The mother's hand-book: a practical treaties on the management of children in health and disease ...

Front matter

Qass Book.

COPYRIGHT DEPOSIT

TUB

Preface

r ~PHE following pages have been written with the hope that the infor- * mation contained in them will be of use to mothers and others who are charged with the responsibility of rearing children.

The author has endeavored to make the book a useful guide, especially to those who live in the country, or in small towns, where medical advice cannot always be obtained when desirecl.

While directions are given for the administration of medicines in simple cases, and when emergencies require prompt action, it has been the aim of the writer to discourage the mother from assuming the functions of the physician and undertaking to treat, by means of drugs, diseases of a serious or complicated character.

The author believes that to recommend a large number of medicines in the treatment of the various diseases to which children are subject would confuse the mother and lessen the value of the book. He has; therefore, confined his treatment to but few remedies, which he believes to be both safe and efficient.

If a mother has some knowledge of diseases and their management, she will often be able to relieve her child of pain and discomfort which might otherwise continue for hours. This is especially true when no medical practitioner is within easy reach.

Again, accidents may happen when immediate relief must be obtained quickly, or else death may speedily follow. In such cases the mother must act promptly and upon her own responsibility. It is believed that under such circumstances the information given in the pages of this book will be found useful.

The feeding of infants is a subject of great importance, and considerable space has been devoted to its consideration.

4 Preface.

It is hoped that those who are about to become mothers will find much in the chapters on Pregnancy and on Confinement that will be of advantage not only to themselves, but also to their offspring.

For the benefit of those who live in districts where medical aid cannot be secured quickly, an Appendix has been added, in which some of those diseases and accidents that may suddenly befall grown persons are treated of in plain and concise language.

A part of the matter contained in the chapter on " The Mother and the Physician" has been taken from the valuable work of Professor Fonssagrives, entitled "The Mother's Work," translated by Dr. F. P. Foster, and published by G. P. Putnam & Sons, New York, 1872.

An experience of more than thirty years in town and country practice, induces the author to believe that the recommendations given in the following pages are judicious, and if strictly followed will lead to beneficial results.

LEVIN J. WOOLLEN.

1701 Ninth Stkeet N. W.,

Washington, D. C, 1891

Chapter I

Pregnancy. Pages.

The influence of the mother's mode of life during pregnancy upon the child.— Deviations from health during pregnancy ; The breasts ; The nipples ; Constipation ; Diarrhoea ; Heartburn ; Water-brash ; Piles ; Toothache ; Pruritus or itching ; Pain from distention of the abdomen ; Cramps in the legs ; Swelling of the limbs ; Salivation ; Vomiting; Hemorrhage; Abortion or miscarriage 11-31

CHAPTER II. Confinement

Preparations for confinement. — Labor — Symptoms of approaching labor; First stage of labor ; Second stage— Nurse's duty in physician's absence ; Third stage of labor ; After-pains; Treatment after labor; The lochia; Flooding; Sore nipples; Abscess of the breast ; Milk fever 32-53

CHAPTER III. Attention to the Child soon after Btrtii

Directions for the nurse— Tying the cord ; Blue disease ; Washing the child ; Dressing the cord ; Clothing the child ; Applying the child to the breast ; Artificial feeding ; Still-born children ; Retention of urine ; Constipation ; Inflammation of the breasts ; Swelling upon the head; Tongue-tie; Inflammation of the eyes; Ulceration of the cord ; Bleeding from the navel ; Chaflngs 54-66

Chapter IV

Accidents and Diseases occurring at or soon after P>irth.

Premature infants ; Suffocation of children in bed ; Deformities ; Mother's marks ; Hare-lip; Club-foot; Closure of the bowel; Closure of the urethra; Film over the eyes; Bowed legs; Spina bifida; Rupture.— Jaundice ; Lock-jaw; Inflammation of the eyes ; Colic ; Erysipelas 67-85

CHAPTER Y.

Teething, or Dentition.

