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NEW

WAEEEN'S

HOUSEHOLD PHYSICIAN,

ENLAKGED AND KEVISED,

BGIirO A

BBIEF DESCEIPTION, IN PLAIN LANGUAGE,

or AUiTHX

Diseases of Men, Women and Children,

WITH THB

LATEST AND MOST APPROVED METHODS OF TREATMENT.

ALLOPATHIC DEPARTMENT
/

IRA WARREN, A.M., M.D.,

Pellow of the Maiiachuietts Meilical
Society, etc.

BEVIgBD BT

WILLIAM THORNDIKE, M.D.,

fellow of Mansachusetts Medical Society, and

Member of Boston Society for the Improve-

ment of Medicine, etc., and others.

HOM(EOPATHIC DEPARTMENT

A. E. SMALL, A.M., M.D.,

President of the Hahnemann Medical
College, Chicago, 111.

BEVI8ED BT

J. HEBER SMITH, M.D.,

Professor of Materia Medica. Boston University

School of Medicine, and laie President of Ma»-

lachusetts Homaopathio Society,

And insny others on special subjects.

FULLY ILLUSTRATED.

By 86 Figures on i6 Splendid Colored Lithograph Plates, 262 ENk^KAviNGs, and

Two Full-Page Manikins.

TAit ieok is published strictly as a Suhtcription Book, and to he sold only as such, A ny person or
persons infringing upon these rights will be held liable.

THB RIOHT OF TRANSLATION IS RESERVED.

BOSTON :
A. I. BRADLEY & COMPANY,

234 AND 236 COMORBM STBBBT,

1898.

\mmmm^

'■'-■''■' •''iiiirfiiiahii'fn 1'"'

TW.Wnrs ffKEfVED

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:^57;5

Entered occonling to Act of Congreu, in the year 1859, by

IRA WARREN,

In the Clerk's Office of the District Court of the DIf trict of Man.

Entered according to Act of Congreis, in the year 1(63, by

IRA WARREN,

In the Clerk's Office of theDistrlctCourt of the District of Mass.

Entered according to Act of Congress, In the year 1870, by

CHARLES ROBINSON, JB.,
In the Office of the Librarian of Congrers, at Washington.

Entered according to Act of Congress, in the year 1885, by

CHARLES ROBINSON, JR.,
In the Office of the Librarian of Congress, at Washington.

Entered according to Act of Congress, in the year 1880, by

CHARLES ROBINSON, Jr..
In the Office of the Librarian of Congress, at Washington.

Entered according to Act of Congress, ir the yaar 1807, by

GEO. A. BLANEY, Admstr. Estate of Ira Warren,
In the Office of the Librarian of Congress, at Washington.

KIOBT OP TRANSLATION IB RESERVED.

This work Is published strictly as a Subscription Book,
and to be sold only as such.' Any person or persons in-
fringing upon these rights will be held liable.

H. M. PLIMPTON A CO., PRIN-.ER8 A BINDERS,
NORWOOD, MASS., U.S.A.

PEEPACE.

This book is written for the people. It is based on the assump-
tion that every man — the mechanic, the farmeiMind the day laborer,
as well as the professional man — has a right to all the knowledge
he 18 capable of acquiring, on all subjects, — medicine not excepted.
1 he book aims, therefore, to popularize and adapt to the many what
Has been claimed as belonging only to the few.

I do not hesitate to avow that my sympathies, as a man, are with
the great masses, who maybe called the bone and muscle of the race.
Ihey are, in the main, more shrewd, more endowed with common
sense, more simple and true in their natural instincts, and conse-
quently less perverted, than those who claim more refinement and a
nigher place m the social scale.

" ^n men," says Hippocrates, one of the great fathere of medicine,
"ought to be acquainted with the medical art. I believe that knowl-
edge ot medicine is the sister and companion of wisdom." Such
knowledge would shield the many from the impositions of quackery.
No one, I venture to say, who reads this book thoroughly, will be
often imposed upon thereafter by quack nostrums, or quack doctora.
Jivery man s physical organization is his own ; and he is charged with
the responsibility of taking care of it. To do this properly, he needs
knowledge of it; and to withhold this from him is another form of
the old oppression, which decreed knowledge and power to the few,
and Ignorance and obedience to the many.

In accordance with the design of the work, it has been written in
plain simple English, and brought within the comprehension of all
who have medium powers of mind.

In preparing this book, a great number of authors have been care-
tully consulted, to whom I acknowledge large indebtedness; yet the
work is not a mere compUation. In dealing with each disease, I
have aimed to sketch a brief pen-and-ink portrait, so like it that
every reader shall know the original whenever he sees it; and then
V give, in the fewest words, the best treatment.
• No work of the sort has ever explained the reasons, or given the
whys and wherefores of medicine to anything like the extent of this :
nor has any one been so extensively illustrated. The engravings
have ^en, with fp- exceptions, done expressly for this work. The
colored lithographs and manikins are inserted at great expense, and
add much to the value of the book.

I. W.

SECOND PREFACE.

The Household Physician was written in the belief that the people were
ready and waiting for a popular medical work based on liberal principles ;
and that one hundred and forty thousand copies have already been sold
is a sufflciont evidence that the belief was well-founded — many persons
assuring the publishers that fifty or one hundred dollars would be no temptar
tion for them to part with the copy they have if they could not obtain
another. Such an extensive sale of so large a book, with the demand
constantly increasing, shows its value.

For these evidences of public favor the Publishers are not ungrateful or
unmindful of corresponding duties on their part. A chapter is now added,
therefore, on "Old Age and its Diseases," — a subject never before intro-
duced into any popular treatise on medicine, and very rarely, indeed, into
any medical book. Great pains have been taken in preparing it, and we
sincerely hope that many fathers and mothers will, in future years, be
kindly remembered in consequence of the suggestions it contains. Also a
chapter oa new popular Gymnastics, illustrated with many cuts.

The Publishers.

THIRD PREFACE.

The Household Physician, now so well known throughout the English
and German-speaking world, again appears before the public, printed from
entirely new plates, revised and improved in accordance with the progress
of medical science of the present day.

Old, obsolete matter has been discarded, and only those methods and
remedies of olden times have been preserved to which, though numerous,
recent discoveries have found nothing superior.

Much new information has been added, including articles on Russian
and Turkish baths at home. Drowning, and on Diseases of the Nervous
System peculiar to modern times. The illustrations have been supple-
mented by fine colored plates and manikins showing the arrangement of the
various organs of the body, the muscles, arteries, veins, and nerves. New
colored plates of medicinal herbs have also been added, thus giving a dis-
tinct idea, not only of the pathological seat of many maladies, but of many
of the sources from whence are derived their specific remedies.

The prescription list has been most carefully revised, and the old heroic
doses of opium in its various forms have been superseded by milder nar-
cotics and sedatives. Mercury no longer shows its hideous features on
these pages, except as it is to be given in syphilitic affections. The work
now airly competes in rich information with any newer system of popular
medicine, and may be relied on, as ever before, for accuracy, best advice,

aud the most modern medical customs.

The Publishbbs.

TABLE OF CONTENTS.

Preface ^ •

General Introductory Remarks

Anatomy

Physiological Laws of Life and Health — Hygiene
Temperaments, Constitution and Symptoms

Skin Diseases

Diseases of the Brain and Nerves

Diseases of the Throat

Diseases of the Chest ....

Heart Diseases

Diseases of the Abdominal Cavity

Venereal or Sexual Diseases

Female Diseases ....

Married Ladies' Perpetual Calendar .

Care of Children and their Diseases .

Diseases of the General System and MisceHaueous Di

Diseases Peculiar to Modem Times

Old Age and its Diseases

Accidents ......

Surgical Diseases ....

Homoeopathic Treatment of Diseases .

A Treatise by A. E. Small, M.D.

Diseases of the Head .

Diseases of the Brain and Nerves

Diseases of the Eye and Lids

Diseases of the Ear

Disorders of the Nose .

Diseases of the Respiratory Organs

Diseases of the Urinary Organs .

Diseases of the Organs of Generation

Diseases of the Skin

Diseases of the, Organs of Circulation

Diseases involving the Various Organs

Diseases of Various Organs and Regions

Dropsies, Hydropsies ....

Insidious Diseases ....

seases

Paob

64
122
134
164
208
229
274

'jm

360
379
443
445
469
493
496
509
317
608
608
613
615
622
625
62"
628
634
638
642
651
653
665
684
686

TABLE OF CONTENTS.

Homoeopathic Treatment (continued). VAa*

MiscellaneouH Diueases 600

Affections of the Mind 692

Surgical Diseases 700

Diseases of Infants 706

, DiBe<\8eH of Women 713

Labor, Parturition 716

Speciflc Indicr aons for Remedies in Fevers .... 720

Poisons and their Antidotes 726

Processes of the Hydropathic Treatment ..,,.*. 732

Domestic Management of the Sick-Room 766

Cookery for the Sick-Room 789

Dieting in regard to Health . . ' 798

Dieting in Disease 801

Bathing 803

Proofs of Death 807

Medicines and their Preparation^ — Materia Medica .... 808

Prescriptions — Recipes 920

Proprietary and Patent Medicines 944

Physical Culture — Gymnastics 960

Pronouncing Dictionary 961

General Index 965

Index to Homoeopathic Department . . . . . . . 982

LIST OF COLORED AND FULL-PAGE PLATES.

Portrait of Dr

Plate I.

II.

" III.

IV.

" V.

" VI.

VII.

" VIII.

" IX.

»' X.

«' XI.

" XII.

XIII.

" XIV.

XV.

" XVI.

" XVII.

" XVIII.

" XIX.

. Ira WaiTen

Sectional Manikin of Human Head
The Human Skeleton . . . .
Muscles of the Human Body
Arteries and Veins of the Human Body
Fig. 1, Measles ; Fig. 2, Scarlet Fever

Small-Pox

Erysipelas

Sectional Manikin of Human Trunk
Internal Organs of Human Body .
Syphilitic Eruptions
Syphilitic Affections of Throat
Medicinal Plants (Aloes, etc.)

" " (Bittersweet, etc.)

" " (Dandelion, etc.)

" " (Ground Ivy, etc.)

" " (Hemlock, etc.)

" " (Mullein, ete.)

" " (Plantain, etc.)

" " (Thoroughwort, etc.)

Frontispiece.

Facing Preface.

. p. 19

Facing p. 27

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GENERAL INTRODUCTORY REMARKS.

Progress of Medicine.

Medicine may be divided into a science and an art. It is a science
as it presents facts and evolves principles ; an art as it consists of
rules for practice. For its present attainments, it is indebted partly
to researches scientifically conducted, and partly to empirical and
haphazard discovery.

As a science, medicine is chiefly indebted, and must ever be, to the
members of what is called the " regular profession." This body of
men, while it contains numerous persons whose talents and attain-
ments do not raise them above the mei'est quacks, does yet embrace
large numbers of men who are alike ornaments of the race, and lights
of their profession. It is to the writings of this class that every stu-
dent must go who would qualify himself for the proper discharge of
the duties of a physician ; and he who attempts the practice of medi-
cine without a knowledge of standard medical writings is either a
fool or a knave — either without the brains to understand science, or
destitute of the honesty to deal fairly with men.

While this is said, however, it must be granted that a respectable
portion of the facts which make up the science of medicine have been
contributed by the industry of men who have not had what is called
a regular standing in the profession. I am sorry to be obliged to add
that the great body of this class have been quacks and charlatans,
while only a few of them have had talents and acquirements.

Nevertheless, they have been too indiscriminately condemned.
Their labois have been useful in various ways, and have contributed
to the advancement of medical knowledge. A regard for truth, not
less than justice to these persons, requires this statement.

One-Idea Men. — The " irregulars," as they have been called, have
generally had their hobbies, which they have ridden with singular
diligence, and often in little better than John Gilpin plight. Yet they
have di-awn attention to great truths, which the regular profession
either did not see, or would not commend ; and they have done this
by dwelling incessantly upon some single idea.

The one-idea men, of every class, have been ridiculed in all ages ;
and indeed have always exhibited some singular obliquities. Yet
when they have been men of learning and talents, they have accom-
plished great things, either for good or evil.

- OENKKAI, INTRODUCTOKY KKMAUKS.

Martin Luther was strictly fv one-idea man. The wliolo forro of
liis extraordinary eharactor was jriventothe ()r()|)ajfation of the sinjirlo
doctrine of justification by faith; and by the incessant efTortH he made
for this purpose, ho sank the doctrine deeper into the heart of Europe
than a hundred ecpially powerful men could have done by giving it
only an ordinary share of attention.

William Ellery ('banning was a one-ideaist. Matu the noblest
work of creation, to be developed, educated, adorned, loved, made
like unto (iod,wa8 the thought of his life, — a thought which ho em-
bellished and moulded into all the forms of beauty which our flexible
language is capable of producing. Under the mild promptings of
his genius, and the workings of this thought, philanthropy, quick-
ened into a new life, spread out her aims, and embraced the world.

Sir Isaac Newton was a one-ideaist. So entirely did he devote his
great powers to astronomy and the liigher mathematics, that he be-
came unfitted for the duties of social and domestic life — so unfitted,
that when induced by his friends to give a little attention to courtship,
he fell into one of his abstractions, and detected himself in using his
lady-love's fore-finger to poke down the ashes in his pipe I But Sir
Isaac advanced mathematical science to a point far beyond its previ-
ous attainments, and laid it under such obligations as no general
scholar could have done.

It is in this way, though in a vastly less degree, and without tlie
scientific method, that one-ideaists in medicine benefit the world.
They seize upon some single remedy, — generally one which has been
overlooked — and using it themselves to the exclusion of all others,
they press it upon the world as the panocba for all its ills. With
them disease is a unit, and they have found its one all-important
remedy. Thus convinced, they jn-ess it upon others with the enthu-
siasm of fanatics. Testing it in all cases, they develop all its virtues.
Those who have the good sense to turn their attention to it have
only to use it in those cases for which its adaptation is proved.

It is in this way that these men become, incidentally, medical dis-
coverers ; and not being burdened with modesty, they never with-
hold their importunities till the world acknowledges whatever value
there is in their discovery. And although they may do some mis-
chief with the single-edged tool which they handle so industriously, I
doubt if they do much more than many better workmen who use too
many. At all events, wise and generous men thank them for their
gift to the profession, small though it may be, and use it in the light
of a clearer knowledge.

Hydropathy. — As an illustration of what I have just been saying,

1 may refer to hydropathy, or the plan of treating all diseases by water.

The singularly careful avoidance, by the whole medical faculty, for
many ages, of the article of pure water as a medicinal, or, rather,
health-imparting agent, was anything but creditable to the profession.

It is now admitted by all sensible men that water, cold and warm,

ORNKRAF, INTRODUCrORY RKMARK8.

force of

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tH he inadu
of Europe

1 giving it

lio noblest
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ich ho em-
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been saying,
868 by water.
1 faculty, for
1, or, rather,
\Q profession,
d and warm,

used at jH-oper times and to a reasonable extent, huH great power over
several diseases, and is a powerful promoter of li'eiilth. No physiinaiis,
except those who arc; too ii lolciit to know what is going on in the
world, or too fast lu(;k(!d in old pnijudicos to touch new things, now
oniit ita use in tmujf cases, I low warm anctsincere my own approval
of water iw a r nedy is, almost every page of this volume will attest.

Indeed, it may honestly be allowed that the hydropathists have
fairly droicni'd the almost criminal professional prejudice against
water. They are in all tlio more need of this (concession, since in
their absurd zeal to cure all diseases l)y water, and make aquatic; an-
imals of men, they have also drowned their own common-sense.

Homoeopathy — This mode of practice is of comparatively recent
origin ; but it has already sunk itself deep into the popular heart,
and has drawn to its support many of the wealthy, the cultivated,
and the intelligent, in our most refined communities. I do not pro-
fess to comprehend and appreciate its principles, nor would it bo
honest in me to pretend to see how its infinitesimal doses can pro-
duce the results which it often shows, and which it is fair to confess
look like singular success ; and saying this, I can neither adopt nor
approve the violent denunciations and censures which so many are
induced (by fashion, I fear) to employ towards this generally well-
cultivated class of practitioners. I hold them as useful members of
the profession, and mean ever to cultivate towards them fraternal
feelings. They give great attention to exercise, diet, the use of
water, etc., — things which contribute very powerfully to preserve
health, and to restore it when lost. In this thing, the oUUchooI
practitioners ought to learn a most important lesson from them. In
truth, they are learning it, but very slowly and reluctant! i/, I am
sorry to say.

The centml idea of the homoeopathist, that " like cures like," the
" great law of cure," as he styles it, I do not feel called upon to dis-
cuss — theories being of much less consequence than rules of prac-
tice. The old-school men have certainly much to learn from him
respecting the augmented power of medicine from the greatest possi-
ble division by trituration. We have learned from him, too,—
though many are too ungenerous to confess the source of the infor-
mation, — that we may gain our purposes with much less medicine
than we were once in the habit of giving.

Eclectics. — There is a large and growing class of physicians, called,
at first, after the founder of the school, Thomsonians. Subsequently,
they were generally known as Botanic Physicians. Now they pass
under the title of Eclectics.

These men, directing their attention, at first, chiefly to cayenne
and lobelia, have gradually extended their zealous researches over
the vegetable kingdom, and have gathered much information worthy
to be preserved. These researches have revealed a sadly neglected
duty on the part of old-school practitioners.

TS^

WT^^^^S?*?***"

8 OKNERAL INTUODUCTORY RRMAKKS.

Tho iHlncatioi) niid tiiltMitM of tliiH cIohh of pnictitioiuM'H have grad-
ually risen, year by ^ear, until tliey liavo Heveral medical hcIiooIh,
where HliidenU an; well inHtrueted in the principles of ni(;(li(Mne, hy
men of real ahility. They have also a liUiraturr of no mean si^ni-
ticance, espceially in the department of materia niedieu. The liut
of renjcdies they liavo ffivnn to the w(»rld, drawn from our home
plantH, are a l>oon of no small value. I regard them an equal in
value to all we were previounly in possession of from the vegetable
kingdom. The sulwtitution of 'ngetiible remedies, in most ciiHes,
for mercurials, can hardly be too highly prized.

Physiologists. — Besides these various direct privctitionera of medi-
cine, there is the large and (}uite intelligent :;laH8 of physiologists,
including the phrenologista, who nearly discard medicine, and ai>-
pealing to the laws of life established by the (Creator, urgt temper-
ance in eating and drinking ; exercise in the oj)en air ; securing of
pure air by ventilating dwellings, school-houses, and (ihurches ; lath-
ing in cold and wa'-m water; cheerfulness of mind ; and the cultiva-
tion of tlie Christian virtues, as the only mtional modes of securing
health and life.

I confess myself inclined to forgive this class their error in Ikvu-
ishing medicine, in view of their zeal and success in disseminating
hygienic information of the utmost value and importaiice to man-
kind. Put man into harmony with nature, and establish over him
the empire of reason, and their theory would be excellent; but as
tilings are, medicines, like prisons, and alms-houses, and large cities,
are " necessary evils."

Other Practitioners. — Finally, we have Mesmerists, Pathetists,
Electro-biologists, Spiritualists, Nutritivists, and what not, all pre-
tending to cure disease by processes peculiar to themselves. They
are all experimenters in different departments of nature, — now
spreading over oiir eyes a large plaster of humbuggery, and now
drawing a small curtain and giving -us a peep into the large and
well-furnished rooms which nature has fitted up for our reception, b}'
and by, when we are better instructed.

All Useful in a Degree. — On the whole. I am disposed to regard
all the operators in the different departments of medicine a* useful
in their degree ; excepting always those mercenary quacks, who lie
about their remedies to make money. Each of all these (I mean all
sincere and true men who believe what they teach) is aiding in some
measure the general advancement. And though the truths, as they
gather and present them, are but fragmentary, they are useful in the
hands of those true Eclectics, who have the wisdom and independence
to select the best things out of all systems.

General Conclusion. — This brings me to remark that there is but
one truly libera' and piulosoTjlvical school oi medicine. It is the Ec-
lectic, — composed of those who have liberality enov gh to reject

niNKKAI, r».TKOI)trCTOUY KKMARKS.

prnvd-
iooIh.
e, 1>.V

i \\ni

home
ml ill
i table
caseH,

medi-
ogiste,
lul a\y-
iMuper-
ring of

; bath-
•ultiva-
3curing

in l)an-
linating
to man-
VQV him
but as
e cities,

.thetists,
till inv-
They
now
nd now
r^e and
)tion, by

lo regard
|ih useful
who lie
Imean all
in some
L as they
lul in the
pendence

tre is but
Is the Ec-
Ito reject

(•very frcliifiiu' iii/iiti'm, and to Hulect out of all HyHteins thone thingH
vvliicli iiH' a|i|iroved by t'xpcrionce and reason.

I liave alrrady Hpokcn (if the school of practitionei's callt'd KchHttic.
To a certain extent tliey an* (entitled to tlu* name, but I tliink not
entirely. They have formed a separate and exclusiv»t Hcbool. They
have turned some articles out of the materia medica /loioti/ili/ for no
letter reasoji than iM'cause their jiarty is conunitted to th.ar rejec-
tion ; whereas tliey should have no party, but allow each man to act
as if he were a citizen of the world only, and not a member of any
restricttnl association. But I will not ([uarrel with them on this
point. I think they are hefoinin</ . .dectic.

Progress of Medicine. — There :;. ra been long periods when the
science and the art of mcdiciiu' made scarcely any i)rogress. They
are now advancing, — in sonu! departments quite rapidly.

The Chemistry of Man, commonly called Animal (.'hemistry, is
opening new sources of light.

The writer was in the habit of asserting, many yeai-s ago, that
most of the true progress in mediiune must come through Animal
('hemistry; and the developments of the last few yeare Imve made
good the assertion. Liebig, a diligent student in chemistiy, has done
much to open the way for inquirei-s in this department. Simon has,
per'iaps, done nmre. Mialhe is a yet later explorer, and has made
valuable discoveries.

The result is that students have now before i. ^ir minds, and are
endeavoring to solve and act upon as fast as possible, inquiries and
propositions like these : —

What is the chemical composition of the solids and fluids of the
healthy human body ?

What is the nature of the changes which occur in the composition
of the solids and fluids during disease?

What alterations in the chemical composition of the solids and
fluids take place during the operation of , medicines ?

Before it can exert any remote action on the animal economy, a
remedy must be absorbed.

Before it can be absorbed, it must be soluble in the fluids of the
living body.

Medicines are subject to chemical changes during their passage
through the system.

These changes are regulated by ordinary chemical laws, and may
therefore, to some extent, be foretold and made available in the cure
of disease.

These chemical laws are disturbed and varied, to some extent, by
the law of vitaliuy, — just as the magnetic needle is made to vary by
disturbing forces.

What are those disturbances, and to what extent, and under what
circumstances, dc ';hey occur?

With these and similar inquiries and propositions before his mind.

fihNERAL INTRODUCTORY REMARKS.

diligently studied, a iniui will in time learn tt> picsciil)u with sonic
intelligent aim. Me will not know 'everything, to be sure, but what
he does know, he will have a reason for knowing. If he give a
medieine, he will have in view the el emieal (dianges of the solids
and llnids of the body, known to be produced by the disease he is
combating. He will also kee]> in mind the solution of the medicine
in the fluids of the body, and the chemical reaction between its com-
ponents and the acids, alkalies, etc., found in the alimentary tube
and elsewhere.

As the science of medicine advances, and becomes liberal and ec-
lectic in its character, gathering from all systems the best attested
facts, and using them to the exclusion of all mere theories, these
facts must not themselves degenerate into mere pettsd theories, but
must be held in subordination to future experience. Medical prac-
titioners, who would meet the wants of the age, must be men of
progress. The light of to-morrow, with them, must nKwlify and im-
prove the light of to-day. They rv iit knock CN'ery hour for admis-
sion into sqme new apartment of nature.

Need of Liberality. — That medical progress may be real, physi-
cians mu3t be free from bigotry. They must have no narrow preju-
dices against any man, or class of men ; but be ready to examine
candidly any new thought or new remedy brought to their notice,
from whatever source it may come.

They should not hedge themselves about with such restrictive by-
laws and Bocietiiry rules as are calculated to fetter their thoughts,
and turn their investigations, by a sort of moral necessity, into the
narrow channels of party conservatism ; remembering that he who is
once enclosed by such restrictio'.is must hew a path for his feet
through bigotry, and even malevolence itself, before he can escape
them, or be a free man in any node sense.

The members of medical societ'.es do themselves no credit, in the
nineteenth century, by putting on airs, and telling others to stand at
a distance. This Avould do better, had medicine become an exact
science ; but while the primary effects of even opium are not settled
— some physicians considerint^ it as ^irimarily stimulant, others as
sedative, others as stimulant to tl^e nerves and sedative to the
muscles, others as neither, and still c thers as alterative, — such ex-
clusiveness seems neither wise nor modest. When the professors of
the iiealing art can hoard medical knowiedgre as misers hor>rd gold,
and can submit its purity to equally certain tests, it will appear in
better taste for them to grow exclusive. Until then, the most be-
coming badge they can wear is the Christian direction : " Let each
esteem others better than himself."

Medical societies, with liberal by-laws, are fitted to do good ; but
it would be hard to show that those with stringently restrictive '"lies
can operate otherwise than as checks upon progress. In truth, they
are apt to become mere catacombs in which to embalm dead ideas .

^Mm

GKNKRAIi INTKOUUCTORY KEMARK8.

3od; but

live ■^'iles

ith, tliey

id ideas.

They are very liable to Im made the instruments for iwcoinplishiiig
the ambitious purposes of a few leading men. They tenil to suppress
all sympathy with everything outside their orgauization ; and they
Ijeget a feeling like that which would forbid the lixed stars to drop
their light into our atmosphere without first coming down and joining
the solar system.

Conservative Leaders. — There are no influences which hold so
steady a check upon medical progress as the conservative leaders in
many of our medical association , Not that they are oi)posed to im-
provement in the medical art, t /ould object to any amount of dis-
covery, if it could come to the profession through channels which they
have the honor of opening. But against all light from outside, or
from obscure sources, they will draw down the curtains, and close the
doors ; and, if it chance by any means, in spite of them, to get within
the sacred enclosure, they will call it darkness, and, as priests of the
temple, will attempt to atone for the indignity offered to the god of
medicine, and fill the whole sky with murky clouds from their altivrs.

These men have strong faith in caste, and in the right of the few
to govern the many. In the low places of society, they look for
nothing but ignorance and poverty. Notwithstanding that the light
of every natural day breaks in the horizon, and ascends, they so far
despise analogies as to insist that all medical light breaks at what
they call the zenith of the profession, and comes dovm. With them
the temples of Esculapius are all rebuilt, and tLcy are the priests ;
and to offer in sacrifice the smallest medicinal plant is a sacrilege,
unless it be entrusted to their hands.

Such persons measure and weigh a man by the amount of money
he has. Property is their god, which gives laws to everything.
With them, knowledge, like property, goes to posterity by will,- —
they being the principal testators. Like their money, t' \ it goes
chiefly to their sons, and to certain favored institutions, by .vhoni and
in whicli it is to be hoarded, and whence it is to go out only ux certain
appi'oved channels, weighed and stamped, like coin from the mint.

These are the men who regard knowledge as a contraband article,
unless regularly entered at the custom-house, with bills of lading
properly certified by the conservative magnates at some other me-
tropolis. With them, knowledge is not like the west wind, fanning
the brow of the peasant as gently as that of the king — not like the
light of heaven, entering the small, clean window of the hut, as
readily as the larger one of the palace ; not a boon which comes alike
freely to all, and which is to be everywhere amplified, changed sus
circumstances and conditions require, and especially adapted to the
present hour. It i,? rather, as they too often view it, like litho-
jrraphed letters '-i advice, printed upon stamped paper, and carefully
sealed up and addressed to posterity. And then, if they can be
made the mail carriera, and be permitted to pass, unchallenged, with
the precious bag, from post to post, and pass it over, carefully sealed,

II! "Til

■ '■.

(iENEKAL INTKOnUCTOllY RKMAKKS.

to the next generation, they will think it has done its work, and that
they have fulfilled their mission.

I would not be unjust or severe, but I cannot but remark fui-ther,
that these men present but one view of humanity. They are monot-
onous objects of inspection. Look at them a thousand times, and
you see only the same unaltered phase of life. To the mariner on
life's ocean, they are not safe lights. If he approach them on the
dark side they remain black as night to him, until he comes round to
their shining front. Th^y are not revolving lights. They have
light : it may be bright and genial ; but it gleams out upon the
watei-s only in one direction. It does not sweep round, and throw its
rays upon every mariner's path.

Such men are useful, but only to a certain class. They have in
them no true omnilogy — they are not all-teaching. Their lives are
ins ructive to their friends, their clique, their party, their school ;
but a stumbling-block, a hindrance, an oppression, an offence to evei-y-
body else. They are like porcupines, with fronts smooth and easy
of access ; but their backs bristle with quills to stick into those on
the wrong side. They are not whole men. Humanity has infused
into them only one or two of its elements. They have length, but no
breadth. They are citizens of Boston, New York, Philadelphia, or
Cincinnati, but not of the world. Within certain circles, they are
genial friends, but cynics and haters outside of them From their high
places they come down to their humble followeid with tokens of
friendly recognition ; upon others they frown and lower like armed
castles.

The True Physician. — How different the character of the true man
and physician ! He is genial in his disposition. He has no dislikes
and antipathies, and hates no men except tyrants. He accepts knowl-
edge, though it come from the humblest source ; believing th( ve is no
experience but will repay a study of it, and no husbandman's plough-
share but turns up a soil worth analyzing. He belongs exclusively
to no party, and can be approached easily by respectable men of
every stamp. Whether belonging to the same society with him or
not, you may take hold of liis nature and draw it out, without hav-
ing it slip from your fingers, and spring back from your presence into
a thousand kinks, like an overtwisted thread. He is a whole man.
God made him for the world, and not for a party. By some strong
influence you may possibly, for a time, draw him from the world into
some iiarrower sphere, but not only will his reluctant nature, like a
retiring tide, run back continually to embrace the continent, but will
soon break from its confinement, and, like a full sea, come back, boil-
ing and running over.

What is now Wanted. — The foregoing remarks indicate one great
leading want, in order that medical knowledge may increase. It is
liberality in the true and full sense. We want true men in high
places, who will not only let their otmi light shine everywhere, but mil
cease to hinder otfier meiCs light from shining.

GENKHAL INTKOltUCTORY KEMAKKS.

man.
Itrong
into
like a
It will
boil-
great
It is
higli
it mil

Beyond this, find of nearly equal importance with it, we want med-
ical knotvledge diffused among the people. We want — what the
world has never seen — a popular medical literature. We want the
temples of Esculapius pulled down, and the priests turned into the
streets to bersome teachers of the multitude, rather than worshippers
in the inner sanctuary.

I know this want will be stoutly denied, but not, I think, on well-
considered grounds. We do not think it necessary to confine a

'•M,

'lere is no
.aymen to
ol)8curest
or push the
Why should
body? They

knowledge of the soul to the ministers of religion.

branch of theology which we do not deem it proper

study; we even popularize it for our children, in

towns of New England, laymen who follow the plough

plane, become, in many cases, eminent theologians.

they not study the lower science which relates to the

liave not been able to heretofore, because its mysteries have been

purposely hidden under technicalities. These coverings should be

torn off.

It is said that those who begin to read upon medicine are very apt
to imagine themselves afflicted with the various symptoms they find
described. To some small extent this is true ; but it is also true
that the light they obtain relieves them from many apprehensions
which their previous ignorance allowed to prey upon them ; as boys
lose their feara when the light of the morning changes to some
familiar object the ghost of the preceding night.

Physicians oppose the popularizing of this kind of knowledge too
often, I fear, upon the sordid ground of self-interest. They think
their own services will be less sought.

We do not dispense with the services of ministei-s because the
people study theology, neither shall we cease to employ teachers and
practitioners of medicine when each man and woman is wise enough
to study the healing art. The principal change we shall witness will
be much larger attainments in knowledge among practitioners, —
just as the ministers of religion now know, and are obliged to know,
ten times as much as in those darker periods when the people re-
ceived all spiritual knowledge from their mouths. The teachers of
any art or science are obliged to keep in advance of their pupils.
Let medicine become a popular study, and we shall have very few
io^norant physicians, and quackery will become one of the impossi-
liilities. Homoeopathists, Eclectics, Hydropathists, and Physiolo-
jifists, believe in scattering medical books, stripped of their techni-
calites, among the multitude, and their people purchase very few
secret, advertised medicines ; — these being cliiefly bought and con-
sixmed by the followers of those who believe this kind of reading
fosters quackery 1

ANATOMY.

Anatomy describes the structiu'e and organization of living be-
ings.

Special Anatomy treats of the weight, size, shape, color, etc., of
each organ separately.

General Anatomy investigates the tissues or structures from which
organs are formed.

Surgical Anatomy or Regional Anatomy (jonsiders the relations of
organs to one another.

Physiological Anatomy treats of the uses or functions of organs in
health.

Pathological Anatomy describes the alterations made upon dif-
ferent organs by disease.

We shall here introduce a very brief compendium only of Sj)ecial
Anatomy.

It is of great consequence that everj' person should have some
knowledge of anatomy and physiology. Self-knowledge ought to
extend to the Iwdy as well Jis the mind. To know one's self, physi-
cally, is to gain a new insight into that wonderfully skilful adjust-
ment of means to ends which is never absent from the works of God.
Without this knowledge, one cannot know how to take care of the
health ; and without health, life loses most of its value.

Structure of the Body.

The human body is composed of solids and fluids.

The fluids are most abundant in cliildren and youth. It is this
which gives softness and pliancy to their flesh. In old age tlie fluids
are less abundant, and the flesh is more hard and wrinkled.

The fluids contain the whole body, as it were, in a state of solu-
tion ; or rather, they hold the materials out of which it is manufac-
tured.

Chemical Properties of the Body.

The four elements, oxygen, hydrogen, carbon, and nitrogen, make
up nearly the whole bulk of the fluids and soft solids of the human
body. A numljer of other elements, cliiefly in a state of combina-
tion, and in much smaller quantities, enter into several of the tissues.

Binary Compounds. — Thus, we ha/e carbonic acid in blood, urine
and sweat; and we have water univei-sally diffused through the sys-
tem, — each of these substances l)eing a binary compound, that is,
composed of two elements.

Compounds of more than two Elements are widely distributed
over the body ; as,

eellu

watei

fi'oin

iinoth

of hid

silk,

Fat

"id con
lias 110
'''« oIei(
^'it is us

ANATOMY.

this
uids

, urine

le sys-
hat is^

ibuted

Carbonate of Soda in serum, saliva, bile, mucus, sweat, and tears.
Carbonate of Lime in cartilage, bone, and teeth.
Phosphate of Lime in Iwnes, teeth, and cartilage.
Phosphate of Iron in blood, gastric juice, and urine.
Chloride of Sodium in blood, brain, muscle, bone, cartilage and
pigment.

Chloride of Potassium in blood, gastric juice, milk, and saliva.

Chloride of Calcium in gaatric juice.

Sulphate of Potassa in urine, gastric juice, and cartilage.

Sulphate of Soda in sweat, bile, and cartilage.

Sulphate of Lime in bile, hair, and scarf-skin. ,

Oxide of Iron in blood, black pigment, and hair.

Organized Compounds. — Besides the above inorganic elements
and compounds, several organized substances, or proximate elements, as
they are called, exist largely in the body. The chief of these are
albumen, fibrin, gelatin, mucus, fat, and casein. Others need not be
named.

Albumen is found in great abundance in the'human body. It is
the mw material out of which the flesh and other tissues are made.
The white of an egg, which is nearly pure albumen, is a good speci-
men of it.

Fibrin, when removed from the human body, changes from a solu-
ble to an insoluble state. In other words, it coagulates in a kind of
net- work. Nearly the same thing takes place constantly in the living
body, when the liquid fibrin leaves its soluble state, and is deposited
as solid flesh. Fibrin bears the same relation to albumen that wool-
len yarn does to wool ; it is spun from it in the busy wheel of or-
ganic life. And the flesh or muscle is related to fibrin as the cloth
is to yarn ; it is woven from it in the vital loom. Fibrin has been
called liquid flesh.

Qelatin exists largely in the ligaments, cartilages, bones, skin, and
cellular tissue. When dissolved, five parts in one hundred of hot
water, it forms a thick jelly. Isinglass is a form of gelatin obtained
from the air-bladder of the sturgeon and the codfish. Glue is still
another form of gelatin. It is extracted from the bones, and parings
of hides, and the hoofs and ears of cattle, by boiling in water. Black
silk, varnished over with a solution of gelatin, forms court-plaster:

Mucus is a sticky fluid secreted by the gland-cells. It is spread
over the surface of the mucous membranes, and serves to moisten and
•Iffcnd them from injury.

Fat consists of cells held together by cellular tissue and vessels,
iinil contains glycerin, stearic acid, margaric acid, and oleic acid. It
liiis no nitrogen. If the stearic acid be in excess, the fat is hard ; if
till! oleic acid preponderate, it is soft. The stearine extracted from
tat is used for making very hard candles.

ANATOMY.

t I

CaAeIn is abundant in milk and constitutes its curd. It is held
in solution in milk by a little soda. When dried, it is cheese. It is
found in blood, saliva, b and the lens of the eye. It forms the
chief nourishment of thos ig animals which live on milk. It is

found in peas, beans, and i^ s. Vegetable and animal casein are
precisely alike in all their properties. Fibrin and albumen contain
almost exactly the same amount of oxygen, hydrogen, cail)on, nitro-
gen, and sulphur, whicli i» found in casein. This Litter, wlien taken
into the stomach, therefore, goes, without much change, to the forma-
tion of the albumen and fibrin of the body.

Physical Properties of tlie Body.

The Tissues. — The solid organized substances of which the human
body is composed, are called tissues. There are various kinds of tissues.

The Cellular Tissue, commonly called areolar, is made up of small
fibres and bands woven together into a sort of ne^work, with numer-
ous little spaces opening into each other. These spaces are filled with
a watery fluid ; and When this is greatly increased by disease, so as
to cause the parts to swell, and the skin to shine, the person has ana-
sarca, or cell-dropsy. The uses of this tissue are to give parts and
organs a kind of elastic cushion to rest upon, so that they may not be
bruised and injured by the shocks of life ; to make a kind of safe
highway for delicate vessels to pass from one part of the body to
another ; and to furnish a beautifully arranged lodgment for the wa-
tery fluid which gives such roundness, smoothness, and grace to the
human form. The opening of the cells into each other exjjlains the
reason why feeble persons have swelled feet and ankles in the even-
ing, and not in the morning — the fluid settling down from cell to cell,
into the lowest parts, while they are up during the day, and running
back to its proper place while they are Ij'ing down during the night.

The Mucous Tissue, or nviicous membrane, lines all the cavities
which communicate with the air, as the month, stomach, bowels, liuigs,
etc. It is supplied with numerous small glands which secrete a
sticky kind of fluid called mucus, to protect the surface from any
injury which might be inflicted by air, or by instating substances
suspended in it.

The Serous Tissue, or membram, lines all the cavities which do not
communicate with the air, that is, all those which are shut, and have
no outward opening. The skull, the chest, and the belly are lined by
this kind of membrane. The membrane itself forms a closed sac.
— one layer of it being attached to the cavity it lines, while the other
is folded back upon and around the contents of the cavity, which are
left outside of the sac. A watery fluid oozes from the inner surfati-
of the sac, to make its sides glide easily upon eacjli other. When
some disease causes this water to Ije poured out too freely, so as to
fill or partly fill the cavity, we have dropsy of the brain, or chest, or
abdomen, as the case may be.

ANATOMY.

lo not

have

led by

Id sac.

1 other

[oh are

lurfai'i'

IWhPii

b aH to

liest, or

The Dermoid Tissue covei-s the whole outside of the body. We
call it the akin, or eutia. It is Himiliar in Htnicture to the mucous
lueinlmines, which are a mere continuation of it. It is harder than
the mucous membrane, liecause more exposed to injury. In health,
it never ceases to secrete and throw off a fluid which we call insen-
sible pei-spiration while it is in the form of an invisible vapor, and
pei'spiration, or sweat, when it is so increased as to be seen. So
^reat is the sympathy between this dermoid covering of the Iwdy
and the mucous membranes, that when it is eJulled so as to stop the
invisible perspimtion, the internal membrane becomes affected, and
we have a sore throat, or diarrhoea, or running at -the nose ; that is
to say, when the skin cannot sweat, the mucous membrane begins to
sweat.

The Fibrous Tissue consists of closely united fibres, and for what-
ever purpose used, forms a fine, dense, and enduring body. In some
cases it takes the form of a membrane, as the dura mater, which lines
tlie interior of the skull and spinal coluimi. The li(/ament8 which
liold the lx)nes together, and the tendons or cords, which fasten the
lunscles to the Ixmes, are fibrous Inidies. It is this firm substance of
which rheumatism frequently takes hold, and this is the reason why
it lingers so much about the joints. It sometimes tiikes hold of the
ligament which fivstens the deltoid muscle to the bone of the upper
arm, about two-thirds of the way from the ellwjw to tlie shoulder.
This muscle lifts up the arm. In this form of rheumatism, therefore,
the arm hangs helpless at the side.

The Cartilaginous Tissue covers the ends of the bone^ where they
come together to make a joini. It is well fitted to make the joint
work easy, being smooth, hard, and elastic.

The Osseous or Bony Tissue varies in its composition, density,
and strength, according to the age of the person, and the uses of the

lM)ue.

The Muscular Tissue, or muscle, he'mg made for a great deal of
pulling and lifting, is formed something like a rope, except that
there ia no twisting. Many small
fil)ies or filaments unite to form
fasciculi. A fasciculus is a bundle
of fibres surrounded by a delicate
layer of cell-tissue called sarcolemma,
— just as a cord is a number of
smaller threads of cotton or hemp
bound together. A number of these
fiusciculi united together make a
muscle, — just as several cords, called
strands, twisted together, inake a
i()l)e. Figure 1 gives us a good view of the fibres and bundles,
liighly magnified.

FlO. 1.

ANATOMY.

The Adipose Tissue is the material which the human Iwdy works
up into pots and cells contivining/n^ It is found chiefly under the
skin and muscles of the belly, and around the heart and kidneys,
liy the increase of this tissue, persons may Iwcome enormously en-
larged without having their muscles at all increased in size. Such a
condition is to he deplored, — the body having become merely the
storehouse or depot of myriads of pots of fat.

Tlie Nervou.» Tissue i» composed of two distinct kinds of matter,
— the one gray and pulpy, called eineritious, the other white and
fibrous, called medullary. The external part of tlie brain and the in-
ternal portion of the spinal cord are composed of the gray or ash-
colored tissue ; the nerves are made only of the white or flbrous
matter, and are inclosed in a delicate sheath called neurilemma.

Vital Properties of the Body.

Bodies begin their growth with a simple cell, which is a delicate
little bladder or shut sac. Cells take their rise in that portion of
the blood which is capable of being organized, and which is called
blastema.

In animal Iwdies each cell generally begins as a minute point in
the blastema, and grows until a transparent bladder or vesicle spjings
out from one side uf it, and soon appears to enclose it. The bladder
is then called the cell, and the point or dot is its nucleus. Within
this nucleus appears another dot, which is called the nucleolus.
When fully ripened, the cell bursts and sets the nucleus free, and
this, in its turn, matures and yields up its contents. Thus all cells
have their origin in germs produced by previously existing parent-
cells. They are multiplied with great rapidity. Having grown to
a certain extent, they lose their fluid contents, and their walls col-
lapsing or coming together, they form simple membraneous discs.
In this way, with some variations, the simple tissues of the body be-
gin to be, and the foundation is laid for the noble structure of man.

Anatomy of the Bones.

The human skeleton is composed of two hundred .and eight bones,
the teeth not included.

When fastened together by natural ligaments, the bones are said
to form a natural skeleton; when attached by wires, an artificial skele-
ton.

In Figure 2, — 1, 1, represent the spinal column; 2, the skull; 3.
the lower jaw ; 4, the breast-bone (sternum) ; 6, the ribs ; 7, the col-
lar-bone ; 8, the bone of the upper arm (humerus) ; 9, the shoulder-
joint ; 10, the radius; 11, the ulna; 12, the elbow-joint; 13, the
wrist; 14, the hand; 15, the haunch-lxme ; 16, the sacrum; 17, the
hip-joint; 18, the thigh-bone; 19, the knee-cap (patella); 20, tlie
knee-jt)int; 21, the fibula; 22, the tibia; 23, ankle-joint; 24, the
foot; 27, 28, 29, the ligaments of the shoulder, elbow, and wrist;

1»
80 ■

21 ._..J

22 ■

23 .
M

ANATOMY.

5J0, tlie liir^e iirtiTv ot" tlu! iirin ; J^l, the ligiimentB of the lup-joint;
•\2, tlie liiij^e hl(i(i(l-V('S8('lH of the thigh; ."{;{, tlie artery of the It-g ;
•i4, .iij, 80, the ligiiiiieiitH of tlio knee-cap, knee, and ankle.

'rh(! piotnherances itr swellingH in certuin parts of the hones are
called proeeHtu-s, and are the puinUt to whii-h ninHcieH and li^iamentH
are ftwtened.

The iMineH are Hnjtplied with nntritive vesm-ls, and, like other parts
of tlie JKid'. , are formed from the hlood. At liist they are compurH-
tively Hoft and eartilaginonH. After a time, in the y(»nng animal,
they hegin to change to lM)ne at certain places, called pointti of onniji-
nation. They are covered with a strong, fihroUs membrane (tailed the
perionteum. A sonufwhat similar covering upon tlie cartilages has
the name of /n-rii'/iondrium, and that which covers the skull is the
pfrioranium.

The hones are compounded of earthy and animal matter. From
the former — phosphate and carbonate of lime — they receive their
strength; from Llu' latter — cartilage — they derive their life.

''ut a bone for a few days into diluted nnuiatic acid, — one part
of acid to six of water, — and the i)ho8i)hate and carlK)nate of lime

will all l)e removed, while
the bone will remain the
same in shape. It will now
l)e comparatively soft, and
may l)e bent, or even tied
into a knot without break-
ing. Place a similar lK)iie
in the tire for a few houix,
and it will also retain its
shape, but the cartilaginous
portion will Ite gone. It is
now brittle, and may Ih;
picked in pieces with the fingers.

The bones are divided into those of the head, thirty ; of the body,
fifty-four; of the upper limbs, «ixiy;foMr ; and of the lower limtjs,

xixty.

Bones of the Head.

The bones of th head are divided 'into those of the »kull, the ear,
and the/fflrv.

The skull has eight bones. They are composed of two plates, one
above the other, with a porous partition between. These two plates
are capable of giving the brain very powerful protection against in-
jury, the outer one being fibrous and tough, — the inner one, hard
and glass-like, and hence called vitreous.

The middle layer has the name of diploe. Its spongy nature
deadens the jar from a blow inflicted upon the outer table. In euily
life, when the bones are tender and yielding, tlxis porous layer is not
needed, and is not found.

Fio s.

In the
backbon(
Ijieast-bo
ealled
cavities,

TJie
»> front,

ANATOMY.

1)6

in, one
pliites
i8t iii-
j, hiivd

I nature

eiivly
is not

Fio. 4.

That the bonps of the skull may not eiwily Hlip by eiioh otlier, and

^'t't out of place, tlicy arc ilovftailiil tojrcther in curiouH lineH called

HiUium. In advanced yeui'H, tlieHe gen-
erally cloHc .ip, the ItoiieH uniting (irmly

together. In early life they are <|nito

open, the Hrin iKtncH nut covering the

whole hniiii. The ojM'iiinj,' of the

coronal suture in childhood in called a

fontanelle. It present* a soft place

upon tlie top of the head, where the

tinker could l)e jjreHsed down into the

liniin. In Figure 4, — 1, 1, hIiow the

coronal HUture on the front and upper

part of the skull ; 2, the Hagittid Huturo

on the top of the skull ; and 8, 3, the

liiM»hdoi(hvl suture, nuining down on

each side of tiie l«vck part of the skull.

Figure 5 shows the skull-bones sepamted from each other at the

sutures : 1, the frontid bone ; 2, the parietivl ; 2, the occipitjil : 4, the

toiupond ; 5, the niwal ; 6, the malar ; 7, the superior maxillary ; 8,

the unguis ; 9, the in-
ferior maxillary. Ar-
nott has demonstrated
that the form of the
skull is the best possible
for sustaining weights,
and resisting blows. The
oummit of the head is a
complete arch, like that
of a bridge.

The ear has .our
small l)one8, whi^^h aid
the sense of hearing.

The bones of the face

are fourteen in number.

They hold the soft part«

in place, and aid in

F.O. B. grinding the food.

Bones of the Trunk.

In the trunk there are twenty-four ribs ; twenty-four pieces in the
backbone or spinal colunui ; four bones in the pelvis and hips ; one
breast-bone, called sternum ; and a bone at the base of the tongue,
called 08 hyoides. They are so put together as to form two great
cavities, namely, the thorax or chest, and the abdomen or belly.

The n'6«, connecting with the backbone behind and the breast-bone
in front, form the thorax, wliich contains the lungs and heart. Fig.

Fl<l. 6.

B ANATOMY.

<i hIiowm tho natural form of the lunilthy f l>08t : 1, is the flpino ; 2, 2,
tliH cnllai'-ltoiiuH ; 8, !l, the hcvcii upjK!!. or tnut lilw; 4, 4, th« five
lower or fiilw rWm; f), tho lirciiHt-lMJiic, i.» which tho tnio lilw arc

united ; (), the sword-Hhaped
«artilapo whir.li conHtitutos tin-
lowor (Mill of tiic hroaut-liono.
called enxifonii rartilage. ; 7, 7,
the upper part (»f two lungs ; 8,
H, the right luug, scon hotwoen
tho ril»H ; 9, 1>, tho left lung ; 10.
10, the heart; 11, 11, the dia-
phragm, or midriff; 12, 12, the
liver; IH, 18, the stomach, 14,
14, the second stomach, or
duodenum ; li), the transverse
colon; IH, tho upper part of the
colon on right side ; 1 7, upper
part of colon on left side.

Fdch piece of the spinal col-
umn is called a vertebra. Upon
every one of these are seven
projections, called processes — a part of which are for linking the
bones together, and the rest to furnish
attachments for tho muscles of the back.

The projections are linked together in
such a way, that a continuous channel or
opening runs down through the whole,
in which is lodged the spinal cord, or
medulla spinalis. This nervous cord is
'jonnected with the base of the brain, and
is u kind of continuation of it.

Between all the vertebrae are certain
cartilaginous cuBhions, which, when com-
pressed, spring back, like India rubber,
and thus protect the brain from being injuriously jarred by running,

leaping, or walking.

The pelvis has four bones :
the two nameless bones — iih
nominata, the sacrum, and the
coccyx. In the side of each of
the nameless bones is a deep,
smooth cavity, called the aite-
tabulum. Into this the round
head of the thigh-bone is nicely
fitted. When the bone is
thrown out of this cavity, the
hip is said to be out of joint.
*'"'• *• The sacrum took its name

FlO. 7.

froi'i
llieiu,
• if (ho
ilie in
", a, t
PdIh'n
culunii

FlO. 9,

ened in tl
nieut, form
•iieubs. A
fore-arm.
%9: 1,
head which
which unit<
Of the t\
"»ites with
"fher bone
— o'l the sf
^[« ««}, witi
"'e ulna ; 2
wJ'ich the ll
!'f the ulna
J"'"t; 6, tlu

MHi

AK ATOMY.

lies :
ill'-
1 the
of
leep,
1 ace-
luiul
cely
is
the
bint,
line

froi'i the (net tliiit tlio hciithuim iiHcd to offer it in siicriflcu'. With
iht'iii, it wiiM the hiujimi hoiii;. Thu iMxicyx is tlic h)wur teiiniMiitioti
(if tlio iMukfK)!!!!. Tlit'Ht) Imhuih iiiM! lepreHoutJMl ill Vi^r. H: 1, 1, lM'illJ»
I hit iiinniiiiiiat^i, 2, thi* Hiutruni ; 8, the coccyx ; 4, 4, the iicotuhuluni :
II, II, i\w (tiihic portion of the niiineUm.s iKUieH ; d, the arcli of tlie
|)iih(>H ; (\ thu union of thu mierum and the lower end of the upinul
cohiinn.

Bones of the Upper Extremities.

Thk should fr-hlaile (seapuhi), the collar-hone, (clavicle), the h<yne of
the upper arm (humerus), tho two hones of the forearm (ulna and ra-
dius), the hones of the wrist (carpal Ixmes), the hones of the
\pnlms of the hand (inetivcarpal Iwnes), the hones of the
thuinh and Jini/ers (phalanges), — these are the bones of
the upper limbs.

The eollar-hone is fastened at one end to the breast-bone,
at the other end to the shoulder-blade. It keeps the shoul-
ders from dropping forward. Many persons allow it to fail
of this end by getting very much bent in early life. This
happens at school, when children are allowed to sit in a
stooping posture. In the French, a race re-
markable for a straight, upright figure, this
bone is said to be longer than in any other
people.

The shoulder-hlade lies upon the upper part
of the back, forming the shoulder. It has a
shallow cavity (glenoid cavity), into which is
inserted the head of the upper arm-lK)ne. Sev-
eral strong muscles are attached to the eleva-
tions of this bone, which keep it in its place,
and move it about as circumstances require.
The upper arm-hone has its round head fast-
ened in the glenoid cavity, by the strong capsular liga-
ment, forming a joint capable of a preat number of move-
ments. At the elbow it is united with the ulna of the
fore-arm. It is a long, cylindrical bone, represented by
l^'ig. 9: 1, is the shaft of the bone ; 2, the large, round/
head which fits into the glenoid cavity; 8, the surface!
whieh unites with the ulna.

Of the two bones of the fore-arm, the ulna is on the inner side, and
unites with the humerus, making an excellent liinge-joint. The
otlier bone of the fore-arm, the radius, lies on the outaide of the arm,
— on the same side with the thumb, — and unites, or articulates, as
we sa), with the bones of the wrist. In Fig. 10: 1, is the body of
the nlna ; 2, the shaft of the radius ; 4, the articulating surface, with
whieli the lower end of the humerus unites ; 5, the upper extremity
of the ulna, called the olecranon process, which forms the elbow-
j'>int ; 6, the point where the ulna articulates with the wrist.

Fio. 9.

FlO. 10.

ANATOMY.

The eight bones of the wrist or carpus are ranged in two rows, and
being bound close together, do not admit of
very free motion. In Fig. 11 : 8, is the scaphoid
bone ; L, the semilunar bone ; c, the cuneiform
bone ; P, the pisiform bone ; T, T, tlie trapezium
and trapezoid bones ; M, the os magnum ; u, the
cuneiform l)one. The last four form the sec-
ond row of carpal bones. 11, 11, are the meUi-
carpal bones of the hand ; 2, 2, the first mnge
of the finger-bones ; 3, 3, the second mnge of
finger-bones ; 4, 4, the third range of finger-
bones ; 5, 6, the bones of the thumb.

Of the five metacarpal bones, four are atr
tsiched below to the first range of the finger-
bones, and the other to the firat bone of the
thumb, while the whole are united to the second
range of the carpal bones above.

Bones of the Lower Extremities.

These are the thigh-hone (femur), the knee-pan (patella), the shin-
bone (tibia), the Hviall hone of the leg (fibula), the bones of the instep
(tarsal bones), the hones of the middle of the foot (metji-
tarsal bones), and the hones of the toes (phalanges).

The thigh-bone is the longest bone in the system. Its
head, wliich is large and round, fits admirably into the
cavity in the innominatum, called acetabulum, and forms
what is called a ball-and-socket j int. In Fig. 12 : 1, is
the shaft of the thigh-bone (femur) ; 2, is a projection
called the trochanter minor, to which some strong mus-
cles are attached; 3, is the head of the femur, which fits
into the acetabulum ; 5, is the external projection of the
femur, called the external condyle ; 6, the internal con-
dyle ; 7, the surface which articulates with the tibia,
and on which the patella slides.

The knee-pan or knee-cap (patella) is placed on the
front of the knee, and being attached to the tendon of
the extensor muscles above, and tf) the tibia by a strong
ligament below, it acts as a pulley in lifting up the leg.

The shin-hone (tibia) is the largest of the two in the
lower leg, and is considerably enlarged at each end.

The email bone Oi the leg (fibula) lies on the out-
side, and is bound to the larger bone at both ends. Fig.,
13 shows the two bones of the leg: 1, being the tibia ;|
5, ihe fibulo ; 8, the space between the two ; 6, the
junction of the tibia and fibula at the upper extrem- '"■
ity ; 8, the internal ankle ; 4, the lower end of the tibia that unites

That he
Joints are
«o coustrucl
«ach other,
tilings, a

ANATOMY.

with one of the tarsal lx)ne8 to form the ankle-joint; 7, the upper
end of the til)ia, which unites with the femnr.

The instep (tiiraus) has seven Iwnes, which, like those of the
wrist, are so firmly l)oun(l together as to allow but a limited motion.

The metatarsal houi's, corresponding with the palm of the hand, are
five in number, and unite at one end with the tarsal l)ones, and at
the other witli the first range of the toe-bones.

The tarsal and mebitjirsal bones are put together in the form of
an arch, the spring of which, when the weight of the body descends
upon it in walking, prevent** injury to the organs above. (Fig. 14.)

The phalanges have fourteen bones. The great toe has two miiges

FlO. 14.

FiO. 16.

Fia. 18.

v.f bones ; the other toes have three. Fig. 15 gives a view of the
upper surface of the bones of the foot : 1, is the surface of the as-
tragalus where it unites with the tibia ; 2, the body of the astragalus ;
3, the heel-bone (os calcis) ; 4, the scaphoid bone ; 5, 6, 7, the cune-
iform bones ; 8, the cuboid ; 9, 9, 9, the metatarsal bones ; 10, the
first bone of the great toe ; 11, the second bone ; 12, 13, 14, three
ranges of bones forming the small toes.

liki*

The Joints.

That bones may be of any use, they must be jointed together.
Joints are of the greatest importance. It is necessary they should be
80 constructed that then^ shall be no harsh grating of the bones upon
each other, and no injurious jars in walking, etc. To prevent these
things, a hard, smooth, and yet yielding, cushion-like substance is

*«^l

■MMM

• ■

W ANATOMY.

required between them in joints. Such are tlie cartilages. Fig. 16
ifivcH a specimen oi these intervening cartilaj,'('8. I), is the body of

a lM)ne, at the end of

wliich is u socket ; C,

the cartilage lining the

socket, tiiin at the sides

and thick in the centre ;

B, the body of a bone, at

^o. 16. the end of which is a

round head ; C, the investing cartilage, thin at the sides and thick

in the centre.

Cartilage grows thinner, harder, and less elastic in old age. Hence
old people are not quite as tall as in middle life, and a little stiffer
in their joints.

The synovial membrane is a thin layer covering the cartilage, and
being bent back upon the inner surface of the ligaments, it forms a
closed sac. From its inner surface a sticky fluid oozes out, which
helps the joints to play easily.

There are other smaller sacs connected with the joints, called
bursa mucosae. They secrete a fluid similar to that from the syno-
vial membrane.

Fig. 17.

FlO. 18.

Fta. 19.

The ligaments. To retain the bones in their places at the joints,
some strong, flexible straps are required to stretch across from one
to the other, and to firmly unite them. Such are the ligaments.

They are the pearl-colored, lustrous, shining parts about the joints,
in the form of straps and cords. There are a number of them so
woven together as to form a complete covering of the joint, called a
capsular ligament. In Fig. 17 : 1, 2, are ligaments extending from
the hip-bone, 6, to the femur, 4. In Fig. 18: 1, is the socket of the
hip-joint; 2, head of the femur, lodged in the socket; 3, the ligament
within the socket. In Fig. 19: 1, is the tendon of the muscle whicli
extends the leg ; 2, the knee-cap (patella) ; 3, the anterior ligament

ANATOMY.

of the ])atella; 6, the long external lateral ligament; 4, 4, the syno-
vial membrane ; 5, the internal lateral ligament ; 7, the anterior and
superior ligament that unites the tibia with the tibula.

Uses of the Bones. .

The bones are to the body what the frame is to the house. They
hold up and retain the other parts in their proper places. They fur-
nish points of attachment for the muscles, to hold the body together
and to give it motion. They also furnish strong, bony cavities for
the lodgment and protection of such delicate organs as the eye, the
brain, and the heart.

A single bone, examined by itself, might not seem to have much
beauty or design about it; it might even look clumsy and misshapen.
But when all the bones are inspected with reference to each other,
we immediately discover a general plan upon which they are made,
and are compelled to admire their beautiful harmony, and the sym-
metrical grace with which they act. They show us that God can
command our wonder, even in the bony frame of our bodies.

^ts,
l)ne-

its,
so
a
lorn
Ithe
lent
tch
lent

The Huscles. .

That part of the animal's body which we call lean meat is com-
posed of muscles. We have already explained that muscles are com-
posed of threads, etc., put together in great numbei-s, forming bundles.
So numerous are these threads and bundles in some cases, that the
muscles which are composed of them have a strength truly wonderful.

Toward the end of the muscle, the fibres cease, and the structure
is so modified as to become a white cord of great density and strength.
This cordy substance is fastened to the bone so strongly, that it is
impossible, except in some rare cases, to detach it. Generally the
bone will sooner break than this attachment will give way. Some-
times this cord spreads out like a membrane. It is then called fascia
or aponeurosis.

The fibres of a muscle have the peculiar property of contractiriff
under a nervous stimulus sent to them by the will. These contrac-
tions cause them to act as pulleys, and to move the bones, and conse-
quently tlie limbs and body, in such direction as the will commands.
This is the special use of the muscles. All our movements are caused
by them. They pull us about, not . blindly and at a nmdom, but
under the direction of an intelligent will.

The manner in which a muscle aista, with the cord attached, may
l)eseen by examining the leg or " drum-stick " of a fowl. If the cord
on one side be pulled, the claws are shut ; if that upon the other
side he drawn, they will open. If both be pulled, they are held fast
in one position, neither opening nor shutting.

An examination of a piece of boiled lean meat will show the

ANATOMY.

FlO. 20.

threads of which it is composed, With proper instruments, these may
be unravelled, as it were, until fibres will be found not larger than a
spider's web. These, covered with sheaths of great delicacy, extend
beyond the fleshy fibre, and with the cell-sutetance connecting the
fibres, are condensed into t' don.

Millions of these sheathed fibres are gathered into a bundle, and
covered with a sheath, and thus form what is called & fasciculus. A
muscle is a number of these fascicula made into a bundle, and cov-
ered with a sheath called n fascia (Fig. 1).

The arm is a number of muscles bundled together, and covered,
likewise, by a fascia.

The fibres in a fasciculus being parallel, act together. But the
fasciculous bundles which make up a muscle act in various ways.

Shape of the Muscles. — Some muscles are fusiform or spindle-
shaped, so that the attachment occupies but a
small space (Fig. 20).

Other muscles are radiate or fannshaped (Fip,
21). Such is the temioral muscle, the thin
edge of which is attache I to the side of the head,
without producing an elevation or deformity.

In some cases the fasciculi are arranged upon
one or both sides of a tendon. In this way a
great number may concentrate their action upon

a single point. Such muscles are called penni-
form, — hieing shaped like a feather (Fig. 29).

In other instances, the fasciculi form circular
muscles, — orhiculares, or sphincters, as
These surroiuid certain openings iijto the
body, which thry are designed to close, either in whole or
in part. They surround the eyelids, the anus, the mouth
of the womb, etc. (Fig. 23).

In still other instances the fasciculi are ranged side by side in

rings, forming muscular
tubes. By the successive
contraction of these rings,
^^° 24. any substance is drivt'ii

through the tube, — as food or drink through the gullet of a cow.
Fig. 24 is a section of the gullet : a, b, show the circular fibres :
«?, the longitudinal.

Sometimes the fasciculi curve around in paiuUel layers or intei-
lace with each other, forming a bag or pouch. By the contraction
of these fasciculi, the contents of the bag will be turned from side
to side as in the case of the stomach, or driven out, as in that of tlic
heart. Fig. 25 sluiws the muscles of the stomach : L, represent*! the
fibres running in one direction ; c, in another ; E, lower end of gullet :
( >, pylorus ; i), beginning of duodenum, or second stomach.

FlO 21

FlO. 32.

they are called.

FlO. 23.

r'Z^r — rr:K^-

PI. 8.

Numbe

as tlic rojK
iinatoinists
They ar
trunk, tlios
tien.

They ar«
this brief a
iiiider tlie
while auotl
tai y, movin
the will,
latter kind,
it to keep r
and mind a

On the

layers of ini

other. Sucl

**''«ry to pel

movements

arms, etc. ]

liatc. hope, f

made expres

The diapl

cavity of the

penetrated b

blood-vessels

• over of a di:

the breath is

the chest at 1

out, the revei

Mode of Ai

spoken, is sin

"loved : 1, is ,
'•"lies below tl
attachments o

*>.^(irtjii

MUSCLES OF THE HUMAN BODY

ANATOMY.

29^

Number of Muscles. — The muscles of the iKidy arc nn numerous
lis the ropes of a ship, — there being five hundred or more. Some
iiiiiitoiniste reckon more, some less.

'llii'Y are divided into those of the head and ttenk, those of the
Inni/c, those of the upper extretnitiea, and those of the lower extremi-
tie».

They are too numerous to be named and indivithially described in
tliis brief account of them. A part of them are voluntary, tliat is,
under the control of the will ;
while another part are involun-
tary, moving without reference to
tlie will, 'rhe heart is of the
hitter kind, it being necessary for
it to keep moving when the will
and mind are asleep.

On the back there are six
layers of muscles, one above an-
other. Such a number are neces-
sary to perform the numerous
movements of the back, neck.
anus, etc. Every expression of the human face, as joy, sorrow, love,
liatc. liope, fear, etc., is produced by the gentle pulling of muscles,
made expressly to indicate these emotions.

The diaphragm is a large flat muscle, reaching across the great
cavity of the body, and dividing the chest from the abdomen. It is
l)i'iietrated by the gullet going to the stomach, and by the great
blood-vessels leading to and from the heart. It is shaped like the
cover of a dinner-dish, the convex surface being turned up. When
the l)reath is drawn in, it sinks down towards a level, thus enlarging
tlie chest at the expense of the belly. When the breath is thrown
out, the reverse takes place.

Fio. 25.

Mode of Action. — The cordractibility of a muscle, of which I have
spoken, is simply its power of shortening itself. The hand is raised

g by the shortening of a mus-
cle in front, attached to the
bone above the elbow, and
to a bone below the elbow.
The contraction of an an-
tagonistic muscle behind,
also attached alwve and be-
low the elbow, brings the
iK''ud back to its place. Fig.
26 shows how all joints are
"lovfd : 1, is the bone of the arm above the elbow ; 2, one of the
'xjiies l)elow the elbow ; 3, the muscle wliich Iwnds the elbow ; 4, 5,
iittaeliinents of muscles to bones ; 6, the muscle that extends the

Fio. 2G.

i. :

ANATOMY.

eU)ow ; 7, attachment to elbow; 8, weiglit in hand. The nuiHcle, 3,
contiacts at the central part, and hringn the hand up to 9, 10.

The complication, variety, and Hwiftness of motion, executed by
muscles, are past conception. Every movement which a human be-
ing makes, from the heavier motions of the farmer in cultivating his
fields, up to the magic touches of the painter's brush, and the metliod-
ical frenzy with which the great master's fingers sweep the piano, are
all made by muscles obeying an intelligent will.

The Teeth.

The teeth are not like other bones, either in composition, method
of nutrition, or growth. When broken they do not unite, not being
furnished with the necessary power of reproduction of lost parts.

Both the upper and lower teeth are set into l)ony sockets, called
alveolar processes. These, with the fibrous gums, give the teeth a
very firm setting.

Origin. — The teeth have their origin in little membranous
pouches within the bone of the jaw, which, in their interior, have a
fleshy bud. From the surface of this the bone or ivory exudes. Tiie
tooth and the Iwny socket are developed and rise up together, — the
former, when sufficiently long, pushing itself through the gum.

Number. — The first set of teeth are only temporary, and are called
milk-teeth. There are but twenty of them. lietween the age of six
and fourteen, these become loose, ard drop out, and the permanent
teeth appear in their places. Of these there are thirty-two, sixteen
in each jaw.

Names. — The four front teeth in each jaw, a, h, Fig. 27, are the
cutting teeth (incisors) ; the next one, c, is an eye-tooth (cuspid) ; the

Fig. 27.

next two, d, Cs are dmall grinders (bicuspids) ; the last three, /, g, h,
are grinders (molars). One appears late on each side, from the age
of twenty to twenty-four, and is called wisdom tooth.

Compo

• int-ernal p
the surfac
which rise
which is c
root or far
vessels pat
into the tc
in tooth-a(

The inc

solid parts,

In niii8ti(

aiuklown r

motion. J

muscles. ]

vegetable-ea

while man

a pretty clei

The teeth

and symmet

kept in goot

their decay i

are spoken o

The alimei
the pharynx,
chyle vessels
oreas).

The prepai
takes place in
cretion of the
on each side.

The Parotli

"peniug into tl

i^^y- This is

Hence the dise

TlieSubma

ot Its angle. ;
of the tongue (
On each side
'''^ne of the ;
P«««» its saliva

ANATOMY.

Composition.— A tooth is composed of ivory and enamel. The

int^.>rnai part is ivory, which is harder than bone. The coating upon
the surface is enamel, which is still harder than ivory. That part
which rises above the jaw-bone is called the crotvn ; it is this only
which is covered with enamel. The part within the jaw is called the
root or fang; this is composed of bony matter, through which small
vessels pass in to nourish the tooth. Small white nerves also pass
into the tooth. — of the presence of which we have terrible eviilenoe
in tooth-ache.

Use of the Teeth.

The incisors cut the food asunder; the molars break down its
solid parts, and grind it to a fineness which fits it for the stomach.

In niivsticating the food, the lower jaw has two movements, the up-
lUuWown motion, like a pair of sheai-s, and the lateral or grinding
motion. These two movements are performed by different sets of
iiuuscles. P'lesh-eating animals have only the up-and-down motion ;
vegetable-eating animals have only the lateral or grinding motion ;
while man has both the up-and-down and the lateral. This seems
a pretty clear intimation that he is to eat both flesh and vegetables.

The teeth aid us in articulating words, and they give a roundness
and symmetry to the lower part of the face. When well formed, and
kept in good condition, they add much to the beauty of the face, and
their decay is an irreparable loss. Their proper care and treatment
are spoken of in another place.

i']

The Digestive Organs.

The alimentary organs are the mouth, the teeth, the salivary glands,
the pharynx, the gullet (oesophagus), stomach, bowels (intestines),
chyle vessels (lacteals), thoracic duct, liver and sweetbread (pan-
creas).

The preparatory process of digestion, the mastication of food,
takes place in the mouth, where the food is mixed with sallAa, a se-
cretion of the salivary glands. Of these glands there are six, three
on each side.

The Parotid Qiand lies in front of the external ear. It has a duct
opening into the mouth opposite the second molar tooth of the upper
jaw. This is the gland that swells in the disease called mumps.
Hence the disease is also called parotitis.

The Submaxillary Qiand is inclosed withinthe lower jaw, in front
of its angle. Its duct opens into the mouth by the side of the bridle
of the tongue (fraenum linguse).

On each side of this string or bridle, and under the mucous mem-
brane of the floor of the mouth, lies the mhlingual gland, which
poun its saliva into the mouth, through seven or eight small ducts.

I,: ,

■■■ >

. I

ANATOMY.

A disease called the frog consists
Fig. 28: 1, the parotid gland; 2,

its

Fia. as.

the swelling of this gland,
duct ; 3, the submaxiTlary ;
^^vv>K\\wm\^w[i^^^HM^^ *4» its duct ; 6, the sublin-

<^^^HM^ gual.

f/^r^ ^iifiH^^^^I^^ ^^^ Pharynx con-

y 4BP^^'^><i^l^EI^^^^^^^^ tiiiuation the mouth, iind

lis tlie cavity just below the
[soft palate. The two piw-
Hiige.H going to the nose
(posterior nares), the one
going to the Htomach
(oesophagus), and the one
going to the lungs (larynx
and trachea ; all meet in
this cavity. In Fig. 29:
1, is the trachea ; 2, the
larynx ; 8, the oesof .lagus ;
4, 4, 5, moaflles of pharynx ; 5, muscles of the cheek ; 6, the muscle
which sui'-ounuB the mouth ; 7, the mus-
cle forming the floor of tlie mouth.

The Quilet or oeaophagus is a long tube,
dcHcending behind the windpipe, the
lungs, and the heart, thiough the dia-
phragm into the stomach. It is composed
of two membranes laid together, like two
pieces of cloth. The inner one is mucous,
the outer muscular. The two sets of
fibres composing the muscular coat are
arranged circularly and longitudinally
(Fig. 25)..

The Stomach lies in the upper part of
the belly, to the left, and directly under
the diaphragm. It has an upper opening,
where the stomach-pipe enters it, called
the cardiac orifice. This is the larger end of the stomach, and lies
on the left side ; the smaller end connecta with the upper bowel, at
which point it has an opening called the pyloric orifice. In addition
to mucous and muscular coats, similar to those which compose the
oesophagus, the stomach has still another over both, a serous coat,
very strong and tough, to give this working organ additional en-
durance. Within, it has many glands to secrete l5ie gastric juice.

The Intestines, or alimentary tube, or bowels, are divided into the
smaU and large intestines.

The small intestine has a length of about twenty-five feet, and is
divided into three parts, — the duodenum, the jejunum, and the ileum.

Of these three divisions, the duodenum is the largest, and is about

Fia. 20.

a foot in
passes l>a
down pel
the belly

The Je

The lie

angle, nea

to prevent

the ileum.

At this

caecum, a 1

dix vermifo

from one U.

The Colo

transverse c

The Ascc

surface of ti
part of the 1
portion whi<
on the left s
of the descei
which is call

The Recti!

ingattheani

The Lacte

mucous mem
tween membn
glands, from
another coUe
Passing, for a
glands to anc
progress increi
ja number, the
"ito the thoraci
»P through tl
J»lly, makes a
forward, and (
^.rge vein whic
% 30 : 1, is
nie-flenteric glar
teals pass; 6,
fuaphragnj.

% the help ,
small vessels mi
«»tofthebowe

1'.

AMATOMT.

a foot in length. It begins at the pyloric oriiice of the stomach, and
passes backward io the under surface of the liver, whence it drops
down perpendicularly in front of the right kidney, and i)a8se8 across
the belly behind the colon, and ends in the jejunum.

The Jejunum continues the above, and terminates in the ileum.

The Ileum is a continuation of the jejunum^ and opens, at an obtuse
angle, near the haunch l)one, into the colon. A valve is located here,
to prevent the backward passage of aubstances from the colon into
the ileum.

At this point the large intestines begin, and here is situated the
mcum^ a blind pouch, or cul-de-sac, attached to which is the appen-
dix vermiformi$, a worm-shaped tube, of the size of a goose-quill, and
from one to six inches long.

The Colon, or large intestine, is divided into the ascendinff colon, the
trantvene colon, and the descending colon.

The Ascending Colon rises from the right haunch-bone to the under
8urfac« of the liver, whence it bends inward, and crosses the upper
part of the belly, below the liver and stomach, to the left side. This
portion which crosses over is the transverse colon. From this point,
on the left side, it turns down to the left haunch, and has the name
of the descending colon. Here it makes a curve like the letter S,
which is called the sigmoid flexure.

The Rectum is the lower portion of the large intestine, terminat-
ing at the anus.

The Lacteals are small vessels which begin in the villi, upon tlie
mucous membrane of the small bowels. From here they pass be>
tween membranes of the mesentery to small
glands, from which larger vessels run to
another collection ol glands; and after
passing, for a space, from one collection of
glands to another, at each stage of their
progress increased in size and diminished
in number, the lacteals pour their contents j
into the thoracic duct. This having passed
up through the diaphragm, out of the
belly, makes a sudden turn downward and
forward, and empties its burden into a
large vein which ends in the right heart.
Fig. 30 : 1, is the bowel ; 2, 8, 4, the
mesenteric glands through which the lac-
teak pass ; 6, the thoracic duct ; 7, the spinal column ; 8, the
diaphragm.

By the help of a magnifying ^lass, an infinite number of these
smaU vessels may be seen starting from the rough, shaggy internal
coat of the bowel.

Fia. ao.

ANATOMY.

The metentery ih a thick sheet of membrane, formed of several
folds of the peritoneum, and spread out from the vertebras like a fan.
The bowels are attached to ite edge, »ud are held by it in their place,
and at the same time have free motion. Between its layers are a
great number of glands, which Hometimes l)ecome diseased and swol-
len in childhood, and prevent the chyle from pasHing along to the
thoracic duct. Thus affect<Hl, children are not nourished, and waste
away with a disease sometimes called mesenteric consumption.

The Liver is a large gland, lying under the short ribs on the right
side, below the diaphragm. It is convex on the upper surface and

concave on the under, and is
composed of several lolies. Its
office is to secrete bile. It
weighs about four pouiiik
Ixjing the largest organ in the
lM)dy. Fig. !U represents the
liver: 1, being the right lol)e;
2, leftlolte; 3,4,smailer lobeH;
10, gall-bladder ; 17, the notch
into which the spinal column
is fitted.

'^'*' "• The Qall-Bladder lies on

the under side of the liver, and receives, it is supposed, the surplus
bile, which is reserved for special occasions. It opens into the gall-
duct, which carries the bile along, and pours it into the duodenum.

The Pancreas, Fig. 32, is a long, flat gland, something like the
salivary glands. It lies tiansversely across the back wall of the
domen, behind the stomach.
It secretes a colorless, al-
kaline fluid called the pan-
creatic juife, the office of
wliich is to emulsify the
different classes 6f food,
so that the lac teals can ab-
sorb it. This fluid is car-
ried by a duct, and poure('
duct enters.

al>

FlO. 32.

. duodenum just where the bile-

The Spleen has an oblong, flattened form. It lies on the left
side, just under the diapliragm, and close to the stomach and
pancreas. It is supposed to be a reservoir for holding the surplus
blood of the liver. It was thought by the ancients to be the seat of
melancholy. The blood in passing through it loses a portion of its
red globules.

The Omentum or catd is a doubling and «3Xtension of the perito-
neum. It is a kind of fatty body, whicii upon the surface of the

bowels
(iate tl
Hence

The
thi! hlo(
kidneys.

The*

region, I

imd two

and weij

called tl

ureter w

kidney is

01' cortict

tlie bloot

'i^i^y the

TheUi

and eight
men, behi
they empt

The Bli

composed

and the in

the interna

it secretes

rosiveness

means of a

"f the orga

iw to give s

relaxes and

The blad

peritoneum,

the bladder

This orga

'"thout it, A

dribbling aw

The Uretl

of the bladd(
tic fibrous,
urine passes

mt^

ANATOMY.

lus
lot

Ihe

bowels and is iit.taclu'd to tlie stomivch. Its use Heems to l)e to lubri-
cate thu l)owel8, and uspecially to protect and keep them warm.
Hence it is often called the apron.

The Urinary System.

The organs of this system are devoted to separating the urine from
the l)loo<i, and carrying it out of the lM)dy. These organs are the
kidneys, the ureters, the bladder, and the urethra.

The Kidneys lie one on each side of the Imckbone, in the lumbar
region, l)ehind thu peritoneum. They are four or five inches long,
and two and a half broad. They are in shape like the kidney-bean,
and weigh about half a pound each. In tlie centre there is a bag
called the pelvis, -which tapers like a funnel, and unites with the
ureter which convevs the urine to the bladder. The texture of the
kidney is dense, presenting in its interior two structures, an external
or (;ortical, and an internal or medullary. The cortical portion has
the blood-vessels, the medullary is composed of tubes which carry
away the urine.

The Ureters are membranous tubes of the size of a goose-quill,
and eighteen inches long, which run down the back wall of the abdo-
men, behind the peritoneum, to the bladder, into each side of which
they empty their contents. *

The Bladder is located in the pelvis, in front of the rectum. It is
composed of three coats; the external is serous, the middle muscular,
and the internal mucous. The external coat is strong and fibrous ;
the internal is drawn into wrinkles, which makes it thick and shaggy;
it secretes a mucus whirh prevents it from being injured by the cor-
rosiveness of the urine. I'he urine is retained in the bladder by
means of a circular muscle, called a sphincter, which draws the mouth
of the organ together. When the quantity of urine is so increased
as to give some uneasiness or pain, this miiscle, by a sort of instinct,
relaxes and lets it out.

The bladder is attached to the rectum, to the hip-bones, to ihe
peritoneum, and to the navel, by several ligaments. In the female
the bladder has the womb between it and the rectum.

Tliis organ is wisely provided as a receptacle for the urine ; v/nich,
mthout it, would produce a great inconvenience by being constantly
dribbling away.

The Urethra is a membranous canal which leads from the neck
of the bladder. It is composed of two layers, a mucous and an elas-
tic fibrous. Through this channel, which is curved in its course, the
urine passes out of the body.

■^:

ANATOMY.

The Respiratory Organs.

These organs consist of the windpipe (trachea) ; divinont and
mbdiviaiona of the windpipe (bronchia) ; air-cells ; and the lungs or
lights.

The Windpipe (trachea) extends from the larynx — the seat of the
voice — to the third dorsal vertebra, where it divides into two tubes,
called bronchia. It runs down the ' <nt part of the throat, with the
oesophagus behind and between it s.",d .he spinal column. It is com-
posed mainly of rings of cartilage, i>.ie ubove another.

The Bronchial Tul>es are, at the div' n of the windpipe, two in
number, but they divide and subdivide until they become very nu-
merous.

The Air-Celis or Vesicles are small, bladder-like expansions at the
ends oi the tubes. They are elastic and swell out when the air
passes in.

The Lungs All the greater part of the chest, the heart being the
only other organ which occupies much space in the cavity. The
size of these organs is larg^ or small, according to the capacity of the
chest. Ea ch lung — for there are two — is a kind of cone, with its
base resting upon the diaphragm, and its apex behind the collar-bone.
They are concave on the bottom, to fit «he diaphragm, which is con-
vex on its upper side.

The right and left lungs are separated from each other by a parti-
tion called the mediastinum, formed by two portions of the pleura, a
smooth serous membrane coming off from the spine and closely en-
veloping each lung ; the heart, covered by the pericardium, lies
in the centre, between them. The right lung is divided into three
lobes ; the left into two.

Each lobe of the lungs is divided into a great many lobules, which
are connected by cellular tissue. These lobules are again divided
into very fine air-cells. Besides these, the substance of the lungs is
compof t= i likewise of blood-vessels and lymphatics, and is well su^)-
plied with nerves.

In the foetal state, before the lungs have been filled with air, tLay
are solid and heavy, something like other flesh, but after all their
cells have been filled with air, and breathing has been established,
they are exceedingly light and spongy, and float upon water.

In cases where infanticide is suspected, and where it is desirable
to know whether the child was still-bom, or bom alive and killed
afterwards, the specific gravity of the lungs, compared with water,
will often settle ^e question.

The foe

lacteals, ca
tlie lungs, i
if not distr
fecting thif
capillaries.

The Hea

side, and is
form is som
ward in the
the left, occ
three inches
case or sac.
The heart
it is endowe(
sides, a right
cular partitic
the lungs ; t
side is divide

The Auric

i^servoirs to 1
parts.

The Ventri

carnece. The
I'ight, beirg r
cavities will c

The Tricus

on the right
'uembrane. '
side. Small ^
pass from th
columnae earn
«re of the bl<
the auricles.

'^if pvlmot
"ght ventricle
"f the left ver
arteries are nn
valves. Fig. 3
^ is tlie right j
Jght ventricle
'll 10, the vesse
the heart.

BMi^

ANATOMY.

The Organs of Circulation.

The food having been digested, changed to chyle, absorbed by the
lacteals, carried to the veins, poured into the right heart, sent up to
the lungs, and prepared for nourishing the body, will still be useless,
if not distributed to every part of the system. The organs for ef-
fecting this distribution are the Jieart, the arteries, the vein*, and the
eapillariea.

The Heart is placed obliquely in the chest, with one lung on each
side, and is enclosed between the two folds of the mediastinum Its
form is something like a cone. Its baae is turned upward and back-
ward in the direction of the right shoulder; the apex forward and to
the left, occupying the space between the fifth and sixth ribs, about
three inches from the breast-bone. It is surrounded by a membranous
case or sac, called the pericardium.

The heart is a muscular body, and has its fibres so interwoven that
it is endowed with great strength. It is a double organ, having two
sides, a right and a left, which are divided from each other by a mus-
cular partition, called a septum. The right heart sends the blood to
the lungs ; the left heart distributes it to the general system. Each
side is divided into two compartments, an auricle and a ventricle.

The Auricles have thinner walls than the ventricles, being only
reservoirs to hold the blood until the ventricles force it along to other

parts.

The Ventricles have within them fleshy columns, called columnce
earnece. The walls of the left ventricle are thicker than those of the
right, beirg required to contract with more force. Each of the four
cavities will contain from one and a half to two ounces of blood.

The Tricuspid valves are situated between the auricle and ventricle
on the right side, and consist of three folds of a thin, triangular
membrane. The mitral valves occupy the same position on the left
side. Small white cords, called chordce tendince, 8^ Lio

pass from the floating edge of these to the
columnas earner, to prevent the backward press-
ure of the blood from carrying the valves into
the auricles.

The pvlmonary artery is the outlet of the
right ventricle ; the larger artery, called aorta,
of the left ventricle. At the opening of these
arteries are membranous folds, called semilunar
valves. Fig. 33 gives a fine view of the heart :
1. is the right auricle ; ti, the left auricle ; 8, the
right ventricle ; 4, the left ventricle; 5, 6, 7, 8,
9, 10, the vessels which bring the blood to and carry it away from
the heart.

Fia. 8S.

ANATOMY.

The Arteries are the round tubes which carry the red blood from
the left side of the heart to every part of the body.

The sides of arteries are stiff and hard, and do not fall together
when empty. They may often be seen open in a piece of boiled beef.

The arteries have tlu-ee coats, — an external, which is cellular, firm
and strong ; a middle, which is fibrous and elastic ; and an internal,
which is serous and smooth, being a continuation of the lining of
the heart. They are surrounded by a cell vestment called a sheath,
which separates them from surrounding organs.

The Pulmonary Artery starts from the right ventricle in front of
the opening of the aorta, and ascends to the under surface of the
aortic arch, where it parts into two branches, sending one to the right,
the other to the left lung. Having divided and subdivided to a great
extent, they end in the capillary vessels, uniting, joining their mouths,
and becoming continuous with the pulmonary veins just where they
pass around the air-cells.

The Aorta is the largest artery in the body. It takes a slight turn
in the chest, called the arch of the aorta, from which are given off the
arteries which carry the blood to the head, etc. ; thence it descends
into the belly along the side of the backbone, and at the bottom of
the abdomen it divides into two arteries, called the iliacs — one going
to each of the lower limbs. The branches the aorta gives off a supply
of red blood to every part of the body.

The Veins carry the dark or purple blood. Being made red and
vital by meeting atmospheric air in the lungs, and then conveyed to
every part of the body in the arteries, the blood loses its redness in
the capillaries, and comes back to the heart in the veins, dark and
purple, and unfit to support life. The veins are more numerous and
nearer the surface than the arteries. They have, likewise, thinner
walls, and when empty, they collapse or fall together. They begin
in the small capillaries, and running together, they grow larger and
larger, and finally form the great trunks which pour the dark blood
into the right auricle. The veins are composed of three coats, simi-
lar to those of the arteries, with the exception of being thinner and
more delicate. These vessels have valves all along their inner sur-
face, to aid in circulating the blood.

The large vein which receives all the dark blood from above, and
pours it into the right auricle, is called the vena cava descendens ; the
one which takes it from below, tvnd disposes of it in the same manner,
is the vena cava ascendens.

The pulmonary veins bring the red blood from the lungs to the left
auricle, and thus are exceptional in their use, — being the only veins
which carry red blood.

The Capillaries are the extremely fine network of vessels between
the ends of the arteries on the one side, and of the veins on the other.

THE

mat

PI. 4.

THE ARTERIES AND VEINS OF THE HUMAN BODY

Tli(>y inos(

one end, a

industrioui

red, and i\

tliey take t

and vitaliz

beginnings

for another

in the lun^

In Fig.

lation. Fi

thrown int

tery, 3, ar

<!arry it to

capilhiry v(

conies in (

and l)ecom

Thence it i

auricle of

veins, 7, 8.

into the le:

forcible C(

sends it foi

11. Its b

distribute i

Iwdy. The

in the capil]

the blood 1(

goes back t

1, by the ve

15, and tht

ens, 16. T

17, prevent

blood from

to the right

lunar valve

blood from

ventricle.

the left ven

vent the bai

Ky a care
the reader n

The passa
and back t'>
its passii- f:
to the right

ANATOMY.

Tlicy inosculate, or join their nioutlis to tlic very small arteries at
one end, and to the equally small veins at the other. They are the
industrious little builders of the human frame. Receiving the blood,
red, and full of life, from the terminal extremities of the arteries,
they take the living particles out of it, and apply them to the renewing
and vitalizing of the body, and then pass it along into the hair-like
beginnings of the veins, dark and Iwreft of vitality, to he carried up
for another freight of chyle, and to be again vitalized by being touched
in the lungs by the breath of heaven.

in Fig. 34 we have a good ideal illustration of the whole circu-
lation. From the right ventricle of the heart, 2, the dark blood is
thrown into the pulmonary ar-
tery, !J, and its branches, 4, 4,
carry it to lx)th lungs. In the
capillary vessels, 6, 6, the blood
conies in contact with the air,
and becomes red and vitalized.
Thence it is returned to the left
auricle of the heart, 9, by the
veins, 7, 8. Thence it passes
into the left ventricle, 10. A
forcible contraction of this
sends it forward into the aorta,
11. Its branches, 12, 13, 18,
distribute it to all parts of the
l)ody. The arteries terminate
in the capillaries, 14, 14. Here
the blood loses its redness, and
goes back to the right auricle,
1, by the vena cava descendens,
15, and the vena cava aacend-
ens, 16. The tricuspid valves,
17, prevent the reflow of the
blood from the right ventricle
to the right auricle. The semi-
lunar valves, 18, prevent the
blood from passing back from the pulmonary artery to the right
vcntricrle. The mitral valves, 1 9, prevent its being forced back from
the left ventricle to the left auricle. The semilunar valves, 20, pre-
vent the backward flow from the aorta to the left ventricle.

By a careful examination of this diagram, with these explanations,
the reader may understand the circulation very well.

The passage of the blood from the right heart, through the lungs,
and back t'> the left heart, is called the lesser, or pulmonic circulation ;
its passu:^3 from the left heart through all parts of the body, and back
to the nght heart, is the greater or systematic circulation.

FIO. 34.

.J'

ANATOMY.

The Absorbent Vessels.

The vessels which absorb the chyle from the small intestines, and
convey it onward towards the blood, are the lacteaU. They have
been described. The veins are also supposed to have the power of

absorption, particularly the small
commencements of the veins.
These have likewise been de-
'^°- «• scribed.

The Lymphatic vessels resemble the lacteals
skin, the mucous membranes,
and the lungs. They are
very small at their origin,
and, like the veins, they in- •
crease in size, as they dimin-
ish in numbers. Like the
veins, too, they travel to- •

wai-ds the heart, and their

They abound in the

Fio. 36,

FlO. 37.

contents are poured into it.
Their walls are composed of
two coats ; -S.\e external is
cellular, and distensible ; the
internal is folded into valves,
like that rf the veins.

These vessels, on their
way to the heart, pass
through soft bodies, called
lymphatic glands, which bear
to them the relation that the
mesenteric glands do to the

lacteals. T
lymphatic g
arm-pits, an(
parts of the
magnified; '.
trunks; Fig
thi'ough it.

Fig. 38 rej
6, show thes(
the commenc
lymphatic ai
of the stomac
13, 14, 15, th
19, 20, the la
the heart.

A cold will
ings aie calle(
from cold, an(
larly in scrofi
and break, for

The exhalar,

Hon.

The Exhala

nations upon tl
terminations uj
posure.

The Follicle

membranes. 1
little bags. Ve

QIands are s
ing many kinds
united in one mi
lias a small d
main duct whic
shows a gland :
through its bo
1, the large duct
substance is car

The mesente
werely modify tl
tnem ; others se
fluids to be used

ANATOMY. 4J

lacteals. These glands are a ooUection ,.f small vessels. The
lymphatic glands are most numerous in the neck, chest, abdomen
arm-p,te and groins. They are also found, to some extant, in othei^
parts of the body Fig 3o shows a single lymphatic vessel, much
maguihed; Fig 36 exhibits the valves along one of the lymphatic

though it^" '' ' ^^"'P'^'^^' ^^'"^ ^''^ '^' vessels pLing

Fig. 38 represents the lymphatic vessels and glands. 1, 2, 3 4 5
b, show these vessels of the lower limbs ; 7, the inguinal gknds ;' 8,'

he commencement of the thoracic duct, into which the contents of
lymphatic are poured ; 9, the lymphatics of the kidneys ; 10, those
?q ir^.T ' ^M^"«««f i»'« liver; 12, 12, those of the lungs ;
1Q Jn' i ' t '^ °^-*^^ ^n'"' ' ^^' ^^' 1^' *h°«« of the face and neck ;
the hit ""^"^ ' *^^ *^°''''''*' '^"'*' ^^' *^^ ly'^Phatics of

A cold will' often cause lymphatic glands to swell. These swell-
mgs are called kernels. They often swell, also, without the irritation

cm cold, and become very much and permanently enlarged, particu-
arlyiu scrofula. In scrofulous subjects they sometimes suppurate
and break, forming bad sores upon the neck.

The Organs of Secretion.

^_JHE exhalants, the follicles, and the glands are the organs of seere-

The Exhalants are the sweat-glands. These have external termi-
nations upon the skin, thus communicating with the air, and internal
t.™mations upon the surfaces of organs n^ot having an' outwTrd^x-

membi-anpl,"'''T. "'" ''"^" T' i^^^^d V" ^^e true skin and mucous ^

iS iZ V ^T °^ *^' '^''^ *"" *^« ^"°"*1^« "'• o'^tlete of these
little bags. Veins and organic nerves are sent to these vessels.

aiands are soft organs, having a variety of structure, and perform •
ig many kinds of secretion. A gland is made up of severallobS
united in one mass, and each of these lobules '

has a small duct, communicating with a jSl^^. C?

main duct which forms the outlet. Fig 39
shows a gland : 2, the small ducts spread
hrough Its body, and running together;
i, the large duct, through which the secreted
substance is carried away.

The mesenteric and lymphatic glands
merely modify the fluids which pass through
tnem; others secrete from the blood either
nuids to be used in the body, or such as are to be cast away

■1^

ANATOMY.

The Vocal Organs.

No sounds touch the heart like those of the human voice, for no
mechanic, however scientific and skilful, has ever been able to make
an instrument which could produce sounds as beautiful, tones its
varied, a timbre as melodious, and inflexions as manifold and agree-
able. It has been compared to wind, reed and stringed instruments.
In touching expression, it is most resembled by the concert-horn, tlie
bassoon, and the hautboy.

Vocal sounds, paat all question, are produced in the larnyx, but
these sounds are grouped, or formed into articulate speech, by the
pharynx, the nasal cavities, the tongue, the teeth, etc.

The Larynx is a kind of cavity or tube at the top of the windpipe,
formed by the union of five cartilages, namely, the thyroid, the cricoid,
the two arytenoid, and the epiglottis. Ligaments bind these together,
and muscles move them.

The Thyroid Cartilage is composed of two parts, and has a con-
nection with the bone of the tongue above, and with the cricoid car-
tilage below.

The Cricoid Cartilage is .shaped like a ring, and hence its Greek
name. It is narrowest in front, and broadest behind. It connectfi
with the thyroid cartilage
above, and with the first ring ;
of the trachea below. Fig. 40
gives a side view of the car-
tilages of the larynx : 1, bone
at the base of the tongue (os
hyoides) : 2, the ligament con-
necting hyoid bone and the
thyroid cartilage ; .3, the front
of the thyroid cartilage ; 4, the
thyroid cartilage ; 6, the cri-
coid cartilage; 7, the wind-
pipe.
'^*'' **■ Fig. 41 is a back view of

the cartilages and ligaments of the larynx : 1, is the back surface
of the epiglottis ; 3, 3, the os hyoides ; 4, 4, the lateral ligaments
connecting the os hyoides and the thyroid cartilage ; 5, 6, the back
face of the thyroid cartilage; 6, 6, the arytenoid cartilages; 7, the
cricoid cartilage ; 8, the first ring of the windpipe.

The Arytenoid Cartilages are upon the back part of the cricoid,
and are connected with the thyroid cartilage by the vocal cords.

The Epiglottis is a fibro-cartilaginous lid, shaped like a leaf, which
covers the upper opening of the larynx. It is connected by a carti-

lage to the 1
iage. Breai
down upon i
passing dow

The Vocal

fibres, enclos
lines in widtl
antt'iior pro;
tilages, and
the anterior
are four ligi
two superior
ter being call
k'tween ther
ineiits thems
the lips of the
tween the suj
is the ventrich
Fig. 42 rep
from above: .
cricoid ; h, h,
verse ar_ytenoi(
ligaments.

The muscles
of pulling then
the laryngeal c
and to relax or
others, the soui
Tightening the

The skin is
entire person.
is the true skin
ture f,nd uses.

TheScarf-SI

"rane. partially

blood-vessels or
a simple coverii
"gents. It is tl
The scarf-skii
'rom it in the si
and dries up int
of these scales,
new layen, are £

ANATOMY.

uge to the bone of the tongue (os hyoides) and to the thyroid carti-
age. Breathing opens and shuts it; and in swallowing, it closes

down upon the top of the larynx, to prevent food and drink from

piissing down the windpipe.

The Vocal Cords are two ligaments, formed of elaatic and parallel
hbres, enclosed in a fold of mucous membrane. They are about two
lines in width, and inserted behind into the
aiitt'iior projection of the arytenoid car-
tilages, and passing forward, are fixed <o
the anterior angle of the thyroid. There
are four ligaments crossing the larynx,
two superior and two inferior, — tlie lat- 2
ter being called vocal cords. The interval
tetween them is the glottis. The ligar
ineiits themselveis are sometimes called
tiie lips of the glottu. The depression be-
tween the superior and inferior liganiciits

is the ventricle of the larynx. r

Fig. 42 represents a view of the larynx ''™' *^-

from above .• a, 6, c the thyroid cartilage, enclosing the ring of the
cricoid; A, A, e, c, the arytenoid cartilages connected by the trans-

Z^T ' '"' '' *^' ^"'"* '"'^ ' "' ''' '^' crico-aiytenoid

The muscles which are attached to the cartilages have the power
of pulling them about so a« to change in various ways the shape of
the laryngeal cavity; to enlarge or diminish the size of the riottis
and to relax or tighten the vocal cords. By these means, and some
othei., the sounds of fhe voice receive theirwious moScations
lightemng the cords, for example, raises the pitch.

The Skin.

The skin is a membrane composed of two layers, coverimr the
en .re pei.om The outer layer is the scarf-skin or^^.l-I J the fnner

luiL r,ud"ust" '' '"'" '' ""■ ^^''' ^'^"'^ ^^'' ^" '^'^ «*^««-.

The Scarf-Skin, called also cuticle and epidermis, is a thin mem-
mne- P'^rtially transparent, like a thin shaving of horn. HavinTS,
lood-vessels or nerves, and consequently no 4ling, it appear. I be
a simple covering to protect the true skin from injury by external
agents. It is thickest on those part« most exposed to friction
froi- itrl ? '' *^! production of the true skin, -an exudation
Z"^J ■ IT °^ * f""'^ ^^^^^ ^« «P"ad out aa a thin layer,
TiiT "P/"^ ^f^""^^ '''*^"«- ^^^ «^<^i«l« ^ composed chiefl; '

tl\ZT \ ^''^' '' «T**"*^y ^^"^ "'^^•^^ off ^ «curf, while
new layers are forming underneath.

ANATOMY.

The lower, softer layer of the scarf-skin, called the malpighian
layer, or rete mucosum, is the seat of ,-:rior. In this part the cells
contain a pigment incorporated with the elementary granules, which
gives to the various races their sevenil shades of color. The depth
of hue is dependent entirely on the amount of tliis coloring matter.

The True Skin, which is called vuiia^derma or coriiim, is a kind of
wel), woven of small fil)res collected into strands. In the upper por-
tion, the web is line and tirm, but grows coarser below. Connected

Fio. 43.

with its under surface is a fibrous web in which the fat is deposited.
Upon its upper surface is the sensitive or papillary layer, composed
of blood-vessels and nerves, doubled into loops, which give little
prominences called papillae. Fig. 43 gives an ideal view of these
elevations, composed as they are, of a nerve, an
artery, and a vein, lying side by side ; 1, 1,
represent the true skin ; 2, 2, the papillary
layer; 3, 3, the arteries; 4, 4, the veins; and
6, 5, the nerves of the papillse.

The arteries, veins, and nerves are spread
over the true skin in great numbers, — so pro-
fusely, that it is impossible to push the point of
the finest needle into it, without piercing a
blood-vessel and a nerve.

Fig. 44 gives a view of the skin : a, a, the
cuticle ; b, 6, the colored layer of the cuticle ;
tf, c, d, c?, the true skin ; e, e, e, fatKiells ; /,/,/
sweat-tubes.

The lymphatics are very numerous in the skin, besides which there
are oil-glands and tubes, and sweat-glands and tubes.

The Oil-Qiands are imbedded in the skin, and communicate with
the surface by small tubes. They are most abundant on the face,

FlO. 45.

nose and ears
the tube, and
1

The Sweat-i

through tlie tri
where it coils t
tory gland. Fi
nified forty diai
two excretory d
tul)e, which ope
fat-cells.
The hair and

The Nervous

nected with each
nerves; the spini

The Brain is t

wnes. It is mac

cipal parts, — the
^*'««w, and the
These are nicely
tected by three m
"wfer, the arach^
mater.

^. % 47 shows a
t'on of the brain, ■
»''d membranes
^ne scalp turned
rented by a, a ; e,
^''ge of the bonea
mater, drawn up
">" convolutions c

The Cerebrum i

'■"Kt-'i' portion of i

MH^

ANATOMY.

noBP and eare. Fig. 4.5 hI.ows an oil-glan.l,
the tube, and c, ita mouth.

— a, being the gknd, b.

W^.

th4.f rf;ui,T]^r:nVri n" *""i ^^^^'^ p- ^'-»

where it coils upon itself inSTlTn^ »" the -neshes at the bottom,

mfied forty dialtersTT^L h« -n ? f i ''''^' *''^' ^^'"»d, mag-
two excretory duct« f;om the fland it *"''"• *?'" ^''""^ ' - 2, the
tul., which opens at 4 wh ch fs th^nS'"' Tf''^ ^''"" «"« ^P'^*^!
fat*ells. ' " '^ **'' ^'^^"ce ot the cuticle; 3, are the

The hair and the nails are appendages of the skin.

The Nervous System.

--; the spinal ner^e. aidlJfe'.X^Srr;:' '^^ ^ ''' --'«^

^n^^ 'ftt iVdf upTfVh^er;^ '"^^^^ '^'^'' -'"^^ *^e ^^^^H-
cipal parts -the cer.irwm, the cere-
allium, and the w^rfw/Za oblor^ata.
Ihese are nicely covered and pro-

te ted y three membranes, the Zr«
»'«J^r, the aracAno^rf, and the pia

tilff ^1 ^t""^^ * considerable por-

ThP^?^"*"^' being removed.
The scalp turned down is repre-

"later, drawn up with a hook • f
"'« convolutions'^ of the braTn '

J^^^*';*'"•"™ « the upper and

'"5>^^ portion of the brain, and is f.o. 47.

AM4T0MY.

(livi(le<l into two hemiflphereB by a fisBure. A portion of the dura
mater dipu into tJuH (;left, and from its re8enil>lanc(! to a Hicklu, in
called the falx cerebri. The dimign of tbiH seems to Iw to support
each half of the brain, and to prevent it from preHsingupon the other
half when the head reclineH to one side.

The undulating surface of the cerebrum is produced by what are
called convolutioHH. The lower surface of this organ is divided into
three lol)e8, — the anterior, the middle, and the posterior.

The Burface of the (iereljruni w of a gray color, culled cortical, or
oinerifioug ; the central portion is white and fibrous, and is called
medullary.

The Cerebellum is about one-sixth the size of the cerebnim. It
lies just under the posterior lobe of the cerebrum, and is separated
from it by an extension of the dura mater, called the tentorium. It
is composed of white and gray matter; when the former is cut into,
there is presented the appeamnce of the trunk and branches of a tree^
called arbor vita:.

The MeduiJa Oblongata is the top of the spinal cord; but being
within the enclosure of the skull, it passes for a portion of the brain.
It consists of three pairs of bodies, united so as to form a bulb.

The Dura Mater is a strong, fibrous membrane which lines the
skull and spinal column, and sends processes inward to support the
brain, and forward, as sheaths for the nerves which go out from the
brain and spinal cord.

The Arachnoid is a serous membrane, and like all other serous
membranes, is a closed sac. It is leilected upon the inner surface of
the dura mater.

The Pla Mater is a vascular membrane, and lies next to and in-
vests the whole surface of the
brain, — dipping into its con-
volutions. It furnishes nu-
triment to the brain.

The Cranial Nerves which
go out from the brain are in
twelve pairs. In reading a
description of them, let the
reader keep his eye on Fig. 48.

The First Pair, olfactory
(6), passes through several
small openings in the ethmoid
bone, and is distributed to
the mucous membrane which
lines the nose. Destroy this,
and the sense of smell is gone.

FlO. 48.

The Secoi

skull, and en
retina. It ii
of sight, call

The Third

iitiid bone to

The Fourt

iniiNcle of the

The Fifth

loots, iuid divi
iiiid noNo, call
the teeth of tl
the third goin
jiiw, and callei
the hranches o
affection callet

The Sixth P

•arotid artery <
Ntmight muscle

The Seventf

teniiil ear.

The Eighth I

Jt sends nervou

The Ninth Pi

■'^"iiie opening w
lous membrane
The Tenth P«

the pharynx, lui
»"a iKJwels.

The Eleventh

"'"th and tenth j

The Twelfth F

i"'fl is its motion-
those who talk m

The Spinal Cor

'n connection wit)
Ihe upper fend of
"ft. Another s
^''hich go to the ui
toi^, where the ne

f^'ssures dip int.
'^™ -^teral parts, w

^hese lateral col

ANATOMY.

The Second Pair, optic nerve (7), paaflea tliroiigh the iweof the
skull, and enters the cavity of the eye where i h oxpiinded upon the
retina- It iH a disease of this nerve which occtisions a gradual loss
of HJpht, called amauroHtit.

The Third Pair, niotoros oculorum (9), passes through the sphe-
noid lx)ne to the muscles of the eye.

The Fourth Pair, patheticus (10), passes to the superior oblique
immclo of the eye.

The Fifth Pair, trifacial nerve (11), like the spinal nerves, has two
mots, and divides into three brandies, one going to the eye, forehead,
iiiitl noHe, called the ophthalmio branch ; another going to the eye,
the tf t'th of the upper jaw, etc., called the miperior maxillary ; and
the third going to the ear, the tongue, and the teeth of the lower
jaw, and called the inferior maxillary. It is a painful condition of
the branoheHof the fifth pair which constitutes the ^'••.libie neuralgic
affection called tie-douloureux.

The Sixth Pair, abducentes (12), passes the opening by which the
carotid artery enters the cavity of the skull, and goes to the external
stniiglit muscle of the eye.

The Seventh Pair, portio n<olIiH (13), is distributed upon the in-
ternal ear.

The Eighth Pair, facial nerve (14), is distributed over the face.
It sends nervous filaments to the muscles.

The Ninth Pair, glosso-pharyngeal nerve (14), passes through the
same opening with the jugular vein, and is distributed upon the mu-
cous membrane of the tongue and throat.

The Tenth Pair, pneumogastric nerve (16), sends its branches to
the pharynx, larynx, gullet, lungs, spleen, pancreas, liver, stomach,
and Iiowels.

The Eleventh Pair, spinal accessory nerve (16), connects with the
ninth and tenth pairs, and is distributed to the muscles of the neck.

The Twelfth Pair, hypo-glossal nerve (17), goes to the tongue,
and is its motion-producing nerve. It 's a nerve of great energy in
those who tivlk much.

The Spinal Cord extends f'om the medulla oblongata, where it is
in connection with the brain, down to the second lumbar vertebra.
The upper fend of the cord presents a bulbous swelling, or enlarge-
ment. Another swelling is found where the nerves are given off
which go to the upper extremities ; and a third near the end of the
cord, where the nerves l)egin which go to the lower extremities.

Fissures dip into the cord before and behind, and divide it into
two lateral parts, which are united by a thin layer of white substance.

These lateral colunuis are divided by furrows into anterior^ lateral.,

; .^K.

^g.^yjiyi!

anat6my.

FIO. 49.

and posterior columns; — the anterior being supposed to be the motor
column, the posterior that of sensation, and the lateral divided iu
function between motion and sensation.

The 5pinal Nerves, connecting with the cord, are in pairs, of
which there are thirty-one. Each pair has two roots, — a motor root,

C, Fig. 49, arising
from the anterior
columns of the
cord, and a send-
tivH root, D, spring-
ing from the pos-
terior columns. A,
is a section of the
cord, surrounded
by its sheath. B,
is the spinal nerve,
formed by the
union of the motor and sensitive roots. After the union, the nerve,
with its motor and its sensitive filaments, divides and subdivides
as it passes on, and is distributed to the tissues of the several
organs.

The thirty-one pairs of spinal nerves are divided into eight pairs of
cervical, twelve pairs of dorsal, five pairs of lumbar, and six pairs of
sacral nerves.

Fig. 50 gives a view of the brain and spinal cord, with the nerves
given off by the latter: 1, 1, being the two hemispheres of the brain;
3, 3, the cerebellum ; 4, the olfactory nerve ; 6, the optic ; 7, the
third pair ; 8, the pons varolii, so called ; 9, the fourth pair ; 10, the
lower portion of the medulla oblongata ; 11, 11, the spinal cord ; 12,
12, the spinal nerves ; 13, 13, the brachial plexus ; 14, 14, the lum-
bar and sacral plexus.

The Brachial Plexus is formed by the interlacing of the four lower
cervical and upper dorsal pairs of nerves. It gives off six nerves,
which are distributed to the muscles and skin of the upper extremi-
ties.

The Lumbar and 5acral Plexus is formed by the last aorsal and
five lumbar nerves, from which nerves go to the muscles and skin of
the lower extremities, and the last lumbar and four sacral, from
which nerves are sent to the muscles and skin of the hips and lower
extremities.

The Sympathetic Nerve consists of a series of knots (ganglia),
lying along on each side of the spinal column, and forming a knotted
chain. There is a knot for each intervertebral space, the neck ex-
cepted. These knots are composed of both cineritious and raeduUarv
matter.

Each knot ]
downward, ext

119.

PlO. 60.

•supplied with bran
nerve of organic
preside over nutril
nerves of the brai
motion and sensati
% 51 is a fin
great sympathetic,
nections with oth«
Jne semilunar ganj
'J'"'g just under t
^fce in this regioi
Jomach sometimes
«"t, the external
''?'; and left coror
'"'fl'Ile, and superio

ANATOMY.

Each knot is a distinct centre, and gives off branches upward,
downward, externally, and internally. All the internal organs are

\'¥^'

FlO. SO.

,•/'

FlO. 61.

supplied with branches from the sjrmpathetic nerve. It is called the
nerve of organic life, and is supposed to ,
preside over nutrition, secretion, etc., as the
nerves of the brain and cord preside over 1
motion and sensation.

Fig. 51 is a fine representation of the
great sympatiietic, witli its knots, and con- 1
nections with other nerves. A, A, A, is '
the semilunar ganglion and solar plexus, ^^ "

b'ing just under the diaphragm and behind the stomach. Its pres-
ence in this region is the reason why a blow upon the pit of the
stomach sometimes destroys life. D, D, D, are the thoracic ganglia ;
E. E, tlie external and internal branches of the same ; G. F, the
light and left coronary plexus upon the heart; I, N, Q, the infei.. ,
middle, and superior cervical ganglia; 1, the renal plexus around the

ANAl'OMY.

kidneys ; 2, the lumbar ganglion ; 3, the internal branches ; 4, the
external branches ; 5, the aortic plexus.

Fig. 52 represents a plexus, showing how the filaments of one
nerve paas to be enclosed in the sheath of another. In this way they
change at once the direction of their journey, and their companions
upon the way.

The Organs of Sight.

The organs of vision are the optio nerve, the globe of the eye, the
muscles of the eye, and the organs of protection.

The Optic Nerve begins by two roots at the base of the brain, the
fibres from which meet, as they come forward, and some of them cross

each other. The two nerves then sepa-
.rate, and enter the back part of the
'globe of the eyes, and then spread out
into a kind of membrane. In Fig. 53 :
1, 1, show the globe of the eye ; 2, the
crossing of the optic nerve ; 8, the
origin of two pairs of cranial nerves.

The Qlobe of the Eye is a better
constructed optical instrument than
man ever made. Its interior is filled
with what are called refracting human
or mediums, which are surrounded and
held in their place by membranes, called coats.

The Coats are the sclerotic and cornea ; the choroid, iris, and ciliary
processes ; and the retina.

The Sclerotic Coat is a fibrous membrane, covering the largest
portion of the globe. To this the muscles are attached. It is the
part which is called the white of the eye. It has a beveled edge in
front, into which the cornea is fitted.

The Cornea is a transparent layer which projects in front, and forms
about one-fifth of the globe. It is shaped like a watch-glass. Its
blood-vessels are too small to receive the red particles of blood.

The Choroid Cpat is a vascular membrane. Its color is brown ex-
ternally, and black within. It is connected with the sclerotic coat
externally, and internally with the retina. It is composed of three
layers.

The Iris is named from its having a variety of colors in different
persons. It is the partition between the anterior and posterior cham-
bers of the eye, and has a circular opening in the centre called the
pupil. Of its two layers, the fibres of the anterior one are radiating,
and dilate the pupil, while those of the other are circular, and cause
its contraction.

FlO. 63.

u'ls ;

ANATOMY.

The Ciliary Processes are a number of folds formed from the in-
ternal layer of the choroid coat.

The Retina has three layers. The external is extremely thin ; the
middle is nervous, being an expansion of the optic nerve ; the in-
ternal is vascular, and consists of a ramification of minute blood
vessels.

The divided edge of their coats may be seen in Fig. 64, namely,
tlie sclerotic, the choroid, and the retina : 2, is the pupil ; 8, the
4, the ciliary process ; .5, the scolloped border of the retina.

uus

FlO. M.

no. 6S.

The Humors of the Eye are the aqueous, the cri/stalline, and the

vitreous.

Th - Aqueous or watery humor is situated in the chambers of the
eye. it is an albuminous fluid, with an alkaline reaction, and a spe-
cific gravity a little greater than distilled water.

The Crystalline Humor is immediately behind the pupil. It is a
lens, and '^ convex both on the posterior and the anterior surface.

The Vitreous Humor is also an albuminous fluid something like the
aqueous humor, but more dense.

In Fig. 55 we have in E a good view of the cornea fitted into the
sclerotic coat ; A, is the choroid ; B, the pigmentum nigrum , C,
the retina ; K, the vitreous humor ; D, the optic nerve ; I, the lens ;
C, the Iris, painted on the backside with pigment; F, the aqueous
humor.

The muscles of the eye, six in number, are attached to the bones
of the orbit behind, and to the cornea in front, by their tendons.
These tendons give the eye its pearly appearance. In Fig. 56,
five of the muscles are indicated by o, 5, c, d, e; f, is the optic
nerve.

If the internal muscle be too short, the eye is drawn in towards
the nose, and the squinting called " cross^ye " is produced.

AHATOMY.

The Orbits are bony sockets which encloue the eye. The optic
nerve passes through a large hole at the bottom.

The Eyebrows are the projecting arches above, covered with short
hair. They prevent the sweat from running down into the eyes, and
also shade them from strong light.

The Eyelids are the curtains which rise and fall in front. The
smooth membrane which lines them is called the conjunctiva. It
secretes a fluid which makes the eyelids open and shut easily.

FlO. 67.

The Lachrymal Qland is at the upper and outer angle of the
orbit. Several small ducts open from it upon the upper eyelid,
through which the tears run down upon the conjunctiva.

The Lachrymal Canals begin near the internal angle of the eye,
by two small-tear points, which communicate with the sac at the
upper part of the nasal duct.

The Nasal Duct is a canal about three^uarters of an inch long,
which runs down to the inferior channel of the nose.

Fig. 67 shows these organ : 1, being the lachrymal gland ; 2, the
ducts leading to the upper eyelid; 8, 8, the tear-points (punota
lachrymalis) ; 4, the nasal sac ; 5, the termination of the nasal duct.

The Ors^ans of Hearing:.

The External Ear is composed of the pavilion of the ear (the pinna),
and the auditory canal (the meatus audltorius externus).

The Pinna surrounds the entrance to the auditory canal. It stands
ou' .'-om the head, and is in common language called the ear.

The rieatus Auditorius in a canal about an inch long, partly bony
and partly cartilaginous, which goes from the pavilion of the ear to
the drum of the ear.

The Drum of the Ear (membrana tympani) is an oval-shaped thin
membrane, inserted into a groove around the auditory canal.

wim

2-lS?y-1rifa!-3£tii;^

'TSl

ANATOMY.

The Tympanum is a cavity within the temporal bone.

The Eustachian Tube is a

channel of communication be-
tween the tympanum and tlie
upper part of the pharynx.
The object of this is to convey
air to the drum of the ear, as
without air no sound can be
produced.

The Labyrinth is a seiies of
chambers through the petrous
bone — embracing the vestibule,
a three-cornered cavity within
thv, tympanum ; the semi-circu-
lar canals, communicating with
the vestibule, and the cochlea,
which makes two and a half

PIO. 68.

the fenestra ovalis ; 4, 6, 10, the

FlO. SB.

turns around an axis, called the
modiolus.

In Fig. 68, a, is the pa-
vilion of the ear; c,' the
auditory canal ; g, the mem-
brana tympani ; k, the t3Tn-
panum ; e, the bones of the
ear ; b, the semicircular ca-
nals ; /, the cochlea; h, the
vestibule ; i, the eustachian
tube ; d, the auditory nerve.
In Fig. 59, we have a
view of the labyrinth laid
open, and highly magnified :
1, 1, being the cochlea; 2,
8, the channels that wind
around the central point
(6) ; 7, 7, the vestibule ; 8,
the foramen rotundum; 9,

gemicircular canals,

PHY8I0I0GICAL LAWS OF LIFE AND
HEALTH.— HYGIENE.

Life, the Infancy of Being.

It may be stated as a general truth that man has but just learned
to live when he is ready to die. We expend a large portion of our
lives in searching out our mistakes, and in striving to undo the mis-
chiefs they have occasioned. This is true in reference both to our
moral and our physical life ; and I draw from it the conclusion that
the present must be only the infancy of our being, and that our blun-
ders and consequent sufferings here will cause us, in the great here-
after, to place a higher value upon knowledge, and to struggle with
new fortitude to rid oui-selves of eveiy bondage.

A life which has just begun to take shape and symraetiy, cannot
be permitted, I think, under the rule of a benevolent Creator, to be-
come extinct. We shall certainly be permitted to take up the broken
thread of life, and, in the clearer light of the future, with the warning
experience of the past, and surrounded by better guards, to try again.
In the meantime, while here, the sooner we become acquainted with
the laws of life, and the better we obey them, the more we shall en-
joy-

Tlie Nervous System.

Man is brought into connection with the outward world through
the senses of feeling, seeing, hearing, etc. These communicate with
the brain and mind through the nerves of sensation.

The nervous system is divided into two great central portions,
the brain and the spinal cord ; and these together are called, by the
learned, the cerebrospinal centre. There are numerous pulpy white
cords, called nerves, which at one end are connected with this great
axis or centre, and from thence run to all parts of the system. A
portion of these nerves start from the base of the brain and run to
the eye, the ear, the tongue, etc. (Fig. 48) ; while another, and a
larger part spring from the cord which runs through the backbone,
and are distributed over the body and the lower extremities (Figs.
50 and 60). One portion of these cords produce feeling ; another
part, motion. The former we call sensitive ; the latter, motor. Both
kinds are widely distributed over the body. Those which spring
from the spinal cord have two roots, one uniting with the back, the

f >'

'^Ir

li.

s\^

"N,

other with
part to wl
mon lan^
comes nm
may move
before. C
root, whic
producing,
to which il
move. Il
thougli it
acutely. 1
nerves tlial
the spinal
pretty well
ill Fig. 60.
If the ci
of motion '
the face be
tion or pas
expressed,
will all be
like statuar;;
to laugh, t
give, expres
feeling of
guish, or lo
impossible,
breath of ai
face will be
ly as before,
or palsy, as
partial orge
result of in ju
or many of tl
producing m
ralgia, tic c
etc., arise i
disease, perh
nuition, of th
sensation.

