Frederick Hollick

“ But the impure state of society has so perverted nature, and blinded common sense, that intelligent women, though eagerly studying the structure of the Earth, the attraction of the Planets, and the reproduction of Plants, seem ashamed to know anything of the structure of the human Body, and of those Physiological facts most intimately connected with their deepest and purest emotions, and the holiest experience of their lives. ”

“ The pains now become more violent than ever, the patient screams with agony, clutches hold of any object near her, throws herself back, draws in her breath, and bears down with all the force she can command. ”

“ The body then begins to twitch, the mouth opens, usually on one side, the tongue protrudes, the head turns on one side, and the blood rushes to it and the face in great quantities. In a short time the jaws close again with great force, and the tongue is bitten if proper care has not been taken to prevent it. At last the eyes began to twinkle, the mouth moves as if the patient were muttering, and the nostrils expand; the arms are thrust straight down by the sides of the body, with the hands firmly closed; the legs are stiffened straight out, and the body is bent back like a bow. ”

“ I question very much if ever bleeding really prevented abortion from flooding, and I cannot but think that it has often brought it on sooner. Nevertheless, if all other means fail to arrest the discharge, and there are no decided objections to the contrary, it might be cautiously tried; though the policy of taking more blood from a person who is already losing too much, is not very evident.
I have often known the most severe flooding stopped, merely by the female lying on her back, drinking plentifully of lemonade, and applying cold wet cloths over the abdomen. ”

“ An experienced practitioner can sometimes predict with tolerable certainty, when called to a labor, how long it will be before it is over; but this is seldom the case, and most frequently his success is owing more to chance than to judgment. If the mouth of the womb be well dilated, the contractions powerful, and the patient vigorous, with the presentation natural, he is of course justified in predicting a speedy delivery ”

“ The use of instruments in effecting delivery is a last resort to save life, and ought to be intrusted only to persons of skill; it may therefore be thought unnecessary to treat of them in the present work, and indeed I should not have done so but for the purpose of satisfying the natural curiosity of females themselves. The greater part of the dread they now experience where instruments are needed, arises from ignorance of their nature and mode of action. ”

“ The Womb is nothing more than the receptacle in which the impregnated egg is placed, and in which it undergoes all the wonderful changes by which it eventually is developed into a perfect human being. The womb is not therefore absolutely needed in conception, and indeed several cases have been known where the new being was formed without the womb altogether, though not perfectly. Its principal use is in fœtal development, which cannot take place perfectly in any other part of the body. ”

“ In young persons the symphysis is soft, and gives way easily, so that they have little difficulty during delivery from this cause; but if a female marry late in life, after it becomes hardened, she may suffer considerably. In this case the coccygis is usually curved inwards considerably, and being firmly fixed the head cannot push it back, and on that account cannot pass, without great difficulty, and with the risk of rupturing some of the soft parts, or breaking the coccygis completely off. There is in fact great difficulty, and some danger, if the first pregnancy takes place late in life. ”

“ From the explanations given above of an ordinary natural labor, it will be evident that but little manual assistance is required, either to the mother or the child, and also what really is called for is of so simple a character as to be easily rendered. It would undoubtedly be improper, and cruel, to leave females at such times without aid altogether; but it is also equally improper and injurious to interfere too much. Excepting in cases of disease and deformity, or of very unfavorable presentations of the fœtus, Nature herself will nearly always effect the delivery ”

“ The headache, which arises from a too full habit, commences with flushing of the face, heaviness in the eyes, dull pain in the forehead, and a sense of uneasiness, with disposition to sleep or dose. It seldom comes on much till the latter months of gestation. Headache may arise also accidentally, from derangement of the stomach, but this cause is easily ascertained by the furred tongue, loss of appetite, and bitter taste in the mouth; it is also felt most acutely in the back of the head, down by the neck, and passes away immediately the stomach is corrected by an emetic, or by fasting. ”

“ In the early months there is more danger to the child from flooding than there is to the mother, because it is nearly certain to lead to abortion. In the latter months, on the contrary, the mother runs the greatest risk, as the child may then live if it be expelled, while the mother may sink and die from excessive loss of blood. There are many females of a very full habit, who suffer but little from hemorrhage, unless it be excessive, indeed some seem to be benefitted by it, and are thus relieved from headache and convulsions. ”

“ Mauriceau recommends that women who are subject to flooding after delivery should be bled twice or thrice from the arm during pregnancy, and once, or oftener, after labor has commenced. There are cases of uterine hemorrhage after the delivery of the child and expulsion of the placenta unconnected altogether with the plethora, or an excited state of the heart and arteries, and where bleeding [324] and low diet do not prevent the accident. Rupturing the membranes at the very commencement of labor is by far the best remedy, the only thing indeed upon which any dependance can be placed. ”

