The most common ailments of pregnancy are dyspepsia, nausea, vomiting, constipation, headache, heartburn, flatulence, salivation, diarrhœa, piles, greedy appetite, loss of appetite, longings, neuralgia, toothache, cramps, swellings of the extremities, pain in the side, insomnia, drowsiness, palpitation of the heart, leucorrhœa, pruritus, etc.
Indigestion or dyspepsia is the most frequent complaint afflicting the human family. It is at the foundation of almost every other disease, many of the above symptoms of pregnancy being attendant upon and caused by it. Men and women in every station of life are more or less subject to it; few are entirely exempt. “A good digestion turneth all to health.” Indigestion is usually attributed entirely to a failure of the stomach to perform its functions. The term is also applied to a defect in any of the assimilative operations throughout the digestive tract. The limits of this work will not permit a dissertation upon these processes and their abnormal conditions.
In passing, however, let me say while there are many causes of dyspepsia, there is no one more potent than the common attempt to nourish the body from food which cannot be digested in the stomach. The principal articles upon which the acid gastric juice has no effect are starch and fats. They can be rendered soluble in alkaline fluids only, which are the saliva, pancreatic juice and the bile. By partaking of the starch and fats to excess, the stomach is overtaxed in expelling them, besides which the body fails to get elements of nutrition in proper proportions from them.
The natural food of the infant contains no starch, the carbonates of milk being sugar and butter. Usually the first solid food given to a child contains little else but starch, such as bread from white flour, and potatoes, rendered more indigestible by the addition of butter and rich gravies. These are lacking in nitrogenous and saline products, consequently the muscles, bones and nerves may not be nourished.
A substitution of the products of the entire wheat, barley, oats and other grains would obviate this difficulty, and lessen the frightful mortality of children. Dr. Bellows says: “So perfectly ignorant are people generally of the laws of nature that they give their pigs the food which their children need to develop muscle and brain, and give their children what their pigs need to develop fat. For example, the farmer separates from milk the muscle-making and brain-feeding nitrates and phosphates, and gives them to his pigs in the form of buttermilk, while the fattening carbonates he gives to his children in butter. He sifts out the bran and outer crust from the wheat, which contains the nitrates and phosphates, and gives them also to his pigs and cattle, while the fine flour containing little else than heating carbonates, he gives to his children. Cheese, which contains the concentrated nutriment of milk, is seldom seen on our tables, while butter, which contains not a particle of food for brain or muscle, is on every table at all times of day.”
Cheese, when digested, furnishes more muscle-feeding properties than any other food, and hence is desirable for working men, and all people engaged in out-door pursuits, but should be taken as food, not as a relish only.
The elements digested in the stomach are fibrine (its type found in lean meat), albumen, casein, gluten of the grains, and the nitrogenous principles of fruits and vegetables.
These are the elements that build up the muscles, while the carbonaceous elements, such as sugar, starch and fats, by combination with oxygen, furnish animal heat. Too much of the latter tend to produce inflammatory conditions, and should be partaken of moderately by all people who do not lead an active out-door life.
The pregnant woman, however, is especially liable to suffer from the multiform miseries of dyspepsia. Her nervous organization is peculiarly sensitive at this time. Many symptoms are also caused by reflex action from the gravid uterus upon the sympathetic ganglia which control the alimentary processes.
Morning sickness.—Nausea, with or without vomiting, occurs so frequently in pregnancy that most women think it a natural accompaniment of their condition, relying upon it as a diagnostic symptom. It may begin the day following conception, but usually appears from the sixth to the eighth week. It is unlike nausea which accompanies biliousness, fevers, the effect of drugs, or even sea-sickness. It is a nausea that one feels from the crown of the head to the soles of the feet; one is “sick to the stomach” all over.
Asking the cause of this, ninety-nine out of a hundred aver they believe it to be natural, and more than all, not to be avoided. Besides, the grandmother of the neighborhood has told them that on account of this, the child will be more healthy, and the delivery easier. Facts do not bear her out in either assertion.
The real causes are to be sought in the violation of physical laws, in dress, diet, exercise, etc. The conditions are, first, an irritation in the womb caused by some existing derangement, which by sympathetic or reflex action is communicated to the stomach, and second, that state commonly called biliousness.
The whole body is supplied with nerves distributed from the brain and spinal column. Besides these, ganglia of sympathetic nerves communicate with all nerves and with each other, being so interlaced that almost every part of the body is in communication with every other part. It is really a complete system of telegraphy. Both the uterus and stomach are remarkable in their supply of nerves, and any disturbance in the former is instantly conveyed to the latter.
It is not unusual that an inflammation or displacement of the womb gives no local symptoms—but by reflex action there are headaches, indigestion, neuralgia, and various ailments. So, of the gravid uterus, if from any existing local disease or any cause in the system, it does not take kindly to its new function, and derangement in the organ ensues, instead of causing local pain and distress it will be communicated to other organs, most frequently to the stomach, producing nausea, vomiting, as well as often acute suffering.
What is biliousness? Ladies, you know the condition to which you apply this term. Frequent headaches, aversion to food, aching of the bones, languid, sleepy and tired feeling. You get up in the morning weary, cross, irritable, out of sorts with everybody, and everybody retaliates by being out of sorts with you. What has happened in the human organism? What do you understand by biliousness? Listen to the answers. One says, “It is an overflow of bile,” others, “Too much bile,” “The liver don’t act,” “The bile has reverted back to the blood,” “The bile is secreted by the stomach,” “Too high living,” etc.