How the

of the extern!
communicate
acted on by e:
sensations." '
with the inte]

HYGIBNE.

other with the /ron^ part of the cord. Cut off the back root, and the

part to which It 18 distributed loses its feeling. As wo say in com'

mon language, it be- ^

comes numb, though it

may move as well as

before. Cut the front

root, which is motion-
producing, and the part

to which it goes cannot

move. It is palsied,

though it may still feel

acutely. The numerous

nerves that spring from

the spinal column are

pretty well represented

ia Fig. 60.

If the cranial nerves
of motion which go to
the face be cut, no emo-
tion or passion can be
expressed. The features
will all be immovable,
like statuary. To smile,
to laugh, to frown, to
give, expression to the
feeliug of pity, or an-
guish, or love, is alike
impossible. And yet a
breath of air upon the
face wiWhe felt as readi-
ly as before. Paralysis,
or palsy, as it is called,
partial or general, is the
result of injury upon few
or many of these motion-
producing nerves. Neu-
ralgia, tic douloureux,
etc., arise from some
disease, perhaps inflam-
niation, of the nerves of
sensation.

How the Mind get* Knowledge. Everything the mind knows
of the external world, it learns through the the orgLs of Teme wSd!
communicate with it through these nerves. Thus, the nm^es ail

ZtZ^'T^:\:'TT''i''''' ^r^^ "" the'bmin anTcaS

ensatons. When the hand is burned the nerves of sensation run

^N.th the intelligence to the brain, which, quick as thought, through

FlO. 60.

^iri

• WiiTiTW

HYCTENE.

the nerves of motion, despatches orders to the muscles to repel the
injury.

Comparison. — The arrangement and operation of the nervous
system are like thoje of the electric fire-alarm system of a city.
The brain is the intelligent centre, like the central office. The
nerves of sensation which carry to the brain, with electric speed,
intelligence of what is going on outside, are like the wires which run
to the central station from the several boxes. The quick carry-
ing to the brain of any information of injury done to some part of
the body, is like sending to the central station from an alarm-box
the intelligence of fire in one of the districts. The rapid transmis-
sion of orders from the mind to the muscles is like flashing the alarm
over the wires to every part of the city. And, finally, the powerful
action of the muscles in warding off danger is like the dashing of
firemen over the pavements and the energetic playing of the
engines.

Sensations.

An effect produced on the mind thi-ough a nerve is called a
sensation. Hunger is a sensation. It is an effect produced upon the
mind through ascertain nerve by the condition of the stomach.
Thirst, pain, heat, cold, are sensations in a similar sense. Nausea
is a sensation produced by some injurious substance acting upon the
coats of the stomach.

Strength of Sensation. — Some sensations are much stronger
than othei-s ; some are very intense. A very strong sensation is
called a feeling. It is common to say, " I feel cold," or, " I feel hot."
We simply mean by this, that the temperature of the weather makes
a very powerful impression upon us.

Kinds of Sensation. — Sensations are either pleasurable or pain-
ful. Pleasurable sensations arise from the proper exercise of some
healthy part of the body ; and they are a suitable reward for any
care the mind may take of the corporeal organs.

The sensations arising from a proper amount of exercise are
pleasurable. The muscles find a sort of enjoyment in action. He
who leads a sedentary life, either from choice or necessity, loses much
enjoyment. Hence, there is pleasure in labor ; and the working-man,
though often pitied by the wealthy, is generally the happiest of men.*
The eye and the ear, when directed to agreeable sights and sounds,
derive the most agreeable sensations from exercise. The air of a
beautiful spring-morning gives impressions which none can describe,
but which all know to be delightful. These impressions are well
fitted to reward us for taking at that season, in the open air, the ex-
ercise we so much need.

Moral Uses of Sensations. — How little we reflect upon the
amount of happiness it is in our power to create by making agreeable

impression
impression
(if families
lies in the 1
(hopping ii
acts of ber
agreeable a
of life, — c
and which
us like spri

In aiming

be governed

of happinesi

stairs, — shi:

refining infl

or for recrea

to wear a fn

flowers of ht

Every hui

ism of whicl

urable or pai

life, it shouL

Wives may j

tion of their

heart of the

the liusband.

pressions upc

fully. Most

the heads of

saying, or do

other. A w

loved either I

who desires t

life, the whol

sions upon ot

Agreeable

tions not onl^
to health. T
Travelling pi
variety of the

Care of the

portant that i

HYGIENE.

impressions upon others. A civil and polite address makes a pleiisant
iin|)re88ion. A kind word, fitly spoken, makes the heart glad. Heads
of families might do much to increase the happiness of their domes-
tics in the kitchen by meeting them with a pleasant countenance, and
(hopping in their ear, now and then, a word of approval. Such, little
nets of benevolence are easily performed, and they make the most
agreeable and lasting impressions upon persons in the lower stations
of life, — creating attachments, in fact, which end only with death,
and which in hours of future sorrow, which come to all, may refresh
us like springs of water in the desert.

" Full iiiauy a shaft at random sent, '

FindH luai'ks the archer little meant;
Full many a word at random spoken,
May heal a wounded heart that's broken."

Sir Walter Scott.

In aiming to make agreeable impressions upon domestics, we should
be governed by the simple desire to create happiness. Their sources
of happiness are comparatively few. They spend their days below
staira, — shut out from a portion of the light of day, and from the
refining influences of the drawing-room, — having little time for rest
or for recreation. How unfeeling to treat such persons with harshness,
to wear a frowning face in their presence, and thus wither the few
flowers of happiness which bloom around them!

Every human being is endowed with the beautiful nervrsus organ-
ism of which I have spoken, and is daily receiving impressions, pleas-
urable or painful, from thousands of sources. In all the relations of
hfe, it should be our aim to touch delicately this sensitive structure.
Wives may add much to the happiness, and I may say, to the affec-
tion of their husbands, by always wearing a pleasant face ; and the
heart of the wife may be made light and glad by gentle words from
the husband. We cannot but love those who make pleasurable im-
pressions upon us, and we necessarily dislike such as impress us pain-
fully. Most of the coldness and alienations which grow up between
the heads of families, spring from the habit of one of the parties, of
saying, or doing, or looking something which painfully impresses the
other. A woman who habitually wears a "sour" face cannot be
loved either by her husband or her children. The man or the woman
who desires to be loved, must cultivate a manner, a look, a speech, a
life, the whole scope of which is fitted to make pleasurable impres-
sions upon others. It is against nature to love what gives us pain.

Agreeable Sensations a Source of Health. — Pleasurable sensa-
tions not only beget love, and increase happiness, but they add much
to health. They exhilarate the spirits and drive away melancholy.
Travelling promotes health and prolongs life, by the number and
variety of the pleasing impressions it makes upon the mind.

Care of the Sick. — Tf the above statements be correct, how im-
portant that the sick should be so dealt with as to have none but

HYQIENE.

aj'p'eeable sensations made upon them. Many a life has been mcri-
ficed to the peevish temper of a nurse. When the nerves are weak
from disease, even slight causes make powerful impressions ; and if
these impressions are of a painful kind, the results are most deplora-
ble. To treat harshly the sick, especially those whose nervous system
is broken, implies either great thoughtlessness or extreme cruelty. A
single harsh word, which would scarcely move one when well, may
send the same person, when sick, almost to distraction. Every word
spoken to persons in sickness should, therefore, l)e gentle and sooth-
ing. Every feature of the face should express either cheerfulness,
or tenderness and pity.

As the painful impressions which disease is making tends to de-
press the spirits and create melancholy, it is not expected that peraons
when sick will exhibit as amiable tempers as when well ; and for
this all due allowance must be made.

Effect upon the Disposition. — This leads me to say that pleasur-
able sensations improve the temper and disposition. This is a fact of
very great importance, and parents should never lose sight of it in
dealing with their children. There are few children but would grow
up amiable and useful members of society, were they dealt with in
the gentle and tender manner which their young and impressible
natures require. From the moment the young mind wakes to intelli-
gence, it will he occupied with something. Parents and guardians
should aim, therefore, to turn it to all those things which will impress
it pleasantly, and at the same time do it no hai-m. Exercise, songs,
playthings, flowers, — to these and other entertainments it should be
led by gentle hands. No thoughtful parent will ever pain a child
by harsh threats and denunciations, or shock it by an oath.

Bad Effect of Unpleasant Sensations.— If pleasurable sensations
improve the health and temper, unpleasant ones do just the opposite.
They break down the health and spoil the disposition.

They are intended to give us a warning of impending injury.
Thus, we have painful sensations when we have overworked the body
or mind. The sensation of weariness tells us that the muscles have
worked as long as their good requires, and that they need rest. Were
this sensation unheeded, exhaustion and entire prostration would be
the result.

When fatigue begins to be felt, either of body or mind, the sensa-
tion may be dissipated by strong tea, or intoxicating drink, or opium ;
but to drive it away in this manner, for the purpose of working longer,
is wrong, and leads, in the end, to disease or exhaustion. It was said
that one of the most brilliant advocates of recent times was dependent
upon opium for the stimulus to carry him through his extraordinary
flights of eloquence ; but his restless motion and nervous face reminded
one that he had bent his bow very nearly to the snapping point, and
that a sudden collapse of his vital powers, at no distant day, might
be feared as the result of such tension.

Persons

sorrow, sh(
jects and c
light, and
sliould visi
I)res8ions.

When w
to use it a
our fault,
feeble. T
which says
hungry for

Need of

ideas of the
the organs
mind, shou
str laments i
and will m
portance, t

imprope

iidierit dis(
eased brain
the offsprii
Among th(
Europe, n(
arises, in a j
practice uni
The wisdon
certain deg]
vation of p
who will ti
body, obser
relations.

Need of

of its duties
than any ot
to this impi
lessened or (
loss of bloc
charged wit
well, the bl
brain, and t
any way, or
it is breathi
brain, and tl
headache, fa

IIYOIENK.

Persons in affliction, whoso spirits are depressed and broken by
sorrow, should have their thoughts turned away from all sombre ob-
jects and contemplations. They should be taken into the open sun-
light, and be diverted by the beautiful things of nature. They
sliould visit cheerfu; society, and open their hearts to pleasurable im-
pressions.

When we penmit any part of the body to remain idle, neglecting
to use it as much an we ought, unpleasant sensations remind us of
our fault. The muscles, when unused, waste away and become
feeble. This is sure to produce an uneasy, nervous state of feeling,
vvliich says to us as plainly as a sensation can, that the muscles are
hungry for exercise, and that it is injurious to let them rest longer.

Need of a Healthy Brain. — In order that we may get correct
ideas of the external world, it is necessary that the brain, the nerves, and
the organs of sense through wliich sensations are made upon the
mind, should be in a healthy condition. It is evident that if the in-
strumenbs of sensation be diseased, the sensation cannot be natural,
and will make a false report to the mind. It is of the highest im-
portance, therefore, that the brain should be sound.

Improper Intermarriages. — This organ, like every other,'may
inherit disease from parents. Insanity, which springs from a dis-
eased brain, is often hereditary. When both' parents are diseased,
the offspring are of course more liable to partake of their defects.
Among the wealthy, and particularly among the royal families in
Europe, nervous diseases and sterility are very common. This
arises, in a great part, from intermarriages among blood relatioJiS, — a
practice under which any people will degenerate, and finally perish.
The wisdom of the Old Testament prohibition of marriage within
certain degrees of consanguinity has been established by the obser-
vation of philosophers and the experience of mankind. Let those
who will transmit to their descendants a sound mind in a sound
body, observe the laws of life, and avoid all marriages with blood
relations.

Need of a Qood Supply of Blood. — B'or a proper performance
of its duties, the brain requires and receives a larger supply of blood
than any other part of the system. One-tenth of all the blood goes
to this important organ. If the quantity or quality be materially
lessened or changed, great disturbance of the brain follows. A large
loss of blood occasions dizziness and fainting. If an atmosphere
charged with too much carbonic acid gas be breathed, as in a deep
well, the blood is not vitalized in the lungs, so as to sustain the
brain, and unconsciousness soon follows. If the air be vitiated in
any way, or have its oxygen extracted, as in large assemblies, where
it is breathed over several times, it becomes unfit to support the
brain, and the result is languid feelings, inability to apply the mind,
headache, fainting, hysterics, and other nervous manifestations.

jr-

HYOIEMK.

Ventilation. — This hIiowh the great necessity of having dwellings,
churcheH, and school-houMeH well ventilated.

Were a good system of ventilation adopted in all our churches,
ministers would seldom preach to sleeping audiences. A congregiw
tion Hitting in one of our places of public worship, where the air in
a single afternoon is as many times used over as the minister's ser-
mons are in a lifetime, can neither hear with attention, nor compre-
hend with clearness.

In many of our school-houses, the ventilation is (juite as bad, and
the consequences worse, Injcause they are occupied six houi-s of tlie
day instead of three, and five days of the week in place of one. In
the small s^hool-.'-ouses which our children filled to overflowing in
former yeai-s, in wnich there was no ventilation, unless they happened
to be blessed with an old-fashioned chimney and tire-pjac3, the effects
upon the nervous system of the children was deploraWe. Many of
the diseases which afflict i j present generation of men and women
had their origin in the bad air of those crowded nuraeries of edu-
cation.

Our dwellings were partly ventilated in olden time, when the
open fire-place received the " back -log," the " top-stick," the " fore-
stick," and other sticks to match ; but since we have been warmed
by the stove and the .furnace we have known little of the luxury of
pure air at the domestic hearth.

Need of Exercise for the Brain. — Health requires that the
brain should be properly occupied with vigorous thought. The
same reasons may be given for this as for the exercise of the muscles.
It is governed by the same laws which apply to other parts of the
system. Use improves its strength and vigor ; idleness causes it to
grow feeble. Of course the labor it is put to should be only reason-
able in amount, and should not be too long continued at any one
time. With the weakening of the brain, the whole bodily forces,
and indeed the whole mental and moral character, fall into feebleness
and decay. It is a great mistake to suppose that the cultivation and
even vigorous use of the mind impairs health and shortens life.
Just the opposite is true. Many of the most eminently intellectual
men, who have worked their brains hard all their lives, have been
distinguished for long life.

Bad Effect of Change in Circumstances. — No class of persons
suffer more from nervous diseases and general ill-health than those
who, having worked hard in early life, with little or no cultivation
of the mind, are suddenly raised to wealth, and immediately drop all
exercise, and fall into habits of indolence and luxury. The condition
of such persons would be much less pitiable, did they take up books
when they lay by the hoe or the broom. But they seldom do this. Many
a woman, in early life, haa felt the glow of health in every limb,
and a thrill of pleasure, too, while scrubbing -the floor on her hands

'','■1 !.f

^>.

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tmmm

and kneei
her damaj
the health
ately, anc
pleasures

Discret

we must I
ply it wit
soon brin^
only until
permitted
a lighter,
than to en

Overw*

used not t
parts of tl
longed ex(
early, and
from this
formerly ;
years, a h
brain. Pi
The result
are depior;
to be culti
forward fa
and fortif;
required t(
Yet pan
verse this
startled eo
of their fo
softening <
the horrorf
though wii

Old Pec

ticularly ci
covers eas
of recover
lapse. 01
tion. The
and easy si

A Suppl

work, nee(
Without tl
to any pari

HYGIENE.

and knees, who has, in subsequent years, reclined in misery upon
her damask-covered lounge, and wondered that she could not have
the health of other days. Let her cultivate her brain, live temper-
ately, and exercise in the open air, and life may again have real
pleasures for her.

Discretion in Exercising the Brain. — In exercising the brain
we must use discretion. We must not sit down in the morning, and
ply it with work during the whole day, without rest. This would
soon bring upon it disease, or premature decay. It should be worked
only until it begins to show symptoms of fatigue. Then it should be
permitted to rest ; or, what is better, be turned to some new subject, of
a lighter, or a different character. This often rests the brain better
than to entirely suspend its action.

Overworking the Brain in Childhood. — Great care should be
used not to exercise the brain too much in early life. Like other
parts of the system, it is tender in childhood, and will not bear pro-
longed exertion. As a general thing, children are put to school too
early, and made to work their brains too hard. Great mischief arises
from this source. Children are born with larger brains now than
formerly ; and it is no uncommon thing to see upon a child of ten
years, a head equal in size to that of an adult. Children run to
brain. Precocity in development of brain and mind is common.
The results of stimulating and hastening the unfolding of such minds
are depiorable. In such children, the brain should be the last thing
to be cultivated. We do not need to urge its growth. It will come
forward fast enough in spite of us. Our chief aim should be to harden
and fortify the general constitution, so that the brain which it is
required to bear up and sustain may long be its crown and glory.

Yet parents are proud of their precocious children, and often re-
verse this rule. They do it thoughtlessly, and would be terribly
startled could they suddenly look into the future and see the results
of their folly. Could they do so, they would see inflammation and
softening of the brain, epilepsy, insanity, paralysis, apoplexy, with all
the horrors of uudescribed and indescribable nervous affections, which,
though without a name, have a terrible reality.

Old People's Brains. — Persons in advanced life should be par-
ticularly careful not to overwork the brain. In middle life it re-
covers easily from great fatigue. In the decline of life, its powers
of recovery are feeble. A single exhaustion may cause its fatal col-
lupse. Old age should be distinguished for gentleness and modera-
tion. The journey of the down-hill of life should be made by sliort
and easy stages, through regions of uiversified beauty.

A Supply of Blood. — EA'iery part of the system, when hard at
work, needs and must have a very large supply of pure blood.
Witliout this, it is torpid and inactive. To cause the blood to flow
to any particular part, it must be exercised. The lumberman, when

HYGIENE.

in the forest in extreme cold weather, stamps his feet vinlpnfl,

the ground, or beat« them against a log, anfwhU hi Wd«^ "^'"'J

proportion that it dmws the vital current to 2Yw7«„;i ^"'^ '"

bram and all otiier working organs. ^ ^' '^'^ "^ *^«

worrer!:i:ei;lftrsat\im^^^ ^^^ ^' -^--an

brain to hard work i.rTf^dLt^l ' 7. . 'n '"^P^^Per to put the

stomach then wrt^ the bio. !.n^ iK^ ^."" "*""^' ^«^"«« th«
the blood be ca ed off fo h K '^'^^^ '^-^^ ^^««* <^^^^' ^«od; and if
the stomach be oaded with fo^'l ^'1?" ""? ^^P* ^^' ^^ould

. thinking; for the i:^:^^%ITi;'7:to:'x i^oii^i '^•^•'

own excitement has had time to subside ^^ ^^''' ^*"

Sympathetic Nervous System

need to go on wh leTe Z'ai^-« . i '' ^'1 ''^*^"''^^ P'""'^^^^^^ ^^^^^^
The nerfous sy^ e n of .vWch WtT "'^•^.^^^"»«t ^^^^^d to them,
tions which areClednvotto/P^'^lf^^f^.^^^^^ -" those fuuc-
will is needed for their performanol' ~s! '?'^ '^'^"'' "° ^^* '^^ the
and the circulation o Tebinod Si ,^''"f «"' absorption, digestion,
well as while we ll e. wt^ kn L'^^^^ fj^ M? "^'^ "^ «^^^P' ^
performance, as in walking Pntin^ "^'^ necessary to their

have to ceas; thrm^meXe 2^ T'^r""/"^' '*"•' '^''^ ^^^^ ^«»W
the result. ^^^ '''^'" ^^^^ ^^««P' ^^d death would be

con^dmoStn; "TvU'E ''''\ n.'' ^^« «^^- ^^ «-
flamed, the stomach seemstn^y, ^ l'- ^'^^'^ ^^^ ^«ng« ^re in-

becaus; this wou d a^ivlte th^T' "^ '^ T^^"^ ''^^^^^^^"^ f««d'
Well would it belf ifS, n t ^^:J ^^ *^^ neighboring organs.

and abstain from bote ^cte ^/"ff "''^'^-f ''''''''' ^ ^^' forbeaifnce,
injure their neighboii ««l%^tification which they know will

r ^^ish to*add'l*frrwo'Ji??fi!!' r ^^/u '"^ ''^^'^^"8^ *h««« observations,
diseases which chamc^rJ/'u'P'^'^*'"^ ^^'. ^'^'^^^^ effects of nervous

Thai tuJ '^"aractenze the present time.

That theya« far more „„i^ ,„„ ,„i„y,^ ^,^„ .„ ^^^^^

m.m

;r'55^^^'~-=*—

HYGIENE.

years, must be apparent to the most careless observer. They are
nothing more nor less than the price we pay for a high civilization,
and especially for our democracy. Among us, every man feels his
individuality, and has a motive for thinking and doing his best.
Thought and action are here unfettered ; and if the race is not to
the swift, nor the battle to the strong, eveiy man acts as though he
thought it was. The great excitement which the struggle for wealth
kindles and inflames, deranges and shatters the nervous system to a
shocking degree.

And wealth, when obtained, does its full share to weaken the
nerves. It brings with it high living, indolence, loss of energy, dis-
sipation, and a weakening of the whole moral and physical powers.
It need not do this ; but, in most cases, it does.

Tlie result is, that, at least, every other person has some nervous
disease, which makes life a misery rather than a blessing. The brain
and nerves are too much developed in comparison with the develop-
ment of the muscles. Half our boys and girls have heads as large
as men and women. It is common to see a boy or a girl at ten talk-
ing and acting like a man or woman. I do not mean by tliis, that
they imperfectly imitate the actions of older persons. It seems to be
natural to them. Their brains are prematurely developed, and their
acts and thoughts have the maturity of adult life.

What is Coining ? — What will be the result of this state of
things, no man can predict. I sometimes think the race will break
down ; that that which was intended to be its ornament and strength
will be its destruction. I hope not. Yet there is danger of it.
Nothing can save us but the wisdom to adopt such means as will
develop all parts of the system alike. No race of men can stand for
many generations such a strain upon the nervous system, unless bet-
ter means are adopted to counterbalance its evil effects than are now
used in the United States. We have got to pause in our swift
career, and look after our health, or we shall become a nation of
maniacs. No proof is needed of what is here said.

Hopeful ConsiJe rations It is proper to say, the considerations

here presented, terrible as they are, are mitigated in some measure by
others of a more hopeful character.

Physiology and the laws of life are now better understood than at
any former period. These subjects are getting "nto our common
schools, and are engaging the attention of our youth. Declining
health has already made us think more of the means of preserving
it, — such as diet, exercise, bathing, travelling, and amusement. To
encourage and intensify this hopeful direction of the public mind, I
propose to devote a few pages to these subjects.

■^I'(

tmmm

HYOIENK.

Pood and Digestion.

F..OM the earliest dawn of existence to the last moment of life our
bodies are constantly changing. Old particles of matter, when tliev
are worn out, leave their places and are thrown out of the systeni
Were this the whole of the matter, our bodies would soon wuste
away, and that would be the end of us. But as fast as the old mate-
rials are thiown away, new ones take their places ; and it is solely
out o.t our food that these new materials are formed.

In order that the food maybe well digested, it must first be broken
into small particles in the mouth. The act of chewing it Ls called
mastication. During this act, if it be well performed, I large quan-
tity of spittle, called saliva, flows out of a number of glands, called
salivary giands, and mixes with the food, forming with it a soft mass
m tlus conaition, it is thrown backward into the top of the throat
called the pharynx. Here, a little cartilage, called the epiglottis
drops down apon the opening into the top of the windpipe, and pre-
vents its entrance into the breath-passage ; and it is pushed alonp
into the gullet, a tube which runs down behind the windpipe and
lungs, and which physicians call the oesophagus. Here a succession
ot muscular bands, circular in shape, contract upon it, one after
another, and force it down into the stomach.

It is importc^nt that two things should be securfid while the food is
m the mouth, namely, that it should be reduced to a good degree of
fineness by chevying, and that a proper amount of saliva should be
mixed with it. If the chewing were not necessary, teeth would not
have been given us; and the salivary glands would certainly not liave
been put in the mouth, if the mixing of water with our food would
serve the purposes of digestion as well.

Eating too Rapidly., —Americans have fallen into a pernicious
error in eating their food too rapidly. Time is not given to chew it
sufficiently to excite a full flow of saUva; and as it cannot be swal-
lowed m a dry state, it is not uncommon to see persons taking a sip
of water after every second mouthful, to enable them to force it into
the stomach. It is a habit we Americans have of cheating ourselves
both of the pleasures and the benefits of eating ; for the only real
pleasure of eating arises from the flavor of food while retained in the
mouth, and the only benefit we can derive comes in consequence of
Its proper digestion.

The food when received into the stomach is in the same condition
as when taken into the mouth, except that it is, or should be, ground
hne by the teeth, and well mixed with saliva.

The Gastric Juice. — The stomach, like the mouth, the windpipe,
and the gullet, is Uned by a mucous membrane. The chief office of
this membrane is to secrete, or take out of the blood, a fluid which
we caU gastnc juice, which means stomach juice, from the Greek

-iPt^'

HYGIENE.

name of stomach, yaorf'p (gaster). This fluid has not much smell
or taste, and looks like spring water. It has a powerful effect upon
food, which, when mixed with it, soon undergoes an important
change, which is apparent to the taste, the smell, and the sight. The
natvu-e of the gastric juice and how it produces Its effect upon food
are not certainly known; but it contsiins two active elements, — a
tree acid and pepsin, whose function is to dissolve the nitrogenous
parts of the food and convert them into albuminose or peptone. The
albnniinose is absorbed by the coats of the stomach and enters
directly into the circulation ; while the sugar and fat pass on to the
duodenum to -be acted upon by the bile, the i)ancreatic juice, and
other secretions of the bowels.

Too Much Cold Water at Meals. — There are some interesting
facts connected with the formation of this fluid, of which it is im-
portant that every person should be apprised.

Its quantity and quality depend on the amount and healthfulness
of the blood which flows to the stomach during the first stage of
digestion. It is, therefore, injurious to drink large quantities of very
cold water with, or immediately after, our meals ; as this will chill
the stomach, and repel the blood from its vessels, so that but little
of the juice can be formed. Digestion, in such case, must be im-
perfect.

This Fluid not Secreted Without Limit. — This fluid does not
flow into the stomach continuously, but only when we swallow food,
and then not as long as we please to eat, but merely till we have taken
what the system requires. If, in the amount we take, we go beyond
the wants of nature, there will not be fluid enough formed to dissolve
it, and the whole will be imperfectly digested, and be a source of in-
jury rather than benefit. This should teach us to be careful that our
food be only reasonable in amount.

Not Secreted in Sickness. — When we are sick, the gastric juice
is either not formed at all, or only in small quantities. Whatever
may be our feelings of lassitude, and however much we may appear
to need food, at such times, it is usjless to take it, for it cannot be
digested, and will only aggravate our disease. If the illness be only
slight, the fluid will be formed to some extent, and food may be
taken in proportion.

Its Secretion Favored by Cheerfulness. — A cheerful disposition,
and a happy, lively frame of mind, are highly favorable to the pro-
duction of the gastric juice ; while melancholy and anger and grief
^nd intense thought of business, at the hour of meals, greatly hinder
its natural flow.

This should teach us to go to our meals with light hearts, and to
make the family board a place of cheerful conversation, and of a light
and joyous play upon the mirthful feelings of all present. Should
any of the family circle be in the habit of using vinegar as a condi-

6(5

HYGIBNE.

ment, we should never be guilty of compelling them to extract it
from our faces. A vinegar face is not easily excused anywhere ; at
the table it is unpardonable. A single countenance of this description
will throw a gloom over a tableful of naturally cheerful peraons ; and
if habitually present at the board, may finally spoil the digestion of
half a dozen, and entail dyspepsia upon them for life.

The stomachs of the sick pour out but very little of this fluid, and
they can tiake but a small amount of food. It is cruel to deprive
them of the power of digesting that little by treating them harshly,
and filling them with gloomy and desponding feelings. I therefore
repeat the substance of the advice given on a previous page : Deal
gently with the sick.

How all this Is Known. — As the stomach is wholly concealed
from view, the reader will very naturally ask how it is known that
the gastiic juice is poured into it in certsiin states of the mind, etc., and
withheld in others. It certainly could not have been so accurately
known, had it not been for an accident which opened the living and
working stomach to the inspection of Dr. Beaumont, a United States
Surgeon. A young man by the name of Alexis St. Martin, a Cana-
dian by birth, but then in the State of Michigan, had a large part of
his side torn away, and a hole of considerable size made into his
stomach, by the accidental discharge of a gun. To the surprise ot
his surgeon, St. Martin recovered ; and the edges of the wound in the
stomach refused to grow together, preferring rather to fasten them-
selves to the borders of the breach in the side, thus leaving the pas-
sage open. A kind of curtain grew down over this, which prevented
tlie food from falling out. Dr. Beaumont, taking advantage of this
state of things, instituted a series of valuable experiments, by lifting
the curtain, and inserting various articles of food, and witnessing the
process of digestion.

Movement of the Stomach. — The presence of food in the stom-
ach causes its muscular coat to contract and throw it about from side
to side, mixing it thoroughly with the gastric juice, and reducing it
to a pulpy mass, called chyme. This, as fast as it is properly pre-
pared, passes through the pylorus into the upper bowel, or duodenum,
called also the second stomach.

Chyme. — A certain witty professor of anatomy and physiology
was in the habit of asking his class if they ever saw any chyme ; and
when they answered, no, as they often did, he called their attention
to what is occasionally to be seen in the morning, upon the sidewalks,
where drunken men have held themselves up by lamp-posts, and left
the contents of their stomachs.

The pylorus, or opening into the bowel, has a very singular and
wise instinct, which is worthy of remark. When a piece of food,
which has not been digested, attempts to pass into the bowel, the
moment it touches the inner surface of this orifice, it is instantly

thrown

'j»»sBP*BBsas

HYGIENE.

thrown back by an energetic contraction ; tliough a portion of well-
prepared chyme, touching the same opening immediately after, is
allowed to pasa unchallenged.

Chyle. — The chyme, when it reaches the duodenum, seems to
ciiuse the liver to S(M;rete bile, and
the pancreas to produce pancreatic
juice. These two Huids aie con-
veyed into the upper portion of the
second stomach, and there are mixed
with the chyme, and cause it to
separate into a delicate, white fluid,
called chyle^ and a residuum, which,
being worthless, is pushed onward,
and thrown out of the body.

Bile in the Stomach. — Most
persons suppose that the bile is gen-
erally found in the stomach ; but
a Tani- H '^^^ '^ * mistake. It is thrown up
by vomiting, because in that act, the

action both of the tii-st and the second stomach is reversed, and the

bile is forced up from the duodenum,
— taking a direction the opposite of
its usual course.

Destination of the Chyle. — The

chyle being separated from the dregs,
is pushed onward in its course by the
worm-like motion of the intestine ;
and as it passes along, it is gradually
sucked up by thousands of very small
vessels, whose mouths open upon the
inner surface of the bowel. These
little vessels are called lacteals, froi/i
the Latin word lac, which means milk,
because they drink this white, milky
fluid. Fig. 61 shows a section of the
small bowel, turned inside out, and
covered with the villi, or root-like fila-
ments, closely set upon its surface, for
absorbing the chyle, and at the bottom
of which the lacteals take their rise.

In these lacteals, and in the mesen-
teric glands, the chyle is gradually
changed, so as to approach nearer and
nearer to the nature of the blood ; but
precisely what the change is, or how
it is effected, is not known. Several

Fio. 02.

HYOIENE.

learned men liave publifllied their tlieories upon these points, and the
writer has opinions upon them; but it is not worth while to trouble
the reader with them. It is B\il1ieient to say that the fluid is carried
by the lacteals to the thoracic du(t,tiirough whi(!h it is conveyed into
a large vein at the lower part of liie neck, wher(i it is jjotired into
the blood, and becomes, after going through the linigs and experi-
encing another and a vital change, the material out of which oui'
bodies aie daily and hourly new-created.

Fig. 62 gives a genei-al idea of the stomach, bowels, etc. : 9, being
the stomach ; 10, 10, the liver; 1, the gall-bladder; 2, the duct which
conveys the bile to 4, which is the duodenum ; 3, is the pancreas ; 5.
the oesophagus ; A, the duodenum ; B, the bowels ; C, the junction of
the small intestines with the colon ; D, the appendix vermiformis ;
E, the coecum ; F, the ascending colon ; G, the transverse colon ; H.
the descending colon ; I, the sigmoid flexure ; J, the rectum.

Nature and Destination of Food.

The food which man requires for his support and development is
of two kinds, inorganic and organic. The firet of these embraces
certain mineral substances, as common salt, sulphur, phosphoru.s,
iron and lime, either in combination or separate.

These are not generally reckoned as aliments, and yet no human
being can live without them. In their absence, the body decays, dis-
integrates, and perishes. Common salt is composed of muriatic acid
and soda. The first is an important ingredient in the gastric juice,
and the latter promotes the secretion of bile. Sulphur is found in
several of the tissues, particularly in the muscles. Phosphorus,
united to fatty matter, is highly honored in forming a portion of
the brain and nerves, and is also combined with oxygen and lime to
make the earthy or hard part of bones.

Found in Food. — These articles it is not necessary often to intro-
duce into the system in a separate state. They are contained, in
larger or smaller proportions, in most articles of food ; and man al-
ways suffers, as all animals do, from theit absence. Common salt is
found in the flesh of animals, in milk, and in eggs. It is not very
abundant in plants ; and we all know how eagerly domestic animab
devour it when it is given to them, and how constantly wild cattle
resort to the salt springs, which, in the grea't West, are called " buffalo
licks." Lime exists in nearly all animal and vegetable substances.
In wheat flour we get it in combination with phosphcric acid, that
is, as phosphate of lime. Lime exists too, in the state of carbonate
and sulphate, in all hard water. Iron is found in the yolk of eggs,
in milk, in animal flesh, in potatoes, pears, cabbages, mustard and
other articles. Sulphur we get in flesh, eggs and milk ; and, as
sulphate of lime, in spring and river water. Phosphorus is derived
from eggs and milk; and flesh, bread, .'ruits, and husks of grain,

r-;:

}''?)!flll

HYGIENE.

coniiuonly called bran, contain even a larger proportion tlian we need
in our diet.

Organic Food, — The organic elements of man's food, which in
bulk embrace almost the whole of it, remain to be considered. In the
animal economy they serve two great purposes. A part of the arti-
cles which compose them are blood-formers, out of which all the
tissues are made, — the other part produces fat, which serves to warm
the body by being burned with oxygen. These articles are derived
partly from the vegetable and partly from the animal kingdom.

Divided into Four Qroups. — For convenience, these articles may

be divided into four groups. For the

tir.st, sugar stands as a type. We there-
fore call it tlie ttaccharine group. It em-
braces starch, gum, and the fibre of wood.
These articles may all be converted into
sugar by a simple chemical process.
Figure 63 gives a microscopic view of
the granules of starch.

The second group we call the oleayinous.
It is composed of oily substances, from
whatever source derived, whether the an-
imal or tht vegetable world.

The third group is the albuminous. A
good type of it is the white of egg.

The fourth is the gelatinous, or Jelly group.

First and Second Groups, Supporters of Respiration. — The ar-
ticles composing the first and second groups are analogous in com-
position, all containing oxygen, hydrogen, and carbon. They are what
Liebig calls supporters of respiration ; the meaning of which is, in
more comprehensible terms, that they are supporters of combustion.
They are the fuel which warms us. They keep the fires going, from
which arises all the heat we have in our bodies. But they are desti-
tute of nitrogen, and, on this account, they are not blood-formers, and
cannot be worked into flesh. Hence, man cannot live on them.

The food articles embraced in the third and fourth groups also
contain oxygen, hydrogen, and carbon ; and to these they add nitro-
gen. This fourth component part, which forms only a small portion
of them, gives them, for some reason never explained, the peculiar
quulity of producing blood and flesh. They are the raw materials,
out of which our bodies are reconstructed from day to day.

Feed a man ever so largely upon sugar, starch, gum, and oils, and
lie will starve as certainly as if he were allowed nothing but water.

Names of Two Great Divisions of Food. — The possession or non-
possession of nitrogen, then, is what distinguishes from each other
the two great classes of food-articles. Those which contain nitrogen

»'lO. «8.

mmd

HYOIKKE.

have been called nitrogenized, and thoae which are destitute of ii,
notirnitrogenized cuni]iound8. As nitrogen is often called azote, the
former class are more frequently named azotized ; the latter, no7t-
azotized.

Let the reader now fix it in iiis mind that the azotized articles of
food produce blood and flcph ; the non-azotized, heat ; and he will
have the key to understand much of what is to be said, and likewise
to unlock many ot the mysteries of diet.

Nutrition Table. — Taking human milk as the standard, and ex-
pressinp the amount of nitrogen it contains by 100, the following
tiible saows the relative amount of nitrogen in the principal flesh-
producing articles of food, and consequently their power of forming
the tissues : —

VEGETABLE.

Rice 81

Bye l(»

Com 120

Buley 12S

Oati 138

WhMt 144

Potatoes 84

Turnips lOti

Carrots ISO

Peas 239

Be.n8 320

ANIMAL.

Human Miik 100

Cows' Milk 237

Oyster SOB

Yolk of Eggs 305

Cheese 331-147

Eel 428

Pork-Ham 807

Salmon 610

White of Egg 845

Herring 910

Haddock 816

Pigeon 78(i

Lamb 8KI

Mutton ... 882

Veal 911

Beef 912

Other Standards of Value. — We must not infer that t^ose articles
which have most nitrogen are necessarily best adapted for human
diet because they are the most effective blood-producers. In deciding
the value of an article for food, other things are to be looked at be-
sides its nutritive qualities. Those which are poor in nitrogen, are
rich in carbon and hydrogen, and are well fitted to serve the double
purpose of nourishing and wanning the body at the same time. The
fitness of n article for diet depends veiy much upon the ease or
difficulty with which it is digested and assimilated. If an article
having a great deal of nitrogen, and being very nutritive, is with
great difficulty reduced in the stomach by the digestive process, it
may be much less desirable for food than one which is digested and
assimilated easily, but is much poorer in nutritive qualities.

Heat-Keneratins; Food Articles.— The reader has before him the
principal blood and tissue-forming food articles. Those which we
reckon as fuel, or heat-generators, are chiefly oils, sugar, starch, farina,
sago, arrowroot, tapioca, gums, etc. These are less essential than the
others ; for the blood-forming articles have within them the ele-
ments out of which fat is formed in the process of assimilation ; for

320

84S
910
816
7M
838
862
911
M2

HYQIKNE.

inimv of them contiiin nU\\vh ; and this, in tlie Innnaii organiam, is
(ihan^'od into fat. The amount of starch in some of these articles is
ii8 follows : —

Wboat Hour, good nunllty, 100, c.ontaiiiM lift to H<i partM in KJO tmre starch.

Whent . 108 " Kl " Wt

Karley iiioul 119 " M •' «6

Hurley ....... 130 " .iT " 37

Hyo Ill " 44 *• 47

Buckwheat 108 " 43 " 44

Indian Corn 138 " (10 " «6

Rice 171 " 88 " 86

Peas 69 " ;W " .'»9 " " "

Wiiite BeanH 09 " 37 " .38 " "

In the Nutritive Food Articles, there i.s a fixed relation existing
between the elements of the tissue-formei-s and the heat-producers
which they contain. Out of a few of them Baron Liebig has con-
jtructed the following table : —

For every ten parts of blood and tissue-formers ther'^' are, —

In Wheat flour, 10 46 In Bwley,

In liye meal, 10 67 In Rice,

In Oatmeal, 10 SO In White potatoes,

In Uuolcwheat, 10 130 In Blue potatoes,

10 OT

10 123

10 86

10 130

Diet a Complex Subject. — From the facts and tables now pre-
sented, it appears that the question of diet is one of complexity; and
that the determination of its several points requires that a number of
things should be taken into the account. First, in deciding the use-
fulness of any article, we may i.uquire respecting —

Its Digestibility. — If an article be not digestible, it is of little
coiisequeiice how much or how little albumen, starch or nitrogen it
may contain. The first and most important inquiry respecting it is,
is it digestible P If not, it is to be rejected ; for, whatever ouier quali-
ties it may have, it can only injure the stomach and embaixass Uie
whole system.

The following table will be useful to the reader, though I do not
set it down as reliable in all cases. There is . ften a great difference
in :lie ease with which different stomachs will digest the same food.
Many stomachs are afflicted with what is called an idiosyncrasy, — a
liabit, peculiar to itself, of rejecting or refusing to digest some one
or more articles wliich are acceptable to all other stomachs. This
tiible shows the length of time required for digesting the several ar-
ticles in the stomach of St. Martin, as shown by the experiments of
Dr. Beaumont; —

■i- 1

HYGIENE.

Article*.

PreparatiODi.

Time.

Articles.

Freparationi.

Time.

Rioe

Boiled

h.m.
1 —

Pork, recently salted

Raw

h.m.
3-

Pig's feet, soused
Tripe, soused

Boiled

1 —

Soup, chicken

Boiled

1 —

Oysters, fresh

Roasted

3 in

Trout, salmon, fresli

Boiled

1 ;io

Pork, recently salted

Broiled

3 1,')

«( 11 It

Fried

1 30

Pork steak

Broiled

3 l.T

Apples, sweet, mellow

Raw

1 30

Corn bread

Baked

3 1,5

Venison, steak

Broiled

1 30

Mutton, fresh

Roasted

3 15

Sago

Boiled

1 45

Carrot, orange

Boiled

3 l,-)

Apples, sour, mellow

Raw

2 -

Sau8a.K0, fresh
Beef, fresh, lean, dry

Broiled

3 20

Cabbage, with vinegar

Raw

2 —

Roasted

330

Codfish, cured, dry

Boiled

2 —

Bread, wheat, fresh

Baked

3 30

Eggs, fresh
Liver, beef's fresh

Raw

2 —

Butter

Melted

330

Eroi'ed

2 —

Cheese, old, strong

Raw

330

Milk

Buiijd

2 —

Eggs, fresh

Hard boiled

330

Tapioca

Boiled

2 —

Fried

330

Milk

Raw

2 IB

Flounder, fresh

Fried

330

Turkey, wild

Roasted

2 18

Oysters, fresh

Stewed

3 30

<i •<

Boiled

2 26

Potatoes, Irish

Boiled

3 ;«)

" domesticated

Roasted

2 30

Soup, mutton

Boiled

330

Potatoes, Irish

Baked

2 30

" oyster

Boiled

3 30

Parsnips

Boiled

2 30

Turnip, flat

Boiled

330

Pig, sucking

'Roasted

2 30

Beets

Boiled

3 45

Meat hashed with )
vegetables j
LamD, fresh

Warmed

230

Com, green, and beans
Beef, fresh, lean

Boiled
Fried

3 45
4-

Broiled

2 30

Fowls, domestic

Boiled

Goose

Roasted

2 30

If 11

Roasted

4 -

Cake, sponge

Baked

2 30

Veal, fresh

Broiled

Cabbage-head

Raw

2 30

Soup, beef, vegeta^ 1

Boiled

Beans, pod
Custard

Boiled

2 30

bles, and bread )

1 ^—

Baked

2 4B

Salmon, salted

Boiled

4 —

Chicken, full-grown
Apples, sour, hard

Fricasseed

2 46

Heart, animal

Fried

Raw

2 60

Beef, old, hard, salted

Boiled

4 15

Oysters, fresh

Raw

2 56

Pork, recently salted

Fried

4 15

Bass, striped, fresh
Beef, fresh, lean, rare

Broiled

3 —

Cabbage, with vinegar

Boiled

4 ;«

Roasted

3 —

Ducks, wild

Roasted

4;!0

" steak

Broiled

3 -

Pork, recently salted

Boiled

4 30

Com cake

Baked

3 ~

Suet, mutton

Boiled

4 30

Dumpling, apple

Boiled

3 —

Veal, fresh

Fried

4 30

Eggs, fresh

Boiled soft

3 -

Pork, fat and lean

Roasted

6 15

Mutton, fresh

Broiled

3 —

Suet, beef, fresh
Tendon

Boiled

630

11 (t

Boiled

3 —

Boiled

6 30

This table may be considered as giving a general idea of the rela-
tive digestibility of the food-articles contained in it. If aot found
exactly right in each individual case, it can be rectified by experience.
The experience of no other individual's stomach will ever be found
precisely lik j that of St. Martin's, — though in its general features,
it may be sufficiently similar to make his valuable. The general
principles of conduct may be learned from the experience of othei-s.
The particular application must come from our own experience and
reason. '

Digestibility Influenced by Amount.— The rapidity with which
any article is digested will vary with the amount taken. A larger
quantity than is called for by the wants of the system will be di-
gested more slowly than the proper amount ; while, on the other
hand, an insufficient supply begets an inability to reduce in the
stomach even the small quantity taken. We may err in taking too

. Mei ™ _ ' _ *w -- ' i.a.i ! J^-i^

rfa

Time.

HYGIENE.

little food as well as in taking too much ; though the former error is
much less likely to occur than the latter.

Choosing Food in HI Health. — But in deciding the kirid and
amount of food we must be guided not only by its digestibility, but
by the state of the health.

If we find the stomach apparently in good working condition, capa-
ble of dissolving properly whatever is submitted to its action, and
yet we are for some cause losing flesh and stre: igth, we should resort
not only to the most nutritious of the albuminous group of the azo-
tized articles, but likewise to the oleaginous group of the non-azo-
tized. We want a great amount of nutriment, and we need oils to
make fat. This is the kind of food generally wanted in constitu-
tional consumption.

In fevers, but little food can be disposed of at l)est ; and that little
must be chosen with reference to its mildness and its unstimulating
qualities. Generally the ^arinaceous or starchy articles are most
suitable, because they have no stimulating and irritating qualities,
and especially because they furnish fuel to be burned with oxygen,
and thus take the place of the animal tissues, which are being rapidly
consumed with this devouring element. In fever, oxygen is literally
burning up the body. In this state of the system, this element ac-
quires, by some means, a singular affinity for the tissues ; and, unit-
ing with them rapidly, forms a true combustion. The physician who
throws to this devouring agent some of the mild, non-azotized articles
which offer it stronger affinities than it finds in the tissues, is as wise
as he who tosses his dog to a hungry lion to avoid being devoured
himself.

Exercise to be Considered. — In deciding the diet, the amount of
exercise is not less important to be considered than the health. The
farmer, who works in the open air, and uses his muscles a great deal,
wants considerably more nutritive, as well as more combustive, food
than one who leads a sedentary life. Of course there is a great deal
more waste of the tissues, and he requires more of the flesh-forming
articles ; and as he breathes deeper, and takes in more oxygen, he
needs more of the supporters of respiration, — the sugars, oils, and
starchy aliments.

Beans. — By turning to the table which shows the amount of nitro-
gen in the different food-articles, the reader will see that beans are
rich in this element. They are, therefore, excellent food for working
men, who are obliged to make great use of their muscles. Our
fathers, who broke and subdued the rocky soil of New England,
showed wisdom even in their instincts in taking so large a portion
of their aliment from the bean, — especially as they oiled it with the
fat of pork. But for the hard-working student, who daily makes
heavy drafts upon his brain and nervous system, beans and peas are
an improper diet. They contain no phosphorus, in the shape of

HYGIENE.

pboHphate of lime ; and no brain can work hard without a due supply
of phosphorus, which forms a part of its substance.

Unbolted Wheat Flour. — For the man who uses his brain a great
deal, there is no other one article of food equal to bread made from
unbolted wheat flour. Fine wheat flour is little better for him than
beans, because the miller has robbed it of much of the phosphorus,
which is found chiefly in the hull or bran.

I mention only two or three articles of food as specimens. By
looking over the tables furnished, and reasoning upon the whole in
the way I have done upon these few, the reader can give every arti-
cle something like its proper value in most circumstances.

Climate. — If health and exercise should influence us in choosing
the kind and the amount of food, climate must do so quite as much.

In the frigid climate of high latitudes, it is necessary that a great
deal of heat be produced in the body, in order to avoid perishing
with cold. There is no mystery now, as there once was, about the
production of this heat. It comes from the burning of carbon and
other substances in the body, where they unite with oxygen, and
make just as real a flre an that which warms our houses. Oils, sugar,
starch, gums, etc., are largely composed of carbon, and readily unite
with oxygen in the body. This is the reason they are reckoned as
fuel, and are called supporters of combustion. And for this reason,
they require to be largely consumed in very cold climates. The in-
stincts of men seem to lead to the same conclusion, for the dwellers
in all high latitudes consume great quantities of oils and fats. The
amountof train-oil, tallow, the fat of seals and other animals, devoured
by the Laplanders, Kamtschatkans, and other northern people, is truly
wonderful.

In hot countries, the fundamental rule for preserving the health is
to keep the body cool. Without observing this rule, the strongest
will often fall victims to the climate in low latitudes. But to keep
cool, of course all the heat-producing articles of food should l)e
avoided. Particularly all alcoholic drinks, which are powerful sup-
portera of combustion, should be rejected. Rice and the various fruits
form the most suitable articles of diet.

The great sacrifice of life witnessed among the early emigrants to
California, was the result chiefly of using ardent spirits and heat-
producing food while crossing the Isthmus, which, to a northern
constitution, is much like a vast oven, heated to a temperature suit-
able for baking bread. There are few persons, with tolerable health
and strength, but could safely endure the hottest climate if they
would avoid alcoholic liquors and confine themselves to an abstem-
ious vegetable and fruit diet.

Bayard Taylor's Opinion. — The distinguished traveller, Bayard
Taylor, reports that while spending a few days in a heated part of
Africa, he lived as the inhabitants did, pretty much e.itirely upon the

HYGIENE.

supply

flesh of well-fatted sheep ; and that he enjoyed, meantime, excellent
health and strength. From this he concludes that animal food is as
suitable in hot climates as in cold.

It is a pity a man of such excellent parts as Mr. Taylor should
have allowed himself to rear so tall a structure upon so narrow a
foundation. That he could live on flesh in eo hot a region, and not
be made sick, only proved that he had a fine constitution, and that
liis health was not easily disturbed ; and when he attempted, from
Iiis limited experience of a few days, to reason against the established
facts of science, and against the well-attested laws of life, he did it
evidently without reflecting that he was in a field of thought which
he never had occasion to cultivate.

The great Jewish Lawgiver doubtless had a reason for prohibiting
pork to the Jews. Whatever that reason was, the prohibition had a
wise bearing upon the health of the people. Palestine has a hot
climate, in which pork-fat is an improper diet.

More Fat in Winter, — It follows from what has been said, that a
more fatty as well as stimulating diet is needed in winter than in
summer. But the change should be made gradually. When cold
weather approaches, the food should become more nutritious and
warming by little and little. The exercise should likewise be in-
creased.

Even the lower animals act upon this plan. In the fall, squirrels
eat nuts, which are full of oil, and grow fat upon them.

The instincts of men move in the same direction. It is in the fall
that the hog, the ox, and the poultry are killed ; and in the winter
that they are largely feasted upon and enjoyed. Upon such food,
combined with various sorts of starch, man fattens ; and a good sup-
ply of fat, deposited in the cells, is equal, in keeping out cold, to a
layer of cotton batting, — to say nothing of the fire kept up within
the body by the burning of such fuel. As hot weather comes on, we
gradually lay aside these fattening articles (or ought to), and return
to the watery vegetables and fruits, such as squash, string-beans,
strawberries, currants, etc.

Few of us, I apprehend, would suffer from heat in summ'er, if we
could persuade ourselves to abandon stimulating and firo-producing
food, and confine ourselves pretty much to a cooling and succulent
diet. Diarrhoeas in summer are not induced by eating wholesome
vegetables, but by combining them with large quantities of animal
food

The State of the Mind. — This should by no means be over-
looked in choosing the kind and the amount of food. If we have
lost friends, or heard desponding news, or experienced calamities of
itny kind, we must, during the first hours of the shock, or even during
the first days, if the affliction be heavy, partake very sparingly of food.
The stomach is in no condition to receive it. The brain lies pros-

tmmm

HYGIKNE.

trate under the stroke, and the stomach, in sympathy with il, u«ks
for a day of sorrow and fasting. Disturb it not.

Heat-producing Food Incompatible with Excitement. — It is

folly to take heat-producing aliment when laboring for days under
high excitements. During political campaigns, when the blood of
politicians is at the boiling point, the diet should be unstimulating,
— containing very little animal flesh, and not much combustive food.
Many a man has died of apoplexy, or of heart-disease, by putting on
the steam when his blood was up. Whenever we have a day of un-
common excitement to pass through, we should always begin and
end it with an unusual degree of al»tinence as to the amount of food
taken, and with special care that the articles be of the highest kind.

Anger Demaad« Abstinence. — Anger is a passion which espe-
cially unfitii the stomach for doing much work. If it occur often, or
be protracted, but little food should be taken. Those who indulge it
have a double cause for abstinence. Both their folly and their stom-
achs call for a fast.

Food Adapted to Different Periods of Life — Food must vary in
different periods of life. The infant needs a fattening diet ; and this
has been supplied in the milk of tlie mother, which contains more
hitter (the fattening portion) than the milk of any other animal.
But as the infant has much less exercise than the young of animals,
its flesh is not wasted, and it does not require so much azotized food,
that is, the reader will remember, foorl witli nitrogen in it. Accord-
ingly, it will be seen by looking at tli table on page 70, that human
milk has much less of this element 'an that of the cow. As the
child grows up, and begins to take acti\ 'xercise, indoors and out,
it wants more solid food, and teeth make their appearance to masti-
cate or chew it.

In Youth and Jlanhood, the great amount of exercise usually
taken calls for larger supplies of azotized aliment, — beef, mutton,
pork, fowl, fish, wheat-flour, corn-meal, rye-meal, potatoes, turnips,
peas, betlns, etc. This is the working part of life, when the tissues
are rapidly wasted by action, and the flesh-forming aliments are
wanted to keep them good.

In Old Age, the exercise is diminished, the blood circulates more
slowly, and the body grows cold. Now is the time to resort to non-
azotized food, — oils, fats, the various kinds of starch, sugar, and the
like. These will furnish fuel to warm the sluggish blood, and will
invest the body with fat, which will serve the purpose both of a cush-
ion and a garment. Wine, beer, porter, and distilled spirits are never
needed by young peraons in health ; but the aged are frequently bene-
fited by them, if taken in small quantities. They are chiefly com-
posed of oxygen, hydrogen and carbon, and are properly ranked with

HYGIENE

the supportera of combustion. They are like^vi8e stirauiant, and add
to the comfort of the old by quickening their circulation. Like tea
and coffee, they diminish the waste of the body, and thereby lessen
the demand for food.

The smallest amount of aliment upon which a healthy adult person
ever lived for any length of time, v.as twelve ounces a day. Upon
this small daily allowance, Lewis Cornaro, a noble Venetian, sub-
sisted in perfect health, during the protracted period of fifty-eight
years. This he was able to do only by adding daily to his food
about twelve ounces of light wines. I shall have occasion to refer
to this case again. '

Cost of Pood.

Onk other consideration must ever influence the great majority of
• men in selecting their food. I mean its cost. It is a matter of great
importance to the poor, to know what kinds of food they can subsist
upon with least expense. Sometimes provisions are so high that
persons in poor circumstances greatly need advice in this matter.
Let me endeavor to furnish some information which shall be of ser-
vice to the reader.

Milk is supplied by nature to be our first food, and is a good type
of all alimentary substances. It contains
(turd, which has nitrogen, and is equivalent
to albumen and fibrin, and represents the
hlood-formers. It has butter and sugar.
These represent the heat-formers. It has
salts, which contain potash, soda, phospho-j
rus, etc. Fig. 64 is a microscopic view of I
good milk ; Fig. 65, of poor milk ; and Fig.
66, of milk adulterated with calf's brains.

Food will be valuable in proportion as
it combines, in due proportion, the articles
contained in the four groups, represented
by albumen., fat., sugar., and salts.

Albuminous Group. — Albumen, fibrin, casein, and gluten, all en-
ter into the substance of animal and vegetable bodies, and are all
composed of the same elements, namely, 48 parts carbon ; 36 of
hydrogen ; 14 of oxygen ; and 6 of nitrogen. In containing nitrogen
they all differ from the other three groups. Albumen being a good
type of them, they are called albuminous compounds. Albumen
forms a large portion of the serum, or colorless part of the blood.
It is the leading principle in alimentation. It is worked up into the
tissues of our bodies. It forms our muscles, our membranes, a por-
tion of our nerves, etc. It is the bricks of which the house we live
in is made. AH the articles, therefore, which are chemically consti-
tuted like it, may well be termed albuminous.

FlO. 64.

HYGIENE.

These bodies, consisting of the four organic elements named above,
have been called quaternary compounds. Besides these elements, they
have a minute portion of sulphur and phosphorus. They are also
called protein or proteinaceous compounds.

Albumen is a very unsUible compound, — tending strongly to de-
composition. This is owing to the complexity of its cor'position.

Fio. 65.

FlO. 6G.

and to its union with the fickle element, nitrogen, which forms chemi-
cal compacts reluctantly, and breaks tliem without remorse. Sub-
stances which coagulate or fix albumen in an insoluble compound,
or preserve the tissues of the body, which are made from it, from
decomposition or putrefaction, are called antiseptics.

Fatty Oroup. — The next group, represented by fat, performs very
important offices in the system, — the most injportant of which is a
union with albumen in the formation of cells. All animal and vege-
table life begins with the cell, — the tiny cup, with which nature dips
all the streams of life out of the great fountain of inorganic matter.
No cell is formed without a minute ]jarticle of oil. Tiie portion not
used in forming cells, is either burned as fuel to keep us warm, by
uniting with oxygen, or it is stored away in the cellular tissues, add-
ing to the bulk of the person. If, then, the very beginnings of life
are dependent upon fat, it is of great importance as an article of diet.
So necessary is it in the economy of life, that when not taken in the
food, it is formed out of albumen in the processes of assimilation.

The Starch and Sugar Group, composed of several kinds of sugar,
gum, etc., is never used in forming the tissues, but they perform im-
portant offices in the changes going on within the human organism.
Thus, sugar of milk is decomposed, and forms lactic acid, so called
from being found in sour milk. This acid plays a veiy important
part in the process of nutrition.

Pure starch is a snow-white powder, having a glistening aspect.
It is composed of grains from .gj^ to ^^^ of an inch in diameter in
the different grains ; being largest in the potato and smallest in
wheat. When examined with the microscope, they appear as in Fig.
68.

HYGIENE.

The Salts Qroup are sufficiently spoken of in another place.

A wise philosopher in ancient time said, " I do not live to eat and
drink; I eat and drink to live." If we intend to eat to live, we must
combine, in our food, the four groups above explained; and if we
would live at as small expense as possible, we must take those arti-
cles which are low in price and rich in nutritive matter. The fol-
lowing table will help the reader make his selections : —

Tabk of the relative value of articles of food arranged according to their proportions of
nutrimt matter in each of the four groups of elements concerned in vital changes.

In 100 pound! of

Gbains :

Wheat

Barley

Oats

Rye

Indian Com . . , .

Buckwheat . . . .

Rice

Pod Plants:

Beans

Peas

Roots :

Potato

Turnip

Carrot

Beet (manKold wurzel)

Long red

Sliort red

Sugar beet ....

Parsnip

Leaf;

Cabbage

Mkal;

Wheat flour . . . .

Ryemeal

Barleymeal

Oatmeal

Wheat bran ....

.-I

15
16
16
12
14
15
13

14
14

76
88
86
86
86
85
86
80

16
16
16
15
l.S.l

10 to 20

8 to 11
9

2
3.03
3.31

2
1.6

4.63

la©

E 3 "I

10 to 19
12 to 16
14 to 19
10 to 15
11

24 to 28
24

2.1
1.6
1.5
• 2
0.48
0.26

2.5

30 to 36

10.8

6.3
12.6
19.3

2to4
2 to 3
6to7
3to4

8.1

0.4

0.7

2to3
2.1

0.«l
0.3
0.4

0.36

r£

2.4

6.6

4.7

6S
60
60
60
74
60
79

18
9

10.36
12.46

70.6
73
74
64
.6

2
3
4

3
3

;toii

Sto4^

lito2

tol

2
3
7.3

The following tables have an admirably practical bearing upon
economy in food : —

100 lbs.

Parley

Beans

Beets

Buckwheat . . .

Carrots

Corn

Oats

Peas

Potatoes

Turnips (field) . .
Do. (Swedish) . .
Wheat Flour . . .
Wheat Bran . . .
Cheese (whole milk)
Cheese (skim-milk)

Muscle-

forminc

Elemenn,

in lbs.

14
26

2i
11
18
28.4
49.8

Fat-forminp;

Blcmenta,

Inlbt.

64
42
12
64
10
77

62
19

9
12
79

6
51.1

6.3

Relatire Propor-
tion of each,
In lbs.

ItoA
Itofj

Husky, or

Woody fibre,

in lbs.

16
10

(?)
26
3
6
20
8
4
2
2

lAlil'iUi

iHri

▲rtlelM.

Barley . . . :

Beans

Corn

Outs

Peas

PotaiiOeB. . . .
Turalpg ....
Flour ^flne) . .
Flour (unbolted)

HYGIENE.

Cost,

Mtuole-prodnolng

Coatof Muacle-pro

Eleuent*.

ducing Klemanti.

$1.00 per bu.

M lbs.

12c. per lb.

1.80 "

16.6 "

lie. "

0J50 "

6.7 "

7*0. "

OM "

8.2 "

7a "

1.00 "

14.3 "

7a "

0.(15 "

1.6 "

Ks,. "

OJ50 "

1.2 "

41a "

n.OO per bbl.

22.0 "

23c. "

4J0 "

24.8 "

18c. "

These tables will well repay study, for their practical use will s.ave
many dollars to the poor. Let it be remembered that producing
muscle is the same thing as producing strength, or labor-power.
Bearing this in mind, the following table will be very interesting: —

One pound of labor-power from Potatoes costs 6Sc. per lb.

" Fine Flour, 2;k;.

" Unbolted do., 18c. "

Turnips,

Barley,

Corn,

Beans,

Peas,

Oats,

41c.
12c.

7ic.
lie.

7c.

Meats are omitted in the table. So far as their nutritive qualities
are concerned, it is of little consequence which are taken. Some are
more digestible than others, and this consideration should influence
those with weak stomachs in selecting. Every person, of coui-se,
knows their relative cheapness.

Among the vegetables given in the table, there is a wider range
for choice. Let us consider them in course.

Wheat. — In this, the four groups are represented in excellent
proportion. When not deprived of the bran, it is perhaps the very
best supporter of animal life. So high have been the regards of men
for it, and so generously have they awarded to it their acknowledg-
ments, that its product, bread, has been everywhere called " the staff
of life." The settlement and cultivation of the immense prairies of
the West have within recent years so increased the production of
wheat, that its cost is now less than half what it was fifty years ago,
and it is indeed within the means of all in America.

Barley.— This has the four groups represented in nearly the same
proportions as wheat. It is, therefore, nearly as valuable an alimen-
tary grain. Unfortunately it is not so toothsome as wheat, ai)d can
never be so popular an article of diet. The Scotch, however, feed
upon it with apparent relish, and doubtless think it strange that for-
eign palates are not better pleased with it.

Oats.— This grain, strange to say, has more albuminous, or nutri-
tive matter, more fat, more starch, and more salts than wheat. In
uniting a large quantity of the four alimentary groups, it surpasses

HYOIKNE.

liutri-
In
basses

every other vegetable substance. In albumen, it is not quite as rich
as peas and beans, and in starch it falls a trille below fine wiieat
rtoiir ; but in fat it is exceeded only by Indian corn. This grain is
likewise cousiuned largely by the Scotch, — a people whose claims to
sliiMwd common sense are well supported by, iw their liardy coustitu-
tioiis vindicate, tiie choice. This grain might well be permitted to
tike tiie j)lace of rice. It affords several times as much nutriment,
u liile it costs only about one-fifth as much. There is good reason
why the hoi-se should thrive upon oats. Most stidjle-keepei-s think
their horses will do more work upon corn-meal, but this must Ihj a
mistake. In using oats for horse-feeding, a large portion of the nu-
triment is lost by not (jrinding them.

Rye. — This is also a grain of considerable nutritive value. It is
much cheaper than wheat ; and r3-e meal has long been a standard
article of diet in New England, — particularly in connection with
Indian meal, as "brown bread." It is useful for relieving costive-
ness, in th« form of " hasty-pudding," with molasses.

Indian Corn. — This stiiple article of American produce needs no
praise from me. It is comparatively cheap, nutritive, and wholesome.
It abounds in fat and starch, and has a fair amount of albumen,
though not as much as the oat, the barley, or the wheat. In salts, it
is rather deficient. Indian corn is strictly an American plant, and is
perhaps the most popular grain in the country. It has emphatically
a national reputation, and is perhaps worked up into more savory
dishes than any otlier. At the South it is an institution. It is there
made into hoe-cake, corn-cake, batter-cakes, batter-bread, muffins, corn-
pone, etc. At the North, we have johnny-cake, Indian and pumpkin-
cake, baked Indian pudding, boiled Indian pudding, beside the well-
known rye and Indian bread, and other preparations. Give an in-
genious Southern or Northern housewife a few simple adjuncts, such
as lard, milk, sugar, eggs, cream of tartar, and soda, and she will
make a pretty respectable larder from this single grain. If molasses
be substituted for sugar, and a little stewed pumpkin be thrown in
by way of garniture, we may have several preparations which are
very nourishing as well as cheap.

Buckwheat. — Poor in nutritive matter, fat, starch, and sugar, but
tolerably well supplied with salts. Jt will do very well for batter-
cakes in winter. When brought smoking upon the table, and served
with sugar or molasses and butter, these cakes are a luxury, in which
the rich may indulge if they clioose ; but for the poor, the amount of
nourishment they afford is too small for their cost.

Rice. — Much like buckwheat, except that it has more fat, sugar,
and starch, and less salts. As an article of diet, it has had too high
a reputation. Those who would live on small means cannot afford
it. Boiled in plain water, it is excellent for a relaxed state oi tlie
bowels; and this about all the conunendation to which it is entitled.

HYOIKMB.

Beans.— The rlclicHt in nutritive mutter of all vegetable substances,
except cabbage and oats. They have more albumen than wiieat, or
corn, or barley, or oats ; but in fat and starch they are lower in Ihe
scale. Add to them salt pork, and the highoet of all nutrient com-
pounds is obtiiined. During not less than four generations, pork
and beans, as the principal diet, nourished an iron-sided race of men
in New England. Hcan-porridge was like honey upon tlie tongue of
the foundem of New England institutions. They ate it morning,
noon, and night ; and thanked God for it every time. And well they
might thank Him ; for, with Indian corn, it furnished them with a
diet better adapted to their condition than any other.

Peas. — Not quite as rich as Iwans in albumen, but more rich in
starch, is of about the same value on the whole. The Canadian French,
in Lower Canada, feed on pciis to about the same extent that the
New Englanders did on l)eans. Pea-soup, as prepared by the best
cooks among them, is a dish of great nutritive excellence ; and, in
my judgment, more palatable than bean-soup.

The Potato. — Three-quarters of this root is water, and it is poor
in all the elements of nutrition. It is a palatable article, and most
persons are much attached to it. As bulk is of some consequence in
food, the potato is not without value. Men do not often live entirply
upon potatoes, — not even in Ireland. Milk, butter-milk, and cop.>
cially cabbage, are united with them.

Turnips, Carrots, Beets, Parsnips. — These are much alike, —
being all poor in nutritive qualities. They serve to please the pal-
ate by furnishing a variety ; but in our city markets they are expen-
sive, and do not furnish an economical diet.

Cabbage. — It is interesting to observe how the instincts of men
have in all tages led them to select those articles of diet which their
circumstances have demanded. The poverty of the Irish has led
them to subsist hugely upon the potato, — a root which the soil of
their country yields profusely. But as this root has but little nutri-
tive matter, necessity required that it should be united with some
other vegetable. The natural instinct selected the cabbage ; and
when chemical science came, at length, to pass judgment upon the
correctness of this instinct, it turns out that the cabbage is the richest
in albumen of any known vegetable. The cabbage, then, is the nat-
ural complement of the potato ; and the Irish had the sagacity, with-
out science, to bring the two together. It is said the Irish have a dish
named " kohl-cannon," consisting of boiled and mashed potatoes and
cabbage, seasoned with pork fat, pepper, and salt, and that it is a
truly savory dish. It certainly is a nourishing and a cheap one. The
ambassador who was sent to tamper with the patriotism of a Roman
who liad dined on beans, wiis asked if he was silly enough to think
gold anti silver could bribe a man who was satisfied with so plain a

HYQISNE.

9»

expen-

of men
ch the li-
as led
le soil of
iiutrl-
th some
^e ; and
)on the
richest
the nut-
ty, with-
Ive a clisli
toes and
it is a
ne. The
Roman
) think
ph'in a

fare, and dcsirod no other. We come to the fonrhision then, that
l)ean-|i()rridgo, pcii-noin), «iU!t-piulding swecflened with nioliisHeH, tuit-
iiieal, iiiid buioy-hreiid, with " kohl-ciiniion " for those who can digest
it, will t'urniBh, for hard-workinjj men, tlm most Knhstiintial diet, at
the smallest possible G"i)en8e. To ren(U'r these dishes savory, and
to make the bible on which they are spread an inviting lx)ard, the
deft housewife must emph)y her best skill in servinjj them. With
the thouspud " fixings, with whi<h a New England matron knows
how to garnish them (or would know how if they came within her
culinary operations), they are well fitted to leave savory impressions
upon tongues which would praise them to the end of life. I speak
of these articles as furnishing a cheap diet for working men. The
indolent, the sedentary, and the effeniimite from various causes, uould
not digest them.

The Amount of Food Taken.

We have already exj)lained that this should be governed, in part,
by the amount of exercise taken, by the condition of the health, by
the state of the mind, by the climate, by the seiuson, etc. It remains
to add a few words in a general way, respecting the rtl)eolute amount
required by an adult man.

It is plain enough that most men eat too much. We come veiy
near, in this country, being a nation of gormands. A principal rea-
son of our over-eating is, that we eat so fast. When the food is well
and slowly masticated and swallowed, the gastric juice has time to
mix with it ; and at the proper moment the appetite ceases. But
when our food is bolted rapidly, nature, finding her laws disregarded,
and all her purposes frustrated, stands back, and lets mh learn to stop,
too late, alas ! from a sense of fullness in a stretched and abused
stomach.

It has already been stated that Lewis Cornaro lived fifty-eight
yeai-s, namely, from the age of forty-two to one hundred, on twelve
ounces of solid food a day, with about the same amount of light
wines. At the age of eighty-four he wrote a book, in which he
praises " divine temperance " in terms which are sometimes eloquent
and often enthusiastic. Indeed it is very rare that a man at tliat
age retains such clearness of intellect, and especially such freshness
of feeling as he evinces in his book. Probably but few could live on
tlie amount of food which he found sufficient. Yet it is said tlie
distinguished John Wesley lived on sixteen ounces a day, which, as
he took no wine, and had to derive the combustive materials for
warming the body from the food, was quite as scanty a fare as that
of Cornaro. Considering that he led a most extraordinarily active
life, both of body and mind, being half his waking hours in the sad-
dle and preaching almost daily, this is probably the most remarkable
case of absteminousness on record. Jonathan Edwards did not, I
think, exceed the same amount of food, but he was not so active a
man.

HYfilKNE.

Putting asido such oxcoptiotml civhpr ns (Ih'hc, w«' nmyHay in round
iiun)bei*H, tliat ii ltilN)riii^ iiiiiii r(M]iiiri!H, ti> k(!(i() him in luniltli, aluiiii
two or two and a half pnumlB of Holid food per day. For miniHtvi'x,
lawyerH, doctoix, aiillioix, and niun-lianUi, ono pound and a lialf is
amply Huniciunt. TUv amount hIiouUI Ik; inciraHod a littlu iiy a se-
lection from Honut of tlu; fnul-fonnurM, if no ft>rmonte<l or alc()lit)li('
drinks Ixt taken, and Hlightly diminished if they are UHed. Tlii' ivii-
Hon is that thuNi' drinkH furnish fuel to l>c lmrni>d in hreatliin^',
which haw to l)e drawn from the food when they are not employi'il,
This furnisheH no motive for usin// ardent spiritM ; for there is fuel
enough tu be had in the oJs, starcheH, and sugani.

Dyspeptics. — U is said that dyHi>eptic8 eat more than {Mirsons in
health ; and, in many caHes, the remark may he true. The appetite
of a person suffering from this disease is almost always morbid, and
the information it gives respecting the real want« of the systenj van
seldom be trusted. If we allow a disetuied sk)math to dictate to us
when and what and how much we shall eat and drink, our misery
for life is a foregone (juestion. A sick stomach is like a spoiletl eliild,
— it cries for what it should not have. If the dyspeptic will live,
and enjoy any amount of peace and eonifort, lie must follow tiiis
simple rule : I'o eat no more than can be diiiegted, even though the
amount be only an ounce a day.

Animal and Vegetable Food.

It has generally been supposed that it was intended man should
subsist on a mixed diet, consisting of both animal and vegetjii)le
substances. Within the last fifty years, however, a school of physi-
ologists have appeared, who affirm that a vegetable diet is alone
consistent with the laws of health. They declare tiiat animal food is
not adapted to man's organization, — that it unduly stimulates the
blood, predisposes tf) fevers, consumptions, diarrhoeas, choleras, apo-
plexy, and numerous other diseases, and of course shortens life.
That such a school should have come into existence in this countiy,
where animal food is more largely consumed than in any other part
of the world, in proportion to the number of people, is not surprising.
We do, undoubtedly, eat too much flesh. So enormous is the consunip
tion, that notwithstanding the vast herds of cattle raised in all our
agricultural states, and especially on the western plains, the deniund
keeps up with the supply so well that beef brings, on an average,
about twenty centa per pound, — at least twice its full value as a
blood-former.

Facts show that man may live upon flesh alone, upon vegetables
alone, or upon flesh and vegetables combined. Is it be»t he should
subsist upon vegetables only, or upon a mixed diet ? A mere affirm-
ation upon these points is of little consequence. To cite facts avails
nothing. Men have a way of making their own affirmations, and of

HYaiENE.

lortkiiig lit factH with oyes which uometimcs see clearly enough on
lK)th HidcH of them, hut totally ignore their existence.

Man's Structure Settles the Question. — To settle thJH matter, we
must a[)]>eal to man's organization. His structure will tell uh some-
thiiiji; we need not mistake. All the works of God show design.
Kvi'iything he has made has a use, and is so contrived as to he
iidiipted to that use. Lions, tigers, and other animals, for example,
whicli feed on flesh alone, have a tshort second stomach, — it heing
(inly ahout three times tiie length of the animal's l)ody. Aninials
witicli eat no flesh have a long second stomach, — that of the sheep
lieiiijr from thirty to thirty-five times the length of its body. A very
iviiiarkablo difference of anatomical structure I

This is the meaning Oi .he difference : Vegetable foqd has a great
(leal of waste matter in i Woody fibre makes quite an item in it«
cDiiiposition. This wiuste portion must be carefully separated from
the nutritive part, and tiiis must all be done in the second stomr. h.
It takes time to do it. It must not l)e done in a hurry. The nutri-
tive materials are destined to build a living structure, whose dura-
tion, like that of all other fabrics, will depend on the care with
which the materials are selected and put together. The second
stomach of the sheep is long, that there may be ample time for the
mixed mass of chyme, when it pisses out of the first stomach, to Xte
(iiaiiged to chyle, and then to lie carerfully separated into the two
parts, the useful and the useless. Animal food is in iXn composition
just like our own flesh, — the « is little waste matter, and not much
time is required for it« separation ; ^ ^nce, the second stomach of
flesh-eating animals is short. Nearly the whole alimentary mass is
([uiekly taken up by the lacteals, and there is no occasion fOr itf
travelling through a long second stomach.

Mans second stomach is in length midway between that of the
fle8h-<^ating and the vegetable-eating animals. If there be design in
the works of the Creator, and if that design in the structure* of the
flesh and vegetable-consuming animals has now been correctly inter-
preted, it is plain that man is best nourished when he eats both kinds
of food. The structure of his teeth and the motions of his jaws
(see p. 80), confirm the same conclusion.

Americans Eat too Much Meat. — Yet, as I have said, there is no
doubt the Americans eat too much meat. Sedentary persons require
but very little. Less is wanted in summer than in winter, — in warm
chiiiat€s than in cold. People of wealth, whose circumstances im-
pose no bodily hardships, need less than the poor, who are much
exposed, and work hard; whereas, they consume more. Those who
<lo not labor with their hands, should never taste meat more than
oncfc a day.

It ife painfuUy-amusing (if such a compound word is admissible)
to hear a nervous female, whose sole exercise consists in going from

m..

HYQIEME.

the parlor to the kitchen once or twice a day, and in making a brief
shopr'ug excursion once a week, complain that she cannot maintuin
her strength unless she eats freely twice a day of moat, vnd takes her
free potations of strong coffee and wine.

A like opinion prevails generally among the feeble who are not
obliged to labor. Tiie child in its nurse's arms must daily, it is
thought, suck a piece of chicken or beefsteak in order to thrive.
Children thus fed have their blood constantly inflamed, and stand a
poor chance when attacked by scarlet fever. The little master or
miss who attends school complains of headache, and grows pale,
feeble, and nervous. The booki are blamed and thrown aside for
what the dishes have done. The doctor is called in and assured
that the dear child can eat nothing but a little fat broth, a custard,
or cake ; and if he prescribe a diet of plain bread and milk, he is
believed to be heartless, and his prescription is not followed.

The Majority of Mankind Eat no Flesli. — All such misguided
persons should be apprized that the great majority of mankind eat
no flesh, because they cannot afford it. And they do not appear to
suffer from its loss. Millions of 7rish do not taste of flesh or fish
from one month's end to another. Potatoes, oatmeal, and cabbage
constitute their chief diet. Rice, poor aa it is in nourishment,
sustains, when combined with vegetable oil, millions of people in
Asia. The Lazaroni of Naples, with active and finely moulded
forms, live on bread and potatoes. These facts do not afford ground
for altogether rejecting animal food, any more than Bayard Taylor's
statement respecting whole tribes in Africa who live upon flesh
furnishes a reason for excluding vegetable aliment. Man may live
and enjoy health upon either, but his organization implies the use
of both.

Proportions of Animal and Vegetable Food.

Upon this subject, it is impossible to fix any absolute rules. This
is a point which must be determined by the temperament, the state
of the health, the constitution, etc. Persons of a scrofulous habit
should eat freelj'^ of animal food. But an inflamed stomach should
never be tormented with flesh. Meat is stimulating, and will i)C
almost sure to do nc'schief v hen there is heat and tenderness at the
pit of the stomach. There are cases of inflammation of this organ,
in which it may be necessary to live on bread and milk, with articles
of the starch group, for months, and even for years.

On the other hand, when the system has run low from some
exhausting disease, which excites no feverish action, it may be
necessary at times to take a diet almost exclusively animal.

It is absurd to talk of the same diet as adaptea to all persons, even
when in health. As well might we expect one shoe to fit every
foot, or one coat every back, or one color every eye, or one doctrine
every mind.

nummm

HYGIENE.

Temperance the Main Thing. — After all, the great thing to hv>
aimed at is tempenince. It is not so necessary to reject one article
and use another, as to partake of all with moderation, " I do not
live to eat and drink ; I eat and drink to live," said a wise philoso-
pher of the olden time. One would think the moderns have
reversed this rule. A modern table has the appearance of being
s[iread for the purpose of inducing men to eat all their stomachs will
hold. A man who can dine daily, for half a dozen years, at one
of our first-class hotels, and then find himself free of dyspepsia and
all other diseases, must have a fine constitution, as well as most
admirable control over his appetite. Mr. Addison said, " When I
behold a full table ^et out in all its magnificence, I fanr^ . see
gout, cholic, fevei-8, )d lethargies lying in ambuscade among the
dishes " ; to which he adds, with much truth, in another place,
" Abstinence starves a growing dist3mper."

Qood Results of Temperance. — A temperate diet has always
been attended with excellent results, and always will be. There are
times of great anxiety, when abstinence should be pushed to the
extreme verge of endurance. During the siege of Gilbraltar, Lord
Heathfield, its gallant defender, lived eight days on four ounces
of rice per day. Dr. Franklin, when a journeyman printer, lived
two weeks on bread and water, at the rate of ten pounds of bread a
week, and was stout and hearty. Dr. Jackson, an eminent physician
in the British army, says, " I have wandered a good deal about the
world, and never followed any prescribed rule in anything; my
iiealth has been tried in all ways ; and, by the aid of temperance and
liard work, I have worn out two armies, in two wars, and probably
could wear out another before my period of old age arrives."

Lord Bacon was right in tlie opinion that intemperance of some
kind or othtjr destroys the bulk of mankind, and that life may be
sustained by a very scanty portion of nourishment. Cornaro, whom
I have before mentioned as having lived fifty-eight years on twelve
ounces of solid food a day, wrote as follow respecting himself in
his eighty-fifth year : " I now enjoy a vigorc"8 state of body and
of mind. I mount my horse from the level ground ; I climp steep
ascents with ease ; and have written a comedy full of innocent mirth
and raillery. When I return home, either from private business or
from the senate, I have eleven grand-children, with whose education,
amusement and songs I am greatly delighted; and I frequently
sing with them, for my voice is clearer and stronger now than ever
it was in my youth. In short, I am in all respects happy, and quite
a stranger to the doleful, morose, dying life of lame, deaf and
blind old age, worn out with intempei-ance." Howard, the philan-
thropist, fasted one day in the week ; and Napoleon, when he felt his
system unstmng, suspended his meals, and took exercise on horse-
l»ck.

Nothing can be plainer than the duty of fasting, when the
stomach, having been overworked, is disinclined to receive food.

HYGIENE.

Brutes invanably follow this suggestion of nature ; they never eat
when sick, — probably because they have no silly nurses to coax
them to swallow stimulating aliments. The habit of putting high-
seasoned food into the stomach when it is inflamed and feverish is
about as wise as directing streams of blue, violet, or red light into
the eye when it is red and swollen with inflammation.

Tea and Coffee.

It is proper, before closing this chapter upon diet, that something
should be said respecting the beverages of tea and coffee.

Some years ago, a meeting was held by the leading physicians
of a city in the old world, in which the merits of tea and coffee were
discussed. In this discussion each man first stated his experience
in the use of these articles, and then consti acted his argument
according to that experience. The amount of what the reader could
learn from the discussion was that Dr. A. had used tea all his life,
and been benefited by it, while coffee had uniformly injured him ; and
that he thought tea should be used, while coffee should be rejected ;
that Dr. B. had taken coffee at breakfast, and found it an excellent
support to the stomach and nervous system, while tea had disturbed
his digestion and his mind ; and that the former was a beverage
of excellent qualities, wnlle the latter was detestable ; that Dr. C.
had always drank both tea and coffee, and recommended them to
everybody ; and that Dr. D. had hi^iself never been able to indulge
either tea or coffee, and would have them both expelled from every
household.

The discussion was not creditable to the learned and really able
men who participated in it. The arguments were all based upon the
miserably narrow basis of single individual experiences. They were
no more valid than that of the man who should hold up a shoe, de-
claring it fitted his foot the best of any he ever had, and recommend-
ing all men to have their shoes made upon the same last.

The truth is, there is but one thing which can be afiirmed univer-
sally of the effect of tea and coffee. They both, when taken, tend to
prevent waste in the body, and, consequently, less food is required
when they are used. This may be afiirmed of tLem in their applica-
bility to all persons, but nothing further. The truth is, some can
drink tea but not coffee, and some coffee but not tea ; some can use
both, and some neither. Every man's susceptibility to the effects of
these beverages is his own, as much as liis susceptibility to the effects
of light, or heat, or atmospheric changes ; and these effects, each per-
son must learn from experience. Coffee often produces, and gener-
ally aggravates, a bilious habit, — an effect which cannot, I believe,
be traced to the use of tea. I have no doubt but that many cases of
confirmed dyspepsia are traceable to the use of coffee alone.

HYGIENE.

Water.

There is one universal beverage ; it is water. All men are fond
of it. In sickness and in health, in joy and sorrow, in summer and
winter, in cold climates and in hot, man loves and drinks water. The
stomach, abused and made sick by stimulating food and drinks, and
repelling everything else, still gratefully opens itself to water. Wher-
ever man exists, therefore, or wherever he should exist, water is
found, either in the form of springs, or running brooks, or rivers, or
ponds, or lakes ; and even where it is not found in some of these
forms, it is periodically dropped down from the clouds. As there is
110 element in nature more necessary for ' j *s existence than water,
80 there is none more universally diffuse'

Pure Water Essential to Health But water varies very mate-
rially, both in its pliysical qualities, and in its adaptation to its pur-
poses. Pure water is as essential to health as pure air. When either
of these fluids is rendered impure by mixture with foreign matters,
disease will be a frequent result. The ancients must have been in-
fluenced by this fact, or they would not have incurred such heavy
expenses in procuring pure water from great distances. The strong
aqueducts through which, for many miles, large streams of water are
even at this day poured into Rome, attost the freeness of the expendi-
tures she mad^ for this purpose in the day of her greatest renown.
We may pity the ancient Romans for being governed in their military
operations by the opinions of augurs and soothsayers, and certainly
these things were silly enough ; but in other things, at first view
equally superstitious, they showed practical wisdom. Vetruvius re-
ports that in selecting the sites of theii: cities, they inspected the
livers and spleens of animals to learn the salubrity of the waters and
the alimentary productions of the region. The size and condition of
these organs do in fact indicate the nature of the pasturage and the
qualities of the water with which animals are supplied. No people
can enjoy good health when subjected to the double influence of bad
water and impure air.

Division of Water. — The simplest division of water is into two
kinds, soft and hard. Rain, river, pond, and snow water is soft:
well and spring water is generally hard. Soft water contains but
little impurities, and when used for washing, forms a good lather
with soap. Hard water contains at least one of the salts of lime,
often more ; mixed with soap, it curdles and turns white. Tte reason
of this is, that the oily acids of the soap unite with the lime, and
form a compound which the water will not dissolve. Such water is
not suitable for domestic purposes.

Chemical Nature of Water. — Water contains, reckoning the ele-
ments of which it is composed in volumes, two volumes of hydrogen,
and one volume of oxygen. These two gases, the unlearned reader

HYGIENB.

will please remember, &.re highly subtle bodies, not visible to the eife ;
and yet, when chemically united, they form a liquid which covei-s
two-thirds the entire surface of the globe, — floating upon its lx)S(im
the navies and merchant ships of all nations, and by its unmeasured
depths and vast breadths and sublime movements, fills the thoughtful
mind with conceptions of creative Power, which words never attempt
to express. Should the two gases which compose this vast body of
water cease to love each other, and fall asunder, the first lighted taper
would set the world on fire, and not a living being upon its surface
could escape destruction.

Impurities in Water. — It is not surprising that a fluid with as
great a solvent power as water, should often dissolve and hold in
solution a great many impuritiss. In passing along through the
earth, before it comes up in springs and wells, it is filtered through
various mineral earths, and becomes contaminated accordingly. In
running through beds of limestone, it takes up a little carbonate of
lime. Salt-beds impart to it common salt (muriate of soda), while
sulphur and other ores tinge it with salts of various kinds.

Warer-Supply. — At the present time all large cities and most of
the towns in this country are supplied with water for domestic pur-
poses, either from ponds or lakes, or from artesian wells, of greater
or less purity, but in almost all cases superior to the common well-
water, so liable to contamination by cesspools and sewage. The re-
sult is that the health of the people has been materially improved,
and fevers, particularly those of a typhoid type, have diminished both
in prevalence and fatality. The decaying vegetable and animal mat-
ter, which formerly was washed into the soil, and percolated into and
poisoned the wells, is now washed away by copious supplies of pure,
fresh water.

Lead Pipes. — In cities, water is usually conveyed through the
dwellings in leaden pipes, — a practice fraught with a danger, to
avoid which various expedients have been devised. That lead does
often become oxidized and impart its poisonous properties to water
when long in contact with it, is a well-known fact. Let a number of
persons drink every morning from the the first water drawn from tiie
pipes, and a portion of them will be attacked with some form of lead
disease. The pipes should be emptied every morning before using
the water for domestic purposes, and then there is little danger. Tin-
lined pipes have been found to be almost entirely free from danger
of lead-poisoning.

Physical and Otlier Properties of Water.— Good water is with-
out smeil, is perfectly clear, and in the mouth has a soft and lively
feel. Whan poured from one vessel to another, it should give out
aiivbubbljb. Boiled and distilled waters have a vapid, flat taste.
This is ovdng to their containing no carbonic acid gas or atmospheric

acid

MVJ

Wff«

HYGIENE.

air, — these being driven off in the act of boiling and distilling. A
hundred cubic inches of good river water contain about 2^ of carbonic
acid, and 1^ of common air.

Carbonic acid is what gives to mineral, or soda water, its brisk,
and even pungent taste. Without a portion of this acid and atmos-
pheric air, water is perfectly insipid, and not fit to be used as a bev-
erage. Hence, if it be boiled or distilled to clear it of earthy matters,
we must expose a large surface of it to the air, and shake it, that it
may re-absorb from the atmosphere what it has lost, and thus recover
its taste. . .

Rain Water is the Result of Distillation on a large scale, and
would be insipid, like other distilled water, only that, after being
distilled off from the waters upon the surface of the earth, it recovers,
while ascending as vapor, the carbonic acid and atmospheric air.

Fishes breathe air as well as land-animals, and hence, lakes upon
the tops of high mountains, where but little oxygen can be absorbed
into the water from the air, are not inhabited by the finny tribes.

The Saltness of the Ocean is simply the accumulation of the saline
substances washed out of the bowels of the earth.

The water which for thousands of years has been distilling off as
vapor from the surface of the ocean is nearly pure. Reing carried
by the winds to the continents, it falls as rain, sinks iulci the earth,
is filtered through mineral substances, comes to the surfaces in springs,
is collected into rivers, and, with all its freight of mineral salts, is
borne back to the ocean. Everything that water can dissolve, and
carry down from the continents, finds a great depository in the ocean;
and as this has no outlet, the accumulation must go on without limit.
Rivers which flow into the ocean contain from ten to fifty grains of
salts to the gallon, — composed chiefly of common salt, sulphate and
carbonate of lime, magnesia, soda, potash and iron ; and these are
the constituents of sea-water.

Cleansing of Impure Water. — Impure waters should be cleansed
before being used for domestic purposes. Distillation is the most
perfect method of purification. Filtration through sand is a good
method. It removes all suspended vegetable or animal matter, and
all living animals. Boiling likewise kills all animals, and throws to
the bottom carbonate of lime. It is this which constitutes the crust
which lines tea-kettles in all regions where limestone exists.

'Settlers in a new country should make it a prime object to find
good water. This is of great moment. Their own health and the
health of their posterity is dependent upon it. Any soil, good or
bad, is not worth half price, if it yield impure water.

Reasons for Prizing Water. — Finally, we ought all to prize water
very highly, for it composes nearly eight-tenthn of our entire bodies, in-
cluding our flesh, blood, and other fluids. Nay, we owe to it the very

HYGIENE.

softness, delicacy, and smoothness of our persons. Our musclfs.
nerves, blood vessels, glands, cartilages, etc., all play smoothly upon
each other in consequence of water. Take all the water out of us,
and we should be dry sticks indeed. All our comeliness would W
gone. Nobody would or could love us. We should be walking
reeds, sh ' -n and sported with by every wind. Let us never forget
how mu ire indebted to water.

Exercise.

Animal life is conditioned upon exercise. Without it health can-
not exist, or life -itself be continued for any great length of time.

Proper exercise communicates motion to every part susceptible of
it. It expands the chest, contracts and relaxes the muscles, quickens
the motion of the blood, moves afresh all the other fluids, and stirs to
the centre of the whole frame. More easy and perfect digestion, the
nutrition of every part, and the proper performance of all the secre-
tions and excretions, are the results of such exercise.

A distinguished physician said : " I know not which is most neces-
sary to the support of the human frame, food or motion." Some of
the finest talents in the world are probably lost for the want of
exercise ; for without it the mind loses its keen perception and its
bounding energy, ita power of application and its general scope. If
men of great talents would give attention to exercise, the world
would reap a larger harvest from their written thoughts.

The arrangements of modern society have very much abridged the
facilities for taking exercise ; but if Trenck in his damp prison,
with fetters of seventy pounds weight upon him, could preserve his
health by leaping about like a lion, most persons could do as much
with the fetters of modern society upon their limbs.

Must be Regular. — Exercise, to be of much service, must be regu-
lar, — not taken by fits and starts, — a good deal to-day and none to-
morrow ; but in reasonable measure every day. Occasional efforts,
with intervening inactivity, only does mischief.

Must be Pleasurable. — It should be connected, too, if possible,
with some pleasing occupation or pursuit. The movement of the
limbs should carry us towards some place or end in which the mind
feels an interest ; exercise will then do us most good. Hence botan-
ical pursuits, the cultivation of a garden, and the like, are often pre-
ferable to a solitary and aimless walk. ,

Must not be Excessive Exercise should never be carried so far

as to produce great fatigue. Extremes are injurious ; and too much
exercise, especially by a sick or feeble person, may he as injurious as
too little.

No clothing should be thrown off after exercise, nor should one
cool off by sitting in a draft of air. Very serious consequences often
follow this practice.

HYGIENE.

Not to be Taken After Meals. — It is not best to take exercise im-
mediately after meals. The reasons for this caution have been ex-
plained. It is true many laboring men go at once to their work after
eating, without apparent injury. Yet they are strong, and can en-
dure what those who use their brains chiefly could not. And even
they do not labor as easily and cheerfully immediately after dinner.

Active and Passive. — Exercise is properly divided into active and
passive. Walking, running, leaping, dancing, gardening, various
sports, etc., are active. While sailing, swinging, and riding in car-
riages are passive. Riding on horse-back is of a mixed nature, —
being both active and passive.

A few remarks upon these several kinds of exercise will have a
practical value to some of the readers of these pages.

Walking is one of the most gentle, easy, and generally one of the
most useful of the active exercises. It is within the reach of all who
have the use of their limbs, and is indulged at the expense only of a
little shoe-leather. To make it agreeable, the face is only to be
turned to some favorite locality, and the mind put in communion
with the voices of nature.

To walk with the best advantage, the body should be kept upright,
the shoulders thrown back, the breast projected a little forward, so as
to give the lungs full play, and the air an opportunity to descend to
the bottom of them. This attitude places all the organs of the body
ill the most natural position, and relieves them from all restraint.
Walking then becomes a source of pleasure. The artist who bends
over his pallet, and gets into a cmmped position, is by this kind of
walking relieved, and his body kept upright. Females, particularly
of the wealthier class, are much more apt to neglect this species of
exercise than males.

It is not so in England. There it is no uncommon thing for ladies
of high rank to walk ten miles a day ; and they do it in shoes of suf-
ficient thickness to protect their feet from all dampness, and in
clothes large enough to give their muscles full play. As a conse-
quence, they enjoy excellent health, and in many cases even retain
their freshness and beauty to old age.

A master of one of the vessels of our navy who spent some time,
lately, in the British Channel, was several times invited to spend the
evening at Lord Hardwick's, where he made the acquaintance of two
•laughters of his lordship, who, in the drawing-room, he thought the
most accomplished ladies he ever saw. Yet those young women, on
two occasions, in company with other friends, walked miles to visit
his vessel, once on a rainy day, clad in thick, coarse cloth cloaks which
no rain could penetrate, and caring as little for wet weather as a
couple of ducks.

Good for the Studious. — For the studious, walking is a most capi-
tal exercise. It varies the scenes so constantly, and brings the mind

■•BiiiiTirann/Tir'

^■''■■■" ■ ■ I

HYGIKNE.

in contact with so many objects, that the monotony of in-door Hfe is
admirably broken. It was a maxim of Plato, that " he is truly a crip-
ple, who, cultivating his mind alone, suffers his body to languish."

Good in Cold Weather. — Walking is valuable in cold weather,
because it exposes one to the cold atmosphere, and hardens the person
against frosty weather, — a consideration of great consequence in
countries which are subject to extremes of cold.

Running and Leaping are forms of exercise which should be in-
dulged with prudence even by the young and healthy. For the feeble
and the aged, they are entirely inadmissible. Used cautiously, in a
system of regular training, they may help raise the bodily powers to
a high degree of agility and endurance. The North American Indian,
who was bred to the chase, ran with surprising swiftness, and for en-
durance was scarcely excelled by his faithful dog. What training
has done for the Indian, it may do for the white man, who may
chance to inherit as good a constitution.

Tlie Qame of Base-Ball requires very active running, and for the
young, it is an exceedingly healthful amusement. It fills the whole
frame with a bounding spirit, and sets the currents of life running
like swollen brooks after heavy rains.

QymnasticA. — The more active species of exercise have generally
been included under the term gymnastics. Among the (ireeks aiul
Romans, feats of strength and endurance were supposed to confer
honor. For this reason, and because war was a laborious calling, re-
quiring bodily endurance and strength, their youth were trained in
the most active exercises. Gymnastic games were with them at once
the school of health, and the military academy.

In England, during the middle ages, acts of Parliament and royal
proclamations were 'employed to regulate and foster those manly
sports and exercises, which fitted the people for the activity required
on the field of battle.

Those preparations for brutal wars would be unsuited to the pres-
ent state of the world ; but the capacity for endurance which these
trainings produced, could be most usefully employed in the laborious
and scientific researches which modern advancement requires. Very
few of our scientific men have sufficient hardness of fi-ame to sustain
them in their laborious studies.

The heart-diseases which prevail so extensively are the result,
many of them, of violent exercise, taken, perhaps, from necessity, and
proving injurious because not a matter of every-day practice. Violent
exercise, more than any other kind, must be regular in order to be
borne.

Needed by Young Women. — Gymnastic exercises and calisthenics
are particularly needed by our young women, to give them something
of the robustness of our mothei-s, a few genemtions back. For the

HYGIENE.

loor life is
uly a crip-
tiguish."

I weatlier,
the pei-soii
qnence in

uld be in-

the feeble

ously, in a

powers to

an Indian,

Hid for en-

it training

who may

nd for the
the whole
'e running

! generally
treeks and
to confer
calling, re-
trained in
3in at once

; and royal
)8e manly
;y required

the pres-
hich these
3 laborious
res. Very
to sustain

the result,
lessity, and
5. Violent
rder to be

alisthenics
something
, For the

want of them, they are dwindling away, and becoming almost worth-
less for all the purposes for which they were made.

In view of this want of exercise the introduction of the lucycle
offers an excellent means of development for ladies, and it is very
gratifying to note its increasing use. It brings into play many of
the nniscles of the body, while affording an exhilarating enjoyment
of fresh air and changing scenery. But caution must be used, not to
overdo one's self. Short rides only should be taken at first, increas-
ing the distance as the muscles l)ecome hardened.

Moderns Physically Inferior to the Ancients. Reason for it. —

It is evident that the moderns are inferior in bodily strength to the
ancient Greeks and Romans. Before the introduction of Christianity,
men knew very little about the future, and therefore strove to make
the most of the present. Hence, they took measures to ensure health
and long life. It is true that a due regard to the welfare of the fu-
ture need not, and should not, prevent a care for the present ; but
from various causes, to be referred to on a subsequent page, such has
been the practice, to the manifest physical injury of the race.

Dancing:, when hedged about with proper restrictions and limita-
tions, has great advantages as a physical training for the young.
There are very few forms of exercise which give so free a play to all
the muscles, and at the same time so agreeably interest the mind.
Begun in early life, and pursued systematicaHy, dancing imparts a
grace and ease of motion which nothing else can give. For this rea-
son alone, it should be cultivated as an art.

Every man and woman is often placed in circumstances in life
where the possession of an easy carriage of body, and an unembar-
rassed manner, would be prized above gold. One's personal influence
in tlie world is greatly increased by an easy, graceful manner. We
all know how a polite manner wins, while a rough and vmcouth one
rejjels us.

Warning against Excess. — While dancing has many things to
recommend it, there are also several considerations which should warn
us against using it to excess, particularly in the ball-rooms of fashion-
able life. So many muscles are called into play, the breathing is so
much quickened, and the air breathed is often so impure, that the
circulation of the blood is hastened almost to fever excitement. And
when to this we add the use of wines and cordials, alternated with
ices and iced drinks, and the exposure, on returning home from balls,
to the chilly night air, under the insufficient protection of light cloth-
ing, we have drawbacks enough to abridge, if not to annihilate the
benefits derived from this otherwise healthful and elegant exercise.

But then it will be said, and truly enough, that these are the abuses,
not the uses of dancing. To these abuses, no parent should permit
the health of a child to be exposed. In the parlor at home, with a few
young friends gathered in to spend an evening ; or, in a well-venti-

XIIMI

IIYGIRNR.

lated hall, under the instruction of a master of known character and
refinement, dancing is of high utility, and much may be said in its
favor. An amusement for which there is so general a fondnoss, one
may say, passion, must be fitted to meet some want of the animal
economy, and perhaps of man's higher nature.

Grace of motion gratifies our sense of the beautiful, and in its na-
ture is allied to poetry. Turning away from the abuses of dancing,
let the reader thankfully use it as one of the very best physical, so-
cial, and rosthetical educatora of youth.

But if dancing is salutary, it is only when every limb and muscle
is allowed to participate naturally and without restraint in the general
motion. When performed in a dress so tight as to restrain all free-
dom, not only is every grace destroyed, but injury of a serious char-
acter may be the result.

The Cultivation of a Qarden is also a species of exercise highly
conducive to health. To the poor it should have a double attraction.
It is not only a healthful exercise, but it yields, in its season, many
wholesome vegetables, the price of which, when they have to be pur-
chased, frequently puts them beyond their reach. It is pleasant to
know that in many of our manufacturing towns the workmen own
small pieces of ground which they cultivate as gardens, — deriving
health both from the labor, and from the vegetables raised. This is
one of the kinds of exercise which are more beneficial from having
an end in view. The man who works in his garden derives pleasure
from the improvement he is making upon his ground, and from the
prospect of advantage to himself and family.

Otiier Active Exercises. — To the exercises already spoken of may
be added those which are mostly taken indoors, — the dumb-bells,
jumping the rope, battledore, etc. They may be resorted to when
the weather is stormy, or when any other cause may prevent one
from going into the open air. Nevertheless, as promoters of health,
they are inferior to those exercises which take one out under the
open sky. They are too mechanical in their nature, and have too
little aim, to be allowed to take the place of the preceding.

Passive Exercises.

Sailing. — This, to many persons, is among the most pleasurable
and exciting of the passive exercises. But the excitement arising
from the motions of a boat, sometimes, in case of timid persons, de-
g lerates into /ear, which is injurious. Young gentlemen who man-
age the boat upon sail:.ig excursions, should never put on too much
sail in a brisk wind, and torment the ladies by exciting their fears, as
their own amusement may be in this way purchased at the cost of
others' health, — a result far enough from their thoughts or inten-
tions, but not the less real.

ja w5-iMwTOiifw i i i iH i nMrii< iBiiMwww».«.

'"nrnfWlifMWii

'-^A'^iiiiaAi

■f<ritii ^

HYOIRNE.

ractcr and
said in itn
(liicHs, one
;he animal

1 in its na-
f (lancing,
lynical, so-

nd muscle
he general
u all free-
rious char-

ise highly
attraction,
^on, many
to be pur-
tieasant to
imen own
— deriving
I. This is
)m having
98 pleasure
i from the

ken of may
lumb-bells,
i to when
revent one
I of health,
under the
1 liave too

pleasurable
ent arising
)er8ons, de-
I who man-
too much
}ir fears, as
;he cost of
s or inten-

Swinging. — The sick may sometimes indulge in this exercise, w^ion
capable of enduring no other. To swing gently has a soothing eflfect,
and often allays nervous irritability in a way which nothing else can.
It is like the lullaby motion of the cradle. It calms and soothes.

Nervous children and grown persons in feeble health are some-
times, by roguish boys, swung too high, and very much excited and
alarmed. This is wrong. It may do great injury. Very few boys
would do it if they knew the evil consequences. Boys and girls are
generally kind-hearted ; and though they may like to hector others,
they will seldom knowingly iin'ure them for their own amusement.

Carriage-Riding. — The advantages to l)e derived from this species
of exercise are probably rated too high. For feeble persons, just re-
covering from illness, who cannot endure walking or riding on horse-
back, it is valuable, particularlj' if taken in an open carriage. But for
those who have more strength, it is less desirable than many other
exercises. True, it is generally an agreeable mode of locomotion, and
for this reason, it is more serviceable than the small amount of exer-
cise afforded by it would lead one to suppose.

Carriages are luxuries, and like all other luxuries, they are apt to
bring on debility, and perhaps shorten life. A man is apt to order
his carriage to the door at the time when increasing wealth enables
him to retire from the active pursuits of life, — the very moment when
he is most in need of some exertion to take the place of that to which
he has l)een accustomed. Yet so it is, luxury comes to enfeeble, at
the time when we need something to harden us.

Could rich men be persuaded to let their luxuries consist, in part,
in doing good, and, like Howard, find pleasure in travelling on foot
to visit those who are sick and in prison, they would be surprised to
see how their happiness would be increased.

Close carriages are generally used by the wealthy. They at best
contain but little air, which is breathed over and over, and becomes
unfit for respiration. The windows of such carriages should always
be open, except in rainy weather, when the latticed windows only
shou'd be used.

Riding in Sleighs furnishes an agreer'ole excitement, and may be
indulged in to some extent with advantage. Yet it can be had only
in cold weather, and persons who partake of its pleasures should be
careful to wear clothing enough to protect themselves against the
frost. This is the more necessary, as very little motion is communi-
cated to their bodies by the sleigh.

Horseback Riding.— This form of exercise may fairly rank next
to walking ; in some states of the system it is preferable. It justly
holds a high rank as an exercise for consumptive persons. Many a
man, and woman too, has been benefited by it when suffering from
lung disease. For those who have hernia, or falling of the bowel, it
is not proper, as the most serious consequences may result from its
use.

lilfi

•i nvniKNE.

The Horse should be Owned, — A feeble man \/ho rides on horse-
back, should, if possible, own his hoi"se ; for, beconiinjr attached to
him, as ho generally does, he will be able to ride farther than ii|)ou
an animal in which he feels less interest. A honse is p. noble cmou-
turo, and a man who loves him will sometimes acquire a passiciji,
almost, for beingupou his back, and witnessing his splendid purfoiin-
ances.

Pleasurable Exercises most Beneficial. — Finally, those exorcises
are most beneticial, and can l>e longest endured, in which we feel the
greatest interest. Place before eveii a feeble man some desirable (»l>-
ject, and he will endure a great deal to reach it; or engage the iiiiiid
of a very tired peraon in something which greatly interests it, and
considembly more exertion will be easily borne;. This is well illus-
trated by the story told by Miss Edgeworth of a certain father, who
had taken a long walk with his little son, and founil the boy appar-
ently unable to walk further, some time before reaching home.
" Here," said the shrewd-minded father, " ride on my gold-headed
cane." Immediately the little fellow was astride the cane, which
carried him as safely home as the freshest horse.

Mentc' Co-operation is of the highest importance in all exercise.
Men who are paid by the job, work with far more spirit than those
who are paid by the day. One would dig in the earth with \ery
little spirit, if he had no motive for doing it ; but if expected with
every shovelful of earth to bring u[) gold-dust, he would not only
work with a will, but would endure a great deal more labor. From
these considerations we may infer that those farmers and manufac-
turers who pay their men the highest wages, make the most money
on their work.

The best time for taking exercise is that in which it does us most
good. For most pei-sons the morning hours may be considered most
favorable. But there are many who cannot take exercise in the early
morning, without suffering from it through the whole day. Some
are able to walk miles in the afternoon, who would be made sick by
similar exertions immediately after rising.

Persons often injure friends who have this peculiarity of constitu-
tion by urging them out in the morning. They do it from good mo-
tives, but are, nevertheless, blameworthy for attempting to advise iu
matters which they do not understand.

Rest and Sleep.

Oim bodies are like clocks ; they run down and are wound up once
every twenty-four hours. Were they obliged to work on uninter-
ruptedly, they would wear out in a few days. It is a merciful pro-
vision that periods of repose are allotted to us. Eveiything has its

-"®^;.?*flAi'.T;-VAt,~ i!K55rei3r«.i'a*a

HYOIENE.

oil liorse-
tiU'lmil to
Imu iijioii
• >l)lo creii-
a passion,
1 pt'ifoiiu-

1 exorcis's

feel ilic

siraltlc dlh

ttu! niiiid

tH it, and

veil illiiH-

itlier, will)

lK)y a|)[)ar-

njj iioiiie.

)l(l-ht>adcd

me, which

1 exercise.

han those

with \^ry

ectcd witli

not only

or. From

. manufac-

ost money

les us most
lered most
1 the early
ly. Some
de sick hy

I constitu-
: good mo-
advise in

id up once
Q uninter-
rciful pro-
ing has its

proper place. Rest is not less a luxury after oxercisc, than exercise
is after rest. They botli confer happiness at the same time thai they
promote our well-l/oing.

Sleeping Rooms. — The largest part of our rest is taken in sleep.
Of course the kind of room in which we sleep is worthy of considera-
tion. Hufeland says: "It must not Ikj forgotten that wo spend a
considerable portion of our lives in the l)ed-chamber, and consecpiently
that its healthiness or iinhealthinuss cannot fail to have a very ini
portant influence upon our physical well-being." It should at lea«t
1)0 huge. That is of prime importance, Iwcause, during the several
iiours tliat wo are in bed, we need to breathe a great deal of air, and
our health is injured when we are obliged to breathe it several times
over. We should at least pay as much attention to the size, situa-
tion, temperature, and cleanliness of the room we occupy during the
horn's of repose, as to the parlors, or drawing-room, or any other
apartment. And yet how different from this is tho general practice
of families. The smallest room in the hoi^ise is commonly set apart
for the bed and ita nightly occupants.

The sleeping-room should have a good location, so as to be dry.
It should be kept clean, and neither be too hot nor too cold. And,
more important still, it should be well ventilated.

One bed, occupied by two persons, is as mucli as should ever be
allowed in a single room ; though, of course, two beds in a large room
are no more than one in a small one. Both are objectionable.

Fire in Sleeping Rooms. — As to having fire in a sleeping room,
that is a matter to be determine:' by the health of the occupant.
Persons who have poor circulation, and are feeble, had better have a
little fire in the bed-chamber in cold weather. For those in good
health a cold room is preferable.

Open Windows in Sleeping Rooms. — In the hot weather of sum-
mer, it is better to keep the windows open to some extent, through
the night, but not on opposite sides of the room so as to make a draft
across the bed.

There is a difference of opinion as to the safety of this practice,
but the experience of those who have used it prudently and persever-
ingly has generally sanctioned its employment. It is presumed that
night-ail is made to be breathed; and if we breathe it habitually,
there is no good reason why it should be considered hurtful. At all
events we have got to do one of three things, — either breathe it, or
be poisoned by air which is breathed several times over, or use very
large sleeping-rooms, and thus lay in a stock to last over night.

An Open Fireplace in a bed-chamber will do much towards its
purification. It carries off foul air. But many persons board up this
outlet as if bad air were a friend with whom they could not think of
parting. At the same time they will carefully close all windows and
doors, as if fresh air were an enemy not to be let in.

100

HYGIENE.

Beds. — It is a pleasant thought that while so many things which
injure health are coming into fashion, some which have a like effect
are going out. Among the injurious things which are silently witli-
drawing are feather-beds.

In earlier times, a bed made of eider-down was thought to be a
great luxury^ to be carefully preserved, and handed down from mother
to daughter. Beds made of hen's feathers, and other coarser kinds,
were thought to be only fit for children. With due deference to
these earlier judgments, it must be said that feather beds, whether
downy or coarae, are not even fit for children. They are composed
of animal matter, and by a slow process of decay, are always, when
stirred, sending up an exhalation which it is not healthful to breathe.

By their softness, too, they increase the general tendency to effemi-
nacy. In warm weather they are too heating. To sink down into
thera, and lie nearly buried all night, is to insure a feeling of lassi-
tude and debility in the morning. Only the strongest persons can
endure it without being made conscious of the evil effects.

Beds must not be too Hard. — On the other hand, it is almost
equally unwise to choose a bed of absolutely unyielding hardness.
When very tired, we may rest even upon a board ; but sleep will
generally be moro sound as well as refreshing, if the bed be some-
what yielding. The hair mattress is the very best bed yet used. It
is healthful and easy. No person once accustomed to it will ever
return to feathera In summer, it is a luxury ; in winter, it is suffi-
ciently warm, though a little more covering is needed than with
feathers.

Bedding. — In hot weather, linen sheets are preferable to cotton,
and of course will be used by those who have ample means. But
cotton ones are good enough, and in winter are decidedly the more
desirable of th<3 two. Cotton is best, too, for those who suffer with
rheumatic affections. For external covering, comforts are objection-
able, because they do not let the insensible pe spiration pass off as
freely as it should. They are light, however, and so are rose blankets,
which have the additional good quality of being porous. We should
sleep under as few clothes as possible, consistently with con. fort.

Night- Dress. — The flannel, cotton, linen, or silk, worn next the
skin through the day, should always be replaced, on retiring, by a
suitable night-dress. The undershirt should be cf the same ma-
terial with that which is taken off, but thinner. If we wear flannel
through the day, we need it quite as much at night.

Do not Cover tlie Face. — The practice of sleeping with the face
entirely covered with the bed-clothes is very injurious. It compels
one to breathe the air over several times.

Natural Position for Sleep. — The most natural position in which
to sleep is upon the right side. This affords the easiest play to the

"■T^aafe'iWa^^^reaBtiBy'gaaw iiiiia^ ^ ATg

HTOIEKI.

101

internal organs. It is best, however, to learn to sleep in different
positions, and to change occasionally from side to side. Upon the
bacic is not so easy a position. To lie in this way obstructs the cir-
culation of the blood, by the pressure of the stomach, bowels, etc.,
upon the large blood-vessels which pass down and up in front of the
backbone. It u very tiresome and inJHrious to lie with the hands
above the head.

Amount of Sleep. — The average auiount of sleep required by
persons in health is from seven to eight hours. Occasionally we find
persons who get along very well with six, or even five hours ; while
some, even in health, require nine. There is no ^vbsolute standard
for all persons, in the amount of sleep, any more than in that of
food. It depends on the temperament, the constitution, the amount
of exercise, and the exhausting nature of the mental application.

The object of sleep is to repair the energies, the extent to which
they are wasted, and the recuperative power possessed, will measure
the amount required.

Late Suppers. — These are a bar to all sound and healthful sleep.
The last meal should always be taken at least three hours before re-
tiring and should be light. During sleep the stomach should have a
chance to rest. It will work the better on the morrow. ^ Some per-
,8ons boast that they can sleep perfectly well after a heavy supper.
Perhaps they can, but, as Franklin lias wisely suggested, they may
by and by " have a fit of apoplexy, and sleep till doomsday." This
will be sleeping too well!

Preparation for Sleep. — Dr. Franklin left behind the record of
a wise life, as well as many excellent moral and philusophical direc-
tions. A good conscience was his prescription for quiet sleep and
pleasant dreams, — a most excellent direction. Sleep is promoted,
too, by withdrawing the mind, a short time before retiring, from all
hard study and exciting themes of conversation, and turning it to
calmer subjects of reflection, such as the moral attributes of God, and
particularly his love and paternal character

Objects oii Clothing.

The clothes we wear are intended, or should be intended, to secure
three objects, — warmth in winter, coolness in summer, and health at all
times.

It has already been shown that our bodies are warmed by their
own internal fires. In the lungs, in the skin, and indeed in all parts
of the body, oxygen unites vath carbon , : d other combustible mat-
ters, producing heat in the same way that it is produced in a grate
where coal is burned ; and as our temperature always needs to be kept
to about 98° Farenheit, it follows that this combustion must always
be going on.

102

HYOIENE.

Now, the atmosphere which surrounds us is alwajrs receiving into
itself the heat which comes to the surface of our bodies, and thus
robbing us of our warmth. In summer, the atmosphere, full of the
rays of a burning sun, may impart heat, instead of taking it away ;
while in winter it takes more than it gives, and would cause us to
parish with the cold, were it not for the protection afforded by our
clothing.

Clothes, of course, have no power to manufacture or impart heat.
They only retain, and keep in contact with our bodies, that which is
generated within us. If we have on a single garment which is made
tight at the bottom and top, so that no current can pass up or down,
there will be a layer of air between it and the body, which, becoming
immediately heated, and being retained there, helps keep us warm, or
rather, prevents us from being cold. With every additional garment
put over this, there is another layer of heated air, adding still more
impenetrable guards against either the intrusion of cold, or the escape
of internal heat.

Bad Conductors of Heat. — But, that our clothes may thus retain
our warmth, and prevent its dispersion, they must be had conductors
of heat, — that is, they must not readily take up the heat and convey
it away from the body. They must slowly absorb the caloric into
their own substance, and then retain it tenaciously.

Linen, which is so universally popular in temperate climates, as
an article to be woi-n next the skin, is unfortunately a good conduc-
tor of heat. It does not afford a warm garment. It conducts heat
rapidly away from the body. Hence it always
feels cool to the touch. It is really no colder in
itself than other kinds of cloth, but it is solely
the rapidity Avith which it conducts heat away
from the body, that gives it the feeling of cold-
ness. It has other qualities which compensate,
in some measure, for this defect. The fibres of which it is composed
are round and pliable, which makes linen cloth smooth and soft, and
the sensations produced by it on the skin altogether agreeable. Fig.
67 represents a fibre of linen, as it appears under a microscope which
magnifies it 155 times.

Cotton is warmer than linen, because it is a worse conductor of
heat. The perfection to which its manufacture has been carried,
makes it almost a rival of linen in softness and pliability. It does
not al)sorb as much moisture as linen, and there-
fore better retains its powers as a non-conductor.
But then the fibres of cotton are not round and
smooth, like those of linen, but flat and spiral,
with sharp edges. Fig. 68 represents two of its
fibres, magnified 155 times. This renders cotton
irritable to some very delicate skins. This is the reason why linen

Fio. er.

FlO. 68.

HYGIKNE.

103

Biving into
i, and thus
full of tlu.
J it away;
iiuse us to
led by our

npart heat,
it which is
ch is made
p or down,
, becoming
8 warm, or
\\ garment
still more
the escape

hus retain
conductors
nd convey
iloric into

limates, as
id conduc-
iucts heat

it always
3 colder in
it is solely
heat away
g of cold-
jmpensate,

composed
I soft, and
,ble. Fig.
ope which

nductor of
sn carried,
. It does
and there-
conductor,
round and
and spiral,
two of its
lers cotton
why linen

FlO. 69.

is better than cotton for binding up wounds, where there is tender-
ness of the surface.

Silk has a round fibre, like linen, which is even softer and smaller.
It absorbs less moisture than cotton, and in its power of retaining
warmth, it is superior to both the preceding. It forniR the most de-
sirable fabric for clothing that we have ; but its cost makes it inacces-
sible to the great body of the people, except as a holiday dress for
the ladies. Its culture in our country, if extensively established,
would be a source of national wealth.

The Fibre of Wool is quite rough, almost scaly, and highly irrita-
tive to delicate skins. Fig. 69 shows fibres magnified 310 times. It
is not possible for some persons to wear it next
the skin. But where this cannot be done it may
be worn outside the linen or cotton ; and being a
good nortrconduetor, it will in this way preseive
the warmth of the body, without either irritating
the skin, or disturbing its electricity.

Wool, in cold climates, is one of the very best
materials of which clothes can be made. In New
England, and, indeed, in all cold and temperate
regions, it should be worn by delicate persons, in
the form of thick or thin garments, all the year round. It does not
readily absorb moisture, and is a dry, warm, and wholesome material
for clothing.

Hair. — Though not precisely in the line of these remarks, hair
may as well be introduced here. Wool is in fact hair. Every part
of the skin, with the exception of that upon the soles of the feet, and
the palms of the hands, is intended to produce hairs. On most parts
of the body, they are short and fine, hardly ri-'ing above the surface.
Upon the head and the face, they grow to coii,.iderable length.

Hair, like wool, is a bad conductor of heat ; and, as growing upon
the head and face, is doubtless intended for some useful purpose.
That it was designed as a warm covering, can hardly be doubted.
The beard, when permitted to grow, is a natural respirator, guarding
the lungs against cold and dust. It has been noticed that black-
smiths who have allowed their beards to grow, had their mustache
discolored by iron-dust, which lodged among the hairs, and very
justly inferred that the dust must have found its way into the lungs,
and done mischief, had it not been arrested by this natural respirator.

That the beard, when long, does Avard off a grcsat many colds and
throat troubles, is too well known to be denied. It has required moral
courage on the part of those who have broken away
from the universal practice of shaving, foe which they
should be honored rather than ridiculed. For those
who do not suffer from throat or lung complaints, espe- 1
cially if they are getting advanced in life, it may not be
thought worth while to abandon the razor. Yet the change would

*!!

FlO. 70.

■P&asvw"

■^^smmmm^ii&m&^^^i<iiiM^>

104

.lYOIENE.

not be regretted. Fig. 70 is a human hair, magnified 250 timts,
showing its scaly surface.

The Color of our Clothing is a matter of some moment. The dark
colors absorb the light, the sun's rays, and heat, much more than the
lighter ones ; and as those bodies which absorb heat well are likewise
good radiators, the dark colors have the highest radiating power. White
reflect heat and rays of light, and is a bad absorber and bad radiator.
In su.amer it prevents the sun's rays from passing inward to heat the
body, and in winter, intermpts the heat of the body in its passage
out. In summer, it makes the coolest garment ; in winter the warmest
one. These facts can be very simply illustrated, by laying, side bj
side, upon the snow, when the sun shines, two pieces of cloth, the
one black, the other white. Lifting them up, after a time, the snow
will be found considerably melted under the black cloth, but not under
the white.

