CONDITION OF THE BREASTS.

It should be the hope, as it is the first duty, of every mother to nurse the coming baby, and in preparation for this function all the healthful measures already set forth will play an important part. In addition to them, however, the breasts and nipples may require some special attention. Ample room for the development of the breasts must be allowed at all times by loose clothing. It will be well to have the physician observe the condition of the nipples about eight weeks before confinement, in order that he may determine whether or not they require special treatment. For toughening they may be washed with warm water and soap at bedtime and anointed afterwards with lanolin and covered with a piece of soft linen.

CARE OF THE TEETH.

The teeth are thought to be more susceptible to decay during pregnancy than ordinarily. This may be partly explained by the demand for the lime salts needed to build up the child's skeleton and partly by the effect that the regurgitation of the acid contents of the stomach has in the development and enlargement of cavities, which lead to toothache and the loosening of the teeth. For these reasons it is advisable for every woman, as soon as she knows that she is pregnant, to go to a good dentist and have such repairs made to her teeth as are needed. There is no reason to suppose that this will have any other than a beneficial effect if attended to early. In addition to this, the teeth should be brushed after each meal and the mouth well rinsed after any attack of vomiting or eructation of gas. Excellent washes for the mouth are a teaspoonful of milk of magnesia or a tablespoonful of limewater or half a teaspoonful of common baking soda dissolved in a glass of water, or other antiseptic washes.

COMPLICATIONS OF PREGNANCY AND HOW TO AVOID THEM.

DISTURBANCES OF THE KIDNEYS.

In order to know whether the kidneys are performing their functions normally, the quantity of urine passed in 24 hours should be measured. If there is less than 3 pints the patient is not drinking enough water. The same conclusion may be drawn when the urine has a darkened color and shows sediment, which conditions are usually due to concentration of the urine. The patient herself can draw no other conclusions from the appearance of the urine. Albumin and sugar, the two most significant abnormal elements, give no clue to their presence save in response to specific chemical tests. Accordingly specimens of the urine should be submitted frequently

to a physician, in order that he may make these tests, and, in case anything abnormal is found, order proper treatment. This examination is so important for her welfare that every woman should insist upon having it made at least once a month during the first half of pregnancy, and oftener toward the end. It is comparatively little trouble to do this, and is a precautionary measure that may serve to prevent a serious complication later. The method of collecting the urine is as follows:

Use a perfectly clean vessel or jar with a cover. Scald it thoroughly and keep in a cool place. Beginning at some convenient hour in the morning, say 8 o'clock, empty the bladder and throw the urine away. Thereafter empty the bladder into the jar each time until the next morning at the same hour. Keep the jar tightly covered. Measure the amount of urine passed, and, after shaking it well, fill a perfectly clean 6-ounce bottle, cork tightly, label with the name, date, and 24hour quantity, and send at once to the doctor. A teaspoonful of boracic acid will help to keep the contents of the jar from decomposing.

NAUSEA AND VOMITING.

The distressing but not usually alarming ailment known as "morning sickness," from which more than one-half of all pregnant women. suffer, may sometimes be relieved by taking a little dry food before rising, such as toast or crackers, chewed and swallowed without liquid; and some women find comfort in taking a cup of tea or coffee. An excellent preventive measure lies in eating six small meals a day, instead of three large ones, and eating very lightly at the last meal of the day. It is important to do all one can to ward off the initial attack, as the tendency to nausea is easily established. To adopt and maintain a healthful mental attitude is of great importance, as worry or any other morbid condition of the mind exaggerates this ailment. It is wise, therefore, to use every effort to keep the mind. from dwelling on the subject of sickness and anticipating an attack of nausea. Out-of-door life and plenty of normal, happy interests will do a great deal to counteract this illness. If, however, in spite of these measures vomiting persists or increases, the doctor should be notified, as the condition sometimes becomes serious enough to require medical skill to cope with it successfully.

HEARTBURN.

"Heartburn "--which, by the way, has nothing whatever to do with the heart-is the sensation of burning in the throat caused by an abnormal development of acid in the stomach. Since fat taken before meals serves to retard the secretion of acids, the trouble may sometimes be relieved by taking a glass of rich milk or a tablespoon90067°-15-3

ful of olive oil 15 or 20 minutes before meal time. If, however, the attack has begun, fat but makes it worse, and the patient must refrain from all fat, such as butter, milk, cream, and fried and greasy foods, until the attack is over. Some physicians prefer to treat this trouble by means of alkaline drinks.

VARICOSE VEINS.

The swelling of the surface veins of the legs, caused by the unusual pressure on the blood vessels, is a somewhat common accompaniment of pregnancy. The patient suffering from this trouble should sit or lie down very often, and when sitting should rest the feet on a stool or chair in order to relieve the pressure. Relief in severer cases may be obtained by wearing a thin flannel bandage about the calves of the legs. Bias strips of flannel, 3 inches wide, are sewed together flat until the strip measures 8 yards in length. It is best to bandage the legs before rising. Begin to wind at the toes, leaving the heel uncovered, carrying the bandage round and round the leg and well over the knees, or higher if the veins of the thigh are distended. The doctor or nurse will demonstrate the method of bandaging if the patient finds it difficult. If in spite of these measures the trouble persists, the doctor will direct the treatment.

HEMORRHOIDS OR PILES.

