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THE
Ladvs   Manual



                 OF




       Homceopathic Treatment



IN THE VARIOUS DERANGEMENTS INCIDENT TO HER SEX,
  WITH A CHAPTER ON THE MANAGEMENT OF INFANTS,



                 BY



    E. H. RUDDOCK, M.D. (EXAM.)


Licentiate of the Royal College of Physicians; Member of
      the Royal College of Surgeons, etc, etc.




FIRST AMERICAN FROM THE THIRD LONDON EDITION,




      Wi\\\)  Notes an* Etrtuttona



                 BY



          R. LUDLAM, M.D.,


Professor of Obstetrics and the Diseases of Women and Chil-
  dren in Hahnemann Medical College; President of the
       Chicago Academy of Medicine, etc, etc
       CHICAGO:

C. S. HALSEY, 66 LAKE STREET.

          1870. 
   Entered, according to Act of Congress, in the year 1870,
                     BY C. S. HALSEY,
In the Clerk's Office of the District Court of the United States,
             for the Northern District of Illinois. 
PREFACE.
  In this Manual the author has endeavored  to point out,
in a systematic  and intelligible manner, the medical and
general treatment of various derangements peculiar to the
female organization.  The statements advanced in nearly
every case may be accepted as tested and confirmed by the
author, and claim that weight which may reasonably be
asked  for the honest declarations of a careful observer.
Still, even in its present enlarged form, the manual is but
an imperfect sketch of a wide and interesting field of labor,
to be filled  up as time and  opportunity permit  Enough,
however, if he has added a fragment to the practical know-
ledge of every-day disease,  which may be useful to those
who consult the volume.
  The value  of Homoeopathy  in the treatment  of the
diseases of  women and children can only be estimated by
those who have  adopted it considerably in this major por-
tion of suffering humanity.  The author's practice in this
department of the  healing art enables him  to  recommend
the  treatment as  immensely superior to that  of  the  old-
school.  Knowing, therefore, how great a blessing Homoe-
opathy is to females and children, he is thankful to observe
how the science is  steadily and  surely permeating  society,
especially the more intelligent and reflecting portion.  And
did  not his own  observations  satisfy him  of the truth,
efficiency,  and  safety of the following prescriptions, he
would, indeed, hesitate to incur the  responsibility of  offer-
ing them to the public.  His personal observations,  made
during a fairly large experience, both in private  and dis-
pensary practice, together with the spontaneous testimony
of the numerous  correspondents  just referred to, enable
him to predict, even more confidently than he did  seven 
4
Preface.
years since, when the first edition was published, the  hap-
piest  results,  whenever  the  directions herein  contained
shall  be faithfully carried out.
  This work  is by no means intended to supersede  profes-
sional Homoeopathic treatment, when it is  accessible, but
to substitute  remedies  and  measures  of  greater value,
and  less dangerous,  than  those commonly employed in
Allopathic  practice.   It were a vain effort to attempt the
suppression of home  medical and general measures, more
especially such as fall within the scope of this Manual; we
have therefore chosen the more promising task of attempt-
ing to reform domestic treatment, by pointing out more
efficient and  less  hazardous  remedies than those too fre-
quently used.   Of course, in every serious or doubtful case,
or when the  treatment  herein prescribed  is  insufficient
quickly to  effect the  desired change, the case  should be
submitted  to  a  Homoeopathic  practitioner.   The ever-
accumulating  resources which  the  educated and  diligent
student of  Homoeopathy has  at command, should encour-
age hope in the most difficult and complex cases.

                                   E.  H.  RUDDOCK.

  12 Victoria Square, Reading, January,  1869.
  Note to the American Edition.—The author having
disposed of the copyright of this Manual, for the United
States, to Mr. C. S. Halsey, of Chicago, has made various
alterations and additions, and  hopes the publication will
prove  as  useful  in America  as it  has already been  in
England.    t
  The  author has recently visited America,  and derived
great pleasure  and profit from intercourse with numerous
professional  and lay Homoeopaths.  He rejoices to find
that a hearty fraternal spirit binds together  the Homoeo-
pathic profession of the old and new country in close bonds; 
Preface.
5
and he will much rejoice if the issue of this Manual, in any
degree, tends to subserve the beneficent cause of Homoeop-
athy in the great land in which he has traveled, and among
the people with whom he has just passed a most agreeable
holiday.

  Reading, London, November,  1869.
PREFACE  TO  THE  AMERICAN  EDITION.
  Some years ago our enterprising publisher, Mr. Halsey,
urged the undersigned to prepare a domestic manual upon
the Diseases  of Women.  In accordance with this request,
considerable  progress had been  made therein, but profes-
sional  engagements had prevented  its completion and
delayed its publication.  Meanwhile Dr. Ruddock's little
volume fell  into our hands, and we soon  recognized that
it  filled the  place more perfectly than anything  we could
write.
  Accordingly, and  with the  author's  approval, the old
plan was relinquished for the present one.
  If the few  notes and  additions we have appended shall
serve to render this popular Manual even more worthy and
acceptable  to American women  than the original work
already  is  to thousands in Great Britain, our  pleasant
labor will not  have been bestowed in vain.
                                       R. LUDLAM.
Chicago, 3rd mo. 1870. 
HINTS  TO  THE  READER.
  First.  In using this work, the beginner in Homoeopathy
is  recommended to make  herself  familiar with  details
respecting  the medicines, the dose, its repetition,  etc., as
described in the introductory chapter, the whole of which
should be carefully read.
  Second. When the Manual is consulted for the treatment
of any particular affection, the whole section devoted to it
should be studied — the symptoms, causes, medicines, and
accessory means — before deciding  on any course of treat-
ment.  One portion of a section often throws  light  upon
another, and hesitation in the choice between two or  more
remedies may often be removed by considering  the causes
or symptoms of the disease under treatment.   Asa rule,
as far as practicable, the medicines  are prescribed in the
order in which  they are  most likely to be required,  or of
their importance; this, however, must never be taken for
granted, but the remedy  or remedies administered  strictly
according to the present symptoms of the patient.
   Third. This being essentially a  book of reference, the
index, placed at the  end of the  volume, is  made  very
copious, and every point of importance may be found by
it.   An occasional half-hour spent in studying the  Manual
will facilitate its consultation  in cases of urgency.
   Fourth.  Sometimes,  medical  terms  are  unavoidably
used;  but they are either explained in the text, or the
meaning is appended to  such words as  seemed to require
explanation as they occur in  the index at the  end of the
Manual. 
CONTENTS.
Preface,................3

Hints  to the Reader,...........9

                       CHAPTER  I.

Introductory,  ..............    "

  Homeopathic Medicines —Directions for Mixing and Taking the
    Medicines — Rules for Patients —The Bidet or Hip-Bath.


                       CHAPTER  II.

Menstruation,..............2°

  Puberty—The Function of Menstruation —Delayed Menstruation
    — Chlorosis, Green-Sickness — Scanty Menstruation — Painful
    Menstruation, Menstrual  Colic — Profuse  Menstruation —Pro-
    longed Menstruation — Suppression of the Menses-Vicarious
    Menstruation —Cessation of the Menses, Change of Life, Criti-
    cal Age.

                      CHAPTER  III.

 Incidental Diseases,...........6l

  Leucorrhcea, Whites - Falling of the Womb-Inflammation of the
    Womb— Hysteria.

                       CHAPTER  IV.

                                             .....82
 Reproduction,...........

   Marriage— Sterility—Conception.

                        CHAPTER  V.

                                     ........101
 Pregnancy,.........
   Signs and Symptoms of Pregnancy - General Rules during Preg-
    nancy.

                       CHAPTER  VI.

 Disorders of Pregnancy,........

   Morning Sickness-Toothache- P^P^™ of the»H^-Heart


    Cramps-Varicose Veins-Swelling of thep.Kxt£™fcal


    tion, Miscarriage. 
8
Contents.
                      CHAPTER VII.

Labor,.................148

  Calculation of the Time of Labor — Calendar Indicating the Three
   Periods of Gestation — Causes of the Sufferings and Difficulties
   of Child-Birth — Preparations for Labor—False Labor Pains —
   Symptoms and Stages of Labor — How to Act in the Absence of
   a Medical Man — General Hints.
                      CHAPTER  VIII.

Management after Delivery,........172

  Diet — Flooding — After-Pains—The Lochia, Cleansings—Milk
   Fever and Child-bed Fever — Retention of Urine — Constipation
   — Diarrhoea.


                       CHAPTER  IX.

Lactation and  Nursing,   .......... 186

  The Breasts — Gathered Breasts — The Nipples — Sore Nipples —
   Diet for the Nursing Mother — Stated Hours for Nursing — Sore
   Mouth of Nursing Mothers — Scanty or Suppressed Milk — De-
   teriorated Milk — Excessive Secretion of Milk, or Involuntary
   Discharges—Too Prolonged Nursing — Weaning.


                       CHAPTER  X.

Management of  Early Infancy and its Diseases, 206

  The New-born Infant—Still-born Infants — Washing and Dress-
   ing Infants — Wet-Nursing  and  Hand-Feeding — Medicines
   specially adapted to Infancy; their Administration,etc.— Infan-
   tile Evacuations—Vomiting—Crying — Sleeplessness— Inflam-
   mation  of  the Eyes — Coryza,  Sniffles—Croup—Red-Gum,
   Heat-Spots—Sore Mouth, Thrush. 
THE
Lady's  HoMCEOPATHIC  Manual.
     CHAPTER I.

INTRODUCTORY.
         I.—Homoeopathic Medicines.

  The medicines prescribed in this Manual may be
procured either in single bottles, or in a case or chest.
A chest constructed expressly for this  work — con-
taining all the remedies recommended, or a selection
of those most frequently prescribed,  and used for no
other purpose — is very desirable for  those who wish
to adopt the treatment  under the most favorable cir-
cumstances.  The medicines should be procured from
an educated  person of known character,  who has
been trained,  and  is exclusively engaged as a Homoeo-
pathic chemist.    Failures in Homoeopathic practice,
we doubt not, often  arise from the inefficiency of the
medicines  employed.   Inasmuch  as any person has
been hitherto allowed  to assume the designation of
" Homoeopathic chemist,"  without submitting to any 
IO
Introductory.
test of qualification, there is the greater need for exer-
cising caution as to the source from whence the medi-
cines  prescribed herein are obtained.    Persons  who
are in doubt on the subject, and  in  whose locality
there  is no such chemist as we have just indicated,
should consult  a Homoeopathic medical  man,  who
will inform them of trustworthy persons from whom
the medicines may be procured.   As a general rule,
Homoeopathic remedies should not be purchased from
an Allopathic druggist's shop, unless a separate room
is specially appropriated to them;  otherwise the vir-
tues of the  medicines are liable to injury by  close
proximity  to strong-smelling  drugs:  and, further,
Homoeopathy with such associations is generally kept
in the back-ground.   Druggists, with  a  few excep-
tions, are  opposed  to  Homoeopathy, often depreciate
it, and when they can do so, recommend their  own
preparations in preference.
  The medicines  used in Homoeopathic practice are
prepared  in different forms—Globules,  Tinctures,
and Triturations.

II.—Directions  for  Mixing and  Taking  the
                    Medicines .

  Globules may be taken dry on the tongue, but it is
better, when convenient, to dissolve them  in pure soft
water.  If tinctures are used,  the required quantity
should  be dropped into the bottom  of  a  glass, by
holding the bottle in an oblique manner, with the lip
resting against the cork;  the bottle should then be
carefully tilted {see the illustration), when  the tincture 
        Directions for Taking Medicines.       11

will descend  and drop from the  lower edge of the
cork.  A little practice will enable a person to drop
one or any number of drops with great exactness.
  Water, in  the  proportion of a table-spoonful to a
drop, should  then be poured upon the medicine.  The
vessel  should be scrupulously clean; and if it has to
stand for  some time after being mixed, it should  be
covered over, and the spoon not  left in the medicine,
but wiped after  measuring each dose.  Fine glazed
earthenware  spoons are the best for this purpose.  If
the medicine has to be kept several days, it should  be
put into a new bottle, particular care being taken that
the cork is new and sound, and that the bottle has not
been used for the medicines prescribed under the old
system.
  Hours.—The  most  appropriate  times for taking
the medicines, as a rule, are, on rising in the morning,
at bed-time, and  if oftener  prescribed, about  an hour
before, or two or three hours after, a meal.
  The Dose.—In  determining the  quantity and
strength  of doses, several circumstances require con-
sideration, such as  age, sex, habits, nature of the dis- 
12                 Introductory.
ease, and the organ involved.  We may appropriately
remark in  The Lady's  Homoeopathic Manual, that
the superior delicacy of the female organization ren-
ders this sex, as a rule, more sensitive to the action of
medicines than the male.   The  circulation is quicker,
and the nervous system more  impressible; and the
dose has often to be regulated  by these peculiarities.
  With the  above exceptions,  and  allowing for any
idiosyncracy  of constitution, the following directions
may be given as to the dose:
  For  an Adult, one drop of Tincture or four
globules; for a Child, about one-half the quantity;
for an Infant, about one-third.
  A drop is easily divided into  two doses, by mixing
it with two spoonfuls of water, and giving one spoon-
ful for a dose.
  Repetition of Doses.—On  this  subject we are to
be  guided by the  acute or chronic  character of the
malady, the  urgency and  danger of the  symptoms,
and the effects produced by the medicines.   In violent
and acute diseases, such as flooding, miscarriage, con-
vulsions, etc.,  the remedies  may be repeated every
fifteen, twenty, or thirty minutes; in less urgent cases
of  acute disease, every two, three, or four hours.  In
chronic maladies,  the  medicine  may be administered
every  six,  twelve, or twenty-four hours,  or even at
more distant intervals.   In all  cases when improve-
ment takes place, the medicines should be taken less
frequently, and gradually relinquished. 
Rules for Patients.              13
            III.—Rules  for Patients.

  Diet.—Homoeopathy is not, as is often stated, a
mere system of diet.  The grand  rule to be observed
is, that patients should partake of  easily digestible and
nourishing  food, sufficient to satisfy hunger;  and of
such drink as nature  requires to allay thirst.   Nearly
all  the general remarks  that  it  seems necessary to
make in this place  are, that  the diet should be regu-
lated by the patient's  observations, intelligently made,
as to what kinds of food  and drink  best  agree with
her, these being modified by  the nature,  stage, and
progress  of the disease  under which  she  may be
suffering.
  The  usual list of articles of food allowed and for-
bidden  is omitted, as unnecessary,  and sometimes per-
plexing.  Ample and special  instructions, are, how-
ever, given  in  nearly every section  of  the Manual;
and these, it is believed, will be  found more satisfac-
tory than general  directions.   Different diseases and
different constitutions require  such  a varied  dietary
scale as to render it impossible to  give any single list
applicable to all cases.  Thus, in cases of diarrhoea,
fruits and vegetables should be eschewed, while a con-
fined state of the bowels requires the free use of these
articles; also,  when  febrile  symptoms  are  present,
meat, eggs,  butter, and  other stimulating food should
be  avoided, restricting  the diet more particularly to
fruits and farinaceous  articles.
  In acute and dangerous diseases, no food whatever
may be proper;  the only admissible article probably 
H
Introductory.
being that which  nature craves, viz., pure cold water,
given in small quantities, at short intervals.
  Drugs.—Persons under Homoeopathic  treatment,
are particularly cautioned against  taking   herb-tea,
senna,  salts,  castor-oil,  pills, and allopathic  drugs.
Leeches,  mustard plasters,  blisters,  and  medicated
poultices often disturb and annoy the patient, and as
they are also injurious, should not be employed.   The
extent to which  numerous patent drugs, declared to
be  potent to cure every disease, are now advertised
and sold in every part of the  country, doing an  incal-
culable amount of  injury, by causing  irritation and
inflammation of the alimentary canal,  and lowering
the tone of the digestive  organs, seems to justify this
caution.  Religious and general literature teems with
these advertisements,  and  by giving a  virtual assent
to the efficacy of the drugs they advertise, often inflict
injury on their too-confiding readers.
  General Directions.—Patients are recommended
to wash themselves all over in cold water, and quickly
and thoroughly dry themselves  with  a large coarse
towel or  sheet, every day, or at  least several times a
week;  during the monthly period, tepid water may
be substituted for cold. The bidet or hip-bath, described
in this  Manual [see  next  section), is strongly recom-
mended for general adoption.   Patients should  also,
if possible, take moderate  exercise daily in the  open
air; or  if the  weather is  unsuitable, in well lighted
and properly ventilated rooms.
  Patients must abstain  from  undue indulgence in
every passion, and guard  against all excessive  emo-
tions, such  as  grief,  care,  anger, etc.;  the  active 
The Bidet or Hip-Bath.            15
requirements of the household, as well as its cares and
anxieties, should  be  controlled and moderated  so as
not to  overtax the body or  overburden the mind;
lastly, the excellent and healthy habit should be formed
of going to bed, and rising, early.
  These hints  are of vital importance, alike for  those
under treatment, and for those who desire the inesti-
mable blessing of a healthy, long life.

          IV.—The Bidet or  Hip-Bath.

   A hip-bath may be  procured  of  any respectable
iron-monger;  in  the  absence of one constructed for
the purpose, however, any wide  vessel about twelve
inches deep, will answer the purpose.  Having poured
water into the bath to the depth of five or six inches,
removed the night-dress as far down as the waist, and
tied the hair back, the lady should plunge the entire face
and hands in the water; then soap the hands well, and
rub the face, neck, chest, and  arms; and immediately
afterwards, bathe these parts with a sponge squeezed out
of the water, drying rapidly by means of a large  towel.
Then,  after throwing a covering over her shoulders
 and back, and removing the dress from the lower part
 of her body, she  should  sit down in  the  water for
 about two  minutes;* the instant she is  thus seated,

   *The time  during which the patient should remain in
 the  bath may be extended from ten to fifteen or  twenty
 minutes. When used as a derivative, it should be cold, and
 the time short;  when used  to dispel congestion, it  should
 be warmer and the time longer.  While sitting in the bath,
 the  shoulders, upper portion of the body,  and  ^e legs
 should be covered by a blanket, with a hole cut out of it tor 
i6
Introductory
she should fill a large sponge with the  water, raise it
as high as the arms will permit, squeeze out the water,
and allow it to fall on the chest, and, again over the
back  and shoulders;  she  may also rub the general
surface, especially of the bowels and lower part of the
back, with the hands or with a bath-glove.   She may
then stand up in the bath for a moment, and sponge
the feet and legs, then step out on to a warm mat, and
at once commence drying herself by means of a sheet
or large  towel, thrown over the shoulders, continuing
the friction till the whole body is  in  a comfortable
glow, when dressing should not be one instant delayed.
After the bath, she should take active exercise, if pos-
sible out of doors,  to promote reaction towards the
skin.
   To render the bath above  described promotive of
health to the  highest  degree, the  following points
should be attended to:
   (i.)    The water should be cold *   If the reader is
unaccustomed  to  a morning  bath such as that just
recommended, and  especially if weakly, she may not
at first be able to  bear the  water cold, and should

the head.  In general, sitz-baths should not be taken with-
out the special advice  of a physician {Dr. Baikie).  These
remarks have reference to the Hydropathic sitz-bath ;  those
in the text to a process of ablution for tonic purposes and
cleanliness.

  *Dr. Baikie, of Edinburgh, remarks in a letter to  the
author, " I rarely use  it colder than 681 to  begin  with,
gradually reducing it  to 64'.   Great mischief is often done
by using  water too  cold, especially when it has access  to
the internal  cavities  of the body, owing  to the violence
of the reaction it creates."  This refers to the Hydropathic
sitz-bath. 
The Bidet or Hip-Bath.           17
commence by using water at about seventy degrees,
gradually reducing the temperature for three or four
mornings, after  which, in nearly every case, she will
be able to use it cold.  The use of cold  water every
morning  on  rising  from  bed, in the  manner just
pointed out, will wonderfully contribute to health  of
body and  cheerfulness of spirits.   During menstruation,
only tepid water may be used, if cold injuriously affects
the discharge.
   (2.)   Addition of sea-salt to the bath.  Sea-salt is
the residuum of evaporated sea-water;  and if it  be
added  in such  quantity  to a  bath that  the  mineral
ingredient is equal to that contained  in salt water, it
will be far more  efficacious  than a simple fresh-water
bath, as  it combines the advantages  of temperature
with  the  stimulating action of the water upon the
skin, imparted by the saline  matter which it holds in
solution.  Occasionally in health, but especially if the
back and hips  are weak, the addition of this salt to
the bath  will be of great  service.  Another  advan-
tage resulting from the addition of salt to the bath is,
that it raises the specific gravity of the water and pre-
vents the  chill which fresh water sometimes causes,
and so enables  persons of  feeble circulation — weak
heart and pulse, and cold hands and feet — to use cold
sponging who  could not otherwise do so.   Sea-salt
can now  be  very generally obtained,  and at a cheap
rate, and  thus persons residing  at a distance from the
coast may  enjoy, to a certain   extent, the advantage
and luxury  of a sea-bath.   In the absence of sea-salt,
a  handful of bay-salt, or  of common  salt,  may  be
added to  the water. 
i8
Introductory.
   (3.)  Coarse linen sheets for drying and friction.
A suitable pair may be procured from any linen-draper
for a few shillings, and forms a very necessary appen-
dage  to  the  bath-room.  If the body is dried with a
small towel, much vital heat  necessarily passes  off
during the exposure, and the benefit of  the  bath is
often  lost from inattention to  this  point alone.  A
sheet  thrown over the whole body prevents  the radia-
tion of heat from the surface and aids reaction.
   (4.)  The process should be quickly and actively
performed.  The bath should  be taken quickly, and
contact with the water  boldly encountered, as it is  the
shock thus given which does so much good, by impart-
ing tone and health to the body.  The entire process,
including  the  drying,  should  be performed  by  the
patient  herself,  as the exercise renders the reaction
more  complete  and  lasting;  but  a weakly person
should have an assistant to rub her  back whilst  she
herself rubs the front portion of her body.
   With  the  exercise of a  little care,  the bath thus
described may be used in nearly every case.  Its adop-
tion would prevent many of the nervous, fancied, and
real ailments of invalids,  and  remove  the excessive
sensibility to cold and disease that often  dims the sun-
shine  of life, and cripples  the  efforts  of  many who
would gladly be employed in doing good.  And if
the author's labors in the production of this book lead
to no  other result  than  the  regular and extended  use
of the morning bath,  he will  not have  labored in
vain. 
Walking, Riding,  etc.              19
           V —Walking, Riding, etc.

  An  impression prevails, especially among young
husbands,  that  women should  walk several  miles
daily.   But  this opinion  needs  qualification.   This
form of exercise should not  be persisted  in at the
expense of  health.   Walking is harmful when  it
wearies and exhausts the person, when she has a dread
of it, and especially if she suffers from those dragging
down,   pelvic pains to which so  many women are
subject.  Like other varieties of exercise the kind and
degree thereof should  be suited to  the strength of the
person, for a walk that would benefit one might seri-
ously injure another.   And then, too, walking simply
to improve one's health, without any other object in
view, does little or no  good.

  Women should  enjoy the free  air habitually.   If
not able to walk, they should ride out daily.  And
they should not go to  drive in close  carriages, but in
open vehicles, which not only ensure them the fresh
air, but the  sunlight  also.   For  our bodies are so
organized  that  they require the  light,  and  women
especially need its vivifying influence.          L. 
20
                 CHAPTER II.

             MENS TR UA TION.


           I.—Maternal  Instruction.

  As puberty  advances,  no prudent  mother will
neglect  to  teach her  daughter to expect  the change
which is the common lot of her  sex, so that the first
appearance  of  the  menstrual flow  may  neither  be
arrested  by  the  alarm naturally felt  at something
hitherto inexperienced or unknown, nor by the dan-
gerous applications to which in her ignorance she may
otherwise  secretly resort.  Some young persons  view
the development of this function with  such disgust,
that they  expose themselves carelessly  or purposely
during the  period to cold  and wet, or use cold baths
or other means of suppression, and thus finally bring
on disordered menstruation and permanent ill health.


     II.—The  Function of Menstruation.

  The periodical recurrence of the menses, periods, or
courses, as they are termed, is one of the most impor-
tant functions of the female organization, constituting
a real monthly crisis.   It consists of an  exudation of
sanguineous fluid, chiefly from the body  of the uterus,
the average quantity being from four to  six ounces at 
         The  Function of Menstruation.         21

each period, and is attended by a congested state of
the uterus,  ovaries,  and  contiguous organs.   The
course of  the  menses  recurs,  in  the  majority  of
instances, every twenty-eighth day, the  very day  on
which it had  appeared four  weeks  previously.  The
duration of  a menstrual period varies in different per-
sons, the most common being about four days.
  There are women,  however, who, although they are
quite healthy,  habitually menstruate as often as every
three weeks, and others in whom the flow returns only
once in  five or six weeks.   With  these persons the
length of the  period  is shortened or prolonged with-
out injury.   For them it is physiological, or natural,
just as it is  for some  persons to have a movement  of
the bowels  once or  twice daily, while, in  case  of
others, they are acted upon only once in two or three
days, or perhaps in a  week.  It is hardly necessary to
say  that artificial  means, designed to regulate  the
return  of the  menstrual flow in this  class of cases
would do more harm than good.
  The menstrual fluid is eliminated from the uterine
vessels, and  is considered by some as a true secretion,
and  by others as  a discharge of pure  blood.   The
latter opinion is the correct one, for it is blood, and not
a mere secretion, although prevented from  coagulat-
ing by being  blended with  the  acid mucus of the
vagina.  It  has been demonstrated  that the addition
of a small quantity of acetic, phosphoric, or of almost
any acid, to  ordinary blood, will  prevent its coagula-
tion, and render it in its  properties and appearance
similar to menstrual  blood.  In  cases,  however,  in
which  the discharge is so profuse, that a  portion of  its 
22
Menstruation.
coagulating constituent — the Jibrine — escapes  with-
out intermixture with the acid mucus, clots are formed.
Thus it  appears that true  menstrual blood, uncom-
bined with the normally acid vaginal mucus, is like
ordinary blood, and equally capable of coagulation;
but that being immediately dissolved in this mucus, it
is  thus enabled to pass off in an uninterrupted course.
And  here  may be observed one of those wise and
beneficial contrivances of the Creator and  Preserver
of all, which so frequently excite  the  wonder and
admiration of the Physiologist.  If no  such solvent
power as that of the acid  vaginal mucus existed, the
coagulated part of the menstrual secretion would, in
consequence  of  its consistency,  be prevented  from
passing along  the  vaginal  canal,  and  would thus
become a mass of dead and  putrid matter, entailing
consequences which would be fearful in  the  extreme.
  The uterine mucus is alkaline, while  that  secreted
by the vaginal mucous membrane is  acid.   It is  as
necessary that the former should be alkaline as that
the blood should be.  If this  mucus were acid,  the
albumen of  which the  spermatozoa  are  composed
would be  coagulated by  contact and  impregnation
would be an  impossibility.                     L.


           Purposes of Menstruation.

  Two  ends seem to be especially secured by this
function:   ist.  The relief of the general system, by
the discharge of  the superabundant blood,  which
during pregnancy is  appropriated  to the formation
and growth of the foetus.  2nd.  It affords a vicarious 
             Purposes of Menstruation.          23

satisfaction  of the sexual instinct, and  thus shields
female chastity.
  First Menstruation.—In this country, the four-
teenth to the sixteenth year is the most common time
for the occurrence of the  first menstruation, although
the age is liable to some variation.  In hot climates it
commences  at  an earlier,  and   in  cold at  a  more
advanced age.   The occurrence of menstruation  in
this  country one or two  or even three  years  earlier
than  the  thirteenth year, or  as  much later  than the
sixteenth year, is not sufficiently  uncommon to justify
any medical interference  should the health be other-
wise good;  although the former must be considered
too early, and the latter too late.  Menstruation com-
mences earlier  in cities and  large towns than in the
country, and two  years earlier in hot than in temperate
climates.   It also occurs in the  daughters of the rich
— in  those  who have  every  comfort  and  luxury,
everything  which enervates  and relaxes,  and at the
same time excites — at least nine months  before it does
in those of  the industrious portions of the community
placed  in the most  comfortable circumstances;  and
full fourteen months, on the average, before it appears
in the poorest classes.
   It is satisfactorily established, that, in every country
and climate, the period of the first  menstruation may
be  retarded, in very many cases much beyond  the
average age, often without producing ill health,  or
other  inconvenience.  Probably the  most successful
mode of managing  females  is  to bring them as far
towards the  perfection  of  womanhood as possible
before the appearance of the menses, at least until the 
24
Menstruation.
fourteenth or fifteenth year.   In carrying out this sug-
gestion, the  following  hints  are of great importance:
  Hints for Preventing too  Early Menstrua-
tion.—Avoid the use of hot  baths, especially  with
the addition of mustard;  indulgence  in  the  use of
hot, spiced, and stimulating  food and  drinks; living
in overheated  or badly ventilated  rooms;  excessive
dancing, novel-reading,  too much  sitting,  and  late
hours; all these practices tend to occasion  precocious,
frequent, copious, or irregular menstruation.
  To  which we  may add feather-beds,  cushioned
chairs, rocking chairs, skating, horseback riding, run-
ning the sewing machine, and  too  much  theatre and
opera going.                                   L.
  Young ladies  of idle habits often corrupt  their
imaginations by novel-reading and similar  means, and
thus excite  a propensity which is  not unfrequently
honored  with the modish  name of sensibility;  and
who, under  a stiff and severe outside, often indulge in
the most wanton and dissolute ideas {Hufeland).
  The education, including the  general habits of our
present social condition, too frequently gives  such a
pressure of training, that the successive stages of life
are hurried  through, and the tastes and peculiarities
of one period are anticipated  in that  which  should
precede it.   Thus,  mere  boys in age and physical
development become young men,  and girls,  young
ladies,  before they leave school.  Such is the preco-
ciousness which the habits and  fashions of  the present
generation engender.
  On the other hand, regular  healthy  occupation of
both the body and the mind;  the daily  use of cold 
            Purposes of Menstruation.           25

baths, or cold sponging over the entire surface of the
body; free exercise in the open air; cool, well venti-
lated  rooms;  plain,  digestible  diet, and abstinence
from hot tea, coffee,  and alcoholic stimulants, tend to
the healthy and highest development of  the  female
form and constitution.
  Sudden Menstruation.—It is not always, how-
ever,  that  this function  advances  gradually  and in
harmony with  the changes described.  Menstruation
may occur for the  first  time  prematurely, and  be
caused by a severe fall, violent jumping, great  mental
emotion, etc.   In such cases there  may be a conside-
rable flow, amounting, in  extreme instances, to abso-
lute flooding,  and  lasting for  several days.   It is
important  that  these  facts should  be   known  by
mothers, so that in sudden and extreme instances they
may  not only maintain their own composure,  and
inspire it in others, but efficiently carry out the follow-
ing important
   Treatment.—A  few doses of Aconitum, if result-
ing from mental emotions, or of Arnica,  if occasioned
by injury or severe exertion, with the following meas-
ures : Rest in the recumbent posture, light  covering,
a cool and well ventilated  apartment, and cool drinks.
These means will often be sufficient to arrest any seri-
ous consequences, or  at  least will  suitably precede  the
more detailed treatment suggested in subsequent parts
of  this Manual, or the attendance of a Homoeopathic
practitioner.
   In other cases, the  occurrence of the menses may be
long delayed, and the delay  attended with  excessive
languor,  drowsiness, periodic  sickness,  fretfulness,
     2 
26
Menstruation.
irritabilitv, or frequent change of temper, violent pain
in the  head or along the spine and  in  the region of
the bowels, a feeling of weight or fulness in the pelvic
region, with  bearing down or dragging sensations and
tenderness or heat; these may alternate  with feverish
reaction, with nervous symptoms, or even with spasms.
The local symptoms,  and  their periodicity, are the
most characteristic.
  In some females the establishment of menstruation
may be accompanied by derangements of the venous,
digestive, or lymphatic systems; and unless successfully
treated at  this period, these disturbances may be pres-
ent, in a  greater or less  degree, during every  subse-
quent recurrence of  the menstrual discharge.
  If the catamenial function, as it is also termed, be
well and  healthily established, new impulses will be
given to every nerve and organ, and the system acquire
superior forces for resisting influences adverse to health.
But, on the other hand, carelessness,  or  constitutional
delicacy, may render this period extremely dangerous
in the propagation of new forms of disease, or in the
development of any latent germs  of disorder which
have existed from  birth.  Hence,  the first appearance
of the  menses  should  be looked  for with  some care
and  anxiety  on the  part of  the mother or  guardian,
and when  it  is  long retarded, the  general health dis-
turbed, and the remedies suggested in this work appear
inopei-ative in aiding the  desired change, professional
advice  should  be  sought without delay.  False deli-
cacy and  improper treatment have needlessly under-
mined the health of  thousands.
  The mother  should keep an account of dates  and 
              Delayed Menstruation.            27

other particulars, and prevent all unusual exposure for
a few days before the expected  flow, such as to night-
air, damp linen, thin dresses;  wet feet, balls, and even-
ing  entertainments.  When the  function  has once
become healthily established, it is satisfactory to remark,
that extreme precaution need  no longer be observed.


  III.—Delayed Menstruation {Amenorrhea).

   Definition.—The  term Amenorrhoea is used  to
describe absence  of the  menstrual discharge.  It is
divided  into (1) Emansio mensium, a delay of the
menses, although the  patient has attained  the proper
age.   (2)  Suppressio mensium, in  which  they have
appeared,  but  as the  consequence of cold or some
other cause, are arrested.   (For this variety, see a fol-
lowing page).   (3)  Retentio mensium, in which they
accumulate in  the uterus and  vagina,  from what is
termed, in medical language, imperforate hymen; or
more frequently, from occlusion of the vagina by the
healing of ulcers, the  consequence of sloughing after
difficult labors.   This  condition requires  surgical
measures for its relief.
   This section  we devote to Delayed menstruation.
As before  stated, the period  at  which the  "change"
first  takes place varies  in  different   constitutions,
climates, and under different  circumstances, and no
active  medicinal means should be  used so  long  as
the health  continues good.  Emmenagogucs, or forc-
ing medicines, such as herb-tea, etc., must be entirely
and imperatively eschewed. 
28                 Menstruation.
  Symptoms.—When all the external signs of woman-
hood have appeared, and menstruation docs not occur,
but there are aching, fulness and  heaviness of  the
head, bleeding at the nose,  palpitation of the heart,
shortness of the breath on slight exertion, weariness
of the limbs, pains  in the small  of the back, in  the
lower part of the  bowels and down the inside of  the
thighs — these may be regarded as so many indications
that nature is seeking to establish this important func-
tion, and justify the  administration of one or more of
the following medicines according to the indications.
  Causes.— Delay  of the menses,  giving rise to  the
symptoms just  noted, rarely  occurs  in  healthy and
vigorous persons, but usually follows as a consequence
of original delicacy of constitution, or of some long-
standing chronic affection.  The popular notion that
a patient  suffers because she does not menstruate is
very fallacious;  for,  except in retentio mensium,  the
patient does uot  suffer from an accumulation,  the
delay is due to a defective  condition  of  the general
health.    Hence the impropriety of giving forcing
medicines, which is  frequently done, often to the per-
manent injury of the, as yet, imperfectly developed
organs. We have known several  instances of extreme
periodic suffering, continued for many years, traceable
to this  cause.  In many cases, too, it will  be found
that the disturbances supposed to be due to delayed
menstruation, really  arise from  the patient's having
taken too  little or innutritious food, or her habits have
been too sedentary or artificial, or that she  has enjoyed
too little pure air; or, in brief, that at a critical period 
              Delayed Menstruation.            29

of her physical development, she  has been subjected
to influences inimical to her  general good health.
  Tardy menstruation is especially significant in those
girls who are predisposed to any form of consumption.
In this class of persons it implies a depraved habit of
body in  which the  menses  may not appear at all, or
in which a vicarious flow of blood is very apt to take
place from  one or  another  of the  mucous  surfaces,
more especially from those which line the respiratory
passages.  If the young girl who has not menstruated,
although she may  be fourteen or fifteen years of age,
has a cough  or difficulty of  breathing, a sore throat,
hoarseness, or pain in her side, it should be taken as a
sign of ill health, and measures immediately instituted
for the relief of these symptoms.  The quaint old rule
should, however, not be lost sight of— " She is  not
sick because she does not menstruate, but she does not
menstruate because she is sick."                L.
  Treatment.—In the treatment of this affection,
it  is  important that the cause should, if possible, be
definitely ascertained.  If no congenital deformity or
mechanical obstruction exist, the delay being evidently
due  to constitutional  causes,  one of  the following
remedies may be chosen:  Ferrum, Phos.,Iod., Calc,
Carb..  or Sulph.  For more definite  symptoms:
Puis., Nux  Vom., Bell, Bry., or Sepia.
  Ferrum.—This  is  a  prominent  remedy when
absence  of  menstruation is  associated with debility,
languor, palpitation, indigestion,  sometimes  leucor-
rhoea,  sickly complexion,  puffiness of the  face and
ankles, and other symptoms  of chlorosis (which see).
  Phosphorus.—Persons of delicate constitutions, sen-
sitive lungs;  in whom expectoration of blood in small
quantities takes the place of the menstrual discharge,
With cough, and pains in the chest. 
3°
Menstruation.
  Iodine.— Scrofulous patients, with enlarged glands,
and a lymphatic constitution.
  Calcarea Carb.— Constitutions  similar  to  Iodine,
but with chronic  indigestion, heartburn, hysteria, etc.
  Calcarea Phos.— Is an excellent remedy when the
patient  has a confirmed cough, with hectic, hoarse-
ness, emaciation and debility.                   L.
  Sulphur.— Scrofulous patients,  troubled with leu-
corrhoea and itching of the genital organs.
  Pulsatilla.— Delayed, suppressed, or irregular men-
struation ; pains in the abdomen and loins; hysterical
symptoms;  nausea and  vomiting;  palpitation of the
heart;  loss of appetite; deranged digestion; with pale
face, lassitude, chilliness,  and headache.  If the patient
has  light complexion, fair  hair, and a timid, easily
vexed, yet uncomplaining disposition,  this  medicine is
the  more strongly indicated.
  Nux Vomica.—This  remedy may have  the prefer-
ence to the last  when  the  patient is of a vehement
disposition, dark complexion, and there is much dis-
turbance of the digestive organs, with costiveness, etc.
  Sepia.—Delayed appearance of the period in per-
sons at the proper age (from venous congestion), with
distension or pain in the  abdomen, giddiness, nervous
headache, easily flushed face, fine sensitive  skin, retir-
ing, melancholy disposition.
  Bryonia.— Bleeding from the nose in place of the
menstrual  discharge  {vicarious menstruation);  dry
shaking cough; heaviness or pressure  in the head;
constipation.
  Belladonna.— Fulness and heaviness of the head
redness of the face, confusion of sight with dread of 
               Delayed Menstruation.            31

 light, a full pulse, giddiness on stooping, with or with-
 out  bearing down.   If there  is  much feverishness
 present, a few doses of Aconitum may precede, or be
 alternated with, Belladonna.
   Administration.— The selected remedies  may be
 administered from four to six days, in the morning on
 rising, one or two hours before the mid-day meal, and
 on retiring to bed.   In mild  cases night and morning.
 After waiting a few days, the course  may be repeated,
 if necessary.
   Accessory  Treatment.— The  feet  should  be
 kept warm and dry, and  comfort  rather than fashion
 should determine the arrangements of the clothing of
 the whole body.   Delayed menstruation  is often the
 consequence of exposure  to  cold,  or  defective circula-
 tion in the surface, which warm clothing would obvi-
 ate.  The necessity  for wearing  drawers, to protect
 the abdomen from  cold, must, therefore, be  obvious.
 Too studious and sedentary habits should be corrected;
 exercise taken  out-of-doors, particularly in the morn-
 ing,  including  walking,  running, and the games of
 skipping-rope,  battledore and  shuttlecock, trundling
 the hoop,  etc.,  as  they  are powerful auxiliaries in
 obtaining health of  body and vigor  of mind.   Such
 exercises are likely to be  yet more efficacious  if prac-
 tised in the country,  on a dry, sandy  soil, and  in pure
 and bracing air.  If pleasant company can be added
 to the charms afforded  by  diversity of  scene,  the
 advantages  will  be still greater.  All these  means
 should be aided by a carefully selected nourishing diet,
taken at regular hours, thrice daily, and consisting of
easily digestible food in due proportions from the ani- 
32                 Menstruation.
mal and vegetable kingdoms.   All made-dishes, high
seasoning, spices, etc., should be  especially  avoided;
also,  except in great moderation, the use of tea and
coffee, and other stimulating drinks.
   Amenorrhea and General  III Health.— It
is most important, as  may be  inferred from the treat-
ment just prescribed, to recognize  the connection, as
cause  and  effect, subsisting  between  the general
deranged health  and the absence of menstruation, as
pointed out under " Causes."   The function of men-
struation, like the other functions of the body,  is best
performed  when the  system  is in  health.   Now,
health is not  promoted by redundancy or excessive
action, any  more than by debility or enfeebled action;
consequently, the exhibition  of stimulants will not
hasten the menstrual function, even in cases of debility,
unless attention be paid to the restoration of the gene-
ral health of  the patient.   " Let,  then,  the morbid
peculiarities of the constitution and habits of  life  of
the patient be taken  into  consideration; let the first
be counteracted,  and the second be improved; let the
sanguine have her excess  of fulness diminished, let
the debilitated  have her powers augmented:  in short,
let the general  health be amended, and the  functions
of health will be restored."   {Sir C. M. Clarke.)
   It is the experience of all  observant practitioners,
that those remedies  act most  efficiently as emmena-
gogues {medicines to promote the menses), which pro-
duce a most decidedly beneficial effect on the  defec-
tive condition of the general health.  In treating such
cases successfully, the production  or  the  reestablish-
ment of the menstrual  secretion is the final result  to 
              Delayed Menstruation.             33

be attained.  Improvement in other respects must be
effected first; the rest will follow as a matter of course,
in the vast majority of cases.  {Hewitt.)
  The views enunciated by the  above and other emi-
nent authorities are well carried out in  Homoeopathic
treatment.   Why have we prescribed such remedies as
Pulsatilla, Ferrum, Phosphorus, JVux vomica,  etc. ?
Not, certainly, as  mere emmenagogues, but rather as
efficient  and well-tried agents  for  aiding to remove
that defect in the health, or general functional inactivity
of the body, which is the real cause of the evil.   The
experience of all Homoeopathic  physicians  proves,
that the first effect of our treatment in cases of delayed
menstruation is the improvement of the general health
and spirits of the patient, the amenorrhoea at length
disappearing as evidence that the cure is complete.
  Marriage and Amenorrhcea.—This is a fitting
place  to offer a suggestion concerning cases in which
the menses have been delayed years beyond the usual
period, and for which marriage has been recommended
as a cure.  Under certain conditions, such a step  is
sometimes successful,  illustrations  having occurred
within the  author's observations.   Before, however,
such  a recommendation is adopted,  a  professional
opinion, carefully formed, should be taken; for, should
the general  health be at fault, as is generally the case,
or the sexual organs be imperfectly developed, disap-
pointment will inevitably follow such a course.
2* 
34
J\Ic?istruation.
       IV.— Chlorosis — Green-Sickness.

