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Fever After Childbirth

breast, breasts, relief, hours, third and woman

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FEVER AFTER CHILDBIRTH Milk the third day after de livery the rush of milk to the breasts becomes usually very marked, and is frequently at tended by considerable disturbance, feverish ness, quick pulse, and headache. The breasts are very full, and may be hard, and markedly knotted and painful. This is the condition called milk fever, and also called popularly a weed. If care has been exercised all through the period of delivery and after it, and every thing has been scrupulously clean, if also the directions given ou p. 646 have been followed, and in particular if the child has been regularly put to the breast every third hour (see p. 560), the chances of such a condition arising are extremely small.

Treatment.—Give a strong dose of opening medicine, a double-strong seidlitz-powder being preferred, or a full ounce of castor-oil. Put the child regularly to the breast every 2i hours. If, owing to the swelling of the breast, the nipple is below the level of the breast, let it be pulled out by means of a breast-exhauster; and if the child cannot empty the breast, let the breast-exhauster be used as well. It is neces sary to keep down the swelling in every way possible. Much relief will be given by laying over the breasts a &,oft handkerchief soaked with ice-cold water. This may be renewed every quarter of an hour or so, if it is giving relief, but care must be taken not to overdo this, and not to permit the mother's clothing to become wet in the process. Warm applica tions, in some cases, are advised, but are to be used at first with caution. The cooling appli cation should first be tried. If the breasts are knotted, gentle light rubbing with oils aids their relief. Meantime liquids must be given to the mother sparingly, and more solid food given. She may suck a small piece of ice to relieve. thirst.

If, within a very few hours, these measures have not given relief, 10 grains of Dover's powder may be given in water, but not until the bowels have been freely opened. A second

may be given in four hours, and, if it seems useful, a third six hours after the second, bat no more without advice. The bowels will pro bably require to be opened again by medicine, as the powders have a binding effect.

Puerperal Fever (Child-bed is one of the most appalling diseases that may follow child-birth. In most cases it is fatal within a very short period, ten days or so after delivery. It may be regarded as due to the passage into the blood of some poisonous ma terial, probably of the nature of a living or ganism, such as has been discussed in Section XXIV., which multiplies in the patient's body, and produces by its activity all the symptoms of the disease. (See SEPTICEMIA, p. 315.) The t)oisonous material may come (1) from the patient herself, or (2) may be introduced from without by, unhappily it is so, the doctor, the midwife, the nurse, or other attendant, or (3) as contagion from some other disease. Thus, to take examples, a patient may have had a miscarriage, the whole of the after-birth, mem branes, &c., may not have come away. The retained portions may undergo changes of de composition in the womb. Suppose now the woman again becomes pregnant. After delivery some of this decomposed material may pass into the blood and occasion the fever. Or a similar thing may occur at an ordinary confinement, fragments of the after-birth may remain behind, undergo putrefaction, and occasion the disease. Thus the woman may infect herself. A medical man may convey the disease by attending a con finement after assisting at a post-mortem, or after dressing foul wounds, &c. Similarly it may be occasioned by the use of unclean instruments, sponges, syringes, &c. An example of the third means of communication is afforded by erysi pelas and scarlet fever. These diseases at tacking a woman, recently confined, assume extremely violent and fatal characters, due to the peculiar condition in which necessarily the woman happens at that time to be.

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