Age at which children cut their teeth; Symptoms of teething; Complications— Vomiting and diarrhoea ; Aphthae ; Ear-ache ; Catarrh of (he air-passages ; Eruptions.— Treatment of teething and its complications ; Cutting the gums S6-96

Contents,

CHAPTER VI. Nursing and Feeding

Mother should he careful of her own health ; Proper quantity of milk at a nursing ; Treatment when mother does not have enough milk ; Proper intervals for nursing ; Throwing up the milk; Feeding from a bottle; Preparation of artificial foods—Cow's milk ; Diluted cream ; Condensed milk ; Lacto-Preparata ; Patent foods ; Substitute for patent foods ; Pearl barley r Gelatine ; Flour ball.— Food for older children . . 96-108

CHAPTER Vir

Weaning the Child.

Dangers of early weaning; Time for weaning; Gradual weaning; Proper kind of food and how to give it ; How to cause the child to quit the breast ; Causes that may lead to early weaning ; Abscess of the breast ; Nursing sore mouth ; Mother's bad health ; When the milk disagrees ; Summer complaint 109-114

CHAPTER VIII. Hygiene op Children

Kindness to children; ,The dwelling; The school-house; Bathing; Sleep; Dress; Exercise ; Learning'to walk; Exercise in childhood ; Dangers of over-exercise . 115-132

CHAPTER IX. The Mother and the Physician

Mothers' conduct towards the physician ; Consultations ; Responsibilities of physicians ; Emergencies ; The sick room ; Giving the medicine ; Symptoms to be noticed by the mother. 133-144.

CHAPTER X. Signs and Symptoms op Disease

Attitude of the child ; The countenance ; Pain ; The cries ; The Voice ; Color of tho *- skin ; The sleep ; The cough ; Convulsions ; The eyes ; The pupils ; The tongue ; The pulse ; The temperature ; The respiration . 145-156

CHAPTER XI. Diseases op the Mouth Throat and Air-Passages

Sore throat or pharyngitis ; Difference between diphtheria and follicular pharyngitis ; Treatment of pharyngitis; Enlargement of the tonsils; Thrush, treatment; Acute catarrh, treatment; Snuffles— not always a trifling disease— treatment ; Cough, treatment 137-171

CHAPTER XII. Other Diseases op the Air-Passages

False or spasmodic croup, treatment; True or membranous croup— usually a fatal disease — treatment; Bronchitis; or catarrhal fever; Capillary bronchitis; Broncho-pneumonia ; Treatment of bronchitis ; Pneumonia or lung fever, divided into three stages— treatment ; Pleurisy ; Chronic pleurisy ; Pleurodynia ; Treatment of pleurisy 172-190'

Contents. 7

CHAPTER XIII. Diseases of the Stomach and Bowels

Vomiting, treatment; Constipation, treatment; Diarrhoea, treatment; Peritonitisdescription of peritonitis— treatment ; Worms, treatment ; Prolapse of the bowel, causes, treatment » 191-201

CHAPTER XIV. Diseases op the Stomach and Bowels — Continued

Bummer complaint ; Three forms— cholera infantum, ileo-colitis, diarrhcea ; Symptoms of cholera infantum ; of ileo-colitis ; of diarrhcea ; Treatment of cholera infantum ; of ileo-colitis ; of diarrhoea ; Thrush; Excoriations 202-215

CHAPTER XV. Fevers

Ephemeral fever; Symptoms; Treatment.— Intermittent fever; Causes; Symptoms; Treatment.— Infantile remittent or Typhoid fever; Causes; Symptoms; Treatment 216-229

CHAPTER XVI. Nervous Diseases

Convulsions; Causes; Symptoms; Treatment.— Chorea or St. Vitus' dance; Symptoms; Treatment. — Stridulus laryngismus ; Treatment. — Cerebro-spinal meningitis or spotted fever; Symptoms;; Treatment. — Hiccough; Treatment. — Night terrors; Symptoms; Treatment 230-243

