Chapter XXXVIII: Letter XXXVII: Cases in Midwifery (1)

A Collection of Facts Illustrative of the Effects of Water-Treatment
before, during, and after Childbirth.

In the year 1843, at which time the water-cure had been heard of this side of the Atlantic only by a very few, I for the first time applied water-treatment in a case of midwifery. I had, it is true, been for months, and I may say years, studying upon the matter, as a student of medicine who is determined, above all things, to learn and practice the truth, ought; yet I had no opportunity of bringing the principles which I believed in to bear directly upon any given case previously to the period referred to. The following then, are some of the leading particulars of my first case:

_Case I._—The lady was a resident of this city, of a feeble constitution by inheritance, and, I think, twenty-one or two years of age. For three or four years previous to her confinement her health had been, on the whole, much improved. Her constitution seemed, indeed, to undergo a remarkable change for the better, in consequence of leaving off tea, coffee, spices, butter, and flesh-meat, and at the same time practicing the daily bath. She, in short, became, as her flesh-eating friends said, “a thorough Grahamite.” Notwithstanding her improvement, however, she suffered miscarriage two or three times in as many years.

During the period of pregnancy of which I am speaking, I advised her to be very particular in keeping up her baths, exercise, diet, etc. She followed the advice faithfully. She suffered somewhat from neuralgic pains in the abdomen, but these were in general readily checked by the use of wet compresses, and the sitting and other baths. Few patients have ever been as faithful as she was in carrying out all good rules. She kept up her bathing and exercise to the very day of labor.

There was one circumstance which operated against her a good deal toward the close of the period. A worthy and skillful medical friend advised that she should have premature delivery brought on, because her pelvis was, as he said, too small to allow of the birth of a full-grown child. This advice, however, she would not, on any account, entertain, notwithstanding she had the utmost confidence in the skill and honesty of her friend. She resolved to trust God for the result, although she was well aware that she was to pass through a most fearful ordeal of danger and suffering. As it proved afterward—for she has borne a number of children since—her own instinct was better than all the knowledge of her medical friend.

Her labor was a very severe one, and she met it with most praiseworthy courage. She was at length delivered safely. The child was of more than average size, but owing to a malformation it could not live. Her maternal feelings were of the strongest kind, and the loss of her child was a great blow upon her spirits. She was, however, up daily, more or less, from the very first. Indeed, it was not two hours after the birth—she having been awake all night—before she stood up, and was thoroughly washed in cold water from head to foot. She knew what cold water had done for her before, and she was not afraid that it would fail her now in her time of need.

She pursued the treatment from day to day, observing the greatest care not to overdo. She understood well, young as she was, the great importance of mental quiet under such circumstances, and saw no company for many days. On the sixth day she had so far recovered as to be able to walk to the Battery, a distance of a mile and a half. The weather being hot, she rested awhile upon the shady seats of that beautiful inclosure, and was much refreshed with the sea breezes which are so genial at that season of the year. Afterward she walked back home, making, in all, a morning excursion of three miles.

This, then, I put down as one of the first of the American cases of hydropathy, and _the_ first in childbirth. Thanks to Priessnitz, there have been thousands since.

_Case II.—June 26, 1846._—Two weeks ago, Mrs. E., of 56 Prince Street, informed me that she had arrived very near the end of the period of her first pregnancy, and that she desired me to attend her in childbirth. By conversation I soon found she was well-informed in the new system, and the modes of preserving health, and this without her having had any particular advantages for acquiring such knowledge. She had read faithfully and understanding upon the subject of health, a duty which too few mothers observe. Mrs. E. is about twenty-two years of age, with constitution naturally very good, although not remarkably strong. Her attention became directed to bathing about two months since. She performed two ablutions daily, and took sitz-baths; discontinued the use of tea and coffee, took very little animal food, living principally upon coarse bread, hominy, cracked wheat, and fruits. She took frequent exercise in the open air, and by these means became sensibly invigorated in general health, and was kept perfectly free from unpleasant symptoms of every kind. I advised my patient to go on as she had done perseveringly and to the last. Her very kind and affectionate husband and her mother, as well as other good-meaning relations, insisted that she should take a different course, particularly in food and drink. But she chose understandingly to pursue her own way, feeling full confidence that she would be able to prove to her friends that she was in the right, and that young persons were not necessarily less knowing than older ones.

_June 26._—To-day Mrs. E. sent for me early in the morning. She had experienced by turns slight labor pains from 9 A. M. the day before; was not able to sleep much in the night. Took baths as usual, and walked in the open air. This morning she practiced general ablution and sitting-baths as usual. Cold water renders the pains more efficient, which is a good symptom. Walking about the room has the same effect. The pains increased very gradually, and this afternoon, notwithstanding they grew more severe, she was able to sleep at times between them. These continued to increase until six o’clock this evening, at which time she gave birth to a remarkably fine, healthy daughter. In a few minutes the after-birth was expelled, and no undue flooding occurred. Wet towels were placed upon the abdomen and the genital parts, and the face, hands, and feet were sponged, each of these applications having a most soothing and refreshing effect.

