The great difficulty of treating disease, by those who are not physicians, is the liability to mistake the character of the affection, being unable through obscurity of the symptoms to ascertain the organ or tissue affected. Without entering minutely into diagnosis, the author will endeavor to simplify the study of morbid conditions of the human body, so that the unscientific may more readily ascertain the disease and apply the appropriate remedy or treatment. 1. General condition pertaining to:
2. The general appearance of the patient.
3. The position or posture.
4. The sensations of the patient. Whenever any of these conditions are at variance with the normal state, the presumption, or rather certainty, is that some organ or tissue is assailed by disease. Some of the general indications of the patient in many cases often make known the character of the affection, when not suggested by other symptoms. For instance, the skin is remarkably moist and soft in delirium tremens; the perspiration profuse and sour in acute rheumatism; exhausting sweats in the latter stages of consumption or profuse suppuration; the crackling feeling of emphysema, and the pitting under pressure in dropsy. The pulse is hard and wiry in abdominal inflammations; in acute hydrocephalus its frequency is very great, slow and labored in brain diseases, irregular in disease of the heart, almost imperceptible in cholera or in the latter stages of the low fevers. The tongue covered with a thin white layer is indicative of disorder of the stomach; when patchy, the stomach is considerably irritated; when yellow, the patient is bilious; when shining, glazed, and chapped, it indicates long-continued inflammation or ulceration of the bowels; aphthous patches indicate imperfect nutrition, etc. In cholera the stools resemble rice-water; when clay-colored, it denotes a deficiency of bile; when yeast-like, fermentation takes place instead of digestion. The urine is dark-colored in fevers, very limpid and abundant in hysteria, scanty in dropsies, acid in rheumatism. The aspect is often very significant. In scrofula the corners of the nose and lips are swollen, in chlorosis a waxy pallor is observed, in malignant diseases a sallow hue, in heart-diseases a blue color of the lips, in pneumonia a dusky flush, in phthisis a hectic flush. When the expression is anxious, it indicates disease of the heart and dyspnoea; when pinched and contracted, there is much suffering, as in the low forms of fever; the skin is white in anaemia, yellow in jaundice and malignant cases; it has a muddy hue in splenic diseases, blue in cholera, and livid in commencing mortification. If the patient's head is elevated by choice in bed, it denotes heart-disease; when he is very feeble he lies on his back; in peritonitis the knees are drawn up; in cramps or pain of the abdomen, he lies on his side. In order that the reader may not have a confused
idea of what is meant by inflammation, I will describe it insomuch as to
give its phenomena. These are redness, heat, swelling, and pain.
When all these are present it constitutes inflammation. When a fever
or disease partakes of this character, it is inflammatory. Chronic
inflammation is characterized by all the essential conditions of the acute
form, differing, however, in this, by being preceded through all its changes
with symptoms so mild that it is only after a certain time that the patient
is much inconvenienced constitutionally. Inflammation always denotes
increase of activity of the vascular system. When of a localized
character, the increase is noticed in the capillary circulation; when general,
as in fevers, or of some important organ, the whole circulatory apparatus
is abnormally active.
MIASMATIC FEVERS These, as signified by name, owe their origin to, or are caused by, a peculiar principle to which the name of malaria or miasm has been given. Of the chemical nature of miasm we literally know nothing; but we have abundant evidence that it is a specific cause of disease. There are, practically, two kinds of malaria: First, koino-miasmata, the product of vegetable decomposition, or terrestrial emanations; second, Idio-miasmata, the deleterous effluvia originating from the decomposition of matter derived from the human body. Both of these are prolific causes of disease, yet the profession, owing to the subtile nature of the miasms, are in a great degree ignorant as to the manner of operation. These two causes may act separately, and produce their different symptoms, or they may operate together, causing a confusion of morbid phenomena. "Marsh gas," or the product of vegetable decomposition,
owing to its diversification, is of course the greater cause of disease.
Two requisites, heat and moisture, are necessary for its production; and
hence, where these abound in any quantity, so proportionably is the miasm
evolved. For this reason, low, marshy lands are at certain seasons
very unhealthy, while those regions at a greater elevation are peculiarly
healthy in this respect. Wherever vegetation is profuse, and to which
abundant heat and moisture are contributed, there we may reasonably expect
a plentiful product of miasm and consequent disease. Experiments
have proved that in decomposition of vegetable matter, animal matter--infusoria--is
produced in very rapid succession, having an exceedingly short-lived existence.
These infusoria are inhaled at every breath, as the air contains swarms
of them, but which are imperceptible to any of the senses. It is
reasonable to suppose that they, in a great measure, contribute largely
to periodic fevers. The diseases generally classed as Malarial are
Intermittent, Remittent, Yellow, and Typhus Fevers.
INTERMITTENT FEVER This is commonly called Fever and Ague, or Chills and Fever. As the name implies, the fever is not constant, as in the continual fevers, but intermits, so that in its career there are well-marked periods of absence of febrile symptoms. It is a fever characterized by a succession of attacks, with equal intervals and intermissions, that are complete, but irregular, owing to the paroxysms being of uncertain duration. By interval is meant the time from the beginning of one paroxysm to the beginning of the next, and by intermission the period of time between the close of one parosysm to the beginning of the next. The length of the interval determines the the variety of ague. When the interval is twenty-four hours, it is called quotidian; thirty-six hours, tertian; and when seventy-two hours, it is called quartan. These varieties duplicate, and are then called double quotidian, etc. The disease is announced by a proxysm which has three stages, the cold, the hot, and the sweating. The cold stage is well marked; the patient yawns, has a feeling of weakness, stretches, no appetite, and no inclination to move. Paleness is observed in the face and extremities; the patient shakes, the teeth chatter, and the skin shrinks, causing horripilation or "goose'flesh." When this stage declines, the hot stage comes on, which is characterized by a high fever. This is followed by the sweating stage, which increases from a mere moisture at first to a profuse perspiration. After this the body returns to its natural temperature, and apparent health returns. During the cold stage the circulation is thrown upon the internal organs, the spleen becomes congested, which organ is enlarged, causing what is known as the ague cake. A quotidian begins generally in the morning, a tertian at noon, and a quartan in the afternoon. The cold stage is shortest in the quotidian, and longest in the quartan. Intermittent fever is more common in the spring and autumn than at other seasons of the year, and in fall more severe and dangerous. TREATMENT. -- Commence treatment with a cathartic, as senna or the Renovating Pill. In the cold stage give hot drinks, and even stimulants may be of service. Induce warmth and comfort by extra covering, foot-baths, bottles filled with hot water applied to the surface, etc. In the hot stage, cooling drinks and anything that mollifies febrile action. When an intermission ensues, administer Peruvian
bark, or, preferably, one of its active principles, quinine. This
can be given in a large dose, or smaller doses repeated. Fifteen
grains may be given at once or in successive doses. It may be taken
in pills or in solution with elixir of vitriol. Quinine is a specific
in this disease, and it rarely ever fails in curing every case, if the
patient be placed under its influence. Peculiar head symptoms and
buzzing in the ears denote the influence of this admirable remedy.
My experience has not taught me that there is much danger in an overdose,
and I consider it more or less harmless; yet, like every other remedy,
it must be judiciously and intelligently administered. The web of
the black spider rolled up in five-grain pills, and taken, one pill at
a time every two hours, is a valuable domestic remedy. Decoctions
of dogwood bark are successful in many cases, so also of the bark of the
tulip tree.
REMITTENT FEVER This is commonly called Bilious Fever. It is a disease whose attack is generally sudden and well marked, without prominent premonitory symptoms, if any, at all times. There is sense of languor and debility for a few days previous to the onset; slight headache, lack of appetite, furred tongue, bitter taste in the mouth in the morning, pain in the joints, and a feeling of uneasiness. The first onset is announced by a rigor or chill, distinct in character, though generally brief and sometimes slight, but at times severe and prolonged. Sometimes the chill is first felt in the feet; at other times commences at the shoulder-blades, or in the back, running from thence through the whole body. Usually there is but one well-marked chill; the paroxysms of fever returning subsequently, and seldom preceded by a cold stage. The symptoms of this disease intensify at certain periods of the day; preceded occasionally, but not generally, by a chill. Between this period of severity in the febrile symptoms and a similar period following there is generally a decrease in the violence of the symptoms, during which the fever moderates, but does not, as in intermittent fever, totally disappear. It remits in severity, and hence the name. The pulse in the hot stage ranges from one hundred to one hundred and thirty. The pains in the head, back, and limbs are almost insufferable. The covering of the tongue is yellowish or dirty white, and in severe cases, in the advanced stage, the tongue is parched, brown or nearly black in the centre, and red at the edges. Food is distasteful, and nausea and vomiting ensue, with frequently pain, upon pressure, in the epigastrium. The bowels are at first costive, but become loose, and the faeces are dark and offensive. TREATMENT. -- Give an emetic or cathartic in the formative stage. When the disease is fully developed, sponge the body all over several times a day with cold or tepid water, whichever is most grateful to the patient, and give cooling drinks, as the effervescing draught. When the fever is high, moderate it with tincture or fluid extract of green hellebore, in doses of from three to ten drops. Dover's powder should be given as a diaphoretic. Ice-water can be drunk at pleasure. A mustard poultice should be placed over the pit of the stomach whenever tenderness exists. Quinine is the great remedy in this disease also, and should be administered in the same manner as advised in fever and ague. It is to be given in a remission. Whenever the fever has been subdued by large doses of quinine, its administration should not be abruptly ceased, but be continued in smaller or tonic doses for several weeks afterward. There is a form of fever called Congestive. It is also called pernicious fever. It is not essentially remittent, but may also be intermittent in character. The congestion may only operate upon one of the internal organs, or upon all of them. Congestion may ensue in the earlier or later stage of the disease. There is usually congestion of the brain, and profound stupor follows. It assumes all types of periodic fevers, but is more frequently quotidian or tertian. The first attack generally simulates a simple attack of intermittent, and excites but little attention. The second attack is severe, producing great coldness, and the patient has a deathlike hue of face and extremities. As the disease advances, the heat of the skin becomes pungent. The skin also becomes dry, husky, and parched, followed, after a time, by a cold, clammy sensation. The eyes are dull and watery, and at times glassy, the countenance dull, sleepy, and distressed; the tongue trembles upon protrusion, indicating weakness, and is at first covered with a whitish fur, which changes to either brown or black; the breathing is difficult, and inspirations often thirty to the minute. Pressure over the liver, stomach, or bowels occasions pain; and the mind is often disturbed, and falls into lethargy and stupor, or is delirious. The treatment is the same as in remittent fever. Quinine and the other remedies are of the same signal service. In stupor friction is to be made along the course of the spine with spirits of turpentine or ammonia. In convalescence the diet must be light and nutritious, and as strength returns may be increased. Exercise out of doors should be encouraged. If recovery be slow, it should be hastened by wine, ale, or brandy, and the usual vegetable tonics. Any person who is suffering from almost a continuity
of the disease, or the so-called chronic form of malarial fever, desirous
of corresponding with me on the subject, I should be most happy to reply
to, for in the vast and beneficent domain of Herbalism there are many remedies
that can be advised as curative, to mention which would occupy too much
space in a volume of this size. We can be eclectic in Nature's laboratory.
YELLOW-FEVER The first symptoms of this fever seem identical with remittent, often well marked by periodicity, but finally reaction occurs, and it assumes a typhoid character. The disease is ushered in generally with a chill, severe at times, though usually moderate, of short duration, and rarely repeated. The chill is followed by slight fever, with increased heat of surface; but this rarely rises to any considerable height, and continues only for two or three days, when, in cases likely to prove fatal, it is succeeded by coldness of surface, etc. Sweating exists in many cases. The pulse is singular in character, but rarely rises above a hundred; the tongue is moist and white for the first few days, but as the disease advances it becomes red, smooth, shining, and dry, having a black streak in the middle. The most prominent symptoms are nausea and vomiting. In fatal cases the vomiting is persistent, and towards the termination the green biliary matter thrown up changes to a thin black fluid, having a sediment like the grounds of coffee. This is the terrible black vomit (vomita-nigra)of yellow-fever. The bowels are generally costive, and the abdomen tender upon pressure. Severe headache generally exists, and the countenance bears a singular expression, in which a smile seems to play upon the lips, but the rest of the face bears a wild or sad look. Restlessness is common to this disease night and day. Blood often escapes from the nose, gums, ears, stomach, bowels, and urinary passages. The skin bears a tinged color similar to that in jaundice. The disease appears both endemically and epidemically. At first the disease is hard to recognize, presenting but the usual symptoms of fevers in their incipient stage, with no symptoms to distinguish the disease, or, if any, very obscure; but when the severe pain in the back and loins exists, the conjunctiva injected, and a red flush of the face and forehead is present, the identity of the disease is no longer in doubt, especially when extraneous circumstances, calculated to suggest the probability of an attack of yellow-fever, are also present. TREATMENT. -- In the early stage of the attack it should be treated, as regards medicines, the same as a case of malarial fever. If any derangement of the stomach exists, a gentle emetic is proper; this rouses the nervous system from its lethargy, promotes the action of the liver, and, by determining the blood to the surface, restores the capillary circulation. The best emetic for this purpose is lobelia combined with boneset. The febrile stage requires a thorough bath with tepid water and whiskey over the entire surface, with friction by rubbing with a towel or the hand. Large mustard poultices should be placed over the spine and abdomen. Immediately upon the decline of fever, if the symptoms denote urgency, administer the antiperiodic remedies advised in intermittent and remittent fever. The sulphate of quinia may be combined with tannin, because the astringent properties of the tannin have a beneficial effect in subduing inflammatory action of the mucous membranes. This remedy should not be delayed a moment if the patient is in a period of prostration, and its retention by the stomach should be favored by anodynes, carminatives, or stimulants, as the case may require. Oil of turpentine and Cayenne pepper can also be combined with advantage in this disease. The strength of the patient must be supported by every means that can be employed -- gruel and weak animal broths, bread-water, my nutritive fluids, milk and water, etc., are important means for this object. The revulsive influence of a blister over the stomach is of great service in this state. If reaction is induced and convalescence established, the remaining strength of the patient must be careully husbanded by proper tonics and wholesome and digestible diet, increasing the quantity as the patient gains strength. All exposed to yellow-fever should avoid the night-air
and sudden changes of temperature; they should sleep in the highest part
of the house; be moderate in taking exercise; they should take nutritious
but not stimulating food, and never expose themselves to infected air with
empty stomachs or when fatigued.
TYPHUS FEVER This is also called Hospital, Jail, Camp, Putrid, and Ship Fever. It is usually preceded by lassitude, debility, and loss of appetite, and ushered in by rigors and chills, and characterized by frequent exacerbations and declines during its progress. It generally presents itself as an epidemic, and runs a uniform course. From the third to the seventh day of the fever the peculiar petechial eruption occurs. It is of a florid, reddish, or reddish-pink color, disappearing on pressure, which distinguishes it from the petechiae of typhoid. The breathing is hurried, the skin dry and hot, the tongue thickly coated, and the thirst urgent. There is great distress about the head, which often results in delirium. This stage of excitement continues generally, with little increase or abatement in the symptoms, for some time. The fever is greatest towards evening, least in the morning. The bowels are generally costive, and if it continues for some time, all the secretions become vitiated, the body exhaling a nauseous odor, and the tongue, gums, and teeth become coated with a dark-brown slime. Collapse generally follows, voluntary powers depressed, surface relaxed, and diminished in temperature, often covered with a clammy sweat; pulse small and tremulous. The tongue becomes black and dry, voice faint, breathing short, feeble, and very anxious. The mental functions become greatly disordered, the patient is restless and fearful, his delirium is low-muttering, and he lies in a state of stupor from which he can be scarcely aroused. Often an irritating cough is present, coming on as if in convulsive paroxysms. In this stage of collapse the patient is disposed to lie on his back, with his feet drawn up, and there is a great tendency in his body to slide towards the foot of the bed. As the disease progresses, all the symptoms of prostration increase. A convulsive motion of the tendons, as in typhoid, is observed; his stupor becomes fixed; hiccough, involuntary discharges from the bowels, a cadaverous smell of the body, generally occur towards the close of the disease. Death, in violent cases, is generally preceded by extreme prostration, cold, clammy sweats, involuntary fecal discharges, and a discharge of grumous blood from the mouth, nose, and anus; or by convulsions. This is a contagious disease, and emphatically one of poverty and low life. TREATMENT. -- Place the patient in a well-ventilated
apartment, wash the body with soap and water, and give an emetic and cathartic,
if the patient's condition requires it. Then give quinine in two
or three grain doses every two or three hours, until its effects are observable.
Control the fever with veratrum, as advised in typhoid cases. If
great prostration is present, add capsicum or prickly-ash to the quinine,
which should be continued in regular doses throughout the greater part
of the course of the disease. A decoction of ladies-slipper, or,
preferably, cypripedin, in two or three grain doses every two hours, should
be given in delirium or tendinous convulsions. Support the strength
with iced-milk, chicken-broth, beef-tea, milk-punch, etc. The bladder
should receive attention, and, if distended, should be evacuated by the
influence of a sitz-bath, or by a catheter. In cases of cerebro-spinal
congestions, make counter-irritations along the course of the spine, apply
cold water to the head, and bottles of hot water to the feet. Convalescence
is to be aided by the proper tonics, as golden-seal, columbo, etc., and
complete repose should be allowed to the convalescent.
ERUPTIVE OR EXANTHEMATOUS FEVERS These are all characterized by fever and the usual
constitutional disturbances, together with an eruption or exanthem distinguishing
each variety. They owe their origin to animal or vegetable malaria,
or both combined, and the peculiarities of this class are, that they, when
once affecting the system, render the patient comparatively excmpt from
any future attack of the disease.
TYPHOID FEVER This is a very insidious disease, its commencement being scarcely perceptible. The patient has a sense of indisposition, but is unable to describe his condition. He feels slight debility, a dull and heavy feeling in the head, which increases and terminates in violent frontal headache. At full development of the disease, the limbs are weak, accompanied by lameness, and sometimes rheumatic pain. The bowels may at first be constipated, but in a few days the tendency is to diarrhoea. The pulse is quickened, a creeping, chilly sensation is felt, and the skin is dry and warm. The tongue is but slightly coated, and the appetite often remains until the disease is fully developed. After the full development, a number of small vesicles, called sudaminae, may be observed on the abdomen. They are small, and may escape notice unless carefully observed. On the fifth day after the occurrence of these, another eruption occurs, which consists of small red or purple spots, resembling flea-bites. These spots are called petechiae. If these are observed, the disease is unmistakably typhoid fever. When the abdomen is percussed, it yields a drum-like resonance, and a gurgling may be heard on the right side, a little below the navel. Nervous symptoms arise, frequently delirium, great pain in different parts of the body, stupor, and a buzzing noise in the head are often complained of. The tongue becomes red, and is protruded with much difficulty, pulse increases, eyes have a watery appearance, and remain partly open when asleep. The breathing becomes difficult, mouth half open; and a black substance (sordes) collects on the teeth. The urine becomes nearly suppressed, and has a dark-red appearance. The bowels bloat, and evacuations of frothy and watery excrement are frequent. If the disease is about to terminate unfavorably, the patient becomes stupid, with low, muttering delirium, his muscles jerk, hiccoughs, picks at bed-clothes, and labors under profound coma. The anatomical character of this disease is ulceration of certain glands, called Peyerian, of the intestines, which are sometimes perforated by the process, when, of course, death inevitably follows. The course of the disease is from 11 to 21 days. TREATMENT. -- If the disease is suspected, the patient
should be placed in bed, and his bowels evacuated by warm-water injections,
if costive. If indigestible food is contained in his stomach, an
emetic of lobelia should be administered. Rice-gruel should then
be given. The tincture of American Hellebore should, on the approach
of the febrile paroxysm, be given until the pulse becomes less frequent,
and perspiration ensues. Lye and slippery-elm poultices should be
applied to the abdomen as long as bowel symptoms prove troublesome.
Quinine and Hydrastin should be exhibited, with a view to overcome the
periodicity of the fever. At the same time a cold infusion of marsh
mallow, acacia, and flax-seed, should be taken. Apply cold water
to the head, and keep the feet warm. Control the fever throughout
its whole course with the veratrum or aconite. If the patient is
restless and unable to sleep, give a little morphine in a decoction of
Ladies'-slipper. If the diarrhoea is persistent, let the patient
take a decoction of rhus and cranes-bill. When the red tongue is
noticed, administer the spirits of turpentine, in from six to ten drop
doses, three or four times a day. Beef-tea, brandy, etc., should
be given to support the strength through the course of the disease.
During convalescence care should be taken that the patient does not eat
hearty food. Convalescence should be assisted by golden-seal and
other tonics. The danger in the treatment of this disease is over-medication,
and hence only such agents as are chemically called for should be given,
and the patient's strength well supported throughout the course of the
fever.
DIPHTHERIA Diphtheria is scarcely more than a modification of scarlet fever. The patient first complains of lassitude, headache, loss of appetite, has rigors and chills, active and quick pulse, a light furred tongue, redness of the back of mouth, enlargement of the glands about the neck, a hot, dry and pungent skin, and in most cases an exudation upon the mucous surfaces of the upper air-passsages. This soon becomes organized into a tough, white membrane, covering the soft palate and tonsils. These sometimes degenerate into ulcers. The breathing in consequence of this membrane becomes hurried and difficult, pulse quick, and frequently the asphyxia ensuing ends in death. It generally reigns as an epidemic and is regarded as contagious. TREATMENT. -- The first step in the treatment should be a thorough emetic and an active cathartic; free perspiration should be produced by aconite or veratrum, and the kidneys should be kept in vigorous operation. Flannel cloths, wet with the compound tincture of capsicum, myrrh, and lobelia, should be applied to the neck, changed every half hour, and applied as hot as the patient can bear it. Jugs of hot water should be applied to the feet. The inflammation of the throat should be subdued by a gargle of a hot decoction of golden-seal. If the disease assumes an unfavorable aspect, give a powder containing one grain of quinine, one-half grain of capsicum, and one grain of hydrastin every two hours. If the patches ulcerate, use a gargle of sumach and wild indigo. For the difficulty of breathing give sanguinaria and lobelia in emetic doses for the purpose of dislodging the membrane. The secretions should be increased even to ptyalism by irisin, the effect of which will be to overcome the adhesiveness of the membrane. The "Herbal Ointment" used for this purpose, and also to subdue the local inflammation, acts specifically and should be used in all cases. During convalescence the diet should be nutritious,
and baths, fresh air, and a liberal amount of fresh fruits ordered.
SMALL-POX (Variola) The symptoms are divided into four periods. The period of invasion occupies about three days, and is marked by languor, lassitude, restlessness, stretching, gaping, petulance, sullen mood; these are followed by chills and rigors. Towards evening the skin becomes hot and dry, pain attacks the head, loss of appetite, nausea, and frequently lumbago. On the third day, heat, fever, flushed face, headache, and in children sometimes convulsions. The period of eruption commences on the fourth day (often on the third), with the appearance of a series of small red circular points (papulae). They do not rise above the surface then, but can be seen in it, and felt by the finger. They are situated in the substance of the skin, and roll about under the finger, the size that of a small pin's head. These gradually enlarge, the patient in the mean time suffering severely, until the period of suppuration arrives. The fever is now great, the hands, feet, and face swell, and salivation is profuse and constant. There is hoarseness and pain, and the saliva emits a most disagreeable odor. Then comes the period of recovery. The pustules scab, the fever and other unpleasant symptoms gradually disappear, and, if all goes right, the danger is over from the twelfth to the fifteenth day after the eruption. What is known as confluent small-pox is when the pustules are very numerous and running together; and when all the symptoms are very severe, the disease is known as malignant. Variola patients emit a peculiar fetid odor, which is characteristic, and distinguishes it from Varioloid. TREATMENT. -- An active purge should be given at the outset. For this purpose a combination like the "Renovating Pills" should be selected, as the catharsis produced is thorough and unattended with subsequent debility or costiveness. Diaphoretics should be given to promote early appearance of the eruption. The patient should be placed in a cool and well-ventilated room, and frequently sponged with tepid water. Not much treatment of a medicinal character is required. The fever should be controlled by aconite or veratrum, as in all active fevers. If complicated with pneumonia, pleurisy, etc., the treatment necessary is such as is advised in those diseases. Pitting to a great extent may be avoided by sweet-oil applied to hands and face. Varioloid is but modified small-pox. It has all the essential characteristics of the disease except its virulence. The treatment is the same as advised for small pox. The utility of vaccination is a mooted question.
It has unquestionably done great harm, as in many cases scrofulous and
syphilitic taints have been implanted. Aside from this, however,
it has been the means of almost banishing the dreadful plague from existence,
and its practice should be encouraged. Great care, however, should
be exercised in the selection of the vaccine virus, so that its purity
is unquestionably established before being used as an agent of prevention.
CHICKEN POX (Varicella) This is a very mild eruptive disease, characterized by a slight fever of short duration, and followed by vesicles which desquamate about the fifth or sixth day. The fever is sometimes ushered in by slight rigors, though there is seldom any chill. There is often headache, and vomiting occasionally. The eruption appears in one or two days after the inauguration of the fever. It consists of red spots at first, which quickly become vesicular, and are frequently attended with itching. TREATMENT. -- Very little treatment is required,
except in cases of feeble vitality, when the disease often assumes a severe
character. In such cases the stomach and bowels should be well-cleansed,
the surface sponged with hot water, and the fever controlled with arterial
sedatives. Tonics should be given if the patient is enfeebled.
The diet should be nutritious, but composed of easily digested articles.
MEASLES (Rubeola). This is an acute inflammation of the entire skin, of an infectious and contagious nature. It is ushered in with chills, followed by heat, drowsiness, pain in head, back, and limbs, sore throat, dry cough, and other symptoms common to febrile action, growing in violence until the fourth day. Then the eruption appears, producing heat and itching. The breaking out appears in patches of half-moon shape, which distinguishes this disease from the other eruptive diseases. They reach their height at the fifth day on the face and neck, and on the legs about the seventh day. Their decline is in the same order as appearance, disappearing about the tenth day, when the scarfskin peals off in the shape of scurf. TREATMENT. -- If the attack be a mild one, all the
treatment necessaxy consists in light diet, acid and demulcent drinks,
as flaxseed-tea decoction of slippery-elm, etc. Sponging with tepid water
is very grateful to the sufferer in all cases. If during the first stage
the eruption should be tardy in its coming, it should be hastened by a
warm bath, and sweating drinks made from saffron, mullein, pennyroyal,
summer savory, etc. If tardy on account of excessive fever, give tincture
of green hellebore, ipecac, lobelia, snake-root, etc. In enfeebled constitutions
stimulants axe necessary.
SCARLET FEVER (Scarlatina). Also a contagious disease. The eruption is in the shape of pimples of a scarlet hue, displayed in patches over the whole surface. The fever is usually more intense than in measles, and accompanied by sore throat, swollen face, and coated tongue. The greatest degree of redness is attained at the third or fourth day. The decline is the same as in measles. Scarlet fever is distinguished from other diseases by the swollen condition of the flesh, which spreads out the fingers peculiarly. The throat becomes ulcerated, and swallowing is attended with pain and difficulty. There is no cough, which also distinguishes it from measles. The following will show the difference between scarlet fever and measles: In Scarlet Fever. The eruption is bright scarlet.
In Measles. The eruption is dark-red color.
TREATMENT. -- This should be cooling in its nature,
cooling drinks, sponging with cold water, etc. In ordinary cases little
more is required, excepting a few drops of tincture of belladonna may be
given several times per day. When high fever exists, give the remedies
advised in measles. Hot foot-baths are advisable. As this is a prostrative
disease, beef-tea and the ordinary stimulants should be given from the
first. What is called malignant scarlet fever is only a severer form than
the above. Gargles of sage and Cayenne pepper are used to allay the throat
aftections. The abscesses in the region of-the ear, and consequent deafness,
can be obviated by subduing the inflammation of that part by the usual
methods.
NETTLE RASH This commences with fever, lasting two or three days; then itching pimples, diversified in shape, appear, which go off during the day and come again at night. Teething causes it sometimes, while at other times it is due to improper diet. TREATMENT. -- This is indicated by the cause.
If due to indigentible food, the stomach must be unloaded by an emetic
of blood-root or ipecacuanha. A lotion of vinegar and water is of
service. Tonics and simple diet will complete the cure.
ERYSIPELAS This disease commences with languor, aching or soreness of the limbs, chilliness, alternating with flushes of heat. The pulse is quick, skin hot, tongue foul, appetite gone, thirst, nausea sometimes; vomiting, headache, restlessness, sore throat, swelling and tenderness of the glands of the neck, arm-pits, or groin, according to the seat of the cutaneous inflammation. The eruption usually makes its appearance, about the third day of the fever, in the form of a small reddish spot, somewhat elevated, painful or tender to the touch. This occurs most frequently upon the face, especially on the side of the nose, cheek, or rim of the ear. In some instances the inflammation advances slowly, in others it spreads quickly over large portions of the body, accompanied by tumefaction, and a burning and stinging pain in all cases. About the third day of the inflammation small blisters, filled with yellow serum, appear, which break about three days afterward. On the fifth or sixth day they begin to dry, and on the seventh or eighth form crusts or scabs, which desquamate, and a new skin forms. In phlegmonous erysipelas the inflammation involves not only the skin, but the subcutaneous tissues also, and the symptoms are all severer. It often assumes a very malignant type, and is then a disease of a most fatal character. It is liable to attack wounds; and those who are nursing patients suffering with erysipelas should never wait upon a woman who has been but recently confined, as she will be very liable to contract puerperal peritonitis, a very fatal disease. TREATMENT. -- Give a lobelia emetic, a mild purge;
and a hot bath at the commencement. In the mild form cover the inflamed
patch with collodion, and renew every two or three hours. The emetic
and purge should be followed with quinine in two or three grain doses every
three hours. The inflamed surface should also be washed with a decoction
of the bark, or a solution of quinine. Bruised cranberries are a
good application. Cloths wrung out of a hot decoction of white-oak
bark and golden-seal should be applied to the inflamed part to prevent
spreading. In wounds apply lint saturated with compound tincture
of myrrh and capsicum. If the fever is violent, treat it as in all
other febrile cases. A nutritive diet should follow medical treatment
as soon as the disease has passed its active career.
ROSE RASH (Roseola) This is an eruptive disease of little importance. The febrile symptoms are slight, more or less attended with gastric derangement, which continues two or three days before the rash appears and subsides with it. The eruption generally commences upon the face, is of uniform redness, and causes itching or tingling. The rash continues from one to five days, and is followed by a slight scaling off of the skin. It is often the accompaniment of dentition and is not contagious. TREATMENT. -- Little more is necessary than a warm
bath and a few drops of veratrum. If the eruption is troublesome,
two or three drops of tincture of Belladonna should be added to a tumbler
of water, and a teaspoonful given occasionally.
ERYTHEMA The eruption of this disease is of superficial redness, generally in irregular patches, slightly elevated, and attended with heat, tingling, and sometimes slight pain. It may be local or owing to constitutional disturbance. It may be caused by friction of contiguous surfaces, as in the groin and arm-pits, in fat infants, particularly when not frequently washed. When owing to constitutional causes, it usually appears on the face, breast or limbs. It lasts from a few days to a week or longer. TREATMENT. -- If the cause can be ascertained, it
should be removed by the proper remedies. Anoint the affected part
with a little lime-water and sweet-oil, or bathe with a strong decoction
of golden-seal. Glycerine may also be applied, but if you can procure
the "Herbal Ointment" (see page 469) I advise its application, as it is
a specific for this and kindred affections.
GLANDERS This may be contracted from the horse, and is a very malignant disease. It is characterized by a purulent and sometimes bloody discharge from the nose, a peculiar pustular eruption, and by tumors in different parts of the body. Its initial stage is the same as in all eruptive fevers, attended with neuralgic pains in the limbs. In the course of four or five days the eruption makes its appearance in different parts of the body, usually most abundant upon the face and limbs. The discharge from the nose ensues in the course of a week or ten days, being at first yellowish, afterwards bloody, and very offensive. The body finally exhales a fetid odor, the mind wanders, delirium and coma follow, and by the end of the second week, or during the third, it generally proves fatal, if not arrested sooner in its course. It is fortunately very rare; and attendants upon a horse affected with glanders should be very careful that they do not come in contact with the virus. The affected horse should be shot, as the disease is very seldom cured. TREATMENT. -- Support the strength of the patient,
and stimulate the emunctories. This can be best achieved by a thorough
alcoholic vapor bath, followed by an active lobelia emetic and a brisk
cathartic. After this give quinine, three grains, and baptisia, two
grains, every two or three hours, for a day or two. The nostrils
should be syringed with warm water, to which a few drops of creosote has
been added, three or four times a day. The throat may be gargled
with the same preparation. Support the strength with chicken-broth,
rice-gruel, cream, punch, porter, ale, etc. If this course is not
effectual, repeat every three or four days.
DANDY FEVER (Dengue) This disease occasionally prevails as an epidemic in the southern seacost towns. There is pain, stiffness of the neck, back, and loins, and swelling of the muscles of the limbs and joints. Intolerance of light, restlessness, chilliness, fever, headache, a full and quick pulse, red eyes, a hot and dry skin, and an intense thirst prevail. The fever usually lasts from one to two days, when a gradual remission occurs, and the patient feels quite comfortable. After an interval of two or three days the fever returns, the pains are increased, the tongue is thickly coated, the stomach irritable, and the patient becomes dejected and fretful. Nausea is a prominent symptom, but seldom any vomiting occurs. About the sixth or seventh day an eruption, resembling scarlatina, appears, and gives relief to the distressing symptoms. It disappears after two or three days, the color of the skin gradually fading, with slight desquamation. The duration of the disease is about eight days. The causes are evidently miasmatic poison, in concert with epidemic influence. TREATMENT. -- Essentially the same as in scarlatina,
accompanied with such remedies as advised in rheumatism. Quinine,
in antiperiodic doses, should also be administered, and the anodynes should
be given if the pains are severe. Tonics may be required in some
cases; and in convalescence, frequent baths, a generous diet, and out-door
exercises should be prescribed.
PURPURA This affection is characterized by a greater or lesser number of livid spots on the skin, from extravasated blood. In simple cases the effusion is confined to the skin and cellular tissues, mostly occurring on the arms, legs, and breasts. The spots at first are small, and resemble flea-bites. The countenance is pale, and the patient complains of debility, loss of appetite, irregularity of the bowels, and periodic fever. If allowed to progress, it will assume a form known as purpura hemorrhagica, in which the spots are longer, and resemble whip-marks or violent bruises. They are a bright red at first, but become purple or livid. A great variety of symptoms are presented by each case, and the disease is a very singular one. TREATMENT. -- In the simple form a very liberal diet
of fresh vegetables, out-door exercise, and some simple tonic, are all
that is necessary. In the hemorrhagic character, quinine, in one
or two grain doses, should be given every three hours. Diet should
consist of green vegetables, salt meats, eggs, and the free use of lemonade.
A liniment of camphor, whiskey, and turpentine should be externally applied.
If internal hemorrahge occurs, give oil of erigeron, in five-drop doses,
every half hour; or matico, in from five to ten grain doses, may be administered
every twenty minutes until it ceases.
ANATOMY OF THE ORGANS OF DIGESTION Mouth. -- The mouth is separated from the nose by the hard and soft palate, and communicates. It is bounded in front by the lips, and its sides by the cheeks. The space between the lips and teeth is called the vestibule. The mouth is lined by a mucous membrane, which is covered by numerous glands, some being mucous and some salivary. The mouth contains a double row of teeth, thirty-two in the aggregate, performing the first process in digestion, the mastication of food. Tongue. -- The tongue is an oblong, flattened, muscular body, which varies in size and shape; it is the organ of taste, and also of importance in speech and mastication. Its posterior extremity or root is attached to a bone, called the hyoid, by yellow fibrous tissue. Its anterior extremity is called the tip; its intervening portion its body. The mucous covering of the tongue is very thick upon its upper surface, and very thin upon its under surface. Upon its upper surface are a number of projections, of various sizes and shapes, called papillae. The largest are eight or nine in number, called papillae maximae, and are situated at the posterior portion of the tongue, in two convergent lines. The smallest papillae are fine and pointed, and are found near the middle of the tongue, and are termed filiform. The tongue assists in the process of deglutition. Palate. -- The palate separates the back portion of the nose from the mouth, and is divided into two parts. The hard palate, of a bony base, covered by mucous membrane, which is continuous with that of the mouth; the soft palate is the membranous separation between the back portion of the mouth and nose. From the middle the uvula projects, about three quarters of an inch in length; from each side of the uvula there are two divergent creswcdentic folds of mucous membrane, which are called lateral half-arches; the space between which constitutes the fauces. Between the anterior and posterior arches of each side is the tonsil gland. The tonsils are about the size of an almond, and consist of a collection of large mucous follicles. Salivary Glands. -- The salivary glands are of light pink color, and their secretion is of great service in mastication and digestion. There are three in number -- the parotid, submaxillary, and sublingual. The parotid is the largest; it lies on the side of the face in front of the ear, and beneath the skin. The submaxillary lies in a depression on the internal face of the lower jaw-bone. The sublingual is the smallest of the three; it is situated under the tongue. Pharynx. -- The pharynx is a muscular and membranous sac, communicating with the mouth, nose, oesophagus, larynx, and the tube (Eustachian) leading to the ear. Its length is about five inches, although this varies by extension and contraction. Its uses are for deglutition, respiration, and modulation of the voice. Oesophagus. -- This is the canal that conveys the food from the pharynx to the stomach. Its length is about nine or ten inches, and its diameter is not uniform, gradually increasing (as it descends). Its upper portion is the narrowest part of the alimentary canal; and hence foreign bodies which are too large to pass through the alimentary canal are generally arrested in the neck. It never contains air. Deglutition is performed by the contraction of the longitudinal fibres of the oesophagus, which shorten the passage, and by contraction of its circular fibres successively from above downward. Stomach. -- The stomach is a conoidal sac, somewhat bent or curved, and situated below the breast-bone or in the epigastric region. The left extremity is much the larger, and terminates in a rounded sac; at the upper portions of this extremity is the cardiac orifice where the oesophagus is continued into the stomach, immediately below the diaphragm. The right extremity is continuous with the intestines, and its orifice is called the pyloric. The structure of the pylorus is much thicker than that of any other portion. The stomach is held in its position by the oesophagus and the duodenum, as well as by reflexions of the peritoneum. The upper and lower curvatures of the stomach are called the greater and lesser curvatures. Near the pyloric extremity of the stomach is a small dilatation called the antrum pylori. The dimensions of the stomach are variable, depending upon the mode of life. It has four coats; the peritoneal, muscular, cellular and mucous. In the stomach the food receives the admixture of the gastric juice, which is the solvent agent of digestion. The fluids taken into the stomach are for the most part absorbed from it; the solids, with the exception of the insoluble parts, are by the action of the gastric juice reduced to a substance called chyme, which in general is grayish, semi-fluid, homogeneous, with a slightly acid taste and smell. The chyme is then poured into the duodenum through the pyloric orifice for the subsequent action of the intestines. Intestines. -- The intestinal canal is from thirty to thirty-five feet in length, and is divided into large and small intestines. The small intestine is four-fifths of the length of the whole canal, reaching from the pylorus to the large intestine; it is cylindrical, and about one inch in diameter; there is a gradual diminution in calibre as it descends. Its coats are the same as those of the stomach. The mucous coat is very vascular, and its absorbents are very numerous. The glands are the crypts or follicles of Lieberkuhn, the glands of Peyer, the solitary glands, and Brunner's glands. The small intestine is divided into duodenum, jejunam, and ileum. The Duodenum commences at the pylorus, and is about twelve inches long. The common duct formed by the junction of the bile and gall ducts opens into it about four or five inches from the pylorus. The Jejunum (from jejunus, empty) constitutes the upper two-fifths of the small intestine, and the ileum the remaining three-fifths. The large intestine reaches from the ileum to the anus, and is one-fifth in length of the whole canal; it differs much from the small intestine, and has a sacculated appearance. It likewise has four coats. It is divided into caecum, colon, and rectum. The Caecum is a cul-de-sac or blind sac, and the commencement of the large intestine, and hence often called the caput coli. At the inferior portion is a worm-like process called the appendix vermiformis. On the side of the caecum is the ileo-caecal valve, an elliptical opening whereby the small intestine empties into the large. The Colon is the largest portion of the large intestine;
gradually diminishes in diameter until it terminates in the sigmoid or
S-like flexure on the left side. It ascends on the right side, and
forming an arch transversely, descends upon the left side. The Rectum
is the terminating portion of the large intestine, and reaches from the
sigmoid flexure to the anus. It is somewhat barrel-shaped, being
larger in the middle than at either end.
DISEASES OF THE DIGESTIVE ORGANS STOMATITIS This is characterized by inflammation of the mouth. It may involve the whole membrane, or be confined to isolated portions. The first prominent symptom is a loss of taste, and a sensation similar to that produced by scalding liquids. The surface is red, very tender, and painful. The inflammation may extend to the fauces, nasal passages, and Eustachian tube. The stomach often becomes irritable, bowels loose, and the patient debilitated and emaciated. When caused by vitiated secretions, produced by the disturbed condition of the lynmphatics while suckling, it is known as "nursing sore-mouth," or technically, follicular stomatitis. It may then extend to the stomach and bowels, causing ulceration, diarrhoea, dyspepsia, dysentery, and great prostration of the nervous system; and if not arrested, the mucous membranes of the air passages are involved, producing cough, expectoration, tuberculous degeneration and death. The teeth may fall out, and the gums be absorbed. Aphthae or Thrush is another form of stomatitis. It is generally characterized by small ulcers scattered over the surface, or in patches of white exudation, which may become thick and absorbed, and leave a raw-looking surface, or a foul spot. Children are very liable to it, and it is generally caused by acidity of the stomach, or general derangement of that organ by improper diet or unhealthy milk. TREATMENT. -- This depends upon the cause, which,
if ascertained, should be removed. If due to carious teeth, they
should be removed, and if owing to dyspepsia, the proper remedies should
be given. The mouth should be frequently washed with a warm decoction
of golden seal. The system should be supported with tonics, a general
diet, and a liberal use of fresh succulent vegetables, as grapes, etc.
should be prescribed. Sage-tea gargles are very useful. The
mother should also pay attention to her diet, so as not to supply the babe
with improper milk. If due to acidity of the stomach, the necessary
absorbents should be administered.
GLOSSITIS This is inflammation of the substance of the tongue, involving its muscular structure. It usually commences with a throbbing pain in the tongue, followed soon after with redness and swelling. In the course of a few hours, the tongue enlarges so much as to fill the whole mouth, forces open the jaws, and protrudes from the mouth. Some fever usually accompanies it. Swallowing is usually almost impossible, speech gone, abscesses may form, and the tongue may even become mortified. TREATMENT. -- If due to a disordered state of the
stomach, an active lobelia emetic should be given, and followed with an
anti-bilious purge, like the Renovating Pill. If due to scalds or
burns, the mouth should be washed with mucilage of flaxseed and slippery
elm. If due to mercury, vapor baths should be taken, a free use of
the syrup of stillingia resorted to, and equal parts of charcoal and yeast
used as a gargle.
QUINSY (Tonsillitis) This consists of inflammation of the tonsils, which may in many cases extend to the adjacent tissues. It usually commences with a slight chill, followed by much febrile excitement, uneasy feeling in the throat, and difficulty of swallowing, which increases in severity very rapidly, until at last deglutition becomes almost impossible. There is a constant disposition to swallow, in order to free the fauces from a tenacious, colorless mucus which adheres to that part. The respiration is not much affected unless in bad cases. From the commencement there is fever, severe headache, and a rapid pulse. The termination is usually an abscess, which at length opens, and a discharge of very fetid pus ensues, which affords relief. The duration of the disease is usually about a week, and is scarcely ever fatal. TREATMENT. -- Administer a free lobelia emetic, and
anoint the throat thoroughly with the Herbal Ointment. In ordinary
forms this will be sufficient. If an abscess, however, forms, it
should be evacuated by an incision. In malarial districts, quinine
in anti-periodic doses may be necessary, and if the fever is severe, veratrum
should be given. The throat should be gargled with a decoction of
golden seal, and to prevent termination into induration and permanent enlargement,
alteratives should be given, especially in strumous habits.
PHARYNGITIS This is characterized either by acute, sub-acute, or chronic inflammation of the pharynx. There is slight pain upon pressure, or in the act of swallowing. It is seldom attended with fever, but in severe cases abscesses may form, causing great difficulty in swallowing and breathing. In the acute form the inflammation is usually limited to the mucous membrane, and simply constitutes an erythematic affection. The chronic form is known as "clergyman's sore throat," and is attended with a dry, hacking cough, hoarseness, and a sense of fatigue of the vocal organs after a slight exercise. TREATMENT. -- The treatment of simple pharyngitis
is but little more than merely to regulate the stomach and bowels, the
external application of cold packs, and a few days' rest. In the
chronic form an invigorating and tonic course of treatment should be pursued,
in connection with rest, baths, and pure air. To relieve the local
difficulty, one grain of stillingia may be mixed with a drachm of sugar,
divided into ten powders, of which one should be taken every two hours.
