DISORIARS SUBSZCLUENT TO I:ALM:RT.
Most of the diseases consequent upon pregnancy arise after delivery, and not during labour. We shall first observe, that Quietude and a horizontal position should be strictly enjoined, as a matter of the greatest moment. And for this reason it is obvious, that as the patient should not be moved early, she ought never to be delivered in herclothes. This, however, is a plan often proposed by the lower or ders of people to save inconvenience and expense ; but it should never be assented to by the practitioner, as it is a very dan gerous experiment to raise the patient to an erect posture, at a time when she can only remain perfectly safe in an hori zontal position. There are many instan ces of the fatal effects of neglecting such a precaution.
A woman after delivery should remain perfectly at rest for at least two hours, and then should by no means be raised upright, but be very gently lifted, just enough to allow the drawing away of the clothes, which, if they give trouble, must be cut away with scissars, to prevent the risk of exhausting the patient by over exertion.
Fainting. Fainting after delivery fre quently happens, and may arise from ma ny causes, most of which are of little con sequence : it is always an unpleasant oc currence, and sometimes dangerous. It may be merely the effect of fatigue ; a woman is just able to bring the child into the world, anti after making perhaps the last exertion she is capable of, sinks into a faint. Frequently she will fall into an hygerical paroxysm, which will easily be perceived, by her laughing, crying, sob bing, &c. which characterizes hysteria. If the fainting proceed from either of the above causes, volatile alkali rouses the patient, and nothing more is necessary ; neither should any apprehension be felt for her safety.
Fainting may be the consequence of the great agitation of mind which the patient has suffered from fear of the ap proaching pains, and, as she thinks, dangers. In such cases nourishing things should be administered, as a small quan tity of good broth, with a table spoonful of wine in it ; or some volatile alkali.
Whenever there is reason to suspect that the fainting arises from loss of blood, the practitioner should never leave it to probability, but instantly examine the truth of his suspicions;. not only on the surface lying next to him, but the upper part of the further thigh, as the blood will sometimes run over the side of the thigh that is furthest off; when the practitioner, not perceiving any discharge from that part whence it is generally observed to flow, has not the least idea of his patient's situation. When upon examination it is found that hzmorrhage has taken place, the placenta being got away, it is to be treated in the common way by acids, &c.
In some rare instances it has happened, that immediately after delivery the pa tient has sunk into a permanent syncope, from which she never has recovered, dy ing without a groan. When there is rea son to suspect the approach of such a state, the patient should be made to swal low a large dose of volatile alkali ; it can do no harm, and is generally highly bene ficial, let the fainting originate from what ever cause. The sptritus sunmoniz comp. and tinct. lavendulz may also be admi nistered, and hartshorn drops should al ways be kept in a lying-in room.
After delivery it is advisable to apply a certain degree of pressure to the parts. This circumstance has been variously re ce iv ed,and very generally misunderstood. A certain degree of pressure is useful ; but if that pressure be too great, it will occasion worse consequences than the want of pressure altogether. The pres sure required is, more properly speak ing, a support, and is of the same kind as we like to feel from a waistcoat in win ter. The intention to be had in view in making it, is just the same as after tap ping in dropsy ; and pressure judiciously applied in both cases will often prevent fainting.