In this state each contraction of the uterine fibres is
attended with much suffering, although the contraction itself may be so
slight as to produce little or no effect upon the os uteri. Most of these
conditions, in a severe degree, form that species of dystocia which arises
from a faulty state of the expelling powers, for the farther consideration
of which we must refer to our chapter upon that subject. In a minor degree
they produce these slight derangements of uterine action, which we are now
considering under the name of _spurious pains_.
_Treatment of spurious pains._ The indications of treatment depend in
great measure upon the cause; and we cannot impress it too strongly on the
young practitioner, as a rule never to be lost sight of, that, whatever is
wrong in the state of the circulation or of the bowels must be first
rectified before having recourse to opiates. Where the stomach is much
deranged at the beginning of labour, nature frequently induces spontaneous
vomiting, with considerable relief to the patient, and mitigation of the
pains; if not a gentle emetic may be administered. Where the bowels are
loaded, the treatment already mentioned must be put into practice, after
which [Symbol: minim] xx of Liquor Opii Sedativus and of antimonial wine
in peppermint water, or gr x of Dover's powder may be given. When there is
diarrhoea with a good deal of griping and tenesmus, a dose of castor oil
with Liquor Opii Sedativus in any aromatic water may be administered; and
if the labour be not yet commenced, gr v of Pil. Hydr. and Dover's powder
may be also given at night. If there be a plethoric or even inflammatory
condition, the lancet will be of the greatest service; it reduces the
temperature of the body, relaxes the soft parts, brings on copious
secretion of mucus, and by relieving the congested state of the uterine
parietes, enables the fibres to contract with more regularity and effect.
In the rheumatic form, laxatives followed by diaphoretics, the warm bath,
and even venesection will be necessary.
By thus treating the spurious pains according to their cause, they will
usually subside readily enough, and be either followed immediately by
pains of a more genuine and effective character, or leave the patient
perfectly free for several hours, or perhaps even days. It is by
inattention to, or ignorance of, these conditions, that patients have been
allowed to remain for several days in suffering, during which they have
been treated as if they had been in natural labour, until at length they
have become so exhausted that, when labour really made its appearance,
they were incapable of undergoing the exertions which this process
demands.
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