288 DR. CHASEPS RECIPES. 



ler or regularity of the patient's ordinary meals, provided there exist the desire 

 for solid food. During the later stages, however, it is wise to confine her to 

 fluids, such as beef-tea, gruel, milk, and tea, and to administer them in small 

 quantities at a time, so as not to overload the stomach and excite sickness. 

 Patients often ask for a little cold water, and many nurses, influenced by old 

 traditions, fear to gratify the wish. A sip of pure water can never do harm, 

 only it must be a "sip" and not a tumblerful, the patient being assured that 

 small draughts, frequently repeated, assuage thirst far better than larger quan- 

 tities. On no account must stimulants be given, except when expressly ordered 

 by the medical attendant. 



Vomiting is a troublesome symptom and distresses the patient, but its 

 influence on the progress of the labor is in no way unfavorable. Should it, 

 however, be excessive, it is well to give a little iced effervescing water from time 

 to time. 



Cramps During Labor.— Many patients suffer very severely from 

 cramp during labor. Relief can frequently be obtained by stretching the limb 

 straight out, and at the same time bending the ankle so as to put the muscles of 

 the calf well on the stretch. Gentle rubbing of the affected part with the hand 

 also affords great comfort. 



In the case of patients who have not borne children previously, it is an 

 excellent plan to diligently foment the perineum from the very outset of labor, 

 so as to render the skin softer and more yielding, and lessen the risk of tearing. 



DUTIES OP A NURSE DURING SECOND STAGE OP LABOR: 

 —What to do in the absence of the Medical Attendant — 

 Supporting the Perineum— Assisting at the Birth — Tying 

 th9 Cord — Breech Cases — The Third Stage — Application of 

 The Binder, &c. — Convulsions— Painting— Palling Porward 

 of the Womb. 



When the pains alter in character, compelling the patient to make efforts 

 to bear down, and the face begins to get flushed and the skin to become moist 

 with perspiration, the nurse may feel pretty well assured that the first stage is 

 over; and if the medical attendant has not arrived, she should request him to 

 be summoned without delay. In the meantime, the patient must be put to 

 bed, and encouraged to bear down and assist the pains. The binder, napkins, 

 and receiver must be spread near the fire in readiness. 



Should the child's head press upon the perineum before the arrival of the 

 medical attendant, a warm folded napkin may be placed in the palm of the 

 nurse's left hand and held against the bulging perineum, the fingers being 

 directed backwards, so that the front edge of the perineum may receive the 

 chief support. The object of this is to prevent the child's head passing too 

 quickly and suddenly forwards to the vaginal outlet and to preserve the perin- 

 eum from being torn. The great point at this stage is to avoid doing too much. 

 Nothing but harm is likely to result from attempts to enlarge the opening by 

 stretching the lips apart with the fingers, or to push back the edge of the perin 



