges unite over the egg or ovum forming a sac--the decidua reflexa. Then follows the development of this ovum and with it the development of the womb, and this growth or development constitutes the process which is called pregnancy.

The Embryo or impregnated egg is nourished in the womb by measures preparing for it. The placenta or after-birth forms during the third month of pregnancy. Its function is to furnish nourishment breathing (respiration) and excreting power to the embryo or impregnated egg. The fully developed after-birth is a roundish spongy mass with a diameter of about eight inches and weighs about one pound. It is usually thickest at the center, the edges thinning out to the membranes. The inner surface is smooth and glistening and is covered by a membrane (amnion) and beneath this two arteries and a vein branch in all directions.

The cord is attached to the inner surface of the after-birth and is of a glistening white color, varying in thickness, and is about twenty-two inches long, but it may be longer or shorter. It contains two arteries and a vein, which run in a somewhat spinal course.

DEVELOPMENT AT DIFFERENT MONTHS.--

First month.--There are indications of the eyes, mouth and anus. The extremities are rudimentary. The heart is 4/10 of an inch long.

Second month.--It is now about one inch long. The eyes, nose and ears can be distinguished. External genitals. There are suggestions of the hands and feet.

[516 MOTHERS' REMEDIES]

Third month.--The ovum is now the size of a goose-egg. Fingers and toes separate, nails look like fine membranes. The neck separates the head from the body. The sex can now be told. Length is five inches. Weight about 460 grains.

Fourth month.--Six inches long and now weighs 850 grains. Short hairs are present. Head equal to about one-fourth entire body. May perceive quickening.

Fifth month.--Ten inches long; weighs eight ounces. Eyelids begin to separate. Heart sounds can be heard. Quickening takes place.

Sixth month.--Twelve inches long; weighs 23-1/2 ounces. There is hair on the head, eyebrows and eyelashes are present. Testicles show near the abdominal rings (openings).

Seventh month.--Fifteen inches long; weight 41-1/2 ounces. Pupillary membrane disappears.

Eighth month.--Sixteen inches long; weight 3-1/2 pounds. Left testicle has descended into the scrotum. Nails protrude to end of finger tips.

Ninth month.--Eighteen inches long; weighs 4-1/2 to 7 pounds. Features are complete.

While this growth goes on in the embryo the womb itself shows changes. The virgin womb averages 2-3/4 inches in length, 1-3/4 inches in width and 1 inch in thickness and weighs about 12 drams. At term (confinement) the womb is about 14 inches long, 10 inches wide, and 9-1/2 inches thick. This increase in size is necessary for its growing contents and is due to both an enlargement of its tissues (hypertrophy) and to an increase in the number of its cells (hyperplasia). The muscular fibres are elongated to about 11 inches, and they are five times thicker than they are in a womb that is not pregnant. The cervix or neck of the womb participates but little in these changes, and remains practically the same until a few weeks before confinement. It becomes softened as the result of congestion, and the glands are more active, secreting a thick glairy mucus. The canal also is more or less dilated.

While this process is going on in the womb, various other conditions show themselves, sometimes in the parts of the body so distant that it may not be easy to discover the connection with the womb. Almost any part of the body is liable to show changes from its normal condition; and yet some of these changes are so constant and regular as to be regarded as signs of pregnancy. It must not be forgotten, however, that sure signs of pregnancy, such as cannot be induced by other causes, are very limited, especially in the early months.

[OBSTETRICS OR MIDWIFERY 517]

Changes occur in the genital organs that may lead a physician to suspect that pregnancy may exist; but the first symptom that attracts the attention of the woman, is the passing of the monthly period. This is not an absolute sign of pregnancy, since other things or conditions may cause it. The effect of the mind upon the body may cause it, and it also occurs sometimes in early married life without any appreciable cause, unless it may be then due to the effect upon the nervous system of the marital relation. Again, the monthly sickness sometimes continues in a greater or less degree, during a part or even the whole of pregnancy. Usually this discharge is due to some diseased condition of the cervix. The fear of impregnation in unmarried women after illicit intercourse will occasionally suspend menstruation for one or two months.

Nausea and Vomiting.--Another symptom upon which considerable dependence is placed is the morning sickness (nausea and vomiting). While this symptom is common, yet its absence does not prove that the woman is not pregnant. Some women go through the whole pregnancy without any sign of this symptom.

Nausea accompanied or not by vomiting may appear at the very time of conception, but it usually appears about the fourth or fifth week of pregnancy and continues until the sixteenth week or longer. In some cases it may last but a short time, in others it may continue until confinement. It may be light or severe; It generally manifests itself upon arising in the morning and subsides in a short time, but it may occur at any time of the day and continue during the entire waking hours. It may be absent entirely and, in rare instances, manifest itself in the husband alone. I have known of one such case. This nausea may be excited only by various odors or sights or may be caused by constipation. An increased secretion from the salivary glands usually accompanies the stomach disturbances and in some cases it may amount to salivation. An irresistible desire for certain articles of food or drink, generally of a sour or acid nature, is often developed. Indigestion, gas in the bowels and belching of gas are frequently present. The appetite is often capricious or it may be entirely lost (anorexia).

