COLLEGE OF PHYSICIANS * 
 
 AND SURGEONS 
 
 7 
 
 Reference Library 
 
 Given by 
 
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Approaching Maternity 
 
 JOHN ROSS PANCOAST, M.D. 
 
 Ucntb JEbition 
 
 PUBLISHED BY 
 
 the; PANCOAST COMPANY 
 
 638 BOURSE 
 
 PHILADELP&IA, PA. 
 
 1897 
 
Copyright 1897 
 
 BY 
 
 John Ross Pancoast, M.D. 
 
 
 PRESS OF 
 
 HATHAWAY & BROTHERS 
 
 PHILADELPHIA 
 
DEDICATED TO THE 
 
 MOTHERS 
 
 OF OUR LAND 
 
Digitized by tine Internet Arciiive 
 
 in 2010 witin funding from 
 
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PREFACE 
 
 I have endeavored in this work, to avoid the use of 
 any technical terms that would only confuse my readers, 
 and it has been my effort to couch my ideas in language 
 that could readily be understood by any woman of 
 ordinary intelligence. 
 
 TJie indications of pregjiancy are as follows : 
 
 Cessation of the menses. 
 
 Enlargement of the breasts. 
 
 Morning nausea. 
 
 Sinking and then protruding of navel. 
 
 Quickening ; or moving of child in the womb. 
 
 It is a difficult matter to calculate accurately, the 
 exact day on which a pregnant woman will be confined. 
 It is usual to figure that two hundred and eighty days 
 from the cessation of the last menstruation, the e\'ent 
 will take place, but many a husband who has been 
 hurriedly called and sent for the physician and nurse, 
 two or three weeks before the birth was due, will testify 
 to the inaccuracy of this uncertain rule. 
 
However, this is as close a calculation as we can 
 make as yet. 
 
 The development of the X-rays may put us upon a 
 more certain basis for calculation. 
 
 It would be well for every prospective mother to 
 prepare for the birth of her child in two hundred and 
 fifty- days. Have your nurse engaged well ahead. Let 
 her come to your house occasionally and get used to the 
 rooms she is to use. This will save many wasted minutes 
 when the birth occurs. 
 
 Starting with the assumption that beyond question, 
 pregnancy exists, I have endeavored to give practical 
 and helpful hints and advice, upon the most important 
 points to be obser\^ed. 
 
 The moment a woman is convinced that she is to 
 become a mother, she should at once consult a reliable 
 physician and place herself as much as possible in his 
 hands. His experience, counsel, and advice will benefit 
 and aid her, beyond words, in her coming ordeal. 
 
 John Ross Pancoast, M.D. 
 
CHAPTER I. 
 
 CLOTHING. 
 
 Perhaps the most important rule to be observed by the pros- 
 pective mother is to avoid any and all garments that would pro- 
 duce any pressure or constriction upon the breasts or waist. 
 
 The expansion of the uterus, as the foetus, or unborn child, 
 gradually increases in size, makes demands upon the already well- 
 filled space of the woman's body, and anything that would hamper 
 or restrict this expansion is likely to prove injurious, not only to 
 the mother but also to the child. 
 
 CORSETS. 
 
 Wear corsets as seldom as possible. For a short time after 
 conception takes place, the young wife cannot bring herself to give 
 up all social enjoyments in preparation for her holy motherhood, 
 and during the early part of her pregnancy she may wear corsets 
 if they are worn loosely Be sure, however, from the first, that 
 there is ample room for the breasts and body around the waist. 
 
 After the. third month of pregnancy they should not be worn at 
 all, in my opinion. By that time social enjoyments will have begun 
 
 5 
 
to assume a smaller importance and appearances will not have to 
 be observed so closely. 
 
 A most excellent substitute for the corset can be found in a waist 
 made of a heavy drilling, to be laced back and front, that its size 
 may be increased as nature demands it. This waist, properly made, 
 will give all the support needed to the breasts and body without 
 hampering in the least freedom of growth and motion. 
 
 GARTERS. 
 
 Have your hose supporters made to suspend from the before- 
 mentioned waist to the stocking, and do not wear the ordinar}^ band 
 garters around the leg. They serve to impede, in a small measure, 
 the circulation of the blood, and at this period a free circulation is 
 desirable and important. There is some restriction caused by the 
 expansion of the uterus among the other organs, and an^-thing 
 tending to increase this should be avoided, or varicose veins might 
 be the result. 
 
 SKIRTS. 
 
 It is essential that as light skirts as can be worn, without danger 
 of cold, should be a part of the outfit of the prospective m.other. 
 Heavy skirts are at any time a menace to a woman's health, but at 
 this time any continued dragging or pressure upon the waist and 
 hips assumes an even more serious aspect. If the weather be cold, 
 a skirt of light flannel, which will give warmth without weight, will 
 be found to be best for house wear. 
 
For wear out doors, the best thing I have found was a flannel 
 underskirt reaching to the shoe-tops, with a Hght-weight, dark over- 
 skirt. Here, again, warmth was secured without weight. 
 
