586 MANAGEMENT OF LYING-IN WOMEN. 



doubted signs of phlegmasia in the abdomen; I believe them to be 

 of no use where the strength and appetite return fairly and rapidly; 

 but where the tongue is broad, whitish, yellow, or greenish the 

 mouth bitter and clammy, and there is no appetite, even although 

 there might be present some degree of fever, tension and sensibility 

 of the epigastrium, a gentle purgative I have often found to be fol- 

 lowed by the very best effects. I have seen these various symptoms 

 disappear on the succeeding day ip most cases, and the health be 

 afterwards restored with a degree of promptitude that I had had no 

 reason to hope for. By freeing the intestinal canal of the mucous 

 deposit with which it is pasted over, the purgatives bring it into a 

 state better fitted for the performance of its functions; the abundant 

 secretions which they occasion to take place from the villous surface 

 of the digestive passages free the system from substances that could 

 prove hurtful only, and impress upon the other functions a sort of 

 shock by which nature profits. 



I prefer the factitious sedlitz water, or from six or eight drachms 

 to two ounces of castor oil; tlieir effect is sufficiently certain, and I 

 have not seen them produce as much irritation as most other evacu- 

 ants. 



1245. The time that a lying-in woman ought to remain in bed is 

 necessarily very variable, and the nine days, the period fixed by the 

 vulgar, can be adopted only as a mean or general term. Five or 

 six days are sometimes sufficient; but if the symphyses should seem 

 to have been somewhat strained, the •womb have a disposition to pro- 

 lapse or become inverted, or the health appear frail, we ought to 

 •wait, and instead of eight or ten days, we should rather require her 

 to lie still for two weeks. In all cases, it would be wrong to per- 

 mit her to return suddenly to her usual exercise, as some practi- 

 tioners allow their patients to do. The first day she gets up she 

 should remain half an hour upon a sofa, and an hour the next day; 

 the third she may take a few steps and remain out of bed for two 

 or three hours; and during the following days she should consult 

 her strength and the degree of fatigue, as the rule for going to bed 

 again. Soon after this she can go down and take a few turns in 

 the garden, or in the yard; but it would be dangerous to go to 

 church on the first occasion of going out. The churches are ge- 

 nerally large, cold, and very freely ventilated. In what is called 

 their Churching, the women should not keep long on the knees; 

 they are sure to be fatigued before they go out, and often contract 

 there the seeds of serious diseases. Real religion does not demand 

 such imprudences; the woman ought to recover some degree of 



