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.

    529/540 (page 507)
    In certain women, lactation is followed by hemorrhage, which re- turns at each nursing. If this continues longer than two or three days, nursing should at once be interdicted. In otiier women, it is only at the end of a few weeks that such hemorrhages occur, and they may be so marked as to become alarming. Ergot internally, or subcutaneously, as- tringent injections, vaginal and uterine, avail nothing. The one thing to do is to put a stop to lactation: if this do not suffice, there is one measure which has answered us, and Tarnier, and Bailly admirably—this is a hot bath at 98.5° F. A curious instance of the kind happened in our practice, and the fol- lowing is a brief account: a young woman, nursing her third child, was seized on the twenty-eighth day after delivery with loss of blood, which finally became abundant. At the end of two days lactation was put a stop to. This, however, did not suffice, and notwithstanding every con- ceivable means, the hemorrhage continued for eight days. On the ninth, she was given a hot bath, 97°, and remained in it one hour and a half. The hemorrhage at once diminished, and disappeared on the next day after a second bath. Fifteen days thereafter, and twenty-three days after the appearance of the hemorrhage, the woman endeavored to nurse her child: the milk returned, and lactation was kept up for fifteen months. Under the influence of the abundant perspirations which affect the puerpera, it is not unusual to see an eruption appear like scarlet fever, but it should not be confounded with this. About the fifteenth day we allow the woman to read, and to do a little fancy work. She may at the same time sit up in bed, although this de- pends on the state of the womb. As long as it is appreciable through the abdomen, we counsel rest on the back, and if involution be slow we give, every two to three days, subcutaneous injections of ergot, to hasten the process. Except in case of hemorrhage, we do not allow the full bath until the menses have returned. [This is an entirely unnecessary pre- caution. American women, indeed, woulS^ not submit to any such rule. Frequently, in nursing women, menstruation does not occur for a number of months. Hygiene, if not dirt, requires a full bath before the expira- tion of such an interval, and such a bath can do no possible harm.—Ed.] There remains still a very delicate question, and this is when should sexual intercourse be resumed ? Certainly not till the menses have re- curred, usually about the sixth or seventh week. Before this period the husband should sleep apart from his wife. In certain young and impres- sionable women, the mere presence of the husband in the bed will pro- voke sexual feelings, which may result in uterine hemorrhage. Wo have in mind two incontestable examples of the kind.