After-pains.—­Women who have borne children frequently suffer from the after-pains, occurring at irregular intervals, for two or three days and they may give rise to much distress.  A few drops of spirits of camphor on a lump of sugar will often give relief when they are not severe.  Also a drop of tincture of blue cohosh taken every two or three hours is valuable.

The bladder.—­If the patient is not able to pass urine it should be drawn once in eight or twelve hours or oftener if required.  A No.7 rubber catheter is best.  After it has been used, it should be sterilized by boiling and then kept in a bichloride solution (1-2000).  It should be washed off with boiled water again before being used to remove the bichloride solution and greased with sterile oil.  The parts should be exposed to pass the catheter, the labia separated by the finger and thumb, and the opening of the urethra and surrounding parts bathed clean with an antiseptic solution; unless you are clean decomposing discharges from the vagina may be introduced into the bladder and a cystitis set up.  The care of the bladder is very important.  It is not so sensitive after the labor and the woman may have urine when she does not think so.  Sometimes she passes a little after trying and then thinks there is no more in the bladder.  Even the attendants are deceived sometimes.  I once had a case where the mother was the nurse.  At each visit I inquired as to the amount of urine passed.  I was told each time it was sufficient.  She suffered severely the second day in the evening.  I went to see her and against the protests of the mother I used the catheter and took away an enormous quantity of urine.  In such cases the bladder should be emptied slowly to save the woman from shock.

A physician cannot always depend upon the patient’s knowledge of her condition even in such matters and sometimes even the nurse is at fault.

[538 Mothers’ remedies]

The bowels.—­There should be a movement of the bowels the second or third day, and a soap and water enema containing a small teaspoonful of spirits of turpentine and one-half ounce of glycerin, will usually be sufficient.  Later cascara cordial, castor oil, etc., may be used.  Should the breasts be much swollen and painful and fever arise, saline laxatives are needed for two or three days, such as citrate of magnesia, rochelle salts, hunyadi water or seidlitz powder may be given.

Care of the Breasts.—­Careful attention should be given them from the first.  The nipples should be bathed after labor, with an antiseptic lotion (bichloride, 1-2000), dried and then covered with castor oil, a small square of clean sterile gauze being laid over each to protect the clothing.  Bathe the nipples before and after each nursing with a warm saturated solution of boric acid and dry them carefully.  The breasts may be supported by a binder, made of