Imatges de pàgina
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can be no possible reason why it should be otherwise. The hope of a happy, and it may be speedy, termination to her sufferings should ever be kept in the view of the patient. It will inspire her with an activity and resolution which will have a most useful and

favourable influence upon her situation. There is no fear, however, of such persons or topics being introduced into the lying-in room, if the previous advice in referénce to the individuals to be selected for this occasion is only acted upon.

I have repeatedly seen the bad effects of a hot and crowded room. I have often been called up in consultation in the night to a labour, which, considering the time it commenced, would have terminated in the day, had it not been protracted by the causes now adverted to. In one of these cases I counted in the lying-in room, and that by no means a large one, as many as half-a-dozen people, who, by the help of a large fire, had rendered the atmosphere so heated and impure, that one would have thought that everybody not necessitated to remain by duty would have been glad to get out of it as soon as possible. To make matters worse for the patient, she was half-buried in a soft feather-bed, while a friend, if not two, were on the bed for the alleged purpose of supporting her back : for supporting her strength, cordials had been from time to time administered. This state of things having existed for hours, with the talking and gossip, and anxious looks of the friends, it is not very wonderful that the patient's strength had become entirely exhausted, her mind depressed, and the natural progress of the labour so interrupted, that artificial assistance had at last been thought necessary. Such assistance, however, was not required, as it seldom is; and the

remedies were as simple as they were successful. I put out the fire, and the friends too. I relieved the patient's mind of its heavy burden by fairly explaining to her how her present condition had been brought about, and by confidently and truly assuring her of a successful issue of her labour. Rest and perfect quiet were then obtained; and after a little while, the apartment having become cool, she fell into a refreshing slumber. By-and-by she was aroused by labourpains, which had been impeded and almost suspended by the former mismanagement; they became vigorous and frequent, and after a while the case terminated naturally and safely.

Such a case as the one just related is by no means a solitary one; and though the state of the lying-in room may not often be quite so bad as the above described, it often approximates to it. These cases are generally talked of afterwards by the friends who have been present, as severe and alarming: they always forget to add one fact-that if so, they themselves were the cause of it.

I must not omit to state that I have witnessed the injurious effects of communicating distressing intelligence to a patient in labour. Whatever may happen, let it not reach the lying-in room. Mental excitement of any kind tends to disturb and interrupt the favourable process of child-birth; and the same remark applies with equal force to the early days after delivery.

Every requisite which is necessary for a lying-in chamber should at this time be in its place, and ready for use. It is unnecessary to detail minutely what is required. The skin of leather, or a large sheet of oil-skin for guarding the bed, or, which is preferable,

the Mackintosh sheeting; the dressing-gown for the patient to wear in the early parts of labour, and the other portions of dress detailed under the section 'Dress; the broad bandage; the small horse-hair cushion for a later period of labour, to be firmly secured to the post of the bed for the feet to press against; pomatum or lard; a skein of strong sewing thread; the flannel receiver, and a plentiful supply of linen generally; the wooden bath, referred to in the next chapter (page 186)—these, and other things which will naturally suggest themselves to all persons familiar with a lying-in room, should all now be in readiness.

The Bedroom. The bedroom of a lying-in patient should be large and airy, and, if possible, communicate with another room. It should have a fireplace for fire in winter, which in the summer should be made in the adjoining apartment. Of all rooms in the house it should be the room least exposed to noise.

The air must

The proper ventilation of the lying-in room throughout the month (as much so as during the labour) must be carefully attended to. be kept cool and fresh; its temperature never allowed to exceed 60° of Fahrenheit; and nothing that would render the atmosphere impure must be permitted to remain in the room one moment longer than necessary. There can be no doubt that one of the principal sources of those diseases of the lying-in room which in former times were so prevalent in this country, was the impure and heated air, together with the smothering system then pursued. The prejudices in which that system originated are not altogether laid aside in the present day; and the medical man's directions upon this subject are too frequently disregarded. I am

continually obliged upon entering the bedroom to draw aside the curtains, to open the door, or order the fire to be kept low, that a hot room may be made bearable.

The bed should have only so much hangings about it as will serve to protect the patient from draught; they should be of a light character; the old-fashioned woollen curtains, being too heavy and too heating, ought to be quite discarded.

Aperient Medicine. As labour approaches, the bowels should invariably be cleared by some aperient; or consequences exceedingly disagreeable to a delicate woman will inevitably occur at the latter stage of the labour. A table-spoonful of castor-oil is the best medicine for this purpose, particularly if the bowels have already been confined a day or two, and there appears to be sufficient time for its operation. If, however, labour has commenced, by no means take aperient medicine, but use the lavement--the injection to consist of one pint of warm thin gruel or barleywater, with two table-spoonfuls of castor-oil.

Sect. 2.-The Period during the Process of Labour.

The Bed. As the patient is to lie on her left side, the bed must be so placed that she may be either at the foot, or on the right side of the bed. Many prefer the support the feet

foot, because the foot-post serves to

during what is called the second stage of labour; but then this post should have a small hair cushion secured firmly to it by straps, for the feet to press against, otherwise they will be found tender and fretted subsequent to labour.

Where there is both a mattress and bed, it is better for the mattress to be uppermost. The patient

in a feather-bed is likely to sink into a hole, which is inconvenient to the attendant, and keeps the patient too hot and close.

And, next, the bed must be 'guarded,' as it is popularly called; that is, so arranged as to preserve it with certainty from being soiled or injured. The method of doing this is very simple. A piece of American oil-cloth, or of Mackintosh sheeting, is to be spread over the mattress, and on this a blanket doubled in four, which is to be covered with a sheet, upon which the patient lies on her left side; and lastly, a sheet, blanket, &c., is to be thrown over her person, as the season of the year may determine. Patients are frequently too warmly covered by the nurse; this relaxes and weakens, when strength is of so much consequence.

It is a common practice on the Continent to deliver a woman on one bed, and immediately after to remove her to another. This plan is sometimes adopted in this country. It is only necessary to observe that such a mode of procedure incurs much danger.

The Dress. When the pains of labour first commence, the dress should be so arranged that if its progress becomes suddenly rapid, it may be readily changed.

A loose dressing-gown is best in the earlier part of the labour. This must be exchanged, when the patient lies down for good, for a chemise and bedgown folded up smoothly to the waist, and a flannel petticoat without shoulder-straps, that it may afterwards be readily removed.

A broad bandage, too, must be passed loosely round the abdomen as the labour advances to its close; and its application must not be left until after the delivery,

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