  Definition.—This is a condition of general debility
affecting young women at  about the age of puberty.
There is anaemia or deficiency of the coloring matter
of the red corpuscles {hcematine) of the blood, which
gives the skin a pale, yellowish, often greenish, hue.
The temperature of  the body is diminished, and mor-
bidly sensitive to  cold.  There is generally delayed,
suppressed, or imperfectly performed menstrual func-
tion.  Respiration, circulation, and digestion are also
disturbed;  and the  whole  organism,  physical and
mental, is feeble and enervated.
  Symptoms.—The approach of chlorosis  is marked
by  a state of habitual inertia and  melancholy;  the
patient becomes sombre and taciturn, weeps  without
cause, and sighs involuntarily; the face becomes puffy,
and the  expression, as it were, veiled; the eyes are
sad  and  languishing; the  eyelids,  which may  be
swollen,  are  encircled  by  dark rings, contrasting
strongly  with the pearly color of the whites of the
eyes, and the pallor of the lips; the breathing is short;
the appetite lost, or so perverted that  substances such
as chalk, cinders, etc., are  desired.  Palpitations and
creeping chilly turns occur, and  the extremities are
cold and often oedematous.   Physical  or mental exer-
tion is attended by a sense of sinking  and fainting,
palpitation and hurried  breathing;   the  catameriial
discharge, if  it ever existed, is  superseded by a pro-
fuse leucorrhoea;  there is  a slight hacking cough in
the morning and after exercise; pulsating headache in
the temples;  desire  for sleep, or rather for repose; 
Chlorosis.
35
mental indisposition; and, indeed, prostration of all
the energies.
  The ancemic bruit, a sign appreciable by auscula-
tion, may be heard over the heart, and  even over the
large veins of  the neck; in these  situations it  may be
heard as an almost continuous humming or cooing
sound, termed in  medical language a bruit de diable,
and attributed to  the  tenuity of the blood.  It can
also be felt, and resembles under the finger the vibra-
tions of a musical chord.
  Causes.— Confinement in badly ventilated or im-
perfectly lighted rooms — underground kitchens and
back rooms, shut  in by high walls  excluding the
direct rays of the sun, and a free circulation of air —
and deprivation of open-air exercise and  recreation.
Some  time since, the writer was  requested to visit a
chlorotic patient in London, in whom the symptoms
were very marked.   She lived in a large house thickly
hemmed in by lofty buildings, and for convenience or
from choice,  passed most of the day in a low  dark
room.    We saw  flowers in the  upper rooms, and
remarked,   "You  have  no flowers in  this room."
Our patient quickly answered, "Oh,  no!  they won't
grow here; they  want more  light."    But she had
failed to perceive that her devitalized frame and lan-
guishing nerve-power were the  result of those bad
hygienic conditions to which she would not even sub-
ject her plants!  It need  scarcely be  added, the treat-
ment  hereafter pointed out was rapidly and perma-
nently cui-ative.
   Other  causes  are — too  studious  and  sedentary
habits; long-continued  grief, anxiety, or fatigue;  mas- 
36
Menstruation.
turbation;  innutritious food — bread-and-butter  and
tea forming  the  staple diet,  when the  appetite  for
animal  food  almost completely ceases.   These  and
similar  causes  may develop a  condition of the repro-
ductive  functions that must  lead, sooner or later, to a
watery  alteration of the blood, and to  the whole train
of symptoms which are incident to such an impover-
ished condition of this vital fluid.
   Chlorosis and Consumption.— Chlorosis is fre-
quently  mistaken  for  consumption,  although  an
examination  of a case at once enables a professional
man to  decide on its real nature.  The presence of the
anaBmic murmurs, previously  described, the  normal
characters of the respiratory movements  and sounds,
the absence  of hectic,  and of wasting to any great
extent, are sufficiently marked to distinguish chlorosis
from  phthisis.   Chlorosis essentially consists  in the
absence of the coloring matter of the blood corpuscles;
whereas in consumption  there is a  contamination
of the blood superadded.  In  the former disease the
temperature is below, but in the latter it is above, the
normal standard.   There is also this essential difference
in the treatment — that in the former we have but to
supply the missing elements  of the blood,  and even
the most unpromising cases  are readily and perfectly
amenable to  our remedies; but in the latter we have
to exterminate a poison, and we need not remark, that
too many cases resist every known  means of cure.
  Treatment.—Ferrum.—The  chief  and  special
indications for  this remedy  are,— fits of oppression,
palpitation, and anxiety;  poor appetite;  puffiness of
the face and lips; coldness of the feet and swelling of 
Chlorosis.
37
the ankles; and  absent, scanty, pale, or watery men-
strual discharge.
   Calcarea carb.— Inveterate  cases, with  loss  of
appetite, pallor of the countenance, etc.  It probably
does good by correcting defective assimilation, that is,
when  the  conversion of  digested  food  into healthy
blood and tissue is imperfectly carried on.
   Phosphoric Acid.—When  the affection is traceable
to masturbation.
   Pulsatilla or JVux vomica.—Chlorosis with marked
symptoms  of indigestion.
   Ignatia.—This  may be   sometimes  required  for
excessive nervousness and mental depression.
   Arsenicum.— Shortness of breath, languor, etc.
   Plumbum.— Chlorosis with obstinate constipation.
   Administration.— A dose of the selected remedy
twice  or thrice daily.
   Accessory Means.— Plenty  of fresh  air; abun-
dance  of sun-light; exercise, out  of doors,  to favor
blood  changes;   recreations,  short  of fatigue,  and
pleasantly-varied amusements; cold bathing, especially
in the  sea or with salt water; digestible  and nourish-
ing  diet, and one or more of the  remedies just pre-
scribed, are generally sufficient to effect  the improve-
ment and cure.   Cold bathing and  out-of-door exer-
cises are extremely necessary, in consequence of the
excessive sensitiveness of chlorotic  patients to cold,
which is thus diminished.  Persons unaccustomed to
bathe  should commence  with tepid water, and  the
temperature be  gradually lowered as  the  strength
admits,  until a  cold  bath  can  be advantageously
borne. 
38                 Moistruation.

  " Mothers should  not hesitate," says Dr. Hempel,
" to find out whether the disease may not be induced
by  secret  habits; great  delicacy  and  caution  are
required in endeavoring to obtain certainty concerning
this all-important  subject."    It  is  desirable also,  as
may be inferred from  the remarks just  quoted, that
such patients  should be  unobtrusively watched and
allowed as little as possible to remain alone.
  Chlorotic patients  are notoriously fond of ease, and
desire to remain in a state of muscular  inactivity; but
this desire must  no more be yielded  to than that of
travelers to  the  soporific  effects of intense cold; for
the habitually  cold skin of chlorotic patients causes a
half-poisoned  state of the blood, by the retention of
what should be excreted,  and the imperfect oxygena-
tion it  undergoes.   They should therefore  be  urged
and enforced  to  exert  themselves, so  that  the blood
may circulate more rapidly, and  thus absorb that due
quantity of oxygen which is necessary to impart to it
those vital properties which excite all the organs  to
perform their proper functions.   (Tilt.)
  Horse-back riding, rowing, croquet, the movement
cure, and the  health-lift, are available  forms of exer-
cise in this disease.  Riding in an open  carriage and
walking in moderation may be useful.
  It is  well to insist  that the  patient shall eat of a
mixed diet,  consisting of  animal  and vegetable sub-
stances  in  proper proportions.  A distaste  for  meat
may be overcome  and a desire created for it by feeding
the patient first upon salt food or fish, as, for example,
mackerel, codfish or herring, and afterwards upon the
more  choice kinds of animal food.  In some  cases
oysters  are  acceptable and  beneficial,  in others the
whites of eggs or milk.                         L# 
Painful Menstruation.            39
          V.— Scanty Menstruation.

  Scantiness of the menses  is only a modification of
"Amenorrhcea."
  Treatment.— If the patient enjoy good health,
notwithstanding the scanty  flow, no medicinal inter-
ference is necessary.  If, on the other hand, unhealthy
symptoms are present during the monthly period, or
if a general derangement of the system should evi-
dently co-exist  with the scanty discharge,  medicinal
and general means must be adopted  to correct the
morbid  condition.  See  the paragraph on  " Gradual
premature suppression,"  in the section  " Suppression
of the Menses."
  The remedies most likely to be beneficial are the
following:   Pulsatilla, Ferrum, JVux vomica, Sepia,
Bryonia, Conium, and Sulphur.   For the  symptoms
indicating the  appropriate  remedy,  and the general
measures  to  be  adopted, consult the two previous
sections.

  VI. — Painful Menstruation—Menstrual
                      Colic.
                 (Dysmenorrhea.)

  Definition.—The  term  dysmenorrhoea is used  to
designate the condition in which menstruation is per-
formed with difficulty and pain.  The pain, the essen-
tial element, is of various degrees  of  intensity, and,
like all uterine and ovarian  pain, is chiefly felt in the
bottom  of the back {sacrum) and  within  the  lower
part of the  abdomen.    The  menstrual  discharge is 
4o
Menstruation.
 generally scanty and imperfect; it  may, however, be
 profuse, or in some  cases the function may otherwise
 be healthily performed.
   Varieties.—Three forms of dysmenorrhoea may
 be indicated,   (i.)  The inflammatory and congestive
form occurs  in plethoric patients of  strong passions,
 fond  of the pleasures of the  table  and gaiety, and is
 accompanied  by the discharge of flocks of fibrine and
 false membranes from the interior of the uterus.  This
 has  been called membranous dysmenorrhea,  hyper-
 trophied portions of the mucous lining of the  uterus
 being discharged.

   This is the  most  intractable and  troublesome form
 of the disease.  In a large majority  of cases it follows
 abortion.  Most  women  who have  it have  had an
 abortion, either  accidental or induced, in the early
 months  or years  of their  married  life.   When this
 miscarriage took  place the lining  membrane  of the
 womb was peeled off or exfoliated,  and subsequently,
 with each return of the menses, a similar loss of this
 structure is sustained.  The  altered membrane may
 come away as a complete cast  of the uterine cavity,
 but is usually thrown off in strings or shreds.  Besides
 being  a  very painful  form  of the  complaint, the
 woman  sometimes suffering as much  as in real labor
 to get  rid of these  shreds or casts, it almost always
 results in barrenness.  In many cases abortion depends
 upon this disposition of the lining  membrane  of the
 womb to detach itself at stated periods.          L.
   (2.)  Neuralgic dysmenorrhea, which occurs in the
 feeble  and anaemic,  as  after nursing, flooding, pro-
 longed diarrhoea, etc.
   (3.)   Obstructive  or  congenital dysmenorrhea,  in
 which the pain is caused by the insufficient calibre of 
             Painful Menstruation.             41

the canal or passage which should convey the blood
from the womb, producing partial and temporary reten-
tion of the  menses.   The  phenomenon may be thus
explained to the non-medical reader:  Naturally the
cavity of the unimpregnated healthy womb will only
contain a very small quantity of fluid, and as soon as the
menstrual blood  accumulates, unless it finds free exit,
it will distend the  uterus,  and thus give rise to pain,
greater  or  less, according  to  the  sensibility of the
patient  and  the amount of resistance.  This variety
also includes mechanical dysmenorrhea from tumors,
polypi,  cancer, fibroid or other tumors of the womb,
so situated as to compress or distort the canal and so
impede the  exit of the menstrual fluid.
   Symptoms. — Severe  bearing-down  pains  in the
uterine  region, resembling the  pains  of labor, and
occurring in paroxysms; aching  in  the  small of the
back, loins,  pelvis and  sometimes extending to the
limbs;  headache, flushed cheeks,  hurried breathing,
palpitation;  cutting and pressing  pains in the abdo-
men.   The  pain  sometimes  precedes the flow several
hours,   or even  days,  and  continues for a longer or
shorter  period, and  may cease or continue when the
discharge is established.  At other times the pain con-
tinues till a  membranous substance (referred to  under
the inflammatory form) is  expelled, when a healthy
discharge may take place, or it  may  entirely  cease.
In  some  cases the  breasts, the  counterparts of the
female generative  organs, become  extremely sensitive
and painful.  Patients subject to  dysmenorrhoea are
generally troubled with confined  bowels, and frequent 
42
Menstruation.
headaches, from congestion in the interval between
the monthly period.
  Sometimes, with the coming on  of the flow,  the
chief complaint is of the breasts, which become swol-
len, tender, and, perhaps, extremely painful.   In rare
instances this sympathetic affection progresses to actual
inflammation and suppuration.  Abscesses have thus
been  due to painful menstruation, especially to that
form of it which is known as ovarian dysmenorrhoea.
In other cases the nipples bleed freely in a vicarious
way, and partly or wholly substitute the uterine flow.
  Other cases are invariably accompanied by a species
of spurious  rheumatism, in which  the suffering is
located  most  frequently in the region of the heart,
attacks  of  which  recur  with great  regularity each
month.
  Again, the  kind and degree of illness  incident to
menstruation  in  dysmenorrhoea  induces a species of
nervous  perturbation which  is quite  peculiar.  The
patient, usually amiable, becomes petulant, is disgusted
with  and distrustful of humanity in general,  and   of
the male sex in particular.   Sometimes  she is in a
mellow or pathetic mood, or she has a fitful religious
melancholy, or, what is still worse, is  possessed with
an insane idea to work, to set her room to rights, and
the plants, the birds, the books, the pictures, stoves,
chairs and furniture must be squared  up  and cleared
up instanter.   She must do  an immense amount of
work in a short time.   After which she is exhausted,
fitful, capricious,  cross, tempestuous,  drums  on  the
piano by the  hour, or writes  explosive letters to  her
husband, or friends, and regulates everything with  the
utmost  irregularity.  And  all because of the reflex
effect of the delay and non-escape of  the menses  as
soon as  they are secreted or poured into the cavity of
the womb.                                     L.
  Causes.—As explained above, dysmenorrhoea may
be due  to  local  causes, as a tumor;  or to a general 
              Painful Menstruation.            43

cause, as debility.   It is not a disease per se, but only
a prominent symptom of  a local or general condition.
Persons  of a  neuralgic, hysteric, or  rheumatic ten-
dency, generally suffer much pain at the  menstrual
period.
  Treatment.—When  the painful symptoms  do
not yield readily to  one or  more of the following
remedies, a cause may be suspected to be in operation
which is not amenable to domestic medicine, and the
case should  be confided to a physician.   Obstructive
dysmenorrhoea from a too narrow canal, rarely requires
surgical  operation,  the professional medicinal treat-
ment being nearly always sufficient.
  Actcea rac. — This remedy has a specific action  on
the womb, and gives  great  relief in  dysmenorrhoea,
more especially in nervous and rheumatic patients.
  Chamomilla. — Pains  resembling those  of labor;
pressure  from  the  small of the  back forwards and
downwards;  colic, with  sensitiveness to the touch;
dark-colored and coagulated discharge.
  Belladonna. — Most suitable to ladies  of a plethoric
habit, and of great mental  activity, with determina-
tion to the brain, pulsative  headache, redness of the
face, confusion of sight, frightful dreams, violent pain
in the back, etc.  It may sometimes be employed with
great benefit after, or alternately with, Aconitum.
  Aconitum. — Menstrual colic with spasmodic pains,
heat in  the  head, cold  feet, from  circulatory dis-
turbances.
  Gelseminum.—Simple, spasmodic  dysmenorrhoea.
  Cocculus.—Menstrual colic, with flatulence and a 
44
Menstruation.
constrictive  sensation  in  the lower part of the abdo-
men, nausea, and dizziness.
   JVux  vomica. — Dysmenorrhoea,  with   obstinate
constipation and accumulations of fieces in the rectum,
causing pressure on  the neck of the  womb and so
rendering the escape of the menstrual fluid difficult
and  painful;  frequent desire  to  urinate; paroxysms
of pressing  and   drawing pain.   Flatulence,  and
haemorrhoidal congestions often attend  this variety of
the disease.
  Pulsatilla. — Scanty menses, attended with cutting
pains in the  uterine  region  and back, which move
from one point to another;  loss of appetite, chilliness,
vertigo, etc.  This remedy is specially suited for females
of light complexion, mild disposition, etc.
  Secale. — Labor-like pains at the time of the appear-
ance of the menses, which  are discharged with great
agony, cutting pains  in  the bladder or rectum; pale
face, cold sweat, and indistinct or flagging pulse.
   Veratrum. — Menstrual  colic, with  nervous head-
ache, nausea and vomiting;  excessive weakness;  cold-
ness  of the extremities; diarrhoea, etc.
  Administration. — A dose  everyone, two, or three
hours, in  acute  cases; in chronic, or as improvement
takes place, every four or six hours.
   Accessory  Measures. — Attention  must  be
directed  to  those  general rules for  the recovery of
health which are  prominently dwelt  upon  in  this
book, and form the basis of the correct treatment of
disease of every nature.   Daily active  exercise in the
open air; the use  of the morning cold bath (in the
intervals of menstruation), or tepid (during the period), 
Profuse Alenstruation.
45
followed by vigorous friction; regular and early hours;
plain, wholesome  diet; abstinence from wine, coffee,
and green tea; and  the avoidance  of influences  that
disturb the mind and temper, are important accessories
in the successful  treatment of dysmenorrhoea.   In
the congestive  form of dysmenorrhoea, the vaginal
douche, recommended in the section on "Leucorrhoea,"
may be  used once  or twice a day in the zVz/er-menstrual
periods  with  great  advantage.   Sexual  connexion,
which tends to increase the congestion  of the uterine
organs,  and the thickness  of  the  membrane  to be
expelled,  should only take place infrequently    As
palliatives during the  period, great relief will  be
experienced  by hot bottles or  flannels  wrung out of
hot water, applied  to the lower parts of  the abdomen;
or a warm hip-bath in which the patient may remain
for twenty or thirty minutes, generally gives effectual
relief.  Rest, both just before and during the period,
is an important adjunct in the treatment.
  An available and useful  application is a bag of  hot
salt, or of dry wheat-bran, heated thoroughly and laid
over the lower abdomen.  The suffering will some-
times be  greatly relieved by placing one or more  pil-
lows beneath the hips, at the same time lowering  the
head.                                         L.


      VII.—Menstruation  too Profuse.
                  {Menorrhagia.)

  Definitions.—Menorrhagia is bursting forth, or
immoderate flow,  of  the menses, either in excessive
quantity, or of too frequent  recurrence, and  is most 
46
Menstruation.
common at about the time of the final cessation of the
menses, and in women of lax fibre, especially if  they
have had many children, or abortions.
  It is difficult to determine the exact quantity of dis-
charge  that should occur  at  each  monthly period,
which varies according to constitution, temperament,
habits, and  climate.  Robust, plethoric  females,  who
eat and drink abundantly, can bear a comparatively
large discharge without inconvenience;  whilst others
of delicate and relaxed constitution would quickly ex-
perience serious  consequences  from a profuse flow.
The monthly loss, however, should never be such as
to occasion debility and general ill-health.   There is a
deep-rooted and  most  dangerous prejudice current,
which leads women to believe that, however great the
discharge, if it occur regularly, it is in perfect accord-
ance with the economy  of nature.  If a medical  man
directs a parent's  attention to the debility and ill-health
following an habitually too copious flow, he frequently
receives the answer, " She is always so." ( Tilt.)   The
fact of a girl being always so is  the  very reason for
adopting such  measures as  should  prevent her  ever
being so.
  Causes.—These  may be local or  general.  Local
causes of  menorrhagia  are  numerous, of which the
following are a few: chronic inflammation, or hyper-
trophy of  the uterus or its cervix;  a granular condition
of the mucous membrane;  polypi;  tumors; malig-
nant or other disease of the womb, etc.  Too frequent
sexual indulgence is another cause; this tends to  pro-
fuse menstruation  by producing  irritation and over-
excitation  of the womb and its appendages. 
               Profuse  Menstruation.            47

   General  causes  are:  acute  and  chronic disease;
severe inflammatory affections; tubercular deposits,
and  Bright's disease of  the kidneys.  The last is an
important cause;  and in  persistent cases  of  menor-
rhagia, especially with oedematous ankles and eyelids,
the urine should be examined for  albumen.   Other
general causes are:  residence in a tropical  or  malari-
ous climate, general debility after suckling, prolonged
mental trouble, too confined or  unhealthy occupation,
luxurious living, chronic derangement of the digestive
or circulatory organs; these, and kindred conditions,
may cause  profuse  menstruation by giving rise to a
congested state of the womb and adjacent organs, and
by causing a morbid condition of the blood.  Regular
excessive monthly discharge,  profuseness  being the
only fault complained of, points to some grave consti-
tutional cachexia as the  cause.   All such cases should
be under the best professional care, so that, if possible,
the systemic fault may be corrected.
   It is by no means unusual for a case of dysmenor-
rhoea to merge  into  one of  profuse  menstruation.
When the period arrives, the flow is retained for some
hours  with  great suffering.  Finally, the  spasm,  or
obstruction, is removed and the discharge becomes
excessive, or hemorrhagic.                      L.
   Treatment.—One or  more of the remedies  pre-
scribed below may be administered, and the accessory
and  preventive measures strictly adopted.  The prin-
cipal  medicines  are  the following:  Aeon.,  Croc,
Secale, Sabina, Ipec, Puis., Bell., Calc, Sep., China,
and  Sulph.
   Aconitum.—A few doses  of this  remedy may pre-
cede, or  be  alternated with, any one of the following, 
48
Menstruation.
when there is much heat and feverishness, and the dis-
charge has only just commenced, or is about to begin.
It may be  administered every one to four hours.
   Crocus.—Dark-colored,  clotted,  too frequent, and
abundant discharge, increased by the least movement.
In sevei-e cases, one drop every fifteen to thirty min-
utes.
   Sabina.—Menorrhagia, the discharge being bright-
red, with uterine irritation and excitement, especially
when the irritation extends to the urinary and  intes-
tinal mucous membrane.
   Secale.—Fetid dark  discharge,  with frequent la-
bor-like pains, loss of contractive power in the uterus,
feeble constitution, weakness and coldness of the ex-
tremities.
   Ipecacuanha.—Flooding —bright-red—the  period
recurs every  two or three weeks, and is attended with
pressure  in the region of the womb,  nausea, etc.
  Belladonna.—Excessive menstruation  with  severe
bearing-down in the uterine region, nervousness, light-
headedness, etc.
  Pulsatilla.—Profuse discharge with shifting pains
in the back and abdomen, especially at the change of
life {climacteric menorrhagia), during pregnancy, or
after parturition.
   Calcarea carb.— Too frequent and profuse men-
struation, especially in scrofulous patients.   It should
be administered between the periods  to  correct the
constitutional condition.
   China.—Excessive weakness, from  the great loss
sustained, with a tendency to perspiration, swelling of
the lower  extremities, buzzing in the ears, and faint- 
Profuse Menstruation.
49
ness.   China is especially useful after the profuse dis-
charge has ceased, in the zWer-menstrual periods, as
part of the constitutional treatment.
  Administration.—When the discharge is so profuse
as to be dangerous, the dose should be repeated every
fifteen or twenty minutes for several times, or until the
flooding ceases.   In less urgent cases, the remedy may
be repeated every two, three or four hours, so long as
it appears necessary.
  Accessory  Treatment.—Quietude, the patient
sparing herself, and chiefly maintaining the recumbent
posture, a few days  before,  and especially during, the
discharge;  household duties, particularly lifting, should
be avoided for some time, at least during the severity
of the symptoms; also warm beverages,  even of black
tea; cold water  is the most  suitable drink;  injections
of cold, or even iced-water up the bowels may be used
with much benefit, especially if the patient is costive
and troubled with piles; cool vaginal injections, with
a female-syringe, tend to relieve a congested state  of
the womb; sexual intercourse should be restricted;
and excessive eating, or stimulating food and bever-
ages avoided.  In more severe cases, cold wet cloths
suddenly applied over the abdomen so as to produce a
shock, light covering, and the horizontal posture, are
absolutely necessary; the  hips  should be as high or
higher than the  shoulders, so as to relieve the uterus
of the column of blood, and the patient  be kept cool,
quiet, and free from excitement.  See also " Accessory
Means"  under  "Flooding  after Labor," as the con-
dition of the womb in menorrhagia and fost-partum
haemorrhage  is the same.
    3 
5°
Menstruation.
  Preventive Measures. — If  an  impoverished
state of the blood is the cause of profuse menstruation,
the defect must be remedied by good diet, pure air,
out-door  exercise,  etc.   Residence in  a tropical cli-
mate, or  in a malarious or unhealthy  locality must be
changed.  Severe  and persistent cases are most bene-
fited by  a temporary residence  on  the coast.   Sea-
bathing,  the  daily use  of the hip-bath, described in
another part  of this Manual (see page 15), and the
sponge-bath,  taken under favorable  conditions, fol-
lowed  by good friction  for several minutes  by means
of a coarse sheet  or  large towel, are of the greatest
service in correcting  the defective  activity of the
cutaneous surface which  so  often co-exists with men-
orrhagia.   Very  weakly patients should have assis-
tance in their ablutions.

     VIII.__Menstruation too  Prolonged.

   When  the  menstrual  flow  continues beyond the
proper time,  it is usually  dependent on  conditions
resembling those  which give rise  to excessive dis-
charge (see "Profuse Menstruation"); or it is one of
the attendants on the  climacteric  period. (See" Cessa-
tion of the Menses.")
   Or  it  may be  a sequel of uterine  congestion: or
of abortion;  in either  instance developing  into a pas-
sive haemorrhage.  This is particularly liable to hap-
pen in those  whose  systems have  been  reduced by
previous  disease or who are predisposed  to haemor-
rhages of various kinds.                        L.
   Treatment.—The  remedies  in domestic practice 
            Suppression of the Menses.          51

most  frequently  required  are:   Aconitum,  JVux
vomica, Pulsatilla, China, and Sulphur.
  As a general remedy for this condition we know of
nothing to compare with  JVitric acid in the second
attenuation.                                   L.
  To rectify the abnormal condition on  which  the
prolonged  menstruation   depends,  the  appropriate
remedies should be administered  during the intervals
between the monthly periods.


IX.—Suppression of the Menses {Amenorrhea?)

  When the menstrual flow has fairly been established
as part of the economy, it is yet liable to be suppressed.
See " Delayed Menstruation," page 26.
  Causes.—Suppression may arise  from  a natural
cause, such as pregnancy (see " Signs of Pregnancy,"
Chap. IV.); frequently, however, it is the consequence
of weakness from sedentary, in-door occupations, com-
bined with want of fresh air and sufficient rest; exces-
sive loss of blood; chronic and acute  diseases; sexual
excesses;  and  mechanical  obstructions:   or  it may
occur suddenly during the flow, from  exposure to cold
and damp, such as getting the feet wet, sitting on  the
ground, eating ices, violent emotions — anger, terror,
fright, etc.— or from  any other cause which abruptly
shocks  the  system.   Suppression, for two or  three
periods,  without pregnancy,  sometimes occurs after
marriage, simply as the  consequence of excessive
excitement.    Wearing thin-soled shoes is a fruitful
source of the decay of female beauty, and the decline
of female health; injury from tight  lacing, although 
52
Menstruation.
considerable, being nothing in comparison with that
resulting  from the fatal  habit of wearing thin-soled
shoes  in  all  kinds  of weather.   {Pulte.)   Dr. G.
Hewitt states that he has often known the menstrual
discharge to be suspended for  one or two periods, in
women who have gone to reside in  a house with stone,
uncarpeted staircases, their previous  residence having
had a wooden  staircase.  Many girls are apt to have
" a check " from the slightest chill or exposure during
the monthly period.   Happily, the effects of at least
some of these causes may be diminished  by the fre-
quency of their occurrence, so  that those accustomed
to bathe  may go into  the sea during  menstruation
with perfect impunity, whilst habitual exposure to the
casualties of life necessarily diminishes their injurious
impressions.
   A sea voyage is very apt to  occasion suppression of
the menses.   A very large proportion of the emigrant
girls  and women who  arrive in New York, after
having been  on  ship-board for some weeks, suffer
from  amenorrhoea.    Indeed, a sea  voyage is some-
times an excellent remedy for  excessive  menstruation
{menorrhagia.)                                L.
   Sudden suppression occasions the most acute suffer-
ing, but chronic  is far more serious, as it points to a
deeper  constitutional cause.   We   have   generally
observed, among the  early symptoms of consumption
occurring in girls  and women, that there has been at
first a scanty secretion of the menses; and that as the
constitutional  disease  has advanced, the suppression
has become complete.
   Treatment.—Aconitum.— Suppression  from ex-
posure to cold, with weariness  and  heaviness; rush of 
Suppression  of the Menses.
53
blood to the head, redness of the cheeks, headache,
and giddiness, aggravated by movement, and attended
with coldness of the feet.   There  may be also a sen-
sation of soreness of the bowels,  and  general feverish
condition.  (See  also  " Sudden  Suppression," page
52.)
  Pulsatilla.—If any  other  medicine  is necessary,
Puis, may follow Aeon.,  especially in  females of a
mild, timid, and amiable disposition, easily excited to
tears or  to laughter;  with languor,  pain  in  the small
of the back and lower  part of the  abdomen, palpita-
tion, nausea or vomiting, sensation of fullness in the
head and eyes, frequent urination, and leucorrhoea.
  Sepia.—Suited to  patients of a delicate constitution
and sallow skin, with pains in the loins, bearing-down
in the lower part of the  abdomen, costiveness, mel-
ancholy mood, and morning  headache.   The suffer-
ings are often  mitigated by exercise and aggravated
by rest.
  Opium.—Recent  suppression,  attended with great
heaviness of the head, dizziness,  lethargy and drowsi-
ness, especially if there be  also obstinate  constipation
and retention of urine.
  Bryonia.—Vertigo, bleeding from the nose, stitches
in the  sides and  chest, dry cough, confined bowels,
severe  pressing pain in the stomach,  irritability of
temper.
   Conium.—Chronic suppression.
  Administration.—A  dose  of  the selected remedy
three or four times a day, at the commencement of the
treatment; afterwards, as improvement ensues, morn-
ing  and night.  The  remedy may be continued  for 
54
Menstruation.
ten or fourteen days, if doing  good.  For  Dose, see
page 12.
  Sudden Suppression.—If the menses are suddenly
suppressed during the period, the patient should be
immediately placed in a hot hip-bath, and afterwards
retire to a warmed bed.  The free action of the  skin
should be further  encouraged by giving  a  few doses
of Aconitum  at  short intervals, and drinking freely
of cold water.  The success of  this  treatment, how-
ever, depends  upon the promptness  with which  it is
adopted.
  Gradual   Premature Suppression.—This  is
generally associated with some deep constitutional dis-
ease, such as consumption,  and should be placed under
the care of a physician without delay.
  Accessory Means.—The cause of the suppression,
and the co-existing impairment of the general  health,
should be carefully inquired into, and, if possible, re-
moved.  All physical or mental depression, undue ex-
citement,  night-air, late  hours,  highly-seasoned and
stimulating food and drink, should be avoided.  The
meals  should  be  taken  with  regularity, and under
pleasant and  cheerful influences, the stomach never
overloaded, the food  simple, nourishing, not  in too
great variety,  and only such as  has been  uniformly
found easy of  digestion.  The drink should be  milk
and water, cocoa, black tea in  moderation, and  pure
water.  Green tea, coffee, and other stimulating drinks
should be omitted, unless  prescribed by a competent
authority.  A change of air to the sea-side or to the
country is mostly advantageous; when this is not prac-
ticable, out-of-door exercise, useful employment, and 
Vicarious Menstruation.           55
agreeable company or  books will aid recovery.   In
short, every means  should be adopted that is calcu-
lated  to give  constitutional vigor.   In  expecting a
return of the  menstrual  discharge,  the  exercise  of
patience is sometimes necessary, as the general health is
often  greatly improved  before this crowning evidence
of cure is obtained.
  Caution.—Here let it be observed, once for all, that
the attempt to remedy any defect in menstruation  by
spirits, decoctions of herbs, by the pills which are pro-
cured With  such fatal  facility at drug stores, or  by
any so-called  emmenagogues, deserves the  strongest
reprehension.   The practice is fraught with life-long
danger to the system, and is therefore to be emphatic-
ally condemned.   Unless it be abandoned, the patient
must be prepared for an ultimate increase in the very
sufferings from which she thus vainly seeks relief.


          X.—Vicarious Menstruation.

   One of the most remarkable phenomena consequent
on amenorrhoea is that in which there  occurs, period-
ically, haemorrhage or  exudation of blood from some
other mucous surface, as  from  the  nose, lungs, stom-
ach,  bowels, bladder; or  from the surface of an  ulcer
situated on some portion of the cutaneous surface.
Such cases are denominated vicarious menstruation.
   It may happen that a leucorrhoea takes the place of
 the proper menstrual flow, in which case it is styled a
 vicarious leucorrhoea.  This form of the  disease is also
 amenable  to proper treatment.                  L.
   Treatment.—The object of treatment in cases of 
56
Menstruation.
vicarious menstruation is to improve the general health,
both  by medicines  and  by suitable hygienic  condi-
tions;  in fact, the treatment  should be identical with
that pointed out in the two sections, " Delayed Men-
struation," and " Suppression of the  Menses."  The
chief  remedies are  Sabina, Puis., Bry., Phos., and
Ham.  v.


  XI.—Cessation  of the Menses—Change of
               Life—Critical Age.

  The cessation  of the  menses commonly occurs in
this country between  the fortieth  and fiftieth  years,
generally about the forty-fifth, but, like the first appear-
ance, its termination varies  in different ladies, and is
in subordination to the temperament, constitution, cli-
mate, and habits  of the individual.   There is usually
some connexion between the periods of the first and
last menstruation, for  the cessation occurs at a later
period  where the  first appearance was wanting in pre-
cociousness.
  Menstrual life, as it is  termed, continues for  about
thirty years in the case of eveiy healthy woman, vary-
ing as above.  Thus,  if she began to menstruate at
the age of fifteen,  the critical period will arrive at about
forty-five; or if at twelve, she will cease to menstruate
at forty-two.   In  some families, however, the change
comes  as early as thirty-five or forty, and  in others not
until fifty  or later.                              L.
  Symptoms.—Whilst the change is in progress, there
is commonly more or less disturbance of the general
health, such as vertigo;  headache; flushes of heat; 
Cessation  of Menses.
SI
nervousness;  urinary difficulties; pains in the back,
extending down the thighs, with creeping sensations,
heat in  the  lower  part  of  the abdomen, occasional
swelling of the  extremities,  itchings of the  private
parts, etc.
   Menstruation ceases abruptly in some ladies.  The
monthly period may be arrested  by cold, fright, or
some illness.   Earlier in life the suppression would
have been followed by a return of menstruation  after
the removal of the cause; but now nature adopts this
opportunity to  terminate  the  function.  Gradual  ter-
mination is,  however, the most frequent, and is  at-
tended with the least disturbance of health.  In grad-
ual extinction,  one period is missed, and then there is
a return; a longer time elapses, and there is, perhaps,
an excessive flow; afterwards some months may pass
away without any re-appearance; then there may be a
scanty discharge, followed, perhaps, by flooding, and
at last the discharge  becomes so scanty and so slightly
colored as  scarcely to attract notice, and then finally
disappears.  {Ashwell.)
  It is very common for the  interval between the
periods to be prolonged to two, three, or even to six
months or more, and then be followed by profuse  or
protracted  flowing.   These  irregular  and excessive
losses of blood in  women of forty or upwards, some-
times lead patients and  physicians to fear they may
depend  upon  uterine polypus,  or  cancer — diseases
which are more incident to this than to any other time
of life.                                        L.
  Treatment.—When remedies  are required, one
or more of the following may be selected:  Puis.,
Aeon., Actcea, Sep.,  Cocc, Bry., Bell., Sulph.
    3* 
58
Menstruation.
  Pulsatilla.—Nausea and vomiting, chilliness, cold-
ness of the feet, heaviness in the abdomen as if from
a stone, pressure in the bladder and rectum, and gen-
eral dyspeptic symptoms.
  Aconitum.—Nervous irritability and excitement.
Aeon, has been recommended as the most soothing of
all  medicines  at the  climacteric period, especially if
the patient be robust or plethoric, and  if there be evi-
dence of local  or general congestion.
  Bryonia.—Congestion of the lungs or chest; indi-
gestion;  suppression  of the menses, with bleeding
from the nose; lancinating  pain in the  small of the
back, with discharge of dark-red blood.
  Actea.—This remedy removes many of the sympa-
thetic disturbances peculiar  to  this period,— pain in
the mammae  and other parts  sympathetic with the
womb; sinking at the stomach; pain in  the crown of
the head; irritability, restlessness, hysteria and melan-
choly.    It dissipates  the  infra-mammary pain  in
unmarried  females which Simpson tells us is to the
womb what pain  in the shoulder is to the liver.   In
the " irritable uterus," when occurring at the change
of life, Actcea is very valuable.  {Hughes.)
  Arsenicum.—Threatened  dropsy, general  debility,
difficult  breathing, and nervous  prostration accom-
panying the change.
  Lachesis.—This remedy is recommended as a most
valuable one for women at the  " change," for flushes,
burning pains at  the  top of the  head,  pains in the
back, and other troubles common at this period.  Fully
crediting the  recommendation,  we  must at the same
time add, that we have no experience with the drug 
Cessation of Menses.
59
ourselves, it being almost the only remedy prescribed
in this Manual with.which we have had no personal
experience.
  Sanguinaria can.—Flushings common at the cli-
macteric change.
  Cocculus.—Spasms or colic-like pains in the abdo-
men, with nausea and vomiting;  giddiness and head-
ache; painful menstruation, with  discharge of coagu-
lated blood.   After the employment of this medicine
for a few days, it may be followed by
  Sulphur.—This  remedy  is  most valuable  when
indigestion,  piles,  itching and burning in the sexual
organs, leucorrhoea, and sweats and flushings accom-
pany the " change;" also  in constitutions marked by
a morbid activity of the skin.
  Phosphoric  acid.—If the menses  are too frequent
and too copious, with great  prostration, oppression of
the lungs, and a bloated abdomen.             L.
  Administration.—In  severe  cases,  a dose of the
appropriate remedy every three or four hours; during
recovery, and in mild cases,  twice daily.
  Accessory Means.—A light  and nourishing, but
not an abundant diet should be allowed, with little or
no wine, and no malt liquors.  An  accustomed dis-
charge is about to cease, or has  already ceased, and
hence it is probable that the system is oppressed, and
that  the weakness so often complained of at this
period  is  imaginary rather  than  real.   If, to remove
the  languor and   inactivity now so  often  present,
stimulants and generous diet be allowed, some impor-
tant organs will most likely suffer.  Small quantities
of spirits are sometimes prescribed to  remove those 
6o
Menstruation.
 distressing  sensations  commonly felt at this period,
 and  are  generally  taken  by the  patient with  great
 satisfaction; but their good effects are only temporary,
 while their continued use is most mischievous.  Veal,
 pork,  salt-meat, pastry,  and  made-dishes  should be
 avoided;  wine, bottled beer,  or any liquid containing
 free acid, or gaseous matter,  seem  to  aggravate the
 disorder  in  a  marked degree.    Vegetable  articles
 should enter largely into the diet;  and beef, mutton,
 fish, or fresh game  may be taken in  moderation once
 a day.  Cocoa forms the best drink for  breakfast, and
 one or two small cups  of tea may be taken for the
 afternoon meal.  The sleeping-room should be cool
 and well  ventilated, and a mattress used rather than a
 feather-bed.  The vicissitudes of the weather should
 be guarded against by appropriate changes of di-ess.
  By way of precaution  the  greatest care should be
 taken  lest, in the effort to  accommodate  itself to the
 arrest of this important function, some serious organic
 disease should  be  developed.  Ovarian dropsy, ute-
rine polypi, cauliflower excrescence, uterine cancer, or
 cancer of the breast, are among the maladies incident
to this period.   There is little doubt that these trouble-*
some and dangerous affections are often due  to a lack
of care at the critical age.                      L. 
6i
      CHAPTER III.

INCIDENTAL DISEASES.
    I.—Leucorrhoea—Whites {Fluor albus.)