CHAPTER XVII. Constitutional Diseases

Consumption ; Three forms— Caseous, Tubercular, and Fibrous consumption ; Difference between consumption in adults and children ; Treatment.— Scrofula ; Affection of the glands ; of the eyes; of the bones ; Treatment.— Pickets ; Causes; Treatment . 244-258

CHAPTER XVIII. Eruptive Diseases

Prickly heat; Itch; Nettle rash ; Dandruff; Red gum; Ringworm; Shingles; Fever blisters ; Simple eczema ; Chronic eczema ; Milk-crust ; Treatment of Eczema ; Scarlet rash ; Treatment 259-2?2

CHAPTER XIX. Acute Contagious Diseases

Mumps ; Symptoms ; Treatment. — Whooping cough ; Symptoms ; Complications ; Treatment. — Diphtheria; Three forms.— catarrhal, croupous, and septic ; Symptoms of the catarrhal torm ; of the croupous ; of the septic ; Treatment of Diphtheria .... 273-284

8 Contents.

CHAPTER XX. Acute Contagious Diseases — Continued

Scarlet fever ; Three forms— the simple, the anginose, and the malignant ; Dropsy following scarlet fever ; Treatment of scarlet fever.— Measles ; Complications ; Treatment— Rotheln or German measles ; Difference between rotheln and true measles ; Treatment.— Chicken-pox ; Difference between chicken-pox and varioloid ; Treatment of chicken-pox 285-29S

CHAPTER XXI. Accidents and Injuries

Burns and scalds ; Gunpowder injuries ; Swallowing foreign substances ; Fractures and dislocations; Sprains; Bruises; Wounds; Frost-bite; Sore ears; Lime in the eyes , 299-313

CHAPTER XXII. Accidents and Injuries — Continued

Drowning ; Internal poisons— Acids ; Ammonia ; White vitriol ; Belladonna ; Camphor ; Corrosive sublimate ; Jimson weed ; Arsenic ; Paris green ; Oxalic acid ; Opium ; Laudanum ; Phosphorus ; Tartar emetic— External poisons — Poison ivy ; Poisonous insects ; Snake-bite.— Foreign bodies in the ear ; in the eye ; in the air-passages ; in the nose.— Choking.— Accidents from lightning 314-330

CHAPTER XXIII. Miscellaneous Diseases

Vaccination ; Selection of matter ; How to vaccinate.— Purpura; Causes ; Purpura hemorrhagica; Treatment of purpura.— Bleeding from the nose; Treatment.— Ear-ache ; Symptoms ; Treatment.— Wetting the bed ; Treatment.— Warts ; Treatment . . . 331-339

CHAPTER XXIY.

Miscellaneous Subjects.

Disinfectants— Quicklime ; Chloride of lime ; Copperas ; Carbolic Acid ; Fumigation- Protection from contagious diseases— Heredity ; The transmission of diseases ; Hemorrhage ; Difference between arterial, venous, and capillary hemorrhage ; Arrest of hemorrhage 340-354

CHAPTER XXY.

Medicines.

How medicines should be kept ; Alcohol ; Alum ; Aromatic Spirits of Ammonia ; Liquor of Ammonia; Muriatic Acid; Calomel; Dover's Powder; Godfrey's Cordial; Glycerine ; Tincture of Iodine ; Syrup of Ipecacuanha ; Persulphate of Iron ; White Lead ; Laudanum ; Sugar of Lead ; Mustard ; Sweet Spirits of Nitre ; Sweet Oil ; Paregoric ; Chlorate of Potash ; Rhubarb ; Tannin ; Vaseline ; Oxide of Zinc ; Precipitated Carbonate of Zinc ; Sulphate of Zinc ; Adhesive Plaster '. . . 355

CHAPTER I. Prevention of Disease

Effects of living in over-heated rooms.— Effects of exposure to cold and wet.; Of constipation of the bowels ; Of continued hard labor ; Farmers' wives over-taxed with hard work ; Bad effects of over-eating ; Danger;of attendance upon burials ; How to avoid malarial disease ; Control of the passions 367-374

