MIDWIFERY. 



257 



Of the ing pain. In this state the stomach becomes filled 

 Puerperal with wind, the bowels are bound, and the patient is 

 *>'*** timid or hysterical. In some instances there is a state 

 "*"""/""* of complete apy rex ia, in others only a remission of the 

 symptom* Short attacks of this fever are not in gene- 

 ral dangerous ; but if they be repeated and prolonged, 

 it is probable that they depend on, or are kept up, 

 by some local disease. There may be incipient and 

 obscure disease in some of the great cavities of the 

 body, or the mammas may be partially affected. In 

 all such case* it is therefore necessary to examine 

 minutely into the symptoms and sensations, for it has 

 happened that some patients have been suddenly cut 

 off, who were supposed to be in little danger. 



When the cold fit comes on, our object is to hasten 

 the hot tan; which is done, not by putting many bd- 

 dotbet on the patient, for these are hurtful, but by 

 {riving frequently a small quantity of some warm 

 drink, Mich as gruel or lemonade, ami applying a bot- 

 tle, filled with warm water, to the feet and pit of the 

 stomach, or to the back, if it feel cold. When the hot 

 fit i established, these application* are to be removed, 

 and the tepid drinks continued till the sweat come* 

 out. Mean* are not to be employed for pushing this 

 far, but by taking a very little drink, and lying quiet 

 for some hours, it is to be encouraged to continue in a 

 moderate degree, till all the uneasy feelings and fere* 

 run symptoms are removed. Then, warm dry linen 

 is to be put on, and cold avoided with care. It re- 

 quires much prudence to ray when the perspiration 

 Might to be checked, but it is a good general rule, to 

 nue it till the fever is removed. After the sweat* 

 ing is over, a little panado with wine is proper. A 

 repetition of the fever U to be prevented, by avoiding 

 those causes which first brought it on, keeping the 

 bowel* open, taking some strengthening medicines, 

 such as bark, and procuring rest by opiates. When 

 there is a tendency to return, and no local disease can 

 be detected, the fit is sometimes checked by taking 

 twenty-five drops of laudanum an hour before the ex- 

 pected time of attack, and applying warm flannel to 

 the back. During the intervals, infusion of bark, or 

 the cautious use of arsenic, will be useful. 



If palpitation occur frequently, either along with 

 this fever or without it, the best remedy is a large 

 dose of laudanum, in a glass of peppermint water, and 

 during the interval, the vol.itile tincture of valerian, 

 with laxative*, or the camphorated mixture, will be 

 ;>tT. 



If the attack* of fever be repeated, or if it become 

 continued, it will be necessary to give up nursing; 

 and indeed in nnny cue* the secretion of milk be- 

 comes to much dil m to render it impossible 

 for the ch.ld to be noun-h -d by the parent. When 

 loci! pain, or symptoms indicating the existence of in- 

 flammatory action in iny organ appear, no cure can 

 be expected till that organ be relieved. 



CHAP. VIII. 

 /,/* Fner. 



The secretion of the milk is often accompanied with 

 a considerable degree of fever, called the milk i 



<s partly owing to that disturbance which is al- 

 ways to A certain degree excited in the sysUni, when- 

 ever a new process is established, and p-rtly owing to 

 the - :mn oi the IT< aU themselves. In 



this view it may, though f short duration, l>e compar- 

 ed to the teething fevsr of infaiiU. l'Li lever com. 



VOL. XIV. PART I. 



Of the 



Puerperal 



Stale. 



Of milk 

 fotcr. 



mences about the second or third day after delivery, 

 and consists of a cold, a hot, and a sweating stage, dur- 

 ing each of which, the symptoms are so much the same 

 with those described under the name of weed, or ephe- lr ~" 

 meral fever, that it is needless to repeat them. It must 

 not, however, be supposed, that the fever takes place 

 in every instance, more than that every child has a 

 teething fever : and even in those cases where the fe- 

 ver is considerable, there is very little danger. There 

 can be no difficulty in distinguishing thU disease, for 

 the breasts are full, hard, and painful, circumstances 

 which at once point out the nature of the complaint. 

 By way of preventing this fever, it has been recom- 

 mended, that the child be applied to the breast as soon 

 after delivery its the strength of the patient will per- 

 mit, and this is extremely proper if the trial be made in 

 such a way as not to fatigue her. It is also useful to 

 procure a stool early, and it is even proper, where 

 the patient is stout, of a full habit, and dues not propose 

 to nurse, to give laxatives more freely, in order to di- 

 minish the quantity of milk, and prevent swelling and 

 irritation of the breasts. 



When milk fever does take place, the treatment is 

 very simple, consisting in giving warm drink, such as 

 gruel, or lemonade, in small quantity, during the cold 

 stage, and applying warm flannel to the feet and stomach. 

 In the hot itage, the curtains are to be thrown open, 

 the coverlet taken off, and tepid drink given to excite 

 perspiration. In the sweating stage the perspiration, 

 which is generally sour-sroelled, is to be gently encou- 

 raged, till it be universal, and the patient feel relieved, 

 then it is to be lessened, and the management is the 

 same as in weed. These means are to be employed to 

 an extent, and with a degree of attention, proportioned 

 entirely to the severity of the symptoms. 



CHAP. IX. 

 Of Inflammation of the Breailt. 



When, in consequence of exposure to cold, or of the OrinAjm- 

 pain and tension, occasioned by the retention of the nation of 

 milk, in those who do not, or cannot suckle, inflamma- lht breasts, 

 tion of the brcatt is excited, there is the greatest reason 

 to apprehend that suppuration will take place. This 

 disease is easily known by the p tin, hardness, and swel- 

 ling which accompany it. In some cases, the whole 

 breait seems to be affected, in others, only one half, and 

 in many the affection is more circumscribed, or small 

 and superficial. This complaint is generally accom- 

 panied by fever, and that is sometimes smart when 

 the mammary affection is so obscure, as to escape ob- 

 servation for several hours, or even for a day or two. 

 When the breast inflames, it is evident that the rctrn- 

 tion of the milk mutt, for a time at least, increase the 

 pain. The first and earliest object therefore, must be 

 to have the breast gently drawn, either by the child or 

 by other means, provided these attempts do not give 

 pain, for if they do so, and the milk do not come readily, 

 more hurt than good will be done. The breast should 

 be gently fomented with a sponge dipped in tepid 

 water, and then covered with a poultice of bread and 

 milk, no as to continue the soothing effect* of the fo- 

 mentation. The patient should keep in bed, and have 

 the bmut properly supported. Spare dry diet and laxa- 

 tives are proper. If the pain and hardness do not very 

 soon go off, but, on the contrary, the former become 

 more severe and throliliing, suppuration must take 

 pluce, and it is to be encouraged by bread and milk 

 poultices, applied hotter t Inn formerly. If the ab 

 2 K 