This ailment differs from varicose veins only in the location. Constipation exaggerates the trouble, and straining to evacuate the bowel is always to be avoided. The call to the closet should be heeded the moment it is felt, but if the bowel does not move readily some simple laxative, such as licorice powder, should be employed. The constant use of a laxative diet is the best preventive measure. The patient should lie down frequently while the attack persists. A pillow under the hips often relieves the pain.

CRAMPS.

In the later months of pregnancy the pressure on the nerves of the legs sometimes gives rise to cramps in the leg muscles. They may attack the patient during sleep or when the legs are suddenly stretched, upon waking. The pain is relieved by rubbing, applying hot cloths, or by elevating the feet.

LEUCORRHEA.

This is the whitish discharge from the vagina, due commonly to the congestion of the vaginal walls resulting from the pressure of the enlarging uterus on the blood vessels through which the blood is ordinarily returned to the general circulation. It is often annoying, but not usually serious. Douches should not be taken for its relief save under medical direction.

TOXEMIA.

As the child in the uterus grows there is constantly being sent back into the mother's blood an increasing amount of waste matter; if, in addition, the mother's own nutritional processes are imperfect and there is difficulty in eliminating all these waste products, a condition may result which will be more or less serious for both the mother and the child. This condition is called toxemia. Some of the common symptoms of toxemia are:

(1) Serious or persistent vomiting.

(2) Repeated headaches.

(3) Dizziness.

(4) Puffiness about the face and hands.

(5) Blurring of the vision, or spots before the eyes.

(6) Neuralgic pains, especially about the pit of the stomach. (7) Muscular twitching.

It must be understood that one or more of these symptoms does not necessarily indicate that toxemia is present, for in many cases the cause of these disturbances may be very easily removed and result in nothing of any consequence. But when such symptoms appear they should always be brought to the attention of the doctor and it will be well to send a specimen of the urine to him immediately. Prevention of the serious results of toxemia, by observing and reporting to the doctor the symptoms which precede it, is of great moment to all pregnant women. There is a tendency among women to regard some of these disturbances as the necessary accompaniment of the condition. There is no truth in the old saying that a “sick pregnancy is a safe one," and it should be entirely disregarded. There is no possible virtue, in pregnancy or in any other condition, in enduring any pain or distress that can be prevented by proper means, and much harm may result from such neglect. Every pregnant woman should strive to keep in mind the plain and simple rules for health, the most important of which it may not be amiss to bring together here:

(1) Guard scrupulously against continued constipation. (2) Avoid an excessive quantity of meat.

(3) Drink a liberal amount of water.

(4) Take plenty of out-door exercise and keep all the rooms of the house well ventilated day and night.

(5) Bathe every day.

(6) Wear light but suitably warm and comfortable clothing.

(7) Sleep at least 8 hours out of 24, and do not become overtired at any time.

(8) Have the urine examined at stated intervals.

(9) Strive to be happy, seek self-control, and do not worry. (10) Consult the doctor when symptoms of illness persist.

MISCARRIAGE.

It is not until the eighteenth week of pregnancy that the union between the placenta and the uterus becomes firm, consequently it is during these early weeks that miscarriage is most likely to occur. There are many possible causes of this mishap. Among them are heavy work, such as washing, sweeping, lifting, or moving heavy burdens, running a sewing machine, or other form of taxing labor, or it may result from indulgence in amusements that jar the body, such as dancing, skating, tennis, golf, horseback riding, climbing, or jolting over rough roads in a carriage or automobile. Miscarriage may also be due to imperfect development of the embryo or to some constitutional disease of the mother, or to some fault in the position of the uterus or to some abnormality of its lining, and in these cases it can not usually be avoided. Many times the cause is impossible to discover, and a woman may establish the habit of miscarriage.

The prevention of many of these accidents lies in guarding against overexertion in the early weeks. If the tendency to miscarriage has been established a prolonged stay in bed may carry a woman past the danger when no other means will avail. At the first appearance of bleeding or abdominal pain the patient should go to bed. If it persists, it is wise to send for the doctor in all cases, but especially if the pregnancy has advanced beyond the sixth week. If the doctor can not readily be summoned she must keep herself perfectly quiet until the disturbance has subsided. If the miscarriage occurs before the sixth week it may appear as nothing more than an unusually severe menstrual period, but a miscarriage at whatever stage is due to the loosening of the membranes which surround the fetus from their attachment to the walls of the uterus. If this loosening is so slight that the life of the fetus is not endangered a miscarriage may be averted, as has been said, by rest in bed. But if the bleeding continues or increases it shows that so great an area of the placental tissue has been detached from the uterine wall that miscarriage is sure to result. The danger then is that portions of this tissue may adhere to the uterus and not be expelled. In order to determine whether this is the case it is quite important that a doctor should be in attendance, and that whatever has been expelled be saved for his inspection. A neglected miscarriage may mean the total loss of health, while, on the other hand, a properly attended miscarriage is scarcely more likely to have bad results than a delivery at term. It is unreasonable and dangerous to regard a miscarriage as something to be concealed, and on this account to deprive oneself of proper care and treatment. This unhappy way of regarding a miscarriage is perhaps partly due to the association in many persons' minds of a miscarriage with a criminal abortion, the results of which are often serious and sometimes fatal. Such an attitude of mind is unjustified,