CHAPTER II. Pain : Its Significance and Treatment

The cause of pain ; Pain in the head ; In the neck ; In the chest ; In the region of the heart ; In the spinal column ; In the back ; In the abdomen ; In the hip ; In the extremities.— Treatment of pain: In headache ; In sick headache ; In muscular rheumatism; In acute rheumatism; In lumbago; In neuralgia; In pleurisy; In angina pectoris ; In the abdomen ; In hysteria ; In sciatica ; In inflammation of the joints 375-384

CHAPTER III. Diseases of the Bowels

Cholera morbus; Causes; Symptoms; Treatment.— Diarrhoea ; Causes; Chronic diarrhoea ; Treatment of diarrhoea. — Dysentery or flux ; Causes ; Symptoms ; Chronic dysentery; Treatment of dysentery 3S5-398

CHAPTER IV. Hepatic, Intestinal and Nephritic Colic

Hepatic or bilious colic; Causes; Symptoms; Treatment.— Intestinal or wind colic; Causes ; Symptoms ; Treatment. — Nephritic or kidney colic ; Causes ; Symptoms ; Treatment 399-403

CHAPTER V. Miscellaneous Subjects

Fainting ; Causes ; Treatment.— Sunstroke ; Causes ; Symptoms ; Treatment.— Hemoptysis or bleeding from the lungs ; Causes ; Symptoms ; Treatment. — Hieruetamesis or bleeding from the stomach; Causes; Symptoms; Difference between bleeding from the stomach and from the lungs ; Treatment of ha?metamesis 404-414

The Mother's Hand-Book.

THE INFLUENCE OF THE MOTHER'S MODE OF LIFE, DURING PREGNANCY, ON THE CHILD.

EVERY woman about to become a mother should bear in mind that her offspring will be influenced to a great extent by her bodily and mental condition during the period of pregnancy. The knowledge that any violation of the laws of health on her part will affect her unborn babe should teach her to be guarded in her actions and longings, and to maintain, as far as possible, a cheerful disposition and an agreeable frame of mind.

Authentic cases are recorded where mothers, agitated by distressing anxieties during pregnancy, have given birth to children who were a prey to nervous or convulsive diseases, or displayed a timidity of character that lasted through life. A sudden shock to the mother, caused by witnessing a frightful catastrophe, or a disgusting object, may injuriously affect her unborn child; but continued nervous excitement, a state of fear, anger or grief, borne day after day, or week after week, is much more apt to stamp its effects upon the child than a sudden fright, or shock of any kind, that soon passes away.

The presence of deformities, or stains, marks or moles, that are sometimes observed on the bodies of infants, are often accounted for by the mother on the ground thai she

[Hi was frightened by some object, or that she had a longing for some fruit that, in her opinion, resembled the "mark" on her child. Such views are erroneous, and rarely, if ever, have any foundation in truth.

Although the mother's mark, or other physical deformity of a child, is rarely, if ever, caused by a " scare" or a " longing," yet there is a direct relation between the state of health and feelings of a mother, while pregnant, and the general constitution of her child. Thus, if the mother, during the term of her pregnancy, be nervous, fretful and passionate, she may expect to give birth to a child possessing in some degree the same qualities of temperament.

It is well known that different children of the same parents are often very unlike in their tastes, habits and dispositions. One may be gentle, kind and even-tempered, while another is entirely different. The probabilities are that in many cases this difference of temperament is due to the mother's mental condition and peculiarities at the time she was carrying her child in her womb.

It therefore becomes the sacred duty of every mother, from the moment of conception, to endeavor to maintain the highest degree of mental and bodily health possible. Such an effort entails upon her no real sacrifice; and while it adds to her own happiness and freedom from many ills, it will conduce to the future welfare of her offspring.