  Definition.—In  a healthy condition, the mucous
lining of the vagina and neck of the  womb, and the
various glands which  stud the vaginal orifice, secrete
a fluid just sufficient to lubricate the opposed surfaces
of the  mucous tract, and for  other physiological pur-
poses.   In unhealthy conditions, this secretion becomes
increased  in  quantity, of an altered character, and
varies   in  color and  consistence;  this  is  termed
leucorrhea.
  This discharge  sometimes  substitutes, or  takes the
place of, the proper menstrual flow in which case it is
called vicarious leucorrhoea.                     L.
  This disease  or  symptom  occurs at all periods of
life, but is most common after puberty, and previous
to the cessation  of the menses, when  so many causes
are in operation to induce free determination of blood
to the  utero-genital organs.
   Symptoms.—A  mucous  discharge from the utero-
vaginal lining membranes of a white, yellow, or green-
ish color, either thin and watery, or of the consistency
of  starch or gelatine.   In severe cases, the whole sys-
tem becomes injuriously affected;  the face is pale  or 
62
Incidental Diseases.
sallow; the functions of digestion are impaired; there
are dull pains in the loins and abdomen; cold extrem-
ities; palpitation and dyspnoea after exertion;  debility
and loss of energy;  partial or entire suppression of
the menstrual flow.   In slight cases of leucorrhoea, the
disease may exist for years without giving rise  to any
very marked symptoms.
  Causes.—An inactive and luxurious mode of life;
a warm climate; the employment of purgative  drugs;
excessive sexual intercourse;  masturbation; menstrual
derangements; polypi, or other abnormal growths of
the uterus; debility and relaxation consequent  on dif-
ficult parturition;  too early exercise after confinement;
prolonged  nursing;  defective nourishment;  loss of
blood,  etc.;  congestions and inflammations  of the
uterus  and vagina;  want of cleanliness; a scrofulous
habit;  general debility and relaxation of the muscular
and membranous structures,  whether  from  natural
organization or disease.
  It may also follow weaning, the indulgence of men-
tal excess and anxiety, indigestion;  or it may be vica-
rious to menstruation, to one of the forms of consump-
tion, to cancerous disease of the breast, and to  certain
nervous affections, as hysteria and  chlorosis.   It may
be caused or perpetuated  by the  use of astringent in-
jections,  tight  lacing, work at the sewing machine,
too prolonged practice at the piano,  literary labor, and
even by change of climate, as for example, a removal
from the  prairie, or low land, to a  mountainous re-
gion.                                          L.
  Leucorrhoea is most  common in the rich, indolent,
luxurious, and dissipated, and in  those who. live  in
crowded cities, and  in  damp or fenny districts; it is
much less frequent in persons of industrious and early 
Leucorrhea.
63
 habits, and in those living in the country on a dry soil.
 Lastly, leucorrhoea is not infrequently caused by irrita-
 tion or disease in an adjacent organ,—thread worms in
 the rectum, piles, stone or catarrh of the bladder, etc.
   Nature.—When it does not come from an  ulcer-
 ated surface, the leucorrhoeal discharge  is of catarrhal
 origin.  The return of the  menses,  the  increased de-
 termination of blood to the womb and vagina during
 coitus, or whenever the passions are  excited, or the
 reflex  stimulus of nursing may find  vent through in-
 creased  glandular activity,  the  natural secretion is
 changed in amount and quality, and a catarrhal flow
 is the consequence.                              L.
   Occasionally leucorrhoea occurs in children of ten-
 der years.  It is  then  generally the result of a want
 of proper cleanliness, of worms, or of the local appli-
 cation for various purposes of  some  irritating  sub-
 stance.  In this, as indeed in almost every other par-
 ticular, the importance of  cleanliness in the  treatment
 of children cannot be overrated.
   Treatment.—Calcarea.—Chronic  leucorrhoea  in
 weak,  scrofulous, and lymphatic constitutions, particu-
 larly when menstruation is too frequent and profuse;
 the leucorrhoea is of a milky appearance, is worse just
 before  the menses, and often attended with  itching
 and burning, and sometimes with falling of the womb.
   Cocculus.—Leucorrhoea just before and after  men-
 struation, with colic  and  flatulent distension of the
 abdomen.
   Pulsatilla.—Suitable in the majority of cases, espe-
cially in  females who  have  not  menstruated,  and in
leucorrhoea during pregnancy, when the discharge is
simple thick white mucus.  Wandering pains in the 
64
Incidental Diseases.
 abdomen, and  flatulence, are  further indications for
 Pulsatilla.
   Kreasotum.—Obstinate, corrosive leucorrhoea, the
 discharge being foul.
   Hclonias Dioica.—Leucorrhoea with a relaxed state
 of the womb and  its appendages.  It is said to im-
 prove the tone of the  sexual organs, and  co-existing
 general debility.
   Sepia.—Chronic leucorrhoea, with passive conges-
 tion of the womb, irregular menstruation, and often
 piles, constipation, and prolapsus.  It is especially in-
 dicated by a delicate sensitive organization.
   Arsenicum.— Thin, burning, corrosive leucorrhea.
 It is chiefly required  in strumous constitutions, and
 in cases of malignant ulceration of the neck of the
 womb.
   Conium.—Acrid leucorrhoea of a milky color, pro-
 ducing much irritation and soreness of the vagina and
 external parts.
   Mercurius.—When there is ground to suspect that
 the discharge is of a syphilitic origin;  irritation, swell-
 ing, or inflammation of the  external parts.
   Sulphur.—Obstinate cases, especially  in scrofulous
 patients,  or following  suppressed eruptions or ulcera-
 tions; the urine is often scalding, and the leucorrhoea
 excoriating, itching, and foetid.
   China.—Leucorrhoea associated with,  or following,
excessive  loss of  blood, severe  purgings,  dropsical
 swellings, fevers, acute inflammations, abuse of drugs,
or other debilitating and depressing causes.
   Administration.—A dose of the appropriate  rem- 
Leucorrhea.
65
edy three or four times daily; in slight cases, morning
and night.
  Accessory Means.—There are several conditions
which are absolutely essential to the successful  treat-
ment of leucorrhoea,  the  most  important  of which
are,—active exercise, short of fatigue, in the open air,
followed by rest, if possible in the horizontal posture;
avoidance of all  sexual excesses, the pleasures of the
table, and exciting  parties  and spectacles, crowded
ball-rooms, etc.   Too much standing is  unfavorable;
sleeping on a  mattress is much more conducive to the
cure than a soft bed; and, lastly, injections of cold
water, repeated several times a day, and cold ablutions,
including the hip-bath, described page 15, are neces-
sary, in  order to maintain proper tone  and  perfect
cleanliness of the utero-genital organs.
  The great importance of this last point cannot be
too strongly insisted upon; for without a strict atten-
tion to cleanliness, all the  remedies prescribed  may
prove unavailing.  This morbid secretion is generally
highly irritating; and when it is permitted to accumu-
late and continue long in  contact with the mucous
membrane, it is liable to decomposition and fetor, and
is most pernicious  to the  healthy condition of the
parts.   On  this  account, frequent  injections  of cold
water, and the thorough  use of local applications of
tepid water and soap, should be strictly carried out.
  Too much sitting is almost as harmful as too pro-
longed standing.                                L.
   The Vaginal or  Uterine Douche.—In order  to en-
sure a continuous stream of water on the inferior por-
tion of the womb, and on the vaginal  mucous sur- 
66
Incidental Diseases.
faces, without  any manual effort on the part of  the
patient, Dr. G. Hewitt has had a simple and effective
instrument constructed.   An india-rubber  bag or res-
ervoir, capable of holding  nearly a gallon of water,
has attached to it a long flexible pipe, which ends  in
the vaginal  exit-tube.   The bag, filled with water, is
hung up above the patient, or placed on  an article  of
furniture a little above the patient's body.   The water
descends by the action of gravitation alone;  the rapid-
ity of the flow is regulated by simply turning a stop-
cock, placed just outside  the vaginal tube, and the
water flows until the reservoir is empty.   This douche
has the advantage of great portability and simplicity.*
The douche should not be used in cases where preg-
nancy is supposed to exist.

   The common  resort to  injections of  alum water,
sugar of lead, and other astringents thrown into the
vagina is harmful and  should not be practiced.   In
some cases it will be absolutely impossible to know
and understand  the nature of  the disease  without a
careful examination by means of the speculum.   And
the intelligent  and  conscientious patient will prefer
that the physician should understand what he is trying
to cure, rather than  that he  should  experiment and
waste time by guessing at the malady and  leaving  it'
for chance  to  indicate  the remedy.  Although the
speculum has  been abused, and thereby fallen into
disrepute with  some, it is certainly a very useful and
necessary instrument.                           L.

  * A similar apparatus is sold in the United States, called
" The Fountain Syringe." 
Falling of the  Womb.             67
 XI.__Falling of the Womb  {Prolapsus Uteri.)

  This  troublesome  derangement occurs  most  fre-
quently in married ladies beyond the  middle age, but
it is also liable to  occur  in young  unmarried females
Of relaxed constitution after dancing, running, or too
severe exertion during menstruation.
  Three degrees of prolapsus uteri  have  been des-
cribed, viz.:  relaxation, where  the slightest descent
has happened; prolapsus, where it exists to a greater
extent;  procidentia, where there is protrusion through
the external parts.  But the term " prolapsus " is now
generally used to express all the varieties; and we have
adopted the same  in  this manual.   Slight relaxation
often exists a long time without attention.
   Symptoms.—These are numerous, and vary in dif-
ferent bearing-down  sensations in  the vagina; weari-
ness, soreness,  and  faintness,  with  indisposition  to
stand;  leucorrhoeal  discharge;  often, increased  men-
struation, and frequent desire to  pass water; nervous-
ness; irritability of temper;  indigestion, constipation,
etc.  In procidentia  the annoyance and inconvenience
are very great, on account of the impediment offered
to walking,  sexual intercourse, etc.
   Causes.—Probably the most frequent cause is get-
 ting up too soon  after child-birth, when the womb is
 larger than  usual, and when also  its supports below
 have  been  weakened by the process of  parturition.
 Occupations, such as those of laundresses, cooks, etc.,
 are fruitful  causes, especially with a too  large  or  re-
 laxed womb.   Other causes are,—injuries from fills,
 sudden straining,  jumping,  over-lifting,  etc.; long- 
68
Incidental Diseases.
continued coughs; excessive vomitings;  tight lacing;
a general relaxed condition of the system, either  con-
stitutional or the result of sedentary habits; too high
living; purgatives, etc.  Thus it will be observed that
the essential elements in prolapsus  are,—an enlarged,
heavy womb, and relaxation of its natural supports,
combined generally with  too  much standing.   Pro-
lapsus  of the womb from rupture  of  the perineum
during labor  is not otherwise  referred to here,  as it
requires  surgical measures for  reuniting the torn sur-
faces.
  With some ladies prolapse of the womb is undoubt-
edly caused by neglect of the habit of going regularly
to stool.  A very frequent cause is the harmful prac-
tice  of taking cathartics  in  child-bed.  Those  who
have had frequent abortions are very prone to uterine
displacements.                                 L.
  Treatment.—Bell.,  JVux v., Stan., Sep., Sulph.,
Helonias, Calc.  c, Ferr.,  China.
  Belladonna.—Dull,  distressing pains in the abdo-
men; drawing, heavy pains in the small of the back,
with pressure and forcing downwards into the genital
organs, which are generally relieved after lying down;
painful menstruation;  excessive general sensibility and
irritability.
  JVux  vomica.—In  addition  to  the  symptoms  de-
tailed under Belladonna, there are indigestion, flatu-
lence, constipation, with frequent ineffectual straining,
difficult  urination,  irritability of temper,  etc.    Too
early and too  profuse menstruation are  further indica-
tions for  this remedy.
   Stannum.—" Bearing-down " sensations, so  often
complained of by women, and prolapsus of the uterus 
Falling of the  Womb.             69
and vagina.   " I have  hardly ever  known  it fail to
cure:  and have been astonished at its power over pro-
lapsus {Hughes).
  S^'a.—Prolapsus with  irritability and disposition
to faint, or consequent upon  leucorrhoea, or when the
menses are  irregular, or flow interruptedly; also loss
of appetite, nausea, constipation, bearing-down after
exercise, frequent desire to urinate, drawing pains in
the thighs, etc.  Sepia  is suited to delicate women of
sensitive skin, nervous habits, and in whom  the  mus-
cular  system  is easily overtaxed.  A yellowish leucor-
rhoeal discharge, with itchings and eruptions, are addi-
tional indications.
  Sulphur.—Chronic  prolapsus, associated  with a
strumous element in the constitution.
  Helonias Dioica.—In prolapsus,  and  other atonic
conditions of the womb, this  remedy is possessed  of
great  curative power.   So striking is its action on the
womb, that it has received the designation of " uterine
tonic."
  Arnica.—This  remedy should precede  any  other
when the displacement  has been occasioned  by a fall,
blow, over-exertion, or  any other mechanical injury.
  Accessory Means.—In  slight  cases, the  recum-
bent posture,  maintained for as long a time during the
day as is consistent with the general health,  especially
during the   monthly period, the use  of appropriate
baths, and the general accessories  prescribed in  the
section on Leucorrhoea, will usually suffice to effect a
cure.   Applications of cold  water to the body gene-
rally, followed by vigorous friction; injections of cold
water, or in some cases, of astringent fluids, by means 
7°
Incidental Diseases.
 of a large-sized gum-elastic vaginal tube, and attached
 to a proper syphon syringe, so as to ensure a good and
 continuous stream of water reaching up to the inferior
 portion of  the womb;  and the daily use  of the hip-
 bath (see page  1=5), are remedial  agents whose great
 value is authenticated by long and extensive practice.
 The utility of these processes  consists in their power
 to produce  metamorphosis {change) of the tissues of
 the body, and in their change the womb  necessarily
 participates.
   In the more severe forms of prolapsus,  in addition
 to abstaining from all domestic  duties, and maintain-
 ing the horizontal posture during the greater part of
 the day,  it  may be  necessary to  employ  mechanical
 means to support the womb, until, by the use of medi-
 cal and  general measures, the parts  have recovered
 their natural tone and contractility.  A good pessary,
 adapted in size and shape to the requirements of the
 case, may sometimes be resorted to, under professional
 advice, with great advantage.
  Prolapsus uteri is so  often associated with constitu-
 tional causes, as to render it  desirable, if practicable,
 to confide the treatment to a Homoeopathic practitioner.


  III.—Inflammation of the Womb {Metritis).

  This affection may occur in any adult female, and
is an occasional serious complication of pregnancy,  or
of child-birth.
  Symptoms.—An  attack may commence with a
chill,  followed by febrile symptoms — full, jerking
pulse, great thirst, nausea and  vomiting,  and  some- 
Inflammation of the  Womb.          71
times diarrhoea with tenesmus, the bladder is irritable,
and  there  is a feeling of throbbing in the vicinity of
the womb, which is swollen and  painful.   The pre-
cise  seat  of  pain  depends upon  what  portion,  or
whether the  whole, of the womb is  involved.  The
patient maintains the recumbent posture, as sitting up
aggravates the pains, throbbing,  and irritability of the
bladder and rectum.   Sometimes the disease takes on
a typhoid character, and there is excessive prostration,
a dirty-yellow coating  and dryness  of the  tongue.
By comparing these symptoms with  those described
under " Dysmenorrhoea,"  they will be seen to vary
sufficiently to prevent confusion in the diagnosis.
  Causes.—Exposure to cold; sitting or  standing on
damp grass, etc.; suppression of the menses; mechani-
cal irritation, as from tumors, etc.
  This  inflammation  is  very likely to  complicate or
succeed certain  menstrual difficulties, as, for example,
retention, dysmenorrhoea, etc.   It also follows abor-
tion, excess of coitus — especially when the sexual act
is indulged too freely and frequently after the menses.
And  it is often caused  by the  sudden  arrest of a leu-
corrhoeal or haemorrhagic flow by the use of vaginal
injections of  cold water or of some harsh  astringent,
as well as by the employment of strong caustics for
the cure of ulceration  of the womb.            L.
  Treatment.—Professional advice is essential in so
serious a disease.  Till it can be had, Aeon, and Bell.
should be administered early in alternation every thirty
to sixty minutes.  As improvement ensues the medi-
cines may be given less often.
  Accessory Means.—Rest, as complete as possible,
simple diet, with cooling drinks, and fomentations of 
72              Incidental Diseases.

very warm water.  In the early stage of the  disease,
the patient may sit in hot water for twenty or thirty
minutes, with the shoulders  and feet covered.   She
must retain the  recumbent posture till the inflamma-
tory symptoms have subsided.

                  IV.—Hysteria.

  Definition.—The  term hysteria is derived  from
the Greek word hystcra, a womb — from its supposed
connection with that organ; but  it  will be  directly
shown that the uterus and its functions are not essen-
tial to the conditions included  under the word hysteria.
The various  phenomena thus  designated  may be
defined as a  nervous disease of a  ge?ieral and not a
local origin, caused by some source  of irritation super-
vening  upon  a condition of depressed  nerve-power
from emotional  causes, and may arise in  conjunction
with uterine  irritation, or  entirely independently of
such cause.   It  consists,  essentially, of a defective or
perverted will,  heightened or altered general sensi-
bility, and, usually, some impairment of the  general
health, but is no more dependent on the female organs
of reproduction than on any other part of her body.
  In proof of this we will adduce the following facts:
Hysteria is  not limited  to the single condition, but
often exists in the married, even in the happily mar-
ried— in  pregnant women, in nursing mothers, and
in women who have passed the critical age.   It often
exists,  in its  highest  expressions,  in persons whose
monthly period  and general uterine functions present
no anomaly whatever;  various functional and  organic 
Hysteria.
73
 diseases of the organs in question often exist without
 any hysterical symptoms;  women  who have been
 born without a  uterus  have  been  hysterical; and,
 again, it is well known, that hysteria does sometimes
 exist in the male sex.
   Causes.—While, therefore, hysteria  is  a disease of
 a nervous  character, it may be called into activity by
 any affection or event that operates powerfully on the
 system, like  suppressed, irregular, or profuse menstru-
 ation,  leucorrhoea,   pregnancy,  prolonged  nursing,
 depressing emotions, fright, the  loss of a  husband,
 child, or friend, disappointed love, novel-reading, and
 a  luxurious  mode of  life.  A predisposition to the
 disease may  be transmitted from the parent, or it may
 be fostered in a daughter by the force of the example
 of a nervous mother or elder sister.
  An hysterical diathesis or tendency may be induced
 by over-study and anxiety, a prolonged strain or worry
 of mind, carrying too  much, as well as carrying too
 little weight  in life,  and also as a consequence of ill-
 assorted marriages.   Whatever jars upon the sensitive
 nature of the girl or woman may insensibly ruin the
 harmony of  her organization, bodily and mental.
                                                L.
  Symptoms.—Hysteria  is  remarkable  for the wide
 range and indistinctive character of symptoms, and
 the multitudinous  diseases  it may mimic;  we  may
 mention  especially,—loss of voice,  stricture  of the
 oesophagus, laryngitis, a barking  cough (more annoy-
 ing to the  hearer than to the patient), pleurisy, heart-
disease, difficulty in urinating, neuralgia, disease of the
spine or joints, and many other inflammatory diseases.
In these cases the patient deceives herself, and endeav-
     4 
74
Incidental Diseases.
ors,  by extreme statements of her sufferings, to  mis^
lead others.   An observant medical  man,  however,
need never be deceived.   In some cases there is indi-
gestion, a more or  less definite affection of the head,
chest,  or  abdomen, or  oth^r  condition of impaired
health  or  constitutional  delicacy.   Some  cases of
hysteria, however, exist, in which there can be detected
no derangement of the general health.
  The  symptoms of hysteria  may be  arranged  into
three classes.   First, that in which the  sensation of a
ball  rising in the throat  {globus hystericus), or a  feel-
ing of suffocation, is  experienced  by the patient, but
without convulsions; second, its paroxysmal form, in
which there is the sensation  of a ball  rolling in the
stomach or chest, which gradually rises  to the throat,
producing a choking sensation and  panting breathing;
and  is  succeeded by partial insensibility, shrieks and
screams, irrepressible crying or  laughter, convulsions,
etc.; third, those irregular forms which  often arise in
the intervals of severe attacks.


     Hysteria and  Inflammatory Disease.

  Sometimes a medical man may for a moment expe-
rience difficulty in deciding whether a patient is suffer-
ing merely from hysteria, or from an  inflammatory
disease; but he is able, by the use of the thermometer,
to determine the point.  The temperature of patients
in acute inflammation is invariably  raised; but the
temperature of hysterical persons  is  always  natural
(9S0  Fahr.)    Further,  the  state  of  the pulse, the
character  of the  pains, and the general condition of 
Hysteria.                   7^
the nutritive processes, furnish additional proofs of the
real character of the disease.   The  ideal nature  of
hysterical  sufferings may  be proved by completely
diverting the patient's attention from the part com-
plained of;  then, firm pressure on a part, or the sharp
movement of a joint, may be borne without complaint,
whereas the slightest  touch was immediately before
said to be  " agonizing in the extreme."


             Hysteria and Epilepsy.

   In hysteria there is absent the suddenness of seizure,
the complete loss of consciousness, the dilated pupils,
the bitten tongue, and the total  disregard of injury  to
person or clothes that mark epilepsy.  There  is much
sobbing and crying, much exhaustion, but no perfect
stupor in hysteria, nor is an attack followed by pro-
found sleep.

              The  Hysterical Fit.

   A paroxysmal form of hysteria may be caused  by
some transitory occurrence, as a real or  imaginary
grievance.   The patient is talking in an agitated man-
ner; she is  laughing or crying, or  both;  then she
bursts out into an immoderate fit of one or the other,
the globus hystericus begins to form and to rise, and as
soon as  it reaches the throat, the patient screams  or
makes an incoherent noise,  appears  to lose all volun-
tary power and consciousness, and fills to the  ground.
On  closely watching a case,  however,  it  will  be
noticed  that there is not absolute loss of conscious- 
76             Incidental Diseases.
ness;  the patient contrives to fall so as not injure herT
self or dress; an attack does not occur  when she is
asleep or alone; the countenance is not distorted as in
epilepsy; the eyelids  may quiver  and  the  eyes be
turned up, but  the  eyes are  not wide open,  nor the
pupils dilated, as in epilepsy, and the patient may be
observed to  see  and to look; the breathing  is noisy
and irregular, but there  is no such  absolute arrest of
breathing as to  cause  asphyxia; the fit continues for
an  indefinite  period,  followed  by  apparent  great
exhaustion, but  not by real stupor.
  She hears and knows all that is passing, and, strange
to say, takes an almost  insane  delight in frightening
the by-standers out of their wits.  In milder cases she
taxes  her inventive faculties and reels  off details of
gossip which, if credited, would set the community in
an uproar.  No matter how chaste or cultivated, she
may,  even, swear or talk  obscenely.  The fit is very
apt to go off with immoderate laughter or crying, or
both  together.   The most  of these paroxysms  occur
in those of a mercurial  temperament.   The disease is
not contagious,  but, from sympathy alone, it is  not
uncommon to find all the females in the room showing
signs  of  this peculiar affection.                  L.


          The  Hysterical Expression.

  An easily flushed face; the features rapidly respond
to the mental  emotions; the upper lip is deep and
prominently  full.    The  eyeballs are large,  and the
sclerotic  (white  of the eye)  of a transparent sky-blue;
the  pupil is  much  dilated, giving a general dark hue
to a naturally light eye, and the conjunctiva is smooth
and bright from tears on every emotion.  The eyelids 
Hysteria
77
are large, full towards the outer angle, giving a droop-
ing,  appealing expression  to  the face (the " sweet
expression" of ladies).  Of these several hysterical
marks, the  puffiness of the eyelid and the dilatation
of the  pupil are  the most constant — indeed are sel-
dom absent and seldom deceive.   {Chambers.)
  Treatment.—Here we must  point out, first the
measures to be adopted  during a fit, and  secondly
those to  be earned out in the interval between one
attack and  another.

               The Hysteric Fit.

  After  the patient's  clothes  are loosened,  and an
abundant supply of fresh air is secured, an attempt
may be made to arrest the hysteric convulsions  by a
method suggested by Dr. Hare, viz., that  of forcibly
preventing the  patient from breathing, for a certain
time, by holding the mouth and nose.  The effect of
such constraint is to make  the  patient, when allowed
to do so, " draw a long breath," this vigorous inspira-
tion  being  usually  followed by  a relaxation  of all
spasm,  and a disappearance of the  fit.   Prolonged
attacks  are  notably  benefitted by this plan of treat-
ment;  in brief ones there  is neither time nor need of
it.   Dashing  cold  water on the  face and  neck, or
pouring  water out of a large vessel  from  a  height
directly over the mouth and  nose of the patient, so as
to stop her breathing and force her to open her mouth,
often succeeds.  "A calm manner," says Dr. Reynolds,
" the absence of all appearance of alarm, and of either
scolding or distressing sympathy,— all of which things 
78
Incidental Diseases.
the apparently  unconscious patient observes  much
more accurately than do her frightened friends,— will
sometimes bring a fit to a speedy end "
   Camphor is an invaluable remedy during an hysteri-
cal paroxysm, and often terminates a fit immediately,
especially if there is  general coldness of the surface.
Two drops  on a piece of loaf sugar, or two  pilules
saturated with  the  strong  tincture may be given two
or three times every few minutes during the fit; or a
phial  of the strong  tincture may be applied to the
nose.
   Moschus.—In other cases this remedy may be used
internally and by olfaction.

          Remedies in the  Intervals.

   Between  the attacks a selection from  the following
remedies  may  be  made, and  the general treatment
afterwards  pointed  out adopted, according  to the
peculiarities of the  case.
   Ignatia.—This is  a most valuable remedy in the
treatment of hysteria  with  the following  symptoms:
exhausted impressionability of  the whole nervous sys-
tem, with frequent changes from high spirits to dejec-
tion; hysteric convulsions with the sensation of a ball
in the throat,  suffocative  constrictive  sensation, and
difficult  swallowing;  hysteria  associated with  disap-
pointment, mortification, or any intense  mental excite-
ment.
   Moschus.—Hysterical attacks -with, fainting, small,
fluttering pulse,  and  coldness  of the  surface.   Like 
Remedies.
79
Camphor, it  is most useful during a paroxysm, by
cutting it short.
   Platina.—Hysteria  with  depression  of spirits,
anxiety, irritability and  nervous weakness, especially
from  uterine  congestion;  early, excessive, or too pro-
longed  menstruation;  sexual excitement.
  Asafetida.—Hysteria from  inertia or irritation of
the biliary system, with burning  and dryness  in the
throat;  cutting, crampy  pains,  or distension  of the
abdomen; constipation or  diarrhoea, with  frequent
urging; high-colored,  strong-smelling urine;  sensa-
tion of  a ball rising in the throat;  premature, painful
menstruation; nausea and inclination to vomit; uterine
excitement; depressed or fitful  spirits.
  JVux vomica.—Hysteria with constipation, disagree-
able,  bitter, or acrid eructations, flatulence, hiccough,
distension and pain in the stomach, headache, giddi-
ness,  faintness, and tendency  to  convulsions.  After
administering it for several days,  Sulphur may be
substituted.
  Aurum.—Hysteria  with excessive menstrual dis-
charge, congestive headache, melancholy, etc.
  Aetata Racemosa.—Hysteria associated with uterine
disturbance;   mental   restlessness,  irritability,  and
despondency;  pains  in the breasts; sinking  at the
stomach,  etc.
  Pulsatilla.—Hysteria evidently depending upon, or
associated with, suppressed period or uterine disorders,
especially when the Puis, temperament corresponds.
It may be followed by Sabina or Silicea.
   Cocculus.—Hysteria with irritability,  dejection and
copious discharges of pale urine. 
8o
Incidental Diseases.
  Aeon.,  Coff., Hyos., Staph., and Valcr., are addi-
tional remedies sometimes needed.
  Accessory  Means.—(i)  Occupation.    Besides
regular out-of-door walking  exercise, cheerful society,
conversation,  and  recreation, physical  and  mental
occupation of a useful nature should be strictly enjoined.
Healthy, useful employment  should become  a uniform
habit, and the patient be led to feel that life is not a
mere holiday to be passed  in frivolity and idleness,
but a highly important period of existence to be spent
in usefulness and enjoyment.  Absence of occupation
favors that  meditative  mood into which  hysterical
patients are liable to fall, and rendei-s a cure improba-
ble.   (2.)  Removal from home influences.  Nothing,
perhaps, interposes greater obstacles to recovery than
the  misplaced tenderness, anxiety, and sympathy of
friends, and the  perpetual  recurrence of  influences
which tend to perpetuate the disease;  so that sending
the  patient from  home, away from  her accustomed
habits and associations,  and  placing  her  under the
care of kind but  judicious  friends, offer a favorable
chance of recovery.  This is easy of accomplishment
in the poorest classes, who can be sent into a hospital;
and in the richest, who  can  be placed under  the care
of a physician or competent friend.  But this is often
next to impossible for the families of retail  storekeep-
ers,  curates, village doctors, and others, from the union
of a light purse with a  weighty feeling of independ-
ence.  One plan can sometimes be adopted,  namely,
to negotiate an exchange of patients,  where  families
of about  the same social standing are simultaneously
afflicted  with  a hysterical   member.   {Chambers.) 
                      Remedies.                   81

 (3.)  The  Shower-Bath.  The fortitude  involved in
 submitting to  the  shock  of a cold  shower-bath is
 splendid  discipline, and  aids  the  cure by giving the
 patient more  moral  power.   Besides, shower-baths
 improve the circulation by forcing the venous  blood
 to the heart and lungs, and bring arterial blood  to the
 surface, as seen in the healthy glow of the surface  of
 the  body.   Patients  not  accustomed to bathe may
 commence by taking two  or three tepid  baths.  To
 prevent  the  inconvenience arising from wetting the
 long hair of the head, an oiled-silk covering may be
 used to keep it dry.   (4.) General cautions.  Crowded,
 badly-ventilated, and  too brilliantly-lighted  churches,
 theatrical exhibitions,  novel-reading,  tight stays, and
 late  hours in retiring at night and  rising in the morn-
 ing, should be  resolutely forbidden.   The  diet, rest,
 study, recreation, as well as the various  bodily func-
 tions, should receive intelligent and uniform attention.
  Especially should  the patient be removed from an
 excess of religious and social excitement, anxiety and
 competition — for  nervous  and susceptible persons
 may sometimes have  too much of these as  of  other
 good things.   The old-fashioned sewing society was a
 hot-bed of  hysteria.   Sometimes a cure will follow a
 complete change of  habits and surroundings.  If she
 has been the victim  of too  much company, the  seclu-
 sion and quiet  of the country may be the  one thing
 needed.  Or if she  has  felt herself unhappy because
 of her isolation  and  remoteness, a change to the town
 or city might  answer  equally well.  Other  cases are
 amenable to a kind, Christian  charity and forbearance
which charges  all real or  supposed wrong-doing to
the   weakness  and  frailty of poor  human nature, and
not to sinful intent.                             L. 
82
   CHAPTER IV.

REPRODUCTION.
                  I.—Marriage.

  In other works, and also to some extent in this, we
have labored  to show the value and  bearing of pure
air  and  water,  light, exercise and recreation,  good
food, etc., on health and long life.   Here, however,
we  carry our labors  further back, and venture to offer
suggestions connected with the exercise of those func-
tions of the male and female  organs of reproduction,
on the integrity  of which depends, perhaps more than
on anything else, the physical and moral qualities of
individuals.
  The question  of the marriage of unsuitable persons,
or of marriage  at  an unsuitable age, is  often either
disregarded, or viewed from a too narrow stand-point,
as if it only  concerned the  individuals  forming  the
alliance.   Our  duty, however, as guardians  of the
public  health, imposes  on  us the responsibility of
enforcing the truth  that  the health, happiness, and
material greatness of future generations are involved
in such marriages.   No one but a physician, who sees
human nature in all, even its darkest aspects, can fully
appreciate the subject, or accurately trace its workings
in society.   The  several  points, here  only  briefly
alluded to, are of pressing importance, and should be 
Marriage.                    83
seriously pondered, in all their  bearings, by persons
contemplating marriage, and by parents and guardians.

               Marriageable  Age.

  From  twenty to twenty-five years of age, may be
stated as the most suitable time of life for contracting
marriage on the part of females;  and from twenty-five
to twenty-eight on that of males.   Although the func-
tion of menstruation commences from the fourteenth
to the sixteenth year, yet the female constitution  is not
sufficiently formed and matured till twenty or twenty-
one years of age to permit of marriage without risk
of injury to health and comfort.   Some exceptions to
this may exist in persons who  have acquired at about
nineteen that physical and  mental perfection which
the majority of  persons in this country only  attain
some  years later.  On the  other  hand, too late mar-
riage  frequently  entails  much  discomfort,   and the
children of such parents are often sickly, and die pre-
maturely.  These points are more fully, and separately
considered further on.

             Precocious  Marriage.

  Physiology clearly  teaches  that both  animals and
plants  must  acquire full development before they are
capable of  reproducing  their species in the highest
and  most  vigorous  condition.   Too early  marriage
often  results in  arrest  of  development, a  shattered
constitution,  and generally impaired health in the
mother; such marriages are also generally " less fertile, 
84
Reproduction.
and the children which are the product of them are
weak, puny, and have an increased rate of  mortality."
{Duncan?)   Further, premature marriage, by antici-
pating the demands of nature, increases the sufferings
and dangers  of childbirth.   Anatomical facts  may
also be  briefly cited to confirm the correctness of our
conclusions.  The  perfect ossification  of  the pelvic
bones, and  their complete union to one another,  does
not usually take place  till after twenty years  of  age;
nor  is  it  till  about  this period that  the pelvis has
assumed  the  form, shape, and distinctive  sexual fea-
tures so admirably suited for the difficulties involved
in commencing childbearing.  It is well known  that
the pelvis of the two sexes differs but little till puberty;
but after that period the female pelvis begins to assume
its striking characteristics; its cavity becomes capacious
and broad  in both its  djameters, and  the inlet and
outlet also  enlarge.   These and other characters, so
necessary for the duties of maternity, are not  fully
developed till after that maturity of growth, the  pro-
cess of years, which only fairly commences about the
time of puberty.  " When  I  am  consulted,"  writes
M. Joulin, " as  to the opportuneness  of a marriage
for subjects who are too young, I am accustomed to
respond to  the  parents that they should  not marry
their daughter until for a year at least her stature has
ceased to increase.   This  is the epoch that I fix for
nubility" {marriageability).

                Late Marriages.

  Under this heading we deem it  desirable to make
some additional remarks with the view of correcting 
Marriage.                   85
popular fallacies on  so  important a subject.  To an
article in the Lancet of December 31, 1864, we  are
indebted for some of  the annexed hints on  the  point
in question.   " The  lateness  of marriages," Graves
says, " may be generally taken as a good test of an
improved state of society, and as exhibiting that power
of moral restraint over the passions which should char-
acterize civilized and intelligent man."   If by late mar-
riages, in the above quotation,  is meant marriage con-
tracted many years after the period  stated in the pre-
vious section as  the most fitting, then, from more than
one point of view, we  must decline  to  regard it  as
indicative of, or favorable  to, the morality of society.
Our experience  rather goes  to prove that men  may be
single and yet have  less control over their passions
than  if they had yielded  to  a  timely disposition  to
marry.   The political, and even the moral philosopher
betrays a lack of sound wisdom, and  an incomplete
view of human nature, if, in his calculations, he ignores
or underrates the sensuous and passionate elements of
our nature.   It  has been suggested that such philoso-
phers have written their great  works in the decline of
life,  and  when  the recollection of those tender but
strong impulses which  entered so largely into their
earlier years was fading from  their memories.  But,
even  after making  this concession, we  cannot hold
them inexcusable; they had the  testimony of history
to the fact that the most refined of the  ancient nations
have  been  the very nations  in which   passion has
assumed  the most disgusting  and  unnatural  propor-
tions.   It may,  indeed, be said that we have in Chris-
tianity a moral influence  operating upon us which those 
86
Reproduction.
nations had not; but  the  gospel, even when it is re-
ceived and embraced as the truth, and becomes influ-
ential in substituting " the heart of flesh for the heart
of stone," never unstrings  our physical  nature,  or
blunts those fine but  strong sensibilities which bind
one human being in affection to another.
  In considering human nature, as medical men, we
can scarcely avoid taking all parts of it into view.  In
the exercise of our profession, we  have  frequently-
repeated evidence that the great functions of the body
and the high aspirations of the soul act and  re-act upon
e.xh other.  Even the boasted celibacy of the upper
classes will not bear investigation, involving as it often
does extensive prostitution of women, or other habits
and vices  at  least  equally demoralizing,  which this
state tends to engender.   Whatever may be the theo-
ries of moral and speculative philosophers, our  profes-
sion compels us to regard  men and women  as com-
plementary beings, mutually dependent on each other
for health, virtue,  and  happiness,  this dependence
commencing on the attainment of manhood  and wo-
manhood.   By observing,  as nearly as  circumstances
permit, the period of marriage before noticed, an im-
portant step will be taken towards maintaining  the
health, happiness, and  morals of all classes.  Nothing
contributes more to  steadiness  of purpose,  to industry
and economy on the part of  a young man than fixing
his affections on a lady worthy to be his partner and
help-meet for life.
  Let, then, the notion that a  man must first  secure
his  worldly position before he should  marry, be dis-
carded ; for should marriage  retard a little  the  attain- 
Marriage.
87
ment of wealth and status, a higher standard of vigor
and virtue  and happiness, which are of the first im-
portance both to families and nations, will be an abun-
dant recompense.
  In thus recording our matured opinion on this sub-
ject, we  may be  excused parading, in a  domestic
manual, the varied kinds  of evidence on which that
opinion is based.   Let the inquiring mind look around,
and a little beneath the  surface of society, and  care-
fully examine what will thus come to view, and proof
will be ample that deferment of marriage many years
beyond the period already indicated is inconsistent
with physical and moral well-being.
  The cheerful consent of mothers to the marriage of
their daughters and to God's appointed way of insti-
tuting separate families, would  minister largely to the
happiness of individuals and the general good.   L.

            Disproportionate  Ages.

  A considerable disproportion between the ages of
the parents is to be avoided.  When  circumstances
are favorable to such  an arrangement,  there should
not be more than four or five years difference between
the ages of the male  and female, the husband being
senior.  It is unnecessary to dwell on this point, as
remarks on previous  sections apply with equal force
to this.

       Ill-Health  a Contra-Indication.

   A little reflection will convince any one of the dis-
astrous consequences likely to spring from the marri- 
88
Reproduction.
age of unhealthy persons.   " The fact cannot be dis-
puted, though  appreciable  with difficulty,  that  the
natural and  special  dispositions of  the individual
descend to him in a certain measure from his origin,
and that parents transmit to their children such and
such moral propensities, just as they do such and such
physical  temperament, or  such  and  such  features.
Hereditary transmission enters into the  moral as well
as into the physical order of the world " {M Guizot).
Disease, then, as well as peculiarities of character, may
be transmitted from parents to children.  This  is no
mere theoretical statement, but a truth based  on  prac-
tical observations  a hundred times verified, and it
should convey a most impressive lesson.   If,  as an
example, the consumptive young man  marry, he can
only become the father of feeble children, who  often,
after a few months or years of suffering, die, and  the
parent is surrounded with  responsibilities and anxie-
ties which press  heavily on his weak frame.  If  the
young woman marry, she  becomes a mother, for  the
consumptive are generally very prolific, and  indelibly
imprints her infirmity on her offspring,  while she  ex-
poses herself to the perils of childbirth a hundred-fold
heightened in such a disease.   The observant medical
practitioner only, who can trace effects to their causes,
can gauge the  suffering and bitter  disappointment
which result from such marriages, and should be  oft-
ener consulted before marriages are formed or arranged.
It will be obvious  that unless the  fountain whence
nearly all  physical  evil flows—hereditary taint — be
itself purified, nothing can  effectually check  the pro-
gress of maladies universally prevalent and destructive 
Marriage.
89
 to happiness, health, and longevity.   So long as a re-
 producing agent is constantly at work, imprinting at
 the  time of impregnation the elements of disease on
 countless numbers of children, nothing can prevent
 the multiplication of evils consequent on disease  and
 premature death.


          Marriage of Near Kindred.

  The tendency of the intermarriage of persons of the
 same blood is to perpetuate and intensify any consti-
 tutional  infirmity in the  next generation.   Family
 weaknesses or defects, perhaps of no grave importance,
 are confirmed  by intermarriage, and  may readily be-
 come developed into actual disease.   The marriage of
 near relatives in whose families a consumptive cachexia
 exists leads to a concentration of the disease in the
 offspring, and lays  the foundation of some of the most
 destructive maladies to  which  the human  frame  is
 liable.  More than this.   A convergence of ancestral
 liability to disease not tubercular, is  likely to lead  to
 that  disease in  its  most  active  form.  On the other
 hand, persons with a slight hereditary liability to con-
 sumption or  other affection,  but without any active
 disease, forming judicious marriages in families of
 healthy blood,  may lead  to such an  admixture  and
 dilution of the disease-element affecting the one paren-
 tal side, that, in process of time, it may become alto-
gether inoperative.
  The general correctness of the fragmentary obser-
vations made in this section are abundantly established
by physiology.  It is not presumed that they can  or 
90                 Reproduction.
always will be literally carried out, at  least not until
the laws of our natural  being are  more generally
studied, and better understood.   Our pbject, however,
is that they should be instilled as first principles into the
minds of the young and  their  counsellors,  in  order
that their application may be facilitated should circum-
stances permit.

                  II.—Sterility.

  There is perhaps no condition in the life of a mar-
ried woman that more frequently gives rise to reproach
and unhappiness than  that of sterility.  If a woman
is sterile, she fails to secure the great purpose of mar-
riage, the natural result of  which is to " multiply, and
replenish the earth."   From circumstances  that  fre-
quently come before us, we regard the subject as  one
of sufficient importance to justify the appropriation of
a section to its consideration.
  To determine in many cases the causes of sterility,
considerable medical knowledge is necessary, and, in
particular,  the anatomy and physiology of the genera-
tive organs.   The application of such knowledge  not
unfrequently enables its possessor to detect and remove
causes of sterility long  in existence that would other-
wise have escaped observation.
  At the very threshold of the inquiry the  question
naturally meets us,  " Is the cause of the  sterility on
the side of the male or female?"   Generally, this  is
one easy of solution.  When such cause exists in the
male, it generally embraces those conditions  which
render sexual intercourse impossible or incomplete, as 
Sterility.                     91
imperfection in the sexual organs, or their defective or
too sudden but transitory response to sexual stimulus.
These  may occur  as  the result of congenital  malfor-
mation, sexual  vices or  excesses, or  of local disease.
As instances in the latter class, we may instance phy-
mosis,  a too short frenum, and diseased conditions of
the urethra.  Most of these yield to appropriate meas-
ures, subsequently allowing  nature's purpose  to  be
satisfactorily effected.    In the absence of any defect
in the external organs, or of obvious local or general
disease, there is good  ground for the opinion generally
entertained by those best informed on the subject, that
the cause of infertility in marriage rarely exists in the
male sex.
   Causes of Sterility.—The  causes of sterility  in
the female may be local, affecting some portion of the
generative apparatus;  or constitutional,  the  sexual
functions  suffering in common with the functions  of
the body generally.

                      Local.

   The local causes are very varied,  and we can only
mention a few of  the more prominent.  Such are,  an
imperforate hymen, or one only so slightly perforate,
that effectual congress  is prevented;  narrowness or
partial closure of  the vagina, either as  a natural defect
or as  the consequence  of difficult  labors; tumors or
polypi in  the uterus or vagina; closure or partial  clo-
sure of the neck  of the womb, or after being torn
during labor, from the  use of caustics; disease of  the
ovaries; adhesion or occlusion of the Fallopian tubes; 
92
Reproduction.
displacements or flexions of the womb; leucorrhoea;
ill-timed, or too frequent sexual intercourse;  mastur-
bation;  disease of contiguous  organs, etc.
  LeucorrJuea.—This discharge may exert  considera-
ble influence by diminishing susceptibility to fecunda-
tion.  Functional alteration in the mucous membrane
of the vagina and uterus, causing considerable excess
in its acid and alkaline characters, may render the male
secretion inoperative, by the destruction of its  sperma-
tozoa, the vitalizing element of the  seminal  fluid.
When leucorrhoea, however, exists to  an extent suffi-
cient to cause  sterility, its influence  on  the  general
health becomes more or less apparent.

  Dysmenorrhea.—Painful menstruation is a  frequent
cause of barrenness,  This is  especially true  in case
the flow is shreddy and stringy, as in the membranous
form of this complaint.  Women  with this disease
may conceive, but in them the lining membrane of
the womb (which should become the outer envelope
of the  foetus) is  detached and thrown off when the
month  arrives, and  the  ovum comes away with it.
This class of persons, therefore, remain sterile,  because,
at the  return of  the  menstrual  cycle (each  month)
they  actually experience  an  abortion.    The only
remedy for this class of cases  is to cure the tendency
in the  lining membrane  of  the  womb  to exfoliate,
after which a successful pregnancy may follow.   (See
Membranous Dysmenorrhea.)                  L.


                 Constitutional.

  The  constitutional causes include  those in which
the general physical powers are exhausted, as  the con-
sequence of acute or chronic disease;  obesity; severe, 
Sterility.
93
protracted, or unaccustomed exertion; too close appli-
cation to business, or excessive  exertion of the brain,
thus  absorbing an undue amount  of nervous power
which otherwise would be more  equally diffused  for
the efficient discharge of the general functions of the
body.   In this way the  generative  system  may be
impaired  by the  divergence  of the  nervous influence
which its  healthy functions demand.

                Luxurious Living.

  A frequent cause of  sterility is  that occasioned  by
indolent and luxurious habits, as excessive indulgence
in the pleasures of the  table, and especially the free
use of wine.  The industrious and frugal  portions of
the community are, it is well known, far more  prolific
than the higher ranks of society.  In his work on the
law of population, Mr.  Sadler incontrovertibly proves
that the fecundity of the human race is diminished by
the indolent and luxurious mode  of life prevalent
among the rich, while it is  augmented by the laboring
habits and spare  diet of the  poor.  .   .   .  the pro-
portionate infecundity of the two being,  in general
terms, as six  to one.
  Great feeders are often  sterile.   Women who are
remarkable for their  pinguidity generally have few
children, usually none at all.   The same rule holds in
the vegetable  kingdom.   By  a change of soil and
surroundings it is  possible  to make a tree grow leaves
only,  and  thus  answer for ornament  exclusively, or  by
supplying different and proper conditions, to cause it
to bring  forth flowers  and  fruit as well  as foliage.
The diet alone  makes  all  the  difference between the
drone and the working  bee.                    L. 
94
Reproduction.
                   Irritability.

  Defective, or, on the other hand, excessive nervous
irritability, may operate as an  obstacle to impregna-
tion.  Deficient sensitiveness, called sexual  frigidity,
may render the person so incapable of responding to
the  sexual  act as  to  hinder fecundation;  or,  the
activity of the structures may be in  such excess that
their vitality is destroyed,  as it were, by their own
vehemence.

