Part 16 (1/2)
As you read his able essay remember there are four other sets of nerves equal to, and just as important in their divisions of life, which are the motor, nutrient, voluntary and involuntary. All of which you as an engineer must know, and by proper adjustment of the body give them unlimited power to perform their separate and united parts in sustaining life and health. Now as I have tried to place into your hands a compa.s.s, flag and chain that will lead you from effect to cause of disease in any part or organ of the whole abdomen I hope that many mysteries which have hung over your mental horizon will pa.s.s away, and give you abiding truths, placed upon the everlasting rock of cause and effect. You have as little use for old symptomatology as an Irishman has for a cork when the bottle is empty. Osteopathy is knowledge, or it is nothing.
CHAPTER XVII.
OBSTETRICS.
Overloading--Similarity of Stomach and Womb--Births--Preparation for Delivery--Caution--Lasceration Need Not Occur--Care of Cord--Severing Cord--Putting on Belly Band--Delivery of Afterbirth--Preparing for Mother's Comfort--Post-Delivery Hemorrhage--Treatment for--Food for Mother--Treatment for Sore Breast.
OVERLOADING.
When in the course of human events and actions of life, a woman disregards the laws of nature to such an extent as to overload the stomach beyond its powers and limits; or another way to present the thought, we will say, if you fill the stomach so full as to occupy all s.p.a.ce, or so much of the s.p.a.ce as to cripple the laws of digestion and retain the food, the decomposition sets up an irritation of the nerves of mucous membrane to such a degree as to cause sickness and vomiting, or any other method of disgorging the stomach, which is the natural process to unload an overloaded vessel. When the nerves cannot take up nutrition, they will then take up destruction and other elements which are detrimental to the process of nutrition, and there is no other process for relief but to unload. The loading that has been deposited in the stomach was for the purpose of sustaining a being. The stomach itself is a sack. When filled to its greatest capacity, it irritates all the surroundings, and in return they irritate the stomach. Thus it unloads naturally for relief. Now we wish to treat of another vessel similar in size, similar in all its actions, which receives nourishment for a being, which nourishment is contained in the blood, and conveyed from the channels commonly known as uterine arteries. To all intents and purposes this nourishment is taken there to sustain animal life, after having constructed the machinery then it appropriates the blood to the growth and existence of a human being. One is the womb, the other the stomach. The placenta in the womb is provided with all the machinery necessary to the preparation of blood, such as is used for all purposes in forming and developing a child. Which is the stomach? Which is the womb? and what is the difference? Both receive and distribute nourishment to sustain animal life. Both get sick, both vomit when irritated and discharge their loading by the natural law of ”throw up”
and ”throw down.” Now note the difference and govern yourselves accordingly. One is mid-wifery, or treatment of the lower stomach during gestation and delivery. The other is the upper stomach that takes coa.r.s.er material and refines the unrefined substances, keeps the outer man in form and being; the other contains the inner man or child, and by the law of ejection, when it becomes an irritant, it is thrown out by the nerves that govern the muscles of ejection.
BIRTHS.
To ill.u.s.trate: I will say, just as long as digestion and a.s.similation keep in harmony and the mother generates good blood in abundance, the child grows, and by nature the womb is willing to let the work of building the body of the child go on indefinitely; but nature has placed all the functions of animal life under laws that are absolute and must be obeyed. We by reason are asked to note the similarity of the stomach and the womb, as both receive and pa.s.s nutriment to a body for a.s.similation and growth. When a stomach gets overloaded, sickness begins, as digestion and a.s.similation has stopped, then the decaying matter is taken up by the terminal nerves, and conveyed to the solar plexus, and causes the nerves of ejection, to throw the dying matter out of the stomach which is above. Try your reason and see the stomach below sicken and unload its burden. Is this sickness natural and wisely caused? If this is not the philosophy of mid-wifery what is? As soon as a being takes possession of its room, the commissary of supplies begins to furnish rations for that being, who has to build for itself a dwelling place. The house must be built strictly to the letter of the specifiction. Much bone and flesh must be put into the house of life, and some of all elements known to the chemist, must be used and wisely blended to give strength; also all material to be used in the house must be exact in form and given strength equal to all forces, that may be necessary to execute the hard and continued labors of the machinery that may be used in all transactions and motions of mind and body. Now we must go to the manufacturing chief, and have him through the quartermaster deliver and keep a full supply of all kinds of material for the work, and when the engine is done, put it on an inclined plane and cut the stay-chains and let it run out of the shop. Be careful and not let the engine deface nor tear the door as it comes out. A question is asked: On what road does the quarter-master send the supplies? As there is but one system over which an engine can bring supplies, we will call that road the uterine system of arteries. The mechanic reports that he will open the door of this great shop of manufacturing, and let it roll out the engine by the power and methods prepared to run out finished work. First you see a door open because the lock is taken off by a key that opens all mysteries; and the great ropes that have been far inferior to the force of resistance, that has held the door shut, are all sufficient in power. By getting sick, muscles become convulsed to rigidity of great strength with force enough to push the new engine of life out into open s.p.a.ce easily, by nature's team that never fails to obey orders to deliver all goods intrusted to its care.