The inhalation of hot vapor from bitter herbs is to be recommended.
Blood-root in connection with constitutional treatment is highly beneficial.
Patients will find that my "Acacian Balsam" in the chronic form is a virtual
specific; the Herbal Ointment should also be outwardly applied. If
owing to a complicated constitutional disorder, or if it exists in association
with catarrh, it constitutes an affection requiring the most skilful treatment,
and those who may wish my advice in such cases may refer to page 390 for
general directions for consultation.
PAROTITIS (Mumps) Mumps is an inflammatory affection of the salivary glands, especially the parotids. It generally commences with slight fever, stiffness of the jaws, and a slight pain or swelling in one or both parotid glands. The parts are hot, painful, and very tender upon pressure. Mastication and swallowing become painful, which causes considerable nervous irritability. Metastasis to the breasts of the female and to testicles of the male is liable to occur, especially if the patient is subjected to undue exposure. Inflammation of the brain may occur in some cases. It reaches its height in about four days, disappearing entirely about the seventh. TREATMENT. -- Keep the patient quiet, and give a
mild purge. For external application a liniment of goose-fat and
camphor is very beneficial. If there be much fever, resort to the
usual anti-febrile treatment. If inflammation of the brain should
ensue, resort to active cathartics, and give small doses of macrotin and
quinine. The "Herbal Ointment" will be found a superior remedy, see
page 469.
OESOPHAGITIS This is an inflammation of the oesophagus, or that portion of the alimentary canal which conveys the food from the pharynx to the stomach. Heat and pain, increased by swallowing, at some point along the tube, are the earliest symptoms. Occasionally there is pain between the shoulders, and, perhaps, tenderness on pressure, with more or less difficulty in swallowing Hiccough, an eructation of glairy mucus, and vomiting, are sometimes present. There is also more or less constitutional disturbance. Ulcers and abscesses may form. It may become chronic, and stricture of the canal at any part of its passage may result, which may so effectually prevent deglutition as to cause death by starvation. TREATMENT. -- In the acute form, the stomach should
be cleansed by a lobelia emetic, and the bowels opened by a purge.
The surface should be sponged with hot water, and sufficient tincture of
veratrum given to maintain a gentle diaphoresis. In the chronic form
the alteratives are to be administered, and the bowels occasionally purged.
The patient should be confined mostly to a vegetable diet of fluid character.
Frequent sips from a decoction of golden seal and slippery elm should be
taken. Stricture of the oesophagus should only be treated by a competent
physician, as the means employed for its cure might do more harm in improper
hands than any possible good.
INFLAMMATION OF THE STOMACH Gastritis) This usually commences in the acute form with violent vomiting and a burning pain in the region of the stomach. Swallowing becomes difficult, thirst is intense, tongue is dry and smooth, headache often violent, delirium and prostration are present. If the stomach only is inflamed, there is constipation; but if the bowels also are affected, there is diarrhoea. The attendant fever is as common, and the disease may assume such a gravity that death inevitably ensues, especially in perforation of the stomach. Chronic gastritis is a common disorder. It is generally of a mild character, unless of long continuance, when it may occasion considerable organic disorder. Its approach is gradual, presenting a variety of symptoms, but may be known from dyspepsia in there being more pain at some particular point, and more frequent vomiting after taking food. TREATMENT. -- Give an emetic, and cleanse the stomach by means of large draughts of warm water. Counter-irritation should be resorted to over the stomach. The vomiting may be checked by opium, and the tincture of crawley may be given to control the fever. If produced by a corrosive poison, the necessary antidotes will, of course, be required. All solid foods should be withheld, and the drinks should be mucilaginous, as marshmallow, slippery elm, gum-water, etc. The treatment of chronic gastritis is not so easily
stated. It depends greatly upon associated conditions and complications.
Diet is an important element in the treatment. My "Restorative Assimilant"
internally, and "Herbal Ointment" externally, generally cure each case;
but some cases are of such a serious character that a cure can only be
effected by special symptomatic treatment. Those desiring to consult
me are referred to questions, page 390.
CANCER OF THE STOMACH The early symptoms of cancer of the stomach are usually similar to chronic gastritis. The appetite is impaired, and frequent nausea and vomiting supervene. The pain in the stomach is of a lancinating character. The gastric functions are impaired, and the mucous discharges become sour and purulent, finally bloody, and if subjected to microscopical examination, cancer cells are found. The complexion has a yellowish-white, waxen appearance, which distinguishes cancer from other diseases of the stomach. TREATMENT. -- The treatment consists chiefly in combating
the symptoms as they occur. Condurango should be given a fair trial
in all cases. If the disease has reached a certain stage, no remedy
will produce a radical impression; but I have the assurance that I have
cured many cases of well-defined cancer of the stomach, in more or less
advanced stages of the disease, by the employment of consistent and energetic
chemical treatment.
HEART-BURN (Gastralgia) Two forms of heart-burn are commonly observed: one, attended by acid eructations, causing irritation of the throat and fauces; and in the other, the ejections from the stomach are rancid and alkaline, and connected with a gnawing pain and distention of the stomach. It principally occurs during digestion, and may be of every grade of severity. It is caused by excess of acid, or an accumulation of gas, in the stomach. TREATMENT. -- This depends upon the cause.
If acid, administer pulverized charcoal, with a little magnesia, or, what
is just as good, compound spirits of lavender. If alkaline, give
lemon-juice as often as required.
GASTRALGIA, OR GASTRODYNIA This consists of a sense of pain, stricture, or contraction, occurring in paroxysms. The stomach feels as if rolled into a ball, or drawn towards the back. It assumes different degrees of violence, being often exceedingly painful. TREATMENT. -- It is instantly relieved by a dose
of some preparation of wild gum, in combination with a fourth of a grain
of gelsemium. External application of the "Herbal Ointment" acts
equally aas specifically.
SPASM OF THE STOMACH This consists of a sense of pain, stricture, or contraction, occurring in paroxysms. The stomach feels as if rolled into a ball, or drawn towards the back. It assumes different degrees of violence, being often exceedingly painful. TREATMENT. -- It is relieved by a dose of some preparation
of wild gum, in combination with a fourth of a grain of gelsemin.
External application of the "Herbal Ointment" acts equally as specifically.
WATER-BRASH (Pyrosis) This also occurs generally in paroxysms. The pain is intense, and of a burning character. An eructation of a thin, insipid, watery liquid occurs, and, when discharged, affords momentary relief. TREATMENT. -- Quinine and the general tonics will
remove this difficulty. Certain habits, as inebriety, anxiety of
mind, etc., are to be overcome, and a generous diet indulged in.
DYSPEPSIA, OR INDIGESTION This is one of the most common affections in the whole catalogue of diseases. Scarcely a human being lives that has not or will not be a victim to this harassing disease. In simple indigestion, the symptoms vary much in nature and severity. One may suffer severely, while another has merely slight depression of spirits. Loss of appetite, nausea, vomiting, constipation alternating with diarrhoea, furred tongue, foulness of breath, palpitation of the heart, pains in various parts, dull headache, hypochondriasis, etc., are present in all cases. The patient's appetite may at one time be wholly lost; at other times it is morbid and ravenous, which, if indulged in, will only add to his misery. There is seldom any healthy feeling of hunger, but, in place of this, the patient has a most miserable sensation of hollowness or sinking at the region of the stomach. Nausea and vomiting are the most distressing symptoms of dyspepsia; the former may occur soon after the food is swallowed, or it may be deferred for an hour or two. The matter ejected is most frequently sour, and mixed with bile, often having the flavor of rotten eggs, which is due to a gas known as sulphuretted hydrogen. This gas, in ascending, often brings the solid food into the throat and mouth, making the patient almost a ruminant animal. Suffering is experienced when the stomach is full or empty, though it differs in various cases. Sometimes not much uneasiness is felt until several hours after eating, when all its attendant horrors are manifested. This is due to fermentation of the food. Water-brash, gastralgia, spasm of the stomach, etc., are constant companions of the dyspeptic, and his days are most miserably spent, while his nights are not much better, because his sleep is not refreshing; the body is not reposed, and he is the frequent victim of horrible nightmares. A dyspeptic patient suffers from every variety of indisposition, and it is easy to learn from his dejected countenance and woe-begone look that he yearns for that comfortable human existence that only a healthy digestive apparatus affords to man. He is fretful and peevish, disssatisfied with others and with himself; has individually no comfort, and allows but little to those around him; everything that was formerly bright and cheerful now bears a gloomy aspect; his smiles are derisive, his opinions cynical, and everything that is bright, cheerful, and lovable has gone with the enjoyment of good health. The disease is in fact a malady that embraces in its symptoms and consequences nearly every physical and mental torture known to mankind. TREATMENT. -- When it arises from inertia of the
stomach, it may be removed by stomachics. If produced by bad habits,
it can only be corrected by strict adherence to the physiological laws
controlling the digestive functions. When it occurs from softening
of the mucous membranes and a deficiency of the gastric secretion, alnuin
is a good remedy; and chelonin acts well in chronic inflammation of the
organ. When dependent upon nervous debility, herbal phosphorus and
cyprepedin act well. Constipation should be relieved by leptandrin
and similar cathartics. Diet and hygiene form a very important part
in the treatment, and these should receive very careful attention.
Fresh air, baths, friction, out-door exercise, careful avoidance of overloading
the stomach, are indispensable adjuncts to all treatment. It is but
just to myself, and eminently due to my readers, to acquaint them with
my mode of treating dyspepsia, and which, I confidently assert, is attended
with as specific results as can be expected from any medicinal agents.
It is my sincere belief that failure is impossible if the remedies are
taken faithfully, for a reasonable length of time. I advise in all
cases and in all forms of the disease, my "Restorative Assimilant," "Renovating
Pills," and "Herbal Ointment." The Assimilant is taken internally,
in prescribed doses, three times a day; the pills are taken as occasion
requires, to keep bowels regular, and the Herbal Ointment is rubbed externally,
once or twice a day, over the region of the stomach and bowels. The
philosophy of this treatment is obvious; the Assimilant restores the tonicity
of the digestive organs, increases secretion of gastric juice, promotes
chymification, stimulates the the accessory organs of digestion, and, by
its assimilative properties, increases the functional action of the absorbents,
and restores the chemical process of digestion to its healthy state.
The pills increase the peristaltic motion of the bowels, augment biliary
discharges, stimulate the mesenteric glands, while, at the same time, they
give tonic power to the whole alimentary canal. The ointment, by
its discutient properties, removes all inflammation, localizes healthy
blood to the organs and tissues, and prevents centralizaiton of morbific
agents.
ANATOMY OF THE LIVER The liver is the largest glandular organ in the body; its office is to secrete bile. It is oblong and oval in shape, and occupies the position on the right side, under the lower ribs. It weighs from four to five pounds; it measures from ten to twelve inches transversely, and from six to seven antero-posteriorly; its greatest thickness is from four to five inches. On the upper surface it is convex, and on the lower concave. Its color is of a reddish-brown, with occasional spots of black. The under surface of the liver presents a deep fissure, called umbilical or longitudinal, reaching from the anterior to the posterior notch, containing the remains of the umbilical vein of foetal life. Sometimes this fissure is converted into a foramen, or opening, the right and left lobes being connected. At right angles to this fissure is another, called the transverse fissure, containing the portal vein, hepatic artery, and hepatic duct, bound together by the capsul of Glisson, a membrane of cellular tissue. The gall-bladder lies in a deep depression upon the under surface of the right lobe of the liver. The lobulus quadratus is that portion of the liver included between the depression occupied by the gall-bladder and the longitudinal and transverse fissures. At the posterior and inferior portion of the liver is a triangular lobe called the lobulus Spigelii. The elongated ridge running from the lobulus Spigelii outwardly is the lobulus caudatus. These lobules are, however, all contained in the two lobes of the liver. The right lobe is the largest and thickest, and the left terminates in a thin cutting edge. The structure of the liver may be seen by tearing the liver of any animal. This will show a granulated arrangement, and each of these granules is usually called an acinus. These acini consist of a terminal branch of the portal vein and hepatic artery, together with the incipient radicles of the hepatic duct and hepatic vein, and in the capillary network thus constituted are numerous cells, which secrete the bile. The liver is liable to a variety of disorders, and,
when affected, exerts a marked influence on the organs and tissues of the
body. The functions of the organ are so important that impairment
arising from any organic cause quickly disturbs the harmony and health
of the whole economy. Its office is to eliminate the superfluous
carbon from the blood. This carbon enters into chemical combination
with other substances, forming the compound known as bile, and which is
poured into the duodenum, or upper bowel, where it assists greatly in the
process of digestion.
DISEASES OF THE LIVER HEPATITIS Inflammation may be confined to its outside covering, or involve the entire substance of the liver. It usually makes its appearance with sympathetic fever, pain, a sense of tension on the right side, inability to lie on the left side, difficulty of breathing, a dry cough, vomiting, and a troublesome cough. As the morbid action increases, high fever with hot skin, thirst, and scanty urine is observed. The pain is acute and lancinating, and is apt to run up to the right collar-bone, and to the top of the shoulder. The pain is increased by coughing, breathing, and lying on the left side. A soreness is felt by pressing over the liver, and usually, when enlarged, is readily recognized by the touch. The pulse is full and hard, bowels costive, stools clay-colored, and the tongue is covered with a dark-brown, or even black coat, and there is a bitter taste in the mouth. TREATMENT. -- Evacuate the stomach and bowels and
apply hot packs, rubefacients, or even vesicants in some cases to the region
of the liver. The purges should be such that will thoroughly evacuate
the bowels with watery discharges, as jalap, elaterium, etc. Promote
perspiration by a spirit vapor bath, or by American hellebore, or other
diaphoretics. When the urine is red and scanty, an infusion of marshmallow,
pumpkin-seeds, or trailing arbutus should be given. Quinine, gelsemium,
and irisin may be neceessary in some cases.
CHRONIC HEPATITIS Chronic inflammation of the liver usually involves the entire organ, and may be the result of the acute form, although it exists independently of it. It is a disease very common in the South and West, and is evidently owing to malarial poison, in connection with heat and atmospheric vicissitudes. It is a very insidious disease, and the whole organ may assume a pathological condition before attracting any special attention. The most common symptoms are a disordered stomach, occasional vomiting, a sense of fulness and weight in the right side, irregular bowels, pains in one or both shoulders, unhealthy stools, yellowness of skin, eyes, and urine, a short dry cough, disturbed appetite, febrile exacerbations towards night, and general emaciation. The patient is generally despondent, his temper is irritable and peevish, and he is frequently the prey to the dread of some impending evil. The exercise of his mental faculties is often impossible in a literary or argumentative direction, and the loss of the cherished attribute of manhood is most frequently added to his misery. If the patient be a female, sexual congress becomes to her a revolting union, and her husband's approaches create in her only a feeling of disgust and scorn. TREATMENT. -- The diet should be regulated, outdoor exercise should be taken, baths liberally used, and chafing liniments applied over the liver; keep the bowels open with leptandrin, or decoction of the plant and give one-tenth of a grain of gelsemium with two grains of quinine every three or four hours, until about twenty doses have been taken. This may be followed by dandelion and blackroot in small doses four or five times a day. An alterative like irisin may also be given. I also most strongly advise my "Restorative Assimilant," "Herbal Ointment," and "Renovating Pills;" to be used about the same as ordered in dyspepsia. The pills, especially, exercise specific control over morbid conditions of the liver, and frequently cure the disease, unaided by other remedies. It is frequently the case that chronic inflammation
of the liver is so complicated that it will not respond to any ordinary
treatment. In such cases a careful analysis of the symptoms and general
condition of the patient must be made, and the treatment so modified and
varied as to suit all the conditions of the case. In these cases
it is difficult to designate the required treatment, as each individual
case is characterized by its own pathological phenomena, and requires essentially
particular treatment. My success in the treatment of these stubborn
cases has exceeded even my own anticipations in many instances, and I now
like to combat the "bilious" foe with my herbal weapons -- and success
usually crowns my efforts. Those who wish to consult me are referred
to page 390.
CIRRHOSIS The result of chronic inflammation of the areolar tissue of the entire organ is often induration or cirrhosis of the liver. The tissues become so firm, and ultimately so constricted, as to diminish the caliber of the portal vein, hepatic artery, and duct, resulting in the wasting away or atrophy of the lobular structure, and the hepatic cells become studded with fat. This condition sadly interferes with the circulation of the blood through the portal vein, producing inflammation of gastric and intestinal linings. It is the hob-nailed liver of some writers. The usual symptoms are constipation, a dry skin, high-colored urine, fickle appetite, and derangement of the nervous system. The spleen often becomes enlarged, while the liver diminishes in size, the pain becomes more intense, and frequently the kidneys are also involved. Digestion is feeble, chills, hectic fever, and night-sweats are often present, and frequently a dropsical condition of the lower limbs and abdomen is observed. TREATMENT. -- All alcoholic stimulants should be avoided, and the action of the liver aroused by prickly ash, leptandrin, dandelion, emetics, etc. The tonics should be given, and Indian hemp should be administered in sufficient quantities to maintain a gentle influence upon the bowels and kidneys. The alteratives, if indicated, should be exhibited, and continued as long as required. This disease is certainly an unfavorable one for
treatment in its advanced stages, but my treatment in well-defined cases
has been attended with the most favorable results, and I hope ere long
that the result of my investigations into the morbid character of the disease
in all its phases, that I have made for many years, will enable me to still
more rob the disease of its formidable nature.
GALL-STONES These concretions are generally oval or pear-shaped, and formed in the gall-bladder or hepatic ducts. They vary in size, from that of a small pea to a fowl's egg, and in chemical composition present cholesterine, coloring matter, and the salts of lime, magnesia, etc. They occur oftener in females than in males, from the fact that their inactive life is more conducive to their formation. They give rise to a dull, heavy pain in the region of the liver, and more or less febrile excitement. In their passage through the duct they cause the most excruciating pain, which is accordingly intensified in proportion to the size of the stone. Impaction of the cystic duct, with complete obstruction and inflammation, ulceration, and perforation of the duct and bladder may occur, giving rise to great difficulties. TREATMENT. -- To reduce the spasm, Dover's powder,
or other anodynes, should be given, and hot packs or fomentations should
be applied externally. A vapor bath and lobelia emetic often afford
great relief. Belladonna plasters should be applied over the region
of the liver, as they dilate the cystic duct, and alleviate the pains.
Thoroughwort is a good remedy, and should be freely taken. If the
stones can be found in the alvine discharges, their chemical character
should be definitely ascertained and the proper chemical treatment resorted
to in order to prevent their re-formation. Those who may desire my
services in this respect can forward to me the stones, and on receipt I
will carefully analyze them, and suggest the proper treatment.
JAUNDICE (Icterus) The most prominent symptoms are yellowness of the skin, eyes, and urine, owing to the deposit of the coloring matter of the bile in the blood. The appetite is impaired, the food is loathed, an uncomfortable feeling of a load at the pit of the stomach is felt. The stomach is sour, sometimes there is sickness and vomiting, a bitter taste in the mouth, a dull pain at the right side, sleepiness, and an uncomfortable feeling of lassitude at all times distresses the patient. The urine is heavily tinged with bile, and the stools clay colored. It is usually idiopathic, but may be a concomitant of other diseases. Torpidity of the liver is the chief cause, yet any functional disorder of the organs may cause it. TREATMENT. -- If caused by inactivity of the liver, the organ should be aroused by a emetic and active antibilious purges. I can certainly advise no better cathartic for this purpose than my Renovating Pill. The liver should be further stimulated to action by the application of an irritating plaster over the region of the liver. Tonics, like quinine, poplar, and liriodendron, may be necessary in some cases. The diet should consist of fresh vegetables, and as much out-door exercise should be taken as the patient can bear. The liver is the seat of many other diseases, but as they are more or less rare, of difficult detection, and treatment difficult, I deemed it prudent not to enter upon any consideration of them. The organ may hypertrophy or atrophy, its blood-vessels may become diseased, it may be affected by syphilitic taint, it may become fatty, it may degenerate into a waxy or albuminous mass; disease may change it into a pigment or nutmeg liver; it may be the seat of hydatids or parasites, tumors or cancer may assail it, and finally it may be the seat of tuberculous matter of a miliary character. The symptoms produced by these morbid conditions are so obscure, and many of them the common property of all, that none but a skilful physician is capable of recognizing the identity of the affection; and I advise all patients who are suffering from any liver disease that present phenomena, not recognizable in the simpler affections of the organ, to intrust his case to a competent physician. I have devoted nearly a lifetime to the study of
liver diseases, and I am ready to maintain that my success in their treatment
is greater than by any other system of medication. I am daily consulted
with reference to some chronic disease of the liver, both in person or
by letter and patients under treatment are scattered in all sections of
the country. Constant communication by
ANATOMY OF THE SPLEEN The organ occupying the right of the following cut, is the spleen. It is a soft vascular organ of a purplish color. It is not a true gland, as it has no duct. The shape of the spleen is irregular and variable, but it is generally the section of an ovoid, with a convex surface resting against the diaphragm, opposite the ninth, tenth, and eleventh ribs, and a convex surface directed towards the stomach. It varies in size more than any other organ in the body. It is generally five inches long and three wide, and weighs from five to seven ounces. The proper substance of the spleen is a soft, pulpy mass, of a reddish-brown color, resembling grumous blood. Its office in the economy is not well understood, but is evidently concerned in the blood-depurating process. It is numerously supplied with lymphatics. The long and flat gland lying between the spleen and duodenum, in the left of the cut, is the Pancreas, or sweet-bread. It is of a light-pink color, and is about seven inches long. Its right extremity, or head, is much the thickest part, and is often called the lesser pancreas. Its left extremity gradually diminishes in breadth until it touches the spleen. The superior edge has a groove for the passage of the splenic artry. Its structure is conglomerate. Its excretory duct is called the duct of Wirsungius. Its secretion is somewhat similar to saliva, hence
it is often called the abdominal salivary gland. Its secretion contains
a larger amount of solid matter than the saliva, and assists in the process
of digestion.
SPLENITIS The functions of the spleen have formerly been the cause of much controversy, nor are they better understood at the present day; but the organ is evidently concerned somewhat in the blood-making process, but that it performs a very important part is doubtful, as the whole organ has been removed without affecting the health in the least. In some countries, the practice of removing the spleen in pigs, for the purpose of facilitating the fattening practice, has been resorted to, which fact has suggested to some over-confident analogists the propriety of removing the spleen in the human subject as a remedy for debility. Splenitis prevails most in malarious districts, and is a frequent result of chills and fever. A feeling of weight, tightness, sometimes pain in the left side, which is increased by pressure, or an attempt to lie on the left side, are the earliest symptoms. The organ enlarges -- sometimes so much that it can readily be felt by the hand. It is known by the name of "ague-cake," and causes numbness and weakness of the legs, difficulty of breathing, palpitation of the heart, obstinate constipation, vomiting of food, piles, dry skin, and occasionally dropsical affections. TREATMENT. -- This does not differ much with the
treatment advised for acute and chronic inflammation of the liver.
Quinine, in combination with leptandrin and irisin, is indicated in all
cases. Counter-irritation should also be made over the splenic region,
and, when complicated with dropsy, the required directions should be administered.
My "Restorative
The spleen may also be affected with dropsy, or become
studded with tuberculous matter. In such events the treatment is
the same as for dropsy and tubercular depositions of any other internal
organ.
DISEASES OF THE PANCREAS The pancreas is rarely the seat of disease. The symptoms of its morbid conditions are usually obscure. It may be affected by inflammation, passive or acute. In typhoid, typhus, and puerperal fevers, it occasionally becomes involved in inflammation. The symptoms of disease of this gland are usually pain in the epigastrium, enlargement and tenderness, a sensation of heat and constriction, salivation, nausea and vomiting, diarrhoea, loss of appetite, despondency, chills, alternated with flushes of heat, and debility, with great emaciation. The vomiting in some instances is very obstinate; the matters ejected are thin, ropy, and of a sour or saltish taste. Jaundice is often observed. TREATMENT. -- Control the disease by equalizing the
circulation with hot packs, veratrum, aconite, mild purges, etc.
In the chronic form, administer mandrake, blue flag, and poke-root, as
these remedies are known to increase the functions of this gland.
Lobelia and capsicum, in some cases of chronic congestion and inflammation,
act with decided benefit. In all diseases of this gland it would
be well, however, to intrust the treatment to a competent herbal physician.
DISEASES OF THE BOWELS The intestinal tube is very seldom affected throughout
its whole extent, but inflammation may involve any portion of it at one
time. If the duodenum is affected it is called Duodenitis,if the
caecum or blind gut is inflamed, it receives the name of Typhilitis, if
it involves the small intestine, it is called Enteritis. These diseases
are very rare, however, and their consideration as separate affections
is of not much importance, except to the nosologist. The treatment
is upon general principles and corresponds with that given in all inflammatory
affections of the intestinal mucous membrane. Dysentery is a typical
case of enteric inflammation, hence we will commence with the consideration
of it.
DYSENTERY (Colitis) This is also known as bloody flux, and consists of an inflammation of the membrane of the colon and rectum, and characterized by small mucous or bloody evacuations, griping, and straining. The disease comes on with loss of appetite, costiveness, lassitude, shivering, heat of skin and quick pulse. These are followed by griping pain in the bowels and a constant desire to go to stool. The passages are mostly small in quantity, and composed of mucus mixed with blood. These passages are attended with severe griping and straining, technically known as tormina and tenesmus. Nausea and vomiting sometimes attend the early stages. When the natural faeces pass off, they are usually formed in round compact balls, called scybala. Fever is commonly present, with a feeble, almost thread-like pulse. The discharges have but little odor at first, but become exceedingly offensive as the disease advances. The chronic form is characterized by frequent small evacuations consisting mostly of mucus, but sometimes mixed with pus, bile, faeces and blood. The symptoms are the same, but less intense than in the acute form. Emaciation, debility, dropsy, and consumption result, if not arrested. When the liver and stomach become disordered at the commencement, it is called bilious dysentery. Various forms of the disease are known as adynamic, intermittent and remittent, typhous, rheumatic and epidemic dysentery; but it is not necessary to classify the disease under these heads. TREATMENT. -- A free lobelia emetic may be given
at the outset, and the bowels evacuated by a purge; castor-oil with laudanum
is the best for this purpose. After the purge, take twenty grains
of quinine and one drachm of leptandrin, divide into six powders and take
one every hour until all are taken. The tenesmus should be relieved
by injecting into the rectum five or six ounces of starch water, containing
about twenty drops of laudanum, as often as is necessary. Ipecacuanha
is a superior remedy. Gelsemium may be given afterwards, and if required
the fever should be controlled by veratrum. The patient should lie
quietly in bed, and his diet should consist of grapes, baked apples, flour
porridge, bread, rice, coffee, beef-tea and ripe fruit. The astringents
are of course necessary, and for this purpose tannic and gallic acids kino,
rhatany, opium, capsicum, cranesbill, etc., can be given. Tonics
should be combined when the patient is weak, and if the debility is very
great the alcoholic stimulants should be administered. I can with
safety recommend my "Restorative Assimilant" as a sure cure for both acute
and chronic dysentery, as well as for all bowel complaints. The Herbal
Ointment should be rubbed externally on the whole abdomen to relieve the
inflammtion. In the chronic form, the astringents, with such other
remedies as may be indicated by the symptoms, are all that is necessary.
DIARRHOEA This common disorder is characterized by frequent and urgent demands to evacuate the bowels. It is usually preceded by a sense of indigestion, fulness of stomach, flatulency, and more or less colic pains. The pain generally subsides after an evacuation, and returns as an indication of another discharge. The discharges may be thick, consisting of ingesta, or they may be serous, or of a rice-water appearance. Sometimes they consist of distintegrated mucous membranes, blood, and bile. There is usually a disagreeable sinking sensation in the abdomen along with the discharge, with exhaustion, a cool skin, and a feeble irregular pulse. It may be attended with fever, indicating extensive irritation of the mucous coat. The urine is usually scanty. When the discharges are composed of serum, and highly colored with either yellow or green bile, it is called bilious diarrhoea; when composed principally of mucus, it is known as mucous diarrhoea, and when of a thin, watery character, the name of serous diarrhoea is given to it. The disease may become chronic. TREATMENT. -- If it occurs in children, a little paregoric, or essence of peppermint or spearmint, usually cures in a short time. Opium in combination with ipecac, as in the Dover's powder, is an excellent remedy. The astringents are all indicated. Starch injections, as advised in dysentery, should also be resorted to, and counter-irritation of the abdomen is also serviceable. In the chronic form the tonics should be combined with the astringents. I cannot recommend my "Restorative Assimilant" (see page 469) too strongly. It is certainly an admirable remedy for this complaint, relieving it most instantly. Chronic diarrhoea may often be so dependent upon
a vitiated condition of the system that it becomes quite difficult to cure.
In such cases the most careful treatment is necessary to overcome the disease.
During the war, and also afterwards, the author was consulted for this
affection by those who contracted it in the army in thousands of cases;
but under proper treatment all recovered.
CONSTIPATION By this is understood a collection of excrementitious matters in some part of the intestinal tube. It is marked by unfrequency of stool, and by the recurrence of fulness and tension in parts of the abdomen. It occurs in patients of a lax and weak habit of body, or it may arise from rigidity of the muscles. It may also be due to imperfect functional action of the stomach, liver, pancreas, etc., in which case the intellectual faculties are dull, the complexion is sallow, the skin dry, urine scanty, acidity of the stomach, and headache. Sometimes the accumulation of faecal matter is so great that the masses can be felt through the abdominal walls. It is frequently caused by an atonic condition of the muscular structure of the intestines, and in very many cases it results from neglect to attend to the calls of nature. These calls should be imperative, and whenever the desire arises they should not be disregarded, but obeyed as quickly as opportunity allows. I once knew a sea-captain who only evacuated his bowels when in port, and who remarked to me that when he "battened down the hatches of his vessel, he also battened down the hatches of his body, and no matter how long the voyages, no stools are made." The consequences were, that whenever he came to port he had a hard time to be relieved of his faecal accumulations. In many other cases no movement of the bowels was observed for ten or twelve weeks. Constipation is attended with various sympathetic affections, and finally deranges the blood, impairs the health, tone, and vigor of the whole system. It is frequently the cause of piles, strangury, dysmenorrhoea, amenorrhoea, leucorrhoea, apoplexy, epilepsy, dyspepsia, insanity, etc. TREATMENT. -- The cause of the difficulty should
be carefully studied, and the proper treatment resorted to. The diet
should be composed of laxative articles of food, as fresh fruits, unbolted
flour bread, etc. If dependent upon a lax state of the muscular fibres,
golden seal, in combination with mandrake and blackroot are the proper
remedies, and when due to vitiated sefcretions of the stomach, liver, etc.,
the American Columbo should be given. In atony of the bowels, nux
vomica should be carefully administered with the cathartics. Cathartics
and enemas are of course indicated for present relief in all cases, and
those should be selected which operate sufficiently, without causing irritation
of the mucous membranes. Kneading the bowels often overcomes habitual
constipation. There exists no better remedy than my "Renovating Pills,"
they cure every case of habitual constipation. The bowels may become
obstructed from other causes, Intussusception, or invagination of the bowels,
or when one part of the bowel is drawn into another portion, produces complete
closure of the canal. The bowels also bcome twisted. These
conditions may be known by the vomiting of stercoraceous or faecal matter,
and when this is observed, instant medical aid should be called for, as
the condition is one of great danger, and requires intelligent treatment.
INTESTINAL WORMS Every animal seems to be a nest for other animals, and man is no exception to the rule. There are five varieties of intestinal worms, all more or less familiar to every one of my readers. 1. Ascaris lumbricoides. -- This worm resembles the common earth worm, and is supposed to belong to the same species. It varies in size from four to eighteen inches in length; it also varies in color, having in some instances a whitish pink hue, and in others a dull, dirty-yellow color. It feeds on the chyme found in the intestines, upon absorption from which the growth of the human system depends. They are generally found in the smaller intestines. 2. Ascaris vermicularis. -- This worm is sometimes improperly called the thread-worm, for there is another variety more like a thread than this. It is commonly called the maw-worm, and is the smallest known. The male is exceedingly small, but the female is about half an inch long. It is very slender, and about the size of small sewing-thread. From the fact that it inhabits the rectum chiefly, it is often called the seat-worm. This is the animal so troublesome and annoying to children, but is occasionally also found in adults. The child infested with them runs about during the day apparently well, but when night comes it complains of itching in the rectum, which is sometimes excessively annoying. 3. Tricocephalus dispar. -- This is the long thread-worm, from one to two inches in length, but sometimes reaches a length of four inches. It is like a small thread, except at the posterior extremity, where it is enlarged. It is not so often found as the others. It is of light color. The male is smaller than the female, and differs little in shape. It is common to all parts of the intestinal canal. 4. Toenia solium or vulgaris. -- This is the common tape-worm. Of this family there is but one variety in the United States, though there is another peculiar to other parts of the world. It varies greatly in length and size. The ordinary length is from seven to fifteen feet, but it sometimes arrives at the enormous length of one hundred feet. It is of a flat, ribbon-like shape, about one-quarter of an inch in breadth in the largest places, and tapers to almost a mere thread at the canal extremity. Its color is whitish or yellowish; and it is made up of numerous segments or joints, which are most distinct and perfect at a distance from the head. These segments resemble a gourd-seed, and are four-sided. The head is smaller than most of the body, with a small point in the centre with openings. It is supposed that this animal can exist or reproduce itself if but a single joint exists, but this is doubtful unless the head exists. When the head is evacuated the remainder will decay and be also expelled. This animal is hermaphrodite, and impregnates itself. It inhabits the small intestines. Persons affected with this worm frequently pass joints, but it often remains in the body for a long time without its presence being thus revealed. 5. Tonia lata, or bothriocephalus latus. -- This is the broad tape-worm, and does not exist in this country unless imported. It is found in Central and Western Europe. It is much broader, and the joints are shorter than in the common long tape-worm. The joints are more perfect, well developed, and thrown off in connected rows, and by a cavity in the centre, and not in the border of the joints. It varies in length from one to twenty feet. Almost every variety of symptoms is found to result from the irritation that worms produce in the human system. The symptoms, however, occur mostly in children, and are generally produced by the long, round, or common worms. The abdomen is prominent, full or bloated; the appetite variable and capricious; sometimes deficient and sometimes voracious. The breath is usually offensive, the tongue has a white-coated appearance, and often the upper lip will be much swollen. The eye-lids also swell often, sometimes so much that the child can barely see; and occasionally swollen patches will present themselves in other parts of the body. Children troubled with worms are apt to pass restless nights, and frequently start in their sleep. Paleness around the mouth, extending up the sides of the nose, is another common symptom. Itching of the anus is the most common and only particular effect produced by the small worms. St. Vitus' dance and epilepsy often result from verminous irritation, but the latter is usually harmless when properly treated. A dry, choking cough is a symptom peculiar of worms. Itching of the nose is a common symptom, and the child is almost incessantly rubbing that member. The symptoms of tape-worm are somewhat peculiar, and deserve a brief notice. Persons of all ages are subject to them, but they are most common to middle age. The disturbance they occasion is that of great uneasiness and distress, which often, sooner or later, destroys the general health. Uneasiness in the head, sometimes pain, slight giddiness and ringing in the ears, are the symptoms most complained of. The twitching of the muscles, especially those at the mouth, and a pinched, contracted appearance of the nostrils, accompanied with itching, are peculiar symptoms of tape-worm. The appetite is variable, the eyelids swollen, the breath offensive, etc., and other symptoms common to other worms are present also in tape-worm. Nausea occurs at times, with ejections of frothy mucus. The patient grits his teeth in sleep; and the abdomen seems full, with contraction of the navel. After a night's sleep there is a sensation of an animal moving about in the bowels, accompanied by darting pains, which subside after eating. The patient becomes weak and nervous, and finally, worn out with excitement, gets hypochondriacal and even deranged. Of course, the most unequivocal symptom is a discharge of joints of the worm. TREATMENT. -- This varies with the symptoms of each case. If convulsions exist, the first step should be to subdue these by brisk friction and warm applications along the spine and abdomen. Anti-spasmodics in these cases should be given; also sweating drinks. If these symptoms are relieved, the compound powder of senna and jalap may be given with pink and wormwood in sufficient doses to produce free evacuations of the bowels. This is to be repeated for two or three days, and is usually successful. It is equally reliable in the treatment of the long thread-worm. The powder is composed of three drachms each of the above herbs decocted in a pint of water; dose, a tablespoonful. It produces sometimes alarming symptoms, but these, however, are harmless and of short duration. Pinkroot and wormwood are good remedies, however, given in any form. The melia azedarach, or the Pride of China, given in decoction, is a favorite remedy; so also is the burr of the red cedar, the efficacy depending upon the turpentine it contains. Santonine in doses of three or five grains is efficacious, and very serviceable because it is tasteless, and therefore readily administered. Blue vertain is a good remedy, and for this reason my "Restorative Assimilant" is so efficient for the expulsion of worms. Seat, or maw-worms are best expelled by injections of moderately strong salt and water, or soap-suds. Turpentine in emulsion also makes an efficient injection. For tape-worm various remedies are used. Kousso, pumpkin-seeds, and turpentine have each a good reputation. Male Fern, however, is the most specific remedy that can be used. It is certain to dislodge the distressing enemy. My "Male Fern Vermifuge" is without doubt the best vermifuge ever compounded and offered to the public. It instantly expels the minor worms, and the tape-worm is quickly dislodged by it. It is composed of such articles as make it applicable to every variety of worms, and it is veritably infallible in its effect. (See page 469.) I admonish all persons to avoid eating pork that
is not well cooked, for it is an established and indisputable fact that
tape-worm is caused by eating raw pork, provided that it is not in a healthy
condition. That which is commonly known as "measly pork" contains
the germs of tape-worm and should not be eaten unless thoroughly cooked.
Tape-worm is most prevalent among the peasants of Central Europe, being
they subsist largely on raw pork.
PERITONITIS This is an inflammation of the serous membrane lining the abdominal cavity, and investing the viscera, and may be either acute or chronic. During the early stages of the disease there is a feeling of lassitude, pain in the back and limbs, chills alternating with flushes of heat, headache and a feeling of uneasiness about the abdomen. As soon as the febrile action is established, the pain becomes sharp and severe. The abdomen is very tender, the slightest pressure by the hand causing most intense pain. The patient lies on his back, with his knees drawn up and shoulders elevated, finding that this relaxes the abdominal muscles, and prevents pressure by the bedclothes. Nausea, vomiting, thirst, constipation and suppression of urine, are frequent symptoms. The face is pale and contracted, respiration is oppressed, each inspiration aggravates the pain; pulse is frequent and small, tongue moist, and the patient is generally wakeful. The abdomen becomes tympanitic, and when a fatal termination is approached it becomes very much distended. The pulse also becomes feeble and quick, and the countenance assumes a ghastly appearance. It is very rapid in its course, death sometimes occurring within twenty-four hours. Puerperal peritonitis is only another variety of this disease, and attacks women in child-bed. It may arise idiopathically, or it may be caused by wounds, blows, falls, etc. TREATMENT. -- The stomach and bowels should be evacuated
by an emetic and purge. If associated with malarial influence quinine
should be given. The fever should be controlled by veratrum.
A large mustard plaster or turpentine stupe should be applied to the abdomen.
Large doses of opium to allay the pain are also indicated. The patient
should drink freely of marsh-mallow or flaxseed tea, and be supported by
tonics, beef-tea, etc.
SUMMER COMPLAINT (Cholera Infantum) This is a complaint which usually attacks children between the ages of two months and three years; it occurs in the warm season, and is chiefly confined to cities. It is very fatal. It commences with a profuse diarrhoea, stools thin and variously colored. The stomach becomes irritable, and rejects everything. Loss of flesh, languor, and prostration follow, and stools become colorless and odorless, skin is dry and harsh, head and belly hot, thirst is great, and fever at night-fall. Delirium is present in many cases, indicated by violent tossing of the head, etc. TREATMENT. -- The child should be removed to a vicinity
abounding in pure air, if possible; otherwise, in a large and airy room,
and may even be taken into the open air occasionally. Its food should
consist of the farinaceous articles of diet, if weaned; otherwise, of its
mother's milk; mucilaginous drinks can also be given. If the vomiting
be obstinate, give camphor, or a little opium, or combined, as in paregoric.
The astringents, as turmeric and cranesbill, must be given to check the
diarrhoea. Rhubarb is a good remedy, also leptandrin, prepared chalk,
etc. Lime-water is grateful, and should be given. Charcoal
is the proper remedy when the stools are very offensive.
CHOLERA MORBUS This is characterized by violent purging and vomiting of bilious matter, attended with griping, sickness and a constant desire to go to stool. The attack is usually abrupt, but it is sometimes preceded by loss of appetite, nausea, headache, chilliness, colicky pains, etc. It occurs generally at night, and the vomiting and purging occur in quick succession. The evacuations are usually copious, consisting of the ingesta first, but afterwards of a sour, acrid, serous liquid, causing a scalding sensation in the throat; there is slight tenderness over the abdomen, hiccough, anxiety, restlessness and exhaustion. The pulse is quick, small and feeble, the skin cool and moist, or bathed in clammy perspiration. It is quite a serious disease and runs a rapid course -- death often occurring within twenty-four hours. TREATMENT. -- If the stomach is overloaded with indigestible
food a lobelia emetic should be given in connection with warm ginger tea.
Hot packs or mustard plasters should be placed on the abdomen, and bottles
of hot water to the feet. Lumps of ice should be placed in the mouth
to allay the patient's thirst. Opium is a very good remedy, and may
be given by mouth or by injection. A tea made of chamomile flowers
or columbo often succeeds well. Where great exhaustion is felt, a
brandy toddy should be given.
ASIATIC CHOLERA This is an endemic disease of India, and visits other lands by travelling in what is called the cholera cycle. The Hindoos call it Purrhee morlii (rapid death); The Mahometans, euncrum vaudi (diarrhoea and vomiting); and the Arabs, el houwah (hurricane). It is evidently caused by a noxious malaria arising from human or animal decomposition. It is characterized by three stages. The first is marked by derangement of the digestive organs, rumbling in the bowels, pain in the loins or knees, twitching of the calves of the legs, impaired appetite, thirst, and especially a slight diarrhoea. These symptoms continue from a few hours to several days. The pulse is frequently very slow, the tongue is furred, and a sense of great debility is present in all cases. In the second stage vomiting occurs, and the characteristic rice-water stools make their appearance. These stools are thin and watery, and have a peculiar spermatic odor. The cramps become excessively severe, drawing the muscles into knots. The tongue is pale and moist, pulse feeble, the breathing hurried, with distress about the heart, great thirst, and the secretion of urine nearly stopped. The thin, colorless fluid discharged by vomiting and purging is the watery portion of the blood, and when so much has been discharged that the blood cannot circulate freely, the patient sinks into the third, or stage of collapse. This is characterized by great prostration, the pulse being hardly perceptible, skin cold and clammy, face blue or purple, eyes much sunken, hands dark-colored, looking like a washerwoman's, breathing short and laborious, a sense of great heat in the stomach, intense thirst, inanition and death. Recoveries from the third stage seldom occur. TREATMENT. -- In the first place the diarrhoea should receive prompt attention. The patient should lie in bed, and from five to ten drops of laudanum every two or three hours should be given. The astringents should also be administered. Morphone can also be given. The diet should be carefully regulated, and every symptom promptly met with an appropriate remedy. In the second stage the treatment should be energetic, quinine should be given, and the sinking powers sustained with tonics, beef-tea, etc. A pill containing opium, camphor, and cayenne pepper should also be administered. Brandy may also be given freely. I also advise my "Restorative Assimilant" as a good remedy; it should be taken in full doses. Its success has been very gratifying wherever it has been used. In the third stage the above remedies are to be pursued
with increased energy, especially the stimulants, and every effort should
be made to promote the warmth of the body.
PROLAPSUS OF THE RECTUM This is more common to children than to adults, and is frequently a sequel to protracted diarrhoea, the falling caused by the debility occasioned thereby. It is also associated with disease of the digestive organs, and is peculiar to persons of feeble habit, or of a scrofulous or tuberculous diathesis. It causes pain in the lumbar region, constipation, sometimes diarrhoea, cardiac irritation, and general prostration. TREATMENT. -- The bowels should be replaced as soon
as possible to prevent inflammation, that would naturally follow.
The bowel can be replaced with the finger, well greased with sweet oil,
gently pressing the tumor within the fundament. Cold water should
be applied to the parts, and a decoction of white oak bark should be injected.