               Emotional Causes.

  We may also notice what may be termed emotional
causes of sterility; and  although these are  probably
less influential  than many of the  other varieties, they
are still sufficient  to operate  prejudicially to concep-
tion.   They embrace the agreeable stimulus of various
senses, such as those of touch,  sight, and hearing, to
an  extent proportionate  to individual temperament.
There should be the most perfect harmony and con-
geniality, the one  responding to the whole  nature of
the  other, without any sense of discord or feeling of
repugnance.   Thus, as pointed  out in  the chapter on
Puberty,  that  epoch is marked  by a most striking
alteration in the features, form and voice, calculated to
exert an immense  influence on the phenomena of con-
ception.    The favorable  exercise of  these faculties
seem to be required in  some  instances to overcome
indifference or  a positive repugnance to sexual inter-
course.
  Moral causes may even lead to physical conditions
which,  affecting  probably  the male more  than  the 
Sterility.
95
female, it is  unnecessary to  mention here, but which
may operate as causes of incapability.
   Incompatibility of  temper,  taste, and  disposition
between husband and wife often  prevents impregna-
tion.   If the wife's tastes  are lady-like, and of the
higher order, with an admiration for wnat is beautiful
in sentiment and refined in spirit, while her husband's
nature is " of the earth earthy," it is very probable that
they will remain childless.   Or if conception does fol-
low the congress of two such individuals, it is rather
an accident  than a natural consequence.  It is  thus
that a man's pipe, or his glass, or his personal address
and appearance, his lack of  sentiment,  his boorishness
may rob him of the whole catalogue of paternal pleas-
ures,  and leave his poor wife to rest under what is too
often  and  carelessly regarded as a  reproach to her
womanhood.
   It is a bad practice for women under these circum-
stances to blunt their  sensibilities with alcohol in any
of its  forms, for should impregnation follow while they
are under  its influence, the  child may be an  idiot or
worse.                                         L.

          Influence  of Temperature.

   We know well that vaginal injections of cold water,
or of  hot water, employed directly after insemination,
generally prevent conception.  A case is related of
a lady, many years sterile, who was in the habit of
using an injection of cold water  after sexual connec-
tion.  One day she accidentally used warm water in-
stead, and  conception resulted therefrom.  M. Coste
has ascertained by experiments that the spermatozoa
of mammalia are  destroyed by cold water, whereas
the admixture of warm water with  the  seminal  fluid
rather favored their  vitality.   Many facts  have come 
96
Reproduction.
under our own notice illustrative of the great influence
of temperature on conception.
  Other causes not enumerated by the author  arc,—
abortion in early married life, the result of harsh drugs,
as the " female pills " which are so extensively  adver-
tised and taken; the vitiation of the male fluid in con-
sequence of private  disease  in years  gone  by; the
sudden  change of posture or  position  by the female
immediately after the act, which  prevents  the  possi-
bility of the spermatozoa and  the  ovule coming into
contact; the practice of fraudulent or incomplete inter-
course for  months or years;  solitary indulgence; the
abuse of aphrodisiacs; spasm of the vagina; inflam-
mation  of the ovaries, and ulceration and inflammation
of the womb.                                  L.
  Treatment.—In  the treatment of sterility, an  in-
vestigation of the cause, which is the first step towards
the cure, should be made, so that if possible it may be
removed.  Sterility from  congenital malformation is
generally incurable.  On  the  other hand,  numerous
cases are exceedingly simple in their nature, and quite
amenable to treatment.  To ensure conception one or
more of the following remedies  only  are  necessary,
with, perhaps,  some  mechanical  measures,  attention
to physiological laws and hygienic conditions, so that
the organs and general constitution may be placed in
the most favorable circumstances.
  Remedies for  constitutional sterility.—Agnus cas-
tus, Baryta carb., Calcarea carb.,  Cannabis, Conium,
Ferr. m., JVux v.,  Phos., Phos. Ac,  Plat.,  Sabina,
Sep., Sulph.
  The selection, the form  of the remedy, and the fre-
quency  of its administration, can only be determined
by the general and local symptoms in each particular 
Conception.                  <f]
case.   Many drugs recommended as possessing aphro-
disiac properties are of doubtful character, or have the
mere power of exciting the imagination.


                III.—Conception.

  Impregnation depends on the union of certain ele-
ments furnished by the male and female organs during
sexual congress, both being alike indispensable.  And
it  needs but a superficial acquaintance with human
history to know that the future  being, in its physical
and intellectual powers, during the whole of life, is to
a great extent determined  by the actual condition of
the sperm-cell and the  germ-cell furnished  by the
parents.   Education, and hygienic  conditions, it is
true, may improve an imperfectly-organized embryo;
but the fact remains, and its general recognition is of
great importance,  that the qualities of the germs fur-
nished at the period of impregnation will cling to the
individual during the entire period of natural life.  The
practical lesson to be gathered from  this fact is, that
sexual connection, at least whenever  conception is a
possible result, should only take place under favorable
conditions.  There should be  at the time the most per-
fect bodily health, freedom  from  bodily fatigue and
mental excitement or depression;  also from  the dis-
turbing influence  of active digestion, as after  a full
meal.   It is more  than probable that conception result-
ing from intercourse at the close of a hard day's occu-
pation, or following great mental excitement, or after
a heavy supper, or under the influence of intoxicating
beverages, or subsequent to previous  excessive sexual 
98
Reproduction.
indulgence, or, in short, when the bodily functions or
organs are impaired, affords a rational explanation  of
many infirmities, or  eccentricities, of the  offspring.
The essential conditions, then, necessary for the pro-
duction of healthy and  beautiful children, are, good
health on both the paternal and  maternal  sides, and
the observance of correct rules, a few of which only
are referred to in this work.

Insemination,  Impregnation,  and  Conception.

   We will here define the meaning we attach to some
of the terms used in discussing this subject.  Insemi-
nation means simply the injection of semen into the
genital passages, as in sexual congress.  Impregnation
implies  the  meeting and commingling of the living
 spermatozoa of the male with the ripened  ova of the
 female.  Conception, however, is the attachment of the
 impregnated ovum to the situation wherein it  is to be
 developed until the time of birth.  Without this attach-
 ment, the ovum may be expelled, and  many cases of
 sterility are due to the inability of the womb to retain
 the ovum in consequence of relaxation, leucorrhoeal
 discharge, etc.   Violent exertion, hours and even days
 after impregnation, sometimes excites uterine contrac-
 tion sufficient to occasion its expulsion.   When, how-
 ever, the impregnated ovum becomes attached to  the
 walls of the womb, its foetal development commences,
 and this fixation is conception.  This occurs probably
 soon after impregnation.  The time  most favorable to
 impregnation is that immediately following the cessa-
 tion of the menstrual discharge.  Women  have then 
Conception.
99
a much greater aptitude to conceive, and this is there-
fore the most opportune period for sexual intercourse.
" Everything seems admirably prepared at this period
for the reproduction of the species"  {Cazeau).   Men-
struation in the human female  is supposed to corres-
pond  with  certain periods  designated as those  of
"heat," or "the rut," in  animals.   At  these  periods,
sexual desire becomes stronger in  the human female
and in the females of mammiferous animals at no other
time.   If sexual  connexion is restricted  to a certain
portion of the inter-menstrual  period, pregnancy will
rarely occur.  The explanation of  this may  be here
briefly summarised.   At  every menstrual period  an
ovum or egg is matured and expelled from its Graafian
vesicle, and a woman is only liable to impregnation
on its meeting and blending with  the spermatic fluid
of the male during  its  progress along her passages.
The time occupied by the  passage of the ovum from
the ovary to the uterus  is  not  accurately known, but
varies from five or six to eight or more days, differing
probably in different persons  and in different condi-
tions of health.   When the passage of the ovum is
completed, the  liability to pregnancy terminates till
after the next menstruation.  It is an interesting ques-
tion, whether a woman can determine the precise time
when this ovum passes off.  We believe, in the great
majority of cases, there are certain signs by which this
event can be recognized, and, consequently a  woman
may be able to determine when the liability to preg-
nancy terminates  for that month.   Those  persons,
therefore, who are anxious to  increase their  families
should connect their hopes with the time of ovulation; 
IOO
Reproduction.
whilst others who, for reasons of health, poverty, or
other circumstances, do not wish to add to the num-
ber of their children, should  then  exercise particular
caution and self-control. 
IOI
  CHAPTER V.

PREGNANCT.
     I.—Signs and Symptoms  of Pregnancy.

   The signs of pregnancy vary considerably in differ-
 ent ladies, both as to their nature and the periods of
 their occurrence.   The  inquiry as to the existence of
 pregnancy is often  one of great importance and  anxi-
 ety, and we  therefore place before the reader the most
 characteristic signs and symptoms to which this con-
 dition gives rise.  In estimating  the conclusiveness of
 these signs, reference must be had to their number and
 importance,  the previous  condition of the  lady, and
 any accidental causes which  may have been  in opera-
 tion to produce abnormal changes.   Only three of the
 following signs can be considered as certain, and these
 only when  clearly  made  out; they are,—the sounds
 of the foetal heart, the movements of the child felt by
 another,  and ballottement.   The other signs are pro-
 bable ones;   probability, however,  almost  rising into
 certainty in some cases and at certain periods of ges-
 tation.
  i.  Absence of Menstruation.  Probably the
first circumstance which leads a lady to think herself
pregnant is the arrest of the usual monthly discharge.
If the suppression of  the  menses  occur in a healthy 
102
Pregnancy.
female, who had before been regular, and who has not
been  exposed to cold or wet, or any other accidental
cause likely to influence the menses, and especially if
at the second or third period they are still absent, preg-
nancy may be  suspected.   This sign will be  much
more conclusive if there  are  superadded  to  it other
symptoms indicative of pregnancy, such as those des-
cribed further on.
  But although this is one of the earliest signs of preg-
nancy, still no certain conclusion can be arrived at from
it, inasmuch  as the menstrual  function may be  sup-
pressed from causes altogether distinct from pregnancy,
or conception may occur prior to the establishment of
menstruation, or immediately after ceasing to  nurse,
and before this function has had time to recur.   Again,
the menstrual discharge may be  suspended as the result
of disease, and pregnancy be induced before that func-
tion  is re-established.
  Other causes arrest this function.  Thus a sea-voy-
age,  the mountain air when one is  not accustomed to
it, mental anxiety, an  entire  change of habits, as in
the  newly-married, in whom this  arrest often takes
place temporarily for  one or two months.   Besides
which see chapter on " Suppression of the Menses."
                                               L.
  It therefore  follows, that  though the  absence of
menstruation  is of considerable value as evidence of
pregnancy, it  cannot, per se, be regarded as a conclu-
sive  proof.
  2.   Morning Sickness.—Generally, in from  two
to six weeks, sometimes immediately after conception,
ladies suffer more or less with nausea, and sometimes
vomiting, on first  taking  the erect posture, probably 
Signs of Pregnancy.             103
from the uterine vessels  being then more congested,
and  hence termed morning  sickness.  Occasionally,
these symptoms are so severe and  persistent as to
impair  very  seriously the  health of  the  patient; on
the other hand, some patients do not  experience  sick-
ness at all.
  In consequence  of its intimate nervous connections
with all parts of the  body, the stomach often acts sym-
pathetically in comparatively trifling derangements.
Cerebral excitement, nervous irritation, affections of
the bowels, kidneys, liver, etc., are all capable of excit-
ing abnormal action in the  stomach  resembling  that
which attends pregnancy.  As a sign of pregnancy,
therefore, this alone is one of  but limited importance;
it may be absent altogether, occur at unusual times, or
take unusual forms; but when it  is  combined with
other symptoms described in this chapter, and  occurs
in the usual  order of time,  it furnishes an important
link  in that chain of evidence which indicates the preg-
nant condition.
  The treatment of  this condition is described further
on.
  3.  Enlargement of the Breasts.—The exami-
nation of the breasts furnishes an experienced observer,
acquainted with the general  anatomy of the glands,
with valuable data on which to found an opinion as
to the existence of pregnancy.  As a  rule, in about
six or eight weeks after conception, often earlier, there
occurs a sensation of fulness, with throbbing and ting-
ling pain in the breasts, accompanied by their enlarge-
ment.   They become larger, firmer, and  feel  knotty,
and after a time  a  milky fluid may be secreted.  But 
104
Pregnancy.
these symptoms cannot alone  be relied upon as  evi-
dence of pregnancy, since irritation of the utero-geni-
tal apparatus, suppressed menstruation, uterine tumors,
or even,  in  some females,  the  appearance of the
monthly discharge, may give  rise to  them.  A tem-
porary enlargement, simply consequent on marriage,
is  sometimes  observable, without  the occurrence of
conception.   Enlargement of the breasts may also be
due to fatty deposit;  in  this  case, other  parts of the
body will present  evidence of a proportional increase
of the fatty material.  The true character of the en-
largement is  easily recognizable by the touch of the
experienced finger; that from fatty enlargement is soft
and  uniform, but that from  pregnancy is hard  and
knotty, the lobules of the gland being felt beneath the
skin, arranged in a regular manner around the nipple.
Enlargement from chronic disease is perhaps less likely
to lead to an  erroneous conclusion, as one breast only
is involved, and that but partially so.
  4.   Darkening of the  Areola around  the
Nipple.—In the virgin state, the color of the nipple
and areola is  usually but a shade deeper  than that of
the skin generally; but in  about six  or eight weeks
after conception, the delicate pink-colored circle around
the nipples becomes several shades  darker, the circle
increasing in  extent, and in  depth of color,  as preg-
nancy progresses.  This change is so strongly marked
in primiparae, as to afford a good  sign of gestation.
It is, howevei", rendered of less general value from the
fact that after the  first pregnancy, the dark  color be-
comes  permanent, and is but little modified by subse-
quent  ones.  Concurrently with the  altered  color of 
Signs of Pregnancy.             105
the areola, the nipples  and surrounding  integuments
become  swollen, puffy, and  more  moist, secreting a
fluid which stains the linen; and the veins beneath the
skin become more visible.   Prominent points or glan-
dular  follicles, varying in number from twelve to
twenty, project from the sixteenth to the  eighth  part
of an inch, immediately around the  base of the nipple.
These changes, which are often well marked, are not,
however, always so.  The darkening of  the  areola is
less marked in ladies of light  complexion;  and some-
thing resembling it, as  also enlargement of the mam-:
mary gland,  is said to be present when the uterus  is
distended from other causes than pregnancy.
  In persons of dark complexion, as in brunettes, the
areola may become so dark that it looks as if bruised,
or even gangrenous, and thus may cause alarm.   L.
  Alterations in the size and appearance of the breasts,
the two signs just referred to, afford to the educated
hand and  eye of the practitioner valuable evidence:
they have also this additional importance—that an ex-
amination of them is easily obtainable, and, for various
reasons, more readily conceded than one involving the
vagina and abdomen.
  5.   Milk  in the Breasts.  This sign, often  con-
sidered very  conclusive of pregnancy, is very unrelia-
ble.   Women who  have borne children,  sometimes
continue to secrete milk for  a long  time—even for
years;  in such cases,  therefore, this sign  is of little
value.   Milk in the breasts also occurs in other con-
ditions of the system besides pregnancy, and  even in
females who  have never borne children.
  In rare cases, milk  may be  secreted by the  breasts
    5* 
io6
Pregnancy.
of a man, instances being on record in which a father
suckled his own child.   In some of the  inferior ani-
mals, as for  example the  bitch, the breasts may be
made to yield milk freely, although the animal  has
never been pregnant.                          L.
  6.  Enlargement of the Abdomen.   After  im-
pregnation, an increased afflux of blood occurs towards
the womb, the tissues of which gradually expand,  im-
parting a feeling of weight, fulness, and sensitiveness
in the utero-genital organs.
  The gradual enlargement of the  uterus furnishes a
tolerably accurate  guide to the  period of pregnancy,
by the height which  it  attains in the abdomen.   In
about two months, the  intestines are somewhat ele-
vated, and by the end of the third month, the enlarge-
ment may be  perceived;  at  the fourth month,  the
womb rises out of the  pelvis in the form of a hard
round  tumor, and then  gradually rises,  and enlarges
the whole abdomen.  It reaches the umbilicus {navel)
at the sixth month, and  is highest at the ninth, when
it  reaches  the ensiform cartilage,  and  impedes  the
descent of the diaphragm;  during the  last month it
sinks a little, probably from some  diminution of liquor
amnii.
  The sensation conveyed to the hand by the pregnant
uterus is very different from that  of  the abdomen dis-
tended by fluid, flatus, etc.;  the former  being firm,
elastic, defined; the movements of the foetus  may  be
felt by the practiced hand;  but in the latter there is an
absence of firmness and elasticity, and  the tumor is
not defined.   On  reaching  the umbilicus, the uterus
pushes it forward,  so that in about the sixth month it 
Signs of Pregnancy.             107
is more prominent than natural, and afterwards it pro-
trudes somewhat from the surrounding skin.
   Enlargement of the  abdomen, as a  sign  of preg-
nancy, is liable to variation;  it may be distended by
gas, or faecal accumulations  in  the  intestines, or by
ovarian dropsy; or the uterus may be enlarged by air,
fluid, or hydatids.  In many  cases, the abdomen even
becomes  flatter at first, from the sinking of the im-
pregnated uterus in the pelvis, attended perhaps with
a slight retraction of the navel.
   7.  Quickening. — Popularly this term is applied
to the mother's perception of the first movements of
the foetus, on the incorrect assumption that it was not
alive from the very moment of conception.  Quicken-
ing  may be  briefly explained  thus:  As soon as the
uterus has become too  large  to remain  in  the pelvis,
it  rises into  the  abdomen, and, sometimes, suddenly,
causing  faintness and sickness; after this, the  move-
ments of the child, pressing directly upon the sensitive
walls of the  abdomen, are felt.
  This sign  of pregnancy  is  by no means a reliable
one, unless the  movements are certainly felt by another
person, as the patient may be  deceived by flatus in the
intestines, or by the force of her own  imagination;
thus women who think  themselves pregnant often
assert that they plainly feel the motions of the  child,
persisting in such statement  until the  lapse of time
convinces them of their error.  On  the other  hand,
cases occur in which no sensation of the motion of the
child is perceived by the mother from  the beginning
to the close of pregnancy.
  8.  Ballottement. — At the expiration of a few 
io8
Pregnancy.
weeks, the  uterus will  be found  lower than  usual,
heavier, and its os more circular, and closed; but after-
wards it becomes higher, more difficult to be reached,
and its neck shortened.  If the woman  be placed on
her knees, and an impulse be given to the finger, bal-
lottement, or the floating of the child, may be felt, for
it  rises a  moment  in the liquor amnii, or fluid in
which the foetus floats, and then, by its  own  gravity,
sinks again on the finger.  The most favorable period
for this test is between the fifth and sixth months.
Before the fifth month the foetus  is  too light, and after
the sixth month it  is  too closely packed to admit of
this  test.  Ballottement is  very  conclusive of  preg-
nancy, and  especially when corroborated by  other
signs, but  determines nothing as  to  the life of the
foetus.
   9.  Kiesteine in the Urine. — By keeping the
urine of a  pregnant female a few  days, a  whitish
scum, of a  fatty or  curdy appearance, forms on the
surface, and then  gradually breaks up again from
decomposition.  Kiesteine probably exists in the urine
from  the first month of pregnancy until delivery, and
arises from the excess of nutriment formed in the blood
of the mother for the child.
   10.  Sounds of the Foetal Heart. — By apply-
ing the stethescope to  the lower  portion of the abdo-
men of either side, usually on the left, about midway
between the umbilicus and the anterior superior spinous
process of the ilium, the foetal heart may be heard at
twice the rate  of the mother's,  viz.,  about  140 per
minute.  The sound has been compared to the muffled
ticking of a watch,  and  the earliest time  it can be 
                Signs of Pregnancy.            109

heard  is the beginning of the fifth  month.   When
the pulsations  of the  foetal  heart are heard, they are
the most positive of all the signs of pregnancy.  At
the same time, the pulsations m.iy be inaudible, and
yet the female may be enceinte, as the foetus may have
died, or the pulsations  m.iy be rendered inaudible only
for a time.
   11.  Other Signs  of Pregnancy, which we will
only name, are:   Change  of color  of the mucous
membrane of the vagina to a dusky, livid hue, often
well marked, and very characteristic; salivation;  the
uterine souffle, caused  by the  rush  of blood  through
the tortuous arteries of the uterus over  the placenta;
sharpness of the features;  irritability of temper; and,
frequently, toothache,  and other nervous complaints.
   From  the  foregoing statements  the reader will
perceive  that  the diagnosis  of pregnancy, especially
in the  early  months,  is far  from being certain;  the
evidence is cumulative, no one sign being alone trust-
worthy, probability rising in proportion to the-accumu-
lation of signs.   Errors in the diagnosis  of  pregnancy
usually arise from the  attention of the observer  being
restricted to  one or two signs only, and omitting to
inquire for other and more conclusive ones.
   In exceptional cases, it is absolutely impossible  for
the physician to decide whether a woman is or  is not
pregnant.  It is good  sign if  your physician  is chary
of promises, and reserved in his decision in such cases;
for it betokens  experience  and honesty on his part.
Time will settle the question.                   L. 
no
Pregnancy.
   II. — General Rules During Pregnancy.

  I.  Diet. —The diet should be simple, nutritious,
and easy of digestion; it should be thoroughly masti-
cated, and but little fluid should  be drunk at meal-
times, especially cold, since it retards digestion.  It  is
an error  to suppose that ladies require more nourish-
ment in pregnancy than at other  times;  and  large
quantities of rich food, taken in the belief that it will
contribute  to  the sustenance of the child, cannot but
be productive of baneful consequences.  Spices, spiced
meat, sausages, and all  highly-seasoned food, and late
suppers,  must be  refrained from.   Plainly-cooked
animal food (once a day), well-boiled vegetables, ripe
fruits,  and such  articles as  rice,  tapioca, arrowroot,
will, if taken  in moderation, rarely disagree with the
stomach.   Pie-crusts, smoked hams, salted meats gen-
erally,  rich sauces,  and  eveiy  article that has  been
known  to occasion indigestion, must be  eschewed.
All  substances  that have a  tendency  to  produce
a costive  state of  the  bowels  should be  especially
avoided,  and, unless some reason exists to the con-
trary, brown bread should be eaten  in preference to
white.   Stimulating drinks — wines, ardent  spirits,
ale, porter, strong  tea  and  coffee, are, as a general
rule, hurtful both to the  mother and the infant.
  2.  Dress. — On this point, the origin of the word
Enceinte, used to  signify the  pregnant  condition,  is
highly suggestive.  It was the custom of the Roman
ladies to wear a light girdle or cincture  round their
waist;   but on  the occurrence  of  pregnancy,  this
restraint  was removed.   Hence a woman so circum- 
       General Rules During  Pregnancy.      in

stanced was said to be incincta  (unbound), and  thus
the term enceinte has been adopted to indicate preg-
nancy.
   It would  seem  scarcely  necessary to  make any
remarks upon the  dress  to be worn  during preg-
nancy, were it not that some females,  considerably ad-
vanced in it,  may often  lace tightly  for  the  sake of
attending public entertainments,  or of diverting notice
from their condition.  At no time should stays be worn,
for the simple  reason  that  they are  never required.
But they should especially be avoided  during preg-
nancy, since a continual and forcible  compression  of
the abdomen while nature  is at work to secure  its
gradual  enlargement  in order   to accommodate  the
growth of the foetus, must  be attended with  serious
injury to the health of both mother and child.  Dur-
ing gestation, the uterus increases on an average from
two to fourteen  inches in diameter.  It must be obvi-
ous, therefore, how vain, as well as criminal, must  be
any effort to contract  it, and  thus to  conceal  its
enlargement.   Palpitation of the heart,  indigestion,
disease of the  liver,  and  costiveness; difficulty  of
breathing,  spitting of blood, and  persistent coughs;
enlarged veins  in  the  legs, swellings in the lower
limbs, disorders  of  the  womb,  deformity of  the  off-
spring, and numerous other affections have their origin
in tight-lacing;  and, finally,  if the child be born alive
and  molded aright,  and the mother  escape her  self-
created perils, it may be questioned  if  compressed
breasts and nipples can afford the requisite aliment.
  The popular idea that  tight-lacing  ensures an easy
and  expeditious  labor  is  fallacious.   This  expedient 
H2                  Pregnancy.
may indeed prevent the child within the womb from
becoming  very large; but  incidentally it is likely to
produce harmful results.  The tight-lacing of pregnant
women is not  only ill-advised, but  pernicious;  for,
under these circumstances especially,  the greatest care
should  be  taken to avoid  an  undue or unusual con-
striction of any portion of the body whatever.   L.
  The dress should be  arranged, as  to  material and
quantity, with the view  to comfort and to the season.
There must  be  no pressure on any part;  even  the
garters  should be loosely worn.  The feet and  abdo-
men must  be kept warm, since habitual  coldness of
these parts predisposes  to colic, headache,  and mis-
carriage.
  3. Exercise.—Exercise is a most important means
of retaining good health during gestation, of securing
a natural delivery, and of favoring the health of  the
infant.  The most useful kind is, walking in the open
air;  for this calls into action more of the muscles of
the body than does any other exercise suited to this
condition.  Walking-exercise is even  more  necessary
in the winter than  in the  summer,  and produces a
much healthier and more lasting warmth than  sitting
before a fire.   Such  exercise  should, if possible, be
taken in the morning before dinner, and  be  of  such a
character as to interest the mind as well as to strengthen
the body.   This will operate most favorably as a pre-
ventive  of  a host of the  morbid conditions  and feel-
ings which are apt to  attend this state.   Care  must,
however, be taken  to  avoid  such a degree of exercise
as may induce positive fatigue; such as too long walks,
going out in  slippery weather, dancing, lifting heavy
weights, and all kinds of violent motion, which  are 
        General Rules  During Pregnancy.     113

liable to cause haemorrhage, miscarriage, and bearing
down of the womb.   The passive  exercise of  riding
in a carriage falls short of the object in view, and, on
the other hand, riding on horseback exceeds it, besides
the danger of fright and  accident, to which the incipi-
ent mother  is then liable.   In wet weather, or when
it is impracticable to walk out, she should select a large
and well-ventilated room, so that the air  she breathes
may be pure.
  As an illustration of the advantages of taking exer-
cise during pregnancy in out-of-door air, and in the
broad light  of day, we may mention the  fact that the
number of cretins in  the Valais has considerably di-
minished since the women have  adopted the practice
of removing from the humid and  sunless air of the
valleys, and residing  during pregnancy on  the  more
exposed and cheerful  heights.
  It will be plain from the  tenor of these general  re-
marks, that lassitude  and  languor  should be striven
against and overcome. On this account the pernicious
habit of sleeping after dinner should not be contracted.
Too little sleep is a less evil than is  too  much.   And
hence females who pass the interval, or a  good part of
it, between dinner and tea, on the couch or the bed,
generally suffer from  a debility which ends in prone-
ness to disease.
  4.  General Hints.—Theatres, balls, or exciting
public meetings  should not be attended;  early habits
should be formed;  all excessive  mental  emotions, as
grief, despondency,  anger, and  the like, are  to  be
guarded against; the  cold or tepid bath should be used
daily, following  it with  vigorous friction;  the  mind 
ii4
Pregnancy.
should be kept tranquil, remembering that parturition
is not necessarily attended by great suffering or immi-
nent danger,—these being, in most instances, the pen-
alty inflicted  on those who  disregard  the  hints  laid
down in  this  section.

  Many pregnant women do themselves infinite harm
by close and unremitting toil at  the sewing-machine,
or with the needle, under the plea that they " must
have the  family-sewing, and that for the expected in-
fant, done  up before  confinement."   And  this  mis-
chief is frequently wrought without the physician and
husband  being permitted to know anything  about it.
All of which is positively wrong.              L. 
"5
        CHAPTER VI.

DISORDERS  OF PREGNANCY.
   In a normal state of social life, pregnancy would be
 a condition comparatively exempt from suffering.  In
 consequence, however, of disorders induced by  artifi-
 cial habits, the excessive use of drugs, constitutional
 diseases, or accidental causes, this condition is too often
 accompanied  by departures  from  health;  some of
 which we have described in the following pages, to-
 gether with the best means for their prevention and
 removal.   The first on the list is


              I.—Morning  Sickness.

  In the  early months of  pregnancy, most women
 experience  more or  less of this;  occasionally nausea
 or vomiting, or both, are very troublesome  and per-
 sistent symptoms, and give rise to  serious concern as
 to the patient's health, especially in the first pregnancy
 of delicate women.   In such cases professional treat-
 ment should be obtained.
  Symptoms.—The  first intimation  of  it generally
 occurs  on rising from bed.  Before  getting up the
patient  may feel  as well as  usual, but while dressing
will be overtaken by nausea, followed by retching, and
perhaps by vomiting.  Perhaps it may not occur  until 
Ii6          Disorders of Pregnancy.
some little time after leaving the apartment, or not till
after breakfast, wliich may be eaten with  zest.   This
disorder may begin almost immediately after concep-
tion, of which it is often one of the earliest symptoms;
but more frequently it does not  commence  until after
the lapse of two  or three weeks, and then continues
more or less constantly and  severely for three or four
weeks, and  in some  instances  till near  the  time of
quickening, or even until confinement.  In some rare
instances, it does  not occur  before the last weeks of
pregnancy, and  is  then apt to be  severe;  in  other
cases, it is altogether absent  during  the whole period
of gestation.
   In some cases this peculiar sickness recurs at even-
ing  or during the  night.  It is not unusual for it to
waken the patient at two or three o'clock in the  morn-
ing, and to pass  off as soon as she  has  eaten  some-
thing.   In this latter respect it resembles  sea-sickness,
and the rule to eat and keep on the  back affords  the
greatest relief.  I have  observed  that whenever this
sickness depends upon either of the  forms of displace-
ment of the womb, which are  incident to pregnancy
(prolapse and retroversion), it is invariably brought on
or aggravated during the latter  portion of the day, or
at night, provided she  has been upon her feet.  It may
sometimes be relieved almost instantly by replacing
the womb.                                     L.
   Diagnosis.—Sickness arising from indigestion may
be distinguished from  that of pregnancy by the former
continuing during the whole day, and by absence of
appetite after the morning has passed, flatulence, furred
tongue, etc.
   Cause.—The increased  action of the  nerve-force
employed in digestion, to furnish material for enlarged 
Morning Sickness.              117
growth, carried to so high a degree as to disturb  the
equilibrium of the digestive and  assimilative  forces.
It is most common among the wealthy and  inactive.
Morning sickness  no doubt  acts favorably by  dimin-
ishing that tendency to  plethora, or  too  great fulness
m the system, which often attends pregnancy.
  Treatment. — Ipecacuanha. — Great  uneasiness
about the stomach; vomiting of undigested food, bile,
or phlegm; relaxed bowels.   Often sufficient in mild
and uncomplicated cases.
  Arsenicum.—Vomiting  after eating  or drinking;
persistent vomiting, with extreme  weakness, and ema-
ciation.
   Veratrum.—Excessive sensibility of the nerves of
the stomach—vomiting being excited  by the least
quantity of water, by moving,  or by sitting up; vom-
iting with great  debility and tendency to diarrhea;
attacks of fainting.
  JVux vomica.—Vomiting with vertigo, restlessness,
and irritability of temper; waterbrash, hiccough, sense
of weight at the pit of the stomach, and constipation,
in women of dark complexion.  It is supposed to act
beneficially by diminishing reflex excitement.   When
this  remedy is  indicated it  often affords  immediate
and striking relief, so that the patient will go through
the remainder  of her  pregnancy with  comparative
comfort.
  Pulsatilla.—Symptoms similar to JVux vomica,  but
with tendency to diarrhea, and for fair persons.
  Any of the following additional remedies may be
employed according to the  constitution and symptoms
of the patient:  Ant. crud., Kreasotum,  Conium, Ly- 
118          Disorders of Pregnancy.

copodium, etc.   Pcpsine is  also recommended as a
valuable and potent remedy.
  Accessory Means.—The simpler modes of treat-
ment are: the regulation of the diet, a change in the
times of eating to those hours when the stomach is
least likely to be affected, and especially avoiding over-
loading the stomach.   Cold food will sometimes be
retained when hot is rejected.   In extreme cases, two
or three teaspoonfuls of  beef-tea, frequently repeated;
or soda-water and milk;  or when these cannot be
borne, small pieces of ice may be sucked.   Sometimes
it is better to give  up  the attempt  to afford nourish-
ment by the mouth, and to depend upon injections by
the rectum for a day or two.


                 II.—Toothache.

  Many females suffer with toothache as soon as con-
ception has occurred, and even recognize their  condi-
tion by this symptom.   It is, however, liable to happen
at any period during pregnancy.  Extraction of teeth
is rarely advisable, as  Homoeopathic  treatment will
generally remove the pain.  A qualified dentist, in-
deed, usually refuses to remove  them  for this  cause,
where it exists alone.
  Symptoms.—The pain may attack one or more de-
cayed teeth, or one quite  sound, or it may extend along
the jaw without affecting any tooth in particular.   It
is sometimes so intense as to render the  patient tem-
porarily delirious.
  Treatment.—Aconitum.—Great restlessness, and
throbbing pains in the face, with  dry burning heat, 
Toothache.
119
  aggravated by all kinds of stimulants.  A lotion, made
  by adding a few drops of the strong tincture from the
  root, to a  little water,  may often  be applied  locally
  with almost immediate  relief.
    Belladonna.—Determination of  blood  to the head
  in addition to toothache,  and great irritability  of  the
t  nervous system; the pains are worse at night, and are
  throbbing,  digging, or piercing, often occurring in
  alternation  with intense headache.
    Mercurius.—Pains in decayed teeth, extending into
  the head; swelling of the glands.   This is an  excel-
  lent remedy in numerous  affections of the teeth  and
  gums,  and has been, perhaps,  more frequently and
  successfully used  in domestic practice than any other
  remedy.
    Chamomilla.—Insupportable  pains, almost driving
  the patient  to despair; heat and redness, especially of
  one side of the face.
    Kreasotum.—This is very valuable for toothache
  from decayed teeth, and not only relieves the pain, but
  tends to arrest the progress of the decay.
    Calcarea, Bryonia, JVux  vo?nica, Pulsatilla,  and
  Staphysagria, have also been used  with great advan-
  tage in various forms of this disorder.
    Administration.—In severe cases a dose every fif-
  teen to  thirty  minutes.  If the  pain  is not relieved
  after  three  or  four doses, another  remedy should  be
  selected.  In  milder cases, a dose every three or four
  hours.
    Accessory Means.—Cold, damp air,  coffee, stim-
  ulants, and  indigestible food should  be avoided; also
  subjecting the teeth to opposite extremes of tempera- 
120           Disorders of Pregnancy.

ture, as taking very hot food, or, on the other hand,
iced beverages.

        III.—Palpitation  of the Heart.

  Pregnant females of a delicate constitution and ner-
vous temperament often suffer from attacks of palpi-
tation.  By some it is experienced immediately after
conception, by others at the  period of quickening, by
others again,  towards the end of pregnancy.
  Causes.—Excessive nervous sensibility;  deranged
digestion; the movements of the foetus in the  womb.
  Treatment. — Moschus. — Nervous   palpitation,
with faintness.
  Aconitum   and Belladonna, in alternation, if  the
complaint  is  connected with a plethoric  condition of
the system
  Cactus grand.—Nervous palpitation, whether recent
or chronic.  It is a most valuable  remedy in many
affections of  this organ.
  Pulsatilla  or JVux vomica.—A few doses of one of
these remedies may be advantageous in palpitation
from  indigestion,  flatulence, etc.
  Accessory Means.—Derangements  of the diges-
tive organs should be guarded against; also everything
that tends to  occasion mental anxiety and excitement.


                IV. — Heartburn.

  This complaint often occurs during gestation, and
may be generally traced to taking more food than the
stomach can  digest, frequently from the  mistaken idea 
Colic.
121
 that the patient now requires more food than at any
 other time.
   Symptoms. — A burning sensation up  the throat,
 and sometimes spasm  of  the  stomach, generally
 attended with frequent eructations  of an acid  or taste-
 less  watery fluid,  when it is  termed waterbrash or
 pyrosis.
   Treatment.—JVux  vomica.—This remedy will
 generally be found efficient in removing these symp-
 toms, and should be administered three or four times
 daily for several days, or until better.
   Pulsatilla. — If the patient is of a mild, timid dis-
 position, with  a tendency to diarrhoea, this  remedy
 may be preferred to  the  former, and administered  in
 the same manner.
   Carbo veg. — Acid, acrid eructations,  with  flatu-
 lence, and  usually constipation, or sometimes diar-
 rhoea.
   Byronia or Sulphur, if the  former remedies only
 afford partial relief.
   Accessory  Means.—The diet should  be  re-
 stricted, avoiding a too exclusive use of  vegetables;
 all pastry,  stews,  twice-cooked meats, hot-buttered-
 toast, raw or  half-cooked vegetables, and everything
 that is  rich and indigestible, must  be excluded from
 the dietary list.


                   V. — Colic.

   Spasm, from  flatulent  distension  of the bowels, is
apt to occur during pregnancy, owing to cold or im-
proper diet.  It generally affects  the large intestines.
     6 
122
Disorders of  Pregnancy.
  Treatment. — Colocynthis. — This  remedy  is
suited to the severest as well as the milder forms of
the disease.
   Chamomilla. — CoWc  associated  with  a  relaxed
state of the bowels, tearing pains around the navel,
and impatience and  irritability.
   JVux  Vomica. — Spasmodic, flatulent  colic,  with
constipation, or alternate constipation and relaxation.
   Accessory Means. — During the violent pains
of colic,  hot applications are useful.   A pint  or a
pint-and-a-half of tepid water,  boldly  injected  up
the bowel  by  an  enema-syringe,  and  repeated if
necessary, is  almost  invariably and immediately suc-
cessful.   Persons subject to colic should wear a piece
 of flannel around  the abdomen  during the  day, and
 keep the feet warm and dry.

                 VI. — DlARRIICEA.

    Diarrhoea  is not so frequent  in  pregnancy as con-
 stipation, but, as previously stated, is  far more preju-
 dicial.   If it is very severe and continues long;  it is
 apt to induce abortion.
    Causes. — Nervous irritation,  induced  by preg-
 nancy;  cold, to  which females  in  this state are very
 liable; disease of the mucous membrane of the bowels.
 Diarrhoea  sometimes follows conception so closely,
 that the patient  has her  attention first drawn by it
 to her condition,  and it may return  regularly every
 month, as  though it were vicarious of menstruation.
    Treatment. —  Pulsatilla.  — Slimy,   greenish,
 and watery stools,  preceded by colicky pains,  the 
Diarrhea.
123
mouth  being  clammy  and  bitter,  without  thirst;
especially if the patient has chills, and the diarrhoea
mostly  occurs  at  night.
  Dulcamara. — Diarrhoea  occasioned  by  cold  or
wet, especially if the motions are greenish or mucous,
and preceded by colic.
  Chamomilla. — Yellow or green stools, bitter taste
in the mouth, thirst, bilious vomiting, sharp pains in
the stomach or bowels; flatulence.
  Mercurius. — Greenish  discharges,  with  much
straining.
  Sulphur. — Chronic diarrhoea.
  Calcarea. — This is particularly  required  if the
diarrhoea  continues  in  spite of the medicines  before
recommended.
  Bryonia, China, Ipecacuanha, Camphor, and Anti-
monium crud., are other remedies.
  Administration. — A dose  every  three  or four
hours;  when  better, or  in  chronic cases, morning
and  night.
  Accessory Means. — In cases of protracted diar-
rhoea, the surface should be kept warm with flannel;
a flannel roller round  the abdomen  often gives great
relief.   Night air, late hours, stimulants, and excesses
of every kind  should  be  avoided.   Food  should be
light, and taken cool or cold, and only  in small quan-
tities at a time.  The most suitable variety is fluid
food, especially milk  and  lime-water,  or  milk  and
soda-water.  Restricting a patient solely to this diet,
for two or three days, or longer, is often alone sufficient
to cure  all sorts of diarrhoea not dependent on a per-
manent chronic cause;  and even where there is such 
124          Disorders  of Pregnancy.
a cause, much temporary benefit is gained {Chambers).
The reason why a fluid diet like the above is so ad-
vantageous  in diarrhoea, is, because it is  both highly
nutritive and does not require a perfect condition  of
the digestive organs to absorb it.

              VII. — Constipation.

  Constipation is a frequent attendant on pregnancy,
especially in ladies who  live  in towns  and lead a
sedentary life.   Although constipation  is generally
far less  injurious  than  a  too relaxed state of the
bowels, it  should  be remedied as  far as possible.
  Causes. — Constipation  in pregnancy is generally
referred to the  pressure of  the enlarged womb  upon
the bowels; but it is often  due to their torpor, conse-
quent  on   the  preponderating  current  of  nervous
and vascular energy towards the womb.
   Treatment. — JVux  vomica. — This  remedy  is
indicated when there are, — indigestion, a sensation
as  if the lower bowel were closed, with frequent and
ineffectual urging to stool.   It is still further indica-
ted in persons of a hasty  and vehement disposition,
or when too little out-of-door exercise is taken.
   Byronia. — Constipation from torpor of the bowels,
especially in warm weather, with  determination of
blood  to the head, and great irascibility  of temper.
It is often  useful in obstinate cases.
   Hydrastis canadensis. — Simple constipation.
   In chronic cases  a short preliminary  course of
Sulphur is  recommended.
   Accessory Means. — Daily out-door exercise; a 
Constipation.
I25
 tumbler of fresh  spring-water  taken either on  going
 to bed or on rising  in the morning; the sparing use
 of animal food, and the free use of vegetables, ripe
 or preserved fruits,  brown bread,  oatmeal  porridge,
 etc., and the hip-bath, as recommended pages 15-18.
 When the bowels remain for  many  days unmoved,
 and there  is in  consequence uneasiness, an enema of
 chilled water at  68° may  be had  recourse  to.  The
 appropriate medicine need not be discontinued on this
 account, for  although the  bowels are  moved by this
 mechanical assistance, their torpidity still  remains  to
 be cured.  We must not omit  to recommend the wet
 compress for the abdomen,  described  in  the section
 on " Piles," as a  most valuable remedy for inactivity
 of the bowels.


           VIII. — Piles  {Hemorrhoids).

   Piles, probably  the most  frequent disease  of preg-
 nancy, are by no  means peculiar to that  condition;
 but some  ladies suffer from  them who  do  not at  any
 other time.  External piles seldom give rise to bleed-
 ing to any great  extent,  while  internal  piles often
 bleed profusely.
   Causes. — The chief  cause is,  pressure  of the en-
 larged womb upon the vessels of the  pelvis obstructing
 the circulation; minor causes are, mechanical pressure
 of the contents  of the bowels in constipation, acrid
 diarrhoea,  etc.
  Treatment.  — Aconitum, Aloes, Bryonia,  Coc-
culus, Ham.  virg., Ignatia, JVux vomica, Pulsatilla,
Sulphur, etc. 
126          Disorders of Pregnancy.