PREPARATION FOR DELIVERY.
A student of mid-wifery can only learn a few general principles, before he gets into the field of experience. Actual contact with labor teaches him that much that he has read and had told to him by professors of mid-wifery in the lectures, is of but little use to him at the bedside.
What he needs to know is, what he will have to do after he gets there.
He must know the form and size of the bones of a woman, how large a hole the three bones of the pelvis make, for the reason that the child's head will soon come through that hole. He must know a normal head cannot come through a pelvis that has been crushed in so much as to bring the pubis within one and one-half to two and one-half inches of the sacrum. He must examine and know, and do this soon after he is called, for the reason, that he will have to use instruments in such deformities, and may wish the counsel of an older and more experienced doctor. And this precaution will give him time to be ready for any emergency.
But more than ninety per cent of all cases are of a very simple nature.
The mother is warned by pains in back and womb, coming and repeating at intervals of one-half hour to less time. When by the finger the doctor can tell the mouth of the womb has opened to the size of a quarter or half dollar, he then may know that labor will soon start in good earnest, and at this time it is well to call for a twine, cut two strings about a foot long, to tie around the navel cord.
CAUTION.
The first duty of the obstetrician is to carefully examine the bones of the pelvis and spine of the mother, to ascertain if they are normal in shape and position. If there is any doubt about the spine and pelvis being in good condition for the pa.s.sage of the head, through the bones, and you find pelvic deformity enough to prohibit the pa.s.sage of the head, notify the parties of the danger in the case at once, and that you do not wish to take the responsibility alone, as it may require instruments to deliver the child, as there is danger of death to the child and mother also, but less danger to the mother than to the child.
Now you have done that which is a safeguard against all trouble following criminal ignorance.
I will give you a condensed rule of procedure in all normal cases of obstetrics. With index finger, examine os uteri; if closed and only backache, have patient turn on right side, and press hand on abdomen above pelvis, and gently press or lift belly up just enough to allow blood to pa.s.s down and up pelvis and limbs. Relax all nerves of the pelvis at p.u.b.es.
SECOND EXAMINATION.
Caution: Wait a few hours; examine os again. If still closed and no periodical pains are present, you are safe to leave case in the hands of the nurse, instructed to send for you if regular pains return at intervals. On your return, explore os again, if found to open as large as a dime, you are by this notified that labor has begun its work of delivery. You now place patient on her back, propped to an easy angle of near thirty degrees, with rubber blanket in place. After you find os, dilated to nearly the size of a dollar, then relax nerves at p.u.b.es. Soon you will find in mouth of womb an egg-shaped pouch of water, which you must not press with fingers till very late in labor, for fear of stopping labor for perhaps many hours. Remember the head can and does turn in pelvis to suit the easiest pa.s.sage through the bones, while in the fluids of the amniotic sack. Now, as you know why not to rupture sack and spill fluids, you are prepared to proceed to other duties, which are to prevent rupture of perineum. Place the left hand on the belly, about two inches above symphesis and push the soft parts down with the left hand; support the perineum with the right hand until head pa.s.ses over. This is necessary to prevent rupture of perineum.
LASCERATION NEED NOT OCCUR.
If you follow this law of nature, lasceration may occur in one out of a thousand cases, and you will be to blame for that one, and may be censured for criminal ignorance. Now you have conducted head safely through pelvis and v.a.g.i.n.a to the world. You will find pains stop right short off for about a minute, which is the time to learn whether the navel cord is wrapped around the child's neck.