A T-bandage should be applied to restrain the bowel from protrusion.
ANAL FISTULA This consists of an abscess occurring in some portion of the cellular tissue around the anus. As suppuration occurs the pus can be detected by the touch, and which sooner or later makes its way to the surface and is discharged. While the abscess is forming the patient is considerably feverish, and feels a tenderness about the anal region. At first the discharge is a bloody pus, which in time becomes watery and acrid, or sanious. The channel through which it passes is called the fistula. If it communicates with the rectum, the flatula is said to be complete; but if it does not perforate the mucous membrane, it is said to be incomplete or blind. Fistula is more liable to occur in scrofulous and consumptive persons than in others, though it may be caused by piles, habitual constipation, or the presence of foreign bodies in the rectum. TREATMENT. -- During the active inflammatory state
the bowels should be evacuated by a mild purge, and if the pain is severe,
an opiate may be given. Flaxseed poultices, or hot fomentations,
should be applied, and as soon as fluctuation is quite evident, an incision
should be made and the pus evacuated. A weak decoction of white oak
bark may then be injected and the parts drawn together by adhesive straps.
The poultices should be continued as long as there is any hope to prevent
a flatulous opening. If the fistula does occur, it gives great annoyance,
and is quite difficult to cure. The surgical treatment consists in
introducing a ligature through the fistulous opening into the bowels and
out the anus, securing it to a small piece of cork, and twisting it once
or twice a day until it cuts through, or by dividing the septum by a knife
and healing it from the bottom. Others cauterize the fistula, and
attempt to stimulate adhesive granulations in that way. I grant that
success attends all these surgical operations, but I do not see the propriety
of subjecting the patient to all the attendant pain and confinement to
bed when a cure can be as radically effected in as short a space of time
by purely medicinal treatment. I have cured very many cases, and
in no instance have resorted to cauterization or the knife. Consultation,
either in person or by letter is free with reference to such cases.
(See page 390.)
PILES (Hemorrhoids) By these are understood the existence of small excrescences within the rectum and around the anus, which are characterized by a varicose condition of the hemorrhoidal veins. They may be situated either internally or externally, and when blood is discharged they are called bleeding piles, if not, blind piles. The tumors vary in size from a pea to a hen's egg. They are more common in women than men owing to the sedentary habits of the former. They are caused by obstruction of the portal circulation, drastic purgatives, habitual constipation, pregnancy, uterine misplacement, etc. TREATMENT. -- If costiveness exists, give some mild
purgative, as senna and leptandrin, or the "Renovating Pill," and keep
bowels gently open, so as to secure one passage a day. Thoroughwort,
in decoction, is also very useful. A compound decoction, or an ointment
made of witch-hazel, white oak bark, and sweet-apple tree, applied to the
tumors, very often cures them. In congestion of the liver, or derangement
of the portal circulation, resort to the treatment advised in chronic hepatitis.
If there is much inflammation, apply a slippery elm, stramonium, or poke-leaf
poultice. Daily injections of cold water are also very useful.
The diet should be regulated, and fatigue should be avoided. As a
remedy for either internal or external piles, I can recommend nothing better
than my "Herbal Ointment." If thoroughly applied to the tumors about
twice a day, it gives instant relief, and cures them in a short time.
DISEASES OF THE ABSORBENT SYSTEM These are diseases affecting the lymphatic glands.
The lymphatic system is that particular system of organs inservient to
the formation and circulation of lymph, and consists of glands and vessels.
When any of these glands become inflamed, the affection is lymphangeitis,
angeioleucitis, or lymphadenitis.
SCROFULA This is commonly known as "King's Evil," and derives its name from the Latin scrofa, a sow, because it was supposed that it also affects swine. It is most apt to occur in persons of sanguine temperament, with thick upper lip. When fully developed, it gives rise to a deposit of tuberculous matter. It is characterized by a morbid state of the system, manifested by glandular swellings, chiefly in the neck, suppurating slowly, and healing with difficulty. At first there appear small, hard, movable kernels about the neck, just under the skin. These are the affected lymphatic glands. No redness or soreness is perceptible at first, but when in course of time they reach the size from a filbert to a hen's egg, or even larger, they come to a head and break, discharging a watery fluid, or a mixture like whey and curd. No great pain is seldom if ever felt. When the ulcers heal, they are apt to leave a puckered condition of the skin, and ugly scars. There is scarcely any tissue or organ in the body that scrofula does not assail, and it forms the basis, in many cases of disease, of all their virulence and stubbornness. Strumous habits are very common, being mostly hereditary; but they may also be contracted by bad habits, or be the sequel to low vitality or prostrating diseases. The taint is apt to become universal if in marriage the health of either party is not considered of equal importance with affection, etc., etc. It impairs the functions of all the organs; it renders the mental faculties more or less imbecile; it gives to the patient a heavy, sullen, and forbidding appearance, and is destructive of all beauty of form or sprightliness of character. It is so serious a disease that no one affected with the taint, however slight it may be, should defer such rational treatment as will cure him of one of the grestest enemies of mankind. TREATMENT. -- How lamentable it is that we have no Kings now-a-days, whose "sacred touch" will cure the prevalent scrofula. In olden times persons believed that if the scrofulous patient could get into the presence of the King, and be touched by his royal hand, his disease would vanish in nothingness. Hence the name of "King's Evil." This folly reached its height in the reign of Charles II, and after the Restoration; the number who flocked to the royal palaces to receive the "touch" is said to have been immense--no less than ninety-two thousand in twelve years. If Kings are no longer divine, and whose sacred touch no longer cures, we are not left hopeless, for the products made by a divine hand as manifested in the herbal world afford us abundant agents of cure, if we but have the wisdom not to ignore them, and the intelligence to use them properly. Rational treatment should be preventive and curative. The preventive treatment consists in regulating the diet and to supply all the chemical material lacking in the histogenic character of the tissues. The habits should be conformed to well-established hygienic laws, and the digestive and assimilative organs should especially be elevated in tonicity and healthfulness. Exercise and bathing are very important, and must not be neglected. When it manifests itself by its characteristic features, tumors, ulcers, etc., the herbal alteratives alone will effect the cure. The best of these are rock rose, stillingia, corydalis formosa, yellow-dock, fig-wort, sarsaparilla, etc. If the system is debilitated the tonics should also be given to give tone to the various organs of the body. The ulcers should be treated as all chronic indolent ulcers--the best application to them being my "Herbal Ointment." My "Blood Purifier" (see page 469) is composed of the choicest alteratives known, and acts specifically in the cure of this disease, and ever since it has been given to the public, its success was asserted in every case in which it received a competent trial. Certain cases of scrofula, in which nearly all the
tissues and organs are involved, and where the vitality of the system is
at a low point, energetic special treatment is necessary. In such
cases the author can be consulted, according to directions given on page
390.
TABES MESENTERICA This consists of an engorgement and tubercular degeneration of the mesenteric glands, followed by emaciation and general disorder of the nutritive functions. It occurs particularly in children of a scrofulous diathesis, and in those who are weaned too soon, or fed on indigestible substances. The disease is often owing to irritation in inflammation of the lining membrane of the intestines, giving occasion to enlargement of the glands of the mesentery, or duplicature of the peritoneum. Diarrhoea, emaciation, loss of appetite, or sometimes immoderate appetite, hardness and swelling of the abdomen, and toward the end hectic fever, are the chief symptoms of this disease. Recovery is seldom from this disease, if it has attained such a stage in which the glands have become extensively disorganized. TREATMENT. -- Digestible food, fresh air, etc., must
be provided for the patient, and the bowels should be kept soluble.
The treatment advised in scrofula should be resorted to in this disease.
The patient's strength is especially to be well supported by good food,
tonics and stimulants. This disease is commonly known as "opneme"
in certain localities, which literally means taking of or wasting away,
and persons can yet be found who ascribe the miserable condition of the
child to the power of witchcraft, and the celebrated "witch doctors" do
yet find employment and supply their amulets or engage in heathenish incantations.
I advise every mother when the first symptoms of this disease are recognized
to at once engage skilful medical aid, and her child may oftentimes be
saved.
ANATOMY OF THE RESPIRATORY ORGANS LARYNX The larynx is a canal formed of cartilages, whose various movements regulate the voice. It is situated in the median line in the upper and anterior part of the neck. It can readily be felt from the exterior, and is commonly called "Adam's Apple." It forms the commencement of the wind-pipe, and in shape is cylindrical below and prismatic above. It is larger in males than in females, which accounts in a measure for the different quality of the voice between the sexes. It is composed of five cartilages; viz., thyroid, cricoid, two arytenoid, and epiglottis. The thyroid is the largest; it occupies the upper anterior portion of the larynx. The cricoid is next in size, and situated at the base of the larynx. Its form is that of a laterally-compressed thick ring. The arytenoid cartilages are two in number, pyramidal in shape, and situated at the upper and back portion of the larynx. The epiglottis is a thin, oval, cartilaginous plate, behind the root of the tongue, and attached to the angle of the larynx; it resembles a leaf in shape, and is perforated with numerous foramina or holes. During deglutition it is pressed over the rima glottidis, thus preventing either solids or liquids from entering the respiratory tract. Within the larynx are two ligaments on either side.
The inferior ligaments are usually called the vocal chords, though they
are more properly ligaments. The space between them is called the
rima glottidis, and the space between the superior ligaments is the glottis.
The larynx is lined with mucous membrane, inflammation of which constitutes
laryngitis.
TRACHEA The trachea (see figure) is a cylindrical tube, four or five inches long, reaching from the larynx to the point of division into the bronchial tubes. It is formed of from sixteen to twenty cartilaginous rings, united by elastic ligamentous tissue. It is lined with mucous membrane continuous with that of the larynx, which is extremely vascular, and covered with numerous follicles. The bronchi or bronchial tubes are essentially of the same structure and arrangement as the trachea; the right bronchus is shorter and of larger diameter than the left. The bronchial tubes ramify into numerous sub-divisions, which finally terminate in the lobules of the lungs. In front of the first two rings of the trachea and
upon the sides of the larynx is the thyroid gland. It is sometimes
much enlarged, constituting goitre.
THE LUNGS The lungs are the organs of respiration properly; they are two in number, and situated in the chest, placed side by side, being separated from the abdomen by the diaphragm. The size varies with the capacity and condition of
the chest, age, inspiration, expiration, and disease. They are conical
in shape, are longer posteriorly than anteriorly, and have concave bases.
The color of the lungs is of a pinkish gray, mobbled with black; these
black spots are more numerous in adult life than in infancy. The
right lung is shorter but larger than the left, whose transverse diameter
is somewhat diminished by the position of the heart. It has three
lobes, the left having but two.
PLEURAE The pleura is a serous membrane investing each lung,
and then reflected upon the walls of the chest. That portion in contact
with the chest is called the pleura costalis; thata covering the lungs,
the pleura pulmonalis.
DISEASES OF THE RESPIRATORY AND CIRCULATORY SYSTEMS CORYZA This is the "running at the nose" or "cold in the head," so frequently contracted. It consists of acute inflammation of the Schneiderian or mucous membrane of the nose, and the sinuses connecting with it. It causes considerable annoyance, and often creates some constitutional disturbance. It is caused by the partial application of cold, as to the back of the head or neck, to the feet, etc., and the effect is especially apt to be produced after perspiration from heat or exertion. When it reigns epidemically it is called influenza. TREATMENT. -- It will usually subside without any
treatment, but the subsidence can be greatly hastened by hot baths, a draught
of ginger tea upon retiring, and the inhalation of some hot aromatic vapors,
such as of balm, water-pepper, etc.
OZOENA This consists of chronic inflammation of the nostrils, with an uneasy feeling, heat, and stiffness of the nose, swelling of the mucous membrane, and an offensive discharge. The nostrils are sometimes closed, owing to the thickness of the membrane. The discharge is often quite purulent, or a yellowish or greenish color, or sanious, and tinged with blood. It is very frequently associated with ulceration, and caries or necrosis of the bone. The breath is usually extremely offensive, and the sense of smell is occasionally lost. It is frequently the result of scrofulous, scorbutic, or syphilitic taint, and is a serious and disgusting disease. TREATMENT. -- The constitutional symptoms should
receive special attention, and if owing to or connected with scrofulous
or syphilitic taint the general treatment for those diseases should be
given. The stomach and bowels should receive careful attention, the
digestion being invigorated by alnuin, viburnin, etc. A salt water
bath should be taken every morning to stimulate the emunctories.
The vapors of tar, naphtha, astringent and narcotic herbs are very beneficial;
an inhaling of mecca oil through an atomizer is successful and necessary
in obstinate cases. Tonics, as quinine, etc., are necessary in some
cases. Those persons who may wish the treatment to be directed by
a competent physician, and who desire prompt relief and cure, may consult
me, as I have given special attention to this disease, and have cured the
most obstinate cases.
CATARRH We now come to a disease that is a bane to the existence
of many a person. The catarrhal patient is never happy, for he knows
that he is inseparably connected with a disease that is excessively annoying
to himself and no less disagreeable to those with whom he comes in contact.
It consists of inflammation of the mucous membrane lining the nose and
sinuses or cavities connecting with it. It is a very common affection,
arising from repeated colds, damp apartments, wet feet, insufficient clothing,
hot rooms, a sudden check of perspiration, and a rheumatic or scrofulous
disposition predisposes to an attack. The symptoms are weariness,
pains in the back and limbs, frontal headache, increased discharge from
the nose, hoarseness, sore throat, impaired vision, fever, constant hawking,
cough, and, if the disease continues, partial or complete deafness.
By the constant dropping of the secretions into the throat, the catarrhal
inflammation is made to extend to the mucous membrane of the throat and
larynx, causing gastritis, tonsillitis, laryngitis, pharyngitis, and bronchitis.
Consumption is not an unfrequent sequel to catarrh, and it may so undermine
the vitality of the system that the most energetic and rational treatment
will only reestablish it. A case that illustrates the ravages of
catarrh in its ordinary severe forms is given in the following letter:
--
RESPECTED SIR: -- My catarrh, which had almost destroyed my power of speech, had nearly lost me the senses of smell and taste, and was rapidly extending to the lungs, by dropping down, has disappeared. I owe this great blessing to your course of treatment. I applied to you by advice of acquaintances, with many doubts; but a "drowning man catches at a straw," and I wrote you a full description of my sufferings. I cannot be too grateful to Providence for having directed me to do this. Use my name in any way you please for the benefit of others afflicted as I was, etc. S. BROWN MILLS. This patient describes the effect of nasal catarrh, as developed in himself, but partially. He has omitted to say that his breath was so offensive that people could not sit in the room with him; that the matter was discharged so copiously that it descended into the stomach, causing vomiting, reducing him in strength and flesh to a comparative skeleton; that he had inflammation and elongation of the soft palate (uvula); had lost his appetite, and was troubled with hectic fever. He was subject to the usual despondency and hopelessness
of patients suffering from long-standing catarrh, and it required every
effort to arouse his drooping spirits to anything like natural vivacity.
In fact, the symptomatic hopelessness and great depression of the spirits
in catarrhal patients is often a greater barrier to speedy cure than the
pathological condition of the disease itself.
It is not merely a local disease, but dependent upon a vitiated condition of the blood; hence, merely local treatment will prove ineffectual: therefore the only successful method of treating this disease, is in combining proper local treatment with appropriate constitutional medication. For years this complaint baffled the skill of physicians universally, and I myself, came to the conclusion, that to really eradicate the disease from the system, a combination of remedies were required: a remedy to cleanse the blood; a remedy for local application; a remedy to circulate the blood, thus arousing the system to action and a medicine to stimulate the liver to aid the system in throwing off the disease. The following treatment meets all these requirements and has proved effectual in curing many thousands of individuals -- many of whom repreented cases of long standing in the most advanced stages of this really dangerous complaint: Accident first brought to my notice Dr. Lane's Catarrh Cure, and I tested it with perfect success in many instances, in conjunction with my Blood Purifier, Herbal Ointment, and Renovating Pills. The following treatment is what I advise in cases of catarrh: A course of the Blood Purifier, consisting of six bottles, taken internally to cleanse the blood. The Herbal Ointment well rubbed in at least once a day across the small of the back, sparingly over the stomach and bowels, and about the forehead and between the eyes to arouse action, assist digestion, soothe the nervous system, and remove irritation. The Renovating Pills taken only often enough to keep the bowels soluble and regulated to one passage per day. They arouse the liver to action and thus aid in throwing off disease. Dr. Lane's Catarrh Cure may be snuffed up the nostrils from the palm of the hand; or, a small syringe may be used; or the Nasal Douche, which is preferable to any other contrivance for the purpose (see illustration) of conveying the catarrh cure gently but thoroughly to the afflicted membranes. The price of the "Nasal Douche" is seventy-five cents and ten cents extra for postage. The catarrh cure should be diluted with warm, soft water, in preference to cold, as the latter has a tendency to produce irritation, or spasmodic action. Those prefering the douche will find it of very great convenience and efficiency, as all parts of the inflamed surface can be reached by its aid. Catarrh can be mastered by the above treatment, and I know of no other that will thoroughly and permanently cure it. Rational treatment will succeed in this, as in other diseases, and those suffering from its presence should act promptly in arresting its progress. We consider the following medicine sufficient to cure the generality of cases: a course of Blood Purifier consisting of six bottles, the price of which is five dollars; two bottles of Dr. Lane's Catarrh Cure of double strength, one dollar and fifty cents each, three dollars; one large pot of Herbal Ointment, fifty cents, and a small box of Renovating Pills, twenty-five cents: total, eight dollars and seventy-five cents. Those desiring to send for my course of treatment for catarrh, may send the money by post office order, or registered letter at my risk, and I will promptly forward the medicine on the receipt of the same by express with full directions for use. Sufferers should not fail to possess the Nasal Apparatus, illustrated above, as by its use the nasal cavities can be thoroughly cleaned and medicated. I have spoken thus confidently regarding the above treatment, knowing how successful it has proved in thousands of cases of catarrh. I am willing to give my advice, or opinion, when
desired to do so, in any case, free of charge, either at my office or by
letter. Address DR. O. PHELPS BROWN, 21 Grand St., Jersey City, N.
J.
LARYNGITIS This consists of an inflammation of the parts composing the larynx, especially the mucous membranes, and may be either acute or chronic. When it is known that in the larynx are situated the vocal organs, and that the aperture for the air to reach the lungs is situated at the apex, it can readily be conceived why inflammation impairs the voice or impedes the respiration. In the acute form there is hoarseness, a pain about the larynx or "Adam's apple," cough, and difficulty of swallowing. If the inflammation is violent the patient's life is in imminent danger from strangulation, caused by closure of the rima glottidis. The voice is often completely lost. In bad cases the patient starts up suddenly in bed begging for air; his lips assume a livid or purplish color, the surface becomes cold, the pulse frequent and feeble, the countenance ghastly, perspiration clammy, and finally death occurs from insufficient aeration of the blood. The chronic form is more common than the acute, and is generally associated with induration or ulceration of the mucous membrane. It causes great debility, emaciation, night-sweats, loss of appetite, vomiting and diarrhoea, and the patient often dies in a state of hectic exhaustion. TREATMENT. -- Control the circulation with veratrum, administer an emetic and purge, and apply hot packs to the throat. Hot water should be used frequently as a gargle. The inhalation of hot vapors, as that of belladonna, lobelia, stramonium, mullein, sweet fern, etc., gives great relief. Some practitioners use ice-bags in place of hot packs to the throat. They seem to answer the same purpose. In case of impending strangulation, no objection should be made to laryngotomy, if in the opinion of the physician or surgeon it is deemed necessary. In the chronic form the disease demands the same treatment, though modified to suit the conditions of the case. A gargle of golden seal, and a syrup of Ceanothus Americanus, or frost-wort, taken internally, are very beneficial. Mecca oil is also used with great advantage. Tonics and stimulants become necessary if the strength is failing. I can offer to the patient an almost sure cure in my "Acacian Balsam," which is to be taken internally, and my "Herbal Ointment," applied externally. If complicated, or owing to syphilitic contamination,
special treatment (see page 390) is advised.
BRONCHITIS Inflammation of the bronchial mucous membrane is of common occurrence. Its severity is proportionate to the size of the tube involved. The disease may exist independently, but is often associated with lung diseases. It may exist either in the acute or chronic form. In the former variety, affecting the large and middle-sized tubes, coryza, sore throat, hoarseness, and slight chills are the first symptoms; lassitude and pain in the limbs are also present, and as the disease progresses there is a sensation of heat, soreness, and rawness of the bronchial surface, oppressed breathing, and a spasmodic cough and pain. The cough in the early stage is followed by a clear, frothy expectoration, with a saline taste, which changes to yellowish or greenish sputa, or it may be streaked with blood. If the small tubes are involved, the pulse is extremely frequent, great difficulty of breathing, blue appearance of the countenance, coldness of surface, and a tendency to asphyxia is noted. As soon as the disease becomes chronic the febrile symptoms disappear, but the pulse remains frequent, and the cough and dyspnoea are persistent, though to some extent relieved by free expectoration. The sleep is irregular, and night-sweats frequent, occasioning great debility. The cough becomes croupy, and diarrhoea often attests approaching dissolution. TREATMENT. -- A hot bath, hot packs, and veratrum
will often terminate the career of the acute form at the outset.
In the more severe forms an emetic should be given, and the hot packs or
chafing liniments to the chest and throat frequently renewed. Blood-root
and other expectorants should be given, and quinine should be administered
if the disease is associated with malarial influence. The tonics
may become necessary to sustain the strength. The vapors of meca
oil, goose-grease, and bitter herbs are beneficial. In the chronic
form the treatment varies with the cause. If owing to syphilitic
taint the treatment for that diseaase should be given, and if rheumatic
in origin, colchicum, in connection with tonics, is the treatment indicated.
The inhalation of the various vapors before alluded to should also be instituted,
and the strength of the patient carefully husbanded by tonics, beef-tea,
wine, whey, etc. A remedy that combines both tonic and expectorant
qualities is found in my "Acacian Balsam," which generally cures the worst
cases very quickly. The "Herbal Ointment" should at the same time
be thoroughly rubbed upon the chest, throat, and back. Consultations,
either in person or by letter, will receive careful and prompt attention.
CROUP Croup is an inflammation of the mucous membrane of the larynx and trachea, or windpipe. It is one of the scourges of childhood. False membranous croup is owing to an oozing of a peculiar fluid, which thickens into apparent membranes, and adheres to the surface of the windpipe. In membranous croup, there is much greater danger than in the simpler form. The symptoms are, difficult breathing, hoarseness, loud and shrill cough, with fever. When the symptoms are violent at first, the disease will be in all probability not fatal, as the membranous croup comes on insidiously, and is scarcely ever ushered in by high inflammation. TREATMENT. -- An early and effective emetic is indicated
in all cases. Some mechanical emetic, as ipecacuanha, alum, etc.,
should be preferred. Flaxseed poultices, my "Herbal Ointment," and
irritating liniments should be applied to the neck. The Dover's powder
should be given to promote perspiration and rest. Inhalation of vapor
from hot water and mullein leaves is of great service. The bowels
should be kept regular. In membranous croup, if the membrane cannot
be dislodged by emetics, and suffocation is imminent, tracheotomy becomes
necessary. Croup may often be prevented by tying a bag containing
powdered rosin, which is electro-negative, around the throat at night.
PNEUMONIA This is commonly called lung fever. It is characterized by inflammation of the parenchyma or texture of the lungs. The patient is generally found lying on his back, complains of pain in his side, has more or less difficulty of breathing, a cough at first dry, but soon accompanied by bloody phlegm. As the disease becomes severe, the phlegm becomes very tenacious, so that it will adhere to the spit-cup if turned upside down. Three characteristic stages are observed in this disease, viz., congestion, hepatization, and softening. In the first stage the lungs become engorged with blood or congested, and if the lungs are percussed a dull sound is elicited, and if the ears are applied to the chest a minute crackling sound is heard, similar to that produced by rubbing fine hair between the fingers and thumb. It is only heard during inspiration, and is caused by the air breaking up the mucous adhesions. The urine is scanty and high colored. In the second stage the lungs become solid, or hepatized, resembling the liver. Some writers call it red softening. The dulness becomes more distinct upon percussion, and a whistling sound is heard if the ear is placed to the chest. The cough is more or less dry, but the fever is aggravated. There is great prostration, restlessness, complete loss of appetite, constipation, a loaded brown tongue, and the respiration is hurried and imperfect. In the third stage the lung softens and becomes filled with matter, and portions of the lung are apt to give way. The cavities may be detected by increased resonance at some parts by percussion, and the cavernous breathing by auscultation. There is also a metallic tinkling heard, and the sputum becomes more liquid, looking like prune-juice, and the general condition of the patient worse in every respect. If the disease advancs into this stage, recovery is not very probable. Pneumonia may be double or single; the right lung suffers, however, more frequently than the left. If pleurisy is associated with it, it is called pleuro-pneumonia. When characterized by great debility and prostration, and is of a low type, it is called typhoid pneumonia. The pneumonia of children is called lobular, as it is generally confined to one or two lobes of the lung. TREATMENT. -- Bleeding formerly was done in each
case, and is again receiving attention by some physicians, but I deem it
injudicious, as a general thing, though it may be of benefit in some plethoric
cases. The treatment should be commenced with a mild cathartic, and
the fever should be controlled with veratrum. The expectorants should
be administered, and in cases of great prostration, beef-tea and alcoholic
stimulants must be given. The chest should be blistered, and a cloth
smeared with lard should be placed on the raw surface. Sleep should
be promoted by lumulin or the opiates, and if great difficulty of breathing
exists, turpentine should be poured on hot water, and the patient allowed
to breathe the vapor. Fresh air, quietude, and rest, with frequent
sponging of the body with tepid water, should not be neglected.
ASTHMA This is characterized by difficult breathing, occurring in paroxysms, accompanied by a wheezing sound, a great desire for fresh air, and unattended by fever or organic disease of the lungs or heart. It is evidently caused by an irritable condition of the cerebro-spinal system or medulla-oblongata, which deranges the nervous influence through the cervical and pneumogastric nerves. It is also called Phthinic. The attack generally comes on suddenly, but in some cases for a few days before the onset there is loss of appetite, flatulence, belching of wind, languor, chilliness, and drowsiness. The attack generally occurs at night, when the nervous system is at its lowest ebb. At first a sense of tightness, with a feeling of constriction about the chest, is felt, which intensifies into a fearful struggle for breath. The patient assumes various postures to facilitate in emptying and filling the lungs, and the feeling that he must have fresh air, induces him to rush to the window and put his head far out to catch the stirring breeze. The hands and feet are cold, the expression haggard and anxious, the body wet with perspiration, and the pulse irregular. The paroxysms usually last for some hours, when breathing becomes more easy. If the symptoms subside without expectoration it is called dry asthma, but when any phlegm is raised it is known as humoral asthma. The paroxysms may recur every night, remitting gradually in severity, before a final subsidence takes place. The very troublesome complaint, which seems to combine the peculiarities of asthma and coryza, occurring in some persons during hay-making, or even later, is called hay asthma. This complaint is often a distressing one. TREATMENT. -- During the paroxysm the inhalation
of vapor of hot water, or that arising from a decoction of anti-spasmodic
herbs, such as conium, belladonna, etc., lessens the severity of the spasm.
The following preparation is a very good remedy: Ethereal Tincture of Lobelia
3ij: Tincture of assafoetida, 3i; laudanum, 3ss; fluid extract of stillingia,
3ij; simple syrup, 3iv; mix, and take a tablespoonful every two hours.
Electro-magnetism, smoking stramonium leaves, inhaling the smoke from burning
paper, dipped in a solution of saltpetre, are all beneficial. The
anti-spasmodics, especially cherry-laurel water, should be taken to prevent
the occurrence of frequent attacks. In hay asthma, changes of locality
will often save the patient from an attack. The tincture of lobelia
is a very good remedy. Quinine and nux vomica carefully administered
are good remedies. Chloride of lime placed in a saucer in the sleeping-room
often gives relief. My "Acacian Balsam" internally, and the "Herbal
Ointment" rubbed externally on the chest, and up and down the spine, have
cured many cases. Many interesting cases have come under my notice
and treatment, but space forbids any allusion to them. By special
treatment I think every case can be cured.
PLEURISY This is characterized by inflammation of the pleura or serous membrane enclosing the lungs. The disease usually commences with a chill, which is succeeded by a sharp, lancinating pain in the side; cough, short and quick breating, and fever. The pain is uaually called a stitch in the side, and is felt somewhere in the mammary region. It is increased by inspiration, cough, and motion, lying on the affected side, or by pressure. As the pain subsides, the effusion of a serous liquid occurs into the pleural cavity. The cough is usually short and dry, though a little frothy mucus may be expectorated. Severe pain often attends, and the patient tries to suppress the cough as much as possible. The breathing is more or less difficult in most cases, and the patient is said to have a catch in his breath. When the effusion is both sudden and copious, the function of one lung may be more or less suspended. The fever is usually considerable, and presents the usual phenomena of febrile affections. At some stages the patient's voice is said to be oegophonous, or similar to a goat's. TREATMENT. -- Commence with a mild cathartic, and
though opposed to bleeding, yet if there is a human ailment requiring bleeding
it is pleurisy, as it often gives prompt relief from pain. Sweating
should be encouraged at the outset, and for this purpose the tencture of
Virginia snake-root, in teaspoonful doses, every half-hour, is the best.
It may be given in an infusion of catnip, balm, or pleurisy root.
The affected side may be fomented with hops, tansy, wormwood, etc., applied
very hot, or it may be blistered. The fever is to be controlled and
the perspiration kept up with full doses of veratrum. Dover's powder
may be given to procure sleep. The diet should be of the very lightest
kind. The alteratives may be given if the effusion is not absorbed,
and should these fail, the surgeon may perform paracentesis, or tapping
of the side.
APNOEA, OR ASPHYXIA Literally the word asphyxia means pulseless, and
was for a long time only used in that sense, but is now applied generally
to all cases of suspended animation. It is produced by the non-conversion
of venous or blue blood of the lungs into arterial, or red blood.
Death is caused in all cases from want of oxygenized blood, and the stagnation
that results in the pulmonary capillaris. There are several varieties
of asphyxia; and as life can in many cases be revived, I shall state the
procedure of resuscitation in each case.
ASPHYXIA BY EXTREME COLD When a person is subjected to extreme cold, the first symptoms are painful feelings, followed by sensations similar to those produced by inhalation of carbonic acid gas. He becomes benumbed, indifferent to the danger of his situation; the muscular system becomes enervated, step grows tottering, speech imperfect; and as these influences increase, the breathing becomes irregular and slow, the muscular powers fail, and he sinks into a state of insensibility and death. TREATMENT. -- Rub the person with snow if practicable,
or the whole body may be submerged in cold water for a short time.
These applications should be gradually increased in temperature until the
surface approaches a natural state, or the muscles and joints are sufficiently
relaxed to admit of free motion. Then resort to artificial respiration
as in drowning.
ASPHYXIA BY INHALATION OF GASES Some gases cause death by spasmodic closure of the glottis, others by want of oxygen. Carbonic acid gas is the most common noxious gas. TREATMENT. -- Place the patient in a region where
pure air abounds, and then practise artificial respiration.
ASPHYXIA BY SUBMERSION, DROWNING Death in this case is not caused by the stomach and air passages being filled with water, but ensues in consequence of the person being plunged in a medium unfit for respiration. In no case where the body is recovered immediately after drowning, should the means of resuscitation be left unemployed. Life has been revived even in cases that were submerged half an hour. TREATMENT. -- 1st. Treat the patient instantly, on the spot, in the open air, freely exposing the face, neck, and chest to the breeze, except in severe weather. 2nd. Send for the nearest medical aid, and for clothing, blankets, etc. 3rd. Place the patient gently on the face, the forehead resting on his wrist. This empties the mouth of fluids, and allows the tongue to fall forward, which leaves the entrance to the pipe free. 4th. Turn the patient slightly on his side, and apply ammonia, snuff, or other irritating substances, to the nostrils; then dash cold water on the face, previously rubbed briskly until it is warm. If there be no success, instantly -- 5th. Replace the patient on his face, and turn the body gently, but completely, on the side and a little beyond, and then on the face, alternately; repeating these measures with deliberation, efficiency, and perseverance, fifteen times to the minutes. When the patient reposes on the chest, this cavity is compressed and expiration takes place; the pressure is removed when turned on the side, and inspiration occurs. 6th. When in the prone position, make equable but efficient pressure along the spine, augment expiration, and remove it before rotation on the side, to facilitate inspiration. 7th. Induce circulation and warmth, while continuing these measures, by rubbing the limbs upward with firm pressure and with energy, using handkerchiefs, etc. 8th. Replace the patient's wet clothing by such other covering as can be instantly procured, each bystander furnishing a coat or waistcoat. Meantime, and from time to time, let the surface of the body be slapped freely with the hand, or let cold water be dashed briskly over the surface, previously rubbed dry and warm. Let the patient often inhale diluted pure hartshorn,
as this stimulates the respiratory organ.
CONSUMPTION (PHTHISIS) This is a constitutional affection manifesting itself in most essential changes in the tissue of the lungs. It may be acute or chronic. The acute form, or galloping consumption, commences with chills, fever, rapid pulse, cough, pain and difficulty of breathing, which are soon followed by night-sweats, hectic fever, great emaciation, exhaustion, and if its course is not arrested, death. The chronic variety is, however, that which we usually meet with. For the sake of convenience, I will class the symptoms of consumption into four general stages, viz, the Incipient stage; the Solidification stage; the Maturation or Softening stage; and the Ulceration and Suppuration stage. The first stage of Tubercular Phthisis is generally stated to be that to which the physical signs indicate a deposit in the lungs. Evidently, however, there is, and must be, an antecedent state of disordered health before the most skilful observer can detect the sound which indicates the least shade or degree of solidification of the lungs, whether by means of the stethoscope, or other methods usually resorted to by the profession for such purpose. When the physical signs are observed, the use of the stethoscope, etc., may be regarded as little more than professional display, without a particle of advantage, except as developing in some degree the actual amount of lesion or injury then sustained by the tissues of the lungs. There must be a causative agent that originates the predisposition or tendency to the deposit of tubercles in the tissues, or which elaborates or prepares the material in the system, from which only tubercle is formed. But we should not wait to see the physical signs develeoped if we would expect uniform and hopeful treatment of tubercular consumption. From my own long experience in the specialty of thoracic diseases, I do not hesitate to say that the actual first set of symptoms of consumption consists simply in the wasting of flesh, particularly if this is attended with, or by, a low scale of health and strength. Such loss of muscle, plumpness, as well as juices and fat, is first noticed in three principal places. The first region of flesh-consuming is usually the face; the second, the hands; the third, over the sacral or hip bones. The sacral region, where it first gives out, is lame and sore. The hands look poor and "scrawny;" the muscles of the arms and legs are soft and flabby. If the face shows it first, the eyes stare; the brow, temples, and scalp look lean; the muscular tissues of all the limbs soon waste, and the pectoral muscles, as also all the chest muscles, waste away, and then the breathing is already become imperfect and weak. The diminished respiration is soon attended with cough; then pains are felt through the breast or thorax. The patient next is sensible of something wrong, and is conscious of a sense of general debility. The fact is, nutrition is lost. The vital powers are flagging, for the wasting of the body, in spite of eating, is more rapid than the repair. Then comes a state of spirit depression -- not the cause of consumption, but caused by the already deficient vitality, and all the more helping on the grand catastrophe; for it is a law of our being, that where nerve structure is not itself nourished, it, too, will fail in its work, just as surely as muscle fibre fails of power from the same cause. To recapitulate:-- 1. -- Incipient stage. This may present itself at a very early age, or may appear in middle age, and the first indications are, generally, a subdued and saddened feeling, the former buoyancy of spirits subsides, and the person becomes languid. The face begins to assume a sickly hue, and, to a practised eye, tells a sad tale. The skin becomes whiter, and a nervousness and sometimes irritable disposition of mind appears; and if any hint be given about consumption threatening, the person rebels against it, and will not tolerate such an idea. The appetite and digestion frequently become impaired, and may manifest itself in capricious fancies for certain sorts of food. A slight cold or any excitement will bring on diarrhoea. The breath is short, and the breathing hurried; running or walking up an incline, or ascending a flight of stairs, is unpleasant, and attended by a fluttering and palpitation of the heart. The strength and weight of the body dimish, but this varies. The sleep is disturbed, the skin becomes hot, there are turnings of the palms of the hands, and cold feet; a short, dry, teasing cough, or tickling, or hawking up of mucus from the throat appears. There is also a feeling of feverishness and uneasiness after meals, which are unfavorable symptoms, indicating the first mal-assimilation of the food, which, if not rectified, will inevitably deposit the germ of tubercles, and hence no time should now be lost in opposing the disease, before it lays siege to the citadel of the body. 2.-- Solidification. The cough, which at first appeared very trifling, now begins to assume an anxious aspect, and becomes troublesome. It may not as yet be attended with expectoration, and if it be, the matter expectorated is of a ropy and viscid nature. The breathing becomes more impeded; hectic fever sets in, with chills and heats, while the weakness of both body and mind increases, although the intellect is sometimes extremely bright or sound to the very last. Pains, like those of pleurisy, are felt about the chest, and are indications of those inflammatory effusions and adhesions which attest the progress of the disease, and the infraction of the lung structure, and the impeding of the access of air to the cells of the lungs. The blocking up of the air cells constitutes the stage of Solidification, and thus interferes with the due motives or functions of the chest, and, if not arrested, creates an afflux of fluid to the parts, thus promoting congestion and fresh deposits in the lungs. 3. -- Maturation and Softening. In this stage, all the former symptoms are aggravated, and consumption is now confirmed. Fresh deposits in the lungs occur, and hasten the maturation and softening. These local lesions in their turn re-act on the system at large, aggravating the general infection and depressing the vital powers. Hence the advancing inertia of all the vital powers -- the universal languor, loss of flesh, and strength, and weight. The cheeks and lips become blanched -- painfully contrasting with the circumscribed hectic patch of the former. The expectoration is changed, and becomes more copious, opaque, and viscid, more massive, and frequently streaked with blood, or mixed with flocculent, wool-like, or curdy particles. It is most troublesome in the mornings, and when going to bed. The feverishness and general exhaustion increase; restless nights, with perspirations, hurried breathing, change in voice, and emaciation also increases. The appetite fails -- either constipation or diarrhoea, more frequently the latter, comes on, with great increase of cough and vomiting after meals. If the disease advanced to this stage, it will require much vigilance and judgment to arrest its progress, as the mischief in the lungs is now very great, and ulcers, rapidly forming, constitute what is called tubercles. 4. Ulceration and Suppuration. The disease now assumes a totally different aspect, and becomes exceeding formidable in its nature and results. The cough becomes more severe, and the expectoration greenish, yellow, or even sometimes like tufts of wood chewed, appearing, when viewed in water, like jagged round balls. Hemorrhage, or bleeding from the lungs, is likely to come on, and the difficulty of breathing is very great. The patient can scarcely lie down; many times he must be kept with his head bolstered up in a chair, or in his bed, when sleep is desired. Sometimes the voice is reduced to a mere whisper, while in others it remains quite strong to the last. The perspiration, or night-sweats, are very copious, and very exhaustive of the vitality of the organism. The ulcers or tubercles in the lungs increase, causing large excavations, from which issue copious expectorations, sapping and undermining the foundation of the entire system. The most unpractised eye can now at once detect the ravages of this disease in the altered appearance of the whole frame; the body is reduced to a mere skeleton; the eyes are sunken; cheek bones prominent, with sunken cheeks; the head bends forward; the chest is wasted, and the breathing becomes distressingly painful. The mental faculties generally become impaired; yet a gracious God, amid all this suffering, frequently permits the faculties to remain intact until the last ember burns out. TREATMENT. -- This resolves itself into such a management of the case as will tend to prevent the development of the disease, or its removal when it exists. It will be seen that consumption has its origin in a vitiated and defective condition of the general organism. This may occur as the result of hereditary predisposition, or from defective nutrition, or from imperfect development of either a part or the whole of the organic structure, and general disobedience to the physiological law of the general organism. Whenever this predisposition exists, the defective organization, as far as practicable, should be remedied by a faithful adherence to the laws of physiology and dietetics. Children possessing this organization should not be confined too closely in schools or to study, but should be reared in the country, and be exposed to fresh air and out-door exercise. Both boys and girls should be allowed to ramble through the fields, and indulge in those gymnastic exercises which tend to give strength and vigor to the system generally, such as jumping the rope, rolling the hoop, flying the kite, hoeing, wheeling, riding on horseback, etc., and not be studiously confined in-doors, because it is a "delicate child." Tidy mothers should not be horrified if they find their child of frail organization making mud-pies, or that he has torn his frock in climbing an apple-tree. Their diet should be plain and nutritious, consisting of bread and milk, oatmeal porridge, baked apples and milk, vegetables, and a liberal amount of meat once or twice a day. Their sleeping apartments should be well ventilated, and they should be warmly clad in all seasons. Misses, upon the approach of the catamenial flow, should be well instructed that the feet should be kept warm and dry, that washing and bathing in cold water should be avoided, and all exposure to cold and moisture is hurtful. The medicinal treatment of consumption has been extensive, and to enumerate all that has been tried and recommended would fill a volume. Some recommend inhalations; these answer their purpose well for temporary relief. The disease must be treated upon general principles. The cough should be allayed by appropriate remedies, the occasional diarrhoea checked by the astringents, the debility removed by tonics, and vitality stimulated by alcoholic liquors. It is beyond question, that spirit-drinking has been beneficial in a number of cases, if taken regularly and moderately. Phosphorus is a good remedy, especially if given in a form as it exists in erythrozylon coca. External irritants, as Croton oil to the chest, answer very well. The blood of the consumptive contains too much oxygen, and too little carbon; hence to supply this deficiency cod-liver oil, which is a highly carbonaceous food, is excellent. It gives warmth to the body, and supplies the disease with material for destruction, without expense to the body. The chalybeates may also be given to give strength and enrich the blood in its red particles. Change of climate is rarely beneficial. The diet must be highly nutritious; fresh air, occasional baths, and plenty of friction, should not be neglected. While investigating the best means of treating this disease, I deemed that if a combination could be made that would prove remedial to all the morbid characters of consumption, that would antagonize each pathological condition as they arose thus holding the disease in abeyance, and allow the forces of reparation and recuperation to mend the ravages of the disease, that such a combination would most surely cure the disease. After various experiments, I finally, by intimate knowledge of the chemical elements of plants and the pathology of the disease, was led to compound the "Acacian Balsam," which has stood the test for years, and the thousands of testimonials of the permanent cure of many bad cases of consumption attest its virtues. It is a superior exhilarant. It purifies all
the fluids and secretions in the shortest reasonable period. It nourishes
the patient who is too much reduced to partake of ordinary food.
It will supply the place of food for a month at a time. It strengthens,
braces, and vitalizes the brain. It heals all internal sores, tubercles,
ulcers, and inflammations. It stimulates, but is not followed by
reaction. It at once obviates emaciation, building up wasted flesh
and muscle, as the rain vivifies and enhances the growth of the grass.
It is without a rival as a tonic, and it immediately supplies electricity
or magnetic force (as if it were a battery) to every part of the enfeebled
and prostrate body. In conjunction with the balsam, I also advise
external application of the "Herbal Ointment" (which answers all the purposes
of counter-irritants) to the chest, throat and back, and the bowels regulated
with the "Renovating Pill" (see page 469).
