WEare in this place only to consider theAcute Distempersof thePuerperial Woman, because the Time oflying-inis not of such a longContinuanceas to admit ofChronick Diseases: And theseAcute Ones, in short, which they are most commonly subject to, are continualFevers, (Either, 1.Essential, that is,Feversproceeding first from theBlood; or, 2.SymptomatickFevers, that is, such as follow upon the internalInflammations, which often attend theChild-Bed-Woman;) as alsoFrenzies,Watchings,Lethargies,Convulsions,Epilepsies, &c.—
BUTmore especially there isoneparticular kind ofFever, which invades almost all labouringWomenthe third or fourth Day after theBIRTH, and is commonly call’d theMILK-FEVER; because about that time, theMILKbegins to generate more plentifully in theBreasts, taking itsRisefrom the Motion and Agitation of theBlood, which converts it from theWombto theBreasts. ThisDistemper, resolving itself about the ninth Day bySweat, is of no dangerousConsequence; provided thePATIENTobserves a good and properDiet, and duly prevents allCold, that might readily stop theSweat, and carefully preserves theMilkfromcoagulatingorputrefyingin herBreasts, whence theSymptomatick FEVERScommonly arise: Wherefore, I say, thisMILK-FEVER, being of the extendedEphemerickSort, and ceasing of itself, requires no greatCure.
ONLYin thisCase, it is a vulgarErroramong thegood Women, that because thisFEVERlasts only four or five Days at most, coming on about the fourth, and ending about the ninth Day after theBIRTH, they take allFeversin this time, for theMILK-FEVER; and consequently thro’ thisMistake, neglecting, or not regarding duly the trueCondition, thePatientis very often endanger’d: WhichMistake, that they may for the future diligently avoid, I shall subjoin here some certainSignsofDistinctionin due Course. But previously——
THECausesof allFEVERSincident to theChild-Bed-Woman, are either theSuppressionof theLochiain whole or in part; or the vitiousQualityof theHumoursaccumulated inGestation, and exasperated in theBirth; or a vitious irregularDIETin the time oflying-in; or the coldAir, or any suchAccidentby bad Management, may readily convert theMILK-FEVERinto aputrid and dangerousone; as a latentCACOCHYMYmay also easily dispose it toCorruption.
THEtrueDIAGNOSTICKS, in my Opinion, are as follow,viz.First, theMILK-FEVERis known from hence, that it always begins about theFourth Day, when theBREASTSbegin to fill withMILK; and then theLOCHIAflowing regularly, theWomanfinds a certainGravityor Weight in herBackandShoulders.
BUT,Secondly, when theLOCHIAaresuppressed, whether in whole, or in part, ’tis then certain that the presentFEVERproceeds from thence; theBELLYthereby swells and is puffed up, as also it ispainedwhentouched; and theHumours, at last, putrefying in theWOMB, it ejects a certainfœtid or corrupt Matter.
WHEREAS,Thirdly, if theFEVERneither proceeds from theMILK, nor from any Irregularity of theLOCHIA, why then it must necessarily either proceed from thevitious Qualityand Preparation of theHumours; or from aCacochymical Habitof Body; or from anirregular Way of Livingin time ofGESTATION.
THEmost certainPROGNOSTICKSare as follow,viz.First, AllAcute DiseasesinChild-bed Women, whoseStrengthis impaired by theirLABOUR, are much more dangerous than in anyOthers.Secondly, These which proceed from theSuppressionof theLOCHIAare most dangerous; because theHumoursputrefying in theWOMB, occasion most severeSYMPTOMS, yea and too commonlyDEATHitself, unless a luckyDiarrhæa, or a timelyEjectionof the corrupted Matter, prevents theMisfortune.Thirdly, The self-same is the unfortunateConsequence, when theDistemperproceeds from the vitiousHUMOURS; forNaturethen not being able to expurgate their abounding Superfluity by theLOCHIA, thePATIENTmust needs be greatly endanger’d, if not overwhelm’d.
THEmost adviseableCure,First, as to theMILK-FEVER, is only to be committed toNature, theWomanusing always a properDIET, and carefully animadverting, that theSWEAT, in which it commonly terminates, be no ways checked, impeded, or obstructed.
SECONDLY, As to theWatchings,Deliria’s,Epilepsies, &c. which thePATIENTis subject to in this Condition; as they proceed only fromVapoursof theBLOODandHumours, ascending to theHead, when theLOCHIAdo not flow regularly, or when theWomanisFeverish: So theCureof these distemper’dCasesdepends (at first) chiefly upon retracting theHUMOURSfrom theHeadto the inferiour Parts, and correcting theCourseof theLOCHIA: Because, if these flow orderly, and the vitiousHumours, from which such depravedVapoursas affect theHead, be removed and evacuated, all suchSYMPTOMSquickly cease and vanish of their own Accord.
THIRDLY, in the other above-mentionedCases, thePATIENTought always to be treated according to the various Circumstances of herCondition; I mean, according to the attendingSYMPTOMS, conformable also to which the ingeniousPhysicianwill always judiciously take his prudent Measures: Since theCuredoes not always depend upon thesame Method; especially when asymptomatick, or concomitantFEVER, joins thefirst, as it very often happens, by anInflammationof someparticular Part, proceeding from something of the vitiousHUMOURSenforcing itself upon the same veryPart.
NOW, in short, tho’ suchInflammationsmay affect anyPartof the Body, yet (I think) the most commonCaseis, that which affects thePLEURA; and from hence (thePleurisyjoining theFEVER) theWomanlabours under both these complicatedAcute Diseasesat once. TheCureof which difficult and dangerousConditionbelongs only to the ablestPhysician, to whom I should be justly censured, in impertinently offering anyInstructionupon this Subject. Finally, in a word, from what has been said in theChapterof theAcute Diseasesof Women withCHILD[181], we may more fully gather what is to be prudently done to Women inCHILD-BED, afflicted with the likeDistempers.