298 DR. CHASE'S RECIPES. 



Should no urine be passed during the first twelve hours, something to aM 

 the patient to do so must be given, as recommended elsewhere; and probably It 

 will be necessary to call a doctor to draw it off by means of the catheter. 



For the first few hours after delivery the vagina and external genital organs 

 are very sore and painful, and the discharge consists of pure blood. Ten or 

 twelve napkins are required during the twenty-four hours succeeding labor. 

 On the second day the discharge becomes less, and each day the quantity dimin- 

 ishes, the discharge itself gradually changing from pure blood to a thick dark 

 fluid, and lastly to a thin serum, like soiled water. The discharge always 

 possesses a peculiar and distinctive odor, but if the odor become offensive the 

 medical attendant should be informed. Similarly he should be told if, after 

 having once ceased to consist of pure blood, the discharge should again assume 

 that character. 



The discharges after labor are termed the lochia; they sometimes last only 

 a few days, and at other times continue for three or four weeks. They vary, 

 too, in quantity in different women, even when they are quite natural and 

 healthy. When they have passed through the changes I have named, they 

 ottght presently to cease, and if, instead of doing so, they continue, and if, 

 especially, they become purulent in character — that is, if they contain matter 

 like that of an abscess — an examination is necessary and the medical attendant 

 must be informed. 



On the other hand, it is not very unusual for the lochia to cease rather 

 early and suddenly, and although this often causes alarm both to patient and 

 nurse, it need not do so provided there is no other sign of ill-health, such as 

 shivering, thirst, and feverishness. 



For the first three days after confinement a patient should on no account 

 be raised to a sitting posture lest an attack of flooding should come on, or faint- 

 ing and even sudden death occur. There is not the same danger in allowing 

 her to turn on to the hands and knees; indeed, I have already said that this 

 posture may be resorted to in the event of any difficulty in using the slipper- 

 pan in the ordinary way. 



After the first three days, provided all is going on favorably, this rule as to 

 the level position may be relaxed a little, by allowing the patient to be propped 

 up by means of pillows or a bed-rest while she is taking food. At all other 

 times, however, she must continue to lie down until the ninth day, when she 

 may be assisted or carried to a couch and allowed to remain upon it for an hour 

 or an hour and a half. At first very little dressing ought to be attempted on 

 these occasions, the patient being protected from cold by wearing a warm 

 dressing-grown, or by having a good blanket thrown over her. The length of 

 time she is allowed to be out of bed may be increased day by day; and on the 

 twelfth or thirteenth day she may be fully dressed. The temperature of the 

 room must be regulated most carefully when the patient first leaves her bed, it 

 l)eing much more important for the room to be well warmed then, than during 

 the time she remained in bed. 



Should there be a suitable sitting-room on the same floor, the patient may 

 take advantage of it as early as the fourteenth day; the lying-in chamber being 