ANATOMY OF THE HEART The heart is a hollow muscular organ, surrounded by a membranous sac called the pericardium. It lies between the two pleurae of the lungs, and rests upon the cord-like tendon of the midriff, in the cavity of the chest. It shape is conoidal, though it is somewhat flattened upon that side that rests upon the tendon of the diaphragm. Its apex inclines to the left side, touching the walls of the thorax between the fifth and sixth ribs. It measures about five inches and a half from its apex to its base, three and a half inches in the diameter of its base, and weighs about six or eight ounces. It contains four cavities, which perform two functions: that of receiving the blood and emptying the blood into the lungs, and that of receiving it again after it has been oxygenated, and distributing it throughout the vascular system. The receptacles are auricles, and the ventricles propel the blood to the lungs and through the body. The auricle and ventricle of the right side receive and propel the venous blood into the lungs. The auricle and ventricle of the left side receive and propel the arterial blood throughout the system. The blood circulates as follows: The ascending and descending vena cavae empty the blood (venous) into the right auricle; from here it passes to the right ventricle, through an opening protected by a valve, downwards; from the right ventricle it is propelled through the pulmonary artery, which divides into two branches, to the lungs; in the lungs it is oxygenated by the inspired air; it is then brought from the lungs, by four pulmonary veins, into the left auricle. The left auricle has an opening communicating with the left ventricle, protected by a valve opening downwards, and from the left ventricle it passes into the aorta, thence to be distributed throughout the body. The right auricle is a cavity of irregular shape, somewhat oblong, and like a cube; anteriorly it has a convexity which is called its sinus; superiorly there is an elongated process resembling the ear of an animal, whence the term auricle. Its walls are thin, and composed of muscular fibres, which are called musculi pectinati, on account of their parallel arrangement, resmbling the teeth of a comb. The superior, and inferior vena cavae enter the auricle from behind. The elevation between the orifices is called the tuberculum Loueri. The coronary veins open into this cavity, and their orifices are protected by the valves of Thebesius. The opening to the ventricle is circular, and surrounded by a dense white line. The right ventricle is a triangular cavity, with thick walls and of greater capacity than any other cavity of the heart. Its muscular structure is in the form of large fleshy bundles, called columnos carneas, from which proceed thin, white cords, called chordae tendineae, attached to the edge of the tricuspid valve. This valve is circular, having at its lower edge three spear-pointed processes, whence its name. It closes downwards, and prevents the blood from returning into the auricle, and, therefore, it passes out by the pulmonary artery. The valves protecting the orifice of the pulmonary artery open outwards, and are called the semi-lunar valves. They are formed by three half-moon-shaped folds of the lining membranes, and their use is to prevent the blood returning from the artery to the ventricle, when it dilates. Behind each valve is a pouch or dilatation, called the Sinus of Valsalva, into which the blood flows by its reflux tendency upon the dilatation of the ventricle, and thus these valves are closed. The pulmonary artery is of the same diameter as the aorta, but its walls are thinner. After its origin it curves upwards and backwards, and divides into two branches, the right of which is larger than the left, and passes under the arch of the aorta. The left auricle is more concealed from its natural position than the right. The four pulmonary veins enter into it, which give it a quadrangular shape. Its walls are muscular and somewhat thicker than those of the right auricle. The partition between the auricles is not always perfect even in adult life. The left ventricle forms by its cavity the apex of the heart; it is like a cone in shape. Its walls are thick, and its columnae carneae numerous, strong and projecting; the chordae tendinea are well developed, and attached to the bicuspid or mitral valve. This valve consists of two leaflets, one of which is much larger than the other. The contraction of the ventricle closes the valve, and the blood passes out by the aorta. The heart is supplied with blood by the right and left coronary arteries; the veins which accompany them empty by a common trunk into the right auricle. It will thus be seen what a complex piece of machinery
the human heart is, and how vital the organ must be. It will be apparent
to every reader that the least interruption or derangement of its functional
action is sure to be manifested upon the integrity of the general system.
Any valvular derangement or breaking down of the septum between the auricles
and ventricles will allow the commingling of arterial with venous blood,
threatening death with asphyxia. Atrophy and hypertrophy interfere
with the muscular action of the walls of the heart, and, in fact, it will
be obvious from the complex character of the structural anatomy and the
importance of the functional actions of the heart, that any disease assailing
the organ is attended with danger.
First Sound. -- Second stage of ventricular diastole. Ventricular systole, and auricular diastole. Impulse against the chest. Pulse in the arteries. Second Sound. -- First stage of ventricular diastole. Interval. -- Short repose, then auricular systole, and second stage of ventricular diastole, etc. Each cavity of the heart will hold about two fluid ounces, but it is probable that the ventricles do not entirely empty themselves at each stroke; they will therefore discharge about one and one-half ounces at each pulsation. Reckoning 75 pulsations to the minutes, there will pass through the heart in this time 112 ounces or 7 lbs. of blood. The whole quantity of blood in the human body is equal to about one-fifth of its weight, or 28 lbs. in a person weighing 140 lbs. This quantity would therefore pass through the heart once in four minutes, or about fifteen or twenty times an hour. It is very probable that circulation is much more rapid than this estimate. The number of contractions of the heart in a minute is about 70 or 75. The frequency of its action gradually diminishes from the commencement to the end of life. Just after birth it ranges from 140 to 130, in old age 65 to 50. Age, sex, muscular exertion, emotions, and temperament exert a controlling influence over the heart's action. In persons of sanguine temperament the heart beats more frequently than in those of the phlegmatic, and in the female sex more frequently than in the male. Its action is also increased after a meal, and by rising from a recumbent to a sitting or standing posture. The time of day also affects it; the pulse is more frequent in the morning, and becomes gradually slower as the day advances. The pulse is always a sure index of health or disease. In inflammation and fevers the pulse is much more frequent than during health. When the vital powers decline it becomes frequent and feeble. In nervous affections with more oppression than exhaustion of the forces, the pulse is often remarkably slow. The membrane lining the interior of the heart is
called the endocardium, and the enveloping membrane on the exterior the
pericardium.
DISEASES OF THE HEART AND CIRCULATORY SYSTEM PALPITATION This is the most common disease of the heart, and may be connected with various structural changes of the organ, yet it frequently exists independently of any organic lesion, and is often sympathetically dependent upon dyspepsia, hypochondria, hysterica, mental agitation, venereal excesses, masturbation, etc. It may also be due to a low and deficient state of the blood, or anaemia. The impulse is weak, fluttering, or tumultuous, generally increased by trifling causes. The beats are increased in frequency, sometimes marked by intermission, and occasionally accompanied by a bellows murmur. The complexion is generally pallid and bloodless, the lips and inside of mouth also pale, the pulse quick and jerking, and the patient complains of breathlessness and fainting. He dislikes animal food, but relishes acids. In females the deficiency of menstrual flow is superseded by the whites, or sometimes the flow becomes very profuse. TREATMENT. -- During the paroxysm a compound of yellow
jasmine, scull-cap, and ladies'-slipper should be given, in sufficient
doses every hour, until relieved. The feet should be bathed in warm
water and the patient avoid all exertion or excitement. If due to
anaemia, the proper remedies as well as nourishing diet should be prescribed.
If co-existent with dyspepsia, hypochondria, etc., the proper treatment
for those affections should be instituted.
ANGINE PECTORIS This disease presents rather difficult pathological features. By some writers it is called neuralgia of the heart. The principal symptoms are, violent pain about the breast bone, extending towards the arms, anxiety, difficulty of breathing, and sense of suffocation. The paroxysm may be brought on by fast walking, over-eating, or violent exercise, but they may also come on when the patient lies quietly in bed. If connected with ossification, or other morbid conditions, it is an affection of great danger. TREATMENT. -- During the paroxysm the most powerful
stimulating and narcotic anti-spasmodics are required. The feet should
be placed in warm water, a large mustard plaster should be applied over
the cardiac region, and one drop of the tincture of aconite may be given
every minute or two, until the spasm is relieved. If it is associated
with any organic disease of the heart, the proper treatment for such disease
should be instituted, and if due to a neuralgic affection of the organ,
the proper remedies for neuralgia should be given. Patients suffering
from this dangerous disease should lose no time in consulting some well-skilled
physician.
PERICARDITIS This consists of inflammation of the sac in which the heart is contained. It does not essentially differ from other serous inflammations, as there may be exudation and liquid effusion, the quantity varying from a few ounces to a few pints. The disease is usually ushered in with a slight chill, followed with fever, or it may commence with fainting. Pain, oppression, weight, palpitation, cough, hurried and difficult respiration, frequent and irregular pulse, inability to lie on the left side, headache, delirium, faintness, anxiety, debility, restlessness, and great nervous irritability usually attend the attack. The face and extremities are swollen, and the urine scanty and high-colored. The essential conditions of fever are always present, the pulse sometimes attaining 120 to the minute. If the acute form advances for several weeks it becomes chronic, or may by insidious advances be chronic from the first. The symptoms are nearly the same as in the acute form. TREATMENT. -- The treatment should be commenced by
a lobelia emetic, an active purge, and the application of hot packs to
the chest. The tincture of veratrum should be given in sufficient
quantities to control the inflammation and lessen the action of the heart.
Usually, from two to five drops every half hour is sufficient. If
associated with rheumatism, colchicum, cannabis sativa, or macrotys racemosa,
should be given. In malarial districts, quinine becomes necessary.
Blistering or local depletion may be necessary in some cases.
This is an inflammation of the internal lining of the heart. There is at first pain about the heart, whose disordered action may be violent, or else feeble irregular, and intermitting. There is more or less difficulty of breathing, and the organ gives forth some abnormal sounds, such as the bellows murmur, the rasping and sawing murmur, arising from thickening of, or deposit on, some of the valves. One or more of the above symptoms occurring during the course of acute rheumatism, may be considered a sign of endocarditis. The patient generally lies on his back, and his pain may sometimes be so slight as scarcely to be noticed, but in dangerous cases there is extreme anguish, liable to be followed by orthopnoea, or necessity of being in the erect posture to be able to breathe, followed by restlessness, delirium, and death. The murmurs may occur at any stage of the disease from the very beginning towards the close. TREATMENT. -- The treatment is essentially the same as for pericarditis in the commencement of the attack, with the exception that it may be necessary to administer stimulants in some cases. Leeches may be applied to the cardiac region, and between the shoulders. Digitalis and veratrum should be cautiously administered to control the heart's action. If associated with rheumatism, colchicum should be given. Mustard poultices, blisters or hot packs may be applied to the chest to hasten the absorption of the deposit of lymph. If myocarditis, or inflammation of the entire substance
of the heart, complicates either pericarditis or endocarditis, the active
treatment advised in the latter diseases will remove it.
CHRONIC VALVULAR DISEASE OF THE HEART This frequently results from chronic endocarditis. They may either be contracted or distorted, preventing accurate closure, or ulceration may occur through the valves. Vegetations and a peculiar deposit may take place under the tissue of the valves, and occasionally there is a deposition of cartilaginous or osseous matter, and in rheumatic or gouty subjects, of the urate of soda, or the valves may become atrophied or wasted away. The effects in slight cases may occasion but little difficulty, but in severe it is apt to produce hypertrophy and dilatation, dropsy, local inflammations, and ultimately death. These results are owing to an impediment in the forward movement of the blood, and to the regurgitation of the same, producing an accumulation behind. This is plainly illustrated in an affection of the mitral valve. If its orifice is contracted by deposits, the blood accumulates in the left auricle by the impediment, and distends it; congestion of the pulmonary veins is the consequence; the lungs share in the congestion, and pulmonary apoplexy may be the result. This of course occasions an insufficient supply of blood to the general system, which the heart is willing to relieve, and, therefore, makes greater efforts, but becomes hypertrophied or enlarged in so doing. Again, suppose some insufficiency in the mitral valve, owing to ulceration, for example, the blood will regurgitate into the left auricle at each pulsation, it produces the same effects. If the semilunar valves are contracted, a less supply of blood is sent to the general system, but congestion of the heart and consequent enlargement and dilatation of the left ventricle may occur. The general symptoms of valvular disease is difficulty of breathing, increased by muscular efforts, or emotion, palpitations, the pulse intermittent or jerky. Distinctive murmurs accompany these affections; in mitral deficiency we hear a prolonged murmur in a low key, like whispering the word "who," in contraction of the aortic valves we have a comparatively superficial sound like whispering the letter "z:" in regurgitations we hear squashing sounds. TREATMENT. -- The mitigation of the urgent symptoms
may be accomplished by ladies'-slipper, hops, or henbane. In violent action
of the heart cherry laurel water may be given with the henbane. Hot
foot-baths and mustard plasters may also be necessary. In sudden palpitation
and difficulty of breathing, the compound spirits of lavender should be
given. Collinsonia is the proper remedy if hypertrophy of the valves
is suspected. In valvular insufficiency the tonics and a liberal
diet should be prescribed. Conium, belladonna, digitalis, irisin,
veratrum, stramonium, and cannabis sativa, are also extensively used in
various combination, if they are indicated.
ATROPHY OF THE HEART This may result from various causes. When it exists, greater resonance accompanies percussion, and the two sounds of the heart will be more feeble, but more distinctly heard. The symptoms are pallor, coldness and dropsy of the extremities, cough, irregular respiration, palpitation, oppression; in females, irregularity or vicarious menstruation. It may occur with the exhausting diseases, as cancer, consumption, diabetes, etc. TREATMENT. -- The patient should avoid all excesses
in mental and bodily exercise. The diet should consist of rich animal
broth, with a liberal amount of fats and sugar, cod-liver oil, and the
tonics should be administered.
HYPERTROPHY AND DILATATION OF THE HEART As these are generally coexistent, they should be considered together. The dimensions of the heart may be increased either by augmentation of its muscular walls, or enlargement of its cavities. The former is hypertrophy, the latter dilatation. The most prominent symptom is difficulty of breathing, produced by any exertion; also, palpitations, which are sometimes so violent as to shake the whole body. The secondary signs are violent headache, vertigo, buzzing in the ears, flashes of light, pulmonary congestion, pneumonia, apoplexy of the lungs, congestion of the liver, bilious disorders, and general and local dropsy. The patient's suffering is often extreme, and, unable to lie in bed, he is forced to assume constantly a sitting posture, with the body bent forward. Death usually occurs suddenly in syncope or fainting. Valvular disease is the most frequent cause, though they may be caused by rheumatic irritation, excessive exertion of the organs from any cause, as violent exercise, playing on wind instruments, violent passions, intemperance, etc. TREATMENT. -- The exciting cause should be removed,
especially valvular disease. The patient's habits of life and occupation
should be regulated, and his diet moderated. Mild cathartics should
occasionally be given and passive exercise engaged in. Digitalis
is the special medicine; cherry laurel water is also used for the same
purpose. These should be carefully administered. The tincture
of aconite and colchicum should be given where it has resulted from rheumatism.
In dilatation the tonics, cod-liver oil, and animal food should be prescribed.
Digitalis is also specially required. Wild cherry bark is an excellent
tonic, and as nervous symptoms are very apt to be present in females, opium,
belladonna, valerian, etc., may be given with advantage. Every effort
should be made to enrich the blood.
CYANOSIS, OR BLUE DISEASE In this disease the skin bears a leaden or purple tinge over the whole body. There is a reduction of warmth, and labored breathing. It is due to the admixture of blue or venous blood with arterial or red blood, and caused by the right and left sides of the heart remaining open after birth, or by obstruction of the pulmonary artery, thereby withholding the blood from the lungs and preventing arterialization. It is a disease confined to infants, and is almost necessarily fatal. TREATMENT. -- The circulation must be sedated by allowing the child complete rest, or by the careful administration of veratrum; good food, fresh air, and protection from extremes of heat and cold are necessary. Apply friction to the head and body by some soft cloth. If syncope occurs, the child should be placed in a warm bath, and camphor applied to its nostrils. The heart is liable to be assailed by other diseases. Softening of the heart may take place without inflammation; it may result in rupture of the heart. Various indurations of the heart may occur, as of the fibrous, cartilaginous and osseous character. Fatty degeneration is a rare disease. Tubercle, cancer, and polypi are also noticed. The heart is the most important organ in the body;
hence its diseases to the physician are full of interest. Nothing
gives to a person greater anxiety than the suspicion or knowledge that
he is affected with heart disease. The dread of sudden death is universal,
and so it generally occurs in cardiac diseases. The most important
requisite in the treatment is its early application, as most of the diseases
can be cured if treatment is bestowed in time, and hence it behooves every
one who feels some abnormal action or uneasiness about the heart to engage
treatment, or seek competent medical aid as soon as possible. Those
who desire to consult me are referred to page 390. My experience
in the treatment of heart diseases has been in extent second to none in
this country, and the success has been most gratifying.
DISEASES OF THE BLOOD-VESSELS Inflammation of the arteries is rare in the acute form. The symptoms are pain and tenderness along the course of the vessel, attended with a thrill or throbbing. Lymph is effused within the vessel, often producing a complete arrest of the circulation, and resulting in gangrene. It is highly probable that in spontaneous senile gangrene the cause is arteritis. Chronic arteritis is more common, but difficult to discover. Deposits occur in the arteries, exciting ulceration, or ossification may occur in old age. TREATMENT. -- Give a mild purge, a hot bath, and
sufficient veratrum to control the circulation. The inflamed part
should be fomented, blistered, or stimulating liniments and counter-irritation
may be applied. The alteratives are always indicated.
ANEURISM This is a pulsating sac, filled with blood, which communicates with an artery. True aneurism consists of a sac formed by one or more of the arterial coats. False aneurism is owing to a complete division of the arteria coats, either fom a wound or external ulceration; the sac formed of cellular tissue. Every artery may be effected with any aneurism, but the aorta, carotids, axillary, brachial, iliacs, femorals, and popliteals are the arteries most commonly affected. The tumor at first is small, gradually increasing, soft and quite compressible, being filled only with fluid blood. It pulsates syncronously with the the heart, and is increased by pressure on the side furthest from the heart. A peculiar thrill is imparted to the hand, and which can be heard if the ear is applied. The strength of the part is much impaired as the tumor enlarges, and the circulation in the extremity weaker. During the progress of the tumor the adjacent parts are displaced and absorbed, even bone is rendered carious and absorbed by constant pressure of the aneurism. The pain and numbness increase, and the general health fails, and at length the tumor may burst, opening upon the skin or somc internal cavity, and prove fatal. TREATMENT. -- Complete rest, and the frequent application
of hot-packs to the tumor should at first be prescribed. A stimulating
liniment may be rubbed over the part. One composed of the compound
tincture of myrrh and the oil of origanum answers the purpose well.
The "Herbal Ointment" is an excellent application. The gentle application
of electro-galvanism should be resorted to if the above treatment does
not suffice. Pressure by well-secured pads, or by the thumbs and
fingers, continued for a long time, is often tried and successful in some
cases. If the above treatment fails, some competent surgeon should
be consulted, who will in practicable cases ligate the artery. Valsalva
had a curious plan of treatment for aneurism. It consisted of repeated
blood-letting, with food enough merely to support life. A cure worse
than the disease.
PLEBITIS AND VARICOSE VEINS This is an inflammation of the veins. The signs are pain and tenderness in the course of the vessel, which soon becomes cord-like and knotted, by which it may be distinguished from arteritis. There are swelling and redness of the adjacent parts, the redness being in streaks. The limb below the part is swollen, from obstruction of the circulation and effusion of serum. Pus is a frequent production of phlebitis, in which case perfect occlusion of the vein above occurs, with the formation of an abscess, or the pus passes into the heart and produces excessive prostration. Varicose veins are the sequel generally to phlebitis. TREATMENT. -- The treatment consists in fomentations, leeching, and occasional purging. The alteratives should also be given. The topical application of tincture of lobelia and arnica are also useful. Rest is enjoined. The abscesses and consequent ulceration should be treated upon general principles. If the veins become varicosed, astringent applications, and careful bandaging, should be resorted to. The best method of curing varicose veins, however,
is by elastic stockings. These give an equable pressure, which can
be so regulated as to afford any compression desired, on every part of
the leg where the varicose veins exist. If the veins are varicosed
throughout the whole length of the limb, the full-length stocking should
be worn. If confined only to the leg, the stocking represented on the right-hand
side of the cut is alone necessary, and in some cases the knee-caps and
anklets are only required, depending upon the situation of the varicose
veins. These elastic contrivances are not only radical cures, but
patients suffering from varicose veins have no idea what ease and comfort
they afford. They give a very agreeable support to the limb, prevent
varicose ulcers, besides quickly reducing the enlarged veins to natural
size. They are made of the best silk, are very durable, and not so
expensive as not to be afforded by the poorest sufferer. All those
desiring these admirable contrivances are requested to correspond with
the author; -- preliminary correspondence as to size, measurement, etc.,
is in all cases essential to secure that perfect adaptation which is indispensably
necessary in order to afford relief and cure. Great harm is done
if the elastic appliance is not eligible in every respect, and therefore
patients should hesitate before purchasing those inferior, half cotton
articles, which are purchasable everywhere; they do not fulfil the conditions
required of them, and are capable of doing great injury, owing to the unequal
compression they afford. Prices as above.
MILK LEG (PHLEGMASIA DOLENS) This is caused by inflammation of the crural veins, hence called crural phlebitis. The inflammation is owing to the pressure of the gravid womb. The popular idea that in this disease, the woman's milk has fallen into her leg, and which has inflamed, is absurd. The disease begins in from two to seven weeks after delivery, with pain in the lower bowel, groin, or thigh. In several days the pain diminishes, and the limb begins to swell, in the calf first most frequently, and from thence extending upward. The skin becoms entirely white, smooth, and glossy, does not pit when pressed, is painful to the touch, and is hotter than the skin of the other limb. Fever is always present. TREATMENT. -- The patient should lie upon her back,
with the swelled limb placed upon pillows, or a bolster, raised so that
the foot shall be a little higher than the hip, and she should by no means
endeavor to walk until the leg is nearly well. A narrow blister can
be applied along the course of the vein, and digitalis may be carefully
administered. Take an old flannel petticoat, with the hem cut off,
and the gathers let out, and dip it in vinegar and hot water, equal parts,
wring it out, and cover the whole limb with it. A blanket or oiled
silk may be placed underneath to keep it from wetting the bed. Repeat
this and keep it up for six hours, and when it becomes tedious to the patient,
it should be removed, and the limb bathed with warm sweet oil, two parts,
and laudanum, one part, and then covered with flannel. In two or
three hours return to the hot water and vinegar, keep up for five or six
hours, then resume the warm sweet oil and laudanum, and in this way alternate
until the inflammation is subdued, or until the calf of the limb can be
shaken. The bowels should be gently moved, and the diuretics administered,
and in cases where the inflammation lasts, and the fever is considerable,
veratrum should be given. If recovery does not take place after the
active inflammation has subsided, the limb should be entirely enveloped
by a spiral bandage, or, what is much better, the full-length elastic stocking,
represented on the foregoing page should be worn. This gives immediate
relief, reduces the leg to natural size, and permits the patient to exercise
without any injurious results following. Those desiring this indispensable
article are requested to correspond with the author.
DISEASES OF THE BLOOD SCURVY (SCROBUTUS) This disease was known to the ancients. The first distinct account of scurvy is contained in the history of the Crusades of Louis IX. against the Saracens of Egypt, during which the French army suffered greatly from it. Lord Anson's voyage, in which more than eighty of every hundred of the original crews perished from the disease, is familiar to every reader of history. This disease illustrated the importance of vegetable food to the human being, as it is a direct result of a diet free from vegetable substances. It used to be very prevalent in the English and American navies, but is now obviated by the ration of lime-juice in the former, and fresh or desiccated vegetables in the latter. It commences with a feeling of languor, or general debility and mental despondence; a sense of fatigue is experienced on the slightest exertion; the face is either pale or sallow, and presents an appearance of puffiness; the gums are swollen, soft, and of a purplish color, and bleed easily; the breath becomes offensive and an eruption appears on the body. The mucous surfaces frequently bleed, the feet become swollen and hard and painful, and a disposition is evinced to inflammation of a low grade of the viscrera, and also to hemorrhagic effusions. The tongue and appetite remain unaffected, and death is produced either by debility or hemorrhage--the intellect remaining sound to the last. TREATMENT. -- Nothing will avail in the absence of
fresh vegetable foods, and hence the chief treatment consists in giving
vegetable food, or the vegetable acid, as citric acid or lemon-juice.
Cabbage and potatoes are excellent, and milk is a good article of diet.
If fresh vegetables cannot be obtained, dried fruits should be substituted.
If the disease has advanced, and there is sponginess of the gums, myricin,
rhusin, and hydrastin may be given in combination with capsicum and cream.
If active hemorrhage occurs, the oils of turpentine, solidago, and mecca
oil may be used to advantage. If chronic blood derangement follows,
as is often the case, the alteratives should be given, of which my "Blood
Purifier" (see page 469) is the best.
HEMORRHAGES BLEEDING FROM THE NOSE (EPISTAXIS) There is no part of the body more disposed to hemorrhage than the mucous membrane of the nose. The blood effused through this membrane escapes generally through the nostrils, but may enter the mouth through the posterior nares. It is often symptomatic of diseases of the liver, spleen, and other organs, and generally attends the last stages of malignant and low fevers. It may be slight or dangerously profuse. In plethoric or rebust patients it constitutes often a means of relief to the vascular system. TREATMENT. -- When it becomes necessary to check
the hemorrhage, the patient should be placed in a cool room, the head elevated
or held upright, and the feet plunged in warm water containing mustard.
The neck should be bared and cold water aspersed over it and the face.
Lemonade and cooling drinks may also be given. When it becomes habitual,
or periodic, and especially if it be vicarious of menstruation, it may
be anticipated by local depletion on the nape of the neck. In the
passive states of the disease, the astringents should be injected into
the nose. Tannin, matico, Monsel's solution, etc., are the best.
If it will not stop, the nostrils should be plugged both anteriorly and
posteriorly.
HAEMOPTYSIS This is a hemorrhage from the respiratory organs. The blood that is expectorated comes from three different sources. It may come from the mucous membrane of the bronchial tubes, from a vessel ulcerated in a tuberculous cavity as in consumption, and from an aneurism of the aorta, or from the large trunks arising from it, in which case it soon proves fatal. Some cases depend on suppression of the menses, and are habitual and not dangerous, but in the majority of cases it is caused by disease of the heart, or consequent to irritation of tubercles. It may be simple, the blood being all spit up, or it may be attended by an infiltration of blood into the minute tubes and air cells, rendering a portion of the lung solid. The symptoms are some degree of pain or oppression at the chest, with cough, which brings up mouthfuls of blood, fluid or clotted. The quantity may vary from a teaspoonful to several pints, so that the patient may be suffocated by the abundance of the blood. TREATMENT. -- A free current of air should be allowed
to pass over the patient, his covering should be light, and a mild purge
should be given to him. The feet should be placed in hot water.
If dependent upon derangement of the menses, the sitz-bath (hot) should
be ordered, and matico or other astringents be given. Or it may be
arrested by putting one drachm of the oil of origanum in a pint bottle,
and allow the patient to inhale the vapor. If matico, tannin, or
other vegetable astringents are not at hand, common salt, acetate of lead,
sulphuric acid, and alum may be used in cases of emergency. Small
doses of digitalis should be given to control the circulation.
HAEMATEMESIS This is hemorrahage from the stomach. Whatever irritates the mucous surface of the stomach, or interrupts the return of blood from that organ is liable to cause this disease. Blows and injuries received by the abdomen, violent concussions of the trunk, pressure, intemperance, worms, powerful emetics, suppression of menstrual discharge, application of cold, or of cold and moisture to the lower extremities during perspiration, or the catamenial flow, prolonged constipation and pregnancy, are all liable to cause it. The blood is usually vomited profusely, is sometimes mixed with food, and generally of dark color. The premonitory symptoms are pain or tension about the stomach, with faintness or a sense of sinking, or of anxiety at this region, flatulent or acrid eructations, lassitude with irregular chills and flushes of heat. TREATMENT. -- Apply ice to the region of the stomach,
and give a full dose of the oil of turpentine conjoined with castor oil,
to be repeated if rejected. Administer the astringents, in all cases
the vegetable, but if not at hand, acetate of lead, creosote, tincture
of iron, alum whey, sulphuric acid, etc., can be given. During the
discharge total abstinence is to be observed, but afterwards, mild mucilaginous
drinks and farinaceous food in small quantity may be given, and the transition
to solid and more nutritious food should be carefully conducted.
HAEMATURIA The source of the blood voided through the urethra may be either from the kidney, bladder, or urethra. When it proceeds from the kidneys, it is attended with a sense of heat and pain in the loins, and sometimes with coldness of the extremities, and the blood is intimately mixed with the urine. When the disease is in the ureters, there is a sense of pain in their course, and fibrous shreds having the shape of the ureters are voided. When the hemorrhage is from the bladder, it is usually preceded by heaviness and tension in that region, extending to the perineum, groins, and small of back; the urine is passed with difficulty; the blood is little, if at all, combined with the urine. If from the urethra, the blood is red, liquid and pure, and comes away generally drop by drop. TREATMENT. -- This depends upon its seat and cause.
If from the kidneys, the oils of origanum, copaiba, cubebs and turpentine
should be administered, and hot packs applied externally. If the
urine is alkaline, as in typhus fever and scurvy, the acids should be given.
If from the bladder or urethra, matico or other vegetable astringents should
be injected. The avoidance of stimulants and absolute rest should
be insisted on in every case.
DROPSIES If in man a large venous trunk is compressed or obliterated,
so that the blood no longer circulates through it, while the collateral
vessels can relieve but imperfectly, dropsical effusion is sure to take
place. The effusion is proportionate to the size and importance of
the vein obliterated. If, for instance, in the vena cava, or large
vein in the abdomen, an obstacle should prevent the return of the blood,
the two lower extremities and the scrotum will become filled with serum.
If the trunk of the portal vein is more or less obliterated, the serous
collection takes place in the abdomen. If the obstruction occurs
at the very centre of circulation, namely the heart, and the return of
blood everywhere embarrassed, the dropsy becomes general, hence dropsy
is one of the most common symptoms of heart disease. Dropsy is often
caused by cold, applied in such a manner as to check the secretions of
the skin; is often connected with eruptive diseases, as scarlatina; it
may result from granular degeneration of the kidneys, debility, exhaustion
from loss of blood, etc.: or from obstruction to the return of venous blood,
owing to tumors, hypertrophy of the liver, glandular enlargements, etc.
BRIGHT'S DISEASE OF THE KIDNEY This is a dropsy owing to a disease of the kidneys. Dr. Bright, of England, first pointed out, 1827, the frequent connection which exists between dropsy and what has since been called granular degeneration of the kidneys, or "Bright's Disease." This state of the kidneys is not an inflammation, but a slow degeneration of its structure, commencing by an abnormal deposit of fat in the cells lining the little tubes in the kidneys. It is a degeneration similar to the tubercular deposit, or the fatty liver common in consumption, and may properly receive the name of fatty kidney. It is a slow, insidious disease, beginning generally much further back than the patient is aware of. By degrees the tubes of the kidneys become blocked up with excessive fatty deposits; the result of this is, that the tubes become dilated, so as to press on the network of the portal veins which surround them. The veins being thus compressed, the capillaries which open into them are unable to discharge their contents, and so become distended with blood, and either allow serum to exude from their walls, or else burst and admit the escape of red particles and fibrine. This may be illustrated in a familiar way. If the mouth of all the little brooklets that flow into a brook be effectively dammed up, so that the brook received none of their supply, the brooklets by constant accession would naturally overflow their banks and inundate the adjacent land, and the brooks go dry. So as the accumulation of the fat goes on, the portal networks of veins and the uriniferous tubes waste away or become atrophied, and hence shrinking of the kidney and deficiency of the kidney ensue. Albumen is always present in the urine in this disease. This can be discovered by boiling the urine in a small tube, the albumen becoming like the white of an egg boiled. Urea, a natural constitiuent of the urine, is deficient. The symptoms in the first stage are weakness and dyspepsia, and the blood loses its red particles very rapidly, but there is little to call attention to the kidneys. In the second stage the symptoms are a pallid, pasty, complexion, a dry hard skin, drowsiness, weakness, indigestion, and frequent nausea, often retching the first thing in the morning, and palpitation of the heart. A most characteristic symptom is that the patient is awakened several times in the night with desire to make water. In the third stage, if the patient is exposed to cold, the kidney becomes congested; anasarca or general dropsy with perhaps ascites, makes its appearance; debility increases, the urinary secretion becomes more inefficient, urea and other excrementitious matter accumulate in the blood; a drowsiness and coma, signs of effusion of blood, are sure precursors of death. It is caused by intemperance, privation of air and light, and neglect of proper exercise; frequent exposure to cold, and the other causes of scrofula and consumption. TREATMENT. -- This is one of those harassing complaints which physicians in family practice seldom have the patience to investigate and manage with sufficient care. The condition of the stomach, bowels and skin should receive especial attention. Free action of the skin should be maintained, as in this way the kidneys are relieved and the blood purified. Stimulating diuretics should not be used. Mecca oil, tonic teas, etc., may be given. There is no better specific agent than helonin, from three to ten grains a day. Eurpurpurin and populin may also be given with good effect. Vapor baths are beneficial, and counter-irritation should be made over the region of the kidneys. It is my confident belief that this grave disease
can be cured in nearly every instance if not too far advanced. I
am induced to such a belief by the success that attends my treatment.
I should be happy to correspond with any one of my readers who may suspect
this affection, and shall cheerfully analyze any urine that may be sent
to me for that purpose, as in my laboratory there are all conveniences
for that purpose. (See page 390). For those under my treatment
the analyses are gratuitously made, but to others a fee of $5 must in all
instances be remitted.
ASCITES This is a collection of water in the belly, though sometimes the fluid is outside of the peritoneum and next to the muscles. There is a sense of distension and weight, especially on the side on which the patient lies. When the collection is large, the breathing becomes short and difficult, and the swelling is uniform over the whole abdomen. In some instances the fluctuation may be heard when the patient moves about. This sound distinguishes this complaint from pregnancy or peritonitis. There are generally loss of appetite, dry skin, costiveness, scanty urine, oppression of the chest, cough, colic pains, and variable pulse. A frequent cause of this complaint is chronic inflammation of the peritoneum; it is also produced by scarlet fever, hob-nailed liver, and other diseases of that organ--in short, whatever obstructs the portal circulation. TREATMENT. -- The remedies for this disease are mainly
diuretics and purgatives. Digitalis is an excellent remedy, but should
be cautiously administered The patient should have as a constant drink
an infusion of two parts of hair-cap moss, and one each of juiper berries
and dward-elder bark; also an infusion of queen of the meadow. The
purgatives that produce watery stools, such as elaterium, should be given.
The compound infusion of parsley is about the best agent to promote the
absorption of the fluid. The skin should be kept well open, and the
stricteest temperance both in eating and drinking must also be observed
If all medicinal treatment fails, the surgeon should be called, who will
perform paracentesis abdominis, or tapping the abdomen; but this should
be degerred until all other means have failed.
HYDROTHORAX This is a dropsy of the pleura, rarely existing as an independent affection, but generally associated with a general dropsical condition of the system. It is particularly liable to be connected with organic heart disease. When the effusion is slight, only a slight uneasiness is felt in the lower part of the chest, but as it increases, the patient suffers uneasiness in assuming the recumbent posture, a cough and difficulty of breathing being the result. The latter often becomes very severe, the face swells, the cheeks assume a purple and the lips a livid hue, the skin is dry, urine scanty, bowels constipated, thirst, and more or less mental excitement ensues. TREATMENT. -- If owing to heart disease, that affection
should receive special attention. The fluid may be evacuated by means
of small doses of elaterium and podophyllum, followed by a free use of
chimaphila, galium aparine, and aralia hispids. Other diuretics may
also be used, and the general rules of treatment observed as advised in
Ascites.
DROPSY OF THE HEART This consists of a collection of fluid within the pericardium. There is a feeling of uneasiness, or pressure in the cardiac region, a slight cough, difficult and irregular respiration, faintness, disinclination to lie down, a feeble pulse, capricious appetite, disturbed sleep and delirium. If there is stupor, cold extremities, the perspiration clammy, and the action of the heart very much disordered, it usually proves fatal. TREATMENT. -- Same as for Hydrothorax. Tapping
may become necessary in both cases.
DROPSY OF THE OVARIES This consists of an accumulation of fluid in one or more cells within the ovary, or in a serous cyst connected with the uterine appendages. The ovary loses its original form and structure, and frequently attains an immense size, containing several gallons of water. The effusion sadly interferes with respiration, and it causes exhaustion and often peritonitis. The serum may exist within the cavity of the abdomen, or be confined within the cystic tumor. As the tumor enlarges, it ascends the pelvis and occupies more and more of the abdominal cavity, and may float loosely in the fluid within it, and form adhesions to the peritoneum, omentum, or neighboring viscera. TREATMENT. -- Galvanism is often very successful. The current should be passed through the tumor, and be as strong as the patient can bear it, and should be passed in all directions for half an hour several times a day. The hydragogue cathartics and diuretics should also be given, and the alteratives administered The strength of the patient should be well supported. This disease is curable by medicinal treatment alone in its early stages if properly treated, but may become so far advanced under improper management, that tapping becomes necessary, or, if the patient's strength will allow, the removal of the whole tumor. The author would be pleased to correspond with any
lady suffering from this serious disease.
DROPSY OF THE SCROTUM (HYDROCELE) This is a collection of water in the membrane which surrounds the testicles. It is often caused by rheumatism, gout, scrofula, etc. In some cases the accumulation is very large. It may be distinguished from scrotal hernia by pressing the tumor towards the anus; if it bounds rapidly forward it is hydrocele. TREATMENT. -- The following is excellent. Take queen of the meadow, one ounce; colt's foot, one-fourth pound; yellow parilla, one-fourth pound. Make one quart of decoction of syrup, and take one tablespoonful three times a day. A suspensory bandage should be worn. These can be had from me at reasonable prices. In some cases the scrotum must be tapped, and the vinous tincture of hemlock bark injected to prevent the return of the effusions. I have under my treatment at all times many dropsical
patients, and if received under my care at a reasonable early stage, no
necessity for tapping arises, and the patient is cured by medical treatment
alone. Any one desirous of consulting me, may refer to page 390 for
the necessary question to be answered.
ANATOMY OF THE URINARY ORGANS The kidneys are two hard glands for the secretion of urine, placed in each lumbar region, just above the hips; they are outside of the peritoneum, or lining membrane of the abdomen, and surrounded with an abundance of fat. The right kidney is rather lower than the left, on account of the superposition of the liver. The length is about four inches, and the breadth two inches. The shape is oval, resembling a bean; the position upright, and the fissure (or hilum) is rather larger than the lower. It is covered by a strong fibrous capsule. The color is a reddish brown. Upon making a longitudinal secton of the kidney, as represented in cut, two different structures are presented. The internal is of a darker color, and consists of about fifteen of what are called the cones of Malpighi, which are arranged in three rows, the apex of each converging towards the hilum. This constitutes the medullary portion of the kidneys. The external structure is of lighter color usually, is extremely vascular, and of a granulated arrangement; it constitutes the cortical portion. The urine is formed in the tortuous tubes of the cortical substance, between whose walls are a number of small bodies called corpuscles of Malpighi. At the apex of each cone is the papilla renalis, and in the centre of each papilla is a slight depression, called foveola. Each papilla is surrounded by a small membranous cup, called infundibulum, into which the urine is first received as it oozes from the orifices of the papillae. Four or five of these infundibula join to form a common trunk, called calyx, and the junction of about three calyces forms a common cavity, called the pelvis, which is conoidal in shape, and from which proceeds the ureter, the excretory tube of the kidney, which conveys the urine to the bladder. The ureter is a cylindrical tube of the size of a quill, with thin, extensible walls. It enters the inferior fundus of the bladder very obliquely, and opens by a very small orifice. Just above the kidney, and reposing on its upper
extremity, placed one on each side, are two small bodies, varying much
in size, called the supra-renal capsules. They have no secretion,
consequently no duct, but evidently perform important functions in foetal
life, when they are much larger.
BLADDER The bladder is a musculo-membranous sac for the reception of urine. It is situated in the cavity of the pelvis, behind the pubic bones, and in front of the rectum in the male, but in the female the uterus and vagina are between the rectum and bladder. In shape the bladder is oval, the larger end being downwards; in women it is more spheroidal; in children it is pear-shaped. It is divided into a superior and inferior fundus, a body, and neck. Its dimensions vary with health and disease.
Ordinarily it will hold about a pint. At the neck of the bladder
is a circular muscle, called the sphincter, which, in a state of contraction,
retains the urine in the bladder until the necessity to voiding it arises.
The urethra is described under anatomy of the sexual organs.
DISEASES OF THE URINARY ORGANS NEPHRITIS This is inflammation of the kidneys, and which may occur either in its substance, its lining membrane, or in its capsule. The symptoms are deep-seated pain in the small of the back, extending down the groins in one or both sides, increased by pressure; urination either increased or diminished, urine scanty and high-colored, and mixed with blood or gravelly matters. If both kidneys are affected the urine may be suppressed, and comatose symptoms present themselves. Chills, fever, deranged stomach, and constipation nearly always attend it. The testicle is retracted, which distinguishes this disease from lumbago, etc. It runs very rapidly into suppuration, the sign of which is the appearance of pus in the urine. TREATMENT. -- The disease should be controlled by
the use of hot packs, vapor baths, lobelia emetics, mild purges, and the
internal administration of aconite and veratrum. The mucilaginous
drinks should be drunk, and the opiates given if the pain is very severe.
In chronic nephritis, where there is debility of the organ, the best remedies
are turpentine, copaiba, buchu, uva urse, pareira brava, and pipsissewa.
DIURESIS This is the diabetes insipidus of some writers. By this term is understood the excessive secretion of pale, limpid urine, without sugar. The principal symptoms are insatiable thirst and the elimination of a large quantity of urine. These symptoms are usually preceded by a variable appetite, constipation, and derangement of the functions of the skin. The copious flow of urine may only be occasional, following over-mental or physical excitement. It may be distinguished from diabetes mellitus by the absence of sugar in the urine. TREATMENT. -- The skin should receive special attention,
and excess of drinking should be avoided. The constitutional debility
should be overcome with baths, and the general tonics; apocynin, from one-eighth
to one-fourth of a grain, four or five times a day, is a specific for this
disease.
DIABETES MELLITUS This is characterized by increase of urine, containing sugar. The first indications of this disease are languor, dry, and harsh skin, intense thirst, pain in the small of back, constipation, with alternate chill and fever. After a time the general health gives way, and there are muscular weakness, loss of sexual power, pain in the loins, coldness of extremities, a burning sensation in the hands and feet, loss of weight, and a chloroform odor of breath. The gums become spongy, the teeth decay, the mind becomes depressed and irritable, and the appetite voracious. Consumption is often a sequel to this disease. The urine has a sweetish taste, due to the presence of sugar, which can readily be discovered by adding yeast to the urine, which gives rise to various fermentation. TREATMENT. -- A healthy state of the general system should be maintained by fresh air, frequent baths, and a generous diet. No sacchaarine or starchy articles of food should be eaten. The bowels and liver should be gently stimulated by small doses of leptandrin and leontodin. Great success is obtained by the use of unicorn root. Mecca oil has also been successfully employed in this disease. Diabetic patients who may desire the author to treat
them, may consult him as directed on page 390.
GRAVEL (LITHIASIS) This disorder consists in the deposition from the urine, within the body, of an insoluble sand-like matter. In health the urine carries off the results of the waste and disintegration of the tissues in a soluble state, but when these matters are in excess the urine frequently deposits them after being voided, on cooling. This often occurs after irregularities of diet, without actually being a morbid condition, but when the accumulation is excessive it causes a serious disease. The gravels are chemically either urates lithates, phosphates, or oxalates, according to the diathesis of the patient. The passage of gravel or renal calculi from the kidneys to the bladder through the ureters, causes the most excruciating pain. When anything in the bladder, as a mucous shred or a large gravel, acts as a nucleus, the constant accessions to this nucleus form what is known as stone in the bladder, which may be of various sizes. In gravel the patient has a dull aching pain in the back, attended with urgent and frequent desire to urinate. Preceded by cutting or scalding pains in the urethra, neck of bladder, or in the course of the ureters. In stone we have the same symptoms, but the sudden stoppage of the stream during micturition is always suggestive of its presence in the bladder, and the patient has a constant desire to relieve the pain by pulling at the end of his penis. TREATMENT. -- Diluents should be freely used, and a strict attention paid to diet. Animal food should be sparingly eaten, and alcoholic drinks totally avoided. The chemical nature of the gravel should be ascertained, and when this is done the chemical opposites administered. No treatment will avail, if not in chemical opposition to the diathesis of the patient. If medicinal treatment is ineffectual after a stone has been formed, the surgeon should be consulted, who will remove it by an operation called lithotrity or another termed lithontripsy. Unless the stone be too large, my experience is that
solvent treatment will prove effectual in nearly every case. The
solvent treatment consists, of course, of such herbal agents as are chemically
opposed to the nature of the calculus. By such a course of medication
my success has been most gratifying.
ISCHURIA, OR SUPPRESSION OF URINE This frequently attends inflammatory diseases, especially acute nephritis. It may either arise from an irritation of the kidney beyond the point of secretion, or from a torpor or paralysis of the kidneys. It is important to distinguish it from retention of urine. It is sometimes very dangerous, being attended with vomiting, drowsiness, coma and convulsions. A vicarious secretion from the skin, bowels, etc., is also often established. It is evidently due to a sort of paralysis of the nerve centres. TREATMENT. -- Leeches may be placed over the loins, and digitalis or squill administered. The demulcent drinks should be freely used. If turic acid is in excess, some carbonate may be given. If dependent upon torpor, the stimulating diuretics, as turpentine, should be used. Frequent hot sitz-baths are also beneficial.
This is often associated with some constitutional weakness. The bladder may be exclusively irritated and not be able to hold the urine, or the little circular muscle at the neck of the bladder may be debilitated or paralyzed, owing to acridity of the urine. In some cases it may be owing to debility of the kidneys. TREATMENT. -- A course of tonics, sea-bathing, cold
baths, warm clothing, etc., together with astringents and stimulating diuretics,
will usually cure it. Small doses of the extract of belladonna will
also afford relief. In case of paralysis of the bladder, nux vomica,
electricity, counter-irritant application to the spine, and local irritants
are necesssary.