 In niikl weather it is a very easy matter to do away with all 
 weight, and then it is only necessary to have the flannel skirt in 
 case of a sudden change to a lower temperature. 
 
 Whenever possible, all skirts should be suspended from the 
 shoulders. This may seem a trifle arbitrary and difficult of accom- 
 plishment in some cases, but I always plead for it with my patients, 
 and never has it been regretted when tried. 
 
 A young wife, who had been married less than three months, 
 sent for me on one occasion to have me examine her to see if she 
 were really pregnant. Two menstrual periods had passed ; her 
 morning sickness had commenced, and my examination developed 
 the fact that she was undoubtedly to become a mother. She was 
 slender and undeveloped, and I readily foresaw a very painful de- 
 livery unless immediate steps were taken to prepare her for the 
 ordeal. She willingly assented to follow the course of baths, 
 exercise, food, rest and mental preparation I prescribed, but 
 demurred at the radical changes in her wearing apparel. 
 
 The result was that in two months she was in an alarming con- 
 dition. The case was stated plainly to her husband, who succeeded 
 in convincing her that the fault lay at her own door. He purchased 
 for her a suit of bloomers ! The trousers were suspended from 
 straps running over her shoulders, and no corsets were worn under 
 the blouse waist. They moved temporarily to a healthy mountainous 
 country, where the prospective mother, attired in her hideous cos- 
 tume, followed to the letter her prescribed programme, including 
 a long walk every day, when the weather permitted. 
 
A few days before the expected time she gave birth, with but 
 three hours' labor, to a strong, heakhy child. She would never 
 have lived through the event had she withstood the entreaties of 
 her husband and her phvsician. 
 
 SHOES. 
 
 For out-door wear a broad-toed extension sole boot should be 
 worn, that the exercise so necessary at this time may be pleasant 
 and unhampered. 
 
 For house wear roomy shoes with low heels and broad toes are 
 best, as by their use an even tread is secured. 
 
 NIGHT >A^EAR. 
 
 For cold weather, it is essential that the night-dress be of a warm, 
 light material, that the body be protected from draughts, and even 
 the small chill that sometimes is felt when first getting into bed and 
 between cold sheets. A soft outing flannel is the best material for 
 this purpose, as it answers all requirements and can be readily 
 washed. 
 
 FOR OUT-DOOR WEAR. 
 
 Walking during the period just before maternity being of such 
 great moment, the question of apparel for outside wear is one that 
 must be considered from the two points of appearance and health- 
 fulness. 
 
A combination of garments that will not be unsightly and will 
 yet be constructed upon principles not violating the rules regarding 
 pressure and constriction must be sought for and obtained. 
 
 Remembering the fundamental principles of keeping all pressure 
 from the waist and breasts, and hanging no garments of weight 
 directly from the waist, will serve to suggest to all women an out- 
 door costume that will render a reasonable walk in good weather 
 an invigorator of no mean power. 
 
 Dress in dark colors ; this will render less conspicuous the in- 
 crease in size and irregularity of outline. 
 
 In conclusion, think more of tne heaith and less of appearances. 
 
CHAPTER 11. 
 
 FOOD. 
 
 There are two important considerations to be taken into account 
 when we come to the question, "What shall the prospective mother 
 eat?" 
 
 These are : 
 
 First. — What food will best nourish herself and her unborn 
 child ? 
 
 Second. — What food will put her body in best condition to under- 
 go child-bearing with least anguish and risk to her health? 
 
 All of the numerous plans devised by heedless people to retard 
 the bony development of the unborn child, and thus render delivery 
 easier and less painful, are to be condemned and forbidden. 
 
 Such a course might render the life of a helpless, unborn child 
 one of perpetual crippledom, and to save a mother a few hours' 
 pain a child might be doomed to years of untold agony of body 
 and spirit. 
 
 A patient of mine, at the time of her first confinement, lived 
 entirely upon apples, oranges, grapes, potatoes, corn starch and 
 oatmeal. She lost strength, and when I was called in I ordered 
 
meat once a day and beef tea three times a day, with a special 
 tonic to build up tissue. 
 
 When her child was born she was in labor for eighteen hours, 
 suffering- frightfully throughout this time ; and the child ! It never 
 moved. It looked like nothing so much as a large mass of discol- 
 ored dough. 
 
 I never allowed that poor young wife to see it. In her weak- 
 ened condition it would have killed her. 
 
 Four weeks later she confided to me that she had disobeyed my 
 instructions ; had never taken any meat or tonic, and but little of 
 the beef tea— and all to escape a few hours of pain, which was 
 unquestionably increased by her weakened condition. 
 
 The proper system to follow is one that will render most healthy 
 the entire system, keep the digestive apparatus clear and not retard 
 the natural growth of the foetus. 
 
 Avoid false stimulants. Too much meat will over-stimulate a 
 woman at this time. 
 
 Avoid fat and grease. They serve only to clog the digestion 
 and overheat the blood. 
 
 EGGS. 
 
