Download Complete Organic chemistry sixth edition william h. brown PDF for All Chapters

https://ebookgate.com/product/organic-chemistry-

More products digital (pdf, epub, mobi) instant download maybe you interests ...

Organic Chemistry Structure and Mechanisms 1st Edition

Harold H. Trimm

https://ebookgate.com/product/organic-chemistry-structure-andmechanisms-1st-edition-harold-h-trimm/

Solid Phase Organic Syntheses Solid Phase Palladium Chemistry Peter J. H. Scott

https://ebookgate.com/product/solid-phase-organic-synthesessolid-phase-palladium-chemistry-peter-j-h-scott/

Organic Chemistry 7th Edition Mcmurry

https://ebookgate.com/product/organic-chemistry-7th-editionmcmurry/

Introductory Chemistry Sixth Edition Steven S. Zumdahl

https://ebookgate.com/product/introductory-chemistry-sixthedition-steven-s-zumdahl/

Organic Chemistry 7th Edition John E. Mcmurry

https://ebookgate.com/product/organic-chemistry-7th-edition-johne-mcmurry/

Organic Chemistry 3rd Edition Janice G. Smith

https://ebookgate.com/product/organic-chemistry-3rd-editionjanice-g-smith/

Organic Chemistry 9th Edition John E. Mcmurry

https://ebookgate.com/product/organic-chemistry-9th-edition-johne-mcmurry/

World History Sixth Edition William J. Duiker

https://ebookgate.com/product/world-history-sixth-editionwilliam-j-duiker/

Silver in Organic Chemistry 1st Edition Michael Harmata

https://ebookgate.com/product/silver-in-organic-chemistry-1stedition-michael-harmata/

Another random document with no related content on Scribd:

the order of nature, as God designed she should do. But she gets her reward even here. There is no period of woman’s life in which she has so great enjoyment, such perfect physical health, as when she is nursing the offspring of her own blood. Her shattered nerves and broken health are poor pay for the so-called enjoyments of a dissipated life.

But it will be said, there are cases in which it is impossible for a mother to fulfill the office of nursing. She may be physically unable; that is, she may not have any milk to give it; her health may be so feeble, and her constitution so much depraved, that it would not be admissible to do so. All this I admit; but such cases are the exception and not the rule.

What are we to think of the mother who voluntarily permits her child to nurse at another breast? How are we to regard the morals of such a mother—one who willingly allows another person to gain the affections of her child—for it always becomes more attached to the one who nurses it than to its own parent? Besides, too, the character of the one who suckles the child is, to a great degree, stamped upon it, and that indelibly, too. Is a mother, then, willing that the child shall take on the character of another, and of one whose disposition and mental peculiarities she probably knows nothing? For one, I cannot envy the man who has a wife that can willingly resign her child to another to nurse.

Rules for Nursing.—After the birth of the child, the mother having rested herself some hours from the pains and anxiety she has passed through, it should be put to the breast with the view of exciting the mammiferous glands to their proper and healthful action. This is better for both mother and child. It may be necessary to make the attempt a number of times, and perhaps for days before the lacteal secretion will be found to take place. But letting the child every now and then make the effort to get milk will be one of the most efficient means of inducing it to flow.

How often to Nurse the Child.—This is a question of great importance; great not less to the parent than the offspring, but one which is by for too much neglected.

It may not be possible to ascertain exactly at what periods it is best to give a child the breast; but one thing may be predicated with the greatest confidence, which is, that there should be a regularity in

regard to it. To give the child the breast every half hour one day, and then, perhaps, the next, for the mother to go away for many hours, is certainly not a good practice.

I am led to believe, after having spent a good deal of thought on this subject, that to nurse a child once in about three hours, is perhaps as good a plan as can be fixed upon. Some have regarded four hours as a proper period; but one thing I am satisfied of, that the three hour rule is a good one; there is far more danger of nursing the child too often than there is from the opposite extreme.

It is common, I believe, for mothers to allow the child to take the breast during the night time. I am of the opinion that this practice, likewise, is not a good one. How much do you become fatigued, worn down, as it were, many of you, by allowing the child to take the nipple as often as it chooses in the night? In such cases, how much better you perceive it would be, to rest during the proper hours, so that when the morning comes, instead of being unrefreshed and stupid, you feel buoyant and elastic as a deer.

I am willing, however, to admit that it is probably the better rule for the child to be nursed somewhat late at night; for example, when you retire to rest; after that it should not be allowed nourishment till morning.