CYSTITIS This is an inflammation of the bladder. The symptoms are pain above the pubes, tenderness on pressure, the pain extending into the penis, scrotum, and perineum, producing straining and pain in urination; sometimes pain over the abdomen, which is swollen, or the inflammation may extend to the peritoneum, causing peritonitis. It may terminate in suppuration, the pus appearing in the urine, or, if the abscess occurs in the coats of the bladder, it may open suddenly. It is caused by direct irritation as by a catheter; also by gonorrhoea, difficult labor, turpentine, cantharides, etc. When the inflammation becomes chronic it is called "Catarrh of the Bladder." TREATMENT. -- Mucilaginous drinks should be freely
used, such as decoctions of marsh-mallow, uva ursi, etc. Dover's
powder may be given to relieve the pain. About three grains of populin
and one-fourth of a grain of gelsemium given three or four times a day,
exerts a marked beneficial influence in this disease; linseed oil and essential
tincture of hydrangea are also remedies of great value. The chronic
form will require special treatment, in accordance to condition and nature
of each case.
ANATOMY OF THE NERVOUS SYSTEM The principal divisions of the nervous system are the brain, spinal marrow, and nerves. The tissue of this system is included in membranes or sheaths, and consists of two differently colored pulpy materials, one of which is white or medullary, and the other gray, cortical, or cineritious. The sheath of the nerves is called the neurilemma, and the internal material neurine. All ganglia and nervous centres consist of a mixture of white fibres and gray globules. An anastomosis is the interchange of fascilculi between
two trunks, each fasciculus remaining unaltered, although in contact with
another. A combination of anastomoses into a network is called a
plexus.
SPINAL MARROW The spinal marrow is the medullary column included
within the bones or vertebrae of the spinal column. It has three
coverings: 1st, The dura mater, which is a white fibrous membrane, and
forms the external; 2d, The arachnoid, a serous membrane, forming the middle
covering. It is extremely thin and transparent; 3d, The pia mater,
a cellular membrane, forming the immediate covering. It is very vascular,
consisting almost entirely of vessels.
THE BRAIN The brain consists of four principal parts: medulla oblongata, pons varilii, cerebrum, and cerebellum. Like the spinal marrow it also has three coverings bearing the same names. The dura mater adheres very firmly to the bones of the cranium and consists of two laminae, which are divided into folds called falx cerebri, tentorium, and falx cerebdi. The medulla oblongata is the upper part of the spinal cord; it is conical in shape, and extends from the first bone of the spinal column to the pons varolii. Its divisions are the corpori pyramidale, olivare and restiforme. The pons varolii is cuboidal in shape, and situated just in front of the medulla. The cerebrum is the largest mass composing the brain. It is oval in shape, and weighs from three to four pounds. It is divided into two hemispheres, each hemisphere consisting of an anterior, middle, and posterior lobe. The surface presents a number of convolutions, or gyri, each separated by deep fissures, or sulci. The interior of each hemisphere is medullary in character, and the surface of each convolution is cineritious for the depth of about one-sixth of an inch. The ventricles of the brain are five in number: they are called the right and left lateral, the third, fourth, and fifth ventricles. The more minute anatomy of the cerebrum is exceeding complex, and not of special importance in a popular work of this kind. The cerebellum constitutes about one-sixth of the
brain, and is contained between the occiput and tentorium. It is
oblong and flattened in shape, and composed of white and gray substances.
According to function the cranial nerves may be divided into three classes, viz.: nerves of special sense, including the lst, 2d, and the auditory branch of the 7th; nerves of motion, including the 3d, 4th, 6th, facial branch of the 7th and 9th; compound nerves, comprising the 8th and 5th. The principal nerve of the arm is the brachial; of the forearm, the ulnar and radial; of the thigh, the great sciatic, which divides, about one-third above the knee, into two large branches, the peroneal and popliteal; further on the popliteal is called the posterior libial. In the pelvis there are the pudic, gluteal, and lesser ischiatic. The sympathetic nerve is distributed with all the other nerves of the body, and by means of plexuses supplies all the internal organs. The nervous system is a complex piece of machinery,
and its anatomy requires much study before any competent familiarity with
it can be gained. The physician, who has an inadequate knowledge
of the anatomy of the nervous system, and philosophy of nervous phenomena,
or the physiology pertaining thereto, cannot hope to treat diseases assailing
the system with any material success. Competence in this respect
is the reward only of a long devotion, and practical experience.
DISEASES OF THE NERVOUS SYSTEM INFLAMMATION OF THE BRAIN (CEREBRITIS) This consists of inflammation of the cerebral substance, and due to long exposure to a vertical sun, the inordinate use of ardent spirits, cold, fright, external injury, the sudden disappearance of an old discharge, and it sometimes occurs as a consequent on small-pox, or erysipelas of the face and scalp, and fevers. The symptoms are violent inflammatory fever, hot and dry skin, flushed countenance, suffused eyes, quick and hard pulse, the arteries of the neck throb, and delirium. The senses are morbidly acute, there being intolerance of light and sound. The person is extremely restless, the muscles of the face are spasmodically contracted, the upper eye-lids hang down, and as the disease progresses, blindness and deafness ensue. The countenance is vacant or idiotic, the eye loses its lustre, the pupils become dilated, and the eyes often squint. In the still more advanced stage, the discharges pass off involuntarily, the countenance becomes pale and sunken, the pulse weak and irregular, the coma more profound, and death soon closes the scene. It is commonly called "Brain Fever." TREATMENT. -- This should be most energetic.
Bleeding to fainting has been the practice of many physicians, but I deem
it unnecessary, as revulsion can be made by other means. Leeches
may, however, be applied to the scalp. The hair shold be closely
shaved from the head, and ice, alcohol or ether, with water, applied to
the head. The decoction of ladies' slipper should be given internally.
At the outset purgatives should be given. Those that act thoroughly,
such as gum bags, colocynth, etc., are the best. The bladder should
be emptied every day. In the stage of collapse, stimulants may be
given.
APOPLEXY This is a condition in which all the functions of animal life are suddenly stopped, except the pulse and the breathing. There is neither thought nor feeling, nor voluntary motion; and the patient suddenly falls down, and lies as if in a deep sleep. The disease assails in three different ways. The first form of attack is a sudden falling down into a state of insensibility and apparently deep sleep, the face being generally flushed, the breathing stertorous, or snoring, the pulse full and not frequent, with occasional convulsions. From this mode of attack death often occurs immediately, but in some cases recovery occurs, with the exception of paralysis of one side, or the loss of speech, or some of the senses. The second mode of attack begins with sudden pain in the head, and the patient becomes pale, faint, sick, and vomits. His pulse is feeble, has a cold skin, and occasionally some convulsions. He may fall down, or be only a little confused, but soon recovers from all the symptoms, except the headache; this will continue, and the patient will sooner or later become heavy, forgetful, unable to connect ideas, and finally sink into insensibility from which he never rises. This mode of invasion, though not so frightful as the first, is of much more serious import. The third form of attack is where consciousness is retained, but power on one side of the body is suddenly lost. The patient retains his mind, and answers questions rationally, either by signs or words. He may either die soon, or live for years, with imperfect speech, or a leg dragging after him, or an arm hanging uselessly by his side. Those persons who have large heads, red faces, short and thick necks, and a short, stout, square build, are more predisposed to this disease, than thin, pale and tall persons. Literary men, especially editors, lawyers, doctors, etc., are subject to this disease, owing to mental overwork. The symptoms preceding an apoplectic attack are headache, vertigo, double vision, faltering speech, inability to remember certain words, sometimes forgetfulness of one's own name, a frequent losing of a train of ideas, and occasionally an unaccountable dread. It is caused by whatever hurries the circulation as strong bodily exercise, emotional excitement, exposure to the sun or severe cold, tight cravats, etc. TREATMENT. -- If the face is turgescent and red,
and the temporal arteries throb, and the pulse full and hard, the patient
should be placed in a semi-recumbent position, with his head raised, his
clothes loosened, particularly his neck-band and shirt collar, and then
quickly as possible, cold water or ice should be applied to the head, leeches
to the nape of the neck, and mustard plasters to the calves of the leg.
Tight ligatures may also be tied around the thighs, sufficiently tight
to arrest the venous circulation; they should be removed gradually as consciousness
returns. Administer a stimulating purgative, as a few drops of croton
oil. Injections may also be given. If the patient is old, and
the pulse feeble, the ice applications, ligature, etc., may be omittted,
and instead apply warm flannels and warm bricks to the body, and administer
camphor. To prevent future attacks, gentle tonics should be given,
and the skin kept healthy by daily bathing and friction. The bowels
must not be permitted to become costive. The diet should be well
regulated. The mind should be kept cheerful and hopeful, and free
from all excitement. Intoxicating drinks should be totally avoided,
and sexual congress should be of rare occurrence. In fact every thing
that might provoke an attack should be avoided.
CONGESTION OF THE BRAIN This consists of an accumulation of blood in the cerebral vessels. The countenance is flushed, the eyes suffused, light becomes intolerable, and there is singing in the ears, vertigo, momentary loss of speech, and sometimes delirium. Simple congestion is merely a functional affection, and in a slight or moderate degree involves no immediate danger. It may, however, produce apoplexy and sudden death. It is caused by any mechanical impediment to the return of blood from the head, as tumor of the neck, heart disease, etc. It is a concomitant to nearly every inflammatory cerebral affection. TREATMENT. -- The treatment consists in diverting
the blood from the head by hot mustard foot baths, and an active cathartic.
Ice or cold water may also be applied to the head, and the circulation
reduced by veratrum. The treatment is the same as advised in apoplexy,
in all essential particulars.
SUNSTROKE The injury done to the brain in this case is the same as in apoplexy, with the exception of the clot. It is essentially congestion of the brain. Persons who are exposed by necessity of pursuit to the extreme heat of the sun, should be protected by a wet cloth or cabbage-leaves placed on the head and under a light hat. The symptoms are first dizziness, followed by intense headache. Thirst becomes excessive, the pulse indistinct at the wrist, violent throbbing of the carotid and temporal arteries, and insensibility ensues by a convulsive shivering of the body. TREATMENT. -- Place the patient immediately in a
cool and shady place, and instantly apply, copiously, cold water, or, what
is better, pounded ice in a bag, to the head. Make friction over
his legs to relieve the congested state of the brain. Application
of turpentine by friction on the spine is also of service. Inhalation
of ammonia or hartshorn is beneficial, and a small quantity of the carbonate
of that substance may be given internally. Continue this treatment
until the patient is out of danger, or until death ensues. In plethoric
patients, bleeding from the arm is required, and in this instance only
is bleeding advisable. After the patient becomes conscious and apparently
out of danger, he is to be removed to his home, and a brisk cathartic administered,
to effect revulsion. In no case should he be allowed again to expose
himself to sun during the first four or five days after the occurrence
of the sunstroke. The application of water or ice to the head should
be abandoned by gradual increase of temperature, to prevent any reaction.
INSANITY This is an unsound manifestation of intellectual power. The indications which should excite alarm are headache, vertigo, mental confusion, fretful temper, inaptitude for usual occupations, defective articulations, dimness of vision, and flightiness of manner. The patient is also aware that he is not right, he shuns his old friends, has frightful dreams, is tortured with wicked thoughts. If it exists with general paralysis it is frequently incurable. Derangement is manifested in various ways, viz:-- 1st Mania. -- This is characterized by general delirium, in which the reasoning faculty is disturbed and confused, if not lost, ideas absurd, wandering, or erroneous; conduct violent, excited, and extremely mischievous. The maniac's hair is crisped, he neglects his family and business, suspects his friends, dislikes the light, and certain colors horrify him, his ears are sometimes very red, noise excites and disturbs him, and he has frequent fits of anger and melancholy, without any cause. His delirium extends to all subjects, and the entire intellect, affections and will are in a chaotic wreck. In puerperal mania occurring after delivery, the delirium is frequently extreme, there being a tendency to suicide or child-murder. Maniacs in general have a disposition to murder or suicide. 2d. Monomania. This is characterized by mental aberration on one subject. The patient seizes upon a false principle, and draws from it injurious conclusions, which modify and change his whole life and character. In other cases the intellect is sound, but the affections and disposition being perverted, their acts are strange and inconsistent. Attempt is made to justify their hallucinations by plausible reasoning. 3d. Dementia. This is a condition in which the weakness of intellect is induced by accident or old age. The ideas are numerous, but vague, confused and wandering; the memory is impaired, and the manners childish, silly and undecided. 4th. Moral Mania. Moral insanity is a condition in which there is a perversion of the natural feelings, affections, temper, habits, and moral dispositions. The conduct is eccentric, and an uncontrolable destructive tendency, or a propensity to every species of mischief, are frequently the leading features. A slight insanity is popularly called "a kink in the head;" in Scotland, "a bee in the bonnet." If insanity is characterized by fear, moroseness and prolonged sadness, it is called lypermania or melancholia. If religion is the theme of delirium, it is termed theomania. If amatory delusions rule, it is called erotomania. If the suicidal tendency is strong, it is designated autophomania, and if characterized by aversion to man and society, it is called misanthropia. If the tendency is to stealing, it constitutes kleptomania. Close confinement, and low diet, such conveniences as prisons afford, are the best cures for this species of mania. It is a pitiful sight to see the thousand fancies in regard to themselves of the insane. One imagines himself as an inspired individual, and charged with the conversion of the world, while another sincerely believes that the devil has entered into him, and he curses God, himself and the universe. Still another believes that he controls the world, and directs the movements of the planets. One believes that all the wisdom is concentrated in him, and offers to teach the wisest. Another imagines himself some grand king, is proud, withdraws from his fellows, and will allow no one to come in his presence without proper acts of homage. Yet another is Napoleon, or some other great general, and he fights his battles anew, and majestically marshals his imaginary army. Idiocy is owing to a congenital deficiency of mind, and in consequence the idiot may often be a deaf-mute, and be governed by insane passions. The cause of insanity is hereditary predisposition, constant revolution in the mind of some painful thought, injured feelings which cannot be resented, mortified pride, perplexity in business, disappointed affections or ambition, political or religious excitement, loss of friends or property, and in general, whatever worries the mind or creates a deep distress. Another prolific cause is masturbation. TREATMENT. -- The real character of the malady should be ascertained, and, if possible, the pathological condition giving rise to the disorder corrected. Out-door exercise, lively amusements, fresh air and daily bathing, contribute largely to establish a cure. The exciting cause should be removed. The stomach and bowels should receive due attention. The tonics should be given to improve the general health of the patient. Ladies'-slipper, scullcap, cannabis indica, gelsemium, aconite, veratrum, belladonna, quinine, opium and lupulin, stand in good repute for this disorder. The moral treatment should be such as is best adapted to the condition of the patient. It is probably best, when practicable, to place the patient in some well-conducted insane asylum, where he will have proper attendance and treatment. If this is not feasible, the physician should make such arrangements as will best secure the patient, if of vicious disposition, from harming himself or others, but in no case should unnecessary restraint be placed upon the patient. I have conducted the treatment in many cases of insanity,
many of whom I had never seen, and wherever my instructions were faithfully
carried out, a cure was generally effected. If any of my readers
have relatives or friends who may have become insane, and who may desire
to know my opinion of the case, or its chances for cure, and will describe
the case to me fully, I will cheerfully state them. (See page 390
for address.)
DELIRIUM TREMENS This is also called mania a potu, and in common parlance it is the "horrors" or jim-jams." It is caused by the sudden withdrawal from the habitual or prolonged use of alcoholic stimulation. Its most prominent characteristics are delirious hallucinations, fear, muscular tremors, weakness, watchfulness, and the want of sleep. The symptoms are incessant talking, fidgeting with the hands, trembling of the limbs, a rapid pulse, profuse sweating, and a mingling of the real with the imaginary. The patient's face is pale and sallow, his eye is rolling, quick and expressive, and is busy day and night, and can scarcely be confined to his room. He is unwilling to admit that anything ails him, answers questions rationally, and does whatever he is bidden at the time. Then he begins to wander again, the expression becomes wild, the eyes vacant or staring, and becomes the victim of pitiful and ludicrous illusions of senses, phantasms and hallucinations of every kind; he sees imaginary objects, such as rats, mice, lice, dogs, cats, snakes, and hears and imagines the most extraordinary and absurd delusions. In favorable cases, sleep ends the crisis about the third or fourth day; where death occurs, the delirium is active until sudden suspension of breath ensues. TREATMENT. -- Sleep is the cure for this disease,
and opium and its preparations are the sovereign remedies. Give one-third
or one-half of a grain of morphia; if this does not produce sleep, give
thirty drops of laudanum every two hours till sleep is produced.
A draught or two of the patient's accustomed drink may also be given, and
large doses of opium may be dispensed with if cold applications are made
to the head, and the use of a tepid bath, prolonged for a few hours.
Lupulin is also a good remedy.
HEADACHE (CEPHALALGIA) This, in its widest acceptation, includes all uneasy sensations of the head. It may be confined to one spot, or embrace one side, as in hemicrania; or it may be diffused, and of indefinite extent. It may be felt in the depths of the brain, or only in the scalp and cranium, and continue for an instant, or last for days and weeks. It is usually paroxysmal, and the pain may be simple or very violent. It is a constant attendant to the different forms of inflammation of the brain. It is caused by various conditions; decayed teeth may cause it. When confined to one side, the pain is of a lancinating character; when due to a disordered stomach, it occurs in the forehead and temples; when it occurs from a congestive state of the brain, it is of a dull, heavy, aching character; when due to spinal irritation, there is a protracted pain in the top or back part of the head; and when it is accompanied by nausea and vomiting, it is called "sick-headache." TREATMENT. -- Immediate relief may frequently be
obtained by thoroughly evacuating the stomach, and drinking hot tea or
coffee, followed by adding ten drops of tincture of belladonna to a tumblerful
of water, and taking one teaaspoonful every ten or fifteen minutes.
A hot foot-bath and bathing the head in stimulating liniments also afford
relief in some cases. If it is due to a full habit, the diet must
be regulated. In some bad cases cold applications to the head, leeches
to the temples, and hot sinapisms to the spine may be required. Rubbing
my "Herbal Ointment" on the forehead temples, and nape of neck gives instant
relief.
HYPOCHONDRIA Among the causes of this distressing complaint are disappointment, misfortunes of a heavy character, care, masturbation, excessive mental labor, undue anxiety, costiveness, neglect of cleanliness, indigestion, sedentary occupations, living in close and gloomy apartments, or wet and marshy localities, excessive indulgence in sexual pleasures, or anything which tends to weaken and disturb the nervous system, or over-stimulate the brain. The mental symptoms are countless. The chief one is a constant dread of some unexplainable evil; the patient fears that his wife, if he has one, is unfaithful, or hates him, or that his business is going to ruin, and he will be reduced to beggary, or that his friends despise him, or that he will be charged with the commission of some monstrous crime, or that he has all, or a majority of the worst physical diseases that surgeon or physician was ever summoned to treat. These are the lightest symptoms, and if not immediately tended to, will become aggravated, and go on increasing in violence and extent until the sufferer dies naturally from exhaustion and misery, gets hopelessly insane, or perhaps commits suicide. The organs of sense are more or less deranged and external sensations are magnified and corrupted even as those of the mind are. Thus, the eye appears to see all sorts of forms which it does not see: the smell detects odors which do not exist; the touch demonstrates to the brain objects with which it does not come in contact; the taste is perverted and disordered to an extent which seems, to an uninterested observer, impossible; and the ears convey imaginary sounds of the most perplexing and terrific character. The queer fancies of the hypochondriac are often of such a character as to obliterate pity for the unhappy individual, and provoke both disgust and laughter. Cases have been known where the victim imagined that he was a teapot, or had glass legs which would break upon the lightest exertion, or was made of jelly, and could not move without dissolving into an undistinguishable mass of gelatinous matter, or was as large as an elephant, or as small as a pipe-stem; or had horns growing from the head, or a bottle attached to the end of the nose, or was covered with creeping and venomous insects. Hypochondria is also productive of fainting spells, cold surface of the body, an eye either glassy and unnaturally brilliant, or without any lustre; palpitations, pains in the stomach, pale and livid countenance, and occasional paroxysms of fever. TREATMENT. -- A cure may be effected by the employment
of such medicines as will restore tone to the stomach and nervous system,
and also by removing, as far as is possible, all the causes which lead
to the origin and perpetuation of the malady. Where it is within
the scope of the patient's means he should be kept continually on the move
(without fatigue), a constant change of scene being one of the most desirable
of self-acting remedies. All allusions to his real or fancied miseries
should be avoided, or, if found necessary, of the kindest and most consoling
description. It is always the case that the hypochondriac will be
the harshest, the most suspicious, and the most ungenerous in every way,
towards his best friends. This is an unfailing type of the disease.
The friends must bear these annoyances patiently and self-denyingly.
To lose one's temper with such a sufferer is to commit a great crime; out-of-door
exercise must be as constant as is consistent with the weather and the
patient's circumstances. Leave the hypochondriac alone as little
as possible. Let him eat and drink but moderately of nourishing but
easily-digested food, and above all things keep him from the use of stimulating
drinks and tobacco. Music has been found highly beneficial in these
cases -- anything is good, in fact, which affords lively amusement.
A cold or tepid sponge bath should be taken morning and evening, and the
rule of "early to bed and early to rise," should never be violated.
The bowels must always be kept open -- a good passage every twenty-four
hours being required -- and where the patient is extremely weak, a good
substantial tonic, such as "Restorative Assimilant," should be administered
three times a day. When the patient has a fainting smell, and thinks
he is dying, give him motherwort tea, with spirits of camphor in it, if
no other assistance happens to be at hand. This is only general treatment
for temporary benefit. To eradicate the disease thoroughly it is
necessary to know all about the individual case, and the chief causes of
its origin and development. Nature's remedies may then be applied
without fear of failure.
NEURALGIA This disease affects one tissue only -- the nervous, and pain is the only symptom. The pain is of every degree of intensity. It may affect every nerve, but is more commonly confined to the most important. The tearing pain comes on suddenly and in paroxysms. It may be so agonizing as to cause a temporary loss of reason. When the fifth pair of nerves is affected it is called tic douleureux; and face ache when confined to the facial nerve and branches. It is called sciatica when the pain begins at the hip and follows the course of the sciatic nerve. It may also occur in the female breasts, the womb, in the stomach and bowels, hands and feet, etc. TREATMENT. -- This is palliative and radical.
The palliative treatment consists in the administering of aconite, hyoscyamus,
ladies'-slipper, belladonna, opium, morphine, lupulin, cicuta, etc.
These can either be applied locally, or taken internally. Morphine
and aconitum should be injected subcutaneously, and immediate relief follows.
In sciatica, blistering along the course of the nerve often cures.
Ten grains each of aconitum and extract of belladonna and one drachm of
lard, form an excellent ointment for external application. The "Herbal
Ointment" (page 469) arrests the pain almost instantly. The radical
treatment consists in removing the cause. If due to malarial influence,
quinine should be given. If associated with kidney disease, that
organ should receive attention. The alteratives are serviceable in
many cases.
BILIOUS COLIC This is neuralgia of the mesenteric net-work of nerves, or rather hyperaesthesia of the plexus. By hyperaesthesia is meant excessive sensibility of passability. It is characterized by sharp twisting pain extending from the navel to the lower portion of the abdomen. It occurs in paroxysms, and is of a most excruciating character. The patient is restless, hands, feet and cheeks are cold, and the pulse is small and hard. The abdomen is tense and distended; obstinate constipation, and usually nausea and vomiting occur. The fits usually last from a few moments to several hours. The matter vomited up is generally bilious matter. TREATMENT. -- Administer an active purgative injection
immediately, and give internally wild yam, camphor, etc., every fifteen
minutes until the pain is relieved. A strong decoction of wild yam
root is a specific cure for this affection. Scull-cap and high-cranberry
bark are also good. The latter is called cramp bark on account of
its excellence in spasmodic affections. The vomiting may be checked
by laudanum. Hot baths, fomentations, etc., are also useful.
HICCOUGH This consists in spasmodic contraction of the midriff, and a certain degree of constriction, which arrests the air in the wind-pipe, thus producing sudden, short, convulsive inspirations, attended by slight sound, and followed immediately by expiration. It is often a symptom of low forms of fever and inflammatory diseases, or caused by the excessive use of alcohol or tobacco. TREATMENT. -- When purely nervous, suddenly attracting
the mind will cure it. Hence the common advice to the hiccoughing
patient, "think of your sweetheart" is so often effectual, because the
fond object absorbs the whole mind. When dependent upon a disordered
state of the stomach, an emetic will relieve it. In fevers it denotes
debility, indicating the need of stimulants.
WHOOPING COUGH (PERTUSSIS) This is a hyperaesthesia of the pneumo-gastric nerve, and not due to inflammation, as may be supposed. It is a contagious disease. It consists of a convulsive cough, attended by hissing and rattling in the windpipe, and ineffectual efforts to expel the breath. This is repeated until a quantity of thick, tenacious mucus is expectorated, when the breathing again becomes free. The paroxysms apparently threaten suffocation, and the agitation affects the whole body. Blood is sometimes started from the nostrils, but, notwithstanding the violence of the symptoms, it is rarely ever dangerous. TREATMENT. -- An emetic may be given at first.
Liniments of olive oil or the "Herbal Ointment" should be applied to the
spine. The antispasmodics are of course indicated, such as belladonna,
a decoction of bitter almond, or of cherry seed, etc. Lobelia is
a good remedy, as is also skunk cabbage; daily vapor inhalations are also
serviceable; cochineal has a good reputation; it should be used with stillingia.
SPASM OF THE GLOTTIS This is also called the crowing disease or false croup. It is common to children, and rarely occurs in adults. It is a spasmodic disease, and distinguishable from croup by the absence of fever. The child is suddenly taken with an impossibility of taking breath, and struggles convulsively for a time, its head thrown back, face pale, legs and arms stiff, and when it begins to breathe it is of a crowing character. TREATMENT. -- In the paroxysm set the child in an
upright position, exposed to a full draught of cool and fresh air, and
sprinkle cold water in its face. Loosen all its clothes around the
neck, slap it slightly on the back, and apply friction along the spine.
If not successful, place it in a warm bath, and then sprinkle cold water
in its face. If due to teething, use the proper remedies and give
some gentle physic.
EPILEPSY This is characterized by the sudden loss of consciousness and sensibility, accompanied with spasms and convulsions. It comes on suddenly, and epileptics, by the sudden attacks, are at all times in danger. They may be taken while descending a flight of stairs, while traversing the bank of a precipice, while crossing a street crowded with vehicles drawn at full speed, or while in a throng of people whose feet would trample them to death, especially in case of an alarm of fire, a great public meeting or pageant, or other sudden danger. But all those afflicted in this terrible way are actually alive to the dangers of which they are the constant expectants. Epilepsy, in its severer forms, is a terrible disease to witness. It is productive of great distress and misery, and liable to terminate in worse than death, as it is apt, in many cases, to end in fatuity or insanity, and so carrying perpetual anxiety and dismay into all of those families which it has once visited. The leading symptoms of Epilepsy are, a temporary suspension of consciousness, with clonic spasms, recurring at intervals; but so various are its forms, and so numerous its modifications, that no general description of the disease can be given. I will first describe the most ordinary type of the disease and then note some of the several variations which occur from the standard type. A man in the apparent enjoyment of perfect health suddenly utters a loud cry, and falls instantly to the ground, senseless and convulsed. He strains and struggles violently. His breathing is embarrassed and suspended; his face is turgid and livid; he foams at the mouth; a choking sound is heard in his wind-pipe, and he appears to be at the point of death from apnoea, or suspension of breath. By degrees, however, these alarming phenomena diminish, and finally cease, leaving the patient exhausted, heavy, stupid, comatose, or in a death-like condition. His life, however, is no longer threatened, and soon, to all appearances, he is perfectly well. The same train of morbid phenomena recur, again and again, at different, and mostly at irregular intervals, perhaps through a long course of years, notwithstanding the best medical science has been exercised to prevent and cure the distressing malady. This is the most ordinary form of Epilepsy. The suddenness of the attack is remarkable: in an instant, when it is least expected by himself, or by those around him, in the middle of a sentence or of a gesture, the change takes place, and the unfortunate sufferer is stretched foaming, struggling, and insensible on the earth. In this country, Epilepsy is commonly called the "Falling Sickness," or more vaguely, "Fits." The cry, which is frequently, but not always uttered, is a piercing and terrifying scream. Women have often been thrown into hysterics upon hearing it, and frequently it has caused pregnant females to miscarry. Even the lower animals are often startled, and appalled by a scream so harsh and unnatural, and parrots and other birds have been known to drop from their perch, apparently frightened to death by the appalling sound. In most of the cases of fits, which have come under my notice and treatment, the first effect of the spasms has been a twisting of the neck, the chin being raised and brought round by a succession of jerks towards the shoulder, while one side of the body is usually more strongly agitated than the other. The features are greatly distorted, the brows knit, the eyes sometimes quiver and roll about, sometimes are fixed and staring, and sometimes are turned up beneath the lids, so that the cornea cannot be seen, but leaving visible the white sclerotica alone; at the same time the mouth is twisted awry, the tongue thrust between the teeth, and, caught by the violent closure of the jaws, is often severely bitten, reddening by blood the foam which issues from the mouth. The hands are firmly clenched and the thumbs bent inwards on the palms, the arms are generally thrown about, striking the chest of the patient with great force. Sometimes he will bruise himself against surrounding object, or inflict hard knocks on the friends and neighbors who have hastened to his assistance. It frequently happens that the urine and excrements are expelled during the violence of the spasms, and seminal emissions sometimes take place. The spasmodic contraction of the muscles is occasionally so powerful as to dislocate the bones to which they are attached. The teeth have thus been fractured, and the joints of the jaw and of the shoulder put out or dislocated. This is the most severe, yet the most common form in which an epileptic attack occurs. Fortunately, there is a large class of cases in which the symptoms are milder. Sometimes there is no convulsion at all, or, at least, is very slight and transient; no turgescence of the face; no foaming of the mouth; no cry; but a sudden suspension of consciousness, a short period of insensibility, a fixed gaze, a totter, perhaps, a look of confusion, but the patient does not fall. This is but momentary. Presently consciousness returns, and the patient resumes the action in which he had been previously engaged, without always being aware that it has been interrupted. Between these two extremes of epilepsy there are many links or grades. Sometimes the sufferer sinks or slides down quietly without noise; is pale; is not convulsed; but is insensible, much like one in a state of syncope, or fainting. As it is impossible to give any single description of epilepsy which will include all its varieties, of course it is still more difficult to offer a strict definition of the disease. We can only say it is a malady that causes a sudden loss of sensation and consciousness, with spasmodic contraction of the voluntary muscles, quickly passing into violent convulsive distortions, attended and followed by stupor or sleep, recurring in paroxysms, often more or less regular. Yet all these circumstances may in turn be wanting. There may be no convulsion, no interruption of consciousness, no subsequent coma or stupor, or even a recurrence of the attack. The duration of the attacks is variable. They seldom continue longer than half an hour; the average duration may be said to be from five to ten minutes. Attacks that spread over three or four hours generally consist of a succession of paroxysms, with indistinct intervals of comatose exhaustion. In the long-continued fits, or in the protracted succession of fits, the patient often dies. The periods at which the paroxysms return are extremely variable. Most commonly they visit the sufferer at irregular periods of a few months or weeks; sometimes are repeated at intervals of a few days; sometimes every day or every night, and very frequently many times in the twenty-four hours. The epileptic attack may come on for the first time at any age. It may begin in infancy during the first dentition, or teething; more commonly about the age of seven or eight years, during the time of the second dentition; more frequently still, from fourteen to sixteen, shortly before the age of puberty. It is apt to occur for a few years subsequently to this. The first fit may not occur till between thirty and forty; or it may occur at sixty, or even at a later period of life. TREATMENT. -- There is perhaps no disease where a greater diversity of medical treatment has been instituted than in Epilepsy. The whole pharmacopoeia has been exhausted, and each remedy extolled for its virtues. One medical man says he cures the disease by trephining; another thinks the oil of turpentine the best remedy; still another recommends the vapor of chloroform. This doctor applies ice, the other cauterizes the back with a hot iron, and yet another speaks highly of a compound of camphor, valerian, assafoetida, naphtha, and oil of cajeput. Unless rational treatment is employed, the disease cannot be cured. If occurring in infants, it should be ascertained if it is not due to teething or worms, and the proper treatment instituted, if so caused. If connected with derangement of the catamenia, masturbation, or spermatorrhoea, the treatment for these complaints is necessary. The anti-spasmodics are indicated in every case, the best of which is blue vervain, although valerian, belladonna, scull-cap, etc., are also good. The general condition of the system should receive strict attention. On page 469 I have given a remedy which will prove
in eight cases out of ten a simple and certain cure. I make no secret
of its composition. I have sent the prescription to many thousands
gratuitously. A fair trial will convince every one that it is one
of the most potent remedies ever discovered for the cure of epilepsy, falling
sickness, or fits. When this medicine is taken, the spasms gradually
grow lighter and lighter, and finally disappear altogether, restoring the
patient to the most perfect normal health. Its effect is truly wonderful.
The time to acomplish a cure is usually from two to three months.
HYSTERICS This is a nervous condition confined to females, though well marked cases of hysteria are occasionally met with in males. The invasion of the disease is sudden and irregular, but in many cases decidedly periodical. The principal characteristics consist in alternate fits of weeping and laughing, with a sensation as if a ball was rolling towards the stomach, chest, and neck, producing a sense of strangulation. Consciousness is lost in violent cases, but it remains clear as a general thing, which distinguishes it from epilepsy. It is dependent upon irregularity of nervous distribution in very impressible persons. TREATMENT. -- During the paroxysms, the feet should
be placed in warm water, and a hot mustard plaster applied to the lower
part of the abdomen. A decoction of equal parts of ladies'-slipper
and scull-cap should be given until the spasm subsides. A tea made
of ginger and bayberry, the tincture of castor, and assafoetida, are also
good. The state of the womb should receive attention, and if dependent
upon indigestion and constipation, tonics and laxatives are the proper
remedies. I have never met with the annoyance or difficulty in the
treatment of this disease that so many practitioners speak of, but regard
the disease as easy of cure.
CATALEPSY This is an affliction of rare occurrence, and appears to be constitutional, or dependent upon some derangement of the nervous and muscular system which baffles inquiry. The sufferer is suddenly seized by it, and, although powerless to move, or speak, and to all appearance dead, is partially sensible of all that is going on around. In some cases, however, the senses are suspended. The body and limbs are not generally rigid, but will remain in the positions in which the bystanders may place them. Many years ago, when the light of science was not so bright, or shed so extensively as it is now, men and women were buried alive while cataleptic. The catalepsy, or trance, often lasts for weeks, the sufferer, in the meantime, partaking of no nourishment whatever. "Absence of mind" is a slight form of catalepsy. TREATMENT. -- During the paroxysms the head should
be showered with cold water, followed by hot foot-baths and stimulating
liniments, with friction to the abdomen and spine. Some aromatic
stimulant, as peppermint sling or compound spirits of lavender, should
also be administered. For the toning of the nervous system and preventing
recurrence of the trance, the "Restorative Assimilant" answers all purposes
admirably.
ST. VITUS'S DANCE (CHOREA) This is characterized by irregular contractions of the voluntary muscles, especially of the face and limbs, there being incomplete subserviency of these muscles to the will. It is a disease which usually occurs before puberty, and is generally connected with torpor of the system and of the digestive organs in particular. The spasms do not continue during sleep, and often, by a strong effort of the will, they can in a measure be controlled. Its duration is long, but usually devoid of danger, unless it merges into organic disease of the nervous centres, or of the heart, or into epilepsy. TREATMENT. -- The general system should be strengthened,
and the intestinal canal stimulated. Purgatives once or twice a week,
with appropriate regimen, will fulfil these. A mild purgative, like
the "Renovating Pill," should be used. The decoction of scull-cap
and ladies'-slipper is very beneficial. It is cured in a short time
by my "Restorative Assimilant."
LOCKED-JAW (TETANUS) This is a disease of the true spinal system, and is manifested by spasm and rigidity of the voluntary muscles. When the muscles of the neck and face are affected it is termed Trismus, or locked-jaw; when the muscles in front, Emprosthotone, when the muscles of the back, Opisthotonos; and when bending to either side, Pleurosthotonos. Tetanus may be either acute or chronic; the former is the most frequent and most formidable; the latter, apt to be partial, milder, and more subject to treatment. It is called traumatic when it follows a wound or injury, and idiopathic when of spontaneous origin. Acute traumatic tetanus is more common in hot climates, and in military practice, and may follow a slight bruise or puncture, especially if some nerve has been injured. The symptoms may appear in a few hours, or in many days; at first, there is a stiffness and soreness about the neck and face, the contraction of the muscles causing a ghastly smile; chewing and swallowing are difficult, the forehead is wrinkled, eyeballs are distorted, nostrils dilated, and the grinning countenance is expressive of horror. Respiration is rapid, the tongue protrudes, and the saliva dribbles. The mind is clear until just before death, which generally takes place in a few days. TREATMENT. -- The indications are to remove all sources
of irritation and diminish the spasm. The wound is to be cleansed
from all foreign bodies, pus to be discharged by a free incision, if necessary,
and warm anodyne poultices and fomentations are to be applied. Excision
of the wound, or division of the nerve leading to it, may be done by the
surgeon. Nutrition and opium are indispensable; the latter may be
used either externally or internally. A lobelia emetic, if it can
be administered, should be given, and a brisk purgative should be given.
Tobacco, either by the mouth, or in enema, is an excellent relaxant.
Camphor, assafoetida, etc., may also be used as anti-spasmodics.
Cannabis indica internally, and ice to the spine, have been used advantageously
in some cases. If, in opinion of the attending physician, it is necessary,
chloroform or ether may be used as an anaesthetic.
PARALYSIS (PALSY) The most characteristic symptom of cerebral hemorrhage is paralysis. Very slight effusion produces this effect, and, in general, its intensity is in direct ratio of the extent of the effusion. It also arises from disease of the brain or its membranes, injuries of the brain and spinal cord, diseases of the cord or its membranes, or any injury of the large nervous networks, the action of lead, etc. The nerves of motion as well as those of sensaton may be paralyzed, and when it exists on one side of the body it is called hemiplegia, and when confined to the lower limbs, paraplegia. When the muscles of the mouth or of an extremity are affected, it is called partial paralysis, and when both sides, whether in their extent or in some of their parts, are deprived of motion, it is termed general paralysis. At the very moment of the effusion it acquires all at once its highest degree of intensity, then remains stationary or begins to diminish. Sometimes the paralyzed part has not previously experienced any disturbance with respect to either sensation or motion; sometimes, however, the patient has experienced in these parts pricking sensations, numbness, permanent or transient, an unusual feeling of cold, a sense of weight, and a certain degree of debility. The part paralyzed suggests the locality of the effusion or injury, but these are only of interest to the pathologist. When the affected muscles degenerate or atrophy, it is called wasting palsy, and when characterized by slow progress, and tremulousness increases to such extent that the agitation prevents sleep, all locomotion, difficulty of chewing and swallowing, etc., it is called paralysis agitans. TREATMENT. -- If dependent upon cerebral hemorrhage, the treatment of apoplexy should be instituted, and afterwards the use of derivatives such as purgatives, alteratives, diuretics, etc., and the use of local stimulants. The patient should be restricted in his diet, and all causes of cerebral excitement, whether physical or moral, should be avoided. The bowels should be well acted upon, and the condition of the bladder attended to. When the organic disease is removed, and all symptoms of vascular excitement have subsided, recourse should be had to nux vomica, or strychnine, tonics and galvanism. In giving strychnine, the lowest dose should be given at first, and cautiously increased. Macrotin, viburnin, xanthoxylin, and rhusin are also good remedies. The local treatment consists in stimulating liniments, blisters to the spine, etc. Those who may desire my counsel and opinion of their
cases, as to nature and curableness, will please write as directed on page
390.
HYDROPHOBIA This is caused by the bite of a mad dog or other hydrophobic animals. The human subject is not as liable to hydrophobia as the lower animals, and it is consoling to know that only about one-tenth of those bitten are attacked by hydrophobia. The interval of the bite and appearance of the disease varies from twelve days to two months. The wound heals like any other bite, but on approach of the disease the scar begins to have sharp pains, and the part feels cold, stiff, or numb. The patient feels a strange anxiety, is depressed in spirit, has an occasional chill, disturbed sleep, and spasmodic twitches. The appetite is lost, and, as the disease progresses, thirst appears, and he attempts to drink; but, the moment the water approaches his mouth, a spasmodic shudder comes over him, he pushes it back with horror, and the awful fact of his condition is known to him, and pitiful expressions escape him. His throat becomes full of glain, viscid mucus, which he continually tries to clear away. He strives to bite his attendants, suffers great depression of spirits, and finally dies from exhaustion, or in a horrible spasm. TREATMENT. -- The wound should be cut out, cups or suction applied to it, or thoroughly cauterized, and the patient should be kept quiet. Copious draughts of whiskey have been advised by some. The red chickweed or scarlet pimpernel is said to
be an absolute remedy. Four ounces of this should be boiled in two
quarts of water until reduced to one quart, and a wine-glassful taken twice
a day. The wound should also be bathed by the same. The common
rose-beetle (cetonia amata), found so commonly on rose-bushes, is an effectual
remedy. I desire in this connection to draw attention to a most absurd,
ridiculous superstition which prevails; that is, if a person be bitten
by a dog which is in perfect health, but afterwards goes mad, the person
also will be affected, so they insist upon the dog being destroyed, for
fear it should go mad at any future period. Instead of this the dog
should be carefully taken care of. Patients would then have the satisfaction
of knowing that there was nothing wrong with it, and their minds would
be at rest.
HUMID TETTER (ECZEMA) This consists in the appearance of minute shining vesicles, not larger than the head of a small pin, on different portions of the body. They are usually clustered together, and surrounded by a red ring. The fluid in the vesicles becomes opaque in a few days, and finally forms light, thin scales, which fall off. In most cases a fresh crop appears as soon as the first crop is matured, in which case yellow crusts form over the diseased patch, and chronic tetter exists for weeks or months. The red eczema is the worst form of this disease. TREATMENT. -- Low diet, cooling drinks, gentle purgatives
and warm baths should be prescribed. The acetic tincture of blood
root should be externally applied. It speedily cures all cases.
Celandine, tar, slippery-elm poultices, etc., are also useful.
TETTER, SHINGLES (HERPES) Tetter is a transient non-contagious eruption, consisting of circumscribed red patches, upon each of which are situated clusters of vesicles, about the size of a pea. After a few days the vesicles break, pour out a thin fluid, and form brown or yellow crusts, which fall off about the tenth day, leaving the surface red and irritable. The eruption is attended with heat, tingling, fever, and restlessness, espcially at night. Ringworm is a curious form of tetter, the inflamed patches being ring-like in form. TREATMENT. -- Light diet, and gentle laxatives.
If the patient is old the tonics should be given. The elder-flower
ointment is an excellent external application. The acetic tincture
of lobelia is also good. Nothing better, however, can be used than
the "Herbal Ointment," mentioned on page 469.
ITCH (SCABIES) This annoying disease is caused by minute white insects, the acarus scabei or sareoptis hominis, which insinuate themselves beneath the skin. It is said that these insects travel in pairs, male and female, husband and wife evidently, and that the female is very much the smaller. Under the microscope the animal appears in the cut, which gives a front, back and side view of it. The elegance of the animal is beyond question, and his mode of burrowing under the skin is sagacious. When placed upon the skin he proceeds to make a hole through it, which he does by his head and fore-feet. Into this he insinuates his whole body. Like the mole, he makes a channel many times his own length, at the end excavating a chamber, where he takes his siesta, and from whence he saunters forth in quest of provender. As age approaches, tired of the home of his youth, he digs onward, scoops out another in which he ends his days, beloved and respected by all his neighbors. Itch is characterized by a vesicular eruption, and makes its appearance between the fingers and in other soft portions of the skin. If the pimples are scratched a watery fluid is poured out which forms small scabs, and if the disease is not cured, extensive sores occur. It is more common among the poor, but James I. of England said that it was only fitted for kings, so excellent is the enjoyment of scratching. It may be a royal luxury, but I am quite sure that persons having the itch would consent for it to be entirely monopolized by kings. A similar disease is caused by the acarus sacchari, an insect very common in brown sugar. TREATMENT. -- Whatever kills the little animal will
cure the itch. This is best achieved by sulphur. It should
be made into an ointment with lard, and thoroughly rubbed into the skin
before the fire, morning and evening for a few days. This will put
an end to the "squatter sovereignty" of whole colonies. An ointment
made from veratrum also does well. Another method is equally if not
more efficacious. Rub the entire surface of the body over with soft
soap for half an hour -- then a warm bath for half an hour, washing it
thoroughly off, and exciting the skin to active circulation. Then
an ointment, prepared as follows, should be rubbed over the entire surface:
Take eight ounces of lard and into it thoroughly rub two ounces of flour
of sulphur, and one ounce of carbonate of potash, making an even and uniform
mixture, and it is ready for use. This, after it has remained on
the skin for three hours, may be well washed off, and the disease is entirely
annihilated. In persons of tender skin, or where considerable inflammation
has been set up by continued scratching, it may be necessary to anoint
with hard soap instead of soft, for it does not contain as much alkali,
and leave out the carbonate of potash in the ointment -- for reason of
its being too stimulating. In these instances, it will take longer
to cure the disease, but it is just as certain in its results. This
mode of treating this disease is an entirely successful one -- and no one
need "to scratch" if these simple directions be attended to.