 There is one element lacking in eggs that is much needed by the 
 prospective mother. That is starch. If some other food rich in 
 starch, like rice, for instance, be used in conjunction with eggs, a 
 very desirable and strengthening dish is the result. 
 
 Eggs can be used in any of the many ways they can be cooked, 
 excepting fried. They must be avoided. 
 
MEATS. 
 
 Beef is by far the best meat for the prospective mother. It must 
 be tender and lean and cooked carefully. Next to beef, in value, 
 is poultry. It should be fresh and tender, and prepared without 
 fat or grease. 
 
 Meat once a day will benefit and strengthen. Unless stimulation 
 is needed, I would advise against the more frequent indulgence after 
 the third month of pregnancy. 
 
 VEGETABLES. 
 
 At this period in a woman's life she must carefully refrain from 
 eating any vegetables that cause indigestion. 
 
 Some women cannot eat cabbage, for instance. Others find that 
 onions cause gastric disturbance. 
 
 The vegetables that are most palatable and most easily digested 
 should be indulged in freely. 
 
 If tomatoes, potatoes, corn, peas and beans have never caused 
 indigestion, I should advise their constant use. They are whole- 
 some, strengthening and easilv assimilated. 
 
 SWEETS, 
 
 The expectant mother may crave certain puddings or flavors 
 of a sweet nature. 
 
As pies and rich pastry of any sort are really injurious, plainly 
 made dishes of rice, sago, tapioca or bread are most excellent food; 
 and flavored with fruit flavors, and varied with eggs, they are very 
 palatable and nourishing. 
 
 DRINKS. 
 
 For a hot drink, my first choice is cocoa, well prepared and not 
 too rich. 
 
 For a cooling drink, lemonade made from fresh lemons and a 
 pure mineral water, sweetened slightly and well shaken with the 
 white of an egg, cannot be equaled. 
 
 Drink as little tea and coffee as possible. Sometimes, if slightly 
 chilled, a cup of hot tea is beneficial, but regular indulgence can 
 do some harm that may as well be avoided. 
 
 Milk must not be taken too freely. It does not digest readily 
 with some people, and prepared milk is preferable in such a case. 
 
 VARIETY. 
 
 It might be well to vary, as much as possible, the w^ays of cook- 
 ing the articles of food to be eaten by the expectant mother. 
 
 The number is reduced so much from the large choice allowed 
 her under ordinary conditions that, unless the style and flavoring 
 are varied, the diet will become tiresome, and inability to eat 
 enough food will result. 
 
Constipation usually accompanies pregnancy, but if a course of 
 proper food be followed, and results be carefully watched, this can 
 be greatly relieved. 
 
 If there is a particular craving for some explicit food, if that 
 food be wholesome and digestible, it is best to gratify the desire, 
 as in most instances nature is demanding some of the elements 
 contained in the coveted article. 
 
 If strong cravings for some unusual food product are felt, the 
 physician should be consulted, and some simple prescription can 
 be had that will contain in solution the desired element. 
 
 Diet is most important, for the nourishment of the unborn child 
 and for the proper preparation and sustenance of the mother. 
 
 SICK STOMACH. 
 
 When there exists a great inability to retain the food eaten upon 
 the stomach, it will be found to be of great assistance if small 
 quantities of liquid nourishment are taken at frequent intervals. 
 
 Perhaps at first even this will be rejected, but if persisted in 
 success will be attained, and the digestive apparatus can be induced 
 to return to a normal state. 
 
 Beef tea, chicken broth or prepared milk are among the best 
 forms of liquid nourishment for use at this time. 
 
CHAPTER III. 
 
 EXERCISE, 
 
 It is a difficult matter to prescribe any one set form of exercise 
 that will be beneficial to the entire race of women. They are 
 constituted so differently; they have led such different lives, and 
 have been subjected to such different trials and physical sicknesses, 
 as to make it impossible to lay down a form of exercise that would 
 be beneficial to each and all of them. 
 
 This is one point, particularly, about which the family physician 
 should be consulted. He will know the peculiarities of the case, 
 and will understand the weaknesses that must be treated with 
 delicacy. He will know how much exercise and what kind is best 
 adapted to the patient. 
 
 There are a number of precautions which must be carefully 
 noted in this connection; perhaps the most important of which is, 
 that during the time that menstruation would have taken place had 
 the prospective mother not been pregnant, no exercise of any kind 
 must be indulged in. 
 
 This is a matter of great importance. Neglect of this rule has, 
 in a number of instances, caused the death of both mother and 
 
child ; and I cannot lay too great stress upon the necessity of great 
 quiet and extra rest during this time. 
 
 Exercise is one of the easiest and surest means of lessening the 
 pain and weariness of the coming labor, and by preparing the 
 muscles of the body that are to be called upon for a supreme effort, 
 the pain and anguish necessarily attendant upon this epoch are 
 greatly reduced. 
 
 A number of muscles that in the ordinary' life of a woman are 
 at rest entirely are called upon at this time to undergo a great strain, 
 and are used in a way entirely different from anything that they 
 have been accustomed to. 
 
