increase in secretion entails diminution in body-weight. Those women who were fat, and bloated, return to the normal state, and sometimes alter so much in a few days that they are scarcely recogniza ble.
Gassner has studied the variations in weight during pregnancy, labor, and the puerperium, and he has reached the following conclusions: A. Pregnancy . —During the last three months of pregnancy, the mater nal body gains at least one-thirteenth of the total body-weight. This in crease is proportionately less in primiparre than in multiparce.
B. labor the woman has lost one-ninth part of the body weight of a gravid woman at the tenth lunar month of pregnancy. This is, above all, the result of the expulsion of the foetus and its annexes, of the loss of blood during delivery, as well as the loss of fecal matter, and the excretions of the lungs and skin. PrimiparEe lose less than multiparEe.
C. During the eight days which follow labor the woman loses one-eighth of her body-weight. 2. This loss is the greater the nearer delivery to term. 3. Primiparte, and women who do not nurse, lose less than multiparEe, and those who do nurse. 4. This loss is in di rect proportion to the total body-weight of the puerpera. 5. During the same interval the amount of lochia from women who do not nurse is far greater than from those who do. 6. The greater loss of weight oc curring during the first few days is due to the increase in the secretion from the kidneys, to the abundance of lochia, and to the excessive per spiration.
D. Total loss due to labor and mean loss amounts to about one-fifth of the total body-weight at term.
E. Usually, at the end of six or seven weeks the loss sustained is re gained; nevertheless, so many conditions may interfere with or favor normal nutrition, that we can only state approximately the time when this return to the normal occurs.
Temperature. — Wunderlich, Gruber, Hecker, Grunowaldt, Winckel, Schroeder, have made a number of interesting experiments in regard to temperature during the puerperium. Hecker has found that : 1, In many cases the temperature of the body rises markedly after labor— from 98.5° to 102°, the normal temperature being The tempera ture appears to rise the higher where the pains have been very intense.
2. At the beginning of the puerperal state the temperature is frequently lowered. The lowest range is seen twenty-four hours after delivery. 3. During the twenty-four hours after delivery, the temperature may exceed the normal by three and a half degrees, without the woman being sick. 4. In general, the pulse rises with the temperature; often, moreover, the pulse is quicker and the temperature does not alter. 5. At about the ninth day, the temperature frequently falls below the normal. This has been called the stage of inanition.
Schroeder gives us the following figures: Wolf gives the same figures as Schroeder, and finds that when lactation becomes established, there is a slight elevation of temperature, about 0.5 of a degree. In agreement with Schroeder he finds that, at this time, the mean temperature is This figure, as we will see, is about the same as that given by Chantreuil in his monograph on lactation. Grune waldt believes this figure too low, and places it at 101°. Winckel, in 1878, analyzing his own observations made in 1861, in connection with those we have just noted, states it as an established fact, that, during the first twelve hours after labor, there is generally a slight elevation of tempera ture, but little above the normal; during the twelve following hours, generally a slight fall in temperature. Whilst this elevation is especially noted when it coincides with the normal evening rise, it may easily es cape our notice, if, labor occurring at night, the temperature is taken the following morning.
After this fall in temperature, at the end of the first twenty-four hours, it begins to rise again. The evening temperature is usually higher than that of the morning; the diurnal oscillations are slight. Usually, this elevation of temperature accompanies the secretion of milk, diminishing when this function is regularly established, or when it is in abeyance as in women who do not nurse.
The temperature of the healthy puerpera ranges to the same degree as during ordinary health, although the mean temperature during the puer perium remains slightly higher than under normal conditions.