(seq. 2)

Milk Fever

Proximate cause, an accumulation of milk in the breast
occasioning pain, {inflammation}, &c never terminating in gangrene
seldom in schirrus

Remote causes Cold constringing ye vessel, -- spirituous repellents
too sudden stoppage of ye Lochia

Predisponent a firmness & imperviousness of ye lactiferous tubes
in an irritable habit -- impeding ye flow of milk -- as in ye 1st lying in --
ye Lactiferous tubes are naturally convoluted -- but yy are made
more so by tight dress -- hence ye milk is drawn with difficulty

Suction makes ye breast more conical -- hence ye tubes straighter

Directions for the pregnant state

Catamenia not causd by a {general} Plethora -- not plethoric while
pregnant -- a Woman menstruates 4 {times} in a year -- ye Child
is found to weigh 15 lbs -- {Mineral} Waters -- Equitation & cold
bathing preferable to VS -- Nausea &c &c rather from a sympathetic
affection of Uterus & weak [?] than Plethora -- Cont Elx Vitrol &c But Excercise to
be avoided if {there} are symptoms of abortion -- or near ye latter end of pregnancy.
To keep open ye bowels -- ripe fruit -- small doses of Aloetics daily (if yy are
not subject to ye piles) mixd {from} alius antiseptic resinous gums -- gentle
emetics -- bitter teas, {vegetable} acids, Columbo, as it preserves bile from pu-
trefaction -- Neutrals -- raw eggs -- [by?] destroy ye tenacity of ye Gluten
obstructing ye D. Common Choledochus cures ye Jaundice --
Children never lie too high -- Women should wear jumps with large
shoulder straps -- if ye belly is pendulous -- Bandage above ye Pubis
{When} near delivery it is good to lye down often --

Natural Births

Confine ye patient to no position -- {When} a pain obliges her to lie
down -- {when} examine {when} it is going off if yr is a proper presentation
tell her off it -- but dont conclude {when} she {will} be delivered -- If costive an Enema
{which} also relieves ye spasms of ye abdomen -- Let ye position be what it will
during Labour -- yet ye Woman should be in a horizontal posture
{when} ye child is born -- grease not always to be used -- a hand against ye
Perinaeum to prevent Laceration -- After ye delivery of ye head ye
shoulders should be allowd to make ye turns -- resting between the
pains -- upon this depends ye easy or difficult exclusions of the
Secundines & After Pains -- {when} ye uterus is suddenly unloaded
ye uterus contracts irregularly & retains ye plactenta [illegible] by a spasm -- & after pains
causd by ye Relaxation {following} -- the Funis should not be cut, till ye circu-
lation has ceasd in it no matter if ye end toward ye woman does bleed
it open it -- Extract placenta by gently pulling ye Funis & {pressing} ye abdomen