 The importance of getting these muscles into proper shape can- 
 not be over-estimated. 
 
 The exercise must be begun early in the period of gestation, 
 and it must be taken systematically and lightly at first and increased 
 as it becomes easier of accomplishment. The moment there is 
 any fatigue felt rest must be taken at once, and do not begin any 
 further exercise until there is a slight desire for it. 
 
 WALKING. 
 
 Perhaps in the list of available exercise there is no one that, 
 under limited restrictions, can be made more valuable than walking. 
 
 There are a few rules that must be observed in connection with 
 it to derive therefrom the greatest benefit; but these are of a minor 
 nature. 
 
 Some women who have suffered from some disease of the uterus 
 are unable to walk without great discomfort. In such a case, the 
 
 i6 
 
physician's advice must be had, and if, in his opinion, walking 
 would be injurious, some other form of exercise must be adopted. 
 
 It is essential in walking at this time that some objective point 
 should be aimed for. Aimless wandering around would only serve 
 to annoy and bore a prospective mother, whereas a brisk walk, 
 taken with the idea of reaching some place or point, would brighten 
 her mind and invigorate her body. 
 
 The body should be so carried that the lungs will be given a 
 full chance to expand. The shoulders should be held well back, 
 and the steps should be taken in a vigorous manner and with great 
 firmness, care being taken not to jar the system by too heavy walk- 
 ing upon the heels. 
 
 BREATHING. 
 
 This subject is one which calls but for brief comment; but it is 
 one of great importance. 
 
 A woman in this condition has need of more oxygen than under 
 ordinary circumstances, for the reason that the blood of her unborn 
 child is to be purified as well as her own, and her entire lung power 
 must be exercised to furnish the requisite amount to successfully 
 supply the needs of both. 
 
 This is one of the reasons why the wearing of corsets is at this 
 time a drawback. A woman cannot breathe freely, and to as great 
 an extent, hampered by this garment, as if her body was given full 
 play, free from confines. 
 
 Five or ten minutes spent every morning and afternoon in the 
 drawing in of deep breaths through the nose will be time well 
 
 17 
 
spent. Ill this way, that part of the lungs that had not been called 
 into play under former conditions will be used and developed, and 
 an immediate effect will be noticeable. 
 
 CLIMBING STAIRS. 
 
 A number of physicians of my acquaintance, have in several 
 instances, recommended to women whom they considered in good 
 physical condition, the exercise to be obtained from walking up 
 and down stairs, as it is claim.ed this will strengthen the muscles at 
 the sides of the waist. While it is a matter of great importance 
 that these muscles should be strengthened, and while the develop- 
 ment of these muscles is something that will greatly add to the 
 ease of the coming trial, I have always felt that it was a subject 
 that required some consideration before being indiscriminately 
 prescribed to many women. 
 
 There is great danger of its proving too great a tax and strain, 
 unless the woman be of a very strong ph^'sical development. I 
 would advise that before this exercise be taken regularly, the fam- 
 ily physician be consulted and fully informed as to the after effects. 
 
 GENERAL EXERCISE. 
 
 There are a number of movements of the legs, arms and body 
 which can be used to great advantage in the development of the 
 muscles, which are so soon to be called upon. Any movement that 
 calls into play the abdominal muscles and those at the sides of the 
 waist, will be beneficial. 
 
 i8 
 
Avoid standing as much as possible. This is very tiresome and 
 produces a mental state, the effect of which is anything but helpful. 
 
 When sitting down, if possible, stretch the body out so that 
 perfect relaxation is obtained. In this way a great deal of rest can 
 be obtained. 
 
 If at first the result of the new forms of exercise is found to be 
 one of weariness, it has been my experience that a cessation of all 
 exercise for a day or two will be very helpful. If it be possible, a 
 drive at this time in the open air, bringing a change of scene with- 
 out any fatigue, will result in much good, and the exercise will be 
 taken up with more zest and interest. 
 
 MASSAGE. 
 
 If it is possible to obtain, once a week, good massage treatment, 
 unless prohibited by a physician, this will be found very beneficial 
 to almost every patient. 
 
 It is a most agreeable treatment, and the feeling of invigoration 
 produced by it will almost invariably result in great good. The 
 body is freshened ; the muscles are softened without becoming 
 flabby, and unless the expectant mother experiences a feeling of 
 enervation, it will have a good effect. 
 
 In conclusion, I cannot impress too deeply the importance of 
 exercise at this time. 
 
 It must be pursued systematically, and at the time of the birth 
 of the child the effects will make themselves shown in a manner 
 that will amply repay all the time and trouble taken. 
 
 19 
 
CHAPTER IV. 
 
 REST. 
 
 There are many times during the period of gestation when a 
 woman feels a sense of languor and weariness. 
 
 This is particularly apt to be the case at the time when, if she 
 had not been pregnant, menstruation would have taken place. 
 
 I have dwelt upon the necessity for absolute rest at this time, and 
 can only say in addition, that much pain and sickness or suffering 
 can be prevented if, at the slightest signal of weariness, rest is 
 taken. 
 