In the case of the infant, care was taken to avoid the great error so generally practiced, of separating the cord by which the child is attached to the mother, too soon.

The separation after due time being made, the infant was washed in soft water made very slightly tepid, with the addition of a little mild soap. No bandage was put about its abdomen, for the reason that it always causes more or less harm—that is, if there is no malformation of parts, and always tends to induce the very difficulty it is designed to prevent, viz., that of rupture. The kind-hearted mother of Mrs. E. insisted, as a matter of course, that the bandage should be applied as in the good days of old, but Mrs. E. said “_Do as the doctor says._” Very light muslin clothing was then placed upon the infant, after which it was left, without drug or dose, quietly to sleep.

_9½ o’clock, Evening._—Returned. Mrs. E., happy and contented, has been enjoying sound, refreshing sleep. Has had no nourishment since morning. Took then a little fruit. Prefers to wait until morning before taking any more. I recommended her to take fruit every day from the first, that the infant may be accustomed to her doing so. If mothers omit fruit for a while and then commence its use, the milk generally distresses the child. I believe that, as a rule, the judicious use of well-matured fruits will not cause any difficulty in the child, provided the above direction is from the first and onward complied with.

Mrs. E. is now to take a bath—that is, with assistance, the whole surface is to be cleansed, portion by portion, by means of cloths wet in moderately cold water. This will cause a sense of great comfort—will increase the strength and promote sleep. As is very common on such occasions, the friends object strongly to the use of cold water. “Oh, it will give you a death cold! how can you do it?” and the like expressions are used. But the patient well understands that she needs the invigorating and soothing effect of the ablution, and that when the system is sufficiently warm, it will not only be perfectly safe, but highly beneficial. She prefers, as she has done, to practice upon rational and well-ascertained principles, rather than to be guided by the whims and caprices that custom with its iron rule entails upon society.

_First Morning after Confinement.—June 27, Six o’clock._—Mrs. E. slept sweetly and soundly during the whole night, waking only a few minutes at one time. She feels greatly refreshed, and able to rise and take a bath; judges by her feelings that she will be benefited by sitting up; has a good appetite. I advise her to sit up as much of the time, little by little, as she feels inclined. She proposes eating very sparingly of well-boiled cracked wheat, with a little uncooked milk and berries.

_Half-past Nine, P. M._—Mrs. E. has sat up at different times during the day. No after-pains or particular discomfort of any kind. Every time of sitting up has done her good. She has taken food at three different times. Will take a sponging now, and retire to rest.

_Second Morning after the Birth._—Mrs. E. slept remarkably well during the whole night. Has been up, performed a bath, walked about the room, and is much invigorated. Felt decidedly the need of the bath; it strengthened her much. Has no after-pains or difficulty of the breasts. The milk secretes abundantly. The bowels are moved by injections of tepid water. Mrs. E. will sit up the greater part of the day.

_Third Morning after Birth.—Eleven, A. M._—Mrs. E. rested well during the night. Arose at six, and took her usual bath. Reclines now awhile. Would be able to walk up and down stairs were it necessary. Her infant is remarkably well, and sleeps the greater part of the time. Mrs. E. is one of that very small number of mothers that has energy of character, resolution, and system enough to nurse her infant regularly, and not during the night time. Once in three hours, between 6 A. M. and 9 P. M., at the very most, is as often as she will allow it to take the breast.

_Seventh Day._—Mrs. E. has been improving day by day, from the first. She has had no inconvenience whatever; no pains of any kind, no swelling of the breasts or feverishness. Has well-nigh her natural amount of strength. Her infant, too, is doing remarkably well.

_Case III.—Nov., 1845._—Mrs. C., a poor woman of this city, not long since made known to me, that in her destitute condition she would receive, as a great favor, if I would attend her in childbirth. She informed me that on previous like occasions, she had suffered beyond description, both at the time of confinement and subsequently. She had borne two children—the first it was necessary for her physician to destroy before the birth could take place. The birth of the second was also attended with the greatest difficulty. It was now some weeks before her expected time. Her husband had deserted her, so that she was compelled to follow her occupation (that of a seamstress) during the whole day and much of the night. From this constant sitting and confinement within doors, she had become much enfeebled, and had a severe and constant pain in the side.

I directed her to wash the whole body daily twice, when not chilly, in Croton water, and to take each half day as much exercise in the open air as she could possibly find time for, and could practice without causing too great fatigue. The woman followed the directions, and was at once sensibly benefited. The severe pain in the side left her almost immediately. When her period arrived, delivery took place in a very short time, and with comparatively little suffering. Bathing in mild forms was practiced the day of, and subsequent to, delivery, and the patient walked about each day, and was scarcely _confined_ a single hour.