It is now seen that the object of' clothing is not to impart heat to
the body, but to prevent its loss ; that it is not to create it, but to
furnish the occasion for increasing its degree. It appears further,
that clothing protects the body against the evil effects of changes of
temperature, and that white garments, by reflecting, instead of ab-
sorbing heat, guard it against the heat of summer.

Clothing should be Porous. — All articles used for garments should
be porous, and permit the free passage of insensible perspiration. The
skin receives oxygen through its pores, and gives back carbonic acid.
It performs a sort of subordinate respiration. India-rubber garments,
worn next to it, interrupt this, and must do mischief. Shoes made
of this material soon cause the feet to become damp and cold. The
dampness is occasioned by the insensible perspimtion, which cannot
escape through the rubber. Such shoes worn in the open air, should
be immediately taken off on entering the house.

Thin Shoes. — The defective way in which American females pro-
tect their feet from cold and wet, is a sore evil; and he who persuades
them to adopt a wiser fashion, and cover their feet with better guard?
against colds and consumption, will deserve the gratitude of the na-
tion. We are in many things too fond of copying foreign fashions:
but if our ladies would, in this matter, follow the excellent example
of English women, they would live longer, and leave a hardier pos-
terity behind them.

The shoes worn by our females, high and low, rich and poor, are
not thick enough to walk with safety upon a painted floor, hardly
upon a carpet in an unwarmed room ; and yet they walk with them
upon cold brick sidewalks, upon damp and frozen ground, and even
in mud.

The result is, that they suffer from colds, sore throats, pleurisies,
lung-fevers, suppressions, inflammations of the womb, and many other
ailments, which in early life rob them of their freshness and beauty,

'•i»^^\

;k«w«iesii;;;^«i^S£uu^^^

HYGIENE.

106

passage

of tlioir health aftfl comfort, of their usefulness to their linusehold
1111(1 the world, and leave them helpless in the arms of their friends,
with a patrimony of suffering for themselves while they live and a
legacy of disease to hand down to their children. Would that they
were wise in season ' Some, to their honor be it said, have already

adopted a safer coui-se.
rected.

It is hoped the evil will be gradually cor-

Never attempt to mould the Form by Dress. — Parents commit a
great error when they attempt to mould the forms of their children,
particularly their daughters, by their dress. This cannot be done.
It is the work of nature, and she wants no assistance in it. The
great object of dress in childhood, as well as in adult life, is to pro-
mote health. With this, there is not much difficulty in preserving
the symmetry ; without it, deformity is almost a matter of course.

The fact cannot be too often repeated, nor too seriously urged upon
parents, that while the foundation of all graceful and just proportion
of the different parts of the body must be laid in infancy, it cannot
be done by tight bands, and ligatures upon the chest, and loins, and
legs, and arms. Upon all these points, the garments of children
should set easy, leaving the muscles at liberty to assume the fine
swell and development which nothing short of unconstrained exercise
can give. Could infants tell all the hon'ors they suffer from the re-
straints put upon them by tight dresses, it would make many a
mother's heart bleed.

In these brief remarks, the principles are given which should guide
us in the selection of our clothing. The intelligent reader will be
able very easily to fill up the outline.

Bathing and Cleanliness.

Aristotle calls cleanliness one of the half virtues ; and Addison,
ill the Spectator, recommends it as a mark of politeness, and as analo-
gous to purity of mind. Both in the Jewish and Mohammedan law,
it is enforced as a part of religious duty. Its requirement as a pre-
requisite to cliristian communion would be wiser than the demands
sometimes made. A dirty Christian may perhaps be found, but not
among those who mean to be intelligent.

The importance of keeping the skin clean is not generally appreci-
ated. The motive for cleanliness is often a lower and meaner one
than should be allowed to have place in the mind. Many persons
would be mortified to have their hands, or face, or neck dirty, who
ilo not wash their whole body once a year. That they may appear
well in the eyes of others, is the only motive with such for keeping
clean.

Offices of the Skin. — If we look a little at the offices of the skin,
we shall better understand the need of keeping it clean.

■■■■

106

HYGIENE.

The skin is not merely a covering to protect us trom the weather.
It is a living structure, curiously wrought, with a large extent of sur-
face, and having important duties to perform in the animal economy.
Its structure is more particularly explained under the liead of " Anat-
omy " and " Skin Diseases." It has been aheady said, that it helps
the lungs in breathing. It does many other things on Wi.ich the health
is dependent.

Number of Perspiratory Tubes. — The skin performs several
kinds of secretion, — that is, it separates several things from tlie
blood, — one of which is the persjnratfbn, or sweat. The sweat is
formed in small glands, situated just under the skin, and is brought
to the surface in small ducts, or tubes, like the hose tlirough which
firemen throw water. These little tubes are spiral, as seen in cut 44.
and run up through the two skins.

These spiral canals are very numerous, covering every part of the
human frame, - there being about 2800 of them upon every square
inch throughout the body ; and as a man of ordinary size has about
2500 square inches of surface, the number of tubes in the skin of one
man is seven millions.

The mouths of these tubes are called tlie pores of the skin. Each
one of these tubes is extended just below the skin ; and there, among
the cells where the fat is deposited it, or rather the two bi-anches into
which it is divided, is wound into a coil, called the sudoriferous or
sweat gland. These ducts are each about a quarter of an inch in
length, which make an aggregate length of tubing in the human skin
of about twenty-eight miles.

Insensible Perspiration. — Through each of these seven million of
quarter-inch hose, there is poxired out, day and night, as long as a
man lives, a stream of sweat in the form of vapor. When this is
thrown off very rapidly, as happens when active exercise is taken, it
accumulates in drops, and is called sweat. Ordinarily it does not
thus accumulate ; it is then called insensible perspiration, — not
being recognized by the senses.

This transpiration may be proved very beautifully by inserting the
naked arm into a long glass jar, and closing up the space around it
at the month so that no air can get in. The inside of the glass will
soon be covered with a vapor, which will grow more and more den.se
until it is converted into drops. Boerhaave says : " If the piercing
chill of winter could be introduced into a summer assembly, the in-
sensible perspiration being suddenly condensed, would give to each
person the appearance of a heathen deity, wrapped in his own sepa-
rate cloud."

Now, this continual exudation of sweat through these millions of
tubes is for a wise and necessary purpose. It is to take out of the
blood and other fluids various salts, which would do mischief if
allowed to remain longer, and particularly carbonic acid, which is

ESfissBEKeanHH

HTGIENB.

107

the weather,
ffentof sur-
iil economy.
'1 of " Anat-
that it helps
h the health

rms several
fs from the
he sweat is
is brought
ough which
11 in cut 44.

part of the

very square

;e has al)out

skin of one

skin. Each
lere, among
unches into
oriferous or
an inch in
luman skin

n million of
s long as a
/^hen this is
is taken, it
it does not
tion, — not

iserting the
! around it
B glass will
more den.se
16 piercing
bly, the in-
ve to each
own sepa-

millions of
out of the
nischief if
, which is

poisonous, — the same matters, in fact, which are thrown out by the
lungs. The skin, in truth, is a kind of helper of the lungs ; and a
lady, by covering herself with garments which have no pores, and
will neither admit air nor let off insensible perspiration, may be
strangled almost as certainly as by putting a cord around her neck,
and closing her windpipe. Almost twice as much fluid passes off
through the skin as through the lungs.

Keep the Pores Open. — It is obvious from what has now been
said, that the pores of the skin should be kept open to preserve
health. When bathing is neglected, and the undergannents are not
changed sufficiently often, the insensible perspiration accumulates
and dries up upon the skin, mingling with the oily matter secreted
by the oil-glands, and with tha slireds of the scarf-skin, and form-
ing a tenacious gluey matter, which closes up the pores. By this
misfortune, that large quantity of worn-out matter which usually
goes off with the fluid througVi the pores is retained to poison and
embarnvss the living current of blood, or seek an outlet through lungs
or kidneys, which are already burdened with quite as much as they
are able to do. How important, then, that these channels through
which the body is purified should be kept open I that the skin shoiUd
be kept healthy and in working order !

The Bath, the Great Purifier. — But this can only be done by .
daily washing. The bath is the great purifier of the human skin.

The antiquity of bathing is very great. The practice is supposed
to reach back to the infancy of the race, or certainly to a very early
period. The inhabitants of Middle Asia are said to have been the
firet to use the bath for the specific purposes of purification and
health. Domestic baths are represented as having been used by
Dioraed and Ulysses. Andromache prepared warm water for Hector
on his return from battle. Penelope banished sorrow by unguents
and baths.

The Baths of the Medes, the Persians, and the Assyrians were
much celebrated. Alexander, though familiar with the voluptuous
baths of Greece and Macedon, was astonished at the magnificence of
those of Darius.

Roman Baths. — As luxury and refinement advanced, the means
of luxurious bathing were multiplied, until establishments were
built by the Romans, the very remains of which excite wonder at
this day. Among these are the Thermae of Agrippa, of Nero, of
Vespasian, of Titus, etc. One of the halls of the building con-
structed for baths by Diocletian, forms at this day the church of the
Carthusians, one of the most magnificent temples in Rome.

Number and Character. — According to Pliny, baths were intro-
duced into Rcme about the time of Pompey ; their first erection
Dion attributes to Maecenas. Agrippa increased their number to

108

HYGIENK.

one hundred and seventy ; and within two hundred years they were
multiplied to about eight hundred. These establishments were sn
vast that one writer compares them to provinces. They were paved
either with crystal, or mosaic, or plaster, and were adorned by Hcidj)-
ture and painting to the very highest degree. They added not
merely to the health and luxury of the people, but contributed to
their culture in the highest departments of art and taste.

Names of Baths. — To the apartment of their dwelling in wliich
they washed their bodies in warm or hot water, the Romans gave
the name of balneum, or bath ; to the public establishments, that of
balnea, or baths. The apartment which held the vessels was called
vasarium. In this were the three immense vessels which conttuned
the cold, warm, and hot water. There were instruments of lx)ne,
ivory, and metal, for scraping the skin, with a groove in the edge,
through which the impurities of the skin might run oif.

On the north front of the thermae was a reservoir of cold water
large enough for swimming, called by Pliny the younger, baptuterinm.
In the centre was a spacious vestibule, and on each side, warm, cold.
and vapor biths, with apartments for cooling, dressing, and refresli-
ments. There was the frigidarium, a vaulted room, a cooling room
midway between the warmer and the open air ; the tepidarium, with
a temperature midway between the above and the hot bath ; and the
calidanum, or the vapor bath.

Then there was the room where the body was rubbed over with a
great number of ointments and essences of the most precious kinds ;
and another in which it was sprinkled over with powder ; and also a
room which held the clothes, in which the bathera undressed and
dressed at pleasure.

All these upartments were double, the two wings being appropri-
ated to the sexes.

Open to all. — These baths, thus numerous and magnificent, were
open to all classes of the people, and contributed largely to the gen-
eral health and physical endurance for which the Romans were con-
spicuous.

The Bath Neglected under the Christian System. —When Jesus
of Nazareth came into the world, he found man's nature cultivated
in a most defective way. The moral element had sunk down to the
lowest place, while the physical had risen to the highest, — just the
reverse of the true order of things. This Divine Teacher came, not
to recomm i a neglect of the body, but a new cure for the imper-
ishable pa. -. Mankind were for the first time systematically taught
to forgive injuries. Prostrate liberty and degraded woman became
the wards of Christianity.

Unfortunately, under the new order of things, the lower element
of man, which had been exalted and worshipped, was cast down and
abused. What the Pagan had pampered, the Chiistian pei-secuted.

*»- ---- ^

HYGIENK.

109

i they were
nte were ho
were jHivcd
hI hy Hculj)-
added not
tribntcd (o

ig in wliicli
)mans gave
intH, that of
was calh'd
1 contained
t« of lx)ne,
1 the edge,

coUl water
aptisterinm.
warm, cold,
nd refresh-
loling room
%rium, with
h ; and the

over with a

iouu kinds ;

and also a

ressed and

appropri-

icent, were
to the gen-
were con-

^hen Jesus

cultivated

own to the

-just the

came, not

the imper-

illy taught

an became

element
down and
teraecuted.

The Imdy, which had been bathed, and scrubbed, and anointed, and
perfumed, waa thenceforward, in consequence of the improper inter-
pretation of certain texts, scourged, and fasted, and clothed in rags.
Thousands believed, and thousands do to this day, that to torment
the body is to please God. Under this feeling, the public and pri-
vate baths were neglected ; and to this day no Christian nation has
fully appreciated the necessity of cleanliness, and of sanitary meas-
ures for the maintenance of the public health. To a considerable
extent, the body is still under disabilities ; still the subject of perse-
cution ; and where this is not the case, it is too often regarded only
as a loose outside garment, to be thrown over the traveller to the
celestial city, and is expected to be well soiled with mud and dust.
The teachings of the Great Master will by and by cease to be per-
verted, and will be applied to raise up man's body, as they have
raised his mental and moral nature, and will make a well-developed
and harmonious being.

In the meantime, it is the duty and the privilege of the physician
to urge a return, not to the magnificence of the ancient regimen for
training the body, but to its real efficiency in a simpler form.

Cold Bathing. — Water applied to the skin at a temperature below
75° of Farenheit, is called a cold bath. If applied to a person with
sufficient constitutional energy to bear it, it is a decided and very
powerful tonic. By this is meant that it promotes the solidity, com-
pactness, and strength of the body.

The first effect of the application of cold water to the skin, is the
sudden contraction of all its vessels, and the retreat of the blood
towards the internal organs. The nervous system, feeling the shock,
causes the heart to contract with more energy, and throw the blood
back with new force to the surface.

This rushing of the blood back to the skin, is called a reaction ;
and when it occurs with some energy, it is an evidence that the sys-
tem is in a condition to be much benefited by the cold bath. When
this does not take place, but the skin looks shrunken, and covered
with " goose flesh," and a chilliness is felt for a longer or shorter time
after bathing, then the inference should be, either that the water has
been used too profusely, or that the bather has too little reactionary
power for this form of the bath. The latter conclusion must not be
accepted until cold water has been tried with all possible guards, —
such as beginning with tepid water, and gfradually lowering the tem-
perature ; bathing for a time, at least, in a warm room ; beginning
the practice in warm weather ; and applying the water at first with a
sponge out of which most of it has been pressed by the hand. With
some or all of these precautions, mosf persons may learn to use the
cold bath. It is always to be followed by brisk rubbing with a coarse
towel or flesh-brush.

The Sponge Bath. — \. wet sponge is the simplest, as well as the
best mode of applying water to the surface of the body. With per-

fiU

tli>

HYGIENE.

sons who are feeble, a [nirl only of the hody should bo exposed at a
time, — which part, having been quickly sponged and wiped dry,
should Ihj covered, and another part exposed, and treated in a likt;
manner. In this way, all parts of the body may successively be kiiI)-
jected to the bnvcing influence of water and friction, with little risk,
even to the most delicate, of an injurious shock. The only furniture
required for carrying out this simple plan of bathing, is a sponge, a
basin, anrl a towel. There is no form of iNithing so universally appli-
cable as this, or so generally conducive to health.

The Shower Bath requires a brief notice. The shock to the ner-
vous system produced by itKs much greater than that from sponging.
Beside the sudden application of coldness, there is a concussion of
the skin by the fall of the water. This form of the bath is excellent
for those who are strong and full of vitality, but is fraught with some
danger for the feeble and delicate. This, however, depends on the
judgment with which it is used. In the form of a delicate shower,
and with tepid water, the frailest body might bear its shock.

The Warm Bath. — A temperate bath ranges from 75° to 85° ; a
tepid bath, from 86° to 95° ; a warm bath, from 95° to 98° ; a hot
bath from 98° to 105°. A warm bath is of the same temperature
with the surface of the body. Of course it produces no shock. To
those who are past the meridian of life, and have dry skins, and l)egin
to be emaciated, the warm bath, for half an hour, twice a week, is
eminently serviceable in retarding the advances of age.

It is a mistake to suppose the wann bath is enfeebling. It has a
soothing and tranquillizing effect. It renders the pulse a little
slower, and the breathing more even. If the bath be above 98°, it
becomes a hot one, and the pulse is quickened.

The temperature of the warm bath, as of the cold, should be made
to range up and down according to the vigor of the frame, and the
circulation of the individual. The aged and the infirm, whose hands
and feet are habitually cold, require it to be well up towards the
point of blood heat. The pulse should not be made to beat faster by
it, nor should sensations of heat or fullness be induced about the
temples and face.

The Vapor Bath. — This differs from the warm bath in being ap-
plied to the interior as well as to the exterior of the body. The
warmth is inhaled into the air-tubes at the same time that it envelops
the external person. The first sensation of the vapor bath is oppres-
sion, and causes some difficulty of breathing ; but this passes off as
soon as the perspiration begins to flow. From' the steam-chamber,
the bather should step into a tepid bath, and after remaining a short
time in this, wipe himself thoroughly with diy towels.

Cold Affusion immediately after either the warm or the vapor bath,
i(i excellent. In Russia it is common, after the vapor bath, to pour

posed at a

npud dry,

in a like

ily IX! Hlll)-

Uttli' risk,

' furniture

sponge, a

ally appli-

to tlio ner-
Hpoiiging.
cu88ion of
) excellent
with some
ids on tlie
te shower,
k.

to 85° ; a
'8°; a hot
mperature
bock. To
and l)egin
■I week, is

It has a
se a little
»ve 98°, it

d be made
, and the

1086 hands

wards the
fiister by

about the

being aj*-
dy. The
envelops
IS oppres-
ses off as
-chamber,
y a short

ipor bath,
1, to pour

HYUIENK.

upon the head of the bather a bucket of warm water, then one of
tepid, and hwtly one of cold ; and to finish with giving hira a good
towelling. It is even said that the natives leave the uteaiu and the
hot bath, and roll themselves in the snow.

No danger need Ik; feared from cold affuwion when the skin is red
and excited by tlie warm bath, provided the nervous frame is not in
a depressed condition. If the body is chilled, and the nerves pros-
trated by disease or fatigue, the appli(!ation of cold water to the skin
may do great mischief, and should in no case bo hazarded. Cold
water applied to a hot skin cannot do harm ; to a cold skin, it can do
nothing but harm. Hence, the cold bath may In; used with advan-
tage on rising in the morning, while the lK)dy is warn>. Another good
time is at ten or eleven o'clock in the forenoon, when the nervous
power is advancing towards its height for the day.

Reaction Necessary. — iVs a means for promoting cleanliness, the
importance of the bath can liardly be overstated. For the support
and improvement of health, it is equally important. But for the pro-
motion of the latter, one prerequisite is essential, — the reaction of
the skin.

Various means are resorted to, to secure this. The Hindoos secure
it by a kind of shampooing, thus described by a writer: " One of the
attendants on the bath extends you upon a bench, sprinkles you with
warm water, and presses the whole body in an admirable nianner.-
He cracks the joints of the fingers, and of all the extremities. He
then places you upon the stomach, pinches you over the kidneys,
seizes you by the shoulders, and cracks the spine by agitating all the
vertebrae, strikes some powerful blows over the fleshy and muscular
parts, then rubs the body with a hair-glove until he perspires," etc.
" This process," siiys the wiiter, " continues for three-quartera of an
hour, after which a man scarcely knows himself; he feels like a new
l)ei.ig." Sir John Sinclair speaks thus of the luxury of the process :
" Tf life be nothing but a brief succession of our ideas, the rapidity
with which they now pass over the mind would induce one to believe
that in the few short minutes he has spent in the bath, he has lived a
number of years."

The Coarse Towel, the horsehair glove, and the flesh-brush are the
appliances commonly used for stimulating the skin, and causing re-
action. For tender skins, the towel is sufficiently rough. With this
the bather should rub himself, unless he is weak and the exertion
produces palpitation. The muscular exertion necessary for this will
help the reaction.

Restoration oi the. Bath deslrabie. — It is greatly to be wished
that the bath miglit be restored to .something like the importance it
held among ancient nations. It is a luxury, a means of health, and
iv source of purity both of body and of mind ; for the morals of any
people will rise when"} the use of the bath is regular and habitual.

112

HYUIENR.

The attempt to cure all diseases by what in called the " water-cure,"
h:tH a hit of fanaticlHm about it, which will cure ituelf in time. But
that water, used judiciously in the form of baths, is a potent moral
and physical renovator of the nice, is not to be doubted ; and this
should commend it to all sensible peo[)le, even though it should some-
times be abused by excess, at* all good things art>.

A people with clean hands, anU clean bodies, and clean health, will
very natunilly come to like clean streets and clean cities, and finally,
dean consciences. A fondness for cleanliness in one form, almost ne-
cessarily runs into a like fondness for it in other forms, until the pu-
rifying desire pei-vades the whole nature, moral as well as physical.

Air and Ventilation.

Water and air are fluids. Water covers two-thirds the surface of
the globe, having a depth, in some places, of five miles or more. Air
covers not merely the remaining third of the earth, but the water as
well. It embraces the entire globe, pressing alike upon land and
water, and having a depth of about forty-five miles. This is a sea of
such magnitude, tliat the Atlantic or Pacific shrinks to a very small
lake in the comparison.

Man has his residence, and walks about fo the bottom of this ocean.
He has no means of navigating it, and, therefore, never rises to its
surface ; but, with his natural eyes, and with telescopes, he discovei's
objects which lie millions and billions of miles beyond it, and even
acquires much exact and useful information respecting them.

This vast ocean of air we call an atmosphere, from two Greek words
signifying vapor, and a sphere, — it being an immense fiuid-sphere, or
globe.

Pressure of the Atmosphere. — This atmosphere presses upon man
and upon every object on the surface of the earth, with a force equal
to fifteen pounds to every square inch ; and as a man of average size
has a surface of about 2500 square inches, the air in which he lives,
presses upon him with a weight of eighteen tons. This would of
course crush every bone in his body, but for the fluids within him
which establish an equilibrium, and leave him unoppressed.

The Phllc^ophy of Breathing cannot be fully explained in the
brief space p 'to this subject; it is enough to say, that, upon

the attem' made to draw in the breath, the muscles of the

breast ne ribs, the diaphragm or midriff at the same time

conti — the whole movement being such as to create a vacuum

in tht xgs. The air, pressing upon every part of the surface, as
mentioned above, rushes in and fills the vacuum. The limgs being
filled, the contraction of the muscles of the belly causes the dia-
phragm, which has sunk down towards a plane, to rise up into the
form of an umbrella, aud squeeze the aii- out of the lungs.

HYGIENE.

113

This is about all that need to Ix) said of the method of getting the
air into and out of the lungs. The whole process is under the con-
trol of that part of the nervous system called the medulla oblongata,
or the top of the sjjinal cord.

Objects of Breathing. — There are at least three objects to be ac-
complished by breathing ; the renewal of the blood and the taking of
impurities out of it ; the warming of the body ; and the finishing uj)
of the process of digestion, and the change of chyle into nutritive
blood.

There is no good reason for attempting here to explain the last of
these objects. To give any idea of the first two, it is necessary to
funiish a very brief explanation of the circulation of the blood.

The heart is double. There are in fact two hearts, a right and a
left, joined together. The right heart receives the blood from the
veins, and forces it up into the lungs, whence it is brought back to
the left heart, and by this is driven through the arteries into e v^ery
part of the body. When received into the lungs, the blood is cf a
dark purple color, and is loaded with carl)onic acid and some other
impurities. It has also l)een deprived, during its circulation through
the l)ody, of most of its oxygen. The small, delicate vessels which
convey this dark and impure blood through the lungs, pass directly
over the air-cells ; and at this moment the carbonic acid and water
pass through the blood-vessels and air-cells, and are borne from the

body on the outgoing breath ; while the oxy-
gen enters the blood through the walls of the
same vessels ; and this exchange, which takes
place with every breath, alters the blood from
a dark purple to a scarlet red. Fig. 71
shows at 1, a bronchial tube divided into three
branches ; 2, 2, 2, are air-cells ; 3, branches of
the pulmonary artery winding around the air-
cells with the dark blood to be reddened.

That carbonic acid and water are borne out of the lungs with every
breath, may be esisily proved. If we breathe into limo-water, it will
become white. This is owing to the carbonic acid in the breath unit-
ing with the lime, and producing carbonate of lime. Then, if we
breathe upon a piece of glass, it becomes wet, showing that there is
watery vapor in the breath. That the blood receives oxygen from
the air we breathe is proved by the fact that the ingoing breath has
one-fourth more oxygen in it than the outgoing.

The lungs, then, take out of all the air we breathe, one-fourth of
its oxygen. If we breathe it over a second, a third, and a fourth
time, it not only has less oxygen each time, and is less useful for the
purposes of respiration, but it becomes positively hurtful by rea-
son of the poisonous carbonic acid which, at every outgoing breath,
it carries with it from the lungs.

Effect of Sleeping in a Small Room. — Now, consider the effect of

Fro. 71.

114

HTOIBNE.

sleeping in a small room, seven feet by nine, not furnished with the
means of ventilation. A pair of lungs, of ordinary size, take in, at
each breath, about a pint of air. Out of this air one-fourth of its
oxygen is extracted ; and when it is returned from the lungs, there
comes along with it about eight or nine per cent of carbonic acid.
As it is not safe to breathe air containing more than three or four
per cent of this gas, the pint which the lungs take in and throw out
at each breath is not only spoiled, but it spoils something more than
another pint with which it mingles ; and as the breatli is drawn in
and thrown out about eighteen times per minute, not less than four
culjic feet of air is spoiled in that time by one pair of Ivmgs. This is
two hundred '••■id forty feet an hour ; and in eight hours, the usual
time spent iU L .e sleeping room, it amounts to one thousand nine
hundred and twenty cubic feet. During the hours of sleep, therefore,
one pair of luags «o %poil one thousand nine hundred and twenty
cubic feet of air ; it is positively dangerous to breathe it.

In a room seven feet by ten, and eight feet liigh, there are five
hundred and sixty cubic feet of air, a little more than one-quarter
the amount spoiled by one pair of lungs during sleeping hours. In
a room of this size, there is not air enough to last one person three
yhours ; and yet two persons often remain in such rooms eight or nine
hours.

Why then do they not perish ? Simply because no room is entirely
air-tight. Fortunately, all our rooms are ;^o made that some foul air
will get out, and a little that is pure will find its way in. Were it
not 80, no man who closed the door behind hir.i, for the night, in a small
bed-^oom, would ever see a return of day

Suppose fifty children are confined in an urventilated school-room,
twenty feet by thirty, and ten feet high. These children will spoil
about one hundred and fifty feet of air in one minute, or nine thou-
sand feet per hour, or ttventy-seven thousand feet in three hours, — a
usual half -day's session. But the room holds only six thousand o-uhic
feet of air, — the whole of which these children would spoil in forty
minutes.

These simple facts show the absolute necessity of ventUation. Yet
ho\v poorly it is provided for in our sleeping rooms, our sitting rooms,
our school houses, our churches, our court houses, our halls of legis-
lation, and even in our anatomical and medical lecture-rooms !

In sick-rooms, ventilation sfiould receive special attention.—

Every disease is aggravated by the breathing of bad air. Yet it is
common to close all the doors and windows of rooms where sick per-
sons are confined, lest the patients should take cold. This is a bad
practice. The sick should have plenty of fresh air. Their comfort
is promoted by it, and their recovery hastened.

It is strange that human beings sliould be afraid of pure air. It
is their friend and not their enemy. Impure air only should be
shunned.

.:X'

■- aUai.T-*--

HYGIENE.

115

The supply of good air ample. — There is no necessity for breath-
ing air which has lost a part of its oxygen, and acquired a portion of
carbonic acid. The supply of good air is ample. An ocean of it
forty-five miles deep, covering the whole glote, seems a pretty plain
intimation that it is not to Ix) sparingly used. When men retire
within their dwellings, and attempt to shut out this great sea of air,
they show about as much wisdom as would be exhibited by fishes
which should build water-tight huts around themselves at the bottom
of the ocean, and swim about continually in the unchanged water
within. Fishes can ordy live in glass globes when the water is
changed every day ; and if the water be changed half a dozen times
a day, they cannot be as healthy as when swimming in the great
ocean.

Cultivating; Trees. — In most of our cities there is almost a crimi-
nal neglect of the cultivation of trees ; yet they add greatly to the
health, and prolong the lives of the citizens.

The leaves of a tree are the lungs with which it breathes ; but in-
stead of extracting oxygen from the air, and giving back carbonic
acid, like man, it takes only the poisonous carboni-j acid, and gives
back oxygen.

Were there no animals on the globe, the vegetables would con-
sume all the carbonic acid, and die for v ant of breathing material ;
on the other hand, were there no trees or other vegetables, the ani-
mals would in time so far exhaust the oxygen as to perish for lack
of it. The two together keep the air healthy for each.

The relation of plants and animals, in all that relates to their
peculiar actions and effects, is a complete antagonism. Their move-
ments are in contrary directions, and by hostile forces. Their oppos-
ing actions may be illustrated thus : —

The ATTiMAii ooNSTmBS the non-nl-
trogenized substances, sugar, starch,
and gum.

The animal peoditcbs carbonic acid.

The vegetable produces the non-
nitrogenized substances, sugar, starch,
and gum.

The vegetable decomposes carbonic
acid, water, and ammoniacal saits.

The yeqbtable disengages oxygen.

The vegetable absorbs heat and
electricity.

The vegetable is a de-oxidizer.

The vegetable is stationary.

water, and ammoniacal salts.

The animal absorbs oxygen.

The animal produces heat
electricity.

The animal is an oxidizer.

The animal is locomotive.

and

We learn from the facts of Geology that the time was in the his-
tory of our globe, when lunged animals could not breathe its atmos-
phere ; it was too much loaded with carbonic acid. The trees then
grew with a rapidity almost incoTiceivable, decomposing the poison-
ous gas, taking to themselves the carbon and setting the oxygen
free, and lifting up their brawny ar* s to heaven in acts of thankful-
ness for the great feast.

At length the noxious gas was exhausted \ and then, pale and
sickly, they feebly held up their hands for help , and God sent num-
berless tribes of warm-blooded uaimals, full of life and energy, that

116

HYGIENE.

and carefully
Ever}'^ narrow
absence, thou-

sported in the exhilarating air, anu destroyed vast forests, thereby
reproducing carbonic acid.

These simple facts should teach man the sanitary importance of
trees and bushes ; and wherever he has a rod, I had almost said a
foot of ground to spare, a tree should be planted
nursed. This is particularly necessary in large cities,
street in a city should be lined with trees. For their
sands of men, women, and children have died sooner than they
otherwise would. We want them stretching up their arms to all
our windows to give us oxygen, and to take to themselves the car-
bonic acid we exhale.

Tight Dresses. — The health may be injured by not breathing air
enough, as well as by inhaling that which is impure. It is therefore
improper to compress the lungs by wearing tight dresses. If the
ribs are held down by the dress, but little air can get into the lungs,
and only a small amount of carbonic acid can be carried out. In
this event, the health is injured in two ways : the blood is not vital-
ized by oxygen received, and it is poisoned by carbonic acid retained.

Tight lacing has in a measure gone out of fashion ; yet too much
of it for the best development of female health is yet retained. As
a knowledge of physiology and the laws of life, and a better judg-
ment of the true symmetry of the female form prevail, this barbar-
ous custom will pass out of use, and the substantial health and
real beauty of the American woman will together rise to a higher
standard.

Fill the Lungs well. — Persons who take but little exercise are
apt to acquire the habit of drawing the air very little into the lower
part of the lungs. This' should be counteracted by taking long and
full inspirations for a short time, every day, while in the open air.
This practice would get the lungs in the habit of opening to the air
quite down to their base, and would make the breathing much more
natural as well as effectual at all times. In the case of young per-
sons, it would enlarge the capacity of the chest, and add to the brief
years of life. Parents should see to it that their children spend
from ten to twenty-five minutes every morning inflating their lungs
with pure air.

Travelling.

It is true that many persons who dwell in one spot, and hardly
move from it all their lives, live to old age. Yet change of location
for a short time, or permanently, does promote health, and protract
life. The mind tires of contemplating one set of objects for a great
length of time ; and in the absence of all stimulation, it sinks into
apathy, and imparts no energy to the body. The physical frame,
partaking of the ennui of the mind, droops. This is doubly true
when one is suffering from illness.

HYGIENE.

117

Travelling is eminently fitted to chaw the thoughts of the nervous
and feeble from themselves, and to turn them with interest to out-
ward objects. This is of great importance. It is better than stimu-
lants and tonics.

The nervous system has great power over the health; and the
pleasurable sensations, excited by visiting new places and scenes,
and conveyed to the mind through the nerves, often awaken in the
constitution energies which are essential to recovery.

Travelling places a man in entirely new circumstances. It sur-
rounds him with novelties, every one of which makes a demand upon
his attention. It breaks up his old trains of thought, which have
been monotonous so long that they have grown oppressive. It
3au8e8 the world to touch him at a thousand new points, and sur-
prises him every day, perhaps every hour, with a view of the false
relations he has sustained to it. It opens to him new depths in his
own nature, and causes him to wonder that they never attracted his
attepoion before. It opens to him one door after another, leading
him into new apartments of knowledge ; and as the world grows, he
finds himself growing with it, until his whole nature dilates and
beats with new life.

Means of Travelling Increased. — The last twenty-five years
have greatly increased the facilities for travelling. Many of the
sick may now seek health in distant lands, who, had their circum-
stances been similar twedty years ago, would have been compelled
to pine at home. The railroads give an easy journey to thousands
with the comforts of the parlor cars.

One thing more wanted. — But one thing is wanted to bring the
means of travelling, for the sick, very nearly to perfection ; it is a
method of propelling carriages upon common roads, by some cheap
power, which can never be exhausted, and which shall be easily man-
aged by the traveller or his companion. This is a prominent want
of the present hour ; a giant discovery, which, at a single stride,
would cany the world forward a hundred years, and which, we may
hope, is in the womb of the near future. The power, it is believed,
will be electro-magnetism. The mode of applying it, when discovered,
will be simple, yet wonderful ; and the results to the sick, beneficent
beyond expression. The human mind cannot conceive the advan-
tages which invalids would derive from such a mode of conveyance.
Journeys might be long or short ; might be made with any rate of
speed which the strength permitted. The morning or afternoon
stages might be discontinued when fatigue demanded, and resumed
at pleasure. Over uninviting regions the traveller might gli'de
swiftly, and linger where Nature spreads her feasts for the mind.

The best Seasonsfor Travelling are spring and autumn. Win-
ter is too cold. A pleasurable excursion may sometimes be made in
summer, but in general the season is too hot for comfort. In chang-

iHri

118

HYGIRNE.

ing climate, food, water, etc., in the stiltry seaHon, there is danger of
contracting very troublesome bowel complaints.

Means of Travelling for the Poor. — There is one painful thought
connected with travelling as a means of health, — it cannot be en-
j'»yed by the poor. When sick they generally have the careful
attention of humane physicians ; they receive from kind neighbors
little delicacies of food and drink ; they are watched witli by night,
and visited by day ; but though suffering from the hard routine of
a laborious life, and needing diversion and recreation more than all
else, they cannot travel. They have not the means, and nobody
thinks of supplying them for such a purpose.

This is a channel into which charity ought to pour some of its
benevolent streams. In large cities there is a class of poor females
who sit in their small rooms and ply the needle diligently through
the whole year, and who run down every summer very near to con-
finement in bed. Two or tlu-ee weeks, in the hot season, spent in
travelling in the mountains and elsewhere, would bring back the
color to the pale cheeks of such persons, and save them many years
both from the grave and from the almshouse. No millionaire could
make a better use of property than to set it apart, at his death, for
the specific purpose of enabling the poor to travel. And if this
suggestion should induce one rich man to consecrate his wealth to
the Godlike work of bestowing health, happiness, and intelligence
upon the poor, the great labor of preparing' this book will not have
been endured in vain.

Amusements.

That which engages the mind, and at the same time impresses it
with pleasurable sensations, is a sufficiently accurate definition of
amusement. Whatever occupies the thoughts and senses in an
agreeable way, and employs them with some degree of intensity,
comes under the same head.

This broad and general definition allovra us to disregard our daily
employments as amusements when they engage our deep attention
and at the same time give us pleasure.

The term " amusements," however, in the more popular sense, is
restricted to those sports, games, plays, exhibitions, entertaimaents,
etc., which involve a mspension of our daily labors, and are properly
called diversions.

When nature is tired and worn with those severe and exhausting
toils by which we earn our bread, amusements turn us aside, divert
us, engage other powers, and allow our tired faculties to rest. They
are, therefore, of very great importance. Even the most trifling
amusements may have the highest value. Their very nature and
object imply that they will be valuable just in proportion as they
divert and rest us. And just in proportion as they do these thinori^,
they give us health.

HYCIENR.

119

One other thing amusements do for us, which must not be forgot-
ten ; they preserve in us, in middle life, and even in old age, the
warm simplicity of childhood. They keep us young in our disposi-
tions and feelings. They keep us in harmony with nature, and con-
sequently artless and truthful. They prevent the formalities of con-
ventional life from stiffening us into cold and repulsive hypocrites.

Selection of Amusements. — Of course the same amusements are
not adapted to all persons. The farmer who has worked his muscles
all day, would not be benefited by a game of ball in the evening ;
yet there are few games more suitable for the student who has bent
for many hours over his books. Care should always be taken, there-
fore, that amusements or sports do not bear upon those limbs or
faculties which are wearied by work.

Amusements improve various faculties. — To one who haa a

taste for art, who is fond of works of genius and poetry, theatrical
entertainments will always be agreeable, and a source of gratification
and health. I know these exhibitions are objected to by many as
immoral and hurtful, but more, I think, from habit and fashion, than
upon any solid grounds of reason or religion. They certainly appeal
to a high order of faculties in the human mind ; and to those who
are fitted to receive them, teach lessons of great moment. Even the
lower exhibitions of comedy, though not particularly improving to
the mind, are yet, from their power to provoke laughter^ among the
most powerful up-builders of health.

Tlie Games of Wtiist, Euchre, etc., engage the minds of the play-
ers in a sort of mental contest, which is exciting, agreeable, and
health-imparting. These games make us skilful in calculating
chances, and judging how men ought to act under certain contin-
gencies. They make us sharp to detect and turn aside the unseen
forces, which tend to oppose and destroy our success in life.

I hardly need to say that money or rather property should never
be staked upon a game of cards, or upon any other game. Gambling
is one of the meanest as well as most destructive things in which men
can engage. It raises the healthful excitement of these innocent
amusements, — innocent when prope 'v pursued, — into raging pas-
sions, which, when defeat comes, as curae it will, sink into remorse
and bitterness as terrible as the mind can conceive. I warn young
men, as they would escape the pangs of a hell on earth, and the loss
of character, happiness, and probably health for life, to avoid any
such abuse of cards.

Chess, Chequers, etc., appeal likewise to the fondness of competi-
tion, which is common to all men. But they cultivate in us a little
more of the mathematical element. As they require very close appli-
cation of the mind, they are not suitable for persons of sedentary em-
ployments, or whose daily avocations require a constant use of the

120

Hy«)IKNK.

mind. Such persniiH hIioiiM cliooHe lighter and more active amuse-
raente.

Lighter Amusements. — Beside these higher amusements, there
are a great number of lighter and more childish ones, which should
not be overlooked.

Some of these are merely physical, involving a trial of strength,
fleetness, action, etc., as the games of ball, cricket, etc. Othera are
domestic in their nature, involving mirth, and various other of the
lighter excitements, as blind-man's buff, puss in the corner, hole in the
wall, fox and geese, hunt the slipper, hurly-burly, roll the platter, etc.

In fashionable American households, these simple domestic plays
have in a great measure gone out of use, — being deemed vulgar, and
below the dignity of ladies and gentlemen. I am sorry to say this;
for the vulgarity, in my judgment, is in those \. ho reject them, and
not in the play.

The oflBcer of our navy, whose visit to the mansion of Lord Hard-
wick I have spoken of on page 93, reports that on the evening of one
of his visits, the ])lay of blind-man's buff was engaged in by the whole
party ; and that his Lordship in attempting to make a short, tfrn dur-
ing the play fell upon his back, when one of his daughters, who was
blinded, caught him by the heels, and being assisted by others, drew
him feet-foremost half the length of the hall, amid the shouts of the
whole party. This would have been deemed very vulgar by fashion-
able people in this country. But to me, who am no believer in any
nobility which Lord Hardwick can receive from kingp or queens, this
simple naiTative raised him at once to a peerage in nature's realm.
Without doubt, he is one of nature's noblemen. A man in his sta-
tion, and with his wealth and temptations to snobbery, who can pre-
serve such simplicity of character, must have a warm as well as a
noble heart in his breast.

Value of Domestic Amusements. — I remark here that, in all our
amusements, we should, as far as possible, seek those of a domestic
character. They are more simple and childlike in their nature, and
preserve in us, even to old age, the freshness of feeling, and truthful
simplicity, which spread so beautiful a greenness over the autumn of
life.

Simple domestic amusements, too, are always gotten up on a cheap
scale; they do not encourage costly extravagance, and can be in-
dulged in by the poor as well as the rich.

But more, and better than all, they keep young men and old men,
and young women and old women, at home, by making the domestic
circle the centre of attraction. They draw the seekers of pleasure
around the hearth-stone, instead of outward in the world. They in-
cline young and old to look to the family circle as the centre of the
most pure, because the most simple and natural, enjoyments. They
teach us to look to home as the centre of life, and to all outside as
onlj its appendages.

-'Hif-i'-:-vMujjeiri,

mmmsi^^^i^^

HYGIKNK.

121

It. has been said that homeg are found only in England; that in
(itlier countries, life wanders, houseless and shelterless, abroad, seek-
ing happiness, it knows not where, while in England it nestles warmly
in the bosom of home. To whatever extent this is true, — and I be-
lieve there is truth in it, — it is owing to the simple household amuse-
ments of England.

An American Want. — One of the great wants of this country is a
more liberal provision for amusements. We attach here too much
value to wealth ; and we pursue it with an intensity altogether in-
compatible with health. We cannot take time for recreation because
we are in so great a hurry to be rich.

If we would save ourselves from a total wreck of health, we must
tako broader and better views of life. We must value it for its solid
comforts, rather than for its glitter and show.

Contrary to the general belief, insanity is very prevalent among
seamen and farmers. The former lead a life of dreary solitude upon
the ocean ; the latter, one, if not of equal, certainly of very objection-
able solitude upon the land. The sailor who does business upon the
great sea should provide himself with great numbers of games to
amuse hira in his wanderings. The farmers of our land should cul-
tivate more of the sociabilities of life. Let them meet together in
the fine summer evenings, like the peasants of France, and dance
upon the green lawns before their cottages. They will till their lands
more cheerfully for it ; enjoy better- spirita and health ; and live to
greater age.

Completeness of Life. — Amusements are necessary in order to
give a completeness to life. The faculties of the human mind are
numerous. It is only when they are all exercised, in their due pro-
portion, that there is a harmonious beauty in our lives. The cus-
toms of society twist us all out of shape, — perverting us mentally,
morally, and physically, and robbing us of every maidy and health-
ful quality. Getting out of the ruts of fashionable life, we must
come back to the simple paths of nature.

I would strongly impress upon parents, teachers, and guardians,
the importance of studying well the various temperaments, physical
and mental peculiarities of their children, in order to judge wisely
of the kind and amount of recreation required by them.

Instance : a pale, delicate child of ten to twelve or fourteen years,
with clear complexion, flaxen hair, blue eyes, slender frame, and' a
nervous, sensitive organization, with strong mental cast, requires
much more recreation and out-door exercise than a full-blooded,
robust child of that age ; a fact not at present duly considered, as a
general thing.

fl3E7tSS?^SS^??

>U^.'>*^i«»^KiS^*l»*«'*'

TEMPEBAMENT8, CONSTITUTION, AND

SYMPTOMS.

Man has thinking^ wanning, nourishing^ and moving powers. For
the performance of each of these great functions, he has organs of
the best possible construction.

For Thinking, he has a brain. If this be large in proportion to his
other organs, it gives a character, a cast, a peculiarity to his whole
organization. Everything about him is subordinate to his brain.
We recognize him, at once, as a thinking and feeling being. He
has an intellectual look. There is a delicacy, a refinement, a sensi-
tiveness, a studious habit, an air of thoughtfulness about him, which
determine his traits, his tone, his temper, his whole character. Hence
it is proper to say he has a cephalic or thinking temperament.

The Lungs and Heart, devoted to renewing and circulating the
blood, are placed in the chest or thorax. If these be large in man in
proportion to other organs, he is characterized by great activity of cir-
culation, by a large supply of red blood, and by the general indica-
tions of a full, warm, and bounding life. This activity gives him
his tone and temper, and shows that his is the thoracic or calorific
temperament.

In the Great Cavity of the Abdomen is done the work of receiv-
ing, digesting, and disposing of the materials which nourish the body.
If the organs which do this work be large in proportion to others, the
body is fed to repletion, and the whole organization speaks of the
table. The habit, the look, the temper, are ell sluggish. This is the
abdominal or alimentary temperament.

The Bones and Muscles are instruments by which the movements
of the body are performed. If these be the largest, in proportion, of
any in the body, then the locomotive powers are in higher perfection
than any others. There is largeness 'of person, energy of movement,
and greatness of endurance. The whole cast of the person partakes
of the strength and coarseness of bone and muscle. This is the
muscular or locomotive temperament.

This gives us four temperaments, as follows : —

I. The Cephalic Temperament, denoted by large brain, activity of
mind, and general delicacy of organization.

122

-T

TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS.

123

, AND

•wers. For
1 organs of

jrtion to his
) his whole
his brain,
being. He
snt, a sensi-
him, which
iT. Hence
It.

ilating the
in man in
vity of cir-
iral indica-
gives him
or calorific

of receiv-
L the body.
others, the
iks of the
Fhi^ is the

movements
portion, of
perfection
novenient,
n partakes
his is the

ictivity of

II. The Thoracic Temperament, indicated by a large chest, force
of circulation, redness of skin, great activity, warmth of temper,
and fulness of life.

III. The Abdominal Temperament, denoted by a large develop-
ment of the stomach, liver, bowels, and lymphatics; by a fulness of
l)elly, fondness of high living, and a disposition to float sluggishly
upon the current of the world, rather than to struggle against it.

IV. The Muscular Temperament, indicated by largeness of frame
and limbs, coarseness of structure, and great power of locomotion
and endurance.

There are some reasons for reckoning but three temperaments in-
stead of four, by reducing the thoracic and abdox mal to one, after
the manner of the phrenological Fowlers, — especially as the organs
in the chest, and their appendages, take an important part in the
process of nutrition. But as the heart and lungs are placed in one
cavity, and the stomach, liver, etc., in another, and as one set of
these organs may be largely developed, and the other defectively, I
have thought it most convenient, on the whole, and quite as philo-
sophical, to letain the four temperaments.

These temperaments seldo.a or never appear single and pure.
They mix and cross with each other in all possible ways.

Medication and Temperaments.

The object of speaking of temperaments in this work is to make
the reader acquainted wit£ the principles upon which remedies are
to be adapted to their development. The philosophical-minded phy-
sician will, in prescribing, always keep the temperament in view.

Persons of a Cephalic Temperament cannot bear powerful medi-
cines, — particularly drastic purges. Their fine, delicate and sensi-
tive organizations would be torn all to pieces by doses which would
hardly be sufficient in a fully-developed muscular temperament.
This should always be borne in mind in prescribing for persons of a
large brain and delicate organization.

In this temperament, too, fevers, instead of running a high and
fiery course, take the low typhoid type, the patient becoming pale,
and showing a constant tendency to sink. Such patients would be
killed by purging, leeching, cupping, sweating, and starving. They
want tonics, stimulants, and every kind of support ich the case
will possibly permit.

Persons of a Thoracic Temperament, having a rapid circulation,
and a fulnesp of blood, are most liable to inflammatory diseases.
When fever attacks them, they have what is called a " high fever."
If rheumatism comes, it is acute rheumatism. Disease takes hold of
them smaHly. As they do everything with emphasis and energy

124

TEM'iiRAMENTS, CONSTITUTION, AND SYMPTOMS.

1.1'

when well, ao, when ill, they make a businefls of it, and are sick with
all their might.

Stimulants and tonics generally make such persons worse. They
want sedatives, and diaphoretics, and Hweato, and purgatives, and
leeches, and cups, and low diet, and cold bathing, and whatever else
will slacken the ferocious swiftness of their circulation.

Those of the Abdominal Temperament are not particularly sub-
ject either to veiy high fevers, or to those typhoid forms which
produce sinking. As in the two temperaments noticed above, their
complaints chiefly attack the organs most largely developed. Their
diseases affect the stomach, the liver, the spleen, and the Ixiwels.
These are the largest organs in their bodies, and are most used ; and,
being overworked, they fall into disease.

As these persons are slothful in all their habits, so their diseases
run a sluggish course. They are not so liable to sudden death as
persons of either of the preceding temperaments. They have all
sorts of chronic diseases which linger a great while, and are cured
with much difficulty.

These persons will bear larger doses of medicine than either of
the preceding. Neither do their constitutions respond as readily to
medicine. A physician will be disappointed if he expects to see
them recovering as fast under its use.

Those of a Muscular Temperament, having little fondness for
any wiing but a hardy, active life, are much exposed to the elements.
Though strong and long-enduring, the hardship of their lives often
breaks them down, and when felled by disease, they are oftentimes
shockingly racked and torn by it.

These persons bear large doses of medicine, and when sick, need
to be treated with an energy proportioned to the strength of their
constitution. Rheumatism, which affects the joints, the ligaments,
and the tendons, is an affection from which they suffer severely.

The Constitution.

In prescribing for disease, it is of very great importance to take
notice of the constitution. This is a different matter from the tem-
peraments. Persons of the same temperament are often quite unlike
in the strength of their constitution. And those having good natural
constitutions, frequently abuse them by improper habits and indul-
gences, and at length come to have broken and very feeble consti-
tuiidns.

Some persons' muscles and other tissues are put together as if
they were never intended to come apart. Like some of the woods
of the forest, — the lignum vitse for example, — they are fine-grained
and tough. A real smart boy will wear out an iron rocking-horse
sooner than one of these persons can exliaust their constitution by

TIMPKBAMBNT8, CONSTITUTION, AND SYMPTOMi

125

e sick with

rae. They
atives, and
utever else

iilarly sulh
rnis which
bove, their
3d. Their
!ie lx)wel8.
wed; and,

ir diseases
» death as
f have all
are cuied

either of
readily to
:ts to see

dness for
elements,
ves often
iftentimes

jick, need
I of their
igaments,
3rely.

e to take
the tem-
te unlike
d natural
id indul-
e consti-

her as if
le woods
3-grained
ng-horse
ution by

hard work. Otliera, to outward appearance equally well made, have
very little endurance, break dov/n easily under hard work, and lose
their flesh from trifling causes.

The state of the constitution, therefore, should always be learned
before much medicine is given ; for what a person of a strong con-
stitution will need, may greatly injure a feeble person, even of the
same temperament.

Habits.— These must likewise be attended to. Persons using
stimulants require larger doses of medicine to affect them than other
persons.

Climate.— Medicines act differently on the same persons in sum-
mer and winter. Narcotics act more powerfully in hot weather and
climates than in cold, and must be given in smaller doses.

IdioAyncraAy.— Medicines of only ordinary activity, act very pow-
erfully, and even violen My on some persons. This is owing to a pecu-
liarity of stomach, or constitution, called idiosyncrasy. It makes the
person, in this particular, an exception to the general rule. And no
physician can knv)w beforehand in what imrticulars this exceptional
disposition will show itself. Persons, however, learn their own idio-
syncrasies, and should make them known to those who prescribe for
them for the first time.

Thi Sex.— The peculiarities of each sex should never be forgotten
in prescribing for the sick.

Males are not so sensitive as females. They will bear more medi-
cine, and their nervous system is not so readily excited by it.

Influence of Age.— Human life is divided into infancy, childhood,
youth, manhood, and old age. Each of these periods has peculiarities
which modify disease.

The First Period, extending from birth to the age of seven years,
is marked by tenderness and excitability, and is alive to every "irrita-
tion. Teething and other disturbances occur at this period, and need
careful management.

The Second Period extends from seven to fourteen, and is quite
subject to disease, including the second dentition. During these two
periods there is no great difference between the sexes ; both are ten-
der, and need careful watching.

During the Third Period, the changes occur which mark and sepa-
rate the sexes. This is a developing period, when the functions be-
come established, and the frame acquires form, proportion, and
strength.

At this time, hereditary tendencies to disease, latent till now, begin
to show themselves, and call for every possible endeavor to break
them up, and fortify the constitution.

. -.rr^aicSBTpcfWy .31

126

TKMPKRAMENTS, CONSTITUTION, AND HYMPTOMH.

The Fourth Period vinbroces tliu vigorouH maturity nf life, wlion
the powera of body and mind, in both sexes, are at the Hutninit of
their excuUunce. The functions are now well established. It Ih dur-
ing this periwl that the female is siibjeut to most of the ImniNNin^
ailments peculiar to her sex. So numerous are these complaints, luiil
so large and valued the class of persons uff;icted by them, that ho who
treats thenj with the greatest skill, and with the delicacy which their
nature demanils, may be said to be ut the head of his profession.

The Fifth Period is that of old iige, wlien the functions are detain-
ing, and the frame is bending u .der the weight of yeara. ()ld age
l)egin8 earlie'" with females than with males. Many ailmelits are com-
mon to this period, which require peculiar management, both medi-
cinal and hygienic.

Proper Frequency of Dose. — Kach suciceeding dose should Ixi
given before the effect of the preceding is gone. If this rule is not
attended to, the cure does not advance. What is gained by each
dose is lost by the rallying of the disease in the interval. Care must
he taken, however, not to apply this rule too strictly with very active

medicines.

How to Examine a Patient.

When a patient is presented for examination, having observed the
tempemment, constitution, sex, and age,

1. Learn the causes of the disease, whether local, specific, or gen-
eral, and also its history.

2. Search out its nature and character, whether febrile or other-
wise.

8. Take notice of the whole train of symptoms, -^ embracing the
pulse, the condition of the mouth, tongue, and digestive organs, the
breathing, the urine, the fecal discharges, the condition of the brain
and nervous system, the state of the skin, etc.

Brief Table Explanatory of Symptoms.

GENERAL APPEARANCE OF PATIENT.

1. Tonic spaHtn of the trunk

2. Distorted features, altered pooltion,

and impaired motion of limbs
'■\. Irregular and perpetual motion
4. Entire and absolute immobility
.'). Qreat and unnatural Iroldneas
(i. Great and unusual languor

7. Ability to lie only upon the back

8. Lying upon the face

9. Lying upon one side

indicates Locked jaws.

" Paralysis of one side. *

" St. Vitus's dance.

" Catalepsy.

" Insanity or delirium.

" The beginning of an acute disease, or

the progress of a chronic one.

" Apoplexy. Organic disease of the brain

or spinal marrow. Acute inflamma-
tion of the lining of the abdomen.
Rheumatism of the joints.

" Several kinds of colics.

" Pleurisy, or inflammation of the lungs.

When one lung only is affected in
consumption, the pai'.ont generally
lies on the diseased side.

t^aifkoA

TEMPERAMENTS, C0N8TITUTI0N, AND HYMPT0M8.

127

in. MnlnUlninK tli« NittlnR poaturn indioaton

only
11. The lieail tlirown bock "

Vi. KflNtlflmnnm Hiid totMinipt ••

13. Uen«nl «nlargem ( of the body "

DUnafin of tlio lionrt or InnRM, wlilrh

interfnroH with br«athln|{.
Hevere diiieaiieMof the larynx and wlnd-

pljMS.

Th« beKlnnlnp of acute Indammatlon.

Fevers. Dellniini, uiid acute inanlu.
CelUlroimy. Eui|ihy»enia from a

wound of the clinNt.

Head, Face, and Neck.

1. TToad bent to one Hide

2. Head increasetl in ilze

3. Hwollon Hcali)

4. Dull exprexNion of face

5. Full, red face, with blood-veaaeU

of eyed injected

6. Pinched, contracted countenance

7. I'iiiched nose, Hunken even, hollow

tonipleH, Hkin of forehead tense
and dry, complexion livid
H, Wrinklefi hvtdm tho forehead
0. Wrinkles from forehead, vertically
to root of nose

10. A white line from inner angle of

the eye to just below the cheek-
liono

11. White line from the upper border

of the wing of the nose (ala nasi ) ,
curved to the outer margin of the
orb of the oye

12. The white line In children from

angle of mouth to lower part of
face

13. A white line external to the last

two, in a semicircular direction
towards the chin

14. Swelling of tlie face and eyelids

15. Transient redness or flushing of

face

16. Hectic flush

17. Paleness of face

18. Dingy, white, or greenish face

19. Yellow tint

20. A citron tint

21. A bluish tint

22. Pc-petual motion of eyelids

23. Forcible closure of eyelids

24. Byelidti remaining open

25. PMsy of the upper lid

20. Plowing of tears over the cheek

27. Nostrils, dilating forcibly and rap-

idly

28. ItohiQg of nostrils in oldldren

Indicates ConvuLiions. Paralysis of oiie-half the

bo*ly. Dislocation of hones of neck.

Swelling of glands of neck.
" Chronic hydropholus. Knlarged brain.

" Erysipolas. Hmall-pox.

" Typhoid fever.

Hwolling of heart. Congestion of

brain.
" Acute Inflammation of peritoneum.

Exposure to severe cold.
" Chronic disease just before death.

" ExcesfllTe pain arising externally.

" Distress, anxiety, and severe internal

pain.
In children, a brain or nervous affec-
tion ; in adults, abuse of the genera-
tive organs.

" In consumption and wasting -f flesh.

The lower part of the line indicates
disease of stomach ; the upper part,
some afTection of upper part of bowel.
When united with the white line
named above, and with a drawing in
of the cheek, fixed eyes, and a wan
complexion. It implies worms.

' An afrection of the chest, with diffl-

culty of breathing.

" Chronic and obstinate disease in the

chest or belly.

" Albumen in the urine.

" Suffering from the monthly irregular-

" Consumption. Chronic aflfections.

Cold stage of fever. Acute inflamma-
tion. Chronic diseases, especially
Bright's disease, during recovery.
A low and deficient state of blood.
Jaundice.
" Cancerous disease.

" Poor circulation in the veins. Cholera.

Typhus fever. Blue disease.
Mania and idiocy.
" Intolerance or dread of light.

" Orbicularis palpebrarum. Paralysis of

the muscle which closes the eye.
Injury of the tliird pair of nerves.
' Obstruction of the lachrymal duct.

Difficulty of breathing.

Worms in the bowels.

The Tongue.

Surface of tongne covered with a
layer of whitish, soft, mucous
substance, which may partially
be taken off with a scraper, —
also, clammy mouth

indicates Derangement of stomach , or bowels, or
both.

128

TBMPEBAMSNTS, CONSTITUTION, AND SYMPTOMS.

icdloates Acute dyspepsia. Asthma.
" Severe oases of acute dyspepsia.

3. State of tongue as above, with

clammy mouth, bitter taste, and
fetid breath.
8. Oreat load on tongue as above,
which pwU off, leaving the
tongue smooth, red and tender

4. TonKue slightly white from small

white pomts, and sometimes cov-
ered with for, like the fibres of
coarae velvet
6. Tongue pale, tumid, cloan and very
smooth

6. Tongue /urred and dry

7. Tongue white and loaded, with

much thirst

8. As above at first, — afterwards

c/ean, red, and dry

9. Tongue white and loaded, with dry-

ness

10. Tongue dry, parched, tender, and

dark brown or black. Pushed out
with great difficulty and tremb-
ling

11. Tongue loaded with white, through

which numerous elongated, very
, red papillae protrude their points

Chronic djrspepsia. Some affection of
the liver, if the fur be yellow.

Chlorosis or green sickness.

Violent local inflammation. Irritation

in bowels.
Inflammatory fever.

Protracted inflammatory fever.

Mild tjrphus fever.

Severer forau of typhus fever.

Scarlet fever.

The Throat.

1. Throat enlarged

2. Violent pulsation of carotid arteries

8. Pulsation of the nameless artery
(arteria innominata) above the
breast b me, and to the right of
the windpipe.

4. Circumscribed swelling about throat

indicates The approach of puberty in females.
" Acute mania. Inflammation of brain.

Enlargement of heart, and dilation
of right ventricle. Anemia.
" Regur^tation from aorta.

Enlivgement of glands.

The Chest

1. General enlargement of one side of indicates Large effusion of water from pleurisy,
chest

" Water from pleurisy settling to the

bottom.
" Emphysema.

" Enlargement of liver.

" Water in heart-case. Enlargement of

heart.
" Aneurism of the ascending aorta.

2. Bulging at the base of a lung

3. Bulging at front upper part of chest

4. BuIgingrighthypochondrium(See

5. Bul^iig m region of heart

6. Tumor where the third rib joins the

breast-bone

7. Tumor between the base of the

shoulder blade and the spine

8. Depression or retraction of one tide

of chest

9. Breathins increased in rapidity.

Oenerally, in health, about
twenty breaths aro taken in a
minute
10. Breathing diminished in rapidity

11. Jerking respiration

12. Breathing with muscles of ribs only

Aneurism of the descending aorta.

Constmiption. Absorption of fluid,

effusea by pleurisy.
Spasmodic asthma.

Pleurisy. Paralysis of respiratory mus-
cles, inflammation of lungs. Emphy-
sema. Pneumothorax. Consumption.

Spasmodic asthma. Obstruc)Jon in
larynx and windpipe.

Abdominal inflammation. Inflamma-
tion of diaphragm.

1. Increased size of belly

The Belly.

indicates Dropsv. Wind in bowels. Inflam-
mation of peritoneum. Obstruction
in bowels. Hysteria.

TEMPERAMINTS, CONSTITUTION, AND SYMPTOMS.

129

2. Enlargement In epigastrium (FUr. 93) indicates Hysteria. Cancer of stomach.

3. Enlargement In hypogastrium (Pig. 96) " Distension of bladder. Ovarian tu-

mors. Accumulation of feces in
bowels

4. Belly diminished In dze " Chronic dysentery. Lead ooUc. Also

in most chronic diseases,

1. Enlarged penis in children

2. Drawing up of testicles

3. Enlargement of scrotum

1. The limbs immovable

2. Limbs contracted and rigid

3. General swelling of limbs

4. Swelling of joints

5. Limbs diminished in size

Private Organs.

indicates Stone In bladder. Masturbation.
" Stone In kidneys.

" Hydrocele. Hematocele. Sarocele.

The Limbs.

Indicates Paralysis.

" Softening of the brain.

" Defective circulation of blood.

" Bhenmatism. Water In the joints.

White swelling.
" Faralysiii. *

The Nervous System.

1. Morbidly increased sensation

2. Tensive pain

3. Dull, heavy pain

4. Smarting pain

5. Shooting, tearing pains

6. Boring pains

7. Contualve pains.

8. Itching. Sensation as of ants creep-

ing over the skin

9. Exaltation of vision

10. Black flecks floating before the

eyes

11. Painfully acute hearing

12. Dull hearing

13. Increase of strength

14. Debility
16. TrembUng

16. Rigidity of upper extremities

17. Cramp

18. Temporary spasm

19. Pain at extremity of penis

20. Pain in right shoulder

21. Pain in left shoulder

22. Exaltation of affections

23. Loss of moral sensibility

24. Ezaltat m of Intellect

Indicates Acute Inflammation of brain and
spinal marrow. Fevers. Hysteria.

" Phlegmonous inflammation.

Enlarged internal organs. Internal
tumor. Effusion of water into cavi-
ties lined with serous membranes.
Felt In the loins previous to dis-
charge from menstruation, and from
piles.

" Scarf -ekln removed.

' " Neuralgia. Cancer.

" Constitutional syphilis. Rheumatism.

Oout. Inflammation of periosteum.

" Bruises. Acute diseases.

" Several diseases of the skin.

" Ophthalmia. Inflammation of brain.

Some nervous diseases.
" Affections of the brain and optic

nerve. Dyspepsia.
" Inflammation of brain. Hysteria.

" Typhus fever.

" Delirium. Inflammation of brain.

Mania.
" Most diseases.

" Cold stage of fever. Nervous affec-

tions. Old age. Action on the sys-
, tern of lead, mercury, strong coffee,

alcoholic drink, tobacco, opium.
" Softening of the brain. Infiltration

of blood into the brain. Hysteria.
" Pregnancy. Hysteria. Painters' colic.

In convulsions of children. Some

affections of the brain.
" Stone in bladder.

" Congestion of liver.

" Disordered stomach.

" Hypochondriasis.

" Mania. Typhus fever. Masturbation.

Melancholy. Sometimes indicates

close of Ufe.

1. Stiffness of chest

2. Pressure upon parta

The Breathing.

indicates Cartilages turned to bone. Pleura
hardened. Distortion from rickets.
Tumors. Dropsy of belly.

180

TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS.

3. Obstruction of air-tubes

4. Compression of lungs

5. Pain in parts moved in breathing

6! Paralysis of muscles of chest

7. Spasm of muscles of chest

8. Deficiency of red blood

indicates Spasm of glottis. Spasm near the
small ends of bronchial tubus.
Mucus, etc., thrown out upon the
inner surface.

" Effusions in pleurisy. Water in

chest. Air in substance of lungs.
Aneurism and other tumors.

" Pleurisy. InflAmmation ol perito-

neum.

" Injury of spinal marrow.

" Locked jaw. Spasmodic asthma.

" Angemia. Chlorosis or green sickness.

1 . Hollow and barking cough

2. Sharp, ringing cough

3. Hoarse cough

4. Wheezing cough

5. Belching cough
H. Cough in paroxysms

7. Cough sounding harsh and concen-

trated when listening with the
stethoscope.

8. Cough sounding hollow, when lis-

tening with the stethpscope, as
thougli it came from a cavern.

9. Cough having a metallic or ringing

sound when listening with the
stethoscope.

The Cough.

indicates Last 8i.age of consumption. Clironic
bronchitis. Some nervous affections.

" Croup.

" Beginning of cold. Chronic laryn-

gitis.

" Asthma.

" Some diseases of larynx.

" Hooping cough. Hysteria.

" Consumption. Inflamination of thn

lungs. Pleurisy. Enlargement of
bronchial tubes.

" Tuberculous cavity. Enlarged bron-

chial tubes.

Large tuberculous cavity.

1. Scanty expectoration

2. Copious expectoration

3. Watery expectoration

4. Mucous expectoration
6. Expectoration of pus

6. Expectorated matter shaped like

coin (nummular)

7. Muco-purulent, iloculent expecto-

ration

8. Tubular expectoration

9. Whitish or greenish expectoration,

that clings to the vessel

10. Yellow expectoration

11. Rusty expectoration

12. Putrid smell of expectoration

13. Faint and sweetish smell of expec-

toration.

14. Expectoration smelling like garlic

The Expectoration.

indicates First stage of acnte diseases of the
lungs.

" Decline of acute diseases of air-passages

and lungs.

" Beginning of bronchitis. Congestion

of lungs. Vesicular emphysema.

" Bronchitis. Inliammation of lungs.

" Consumption. Third stage of inflam-

mation of lungs.

" Tubercular consumption. Bronchitis

of measles.

" Consumption far advanced.

Plastic bronchitis. Pneumonia.

Acute affections of lungs, particularly
bronchitis

Chronic bronchitis. Other chronic af-
fections of the lungs and throat.

Inflammation of tL ' lungs.

Gangrene of the lungs.

Bronchitis. First sta^o of consumpti jn.

Broncho-pleuial fistria.

1. Dull, heavy, aching pain at the

base of the chest

2. Soreness about the breast bone, and

between the shoulders

3. Sharp, sudden, tearing pain below

the nipple

4. Pain darting from front part of

chest to between shoulder blades

5. Constant paiu between the shoulders

Pain.

indicates

Acute bronchitis-

'■

j-V,".! J b/onci'.itis.

Pleurisy.

Consumption.

Consumption. Green sickness. Other
chronic diseases.

TEMPERAMENTS. CONSTITUTION, AND SYMPTOMS.

131

«m near the
Oiial tubus.
iUt upon the

Water in
ice of lungs.
nors.
n of perito-

; asthma.
:een sickness.

on. Clironic
lUH affections.

tironic luryii-

ia.

lation of the

largenient uf

ilarged bron-

leases of the

if air-passages

Congestion
iphysema.
jn of lungs,
ige of innani-

iimonia.

, particularly

er chronic af-
d throat.

consuuipti ju.

The Pulse.

^' ^W.rfi^lfir^''"'"' compression indicates Intiammatory affectionH. osi.ecially of
Dy tiie linger the substance of large organs, as the

liver, etc.

I'rostration from disease. Nervous and
clironic affections. Fear. Diseases
of women and children, and old per-
sons.

Congestion of brain. Apoplexy. Dis-
ease of heart.

Inflammation of stomach, bowels,
bladder, etc. Hysteria, and other
nervous affections.

Inflammation of membranes. Active
bleedings. Lead colic, et«.

Affections cliaracterized by debility.

Inflammatory diseases. Hemorrhages.
Apoplexy. Sometimes in disease of
heart.

Weak pulse, easily pressed down

."?, Full pulse, as if the artery were in-
creased in size

4. Small pulse, opposite of full

5. Hard, sharp, contracted pulse,- ,.
brating like a cord under the finger

- vi-

«. Soft pulse, yielding readily to pres-
sure

7. Frequent pulse

8. Slow pulse

Relating to Digestion.

1. Tongue trembling and dry, and di-

minished in size

2. Voracious appetite

3. Diminished appetite

4. Ii-.creased thirst

5. Thirst gone
(i. Vomiting

7. Pain increased by pressure

8. Pain relieved by pressure

9. Urgent desire to go to stool

10. Watery stools

11. Mucous stools, like white of egg

12. Hard and lumpy stools

13. Clay-colored stools

14. Yellow or dark-brown stools

15. Dark-green stools

16. Stools red, and streaked with blood

17. Pitchy black stools

18. Stools pure blood, with no colic

19. Stools like rice-water

20. Black stools

21. Shreds of false membrane in stools

22. Fat with stools

23. Fetid stools

indicates Typhoid and other low fevers.

Pregnancy. Hysteria. Insanity. Some-
times in dyspepsia.
" In most acute diseases.

Acute affections of stomach and bowels.
Cerebral disease, with coma.
" Early pregnancy. Colic. Disease of

brain. Inflammation of stomach.
Hernia.
" Inflammation of internal organs.

Over-distension of bowels. Neuralgia.
Colic.
'■ Dysentery. Sometimes in diarrhoea.

Diarrh&a, Cholera.
'' Chronic inflammation of colon.

Constipation. Colic. Cancer of stom-
ach.
" Deficiency of bile.

" Too much bile.

Bile from children after taking cal-
omel.
■' Dysentery.

" Meltena.

" Bleeding piles.

" - Asiatic cholera.
" Iron taken in medicine.

" Dysentery. Diarrha>a. Worms.

Diabetes. ConsmniJtion.
" Diseases attended by debility.

The Urine.

kuess. Other

1. Diminished secretion of urine

2. Retention of urine in the bladder

3. Urine increased in amount

4. Red or yellow sand deposits in urine

(uric acid)

5. White sediment in urine (earthy

phosphates)
B- Oxalate of lime deposits in urine

7. Blood in urine

8. Albumen in urine

9. Mucus in urine

10. Sugar in urine

indicates Dropsy. Inflammatory and febrile
diseases.

" Paralysis. Typhoid fever. Hysteria.

" Diabetes. Cold stage of fevers. Hy-

steria. Various passions of the mind.

" Fevers. Acute Rheumatism. Con-

sumption. Dyspepsia. Great indul-
gence in animal food.

" Depressed state of the nervous system,

of serious import.

" Derangement of digestion.

" Bleeding of kidneys, etc. -

" Bright's disease.

" Inflamed mucous membrane of ure-

" thra, bladder, etc.

Diabetes.

132

TEMPERAMENTS, CONSTITUTION, AND SYMPTOMS.

The Perspiration.

!■ Profum {Mnpiratlon

2. Diminished perspiration

3. Night sweats

4. Sour-smelling sweat
6. Fetid smelling sweat

6. Sweat with mouldy odor

7. Smalling like ammonia

8. Sweat having the odor of mice

9. Sweat smelling like rottenstoue

indicates Acute rheumatism. Decline of acuto
" inflammations and fevers, beine

sometimes critical.

" ^n/'il**** **' **"*** disease. Dropsy.

" Consumption. ,

" Rheumatism. Oout.

" Some debilitating fevers.

" Measles. Scarlet fever.

" Typhoid fever sometimes.

" Insanity.
Miliary.

The Temperature.

1. (General heat of surface

2. External local heat

3. Hot forehead

4. Hot scalp

fS. Skin of chest hot
1 6. Hands and feet hot.

7. Acrid heat, burning the hand when

applied

8. Chflfs

9. Low temperature
10. Cold hands and feet

indicates Fevers.

Inflammation.
Headache.
Disease of brain.
Inflammation in chest.
Consumption.
Typhus fever.

Beginning of fever.
Poor circulation.

Nervous diseases. Dyspepsia. Impure
state of the blood.

The Temperature of the Body.

The use of the thermometer is an important addition to the means
of making physical examination, and is one of the improvements in
modern medicine.

It is intended to measure the heat of the oody.

The best kind now in use is the self-registering.

The bulb of the instrument is to be placed in the warmest part of
the body, and should be allowed to remain there for eight to ten
minutes.

Some place it under the tongue ; some in the axilla.

Sometimes it is necessary to introduce it into the rectum or vagina.
In these parts the temperature is a degree higher than in other parts.

The normal temperature of the body is from 98° to 99° Fahrenheit,
in the great majority of persons.

Exceptionally it may be half or a whole degree either above or be-
low this range.

The normal fluctuations are inconsiderable in comparison with the
variations of disease.

The natural variations in health are as follows : The temperature
is at its minimum at five o'clock A. M. ; the maximum is reached in
the latter part of the afternoon, and then decreases till five o'clock

A. M.

By means of the thermometer we are able to determine all differ-
ences with precision.

TEMPBRAMBNT8, CONSTITUTION, AND SYMPTOMS.

188

The increase of heat in different febrile diseases rarely exceeds
110° Fahrenheit, ant* as a rule the amount of increase is a criterion
of its severity.

An increase to lOO^ Fahrenheit or 101° is evidence of mildness of
the disease.

If the thermometer indicates steadily 106° Fahrenheit, it is certain
tliat the disease is severe.

A persisting temperature above 106° Fahrenheit denotes that there
is great danger, and an increase to 108° to 110° Fahrenheit is usually
a fatal sign.

The abnormal changes of temperature consist of more or less in-
crease.

Diminution below the normal standard is comparatively rare ; yet
it sometimes occurs and is of some importance.

In the course of typhoid fever, a sudden decrease may indicate in-
testinal hemorrhage. Sometimes the temperature falls without im-
provement in the other symptoms. This is an unfavorable symptom.

The value of thermometric changes depends in no small measure
upon the symptoms with which they are associated.

: .,iw;j ?.i ^fe'teH.''. ' ->^ . ' -' ' >- '■ '~' ^ ' ' ' -' -"' ' •-••

Iff

ULl

SKIN DISEASES.

The skin is the soft and pliant membrane which covers the entire
surface of the body. The interior, like the exterior is likewise covered
by a skin, which, from its always being moist, is called a mucous
membrane. At the various openings of the body, the outer and the
inner skins are united, — forming one continuous skin, — like the
same piece of silk turned over the border, and covering both the out-
side and inside of a bonnet.

From this continuity or oneness of the skin and mucous membran ;
springs an important medical law, namely, that a disesise of the skin
may spread to the mucous membrane, and a disease of the mucous
membrane may spread to the skin. We see this illustrated by the
breaking out around the lips v/hich follow colds, and the itching of
the nose of children when the mucous membrane of the bowel is irri-
tated by womwj.

The Skin is Composed of Two Layers. — These are separated from
each other by the action of a blister. The thin portion which is raised
up by the fluid of a blister is called the scarf skiti, the cuticle, or the
epidermis; that which remains in connection with the body is the
sensitive skin, the cutis, the derma, or the true skin. The two skins
have very different offices to perform. The scarf-skin is horny and
insensible, and serves as a sheath to protect the more sensitive skin
under it. Were the scarf-skin taken off, we could not bear to have
anything touch us.

The derma, or true skin, and its glands, etc., are the seat of all the
cutaneous diseases. These may be separated into four great divisions,
— namely, diseases of the true skin, diseases of the sweat glands and
tubes, diseases of the oil glands and tubes, and diseases of the hairs
and hair glands.

Then the diseases of the true skin are divided into

Inflammation of the true skin ;

Enlargement of the papilloe of the true skin ;

Disorders of the vessels of the true skint-
Disorders of the sensibility of the true skin ;

Disorders of the color-producing function of the. true skin.

The inflammation of the true skin is conveniently divided into two
groups, — namely,

Such as are marked by inflammation of the derma and mucous
membranes, with constitutional symptoms of a specific kind, and

134

3 the entire
k'ise covered
I a mucous
ter and the
— like the
Jth the out-

i membran j
of the skin
ihe mucous
ited by the
itching of
3wel is irri-

irated from
ih is raised
'icle, or the
)ody is the
! two skins
horny and
sitive skin
ir to have

; of all the

; divisions,

jlands and

the hairs

SKIN DISEASES.

135

Surli aH arc (liHtin^nnslu'd by iiiflaniniiitioii of the derma, withnut
consfitutional symptoms of a specij'u; kind.

Congestive Inflammation of tlie True Sl<in.

The First of these Qroups. — those characterized by inflammation

of the cutis, with constitntional symptoms of a specific kind, embraces

measles, scarlet fever, varioloid, and cow-pox.

Measles. — Rubeola.

Measles is an acute inflammation of the entire skin, both external
and internal, associated with an infectious and contsigious fever.

Symptoms — The disease sets in with chills, succeeded by burning
heat, listlessnesH, languor, drowsiness ; pains in the head, back, and
limbs ; frequent pulse ; soreness of the throat ; thiret, nausea, vomit-
ing, frequent dry cough and high-colored urine. These symptoms
hicrease in violence for four days. On the third day the eyes become
inflamed, cannot bear the liglit, and pour fourth a profusion of teai-s.
This last symptom is called coryza. The nose likewise discharges a
large quantity of watery secretion, and sneezing is frequent. The
larynx, windpipe, and bronchial tubes become inflamed, and hoarae-
iiess, soreness of the breast, etc., are the result.

The redness of the skin and breaking out appear about the fourth
day, and produce heat and itching. This breaking cut is character-
ized by a patchy redness, which, on close inspection, is found to con-
sist of numberless minute red points and pimples, collected into
patches in the shape of a half or quarter moon. They appear first on
the forehead and front of the neck, then upon the cheeks and around
the nose and mouth. On the fifth day they reach their height in this
region, and then appear upon the body and arms, and on the sixth
day, upon the legs. The color of the skin, when the inflammation is
at Its height, is of a bright raspberry red. The decline of the rash
takes place in the same order in which it comes out. The redness
fades on the sixth day upon the face ; on the seventh, upon the body
and hmbs ; on the eighth, upon the back of the hands. The coiyza,
the hoarseness, and the cough, decline about the seventh day, while
a diarrhoea comes on about the eighth or tenth, — showing that the in-
flammation of the mucous membrane is subsiding. When the inflam-
mation disappears, the whole scarf-skin peels off in the form of a
scaly scurf. The artist has given a good picture of the disease in the
beautifully colored lithograpli, Plate I, Fig. 1.

Treatment — When the disease is mild and regular in its course,
scarcely anything will be required, except mild diet, slightly acid
dnuks, with flax-seed tea, slippery elm, or some equivalent, to quiet
the cough. Sponging with tepid water, if done with frequency, mod-
erates the fever, and adds to the comfort of the patient. If the fever

—t^a^asKB?-

186

HKIN DISEASES.

runs high, take half an ounce of i-ochelle salt, and uae recipe 125.
Should the eruption "strike in," apply leeches or cups over the in-
ternal organ affected, if any, and recall the rash by sweating.

Those who have been exposed to the contagion, and are liable to
have the disease, should avoid all unnecessary exposure to wet or
cold, — keeping the feet warm and dry, and the whole body well clad.
With these precautions, and a mild, unstimulating diet, much of the
force of the disease may be broken.

During the first stages of the disease, bathing the feet once or twice
a day with hot water, and freely using warm, sweating drinks, as
saffron, summer-savory, pennyroyal, bilm, and mullein tea, and put-
ting mustard drafts to the feet, will hasten the coming out of the
eruption.

Should the breaking out be delayed by excessive fever, give full
doses of tincture of veratrum viride, or nauseating doses of ipecac,
antimony, lobelia, or hive-syrup, and teaspoonful doses of compound
tincture of Virginia snake-root.

Besides the milder forms of the disease, cases occur, chiefly in
broken-down constitutions, in which the rash delays its coming out
till the seventh day, and is then mingled with dark and livid spots,
which remain, ofteii, for ten or twelve days. The fever is of a low,
typhoid kind, and the patient is extremely weak and languid.

In this condition of things, the patient must be supported by tonics
(77 and 59), and whisky, and expectoration promoted by some appro-
priate remedy, if required.

If at any stage of the disease there should be fixed pain in any
part of the chest, which is made worse by coughing, or by taking a
full breath, we may conclude there is some inflammation of the
chest ; and it must be treated as directed for pneumonia.

Scarlet Fever. — Scarlatina.

This is likewise an acute inflammation of the entire covering of
the body, both external and internal, connected with fever which is
infectious and contagious.

Symptoms. — The fever comes on somewhere between the second
and tenth day after exposure. On the second day of the fever, the
eruption comes out in the form of very small points and pimples,
which appear either in patches, or constitute a general redness, of a
bright scarlet color. In Platk I, Fig. 2, the artist has given a fine
picture of the disease.

The disease begins with languor, pains in the head, I ack, and limbs,
with drowsiness, n&Uf»ea, and chills ; and these are followed by heat,
thirst, etc. When the redness appears, the pulse is quick, and the
patient is anxious, restless, and sometimes delirious. The eyes are
red, the face swollen, the tongue covered in the middle with white
mucus, and is studded with elevated points of extreme redness. The

SKIN 0IBKA8B8.

137

3cipe 126.

'er the in-

ag.

3 liable to
to wot or
well clad.

auh of the

36 or twice
drinks, as
., and put-
3Ut of the

', give full
of ipecac,
compound

chiefly in
oming out
ivid spots,
I of a low,
lid.

:l by tonics
)me appro-

lin in any
y taking a
3n of the

jvering of
r which is

he second
fever, the
1 pimples,
[ness, of a
fQn a fine

md limbs,
d by heat,
, and the
eyes are
irith white
less. The

tonsils are Rwclled, and the throat red. Tbn grciitrst dngren of led-
iiusH is reaclied on the evening of the third or fourtli day from it« l)e-
ginning, when a gentle moisture appearH, tlio diHease I>egi)i8 to decline,
with itching, and the scai-f-Hkin falls off in branny scaU^s.

A swelling or putliness of ti>e tlesli, which spreads out tin* tingers
in a singular manner, seems to be peculiar to scarlet fever.

In the first stage of the complaint, the tongue, as stated al)Ove, is
covered with a fur ; but as it advances, the tongue often Ixicomes
suddenly clean, and presents a glossy, fiery-red surface, which is
sometimes, with the whole lining of the mouth, raw and tender.

It is peculiar in this complaint, that the inflammation of the
throat alwayp runs into a stiite of ulceration. As far us can be
seen, on pressing down the tongue, the throat is swollen and of a
deep, florid I'jid ; and on the tonsils may be seen white or gray
ulcers. This makes swallowing very ditiicult, and aggravates the
sufferings of the patient. The great amount of mucus in these
parts causes also a continual rattling in the throat.

The eustachian tube, which extentls up to the ear, is apt to get
involved in the inflammation, and cause swelling and pain in that

region. The glands under the ear and jaw
sometimes inflame, and after a time they oc-
Ciisionally break. Abscesses formed in the
ear frequently produce some deafness which
is not easily cured.

In the cell-dropsy, which sometimes appears
after scarlet fever, the crystals of urate of
ammonia may often be found in the urine
with the microscope (Fig. 72).

This disease resembes measles, but may

*■'<*• "• be distinguished from it by the absence of

cough ; by the eruption being finer^ and of a more scarlet color (see

plate) ; by the rash coming out on the second day instead of the

fourth ; and by the ulceration in the throat.

Treatment. — In ordinary cases, the treatment should be very
simple. The apartment should be kept cool, and the bed-covering
light. The whole body should be sponged with cool water as often as
it is hot and dry, and the patient be permitted to take cooling drinks.
Besides this, in many cases, very little is needed, except to give a
few drops of the tincture of belladonna, night and morning.

In some cases where there is a good deal of fever and soreness of
throat, give tincture of veratrura (125) often enough to keep down
the pulse. Give every half hour (an adult) till pulse reaches sixty.
Aconite in drop doses to children every fifteen minutes. In addi-
tion to this, the feet and hands should be soaked in hot water, with
a little ground mustard, or pulverized ca3'^enne, stirred in. This
bath should be continued twenty minutes, twice a day, for two or
three days.

rSMSS&K'

.ai ii. l <wJli lM ii ll iiiiii ' iiii»i nr i i i i w ' i *' iiii > i ni iiiii r i H l » i T ' i n ' i " i " ' '

SKIN niHRAHRn.

The cold 8tajr« having piwHcd, and the fovor Hot in, wiinn water
may Iw ubjhI without the miiHtard, eU-. If tiic head Ik; iifTecU-d, um
nuiHtui'd (IniftH upon the feet. Shouhl the JK)welH lie coHtivo, they
may \x' gently o[)(auHl hy Honie very miUi physic.

No Holid food Hhould bo aUowed ; but after the fiixt shock of the

di8eit«e iH pusHed, dnnka, in reiwonablc (juantiticH, will Iw advisable,

Buch au cold wattu', lemonade, barlMtrry and tamarind water, rice
water, balm or tlax-Heed tea, and Home thin wat<*r-gruel.

To promote the action of the skin, the HpiriUi of nitre, with other
articles (125), adapting the dose to a child, will be found useful.
The nitrate of poUwh iw UHeful, given in on»> to three-grain doses,
dissolved in water, every three or four houm.

Muriatic acid, foity-tive drops in a tumbler filled with wattu-, and
sweetened, and given to a child in teiuspoonful doses, is a good remedy.

In very violent attacks, the system sometimes inclines to sink im-
mediately ; typhoid symptoms show themselves ; there is great pros-
tration ; the eruption strikes in; the skin changes to a purple or
mahogany color; the tongue is of a deep red, nr has a dark-brown
fur upon it, and the ulcers in the throat become putrid. This is
called scarlatiua maligna ; but it is only a severer form of the same
disease.

The treatment of this form must be different from that recom-
mended above. It must Iw tonic. Quinia (66) must be freely given.
Wine whey, mixed with toast-water, will be useful. Tincture of
cayenne, in sweetened water, may be given often in small doses.
Ammonia (135) may likewise be given as a stimulus. Gargles (245)
(244) (243) are also required.

A dropsical affection is one of the most frequent results of scarlet
fever. It is believed that this seldom occurs, if the warm bath is
daily used, as soon as the skin begins to peel off. After the dropsy
has set in, give the warm bath twice a week, and encourage perspi-
ration by the compound tincture of Virginia snake-root, and similar
articles. The child should have a generous diet, at the same time,
to bring up its strength.

Anointing the skin with vaseline at night and washing off in the
morning with suds removes the poisonous scales, and lessens the
danger of contagion, as well as improves the activity of the skin.
Nasal and aural catarrhal diseases are commonly observed to follow
scarlet fever and need attention of a physician. Rheumatism like-
wise is a frequent sequela, wliile nephritis or inflammation of the
kidneys is often a sad reminder of the disease. These two compli-
cations are to be treated as directed elsewhere.

TABLE EXHIBITING THE DIFFERENCE BETWEEN SMALL T OX, VARIO-
LOID, SCARLET FEVER AND MEASLES.

SMALL-POX.

VABIOLOID.

first. Period between expocure and when dU-
ea«e flnt abowa Itaelf li from five to twenty daya —
oaokUy abowa itaelf in ten or twelve daya.

First. Period of InoubRtfn*. more Irregnlar
than Buiall- Pox — from five u < wty daya— av-
eragea twelve daya.

tm^

•iirm wdttT
rented, put
Htivo, they

Jck of the
IviHiiblu, —
water, rice

with other
nd UNefiil.
ail) doHes,

watt(r, and
)d remedy,
o sink im-
jreat pros-
pur j)le or
ark-brown
1. This is
the same

lat recom-
Jely given,
incture of
lall doses,
jles (246)

of scarlet
11 batli is
he dropsy
ge perspi-
ud simihir
iime time,

off in the
jssens the

the skin.

to follow
itism like-
on of the
ro ' compli-

)X. VARIO-

nore irregnUr
)Pty (Uyi — «T-

SMALL POX

■*■■'"

dfeo

o-^

Q- O*^

* ..' e

^o^

0r^O

*j..-,ai;-.ii «'l*tf*, /S'jfefAVS

■p^;. . .^v^;*p<- "

Proof ress of M, ^

SnuxU Pox. *^'

l?f<iajj.2'}il4»y.3'iday.5'^dMf. S^day. Hf'kUui.

M.-»r^ (.4!«;fffii

Progivssof
Varioloid.

# i #

/?.*«%. ?'^rfay. ^.'^<%. -^.'^^fcty. 5/^<%. 7/??V«y.

Progress of
Vaccination,

4^hday. e^^oLay.

a^hihxy.

llf'^day.

SKIN DISEASES.

139

;^^

Secnnit. The fever and temperature U high, bat
ia less after rash appears.

Third. The rash appears on third or fourth day
and is seen on the forelieail or Kouie part of face.

Fourth. The eruption first consists of pimples,
then watery blisters wbioh become white and sink
in the center.

Fi/th. The tor.^e is coated and swollen .

Sixth. The eyes do not run, and broncbitia does
not appear.

fieventh. Sore throat is often present but not to
as great an extent as in Scarlet Fever. Delirium
and convulsions may occur.

Eighth. Beoondary fever appears after several
days.

Ninth. There are apt to be pocks and the eye-
sight be weakened, but by modem treatment it
can usually be avoided.

8CABLET FETEB.

Firtt. Period between contagion and when dis-
ease first shows itself is usually from three to six
days, but may be much longer.

Second. Fever greatly increased and continues
without abatement after eruption appears.

Third. Eruption makes its appearance on sec-
ond AV on the chest and neck and spreads over
the l)ody during tl'« next twelve hours.

Fourth, The eruption extends over the entire
skin.

Fifth- Eruption lasts from six to seven days
when it begins to come off in larpe scales.

Sixth. Tongue is covered with little red points.

Seventh. There is little trouble with bronchitis
or running of eyes.

Eighth. Sore throat.

Ninth. The mind is apt to be affected and there
may be delirium.

Tenth. Usually no seoondary fever.

Eleventh. In Scarlet Fever there is great .dan.
ger of the patient being left with kidney trouble,
or the eyes, ears, or throat may be affected.

Second. Fever high till rash is well developed
and then a greater &provei.ient than in Small-
Pox.

Third. Eruption appears on third or fourth
day.

Fourth. Rash consists of pimples, may ^o on
to pustules and blisters, but usually subi'ide be-
fore advancing so far.

Fifth. Tongue coated and swollen.

Sixth. No nose or eye symptoms as a rule.

Seventh. Bore throat mild. Delirium and sev-
erity of diseiwe often marked at Iwginning but
quickly subside.

Eighth. Secondary fever less marked than In
Small- Fox.

Ninth. Instead of rapidly convalescing, the
patient often shows an amount of weakness and
anemia all out of proportion to preceding symp-
toms.

MEASLES.

Firtt. Period between exposure and when dis-
ease first shows Itself is from seven to fifteen
days.

Second. There Is a moderate fever. It does
not decrease but increases alter eruption.

Third. Eruption appears on fourth day on
face and spreads over rest of body in about two
days.

Fourth. Eruption is orescent-shaped, rest of
skin healthy.

Fifth. Eruption lasts about five days, then
peels off in scales.

Sixth. Tongue has red edges and is coated.

Seventh. The nose and eyes run and bronchitis
is usually apparent.

Eighth. Usually throat is not sore.

Ninth. The mind is not affected.

Tenth. The fever subsides after the third day
and there is no secondary fever.

Eleventh. The patient's eyes may be inflamed
and consumption or bronchitis follow.

Small-Pox. — Variola.

This is another disease characterized by acute inflammation of
the entire skin, both external and internal, connected with infectious
and contagious fever. The eruption has the form of red points,
which soon becom^ pimples, then vesicles, then flattened and scooped-
out vesicles, then pustules, and finally hard brown scabs. These last
fall off from the eleventh to the twenty-fifth day, and leave behind
them small pits and scars. The fever is remittent, and precedes the
eruption some three or four days, — ceasing when the eruption is
developed, and returning when it has reached its height. The
period between exposure and the attack of the disease, called incu-
bation, is from five or six to twenty days, — being short in the severe
cases, and longer in the milder ones.

Symptoms. — The 'disease begins with languor and lassitude, with
shivering, and pains in the head and loins ; with hot skin, and quick-
ened pulse and breathinpf- -yi^h thirst, loss of appetite, and furred
tongue ; with nausea, vo. iting, constipation, restlessness, and uni-
vei-sal prostration. To these symptoms sometimes succeed <lifBcult
breathing, cough, drowsiness, and even insensibility. The tongue,
white at firet. soon becomes red at the point, and over the whole

140

SKIN DISEASES.

surface. The fever is highest during the night. The constitutional
symptoms are more violent just before the eruption, but immediately
subside, and soon disappear, when the breaking out is established.
The eruption is at first in the shape of small red points, which are
1ia'>d to the touch, and shaped like a cone, and are proportionate in
number to the subsequent pustules. In Plate II the artist has
well exhibited the developed disease, as well as the progress of the
eruption from day to day.

Treatment. — Like the two preceding disease.., the ordinary, un-
complicated form of this requires only the most simple treatment.
Not much is wanted, except confinement in bed, cooling drinks, cool
and even temperature, frequent change of linen, and sponging the
body with cool water. But when what is called the fever of inva-
sion is past, and the eruption is fvlly developed, and has brought
along with it the secondary fever, then some recipe, as (131), (355),
(126) will be in place, and some gentle laxative to keep the bowels
open (8), — also gentle injections (249), and opiates to relieve
sleeplessness and nervous symptoms ; (366) (367) may be used if
very sleepless.

Should the system, at this period, appear to be sinking, a more
generous diet, and a little wine may be allowed. If the brain
suffers, apply cold ice-cloths to head, or an ice-bag behind the ears,
and put the feet in a mustard bath (242). If the breaking out
appears with difficulty, put the patient into a warm bath, and give
extract of jaborandi (368). Gargles will frequently be needed for
the inflammation, and dryness of the mouth and throat (243).
Cold sponging may be considered as highly beneficial, in both the
primary and secondary *ever. The belladonna likewise is a useful
remedy, used in the same way as in scarlet fever. The plaster (288),
applied to the face, will, it is said, arrest the formation of matter,
and prevent the unsightly scars which so often cover the face of
persons who have suffered from small-pox. Paint the face once or
twice a day vnth glycerine, which will effectually prevent pitting.
The use of collodion is still better.

To avoid Pittins:, and the occurrence of unsightly scars of the
face, several methods of dressing have been used. The simplest
consists in covering in the vesicle with iodof orm-collodior , say,
twenty grains of the former to one ounce of the latter. Having
pricked the vesicle with an absolutely clean needle, one, for instance,
that has been boiled in sodarwater for five minutes, a layer of this
collodion should be applied a..d allowed to dry on at once. Should
pus form under this coating it must be released by washing off the
collodion with alcohol. The wound is then to be thoroughly disin-
fected with carbolic acid water (one teaspoonful to pint of water)
and the collodion again applied.

This process will avoid most of the pitting.

m^rr

SKIN DISEASES.

141

Varioloid. — Varicella.

Varioloid, or modified small-pox, begins with symptoms similar
to those of small-pox, but much milder in degree. These symptoms
are feverishness, nausea, vomiting, pains in the loins and head, and
a quickened pulse. The eruption comes out on the third or fourth
day, and looks like that of small-pox. It reaches its height the
fourth or fifth day, and then declines without any secondary feve'-.
The pustules dry up and form brown scabs which fall off in a few
days, and leave slight pits, and a few red or purple spots.

Varicella appears under a variety of forms, called " hives," " swine-
pox," " chicken-pox," " horn-pox," etc. But they all have a family
likeness, and need not be described. The treatment of all these
forms must be conducted on the same principles with small-pox.
Sponging the skin in all these inflamhaatory conditions has the hap-
piest effect, and should seldom be omitted.

Cow-Pox. — Vaccina.

This disease exists to some extent among lower animals, and is
identical with small-pox in man. The immortal Jenner taught the
world that the pus taken from the cow having this disease, and in-
troduced under the skin of man, would produce an eruption similar
to that of small-pox, and that this would protect the system from
the latter disease. This was an immensely important discovery, and
will render the name of Jenner famous through all time.

It is a question of great importance how far vaccination, or inocu-
lation with the matter of cow-pox, does, in fact, protect tlxe system
from small-pox. That it is a protection, to a certain extent, is
doubted by none. That in some instances it protects through life,
is likewise generally admitted. Is it a protection in all cases, and
through the whole life? Perhaps not, though this is a disputed
point. Probably the mild form of the vaccine disease does not im-
press the system powerfully enough to last more than a certain num-
ber of years. Most thinking physicians now believe it is wise to
revaccinate occasionally, to make sure of the protection. It is done
with little trouble, and may save a terrible infliction. Plate II,
^^S- 4, gives a good idea of the appearance and progress of the
eruption.

The Second Group of diseases, characterized by inflammation of
the true skin, without constitutional symptoms of a specific kind, are
Erysipelas, Nettie-Rash, False-Measles, and Inflammatory Blush.

Erysipelas. — St. Anthony's Fire.

Erysipelas is a diffused inflammation of the skin, affecting only
a part of the surface of the body, and is accompanied by a fever,
which is generally thought to be infectious and contagious. The

! f

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mknim

wmM

142

SKIN DISEASES.

local inflammation is disposed to spread ; it extends deep, and is
attended by swelling, a tingling, burning, and pungent heat, and ])y
a redness, which disappears when the skin is pressed by the fiuger
and returns on remitting the pressure.

Symptoms. — The constitutional symptoms are chilliness aiul
shaking, succeeded by heat ; lowness of spirits, lassitude, pains in
the back and limbs, pains in the head, quick and hard pulse, thirst,
loss of appetite, white . and coated tongue, bitterness of moutli,
nausea, vomiting, pain in stomach, and costivencss.

These symptoms go before the local inflammation several days;
they increase with the redness of the skin, and disappear upon its
decline. The nervous system is sometimes severely affected, and
indicated by low, muttering delirium. At the close of the inflam-
mation there is generally a relaxation of the bowels, and the scarf-
skin peels off. Sometimes matter forms under the skin, and occa-
sionally mortification occurs. The face is the most frequent seat of
the disease. It commonly begins on one side of the nose, and soon
spreads over one side of the face, closing up the eye, and changing
the features in a shocking manner. See Plate III, Fig. 1.

Somewhere about the third, fourth, or fifth day, very minute blis-
ters appear on the inflamed parts, filled with water, which increases
until the blisters break and let it out. The disease comes to a head
on the eighth or ninth day, when the blistered parts dry, and the
skin begins to peel off.

Treatment. — In the treatment two things are to be done, — to
subdue the fever, and the local inflammation. The fever is assuaged
by rest, mild diet, gentle laxatives (26), (21), (125) ; and by the
use of tincture of veratrum. For the local inflammation, various
things have been advised, but nitrate of silver, on the whole, has the
preference. First wash the inflamed part with soap and water to
remove any oily substance, and wipe the skin dry. Then moisten
the inflamed and surrounding skin, and pass over it a stick of nitrate
of silver, touching not only the inflamed part, but going even an
inch beyond it on all sides. Or, a solution of nitrate of silver and
nitric acid (214) will in many cases, according to Dr. Higginbottom,
do even better. A solution of copperas (215) is a good application.
So is (303).

In mild cases, flour may be dusted on the inflamed part from the
dredging-box. Warm fomentations are also useful, and cloths wet
with water, and laid on. A solution of perchloride of iron, applied
to the inflamed skin, is much used now, or water as hot as can he
borne.

In erysipelas the powers of the system are generally reduced, and
tonics, such as quinine, wine, etc., are genemlly required. Dr.
Robert Williams, — high authority in these matter's, — says he puts
his patients upon milk diet, gently opens the bowels, and gives them,
daily, from four to six ounces of port wine, together with sago, and
that he seldom has to change this coui-se, whatever the symptoms.

ERYSIPELAS

3ep, and is
eat, and by
the finger,

liness and

e, pains in

ilse, thirst,

of mouth,

eral days;

r upon its

fected, and

:;he inflani-

the scarf-

and occa-

int seat of

, and soon

changing

inute blis-
increases
to a liead

y, and the

lone, — to
! assuaged
nd by the
1, various
ie, has the
water to
1 moisten
of nitrate
[ even an
nlver and
inbottom,
iplication.

from the
loths wet
1, applied
8 can be

iced, and
ed. Dr.
be puts
/es them,
3ago, and
ptoms.

PI. 3.

INFLAMMATORY BLUSH

Fig.l

■iiiT idirn'ii

iii>T8iirr[im«

■ii^l<ilir»Oiilii

Ki i

1 1

'^s m^^m _

^rn

mt^

^iU^'

SKIN DISEASES.

143

For the inflamed skin, a tea made of buckwheat meal is a good
wash. Alcohol and water, or new rum, may be used for the same
purpose. »

Nettie-Rash. -- Urticaria.

Nettle-rash begins with fever, which lasts two or three days,
when wheals of various shapes, round, oval, and oblong, appear in
the midst of red, slightly elevated patches, attended by great itching
and tingling, as if the common nettle had been applied to the skin.
The wheals go ofif during the day, and come again at night. The
eruption is often a symptom of other diseases, or of mental anxiety.
Sometimes it is the effect of articles of diet. Children have it occa-
sionally while cutting teeth. A lighter form of the disease exists, in
which the wheals appear and disappear at short intervals, according
to the heat of the weather, the exercise, diet, etc.

Treatment. — The treatment varies according to the cause of the
disease. If tliis be anything offending the stomach, especially if it be
putrid fish, an emetic (2), (4) will be required, followed by brisk
physic (359). After which take a few doses of quinine (75). For
external application, the lotion (216) or common vinegar and water
(215) will be useful. Dr. "Wilson recommends corrosive sublimate,
etc. (217), as the best lotion to apply outwal-dly. Soda bath better.

The diet should be simple and cooling, ail stimulating food and
condiments being avoided. Fruit, candies, and berries often the

cause.

Rose-Rash.— Roseola. — False Measles.

Symptoms — The summer rose-rash appears first on the arms, face,
and neck, thence it spreads over the whole body, producing tingling
and Itching. It is usually preceded by the symptoms of fever-chills,
succeeded by flushes of heat, languor, pains in the head, back, and
hmbs, restlessness, quick pulse, and thirst. The rash appear in
small irregular patches, paler than those of measles, and of a more
roseate hue. There is some hoarseness from inflammation of the
throat. The rash never continues more than five days, unless it be
merely partial, in which case it sometimes comes and goes at inter-
vals for weeks. If it "strike in," it generally produces disturbance
of the stomach, headache, and faintness, which are relieved by its re-
appearance.

The autumnal rose rash is in more distinct patches than the former,
of a^ circular figure, slightly elevated, and of a dark damask-rose hue.
seldom any fever, or itching and tingling.

Treatment.— For the firs^described form of the disease, light diet,
acid drinks, and gentle laxatives; for the second, recipe 59 or 51, ac-
cording to convenience.

iHri

144

8KIN DISEASES.

Inflammatory Blush. — Erythema.

Whvt is called marginated inflammatory blush, is a mottled, red,
smooth fullness of the skin, occurring on the extremities and loins, in
irregular patches, bounded on one side by a hard, elevated, red border.
This species of disease attacks old people, and indicates some inter-
nal disorder, which is dangerous.

Another form of the complaint appears on the arms, neck, and
breast, in extensive, bright-red, irregular patches, slightly elevated.
The redness, at its height, is very vivid, and continues about a fort-
night, when it assumes a pvirplish hue in the centre.

Treatment. — Light diet, gentle purgatives (21), soda bath to al-
lay the tingling and secure sleep, and the mineral acids (63), with
bitter tonics, comprise all that is required, except sponging with
water, and friction.

Watery Pimples.

We now come to a class of diseases character-zed by watery pim-
ples. Wilson says they are distinguished by " effusive inflammation of
the derma," which means that there is inflammation of the true skin,
which causes water to be poured out on top of the derma, and under-
neath the scarf-skin, causing the latter to be lifted up in the form of
small or large blisters, or vesicles. At first the fluid in these pimples
is transparent, but in a short time becomes milky. Sometimes this
fluid al^orbs ; at other times, it dries up, and with the cuticle scales
off as scurf.

Eczema and Salt Rheum.

Eczema is an inflammatory, acute or chronic, non-contagious skin
disease characterized at first by redness, little pimples, vesicles or
pustules and is attended by more or less burning itching. This pro-
cess terminates either in the formation of crusts as the result of dried
sticky serum, or else in the formation of fine scales.

No skin disease has such a variety of aspects nor such grades of
inflammation. There is generally more or less oozing of the blood-
serum, which dries and thickens, forming crusts. There is usually
more or less thickening of the skin, making it like leather ; there is
generally some considerable scaling.

Eczema may subside in a few weeks never to return, or, what is
more probable, may lapse into a chronic state and continue for months
and years, with bothersome symptoms, which are extremely annoying.

Salt Rheum is a chronic eczema of this last variety.

Treatment. — In the acute stage of eczema, soothing lotions, pow-
ders, or ointments should be used, such as 372, 373, 374, Some are

SKIN DISEASES.

145

)ttled, red,
id loins, in
red border,
ome inter-
neck, and
r elevated,
•ut a fort-

)ath to al-
;63), with
ging with

itery pim-
imation of
true skin,
nd under-
le form of
le pimples
times this
icle scales

ious skin
esicles or
This pro-
t of dried

grades of
he blood-
s usually
; there is

•, what is
ir months
,nuoying.

)ns, pow-
Some are

better treated with powders, some by lotions; the itching «nd heat
are best relieved by 373. 8 "" " "e*!-

In the more chronic variety some stimulating ointments are needed,
like 375 Carbolic ac.d, 10 or 15 grains to the ounce of oleate of
zinc ointment, is an admirable remedy for the itching and burnine
Salicylic acid, 10 grains to the ounce of benzoated zinc ointment
llz'^r T^y ««'-^i««fl>le, while tarry preparations generally are
the most satisfactory in this chronic stage.

^.ill!, w ""'"^'^ however, w often so stubborn to treatment as the
different forms of eczema. The cure often will be slow and medi-

cTl wrnt ^ ''^'^^''* '''^ ^°^^^ ^^"^^^^« '' «--^ -<!-- «P-

• ^K?*T "** J"®"** i" Children— After oiling freely the crusts over
night and washing off wi^h suds in the morning, appl^ Salicylic acll
1 part, tincture benzoin 2 parts, vaseline, 50 part«. The very chronic
thick, and indurated skms require 360, and in many cases 219, espe-

L^^i^ . V?' *^">^«]« regulated and the hygiene of the skin a^
tended to, while tonics and general systemic measures are often called

Tetter^ Shingles.^ Herpes.

After a slight feverish attack, lasting two or three days, clusters
of small transparent pimples, filled sometimes with a colorIes8,Tom2
times with a brownish lymph, appear on the cheeks or forehead, or

mt^^Z'T '■ ~ ^""^ ^* *T' ^'^ *^« ^^^y- The pimples are a
little larger than m eczema,- about the size of a pea. After a few
days the vesic es break, pour out their fluid, and form brown or yel

Z Si: T.*'" '^.'^"* '^' *?*^ day, leaving the surface^red
and irritable. The eruption is attended with heat, itehing, tingling,
orm ofl ^««^l«««"«f«'f P««ially at night. Ringworm is a cur ou^
form of herpes, in which the inflamed patehes assume the form of a
nng. Shingles usually attack the aged about the ribs of one side,
and are evidences of impaired health and nutrition. They are verv
prostrating and require tonics from the start. ^

Treatment.— Light diet, gentle laxatives. If the patient be ad-
vanced in life, and feeble, a tonic (75) will be desirable. For exter-
nal applicatjon, belladonna (173), o J an'ointment of sulphuret of lime,
(174), or elder-flower ointment, ete. (175). Equal parts of chloral

Itch.— Scabies.

n^l^'ft^^ -^'f"^^ *"" '^*'''' ^""^ "^^^«' *^°"gh it is much less com-
mon than in former years. It is found frequently among the ^o^

••' r' irtiiiiii'

■i^

146

SKIK PI8KA8E8.

whose nondition in life does not give them the means to guard at all
pointw against it ; l)iit it is most common among such as neglect per-
sonal cleanliness.

Symptoms. — An eruption of distinct, cone-like, watery pimples,
whicli are transparent at the summits, and are accompanied by an ex-
cessive itching, which is made worse by high-seasoned food, by drink-
ing liqUor, and by the heat of the bed. When these pimples are
scratched and torn, a sticky, watery fluid is poured out, which forms
small scabs ; and, in time, if the disease is not cured, these scabs be-
ing torn off, extensive sores are made.

Cause. — It will excite the wonder of many readers to state that
animals of so small a size as scarcely to be seen with the naked eye
exist in the skin of man. Yet such is the fact ; and it is the presence
of these minute creatures, or the effect of their presence, which con-
stitutes the disease called itch. The little creature (^acarus scabiei,
by name), a species of mite, is one seventy-seventh part of an inch in
lengtli ; and when closely inspected under the microscope, is really a
beautiful, I may say an elegant, animal. Here are a front, a side, and
a back view of liim, well done by the artist.

Fro. 78.

FIO. 74.

FlO. 75.

His Method of Attack. — When placed upon the skin, the little
fellow, like the squirrel and other ground-animals, sets himself to
make a hole through the scarf-skin with his head and fore feet. Into
this he pushes his whole body. He then begins to burrow himself in
the derma or true skin — making a channel many times his own
length, at the end excavating a chamber where he sleeps, and whence
he goes out to do his day's work at mining, or boring for food. When
tired of this sleeping apartment, he digs onward and scoops out an-
other.

This travelling, and boring, and turning about in an organ as sen-
sitive as the true skin, must, of course, occasion a tickling and itch-
ing ; and from this circumstance the disease took its name of itch.
But this itching is not painful. James the Fii-st is said to have re-
marked that the itch was fitted only for kings — so exquisite is the

SKIN DISRASIS.

141

uard at iill
Jglect per-

y pimplcH,
I by lui ex-
, by tlriiik-
iinples are
Wch forniH
scabs be-

state that
naked eye
e presence
vhich con-
Ma scabieu
an inch in
is really a
I side, and

the little
limself to
feet. Into
himself in
} his own
id whence
od. When
)8 out an-

au as sen-
and itch-
le of itch.
) have re-
iaite is the

onjoymentofscratchiMjj. Probably it is a royal luxury. He ll.at as
' ™^V'"'"8t persons would consent to have it all done by roval fin-
ffers. They have been used for meaner purposes.

Treatment.— Whatever will kill the little animal descrik-d above,
will cure the itch. Various agentw have been employed for this pur-
pose, but none have been found equal k, sulphur. The compound
sulphur mntment is a sovereign ren.edy for the disease. Four ounces
of this should be well rubbed into the skin, before the fire, morning
and evening, for three or four days. This will put v end to the
whole colony of these sovereign squatters upon forbidden soil.

1 wo ounces of sulphuret of potash, and the same amount of soft-
soap, dissolved in a pint of water, and applied well to the skin, is
used in many cases with good effect.

Caustic potaah, one part to twelve part« of water, applied in a sim-
ilar way, 18 sartl to be a pretty sure remedy.

A solution of the chloride of lime, used as a wash, will often effect
a cure.

The ointment of the American hellebore sometimes does well.

liefore applying any of these preparations, let the skin be washed
with warm water and soap, and well dried. Be sure the parasite is
killed before ceasing treatment. Best to continue few days longer
than what is apparently needed. ^

Rupia.

This is from a Greek word which means dirt, from the dirtK!olored
crusts which are formed after the breaking of the large waterv pim-
ples. The vesicles are like those of eczema and herpes, except that
they are laryer. This is distinguished from all other skin diseases by
the formation of unhealthy, foul, and burrowing sores, which pour
out a reddish matter in such quantities that it collects and dries upon
the sore, and forms a crust of great thickness, — sometimes of the
size of an oyster-shell. Rupia has its origin in a weakly and debili-
tated constitution, and cannot be cured without renovating the whole
system. It is a manifestation either of syphilis or lupus.

Treatment.- Warm baths once or twice a week, with generous
and nutritious diet. Tonic medicines (63) (51) C67) (61) (65) will
be required. For external treatment, dust the surface of the ulcers
with cream of tartar, or apply nitrate of silver (214) r219) r220^
white vitrol, etc. See syphilis. ^ ^ <. ">>'

Pemphigus. — Pompholix.

The first of these t^rms is from the Greek, and means a bubble :
the second, pompho IX, is from the same language, and means a water-
bubble This IS still more applicable to the disease in hand, which
consists, in fact, in the raising up of the scarf^kin in the shape of

148

SKIN DIBIA8S8.

hubbleH, containing a watery fluid. These hubbies ar<i just liko rom-
mon blisters. They vary from the size of a split pea to that of n
hen's egg. They rise up very rapidly, and break in Lwo or three
days, leaving a raw surface which soon becomes co\-orcd by a thin
crust.

Treatment. — Similar to that for Hupia, with the luldition of iodide
of potassium (140), and applying the stick nitrate of silver to the
whole surface of the ulcer, and a short distance l)eyond it on all sides,
or the ointment (176). See treatment for syphilis.

Mattery Pimplei,

Another natural group of skin diseases are distinguishod by an
eruption of pimples, filled, not with water, like those just described,
but with matter. The pimples of this class are not transparent, or
whitish, but opaque and yellow from the first. The matter is poured
out upon the true skin, and raises up the scarf-skin, in the same way
at lie watery pimples. As in the preceding diseases, too, the drying
up of the matter forms crusts. But these pimples are never so small
as those of eczema, uor so large as those of pemphigus.

Crusted Tetter. — Impetigo.

This eruption consists at first of slightly-elevated pustules or pim-
ples, closely congregated, with an inflamed border. These break, and
the surface becomes red, excoriated, shining and full of pores, through
which a thin, unhealthy fluid is poured out, which gradually hardens
into dark, yellowish-green scabs. These scabs sometimes look like a
dab of honey dried upon the skin. This has given impetigo the name
of "honey disease," or honey scab. This honeyed look is well repre-
sented in the crusts which form on the lips and ears of children.
Sometimes these scabs cover nearly the whole face, and are called the
milk crust. This is putting the agreeable words milk and honey to
rather questionable uses ! When this crusted tetter invades the head
or scalp, it causes the hair to fall, and becomes what is called a scall.
Impetigo may be simple, or contagious, or syphilitic.

Treatment. — The vapor bath, and water dressing. The following
ointments are useful : oxide of zinc, white precipitate, or diluted ni-
trate of mercury (178). Hydrocyanic acid (221), applied externally,
has a fine effect. The crusts should first be removed by a weak lye
made from hard-wood ashes, or potash ; then, after applying one of
the ointments above, or the lotion, cover the part with oil-skin. If
the crusts are on the head, the hair should be cropped off before the
remedies are applied. When of syphilitic origin, treat as for that
disease.

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SKIN DI8EAS1E8.

149

Papulous Scall. — Ecthyma.

The mattery pimple called ecthyma is developed on a highly in-
flamed skin. The bladders are about the size of a split pea, and are
surrounded by a broad ring of redness. They are generally separate,
not clustered like impetigo. They are scattered over various parts of
the body, and are followed either by a hard black crust, or by a sore.
The disease is either acute or chronic. The latter attacks weakly
children, and persons reduced by sickness or low living.

Treatment. — For the acute form, give a generous diet, with oint-
ment (176), and the cold sponge-bath on the sound parts. Use
(176) (176) (214) (211) for external application. Hygienic treat-
ment, tonics, and stimulants are called for ; iron, quinine, arsenic, and
nux vomica.

Scaly Eruptions.

The scaiy eruption is called a dry tetter. It is an inflammation of
the true skin, and is distinguished from the rashes and pimples by
the alteration of the scarf-skin. The diseases forming this group are
three in number, — lepra, psoriasis, and pityriasis.

Leprosy. — Lepra,

In this disease, the eruption makes its appearance as a small, sal-
mon-red spot, raised a little above the surrounding skin, and consti-
tuting, in fact, a flat pimple, almost as large at the top as at the bot-
tom. On top of this pimple the scarf-skin becomes rough, and after
a little while a thin scale is produced. New layers are added to its
under surface, and it accordingly grows thicker. It has a bright,
silvery lustre. These scaly spots multiply, and become the form of
leprosy called lepra guttata, from the Latin gvtta, a drop, the scales
looking like drops of water on the skin.

But the eruption more frequently spreads out into circular patches,
of the size of a fifty-cent piece. These generally appear below the
elbows and knees, and on the breast and shoulders, and back of the
hands. Sometimes the entire hand is covered with scales of a pecu-
liar silvery whiteness. These patches heal from the centre.

Psoriasis.

This differs from lepra in the eruption being more irregular. The
spots sometimes come out in thick clusters, and blend in various
ways. Instead of appearing in distinct circular forms, as in leprosy,
the patches are irregular, and of every size. Instead of one well-
formed and thick scale, there are many small and thin ones. And
instead of a depressed centre with rising edges, the surface m level.
While leprosy is a circular dry tetter, this is an irregular dry tetter.

150

SKIN DISEASES.

Treatment Pyrogallic acid in ointment, 10 to 40 gr. to oz. Ap-
ply daily ; it discolors the skin for a while. Chrysoplianic acid in
same strength is the best remedy known. It also discoloi-s the skin
and inflames the neighboring skin for a while. Recently the thyroid
gland of the sheep has been used in five-grain ta.blet8 three times
daily as an internal medicine with much success.

Pityriasis.

This is much like the two preceding, except that it gives rise to
a copious production of very small bran-like scales. Indeed, its name
is from the Greek, and means chaff or bran. It is a branny tetter.
It may occur on any part of the body.

Treatment. — When the skin is highly inflamed and stiff with heat,
pain, and itching, the diet should be light, and the drinks of a cooling
and unexciting kind. The warm bath and gentle friction of the skin
are useful. Laxatives or tonics may be employed, according to the
indications, — frequently laxatives first, and tonics afterwards. The
specific remedies for curing the disease are unknown ; iodide of potas-
sium (140), arseniate of iron (68), Fowler's solution, in two-drop
doses, three times a day ; or Donovan's solution, in five-drop doses,
three times a day. For extevnal application, use a naphthaline oint-
ment](177), zinc o'ntment, white precipitfite ointment, diluted nitrate
of mercury ointment, or solution of corrosive sublimate (212).

Dry Pimples.

These are distinguished by the high degree of irritation of the
skin which they create. They are exceedingly troublesome, not only
from the distress and itching they occasion, but because they are
likely, in consequence of this, to be torn into painful and obstinate
sores.

When appearing in children, they are called red gum, and tooth-
rash. In grown persons, one form is named lichen, and another, dis-
tinguished by excessive itching, prurigo.

In this form of pimpljs, the fluid is not poured out upon the sur-
face of the true skin, — as in several of the preceding diseases, — bat
is collected within the tissue of this organ, and the pimples feel hard
under the finger.

The tooth-rash of infants is always accompanied with some fever-
ishness, aused generally by irritation of the gums from growing teeth,
occasionally by flannel worn next the skin.

Lichen has a variety of forms. In one case the pimples are of a
bright red, in another, bluish or livid. In one case they appear in
circular groups, in another they produce great disorganization of tlie
akin, and occasion terrible suffering.

.MlStX:,

SKIN DISEASES.

151

jr. to oz. Aj)-
lianic acid in
•loi-s the skill
ly the thyroid
i three times

gives rise to
eed, its name
ranny tetter.

iff with heat,
1 of a cooling
1 of the skin
rding to the
ivards. The
ide of potas-
in two-tlrop
-drop doses,
thaline oint-
uted nitrate

:2i2).

ition of the

le, not only

le they are

obstinate

and tooth-
nother, dis-

»n the sur-
ises, — but
feel hard

)nie fever-
v^ing teeth,

3 are of a
appear in
on of the

Prurigo is a still more cruel disease tluin lichen. '. ..o pimples are
not very manifest, but the skin is thickened or swollen, and con-
densed. The suffering from it is terriMe. It gives one no sleep,
night or day. That form of it called ant-bite prurigo gives the sen-
sation of millions of ants eating the flesh, or as many red-hot needles
piercing it. This renders the existence of many elderly persons a
terrible burden.

Treatment. — Careful diet, and gentle aperients and tonics, accord-
ing to the condition of the system. Externally, the cold salt-water
sponge-bath, and glycerine, vinegar and water, applied with a soft
sponge. Tar and sulphur are among the more successful remedies in
fighting this rebellious disease (362). Iron, quinine, cod-liver oil.
For relieving the terrible itching of the private parts, which females
sometimes suffer, I have found morphine (223), for external use,
very effectual.

Lupus.