 Dress comfortably and lie down until all sensation of fatigue is 
 gone. 
 
 Be careful that you are not in a draught and that the feet are 
 sufficiently covered to give that sense of warmth that is always so 
 delicious. 
 
 If there is the smallest feeling of coldness in the feet, retain the 
 stockings, remove the shoes, and place a hot-water bag under the 
 feet. 
 
 A tendency to fidgeting or nervousness can be overcome by 
 reading something mildly interesting that will take the mind away 
 from thoughts of physical discomfort. 
 
It is better, for the obtaining of complete rest, that the reading 
 should be dispensed with as soon as quietude of mind and body is 
 reached, that the eyes and brain may also share in the relaxation. 
 
 Exclude from the room in which rest is taken all light, that sleep 
 may be induced. 
 
 The best time to rest is immediately after fifteen or twenty min- 
 utes of proper exercise, as at that time the muscles and bodily func- 
 tions appreciate particularly a cessation of labor, and the work of 
 building up and recuperating goes on to great advantage. 
 
 If there is a tendency toward sleeplessness at night, the midday 
 nap should be carefully cultivated, as very often lack of rest will 
 conduce toward inability to sleep at night. 
 
 If, during the day, five or ten minutes can be secured, great 
 benefit can be derived by complete relaxation of the body and 
 mind. 
 
 Throw yourself down on the bed and rest every faculty and 
 muscle, and your sleep that night will be fresher and sweeter for it. 
 
 SLEEP. 
 
 A multi-millionaire once said to me that he was happier when 
 he was poor than since the time he had acquired a great fortune, 
 as his nights in the former years had been spent in profound slum- 
 ber, whereas they were spent later in '' planning y 
 
 "Planning for what?" I asked him. "You have everything 
 money will buy. ' ' 
 
 "Planning for those things money will not buy," he answered, 
 with a smile. 
 
Perfect sleep can be had only when mind and body are at ease. 
 A restless mind will produce troubled dreams. A suffering body 
 will procure broken slumber. 
 
 Cultivate ease of mind and ease of body, and your repose will 
 be healthful and profound. 
 
 If, when you retire at night, there is a tendency toward sleep- 
 lessness, something is wrong. 
 
 Study carefully 3-our feelings. Discover whether you are too 
 warm or too cold. Try another position. A^ery often the increase 
 in size of the abdomen will render necessary some support for the 
 additional weight. A pillow or bandage will answer. 
 
 If the evening can be spent comfortably and quietly without 
 excitement, and the afternoon nap of at least one hour has been 
 had, the best time to retire for the night is ten o'clock. 
 
 Sleep alone, when possible, but have within call your husband 
 or some one whose presence is grateful to you, in case of need. 
 
 VENTILATION. 
 
 The healthiest woman in the world could be reduced to a piti- 
 able state of ill health if she were obliged to sleep in a room 
 improperly ventilated. 
 
 When we think that the air we breathe is inhaled for the sole 
 purpose of purifying the blood, we can appreciate how important 
 and vital it is that this air should be fresh and pure. 
 
 Uncontaminated air contains that necessary element, oxygen, 
 without which we cannot live, and the expectant mother must 
 inhale sufficient to purify, not only her own blood, but that of her 
 unborn child also. 
 
Therefore, the sleeping room must be ventilated in such a way 
 as to insure a never-ceasing flow of pure air without creating a 
 draught. 
 
 There are many ways of attaining this end, all of which are so 
 simple that they need not be mentioned in detail. 
 
 Have a thermometer in the bed-room, and endeavor to maintain 
 a temperature that will never go below fifty-five degrees Fahrenheit 
 during the night ; and throughout the day sixty-five to seventy 
 degrees should be the figures between which the thermometer 
 should range. 
 
 It is very much better that no lights should be kept burning in 
 the bed-room during the night. 
 
 Disagreeable odors are produced, and oxygen is consumed that 
 should be saved for slumbering humanity. 
 
 If, for any reason, a light should be needed suddenly during the 
 night, one should be kept burning in an adjoining hall or room 
 where it could be reached quickly in case of necessity. 
 
 All the rest that can be obtained will serve to strengthen the 
 body for the coming trial, and the importance of it cannot be over- 
 estimated. 
 
 23 
 
CHAPTER V. 
 
 BATHING. 
 
 The best housekeeper I have ever known was a lady of ample 
 means, who fretted herself so much over the condition of her furni- 
 ture and wall-paper, that she had no time left in which to keep her 
 own body clean. 
 
 Her house was immaculate from cellar to roof. It was swept 
 from top to bottom every day, and immediately every room was 
 dusted and put to rights. 
 
 One day she personally superintended the cleaning of the cellar 
 in her house, and immediately afterward sat down to luncheon with 
 a huge smut of dust upon the side of her nose! 
 
 Furniture and other household belongings will stand uncleanli- 
 ness much better than the human body, and cleanliness is even more 
 essential during the time just preceding childbirth than under 
 ordinary conditions. 
 
