[Read before I.H.A., Bureau of Obstetrics, September, 1944].
R. S. FARIS, M.D.
In this paper we shall deal solely with the use of various remedies given by mouth. No mention will be made of any adjuvant treatment, such as the indications for the use of forceps or the application of pressure in some of the haemorrhages.
The subject will be considered under three heads: Complaints During Pregnancy, During Parturition, and During the Puerperium.
It is not the purpose of this paper to mention every remedy in the materia medica but to consider under each heading these remedies most often called for in the respective conditions. Doubtless many other valuable remedies will be suggested in the discussion.
COMPLAINTS DURING PREGNANCY.
APIS: Suppression and what scanty urine there is, is highly colored, loaded with casts; stinging pains and strangury or there may be frequent urination; involuntary or incontinence; last drops burn and smart; burning and soreness on urinating.
MERCURIUS CORROSIVUS: Intense burning in the urethra; urine hot, burning, scanty, suppressed; bloody, greenish discharge; filaments, flocks or dark flesh-like pieces of mucus in the urine; the tenesmus is pronounced.
ARSENICUM ALBUM: Scanty, involuntary, burning urination; bladder feels as if paralyzed; epithelial cells; cylindrical clots of fibrin and globules of pus and blood; after urination there is a feeling of weakness in the abdomen; uraemia, anguish with thoughts of murder especially in drunkards. This patient is very restless and is usually worse at night. Exhaustion from the least exertion.
CANTHARIS: Intolerable urging, violent paroxysms of cutting and burning in the whole renal with painful urging to urinate. Cutting before, during and after urination. Urine scalds and is passed drop by drop. Constant desire to urinate. Urine jelly- like; shreddy. Fruitless efforts to urinate. Retention of urine causing pain.
HELONIAS: Urine phosphatic; profuse, clear. Saccharine. Constant aching and extreme tenderness of kidneys, especially at night. Can trace the outline of the kidneys by means of the burning in them; weariness, languor, weight in the region of the kidneys; mind dull, inactive, especially in the afternoon and evening; burning and scalding when urinating; desire frequent and urgent. Involuntary discharge of urine after the bladder seems to be emptied.
TEREBINTHINA: Strangury, with bloody urine. Scanty, suppressed, with the odor of violets. Constant tenesmus; affections of the kidneys, worse from living in damp dwelling; pressure in the kidneys when sitting, better from motion.
ASARUM: During the first month of pregnancy, the stomach rejects everything; constant nausea with loathing of food with a perfectly clear tongue; constant chilly feeling even in a warm room; nervous hyperaesthesia, even scratching on linen or silk is unbearable; constant desire to urinate.
CHELIDONIUM: Nausea with heat in the stomach, followed by generalized bodily heat; heartburn, prefers hot food and drink; pains through stomach to back under scapula; jaundice is often present.
JATROPHA: Hiccoughs followed by copious vomiting; nausea and vomiting brought on by drinking, with acrid feeling in throat; great thirst; very easy vomiting; heat and burning in the stomach with crampy, constrictive pains in epigastrium.
KREOSOTUM: Vomiting of sweetish water before breakfast; breakfast and dinner being returned together and vomiting again after supper; vomiting of food several hours after eating; feeling of coldness as of ice-water in the stomach; pulsations all over the body.
NUX VOMICA: Nausea in early morning with faintness; vomiting after eating or thinks that she would feel better if she did vomit; food and drink smell bad to her; cannot bear the smell of tobacco; bitter, sour taste; belching, hiccoughs and heartburn; vomiting of sticky mucus and sour fluid; restless sleep especially after 3 a.m.; great depression and irritability; wants to be left alone; longing for alcoholic stimulants; constipated.
SEPIA: Eructation; frequent with effort to vomit; bitter, sour; taste like rotten eggs; heartburn extending from stomach to throat; nausea before breakfast, also from the smell of food, also when riding in a carriage; feeling of goneness in stomach, not relieved by eating; longing for acids and pickles; vomiting of milky water or mucus.
TABACUM: Nausea with deathly faintness and pallor of the face relieved by going into the open air; nausea when beginning to move; vomiting of acid liquids and mucus; rapid emaciation; cold sweat.
FALSE LABOR PAINS.
