℞ Tinc. digitalis ℥iss.Extr. Hyociami ʒi.Emuls. Camphorat. ℥iv. misce.
℞ Tinc. digitalis ℥iss.Extr. Hyociami ʒi.Emuls. Camphorat. ℥iv. misce.
℞ Tinc. digitalis ℥iss.Extr. Hyociami ʒi.Emuls. Camphorat. ℥iv. misce.
℞ Tinc. digitalis ℥iss.
Extr. Hyociami ʒi.
Emuls. Camphorat. ℥iv. misce.
It is also an essential point, that the bowels be kept open, and the patient put upon a light diet. As the attacks are very apt to come on at night, when the person is about to fall asleep,we sometimes find it useful to give a dose of tincture of hyocyamen and ether at bed-time, and must take great care that the patient be not afterwards disturbed or put off her rest.
When she is much troubled with flatulence, during the intervals the tincture valeriana ammoniata is of considerable service. Tonics and the cold bath are also proper. Hysteria either consists in or depends upon a preternatural aptitude in the different organs, to have their actions morbidly increased, or rendered irregular; and hence it may affect secreting as well as muscular parts; and many of the discharges of lying-in women will be found to be, in this sense, hysterical, and to alternate with other symptoms, such as globus, palpitation,headach, &c. and even the most troublesome of all the discharges, that proceeding from the uterus not recovering or contracting properly, is, I believe, properly speaking, an hysterical affection, connected with several others, and alternating with them.
The next disease which I shall mention is also, I believe, altogether hysterical. I mean that resemblance of fever which is often met with after either abortion or delivery, at the full time, and which is, like the rest of its tribe, abundantly obstinate.
This is not to be confounded with milk-fever, or other general diseases arising from local injury. It is sometimes preceded by palpitation, frightfuldreams, and other nervous affection[12]. At other times it attacks directly with a shivering fit; which is soon alternated with heat; then the heat becomes steady and distressing, and continues until a profuse perspiration carries it off.
The head is generally pained in the two first stages, and the pulse is frequent in them all. The thirst is considerable, the stomach filled with flatus, and the belly bound. Often we have irregular action of the heart occurring in all the stages, whilst the mind is weakened, andthe patient is much afraid of dying. The paroxysm continues for several hours, and, like ague, is apt to return regularly for a length of time.
In the cold stage, we give small quantities of warm fluid. In the hot stage, we lessen the number of bed clothes; but must not do this suddenly, as the shivering is very apt, in either this or the sweating stage, to return, upon slight exposure to cold.
In the last stage, we are careful not to encourage the perspiration too much, by refraining from warm drink, for much sweating only tends to render the disease more obstinate. A repetition is to be prevented, by keeping the bowels open, by the use of the bark, conjoined with antispasmodics, and by carrying the patient,as soon as possible, to the country.
The last disease, which I shall speak of, proceeds from the retention of the whole, or a part of the secundines, for a length of time after the expulsion of the fœtus. This circumstance, as I have formerly mentioned, may sometimes occur in that state of the uterus, which gives rise to hemorrhage, appearing as a joint effect with it. In this case, however, we must not conclude that the one symptom is dependant on the other, for both proceed from a common cause, the want of contraction of the uterine fibres.
It occasionally happens, that no hemorrhage accompanies this retention, but the remains of the ovum putrify, andafter many days come away in a very fœtid state. Until this expulsion takes place, we have very offensive discharge from the vagina, and not unfrequently loss of appetite, prostration of strength, frequent and small, but sharp pulse, hot and parched state of the skin of the hands and feet, with other febrile symptoms, even to an alarming degree, and generally accompanied with hysterical affections.
When this disease proves fatal, there are often, but not always, conjoined towards the termination symptoms of inflammatory action in the uterus.
The practice, at one time, was to endeavour, with the fingers or forceps, to extract the remains of the ovum; but this is not always successful, and is productiveof much irritation. We find it most useful to keep the parts clean, by injecting infusion of camomile flowers with a small quantity of oxygenated muriatic acid, to open the bowels with gentle laxatives or clysters, to support the strength by light nourishment with small portions of wine frequently repeated, if agreeable to the patient, and plenty of subacid fruit, whilst, at the same time, we, if necessary, procure rest, or allay irritation by opiates.
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