Breasts.--Changes in the breasts also constitute a sign of pregnancy. As an early symptom, there may be a feeling of fullness, sometimes pain. They become larger and firmer from the development of the individual lobules, which have an irregular knotty feel. A fat deposit takes place between the lobules and in the other parts of the breast. The nipples increase in size, are harder to the touch, become more prominent. A few drops of a turbid fluid, colostrum, may be pressed from the nipple as early as the third month. The veins under the skin become larger and more conspicuous. The rose-colored circles (rings) around the nipples are broadened and are slightly elevated above the surrounding skin and there is a marked increase in their pigmentation, the color varying with the complexion of the individual from reddish pink to brown and black. These changes usually occur at the beginning of the third month, and if the woman has already had a child the question of pregnancy has been decided by inspection of these breast changes.

Bladder.--This is sometimes irritable in the later months, causing a frequent desire to pass urine. It sometimes occurs in the second or third week and is sometimes followed, later, by an inability to retain the urine which escapes at any time. This, however, is not frequent.

[518 MOTHERS' REMEDIES]

Abdominal changes.--There is a slight flattening of the lower abdomen at the second month, due to the sinking of the womb. There is also a slight retraction (drawing back) of the navel. After the third month, when the womb begins to ascend out of the pelvis, a progressive enlargement of the abdomen begins and continues until near the end of pregnancy, when the womb again sinks and the so-called lightening occurs. The protrusion of the abdomen is more marked usually on the right side. There is often an increased deposit of fat in the lower portion of the abdomen, as well as on the hips and thighs. The navel may protrude after the sixth month,

Pigmentation.--Pigmentation or darkening of the middle line of the abdomen begins by the eighth or twelfth week, and a dark band about 1/8 of an inch wide extends from the pubis (bone) to and around the navel or even higher. This shows plainer in brunettes, where it is quite conspicuous. Discolorations also appear on other parts of the body, especially on the face, "moth patches."

Quickening.--This is caused by the movement of the child (foetus) in the womb. The impact of the enlarging womb, through the child (foetal) movements, against the abdominal wall about the sixteenth week of pregnancy gives rise to this sensation called quickening. Some women claim to have experienced this sensation at a much earlier date, and by some it is not felt at all. Gas in the bowels and contraction of the muscles of the abdomen may give a chance for mistakes. In the later months of pregnancy, the movements sometimes become so violent as to produce perceptible movements of the womb and the abdominal muscles, and sometimes they are the cause of the pain.

The Blood.--The blood is increased in quantity and slightly altered in its composition. The water, fibrin and white corpuscles are increased; the red cells are at first relatively diminished, but later return to normal.

Nervous System.--The nervous system is over sensitive and the disposition of the woman may undergo a radical change, mental exaltation and depression are often exhibited.

Constipation is the Rule.--Neuralgias in different parts of the body, especially in the face and teeth, are common. Palpitation of the heart and difficulty in breathing may be experienced. A discharge from the vagina is almost always present, due to the increased circulation in the cervix and vagina.

The Foetal Heart-beat.--This is the one positive sign of pregnancy and it may be heard as early as the sixteenth to the twentieth week. It has been compared to the ticking of a watch under a pillow. It ranges in frequency from one hundred and ten to one hundred and fifty to a minute.

[OBSTETRICS OR MIDWIFERY 519]

Pelvic Signs.--As early as the first month of pregnancy a faint violet color of the anterior wall of the vagina just below the opening of the urethra may be distinguished. In the third month this color has become purplish and pronounced. This sign is present in eighty per cent of cases. There is also a more or less marked lividity of the vaginal portion of the cervix from the first month of pregnancy. Also there is softening of the cervix as early as the sixth week, and as pregnancy advances the whole of the cervix is softened.

Duration of Pregnancy.--This is for all practical purposes two hundred and eighty days.

How to Determine Date of Confinement.--The best rule is to count backward three months from the first day of the last menstrual period and add seven days to it. To be more accurate, in April and September only six days should be added; in December and January, five days; and in February, four days.

Position of the Womb.--At four months the top of the womb has risen above the pelvic brim bone in front; at five months, it is midway between the bone (pubic) and the navel; at six months, it is at the navel; at seven months, it is four fingers breadths above the navel; at eight months, it is midway between the navel and the bottom of the breast bone; at nine months, it is to the breast bone; from the middle to the end of the ninth month, the top of the womb sinks to about the position occupied at the eighth month.

Twins occur about once in ninety to one hundred and twenty, triplets once in one thousand eight hundred and seventy-five, and quadruplets once in three hundred and seventy-one thousand one hundred and twenty-six pregnancies. The causes are unknown. Twin conception is more common in women who have borne children, and more so in the elderly than in the young, first bearing women (primiparae).

Sex.--Children from the same ovum (egg) are always of the same sex. Of twins in general, more than one-third are males, less than one-third are females, and in the remaining one-third both sexes occur. The after-birth is always, at least at first, double.

Diagnosis.--In twin pregnancy the symptoms and disorders of pregnancy are apt to be exaggerated, and watery swelling above the pubic bone is almost always present in the latter months. The abdomen is larger and broader and there may be a depression dividing the abdominal wall in two spaces. The womb is much distended and the walls are thin.