STOMACH AND DIGESTIVE DISORDERS.
Derangements of the Stomach and Di gestion are exceedingly common in pregnancy, are, in fact, almost constant, and are to be regarded as quite natural, if within certain limits. They depend mainly upon the sympa thetic nervous relationship existing between the womb and digestive system ; to some extent they are due to the pressure of the enlarging womb, and in some cases may be very marked because of displacement caused by the increased weight of the organ. They may occur through out the whole course of the pregnancy, but they are often worse in the early months, be ginning within a few weeks of conception, and being markedly relieved about the period of quickening, when the womb rises up into the belly. Perhaps the relief at this time is due to the greater room for growth thus afforded, and the consequently lessened pressure. Some women, however, scarcely suffer at all from such disturbances, while in others the distress is excessive. It also sometimes Wappens that a woman who has been much disturbed for two or three pregnancies passes through Nil other almost without them, and the reverse also often happens.
Vomiting is one of the commonest of these disorders, and because of this is counted as one of the earliest and most usual signs of pregnancy (see p. 627). It is only when excessive that it should receive treatment, and it often happens that nothing gives relief. The patient should begin by maintaining the regularity of the bowels, which is best done by a wine-glassful of Hunyadi Janos mineral water, taken each morning before rising. This affords much re lief if regularly taken. The effervescing citrate of magnesia is also useful. Then careful atten tion should be paid to the diet, as the vomiting may be largely controlled by finding the food that agrees best. Marked relief is frequently obtained by taking a cup of warm tea before rising, or by breakfasting in bed, and not rising for some little time afterwards. If such means fail, let the patient try the effect of taking small quantities of food often, and among the kinds of food milk, and milk with soda, are to be preferred, or milk and lime-water. Used in
this way barley-water is highly spoken of. Fre quent sips of iced milk may be found to the irritability. The only medicine to be m commended as a soothing agent is bismuth, which may be taken several times a day in 10 grain doses in water, or 1-grain doses of oxalate of cerium may be tried. Iodine is sometimes remarkably useful, b to 10 drops of the tincture being taken diluted with a wine-glassful of water, on the empty stomach, in the morning. A pessary of belladonna (see PESSARIES) has now and again succeeded when other means failed.
In some cases, happily very rare, the vomit ing defies treatment, and is so persistent, with even the smallest quantities of food, that the patient becomes much exhausted, and brought into a condition of great danger. It is under such circumstances that a medical man would consider whether he were justified in inducing premature labour. This is a question for a skilled physician carefully to consider; it is here only mentioned as a last resort when the life of the mother seems threatened.
Acidity, Heartburn, and Painful Diges tion are other forms of disturbance, and some times are the only forms, vomiting being entirely or nearly entirely absent. Bismuth in 10-grain doses, or half a tea-spoonful of the ordinary bicarbonate of soda (baking soda), or bicar bonate of potash, dissolved in water, is useful for these disorders, though the relief is only temporary. To the soda, dissolved in water, a tea-spoonful of sal-volatile (aromatic spirits of ammonia) may with advantage be added.
Constipation is best met by the use of the Hunyadi Janos mineral water, as recommended for vomiting.
Looseness of Bowels may occur every now and again. It should be met if possible by change of diet, the use of lime-water and milk, &c. If these means fail, 5 to 10 drops of laudanum in water may be employed, but this is to be had recourse to sparingly and with care.
Perverted Appetite or Loss of Appetite is another of the troubles of pregnancy. The craving for improper articles must be resisted, but a feeble appetite must be coaxed, and care ful dieting will usually be sufficient to meet it.