 The skin must be kept clear and in a vigorous, healthy condition, 
 that all the impurities that exude through the countless pores may 
 have unobstructed exit. 
 
There are lots of men who do not wash their bodies more than 
 once a month who would discharge their coachmen if the coats of 
 their horses did not shine like satin. 
 
 I particularly favor for the expectant mother a tepid sponge 
 bath for the morning, and just before retiring for tlie night a warm 
 sitz bath. 
 
 If either of these is followed by any ill effects, the frequency of 
 them must be moderated. 
 
 Do not take the sitz bath every night if after you have gone to 
 bed there is a sense of wakefulness or fatigue. 
 
 It should not be too warm at any time, as very heated water has 
 a tendency to affect materially the unborn child. 
 
 I have known of many instances where a shocking miscarriage 
 has been caused by the too frequent application of a very warm 
 bath. 
 
 A feeling of buoyancy and exhilaration should follow close upon 
 the bath. The blood should seem to run more freely, and a warm 
 glow should be felt over all the body. 
 
 If none of these symptoms are present, and instead there is a 
 feeling of depression and languor, something is radically wrong, 
 and moderation in bathing must be observed temporarily. 
 
 A good substitute for the baths before mentioned can be found 
 in a hard, brisk rubbing of the entire body with a flesh-brush or 
 coarse Turkish towel. 
 
 This rubbing invigorates the skin, opens the pores, and brings 
 the blood to the surface, thereby benefitting the circulation and 
 cleansing the skin of many impurities. 
 
 While bathing the entire body at this time, by getting into a 
 bath-tub filled with water, might not result in serious harm, it is 
 
 25 
 
better to avoid the risk of cold or enervation and confine the bath- 
 ing to the tepid sponge bath in the morning and the sitz bath at 
 night. 
 
 The chances of taking cold can be materially lessened by 
 sponging the body with water that is as cold as feels comfortable 
 to the skin. 
 
 Immediately after this sponging, a brisk, hard rubbing with a 
 coarse towel should be indulged in, this serving to restore the cir- 
 culation and warm the surface of the body. 
 
 A cupful of sea salt dissolved in the water adds to the stimu- 
 lating power and is beneficial to the skin. 
 
 FOOT BATHS. 
 
 A cold foot bath is the best remedy for cold feet that has been 
 discovered. 
 
 Before immersing the feet in the tub of cold water they should 
 be rubbed briskly with a coarse towel or flesh brush. 
 
 Then dip one foot in the water, keeping it there for about ten 
 seconds. On withdrawing it rub it vigorously until dry, after which 
 wrap it up in the towel and treat the other foot in like manner. 
 
 Repeat this until each foot has been dipped and rubbed thor- 
 oughly dry at least three times. 
 
 Upon getting into bed, if there is the slightest feeling of coldness 
 in the feet, a pillow laid across them will sen.-e to restore them to 
 a pleasing warmth. 
 
 A brisk rubbing with the hands, of a few drops of alcohol upon 
 the soles, will often stimulate the circulation. 
 
 26 
 
CAUTION. 
 
 At the time when under ordinary conditions menstruation would 
 ha\e occurred the tepid sponge bath alone should be used. 
 
 For three or four days it is wise to dispense with the sitz bath, 
 and avoid all risks. 
 
 The sponge bath is perfectly cleansing, and offers so little chance 
 of bringing on undesired effects that it can be continued at this time 
 without fear. 
 
 Perfect cleanliness will result in greatly aiding to bring the pros- 
 pective mother to a perfect condition for the coming event. 
 
 Every day after the sponge bath a thorough rubbing of the 
 abdomen with olive oil will serve to soften the skin and render 
 more pliable the muscles that must relax most at the time of 
 delivery. 
 
 This treatment should also be given in moderation to the breasts 
 and nipples, care being taken to rub very gently. 
 
CHAPTER VL 
 
 STATE OF MIND. 
 
 While the whole operation of the reproduction of mankind is a 
 thing of great mystery' and incomprehensibility to the human mind, 
 there is nothing in the physical part of it so deeply wonderful and 
 hard to understand as the relation that exists between the mind of 
 the prospective mother and the forming disposition and character 
 of the unborn child. 
 
 From a materialistic point of view, it is difficult for us to compre- 
 hend how impressions made upon the mentality of a pregnant woman 
 can be conveyed through physical channels to the growing fcetus 
 she is carrying; but that this is the case is established beyond doubt. 
 
 Women, who for any cause allow themselves, at this period of 
 their existence, to worry or become nervous, are apt to see reflected 
 in their children disagreeable traits of disposition and temperament. 
 
 It is very important, therefore, that a great deal of care should 
 be exercised and trouble taken to engage the mind of the pros- 
 pective mother in pursuits of a pleasing and intellectual character, 
 that the child may have a good disposition and a desire for the 
 cultivation of the mind. 
 
 Anything of an unpleasant or irritating nature should be studi- 
 
ously avoided, and self-control and ecjuable calmness of mind and 
 body sought after. 
 