  JVux vomica and Sulphur. — In the  majority of
cases, the alternate use of  these medicines will afford
marked relief, especially in persons who have indulged
in coffee, or stimulating drinks, or who lead an inac-
tive  life, and when there are alternate  constipation
and diarrhoea, frequent protrusion of the lower bowel,
pain in the small  of the back, painful  urination, with
aggravation of the symptoms  after meals and during
mental labor.  A dose of JVux vomica at night, and
one of  Sulphur  in the  morning,  for  one  or  two
weeks.
  Aloes. — Haemorrhoids  attended  with bilious de-
rangement or torpor of the liver, and profuse discharge
of blood, which  feels  hot and  is  dark-colored.   It
may be administered in alternation with  Sulphur, or
it may precede or follow the use of that remedy.
  Aconitum. —Often  useful to commence  the treat-
ment with, when there are sensations of fulness, heat,
inflammation, and throbbing  in  the  anus and small
of the  back, and  discharges of bright-red blood.   A
dose every fourth hour, for one  or two  days, to be
followed by some other suitable remedy.
  Chronic Piles require one or more of the follow-
ing remedies, which  will be most advantageously
administered twice  or thrice daily, in the intervals
between the attacks:  Calc. carb.,  Carbo veg., Nit.
Ac, Ars., Phos., Lye, and  Sulph.
  Accessory Means.—In external  piles, Dr. Nor-
ton remarks,  great comfort will be found by applying
cotton  wool  to the  part;  it requires no  bandage to
keep it in its place, and can be renewed  as often as
required.   In internal piles, half-a-pint to a  pint of 
Piles.               '      127
water injected up the bowel in the morning has often
a most salutary effect;  it constricts the blood-vessels
and softens  the faeces before the accustomed evacua-
tion.   An india-rubber syringe, with an  ivory tube,
should be used, it being much  more efficient, and less
liable to injure the part, than  glass.   If the tumors
are too  painful  to permit  of injections, the parts
should  be  washed with tepid  water;  if  they  are
much  swollen  and  extremely  tender,  the  patient
should sit over  the steam of  hot water, or  foment
the parts with moderately warm water.  When the
inflammatory symptoms have  subsided, washing the
parts  with cold  water,  and cold injections, will do
much  good.
  The Abdominal Wet Compress. —This is made
of three  or  four thicknesses of coarse  linen cloth, to
fit the  individual,  so as to cover  the whole abdomen,
including the liver and spleen, and  extend down to
the pubes.   This  is to be wrung out  of cold water,
covered with oiled-silk or india-rubber cloth, to prevent
too rapid evaporation, and  secured  by  three  broad
tapes round the hips and waist.  The compress should
fit as closely as possible, so as to avoid displacement,
otherwise air enters  between  it and  the skin,  and
cold, instead  of a moist heat, is produced.   The best
time for wearing it  is during the night; and when
taken  off in the morning,'the part which has been
covered should  be sponged with  cold water.  " The
wet compress," says Dr. Baikie,  " is equally applica-
ble to all uterine diseases, and indispensable in most."
This gentleman  also prescribes it in various affections 
 128      r     Disorders of Pregnancy.

 of the throat, and in chronic constipation and  dys-
 pepsia.
   Cold sitz-baths are rarely admissible in piles, as they
 increase local congestion  by the reaction they occa-
 sion, and should not be used except by medical advice.
   The Diet. — In piles  this  should  be moderate,
 unstimulating, and easy of digestion.   Coffee,  pep-
 pers, spices, the excessive  use of animal food, and all
 stimulating beverages, should be avoided.   A  liberal
 quantity of vegetables and ripe fruits is recommended.
 Bread made from unbolted flour is inadmissible.   On
 this  subject, Dr. Baikie, in a communication  to the
 writer, makes the following remarks:   " Bread from
 unbolted flour is both wholesome and  nourishing for
 those accustomed to it from infancy;  and  to people
 suffering  from simple constipation, without piles, its
 occasional  use, instead of physic, is most desirable.
 But in all cases of piles, or when the rectum is irrita-
 ble, the  mechanical action of the spiculae of bran is
 most injurious, and sure to produce aggravation."


         IX. — Incontinence  of Urine.

  The bladder  is  frequently affected  in pregnancy.
The patient is tormented with a frequent and painful
desire to urinate, which, if not immediately gratified,
may result in  an  involuntary discharge of urine.  If
the patient has a  cough,  the  inconvenience will be
greatly increased, as each paroxysm will be likely to
allow the urine to escape.  In  many cases this  condi-
tion is very distressing; the constant discharge excori-
ates the parts more or less,  so that the patient can only 
              Retention of Urine.               129

move about  with pain; whilst at the  same time an
offensive urinous odor is exhaled from the person.
   Treatment.  — Pulsatilla.  — Incontinence  in
feeble, sensitive patients, of gentle and timid dispo-
sitions.   There  is frequent desire to urinate, with
spasmodic  pain  in  the neck  of  the  bladder,   and
watery urine.  A dose every four hours.
  Nux vomica. — This remedy  is useful  in females
of an opposite disposition, with similar symptoms.
   Cantharis.—Great  irritation  of the  bladder, with
irresistible desire  to  urinate, and discharge of only a
few drops o*f  scalding or acrid urine.
  Belladonna.—Relaxation of the neck of the bladder,
and  consequent  inability to retain the urine.   The
emissions are copious, frequent, and the urine pale and
watery, or yellow and  turbid.
  Cannabis—Involuntary emissions, from irritation of
gravel or sand in  the bladder.
  Accessory Means.—See the next section.

           X.—Retention of Urine.

  This, the opposite condition to the former, may arise
from similar  causes, and be met by pretty nearly the
same remedies.  It requires prompt attention, as  the
pressure of the over-distended bladder upon the uterus
may occasion serious inconvenience.
  Treatment.—The  principal  remedies  are—Can-
tharis, Aconitum,  Belladonna,  Nux vomica, Cam-
phor.
  Cantharis.—Urging to  urinate, with cutting and
tearing pains.
    6* 
130          Disorders of Pregnancy.

  Nux vomica.—Painful ineffectual desire to urinate,
with  discharge,  drop  by drop,  especially in  persons
accustomed to the use of wines  and  spirits.   This
remedy will often  enable the bladder  to recover  its
contractile  power.
  Aconitum.—Retention, with  inflammatory symp-
toms ; congestion to the head, redness of the face.  It
may be alternated with, or precede Cantharis.
  Camphor.—A valuable remedy in spasmodic reten-
tion, at the commencement of the difficulty, and when
but little fever exists.   Coldness and shivering are fur-
ther indications for this remedy.   It is best adminis-
tered  on loaf-sugar, two drops  every  fifteen  minutes
for three times.
  Administration.—Except the tincture of  Camphor,
a dose of the selected remedy every one to four hours,
according to the urgency of the  symptoms.
  Accessory Means in Urinary Difficulties.—
The patient should make regular efforts to pass water;
and if she fail in her  endeavors, the catheter may be
introduced  at certain intervals until the medicines shall
have restored the functions of the bladder.  If the re-
tention should arise from an accidental delay in not at
once satisfying the call of nature, a single introduction
of the catheter will generally remove the  difficulty.
Often, however, the use of the catheter is entirely sup-
erceded by one or more of the medicines just recom-
mended, or even  by the following measures.   The
sudden application of a towel to the bowels, after im-
mersion in cold water, causes an immediate contraction
of the bladder,  and  consequent discharge of urine.
Sometimes the alternate application of a hot and cold 
           Itching of the Genital Parts.        131

wet towel  is speedily successful.  Fomentations, and
injections of water into  the  bowel or  vagina, afford
great relief, and often supercede the use of the catheter.
The diet must be sparing, and in severe cases be re-
stricted to gruel and demulcent  drinks—barley-water,
gum-water, linseed-tea,  or  simple cold water.   All
acid  drinks must  be avoided, and everything that is
very salt.

     XL—Itching of  the Genital  Parts.
                 {Pruritus vulve).

  Symptoms.—An aphthous efflorescence, similar to
the thrush of infants, incrusts the inner surface of the
labia and adjacent parts in this disease;  sometimes the
affection penetrates to a considerable depth in the di-
rection of the womb.  In other instances, the aphthous
condition is not  present, but, in place of it, there is a
great deal of irritation of the same parts, which assume
a copper color, and present a number of slight abra-
sions.  From the  whole of the  parts laboring under
this  peculiar  irritation,  a vitiated watery discharge
seems to be almost  constantly oozing, the accumula-
tion of which is attended with the most indomitable
itching.  This disease is not confined  to pregnancy,
but may attack a female  at any time;  she is, however,
most liable to it during gestation, and at the decline of
the menses (Williamson).
  This  pruritus  sometimes  causes miscarriage,  and
ought not, therefore, to be neglected.   It  is more liable
to occur in women who  have had leucorrhoea, or per-
haps some slight but persistent trouble with the  urin- 
132          Disorders of Pregnancy.

ary function.  In others it  is  a concomitant  of the
sore-mouth  which  may exist  during  pregnancy, or
lactation, or both.   In rare  cases, this  affection  may
alternate with other diseases, as for example,  inflam-
mation of the eyes.                             L.
  Causes.—The increase of fluids in this part in the
early months of pregnancy, when it is not infrequently
experienced; any conditions leading to congestion of
the generative organs, as  inactive habits,  too much
sitting, especially if combined with too high living, or
the use of stimulants; at times it is owing to an aph-
thous form of inflammation of the mucous membrane
of the vagina.  A  want of  proper cleanliness,  also, is,
no  doubt, a  frequent  cause of this distressing  com-
plaint.   Disorders  of the  digestive  organs,—consti-
pation,  piles, etc., are frequently associated with this
condition.
  Treatment.—Aconitum.—If  the  parts are very
much congested, and the mucous lining of the vagina
looks as if engorged with blood.
  Mcrcurius.—If  the case  be  of the aphthous  variety,
after Aconitum has been administered for a day or two,
it may be followed by Mercurius, a dose  of which
may be  administered  every four  hours  for  several
days.
  Sepia.—Inflammation and  swelling of  the labia;
corrosive leucorrhoea, with bearing-down, itching, and
excoriation of the parts.  A dose thrice daily.
  Other remedies often  required:  Ars., Stan., Bell.,
Lye, Sulph.
  Accessory Means—Local  treatment is generally
necessary.   Frequent and thorough ablutions of  the 
Cramps.
r33
 external parts with tepid or cold water are very desira-
 able for the comfort of the patient, and, at the  same
 time, conducive  to  her recovery.   The  hip-bath, des-
 cribed  in  another  part of this manual  (see page 15),
 used several times daily during  an attack, and  perse-
 vered  in afterwards once a day, will be found very
 efficient in aiding  the cure, and of  preventing  this
 troublesome affection.  Temporary relief may be ob-
 tained  by  a solution of  borax in water, applied  two
 or three times a day to the parts; but  the above reme-
 dies and measures can alone be relied  on for a perma-
 nent cure.
   Other expedients are sometimes permissible and use-
 ful.  Thus a tablespoonful of Cologne water may be
 put into a teacupfull of warm water, and cloths which
 are moistened with this  mixture applied  directly.
 Scanzoni extols  a  liniment  composed of chloroform
 two parts  and almond oil thirty parts.   Others  have
 used a mixture of melted lard and chloroform.   L.


                  XII.—Cramps.

  Pregnant females are very liable to cramps or irreg-
 ular pains in the abdomen, loins, calves of the  legs,
 and feet, especially  about the fourth and  fifth  months,
 and towards the end of gestation.
  Causes.—The efforts made to support the  increas-
 ing weight of the abdomen, and to maintain the equi-
 librium of the body, which call  into increased  use
 certain nerves  and muscles, probably account for these
 sufferings.
  Treatment.— Veratrum.—Cramps  in the calves
of the legs and feet. 
 134          Disorders of Pregnancy.

   ATux vomica.—Cramps  associated with nervous £>i
 dyspeptic symptoms.
   Rhus tox.— Aching-pain from effort or fatigue, prin-
 cipally affecting the lumbar regions.
   In our observation nothing  has given such  signal
 relief to these cramps as the internal and local use of
 Camphor.                                      L.
   Administration.—A dose every one, two, or three
 hours, according to the severity of the  symptoms.


             XIII.— Varicose Veins.

   A dilation of the veins of the legs, causing the legs
 to become swollen  and painful, and  preventing the
 patient from  taking the necessary walking exercise, is
 a frequent accompaniment of pregnancy.
   Symptoms.—The enlarged veins are most frequent
 on the leg below the knee, but the veins of the thigh
 are also liable to be involved; in some cases  the veins
 of the labia majora, the vagina, and even of the os uteri
 become varicose.   Both limbs may be equally affected,
 but when the womb is more inclined to one side than
 the other, the corresponding limb will be affected most.
 Sometimes the foot becomes quite purple, from the
 congestion of the minute vessels, and the veins in the
 thigh and leg acquire an  enormous size.  The veins
get larger when the patient  is much  on her feet, or
allows the limb to hang down, but decrease in size
during rest and the horizontal posture.
   Cause.—Pressure of the enlarged womb upon the
iliac and inferior cava, and so obstructing the return
of blood from the  parts below.  It  is  most  frequent 
Varicose Veins.
135
 when the uterus is too low, when  the  person  is very
 heavy, and in those who have  borne many children.
 As the derangement is caused  by the pressure conse-
 quent on pregnancy, after delivery the veins soon re-
 gain their usual size.
   Treatment.— Pulsatilla.—Enlargement of  the
 veins, causing swelling of the limbs; the veins are of
 a bluish  color, painful  and inflamed.
   Nux   vomica.—Varices, with  enlargement of  the
 abdomen,  haemorrhoids, constipation, and  frequent
 bearing-down pains.
   Hamamelis virg.—In severe cases, with  profuse
 bleeding.  A dose every two or three  hours.  Exter-
 nal treatment is also necessary.   The  limb is to be
 bandaged from the toes to a little  above the knee, or
 to the hips if the disease extends above the knees;  be-
 neath this bandage, compresses of linen should be laid
 over the  enlarged veins,  and kept wet with a  lotion,
 prepared by adding one  part of the pure tincture of
 Hamamelis, to four parts of water.*
   Arnica, both internally and externally, may some-
 times be used instead,  if the  limbs or veins feel sore,
 and the circulation has been long impeded.
   Belladonna, Arsenicum, Lycopodium, and Sulphur,
 are also useful under certain conditions.
   Accessory Means.—A bandage, about two and a
half  inches in width, should be applied when there is
least swelling, commencing at the foot and proceeding
upward with a gentle and equal pressure; this will be
found very useful in  recent cases, but less so in those

  * Or with the "Distilled Extract of Hamamelis." 
136          Disorders of Pregnancy.

of long continuance.  The best support, however, is
that obtained from an elastic silk stocking, which will
draw on like an ordinary stocking.   To ensure its  fit-
ting the foot and leg, it should be  made  to  measure.
All ligatures, such as garters, must be removed.  Rest,
in the  recumbent posture, or the limb kept  in a hori-
zontal position, is necessary in severe cases.

XIV.— Swelling  of the  Extremities {QSdema).

  In advanced pregnancy, women often suffer from a
puffy swelling  of the ankles, and  sometimes of  the
thighs, or even of the external genital parts.   Change
of posture has great influence upon the swelling of  the
legs; in the morning it is but slightly perceptible, but
during the day it increases, and towards  night it is at
its greatest degree.
  Treatment.— Arsenicum.— OZdema with much
debility, weakness,  and prostration;  feeble and irreg-
ular pulse, and coldness of the extremities.
   China.—Dropsy  occasioned by loss of blood, diar-
rhoea, or dysentery.
  Ferrum.—GSdema depending  on  an anaemic or
chlorotic condition.
  Administration.—A dose three or four times daily.
  Accessory  Means—Rest in the recumbent pos-
ture often lessens the  inconvenience.   See " Varicose
Veins."

         XV.—Vertigo and Headache.

  Another derangement not uncommon to this period
is Vertigo or Giddiness.  In  the  early months it is 
Vertigo and Headache.
l37
 generally of a nervous character;  at a later period it
 frequently arises from plethora.
   Symptoms.—The following are generally present:
 variable, capricious, or diminished appetite;  dimness
 of sight; disposition to fall forward; a feeling of weight
 on the top of the head or back of the  neck;  palpita-
 tions;  nervous  tremblings,  etc.  In most cases the
 symptoms are worse in the morning.
   Treatment.—Aconitum.— Giddiness as if intoxi-
 cated, on rising from a seat, faintness on rising from a
 recumbent  posture, with  dimness  of vision,  heavy
 pressive pains on the  top of  the head or in the fore-
 head, redness of  the  eyes, intolerance of light, dark
 spots before  the  eyes,  scanty urine, etc.  Especially
 suited  to plethoric women of florid  complexion  and
 nervous temperament.
   Belladomia.—Rush of blood to the head with stag-
 gering  and trembling; buzzing in the ears;  violent
 throbbing of the arteries of  the temples;  sparks be-
 fore  the eyes,  double vision, intolerance of light  and
 noise; disinclination to move.
   Nux vomica.— Constipation;  suppressed  or scanty
 urine; bitter, acid, or insipid  taste;  the symptoms are
 worse in the morning and better in the open  air.   It
 is chiefly suitable for irritable  persons, of  sedentary
 habits, or who take wine, coffee, etc.
   Opium.—Drowsiness, imperfect sleep, heavy breath-
 ing, giddiness, with stupidity or illusion of the senses.
   Other remedies to select from are: Pulsatilla, Sepia,
Platina, and Sulphur.
   Adtninistration.—A dose every two or three hours; 
138         Disorders of Pregnancy.
in mild cases, or during improvement, morning and
night.
  Accessory  Means.—Regularity  in   meal-time,
avoidance of stimulating food and drinks, especially
spirits, strong tea, coffee, etc.  The daily action of the
bowels should be promoted  by such measures as are
prescribed under " Constipation: " and further, a suffi-
cient amount of recreation should be taken every day
in trie open air.

         XVI.—Melancholy,  Fear, etc.

   Fear, anger, joy, grief, etc., operate powerfully upon
the heightened susceptibility of the pregnant state, and
may affect  both the mother and child unfavorably.
A morbid dread, causing the  sufferer to view events
through a darkened and distorted medium, may pro-
duce trembling of the  body, weakness of the limbs,
alarming dreams, nightmare, nervous irritability, lcad-
ino-  her to despair of  life,  and  even  to wish that  it
were extinct.  Injudicious friends often aggravate this
morbid  state of feeling, by  recounting accidents and
unpropitious  results of  pregnancy which  probably
never occurred.   Such  thoughtlessness cannot be too
strongly deprecated.  The statements are, as hinted,
almost always untrue, but they may appear so real  to
the patient as to operate powerfully on her mind, and
thus produce the  most serious  results.   Everything
should be done—not to agitate her mind, but to calm
and assure it.
   Treatment. — Aconitum.—Palpitation  and ex- 
Hysterical and Fainting  Fits.        139
 citement  from  fear  and  apprehension;  restlessness
 and anxiety.
   Pulsatilla. — Melancholy  and  tears;  headache;
 heartburn,  and  uneasy  feeling  at  the  pit  of the
 stomach;  a multitude of  cares  oppress the  mind.
 In such cases,  Pulsatilla  often  produces a satisfac-
 tory change in  the whole  system.
   Opium. — If anxiety, oppression of the chest, trem-
 blings, etc., have been produced by a sudden fright.
   Chamomilla. — From violent passion.
   Coffca. — From  sudden joy.
   Ignatia. — From sudden or  long-continued grief.
   Administration. — In sudden attacks, a dose every
 half-hour or hour, for two or  three times; in slight
 cases, two or three  times daily.
   Accessory Means. — Useful occupation,  com-
 bined with out-of-door exercise, and cheerful company
 or books.


    XVII.—Hysterical and Fainting Fits.

   These are not frequent accompaniments  of preg-
 nancy, except at the period of quickening, and in weakly
 and  delicate females.   The fits  are far from  being
 serious, except when  associated  with organic disease
 of the heart.  If they occur towards the end of preg-
 nancy, they may render convalescence after  parturi-
 tion more tedious than  it would otherwise be.   They
 arc also unpleasant occurrences  at the time of  labor.
  Symptoms. — These differ greatly  from  epileptic
fits, as  there is  no choking noise in the throat,  or
biting of  the tongue.   (See the section on  " Hyste- 
 140          Disorders of Pregnancy.

 ria.")   There  is a sensation of languor, with dispo-
 sition  to yawn;  everything  appears to turn round;
 the sight becomes defective, the face pale, with  buz-
 zing and ringing in  the ears; the patient sighs and
 becomes insensible.
   Causes. — A weakened  state of the system, from
 diarrhoea or other discharges; prolonged sleeplessness;
 intense toothache; anger or fright.
   Treatment.  —  Moschus. —  Sudden  faintings,
 with vertigo,  or tendency  to  hysteria, spasms, etc.
   Camphor. — Fainting fits with chilliness.
   Veratrum. — Fainting associated  with prolonged
 diarrhoea  and  sickness.
   China. — Fainting  from debilitating discharges.
   Ignatia. — If  the  patient  is feeble,  melancholy,
 and  ready to weep  upon  trivial provocation.
   Chamomilla. — If a fit  of passion has occasioned
 the affection.
   Nux vomica. — If  the patient takes too little out-
 of-door exercise, or suffers from constipation.
   Pulsatilla. — If  the  patient is of  great  nervous
 susceptibility, with a  disposition  to shed tears.
   Administration. — During  a  fit, a dose  of the
 selected remedy  every ten or fifteen minutes;  after-
wards,  every three or four  hours.
   Accessory Means. — The exciting cause must, if
possible, be removed, and the patient strictly adhere
to the dietetic and general rules as recommended  in
the third section of the introductory chapter. 
          Pain  and  Tension of the Breasts.      141

   XVIII. — Pain  and Tension of the  Breasts.

    Some women are  troubled with a pricking, or acute
 pain  in one or both breasts; the pain  may become
 exceedingly troublesome, constant, or recur in  parox-
 ysms ;  generally there  is no fever, although excessive
 suffering may cause sleeplessness  and  want  of appe-
 tite.
   Causes. — Sympathetic  irritation in the breasts,
 through pregnancy, which determines a flow of blood
 to those organs;  compression  of the breasts with
 stays, etc.

   There are those who suffer from swelling and hard-
 ening  of the  breasts  whenever  they menstruate.
 Painful and protracted menstruation  is very  apt to
 be accompanied  by this  symptom.   Sometimes it
 results  from  the presence of some foreign  growth
 in the  womb,  or from  enlargement of  the  ovaries,
 as in ovarian  dropsy.    More frequently  it  is inci-
 dent  to pregnancy,  in which case it  may  become
 so severe in degree as indirectly to  induce abortion.
                                              L.
   Treatment. — Bryonia is  the  most  important
 remedy, especially when there is a pricking sensation
 without inflammation.
   Belladonna.  — Erysipelatous  redness,  heat, and
 hardness.
   Administration. — A dose thrice daily for three or
 four days.
   Accessory Means. — No  tight  articles of dress
 should be worn.

   The application of a thick layer of cotton  batting to
the breast, and worn for some time consecutively, will
afford great relief;  or, anoint  the breast with a mix- 
142          Disorders of Pregnancy.
ture of Tinct. of Hamamelis and Sweet Oil, in  the
proportion of one  part  to ten, or of Chloroform one
part, and Glycerine twenty parts.               L.


        XIX. — Abortion — Miscarriage.

  When the expulsion of  the  foetus  occurs  in  the
early  months  of pregnancy,  it is termed  abortion;
after about the sixth month, miscarriage.  The words
are, however, often used synonymously.   When mis-
carriage has once  occurred, a predisposition to it is
engendered in subsequent pregnancies, and especially
at about the corresponding period.  The treatment
should, if  possible, be confided to a Homoeopathic
practitioner.  Abortion or miscarriage must  be  re-
garded as  a very serious evil;  it not only deprives  the
mother of the  product of her pregnancy, but often
places  her  health and even life in peril.
  Symptoms. — These  may be grouped under three
stages:
  1st.   Slight  Symptoms of Miscarriage. — A feel-
ing of indisposition to exertion, depression, weakness
and uneasiness at the bottom of the back and  at  the
lower  part of the  abdomen, and  other symptoms
resembling those which often precede menstruation.
  2nd.    Symptoms directly  threatening  miscar-
riage. — Slight  and  increasing discharge of  blood;
cutting pains in  the loins and abdomen, recurring in
paroxysms, and wittvincreasing intensity.
  3rd.  Miscarriage. — The  pains become severe,
and  recur at  regular  intervals;  there are  bearing-
down,  serous discharges, and expulsion  of the foetus. 
             A bortion—Miscarriage.            147

  Causes. — The most frequent exciting causes are
the  following:   Over-reaching;  falls  and blows;
taking a false step in going up or down stairs;  lift-
ing heavy weights; long walks;  horseback  exercise,
or riding in carriages over rough roads;   dancing;
late hours;  tight garments, especially such as exert
undue compression upon the abdomen; indigestible
food;  purgative drugs,  especially  such  as operate
directly upon the uterus;  violent mental emotions, as
anger, grief, fright, etc. Also all circumstances which
immediately or remotely excite abnormal contractions
of the uterus, and thereby  produce expulsion of its
contents.
  To which add,  excessive care from nursing  the
sick;  exposure  to  malignant  scarlatina,  diphtheria,
small-pox,  or typhus fever;  attacks  of dysentery,
and  cholera morbus;  uterine  dislocations  in  the
early  months;  and  too frequent sexual indulgence.
                                              L.
  The predisposing causes are:   Feebleness of con-
stitution;  too slight an attachment  of  the embryo to
the womb  during the early part of pregnancy;  pro-
fuse  menstruation;  too great rigidity  of the uterine
fibres,  and an unyielding condition of the  walls of
the womb, which opposes too much resistance to the
expansion  which  that organ ought to undergo;  a
relaxed condition of  the uterus or of the neck of the
womb;  long-continued  leucorrhoea;  acute  diseases,
particularly those of  the uterus and  abdominal  vis-
cera ; want of sufficient healthy exercise, by which the
vigor of the entire system is maintained unimpaired.
  One of the strongest  predisponents  of abortion,  is
the return of "the  month."  Just at  the  time the 
144          Disorders of Pregnancy.
pregnant woman  should have  menstruated, she will
be a thousand times more likely to miscarry than at
any other period.   For this reason, and throughout
pregnancy,  whenever the month  comes round,  she
should be especially careful  and  quiet for some days.
This one precaution may be sufficient to cure what is
improperly styled the habit of aborting.        L.
  Treatment. — Homoeopathy possesses such effec-
tive remedies for averting miscarriage,  even in very
unfavorable cases, or, where  miscarriage is inevitable,
of preventing its injurious effects to the constitution,
that none need despair of a fortunate result.   The fol-
lowing are a few of the remedies to be used according
to the indications present:
  Secale. — Severe forcing-pains, with  discharge  of
dark blood  at each pain; and when the patient  has
been previously affected  by painful menstruation; also
after miscarriage.
  Sabina. — Miscarriage from  irritation,  especially
at about the third or four month, even if labor-pains
and a discharge of blood have set in.
  Crocus. — Profuse discharge of blackish clotted
blood.
  Ipecacuanha. — Flooding of bright-red blood, with
nausea  and  tendency to faintness.   Also  useful  in
preventing  miscarriage  when  the  patient first expe-
riences  pressure downward, sickness,  coldness,  etc.
  Administration. —  A dose  every  one  to three
hours,  according  to  the urgency  of the  symptoms.
  Accessory Means. — Immediately after a patient
has had the least " show," she should lie down in a
cool, well-ventilated room, on a sofa or  hair mattress,
and maintain that  position till all  symptoms of mis- 
A bortion—Miscarriage.
H5
 carriage  have disappeared.   Merely resting the  legs
 and  feet is quite insufficient.  In cases, however,  in
 which miscarriage is only apprehended, it is not neces-
 sary to restrict the patient wholly to the recumbent
 posture;  gentle and moderate out-of-door exercise  is
 necessary, as entire rest weakens the constitution  and
 augments any existing predisposition.   Sexual inter-
 course must be avoided;  also coffee and all kinds of
 drink that occasion flushings, excitement, etc.
   Treatment after Miscarriage. — China  will
 generally be  found advantageous in  restoring  the
 enfeebled system  after  miscarriage.    A dose  four
 times a day for a day or two.
   Pulsatilla. — This remedy is very useful in restor-
 ing the tone of the uterine organs.  It may be given
 thrice daily for a week or two.
   See also the chapter on " Menstruation too Profuse."
   The patient should be kept quietly in bed, and  the
 same care be taken  of her by the nurse as if she had
 gone through  with labor  " at term."   The nine-days'
 rule is just  as applicable  in  the one  case as  in  the
 other.  One reason why  there are so  many  dilapi-
 dated, broken-down women  in  community, is, that
 these patients are allowed to get up and  go around
 almost  immediately th<Twomb is emptied  of its con-
 tents;  as if it could fold upon itself and recover from
 the shock without the necessary time and repose of
 the organ.  Perhaps one-half  the cases  of uterine
 displacement are due to this cause alone.      L.
  Preventive Remedies.—Where a predisposition
to miscarriage exists, the following treatment should
be commenced as soon as the person is known to be
pregnant,  and  continued for two or three months.
  Actea Rac — This is one of the best remedies  for
    7 
 146          Disorders of Pregnancy.

 preventing  miscarriage, the tendency to which it not
 only corrects, but, administered for some time before
 parturition, is said to facilitate that process.
   Secale, Sabina,  and Calcarea are also  valuable
 remedies.
   Administration. — A dose morning and night.
   General Preventive Measures.— When, from
 delicacy of constitution or a previous miscarriage, there
 is reason to apprehend its recurrence, every attention
 should be directed towards  maintaining as vigorous a
 state of constitution as possible.   The diet should  be
 good and liberal, but restricted to wholesome  and di-
 gestible  kinds of food.  Open-air exercise should  be
 taken for two or three hours a day, if it  can  be done
 without fatigue.  A hair mattress is the  proper  kind
 of bedding to sleep upon, and cold or tepid  sponging
 should be  practiced night  and morning, whether  in
 summer or winter.  Sometimes a hif-bath should  be
 conjoined with the sponging.  The patient should  sit
 in the bath, about half filled  with water, for about three
 or four minutes, on rising in the morning.  Whilst in
 the bath, the water should be dashed upon the stomach
 and  back, with the hand, or by  means  of a  sponge.
 After the  bath, the  body should be rubbed with a
 strong rough towel, until the skin  becomes red.  (The
 hip-bath is more fully described on page  15).   When
there are distinct threatenings of  miscarriage,  the pa-
tient must  strictly confine herself to the recumbent
posture, even for weeks, should  it be  necessary;  and
especially after miscarriage has#taken place, must she
retain that position for at least several days.  We must
insist on the necessity for allowing the uterus a period 
A bortion—Miscarriage.
HI
of rest, which is  equally necessary after an  abortion,
and after an ordinary labor; in many cases, the habit
of abortion is only to be broken through by enforcing
a separation of the husband and wife for some months,
during which time efforts are to be used to reduce the
uterus to its normal size and to its natural condition
{Dr.  Graily Hewitt).  Along with the repose of the
body  here recommended, a quiet and tranquil state of
mind, should, as far as possible, be maintained.  Dur-
ing the whole term of pregnancy, hot drinks,  especi-
ally hot tea, should be avoided  {Norton). 
148
CHAPTER VII.

   LA BOR.
   I.—Calculation of the Time of Labor.

  The following table will be especially valuable  to
the newly-married lady, who, through delicacy, might
hesitate to seek advice on  a subject of great  import-
ance and interest.  Much time may be  saved, often
great anxiety avoided, and timely medical and  other
attendants secured, by ability to approximate in  reck-
oning to the hour of solicitude and hope.
  The period of pregnancy, from conception till con-
finement, is calculated at  ten  lunar months, or forty
weeks, which amount to 280  days.  It is sometimes
reckoned at nine calendar months, that is, 273  days,
or 39 weeks;  probably, however, forty weeks is the
safer  reckoning,   When  the  date  of conception  is
known, the reckoning begins from that day.  If that
be not known, then the calculation must commence
from the last monthly period.   If the time of the last
monthly course cannot be remembered, then  that of
quickening, or when the movements of the child are
first  perceived,  must be made  use of.  Although  in
women sexual connexion is not confined to the time
When the ovarian follicles burst, yet it is an old obser-
vation, confirmed by the experience  of some of the 
Calculation of the  Time of Labor.
most eminent modern accoucheurs, that conception is
more likely to occur within a few days after the cessa-
tion of the  menstrual flux than at other times;  and
hence some medical men reckon the duration of preg-
nancy at nine months and eight  days from  the last
menstrual period.
   Ladies who make use of the annexed table, should
bear in mind that the period of pregnancy is slightly
altered by the age of the  parties  concerned; the fact
being fully and   undeniably proved,  viz., that the
younger the husband and wife, the shorter the  term
of utero-gestation; and vice versa,  as age increases, the
term  of gestation is proportionably lengthened, {Clay).
   Dr. Clay  states that he once witnessed a curious ex-
periment in reference to this  subject, on  the  eggs of
domestic fowls.  Poult eggs can be easily distinguished
from  those  of  hens of three  or more years old.  A
certain number of them  were placed under a young
hen, and an equal number of eggs from older fowls
under an old hen.  The  result was, that every chick
had escaped its shell from under the young hen at least
twenty-four hours, some  even as  much as thirty-six,
sooner than  those of the old  hen.   This  difference is
very remarkable  in so short a  period of incubation.
He infers from this, and other circumstances, that the
duration of  the gestative  period is far more definite
than has hitherto been supposed, and  that where the
circumstances are similar, the  result  as to the length
of term is very nearly the same.  In maintaining that
utero-gestation  is  definite  and regulated  by age, the
age is not to be calculated by that of the mother alone,
but by the combined ages of both parents. 
r5o
Labor.
Calendar Indicating the Three  Periods  of
                 Gestation.
Concep.		^jiick.	Labor. Co	ncep.	Quick.	Labor.
[an. 1 M		ay 20	Oct. 7 Fe	b. 9	June 28	Nov. 15
2		. 21	..8	10	•• 29	.. 16
	• 3 •	. 22	.. 9	11	.. 30	.. 17
	• 4 •	• 23	10	12	JulJ 1	.. 18
	• 5	■ 24	11	13	2	.. 19
	. 6	• 25	.. 12	14	•• 3	20
	• 7	. 26	..13	15	• • 4	21
	. 8	• 27	..14	16	• • 5	22
	• 9	. 28	..15	17	.. 6	•• 23
	. io	. 29	..16	18	• • 7	•• 24
	. n	• 30	..17	19	.. 8	• • 25
	. 12	• 31	..18	20	.. 9	.. 26
	• *3 Ji	ine 1	..19	21	.. 10	.. 27
	• J4	2	.. 20	22	11	.. 28
	• *5	• 3	..21	23	12	.. 29
	. 16	• 4	..22	24	• • 13	.. 30
	• 17	• 5	..23	25	.. 14	Dec. 1
	.. 18	.. 6	..24	26	.. 15	2
	.. 19	• • 7	..25	27	.. 16	3
	20	.. 8	..26	28	.. 17	4
	.. 21	.. 9	.. 27 Mi	ir. 1	.. 18	5
	.. 22	.. 10	..28	2	.. 19	6
	• • 23	11	..29	• 3	.. 20	7
	.. 24	.. 12	..30	• 4	.. 21	8
	• • 25	• • J3	..31	• 5	.. 22	9
	.. 26	.. 14	Nov. 1	6	•• 23	10
	.. 27	• • i.S	..3	• 7	.. 24	11
	.. 28	.. 16	• • 3	. 8	•• 25	12
	.. 29	• i7	.. 4	• 9	.. 26	• • 13
	.. 30	. 18	• • 5	. 10	.. 27	.. M
	• • 31	. 19	.. 6	11	.. 28	.. is
F	eb. 1	. 20	.. 7	12	.. 29	.. 16
	2	. 21	.. 8	13	.. 30	.. 17
	• • 3	. 22	••9	H	•• 3i	.. 18
	•• 4	• .23	.. 10	15	Aug. 1	.. 19
	• • 5	• 24	..11	16	2	20
	.. 6	• 25	.. 12	i7	•■ 3	21
	■• 7	. 26	..13	18	• • 4	22
	.. 8	• 27	. 14	l9	•• 5	• • 23
 
Calculation of the
Concep.  Quick.   Labor.
Mar. 20		Aug. 6	Dec. 24
.. 21		■■ 7	•• 25
	.. 22	.. 8	.. 26
	•• 23	.. 9	.. 27
	•• 24	.. 10	.. 28
	•• 25	11	.. 29
	.. 26	.. 12	.. 30
	.. 27	•• 13	•• 31
	.. 28	.. 14	Jan. 1
	.. 29	•• *5	2
	.. 30	... 16	•• 3
	■• 3i	.. 17	4
A	pril 1	.. 18	•• 5
	2	.. 19	.. 6
	■• 3	.. 20	•• 7
	•• 4	.. 21	.. 8
	■ • 5	.. 22	•• 9
	.. 6	•• 23	.. 10
	• • 7	.. 24	.. 11
	.. 8	•• 25	.. 12
	• 9	.. 26	•• *3
	. 10	.. 27	.. 14
	. 11	.. 28	•• 15
	. 12	.. 29	.. 16
	• *3	•• 30	.. 17
	• H	•• 3i	.. 18
	• 15	Sept. 1	.. 19
	16	2	.. 20
	• 17	•• 3	.. 21
	. 18	•• 4	.. 22
	■ *9	•• 5	•• 23
	. 20	.. 6	.. 24
	. 21	•• 7	.. 25
	. 22	.. 8	.. 26
	• 23	• 9	.. 27
	. 24	.. 10	.. 28
	• 25	.. 11	.. 29
	. 26	.. 12	.. 30
	• 27	•• 13	•• 3i
	. 28	■• H	Feb. 1
	. 29	■• 15	2
	• 3o	.. 16	•• 3
M	ay 1	.. 17	.. 4
Time of Labor.      151
Concep.		Quick.	Labor.
May 2 Sept. 18			Feb. 5
■• 3		.. 19	6
	•• 4	. . 20	7
	• • 5	. . 21	8
	.. 6	. . 22	9
	■• 7	•• 23	10
	8	.. 24	11
	.. 9	•• 25	12
	.. 10	.. 26	•- 13
	11	.. 27	.. 14
	12	.. 28	15
	•• 13	.. 29	.. 16
	•• H	•• 30	.. 17
	.. 15 (	)ct. 1	.. 18
	.. 16	2	.. 19
	.. 17	•• 3	20
	.. 18	•• 4	21
	• 19	• • 5	22
	.. 20	.. 6	.. 23
	.. 21	• • 7	.. 24
	. 22	.. 8	.. 25
	• 23	■• 9	.. 26
	• 24	10	.. 27
	• 25	11	.. 28
	. 26	12	Mar. 1
	• 27	■• r3	2
	. 28	•• 14	3
	. 29	• • 15	4
	• 3°	.. 16	5
	• 31	.. 17	6
>	ine 1	.. 18	7
	2	.. 19	8
	• 3	.. 20	9
	• 4	.. 21	10
	• 5	.. 22	11
	. 6	•• 23	12
	• 7	.. 24	•• 13
	. 8	■• 25	14
	• 9	.. 26	•• 15
	10	.. 27	.. 16
	11	.. 28	•• i7
	. 12	.. 29	.. 18
	• 13	•. 3°	.. 19
 
r52
Labor.
	Concep.	Quick.
une 14	Oct. 31	Mar. 20	July 27	Dec. 13	May 2
■• 15	Nov. 1	21	.. 28	.. 14	3
.. 16	2	.. 22	.. 29	•• 15	4
•• 17	•• 3	•• 23	.. 30	.. 16	S
.. iS	•• 4	.. 24	•• 31	•• 17	6
.. 19	•• 5	•• 25	Aug. 1	.. 18	7
.. 20	.. 6	.. 26	2	.. 19	8
.. 21	•• 7	•• 27	•• 3	.. 20	9
.. 22	.. 8	.. 28	•• 4	.. 21	10
.. 23	•• 9	.. 29	•• 5	.. 22	n
.. 24	10	.. 30	.. 6	•• 23	12
•• 25	11	•• 3i	•• 7	.. 24	13
.. 26	12	April 1	.. 8	.. 25	•■ H
.. 27	•• 13	2	•• 9	.. 26	•• 15
.. 28	.. 14	• 3	.. 10	.. 27	.. 16
.. 29	•• 15	•• 4	.. 11	.. 28	.. 17
•• 30	.. 16	•• 5	.. 12	.. 29	.. 18
uly 1	•• 17	.. 6	•• J3	.. 30	.. 19
2	.. 18	•• 7	.. 14	•• 31	20
•• 3	.. 19	.. 8	•• JS	Jan. 1	21
• 4	.. 20	•• 9	.. 16	2	22
• 5	.. 21	.. 10	.. 17	.. 3	•• 23
. 6	.. 22	.. 11	.. 18	• • 4	.. 24
• 7	.. 23	.. 12	.. 19	.. 5	.. 25
8	.. 24	•• !3	.. 20	.. 6	.. 26
• 9	• • 25	.. 14	.. 21	• • 7	.. 27
. 10	.. 26	•• 15	.. 22	.. 8	.. 28
. 11	.. 27	.. 16	•• 23	• • 9	•• 29
. 12	. 28	.. 17	.. 24	.. 10	.. 30
• J3	.. 29	.. 18	•• 25	11	• 31
• 14	.. 30	.. 19	.. 26	.. 12	June 1
• 15	Dec. 1	.. 20	.. 27	• • 13	2
. 16	2	.. 21	.. 28	.. 14	3
• i7	•• 3	.. 22	•• 29	• • is	4
. 18	•• 4	•• 23	.. 30	.. 16	5
• l9	•• 5	•• 24	•• 3i	.. 17	6
. 20	.. 6	•• 25	Sept. 1	.. 18	7
. 21	•• 7	.. 26	2	.. 19	8
. 22	.. 8	.. 27	•• 3	.. 20	9
• 23	• 9'	.. 28	.. 4	.. 21	10
• 24	.. 10	.. 29	■• 5	.. 22	11
• 25	.. 11	.. 30	.. 6	•• 23	12
. 26	.. 12	May 1	•• 7	.. 24 |	13
 
Cfl
ONOob-^o^^^^wSoNOCxvroN^^^toMONO&^ON^^^K-o
4- Oo to w o NO 00-4 Onc^i 4* oo to M O NO 00
3.
                  tOtOtOMtOtOtOtOtOHnMMHIIMIIIIM
OC-I ONVi + UWm 00-4 OnVi 4*. Oo to m  o no 00-J Onc^i + Ojmm Od 00-1 Q\(j\ 4>. Oo
SI
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&£-££ S « ONO 5)M &£4-£ S S  QNO 00-4 ONCn^Oo to  -, % n£ &-S &£ £ £  g K g £ 3,-3 S,£ _£
    UklUUtJtJtlMUUMHHHMHHHHHH                     ..., .  ., .. „ , ., .
to « O NO 00-4 ONOi 4* U) to w  o NO 00-4 ONOi 4*. Oo to  m O NO 00-T On^ 4>- U> to ii « o NO 00-S 0\£ -£ <£ m m
"O  .
BnS So-s on^-^w g s Svo oo^r on^^w to m^^n^ &.$ &£££ s  s SnS a^3 o\£££ s
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               WHKIMMMNWMIJMIjmmhhnbmmmm                     ,  .
-T OV-n + W»hmC«C  00-4 ONOi 4^ Oo to w O NO 00-4 ONta 4> I/O to  « Q NO 00-4 ON<-n 4. Oo to « ^ Q no O0"^4 
154                   Labor.
Concep.		Quick.	Labor. C		oncep.	Quick.	Labor.
Dec. 3		Apr. 21	Sept. 8 D		ec. 18	May 6	Sept. 23
	■ 4	. . 22		• 9	• *9	•• 7	.. 24
	■ 5 . 6	•• 23 •• 24		10 11	. 20 . 21	.. 8 • • 9	■• 25 .. 26
	■ 7 . 8	•• 25 .. 26		. 12 • 13	. 22 • 23	10 11	.. 27 .. 28
	• 9	.. 27		■ H	• 24	.. 12	.. 29
	. io . n	.. 28 .. 29		• 15 . 16	• 25 . 26	•• 13 .. 14	.. 30 Oct. 1
	12 • 13	.. 30 May 1		■ 17 . 18	• 27 . 28	.. is .. 16	2 3
	• 14	2		• *9	• 29	.. 17	4
	• 15	•• 3		. 20	• 30	.. 18	5
	. 16	•• 4		. 21	•• 3i	.. 19	6
	• i7 1 •• 5			. 22			
II.—Causes of the Sufferings and Difficulties
          of Childbirth.—Civilization.

