Of Swelled Leg.
After delivery, one of the legs is sometimes affected with a painful swelling, which is often, though not always correctly, attributed to some violence in the labour, or some imprudence afterwards. It makes its appearance about ten days after delivery, sometimes sooner or even later. It begins with fever, and pain in the back, or lower part of the belly, particularly about the groin, where there is considerable stiffness felt. The pain may gradually extend down the limb, but more fre quently it is, after these symptoms, suddenly felt in the calf of the leg or knee, and presently the whole limb, which formerly perhaps was cold, becomes hot and swelled. The acute pain slowly abates, but the limb continues tender, and can scarcely be moved. el he pulse becomes much quicker, the lace pale, the strength is greatly impaired, and frequently very co pious pet spiratiun auds to the weakness.
Tne duration of this disease is variable, but in gene ral it is considerable, and occasionally alter one thigh becomes beam, the other becomes affected with simi lar symptoms. In one case, which lately was attended by the author, the inferior and both superior extremi ties were successively attacked. The complaint in the upper parts was preceded by pain and stiffness in the side of the chest. There is always great debility at tendant on this disease, and even a tendency to syn cope.
The treatment consists in the immediate application of leeches, or of hot solution of acetite of lead to the groin, at the same time that a purgative is administer ed. It the symptoms go on, and tne limb becomes af fected and swelled, relief is sometimes obtained by rubbing with camphorated oil, or tincture of soap and opium ;* but fonientations with hot water are more generally useful At the same time the bowels are to be kept regular with el cant of tartar, and sleep pro cured by When the acute symptoms are over, and the limb only remains weak, friction with the flesh-brush is proper, and a roller should be applied with moderate firmness from the toes to the groin. The cold bath is useful to re-establish the health. The diet ought, after the inflammatory symptoms have abated, to be nourishing, and the re-establishment of the health is promoted by removing to the country. Tonic medicines
at this period are also useful.
Of Efiliemeral and Remittent Fevers.
Women, who are disturbed much in their repose, who have suffered greatly during labour, who have very sure nipples, who are inattentive to their diet, distressed in their mind, or exposed to cold, are liable to an attack of lever, called in this country a weed. The fit begins with chillness, cold feet, and violent trembling ; pain in the back, headach, and in some instances, inclination to vomit. Presently flushes of heat are felt, which at last become steady, and the pa tient feels extremely hot and restless. In some time afterwards, perspiration breaks out, continues for a considerable time, and at last abates, leaving the pa tient free from fever, but very languid. During both the cold and hot stage, the pulse is frequent, and there is thirst ; but in the sweating stage both these symp toms decline. The whole fit is usually finished with in twenty-four hours, frequently in a much shorter period. There may be only one attack, but it is not uncommon for the fits to come on every day for more than a week, nearly about the same time, or an hour sooner or later each day ; and in that case they are pre ceded by coldness in the back, accompanied with ach ing pain. In this state the stomach becomes filled with wind, the bowels are bound, and the patient is timid or hysterical. In some instances there is a state of complete apyrexia, in others only a remission of the symptoms. Short attacks of this fever are not in gene ral dangerous ; but if they be repeated and prolonged, it is probable that they depend on, or are kept up, by some local disease. There may be incipient and obscure disease in some of the great cavities of the body, or the mamm? may be partially affected. In all such cases it is therefore necessary to examine minutely into the symptoms and sensations, for it has happened that some patients have been suddenly cut off, who were supposed to be in little danger.