This makes its appearance in the form of one or more circular
elevations, of a dull red or salmon-color, and partially transparent.
When pressed under the finger, these elevations are found to be soft,
and when the finger is removed, they are flat and whitened. They
generally appear on the face, and particularly the nose.

In another and worse form of the disease, the tubercles are harder;
and after a time, they become covered with thin brown scabs, which
are scratched off, and followed by others,
and these by others, until ulcers appear,
which are sometimes slow and sometimes
rapid in their progress. The whole nose
has been destroyed by them in a month.
(See Fig. 76.) This is one of the dis-
eases which Eriismus Wilson thinks, and,
in my judgment, correctly, to be, like
scrofula, the result of the syphilitic poi-
son, filtered through the blood of several
generations. It is a disease which is the
most destructive in the shortest time of
all diseases.

Treatment. — The internal remedies
are iodide of ai-senic (141), and iodide
of potassium (140) ; the external, vine-
gar of Spanish flies ; and to promote the
healing of the ulcers, a weak solution of nitrate of silver (211) (214)
is adapted.

Hardly any disease has been treated by so many different remedies.
At present the prospect of a cure is good, as certain anti-tubercular

FlO. 76.

1^.^:

152

SKIN DISEASES.

lymph injections have been found effective ; but no time should be
lost in immediately consulting a surgeon, as ite growth can be ar-
rested, and the disease may be exterminated by early treatment.

Warts and Corns. — Verruca — Tylod% — Clovtis.

In the derma or true-skin there are a great many small arteries,
veins, and nerves, unit d together, and formed into loops (see Fig.
43), resembling, in shape, the peaks of miniature mountains. These
are called papillce. 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 is thickened;
and together they form what is called tvarts. Corns are formed by a
somewhat similar growth of the papillae, brought about by the pres-
sure and friction of tight boots and shoes.

Treatment. — For warts, take a piece of diachylon plaster, cut a
hole in the centre the size of the wart, and stick it on, the wart pro-
jecting through. Then touch it daily with aqua fortis. Nitrate of
silver sometimes answers well for touching it. They may be taken
off very neatly, sometimes, by tying a string tight around them.
Corns should be shaved down close, after being soaked in warm
water and soap, and then covered with a piece of wash-leather, or
buckskin, on which lead plaster is spread, a hole being cut in the
leather the size of the corn. They may be softened, so as to be easily
scooped out, by rubbing glycerine on them. Manganic acid destroys
warts and corns rapidly. Bunions, which affect the joint of the great
toe, must be treated with fomentations, and sugar of lead water
(224), when there is considerable inflammation, with rest in a hor-
izontal position. But the best cure for corns and bunions is to put
away tight shoes. Wear a bunion-plaster for some time to take the
pressure off of the corn or bunion.

Mother's Marks. — Naevus.

The small vessels of the skin, called capillaries, suffer certain al-
terations of structure which pass under the name of mother's marks.
These marks are simply a great dilatation of theie minute blood-ves-
sels. They vary in size from a mere point to a patch of several
inches square.

The smallest of all is the spider mark. It is a small red point,
from which several little straggling vessels spread out on all sides.
Sometimes this is of the size and appearance of a red currant ; at
other times, of a strawberry or raspberry ; and occasionally it is even
much larger, and is compared to a lobster.

When the circulation is active through them, or the individual is
excited by exercise, or by moral causes, these marks are of a bright
red color. Some are naturally livid and dark-colored, and look like

b«.U4l

SKIN mSRASKS.

153

me should he
th can be ar-
'eatment.

• Clovus.

mall arteries,
ops (see Fig.
tains. These
any apparent
g theniselves
is thickened;
i formed by a
by the pres-

plaster, cut a
the wart pro-
. Nitrate of
nay be taken
round them.
ed in warm
sh-leather, or
? cut in the
i to be easily
icid destroys
; of the great

lead water
est in a hor-
)ns is to put

to take the

r certain al-
ler's marks,
blood-ves-
of several

red point,
all sides,
iurrant; at
it is even

dividual is
a bright
look like

blackberries, and black currants. The blueness of these is owing to
the vessels being still more stretched and dilated, and to the conse-
(juent slower passage of the blood through them, which gives more
time for its change from the arterial red to the venous blue.

Treatment. — If the mark is not making progress, it had better be
let alone, or only subjected to gentle pressuie by piitting a piece of
soap-plaster over it. When its course is threatening mischief, it is
sometimes cured by pencilling a small portion of its surface, from
time to time, with nitric acid. They may be operated on with safety
by electrolysis and other methods.

Disordered State of the Nerves of the Skin.

Itching. — Pruritus. This is supposed to be dependent on an al-
tered condition of the nerves of the skin, and consists in a painful
sensation of itching. There is no perceptible alteration in the ap-
pearance or structure of the skin. This itching is thought, generally,
to be a result of sympathy, through the nerves, with some diseased
and excited condition of a distant part. The itching^ is brought on
by the most trifling causes, and for hours may deprive the sufferer of
every particle of repose. It more frequently affects the fundament,
or the private parts, particularly the scrotum.

Treatment. — As this disease is only a symptom of several others,
the constitutional treatment belongs under the heads of these other
diseases. The local applications for relieving the itching are, a solu-
tion of sugar of lead (224), hydrocyanic acid (363), of corrosive sub-
limate (212), diluted nitrate of mercury ointment, and poppy fomen-
tations. Also (223). Tonics are often of first importance. Weak
solutions of carbolic acid or soda water at tim6s suffice.

Disorders Affecting the Color of the Skin.

Colored Patches. — Maculae. The depth of color in the skin de-
pends on the amount of a certain coloring matter, called pigment, in-
corporated with the deeper and softer portion of the scarf-skin. In
the scarf-skin of the inhabitants of northern latitudes, there is but
little of this pigment ; in that of the dwellers of Africa, there is a
great deal ; among the inhabitants of Southern Ev\rope, the quantity
is intermediate between tlie two.

The depth of color in the skin depends on the energy of its action.
In the tropics, where light and heat are in excess, the skin is stimu-
lated to great action, just as vegetation is, and the color is increased
and intensified. This is illustrated every year before our eyes. In
summer, under the heat of the sun and the flood of light, the pigment-
forming power is increased, and the fairest skin is browned ; while
the withdrawal of these forces leaves the winter's scarf without pig-
ment, and blazoned. ..

154

SKIN DI8EASBH.

What the sun aiul light do, uadei' iiiituml circumstances, (hscased
action may effect. Hence we occasiDUiilly meet with alterations of
color in the skin, from a disordered state of the system. We wit.'iesK
the formation of patches of dark color and irregular shape on various
parts of the body. Sometimes they are raised al)Ove the level of tlio
skin, and are called moles. At other times, they have no elevation,
and spread over the whole body.

Occasionally, from some peculiarity of constitution, the pigment is
diminished, and white patches appear all over the body. At other
times, a black person will become completely white. Such are called
albinos.

In many cases the coloring of the skin has varieties of tint, as when
pei-sons of light complexion, are, in the summer season, covered with
yellow si)ots, like stains. These spots are known by the name of
freckles, or, in learned language, lentigo.

Treatment. — It is generally best not to meddle with a mole. If it
be very unsightly, let it be removed by two incisions, biking out an
elliptical portion of skin, and,clo8ing the wound with sticking plaster.
In the case of bleached places, apply the shower bath, tonics, and a
stimulating liniment (168) to the faded spots. For the change of
color Ccalled sunburn, a liniment (191) of lime-water, etc., is the best
preparation. For freckles, use recipe 360, or, perhaps, still better,
364.

Disorders *of the 5weat-Qlands.

The perspiration is sometimes greatly increased above nature's de-
sign. This is, technically, idrosis. In other instances there is too
little sweating. This ^ called anidrosis. Sometimes the perspiration
is so altered in its physical qualities as to have some peculiar smell.
This is osmidrosis. In some rare instances, according to old writers,
the sweat was changed in color. This was chromidrosis. And now
and then a case occui-s of bloody perspiration, of which the most
memorable case on record is that of the Redeemer of men, who, in
the garden, sweat great drops of blood. Several cases of this are re-
corded in medical l)ooks. It is called hcemidrosis.

The proper action of the skin being so vitally important to health,
these changes often involve very serious consequences.

Treatment. — Either too much or too little sweating can generally
be corrected by the cold or warm bath, friction, tonics, and proper
clothing. Small doses of jaborandi, also ergot and strychnine, are
among the best internal medicines (365).

Disorders of the Oil -Glands and Tubes.

That the skin may be liml)er, healthy, and fit for use, it is neces-
sary to have it oiled every day. For this object, the Creator lias

ices, diseased
ilterations of

We witness
[)e on various

level of the
no elevation,

e pigment is
y. At other
z\\ are called

tint, as when
levered with
ihe name of

mole. If it
^ing out an
:ing plaster,
onics, and a
I change of
, is the best
still better,

lature's de-
lere is too
erspiration
iliar smell.
Id writers,
And now
the most
n, who, in
;lus are re-

to health,

generally
id proper
mine, are

is neces-
eator has

SKIN DISEASES.

155

wisely provided, by placing in the true skin a largo number of very
Huuill glands and tubes, whose office it is to prepare and pour out
upo!i the surface the proper amount of oil. The gland, regular little
oil-pot, is in the true skin ; and from it a ptece of hose or tube runs
up through the scarf-skin, through which the oily fluid is poured out.
Some of these tubes are spiral, others are straight. On some partH
these vessels do not exist; on othera they are (juite abundant, — as on
the face, nose, ears, head, eyelids, etc. They produce the wax of the
ears; and on the head, they open into the sheath of the hair, and fur-
nish it with a hair-oil or pomatum better than the chemist can make.
These little vessels are always at work, when the skin is healthy ;
and no persons need W afraid to wash all over every day, lest, as the
Boston Medical Journal taught, the skin will be injured by having
the oil removed from it. You might as well be afraid to eat a
meal of victuals, lest the saliva should all Iw swallowed with it, and
none be left for future use. There is oil enough where that upon
the skin comes from, and the vessels which produce it are not injured
by work, any more than the muscles of the legs are by walking.

Qrubs or Worms. — But, unfortunately, the skin is not well taken
care of in all cases, as in cities and towns where sedentary habits pre-
vail. Here, the actions of the skin, instead of being regular and com-
plete, are often sluggish and imperfect ; and the contents of the oil-
cells and tubes, instead of flowing easily, become hard and impacted,
and the vessels are not emptied. When this matter beconies station-
ary, dry, and hard, it distends the tube, and fills it to the suiiace; and
then coming in contiict with the dust
and smoke of the atmosphere, the ends
become black, and look like the heftds
of worms. These spots are common
on the nose and face of persons who
have a sluggish skin. They may be
squeezed out by pressing tlie nails on
each side of them. These are called
gruhs and tvorms, or, technically, come-
dones. When this matter produces in-
flammation of the tube, there is then a
black spot in the middle of a red pimple,
and the disease is called spotted acne.
Now and then the oily matter becomes very hard, producing spine-
like growths, and even horns (Fig. 77) ; and again, it collects and
forms soft tumors, as wens, etc. These are technically called encysted
tumors. Sometimes the action of the glands is too great, and oil is
poured out so profusely that the face shines with it. At other times
there is so little that the skin is dry and hai-sh. In the hardened
oily matter, which constitutes grubs, are found small animals, which
Ur. Wilson calls the "animal of the oily product of the skin." On
page 156 are three views of him. ,

156

SKIN DISEASES.

Treatment— For roughness and harshness or skin, wasli with «..
and water every night, and rub well into the skin XThe fi T„ i

V ;, a weejc. Vr, rub the skin every morning with a damp

Via. 78.

FlO. 79.

FlO. 80,

«ao„ ^ •'^ -^ , applied. Ihe spinous variety, or porcuninA dis-

TrnTtwii I'dr F '^"'"'r^ ?• '*'r^ *^« "«« -^ the^olntm ft
iifl* ^^; *^"' S^""^' stimulate the skin by washintr it

W«l '""f rP""*^' '""''^ ^ •^^y' ^'^d rubbing briskly witi a oLe
towel; and by using the corrosive sublimate (225) a/aTotion
A spare diet will do much towards improving ih^ skin i^' many

^^ S (352rrheal"-^"^' '^^^^^^ *^^ '°^^ ^^^'^ ^^ (^^^I

Barbers' Itch. -Jackson's Itch. — Sycosis.

iin^^^i!^ ""^"^ much like acne,- only differing from it in its loca-
tion It appears chiefly on the haiiy parte of the face,- th? chin

of theTec^' uV'^T '' *^ ,"'^^^ '"' ^h« «y«brows, 'and the nap
ot the neck. It consists in little conical elevations, which maturate

pimples are of a pale yellowish color. In a few days they burst and
n stTflnUrZ ""!' ''''"V'^r ^*^^' '^^^"-'^ cruL.""These

nesl'o'f the'ski:;." '""''' '^ ^ ^^^"'"^ «^"«^*^- "^ ^^^ -^ tight-
duH ^.nl'^'^'J' supposed to be brought on frequently by using a
fnlraVd%tT"o?yeai^^^^^^"^^^^^^^

.. -t-^

SKIN DISEASES.

157

wli with soap
the bath, and
sulphur, etc.
vith a damp

80.

ice, the lini-
rcupine dis-
ing a large
le ointment

washing it
[ith a coarse
ation.
in many

first (360)

SIS.

its loca-

the chin,

the nape

maturate

m. These

burst, and

These

pimples

md tight-

y using a
'or many

Treatment. — The most important part of the treatment is the re-
moval of the cause. The beard must not be pulled with a dull razor;
the shaving had better be discontinued altogether, and the beard be
merely cropped off with scissors instead. All intemperance in eating
and drinking, and exposure of the face to heat, must be avoided. A
light, cool diet will do much towards curing the disease.

The nitrate of mercury ointment, and a solution of oxalic acid, are
the best applications. If one does not succeed, try the other. Black
wash is to be used when the face is much inflamed.

Disorders of the Hair and Hair-Tubes.

The hair is an appendage of the scarf-skin, and is intended to be
both useful and ornamental.

It is subject to several disorders. It may grow too long, or too
thick, or it may appear in an improper place. This last happens in
the case of those little spots and patches which disfigure the face,
and are '^alled moles. The hair may be defective in its growth, or
may fall off prematurely from various causes, or in the natural course
of things from old age. This last is called calvities. It may change
its color, too, under a great variety of circumstances, and at nearly
every age. It is not very uncommon to find a single lock varying in
color from that which surrounds it. Old age, the winter of life, nat-
urally brings the frosted locks; but they frequently appear also upon
the heads of younger perso s. Strong mental emotions, such as fear.
grief, or sorrow, may bring a bleaching of the hair in a brief period,
or even suddenly. Byron, in his " Prisoner of Chillon," beautifully
refers to this fact : — - .

" My hair is gray, but not with years,
Nor grew it white
In a single night,
As men's have grown from sudden fears."

Porrtgo. — There is a troublesome disease of the hair and hair-tubes
called porrigo. It begins with the formation of a thin layer of scurf
either around single hairs, or in patches which enclose several. These
patches frequently have a circular form, which give to the affection
the character of a ringworm. The hair-tubes are generally a little
elevated, in the shape of papillae, which gives to the diseased scalp
the appearance of "goose-flesh." These hairs, losing their proper
nourishment and healthiness, break off at unequal distances from the
skin, leaving their rough ends twisted and bent, and matted into
thick grayish and yellow jrusts. Upon the surface of these crusts
may generally be seen the ends of a few hairs, looking like the fibres
of hemp or tow. The scratching causes inflammation of the skin after
a time, and matter is poured out, which still further mats the hair,
and thickens the crusts. There are several varieties of this disease,
differing slightly from each other ; but this general description will
answer all practical purposes for this work.

■«*?-

158

SKIK DIHEARRS.

The reader will often notice ii diHease of tlio liair-plands, clmrarter-
ized l)y a yellowish and dirty-looking powder, covering the acalp iuid
hairs. This matter is eoUected at the mouths of the follieles, and
considerable of it is strung upon the hairs like Insads. Pull out ii
hair, and the roof will Ikj fk)und thin, dry, and starved in its ajjpear-
ance. In this <lisease, it is difficult to keej) the hair cleansed, or to
prevent its falling off.

FavuSr — Still another disease, called /rt7'M«, is known hy the collec-
tion of a yellow substance, at first, around the cylinder of the liair.
This 8ul)staiu',e, after a ♦inie, spreads out upon the scurf skin, and
dries into yellow crusLs, in the form of a cup, around the base of each
hair. A numlier of these cups, collected together, look like the cells
of a honey-comb. This disease is contagious, and is communicable
by contjict to any part of the skin.

Treatment. — For removing the hair from particular parts of the
scalp, it is common to resort to depilatories. Of these, the recipes
260, 261, 262, are frequently used, and are as good iw those adver-
tised ; indeed, they are the same. Forceps are the Inist means.

To prevent loss of hair, and to restore it when lost, the circulation
should be stimulated in the small vessels of the scalp. With this
view, washing the head every morning with cold water, drying it by
friction with a rough towel, and brushing it to redness with a stiff
hair-brush, are excellent. To these should l)e added some stimulating
ointment (183), or liniment (257), (258), (2o9). These last are about
the best known preparations for causing the growth of the hair.

Ringworm of the scalp requires attention to the diet, and such
remedies as will improve the general health, with stimulating appli-
cations externally (267), (258), (259). 366 is the newest and best
mode.

To color the hair, several preparations are used. Of these, 163 is
about the l)est. It produces a beautiful black. A preparation of sul-
phur and sugar of lead ^264) is the famous compound recommended
by General Twiggs, and extensively used. Preparations of nitrate of
silver (265), (266), (311) a.e much in use in some quiirters. They
perhaps give a finer black to thp hair, but they render it dry and crisp,
and they will stain, the skin, if care is not used iii applying them.

Use care in the use of these remedies.

In Favus, the two great objects to be gained are, to remove all lo-
cal causes of irritation, and to excite the diseased hair-glands to
healthy action. The first object is affected by cutting off the hair
with the scissors, and removing the crusts by washing the scalp with
castile soap and water. It may be well first to wet the crusts through
with corrosive sublimate (212), in weak solution. The washing with
foap and water should be repeated every day, and b§ followed by
rubbing into the scalp a stimulating ointment (183). A very weak
solution of tlu! nitrate of mercury (226), applied every other day,
with a camel's hair brush, sometimes produces excellent effects.

iida, cliftnvcter-
the scalp and
folliclcH, iin«l
1. Pull out ii
in its a|)j)ear-
leanaud, or lo

by the oollec-
' of the liiiir.
;uif skiu, and
hiiso of each

like the cells
;©niniunicable

parts of the
e, the reiiipes

those adver-

nieans.
he circulation
1. With this
, drying it hy
9 with a stiff
e stimulating
last are about
the hair.

iet, and such
ilating appli-
vest and best

lese, 163 is
■ation of sul-
ecom mended
of nitrate of
rtere, They

y and crisp,
ng them.

niove all lo-
ir-glands to
off the hair
scalp with
ists through
ashing witii
followed by
very weak
other day,
effects.

SKIN DISKABES.

159

Lice.

PediculofliA or Lice is a contagious, animal, parasitic affection,
chara(;t<'ii/tMl by the presence of pediculi in the skin and scratch-
marks of the sufferer ensuing from the annoying itching. There are
a number of varieties classified according to the peculiar parasite and
its location. They all cause great discomfort and itching.

The Pediculosis Capitis, or head-louse, is found in the scalp, and
is a long, oval l)ody with six legs furnished with nails; it has an oval
head with two prominent eyes and two horns. The ova or nits are
small whitish iMxlies closely glued to the hair
and look like small pieces of dandruff. One or
two are deposited on a hair.

They occur for the most part in poorly nour-
ished children brought up under bad hygienic
surroundings, and thence communicated to
others. They cause extreme itching and scratch-
ing, so that often the irritation is unbearable and
the sticky serum of the blood mats together the
hair, forming crusts. Sleep is often interfered
with and ill health results. (See Fig. 81.)

Pediculosis Corporis, or body-louse, is gen-
erally the property of the clothing ; it is some-
what larger than the head-louse and deposits it«

eggs in the seams of the clothing, remaining on the body only long

enough to gain sustenance. The young are hatched in five or six

days. The louse reproduces again in

eighteen days. As the parasite crawls

about it produces extreme itching and

the scratcliing follows, resulting in long

lines of excoriation. The chief locations

for this parasite are the back, chest, abdo-
men and thighs. The middle-aged and

elderly are more apt to be attacked than

the young. Here unclcanliness again is a

prime factor in their occurrence. (Fig.82.)

Pediculosis Pubis, or crab-louse, is a
smaller, shorter, stouter parasite than the
two I receding, and attacks the pubes par-
ticularly, but is also found in the axillae
and over the eyelashes and beard of the
male. Thoy may be seen clinging closely to
the skin with remarkable tenacity. They
occur on adults and pioduce the same lesions as the other varieties.
They are generally the result of promiscuous sexual intercouree.
( Fig. 83.)

Kio. 81.
BEAD- LOUSE,

FlO. «i.
BODT-LODSE.

1«0

SKIN DISEASES.

Treatment. — The main object in the tieatr
ment of these filthy diseases is the destruction
of the parasite. The lesions they produce
disappear with the disappearance of the ani-
mal. It need hardly be said that strict clean-
liness of person is a sine qua non. The rem-
edies usually employed in their extermination
are the mercurials, sulphur, carbolic acid, to-
bacco, etc.

cBA^LouBB. I^ case of the head-louse the most effica-

cious method of treatment consists in saturating the head over night
with petroleum and washing off with soap in the morning. In young
children the hair may be cut to get rid the more easily of the nits,
but this is not necessary. The applications of petroleum may have
to be repeated several times and the hair frequently washed with soft
soap, soda washes, vinegar, etc., to get rid of the nits. If the louse
be of the body variety the treatment must be directed to the clothing,
which is to be changed often and either boiled or baked. This pro-
cess is to be repeated until no more parasites are found. The itching
of the body is best allayed by carbolic acid lotions (one teaspoonful
to pint of water).

The crab-louse is best treated by the well-known mercurial oint-
ment, or blue ointment, and is to be washed off with soap and water
each morning. It must be persisted in till no more crabs are found
and no further itching is noticed.

Bed-Bugs.

The best preventives against these annoying bugs is corrosive sub-
limate and pyrethrum powder. Purchase a small bottle of the corro-
sive sublimate tablets, usually sold at the druggists for surgical pur-
poses, and dissolve one in a quart of water. This solution is to be
freely used about the cracks of the bed, after it has been taken apart,
and also about any wooden furniture of the room as well as the wood-
work of the room. The powder is then to be used freely. This pro-
cess is to be repeated several times.

The bites themselves are best relieved by carbolic lotions, vinegar
and water, ammonia and water, etc.

Freckles.

This is a disease of the pigment layer of the skin and consists in
a deposit of the coloring matter of the skin in irregular shapes,
of the size of a pin-head or pea, and are yellowish, brown or even
blackish, occurring for the most part on the face and back of the
hands. They may be few and scattered or exceedingly abundant
and cover a large area. All ages are subject to them except in very
young children. The light<;omplexioned are more subject to them.

SKIN DISEASES.

161

t in the treat-
le destruction
;hey produce
B of the jini-
t strict clean-
t. The reiii-
xterniination
3olic acid, to-
most effica-
d over night
g. In young
5^ of the nits,
m may liave
lied with soft
If the louse
the clothing,
. This pro-
The itching
teaspoonful

rcurial oint-
p and water
8 are found

rrosive sub-
f the corro-
irgical pur-
)n is to be
aken apart,
s the wood-
This pro-

ns, vinegar

consists in
ar shapes,
^n or even
ck of the
abundant
pt in very
; to them,

while the red-haired seldom escape them. Sunlight develops them so
that many have them conspicuously only in summer. The possession
of freckles is a matter greatly of idiosyncrasy, as many people never
have them, no matter how much they may be subjected to the sun.

Treatment. — One's aim in treatment should be toward destro}'ing
the pigment layisr by some corrosive agent, like corrosive sublimate,
which perhaps is the best remedy.

Two grains tc( the ounce in water will in most cases prove suffi-
ciently strong. The susceptibility of the skin to this remedy and the
extent of the area involved have much to do with the strength of the
remedy employed. This remedy is poisonous and is to be used with
care. Do not get it near the lips, but to effect a cure it must be per-
sijted in for quite a while.

A\' ashing the face in buttermilk several times a day is excellent.

Corns.

Of all the minor ailments of the human body, few are more dis-
tressing than the inflamed corn. They consist of a thickening of the
outside or horny layer of the skin. As a secondary change, conse-
quent on long iriitatiou, the nerve and blood supply increase and an
extreme tenderness is produced, amounting often to incapacity to
walk or work. They are caused mechanically by the undue pressure
of the boot against the joint or biy one toe pressing against another.
Too short a boot, which causes pushing out of *he big toe joint, too
narrow a boot, causing crowding of the large joints, are the more fre-
quent causes of the com.

Bunion.

The bunion is produced by wearing too short a boot, as a rule, and
consists in the gradual displacement of the big-toe joint, so that fi-
nally there is an actual deformity. The corn usually is added to this
deformity.

Treatment. — The outer layers of the corn should be softened and
scraped off by a sharp, thin knife. The softening process may be ef-
fected by soaking in a soda solution, or better still, by the following
mixture : —

Salicylic acid one-half ounce

Extract cannabis indica ten grains

Collodion one scruple

This is to be applied each night. Care is to be exercised in not
paring the corn too closely lest bleeding occur and poisoning ensue
from the unclean knife that may be used. Pressure of the boot must
be avoided by the substitution of another form of boot and also per-
haps by wearing a plaster with a hole in the center, thus distributing
the pressure over a greater area. When trimmed the corn is to be

162

SKIN DISEASES.

likewise covered by a corn-plaster bound on the foot by strips of
adhesive plaster. Painting with iodine often takes out the sore-
ness and hardens the skin so that it may be more readily cut. In-
flamed corns should be poulticed and treated like any pus wound.
Spirits of turpentine will often take the soreness out of a corn. Ab-
sorbent cotton, or better, wool, worn between the toes, will prevent
or cure a corn between the toes.

Dandruff.

This is a Hjsease of. the sebaceous glands of the scalp, characterized
by a large secretion of the sebaceous matter and forming crusts or
scales. The secretion may be so thick and oily as to mat together
the hair, or so dry as to fall off the head in a shower when the head
is combed. It is the most frequent cause of baldness. Tlie crown
of the head is the most frequent location of this disease.

Treatment. — Inasmuch as those subject to this disease are often
below par in health, such constitutional remedies as cod-liver oil and
iron are valuable adjuncts in bringing about a cure. Should the
amount of scales be considerable, especially if there are crusts, as in
the case of little children, the best procedure consists in oiling the
scalp over night wit'i some bland oil, wearing a flannel cap, and wash-
ing off the oil in the morning with soft-soap and water. The follow-
ing blood tonic is an admirable one for adults : —

Tincture of iron one ounce

Dilute phosphoric acid one ounce

Syrup of lemon two ounces

Take one-half teaspoonful in a wineglass of water three times daily.
Use a glass tube to avoid staining the teeth. The scalp needs a
shampoo once or twice a week ; the following will be found to be a
suitable one: —

Green soap eight ounces

Alcohol four ounces

Put a little here and there over the scalp and then rub up with
warm water. The scalp may then be stimulated night and morning
with a little of the following lotion :^ —

Tincture of cantharides three dr9,chm8

Tincture of capsicum three drachms

Castor oil two drachms

Alcohol two ounces

Spirits rosemary two ounces

Another good remedy for daily use : —

Hydrate of chloral two drachms

Water four ounces

■Ml

SKIN DISEASES.

163

by strips of
ut the sore-
ily cut. In-

pus wound.
1 corn. Al>
will prevent

iharacterized
ig crusts or
nat together
en the head
Tlie crown

use are often
liver oil and

Should the
trusts, as in
n oiling the
p, and wash-

The follow-

unce
bnce
unces

imes daily,
needs a
ind to be a

ounces
unces

) up with
id morning

Irtichms

Irachms

achms

nces

noes

ichms
nces

The yolk of two eggs well rubbed into the scalp and afterwards
washed off with hot water is ilso a good cleansing agent and sham-
poo.

For very stubborn cases the following lotion applied night and
morning will be found efficacious : —

Corrosive sublimate 12 grains

Glycerine 4 drachms

Alcohol 6 ounces

Spirits rosemary 4 drachms

Whatever method is pursued, the application must be persevered
in and applied from twice daily to once every few days according to
progress made and severity of case. . •

Baldness.

This disease is generally the outcome either of some constitutional
weakness and requires general tonic treatment like iron and cod-oil,
or is the result of some local lesion of the scalp proper. i' nen due
to sypliilis, the hair falls out suddenly and quite extensively ; the
eyebrows also saffer the same way. Its treatment is to be conducted
on the same plans as directed under treatment of the syphilitio dis-
ease. Eczema, scrofulous blood, etc., may also be the exciting cause
of baldness. Baldness may ensue in areas only, and oftentimes is as
complete as though no hair had ever grown there. This form is apt to
be very stubborn and requires very irritating treatment, like blisters
or the rubbing in of strong carbolic acid once a day for a number of
days before ceasing treatment.

The baldness of old age is of course irremediable, but may be ar-
rested by attention to the general health and the employment of rem-
edies mentioned under the consideration of dandruff.

As has been mentioned, dandruff is the most fertile source of bald-
ness. When once the scalp is clean and the dandruff is cured the
following lotion will be found to be of great value in those cases of
baldness characterized by the hair falling out in small patches : —

Carbolic acid one drachm

Alcohol one and a half ounces

Castor oil two drachms

Oil bitter almonds ten drops

Strong carbolic acid itself may be rubbed in the inveterate cases.
The following lotion also contains desirable ingredients : —

Tincture cantharides . . . one and a half ounces
Tincture capsicum .... one and a half ounces ' ;

Castor oil two drachms

Cologne one ounce

MHi

DISEASES OP THE BRAIN AND NERVES.

Thf, brain and spinal column are the great centres of the nervous
system.

The brain produces sensation, thought, and voluntary motion. When
this organ is diseased, therefore, we may expect one of these functions
to be either disturbed or destroyed.

Of Sensation there are various disturbances, pervsrsions, and sus-
pensions, caused by disease of the brain and nerves ; such as nausea,
giddiness, specks floa./ing Vnjfore the eyes, ringing in the ears, decep-
tive tastes and sr lells, latolerable itching, neuralgic pains, boisterously
high spir' a, depression without apparent cause, anxiety, and dread.

Thought, in like manner, is disturbed and perverted in many ways.
There is high delirium, dullness and confusion, loss of memory, weak-
ened judgment, and every degree of stupor, down to l utire loss of
consciousness.

Voluntary Motion is perverted and destroyed in muscular twitch-
ings, trembling of the limbs, spasmodic stiffness, involuntary jerk-
ings, convulsions, muscular debility, and palsy.

The brain is composed of three parts, — the cerebrum, the cerebel-
lum, and the medulla oblongata. These are all contained witliin the
skull bones, and are immediately covered by three membranes, called
the dura mater, the arachnoid, and the pia mater. The dui mater is
a strong, fibrous membrane lying next to the skull-bones. 1 arach-
noid is a serous membrane, lying next below, and the pia matei hich
means pious mother, is a vascular membrane, lying next to the brain,
dipping into it in places, and containmg the vessels which bring to it
all its nutrient materials. Hence its name.

These membranes are all liable to be inflamed, — and so is the
brain.

Inflammation of the Dura Mater.

The inflammation of this membrane does not often occur sponta-
neously ; but it happens frequently from external injuries, as blows
upon the head.

After a blow upon the head which stuns him, a man may recover
himself, and for some days remain in perfect health. Then he has

164

■'•^sattm

DISEASES or THE BRAIN AND NERVES.

166

SBVE8.

;he nervous

ion. When
le functions

ns, and sus-
t as nausea,
ears, decep-
wisterously
nd dread.

many ways,
aory, weak-
ire loss of

liar twitch-
itary jerk-

the cerebel-
witliin the
lies, called
mater is
arach-
tei, hich
the brain,
jring to it

so is the

sponta-
as blows

y recover
1 he has

liiiin in the head, is restless, cannot sleep, has a (lushed face, red eyes,
hot skin, hard pulse, rigor, nausea, vomiting, — ending with convul-
sions and delirium.

This disease is often caused by what is called otitis, or inflamma-
tion of the internal ear. In such ca»es, iiiHammation will arise within
the tympanum, causing intense earache ; matter conies at length from
the external ear, but the pain does not stop ; the patient shivers, be-
comes drowsy, perhaps delirious, and finally sinks into stupor. The
dura mater is inflamed.

Treatment. — When the disease arises from inflammation in the
ear, leeches are to be applied behind the ear, and blisters and other
irritants afterwards. Other modes of treatment will be mentioned
after the next two forms of disease.

Inflammation of the Arachnoid and Pia Mater.

Arachnitis.

These two membranes are generally inflamed together. They
are so intimately connected that each involves the other in its own
troubles.

Generally this is divided into three stages : —

The Irritative, characterized by wakefulness, irritable temper, re-
pugnance to strong light, and contraction of the pupils.

Tlie Infiammatory Stage, known by transient pains in the head,
alternating with similar ones in the bowels, increased restlessness and
irritability, a quick and t«nse pulse, an expression of discontent on
the face, the eye-brows knit and frowning, the eye-lids half closed,
retching and vomiting, deep sighing, and torpid bowels.

The Depressing Stage, in which the delirium is more continuous,
the countenance has a look of surprise and stupor, the pupils are con-
tracted or dilated, the white of the eyes injected and red, the pupils
rolled up during sleep, constant sleepiness, inattention to surrounding
objects, torpidity of mind, gradually increasing until complete coma
closes all the senses.

The disease does not always exhibit all these symptoms, or come on
in the regular way described. Sometimes the first thing noticed is a
long-continued paroxysm of general convulsions. Again these con-
vulsions will come on after violent pains in the head, and are attended
with screaming.

Inflammation of the Brain. Brain Fever.

Encephalitis. — Phrenitis.

Acute and general inflammation of the brain and its membranes
has two stages. '

The Stage of Excitement, in which there is intende and deep-seated
pain in the head, extending over a large part of it, a feeling of tight-

■■ '\

166

DISEASES OF THE DRAIN AND NERVES.

rifcos across the forehead, throbbing of the temporal arteries, a Hushed
face, injected eyes, looking wild and b? lliant, contraction of the pupils,
great shrinking from light and violent sound, delirium, want of sleep,
general convulsions, a parched and dry skin, a quick and hard pulse,
a white tongue, thirst, nausea and vomiting, and constipation of the
bowels.

The Stage of Coliapse, in which there are indistinct mutterings,
dull and perverted hearing and vision, double vision, the piipil from
being contracted expands largely and becomes motionless, twitchings
of the muscles, tremors and palsy of some of the limbs, a ghastly and
cadaverous countenance, cohl sweats, profound coma, and death.

The disease will not show all these symptoms in any one case. It
runs a rapid course, causing death, sometimes, in twelve or twenty-
four hours ; or it may run two o: three weeks.

Treatment. — This should be energetic, and administered early.
The measures usually employed are hot foot-baths., and the application
of cold to the head., with occasional mustard poultice to legs.

General Blood-letting. — This is much approved by many ; for
myself, I do not like it. Wet cups and leeching are about tlie extent
to which I would ever carry the abstraction of blood in these diseases.
These may sometimes be applied with advantage to the neck, and be-
hind the ears.

Cold Applications. — These, applied to the head, are of great im-
portance. First, shave the head, and put on cloths wetted in water
as cold as it can be made, changing them often ; or, put powdered
ice in a flexible bladder, and lay it upon the head, — taking care not
to make it too heavy. Heat in a few cases is better borne.

Cathartics. — These, while the inflammation is in the active stage,
should be thorough and energetic. To effect it, many use calomel
and other forms of mercury. They are not needed. Croton oil is one
of the best articles (31), or colocynth, gamboge, etc. (82), without
the oil, or the compound powder of jalap.

In the stage of collapse, if tliere is pallor of the countenance, a
feeble and flying pulse, great debility and tremors, coldness of the
extremities, etc., give wine and other stimulants.

See that the bladder is emptied every day.

The feet, in the early stage of the complaint, should be bathed in
warm water, or mustard and water (242). Mustard draughts must
also be put upon the feet.

The tincture of veratrum, given in full doses, to bring down the
pulse, and produce sweating, must not be omitted. Give (351).

Softening of the Brain. — Ramollissement.

Inflammation of the brain, when it has run its course, sometimes
leaves this organ, or portions of it, in a softened condition. The

5s, a flushed
f the pupils,
int of sleep,
hard pulse,
tion of the

mutteriugs.
pupil from

twitchings
ghastly and

death,
le case. It
or twenty-

ered early,
application

rS.

many; for

the extent

se diseases.

ck, and be-

f great ini-

d in water

powdered

g care not

tive stage,
36 calomel
I oil is one
), without

benance, a
S8 of the

)athed in
its must

own the
J51).

imetimes
n. The

niSEASES OP THE BRAIN AND NERVES.

167

same mischief may happen to the bruin from the blood-vessels which
run to it being diseased, so as not to be able to carry blood for its
proper nourishment.

Symptoms. — The most remarkable symptom of this disease is the
rigid contraction of the muscles which draw up the limbs ; the hand
may be clenched and pressed against the shoulder, or the heel carried
up to the hip.

The other symptoms are various, — tingling and numbness in the
ends of thu fingers ; perverted vision, and sometimes blindness ; par-
alysis of one limb, or half the body; difficulty of answering ques-
tions ; forgetfulness, making it difficult, at times, for the patient to
remember his own name. General treatment is indicated.

Suppuration and Abscess of the Brain.

When a diseased brain is examined after death, sometimes matter
is found mixed in with the softened portion. This shows that suppu-
ration took ;jlace. At other times, the matter is found in a cavity,
which shows that an abscess had formed during life.

The symptoms of these mischiefs are convulsions in the earlier
stages, and palsy in the latter. Surgical methods now often save
life, and cause a cure in these cases.

Induration of the Brain.

Instead of softening the brain, inflammation sometimes does the
very opposite, — it hardens it, — producing a change something like
that which happens to white of Qg^ when dipped in hot water.

Convulsions appear as the result of this change, as in suppuration
and abscess ; palsy much more seldom.

Tumors bf the Brain.

Tumors infect the brain occasionally, — growing around it, on all
sides, pressing themselves into its substance, and causing many dis-
turbances. Cancers and hydatids are found there. The signs which
these irritating bodies produce are like those of other diseases of the
brain, and therefore cannot be distinguished daring life. Syphilis is
often the cause of them, and, when due to this, may be cured.

Delirium Tremens.— Drunkard's Delirium.

Mania a Potu.

This is often mistaken for brain-fever ; but it is quite a different
disease. It is not the result of inflammation of the brain, but of irri-
tation. It is important to distinguish it from inflammation, because
the remedies wWch are employed for that would be injurious if used
for this.

I .i

ij^

108

DISEASES OP THE BRAIN AND NERVES.

The Symptoms art; incosaant talking, fidgeting with the hands,
trembling of the limlw, a rapid pulse, profuse sweating, utter sleep-
lessness, and a mingling of the real with the imaginary in the hiiHy
talk. The patient is apt to think some one is about to do him a
great injury, yet is unwilling to be alone. His face is pale and sal-
low (sometimes red and flushed), his eye is rolling, quick and ex-
pressive, his speech stuttering and inarticulate, — bodily and mentally,
he is busy day and night, and can with difficulty be confined to his
bed or room. As the disease advances, and he has been long without
sleep, he imagines vermin to be crawling upon his scalp and body ;
troops of rats run across his bed, or look at him out of the wall ;
giant boxers confront him, and he squares off for a round at fisti-
cufis ; animals, figures of all shapes, and horrible monsters frighten
his imagination ; devils laugh at liim, and dance before him. In long
and sleepless houi-s, he Uilko and chatters with these spectral phan-
toms, — now beckoning them, now shrinking from them, till he wears
out and sinks from exhaustion. This is a disease of drunkards and
opium eaters. The attack generally occui's in consequence of the
withdrawal for three or four days of the accustomed stimulus.

Treatment. — Opium and its preparations are the sovereign rem-
edy. Give one-third of a grain of morphia; if this does not quiet the
patient, give thirty drops of laudanum every two houra, till sleep is
produced. Sleep will cure him, and notliing else will. A draught
or two of his accustomed drink, brandy, gin, or whatever it may be,
will also generally dispose him to sleep, if he be not already in drink.

Recently, a very effectual remedy has been found in the use of
tepid baths, prolonged from four to ten hours, in connection with
cold applications to the head. In connection with this, small doses
of opium are required ; but the treatment may yet prove to be very
valuable by enabling us to dispense with excessive doses of opium.
Twenty grains of chloral may be given every hour till patient sleeps.

Inebriety.

In the beginning of the present century insanity was regarded as a
visitation of God's displeasure and not as a disease subject to scientific
investigation and amenable to treatment. Inebriety is regarded now
as insanity was some hundred years ago, the disease being consid-
ered irremediable. Alcohol is a poison, and like other poisons is cap-
able of destroying life. In large doses it becomes a powerful irritant
or a narcotic producing coma and death. It being constantly intro-
duced into the system produces a general disease in the system. We
believe inebriety can be cured like any other disease, but is subject to
relapses like other diseases.

The " alcohol habit," under the title Inebriety, oftentimes has the
symptom or outward manifestation of diseased conditions, which an-
tedate the alcoholic craving, and are its predisposing and exciting
causes which retard, and sometimes even prevent a cure.

DISEASER OF THE BRAIN AND NERVES.

169

the liHiul.s,
utter sleep-
in the hiisy
do him a
ale and sal-
ick and ex-
id mentally,
fined to his
ong without
and lx)(ly ;
if tlie wall ;
ind at fisti-
ere frighten
m. In long
ctral phan-
ill he wears
nkards and
ince of the
ulus.

!reign rem-
it quiet the
ill sleep is
A draught
it may be,
ly in drink,
the use of
[ction with
mall doses
io be very
of opium,
ent sleeps.

irded as a

scientific
rded now
g consid-
►ns is cap-

1 irritant
itiy intro-
»m. We

ubject to

has the
vhich an-
exciting

In thu popular, and too ofttm in tlu; professional mind, alcohol in
regarded as the cause and root of the wliole evil of inebriety. We
desire to assert that inebriety is frequently dependent upon caa'^es
with which alcohol has nothing to du. There is a neurotic craving
— it may lie congenital, it may be developed as the result of disease
or accident. This craving demands the various forms of narcotic
stimulants, those that first excite, then produce narcosis more or less
complete. Alcohol fuUills this condition, is easily accessible, reason-
ably inexpensive, and is the one drug that meets a morbid craving
that seenus to be almost universal.

We do not fail to recognize the deteriorating effects of alcohol
manifested principally, at least, more pronouncedly upon the nervous
system as seen in the various forms of insanity. We also note the
degenerating effects of alcohol on lung, liver, kidney or other organs
and tissues of the body ; or as a special poison in the same sense that
lead, arsenic and tobacco produce their effects.

We believe that the great majority of inebriates become so from he-
redity, environment and disease, that produces physical degeneracy
and pushes them over and plunges them into inebriety.

The patient with fever craves and may drink water freely, exces-
sively and injuriously. The diabetic is an aqua-maniac in a certain
sense, but in neither case do we recognize the aqua-mania or water
craving as the disease, but rather r.s proceeding from certain abnor-
mal conditions whiclj we readily recognize. So the liquor thirttt is
the result of morbid ('onditions that produce an abnormal desire,
which alcohol seems, temporarily at least, to satisfy.

The excessive use of Jilcohol, while it is oftentimes the cause of
various diseases of the nervous system, and also a frequent cause of
insanity, is also the precursor or initiatory symptom of certain disepses
of the nervous system and also of insanity.

The paretic will crave and use alcohol in the earlier stages of his
malady. The victim of nervous syphilis is addicted to it, more es-
pecially in the later stages, when the nervous system becomes in-
volved.

Any depressing, exhausting, or painful disease may produce the
alcoholic craving, alcohol being sought for its stimulating properties.

Alcohol, moreover, is second only to opium, ether, or chloroform
as an anaesthetic ; indeed, has been used aa a substitute for the latter.
Hence, persons find experimentally that alcohol relieves pain, and
its use is carried to a harmful extent, its deleterious effects produced,
and inebriety established.

It is possible that a healthy individual, with good peraonal and^j
family history, may use alcohol sociably or as a matter of custom, un- /
til the habit becomes firmly established.

The alcohol breaks down the constitution, invades and degenerates
the nervous system, and thus develops inebriety, because the alcoho-
lic degenerations, or even functional disturbances of the nervous sys-

170

DISEABRS OF THE BKAIN AND NEKVSa

teni, are the very coiulitioiiH tinder which inebriety is estuhliHhed.
We say this is i)OH8il)le, but wo assert again that l)tihinc{ the hu-^v
majority of inebriates will Ihj found a defective family or persomil
history, not only complicating but causing the inebriety ; retaidinp,
oftentimes preventing a cure.

It can be thus seen that inebriety is but a symptt)m — a flag of
distress hung out by the nervous system. As some one hius aptly
said, "neuralgia is the cry of a diseased nerve," so the " drink-craze''
is the cry of the neurasthenic for a stimulant, of the? puin-tortured
nerve for an amesthetic, of the victim of insomnia for a hypnotic.

Not any patient that applies for relief to the pliysician needs a
more careful examination than does the inebriate. You may rest as-
sured that there is some underlying cause, probably several that must
be removed if we would restore the inebriate to his former habits of
sobriety. If he is found suffering from the later manifestations of
syphilis he will need special treatment for this condition, especially
if the nervous system is involved ; a painful stricture of the urethra
may require division.

Chronic malarial poisoning with its complicating disorder of stom-
ach, liver and spleen, will demand special treatment. In a cfuie on
record the irritation of a tape-worm produced a tendency to the ex-
cessive use of alcohol, which tendency passed away when the wonn
was expelled.

In a word, a large majority of inebriates are diseased persons, and
tliat primarily and antecedent to their inebriety, which is appended
to and aggravates their diseased condition.

Special diseases, therefore, require special treatment, irrespective
of the inebriety, if we would cure the inebriate. In this connection
we may ask, are there any drugs that we can substitute for alcohol
that will take its place, and satisfy the inebriate, as a substitute for
alcohol ?

Opium and the salts of morphia will do so in a marked degree, al-
though cocaine, chloral and the bromides have been so used.

The use of opium or morphia is not uncommon among inebriates
who desire to " leave off alcohol." The inebriate, as a rule, is a con-
genital neurotic. From birth almost, he reaches out for some drug
that will gratify or meet his neurotic craving. The alcohol and the
opium habit to the inebriate are convertible habits, and the inebriate,
like a pendulum, will swing from alcohol to opium ; not infrequently
the two habits are combined, as in the form of tinct. opii, constitut-
ing a mixed habit, in which the effects of both alcohol and opium
have to be considered. Occasionally a case is presented in which
morphia is used hypodermically, and the alcohol used in the usual
manner. In cases where opium addiction is associated with the habi-
tual use of alcohol, the opium habit is of paramount importance and
the alcohol assumes a secondary place.

The fact that opium can sutetitute alcohol is the keynote to many
vaunted secret cures, in the so-called " narcotic treatment " for alco-

estHblishod.
>'' the liiij,r(.

01' personal
■; retaidiiiy,

— a flag of
i« has aptly
Iriiik-craze "
uin-t«rturt'(l
i.Vpnotio,
ian needs a
may rest as-
al that must
pr hahits of
'estatioiLs of
I, especially
the urethra

ler of stoni-
a case on

"■ to tlie ex-
the wonu

ersons, and
J appended

rrespective
connection
or alcohol
Jtitute for

degree, al-

inebriates

is a con-

^me drug

and the

nebriate,

iquently

eonstitut-

id opium

n which

le usual

the habi-

ance and

to many
for alco-

DIBIASEB OF THE BRAIN AND NIRVES.

171

hoi. It simply substitutes one habit for another, and as long as the
victim is taking the so-called remedy he is reasonably comfortable.
Mut I admit if the " narcotic treatment " was carefully practiced, in
judicious hands it might, in conjunction with such other remedial
measures as would best eradicate the primal causes of the inebriety,
prove useful, if not curative, in cases oi inebriety.

Are there any drugs that are specifically l)eneHcial for the treatment
of inebriety as such ? We would state that drugs that act directly as
a stimulant to the nervou., lystem are of value. Strychnia is a type
of this class of drugs, and one of the best of it class.

Luton, of Rheims, Belgium, was the first to point out its value in
alcoholism. Then the Russians used it largely and it was known as
tiie " Russian treatment," and finally, the Americans adopted its use
in such cases.

Strychnia has proved serviceable as both abortive and curative in
acute alcoholic delirium, as well as useful in the more chronic forms
of alcoholism. It seems to be tolerated in such cases — in cases of
alcoholic poisoning under normal conditions, we have no record of
the value of strychnia as an antidote ; interesting experiments might
l)e made on the lower animals with the view of determining this
point. Strychnia is an excellent cardiac tonic, and one of the best
respiratory stimulants, and might be used in general medicine in
cases in which aicohol is oftentimes prescribed.

Oxide of zinc, during the past twenty years, has been used with
advantage in cases of chronic alcoholic intoxication.

Quinine has been used more particularly in the later or convales-
cent period of the treatment of alcoholism.

The so-called " Red Cinchona Cure " for a time interested the pub-
lic. Rational medicine does not recognize any special drug or speci-
fic remedy as a universal cure for inebriety, nor does clinical experi-
ence form any basis for such a claim. From the very nature of the
case, such a remedy would be impossible. The aetiology of inebriety
is dependent on such a variety of causes and its environments and
complications so numerous that any one remedy could not fulfill all,
or even meet the more important of these conditions. However val-
uable drugs may be to meet certain indications in the various condi-
tions incident to inebriety, we believe that so far as the curative
treatment of inebriety is concerned, drugs must assume a secondary
place, valuable as they may be in their respective spheres.

In the treatment of the alcohol habit we place first: Restraini and \
seclusion in a special asylum for a definite period, and totat abstinence J
duri'iig this period.

In a few words, concisely expressed, this statement includes the
plan now adopted by the leading asylums of this country and of
Europe for the recovery of the inebriate. It involves restraint,
(legal, if need be), seclusion, a special institution, in which all the
latest and best methods of dealing with the inebriate are procurable,
a sufficient period in which to apply these measures, and we need

172

DIHRABK8 or TIIK BRAIN AMD NRRVIS.

hurdl)' iiclJ, a long period of total abstinence from ail alcoholic limiois.
Wo need hardly add that diet, rest, recreation, liygienic Hnrronndin^p*,
and the exhibition of appropriate drugs are all included in the al)ove
plan.

The cauHes of degeneration Iniing removed, i\w fa(!torH of regenera-
tion l)eing brought into action, new formation of nerve, nniHcle uiii)
tissue must supplant degenerated tissue, if haply organic disease him
not resulted in irrepamble injury.

We have hinted at an hysterical element in the history of inebriety.
The inebriate, whatever may be his condition, is largely intluenced
by his surroundings.

In the light of such an hysterical element in the clinical history of
inebriety, we can readily account for the apparent success of the so-
called temperancie movements that sweep over comn unities periodi-
cally and effect many apparent euros, or rather, in the language of
the day, reformations. Such an element will also explain why, after
such a tidal wave of excitement, relapses take place oftentimes in
large numbers, and the period of excitement is followed by a period
of reaction.

The occurrence of relapses is readily accounted for by the fact that
the stimulus of the period of excitement buoys up the inebriate for
the time Ixjing, during which strong mental emotion is a powerful
factor. He is keyed up, as it were, for the time, and sustained by a
moral stimulus. When this is withdrawn, reaction, followed by cor-
responding depression, sets in, and the old method of stimulation is
again imperatively demanded and yielded to.

Why some inebriates go through such a period of excitement and
do not relapse, and why othere do, can be accounted for by the fact
that the former are in a reasonable degree of physical health, and are
not bui'dened, dragged down and handicapped, either by disease that
is non-alcoholic, or that is the result of alcoholic degeneration. The
inebriates so affected are not influenced, or if at all, only temporarily,
by the so-called " temperance revivals " that appear and disappear
with almost stated regularity in large and small communities and we
must add do good, but only in the channel indicated.

It is also operating through this hysterical feature of inebriety
that charlatanism may effect a temporary, possibly a permanent suc-
cess in a certain class of cases.

In cases where the hysterical element largely preponderates, we be-
lieve psycho-therapeutical agencies, or even those that appeal to
purely mental conditions, will be of service, but they will not cure a
cirrhosed liver, lung, or kidney, or remove the physical causes upon
which the inebriety may depend. In addition to those measures that
appeal to the higher moral nature, there ought also to be combined
such as meet certain intelligent wants. To this end all reasonable
amusements, entertainments, and especially such occupations as will
interest the person and keep him busy, should be encouraged, if not
made compulsory.

V .

DI8KAHE8 OK THE tiUAIK AND NKKVKS.

173

f>li(' liiiuors.
rroundingH,
" the above

^f regeneni-
nuiHcIe mid
•liHi'iise iuM

•f in(d)riety.
' iiiHuenoeU

il luHtoryof
of the 80-
ies peiiodi-
Higiiage of
why, ftfter
/ontimeH in
by a period

le fact that
ebriate for
V powerful
[lined bv a
red by cor-
iiuhition is

mient and
)y the fact
h, and are
sease that
The
nporarily,
isappear
8 and we

inebriety
nent suc-

68, we be-
ppeal to
ot cure a
868 upon
urea that
jorabined
iBsonable
as will
, if not

Incidentally I may mention hypnotism iw having Imhmi used espe-
cially by French [ihysiciauH, with some l)eneflt in cases of chronic al-
coiiolism. I have no data to give, and have not had any personal
experience with it.

The Bi-Chloride of Gold cure, known as the Keeley cure, is in
many cases successful, but not in all. Would advise its use as a List
resort; though we think its use sometimes leads to insanity and
suicide. It cures at all events for the time being.

If the t(!mper.in('e advocates would supply light, warm, cheerful
places of resort with h(tt and temperance drinks, supplied with pool
imd billiard bibles where the poor could spend their evenings and
meet each other and amuse themselves at v reasonable expense, and
establish cooking schools for the wives vf. • • they could learn how
to cook nourishing and palatable food which would supply the body
with the nourishment which it must have and recjuires, we believe
it would do more towards tempci'ance than all the laws that could
be passed.

Enlars^ement of the Brain. — Hypertrophy.

This is chiefly a disease of childhood. It consists in an unnatural
growth of the brain. Sometimes the skull grows with it, and there
may not be any, or only slight, symptoms of disease.

The complaint is sometimes congenital, — the child being born
with a head far above the natural standard Jt size. Sometimes a
child's head, from this disease, will reach the size of p'' adult's by
the time it is five or six yeara old. This is not necessarily a disease,
though children that suffer from it are very apt to die finally of some
affection of the brain.

Symptoms. — Dullness of intellect, indifference to external objects
great irritability of temper, inordinate appetite, giddiness, and an ha-
bitual headache, which at times is very severe. In addition to these,
there are, at times, convulsions, epileptic fits, and idiocy. There is a
peculiar projection of the parietal bones, which serves well to distin-
guish this disease from acute hydrocephalus.

Treatment. — As far as possible, suspend and repress all exercise
of the mind. Take the child from school as soon as the disease is
discovered, and put it to the most active muscular exercise in the
open air. The moment there is any excitement of the brain, or heat
on the top of the head, apply cold water, ice, or cold evaporating
lotions. If, as the child grows up, the signs of mischief increase, the
diet must be simple, and carefully regulated. Bread and milk only
is sometimes advisable.

Shrinkin,? of the Brain, — Atrophy.

This is a disease in which the volume of the brain is diminished.
Thei-e are' two forms of 't; one is congenital, the brain not being

i ' i

174

DISKABE8 OF THE BKAIK AND NERVES.

properly developed at birth ; the other occurs in consequence of dis-
ease either in the membranes or the arteries. The symptoms are not
distinguishable during life from those of other brain affections, and
therefore it can only be treated according to general jjrinciples.

Water in the Head. — Acute Hydrocephalus.

This, like enlargement of the brain, is likewise a diseaso of child-
hood, and often attacks scrofulous children.

Being an inflammatory disease, if, is important to have early notice
of its existence, and, if possible, to be aware of its approach ; which
we may be, frequently, by observing the following premonitory

Symptoms ; namely, a disturbance of the digestive functions, indi-
cated by a capricious appetite, — the food at one time being disliked,
at another devoured greedily; a foul tongue, offensive breath, enlarged
and sometimes tender belly, torpid bowels, stools light-colored from
having no bile, or dark from vitiated bile, fetitV, sour-smelling, slimy
and lumpy. The child loses its healthy look, and grows paler and
thinner. Its cv-stomary spirit and activity are gone ; it is heavy, lan-
guid, dejected ; it is fretful, irritable, uneasy ; and sometimes is a lit-
tle tottei-ing in its gait.

After these warning symptoms, the disease may begin in one of
three ways : —

The pains in the head become more severe and frequent, and are
sharp and shooting, causing the little patient to wake and shriek out.
As the drowsy state advances, the shrieking gives place to moaning.
Beside these symptoms, there are stiffness in the back of the neck,
pain in. the liml)s, great tenderness of the scalp, vomiting, sighing,
intolerance of light, knitting of the brows, increased disturbance of
stomach and bowels. This stage may last ten ' o fourteen days, the
chi'd growing more weak and peevish.

.iVnother form of attack is marked by acute pain in the head and
high fever, convulsions, flushed face, brilliant eyes, intolerance of light
and sound, pain and tenderness in the belly, stupor, great irritability
of stomach, causing retching and vomiting upon every attempt to sit
up in bed.

The third mode of attack is very insidious, — the early symptoms
being mild and hardly noticeable, or not even occurring at all. In
such case, the convulsions or palsy come suddenly, without notice,
bringing swift and unexpected destruction. This has soraetiriies been
called water-stroke.

The First Stage is the period of increased senisibiiity and excite-
ment, caused by inflaaimation, in which the pulse is quick and irreg-
ular.

The 5econd Stage is one of diminished sensibility, or lethargy, dur-
ing which water is effused upon the brain, and the pulse is slow.

■'*»»■ TSBB

DISEASES OF THE BRAIN AND NERVES.

17B

ence of dis-
;om8 are not
ections, and
iciples.

alus.

wo of child-

oarly notice
ach; which
nitory

ictions, indi-
ng disliked,
th, enhvrged
olored from
dling, slimy
8 paler and
I heavy, lan-
mes is a lit-

ti in one of

;nt, and are
[ shriek out.
to moaning,
f the neck,
ng, sighing,
turbance of
sn days, the

le head and

ace of light

irritability

empt to sit

symptoms
at all. In
3ut notice,
tithes been

md excite-
I and irreg-

^argy, dur-
slow.

The Third Period is one of palsy and convulsions, with squinting
of the eyes, rolling of the head, stupor, and a rapid, thread-like pulse.

Treatment. — The first or inflammatory stage of the fever is very
important, and must be controlled for five or six days. Scammonv and
croton oil (33) may be chosen for this purpose. Apply cold water,
ice, etc., to the head. Use tinct. veratrum viride or (355).

In the second stage, put blisters upon the back of the neck, and one
upon the bowels if they are very tender.

In the third stage, effusion having taken place, use the warm bath,
or the vapor bath, — also digitalis, squills, and iodide of potassium,
(144), (128), (302), (130). The effusion, if permanent, may be
drawn off.

Confine the child to a darkened room, of moderate temperature, —
excluding all noise and causes of excitement, and let him lie upon a
hair mattress, with his head somewhat elevated.

Diet. — Gruel only during the stage of excitement, — during that
of collapse, it should be nourishing, but mild and easy of digestion,
as beef tea, plain chicken or mutton broth, and animal jellies. At
the same time, support the patient by the cautious use of the aromatic
spirit of ammonia, ten drops every four hours, valerian, wine whey,
and infusion of gentian, columbo, or qua8><ia, (64), (66).

Dropsy of the Brain. — Chronic Hydrocephalus.

Acute hydrocephalus is an inflammation; chronic hydrocephalus,
now to be considered, is a dropay. It often begins before birth. It
consists in the accumulation of enormous quantities of water within
the brain, sometimes within its ventricles, at other times upon its
surface. When it occurs soon after birth, it advances slowly and
imperceptibly, — the enlargement of the head being the first thing
noticed.

The skull being tender in infancy, it separates at the fontanelles,
as the fluid accumulates, and the head, at times, attains an enormous
size, — so great that the child cannot carry it upright, but lets it droop
laterally upon the shoulder, or forward upon the breast.

As the disease advances, the senses become blunted, the child is
deaf or blind, the intellect is weakened, perhaps idiocy appears, the
flesh and strength pass away, convulsions and paralysis come in their
turn, and a stupor is apt to occur which ends in death.

Treatment. — The remedies may be external, or internal, or both.

Internal Remedies. — These should be purgatives (33), (31), or
diui-etics and alteratives (302), (145), (144).

External Remedies. — Apply an ointment of the iodide of potas-
sium to the «(;dlp every night (185). A tight bandage applied over
the whole head will sometimes have a favorable effect. Another ex-

1 1'

{;

.Xiffyre'

176

niSEABKS OF THE BRAIN AND NEKVE8.

pedient is to puncture the skull and draw off the water. Tapping
the brain has effected a cure in many cases, and perhaps promises the
most relief of any remedy we have. In newly-born ciiildren with this
affection, it is the best means.

FIO. 84.

Diseases of the Spinal Cord.

Thkiie are few diseases more interesting, as a study,
than those which affect the nervous cord which runs
through the centre of the back-bone. This cord is a
continuation, an appendage or tail of the brain. (See
Figure 84.) It is the seat, and centre of certain ner-
vous functions, called reflex, by which so many move-
ments take place which are not under the control of the
will.

In order that we may feel what takes place in any
part of the body or limbs, and that the will may have
power to move such part, it is necessary that nervous
matter should be continuous and unbroken between the
part in question and the brain.

If the spinal cor- . be cut, broken, or crushed at any
point, all those parts which receive nei-ves from helow
the injury, lose their power of motion and their feel-
ing. When the injury \s in the upper part of the cord,
the breathing and the circulation will stop, and death
is the immediate consequence. If the middle portion
of the cord be the seat of the injury, the bowels and
other organs may lo6e their motion and feeling ; if the
lower portion, then the lower limbs only will be the
sufferers.

Diseiise or injury in the upper part of the cord is
therefore much more dangerous than the same thing
the lower.

Inflammation of the 5pinal Cord.

The membranes which surround the cord may be inflamed just as
those are which enclose the brain ; but as the cavity running through
the spine is quite small, there cannot very well be inflammation of
the membranes without its involving the cord at the same time.

Symptoms. — Pains, often intense, running along the spine, extend-
ing out into the limbs, and made worse by motion. They are similar,
in some respects, to rheumatic pains. There is rigid contraction, and
sometimes violent spasms of the muscles of the back and neck, — so
great, at times, as to bend the body back into the shape of a hoop ;
also a feeling of constriction in various parts, as if they were girt by
a tight string; a sense of suffocation; retention of urine; a most

DISEASES OF THE BRAIN AND NERVES.

177

'. Tapping
jfomises the
en with this

aa a study,
which runs
8 cord is a
rain. (See
certain nei-
nany move-
introl of the

iace in any
1 may have
aat nervous
aetween the

shed at any
from below
[ their feel-
of the cord,
, and death
die portion
bowels and
ing; if the
will be the

;he cord is
lame thing

led just as
lig through
imation of
time.

le, extend-
Lre similar,
Action, and
leck, — so
|f a hoop;
pre girt by
a most

obstinate constipation and frequent chills or rigoi-s. The pain which
is felt along the cord is aggravated by rapping upon the spine, but
not by pressure.

The above symptoms are supposed to be the result of inflammation
predominating in the membranes. When its seat is more particularly
in the substance of the cord, the symptoms are, — convulsive affec-
tions of the head and face, inarticulate speech, loss of voice, squint-
ing, and difficulty of swallowing, if the extreme upper part of the
cord is iaflamed; if the disease l)e slightly lower, difficulty of breath-
ing. Irregular action of the heart, and tightness of the chest; if lower
still, vomiting, pain in the belly, sensation of a cord tied round the
abdomen, pain and heat in passing water, retention of the urine, ina-
bility to retain the urine, desire to go to stool, or involuntary stools.

Spasm and stiffness, then, are the results of inflammation of the
merabranes ; convulsions and palsy, of the same affection of the cord.

Treatment, — When the inflammation is acute, apply a few leeches
or wet cups along the sides of the spine. In chronic inflammation,
powerful friction, or mustard draughts, stimulating liniments (1 90),
or plasters, will generally answer the purpose.

Apoplexy.

Apoplexy is that condition in wliich all the functions of animal
life are suddenly stopped, except the pulse and the breathing ; — in
which there is neither thought, nor feeling, nor voluntary motion ; in
which the person falls down suddenly, and lies as if in a deep sleep.

Modes of Attacki — There are at least thi'ee ways in which this ter-
rible disease may make its assault.

The First form of atta jk is a sudden falling down into a state of
insensibility and apparently profound sleep, — the face being gen-
erally flushed, the breathing stertorous or snoring, the pulse full and
not frequent, with occasional convulsions.

From this mode of attack some die immediately, others get entirely
well, and others get off with the exception of paralysis on one side,
or the loss of speech, or some one of the senses.

•

The Second form of attack begins with sudden pain in the head.
The patient becomes pale, faint, sick, and vomits, — has a cold skin
and feeble pulse, and occasionallj' some convulsions. He may fall
down, or may be only a little confused, but will soon recover from all
the symptoms, except the headache, — this will continue, and the pa-
tient 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 appearing so frightful as the
first, is of much more serious import.

178

DISEASES OF THE BRAIN AND NERVES.

In the Third form of attack there is sudden loss of power on one
side of the body, and also of speech, but not of consciousness. The
patient retains his mind, and answers questions either by words or
signs. This may be called paralytic apoplexy. The patient may
either die soon, or get well, or live for years with imperfect speech,
or a leg dragging after him, or an arm hanging useless at his side.

The Persons Attacked are apt to have large heads, red faces, short
and thick necks, and a short, stout, square build, though it occui-s
often among those ^^hn are thin, pale, and tall. The tendency to it
increases in advanced life.

The Forerunners of apoplexy are headache, vertigo, slight attacks
of palsy, double vision or seeing two objects when there is but one,
faltering speech, inability to remember certain words, sometimes a
sudden forgetfulness of one's own name, a frequent losing of the
thread of ideas attempted to he pursued, and occasionally an unac-
countable dread, for which no reason can l)e given.

Erciting Causes. — Whatever hurries the circulation of the blood,
as strong bodily exercise, is an exciting cause. So are all those things
which cause the blood to flow towards the head, as coughing, sneez-
ing, laughing and crying, straining at stool when costive, lifting heavy
weights, singing, and playing on wind instruments. To these may
be added, exposure to the sun, the bad air of crowded rooms, holding
the head down, or turning it around to look backward, tight cravats
worn about the neck, and exposure to severe cold.

Treatment. — If the patient have the appearance of suffering from
fulness of blood in the head, as evinced by redness and turgescence
of the face and throbbing of the temporal arteries, and if the pulse
be full and hard, feeling like a tense vibrating rope under the finger,
place him in a half-recumbent posture, with his head raised ; loosen
his clothes, particularly his neck-cloth and shirt collar, and whatever
may press upon the neck, and then as quickly as possible apply cold
wet cloths to his head, changing them often. Ice is still better, if it
may be had. Apply wet cups to the nape of the neck, and mustard
draughts to the soles of the feet. — at the same time applying tight
ligatures around the limbs, to pievent the blood from returning
rapidly in the veins. The ligatures should be gradually removed
when the patient recovers his consciousness^ Also administer a
stimulating, purgative injection (246), and place t vo drops of ci-oton
oil, rubbed up with a little pulverized loaf sugar, far back upon the
tongue. Repeat the injection every fifteen minutes, till the Ixtwels
are thoroughly moved. This is one of the few diseases suitable for
bleeding.

If the patient be old, and the pulse small and feeble, with no ful-
ness or beating of the temporal arteries, or swelling of the veins of
the neck and forehead, the countenance being pinched, and the skin

DISEASES OF THE BRAIN AND NERVES.

179

ower on one
sness. The
by words or
patient may
feet speeeli,
b his side.

I faces, short
^h it occui-8
ndency to it

light attacks
B is but one,
sometimes a
asing of the
Jly an unac-

jf the blood,
those things
rhing, sneez-
iifting heavy
) these may
ams, holding
tight cravats

ffering from

turgescence

if the pulse

ir the finger,

ised ; loosen

lid whatever

apply cold

better, if it

,nd mustard

(lying tight

returning

ly removed

minister a

)S of croton

upon the

the bowels

lUitable for

irith no ful-
Ihe veins of
Id the skin

liloodlesB and cold, the cupping, purging, and applying the ligature
iiuist be omitted. In this case it will l)e lietter to apply warm
ttannels and hot bricks to the surface, and administer ammonia
and camphor (283), (135) internally.

To prevent future attacks, gentle tonics should l)e used, and the
skin should be kept healthy by daily bathing and friction. The
towels must not 1 >e permitted to become costive. The diet should
Im light, chiefly vegetivble, and almost entirely so in hot weather.
The food should be well chewed. Tho mind should be kept cheer-
ful and hopeful, and free from great excitement. The sexual
passion should l)e restrained, and very rarely indulged. Intoxicating
drinks should be abandoned, if used, and all tight cravats l)e dis-
carded from the neck. Direct rays of the hot sun in summer should
\m carefully shunned. No food should be taken for three hours
lief ore retiring, and a mattress only, of some degree of hardness,
should be slept upon, — the head being always well elevated. To
these precautions, I would add dipping the feet every night before
retiring in cold water; and, if any tendency to cold feet be sx-
perienced, dusting pulverized cayenne in the bottoms of the
stockings.

Sunstroke. — Coup de Soleil.

This is much like apoplexy; in fact, it is a kind of apoplexy. It
occurs in warm climates, or on very hot days in temperate regions, by
exposure to the sun.

It begins by hesidache, tliirst, dizziness, and sometimes difficult
breathing and bilious vomiting. The patient drops down senseless,
ivs in apoplexy, and unless immediate relief is obtained, soon dies.

Treatment. — Take the patient immediately into the shade, and
employ about the same remedies as for apoplexy (361). Apply ice
to the head.

Palsy. — Paralysis.

Palsy is a loss of the power of voluntary motion and feeling, one
or both coming on, sometimes gradually, but more often suddenly,
and extending at one time to a part, at another time to the whole
lx)dy. It is a kind of station-house on the way to apoplexy, where
passengers stop, not merely to stay over night, but to rest many days,
or even years.

A great injury inflicted upon the brain, either by pressure or other
cause, will induce a complete loss of motion and feeling, and this ex-
tending to the whole structure, brings likewise a loss of conscious-
ness, which is apoplexy. A smaller degree of pressure, or a less
injury upon the same brain, would occasion a loss of motion only, or,
if a loss of feeling were experienced also, it would only extend to a
part of the body, and consciousness would remain. This would be
palsy. The disease is like apoplexy in kind, but stops short of it in
degree.

t <

180

DISEASES OF THE BRAIN AND NRRVKR.

Hctniphlegia.

When palsy affects an entire half of the body, dividing it through
the centre of the face, necl: body, etc., from head to foot, it is called
hemipMegia. It is more nearly allied to apoplexy than any other
form of the disease, and is generally ushered in by pretty well-marked
apoplectic symptoms.

Symptoms Sometimes there are no premonitory symptoms ; but

often before the attack there are flushed face, swelling of the veiris
about the head and neck, verti a sense of fullness, weight, and
sometimes pain in the head, ring the ears, drowsiness, indistinct

articulation of wordis, or even loa.s peech, confusion of mind, loss
of memory, and change of disposition, — amiable persons being made
sullen and peevish, and irritable ones mild and simpering. After
the attack, the countenance generally acquires a vague expression ;
the mouth is drawn to one side ; the lower lip on the palsied side
hangs down, and the spittle dribbles away. The speech is altered,
and the mind is generally impaired.

In some instances, the patient recovers in a longer or shorter time ;
in others, little or no improvement takes place, and the patient, after
remaining helpless, often for a long time, dies either from gradual
exhaustion, or suddenly from apoplexy.

Causes. — Hemiphlegia and paraphlegia are caused by pressure
upon the brain, by the effusion upon it of blood or water, by a tumor,
by mechanical injuries, by the striking in of eruptions, and by intem-
perance in eating and drinking. Paraphlegia often results from dis-
ease or injury of the spinal marrow.

Paraphlegia.

This form of palsy divides the body transversely, at the hips, and
confines itself to the lower extremities, and to the parts about the
pelvis.

Symptoms. — When it arises from affections of the brain, it is at-
tended by pain in the head, giddiness, drowsiness, dimness of sight,
and impaired memory. Numbness is sometimes felt in the upper ex-
tremities as a forerunner of this form of palsy. At first there is a
slight stiffness and awkwardness of the motion of the legs, which
continue to increase till a cane is needed to balance the body and
make it steady. From a paralysis of the neck of the bladder, the
stream of urine grows more feeble, and finally dribbles away involun-
tarily. The bowels are for a time costive, but when the circular
muscle which closes the fundament becomes palsied, the feces pass
without consent of the will.

When disease of the spinal cord is the cause of the complaint, it
is apt to come on gradually ; languor and weakness are felt in the

DISEABL:^ Or THE BRAIN AND NRRVES.

181

' it through
it is called
any other

irell-marked

ptoms ; but
f the veins
veight, and
1, indistinct

mind, loss
jeing made
ng. After
sxpression ;
ulsied side

is altered,

orter time;
tient, after
m gradual

Y pressure
ly a tumor,
. by intem-
8 from dis-

hips, and
ibout the

it is at-
of sight,
upper ex-
here is a
rs, which
x)dy and
dder, the
involun-

circular
ces pass

)laint, it
in the

knees, the legs are not easily directed in walking, — Ixsing throv/n
across each other, causing tripping and stumbling. By degrees the
loss of power increases in the thighs and legs, until at length the
whole lower extremities become palsied and useless.

Local Palsy.

Palsy is called local when it is confined to a single limb, or muscle,
or locality. One of these forms is called /acmi palsy. It affects one
half the face only, and is a good specimen of these affections. It
removes all power of expression from one half of the face, and leaves
the features still, blank, and unmeaning. With the affected side of
the face, the patient cannot laugh, or weep, or frown, or express any
feeling or emotion, while the features of the other side are in full
play. Among the ignorant, who do not comprehend the extent of
the evil, the drolluess of the expression excites laughter.

Shaking Palsy.

The nature of this form of palsy is well expressed by its name.

Symptoms. — The first symptom of this complaint is a weakness
and tremor of the head or hand. In about a year the other hand, or
the lower extremities become affected ; and the patient begins to lose
his balance in walking. Then the trembling becomes perpetual ; no
limb or part remains still. Reading and writing are no longer possi-
ble, and the hand cannot even carry the food to the mouth. The
balance cannot be maintained in walking ; there is a tendency to fall
forwards, and to avoid it, the patient is obliged to run or move
quicker, and upon the toes.

At a later period, the tremor continues during sleep ; there is in-
creased weakness ; the body is bent forward, the speech becomes in-
distinct, swallowing difficult, and the bowels torpid. At last the
urine and feces pass involuntarily, and delirium and coma bring life
to a close.

Lead Palsy.

In this disease the muscles of the forearm are palsied, so that the
wrists " drop," as it is said, and the hands hang down when the arms
are stretched out. It is caused by the gradual introduction of lead
into the system. It is a disease, therefore, peculiar to painters, —
particularly those who use carbonate of lead, or white lead, as it is
called. It is generally the sequel of painter's colic.

Treatment. — A sudden and severe attack of palsy requires the
same treatment as apoplexy. When the bowels a^re obstinately con-
stipated, they must be moved by scammony and croton oil (31), (32)
and by injections (246).

182

niSBABKS OF THR BRAIN AND NKRVE8.

When all tho syniptomH of (lutennination of l)l()o(l to the head have
disappeared, and t\w diHeawe hius Ixjconie strictly clironic, excitinjr
remedieH must he employed, as frictions, stimulating liniments, blis-
ters, stimulating baths, cold affusion, and electricity. Among the in-
ternal remedies, strychnine has the best reputation (85), (80). The
tincture of the poison oak is well recommended (284). An altera-
tive (145) should likewise be used.

Apply counter-irritants along the track of the spine, such as blis-
ters, the moxa, the compound tar-plaster, and the pitch-plaster.

At firat the diet should l)e light ; but after the more aciive symj)-
toms have disappeared, it should l)e nutritious, and sometimes stimu-
lating. Flannel undeVclothes should always be worn next the skin.

For lead palsy, the best remedies are iodide of potassium, or sul-
phuretof potassium. The dose of either of these is from three to ten
grains, three times a day, dissolved in water, one ounce of the salt to
six ounces of water, and taken in simple syrup. The affected limb
should also be soaked an hour each day in a gallon of water, with
half an ounce of sulphuret of potassium dissolved in it.

Hydrophobia. — Rabies.

The bite of the mad dog, or mad wolf, or other hydrophobic ani-,
mal, is the most dangerous of all poisoned wounds, because it is apt
to be followed by a disease for which there is no cei^tain remedy.
Fortunately, the human subject is not as susceptible to the effects of
the poison as some of the lower animals ; for only about one-tenth of
those bitten are attacked by hydrophobia.

Symptoms. — The interval between the bite and the appearance of
the disease varies from twelve days to two months. The wound
heals like any other bite of a similar animal. After a time, the scar
begins to have darting, lancinating pains, which, if it be a limb that
was bitten, run up towards the body. Sometimes it feels cold, or
stiff, or numb, or becomes red, swelled, or livid, and occasionally
breaks open, and discharges matter. The patient feels a strange anx-
iety, is depressed in spirit, has an occasional chill, and disturbed
sleep, and spasmodic twitches. The pulse is above its natural state,
both in quickness and strength, and the nervous system is very im-
pressible. The senses are all more acute; trifling noises produce
agitation, and the eyes are so disturbed by the light that the patient
sometimes hides himself in a dark place. The appetite is lost. This
is the first stage.

Thirst now appears, and he attempts to drink. But the moment
water approaches his mouth, a spasmodic shudder comes over him ;
he pushes it back with horror ; the awful fact of his condition flashes
upon him ; and he cries out, " What I have dreaded has come upon
me."

Thenceforward he can swallow no fluids ; complains of pain and

ip uMiia

head havo
!, exciting
lent*!, hlis-
»iig the in-
86). The
An alteia-

;h as bliH-
ster.

Dive syinp-
Ties 8timu-
t the skin,
im, or Kul-
iree to ten
the salt to
ected limb
^ater, with

ihobic ani-,
e it is apt
n remedy.
! effects of
le-tenth of

earance of

he wound

, the scar

limb that

s cold, or

[casionally

nge anx-

disturbed

ral state,

very im-

produce

le patient

1st. This

moment
/er him;
^n flashes

le upon

)ain and

DISEASES OF THE ORAIN AND NERVES.

188

stiffness about his neck ; is thrown into convulsions by the sight of
water, or even the sound of liquids agitated in a vessel, or by a
breath of air blowing upon him, by a bright light, oi- by the glare of a
mirror. His throat is full of a viscid, glary matter, wliich he con-
tinually tries to clear away. Thus, between convulsions, in which
lie struggles, and sometimes strives to bite his attendants, and com-
parative stillness, during which he suffers great depression of spirits,
lie passes three or four days, and then dies either in a spasm, or from
exhaustion.

Treatment. — Cut off the bitten part, or apply dry cupping, or
suction, at once. Also the caustic potash. The internal remedies
heretofore employed have had little success. Perhaps nothing now
known promises more than to have the patient vaccinated by the
recently discovered virus. The tincture of scullcap, in two or three
dram doses, will allay the nervous agitation, and is always worth
using. It has been proposed to clear the throat of the tough mucus
by cauterizing it with a strong solution of nitrate of silver (219), ap-
plied with a shower syringe. The remedy is worthy of a trial.

Some of the Western physicians declare the red duckweed, or scar-
let pimpernell, to be an absolute remedy for this disease, and cite
some quite remarkable cases of its success. Four ounces of this
plant, in the dried state, are directed to be boiled in two quarts of
strong beer or ale, until the liquid is reduced one half. The liquid
is to be pressed out and strained, and two drams of laudanum added
to it. The dose for a grown person is a wane-glassful every morning
for three mornings. A larger dose is required if the disease have
begun to show itself ; and if the case be fully developed, the whole
may be taken in a day. The wound is to be bathed with the same
decoction. The medicine, it is said, produces profuse sweating. It
is worth a trial.

Considerable has been said of late of a remedy used in some parts
of Europe, and said to be effectual. It is the " golden cenotides "
{cetonia aurata), or common rose-beetle, found in large quantities on
all rose-trees. A similar insect is said to infest the geranium-plant.
When collected, they are dried and powdered ; and given in this
form, relieve excitement (so it is said) of the brain and nerves, and
throw the patient into a sound sleep. Immediate suction and disin-
fection of the wound is admirable, followed by caustics.

Muscular and Nervous Derangements from

Wounds.

In some persons, a very small local injury will produce violent dis-
turbance of the nervous system. Some will faint and be thrown into
convulsions and vomiting from causes scarcely greater than the prick
of a needle ; and, before Morton gave the world the boon of ether, it

184

D18RA8K8 OF THK liRAIN AND NKRVBR.

wHH not very unoominoii for (lerBoiiH to die under tliu ku'iUi of tlx*
Hurg«5on. Olio of tho most serious disturbancws from wounds, of )i
nervous and niusuular uhuructor, is

Locked Jaw. — Tetanus.

This is spnsmodic contraction, with rigidity, or stififness, of the
voluntary musules. Sometimes this rigidity is {urtial, at other tinieH
univeraal throughout tlie system.

Tetanus is produced hy two causes, exposure to cold (idiopatiiic),
and bodily injuries, particularly the injury of a nerve (tniuniatic; te-
tanus). This last is the most frequent, — p'irhaps the only form of
the complaint.

The Symptoms are long-continued, violent and painful contraction
or cramp of the voluntiiry muscles. At first there is diiTiculty and
uneasiness in turning the head, with inahility to open the mouth
easily, — then the jaws close gradually, but with great firnnieHs ;
swallowing now becomes difficult, and a pain, starting from the
breastbonti, pierces through to the back, — probably caused by cramp
of the diaphragm or midriff. The cramps now extend to the muscles
of the body, the limbs, the face, the tongue, etc., which continue in a
state of rigid spasm, — being swelled and hard in the centre, — till
the disease yields, or tho patient dies. At times the abdominal
muscles are so tense as to make the belly as hard as a board. Occa-
sionally the patient is drawn backward into tho shape of a hoop, so
as to rest on his head and heels (epiathotonos) ; at other times he iri
drawn forward in the shape of a ball (emprosthotonoa) . All the con-
tractions are attended with intense pain. It is the racking of the en-
tire body with cramps like those which sometimes attack the calf of
the leg. So violent are the contractions that the teeth are dometimes
broken by them, and the tongue is often badly bitten. In the mean
time, the appearance of the sufferer is frightful. The forehead is
wrinkled, the brow knit, the eye-balls motionless and staring, the
nostrils spread, the corners of the mouth drawn back, the set teeth
exposed, and all the features fixed in a ghastly grin.

Treatment. — The only known remedies for this disease are chlo-
roform and ether, taken either into the stomach, or by inhalation, in
quantities sufficient to contr:)! the spasm, and to be pursued as long
as they continue to occur. The costiveness must be removed by one
or two drops of croton oil, administered in a spoonful of gruel. Re-
lieve the nerve or remove the foreign body from wound.

Epilepsy.— Epileptic Fits.

This disease has been sometimes called the failing aickneaa, but
generally passes under the more vague title of fit$.

DISBASEH UK THE lilUIN ANU NKRVBH.

185

nif(( (if till'
oiiiuIh, of u

lesH, of tlie
uther timeH

(Uoputliio),
uiiniitic te-
lly form of

contraction

RRculty and

the mouth

firmnt'HH ;

5 from the

i by cranij)

he muscles

ntinue in a

ntre, — till

abdominal

,rd. Occa-

a hoop, so

limes lie m

.11 the con-

of the en-

le calf of

sometimes

;he mean

irehead is

iiring, the

set teeth

are chlo-
alation, in
■id as long
ed by one
■uel. Re-

kneM, but

Symptoms. — The diseaso in characterized by a temporary Iosh of
fonBciouHnesH, strong spasnm and intervals lietween the tits. The at-
tack is sudden, generally witlumt warning, and attended with a loud
cry, when the piuient falls down, is senseless and convulsed, struggles
violently, breathes with enibarrasHment, has a turgid and livid face,
foams at t'le mouth, bites his tongue, has a choking in the windpipe,
and appears to 'o at the point of death. I'resently, in from five
minutes to half an hour, and by degrees, tiiese symptoms diminish,
and at length cease; and the patient falls into an apparent sleep. In
a short time more he recovei-s, and is aj)parently well. These attacks
come again and again, and at irregular intervals.

This is the worst form of the disease ; there is another class of
oases in which the symptoms are much lighter, — there being no tur-
gescence of the face, no foaming at the mouth, no cry, no convul-
sions ; but merely a sudden and brief suspension of consciousness, a
fixed gaze, a feeling of confusion, or a totter, from all of which the
recoveiy is speedy.

Causes. — These are numerous, — as worms, disturbance from indi-
gestible food in the stomach and Iwwels, difficult teeth-cutting, ner-
vous irritation, either direct or by sympathy, sexual excesses and
masturbation, disease or injury of the brain or spinal marrow, gall
stones in the excretory duct of the liver, stone or gravel in the kid-
neys and bladder, fright, distress of mind, passion, great loss of b^ood,
and many others.

Treatment. — But little can be done during the fit, except to pro-
tect the patient from being injured by the violence of the coBvulsions.
To do this, place a piece of leather, cork, or other substance not too
hard, between the back teeth to prevent the tongue from being bitten.
Remove the neckcloth, and unbutton the shirt-collar. If the stomach
and bowels are suspected to be overloaded, give an injection (246).

The treatment during the intervals must depend on the cause of
the disease. If worms be the cause, expel them ; if the attacks be
excited by difficult teething, Icnce the gums ; if by uterine disturb
ances, search out the nature, and give the treatment recommend jd
under the proper head ; if masturbation, command its entire discon-
tinuance as the only hope of relief ; if the complaint arise from in-
digestible food, great attention must be given to the diet and general
health.

In all cases, indeed, the diet should be carefully regulated, being
light, nutritious, and easy of digestion. The sleep should be taken
at regular houi-s, and daily exercise in the open air be insisted upon.
The bowels must be kept regular, by the food, if possible ; if not, by
mild laxatives. Apply along the spinal column 195, once a day, rub-
bing it well in ; also, now and then, mustard poultices.

In addition to these remedies, give pills of iron and quinine (72).
one after each meal, — also oxide of zinc (270), which is one of our

186

DIIKAHEB OP THK HRAIN AND NBRVRS.

very bent remedieH. Of tho pills, one nhould Ik; taken three timcN ;i
day. Kruniitle nf Hodium, 1 driiin in 24 luiurH, nioHtly at Iwdtime.

We can Holdoni go amiHH in giving medicine calculated to relievo
nervous irritation, and to huild up the general HyHtem. For tliiH pur-
pose, the valtM'ianate of quinine, and tho extract of hlack cohosli (7i))
are well adapted. Citrate of iron and strychnine (316), is a very val-
uable remedy.

It is said that a black silk handkerchief thrown over tho face of ii
person in a fit, will immediately bring them out of it. It is an ex-
periment easily tried ; and having seen it in a respectable medical
journal, I give it for what it is worth. The bromides in large doses,
long-continued, sometimes cure epilepsy (367).

Catalepsy. — Trance. — Ecstasy.

Cataleptic fits are simply what is known to all the world under
the name of trance ; and ecstasy is a modification of the same nervous
disorder. It is a state in which the mind becomes so intensely al>-
sorbed in something outside of its earthly tenement, that it withdraws
all control over the body, and all -apparent co:i'iection with it, leav-
ing it as if dead. There is a very light tick'ng of the heart, just pe:
ceptible to a cultivated ear, but the breast does not rise and fall with
breathing, tho features are all inexpressive and still, the eyes are wide
open and motionless, apparently staring after the departed intellect;
and the body and limbs are entirely passive, — remaining unmoved
where they are placed by others, however tiresome and uncomfortable
the position. In a word, a person in catalepsy is, in appeamnco, like
a marble statue, or like a human body suddenly turned to stone, or,
like Lot's wife, to a pillar of salt. There is as little feeling, or
thought, or consciousness, as if the bowl had been instantaneously
brokei< at the cistern, and the apparent death were real.

It is a peculiarity in this disease that the patient, on recovery
fron a fit, lakes up the thread of conscious life just where it was
broken by the attiick. Thus, if she were lifting a cup ci water to
the mouth, she would hold it steadily, with the mouth open, till the
return of consciousness, and then place it to the lips, as if no inter-
ruption had occurred ; or, if convei-sing, and in the midst of a sen-
tence, the unfinished words would be uttered at the end of the fit,
even though it should last many days.

Persons in a cataleptic fit have much the appearance of one in the
mesmeric state ; and the statue-like position in which an attack fixes
a patient, reminds one of the manner in which the psychologists, so
called, will arrest a man under iheir influence, and mttke him im-
movable, with one foot raised in the act of stepping.

The disease attacks females much more often than males.

The premonitory symptoms are much like those of epilepsy, and
the treatment should be about the same.

three times ii
it Iwdtinip.
0(1 to relieve!
For tliiH iMii-
: cohosii ('(!•)
is II very val-

tho face of a

It is an ((X-

:4ihle niedieui

» large doses,

world under
lame nervous
intensely iil>-
it withdraws
ivith it, leiiv-
art, just pe;
and fall with
3ye8 are wide
ed intellect;
ug unmoved
iicomfoTtable
earance, like
to stone, or,
! feeling, or
antaneously

on recovery
here it was
rf water to
)en, till the
if no inter-
st of a sen-
1 of the fit,

one in the
attack fixes
ologists, so
ce him im-

BB.

ilepsy, and

DISEASEtl or TlIK IIUAIN ANU MKRVIS.

Saint Vltu8*8 Dance.— CAorga.

187

This diaeaae is chiefly confined to children and youth between the
ages of eigh*. and fourteen. Hut few cases occur after pul)erty.

Symptoms. — The coniplaiht affects mostly the muscles and the
limlw. It excites curious antics, — such as we should suppose would
occur if a part of the muscles of voluntjvry motion had hatched a
mimic reUdlion, broken away from the control of the will, and in
sheer niiHchicf and wantonness, were tripping their fellow muscles,
and playing tricks with the patient. A few of the muscles of the
face or lindw Ixigin their mischievous pranTcs by slight twitches,
which, by degrees, l)ecomo more energetic, and spread to other parts.
The face is twisted into all kinds of ridiculous contortions, as if the
patient were making mouths at 8dmel)ody. The hands and arms do
not remain in one position for a moment. In attempting to carry
food to the mouth, the liand goes part way, and is jerked back, starts
again, and darts to one side, then to the other, then niouthward
again; and each movement is so quick, and nervous, and darting,
and diddling, that ten to one the food drops into the lap. If the at-
tempt be made to run out the tongue, it is snatched back with the
quickness of a serpent's, and the jaws snaj) together like a fly-trap.
The lower limbs are in a state of perpetual diddle ; the feet shuffle
with wonderful diligence upon the floor, as if inspired with a cease-
less desire to dance.

It is supposed by some that the disease consists in a partial palsy
of a part of the muscles. The will in that case not being able to
control the palsied muscles, when it commands the others to move,
tlieir action is not balanced, and they twitch the face and limbs into
all the capricious and fantastic shapes we witness.

Others, and probably with more truth, hold that the "seat of the
disease is in the cerebellum or little brain. It is supposed to he one
of the functions of this organ to preside over and regulate the loco-
motion, — that it holds the office of chief engineer, and that its
duties are to keep the muscles in subjection to the will. The com-
bined and consenting action of several muscles is needed for every
movement. It is the business of the cerebellum to maintain this
oneness of purpose and action — to see that no muscle flinches so as
to disturb the harmony of the movement. When the cerebellum is
diseased, all is confusion, — just as the locomotive runs from the
track when tho engineer is smitten with palsy.

The disease is not dangerous, but when it continues for many
years it is apt to weaken the mind, and it sometimes very nearly
destroys it.

Causes. — Whatever excites and weakens the nervous system, as
powerful emotions of the mind, overworking the mind, reading ex-
citing novels, eating too much meat, fright, striking in of eruptions,
self-pollution, etc.

188

DISEASKS OF THE BRAIN AND NERVES.

Treatment. — In the first plane, remove all causes of excitement.
Take the patient from school, and require some sort of cheerful out-
door exercise, daily. Take away all books, and be careful not to do
anything to occasion anger or fear, or any kind of injurious excite-
ment. Apply spinal ice-bags gradually and regularly.

In the second place regulate the diet — making it more animal
ard stimulating if it has been to low, and more vegetable and cool-
ing if it has been too high.

In the third place, if the above changes have not been sufficient
for the purpose, open and regulate the bowels with some gentle
phyBio (30), (34) for a few days.

In the last place, build u^^^ the nervous system with oxide of zinc
pills (270), three a day ; or iron (63), (80), or black cohosh, scull-
cap, etc. (79), or the compound valerian pill (81). Sulphate of
zinc (82) will sometimes succeed ^hon the oxide fails ; and where
there is scrofula, the iodide of zinc is to be used.

To these remedies should be added the shower-bath, beginning
with tepid water, and making it a little colder every day. If the
shower-bath frightens the patient, or is not otherwise well borne, take
the sponge bath. " Fowler's Solution " has the most marked effect
on the disease. Three drops gradually increased till coryza ensues ;
stop and begin again.

Chronic Chorea.

This can hardly be said to amount to a disease. It consists rather
in uncouth tricks, arising from some slight disorder of particular
muscles, and grown into a fixed habit, such as shaking of the head
every three to twenty seconds, repeated squinting of the eyes in con-
nection with a peculiar knitting of the eyebrows, wrinkling of the
nose, shrugging of the shoulders, lifting the ears up and down, or
even moving the whole scalp back and forth. These movements are
commonly made without a consciousness of it ; and generally there
is no power to suspend them without a painful effort which cannot
be easily continued.

No medical treatment is of any avail. These tricks can only be
corrected by great wajtchfulness and effort on the part of the person
suffering from them, and in many cases, not even by such means.

Cramps.

Cramp is expeiienced .n the calves of the legs, the thighs, the
stomach, the breast, the womb, etc. It is a very painful, sudden, and
violent contraction of one or more muscles. The part is sometimes,
as the phrase is, " drawn up into knots." When it attacks the stom-
ach, it is" a very dangerous affection. Women are subject to it about
the third or fourth month of pregnancy.

They occur more frequently at night as the result of over-fatigue

i>i Uii liii»rii|-Y'V.'j

DISEASES OF THE BRAIK AND NERVES.

189

excitement,
heerful out-
il not to do
ious excite-

lore animal
3 and cool-

ti sufficient
)me gentle

ide of zinc
hosh, scuU-
Julphate of
and where

beginning
ly. If the
borne, take
rked effect
'za ensues ;

sists rather

particular

f the head

3'es in con-

ng of the

down, or

lements are

lly there

ch cannot

m only be
^he person
leans.

pighs, the
iden, and
bmetimes,

(the atom-
it about

pr-fatigue

and indigestion during the day. These spasmodic contractions often
occur in the abdomen and are accompanied by diarrhoea due to indi-
gestion. Abdominal cramps are also a symptom of locomotor ataxia
and other spinal diseases. The cramp of swimming is often due to
an over-straining of some one group of muscles not hitherto much
used, the sudden fatigue causing cramp. They may be also of ner-
vous origin. Rheumatism is not infrequently the sole cause of pain-
ful muscular spasms.

Causes. — Drinking cold water when very hot and perepiring, ex-
posure to damp night air, debility, indigestible food, and excesses in
eating and drinking, and particularly over-straining the muscles.

Treatment. — Moderate the excessive labor and straining of the
muscles which produce the cramps. When an attack occurs in the
legs, tie a cord or handkerchief tight around the leg above the af-
fected muscle. This will generally produce instant relief. Aiso
briskly rub the parts with hot water, alcohol, ammonia, spirits of can-
phor, paregoric, or laudanum.

When it occurs in the stomach, apply warm fomentations, or what
is better, a mustard paste (165). Take hot Jamaica ginger or neuro-
pathic drops. The bowels, if confined, should be opened with an in-
jection.

Cramps of the limbs which afflict women in the family way, can
only be mitigated, not cured, till after confinement. As a palliative,
high cranberry bark, scuUcap, etc. (87), will be found useful.

Pain of the Nerves. — Neuralgia.

This disease affects one tissue only, — the nervous ; and has one
83anptom, — pain.

In apoplexy, the nerves, rendered powerless and senseless by an ex-
ternal force, are like a man under a bank of earth which has slid
down upon him. In palsy, they are suddenly bereft of feeling and
motion by a blasting scourge within, — as one is smitten down by a '
pervasive charge from a magnetic battery. In epilepsy^ the nerves
are grasped and for a time held senseless by an unseen power, in
which they struggle, as a man strives in the folds of the anaconda.
In catalepsy, they are suddenly stiffened into senseless strings, for
such automatic use as the bystander may, for the time, choose to
make of them. In chorea, they are set to dancing by an invisible ex-
hilaration, as a man is suddenly crazed by brandy.

In neuralgia, the nerves are neither crushed, nor collapsed, nor re-
strained for a time, nor stiffened, nor exhilarated. They simply have
their sense of feeling intensely exalted ; they are filled with pain.
The pain is generally of a peculiarly darting, piercing character. The
patien, sometimes calls it tearing pain. It comes on in sudden par-
oxysms, with intervals of freedom between. The attacks are some-

190

DISEASES OF THE BKAIN AND NERVES.

times like an electric shock, and are so agonizing as to bring a tem-
porary loss of reason. Occasionally there is great tenderness of the
parts affec ' and some fulness of the blood-vessels in the neighbor-
hood ; but generally the signs of inflammation are all absent, except
pain.

Neuralgic pains occur in almost every part of the system. One of
the most familiar forms of the disease is known under the name of

. Tic Douloureux.

It occurs in those branches of the fifth pair of nerves which go to
the face. (See Fig. 85.) Sometimes
one, sometimes all of the three branches
are affected, but more often the middle
branch only. When the uppor branch
is the seat of the disease, the pain is in
the forehead, the brow , the lid, and some-
times the ball of the eye. The eye is
generally closed during the pain, and
the skin of the forehead is wrinkled.
When the affection is in the middle
nerve, the pain is preceded by a prick-
ing sensation in the cheek, and twitch-
ing of the lower eyelid. Soon it spreads
in quick and piercing pangs over the
cheek, reaching the lower eyelid, the
sides of the nostrils, and the upper lip.
If in the lower branch, it sends its light-
ning shafts to the chin, the gums, the
tongue and even up the cheek to the ear.

Face-Ache. — There is a species of nervous pain called face-ache,
which does not quite amount to tic douloureux, but is nevertheless
veiy afflictive. It occurs principally in the jaw, which seems to be
filled with pain. No one spot seems to be more affected than another.
From the jaw the pain often goes to the whole head, but it has not
the stabbing intensity which generally characterizes neuralgia. It
often proceeds from defective teeth.

Hemicrania.

This is a neuralgic pain, confined to one side of the head, — gen-
erally the brow and forehead. Sickness of the stomach often attends
it, and in many cases it is periodical, — coming on at a certain hour
every day, and lasting a given time, and then passing away. .

It may be caused by whatever debilitates the system, as hysterics,
suckling an infant too long, or low diet. In fever and ague districts
it is frequently produced by miasm. In many instances, the cause
cannot be discovered.

FlO. 86.

DIBEASKS OF TUB BRAIN AND NBRVES.

191

ring a teni-
ness of the
le neighbor-
ient, except

m. One of
3 name of

which go to

face-ache^

levertheless

lems to be

,n another.

it has not

Igia. It

|ad, — gen-
attends
un hour

I hysterics,
districts
the cause

Sciatica.

This is a pain beginning at the hip, and following the course of
the sciatic nerve. Occasionally it is an inflammatory complaint;
sometimes is connected with an affection of the kidney; but fre-
quently it is a purely neuralgic or nervous pain ; and I have there-
fore thought it best to place it here, with nervous diseases.

Besides the various forms of neuralgia now noticed, the disease
occurs, — sometimes with great severity, — in the female breast, in
the womb, in the stomach, in the bowels, in the thighs, in the knee,
and even in the feet. In many of these cases the disease is not where
the pain is felt, but in the brain or spinal marrow, and consequently
the true source of the complaint very often escapes detection. An
excellent Episcopal clergyman in Northern New York, the Rev. M.

B , with whom I studied Latin and Greek preparatory to college,

had a neuralgic pain in the knee so intense, persistent and exhausting,
that the limb had to be cut off at the thigh to save his life.

Treatment. — This must be as diversified as the causes of the dis-
ease. For a general Bi use 368.

For tic douloureux, and some other forms, give internally, valerian-
ate of ammonia (88); also 89, 90, 91, 92, 93, 316, and 84, as tonics.

For external use in tic douloureux, and other neuralgic affections,
the prescriptions 188, 196, lb/,' 198.

For the face-ache, above mentioned, muriate of ammonia (134), in
half dram doses, is a very valuable remedy.

When the disease is caused by miasm, and has a periodic character,
like ague, it must be treated with quinine (67), (79), and if there be
a low state of the blood, iron (72), (93) must be given at the same
time. The galvanic battery often acts like magic in neuralgia.

The shower-bath, exercise in the open air, and whatever else will
build up the general health, must be used according to circumstances.

Neuralgic pain of various kinds often yields readily to some one of
the many coal-tar products like phenanthrene, antikamnia and ammo-
nol: say 10 grains of either every two to four hours according to the
intensity of the pain. The last named product is quite harmless and
produces no numbness or faintness which is said to follow at times
the use of some of the others.

Avoid rich or fatty foods. Live on a plain nourishing diet. Take
exercise out of doors as much as possible.

Derangement of Mind. — Insanity.

Most writers on this disease have attempted a definition of it. I
have never seen one which suited me. Here is mine. Insanity is a
wrench of marCs nature, which sets his intellectual and moral faculties
awry in their relations with the external world.

:;f

192

DISEASES OF THE BRAIN AND NERVES.

Ill a state of mental and moral health, he looks straight at the out-
ward world, and sees it as it is ; insanity gives him an angular con-
nection with it and he sees it as it is not; its objects have all changed
their relative places ; objects at the right in the panorama of life have
moved to the centre, or gone quite over to the left ; whil'i things at
the top have gone to the bottom, and those in the lowest places have
taken the highest. With the thoroughly insane, the world has gone
back to chaos.

These persons have their sensibility very much altered and per-
verted. Errors of the senses and illusions cheat them. In niaiiv
cases, they cannot read because the lettei-s are mingled in a confused
mass. They often do not recognize their friends, and regard them
as strangers or enemies.

They become awkward in the mechanical use of their hands, and
their touch loses the power to coirect the errors of the other senses.
Hence they are cheated in regard to the size, form, and thickness of
bodies.

They are haunted, at times, with smells which have no existence,
and thjey hear voices distinctly speaking to them from clouds, or from
trees ; and these voices have the familiar tones of a friend, reliitive,
or enemy.

The insane lose the power of comparing ideaa. They associate
things the most unlike, and often in a ridiculous way.

They also lose the control of themselves, and come under the do-
minion of their passions ; and then they will do acts which they them-
selves disapprove. One of strict integrity, of unblemished morals, and
of excellent standing, becomes insane, and immediately steals what he
does not want, makes infamous i )roDosals, and indecent gestures, and
is in every respect the opposite of ^lis past self.

The insane often become averse to those who were previously
among the most <lear to them. For acts of kindness, they repay
abuse. They fly from their best friends. This is the result of their
fear and jealousy ; for they are very cowardly and jealous. This alien-
ation from friends is almost a characteristic of insanity, and is one of
its saddest features. The moral affections are always disordered, per-
verted, or annihilated in insanity. So much is this a leading feature
of the disease, that it is only when the insane begin to recover their
moral affections, when they begin to wish to see their children and
friends, to fold them onc« more in their arms, and to enter the family
circle and renew its joys, that we can count upon any certain signs
of a cure.

The insane have a thousand strong fancies in regard to themselves.
One thinks himself inspired of God, and charged with the convei-sion
of the world ; while another, equally sincere, believes the devil has
entered into him, and that the pains of hell are already taking hold
of h'm, and he curses God, himself, and the universe. Still another
is the " monarch of all he surveys," and much more ; he governs the

-Al-:^

DISEASES OF THE BKAIN AMD NERVES.

193

t at the out-
.ngular con-
all changed
, of life have
\<i things at
places have
>rld has gone,

•ed and per-
i. In many
n a confused
regard them

r hands, and
other senses.
. thickness of

no existence,
3uds, or from
end, relative,

hey associate

mder the do-
sh they them-
|d morals, and
teals what he
gestures, and

previously
they repay
3sult of their
This alien-
md is one of
ordered, per-
,ding feature
•ecover their
children and
sr the family
sertain signs

I themselves.
_ convereion
le devil has
taking hold
Still another
[governs the

world, and directs the stars. One has all knowledge, and affects to
teach the wisest. Another is proud, and withdraws from his fellows,
bidding them not to come into his presence without proper acts of
homage, — calling himself, it may be, a king.

There are five kinds of insanity. I will speak of each of them
briefly.

Melancholy. — Lypemania.

This is characterized by moroseness, fear, and prolonged sadness.
The melancholic person is lean and slender, with black hair, and a
pale and sallow countenance. His skin is brown or blackish, and
dry and scaly. His physiognomy has a fixed appearance, the muscles
of the face are drawn tight, the eyes are motionless, and directed to
one point, the look is askance and suspicious, and the general expres-
sion is one of sadness, fear, and terror. He desires to pass his days
in solitude and idleness. He walks as if aiming to shun some dan-
ger. His ey< iind ear are on the watch for evil.

These persons do not sleep much. They are kept awake by fear,
jealousy, and hallucinations. If their eyes close, they see phantoms
which terrify them.

Their secretions are disordered. The urine is either abundant and
clear, or scanty and muddy. They sometimes retain their urine for
days. One patient did not dare to make water lest he should drown
the world, but was finally persuaded to it by the assurance that he
would extinguish a fire which was devouring a city.

Insanity on One Subject. — Monomania.

This is a chronic affection of the brain, not attended by fever, and
characterized by a derangement of the intellect, the affections, or the
will, upon one subject only. The patient seizes upon a false princi-
ple, 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. These they attempt to justify by plausible
reasoning.

Mania.

This is also a chronic affection of the brain, generally without
fever. The countenance of the maniac is sometimes flushed, at other
ti .es pale. The hair is crisped ; the eyes injected, shining and hag-
gard. Maniacs dislike the light, and certain colors horrify them.
Their ears are sometimes very red, and are disturbed by a tingling,
and a rumbling sound. Noise excites and disturbs them. They suf-
fer from false sensations, illusions and hallucinations; and their ideas
come with great rapidity, and are confused and without order. Their

194

DISEASES OF THE UUAIN AND NRKVKS.

affections are in a state of turmoil, and their judgments are all erro-
neous.

Unlike the monomaniac, their delirium extends to all subjecte.
Their entire intellect, affections and will, are a chaotic wreck.

Dementia.

Herk is another chronic affection of the brain, without fever, in
which the sensibility, the intellect, and the will, are all weakened.
Demented persons have not the power to concentrate their minds on
anything, and can form no correct notions of objects. Their ideas
float after each other without connection or meaning. They speak
without any consciousness of what they are saying.

Many of them have lost their memory, or, like old person-*, they
rememl)er nothing recent, — forgetting in a moment what is just said
or done.

The demented have neither desires nor aversions ; neither hatred
nor love. To those once most dear to them, they are totally indif-
ferent. They meet friends long absent without emotion, and part
from their dearest ones without a pang. The events of life passing
around them awaken in them no interest, l^ecanse they can connect
themselves neither with the past nor the future ; they have no remem-
brances nor hopes. Their brain is inactive ; it furnishes no ideas or
sensations. They are no longer active, but passive beings ; they de-
termine nothing, but yield themselves to the will of others.

They have a pale face, a dull eye, moistened with tears, an uncer-
tain look, and a physiognomy without expression. They sleep pro-
foundly, and for a long time, and have a voracious appetite.

Idiocy.

Idiocy is in the condition in which the intellectual faculties have
never been manifested. We are not to infer disease from it, any more
than we infer it in the lower animals from the absence of intellect.

In idiocy there is no mind, oecause the brain is not large enough
to be the organ of intelligence. It always dates back, therefore, to
the beginning of life. Everything about the idiot betrays a defective
organization. The demented person, the monomaniac, etc., once had
intelligence ; the idiot, never. They, in many cases, may be cured ;
he is hopelessly incurable. They had blessings which have been taken
from them ; to him, none were ever given. They were once the pride
and hope of their friends ; he, from his birth, was the smitten and
blasted one of his family. He never reaches an advanced age, —
rarely living beyond thirty years.

These remarks are sufficient to show the difference between idiocy
and other forms of mental d mgement. In the other forms of in-
sanity there are brains enougli, but they are diseased ; in this there is
no disease ; the smallness of the brain is the primal and fatal defect.

•'.i_j_^__

DISEASES OF THE DKAIN AND NRIiVES.

195

are all erro-

ill subjectB.
reck.

lut fever, in

11 weakened,

sir minds on

Their idesw

They speak

•erson-i, they
t is just said

iither hatred
totally indif-
)n, and part
life passing
can connect
fe no remem-
3 no ideas or
igs ; they de-
jrs.

rs, an uncer-
ey sleep pro-
)ite.

.culties have
it, any more
f intellect,
urge enough
therefore, to
; a defective
,c., once had
ly be cured ; .
been taken
Ice the pride
mitten and
ced age,—

Iween idiocy
forms of in-
this there is
Katal defect.

This form of menUil derangement is caused by a defective develop-
ment of the brain. That the other forms are produced by disease of
the brain, there can be no doubt.

Some have supposed insanity to be a mental disorder merely, hav-
ing nothing to do with the body. They might as well suppose the
delirium of fever to he a disease of the mind only.

Insanity is an unsoundness of the brain and nerves which proceed
from it, in every instance. At first it is probably only excitement of
the brain ; but this, long continued, becomes a chronic inflammation.
The brain and nerves of an insane person are undoubtedly sore, and
hence the painful thoughts and feelings which afflict them. When
the soreness is much increased, they are violent and furious ; when
it subsides, they are calm. In consequence of this inflammation and
soreness of the brain, an insane person can no more think, or reason,
or will, or feel correctly, than a person with an inflamed stomach can
dig6st food well, or than one with inflamed eyes can see v/'ell.

Causes of Insanity. — Hereditary predisposition ; painful subjects
of thought or feeling long revolv od in the mind ; injures feelings
which cannot be resented, mortified pride, perplexity in business ;
disappointed affection or ambition ; great political, religious, or social
excitements ; sudden and heavy strokes of misfortune in the loss of
property and friends ; and in general, whatever worries the mind for
a long time, and creates a deep distress, may be a cause of insanity.

But one of the most prolific causes, and worthy of special mention,
is masturbation, or self-pollution, — a vice contracted by thousands of
ycung people, both male and female.

Besides the above, I may mention several physical causes, as con-
vulsions of the mother during gestation, epilepsy, montlily disorders
of women, blows upon the head, fevers, loss of sleep, syphilis, exces-
sive use of mercury, worms in the bowels, and apoplexy.

Chances of Cure. — Idiotism is never cured.

Melancholy and monomania are cured when recent, and do not de-
pend upon organic disease.

Dementia is sometimes, though seldom, cured.

Chronic insanity, of long standing, is not easily cured.

Insanity which has been produced by moral causes, acting suddenly,
is generally curable ; if the causes have acted slowly and long, the
cure is more doubtful.

Excessive study causes insanity which is hard to cure.

If caused or continued by religious ideas, or by pride, it is not
often cured. ,

Insanity caused and maintained by masturbation is cured with
great difficulty.

Treatment. — The treatment of the insane is now almost confined,
as it should be, to public hospitals. In these institutions, all the
means are provided which humanity has been able to devise, to lift

106

DISKARKS OF THK BRAIN AND NKRVKS;

t'roui these unfortunate beings the terrible shadow which iK uiMtii
thera. Here they have safety, comfort, recreation, friendly guardians,
rest, and medicine.

They have safety from the annoyances which well-meaning but
mistaken friends at homo almost always commit in contradicting, iind
reasoning with, persuading, and threatening them ; for only in these
humane institutions has it been well learned that to do so is no wiser
than to pei-suade, scold, or threaten a neumlgic pain in the face, an
inflammation in the stomach, or a felon upon the finger. They are
safe, too, from the impertinent scrutiny of neighbors, the hootings of
unthinking boys in the streets, and especially from the causes, wliat-
ever they are, which have produced the disease. And so far, this is
just the treatment they want, — no contradiction, no impertinent
scrutiny from neighbons, no abuse in the streets, and a withdrawai of
the causes which have produced the disease.

In these institutions, too, they have comforts. They have clean
rooms, galleries, lodges, bathing-rooms, yards and gardens for exer-
cise and walking, safe, quiet, well-aired bed-rooms, and clean and
comfortable beds ; cheerful dining rooms, and plain, wholesome, and
nutritious food. And this, likewise, is the treatment they require.

They have recreation, — dances, cards, l>ack-gammon, chequei-s,
chess, billiards, nine-pins, walking parties, riding parties, gardening,
and an indulgence in those arts of painting, music, drawing and
architecture for which they may have a taste. And suc;h recreations
are powerful instruments in the cure of all disorders of the nervous
system.

Here, too, they have friendly guardians, who have long studied
their complaints, and have imbued their souls with a sympathy which
goes down into the depths of their sufferings, and allies itself with all
their sorrows ; — men and women who are willing to act the part of
guardian angels ; to be their friends ; who know how to gain their
confidence ; and who use the influence acquired by love, in leading
them back towards health and happiness. And this, too, in curing
the insane, is of great consequence, for none can do them good till
they have their confidence, and this can be gained only by love and
wisdom.

In these insane asylums, they find rest. When the brain is hot
from inflammation, and they are raving from delirium, they are here
withdrawn from the noisy crowd, and shielded from the rude shocks
of the world. If need be, they are placed in solitary rooms, where
silence spreads its soothing stillness through their excited brains.
And it is of the greatest importajice that the sore and torn feelings
should rest ; for rest allays excitement, and 'irings sleep ; and with-
out a proper amount of sleep recovery is : possible.

Finally, in these institutions, they receive the best medical treat-
ment. They have warm and cold bathing, judiciously administered ;
they have simple cathartics when the bowels are bound, as salts, cas-

■'>^«k;;S' •^•j'*3«'j(t?jyk»?-ii£i<u*-\^::<»i*A'^ij.*^

iv.

DISEASES OK THE BRAIN AND NERVKS.

197

;h is updii
guardians,

janing but
[ictiiig, and
ly in these
is no wiser
lie face, an
They are
bootings of
uses, \vhat>
far, this is
ni pertinent
hdrawal of

have clean
s for exer-
clean and
esome, and
T require.
, chequei-H,
gardening,
iwing and
recreations
le nervous

ig studied

ithy which

with all

le part of

jain their

n leading

in curing

good till

love and

lin is hot
are here
e shocks
us, where
brains,
feelings
and with-

cal treat-
nistered ;
lalts, cas-

tor oil, and magnesia ; tonics for debility, such aa quinine, iron, cas-
sia, columbo, chamomile ; and quieting medicines for their excite-
ment, such as opium, morphine, cicuta, hyoscyamus, belladonna, stra-
monium, scuUcap, and valerian. Prescription 74 is a combination
n)uch used. Here, too, broth, gruel, and milk, are administered by
the forcing pump to such as Uike a fancy not to eat, — an expedient
which has saved many lives. Fruits of all kinds, as strawberries,
cherries, currants, plums, apples, peaches, and grapes, are allowed
freely. Cold water, sweetened or otherwise, is the drink. To these
things are added lively conversation, and whatever will divert the
mind from reflection, and internal imaginings and revery.

Thus I have indicated, very briefly, the treatment which the insane
receive in public institutions. That the chances of recovery in these
humane retreats is much greater than at home, does not admit of a
doubt. When it is not convenient to send an insane person to a hos-
pital, the treatment should be as near like the one here sketched as
circumstances will permit.

Hypochondria.

The common names of this disease are low spirits, spleen, vapors,
nypo, and the blues. It produces constant fear, anxiety, and gloom.
Business, pleasures, the acquisition of knowledge, and all the useful
pui-suits of life, become insipid, tasteless, and even irksome to the hy-
pochondriac. His mind is full of the belief that something dreadful
is about to befall him. He is either going to be sick, or to die, or
lose his property or friends. He has no mind to engage in any busi-
ness, nor does he wish to go anywhere, or to see anybody. Night
and daj'^ his spirits are down to zero, and his heart has a load too
heavy to bear. He is wholly occupied with his troubles and his feel-
ings. He thinks he has various diseases, and wears out his friends
by talking of his sufferings. He feels of his pulse often, looks at his
tongue in the glass, and several times a day asks a friend if he does
not look pale or sick.

The external senses manifest symptoms of derangement as well as
the thoughts, feelings, emotions, and passions. There are roarings in
the ears, like a waterfall, or the noise of a distant carriage. Floating
black specks, or bright sparks, are seen before the eyes. These indi-
cate a slight fulness of the blood vessels, and perhaps, in some in-
stances, sparks of electricity passing to or from the eye, and are in no
proper sense subjects for the alarm they cause. At one time the per-
son will feel as large as a barrel, at other times not larger than a
whip-stock; the head will feel light or heavy, large or small. The
skin will twitch in different parts, or feel numb, or have the sensation
of spiders crawling on it. The smell and taste become perverted ;
the hypochondriac will smell odors and flavors, at times, where there
are none.

108

DIHKA8K8 OF Till BRAIN AND NKRVB8.

These errors of tin' HenneH arc all owing to soiin' Hliglit dJHordt'r of
the organH of sense ; and they are no more wonderful than that the
mind should perceive personal danger, poverty, and death itself, when
none of these things are impending.

These persons are subject to fainting turns, when the hreatliing
will appear to stoj), the body become cold, the face pale ; there will
be distress in the region of the heart, which will apparently stop l)eat-
ing, and the ])erson will feel as if dying. At the same time the mind
will remain clear. These nervous spells are alarming, but pass off
without danger.

These persons become changed in their moral dispositions. They
are jealous, fjike a joke as an affront, and feel the greatest distress at
any apparent lack of attention or neglect on the part of friends.
They put the worst construction upon the actions of friends. They
are irritable, fretful, peevish, and fickle.

The complaint is distressing, but does not appear to shorten human
life.

The seat of the disease is in the brain and nerves. It is caused hy
anxiety, care, disappointment, working the brain too hard, diseases of
the liver and stomach, costiveness, sedentary habits, excessive vene-
real indulgence, and masturbation.

Treatment. — This cHsease is more easily prevented than cured. It
would be almost entirely prevented in this country if in childhood we
were all taught to be contented with humble competence, to love ac-
tive labor, and to think it honorable, instead of struggling after
wealth, and falling into unhappiness when it does not come.

Remedies. — Of all the remedies for this complaint, that which is
most important is active employment out of doors. The human body
was made for motion. Without it the blood cannot be distributed to
the several organs. The senses, — the eye, the ear, the touch, —
should be much in communion with nature. In this way they are
strengthened. Nature is their great physician. Man is a creature of
aensation ; and if too much occupied with feelings, thoughts, and deep
reflections, the nerves will be irritated, and begin to give deceptive
sensations. A very nervous man should fly to some active occupa-
tion, if he would be rid of suffering.

The open, fresh air is very important to restore the system to
soundness.

Temperance, both in eating and drinking, will do much for this
class of patients, yet they are the very persons who eat largely, and
they often fly to the excessive use of stimulants to drive away their
sorrow. By so doing, they aggravate the disease.

Amusements are very important for hypochondriacs. Lively com-
pany, cheerful and witty conversation, with mirth and laughter, lively
songs and instrumental music, are all desirable ; and so are gunning,
fishing, riding, billiard-playing, und travelling.

. 1 . ~v- ^ .

niBKABKS OF THK HKAIN AND NRRVR8.

199

•liHonltT of
ill that the
iUelf, when

) breatliinfj
; tlwre will
y Htop l)eat-
le th(! mi IK I
)ut pa8H off

0118. They

b distress at

of friends.

nds. They

rten human

Never allow these patientw to Im- alone, and to have time to brood
over their mi.sery. See that they go early to l)ed, and rise betimes in
the morning. The warm bath, the (!old shower, or sponge ba'h, with
brisk frietion, arc. not on any account to be omitted. The diet should
bo light, nutiitious, ;«ii(l generous ; but fate, acids, liquors, and coffee,,
must Im* forbidden.

But little medicine will be required. If there be costiveness, let
cracked whaat lie eaten ; if this does not answer, a little rliubarb
and bicarlioiiate of potassa (85), or leptaiidrin, podophyllin, etc. (86),
may be given as required by the .symptoms. A teaspoonful of cal-
cined magnesia once a day, or the infusion of tboroiighwort, drank
cold, will often answer an excellent purpose. A 1m)w1 of warm
motherwort tea, with a teaspoonful of spirits of camphor in it will do
well in fits of fainting when there is a sensation of dying. A tea-
spoonful of sulphuric ether mayl)e given at the same time. If there
be debility, tonics are sometimes useful (50), (49), (54), (55).