There is one fact to be mentioned in her management of the infant. She was directed at first to have it washed in tepid water. Supposing she would follow the same course for the future daily washings, I made no further inquiry till some days after, when I ascertained that she had used the water of the natural temperature. I asked her why she did not moderate the temperature of the water as at first, and as people generally do. She answered, that when she bathed herself before the child’s birth, every bath seemed to strengthen it very much; and, therefore, she chose to use the cold water now for the same reason. She had the good sense always to keep the child sufficiently warm, particularly after the bath. It is proper to mention that the Croton water at this time was not far from 65° Fah. The child has been, and is now, one of the healthiest and most vigorous I have ever seen of the age.

The above notes were written some months since. The case is again brought to mind, by the mother’s coming to-day to work for us at her usual occupation. She says, “What a strange thing it is, my little baby has never been sick a single hour. What wouldn’t I give if my other boy could have been so.” The child is one of the brightest imaginable; knowing, observing, good-natured, and now, at the age of six months, sits near his mother, playing, laughing, crowing—the most perfect picture of health. He is every day once, and generally twice, washed in cold water.

_Case IV.—Oct. 25, 1847._—The same woman was again confined early last spring. She had been living, I found, in a small cellar-room, where there were but three small panes of glass, and to which the sun could never come. The place was damp and dark, and the air necessarily very foul, it being in an alley in which many poor, dirty families were living. Here the poor woman lived, paying an exorbitant rent, supporting herself and two children by the hardest work rather than beg.

The night of her confinement was a very stormy one. The wind howled among the old buildings, tearing off shingles and shutters, and the rain poured down in perfect torrents. Ships were lost that night, and sailors, with the captain and officers, swept overboard.

The labor this time, as before, was an easy one. It took place at midnight. Every thing went on well, and she was, after a reasonable time, left to get sleep, as we supposed she would. I found, however, in the morning, that, notwithstanding she had been wholly free from pain, she had not slept at all. She acknowledged that, powerful as had been the effects of water for good at the previous time, the old ideas had yet haunted her, that she must either die, or submit to the application of those terrible instruments that had been used in her first confinement. She now felt so rejoiced at her getting through again safely, that she could not sleep at all. So we found her in the morning early, she, her two children, and the new-born babe, all on one narrow settee bed together, apparently contented and happy.

Two ladies who understood these matters of water-treatment, went now, it being Saturday morning, and administered our patient a bath. The water was moderated a little, but left still quite cool. This day she could obtain no sleep, for she had but one room, and the children must remain there. She sat up considerably, but not so much as to cause over-fatigue. In the evening the ladies went again, and administered the bath. She slept well during the night. The next morning, Sunday (the second day), the ablution was administered at 7 o’clock, at which time the patient arose. She remained up all day, until 10 o’clock in the evening, at which time the ladies again administered the bath. She slept well this night, was up all the next day, and so onward, and has been constantly well up to the present time.

_Case V.—Dec. 12, 1845._—Was called in the night between one and two, by Mr. Brown, living at 40 Oliver-st., to visit his wife, then in labor. At the beginning of the evening previous, Mrs. B. began to experience premonitory symptoms—took, as usual, a sitting-bath, reclined upon the bed, and slept about three hours, when she was awakened at 10 o’clock by labor pains. These occurred regularly until the time of our arrival and onward, growing more and more effectual, until four in the morning, at which time she gave birth to a fine healthy daughter. The after-birth was cast off in a few minutes, after which Mrs. B. felt easy and inclined to rest. After being made comfortable, she was desired to sleep awhile, and was told that she would be refreshed and invigorated by an ablution after sleep, and that she would be able to sit up a short time by way of a change.

_Nine, P. M._—Returned to see Mrs. B. Found her quite comfortable, after-pains slight; had slept a part of the time. From the commencement of labor she had drank as freely of Croton water as was desired—had drank nothing but cold water for about a year. Had she been accustomed to warm or hot drinks there would have been a liability to increase of after-pains by taking cold water. In such cases the drink must be warm, unless there is much feverishness and thirst, in which the cold drink would be tolerated and most agreeable. Appetite was good. Mrs. B. said she could relish any thing; was very fond of Indian mush, with a little syrup; thought she had better not take any thing till dinner time—she would drink water, and be on the safe side. To this I of course agreed. She felt none of the giddiness, nervousness, great weakness, and depression of spirits she had always hitherto felt after childbirth. There was now and then a slight after-pain. She sits up little by little, and drinks water when she feels an inclination. She will take food once to-day, that is dinner, and I will come again by evening.

_Seven, P. M._—Returned again. Mrs. Brown has been sitting up and bearing her weight at different times during the day. She ate of the plain favorite dish, Indian mush and molasses, with a piece of dry bread, and water to drink. The bread tasted very sweet, the appetite was so good. The husband had now returned, and the bathing could be carried out. A wash-tub was brought into the room, and placed before the fire to be warmed. At the same time, water, warm and cold, was procured. A stick of wood was placed under one side of the tub, and thus the two-fold object of a hip and general rubbing-bath could be accomplished at the same time. Mrs. B. walked to the tub, and, her husband aiding, took a good bath. The water was made mild, of about 80° or 85° Fah.; while sitting in the bath, the body being well guarded all about with blankets, a good deal of rubbing was practiced upon different parts of the system, and particularly the back. This had the effect of promoting after-pains, and of strengthening the part, and in fact the whole system, very much. The lower extremities were, of course, outside the tub, and those were bathed afterward. A night-bath of this kind at such times seems, indeed, to increase the strength tenfold. Pains are relieved, the nerves strengthened, and a wonderful change wrought.