“ If the return of the cord cannot be effected, and the progress of the labor will allow of it, the hand is introduced and the child turned, unless the position of the head will allow of the advantageous application of the forceps, in which case they are mostly resorted to. The only general rule is, to terminate the labor as speedily as possible, consistent with the welfare of the mother. In spite of all that can be done the pulsation is often found to cease, and when the child is born it is either quite dead or breathes but a few times. ”

“ Those persons who make light of this disease, and pretend to say that this or that simple treatment is all-sufficient, either deceive themselves or wish to impose upon others. There are few affections more serious, as will be evident when it is borne in mind that, on an average, two females die out of every three attacked by it. To avoid all liability to it as far as possible, attend well to the general health during pregnancy, have everything comfortable, clean, and wholesome, during labor, and be careful to avoid cold, damp, and all kinds of mental and bodily excitement afterwards. ”

“ The body should be well rubbed over the heart and lungs, either with the hand or with a soft, dry napkin. Cold water may also be dashed on the face, and the hands may be well chafed. If the fit still endures, a mustard plaster may be placed on each arm, or the whole body may be placed in a warm bath, if convenient. Care should also be taken to admit the fresh air freely. As soon as she begins to show signs of consciousness, a little wine or brandy may be placed in the mouth, and the body may be elevated a little. ”

“ Notwithstanding the contrary experience of society, as it now exists, it is well known that extreme suffering, and danger to life, are not necessary nor even probable accompaniments to child-birth; for it is invariably found, when females live under circumstances favourable to their full physical development and health, that it occurs speedily, and with little or no difficulty or pain. ”

“ On making an examination the mouth of the Womb will be found to be dilating, and a discharge of mucus, tinged with blood, issuing from it. The membranes may also be felt protruding into the Vagina, and distended, like a bladder. The female complains of being drawn powerfully together in the inside; she trembles, and gasps for breath; her pulse sinks, and she often becomes sick and deadly faint; she complains of great thirst, and breaks out into profuse perspiration; frequently she will weep, and apparently suffer from some terrible apprehension, while her strength will be completely exhausted. ”

“ As a general principle we may say that it is done either to change the presentation, when unfavorable, or to terminate the labor when it is lingering, or when it is desirable to have it over as quickly as possible. The feet may be drawn through the mouth of the Womb when it is but little opened, and when they have once passed, the limbs and body soon follow, and the head seldom remains long behind. The fœtus may in fact be compared to a wedge, of which the feet are the point, and if they enter the passage the rest part is gradually driven after by the uterine contractions. ”

“ If the head be larger than natural, from any cause, or if the Pelvis be too small, or deformed, this mutual adaptation does not exist, and delivery of course becomes difficult, or dangerous, and sometimes impossible. The only obstacle therefore, which can seriously impede the expulsion of the fœtus, or prevent it altogether, is this want of conformity, in size and shape, between its head and the bones of the Pelvis. The soft parts may retard labor considerably, by being contracted or rigid, but can generally be made to give way, either by the efforts of nature or by manual assistance ”

“ The child's heart begins to beat so strongly, and its circulation is so vigorous, that the sound of it can be heard externally. The same means are taken to ascertain this that are used in sounding the chest of an adult. If the ear be placed on the Abdomen, over the womb, the beating of the fœtal heart may [112] be heard quite plainly; and if the stethoscope be used it will be still more distinct. This practice is called Auscultation. The signs furnished by it are certainly of the greatest value, and frequently enable us to detect pregnancy with unerring certainty. ”

“ Whenever the child can be brought away by the natural passages, though it be piecemeal, it always is so brought, unless the danger to the mother be greater than by the cesarian operation, in which case that operation is resorted to. By means of an instrument called the Cephalotribe, which crushes the head, the child may be brought away, unless very large, when the pelvis only measures two inches. When the passage is less than two inches, the only resort is to the cesarean operation, which sometimes succeeds, and saves both mother and child, though more frequently the mother sinks. ”

“ A warm bath, or fomentation with warm water and Laudanum, will assist, and sometimes relieve alone. To ease the burning and distress the patient must drink freely of gum water, or barley tea, with a little Syrup of Poppies.
There is one manœuvre which, if practised aright, will nearly always allow the female to urinate with ease, and fortunately she can practise it herself. It consists in introducing two of the fingers into the vagina, and raising up the womb, as if practising the ballotment. This removes the pressure from the bladder, and the urine then escapes by natural effort. ”