8 caused l)y
, diseases of
essive vene-

m cured. It
tiildhood we
to love ac-
'gling after
ne.

at which is
uman body
tributed to
touch, —
ly they are
reature of
I, and deep
deceptive
ve occupa-

system to

for this
rgely, and
iway their

ively com-
ter, lively
gunning.

Hiccous^h. — Singultus.

Thw is a sudden, jerldng spasm of the midriff, occurring every few
niomentti in bad cases, causing the air to he driven out of the lungs
with such suddenness as to produce a noise something like the invol-
untary yelp of a puppy. It is generally caused by acidity of the
stomach, which irritates the nerves distributed to i^ neighborhood,
and is not diflRcult to remove ; but when it occurs towards the close
of some acute and gi-ave disease, it is sometimes a sign that dissolu-
tion is at hand.

Treatment. — Startle the person suffering, by exciting surprise, or
fear, or anger; or let a few small draughts of cold water l)e taken in
quick succession; or, let the brf;ath be held as long as possible. If
the stomach is sour, take a te».jpoonful of bicarbonate of soda, dis-
solved in half a tumblerful ot cold water. To expel wind from the
stomach, if it be present, take some warm aromatic essence of pep-
permint, ether, or conpound spirits of lavender. But one of the
most effectual remedies is heavy pressure made upon the collar hones.
It is simple, and very effectual. Cocaine, one-eighth grain every fif-
teen minutes, is a very simple and often efficacious remedy.

Fainting. — Syncope.

Fainting is preceded by a distress .about the heart, a swimming
of the- head, sometimes sickness at the stomach, colt'ness of the hands
and feet, and a loss of sight, or a sense of things growing dark. The
breathing diminishes, the pulse becomes small, the face deadly pale,
and the patient wilts down, and becomes more or less unconscious of
what is passing around.

Whatever causes debility, particularly of the nervous system, will

-weic-

200

DIBRA8C8 OK THE BHAIN AND NKHVB8.

predispoHe to fainting. Peraons much wetiktuuMl l)y dlHeivHc, faint
easily, especially when tiiey attempt to stand Htill. When on their
feet, such persouH HJiould keep moving. Fainting Ih HonietinieH in-
duced by Hudden surpriHeH and eniotionH, hy violent pains, by the
aight of human blood, and by irritation of tlie coats of the stomach
by indigestible food.

Treatment. — I^ay the ]>atient upon the baek,with the head low; let
freah air into tlie room instantly, and apply gentle friction. Sprinkle
a little coM water upon the face, and hold spirits of camplutr, etlier,
hartshorn, or vinegar to the nose, — rubbing a little of the spirits of
camphor U})on the forehead, and about the nostrils. As soon iis tiie
ptitient can swallow, give a teaspoonful of compound spirits ot lav-
ender, with ten drops of water of ammonia in it.

Persons subject to fainting should not go into crowded assenihlies
where the air is biid ; neither should they wear tight dresses, or allow
themselves to get excited. Cold bathing, a well-regulated diet, and
vegetable tonics, will do much to break up the habit.

Dizziness of the Head. — Vertigo.

This affection makes objects which are stationary appear as if
moving, or as the phrase is, " turning round." When seized with it,
one will have a sensation as if falling, and objects about him will
seem to be in motion.

It is caused by irritation of the nerves of the stomach in dvspep-
sia, by long application of the mind, by a weakened nervous system,
by hysterics, and by a fulness of the blood-vessels of the head.
When it proceeds from most of these causes, it is not dangerous ; but
when caused by impending apoplexy, it is a symptom of very serious
import.

f Treatment. — Find out the cause and remove that, and the dizzi-
/ BjBss will disappear. If it come from dyspepsia, eat lightly ; if from
' costiveness, open the bowels either by coarse food, by daily cold
\ water injections, or by some gentle physic. Avoid coffee, ardent
I spirits and late suppers, and take much exercise. Keep the feet

Iwarm, and the head cool. See to the liver ^d heart.

Disturbed Sleep. — Nijr'-

.. — Incubus.

In this complaint the sleep is di generally by some fright-

ful image. Whatever of an alarm. ^naracter is presented to the
raind in sleep, causes fear, or some other painful emotion, the same
as when awake. And when the attempt is made to resist, or to flee
from the danger, it is ineffectual, because the muscles are locked fast
in sleep. The fear being increased by the inability to escape, the
sleeper makes all sorts of horrible noises, indicating distress of mind.
The danger seen is as real to the sleeper as if he were awake, and he

niBEAHES OF THE BKAIN AND NEKVB8.

201

AciiHo, faint
iMi on tlieir
uutinieH in-
liiis, by tho
he Htomach

!ad low ; let
I. Sprinklo
|»li()r, otlicr,
w Hpii'iUt (if
8()on aH tli(5
irits ot lav-

[ asseuiblies
es, or allow
d diet, and

ppear an if
zed with it,
ut him will

in dvspep-
3U8 system,
the head,
jerous ; but
rery serious

:i the dizzi
|ly ; if from
laily cold
:ee, ardent
sp the feet

9US.

bme fright-
Ited to the
the same
, or to flee
locked fast
Escape, the
Is of mind.
Ike, and he

tries to do jiiHt what he would if awake. Sometiniea the Nonsution is
that some h(!avy weij;fht, or perhaps some horribh' monster, is iipoii
the breast, nearly pressing the brcatii out of the l)0(iy.

At times, the power of motion 'is not almcnt, and then disturbed
dreams may eanse one t(» talk, or to rise and walk, or run. Children
will laugh or cry, or scream, which shows that their minds are agi-
tated by different passions. Persons who indulge gloomy ..nd troub.
lous thoughts in their waking hours are apt to be disturbed with
sleep-walking, sleep-talking, and frightful drear.is, as of falling down
precipices, during the hours for repose.

There is nothing very wonderful al)out these disturbances of sleep.
It is only neciessary that there should be an unusual sensitiveness of
the brain, or that a hearty supper, eaten late, should irritate the
nerves of the stomach, atul that distressing tlioughts should be dwelt
upon during the day and evening, in order to produce all the walk-
ing, talking, dreaming of hobgoblins, shipwrecks, fires and polar
beai-s, which distress so many unfortunate sleepers.

In night-walking there is simply a little more wakefulness than in
night-talking, and in this latter, more than when one falls from a high
place, and in this perhaps slightly more than in real ineuhuif, when
one is in tin greatest peril, but cannot move at all.

Treatment. — When sleeping persons groan, or make any noise
indicating nightmare, shake them, and they will come out of it at
once. As these troubles are often caused by a weakened still e of
the nerves, much out-door exercise should be taken. The diet should
l)e simple, and well regulated. The suppers should be light, and
never taken late. The evening should be spent in some pleasant
amusement, which will drive awoy care ; and the last hours of wake-
fulness be occupied with pleasant reflections. One afflicted witli
nightmare should not lie upon the back, nor with the hands over the
head. Acidity of the stomach, and costiveness, if they exist, should
be removed by neutralizing mixture.

Headaches.

These are not alwajrs caused by disorders of the brain and nerves,
but they frequently are, and this seems the proper place to speak of
them.

It is unwise ever to neglect headaches. They are sources of great
suffering, and often lead to serious derangements of the health. In
childhood they have a more serious meaning than in adult life.
They often indicate the approach of scarlet fever, or measles, or of
other diseases.

Headaches are more common among the civilized than the uncivil-
ized ; more frequent among females than among males ; among those
of sensitive feeling than among the more obtuse ; among those who
think much than among those who think little ; among the sedentary
than among the active.

•■Sfssssr-

....ikU~kiMi»^' ^

202

DISEASES OF THE BRAIK AND NERVES.

Causes of Headaches. -They are dependent on various causes,
as derangement of the circulating system, of the digestive organs, of
the nervous system, etc. Among those dependent on disturbance of
the circulation, are

Headaches from Eye Diseases. — Myopia, or nearnsightedness ;
Hypermetropia, or far-sightedness ; Astigmatism, or the inability to
see equally well horizontel and vertical lines, as well as other irieg-
ularities of vision, are frequent sources of headache. These head-
aches are caused by overtaxing certain groups of muscles, or by fixing
the eyes too long on one objective point, as experienced in prolonged
study or reading, especially under unfavorable circumstances. These
headaches are more or less similar in their symptomatology. The
ache is generally dull, situated mostly in forehead and over eyes, but
may also be spread from base of brain to the eyes ; oftentimes it is
accompanied by nausea, especially after prolonged use of eyes under
improper conditions.

The treatment of these headaches consists in absolute rest of the
eye, in case of overwork, and the fitting, by a competent oculist, of
such glasses as will rectify the irregularity in the eye proper.

Astigmatism is a common source of headaches, and often is so in-
sidious in its development as to escape attention. A rough test
may be made by drawing several horizon*^"' and several vertical
lines in close proximity, and then placing pt fio»;>e distance (15 to 20
feet) from the eye. If either set cannot i « as clearly seen without
blurring as the other, you have good cause t,^ su' iect Astigmatism,
and should consult an oculist. Do not dally .„i these eye-head-
aches, as you will be doing -v permanent injury to your eyes.

Tea and Coffee Headaches — In the nervous, and oftentimes in
the gouty and rheumatic person, the use of tea or coffee will cause
violent headaches. Tobacco likewise after prolonged use shows a
tendency to head'^ches. The ie luxuries of life should be discontin-
ued at once for at least or j month. An extra strong cup of black
coffee, to be sure, will stop the headache for the time being, but only
adds fuel to the fjre in the long run. Bromo-caffeine, as ordinarily
sold by the druggists, taken in teaspoonful doses every half hour,
will relieve the malady. We would strongly advise any one that has
constant or periodical headaches, if he uses eithe" tea or coffee, and
especially coffee, to leave them off entirely for three months. It may
be the sole cause, and if caused by tea or coffee, there is no possi-
bility of their cure by medicines while you continue their use.

Plethoric Headaches. — These are dependent on a general fulness
of blood. They are of two kinds. One is occasional, and lasts but
a few hours. The other lasts for dajrs or weeks. It occurs most
often in the night or morning. Persons whose occupations require
stooping have it most. A little dizziness is generally felt on rising
up from a stooping posture. It is brought on by the bad air of

DISEABKH OK THE BKAIN AND NKRVE8.

203

•10U8 causeH,
fe organs, of
sturbance of

sightedness ;

inability to

other irieg-

These head-

or by fixing

in prolonged

nces. These

ology. The

krer eyes, but

sntimes it is

f eyes under

rest of the
it oculist, of
oper.

'ten is so in-
. rough test
eral vertical
ce (15 to 20
seen without
astigmatism,
sse eye-head-
yes.

tentimes in
; will cause
jse shows a
>e discontin-
up of black
ig, but only
ordinarily

half hour,
ne that has

coffee, and
It may

is no possi-

use.

sral fulness
lasts but

Bcurs most

|)ns require
on rising

I bad air of

crowded rooms, and is attended by costive bowels, short breath, and
a white furred tongue.

Tfie persistent headache is accompanied by a sense of fulness, and
sometimes of throbbing over the brows and temples, with a sensation
of dizziness, and of mist before the eyes. The sufferer feara exertion
and is constantly looking for a rush of blood to the head. Nature
sometimes relieves this form of headache by a diarrhoea, or by bleed-
ing from the nose.

There is another form of plethoric headache, differing slightly from
the above, in which there is too much blood, and it is made too fast,
but it does not circulate so rapidly. The muscles are not very firm,
and the heart does not propel the blood with much force. This form
of headache is connected with congestion.

Headaches of Indigestion. — These are caused either by taking
improper articles of food, or by eating too much of those which are
proper. The sensation in the head is not always a pain, but some-
times only a dull weight, attended by languor and disinclination for
exertion ; a tongue white in the centre, and pale red at the tip and
edges ; cold and numb fingers ; slight nausea ; languid and feeble
pulse ; dim and indistinct sight ; eyes aching when employed ; and
difficulty in fixing the attention.

Sick Headaclie. — This has received its name from the constant
nausea or sickness at the stomach which attends the pain in the
hf ^d.

This headache is apt to begin in the morning, on waking from a
deep sleep, or after sleeping in a close room, and when some irregu-
larity of diet has been committed on the day before, or for several
previous days. At first there is a distressingly oppressive feeling in
the head, which gradually merges into a severe, heavy pain in the
temples, frequently attended by a sense of fulness and tenderness in
one eye, and extending across the forehead. There is a clammy, un-
pleasant taste in the mouth, an offensive breath, and the tongue cov-
ered with a yellowish-white fur. The sufferer desires to be alone,
and in the dark. The hands and feet are cold and moist, and the
pulse feeble.

Accompanying these symptoms, there is a depressing sickness at
the stomach, which is increased by sitting up, or moving about.
After a time, vomiting comes, and relief is obtained.

Bilious Headaclie. — This is most common in summer and au-
tumn. It a^icts persons of dark complexion with black hair and
melancholy dispositions. There are two kinds, one is due to an ac-
cumulation of bile in the system ; the ^<ther, to a large secretion of
bile.

Ir; the first variety the skin is dingy and sallow, the spirits de-
pressed, the bowels costive, and there is wind in the stomach, with a
dull, aching pain on the right shoulder. The pain is in the forehead,

204

DISEASES OF THE BRAIN AND NERVES.

eyebrows and eyelids, and the " white of the eye " is a little yellow-
ish. The tongue has a brown fur, and is cracked in the centre.
There is a bitter taste in the mouth on waking in the morning, after
restless nights, and frightful dreams.

In the second variety, which is due to an " overflow of bile," the
symptoms are much like those of the first kind, but the pain is not so
continuous. In addition to the symptoms named, there is a throb-
bing, rending pain in the head, the skin is hot and the face flushv 1,
the limbs are sore, and there is a luminous halo or ring around ob-
jects looked at, and a feeling of giddiness.

Nervous Headaches. — These are more common among females
than males. They occur most frequently among persons of high sus-
ceptibility, who are easily elevated, and as easily depressed. They
are often connected with indigestion.

The pain is usually acute and darting, and is made worse by light,
with a feeling as if the temples were, being " pressed together," and
a " swimminess " in the head. There is sometimes a sense of sink-
ing, with a dread of falling, and great despondency and restlessness.
The bowels are generally costive, and the sight dim. The pain comes
on most commonly in the morning, lasts through the day, and abates
in the evening.

Hysteric Headache There is a nervous headache dependent on

the hysterical condition. It is generally confined to one small spot,
frequently over the eyebrow, and is sometimes compared to a wedge
or nail driven into the skull.

Headache from Exhaustion. — Still another species of nervous
headache arises from extreme exhaustion, produced by great loss of
blood, by diarrhoea, or by over-suckling. The pain is generally on
the top of the skull, and is often compared to the beating of a small
hammer on the head.

Brow Ague. — This is intermittent in its character, and is brought
on b}' exposure to cold and moisture in damp and marshy districts ;
and in this respect is much like ague.

Meg^rims. — This is most frequent among females. It is often de-
pendent on the same causes as Brow Ague, and is also produced by
long and exhausting watching over sick children, distress of mind,
and indigestion.

In both the above forms, the pain is intermittent, seldom lasting
long, but being of a sharp, piercing character like that of tic doulou-
reux. Tin pain of Megrims usually begins at the inner angle of the
eye, and extends towards the nose ; the parts being red and sore, and
the eye-ball tender. In Brow Ague, pain and great tenderness cover
an entire half of the head, compared by the patient, sometimes, to
" an opening and shutting of the skull." It begins with a creeping
sensation over the scalp.

DISEASES OF THE BRAIN AND NERVES.

205

ie yellow-
be centre,
ling, after

bile," the
1 is not so
i a throb-
ie flushv 1,
round oh-

g females

high 8U8-

id. They

J by light,
ther," and
e of sink-
jtlessness.
lain comes
bud abates

endent on
mall spot,
) a wedge

nervous
it loss of
erally on

a small

brought
iistricts ;

often de-
duced by
of mind,

lasting
I doulou-
Jle of the
lore, and
tes cover
limes, to
ireeping

Rheumatic Headaches. — These generally affect persons who have
been subject to rheumatism, and are often brought on by uncovering
the head when sweating. The pain is usually in the brow, (he tem-
ples, or the back of the head, and is dull and aching, — rather an in-
tense soreness than a real pain ; and the painful part is excessively
tender upon pressure. The skin is moist, but not hotter than natural.

Treatment. — In considering the treatment, I will take up the same
order in which I have spoken of the different forms of headache.

Plethoric Headaches. — Not much medicine should be taken for
these, if it can be avoided. A diuretic (131) may be taken twice a
day, and an occasional dose of gentle physic at night, followed by (7)
in the morning. This will generally give great relief.

Meat should be taken but once a day, and the whole diet should
l)e spare, the appetite never being fully satisfied. All spirituous drinks,
including distilled and fermented, should be let alone, and coffee like-
wise.

Much exercise should be taken in the open air. The hair should
be kept short, and the head elevated during sleep. Bleeding at the
no3e, when it occurs, must not be too suddenly stopped. Two drops
of the tincture of aconite root with three of the fluid extract of gel-
semium repeated once a half hour for three or four times will be
found to be of great value in the treatment of this form of headache.

The hot-water bottle applied' to thr o part of the spine between the
head and shoulder blades will also give great relief.

Congestive Headaches. — The exercise, diet, mode of sleeping,
etc., should be the same as in plethoric headaches. In this complaint,
there is too much blood in the head, and it inclines to stagnate. The
feet and hands are cold ; and gloves and stockings of wool, and other
bad conductors of heat from the body, must be worn.

Occasionally a little gentle physic (319) is desirable to induce the
bowels to act every day. If there is great debility, iron (71), (74),
(75), (320), will be required. The ic3 bag applied to the last six or
eight inches of the spine will call the blood to the extremities. The
aconite and gelsemium recipe as given above is also very useful.

Headache of Indigestion. — If the pain come immediately after a
meal, and can be traced to something eaten, an emetic (2) may be
taken, if the person be tolerably strong. If the pain come on some
hours after eating, take rhubarb and magnesia (28), (14), or fluid
magnesia. \VTien the system is debilitated, take a warm draught
(322) in the morning after a light breakfast, or twice a day, a bitter
with an alkali (323). If the stomach be very irritable, bismuth, at
meal times (324), (326). When it occurs after a debauch, take re-
cipe (325).

Sick Headache. — When it results from food taken, a draught of
warm chamomile tea, or a little weak brandy-and-water, will generally

:<1

206

DISEASES OF THE BKAIN AND MEKVEU.

I it

/ r

give relief. If the sickness continue, soda and water, with a little
ginger may do well, or a mustard poultice upon the stomach (166)
may be required. As soon as it can be kept on the stomach, a dose
of physic (826) must be tivken ; and if relief does not come after the
operation of this, give a bitter and an aromatic (327). The patient
must have perfect rest. If there be great lack of tone in the system,
the mineral acids (328), (329) will be excellent.

The diet must he carefully regulated, Jis in plethoric and conges-
tive headaches. Cocaine, one-eighth grain every fifteen minutes till
the nausea stops, and then a dose of physic is an excellent method of
treatment. Ten grains of amenonol (ammonol) every hour will
stop the pain, and very often tlie same amount of phenacetine will
accomplish the same result.

Bilious Headaches. — These are generally connected, more or less,
with some affection of the liver.

During an attack, if the suffering be great, attended by nausea,
give an emetic (2). In milder cases, give Tecipe (321). If there be
costiveness, give recipe (330) at night, and (7) in the morning.

A few doses of podophyllin, leptandrin, etc. (34), (36), (39), to re-
lieve the liver when the bile does not flow fast enough, will diminish
the frequency and force of the attack. The fluid extract of dande-
lion, taken for some time, often does good service.

The diet should be light, and chiefly vegetable, and exercise in tlie
open air must not be omitted. The daily sponge-bath, with friction,
is excellent,

Nervous Headaclies. — The first thing to be done is to relieve the
pain, and this may generally be accomplished either by preparation
(331), or (332), or (333), or (88), or (93), or two or three drops of
tincture of nux vomica in a spoonful of water, taken three times a
day. 351 will be found usually to be of most service.

In simple nervous headache, diet is of the greatest importance ; in
hysterical cases, exercise ; in headaches from exhaustion, tonics (81),
(79), r63), (73), (64), (61), (60).

Of the simple remedies found on the druggists' counter bromide
of caffein in effervescent form is very efficacious.

Riieumatic Headaches. — Take a light diet, with but little animal
food. Wear warm clothing, and avoid exposure to wet feet and damp-
ness generally, and go to a mild climate, if convenient.

When the local pain is great, apply hot fomentations, or a stimula-
ting liniment (334), or a mustard poultice, to the back of the neck.
In the beginning of the treatment, a little physic at night (335) is
useful. 10 grs. potassium iodide, gradually increased, in water, is
the best medicine.

Before closing this chapter on headaches, let me enter a respectful
protest against the indiscriminate use of the thousand and one reme-
dies advertised to cure headaches ; for in a great majority of cases it

with a little
omach (166)
mach, a doso
>me after tlie
The patient
1 the system,

and conges-
minutes till
it method of
y hour will
lacetine will

nore or less,

by nausea,
If there be
jrning.
(39), to re-
ill diminish
b of dande-

rcise in the
th friction,

relieve the
jreparation
36 drops of
3e times a

rtance ; in
nics (81),

sr bromide

tie animal
md danip-

a stimula-
the neck.
; (335) is
water, is

•espectful
•ne reme-
f cases it

DISEASES OF THE BRAIN AND NERVES. 207

given away by patent ^edi^Cl^L'^^^^^^^
cures for headaches. These vendera hav?l ''''""*^'^«^ ^heir specific
since the introduction into LlSrof thA Ti '" '^"'"''«^« "^ ^^^e,
samples of headache cures may S found "°^^-<^'; Products, so that
little while. For the molt Z7 thJ °" ''"^^ doorsteps every

H. acetenilide or antiSnr^cauro'f T^^^ "^ ^^** '^ ^"«^^
with other coal-tar producte It l\ cheapness as compared

them all,oftencausing Wueness of tt'T'^'^fl'^" ""^^^ ^^™f"l of
dizziness, faintness, etc^ W other 8imS«r^^''/"?"""«^ °^ *^« heart
ger may be expected, and yet no on^oulbf ^^^^^^ "'"^^ '^^°-

without the consent and a^ppiSri of thf f^.^r*'? ^ *''" ^^"^^dies
of phenacetine for an aduKDeated f^"/"""^^ Physician. 8 grains
will cure more headaches of ^1 5^117° ^?"' *'°'^' ^« doubt
drug. LactopheninandLlnolaresirn7.^" '^^ °'^^^ «^"^^«
headache which have the ^^^1^ J^ Jf ^^"^^^ "^"^^dies for
duct« without any of their iScte AnfT^ '^'^'"* ^ ««^^-*^^ P^o-
cine of the coal-tar group, enioys a Jart^ff^ ' proprietaiy medi-
but for general neuralgic pa n and,???' "1 '^"^^ ^°' headaches
eve^two to four houS a?^rdL"g^o^K TrL^t-^^^^^ ^°-
stop a large proportion of these aches ^^^f^^^^.'^^ "^ the pain, will
the bromides are always safe and nffl ^ ^^'^""^ combinations of
aches, especially if neTe-elemen? is Itrnr ' !?"''^* ^" ^'^""^ head-
caffein, bromoieltzer, bromc^oda eiV '^''' '^T''''''' ^romo-
small bottles in an eff rvesc'rand' p^iaS: f^"'"^ ^^' "^ ^

«.Ts>^!S5;3aiEEas3

DISEASES OF THE THEOAT.

The diseases which seat themselves in the throat, and in the great
cavity of the chest, have occupied a large share of my attention for
the last ten years. My practice in these complaints has been largo,
— being drawn from every part of the United States, and the British
Provinces. No class of diseases from which men suffer are more nu-
merous than these, and none have so generally baffled the skill of the
profession. For this reason, I wish to present here a brief, practical,
and common-sense view of these complaints, which shall be of real
value to the thousands of families who consult these pages.

Increase of Throat Diseases. — A striking increase in the number
of throat diseases has been witnessed within the last few years. A
person suffering from any of them will find, on speaking of his com-
plaint, that a number of his neighbors are afflicted with troubles of a
similar kind. I have thought that in some of their forms these dis-
eases have fastened upon the throats of not less than half our popu-
lation. And when it is considered that they are the natural, and if
unmolested, the certain harbingers of lung disease, it is wise to make
a note of the above fact. As I shall describe them in the nasal cavi-
ties, the pharynx, the fauces, etc., they all have a natural proclivity
downwards. From these upper cavities they pass, by one short step,
into the larynx, — the cavity where the voice is formed, — and then,
by another equally short and easy stage, into the body of the wind-
pipe. It is a singular fact that their progress is always from the
upper breathing passages downward, and never from the lower pas-
sages upward. They afford a parallel to the order of progression in
the moral world, in which evil tendencies are toward a lower depth.

A Mistake Corrected. — Before describing the several diseases
which belong to this family, I wish to correct the mistake which so
generally classes them all under the term Bronchitis.

They all consist in a simple inflammation, acute or chronic, either
of the mucous membrane lining the several cavities to be spoken of,
or of the small glands or follicles connected with that membrane ;
and each disease takes its name from its particular location. Thus,
the inflammation of the membrane lining the upper part of the throat,
or pharynx, is called Pharyngitis. Inflammation in the top of the

208

i. -..JiBMH

in the great
itention for
been largi;,

the British
re more nu-

skill of the
jf, practical,
. be of real

the number
V years. A
of his corn-
roubles of a
IS these dis-
f our popu-
iural, and if
ise to make
nasal cavi-
|1 proclivity-
short step,
and then,
the wind-
Is from the
lower pas-
jgression in
|wer depth.

il diseases
|e which so

bnic, either
spoken of,
lembrane ;
hn. Thus,

(the throat,
pop of the

DISEASES OF THE THHOAT.

windpipe, or larynx, is Laryngitis. In the windpipe, or trachea, it ia
IVachitis. In the bronchial tubes, it is Bronchitis. As the bronchial
tubes exist nowhere except in the lungs, below the division of the
windpipe, there can be no Bronchitis in the throat. Nevertheless, it
is the same disease with Laryngitis and Pharyngitis, and differs from
them only in being in a more dangerous place.

As the windpipe descends into the chest, it divides below the top
of the breast-bone into two branches, one going into the right, the
other into the left lung. These branches divide and subdivide very
minutely, and send their ramifications into every part of the pulmon-
ary tissue. Thus situated, Meckel has compared the windpipe to a

Fro. 86.

hollow tree with the top turned downward, — the larjmx and trachea
representing the trunk, and the bronchial tubes, with their innumera-
ble subdivisions, the branches and twigs. (Fig. 86.)

If the reader will now understand that the trunk and branches of
this bronchial tree 're hollow throughout, and lined with a delicate
and smooth mucous membrane, and that the diseases to be described
are inflammation either upon this membrane or the small glands con-
nected with it, causing swelling,Tedness, unhealthy discharges, rough-
ness, etc., he will have a good general idea of them.

Nasal Catarrh.

I TAKE these diseases in the order of their location. Nasal Catarrh
consists in inflammation, which begins behind and a little above the

■WRSrTBBBSSSS!?'

310

DISEASES OF THE THROAT.

veil of the palate, and extends upward from thence into the nose. It
is an exceedingly troublesome complaint, and afflicts great numbers.
It passes under the name of Catarrh in the Head.

The inflammation is not confined to the nasal cavities. It extends
frequently to the air-cavities, called antrums and ainvses, which cover
a considerable portion of the face, and extend to the lower part of the
forehead. Persons sometimes feel as if their whole face were in-
volved in the disease, and were almost in a state of rottenness, — so
great is the amount of matter discharged from the head. Such free
discharges cannot be wondered at when we reflect that all the air
cavities in the face are lined with the same mucous membrane which
lines the nose, and that they all communicate w ith the nasal cavities.

The " horn ail," among cattle, is a similar inflammation of the inner
surface of the horns ; and the " horse distemper " is an inflammation of
the air cavities in the head of the horse, and is much the same disease
with our catarrh in the head.

The catarrh often creates a perpetual desire to gtoallow, and gives
the feeling, as patients express it, " as if something were sticking in the
upper part of the throat"

When the inflammation has existed a long time, and ulceration
has taken place, puriform matter is secreted, and drops down into the
throat, much to the discomfort of the patient. Indeed, this is one of
the most distressing features of the complaint, as this matter often
descends into the stomach in large quantities, causing frequent vom-
iting, and a general derangement of the health. Many times the suf-
ferer can only breathe with the mouth open. Upon rising in the
morning a great effort is required to clear the head and the extreme
upper part of the throat. There is occasionally a feeling of pressure
and tightness across the upper part of the nose ; and the base of the
brain sometimes suffers in such a way as to induce headache, vertigo,
and confusion. The smell is frequently destroyed, and sometimes
the taste. The inflammation sometimes gets into the Eustachian
tubes, the mouths of which are behind and a little above the veil of
the palate, and extends up the lining membrane to the drum of the
ear, causing pain or deafness, and occasionally both. In addition to
this catalogue of evils, there is often added inflammation and elon-
gation of the uvula or soft palate.

Treatment. — The following is a fair illustration of my mode of
treatment: —

Mr. , of Boston, came under treatment for a bad case of ca-
tarrh in the head, complicated with follicular disease of the pharynx,
or upper part of the throat. In addition to nearly all the symptoms
mentioned above, he had a stench from the nose exceedingly offen-
sive to all about him. So much had the disease worn upon him that
he had become bilious, sallow, dejected, and low in strength and flesh.

When it is said that to all these were added a cough and loss of aj)-
petite, with insidious approaches of hectic, it will not be surprising

BT?-,-^

DISEASES OF THP! THROAT.

211

the nose. It
it numbers.

It extends
wrhich cov(!r
: part of the
ce were in-
snness, — so
Such free
/ all the air
brane which
isal cavities.
of the inner
immation of
lame disease

', and gives
ioking in the

I ulceration

wn into the

lis is one of

latter often

quent vom-

nes the suf-

jing in the

le extreme

of pressure

jase of the

he, vertigo,

sometimes

Eustachian

the veil of

•um of the

,ddition to

and elon-

ly mode of

[a&e of ca-
pharynx,
[symptoms
iigly offen-
him that
I and flesh,
[loss of aj)-
surprising

tliat his friends saw the most serious results impending, even tliougli
assured by me that the disease had not yet tiikisu a firm hold of Km
lungs. The first tiling done for him was to cut <»ff the uvula. Five
days after, I began to bathe the whole nasal cavity, thiee times a
week, with a shower syringe, by pushing the smooth bulb up behind
the veil of the palate, and throwing instantaneously a most dv<^licate
shower of medicated fluid up both sides of the septum. The upper
part of the throat was likewise bathed by the use of a shower syringe
made expressly for that part, and the larynx, or place where the voice
is formed, by a long, bent instrument made to reach this part of the
tliroat. The solution used consisted of half a dram of crystals of ni-
trate of silver dissolved in one ounce of soft water.

The nitrate of silver powder was inhaled once a day with the pow-
der inhaler. In this way the nasal cavities and throat were kept
cleansed, and the articles used gradually subdued the inflammation,
setting up a new and healthful action in place of the diseased one.
The stomach was relieved of the offensive matter which had daily
and nightly gone down into it, and the system of the poisonous ef-
fects of its absorption. The great danger which threatened the lungs,
and which would soon have been realized in their destruction, passed
away. The skin gradually resumed its P'-oper color ; the aopetite,
flesh, spirits, and strength came back, and Mr. B. has been oince in
the enjoyment of good health,. pursuing his business cheerfully.

When the above treatment fails, as it does occasionally, I am in
the habit of changing the solution, using sometimes a weak solution
of acid nitrate of mercury, twenty drops to an ounce of water. In
other cases, a solution of sulphate of zinc serves a good purpose. A
dilution of the tincture of arnica-flowers is a preparation of some
value in these cases. There are other preparations, too numerous to
mention, which I am in tKe habit of using. I will add, that the
nitrate of silver powder, snuffed once a day, a pinch at a time, is far
more successful than any other snuff ever made, but should be used
only in severe cases» and with caution.

Nasal catarrh is such a common affliction in the Eastern States, as
to be a widespread curse. Douching the nose with salt and water
(warmed) cleanses the nose of the foul mucus. The douche should
be from a bag hanging only a little higher than the head, or it may be
given by means of a common, blunt-pointed syringe, care being taken
not to use too strong force, nor to point the syringe in the direction
of the eyes. The stream of water should be directed straight ahead
parallel with the floor ; the mouth must be open, and the patient as-
sume the position of the countryman when gazing or gauking at the
sights on his first visit to the city. The water then runs down the
throat and also out of the other nostril. This process should be em-
ployed on both sides till the head is clean. The cablets put up by all
wholesale druggists, called "Carl Seller's alkaliae tablets," is the best
remedy for a nasal douche. The subsequent treatment is best ad-

!t-?«?«H9SSS?

212

DI8EA8RR OF THR THROAT.

vised b}' a physician, and usually consistH in thu use of soiue inloila-
tion or spray.

Inflammation of the Pharynx. — Pharyngitis.

This is an inflammation of the upper and back part of the throat,
or all that part which can be teen when the mouth is stretched open.
It causes a redness of the mucous membrane lining the part, which
is deep in proportion to the intensity of the inflammation. This
complaint is generally connected with the one I am about to desciilMi;
and since the treatment is the same the reader is referred to what
next follows.

Adenoid Growths.

In young children a very disagreeable catarrhal affection often ex-
ists in the naso-pharynx just behind and above the uvula. This is
caused by continued catarrh till at last small growth's occur like
proud-flesh, and not infrequently block up the passage from the nose
to the mouth, to that extent that not only is loud snoring produced at
night, but breathing becomes difficult by day. In severe cases the njv
per jaw becomes angular, and the face assumes a peaked, pinched look.
These growths are extremely common in children, and are produc-
tive of much mischief. The inability, in severe cases, to properly
breathe deprives the lungs of their proper amount of oxygen, so that
the little one suffers in nutrition and growth.

Treatment consists in scraping away with a scoop, or even with
the finger, these soft, granulating masses. The effect is almost mar-
vellous : the child breathes quietly, without snoring, the color re-
turns to the cheeks, and the blood receives a new supply of food from
the full supply of oxygen. In modern times, nothing has been in-
augurated in the treatment of children's throat and nose diseases so
beneficial and happy.

Clergymen's Sore Throat. — Follicular Pharyngitis.

This disorder made its appearance in this country in 1830, and the
attention of the profession was first drawn to it, as a distinct disease,
in 1832. Some have supposed its origin to have had a hidden con-
nection with the epidemic influenza which spread over the civilized
world in 1830, and affected all classes of persons ; but this is only
conjecture. In its early developments it attracted notice chiefly by
its visitations upon the throats of the clergy. Hence its popular
name of Clergymen s Sore Throat. It was soon found, however, to at-
tack all classes of persons indiscriminately, whether engaged in any
calling which required a public exercise of the voice or otherwise. It
was noticed more by public speakers and singers, on account of the
greater inconvenience it gave them.

The disease consists in a chronic inflammation of the mucous fol-

DI8EABBS OF THE THROAT.

918

tine iiilialii-

igitis.

tlio throat,
tched open,
part, which
tion. This
to descrilw;
ed to what

in often ex-
a. This is
occur like
ni the uose
iroduced at
vses the nj)-
iiched look,
ire produc-
to projiprly
jen, so that

even with
ilmost mar-
color re-
food from
been in-
Idiseases so

wngitis.

iO, and the
act disease.,
Idden con-
civilized
kis is only
[chiefly by
popular
Iver, to at-
\d in any
prwise. It
it of the

Holes, or glands, connected with the mucous membrane which lines
the throat and windpipe. The ottice of these little glands is to secrete
ii fluid to lubricate the air pa.ssages. When inflamed, they spread an
acrid, irritating Huid over surrounding part8, which excites inflamma-
tion in them. Hence a geneml inflammation of the upper [)art of the
throat or pharyngitis usually attends the follicular diseiwe, and I
shall speak of the two together. This inflammation of the glands
and the membrane, being neglected, iis it generally is, lingers on from
month to month, or from year to year, making in some cases slow
progress, in othera more rapid, — made a little worse and its step
slightly quickened by every fresh cold, and finally results in ulcera-
tion. The expectoration thenceforwanl becomes puriform, and finally
undistinguishable from that of consumption, with all the symptoms
of which the patient finally dies. Indeed, l)efore its nature was un-
deiTntood by the profession, it wiw considered the most fatal form oi
consumption, l)ecause it could Ikj affected only in a very small de-
gree, if at all, by medicines taken into the general system. For the
milder cases one will find great comfort in the use of the troches of
cubebe and ammonia, the inhalation of benzoin with steaming water,
also from such throat-tablets as the Chloramine.

Inflammation of iVIucous Membrane and Qlands
of Larynx. — '■ Follicular Laryngitis.

A FEW strong and beautifully formed cartilages unite to form a
curious and convenient box or cavity at the top of the windpipe,
called the larynx. Across this enclosure are stretched two remark-
able ligaments, called the vocal cords. They are from half to three
quarters of an inch in length, and are rendered more or less tense by
the small muscles with which they are connected. Just above these
cords are two cavities, which, with the ligaments, act an important
part in the formation of the voice. Here is produced the sound,
which is modified and articulated by the tongue, the lips, and the
r.i'^al cavities.

When disease reaches this cavity, and the fluid secreted to lubri-
cate ihese cords becomes acrid, the voice, from this and other causes,
is made hoarse ; and when, at length, these ligaments are altered in
structure by inflammation and ulceration, the voice suffers a gradual
extinction. I haro treated a large number suffering entire loss of
voice, and am happy to say it has been generally restored, where the
lungs have not been involved in the disease, '^here is often also a
little sensitiveness, or even soreness, in some cases, in the region of
the larynx, which may be felt by pressing upon that prominence in
front of the throat, called Adam's apple.

icous fol-

214

DI8RA8R8 OF TIIK THROAT.

Inflammation in the Windpipe.— Tracheitis.

This complaint and the one preceding it differ only in their local-
ity from those deHcribed in the upper cavities ; and they are more
alarming, IwcauHc two removes nearer the citadel of life. Happily,
we know that the seat of these diseases may be easily reached, and
we have a shower syringe, so arranged as to pour the remedial i.gent
directly upon them, without any loceniting disturbance of the parts.

Symptoms. — The approach of these disorder is often so insidious
as hardly to attract notice, — sometimes for. months, or even yeans,
giving no other evidence of their presence than the annoyance of
something in the throat to be swallowed or hawked up, — an increased
secretion of mucus, and a sense of wearisomeness and loss of power in
the throat, after public speaking, singing, or reading aloud. At
length, upon the taking of a severe cold, the prevalence of an epi-
demic influenza, or of an unexplained tendency of disease to the air-
passages and lungs, the throat of the patient suddenly becomes sore,
its secretions are increased and rendered more viscid, the voice grows
hoarse, the difficulty of speaking is aggravated, and what was only
an annoyance becomes an affliction, and a source of alarm and dan-
ger. These diseases clearly belong to the family of consumption, and
need early attention.

Causes. — It is amusing to reflect upon the theories which writers
were in the habit of constructing, a few years since, to account for
the throat affection among the clergy. It was attributed by some to
speaking too often, by others to speaking too loud. One class of
writers thought it arose from muffling the neck ; another, from a
strain of voice on the Sabbath to which it wajs not accustomed on
other days.

The cause lies deeper than any of these trifling things. As it con-
cerns ministers it may generally be expressed in two words, — labor,
anxiety.

The clerical order are placed just where they feel the force of the
high-pressure movements of the age. They are the only class of
recognized ingtructors of adult men, and are obliged to make great
exertions to meet the wanta of their position. The extremely trying
circumstances in which they are often placed, too, in these exciting
times, by questions which arise and threaten to rupture and destroy
their parishes, weigh heavily upon their spirits, and greatly depress
the vital powers. And when we add to this the fickle state of the
public mind, and often the shifting, fugitive character of a clergy-
man's dwelling place, and the consequent liability to poverty and want
to which himself and family are exposed, we have a list of depressing
causes powerfully predisposing to any form of disease which may
prevail.

niSEASEB OF THE THROAT

216

heitis.

their looal-
y are more
Happily,
cached, and
ledial i.gent
f tlie parts.

so insidiouH
even years,
noyance of
bii increased
of power ill
vloud. At
I of an epi-
I to the air-
comes sore,
voice grows
it was only
n and dan-
[uption, and

lich writers
iccount for
by some to

e class of
ler, from a

tomed on

I As it con-
3, — labor,

|rce of the
class of
[ake great
|ely trying
exciting
Id destroy
ly depress
Ite of the
la clergy-
land want
Bpressing
lich may

It will Im) pardoned me, I think, if I Kuggest here, that tho nature
of a clergyman's calling is of so serioiiH a eh. \ctor, that ho some-
times (;arri(!H himself with too much Hcdateness, keeps himself too
much braced up, and does not allow himself hours enough of that
cheerful, light-hearted abandon, which is essential to the health of
every sedentary man of mental habits. The hard-thinking and hard-
working minister, who will retain his health and save his throat, must
have some moments, at UniHt, when the weighty responsibilities of his
oJfice are lifted up from his soul, and he becomes, for the hour, the
jocund, playful boy of earlier days. How far he can consistently re-
lax and let himself down, or in my view of the matter, raise himself
up to the simplicity and mirth of childhood, he alone can be the judge.
As a physician, I prescribe ; as a minister, he must decide how far
my prescription can be followed.

Reading Sermons. — There is one practice, which, though it has
not much to do with inducing this disease, does frequently aggravate
it when once established ; I mean the habit of reading sermons from
manuscripts, — especially when it is done in a sort of mechanical
way. Every person who has suffered from throat-ail has doubtless
noticed that to read aloud, for half an hour, from a book, occasions
more fatigue and irritation in the throat than extemporaneous speak-
ing, in the same tones, for one or two hours. The reason is, that in
the latter case the mind conceives the thought in season for the or-
gans of speech to fall into a natural attitude, and utter it with ease.
The two work hannoniously together, — the instruments of articula-
tion following the mind, and easily and naturally uttering its concepn
tions. Whereas in the case of reading, the mind itself is, at least
partially, ignorant of what is coming until it is just upon it, so that
the organs of speech, being warned of what is to be done only at the
moment their service is required, do their work under a perpetual
surprise and constraint. The difference is, in some respects, like that
between walking freely at large, without regard to where the feet are
put down, and being obliged to step exactly in the footprints of some
traveller who has gone before. In the latter case, the muscles tire
much sooner, because they work in fetters.

I have thus spoken particularly of the clergy, though it is not by
any means they only, but all classes Oi people who are afflicted with
tliis dangerous malady.

These diseases often begin with a cold. But colds are seldom taken
except when the nervris system is depressed, so that they are, in fact,
to be traced back to the same cause which I have assigned to catar-
rhal or throat complaints themselves.

These Complaints Worse at Night. — It is worthy of note, that all
these complaints, and many others, are worse during the night. This
is easily explained when we remember that the atmosphere has the
least amount of electricity in it at three o'clock in the morning, and
that the first minimum atmospheric pressure, which happens twice a

216

DISEA8K8 OF THE THROAT.

day, occurs not far from the same hour. From three to four in. thr
mom'.ng, therefore, the nerve-power sinks to its lowest ebb; and those
diseases which owe their existence to anxiety, overwork, etc., suffer,
at this time, their greatest daily aggravation. Death occura, too, more
often during these hours, than in any other poi-tion of the twenty-
four.

Treatment. — Some years ago these diseases were thought to be
incurable ; and by all the appliances of medical art then known, they
were so. But time has brought a successful method of treatment, as
well as a clearer knowledge of their nature.

This treatment consists in what is called topical medication, or the
applying of the medicine directly to the diseased part. The medici-
nal agent more extensively used than any other is a solution of crys-
tals of nitrate of silver. This substance is not, however, adapted to
every case, — other articles succeeding better in some instances. Mod-
ern chemistry has given us a variety of agents from which the skilful
physician may select a substitute, should the nitrate of silver fail.

The operation of appljdng this and other substances to the air pas-
sages, is a delicate one, requiring tact and experience. Surgeons had
supposed it an anatomical impossibility to introduce an instrument
into the larynx ; but this has been practically demonstrated to be a
great mistake.

Instruments. — The instrument devised and used by Dr. Horace
Green is a piece of whalebone, bent at one end, to which is attached
a small, round piece of sponge. This, dipped in the solution, is dex-
terously introduced into the laryngeal cavity, and applied directly to
the diseased part.

I formerly used this instrument myseK, and am happy to know,
that, notwithstanding its defects, it was generally successful. Yet
where the larynx was highly inflamed, with a swollen and ulcerated
condition o*. the epiglottis and lips of the glottis, I am sure I some-
times had the singular powers of the nitrate of silver put at defiance
by an irritation evidently produced by the eponge of the probang.
Upon its introduction, in such cases, the parts contract upon and
cling to it, and suffer aggravated irritation, almost laceration, upon
its withdrawal, however carefully effected.

Laryngeal Shower Syringe. — Such defects in the probang led me
to contrive an instrument, which I call a Laryngeal Shower Syringe.
It is in the form of a syringe, the barrel and piston of which are
made of glass, silver, or gold, as may be desired. To this is attached
a small tube, made of silver or gold, long enough to reach and enter
the throat, and bent like a prolong, with a globe or bulb at the end,
from a quarter to a third of an inch in diameter, pierced with very
minute holes, which cover a zone around the centre about one-third
of an inch in breadth.

This silver bulb I daily introduce into highly inflamed and ulcer-

DISEASES OF THB THROAT.

217

' four ill til,'
<; and thoso
, etc., suffer,
irs, too, more
the twenty-
ought to be
known, they
treatment, as

jation, or the
The medici-
ition of crys-
r, adapted to
ances. Mod-
h the skilful
ilver fail.
) the air pas-
Surgeons had
1 instrument
ited to be a

r Dr. Horace
ii is attached
ition, is dex-
d directly to

)y to know,
jssful. Yet
id ulcerated
lure I some-

at defiance
le probang.
It upon and

ition, upon

ing led me
\er Syringe.

which are
lis attached

and enter
}.t the end,

with very

one-third

land ulcer-

ated larynges, generally without any knowledge of its presence on
the part of the patient, until the contained solution is discharged.
The instrument, being charged, is carried to the proper place, when a
delicately quick pressure upon the piston causes veiy fine streams to
flow through the holes in the form of a delicate shower, and all sides
of the walls of the larynx are instantaneously bathed.

How Introduced. — The introduction of this instrument into the
larynx is easy. Upon the approach of any foreign substance, the epi-
glottis instinctively drops down upon the entrance to the larynx,
guarding it against improper intrusions. It has been found, however,
that when the root of the tongue is firmly depressed, this cartilage
cannot obey its instinct, but stands erect, its upper edge generally ris-
ing into view. Availing himself of this, the surgeon has only to de-
press the tongue with a spatula, bent at right angles, so that the left
hand holding it may drop below the chin out of the way, and as the
epiglottis rises to view, slip the ball of the instrument over its upper
edge, and then with a quick yet gentle motion, carry it dovmward and
forward, and the entrance is made. I have often admired the faith-
fulness of this epiglottic sentinel, who, when overborne by superior
force, stands bolt upright, and compels us to enter the Sacred temple of
speech directly over his head !

Pharyngeal Shower Syringe. — For washing the upper part of the
throat, I construct the instrument with a straight tube, with holes
over the outer end of the globe, and extending to the centre. This
washes instantaneously the fauces and pharynx, but does not throw
the solution back upon the tongue. Its main advantage over the
probang is, that it Imthes every part of the fauces and pharynx in-
stantaneously, and does not subject the patient to the coughing and
gagging which follow the slower and rougher process of drawing the
sponge from side to side across the cavity of the throat.

Nasal 5hower Syringe. — Inflammations in the back passages to
the nose, called catarrh in the head, have been almost inaccessible by
any reliable healing agent, and consequently incurable. The probang
could only reach a short distance, and occasioned great suffering. I
have had a syringe constructed with the tube bent at an angle of
forty-five degrees, and the ^lobe, very small, pierced with a few fine
holes at the upper end. Carrjang this globe up behind the velum
palati, with a single injection I wash both passages clear throu gh. I
have had the pleasure of curing a large number of bad cases, of many
years' standing, to the surprise and delight of the patients.

About nineteen-twentieths of the physicians who have examined
these instruments, and so far as my knowledge extends, all who have
used them, think them much better than the probang. As to patients,
I have yet to see one who will allow the sponge to be used after try-
ing both.

Have Superseded the Probang. — In my own practice the syringes

■onti

mmmm

218

DISEASES OF THE THROAT.

have superseded the probang altogether. My reasons may be briefly
stated. I have already said there is less irritation produced. A piece
of sponge drawn over an inflamed surface, especially when clung to
by the irritated and quivering paits, mast necessarily, in some cases
at least, aggravate the symptoms of disease. To tliis consideration
add the comfort of the patient during the operation. It is so quickly
and delicately done with the syringe, that it is scarcely known when
tiie act is performed. The straight syringe does not touch the throat
at all. On touching the probang to the throat, the nitrate of silver
unites with the mucus upon the surface, instantly covering the sponge
with an albuminous pellicle, something like that which lines the shell
of an Q^g, preventing, in a degree, the further pressing out of the
solution, and rendering its contacts with other parts of the surface
comparatively powerless. For this reason, the sponge pushed down
into an ulcerated bronchus, as Dr. Green recommended, must be ut-
terly valueless as a remedial agent. Mopping, as it does in its whole
course, a larynx and trachea, lined in some cases with puriform niat>
ter, and generally with mucus, every inch of its descent doubles the
gravity of this objection. Let it be considered, too, that in applying
the remedy to an ulcerated larj'nx, the sponge cauterizes the healthy
parts above, in its descent, and thus unfits itself lor doing much for
the diseased part ; whereas the syringe retains its solution till it
reaches the affected place, and then pours a clean shower directly
upon it, and upon no other part.

Considering these manifest advantages of the syringes, I am sur-
prised that any physician should still use the probang, — especially as
one of these instruments, the Nasal Syringe, accomplishes an object
which the probang cannot effect at all, not even in a rough way. I
have wondered, too, how any parent can allow a child, suffering with
croup, to be tormented by having a sponge pushed down its throat,
when a syringe would give it so much less pain.

I will mention briefly one or two cases of croup and diphtheria, se-
lected from a great number treated by me for the last few years, where
the syringes were successfully used, after several attempts to use the
probang had been made, and failed, and where the pain caused by
using was so small, and the relief so instantaneous and complete, that
the patients were anxious for my return to use it again.

I was called to see a little boy of Mr. R., five years old, who had
had an attack of membranous croup some days previous ; and when
I saw him the voice had sunk to a whisper, and the cough was en-
tirely muffled, so that I had no doubt of the fatal termination of the
case, and expressed my opinion to that effect to the astonished parents.
The probang had been used by the physician in attendance, which
had caused so much suffering that for the two days previous the par-
ents had prohibited its use. It had no doubt increased the irritation,
besides nearly causing strangulation.

It was, therefore, with great reluctance that they consented to let

DISEASES OP THE THROAT.

219

I to let

me use the syringe, which I did, to the great relief of the little suf-
ferer, and to the entire satisfaction of the parents.

The strength of the solution of the crjrstals of the nitrate of silver
used was 20 grains to the ounce of water, which I injected freely,
once in three hours for the first day, and then two or thi-ee times a
day for two or three days. His recovery was rapid and complete.

I will now mention the case of a young woman, with diphtheria,
where the syringe was used with success.

I was called to see a young lady, who had an attack of diphtheria
the day previous. Found her in bed, very much prostrated, breath-
ing with great difficulty, and uttering at every inspiration a croupal
sound, which at times was followed by a short, convulsive cough.
The face was flushed, pulse 124, small and feeble, and she complained
constantly of a sense of suffocation and of great distress in the lar-
yngeal region.

On inspecting the throat, the fauces and the pharyngeal mem-
brane, as far down as it could be seen, presented the appearance of a
high degree of inflammation. One of the tonsils was nearly covered
with the diphtheric membrane, and the upper and back part of the
throat were thickly studded with small white or cream-colored spots.

The physician in attendance had tried first a swab, or mop, as she
termed it, and then the probang, which gave her so much pain that
he was obliged to give it up. He then gave up the case as hopeless.
At my earnest solicitation she consented to the use of the syringe.
With a solution of the crystals of the nitrate of silver, of the strength
of 60 grains to the ounce of water, I injected freely the fauces and
the upper part of the cavity of the larynx. For a few moments the
difficulty of breathing and feeling of strangulation was increased,
but very soon a large amount of viscid, ropy mucus was discharged.
In the course of half an hour after the use of the syringe, the symp-
toms had improved, the respira-
tion was less laborious, so that
in a short time the patient ob-
tained some sleep. I was after-
ward called, aa she thought her-
self worse, but found that an
application of the caustic with a syringe was all that was required.
There was no further trouble with the case.

These syringpo or similar ones can now be bought of any large
dealer in surgic-.i i.istruments. Figure 87 represents the syringes as
they lie in a case.

Mode of Using. — The glass barrel and piston of my instruments
are delicate, but they ueed not be broken. I handle them with the
same east, that I do a spoon in feeding myself, and not in a very dis-
similar wfvy. The Ir^st three fingers are placed on the under side of
tlie barrel, with the thumb on the upper side, — the index finger be-
ing poised over the end of the piston, ready to drive it home at the

rio. 87.

. rrM«iiaHCKMMP«

220

DISEASES OF THE THROAT.

V \

proper instant. The motion of the piston should be quick, so as to
cause the streams to leap out in jets ; yet delicate, that they may not
impinge with too much force upon the diseased surfaces.

They should be rinsed with water immediately after being used.
But even with this precaution, a small residuum of the nitrate re-
mains and crystallizes, and after a time partially closes the holes.
They must then be picked out with the point of a needle.

When the silver tube becomes detsvched from the glass, it may be
fastened on with common sealing wax ; first melting the wax and
sticking it around the glass; then heatirg the silver over a lamp, and
pressing it on.

Amount of Solution to be Used. — The amount of solution to be
used should be small. Half a dram is enough. The piston of the
syringe need be drawn up only from an eighth to a third of an
inch. Strangling is not often produced by these operations ; but to
make its prevention still more sure, let the patient be directed to fill
the lungs with a long inspiration while the operator is depressing the
tongue.

Strength of Solution. — The strength of the solution in ordinary
cases of chronic folliculitis, etc., should generally be about forty
grains of the crystals of the nitrate of silver to the ounce of water.
But in all acute diseases of the air passages, it should be considerably
stronger, — varying from one to two drams. A preparation of this
strength is powerfully antiphlogistic and sedative. In those cases of
chronic disease, where the inflammation is of a low grade, and the
mucous membrane is in a relaxed, atonic condition, looking either
sodden and pale, or of a dark color, like the cut surface of beef some
days exposed to the air (as is often the case in throats of literary dys-
peptics), then a solution of fifteen to thirty grains to the ounce is
sufficient. This strength acts as a stimulant, and is well suited to
throats in such condition, but would be injurious in high grades of
inflammation. Catarrh in the head generally requires only about this
strength. I am sorry to say, the topical mode of treating throat affec-
tions has been in some places injured, in the public estimation, by a
lack of knowledge and judgment on the part of the operator, in
choosing the strength of his solution.

To determine the proper frequency of the operation, also requires
judgment and experience. In an ordinary case of chronic disease,
the treatment may begin by showering the throat once a day for a
week. Then the operation should be repeated three times a week, for
a shorter or longer period ; then twice a week, and at last once a week.

Attendant Diseases. — Among the persons I am treating for dis-
eases of the air passages, many are dyspeptic and suffer with depres-
sion of spirits. So often doea this symptom present itself that I re-
gard it as almost one of the peculiarities of throat disease. Persons
thus depressed generally have the dark and dingy look of the face
which indicates functional derangement of the liver. They are often

DISEASES OF THE THROAT.

221

emaciated, nervous, hypochondriacal, irritable in temper, and are ex-
hausted by an excessive secretion of urea. The urine of such per-
sons is always acid, and loaded with crystals of oxalate of lime.

An explanation of this fact has been attempted, by supposing that
the oxydation of carbon (of which these persons have a superabun-
dance), imperfectly accomplished in inflamed respiratory organs, is
vicariously effected in the capillaries of the kidneys, — oxalic acid
(C2O2) instead of carbonic acid (COj) being the result.

The crystals of oxalate of lime are octahedral in form, .d, in the
field of a good microscope, are beautiful objects for inspection.

Lawyera, clerygmen, statesmen, and, in general, those who labor
hard mentally, with but little bodily exercise, and who have a great
weight of care resting on them, are the persons who suffer most from
this complication. Generally the inflammation in the throat is of a
low grade, and must not be treated with a very strong solution of ni-
trate of silver.

Of course when these attendant diseases exist, something more is
needed than the local treatment. For the troubles just described, the
treatment for hypochondria and dyspepsia will be proper.

Elongation of the Uvula.

The uvula is the small teat-like or
pendulous orptn which hangs down
from the palatine arch, just over the
root of the tongue. It is very apt to
get inflamed, and its parts becoming re-
laxed, it stretches out lengthwise, so
that its lower extremity sometimes rests
upon the tongue. (Fig. 88.) When
this happens, it flaps about, backward
and forward, and to the right and left,
— touching the throat at various points,
and by the tickling sensation produced,
exciting a most incessant, uncontroll-
able, and racking cough. Some of the
most distressing coughs I have ever
heard have been produced and kept up
by this cause alone. Many a fatal con-
sumption has begun in this way. When
long inflamed, it often gets much out
of shape, being sometimes bent nearly
double.

Treatment. — In some cases, the
uvula, thus elongated, may be reduced
back to its natural size, by an astrin-
gent gargle, composed of an infusion of
white-oak bark, with a little alum dis-

FlO. 88.

-JP

222

DISEASES OF THE THROAT.

solved in it (282) ; but it will generally stretch out again and again,
upon the appearance of any fresh cold, and, therefore, the only certain
cure is to cut it off.

To do this, take hold of it with a pair of common forceps, and
having stretched it down a little, clip it off above the forceps, with a
pair of curved scissors. Nearly the whole of it should generally be
removed. To take off a part only leaves a stump, which is often
more objectionable than the whole organ. Its removal never injures
the speech in the least. In many cases of nasal catarrh, this organ
is a sort of diseased centre, from which inflammatory action spreads
upward into the nasal cavities, and no medicine or power on earth
can effect a cure until this offending member is snipped off.

Acute Inflammation of the Tonsils. — Tonsilitis.

The tonsils are chiefly a collection or mass of small mucous folli-
cles or glands. They secrete a portion of the fluid which keeps the
throat moist.

There is a class of persons who suffer about every winter, some-
times oftener, with an attack of acute inflammation of these glands,
which causes gioat suffering for several days. The trouble usually
is ushered in by high fever, backache, headache and often by chills ;
the temperature often reaches to 103° and 104° F. ; swallowing is
difficult on account of the swollen glands, while pain in the ear is
not infrequent. The tonsils are at first swollen, reddened and in-
flamed ; later a whitish patch of secretion forms on the surface of
the gland and is distinguished from that of diphtheria by being
whiter and less tenacious; if removed, the underlying surf ao 3 does
not bleed as in the case of diphtheria. It is, however, very difficult,
at times, to distinguish between the two diseases at first.

Another form of Tonsilitis occurs without patches, and is in
reality an inflammation of the substance of the gland itself. This
variety, often called Quinsy, goes on developing into an abscess, the
anterior pillar of the fauces becomes intensely red, swollen and
shiny.

Treatment. — For the more common variety some antipyretic to
reduce the fever and allay the intense aching of the head and bones
is properly indicated. For this purpose 10 grains of Phenacetine
(for an adult), repeated every two to four hours according to the
effect produced, is quite efiicacious. Ammonol in same dose may
also be used. Some simple astringent and soothing gargle will next
be found to render signal relief. Tannin, 30 gr., strong Carbolic
Acid (96%), 30 drops, Glycerin, 1 oz., and peppermint water, 3 oz., is
an admirable gargle for the average case : this should be used hourly.

Equal parts of Glycerin, Alcohol and Water makes a very sooth-
ing gargle, while equal parts of Peroxide of Hydrogen and Water is
preferred by many. The diet should be limited in amount and con-
sist only of liquids.

' rK'l

DISEASES OF THE THROAT.

223

md again,
ly certain

:ceps, and
ps, with a
lie rally be
1 is often
er injures
ihis organ
»n spreads
on eartii

.silitis.

C0U8 foUi-
keeps the

ter, some-
se glands,
le usually

by chills;
lowing is
the ear is
id and in-
surface of

by being
rfao3 does
r difficult,

and is in
If. This
scess, the
)llen and

)yretic to

md bones

lenacetine

ig to the

lose may

Iwill next

Carbolic

3 oz., is

hourly.

by sooth-

I Water is

and con-

The second variety, tending to pus formation, is to be treated sur-
gically by first applying a solution of cocaine and lancing. The
relief resulting from evacuating the pus is immediate.

It has been found that Tonsilitis is apt to be recurrent and that
he who has suffered once is very prone to have one or more attacks
annually thereafter. This class requires constitutional treatment in
the intervals as outlined below.

These inflammations are likewise found to be an expression often-
times of rheumatism, and need corresponding treatment. But the
only cure is to be found by cutting off the tonsils, after the inflam-
mation has subsided. This will put an end to the attacks at once.

Tonsils which are subject to these periodical attacks of acute in-
flammation are always more difficult than others to operate ujion, as
they are almost invariably bound down very tight to the throat, and
cannot be raised up for convenient excision.

Chronic Inflammation of the Tonsils.

In many of the follicular diseases of the throat, these glands are
affected by a chronic inflammation, and are found enlarged, and
sometimes very much hardened. In such cases they secrete a thin,
unhealthy, irritating fluid, which is spread over the throat, increasing
and perpetuating its disease. Much of this secretion finds its way
into the stomach, and thence into the circulation.

In the throats of many young persons and children, these glands
are permanently so large as nearly to fill the fauces. The respiration
of many children thus afflicted is difficult, and when asleep they can
only breathe with the mouth open. The defective breathing of such
children often occasions contractions of the chest, and thus lays the
foundation for consumption. From these diseased parts, the inflam-
mation often spreads upwards, into the posterior nares, and many
times entei-s the eustachain tubes, causing deafness or pain in the ears.
Such children often breathe as though they had a bad cold in the
head. Their health and safety require an immediate attention to
this state of things.

Chronic inflammation of the tonsil, likewise the recui-rent acute
form, may be dependent on poor blood or rheumatism. Those causes
are met by blood-building medicines like Syrup of the Iodide of Iron
in 10-drop doses three times daily, cod liver oil, and by some one of
the many preparations of iron, arsenic, and strychnia combinations.
It is found that genemlly the excision of the tonsil may be averted
by visiting the surgeon, who will hunt out the little crypts or holes
with which the gland is studded, and by gently cutting the narrow
bridges which separate these holes, destroy these cavities. These
little holes retain small particles of food and decomposed secretion,
which after a while, if allowed to remain, set up a follicular tonsil-
itis. The size of the gland is thus greatly diminished and the little

■

224

ItlSKASES OK THK THROAT.

secreting follicle destroyed. Many a little Hufferer can thus bo spartMl
the harsher method of excision, and bear with good grace, especially
if cocaine be used, what otherwise might be a painfiil and bloody
operation. But, as has been said, excision in many cases must be
resorted to.

Curability of Throat Diseases. — I have dwelt somewluit upon
the preceding fonns of tliroat disease, because they prevail to a fear-
ful extent, and are, in thousands of cases, but the first staj^es of fatal
disease of the lungs.

If not counectetl with lung disease in the heyinning, my experience
in treating them enables me to say, emphatically, they are generally
curable.

But patients often put the question to me — " If cured, will I ever
have the complaint again ? " My answer is — " Unless I can plant
in your constitution a better protection than your Maker put there at
your creation, you will of coui-se be liable to a second attack." But
then, where the lungs have been entirely free from disease, I have
never yet seen a case of 8inii)le throat complaint relapse and become
dangerous after proper treatment with the syringes. Let not those,
therefore, who have been benefited, but not entirely cured by this
treatment, undervalue what hius been done for them. Even in such
cases, the advantage derived to them amounts to just the value they
attach to the continuance of life.

Danglers of Delay. — In closing these remarks, let me warn the
reader against the dangers of delay. Many of those who finally seek
medical attendance in these complaints, fiist try all nostrums, and
tamper with their disease till the case is either critical or hopeless.
Too many wait till they are near enough to the engulfing whirlpool
to hear it roar, before they seek in any practicable way to escape its
dangers.

Many persons neglect a slight inflammation of the pharynx, which
might have been cured in a few days, but which, from long neglect,
has gradually crept down the windpipe, spread over the widely dis-
tributed mucous lining of the bronchial tubes, and thus become cur-
able only in a partial degree, and after long and tedious treatment.
Hundreds of persons are now suffering from slight attacks of this
sort, who might be rid of the affliction in a week or a fortnight, but
who will either carelessly give it no attention at all, or resort to use-
less nostrums, until it has run through its primary stages and invaded
the constitution, and will finally die of some of the forms of pulmo-
nary disease.

A Cold. — Influenza.

A SLIGHT attack of the disease about to be described, affecting only
here and there -a person, and lasting only for a few days, is called a
cold. When it affects a large part of the community at the same

DI8EASK8 OF THE THROAT.

225

be spaiiMl
sspecially
id bloody
I must be

bat upon

to a feai-

38 of fatal

xperienco
generally

«rill I ever
can plant
it tbere at
3k." But
se, I have
1(1 become
not those,
3(1 by this
Bn in such
/alue they

warn the
nally seek
■rums, and

hopeless.

whirlpool

escape its

nx, which
neglect,
i^idely dis-
come cur-
;reatment.
of this
ight, but
irt to use-
invaded
if pulmo-

[jting only

called (t

I the same

time, lasting many days, or even weeks, it is then an epidemic, and
passes under the name of infliiema. In tliis latter form, it sometimes
spreads over a whole country, and has at times, as in 1882 and 1894,
extended to nearly the whole civilized world. It often shows marked
severity in its progress, and leaves serious results behind.

Symptoms. — A tingling, with drjiiess, and a sense of fulness in
tiie mucous membrane of the nose, are among the first indications of
an attack of this complaint. Sneezing is a common symptom. Soon
pain is felt in the forehead, and breatliing through the nose becomes
difficult. The eyes are red and watery, the throat is sore ; there is a
dry cough, hoarseness, thirst, general lassitude, chills, and a desire
to get near the fire. The mucous membrane of the nose^ throat,
windpipe, and breathing-tubes is inflamed, red, swollen, and some-
times painful.

In a short time, water begins to run from the nose and eyes, and
the cough becomes a little more moist. There is also a slight dis-
charge from the throat and tubes, which gradually increases, and, at
length, as the disease declines, and becomes less acute, the expectora-
tion is thick and yellow.

Aching of the back and limbs, thirst, loss of appetite, flashes of
heat, and chills whenever the patient is exposed to air a little cooler
than he is accustomed to, are almost constant attendants upon the
disease.

Causes. — It is r ot always easy to say what tho causes of this com-
plaint are. Frequently, it can be traced to an improper exposure to
cold or dampness ; but in a great majority of cases, especially when
it takes the form of influenza, the causes are not obvious. They
probably exist in some peculiar states of the atmosphere, and in a
depression of the nervous system.

The influence upon disease of the different degrees of density in
the air which surrounds us, and of other circumstances affecting it,
have not been much studied. Some valuable facts will be drawn
from this source before many years. The putting upon the body, or
taking from it, several tons of pressuie every time the barometer rises
or falls, must have, of itself, no small influence upon its health. The
comparatively new science of Phjrsical Geography, by spreading be-
fore us its interesting facts in regard to temperature, storms, atmos-
pheric currents, etc., is opeiijiig the way for the physician to learn a
great deal more about the cftuses of disease than he now knows.

Treatment. — In mild cases, only the most simple treatment is re-
quired, — such as remaining in the house for a few days, soaking the
feet in warm water, taking a gentle sweat, drinking warm infusions
of flax-seed, mullein, slippery elm, or warm lemonade, and taking
only a spare vegetable diet. If the bowels be costive, some gentle
phjrsic (84), (41) may be used. A laxative drink (132) will like-
wise be useful.

226

DISEASES OP THE BRAIN AND NERVES.

At the outset, eapecially when the nose nins water, a small rloRp of
atropia, jj^ grain, taken every two honrs till the throat is dry, will
entirely arrest the disease at this point. The coryza pill found at
the druggists' is a more valuable remedy still.

When the attack is more severe, sweating must he induced by de-
cisive meaMures. This may Ikj affected by the spirit vapor-bath, or
by putting the patient in bed, j)utting l)ottles of hot water to the feet
and sides, and administering warm drinks, and the compound tinc-
ture of Virginia snakeroot. Five drops every hour of the tincture
of veratrum viride will often cause very free perspiration, and will
reduce the inflammatioji upon the mucous surface.

An emetic is sometimes very useful. To produce vomiting, use
the powder of ipecac, ten to twenty grains, or the compound tincture
of lolwlia.

It soothes the inflamed mucous surfaces very much to inhale the
vapor from half a j)int of hot water, with five drops of tincture of
veratrum viride, or the same amount of the tincture of aconite root.

If the cough is severe, use the preparations recommended under
bronchitis and consumption.

In the latter stages of the diseiuse, if there be debility, — as there
generally is, — quinia, iron, nux vomica, etc. (75), should be taken ;
or, to su[)port the nervous system, the extracts of scullcap, and bone-
set, and the sulphate of quinia (81) will be found useful. At this
stage of the complaint, the diet should be more liberal and nourishing.

The patient should not venture into the open air until the unpleas-
ant sense of chilliness, peculiar to the disease, ceases to be produced
by exposure.

La Grippe.

This is a variety of influenza with which the world has l>ecome
well acquainted within the last few years. Its history is interesting
and its symptoms and results are sevei'e and annoying. It is one of
the most severe forms of catarrhal disease of the nose or throat with
which we are acquainted. It owes its origin to a germ which found
its birth in the filth and pollution of eastern Europe, and has visited
the globe with terrible ravages on several occasions since the Middle
Ages. It spreads by travelling the most frequented paths of com-
merce, and attacks those in a depressed state of health. The varieties
of la grippe are as numerous as that of any other disease. The catar-
rhal form is much like that of ordinary head influenza, only it is more
severe and prostrating ; the bronchial assumes the influenza type, at
first, but soon attacks the lungs and sets up a severe, prolonged and
harassing bronchitis ; the intestinal variety, besides producing the
general symptoms of malaise, fever, cough, severe aches and pains,
gives rise to a diarrhoea which lasts many days and is very debilita-
ting; the most common variety, however, is the rheumatic, which is
ushered in by chills, fever, muscular pains, coryza, cough and general

imiiU doRft of

iH dry, will

ill found at

luced by dt;-
ipor-buth, or
r to the feet
1 pound tinc-
the tincture
on, and will

omiting, use
ind tincture

o inhale the

tincture of

iconite root.

nded under

— as there
i be taken ;
p, and bone-
il. At this
nourishing.
;he unpleas-
•e produced

hfis l)econie

interesting
It is one of
throat with
^hicli found

has visited
the Middle
ihs of com-
he varieties

The catar-
y it is more
iza type, at
longed and
ducing the

and pains,
ry debilita-
te, which is
ind general

DISEASES OF TIIE THROAT.

227

rheuraat c pains. The chamcteristic feature of all of these forms is
the great prostration which accompanies these symptoms and thTolv
stim«)y with which it clings to the patient.

The sequelae of the dise.wc, though much exaggerated, are numer-
ous^ The aged are often left infirm with heart wtakness the Zng
^mglL """" '" ^'««'^««''*'^d the middle-aged with cLS

Many an undiscovered disease has passed unnoticed under the dis-
ZZl: " ^"^^''-^ ^^ ^f. "-l"»l't served as a bn«.d mantl ".
cover our ignorance of real disease and been made an easy refuge for

a dZ;;r'"^V'*'y ^"^ "'^r'^ ^' «„!«« cannot be uveLstlmated
and death has not infrequently resulted.

Treatment— Tlie onset is to be met with large doses of quinine
say 10 grains on retiring, by phenacetine and stlol, 10 grains each
t..ken with some hot lemonade on retiring. Tliis lattef may tere
peate eveiy three hours. The coryza is checked by small repe^tid

blets bought at the druggist's - one taken every two houi-s till the
^ZX/Sn^"" '^^^ ^ ^^^ '^ ''^^' ^--^ T^« ^«^ility is t:

Acute Inflammation of the Epiglottis.

This is the disease by which our country lost its most loved and
uncSrr^. TT' ^n^' Washingtoi/ This complaint was not
undei^tood at the time of his death, - the intelligent physicians who
attended him supposing it to be inflammation of the windpipe. Fmm
their very clear description of the symptoms, we now know it to have
been an acute inflammation of the epiglottis and glottis.

^rom the rapid inflammation of the epiglottis, water is effused into
h hp'n '^f'' '" iT *" P"^ 1"P' "'^'^ P^^^^'^* it fr«°^ shutting down

wi&'''*""-*"^i'^ ^'^^^^ ^^^^"« ^i*^^ ^ severe chill, accompanied
with some pain, and a sense of stricture or tightness in the upper and
m nfS sw.n *.h^-t. The,e is eough, witS difficult and som ime
painful swallowing These symptoms are soon followed by quick
andsoorr' b^^^t^^g-. Speaking aloud is from the first ifficult,
thp W i^ "'' impossible. As the complaint runs it« rapid course

^te^Trlng^^^^^^^^^^ "^°^^ '^«^^"^^' ^"^ '^^^ -- --^^s^f- -ml

nitm W fn vl" ^'?'& 7"^.«^iately to the parts a strong solution of

to on^ I i l ?' '''^''*'°^ «^«"^^ b« of *he strength of ninety
to one hundred and twenty grains to the ounce of soft water. It

228

UmEAUKH OF THE THKOAX.

Hhould be applied oveiy hour or two till the feeling of suffocation
subsides, and should be done with the laryngeal shower syringe,
though if this is not at hand the sponge probang may be used.

While this local treatment is being employed, libeml doses, from
five to twenty drops, of tincture of veratrum viride should be given
every hour, watching the effect, and discontinuing when the pulse
sinks too low.

Hot fomentations applied externally, and filling the room with
steam, m recummeiidud in cases of croup, would bu usef

Mu m ps. — Parotitis.

This disease appeal's ruost often among cliildren ; but as it is not
confined to them, I have not placed it among their complaints.

Symptoms. — It begins with soreness and stiffness in the side of
the neck. Soon a swelling of the parotid gland takes place, which is
painful, and continues to increase for four or five days, sometimes
becoming very large, and making it difficult to swallow, or open the
mouth to receive food. After the fouith or fifth day the swelling
subsides, and disappears in from seven to ten days.

Both glands generally swell about the same time, but sometimes
the swelling appeara in one only after it has subsided in the other,
and occasionally the swelling is wholly confined to one side.

When the swelling is great, there is heat, and sometimes fever,
with diy skin, quick pulse, fuired tongue, constipated bowels, and
scanty and high-colored urine.

The affection is sometimes translated, as we say ; that is, in females,
the breast swells, and in males, the testicles become swollen and pain-
ful. This accident generally happens in consequence of taking cold
from some imprudence.

The disease is contagiuus ; that is, it is communicated from one
person to another.

Treatment. — In mild cases, very little treatment is required.
Keeping the face and neck warm, avoiding exposure to cold and
damp, drinking warm infusions of balm, spearmint, or sage, and ap-
ply a poultice of flax-seed over the glands until the patient is fully
relieved ; or the compound powder of jalap, if there be costiveness,
is about all that is required. The diet should consist of rye hasty
pudding, or brown bread and sweetened water.

If the case be severe, and other glands swell, physic must be freely
used, leeches must be applied, and cooling lotions, or poultices.
Sweating must also be induced by the compound tincture ol Vir-
ginia snakeroot, or by a vapor bath.

In young girls mumps often attack the ovaries and make the in-
valid a great sufferer for a few days ; the testicle of the male is simi-
larly affected at times. These complications call for soothing appli-
cations and rest in bed.

mmi

suffocation
er syringe,
used.

doses, from
d be given
I the pulse

room with

w it is not
lints.

;he side of
le, which is
sometimes
ir open the
e swelling

sometimes
the other,
le.

mes fever,
Jwels, and

in females,

and pain-

iking cold

from

one

required.

cold and
e, and ap-
it is fully
)8tivene88,
rye hasty

; be freely
poultices,
•e ol Vir-

:e the in-
le is simi-
ing appli-

DISEASES OP THE CHEST.

Consumption.-^ Phthisis.

At the head of the .liseases of our cUniute stands Consumption,—
flt wieir head both .is it respects prevalence and fatolity. SmaU-^x

ri „T/r''' '"^ '^°^r"t ^'^ ^"'^^« ^» *heu visitations; but S
are all their aggregated slaughters compaied with the ce,iseless, silent

;::s Jt ^i s^ tiT^ -''''' -^^^ ^^^y ^" «^«^^ ^-^ p^- th^

Boston, from its population of 476,000, loses by consumption about
twenty per week, eighty per month, or about nine hundred per
annum. An equal mortality from any disease not often amon/us
would send our citizens in terror to^^the countiy, and causXe
stoutest hearts to feel that "in the midst of life we are in death "
Massachus|etts loses about seven thousand per annum; New England
not less than twenty thousand; and with the State of New York

vear ?' WhT'""" "^ ^^'^^^g^f di««««« «well to forty thousand a
year! What an army I Picked from the choicest I All sundered
vTld ^rwf".^ ^' and leaving more blight and sorrow behind than
wou d perhaps twice or thrice the number whom any other pestilence
woiUd have selected. The magnitude of the evil places the^question
of the remedy before aU others that peitain to the healing art.
ih. ■ fu"^^^ number of deaths occur in Massachusetts, beinff in

nni'^ — ^^"'^ °^.""^ '"^ ^""^^y *^^« ^^"*i^«d a»d fifty. The smallest
number is »n Georgia, being about one in two thousand one hundred

Th; nLi, Tv^^f^^o ^ "'°'*^ unfavorable as a place of residence.
Ihe Northern Middle States, Western Central and Pacific Coast
Stetes are most favorable. The most healthful for consumptives, I
sTcnFn <^ '^ the following order: Georgia, New Mexico, Wiscon-
sin Colorado and Califorma. A permanent residence in any of them

iTfp Z? '"P'^^rf '^ ^''^'^ ''' ^'^^ «^g^«' ^""^ ^i" S'^'^4 prolong
ite, unless in the last stages, in which case I would strongly advis!
tne patient to remain at home among friends and home comforts.
Alter a change of climate it is dangerous to return unless a perma-
nent cure has taken place.

Methods of Examining the Chest.— Before speaking further of
oonsumption, I propose to do what has never been done, namely, to

229

230

DIJBA8ES OF THE CHEST.

inbu^ict the general reader very briefly in the method of examining
the chest to learn the existence of disease. Perhaps this will bt^
considered a departure, in some slight degree, from my purpose to
make this entire book intelligible to the general reader. If so, my
reply is, that there are many school teachers, mechanics, masters of
vessels, and farmers, who have niquiring minds, ar i sagacity enough
to learn the physical signs of chest-diaease, and to make them, in
many cases, practically useful; and that even readers of little re-
flection cannot fail to comprehend a portion of my explanations.

Position of the Patient. — In performing percussion upon the
front of the chest, the patient should be required to sit in a square
position, with the arms hooked over the corners of the back of the
chair, and the head thrown a little back.

Instrument with which to Thump. — The index and middle
fingers of the right hand are to be brought together, into a line, and
used as the percussing instrument. The blow given with these is to
be smart and quick., rather than heavy.

Medium to Thump Upon. — Either the index or middle finger of
the left hand is to be pressed firmly upon the surface of the chest to
be percussed or struck, and thus used as a plexiraeter.

Auscultation. — Listening for the purpose of hearing within the
chest the sounds produced by breathing, talking, coughing, etc., is
called auscultation.

Fia. 90.

Fig. 91.

Instruments with which to Listen. — The naked ear is generally
considered best for hearing low and delicate sounds ; but for hearing
loud and rough ones, it is not so good as the stethoscope, repre-
sented by Fig. 90. A still better instrument is the double-eared
stethoscope, Fig. 91. It magnifies the sounds very much, and is apt
to confuse an examiner not accustomed to it ; but when the ear is
once familiar with it, the aid it affords is very valuable.

mmmm

niSEASES OF THE CHEST.

231

examining

this will K'
purpose tt»
If so, niy
, masters of
city enough
ke tliem, in
of little re-
nations.

n upon the

in a square

back of the

and middle
) a line, and
li these is to

lie finger of
the chest to

f within the
liing, etc., is

IS generally

[for hearing

jope, repre-

juble-eared

and is apt

the ear is

The examiner should pass from side to side, continually comparing
the sounds upon one side, with those upon the other.

The patient must bo calm, and the examiner in no hurry.

Healthy Sounds. — To become skilful either in percussion or aus-
cultation, the examiner's ear must first be trained to healthy sounds.

These are best heard in the child, iu whom they are louder than
in the adult.

In describing the healthy sounds in the different regions of the
chest, I shall refer the reader constantly to Figs. 92 and 93.

C^lavicular Region. — This, in Fig. 92, is represented by 1, 1.
Urjon thumping upon the collar-bones, the sound given out at the
breast-bone end should be very clear ; less clear in the middle ; and
dull at the shoulder end.

Subclavian Region. — This is represented by 2, 2, and lies be-
tween the collar-bone and the fourth rib, on both sides. It covers a
considerable portion of the Tapper lobe of the lungs. The sound
upon striking this place should be very clear.

Fig. so.

FlO. S3.

The Mammary Region, represented by 3, 3, extends from the
fourth id the seventli rib, on each side. In the upper part of this
region, the healthy sound is clear ; but at the bottom of it, on the
right, the sound is deadened by the liver; on the left, by the heart.

The Infra-Mammary Region, 4, 4, lies between the seventh rib
and the edge of the cartilages of the false ribs. On the right side,
the liver makes the sound dull; but under the left side lies the
stomach, which is hollow, and the sound is generally quite loud.

DISEASES OF THE CHEST.

In th« 5ternal Region, 5, 6, 7, wLicb covei-s the breast-bone, the
sound is generally clear.

The Axillary Region, 8, 8, is in the arm-pits. In this the sound
should be clear.

The Lateral Region, 9, 9, is immediately below the above, and
yields, likewise, a clear sound.

The Lower Lateral Region, gives a dull sound on the right side,
and on the left a very hollow one.

Fig. 93 represents the back part of the chest. In looking at this,
we see the

Acromial Region, represented by 11, 11. In this space the sound
is dull, but it has not much meaning.

The Scapular Region, 12, 12, covers the part occupied by the
shoulder-blades. It gives rather a dead sound.

The lntra-5capular Region, 13, 13, lies between the shoulder-
blades, on each side of the back bone. If the patient's arms are
crossed, and the head bent foi-ward, a clear sound will be obtained.

The Dorsal Region, 14, 14, covers the base of the lungs, and, in
health gives, a clear sound.

Observation. — If, now, on thumping upon the chest, we find a
(lull, dead sound in any spot where a clear one oug'at to be yielded,
we are to conclude that underneath there is not the usual quantity
of air ; but we cannot tell merely, by percussing, whether tubercles
are deposited there, "or the lung has become solid by inflammation,
or water has been poured out into the cavity of the pleura. This
point must be determined by auscultation, etc., to be explained
gradually as we go along.

Auscultation of Breathing. — On applying the ear or the stetho-
scope to the chest, two sounds are heard which immediately succeed
each other, — the louder is produced by the ingoing breath, or in-
spiration ; the weaker by the outgoing breath, or expiration. These
sounds will be further explained as we go along.

Auscultation of the Voice and Cough. — The chest of a healthy
person speaking communicates to the ear no distinct sound, but only
a vibratory sensation, called, in technical language, the pectoral fre-
mitus.

.Over the larynx and windpipe, the examiner may hear natural
pectoriloquy ; between the shoulder blades, in the space correspond-
ing to the roots of the lungs, natural bronchophony.

Philosophy of Chest Sounds. — The fullness and clearness of

sound upon percussion, depends upon the amount of air in the chest.

The sounds called breathing murmurs, are caused by the expansion

shoulder-
arms are
btained.

:s, and, in

ve find a
B yielded,
quantity
tubercles
mmation,
ra. This
explained

16 stetho-
r succeed
th, or in-
. These

I healthy
but only
':oral fre-

' natural
Tespond-

jness of
he chest,
cpansion

DISEASES OF THE CHEST.

and contraction of the airKiell.s or vesicles, as the air passes in and
out ; hence they are called vesicular murmurs.

The friction of the air against the sides of the windpipe and large
bronchial tubes causes the blowing sound heard in those parts.

In children a larger amount of air enters the lungs, and the air
vesicles are expanded with more force; hence their breathing has a
ouder sound, which is called puerile respiration. This kind of
breathing, heard in the grown person, is a sign of disease.

I he lung tissue is a bad conductor of sound; and the voice is ac-
cordingly heard only over those parts where large bronchial tubes
are near the surface ; heard elsewhere, it indicates disease.

Division of Consumption. — Consumption raay be divided into

ZS ^ w^'" "' T^ '^' ^^°^''^^^1- The former has a on-
stitutional, the latter a local origin.

^irst Stage of Tubercular Consumption.

Physical Signs.— Dullness of sound on and under the collar-
'riten?ir'Th-^"n"^'^ expirationaugmentedboth indur^ bn

^^^Occasionally a pulmonaiy, crumpUng sound. Dry, crackling rat.

The resounding of the voice increased at the top of the lungs.

General Symptoms. — A sense of weariness and languor.

Occasionally, slight, %ing pains about the chest and fhou dera

A peculiar sensitiveness to the effects of cold «"«^^aer8.

Breathlessness on moving quick, or ascending a hill or stairs. '
Ju 7 'i^f'' ^ blue lividity of the lips and^ roots of the Wer-
nails, and coldness of the hands and feet. ^

tlie rntMvij'J^ *T.'^''' "^'^/* *^^« '^'^y ''^Se, a cessation of
tiie monthly turns. These usually stop later in the disease.

at S?!orof°th«'r^^' ^r"'"*^"^ °^ *"^^^^«« ^^^^' ^l^ay« begins
tenest on tl« ^Zf':^T'''\^''^ ^*^«^ *h«"&bt they 'appeared
oltenest ou the nght side first; Louis, Andral Watson, Sir James
Clarke and others, believed they appeared more often on the U sWe

appear first about as often upon one side as upon the other.
structionnTC'^ crumpling sound is caused by a mechanical ob-
lurint Th. / expansion of the lungs. It is generally heard only

dtedVv blow^^ "'' "^ the breath. The soi^d is like that prS^
uiicea by blowing upon very fine paper. ^

234 DISEASES OF THE CHEST.

Second 5tas;e.

Physical Signs* — Marked dullness of sound on the collar bones,
and extending below them.

Inspiratory murmur diminished in duration and intensity ; expira-
tory murmur augmented in both.

In upper lobes of lungs, moist, crackling rattles, succeeded by
mucous rattles. Also bronchial respiration, or tubular breathing.

In lower lobes of lungs, puerile respiration.

Sounds of the heart heard under the collar bones.

Bronchophony heard in the same parts as bronchial respiration.

Qeneral Symptoms. — A quickened pulse ; slight fever towards
evening, oftentimes amounting to quite high fever.

Great susceptibility to the effects of cold, and liability to take cold
easily.

Bowels generally costive ; oftentimes seat of pain.

The eye has a peculiar whiteness and lustre.

The skin and mouth bcQome dry in the afternoon ; chills occur
about midday, followed by fever, during which the cheeks are flushed.

As the second stage advances to its close, a dry, burning heat
aflflicts the palms of the hands and soles of the feet.

Night-sweats occur at this time.

Observations. — A hollow, elastic body, containing air, gives,
when struck, a clear sound. The dullness of sound on percussing
the chest, arises from the absence of air in the air-cells, — these
having been pressed together, or obliterated by the deposit of a mass
of tubercles. The destruction of these cells causes the cessation of
the respiratory murmur.

This stage of the disease is often accompanied by an inflammation
of the mucous membrane lining the air-tubes. The air, pushing its
way through the mucous secretions in these tubes, forms bubbles, the
bursting of which causes the rattle. The crepitant rattle is produced
by inflammation around the tubercles. The moist, crackling rattle
is caused by the softening of the tubercles.

The lungs, rendered more solid by the deposit of tubercles, become
better conductors of sound ; and this causes the beating of the heal-t
to be heard as far off as under the collar bones.

Bronchial respiration gives the idea of air blown through a tube ;
cavernous respiration, of air passing into a large enclosed cavity.

Third Stage.

Physical Signs. — In this stfl.ge cavities are formed. If the cavi-
ties be small, and considerable tuberculated lung surrounds them, the
sound, upon percussion, is still dull.

DISEASES OF THE CHEST.

235

liar bones,

y; expini-

ceeded by
athing.

iration.
ir towards

• take cold

lills occur
re flushed,
ning heat

an', gives,
percussing
i, — these
of a mass
ssation of

aniniation
ishing its
bbles, the
produced
ng rattle

become
the heatt

a tube;
,vity.

;he cavi-
;hem, the

If the cavity he large, and near the surface, there is occasionally a
tympanitic sound with musical tone.

Sometimes a sound is heard like striking a cracked pot.

Gurgling; cavernous rattle ; cavernous breathing; amphoric breath-
ing; now and then, metallic tinkling; pectoriloquy; cavernous cough.

General Symptoms. — Great loss of flesh, and weakness ; diarrhoea
and nightflweats ; swelling of the feet and legs ; sore mouth ; and
raising of matter with specks of tubercle in it like crumbs of cheese.

Observations. — The gurgling rattle is caused by air displacing
liquids, and the formation and bursting of bubbles. It resembles the
sound produced by blowing through a tube immersed in soap-suds.

Cavernous breathing is notliing more nor less than the sound pro-
duced by air, breathed in and out, entering and retiring from a
cavity. The air appears, sometimes, to one listening with the stetho-
scope, as if it were sucked into his ear during inspiration, and blown
back again during expiration.

Amphoric respiration is simply an augmentation of cavernous
breathing, and results, of course, from an increase of size in the
cavity.

In pectoriloquy, words uttered by the patient seem to pass through
the stethoscope into the ear of the listener. The cavity pliould be
empty, moderate in size, and have dense walls, in ordei to furnish
the best specimen of this sound.

Air suddenly driven backward through the windpipe, and out of
the mouth and nose, by smart raps upon the chest over a cavity,
gives the sound of the cracked pot. It is best heard when the pa-
tient's mouth is partly open. The same sound is produced, on the
same principle, by locking the fingers of the two hands, and joining
the palms, so as to leave a small space or cavity between them, and
then expelling the air from that cavity, by gently striking the back
of one hand upon the knee.

Causes of Consumption. — The hurcan constitution, as shown by
Liebig, in his profound work on Animal Chemistry, is governed by
two forces, the nervous and the vegetative. The former disposes the
particles composing the body to a state of motion ; the latter inclines
them to a position of rest.

In vegetative life there is motion in one direction only, so to speak;
that is, niution which tends to the opposite of motion, namely, rest.
In vegetables, whose life is wholly under this power, there is no waste ;
for here, all ultimate particles, having once taken a place of rest,
remain undisturbed. In a tree, a layer of matter once deposited,
alwajrs remains. Hence there is growth as long as the tree lives.
There is no power to break up and destroy.

But in the animal body there is motion in two directions, or a
circuit of motion. Particles which under the vegetative force have
been put to rest, are perpetually being displaced by the nervous energy,

236

DISEASES OF THE CIIKST.

and reduced to unorganized amorphous compouiicls, to bo burned in
warming tlie sj^tem, or cast out by the several excretory processes.

So constant Ls the action of these two forces, that John Hunter
compared the human system to a whirlpool, into which the particles
of matter are per[)etually poured, under the influence of the vegeta-
tive power, and out of which they are as constantly whirled by the
nervous force.

By a little reflection upon these antagonisms, the reader will see
that it is just when the vegetative force transcends tlie nervous, that
the body increases in weight, and acquires that state in which tlie
blood corpuscles alxiund, and the tendency, if to disease at all, is to
that of the inflammatory kind. It is the tonic condition of the sys-
tem. Nutrition is more rapid than destruction. New particles are
laid down faster than old ones are taken up. The body grows.

On the other hand, when the nervous force overmastei-s the vegeta-
tive, when the outward or centrifugal motion of the whirlpool prevails,
then it is that the body is attenuated, the blood thinned and made
serous, and the consumptive or atonic condition is established. Noxo.,
there is too much motion. The nutritive particles, instead of tending
to a state of deposit for the rensupply of waste matter, become fugi-
tive in their habits, perpetually fleeing, like convicts escaped from
prison. Introduce this power, in excess, into the vegetable kingdom,
and the matter deposited upon the tree, instead of remaining to swell
its bulk, would be driven off by the nervous force ; and the tree, in-
stead of growing, would be annually lessened, become sickly, and die
of consumption.

In Tubercular Consumption, the system is like a field deluged by
a flood ; nothing can take root. The repeated shocks of the nervous
battery sent to the absorbents so quicken them in their work of re-
moving waste matter, that they dislodge much which is not yet worn
out, and assist in casting out of the system not a little designed to be
used in its renewal. A healthy deposit is thus prevented, and nutri-
tion is at an end. The nutritive arteries, those little builders of the
human frame, are overmastered by the stimulated lymphatics ; the
constructive material is wrested from them, and borne beyond theb
reach, and the body wastes from want of nourishment. The blood
becomes thin and watery; and from the increased serous portion,
chiefly albumen, are deposited upon the lungs and other tissues the
albuminous tumors called tubercles.

Here is found the cause of that peculiar smalliieas of bone and
muscle, and thinness and tallness of person, so peculiar to consump-
tives. The absorbents, under the power of a very active nervous
system, take down " the house we live in " faster than the nutritive
arteries, confused by the motion around them, can effect its recon-
struction. It is simply an unbalancing of the antagonistic forces,
which build and pull down our earthly tenement. The men that de-
molish are more numerous and better fed than the artisan buildere.

DISEASES OF THE CHEST.

287

burned in
rocesses.
11 Hunter
! particles
le vegetii-
ecl by tlio

r will see
V0U8, that
vhich the
> all, is to
f the sys-
cticles are

'0W8.

he vegeta-
1 prevails,
md made
3d. Now,
)f tending
ome fugi-
iped from
kingdom,
\g to swell
le tree, in-
y, and die

eluged by
e nervous
rk of re-
yet worn
ned to be
nd nutri-
rs of the
tics ; the
nd their
he blood
portion,
sues the

It is this destructively nervous force which gives to consumptive
persons their proverbial mental activity ; which causes them often to
dazzle the world with the splendor of their gifts, and to bless their
friends with the warmth of their affections. They are usually the
choice spirits, the idols of their relatives, and the favorites of the com-
munity in which they live. Their mental movements, and the exer-
cise of their affections, are characterized by brilliancy and warmth.
Of all persons, they are best fitted to enjoy life, and to impart happi-
ness. Loving all, they are by all loved in return. They are speci-
mens of partially etherealized humanity, stepping lightly across the
earth, to whom friends passionately stretch out their arms, and em-
brace — their shadows I

These views will appear the more reasonable, if we consider that
in children the vegetative power is very active, while the nervous
energy is comparatively weak. The preponderance of the former
over the latter causes the rapid growth of children. The little arterial
builders work faster than the lymphatic demolishers. This explains
why so few children die of consumption.

But from the age of seventeen to thii-ty-five, when the vegetative
power is losing something of its extraordinary activity, and the nerv-
ous force is showing its highest capabilities, — then it is, as this
theory indicates, that tubercular consumption does its dreadful work,
— then, that *he outward world of this physiological Maelstrom casts
upon the shores of mortalit}'' so many thinned, exhausted, and lifeless
human forms. More than three-fourths of all who sink under this
disorder die between the ages just named. The brain, between these
points of time, acquires its full size and force.

This disease prevails most, too, in those countries where an enlight-
ened civilization gives to the nervous system its fullest development,
as in Great Britain, France, and the United States, and in those
where the nutritive process is most retarded by a relaxing climate ;
and it is scarcely known among those people who are but little en-
lightened and have small brains, and among those who live in high
and invigorating latitudes. As the most enlightened, however, are
generally found in temperate climates, and those with the least culti-
vated brains in low latitudes, the rule is not perfectly explained by
facts ; yet it shows itself sufficiently to establish its validity, and to
afford another proof of my theory.

)ne and
fonsump-
nervous
lutritive
recon-
forces,
I that de-
lilders.

Bronchial Consumption.

The persons exposed to bronchial consumption are generally of an
opposite habit to those described above, — having the nervous force,
in health, well subordinated to the vegetative, the assimilation good,
and the blood well supplied with red globules. They have usually a
full habit and an active circulation. The absorbents, and other ves-
sels in the lungs, working in the midst of a large amount of caloric

238

DISEASES OK THE CHEST.

^i: \

evolved by an energetic i-espiration, often ttike cold, which brings on
lung-fever and pleurisy, and these lay the foundation for the ultimate
destruction of the lungs. For the same reason, the skin of this class
of persons becomes diseased, and more often the inner skin, or mu-
cous membrane, and most often that portion of mucous membrane
which goes down into the lungs and lines the air-tubes. It is inflam-
mation of this which constitutes bronchitis, and which lays the foun-
dation for true bronchial consumption.

As that class of persons who are exposed to the tubercular form of
the disease suffer a general loss of carburetted hydrogen in its several
forms, colliquative diarrhuia, sweats, increased breatliing, and all con-
ditions that carry fat out of the system, so those who suffer from
attacks of the bronchial tj-jjc of the disorder are generally afflicted
with the opposite condition. They have too much carbon.

It is well ascertained that carburetted hydrogen, accumulated in
the system, acts as a poison. And that class of bilious persons who
are subject to this disease often have their excretions badly performed.
For this reason, carbonaceous compounds accumulate in the system,
and give rise to the symptoms of morbid poison circulating in the
blood. This led Dr. Madden to suspect the presence of such poison
in the blood of all consumptive persons. Ht( saw the evidence of it
in numerous cases, and not distinguishing the one class from the
other, he inferred its presence in all.

ill
{

Constitutional Difference.

The constitutional difference between the two forriis of consump-
tion appeai-fi to be this : the tubercular type is usually attended, in its
origin, by a tolerably good state of the digestive function, in connec-
tion with bad assimilation ; while the bronchial form generally has
its foundation laid in connection with bad digestion, accompanied
with healthful assimilation. In the former case, the food is well di-
gested, the pabulum is properly prepared, but the nutritive arteries do
not use it for renewing the tissues. In the latter case, the digestion
is bad, the pa^bulum poorly elaborated ; but the re-constructive vessels,
under the control of a well-developed system of organic nerves, use
it to the best advantage. In the one case there are good brick-waA;er«,
and lazy hvick-layers ; in the othei:, the reverse.

It happens, however, that before the fatal close of the disease, tu-
bercular patients usually become afflicted, more or less, with bad
digestion, and bronchial patients with defective assimilation ; so that,
in the end, they present us with much the same class of symptoms.
Starting from opposite poles in life's celestial sphere, they meet at
the culminating point of death, and disappear under identical aspects
of the heavens.

DISEASES OF THE CHEST.

239

^ brings oil
he ultimate
if this class
iin, or mu-
menibraiiu
ft is inflam-
8 the foun-

lar form of
its several
nd all cou-
uffer from
ly afflicted

nulated in
irsons who
jerformed.
le system,
ng in the
ich poison
ence of it
from the

consurap-
ied, in its
n connec-
3rally has
ompanied
i well di-
rteries do
digestion
e vessels,
irves, use
k-makers,

sease, tu-
A'ith bad
; so that,
Tuptoms.
' meet at
.1 aspects

Exciting Causes of Tubercular Consumption.

IHE preponderance of the nervous force hein r f>,» uf„+ u- u

burned by the steam-engine are scarcelT^nL ^T ^'^^^

^.^N„r are the pa«si„„» aud aentimente le,, exerci.ed, or le„ destruc

ature, sleeping in damp sheets, etc. Th^se eS til f ^f P^'"
or depress the vee-etativp nr ,-r,fl \T *"® nervous force,

tubes,^or the subTt^^^e of the unTn tl """'T ^'^"^ «^ *^« '^i-
encloses them, so Tto induce one form n^ S.^°^^?^°^ ^'^^k which
the principles I have explained ' ''^'' '^ consumption on

due^t: XtfofTbtrlsTthTr^^^^^^^^ ^r.o^. no.^^.ys, to be
cords, the upper mrts of fS f ^^'^ neighborhood of the vocal

of th sare^^P's^tuberlrTV"'' ""' ^"^^q^^^^' ^t the ba.es

5«.7;«., which croi^IytseeT^th'.^rh"^^^^ ''^- ^^^''^^^
and then only after beinj steinpd w,Tk . ^^ ^?'''^'' microscope,
they absorb TliPSfl S ^'^ f '**''' ^'^^^'^^ colors which

bacflli, and appear u^^^^^^^ ^'' "^ the rod-shaped variety of

rods about TS :n leUh Th?'"^' '' ^^"^' ^'^^^^^ 1^»«« or
person meaS tuWculos^^of some pa^oH "•''' ^P"'"'" «^ ^
they are associated with tL preseTc/of Jl ^^^'J'rP'^'^S^^ i when
the microscope) they are a p^ooToTth^^dtrbel^^^^^^^^^ Z^

240

mSKARKS OF THK CHEST.

L . ".,*■-/■'

proper. The examination of one's sputum, therefore, in the early
part of any prolonged and suspicious cough, becoi: es an alwolute ne-
cessity, since thereby one is made aware, in the earliest stages, of
this dreadful disease, and an opportunity offered of attacking it at once
in ita incipiency. This modern discovery has given rise to much
experimentation in treatment with the aim in view of killing out the
germ. Robert Koch of Berlin announced to the world, a shoit time
ago, that he had discovered an agent, which he called Tuberculin
that would eradicate these death-producing germs, but time has
shown his efforts to bo unsuccessful as yet, although promising of
great results in the future. These germs are contagious in character
so that we now can explain why mjtny contmct consumption in whose
ancestral blood there never existed any tubercular taint.

We know that husband may impart the disease to wife and mother
to daughter if only the system is in a receptive state to offer a lode-
merit to the germs. These tiny but most enduring bacilli retahi
their life for an indefinite time in the midst of dust and other dried
secretions, so that a practical point is that all persons suffering from
tuberculous diseases should be exceedingly careful where they spit
and with whom they sleep. To raise the sputum into small paper
cups which may be burned is a common and very prudent custom

Ihis discovery, while not disproving the old theory of heredity
nevertheless explains many a case of acquired Phthisis, and clears uj
many an old-fashioned theory.

These are indisputable facts from which the medical profession at
present hope to derive practical benefit by the discovery of some
germicide which may be applicable and safe for internal administra-
tion.

Can Consumption be Cured ? — In many caaes it can. It may be
cured, first, by the absorption of the tubercles. The celebrated John
Hunter shows, in his work on the blood, that the absorbent vessels
have a sort of elective a#m«y, by which they take up and remove "all
adventitious new matter, as tumors" (tubercles are albuminous tu-
mors), more easily " than those parta which were originaUy formed "
Were this not so, an activity in these vessels equal to the removal of
tubercles would cause them to waste all the tissues, and aggravate
rather than cure consumption. Probably this does occur where
proper hygienic means are not used to quicken the excretions. This
hygienic treatment, to be spoken of hereafter, is not generally em-
ployed, -certainly not as effectually as it should be. Here is the
source of Laennec's fatal remark, so often quoted and so widely en-
dorsed, that nature's efforts towards effecting a cure are injurious,
and those of art are useless." Laennec's position cannot be true, if
Hunter s statement is correct. If the absorbents, by an elective in-
stinct, take up adventitious matter rather than the natural tissues,
filv^ reason why they reverse this rule in consumption is, that by
a weakened state of the constitution, the ultimate particles are not

DISEASES OF THE CHEST.

241

1 tho early
il)8olute ne-
t stages, of
ig it at once
ie to much
ing out tlio
I shoit time
Tuberculin,
it time has
romising of
n character,
on in whose

and mother
offer a lodg-
lacilli retain
other dried
ffering froiu
re they spit
small paper
it custom,
of heredity,
nd clears up

)rofession at
pry of some
1 administni-

It may be
)rated John
mt vessels
remove "all
iminous tu-
[ly formed."
removal of

aggravate
3cur where
lions. This
[nerally em-

[ere is the

widely en-
injuriom,

be true, if
lelective in-
1ml tissues,

is, that by
lies are not

well put together^ and are more easily Uiken apart than those of the
adventitious tul)ercular tumors ; and if we would restore these vessels
to their natural activity, we must improve assimilation, and knit the
unloving molecules into a firmer brotherhood. We must make the
flesh hard, so that the absorbents cannot pick it to pieces. Do this,
and "nature's efforts to effect a cure" will not "bo injurious."

A second form of euro is the reestablisbment of the assimilative
function, the building up of the geneml health, the arresting of the
tubercular deposit, the reducing of tubercles already formed to an
indolent state ; and then, by a strict observance of the laws of health,
keeping them in that condition through life.

A third mode of cure is the healing of the cavities after the tuber-
cles have softened, broken down, and been expelled in the form of
expectoration.

A fourth method of cure is a change of tubercles to calcareous
matter. These calcareous tubercles, Laennec says, "are consequent
to tuberculous affections that have been cured" And Andral, at one
time, hoped to learn how to effect cures by changing tubercles to
" the calcareous phosphate."

I have had several cases of cure by this last method, and have
quite a collection of calcareous substances which my patients have
coughed up, — one of which was raised in my presence by a lady
who was a few years before in hopeless consumption, but is now in
good health.

Treatment. — This should be of two kinds, local and general.

The local treatment of consumption is by the inhalation of vapors
and powders into the lungs. It has been practised, more or less, by
individuals, for many yeai-s, particularly in Europe ; but for some
unaccountable reason, the profession generally have never used it,
and do not know much about it. I had the honor, some years ago,
to bring it freshly before the American public, in some articles writ-
ten for popular reading, since which time it has been rapidly gaining
public confidence, and is now attracting much attention. Convejdng
the rsmedy directly to the diseased parts, it strikes the common-
sense mind as eminently reasonable and necessary.

I shall speak of inhalation, therefore, very earnestly, not as a
palliative of consumption only, but as far more, as a remedy. After
long and patient use, my experience allows nie to say, that I know
it, in many cases, to be such ; and knowing this, I should be criminal
not to press it upon the public; for it is the great multitude of
sufferers, pressing fast through the gate of death, who need to hear
words of hope.

Consumption a General Disease. — It is not denied that con-
sumption is a general disease, needing constitutional treatment; but
it has also a local development in the lungs, first in the form of al-
buminous tumors, called tubercles, and then, after the softening.

I T t'

242

DISEASF.S OF THE CHEST.

breaking down, and discharge of these, in the more formidable shape
of ulcerous cavities, whicli, beginning at the summit, devour thu
lungs down to the base. Can it be reasonable to api)ly no remedy
directly to this local disease ? Not so does our profession deal witli
other local diseases. To an inflamed skin we apply poultices, cold
compresses, solutiouK of acettite of lead, nitrate of silver, etc. ; to
leprous or scaly affections, sulphuret of potash, bichloride cf mer-
cury, zinc ointment, nitrate of mercury ointment, sulphur, creosote,
etc. ; to weak and inflamed eyes, sulphate of copper, sulphate of
zinc, nitrate of silver, and opium ; to chronic ulcers upon the skin,
tannin, pulverized rhubarb, opium, or cinchona ; and to an inflamed
tliroat, nitrate of silver and other articles. These are but specimens
of the thousand cases in which we use local remedies. Why, then,
when the mucous membrane, ,vhich lines the air tubes, becomes in-
flamed through all its branches, should we neglect, by the inhalation
of medicated vapor, to apply a remedy directly upon the whole in-
flamed surface ? Why, when tubercu' matter is l)eginning to be
deposited upon the surface of the air cells, and of the small bronchial
tubes, shouhl not the vapor go right to those parts, and cause, as it
woidd, the immediate expulsion of tliiu offending and dangerous
matter ?

Uneducated common sense sees the reasonableness of these sug-
gesvions at a glance. Many a person, with jjulmonary disease, dies
of suffocation, not because there is not muscidar strength to expel
the matter which is strangling him, but because the lungs below the
large pellets of mucus, which plug up the bronchial tubes, cannot be
inflated, and have therefore no means of driving out the offending
substance. Yet a proper medicated vapor, drawn in with the breath,
would either dissolve the mucus, or rouse up the expiring membrane
to cast it off.

If the reader were to place one end of a stethoscope directly over
the disease upon the breast of a person in the third stage of consump-
tion, and should then ask him to talk, the words spoken would seem
to rise up through the instrument, and enter, well articulated, into
his ear. This, in technical language, is c»X\edi pectoriloquy, — a word
signifying chest-talking. It implies a cavity in the lung. If now the
patient be asked to cough, a gurgling and splasliing sound will be
heard. This denotes that the cavity is partly filled with fluid, which
is dashed about by the air explosively driven through it by the portion
of lung below. Here we have an excavated ulcer, with aU its filthy
contents, composed of pus, mucus, serum, and dissolved tubercles,
lying in it day and night to aggravate its unhealthy condition. What
more reasonable, what more necessary, than that a soothing, altera-
tive, or astringent vapor should be drawn into this cavity, to cause
its sides to heal, and its absorbents to remove this fluid? A surgeon
who should permit an ulcer upon the surface of the body to remain
in that condition without a local dressing would be deemed unfit to
practise his profession.

...M-.^ua^luari-'

IMAGE EVALUATION
TEST TARGET {MT-3)

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HiotogRsphic

Sciences

Corporation

""^ V

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23 WEST MAIN STREET

WEBSTER, N.Y. 14580

(716)872-4503

.r>sr.,:- S'L.tA.:^ ,.Xt^.^'

..^^....MiL, .^±1 .

CIHM/ICMH

Microfiche

Series.

CIHM/ICMH
Collection de
microfiches.

Canadian Institute for Historical Microreproductions / Institut Canadian de microreproductions historiques

DISEASES OF THE CHEST.

248

Both in tubercular disease and in simple bronchitis, the bronchial
tubes almost always suffer some physical change. The raucous
membrane lining these tubes is generally softened. At other times
the tubes become enlarged through their whole length, so that many
of them, from tJie size of a quill, reach the bigness of the finger of a
glove. In still other caseS; the straining produced by coughing
causes a tube to belly out at some point, forming a sack, which is
generally filled with mucus or purulent matter. At still other times,
a tubercle will press against a tube so as to flatten it and convert it
into a musical instrument, the air, as it is diawn laboriously through,
producing a high or low note, according to the size of the pipe.
These physical changes are all produced by causes which the inhala-
tion of a suitable vapor, at tlie proper time, would almost infallibly
remove. How strange that this remedy, — so simple, so effectual,
so easily comprehended, — should have been so little used I

Right at this vital point in the lungs, where the blood runs in a
ceaseless current, — where the whole of it goes every two minutes to
renew its vitality by contact with atmospheric air, — we have, in
thousands of cases daily occurring, inflammation Avith roughening or
softening of membrane, with its consequent harsh breathing ; we have
mucus, tough or glairy, to impede and interrupt respiration ; we have
tubercles in the hard or soft state, adding to the general embarrass-
ment, and not only lessening the vitality of the blood, but disturbing
all the sympathies of the system ; — and yet the practice has been,
and is, to attack these central distm-bers of life only through the cir-
cuitous path of the stomach, lacteals, etc.

I have investigated faithfully the effects of the various substances
proposed for inhalation by European physicians, and have explored a
wide field of new remedies, not before used, several of which have
proved to have qualities of great remedial power.

The chief remedies I employ for inhalation are the following .

Alterative Inhalant, composed of iodine, six grains ; iodide of
potassium, twelve grains ; tincture of ipecac, one ounce ; tincture of
balsam of tolu, six drams ; ethereal tinctui-e of conium, one and a half
drams ; alcohol, half a pint. These are to be mixed. The dose is
one to two teaspoonfuls, to be inhaled ten or fifteen minutes, in
about a gill of hot water.

The ethereal tincture of conium is made by keeping a dram of
powdered conium in one ounce of sulphuric ether a week.

The above inhalant is used in the tubercular forms of consump-
tion, particularly that of the scrofulous kind, and in mauy cases of
bronchitis.

Expectorant Inhalant. — Take pleurisy root, half an
squill, one ounce ; ipecac, two drams ; black cohosh, two
queen's root, one ounce and a half; American hellebore, two drams;
diluted alcohol, one pint. Grind the roots, etc., and add the alcohol.

ounce ;
ounces ;

244

DISEASES OF THE CHEST.

Let the whole stand one week, shaking or stirring daily. Draw off
and filter through paper. Two teaspoonfuls make a dose, to be in-
haled same as preceding.

This is to be used when the cough is hard and dry, and the expec-
toration difficult. It makes the raising easy, lessening the soreness
of the chest, and the harshness of the cough.

Soothing, Febrifuge Inhalant. — Take belladonna leaves, half an
ounce ; black cohosh, two ounces ; American hellebore, half an ounce ;
poke-root, two drams ; aconite root, one ounce ; diluted alcohol, one
pint. Grind the roots, etc., add the alcohol. Let the whole stand
one week, stirring daily. Pour off and filter through paper. Dose,
one to two teaspoonfuls, to be inhaled as the preceding.

This is excellent in all cases where the skin is hot, the pulse
quick, the tongue and mouth parched, the chest sore, and the system
suffering during the whole or a part of each day, from a general
feverish condition. It is proper in all the forms of chest disease.

Astringent Inhalant. — Take of wild indigo, one ounce ; catechu,
half an ounce ; Peruvian bark, one ounce ; golden seal, one ounce ;
diluted alcohol, one pint. Mix, and let the whole stand one week,
stirring daily. Drain off, and filter through paper. Add two di-ams
of creosote. One to two teaspoonfuls to be inhaled as preceding.

This is to be used when the expectoration is profuse and easy, un-
attended by fever, either in the latter stages of chronic bronchitis,
when the mucous membrane of the tubes is in a relaxed condition,
or, in the third stage of tubercular disease, for the purpose of con-
stringing, cleansing, strengthening, and healing.

Antiseptic Inhalant. — Take wild indigo, one ounce ; belladonna
leaves, half an ounce ; diluted alcohol, one pint. Mix, and let the
whole stand one week. Pour off, and filter through paper. Then
add solution of chloride of soda two ounces. Dose, one to two tea-
spoonfuls, to be inhaled as the preceding.

This is used in cases of gangrene of the lungs,, generally distin-
guished by considerable expectoration having a very fetid smell.

Anti-Hemorrhagic Inhalant. — Take witch-hazel bark, two
ounces ; black cohosh, four ounces. Grind, and add one pint of
diluted alcohol. Let the mixture stand one week, stirring daily.
Pour off, and filter through paper. Add to this two drams of creo-
sote. Dose, one to three ieaspoonfuls, to be inhaled as preceding.

This is an excellent remedy for bleeding from the lungs. When
there is a tendency to bleed, it should be used for a long time. It
may frequently take the place of No. 4, as an astringent inhalant.

For immediate relief give strong solution of salt water.

Object of Inhalants. — Being vaporized and inhaled, these articles
enter every air-cell throughout the lungs. Their object is to soothe
and mollify inflamed mucous surfaces, to reduce enlarged bronchial

■ >i nn* i<ii m i iijn ii (, M

riSEASES OF THE 0HB8T.

24r

. Draw off

le, to be in-

i the expec-
ihe soreness

ves, half an
[f an ounce;
alcohol, one
^•hole stand
per. Dose,

b, the pulse
[ the system
a a general
disease.

36 ; catechu,
one ounce;
I one week,
[ two dmms
eceding.
id easy, un-
bronchitis,
I condition,
lose of con-
belladonna
md let the
per. Then
to two tea-

:ally distin-
smell.

bark, two
ne pint of
ring daily,
ns of creo-
'eceding.
TB. When
time. It
nhalant.

ese articles
to soothe
bronchial

glands which press upon neighl)oring parts and ciiuse bleeding, to
stimulate the absorbents to take up and remove tubercles, to dissolve
tubercles out of the pulmonary tissue, to cause ulcerous cavities to
expel their mattery contents, and to stimulate their sides to take on
a healing process. They should be used from three to six times a
day, the inhalation continuing from ten to fifteen minutes.

Other Inhalants. — Great numbers of other articles have been
used, which I have not space to describe. I will mention, however,
that the following are sometimes employed with advantage : —

For an Expectorant Inhalant, take alcohol, four ounces ; tincture
of camphor, half an ounce ; tincture of tolu, two drams ; naphtha,
one dram ; benzoic acid, thirty grains ; oil of bitter almonds, four
drops. Mix.

For an Anodyne Inhalant, take alcohol, four ounces ; naphtha, one
dram ; benzoic acid, thirty grains ; chloroform, twenty-five drops ;
tincture of henbane, half an ounce. Mix.

For an Astringent Inhalant, take alcohol, four ounces ; naphtha,
one dram ; benzoic acid, thirty grains ; chloroform, one dram ; tannin,
eight grains. Mix.

Mode of Inhaling. — For inhaling these, a sponge is fitted into a
glass cup, to which a flexible tube is attached. A small quantity of
the mixture is poured upon the sponge, and the vapor arising is
drawn into the lungs through the tube.

To the expectorant inhalant may be added, occasionally, half a
dram of nitric acid.

These latter formulas are the principal ones used by those who
practice what is called cold inhalation.

A very common mode of inhaling volatile remedies is by saturat-
ing a little cotton, contained in a wire basket, with the desired oil or
fluid, and placing it over the mouth and nose. It is to be worn
throughout the day. Oil of peppermint, creosote, menthol, oil of
eucal3rptus, etc., etc., are among the more common remedies thus
used.

A good inhaler can be bought of any dealer in surgical instruments.

Constitutional Treatment. — The rapid breathing in consump-
tion creates too much oxydation of the blood, — so much, that the
muscles, especially the heart, are usually of a bright red. To prevent
the patient from being literally burned up by oxygen, the blood
must be de-oxydated as fast as possible.

While there is too much of oxygen, there is, at the same time, a
deficiency of carbon. Hence the cold hands and feet, and the gen-
eral inability to bear frosty weather. The little nutritive arteries, in
these thin-blooded persons, stand shivering and torpid with cold, un-
able to perform their allotte.1 function of nutrition. There is not
fire enough, and fuel must be had in the form of carbon. Hence one
of the advantages of cod-liver oil. This oil, too, as carbon, devoui-s

246

DISEASES OF THE CHEST.

the oxygen of the blood, and prevents its destroying the patient.
Phis idea also explains the fact mentioned by Beniiet and others,
that in their post-mortems they found the evidences of healed ulcei-s
in numerous persons who had been spirit-drinkers while living. Ami
Liebig helps the explanation by saying that alcohol, taken into the
system, circulates in a free state in the blood, and devours its oxygen.
To which I beg to add, that the malaria of intermittent and bilious
fever districts, has been pretty satisfactorily proved to be an instable
organic body, consisting of sulphur, carbon, and hydrogen, all of
which have an affinity for oxygen, and devour it in the system.
Consumption is not found in such districts

As I am here treating of the chemical effects of remedies (and to
this test most remedies must finally come), I will mention that tar-
trate of antimony and potassa arrests the circulation in the pulmonary
arteries, — which fact gives a complete and luminous view of its
power to prevent oxidation. But I am obliged to detract from its
merits, by stating that it also retards the circulation in the capillaries
of the system generally, and so hinders c?e-oxidation.

Phosphorlis. — There is an article which has more recently pre-
sented itself to the notice of the profession, to which I wish to invite
special attention. I refer to phosphorus. This agent, for a time,
challenged our notice in the shape of phosphate of lime ; but we could
never feel sure that this article was dissolved in the fluids of the
body. We now use, and with far more marked effect, the hypo-
phosphites of lime, soda, potash, and iron. These are used in tlie
form of the syrup of the hypophosphites. The dose is a teaspoonful
before each meal. The effect unon tubercular disease is immediate
and gratifying.

Need of Phosphorus. — Cerebric acid contains nitrogen and phos-
phorus, and is t'.ie peculiar component of the brain and nervous sys-
tem. By combustion and the changes of oxidation in the brain, the
phosphorus of cerebric acid is converted into phosphoric acid ; so that
every act of the brain produces phosphoric acid. How rapid, then,
must be the consumption of the phosphoric element of the cerebric
acid, in that highly active p,nd excitable state of the nervous system
which I have described as peculiar to consumption. And how neces-
sary, in order to save the brain from destruction, to meet this increased
demand for phosphorus, by introducing it into the system.

Mulder regards the fibrin of the blood as the carrier of oxygen; and
by this oxidation, the fibrin becomes converted into the binoxide r.nd
trioxide of protein, — its phosphorus and sulphur (for it ccitains
both) being converted into phosphoric and sulphuric acids. Adding
phosphorus and sulphur, therefore, as medicinal agents, would seem
to be the proper way to supply the fibrin with materials destructive
of its freight of oxygen.

It is well known that the salts of phosphoric acid are essential for

DISEASES OF THE CHEST.

