Pregnancy is a normal condition and one which every young married woman looks forward to with hope, if she has the correct attitude towards life.
We have all seen delicate girls marry and were doubtful about their strength to have children, but nature seems to join with the desire of the mother. The frail young woman broadens out during pregnancy and becomes a robust expectant, capable of withstanding the foetal development and delivery with ease. It is only when nature is met by some previous defect, such as tuberculosis, pelvic deformity or a severe kidney involvement that it cannot step in and take charge of the case with complete satisfaction.
Even in tuberculosis nature is not balked. I have seen several cases of advanced pulmonary tuberculosis where the young woman became pregnant and nature seemed to rob the germs of their victim. often it is only a stay of execution, however, because after birth the germs are doubly active.
It is the doctors duty to keep a constant keep a constant watch over the expectant mother as soon after conception as he is consulted. In fact it is nature or the rebellion of the body against the laws of nature which often send the young married woman to her doctor because of nausea. The doctor must then make a blood test, a urine test, examine the heart and lungs, and take the blood pressure.
Sometimes this trying time for the young mother will be the warning for the doctor that all is not well. The frequent headaches, the rising blood pressure, and a trace of albumin in the urine should be sufficient evidence for him that he is not dealing with a blood condition brought about by pregnancy but that he is confronted with nephritis.
It is true there are a number of conditions which may produce albuminuria.
1. Physiological. A trace of albumin may be found and an entire absence of any other symptoms whatsoever. I have never met such a case, at least not in a pregnant woman.
2. Certain febrile conditions, such as scarlet fever, measles, or even influenza. In pregnancy this would be very dangerous both to mother and child.
3. Certain nervous affections, such as epilepsy, chorea, cerebral haemorrhage, or delirium tremens. Also exophthalmic goitre may produce an albuminuria. If the doctor has been consulted before the wedding these same conditions should be sufficient grounds for him to refuse to grant a clean bill of health and thus prevent the marriage until these nervous conditions are corrected.
4. Certain patients may have an interstitial nephritis producing albumin. To a certain extent this is physiological. It is physiological in this disease and, while it complicates the pregnancy very much, it does not have the grave significance that a true nephritis has. I have one woman with this condition whom I have cared for in five confinements, and she has had albumin during the whole pregnancy with all and yet had normal births.
5. There are also women who have married who have Brights disease-parenchymatous nephritis. These women may become pregnant. These cases should be checked, too, before they reach the altar by our state laws and the doctors examination.
6. A year ago I was consulted by a woman who was pregnant. I found she had secondary anaemia. She told me she had miscarried three times before because of the same condition. There was a trace of albumin in the urine but the blood picture was alarming. Haemoglobin was only 40 percent. Strange to say, although she had taken quantities of iron both by mouth and hypodermically, Ferrum phos. 45M. changed the picture in three weeks. Alas, in her fifth month she contracted measles from her little son and again miscarried.
According to Bartlett there are other conditions causing albuminuria but we will not take them up now.
Whether the alkaline balance is lowered in the blood or whether certain toxins in the blood may be the sole cause, we meet these nephritis cases in pregnancy.
It may come in any stage of the pregnancy, but my observation is that it is more apt to begin in the first three months. The hearts action is accelerated, the blood pressure rises, and the urine may cause burning and distress. It may also become scant and high colored. I may say that if there is a trace of albumin and none of these symptoms take place, then it is quite possible the condition is of long standing and the patient has established a tolerance, a tolerance which will see her through to a safe delivery.
My worst cases have been in the robust women of strong physique, often inclined to be fleshy, with red cheeks and strong bodies. They are frequently very nauseated in the early months and come to you with this distressing condition. Soon another condition is disturbing-frequency of urination and the burning on passing a small amount. This leads to an examination of the urine showing the albumin, and the rising blood pressure, headache, and puffiness under the eyes are all characteristic.
Having ascertained the condition, what shall we do? Diet is necessary at once-a milk diet with orange juice and plenty of water. Until the burning and urinary distress is relieved the patient should go to bed and stay there.
In the early stages if nausea is distressing Dr. Royal of Iowa advocates 10 C.C. of the husbands blood injected into the buttocks. I have found this method splendid. Not only does it stop the nausea but it also checks the nephritis. Both the husband and wife are pleased with the spectacular method. One couple a year ago told how I used blood transfusion for them.
The next thing is the indicated remedy. This may be any remedy in the category. Look for the symptoms.
Belladonna is clearly indicated in the full-blooded type with increased tension, headache, red face, throbbing arteries, dilated pupils, and soreness in the bladder region.
Ferrum phos. is indicated where the pulse is not so throbbing. The patient is anaemic and the face while flushed is more florid. Often a history of a severe cold caused the trouble. The patient is chilly at 4 to 6 a.m. and worse on the right side, by touch or a jar. I now use this remedy in high potency.
Merc. cor. has a great tenesmus of the bladder and often of the bowel too. The urine is hot and scanty, often with blood in it. There is bloated appearance of the face, limbs and body.
Hamamelis is extremely useful if there is much blood. There are many varicose veins, also passive congestions, and great weakness and soreness. Use in 3 to 5 drop doses.
Eupatorium purp. has burning and full feeling of the bladder, strangury, chills and pains run up the back, left-sided headache, and bone pains.
These are only a few of the remedies you may need. If the blood pressure goes down, headache stops, and the pulse slows, do not be alarmed if the albumin is not all gone. When delivery time comes take the blood pressure, give the indicated remedy, and watch your patient. FORT MORGAN, COLO.
DISCUSSION.
DR. GRIMMER: This was a good paper and concise. Of course, as Dr.Bowie stated, those remedies mentioned are not the only remedies we have, but they are high type.
It is a pity that the expectant mother cannot have more homoeopathic physicians like Dr. Bowie to take care of her. She would go through easier and have none of t he consequences of bad drugging, and, what is more, the children that come into the world under homoeopathic care have gone a long step forward to better health and to health that will go on to future generations.
I am thoroughly convinced that if we could have three generations of homoeopathic treatment we could eradicate most of the tuberculosis and cancer in the race. The is a pretty startling statement, but I believe it is true, because we see what we can do in just one generation with careful homoeopathic prescription.
The doctor thought I would take issue with him on some questions of potencies versus tinctures. You might think it strange, but I have used tinctures quite a few times to very good advantage. I think all of our men have at some time. Even Dr.Hahnemann himself cured the poor old washerwoman with tincture of Bryonia, and very well. If your remedy is indicated, you can give anything from tincture to the DM. potency and get results. It is true that as we get along in our work we can select better whether the case will be more applicable to the tincture or more applicable to the potency. We do not need to be divided any longer on the potency question. It is the question of the one remedy that counts.
I would like to mention another remedy not mentioned, and that is Phosphorus. It is a wonderful remedy in many forms of Brights disease and albuminuria. The extreme thirst for ice-cold water is one of the things that will lead to Phosphorus, and you quickly have to differentiate from some of the other remedies.
As the doctor said, we must individualize and get the remedy best suited for each individual case if we get the ideal homoeopathic remedy.
DR. DIXON : Phosphoric acid did yeoman service for me in a good many albumin cases.
Dr. Bowie mentioned in his paper that some people carry albumin through a long life without any bad symptoms. I have a man, now well up in his seventies, who, when he was twenty-five years of age, was refused life insurance because of a trace of albumin in his urine, which he has had all his life. I have been the family doctor for forty years, and that man has not had a severe illness in all time, only little acute things like a cold or a touch of rheumatism.