  Most of the sufferings  attendant upon  parturition
arise from those habits of life which it is the object of
this  manual to expose, and to guard the present gener-
ation from falling into;  such as—diet of an improper
quality, or quantity;  the use of stimulating beverages;
want of pure air and healthy exercise;   tight lacing;
late  hours; and other injurious habits.  Amongst sav-
age  tribes, child-bearing is comparatively free from the
suffering  and danger which too frequently attend it in
an artificial state of society.   Catlin tells us  that an
Indian woman on the march will often deliver herself,
and  safely rejoin her companions with her newly-born
child on her  back  before night has set in.  What a
contrast to the physical disabilities which follow in the 
                Obstructive  Causes.              ice

train  of  civilization!   Even in our  country healthy
women, of regular habits, accustomed to out-of-door
exercise, and whose general mode of life is natural, are
freed from the long train of miseries which are the too
frequent concomitants of the period of labor.
  The popular idea that the wild life of Indian women
exempts them altogether from the dangers and suffer-
ing contingent upon child-birth  is fallacious.   The
truth  is, they often die in labor for lack of proper treat-
ment.  Cases of preternatural labor are relatively more
frequent among women who are exposed to the hard-
ships  of frontier life  than with those who belong to
the better classes in our cities and towns.
  Oviparous animals have been known to lose their
lives while in labor, striving to be delivered of the egg.
This  is true of the  ostrich, the  tortoise,  and  other
creatures.                                      L.

               Obstructive Causes.

  At the same time, causes of difficult labor  may
exist of a more remote nature, and  less  directly refer-
able to the habits of the patient.  Such are—contrac-
tion and  deformity of the bones of the pelvis from
rickets, or from a similar disease in  adult life;  obstruc-
tion from tumors, dropsy, the large size of the child,
or from a hydrocephalic head;  wrong presentation,
etc.   The management of these cases requires profes-
sional knowledge and skill.
  Simpler causes of difficult or tedious  labors are—a
distended bladder; accumulations in the lower bowel;
or indigestion from a too full meal, or from food that
disagrees, taken just  before labor sets in.   Prompt
treatment suffices at once to remove these obstacles to
the progress of labor. 
i56
Labor.
                Powerless Labor.

  Powerless  labor  is generally due to constitutional
feebleness, as from  previous ill-health, too frequent
labors, etc.  Here, of course, preventive  treatment is
indicated.  This includes  nourishing  diet,  pure air,
suitable  exercise, and the  administration of  one or
more of  the remedies which our rich Materia Medica
offers.

             Preventive Treatment.

  This seems  a proper  place  to  make a remark on
treatment preparatory to labor  in cases about which
any difficulty  is apprehended.   Our  pharmacopoeia
contains remedies  which, selected  according to the
requirements of each case, and administered once or
twice a day for some time prior to parturition, tend to
facilitate that process, and even to correct conditions
that would otherwise operate  as  causes of difficulty.
Patients for whom we have prescribed during gesta-.
tion have  often told us of the comparative absence
of pains and difficulty which they had  experienced in
previous labors; and these  instances have  been too
numerous to allow of their being regarded  as mere
coincidences.   As  far as our observations extend, the
difficulties and  dangers of parturition are far less when
under Homoeopathic than when under  Allopathic
treatment; to say the least, they are then reduced to a
minimum, and especially when preparatory treatment
has been adopted.
  Means to ensure an Easy Labor.—Many expe-
dients have been resorted to during the later months 
             Preparations for Labor.          157

of pregnancy, with a view to shorten delivery and  to
lessen  the suffering  incident thereto.  Among  them
are the hip-bath, tight lacing, the local  and internal
use of Belladonna, Gelseminum, Macrotin and Cauto-
phyllin.  In a few cases physicians have had such con-
fidence in these measures that they have been tempted
to promise almost anything the patient  desired.  As
a rule  the experience of the profession is adverse  to
their  employment.  A more general reliance  upon
healthy exercise,  food, and  diversion, will secure the
best results, and leave the system free for proper medi-
cation  when it is necessary.  " He is the best physi-
cian who knows  when to do nothing."          L.


III.—Preparations for  Labor—The  Monthly
                      Nurse.

   She should be  a middle-aged  married  woman, or a
widow;  of temperate, kind, and cleanly habits; and
free from any defect  of sight or  hearing.  If such an
arrangement is convenient, the nurse should be selected
by the medical  man, be  engaged early, and, as the
whole  of her time and the best of her energies are  to
be devoted to the lady and  the  infant, she should be
liberally remunerated.


              The  Lying-in  Room.

  If practicable,  a  spacious,  well-ventilated   room
should be selected, which allows both the admission
of fresh air, and the  escape of tainted  air.  Renewal
of the air is generally best secured by occasionally
leaving the door ajar, having the fire place open, and
the top sash of the window more or less down accord- 
i58
Labor.
ing to  the  season.  Fresh air wonderfully aids a lady
to go  through  the  process of parturition.   If the
weather is  cold,  a fire may be kept  in the  room, but
neither the mother nor infant should be exposed to its
direct influence.


     Who  should be in the Lying-in Room.

  In addition to the medical man and the  nurse, one
female friend—not the mother of  the patient—may
likewise be present in the chamber;  she  should  be a
prudent, cheerful  person, and if  herself the  mother
of children, so  much  the better.   If convenient, the
mother of  the patient may be in  the house, or within
a short distance, the knowledge of  such  fact tending
to comfort the patient.  She should  not, however, be
in the lying-in-chamber, as maternal anxiety is there
often very  embarrassing.  Remarks calculated to de-
press the patient, especially any referring to unfavor-
able labors, are  strictly improper.
  Usage varies  in this respect in different countries
and communities.   In this country neither the mother
nor the husband is generally excluded from  the lying-
in chamber.                                   L.

              Minor Preparations.

  All  articles of clothing necessary for the mother and
infant  should be well  aired ready for immediate use,
and so arranged that they may be found in an instant.
A little fresh, unsalted lard;  about twelve inches length
of nice twine, or four or five threads; a pair of scissors;
and a  few patent pins.  Also a piece of water-proof 
             Minor Preparations.               159

sheeting, or strong oiled-silk, or even a common oiled-
cloth table-cover,  should be placed under the blanket
and  sheet over the right side of the bed to protect it
from being injured by the discharges.

           Attention to the Bowels.

  Attention to the action of the bowels is  necessary.
Generally the bowels  are somewhat relaxed—a wise
provision of nature,  for by  thoroughly emptying the
bowel, more space is gained for the birth of the child.
Should, however,  the bowels be confined, an injection
Of a  pint of tepid water will be sufficient to  empty the
intestine, and is far preferable to the common but rep-
rehensible practice of taking castor oil,  or  any other
aperient drug.   Ample experience leads us emphati-
cally to denounce  the practice of giving purgatives, as
both unnecessary  and  hurtful.   A  good injection of
water as soon as labor has set in,  however, especially
if the lady is costive, will not  only greatly facilitate
the birth of the child, but obviate the unpleasant oc-
currence of an  escape of fasces during parturition.  If
there is considerable collection of hardened fasces,  a
warm soap-and-water enema may be necessary.

                  The Bladder.

  During labor, a lady should never neglect to pass
water as often  as necessary.   The  proximity of the
bladder to the womb renders it most undesirable that
the  former should be distended with urine, as nature
requires the utmost available space for the passage of 
i6o
Labor.
the child.  This hint is especially necessary in first la^
bors,  when from  a refined sensibility, ladies  are apt
to suffer much inconvenience from inattention to this
point.   If there is inability to pass water, the measures
suggested in the section on " Retention of Urine," page
113, should be adopted, or the doctor should be  in-
formed of the fact.  The importance of attention  to
the state of the bladder during labor can scarcely be
overstated.

            Position of the Patient.

   During the  precursory stage of  labor,  she should
not confine herself to bed—not even to her own bed-
room, unless she desires it—but walk about a little; a
certain amount of unrest leads her from place to place,
and it would be most undesirable to confine her to her
bed.   A change of position is a good  preventive or
remedy for cramp  of the legs and thighs, which occa-
sionally comes on,  more especially when she is restrict-
ed to one position.   If medicine is necessary to remove
this symptom, see under  Cocculus and  Pulsatilla,
further on.

            IV.—False Labor Pains.

   Towards the close of gestation, a lady is apt to suffer
from pains which may be mistaken for those of labor,
but which are of a  perfectly  distinct character.
   Diagnosis.—The following table exhibits the differ-
ence between  true and false pains: 
False Labor Pains.
161
      True Pains

(i.) Come on and go off
  regularly, gradually in-
  creasing in  frequency
  and severity.
(2.) Are  situated in  the
  back and loins.
(3.) Are grinding or bear-
  ing down,  according to
  the stage of labor.
(4)  Arise from  the  con-
  traction  of the uterus,
  and the resistance made
  to its efforts, and on ex-
  amination, the mouth of
  the womb is found di-
  lated at each pain.
(5.) Are usually  attended
  with a show.
     False Pains

(1.) Are irregular in their
  recurrence, or, in some
  instances, are unremit-
  ting.
(2.) Are chiefly confined
  to the abdomen.
(3.) Are of a colicky na-
  ture.

(4.) Are caused by cold,
  flatulence,   indigestion,
  spasm, fatigue, etc., and
  have no effect upon the
  os uteri  (mouth  of the
  womb), which is found
  closed.
(5.) Are &;zattended with
  a show.
  Treatment.—Pulsatilla.—If the term of pregnan-
cy has not arrived, a dose of this medicine will gener-
ally quiet this abnormal action; and if it has, the prob-
able effect of the same remedy will be to change the
irregular into true and effective labor pains.

  Chamomilla.—This is  a valuable remedy, even if
there are cramps in the calves; there may be a tenden-
cy to bilious diarrhoea, and frequent urging to urinate.
  Aconitum.—Young, plethoric  females,  with  full
pulse, congestion to the head, flushed face, etc.

  Administration.—In severe cases, a dose of the se-
lected remedy every thirty minutes;  in milder cases,
every three or four hours until improvement ensues, or
another remedy is chosen. 
162
Labor.
     V.— Symptoms  and  Stages of Labor—
               Symptoms  of Labor.

  The earliest is a diminution of the size of the waist,
from sinking of the child lower down in the abdomen.
This subsidence of the womb gives the lady a feeling
of lightness and  comfort;  pressure on  the  thoracic
region being removed, she  breathes  more  freely, and
she is better able to take exercise.   Occasionally, how-
ever, this alteration in the position of the womb leads
to irritability of the bladder  by its  pressure on that
viscus, giving  rise to a frequent desire to  urinate.
After this symptom has existed for a few days, or even
in some cases only a  few hours, the more  immediate
symptoms  occur; these are, agitation, dejection of
spirits, flying pains, frequent  inclination to  relieve the
bladder and the   bowels,  relaxation of the  external
parts, and  a slight discharge of  mucus tinged with
red, technically called " the  show."   This  latter  is
the most certain indication  that labor has really com-
menced.
  At this  stage,   sometimes  shivering  and  sickness
come on;  but as they are not unfavorable  symptoms,
they require no  particular  treatment, certainly not
brandy, for their removal.


               Stages of  Labor<

  Labor has been divided into three stages.  The first:
in which the uterus alone  acts, commences with the
first uterine contractions, the pains being of a grind-
ing character;  the os uteri  (mouth of the womb) 
Stages of Labor.              163
gradually dilates  until it is  sufficiently capacious to
admit the passage of the head of the child.  In  this
stage it is not necessary for the lady to confine herself
to bed; she is  better walking  about  the room, occa-
sionally lying  down  when a pain  comes  on.  She
should not  on any account bear down, as some igno-
rant nurses advise;  for before the mouth of the womb
is sufficiently dilated, the child could  not be born, ex-
cept by rupture of the womb.
   The second stage of labor is indicated  by the  pains
being of a forcing, bearing-down nature; the abdom-
inal muscles and  the diaphragm assist the  action of
the uterus,  acting in an  involuntary and  reflex man-
ner: this stage  terminates with the birth of  the  child.
In this stage the lady should remain on the bed.   Even
now she should  make  no voluntary efforts to  bear
down,  especially in the  absence of pain; she  should
keep her eyes closed, to prevent injury to them during
the irresistible  straining which  attends the  expulsive
pains.
   The third stage includes  the expulsion of the  pla-
centa, which generally takes  place in  about fifteen or
twenty minutes, or it may be a little  longer, after the
birth of the child.

               Length of Labor.

   It has been laid down as a general rule, that a first
labor continues six hours, and a subsequent one three
hours.   This calculation dates from the commence-
ment of actual labor; if the premonitory flying-pains
are  included, the  time would probably be  doubled. 
164
Labor.
The first labor of a lady who marries beyond the age
of thirty usually occupies a considerably longer time
than one who marries at about the age previously indi-
cated.

                 Tedious  Labor.

  This seems the proper place to remark, that tedious
labors are, as a rule, natural, and by no  means neces-
sarily dangerous; on the contrary, a lady usually makes
a more rapid  and perfect  recovery after a  slow than
after a  quick labor.   Except in preternatural  cases,
which must be conducted according to the knowledge
and skill of the medical  man, medicinal or manual
interference is rarely necessary;  time, patience, and
good management only being required to bring a nat-
ural labor to a successful issue.
   Treatment.—The following remedies will gener-
ally alleviate the sufferings of abnormal  conditions of
parturition,  and  shorten its period.
   Pulsatilla.— If the pains are too feeble, and  occur
at too long  intervals,  or if they are  diminishing in
strength and frequency; or if attended with vomit-
ing, or with spasms in  the  stomach;  severe  pain in
the back and loins,  or painful drawings in the thighs.
   Secale.—Excessively severe pains, with  slow pro-
gress of the labor, and faintness and exhaustion of the
patient.
  Belladonna.—Very severe bearing-down pains, with
convulsive  movements;  great agitation and conges-
tion to the head, and even frantic rage and  delirium;
red and  bloated  face,  and  distension of the blood-
vessels. 
Tedious Labor.               165
   Coffca.—Excessively violent pains, with great men-
tal and nervous excitement, and restlessness.
   Cocculus.—Cramps and convulsions in  the lower
part of the abdomen, in  the  limbs, or in  the whole
body.
   Administration.—A  dose of the appropriate rem-
edy  every fifteen, twenty, or  thirty minutes, as the
case may require.  If no relief follows the third dose,
it  may be desirable to select another medicine.
   Accessory Means.—Friction over the abdomen,
with moderate pressure,  is often of much service dur-
ing the pains, especially in the latter  stages of labor,
by exciting the action of the womb.   This should be
continued till the placenta  is detached.
   Chloroform in Labor.—A natural labor is best,
and  its  attendant  pains  should  be  patiently borne,
especially if all  be going  on  well.  Probably chloro-
form slightly retards parturition  by somewhat weak-
ening, or rendering less frequent, uterine contractions;
still  a lady may be delivered naturally under its influ-
ence.  It is unattended with danger to the child, nor is
it  liable on the part of the mother to occasion haemor-
rhage, or tend to the production of puerperal mania.
The pulse and the  respiration furnish  reliable indica-
tions as to the extent to which it may be carried, and
the length of time  the  inhalation may be  continued.
When requested by a patient to administer it, and no
objection to its  use exists, the author never  hesitates
to do  so.  It should not, however, be administered
except by the sanction and under the  care of a quali-
fied  medical  man.  It  may be given by pouring a
sufficient quantity into a tumbler and letting the patient 
i66
Labor.
inhale it in small doses, well diluted with atmospheric
air, and when the stomach is empty.   Various kinds
of scents  are  now  put into chloroform, and  it may
almost be said to have become more a question of
perfumery.
  The  indiscriminate and reckless use of chloroform
is not approved or practiced by the careful  and con-
scientious physician.   Although this agent  is not so
generally employed  as it was a few years  ago, still,
with proper precautions, it is a great blessing and boon
to the woman who must undergo the " perils of child-
birth."   The patient  should commence to take it when
the grinding, dilating pains of the first stage of labor
are passed, and have  been succeeded by the real, forc-
ing, expulsive  pains  of the second  stage.  It  should
be inhaled just as  the pain returns.   Unless instru-
mental  delivery has been determined upon, the patient
need not be made entirely unconscious by it.  It should
not be  allowed  if the  woman flows freely.  Talking
in the room should be prohibited while she is inhaling
the anaesthetic.   And on no account should  her  head
be raised, or she  allowed to sit up in the bed, for some
hours after its  use.                             L.


    VI.— How to Act  in the Absence of a
                  Medical Man.

  Labor sometimes comes on earlier than was antici-
pated, or its stages are gone through so rapidly as not
to give  sufficient time for the attendance of a medical
man; it is therefore desirable to know how to  act  till
he arrives.  Calmness,  judgment, self-possession, and
attention to the following points, are generally  all that
is necessary in ordinary cases for the safety and  com-
fort of the lady and infant, at least until the arrival of
the accoucheur. 
        Birth Before the Doctor's Arrival.     167

     Birth Before the Doctor's Arrival.

  If, when the head is born, the face gets  black, the
exit of the shoulders should  be aided by slight trac-
tion, by means of the index finger inserted in the axilla
{arm-pit); but  on no  account should  the head  be
pulled, or dislocation of the neck might result.   After
this the remaining exit of the body and nates (buttocks)
should not be hurried.
  When the  child is born, the  nurse should at once
remove it from contact with  the mother's  discharges,
place it where it has room to breathe, and see that the
mouth  be not  covered with  clothes.  The  mouth
should also be  examined, and  any mucus that may
have accumulated in it  removed.   At the same time
it is veiy important to  notice whether  a coil of the
umbilical cord {navel-string) be tight  round  the  in-
fant's neck; and if so, to instantly liberate it to prevent
strangulation.   If there are two or three coils, loosen
them a little  to allow the child to breathe.

   To Tie the Umbilical Cord {navel-string).

  Place the ligature—a piece of twine, or four or five
threads—about  two inches from the body of the infant,
and tie it firmly by a double knot round the umbilical
cord;  two or three  inches further from the body of
the child a second ligature has to be similarly applied,
and the cord then cut between the two  ligatures with
a pair of blunt  scissors.   The cord should not be liga-
tured till the child has given signs of life  by its cries
of vigorous breathing, or until all pulsation in the cord
has ceased. 
168
Labor.
           The Placenta {after-birth).

  The umbilical cord having been ligatured and divi-
ded, no attempt should be  made, by pulling at it, or
otherwise, to remove the placenta.  The only justifia-
ble interference is firm pressure and occasional friction
over the region of the womb, which tends to encour-
age contraction of that organ, by which means detach-
ment and expulsion of the placenta is effected.   We
may judge whether the placenta is detached, by exam-
ining over the lower part of the abdomen, and if the
womb is felt contracting, and  hard like a cricket-ball,
the placenta is detached,  and if not expelled, is in the
vagina {passage to the womb) ; two fingers  may then
be passed up to the  insertion of the cord, where  the
placenta may be grasped  and brought  away steadily
and evenly, with a spiral movement, but without using
force.  The spiral movement tends to overcome  the
pressure of the atmosphere, and also winds the mem-
branes into a kind of  rope, so that they are less likely
to be torn.


          Application of the  Binder.

  The binder  is  simply a  piece  of  strong  linen or
sheeting, about twelve inches wide and a yard and a
half long, so as to include the whole of the abdomen.
It should be applied  moderately firm, secured by pat-
ent pins, and as soon as it becomes loose it should be
readjusted.   The binder is useful in two respects; it
favors contraction of  the uterus,  and thus  tends to
obviate haemorrhage;  it  also  aids the return of  the 
General Hints.
169
abdomen to its former size, and prevents the condi-
tion described by nurses as " pendulous belly."  The
binder should be kept on for a week or ten days  after
labor.
   Concerning  the  use  and  necessity of the binder,
physicians are not agreed.  Some  always apply it-
others discard it altogether.  Since, if carefully applied,
the bandage can do no possible harm, and may serve
to prevent  serious mishaps, as for example, haemor-
rhage, or uterine displacement, we think it had better
be adjusted before the patient is left.             L.

             VII.—General Hints.

   The first few hours after the birth of the child should
be essentially hours of repose.   For an hour, at least,
the lady should  maintain the same position as during
labor, and be no more disturbed than is necessary to
apply the binder, remove the soiled napkins,  and ren-
der her as comfortable as the circumstances will permit.
She  may not on any account make the slightest exer-
tion  herself, or haemorrhage is very liable to occur.
One or two hours after labor the tendency to haemor
rhage is much reduced.  A cup of cool, not hot, tea,
or a  little warm arrowroot or gruel  may be given her;
but,  except in extreme cases, or under the advice of  a
medical man, no brandy or other stimulant should be
permitted.
   Brandy is admissible in case  the patient has been
for a long time under the influence of chloroform, and
the labor has been very protracted and exhaustive. L.
   If the lady desires to  pass water soon after labor,
she should do so in  a lying posture, but on no account
     8 
170                   Labor.
sit up  for  that  purpose,  as dangerous haemorrhage
might thus be occasioned.  If by good management
and quietude for two or three hours she obtains a little
sound  and refreshing sleep, it is surprising  how soon
she will revive.  After this, should no  untoward cir-
cumstances forbid, she may be changed and placed in
bed, preserving  the  horizontal posture.  As  soon as
the infant is dressed and the mother made comfortable,
the child should be presented  to  the  breast.  By this
means the nipple is most  likely to assume  the proper
form, the flow of milk  is facilitated, and the action
thus excited in the  breasts, tends, by reflex action, to
promote vigorous uterine contraction,  and thus consid-
erably reduces the danger of secondary haemorrhage.
As suggested in the section on " Flooding," the nurse
should examine the napkins very frequently at first, to
ascertain if there  is  any undue  haemorrhage.   The
labor being thus completed, it seems  almost unneces-
sary to add that  the window blind should be let down,
noise shut out, conversation forbidden, and everything
done to induce the patient to sleep, at the  same  time
making due provision for good ventilation.  As  soon
as the  child is washed  and dressed,  and the mother
made comfortable, the nurse only should remain in the
room.
  It is safe, in order to anticipate and prevent  sore
ness as much as possible,  to administer Arnica inter-
nally;  a few drops of the dilution in half a  tumbler
of water; a dessertspoonful to be given every  hour for
three or four times.  When the afterbirth has  been
expelled, Arnica may also be applied externally to the
parts by wetting a  napkin with the  lotion, made by 
General Hints.
171
mixing twenty drops of the  pure tincture of Arnica
with a tumbler of water, renewing the application  as
often as may be required.
   Coffea.— Sleeplessness,  nervous  excitement,  and
restlessness.
  Aconitum may be  submitted for Coffea and given
in the  same  manner, should any feverish symptoms
occur. 
172
                CHAPTER VIII.

      MANAGEMENT AFTER DELIVERY.


                     I. — Diet.

  Errors on this point have arisen  no doubt from
parturition having been regarded as a  state of disease,
instead of a physiological condition.   Labor is a pro-
cess of health, and under ordinary favorable circum-
stances there is no fever or febrile reaction,  or any
danger of inflammation;  why then should a lady be
restricted to gruel or low  diet for a  week?  Under
such a diet inflammatory symptoms  are liable to be
called into existence,  and bad matters  are more readily
absorbed by the uterine vessels.  A  good diet is the
best prophylactic against inflammation.   The diet we
invariably give is nourishing, digestible, solid food from
the very  commencement; and we have never seen any
untoward results.   On the contrary, many ladies for-
merly under the care of doctors who gave only a "slop"
diet, have  expressed  to us  their thankfulness for the
earlier and more complete restoration  to their former
condition, and their exemption from debility and other
evils inseparable from a low diet.  If a lady is deliv-
ered in the evening or early morning,  and there are no
unfavorable symptoms, we allow a mutton chop for
dinner on the first day; for other meals, cocoa or tea, 
                     Flooding.                  173

cold-buttered-toast,  or bread-and-butter, a  breakfast-
cupful of arrowroot or gruel, light farinaceous  pud-
dings,  etc.  A too exclusive use of gruel and other
"slops" is apt to distend the stomach, produce constipa-
tion, and retard the necessary changes in the womb.
  For  general  use during the first  three days—until
the milk comes freely, we know of nothing to  com-
pare with oatmeal  porridge.  It is grateful to  most
patients—if well-made—keeps the bowels soluble, and,
more than all, satisfies the desire for food.   We heart-
ily endorse the author's position that the lying-in pa-
tient should be well nourished.                  L.


                 II. — Flooding.

  This is one of the most frequent, and at the  same
time, the most serious of the accidents which compli-
cate the expulsion of  the  after-birth.  The haemor-
rhage generally comes on with a rush a few minutes
after the child  is  born,  and before  the placenta is ex-
pelled;  occasionally it does  not  come on  for several
hours,  or in rare cases even for several days.
  Symptoms. — The blood usually appears  externally,
which the accoucheur or nurse instantly recognizes, and
is sometimes so sudden and  abundant as to place the
lady in great danger;  at other times the discharge  is
confined to the cavity  of  the womb,  where it  may
escape detection, or be only recognised when it is diffi-
cult or impossible to remedy it.   Pallor of the  face,
small pulse,  dimness of vision, debility and fainting,
are symptoms which accompany haemorrhage, whether
the discharge be internal or external.
  Treatment.—Secale, Ipec, Sab., Ham.  v., Crocus. 
 174        Management After  Delivery.

   For the symptoms indicating these remedies, con-
 sult the article " Menstruation too Profuse."
   Accessory Means. — Immediately  the haemorr-
 hage occurs, one hand is to be placed on the abdomen,
 to grasp the uterus to stimulate it to contract;  at the
 same time napkins saturated with cold water are to be
 suddenly dashed on  the external  parts; the patient  is
 to remain  quite still, the hips being a little elevated,
 and the pillow removed from her head.  If necessary,
 she should have brandy, but slightly diluted with wa-
 ter, in small quantities, at frequent intervals.  In this
 form it is the best stimulus to the  heart, and less likely
 to excite sickness.  Beef-tea, the best variety of which
 is Liebig^s extractum carnis* should be given in  small,
 but  in frequent quantities.  The application of the
 child to the breast is also another useful measure, as it
 tends to excite uterine contraction.   The patient should
 be lightly covered, the room kept cool, and a free cir-
 culation of air promoted.   After a profuse flowing, the
 patient is naturally inclined  to sleep; this  tendency
 should not be interrupted too soon, as it wonderfully
 recruits the exhausted powers.  The patient must not,
 however, be left alone, and  frequent examinations
 should be made by the attendant.   In the  majority of
 cases, profuse haemorrhages may be prevented by skill
 and attention on the  part of the  accoucheur.  If the
 after-birth is still within  the womb and the woman is
flooding  it should be removed at once.   Then tighten
the binder, which is to be applied over a towel folded
as a compress.  As a rule the  more pain  the patient

  * Other excellent beef extracts are sold in the United
States. 
After-Pains.
175
experiences soon after delivery the less the danger from
loss of blood.   See also "Accessory Treatment"' under
"Menstruation too Profuse."
  Preventive Means—After delivery the patient
should remain in  silence, and enjoy the most absolute
repose of mind and body for at least half an  hour or
an hour.  A clean and well-warmed napkin should be
applied to the vagina as soon after delivery as possible,
and the nurse strictly enjoined to examine it, at least
every few minutes at first.   In this way any excessive
discharge will be  easily detected.  As before remarked,
after  the  lapse of one  or two  hours, the danger of
haemorrhage  is much reduced.


               III. — After-Pains.

  Except after a  first labor, women generally suffer
from  after-pains,  the nature  and intensity of which are
much influenced  by the character of the labor, and the
constitutional peculiarities of the patient.  After-pains
are liable to increase  with each  succeeding labor,  and
unless proper treatment is adopted, the pains may be
very  excessive, and prevent sleep.  Much, however,
may be done both in the way of preventing them, and
of moderating their violence.
  After-pains are sometimes very troublesome in  case
of women who have taken chloroform during labor.
Either  the pains  are more  severe than others experi-
ence, or from not having suffered pain prior to delivery,
more complaint  is made.   In this case five drops of
chloroform may be put into half a glass of water and
a  teaspoonfull given internally as  often as the  pain
recurs.                                        L. 
176       Management After Delivery.
  Cause.— Uterine Contraction.—After the birth of
the child and the detachment and expulsion of the after-
birth, muscular contractions are still necessary to close
the now empty womb, and to reduce that organ to its
natural  size in the uni impregnated state.
  Treatment. — Secale. — Continuous and unremit-
ting  after-pains.
   Chamomilla.— After-pains of irritable patients.
   Coffea. — Extreme sensibility, the pains being  al-
most insupportable, with sleeplessness and restlessness.
   Gelseminum sem. — This remedy is recommended
for after-pains, from  its remarkable power of dimin-
ishing muscular activity.
  Arnica.—Pains following a  very protracted labor.
This remedy may also be used  externally.   Thirty
drops of the strong tincture of Arnica to a teacupful
of warm water.  Saturate a  napkin with the lotion,
and  apply it warm over the lower part of the abdomen,
covering it with oiled-silk to prevent too rapid evapor-
ation.
  Belladonna. — After-pains  with  headache,  intoler-
ance of light and noise, flushed face, and general nerv-
ousness and unrest.
   Camphora. — Cramp-like pains  which  are  veiy
severe and threaten to bring on  spasms.
  Nux vomica. — Severe after-pains accompanied or
followed by the escape of large firm clots.       L.

         IV. — The Lochia {Cleansings).

  This  is  a healthy discharge  which takes place after
delivery, and in color and appearance at first resembles
the  menstrual  discharge.  Gradually however it be- 
The LocJiia.
177
comes lighter, yellowish, and before its final cessation,
of a greenish or whitish hue.   In a majority  of cases
the red color changes in about a week or ten days to
the yellowish shade.   It varies considerably in different
females, being  in some thin and scanty, and continu-
ing only  a few days; and in others  is so profuse as
almost to amount to flooding, and  lasting for  weeks.
In some cases, too, it has a disagreeable odor.
  Treatment.—Aconitum. — Discharge too  pro-
fuse, and of a bright-red color.  A dose of this remedy,
administered thrice  daily for  one or two  days,  will
often restore the discharge to its normal condition.
  Calcarea. — If,  after the above,  the unhealthy  dis-
charge continues, and especially  when there are itch-
ings felt deep in the abdomen, and  when there is pro-
fuse  perspiration, give two or three doses at intervals
of six hours.
  Bryonia.— Suppression of the lochia, with headache,
fulness and heaviness, or with pressure in the temples
and forehead, throbbing pains in the head, aching in
the small of the back, and scanty urination.   A dose
every four hours.
  Platina. — .Suppression with deep mental  depress-
ion; dryness  and  great sensitiveness of the sexual
organs.
  Pulsatilla.—Too scanty, or suppressed, discharge,
without fever or congestive headache.
  Accessory Means. — After a  confinement, ablu-
tion  of the parts, by means of a soft sponge and warm
water, at least twice in every twenty-four hours, the
parts being immediately but thoroughly  dried,  is
essential for the health and comfort of the patient.  The
     8* 
178        Management After Delivery.

napkins  should be frequently changed,  and always
applied warm, as the application  of cold might be fol-
lowed by an arrest of the lochial discharge.  If the dis-
charge is bright, or  continues too long, the patient
should retain the horizontal position, be kept  quiet,
and fed with proper diet.  In suppression of the lochia,
flannels wrung out  of hot water should be applied to
the external parts, and  frequently renewed, a  second
flannel being ready when the first is  removed.   (See
also the next section.)


  V. — Milk-Fever  and Child-bed (Puerperal)
                      Fever.

  When the breasts are first called upon to perform
their  function,  there is sometimes  a  little circulatory
disturbance, which is  called the  " Milk-Fever."   In
severe cases, there  is  the  speedy accession  of more
serious symptoms, which frequently  run on into the
formidable disease called puerperal  or child-bed  fever.
According to  the best  authorities,  this  fever is very
fatal,  Dr. Furguson being of the opinion that,  " with
all the resources which  medicine at present offers, we
shall  find that one case in every three will die; "  and
that  " to save two out  of three may  be termed good
practice."   When the disease  proves  fatal,  death
usually occurs in from one to eight days.  The disease
has often  appeared as an  epidemic, attacking  any
woman who happened  to be confined at the time.  It
is, therefore, no small matter that we  have in our Ma-
teria Medica—which, of course, Dr. Furguson and his
colleagues ignore—remedies  which, prescribed  accor- 
Milk-Fever and Child-Bed Fever.
ding to the law of similia, and given in the early stage,
are sufficient to cure this disease in nearly every case.
It is also encouraging to know that even  bad cases
seldom prove fatal under skillful Homoeopathic treat-
ment.
   Facts  prove  that under  this system  of treatment,
cases of  child-bed  fever  are  not one-tenth  part  as
frequent as under the  old regime.   A chief reason is
to be found in  our not prescribing or allowing opium
and cathartics  to lying-in women.               L.
   The measures pointed out below are only intended
to commence the treatment until the doctor arrives.
   Symptoms. — Alilk-fever  usually occurs  shortly
after delivery.   There are,—pricking sensations in the
breasts, which  gradually  swell  and harden,  accom-
pained by febrile action in the system;  and in some
cases, pains in  the head, scanty urine, constipation, etc.
   In puerperal fever there are,—in addition  to the
above, rigors {shivering-fits); pain, and great  tender-
ness over the region of the  womb; suppression of the
milk (if it has been secreted at all), also suppressed, or
scanty and foetid  lochial  discharge;  there are  severe
pains in the head, flushed  face,  glistening eyes,  and
sometimes delirium; distension of the abdomen; and,
unless  the disease is checked, typhoid  or malignant
symptoms rapidly supervene.  This fever commonly
occurs  within a few days  after child-birth; and it is re-
markable  that in most cases the patient loses all inter-
est in the  infant, and even refuses to let it suck.
  Treatment. — Aconitum. — This remedy  should
be given  as soon as the  first indications  of  fever are
noticed.   It is usually sufficient in simple milk-fever,
and when there are no symptoms of brain-disturbance. 
180        Management After  Delivery.

  Bryonia. — Greatly distended  breasts, oppression,
and shooting pains in the chest.
  Belladonna. — Congestive  headache,  flushed face,
altered pupils, great restlessness, tossing about, mental
distress, and other symptoms of approaching delirium
or severe disease.   If the lochial  discharge is  not  en-
tirely suppressed, but is foetid, this remedy is still very
suitable.   At the same time, Aconitum should be con-
tinued in alternation with Belladonna, and at brief in-
tervals, till professional aid is  available.
  Hyos., Strain., Opium, Ars.,  Bry, and Rhus,  are
remedies often required in the advanced stages of  the
disease.
  Administration.—A dose every one to three hours.
  Diet and Accessory Means.—In simple  milk-
fever, it is generally only necessary to supply the patient
with some warm drink, such  as rice, or barley-milk,
to guard against a chill, or any mental excitement, and
to apply the child to the breast  early.   In the more
complicated  fever, frequent small  draughts  of cold
water should  be  given;  this  relieves the thirst, and
promotes  perspiration;  strong  beef-tea  between  the
doses of medicine will help to keep up  the patient's
strength;  and perfect rest and quiet, with absence of
all appearance of excitement or alarm in the attendant
are imperatively necessary.  Hot applications over the
lower part of the abdomen, if there is great pain, and
occasional sponging of the body with tepid water will
be soothing.   The napkins should be frequently exam-
ined, and all  foul discharge effectually cleansed away,
and the room disinfected with Carbolic acid.    Indeed,
\vhen the discharges are offensive, it is well to  inject 
Retention cf  Urine.
181
up the vagina a quantity of  hike-warm water, to
which half-a-dozen drops of Carbolic acid have  been
added.
   A more pleasant preparation consisting of ten grains
of the Chlorate of potassa to the fluid ounce of water,
may be had of an ordinary druggist.   Of this put a
teaspoonful  in a teacup of water,  and use either as a
vaginal injection  or apply locally by means of wet
compresses.
   In case the  abdomen is much swollen and tender, a
poultice made of dry wheat-bran sewed into a bag and
heated thoroughly, should be applied.   It is light, dry,
retains its heat for a long time,  and seems to  hold
some specific curative relation  to  the inflamed struc-
tures.,                                          L.

           VI.—Retention of Urine.

   Retention of urine is not infrequent after parturition,
especially after severe and tedious labor.
   Treatment.—Cantharis, Nux vomica, Hyos., or
Aconitum.  See " Retention of Urine  during preg-
nancy."
   Accessory Means.— A lady should pass urine
within about six or eight hours after delivery, or earlier
if necessary; she should do this while in a horizontal
posture, to prevent flooding, or other  serious conse-
quences which might arise from the effort of sitting up
to do so.  It may  be worth while to add, that the pot-
de-chambre  used  by the lying-in  patient should  be
warmed, and the rim protected with flannel.  Should
there be inability to pass urine,  a cloth wrung  out of
hot water, and applied to the parts, will often remove
the difficulty.  Should, however, the  difficulty con-
tinue, the medical attendant should be made acquainted 
182        Management After Delivery.
with  the circumstance,  so  that if necessary he may
draw off" the urine by means of a catheter—a measure
unattended with pain or exposure.

               VII.—Constipation.

  Contraiy to the ordinary practice of  interference
with  the operations  of nature,  adopted  by the old
school of medicine, Homoeopathy does not recognize
the necessity for acting freely upon the bowels on the
third day after delivery.  When the system is so re-
markably susceptible  to morbid impressions, and occu-
pied in establishing a new function which is to transfer
the vascular and nervous erythism from  one part of
the female economy to another, where  is the wisdom
of  disturbing the whole organism by a forcible inter-
ruption of the process,  which in  some constitutions
nature has scarcely power to effect at all ?  At such a
moment, the most passive  condition of the system  is
that which every good physician should study to secure,
and not by the administration of active purgatives to
set up new and morbid actions, the issue of which no
one can foresee.  This unphilosophic practice, adopted
from age to age by the physicians of the  old school,
fully accounts for the direful consequences which so
frequently invade the puerperal  state,  particularly in
delicate and sensitive women {Leadam).
  It is a natural condition  for  the  bowels to  remain
unmoved for a few days  after delivery.   It gives rest
to the womb, and to the  parts in the neighborhood of
the bowel.    Instead  of injuring, it  conserves  the
strength of the patient, and should on no account be 
Constipation.
i83
interfered with.  In four or five days, however, if the
patient has had no evacuation, and complains of pain
in the bowels or fulness  in  the  head, adopt the fol-
lowing
  Treatment.—Bryonia.—Two or three doses,  at
intervals of three hours.
   Nux vomica and Sulphur may be given, afterwards,
if necessary, every four hours, in  alternation, for  sev-
eral times.
   Accessory Means.—The moderate  use of plain,
unstimulating  solid food, at  suitable intervals after
confinement, will  furnish the proper  impulse to the
intestinal canal, and thus be more likely to facilitate
an evacuation than will persistency in  liquids.  When
it is ascertained that the action of the bowels is arrested
by a collection of hardened  faeces in  the  rectum, the
enema lavement, as recommended, page 125,  will  be
required.
   Castor oil, aperient pills, are, the writer feels justi-
fied in stating, never required.   He has attended many
ladies in their confinements who  had  previously been
under the care of Allopathic  medical men, and  who
have assured him  that their bowels were never relieved
after confinement  till castor  oil had been taken;  but
he has not, either  in these or other cases, ever  found it
necessary  to have  recourse  to  any aperient drug.
Good management, suitable diet,  and, if the symptoms
justified it, the occasional administration of a Homoeo-
pathic remedy, have in his hands been uniformly suc-
cessful.
   Every patient should  be careful to take only what
her physician prescribes.  This precaution is neces- 
184       Management  After Delivery.
sary, because  a majority of  nurses  will  insist  upon
giving " something  to  open the bowels," without thq
doctor's  knowing anything of  it, two or  three days
after delivery.   Much  serious harm has  unwittingly
resulted from  this cause.                        L.


                VIII.—Diarrhce A.

  This is a much more serious condition than  the
former, and suitable means should be taken to correct
it as early as possible.

  The diarrhoea of lying-in women is more serious in
summer than  in the winter  months.  It is especially
so when bowel affections,  as dysentery and cholera-
morbus, are prevailing.  If such patients have dysen-
tery, the tenesmus of  the  bowel is  very liable  to be
followed by intractable displacements of  the womb.
Moreover, these affections are, under  these circum-
stances, more than  usually dangerous.   An involun-
tary diarrhoea in the case of one who has but recently
been confined, should be treated promptly and care-
fully.                                          L.
  Treatment. — Pulsatilla. — Diarrhoea occasioned
by the use of  too rich or fat food, pastry, or other errors
of diet.
  China.—Diarrhoea from debility, and especially if
there has been a previous relaxation, or much loss of
blood, profuse lochia, etc.
  Antimonium crud.—Thin,  watery,  offensive dis-
charges,  accompanied  by marked gastric  symptoms,
such as  clammy or bitter state of the mouth,  white-
coated tongue, nausea,  heavings, etc.
  Phosphoric acid.—Obstinate  cases, the evacuations
being watery, painless,  and almost  involuntary; also 
Diarrhea.
185
if there is  tenesmus, or protrusion  of  haemorrhoidal
tumors, etc.
  Administration.—A dose of the selected  remedy
every three hours, or after every evacuation, until relief
is obtained.
  Accessory Means.—The patient should remain
perfectly quiet,  and in a  recumbent  posture.   The
food should be  light  and digestible, taken  in  small
quantities,  and cool or cold.  See also " Diarrhoea," in
the chapter on " Disorders of Pregnancy." 
186
        CHAPTER  IX.

LACTATION AND  NURSING.
   It has been truly said, every healthy mother should
nurse her own offspring.  The reason for this may be
inferred from the constitution of the female organiza-
tion.  After the birth of the child, nature continues
to secrete  an excess of nutrient matter; but this excess
is transferred from the  uterine system  to the breasts,
where it is secreted in the form of milk for the  nour-
ishment of the young offspring.   Eighteen months is
the  usual period during which  the child should be
supported by the mother: nine months previous to
birth,  and  about nine months  after.   The female
organs  are so arranged, that in carrying on  the func-
tions of reproduction, one portion relieves the otlxr.
During gestation, the breasts enjoy comparative repose,
the development and growth of  the  infant devolving
upon the uterus.  After  birth  this  responsibility is
transferred to the breasts, the  uterus resting for a long
time from the process of utero-gestation.

                 I.—The Breasts.

  Much inconvenience and suffering may be obviated
by paving proper attention to  the breasts  during  preg-
nancy.   For the  last  two  or  three  months they 
Gathered Breast.               187
should be regularly bathed with cold water every morn-
ing, and left perfectly dry.  If the  breasts are painful,
hard, and much distended, two thicknesses of old linen,
wrung  out of cold water, may be  placed over them,
and covered with  oiled-silk.   A kind of sling should
then be formed by means of a handkerchief  or band
secured at the back of the neck, and so arranged as to
support the  breast.  Only a sparing quantity  of fluids
should be permitted.

