which is one constructed to act either as an enema apparatus, or, by placing the vaginal pipe over the enema pipe, as a vaginal syringe. She will thus be armed at all points, and will be ready for any emergency. It is an admirable invention, and cannot be too well known. (3.) I should advise a nurse never to quack either the mother or the babe. A quacking nurse is a dangerous individual. The only person that should prescribe for either mother or babe is the medical man himself. A nurse has no business to course upon a doctor's preserves. She should remember that he is the one to give orders, as he, in the lying-in room, is the commander-in-chief, and must be obeyed. (4.) I should recommend every monthly nurse, while waiting upon her mistress, to wear either list slippers or the rubber slippers, as creaking shoes are very irritating to a patient. "Nurses at these times should wear slippers and not shoes. The best slippers in sick-rooms are those manufactured by the North British Rubber Company, Edinburgh they enable nurses to walk in them about the room without causing the slightest noise; indeed, they may be called 'the noiseless slipper '—a great desideratum in such cases, more especially in all head affections of children. If the above slippers cannot readily be obtained, then list slippers-soles and all being made of list—will answer the purpose equally as well."—(Advice to a Mother.) While speaking on the duties of a monthly nurse, there is one reprehensible practice of some few of them I wish to denounce, which is this:A nurse declaring at each pain, when it will probably be two or three hours before the labour is over, that two or three pains will be all that are needed! Now, this is other either for giving an injection up the vagina, or for washing out the vagina with warm water. The best quality of apparatus ought always to be chosen. C. Mackintosh & Co.'s Patent Vaginal Syringe (No. 2 size) is a capital vaginal syringe; but it will only act as a vaginal; whilst Higginson's and some others will act a double purpose-either as an enema or as a vaginal syringe. 66 folly, it is most disheartening, and makes the patient impatient and to believe in bitterness of spirit, that "all men," and women, too, are liars." A nurse should take her cue from the doctor, and, if he should happen to be a sensible man, he will tell his patient the truth, and express an opinon how long it will be before she is likely to be delivered. Truth in this, as in everything else, is the safest and the best ! CONCLUDING REMARKS ON PREGNANCY. 470. The premonitory symptoms of labour having now commenced: everything being in readiness for the coming event; clothes, sheets, flannels, diapers, all well aired; everything in order, so that each and all may, even in the dark, at a moment's notice, be found; the bed-room well ventilated; the nurse being in the house; the doctor notified that he might be wanted; all the patient has now to do is to keep up her spirits, and to look forward with confidence and hope to that auspicious moment which has been long expected, and which is now about arriving, when she will be made a mother! and which event-the birth of her child, ushered as he is into the world with a cry (O, joyful sound!)—she will realise as the happiest period of her existence she will then be amply repaid for all her cares, all her anxiety, and all her anguish : "A woman when she is in travail, hath sorrow because her hour is come; but as soon as she is delivered of the child, she remembereth no more the anguish, for joy that a man is born into the world."-St John. PART III. LABOUR. The child was prisoner to the womb; and is, THE PRECURSORY SYMPTOMS OF LABOUR. 471. A day or two before the labour commences the patient usually feels better than she has done for a long time; she is light and comfortable; she is smaller, and the child is lower down; she is more cheerful, breathes more freely, and is more inclined to take exercise, and to attend to her household duties. 472. A few days, sometimes a few hours, before labour commences, the child "falls," as it is called, that is to say, there is a subsidence-a droping-of the womb lower down the belly. This is the reason why she feels lighter and more comfortable, and more inclined to take exercise, and why she can breathe more freely. 473. The only inconvenience of the subsidence of the womb is, that the womb presses on the bladder, and sometimes causes an irritability of that organ, inducing a frequent desire to make water. 474. The subsidence—the droping--of the womb may then be considered one of the earliest of the precursory symptoms of childbirth, and as the herald of the coming event. 475. She has, at length, slight pains, and then she has a "show" as it is called: which is the coming away of a mucous plug, which, during pregnancy, had hermetically sealed the mouth of the womb. The "show" is generally tinged with a little blood. When a "show" takes place, she may rest assured that labour has actually commenced. One of the early symptoms of labour is a frequent desire to relieve the bladder. 476. She has now "grinding pains," coming on at uncertain periods; sometimes once during two hours, at other times every hour or half-hour. These "grinding pains" ought not to be interfered with; at this stage, therefore, it is useless to send for a doctor; yet the monthly nurse should be in the house, to make preparations for the coming event. Although, at this early period, it is not necessary to send for the medical man; nevertheless, it is well to let him know that his services might shortly be required, in order that he might be in the way, or that he might leave word where he might quickly be found. 477. These "grinding pains" gradually assume more regularity in their character, return at shorter intervals, and become more severe. About this time, shivering, in the majority of cases, is apt to occur, so as to make the teeth chatter again. Shivering during labour is not an unfavourable symptom; it proves, indeed, that the patient is in real earnest, and that she is making progress. 478. She ought not, on any account, unless it be ordered by the medical man, to take brandy as a remedy for the shivering. A cup either of hot tea or of hot gruel will be the best remedy for the shivering; and an extra blanket or two should be thrown over her, which ought to be well tucked around her, in order to thoroughly exclude the air from the body. The extra clothing should, as soon as she is warm and perspiring, be gradually removed, as she ought not to be kept very hot, or it will weaken her, and will thus retard her labour. 479. Sickness frequently comes on in the beginning of the labour, and may continue during the whole process. She is not only sick, but she actually vomits, and she can keep little or nothing on her stomach. 480. Now, sickness in labour is rather a favourable symptom, and is usually indicative of a kind and easy confinement. There is an old saying that "sick labours are safe." Although they may be safe, they are decidedly disagreeable! 481. There is, in such a case, little or nothing to be done, as the less an irritable stomach is meddled with the better. The sickness will probably leave as soon as the labour is over. Brandy, unless prescribed by the doctor, ought not to be given. 482. She must not, on any account, force downas her female friends or as a "pottering" old nurse may advise to "grinding pains;" if she do, it will rather retard than forward her labour. 483. She had better, during this stage, either walk about or sit down, and not confine herself to bed ; indeed, there is no necessity for her, unless she particularly desire it, to remain in her chamber. 484. If, at the commencement of the labour, the "waters should break," even if there be no pain, the medical man ought immediately to be sent for; as, in such a case, it is necessary that he should know the exact presentation of the child. 485. After an uncertain length of time, the character of the pains alters. From being "grinding," they become "bearing down," and are now more regular and frequent, and the skin becomes both hot and perspiring. These may be considered the true labour-pains. The patient ought to bear in mind then that "the true labourpains are situated in the back and loins; they come on at regular intervals, rise gradually up to a certain pitch of intensity, and abate as gradually; it is a dull, heavy, deep sort of pain, producing occasionally a low moan from the patient; not sharp or twinging, which would elicit a very different expression of suffering from her." --Dr Rigby. |