247

the patient.
t and othci's,
healed ulcers
living. And
ken into the
rs its oxygen,
t and hilioiis
)e an instable
rogen, all of
I the system.

edies (and to
bion that tar-
he pulmonary
3 view of its
ract from its
the capillaries

recently pre-
wish to invite
t, for a time,

but we could

fluids of the
ct, the hypo-
! used in the
a teaspoonful

is immediate

jen and phos-

nervous sys-
the brain, the

acid ; so that
V rapid, then,

the cerebric
rvous system

d how neces-
this increased
3m.

oxygen; and
biuoxide r.nd
)r it ccatains

ds. Adding

would seem
s destructive

essential for

the formation of azotic compounds, — conii«)und8 wlii(^h are neces-
sary to sustain animal life. It should be reiuumbcrcd, too, as collat-
erally illustrating this fact, that the tribasic phosphates of potash, soda,
lime, and magnesia, j)lay an important part in the growth and perfec-
tion of plants. They are always found in the seeds of the cerelia, and
no mature grains are produced where phosphates are absent from the
soil. For the production of abundant grain-crops, it is necessary
that these salts should exist in the soil, or be applied to it in manures.

It is known, moreover, that in all chronic diseases distinguished by
wasting of tlie tissues, a much larger quantity of phosphates is ex-
creted by the kidneys than in the normal state. Hence there is no
healthful growth ; and the human organism, like the soil, exhausted
of its phosphates by successive croppings, brings nothing to perfec-
tion, and needs to have its drained salts re-supplied.

I cannot but call attention here to the inorganic substances found
in healthy human blood. According to very careful analyses, by
Schmidt :

1000 parts of blood-corpuscles, contain :

Chlorine 1.686

Sulphuric Aeki 0.066

Phosphoric Add 1.134

Potassium 3.328

Sodium 1.052

Oxygen 0.667

Phosphate of Lime 0.114

Phosphate of Magnesia .... 0.073

1000 parts of liquor sanguinis (serum
and fibrin), contain :

Chlorine 3.664

SulhuricAcld 0.115

Phosphoric Acid 0.191

Potassium 0.323

Sodium 3.341

Oxygen 0.403

Piiosphate of Llrao 0.311

Phosphate of Magnesia .... 0.222

Iron is omitted. Now, I venture the prediction, that out of these
figures, mainly, in connection with those which represent the consti-
tuents of the saliva, the bile, the gastric juice, the pancreatic secretion,
and the organic compounds of the blood and tissues, are to be evolved
within a few years a correct and partially demonstrative system of
medication. In consumption, all the inorganic bodies represented by
the above figures, with the exception of oxygen, are deficient in quan-
tity. By reflecting upon the proportions of these several bodies, par-
ticularly upon the large amount of clilorine and soda in the plasma,
and of potassium in the corpuscles, the mind can hardly fail to obtain
useful hints. I have not hesitated to make one of these hints the
ground of a very free use of alkalies, — particularly in the form of
bathing.

Sugar of Milk. — There is one other medicinal article which I deem
worthy to be mad prominent, and to be placed side by side with cod
liver oil and the hypo-phosphites. I refer to sugar of milk. It belongs
to that class of non-nitrogenized articles which Liebig has denomi-
nated supporters of respiration. Its great affinity for oxygen is well
worthy to be taken into the account, in considering its value in con-
sumption. So great is this attraction, that, with ammonia and other
alkalies, it has the power of reducing some of the metallic oxides.

248

DISEASES OP THE CHEST.

When taken into the stomach, it is rapidly alworbed into the blood,
which, being an alkaline fluid, augments its great de-oxidating power
to a considerable degree. It unites rapidly with oxygen after enter-
ing the blood, forming carbonic acid and water. A part of it, how-
ever, does not enter the blood in an uncompounded state, but is
changed in the stomach into lactic acid ; and this, in the blood, be-
comes an alkaline lactiite. But the portion thus changed appears
also very useful ; for Lehmann says : " We know of no substance
which could better act in the blood as food for the respiration, than
the alkaline lact^ates."

Corroborative of these views is the fact that all those kinds of
milk, such as goat's, ass's, etc., which contain the largest amount of
sugar of milk, have at different times, and in various countries, ol>-
tained a reputation for curing consumption. Goat's whey, in which
this article abounds, and from which it is largely manufactured, has
been celebrated for its virtues in this line. Ancel speaks of it as an
excellent remedy ; and Pereira says, " Sugar of milk, in consumptive
cases and chronic 'diseases of the digestive organs, is a most valuable
aliment."

One of the best forms of taking sugar of milk is that of a gruel,
which is quite palatable, and may be freely eaten by consumptive
persons.

Creosote, Quaicol, etc. — Modern researches having proved that
consumption, as well as many throat and other diseases are propa-
gated by germs or bacilli, as explained on page 239, medical investi-
gators have for a long time been seeking some agent that would
destroy these germs without at the same time injuriously affecting
the human system. A few years ago Dr. Robert Koch, a celebrated
German scientist, who had long been investigating the consumption,
cholera, and other microbes, thought he had discovered a lymph that
would destroy or at least counteract the consumption bacillus ; but
unfortunately it proved a failure. Creosote, carbolic acid, guaicol
and similar drugs kill the germ when outside the body, and for this
reason most therapeutists of to-day use these remedies in as large a
quantity, and for as long a time as tho system will tolerate. At all
events, whatever may be the outcome of thecustom at present in
vogue, creosote certainly arrests the rapid proliferation of germ-life
in the lungs, improves the appetite and digestion, lowers the temper-
ature, and apparently helps the patient. The only offset to the use
of this class of remedies lies in the fact that one cannot thoroughly
disinfect the blood sufficiently to kill these germs completely. Creo-
sote made from beechwood, taken in three-drop doses with a wine-
glass of milk, after food, three times a day, is the usual form of
administration. This dose should gradually be increased till ten and
even twenty drops are taken at a time. The carbonate of creosote is
a more elegant and perhaps more effective form of the drug. This
medicine may also be procured in the form of capsules .and pills.

■-~-i»<B«a>i iir«Mist'jtaitaw'<

:he blood,
ng power
fter entei-
f it, how-
te, but is
blood, be-
d appeal's
substance
tiou, than

I kinds of
imount of
ntries, ol)-
, in which
tured, has
)f it as an
isumptive
t valuable

f a gruel,
isumptive

oved that
are propa-
al investi-
hat would
k affecting
celebrated
sumption,
onph that
lUus; but
d, guaicol
d for this
IS large a
. At all
resent in
germ-life
e temper-
,0 the use
loroughly
y. Creo-
h a wine-
form of
I ten and
reosote is
g. This
pills.

DISEASES OF THE CHEST.

249

By Dr. Cyrus Edison's recently discovered product &f carbolic
acid, iusepsin, it is claimed that seventy per cent of consumptive
oases can be cured. It can only be administered as a hypodermic
injection, however, at the hands of an experienced practitioner.

The Coug^h. — The best article I have ever used for this is the
"Pulmonic Cherry Cordial." I was five years in compounding this
article to suit me, and I believe it to be the very best cough prepa-
ration ever made. Dose, from one to two teaspoonfuls.

Pulmonic Cherry Cordial. — Wild-cherry bark, ground, 10 pounds
ipecac root, 20 ounces ; bloodroot, 24 ounces ; squill root, bruised, 12
ounces ; pulverized liquorice root, 5 ounces ; cochineal, bruised, 2
ounces ; anise seed, 32 ounces ; fennel seed, 8 ounces ; orange peel,
16 ounces ; acetate of morphine, 12 drams ; alcohol, 8 gallons ; water,
8 gallons ; pulverized white sugar, 40 pounds ; sulphuric acid, 1
ounce.

Directions for making. — Grind all the articles to a coarse powder
except those directed to be bruised or pulverized, and put them all
to the alcohol except the wild-cheriy bark, the water, the sugar, and
the sulphuric acid. Let them stand one week, shaking or stirring
thorouglily twice a day. Then, having kept the wild-cheny bark two
days in a covered vessel, with water enough ujjon it to wet it through,
place it in a percolator, and run eight gallons of water through it.
Add this to the alcohol and other ingredients. Let the whole stand
tliree days longer, stirring as before, twice a day. Draw off, and fil-
ter through paper. Now add the sugar, and lastly the sulphuric acid.
The acid is intended mainly to improve the color, by acting chemi-
cally upon the cochineal. The color is a fine cherry red, tinged with
orange.

I have given the directions for making sixteen gallons — this being
the smallest quantity in which I make it. Any person can easily
make the calculation for reducing the quantity. The assertion pre-
viously made that tliis is the " best cough preparation ever made," I
see no cause to modify in the smallest degree. Were it kept in
every apothecary shop, and were physicians to prescribe in pul-
monary complaints, adding a little syrup of squills or wine of ipecac
when a more expectorant effect is wanted, or a little morphine if
greater narcotism is sought, it would save them much trouble in com-
pounding cough syrups, and give them much more satisfactory re-
sults. I have compared its effect, again and again, with the best
other preparations in use, and I pledge my word that it will succeed
in twice as many cases as any other compound that may be chosen.
Let physicians try it; and I will be responsible for ever hair's
breadth in which they find this proportion of successful results
abridged.

When a more quieting effect is needed, a little morphine may be
added to this preparation ; if a more expectorant influence is required,
add a few drops of the tincture of veratrum viride. For the great

■\ ■'»

■ — "" ■>»"

250

DISEASES OF THE CHEST.

majority of cases, it will l)e found to be right without any addition.
When this is notathand, my of the preparations (108), (112), (100),
(113), (110), etc., may be used. Another good preparation is Dr.
King's consumption cure.

Night Sweats. — The very best preparation for these sweats ia a
compound of the oxide of zinc, one dram ; extmct of conium, half a
dram ; to be made into twenty pills, of which one or two are to be
taken every night. The sponge bath also does much to check these
sweats, and vinegar baths (369). Atropia, ^U of a grain on retiring,
and especially Agaricin, ^ grain, will cause the sweats to stop abso-
lutely.

Diarrhoea. — This is a most exhausting symptom in the latter
stages of consumption. The only remedy which has much effect in
controlling it is the iris-nitrate of bismuth. This should be given in
doses of thirty grains immediately after, or at the time of each meal.
These doses are much larger than used to be given ; but they will
do no harm. Given to tliis extent, I find the bismuth very effectual.

Iron.— This preparation, in some of its forms (316), (73), (159),
(102), is almost always needed in consumption. If the scrofulous
habit be strongly marked, give syrup of iodide of iron, in thirty-drop
doses, three times a day. It should be taken in a glass of water. To
the feeble administer Gude's pepto-mangan in teaspoonful doses three
or four times daily. This is one of the simplest and most effica-
cious forms of iron we have.

External Irritants These are needed where there is much in-
flammation and soreness of the chest. Blisters should very seldom
be used. Croton oil, from two to half a dozen drops, rubbed over
the sore part, generally answers very well. Sometimes the mustard
paste, applied to the extent of producing redness, two or three times
a week, is sufficient. Nitric acid, reduced with water to a strength
a little above the strongest vinegar, answers a good purpose for
keeping up an irritation.

Atmospheric Inhaiation.-- -It has been said by Laennec and others,
that asthma has sometimes the effect of arresting tubercular consump
tion. Dr. Ramadge thought this was effected by an expansion of
the vesicular structure of the lungs ; and he reasoned that the same
expansion, by mechanical means, would secure a similar end. To ef-
fect this, he made his patients take long breaths through a tube con-
structed for the purpose.

It is manifest that the philosophy of atmospheric inhalation was
not understood by Dr. Ramadge, nor has it been by any of his fol-
lowers in this country.

Rokitansky thinks the tubercular habit depends upon the excess
of fibrin in the blood ; and says that the reason of consumption being
arrested by pregnancy is, that this condition offers a mechanical ob-

• •TmriiiiBHJSMMiSWi''''''''

' I

IHSEASKrt OK THK CHEST.

261

ly addition.
I2),(10!t),
ition is Dr.

sweats is a
lium, half a
ro are to Ihj
check these

on retiring,
) stop alwo-

a the latter
ich effect in
be given in
f each meal,
ut they will
ry effectual.

:73), (159),
B scrofulous

thirty-drop
f water. To
I doses three

most effica-

is much in-
very seldom
rubbed over
the mustard
: three times
} a strength
purpose for

c and others,
lar consump
jxpansion of
lat the same
end. Toef-
1 a tube con-
halation was
ly of his fol-

a the excess
nption being
jchanical ob-

stacle to the transmission of blood tlu-ough the lungs, — thus pre-
venting its excessive oxidation, ai'd keeping it in a venous state.
This destroys the fibrinous condition, on which he thinks tuberculosis
depends.

Now this ift precisely what is done by atmospheric inhalation. The
trachea divides, on its entrance into the lungs, into two branches,
which again divide ana subdivide until the tubes become smaller
than can be seen, each terminating in a minute air-cell. Over this
entire surface the air is intended to be brought into communication
with the blood for the purjjose of oxidating it. By forcible inhala-
tion, the air-vesicles are inflated to the extent of their capacity, by
which means the extreme branches of the pulmonary arteries are so
flattened between these extended cells, as to be able to convey but a
small amount of blood, and but little is oxidated. This furnishes a
mechanical obstruction to the transmission of the blood, and secures
the defibrination of which Rokitansky speaks.

This is my view of the philosophy of atmospheric inhalation. The
benefit results, not from a larger amount of oxidation, as is generally
supposed, but from a smaller. Asthma does the same thing by pro-
ducing spasmodic contraction of the extreme bronchial tubes, and
preventing air fro.n entering the cells.

The same end is gained in part by certain kinds of employment, as
glass-blowing, playing upon wind instru .lents, and the like. Writers
of distinction mention cases of recovery from incipient consumption
by a vigorous use of the lungs in singing. Dentists subject their
lungs to a similar process of expansion in the use of the blow-pipe ;
the writer has known several instances in that profession, in wldch
recoveries have taken place.

The Conclusion to which I come is, that atmospheric inhalation
may be used with great advantage in some ciises, but should never
be resorted to. except under the direction of a competent physician.
In a congested state of the lungs, with hsemorrhagic tendencies, or
with inflammation and soreness, it is well fitted to produce fatal
bleeding and is of course dangerous.

External Use of Water. — As a relaxation from severe exertions,
the ancients had frequent recourse to bathing. Those who contended
in the race, throwing the javelin, and wrestling, at Rome, plunged
into the Tiber while warm and panting with their efforts. That this
promoted prowess and physical endurance, none can doubt.

Louis, the great French authority on pulmonary diseases, lays
down several rules to be observed by consumptive patients, and par-
ticularly mentions cold bathing.

Few things give tone to the capillaries of the skin like cold water,
systematically applied. It rallies the powers of the constitution, and
improves assimilation. And by it another object is gained of scarcely
less importance, — that of gfuarding the system against taking cold.

Mil

fc:JiKUIii^'^^-

^^t£Uy,^'t^

:?"fSm:.iZ^f^:^:'W^;gSl::rj

352

DISEASES or THE CHEST.

Those in the daily habit of applying cold water to the whole perann
seldom suffer from colds ajul catarrhs ; they generally l)ecome har-
dened so as to endure the assaults ol the elements.

Consumptive persons should generally use the sponge bath, with
cold water, if it can be endured, otherwise the tepid bath, to be fol-
lowed, in all cases with brisli rubbing, with a coai-se towel. If a sense
of chilliness and discomfort fol'ows tlie bath, a large poition of the
water must be squeezed from the sponge, so as to use but very little,
and the washing must be speedy, and the rubbing more lively than
usual, — beginning with tepid water, and gradually lowering the
temperature till it can be borne cold. A large teaspoonful of salera-
tus to each quart of water should be used.

Diet.

The diet, like all other parts of the treutment, must have reference
to the present condition of the patient. If the disease take the bron-
chial form, and rapid breathing, and other conditions calculated to
carry fat out of the system have not yet supervened ; or if the pa-
tient have thii-st and hectic, the diet must be spare and simple, —
consisting chiefly of milk and farinaceous sulwtances.

But in all cases where the disease is tubercular, or, being bronchial,
has reached the stage of emaciation, the very earliest moment at
which the fever can be subdued should be improved to build up the
patient with a generous diet. I have seen cases where the stuffing
sometimes resorted to for fattening turkeys for Thanksgiving would
seem to be almost justifiable. A good rule is to give the most gener-
ous diet that can be taken without disturbing the stomach, or increas-
ing the feverish symptoms. Animal food with a good quantity of
salt should be f i eely taken. Pat meats, if well received by the stom-
ach (and they generally are if taken cold), are particularly useful.
The same is true of sweet butter and cream.

Out-Door Exercise.— Without exercise, as a general thing, the
consumptive patient will die. Exercise involves muscular exertion,
which is attended by the tension, compression, and greater compact-
ness of the muscles used. This compression of the muscles within
the sheaths (fasciae) which enclose them sends out their blood, and
pushes it forward towards the surface. Reaching the extremities of
the arteries, the blood passes through capillary tubes, almost incon-
ceivably fine, into the capillary veins of similar fineness, whence it
flows through larger and larger veins back to the heart. At the mo-
ment of its passage from the capillary arteries to the capillary veins,
it ceases to be red or arterial, and becomes purple or venous blood.
The oxygen in the arterial and the carbon in the venous blood unite,
forming a literal combustion, just such as we produce in our stoves
and grates by bringing together the carbon of the wood and the oxy-
gen of the atmosphere. By this combustion our bodies are warmed.

olo person
come hiir-

batli, with
to be fol-

If a HCllHti

ion of tlie
very little,
ively than
ering the
I of salera-

) reference
! the bron-
3ulated to
if the pa-
simple, —

bronchial,
loment at
ild up the
le stuffing
ing would
lost gener-
or increas-
uantity of
the stom-
■ly useful.

hing, the
exertion,
corapact-
es within
)lood, and
emities of
58 1 incon-
w. hence it
t the mo-
ary veins,
us blood.
)0d unite,
ur stoves
I the oxy-
warmed,

DI8KASK8 OK THE ClIKHT.

263

and the little secreting, exhalant, and other vessels, are raised to a
teniperaturo that enables them to work.

Every muscular contraction and compression helps push along the
venous blood in larger quantities to she right auricle of the heart,
which, receiving a fuller supply of its natural stimulus, contracts more
energetically, forcing the fluid into the right ventricl'^. From thence
it is expelled with increased energy likewise along its only pathway,
the pulmonary artery, into the lungs. Rushing in here in greater
volume than natural, a demand is made for deeper inspirations of
air to vitalize and fit it for its descent by the pulmonary vein, to the
left auricle. Coming here also as the natural stimulus, in larger
quantities than usual, it gives increased energy to its own j)ropulsion
into the loft ventricle, from whence it is driven out through the arte-
ries to all parts of the system, by the powerful strokes of that strong
muscle.

Thus it goes its round, u"ged on by exercise, parting with its oxy-
gen more and more freely in the capillaries, giving more activity to
the vessels of th^ skin and other tissues, increasing the depth and
strength of breathing by carrying more venous blood to the lungs ;
improving the digestion, carrying a better elaborated pabulum to the
nutrient arteries, and causing them to work it up more diligently in
renewing the tissues.

Nor is this all. Every wrench of a muscle forces some old, worn-
out particles from their places, tallowing none to remain except such
ii8 are firm, and able to bear the brunt of exertion. The flesh of those
who exercise much becomes hard and enduring.

I say then to the consumptive, if you would live and not die, exer-
cise, exercise, exercise. It is the first, second, and third thing. If
you ask for the modes of exercise, I say take it on foot, out of doors,
every day, to the extent of a small amoui. of fatigue. Don't be
frightened by a single cloud, or even by a cohort of them. You have
as good a right to be out as the clouds ; and they will not look more
angry, but rather more agreeable from finding you abroad in their
company. The elements of rature are at war with organic life.
Against them the vital principle has to maintain a perpetual struggle ;
and he who loses the power to meet and gain the victory over them
by out-door exercise, is beginning to die.

Go abroad, therefore, often. Try it again and again. Extend
your walk a little every day. Stretch it out to the distant fields.
Gather flowers from the top of the hills and from the bosom of the
valleys, and bring them home as trophies of your victory.

If not able to begin with walking, ride as often as possible in a
carriage. The jolting of a "ehicle will jog the blood along much
better than no exercise.

Horseback riding is still bet* It combines., in some measure,
the passive exercise of carriage iding, with the active exertion of
walking on foot.

264

DISEASES OF THE CHEST.

Numerous other modes of exercise may be resorted to with advan-
tage. Dumb-bells, adapted in size to the strength of the patient,
and used with caution, are highly serviceable. The battledoor, the
footb ill, bicycle riding, pitching quoits, and the athletic sports of the
gymniisium, all have their appropriate place. The greater the variety
the bettei", as by it all parts of the system are brought into play, and
both the mind and the muscles ;;3t the change which they need.

It is hard to impress patients with the importance of this subject.
Say what you will, they somehow or other get the idea that a mod-
erate amount ci: 'ixercise, taken when they feel like it, is all that is
required. Fatal mistake 1 Whatever the physician may do, the pa-
tient has a great deal to do for himself. He must strive to develop
Ids physical powers to the utmost. He must train himself as runners
and fighters do when preparing for their surprising feats ; for he is
running against the swiftest disease (or the surest winner) of our cli-
mate, and fighting with the elements.

If he regards life as not worth this exertion, of course he will not
make it ; but I beg him to consider that without it recovery will be
uncertain, and in many cases, impossible. Do as I have directed, and
if your medical attendant is skilful, the current of health will, in
many cases, begin to flow back to you. Life will renew to jou its
policy of insurance, and multiply your days.

Travelling: — Consumptive patients have generally been sent to a
southern climate. But where the case involves dyspepsia and affec-
tions of the liver, low latitudes are generally unfriendly. Liver com-
plaints are the bane of a southern climate, and a sallow complexion is
the inheritance of a southerner.

Tubercular persons, chilled by our northern climate, are sometimes
temporarily relieved by the warmer atmosphere of the south. But
the relief is only temporary ; for, having lost the powSr, as they im-
agine, to bear the frowns of our northern sky, they are dying, and
will die anywhere unless they recover this power. And the way to
retrieve a lost advantage over an enemy, is, not to retreat to a point
where recovery will be harder, but to meet him at once. If the con-
stitution cannot bear up against an enemy under the bracing of a
northern atmosphere, it will be still harder to do so under the wilting
of a southern.

After all, the objects aimed at should be change and travelling.
The exercise involved, the constant exertion required in getting from
place to place, the agreeable sensations produced by the motion of
cars and steamboats, the ever varying change of sights and sounds,
and the constantly increasing stock of one's ideas of men and things,
— these are what rally the constitution, and open anew the springs
of life.

Especially should all journeys for health be taken, if possible, with
an object in view. Let the consumptive start with the view of see-
ing the cave of Kentucky, the prairies of the West, tlie great lakes

1 advan-
patient,
loor, the
ts of the
3 variety
(lay, and
jed.

subject,
a mod-
[ that is
I, the pa-
develop
I runners
'or he is
i our cli-

will not
y will be
cted, and
\ will, in
I _j'ou its

sent to a
md affec-
iver com-
plexion is

ametimes
th. But
they im-
ying, and
le way to
,0 a point
the con-
ing of a
le wilting

ravelling.
ting from
aotion of
I sounds,
id things,
springs

ible, with
w of see-
eat lakes

DISEASES OF THE CHEST.

255

of the North, the falls of Niagara, the fortress of Quebec, the Sague-
nay river, the doctor, who he has reason to think will cure him, —
anything which he is willing to make exertion to see, and that he is
sure his eyes will rejoice in beholding.

I have thus spoken of consumption more at large than of other
complaints, becarse it is the great disease of the world, and is in-
creasing with the advancement of civilization.

Acute Bronchitis.

This is an acute inflammation of the mucous membrane lining the
air-tubes in the lungs. , It is generally quite a serious disease.

Physical Signs. — The sound upon percussion is generally good.
If there be any (' illness, it is commonly in the lower and back part
of the chest. This occui-s only in " Capillary Bronchitis."

The breathing murmurs are sometimes more, sometimes less in-
tense than natural. Occasionally they are almost extinct.

In the early stage, sibilous and loud rattles.

In the more advanced stage, mucous rattle.

Now and then sub-crepitant rattle accompanies the inward-drawn
breath.

General Symptoms. — The disease begins with chills followed by
fever ; tightness across the chest, difficulty of breathing, hoarseness,
loss of strength, costive bowels, and a quick and hard pulse. Water
runs from the eyes and nostrils, and there is a dry, harsh, croupy
cough.

After a few days, mucus begins to be raised. This expectoration
gradually becomes more copious, and is opaque, yellowish, or green-
ish, and occasionally streaked with blood. This mucus is verj' ropy
and adheres to the vessel.

There is more or less pain in the chest ; pain across the forehead,
which is increased by coughing; and a pale and anxious countenance.

In severe cases, the tightness across the chest is extreme, with a
sense of suffocation, causing the patient to call for the opening of
the windows. There is great diificulty of breathing ; a paleness and
lividity of the cheeks and lips ; a loud wheezing and rattling in the
throat, followed by cold sweat, insensibility and death.

In children the disease comes on like a common cold, attended by
a sore throat, a great desire to drink, but a disinclination to take
food. But two or three swallows of drink can. be taken at a time
for want of breath. The phlegm is frequently vomited up spon-
taneously.

Observations. — The loud and sibilous rattles are produced by
similar causes, namely, the passage of air along tubes whose interior"
is dry and rough from inflammation, or whose calibre Is contracted or
altered in form by the swelling of the membrane, effusion upon its

■»■'

I: V- ■■'

DISEASES OF THE CHEST.

inner surface of a tough, mucous substance, or a pressure upon its
external surface of tubercles, swollen glands, aneurismal tumors,
etc. The two sounds differ mainly in the key upon 'which they are
pitched, — the sonorous, or low-keyed, conihig from the larger tubes;
the sibilous, or high-keyed, from the smaller, — just as the low notes
of an organ come from the large pipes, and ihe high notes from the
small ones.

. The sibilous rattle has been compared to the chirping of birds, the
squeaking of puppies, the whistling of air passing through a key-
hole, etcj; the sonorous, to the snoring of a sleeping person, tlie
cooing of doves, and the sound of the bass-string of the violoncello
rubbed with the finger.

Causes. — It is generally brought on by a sudden cold, by changes
of the weather, and by inhaling irritating substances. It is a second-
ary result, too, of scarlet fever, measles, small-pox, hooping cough,
and the remittent fever of infants.

Treatment. — In mild cases, give warm balm or flax-seed tea, hot
lemonade, or other similar drinks, — at the same time soaking the
feet in hot water, and, on retiring to bed, apply bottles of hot water
to the feet and sides, to produce sweating. If the bowels be costive,
some gentle physic, as rhubarb and magnesia, or salts and senna, may
be taken.

In the case of infants, an emetic of wine of ipecac, or compound
tincture of lobelia, should be given, and followed with slippery elm
and flax-seed tea. The compound tincture of lobelia, with tincture
of veratrum viride, may be continued for a time as an expectorant.

In more severe cases, both of adults and children, an active emetic
is required, — perhaps the compound powder of lobelia is as good as
any. This must be followed with tincture of veratrum viride, in full
doses, so as to reduce the pulse at once, and keep it down to the
natural standard. This is one of the very best articles in this com-
plaint, and will generally very much lessen its violence and duration.

If there is much difficulty of breathing, the air of the room must
be kept moist, as recommended in croup.

The room should also be kept warm, — decidedly warmer than in
the case of other fevers.

A gentle perspiration should be kept up by small doses of com-
pound tincture of Virginia snake-root, and by frequently bathing the
surface, or else by tincture of veratrum.

Mustard should be applied to the chest, and to the soles of the feet.

The cough may be managed by preparations (104), (106), (110),
freely given.

The diet should be confined to barley-water, toast-water, apple-
water, rice-water, and. a solution of gum-arabic.

1 upon its
il tumore,
[1 they are
ger tubes;
low notes
from the

E birds, the
igh a key-
person, the
violoncello

by changes
18 a second-
ing cough,

eed tea, hot
loaking the
E hot water
} be costive,
senna, may

• compound
slippery elm
ith tincture
ipectorant.
ctive emetic

as good as
iride, in full

own to the
this com-
id duration.

room must

mer than in

ses of com-
bathing the

of the feet.
06), (110),

rater, apple-

mSEASES OK THE CHEST.

Chronic Bronchitis.

This is an inflammation of the mucous membrane of the air-tubes,
which continues a great length of time, without any sudden or re-
markable changes.

Physical Signs. — The percussion-sounds are similar to those of
acute bronchitis. When a bronchial tube is dilated, we sometimes
have dullness around the '»Led part.

The breathing murmur w always accompanied by a mucous, sono-
rous, or sibilant rattle, — sometimes by a subcrepitant.

When dilatation of the tubes exists, the intensity and duration of
the sound of the ingoing breath is decreased, — of the outgoing
increased.

In this state of the tubes, we also have cavernous breathing, bron-
chophony, sometimes pectoriloquy, and bronchial or cavernous cough.

General Symptoms. — A cough is generally present, which is in-
creased in wet weather, and by every slight cold. This comes on in
paroxysms ; is generally worse in the morning ; and is relieved by
raising freely. The matter raised is generally yellowish, but some-
times whitish and sticky; and in the latter stages is thick, and
sometimes very much like that of consumption. Indeed, the disease
often ends in bronchial consumption. •

Remarks. — The breathing is bronchial or cavernous when the
dilated portion of the tube is empty; if it contain fluid, the
mucous rattle will be heard.

Dullness on percussion will exist if a dilated tube press upon the
surrounding portion of lung so aa to condense or make it solid.

Dilatation of the tubes occurs only in chronic bronchitis of long
standing. Its physical signs are much like those of a cavity in ad-
vanced consumption. The examiner may learn to distingfuish them
by considering that in consumption, dullness precedes the cavity, while
in bronchial dilatations, 'the cavity precedes dullness.

The dilatation or swelling out at some point of a bronchial tube
is caused by obstructions to the passage of air through it, — just as
an India-rubber tube, partially closed up at a given point, will bulge
out just in front of the obstructed place, when air is forcibly blown
through it, and just as the left ventricle of the heart enlarges when
the blood is obstructed in its passage through the aortic valve.

Causes. — It often occurs as the result of acute bronchitis, and
also of measles, hooping-cough, etc. But taking cold, and damp and
changeable weather, are more frequently its causes. It most often
follows chronic inflammations of the throat, which, being neglected,
pfradually creep down the windpipe into the tubes, and become very
ol)stinate in their character.

DISEASES OF THE CHEST.

Fio. 94.

T iment. — Medicinal inhalation is one of the best remedies for

this complaint. The inhaling powder has, in many cases, great

efficiency. The dose is about what can lie on a ten-cent piece. It

should be used once a day, in an instrument represented in the cut.

This instrument I had constructed for my use. It consists mainly

of a glass tube and a receiver, —
the latter being something like a
tube-vial, pierced with fine holes
around the lower end. The pow-
der is poured into the receiver,
which is placed in the larger tube,
and twirled between the thumb and finger while inhaling.

When the powder cannot be easily got down into the tubes in the
lungs, — as often happens, — the inhalation of medicated vapor will
do better. If the expectoration be diflicult, the expectorant inhalant,
described under "consumption," should be used; if the expectoration
be too profuse and free, the astringent inhalant must be taken.

The cough preparations recommended for consumption, also (113),
(112), will be the proper ones in this complaint.

The daily alkaline bath, and brisk friction, are particularly service-
able.

Out-door exercise is almost as necessary in this disease as in con-
sumption.

Enlargement oi the Air-Cells. — Emphysema.

This disease consists in » Tgement of the air-cells, the oblitera-
tion of their vessels, and the wasting .:f their walls.

Physical Signs. — Thumping upon the chest gives a clearer and
louder sound than natural, — one which is tjonpanitic, or drum-head
like.

The murmur of the ingoing breath is diminished both in duration
and intensity, — of the outgoing breath, it is increased.

Dry, crepitant rattle attends the ingoing breath only; occasionally,
sibilous rattle.

Qeneral Symptoms. — Habitual shortness of breath, and very
great difficulty of breathing, occurring in paroxysms, which cause
the patient to rush to the open window for air.

There is generally a cough, and the matter raised is frothy, liquid,
and mucous, or watery.

The face has a peculiar dusky color, and the countenance an anx-
ious, melancholy expression. The nostrils are thick, and the lower
lip full. The muscles of the neck are large, and the gait of the pa-
tient is stooping. The strength is wasted in proportion to the diffi-
culty of breathing.

Emphysema tends to produce disease of the heart, Brighrs (liseisc,
and venous congestions in the head.

DISEASES OF THE CHEST.

259

medies for
ises, great
piece. It
n the cut.
8ts mainly
eceiver, —
iiig like a
fine holes
The pow-
B receiver,
arger tube,

ibes in the
vapor will
Lt inhalant,
pectoration
iken.
also (118),

rly service-
as in coQ-

sema.

le oblitera-

clearer and
drum-head

n duration

casionally,

and very
hich cause

thy, liquid,

ice an anx-
the lower
of the pa-

o the diffi-

il's disi'i-^i'.

Observations. — The tympanitic sound is caused by the increased
luuount of air in the cells.

The air-cells have lost their elasticity, the air., in a great degree,
remains in them, — not passing in and out, — hence the absence of tlic
vesicular nuirmur.

The crepitant rattle attends the ingoing breath oiily, and is sup-
posed to arise from the expansion of the lungs which are in a drier
state than natural. It has been compared to the sound producd by
blowing into a dried bladder.

Treatment. — To whatever extent the air-cells are destroyed, to
that extent, of course, the disease is incurable. It may, however, be
palliated and relieved to a great extent.

Generally, bronchitis exists in connection with emphysema ; and
when this is found to be the case, the remedies for that disease must
be employed. (370) often is curative.

The inhalation of tincture of stramonium, in one or two teaspoon-
ful doses, the same as the alterative inhalant is used, will be useful.

To be taken internally, an excellent preparation may be made by
uniting one dram of etheral tincture of lobelia with two drams of
tincture of ipecac, and two ounces of ammoniac mixture. The dose
is one or two tablespoonfuls. Half-grain to gi-ain doses of extract of
cannabis indica are excellent to relieve the difficulty of breathing.

Tne diet must be very carefully regulated, as overindulgence at the
table aggravates the symptoms.

Change of air is often highly beneficial ; but it is impossible to
predict its effect beforehand in each individual case.

Swelling of the Lungs. — Hypertrophy of the Lungs.

This can hardl}-^ be regarded as a disease. It jifenertilly takes place
in but one lung, and is the result of the inaction of the other. Thus,
when one lung is diseased, the other has to do the work of both ; and
being overworked, it enlarges, as the heart or an arm does when very
much exercised.

The only treatment required is to eat sparingly, and exercise Avith
great moderation, so aa not to increase the rapidity of the breathing.

Pulmonary Apoplexy.

This is generally the result of a disease of the heart, particularly
of the mitral valve.

Physical Signs. — Percussion yields a clear sound, except where
the en^'orgement of blood is large, and near the surface, — in which
case, it is dull.

TLe sound of breathing is feeble or absent over a limited space.

2eo

DISEASES OF THE CHEST.

Bronchial breathing is heard in some places, and bronchophony in
part, in the same regions.
Mucous rattle is also heard.

Observations. — In this disease the small air-tnbes and air-cells are
the seat of bleeding ; and the blood becoming coagulated here, closes
these vessels against the entrance of air. This explains the feeble-
ness or absence of the breathing murmur.

The fluidity of blood in the immediate vicinity gives rise to the
mucous rattle.

Qeneral Symptoms. — These are, difficulty of breathing, tightness,
and dull pain in the chest. The mucus raised is tinged or streaked
with blood. The blood raised is darkish, and dirty-looking. This
last symptom, the dirty look of the blood, is peculiar in tills disease.

Treatment. — The most important remedy is dry-cupping upon the
chest. This will often arrest the d'sease at once. Counter-irritation
by croton-oil is also useful. A free movement of the bowels by a
preparation containing croton-oil, or elaterium (31), (33), has an ex-
cellent effect.

Air in the Cliest. — Pneumothorax.

This disease consists in the presence of air in the cavity of the
pleura. Generally, there is also water in the pleural sac at the same
time ; the water, being the heavier fluid, occupying the lower part of
the cavity, and the air the upper part.

Physical Signs. — Tympanitic or drum-like sound over the upper
part of the side. Dull sound over the lower part. Breathing mur-
mur diminished or suppressed. Amphoric 1 reathing. Metallic tink-
ling.

Qeneral Symptoms. — Great oppression of the chest, and difficulty
of breathing ; generally attended by palpitation of the heart, and fre-
quently by severe pain under the breast-bone, on the affected side.
The patient generally has to remain in the sitting posture, and can-
not lie an instant on the sound side.

If, on percussion, one side of the chest sounds louder than the
other and the breathing murmur is heard distinctly on the side which
gives only a moderate sound, and is not heard at all on the loud-
sounding side, we may be sure it is a case of air in the chest.

Observations. — The metallic tinkling is like the sound produced
by dropping a pin's head into a metallic dish, or like the distant tink-
ling of a sheep-bell, or the gentle pulling of the string of a violin.

It is supposed that when the fluid in the cavity of the pleura hap-
pens to be higher than the orifice, the air, when it enters at each
in-drawn breath, forces its way up through the fluid, in the shape of

DI8EA8K8 OF THE CHEST.

261

phony

III

ir-cells are
here, closes
the feeble-

■ise to the

, tightness,
r streaked
ing. This
lis disease.

g upon the
r-irritation
)wel8 by a
has an ex-

'^ity of the
t the same
fer part of

the upper
hing mur-
tallic tink-

i difficulty
rt, and fre-
icted side.
!, and can-

■ than the

side which

the loud-

JSt.

produced
stant tink-
i violin,
leura hap-
^ at each
B shape of

bul jlt's, and, bursting at the surface, gives the tinkling sound. This
sound is sometimeH produced, too, by the failing of drops of liquid
from the upper part of the cavity, upon the surface of t'^e fluid.

The amphoric breathing is like the sound produced by blowing
obliquely into an empty cask. One writer says he heard the same
sound when out shooting on a rough day, produced by the wind blow-
ing sideways into the guu-barrel.

Treatment. — I would recommend the use, two or three times a
(lay, of the antiseptic inhalant, mentioned under the head of con-
sumption.

To this should be added dry-cupping over the whole chest, which
generally gives great relief. Blisters may also be used.

Sweating must be encouraged in the manner recommended under
acute bronchitis.

For the difficulty of breathing, give half-grain doses of cannabis
indica, or five-drop doses of tincture of aconite, or one-sixth of a
grain doses of svapnia. Extract of belladonna, or of stramonium, is
I'lso worthy of trial.

Water in the Chest,— Hydrothorax.

This disease consists in a collection of water in the cavity of the
pleura.

Physical Signs. — There is a dull sound over the effusion.

The breathing murmur is diminished, and gradually disappear
altogether over the space occupied by the effusion.

Bronchial breathing is heard in the same part.

When the amount of fluid is small, egophony is heard in the mid-
dle regions of the chest.

Bronchophoi.y is heard when the effusion is larger.

General Symptoms. — Either upon lying down, or using active
bodily exercise, the patient finds his difficulty of breathing increased.
When in bed, he lies with his head and shoulders raised, which, by
causing the fluid to settle at the bottom of the cavity, prevents, in a
measure, its pressure upon the lungs, and gives him a little rest.
His sleep is interrupted by sudden starts with alarm and terror. The
pulse is hard, the thirst great, the urine scanty and high-colored, and
has a sediment. After a time the feet swell, the face is pallid and
livid, and the countenance expresses anxiety and alarm. There is a
short, dry cough.

When the quantity of fluid in the chest becomes large, the patient
cannot lie down at all, and only gets short and disturbed naps in the
sitting posture.

Of all the symptoms, the starting in sleep is the most cei-tain sign
ot the disease.

)^3i^^d&S^^M^--

262

niSKASKH OK THE 0HE8T.

Causes. — In some rare cases, this may occur .\n a primary disease,
— that is, as a disease not dependent U)>on any other m its cause.
The greater numlwr of cases, however, arc secondary. They arise
from organic disease of the heart, or liver, or stomach. Inflammation
of the pleura is a very frequent cause.

A plethoric, or full state of the systen., predisposes to this com-
plaint, — particularly in those persons who indulge freely at the
table.

It may arise, too, from the striking in of skin eruptions ; from the
free use of liquors ; and from frequent excessive bleedings or purg-
ings.

Treatment. — Dry-cupping is a valuable remedy, and should al-
ways be practised.

The chest should be painted with the tincture of iodine, and a
good degree of substantial soreness be kept up.

The internal remedies are purges (31), (14), (30), and diuretics
(123), (129), (130), (131) when the patient is not very weak.

The iodide of potassium, in doses of five or six grains, once in
three or four hours, is an excellent remedy. The following is a good
form of taking it: iodide of potassium, one ounce ; fluid extract of
pipsissewa, two ounces ; water, half a pint. Dose, one teaspoonful.

The skin should be bathed and rubbed daily, three or four times,
with much friction. Tapping the chest should be done when the
fluid persists any length of time, otherwise a simple hydrothorax may
become a doubly serious empyema or pus in the chest.

Pleurisy. — Pleuritis.

Pleurisy, or pleurisy fever, as it is sometimes called, is an in-
flammation of the pleura, or the membrane which lines the chest,
and, at the same time, is folded back so as to cover the outer surface
of the lungs.

The pleura, as is elsewhere explained, is a short sac or bag, whose
inner sides are kept moist, so that they may slide easily upon each
other as they are moved by the alternate contractions and expansions
of the lungs in the act of breathing, and whose outer sides are made
to grow, — one to the inside of the chest, and the other to the out-
side of the lungs.

Pleurisy and lung-fever, then, must be kindred diseases, and exist,
more or less, together. In truth there is almost always some affec-
tion of the pleura in lung-fever, and some affection of the lungs in
pleurisy. The pain in Iqng-fever is owing to some inflammation of
the pleura ; and the appearance of the rusty-colored phlegm in pleu-
risy indicates that the lungs have been reached by the inflammation
of the membrane which covers them.

Physical Signs Flatness on percussion, at the lower part of the

chest, which ascends as the effusion of water increases.

. tf.iiii« iiMimtrntin^ummmimmimmimm

D18EAnE8 OK THR CHEST.

263

ly (lisoiiHp,

itH cause.

I'hey iiiise

lamination

this coni-
\y at the

from the
1 or purg-

should al-
ine, and a

i diuretics
lyeak.
LS, once in
; is a good
extract of
aspoonful.
our times,
when the
liorax may

is an in-
the chest,
«r surface

ag, whose
3on each

xpansions
are made
the out-

and exist,
)me affec-
lungs in
mation of
a in pleu-
immation

art of the

If the efftised fluid is not great, tliere is puerile hreathing at the
top of the lung.

Friction sound is heard occasionally in first stage of disease.

Ego])hony is heard when the amount of fluid in the pl*)UiU is
small.

As the amount of water increases, bronchophony appears.

General Symptoms. ■ — This disease is most frequently introduced
by shiverinffs, which are soon succeeded by high fever, with a pecu-
liarly hard, resisting pulse; sharp, stabbinff pain in the side, — gener-
ally just below the ni[)ple, but sometimes extending to the shoulder,
arm-pit, and back ; hurried and intelrupted breathing ; and a short,
dry cough.

The pain is greatly aggravated by motion, coughing, or an attempt
to take a long breath. It holds the patient under constant and
powerful restraint. We find him lying upon his back, or his well
side; his countenance full of anxiety, — fearing to move, cough, or
even breathe needlessly ; and often crying out fro»n the keen torture
these necessary acts inflict in spite of all his caution.

At a more advanced stage, when the tenderness has somewhat
abated, he will prefei to lie on the diseased side, as this leaves the
healthy lung more o c liberty.

Observations. — The first effect of the inflammation of the pleura
is to dry up the moisture with.which its inner surfaces are lubricated,
or made smooth and slippery. As a consequence, these surfaces be-
come rough, and rub harshly upon each other, and produce a sound,
in the early stages of pleurisy, like that of rubbing two pieces of wet
leather together. It may be imitated by rubbing the finger back and
forth upon a table. It is sometimes a creaking noise, like that of
new shoes.

As the disease advances an important change takes place in the
state of things. Instead of an unnatural dryness, a watery fluid is
poured out copiously from the inflamed surfaces of the pleural sac.
This is called the period of effusion. This generally, though not al-
ways;, relieves the pain. But, by compressing the lung, causes dan-
gerous difficcl'cy of breathing.

The air-cells are compressed by the effused fluid, and are not
penetrated by air. Hence the al)sence of the breathing murmur.

The pouring out of water between the layers of the pleura, com-
presses the lung, and removes it from the walls of the chest. Hence
the dullness or deadness of sound upon percussion.

When listening with the stethoscope, the voice of the patient
sounds feeble and interrupted, like the bleating of a goat, and is
hence termed, egophony, or goat-voice.

This peculiar voice is heard only when the effusion of water has
been moderate in quantity, and only a thin layer of liquid lies be-
tween the ribs and lung. It is caused by the voice passing over this

264

DISEASRS OK THE CHEST.

thin layer, which is thereby thrown into vihratiom, or wav}', quivering
motions. When thus agitated, the fluid reacts upon the voice,
making it sharp and tremulous.

When the effusion has become large, these effects cease ; but an-
other sign then shows itself, and distinguishes pleurisy from the
healthy state, and likewise from the solid, hepatized state of the
lung in lung-fever. It may be discovered thus :

If the hand be laid flat upon the chest of a healthy person, while
he is speaking, a vibration or thrill will be left. If, in like manner,
the hand be laid upon the chest of a person having lung-fever, with
hepatized lung, this thrill will be found still more perceptible. But
when the hand is placed over the place of watery effusion on the
chest of a person having pleurisy, there will be discovered, when the
person speaks, no thrill whatever. The absence of this thrill, then, is
one of the very best signs of pleurisy with effusion.

Persons recover from pleurisy sometimes very rapidly, before effu-
sion has taken place. It is then said they have had an attack of dry
pleurisy. When liquid has been poured out, even in considerable
quantity, it is sometimes reabsorbed, and the patient recovers per-
fectly. In other instances, it compresses the lungs, interferes seri-
ously with breathing, reduces his strength, and he sinks rapidly.

Treatment. — Pleurisy has been divided for description and treat-
ment into three stages, following the natural events of the inflamma-
tion. The first stage comprises the period from the first onset to the
time when effusion commences. The second stage, or stage of effu-
sion, extends to the time when the liquid begins to diminish ; and
the third stage consists of the period occupied by the absorption of
the liquid.

Should the quantity remain stationary or diminish very slowly
after the lapse of two or thi-ee weeks, the disease becomes chronic.

The indication for treatment during the first stage is to arrest the
progress ( f the disease, to diminish its intensity, to limit the amount
of morbid products, and to relieve suffering.

If the patient is robust, has a hard, frequent pulse, accompanied
with extreme pain and fever, blood-letting is indicated. The abstmc-
tion of ten to fifteen ounces of blood will give great relief and
diminish the intensity of the attack ; but if the patient is not seen
early, and is of a feeble constitution, some other measures should be
substituted for it. The mass of blood may be lessened by saline
cathartics, such as the sulphate of magnesia, or the bitartrate of
potash in combination with jalap.

The effect of a full dose of Epsom salts is equal to the abstraction
of a pint of blood from the system. Depletion is obtained this way
without the impoverishment of the blood.

The frequency and force of the heart's action may also be affected
by the nauseant sedatives, such as tartarized antimony and ipecacu-
aixha, and by the direct sedatives, such as the tincture of aconite and

M8EA8KB OP THR CHEST.

265

iivering
I voice,

but aii-

•oin lilt!

of the

Q, while
manner,
er, witli
e. But
on the
irhen the
, then, 18

ore effu-
ik of dry
siderable
vers per-
eres seri-
idly.

md treat-
nflamnia-
»et to the
B of effu-
liHh; and
rption of

•y slowly
ihronic.
irrest the
amount

>mpanied

absti-ac-

[elief and

not seen

[hould be

by saline

irtrate of

3tra.ction
this way

affected
ipecacu-
lonite and

nf veratrum viride; therefore, if blood-letting is contra-indicated, the
tinit thing U) be done is to give the sulphate of magnesia, and follow
it with some diaphoretic like (130), to alleviate the painful stitch in
the side "nd to tmnquillize the system.

It is well to administer salicylate of soda in 10-grain doses every
three hours till a little ringing is heard in the eai-s, then once in four
hours. This drug increases the action of the skin anil kidneys and
overcomes the rheumatic element present in most if not all pleurisies.
The diet should be dry, all liquids Iwing excluded, that the abstrac-
tion of water from the chest may be favored.

Nothing gives so much and such immediate relief to pain as a
subcutaneous injection of morphine. Aconite also is a valuable
sedative in this stage. It may be given in half or whole-drop doses
every fifteen minutes for two hours ; then afterwards a drop, to be
repeated hourly till some impression is made upon the heart's action.
Smaller doses are to be given if the pulse becomes feeble.

In the second stage, if the acute symptoms have yielded to treat-
ment, as they usually do, the object of treatment is to promote the
absorption of the fluid. This is done by the judicious use of saline
cathartics and by diuretics, for the Iwwels and the kidneys are the
natural pumps of the system.

The application of counter-irritants is also of use for this purpose,
such as the tincture of iodine, and small blisters, which are to be
allowed to remain on till vesication, and then the blister is to be
dried up and a new one applied. If at any time during this stage
the effusion is rapid and excessive, so as to endanger life, it is to
be drawn off by puncturing the chest between the fifth and sixth
ribs on the side with a small trocar, and the fluid is to be drawn off
by suction.

Convalescence commences when the liquid begins to be absorbed ;
and active medication should then cease, and that course should be
pursued which will lead to the restoration of the general health.
This is done by tonics, a nutritious diet, and other hygienic means.
If the effusion ceases to be absorbed or the process takes place very
slowly, then that state of things exists which is called chronic pleu-
risy. Then the main objects of treatment are to effect the removal
of the fluid, and to develop and sustain the powers of the sjrstem.
Under these circumstances, it is better to discontinue remedies which
act upon the bowels and kidneys, at least for a time, and try general
treatment. This consists of tonics, stimulants, and general exercise
in the open air, and with this the surgical removal of the fluids from
the cavity of the chest.

The operation is now so much improved, and is so safe and simple
and attended with so little pain, that it has become an every-day
practice, and an operation which was only resorted to as an extreme
measure to save life, is now admissible whenever the pleural cavity
remains filled with liquid, after only a brief trial of the remedies
assigned to promote absorption. -

:-\"

266

DIHRAHKH OK THK CHR8T.

Lung Fever. — Pneumonia.

This diHeoHe, by common uoago, has beon called a fever ; but by
physicians it is reckoned as one of the infiammationt. It is inflamma-
tion of thti lungn or liijhU ; and whatever fever there may be results
entirely from this local inflammation.

Signs and Symptoms. — A patient suffering with lung fever is
generally found lying upon his back, with some pain in the side ;
more or less difficulty of breathing ; a cough, at first dry, but soon
accompar.ied by raising a thick, sticky, rusty-colored matter, composed
of a mixture of phlegm and blood. As the disease increases in
severity, this matter will become more sticky and tenacious, so that
it will adhere to a spit cup turned upside down. There will be more
difficulty of breathing, greater prostration, and perhaps some delirium.

For the purpose of more clearly describing this complaint, it is
found convenient to divide it into three stages, or degrees of progress.

First Stage. — This is called the stage of engorgement. The lungs
during this stivge are engorged or crowded with blood. If we could
inspect them, we should find the inflamed portion redder, thinker, and
heavier than usual. We should find them weaker, that is, more
easily torn than in the natural state ; with less air in them, and con-
sequently crackling less upon pre.«jure, — yet not entirely destitute
of air and crackling, and not so heavy as to sink in water. Rapping
upon the chest at tliis period gives out a flatter, duller, or less hollow
sound than usual. On applying the stethoscope, we hear less of the
natural rustling sound of health ; and, either mingling with, or over-
coming it, we hear a minute crackling sound, as the air passes in and
out in breathing.

This crackling has been compared to that produced by fine salt
tluown upon red-hot coals ; or by that of rubbing a lock of fine hair
between the thumb and finger near the ear. It is caused by small
bubbles of air being forced along the moist and sticky sides of the
small tubes and air-cells. It is heard only while the breath is being
drawn in.

Second Stage. — If the inflammation advances to the second stage,
the swelling of the diseased lung increases so as to force out the air
entirely, and it becomes solid, and wholly useless for the purpose of
breathing. In solidity and general appearance, it resembles a piece
of liver. Hence it is said to be hepatized, or liverized ; and this is
called the stage of hepatization.

I As the lung grows more solid, its vitality and strength diminish ;
it is not near as strong as a piece of healthy liver, though it looks
like it ; it is soft and easily broken ; indeed it seems to be in a state
of commencing decay or rottenness. Hen je some writers, in order
to be more precisely correct, call this the stage of red softening.

frrrwapitti-.—je^.;^

■-s^-fsssmmm^ms^^sn^'-

DIBBABr,S OF TIIR OIIEBT.

267

; but by
nflamtna-
te resiulUi

fever is
the Hide ;
but soon
!omp08ed
reiVHes in
I, HO that
i be more
delirium,
lint, it Ls
progress.

rhe lungs

we could

taker, and

is, more

, and con-

dec'citute

Rapping

iss hollow

ess of the

or over-

les in and

fine salt
fine hair
by small
es of the
is being

>nd stage,
at the air
irpose of
!S a piece
this is

iminish ;

it looks

n a state

in order

ling.

With incrcouefl solidity, there is of course inoreasod dnllneM on
porcuHsion. When the stethoscope is applied to the (;hest, we hoar
no sound of air paHsing into and out of the diseased lung; no natural
rustling, or minute crackling; but in their stead, we have a kind of
whistling, produced by tlie air passing back and forth in the wind-
pipe and ita branches, but finding no entrance into the solidified air-
cells. The breathing sometimes sounds like a sort of puff, — owing
to the column of air rebounding when refused admission to the
closed-up cells.

The general symptoms now increase in severity. There is greater
difficulty of bFeathing ; the phlegm is more gluey ; perhaps some
delirium phows itself ; and the patient grows weaker.

Third S to *e. — At this period, the lung changes from red hepa-
tization or red toftening to gray hepatization or gray softening, and
matter is now found diffused through its whole substance. The
percussion sounds are much the same as in the second stage. On
listening, wc hear more of the rattling sound produced by disturbed
phlegm. The matter raised is thinner, — more like liquid ; and
looks like prune-juice. The symptoms generally indicate that the
patient is sinking. Patients may recover from the first and second
stages, but rarely from the third.

Treatment. — Pneumonitis has been divided into three stages,
corresponding to tlie inflammatory events of the disease: the first
stage is that of active congestion, the second, that of solidification,
and the tliird, that of t lution. The duration of the first stage is
from twenty-four to forty-eight hours, of the second from two to
four days, and the stage of resolution lasts from eight to ten days.
Different cases vary, however, in these times. These different stages
furnish different remedial indications.

The objects of treatment in the fii-st stage are to arrest the disease,
to lessen its intensity, to relieve pain, and to promote toleration of
the disease.

When high fever, a hard pulse, and extreme pain are present in a
robust constitution, the abstraction of blood from the arm is indi-
cated. These cases are not frequent, for lung fever mostly occurs
in patients with feeble constitutions, but when practised in the
proper cases, the relief to pain and embarrassment of breatldng is
often immediate and marked. In those cases where blood-letting is
contra-indicated, the same end can be secured, but more slowly, by
saline cathartics and sedative remedies. After saline purgation, if
the skin is hot and the pulse is frequent, tartar emetic may be given
in small doses as a nauseant sedative ; but it must not be carried to
the extent of distressing nausea. After this follows the use of vas-
cular sedatives, such as the tincture of aconite and the tincture of
veratrum viride, if not contra-indicated by the feebleness of the
patient with a tendency to depression.

268

DISEAS7.S OF THE CHEST.

• Sometimes the sulphate of quinine, in a full dose of from twenty
to twenty-five grains at the onset, or within eight or ten hours, will
arrest the disease. It may be well to try it, as it can be administered
with perfect safety. Opium is of great importance also, to relieve
pain and tranquillize the system.

Cold or wai^n applications to the chest may be used according to
the preferences of the patient. Warm applications act as revulsents ;
the cold diminishes the determination of blood to the part, and re-
lieves the pain by obtunding sensibility. Counter-irritants are not
advisable in that stage.

The treatment of the second stage aims at the promotion of reso-
lution of the inflammation, the palliation of the symptoms, and the
maintenance of the powers of Hfe.

The tinctures of veratrum viride and aconite may be continued in
this stage, if there is considemble fever and there is no tendency to
asthenia ; but the leading measure is to support the system.

The rational use of veratrum viride, than which there is no better
drug in Pneumonia, consists in giving five-drop doses hourly till the
pulse reaches jixty per mii .ute, then just often enough to keep the
pulse in that neighborhood.

This course embraces the use of tonics, stimulants, and nutritious
diet. The use of alcohols is necessary in most cases, and sometimes
very freely. The diet should consist of milk, farinaceous substances,
and animal broths. Quinine in tonic doses is the best remedy in
this stage.

The preparations of opium are very useful, and only contra-indi-
cated by the accumulation of mucus in the bronchial tubes.

Digitalis is useful in five to ten grain doses three or four times a
day, when it is necessary to increase the heart's action.

The carbonat" of ammonia is necessary in cases of extreme pros-
tration.

The external application of the tincture of iodine is the best
counter-irritant in this stage.

During the third stage, all those hygienic measures which improve
the general health are to be pursued.

Typhoid Lung Fever. — Typhoid Pneumonia.

This is an inflammation of the lungs, differing from the preceding
only in the character of the fever attending it, which is of a low,
typhoid character. The disease, like typhoid fever, is characterized
by great debility and prostration.

Symptoms. — These are a combinat-.on of the symptoms of pneu-
monia and of typhoid fever. The disease begins mth great weari-
ness, lassitude, dizziness, pain in the head, back, and limbs. Soon
there is much difficulty of breathing, tightness across the chest, with
a dry, short, hacking cough.

Hmt aHJMMMM I IfcMMWBMi^ W

DISEASES OF THE CHEST.

269

As the disease advances, the active syniptoms pass away ; there is
a dull pain across the chest ; drowsiness is very apt to come on, with
the various symptoms of sinking peculiar to typhoid fever. The
skin is harsh end dry, the temperature uneven, the tip and edge of
the tongue red, and the middle covered with ,i yellow or brown fur.
The bowels are tender, swollen, and drum-head like ; while there is
often a diarrhoja, — the discharges having a dirty-yellow color.

Treatment. — This should be like the treatment of pneumonia
and typhoid fever united.

Great care must be taken not to use reduc' remedies. While
active 'rging must not be used, yet, if there i*re symptoms of an
inactive state of the bowels, podophyllin and leptandrin (34), (39),
may be employed with advantage.

When there are symptoms of great depression, use tonics (46),
(48), (50), (63), (60), (64), (67), (73), taking care to keep the
cough loose by flaxseed, slippery elm, and marshmallow tea, and by
some external irritant.

f pneu-

it weari-

Soon

st, with

Broncho-Pneumonia.

This is an infectious inflammation, characterized by an exudation
from the blood-vessels, the formation of new connective tissue, and
the growth of bacteria. The disease involves the walls of the bronchi
and the air-spaces surrounding t"he inflamed tubes. It is frequently
called capillary bronchitis and catarrhal pneumonia. It is the ordi-
nary pneumonia of children, and is frequently seen in young people.

It comes on primarily, but is often secondary to measles, whooping-
cough, etc.

Symptoms. — In the very young, the only symptoms are fever,
prostration, and rapid breathing. There is no cough, no physical
signs, but the disease is, almost ^ ways, fatal within a few da,y%^ time.

There is a great difference in the invasion of the disease in dif-
ferent cases, the severer cases being ushered in by one or more con-
vulsions, by rapid rise of temperature, vomiting, difficulty in breathing,
and delirium; the milder cases beginning with lower temperature,
moderate prostration and shortness of breath.

The height of the temperature is, as a rule, in proportion to the
severity of the disease. Temperatures of 106° and over are usually
fatal. The pulse reaches 160 to 170 in adults, and even higher in
children, — so high, in fact, that it cannot be taken. The respiration
varies from 40 to 80. Sleeplessness, restlessness, and even delirium
are frequently present. The face is flushed, the tongue coated, and
oftentimes diarrhoea and vomiting occur. Cough is usually present,
and in the ynng the sputum is swallowed. The urine is frequently
albuminoua and contains casts.

Between the second and fifth days the signs of consolidatioD and

270

DISEASES OF THE CHEST.

pleurisy appear, i. e., dullness on percussion, bronchial breathing and
bronchophony with crepitant rattles.

The duration of the disease in children varies : of the fatal cases
the majority die within the first fortnight. The cases which recover
vary from one to chree weeks, though many persist for six and eight
weeks. The softening and absorption whicii occurs in all pneumo-
nias that recover occupy a much longer period in broncho-pneumo-
nia than in lobar pneumonia.

Many cases of broncho-pneumonia are complicated by cerebral
svmptoms of convulsions, delirium, stupor, vomiting, etc., even before
any marked lesions in the lungs appear; as these subside the lung
symptoms appear. Many cases are protracted for a long time, and
though they may terminate favorably at last, yet they are apt to run
into a chronic hardening of the lung \>aich lasts for jears; or they
recover with a permanent consolidation of the lung. Some die of
exhaustion.

Treatment. — The use of hot fomentations and poultices over the
chest and the administration of small doses of ipecac and aconite at
short intervals soothe the bronchitis and pain.

For the cerebral symptoms, phenacetin and the bromides are very
useful. Aconite and digitalis are usually employed when the pneu-
monia stage comes on. As a rule stimulants are not required in
children, in whom the disease most frequently occurs.

In convaleaence, iron, q "nine, cod-liver oil, oxygen and a change
of air apj to be recommenaod.

Other Forms of Lung Inflammation.

Op the various other forms of lung inflammation which occur,
mention may be made of pneumonia dependent on Heart Disease ;
Interstitial Pneumonia, or the formation of new connective tissue
and obliteration of the air-spaces ; 1 abercular Pneumonia, which is
caused by the presence of tubercle bacilli ; Acute and Chronic Mi-
liary Tuberculosis, characterized by the presence of numerous minute
nodules called miliary tubercles ; Acute and Chronic Tubercular
Consumption^ Gangrene of the Lung, where a portion of the lung
has lost its vitality and the germs of putrefaction have entered.

Asthma.

Asthma may be defined to be great difficulty of drawing in the
breath, — coming on suddenly, sometimes gradually, -— accompanied
with a sense of extreme suffocation, and a desire for fresh air ; con-
tinuing for a longer or shorter period, and then passing away, and
leaving the patient a period of comparatively easy respiration.

Symptoms. — There are sometimes no premonitory symptoms,
the attack coming on suddenly, and without warnings but more fre-

DISEASES OF THE CHEST.

271

ling and

»1 cases
recover
ad eight
pneumo-
pneumo-

cerebral
n before
;he lung
ime, and
)t to run

or they
e die of

over the
conite at

are very
he pneu-
[uired in

i change

ih occur,
Disease ;

e tissue
[which is
Ionic Mi-
minute

bercular

;he lung

■ed.

in the

ipanied

|iir; con-

(ray, and

iptoms,
Lore fre-

quently there are, for some days before the onset, loss of appetite,
flatulence, belching of wind, irritability, languor, chilliness, oppres-
sion, and drowsiness. The hard breathing generally makes its
appearance in the night, — quite often at three or four o'clock in
the morning, when the nervous system is at its lowest ebb. There
is first a sense of tightness, or stricture, across the chest, which
seems to expand with difficulty. The patient can no longer remain
lying down ; he rises up, draws up his kn<>.es, and, leaning forward,
puts his elbows upon them, and his head upon his hands, and then
struggles hard to di-aw in his ^-"ath ; which, passing in slowly and
laboriously, produces a loud jzing sound. Sometimes he feels
that he must have fresh air, a., rushing to a window, puts his head
far out, to catch a stirring breeze. The hands and feet are cold, the
face haggard and distressed, — sometimes a little red and swollen,
but more generally pale and shrunk, — the body wet with perspira-
tion, the pulse irregular, feeble, and small, though sometimes not
disturbed. These symptoms continue for some hours, more or less,
when the breathing becomes more easy, and there is a little phlegm
raised, sometimes considerable. This cessation of difficult breathing
may be complete, or only partial ; and lasts for a longer or shorter
period, when the attack again recurs.

Causes. — It is well known that Asthma has its cause mainly in
the nervous system. The air-tubes are encircled with a series of
little bundles of fibres, which are, in fact, muscles, and like all other
muscles have the power of contracting or shortening themselves.
These muscles, too, like all others, have nerves distributed to
them ; and when these nerves become diseased or irritable, they will
become disturbed on certain occasions, and cause these small, circu-
lar puckering strings to contract and close up, the air-tubes near
their terminations, very much as the puckerihg-string closes the
mouth of the work-bag, so that very little air can pass into the air-
cells, and that little with great difficulty and slowness. When these
contractions take place, and the air is thus shut off, the result is a fit of
asthma. This disease may be brought on by any of those states of
the atmosphere which disturb or irritate the bronchial surfaces, or by
any of the numerous causes which mysteriously unbalance the
nervous system. A fit may be brought on by whatever disturbs the
mind.

Treatment. — The disease has been regarded as extremely diffi-
cult of cure. There are certain remedies, however, which have a
remarkable control over it, and, if skilfully used, will frequently
bring it to a complete termination, and, even in the worst cases, to a
state of very great mitigation and improvement.

Inhalation. — The most important and certain remedy is the use
of the Alterative Inhalant, described on page 243. 1! have with this
article alone effected some surprising cures ; yet it is well to combine

272

DISEASES OF THE CHEST.

other treatment with it. I have had several cases of a most distress-
ing character, — the attacks continuing night and day, — in which
the inhalation, judiciously administered, has caused the disappearance
of the complaint within twenty-four hours, and in which no return of
suffering has occurred for several weeks, and then only in a modified
form. This remedy should be used four or five times a day.

Iodide of potassium is a most valuable internal remedy in this
complaint; indeed, in a certain sense, it is silniost a specific. It
should be used (prescriptions 101, 138, 140, 151) at the same time
with the inhalation. The following preparation is a very good
remedy for this disease : Ethereal tincture of lobelia, two ounces ;
tincture of asafoetida, one ounce; grindelia, one ounce; iodide of
potassium, two ounces; simple syrup, four ounces. Mix. Dose,
from a teaspoonful to a tablespoonful, every hour or two.

Several other remedies are used for asthma, with more or less
success, such as electro-magnetism, smoking stramonium leaves,
burning paper dipped in a strong solution of nitrate of potash, and
inhaling the smoke, etc., — but none of these have as much value as
the tTTo remedies first named.

In as grave a complaint as a severe case of asthma, it is always
well to seek the aid of a physician.

Hay-Asthma. — Hay-Fever.

This is a very troublesome complaint, which seems to combine
the peculiarities both of asthma and of influenza. Fortunately, it
ftttacks but few persons, and those only at particular seasons of the
year, — namely, while hay is in blossom, and during hay-making.

Symptoms. — These are a combination of the symptoms of the
two diseases above named. There is great irritation of the eyes,
with sneezing, and a free discharge from the nose. There is
tightness across the chest, diflSculty of breathing, and a pricking
sensation in the throat These symptoms often appear in great
severity, making the complaint a really distressing one.

Cause. — This disorder appears to have but one cause, — namely,
some sort of emanations from the grasses, flowers, etc., while in
blossom ; which emanations come in contact with the mucous lining
of the eyes, nose, and throat, producing very great and teasing irri-
tation.

Treatment. — One of the best remedies for this troublesome com-
plaint is to avoid the cause, by removing, during the flowering and
haying seasor, to some large city, or, still better, close down to the
seashore, where flowers and hay do not grow.

Of medicines, the tincture of lobelia, taken in moderate doses, is
a very good remedy. Quinine and iron, given in combination (75),
are valuable preparations. Strychnine and nux vomica, in connec-

W;^Si,^I^S!iS.

lost distress-
— in which
sappearaiice
110 return of
1 a modified
day.

ledy in this
speoific. It
I same time
very good
wo ounces;
i; iodide of
Aix. Dose,

lore or less
um leaves,
potash, and
oh value aa

t is always

to combine
•tunately, it
sons of the
making.

oms of the
i the eyes.
There is
a pricking
.r in gre&t

— namely,
1., while in
sous lining
easing irri-

esome com-
R'ering and
)wn to the

be doses, is
ation (75),
in connec-

DISEA8E8 OF THE CHEST. 273

t V^ .'l'.'" "'"^ "^'° ^ '^Wed in one of thesf solutions, and

hung about the apartments of the house. The hands and face may

likewise be washed, once or twice a day, in a weak solution. ^

Ihe oxide of zinc and the extract of nux vomica, made into pills,

ornTtT '^'' ""' '" \^^^ " ^"^ °^ '^' extract to each pill,Cd
one pill taken morning and evening, should not be forgotten

m.?oi!^ '"T""' ^T^^ ^y "^^^'^^ °^ '' «^"^«1'« hair brush on the

aTd'^m-^igr t^lt^ ^°^^' '- ^- "-^ '^ «^-^ ^ P— y^-

rpJif;/°"T'i!^ formula is the most efficacious of this class of
reraediBs and should be painted onto the nasal mucous membrane as
high HP as possible ; its use maybe repeated several times till the
membrane becomes numb.

Cocaine 19

Antifebrin ok 5!*

Alcohol ... i^f-

Simple Elixir ...!.' ' tZ'

Mix and shake before using.

.W.|!l»^*,.^Jn^^■*

HEART DISEASES.

Life rests upon a tripod, — the brain, the lungs, and the heart.
These are equally important to its we'1-being and continuance.

In substance, tbe human heart is a bundle of muscles, so put to-
gether as to bear the greatest possible amount of work. In size,
shape, and look, it is much like the heart of the hog. I wish it
never had a likeness to it in its moral nature.

The heart is enclosed in a case or sac, called the pericardium. It
lies between the two lungs, a little to the left side of the chest. Its
point is under the sixth rib on the left Ride, and its lower surface
rests on the diaphragm, — a horizontal partition between the chest
and belly.

The heart is double. It has four cavities, — two for receiving the
blood, which are called auricles, and two for driving it out, called
ventricles.

The venous, or dark blood, is brought from all parts below, and
emptied into the right auricle through the ascending vena cava, and
from all parts from above, and pour into the same cavity through
the descending vena cava. From this it passes into the right ventri-
cle, which contracts, and forces it through the pulmonary artery into
the lungs, where it becomes red, and passes into the left auricle
through the pulmonary vein, thence into the left ventricle, which
contracts, and throws it out through the great aorta to all parts of
the body. Fig. 95 gives a good idea of Ijie circulation through the
heart and lungs.

The heart is divided into two sides, which are separated from each
other by a muscular partition, — each side having an auricle and a
ventricle.

The auricles have comparatively thin walls, as they are only used
for reservoirs. The walls of the ventricles are much thicker, being
used, — particularly that of the left side, — for forcing the blood
over a large surface.

Between the auricle and ventricle on the right side, are three folds
of triangular membrane, called the tricuspid valves. Between the
auricle and ventricle on the left side, are three valves, called mitral.

At the beginning of the pulmonary artery, and the aorta, are three
half-moon shaped folds of membrane, called semilunar valves.

274

l t i i i ai»ftii)iiM i wiiwiiiwu»« Mi8ia»teBHia

B B W iis ^tsr!;

HEART DISEASES.

276

The office of all these valves is, to close after the blood has gone
through, and prevent its flowing back while the cavity is being again
filled. They do the same duty, in fact, as the valves of a pump.

Through this heart, thus constructed, all the blood in the body, —
about twenty-eight pounds, — passes once in about one minute and a
half. This is rapid work ; and when we consider that the heart
works in this way through the whole life, resting not, day or night,
we cannot wonder that it gets out of order.

the heart,
lance.

so put to-

t. In size,

I wish it

^m&^^

irdium. It

chest. Its

wer surface

n the chest

eceiving the
; out, called

below, and

la cava, and

ity through

right ventri-

artery into

left auricle

ricle, which

all parts of

;hrough the

Id from each
iricle and a

16 only used

jicker, being

the blood

le three folds
between the

ailed mitral,
fta, are three

tves.

FlO. 96.;

The whole heart is seldom affectefi. The left side is more liable
to disease than the right.

Impulse of the Heart.

The ear, when placed over the heart, feels, at each beat, a slight
shock. This is felt at the same time the first sound is heard. This
impulse is caused by the apex or point of the heart being thrown up
against the ribs by the contraction of the ventricles. It is felt best
between the cartilages of the fifth and sixth ribs on the left side.

The Sounds of the Heart.

On appljring the ear to the chest just over the heart, two sounds
are heard. The first one is dull and slightly prolonged ; the second
is a shorter and smarter sound, having a sort of clack. These occur
in pretty rapid succession, and then comes a brief interval. And this
round of action, first a long and dull sound, then a short and smart
one, and then an interval, — called the heart's rhythm, — is repeated
continually. If the space of time occupied by the rhythm be divided

276

HRART DISKA8EB.

into five parts, the first sound will take about two parts, the second
one, and the interval of repose, the remaining two, The first sound
is heard about the time of the contraction of the ventricles, and Ik
therefore called the 8i/»tolic sound ; the second is synchronous with
the opening of the ventricles, and is called the diantolic sound. The
syllables too-to — too-to, very fairly represent the two sounds of the
heart. These sounds are heard over the largest space in lean
persons.

Percussion Sounds.

If the ends of the fingers be struck upon the cheat over the heart,
a dull sound will be heard over a space from one and a half to two
inches square, — beginning at the fourth rib on the left side, and ex-
tending down nearly to the sixth. The dullness is diminished by
lying upon the back, and increased by leaning forward, and by taking
a full breath. The deadness of sound is caused by the heart being
a partially solid body. The lungs which surround it yield a clear
sound.

If a solid substance, as large as the heart, were placed on the in-
side of a drum, against the head, only a dead sound would be ob-
tained by striking on that spot ; everywhere else, the sound would
be louder. •

Altered Sounds of the Heart.

These sounds are changed by disease in a variety of ways, both as
to their character and duration. One or both sounds may be turned
into a noise like the blowing of a pair of bellows. This is called the
bellows sound. When this sound is very harsh, it may become like
the noise of a rasp, or file, or saw. These altered sounds are all pro-
duced by an altered condition of the valvular passages throucrh
which the blood passes. If you build an aqueduct of equal dim^;.;-
sions tliroughout, and smooth on the inside, you may send a certain
volume of water through, at a given speed, without noise. But if
you make sudden contractions in the aqueduct, or allow large stones
to project into it, and then attempt tc send through the same body
of water, at the same rate of speed, you will hear all sorts of noises.

Enlargement or Hypertrophy of the Ventricles.

This is simply a thickening, or an increase of bulk, in the walls
of the ventricles. The muscles composing the walls of one or both
of these cavities grow thick and large.

Physical Signs. — Impulse stronger than natural. When consid-
erable, it is accompanied with a lifting and heaving of the parts.
Dull sound on percussion over a larger space. First sound of heart
prolonged; second sound feeble. The interval of silence, shorter
than natural. In bad cases, the second sound is nearly extinguished.

^m^

^^^

--^^^^'

HBART DISEASES.

277

he secoml
iret sound
les, and is
incus with
und. Tlic
ids of the
B in lean

■ the heart,
ilf to two
de, and ex-
inished by
. by taking
eart being
Id a clear

on the in-
ald be ob-
iind would

lys, both as

be turned

called the

icome like

ire all pvo-

throuerh

lal dinivii-

a certain

But if

rge stones

ame body

of noises.

Tides.

the walls
ae or both

en consid-
the parts,
of heart
e, shorter
inguished.

Qeneral Symptoms. — Hypertrophy of left ventricle gives a strong,
prolonged, and tense pulse. I'alpitation more constant than in any
other disease of the heart. In advanced stivges, the patient is easily
out of breath. There is a rush of blood to the head on making exer-
tion or stooping, with more or less throbbing and lancinating head-
aches, which are aggravated by suddenly lying down or rising up.
There are vertigo, ringing in the ears, sparks of light and other illu-
sions before the eyes ; also a purplish, violet or livid color upon the
cheeks, nose, and lips. In many cases there is a dull, severe aching
pain in the region of the heart, and extending towards the shoulder
and the inside of the arm.

When the riffht ventricle is enlarged, there is a swelling of the ex-
ternal jugular veins.

Ca'ises. — The walls of the heart are thickened by overwork, in the
same way that the blacksmith's arm is made muscular and large. All
muscles gi'ow in the same way. More action sends more blood to
them, and this causes an increase of nutrition.

Whatever interposes an obstacle to the passage of the blood through
tlie valviilar openings, will cause the ventricles which force it through
to work harder. Hence, obstructions in the semilunar valves cause
hypertrophy of the ventricles.

Any excitement of the mind, or any great exertion, which causes
the heart to beat harder and faater^ if it be often repeated, will induce
a thickening of the ventricles.

Treatment. — First, remove, as far as possible, all causes of excite-
ment which produce palpitation. If the head is much affected, apply
wet cups to the back of the neck. The same may be applied over
the heart. This will generally improve the symptoms at once. A
blister placed over the heart will likewise make a favorable impres-
sion.

The meals should be taken at regular intervals, and should be very
light The food should be plain and simple, and composed much
more of vegetable than of animal food. In fact, the diet should be
80 spare as slightly to reduce the strength.

The patient should be careful never to take violent exercise, or,
indeed to be in a hurry about anything. In bad cases, walking up
hill, or against a strong wind, is often out of the question, and must
in any case be attempted with great caution. Staircases are to be
shunned as enemies. An attempt to run, even to avoid being left by
the cars, might, in some cases, prove immediately fatal. Carriage-
riding is not objectionable.

The passions must be held in the most thorough subjection. Ex-
citements of all sorts are dangerous, and must be avoided.

For the first week or two of treatment, active purgatives will be
useful. For this purpose, epsom salts and senna will answer a good
purpose, and should be used so as to procure two or three watery
stools a day.

278

HEART DIHRASKS.

Ill addition to this, Homo sedative to lesson the force of the heart's
action is genemlly needed, especially when there is consideraltle
palpitation. For this purpose, tincture of black cohosh, and tiiuturc
of scuUcap, or the former with tincture of digitalis (285), (9-4), arc
quite useful. Three to ten drops of tincture of the American hel' j-
bore (venitruni viride) will reduce tlie action of the heart perhaps
more effectually than any other inodicine, for a. few days or weeks.

Dilatation of the Ventricles.

The several cavities of the heart hold about one and a half ounces
each. Dilatation is simply an enlaryement of these cavities, so that
they will hold more. And this increase in the size of the cavity in
simple dilatation is generally at the cost of the walls, which are made
thinner and weaker, — just as the walls of a bladder are made thinner
by blowing into it and increasing ita internal dimensions.

Physical Signs. — Impulse more abrupt, and less marked than natr
ural. Dull sound on percussion commensurate in extent with the
dilatation. The first l)eat of the heart, clearer, louder, and shorter
tiian natural, and more nearly resembling the second.

Qeneral Symptoms. — Difficulty of breathing; terrific dreams;
starting from sleep ; swelling of the feet and legs ; purple, violet, or
blue color of the cheeks, nose, lips, and especially around the eyes ;
feeble and oppressed palpitation ; various disturbances in the head ;
bleeding from the nose, stomach, bowels, and womb ; and frequently
eiUargement of the liver.

Explanations. — The first sound of the heart is short and not well
marked, in consequence of the muscular walls of the ventricles in
this disease being thin and in a weakened condition, so that every
stroke they make is short, quick, and spasmodic, instead of stron^
and lifting, as in hypertrophy. For the same reason, the impulse is
a brief blow dealt the walls of the chest, which gives a slight shock,
but has not power enough to lift the chest up. The blow is quick,
because the muscle is thin and can contrect quicker than a thick one.

Dilatation, by thinning the walls of the cavities, enfeebles the heart,
and shows us an obstructed circulation. Accordingly the blood is
not transmitted by the left ventricle, and being retained in the lungs,
it causes a crowded state of the vessels, and difficulty of breathing ;
also congestion of the brain, with terrific dreams, etc. And. this en-
gorgement of the lungs, being propagated backwards to the right
heart, great vein j, and all their ramifications, produces dropsy of the
feet and legs, discoloration of the face, passive hemorrhages, and con-
gfestion of the brain, liver and membranes. Fig. 95 gfives an idea of
how all this happens.

Treatment. — As in many other diseases, search out the causes, and
remove them. If it be obs^uction of the circulation in the lungs by

HEART DISEASES.

279

the heart's
iiHidemUe
id tiiK.tuie
, (94), aro
icim hel'a-
rt peilmpn
r weeks.

lalf ounces
as, 8o that
) cavity in
1 are made
.de thinner

d than nat-
t with the
,nd shorter

c dreams;
, violet, or
the eyes;
the head;
frequently

d not well
ntricles in
that every

of strong
impulse is
ght shock,
V is quick,

thick one.

the heart,
3 blood is

the lungs,

jreathing ;

id. this en-
the righi

jsy of the
and con-

an idea of

auses, and
lungs by

bronchitis or other complaint, that needs tho first attention. If it Im-
caused by violent exercise, by sti-ong enrntions of the mind habitually
indulged, or by drunkenness, or any other irregularity of lift), these
iiabita must be corrected without delay.

If it be caused by organic disease of the valves of the heart, relief
cannot be so readily obtained ; but even in these cases, it is to be
sought and expected.

The circulation is to be kept as tranquil as possible by a strictly
([uiet and orderly life, and a plain, moderate, unstimulating diet. In
this disease, however, it should be more nutritious, and composed to
a larger extent of meats, than in hypertrophy.

In some cases the general health and tone of the system will need
to be improved by bitters (60), (67), (64), (69), (79), mineral acids
(60), iron (269), (61), and aromatics (115). The compound mix-
ture of iron is a good preparation when this mineral is called for by
a low state of the blood.

The stomach should be kept in the best possible condition, as a
very small disturbance of it, even from acidity, will set the heart to
l)eating very violently.

If hysterical symptoms are present, tho compound galbanum pill,
and valerian (97), and other nervines will be called for.

In attacks of great difficulty in breathing, immerse all the extremi-
ties in warm water, and throw a blanket around the patient to pro-
mote sweating, — at the same time admitting fresh air to satisfy the
desire for breath. Give a draught, composed of ether, camphor,
ammonia, etc. (1S5). This may be repeated two or three times, at
intervals of Iialf an hour, or an hour, according to the urgency of the
case.

Hypertrophy with Slight Dilatation.

This is one of the most common complications of heart disease.
It consists both in a thickening of t le walls of the he-.rt, and an en-
largement of the cavities, — the f '.rmer being more marked than the
latter.

Physical Signs. — Both sounds are louder than in any other dis-
ease of the heart, and are heard sometimes over the whole chest.
The impulse is strong and heaving, with an abrupt back-stroke. In
bad cases, the whole person, and even the bed, is shaken by it. The
dull sound on percussion covers a large space.

General Symptoms. — The same as those of the two diseases of
which it is composed, slightly modified by the action of each upon
the other.

Dilatation with Slight Hypertrophy.

This is an enlargement of the cavities of tne heart, with a slight
thickening of its walls ; the dilatation being the predominant disease,
or greater than hypertrophy.

280

HIART DIBRA8ES.

Physical Slffns< — PorcuBHion giveH a dull Hound in the region nf
the heart, in proportion to it« nize. The first l)eat reHemblcr, the sec-
ond. The Houond Ixsat is loiidor than natural.

The impulHe i8 a short, quick stroke, which contrasts strongly with
the slower and heavior one of hypertrophy and dilat^ition.

The general Hynijjtoms and the treatment are a modification of
those of the two disease united in it. It is, however, to be kept in
mind that the dilatation takes the lead ; and, furnishing the predomi-
nant symptoms, is specially to l)e regarded in the treatment.

Aneurismal Tumors of the Heart.

When, from some obstruction in the valves, the blood cannot easily
pass out of an auricle or a ventricle, its inner walls may become
unable to bear the distending force, and giving way, let the blood
through against the outer coats, which stretch, and swell out into the
shape of a tumor, — the inside of the tumor becoming a regular sac.
Such a state of things constitutes an aneurism of the heart. Of
course it is a very grave disease.

Softening rf the Heart.

In this disease the substance of the heart becomes soft, and easily
broken. It is genemlly the result of some form of inflammation.

Physical Signs. — The contractions of the heart being weakened
by softening, the impulse is reduced in force, and both beats are
weaker, and often they are intermittent. The first beat becomes
short and flapping, like the second.

Qeneral Symptoms. — A quick, feeble, small, and faltering pulse,
great anxiety, and a disposition to faint. General languor ; a sallow,
bloodless, withered complexion, with a purple, livid tint of the lips
and cheeks, and frequently, general dropsy, from the inability of the
heart to propel its contents.

Treatment. — When accompanied by acute inflammation, softening
is to be treated on the same principles as inflammation of the heart-
case.

If it be a result of chronic inflammation, it calls for iron, bitters,
nutritious animal food, and good air.

Induration of the Heart.

The muscular substance of the heart sometimes undergoes a hard-
ening process. It is occasionally so much hardened as to sound,
when struck, like a hollow horn vessel. The disease is rare.

It increases the heart's impulse, like hypertrophy ; and it requires
about the same treatment as that disease.

i!c4*!:'.\V.av

HBART DI8EA8IS.

28t

region of
:5 the sec-

mgly witli

ication of
le kept in
3 predomi-
t.

mot easily
ly become
the blood
it into the
jgular sac.
leart. Of

and easily
oatioD.

weakened

beats are

: becomes

ing pulse,
a sallow,

if the lips
ty of the

Hoftening
16 heart-

n, bitters.

38 a hard-
to sound,

; requires

Fatty Degeneration of the Heart.

The heart HometinicH Iwconies overloaded with fiit, which in depos-
ited between the hearUcuse and the mu8(;iihtr Huljotiince, — covering
the organ all over externally, and in some cases penetrating to some
depth into its sulmtance. The muscular walls themselves become
thin and flabby.

Symptom*. — The sounds of the heart are diminished, — especially
the first. The pulse is irregular. Pain, and a feeling of oppression
in the region of the heart, with general signs of retarded circulation,
such as congestion of the bnvin and liver. There is occasiouall} "d-
diness, loss of meuiory, and i iilpitation.

Treatment. — Exercise, mental excitement, and stimulating drinks
must be avoided ; and the patient must live for one or two yeare on
a very light diet, takiug but very little auimal food.

Bony and Cartilaginous Productions in the Heart.

Tfiese productions in the heart are fortunately rare. Yet they
occur; and the point of the heart, in its whole thickness, is some-
times changed to cartilage. The ventricles are sometimes so ossified
as to resemble the bones of the head.

The symptoms of these degenerations are . obscure ; and as such
cases are not curable, it is ol less consequence that we should Ikj able
to know their precise nature during the life of the patient. The
treatment can only afford temporary rel' ', and should be such us is
prescribed in other heart-diseases with similar symptoms.

Shrinking of the Heart. — Atrophy.

The heart, liko any other muscle, is liable to defective nutrition,
and in consequence of it may become Rmall. It shrinks, in some
cases, to the size of an infant's heart.

The complaint is generally caused by whatever reduces the general
flesh, as consumption, diabetes, chronic dysentery, cancer, and exces-
sive loss of blood.

It can hardly be called a disease. Persons who have it are less
subject to inflammatory diseases than others, though they faint from
slight causes, &n<} have nervous affections.

Treatment. — If its causes can be discovered, treait them; if not
the treatment should be the same as for dilatation.

Acute Inflammation of the Heart-Case. — Pericarditis.

The pericardium, or heart-case, is a membranous sac, in which
the heart is contained. It is composed of two layers. The outside

••■ ,

282

HEART DISEASES.

one is fibrotis, dense and white ; the inside one is serous. The serous
liiyer forms the lining of the fibrous one, and then is reflected over
the heart and the roots of the large blood-vessels.

When the pericardium becomes acutely inflamed, it thi-ows out
both lymph and serum or water. The lymph often causes the two
layers of the sac to grow together.

Physical Signs. — The impulse is strong when the effusion of water
is small, — feeble and unequal when it is large. Percussion yields a
dull sound in proportion to the amount of fluid in the sac.

When listening with the stethoscope, a rough noise is heard, resem-
bling either the rasping of wood, the grating of a nutmeg, the rustling
of silk, or the crackling- of parchment. Sometimes it is softer, like
the blowing of a pair of bellows. Occasionally it resembles the
creaking of a new shoe-sole, or has a low creaking, like the tearing
of linen cloth.

When there is effusion, the ordinary beats of the heart sound dull
and distant.

General Symptoms. — Acute inflammatory fever, generally pre-
ceded by chills, with pungent pain in the region of the heart, shooting
to the left shoulder-blade, shoulder, and up: -^r arm.

Pain increased by taking a full breath, by stretching the left side,
by percussion, and by pressure between the ribs over the heart.
Sometimes the pain is in the epigastrium, or left hypochondrium.
Inability to lie on the left side.

Explanation. — The noises mentioned above are produced by the
rubbing together of opposite surfaces of the heart-case, made rough
by the exudation of lymph. The rasping is supposed to be caused
by firm and rugged lymph ; th« rustling and creaking, by soft and wet
lymph; the bellows muiinur, by soft and dry lymph; the creaking,
croaking, and crackling, by drg, tough lymph. These sounds may all
be imitated by rubbing a damp finger upon the back of the band,
while listening with the stethoscope applied to the palm.

Chronic Inflammation of the Heart-Case.

When acute pericarditis runs for more than ten days or a fortnight,
it becomes chronic. It is chronic from the beginning, when it runs a
slow, insidious course, without marked or violent symptoms.

The symptoms are much the same in kind with those of the. acute
form, only less in degree. This low grade of the sjmaptoms of the
disease renders it more obscure than the acute.

Treatment. — In the acute form of the disease, apply wet cups
over the region of the heart, or apply from a dozen to forty leeches
to the same parts.

At the same time, move the bowels freely by an injection (247),
or by a purgative pill (31).

HEART DISEASES.

283

The strength and amount of the remedies employed in each case
must be in proportion to the vigor of the patient's constitution.

It is of great importance that the treatment should be active and
prompt, and that the disease should be broken down early.

Diluent, cooling drinks (112), (129), (298), (299), should be al-
lowed as freely as the patient desires, in order to dilute the blood,
and render it less stimulating to the heart.

At the same time, five to fifteen-drop doses of tincture of veratrum
viride should be given every hour, to bring down the action of the
heart. Ten-drop doses of tincture of digitalis every four hours are
good.

Let the diet be wholly of barley-water, thin gruel, weak tea, or
arrow-root.

During recovery, the diet must be spare, and the greatest tranquil-
lity of mind and body be preserved.

In the treatment of chronic cases, when the cavity appears to con-
tain fluid, counter-irritation is suitable. Blisters, croton-oil, the com-
pound tar-plaster, and especially the tincture of iodine. The diet
may be a little more nutritious than in the acute form of the disease,
— embracing light animal food and broths.

(247),

Inflammation of the Heart. — Carditis.

This is an infl> mmation of the muscular substance of the heart.
When existing alone, it is a very rare disease. Being mixed up with
other forms of heart disease, it does not require any separate account
of ite symptoms or treatment.

Acute Inflammation of the Lining of the Heart.

Bhdocarditis.

The heart is one of the citadels of life. Disease attacks it on all
sides. In this complaint, it has entered the fort and taken possession.
The inflammation is on the lining membrane.

Physical Signs. — The impulse is violent, abrupt and regular, as
long as the circulation through the heart is free, but when this is im-
peded, it is at first a confused tumult (which generally happens when
a fort is first taken), and gradually sinks to a feeble flutter.

The dull sound upon percussion covers a space of from three to
seven square inches.

The beats of the heart are generally accompanied or marked by a
bellows murmur, the loudness of which depends on the strength
of the heart's action.

General Symptoms. — Inflammatory fever. The action of the
heart being generally violent and abrupt, the pulse corresponds with
it, and is strong, full and hard.

284

HEART DISEASES.

Explanation. — The bellows sound is supposed to depend on the
inflamed and swollen condition of the valves.

The dullness on percussion will be slight when the circulation
through the heart is free ; — more distinct and marked when it is
obstructed.

Dr. Hope says the disease may be anticipated, if a person be »M(/-
denly attacked with these three signs : namely, fever, violent action
of the heart, and a murmur which did not exist before.

This disease, like inflammation of the hearlrcase, is often produced
by, and is intimately connected with, acute rheumatism, and is then
to be treated on same principles as rheumatic disorders.

Chronic Inflammation of the Heart's Lining:.

Physical Signs. — The impulse more perceptible and diffused than
natural.

The dull sound upon percussion covers a .space of from four to
eight square inches.

There is a sawing, rasping, or filing sound. This sound may cover
one or both beats of the heart. Sometimes these unnatural sounds
are double ; in which case, the first is caused by an obstruction to the
natural flow of the blood forward ; the second, by the regurgitation
or retrograde flow of the blood from some defect in the valve, — just
as a pump-valve may get out of order, and allow the water which
has gone through to flow back.

Explanation. — A variety of organic changes occur in the valves,
which give rise to the murmurs. Inflammation of the lining mem-
brane of the heart reaches the valves, causing puckering, thickening,
vegetative, cartilaginous, bony and ft,t-like degenerations, which oh-
ttruet the blood in its onward flow, or prevent a closure of the valves,
and allow it to flow back ; the former causing the first sound, the
latter the second. If the unnatural noise be synchronous with the
first beat of the heart, it implies disease in either set of the semilunar
valyes, or an impossibility of closing the auriculo-ventricular open-
ings ; if it accompany the second beat, it signifies that either set of
the semilunar valves may be open.

A murmur attending the first beat of the heait must be caused by
a current of blood from a ventricle ; one attending a second sound,
by a like necessity, is produced by a current into a ventricle. •

Treatment. — The same as that for pericarditis. It should be
equally prompt and vigorous. It must not be forgotten that this dis-
ease leads to various organic diseases of the valves of a very grave
character, and that such mischiefs can only be escaped by cutting the
disease short in the very beg^inning.

HEART DISEASES.

285

id on the

irculation
rhen it is

n be gud-
int action

produced
.d is then

ning.

'used than

n four to

may cover
al sounds
tion to the
urgitation
ve, — just
,ter which

be valves,
ling mem-
xickening,
which 0^
he valves,
ound, tlie

with the
iemilunar

ar open-
ler set of

laused by
sound,

lould be
this dis-
sry grave
tting the

Disease of the Semilunar Valves.

The inflammation of the lining of the heart makes sad work with
the valves. The semilunars are subject to various changes in their
structure.

Physical Signs. — Obstructive Murmur. — In disease of the semi-
lunars, the firat beat of the heart is accompanied or obscured either
by the bellows murmur, or a sawing, rasping, or filing sound. The
unnatural murmur, whatever it is, appears superficial or near. The
second beat is natural.

When the opening into the aorta is contracted, or in any way ob-
structed by unhealthy growths, so that the blood is subjected to more
than a natural degree of friction in passing, this sound will be heard.
It is called obstructive, because it arises from the obstruction of the
blood in its forward course.

Regurgitant Murmurs. — First beat of heart natural. Second
beat accompanied or replaced by bellows murmur. There is some-
times a musical murmur.

Explanation. — The regurgitant murmurs arise from the valves
being too small, or defective in some way, and allowing the blood to
flow back through the orifice.

This murmur is loudest opposite the semilunar valves, and is more
audible above these valves than below them.

When the aortic valves are contracted or shortened, and the open-
ings are not guarded by them, so as to prevent the backward passage
of the blood, there is a double bell vs murmur, — one when it is
driven through the orifice, and another when it flows back.

Disease of the Mitral Valves.

Physical Signs. — Obstructive Murmur. — First beat of heart
natural. Second beat accompanied or replaced by bellows murmiir.

Regurgitant Murmurs. — The first beat of the heart accompanied
by a ioud and rough bellows murmur. This sound is like sawing or
filing. It is loudest above or below the nipple, between the fourth
and seventh ribs. There is occasionally a musical murmur. The
second beat of the heart is natural. Sometimes there is a purring
tremor.

General Symptoms of Valvular Disease. — Cough, in many cases
with watery expectoration ; difficulty of breathing ; frightful dreams
and starting from sleep ; congestion of the lungs ; expectoration
stained with dark and grumous blood ; swelling of the jugular veins ;
a livid look of the face ; a feeling as if a cord were tied tight around
the lower part of the chest ; general dropsy, of the legs and feet in

286

HEART DISEASES.

particular; passive hemorrhages from the mucous membranes; en-
gorgement of the liver and spleen ; congestion of the brain, with feel-
ings of oppression. When the mitral valve is contracted, admitting
regurgitation, the pulse is small, weak, irregular and intermittent.
These are the worst symptoms of an advanced stage.

Explanations. — The examiner will distinguish the various sounds
thus:

The murmurs generated at the origin of the arteries spread their
sonorous currents upwards along these arteries'

Those produced in the auriciilar orifices will be conducted into the
auricles, and propagated downwards towards the apex of the heart.

Which Set of Valves. — To learn in which set of valves it origi-
nates, therefore, find its seat, and trace its direction.

Finding the murmur to be in the aortic orifice, it is then known to
be obstructive, if the first sound is morbid, and the second sound natu-
ral ; and regurgitant, if the first sound is natural, and the second sound
morbid.

But if the murmur be in the mitral orifice, it is obstructive when the
first beat of the heart is natural, and the second beat morbid ; and re-
gurgitant when the first beat is morbid and the second beat natural.

The Pitch or Key of a murmur depends on the distance of its seat
from the ear of the listener, — nearness giving a high, and distance a
low key. Thus, a murmur seated in the orifice of the pulmonaiy
artery, being nearer the surface, has a higher pitch than any other.
It is on about the same key with a whispered «, — sometimes a little
lower, and depending somewhat on the strength of the current of
blood, a strong current elevating, and a weak current depressing the
tone.

The mitral orifice is situated opposite the junction of the cartilage
of the third rib with the left side of the breast-bone. The aortic
orifice is about half an inch to the right of this, and the same dis-
tance lower. It is known by the key being lower, — about like a
whispered r, which is the ordinary type of thr .awing sound.

Murmurs from pulmonic and aortic regurgitations are about two
tones lower, in consequence of the currents of the blood being weaker.
They are like whispering awe by inspiration and if the click of the
valve be heard, the sound will be changed to paw.

Murmurs in the mitral valve, being more deeply seated, are about
four tones lower, and are like a whispered who.

The tricuspid murmurs are higher than the mitral, because nearer
the surface.

The musical murmur has been compared to whistling, the cooing
of a dove, and the mewing of a kitten. It generally results from re-
gurgitation.

The purring tremor is caused, generally, by regurgitation through
the mitral valve.

MMI

HEAKT DISEASES.

-> 287

anes ; en-
with feel-
idmitting
littent.

U8 sounds

•ead their

d into the
heart.

i it origi-

known to
mnd natvr
mid sound

'e when the
I; and re-
itural.

of its seat
distance a
julmonaiy
any other,
les a little
jurrent of
•essing the

cartilage
'he aortic
same dis-
tut like a

tbout two
g weaker,
ik of the

I are about

Ise nearer

|ie cooing
from re-
through

Other Symptoms Explained. — The difficulty of breathing, fright-
ful dieama, congestion of the lungs, hemorrhages, engorgements, etc.,
mentioned above, all proceed from such valvular stiffenings, pucker-
ings, ossifications, enlargements, and contractions, as occasion a decid-
edly obstructed circulation.

The small, weak, irregular, and interrupted pulse, is caused by con-
traction of the mitral valve, which occasions an insufficient or irregu-
lar supply of blood to the ventricle, and causes the ventricle, by losing
the resistance of the valve, to expend its force in a backward as well
a forward direction, thus sending but little blood into the arteries.

Treatment. — The tendency of valvular disease is to produce hyper-
trophy and dilatation. The strong and ceaseless efforts of the ven-
tricle to drive the blood through an orifice obstructed by valvular
disease, will of course make the walls grow thick, which is hjrpertro-
phy ; and at the same time, the accumulation of blood which cannot
be driven forward fast enough, must tend to swell and enlarge the
cavity, — which is dilatation.

The great object of treatment, therefore, is to diminish the force
and activity of the circulation, — to induce the heart to cease striving
to do what cannot be done.

To accomplish this, give sedatives (285), (94), (124). The helle-
bore and cohosh will be found particularly serviceable.

The tincture of the American hellebore is about the best of
all. Purgatives may be given according to the strength of the
patient.

When there is dropsy, and a scanty secretion of high-colored urine,
diuretics, or medicines to increase the action of the kidneys, are very
important. For this purpose, digitalis and acetate of potash (130)
are excellent. Should this not succeed in reducing the dropsy, an
active purgative (31) may accompany it.

Diaphoretics, or medicines which promote perspiration, are also
useful. This opening of the skin, however, is generally brought
about by the hellebore, etc. (124), (358).

The diet should be unstimulating, and yet should be sufficiently
nourishing to prevent the patient from running too low. Animal
food of the most digestible kind may be taken once a day ; though
there are many cases requiring its entire rejection.

The passions should be kept in the most perfect subjection, and
the life should be as tranquil is possible. Nothing must be done in a
hurry.

Water in the Heart-Case. — Hydropericardium.

This disease is common as an attendant of general dropsy.

Physical 5igns. — The impulse is undulatory, as if transmitted
through a fluid, and it is not always of the same strength.

The dullness extends upward in a conical form, in proportion to

288

HEART DISEASES.

the amount of fluid, — sometimes rising as high as the second rib.
The impulse does not coincide with the first beat of the heart.

General Symptoms. — The patient has a sensation of tw- heart
heintj in afioathuf state. The pulse is small, frequent, and intermit-
tent.

Explanation. — The reason that the impulse does not occur at
the same time with the first beat of the heart is, that the apex does
not immediately strike the walls of the chest, — some time being re-
quired to push it up through the fluid.

The l)eat8 of the heart sound more distant than natural in conse-
quence of the organ being pushed away from the walls of the chest
by the fluid.

Palpitation. — Nervous Palpitation. — Ansmic

Palpitation.

There is a great deal of palpitation of the heart dependent on
dyspepsia, hypochondria, hysterics, mental agitation, excessive study
with deficient sleep, venereal excesses, and masturbation.

Palpitations likewise occur from what is called anaemia, or a low
and deficient state of the blood.

Physical Signs. — The impulse is weak, fluttering, or tumultuous,

— generally increased by trifles.

The beats of the heart are increased in frequency, and sometimes
marked by intermission. Now and then they are accompanied by a
bellows murmur. There are musical murmurs in the jugular veins,

— loudest a little above the collar-bones.

General Symptoms. — The complexion is generally pallid and
bloodless ; the li[>s and the inside of the mouth partaking of the
same paleness; the pulse quick, small, weak, and jerking; and during
palpitation it sometimes has a thrill. Slight causes produce breath-
lessness and faintness. A dislike of animal food, and a fondness for
acids. The monthly discharge in females is deficient, and the whites
take its place. Sometimes the menses are too profuse, lasting for
several days, and consisting only of blood. In this state of things
there is great feebleness both of mind and body, with rushing noises
in the ears.

Explanations. — The murmurs depend on a lack of blood. The
conditions of their existence are, thinness of blood, a swift and spas-
modic circulation, and particularly an unfilled condition of the blood-
vessels. A brook is the more babbling in proportion as its water is
more shallow. It is a law in physics, that heaviness of freight gives
steadiness of motion ; and lightness of freight gives unsteady motion.
The fireman's hose trembles and vibrates when only half full of
water. In like manner the blood-vessels are agitated when imper-
IVctly filled.

HEART DISEASES.

289

jond rib.
rt.

tw. heart
intermitr

occur at
pex does
being re-
in conse-
the chest

emic

ndent on
ive study

or a low

oaultuous,

jometimes
nied by a
liar veins,

)allid and
ng of the
nd during
ce breath-
ndness for
the whites
asting for
of things
ling noises

ood. The
t and spas-
the blood-
ts water is
eight gives
tdy motion,
alf full of
[ie» imper-

Treatment: — This is to be governed altogether by the cause of
the trouble. If it be dyspepsia, hypochondria, hysterics, etc., these
several diseases require their usual treatment ; when they are cured,
the palpitation will stop.

But when it is caused by alow state of the blood, then give for
several weeks, iron, the compound mixture, and (316), (310).

The food must likewise be nourishing, — tender meat, beef and
mutton, with broths, etc.

Gentle exercise will be required, and much exposure to a bracing
out-door air.

Neuralgia of the Heart. — Mgina Pectoris.

This is a strictly nervous disease. It begins with a sensation of
pain and constriction in the region of the heart. This pain is accom-
])iinied with more or less pain and numbness in the left arm. In
females it is not uncommon for it to be attended by great sensitive-
ness and pain of the breasts. When the attack is violent, the pain
in the heart is excruciating, and even terrific. There is attending
this a feeling of great oppression in the chest, amounting, in the
worst cases, to a seiise of suffocation. The heart palpitates violently,
the brain is oppressed, and f^rinting sometimes occurs.

The disease is brought on, in nervous subjects, by over-excitement
of the heart. Walking up hill, against a strong wind, may bring it
(in. If walking at the time of the attack, the patient is compelled to
stop, and stand still till the pain subsides.

The disease is often connected with organic changes in the heart's
structure, such as ossifications and other alterations.

Treatment. — When the complaint depends on organic disease
of the heart, the treatment must be directed to the cure of these
diseases.

To relieve a severe attack, the patient should be instantly placed
in a quiet position ; wind in the stomach, if present, should be ex-
pelled by peppermint or anise water, or ether, or (115), or some other
aromatic. If there is acidity or sourness of the stomach, it must be
corrected by a teaspoonful of soda in half a tumbler of water ; and
if the stomach be full of undigested food, let the patient take a table-
spoonful of ground mustard, stirred up with a teacupful of warm
water. This will cause almost instant vomiting.

These things being done, give some quieting or antispasmodic
medicines, or one of the following prescriptions : (285), (97), (136),
(124). Inhale 5 drops of nitrite of amyl on a cloth frequently.

Greav relief is often obtained by sending a current of magnetism
through the region of the heart, by applying one pole of the machine
in front, and the other upon the back.

During the intervals, the general health is to be improved by a
wholesome, nourishing diet, gentle outrdoor exercise, and a careful

^m^'

290

HBAllT DISEASES.

control of all the passions. ,U of a grain of nitro-glycerine every
hour, while in pain, steadies and slows the heart.

Polypus of the Heart.

A PORTION of the fibrin sometimes separates from the blood in
the heart and large vesaels, and becoming more or less organized,
forms polypuses, which fill the cavities to which they are attached,
and seriously obstruct the circulation.

Physical Signs. — When the pulsations of the heart, previously
regular, become suddenly anomalous, confused, and obscure, so that
they cannot be analyzed, we may suspect a polypus.

aeneral Symptoms. —A sudden and great aggravation of the bad
breathing, without any visible cause, — the patient being in agony
from a sense of impending suffocation, and tossing about from side
to side, struggling for breath. The pulse small, weak, irregular, in-
termittent, and unequal; the surface and extremities cold; the face,
livid, — to which there is generally added nausea and vomiting.

Treatment. — When the polypus is once formed, the case is hope-
less. The treatment, therefore, can only be preventive.

The chief things to be done are, to keep the patient in a state . t
entire tranquillity, and to bring the circulation to the surface, by keep-
ing the skin warm, and excited by friction. This will call the blood
away f.ora the heart and great vessels, and lessen the chances of the
polypus.

Displacements of the Heart.

The heart may be misplaced from birth. I have seen a case in
which it lay upon the right side, and had always been in that posi-
tion. Its action was natural.

A variety of causes may tend to push it out of its place, as water
in the cavity of the pleura. In such cases, it will return to its place
when the water is drawn off or absorbed.

m ' ' ! S^,r ^^' :\'m^J ' ^^^^^IMl>^!i^LS ' -&'^ S!r£^

wsmr^

ne every

blood in
n'ganized,
attaciied,

)reviou8ly
e, so that

of the bad
in agony
from side
egular, in-
; the face,
liting.

Be is hope-

a state «f
ic, by keep-
. the blood
ices of the

•c :!

a case in
that posi-

e, as water
bo its place

m-^

PI 7

THE INTERNAL ORGANS OF THE HUMAN BODY.

PI 7

DISEASES OP THE ABDOMINAL CAVITY.

Undkb the above head I shall consider most of the diseases which
occur in the great cavity below the diaphmgm, called the abdomen
or belly. These affections are quite important, and make up a con-
Hiderable part of the ills we suffer from disease.

Before speaking of these diseases, however, I will call the reader's
attention to a profile view of the
relative position of the several or-
gans lodged in this cavity.

In Fig, 9G, L is the liver, S the
Htomach, C the colon, R the rectum
l\ the bladder, P D the pancreas,
and I the intestines. The double
lines, folded back upon each other,
and surrounding most of the or-
gans, represent the peritoneum^ a
membrane which lines the g^at
cavity of which I am speaking.

It will be well, too, before pro-
ceeding further, to make the reader
acquainted witli the names of cer-
tain regions of the abdomen which
he will find constantly spoken of
in medical books. I have not
used these terms much in my
Ixjok ; but it will be convenient
to be acquainted with them. Phy-
sicians who are careless in their
readings are not always familiar
with their exact locality.

In Pig. 97, the abdomen is di-
vided into nine different regions
by the drawing of two parallel lines up and down, 2, 2, and 8, 8,
and two lines across, 4, 4, and 1, 1. This gives three regions above,
three in the middle, and three below.

In the upper row, 6 is the epigastrium or epigastric region, in which
are the left lobe of the liver, and a portion of the stomach ; 6, on the

291

FlO. 96.

202

niSFARKS OK TIIR AnDOMINAI. CAVITY.

FlO 97.

right side, is the right hi/poi'liondrium, in which is Um rijjlij, |oIh> of ilm

livor ; iiiul f), mi tho h-t't Hidt;, is the lejt
hjipochondriumy which coiitniiis tho sphuMi,
and 11 portion of this Htomach and liver.

In the nii(Ullo row, 7 is tlio umbilical
m/ion, which contains tho small intestines.
On the right side, H is the rif/ht lumlxv
reyion, which holds tho right kidney and
tho ascending colon ; and 8, on tho left, is
the left liimliar re/jion, whi(!h contains the
left kidney and the descending colon.

In tho lower row, 9 is tho hi/pot/agt n'tim
or hi/pof/astrio rej/ion, which contains h
portion of the small intestines and hladdci .
On the right, 10 is the riffht iliac fima,
containing tho cceeiim or caput coli ; iiiul
10, on the left, is the left iliac fossa, con-
taining the sigmoid flexure.
And now I may as

well present, in Fig. 98,

a front view of many of

the organs, both in the

chest and abdomen: 1, 1,

1, 1, are the muscles of

the chest ; 2, 2, 2, 2, the

ribs; 3, 8, 8, the upper,/

middle, and lower lobes]

of the right lung; 4, 4,1

the lobes of the left lung;1

6, the right ventricle of|

the heart; 6, the left ven-
tricle ; 7, the right auricle

of the heart; 8, the left

auricle; 9, the pulmonary

artery; 10, the aorta ; 11,

the vp "^^'a descendens ;

12, indpipe ; 18,

.*; 14, 14, 14,

.<3 pleura; 15, 16,

cho diaphragm; 16,16,

tne right and left lobes of

the liver; 17, the gall-
bladder ; 18, stomach; 26,

the spleen; 19, 19, the

duodenum ; 20, the as-
cending colon ; 24, the

transverse colon ; 25, the

descending colon; 22, 22, 22, 22, the small intestines; 28, 23, the

rio. 98.

I*.

niBKAflFft np THK AHHOMINAI, riAVITY.

203

■•14.

walls of till) Iwlly turned down; 24, the thorarir, diict, <>[)eiiing intr)
tho left Hnl)clavi>in vein (27).

Acute Inflammation of the LWer. — I Icpai His.

The liver is the largost gland in the l)ody. (See Fig. 81.) It lies
in the right side, and iit the top of the great ulxloniinal cavity, di-
rectly under the midriff, tnd lapping upon the stoniaoh. Fig, 90
showH itH relative position. Its otHuu woh HUppcsed to Iw to take tiiv
superabundant carbon out of the blood. TIuh carbon it unites vitii
other elements and forms bile, the peculiar bitter sul)8tance which is
poured into the upper bowel, and greatly aids digestion.

The liver is liable to become inflamed from several causes, such
as gravel-stones, external violence, suppressed secretions, hot climates,
intlammation of the duodenum, etc.

Symptoms. — These are sympathetic fever, with pain, and a sense
of tension in the right side, inability to lie on the left side, difficulty
of breathing, a dry cough, vomiting, and hiccup.

The pain is acute and lancinating generally, though sometimes
dull and tensive. When sharp, it is like the stitch of pleurisy, and
it indicates that the peritoneum which covers the liver is inflamed.
When dull, it is the body of the organ which is suffering. When
the convex surface of the liver is the se.\t of the disease, the pain is
apt to run up to the right collar-bone, and to the top of the right
shoulder. Breatlung, coughing, and lying on the left side, increase
the pain. A soreness is felt by pressing over the liver. The pulse
is full, hard, and strong, tho bowels are costive, and the stools are
clay-colored, owing to not being tinged with bile, — this having
stopped flowing. The tongue is covered with a yellow, dark brown,
or even black coat, and there is a bitter taste in the mouth.

Explanation. — The bile, secreted by the liver, is poured into the
upper bowel, and gives the brown or yellow color to the contents
of the bowels. When the liver is inflamed, it cannot work, — it se-
cretes little or no bile, and the discharges from the bowels lose their
color. The bile is slightly laxative, and when it ceases to flow into
the bowels, they become bound or costive. When the liver does not
work, the bile has to be taken out of the blood by the kidneys, and
the urine becomes of a deep yellow color. Much of it goes out
through the skin, too, which is likewise yellow, and the sweat be-
comes so yellow as to stain the linen.

Treatment. — Flax-seed poultices applied over the liver are veiy
good. Purgatives will also need to be used pretty freely at iiiyt.
Those which produce watery stools (31), (247), (34), will be of the
greatest service.

After the cups and purgatives have been thoroughly used, blisters
will be useful, and it will be better to apply several in succession,

294

DISEASES OF THE ABDOMINAL CAVITY.

rather than to keep the first one open. Or, in the milder cases, ;i
mustard poultice may be applied over tli ^ whole side, and even along
the dpine.

Frictions over the stomach and liver with dilute nitro-muriatic
acid, and a foot-bath of the same, will sometimes do well. The acid
should be reduced with water to about the strength of sharp vinegar.
Water a little soured with this same acid makes an excellent drink
for the patient.

Perepiration should be induced by the spirit vapor-bath, and kept
up ger " by the tincture of the American hellebore, from three to
ten divtps ?very hour. Or, the same thing may be done by prescrip-
tions (12fi;, (358).

When tb urine is small in quantity and red, ^,ive some diuretic,
as iafusioK ^^ marshmallow-root, pumpkin-seeds, or trailing arbutus.

The diet should be rice-water, gruel, and toast-water. While
getting up, it may gradually be improved, and some light tonics
(49), (58), (64) be added to it.

Chronic Inflammation of tlie Liver.

Hepatitis.

Chronic

There are few chronic diseases for which the physician is more
often consulted than this. In the warm climate of the South, in
the bilious districts of the West, and indeed even in the Middle and
Eastern States, it meets us continually, and demands our attention.
That it is difficult to cure must be admitted; but a constant famil-
iarity with chronic diseases, for several years, has convinced me that
it is generally curable.

Symptoms A sense of fulness and weight in thp right side

with some enlargement, and shooting pains felt in the same region,
particularly when it is pressed, with pains in one or both shouldei-s,
and under the shoulder-blades ; uncomfortable sensations when lying
on the left side; yellowness of the skin, eyes, and urine; bowels
irregular, loose, or costive; appetite disturbed; sometimes a dry,
hacking cough; shortness of breath; tongue whitish, and brown or
yellow towards the root ; a bitter and bad taste in the mouth in the
morning. The urine deposits a sediment on standing. There is
generally a low and desponding state of mind, with irritability and
peevishness of temper.

The skin is often covered with yellow spots and with a branny
substance. The various symptoms of dyspepsia are often present.
The nervous system is generally much disturbed, and there is a dis-
inclination to apply the mind. There is frequently a great dread of
imagined evil, supposed to be impending.

Treatment. — This does not require *:o be as active as that for the
acute form of the disease.

""steiHB

DISEASES OP THE ABDOMINAL CAVITY.

295

If there l)e much tenderness of the liver, begin with mustai-d
poultices, and the compound pills of podophyllin, or the compound
pills of leptandrin, or (36).

I have abandoned the use of mercury in this disease, as in most
others; but if any prefer to use it, the blue pill (52) will be found
the most useful form.

The compound tar-plaster placed over the liver, in bad cases, is
often very serviceable.

An alterative (138), (146) will be found useful.

The daily alkaline sponge-bath must on no account be omitted.
Vigorous friction must follow it. Vigorous constitutions will bear
the shower-bath; in such cases it may, occasionally, take the place
of the sponge-bath.

The diet must be simple, yet nourishing and wholesome, and
embracing but a small amount of fat, as this is composed largely of
carbon, and the liver is unable to remove what i^ already in the blood.

Especially and above all, out-door exc-cide must be taken to the
full amount of the strength, and the thoughts be occupied with
cheerful subjects. Let the hot sun be avoided, and the summer
exercise be taken in the cool hours of the day.

The recovery from this, as from all other chronic diseases, must
necessarily be slow.

Congestion of the Liver.

This is not strictly a disease, but the result of gastro-intestinal
disorders. There is an enlarged, congested liver, with a sense of
fulness and weight in the right side under the ribs.

The application of heat, and even leeches, to the side, and the ad-
ministration of saline laxatives, afford relief. The diet must be light
and farinaeeous.

Passive Congestion of tlie Liver

Results from mechanical obtruction to the outflow of blood from
the liver. When this condition has existed some time, there is a
sense of weight and fullness in the liver region when sitting up or
lying on the left side. The liver is enlarged and tender; the breath
is shortened, and pain may be present, extending to the shoulder.

Jaundice is usually preseno, but only to a slight degree. When
the heart is the cause of the obstruction to the outflow of blood,
there is often present an associa id gsistro-duodenal catarrh, in which
case loss of appetite, nausea, vomiting, belching of gas, and pain,
are also present. In the later stages of a ] rolonged case, ascites, or
dropsy of the peritoneal cavity, is present.

Prognosis. — The outcome of passive congestion of the liver is
usually grave, since it is the result of some structural disease else-
where, as of the heart, asthma, chronic pleurisy, tumors, etc.

296

DISEASKS OF THK ABltOMINAL CAVITY.

Treatment. — The indications for treatment are to strengthen the
lieait wilh digitalis, strophanthus, etc., increase the strength of tht;
patient with strong, stimulating food, and to deplete the portal circu-
lation by vegetable laxatives like podophyllin, rhubarb, aloes, etc.;
the salines also furnish an agreeable method of depletion, as for
instance, Crab-orchard water, Hunjadi, etc. It occurs usually after
middle life, and is more common in women than men. It is usually
secondary to cancer elsewhere, as in the bowels or stomach, rectum
and womb. The liver is increased in size, and is frequently studded
with cancerous nodules, which in well-marked cases may be felt
through the abdominal wall.

The disease usually gives rise to loss of appetite, nausea, vomiting,
constipation, emaciation and weakness. Pain over the liver is gen-
erally present, while jaundice exists in about fifty per cent of cases
Dropsy of the bowels exists likewise in about the same proportion of
cases. Hemorrhages from the nose, stomach and bowels occur in
the later stages of the disease. The temperature is usually lowef
than normal, and the pulse slow, especially if jaundice be present ;
the urine is diminished in amount and high colored. The disease
progressively advances to a fatal termination inside of a year. No
kuowu treatment is of avail in arresting the terrible malady.

Cirrhosis of the Liver.

This is a disease characterized by an excessive increase of the
fibrous tissue in the liver, whose later function is to contract and
squeeze out, so to speak, the softer, glandular structure of the liver
proper, thus causing its atrophy and diminution in size. The dis-
ease is caused mainly by the introduction into the portal system of
some irritant like alcohol. It is generally known as the gin-drinker's
liver, but it does not result especially from gin any more than from
any other spirit. It is, at all events, essentially a disease due to pro-
longed though moderate use of spirits of one sort or another, and
occurs between the ages of thirty and sixty, mostly in men.

The symptoms of this disease are at first those of gastric and intes-
tinal disorders due to alcohol, as nausea, flatulence, constipation and
looseness, etc.

Dropsy is finally the most pronounced symptom of the diseiise, but
hemorrhages from the bowels not infrequently occur. The disten-
sion of the abdomen by dropsy is sometimes enormous ; finally the
feet and legs become swollen, emaciation and weakness progress, and
the patient may finally die in coma or convulsions. The disease, when
suffisiently advanced to be recognized, is incurable.

Treatment. — The treatment is to be directed toward the removal
of all irritating food and alcohol. The diet should consist largely of
milk; green vegetables and fruit, beans, peas, eggs, lean meat, etc.,
may be taken if well borne.

DISEASES OF THE ABDOMINAL CAVITY.

297

The stomach and bowels .are to be kept in good condition, th«>
dropsy drawn off or removed by means of loose evacuations from the
bowels.

