Complications of pregnancy / by Edward P. Davis.

  • Edward P. Davis
Date:
1931
Catalogue details

Licence: In copyright

Credit: Complications of pregnancy / by Edward P. Davis. Source: Wellcome Collection.

    201/400 (page 181)
    impossibility of lying- down for sleep, the pallor instead of the dusky hue in the face and, in extreme cases, the patient’s fright and sense of impending- danger, and threatened failure in the action of th e heart. In choosing a method of treatment to aid such a case, the patient’s environment must first be studied to find what is constituting her great- est burden. If, for example, she be working in a factory, running a machine whose gear is too heavy for her, that must be obviated. If domestic work is overtaxing her, she must be relieved of this. If sudden mental or nervous shock or g'reat depression are present, these must receive attention; but the first element of successful treatment will be the study of the patient’s social conditions and the removal of the greatest exciting cause. Next in order comes physiological rest. In almost all cases this requires confinement to bed or couch and, in extreme cases, strict con¬ finement to bed with the use of the bed-pan. The patient’s posture must be that most comfortable for herself. While she requires nourish¬ ment, this must be of such a character as to make the least demand upon the digestive organs and leave the least residue. In selecting the diet, the mistake must not be made to add greatly to the quantity of fluid ingested, for, if the patient’s tissues are water-logged, she will not improve by the addition of fluid. She will, however, be greatly im¬ proved by the abstraction of fluid, and this may be most safely done through the intestine. Thus purgative medicines which produce free watery stools are indicated, such as the compound cathartic pill, the compound coloc.ynth pill, small but repeated doses of Epsom salts in hot water and high purgative enemata, jalap in combination with drugs to prevent colic, calomel followed by salines, all are useful. The dryness of the diet must depend upon the condition of the patient’s tissues. The drug most useful in maintaining the compensation of these pa¬ tients is digitalis, and there is room for considerable choice in the prep¬ aration administered and the mode of its use. Many experienced ob¬ servers believe that the best quality of digitalis leaves is the most valu¬ able form in which this can be used. The question of dosage depends entirely upon the behavior of the patient under the use of the drug. Beginning with a moderate dose, it may be increased in accordance with the patient’s tolerance to the effect produced. A reliable tincture of digitalis has long been found a useful preparation; digalen, digitalin, fat free tincture of digitalis, are all of value. It is important, if possible, to use them without disturbing the stomach, but, if this cannot be done, then the drug must be given by hypodermatic injection. Where there seems necessity for stimulating the heart muscle, strychnin may be added in varying doses. If the patient s stomach is not irritable, tincture of nux vomica may be useful. \\ here blood- pressure is very deficient and the tone of the vessels is greatly impaired, belladonna in small doses will do good. This may be used as a tincture or, if hypodermatic medication is employed, in the form of atropin. Tincture of strophanthus is not ordinarily required, except in extreme