   II.—Gathered Breast {Mammary Abscess).

  This  may take place at any time  during the nursing
period;  but it is  usually an  accompaniment of that
great functional change in the glands which marks the
commencement of lactation,  especially in the first or
second month, often as early as the  fourth or fifth day,
after the birth of the child.   It is most likely to  arise
after the birth of the first child.
  Symptoms.—These vary according to the situation
and extent of the  inflammation.  If it  merely affects
the subcutaneous cellular tissue covering the gland, it
will present only the features common to an abscess in
any other situation near the surface.  If the  inflam-
mation occurs in the tissue behind  the gland  and on
which it is placed, the pain is very severe, throbbing,
deep seated, and is increased by moving the arm and
shoulder;  the breast becomes swollen, red, and more
prominent, being pushed forward by the abscess be-
hind.  Sometimes, but less frequently, the gland itself
is involved,  when  the pain  becomes very  acute and
lancinating,  the swelling very considerable, and there 
188
Lactation and Nursing.
 is much  constitutional  disturbance, quick, full  pulse,
 hot  skin,  thirst,  headache, sleeplessness,  etc.   This
 variety of gathered breast is preceded by a rigor {shiv-
 ering-fit), followed  by heat,  and the  case should be
 immediately placed  under the care of a medical man,
 who may only then be able to arrest the further pro-
 gress of the disease.
  Causes. — Exposure to cold, by  not covering the
 breasts during nursing; sitting up in bed, uncovered,
 to nurse the child; too  small, depressed,  or sore nip-
 ples, so that the breast becomes distended with  milk,
 favoring inflammation and suppuration; efforts of the
 child to suck when  there is no milk in the breast;
 strong  emotions;  mechanical  injuries; too prolonged
 nursing, the abscess not appearing until a late period
 —the tenth to the twelfth month.  The great predis-
 posing  cause is constitutional debility; hence it most
 frequently happens after a first labor, which is often a
 protracted one;  after giving birth to twins; and after
 profuse haemorrhage.  Debility leading to abscess may
 occur as the result of innutritious slop-diet, too often
 adopted during the first  week of confinement.

  The  wearing of pads and tight-fitting stays which
 keep the  breasts  too  warm and compressed, bound
 down and bruised, often occasions this species of mar-
 tyrdom.
  It should not be forgotten that for  some unaccount-
 able reason  certain women are so strongly predisposed
to mammary abscess that no matter how much care is
taken to prevent it,  they are certain to have one  or
more during the nursing period.   For  this reason  the
nurse and the doctor are  sometimes blamed when they
should not be.                                  y 
Gathered Breast.              189
  Treatment. — Aconitum. — A  dose  every two
hours for several times.  At the same time, the breast
should be emptied by a breast-pump; or if it does not
give the mother much pain, by applying the child to
it.  If these measures  are  adopted  during  the first
hours, when the pain and other symptoms which in-
dicate an attack have been  observed, and before the
swelling has acquired large proportions, the symptoms
will probably be at once arrested.
  Bryonia. —  If the collection of milk is considerable,
and the breasts are hard, or  feel  heavy and  painful,
with burning heat.   Whenever, from the first coming
in of the milk,  from catching cold while nursing, or
from  abrupt weaning, the breasts become swollen,
tender, knotty, and painful, Bryonia will almost cer-
tainly resolve the  inflammation and prevent the forma-
tion of abscesses (Hughes).  The author has repeatedly
verified this remark; but the remedy should be given
early.
  Belladonna may be alternated with Bryonia, every
three hours, if the surface  of the breasts exhibits an
erysipelatous redness, and is shining.
  Hcpar sulphur. — If the patient is scrofulous, and
if signs of  suppuration are present.  A dose  thrice
daily, for several days.
  Silicea. — This remedy is often of great service in
mammary abscess, when  suppuration is threatened or
has commenced, and especially if the formation of the
abscess has been indolent.
  China. — Abscesses following tedious and exhaust-
ing labors, excessive loss of  blood,  or diarrhoea.
  Arsenicum.—Abscesses   having a  gangrenous 
 190           Lactation and Nursing.

 appearance, accompanied with burning pain and great
 debility.
   Sulphur. — Profuse suppuration, with chilliness in
 the forenoon, feverish symptoms, and flushed face in
 the after-part of the day.
   Accessory Means. — Two or three hours  after
 labor—sooner if there is much haemorrhage—the infant
 should be applied to the breast, but only about once in
 every  four hours, until the supply of milk is uniformly
 secreted.   It is important to remember that mammary
 abscess is a symptom which strongly points to consti-
 tutional feebleness, indicating the necessity for plenty
 of nourishment, and  in some  cases,  the  use of  such
 stimulants  as stout or wine.  The breasts should be
 supported by a broad handkerchief,  as their weight
 aggravates  the patient's sufferings greatly; a linseed
 poultice,  or a piece  of spongio-piline dipped in hot
 water, should be applied to the part; this will allay the
 pain,  by relieving tension and causing perspiration.
 In extensive engorgement and induration, an opening
 is necessary, and should be  made in the most depen-
 dent  situation as soon as  fluctuation is  discovered.
 The matter should be evacuated early as soon as it can
 be felt, or it will be diffused in various directions
 through the breast.
   The preventive treatment consists in relieving the
 breasts as soon as they are filled; in keeping the patient
.warm; and in good diet.

               III.—The Nipples.
   It is necessary during pregnancy to examine whether
 the nipples are of the  proper size  and shape, for in 
Sore Nipples.
191
many  instances  they are deficient, or have been so
thoroughly compressed by tight clothes, that, after con-
finement,  they can,  properly  speaking,  scarcely  be
called  nipples.  A very simple and efficient  measure
has been suggested in these cases:  the nipple is to be
drawn out,  and  a piece  of woollen  thread or  yarn
wound two or three times around its base, and tied
moderately tight,  but not so as to  interfere with the
free circulation of the  blood.   In this way  the nipple
may be kept permanently and  sufficiently prominent;
the woollen threads may be worn for  many days with-
out inconvenience, and often with  permanently good
results.

               IV. — Sore Nipples.

  In most cases, if the preparatory treatment already
suggested be adopted,  sore nipples will be prevented.
But where there is a tendency to excoriation and sore-
ness,  the  nipples and the breasts  around  should  be
bathed several times daily with  a  lotion made  by
adding twenty drops of the pure tincture of Arnica*
to a tumbler of water.  The author of this work can
testify  to the entire success of this application in a very
large number  of  cases  which he has treated.  The
lotion should be applied after  each time of suckling,
and  the nipples  moistened with saliva or mucilage,
before  again allowing the child to suck.
  In obstinate  cases, in which, the complaint appears
to be owing to constitutional causes, administer one or

  * If there is a predisposition to erysipelas in  the patient,
Calendula lotion will be preferable, and may be applied in
the same manner. 
192          Lactation and Nursing.

more of the following remedies:    Calcarea,  Mcrcu-
rius, Graphites, Lycopodium, Silicca, or Sulphur.
  Administration. — A dose of Calcarea every  six
hours,  for  four or five times; if the inconvenience is
diminished, continue the remedies several days longer;
but  if  there  is only slight improvement, administer
another medicine in the same manner.
  Accessory Means. — In order to prevent sore nip-
ples, they  should be washed over gently with tepid
water  immediately after the  child has been nursed,
very carefully dried, by dabbing—not rubbing—with
a piece of soft linen, or a fine towel, and then dusted
with superfine wheat-flour or finely-powdered starch.
As  before  recommended, the entire breast and chest
should receive daily morning  ablutions with  water,—
cold, if the patient can bear it, but if not, tepid may be
used for several times, gradually reducing it, however,
to the natural coldness.
  If the nipples are  sore, feel hot, and burn, apply
small cloths wet in cold water, or rose water.   A good
domestic expedient is mutton marrow, applied in the
same way.   Or  take four parts of yolk of egg and five
parts of glycerine, and rub or shake well together, and
apply locally with the finger or a camel's hair brush.
This is simple  and available, will wash off,  excludes
the  air like a varnish, and is harmless  to the child.
Another old-fashioned but efficacious expedient is to
stew quince seeds,  and apply the gummy  product
directly to  the nipples.  Some cases will be  cured at
once by making the child nurse  through  a nipple-
shield exclusively.                             L.
  Preventive  Measures. — In addition to the pre-
paratory treatment above referred to, the infant should
only be allowed  to suck at stated periods—say every 
Diet for the Nursing Mother.        193
third or fourth hour, as previously pointed out.   The
habit of permitting the infant to have the nipple almost
constantly in the mouth very frequently leads to ten-
derness and soreness.  The child's mouth should be
examined, and  if  found to be suffering from Thrush
{Aphthce), proper treatment should be at once adopted,
or sore nipples will most likely result.   For the  treat-
ment  of this affection, see the section on  " Thrush, "
in the chapter on " Diseases of Infancy."

      V.—Diet for the Nursing Mother.

   Although a lady does not require extra good living
when nursing, care and discrimination in the selection
of her food are  necessary.  This is evident  from the
well-known  fact, that cow's-milk very much partakes
of the  food  on which the animal lives.  Thus, if a
cow feeds on swedes, the milk and butter have  a tur-
nip-flavor.   This  decides, beyond a doubt, that the
milk does partake of the qualities of the food  on which
she feeds.  The same reasoning holds good in regard
to the human species, and proves  the  impropriety of
a nursing mother being allowed  to eat anything gross,
indigestible, or unwholesome!
   It is  not  intended by these remarks that  a nursing
woman should be  excessively particular as to her food.
Let her take both animal and vegetable food, varying
it from day to day; let her ring the changes on boiled,
and stewed,  and grilled, and roast meats;  on mutton,
and lamb, and beef,  and chicken, and game, and fish;
01  vegetables—potatoes, and turnips, and brocoli, and
cauliflower,  and asparagus.
    9 
 194          Lactation and Nursing.

   On the other hand, she should not take gross meats,
 such as goose, or duck; highly-salted beef; shell-fish,
 such as  lobster or crab; rich dishes; highly-seasoned
 soup;  pastry;  cabbages and greens, if found  to dis-
 agree  with the infant;  or any  other article  of food
 which is rich  or indigestible, and which  the  mother
 has found to disagree with herself or child.
   A nursing woman  is subject to thirst;  under such
 circumstances, milk-and-water,   barley-water,  toast-
 and-water, etc., are  the  best beverages; beer or wine
 only adds fuel  to the flame.
   A lady who is nursing is liable to fits of depression.
 The best remedy is a short, pleasant walk in the coun-
 try or  a drive.  Wine  or stimulants should  not be
 resorted to, for they  would only raise her spirits for a
 time, and  then depress them in  an increased ratio.
 {Chavasse).
   General  social intercourse is  an excellent stimulus
 in these cases.   But too much of society,  and of the
 fret  and friction of the domestic  machinery, may not
 only worry the nursing mother  herself into positive
 illness, but so impair the quality of her milk  as very
 seriously to  compromise the health of her child or
 children.                                       L.

       VI.—Stated Hours for Nursing.

   A habit very generally prevails, on the part of the
 mother, of giving the infant the breast too frequently;
a habit prejudicial alike to the mother and the child.
It may be laid  down as a rule, that for the first month
the infant should be suckled about every two  hours,
and  every  three or four hours during the  night; the 
         Sore Mouth of Nursing Mothers.      195

intervals should be gradually lengthened until  about
the third month,  when the  infant should have the
breast only every three or four hours during the day,
and about  every sixth hour  at  night.   Even during
the earliest period of infancy,  a child will  acquire
regular  habits  in  this respect, by judicious manage-
ment on the part of  the  mother.   By  giving the
breast only at regular stated times,  as just recom-
mended, the mother will  be able to  obtain proper
rest, and hours of  uninterrupted  sleep,  which  can
scarcely be enjoyed by those who have got into the
bad habit of permitting the infant to be at  the breast
during a considerable part of  every night, or of offer-
ing it to the child whenever  it cries or manifests any
uneasiness.


   VII.—Sore  Mouth of Nursing  Mothers.

  This  is an  affection  from  which nursing  females
occasionally suffer.  It consists of  inflammation of
the lining of the  mouth, which is  covered with very
small ulcers; these cause stinging  and  burning  sen-
sations,  and a cheese-like matter exudes from  them.
A profuse flow of saliva is also frequently present.
  From abundant observation, we  are convinced  that
nothing is  more grateful and  beneficial in this disease
than to take some form of vegetable  acid, freely and
habitually.   Lemonade, oranges, grapes, baked apples,
pears, tomatoes, etc., are frequently sufficient to  cure
the disease without any other remedy.   Or,  the  Sul-
phuric,  or Nitric acid, may be given internally, in an
attenuated form.   Other cases are curable by moderate
quantities of one or another of the malt liquors.   L. 
196           Lactation and Nursing.

  Treatment.—Aconitum at the onset, which often
cures the affection at once.
  Mcrcurius may follow, if Aeon,  is not sufficient.
  Tincture of the  Acetate of Iron, of which twelve
or fifteen drops may be added to a teacupful of  water,
or a solution of Borax  (four grains  to  an ounce of
water), may be  used  as a wash, and will modify the
soreness considerably.

      VIII.—Scanty or Suppressed  Milk.

  Causes.—Exposure  to cold, powerful emotions of
the mind, or any circumstances likely to cause general
febrile symptoms.  See also " Milk Fever."
  Treatment.—Pulsatilla.—Partial or entire  sup-
pression, without febrile symptoms.  The immediate
administration of this remedy  exerts a healthful influ-
ence over  the female constitution, in almost  every
departure from  the normal course  during the whole
period of nursing.  A,dose every two of three hours,
for the first twelve hours; afterwards, if the symptoms
are more favorable, a dose eveiy six hours, for several
times.
  Aconitum.—If feverish symptoms are present, and
the suppression  is the  effect  of a chill or  of  taking
cold,  administer Aconitum every  hour or  two, for
three or four times; afterwards every three or four
hours, for several times.
  Coffea.—Great  restlessness  or  sleeplessness.  A
dose or two will generally remove these symptoms.
  Chamomilla.—If the  suppression was caused  by a
fit of anger. 
Scanty  or Suppressed Milk.        197
   Accessory Means.—When  the  distension and
consequent irritation have been relieved by the appro-
priate medicine,  the milk which has been arrested
will  generally flow quite freely.   Should the dis-
charge  continue  imperfect,  the  breast-pump  may be
used, or  what is better, a strong child may be ap-
plied, and will in all probability soon reduce the evil.
   Method for Promoting the Flow of Milk.—
In all cases where the flow of milk is tardy, the fol-
lowing plan for  accelerating  it  will be found  to be
available and  safe:   Take a decanter and fill  it with
boiling water; when it  is thoroughly hot, suddenly
empty it,  and place it  on the  breast, with the  nipple
in the neck of the bottle.   The gradual cooling of the
decanter will create a vacuum;  the nipple will  be
gently pressed into  it without pain, and  the atmo-
spheric pressure  on  the breast will, in almost  every
instance, cause the  milk immediately  to flow.  The
experiment may safely be repeated after a short  inter-
val if it  does  not  happen to be successful at first.
Great care  must  be  taken to protect the breast  of
the patient, by covering the  mouth of the decanter
with  leather or thick flannel.    If a hole is made in
the centre of this, the nipple will be kept in its proper
position.
   Diet.—A nutritious and digestible—not an extra—
diet is necessary.   Cocoa, where it  can be obtained
good, is one of the  best auxiliary means for improving
the quality and increasing the quantity  of the mother's
milk.  The writer has known  it to succeed in the most
marked manner, in  cases in which  other means had
failed.  During the whole period of nursing this nour- 
 198          Lactation and Nursing.

 ishing beverage will be found highly conducive to the
 health of both mother and child.
   An infusion of coriander seeds is sometimes won-
 derfully efficacious  in  promoting  a free secretion of
 milk.                                         L.

            IX.—Deteriorated Milk.

   If the various suggestions we  have made in this
 manual are carried  out, there will rarely be cause for
 complaint of bad milk.  When, however,  the milk is
 bad, the infant  vomits after  each act of sucking, or
 refuses altogether to take  the breast.   An endeavor
 should be made to ascertain whether this condition of
 the milk be owing to the previous diet of the mother,
 to any emotional disturbances, or  to the state of  her
 health.   If possible, the cause should be removed.
   Treatment.—Aconitum.—If the alteration in the
 quality of the milk is due to fright, anxiety, or grief.
   Chamomilla.—If a fit of anger  has been the cause.
   Nux vomica.—If the milk has been affected by po-
 tations of spirits.
   Calcarea.—Thin, watery milk.


X.—Excessive Secretion of Milk, or Involun-
                tary Discharges.

  Treatment.—Aconitum.—If there be much fever,
present.   A dose every three  hours, for three  or  four
times.
  Bryonia.—If the efflux of milk is very considerable,
and the breasts greatly  distended, so as to produce pain
and oppression of the chest, this medicine will gener- 
Too Prolonged Nursing.           199
ally relieve the tumid breasts and check the fever.  A
dose thrice daily, for several days.
   Calcarea.—If the secretion of milk is too abundant,
the breasts painfully swollen, and the milk constantly
escaping of its own accord.  A dose night and morn-
ing, for several days.
  Pulsatilla.—The morbid state of the glands will be
corrected by this  remedy.
   China.—Debility consequent on  the  excessive flow
of milk.
   Accessory Means.—Warm fomentations, applied
so as  to maintain an  equal temperature  around the
distended breasts, are often very soothing to the patient.
Gentle  frictions with warm oil over the  surface are
useful in promoting the absorption of the excess of
milk.   During the continuance of  the  inconvenience,
nipple-glasses for receiving the milk should be worn,
and a piece of flannel  applied to the breast, to prevent
the dress from being soiled.
   Gum camphor dissolved in sweet oil  or glycerine
may be applied  to. the  breasts with a view to lessen
the quantity of milk secreted.   Too frequent nursing
or emptying of the gland tends to  increase the flow.
The same is true of drinking very freely of almost any
fluid.                                          L-

         XI.—Too Prolonged  Nursing.

   The  process of lactation forms a great drain on the
constitution,  and although healthy women, under fa-
vorable circumstances, suckle  their children for a con-
siderable time without sustaining any injurious effects,
still in  delicate persons, or under unfavorable hygienic 
200          Lactation  and Nursing.

conditions, nursing, even within the otherwise healthy
term, may be  productive  of serious and  permanent
mental and physical results.
  The period  when nursing  becomes hurtful  varies
considerably in different cases, from a few weeks after
the birth of the child to ten or  twelve  months.
  Symptoms.—The symptoms  which  indicate that
lactation is injuriously affecting  the mother are:  aching
pain in the back, or a dragging sensation when the
child is in  the  act of nursing, accompanied  by a feel-
ing of exhaustion, sinking, and emptiness afterwards;
general weariness and fatigue;  want of, or  unrefresh-
ing  or  disturbed sleep;  headache at  the  top of the
head, the  painful  spot being  often  perceptibly hotter
to the touch  than  other  parts;  dimness  of  vision;
noises in the  ear; loss of appetite; dyspnoea and pal-
pitation  after  exertion or ascending  stairs.  If the
nursing is  persisted  in, the patient becomes pale, thin,
and  weak; other indications of debility follow—night-
sweats;  swelling of the  ankles;  nervousness; and
extreme depression of spirits, the melancholy being
often of a  religious character.   In short, we may have
symptoms which  are  the  precursors  of  puerperal
mania, and it is important that these symptoms should
be early detected, because  they are then amenable to
treatment.
  The  symptoms of excessive lactation  may occur in
delicate women who  have had  several children in
quick succession.   Also as the consequence of inhe-
rent deficiency of the vital powers; imperfect nutrition;
haemorrhage, abortion, or exhausting leucorrhoea, or
any  other accidental cause  of debility,  involving most 
             Too Prolonged Nursing.          201

injurious, often lasting, consequences to the mind and
body.
  Treatment.—China.—Great weakness, noises in
the ears, palpitation of the heart, swelling of the legs,
etc.; especially if the patient has been subject to night
sweats,  excessive menstruation, severe  haemorrhages,
or leucorrhoea.
  Actea rac—Mental dullness and heaviness; melan-
choly;  alternate depression  and  exaltation.    This
remedy is especially valuable in melancholy from too
prolonged lactation; it is also useful when this symp-
tom occurs during menstruation or pregnancy.
   Causticum.—Excessive appetite, followed by a sense
of emptiness soon  after eating,  or  loss of appetite;
irritable, easily vexed, or vehement, disposition;  im-
paired memory; nervous  anxiety, with despondency;
throbbing headache, with pulsations and noises in the
ears;  threatened amaurosis; twitchings and jerkings
in various parts of the body;  profuse  leucorrhoea;
copious sour perspirations.
   Calcarea.— Scrofulous or chlorotic symptoms, with
loss of  appetite, emaciation, and consumptive  ten-
dency.
  Phosphorus.—Dry  cough, short  breathing,  with
predisposition  to consumption.
  Lycopodium, Pulsatilla,  Rhus, and  Bryonia, may
also be prescribed in certain conditions.
  Administration.— A dose  of  the selected remedy
every four or six hours.
  Accessory  Means.—In addition to the  adminis-
tration of remedies suited to  the  existing symptoms,
it is of the first importance that the cause of the symp-
    9* 
202          Lactation and Nursing.

toms  should be at once  removed;  indeed,  nothing
short of this will in general be  of the  slightest use.
Weaning, therefore, is the first indication, and should
be commenced at once; the attempt to force the sup-
ply of milk  by large and  frequent quantities of beer,
wine, or spirits, will only tend  to the  more  perfect
exhaustion of the mother.  Should the infant  be four
or six weeks old, it may be weaned with a fair chance
of doing tolerably well.   Indeed, cases now and then
occur in which the function of lactation  cannot  be
continued even so long as a month.   In slight cases,
however, and when the infant is but  a few  weeks old,
the mother should have a good  supply of plain nour-
ishing food, and should take cocoa,  to  the exclusion
of tea, coffee, etc.   This beverage is  often  productive
of the best results in augmenting the secretion of milk.
If, notwithstanding the use of these  means, a proper
supply of milk is  not yielded,  and   the health and
strength of  the patient do not improve, all attempts at
nursing  should be at  once abandoned.   The child
should be fed in part with Sugar-of-AIilk,  an almost
perfect imitation of breast-milk, or, when  the child is
a little older, Neavds Farinaceous Food, or some sim-
ilar preparation.*   These  articles have now been exten-
sively used, and in all cases in which infants are wholly
or partly deprived  of the  natural supply of  milk, they
should be fed with one of  them, since they answer
every purpose.  They are  readily and  economically

  * In America a compound  of  malt and  wheaten flour,
heated to a considerable degree — and called "  Comstock's
Rational Food"—is much used and well  spoken of by
medical men. 
Indications for Weaning.          203
prepared, and  often entirely supercede the necessity
for a wet-nurse, by divesting hand-feeding of  danger.
  We know of no food so suitable for infants deprived
of breast and  milk, as that which can be made by
boiling  Graham  flour for half an hour, straining it
through  a cloth, adding a  little sugar and salt, and
enough water to enable it to be fed through a  nursing
bottle.  As the babe grows older, add a  little cream.
                                              Li.

           Indications for Weaning.

  Further, should the  monthly  courses return,  or
should pregnancy commence, weaning should imme-
diately take place.   To persist in  nursing under such
circumstances would be a course fraught with danger
to the mother, and, probably, productive of perma-
nently feeble health and stunted growth in the infant.
Mania, where  there is any predisposition  to  it, is ex-
tremely likely  to happen when pregnancy or  mens-
truation  is allowed  to  proceed simultaneously with
lactation.

                  XII.—Weaning.

  The ordinary period for weaning is about the ninth
month; and the time that the child is in  good health,
and  free  from the irritation of  teething, should be
chosen as the most appropriate.
  The old idea, which is still extant among the credu-
lous,  that the  " sign"  in the moon has  any signifi-
cance as to the proper period for  weaning a  child, is,
to use a cant phrase,  " all moonshine."          L.
   If  the  mother  is  feeble  and sickly, it is generally
desirable to wean the  infant when  it is six months 
204          Lactation and Nursing.

old, or, as stated  in the previous section, even at  the
end of the first or  second month, if the mother pre-
sents  evidence  of suffering from lactation.  On  the
other hand, if  the  child  is very feeble, or suffering
from  any disease, it may be well to  nurse it to  the
tenth or eleventh  month, if  the mother's health is
robust.   Beyond that  time nursing is nearly always
productive of serious consequences both to  the mother
and child.  When weaning is decided upon, the mother
should gradually diminish the  allowance of the breast,
and increase the supply of suitable kinds of food;  " at
length  she  should  only  suckle  him  at night;  and,
lastly, it would be well for the mother, either to send
him away, or to leave him at home and to go  away
herself  for a few days.   It is a good plan  for  the
nursemaid to  have  a  half-pint bottle of  new  milk
(which has been previously boiled to  prevent it from
turning sour), in bed, so as to give a little to the child
in lieu of the breast.   The warmth of the body will
keep  the milk of a  proper temperature, and supersede
the use of lamps,"  etc.   As  soon  as the weaning is
commenced, the mother should remain very quiet for
a few days, in order that  the swollen  breasts  may  not
suffer from  the motion  of the arms  or the pressure of
the stays, and that  the system  may be free from  ex-
citement.  She  should take very light nourishment;
refrain from food likely to induce thirst; drink as little
as possible, and that cold water;  keep the breasts
covered with some  light, warm material; and eat  dry
food.
  Treatment.—Bryonia may  be administered  if
the milk continue in excessive quantity. 
Weaning.
205
  Belladonna, if there be redness and painful  disten-
sion of the breasts.
  Calcarea,  Pulsatilla,  and  Rhus  tox.,  are  also
remedies sometimes required  in  this condition.
  Accessory  Means.—In addition  to the  sugges-
tions offered above, if the flow of milk  continue too
abundant during the first few days of weaning, nip-
ple-glasses may be kept applied  to  receive the milk;
gentle  friction  with the hand, lubricated with olive
oil,  may also be had  recourse to, for softening  the
skin.   The breasts must  not  on  any account be
drawn, as  a continued secretion is thus  promoted;
such a practice also  endangers the formation of
mammary abscesses.
  The  breasts should not only be kept soft, but warm
also.   Camphorated, or phosphorated oil, are prefera-
ble  to  simple Olive oil.   They may be rubbed in
gently, applied  by means  of a  bit of flannel, or, bet-
ter  still, heated  in by means  of a  hot shovel, or by
sitting  very near the fire.                       L. 
206
                 CHAPTER  X.

MANAGEMENT  OF  EARLY INFANCY AND
                 ITS  DISEASES.
   The following brief sections include the general
management  of infants  only during the first few
months.   Ailments incidental to more advanced chil-
dren—teething, the eruptive fevers,  hooping-cough,
inflammations of  the  chest  and abdomen, etc., are
not introduced into this manual.


           I.—The New-Born Infant.

   As  an illustration of helplessness  and  weakness,
nothing can exceed that which an infant presents at
birth.  It requires help of every  kind, and if aban.
doned, it soon perishes.
   If an  infant is born before the  doctor's arrival, it
should receive the attentions pointed out in the sec-
tion on " Labor."  If the child be healthy and strong,
it will  cry vigorously;  for the transition from  a con-
dition  of unconscious repose, in a bland  fluid, at a
temperature of 980 Fahr.,  to the contact of rough
clothes and a  comparatively cold temperature, is cer-
tainly not agreeable.  The act of crying helps to fill
the lungs with air, and thus the functions of breath-
ing and circulation are established. 
The First  Wash.
207
  As a  rule, the stronger the cries of the child, the
more vigorous  it is.   Weak, puny children  scarcely
cry at all.  The same is true of infants who have suf-
fered much from protracted, or instrumental delivery.
Boys cry more  lustily than girls.


                The First Wash.

  As soon as  breathing is fairly established,  and the
navel-string tied, the infant should be enveloped  in
soft  warmed  flannel,  and, everything  being  ready
beforehand, it  should be immediately washed.  We
say immediately, for a new-born child  is often allowed
to remain a long time before it is washed, and  even
then it is not always washed quickly and skillfully, so
that it shivers,  and  the skin becomes blue before it is
placed by its mother's side.
  At birth the infant is covered  with  a greasy, tena-
cious matter; this should be washed off by means of a
fine  sponge, with warm water and a  little soap, and
then carefully dried with a soft warmed towel.  If the
unctuous  matter does not easily come  off,  no  force
should be employed in removing it, as it will come off
with subsequent washings, or scale off in a day or two.
As soon as the washing is completed, a little violet-
powder—finely-powdered  scented  starch—may  be
dusted lightly on the surface, especially in the creases
of the joints.   Immediately after washing, the infant
should be laid in its mother's bosom, and not, as is too
often the case, placed by itself in a cradle, where it is
in danger of being too  cold.  As a general rule, for
the first few weeks it  should sleep in the same bed 
208        Management of Early Infancy.

with its mother, especially during cold weather; after-
wards it should sleep in a cradle or cot.


            Dressing of the Navel.

  This  is to be done by folding a piece of soft linen
into four or six thicknesses,  about six inches by three,
and cutting a hole through the centre for the remnant
of the cord, winding round it a strip of soft linen; then
one half of the  folded  linen should be doubled over
the other half so that the portion of cord lies between
the folds, and directed upwards  towards the chest; the
whole is to be kept in  apposition by a band,  about
four inches wide, passed gently round the child's abdo-
men, and  worn till the remnant of the cord comes
away, which is  usually about the sixth or seventh day.
Till then, great  care should be exercised not to disturb
it during washing.
   Prof. Sanders wraps the stump of the cord in cot-
ton-batting so completely as not to allow it to come in
contact with the skin  of the abdomen.  He insists
that with this simple dressing there is less danger of
inflammation than with the old.                 L.


    Presenting  the  Infant to the Breast.

  As soon as the mother has somewhat recovered
from  the exhaustion of labor, the infant should be put
to the breast.  The disturbances incident to the com-
ing of the  milk are often prevented or much  dimin-
ished  by applying the child to the breasts as early after
delivery as practicable;  it also tends  to appease the 
Still Born Infants.             209
wants of the infant, and  in the mother reduces the
chance of secondary uterine haemorrhage  and milk-
fever.

           II. — Still Born Infants.

  Children are sometimes born apparently dead, and
if prompt and skillful means are not adopted, this con-
dition may pass into one of real and permanent death.
So long, however, as the heart continues to beat, no
matter how feebly, there is a probability  that well-
directed efforts will be successful in exciting breathing.
  Causes. — Constitutional feebleness,  so that the
effort necessary  to  commence  breathing  cannot be
made; obstructed circulation during labor by pressure
or twisting of the navel-string; too  long-continued
compression of the head; tenacious mucus in the mouth
and throat, preventing the entrance of air; etc.
  Treatment. — Efforts  to promote breathing are to
be made before the navel-string is divided.   Obstruc-
tive mucus should be carefully wiped away from the
mouth and throat, and the general surface exposed to
cold  air; an attempt should then be made to excite the
function of breathing by blowing in the infant's face,
sprinkling cold water on the face  or chest, or alter-
nately cold and hot, and by giving several smart blows
with the hand on the  buttocks and back.   The back
and  limbs should be  well rubbed, while the face  is
freely exposed to the air.

  Sometimes the  act of swallowing  a  little weak
brandy  and water  [warm], will  arouse  respiration,
and  set the little machinery in  motion.        L. 
210      Management of Early Infancy.

   If these means are not successful, and pulsation has
ceased  in the  navel-string, it  should  be  divided  as
before directed, and the infant plunged into a warm
bath, 980 Fahr., or wdiat is agreeable to the  back of
the hand.  If  the sudden plunge does  not  excite
breathing, it will be no use keeping the infant in the
bath beyond a minute or two, and Dr. Marshall Hall's
ready method should be tried, as  follows:
   " Place the infant on its face; turn the body gently,
but completely, on the side and  a little beyond, and
then on the  face, alternately; repeating these measures
deliberately, efficiently, and perseveringly, fifteen times
in the minute only."

     III.—Washing and Dressing Infants.

   Washing.—Infants should be washed twice in the
twenty-four  hours,  morning and  evening.   The best
method' is to dip the baby into a bath of tepid  water,
while the head is supported by the hand and arm of
the nurse, and  then have the whole surface of the
skin rubbed with  a soaped soft  sponge or piece of
flannel,  and  quickly and thoroughly dried with a fine
towel.
   During warm weather, tepid bathing should not be
continued beyond one or two  months, after which it
should gradually  be  substituted for  cold.   Feeble
infants may require tepid bathing somewhat longer.
For children born in the winter, the luke-warm bath
should be continued till the approach of warm weather,
when the change to cold  should be made.  Except as
above stated, the use of warm bathing is  to be em- 
Wet-Nursing, etc.
211
phatically deprecated.  The use of cold water, on the
other hand, forms a great protection  to  children,  as
well as to adults, against excessive sensibility to cold.
  The Dress.—Besides adapting it to the season, the
clothing  should  be loose, soft, light, warm, arranged
to fit without pins,  and  cover  the legs, arms,  and
neck.  The  clothing  should be scrupulously clean,
and  all soiled  and wet articles immediately changed.
Caps are unnecessary; the aim should be  rather  to
" keep the head cool  and the feet warm."  In all cases
the night clothing should be looser  and less warm
than  that worn in the  day.   It is also important that
the dress should not impede the free  movements of
the  limbs, or exert pressure on  the  digestive and
breathing organs.

    IV.—Wet-Nursing and Hand-Feeding.

   Unless she be incapable from debility or  disease to
furnish the necessary supply of milk, it is the natural
duty of every mother to nurse her own children.  Milk
is the proper aliment for infants, at least during the
first few  months of life, and if no unavoidable obstacle
prevent,  this  nourishment should be yielded by  the
mother in person, who should be jealous of deputing
the duty to another.
   Should, however,  a  mother be unable  to fulfil this
maternal duty, from constitutional or accidental debil-
ity or disease, the infant must either  derive its supply
from a wet-nurse, or be " brought up  by hand."   If
the  mother  has any  tendency  to  consumption,  all
thought of nursing should be abandoned from  the 
212       Management of Early Infancy.

first, and  either a wet-nurse or feeding with Sugar
of milk adopted.

   Qualities a  Wet-Nurse  Should Possess.

  The principal requisites for a good wet nurse are—
that she be between  twenty and thirty years of age;
of active and temperate habits; of a robust and healthy
constitution; of a quiet,  patient, cheerful disposition;
exempt from  any scrofulous or syphilitic taint; com-
plexion fresh and clear, and skin free from eruptions;
gums  red and firm; teeth  sound; tongue clean, and
breath sweet; breasts firm, vascular, and well-formed,
with  well-developed  nipples;  milk abundant,  rather
thin, and  of a bluish-white color;  and, lastly, it will
be well if the date of her labor does not differ  mate-
rially from that of the parent whose place she is to fill.
In  order  to keep the wet-nurse in good health, she
must live regularly on simple, nourishing, and  diges-
tible food, and much in the way she has been  accus-
tomed to;  she must  avoid  overloading the  stomach,
and so inducing dyspepsia; she may  drink beer or
wine in moderation, when she has previously been in
the habit of doing so, though if she can be persuaded
to  try milk, or milk-and-water, it will  be better; she
must be scrupulously attentive to cleanliness; and she
should take daily moderate  exercise in the  open-air.
If the catamenia  appear while she is  nursing, or if
conception takes  place,  the infant  will probably not
thrive as  it ought, owing to  the  diminution  of the
lacteal secretion;   and a fresh nurse  will  generally
have  to be  procured.   Moreover,  when the  nurse 
Hand-Feeding.              213
suckles a child of her own  along with  the  nursling,
constant care must be taken to ascertain that the sup-
ply of milk is sufficient for the wants of both.  Suck-
ling from a suppurating  breast is bad  both for infant
and nurse.   The only sure test of the goodness of the
nurse is  the condition of the child;  if the latter, con-
sequently,  does  not thrive, but  becomes thin and
puny, feverish and thirsty, sick, constipated, irritable,
and  restless,  the nurse should be at once  changed.
{Tanner).

                 Hand-Feeding.

  Should it be necessary or desirable to bring  up the
child  by hand, the  nourishment  should bear the
closest possible  resemblance  to  the mo'ther's   milk.
The substitutes ordinarily adopted, to the great detri-
ment of the  infant's health,  are  numerous  sorts of
" Infants'  Food,"  cows'  milk diluted or  not with
water, arrowroot,  biscuits,  etc.    The  best  method,
and  one which we have  known  successful in numer-
ous instances, is  cows' milk  assimilated  to  human by
slight dilution with water, and the addition of  Sugar
of milk, the cows' milk containing more oil {cream),
but less sugar than that of -woman.
  Formula.—The late Mr. H. Turner, to whom we
are  indebted  for the discovery, directed it  to be pre-
pared  for use, as follows:  "Dissolve one ounce of
the Sugar  of  milk in three-quarters of a pint of boil-
ing water.  Mix as wanted with an equal  quantity
of fresh  cows' milk, and let the infant be  fed  with
this from the feeding bottle in the usual way. Always 
214      Management of Early Infancy.
wash the bottle after  feeding, and put  the  teat into
cold water, letting it remain until wanted again."
   In carrying  out  the above  directions, it  is  neces-
sary to use  cows'  milk of good quality, and always
to  administer  the  food of  a uniform  temperature,
namely, that of breast-milk, and for the first month
not  oftener than every two  to three hours during the
day, and every three or four  hours during the  night.
On no  account should the baby be allowed to sleep
with the  tube of the  bottle in its mouth, to suck as
often and as long as it likes.
   About  the fourth or fifth  month, Sugar of milk
may be gradually  discontinued, and Ncave's  Fari-
naceous Food, or a similar preparation, substituted.
About  the  eighth  or  ninth  month, when the teeth
usually begin to appear, a gradual change of diet  is
necessary.   This should consist chiefly of farinaceous
preparations — arrowroot,  sago, and tapioca,  made
with milk;  afterwards sop made with bread  without
alum, and  bread-and-milk,  light puddings,  oatmeal
porridge, and a little mutton  broth, beef-tea, or bread
soaked  in a little gravy as it escapes when cutting up
a joint of meat.

V.—Medicines specially adapted to Infancy;
           their Administration, etc.
   As ailments are  pretty certain, sooner or  later, to
arise in children, it is  proper  to be  prepared  to act
promptly  for  their  relief.   In  consequence of  the
activity of the vital  powers, and the  quickness and
force of the circulation, there is a remarkable suscep-
tibility to inflammatory action, disease rapidly running 
Medicines Adapted to Infancy.       2icj
on to organic mischief.  A few Homoeopathic  reme-
dies in a small case or chest are invaluable  in  every
house in which there are children.  The absence  of
nauseousness  is  an advantage which  mothers can
appreciate who have witnessed the natural and proper
disgust of children to draughts and pills.  The agree-
ableness of our remedies is, however, only one advan-
tage;  for the diseases of children are most strikingly
controlled by Homoeopathic remedies.  The following
medicines are especially recommended  to be always
kept in readiness:

      Aconitum                Ignatia
      A rsenicum               Ipecacuanha
      Belladonna               Mercurius
      Bryonia                  Nux vomica
      Calcarea                 Phosphorus
      Chamomilla              Pulsatilla
      Cma                     Rhus tox
      Coffea                   Spongia
      Hepar sulphur           Sulphur

  For infants the remedies are most conveniently ad-
ministered in Globules,  just  crushed, and placed on
the tongue, which may be moistened with a few  drops
of water; or one Globule  may be  dissolved in  a tea-
spoonful of water and administered for a dose.   Tinc-
tures, however, are equally serviceable;  a few  drops
may be mixed, and administered in the proportion  of
half-a-drop for a dose.
  The prompt administration of a few doses of  an
appropriate  remedy will often  be alone sufficient,  or
afford temporary relief, till the arrival of a  Homceo- 
216      Management of Early Infancy.
pathic physician, or if there be not one within reach,
till one can be consulted by letter.
   In the treatment of infants, perseverance and hope-
fulness are necessary.  Patient attention  should be
given  to  the  investigation of every ailment,  and no
case should be abandoned as  altogether hopeless.   It
is well known that children  often recover from  the
most severe  diseases, and  in the great  majority of
instances, especially if taken in  time, the balance will
quickly turn in the right direction.

          VI.—Infantile Evacuations.

   The first stool  after birth is  called the  meconium,
and is of  a bottle-green or black color, and is gener-
ally passed soon after birth.  Till Homoeopathic teach-
ing  disclosed  its injuriousness, it was customary to
administer a  purgative,  the  early discharge  of  the
meconium being deemed of great importance.  Should
this be a little delayed, it  is of no consequence, as  the
mother's first milk is  thinner than what follows, and
of a somewhat laxative nature;  even the mechanical
distension caused  by the first food will usually cause
the bowels to act.  Should  the discharge, notwith-
standing, be tardy in its appearance, this is a  far  slighter
evil than  the administration of  castor oil or any other
purgative.
   Remedies  for Constipation.—Bryonia.—Con-
stipation  in irritable children,  and when  the stools
are large and pa'ssed with difficulty.
   Nux vomica.—Frequent, ineffectual urging.
   Opium.—Torpor of the bowels; evacuation of small
round balls. 
Infantile Evacuations.            217
  Mcrcurius. — Sallow skin;  pale  stools;  increased
flow of saliva.
  Sulphur.—Chronic constipation.
  Accessory  Means.—Frictions.   Lay the  infant
across the lap, naked, and rub with the warm hand first
the spine and then the abdomen, dressing it directly
afterwards.   Sometimes an  enema of tepid water  is
needed.  As children  get  older  they should be in-
structed to  solicit the action of the bowels every morn-
ing after breakfast.  It is also particularly necessary to
avoid the use of bread containing any alum.
  Remedies for Diarrhoea.—Chamomilla.—Pale-
green-colored, and too frequent  motions;  pains in the
abdomen;  peevishness; yellowish tint of the whites
of the eyes.
  Mcrcurius.—Whitish, very green-colored, or muc-
ous discharges.
  Mercurius cor.—Bloody, as well as mucous, evac-
uations, with straining.
  Rhubarb.—Loose, sour-smelling evacuations.
   Veratrum.—Almost continuous  diarrhoea,  with
sickness, pale face, etc.
  Arsenicum.—Diarrhoea with   rapid  emaciation,
pinched face, etc.
  Calc carb. — Chronic diarrhoea of  scrofulous chil-
dren.
  Accessory Means.—In recent cases, a teaspoonful
of arrowroot stirred in a little cold water, given cold;
rice-water,  made  in the same manner as barley-water,
administered cold and  thin, is useful.  In more pro-
tracted cases, small quantities of broth or beef-tea, with
the addition of rice, given  cool,  are beneficial, if they
     10 
218      Management of Early Infancy.

do not aggravate the symptoms.  Also the tepid com-
press over the abdomen, and frictions down the spine
and over the abdomen.


                 VII.—Vomiting.