WATERY BLEBS (PEMPHIGUS) This is characterized by loss of appetite, febrile symptoms, at first, followed by a bright red eruption of a smarting or burning sensation. In the centre of this eruption, minute vesicles appear, which gradually enlarge in blisters in the shape of bubbles and contain a watery fluid. They vary in size from a split pea to that of a hen's egg, and rise very rapidly, and break in a few days, leaving a raw surface, which soon becomes covered with a crust. TREATMENT. -- The surface of the body should be bathed,
and the bowels opened by a gentle purge. The inflamed surface should
be covered by a slippery-elm poultice, and be kept moist with tincture
of lobelia. When the constitution is feeble, quinine, alnuin, etc.,
should be given. The diet should receive especial attention, and
out-door exercise enjoyed.
RUPIA This is a small blister, or vesicle, about the size of a chestnut, which at first contains a darkish fluid, which dries into a crust, falls off, and leaves an indolent ulcer. It is always connected with a vitiated constitution, and is dependent frequently upon imperfect diet, although chronic disease, such as syphilis, phthisis, dyspepsia, and poisonous mineral medicines, not unfrequently produce it. TREATMENT. -- The digestive organs should be corrected,
and the blood nourished and enriched by wholesome diet and tonics.
The local applications should consist of emollient poultices, and kept
constantly moist with the tincture of hydrastin, baptisin, or myrrh.
A poultice of equal parts of bayberry, white pond lily and slippery-elm
is very beneficial. The cause, however, is always to be ascertained
before the treatment is interposed.
CRUSTED TETTER (IMPETIGO) This consists of mattery pimples developed on a highly inflamed skin, appearing chiefly on the extremities and rarely met with in children in the acute form. It is either acute or chronic. The eruption in the acute form is preceded by a slight fever, and in about thirty-six hours red spots appear on the skin, accompanied by heat and tingling. On the second day, the centres of these spots are raised by the pus contained, to which the name of phyzacious pustule is given. This stage is accompanied by much pain. Maturation occurs from the fourth to the sixth day, and the disease usually terminates in two weeks. The chronic form is more common, and afflicts young children oftener than adults. TREATMENT. -- For the acute form, low diet, gentle laxatives, and the application of oxide of zinc ointment. The pustulated surface should also be covered with slippery-elm poultices, and kept constantly moist with tincture of lobelia. In the chronic form, in addition to the above, the tonics should be given, and the blood should be enriched by proper medication and nutritious diet.
This consists of mattery pimples developed on a highly inflamed skin, appearing chiefly on the extremities and rarely met with in children in the acute form. It is either acute or chronic. The eruption in the acute form is preceded by a slight fever, and in about thirty-six hours red spots appear on the skin, accompanied by heat and tingling. On the second day, the centres of these spots are raised by the pus contained, to which the name of phlyzacious pustule is given. This step is accompanied by much pain. Maturation occurs from the fourth to the sixth day, and the disease usually terminates in two weeks. The chronic form is more common, and afflicts young children oftener than adults. TREATMENT. -- For the acute form, low diet, gentle
laxatives, and the application of oxide of zinc ointment. The pustulated
surface should also be covered with slippery-elm poultices, and kept constantly
moist with tincture of lobelia. In the chronic form, in addition to the
above, the tonics should be given, and the blood should be enriched by
proper medication and nutritious diet.
LEPROSY The eruption in this disease makes its appearance as a small red spot, elevated a little above the general skin, usually occurring first on the limbs. The scales occurring on these patches occur in layers, one above the other, and have a bright silvery lustre. This is the lepra alphoides. The Hebrew leprosy was a variety of this form. What was known as the Leuce was generally not scaly, but consisted of smooth, shining patches, on which the hair turned white and silky, and was totally incurable. When leprosy is of dark livid color, it is called lepra nigricans, and when copper-colored, it is due to syphilis, and is termed lepra syphilitica. The leprosy of the Arabs is what is known as Elephantiasis, and the Greek leprosy includes the varieties met with at the present day. Leprosy is endemic in Egypt, in Java, and certain parts of Norway and Sweden. TREATMENT. -- The means best adapted for its removal,
are, a mild, unirritating diet, emollient fomentations, sulphureous baths,
fumigations, etc., but often all treatment is ineffectual. A warm
solution of the sesquicarbonate of potash is effectual in some cases.
An ointment of glycerine and hydrrastin, and the acetic tincture of blood-root,
is also serviceable, but as a topical remedy, nothing could be superior
to my "Herbal Ointment."
DRY TETTER (PSORIASIS) This differs from leprosy in the eruption being more
irregular. The spots sometimes come out in thick clusters, and blend
in various ways. The eruption is not circular as in leprosy, but
consists of irregular patches of every extent, and the surface is more
tender and irritable than in leprosy. There are many varieties of
this disease. The "Baker's Itch," "Grocer's Itch," and "Washerwoman's
Scall," are only different varieties of psoriasis.
PITYRIASIS This name is from the Greek pityron, signifying bran. It is characterized by patches of yellowish, or reddish yellow color, covered with fine branny scales, accompanied by smarting, itching, and burning. It may occur at any part of the body, under three or four varieties of form. TREATMENT. -- The treatment advised in psoriasis
will answer in this disease.
LUPUS This is the "Jacob's Ulcer" of common parlance, and from its rapacity it is named Lupus, which is the Latin name for wolf. It is also called "noli me tangere," touch me not. It occurs in a variety of forms, generally upon the face. It commences by slight thickening and elevation of the skin, usually not larger than a wheat grain. A thin, hard, brownish scab appears on its surface. The disease extends usually slowly, but sometimes very rapidly, and cases have occurred where the whole nose has been destroyed in a month. It is very rapacious, destroying even the bones in its progress. TREATMENT. -- When it first makes its appearance
it should be thoroughly destroyed with caustics, and healed by zinc ointment.
At the same time, the alteratives should be given. My "Blood Purifier"
(see page 469) is excellent for this purpose. Early institution of
treatment will only prevent destruction of tissue.
ELEPHANTIASIS This is characterized by the development of tumors upon the skin, varying in size from the head of a pea to that of an apple, or even larger. Eventually these tumors ulcerate, and discharge an unhealthy pus, in some cases affecting the bone, and resulting in mortification and death. It is endemic in Lisbon. At first there is a discoloration of the skin of the face, the lobes of the ear lengthen, and the wings of the nose spread out; then the face becomes tuberculous, the features are puffed out, the lips thicken, the whiskers, eyebrows, and eyelashes fall out. The tubercles ulcerate after some years, there is ozoena, the finger and toes mortify, and the body exhales a most loathsome odor. This is the leprosy of the ancient Egyptians. TREATMENT. -- The parts should be thoroughly bathed
with a strong solution of the sesquicarbonate of potash, and stillingia
and other alteratives administered. Where the parts become swollen,
painting with the tincture of iron, followed by astringent poultices, has
been found very beneficial. When confined to the extremities, amputation
may become necessary.
ACNE This is a small pimple or tubercle which appears on various parts of the face. The disease leads to no particular evil results, save that it is unpleasant, slightly painful, and disfiguring. It commonly afflicts the young and robust of both sexes, and generally indicates strong passions, and too great an indulgence in animal food, or neglect of ablutions and out-of-door exercise. It is sometimes, in its more severe forms, the consequence of solitary practices. The common form of the disease is an eruption of hard, distinct, inflamed tubercles which remain unchanged for a long time, or else slowly advance to partial suppuration. They are to be seen on the forehead, cheeks, and chin, and sometimes on the nose. It is commonly known as the brandy face or rum blots. TREATMENT. -- Attention to the general health becomes
necessary. It is not well to drive them in by lotions, as they are
then liable to break out in some internal organ. Attention to diet,
plenty of exercise, a pure imagination, and a clean body, together with
open and regular bowels, will soon effect the disappearance of this troublesome
enemy of good looks.
WARTS AND CORNS Warts consist of collections of hypertrophied cutaneous papillae, on loops of veins, arteries and nerves. These loops, frequently, without any apparent cause, take on a disposition to grow, and by extending themselves upward, they carry the scarf-skin along with them, which thickens, and the whole forms the wart. Corns consist in excrescences confined mostly to the toes and soles of the feet, resulting from wearing tight shoes. They occasionally form on the elbows and knees, or on the extremities of the fingers. When occurring between the toes, they are called soft corns. Bunions consist of an enlargement, thickening, and inflammation of the mucous bursa at the side of the ball of the great toe. Occasionally the bursa suppurates, and a fistulous opening left after the pus has evacuated. TREATMENT. -- Corns may be cured by shaving them
slowly and applying nitro-muriatic acid or chromic acid ointment.
For soft corns acetic acid is better. Warts should be clipped off
with the scissors, and chromic acid applied, or any other cauterizing agent
will answer. The tincture of thuja is also excellent. Bunions
are cured by bathing them frequently in the oil of erigeron.
PRURITIS This is dependent upon an altered condition of the
nerves of the skin, and consists in a painful sensation of itching.
There is no perceptible alteration in the appearance of the skin, and the
itching is generally the result of sympathy, through the nerves, with some
diseased condition of a distant part. It more frequently affects
the fundament, the scrotum, or the vulva of females.
MACULAE, OR SPOTS This affection, which is characterized by an increased hue of the pigment of the skin, consists of freckles and moles. Ephelis lenticularis, or common freckles, appears in small yellowish, brownish, or greenish-yellow, irregular, rounded spots, caused particularly by the influence of the sun's rays upon the parts. It occurs generally in females, owing to their fine skin. Ephelis hepatica is observed in females during pregnancy. Ephelis violacea is caused by the long use of nitrate of silver. Moles are dark colored patches, usually covered with hair. Noevi or mother's marks are called aneurisms by anastomosis, or an inter-connection and enlargement of the arterioles of the skin. Leucopathia, or Albinism, consists of a diminution of the coloring matter of the skin. It is found in all races, but is most striking in the black. TREATMENT. -- Freckles may be removed by keeping
out of the sun, and frequently washing the face in a solution of lactic
acid. Fresh buttermilk answers the same purpose. The best remedy,
however, is to be found in my "Floral Bloom." It quickly removes
freckles, moth patches, etc., and makes the skin clear and transparent.
Moles and mother's marks belong to surgery, and may in many instances be
removed. Albinism is incurable.
SCALLED HEAD (TINEA FAVOSA) This is caused by an insect by the name of achorion Schonleinii. The eruption takes the shape of large flattened pustules, which have an irregular edge, and are surrounded by inflammation. Sometimes they appear first behind the ears, and at other times upon the face, spreading thence to the scalp. The face is usually involved to some extent wherever the eruption may originally show itself. Scalled head is mostly confined among children. In the outset of the disease the pustules on the scalp are generally distinct: -- on the face they rise in irregular clusters. They are atttended by much itching, and the efforts to relieve this torment hasten their breaking. When broken they discharge a viscid matter and run together, gradually forming sores of a vicious character. These sores are covered by yellowish-greenish scabs which present a revolting appearance. TREATMENT. -- The hair should be shaved close to
the scalp, and the head thoroughly washed with soap and water, after which
the zinc ointment should be applied in the morning and the tar ointment
in the evening. Alteratives should also be given. This course,
if persisted in, will remove the disease.
TINEA SYCOSIS This is commonly known as "Barber's Itch," and is confined to the face, especially to that portion covered by the beard. It is characterized by inflammation of the hair follicles, causing an eruption of small pustules forming incrustations eventually. It may be consoling to those who suffer with it to know that it is caused by a parasite with the humble name of microsporon mentagraphytes. TREATMENT. -- Shave the beard, and paint the part
with a strong tincture of iodine for a few days. Follow this with
a poultice, composed of equal parts of lobelia, blood-root, myrrh, and
slippery-elm. Depilation, or pulling out the beard, may be necessary in
some cases to effect the cure.
BALDNESS (ALOPECIA) This may be partial or general, temporary or permanent, and occur at any period of life. Senile baldness usually takes place gradually, the hair first becoming thin on the crown, or on the temples and forehead. It is owing generally to the general loss of the nutritive functions of the hair, and of the follicular apparatus. Loss of color of the hair (canities) may depend upon advanced age, disease, or deep mental emotion. It usually occurs gradually, after the age of forty. Cases are recorded in which the loss of color was complete in eight days, while in others the hair was almost completely blanched in a single night. TREATMENT. -- If the hair follicles are not destroyed,
baldness may be cured. The tincture of cantharides, lac sulphur,
shampooing, etc., are each to be recommended. Tonics and strict cleanliness
also promotes the growth of the hair. In my "Woodland Balm" (page
469) the bald or gray will find a remedy which has no superior for restoring
the hair to a healthy growth and natural color.
ENTOZOA These grow in the body without forming attachments to its structures, have an independent life of their own, and possess the power of reproduction and generation. Several species infest the human body, some appearing always in the same organ and some in a particular tissue, and appearing oftenest where that tissue is plentiful. Scarcely any portion of the body is exempt from such growths. Their origin is a subject for two suppositions -- that of generative reproduction, and of accidental or spontaneous development of germs that take on modes of life and development characterizing them afterwards. The first supposition is more philosophical, comports more with analogy, and is unquestionably the true theory. The interest attached to these growths, however, is their effect upon the system and cause of disease. Their presence in the system causes morbid phenomena, disordered functional action, and loss of health. The mischief they do in the system depends upon their number, size, rapidity of growth, and species. When numerous or large they imbibe so much nutriment as to rob the system of its necessary sustenance. Their habitation is generally a seat of irritation or inflammation, and more particularly when their location is in a cavity, and when they possess power of motion. Psychodiara. -- Hydatids. -- These are organized beings, consisting of a globe-like bag of albuminous matter; the texture divided in layers, and containing a limpid, colorless fluid richer in gelatin than albumen. They live by inbibition, have no sensibility or power of motion, and appear more like a vegetable than an animal in their modes of life and reproduction. There are two kinds of hydatids, the acephalocyst, or cyst without a head, and the echinococcus, which is not different from the other in form but in containing minute animals (vermiculi echinococci) within it. The former is common to the human body, and generated between layers of membrane. The usual abode of hydatids is in the lungs, liver, ovaries, spleen, kidneys, etc. The hydatids occurring in the womb are often mistaken upon expulsion for products of conception, and their presence in that organ often produces similar signs as in pregnancy. Sterelmintha. -- These consist of solid porous texture, perforated by canals or cavities, which serve the purposes of digestion. These animals are hermaphrodite, i.e., having both sexual organs on one individual. The varieties of tapeworm belong to this class. So also the cysticercus, which occurs in the muscular structure and in the watery portion of the eye. The liver-fluke -- distoma hepaticum -- also belongs to this class, but which rarely occurs in man, but is supposed to cause the well-known "rot" in sheep. Coelelmintha. -- This class has a higher organic development than the preceding. It embraces several species of worms having hollow cylindrical bodies, distinct alimentary canals, with a mouth at one extremity and an anus at the other, a nervous system, and the sexual organs on different animals. The common intestinal worms belong to this class; so also the trichina spiralis -- causing the disease described below which is an animal which exists within the minute, white, ovate cysts imbedded in the muscles. The guinea-worm (filaria raedinensis), so common to Africa and Asia, but unknown in this country, is a hair-like worm developed beneath the skin, especially in the scrotum and lower extremities. It can be withdrawn when a pustule ensues, by care and patience, wrapping it around a stick until the end appears. The strongulus gigas is an animal that locates itself exclusively in the kidney, and sometimes attains an enormous size. Its body is round, but tapers toward both ends. It sometimes attains a length of three feet, and a thickness of half an inch. It causes impairment of functions, waste of the renal structure, and sometimes inflammation, with pain and bloody urine. It is sometimes expelled through the water passages. TREATMENT. -- The treatment of parasites is indicated
by their character or place of abode. If they exist in the alimentary
canal, such remedies as are known to expel them should be employed.
Anything is a good remedy that is harmless to the system but destructive
of life to them. Various agents are poisonous, such as cherry-laurel
water, camphor, oil of cubebs, oil of turpentine, copaiba, etc., but these
must be cmployed at proper seasons and in such quantities that they will
not harm the general system.
TRICHINIASIS This is a disease caused by the trichina spiralis which infests various animals, especially swine. If the meat of the hog affected is eaten raw or insufficiently cooked, it is most like to cause this dangerous disease. Thorough cooking destroys the parasites. The symptoms are extensive gastric disturbance, with nausea and a tendency to vomit; associated with rheumatic pains, stiffness of the muscles, irregular pulse, intermittent fever, which is violently aggravated in paroxysms, thirst, restlessness, nervous excitement, and utter wakefulness. The face generally swells, great prostration ensues, and the patient generally dies in a paralyzed condition. TREATMENT. -- In the early stage an actiave lobelia
emetic should be given, and followed by a full dose of castor oil or spirits
of turpentine. An alcoholic vapor bath should be taken, and sufficient
veratrum to control the fever. If sleeplessness prevails, opium should
be given. The above treatment may be repeated if not at first successful.
The first requisite of an infant is plenty of pure and fresh air. It should be kept in open air as much as possible, and when in-doors in well-ventilated rooms. When carried in the open air, their heads should not be enveloped in blankets, and when sleeping, their faces should not be covered with the bed-clothes. The infant needs and should have all the oxygen a pure air affords, which is so essential to its proper growth. The Skin. -- The skin of infants should be kept clean, to render them less liable to cutaneous diseases. The unctuous covering of a new-born child should be removed as soon as possible. This can readily be done by smearing it with pure lard, and washing with white Castile soap and water. Do not use the brown Castile soap, as it contains oxides of iron, which are irritating substances. Infants should be washed every day with warm water, to be followed in course of time with tepid water, then temperate, and finally, at an age of some months, with cold water. Clothing. -- The young child should be amply clothed, care being taken that they are sufficiently loose, to admit free motion in all directions. Flannels should be placed next to the skin in winter, and cotton in summer. Food. -- Proper regimen is of the utmost importance to the health of the young. Until the first teething, the proper and natural food is the mother's milk. If the mother is unable to nurse her child, a wet-nurse should be procured. If the mother's milk is insufficient, cow's milk, sufficiently diluted with water and sweetened with loaf sugar, should be taken in addition. This should be taken from a sucking-bottle, which, when not in use, should be kept in water, to prevent becoming sour. A nursing woman should pay the greatest attention to her health also, and, for obvious reasons, a scrofulous or consumptive mother should never suckle her offspring; she should also place a check upon her passions, as violent passion, grief, envy, hatred, fear, jealousy, etc., tend to derange the character of the milk, and often superinduce disorder of the infant's stomach, and throw it into convulsions. The diet of the mother should receive strict attention. Her drink should be simply water, or weak black tea, and her food plain and wholesome. Pastry and the richer articles of food should not be eaten. She should take daily moderate exercise to induce better assimilation of aliments. When her milk is scanty, a sufficiency can frequently be induced by placing a bread and milk poultice, over which a moderate quantity of mustard is sprinkled, on the breasts. Weaning. -- The child should be weaned after the
appearance of its first teeth. Nature then designs it to have different
food. Spring and fall are the proper seasons for weaning; no child
should be taken from the breast in the midst of summer. The weaning
should be a gradual process, and the food to be given should be of the
character of milk. Bread and milk, boiled rice and milk, soda-crackers
and milk, soft boiled eggs, roasted potatoes and milk, preparations of
sago, arrowroot, tapioca, oatmeal gruel, rice pudding, and similar substances
are all indicated. My nutritive fluids, given on page 205, can also
be given with good service. From these, in course of time, more solid
articles of food can be given them. Sugar in moderate quantities--
wholesome. Excessive eating should not be suffered. Water is
the best drink.
The baby exhibits indisposition by cries, struggles, etc., and if these are carefully noted, every mother may know what ails the baby. A baby suffering from stomach-ache sheds tears copiously, and utters long and loud cries. As stomach-ache is paroxysmal in character, so will its cries remit, and enjoy repose, to be followed by movements up and down of the legs and the peculiar cry. To cry in inflammation of the organs of the chest is painful; it therefore does not cry or shed tears, but utters a muttering cry, abruptly completed, and coughs after long breaths. In diseases of the brain, the child shrieks piercingly, followed by moaning and wailing. In extensive congestion, there is quiet dozing and probably snoring. Loss of appetite, fretfulness, restlessness, thirst,
great heat of skin, are all indications of disease, and require that solicitude
and treatment that every fond mother should know how to bestow.
TEETHING Many children are lost from teething. The process
of dentition often occasions fits. Its symptoms are, swollen and
inflamed gums, fever, pain, and heat in the head, sore mouth, etc.
Scarification of the gums is often resorted to; but if proper attention
be paid to the case in its inception, no such barbarous and injurious method
of palliation need be embraced. Bathing the head with diluted spirits,
and the feet with warm mustard water; keeping the bowels free and regular
by the simplest of herbal laxatives; and placing a plaster (composed of
two-thirds flour mustard, one-third flour, and sufficient vinegar to produce
the requisite moisture) between the shoulders, will generally obviate all
danger and mitigate the pain and suffering. When the sprcckled sore
mouth incidental to teething makes its appearance, treat the child as above,
but wash the mouth with a mild solution of borax, and use for diet (if
the child be weaned) gum-arabic water, and barley or rice water.
If the stomach is acid, the bowels are griping, administer mild doses of
magnesia. Warm baths are always beneficial to children who are teething;
but great care should be taken that the little ones do not catch cold after
the baths.
GENERAL DISEASES GOUT This is due to the presence of lithic or uric acid in the blood. The attack usually makes its appearance in the night. The patient is first awakened by an intensely burning and wrenching pain in the ball of the great toe, or some other small joint. This pain continues for about twenty-four hours, and is accompanied by fever. It then remits, and the patient may get sleep, though for several successive days he suffers from the attacks. A similar visitation will likely result after a considerable interval. Recovery from the first attack may be complete--the skin peeling off from the red and swollen joint, and leaving it strong and supple as ever; but, after several repetitions of the attacks, the joint becomes stiff, owing to the deposit of lithic acid concretions or chalk stones. It is a disease entirely local in its character. It vitiates the blood, affects the general system, and the attack is generally preceded by general symptoms, irritability of temper, unpleasant sensations in the stomach and head, and uncomfortable feelings of body and mind are premonitory symptoms of this disorder. The pain is most excruciating. The stomach, heart, lungs, head, eyes, etc., may also be subject to gouty inflammation. It is caused by luxury and indolence, in the plurality of cases. TREATMENT. -- During the paroxysm the anodynes should be given and applied; subcutaneous injection of morphine is best. The constitutional treatment should be composed of chimaphilin and apocynin in combination; aolchicum is also a very good remedy; chloroform liniment may also be externally applied. The patient's habits must be regulated, and his diet simplified, to prevent recurrence of the disease. Those who may desire consultation with the author,
in regard to this disease, are referred to page 390. Consultations,
either in person or by letter, from those who may desire treatment, are
carefully and gratuitously attended to.
RHEUMATISM This very painful affection is most frequently brought
on by exposure to wet and cold after violent and fatiguing exercise of
the muscles. The acute form is characterized by high fever, with
a full bounding pulse, furred tongue, and a profuse sweat which has a sour
smell. The urine is scanty and high colored; the joints swell and
are slightly red and very tender. The pain is agonizing when the
patient attempts to move. If the affection changes from one part
to another it is called metastatic, and is very dangerous, as it may suddenly
seize the lining membrane of the heart, and prove fatal.
TREATMENT. -- The bowels should be evacuated by a purgative, and the tinctures of black cohosh and veratrum given until free perspiration is produced. The tincture of black cohosh, two parts, and tincture of colchicum, one part, in doses of from twenty to forty drops, is also a very valuable remedy. For articular rheumatism the alteratives should be given. My "Blood Purifier" is a sure and efficient cure, and the pain is almost instantly relieved by the application of the "Herbal Ointment" (see page 469). Electricity may be resorted to in the chronic form. The treatment does not materially differ from that advised in the acute. Fomentations of hops and cicuta, or stramonium leaves, placed upon the inflamed and swollen joints, will materially relieve the pain. Rheumatism in the chronic form is often a very difficult
disease to cure; but if properly treated, by purely chemical medication,
the acid condition of the blood will be negatived, and the patient relieved
of his painful malady. Of the thousands of cases that have been under
my care, I do not recall one failure.
HIP DISEASE (MORBUS COXARIUS) This is a disease of the hip-joint, and common to scrofulous children. At first there is slight pain, commonly felt in the knee, lameness, and stumbling in walking, tenderness in the groin, and pain is produced by pressing the head of the bone suddenly against the socket. The limb is longer than the other, which is owing to a depression of the pelvis on the diseased side, the weight of the body being supported on the opposite limb. If the disease is not arrested, destruction of the head of the bone and socket results, and the thigh-bone is drawn up, constituting a spontaneous dislocation. Often an abscess forms and opens externally. The toes may be turned inward or outward. This disease may be positively ascertained in the following way: -- Remove the clothing of the patient and place him on any flat surface, as a bench, or table; if he is placed so that the spine everywhere touches the table, the patient's knee on the affected side will be drawn up, the weight of the leg resting on the heel. If now his knee will be pressed down, the spine will be bent inwards, so that it no longer touches the table. This is an unerring diagnosis. TREATMENT. -- At the commencement of the disease
a large irritating plaster should be placed over the entire hip, and caused
to remain until a thorough counter-irritation is effected, and a discharge
ensues. Perfect rest is necessary, and the limb should be confined
in a carved splint. Iodine may also be externally applied, and the
general health improved to tonics, alteratives, and nutritious food.
Counter-extension as advised in cases of fracture is advisable in all cases.
A competent surgeon should direct the treatment.
WHITE SWELLING (HYDRARTHRUS) This disease occurs most frequently about the middle period of life, but is, however, very often seen in children. It will never appear before the age of puberty without a deviation from health, but not always so when it makes its appearance in after-life. It is a disease of the knee-joint characterized by swelling and white color, owing to the tension of the skin. It is of two varieties; both, however, destroy the synovial or articular membrane of the joint. One begins with a trifling stiffness, slight swelling, and in effect reduces the membrane to a pulpy, degenerate mass. The swelling increases gradually, and when the part is touched, it reveals the presence of fluid. Finally the cartilages ulcerate, and the disease assumes such characters that amputation becomes absolutely necessary. The other form begins with pain in the joint, which is severe at one point, and attains its height in a week. It is characterized by inflammation of the synovial membrane, and in a few days the joint becomes swollen from a collection of water. TREATMENT. -- At the commencement bathe the parts
with the following liniment:--oil of hemlock, 3 iv.; dissolve as much camphor
in it as it will take up, and add twelve drops of croton oil, and three
drachms of tincture of iodine. Bathe the limb thoroughly, after which
apply hot cloths wrung from a strong infusion of arnica flowers and lobelia,
and change as often as they grow cool; with each change apply the liniment.
This will arrest the disease if applied at the onset. The patient
should be purged, and the compound syrup of chimaphila be administered
to him. If the disease is farther advanced, and openings exist, they
should be enlarged, and ointments and poultices applied, and the constitution
supported by tonics and antiseptics. Splints and entire rest may
be necessary in some cases, and when connected with a scrofulous diathesis,
my "Blood Purifier" should be taken internally, and the "Herbal Ointment"
applied externally. These will quickly eradicate the disease.
HECTIC FEVER Hectic fever is remittent, dependent upon local irritation, and rarely, if ever, idiopathic. It is attended by great and increasing debility, a weak, quick pulse, hurried respiration on any exertion, and increased heat of the skin. The febrile exacerbations are preceded by a slight chill, are slight at first, but soon become more evident, especially in the evening. The skin is at first dry, and the increased heat is more evident in the hands and face. The fever terminates in a free, profuse perspiration. The bowels are at first costive, but soon become relaxed, and an exhausting diarrhoea comes on; the urine is various, generally it is pale, and does not deposit; while there is generally a pallor of the surface, the cheeks present what is aptly termed the "hectic blush." As the disease advances, the whole frame becomes emaciated, the eyes sink in their orbits, but are brilliant and expressive; the ankles and legs sometimes swell, and the sleep is feverish and disturbed. Finally the debility becomes so great that the patient expires while making some slight exertion. Hectic fever accompanies nearly all forms of disease connected with great debility, especially scrofula and consumption. It may also be met with in surgical practice in disease or injury of the joints. TREATMENT. -- This depends much upon the cause or
causes which give rise to it. If the digestive mucous membrane is
diseased, the treatment consists in strict attention to diet, and in the
administration of tonics, diaphoretics, and diuretics. The antiseptics
should be given. Strychnine in doses of one-eighth of a grain is
decidedly the best agent for this purpose. Cherry-laurel water should
also be given. The fever is controlled, like other fevers, with veratrum.
If associated with consumption, the "Acacian Balsam" (page 469) will cure
it. Stimulants are very serviceable to counteract the debility.
General diet and cleanliness are not to be neglected.
CURVATURE OF THE SPINE Curvature of the spine is due to caries or destruction of the bodies of the vertebrae. There are several varieties of curvature; what is known as lateral curvature consists in the distortion of the spinal column either to the one side or the other. In this case there may be no caries of the spine. It consists in depression of one shoulder, the body being thrown out of its axis, by the curvature. This affection is caused by occupations which keep the body in a laterally distorted position, and tax one side of the body more than the other. It is produced in children who study their lessons at school, with one elbow resting on a high desk, etc. In Pott's Curvature of the Spine, the angular curvature is produced by caries of the vertebrae, or ulceration of the substance between the vertebrae, followed by more or less loss of power over the lower extremity. In examining the spine, one or more of the spinous processes is found to project beyond the others. Hump-backs are usually caused by curvatures of the spine, but they may also be caused by projection of the sternum, or deviation of the ribs. TREATMENT. -- If associated with scrofula, the treatment for that disease should be instituted. In lateral distortion, calisthenic exercises should be engaged. In Pott's disease extensive counter-irritation should be made over the diseased part, and vigorous tonics given. The treatment, however, best adapted to obviate all curvatures of the spine, is purely mechanical, and consists of braces, supporters, etc. Nothing else will achieve any satisfactory results. By mechnical appliances the spine is rendered straight, and compelled to maintain that position until a cure is effected. These mechanical appliances should be applied early, and be accurately adjusted and well fitted. I am constantly applying such appliances in my office,
and the results are excellent in nearly all cases. Those who cannot
avail themselves of a personal consultation, may send age of patient, nature
of curvature, height, and measure around the waist, and a suitable appliance
will be sent. Preliminary correspondence free.
IMPERFECTIONS OF THE HUMAN FORM These embrace those only which are of slighter degree, and of idiopathic origin. They are usually acquired more or less early in life. Not unfrequently they result from bad management of the infant, having its head always too highly bolstered up, and the chest compressed by tight clothing. The school-room, however, is the arena where the human form is robbed the most of its symmetry. It is gratifying to know that greater attention is now paid to this evil, but still to a great extent the seats and desks provided for the pupils are perfect outrages upon their physical natures. The seats are invariably too high and the desks too low, obliging the pupil, for five or six hours, to sit with his head down, his spine curved backwards, and his feet dangling in space. This unnatural position soon causes a loss of erect carriage, and induces stooped shoulders, and incapacious chests. It is but rarely that we see persons having an erect posture in standing or walking, and but few have that prominent chest, so necessary to the perfection and elegance of the human form, and to the full breathing capacity for the lungs. The shoulders should be in the perfect form thrown backwards, and the body erect, the only curve in the spine being the natural inward one in the lumbar portion. TREATMENT. -- Elegance and symmetry of form can only be gained by proper gymnastic and calisthenic exercises. These should be of such a character as to be best adapted to overcome the particular deformity. In all cases suitable braces should be worn. These gently force back the shoulders, thereby increasing the volume and capacity of the chest, and enable the wearer to maintain the erect posture without fatiguing effort. In all pulmonary disease, or where there exists an insufficient capacity of the chest, these braces should be worn. In the male they take the place of suspenders and in the female they can be made to serve the purpose of sustaining the weight of the skirts. Nothing could be more conducive to health than these appliances; they often prevent the onset of consumption in those predisposed hereditarily to that disease. It is a well-known fact that the man or woman having an erect form and expanded chest is much less liable to disease, and at all events possesses greater vigor of health. The reason of this is obvious. It is particularly advisable that every person having a defective form should wear a shoulder brace. The braces represented in the above cuts are of the author's own invention, and he does not hesitate to claim for them a decided superiority over all other braces for this purpose. They are worn with great comfort, gently obliging the wearer to maintain the erect posture, and enabling him to thoroughly inflate his lungs, which in course of time will lead to permanence of the upright stature with an expanded chest. All persons desiring these superior braces can obtain
them by addressing the author. Price two dollars.
ABSCESS An abscess is a collection of pus or matter in the substance of some part of the body. When the matter is poured out from some part, the process is called suppuration, when it collects in a tissue, it is an abscess. It commences with all the symptoms of inflammation, fever, pain, redness, and swelling. The centre is firm, with swelling surround it. The formation of pus is indicated by rigors, an abatement of fever, and a feeling of weight, tension, and throbbing. The centre softens, which is termed pointing, and fluctuation is felt. There is a natural tendency to discharge the pus, which is more apt to be towards the skin. It is less apt to open into serous than into mucous tissues. The abscesses that form in scrofulous cases are called cold, because the conditions of inflammation are absent. They heal, after the discharge of pus, by a process called granulation. TREATMENT. -- The indication to be fulfilled in the
treatment of abscess is to prevent the formation of pus, to evacuate it
when formed, and to heal the parts so as to prevent further secretions.
To prevent its formation cold applications and leeches should be applied
to the part the patient purged, and restricted to a low diet. When
matter is formed warm fomentations and poultices should be applied, to
hasten the progress of the pus to the surface. If abscesses distinctly
point they need not be opened, but allowed to burst themselves, but if
they occur in loose cellular tissue, under hard skin, and show a tendency
to burrow, they should be evacuated by a free incision. After evacuation
the poultices should be continued, or the parts be dressed with stimulating
ointments, of which the "Herbal Ointment," page 469, is the best.
This is also called whitlow, and is an abscess of the fingers, of which there are three kinds, the first situated upon the surface of the skin, the second under the skin, the third within the sheath containing the tendons of the fingers, and sometimes involving the covering of the bone. The latter form is the most terrible, and begins with redness, swelling, and a deep-seated and throbbing pain, which becomes so excruciating as to banish all sleep, and nearly drive the patient to distraction. Relief is only secured by discharge of pus. TREATMENT. -- Carry the hand in a sling and use poultices.
A poultice made of equal parts of slippery-elm, poke-root, flaxseed meal,
and lobelia seeds, mixed with hot lye, and changed twice a day, is an admirable
application. When the pain becomes great, the abscess should be laid
open with a knife, cutting down to the bone. Nothing will insure
loss of bone but a thorough and deep incision. This is most painful,
but will give instant relief. After the evacuation, the treatment
is to be followed as in ordinary acscess.
ULCERS Ulcers are breaches of continuity of surface, being caused by disease or unrepaired injury. A simple or healthy ulcer has its surface covered with a thick, creamy, yellow pus, not too profuse, and inodorous. The granulations are small, florid, pointed, sensative, and vascular. A scrofulous ulcer is one occurring in debilitated constitutions, most frequently upon the neck and joints. They originate in the cellular tissue, beneath the skin, exist generally in clusters, and are characterized by imperfect and slow suppuration. An indolent ulcer occurs most frequently in the lower extremities of old persons, and is the most common of all ulcers. It is owing most frequently to a sore having been neglected or badly treated. Its surface is smooth, glassy, concave and pale. The discharge is thin and serous, and the surrounding tissue is swollen, hard and of a dusky-red color. It is painless, and the patient is apt to let it go unnoticed, unless if by accident, exposure, or over-exertion, it inflames and becomes painful. An irritable ulcer is one having an excess of organizing action, with a deficiency of organizable material. It is superficial, having an equal surface of a dark hue, and often covered with tenacious fibrin. It occurs most frequently near the ankle. It is very sensitive, and attended with great pain. A phagedenic ulcer is one of irregular form, with ragged abrupt edges, and uneven brown surface, looking as if gnawed by an animal. It is attended with burning pain, and great constitutional disturbance. A varicose ulcer is dependent upon a varicose condition of the veins, and usually occurs in the leg just above the ankle. They are indolent, and mostly moist on the surface. TREATMENT. -- In the simple ulcer the treatment is simply protective. Water dressings are the best, as they keep the parts clean and remove the liquid pus. The "Herbal Ointment" is equally good. If the granulations become too luxuriant, an astringent wash, or slightly cauterizing them, becomes necessary. In scrofulous ulcers constitutional treatment must be instituted. The soft infiltrated tissues surrounding the ulcers should be destroyed by escharotics, and after the slough is removed, the healthy granulated surface treated as a simple ulcer. In indolent ulcers the sore should at first be cleansed by poultices. Healthy granulation should be aroused by lightly touching the ulcer with nitrate of silver, sulphate of copper, etc., or the same effect may be produced by strips of adhesive plaster being placed over the entire surface of the ulcer. In irritable ulcer the treatment should first be constitutional, and tonics and stimulants administered. The part should be relaxed, rested, and elevated This should be followed by a light poultice, or warm-water dressing, or if there is great pain, fomentations of the infusion of opium, conium, or belladonna should be applied. In the treatment of phagedenic ulcers, fresh air and good diet are all-important. The secretions must be corrected, and a Dover's powder given at night. The ulcer should be thoroughly destroyed by escharotics, followed by warm poultices. In varicose ulcer cold water, rest, regular bandaging, or laced stocking, constitutes the treatment. Strapping with strips of adhesive plaster, by the support afforded, is excellent in all cases of ulcers. My "Herbal Ointment" (page 49) acts most admirably
as a local application in all cases of ulcer. It causes healthy granulation,
relieves the pain, and speedily causes union of the edges.
BOILS (FURUNCULUS) Boils occur most frequently in the young, and in those of plethoric habit, in those parts where the skin is thickest. They are usually gregarious, and depend upon derangement of the stomach and intestines, and frequently succeed eruptive diseases. The swelling is of a conical shape, having a hard, red, and painful base, and a yellow apex. If left to itself it bursts and discharges pus, and a core or slough of cellular tissue; when completely emptied, the heat and pain subside. TREATMENT. -- Poultices and warm fomentations should
be applied early, and as soon as pus has formed, the boil should be opened,
after which the granulated wound should be dressed with basilicon ointment.
If my "Herbal Ointment" is procurable, it may be applied form the first,
as it speedily draws the boil to a head, and quickly heals it after discharge.
CARBUNCLE (ANTHRAX) This is a serious disease; it is a solitary inflammation of the cellular tissue and skin, presenting a flat, spongy swelling of a livid hue, and attended with dull heavy pain. It varies in size, and its progress is slow. Like the boil, it appears more often upon the neck, the shoulders, the back, buttocks, and thighs. The constitutional symptoms are low throughout, and the attendant fever is apt to be typhoid in character; prostration and delirium often terminate the case. It most frequently attacks high livers of an advanced age. TREATMENT. -- During the formation, apply either
fomentations and poultices, or cold water dressing. An incision in
the form of a cross should be made free and early, which may be followed
by caustic applications, in order that the dying parts may thoroughly be
removed. After this is done, the wound is to receive ordinary treatment.
CHILBLAIN'S (PERNIO) This is an affection of the skin, produced by sudden alternations of cold and heat, most commonly affecting the toes, heels, ears, or fingers. It is attended with itching, swelling, pain, and slight redness at first; it may afterwards become of a livid hue, with vesications and ulcerative fissures, which are difficult to heal. TREATMENT. -- Wash the parts thoroughly, and then
apply tallow, and if on the hands, draw on a pair of old gloves, especially
at night. The "Herbal Ointment" is a sure and rapid cure for chilblains.
BURNS AND SCALDS There are three principal divisions of these injuries, which may be produced by hot fluids, vapor, flame, or solids. 1st. Those which produce mere redness and inflammation, terminating in resolution, and perhaps desquamation. 2nd. Those causing blisters on the skin, which often dry up and heal; but if the true skin has been injured and inflamed, suppuration, and ulceration will result. 3rd. Those causing the death of the part, in which there is not much pain, and which are followed by sloughs. Extensive burns, even if superficial, are very dangerous, and those upon the trunk are more dangerous than those upon the extremities. The symptoms are paleness and shivering, with a feeble, quick pulse, often prostration, coma, and death. The greatest danger is during the first four or five days, from collapse; subsequently from an affection of the head, chest, or abdomen or from prostration. TREATMENT. -- Bathing the part in cold water will
mitigate the pain, heat, and inflammation. Afterwards it must be
protected from the air by raw cotton, or some bland unctuous substance.
My "Herbal Ointment" gives instantaneous relief. Glycerine and carbolic
acid are used by some, and linseed oil and lime water, or linseed oil,
prepared chalk, and vinegar, by others. The indication is only to
exclude the air. The blisters should be discharged of their contents,
care being taken that the skin is not removed. The nervous excitement
is to be calmed by opium, and sinking prevented by stimulants, but care
is to be taken that over-stimulation does not result. The separation
of sloughs is to be promoted by rest, poultices, and fomentations.
In joints passive motion is to be made to prevent stiffness.
GOITRE (BRONCHOCELE) This is an enlargement of the thyroid gland, an organ that if it performs any functions at all, does so only in foetal life. It generally commences by moderate increase of the gland, or thickening of the neck, and advances gradually until a portion or the whole gland becomes enormously swollen. It causes dyspnoea, and sometimes obstructs circulation to the brain, when the tumor acquires considerable magnitude. It is more common to females than males, and generally occurs before puberty. The species of idiocy sometimes associated with goitre is called Cretinism. TREATMENT. -- Alteratives and discutients.
The alteratives, such as stillingia, rock-rose, etc., are to be preferred,
and externally iodine may be applied. Those who may desire my counsel
in this disease are referred to page 390.
RUPTURE (HERNIA) This signifies a protrusion of the abdominal viscera. The predisposing cause is a weakness of the abdominal walls, at the natural openings. This weakness may be increased by injury, disease, or pregnancy, or it may also be due to congenital difficulty. The exciting causes are muscular exertion, jumping, straining, playing on wind instruments, coughing, lifting weights, tight clothes, parturition, straining at stool, etc. Hernia is divided, according to the site of the protrusion, into inguinal, ventro-inguinal, umbilical, ventral, perineal, vaginal, pudendal, thyroideol, and ischiatic; in condition, into reducible, irreducible, and strangulated, and if the contents are entirely intestinal it is called enterocele, but if it contains omentum it is termed epiplocele. The symptoms of hernia are a painful swelling forming at some part of the abdomen, which is compressible and soft, and can be made to disappear by pressure in the proper direction, and it often disappears spontaneously. An enterocele is smooth, elastic, and globular, retires suddenly and with a gurgling noise. An epiplocele is more irregular in form, has a doughy feel, and retires slowly without noise. Reducible hernia is one in which the contents of the sac can be reduced with proper manipulation. Irreducible hernia is owing to adhesions or from membranous bands stretching across the sac, etc., when the contents cannot be replaced; and when the contents of the sac are incarcerated, with inflammation and an interruption to the passage of faeces, it is called strangulated. The more common forms are the inguinal and umbilical. Inguinal hernia is called scrotal when the intestine has descended from the groin into the scrotum. TREATMENT. -- The treatment consists in reduction and retention. This can only be achieved in the reducible hernia. Reduction is effected by a manipulation called taxis, the patient being placed in a recumbent position, and the muscles of the abdomen relaxed; gentle and steady pressure is made by the hand in the direction of the descent. Retention is effected by continued and suitable pressure by means of the pad of a well-fitting truss. By constant and careful use of a truss, a radical cure may be effected. A lobelia emetic, or the patient may be chloroformed, to relax the muscles, may be resorted to, if replacement cannot be performed without them. In irreducible hernia, the treatment consists in carefully regulating the bowels, avoiding great exertions, and wearing a suitable truss to prevent further protrusion. Strangulated hernia, if it cannot be reduced by taxis, becomes a subject for the surgeon. Radical cures may also be performed by the surgeon. I have constantly manufactured for my patients a most excellent truss, which effects many cures. It is a light appliance, and occasions no pain or inconvenience to the wearer. It is the most comfortable truss that can be worn, is cleanly and durable, and easily adjusted. It is called the "Champion Truss"--a distinction to which it is clearly entitled It is the greatest triumph of skill and genius ever attacined in this or any other country for the retention and radical cure of hernia or rupture. Its qualities may be briefly stated, as follows:, viz.: -- It is worn with perfect ease and safety.