Dr. Dio Lewis says: “Biliousness is piggishness.” My habit has been to define it simply as overfeeding. At least, the elements of the bile are in the blood in excess of the power of the liver to eliminate them. This may be caused by either inaction of the organ itself, or superabundance of the materials from which the bile is made. Being thus retained the system is burdened, or to use a homely but expressive phrase, is clogged. To produce this, food may be too great in quantity, or too rich in quality. Especially is it caused by the excessive use of fats and sweets. How does this biliousness produce nausea in the pregnant woman, and why does it show itself in this way, when she was comparatively well previous to this condition?
In the new process of gestation the whole system is roused to action, and nature makes an effort to relieve the organs of all foreign or bilious matter. Her first means to produce this result is by nausea and vomiting. Many women have an attack of bilious fever, more or less severe, in the first months of pregnancy.
Three causes may induce this state of the system: food which is too nutritive or too abundant; lack of exercise conducive to normal action in the assimilative organs; and clothing that in any way restricts this action. At any time, the bands and corsets so universally comprising a part of woman’s dress are injurious, because they restrict the action of the liver and other organs, but they are doubly deleterious when there is a natural increase in size. The direct pressure of the viscera upon the uterus will also produce irritation in that organ.
I was spending a few days with an old friend who was four months advanced in pregnancy. She had had no unpleasant symptoms. One day as we were on the street walking, she was suddenly seized with vomiting. Trying to investigate the cause, I asked her if she wore the dress she was accustomed to. “No,” she said; “I have not had this on for months, and it is too tight.” She loosened it under her cloak, when the symptom disappeared.
In the last months of pregnancy, vomiting is often caused by pressure of the enlarged uterus upon the stomach. This cannot occur where the natural figure has always been unquestionably preserved.
One potent cause of morning sickness is the habit of entering upon the sexual relation frequently during gestation. By this means a hyperæmia in the reproductive organs as well as exhaustion of the nerve supply is produced. By reflex action nausea is the result. Incalculable benefits would be derived if married people imitated the lessons of lower animals in this matter—thereby conserving all forces for the benefit of offspring.
Treatment for morning sickness.—If inflammation or ulceration of the uterus is chronic, one can not expect to overcome the nausea entirely in a short time (Chap. XXI.)
In the case of biliousness, a plain, light diet with plenty of acid fruits, avoiding fats and sweets, will ameliorate if not remove it. Don’t force the appetite. Let hunger demand food. In the morning the sensitiveness of the stomach may be relieved by taking before rising a cup of hot water, hot milk, hot lemonade, rice or barley water, selecting according to preference. For this purpose many find coffee made from browned wheat or corn the best drink. Depend for a time upon liquid food that can be taken up by absorbents.
The juice of lemons and other acid fruits is usually grateful, and assists in assimilating any excess in nutriment. These may be diluted according to taste. With many, an egg lemonade proves relishing and acceptable.
In biliousness, with or without nausea, hot fomentations in the region of the stomach and liver, for an hour once or twice a day, followed by tepid bathing and hand friction will be found invaluable.
Warm or hot enemas are exceedingly beneficial. In order to be effectual, follow minutely these directions. Place in a Fountain Syringe two or three quarts of soft water as warm as can be taken. A tablespoon of salt will make it more effective. Suspend the reservoir as high as the hose will allow. Lie upon the right side with knees flexed. Introduce the long rectal tube, or what is better for many, the vaginal tube far enough in the rectum to pass the internal sphincter muscle. It ought to enter three or four inches. Let the water pass into the bowels slowly, having them manipulated upward by an attendant, especially making passes up the right side.
This causes the water to pass through the ileocæcal valve from the large to the small intestines. Once in the latter, it is taken up by the capillaries of the portal vein, and more or less of it conveyed to the liver. This stimulates a secretion of bile and it is not unusual for five or six free evacuations to follow. It is quite as effectual as an active purgative without any poisonous results of the drug. This enema should be retained from twenty minutes to half an hour. It is also much more efficacious when preceded by the use of a hot fomentation over the liver. This injection is an exceedingly valuable remedial agent both in acute and chronic difficulties. By its use in sick headache, bilious colic, congestions in the stomach or abdominal viscera, the physician’s visit and fee will often be saved.
The exercises recommended in Chap. V, for constipation, are invaluable for biliousness.
Before closing this chapter, let me repeat and emphasize, “Do not force the appetite.” Food which neither relishes nor digests will do more harm than good. Tradition and prejudice have all conspired to so engrave in your being that you must not only eat, but stuff, because you are eating for two, that both you and your friends think food must be taken at all hazards. So, what is your custom? You rise in the morning sick and disgusted. The very smell of food is intolerable. Still you sit at the table instead of getting away from it, and eat probably beefsteak and hot bread, washed down by a cup of coffee. Of course you must take what is the most nourishing! These are scarcely swallowed until you have proofs that so much provision is wasted.
By nine o’clock you make another attempt. You go to the pantry, find some cold chicken, a piece of lemon pie, and a pickle. But no, the stomach refuses these. At eleven o’clock a confidential friend calls. She commiserates you, and knows that both you and the fetus will starve. She goes to her own larder, brings you a piece of pound cake, some custard and jelly; possibly a piece of mince pie. Do these share the same fate? Perhaps not. Her cheery laugh and neighborly sympathy, and the more propitious time of day, make it possible for this to be retained. But pause, my friend. Has the blood received the best nutriment for building a healthy organization for yourself or child?
Very little, if any extra food is essential to nourish the fetus, especially the first few weeks of pregnancy. The total average increase of weight is less than one-half an ounce a day, and one-fourth of this would be an approximate estimate for the first three months. It can readily be seen that simply the suppression of the menses would give nearly, if not quite, all the extra nutriment for the first few weeks, at least. Appropriate food, and the proper conditions for assimilation are far more important than increase in quantity.