 Revolting sights and alarming experiences must be prevented 
 to as great an extent as possible. 
 
 One of my patients, who was badly frightened by a harmless 
 mouse in the fourth month of her pregnancy, gave birth to a child 
 which bore upon the left cheek the vivid burning outline of one of 
 those animals. 
 
 PRECAUTIONS. 
 
 It is unlikely that any physician of established practice has gone 
 through his career without being requested a number of times to 
 prescribe something to relieve a woman w^ho has missed one men- 
 struation and does not desire a child. 
 
 Different doctors regard this request differently. Some hold 
 that it is a moral wrong to prevent the birth of a child; others, that 
 in the first two months there is no specific life, and if a woman is 
 in good physical condition she can bear very well the results of 
 mild treatment in this direction. 
 
 I have always refused to give any medicine that would bring on 
 the desired flow, doing what I considered my duty in the matter. 
 
 But — and here lies the application to our present chapter — if 
 relief has been sought and not obtained, there must be no fretting 
 or worrying over the prospect of an addition to the family circle. 
 It can do no good, and will do some harm beyond question. 
 
 It would be as rare and unusual for a happy, healthy child to be 
 born of a mother who had tried in every way to "get rid of it" 
 and failed, as would be the birth to black parents of white off- 
 spring ! 
 
If matters assume the shape that an unwelcome child is to be 
 born, it must be looked at philosophicall}' and taken calmly, with 
 the idea always uppermost that, if it is inevitable, the child shall 
 be one to be proud of and loved. 
 
 When a child is desired, how different everything looks ! 
 
 All is preparation and prospect for the coming stranger, who is 
 to be a ruler in the blessed household. 
 
 Very often the birth of a child is prevented that the events of 
 the next few years would have rendered a most welcome addition 
 to the family. 
 
 The systematic preparation of the physical life of a woman will 
 do so much toward reducing the pain of labor and confinement 
 that a woman may look forward to her delivery as a great boon and 
 blessing. 
 
 As a rule, labor is short and the pain is never unbearable or 
 torturing, except in rare instances where indiscretions have been 
 committed ; and the physician in charge can and does do much to 
 alleviate the suffering, even using an anaesthetic when necessary. 
 
 A great many young wives express the fear that they ^^■ill die in 
 labor, but statistics prove the percentage to be very small. 
 
 Having carefully prepared body and mind for the coming 
 motherhood, a woman should approach it with calmness and 
 unflinching courage, trusting herself to the hands of her physi- 
 cian and nurse. 
 
 THE HUSBAND. 
 
 A man can never do enough for the wife who is shortly to bear 
 him a child. 
 
 30 
 
There is much he can do to Hghten and brighten this time of 
 waiting and preparation. 
 
 Little attentions and courtesies that show his appreciation of 
 her condition ; small inexpensive presents for herself or the coming 
 child ; an interest in every symptom that bespeaks the approach of 
 the event ; comfort when depression sets in, and sympathy at all 
 times. These all mean a great deal to the prospective mother. 
 
 She should never hear bad news or the relation of worrisome 
 events from her husband's lips ; but the telling of interesting 
 happenings or bright occurrences will lighten her spirits and drive 
 away care. 
 
 Until a woman feels that her appearance is too unsightly, light 
 amusements and theatrical performances that are not too emotional 
 will be found beneficial. Music particularly should be heard on 
 every possible occasion, and if there is no music in the home, an 
 evening could not be spent to better advantage than at a good 
 concert that does not overtax the nerves of the prospective 
 mother. 
 
 Last, but not least : 
 
 A man once told me that the easiest delivery his wife had ever 
 had took place two days sooner than expected and one day after 
 he had had a connection with her ! 
 
 Thank Heaven, there are not many such brutes as this ! What 
 really took place was a miscarriage in my opinion, superinduced by 
 coition. 
 
 That it was not troublesome was a piece of good luck, and must 
 have been the result of the woman's excellent condition. 
 
 It is better that during the entire pregnancy sexual intercourse 
 should be abstained from. 
 
During coition the uterus is subjected to great disturbance ; 
 congestion of many of the parts follows, and the effect upon the 
 nerves is of a harmful nature. 
 
 The entire vital energy of the woman is needed and should be 
 saved for the coming event, and a husband should practice self- 
 control and forego selfish indulgence at this time. 
 
 Strive rather to elevate and develop the intellectual side of the 
 woman, and if her mind is kept occupied upon helpful, enter- 
 taining subjects, the good result will show later on. 
 
CHAPTER VII. 
 
 THE BIRTH. 
 
 If, as has been advised, the physician and nurse have been 
 engaged early in the pregnancy, as the time of birth approaches, 
 the greater part of the preparation can be made without much 
 trouble and worriment. 
 
 I have endeavored to offer many words of advice that would 
 make unnecessary many visits from the doctor; but his counsel 
 should be sought should any serious complication arise. 
 