Patients desiring the "Champion Truss," will please send the following measurement, viz., around the body where the truss is worn and state whether right, left, or double. Trusses of the highest mechanical perfection are also furnished for every other variety of rupture. The price of the "Champion Truss," with medical advice
pertaining thereto, is twelve dollars.
The eye is one of the most delicate as well as the
most complicated organs of the body, and its diseases are but very imperfectly
understood by the ordinary practitioner. A great deal of mischief
has been done by improper treatment of diseases of the eye, and I may also
include the ear, and many persons who now mourn the loss of sight and hearing,
partially or wholly so, might yet be in enjoyment of those senses if they
but had received the proper treatment. Under this head I shall include
those diseases only which are capable of treatment in domestic practice.
CONJUNCTIVITIS This is an inflammation of the conjunctiva or mucous membrane of the eyelids. The sensation is as if particles of sand had insinuated themselves beneath the lids, accompanied by heat, pain, and increased lachrymal secretion, also intolerance of light. In severe cases, headache, nausea, constipation, loss of appetite, etc., are present. The causes of this form of inflammation are mostly local, as particles of sand, dust, insects, etc. TREATMENT. -- Remove the cause. If due to foreign
particles in the eye, they should be removed. Bathe the eye thoroughly
in water, rubbing towards the nose. If iron or steel is suspected,
a vial cork, rubbed smooth with flannel, should be touched to all parts
of the eye, which will remove the particles. When the eye is relieved,
a mild purgative may be given, and cold water applications made to the
eye. In severer cases, lotions of nitrate of silver, sulphate of
zinc, etc., become necessary.
CATARRHAL OPHTHALMIA
TREATMENT. -- Apply cold soft water to the eyes with
little muslin packs, and give a purgative. If this will not relieve
the inflammation, cold slippery-elm poultices, or the domestic practice
of applying "smear case" to the eyes, may be resorted to. In obstinate
or chronic cases a solution of four grains of sulphate of zinc to the ounce
of water may be applied two or three times a day with a small brush.
The eye should also be bathed with a decoction of golden seal. My
"Herbal Ointment" (page 469) is excellent in all ophthalmic diseases.
PURULENT OPHTHALMIA The symptoms of this disease peculiar to children are similar to the Catarrhal Ophthalmia of adults. The eyes are kept constantly closed, the lids are red and swollen, and glued together by thick purulent matter becoming dry. The skin is dry and the bowels irregular. It is generally due to exposure to damp and cold, injuries in washing the child, acrid matter, or to a scrofulous constitution. TREATMENT. -- In the treatment of this affection
the eyes should be thoroughly washed in a cold, weak solution of hydrastin,
four or five times a day. Saturate packs with cold water, containing
a little tincture of lobelia, and apply to the eyes and change when they
grow warm. The bowels should be kept open with gentle laxatives.
Some cases may need a solution of vegetable caustic, sulphate of zinc,
or nitrate of silver. If caused by a scrofulous condition, use alteratives
of which the "Compound extract of Rock-rose and Stillingia" is the best
(see page 469).
SCROFULOUS OPHTHALMIA This disease is chiefly confined to children. The child scarcely can bear the light, the lids are spasmodically closed, and the head constantly turned away from the light. The eye is not very red, but a few of the large vessels are considerable injected. It is very liable to recur, and may prove obstinate, and cause ulceration of the cornea. TREATMENT. -- In this disease it is very important
that the general health should be looked after. The local treatment
before advised should be resorted to, and the constitutional treatment
should be very active and energetic.
STYE (HORDEOLUM) This is a small painful pustule on the margin of the eyelid, having its origin in ciliary follicles. TREATMENT. -- It may usually be cured by applying
spirits of hartshorn by means of a small steel needle, puncturing the tumor
slightly. If this does not remove the inflammation, slippery-elm
poultices should be applied, and tonics and alteratives given.
This complaint is due to anaesthesia of the optic nerve. The patient sees objects indistinctly, even when they are lit up by a bright light; they appear surrounded with a fog or mist, and no effort nore the employment of artificial means increasse the distinctness. The outlines of objects appear not only indistinct, but also broken, and thus disfigured, the faculty of distinguishing colors is frequently lost, and double vision is not infrequent. This condition, as aabove described, is more properly amblyopia, it is only called amaurosis when the vision is entirely lost. TREATMENT. -- Electro-galvanism is one of the most
promising remedies. Powdered bay-berry root, taken as snuff, is occasionally
useful. Blisters behind the ear often afford relief. Nux vomica
should also be given. The disease is often very obstinate, but I
have cured some of the most unpromising cases.
FOREIGN BODIES IN THE EYES These should be sought for by inverting the lids,
and having the patient turn the eyes in every direction. If it be
found to adhere to the mucous membrane of the cornea or conjunctiva, it
can usually be removed by a silk handkerchief wrapped around a probe.
If lime, mortar, or lye should get into the eye, it should be removed and
the eye washed with a weak solution of vinegar and water. The ensuing
inflammation should receive usual treatment. If the foreign bodies
enter the interior chamber of the eye, the surgeon should only remove it.
FOREIGN SUBSTANCES IN THE EAR Children frequently put peas, beans, kernels of corn,
etc., into the ear, which, if allowed to remain, will produce active inflammation.
Foreign bodies may also enter the ear by accident. These should all
be quickly removed. It should be done by syringing the ear with warm
water, or by means of forceps. Excessive accumulation of wax is to
be removed by syringing with warm water frequently, and not by ear-scoops.
EAR ACHE (OTALGIA) This is a neuralgic afffection, and is caused by local inflammation, cold and exposure, and carious teeth. TREATMENT. -- If caused by inflammation, a warm poultice of slippery-elm, moistened with laudanum, should be applied, and frequently changed. If caused by carious teeth they should be removed; sweet oil and laudanum dropped in the ear often gives relief, and the common practice of blowing hot tobacco smoke into the ear is also useful. Many of the eye and ear diseases are surgical in
their character, such as strabismus, a few cases of cataract, etc., but
a great many of them are amenable to medical treatment. Even cataract,
which heretofore was considered eminently surgical, may in many cases be
entirely cured by medicinal treatment alone. I have cured a case,
in which there was total blindness for ten years, in the short space of
two months. The patient ever since is in the full enjoyment of sight.
My treatment has also been equally successful in cases of deafness.
I regard all cases subject to relief or cure in which the tympanum or drum
of the ear is not destroyed. If persons suffering from chronic diseases
of the eye or ear will write and state their cases fully to me, I will
cheerully give my opinion by return mail.
MALIGNANT AND VENEREAL DISEASES CANCER (CARCINOMA) This is a malignant tumor. In the first stage it is hard, in the second stage it ulcerates. The seat of cancer is in the female breast, the skin, the tongue, the stomach, the womb, the lips, etc. It rarely occurs in subjects under thirty years of age. It is at first a small hard tumor, movable, but eventually it forms deep and superficial attachments. It grows in general slowly, is irregular in shape, and painful. The pain is mostly sharp, lancinating, and is much increased on pressure. In the course of time the tissue beneath the skin is absorbed, and becomes attached to it, and it presents a bluish, nodulated appearance. Ulceration usually takes place by absorption of the skin, and as sloughing proceeds, the edges become ragged and everted, hving a bluish purple color, and discharges a fetid, sanious pus. There are five varieties of cancer, though microscopically
they are essentially the same.
Encephaloid is soft and brainlike in its appearance, and hemorrhagic in character, frequently met with in the globe of the eye, testes, nares, etc. Colloid resembles glue or honey in the comb, and usually occurs in the internal viscera. Melanosis, or melanotic cancer, is of a black color, either soft or hard, and occurs mostly upon serious membranes. Epithelial cancer is usually found upon the lips. These various forms may exist separately, or one variety may be associated with or take the place of another. TREATMENT. -- As long as this disease was regarded as purely local in character, the only treatment resorted to was extirpation either by cauterizing agents or by the knife; but since the pathology of the disease is better understood, and its constitutional character ascertained, the treatment employed has been considerably modified. I have long ago held that cancer was a constitutional affection, so instructed my patients, and based my treatment upon that opinion. It is well to remove the tumor by the knife or cautery, but the liability to recurrence is always great unless constitutional treatment is employed. The cauterizing agents are blood-root and chloride of zinc made into a paste, and then applied to the cancer, the skin having first been removed by a blister. This is reapplied until the whole mass is dead, when in course of time it comes away as a slough. The expressed juices of poke, laurel, blood-root, and yellow-dock answer the same purpose. The constitutional treatment consists in toning up
the general system, abstaining from fatty diet, bathing, and the employment
of alterative treatment. Recently, a plant has been brought into
notice by the name of Cundurango (Equatoria Garciana, see page 74) which
is destined to revolutionize the treatment ot cancer. I have tried
it in several cases, and it answered every expectation. I regard
it as a virtual specific in cancer, and shall, notwithstanding its very
high price, employ it in every case, thereby hoping to make my success
in the treatment of this malignant disease more certain. It is a
matter of regret that spurious articles are in the market, thus bringing
the genuine article, which is yet difficult to obtain, into disrepute.
SYPHILIS Syphilis is occasioned by a specific poison which is conveyed by contagion or actual contact. It first shows itself upon the genital organs in the form of a small yellowish pimple, or pimples, the presence of which is at first made manifest by itching and slight soreness. The pimples (called chancres) break, and gradually change into a red, hard-edged shallow ulcer. This ulcer is circular or oval in form, and is surrounded by a ragged border. The skin and tissue in the immediate vicinity become inflamed, and, unless proper remedies be immediately applied, the virus is absorbed into the system, and the consequences are of the most deplorable character. There are many kinds of chancre, viz.:--inflammatory, indurated or hard, sloughing or perishing, phagedenic or eating, and gangrenous or likely to mortify. Next in order, if stringent curative measures be not adopted, is the bubo, which is a swelling of the glands of the groin, caused by the absorption of the poison. The bubo will usually make its appearance in about a fortnight after the sore is discovered. It advances to suppuration, and also becomes a sore, when it receives the name of "glandular chancre." Sometimes growths resembling certain vegetables appear, in the male, upon the organ and on the membrane lining of the foreskin. In the female, they will be found in and at the entrance of the vagina, and sometimes on the neck of the womb. These are primary symptoms, and, if quickly but radically exterpated or cured, will not result in any very serious constitutional derangement; but if neglected, the virus is absorbed into the blood, and the infection reaches the entire system. When the disease becomes constitutional, the results are most deplorable. The syphilitic ulcer then appears at various parts of the body, more usually upon the arm and forearm, forehead, shin and chest. These ulcers are quite characteristic, so that the experienced surgeon at once knows their specific nature upon sight. The affections of the skin and mucous membrane are called secondary, those appearing upon the bones, etc. are tertiary. In these advanced stages of the disease the gravity is such as should urge each affected person to employ competent surgical or medical aid, and not longer to postpone such active treatment as is required. Neglect of so important a duty on the part of the patient will result seriously to him, as the progress of the disease is unerringly from bad to worse in every case. TREATMENT. -- In primary syphilis, the chancre should be destroyed effectually by nitrate of silver, nitric acid, or caustic potash, and heal the parts by mild dressing. If this is effectually done, with proper constitutional treatment, no secondary symptoms will supervene. In secondary and tertiary syphilis the treatment is very important, and must be correct in order to eliminate the disorganizing taint. The treatment is necessarily alterative and tonic. The following may each be specifically employed, either singly or judiciously combined: -- Phytolaccin, corydalin, chimaphilia, tincture of kalmia, menispermin, ceanothus americanus, sarsaparilla, stillingia, and by some iodide of potassium, but never mercury. Mercury in any form is not a specific, and in effect most pernicious. When buboes appear, they should be discussed by a mixture of tincture of iodine, 3ij; tincture of arnica, 3ij; tincture of scrophularia, 3ij. This should be applied by wetting pads of linen with it and securing them by adhesive strips. If suppuration has taken place, the treatment of abscess is to be employed. During treatment, the patient should abstain from all fat meats, spiritous liquors, and excesses of every kind. If any person is conscious that he or she is affected with a syphilitic taint they should never marry, for the offspring will surely be miserable objects of pity, and conjugal bliss very uncertain. The taint must be thoroughly eradicated, so that not a vestige remains, before a marriage, physically pure, can occur. If rightly treated, syphilis is not a formidable
disease to cure, yet how many suffer hopelessly on, after having for years
been subjected to mercurial treatment. Purely chemical herbal treatment
will only remove the serious disorder from the system, as attested by the
thousands of cases under my treatment, in which every trace of the disease
has been obliterated from the economy.
GONORRHOEA This is vulgarily known as clap, so named from the French clappe, a bow-string. It received this name on account of the chordee occurring in the disease. This is caused by the violence of the inflammation, which abnormally expands the cavernous body of the organ and is painfully drawn downwards, so that the urethra occupies the relative position of the string to a bow-gun. This is a disease of the mucous membrane which lines the private parts of the male and female, and is communicated as is syphilis, by contagion, or actual contact. It commences with itching and uneasiness about the private parts, and a peculiar feeling of soreness in the urethra, or urinary canal. A scalding sensation is also felt when the patient makes water. In a day or two a whitish matter makes its appearance at the orifice of the urethra, and this will soon increase greatly in quantity, and assume a greenish-yellow color. The parts will be much inflamed, and the urethra will become thickened and very sore. The consistency and quantity of the pus-like discharge vary in different persons. It usually makes its appearance in from three to five days after exposure. It may propagate itself upon other mucous membranes after inoculation. TREATMENT. -- A purgative should be taken at first, and at the same time the parts should be thoroughly packed with cold or hot water. The following are the remedies mostly employed as internal remedies: -- Oil of copaiba and cubebs, matico, gelsemin, oil of erigeron, oil of turpentine, etc. These oils should be taken in medium doses, and in emulsion with acacia, etc. The internal injections are vegetable astringents, sugar of lead, sulphate of zinc, etc. The injections should not be strong, and be carefully made, otherwise orchitis may follow. Applying cold water relieves the chordee. The treatment is not difficult, and, if properly
directed, will soon relieve the patient.
GLEET This is one of the results of abused or neglected gonorrhoea. It is a continued discharge of a thin and clear character, after the inflammatory and painful early symptoms have disappeared. It is caused by debility of the parts, or by unhealthy action of the glands in the urinary passage. It is sometimes, especially in persons of a scrofulous habit, a fixture for years, and constitutes a drain upon the system, the effects of which can only be obviated by the most scrupulous care and attention. The old style of treatment involved the use of cauterizing injections, and the bougie, together with blisters applied to the perinaeum. It had the effect of imperfectly remedying, or else of aggravating the complaint, and rendering it next to impossible of cure. TREATMENT. -- Same as for acute gonorrhoea, but it should be more energetic. Those who may wish to instrust their cases to my treatment, may rest assured that they will be quickly cured, and everything held confidential. The fear of exposure does frequently much mischief, and the dread of losing caste in society, or a feeling of shame, often tempts the sufferer to withhold his case from the family physician for treatment, or he may endure his mental and physical torture in silence as long as he can, and then finally intrust his case to the ignorance of a companion, who may know some recipe, or he may employ the treatment of some incompetent, uneducated physician, found everywhere, especially in large cities, who also maltreats the case, so that finally the disease, which at first was readily curable, has become a very serious affection. The wrong of such a course is obvious, and I advise
the reader, who has or may become unfortunate in this respect, to confide
his or her case to some honorable and competent physician, as soon as the
disease manifests itself.
DEBILITY OR LOSS OF VITALITY This is a condition of the organism characterized by loss of vitality, or deterioration and diminution in the quality and tone of the vital forces. It is one of the chief predisposing causes of disease, and is of itself a condition characterized by all the elements of ill health. The principal causes of debility are improper nourishment, impure air, excessive bodily and mental exercise, want of exercise, long exposure to intense heat or cold, intemperance, depressing states of the mind, and of course a prostrative disease. When not a heritage of the organism, it is generally produced by some flagrant violation of physiological law, depleting the vital forces by the disorganization of organic functions which ensues, or by the loss of vital elements through the eliminating organs, chiefly the kidneys. That the reader may have a correct understanding of what is meant by vitality, it may be well to give its physiological sense. Though derived from the Latin vita, life, it has a somewhat different signification from that which is expressed by the word life. It signifies the constituent principle or essence of life rather than the entity itself. Hence vitality is not properly life, but the element conducive to its perfection and prolongation. It is that principle that gives to the physical organization its vigor, elasticity, and tone, to the mental organs, acuteness, vivacity and sprightliness, and to the whole organism a high standard of health. If the habits are not in violation of hygiene or physiology, and the expenditure of the vital forces not exceeding the production, the normal condition of the organism would be one of health and vigor, and almost complete immunity from disease. If the expenditure exceeds the production it engenders the condition termed debility. Improper and sinful habits of life, especially in the young, are alarmingly destructive of vitality in consequence of engendering diseases characterized by losses of vital secretions. The intemperate very frequently incur the penalty of over-indulgence in intoxicating beverages by inducing structural diseases of the internal organs, especially Bright's disease of the kidney, wherein the blood becomes devitalized by loss of its albumen through the urine. In the male economy at an age often quite immature there is induced an affection characterized by involuntary expenditure of a secretion, directly by an improper and sinful life. The element thus constantly expended, and which occurs invariably without any exercise of the voluntary powers, is beyond all question the most highly organized and more intrinsically vital than any other secretion of the organism. This affection, peculiarly masculine, is one of the most prolific causes of debility and is conducive to greater physical misfortune than any other pathological condition induced by violation of physiological laws. The chemical nature of the secretion is highly phosphatic, and as phosphorus is a very important constituent of nerve tissue, its constant involuntary escape from the organism, whether in the urine or otherwise, preys fearfully upon the nerve tissue for phosphatic supply, and eventually, and often quite rapidly, produces atony of the nerve-centres, and a general intonicity of the nervous system, or what is more commonly known as nervous debility. Of the various systems composing the organism the nervous can least afford to lose its vitality, or to become enfeebled. It is the principal or controlling system of the organism, the others being more or less subordinate. If by any depleting causes its just complement of the vital forcs becomes reduced, its individual integrity is not alone compromised or destroyed, but muscular action, circulation, digestion, assimilation, and the mental operations also become enfeebled, hence the vital standard of the nervous system is of extreme importance to the general welfare of the whole organism. Precisely the same pathological condition results from another cause, a sedentary habit of life. It is due to such exciting causes that clergymen and other persons of sedentary habits suffer so frequently from nervous or general debility. When the muscular system is permitted to degenerate from want of proper exercise it gives to the organism a condition of laxity or intonicity which in the male induces the previously mentioned loss of a highly vitalized secretion, and in the female an uncompensated loss of nervo-electric force. Debility is the result in both cases, though the devitalization is more rapid in the male, proportionally to the physical vigor inherent to the different sexes, than in the female. This is explained by the fact that in the male economy a greater loss of the phosphates occurs. In all persons of studious habits, and where bodily exercise is insufficient, the urine is loaded with phosphates, which is indicative of the breaking down of nerve tissue. Consequently in the male there is not only the usual phosphoric loss due to nervous waste, but the super-addition of the involuntary loss of a secretion which, as has been stated, is highly phosphatic in its chemical nature, makes the depletion of the phosporus essential to a vital condition of the organism, doubly great. In a debilitated condition of the nervous system, or, as it is usually denominated, nervous debility, from whatever cause the loss of vitality may ensue, there is in general quite a train of symptoms, as may be supposed when this more important part of the economy has become devitalized. This form of debility may usually be recognized by a marked facial expression, a characteristic mannerism, and by a peculiar mental state. The skin of the face is pale and sallow, and usually affected with acne; there is a dark circle around the orbits, the pupils are dilated and sluggish, the eyes become lustreless, and the face has a haggard, troubled furtive expression. These physiognomic characteristics are due to atony or want of tone in the cerebral nerve-centres, and from the same cause the devitalized patient is listless, shy, retiring and easily confused, society loses its charms, and solitude is preferred, but has, however, no compensating or satisfying influence over the patient. There is a want of steadiness and decision in his locomotion, his inferior extremities are deficient in power, and all the movements are suggestive of a mind ill at ease. The mental operations are confused, speech becomes awkward and often without directness; memory is defective, and the patient is usually absent-minded and given to reverie. Pains in the lumbar region, and a sense of weight and aching in the loins are experienced. The appetite is capricious, and digestion feeble. The mind is deficient in power of attention, the imagination is constantly pervaded with vague erotic dreams, the moral sense is blunted and the perceptions are dull and confused. Pains in the coursse of the principal nerves and extreme nervous sensibility are experienced. The patient also can fix his mind on any subject with difficulty; his attention wanders, and he is given to day-dreams and erotic visions. The urine, of course, contains phosphates, the source of which, whether nervous or secretional, is easily determined by analyzation or microscopical examination. Urates are also found in the urine. Those who suspect such vital loss, may with sufficient certainty for all practical purposes ascertain the fact by a simple experiment. The morning urine should be placed in a clean half-pint bottle, and let it stand from forty-eight to seventy-two hours. If there is then found a remarkably peculiar or cloudy sediment or deposit at the bottom, the fact is quite evident that some of the losses alluded to occur, and proper aid should be sought at once. Such, briefly, are the evidences of a devitalized nervous system. The condition, as is palpable to every one, is fraught with danger to the general welfare, and even to life, if the process of depletion of the vital forces continues too long, or, if, by special virulence of the exciting cause, the devitalization is rapid in occurrence. Any loss of vital power should be regarded with solicitude and deep concern by every one who places a proper estimation upon vigor of the organism and its special functions. Careful and judicious treatment must not be neglected, as by such a course only can revitalization be speedily and adequately effected. As soon as loss of vital force becomes apparent, so soon should the services of a competent and experienced physician be engaged. In any stage of devitalization, rehabilitation of the organism with vitality can again be accomplished, the only requirement being employment of competent medical aid, and the exhibition of viralizing remedies. Revitalization can, however, only be effected by herbal remedies, as their organic nature alone afford the elements required for reendowment of the system with vital force. Minerals are lifeless, and can there impart no vital element. Those desiring to consult the author with reference
to debility or loss of vitality from any cause whatever, may refer to page
385, where his mode of treatment is described, and to page 390, where the
necessary questions are asked.
SATTYRIASIS This is a disease characterized by a constant and insatiable desire for coition, and so called because the satyrs of mythology were greatly addicted to excesses. The disease is accompanied by a strange power of frequent congress without exhaustion. It is a nervous disease, dependent upon a disordered state of the cerebellum. TREATMENT. -- It can be cured by a low diet, frequent
shower baths, physical out-door labor, ice bags to the cerebellum, a hard
bed, and hop pillows.
STRICTURE OF THE URETHRA This is a diminution or contracted condition of the tube, and may be either spasmodic or permanent. Spasmodic-stricture depends on spasm of the muscles of the perinaeum, or upon contraction of the muscular portion of the urethra. Exposure to cold and indulgence in drink favor an attack, which usually occurs after dinner. It generally occurs in persons with permanent obstruction. The urine is suddenly retained, the desire to urinate causes incessant straining, the bladder becomes distended, the countenance anxious, the pulse quick, the skin hot, and at last the urine dribble, or the bladder may burst, and extravasation occurs into the peritonaeum or perinaeum. There is another variety of this affection, termed inflammatory stricture, caused by abuse of injections, exposure, or intemperance during acute gonorrhoea. Permanent stricture is a contraction from permanent inflammation, plastic deposit having taken place in the tissue beneath the mucous membrane. The occasion of this inflammation may be gonorrhoea, venery, kicks or blows, riding on horseback, acrid urine, drinking, etc. It is situated most frequently in the membranous portion of the urethra, usually a few inches from the meatus. The extent and degree of contraction vary. Sometimes the stricture is very tight, but limited, as if a thread had been tied around the urethra; most frequently it is of greater extent, containing from a quarter of an inch to several inches. Several strictures may exist at once. Permanent stricture comes on gradually, occurring mostly in middle-aged men. Urination is frequent, tedious, and painful; the stream is thin, twisted, or forked; and a few drops pass after urination, which had collected behind the stricture. There is pain in the perinaeum, thighs, and loins; erection is often painful; chill and fever constantly occuring as in ague; the testicles, rectum, and bowels sympathize, and the general health is greatly impaired. It is a disease that causes extreme annoyance, pain, and disorder, and should receive early and competent treatment. TREATMENT. -- The indication in spasmodic stricture is to overcome the spasm, and relieve the bladder. This is usually effected by warm hip baths, Dover's powder, laudanum enemata, and cold water upon the genitals. A favorable mental impression is made by pouring water from a can, in a small stream, from some height, into a vessel containing water, in imitation of urination. A few sniffs of ether will usually relax the spasm, but if these means fail, the urine should be drawn off by a catheter. In permanent stricture dilatation by means of a flexible bougies is the usual method of cure. Great caution is necessary in the use of these. Some use caustic applications, and in some cases puncturation is resorted to. In some cases opening the urethra may be necessary, as the stricture is so extensive and complete that no other means are available. These surgical means may at times be necessary, but
I have cured very many cases by purely medicinal treatment, and it is very
seldom that I employ bougies, but compel absorption of the deposit by alterative
treatment. In some cases, however, I frequently combine dilatation
with medication. Those desiring consultation are referred to page
390.
PROSTATITIS This is inflammation of the prostate gland. It usually accompanies gonorrhoea, but may exist independently. The discharge is similar to that of urethral inflammation, and when the result of chronic inflammation the discharge is called prostatorrhoea. The gland is frequently enlarged. Chronic inflammation is commonly brought on by gleet, stricture, horse exercise, etc., and is most frequently met with in advanced life, and disappears upon the removal of the cause. The gland is also enlarged in old persons -- a hypertrophy independent of inflammation. The bladder sympathizes, and becomes irritable; the urine is foetid, mucous, and its stains are often retained. It causes most intense suffering. TREATMENT. -- Leeches, rest, counter-irritation,
alteratives, laxatives, and enemata constitute the usual treatment.
In hypertrophy of the organ, the usual treatment should be instituted.
The medicinal treatment, as in stricture, is important, and should only
be intrusted to those who fully understand the anatomy of the organ, and
the pathology of the disease.
ORCHITIS This is the hernia humoralis of older writers. Swelled testicle is a common accompaniment of mumps. It is often the result of an injury, but oftener of gonorrhoea and its treatment; exercise, wet and cold often induce it. The gland enlarges greatly, fever attends, causing intense pain. It is usually confined to one of the glands, and mostly the epididymis. The cord is often swollen and painful. TREATMENT. -- Low diet and the recumbent position
are essential. The weight of the tumor should be supported by a suspensory
bandage. After the acute symptoms have subsided, friction with astringent
lotions, and compression by adhesive straps, will be useful. The
hardness and swelling are likely to remain unless discussed by the alterataives.
VARICOCELE This is a varicose condition of the veins of the spermatic cord. The causes are such as to produce obstruction to the return of blood: constipation, corpulence, tight belts around the abdomen, and warm climate. It is usually coexistent with genital weakness. The left side is more frequently affected than the right, because the left spermatic vein is more likely to be compressed by the faeces in the sigmoid or S-shaped flexure of the rectum, and because it is longer and not so direct in its course. The swelling is pear-shaped and feels like a bunch of earth-worms. TREATMENT. -- The cause, if ascertained, should be removed, and the scrotum constantly bathed in cold water, and supported with a suspensory bandage. The veins are sometimes obliterated by a surgical operation. It can usually be overcome by proper medical treatment, however, and the operation should only be the last resort. I use for my patients a self-adjusting suspensory
bandage, which can be so arranged that any extent of compression can be
made, and which in construction is simple and very durable. It is
the only perfect suspensory bandage or scrotal supporter made, and the
only one from which any great benefit can be expected. It is eminently
serviceable in this disease as well as in orchitis, and no one suffering
from these diseases should do without them. Sent by mail, postage
prepaid, on receipt of $3.
DISEASES OF THE FEMALE ORGANS OF GENERATION The genitalia of the female is the controlling centre of her whole economy. If the womb and its appendages are in a healthy state, the female figure preserves its artistic rotundity, her mind its sprightliness, and her humanity its benevolence and sympathy. When diseased, she becomes fretful, peevish, and inconsolable. The province of the physician, therefore, becomes one of great importance, and it is his duty that he should not only thoroughly understand the pathology of uterine diseases, but in his humanity he should combine a fine feeling of compassion, with correct ideas of the treatment required. He should prove worthy of the trust confided to him, in sympathy, considerateness, and skill. No greater trust can fall upon him; he is not only
accountable for the physical welfare of the patient, but bears a further
responsibility. If his treatment is not judicious and rational, his
patient becomes a victim to a gloomy depression of spirits, and to an irrespressible
feeling of languor and misery, that sternly bid away all brightness of
life. He will but poorly do his duty if he follows but the beaten
track of a routine practice, and, after successive trials, consigns his
suffering patient, by pronouncing her incurable, to a condition but little
better than the grave. Uterine diseases are not incurable, but when
properly treated, they yield kindly to medication, as the disposition of
all womb affections is to get well, needing but proper medical assistance
to stimulate and encourage the forces of recuperation to overcome the assaults
of disease (See page 390)
VULVITIS This is characterized by redness and slight tumefaction of skin, covered with mucus, while in neglected cases the parts are found much excoriated. It generally arises from want of cleanliness, or from the acrid character of the vaginal and uterine secretions. It may, however, be produced by excessive marital indulgence or syphilitic taint. The symptoms consist of great pain and tenderness, a mucous discharge, a smarting in passing urine, and a constant pain about the loins and thighs. TREATMENT. -- This should be treated by hot packs,
elm poultices, and a wash of a weak solution of sulphate of zinc, or tincture
of myrrh. Quinine, macrotin and leptandrin should be given internally.
The parts should be thoroughly cleansed every day.
CLITORITIS Inflammation of the clitoris, both acute and chronic, may exist from want of cleanliness, or be produced by indiscretions. It is accompanied with burning, itching, and smarting sensations. Enlargement is the usual result of either acute or chronic inflammation, in which case there is extension of the labia, producing irritation, and labial leucorrhoea. TREATMENT. -- When the parts are inflamed, sitz-baths,
hot packs, and laxatives will usually relieve it. In case of hypertrophy,
it may be painted once or twice a week with a weak tincture of iodine,
and the compound syrup of stillingia given internally. When there
is extensive enlargement, amputation should be resorted to.
IMPERFORATE HYMEN This is not likely to be discovered until the commencement of menstruation. It may then be suspected, if the female has all the symptoms which accompany the menses, without the discharge of the fluid, and if these symptoms should occur at regular periods, accompanied with a sense of weight and fulness of the vagina, especially if an enlargement is perceptible in the lower abdomen, with pain and tenderness. The symptoms ameliorate in a few days, but return at each menstrual period. If by inspection a hemispherical tumor, of a livid or bluish color, soft and fluctuating, is discovered, the fact is most certain, that it is caused by an imperforate hymen. In most cases the membrane is thin, but it is sometimes from one-fourth to three-eighths of an inch thick. TREATMENT. -- Press the finger against it gently,
and attempt to lacerate it by the finger-nail. If it will not yield,
perforation should be made by a proper instrument in the hands of a surgeon.
VAGINITIS This consists of either acute or chronic inflammation of the vagina. It may be confined entirely to the mucous membrane, or it may extend to the cellular tissue beneath. It is attended with pain, swelling, and redness of the vaginal canal; the mucous membrane is of a vivid red color, and the folds are more developed and prominent than is natural. At the first stage there is an arrest of the secretions, but after a few days serous exudation occurs, which becomes purulent, and of a yellowish or greenish color. The disease may arise from cold, which is the most frequent cause; from injuries to the vagina by violence, imprudence in the marital association, exertion after delivery, high living, etc. TREATMENT. -- A gentle purgative should be taken,
and the vagina frequently injected with warm water, the patient kept quiet,
and the inflammation controlled by veratrum. Astringent injections
are also useful. The chronic form should be treated as vaginal leucorrhoea.
MENSTRUATION Though this is not a disease but a healthy function, but as, from various causes, derangement of the function occurs, it is proper that it should be perfectly understood. Menstruation is the term applied to the phenomenon that attends the rupture of what is called the Graafian follicles of the ovary, and the discharge of an ova, or egg. It is a bloody discharge from the female genitals -- not differing from ordinary blood, excepting that it does not coagulate, and in its peculiar odor. The blood comes from the capillaries of the womb and vagina. Menophania or the first appearance of the menses, is usually preceded by a discharge of a fluid whitish matter from the vagina, by nervous excitement, and by vague pains and heaviness in the loins and thighs; numbness of the limbs, and swelling and hardness of the breasts. The first appearance is an evidence of capacity for conception. It generally appears about the age of fourteen, but varies from nine to twenty-four years. In warm climates women begin to menstruate earlier, and cease sooner than in temperate regions; in the cold climates the reverse of this holds as a general rule. The manifestations of approaching puberty are seen in the development of breasts, the expansion of the hips, the rounded contour of the body and limbs, appearance of the purely feminine figure, development of the voice, and the child becomes reserved, and exchanges her plays for the pursuits of womanhood. More or less indisposition and irritability also precede each successive recurrence of the menstrual flux, such as headache, lassitude, uneasiness, pain in back, loins, etc. The periods succeed each other usually about every twenty-eight days, although it may occur every twenty-two, twenty, eighteen, fifteen or thirty-two, thirty-five, and forty days. The most important element is the regularity of the return. In temperate climates each menstrual period ordinarily continues from three to six days, and the quantity lost from four to eight ounces. The menses continue to flow from the period of puberty till the age of forty-five or fifty. At the time of its natural cessation, the flow becomes irregular, and this irregularity is accompanied occasionally with symptoms of dropsy, glandular swelling, etc., constituting the critical period, turn, or change of life; yet it does not appear that mortality is increased by it, as vital statistics show that more men die between forty and fifty than women. It should be the duty of every mother or female in charge of a child, in whom age or actual manifestations suggest the approach of puberty, to acquaint her with the nature of her visitation, and the importance of her conduct in regard to it. She should be taught that it is perfectly natural to all females at a certain period, and that its arrival necessitates caution on her part with regard to exposure to wet or cold. The author has made the acquaintance of the history of many cases of consumption, and other diseases, which were directly induced by folly and ignorance at the first menstrual flow. The child is often kept in extreme ignorance of the liability of womanhood occurring to her at a certain age, and hence when she observes a flow of blood escaping from a part, the delicacy attached to the locality makes her reticent with regard to inquiry or exposure; she naturally becomes alarmed, and most likely attempts to stanch the flow, with bathing or applying cold water to the part, thus doing incalculable mischief. This purely feminine physiological function should
be well studied and understood by all females. At least they should
know that the phenomenon is a natural one, liable to disorder, and that
the best interests of their general health demands care and prudence on
their part to maintain regularity, etc., of the flow. Disregard of
such a duty will surely entail much misery.
AMENORRHOEA This may occur in three forms. 1st. Where evacuation has never occurred, or retention of the menses. 2d. Where there has been no secretion. 3d. Suppression. There are cases where the secretion has been perfect, but the discharge prevented by occlusion of the vagina, or imperforate hymen, etc.; again, secretion may never have occurred, owing to a congenital deficiency of the ovaries; and there are cases where the uterus and ovaries are sound, yet no flow from the vagina. The most common variety, however, is suppression after they had once been regularly established. It may cease by degrees, as in consumptive and scrofulous patients, or occurs as the result of cold, which induces inflammation of the uterus or ovaries. It may also be induced by excessive venery, wet feet, ice water, insufficient clothing, bathing, fear, grief, anxiety, emetics, drastic purgatives, falls, copulation during flow, etc. The symptoms are weight, pain in the head, loins, and uterine regions, hot skin, apoplexy and epilepsy in some cases, vicarious hemorrhages, palpitation of the heart, constipation, chills, loss of appetite, etc. TREATMENT. -- Give a hot foot-bath, if the suppression
be recent, and apply hot mustard poultices to the breasts. Internally
give tansy, thyme or wintergreen tea, keep the patient warm, and allow
but gentle exercise. A compound decoction of seneca, cotton root,
and Indian hemp is also very beneficial. In obstinate cases, a hot
sitz-bath should be given during the operation of the medicine, so as to
centre the blood in the pelvis. If this does not succeed, the system
should be invigorated by quinine, blue cohosh, life root, wine, etc., and
then the above treatment repeated. The chronic form of the disease
should be treated by supporting and invigorating remedies, such as bayberry,
black cohosh, sitz-baths, galvanism, tonics, etc.
DYSMENORRHOEA Painful menstruation occurs generally in single women, and is produced by inflammation or ulceration of the mouth of the womb, neuralgia of the womb during menstruation, indiscretions, constipation, and a nervous irritable temperament. The symptoms are restlessness, heat, flushed face, weight and heaviness in the head, pain in the back, and pelvic regions, sometimes so severe as to cause fainting. After a time the pain becomes bearing down, accompanied by a shreddy discharge, or blood-clots. In young and plethoric subjects, but little effect is produced on the general health, but in nervous persons the health fails, and not unfrequently, consumption ensures. Women subject to dysmenorrhoea are liable to cancer after the turn of life. TREATMENT. -- When the disease is produced by inflammation
or ulceration of the mouth of the womb, hot sitz-baths, with hot vaginal
injections frequently repeated, in connection with ten or fifteen drops
of the tincture of crawley every two or three hours, will usually relieve
it. Mild purges should also be taken. When due to neuralgia,
black cohosh should be given, and the treatment of neuralgia instituted.
Senecin, gossypiin, and gelsemin, are also valuable. When produced
by an irritable constitution, ladies'-slipper, scullcap, etc., should be
given. Out-door exercises and a nutritious diet should be prescribed.
MENORRHAGIA This is characterized by profuse, prolonged, or too frequent menstruation, separately or conjoined. It is accompanied by headache, hot skin, full pulse, weight in the back, hips, loins, pelvis, etc. It is caused by hot rooms, abortions, leucorrhoea, falls, marital excesses, long walks, constipation, etc. The health gives way, the patient becomes bloodless, and exhaustion ensues upon the least exercise. TREATMENT. -- This should be treated by wild cherry,
gelsemin, unicorn root, beth root, and injections of a decoction of golden-seal,
matico, and cinchona. If the hemorrhage is active, a strong decoction
of tannin or cranesbill may be injected, and ten or fifteen grains of cayenne
pepper administered. The oil of erigeron is also useful. Tonics
should be given in relaxed condition of the system.
VICARIOUS MENSTRUATION This is a discharge from some other part than the uterus, usually occurring in the unmarried. In the married, they are usually barren. The blood may escape from any part of the skin or mucous membrane, in the form of bleeding from the nose, lungs, etc. TREATMENT. -- Ten or fifteen drops of the oil of
solidago should be given four or five times a day, in connection with sitz-baths,
tonics, etc. Life root is especially valuable.
CHLOROSIS This is a disease characterized by chronic anaemia, or bloodlessness, affecting females about the age of puberty. In some instances it is undoubtedly dependent upon a nervous affection, but in most instances it is connected with disordered menstruation and other causes. The red corpuscles of the blood are pale and small, and diminished in numbers. The countenance assumes a wax-like hue, which is so remarkably characteristic, that the disease is called by nurses "green sickness." The appetite is irregular, with craving for particular kinds of food, the urine is thick and full of sediment, and there is usually vertigo, headache, backache, hysterical affections, dysmenorrhoea, and leucorrhoea. The tongue is flaccid and indented at the edges, the pulse is weak and quick, and there is a feeling of general languor, with great indisposition to bodily or mental exercise. TREATMENT. -- When arising from feeble and imperfect
digestion, give prickly ash, alder, golden-seal, and nux vomica, cautiously.
The animal oils are also very serviceable. The great object in the
treatment of this disease is to restore the general health, and not to
force menstruation by agents having that power. The patient wants
strength and blood, and when that is achieved, menstruation will be natural.
Baths, friction, out-door exercise, and a nutritious diet should not be
neglected.
CESSATION OF THE MENSES We have already stated that this usually occurs between the ages of forty and fifty but in some cases it occurs much earlier, in others much later. The courses become irregular, often staying away two or three months. Nausea and vomiting, swelling of the abdomen, tenderness of the breasts, etc., are the prominent symptoms. Pregnancy may somtimes be suspected, and there are frequently uterine pains, a dragging sensation in the back and loins, accompanied by violent headache, a loaded tongue, and symptoms of indigestion. A sudden return of the menses mitigates the symptoms, which usually last longer than is natural, and also more profuse. TREATMENT. -- If the symptoms are slight, regulate
the bowels and diet, bathe the surface, and occasionally wear a pack, saturated
with equal parts of whiskey and water, upon the lower bowel. If more severe,
take unicorn root in decoction. Ladies'-slipper, wafer-ash, and black
cohosh, are also very good. The tonics should also be given in debilitated
subjects. In fact, the constitutional symptoms should be met with
such remedies as are indicated, as soon as they manifest themselves.
LEUCORRHOEA This is commonly known as the whites. It consists of a discharge from the vagina, or inner cavity of the womb, of a catarrhal character, varying in color from a light to a yellowish-green, or reddish-brown. It is usually due to inflammation of the mouth and neck of the womb (cervicitis), but it is also caused by congestion and inflammation of the interior membrane of the organ (endo-cervicitis), in which case it is more serious, and more difficult to cure. There are few females who are not occasionally subject to moderate leucorrhoea. It may be known by the discharge, but also by the attendant pain and a sense of heaviness in the loins, abdomen, and thighs, disordered digestive functions, palpitation of the heart, etc. It causes great impairment of the general health when long continued. TREATMENT. -- Wear flannels next to the skin, and
pay attention to the general health. Keep the pores open by the proper
medicines. In acute cases inject cold water, and in chronic, warm
water. This will modify the inflammation. After this, injections
of a strong decoction of golden-seal, white oak bark, or cinchona, should
be frequently used, and witch-hazel taken internally. Dogwood, bayberry,
black and blue-cohosh, and gelsemin, are also used for the same purpose.
The astringent injections are also serviceable. Rest and quiet are
important in the treatment of the disease. Patients should, however,
intrust the treatment to an intelligent physician, who should ascertain
the cause, when, if the proper treatment is given, the disease will soon
be cured.
ULCERATION OF THE WOMB This is chiefly confined to the neck of the organ, occurring most frequently in those who have borne children. It is caused by excesses in married life, imprudence during menstruation, as standing, walking, lifting, etc., and very often premature efforts after abortion or labor. There is always more or less discharge associated with ulceration, which in quality is mucous, purulent, or starchy, and in color, milky, greenish, yellowish, or brownish,- often tenacious masses of mucus, like starch, come away. It affects the general health similarly to leucorrhoea. TREATMENT. -- Rest should be observed, and marital
excesses abandoned. The treatment for leucorrhoea should be instituted.
Vaginal injections of red-raspberry leaves and golden-seal prove very beneficial
in this disease. The constitutional treatment in this disease is
more important than any local applications, and should take precedence.
FALLING OF THE WOMB (PROLAPSUS UTERI) This is denoted by pain in the back and loins, heat in the vagina, painful copulation, painful and irregular menstruation, constipation and diarrhoea in alternation, irritable bladder, etc. The mouth of the womb can be more readily felt than is natural, feeling spongy and hot, and very tender on pressure. It may be ulcerated, and bleed upon the slightest touch. The patient has all the symptoms of dyspepsia, hysteria, neuralgia, palpitation, cough, and difficulty of breathing. It is directly caused by weakness of the broad and lateral ligaments, and remotely by various causes. It is a disease severe in its effects, causing much suffering and impairment of health. TREATMENT. -- The patient should observe perfect
quietude. The inflammation and ulceration of the womb treated as
previously described. The womb should be gently replaced to its normal
position, the bowels kept open by mild laxatives, and the vagina injected
with a warm decoction of hemlock and white oak bark. Pessaries do
more harm than good, but abdominal supporter to sustain the weight of the
bowels should be worn in all cases. (See page 370)
UTERINE DROPSY (HYDROMETRA) This is an accumulation of fluid in the womb, caused by inflammation and constitutional debility. During the first months the symptoms resemble those of pregnancy; but by introducing the finger, so as to touch the neck of the womb, and pressing the tumor, fluctuation of fluids is felt. The menses are usually suppressed, and general debility will appear, if the disease continues. The patient may die from exhaustion, or the walls of the womb may be ruptured from the pressure of the fluid, causing fatal peritonitis. TREATMENT. -- A tonic and hygienic treatment should
be prescribed, and if you can introduce a catheter into the womb and evacuate
the fluid, it should be done, but it is better to intrust this to an able
physician.