It should be remembered that pregnancy is a physiological process, and that under favorable conditions there should be but little deviation from ordinary good health. The idea that it is a period of great danger is not well founded, unless it is rendered so by mismanagement on the part of the mother herself. But while it is a physiological condition, and not necessarily connected with any great departure from usual health, yet during this period slight causes may produce greater disturbances in the patient's system than would be the case under other circumstances. This knowledge should teach the mother that while she can rest assured of a safe delivery in the end, if she pays strict attention to the laws of health, and exercises care and prudence in her methods of living, yet she must not forget that now she must be even more guarded than before; otherwise by her own imprudence and folly she may lay the foundation for troubles that are liable to last through life, and seriously affect the well-being of her offspring.

" Gloomy, painful and harassing impressions should be guarded against, and good nature, equanimity and cheerfulness cultivated by all around her." She should engage in healthful and invigorating occupations, such as will insure her a proper amount of bodily exercise and at the same time give employment to her mind, thereby preventing her from dwelling too much upon her condition and the dangers that she fancies are in store for her.

Attention must be given to the necessity of breathing good fresh air, to sleeping in a room that is properly ventilated and not too dark, to exercise in the open air, to diet, and to all the ordinary conditions of good health. In regard to diet, it may be said that the food should be of a nourishing character and easily digested.

A healthy woman need not make much change in her diet during pregnancy. If her appetite is good, and her digestion perfect, she may eat more than before, since there is an increased demand upon her to furnish nourishment for her unborn child.

It is important that the mother should not restrict herself to a too limited amount of food, thinking thereby to relieve herself of heartburn, flatulence, nausea and other troubles that attend upon indigestion.

The "longings" for certain articles of diet, that some women indulge in during pregnancy, are rarely seen in one of good health and well constituted mind. They are usually found in delicate, nervous and irritable women, who have not a proper occupation to engage their time and thoughts. Much can be done in these cases by advising the patient to fix her mind on more wholesome matters, and at the same time to partake of a proper amount of plain, mild food. Occasionally, in confirmed cases, it may be advisable to yield to some extent to the depraved longings of the patient.

Pregnancy and childbirth may be seriously affected by the mother's method of dressing before becoming pregnant.

The young wife who has reason to believe herself pregnant should so arrange her dress as to avoid unduly compressing any part of the body. The chest must be left free to move without restraint at each act of respiration. The clothes must fit loosely around the waist, as pressure upon the abdomen is not only hurtful but often dangerous.

Those who from childhood have been encased in unyielding stays and corsets will probably, when they become mothers, pay the penalty of their previous folly. The human body needs no artificial aids to its shapeliness, for, if there be no undue pressure upon any part of it, and if perfect freedom be given to its muscles and various organs, the figure will develop gracefully and elegantly.

But if a young married woman has been accustomed from childhood to the use of stays and corsets, it may not be best to lay them aside at once. Long continued use may render their support, to some extent, necessary; and in such cases it will be well to substitute a corset made of thin whalebones for the stiff steel blades in common use. Even this should be worn loosely, so as to admit of free respiration and the gradual enlargement and ascent of the womb.

" If women could be convinced that, as a general rule, the danger attending confinement in childbed is in proportion to tlie previous sound or unsound condition of the system, and to good or bad management at the time, they would be much more anxious than they are to conform to the laws of health, both for their own sake and for the sake of the child whose welfare is so largely committed to their trust. "

DEVIATIONS FROM HEALTH DURING PREGNANCY.

As pregnancy has such a wonderful effect upon the womb, changing its size, its form, and even its structure, it is scarcely possible that a woman can pass through the pregnant state without the various functions of the body becoming greatly affected. In a few cases the changes in the system, wrought by pregnancy, seem to be salutary, the patient enjoying better health than at any other period. In a majority of cases, however, disagreeable symptoms are experienced as the result of the changed condition of the uterus. These troubles, which in many are so slight as to amount merely to discomforts, are in other cases so great as to seriously impair the health of the patient.

The breasts must receive attention during pregnancy. The skin covering the nipples is thin, sensitive, and liable to become inflamed from slight causes; hence the dress should be arranged loosely, so as to avoid all pressure upon the parts.

