9. MANAGEMENT AFTER DELIVERY


Homeopathic remedies for past-partum depression include Arsenicum, Aurum, Belladonna, Cann. I., China, Cim., Hyoscyamus, Ignatia, Platina, Pulsatilla, Stramonium, Verbascum A., Verbascum V….


58. DIET

ERRORS on this point have arisen from parturition leaving been regarded as a diseases, rather tan a physiological condition. Labour is a process of health, and under ordinary favourable circumstances 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? Indeed, under a low 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 never seen any untoward results. On the contrary, many ladies formerly under the care of doctors who have 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. When a patient is delivered in the night or early morning, and there are no favourable symptoms, we allow a mutton chop for dinner on the first day; for other meals, well- made oatmeal-porridge, cocoa or tea, cold-buttered-toast, or bread-and-butter, a breakfast-cupful of arrowroot or gruel, light farinaceous puddings, etc. A too exclusive use of gruel and other slops is apt to distend the stomach, produce Constipation, and retard the necessary changes in the womb.

59. FLOODING

This is one of the most frequent, and at the same time the most serious of the accidents which complicate the expulsion of the afterbirth. The haemorrhage generally comes on with a rush a few minutes after the child is born, and before the placenta is expelled; 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 recognises, and is sometimes so sudden and abundant as to place the patient in great danger; at other times the discharge is confined to the cavity of the womb, when it may escape detection, or be only recognised when it is difficult or impossible to remedy it. Pallor of the face small pulse, dimness of vision, noise in the head, and fainting, are symptoms which accompany dangerous haemorrhage, weather the discharge be internal or external.

MEDICINAL TREATMENT. Caulophyllum, Croc., Hamamelis, Ipecac., Sabin., Secale The indications for these remedies will be found under “Profuse Menstruation,” pp. 43-46.

ACCESSORY MEANS. Immediately the haemorrhage occurs, one hand, previously dipped in cold water, should be placed on the abdomen, to grasp the uterus, to stimulate it to contract; if the same time napkins saturated with cold water (or else hot water See next page) should be suddenly dashed of the external parts. An enema of ice-cold water will often be effectual. Small lumps of ice. when they are obtainable, may be introduced into the vagina, and carried event to the uterus, or pushed up the rectum, to arrest haemorrhage; at the same time, small pieces of ice, in considerable quantities, should be frequently swallowed.

The internal and external employment of ice in this manner will rarely fail to effect early and vigorous contraction of the womb. The patient should remain quite still, the hips being a little elevated, and the pillow removed from her head. On the other hand, and application of heat to the spine by means of Chapman’s spinal bags is very efficacious. (See p. 10.) Hot-water injections have also been recommended, as exerting a far more energetic action in the contraction of the arterioles, and thus contracting the uterus. The water employed has been at the temperature of 120 degree. The application of the child to the breast is also useful, as it tends to excite uterine contraction. The patient should be lightly covered, the room kept cool, and a free circulation of air promoted. If the discharge has been alarming, and the patient appears on the point of death, she should have brandy, but slightly diluted with water, 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, or Liebig’s extractum carnis, should be given in small quantities, but frequently.

After flooding the patient is generally inclined to sleep. This tendency should not be interrupted, as sleep 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 skilful medical treatment.

PREVENTIVE MEANS. After delivery the patient should remain in silence, and enjoy the most absolute repose of mind and body for least half an hour or an hour. A clean and well-aired 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.

60. AFTER PAINS

Except after a first labour, women generally suffer from after- pains, the nature and intensity of which are much influenced by the character of the labour and the constitutional peculiarities of the patient. After-pains are liable to increase with each succeeding labour, 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.

CAUSE. Uterine Contraction. After the birth of the child, and the detachment and expulsion of the afterbirth, muscular contractions are still necessary to close the now empty womb, and to reduce that organ to its natural size in the unimpregnated state. This is termed Involution. After-pains are said to be often troublesome in women who have taken chloroform during labour. This may be due to the severity of the pains, or the pains may seem greater from their mitigation during labour. In the latter case, Dr. Ludlam recommends five drops of Chloroform to be added to half a tumbler of water, and a teaspoonful to be administered as often as the pains recur.

MEDICINAL TREATMENT. Arnica, Belladonna, Camph., Chamomilla, Coffea, Gelsemium, Nux V., Sabin., Secale, Xanth.

INDICATIONS FOR THE PRINCIPAL REMEDIES.

Arnica. Pains following a protracted, hard labour. This remedy may also be used externally. Twenty drops of the strong tincture of Arnica to a teacupful of warm water. A napkin, saturated with the lower part of the abdomen, and covered with oiled silk or dry flannel to prevent too rapid evaporation.

Belladonna. After-pains, with headache, flushed face, nervousness, and restlessness.

Chamomilla. After-pains or irritable patients.

Coffea. Extreme sensibility, the pains being almost insupportable, with sleeplessness and restlessness.

Gelsemium. From its remarkable power of diminishing excessive muscular activity, this remedy is recommended.

Viburnum covers the same symptoms.

Nux Vomica. Severe after-pains and the discharge of large from clots; flatulence.

Sabina. Intermittent forcing-pains.

Secale. Continuous forcing after-pains. A high potency is better than a low one.

Xanthoxylum. This remedy is said to be of inestimable value in after-pains.

61. THE LOCHIA (Cleansings)

This is a healthy discharge which takes place after delivery, and in colour and appearance at first resembles the menstrual discharge. Gradually, however, it becomes lighter, yellowish, and before its final cessation, of a greenish or whitish hue. In a majority of cases the red colour changes in about a week on the yellowish shade. It varies considerably in different women, being in some thin and scanty, and continuing with a few days, and in others is so profuse as almost to amount to flooding, and lasting for weeks. The latter is most common in patients who have been troubled with too copious menstruation, who have borne many children, and who have indulged in the pleasures of the table. In some cases, too, this discharge has a disagreeable odour.

IRREGULARITIES. The following deviations from the normal discharge require medical and hygienic treatment: A sudden arrest of the lochia; a too prolonged or sanguineous discharge; lochia having foetid odour. The latter condition may be blood-poisoning. (See Section on “Puerperal Fever.”)

MEDICINAL TREATMENT. Aconite, Belladonna, Bryonia, Calcarea C., Hydras., Hyoscyamus, Platina, Pulsatilla, Sabin., Secale, Sepia, Sulphur

INDICATIONS FOR THE PRINCIPAL REMEDIES.

Aconitum. Too profuse bright red discharge with quick pulse, scanty, hot urine, and for plethoric patients. If there is pain from slight pressure over the womb, a strong Aconite lotion, hot, should be applied over the seat of pain.

Belladonna. Scanty discharge with headache, flushed face, and confusion of ideas; also when the lochia is foetid, and there are the above symptoms.

Bryonia. Suppression of the lochia; intense headache, with fullness and heaviness; pain in the breasts; aching in the back; hot, red, and scanty urine.

Edward Harris Ruddock
Ruddock, E. H. (Edward Harris), 1822-1875. M.D.
LICENTIATE OF THE ROYAL COLLEGE OF PHYSICIANS; MEMBER OF THE ROYAL COLLEGE OF SURGEONS; LICENTIATE IN MIDWIFERY, LONDON AND EDINBURGH, ETC. PHYSICIAN TO THE READING AND BERKSHIRE HOMOEOPATHIC DISPENSARY.

Author of "The Stepping Stone to Homeopathy and Health,"
"Manual of Homoeopathic Treatment". Editor of "The Homoeopathic World."