“ There are some females, however, who will remain without sleep, or at most take but very little, for a long time, without suffering any inconvenience.
This affection is essentially a nervous one, and the only means likely to relieve it are those that have a tendency to soothe and calm the nerves. If the patient be surrounded by any irritating circumstances they should be at once removed, or she herself removed from them. Particular attention must be paid to the diet, so that no derangement of the stomach or bowels be kept up, and a regular system of out-door exercise must be practised. ”

“ The nature of the assistance proper to be given, in any particular stage of labor, will be evident on inspecting the structure of those parts, of both mother and child, which are brought in connection at the time, and by considering how their mutual relations require to be changed and modified. If those relations are already such as are required, and the system retains sufficient force, nothing can be done with any advantage—we must wait, and let Nature operate herself. ”

“ The female must be quite still till it is stopped, and must be careful when she begins to move about again, because it is liable to break out afresh. Those of a very full habit must live low, and avoid all stimulants, so as not to increase the quantity of blood in the body more than is necessary. It is advisable to remove the varices, as much as possible, before labor comes on, particularly if they are situated on the lips, or in the vagina, because they may burst during delivery and cause considerable [397] inconvenience, or even danger. ”

“ The sympathetic irritation of the uterus, in some females produces extraordinary phenomena of this kind, from simple desire to the most furious craving, and from mere caprice to actual insanity. There is no doubt but that many of these unusual desires, or longings as they are called, are either produced or much aggravated by the imagination of the patient, and frequently would never be experienced at all, if the idea was not suggested by other people having had the same. Custom and imitation are very powerful in such cases, particularly when the nervous sensibility is much exalted. ”

“ There is always more or less danger of retention of urine, from the pressure that has been exerted on the bladder; and if it be allowed to continue too long its removal becomes exceedingly difficult. If on making the attempt the urine does not flow, the catheter must be used, and the sooner the better. The pain arising from retention of the urine has often been supposed to arise from inflammation of the womb, or bowels—neither patient nor physician knowing its real source, till the passage by the catheter gave relief. ”

“ It is therefore the duty of every mother, if she has the slightest suspicion that her daughter is deformed, though it may not be apparent, to have her examined before she is allowed to marry. Many have lost their lives for want of this precaution. Severe blows or falls in early life may also create a pelvic deformity, and this, as a possible consequence of such accidents, should always be borne in mind. The means by which the form and size of the pelvis are ascertained, as before stated, are simple, and such as need not in any way be feared. ”

“ The fore-finger being introduced, ballotment may be practised, to ascertain if pregnancy really exists; and if the evidence from this source is not sufficient, auscultation must be resorted to. After being satisfied on this point, the mouth of the womb must be carefully examined, and its degree of dilatation noticed. If the female has pains, their character and frequency must also be noticed, and the effects they produce on the parts. It will generally be possible by these means, to discover how far the labor has progressed, and even to form an opinion how long it is likely to last. ”

“ It may also be added that it is much more dangerous, at any time, when caused by violence of any kind, or by forcing medicines, than when it occurs naturally. The danger is much increased if it occurs during fever, or any eruptive disease, or if the patient be suffering from diarrhœa or convulsions. As a general rule we may say, in all cases, that miscarriage or abortion is always more dangerous to [417] mother and child than natural labor, both in its present and in its future consequences. During an attack of jaundice an abortion may terminate fatally in a few hours ”

“ The wondering ignorance, in which most females are kept, makes them disposed to be led away by a morbid imagination, and constantly liable to be imposed upon by silly and erroneous statements, which they of course implicitly believe. These longings are always the strangest, and most frequently met with, among the most uninformed and unthinking, though they are occasionally met with under all circumstances. As a sign of pregnancy this longing is not much to be relied upon alone, because marriage alone often produces it, and so do many uterine derangements. ”

“ Rachitis usually attacks children somewhere between nine months and two [268] years of age, and produces a variety of well marked symptoms; such as large head and belly, protrusion of the breast-bone, flattening of the ribs, emaciation of the limbs, and various deformities of the bones. The patient may recover from the disease, but the deformity of the bones often remains, and therefore no female should become pregnant, who has had rickets, till the shape and dimensions of her pelvis are known, or it may cost her life. ”

“ In all cases the only proceeding which offers any chance of recovery is, to deliver as soon as possible, because when the fœtus is expelled the uterus begins to contract, so as to close the wound, and when that is effected, if but little fluid has passed into the cavity of the abdomen, all may yet go well. It may frequently happen, when the hand is passed into the womb, to turn and deliver, that nothing can be found, the fœtus having passed through the opening into the abdominal cavity, in which case the hand must be passed through the opening also, and the fœtus be brought back if possible. ”