A Text-book of Diseases of WomenPenrose, Charles B. (Charles Bingham)
Science
A Text-book of Diseases of Women
Penrose, Charles B. (Charles Bingham)
Women -- Diseases
Thirst is always present after celiotomy, and is usually the symptom
of which the patient complains the most. There is much diversity of
practice in regard to the administration of water after celiotomy. The
writer allows no water during the first twenty-four hours. During this
time the lips and mouth are frequently moistened with a cloth wet in
cold water or wrapped about a piece of ice. At the end of twenty-four
hours small quantities of hot water or cold soda-water (1 dram) are
given every fifteen minutes or half hour, and gradually increased as it
is found to be retained by the stomach. Hot water relieves thirst as
well, and is not so likely to cause vomiting, as cold water.
The chief objection to the early administration of water after
celiotomy is that it may cause vomiting. Some operators avoid this by
administering the water by the rectum.
Another reason, more or less theoretical, for withholding water is that
the absorbing power of the peritoneum is greatest when the tissues of
the body contain a deficient amount of water.
Pain after celiotomy seems to bear no relation whatever to the
amount of traumatism that has been inflicted. More discomfort may
be experienced after ventro-suspension of the uterus than after a
hysterectomy. In operations upon the generative organs the chief
seat of pain is in the region of the sacrum. Pain is also felt in
the ovarian region and in the abdominal incision. The pain begins
to abate after the first fifteen or twenty hours. Opium should not
be administered unless it is absolutely necessary to allay nervous
excitement in a cowardly woman. In such a case a small dose (gr. ⅙) of
morphine may be administered hypodermically.
The writer rarely finds it necessary to administer an anodyne. Most
patients are able to endure the pain if they are properly encouraged by
the physician and the nurse.
There are several objections to the administration of opium. It
increases the thirst and it diminishes the functional activity of the
gastro-intestinal tract. It retards the passage of flatus by the rectum
and causes tympanites, and it increases the difficulty of moving the
bowels. It obscures and delays the recognition of symptoms that may
demand immediate treatment. The patient who has had no opium is more
comfortable at the end of three or four days after celiotomy than one
to whom it has been given.
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