In the majority of instances, there are practically no symptoms of pregnancy excepting the skipping of the menstrual flow, till about the beginning of the third month.

Morning sickness, consisting in nausea and vomiting of a little mucus usually begins in the third or fourth month and persists for three or four months, more or less regularly. Through sympathy, sometimes even without the witnessing of the attack, the husband may similarly be affected. In the latter case, the trouble is purely neurotic.

As soon as pregnancy is positively diagnosed, the hygienic and dietetic care of the woman should begin. Not to mention distinctly pathologic states, it should be borne in mind that pregnancy is practically a disease, with definite etiology - which may even be said to consist in the invasion of a germ, - symptomatology, organic and functional disturbances, and even a pretty definite mortality of not far from 1%.

Every pregnancy involves an increased strain on the circulatory organs and upon most or all of the glands, both ductless and excretory, concerned in metabolism. Aside from the pelvic organs, the thyroid, heart, vessels, kidneys and liver are the principal organs threatened.

The specious stimulation and secondary depression of tea, coffee and alcoholics should be avoided. The vulnerability of the liver renders it at least doubtful whether the common use of beer and ale is advisable. Moderate indulgence in these various habits may be allowed.

The ordinary cases of morning sickness require no special dietetic restriction, but it must be remembered that so-called morning sickness may be merely the first stage of a true hyperemesis or an indication of (1) uterine incarceration or other serious local abnormality requiring mechanic or genuinely surgical interference or (2) that it may indicate serious metabolic disturbance: a. of the thyroid; b. of the liver; c. of the kidneys; d on account of local septic involvement of a dead foetus; e. on account of alientary auto-intoxication; f. (a fact usually ignored by obstetricians and gynaecologists) on account of purely local functional or organic digestive disturbance, to which the pregnancy is at most a predisposing or exacerbating factor.

Hence, the use of one drug after another in the treatment of morning sickness and, a fortiori, of genuine hyperemesis, is asinine.

The diet throughout pregnancy should be simple but fairly varied. Particular care should be taken to exclude the beverages already mentioned, large amounts of meat, especially canned goods, sea foods at a distance from the ocean, undrawn poultry, stale eggs etc., in which decomposition may have begun, and also liver, thymus, kidney etc., on account of extractive waste.

Cereals, milk, cream and butter, fresh eggs, small amounts of fresh meat, poultry, fish etc., leguminosae (pod vegetables), both kinds of potatoes and other vegetables comparatively rich in nutriment and containing little indigestible residue, soft fruits free from seeds, should be the mai

While it is important to secure daily passages of the bowels, peristalsis should not be stimulated by undue amounts of seedy fruits, fodder vegetables etc., which act as mechanic irritants, nor by malt liquors etc., which act by favoring fermentation. It is far better to use cascara, purpetrol and other medicinal laxatives or to secure evacuation by enemas or soap or glycerine suppositories.

While the weight of the child amounts to little, less than two pounds a month including the membranes, placenta and liquor, amnii, allowance must be made for the metabolic changes in the foetus and for increased circulatory and other functions in the mother. Hence, the pregnant woman requires a more liberal diet than the non-pregnant. On the other hand, as violent exercise and hard labor are contraindicated, and as, during the last two or three months of pregnancy, the woman must be partially invalided, she is unable to care properly for foods that lay an extra strain on the digestive and eliminative organs.

It is advisable, if practicable, to check the quantity of nutriment ingested and the excretion of the nitrogenous waste, quite accurately. An excellent rule of thumb is that the nutriment should be sufficient to increase the weight quite regularly to the gross amount of two or three pounds a month.

Peculiar cravings should usually be gratified in moderation.

Any distinctly pathologic condition occurring during pregnancy, as anaemia, thyroid disturbance, renal insufficience or frank lesion, chorea etc., as well as diseases continued during pregnancy, require appropriate management which, in general, is not contra-indicated by the pregnancy itself.