Hydrochloric acid in three-drop doses, well diluted, after meals,
may be of service, while bitter stomach-tonics are to be given before '
eatiug.

Acute Inflammation of the Spleen. ~ Splenitis.

Thk spleen is in the upper part of the belly, on the left side,
opposite the liver. It is subject to acute inflammation, which is
known by a pain just under the short ribs on the left side, also by
swelling, soreness to the touch, and by more or less fever. The pain
often shoots ui) through the midriff and to the left shoulder. There
18 a short, di-y cough ; a feeling of tightness about the heart ; a sick-
ness at the stomach, and vomiting ; and a discharge frequently of
black blood from the bowels. The urine is scanty, is passed with
some difficulty, and is high-colored.

This disease appears most frequently in hot climates, and is often
connected with intermittent fevers.

Chronic Inflammation of the Spleen.

This prevails most in fever-and-ague districts, and is a frequent
result of chills and fever. It is generally very stubborn, often lasting
many years.

Symptoms — A feeling of weight, tightness, and sometimes pain
in the left side, the pain being increased by pressure, or an attempt
to lie on the left side. The organ sometimes enlarges very much, so
that it can be felt by the hand. This enlarged mass passes under
the common name of " ague cake." There are sometimes numbness,
weakness of the legs, difficulty of breathing, palpitation of the heart,
inability to exercise much, otetinate constipation, vomiting of food,
piles, diy skin, tongue coated white or red, low spirits, and occasion-
ally dropsical affections.

During the chill in fever and ague, the spleen becomes enormously
loaded with blood. Surfeited and stretched in this way again and
again, it is not strange that the organ should become diseased.

Treatment. — This should be about the same as the treatment for
acute and chronic inflammation of the livei-.

After the active symptoms of inflammation are subdued, the warm
bath may be used one or twice a week.

In the chronic form of the disease, counter-irritation with the
compound tar-plaster, with mustard poultices, croton-oil, or tincture
of iodine, will be particularly needed.

Among medicines, muriate of ammonia (53"), has a high reputation.

^^"WIIM

298

DISEASES OF THE ABDOMINAL CAVITY.

To keep the lx)wel8 open, [)odophyllin, quinine, and mix vomica
(46), liave a fine effect. Iron may be given (73) when the patient
is bloodless and pale.

Jaundice. — Icterus.

The jaundice is a very common disease, and to be known needs
only to be seen ; but inasmuch as it may be but a symptom rather
than a disease per se, it behooves one to be careful that some hidden
disorder be not preying upon the system. Among the more common
affections which give rise to jaundice are gastro-duodenal catarrh,
frequently affecting children, obstruction of the gall-ducts by thick
bile or mucus, or by gallnstones ; cancer, chronic forms of liver com-
plaints, and some forms of blood diseases.

Symptoms. — The most prominent symptoms are, yellowness of
the skin and whites of the eyes, saffron-colored urine, and whitish or
clay-colored stools. So full is the urine of bile, that a piece of white
linen dropped into it receives a bright yellow tinge.

Besides these symptoms, there are impaired appetite, a loathing
of food, the sense of a load at the pit of the stomach, sourness of
stomach, sometimes sickness and vomiting, a bitter taste in the moutli,
disinclination to move about, sleepiness, a dull pain in the right side,
which is increased by pressure.

The entire body of a person who has died of jaundice, including
bones, muscles, and membranes, are found to be full of bile, and col-
ored yellow.

Explanation. — The bile flows into the upper bowel, a little below
the stomach, through a duct or tube about as large as a goose-quill.
This little tube or vessel receives the bile from a smaller tube, called
the hepatic duct, and from another which goes to the gall-bladder,
called the cystic duct.

These little tubes sometimes get obstructed or plugged up by
sticky, thickened, or hardened bile, or by gall-stones, formed in the
liver ; and the bile, finding no outlet through its natural channels, is
taken up by the absorbents, distributed over the system, and produces
the yellowness we witness. When these ducts and the gall-bladder
are filled and stretched by this thickened and hardened bile, they be-
come tender and sore. Hence the sore feeling in the side when
pressure is made.

There is another explanation of the way in which the yellowness
of jaundice is produced, and it mattei-s not whether it or the one just
given be adopted. It is this : The bile is formed by the blood, and
not by the liver. The office of the liver is to draw or strain off the
bile from the blood. And when this organ is inflamed, or irets slug-
gish and will not work, the blood is not relieved of its yellow freight.
The bile accumulates, and in attempting to escape through other
channels, it lodges in the various tissues, particularly in the skin.

vomica
patient

n needs
(1 rather

hidden
common

catarrh,
by thick
ver com-

mmess of
hitish or
of white

loathing
irness of
le moutli,
ight side,

ncluding
, and col-

,le below
ose-quill.
be, called
l-bladder,

id up by
d in the

annels, is
produces
l-bladder
they be-
de when

llowness
one just
lood, and
off the
rets slug-
freight,
gh other
skin.

DISKA8E8 OF THE ABDOMINAL CAVITY.

JM9

Treatment. — An infusion of thoroughwort, drunk freely every
day, is a valuable remedy. The inner bark of the barberry steeped
in cider, or this article compounded with others (286), (287), will
be found excellent.

The diet should be plain, wholesome, and nourishing, but com-
posed mostly of vegetable articles, particularly green vegetables and
berries when they are to be had.

Cold water should be the principal drink ; or drink and medicine
may be combined in the shape of three drops of murisvtic acid, and
two drops of nitric acid, dissolved in a tumbler of water slightly
sweetened. This is generally a pleasant drink, and will assist very
much in the cure.

The warm bath once or twice a week, and the alkaline sponge-bath
every day, with smart friction, must not be omitted.

When jaundice is caused by the passage of gall-stones through the
bile-duct, there is sometimes terrible pain and suffering, — the stone,
occasionally, being as large as a nutmeg, and forcing its way through
a quill-sized tube. So great is the distress that the patient sometimes
rolls upon the floor in agony. To alleviate this pain, large doses of
opium, laudanum, or morphine, are required. A large teaspoonful of
bicarbonate of soda dissolved in a tumblerful of hot water is an ex-
cellent remedy if drunk at a single draught. It relieves the acidity
of the stomach, and acts as a fomentation to the internal seat of the
pain. MusUvrd poultices, or warm fomentations, over the seat of the
pain, are required. The warm bath is excellent.

The acid bath, made by mixing three parts of muriatic acid with
two parts of nitric acid, and adding as much of this mixture to water
as will make it about as sour as weak vinegar, is valuable in jaundice.
Only a quart of water need be taken ; and the solution should be
applied with a sponge. It is of the right strength, if it produce a
slight tingling of the skin.

Qall-Stones. — Biliary Calculi.

These are brownish, ohocola -colored concretions which form
either in the gall-bladder itself, in the duct leading from the gall-
bladder, or in the common duct which is formed by the
union of the gall-duct and the hepatic duct which leads
from the liver. They are solid, generally have bodies of
irregular shape and size, and have facets cavised by the
stones being impacted ag^ainst one another. Fig. 99
shows their appearance. These concretions are formed
of inspissated bile and organic salts. When they settle into the ducts
their natural course is downward through the duct into the bowel,
where they are naturally carried off with the faeces. Their passage
through these ducts is accompanied often with extreme pain and
colic, the pain being the severest of any to which the system is sub-
jected, and generally requires an opiate. When once an attack of

FlO. 99.

800

PI8EASKS OF THE ABDOMINAI, CAVITY.

gall-fitones has occurred, the patient is liable to more, as they seldom
exist singly in the gall-bladder. These repeated attacks have lieen
the subject of a great deal of thought among surgeons.

Symptoms. — An almost constant uneasiness in the right hypo-
chondriac region, with spasms of pain, coming on suddenly, and last-
ing for a time with gi'eat severity, and then subsiding. The pain is
caused by a stono being suddenly forced into tlie duct and moving
forward in it, and it sulfides when the stone either stops, or gets
through the duct. When the stone reaches the bowels, it passes off
with the stools.

The patient generally has a pale, sallow complexion, a small, feeble
pulse, and often suffers from nausea and vomiting, and from restless-
ness and hurried breathing.

Treatment. — To reduce the spasm, give svapnia powder in full
doses, or chlorodine. Also, apply mustard over the right hypochon-
drium and stomach, and fellow it with hot fomentations with hops,
or use wet cups.

If the stomach is irritable, give the neutralizing mixture until it
moves the bowels. To relieve the intense pain, morphine should be
administered, together with hot baths and hot cloths over the abdo-
men.

Sweet oil was at one time advocated as a solvent of these bodies,
but experience has not proven the validity of the claim. Many
practitioners, however, still insist that oil in large doses hastens the
passage of the stones.

To remove the acidity on which the foi-mation of these stones so
often depends, a neutralizing preparation (338) may be given for a
long time, the diet, in the mean time, being well regulated. The
sponge-bath with saleratus and water, should be taken daily, followed
by brisk rubbing ; and free exercise in the open air should on no
account be omitted.

Of late years it is customaiy to treat this complaint surgically,
operating directly on the gall-bladder by incising it and removing
the stones. If the ducts become obstructed, they too are incised and
the stones dislodged, either by pushing them down into the bowel,
or otherwise, as maj' be most convenient. The gall-bladder is either
sutured to the abdominal wall, and a biliary fistula forms, discharg-
ing the bile upon the abdominal wall; or it may be drained off into
a bottle; or, as has been recently advocated, the bladder may be
sewn up tightly and replaced. Sometimes communication is estab-
lished between the gall-bladder, or the duct, and the duoden m, by
means of an ingenious device called " Murphy's Button." This
button, invented by Dr. Murphy of Chicago, is intended to di-aw to-
gether the parts to he connected, retaining them in that position.
A fter some days the walls slough away, and the button passes into
the bowel, and is thus removed from the system. By this means

DISEASES OF THE ABDOMINAL CAVITY

301

jy seldom
lave been

rlit hypo-
, and last-
le pain is
1 moving
8, or gets
passes off

all, feeble
n restless-

er in full
hypochon-
/ith hops,

e until it
should be
the abdo-

se bodies,
11. Many
astens the

I stones so
iven for a
bed. The
', followed
lid on no

surgically,
removing
icised and
he bowel,
r is either
discharg-
d off into
r may be
I is ostab-
len m, by
n." This
3 di-aw to-
t position,
asses into
lis means

many stubborn cases of impacted gall-stone have been permanently
cured.

Abscess of the gall-bladder, inflammation of the surrounding
tissue, and even death are not infrequent results of the presence of
these foreign bodies.

For preventing the formation of gall-stones, see the articles on
Biliousness, Diet, etc.

Acute Inflammation of the Stomach. — Gastritis.

This is a rare disease. It is generally induced by irritating and
corrosive substances taken into the stomach. Poisons, as ai-senic,
aquafortis, corrosive sublimate, and the like, are the most common
causes of it. Blows, sudden stoppage of sweat, and excessive use of
ardent spirits, may also excite it.

Symptoms. — It is marked by burning pain in the stomach, thirst,
restlessness, anxiety, constant vomiting, prostration of strength, a
quick, hard, and small pulse, incessant retching, a sunken counte-
nance, hiccough, cold hands and feet, and a damp skin.

Treatment. — If the inflammation be excited by poison, the reme-
dies named under antidotes for poisons must be first employed.

The poison being neutralized or thrown off, the inflammatory con-
dition must be combatted with the remedies usual for such states.
Mustard poultices to the feet, along the spine, and particularly over
the pit of the stomach, will be among the first things to be employed,
and should be followed by hot fomentations of stramonium leaves or
hops, — both the fomentations and the poultices to be repeated as
occasion may require. Dry cupping over the region of the stomach
is useful. Small and repeated doses of bismuth, or |-grain doses of
cocaine, are generally very soothing to the stomach, and relieve the
terrible vomiting.

Drinks. — Cold water, bread-water, rice-water, arrow-root gruel,
infusion of slippery-elm bark, and of mai-shmallow. These should
be taken in very small qaantities, — say a teaspoonful at a time, —
about twenty drops of tincture of aconite-root being added to a half
tumblerful. Lumps of ice may be held in the mouth, and occasion-
ally swallowed.

Injections. — Emetics and physic are not proper, but injections
(248), (263), or simply soap-suds, will be required.

The remedies must be pursued until all tenderness has disappeared
from the pit of the stomach.

While the patient is recovering, great care must be taken not to
overload the stomach with food. Arrow-root, sago, and milk are
among the first articles to be allowed. After these, will come gnid-
ually beef-tea, chicken-broth, soft-boiled eggs, and beef-steak, until
the whole diet can be restored.

302

DISEASES OP THE ABDOMINAL CAVITY.

Chronic Inflammation of the Stomach.

This is a much more common disease that the preceding ; indeed
it is very common. Though it does not put life in immediate danger,
it perverts the feelings of the stomach, and causes many of the symp-
toms of indigestion. Dyspepsia, however, is a different complaint,
and not iiecessarily connected with inflammation.

Symptoms. — There is generally pain in the stomach, which is in-
creased by the presence of food, and by external pressure. The pain
is sometimes felt only during digestion. The fermentation of tlie
food in the stomach generates a gas, which is frequently belched up.
This is what is meant in common language by having " wind in the
stomach," and " belching wind." The meals are frequently vomited
up ; the appetite is lickle, sometimes voracious, and again nearly ab-
sent ; the thirst is likewise variant ; the tongue is white in the centre,
and red at the sides and tip, — sometimes smooth and red all over,
like a slice of raw beef. The urine is scanty and high-colored.

The disease is very liable, if badly managed, to lead to ulceration
of the coats of the stomach, and thence to a fatal end ; for an ulcer
may penetrate the walls of the stomach, and let its contents into the
abdominal cavity, which would excite an immediately fatal inflam-
mation.

Treatment. — If there be much tenderness, we may apply leeches
over the stomach. With less tenderness, counter-irritation will an-
swer,* — as blisters, croton-oil, mustard poultices, the compound tar-
plasters, or dry cups.

The skin of the whole surface should receive special attention.
The warm or the cold bath should be used often, according to the
strength of the patient. When the reaction ;is good, a cold compress
bound upon the stomach every night, will do much to bring relief.

The diet cannot be too carefully managed. While there is consid-
erable tenderness, the nourishment must be of the most simple and
unirritating kind, — consisting of little more than the most bland
nutritive drinks ; and even these should be taken in small quantities
at a time. Gum arable water, rice-water, barley-water, arrow-root,
gruel, tea, and toast without butter, will be amply sufficient to keep
soul and body together, and will, in two or three weeks, generally
starve the enemy out of his quarters. After this, a more nourishing
diet may gradually be resumed. Many of the recent proprietary
foods serve an admirable purpose in furnishing a large amount of
nutriment in small bulk, which is easily digested. Among these
may be mentioned proteinol, in teaspoonful to biblespoonful doses,
liquid peptonoids, malted milk, koumiss, matzoon,, etc. These latter
are milk preparations with the cooling and refreshing taste of soda.

DISEA8KS OF THE ABDOMINAL UAVITY.

303

IndSgestion. — Dyspepsia.

Dyspepsia is a disease of civilization. Savages know nothing of
it. It is the costly price we pay for luxuries. All civilized nations
suffer from it, more or leas, but none so much as the people of the
United States. It is here, in the new world, that the disease has
become domesticated, and we, as a people, who have threatened to
monopolize its miseries.

Few disordere inflict upon their victims greater suffering; yet it is
not particularly dangerous, and it is even loubtful whether it tends
very much to shorten life, unless the lengv . of life be judged to con-
sist in the sum of happiness enjoyed, — in which case few complaints
shorten it more.

Symptoms. — These vary very much in different stages of the dis-
ease, and in different persons. In general the complaint begins with
a sense of fullness, tightness, and weight in the stomach, sooner or
later, after meals, and a changeable, diminished, or lost appetite.
Cooasionally, the app-tite is craving, and when, in obedience to its
promptings, a large meal is taken, there is pain in the stomach, with
general distress and nervousness, and sometimes vomiting. Flatu-
lency and acidity are common, with sour and offensive belching of
wind ; and very often there is a water-brash, or vomiting of a clear,
glairy fluid when the stomach is empty. Dizziness is a prominent
symptom. There is a great deal of what patients call an " all-gone "
feeling at the pit of the stomach, — a weakness so great at that par-
ticular spot, that it is very hard to sit up straight. There is a bad
taste in the mouth ; the tongue is covered with a whitish fur ; there
is headache, heartburn, palpitation at times, high-colored urine, and
tenderness, now and then, at the pit of the stomach. The bowels
are generally irregular, sometimes very costive, at other times loose,
when portions of food a^e passed off undigested.

Nervous Complication. — Such are the symptoms in a case of
simple disorder of the stomach, when no other part of the system is
materially involved. This is indigestion, well-marked, and distressing
enough ; but it is only a part of what is understood by a case of
modern dyapepna. In thia^ either the indigestion, in its course, dis-
turbs and involves the nervous system, or the nerves become them-
selves disordered, and produce the indigestic Sometimes one hap-
pens, sometimes the other, it matters not which ; both are present —
the affec :ion of the stomach and of the nerves — in a case of thorough
dyspepsia. To make out a full case, in its tormenting completeness,
we mast add to the above symptoms, great depression of spirits,
amounting at times to complete hopelessness and despondency; a
dread and fear of some impending evil ; a lack of interest in passing
events ; unwillingness to see company or to move about ; an irritable
iind fretful temper ; a desi.e to talk of one's troubles, and nothing

304

DI8KA8KS OK THE ABDOMINAL CAVITY.

else ; a sallow, haggard, sunken, and sometimes wild expression of
countenance ; a dry, wrinkled, and harsh skin, with unreireshinp
sleep, disturbed by all sorts of annoyances and difficulties, such m
shipwrecks, falls down precipicps, and nightmare.

The man who bus all these symptoms, or any considerable portion
of tht'in, lias dyspepsia, and is about as miserable as if all the sorrows
of life were electrical currents, and were running through him con-
tinually.

Causes of Dyspepsia. — To healthy digestion, three conditions are
especially necessary, — that the footl should be well chewed and
mixed with saliva before it is swallowed ; that the stomach should
pour out and mix with it the right amount of healthy gastric juice ;
and that it should be well churned wliile in the stomach.

It is well known that tiie firat of these conditions, a thorough chew-
ing of food, is rare in this country. We eat too fast ; we do not
masticate our food ; we bolt it whole.

This Ls the first cause of dyspepsia, and it is tlie fruitful mother of
causes. It furnishes the occasion for eating too much ; for when the
food is swallowed with such rapidity, the stomach is taken by sur-
prise, as it were ; it cannot secrete gastric juice fast enough to bo
diffused through the fast-growing mass ; and the appetite does not
decline until a great deal too much is taken. The coats of the
stomach, lx;ing stretched unnaturally, do not pour out the gastric
juice at the right time, or as much of it as is wanted, and what there
is, is altered in quality.

Moreover, the stomach being overburdened, cannot tuni over and
e'liurn it contents properly.

To fast eating, we may add, high-seasoned dishes, too stimulating
fur the stomach ; eating between meals, and at unseasonable houre,
— particularly at bed-time ; excessive use of strong drinks and
tobacco ; habitually sitting up late at night : inactive habits of body ;
and excessive use of the mind.

No causes of dyspepsia are more active chan those which disturb
and fret the mind. It is surprising how suddenly any mental ag'ta-
tion will put an end to the appetite, and suspend digestion. And
when these mental disturbances are protracted, when care becomes a
daily and hourly companion, dyspepsia is almost sure to show itself.
Considering the numerous causes of unpleasant mental excitement
which we have in the politics, the business, the ambition, the family
jars, etc., of this country, it is a wonder that dyspepsia is hot even
more prevalent. It is hard for the sensitive to escape.

These causes may seem too simple to be the frequent origin of so
much misery, and yet whole volumes might be written on this one
subject. One cannot too forcibly nor too frequently remind the
reader of the importance of these simple and brief remarks. No
treatment will avail if they are not heeded.

UI8RASKP OF THK ADDOMINAL CAVITY.

806

tBion of
I'reHhiiij^
such aH

I portion
) sorrows
liim con-

itions are
wed and
h should
ric juice ;

igh chew-
'^e do not

mother of
when the
3n by 8ur-
ugh to Ix!
does not
its of the
;he gastric
what there

1 over and

timulating
,ble hours,
rinks and
of body ;

[ch disturb

sntal ag'*^a-

;ion. And

becomes a

[how itself.

ixcitement

the family

hot even

rigin of 80
In this one
}emind the

larks. No

Urinary DeposiU. — Before speaking of the treatment of dyspep-
sia, it will bo proper to take notice of certain deposits in the urine,
to which persons suffering from this complaint are liable, and the
discovery of wliioh will, in many cases, indicate the treatment.

Many dyspeptics have acid urine, which is loaded with cry»tah of
oxalate of lime. These persons are much depressed in spirit, and
look upon the dark side of everything. They are painfully disturbed
by small annoyances, are imtablo in temper, incapable of exerting
themselves, look with dread upon tlio future, and generally have the
(lark and dingy look of the face whioh indicates functional derange-
ment of the liver.

The most of these crystals are octahedral in form, and in the field
of a good microscope are beautiful objects for inspection. (Figs. 100
and 101.) To o'-tain them, take a portion of urine passed in the
morning (urina sanguinis}, and let it stand till a deposit takes place.
Pour off the upper portion of the urine ; put a part of the remainder
in a watc'ij-glass, and gently lieat it over a lamp. The heat will
cause a deposit of the crystals.

no. 100.

Fro. 101.

no. 103.

The oxalate of lime is frequently found in urine, the crystals hav-
ing the form of dumbells. When examined by polarized light, they
appear beautifully colored and striated. (Fig. 102.)

The urate of ammonia, and uric acid gravel, are likewise found in
large quantities in the urine of many dyspeptics. Some are ex-
hausted by them, and reduced almost to skeletons, and to a wretched
state of health, — having boils, eruptions, etc.

To find the urates, put a little of the urine containing the deposit
in a test-tube, and warm it gently over a lamp. If the deposit readily
dissolve, it is probably urate of ammonia (Figs. 103 and 104), and
may then be examined under the microscope, to make the matter

sure.

To find uric or lithic acid, let morning urine stand until a solid
deposit has sunk to the bottom ; then pour off the liquid, and place
some of the solid portion upon .. glass, and examine it with a micro-
scope, and if this acid be present, its peculiar crystalline forms
(Fig. 105) will he discovered, either alone, or mixed with urate of
ammonia.

806

mSRASKS OF THR ABDOMINAL CAVITY.

In thofle cases in which there is a great prostration of the nervous
system, with ii Iokh of sexual power, ImuI feelings in the head, perhaps
pain and weakness across the loin:'*, and a tendency to consiuuption,

rio. 108.

FlO. KM.

we may suspect the presence of the triple phosphates in the urine.
Phosphorus m one of the elements of the hrain and nerves, and when

there is a constiint drain of this element
through the kidneys, the nervous system
is gradually exhausted. To find the triple
phosphatt^s, put some morning urine in a
glaiis vessel, and let it stand till a sedi-
ment has gone to the bottom. Put some
of the sediment in a test-tube, and warm
it gently over a lamp. If the warmth
do not dissolve the deposit, add to it a
little acetic acid; if the deposit dissolve in
the acetic acid, it probably consists of earthy
phosphates. This is then to be exam-
ined under the microscope to ascertain
whether it is the plio8{)hate of lime, the
triple phosphate, or a mixture of both.

Fig. 106 shows us the prismatic crys-
tals of the triple phosphate. In a few
rare cases, these are penniform (Fig. 107). Fig. 108 gives us an-
other specimen of the crystals of the triple phosphates, as they

7^ Ay^-

FlO. lOS.

FlU. 106.

FIO. 107.

-i^,v\

FlO. 108.

appear under the microscope, mixed with amorphous particles of
phosphate of lime. If an excess of ammonia be added to the urine,
the crystals become star-like and foliaceous, as in Fig. 109.

mSKASES OK TIIF AHPOMINAI, CAVITY.

307

the nervom
jad, perhaps
^iwumption,

I the urine.
8, and when
ihis element
/OU8 system
lul the triple
^ urine in a
I till a sedi-

Put some
5, and warm
the warmth
add to it a
it dissolve in
Ists of earthy
3 be exam-
to ascertain
of lime, the
e of both,
smatic crys-

In a few
fives us an-
;e8, as they

lO. 108.

particles of
» the urine,
9.

Treatment of Dyspepsia. — Ah there are few cnmplaintH whicli
(listreHH the i Lient morn thiiii dyspepsi.., so tluiro are few which jjive
till! physioiai. lUore trouble, (it^norally our
art has failed upon it t)e(;ause too much ha.s
liet'ii required of us. We have not merely
been asked to euro the disease, but to do it
while the patient eontiuu(!s the indulgenec
(if his appetite, or his exces-sivo application
to business or study. It luislMsen ex[)ected
of us, that wii-ii medicine we should contra-
vene the laws of nature, and restore health
while the causes of the disease are in full ac-
tivity.

This complaint is often brought on by
not keeping the l:Kiwels open. To euro it, therefore, one of the first
things to })e done is to remove costiveness and regulate the bowels.

One of the very best articles I know of to remove constipation is
Mettauer's Aperient. I have placed it in the departmei ', of Phar-
macy ; it ought to be in the United States Dispensatory. Taken
immediately after meals, in doses of a teaspoonful, it corrects a(;idity
of the stomach, it gently opens the bowels, and when its action is
over, will be found to have diminished the costiveness, rather than
increased it, as most kinds of physic do. It is excellent in the bil-
ious forms of dyspepsia, — acting fiiiely upon the liver, — particularly
if a few drops of aqua rcgia in water be taken before meals, — the
iiperient being taken after.

If piles exist, this mixture will he objectionable on account of the
aloes, and the fluid neutiulizing extract may take its place. Sweet
tincture of rhubarb and soda (37), is sometimes preferable to the
aperient.

Several other preparations (38), (289), (39), (290), will be found
useful to remove costiveness and debility of the stomach.

For acidity, besides the remedies already mentioned, prepared char-
coal may be used, in teaspoonful doses, or carbonate of magnesia, or
fluid magnesia, or trisnitrate of bismuth. A good remedy is pulver-
ized gufaiacum, rhubarb, prepared charcoal, and carbonate of mag-
nesia, equal parts; also (28), (37), (38), (42). If crystals of oxa-
latb of lime be found in the urine, give a few drops of aqua regia, in
water, thrje times a day.

Hygienic Treatment. — The didt must be managed with great pru-
dence. Food must be taken in such quantities only as the stomach
can digest, however small that quantity may be ; and it must be taken
slowly, and well chewed. No article should be touched, or thought
of, which disagrees with the stomach. Costiveness may frequently
I* entirely removed by eating no bread except that made from un-
bolted wheat-flour, commonly called Graham bread (that made from
Franklin Mills flour), or by making one of the three daily meals of

308

DISEASES OF THE ABDOMINAL CAVITY.

boiled cracked wheat, with milk or molasses. If the triple phosphates
be found in the urine, there is a special reason why the unbolted
flour, or the cracked wheat should be used. The wheat-grain abounds
in phosphorus, the largest portion of which is in the bran, and this
is much needed when the kidneys are robbing the brain of its phos-
phoric element.

Not too much Brain-work. — It is important that the brain and
nervous system should be relieved of the burden of too much work,
and that the thoughts should be turned into the most agreeable chan-
nels. If the patient would get well, the disinclination to move about
and see company must be resisted. In many cases, dyspeptics are
like sea-sick persons, — feeling as though they would rather go over-
board than move. In such instances, friends must not be harsh with
them, and frown upon their listlessness as if it were a fault ; but
rather treat them affectionately, and beguile them out by all sorts of
pleasing enticements. Exercise must be had, every day, and be con-
nected, if possible, with an object, so that it may be performed cheer-
fully. It is important to engage the mind in the exercise; and for this
purpose, some contested game is very useful, as playing at billiards,
rolling nine-pins, pitching quoits, or, where the strength will permit,
playing ball or riding the bicycle.

Cheerfulness. — Nothing does more to drive away dyspepsia than a
cheerful, lively, and even mirthful state of mind. All the nervous
influences sent from the brain to the stomach should be of the most
agreeable kind. Some people think it vulgar to laugh. Let such
stand with long faces in life's shadows, if they choose. As a general
loile, the best men and women laugh the most. Good, round, hearty,
side-shaking laughter, is health for everybody ; for the dyspeptic, it
is life.

Dyspeptics who have a taste for it, and can endure the expense,
should travel. A voyage to Europe, and a year spent in seeing the
wonders of the old world, will generally cure the most stubborn case
of indigestion. This, however, depends upon circumstances. For
those having the finer organizations and the higher natures, extensive
travelling is sometimes indispensable. The narrow circle of thoughts,
associations and things in tho:r own neighborhood, do not fill the
compass of their wants ; their many-sided faculties need to be drawn
on by the large variety to be found only in travel. Their large and
impressible natures want to be filled full in order to drive outdisease,
and it takes a world, or a considerable part of it, to fill them. The
dyspepsia of such natures is not comprehended by the multitude, and
even physicians are often amazed that their narrow prescriptions do
not reach it.

Heartburn. — Cardialgia.

This is a gnawing and burning pain in the stomach, attended by
disturbed appetite. It is generally caused by great acidity of the

DISEASES OP THE ABDOMINAL CAVITY.

309

)ho8phates

unbolted

n abounds

I, and this

its phos-

brain and
uch work,
lable chan-
love about
eptics are
r go over-
harsh with
fault; but
dl sorts of
nd be con-
ned cheer-
nd for this
b billiards,
ill permit,

)sia than a

e nervous

the most

Let such

a general

id, hearty,

speptic, it

! expense,

seeing the

aborn case

ices. For

extensive

thoughts,

ot fill the

be drawn

large and

ut disease,

em. The

itude, and

iptions do

bended by
ity of the

stomach, and is a symptom of dyspepsia, and often afliicts pregnant
women. Whenever too much food is taken, it is liable to ferment,
and become extremely sour, — causing heartburn. In such cases,
vomiting often occurs ; and what is thrown up is sour, and some-
times bitter.

Treatment. — Immediate temporary relief may be obtained by
swallowing a teaspoonful of soda, magnesia, or chalk, in a tumbler of
cold or warm water. Fluid magnesia, or lime-water, will answer the
same purpose. If there is wind in the stomach, as well as acidity, a
teaspoonful of the aromatic spirit of ammonia, or (135), will often
still the uneasiness in a moment.

To cure the complaint, the stomach must be strer Jiened by the
remedies directed for dyspepsia.

Spasm or Cramp in the Stomach. — Gastrodynia.

Though generally of shorter duration, this is more violent than
heartburn. It is attended by a sense of fullness, by anxiety, and by
great restlessness. In females, hysterical symptoms are often coupled
with it. Great quantities of air or gas are generally expelled, and
the pain shoots through to the back and shoulders.

Treatment. — A strong purg^ative injection (248) will often bring
immediate relief. The sweet tincture of rhubarb and soda (37), with
a few drops of tincture of cayenne mixed with it, will often bring
speedy relief. So will a mustard poultice laid upon the stomach.
The mustard poultice is a remedy of great excellence, in many cases.
It deserves to be called the poor man's friend.

Water-Brash. — Pyrosis.

This consists in a discharge from the stomach, generally in the
morning, of a thin, glairy, watery fluid, sometimes insipid, at other
times sweetish, and at still others sour. A burning heat or pain in
the stomach attends, and seems to be the immediate cause of the
discharge. The discharge appears to be the natural mucus of the
stomach, which is poured out in large quantities in consequence of a
kind of catarrh of its mucous lining. The amount thrown up varies
from a spoonful to a pint or more.

The complaint is caused by a poor, innutritious diet, or by what-
ever causes the blood to become thin and watery.

Treatment. — Ten or fifteen drops of water of ammonia, in half a
tumbler of water, will quiet tlie distress, and check the discharge.
The most effectual remedy I am acquainted with for breaking up the
discharge, is the trisnitrate of bismuth, taken at meal-times, in from
twenty to thirty-grain doses, three times a day. The compound pow-
der of kino is a valuable remedy. The compound tincture of senna
and the tincture of balsaiu ^i tolu, in equal parts, and administered

310

DISKASES OF THE ABDOMINAL CAVITY.

in tablespoonful doses, are sometimes useful. The tincture of nux
vomica is a good remedy.

To restore the blood, some of the various preparations of iron (74),
(80), (78), (316), will be required.

The diet should consist of easily-digested, nutritious food,
soupsv broths, fresh meat, and unbolted wheat-bread.

Vomiting*.

This occurs under a great variety of circumstances. It may be
induced by acidity of the stomach, by irritability of the stomach, by
distress of mind, by injury of the brain, by offensive odors, and by all
organic diseases of the stomach.

Treatment. — Generally, it is cured by treating the disease which
induces it. But in many cases it persists very obstinately, and may
become the chief thing to be attended to. In such cases, it may re-
quire a careful investigation of the cause to check it. But generally
some aromatic, as ginger, spearmint, peppermint, or spice-tea, will
put an end to it. Some cordial or stimulant, as brandy, champagne,
tincture of ginger, paregoric, elixir solutis, or cherry brandy, will
answer well. Strong coffee, without sugar or milk, will, in some
cases, act like a charm. If it is dependent on acidity, the remedies
are given under " dyspepsia." If caused by irritixbility of stomach,
a pill of extract of belladonna and ipecac (339) will do well.

While vomiting, the patient should lie still in bed, and in bad
cases, a mustard poultice should be placed upon the stomach.

The vomiting of children may sometimes be stopped by wetting a
piece of cloth with laudanum, and laying it upon the "t of the
stomach.

Seasickness.

This is the great terror of persons who, for the first time, croRs the
ocean. • It is said that dark-complexioned persons suffer more from
it than other;.

If it cannot be entirely prevented, it may be mitigated by lying
flat upon the back. To lie on deck, in the open air, is much better
than lying in the close air of tie cabin or stateroom. A wineglass
of brandy, or iced champagne, sipped now and then, will relieve the
sickness very much. For a child, it is sometimes sufficient to wet a
cloth with mustard, and lay it upon i\e pit of the stomach. Creo-
sote, one drop at a dose, made into a p;!1 h excellent. Ten drops
of hartshorn, in half a tumbler of water, is good for some. But the
best known i-emedy is chloroform, taken in doses of from forty to
eighty drops, suspended in water by means of a little gum-arabic.
Bromide of soda in large doses, daily, prevents it, or bromo-caffein
when it first comes on. Cocaine in one-eighth grain doses every
twenty minutes is usually very helpful. A spinal ice-bag placed

n^- ^j - wiw f ^ n ^ 'iyw

mnm^mimmmm

DISEASES OF THE ABDOMINAL CAVITY.

311

opposite the stomach while the sufferer lies upon the back will do
more toward curing sea-sickness than any other single remedy.
These bags are about eight inches long, made of thin rubber, and are
to be filled with small pieces of cracked ice. When the ice melts
refill the bag.

Milk Sickness.

This disease prevails in the West, chiefly in the neighborhood of
level, heavily-timbered, rather wet oak-land.

The cattle, horses, and sheep, which range in this land, are fre-
quently attacked by a disease which the people call the trembles. It
is supposed to be produced by eating some plant growing upon those
lands, 88 cattle which feed in the neighboring regions are free from
it until they find their way into these low grounds. It has been sug-
gested that the offending plant may be the poison ivy (rhus toxicoden-
dron) . Be this as it may, the calves, soon after sucking cows which
have run in these grounds, are seized with trembling, and frequently
die of the disease. Dogs which lap the milk are affected in a similar
manner. Children drinking it leave the table and vomit. Upon
grown persons the effects are more severe, but not so sudden. The
eating of the beef, mutton, or veal, of affected animals, brings on the
same disease.

Symptoms. — The disease sets 'in with sickness at the stomach,
which is preceded by general debility, more particularly of the legs.
There is nausea, vomiting, and the breath is so offensive and peculiar
that those acquainted with the complaint immediately recognize it
from this smell.

These existing for weeks, constitute, in some cases, the whole of
the symptoms. In other cases they are more severe, being attended
by chills and flushes, great oppression about the heart, anxiety, deep
breathing, heat in the stomach compared to fire and boiling water,
violent retching and vomiting, alarming beatings of the heart, and
throbbings of the large vessels, and cold extremities, — producing,
all together, extreme distress.

In most cases, the vomiting returns eVery hour or two, attended
by great burning at the pit of the stomach, the substance thrown up
having a peculiar bluish-green color, and a sour smell. As soon as
this discharge takes place, the patient falls back upon the pillow, and
lies easy until another turn comes round. . The tongue is covered
with a whitish coat, the bowels are obstinately costive, and the pulse
is small and quick.

Treatment. — It is believed that the neutralizing mixture, given
in tablespoonful doses every time the nausea and burning ciensation
are felt, is the most effectual remedy yet used. It relieves the
acidity, and seems well adapted to allay the irritation. Some anti-
bilious physic (40) to move the bowels should also be given.

MillJi

HMMMHBt^.

312

DISEASES OP THE CHEST.

Besides these remedies, a mustard poultice should be put upon the
stomach, and hot bricks to the feet, and the patient be kept still for
some hours. The diet should be very mild, — only toast-water, rice-
water, or thin gruel.

Acute Inflammation of the Peritoneum. — Peritonitis.

This disease affects the extensive membrane which lines the whole
inside of the belly, an extenpion of which forms the omentum or
apron. It is an inflammation to which women are much exposed
after confinement, and is known, in such cases, as child-bed or puer-
pral fever. It is common among men also, and is a grave disease.

The accepted notions of no disease have undergone so much of a
revolution of late years as those relating to peritonitis. It was formerly
considered to be generally of spontaneous or idiopathic origin, whereas
now we know it to be the outcome of some one of se . o^al diseases,
but lately understood, as for instance, appendicitis, septicaemia or
blood-poisoning, inflammation of the fallopian tubes and ovaries,
tuberculosis, abscess of gall-bladder, strangulated hernia, etc.

Symptoms. — Like other forms of fever and inflammation, it is
preceded by chills, with increased heat of surface, thirst, full, strong,
and frequent pulse, flushed face, and red eyes, dry tongue with red
edges, dry skin, restlessness, short, quick breathing, nausea and
vomiting.

The pain is increased by the patient sitting or standing up, — the
bowels being thus pressed against the inflamed membrane. Lying
upon either side is painful for the same reason. To lie flat upon the
back, with the feet drawn up, is the only endurable position. The
patient lies still, for all movements give pain.

The pain in this disease is generally sharp, cutting, and pricking,
but is not always equally intense. It is aggravated by the passage
of wind along the bowel, by which the inflamed membrane is slightly
stretched.

When the disease is advancing towards a fatal termination, the
belly becomes greatly swollen and tense, — having to the hand a
peculiarly tight, drum-head feeling ; the pulse is rapid and feeble ;
the countenance is full of anxiety, and is pinched and ghastly ; and
a cold sweat breaks out.

Treatment. — Small doses of antimony, lobelia, or ipecac, to pro-
duce nausea and a moisture upon the skin, are generally among the
first things given. The tincture of veratrum viride, in five to ten-
drop doses, repeated every hour, will accomplish the same thing more
effectually than any other known article. For such purposes, I give
it the first place among medicines. A large poultice of white bread,
rye-meal, or flax-seed, may be spread over the belly ; or cloths wet
with cold water will be still better, if the patient be full-blooded,
and naturally strong. The bowels should be moved at once by some

T)I8EASE8 OF THE ABDOMINAL CAVITY.

313

active physic, as Dutteriuit, salts, magnesia, castor-oil, or cream of
tartar (20), (17), (18), (27),or by podophyllin, etc. (40), (41), (31).

The two main indications in the treatment of peritonitis after having
discovered and treated the causes, are the thorough draining of the
bowels of their watery secretions by some gentle saline which will
not stir them up ; and secondly to maintain them in a state of quiet and
rest. The first is met by magnesia in the form of the solution of the
citrate, say one-half bottle every four hours till copious watery move-
ments occur. Tliis drains the glands and causes a flow of the poi-
sonous effete material into the bowels and rids the system of so much
poison. The second indication is met by opium in some of its many
forms. It is often, however, a serious problem for even the physician
to decide, and should only be undertaken with his advice.

The drinks should be lemonade, soda-water, tamarind-water, cur-
rant-jelly dissolved in water, and preparations (298) and (299).
Indian-meal gruel, toast-water, barley-gruel, and the like, are the
only allowable diet.

Chronic Inflammation of the Peritoneum.

When the acute inflammation of the peritoneal membrane is not
successfully treated, it may run on for a time, and then subsid" into a
lower grade of inflammation, called chronic, and in this state remain
for an indefinite time. But it often arises independently of the acute
disease, and attacks persons of both sexes, and of all classes and ages.
Scrofulous children have it, and, wasting away under it to mere skel
etons, are said to have consumpdon of the bowels.

Symptoms. — These are sometimes very obscure, and the advances
of the disease stealthy. At first there may be only a little soreness
of the belly, so slight, as not to be noticed except after hard work, or
upon some wrenching motion. Generally, there is a sense of fullness
and tension of the belly, although it may not be increased in size.
After a time, it enlarges a little, and its tension or tightness increases,
especially towards evening. By pressing carefully with the hand, a
deep-feeling tension may be detected, giving to the hand a sensa-
tion as of a tight bandage underneath, with the skin and integu-
ments sliding loosely over it. If water has been poured out into the
abdominal cavity, its fluctuation may be frequently detected by press-
ing upon one side of the belly with the palm of one hand, and strik-
ing the other side with the ends of the fingers.

As the disease goes on, the features become sharp and contracted,
and the countenance grows pale and sallow. Costiveness comes on,
sometimes chills and fever, with debility, loss of flesh, cough, difficult
breathing, hectic, and swelling of the legs.

Treatment. — Costiveness, if present, may be relieved by Mettauer's
aperient, or the neutralizing mixture, assisted by coarse bread, and
boiled cracked wheat.

314

DISEASES OF THE ABDOMINAL CAVITY.

Daily bathing is especially necessary, particularly the alkaline
sponge bath, with vigorous friction over the bowels. The warm bith
once or twice a week will be useful. In some cases, a wet towel
laid upon the bowels over night, and well covered by flannels, will
afford relief ; or the compound tar-plaster may occasionally be used.

If there be dropsy of the belly, iodide of potassium (138) should
be taken freely, and the skin made sore over the inflamed part, by
tincture of iodine, well rubbed in, once a day.

If the patient be pale and bloodless, give iron, quinine, etc. (74)
(76), and let the diet be nourishing ; and if nervous symptoms be
connected with the debility and paleness, add some nerve-tonic (93),
(81), (316). When the disease is known to be the outcome of a
deposit of tubercles on the peritoneum, it is now customary to open
the abdomen under antiseptic methods and wash out the cavity. The
effect of a mild sallrsolution and the light and air oftentimes arrests
the disease.

Acute Inflammation of the Bowels. — Enteritis.

By inflammation of the bowels is generally understood an inflamed
condition of the muc&us membrane which lines them ; but tliis, most
commonly, is only a part of the disease ; it involves more or less,
besides this mucous lining, the whole substance of the bowel. After
an inflammation has existed some time, and even, in severe cases, at the
start, certain poisonous substances are formed as the result of germ
invasion, called toxines. These are genuine poisons, and often
spread rapidly through the walls of the bowels by means of the
numerous lymphatic vessels to the peritoneum itself, — that delicate
membrane which we have seen covers all organs within the abdomi-
nal cavity. When this membrane once becomes poisoned, an acute
inflammation sets up, which masks all other symptoms, and is indeed a
veritable blood-poison. We have then to deal with peritonitis.

Symptoms. — The disease begins with a chill, and with uneasiness
and slight griping pains, which increase in severity until they are in-
tense and burning. Pressure aggravates the pain, which is most
intense about the navel, but extends more or less over the whole-
bowels.

From the beginning there is sickness at the stomach, and some-
times vomiting ; there is loss of strength, costiveness, great anxietfy,
thirst, heat and fever, dry, furred, and red tongue, and but little urine,
with pain in passing it. The matters passed from the bowels are
dark and fetid ; and the whole belly is tender and sore to the touch.
The pulse is quick, hard, and small.

The stomach will be but little affected, comparatively, when the
disease is at some distance from it in the lower portion of the bowels.
Indeed, the nearness of the inflammation to the stomach, or its re-
moteness from it, may be judged pretty correctly by the degree of

DISEASES OF THE ABDOMINAL CAVITY.

315

disturbance in that organ. The length of time after drink and medi-
cines are swallowed, before they are vomited up, is a pretty good
measure, likewise of the distance of the disease from the stomach.

How to Discriminate This disease is liable to be confounded

with colic, and with inflammation of the peritoneum. It is impoitant
to distinguish it from colic, particularly, because the treatment for that
would aggravate this. In this disease the pain is increased by pres-
sure; in colic, it is not, but is rather relieved. In enteritis, the pain
remits, but never ceaaes wholly, as it does in colic. In enteritis,
the knees are drawn up, and the breathing is short; in colic it some-
times gives relief to stretch the feet down, and the breathing is not
altered.

To distinguish it from inflammation of the peritoneum, take notice
that diarrhoea is much more common than in this latter complaint,
while the pulse is not as quick, nor the pain as severe.

Treatment. — This should be very much the same as that recom-
mended for peritonitis. Perhaps in both diseases it might be veil
to begin with covering the belly all over with leeches.

The tincture of veratrum viride, in full doses, so as to keep up a
free perapiration, cold compresses, mustard poultices, hot fomentations,
poultices, blisters, soothing and quieting injections, and demulcent
drinks, as slippery elm, marshmallow, flax-seed, etc., if judiciously ap-
plied, will do about all that we have it in our power to accomplish.

In this disease it is well to inquire if the patient has a hernia, for
if so, it is liable to become strangulated without his knowledge. A
strangulation of the gut may be the cause of the disease. When this
happens, the complaint is very unmanageable. The bowel may pos-
sibly, in such case, be disentangled by applying a large dry cup ; or,
what is better, a number of small ones ; but the tenderness of the
belly makes the use of this remedy difficult. Here again magnesia
may be of signal benefit unless the movements are already too copious
and exhausting, in which case disinfectants or astringents must be re-
sorted to. The possibility of tuberculosis must not be ignored.

Chronic Inflammation of tlie Bowels.

Like other chronic inflammations, this may follow the acute torm,
but it also results from various other causes, as unripe fruit, taking
cold, drastic physic, and improper treatment of other diseases.

Symptoms. — Red end and borders of the tongue, dull pain in
belly, increased by pressure and rough motion, abdomen either swelled
or flat, skin dry and husky, feet and hands cold, small frequent pulse,
thirst, loss of flesh, low spirits, urine scanty and high-colored, and
dirty, slimy discharges from the bowels, from one to four times a
day.

Treatment. — To begin with, blisters, or croton-oil, or mustard

_ll

316

DISEASES OF THE ABDOMINAL CAVITY.

poultices, or dry cups, if the tenderness is not great, or leeclies if it is.
If the bowels are hot and feverish, bind a cold compress upon the
belly over night, covering it well with flannel. The warm bath
should be used twice a week. Salol, ten grains every three hours,
bismuth and opium, are in this case very valuable. Wasliing out the
lower bowel with hot water by means of a syringe often soothes and
heals.

The diet must be of the most simple, unirritating kind, beginning
with a solution of gum-arabic, rice-water, barley-water, arrow-root or
sago-gruel, and gradually rising, as the symptoms improve, to beef-
tea, mutton and chicken broth, tender beefsteak, etc.

When the strength will permit, gentle exercise must be taken in
the open air, but not on horseback, or in hard, jolting carriages.

As soon as the inflammation is subdued, some mild laxative (35)
may be given, in connection with an infusion of wild-cherry bark,
geranium, and Solomon's seal, equal parts.

Appendicitis.

This is one of the so-called modern diseases, — not that it has not
existed for a long time, but that not till lately has it been recognized
as a distinct ailment. Formerly it fell under the general category
of peritonitis or inflammation of the bowels. American physicians
have done more toward discovering its characteristics than others.
It is an inflammation of the appendix vermiformis, which is situated
at the end of the large bowel, in the right flank, close to the junction
of the colon witli the small bowel (see Fig. 60). This organ is a
small, round, tail-like body, about the size of a slate-pencil, and aver-
ages some three inches in length. It is hollow, lined with mucous
membrane, and covered like the bowel proper with a peritoneal mem-
brane. It secretes mucus. Its use is as yet unknown, being thought
by many to be a rudimentary organ like the uvula, without function,
and possibly analogous to the herbivorous stomach. Whenever small
seeds enter the cavity of this organ (which is in reality a rare occur-
rence) or whenever, from any cause, a catarrhal inflammation is de-
veloped in it, the secretion increases, and being confined, aggravates
the trouble. This catarrhal inflammation is generally mild and the
trouble often subsides either for good or to start up again sooner or
later.

The inflammation may, however, become purulent, the germs pen-
etrating the walls of the appendix and causing a general inflammation
of the peritoneal coat of the bowel. In these cases nature fights
hard to resist the invasion of the germ and throws out a large amount
of lymph and serum, which, when it hardens, often acts as a barrier
to the furtl ,.' progress of the peritonitis which has begun about the
appendix. These cases are characterized by a hard lump in the ap-
pendicular region, the inside of which contains pus as a rule, which

T>W l )^i i| »l » l il .,-V. i | | i,H,|ij.> ■

DISEASES OF THE ABDOMINAL CAVITY

317

lies if it is.
upon the
i^arm bath
ree hours,
ig out the
jothes and

beginning
ow-root or
B, to beef-

i taken in
iages.
ative (35)
erry bark,

it has not
'ecognized
I category
physicians
an others.
is situated
e junction
)rgan is a

and aver-
;h mucous
neal mem-
ig thought
, function,
ever small
are occur-
ion is de-
tggravates
i and the
sooner or

erms pen-
ammation
ure fights
je amount
} a barrier
about the
in the ap-
ile, wliich

has escaped from the bursting appendix. Cases of this class are ex-
tremely dangerou < and require the immediate aid of a surgeon, as
they are bound to give trouble sooner or later, even if the first attack
does not prove fatal.

There is still a third class of cases, called fulminating, because
from the very first they seem to be purulent, and spread lapidly into
a general peritonitis, death occurring within a few days from the ap-
pearance of the fiiBt symptoms. These cases are the most hopeless
of all, and must be operated on without the slightest delay, since im-
mediate evacuation of the pus, before a general infection of the ab-
dominal cavity supervenes, is the only possible hope of saving the
patient.

Symptoms. — The disease, as generally observed, begins with lan-
guor and pain in the abdomen, with special soreness on the right
side, oftentimes nausea and vomiting, constipation, a slight rise of
temperature, and headache. As the disease progresses the tenderness
amounts to pain, a bunch may be felt by the medical attendant : the
temperature gets a little higher and symptoms of pus formation set
in. The case may hang in this initial stage (up to the point of pus
formation) for several days and finally subside, ^t being a more or
less catarrhal inflammation; but when pus has nice formed the pa-
tient cannot escape without an operation for the removal of the of-
fending body. Many surgeons at the present day even take the
ground that every inflamed appendix should be removed.

Treatment. — The medical treatment consists in giving magnesia
in form of the solution of the citrate, with a light diet, and keeping
the patient in bed. Poultices may be of some benefit. Opium should
not be used unless pain is extreme.

The operation for appendicitis, when performed between the attacks,
is a comparatively safe one in competent hands ; but it becomes a very
grave one if pus forms rapidly and invades the general abdominal
cavity. Between these two classes of cases there are all grades of
difiiculty and danger.

Cancer of Intestine.

This disease is much less frequent than cancer of the stomach,
constituting about five per cent of all cases of cancer. It occurs
usually about the middle period of life. We are in absolute igno-
rance of its causation in this region. The rectum is the most favor-
able part of the bowel for its development, the large intestine next,
and then the small intestine.

Symptoms. — Intestinal hemorrhage, pain ; emaciation, irregular
movements of the bowels, pain in the sacral region, radiating to the
genitals and down the course of the sciatic nerves (in case of rectal
cancer), are among some of the indefinite symptoms of cancer of the

818

DIBKA8E8 OF THK ABDOMINAL CAVITY.

bowels. When well marked and when located favorably, a tumor
may he discovered by palpation, but often this cannot be felt and tlie
masses which at lirst seem to indicate cancer may afterward prove
to be merely fajcal accumulations. When the mass can be felt in
the rectum the diagnosis becomes clearer. The prognosis of the
disease is extremely unfavorable.

Treatment. — As for treatment, only in rare cases is much aid
ever procured. The formation of an artificial anus in the left flank
may avert for a while the final end. The injection of the new cancor-
serum is still of doubtful success.

Opiates to relieve pain, nourishing food frequently repeated, and
the use of antiseptic enemas, are, for the most jmrt, the chief meas-
ures that afford relief.

Intestinal Obstruction.

This is a mechanical interference with the movements of the fce-
ces, and is caused either by intussusception or invagination, con-
striction, twists, stricture or hernia. These conditions are frequently
produced by irregular movements of the bowels as a whole, and by
irregular movements in various parts of the same, there being an
increased peristalsis in one part and constipation in an adjacent part.
Many cases of intussuception occur at the ileo-ctecal valve, the small
bowel entering the large lx)wel and being driven downward. The
circulation of the bowels is naturally interfered with, and intense
congestion occurs, with swelling and final obstruction of the calibre
of the gut. Pain becomes paroxysmal and peritonitis ensues. Pain
increases, with vomiting and the discharge of mucoid stools ; finally
the patient dies of exhaustion.

Constriction of the bowel forms the larger proportion of cases and
is not infrequently caused bj' fibrous bands which are the result of
inflammation. Strangulation may be produced by a loop being held
down by such bands or by being twisted about it. Intestinal ob-
struction, ulceration, and even perforation are common results.

A twist or volvultis is also a cause of obstruction, though less com-
mon than the two causes just mentioned, and occurs generally near
the sigmoid flexure.

Stricture of the bowel usually occurs at the sigmoid flexure, or in
the rectum, and is not usually complete, some small amount of fiecal
matter still escaping. Tumors, like cancer, not infrequently cause
stricture by their compression.

Functional obstruction occurs chiefly in hysterical females, but also
in disease of the brain and spinal cord, as well as from peritonitis
and blows on the abdomen. It is the result of a paralysis of the
bowel.

Impaction of fauces is still another frequent cause of obstruction.
The contents of the bowels, especially in the rectum, become hard,

"" • 'mmMtt^Km . i i mm

Bi.mi i uAjn^j giftjt i w i j *» i i .^. ' i.u. i iu)mw!'. i ;.'Miu^ -— - — *-^r^

mSEASKS OF THK ABDOMINAL CAVITY.

319

iy, a tumor
felt and the
»rard prove
be felt in
osis of the

I much aid
le left flniik
uew cancor-

peated, ami
chief meati-

of the fee-
lation, con-
frequently
3le, and by
e being an
jacent part.
3, the small
vard. The
md intense
the calibre
ues. Pain
ols; finally

F cases and
e result of
being held
testinal ob-
sults.
h less com-
lerally near

ixure, or in
.nt of fiecal
ently cause

Bs, but also
peritonitis
ysis of the

ibstruction.
3ome hard,

blocking the passage till quite a perceptible bunch may be felt ex-
ternally. The channel is notalways blocked completely. Gall-stones
may become impacted near the ileo-cascal valve in their pasaage
downward, and form the starting point of the faecal accumulation.
These various causes produce either acute or chronic obstruction.

SymptomA. — In the acute variety, pain, vomiting and constipa-
tion are the prominent symptoms. There are at first some digestional
disturbances, with moderate pain. Afterwards the pain becomes
severe, even intense, and is usually located near the seat of the ob-
struction. It is at first colicky and intermittent, but finally becomes
continuous and severe over the whole abdomen. Vomiting sets in,
first of food, then later of bile, and finally stercoraceous if the ob-
struction becomes complete. Vomiting occurs whether the obstruc-
tion is in the large or small bowel. Before the close of the soenr
this vomiting a«sumes a ricewater-like character, perhaps attended
with hiccough.

There is an absence of the passage of wind, although at fii-st some
small amount of faecal matter may pass. In intussusception there
are usually bloody discharges in addition to constipation. The ab-
domen of course soon becomes tympanitic or swollen, and sounds of
water and gas may be heard very distinctly.

The general symptoms are those of a very grave disease, — restless-
ness, cold extremities, pinched features, and cold, clammy skin. The
pulse is small, the temperature generally subnormal, tongue dry, and
thirst very pronounced.

In the event of chronic obstruction, all these symptoms appear very
much more gradually. Pain is less severe, vomiting often absent tiU
the obstruction becomes complete. The faecal matter may often be
several feet long before the obstruction becomes severe. Long-stand-
ing constipation which does not respond to proper laxatives should
arouse suspicion. The stools themselves are often ribbon-like in
shape and very small, not infrequently resembling the faeces of sheep.

The prognosis of obstruction of the bowels is usually very grave,
and the duration of life varies from a few hours to ten or twelve days.
The higher up the obstruction, the worse the prognosis. Simple
faecal impaction perhaps offers the most hope; next those cases
amenable to surgical interference.

Treatment. — Opium to relieve pain and to stop the exaggerated
peristaltic movement in parts of the bowel above the obstruction is
surely indicated ; it also relieves the vomiting. Continued, large
enemas of suds and oil, and even the addition of turpentine, should be
resorted to at once as soon as the trouble has been made out. These
are best given with the hips elevated, and should consist of four to
six quarts of water ; they are to be given slowly and without much
force. Oftentimes an anaesthetic is needed.

If the obstruction is from fsecal impaction, small, repeated doses

320

DI8EARK8 OF THK ABDOMINAL CAVITY.

of Bomo fliUine should bo used ; say two ouncos of tho solutir n of tho
citmtu of magnesiu every two hours. Castor-oil in teaApoonful (loses
hourly till movement occurs is also good. But if the olwtructioii is
from intussusception, twist, stricture, etc., all laxatives must Ikj
strictly interdicted. Finally, these simple means failing and the case
lie suspected to be due to impaction by foreign bodies, fibrous bauds,
etc., the abdomen must Imj opened and the seat of the obstruction
found and if possible removed. The operation in this class of cases
is not attended with a great percentage of recoveries, and yet the
fatal termination is much surer if left alone ; in many cases it is
brilliantly successful.

External methods of treatment by hot fomentations of turpentine,
and even of massage, often add greatly to a favorable termination.

The diet must be very light and nutritious, and in case of vomiting
must be given by the rectum. After Liie obstruction has been re-
lieved, one must be very careful about the diet and see that the bow-
els are open daily.

Wind Colic. — Platulent Colic. — Interalgia.

This is a severe and distressing pain in the bowels, — sometimes a
stoppage, and a swelling about the pit of the stomach and the navel.
What children call belly-ache is a mild form of it. The wind passing
from one portion of the bowel to another causes a rumbling noise.
The pain is not increased by pressure ; and this distinguishes it from
the pain of inflammation. It moves about, too, from place to place,
and is much relieved by the escape of wind up or down.

The complaint may be caused by a weakness in the digestive or-
gans, by eating indigestible food or unripe fruit, by costiveness, and
by taking cold. Some persons always have the colic excited by eat-
ing certain kinds of fruit.

Treatment. — When the complaint is caused by an indigestible sul)-
stance taken into the stomach, the offending matter should be thrown
off by an emetic as yoon as possible. If this does not bring relief,
let it be followed by a dose of salts, salts and senna, compound infu-
sion of senna, elixir salutis, elixir pro., or sweet tincture of rhubarb.
If there is no sickness of the stomach, a little essence of peppermint
or spearmint in hot water, or brandy, gin, or whisky, in hot water,
may prove sufficient to expel the wind, and relieve the pain. Ginger
and hot water does well with some. If there be costiveness, and the
pain is obstinate, let the bowels be unloaded by a stimulating injec-
tion (248), (249), (250). Inject one dram of ether in a little starch-
water into the bowels, and relief will often be instant. It can be
repeated every half-hour. The injection of a table-spoonful of tur-
pentine in suds can also be tried and repeated eveiy two hours.

■ iW i ii wa »i| »M.W l t i VMI jrjmTJIIiMiflU tWKI

W»! l ' ' I ._WJJ,. J»-WJ ' >W-W ' !X».

iticn of tlu!

on fill (loHCK

Htructioii JH
iH must be
nd the ca8(!
roiiH haiulH,
obstruction

188 of caBOS

md yet tlie
ca«es it is

turpentine,
nination.
)f vomiting
IS lieon re-
at the bow-

Igia.

ometimes a
1 the navel,
ind passing
iling noise,
hes it from
e to place,

gestive or-
■"eness, and
ted by eat-

Bstible sul)-
'. be thrown
ring relief,
ound infu-
if rhubarb.
)eppennint
hot water,
in. Ginger
ss, and the
ting injec-
btle starch-
It can be
:ul of tur-
ours.

DI8KA8K8 OF Tl« ABDOMINAL CAVITY. 321

Air-Swelllngs. — Ti/mpaniteB.

It is quite common for persons in delicate health — particularly
females — to have their stomach and bowels swell up, sometimes
slowly, sometimes suddenly, so that they cannot bring their clothes
together. They do not know what to make of it; it sometimes
(ilarins them ; and they ask their medical adviser what it means.

These swellings may occur from an accumulation of air within
the bowels, and also within the abdominal cavity. This latter gives
the belly a peculiarly hard feel, like the head of a drum, and when it
is pressed upon with the finger no indentation remains. It usually
is the result of a weakened sympathetic nervous system, brought
about by some one of the many abdominal diseases.

Treatment. — If the air be in the intestinal tube, a stimulating in-
jection may bring away the wind. It may be composed of one pint
of infusion of peppermint, one gill of tincture of prickly-ash berries,
half a gill of tincture of castor, and a teaspoonful of ginger. The
l)owels of the patient should be rubbed for a long time ; and in all
forms of the complaint, it would be well to do this every day. Some-
times the wind may be drawn off by inserting into the rectum a long
rubber tube. Treatment often resolves itself into a cure of some
existing uterine or ovarian diseaae and the various phases of peri-
tonitis, in which latter case there is fever and other well marked
symptoms.

The best constitutional remedies are tonics, — iron, quinine, mineral
acids, and bitters, (48), (65), (59), (60), (62), (63), (64), (71),
(73).

Exercise in the open air, and a careful regulation of the diet, will
do much towards removing these troubles. Costiveness must be care-
fully guarded against.

Bilious Colic.

This is a dangerous disease. There is pain of a griping, twisting,
tearing kind, — what the ancients called atrocious pain. It is chiefly
about the navel, but sometimes tortures the whole bellv. It comes
and goes in paroxysms. Sometimes the abdomen is drawn in, at
other times it is swelled out, and stretched like a drum-head. At
first the pain is relieved by pressure ; after a time the belly is tender to
the touch. There is thirst and heat, and a discharge of bilious mat-
ter from the stomach. In the worst cases, the pulse is small, the face
pale, the features shrunk, and the whole body covered with cold
sweat. While the head is hot the feet are cold. In advanced stages
of the disease, the action of the bowels is sometimes reversed, and
the fecal matter forced up through the mouth, owing to impaction of
fteces or other obstructions of the bowel.

822

DISEASES OF THE ABDOMINAL CAVITY.

Causes. — Costiveness, irritating substances in the bowels, thick,
vitiated bile, long exposure to cold, torpidity of the liver and skin,
great unnatural heat, with dampness, obstruc' )d gall-duct, etc.

These attacks are usually the result of indigestion in the upper
bowel, near the bile-ducts, creating a thick mucus which obstructs
the passage of bile from the ducts into the bowels. A regulation of
the duct, small doses of podophyllin or the acids, with daily doses of
some mild bilious laxative, will prevent their return. Crab-orchard
water, sal-muscatelle, and other simple medicines answer every pur-
pose.

Treatment. — Administer an active purgative injection immediately
(251),(252). Internally, dioscorin, camphor, etc. (340), every fifteen
minutes until relief is obtained, at the same time 'covering the whole
belly with a large mustard-poultice. A strong decoction of the wild-
yam root, drunk freely, is a medicine of some value, — so is a decoc-
tion of scullcap and high-cranberry bark, eoual pai-ts. This latter
article is excellent in spasmodic affections, ou .vhich account it has
gained the name of cramp-bark. The sickness at the stomach may
frequently be allayed by effervescing drafts, to which twenty-five or
thirty drops of lavender are added. Croton-oil, given in one-drop
doses, done up with crumb of bread, will sometimes succeed well as
a purgative medicine ; or castor-oil and spirits of turpentine, equal
parts, in two great spoonful doses, may be tried before the croton
oil.

The warm bath is worth remembering, and trying, too, if the
means are at hand. Hot fomentations of the bowels with a decoc-
tion of poppy-leaves, stramonium-leaves, hops, wormwood, boneset,
or peppermint leaves, should not be overlooked. Bottles filled with
hot water, or hot bricks rolled in flannel, should be placed at the back
and feet to promote perspiration.

Persons subject to this complaint may derive advantage from one
pill composed of extract of high-cranberry bark, etc. (100), taken after
each meal for some months. At the same time a reasonable amount
of exercise should be taken out of doore, and a sponge bath, with
friction, be employed daily. Care should be taken not to be often
exposed to the hot sun.

Painters' Colic. — CoUca Pictorum.

This form of colic is caused by the slow introduction of lead into
the system, — generally the carbonate of lead. It passes under the
different English names of painters' colic, Devonshire 3olic, and dry
belly-ache. The first of these is the name by which it is most com-
monl}' known, f-om its frequent occurrence among painters, who use
white lead (carbonate of lead) a great deal in the preparation of their
colors.

Symptoms. — The disease generally comes on in a very gradual

,< i iW<l)ip, m i »,||l|i<HBIH Ii|ii| . ril lHH| i JI!ai i l l i l », i TO»Wl ' JUI ' HM«u i u > .,L. I -

l ' >"i!l,£

DISEASES OP THE ABDOMINAL CAVITY.

823

)wel8, thick,
sr and skin,
st, etc.

1 the upper
jh obstructs
egulation of
lily doses of
yiab-orchard
' every pur-

imraediately
ivery fifteen
g the whole
of the wild-
[) is a decoc-

This latter
ount it has
omach may
enty-five or
in one-drop
;eed well as
titine, equal

the croton

too, if the
th a decoc-
)d, boneset,
1 filled with
[ at the back

e from one
I taken after
ble amount
bath, with
to be often

)f lead into
I under the

lie, and dry

most ccm-

rs, who use

ion of their

3ry gradual

way. At first, the appetite is impaired, there is a slight nausea,
belching of wind, languor, very obstinate costiveness, transient pains,
with a feeling of weight and tightness in the belly, and a disinclina-
tion to make any exertion.

By degrees, the pain in the bowels, and particularly about the na-
vel, becomes more severe, and has a twisting character. The belly
becomes hard, drawn in, and a little tender to pressure, and the stom-
ach very irritable. The pain occasionally slacks off a little; but
never, even in mild cases, entirely stops, as in other kinds of colic.

In some severe cases, the pain runs up to the chest, and down the
arms ; also down to the bladder, causing the urine to be passed with
pain and difficulty, and giving a sense of weight and liem ing down
a the lower belly. During the severest pains, the countt'nance is
pale, conti-acted, and full of suffering ; cold sweats break out upon
the face and limbs, and anxiety and agitation seize the patient.

When the disease is not seasonably removed, it degenerates into
the chronic form, the mental and physical energies become torpid,
the circulation in the small vessels inactive, the skin dry, harsh, shriv-
elled, pale, sallow, or of a leaden hue, the temper irritable, despond-
ing and gloomy, and the body wasted. Besides all this, the muscles
which lift up the lower arm become palsied, so that, when the aims
are niised, the hands hang down in a helpless condition. In some
cases, there is a blue line along the edges of the gums.

Treatment. — For relieving the pain and opening the bowels, the
treatment should be very much the same as that for bilious colic.
There is one article, however, which is thought to have some special
influence in cu' ^ng this disease, after it has become chronic ; it is
alum. Fifteen grains of alum, two of aloes, two of jalap, and four
of ipecac powder, may be mixed, and taken for a dose two or three
times a day. If the muscles of the arm be palsied, one thirtieth of
a grain of strychnine may be added to the above. The aromatic sul-
phuric acid, taken as a drink, fifteen drops to the tumblerful of water,
is always worthy of trial.

The use of the electromagnetic machine maybe tried for the palsy;
or a splint applied to the arm and hand, with vigorous friction once or
twice a day, will sometimes do much for recovering the use of the
muscles.

But the best remedy for the palsied muscles is iodide of potassium
(146), taken freely. The P'llphuret of potassa, one ounce dissolved
in a quart of water, au^ taken in teaspoonful doses, three times a day,
is also worth a trial. The affected arm should be soaked an hour,
once or twice a day, in the same amount of this latter salt, dissolved
in a gallon of water.

Means of Prevention. — The numei-ous persons wl 3 work in lead
should comb their hair with a fine comb, wash their hunds and face,
and rinse their mo^'th s dveral times a day, and also wash the whole

824

DISEASES OF THE ABDOMINAL CAVITY.

person with soai) once or twice a week, and with clear water, or sal-
eratus and water, once a da3\ Their working clothes should be of a
kind to admit of being washed once or twice a week, and they should
be put off for others when out of the workshop. A paper cap should
be worn while at work. The food of the workmen should not be ex-
posed to the vapoi-s or floating particles of lead, and consequently
should not be carried into the shop ; and when much of the poison is
floating in the air of the workroom, it is a good plan to wear a mask
to prevent its being drawn with the breath into the throat and lungs.
It has been said that those who eat freely of fat meats, butter, and
other oily substances, are not attacked by the disease, though exposed
to the poisoA. I know not what protection this can give, unless the
skfn is in this way kept more oily, which prevents the absorption of
the poison. This would seem to afford a hint in favor of anointing
the whole person once or twice a week with sweet-oil.

Costiveness. — Constipation.

T?EW disorders are more common than costiveness. By this term
I mean a sluggish state of the bowels, which causes them to retain
the faeces longer than is warranted by health. In this complaint, the
discharges from the bowels are not always less frequent than they
should be, but they are less in quantity, are compacted and hard, and
are passed bj hard straining, and sometimes with considerable pain.

Symptoms. — Headache, dizziness, feverishnesa, bad feelings in the
head not easily described, loss of appetite, sometimes nausea, but
little desire to go to stool, a weight and heaviness about the lower
part of the belly, and a sense of confinement over the whole body.

Causes. — Sedentary habits, particularly when connected with close
application of the mind ; astringent articles of medicine ; stimulating
diet, composed chiefly of animal food ; various diseases, particularly
those of a nervous character, and especially, a neglect to evacuate
the bowels at proper periods. All these causes tend to weaken the
bowels, and gradually to arrest that peculiar undulatory movement,
or worm-like action, called the peristaltic motion of x,ne bowels. It
is this continual contraction of the muscular fibres of the intestines
from above downward, which pushes the contents steadily along; and
whatever weakens the force of this vermicular play of the intestinal
walls, brings on constipation. .

Treatment.- — One of the first things to be done is to establish the
habit of attemptinq to evacuate the bowels at a particular hour every
day. The best time for most persons is -soon after breakfast in the
morning. Whether successful or not, the attempt to procure an evac-
uation should on no account be omitted. This regularity will often
do much to break up the costive habit.

Diet. — To this should be added a careful regulation of the diet.

DISEASES OP THE ABDOMINAL CAVITY.

325

iter, or sal-
)uld be of a
they should

cap should
1 not be ex-
)n8equently
he poison is
rear a mask
t and lungs.

butter, and
igh exposed
, unless the
sorption of
f anointing

y this term
n to retain
nplaint, the
. than they
d hard, and
rable pain.

dings in the
musea, but
i the lower
ole body.

i with close
stimulating
particularly
» evacuate
weaken the
movement,
bowels. It
) intestines
along; and
e intestinal

stablish the
hour every
fast in the
lire an evac-
will often

if the diet.

The quantity of food taken should be no greater than can be easily
digested. Full meals which distend the stomach and cause it to press
upon the bowels embarrass their movements. Bread made from fine
wheat flour is an abomination in this disorder. Eat only that from
unbolted flour. Cracked or rolled wheat, prepared as directed among
dietetic preparations, is excellent for the cure of costiveness. Fresh
vegetables, as peas, beans, potatoes, squashes, and ripe fruits, in their
season, are all wholesome, and help to relieve costiveness. But rich
pies, puddings, cakes, doughnuts, and all that sort of trash, increase
the disorder.

Water Injections, etc. — One of the best remedies is water, cold
or tepid, according to the condition of the patient, injected into the
bowels with the fountain syringe. Syringes for this purpose may be
obtained in any drug-store, and one should be in every family.
Water used externally, in the form of the sponge-bath, is also useful.

Medicines. — All the above measures having failed to give relief,
take Mettauer's aperient, or the neutralizing mixture. If these fail,
podophyllin, etc. (36), may have a trial. A cold decoction of thorough-
wort, drunk daily, sometimes has an excellent effect. It must be re-
membered that medicines may make mattere worse, and they should
be used cautiously. Cascara Sagrada taken in small, repeated doses,
say, half a grain once, twice or more times daily till the bowels move,
for some weeks, then gradually decreased, often yields excellent re-
sults. A glass of some aperient like Hunyadi Janos water, one-third
glass with one-half glass of plain water on rising, will then take the
place of the cascara ; and finally a glass of plain water will accom-
plish all that previously required the use of the cascara. Daily knead-
ing of the bowels, following the course of the large bowel, will add
greatly to break up the sluggishness of the muscular atony of the
bowel-walls.

Piles. — Hemorrhoids.

There are few complaints more common than the piles, and
scarcely any which cause more trouble and misery. They consist in
a fullness of blood, and languid circulation in the lower portion of the
lower bowel or rectum. In consequence of this congestion, either the
veins of the gut become enlarged or varicose, or the blood gets infil-
trated into the cells beneath the mucous membrane, and collects, so
as to form bloody tumora.

These tumors, which are seldom absent, are the leading features of
the piles. They sometimes appear externally, around the anus ; this
is external piles. At other times they are within the bowel ; the com-
plaint is then called internal piles. They are called bleeding piles
when blood is discharged, and blind piles when it is not.

Symptoms. — Usually there is a sense of weight and weakness in
the lower part of the back and lions, with a painful itching alxjut the

../

326

DISEASES OF THE ABDOMINAL CAVITY.

-•a I

■ il

anus. On going to stool, there is a burning, cutting pain experienced,
which is followed by bearing down and tenesmus. If it be bleeding
piles, the little tumors will bleed at every motion of the bowels.
There are frequently disagreeable sensations in the head, general las-
situde, an irritable state of mind, and a sense of fullness and anxiety
in the stomach. The pains experienced range all the way from the
slightest twinges up to the most terrible sufferings, which appear like
tearing the body asunder.

Causes^ — Everything that irritates the lower bowel, and causes a
determination of blood to the part. All drastic physic has this effect,

— particularly aloes, which acts especially upon the rectum. Habit-
ual costiveness, straining at stools, riding much on horseback, sitting
a great deal, tight-lacing, high-seasoned food, and stimulation gener-
ally, lifting and carrying heavy weights, and indurations of the liver,
as well as a bilious indigestion. "^

Females during pregnancy are much affected with piles, which are
induced by the costiveness so peculiar to their condition, and by the
pressure of the enlarged womb upon the veins of the pelvis.

Treatment. — This should be medicinal and dietetic.

Great care must be observed not to push medication too far. Ac-
tive purging will do great mischief. Yet costiveness must in some
way be corrected. For this purpose, no remedy that I have ever
tried has done better in this complaint than an electuary composed
of confection of senna, flowers of sulphur and cream of tartar (6),
taken in doses just sufficient to procure one natural motion of the
bowels each day. Pills made of extract of thoroughwort are said to
do well. If the liver be in a congested state, take some of the arti-
cles recommended in the chronic inflammation of that organ.

For the local treatment, nothing is better than two ounces of lard
and one dram of the flowers of sulphur mixed, and rubbed between
two plates of lead until they are well blackened. This ointment is
not only soothing but curative, both in the bleeding and blind piles.
An ointment of almost equal excellence may be made from one hand-
ful each of witch-hazel bark, white-oak bark, and sweet-appletree ,
bark, boiled together in one pint of water down to one-third of a pint.
Then strain, and add two ounces of lard and simmer away the water,

— stining continually before and after removing from the fire, till it
cools. Witch-hazel suppositories are excellent, as is also an oint-
ment composed of 1 ounce stramonium ointment, 6 grains pulverized
opium, and 6 grains tannin.

If there is much inflammation and distress, an emollient and
soothing poultice should be applied, composed of slippery-elm
bark and stramonium or poke leaves. Steaming the parts is some-
times useful, by sitting over a hot decoction of hops, stramonium,
and poke.

Piles may often be cured by the use of the domestic syiinge. Daily

11
^1

sem

fffm$^^

DISEASES OP THE ABDOMINAL CAVITY.

327

Jxperienced,
be bleeding
the bowels,
general las-
and anxiety
ay from the
appear like

ind causes a
i this effect,
im. Habit-
)ack, sitting
ition gener-
of the liver,

s, which are
and by the
vis.

10 far. Ac-
ist in some
' have ever
y composed

tartar (6),
tion of the

are said to
jf the arti-
^n.

ices of lard
jd between
ointment is
blind piles.
a one hand-
5t-appletree ,
I of a pint.
r the water,
3 fire, till it
lo an oint-
pulverized

)llient and
iippery-elm
18 is some-
lamonium,

ige. Daily

injections of cool or cold water will do much to strengthen the bowel,
and restore the dilated veins to their natural condition.

The food should be of a laxative nature, corn-bread, rye-pudding,
bread of unbolted wheat flour, mealy potatoes, ripe fruit, pudding
and milk, buckwheat cakes, broths, and a little tender meat once a
day.

When the piles are very painful an ointment of cocaine, ten
grains, vaseline, one-half ounce, smeared well over them, is exceed-
ingly grateful. Five-grain iodoform suppositories are very effective
in reducing piles ; its odor, however, is quite objectionable to many.
Surgical treatment is often the only resource left for their cure.

Looseness of the Bowels. ^Diarrhoea.

Looseness, or relax of the bowels, is manifested by frequent, copi-
ous, and thin or unusually liquid discharges. The excessive dis-
charge may be caused either by irritating and unwholesome food, by
inflammation and ulceration of some portion of the bowels, or by de-
bility.

5yniptoins. — Rumbling noise in the bowels, with more or less
weight and bearing down and uneasiness in the lower part of the
bowels. This pressing down and uneasiness are relieved as soon as
the evacuation takes place, but returns when another is near at hand.
Griping is generally present, the strength is reduced, and the skin is
pale, dry, and, after a time, sallow.

Treatment.- — When the complaint is caused by irritating food, it
will generally stup as soon as the offending substance is removed, and
not much medicine will be required.

To neutralize any acidity, to remove wind, allay irritation, and
strengthen the stomach, the compound syrup of rhubarb and potassa
is well adapted, given in teaspoonful doses, every hour, till it oper-
ates. A little paragoric added to it occasionally, or essence of pep-
permint, or spearmint, may aid its good effects.

If nausea and vomiting are present, put a mustard poultice of one-
third strength upon the stomach, and give one-tenth grain of cocaine in
a teaspoonful of water every fifteen minutes. If there is much grip-
ing' give an injection (248), with twenty drops of camphor in it.
A common diarrhoea may generally be arrested at once by prescrip-
tions 159 or 162, in teaspoonful doses, after each discharge.

When there is inflammation and ulceration of the bowel, the treat-
ment must be similar to that for dysentery, — fomentations exter-
nally, and the occasional i se of starch injections, mild cathartics (9),
(10), and poultices externally.

Chronic Diarrhoea.

The acute form of diarrhoea, not being properly managed, oft«n
runs on, and becomes chronic, aiid is at times exceedingly difficult
to cure.

13 1

«1L

328

niSKASES OF THE ABDOMINAL CAVITY.

Symptoms. — Frequent discharges, generally with some pain and
griping, restlessness, thirst, poor appetite, debility, loss of flesh, dry,
rough, and somewhat sallow skin, and tongue dry and dark-colored.
The food often passes through the bowels pretty much in the condi-
tion in which it was swallowed. The liver is generally out of order,
and the bowels are frequently afflicted with a low grade of inflam-
mation.

Treatment. — In this form of the disease, astringents and tonics
will generally be required. Sometimes a teaspoonful of brandy, in a
little sweetened water, or in clear water, several times a day, will
effect a cure. Good cherry brandy is a valuable remedy ; so is black-
berry brandy. Many of the worst cases have been cured by taking
no nourishment, for a long time, except milk, with a little lime-water
in it.

When the liver is involved in the complaint, as evinced by light-
colored stools, leptandrin, geranium, etc. (341), may be given with
advantage.

In some instances, when there is considerable debility, pills of
quinine, catechu, etc. (342), will do well.

A sponge-bath must be taken daily, and the skin be well rubbed
after it.

Cholera Morbus.

The above name is given to a disease common in warm weather,
and characterized by sudden attacks of bilious vomiting and purging,
with severe pain in the belly, cramps, and general fever and sul)se-
quent prostration. The great amount of bile secreted and discharged
has given it the name cholera, from choloa, bile.

Symptoms. — The disease begins by sickness and distress at the
stomach, which is succeeded by violent gripings, with vomiting of
thin, dirty-yellowish, whitish, or greenish fluid, with discharges from
the bowels similar to that vomited. The nausea and distress, with
some few exceptions, continue between the vomiting and purging,
and the pain, at times, is intense. The pulse is rapid, soon becoming
small and feeble, the tongue dry, the urine high-colored, and there is
much thirst, though no drink can be retained on the stomach. It is
to be distinguished from diarrhoea by the bilious discharges.

Treatment. — Apply a large mustard poultice over the stomach and
liver, and give tablespoonful doses of compound powder of rhubarb
and potassa, every half hour, until the vomiting and nausea are
checked, adding to each dose five to ten drops of camphor, if neces-
sary. Perhaps it would generally be best, however, to give liberal
draughts of warm water, at first, or flax-seed tea, that all the solid
contents of the stomach and bowels may be washed out.

A teaspoonful of laudanum in a wine-glass of flax-seed tea, given
ns an injection, every two hours, will sometimes do excellently well;

DISEASES OF THE ABDOMINAL CAVITY.

329

le pain and
flesh, dry,

irk-colored.
the condi-

at of order,
of inflam-

and tonics
irandy, in a
a day, will
so is black-
l by taking
lime-water

d by light-
Sfiven with

y, pills of

ell rubbed

n weather,
d purging,
and subse-
discharged

ess at the
jmiting of
arges from
tress, with
1 purging,
L becoming
id there is
ich. It is
i.

omach and
•f rhubarb
lausea are
, if neces-
ve liberal
the solid

tea, given
ntly well;

or a tea made of ohamoniile flowers, or Colombo, and made sour by a
few drops of nitric or sulphuric acid, and given internally, will some-
times succeed better than most other things. One grain of svapnia
and thirty grains of bicarbonate of soda dissolved in an ounce of sweet
tincture of rhubarb, and given in teaspoonful doses, every half hour
will often have a fine effect. The prescription 162 is also valuable.
Hot-water bags should be applied to the feet, and warm flannels,
or other kinds of dry heat, to the whole body.

Asiatic Cholera.

Besides the above name, this fearfnl disease has been called epi-
demic cholera, malignant cholera, spasmodic cholera, and cholera
asphyxia. It first attracted notice in Bengal in 1817, whence it
spread westward through Europe, and in 1832 it reached Quebec, on
this continent. It has since then visited Asia and Europe several
times with great severity, and has even been present on our shores.
But at the present day the strict vigilance of sanitary boards has
done much to prevent its spread and mitigate its terrors. Through
the investigations of Koch and other.-; it is now known to be propa-
gated by a microbe, called the comma bacillus, and the efforts of
investigators is now being directed to the discovery of an agent that
will destroy this germ and thus control the disease.

Symptoms ^ First Stag^e. — The first, premonitory stage, is

mirked 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 ; and these
symptoms continue from a few hours to several days. I should add
to these symptoms what is said to have been recently discovered,
namely, that for several days before the attack, the pulse is down to
forty or fifty heats in a minute. This, if it prove to be reliable, is a
veiy valuable symptom.

Second Stage. — This stage is marked by vomiting and purging a
thin, colorless fluid, looking almost exactly like rice-water ; by severe
cramps in the calves of tho legs, which soon attack the bowels and
stomach. These cmmpi are excessively painful, and draw the mus-
cles into knots. The tongue is pale and moist; the pulse feeble,
though sometimes full and firm ; the breathing hurried, with distress
about the heart ; great thii-st ; a feeling of internal warmth, and the
secretion of urine entirely stopped.

These thin, colorless discharges by vomiting and purging, are the
serum or watery portion of the blood, which oozes through the sides
of the blood-vessels, and runs off rapidly, leaving the crassamentum,
or red, solid part of the blood, stranded upon the inner surfaces of the
arteries and veins. When so much of this is discharged that the
blood cannot circulate freely, the patient sinks into the

830

DI8EA8E8 OF THE ABDOMINAL CAVITY.

Third Stage, which is characterized by great prostration ; pulse
hardly perceptible ; akin cold and clammy ; face blue or [)urple, and
eyes mnrh Huuken ; liandH dark-colored and sodden, looking like a
washerwoman's ; breathing short and laborious ; a sense of great heat
ill the stomach ; and intense thirst. Recoveries from this stage sel-
dom take place.

Treatment. — In the first stage, the diarrhoea should receive the
most prompt attention. From five to ten drops of laudanum, re-
peated a few times, every three hours, will generally put a stop to it.
Catechu (162) is also a suitable remedy. The compound syrup of
rhubarb and potassa, with some other articles (843), in tablespoonful
(loses, every hour, till it opei-ates gently, is worth a trial. The diet
should of course be very carefully regulated at such a time, though
not particularly changed, except to leave off any indigestible article
which is known to be injurious, and to be made a little more sparing
than in time of perfect health.

When the second stage has set in, or the stage of vomiting, purg-
ing, and cramps, the treatment must be energetic. The sinking pow-
ers must be sustained by chloroform, opium, and ammonia (119), or
by camphor, opium, and cayenne (344), giving one pill every hour.
Brandy may also be given freely.

The warmth o* the surface must be promoted by all possible means,
hot bricks and bottles, tincture of cayenne, friction, etc.

In the third stage, the remedies recommended above are to be pur-
sued with increased energy, particularly the stimulants, and the efforts
to promote the warmth of the surface.

f (

Dysentery. — Bloody Flux. — Colitis.

This is an inflammation of the mucous membrane lining the lower
or large bowels. The small bowels begin at the stomach, and are
eight or ten yards long ; being largest near the stomach, and dimin-
ishing in size as they approach their termination in the caecum. The
lower or large bowels are two or three times as large as the small
ones, and from their junction with the latter, they extend about six
feet to the outlet, or anus. The large bowels are composed of the
caecum, the colon, and the rectum. The rectum is about one foot in
length.

In most cases of dysentery, the rectum, and about half the adjoin-
ing portion of the colon, experience the chief force of the inflamma-
tion. Sometimes the whole of the colon and caecum are affected.
Sometimes the mucous membrane lining these is ulcerated, and, be-
coming wholly disorganized, passes off in shreds.

Symptoms. — The disease comes on with loss of appetite, costive-
ness, lassitude, shivering, heat of skin, and quick pulse. These are
followed by griping pains in the bowels, and a constant desire to pass

DISEASES OF THE ABDOMINAL CAVITY.

881

ion; pulse
uiplt', and
ng like a
great heat
stage sel-

3ceive the
!anum, re-
stop to it.

syrup of
lespoonful

The diet
le, though
ale article
re sparing

ing, purg-
king pow-
(119), or
^ery hour.

)le means,

to be pur-
ihe efforts

the lower
, and are
id dimin-
um. The
the small
ibout six
id of the
le foot in

le adjoin-

nflamma-

affected.

, and, be-

I, costive-
rhese are
■e to pass

their contents. In general the passages are small, composed of mucus
mixed with blood. These passages are attended and followed by
severe gripings and inclination to strain, learnedly called tormina, and
tenesmus. They are sometimes, in the early stages, attended by nau-
sea and vomiting. The natural feces, which do not pass off much,
are small in quantity, and formed into round, campact balls, or irreg-
ular, hardened lumps. This tenesmus, or great desire to strain, will
continue, perhaps increase, for several days — the discharges being
mostly blood in some cases, and chiefly mucus in others. Having
generally but little odor at fii-st, these discharges become, as the dis-
ease advances, exceedingly offensive.

Causes. — Dysen tery is very frequently caused by sudden changes
from hot to cold, by which sweating is suddenly checked, and the
blood repelled from the surface. Hot climates, and dry, hot weather
are predisposing causes. All green, unripe, and unwholesome food,
and indigestible food of every sort, may induce it.

Treatment. — In mild cases give a tablespoonful of castor-oil and
two teaspoonfuls of paregoric, mixed, once a day. Sometimes, in
place of the above, a dose of rochelle powder, dissolved in water, and
eleven or twelve drops of camphor, may be taken. A moderate quan-
tity of flax-seed or slippery-elm tea, may be taken as a drink, and the
bowels be well emptied by an injection of starch.

When there is much pain in- the bowels a mustard poultice laid
upon them will have a good effect. The starch injections should, in
such case, have half a teaspoonful of laudanum mixed with it. The
compound syrup of rhubarb and pdtassa will often act favorably,
given in tablespoonful doses.

If there is reason to suppose the liver is affected, give podophyllin,
etc. (46).

The patient should not be allowed to sit up, and must be kept very
still, and be allowed only a very scant diet, as flour porridge, well
boiled, rice water, etc.

Chronic Dysentery.

When dysentery " runs on " for some time, it is liable to become
chronic.

Symptoms. — Looseness of bowels, — the discharges being un-
healthy, more or less bloody, attended by bearing down, or a desire
to strain, and being in number from two to forty a day. There is
great debility, the pulse is weak and quick, the tongue slightly furred,
the appetite lost, the face pale and sallow, the skin dry and parched.
Sometimes the relpx alternates with costiveness.

Treatment. — In this form of the complaint, astringents will be
necessary (169), (161), (162), (345), (346), (347).

Injections may be used, if necessary, composed of nitrate of sil-

382

DISEASES OF THE ABDOMINAL CAVITY.

ver, fifteen grains to the ounce of water, or an infusion of golden seal,
with a little tincture of prickly-ash berries added to it.

The diet must be very light, easy of digestion, and nutritious. In
Home cases, it should be composed chiefly of wheat porridge, or boiled
milk and boiled rice. In other cases, a little tender beef-eteak should
be taken once a day.

Worms. — Vermes.

The intestinal canal is subject to various disturbances from the
presence of worms. Of these troublesome tenants, there are three
principal varieties.

The Ascaris, or pin-worm, called also maw or thread worm, is a
small, wliite, thread-like worm from half an inch to an inch in length.
These worms live, in great number, in the rectum, where they excite
great irritation and itching.

The Lutnbricus, or atcaria lumbricoideg, is a round worm, about an
eighth of an inch in thickness, and from an eighth to a quarter of a
yard in length. Its color varies from a milky whiteness to a deep
red. It generally occupies the small bowels.

The Tenia Solanum, or tape-worm, is a flat worm, with four suck-
ers at the head, is from a few feet to some hundreds in length, and
full of joints. It dwells in the small bowels, and feeds on the chyle
as it comes along, before it is absorbed by the lacteals. In this way,
it robs the body of nourishment, and produces great loss of flesh, and
an enormous appetite.

Symptoms. — In the grown person the symptoms of worms are
qiiite obscure, except an intolerable itching within the anus, which
generally indicates pin-worms.

In children worms are indicated by paleness, itching of the nose,
grinding of the teeth and starting in sleep, irregular appetite, bad
breath, swelled upper lip, picking of the nose, hard swelled belly, and
one cheek constantly flushed.

Treatment. — For expelling worms various articles have been used.
Among these spirits of turpentine (165) has a high reputation. The
following preparation does well : Spirits of turpentine, half an ounce ;
essence of anise, half an ounce ; castor-oil, one ounce ; worm-seed
oil, one ounce. Mix. The dose for a child one or two years old is
ten to twenty drops, eveiy two or three hours. In two or three days,
a brisk physic should be given. The worm-powder is quite success-
ful.

One of the most popular remedies is the pink-root. It should be
united with a purgative. The following is a good preparation: Pink-
root and senna, each half an ounce ; bitartrate o^ potassa, one dram ;
pulverized jalap, half a dram ; cardamom seeds, half a dram ; extract
of liquorice, two drams. Mix, and add half a pint of boiling water,
liet the whole steep an hour. Give a tablespoonful or two, occasion-
ally, till the worms are expelled. •

DISEASES OF THE ABDOMINAL CAVITY.

388

An injoction composed of quassia (66), or aloes (22), or of simple
sweet-oil, is very effectual *in removing pin- worms from the lower
bowel. So is an injection composed of the red iodide of mercury,
one grain; iodide of potassium, half a grain; and two pints of
water.

Most of the above preparations are thought to be successful in ex-
pelling all kinds of worms ; but for the tape-worn .o other remedy
has yet shown itself as effectual as pumpkinrseeda. The seeds should
be well bruised, and steeped in water. This should be drunk freely
for several days, if need be. It is believed to be a sure remedy, oven
in cases of several years' standing.

In all cases of worms, the diet should be carefully chosen, and be
connected with proper exercise, pure air, frequent bathing, and all
those measures which tend to improve the general health.

After the expulsion of the worms, tonics should always be taken
to strengthen the bowels, that the same evil may not return.

Acute Inflammation of the Kidneys, — Nephritis.

Before speaking of this disease, I wish to give the reader a general
idea of a kidney, and shall do so by the use of two cuts.

Fig. 110 presents the external surface of the right kidney, with its
renal capsule mounted on top ; i, being its upper edge ; /, h, superior
and inferior branches of the emplgent artery ; c, d, e, three branches
of the emulgent vein ; a, the pelvis of the ureter ; b, the ureter.

Fig. Ill is the same kidney laid open ; 1, being the super-renal
capsule ; 2, the vascular portion ; 3, 3, the tubercular portion, consisting

FlO. 110.

Fio. 111.

of cones ; 4, 4, two of the calices receiving the apex of their corres-
ponding cones; 5, 5, 5, the three infundibula; 6, the pelvis; and 7,
the ureter.
The kidneys are glands, and their office is to draw or strain off

884

DIBRABRS OP THE ABDOMINAL CAVITT.

from Lho l)ody those effete or worn-out particloH, or product* of deenif
which corUain nitroi/en, while the liver tukes away thoHO carhoiMceoum
matters whieh have no nitrot/en. These UHeless HulwtiinceH which jro
out tlirougit tiie kidneys are genenvUy in tlio form of urea. In citrry-
iiig off these matters, the kidneys may have more to do than properly
belongs to them; and may be so stimulated, or irritated, or injured
in some way, as to become inflamed.

Symptoms.— Like most other inflummatory disesBes, it iHjgins with
cold chills and rigoiv, especially in the back and loins, followed by
fever and pain. The pain frequently extends to the bladder, the loins,
and the thighs, and is of a severe, lancinating kind — though some-
times obtuse. Pressure, motion, straining, or ttvking a full breath, add
to its pungency. The urine is scanty, high-colored, sometimes bloody,
and can only be passed drop by droj). In the loins theie is a sense
of heat, gnawing, and constriction ; the bowels are either constipated,
or relaxed by diarrhoja. A numbness of the thigh, and drawing up
of the testicle on the affected side, are marked and peculiar symptoms.
In some cases, there are nausea, vomiting, oppression of the stomach,
faintness, hiccough, drum-head distention, and rumbling of the bowels.
The skin is hot and dry, the pulse hard and frequent.

Causes. — The use of cantharides, oil of turpentine, and other di-
uretics, taking cold, violent exercise, mechanical injuries, the transla-
tion of rheumatism or gout, the striking in of skin eruptions, and
gravelly formations in the kidneys or ureters.

Distinctions This disease is to be distinguished from colic by

the pain being increaeed by pressure, and by the frequent but difficult
discharge of red urine ; from lumbago^ from its being confined fre-
quently to one side, and also by the urinary troubles, and by the
nausea and vomiting; and from all other diseases, by the numbness
)f the thigh, and the drawing up of the testicles.

Terminations of the Disease. — It runs a rapid course, and may
terminate by resolution, or by suppuration. When the latter happens,
it is indicated by the decline of the more violent symptoms, a throb-
bing and a sense of weight, with chills, followed by flushes of heat,
and sweating. The matter formed, generally small in quantity, may
pass into the cavity of the kidney, and thence through the bladder to
a natural outlet with the urine.

Treatment. — Either put the feet into a hot mustaid-bath, or put
mustard drafts upon them. At the same time apply a large mustard
poultice upon the small of the back, and follow it up with hot fomen-
tations of stramonium leaves and hops, or stramonium and wormwood
or tansy.

Let perspiration be induced as soon as possible by five to ten-
drop doses of tincture of veratrum viride, repeated every hour, or by
teaspoonful doses of the compound tincture of Virginia snake-root,
given ever}' half hour.

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Sciences

Corporation

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ues

DISEASES OP THK ABDOMINAL CAVITY,

If costiveness exist, the bowels must be opened by epsom salts,
cream of tartar, or salts of tartar ; or by copious injections of warm
water, containing a few drops of the tincture of arnica-leaves. Such
injections not only unload the bowels, but act as a local bath, by lying
in the bowel near the inflamed kidneys.

The drinks must be mucilaginous and diuretic. The marshmal-
low root and peach-leaves, slippeiy-elm bark, flax-seed, mullein, elder
blows, hair-cap moss, and cleavers, are all valuable. If the disease is
caused by gravel, twenty drops of liquor potassse, largely diluted
with flax-seed and upland-cranberry tea, and taken freely as a drink,
is excellent. We recommend Poland water in large quantities.

Chronic Inflammation of the Kidneys.

This is frequently the result of the acute form of the disease, but is
also produced by injuries and other causes.

Symptoms. — A weakness in the small of the back, and a dull,
heavy pain in the kidneys. The urine is passed often and in small
quantities. It is alkaline — sometimes white and milky — and has
in it deposits of phosphate of lime, and triple phosphates.

Treatment. — Infusions of pipsissewa, uva ursi, trailing arbutus,
wild carrot, queen of the meadow, buchu-leaves, or foxglove aie use-
ful diuretics, and may be taken with advantage.

The bowels must be kept open with some gentle physic (18), if
they are costive ; and the alkaline sponge bath, with friction, be used
daily.

An eruption may be brought out upon the small of the back by
rubbing on a few drops of croton-oil ; or, if the patient prefer it, a
mustard poultice may be applied two or three times a week.

The food should be nutritious, and easily digested, and a little ex-
ercise be t<aken daily in the open air.

Acute Inflammation of the Bladder. — Cystitis.

This disease affects the lining membrane of the bladder, — some-
times its muscular substance. It may attack the upper portion, the
middle, or the neck of this organ. It runs a rapid course.

Symptoms. — Burning, piercing, and throbbing pain in the region
of the bladder. The pain extends to the perineum, and in some
cases, to the testicles and thighs, and is much increased by pressure.
The perineum, the space between the fundament and testicles, feels
sore to the touch. The desire to pass urine is incessant, but the
effort to do so is mainly ineffectual. The water passes off drop by
tlrop, with great pain, or is entirely stopped, causing enlargement
of the bladder, and great distress. Mucus from the inflamed lining
of the bladder passes off with the water. Nausea, vomiting, and

886

DISEASES OF THE ABDOMINAL CAVITY.

great anxiety are common. The bowels are bound, and when the
disease is on the side next the lower bowel, there is a desire to empty
the bowels ; and if the inflammation be in the neck, there is great
pain in the perineum, and frequently an entire retention of the water.
The pulse is full, hard, and frequent, the skin hot and dry, the thirst
urgent, and the patient restless and dejected.

Causes. — This disease may be produced by taking cantharides and
turpentine ; by irritating sutetances forced into the bladder with a
syringe, or by pushing bougies or catheters into it ; by gravel-stones
in the bladder ; by retained urine ; by external injuries ; by gonor-
rhoea ; and by cold applied to the feet, or to the lower portion of the
abdomen.

Treatment. — If the urine be rettiined, it is of the utmost impor-
tance that it be early drawn off with the catheter, lest a distention of
the bladder bring on mortification. Great care is required not to pro-
duce irritation by any roughness in introducing the instrument.

Leeches should be applied upon the lower part of the bowels, the
perineum, and around the anus. When these are removed, warm
poultices should be applied. Cold compresses will often do as well.
The bowels must be opened with epsom salts. Injections of warm
water, with a few drops of tincture of arnica-leaves, will act finely as
a local bath, — the water being retained as long as possible.

The tincture of veratrum viride will be required in five to ten-drop
doses, or the compound tincture of Virginia snake-root, to induce
perspiration. Ex. jaborandi may sometimes be used for the same
purpose.

Drinks must be taken very sparingly. A small amouint of cold in-
fusion of slippery-elm bark, or marshmallow and peach-leaves, or
cleavers. This mucilaginous drink must be the beginning and the
end of the diet during the active stage of the disease. Alkalis are
exceedingly useful in allaying the pain and smarting of urination,
perhaps the bestremedybeingliq. potass, citratis, in tablespoonful doses
every two hours. Suppositories of opium and belladonna in one-fourth
grain doses by the rectum every two to four hours allay the frequent
urination and pain and quiet the spasm of the neck of the bladder.

Chronic Inflammation of the Bladder.— Cystirrhoea.

This is much more common than the active form of the disease.
It often arises from the same causes which produce acute inflamma-
tion of the bladder.

It often passes under the title of "catarrh of the bladder." It is
a chronic inflammation of the mucous lining of that organ, and is a
very common and troublesome affection among old people.

Symptoms. — Slight lancinating pains, with a feeling of heat in tlu;
region of the bladder, and a sense of weight and tenderness in the

DISEASES OF THE ABDOMINAL CAVIIV.

837

when the
to empty
B is great
the water.
, the thirst

arides and
ier with a
ivel-s tones
by gonor-
tior of the

lost impor-
stention of
. not to pro-
iment.
bowels, the
3ved, warm
do as well.
ns of warm
Lct finely as
le.

'. to ten-drop
I, to induce
ir the same

t of cold in-
leaves, or

ig and the

Alkalis are
urination,

jonful doses

one-fourth

le frequent

6 bladder.

hfstirrhcea.

the disease,
inflamma-

ier." It is
an, and is a

heat in tlx'
Iness in the

perineum ; frequent and tormenting desire to pass water, with occa-
sional spasmodic action of the bladder. The urine is loaded with
tenacious mucus, just as the expectoration has large quantities of
mucus in it when there is inflammation of the membrane lining the
windpipe and bronchial tubes. When the water has stood a while,
this mucus settles at the bottom of the vessel, leaving the fluid clear
above. Great quantities of this are son^etimes passed, — amounting
even to pints in a day. The triple phosphates of magnesia and am-
monia are often found in the water.

Frequently there are demngements of the appetite and digestive
functions, a white or brown fur upon the tongue, a harsh, dry skin,
with thirst and general debility, — especially in the back and loins.
Sometimes there id a little fever.

Treatment. — To reduce the inflammation, apply leeches, or mus-
tard, or croton-oil, or a cold compress every night.

As a diuretic, give an infusion of buchu, uva urei, trailing arbutus,
queen of the meadow, etc. Tincture of veratrum viride and sweet
spirits of nitre (125) is a good remedy. The compound infusion of
trailing arbutus is well recommended. So is the compound balsam
of sulphur. An infusion of the pods of beans has been well spoken
of.

An injection into the bladder, once a day, of a tepid infusion of
golden-seal root, with much care, may be of great service; or an
infusion of equal parts of golden-seal, witch-hazel, and stramonium.
It may be done with a gum-elastic catheter and a small syringe.

The bowels must be kept open with the neutralizing mixture, or
some other mild physic ; and the skin bathed with saleratus and
water once a day, and rubbed well with a coarse towel.

Should there be any scrofulous, or gouty, or rheumatic condition of
the system, the remedies for those complaints may be used in addition
to the above.

Disease of the Supra-Renal Capsules.

The supra-renal capsules are sm^ll bodies situated above the kid-
neys. (Fig. Ill, i.) Their office is not well understood. It has
been found of late that they are subject to a disorder having peculiar
symptoms. Tliis is a comparatively new disease.

Symptoms. — The most marked symptom is a peculiar change in
the color of the skin, called " bronzing." This bronzing process lo-
gins in patches on those parts exposed to the sun, and to friction,
as the neck, the bsicks of the hands, the fronts of the thighs, and the
arms. These patches look, in color, like spots upon a bronze statue,
deprived of their gloss.

Another marked symptom Ls a general debility, which comes on
witliout any apparent cause, — there being, generally, no evidence of
niganic disesise, and no loss of flesh, — and is attended with faint-

838

DTSKASRS OF THK ABDOMINAL CAVITY.

ings, loss of energy both of body and mind, a peculiar flabbiness of
flesh, and an early death, apparently from sheer weakness.

The blood becomes depraved, and loses its coloring matter, as
shown by the paleness of the skin where there is no bronzing.

The pulse is generally very soft and compressible. The stomach is
irritable, the appetite is gone ; there is nausea and sometimes vomiting,
with pain and a sense of sinking at the pit of the stomach. Fre-
quently there is costiveness, sometimes diarrhoea, and pains in the
back and loins. In some cases there are epileptic fits, failure of
memory, change of temper, or a numbness of the fingers, legt, etc.

Treatment This disease is a peculiarly fatal one. As no mode

of treatment has yet proved successful, it is well to observe caution
in prescribing.

The treatment prescribed for chronic inflammation of the kidneys,
would perhaps be as safe as any that could at present be proposed.

Bright's Disease of the Kidneys. — Albuminuria.

This peculiar disease was first explained to the profession in 1837,
by Dr. Bright, of England, whose name it took. It consists of a dis-
order of the kidneys, — probably a congestion and an obstructed cir-
culation in them, from which arise two most important effects ; first,
albumen, an essential alimentary constituent of the blood, is secreted
and passed off, in larger or smaller quantities, in the urine ; and sec-
ondly, urea, the worn-out matters of the blood which the kidneys are
made expressly to carry off, is permitted to remain. If the urine of
a person having Bright's disease be examined, therefore, albumen,
which should not be there, will be found, and urea, a natural constitu-
ent, will be absent. The presence of albumen, however, while ab-
normal, is not necessarily indicative of Bright's disease, as it may
proceed from indigestion and blood disorders.

Method of Examination To discover albumen in urine suspected

to contain it, place a little in a test tube, and boil it over a spirit-
lamp. If albumen be present only in minute quantity, it may caupe
only a delicate opalescence ; if in larger quan-
tity, it may separate in curdy flakes, and fall to
the bottom as a more or less abundant white
precipitate. If very abundant, the liquid may
become nearly solid.

The albumen is the same as the white of an
egg, and the boiling has the same effect in
whitening and hardening it, as upon that sub-
stance.

no. 112. Albumen is sometimes found in the urine in

a coagulated state, and having the shape of tubes or worms (Fig.
112). This is quite common in Bright's disease. The deposit seems
to be made up of fibrous casts of the uriniferous tubes of the kid-
neys.

»;a:«sa

abbiness of

matter, as
izing.

9 stomach is
J8 vomiting,
lach. Fre-
ains in the

failure of
legi, etc.

\8 no mode
rve caution

he kidneys,
proposed.

ninuria.

ion in 1837,
ists of a dis-
itructed cir-
fects ; first,
, is secreted
le ; and sec-
kidneys are
;he urine of
re, albumen,
ral constitu-
sr, while ab-
3, afi it may

ae suspected
/er a spirit-
t may cause
arger quan-
, and fall to
idant white
liquid may

white of an
le effect in
jn that sub-
he urine in
i^orms (Fig.
sposit seems
of the kid-

DI8EA8E8 OF THE ABDOMINAL CAVITY.

339

Symptoms. — The two unnatural conditions mentioned above
give rise to the symptoms of Bright's disease. One of them, how-
ever, is itself the most constant and characteristic symptom of the
disease, namely, the presence of albumen. This, too, being one of
the nutritive constituents of the blood, its abstraction thins the
serous portion of the blood, and causes it to filter out of its vessels
into the cells, — causing dropsy of the cells, usually called cellular
dropsy, or anasarca. This general dropsy begins frequently in the
face, and spreads rapidly over the whole body and limbs. In addi-
tion to this, there are pains in the back and loins, a gradual failing of
strength, and a derangement of digestion. The skin becc mes drj,
with a pale and bloodless appearance, and theie are frequently thirst,
nausea and vomiting. The urine frequently has fat, blood, epithelial
scales, mucus, blood-discs, fibrous casts of the uriniferous tubes, and
saline sediments ; and is genenally lighter l)y weight than in health,
and less in quantity, and is apt to be red, brown, or dingy in color.

The retention of urea in the blood acts as a poison, and causes,
toward the latter end of the disease, when accumulated in large quan-
tity, drowsiness, convulsions, and apoplexy.

A frequent desire to make water, with a shifting back and forth
of the bowels between costiveness and diarrhaea, are common symp-
toms.

Treatment. — The results of treatment in this diseaso are often un-
satisfactory. Yet if biken in season, investigated with proper care,
and treated with due diligence, much mfiy be done for its cure. It is
one of those harassing complaints, which physicians in family prac-
tice seldom have the patience to investigate and manage with suffi-
cient care.

Let the healthy and active condition of all the vessels of the skin
be the first object aimed at. Tliis will relieve the laboring and falter-
ing kidneys of a portion of their burden. The alkaline sponge-bath
with vigorous friction every day will secure tiiis object.

In the next place, the skin being put in a working condition, should
be made to work by some internal diaphoretic, — as the tincture of
veratrum viride, in doses of from five to ten drops, or the compound
tincture of Virginia snake-root, in teaspoonfnl doses.

The kidneys may be still further relieved, especially when there is
considerable tenderness and other signs of inflammation, by cupping,
leeching, mustard-poultices and croton-oil.

The bowels should be regulated by some gentle physic, as cream of
tarter dissolved in flax-seed tea, lochelle powders, epsom salts, etc. In
some cases, podophyllin and leptandrin (40), or tho compound
powdei of jalap (41), ai-e useful.

When ithere is dropsy of the cells, elaterium may be used as physic
(31), or the kidmys may ,be jogged by digitalis (130), (129), its effects
being carefully watched. Cider, freely drunk, has been found useful
in some cases.

340

To restore
the essential
the vegetable
be used daily.

Coffee, and
bread, high-se
nothing must
cannot easily

DISEASES OP THE ABDOMINAL CAVITY.

the blood, iron (73), (93), (74), (75), (72). (71) is
article. When there is considerable debility, some of
bitters, as quinine, quassia, gentian, Colombo, etc., may

ail indigestible articles of food, as rich pastries, new
lujoned meat, and fats, must be avoided, — in a word,

be taken, either in kind or quantity, wliich the stomach
digest.

Diabetes.

This disease is a kind of diarrhoea of the kidneys. The amount
of urine secreted and discharged is large, sometimes enormous in
quantity, amounting even to seveial gallons in twenty-four houns.
Everything taken into the stomach seems to run off by the kidneys.
The food and drink being mostly converted into urine, do but little
good. The kidneys having got into an exalted state of action, do
too much, — just as the mucous membrane of the air-tubes does in
bronchitis.

Nature of the Urine — Not only is there too much urine discharged,
but, instead of being lighter than healthy urine, as in Bright's disease,
it is heavier, and instead of holding albumen in solution, it contains
grape-mgar.

To Detect Sugar. — Put a little of tlie suspected urin^ in a test-
tube ; add to it a drop or two of solution of sulphate of copper, which
will give the fluid a pale-blue tint. Now add liquor potassa in
excess : if sugar be present, this will throw down a pale-blue precipi-
tate (hydrated oxide of copper), which will immediately re-dissolve,
forming a purplish-blue liquid. Boil this over a lamp ; if there be
sugar, a reddish or yellowish-brown precipitate (sub-oxide of copper)
will be thrown down ; if no sugar, a black precipitate (common oxide
of copper) will fall to the bottom.

Another 7fe««.— Place a little urine in a tesUube; add to it half
its volume of liquid potassa, and boil five minutes. If there be sugar
present, the liquid will take a brownish or bistre tint.

Growth of Torula as a Teat. — Place a portion of saccharine mine
in a warm place, and a scum will soon rise, as
if a little flour had been dusted on it. This,
when examined under the microscope, proves to
be minute oval bodies. These expand and dilate
I the vesicle containing them into the form of a
' tube. They still continue to erdarge, and pro-
ject from the parent bladder, like buds. The
whole then resembles a jointed fungoid growth
(Fig. 113), which finally breaks up, and falls to
the bottom, as a copious deposit of oval vesicles
or spores.

FIO. 113.

• 'iltTtitiiidinrriiifcTlir'"'"-'^"" '

DISEASES OF THE ABDOMINAL OAVITY.

841

)• (71) 18

, some of
may

etc.

tries, new
II a word,
a stomach

18 amount
)rmous in
)ur horn's.
8 kidneys.
I but little
action, do
BS does in

ischarged,
t's disease,
t contains

I in a testr
per, which
potassa in
le precipi-
e-dissolve,
: there be
copper)
laion oxide

to it half
be sugar

rine urine
)n rise, as
it. This,
proves to
and dilate
form of a
and pro-
lids. The
id growth
id falls to
il vesicles

Other 5ymptoms. — Great thirst, craving appetite, dry skin, a
sense of weiglit and uMea.sine8s in the stomach after eating, dry and
parched mouth, wliiU? and foul or clean and red tongue, wasting of
llt'sli, languor and aversion to exercise, debility, pain and weakness
ill the loins, co.>?tiveness, loss of the sexual feeling, and cold teet.
As the disease di-aws towards a fatal end, the gums become spongy,
the breath fetid, sometimes smelling like urine.

Treatment. — The skin should have about the same treatment as
that recommended in Bright's disease. Also, the same counter-irrita-
tion over the kidneys. The bowels must be kept open by some
gentle physic (13), (12), (15).

Tonics. — These will be required to restore the tone of the system,
particularly iron, — same preparations as recommended in Bright's

disease.

Astringents to check the flow of urine will be needed. Alum, in
tliree-grain doses, three times a day, or sugar of lead, or white vitriol,
or clear opium, will be serviceable. Creosote, in one or two-drop
doses, and tincture of cantharides, have each cured cases.

One scruple of Peruvian bark, one scruple of wild-cranberry leaves,
powdered, and half a grain of opium, mixed and taken three times a
day, is a good remedy.

All articles which contain sugar and starch must be forbidden in
the diet. Bread and potatoes contain a large amount of starch ; and
beets, parsni^^s, and some other vegetables, have sugar. It is best
to confine the patient almost entirely to tender, fresh meats ; and the
drink, notwithstanding the great thirst, must be restricted to a very
small quantity. Saccharin should be used to sweeten drinks instead
of sugar.

Bleeding from the Kidneys, etc. — Hcematuria.

By this I mean a discharge of blood from the urinary passage. It
may come from the kidneys, the ureters, the bladder, or the urethra.

Symptoms. — The passage of the blood is preceded by pain in the
region of the bladder or kidneys, and accom-
panied by faintness. There is generally heat
and distress in the loins, and tenderness upon
pressure in the region of the bladder or kid-
neys, according to the place from which the
blood comes.

It is sometimes difficult to decide whether
the coloring matter in the urine is really blood.
In such cases, the microscope will generally
detect the blood corpuscles, if present. They
commonly appear as in Fig. 114, having a yellow color, and being
pretty uniform in sxze.

op
o P

\o o

o \ o

Fl». 114.

342

DISEASES OF THR ABDOMINAL CAVITY.

Treatment. — This must of course vary according to the nature of
the case, and the immediate cause producing it. Where active bleed-
ing exists, the patient must have absolute rest in bed, with applica-
tions of cold to the hips and loins. If the patient l)e strong and full
of blood, w^et cups or leeches may be applied over the kidneys, or the
bladder. In such cases, too, the bowels must be freely moved with
some preparation of salts (14), (18), (20), (25).

Sugar of lead is a valuable remedy; but it should be given in large
doses for a short time, rather than in small doses for a long time. It
is best taken in form of solution (348), two great spoonfuls every
two hours, until five or six doses are taken.

But the best remedy is gallic acid. It seems to have extraordinary
power in this complaint. It should be given in five-grain doses,
mixed with a teaspoonful of mucilage of gum-arabic, and t'en drops
of tincture of henbane.

Suppression of Urine. — Ischuria Renalis.

This disease is, in one respect, just the opposite of diabetes.
While immense quantities of urine are secreted in that, none is se-
creted in this. In that, the kidneys do too much ; in this, they do
nothing.

This complaint is sometimes called paralysis of the kidneys. It
usually occurs in old persons, and those inclined to corpulency.

Symptoms. — The patient makes no water; and if the catheter be
applied, none will be found in the bladder. The patient feels unwell,
restless, anxious, with a slight pain in the loins and bowels, perhaps ;
but on the whole not illness enough to give any very good account
of it. After a little time, nausea comes on, and perhaps vomiting,
and soon drowsiness, wanderings of mind, incoherent talk," hiccough,
stupefaction, and death. These head symptoms are caused by the
shutting up, in the kidneys, the natural outlet of urea, of an excre-
mentitious matter, which acts as a poison to the nervous system.
Before death, the perspiration has a strong smell of urine.

Treatment. --The cause of this complaint not being known, the
treatment must necessarily be a little uncertain. We cannot go
amiss, however, in placing the patient immediately in a warm bath
for fifteen or twenty minutes. Then apply wet cups over the kidneys,
and follow these either by mustard poultices or by hot fomentations.

Let the bowels be opened by the compound powder of jalap, or by
elaterium (31). Epsom salts or cream of tartar might in some cases
be substituted for the above. A stimulating injection is also desira-
ble (246).

Diuretics, as sweet spirits of nitre, digitalis, queen of the meadow
and peach-leaves, equal parts, and marshmallow, are of course called
for.

le nature of
ctive bleed-
ith applica-
ng and full
neys, or the
moved witli

ven in large
g time. It
nfuls every

traordinary
[rain doses,
1 t«u drops

lis.

)f diabetes.

none is se-

his, they do

idneys. It
idency.

catheter be
eels unwell,
Is, perhaps ;
jod account
a vomiting,

,* hiccough,
ised by the
an excre-
3U8 system.
I.

known, the
cannot go
warm bath

the kidneys,

mentations.

jalap, or by
some cases
also desira-

he meadow
)ur8e called

DISEASES OF THE ABDOMINAL CAVITY.

343

Much of the poisonouM matter retained mayln^ got out througli the
skin, by a free use of the compound tinclun; of Virginia Hiiake-root
or tincture of vemtrum viride in full doses.

Although the symptoms, in the earlier stages of this (;omplaint,
may not attract much attention, or Iw thought worthy of notice, yet
the treatment should be prompt and energetic, as a fatal termination
is sometimes reached in the brief space of forty-eight hours.

Retention of Urine.

This disorder is often confounded with suppression of the urine,
but it is different in eveiy respect. In suppression, the urine is not
formed by the kidnej^ ; in retention, it is formed, and, in some cases,
poured into the bladder, but is retaintd on account of some inability
to pass it.

Ischuria. — This is one of the forms of retention. In this com-
plaint, the urine has passed from the kidneys to the bladder, but from
some cause, generally palsy of the muscles of the bladder, it cannot
be passed off. In this case, there is no pain, but the stream of water
flows off with slower and slower pace, — the patient having to make
tiresome efforts with the abdominal muscles to get the bladder
emptied. As the quantity discharged diminishes, the f'abire to uri-
nate grows more urgent. Pressure just above the pubes gives pain,
and the bladder feels under the hand like a large, hard tumor.

Dysuria. — In this form of the complaint, the water is passed to
some extent, but with pain and heat along the water-pipe. This is
generally caused by some inflammation along the urethra.

Strangury. — In this the water is only passed drop by di-op, and
with great burning, scalding, and tenesmus in the neck of the bladder.
When there is considerable inflammation, the skin becomes hot, the
pulse hard and quick, and the tongue covered with a white fur.

Causes. — These several f oi-ms of the complaint are caused by palsy
of the bladder, gonorrhoea, inflammation in the neck of the bladder
or the water-pipe, mechanical injuries of the bladder in child-bearing
or otherwise, by tumors pressing upon it, by irritation from gravel or
stone within its cavity, by stricture or partial closing up of the ure-
thra, by disease of the prostate gliind, by taking spirits of turpentine
or cantharides, or by the absorption of this latter article when used
as a blister.

Treatment. — It is obviously necessary in this complaint, that
treatment, in order to be of any avail, should be prompt ; for when
the retention is complete, the bladder will burst in from two to five
dayrs, and cause the death of the patient.

The treatment must vaiy according to the cause of the retention.

If it be caused by palsy of the bladder, the common flexible cathe-

844

DISEASES OF THE ABDOMINAL CAVITY.

t«r miiHt b« 1186(1 daily until the muscular fibres recover their IohI
power. When much irritation is caused by introducing it, it is better
not to withdraw it, but to oIoho its oxtcrnal orifice with a Hinall i)luf,',
which the patient vnu remove an often aH necessary to let off the
urine. To remove the paralynis, the electro-magnetic machine is
woith a trial, the current being passed through the bladder. At
the Hame time let the patient bike stiychnia (Sh), (80), (83), (96).
Cantharides, in the form of tincture, or in connection with strychnia
(291), is ofter used.