  Vomiting of milk is very common  in  infants, and
shows, when the milk is returned uncurdled, that the
function of  digestion is at fault; on  the  other hand,
when  the  milk returned is curdled, it simply shows
that the stomach has been overloaded.  A single act
of vomiting, as when the stomach has been over-dis-
tended, or indigestible food has  been taken, is favora-
ble rather than otherwise.  Persistent and troublesome
vomiting requires  careful treatment.
  Treatment. — Ipecacuanha. — Simple vomiting
from overloading the stomach, or from indigestion.
  Pulsatilla. — Vomiting with diarrhoea, and when
traceable to errors in the mother's diet.
  Antimonium crud. — Vomiting  from  loss  of tone
in the  stomach, nausea, eructations, etc.
  Accessory Means—A change of diet is generally
necessary in the case of weaned or hand-fed children,
and of the mother's diet, or of her habits, in the case of
those who are fed by  the breast.   As too frequent
feeding is often the cause of vomiting, the stomach
must be allowed  a little rest between one meal and
the following.   After the child  is a week or two old,
plenty  of fresh out-of-door  air  and sunlight  will
improve the tone of the digestive organs. 
Crying.
219
                 VIII. — Crying.

  Causes.— In a majority  of instances, the crying
and fretfulness of an infant depend upon some mechan-
ical cause,—uncomfortable clothing, the point of a pin
in contact with the body, improper or over-feeding, wet
napkins, etc.  Crying is also the language by which
it makes its wants known; but it is a mistake to sup-
pose that the child should be presented to the breast,
or that  it is  hungry,  merely because it cries.  The
time since  the  previous  suckling  will determine the
necessity or otherwise  for feeding the child.  It is often,
however, due to indigestion, causing colic or wind, in
hand-fed children, or in infants  suckled by improperly
selected wet-nurses.
  Treatment.— Chamomilla.—Constant crying and
drawing up of the legs; pain or distension of the abdo-
men; looseness of the bowels; crying supposed to be
from earache or headache.
  Belladonna.—Crying  without   any appreciable
cause; flushed cheeks,  glistening eyes; starting out of
sleep and crying.
  Coffea. — Nervousness,  restlessness, and tossing
about.
  Aconitum.— Restlessness with febrile heat.
  Accessory Means.—The cause of crying should,
of course,  be sought out and  removed.  Relief and
quietness may often be obtained by rubbing the abdo-
men with the warmed hand. 
220      Management of Early Infancy.
              IX. — Sleeplessness.

  Sleeplessness is a concomitant  of  many  diseases,
from pain  and other causes.  In children  it may be
due to nervous irritability,  teething,  irregularities in
circulation, etc.
  Treatment.— Coffea.—Nervousness,  much cry-
ing, irritability, etc., without distinct febrile symptoms.
  Aconitum.—Hot, dry skin, and other symptoms of
fever.
  Belladonna. — Sleeplessness during teething, with
headache, flushed face, etc.
  Ignatia. — Nervous excitement.
  Accessory  Means.—Sponge the forehead and
hands with cold water, but keep the feet warm.  Let
the child have regular out-of-door air.   On  no account
administer soothing syrups or powders.  One of the
above remedies is infinitely superior.   A warm bath
for a few minutes will often soothe a  sleepless  infant,
and act as an excellent narcotic.


        X. — Inflammation of the Eyes.
            {Ophthalmia Neonatorum.)

  Two or three days after birth, occasionally not for
two or three weeks, infants are liable to inflammation,
involving  the eyelids, and sometimes extending to the
eyeballs.
  Symptoms. — A profuse discharge of thick  yellow
pus, which collects between the eyelids and the globe;
this being removed,  the conjunctiva is  seen  swollen,
and so vascular as to resemble crimson velvet; the cor- 
Inflammation of the Eyes.         221
nea looks smaller  than natural, and as if sunk in the
bottom of a pit.  The infant is very restless and fever-
ish.
  Causes.—Contact of the eye or eyes of the child
with leucorrhoeal or gonorrhoeal discharge in the vagi-
nal passage during birth.   Possibly, irritation of the
eyes after birth from  neglect of cleanliness,  exposure
of the eyes to a bright light or a strong fire, or to soap
or some mechanical irritant, may be a cause in other
cases.
  Treatment. — Argentum Nitricum.—This rem-
edy is a specific in most cases.
  Belladonna.—Discharge  of foul matter;  swollen
eyelids; dread of light.
  Aconitum. — At the  commencement, if there is
febrile disturbance.
  Sulphur. — After the  other remedies,  to render the
cure permanent.
  Accessory Means. — These consist chiefly in the
observance of great cleanliness, the eyes being sponged
or syringed out many times in  the day, and in gently
smearing the edges of the lids with  olive-oil or a little
lard by means of a camel's-hair pencil before the infant
goes to sleep.   It is important never to bathe inflamed
eyes with  cold water, as  it is sure to aggravate  the
symptoms.  On the other hand, warm sponging and
fomentations nearly always do good.  The preventive
measures must have for their object the improvement
of the mother's health prior to parturition,  including
the arrest of the local symptoms which  are so frequent-
ly a cause of the disease in the infant. 
222       Management of Early Infancy.

             XL —Coryza {Sniffles).

  Infants  are  liable to suffer from a kind of catarrh,
with  obstruction of the  nose, which interferes with
breathing  and suckling.  Occasionally it  is so  severe
that the child  can only breathe through  the mouth,
and suckling has to be abandoned, as it causes suffo-
cation.  It is generally due to exposure to cold, neglect,
improper clothing, etc.
  Treatment. — Aconitum.—If given  early,  and
repeated several times at  short intervals, this medicine
is generally  sufficient  to cure.
  Nux vomica. — Dry   obstruction,  or  watery  dis-
charge during the day, and stoppage at night.
  Alercurius.—Profuse mucous discharge, with sneez-
ing, soreness, and itching.
  Euphrasia. — When the eyes also are much involv-
ed,  with abundant watery discharge from them, etc.
  Accessory  Means. — The  interior  of the nose
should be frequently smeared with simple cerate, cold-
cream, or  tallow, to prevent the discharge from form-
ing into hard crusts.  If  suckling is difficult or impos-
sible,  the milk should be  drawn off, and the infant fed
by  means of a spoon.


      XII.—Croup  {Laryngismus Stridulus).

  Croup is of two varieties—Spasmodic, and inflam-
matory.  The Spasmodic occurs at the youngest  age,
before the end of the  first dentition.
  Symptoms.—It comes on suddenly, usually in the
night, with  a spasm of the  muscles of the throat, so 
Croup.                    223
that the child struggles to get its breath, with a choking
noise, and becomes livid in the lips.  It usually occurs
during  dentition,  or irritation  in the stomach  and
bowels.  Under proper treatment the attack generally
soon passes off, but sometimes  it is premonitory of
disease of the brain.
  Inflammatory  Croup  is  less  frequent,  and  often
Dccurs after  the primary  dentition  to near  puberty.
This variety should  always  be  under the  care  of a
Homoeopathic practitioner.
  Treatment of Spasmodic Croup.—Aconitum.—
In urgent cases, this medicine should be administered
every fifteen minutes, and in less urgent cases, every
one  or  two  hours, if there  is heat,  thirst,  short dry
cough,  and difficult  breathing.   This remedy  is of
priceless value in the early stage  of the disease.
  Spongia.—If Aconite produces  perspiration, and
the spasmodic breathing continues, administer Spongia
instead  of Aconite, or in alternation with it.  This
remedy is  particularly indicated if  the  breathing is
labored, loud, and wheezing, and the cough hoarse,
hollow, barking, or whistling.
  Hepar sulphur.—When  the cough is loose, has
the ringing or  brassy sound so peculiar to croup, and
is attended with a constant rattling in the chest, dur-
ing which  the patient tries in  vain to get  relief by
expectoration.  This remedy is often well adapted to the
inflammatory form of the disease.   If febrile symp-
toms are also present,  Aconitum  must be alternated
with Hepar sulphur.
  Administration.—In severe cases, every fifteen  to 
 224      Management of Early Infancy.

 thirty  minutes;  in less severe cases, or as improve-
 ment ensues, every one to four hours.
   Accessory  Means. — The  feet should  be kept
 warm, and there should be no strings or tight articles
 round the neck.   A warm-bath, and hot-water appli-
 cations to the throat,  are highly advantageous.  Dur-
 ing an attack, water  only is admissible; afterwards,
 milk-and-water,  etc.
   In the worst  cases, one precaution  should not  be
 forgotten:  Keep the  child awake until the symptoms
 are  manifestly relieved; give the medicine regularly,
 and do not be deceived by its inclination to sleep
   We have  more confidence  in  the second  or  third
 decimal trituration of Tart, emetic, than in any or  all
 other remedies in ordinary croup.  It should be given
 in solution, and  frequently repeated.            L.


    XIII.—Red-Gum—Heat-Spots of  Infants.

   This consists  of a  crop of pimples, usually on the
 face, neck and arms, but sometimes more or less over
 the whole of the body.
   Causes. — Too warm, or infrequently  changed
 clothing, heat of the weather, indigestion, the mother's
 milk, teething, etc.
  Treatment.—Rhus tox.—Confluent, or small red
pimples,  with a watery secretion.
  Sulphur.—Eruption with itching or burning.
  Aconitum.—Redness and fever.
  Accessory Meaxs.—Sponge the skin with warm
water several times a  day; avoid too warm clothing. 
Sore Mouth.
225   .
     XIV.—Sore Mouth—Thrush  {Aphthe).

  Symptoms. — Small  vesicles or white  specks  ap-
pear upon the lining  membrane of the mouth, and
are sometimes so connected  as to form a continuous
covering over the tongue, gums, palate,  etc.   The
disorder may also extend  to the stomach and bowels,
setting up violent diarrhoea and such general  disturb-
ance as to require the greatest skill and care to prevent
a fatal  issue.
  Causes. — A  delicate  or   strumous  constitution;
insufficiency  or  unhealthy condition of the mother's
milk; or, in infants who are fed by hand, an unsuita-
ble quantity or quality of food;  want of cleanliness;
general disease.
  Treatment.—Borax  has  a  specific power over
this  affection, and  will alone cure if the disease is
limited to the mouth.   The  child's mouth may also
be washed  with a  weak solution  of  Borax  (four
grains  to one ounce of water), by means of a soft
brush.
  Mcrcurius.—Is indicated by dribbling saliva, diar-
rhoea, offensive  breath, etc.;  if administered when
the white specks first  appear, it is often alone suffi-
cient.  A dose every six hours, for several days.
  Arsenicum.—If the  affected  parts become brown
or black,  and  have an  offensive smell;  or if  the
stomach and bowels become affected, and  exhausting
diarrhea is present.
  Sulphur may follow  Arsenicum or  any other rem-
edy, if the  latter does no further good;  also when
the thrush has nearly subsided, to prevent a  relapse;
     10* 
226      Management of Early Infancy.

and  when there are eruptions on the skin.   A dose
night and morning.
  General Treatment. — Strict cleanliness, good
ventilation,  abundance of fresh, out-of-door air,  and
suitable diet.   If the  sore mouth be due to ill-health
in the mother or nurse, the child should be at  once
weaned, and fed as already directed.
Church, Goodman & Donnelley, Printers, Chicago. 
 
 
INDEX.
Abdomen, enlargement of, 106
-----to be kept warm, 113, 122
Abdominal compress, 127
Ablutions, see "Hip-bath"
-----after labor, 177
Abortion, 142.
Abscess in the breast, 187
Accouchment, see " Labor"
After-birth, how to remove the, 168
After-pains, 175
Age suitable for marriage, 83
Ailments incidental to pregnancy,
                               115
Air, fresh, during labor, 157
Amenorrhoea {absence, retention, or
  suppression of the menstrual dis-
  charge), 27
-----and marriage, 33
-----and the general health, 32
-----causes of, 28
Amnion, see  " Liquor amnii"
Anaemia  {deficiency   of red  cor-
  puscles in the blood), 34
Anaemic, bruit, the, 35
Anger, 138
Ankles and feet swollen, in,  136
Aphrodisiacs  {medicines which in-
  crease the functional  activity  of
  the generative organs), 96,97
Aphthae a cause of sore nipples, 193
-----of infants, 225
Areola around the nipple, darkening
  of, as a sign of pregnancy, 104
Arnica lotion after delivery, 170
----- -----for sore nipples, 191

Ballottement, 107
Bandage after labor, 168.
Barrenness, 90
Bathing or sponging the body re-
  commended, 15, 25,  37, 65, 69, 113,
                      133,  M6. l8°
Bath, see " Hip-bath."
Bay-salt, 17
Beef-tea, 174, 180
" Bearing down," Impropriety of, in
  labor, 163
Bellyache of infants, see "Crying)"
Bidet or hip-bath,  15
 Binder, the, 168
 Birth before the doctor's arrival, 166
 Bladder during labor, 159
 Blood, menstrual, 21
 Borax in itching of the genital parts,
                               133
 Bowels, 159,  see  also " Constipa-
  tion:" " Diarrhoea;" and "Infan-
  tile Evacuations "
 Brandy, 162, 169, 174
 Breasts, the 186
 -----enlargement of as a sign of
  pregnancy,  103
 -----gathered, 187
 -----milk in the, 105
 -----pain and tension of the, 141
 ----- preparation of the, 187, 190
 Brown bread, no, 125
 ---- -----  injurious in piles, 128
 Bruit (Fr. a noise), 35
 Buzzing in {he ears, 48

 Calendar, Ladies', 150
 -----------observations on, 148
 Caps unnecessary for infants, 211
 Carbolic acid, 181
 Carriage-exercise, 113
 Castor-oil, 159
 Catamenia {according to the month,
  the monthly period, the menses, or
  the courses), see "Menstruation"
 Catheter, 130,  182
 Cautions in hysteria,  81
 Celibacy and late marriage, 84
 Cessation of the menses, 56
 -----as a sign of pregnancy, 101
 Change of life, 56
 Chest for medicines, 9
 Child-bed fever, 178
 Childbirth, see " Labor"
 Chloroform in labor. 165
 Chlorosis {green sickness), 34
-----and consumption, 36
Christianity never unstrings human
  nature, 86
Chronic piles, 126
Cleanliness, 62, 63, 65, 133
Cleansings, 176
Clothing, see  "Dress" 
228
Index.
 Coagulated blood, 22
 Cocoa, 197, 202
 Cold bath, 14, 24
 Colic, 121
 -----menstrual, 39
 -----of infants, 219
 Complementary, the sexes are, 86
 Compress  for the abdomen, 127
 Computation of time of labor, 150
 Conception, 97
 -----favorable period for, 9S
 -----recognition of its immediate
  phenomena, 9S
 Congenital dysmenorrhoea, 40
 Constipation after parturition, 182
 -----in pregnancy, 124
 Consumption and chlorosis, 36
 -----and marriage, 88
 Correspondents, 4
 Coryza, 222
 Cotton-wool in piles, 126
 Courses, the, 20, 60
 Cramps, 133
 -----during labor, 160, 161
 Cretins, 113
 Critical age, 56
 Croup, 222
 Crying of  infants, 219
 Curdled milk of infants, 218

 Dancing, excessive, 24
 -----in pregnancy, 112
 Debility a  cause  of abscess, 188
 -----and chlorosis, 32
 Delayed menstruation, see  "Amen-
  orrhoea "
 Delicacy of constitution, 28, 146
 Depression, fits of, when nursing,
                               194
 -----of spirits, 79
 Diarrhoea after, confinement, 184
 ----- in pregnancy, 122
 -----of infants, 217
 Diet after labor, 172
 -----hints on, 13
 -----in chlorosis
 ----in piles, 128
 ---- in pregnancy, Iio
 -----when nursing, 193
 Difficulties in  labor, 15^.
 Directions  about medicines, 10
 -----general, 14
 Diseases of infancy, 206
 Disorders of pregnancy, 115
 Dizziness and headache, 136
 Dose, n
 Douche, vaginal, 4^5
Drawers as an article of dress, 31
Dress during pregnancy, in
-----for comfort rather  than fash-
  ion, 31, 112
Dressing infants, 210
 Drop tinctures, how to, 10
 Druggists and homoeopathic medi-
   cines, 9
 Drugs  hurtful, 14, 28, 55, 62, 6S, 96
 Dysmenorrhoea {painjul menstrua-
   tion), 39
 Dysmenorrhoea a cause of  sterility,
                                 92

 Education and menstruation, 24
 Elastic stockings, 136
 Emmenagogues {medicines to bring
   on J he courses), 49, 28, 32, 55
 Emotional causes of sterility, 94
 Encicnte, meaning of the word, in
 Enema, 122;  :.ee " Injections "
 Enlargement of the breasts, 103
 Epilepsy and hysteria, 75
 Excessive secretion of milk, 198
 Exercise during pregnancy, 112
 -----recommended,  14, 31,  38,40,
   54, 6$, "2, 124, 138,  139, 143, 157
 Eyes, inflammation of, 220

 Fainting, see also  " Fits"
 Faintness, 78, 139,  173
 Falling of the womb, 4S, 67
 False delicacy, 26
 -----pains, 160
 Fear, 138
 Features sharp in pregnancy, 109
 Feet warm and dry, 31, 112, 122
 -----and ankles swollen,  112,  136
 Female functions, instructions in, 20
 Fever,  puerperal, 178
 -----the milk, 178
 First menstruation, 22
 Fits, hysterical and fainting, 75, 139
 Flannel, 122, 123.
 Flatulence in infants, see " Crying"
 Flooding {Menorrhagia), 45
 -----after delivery, 173
 Fluid diet in diarrhoea, 122
 Fluor albus {-whites), 61
 Foetal heart, sounds of, 108
 Food for infants, 202
 Forcing medicines,  255, 283
 Fresh air in labor, 157
 Friend in the lying-in room, 157

 Games,  out-door, 31
 Garters not to be used, 136
 Gathered breasts, 187
 General rules tor patients, 13
 Giddiness, 136
 Glasses for the nipples, 205
 Globus  hystericus, 75
 Green sickness, 34
Grief, 138
Gruel, its exclusive use condemned,
                               172 
Index.
229
Haemorrhoids (piles), 125
Hall's (Dr.) method, 210
Hand-feeding, 211
Headache, 136
Health, defective, 32
Heartburn, 120
Heart, palpitation of, 102, 119
-----sounds of the foetal, 108
Heat-spots of infants, 224
Herb-tea, 27
Hints, general, 113
-----to the  reader, 5
Hip-bath described, 15
----- recommended, 45, 54, 65, 70,
  72,  125, 146
Home influences, removal from, 80
Homoeopathic medicines and chem-
  ists, 10
Hoop, game of the, 31
Horse-back exercise, 113, 143
Hot-buttered-toast,  120
Hot drinks to be avoided, 147, 169
Human  nature  as  seen by the phy-
  sician, 86
Hymen, imperforate, 27, 91
Hysteria, 72     »
Hysterical expression, 76
------fits, 75, »39

Idle habits injurious, 23, 93
Ill-health and marriage, 88
Imperforate hymen, 27, 91

Impregnation, 98
Incontinence of urine,  128
Indian women and childbirth, 154
Infancy, management of, 206
Infantile evacuations, 216
Infants, artificial food for, 213
----- regularity in nursing, 194
----- still-born, 219
----- to be  applied early  to   the
  breast, 170
Inflammation of the eyes, 220
Injections, 45, 49, 65,  69, 122,  125,
  127, i$*,iS9, 155, 183
Insemination, 9S
Instruction of daughters, 20
Irritability of temper, 109
----- sexual, 94
Itching of the genital parts,  131

Joy, the effects of excessive,  138

Kiesteine  in  the urine,  a  sign of
  pregnancy,  108

Labor, 148
----- after-treatment,  172
-----a physiological condition, not
  one of disease, 172
-----calculation for the time of, 148
Labor, causes of its sufferings, 154
----- chloroform in, 165
----- constipation after,  182
----- general hints after, 169
----- getting up too soon after, 67
----- how to act till the doctor ar-
  rives, 167
----- length of, 163
----- management after, 172
----- pains, false and true, 160
----- position for, 160
----- powerless, 156
----- preparations for, 157
----- retention of urine  after, 1S1
----- stages of, 162
-----symptoms of approaching, 162
----- tedious, 164
Lactation and nursing, 186
Ladies' Calendar, 150
Late hours, 24, 113
-----marriages, 84
Leucorrhoea (whites), 61
----- vicarious, 55
----- nature of, 63
----- as a cause of sterility, 92
Liebig's extractum carnis,  174
Lime-water and milk, 123
Liquor amnii (the mater which sur-
  rounds thefxtus  in the uterus, to
  permit of its extension, and to
  prevent injury from pressure), 108
Lochia, the, 176
----- ablutions  during  its   dis-
  charge, 177
Looseness of the bowels, see "Diarr-
  hoea"
Luxurious living, a cause of  ster-
T Mltv> 93
Lying-in room, the, 157

Mammary abscess, 187
Management after  delivery, 172
-----of infants, 206
Marriage,  82
-----and amenorrhoea, 33
----- disproportion in ages, 87
----- of near kindred, S9
----- too  early, 83
Marriageable age, 72, S3
Marshall Hall's (Dr.) ready method,
                               210
Maternal instruction, 20
Mattresses, 60, 146
Mechanical   dysmenorrhoea   ex-
  plained,  40
Meconium, 216
Medicine-chest, 9
Medicines  and directions, 9-12
-----for infants, 215
Melancholy, etc., 138
Menorrhagia (excessive flowing of
  the menses), 45 
23°
Index.
Menstrual blood — its character, 21
Menstruation   (from   mensis, a
  month.   The monthly discharge
 from the uterus; also called the
  catamenia, courses, etc.), 20
----- affected by sea-voyage, 52
----- affected by change of habits,
                               102
----- absent, as  a sign of  preg-
  nancy, 101
----- cessation of, 56
----- commences  earlier  in  cities
  and towns, 23
----- delayed, 23, 27
----- first, 23
----- painful, 39
----- purposes of, 22
----- scanty, 39
----- sudden, 25
----- suppression of, 51
----- too  early, hints for prevent-
  ing, 23
----- too  profuse, 45
----- too prolonged, 50
 ---- vicarious, 55
Metritis (inflammation of womb), 70
Milk and lime-water, 123
Milk, deteriorated, 198
----- excessive flow of, 198
-----fever, 178
----- forcing the supply, 202
-----in the  breasts  as a  sign of
  pregnancy,  105
----- scanty, 196
----- suppression of, 196
-----to promote the  flow of, 197
Miscarriage,  142
-----prevention of, 146
Monthly nurse, 157
Morning bath, 15; see also "Bath-
  ing"
Morning sickness, 115
-----------as a sign of  preg-
  nancy, 102
Mother, diet of the nursing, 193

Navel, how to dress, 208
Navel-string, how to tie, 167
Neuralgic, dysmenorrhoea, 40
Nine days' rule after abortion, 145
Nipple-glasses, 205
Nipples,  darkening  around  the, a
  sign of pregnancy, 104
Nipples, how to elongate them, 191
----- sore, 191
Novel-reading, 24, 73
Nurse for  infants, 212
-----the monthly, 157
Nursing, 186
■----- diet while, 193
----- stated  times for, 194
----- too prolonged,  199
Oatmeal porridge in constipation,
                               125
-----------after confinement, 173
Obstructive dysmenorrhoea, 40
Occupation, necessity for, 24, 80, 139
OSdema (swelling from serous effu-
  sion), 111,  136
Open carriages, 19
Ophthalmia Neonatorum, 220
Os uteri (the mouth or orifice of the
  womb), 162
Ovum and ovaries, 98

Pain and tension of the breasts, 141
Painful menstruation, 39
Pains, false and true, in labor, 160
Palpitation of the heart, 119
Parturition, see "Labor"
Pelvis (named front it resemblance
  to a basin, is the bony cavity form-
  ing the lowest  part of the trunk,
  and contains the bladder, uterus,
  and rectum), S4
Pepsine, 118
Perineum  (the lower part  of the
  vaginal orifice), rupture of, 68
Periods, The, see " Menstruation "
Pessaries, 70
 'Pendulous belly," 168
Physician's view of human nature,
                                86
Physiologist's wonder and admira-
  tion excited, 22
Piles in pregnancy,  125
Placenta (after-birth), how to re-
  move, 168
Poult eggs, 149
Precocious education and habits, 24
Pregnancy, ailments of, 115
    — general rules during, no
-----certain signs of, 101
 -----signs of, 101
Prevention of miscarriage, 146
Primiparae (first deliveries), 104
Procidentia (protrusion) uteri, 67
Profuse menstruation, 4.5
Prolapsus  uteri  (falling of the
  womb), 67
Prolonged nursing, 199
Prostitution, 87
Pruritus vulvae, 131
Puberty (from piibeo, to wax ripe.
   That period of life when the indi-
  vidual becomes capable of propa-
  gating her species), 20
Puerperal fever,  178
Purposes of menstruation, 22
Pyrosis, 120

Quickening,  as  a  sign  of  preg-
  nancy, 107
-----see " Ladies' Calendar," 150 
Index.
231
Reader, Hints to the, 5, 6
Reckoning of pregnancy,  148
Red-gum of infants, 224
Relaxed bowels, 122,  184
Reproduction, 82
Rest for the uterus, 146
Retention of the menses, 27, 39
-----of urine in pregnancy, 129
-----------after confinement,
                            153-48'
Rigor (a sudden coldness with shiv-
  ering),  179
Rules for patients, 13
-----during pregnancy, no
Salivation, a sign of pregnancy, 109
Sea-bathing, 50
Sea-salt, 17
Sewing machine injurious, 24, 114
Sexual frigidity, 94
-----intercourse, excessive, 45,55,
                     62, 65, 92, 143
Sheets for friction, 18
Shoes, thin-soled, 51
" Show," the, 144, 162
Shower-bath,  81
Shuttle-cock, game of, 31
Sickness, morning, 115
Signs and symptoms of pregnancy,
                               101
Signs of approaching labor, 162
Sitz-baths, 15, 128
Skipping-rope, 31
Sleeping after dinner, 113
Sleeplessness of infants, 220
Slop diet, 172, 1S8
Sniffles, 222
Soda-water and milk, 123
Soothing-syrups and powders, 220
Sore mouth of nursing mothers, 195
Sore nipples,  191
Spasm, 121
Spermatozoa,  (minute  infusorial
  animalculx in  the semen), how
  destroyed, 95
Spirits, 59;  see also  "Stimulants"
Sponge-bath,  25;  see "Bathing"
Stages of labor, 162
Stated hours for nursing, 194
Stays, m
Sterility,  local and general causes
  of, treatment, etc., 91
----- whether it affects the male or
  the female, 91
Still-born infants, 209
Stimulants  to be avoided, 97,  no,
  132, 138, i54- '94 £
Stocking, elastic, 136
Stories of injudicious women, 138
Suckling, too long, 199
Sudden menstruation, 25

Sufferings of child-birth  causes of,
                               '54
Sugar-of-milk as food, 202
Suppers, no
Suppression of the menses, 51
----- gradual premature, 54
----- chronic, 52
----- sudden,52
Swelling of the extremities, in, 137
Swollen veins, in,  134

Tension of the breasts,  in, 141
Theatrical exhibitions, Si, 113
Thin-soled sho s, 51
Thirst when nursing, 194
Thrush, 225
-----and sore nipples, 193
Tight lacing,  51, 81, no, 143, 157
Times for nursing,  149
----- for taking medicines,  11
Tinctures,  10
Toothache, a sign of pregnancy, 109
----- treatment of, 118
Treatment after delivery, 172
Triturations, 10
Tumors and dysmenorrhoea,  41

Umbilical cord, how to  tie, 167
Urine, incontinence of,  128
-----retention  of,  during preg-
  nancy, 129
-----retention of, after labor, 1S1
Uterine contraction, 176
----- douche, 66
-----souffle,  109
Uterus (womb), development of, 20
----- rest for, 146

Vagina, color of, in pregnancy, 109
Vaginal douche, 45
-----------described, 66
----- injections, 45, 49, 65
Varicose veins, 134
Veins, enlarged, in, 134
Vertigo and headache, 136
Vicarious (substitutional) menstru-
  ation, 55
Vomiting of infants, 218

Walking exercise, 19, 112
Washing and dressing infants, 210
Water, cold, 16
Water-brash, 120
Weakness, 48
Weaning, 203
----- indications for, 203
Wet-compress described, 127
-----in constipation, 125
Wet-nurse, the, 212
Wet-nursing, 212
Wind in infants, 121
Whites, 61
Womb, development of, 20
----- falling of, 67
-----inflammation of, 70 
 
VALUABLE   MEDICAL  WORKS.
              THE   STEPPING  STONE


                                TO


HOMCEOPATHY   AND   HEALTH-



First American Edition, from the Sixth London Edition, with a

            Materia Medica and Clinical Directory.


         BY  DR.  E.   H.  RUDDOCK,

                  Author of " The Lady's Manual."


Revised and  Enlarged to  suit American Customs and Diseases,
                     by the American Editor.

         Price, $1.00.  Free by mail.

    " A sort of New Testament for  the body—'A stepping stone to health!'
*    *    *    He who never opened the book  before,  is able to  find the
remedy he wants."—Homeopathic Record.

    "An admirable work for those commencing the practice; and to the
experienced Homoeopath it will expedite the  selection of  a remedy."—
Farmer's Journal.

  " A perfect manual on a vital subject, and a copy should be in every home.
It will be a valuable hand-book to every mother for its simple  description of
various diseases."— Wesley an  Times.


                   50,000   COPIES

of the  English edition have already been  sold, and the American edition
will be found to have many valuable additions.
   The Homoeopathic Vade-Mecum of Modern Medicine and Sur-
gery.—For Junior Practitioners, Students, Clergymen, Missionaries, Heads

of Families,  etc.  Third edition, re-arranged and greatly enlarged.  Toned
paper, with  extensive Materia Medica,  and a Chapter on  Toxicology.

Price $3.  Free by mail.

  On Consumption :  Its Preventive,  General and Homoeopathic Treat-
ment—-The  work includes Chapters on the Constitutional Origin, Pathol-

ogy, Curability, Providential Purpose, Symptoms, Physical  Signs, Causes
and Treatment of Consumption.  Price 50 cents.  Free by mail.

  The above books for sale at all the Homoeopathic Pharmacies. 
  COMPOUND  CARBON CRACKERS,

                     FOR DYSPEPTICS.
Composed of recently Calcined Willow Charcoal, etc., combined
                     ■with  Graham Flour.

   On account of the difficulty and unpleasantness of taking Charcoal, it
has not hitherto been employed, either by physician or patient, so much as
its Valuable Medicinal Properties demand.  This objection is now
overcome,  as these  biscuits  are not only free from disagreeable taste, but
are palatable and highly nutritious.
   Recently calcined Willow  Charcoal is  a powerful  Disinfectant and
Absorbent, and when administered internally, is a valuable  remedy for
Heartburn, Waterbrash, Acidity of Stomach, Nausea, Eructa-
tions, Constipation, and other forms of Indigestion. It is employed
in these complaints with the  most favorable results by eminent physicians,
both in Europe and America.  Amongst others, M.  Belloc found it
especially efficacious in Gastralgia, etc., and his  observations were con-
firmed by the French Academy of Medicine; other noted men  recommend
its use, for whose opinion see United States Dispensatory, etc.
   The Carbon Crackers are of great benefit in the Vomiting of Pregnancy.
   The crackers should  be taken three or four times a day, and may be used
at meals in place of ordinary bread.
   For infants, soften one or two in milk or water, and give to prevent
Acidity of Stomach, Flatulence, etc.
   N. B.—Persons suffering  from Fetid Breath, arising from disordered
digestion or decayed teeth, will find these an effectual and pleasant remedy.
   Price, 75 cents in  boxes containg 3 dozen biscuits.
   Manufactured by
                                 C. S. HALSEY,
                                       66 Lake Street, Chicago.
             And  sold at the Homoeopathic Pharmacies.

  Are you  troubled with Chapped  Hands or  Lips?

                THEN BUY  A  JAR OF THE


  CALENDULA   JELLY.

It is neat, inexpensive, elegant and effective.  Superior in every
    respect to any of the GREASY preparations, such as
         Camphor Ice,  Cold Cream, or Lip Salve,
                          now in use.

                      Prepared by  C. S.  HALSEY.

  PRICE,  25 Cts.                 66  Lake  St.,  Chicago.

Can be obtained of Homoeopathic  Physicians and Pharmaceutists in the
                         United States. 
LACTEAL   SYRUP,

        For Increasing the  Flow of Milk in
                  Nursing Mothers.

Prepared  under  Instructions of PROF.  LUOLAM,
       The American Editor of " The Lady's Manual"

    It has been long  known that  certain plants had the effect
of increasing the secretion of milk in cows feeding upon them,
and certain experiments have proven that the plant from which
this syrup is prepared has the power of promoting this secre-
tion in the human mother—while it is perfectly harmless and
healthful otherwise.
   It is put up in pint bottles, at $1.00 each, and can be had at the Homoe-
opathic Pharmacies, and  of respectable Druggists.
Prepared  by C. S. Halsey, 66 Lake St., Chicago.
           THE CELEBRATED  ENGLISH

Arnica   Corn   Plasters.

          PREPARED ON THICK WHITE FELT,
                  AND SO MADE THAT

   They at once remove  the Pressure from the  Corn,
AND BY THE ACTION OF THE ARNICA RELIEVE THE PAIN AND SORENESS.


    PRICE FIFTY CENTS  PER BOX.
              Sent free by mail on receipt of price.

                    prepared by

     C. S. HALSEY, 66 LAKE  ST., CHICACO,
And sold at the Homoeopathic Pharmacies, also by respectable
                      Druggists. 
The  Fountain   Syringe.
    Eminent Physicians who have examined it agree that it is
constructed upon the only correct principle ever applied to the
construction of a Syringe, and the only one that can be used
with safety.  Being " self-acting," it is much more easy in
its application.  It has no valves to get out of order—" no air
injected."
    It consists of a rubber bag, holding, in the medium size
apparatus (No. 2,) about a quart, attached to about six feet of
rubber tube, which has near the end a brass  stop cock.  Suit-
able pipes fitting the end  of the tube,  are  provided for the
rectum, vagina and urethra.  There is also a spray  tube for the
eye, or wounds, and a nasal tnbe, making the apparatus an
excellent nasal Douche. All that is required in using it is
to fill the bag, hang it up above the patient's head and apply
the proper pipe where desired.
    PRICE OF THE No. 2 SIZE, $3.00.
                    FOR SALE BY
C.  S.  HALSEY,  66 LAKE  STREET,  CHICAGO,
        And at all other Homoeopathic Pharmacies. 
        SELF   ENERVATION,


                           ITS


Consequences  and  Treatment:


                           BY


          C.  S. ELDRIDGE,  M.  D.


   & ent  Free \»y  Mail  for  One  I>ollar.
    This work, though written for professional  reading, is also

calculated  to be of use to intelligent laymen.  Parents and

guardians, who peruse the work, will thank the author for his

valuable hints and suggestions.



    The fearful prevalence of this  vice  alluded to, and the

terrible  evils resulting from  it, make it important  that every

one who has the care of children, should  be well informed for

its prevention, or for its detection and treatment.
  Note by the Editok.—We have adopted the title "Self Enervation,"
tliinking it to be less inelegant than the terms usually employed, such as
masturbation, onanism, sell-pollution, sell-abuse, etc.  While it as clearly
conveys the same  meaning, it affords, although new, a mild and precise
definition of the subject under consideration. 
THE  NEW
Veterinary   Manual !


     GIVING COMPLETE DIRECTIONS

             For the Homeopathic Treatment of

Diseases of Horses, Cattle, S^eeP» E)°»sj
        AND  OTHER DOMESTIC ANIMALS.

FARMERS,
         STOCK DEALERS,

                    and LIVERY KEEPERS,
Will find this little Book and a Case of the Remedies

         PERFECTLY INVALUABLE!
The expense is trifling, but the saving thereby is sometimes very great.
                  Published Dy
  C. S. HALSEY, No. 66 LAKE STREET, CHICAGO.
        And for Sale at the Homoeopathic Pharmacies.
PRICES OF  CASES OF  MEDICINES FOR VETERI-
                 NARY USE.

24 2 drm. and 4 % oz. Vials, with Book,   -   -   - 6 00
24 % oz. and 51"     "     "    -   -   -   10 00
24 2 "    "    "    "     "   -   -   -   - 20 00 
          THE CELEBRATED VOLTAIC CURE  FOR

   Neuralgia, Rheumatism, and all Nervous  Diseases.

                   DR.   HALL'S



 B^]STDS  and  SOLES.
        A Scientific  an.) Rational  Method of  Curing
 All diseases  originating in a disturbed condition of the electrical  01
               vitalizing forces of the body j such as
 Cold  Feet. Nervous Headache, Rheumatism,  Neural.
    gia, Dyspepsia, Paralysis,  St. Vitus' Dance, Fits,
       Cramps, Weak Joints, Sciatica, Contract-
          ed Sinews, Sprains, Hip Complaints,
     Spinal Affections, and all Nervous Disorders.
   These Electrical appliances can be depended on as a remedial agent
 of positive  reliability in all such complaints, and will save thous-
 ands from  complicating  their  afflictions by  resorting  to  injurious
 remedies and improper applications.

       The Voltaic  Armor, Soles and Bands
 Are made on the principle of the VOLTAIC PILE, and being per-
 fectly flexible, can be worn under the feet or on  any part of the body
 without the least inconvenience.
   They Restore the Equilibrium of Electric Action  in the System
 And impart life and vigor  to every organ of the body.   For restoring
exhausted vital  energy, and in  all diseases having their  origin in the
loss of vital  power, through excess, sedentary  habit?, or the use of
powerful and pernicious drugs, the Armor may be used with  the full-
est assurance of success.
  Circulars giving more full description of the Apparatus, also numerous and
reliable testimonials of the beneficial results of  the use of the Armor are in
our possession, and will be forwarded to parties desiring them.
                          PRICE:
Bands for the Knees, each.....$2 26
Bands for the Thighs, each__2 50
Bands for the Waist, each..... 5 00
Soles, per pair____......____f 1 00
Bands fnr the Head, each......  2 00
Bands for the Wrists, each.....  1 00
Bands for the Arm, each.......  2 00
  In ordering, state the size of the boot or  shoe worn, also the width re-
quired, or, if bands, state the part of the body they are intended for.
  Sent to all parts of Uie United States on receipt of the above prices.

  Address                    O. S. HALSEY,
                               66 Lake Street, Chicago.
  General Agent for the Northwest. 
"2.
%
    Put up in large tin canisters, at $1.00 each ; sample box-
  es, 25c.
    We have numerous  testimonials  from physicians who
  daily prescribe it in  their practice, and from well-known
  citizens who make use of it in their families.
    It consists of Malt and Wheaten Flour, mixed in certain
  proportions, and heated to a degree which produces chemi-
  cal changes, resulting in the formation of an exceedingly
  nutritious compound.
    The process  is patented, and the preparation a strictly
  scientific one, the substance possessing the same chemical
  composition as healthy human milk.
    COMSTOCK'S KATIONAL FOOD has a large sale East
  and West, and is being employed with wonderful success
  as a most nutritious, wholesome FOOD for INFANTS, IN-
  VALIDS, and DYSPEPTICS, and particularly as a
   SUBSTITUTE FOR  BREAST IVHLK
  for Children BROUGHT UP BY HAND, and for WEAN-
  ING  CHILDREN.  It can be fed from a bottle like milk.
  It can  be had of C. S. HALSEY, 66  Lake Street,
Chicago,  and at any other Homoeopathic Pharmacy. 
CASTILIOT  POWDEES
           AN ARTICLE  OP DIET
  FOR  WEAKLY INFANTS.
  The composition of the Castillon Powders is well known to
Physicians and Pharmaceutists.  Though it is simply a com-
bination of mucilaginous and starchy substances, with a small
proportion of carbonate of lime of a peculiar preparation, yet,
when combined with pure milk (according to the directions
for use), the resulting substance is found to possess such
nutritive and medical virtues as to make the Powder an indis-
pensable necessity in the treatment of many cases of diseased
conditions of the stomach and bowels of weakly infants.
  There are numerous instances on record, where children—
who, from difficult teething, or other causes, constitutional or
hereditary, were pining away, as the result of distaste for food,
or from inability to retain and digest any of that given them—
have yet taken with avidity the food prepared  from these
Powders, and thrived upon  it, the disease  of  the bowels
quickly disappearing without other medical treatment.
  This prepared food is also an invaluable aid  in weaning
children  from the breast,  and is highly recommended in the
ordinary SUMMER COMPLAINTS of children, as well as in
many case of DIARRHOEA of adults.
                     ----o----
The CASTILLON POWDERS  are  pnl  np in neat
             boxes  of  one dozen  eaeh.
  PRICE,   ::::::  FIFTY CENTS PER  BOX.

The Castillon Powders are put up in neat boxes of
        one dozen eaeh, with full directions.
          PRICE, FIFTY CENTS PER BOX.
  They  can be obtained from Homoeopathic  Physicians
and Pharmaceutists, and from respectable Druggfsts.
     Manufactured by
                            C. S. HALSEY,
                                    66 Lake Street. 
THE  NORTH  AMERICAN
UTERINE SUPPORTER
    This  improvement on  the well-known  "Ilockcrt
Supporter," meets with very ready sale and with excellent
success in all cases of

          PROLAPSUS UTERI,

which can be relieved  by  a  mechanical support.  It has
been practically tested, and found to give the most perfect
relief.  It is light, durable, not liable to get out of repair,
can be perfectly fitted to any form or size ; putting it on
and laying it off is the work of but half a minute; it is so
easy that one is hardly aware of its presence; and the  re-
lief is immediate and delightful.
  Many who have scarcely been able to walk  across the
room for years, are enabled to walk with perfect comfort
and security the moment after it is adjusted.
  The new pattern of this Supporter is very easily adjusted,
and can be considerably varied in size and shape, so as to
euit any form.  In ordering, it is only necessary to give the
measure round the body just above the hips.
  The springs  can be bent to any shape, and will retain the
shape given—and by a screw adjustment at each end can
be made longer or shorter at will.
Retail Price,
each, $12.00 
g®IMEf   ¥0&t£I©   SAlffiBB¥.
Patented  January 26th, 1869.
  This Battery produces a direct galvanic current of great
intensity, and of  "force"  sufficient  to  overcome the  resist-
ance of the human body, and influence all the tissues.
  It is more constant in action, more simple and durable in
construction, and, though it 1 jqinres only a table spoonful of
common vinegar to excite the i urrent, produces a more power-
fid current than any other Pocket Voltaic apparatus now ex-
hibited.
  The case containing it is but one  inch thick,  three  inches
wide and five inches long.
  Directions for Operating the Battery.—Press the two sets of plates
together, sldewise, being careful that the red ends of the two backs are
both uppermost; then saturate a small piece of sponge with strong vinegar,
and press It out over the edges of the plates until the spaces between them
are  filled. Set the Battery, red end uppermost, upon the bottom of the
case, putting the copper slip through the loop in the case, as in  the engrav-
ing.  The positive and negative poleswhere the cords are to  be attached
are  marked Pand N.
  The Voltaic Battery does not  "give a shock," but when working pro-
perly the wire brush connected with the negative pole  will produce a
sensation of  pricking or burning when applied to the face or bare arm, the
other electrode being moistened and held in the hand.
  After the apparatus is used, separate the two sets of plates, rinse in clean
water, and let dry a little before returning to the case.
  If the action of the  Battery is too powerful for the patient, slide the plates
partially out of position.  By covering the flat electrodes with wet cloth or
paper the action is made more gentle.

  Price of Battery, including a Book of Instructions for Vol-
taic treatment of Disease, $6.50.

       FOR SALE BY DRUGGISTS AND PHARMACEUTISTS EVERYWHERE.

             C.  S.   HALSEY,  Proprietor,
                              66 Lake Street, Chicago 
 
i*7d
o ) 
.frMEftW.Wyjft*