_Second Day (Sunday), between Eight and Nine, A. M._—Mrs. B. slept well during the night, and until late this morning. All were in bed so long, and as Mrs. B. appeared so well, it was thought best, for want of time, to omit the general bath until toward dinner. Told her that, for a change, it would be best to go occasionally to other parts of the house; but to be careful not to overdo, or to be up too long. At any time pain or weakness was felt in the back, a good rubbing of the part with the wet hand or towel would prove very serviceable. Requested Mr. Brown that an enema of tepid water be administered. This could be repeated twice if necessary to cause the desired effect.

_Six o’clock, P. M._—Mrs. B. has eaten to-day sparingly twice, a breakfast and dinner, the last with her family. Has walked up and down stairs without inconvenience or assistance.

_Third Day (Wednesday), A. M._—Mrs. B. rested well last night. Feeling a little fatigue the preceding evening, she concluded to omit the bath. It would have been refreshing, however, but this morning she feels remarkably well, and has been doing light work. Has been up nearly all the morning. Took the sitting and general rubbing-bath early before breakfast. Was cautioned not to be up or to do too much. Food to be plain, as usual, and the drink, cold water.

_Seven, P. M._—Mrs. B. has been up most of the day. Appetite remarkably good; thinks she took a little cold by sitting unconsciously in a draught of air. A carious tooth commenced aching, which proved a warning. There has been some feverishness, probably nothing more than milk fever. This will be prevented by the tepid-bath, the latter to be repeated as often as the feverishness returns, if such should be the case. There has been some caking and pain in the breasts. The pain is effectually removed by perseverance in placing very warm or hot wet napkins upon the breasts, covering these with dry warm flannels, and repeating them very often until the pain is relieved. Breasts to be well drawn, and the bowels moved by a full injection of tepid water. If Mrs. B. perseveres as she always has, she will have a good night’s rest.

_Fourth Day._—Mrs. B. rested well; continues the baths, plain diet, sitting up, and moderate exercise, as usual, and is progressing rapidly toward firm health and strength.

_Fifth, Sixth, and Seventh Days._—Mrs. B. proceeded cautiously, and with the most favorable results.

_Eighth Day, Eleven, A. M._—Mrs. B. has been about all the morning, has been giving way to her great propensity to industry, practicing at the wash-tub. She does not believe at all in idleness. The only danger is that she may do too much.

_Ninth Day._—Mrs. B. is about as usual; feels that she has an abundance of strength to walk some distance in the city. She could walk out with impunity, notwithstanding the weather is very cold, but it is thought best, on the whole, since she is so much about house, and pays so much attention to bathing and ventilation, that she should remain within doors yet, a little.

She says that at the end of three weeks from the birth of the child next older, when beginning to attempt to sit up, she was weaker than she has been at any moment since the birth of the last one. With all her children she has been very weak.

_Case VI._—Late in the month of January, of the present year (1850), I was called early in the morning to visit a young married lady, in Fourth Avenue, who was said to be in great suffering from spasms and vomiting. She had not slept during the night, and it was necessary for her husband to remain up with her the whole time. I found her with very high general fever, and oft-recurring spasms, attended with bilious vomiting. The fact of her being in an advanced stage of pregnancy, with this complication of untoward symptoms upon her, designated the case too clearly to a practiced observer, as being one of both delicacy and danger. The parties in the case had no knowledge whatever of the water-cure, or of my particular methods of treatment, and had called me, being the nearest physician, and, as they supposed, of the old school. No medicines had as yet been administered, but the patient, as is common on such occasions, had been deluged with a great variety of articles, in the way of liquid food and drinks, with the hope of “settling the stomach,” a process which can seldom succeed, and, as often practiced, is quite sufficient of itself to make even a well person sick.

The patient and her husband both thought, as a matter of course, that “some physic must be given.” I told them we would first give a tepid-bath, at 70° Fah. This I assured them would give great relief, and knowing well, too, the great prejudice among English people (for they were English) against bathing in pregnancy, I aided the husband, with my own hands, in administering it, thus to be certain of its being well and faithfully done. This they both thought at the time a rather harsh method of treatment; but they had employed the doctor, and he being resolute and determined, they could not refuse. The bath gave great relief, and then, all shivering and cold, a very large wet girdle was put upon the patient, after which she was wrapped warmly in bed, with moderately warm bricks to the feet.