BELLADONNA: Pain deficient; cease; have only periodic slight pressure on sacrum; pains come suddenly with too quick bearing down as if everything would be ejected from pelvis, then pains cease suddenly.
CAULOPHYLLUM: Labor pains short, irregular, spasmodic, patient is very weak and no progress is made. Pain like pricking of needles in cervix; severe spasmodic, intermittent pains, without progress, from inharmonious action between fundus and cervix.
CHAMOMILLA: Pains spasmodic and press upwards distressing with tearing pains down legs; can scarcely be endured, they drive her frantic.
PULSATILLA: Pains deficient, irregular and sluggish; excite suffocation and fainting spells, must have doors and windows open; inertia of the uterus. This remedy often corrects the malposition of the foetus by stimulating the muscular walls of the uterus.
COMPLAINTS DURING PARTURITION.
BELLADONNA: Pains come and go suddenly; appears as if stunned; semiconscious and loss of speech; convulsive movements in limbs and muscles of the face; paralysis of right side of the tongue, foam in mouth, renewal of fit with every pain.
CICUTA VIROSA: Eclampsia with bending of the head and neck backward. General action of the patient is violent; convulsion and violent distortion of the limbs and whole body; great prostration.
HYOSCYAMUS: Cold sweat, pale face, suffocative spells during labor, facial muscles greatly agitated; spasm with much nervous irritability.
STRAMONIUM: Convulsion after labor, with copious sweating; sight of water or anything bright or glittering brings on spasms. Violent mental symptoms characterize this remedy.
CAULOPHYLLUM: Spasmodic and irregular pains which fly in all directions; shivering without progress; tormenting, useless pains at beginning of labor; inertia of the uterus with great relaxation of tissues.
COFFEA CRUDA: Ineffectual labor pains; contraction of uterus and pressure upon the cervix, causing only pain in small of back; she feels every pain intensely, weeps and laments with constant extreme fear of death (but nothing of the spiteful crossness of Cham.); pains though severe are not efficacious.
PULSATILLA: Inertia of the uterus; pains slow, weak, insufficient or spasmodic and irregular exciting fainting; wants doors and windows open, fears suffocation, especially in the mild weeping type of person.
CANTHARIS: Painful urination; burning pain in the pelvic portion of the abdomen and back; abdomen sensitive, feverish; swelling of the lips of the os; vomiting.
GOSSYPIUM: Retained placenta, adheres firmly to the walls of uterus; requires excessive force to be dislodged.
PULSATILLA: Want of action or spasmodic contraction; intermittent flow of blood; restless; wants cool, fresh air.
COMPLAINTS DURING THE PUERPERIUM.
ARNICA: Pains violent and return when the baby nurses. Indicated in the last stage of labor and another dose after the placenta is removed, on account of the bruised condition of the genital organs and the strain of the general muscular system.
CHAMOMILLA: Distressing after-pains which render her frantic and ill-natured; intolerant of pains.
CUPRUM METALLICUM: Very severe after-pains in women who have borne many children; cramping after-pain which often produces cramps in the extremities.
PULSATILLA: Pains, too long and too violent; worse toward evening; restless and changeable in her feelings, now better, now worse; wants fresh air.
RHUS TOXICODENDRON: Pains worse at night with scarcely any during the day; relief from changing position and from being well covered; cramps in the calves; pelvic articulations stiff on beginning to move.
SABINA: Pains run from sacrum to pubes; discharge of fluid and clotted blood with the severe pains, extending from pubes to thighs; abdomen very tender to touch.
SECALE: Pains too long and too severe; though feeling cold does not wish to be covered.
BELLADONNA: Profuse flow of bright red blood, which feels hot as it escapes from the vulva; blood flows profusely between the after-pains; cutting pains from hip to hip; vascular excitation shown by throbbing carotids, flushed face, red eyes, full bounding pulse; gentle pressure on uterus causes nausea; there is an undulating wave-like feeling all over body from head to feet.
ERIGERON: Profuse and alarming flood of bright red blood, flows in “fits and starts,” comes on with sudden gush and then stops again; every movement increases the flow; dysuria; pallor and weakness due to loss of blood, much irritation of rectum and bladder.
HAMAMELIS: Passive haemorrhage with anaemia; flow steady and slow, blood of dark color, no uterine pains; flow only during the day, none at night; bearing down pains in the back.