At what time to cease Nursing.—This, too, is a question which deserves a careful consideration—one on which the health of both parent and offspring very much depends.

It is probably true that women in the civilized and refined parts of the world do not, as a general fact, nurse their children for as long a period as is the case among the savage nations.

The Indian women of our own country, it would appear, are in the habit of continuing to suckle their children two years or more before weaning them. Nor do they at all allow of cohabitation during this period—a practice which might well be imitated by the more enlightened portions of the human race. “I shall not undertake to determine,” says Dr. Rush, “how far the wholesome quality of the mother’s milk is increased by her (the Indian woman’s) refusing the embraces of her husband during the time of giving suck.” If, then, the mother’s milk is to be deteriorated by the practice referred to, her health, also, must suffer in a corresponding ratio.

It would appear, also, that in Bible times the period of nourishing children at the breast was prolonged to a much greater period than is common in these latter times, for we read of the giving of suck three years.

Reappearance of the Menses.—Some have supposed that the period of nursing should be graduated according to the reappearance of the catamenial discharge, because, as they have supposed, the milk is deteriorated by that circumstance.

Let us inquire, in the first place, at what time after a woman has given birth to a child, does the menstrual function ordinarily commence?

Some authors tell us that this does not happen for nine or ten months, usually. Dr. Meigs tells us that he expects his patients “to become unwell at the seventh month of lactation.” “But more frequently than is generally believed,” says Dr. Tilt, “the periodical flow coincides with the secretion of milk as early as the second or third month of lactation, and this in perfectly healthy women; and I am in a great measure able to confirm the assertion of certain authors, that menstruation often continues regularly from the beginning of lactation.” These, however, are exceptional cases, the rule being that a number of months, ranging probably from seven or eight to fifteen, elapses before the menses reappear.

But it is by no means proved that lactation should be made to cease as soon as the woman has her monthly discharge. I have myself known numbers of cases in which nursing was continued for some months after, and apparently with good results to both mother and child. How is it in those cases where the menses do not cease at all, or, at farthest, come on at a much earlier period than it would be advisable to wean the child? Must we be obliged to wean the child in these cases? I think not.

Dr. Hassall, of London, we are informed, examined with a microscope the milk of a lady taken from her on the second day of menstruation, which had come on for the first time at the ninth month of lactation, and he reported that the milk was perfectly normal in quality.

Dr. Tilt informs us that, having carefully interrogated one hundred women in whom menstruation had returned at different periods of

lactation, he learned that the quantity and quality of the milk were varied as follows:

The same in

45

Diminished only at the menstrual time 8

Completely checked in 1

Impoverished only at the menstrual time 5

Impoverished then and thenceforth 2

Increased at the menstrual time 24

A rush of milk afterward 15 100

In making the above observations, the thriving of the children was the estimate of the quality of the milk. By “impoverishment,” was meant that the milk looked like whey, and sickened the children.

My belief, then, you will understand to be, that some other criterion than the reappearance of the menses is to be looked for in regard to the time you should continue to suckle a child. Your own health, the infant’s health, the season of the year, the stage of teething, and a variety of circumstances, are to be taken into the account. And I am fully persuaded that the mere fact of the menstrual discharge coming on, is not a sufficient reason why the child should be weaned. Moreover, weaning should be a gradual process, which it cannot be if a woman must cease to nurse it as soon as the menses come upon her.

Food and Drink proper during Lactation.—As a general principle, it may be stated that whatever is best for the constitution of the mother, is also best for that of the child.

Every thing that goes to injure the mother during the period of lactation operates powerfully upon the mammary secretion, deteriorating it in the same proportion that it acts as an unfriendly agent upon her. This secretion, too, be it remembered, is one of the very first of the fluids of the body to become affected under unfavorable circumstances. We know how quickly the milk of a distillery-fed cow becomes impoverished and unhealthy, when the

improper food is given to the cow; and precisely the same great physiological principles hold good in the woman as the animal.

