Volume 1

The household physician : a family guide to the preservation of health and to the domestic treatment of ailments and disease, with chapters on food and drugs and first aid in accidents and injuries / by J. McGregor-Robertson ; with an introduction by John G. McKendrick.

M'Gregor-Robertson, J. (Joseph), 1858-1925

Date:: 1899

Credit: The household physician : a family guide to the preservation of health and to the domestic treatment of ailments and disease, with chapters on food and drugs and first aid in accidents and injuries / by J. McGregor-Robertson ; with an introduction by John G. McKendrick. Source: Wellcome Collection.

589/602 (page 517)

$applications. A brisk dose of opening medi- cine (seidlitz-powder) should be given. If matter forms, it must be “let out” by the abs- cess being opened, and should on no account be allowed to burst. Whenever the breasts are large and swollen, great relief is given by a bandage passing under the affected breast and over the opposite shoulder, so as to support it. It is also necessary to keep down the swell- ing of the breasts as much as possible by regu- lar removals of the n)ilk. If this is not pro- perly done by the child, a breast-exhauster, or breast-pump, must be secured at once, and the milk must be frequently drawn off by its means. The exhauster and its mode of application ai’e shown in Plate VIII. It is advisable to apply the exhauster every two hours or so, to remove by its means small quantities of milk frequently rather than to attempt to remove a large quan- tity at one time. If this is done and the other measures advised are adopted, threatened in- flammation of the breasts will often be speedily subdued. Convulsions occurring during pregnancy or labour, or after child-birth, are of very serious meaning. They are commonly due to the con- dition known as albuminuria (see pp. 295 and 513), although they may ocour without such a condition, caused, as some believe, by a too watery condition of the blood inducing a state of bloodlessness (An.^emia, p. 234) of the nerve centres. Symptoms.—Convulsions may occur with- out any warning, but usually warning of the coming attack is given by the occurrence of headache, usually of the front of the head, of a very intense kind, and likely to be continuous when the fit is near at hand. Another warn- ing sign is derangement of vision, dimness or 0 mess of si^ht, or some other disturbance of deal ness of sight. In a few cases severe pain is felt over the pit of the stomach. One sign which ought not to be disregarded is puffi- ness of the face, and swelling of the ankles, feet, and external genital organs. Such a con- dition ought to lead to immediate medical ad- vice. The fit itself is of a marked kind. The eyes are fixed, within a few seconds the face and eyelids are spasmodically twitched, the eyeballs roll, and the face is pulled down first to one shoulder and then tO' the other, the mouth being also twisted, and the upturned eyes show only the white part of the ball. The convulsive movement then passes quickly over the rest of the body, and for a little the whole body is stiff, head being bent back, limbs stretched out, and hands clenched. After a brief j)eriod iiregular spasmodic movements occur of great violence. The face is violently twitched, the arms jerked, the tongue is often Ciiught between the teeth and severely bitten, and froth mixed with blood from the tongue escapes from the mouth. Breathing is sus- pended till the face becomes purple. Motions from the bowels and water from the bladder ai’e often passed. All this time there is com- plete loss of feeling and consciousness. As the fit passes off the spasms become less, the move- ments gradually cease, breathing becomes na- tural, and the face loses the ])urplish hue, and consciousness may be soon restored, or the patient may lie in a heavy torpor for some hours. When consciousness is restored the patient complains probably of headache and a dull stupid feeling. One attack may succeed another, consciousness not returning in the in- tervals, or there may be but one attack alto- gether. The more severe and pi’olonged the attack, and the more frequent its recurrence, the graver is the case, though the author has seen one attack follow another for a couple of hours, and recovery take place. One in every three or four cases proves fatal. If the convulsions occur before labour has set in they are extremely likely to jirovoke laboui’, and thus the life of the child is threat- ened. When labour is brought on it is often accomplished with great rapidity. The birth of the child has, however, a tendency to lessen the severity of the attack. Treatment.—Very little can be done by an \inskilled person. A medical man would pro- bably administer chloroform, and if labour had begun would, if possible, effect delivery. Harm would not be done if, when medical aid was not obtainable, a draught containing 20 grains of chloral hydrate, dissolved in water and simple syrup, were given immediately after one attack to prevent, if possible, a second. The dose could be repeated in three or four hours. Insanity may occur during the child-bearing period, during labour, or after delivery. It is most common in those with diild for the first time, and in many there is an inherited ten- dency. In cases occurring during the child-car- rying period, or after delivery, the commonest form is melancholia, evidenced by great depres- sion of spirits and delusions, and when the case$