IPECACUANHA: Profuse bright, gushing, with nausea; increased with every effort to vomit; gasping for breath; stitches from navel to uterus; coldness of skin which is covered with cold sweat.
SABINA: Painless loss of dark red blood immediately after parturition, especially in plethoric women with habitual menorrhagia and tendency to abortion.
SECALE: Painless flood in feeble, cachectic women; general coldness which patient feels too warm and does not wish to be covered; haemorrhage passive, dark colored and continuous, seldom clotted and sometimes offensive; the slightest motion aggravates the flow, particularly where weakness is not due to loss of blood.
KREOSOTE: Offensive black clots mixed with water; excoriating lochia almost ceases to flow, then freshens up and becomes more profuse and bloody; and again almost disappears, to return again and again. Low spirited.
SILICA: Discharge excoriates; after pains are in the hips; pure blood flows every time the baby nurses.
LOCHIA, HOT AND SCANTY.
BELLADONNA: Flow feels hot to the parts; flushed face and injected eyeballs; pain in uterine region comes and goes suddenly.
BELLADONNA: Discharge very offensive and feels hot while being passed; fever with thirst and delirium; unrefreshing sleep; cannot bear the slightest jar of her bed.
CARBOLICUM ACIDUM: High fever alternating with chills of short duration followed by profuse sweat, with restlessness; craving for food and drink.
BAPTISIA: Lochia acrid and fetid; great prostration; distended abdomen, fullness, flatulence, rumbling, feels as if vomiting might relieve; sharp shooting pains in the bowels.
KREOSOTE: Stitches in vagina, proceeding from the abdomen, causing her to start with every pain; putrid, excoriating lochia, repeatedly almost ceasing only to start up again; lochia blackish and lumpy.
SECALE: Strong tendency to putrescence; discharge of sanious blood, with tingling in legs and great prostration; lochia dark and very offensive; burning fever interrupted by shaking chills; cold limbs; cold sweat over whole body; gangrene.
URINARY RETENTION OR SUPPRESSION.
ARSENICUM: No sensation or desire to urinate and no power to do so on account of atony of the bladder; seems to have lost all control over power to emit.
CAUSTICUM: Retention of urine with frequent and urgent desire to urinate, but occasionally a few drops pass off involuntarily.
ARNICA: Retention of urine with urging to urinate, with sore, bruised feeling of the parts from mechanical injury; constant dribbling of urine after delivery.
NUX VOMICA: Painful and ineffectual desire to urinate, pain being burning and tearing; retention of urine with frequent desire for stool.
It is presupposed that the general symptoms of the various remedies mentioned are already known, as this paper is dealing just with the particular symptoms under the various headings.
Since not very many different remedies are mentioned, I shall feel slighted if someone does not take me to task for failing to mention his “pet” remedy for some of these conditions. RICHMOND, VA.
DR. CARR: I might mention a remedy in pernicious vomiting and that is Symphoricarpus racemosa. I had that demonstrated in my own wifes case, and Dr. Fahnestock at the time this must have been twenty-five years ago was called from Piqua. I was practising in Greenville at the time and he came with a thirtieth potency in his vest pocket. I told him I had failed on the remedies and he administered Symphoricarpus racemosa, and she went on to full term.
There is another remedy and that is Cadmium sulphate, especially when the nausea is very intense, on just touching of the lips when trying to drink or eat anything. That will correct the condition very quickly.
DR. VAN NORDEN: While at Childrens I had charge of the Maternity Department there, thirty mothers and thirty babies under my care at one time, and we had quite a number of cases of retention of urine, and the doctor on service there sort of ridiculed it. I said, “How about a remedy?” and suggested the use of Apis.
He said, “That is a mechanical condition. Medicine wont do any good there”.
I said, “Suppose you try it”.
Well, I suppose I had in that year probably thirty to forty cases of retention of urine and there wasnt one case that Apis didnt relieve inside of an hour.
DR. STEVENS: I was only wishing this paper of Dr. Faris would be published for a textbook for obstetricians. It seems a pity not to have the whole thing together in some easily available form.
DR. SUTHERLAND: That would be very helpful to some of us who believe that homoeopathy in obstetrics is really useful.