After having allowed the patient to rest awhile, a large injection was administered, and with the best effect. Occasionally, too, retching still occurred (for symptoms of this kind never cease suddenly, and, indeed, should not), at which times tepid water was given freely to drink, for the purpose of aiding vomiting.

Thus the treatment was pursued: as the symptoms appeared to demand, the tepid half-bath, with a good deal of friction, the wet girdle, constantly or nearly so, the injections, and the water-drinking were kept up. From the first moment onward, the patient recovered as rapidly as could be desired. She slept a good deal during the day, and also well at night. The next morning she was quite well, although weak. She then commenced taking nourishment gradually. No further serious troubles were experienced during the period of pregnancy.

The 4th of April, 1850, the above-mentioned lady, at about the end of eight months of pregnancy, as was supposed was delivered. There was more or less of pain during thirty-six hours previous to the birth. The pains were rather severe during the most of twenty-four hours, proving that good health, with abundant exercise and bathing, are not necessarily of themselves capable of causing short and easy labor.

The child was born at about five o’clock in the afternoon. Soon a thorough ablution was performed in the sitting-bath. No patient ever had a better understanding of what was necessary in the case, and none, certainly, could be more free from all sensations of false modesty or delicacy; nor could any one pursue the treatment with greater confidence than she did. There was no time when she could not easily sit up or stand, if necessary, and, with the good nursing of her husband, she improved most rapidly. She wore the wet girdle most of the time, alternating, however, now and then, with simple fomentations. She bathed four times during the first twenty-four hours after the birth, washing the whole body thoroughly at each time, the water being moderated to from 60° to 70° Fah. She sat up during this time about six hours in all, and walked by spells a little in her room. She suffered somewhat with after-pains, but the means before mentioned, together with injections to the bowels, generally brought relief. All along her appetite and sleep were good.

The second day the patient sat up most of the time, and walked to other parts of the house, and for an hour and a half visited a friend. She could have gone abroad in the open air, had it been necessary for her so to do.

The third morning, that is, when her infant was two and a half days old, the patient walked with her husband a distance of about three fourths of a mile, visiting a friend. She was fatigued somewhat, but, on the whole, benefited by the undertaking.

After this, she walked abroad in the open air daily, always having to go down from the third story of the house in which she lived. In one week she went about the city, teaching her scholars in French, German, music, etc., as she had done up to the very day of labor.

And now, to exhibit things in their true light, let this lady’s case, as it occurred under water-treatment, be contrasted with the drug-treatment employed on a previous like occasion.

Between two and three years before, she was pregnant with her first child. Then, as during the last time, she was attacked with cramps, vomiting, and fever. She was laid by a fire in an almost insensible state, and had mustard draughts placed over a large part of the surface. She was also dosed a good deal internally, and salivated with calomel.

At labor, as well as during pregnancy, she was attended by one of the best physicians of London. It was three weeks before she could leave her bed; in four weeks she left her room for the first, and did not go out of the house until six weeks had elapsed. _She was then no stronger than in two days after confinement, under water-treatment._

Here, then, was a great difference in the result of the two methods—a difference so great that it cannot possibly be appreciated, except by those who have actually experienced them in their own persons.

One fact more should be mentioned in this case; the lady had been exceedingly depressed in mind through the whole, or most of the period; she, with her husband, having left the Old World for the New. A combination of circumstances most perplexing and depressing had worked upon her mind, and she was haunted perpetually with the idea that she must die a stranger in a strange country. Thus things went on till about nine weeks before she was confined, or the time before-mentioned, of her acute illness. But no sooner were the laws of life, health, and disease unfolded to her ever-active and intelligent mind, than she at once set resolutely and cheerfully to the performing of every task. No item in the way of bathing, exercise, diet, etc., was ever omitted. The story of her case tells whether or not she was rewarded for her faithfulness.

_Case VII._—Early in the morning of the 22d of May, 1850, I was called to visit a lady of this city, about thirty years of age, far advanced in her sixth pregnancy. She had, during this period, as before, been much in the habit of taking alcoholic stimulants, principally in the form of brandy, judging, from her feelings, she needed the stimulus. But its only effect was to render her at all times much more liable to take on inflammatory disease.

Four days before I was called, this lady was taken with very severe bilious vomiting, and cramp of the stomach. Two physicians were consulted, and a variety of medicines used. Still the patient continued, day by day, to grow worse, and could get neither relief nor sleep. Being told that she was in danger of convulsions, she and her husband concluded they would change their physician and try the water-treatment.

I found the patient then retching and vomiting almost incessantly, the stomach cramping, the bowels constipated, with high general fever and flush of countenance, the pulse being 130 per minute, or about double its normal beat, and the patient had not slept for three days.

