142 CHAPTER VI. HINTS FOR THE LYING-IN ROOM RE- Sect. 1.-The Period previous to Labour. Of Labour itself, and the use of Chloroform.-Dread of suffering, and anxiety for her safety, are the two feelings which predominate in the minds of most women in anticipation of labour. If they knew how wonderfully their organisation is in all respects adapted to the end designed, their fears would be changed into calm and confident reliance upon Him who has so created it. The process of natural labour displays the most exquisite adjustment of means to ends. It is impossible not to see how conspicuously the safety of the mother has been provided for; and how admirably, in every circumstance of the entire process, her powers have been proportioned, and her capability of exertion fitted, to the necessities of the The late Dr. Denman, one of the most practical and eminent physician accoucheurs of his day, says, 'Your safety in childbirth is insured by more numerous and powerful resources than under any other circumstances, though to appearance less dangerous.' Harvey, the immortal discoverer of the circulation of the blood, referring to this subject, observes, "Yet this ease. is not more worthy of admiration than the other works of nature, "for all things are full of God," and the Deity of nature is ever visibly present.' Such facts are surely calculated to remove unnecessary apprehension, and particularly that undefined dread which all women suffer under, more or less, when looking forward to labour for the first time. Weigh these thoughts well, and they will tend greatly to strengthen and fortify the mind in prospect of that measure of suffering which is inevitable, and to relieve it of that needless anxiety respecting the result to which inexperience and the idle gossip of the ignorant may have given rise. The amount of suffering to be endured is uncertain, being unequal in different women, and in the same women in different labours. I have known cases, and have heard and read of others, in which the patient declared she had no pain-there was a sensation of bearing down, and the child, to the amazement of the mother, was born. These are exceptions to the general rule, as are those of the opposite kind, viz. of excessive suffering. In the majority of cases the pain endured lies, of course, between these two extremes. My experience, therefore, in the lying-in room, is not in accordance with that of some, who speak of the pains of labour as usually characterised by great suffering and anguish, and in the last stage as 'absolutely indescribable.' Happily, as far as I have observed, such cases are the exceptions. I desire to impress this fact strongly upon the reader's mind. Indeed to use terms of exaggeration upon such a subject is likely to be most mischievous, as it is certainly in effect most cruel. One would almost fancy that, since chloroform has come into use, the process of labour has acquired an intensity of suffering, which, before, it was never thought to possess. I can only account for this by the supposition that the magnitude of the evil has been unconsciously exaggerated in the effort to make the virtues of the remedy the more conspicuous. I fear the diffusion of erroneous estimates of the suffering endured may cause a great amount, in this natural process, of unnecessary mental distress; and I feel it, therefore, the more necessary to affirm my honest belief in the opinions expressed above, being desirous that my readers should not be robbed of the encouragement and comfort which, if well founded, they are so calculated to impart. It is unnecessary to describe chloroform. Every one is aware that, in 1847, a substance was reported to have been found that would annihilate the pains of labour. The announcement was welcomed by the public with feelings of thankful joy and wonder. Expectant mothers became greatly excited and interested, anxiously inquiring as to the efficacy and safety of the drug, and many earnestly importuning for its use. Being affirmed that it was perfectly safe, and that it in no way interfered with the process of parturition many professional men at once adopted the remedy, and employed it in almost all cases. The author of this work, in his early editions, wrote a chapter on chloroform. No doubt this was a wise and useful addition to the book so long as the use of chloroform was little understood. Now all this is changed; and the Editor of the present edition thinks it better to leave the matter of chloroform, the indications for its use, and the mode of its administration, in the hands of the medical practitioner; he will advise I need when and how the drug shall be administered. only say that although the risk of accidents is very small, yet that it does exist, and that under these circumstances chloroform may not be used indiscriminately. I will especially caution against the selfadministration of this dangerous drug. It will still be fresh in the memory of my readers that a most painful calamity recently occurred from the self-administration of this anæsthetic (November, 1875). One of the leading medical journals, in commenting on this case says: The unskilled person, who indulges in these narcotics for the relief of pain, or as a nervous sedative, on his own responsibility, takes an immeasurable risk, of which the fatal consequences are but too often shown publicly by sudden death.' 6 I am bound, however, to admit, that there is less risk from chloroform during a prolonged or difficult labour, than perhaps under any other circumstances or conditions; and I would advise, therefore, whenever the medical attendant counsels its administration, that the patient willingly and cheerfully submit herself to its influence, fully relying, as she may do, that it will not be recommended unless there is some great need for its use. Symptoms of Labour approaching. For some time before the commencement of actual labour a variety of changes is taking place, which nature is making preparatory to the process itself. Of these, however, the female knows nothing, except indeed of one change, which becomes marked and evident enough in most cases, viz. an alteration in the form and size of the abdomen. This is sometimes so considerable, that a woman often appears, and really is, less in the ninth than in the eighth month of pregnancy. This sub L |