Volume 1

Cyclopaedia of obstetrics and gynecology ... / [edited] by Egbert H. Grandin.

Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Cyclopaedia of obstetrics and gynecology ... / [edited] by Egbert H. Grandin. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    526/540 (page 504)
    A TRKATISE ON OBSTETRICS. ternity Hospital, vaginal injections, in normal cases, have been entirely dispensed witli, and that it is the exception at this institution to see the temperature rise more than one to one and a half degrees above the nor- mal, and this rise, during the puerperal period, is of no moment. Our only objection to vaginal injections, as a routine measure, is that they may readily be the source of infection, especially if our nurse be careless. The better plan, is never to touch the vagina, during the puerperium, ■with finger or with syringe nozzle, unless symptoms call for it, and the chief symptom is foetid lochia, when vaginal injections should be at once resorted to, followed, if need be, by intra-uterine. In case of instrumen- tal interference, or the birth of a foetid child, we would go further than Charpentier, and wash out, not alone the vagina, but the uterus once, thoroughly, immediately after the expression of the placenta. We would further prefer sublimate, 1 to 4000, to carbolic, except where frequent irrigation is called for, and then, remembering the possibility of poisoning from this substance, would substitute carbolic, orcleanboiled water.—Ed.] The woman's stay in bed should be prolonged as long as possible—it should be absolute for the first six days. It is only at the end of this time that we allow the bed to be re-made. The woman should be carried to another bed, or where she is too heavy, we can place the second bed by the side of the first, and she may roll herself into it. Thereafter the bed should be changed every two to three days. She should remain in bed at least three weeks, oftener longer, than less; all depends on the process of involution. At the end of this time, she may be allowed to change to a sofa or a reclining chair. Only at the end of the thirtieth day will we allow her to walk, and only at the end of the fifth week should she resume her household duties. She should not venture out before the sixth week. We would like to wait for the return of the menses, which is usual about this time, but this is impossible with women who feel well. When the menses return, we make our patients return to bed, or at least to a reclining position, for two to three days. The first outing should be on foot, and it is only after some days that we allow the use of the car- riage. Convinced as we are of the slowness with which involution occurs, and of the influence of involution on the production of uterine disease, we believe it right to insist on prolonged rest after delivery, and the more women retard the resumption of their customary duties, the more they assist perfect involution, and consequently the more likely they are to pos- sess perfect health. It goes without saying that if, before labor, the woman has had uterine disease, (metritis, displacement, etc.), her sojourn in bed should be further protracted, and that we cannot indicate the exact limit. When the woman leaves her bed, we allow her to wear corsets, but we insist on an abdominal supporter being also worn for at least six weeks. This is particularly important in women who are very stout, and in those