_Treatment._—This was very simple. The whole body was well washed in water at about 80° Fah., a full clyster was administered, and wet, cooling fomentations were put freely over the chest and abdomen. Almost immediately the patient experienced a short but refreshing sleep. The cloths were changed often, the surface was sponged as it became too hot or uncomfortable. The general washing in the wash-tub was practiced once in four hours from the first, which always brought sleep. When retching and nausea came on, tepid water was taken freely to help the vomiting. This gave great relief. No other drink than water was taken, and no food until the vomiting had ceased. After this, well-boiled Indian-meal gruel was given, beginning with a single tea-spoonful at first, and then increasing the quantity as could be borne, at the next regular meal-time. After the first day the patient was bathed three or four times in the twenty-four hours. The clysters and fomentations were continued as circumstances required. No very cold water was used in any form.

In three days’ time the patient was up and about, and in all respects quite well, though somewhat weak.

Eleven days after commencing the treatment in the above case, namely, on Sunday morning, the 2d of June, 1850, the patient was taken very suddenly in labor. Within half an hour after the very first sensation of any pain, and before her husband could call me, her child was born, a sixth son. She suffered but little, and was delivered while in the standing posture, but the after-birth remained unborn. I found her weeping for fear that she would be subjected to some horrible water-applications, of which she had read. I told her that my mode of practice was altogether different from that which she so much feared, and that, at any rate, no honest physician would ever subject a patient to any process which she could not heartily concur in. I told her, moreover, that I would much prefer that she should have her old physician if she chose, and that she could not possibly offend me if she would but frankly take her own choice. Her husband then desired that she would pursue that course which she herself preferred. With the explanation I had given, she concluded at once to go on with the matter as I might see fit to advise. “Well,” said I to myself, “we will see how a mixed treatment will answer—a little of the old, and a little of the new.”

The patient was perfectly willing to be bathed in tepid water, which I also advised. But she wanted the old-fashioned obstetrical bandage or binder, as she had used it before. I explained to her all about its nature and effects, and consented that she might use it if she would take it off at each time of bathing, and at all times when she found it causing too great heat. Her husband bathed her four times the first day in bed; the women would not help at all. She was able to sit up in bed, and the second day and onward, she bathed herself, the old nurse always making herself absent at the time. She had suffered with after-pains before, but nothing worth mentioning this time. Injections were used from time to time, and the wet towels over the abdomen. The second day the patient was up in her room. The third morning, as I went to her door, I heard some one singing, and, on entering, found it was the patient herself, alone, sitting up with her infant in her arms.

The fourth morning the lady was so well that there was no excuse for a doctor any more. She said she had to keep her room, and mostly her bed, for four weeks always before. Now in three days she was perfectly well, bathing herself repeatedly every day; whereas always before she had never dared wash herself short of a whole month, _and then only with whisky_! She was now convinced that the only safe way to prevent taking cold, was _to bathe_.

This, then, may be put down as a remarkable case. Eleven days before labor the patient was very dangerously sick. The birth was exceedingly easy and short; and, although such labors are not, on the whole, as safe as those which are more difficult and protracted, she yet recovered her usual health in a remarkably short period of time, and without any mishap or pain. She bathed but very little, comparatively, although that little told well. No application whatever of cold water was made.

_Case VIII._—While the cholera was committing its fearful ravages in the city of Brooklyn, during the summer of 1849, a worthy and intelligent lady, the wife of a sea captain, was preparing to leave for the country, whither I was to go with her to attend her looked-for case of childbirth. Monday, the 9th day of July, she was busy packing trunks and preparing to move, and probably overworked. At all events, she did not feel well, and experienced pains similar to those of labor, all day Tuesday. I remained in the house over night, but in the morning the patient was better. Still there occurred at times periodical pains, and I told the patient that if they were true and natural pains of labor, a bath would accelerate and make them worse; or if they were false pains, and such as did not indicate the near approach of labor, the bath would cure or render them less. They were, however, increased.

At eight o’clock in the evening labor came to a close, the result being a fine, healthy, female child. One hour after, namely, at 9 o’clock, the patient feeling rested, was helped into a sitting-bath tub, and well washed, for some minutes, over the whole surface. The water was fresh and cool from the cistern. As may be imagined, the patient felt incomparably more comfortable after a good cleansing in this manner, and a degree of refreshment that can be conceived of only by those who have had the practical illustration of it in their own persons, was experienced. A plenty of wet linen towels were placed over the abdomen and genitals, and by these means the patient was enabled to pass, on the whole, a very good night.

She had, she informed me, always suffered intolerable anguish for days after the birth of her other children, five or six in number, I believe. Even with the first—a thing very uncommon—she had experienced most severe torture. It was therefore a great object at this time to do every thing possible to prevent the after-pains. Toward morning, as she began to grow more warm, the pains came on in a slight degree.

At 6½ o’clock (the 12th, the first morning after the birth), the patient was again thoroughly washed from head to foot in the hip-tub. After this a large linen sheet, the whole being wet, and folded in the form of a very large girdle (large enough to cover the whole trunk of the body), was employed. It was wrapped round from end to end, its object being to act as a great and moderately cooling, and necessarily soothing fomentation, to the body, to keep off inflammation and subdue pain. The weather being most excessively sultry and hot, only one dry sheet was placed over her as a covering. She was to remain in this condition so long as the wet sheet did not become uncomfortable or too warm. At 10 the same forenoon, after having slept a good nap, a second ablution was practiced.