 As the time of confinement draws near, the breasts and nipples 
 need special attention. In every case where it can be done, the 
 child must nurse from the breast rather than from a bottle, and 
 occasionally, if these parts have been neglected, great soreness and 
 pain will follow. 
 
 A little olive or sweet oil rubbed gently upon the nipples twice 
 a day, after sponging with tepid water, will be found beneficial. In 
 the month just preceding the expected birth, at least once a day, 
 bathe these parts with a weak solution of alcohol in which a piece 
 of alum the size of a filbert has been dissolved. 
 
 Keep up the exercise taken as long as it can be accomplished 
 without inconvenience ; and when walking becomes a matter of 
 
 33 
 
difficulty, the other prescribed forms can be followed, the leg 
 movements in bed being very useful at this time. 
 
 Endeavor to secure a nurse who will be pleasing to you and 
 amenable to the desires of your doctor. 
 
 Ignorance or ugliness of temper on her part might add woefully 
 to the discomfort of the patient ; whereas, on the other hand, 
 competence, willingness, and a sunny disposition will brighten and 
 help the mother and child. 
 
 LABOR. 
 
 As the date, that under ordinary conditions would have been 
 the tenth menstrual period, approaches, the womb containing the 
 child will sink slightly in the pelvis, and the discharge from the 
 vagina will contain small quantities of blood. 
 
 Wlien labor first begins, the pains will be short and sharp, much 
 like a cramp, with quite long stretches of time between them. 
 
 Everything should then be gotten ready and the doctor advised. 
 
 If the hand be placed upon the abdomen just over the womb, 
 the contractions and relaxations can be felt during these pains. 
 
 The amniotic sac, in which the unborn child has up to this 
 period been floating, is likely to break at this time, and prepara- 
 tions should be made to prevent the rush of liquid from saturating 
 the clothing. 
 
 The mouth of the womb is opening, the sac is broken, and the 
 child will shortly descend into the world. 
 
 The pains will now increase in frequency, and there is a small 
 sense of fatigue between the spasms. 
 
 34 
 
The nurse will now be able to render great assistance in aidini^ 
 the birth by cheering counsel and helping hands, and her experi- 
 ence will enable her to suggest many reliefs. 
 
 THE BIRTH. 
 
 In most cases the child will be born without the actual assistance 
 of the doctor; but for the ease of mind of the mother, and to avoid 
 unnecessary risks, it is preferable that he should be on hand as 
 soon as possible after the labor pains commence. Especially is this 
 the case when it is the first child. 
 
 If the labor should be short and the birth occur before the doc- 
 tor arrives, the nurse must see that the cord is free and that the 
 child is warmly covered and with its body and head in such position 
 that it can breathe freely. 
 
 When the pulsing in the cord has ceased, and the child has cried 
 vigorously, if the nurse is capable, she may sever the cord after 
 making the necessary bindings upon it. 
 
 This is a doctor's work, and he should be on hand if it is 
 possible. 
 
 The after-birth soon follows, and the mother has before her now 
 only recuperation and convalescence. 
 
 Great care and caution must be exercised at this stage. Perfect 
 quiet and all the rest obtainable are needed. 
 
 The husband may enter the room, but his stay should be short 
 and a visit of sympathy and consolation only. 
 
 The mother must make no exertion ; must talk very little, and 
 must get all the sleep she can. 
 
 35 
 
The doctor must have absolute control of the lying-in room, and 
 the rules laid down by him must be followed to the letter. 
 
 For this reason it is very often advisable to allow the doctor to 
 secure the nurse, that perfect harmony and understanding may 
 exist between them. 
 
 I remember on one occasion, in the third year of my practice, 
 I was suddenly called in a confinement case that had been in the 
 hands of a celebrated physician, who was suddenly stricken with 
 paralysis. I was young and beardless, and the nurse, who was old 
 and experienced, regarded me with much contempt. 
 
 ISIy orders were not always obeyed, because, as she said, "Dr. 
 Blank never did it that way." 
 
 She annoyed me very much, and on the third day I was obliged 
 to ask for her dismissal. 
 
 The request was granted, and things went on much better. 
 
 Later, knowing her to be competent, I recommended her to 
 one of my own patients, and she was one of the most tractable, 
 obedient and willing nurses I have ever known. 
 
 A few hours after birth, if the mother feels like it, the child may 
 be given its first nursing, and if the supply of milk be ample, there 
 is nothing on which it will thrive so well as mother's milk. 
 
 CONCLUSION. 
 
 Beyond this point all must be entrusted to the physician and the 
 nurse. 
 
 Maternity has come ! 
 
 All the preparation and care have had their good eftect, and 
 another healthy human being is the result. 
 
 36 
 
By the exercise of care, with good nursing, proper food, plenty 
 of rest, absolute cleanliness and attention to all the little details, a 
 slow, sure convalescence will be insured and the greatest event in 
 a woman's life becomes a matter of history. 
 
 If my advice and counsel will help one woman to bring into 
 the world, with more ease, a healthier, better child, I will be 
 repaid. 
 
 God bless our mothers ! 
 
 THE END. 
 
 37 
 
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