Suppose you have a fine cow, to which you have become very much attached, and that has a fine calf; or even suppose you have a sow, to which you have devoted a more than ordinary share of attention, and that she has a fine brood of pigs. It is naturally to be supposed that you would take as much pains as possible with the cow, that she might give good milk for the calf; and if you have a fancy for raising pigs, you would be equally careful in regard to the sow. We will suppose you think there is danger that the animal will not produce milk enough for the required purpose. In such a case, would you give it tea, coffee, or porter to drink? Most assuredly you would not; nor would you consider any woman in her right mind who would. Now, it is just as improper and inconsistent for you to take these articles, any one of them, with the view of improving either the quantity or quality of the milk, as it would be to give them to animals for the same purpose. Farmers can tell you how much better it is for animals, when they are giving milk, to have pure water to drink; and the purer and softer it is, the better does the animal thrive in every respect.

I will not deny that a woman probably needs more fluid when she is nursing than she does at other times, and I presume that she feels a desire for more; if so, she can take it. But surely no one will tell me that there is any thing in the wide world that will at all compare with pure water as a means of quenching the thirst.

In nursing, as well as in all situations, you will find the diet to have a great influence in regulating the desire for drink. If you eat salt, and highly seasoned or sweetened articles, you will experience much more thirst than you would if the diet were more simple. A stimulating diet causes a degree of fever in the body; and water being the best and most natural of all substances for curing fever, nature sets up a demand for it. Remember, then, when you eat any thing that makes you dry, you are doing unwisely, because you are causing a degree of gastric fever, greater or less.

I need not, I think, go any more into details concerning what you should eat and drink while giving suck. The great thing is to do the best possible for your own health, and that also will be best for the child. You should not eat or take nourishing drink any oftener than

you would do at other times, nor should you overdo in quantity, because you think you have two to support.

LETTER XXXI. OF TWINS, TRIPLETS, ETC.

Twins, Triplets, and Quadrigemini of comparatively rare Occurrence Of the Signs of two or more Children in the Womb Management of Twin and Triplet Cases The Nursing of Twins.

It sometimes happens that the woman gives birth to two or more children at the same time. When a mother has twins it is usually the case that both children are smaller than the natural size; they are not, however, both of the same weight; one may be of moderate size, while the other is still more diminutive. But cases have been known to occur, in which both children were above the natural standard. The average weight of twelve twins, examined by Dr. Clarke, as quoted by Dr. Burns, was eleven pounds the pair, or five and a half pounds each, bringing each child considerably under the average weight of a child born singly. Usually the two children, taken together, weigh considerably more than the one at a single birth.

Twins are fortunately of comparatively rare occurrence; so much so as to render it difficult to establish the proportion between them and single births; the cause of their production is evidently mysterious, and altogether beyond the power of human control.

In the Middlesex Hospital, London, according to Dr. Dewees, there was on an average but one case of twins in about ninety-one of births. In Dublin the proportion is greater; in the hospital of that city it was found that one woman in fifty-eight had twins; in the Westminster Hospital, in London, one in eighty; in Dr. Burns’ practice, one in ninety-five; in La Maison d’Accouchement, in Paris, there were, in twenty years, thirty-seven thousand, four hundred and forty-one single births, and four hundred and forty-four twins; in the

l’Hospice de la Maternité (Hospital of Maternity) of Paris, the proportion was about one in eighty-eight, according to one return, but according to the testimony of Madame Boivin, of the same institution, the proportion was only one in about one hundred and thirty or forty, while in that of La Maison d’Accouchement the proportion was about one in ninety-one. Dr. Dewees regards, that in this country the proportion of twin cases is, on an average, one in seventy-five. In Wurtemberg, in Germany, there were, according to Dr. Burns, twins once in about eighty-six cases of births.

Triplets.—These are very much more rare than twins. In the returns of the cases in La Maison d’Accouchement, as furnished by Baudelocque, there appears to have been but one in more than eight thousand cases; in the returns of Madame Boivin, of the cases in the l’Hospice de la Maternité, there is one in rather less than seven thousand. In La Maison d’Accouchement there were, according to Dr. Burns, in twenty years, thirty-seven thousand four hundred and forty-one single births, and five triplets. At Wurtemberg, in Germany, there were triplets once in about seven thousand.