She now took a trifle of nourishment in the form of oatmeal gruel, the first since the birth of the child. The two whole days previous, likewise, she had not eaten in all the amount of half a common meal. This three days’ abstinence proved a most valuable means in warding off fever and pain. Nor did it materially impair the strength.

In the afternoon of the same day (the 12th) the patient again took a good bath, fresh from the cistern. She slept considerably both forenoon and afternoon, _and suffered positively no more pain_. She sat up in her rocking-chair to rest herself in the afternoon and evening, at which time still another bath was to be repeated; but feeling so comfortable, and sleeping withal, she concluded to omit it.

The next morning (the 13th) the patient sat up and took her breakfast, namely, a small piece of simple brown-bread toast.

Thus she went on, bathing and using the fomentations freely each and every day, and very soon regained her full strength. Indeed, she was not at any time so weak as to prevent her walking. She always, after the first night, appeared happy, cheerful, and smiling. She now had no pains whatever, while always before, in childbed, she had suffered greatly for many days after the birth.

The peculiarities of this case are the following:

1. The patient bathed during the whole period of pregnancy daily, by means of that invaluable application, the dripping or rubbing wet-sheet.

2. She wore, of her own accord, the wet compress over the stomach the whole time of pregnancy, night and day; a means which seemed most effectually to prevent heart-burn, nausea, and a host of stomach difficulties, to which she had on previous like occasions been subject.

3. The very abstemious diet subsisted on. She ate much of the time but little else than brown bread and water, and this in small quantity.

4. The extreme heat of the weather.

5. The fact that epidemic cholera was raging most fearfully at the time, in the same neighborhood.

6. The great amount of treatment that was practiced.

7. The freedom from all after-pains, to which the patient had on all previous like occasions been subject.

8. The great rapidity with which she recovered her full strength.

Let those who would imitate a treatment of this kind, be sure of the _principles_ on which they act. Experience is the great teacher in these things. The timid and inexperienced must be content to practice in a less heroic mode.

_Case IX.—July 15, 1850._—This is the case of a lady who resided in our establishment, about thirty years of age, of delicate health, and scrofulous tendency. She bathed through her whole period, and paid tolerable regard to diet, but was too much encumbered with domestic duties to allow of suitable exercise in the open air. This was her second pregnancy.

She came to labor very suddenly on the evening of the above date—labor lasting only about half an hour. The pains were exceedingly severe. The presentation of the child was an obscure one, but I succeeded in bringing down the feet foremost, and then, by arranging successively the body and the head in a proper position, I met with no serious obstacle in effecting the delivery. The after-birth came away in a short time, with very little manual aid. Cold wet cloths were at once placed over the abdomen, genitals, and thighs, and often renewed. There were some after-pains. After resting half an hour, the patient was raised as she desired, placed in a hip-bath, and thoroughly washed all over with water, temperature of the Croton, and which produced an effect which she designated as “heavenly.” A folded wet sheet was placed about her body, and being left in a condition which would not allow of her becoming either too hot or too cold, she soon slept sweetly. She had also slept somewhat before the bath. Changing the wet application from time to time, she obtained a very good night’s rest.

The next day she used the wet applications according to her feelings of comfort, and was washed four times thoroughly from head to foot in a hip-bath. Immediately after the first bath, early in the morning, she sat in a rocking-chair, had water brought to her, and then washed her infant, unaided, with her own hands, because no one could perform this important duty so well as herself; she continued so to do daily from the first.

She was herself bathed three or four times daily until she was perfectly recovered, which was in a very short time. She sat up four hours the first day, and so onward. Her infant did remarkably well.

About midsummer, 1847, this same lady was confined, under my care. Not long before the beginning of pregnancy at that time, she had suffered from a very severe attack of fever; but by dint of perseverance in good habits, she got along very well through the period, though the labor was a severe one, and the perineum became torn. There was likewise some trouble from swelling of the breasts. But notwithstanding these drawbacks, she was able to sit up, walked out very soon, and on the whole recovered remarkably well. The sitting-bath and wet compresses had evidently a very salutary effect in healing the perineum; the child also thrived well. This lady had been some years, for the most part, a vegetarian, and drinks neither tea nor coffee.

_Case X.—July 31, 1850._—A lady residing in a healthy part of the country was confined the tenth time at this date. She ate no flesh-meat during pregnancy; the diet was entirely vegetable, including the different kinds of berries and fruits in their season; her drink pure water only.

Living thus, she was able to attend to the dairy, making her own butter, and performing all the cooking herself for a family of eleven persons, up to the very day of her confinement.