If the breasts become swollen and painful, causing the patient much trouble and anxiety, they should be gently and carefully rubbed with warm sweet oil once or twice a day until the trouble subsides.

During the latter months of pregnancy the nipples should be examined, and if they be flattened or sunken, measures must be taken to make them prominent, so that the child maybe able to suck. This can be done by frequently placing the inverted bowl of a clay pipe over them and drawing them out gently by suction. Neglect of this precaution may give rise to a great deal of trouble and suffering, ending in sore nipples, and, in some cases, in abscess of the breasts.

A useful wash for nipples during the last month of pregnancy is made by dissolving a tablespoonful of tannin in a gill of alcohol, to which a gill of water has been added. This can be applied morning and night by dipping a camel's hair pencil, or a feather, into it and touching the nipples. No rubbing or friction is permissible, merely wetting the nipple being sufficient. A nipple treated in this manner is not likely to become cracked, or sore from the efforts of the child in sucking.

Women usually complain of constipation of the bowels during the period of pregnancy. The tendency to this trouble should be counteracted, if possible, by a proper regulation of the patient's habits and diet. She should eat brown bread and plenty of fruit, such as stewed prunes, Stewed rhubarb, baked pears, baked apples, oat-meal mush with fresh milk, etc. An occasional injection of a pint of tepid water will aid in overcoming the trouble.

Much assistance can be given the bowels in cases of constipation by visiting the water closet at a certain hour each morning and remaining quite a while, gently persuading the bowels to act.

If these measures fail to correct the trouble, recourse may be had to mild aperient medicine; but patients should remember that medicines should be used only after the means above mentioned have proved ineffectual.

Castor oil is an old and safe remedy, but its disgusting taste renders its use very objectionable to most persons. It should be taken in small doses, and if properly administered the patient will scarcely taste it. The best way of administering castor oil is to take a small cup and rinse it out with hot water; then squeeze into it a tablespoonful of the juice of an orange; then pour in the oil, and on top of this squeeze a little more orange juice. Now rinse the mouth with some of the juice of the orange, and quickly swallow the oil, taking pains that none shall stick to the lips. Have a wet napkin at hand and thoroughly wipe the lips before taking a breath, and the oil will not be tasted. If an orange be not at hand, essence of cinnamon or peppermint, or some similar liquid, can be substituted. If oil cannot be taken, recourse may be had to the citrate of magnesia, or a Seidlitz powder early in the morning.

Pills of castile soap, softened with a few drops of sweet oil, of which three or four may be taken at bed-time, will often serve a good purpose.

Diarrhoea. — Sometimes a pregnant woman is subject to diarrhoea. It may be the result of previous constipation, nature making an attempt, in this manner, to get rid of the long retained fecal matter.

If such be the cause, the proper remedy is a mild aperient, such as a syrup made of the root of Turkey rhubarb, or, if preferred, the citrate of magnesia, or a Seidlitz powder. For a few days the diet must be mild and bland, composed of such articles as chicken broth, oat-meal gruel, rice, tapioca and kindred articles. If the diarrhoea is attended with much pain, relief can usually be obtained by placing warm applications over the bowels.

In cases that are stubborn, and especially if there be a tendency to flux, an occasional dose of Godfrey's Cordial (a dessertspoonful), added to a like quantity of the aromatic syrup of rhubarb, will afford great relief.

Heartburn is a most common and distressing complaint, and sometimes continues throughout the whole course o( pregnancy; but usually some relief is obtained about the close of the eighth month. It is a sign of indigestion and is caused either by overtaxing the stomach with food, or by pressure made upon it by the womb, or by both.

The patient should reduce the quantity of food at each meal, and be more careful of the quality, eliminating from her diet such articles as do not agree with her. If the heartburn continues, temporary relief can often be obtained by taking a large teaspoonful of calcined magnesia in a wineglassful of warm water. If this does not afford relief the patient may take a teaspoonful of the bi-carbonate of soda (common baking soda) in a wine-glassful of cold water.