Quadrigemini.—Instances of four children at a birth must be exceedingly rare. It is not uncommon to find the announcement of such cases in our public prints; but the truth of these ought evidently to be questioned in most cases; and yet such an occurrence has been known to take place. An instance was said, on good authority, to have occurred in Paris, in October, 1823. Dr. Dewees cites a German author, as giving the case of a woman in Strasburg, who had eleven children at three deliveries, making, of course, four of each at two of the births, and three at the other. The same author quotes from the Albany Argus what he designates an account of “unparalleled fecundity.” Dr. O. F. Paddock, a respectable physician of Fort Covington, Franklin County, gives, in the Franklin Telegraph, an account of an extraordinary birth of five children at one time, from the same mother—three daughters and two sons. Four of them were born alive, but lived a short time. The birth was premature three months, but they were perfectly well-formed and well-shaped. The average weight was about two pounds, and not much difference in their size. Their parents had lately emigrated from Ireland, and arrived in this country in August, 1825. This case is rendered more remarkable by the fact that the mother of these five was delivered, on

the 20th of February, 1826, of two; making, in the whole, seven children in less than nine months. The last were born on the 25th November, of the same year.

The same author quotes also another account of remarkable fertility from Dr. Ryan, editor of the London Medical and Surgical Journal. This learned gentleman was called to a patient, aged fortyone, of a sanguine temperament, who had menstruated at the age of twelve, and married between eighteen and nineteen. She had a seven months’ child in the eighth month of her marriage; had twins about the fourth month three times during the year 1829, and again, December 31, when she was attended by Mr. Whitemore, of Cold Bath Fields, and delivered of two infants; and on January 28th, 1830, she was attended by Mr. Thomas, of Bagnigge Wells Road, and delivered of an infant, which he considered of the same age as the preceding. On the seventh of June, 1830, she aborted at the third month; and on the ninth, a second fetus was expelled; and as there was no discharge whatever from that time to the period when Dr. Ryan wrote, she considered herself still pregnant. The abdomen was about the size of a woman’s in the fifth month of utero-gestation. She had twenty-four children in twenty-one years, and menstruated regularly before marriage, and was always in good health when suckling, and ill when breeding; and always became pregnant about the fifth month of lactation. Her mother was seventy years of age, and in good health; she had eighteen children born alive. A relation of her husband had thirty-two children, including miscarriages.

Dr. Dewees gave a case some years since, of a lady with whom he conversed, who was then in her thirty-eighth year, and who declared to him that she had been pregnant two-and-thirty times. Of this number eleven children had been born alive, and at the full time. She repeatedly miscarried of twins, and no abortion was less than near three months. She had been married nearly twenty-three years.

As regards the number of fetuses that may exist in the womb at a time, fable has exerted itself to an almost endless extent; thus, the story of the Countess of Hannenberg may be cited as an instance. She, in consequence of a curse pronounced by a beggar-woman, to whom she had refused money, was delivered of three hundred and sixtyfive fetuses; that is, one for every day in the year, in fulfillment of the wish of the offended mendicant, which was, “that she might

have as many children at a birth as there are days in the year.” The curse was said to be accomplished; and, in proof of it, the fetuses are shown to strangers that visit the museum at Leyden. This fable did very well for the year 1276; but, if such cases were said to happen now, they would be more scrupulously investigated, and more rationally accounted for. In the case first noticed, the sexes were pretended to be discoverable, and all the males were called John, and all the females Elizabeth, at their baptism.

Signs of Twins.—A vast deal of thought and investigation have been put forth on the subject of ascertaining twin cases before birth. The physician is often consulted on this subject; but, it need hardly be said that the wisest and most experienced can hardly do more than guess upon so important a matter. Dr. Dewees tells us, we should always answer the question in the negative, and for two reasons, especially; first, because it is impossible to decide it positively; and, secondly, if it could be so decided, it never should be, as much mischief might arise from the uneasiness and fear it might produce.

It may not, however, be wholly uninteresting to our readers to know something of the signs which have been supposed to indicate the presence of more than one child in the uterus. Women who are more than ordinarily large, are apt to suspect themselves pregnant with twins; we very often see such cases, and yet, in few instances, comparatively, the surmises of such patients prove true; they are in general happily disappointed, for no mother, I think, would prefer to run the greater risk of bearing twins.

If a woman be unusually large in the early part of pregnancy, and increase proportionably to the full period, there is some reason, as Dr. Denman regards, that she will have twins; but people will vary very much in regard to what constitutes “large,” and what “small,” in reference to the size of the abdomen in pregnancy: a few will suppose themselves very large when they are, in fact, only of common or moderate size. Particularly in cases of first pregnancy patients are apt to be misled on this subject; there can be no surprise if conjectures on the subject of twins often prove fallacious.

The abdomen of all women with child is in general uniformly distended, without any inequality. It sometimes, however, happens that the tendons, which form what is called the linea alba, which