Labor commenced in the evening, and soon after, at the recommendation of her husband, she was sponged over the whole surface with cold spring water, and soon after took a cold sitting-bath. In about an hour after this she was delivered of a fine plump boy weighing ten pounds. After resting a little, and being somewhat fatigued and suffering some pain, her husband proposed another ablution, to which she readily consented. After this she slept well till sunrise the next morning. The wet girdle had been worn nights some time previous to labor, and was continued about a week after it.

The first morning she was washed all over, and felt very comfortable after it. She partook of rye-bread toast and blue-berries, with water for drink; this was her whole breakfast, and her appetite was good. At night she took a sitz-bath for five minutes, the chill taken off the water, then sponged the body and retired to rest; she slept well all night. She had no nurse but her husband.

The second morning she experienced no pain; followed the course of the preceding day, namely, the bathing of the body and the sitz-bath washing; partook of unleavened wheat-meal cakes for breakfast, with good ripe berries; for dinner, corn-bread with berries; supper, dry toast made of brown bread, with blue-berries; no drink at any time but the best of pure cold water. The third morning she walked about the room; helped to bathe herself; appetite good; food pretty much the same as the day previous; spent a large share of the day sewing; sitz-bath washing as usual at night. The fourth day she was able to bathe and dress herself, partook of meals with the family, and kept about house all day.

From this time forward she took the entire care of her child; neither mother nor child have taken one particle of medicine, nor any herb drinks of any kind or name, and both have been perfectly well and regular in all their habits up to this time, it being two months since the birth. All that the child has ever had was two or three tea-spoonsful of cold water at the time of its birth; after which it was put to the breast. I ought to mention that the child has also, from the very first, been washed every morning in water made slightly tepid.

_Case XI._—This is the case of a newly-married lady of this city, twenty-four years of age, of nervous temperament, studious habits, and highly sensitive but well-balanced mind. She had been for years engaged in teaching in the South, and suffered very much with dyspepsia. She had followed water-treatment, pretty thoroughly, one year before she became pregnant. The first four months of this period, it being the winter season, she took the sitting-bath an half hour every morning in cold water, and after it bathed the whole body. During the day she wore a large wet girdle, covering the whole trunk of the body, always during the day rewetting before it became dry; at night it was left off.

She experienced at first much trouble from nausea and prostration.

By the use of the wet girdle, the sitting-bath, and general washing, in connection with abstinence—for she passed whole days eating not more than a fourth part of a Boston cracker in the twenty-four hours—she soon got the mastery of her stomach-sickness, and other troubles.

After the first four months she took the half-hour sitting-bath and general washing three times daily, and wore the large wet girdle as before. She was active in her habits, and for the greater part of the time appeared in as good health as ever in her life before. She remained in the city until the summer, and then left for the country.

About the middle of August, 1850, as she was on the point of returning to the city to make ready for her approaching confinement, under my care, she met with a fall. This brought on labor some weeks earlier, as she supposed, than it should have been. It was rather severe, lasting twenty-four hours. She took ether, as is the custom with many in New England, where she was—an unnatural and injurious practice as I regard it to be. Her child was born on the morning of the 15th of August, soon after midnight. During labor she ate nothing, bathed a number of times, and took clysters of water, all of which served to refresh the system.

In less than an hour after the birth, she was helped into the tub; sat some ten minutes in the water, and was washed over the whole surface. She could easily have borne her weight. The wet girdle was applied, and other cooling fomentations, after which she slept soundly till morning.

She was then bathed again, as before, and after this washed her infant herself, and dressed it the first time, and thereafter continued daily to take the care of it.

She took daily three baths in the wash-tub, the water always at about 70° Fah., and continued to wear the wet girdle and compresses night and day the whole of the first two weeks.

The first day she sat up half an hour, besides taking the baths. She could easily have remained up a large share of the time, but being among those who knew nothing of water-treatment, she preferred being on the safe side. The second day she sat up an hour, and felt well and strong. The first and second days she ate almost nothing. The third day she was up all the time, and took her meals with the family. The fourth day she walked out, and visited two families near. The fifth day she carried her child in her arms, walking with perfect ease a quarter of a mile, and feeling no fatigue. During the first days she had some trouble with swelling of the breasts. Cold water was poured upon them a good deal, and wet compresses worn. She also persevered much in drawing them herself with the tobacco pipe, and by these means conquered the difficulty readily. In three weeks she was able to travel alone with the infant, some 250 miles, to this city. She came first about four miles in a stage coach, thence by railroad to the steamboat, thence over night to the city, and then rode nearly or quite three miles over the rough pavements in the morning to her city home, it being just three weeks to a day from the birth of her infant.

This worthy and intelligent lady remarked, that she considered it her duty to make known to the world her experience in the water-treatment. She said “that many suppose they cannot avail themselves of the advantages of the new method, for the reason that they are not within the reach of a physician who is competent to practice it. But,” she continued, “there is not a lady in the whole United States who may not readily learn as much about it as I myself did. I gained all my knowledge from books, and had never for once conversed with any one who had gone through with the treatment in childbirth.” Great good must necessarily be accomplished if women will but read, understand, and practice, carefully and intelligently, for themselves.