Water Brash. — This consists of an eructation of a thin, watery fluid, often in large quantities, from the mouth, and is a usual accompaniment of heartburn. In some cases water-brash continues during the whole term of pregnancy.

The same remedies used in heartburn are proper in this affection, and, in addition, a teaspoonful of charcoal in a half glassful of water should be taken occasionally.

Piles. — Pregnant women are often afflicted with piles, which, according to their situation, are called internal or external. They may be either blind or bleeding. The latter may give rise to considerable loss of blood when at stool, and therefore the patient should relieve her bowels as quickly as possible, and remain over the stool no longer than is necessary. If the piles be internal and protrude only during straining at stool, the patient must carefully replace them with her fingers as soon as the bowels are emptied. If the piles cannot be easily returned, and are painful, the patient should occasionally sit in a vessel containing water as hot as can be borne. This will greatly relieve the pain and inflammation; after which the piles should be well anointed with an ointment made by mixing a teaspoonful each of gum camphor and powdered galls with four tablespoonfuls of fresh lard.

Piles are always rendered more painful by a constipated condition of the bowels. When it becomes necessary to resort to medicine to keep the bowels open the best remedy will be found to consist of equal parts of flour of sulphur and cream of tartar, to be well mixed. A large teaspoonful of this mixture can be taken each morning in a little molasses or thick syrup. If the patient objects to the sulphur and cream of tartar mixture, she can take either the citrate of magnesia or Tarrant's Seltzer powder.

An occasional injection, carefully made, of a pint of warm water will afford great relief, and may sometimes take the place of purgative medicine. Care must be exercised in introducing the point of the syringe to avoid injuring the piles.

The disease usually lasts during the whole period of pregnancy; but temporary relief can be obtained by following the directions above given.

Toothache. — Pregnant women are liable to suffer greatly from toothache, and there is a popular belief, sanctioned by some medical writers, that a tooth ought never to be extracted during pregnancy. This is erroneous; for, while a pregnant woman ought not to have a tooth extracted for a trifling or transient toothache, she should not hesitate to have the operation performed when she finds it impossible to obtain relief by ordinary remedies, and when the pain has been so severe and long continued as to deprive her of rest and sleep. The only danger in extracting teeth under these circumstances is in the shock of the operation, which, in a very delicate, nervous woman, might possibly lead to a miscarriage. But this very rarely occurs; at least, such cases have never come under my observation. The constant and severe pain of an aching tooth, which destroys sleep and reduces the patient to a weak, exhausted and nervous condition, is more likely to lead to a miscarriage than the mere operation of extracting a tooth.

But before the patient submits to such an operation, every means of allaying the pain by local applications should be tried. If the tooth bo much decayed and the hollow part exposed, it can be filled with a bit of cotton that has been soaked in oil of cloves, or in a mixture of cloves and chloroform. Sometimes the chloroform alone, or equal parts of chloroform and laudanum, will answer a good purpose. If this does not give relief, the cotton may be wet with creosote and placed in the cavity. If creosote is used, it must not be permitted to touch the gums, tongue, or cheeks, as it will burn them. To avoid this, the parts should be protected by placing cotton in the mouth, leaving only the tooth exposed. With care, the creosote can then be inserted in the cavity without danger of its touching the gums or other parts of the mouth. If the aching tooth be in the upper jaw, it is not likely that such applications will afford the same relief as they would if it were a lower one.

If these remedies do not ease the pain, recourse must be had to the application of flannel wrung out of hot water and applied to the side of the face. If properly applied the hot cloths will nearly always give relief. Take a piece of flannel a yard or more in length, and of the usual width; fold it the whole length, making it about six inches wide, Now double it so that it will be only half a yard long. Dip this into very hot water in such manner as to wet the whole flannel except about six or eight inches of the free ends. Squeeze the surplus water out of the flannel, and fold the wet part upon itself, forming a compress about six inches square. Fold the free ends of the flannel (which are dry) over the wet compress on each side, and apply it to the face.