ANTEVERSION AND RETROVERSION If the womb falls forward upon the bladder, and towards the pubes, it constitutes anteversion. In this case the top or fundus of the womb is turned forward to the bladder, and the mouth towards the rectum, and the neck towards the bladder. If the womb is anteverted and turned upon itself, it is anteflexed, and when retroverted and turned upon itself it is called retroflexion. These displacements may occur suddenly or gradually, causing great distress. The usual symptoms are costiveness and straining at stool, frequent urination, painful menstruation, pain in the lumbar region, and down the limbs, neuralgia, hysterics, and nervous debility. It is a serious affection, and should receive early attention and proper treatment. TREATMENT. -- The organ is first to be replaced to
its normal position, and then the treatment for falling of the womb instituted.
Such important diseases should, however, be confided to the care and directions
of a competent physician. Great relief is at all times gained by
wearing abdominal supporters.
HYDATIDS These consist of a formation of small cysts or bladders of water in the uterus, developed from the inner membrane, and vary in size from half a pear to a partridge's egg. They are usually oval, with a thin wall, opaque, and contain a thin fluid. They are most frequently in clusters, and numerous. The symptoms simulate those of early pregnancy, such as nausea, vomiting, enlargement of the womb, fulness of the breasts, suppression of the menses, etc. In a few months, the patient feels a weight and uneasiness about the abdomen, followed by uterine pains, hemorrhage, and expulsion of the hydatids. TREATMENT. -- If the flooding is excessive, control
it by injecting vinegar or astringents and administer ten or fifteen drops
of the oil of erigeron every fifteen minutes. If the pain is
not sufficient to expel the masses, give a warm infusion of blue cohosh
or cotton root. Ergot may also be given. After the expulsion
the patient should receive tonic treatment.
PREGNANCY AND ITS ACCIDENTS PREGNANCY The first sign of pregnancy is a cessation of the menstrual flow. This will generally be noticed between two and three weeks after conception, and about the same time the woman will discover her breasts to be enlarging, and notice that the rings around the nipple are darker, and cover more space than usual. She will also, to a greater or lesser degree, experience nausea in the morning, and often be afflicted by vomiting, while she will experience dull pains in the "small" of the back, a decided disinclination for exertion, and considerable nervousness. As the womb increases in size and weight (which becomes apparent between the second and third months after conception), it sinks lower into the cavity of the pelvis (or part of the trunk which bounds the abdomen below), and produces much suffering, especially when the pelvis is small or narrow. After the fourth month, the womb, finding insufficient accommodation in the pelvis, mounts higher, and seeks room in the more capacious and yielding belly. Then the distress in the back, and the sickness and vomiting are somewhat modified, or in some, comparatively disappear altogether. When the condition of pregnancy is first discovered, the woman, no matter how robust, should avoid all over-exertion or excitement, and should bear in mind constantly St. Paul's motto of "moderation in all things.": A state of indolence is productive of disastrous, or, at least, painful consequences. Judicious exercise, and a determination to be cheerful and contented, will do much towards suppressing the usual annoyances of preegnancy, while moping and idling will increase them, and will almost invariably bring about a hard labor. Thus the poor working woman, providing she does not labor too hard, or expose herself imprudently to the vicissitudes of the weather, rarely suffers so much in child-bed as the woman who lives only to be petted and admired, and who seldom breathes the air of heaven in its delicious purity. Among the many incidental afflictions of pregnancy, are costiveness and piles. These are produced by the pressure or the enlarging womb upon the lower bowel. This, becoming filled with hardened matter, in turn presses upon the womb, and endeavors to crowd it out of the way. The combined and continual pressure of the womb and bowel upon the water-pipe, causes great difficulty in making water, and their uninterrupted weight upon the ascending veins produces congestion in the lower bowel, and hence the appearance of painful and disagreeable piles. The stomach and bowels should be kept in the best possible order. To prevent or ameliorate piles, use seidlitz powders every day, and inject into the bowels half a pint of pure cold water every morning. With regard to nausea, if it continues after the first three months, eat nothing but plain, yet nourishing food, and use chamomile flower tea as a beverage. The habit of swathing or bandaging during any period of pregnancy is decidedly injurious, unless the woman be of a very fragile form and debilitated constitution. The child quickens about the end of the fourth month, when its motions will often produce hysterics and fainting fits, and the mother (for such she then is) becomes peevish, irritable, thin and weak. Great care must be taken to combat this peevishness and irritability by fixing the mind upon pleasant thoughts, and mixing with lively company, if it be available. It will be as well, too, for the woman to lie down a little while, two or three times a day, and not to remain in an erect position too long without taking a little rest. During the last three months, the woman will generally suffer much uneasiness "all over," and will experience trouble in the attempt to get a perfect night's rest. They should not touch opiates under these circumstances. When varicose swellings of the veins of the legs are produced, a good plan is to wear a laced stocking over the affected parts, and this should be adjusted so as not to press too tightly upon the limb. It should be arranged so that the pressure will be equal throughout its length. Sometimes delicate women have convulsive fits in the last stage of pregnancy. These are dangerous, and no time should be lost in calling in an experienced midwife to take charge of the case. However, a two-grain opium pill administered internally, an injection of warm suds, and mustard plasters applied to the feet, and between the shoulders, will not fail of giving speedy relief. Also bathe the feet in warm water. The habitual use of the warm bath will often prevent these convulsions. Palpitation of the heart, cramps of the legs and thighs, toothache, puffy swellings, suppression of urine (use parsley tea for this), lethargy and headache are always accompaniments of pregnancy. For cramps and swellings, bathe the parts with warm water and red pepper, or mustard. If the swellings are very troublesome, apply fomentations of bitter herbs. In order to prevent sore nipples (which, if neglected, merge into caked and broken breasts, bathe them daily several times with alum-water, or a decoction of white oak bark. This bathing should be commenced about six weeks before confinement. Fox-glove (digitalis) is recommended by many for palpitation of the heart; but I discountenance its use. A little compound spirits of lavender, in water, and moderate doses of Turkey rhubarb will alleviate the attacks. All pregnant women should wear flannel drawers and keep the feet warm. All expectant mothers may greatly render a coming labor more easy and painless, if, at about the eighth month, they thoroughly rub my "Herbal Ointment" (see page 472) externally on the abdomen once a day, and continue until labor, and at about the middle of the ninth month they should lubricate the vagina and womb with the ointment. This has the effect of making the mouth more dilatable, the soft parts more yielding, and consequently a safe and comparatively easy labor. The time of labor to every expectant mother causes constant solicitude, and scarcely any woman approaches the period fearless of the result, but very anxious as to the suffering or safety of life. In the present condition of civilized woman, we well know that the phenomenon of childbirth is attended with pains of an agonizing character, but that the suffering is mostly owing to habits of life, dress, etc., now characterizing woman, is equally certain. It would be an anomaly in nature if a process, so natural to females as childbirth, was originally ordained to be agonizingly painful, and it is quite evident that the pain now characterizing nearly all cases of labor is an infliction imposed by nature in consequence of violation of some of her laws. We are glad to see intelligent women approaching this subject, and have seen no brighter gleam of sunshine than Mrs. Stanton's recent address at San Francisco, which no false delicacy should prevent being reproduced in every paper in the land. She said, "We must educate our daughters that motherhood is grand, and that God never cursed it. And the curse, if it be a curse, may be rolled off, as man has rolled away the curse of labor, as the curse has been rolled from the descendants of Ham." While saying that her mission among woman was to preach a new gospel, she tells the women that, if they suffer, it is not because they are cursed by God, but because they violate his laws. What in incubus it would take from woman should she be educated to know that the pains of maternity are no curse upon her kind. We know that among Indians the squaws do not suffer in childbirth. They will step aside from the ranks, even on the march, and return in a short time bearing with them the new-born child. What an absurdity, then, to suppose that only enlightened Christian women are cursed. But Mrs. Stanton says that one word of fact is worth a volume of philosophy, and gives her experience as follows: "I am the mother of seven children. My girlhood was spent mostly in the open air. I early imbibed the idea that a girl was just as good as a boy, and I carried it out. I would walk five miles before breakfaast, or ride ten on horseback. After I was married I wore my clothing sensibly. The weight hung alone on my shoulders. I never compressed my body out of its natural shape. My first four children were born, and I suffered but very little. I then made up my mind that it was totally unnecessary for me to suffer at all; so I dressed lightly, walked every day, lived as much as possible in the open air, ate no condiments or spices, kept quiet, listened to music, looked at pictures, read poetry. The child was born without a particle of pain. I bathed it and dressed it and it weighed ten and one-half pounds. That same day I dined with the family. Everybody said I would die, but I never had a relapse or a moment's inconvenience from it. I know this is not being delicate and refined, but if you would be vigorous and healthy in spite of the diseases of your ancestors and your own disregard of nature's laws, try." While we heartily endorse all that Mrs. Stanton has
said in this matter, we could not advise every mother to "dine with the
family" on the day of her labor. It would be an exceedingly dangerous
proceeding; but if every woman would be willing to practise the same initiatory
training, which is so healthful, because in accordance with physiological
laws, there is probably no doubt but that she would also be able to "wash
her own baby" and "dine with the family," on even as substantial a dish
as pork and beans proceeding.
PUERPERAL FEVER Child-bed fever is a very fatal disease, and frequently follows parturition. Scrofulous women are peculiarly liable to it. The disease manifests itself in every degree of intensity. The usual symptoms are weight and soreness in the lower part of the abdomen, accompanied by lassitude and debility, capricious appetite, imperfect after-discharge, spongy condition of the gums, constipation, and scanty and high-colored urine. These symptoms continue for two or three days after delivery, when the patient will be seized with chills and rigors. These are soon followed by a hot and pungent skin, pain in the head, nausea, and sometimes vomiting. The pulse becomes hard and quick, respiration rapid, the secretions are arrested, and the pain centres in the lower part of the abdomen and becomes very severe. The bowels are bloated, and very tender, and the lochia or after-discharge is entirely suppressed. In many cases delirium is present, also agitation and a sense of impending death. The worst form inswhen it presents the appearance of malignant scarlet fever. TREATMENT. -- The bowels should be freely opened
with a purgative, after which opium should be administered in tolerably
large doses. Warm slippery-elm emulsions should be frequently injected
into the vagina, with a view to bring on the lochial discharge. The
fever is to be controlled by aconite or veratrum. Tonic stimulants
and carminatives should be used, according as the disease shows excitement
or depression. In the low form, quinine and camphor are indicated.
In the gangrenous form, put charcoal and yeast poultices to the abdomen,
and give a decoction of wild indigo in wine and yeast four or five times
a day.
INVERSION OF THE UTERUS This may be partial or complete. When partial, it may be known by the absence of the fundus or top of the womb behind the pubic bones, and the presence of a large solid tumor in the vagina, accompanied by profuse hemorrhage, intense pain in the pelvis, violent straining, vomiting, fainting, cold clammy sweat, and feeble pulse. Complete inversion is recognized by the presence of a reddish livid tumor filling the vagina, and protruding beyond it. It may occur spontaneously in atony of the womb, or from irregular contractions, or it may be caused by violence in extracting the after-birth, shortness of the cord, delivery in the upright position, tumors, etc. TREATMENT. -- Watch the tumor carefully, and at the
moment when there is no contraction, the fundus should be depressed with
one finger, and indented like the bottom of a bottle, and make continued
pressure until reposition is sure. Then control the hemorrhage, if
any is present, with ice to the pelvis, or vinegar injections, and give
stimulants if the patient is exhausted.
ABORTION OR MISCARRIAGE Abortion or miscarriage signifies the expulsion of the foetus from the uterus, before it is sufficiently developed. The causes may be either natural or violent. Among the most prevalent causes, are mercury, constitutional syphilis, either in the father or mother, small pox, sudden and violent excitement of the blood-vessels by surprise, fright, anger, etc. It may also be caused by disease of the embryo, disease of the afterbirth, or direct violence to the abdomen. If it occurs in the early stage, the patient feels languid, uneasy and despondent, and is troubled with alternate chills and flashes of heat; there is nausea, palpitation, pain in the back, and tenderness over the abdomen. The breasts become flabby, and there is more or less hemorrhage. In the more advanced stages, the pains are more severe, and frequently the hemorrhage is so violent that the life of the patient is endangered, unless the proper remedial agents are employed. If miscarriage occurs once, it is liable to recurrence, and hence pregnant woman should be very careful. TREATMENT. -- Those predisposed to abortion, should
carefully avoid purgatives and diuretics, should indulge in no violent
exercise, and take a cold sitz-bath every morning on rising, followed by
brisk friction with a crash towel. Unicorn root and bayberry should
also be taken internally. The pain should be subdued by hyoscyamus,
and the hemorrhage checked by the oil of erigeron, or cayenne pepper and
matico may be taken. If abortion, however, defies treatment, a strong
decoction of cotton root, or ergot, should be taken to promote rapid expulsion
of the foetus. After it is expelled, if hemorrhage occurs, the oil
of erigeron should be given, and much care observed, until the placenta
is removed. During convalescence the patient's strength should be
maintained to prevent weakness of the womb.
INFLAMMATION AND ABSCESS OF THE BREASTS During and after pregnancy the breasts are very liable to become inflamed and sore. The patient shivers, has pain in the head, loss of appetite, is constipated, and her urine is high-colored, and pulse quick. The breasts become red, painful, and swollen, and if the inflammation is allowed to continue, an abscess is formed, which, sooner or later, opens and discharges. Cold during nursing, accumulation of milk, injuries, diseases of the womb, scrofula, etc., are the principal causes. TREATMENT. -- Subdue the inflammation by applying
the following: -- Take arnica flowers 3j.; lobelia leaves, 3ss; hops 3ij.
Make a strong decoction, and apply cloths wrung from it hot as the patient
can bear, and repeat every fifteen or twenty minutes. A small dose
of aconite may be given internally to control the fever. A mild purgative
should also be taken, and if the patient is debilitated, the general tonics
should be exhibited. If the abscess, however, will occur, it should
be opened, and then poulticed with slippery-elm. For caked breasts,
apply hot packs, and change them frequently, and between each application
bathe the breasts with a liniment composed of equal parts of lime-water,
sweet-oil, spirits of camphor, and oil of horsemint.
SORE NIPPLES This is one of the most common and troublesome difficulties connected with the breasts, after child-birth. It is very frequently caused by want of cleanliness on the part of the mother or child. TREATMENT. -- Wash with castile soap and warm water
after each nursing of the child, and then sprinkle the nipple with very
fine powdered hemlock bark. Or make and use the following ointment:
-- Take balsam of fir, 3j.; white wax, 3ij; melt together, then add ten
grains each of tannin and powdered bayberry. Apply this as often
as necessary, previously washing the breasts. Cover the nipple with
folds of linen during the intervals of nursing. My Herbal Ointment
(page 469), is a speedy cure for this painful affection.
RELAXATION OF THE ABDOMINAL MUSCLES One of the most frequent sequels of pregnancy is a permanent relaxation of the abdominal muscles, more or less in degree. The abdomen becomes pendulous, occasioning great inconvenience, suffering, and often inducing malposition of the womb, and other affections. The only way to remedy this relaxed condition is by artificial support, which is to be kept up until the muscles have again attained their full powers of contraction. Ladies are therefore in the habit of wearing bandages, though these but inadequately supply the necessary support, owing to the difficulty of proper application, so as to secure the equalization of pressure, and the stability of position, necessary. Mechanical appliances should only be used for the purpose of support. These are called abdominal supporters. Decidedly the best supporter is the one represented in the cut, an appliance so arranged as to supply the firmest support by means of elastic springs. It gives no uneasiness to the wearer; on the contrary it affords the most comfortable support, enabling the sufferer, who before could scarcely walk, to do so with the utmost facility, occasioning no pain or inconvenience. Supporters are absolutely necessary in all cases, as no medicinal treatment will overcome the relaxation, on account of the constant super-imposed pressure of the bowels. These supporters should also be worn in all cases of uterine misplacements, as they afford the greatest relief, and serve as an almost indispensable adjunct to the required medicinal treatment. Another supporter, represented by the adjoining cut,
is also a meritorious one, having many excellent qualities. It is
especially well adapted to corpulent females. Equality of support
under all circumstances is gained by an elastic band in the pad at front.
These supporters are the result of thorough study as to the requirements
of such appliances, and the author is convinced that they are the best
articles for the purpose designed. Their many qualities will at once
be apparent both to the professional man or to the patient. The measure
required is the size around the lower part of the waist.
THE CONDUCT OF A CASE OF LABOR This should never be attempted except by a physician
or competent midwife, but, as it may sometimes take place in railroad cars,
in voyages, etc., the duty may fall to the lot of almost any woman or man,
and hence it is important that they should know how to proceed. These
hints may also be useful to perhaps many in the backwoods, where the population
is scarce, and where the nearest doctor lives "a day's journey" away.
HOW DO YOU KNOW THAT THE PATIENT IS IN LABOR? This the mother frequently knows herself, but she
may sometimes be deceived by what are spurious pains. If she is in
labor, she will have what is called "come and go" pains, which at first
are moderate and wide apart, but which finally become more intense and
succeed each other at shorter intervals. She will describe those
as bearing down pains, and frequently they are so severe as to cause cries
and gestures, the former being of a mourning or complaining character,
the other twisting and writhing. She will also have a mucous discharge
from the vagina, which is called a "show." She will probably wish
to void her urine often, and to relieve her bowels, which should be encouraged.
During this stage, the mouth of the womb is dilating. Now it will
be well for you to pass your finger well up into the vagina, and you will
most probably find that the mouth of the womb is dilated, and in extent
it depends upon the time at which you may make the examination. When
the pains become "thick and fast," you may again make an examination, and
you will probably find a fluctuating tumor, which is the bag of waters.
If this does not burst itself, you may rupture it with your finger, but
do not allow yourself to be frightened at the forcible rush of the waters.
If you have withdrawn your hand, you may again insert it, and you will
most likely find the head about descending into the vagina. If it
is the head or breech it will be a natural labor (which I hope it may always
be, for I do not believe I could teach you how to proceed in what is called
a preternatural labor). If the head is there, all right. You
may give the soon-to-be-mother your hand, or you may tie a sheet to the
bed-post and let her pull at that, or if her husband is present, or if
you are he himself, let her press him around the neck whenever an expulsive
pain occurs. This will greatly aid her, and you do not know how thankful
a woman is in such a case, when she observes apparent assistance on your
part. After a few good pains, the head of the child will be born,
and then the worst is over, for usually one pain more will cause the birth
of the whole child.
WHAT WILL YOU DO NEXT? As soon as it is born, you will probably hear the
child gasp and cry, which is caused by pain ensuing upon sudden expansion
of its lungs. If it does not do this, take the child and shake it
gently, give it a few slaps on the buttocks, and empty its mouth of any
secretions that may be found there. By doing this, the child may
soon cry--when it is all right. If, however, it should not be so
easily resuscitated, sprinkle a little water on its face, and if it looks
blue in the face, cut the cord, and let it bleed a little; then put your
mouth to that of the baby, and while holding its nose shut, blow your own
breath into it and fill its lungs, and then press gently on its chest,
in imitation of expiration. Do this as long as there is any hope,
and your efforts may often be crowned with success. We will suppose,
however, that the baby is a struggling, crying, healthy darling.
Then, as soon as you do no longer feel the cord pulsate, you can separate
it from the mother. To do this take a few strands of thread and tie
it round the cord, not so tight as to cut through, about two inches away
from the navel. Then take a pair of scissors and cut the cord through
about half an inch away from the ligature, not on the side, however, towards
the navel; you can put two ligatures on the cord, if you like, and cut
between them. Then take the baby away, but be careful how you do
it, or else an accident may befall you, and hand it to the proper person
to be washed and dressed. The baby is very slippery, so take it up
in this way: put its neck between the thumb and forefinger of your left
hand, and put the palm of the right under its buttocks; you then have it
secure, but do not be too anxious about its safety, or you might choke
it.
WHAT NEXT? You must now pay attention to the exhausted but joyous
mother, rejoiced that she has passed such an agony of pain as you can form
no conception of, such that you have never felt and never can feel, unless
you have been or will be a mother, and yet she will now greet you with
a sweet, smiling countenance. Her anxiety, however, is not over until
she is relieved of the after-birth. By the time that you have got
through with your duty to the baby, you will probably find the after-birth
expelled into the vagina, by the after-pains. If such is the case,
take the cord and pull gently downwards and a little upwards, but by no
means pull so hard as to tear the cord, or invert the womb. If it
will not come, wait, and in a short time try again, and you will most probably
find it to come away readily. If you should find her flooding, take
a rag, saturate it with vinegar, or take a lemon, divest it of its rind,
and then pass it into the womb and squeeze it. This causes contraction
of the organ, and stops the hemorrhage. You may also apply ice to
the spine for this purpose, and if you have ergot in the house, give a
pretty large dose of that. After delivery of the after-birth, take
a towel, and pass it around the pelvis of the mother, and bind it pretty
tightly; cover her up warmly, and allow her to sleep, and so recover strength,
as you may suppose that she is very much exhausted by this time.
YOUR WORK IS NOT DONE YET. The baby has to be washed. This is a tedious job, unless you know how to proceed. All babies are covered with more or less unctuous matter, and this should be removed, or else it is liable to get a skin disease. After you have got your rag (a soft woollen one is the best) and some pretty warm water, smear the child over with pure lard or sweet oil, and then use castile soap and water, and you will soon have it clean. Be careful, however, not to get soap into its eyes, or else you will have to treat it in a few days after for sore eyes. Now you have got it clean, but you must not put on its clothes, until you have dressed the navel, and put on its belly-band. To dress the navel, take a well-worn cotton rag, cut it into patches of about four inches in diameter, take three or four of these and put a hole through the middle of them. Cut also a little bandage, half an inch wide, and wrap it round the navel string, then slip it through the patches, and lay the string pointing towards the left shoulder. Now, put on the woollen belly-band, moderately tight, and secure it with needle and thread, not with pins. You may think this caution unnecessary, but if you had seen as many torn limbs and deep scratches in infants as I have you would not think so. After this you can put on its whole toilet, and lay it in its proper warm nest--its mother's arms. But you may think the baby is hungry, and that it needs some physic; so you give it some gruel, and follow this up either with castor oil and sugar, molasses, or butter and sugar made into a paste, and force them down the little victims throat. I say victim, because you could not easily do more harm, and yet this abomination is done every day. If the mother has milk, put it at the breast as soon as you can; if not, let it wait until she has, -- it won't starve. It needs no purgative, for the colostrum or first of the milk is by nature designed as a laxative, and if it gets that, it will soon have the black stools, or discharge of meconium, as doctors call it. By no means give it soothing syrups nor spirits, nor put a cap on it, or wash it with spirits. If you take my advice in this matter, the baby will be the better for it, and there will not be a necessity, which is so often the case, of the early exchange of its little dresses for a tiny shroud. In about twelve hours after delivery the mother may
be cleansed, and her bed changed, and light food given to her. She
should remain in bed for at least ten days, after which, if she feels strong,
she may sit up, but should avoid exertion. If she has insufficient
milk, follow advice given on page 328.
LOCHIA For some time after child-bearing, a discharge takes
place from the womb which is called lochia. It is at first red; but
if all goes well, in a few days the red appearance subsides and gives place
to an effusion of a greenish color and a peculiar odor. When the
womb is reduced to its original size, the lochia ceases. If it is
checked before it should be -- and in some women it ought to continue a
month -- or if the flow proceeds with irregularity, great distress and
danger are the consequences. The immoderate flow of the lochia is
not so disastrous as the suppression. The latter may be produced
by cold, by chilled drink, by mental excitement, or, in fact, by any undue
exertion of either mind or body. The results of the suppression of
the lochia are great fever, restlessness, heat, pain in the head, back,
and loins, delirium, inflammation of the womb, colic pains, costiveness,
nervous excitability, muscular contractions, and, in fact, general distress.
The first and only thing to be done is to restore the flow. For this
purpose, if the patient can bear it, the warm bath must be used; fomentations
should be applied to the abdomen; large emollient injections should be
given in the rectum, and sudorific medicines (not of a mineral character),
assisted by copious diluent drinks, should be administered. The acetate
of ammonia will be found very useful. A profuse and general perspiraton
is the precursor of rapid recovery and safety. While the lochia is
apparent the patient must not endeavor to get up, or to undergo any noticeable
degree of exertion, or be exposed either to atmospherical changes, or imprudence
in diet.
THE TREATMENT IN ACCIDENTS The treatment of fractures, dislocations, etc., should
always be intrusted to the surgeon, but the emergency of such cases may
be so great in certain instances that a few minutes' delay might prove
fatal to the patient. Hence, I will attempt to instruct the reader
how to proceed and what to do before the doctor comes. In all cases
where surgical help can be procured, it should be done as quickly as possible,
but dangerous accidents may occur where surgical aid is impossible to procure,
and, therefore, the treatment devolves upon others.
WOUNDS In case of wood-choppers, hunters, etc., away in the backwoods, or in any other case where this precaution is necessary, they should provide themselves always with bandages, Monsel's solution, and a roll of adhesive plaster, and then they are prepared for nearly all cases of accidents that may befall them. The worst feature about a wound is the bleeding, unless, as in case of gun-shot wound, a vital part is injured. We will suppose, however, that unfortunately one received a wound, either from some sharp instrument, or a gun-shot wound, or some part of his body was lacerated, contused or punctured from some cause, and that the wound was bleeding freely. Before the wound is dressed the character of the bleeding is to be noticed. If the blood is dark-colored and flows regularly in a stream, it is venous blood, and you will be able to control it easily; but if it is bright-scarlet, and spurts out in jets, some artery has been wounded -- always a dangerous accident. If the wound is a gun-shot one and received in the trunk, all you can do on the moment is to hermetically seal the wound. Take the adhesive plaster, and cut a piece from it large enough to cover the wound well, and then apply over the wound so as to seal it effectually against escape of blood or entrance of air; or take a rag and shape it in a pledget, and tie it on the wound firmly with a bandage or handkerchief. If internal hemorrhage occurs, you cannot do anything, and the patient will probably die. If the wound is in the arms or legs, then you can always do something. If the bleeding is venous, you will be able to arrest it by applying cold water. Elevate the limb, and use compression. If this does not arrest it, apply some of the Monsel's Solution, which is a solution of the persulphate of iron, which quickly stanches the blood by coagulation. After the hemorrhage has ceased, apply a bandage. If the blood comes out in jets, you may know that an artery is wounded, and that no time is to be lost. No styptics will arrest hemorrhage from any important artery, but in such cases instantly apply the Spanish windlass, which is made by tying a handkerchief around the limb, and twisting it with a stick, until the hemorrhage ceases. This compression is to be maintained, until the patient can have the attention of a surgeon. Be careful, however, to apply the windlass above the wound towards the heart. If you have to deal with any ordinary wound, cut,
etc., draw the edges together with strips of adhesive plaster, and put
on cold water dressings.
FRACTURES These accidents often happen where no surgical aid
can be conveniently procured. Any one can easily detect a broken
bone by the person not being able to raise the limb, by its bending where
it ought no, by pain, and by crepitation, or crackling sound if the parts
are moved. When the bone is merely separated into two parts it is
called a simple fracture; when an open wound communicates with the fracture
it is called compound; when the bone is broken into numerous fragments,
it is termed comminuted, and complicated when attended with dislocation,
laceration of large vessels, etc.
HEAD The bones of the head and face are liable to be broken
by blows, falls, etc., and need immediate medical attendance. All
you can do before the arrival of the surgeon, is to raise the head, apply
cold water, avoid all noise and excitement, and arrest the bleeding by
the means heretofore advised.
COLLAR BONE This bone is usually broken by violence upon the shoulder, arm, and hand. It is generally broken near the middle of the bone, the part is painful and swollen, and every attempt at motion produces pain; the shoulder is sunken and drawn towards the breast-bone. The patient usually is found supporting the arm with his hand, to relieve the pressure upon the sensitive network of nerves in the armpit. TREATMENT. -- Push the shoulder backwards, and press
on the seat of fracture, until you get it in its place. Then make
a wedge-shaped pad and put it in the armpit and secure it there by a bandage,
which surrounds the chest. Then bring the elbow to the side, and
place the fore-arm in a sling; then take bandages, and secure the whole
arm so tightly in that position that it cannot be moved. The surgeon
may then be called, or, if the above advice is properly and effectually
obeyed, the cure will be a good one.
BROKEN RIBS This is known by pain when the patient breathes, or on pressure where the injury has taken place. Crepitation is also felt when the hand is placed over the part during respiration or coughing, and if the pleura is injured, the chest swells, or emphysema appears. TREATMENT. -- If the broken ends project, apply a
compress over it; if there is a depression, a compress is to be placed
at each extremity. If there is a bruise, apply hot fomentations;
then take a bandage six or eight inches wide, and draw it tightly around
the chest over the injured part. This gives great relief, as it prevents
expansion of the chest in respiration, and holds the broken ends in opposition.
Keeping this bandage firmly applied is all that need be done in the way
of treatment.
FRACTURE OF THE HUMERUS This is the bone between the elbow and shoulder. It may be detected by the ordinary methods. TREATMENT. -- Place the bones in apposition, making
sure that it is right, by comparing it with the sound arm. Then take
four splints, and put one in front, one behind, and one on each side of
the arm. Secure these with a bandage. This dressing will do,
until better attention can be given to it by a competent doctor.
Place the arm in a sling.
FRACTURE OF THE BONES OF THE FOREARM There are two bones here, the radius and ulna. They may both be fractured, or only one of them. The fracture is easily detected. TREATMENT. -- The difficulty here is to observe the
space between the bones, which is called the interosseous space.
The fracture is readily reduced by drawing the arm forwards, and when this
is done, press the muscls into the interosseous space. Now, take
two splints, well padded on the inside, reaching from the elbow beyond
the fingers, put one on the inside and the other on the outside of the
forearm, and secure them with a bandage The arm should be carried in a
sling.
FRACTURE OF THE BONES IN THE HAND, FOOT, OR ANKLE These solid bones are almost always wounded by such accidents that tend to crush them, as machinery, threshing machines, heavy weights falling on them, etc. TREATMENT. -- Dress the open wound as any other,
then cover the whole hand in several folds of rag, or handkerchief, dipped
in cold water.
FRACTURE AT THE HIP-JOINT This is a very serious accident, and liable to occur in aged people. One that receives this injury cannot stand or rise from the ground. If the patient is placed upright the injured limb will be found much shorter than the other, and the foot turned outwards. What is called osseous union rarely if ever occurs in this fracture. TREATMENT. -- In old persons support the limb by
pillows and restrain all motion. This is all you can do. In
other cases, make two splints, one reaching from the arm-pit to about six
inches longer than the foot, the other from between the legs, extending
to the same length. Pad these well, especially at the upper ends.
Apply them to the inner and outer side of the leg and secure them with
a bandage. Now make a foot-board with two mortised holes in it, through
which the splints can pass. Bore holes in the lower ends of the splints
every half inch. Put on the foot-board, and attach the foot to it
firmly, then pull the foot-board down so as to stretch the leg well, for
this secures what is called extension, which is necessary in these cases.
The splints resting against the arm-pit and perinaeum affords what is called
counter-extension. See in all cases that you have the leg straight.
FRACTURE OF THE THIGH-BONE Fracture of the shaft of this bone is easily recognized
by shortening, crepitation, etc., and you should treat it just the same
as advised in the fracture of this bone at the hip-joint. If this
fracture should occur away from home, in the fields or elsewhere, get some
stiff straw, or bits of very thin board, or if you have a "stove-pipe"
hat take that, knock out the crown, take off the rim, and split it up at
the sides. Bind these around the limb rather tightly with suspenders,
handkerchiefs, or tear your shirt up for bandages. Then you can safely
remove the patient to a place where he may receive the proper treatment.
FRACTURE OF THE CAP OF THE KNEE OR PATELLA There are two bones below the knee, the tibia and fibula, and a fracture, occurring in one or both of them from a fall or direct violence, is a frequent accident, the tibia being most frequently broken. The signs are evident. Crepitation, pain, want of motion, etc., declare it. TREATMENT. -- When both bones are broken, or when the fibula alone, or when the upper part of the fibula is fractured, the best and most simple apparatus is the fracture-box and pillow. Make a box considerably wider than the leg, with only one end board, and that considerably higher than the sides of the box -- the box has no lid. Put a pillow, or little bags of chaff or bran in this; put the broken leg into this; see that it fits well; then secure the foot to the foot-board, so as to prevent lateral inclination. The great object in the treatment of fractures is
to keep the broken ends well together, or in apposition, and keep them
there. Nature will do the healing part. In bandaging limbs,
be careful that you get them smoothly on the parts, and make allowances
for the swelling which occurs. If a bandage is formed too tight,
it should be removed, or else mortification of the limb will ensue.
DISLOCATIONS The signs of limbs being out of joint are deformity,
swelling, and a hollow where none should be, shortening or elongation,
pain and immobility of the limb.
BROKEN NECK, OR BACK This is nearly always accompanied by a fracture. It may be produced by convulsions, falls, hanging, etc. The chances of life are small, on account of injury done to the spinal marrow, or the action of the diaphragm may be suspended by compression of the phrenic nerve. TREATMENT. -- Lay the person (if in the neck) on
his back, plant your knees on the patient's shoulders, grasp the head firmly,
pull gently, and at the same time put the head into its proper place; but
this must be properly and gently done, or else you may do great harm.
If in the back, do nothing.
DISLOCATION OF THE JAW This is often caused by yawning, by convulsions, or by blows on the chin, when the mouth is wide open. The mouth gapes and cannot be shut, the saliva trickles, there is great pain, and the patient cannot talk. TREATMENT. -- Seat the patient on a low stool, stand
in front of him, and then press your thumbs upon the last molar or grinding
teeth very firmly. Be careful, however, to have your thumbs well
protected with wrappings, or else you may be severely bitten. By
doing this you get the articular ends of the jaw-bone from their unnatural
position, and reduction is caused by the normal action of the muscles.
When you hear the snap, you may be sure that the bone is in its proper
position. After reduction, the chin should be confined by a bandage
for a week or ten days.
DISLOCATION AT THE SHOULDER This may be displaced in three directions, viz.: inwards, downwards and backwards. By comparing the injured with the sound shoulder, you may be able to tell that it is a dislocation. Where the head of the bone ought to be, you will find a depression, and you will most likely find a tumor, near the breast, in the arm pit, or towards the back, according to the manner of dislocation. TREATMENT. -- Lay the person on his back, and sit
down beside him on the injured side, and put a round pad in the arm-pit.
Then take off your boot, put your foot against the pad, grasp the patient's
arm, or tie a towel to it, put it around your neck, and pull in that way.
When while you pull at the arm and push with your foot, tell the patient
to turn round, or you may carry the arm across his chest. While this
is done, a snap will be heard, and the bone is in its proper place.
DISLOCATIONS AT THE ELBOW When both radius and ulna are dislocated, the forearm is bent nearly at a right angle, and is immovable. When the ulna alone is dislocated, there is a tumor projecting posteriorly, the elbow is bent at right angles, and the forearm is turned upwards. The radius is dislocated at the elbow either forwards or backwards. When backwards the head of the bone forms a prominence behind, the arm is bent and the hand prone. When fowards there is a distinct prominence in front, the arm is slightly bent, and the hand supine. TREATMENT. -- When both bones are dislocated, or
in case the ulna is alone out of joint, make forcible extension of the
forearm over your knee, placed at the elbow, to make counter-extension.
Then bend the forearm while making extension, and reduction will take place.
In forward dislocation of the radius make forcible extension, and while
doing so, turn the hand from without inwards, called pronation. In
backward dislocation make forcible extension, and turn the hand from within
outward, or supination. In either case you should press the head
of the bone into proper position with your thumb. Then advise rest,
cold applications, and a sling.
DISLOCATIONS AT THE WRIST The luxation of both bones of the forearm from the bones of the hand is rare. When it occurs forward there is a great projection in front, and the hand is bent backwards; when backwards, the projection is behind, and the hand is flexed. If the radius alone is dislocated the hand will be somewhat twisted. If the ulna is dislocated, it may be easily recognized by a projection on the back of the wrist. TREATMENT. -- The reduction of both bones is effected
by making extension and pressure. If either of the bones are dislocated,
the reduction is performed in the same manner. Pain, swelling, and
stiffness of the joint may follow, which should be obviated by cold applications,
rest, lotions, etc., and a light splint may be applied to prevent its recurrence.
DISLOCATION OF THE BONES OF THE HAND Displacement of the bones of the carpus or body of the hand rarely occurs. The bones of the fingers are occasionally dislocated, but more frequently the thumb is dislocated backwards. TREATMENT. -- Make extension in a curved line, by
means of a narrow bandage or tape, firmly applied by a close-hitch upon
the finger.
DISLOCATION OF THE RIBS Dislocation of the ribs from the spinal column may
sometimes occur by severe falls, or blows upon the back, and from the breast
bone, by violent bending of the body backwards. Great pain and difficulty
of breathing follow in either case.
DISLOCATION AT THE HIP In this case the leg is shortened and the foot is turned inwards. It may be dislocated in five different ways;--upwards and backwards is, however, the most common dislocation. In all cases you may know that displacement has occurred, by comparison with the articulated limb. TREATMENT. -- The accident is so serious that no
attempt should be made at reduction, except by a surgeon, but if it happens
when no such aid can be procured, you may proceed as in dislocation of
the shoulder. If you cannot make sufficient extension in that way,
you may attach pulleys to a towel fastened above the knee, and make counter-extension
by means of a folded sheet in the perinaeum. After full extension
is accomplished, push the head into the socket, or so manipulate the leg
that its movements will force reduction. After reduction, the patient
should be kept at rest, and walking should not be attempted for several
weeks.
DISLOCATION OF THE KNEE-CAP This may be dislocated in various directions. It is characterized by the leg being stretched, and a prominence formed by the patella in an abnormal situation. TREATMENT. -- Raise the patient's leg and rest it
upon your shoulder. While in this position, force the bone into its
place with the hand.
DISLOCATION AT THE ANKLE This may be forwards, backwards, inwards and outwards, and are the results of severe force. The bones' ends are usually fractured at the same time. It is a very serious accident, and when it occurs to patients whose constitutions are bad amputation may often be necessary. TREATMENT. -- Reduction is effected by bending at the knee, and while in that position, drawing the foot forwards. In all cases of dislocations and fracture communicating
with joints, the danger is anchylosis or stiffness of the joints.
This is to be obviated by what is called passive motion, which is to be
instituted in all cases, a few weeks after the accident. It is accomplished
by taking hold of the limb and moving it in natural directions, as far
as consistent, and repeated after suitable intervals. The patient
is to be enjoined, also, when practicable, to exercise his limb at the
wounded articulation. There are many other fractures and dislocations
that I have not spoken of, for the reason that they are all so serious
that the treatment should only be attempted by those having the proper
anatomical knowledge and surgical skill.
PREVENTION OF EPIDEMIC DISEASES The alarming fatality consequent upon an epidemic reign of disease demands the closest scrutiny upon the part of communities, large or small, to guard against its approach or prevalence. Medical skill is unable to cope with the fearful onslaught of epidemics, and in many cases epidemic diseases are of so violent a character that the most vigorous constitutions succumb to the assault, and the profoundest medical skill and most rational medical treatment are unavailing. It is questionable if medical science will ever be able to materially decrease the rate of mortality that usually ensues upon epidemic reign; the subtle ethereal poison causing epidemics being of too violent a character to allow ascendency to be gained by material medicinal agents. Since it is questionable that mastery can be gained by medicinal or therapeutic agents, the proper remedy is suggested, not by investigating the best agents of cure, but in measures of prevention, as the author is quite certain that by proper knowledge and concerted action the spread of an epidemic can be limited, and its onset prevented. Epidemic diseases belong to the class which has been conveniently but inaccurately designated "zymotic." They are generated, according to the most modern physiological doctrine, by a specific poison, introduced into the body from without, which is capable of causing morbid changes in the blood, and of destroying life. The poisons of varioius epidemic diseases are distinct inter se; the contagion of typhus, for instance, being altogether different from that of small-pox, and the contagion of cholera from that of diphtheria, and yet it is plain that they are all somehow related, and capable of gradual transmutation from one type into another. Some ancient types have died out -- the black-death, the sweating sickness, and the plague; but new types, undescribed by the old physicians, have arisen. We are able to note remarkable "waves of disease;" at one time the great mortality is from typhus, at another from small-pox, at another from scarlatina. In England they have recently had a succession of epidemic. The outbreak of cholera in 1866 was followed by typhoid fever, and as the latter began to abate in violence, scarlatina appeared in the most malignant form, and attacked the metropolis. This disease had begun a year and a half ago to decline in London, but at the same time it began to spread through other parts of the kingdom, where it has since raged distructively. A little later than the scarlatina, relapsing fever, which has been rare in these countries since 1849, broke out with great severity, also attacking London first, and, when it had spent its force there, extending itself into the provincial towns. Lastly, they have been visited with an epidemic of small-pox more severe than any outbreak of that disease which has been recorded in England during the present generation. And no sooner has the small-pox begun to abate its violence than they are threatened with a return of cholera. This periodicity of disease is yet to be explained; but it is established that, given the same conditions for the reception and propagation of contagion, about the same proportion of lives will be carried away, whether the prevailing epidemic be scarlet fever or typhus, or relapsing fever or small-pox. The blood-poisoning of the zymotic diseases, which is thus various and changing in type, is traceable, however, to the same class of causes. In some epidemics the germs of contagion are far more volatile than in others, but, in all, we know by experience that, if we can isolate the patient and submit his immediate surroundings to disinfectant agents, we check the spread of the disorder. Pure air and pure water are irreconcilably hostile to contagious disease. The first duty, therefore, of sanitary administration is the enforcement of effective ventilation, the supply of a fixed quantity of fresh air to every person in every house. This is an innovation which will of course be resisted both by ognorance and self-interest, but no infraction of real liberty will be committed in preventing ignorant or self-interested persons from doing mischief to the community by sowing the seeds of disease broadcast. The next step in the work of prevention is to insist upon a free and well-distributed system of sewers to carry away at once from every habitation the impurities which poison the air, and which, even when they do not directly progagate contagion, insidiously weaken the constitution of those subjected to their influence and prepare them for the reception of the germs of disease. Most country villages and many small towns are almost wholly destitute of systematic drainage, and cesspools, which are the commonest substitutions, are merely traps for infection. The enforcement of drainage and the abolition of cesspools are reforms which experience has shown will never be carried out by the local authorities, and is especially an improvement which ought to be and can be carried by pressure from a strong central executive office. A third precaution is systematic disinfection, not only of everything connected with and surrounding a person suffering from contagius disease, but of all places where dirt unavoidably accumulates, and whence at any time effluvium can be perceived to proceed. These precautions, howver, though valuable tin themselves, and also as tending to effect the further object to which we are now able to refer, are quite unavailing unless supplemented by securities for a pure supply of water. Cholera, as we have seen, is held to be propagated almost exclusively through polluted water, and there is scarcely a form of epidemic that is not to some extent disseminated in the same way. We have stated that it is doubtful if sanitary reform can ever be properly enforced by local authority, and hence, advocate that its requirement should be insisted upon by national statutes. The health of any country is as much a principle of political economy as its freedom and just as worthy, if not more so, of vigilance; and it is to be hoped that the day is not far distant when legislators in every land will see the absolute necessity to enact such laws rendering thorough disinfection and drainage obligatory upon all its citizens. Physicians have long advocated so desirable a reform, and neglected no opportunity to teach the people the virtue of and benefits to be derived from disinfection; but the absence of any epidemic gives a false sense of security, and the advices are unheeded until the deathly blast of the epidemic is upon them, when their folly is exposed and the wisdom of precaution established. Of the disinfectants, the following are the best: -- Chloride of lime, Labarraque's solution, carbolic acid, and bromo-chloralum. Chlorine gas is probably the best, but not so practicable for universal use. Most of them are comparatively cheap, and no household should be without a sufficient quantity. All cesspools, sinks, etc., should be thoroughly
disinfected whenever they become offensive and exhale noxious vapors, and
no pools of stagnant water or other filthy places should be permitted to
remain undrained for any space of time. If such a desirable reform
could become of universal operation, the reign of epidemics would be over
and become things of the past.
JAPANESE CORN FILE This file is the only practical cure for corns.
It should always be used instead of a knife. With a little care the
corn can be filed down to a perfectly smooth, level surface, which result
can never be attained by the use of the knife. After the corn is
filed down smoothly and evenly in every part, My Herbal Ointment should
be applied night and morning. The price of the ointment is 25 cents
per pot, and two cents extra for postage. It is sold by druggists
generally. The price of the Corn File, prepaid by mail, is 50 cents.
No one afflicted with a corn will ever regret the small sum of money it
costs.
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