If the retention is caused by inflammation of the neck of the blad-
der, leeches should l)e applied to the perineum, and three or four drops
of croton-oil may 1k^ rubbed on just above the pubes to bring out an
eruption. Warm fomentations will also be serviceable, and warm
hip-baths. Cooling diuretics, as infusions of marahmallow, cleavers,
pumpkin-seeds, buchu, sweet spirits of nitre, etc , must not b§ pmitted.

Inability to Hold the Urine. — Enuresis.

This complaint, generally called incontinence of the urine, is quite
common among children. In some cases the child has no ability to
hold it8 water at any time ; but generally it is only passed off invol-
untarily at night while in bed. In adult life it m less frequently met
with, except among the old.

Causes. — Irritation of the roots of the spinal nerves which go to
the bladder, mechanical injuries of the bladder, palsy of the bladder,
particularly in old people, debility of the neck of the bladder, a gen-
eral weakness of the nervous system, worms in the bowels, piles,
whites, gravel or stones in the bladder, long prepuce in boys, etc.

Treatment. — As a general rule, the change of constitution which
occurs at puberty cures this complaint. But as this does not always
happen, it is important that parents do everything in their power to
break it up earl^ , lest it become an affliction for life.

Children who suffer from this disorder are apt to drink largely.
This habit should be restrained. But little drink should be allowed,
whatever the desire for it. Care should be taken that the child make
water before going to bed, — also that it be aroused at a late hour for
the same purpose, and that the foot of the bed be elevated so as to
draw the urine away from the neck of the bladder.

The skin should be washed all over, every day, with cool, or cold
water, and vigorously rubbed with a coarse towel. This will cause
the excess of fluids to pass off thiough the skin, and lessen the action
of the kidneys.

In some instances children urinate in bed through carelessness,
being half conscious of what is occurring, but not caring enough to
rouse themselves. In such cases, they are often cured by some de-
cided correction, — the impending act of passing water connecting

DISEASES OF THE ABDOMINAL UAVITY.

345

their IohI
b Ih Ixitter
[null i>lug,
3t off the
mchinu Ih
Ider. At
53), (95).
Htrychtiia

■ the blad-
four drops
ing out an
ivnd warm
, cleavers,
1^ gmitted.

is.

16, is quite

) ability to

off invol-

uently met

/hich go to
le bladder,
der, a gen-
vels, piles,
ys, etc.

tion which
lot always
r power to

k largely.
)e allowed,
lild make
te hour for
3d so as to

or cold
will cause
the action

lelessness,

enough to

some de-

jonnecting

itself in their mind with the corrootion, and recalling them inHtaiiUy
to full coMsciouNucss. Of ('ourse this mode of relief should be resorted
to with great judgment and caution.

When the complaint proceeds from debility or rehxntioii of the
neck of the bladder, the compound infusion of trailing arbutus and
the isinglass custard found among dietetic preparations, may In; used
freely. The tincture of cantharides, from ten to forty drofw to chil-
dren, may be given, and increased gradually to a hundred, or until
slight difficulty is felt in puasing the water. Then stop, and give
the urticles mentioned al)<)ve. Spirits of turpentine is useful to some
extent, given also in stnall doses, and (tontinued for some time.

If the disorder be caused by irritation of the spinal nerves, cold
water douched upon the back, or croton-oil rubbed along the spine,
or a warm stimulating or irrittiting plaster upon the lower part of the
back, /ill be required. The electro-magnetic machine may do well
in some cases. Tincture of belladonna, given just as tincture of can-
tharides above, afternoon and at Ixidtime, gives best results usually.
Belladonna after a while troubles tlie eyes and must be stopped.

Urinary Deposits. — Gravel. — Stone.

Unnatural deposits in urine are to be regarded simply as evi-
dences of changes which disease is making in the body. As such
they are valuable, — more valuable, in many cases, than any or all
other symptoms we can study, and most valuable from the ease with
which they may be investigated. Yet but very few physicians, com-
paratively, pay any special attention to them, or make any effort to
acquire the small amount of knowledge needed for their detection.

Sources of the Urine. — The urinary secretion has three ; irces.
The largest bulk of it comes from the superabundance of drink taken
into the stomach. This is shown from the free flow of pale urine
after taking copious drafts of water or other fluids. Such quantities
of water as are often drunk, would embarrass the functions of animal
life, were it not pumped off by the kidneys.

A second source of supply for the urinary secretion is to be found
in the elements of imperfectly digested food, and also some abnormal
elements arising from incomplete assimilation. Oxalic acid is a
specimen of the latter, being sometimes largely excreted, in dyspep-
sia, soon after a meal.

The third source of urine is found in those old and worn-out atoms
of the system, which can serve no further useful purpose in the ani-
mal economy, and which cannot be got rid of by the lungs or skin.
It is only, however, one portion of the dead tissue, namely, that which
is rich in nitrogen, which goes out through the ♦• .1 strainer ; an-
other portion, which has a preponderance of inflai. lable elements —
carbon, hydrogen, and perhaps sulphur — takes the outward channel
t)i rough the liver, as bile.

p5»

346

DISEASES OP THE ABDOMINAL CAVITY.

Characteristics of Urine. — Healthy uiihe has a light amber color,
is transparent, arul has different degrees of density, its specific gravity
varying from 1.003 to 1.030. It has an aromatic, violet-like smell,
and a bitter, disagreeble taste, like salts.

That which is passed a little time after drinking largely, is pale,
and has a low specific gravity, varying from 1.008 to 1.009, and is
called urina potus. That passed soon after 'he digestion of a full
meal, is called urina chyli, or urina cibi ; it has a specific gravity from
1.020 to 1.030. That which is secreted from the blood, and is passed
before eating or drinking iii ,.he morning, is called urina sanguinis;
and has a specific gravity of from 1.015 to 1.026. This is the best
specimen of the average density and nature of healthy urine.

Healthy urine contains urea, uric acid, sulphuric acid, phosphoric
acid, lime, magnesia, phosphate of soda, etc. It; is only when these
are discovered in excess, that they indicate disease.

Examination of Urine^ — Let a piece of blue litmus-paper be first
dipped in the urine ; if it be acid, the color of the paper will be
changed to red,OT reddish-brown. Should the blue color remain un-
changed, then use 'yellow turmeric or reddened litmus paper ;
if the urine is alkaline, the turmeric will become brown, and
the reddened litmus will be changed to blue. If the color in
both cases remains unaltered, the urine is neutral ; that is,
neither acid nor alkaline.

This being done, let the specific gravity be taken. This is
easily done by the urinometer (Fig. 116). This instrument
is known also by the names hydrometer, and gravimeter. It
is generally made of glass. When placed in distilled water,
it will sink to a certain point; and as all bodies immersed in
fluid displace a bulk equal to themselves, it follows that in
a fluid denser than water, the instrument will not sink so
deep. The Space above the large bulb is marked off into de-
grees corresponding to different densities. When this instru-
ment is immersed in urine, and has come to rest, the number on the
graduated scale, which stands at the surface of the liquid, when
added to 1.000, will represent the specific gravity of the fluid. If, for
example, the surface of the liquid corresponds with 9 on the scale,
the specific gravity of the urine will be 1.009 ; if at 26, it will be
1.025.

By attending to the specific gravity of the urine, the physician may
often gain important information respecting his patient, as it may be
made to show him how much solid matter is daily carried out of the
body through the kidneys. This, at the bed-side, may often give
useful hints in regard to treatment.

The following table, constructed by Dr. Golding Bird, shows at a
glance the amount of solid matter in 1000 grains of urine of different
densities : —

FIO. 118.

i 1 1 ilnliiMiillilljWMlMliimHIMi

^M^a^

mber color,
iific gravity
rlike smell,

ely, is pale,
009, and is
m of a full
[ravity f lom
1(1 is passed

sanguinis;
is the best
ine.

phosphoric
when these

iper be first
per will be
remain un-
;mus paper;
brown, and
the color in
al; that is,

in. This is

instrument

dimeter. It

;illed water,

mmersed in

ows that in

not sink so

off into de-

this instru-

mber on the

quid, when

aid. If, for

a the scale,

), it will be

ysician may

18 it may be

I out of the

often give

shows at a
of different

DISEASES OF THE ABDOMINAL OAVITT.

347

Speoiflo
Gravity.

Solids.

Water.

Speciflc
Gravity.

SoUdi.

Water.

Speoiflo
Gravity.

SoUd(.

Water.

Specific
Gravity.

Solldi.

Water.

1001

2.31'.

997.67

1011

26.63

974.37

1021

48.93

951.07

1031

72.23

927.77

1002

4.66

905.34

1012

27.96

972.04

1022

61.26

948.74

1032

74.66

926.44

1003

6.99

993.01

1013

30.29

969.71

1023

53.59

946.41

1033

76.89

923.11

1004

9.32

990.68

1014

32.62

9t)7.38

1024

55.92

944.18

1034

79.22

920.78

1005

11.6S

998.35

1016

34.96

!)65.05

1026

68.26

941.75

1036

81.66

'J18.46

1006

13.98

986.02

1016

37.23

962.72

1026

60.60

939.42

1036

83.88

916.12

1007

16.31

683.69

1017

39.61

960.39

1027

62.91

937.09

1037.

86.21

913.79

1008

18.64

981.36

1018

41.94

958.0(1

1028

65.24

934.76

1038

88.54

911.46

1009

20.97

979.03

1019

44.27

955.73

1029

67.67

932.43

1039

91.87

909.13

1010

23.30

976.70

1020

46.60

963.40

1030

89.90

930.40

1040

93.20

906.80

The mode of using the above table is this. Having learned the
density of the urine passed in twenty-four hours by means of the
urinometer (Fig. 115), a glanc at the table will show the proportion
of solid matter and water in 1000 grains of the urine. Then, by
weighing the whole quantity of urine passed in twenty-four hours,
the weight of solids drained off by the kidneys may be determined
by the simple rule of proportion.

Symptoms of Qravel. — A sudden attack of pain in the region of
the kidneys, so acute and severe, frequently, as to cause fainting and
even convulsions. The pain runs down to the groin and thigh, caus-
ing a numbness on the affected side, and a drawing up of the testicle.
The pain is excessive at times^, and then remits. Finally it stops
suddenly.

Leading from the kidneys to the bladder are two small tubes about
the size of a goose-quill, called ureters, — being the appointed chan-
nels of the urine. The pain, of which I have spoken, is caused, gen-
erally, by the passage of a stone along one of these small tubes. If
the stone happen to be a- little too large for the tube, or uneven or
ragged upon its surface so as to bruise and tear the delicate lining
of the ureter, severe pain is the result. The pain is intense when the
stone moves along ; remits when it stops ; and suddenly ceases alto-
gether, when it gets through, and drops into the bladder.

Sometimes there is no pain, the gravel being so fine as to pass
through the ureters very easily. It then passes through the urethra
also, and is found as a sediment of the urine at the bottom of the
vessel.

These urinary deposits are various, and quite unlike each other in
kind. They indicate different states of health, and require to be
spoken of separately.

Uric-Acid Qravel.

This form of deposit passes indifferently under the name of uric
acid gravel, or lithie acid gravel. The person who is in the habit of
passing this kind of deposit largely, is said to have the lithie or uric
acid diathesis or condition.

The urine of persons in this state lets fall, after it has stood awhile,

84a

DISEASES OF THE ABDOMINAL CAVITY.

a reddish sediment, like brickdust. This consists chiefly of urate of
ammonia (Figs. 116 and 117), tinged with certain coloring matters.
This coloring substance may be more or less abundant, anil give to
the deposit various shades, as dirt;y-white, yellow, pink, and red. The

FIO. 116.

Fig. 117.

pure uric acid sometimes appears as fine sand, or large crystals (Fig.

118). The urine is of a dark copper-color, about like brown sherry^

and is more scanty than in health. It is
also highly acid, giving to litmus paper
a deeper shade of red.

Persons who pass this kind of gravel
largely are apt to be troubled with in-
flammatory complaints; with acidity of
the stomach and heartburn; and some
of them with gout and rheumatism.

Placed under a blowpipe, uric acid is
decomposed, and gives out an odor like
that of burnt feathers, combined with
the oil of bitter almonds, it is dissolved
by liquor potassa, from which muriatic
and nitric acids precipitate it; and by
sulphuric acid, from which it is precipi-
tated by water. Acetic, nitric, and mu-
FiG. 118. riatic acids, alcohol, ether, and water, do

not dissolve it.

Causes. — Uric acid is the form in which nitrogen and the effete
compounds which contain it are got out of the body. It is the result
of the decomposition of the tissues of the body. Its gravelly particles
are the sands of life daily washed out of us, — reminding us always
that we are wasting away. Whatever causes the body to waste
rapidly, produces it in excess. We find it, therefore, in the urine of
those who suffer from gout, rheumatism, dyspepsia, fevers, debility of
the genital organs, straining of the loins, etc., which produce loss
of flesh.

Treatment. —The remedies for this uric-acid gravel are the alka-
lies, bicarbonate of potash, bicarbonate of soda and magnesia. The

ite

■• « l» "

DISEASES OF THE ABDOlfflNAL OAVITT.

349

:)f urate of

g matters.

1^. give to

red. The

■stals (Fig.
iwn sherry,
alth. It is
tmus paper

d of gravel

ed with in-

acidity of

and some

latism.

uric acid is

n odor like

bined with

dissolved

muriatic

; and by

is precipi-

and mu-

water, do

the effete
the result
y particles
us always
to waste
\e urine of
debility of
oduce loss

the alka-
is'm. The

first named is generally the best. It may be used in the form of the
neutralizing extract, — especially if there be costiveness. If the bowels
do not need physic, let the potash be taken in the shape of lye made
from hard- wood ashes ^300). Fluid magnesia i& an excellent remedy ;
so is liquor potassa, taken in twenty or thirty-drop doses. The urine
must be w.itohed, and these remedies discontinued when it becomes
alkaline. Black coffee drunk freely every day is an excellent remedy.

At the same time the stomach should be. supported by some bitter
tonic, as the infusion of quassia, gentian, oolumbo, Peruvian bark, etc.

Iron is, in many cases, not to be ove: )ked. If the patient be
nale and bloodless, some of the preparations of this metal will be
needed (61), (73), (74).

Acid must be carefully avoided, both in food and drink.

The diet must be plain, digestible and nourishing, and quite mod-
erate in amount. The quality is of less consequence than the quan-
tity.

Exercise is of great consequence, and must be regular, and, if pos-
sible, in the open air.

The skin must receive daily attention in the shape of an alkaline
sponge-bath, with friction. This will throw upon the skin much of
the labor done by the kidneys. Poland Spring water used in large
quantities is good.

Phosphatic Deposits.

These deposits are indicated by a state of the urine just the oppo-
site of that which contains the uric-acid gravel. They are contained
in urine which is either alkaline when passed, or becomes so very soon
by standing.

As the urine cools, a white sand falls to the bottom, and frequently
a film forms upon the surface of the water. Looking at this film in
different lights, you may see in it the several colors of the rainbow.
Skira off this pellicle, place it upon paper, and let it dry ; and you
may then see the little shining crystals. This urine quickly grows
putrid and offensive. Sometimes it smells strongly of ammonia.
The more phosphates it contains, the sooner it becomes alkaline.

These deposits are generally the triple phosphates. Healthy urine
contains the phosphate of magnesia in a state of solution. Under
some circumstances, the urea of the urine is decomposed in the kid-
neys, anr^. ammonia is disengaged. This combines with the phosphate
of magnesia, and forms the triple salt of the phosphate of ammonia
and magnesia, which is not soluble.

Symptoms. — A sallow complexion, a languid, spiritless state of
mind, and an exhausted, debilitated condition of body. The urine is
pale, rather copious, slightly turbid, has a low specific gravity, and
smells unhealthy, having sometimes the faint odor of weak broth.
There is generally derangement of the digestive organs, windy stom-
ach and bowels, nausea, constipation, or diarrhoea, stools of various

iir

360

DISEASES OF THE ABDOMINAL CAVITY.

colors, and sometimes, in diarrhoea, resembling yeast, and an aching
pain and weakness in the loins.

Causes. — These deposits are produced by great debility of the
constitution, by injuries of the spine, dyspepsia, defective assimila-
tion of food, bad diet, irritation of the neck of the bladder, and or-
ganic disease of the kidneys. But they are caused more especially
hy whatever wears and exhausts the nervovs system^ as heavy cares, de-
pression of spirits, sedentary habits, great; mental exertions, mastur-
bation, and venereal excesses.

Tre»tment. — These deposits being connected with great debility,
care i-ust be t^ken not to make the matter worse by taking active
purgatives, by extrexne fasting, or by any means which will incresise
the weakness.

On the contrary, the strength must be supported by all the means
that can be commanded. With this ^ iew, the citrate of iron (75)
may be taken. Arsenic combined with iron (80), to allay irritability,
and impart strength at the same time, may be used. The valerianate
of iron (93) is excellent for the same puipose.

Connected with a state of urine just the opposite to that which
holds the uric-acid deposits, this form of gravel calls for the opposite
remedies. Instead of the alkalies, the acids are wanted. The nitric
and muriatic acids, with a vegetable tonic (Tfi), may be used. Borax
is spoken of in high terms, and is thourht by some to have great
power in turning alkaline urine acid. T e compound balsam of sul-
phur is highly spoken of, and the compouii infusion of trailing arbu-
tus is also mentioned with approbation.

It is all-important to throw off care, and to give the mind a chance
to rise up with all the elasticity it has. To bring this about, journeys
and amusements are useful. The society of lively, laughing, witty
friends will do a great deal to give the spirits a lebound, and the
whole health an upward movement. Such persons are a blessing to
th^ world ; and he who reckons a few of them among his friends will
live the longer for it.

The skin should have the benefit of the daily tonic effect of a
sponge-bath, with water at first tepid, and afterwards cool ; and exer-
cise, out of doors, should be habitual, and connected, as much as pos-
sible, with objects of pleasure.

The drinking of hard water is highly injurious ; and if none other
can be had, it should be distilled, and then spread out to the atmos-
phere, in shallow vessels, that it may recover its pleasant taste by
reabsorbing air and carbonic acid.

Oxalic Deposits.

. Oxalate of lime a\ the urine is the cause of this kind of gravel,
It appears in the form of dumb-bells, and octahedral crystals. (Figs.
119, 120, and 121.)

1 an aching

lility of the
ve assimila-
ier, and or-
B especially
f-y cares, de-
3ns, mastui-

eat debility,
iking active
irill increase

LI the means
f iron (75)
r irritability,
3 valerianate

I that which
the opposite

The nitric
sed. Borax

have great
[vlsam of sul-
railing arbu-

ind a chance
)ut, journeys
yhing, witty
nd, and the
blessing to
friends will

effect of a
1; and exer-
nuch as pos-

E none other
the atmos-
i,nt taste by

d of gravel.
T.h. (Figs.

DISEASES OF THE ABDOMINAL CAVITY.

351

The urine has a specific gravity of 1.015 to 1.025, and is genemlly
of a dark amber-color, and clear and bright ; it is generally acid,

Fio. iia

Fio. lao.

Fio. 121.

though occasionally alkaline or neutral. Urea is generally found in

it, and epithelial cells (Fig. 122). Unlike the

uric and phosphatic urines, it is quite free

from sediments, except, as often happens, there

is a large amount of urea in it, in connection

with the oxalate of lime.

When the urate of ammonia is combined with
the oxalate of lime, it often happens that the
latter has to be dissolved with a little liquor
potassa, before the former can be seen with the
microscope. *''*'• *^-

Symptoms. — Great depression of spirits, excitable state of the ner-
vous system, painful susceptibility to external impressions, dyspeptic
symptoms, and disturbances of the liver, a fear and dread of consump-
tion, emaciation, inability to make exertion, — the' smallest exertion
causing fatigue ; in men, a deficient sexual power, a pain and weight
across the loins, and some irritability of the bladder.

Causes. — These deposits are supposed to result, like most other
derangements connected with loss of flesh, in too great a degree of
oxidation. Vegetables produce oxalic acid by just the opposite pro-
cess, namely, deoxidation.

Whatever depresses the vital powers, may generate this deposit,
as mental depression, overwork of the brain, burdensome cares, idle-
ness of mind or body, masturbation, debaucheries, intemperance, vene-
real excesses, and injuries of the spine.

This deposit may also be produced by certain articles of diet, which
contain the oxalic acid. Among these may be named the rhubarb
plant, which in summer is largely used for tarts ; and sorrel.

Treatment. — The treatment for these deposits should be very
much like that for the phosphatic. The stomach and liver should
receive some special attention. A pill of leptandrin, podophyllin,
etc. (39), may be usvorl with advantage. The preparation of nitric
and hydrochloric acids (76) mu-^it generally be taken for some time.
In cases of great irr'tability, the sulphate of zinc (82) does well.

352

DISEASES OF THE ABDOMINAL CAVITY.

The diet should be plain, digestible, and nourishing, — all articles
containing oxalic aoid being rejected, as the rhubarb plant, sorrel,
tomatoes, onions, etc.

For the rest, folJow the directions for the treatment of phosphatic
deposits.

Urate of Ammonia Deposits.

The urine which contains these deposits is generally pale, and of
low specific gravity, about 1.012. It becomes opaque on cooling,
from the deposition of a nearly white urate of ammonia. Instead of
falling down readily, tliis forms ropy masses in the fluid, and looks
like mucus or pus, or something between the two. Its real nature is
discovered by applying a little heat, which quickly dissipates it.

Microscopic Character. — Place a drop of this turbid urine te-
tween two slips of glass, and examine it closely with a microscope ;
you will see myriads of minute globules adhering together in lirear
masses. Now place a drop of the turbid urine in a watch-glass, and
gently warm it ; as soon as it has become clear, add a drop of hydro-
chloric acid to it, and when it is cold, examine it with the microscope.
The muddiness will be gone, and you will now see lozenges, or thick
cohering prisms of uric acid (Fig. 123). The explanation of this is,
that the hydrochloric acid combines with the ammonia, forming muri-
ate of ammonia in solution, and liberating the uric-acid crystals.

FiQ. 12a

FIO. 124.

Urate of soda (Fig. 124) is sometimes found in urine, which has
similar chemical reactions with urate of ammonia.

Causes. — These deposits are generally produced by some over-
eating, or derangement of the skin.

The treatment is the same as that for uric-acid gravel.

Hippuric Acid Deposits.

These deposits appear in the healthy urine of the cow and the
horse ; and also in that of human beings, but in such small quanti-
ties as to be scarcely appreciable.

They sometimes, however, appear in unhealthy proportions ; but
they never show themselves as a sediment, until after the addition

-atasmaaCMMHaMH

■ all articles
>lant, Borrel,

phosphatic

pale, and of
on cooling,
Instead of
1, and looks
3al nature is
pates it.

id urine l)e-
microscope ;
er in lii;ear
sh-glass, and
op of hydro-
micro3coi)e.
ges, or thick
on of this is,
irming muri-
jrystals.

!, which has
some over-

ow and the
mall quanti-

)rtion8 ; but
he addition

DISEASES OF THE ABDOMINAL CAVITY.

85S

of a stronger acid. The urine containing them is generally slightly
acid or neutral, — sometimes alkaline, — having a low specific gravity,

from 1.006 to 1.008. The triple phosphates
are often found in it.

To detect these deposits, fill a large watch-
glass with urine, and evaporate it over a lamp
to a few drops. Then add to it about half
its* bulk of hydrochloric acid, and set it aside.
The addition of the acid produces a bright
pink color, and an odor like new hay. After
a few hours, if the hippuric acid be present, its
'*»• "»• peculiar crystals will be seen. (Fig. 126.)

Cause. — In man, this deposit is supposed to depend on the
absence of food having a good share of nitrogen. The urine of
vegetable-eaters contains it in largest quantities.

Treatment. — The only treatment required is a diet composed in
good proportion of animal food, a proper attention to the skin by
bathing, etc., and when debility exists, tonic medicines, as iron and
bittera, with out-aoor exercise enough to keep the muscles in working
order.

Cystine Deposits.

These do not occur in healthy urine, and rarely as an element in
diseased action. They contain twenty-six per cent of sulphur.

Urine which contains cystine is of a pale yellow color, and has a
low specific gravity. It frequently has an oily appearance, and its
smell is peculiar, resembling that of sweet brier. Sometimes its odor
is fetid, like putrid cabbage. On being kept for a short time, it has
its surface covered with a pellicle which looks oily, and consists of a
mixture of crystals of cystine and the phosphate of ammonia and
magnesia.

The cystine deposit appears to be diffused through the urine, which
is always turbid when boiled. It is a white or fawn-colored powder,
and falls to the bottom as a sediment. It undergoes no change by
warming the urine, and this distinguishes it from white urate of
ammonia. It is not soluble in diluted hydrochloric or strong acetic
acid, which distinguishes it again from the earthy phosphates.

To test this deposit, add liquor ammonia to a portion of it, and
shake them. If the deposit be cystine, it will dissolve readily. Allow
a few drops of the solution to evaporate on a slip of glass, and the
six-sided tablets of cjrstine will remain, which may be examined under
the microscope. (Fig. 126.)

It is to be remembered that occasionally the chloride of sodium or
common salt crystallizes in octahedral forms (Fig. 127), which, in
some positions, may look very much like cystine. The r-^ady solu-
bility of the chloride in water, and the absence of all color when they
are examined by polarized light, will prevent mistaking these crystals

I IH

354

DISEASES OF THE ABDOMINAL UAVITY.

for cystine. If urine containing common salt Ix' quickly evap«»mtod
on a slip of glacs, and be then examined, instead of the octahedrouH,
we find crosslets and daggers. (Fig. 128.)

no. 136.

FlQ. 127.

FlO. 128.

Cause«. — i\.n excess of sulphur in the tissues, a scrofulous consti-
tution, and hereditary predisposition, with defective oxidation, and
torpidity of the liver. It is often found in the urine of girls who
have the green sickness.

Treatment. — The great object is to improve the general health,
which is to be done by attending to the skin, and the administration
of iron and bitters, and also alteratives. The syrup of iodide of ij-on
is a valuable remedy. Podophyllin and leptandrin (34) are wanted
to regulate the liver. The nitro-muriatic acid (76) should be tried.

The daily sponge-bath, and daily exercise, as in most chronic com-
plaints, must on no account be neglected.-

Stone. — Calculus.

It often happens that the proper treatment for removing urinary
deposits is not adopted in season. In such cases, gravelly particles,
finding a lodgment for a time, in the kidneys or bladder, are apt to
draw other particles to themselves, which become fastened to them,
and form a layer quite around them. Over this, other layers form in
succession, until a stone is produced so large that it cannot pass off.
These grow to various sizes, — being sometimes so large as to fill the
bladder.

Uric-Acid Calculus. — The most common of these formations is the
uric-acid calculus. It is generally smooth or slightly tuberculated on
the surface, and varies in color from a pale yellowish-fawn to a red-
dish-brown. When sawn through the centre, its layers will be found
tolerably regular, but of different thickness. (Fig. 129.)

To test it, place a small fragment upon platinum foil under the
blow-pipe. If uric acid, it blackens, and gives out an odor like burnt
feathers mixed with the oil of bitter almonds.

Mixed Calculus. — These calculi are frequently composed of two
or more different kinds of matter arranged in irregular layers. Fig.
180 is a mixed calculus, — the dark layers being oxalate of lime, the
light ones uric acid.

mum

DI8KA8E8 OF THE ABDOMINAL CAVITY,

855

■ evapomtod
)ctahedronH,

•'la. 128.

iilous consti-
idation, and
of girls who

leral health,
[ministration
adide of ij-on
I are wanted
aid be tried,
jhronic com-

rmg urinary
ly particles,
, are apt to
ed to them,
yers form in
lot pass off.
as to iill the

In testing such, fragments of each ingredient should be separately
examined.

Urate of Ammonia Calculus. — We occasionally meet with a cal-
culus composed of the urate of ammonia. These calculi, whtn found,
are generally small in size, smooth or slightly tuberculated upon the
surface (Fig. 131), and of a pale slate or clay color. When heated
before the blowpipe, it gradually disappears.

FlQ. 129.

KlU. 130.

PlO. lUl.

Phosphate of Lime Calculus. — This has a smooth polished s'm-
face, and quite regular layers, which separate easily when the calculus
is cut asunder. It has a pale fawn or stone color. (Fig. 182.)

It chars before the blowpipe, and gradually becomes wliite as the
carbon burns away. Diluted nitric or hydrochloric acid dissolves it
without effervescence.

Oxalate of Lime Calculus. — ^ This is frequently met with uncom-
bined with others, but more generally its nucleus is uric acid or urate
of lime. It commonly has a brown, dark-olive, or dirty-purple color.
Its surface is irregular and somewhat rough. It looks like the fruit
of the mulberry, and is known as the mvlbenry calculus. (Fig. 138.)

It dissolves, without effervescence, in diluted nitric or hydrochloric
acid. When thus dissolved, the addition of a little ammonia will
cause it to fall to the bottom as a white precipitate.

lations is the
erculated on
wn to a red-
^ill be found

)

1 under the

or like burnt

osed of two
ayers. Fig.
of lime, the

FlO. 132.

FIO. 133.

FIO. 1S«.

Fusible Calculus. — This is a mixture of phosphate of lime and the
phosphate of ammonia and magnesia. It is the most common of
all the calculi, except the uric acid. It has an oval, irregular form
(Fig. 134), and is white, soft, and friable, like chalk. Sometimes it
is hard. '

It may be known by the readiness with which it melts down before
the blowpipe, without being consumed.

Causes. — The causes of the different kinds of gravel have been
already explained. Generally atones of the bladder are formed in the

366

DIBBASES OF THE ABDOMINAL CAVITY.

kidney, and descending through the uretere into the bladder, arc pr(>-
vented fi-om passing out through the water-pipe by an enhirged proH-
tate gland. Remaining in the bladder, they soon get encrusted over
by other matters in the nrine, and grow by ciccrotion to be stones.

Symptoms. — When a stone in the bladder reaches a certain size,
especially if it is rough, it always produces suffering. A dull, annoy-
ing pain is felt at the end of the penis. The desire to make water in
frequent, and there is a sense of weight in the perineum. Sometimes
the stream of urine is suddenly stopped by the stone falling on the
orifice of the urethra. As the bladder becomes nearly emptied, it
embraces the stone, and the pain is inci-eased. Jolting in a carriage
causes great pain. Mucus passes off with the urine, and sometimes
blood. After a time, the appetite fails, hectic sets in, albumen ap-
pears in the urine, and the patient sinks under inflammation of the
bladder.

These symptoms being found in diseases of the kidneys and blad-
der, no one is authorized to pronounce upon the existence of stone,
until the stone has been touched by a metallic sound introduced into
the bladder.

Treatment. — The only effectual treatment is a choice between
three operations, — lithotrity, lithotomy, litholopaxy.

The first consists in introducing an instrument, a kind of forceps,
into the bladder, through the urethra, taking hold of the stone, and
crushing it. The preparatory treatment consists in correcting the
unhealthy state of the urine, and the frequent introduction of bougies
or sounds to enlarge the water-pipe for the easy entrance of the
crushing forceps. The after treatment consists in diluent drinks to
increase the urine, injections of warm water to wash out the frag-
ments, with hip-baths, soothing injections, and leeches or cupping
upon the perineum.

Lithotomy consists in making an incision into the bladder through
the perineum, and taking out the stone or stones whole.

Litholopaxy consists in crushing the stone in ntu by means of the
lithotrite and syphoning out the debris.

Dropsy of the Belly. — Ascites.

This is a collection of water in the cavity of the belly ; sometimes
the fluid is outside of the peritoneum, and next to the muscles.

Symptoms. — An enlargement of the belly, with a sense of disten-
tion and weight, — particularly on the side on which the patient lies.
When the collection of water is large, .the breathing becomes short
and difficult, and the swelling is uniform over the whole abdomen.

In some instances the fluctuation of the water may be distinctly
heard when the patient moves about, — just as we may hear the
water in a half-filled barrel when it is rolled over. This sound of
the fluid, when heard, distinguishes the complaint from pregnancy.

DIBEASES OF THK ABDOMINAL CAVITY.

357

iiiid Ifom the drum-head state of the bowels. This fluctuation nmy
Hometimes be produced by pressing ujKjn one side of the belly while
the patient is standing or sitting, and striking the other side with the
ends of the fingers of the other hand.

In some citses, there is loss of appetite, dry skin, eostiveness, scanty
urine, oppression of tho chest, cough, colic pains, and variable pulse.

Causes. — A frequent cause of this complaint is chronic inflamma-
tion of the serous membrane which lines the abdomen, — I mean the
peritoneum. It may also be produced by scarlet fever, fever and
ague, disease of the heart, particularly dilation of the right cavities,
and diseases of the liver, particularly the shrivelled, hobnail condition
of the liver, — in short, whatever causes a pressure upon the portal
veins, and obstructs the venous blood returning fi-om the intestines.

Treatment. — The remedies for this disease are mainly diuretics
and purgatives. The IwweLs may sometimes be reduced in a few
days from an enormous size, by medicines which excite the action of
the kidneys. Digitalis combined with acetate of potash, etc. (130),
forms an excellent preparation. The patient should have as a con-
stant drink, a strong infusion made from two parts of hair-cap moss,
and one each of juniper berries and dwarf-elder bark ; also an infu-
sion of queen of the meadow.

The purgatives used in this complaint are those which produce
watery stools. One of the best of these is elaterium. It will some-
times carry off the water with great rapidity ; combined with some
active catliartics (31), it will have all its good effects without the
griping it is apt to occasion alone.

Cream of tartar, taken in large doses, every day, will sometimes do
wt 11. Epsom salts produces watery stools, and is a good remedy.

For promoting absorption of the fluid, the iodide of potassium,
taken in from three to ten-grain doses, three times a day, is a valua-
ble medicine in many cases. The compound infusion of parsley is
said to be still better.

The skin must receive careful attention. The alkaline sponge
bath, with friction, will increase the tianspiration of fluid through
that organ. Exercise does much to keep up an active circulaticm,
and to lessen dropsical effusions.

The strictest temperance, both in eating and drinking, must be
olwerved. A light and nourishing diet, with water, tea, and the
diuretics named above for drinks ; beyond these the patient must
not go.

A kneading and shampooing of the bowels once a day has an
excellent effect ; it gives activity to the circulation in obstructed
veins. A bandage tied close ai'ound the bowels, and tightened as
the water diminishes, has an effect upon the sluggish vessels similar
to that of the laced stocking in varicose veins of the legs. It lessens
the liability of a return of the complaint. *

358

IM.SKASKH OK THK AUDOMINAI. CAVITY.

Dropsy of the Cells. — General Dropsy. — Ananarra.

JuHT undcir tho Hkin in a ineniimino coinposed (^liiufly of colls,
called tho cellular inombraiie. When a ((mHideiablo part or tlio
whole of these celln are filled with a watery lluid, we call tho com-
plaint anaaarca, or cell-dropiiy. If, iMisideH this, there isi a eoUectiuii
of water in the large cavities, we give it tho name of general dropty.

Symptoms. — The dineaHe generally Iwgins with a swelling around
the ankle aiul leg, which is more visible at night after standing and
walking, and is less perceptible in the morning in consecjuence of
the horizontal position of the night. To tho touch of another person,
dropsical feet and legs feel a little colder than natural ; and when
hard pressed with the finger, a pit will be sunk ii: the flesh, which
remains some time before it fills u[). As tlie disease advances, the
skin of the legs becomes smooth, shining, and sometimes even cracks
open to let out the water. The limbs, and indeed tho whole person,
become stiff, heavy, and clumsy.

As the disease advances, and ascends to the belly and chest, there
is shortness of breath, a sense of suffocation on moving or lying
down, a tightness and distress across the epigastrium, thimt, dryness
of skin, wakefulness, loss of appetite, scanty and deep-colored urine,
and a slow fever.

Cause. — General dropsy is caused by whatever weakens the gen-
eral system, and by such circumstances as obstruct the circulation in
the veins. The most frequent causes, therefore, are certain diseases
of the heart and kidneys.

Explanation. — Modern physiology has demonstrated that the veins
do a certain part of the work of absorption. The serous membranes
which line the larger cavities of the body exhale watery fluid enough,
and no more than enough, to keep them moist, and cause the organs
within to play smoothly upon their surface. If the fluid were not
taken away as fast as it is poured out, the cavity, being a shut sac,
would become full, and we should have dropsy. It is the office of
the veins to absorb this fluid and convey it away in the general cur-
rent of the blood.

This is the method of their doing it : The walls oi the veins are
80 constructed as to permit watery fluids to pass through them, either
in or out. When they are comparatively empty, or only moderately
full, fluids on the outside pass in, and mingle with the contents.
This is called endosmosis. When they are very full, the watery
portion of the blood will filter through, and pass out. This is called
exosmosis.

Now, if the reader will thmk a little, he will easily see that if the
veins are bavaly full enough not to allow any fluid to pass in, the
natural exhalations of the shut sacs would bring on dropsy ; but if

- ' wwn. ' te'Xsfxt^.vi4stiMi i»t) B, sj^ ^gg0ggg0fij^ffgfii^^

l«

Hi II I'l

DlrtEAHRS OF THE ABDOMINAI, CAVITY.

369

I namrca.

y of coll8,
)art ur tlie

II tho coin-
i collection
tral dropmj.

iinfj around
niKling and
■»e(juenco of
;her person,
; and when
llcsh, which
IvanceH, the
even cracks
lole person,

chest, there
iig or lying
ii-st, dryness
lored urine,

ens the gen-
irculation in
ain diseases

lat the veins
membranes
uid enough,

the organs
id were not
a shut sac,
le office of
general cur-
ie veins are
them., either

modei-ately
le contents.

the watery
his is called

3 that if the
pa89 in, the
psy; but i?

the veins are ho full as to ciuse water U^ Jlau' out, then the dropsical
accumulalion will Ixi still more rapid.

Such being tlu! ollico arid nature of tho veins, the reader may
learn how di.raxr of the rii/ht aide of the heart will vn\i»o droi^y.
When the right ventriclo is 8o dilated and weakened that it cannot
send tho blood forward to the lungs, of course the veins which bring
it to the right nide of the heart, will become full, and greatly distended.
Dxosmosis will then occur; the watery portion of the blood will
iwgin to run out, either into the larife cavities, or into the cells, and
dropsy, either general of local, will be the result.

Treatment. — Tliis niu ' be goverened very much by the cause of
the disease.

In dropsy from disease Oi' the heart, we may use diuretics and
such otlier methods as are recommended for dropsy of the belly.
If the urine is strongly acid, depositing the brick-dust sediment,
the alkalin(! diuretics will »," the best, as the acetate and bicarbon-
ate of potash combined, and dissolved in water. The bitartrate of
potassa. to act upon the bowels, is a proper remedy. If the disease
arise from general debility, the following powder will be useful:
(ligitalin, three grains ; cinchonia, half a dram ; phosphate of iron,
half a dram ; and white sugar, one dram. Mix, and triturate ; divide
into sixteen powders, and give one, iu pumpkin-seed tea, four times
u day.

■^t:^

»'•■ I.

VENEREAL OR SEXUAL DISEASES.

Op all the diseases to which flesh is heir, none bring so much
misery, moral and physical, as those called sexual or venereal. To
the physician, they are the source of the greatest anxiety and per-
plexity. They bring him into possession of the most delicate secrets,
— secrets which involve the peace of families and neighborhoods, —
secrets which his honor as a man, and his truth as a physician, compel
him to lock fast in his own breast, and hold sacredly apart even from
his nearest companions, — se'' "^ets which, if revealed would fill domes-
tic circles with unuttemble bitterness and heartburning's, and whole
neighborhoods with scandsil and immorality. These secrets are often
a burden to him. They are in his breast like undigested food in the
stomach, — disturbing the whole nature.

The patient, if a man of sensibility, suffers even more, of course,
than his physician. In many cases, he is a man of virtuous inten-
tions, and perhaps of religious habits, who has fallen in a momtint of
temptation ; and he fears that the effect of his sin will spread itself
through his whole system, and extend to the end of life ; or, still
worse, that having poisoned the fountain of his life, it will go down
as a heritage of misery to his offspring ; or, what he would deprecate
as almost equally calamitous, that the partner of his bosom may be-
come the innocent partaker of his disease.

In this state of apprehension, he turns to his physician, not merely
to keep his secret, but to cure his disease. How great a pity that, in
such circumstances, he does not always fly immediately to an honor-
able physician, instead of seeking the advice, as many do, of those
miserable quacks, who l",i-e liim to their dens only to get his money,
having no intention or ability to cure his complaint.

These diseases are divided into two great branches, characterized,
in part, by different symptoms, and generally held to be entirely dif-
ferent complaints. The first to come under consideration is-

Pox. — Syphilis.

This disease had a very early origin. It was knf^wn among the
Jews, as we learn very clearly from the fifteenth chapter of Leviticus.
Dr. Adam Clarke's Commentary upon this chapter, at least, makes it
apparent. David, the king of Israel, has unconsciously left on record,
in the thirty-eighth Psalm, a most graphic description of Tertiary

860

E8.

80 much
jreal. To
jr and per-
kte secrets,
•rhoods, —
an, compel
even from
fill domes-
and whole
ts are often
[ood in the

of course,
lous inten-
moment of
iread itself
e ; or, still
1 go down
deprecate
m may be-
not merely
ity that, in
3 an honor-
o, of those
his money,

Uracterized,
ntirely dif-
iff

among the
Leviticus.

t, makes it
on record,

f Tertiary

VKNEREAL OR SEXUAL DISEASES.

361

Syphilis, experienced in liis own person. Dr. Clarke says : " It
most likely the Psalm was written in reference to some severe afflic-
tion that David had, after his illicit commerce with Bathsheha ; but
of what nature, we are left to conjecture from the third, fifth, and
seventh verses." The Psalm is dated not quite a year after the act
alluded to, — about the right time for the terrible symptoms David
describes to make their appearance.

The term syplulis is from a Greek word signifying filthy. There
is one unvarying sign of this disease, — the existence of an ulcer or
ulcei-s, usually upon the genital organs. The French call this ulcer a
chancre. The common name is simply vet sore, or ulcer. A

pimple first appears ; on the summit of this t ,tule forms ; then the
rupture of the top of this brings to view the ulcer or sore. This ulcer
is shallow, more or less circular or oval in form, bounded by a perpen-
dicular and slightly jagged border, and furnished with a smooth, yel-
low base, moistened by an unhealthy secretion. The skin around the
sore is a little thickened and inflamed. This is a simple venereal
ulcer. It generally lasts about five weeks, and tiien heals.

But it is not always thus simple. It may be an inflammatory
chancre, attended by excessive inflammation. It may be what is
CitUed a doiighing chancre, characterized by the perishing and falling
off of large parts of flesh. It may be gangrenous, or marked by a ten-
dency to mortification. It may be phagedenic, or eating, — being dis-
tinguished by a rapid loss of substance, or eating away of flesh. Or,
finally, it may be indurated, — being noted for the peculiar liardness
of the base, and of the flesh immediately around it.

A venereal sore is the result of impure connection with a person
having the syphilitic disease. The poisonous secretion of a sore,
applied to the skin of a healthy person, produces inocidation, and a
new sore upon the previously healthy person is the result. This
chancre appears in a few days after coition, — a certain time being
required for it to produce its effect, as in the application of vaccine
matter to the arm.

Bubo. — The next symptom in the order of occurrence, which fre-
quently follows the ulcer, is the bubo. It is named from a Greek
word which means groin, from its usually appearing in that part.
It is a painful swelling of the inguinal gland in the groin, and is
caused by the absorption of virus or poisonous matter from the
chancre. This gland is one of the lymphatics, a class of vessels as
numerous, all over the system, as the veins and arteries. They are
likewise called absorbents. Those that originate from the private
parts absorb the poison from a venereal sore, and convey it to the
glands in the groin, which being poisoned by it, inflame and swell.

The bubo generally appears in from one to two weeks from the
appearance of the ulcer. It is usually upon the same side which the
chancre occupies upon the penis. When the bubo advances to oup-
puration, and becomes an open sore, it is then a glandular chancre.

■4

t', I

362

VENEREAL OR SEXUAL DISEASES.

^^egfetations. — These are peculiar growths appearing upon differ-
ent parts of the skin, which resemble certain vegetables. They are
found most frequently, in the male, on the head of the penis, and on
the membrane lining the foreskin. In the female, they are- found at
the entrance to the vagina, and not infrequently in the vagina itself.
They sometimes appear on the neck of the uterus.

Primary Disease. — Thus far, the diseases noticed are what are
dalled primary. If properly treated, and cured in season, the consti-
tution is not infected, and no subsequent troubles appear. But a
result so fortunate as this is not common. Generally, the treatment
is either too long delayed, or is too brief and superficial. The poison
is, in consequence, absorbed into the circulation ; the whole con-
stitution becomes infected ; the fluids and solids are so acted on and
altered, in fact, that a special constitution is created. For this reason
the affections of the skin, the mucous membranes, the bones, etc.,
which follow, are called

Constitutional. — These constitutional diseases never appear im-
mediately, as the result of an impure connection, but only after those
affections already noticed. The primary diseases are local ; the con-
stitutional affections are general.

The first thing which strikes the eye in these constitutional com-
plaints is the color and appearance they give the skin. It has a red-
dish, coppery tinge, and a peculiarly dirty appearance.

The order in which the several parts are affected, are, first, the skin
and mucous membranes ; second, the hard substance surrounding the
bones, called periosteum, the tendons, and the bones themselves.
Those affections which appear upon the skin and mucous membrane
are usually called secondary, because they are the second to appear ;
while those affecting the bones, etc., are denominated tertiary, be-
cause, in the order of their appearance, they are in the third class.

Eruptions of tiie SIcin, and Ulcers. — Of the constitutional erup-
tions, there is a great variety, — so great that I cannot, in small space,
give a minute description of them. The breast and arms are not
infrequently the first to be affected. Attending these eruptions there
is little uneasiness, and no pain ; though there is sometimes a slight
itching. The first breaking out is usually of a copper color, some-
what paler than it subsequently is. The eruption is often in the
form of blotches, elevated only a very little above the skin. They
are composed of small pustules, ^vith a little fluid in them, which
soon dries away, and the whole may be rubbed off like bran. This
may leave the skin looking tolerably sound, and inspire the belief
that no further mischief is to be experienced. No hope can be more
delusive. Parts afflicted with this complaint show no tendency to heal.
The first crop of pimples is soon followed by a second, which pro-
duces a thicker crust, and yields a larger amount of bran. This
rubbed off, small ulcers appear underneath.

''•fmmamiomm

upon differ-
They are
snis, and on
,re- found at
agina itself.

re what are
, the consti-
jar. But a
B treatment
The poison
whole con-
cted on and
' this reason
bones, etc.,

' appear im-
j after those
al ; the con-

itional com-
't has a red-

irst, the skin
•ounding the

themselves.
3 membrane

to appear;

tertiary, be-
lird class.

itional erup-
small space,
:m8 are not
jtions there
nes a slight
color, some-
)ften in the
jkin. They
them, which
bran. This
e the belief
can be more
'Mcy to heal.
, which pro-
bran. This

VEKKREAL OR SEXUAL DISEASES.

363

Vesicular Uruptions. — There is another syphilitic affection of the
skin, which appears in the shape of vesicles, like small-pox. These
dry and leave a scab.

5caly Eruptions. — There is still another affection, which is in
the form of scales, and one scale will be piled upon another. It
begins with an eruption of copper-colored blotches, which become
covered with scales ; these are succeeded by scabs, and when these
full off, shallow ulcers are left with copper-colored edges. (Fig.
135.) This is a stubborn form.

Fig. 136.

Tubercular Eruptions. — la another variety of the disease, broad,
red, copper-colored tubercles, or hard elevations appear, most com-
monly about the sides of the nose, or on the cheeks. Gradually they
suppurate, and are succeeded by deep ulcers, terminating in scars.
This is an unfavorable form of the disease, and usually appc i-s some
considerable time after the primary symptoms, in persons whose con-
stitution has been shattered. Plate V.

This rather belongs to the tertiary form of the disease ; and in addi-
tion to the above, patches of unhealthy inflanunation are apt to form
on the tongue, and after a time break, disclosing ragged, orange-
colored ulcers. Plate VI. Fig. 2.

Many other forms of eruption exist ; but in a popular work like
this, it would be useless to make the nice distinctions which their
description would require.

Some of the worst forms of the secondary affections are found
upon the mucous membrane of the mouth and throat. These corres-
pond, in number and size, with the affections of the skin. They
affect the lips, the internal sides of the cheeks, the tongue, the tonsils,
the pharynx, the soft palate, the nasal cavities, etc. They are terribly
destructive in their effects, forming gaping ulcers, and eating deeply
into the parts. They often make shocking work in the whole mouth
and throat; and, when attended with considerable inflammation,
make it almost impossible to swallow anything, or even to open the
mouth. I have often seen breaches through the palatine arch (Plate
VI, Fig. 1), and even the whole arch destroyed (Plate VI, Fig. 2).
Persons have often died from starvation, — not being able to swallow.
The ulcers sometimes take hold of the tonsils, and "dig them out as
if it were done with a punch."

These ulcerations affect the imicous membranes of the genital
organs. In the female, they often affect the vagina and the neck
of the womb, and thus may exist for a long time, as the cause

364

VENEREAL OK SEXUAL DISEASES.

1 .1

of whites, without being suspected as such. They affect also
the mucous lining of the fundament and the large bowel. They
sometimes ex' ' in the ear, and more often in the eye. This latter
affection pai^ " ler the name of syphilitic iritis. In Plate V.
the artist ha; represented this form of constitutional disease in

the eye.

The disorder having, by frightful ulcers, run riot upon the delicate
structures of the skin and mucous membranes, advances boldly on-
wards, attacking the muscles, the tendons, the haid covering of the
bones and the solid bones themselves. No part of the human franie-

— not even the skeleton — can escape this devouring complaint.
The bones of the nose and face are generally the first to be attacked.
These perish slowly, — falling away piece by piece, — the nose, in
the mean time, sinking down nearer to a level with the cheeks.
From these parts the disease may spread to the bones of the whole
system.

These affections of the bones are attended by pains of almost
every kind and degree. These pains are sometimes fixed in one
place ; at other times wandering, the whole skeleton being painful.
In these latter cases, they seem to the sufferer to reach the very mar-
row. Sometimes when the pain is fixed in one place, the feeling is
such as might be supposed to be experienced if the bone were being
bored. These pains are most terrible during the night.

Upon those parts where the skin is near the bone, as the forehead,
or shin, syphilitic nodes or tumors often appear, which are hard, like
cancerous tumors. Besides the above, there are the loss of the hair
(alopecia), blindness, deafness, and various other mischiefs, resulting
from syphilis, which need not be described.

Is the Constitutional Disease Communicable ? — Many believe,

— even among those who are eminent in the profession — that the
constitutional forms of the disease are not communicable. A few
years ago, indeed, this latter opinion was generally received. It is
now quite extensively doubted, or rather disbelieved. Facts are con-
stantly occurring under the eye of unprejudiced physicians, which
make it very evident that the constitutional disease may be commu-
nicated from one person to another.

The Disease Hereditary — Xt is no small amount of suffering,
bodily and mental, which the individuals endure who contract this
disease. But the inflictions visited upon them, severe as they are,
are small compared with the aggregate of ills entailed by it upon
the long line of their posterity. Whether it be the man or the
woman whom the sphilitic virus has inoculated, if it be allowed to
be absorbed, so as to affect the constitution, it will be very likely to
be sent down to the children, and children's children. The divine
law which links the sins of the father with the sufferings of even the
third and fourth generation, is nowhere more painfvdly illustrated

'^!st;ssiaiti:tii9simm:giimm

affect also
vel. They
This latter
Plate V.
1 disease in

the delicate
3 boldly 011-
ring of the
iman frarae-
coraplaint.
36 attacked,
the nose, in
the cheeks.
I the whole

8 of almost
xed in one
ing painful,
tie very mar-
ie feeling is
5 were being

;he forehead,

re hard, like

of the hair

fs, resulting

any believe,
that the

,ble. A few
ived. It is
cts are con-

cians, which
be commu-

bf sr.ffering,
Contract this
I as they are,

by it upon
man or the

allowed to
[ery likely to

The divine

of even the
ly illustrated

VENEREAL OH SEXUAL DISEASES.

865

than in the scourging descent, through many generations, of this ter-
rible disease. It may be passed down to posterity by either of the
parents ; but if both be diseased, the transmission will be more cer-
tain. If the mother be infected, she will infect the child while car-
rying it. If the father's constitution be poisoned, the child will
receive the infection from him, through the semen, and will be
likely, while in the womb, to infect the mother. I recollect but one
author of note (Ramsbotham) who has mentioned this mode of in-
fection. I have myself seen two cases of it.

This constitutional disease, whether it exist in the mother, or be
communicated to the child, and thence to her, by an infected father,
is a frequent cause of abortion. Throughout nature, blight is the re-
sult of a diseased parentage. Mature fruit is seldom obtained from
infected seed.

Is the Constitutional Disease Curable ? — No question connected
with the complaint possesses a greater interest than this. None is
pressed more earnestly upon the physician. In a certain sense the
disease i« curable. Its outward manifestation may be wholly re-
pressed. The health of the person suffering from it may be restored,
and become, in an important sense, good. But this cure ia iiever
brought about by nature ; it may he, and ia often effected by medicine.
I have never failed to effect such a cure in any case which has come
under my treatment. Such results may properly, in general terms,
be called cured.

Yet there is a sense in which a cure never occurs. It is a well-
attested fact, that a system once thoroughly pervaded by the poison
is never completely purged of it. It may be shorn of all its active
malignancies ; but it has too intimately permeated the tissues and
solid bones to bo wholly expelled. Pursue it as we will with the
remedial forces of our art, it still takes refuge in the most subtle pro-
cesses of animal life, — still infects the currents of being, and finds
expression in the scrofula, in the lupus, and in the scaly affections of
other generations. Dr. Erasmus Wilson, the great authority in skin
diseases, says : " I feel convinced that a considerable proportion of
those diseases which pass under the name of scrofula are the produce
of the syphilitic poison, — are, in fact, not scrofulous, but syphilitic."
Astruc thought the same, and suggested, what is doubtless true, that
the transmission of syphilis must occur through several generations
before it becomes scrofula. Bierchn, Campor, Stoll, Portal, Hufeland,
and Alibert, have all advocated the same opinion.

This is doubtless right, though there are many authorities on the
other side. He must be a poor observer who cannot discover a prob-
able filial relationship of scrofula to s\nphilis.

A variety of facts, admitted by the vvrhole profession, go far towards
<lemonstrating this relationship. Scofula is always herediiiuy. It
is a disease of the parent, imparted to the offspring. But there is
scarcely any disease so certainly sent dov/n to posterity as syphJiis.

■%-

866

VEMEBBAL OR SEXUAL DISEASES.

Scrofula is like syphilis in many of its characteristics. It is like it
in its power of propagating itself from parent to child. It is like it in
affecting nearly all the children of disesised parents. It is like it in
the variety of the structures it attacks,' — affecting the skin, tho
mucous membranes, the bones, etc. Like syphilis it produces hard
tumors, ulcefs of the skin, abscesses, and decaying of the bones.
And finally, the great remedy for tertiary syphilis, iodide of potas-
sium, is likewise the great remedy for scrofula; and, indeed, almost
every remedy which acts favorably upon one, is found useful for the
other. This could hardly occur were not the diseases identical in
nature.

We can scarcely be surprised tliat a disettse so widely diffused as
scrofula should be the product of syphilis, when we reflect how fright-
fully prevalent were the causes of this latter affection during the
earlier and the middle ages of the world.

To pass over the records of earlier times, with merely mentioning
Abraham, and Lot, and Jacob, and Reuben, and Samson, and David,
and Solomon, and numerous females, of whom some singular things
Are written in the older scriptures, and omitting all mention of the
incredible and almost universal debauchery and prostitution of
Greece, and Rdme, and Persia, and Media, and Egypt, I may say that
Europe, in the middle ages, wag well-nigh converted into a vast brothel.

Foremost in the race of profligacy were those in authority, kings,
and emperors. The licentiousness of Childeric knew no bounds. He
carried ofl' and violated the wives and daughters of his vassals, with-
out regard to any right, human or divine. His successors were gen-
erally a race of lecherous men, who spread debauchery on every hand.
The French monarchs, from Pepin and Charlemagne, were a race of
debauchees. Their coui-ts were national brothels, in which the finest
women in the land were trained in the arts of seduction and lust.
Francis I, in 1516, endeavored to invest prostitution with elegance
and chivalry, and even to ennoble it, by abandoning the public
women of the palace to his subaltern officers, and substituting for
them ladies of noble blood. In this movement, the nobles and the
officers gave the king their support.

* ' ' They are all gone aside ; they are altogether become

filthy; there is none that doeth good, no, not one."

Brantome justifies Francis in his selection of girls of noble blood,
on the ground that " they could not communicate the venereal dis-
ease to the noblemen of the courts, like the common prostitutes."
But the king, who was previously diseased, infected them; and these
noble women, so called, passing from the arms of the prince to those
of the courtiers, presented to them the fatal infection received from
the king.

The way in which Francis himself was infected illustrates, in a
most shocking manner, the morals of the times. His illicit loves with

&i 'Tr,ni»f«! lH« Mlil(i|iin|f li ll i i l t Mi i i

VENKRKAL OK SEXUAL UI8EASEH.

367

It is like it
iH like it in

is like it in
e skin, the
)duce8 hard

the bones,
le of potiis-
leed, almoHt
leful for tlie
identical in

diffused as

. how f right-

during the

mentioning
and David,
fular things
ition of the
Jtitution of
nay say that
vast brothel.
ority, kings,
ounds. He
assals, with-
8 were gen-
every hand.
re a race of
the finest
[1 and lust.
;h elegance
the public
ituting for
es and the

3me

oble blood,
mereal dis-
rostitutes."
and these
ice to those
eived from

trates, in a
i loves with

tlu! Bello FerroniiNro wore not concealed from her huKband, who,
tlidUgh obliged oiitwaitlly to regard the dalliiince of hia wife with
the monarch as an honor, was inwardly indignant, and determined
to become infected himself, and thus disease his wife, and revenge
himself upon the king. This plan was suggested to him by a noble
who had another motive, namely, that of punishing Francis for some
pei-sonal spite. " How," said the husband, when tlie suggestion was
made, " shall I give tliis disease to my wife, when we are both
Hound?" " (ro visit an infected girl," said the noble, "and to ren-
der the matter certain, as I am infected, I will see your unfaithful
wife." The result was such as the husband desired ; and in l/)47,
FniiKUS I, the gay and chivalric monarch, perished of the most foul
and loathsome of all diseases.

Debauchery did not die with him. It was cherished by his succes-
sor, Charles IX, and his mother, Catherine de Medicis, and bis grand-
son, Henry III. The reigns of Henry IV, Louis XIII, Louis XIV,
the Regency, and of Louis XV, were stained by the same licentious-
ness and disregard of public decency, until the wliirlwind of the revo-
lution came to purify the moral atmosphere.

The reader will now, I think, be in no mood to wonder that the
men and women, and many of royal progeny, whether the dishonored
occupants of thrones, or the more private recipients of the public
bounty, are a scrofulous and degenerating race. Nor need it be
much wondered at, that so large a portion of men and women every-
where have more or less scrofula in their frames. Happy are those
who can find no trace of this complaint in their constitution 1 They
should rise up and call their virtuous progenitors blessed. They
should especially thank God that they have sprung from the loins of
a race more noble and kingly in the eyes of Heaven than all the
••oyal lines of the world.

Treatment of Syphilis. — In the treatment of this disease, the first
tiling which requires attention is the pimple, pustule, or sore. This
must be instantly touched with caustic. There should be no delay,
for if the sore be not syjihilitic, the caustic will do no harm ; and if
it be, the most terrible results may be averted. The general belief is
that poison remains in the sore for a time before it is absorbed into
the constitution. It is of the utmost importance that it be destroyed
Itefore the ab.-iorption takes place.

The caustics used are nitrate of silver (stick nitrate), nitric acid,
cliloride of zinc, potassa with lime, caustic potassa, and the painle.ss
(!austic.

The nitrate of silver is much used, but the best surgeons now re-
gard it as useless. It does not prevent the absorption of the poison.
The caustic potassa, the potassa with lime, and the painless caustic,
are the sure remedies, — that is, if applied in season. But they must
be employed with caution. It will not do to trust them in bungling
hands. A little vinegar and water must be immediately used to neu-

■m>

368

VKNKKKAL OK SEXUAL DISEA8K8.

J
i

trolize the caustic when it has accomplished what we desire. After
the sore is cauterized, a piece of lint, dipped in a Holutioii of watery
extatict of opium, one dram to four ounces, should Ih) laid on it; and
the organ enveloped in another piece of lint soakt'd in tepid water,
and covered in oiled silk. The patient should remain at rest as much
as possihle, keeping the penis elevated, and repeating the opium
dressing tt) the wound, and the water dressing to the whole organ,
night and morning. In addition, the patient should take two pills
(19), to be followed, night and morning, for three or four days, with
a tablespoon! ul of (20). In some cases, a piece of lint, wet with the
tincture of muriate of iron, diluted and kept upon the chancre, will
cause it to heal kindly, and with safety to the patient.

If this treatment be adopted early and properly, the patient is
cured, and nothing further needed. But time is generally lost. The
poison is alworlKjd before the patient is seen by the physician ; and
the question then is, how it is to be driven out.

To accomplish this, the diet should be regular and unstimulatiiig;
alcoholic drinks and tobacco should be forbidden ; the mind should
be ke^>t at rest ; a cold or tepid bath should be taken daily ; the ac-
tion of the bowels and kidneys should be kept properly regulated.
These things will put all the expelling agencies in proper condition
for work ; and no single medicine will put them all into action like
mercury. For this reason, no other single drug has enjoyed a repu-
tation for curing pox so wide as this.

But it must be used with judgment. No remedy is more safe, if
judiciously employed, or more destructive, if abused. The profuse
and ill-considered way in which it was used in former times, raised a
prejudice against it which is un reasonably cherished at the present
day. Abuse made mercury a curse ; judicious use makes it a blessing,
— at least in this disease.

The blue pill is one of the best forms of it (148), combined with
extract of henbane. One pill at night is the usual amount to he
taken. Some prefer the mercury with chalk (149) ; others, the corro-
sive sublimate (160) ; others, the proto-iodide of mercury (136).
Some one of these should be given about five days, in the doses named
under the recipes, — being careful not to produce salivation. After
the fourth or fifth day we can generally increase the frequency of the
dose. Should salivation be accidentally induced, it should be arrested
by a solution of chlorinated soda (205), one part to twelve of water.
The mercurial treatment should continue for two years after the sore
has disa^^^icared; after this prolonged treatment iodide of potassium is
used for another year in as lurge doses as the patient can take with-
out producing ill effects. At the expiration of two years, if the
patient has taken his medicine regularly, he may be considered cured,
at all events, sufficiently so to marry and have children.

Water should be taken freely, and various diluent drinks. They
wash the poison out through the millions of avenues, called pores,
just as we wsish filth out of cities by pouring water into the sewers.

flesire. After
tion of watery
aid on it; and
11 tepid water,
it rest as niucli
ng the opium
whole organ,
take two pills
our days, with
t, wet with the
) chancre, will

the patient is
illy lost. The
hysician ; and

instimulatinfr;
mind should
daily ; the ac-
)rly regulated,
oper condition
nto action like
ijoyed a repu-

i more safe, if
The profuse
times, raised a
it the present
is it a blessing,

;ombined with
amount to he
iiers, the corro-
orcury (136).
.e doses named
nation. After
squencyof the
lid be arrested
elve of water.
i after the sore
»f potassium is
3an take with-
years, if the
isidered cured,
1.

irinks. They
, called pores,
;o the sewers.

t^mm

a»Wi!,«--rfe^-cr.^-iSis.-iy;'titfe,;j$BtjgESWi^

YKi'tKUKAL OR 8BXUAL UIHKASU.

M»

I should mention that there are those who claim to cure the disease
with other remedies, without mercury, and I am not disposed to be
dogn.itical, and say it cannot be done. F'or tliis purpose, perhaps as
good a recipe as has been proposed is the compound syrup of stillin-
gia, tincture of poke-root, tincture of sheep-laurel, each four ounces,
mixed ; of which, from a teuspoonf ul to half a tablespoonf ul is to be
tiiicen three times a day. I think well of this remedy, especially if it
Ih) in connection with a small amount of mercury. If stillingia be
used, obtain McDade's stillingia comp., 1 dram three times daily.

The Bubo, if not attended with pain, may be treated with com-
pression, by a piece of plaster of ammoniac with mercury, or by
touching it with nitrate of silver. Should there be inflammation,
iiiid the formation of matter bo inevitable, the br bo should be opened
by touching it w'*,h the caustio potassa ; and thj resulting sore must
be treated with the solution of opium and water dressing. Should
the sore need stimiilating, it may be touched lightly with nitrate of
Hilver.

Eruptions upon the 5kin. — In treating the disease after it appears
upon the skin, etc., we shall derive great advantage from the use of
either the warm or the vapor bath once a day. With this, if the case
bo not very old, we may employ (148) or (150) ; but if the disease
be an old one, showing itself in the throat, or attacking the bones of
tiie face, we must give iodide of. potassium (188), combined with
compound decoction of sarsaparilla. This i& the great remedy for
tertiary syphilis ; but when the case is obstinate, it may sometimes
be discontinued, and the corrosive sublimate (139) be subotituted
for it.

It is to be observed that the older the disease grows, and the more
chronic its character, the more does mercury lose its control of it. In
the first attack, the blue pill is the best ; in the second, as a general
thing, the iodide or the biniodide of mercury : in the third, the cor-
rosive sublimate ; in the attacks subsequent to this, particularly in
the tertiary form of the disease, the iodide of potassium. When the
throat and nose are so ulcerated as to make a case absolutely terrible
to contemplate, it is surprising to see how rapidly the recovery will
often take place under the influence of this latter remedy.

For syphilitic iritis, apply frictions twice a day on the eyelids and
oyebrows with ointment (1T2), (173) ; and administer internally two
pills of (186) daily.

Clap, — Gonorrhoea. — Blenorrhagia.

The reader is aware that the nose, mouth, and lungs are lined
with a mucous membrane, which is liable to become inflamed from
\ iirious causes. This inflammation we call a cold or catarrh. During
its continuance, mucus and other matters, of different colors and
degrees of consistency, are more or less freely discharged.

•

■,j

870.

YEKSBEAL OR SEXUAL DISEASE&

The mucous membrane of the private parts of both sexes is just
like that of the mouth and throat, and subject to similar inflamma-
tions and discharges. But these inflammations of the private parts,
instead of being produced by change of weather, etc., generally result
from the application of tie specific poison or germ-microbe of
gonorrhoea. When r woman abandons herself to unlimited inter-
course with different men, the private parts become stimulated to so
unnatural an extent, that the secretions of the parts, which are largely
augmented, at length become altered in their nature, acrid, and finally
poisonous, — 80 acrid and poisonous that they cause inflammation of
the parts, and when brought in contact with the male organ, in the
sexual act, they poison and inflame that. The specific germ of
gonorrhoea is called the gonnococcus.

This is the shortest and plainest explanation I can give of clap.
From this explanation, one may learn why a man will sometimes take
a disease from a woman who has never had any evidenct of being
diseased herself. If she have indulged her sexual propensities un-
reasonably, though not enough to produce inflammation upon herself,
her secretions may yet have become acrid enough to poison one whose
organs are delicate and sensitive. And more than this, — the secre-
tions of a female may become acrid and poisonous from other causes
than excessive venery. The discharges in bad cases of whites will
sometimes irritate and inflame the male organ, and induce a disease
which has every appearance of gonorrhoea. A husband, in great
distress of mind, sometimes submits a case of this sort to the phy-
sician's inspection, and lays upon him the delicate and responsible
duty of deciding whether the wife has been unfaithful. No act in a
whole professional life can be more momentous than a decision of this
sort. If a man be well skilled in his art, he may give an answer in
Buch case, which shall dispel the most terrible apprehensions, and
save the peace of a loving family.

The poison, when communicated by a diseased person to the male
or female organs, requires a certain time for the germs to produce
their peculiar effect, — generally from three to eight days.

Symptoms. — The first symptom of the disease is uneasiness in the
end of the penis, accompanied, generally, with a little redness, and
diflBculty in passing water. The color of the first discharge may be
white or straw-colored. There is tenderness where the parts are red.
Scalding in passing water is sometimes, not always, present at fii-st.

This is the beginning, or first sfcige of clap. Now is the time to
cure it easily. But, unfortunately, the physician seldom sees a case
in this early stage. Before he is allowed to inspect it, the second
stage has generally appeared, which is known by violent scalding
when water is passed, by chordee, or painful erections of the penis,
and by an increased discharge of greenish matter often tinged with
blood, and coming from much farther down the urethra, or water-
pajsage. The matter sometimes comes from as far down as opposite

- ■>vvii'**fteifp

'-sMiMfiBaaNH

ii^HeSMMMB^',

exes is just
tr inflamma-
rivate parts,
erally result
-microbe of
naited inter-
ulated to so
h are largely
[, and finally
tmmation of
rgan, in the
fie germ of

ive of clap,
letimes take
Cfc of being
tensities un-
pen herself,
a one whose
— the secre-
)ther causes
whites will
ce a disease
d, in great
tx) the phy-
responsible
No act in a
ision of this
1 answer in
nsions, and

to the male
to produce

iness in the
edness, and
rge may be
jrts are red.
at at fii-st.
the time to
sees a case
the second
at scalding
the penis,
dnged with
I, or water-
as opposite

VENEREAL OR SEXUAL DISEASES.

371

the scrotum, or bag which holds the testicles. There is more or less
pain the loins and back. The whole body of the penis may become
affected, and abscesses form.

A third and more tenible stage of the disease begins when the in-
fl".mmation has reached the lowest part of tho water-passage, just
where it enters the bladder. Around this part of the passage, and
lying upon the bladder, is a gland in size and shape like the largest
chestnut. It is called the prostate gland. On either side of it lie the
receptacles of the semen, each of which sends its duct into the water-
piissage. When the inflammation extends through this gland, it irri-
tates the neck of the bladder, and causes a distressing desire to pass
water ; and from its proximity to the larger bowel, it sends its irrita-
tion thither likewise, and impels a terrible effort to evacuate the
bowels, called tenesmus. It is the same awful feeling experienced in
dysentery. Few things can be more terrible than these two distress-
ing feelings conjoined, — the desire to pass water and to empty the
bowels. Racked with terrible pains and awful tenesmic distresses,
and often with painful erections, the patient passes back and foi-th
between the bed and stool, — often vowing in the sincerity of his
heart, that if he can but recover from this, he will never be caught
again. The enlargement of the prostate gland may become chronic
and permanent, and be the affliction of a man's life.

Stricture. — One of the most troublesome and persistent conse-
quences of gonorrhoea is a partial closing up of the water-pipe, at-
tended generally by quite a serious obstruction to the passage of the
water. It is called stricture. The mucous membrane which lines
this passage, being long inflamed, becomes thickened and l6ss pliable
or elastic. The tissues which lie underneath this membrane also
become swollen and hardened, and, pressing upon the water-passage,
lessen it still further, making the stricture more difficult of cure.

In stricture, the stream of urine is altered in size, length, and force.
Its course is changed, when the stricture is lateral. The stream is
often flattened, like the blade of a pen-knife, or twisted like a gimlet,
or forked, one stream reaching beyond the other. In consequence
of obstruction, the bladder is not entirely emptied, and the desire to
urinate immediately returns, and is very urgent.

Qleet. — Another veiy troublesome result of gonorrhoea is gleet, —
a thin, colorless discharge, which persists, in a chronic form, after all
active inflammation has subsided. It is very annoying, and very ob-
stinate. It is often dependent on the altered conuidon of the mucous
membrane occasioned by stricture.

Orchitis. — Another very severe result of clap is swelling of the
testicles, called or'ihitis. . It begins frequently with chills and fever,
with a feeling of weight in the scrotum, and pains in the loins. The
swelling rapidly increases, and reaches its height in ham three to five

days.

III

^iamitSmUmmm

iSRx

372

VXNEBEAL OR SEXUAL DISEASES.

Besides the above, there are still other mischiefs which follow this
disease, such as inflammation of the prostate gland, already described,
of the bladder, and of the kidneys.

In the female gonorrhoeal inflammation affects the external geni-
tals called the vulvae, the water-pipe, the vagina, and the neck of tlie
womb, and often plays havoc with the ovaries and Fallopian tubes. In
women the disease is often fatal by ascending the tubes and penetrat-
ing to the abdomen, where an acute peritonitis is set up, with the
formation of pus.

There is a difference of opinion as to whether gonorrhoea ever pro-
duces secondary or constitutional symptoms. Ricord, the great
French authority on this subject, aflBrms, and with him a great num-
ber of followers, including most of the profession in this country,
that constitutional symptoms never follow clap ; that they never re-
sult from anything but a »yphilitio ulcer. Vidal, a French authority,
safer, in my judgment, than Ricord, though not as renowned, says, on
the contrary, that secondary and tertiary complaints do follow viru-
lent gonorrhoea. Wilson, the highest English authority, and many
others, agree with him. Unprejudiced observers feel well convinced
that this latter opinion is right. I have myself seen not less than
half a dozen cases of secondary and tertiary syphilis, which were
preceded by gonorrhoea, and nothing more.

Treatment. — In the first stage of the disease, there are two meth-
ods of treatment, either of which may be adopted with success. The
first, which has many advocates, is the local treatment. An injection,
with a glass syringe, is immediately made, of a solution of nitrate of
silver, of tho strength of five to ten grains to the ounce of water. It
should be retained from one to five minutes, by pressing the head of
the penis between the thumb and finger. If done before the third
day, this will generally cure the disease.

The physician should have entire control of the patient, and com-
pel him, if possible, to keep his room, and live for a few days on
crackers and water, or something equally simple. All meats and
stimulating drinks are to be excluded.

The other mode of treatment, which is perhaps the more commonly
adopted, is more general in its nature. It embraces the use of warm
baths, warm sweating drinks, and rest. If the patient is full of blood,
and strong, from five to fifteen leeches are applied to the space be-
tween the scrotum and fundament. These things, with a low diet,
will frequently reduce the disease in a few days. If the discharge
should continue, after a fair trial of the above, then copaiba and
cubebs (272) q,re to be used. Several articles are added in the above
prescription, to make the copaiba acceptable to the stomach. This
preparation can be taken by most persons, and generally produces
very gratifying results. Vidal strongly recommends an electuary, or
thick paste (278), of which a piece twice as large as a nutmeg is to
be taken in the course of the day. The prescriptions which contain

- -•"•"~'T-"'°°iiftj|ifiitffTrr"

h follow this
dy described,

sternal geni-
B neck of tlie
in tubes. In
and penetrat-
up, with the

loea ever pro-
d, the great
a great num-
this country,
bey never re-
ich authority,
vned, says, on

I follow viru-
cy, and many
ell convinced
lot less than
, which were

ire two meth-
uccess. The
An injection,
of nitrate of
of water. It
r the head of
)re the third

mt, and corn-
few days on

II meats and

ire commonly

use of warm

full of blood,

ihe space be-

;h a low diet,

he discharge

copaiba and

in the above

mach. This

illy produces

electuary, or

lutmeg is to

'•hich contain

VENERBAL OR SEXUAL DISEASES.

373

copaiba and cubebs are numerous ; but the above two are as good as
ii hundred. With these articles, the baths, the leeches, and the re-
pose, are to be united.

Vidal says he never resorts to injections fn-st, but employs the anti-
inflammatory course Hist. If that fail, then he uses the injection
(207), three or four times a day ; and if he employs the nitrate of
silver at all, it is only as an astringent (208). Prescription (304)
is a valuable injection.

When the second stage sets in, and the symptoms become more
violent, injections must not be used. For the very severe scalding in
passing water, which is now felt, take thirty drops of a solution of
potassa in half a tumblerful of water, twice or three times a day.
Persons of full habit, may be benefited by dissolving a grain or two
of tartar emetic in a tumbler of water, and taking to the extent of
producing a little nausea. Relief is occasionally obtained by holding
the penis for some time in warm water.

For the painful chordee, or erections, camphor and opium (120) ar*-
required, — from one to three pills a day. Thirty drops of laudanum
may be given when the patient retires. Cold applications to the gen-
ital organs, or walking barefooted upon the cold floor, will frequently
give relief. When other things fail, three pills a day may be taken
of extract of hyoscyamus, containing from one to four grains each.
The quantity of cVrinks must be diminished, and cold lotions must be
applied to the penis on going to bed, — the patient covering himself
lightly.

Qleet is generally very obstinate, and often requires a very pro-
tracted treatment. If there be any tenderness along the under side
of the penis, it is well to apply three or four leechet. Occasionally
recipe (272) will have an excellent effect. But gleet is an unhealthy
action, sustained by habit, and may often be cured by simply exciting
a new action which shall break the old habit. It is alwa}'s well,
therefore, to resort to injections. Sugar of lead and sulphate of zinc
(207) answer a good purpose ; or sulphate of zinc and tonnin (209)
may be tried. Chloride of zinc (210), does well in some obstinate
cases.

But gleet is often dependent on stricture, and when this is the case,
we must learn the location of it by exploring the water-pipe with a
bougie. When the instrument reaches the constricted part, the pa-
tient feels pain, or the surgeon meets an obstruction, — often both.
When the stricture is found, it is either to have the solid nitrate of
silver applied to it with an instrument called the parte cauatique, or a
solution of nitrate of silver (211), or of acid nitrate of mercury
(226), with a shower-syringe. When these means fail, we must pass
a small bougie gently through the stricture ; then a larger, and then
a still larger one, until the obstruction be removed. They should be
used once or twice a day, and not be retained long in the passage.
They frequently have to be used ten or twelve weeks, and should

374

VENEREAL OR SEXUAL DISEASES.

not be discontinued till the cure is complete. Put no confidence in
those quacks who promise to cure these old troubles in a few da}s.
They want your money, but have no expectation or ability to cure
you at all.

For inflar'nation of the testicles, apply leeches at once. To this
should be ai led warm fomentations and poultices. If these means
fail, more serious measures are to be adopted, which it would be oul
of place to describe in this book.

Inflammation of the prostate gland is also to be treated with
leeches and poultices ; likewise a warm hip-bath. The water must
be drawn off with a catheter until it can be passed in the natural
way.

Prevention of Sexual Diseases. — I have several times been in
doubt as to the best method of presenting some of the topics which
the wide scope of this book has brought before me ; but no one sub-
ject has perplexed me like the one announced in the above head-
ing, — not that it is not easy enough to furnish the rules for
preventing venereal disease, but that it is a grave question in morals
whether to instruct the world in the methods of such prevention is
right. Is it proper to give any other advice than the simple direction
to abstain from all liability to disease ? That is the question.

If such advice would be heeded, of course no other should be
given. But it would not. If the person disregarding it would alone
suffer the penalty of the transgression, it might then be best to em-
body the whole advice in the simple imperative word, abstain ! But
this cannot be. The infection will be imparted to a third person, and
onward to thousands ; and many of these thousands will be innocent
wives, who will perish of the disease, or send the infection down to
the second, the third, the fourth, and to all generations ! While a
strict morality might seem, therefore, at first view, to forbid the in-
culcation of rules for avoiding infection, the good of the race would
appear to justify and lequire it.

The first requisite for prevention is cleanliness. Frequent washing
is of prime importance.

The precautions should not be the same before and after the vene-
real act, when a person is about to expose himself to risk. Before
the act, the parts should be carefully examined to see if there be any
break in the skin. The least breach in this covering of the penis
greatly promotes contagion. Before coition, there should be no wash-
ing with soap, for this deprives the parts of the mucus and oil, —
thus rendering the naked and exposed skin liable to infection. On
the contrary, to apply a solution of alum, tannin, or a decoction of
oak-bark, or aromatic wine, constringes or hardens the covering of the
organ, and rendere contagion more difficult. An article called con-
dom is often used to ward off disease. It is a sack made of gold-
beater's skin, and is drawn over the penis like a glove over the finger,
and thus protects it from contact with poisonous matter.

^^><*^jfm^^Mi'^^^^memi^mismi^mmtm^mvmpm,-.-.

iifidence in
. few days,
lity to cure

!. To this
lese means
)uld be out

eated with
ivater must
the natural

les been in
)pic8 which
no one sub-
tbove head-
i rules for
n in morals
■evention is
)le direction
stion.

• should be
would alone
best to em-
dain ! But
peraon, and
be innocent
3n down to
While a
■bid the in-
race would

jnt wflhing

sr the vene-
3k. Before
[here be any

the penis
I be no wash-
and oil,—
tction. On
lecoction of
jring of the
I called con-
Ide of gold-

the finger,

VENEREAL OB SEXUAL DISEASES.

375

Of still greater importance are prompt measures of prevention
nftp.r the act. Lotions should be immediately applied to every part
of the organ, and in the case of females, should be used as injections.
These lotions should be acids or alkalies. A mixture of vinegar and
water has been recommended as an excellent wash. Ricord recom-
mends aromatic wine; Malapert, corrosive sublimate (212), in the
form of solution. Probably the best preventive is composed mainly
of alcohol and soap (213), as recommended by Langlebert.

An exposed person, using any one of these solutions, particularly
the last, or, in the absence of all these, washing thoroughly with soap
and water, will be likely to escape contagion.

Medical Police. — What is called general prophylaxis, or preven-
tion, or medical police, is not a subject of legislation in this country.
The moral sense of the American people does not admit its necessity.
In Europe, the authorities watch over prostitution. They even go so
far as to regulate it. They appoint practitioner, whose duty it is to
act as a sort of medical police, and particularly to visit houses of
prostitution once or twice a week, and examine all the inmates.
When a girl is found diseased, she is immediately removed to a hos-
pital, and not permitted to return until she is well.

5elf-Pollution. — Masturbation.

There is probably no vice to which so many boys and young men,
and even girls and young women, are addicted, and from which so
many constitutions break down, as self-pollution. Small boys and
girls learn the vile practice of the larger ones at school, and generally
continue it up to maturity, without the least suspicion that they are
inflicting upon themselves either a moral or a physical injury.

This comes of the false modesty and bastard morality which with-
holds from the young all knowledge of the proper functions of their
sexual organs, and of the inconceivable mischief resulting from their
abuse. A gentleman of distinction lately said to me : "I instruct my
boys as faithfully on this subject as upon any other moral or physical
question, and I tell my wife it is her duty to do the same with the
girls." This is wise. Yet, how few parents ever speak to their boys
or girls on the subject, to give them the least reason to suppose there
is any better rule for their conduct than their own desires I

Symptoms. — These are very numerous. The principal are, head-
ache, wakefulness, restless nights, indolence, indisposition to study,
melancholy, despondency, forgetfuluess, weakness in the back and
private organs, a lack of confidence in one's own abilities, cowardice,
inability to look another full in the face, and, among females, hyster-
ics, wliites, and a desire for seclusion from society and solitude.

I have already spoken of the receptacles of semen, lying on each
side of the prostate gland. From the fore part of these receptacles,
the semen passes thixtugh two- ducts, about a finger's breadth in

876

VENEREAL OR SEXUAL DISEASES.

length, into the urethra or water-pipe, just in front of the prostate.
From excessive self-pollution, these ducts become very irritable, ami
also debilitated and relaxed, — so much so that they will not retain
the semen ; and during lascivious dreams, it flows off. These semi-
nal losses are called "nocturnal emissions." So constant is the drain
they keep up upon many young men who have abused themselves
excessively, that *the whole man, mentally, morally, and physically,
becomes a wreck. There are few objects more pitiable to behold
than a young man in this condition, — his nervous system feeble,
tremulous, and broken ; his memory weakened and fading out ; his
eye unsteady and incapable of looking a friend in the face ; his loins
and back weakened, giving him the feeble gait of old age ; his once
erect form cowed and bent; his high sense of manliness all oozed out
of him ; his mind taking up and dropping the simplest threads of
thought, losing its way in the plainest paths of reflection, and often
starting back affrighted at the glimpse of chaotic insanity opening
before him, — turning here and there for relief, but finding little hope
of recovery, except in marriage, and yet knowing himself unfitted to
be the husband of an intelligent woman I

Treatment. — Every kind of treatment, no matter how judicious or
well applied, will be unsuccessful, unless the vice which has produced
the diseap;:, be absolutely and entirely abandoned. This is the first
thing to be seciu-ed. It may be extremely difficult for the patient to
do this, with his mental and moral nature all broken and in ruins, —
with no heart to feel, nor will to execute ; and yet it must be done,
or a cure cannot be effected.

To bring this about, everything must be done by the physician to
strengthen the moral nature of the patient, and to raise his self-respect
and hope. The most careful directions must be given for restraining
the imagination. The patient must be directed and encouraged to
drive out from the mind, instantly, and upon all occasions, every
lascivious thought; to cultivate the society of the most intellect-
ual and virtuous females ; to make himself hv^y with useful and, if
possible, agreeable employment; to avoid solitude; and to sleep with
some friend. He should sleep on a mattress, and never on feathers ;
always on the side, never on the back.

Where there is considerable debility, tonics will be required, as the
mineral ids (GO), (62), (78), and bitters (77), (67), (66), (59),
and str>oimine (83), (95), (86), and iron (80), (93), (72), (73),
(71). In addition to some of the above preparations, the syrup of
the hypophosphites should be taken for some time.

The food should be nutritious and easy of digestion, and the cold
alkaline sponge-bath should be taken once a day, with brisk rubbing;
and the private parts should be washed daily with cold water, espe-
cially just before retiring.

In conclusi£>n, I say emphatically to parents, do not let your sons
and daughters remain ignorant on this subject. It is plainly your

38gaaa5^Kv; »aaihwtj.;^ifaM<aiiijiW>ia^^

VENEREAL OB SEXUAL DISEASES.

877

le prostate,
ritable, and
not retain
rhese semi-
is the drain
themselves
physically,

I to behold
tern feeble,
ig out; his
i ; his loins
>; his once

II oozed out
threads of
, and often
ity opening
; little hope
unfitted to

iudicious or
« produced
is the first
) patient to
in ruins, —
st be done,

lysician to
self-respect
restraining
ouraged to
ions, every
t intellect-
ful and, if
sleep with
a feathers ;

ired, as the
■66), (59),
:T2.), (73),
e syrup of

id the cold
k rubbing;
rater, espe-

your sons
ainly your

duty to enlighten and to warn them. It is a matter in which young
peraons are generally disposed to do right, if rightly instructed.
Avail youi-self of your right to give counsel, and, if need be, to use
authority.

Says Ware: "The deleterious, the sometimes appalling conse-
quences of this vice, upon the health, the constitution, the mind itself,
are some of the common matters of medical observation. The vic-
tims of it should know what these consequences are ; for, to be ac-
quainted with the tremendous evils it entails, may assist them in the
work of resistance.

" To you, parents, on whose sho ilders is carried the weighty re-
sponsibility of rearing your children In a pure atmosphere, let me say
that to shut your eyes against the p; obabilities of youth is an error
and a sin. Let the mother learn to know the restlessness and ac-
tivity of youth ; let the father recall his early ambitions, his longing
for excitement, and his reaching out after life and activity in various
ways. Do not repress these natural instincts, but learn to guide them
into proper charmels. Keep at home the attractions of public places ;
have music and games, mirth and gayety ; invent amusement and
mirth, and banish dullness and apathy. Do not argue that your boy
is better than other boys and your daughter superior to your neigh-
bor's frivolous girls. The boys and girls guilty of this vice are
somebody's children, and thesq somebody's children are nine to one
your children. See that your children lead an active, physical life,
that out-door games and gymnasium exercises enter largely into their
lives ; keep them busy, give them something to do to occupy their
attention beside their studies ; let them study with a will when they
study, and play equally hard when they play. Do not be afraid to
talk on» these matters with your children, and explain in a rational
way what passion is, and how it is to be governed and how used.
If you have that unfortunate amount of prudery and false shame
so common to many people, and feel you cannot talk with your chil-
dren about such matters, send them to your family physician and let
him have a plain honest talk with the children. ' Well stated in-
formation never yet contributed to human inflammation.' Read
them Storer, Ware and Wilder on 'What Young People should
Know,' and make them realize tlxat a 'healthy knowledge is the
best preventive r gainst an unhealthy ignorance.' Do not wait till
the young have already grown up in the vice, — your admonitions may
then be too late, — nor fancy your children have not been thrown in
with influences which corrupt, and that by broaching the subject to
them you are informing them of a subject they may never otherwise
have heard of. Remember the statement: 'whether or not we
ought to hide this subject from the young, if we could, the truth is,
we cannot if we would.' "

To you, young men, in particular, let me warn you against a seem-
ing propriety on your part to keep your silence. If you are given

378

VBNEREAL OR SEXUAL DISEASES

to the habit, however slightly, go to your father, your mother, your
family doctor. Confession will strengthen your will and purpose to
overcome the temptation. Do not lie to the family physician in his
inquiriea : he is your friend and wishes you only success ; he is ac-
quainted with these ailments and knows your temptations ; he ap-
preciates and respects your noble desire to rid youiself of the evil.

Do not, above all else, read the numerous pamphlets on Sexual
Debility, Lost Manhood, etc., or be duped into answering advertise-
ments in the public prints offering to send you literature on the 8u]>
ject. No man can afford to send you free publications and postage-
stamps unless he sees as an outcome a fee at the end of the book in
the shape of medicines and other promised help. Steer religiously
clear of these smoothly written books and these specialists in the art
of restoring lost manhood. Your experience with them will be
much like the countryman with bunco^teerers.

Make every honest endeavor to conquer an unruly passion while
it is young, and the more readily conquerable, but never despair of
being helped by suitable aid, however long the passion may have been
victorious over you. Do not ascribe your weakness in fighting temp-
tation to the Almighty, the sins of your parents, or the example of
your elders or associates, but go at the demon with a will and the
fight is yours. Having conquered the enemy, the results of the past
can be overcome by a pure life and the dictates of your physician ;
nay, I may even add. Nature restores herself if only she can be as-
sisted. In fact there is no specific for the troubles that arise from
this vice. The only rure is to absolutely stop the habit and imme-
diately thrust out all lascivious thoughts as soon as they enter the
mind. Build up the strength and in time nature and marriage will
do the rest.

Tt i*yt^'

.'^ JStti.

nother, your
1 purpose t(i
iiciaii in his
8 ; he is an-
ions ; he ai>
i the evil.
i on Sexual
ig advertise-
3 on the 8ul>
and postiige-
the book in
• religiously
ts in the art
lem will be

assion while
r despair of
lyliave been
fhting temp-
example of
i^ill and the
i of the past
r physician ;
) can be as-
; arise from
and imme-
jy enter the
larriage will

FEMALE DISEASES.

In addition to the diseases common to both sexes, women are
subject to a class of distressing complaints peculiar to themselves,
and denominated, in general terms, female diseases. Involving con-
siderations of a delicate nature, these complaints have too generally
and too long been shut out from works intended for popular distribu-
tion. Hence there is a general ignorance of a class of diseases which
are fast unfitting woman for the high duty of continuing the race;
and the subjects of these maladies are generally themselves so unin-
formed of the true nature of their sufferings, that they are neither
prepared to seek relief in the proper direction, nor to submit to the
remedy if it chance to be proposed.

It is intended heie to speak of these disorders, as I have done of all
others, in a plain and simple way, to describe them, so far as the
present state of medicine permits, just as they are, and to make
known the modes of treatment which have been found available for
their cure. The sufferings of woman require this ; the interests of
humanity require it ; and the writer is impelled to it, as he thinks,
by a just sense of responsibility.

Physicians, in my judgment, are chargeable with a great wrong in
concealing within their own breasts information upon what are called
delicate subjects, — information which the good of the world requires
should be divulged, and which they ought to pour into the public
mind, and make common, and which they would thus popularize, but
for their stiff pride and conservatism.

The idea that our knowledge cannot be imparted to the world
without injuring the public morals, is simply absurd. We are more
afraid of bringing the common people too near to us, of letting down
our dignity, and of opening our profound secrets to popular eyes.
The result is as it should be, that unsophisticated people are apt to
give physicians a wide berth, and to have nothing to do with them
unless necessity compels. Let doctors strip off their reserve, and
while they remain gentlemen, become likewise companions, impart-
ing their knowledge freely and ic.miliarly to all, and the public con-
fidence, now considerably shaken, will be frankly restored to the pro-
fession.

It should be the object of a good physician to know all he can, and

. 379

"^. I t . .^L l . l )f ' SJL ' l. 'I La ! TTC-: .,

380

FKMALK DI8EABKB.

to impart hia knowledge to as many as possible. Knowledge is nf»»i
merely power : it is happiness, it is wisdom, it is health, it is virtue ;
yes, it is always virtue, except in some rare instances, where the woret
natures pervert it. No physicians are so much loved as those who
are frank, and have no concealments. The day for mysterious nods
of the head, and rollings of the eyes, and shrugs of the shoulder, has
gone by. Men, and women too (or those of them who are wise),
wish to know distinctly what their diseases are, and what is necen-
sary, not to palliate and prolong, but to cure them.

Time when Female Diseases Begin. — Female coniplaints begin
to make their appearance at the period of life called puberty, — the
time when the girl passes from childhood to womanhood. This is the
period when menstruation is established, which consists of a discharge
from the genital organs, composed of blood and mucus, and which
occurs, when regular, every four weeks. Up to this period, the system
of reproduction has remained dormant. By the intervention of this
mjnsterious function, the young female becomes a new being. The
heart unfolds itself to new emotions ; the mind assumes a solidity
before unknown, and even the body acquires beauty from a sudden
rotundity of form.

This is the period when the great question of female health is very
apt to be settled once for all, and for life. The girl who is well
trained at this time, generally has a foundation laid for health and
character, which is worth more to her than riches. At no time does
the mother need so much wisdom and knowledge as now. To es-
tablish the health and develop the affections of the daughter at this
critical period, is a sacred trust which she can devolve upon no other
being ; nor can she meet her responsibilities at this time, unless better
informed than most mothers are. The general apathy in regard to
this maternal duty is deplorable.

False Delicacy. — The refmed delicacy which withdraws these
subjects from the public gaze is commendable, for it casts a beauti-
ful charm over society; but when carried so far as to cast a veil even
over the eyes of mothers, it is quite unnatural, and leads to the worst
results ; for in the bad management of girls at this critical period is
laid the" foundation of so many of the diseases which shatter the con-
stitution of so many women. For this bad management, it is not
mothers alone who are to be blamed. The neglect of the medical
profession to furnish the necessary information should come in for its
full share of reproach.

The Establishment of the Menses. — Nature always comes slowly
and by degrees to the inauguration or establishment of any of her
great functions. It is so in regard to menstruation, or, as it is va-
riously called, " the menses," " the courses," " the change," etc. For
some ti >ne btifore the flow begins, there are certain symptoms, or pre-
monitions, wliich to the eye of the physician plainly enough foretell

'€isi^^il£

ttMWlHii

VKMALK DISKA8RB.

881

[edge is nnf,
it is virtue ;
ire the woi-st
8 those will)
iterious noils
ihoulder, has
a are wise),
lat in neces-

plaints begin
berty, — the
. This is the
t a discharge
, and which
i, the system
ntion of this
being. The
BS a solidity
m a sudden

lealth is very
who is well
r health and
no time does
low. To es-
rhter at this
ij)on no other
unless better
in regard to

idraws these
sts a beauti-
jt a veil even

to the worst
ical period is
itter the con-
sni, it is not

the medical
ome in for its

comes slowly
f any of her
r, as it is va-
Te," etc. For
•toms, or pre-
jugh foretell

the impending change. To the mother these signs would be equal-
ly intelligible, were she as well informed as she should bt. It is
jilairly her duty to be intelligent enough to assist nature in the es-
tablishment of this important function. But how often, either from
ignorance or from false ideas of delicacy, does she fail to interfere,
and allow tlie daughter to be taken by surprise, and perhaus fright-
ened and thrown into convulsions 1

From inquiries made of about one thousand women, a distin-
guished English physician found that about one-quarter were unpre-
pared for the appearance o5 the menses. Some of the girls were
frightened and went into hysterical fits; others thought they were
wounded, and washed with cold water. The flow was stopped in
several cases, and in some never restored ; while the health of all
in whom it was interrupted was seriously impaired.

Symptoms of the First Menstruation. — A variety of symptoms
precede and foretell the first menstruatiou. Headache, dizziness,
sluggishness of thought, and disposition to sleep ; these occurring in
a girl, may be taken tvs hints that the " change " is at hand. If to
these be added pains in the back and lower limbs, the intimations
will be still more significant.

At tliis time a girl loses a relish for the society of children ; she is
apt to acquire a taste for solitude ; her temper becomes wayward and
fretful ; her eyes acquire a peculiar lustre ; she becomes a sort of
mystery to her friends and herself ; not her physical frame only, her
whole character is changed. She is about stepping into a new life.
Her emotions, thoughts, anticipations, retrospections, are all new to
her, and her outward manifestations are new to her friends. An in-
telligent mother will not fail now to prepare her mind for the impor-
tant event close at hand.

The age when this change takes place depends very much upon
a variety of circumstances. It occurs much earlier in warm than in
cold climates. It is hastened by high living ; by the whirl and bustle
and excitement of city life ; by reading novels which are full of love-
incidents ; by attending balls, theatres, and parties ; and by mingling
much in the society of gentlemen.

Early Menstruation not Desirable. — It is a law, both in animal
and vegetable life, that the later the period at which maturity is
reached, the greater the solidity of the body, i nd the longer it lives.
Girls who menstruate early do so because the body is weakened by
climate or luxury, and tht nervous system unduly developed by ex-
citement; while those who come late to womanhood have firmer
constitutions, enjoy better health, and live longer. Those mothers,
therefore, commit great errors, who are anxious and administer
" forcing medicines," because their daughters do not menstruate at
fourteen or fifteen. If girls are suffering from no special ill-health,
no anxiety need be felt if «♦ the custom of women " do not come to

382

FBMALK DISRABSH.

,them till the age of eighteen, or even twenty The delay should
excite thiiiikfulnoHH mtlier than re^rret. It hIiowh that the cuuHtitu-
tion has not in it the Heeda of early dissolution ; that it is fortifying
itself against future disease.

(lirls who (ionie thus tardily t*") maturity are much more "regular"
in after life. They Ixjar children with fewer iu;cidents, and are af-
flicted much less with female diseases. The duty of mothers is i)lain:
it is to bring their daughtera forward as late as possible, by refusing
their early admission to society, by withdrawing from them all excit-
ing reading, by prohibiting their early attendance at parties and
theatrical entertainments, by prescribing for them the most unstimu-
lating diet, and by requiring a large amount of exercise in the open
air.

A wide investigation has shown that the first menstruation occurs,
in hot climates, at the average age of thirteen years and nineteen
hundredths ; in temperate regions, at fourteen years and seventy-four
hundredths ; in cold latitudes, at sixteen years and fifty-three hun-
dredths. Under the hot-house culture of modern society, and espe-
cially among the wealthy classes, where indolence, luxury, and excite-
ment unite to weaken the constitution, this change is constantly oc-
curring at a more tender age.

How Female Diseases are Induced. — All living things have
their origin in germs. The germ from which the higher animals
spring, man included, is an ovum or egg. Every animal and every
vegetable is provided with an organ for the production of germs. In
woman, this organ is called an ovary. There are two ovaries, about
half an inch in length, one lying on each side of the womb, to which
they are attached by ligaments or cords. The ovarian bodies con-
tain vast numbers of vesicles, or cells, or eggs, which are the true
germs of human life, and the only sources from which it can spring.

Between the ages of fourteen and forty-five (speaking in geneml
terms), every healthy woman matures and deposits an ovum once in
twenty-eight days. This vesicle, some time before the monthly flow,
begins to germinate and swell, and after a time, like a grain of wheat
in the earth, it bursts its covering and springs forth. It then passes
through what is called ' - Fallopian tube into the womb, whence it is
cast o£f.

During the sv' a bui-sting of this vesicle or germ, the ves-

sels of the c Mii. womb, and particularly of the membrane

lining the woj i its neck, are so crowded with blood as to pro-

duce in the parvo a state of congestion. If the parts be examined
with a speculum at this time, they will lie found red, sensitive, and
almost inflamed. So great is this congestion, that the woman often
complains of pain in the ovaries and the womb, and a general
sense of heat, aching, and dragging down in the lower part of the
bowels. The pain often extends to the back, the groins, and the
thighs.

VXMALK DI8KABKS.

388

lay should

le constitii-

fortifyitijj

" regular"
vnd are af-
I'sis plain:

y refuHiiijf
n all excit-
)artie8 and
t iinstimu-
n the open

iion ocoura,
1 nineteen
venty-four
three hun-
, and espe-
and excite-
stantly oc-

ings have
3r animals
and every
germs. In
ries, about
}, to which
)odies con-
8 the true
jan spring,
in geneiul
m once in
nthly flow,
n of wheat
hen passes
hence it ^^

n, the ves-
membrane
as to pro-
examined
sitive, and
nan often
a general
irt of the
i, and the

This Condition Repeated Every Month. — When we consider
that this state of things is roiH^ated every four weeks, and that the
congested or crowded state of the vessels begins somo 'lays before
the monthly flow, and lasts, in all, some ten days, making about one-
third part of every month, we need not wonder that inflammation so
often supervencH, with all its attendant ill-health and suffering.

Increased by VariouA Causes If re reflect, further, that this

congestion is increased, among the wealthy, by high living, and
among all clasHcs, by over^itiniulation of the nervous system, and by
the lascivious morals of the age, we see stronger reasons for expect-
ing — what is reall}' occurring — a continually increasing amount of
suffering from female diseases.

And when we know, still further, that American females are care-
less of their health ; that they often attend balls and theatres at the
very time of suffering from this monthly visitation ; that they fre-
quently wet their feet, and otherwise expose themselves to colds, we
cannot feel surprise, even when we learn that from one-half to three-
fourths of all women in cities, and quite a large proportion of them
in the country, have inflammation of the ovaries, or of the womb, or
of the neck of the womb, or suffer some of the forms of displace-
ment of this latter organ.

Child-Bearing. — The inflammatory state of the Titerine organs is
often induced by injuries received in child-bearing, and by excessive
indulgence in sexual pleasures.

Wealcness of the SexuaP System The womb, moreover, like

any other organ, may be naturally frail, and easily affected by dis-
ease. This weakness of the sexual system is indicated by the diffi-
culty with which menstruation is established, and the presence of the
whites, both before and after each monthly flow. Women in whom
the generative organs are weak, are much more liable to inflamma-
tion of the womb, ^nd to all complaints peculiar to the sex.

Description of the Sexual Organs — Before describing the par-
ticular diseases to which the female generative organs are liable, it
is proper to give the reader a brief description of the chief of these
organs.

The Womb itself, in its healthy, natural state, is about two inches
long, and one inch broad — weighing a little more than an ounce,
and is in shape like a pear. It is lined with a mere rudimentary
mucous membrane.

The Necic of the Womb has a cavity distinct from that of the
body of the organ, and is lined with a mucous membrane well sup-
plied with follicles or glands.

The Fallopian Tubes open, one from each side of the base, or
largest end of the womb, and extend outward to the ovaries.

■ ' Mjwwui-i o mmmMi

WS^

384

FEMALE DISEASES.

The Ovaries are glandular bodies lying one on each side of the
base of the womb. They are more particularly explained else-
where.

Fig. 136 gives some idea of these organs. A, is the body of the
womb ; B, the neck of the womb ; C, C, the vagina ; D, one of the

n
\

■

FlO. 13S.

ovPTies ; F, F, the Fallopian tubes ; E, E, the fimbriated extremi-
tif i ; G, the small ligament attaching the fimbriated extremity to the
o'.ary.

Inflammation of the Neck of the Womb. — Inflammation of the
body of the womb is a comparatively rare disease, but inflammation
of the neck of this organ is so common that in nearly nineteen out
of twenty cases, when *->male8 seek relief for whites, for painful men-
struation, for stoppage of the menses, or even for what they suppose
to be a falling of the womb, a careful examination will show that
this pendant portion of the womb is in a state of marked inflamma-
tion, or of absolute ulceration. The whites, if they continue with-
out intermission from one menstrual flow to another, are almost al-
ways the result of one of these conditions of the uterine neck.

It would surprise most persons out of the medical profession, and
many physicians, to know how large a proportion of the more grave
diseases which inflict such terrible suffering upon woman, and so
completely shatter her constitution, are dependent for their exist-
ence upon a simple local inflammation, either in the neck of the
uterus, or in one or both of the ovaries. Many a female has for
years suffered agonies, greater than those of death itself, arising, as
she supposed, from a complication of ills which invade every part of
the system, while the whole of her troubles arose, in fact, from an in-
flammation of the neck of the womb merely.

Difficulties of Studying: Uterine Diseases The social rela-
tions of the sexes, and the great delicacy of the matters to be inves-
tigated, for a long time prevented direct examination and investiga-
tion, so that little knowledge was gained, and as little benefit con-
ferred.

L side of the
:plained else-
body of the
), one of the

kted extremi-
remity to the

nation of the
inflammation
nineteen out
painful men-
they suppose
II show that
ed inflamma-
)ntinue with-
'e almost al-
e neck,
ofession, and
more grave
man, and so
■ their exist-
neck of the
nale has for
[f, arising, as
3very part of
., from an in-

I social rela-

; to be inves-

id investiga-

benefit con-

B3i£^'«.

FEMALE DISEASES.

Woman, always distinguished for her modesty, could not be ex-
pected to invite investigations which were not proffered, whatever the
extremity of her sufferings ; and man, scrupulously sensitive lest he
should make himself an intruder by stepping within delicate enclos-
ures, have both, in times past, mistaken their duty by misinterpreting
the demands of the highest delicacy.

Needful Examination not Indelicate Rightly viewed, no in-
quiries or examinations are indelicate which are necessary to a full
understanding of the nature of disease, and which are made with the
sole purpose of rendering its cure possible. I agree with Dr. Meigs,
the elder, that the delicacy or indelicacy of examining the persons of
females for the purpose of exploring disease, depends on the motive
with which it Is done. To pure-minded persons, it is never, I think,
a source of impurity. On the contrary, the self-restraint, the honor-
able feeling, and the nice sense of delicacy which it calls into exercise,
often heighten the tone of a man's virtue, and certainly increase a true
woman's respect for it. Unfortunately, there is now and then a gross-
minded man in the profession, who, in these investigations, will vio-
late the most sacred of all trusts committed to his hands; but such
monsters — few in number — soon find their level, and are shunned
as the most vile of the race.

It is now 80 well understood, that these investigations do not lead
to immoralities, that the most highly educated, intelligent, refined,
and virtuous females almost invariably raise the fewest objections to
such examinations as a physician of character may propose.

Methods of Investigating Female Diseases. — The symptoms of
these complaints will be spoken of in their proper place, as the
several diseases come under a brief review. I merely wish to allude
here to the methods of physical exploration which modern practice
has called to its aid.

Tile Toucii. — These methods consist, first, of what is called the
touch, which, is made either externally upon the bowels, or internally,
with the index finger, through the vagina, or passage, from the external
genital oi^ns to the neck of the womb.

Tlie Speculum. — In the

second place, of ocular in-
spection of the vagina and
neck of the uterus, through
an instrument called the spec-
ulum. By this instrument,
the eye, as well as the finger,
is made to assist in learning
the real condition of the parts.
The finger informs us
whether there is any devia- fio. 137. simi' speculum.

'^f

I i

386

FEMALE DISEASES.

tion from nature in the bulk, the firmness, the smoothness, or the
sensibil' y of the parts ; while the sight, through the speculum, affords
absolute certainty as to
whether the parts are suf-
fering from inflammation,
ulceration, abrasion, or
eruption.

There are a variety of
specula in use by modern
physicians, but all are es-
sentially of two kinds ; first, a so-called Sims'
Speculum (Fig. 137), the end of which, when
inserted into the vagina and pulled upon, allows
the air to enter and balloons out the vagina so
that the parts can be readily seen. This specu-
lum necessitates what is known as Sims' posi-
tion, i. e. the woman's hips resting on the edge
of the bed or table, knees flexed, and chest rest-
ing on bed with left arm out from behind her.

The second variety of speculum is what is
known as the duck-bill pattern (Fig. 138). By
a separation of the two blades, the neck of the womb slips in between
them. The speculum is then fastened with a thumb-screw, leaving
the hands of the physician free. This speculum is used with the
woman on her back, and feet resting on the bed or table, with knees
flexed.

We also give an illustration of an older kind, which is still used
to some extent. The end is so shaped as to catch the neck of the

Fro. 138.
Dack-biU Speoolnm.

Fio. 189.

womb, and then by drawing the instrument forward slightly, the
diseased surface is presented for as perfect inspection as. if located
externally (Fig. 139).

Inflammation, Ulceration, and Enlars^ement of the
Neck of the Womb.

Inflammation of the neck of the uterus is very common ; ulcera-
tion and permanent enlargement (technically called hypertrophy), are
its resulte, when it is not arrested in due time. These affections- in
fact, and the same troubles as they affect the ovaries, make up the

FEMALE DISEASES.

387

mess, or the
ilum, affords

lo. 138.

>ill Speonlnm.

8 in between
srew, leaving
jed with the
, with knees

is still used
neck of the

slightly, the
as. if located

;nt of the

non ; ulcera-
•trophy),are
iffections. in
nake up the

bulk of female diseases, — being the real causes of the most of those
symptoms which have passed under the name of whites, suppression,
painful menstruation, sterility, general debility, etc.

The ne(;k of the womb, when healthy, is soft and smooth. No
hardness or condensation of tissue can be felt by tlie finger c ""ss-
ing over it. It is elastic, too, and fef Is unctuous to the touch. This
latter sensation is communicated by the layer of mucus whicli covers
it. Pressure upon it produces no pain.

Inflammation, when found in this part, may begin in the mucous
membrane which covers the neck, or in that which lines its cavity, or
in the small glands in the body of the organ.

Symptoms. — Inflammation of the mucous membrane covering
the neck of the uterus destrojrs the unctuous feel which it has in
health. It also causes the neck to swell, its vessels being crowded
full of blood. If the body of the organ, as well as tlie surface, be
reached by the inflammation, it will be hardened and enlarged; and
in consequence of its increased weight, it is apt to drop down some-
what into the cavity of the vagina. In married ladies, it is often, by
physical pressure, pushed a little backward, or retroverted. Exami-
nation with the speculum shows the inflamed neck to be of a vivid
red, instead of a pale rose-color. It may be covered with red or
white pimples, which are glands enlarged with muco-pus.

In the healthy state, the mouth of the womb is so much closed as
to be just perceptible when the finger passes over it. Inflammation
causes it to be more or less open, and its lips to be parted.

Inflammation followed by Ulceration. — In a majority of cases,
inflammation of the neck of the womb and of its cavity is soon
followed by ulceration, which generally appears first around the
mouth, and just within the cavity of the neck. From thencu it
spreads both inward and outward.

Various Degrees of Ulceration, etc. — Of course, these inflamma-
tions and ulcerations mix and run into each other in all possible
forms, — presenting excoriations, or raw pl"'es; gmnulations, or
pimply surfaces; and indurations, or harde d parts. Sometimes
these pimply patches will be red and hard, and again the whole sur-
face will be spongy, and will bleed upon the slightest touch.

In many cases, these ulcerations make wretched work with the
mouth of the womb, eating deeply into the cavity, and giving it a
ragged and unsightly appearance.

Velvety Feel from Ulceration. — Ulceration generally gives to the
surface on which it exists, a soft, velvety feel, which the finger gener-
ally recognizes. This velvety sensation, with the open state of the
mouth, are the most important evidences we can derive from the
touch, of this form of disease.

The Discharge from these Ulcers is always Pus, or, in common

388

FEMALE DISEASES.

language, matter. It is sometimes poured out scantily, at other tiiues
very freely. It may be thick and yellow, or thin, and of a lighter
color.

The inflammatory and ulcenited condition of the neck of the
womb often gives rise to pain ; and when the seat of the disease has
not been examined, as it should be, this pain has frequently been
called neuralgia. In this way, ignorance has compelled neuralgia to
stand sponsor for a great many pains with which it has had nothing
to do.

These Ulcers Disturb Menstruation. — Menstruation is generally
changed more or less in its character by the presei ^e of inflammar
tion or ulceration in the neck of the womb. It usually becomes more
painftd. In some cases it is made more profuse, in others more scanty.
It may come on more frequently, or it may be postponed, protracted,
or abridged in its continuance. There is generally pain of a dull,
aching kind, low down in the back. There is often a feeling of full-
ness, pain, and a sense of bearing down in the lower part of the
bowels ; sometimes the pain extends to the groins and thiglis.

Extensive Disturbances from these Inflammations, etc. — The

nerves with which the womb is liberally supplied belong to those of
the sympathetic system. Hence, the condition of the uterus influ-
ences a wide circle of sympathies. By these nerves this organ is
brought into close relationship with the organs of animal life. If the
former suffer, the latter suffers also. The stomach, being intimately
connected with the womb, physically, feels keenly these inflammations
and ulcerations of the uterine neck. At times, the pain, debility,
general disturbance, and dyspeptic state of the stomach are such as
to cheat both the doctor and the patient into the belief that this organ
is the seat of the disease. But in such cases, the symptoms of stom-
ach disease will all disappear the moment the local affection is re-
moved from the neck of the womb.

The liver, too, often participates in these troubles, and becomes
sadly deranged. It is sometimes even greatly enlarged and congested,
a,nd patients frequently have the various symptoms of what are called
liver complaints.

Severe pains are sometimes felt under the breast-bone, and over
the chest generally, making the patient apprehensive of disease of
the lungs ; and indeed consumption is not a very infrequent result
of uterine diseases.

Pains are often felt in the region of the heart, which organ is often
harassed with palpitations.

The flesh is apt to waste under the symptoms excited by these in-
flammatory and ulcerative processes in the uterine neck ; and even
the brain, though lying in some measure beyond the circle of influ-
ences set in motion by the organic nerves, suffers disturbance and
pain.

at other tinioH
I of a lighter

neck of the
le disease has
jquently been
I neuralgia to

had nothiug

n is generally
of inflamma-
aecoraes more
8 more scanty.
d, protracted,
ain of a dull,
jeling of fuU-
r part of the
ihiglis.

J, etc. — The

g to those of
uterus influ-
this organ is
1 life. If the
ng intimately
nflammations
)ain, debility,
are such as
hat this organ
jOvciB of stom-
Eection is re-

and becomes
ad congested,
hat are called

)ne, and over
of disease of
jquent result

srgan is often

by these in-
ik ; and even
rcle of influ-
urbance and

rEMALE DISEASES.

389

Even the special senses of sight and hearing may be drawn into
this general vortex, and both be much impaired. And to crown this
catalogue of ills, it may be mentioned that those distressing things
called hysterical fits proceed from the same local disorders.

In brief, there is scarcely a point in the human body to which these
inflammatory and ulcerative conditions of the uterine neck may not
send theii- sympathetic pains and aches, and where they may not in
time induce real disease. This is the reason why so many women
suffering from these local complaints, tell the physician, when con-
sulting him, that they are " diseased all over." If asked where the
complaint is located, they will answer, " It is everywhere." In the
most earnest manner the assurance will be given, '■'■Doctor, there isn't
any well part about me."

Treatment. — It is just as unreasonable and useless to treat these
inflammations and ulcerations through the stomach, as it is an in-
flamed or ulcerated throat. They are local diseases, affecting a par-
ticular part, and the remedy must be local.

Like all other affections, these can only be managed intelligently
after their nature is well understood. Nothing can really be done to-
wards a cure until it is known what the matter is{ and no competent
physician will move a single step in the treatment of one of these
cases until he has made a thorough examination. He owes this to
himself and to his patient, the more so as the neck of the womb
may be as easily examined as the upper part of the throat, and the
local remedy may be almost as. readily applied in the former case as
in the latter.

If, upon the introduction of the speculum, the uterine neck be
found simply inflamed and enlarged, the application of ichthyol and
glycerin to the canal will reduce the swelling and inflammation ;
while a tampon of wool soaked in the same and placed beliind the
womb will reduce the entire swelling- of the womb by the watery
discharges which are produced. The patient must learn to lie down
most of the time. If this should not succeed (though it will in most
cases) then introduce a speculum, and when the neck of the womb
is fairly lodged in its extremity, drop in two or three leeches and al-
low them to fill.

One who is not accustomed to treat these affections in this simple
way, will at first be surprised at the rapidity with which the local
trouble will disappear, and with it the thousand and one aches and
pains which torment the whole body. As the terrible pains in the
whole face and head which are produced by a single tooth all in-
stantly come to an end when- the tooth is extracted, so do the bad
feelings all over the body subside as fast as the local ailments of the
uterine neck are cured. There is no exception to this rule, except
where the sympathetic affection has become fixed by long neglect
of the primary uterine disease. It is, therefore, surprising that so
many excellent women, whose lives are of the greatest value to them-

■ j-fyir- yv^i^M

■mnTrt^nti'ttfr I'tiiiTt-iMwtifirr > ^'.?'^Ll'-''V'«?i«;>i' il^.^..

390

FEMALE DIBEA3KS.

;

Helves and frieiitU, should be permitted to perisli of these ibilnionts,
when the cure is so simple, and many times so entirely within tlu!
reach of the most ordinary skill. It is a reproach to the pnifessioii
which should be wiped away.

If there are a Imndred motives for gaining the mastery over other
diseases, there are a thousand for learning to control these. More
than any other diseast or all othei-s, they make the homes of men
desolate, by robbing them of women, their ornament and solace. The
physician who neglects to make himself acquainted with all there is
to be known of these complaints, shows himself not only unfit for his
profession, but deficient in some of the prime elements which combine
to make a true man.

Hardening: of the Uterine Neck. — In many cases the uterine neck
is not only inflamed and enlarged, it is indurated and hardened. At
times it is enlarged and hardened on one side, and not much on the
other. In still other cases, there are enlarged spots, or nodes, giving
the whole neck a knotty feel under the finger.

These hardened conditions of the uterine neck proceed from vari-
ous causes, and are more difficult to cure than the ordinary inflam-
mation, or even ulceration. They sometimes indicate cancerous dis-
ease, and then, of course, involve the most serious considerations.
The glycerin tampon and the hot vaginal douche will do more for
this hardening than all else combined.

Uterine Syringe. — For applying the several remedies to the inter-
nal cavity of the uterine neck, I have contrived a silver syringe, which
is bent a little at the extremity, and pierced with fine holes all round.
With this instrument, the remedy is carried directly to the diseased
part, and applied instantaneously to every side of the cavity.

Besides these local applications, it is frequently necessary to resort
to soothing or astringent injections into the vagina, hip-baths, and
injections into the bowels, some mild physic, and rest in a horizontal
position. These matters will all be judiciously regctlated by the at-
tending physician, il he is master of his business.

Inflammation, etc., of the Ovaries. — Ovaritis.

The inflamed condition of the ovaries is indicated by increased
heat, and pain upon pressure. The pain in the ovarian region is
sometimes intermittent, sometimes constant, and occasionally passes
down to the loins and thighs.

There are acute and chronic inflammations of the organs ; but it
will be sufficiently accurate, in a work of this kind, to treat of them
as essentially one.

The effects of inflammation upon the ovaries, as upon other bodies,
are various, sometimes enlarging and hardening, at other times col-
lapsing and blasting them. This last effect, it is hardly necessary to
say, cuts off all hope of bearing children.

'--mmStSUti

^•UfijiUK^"^'. i. y .' . . . ' i3tMtixr^i^ \^^\M 'ji

FEMALE DISEASES.

391

380 idlmonlx,
y within tlu-,
le prt)fe88ioii

•y over other
ihese. More
jmes of men
solace. The
h all there is
r unfit for his
lich combine

uterine neck
irdened. At
nuch on the
nodes, giving

3d from vari-
inary inflani-
ancerous dis-
msiderations.
do more for

s to the inter-
yringe, which
)le8 all round,
the diseased
ivity.

isary to resort
lip-baths, and
1 a horizontal
ed by the atr

Ovaritis.

by increased
ian region is
ionally passes

'gans; but it
treat of them

other bodies,
er times col-
r necessary to

The Causes of ovarian infiauunation are numerous. One of the
most impoi'tiint caiiHus hah already been noticed, namely, the congen-
tion of tht parts, for several days, at every menstrual period. This,
amounting iw it does almost to inflanimution, is often intensified by
other causes, such as wetting the feet, taking sudden colds, excessive
fatigue from dancing, and exciting drinks.

Sexual indulgence often proves a cause of inflammation ui these
bodies. It is particulary apt to have this effect in the newly-married
female, with whom it is a novel stimulus, and often applied with im-
moderate excess. In late marriages, when the stimulus i the ovaries
liiis long been denied, its sudden presentation is liable to jake an in-
flammatory impression. Its entire absence, too, in persons of strong
passions, may result in ovarian disease.

This inflammation may be produced by the new state of things
existing at the critical period called the turn of life, when it reacts on
the womb, producing the floodings which often bring menstruation
to a close. The congestion, too, which has been present every month
for many years, ''^es not immediatelv cease at this change ; and not
finding relief by the accustomed flo\^, the ovarian bodies are exposed
to inflammation.

In all large cities, the pest-houses of civilization, where the women
are more numerous than the men, there are many females whose vir-
ginity is a burden, and numerous others who give themselves up to
sexual excesses ; to both these classes, the turn of life is very liable
to promote these ovarian disorders.

There is another class of causes, which, though not so easily re-
cognized, are equally cogent in exciting this form of disease. I mean
all those excitements which arise from unbridled thoughts, from
books of questionable character, from music, social intercourse, and
stimulating food and drinks, — all which promote and intensify burn-
ing desires, which, though natural and proper in themselves, cannot
lawfully be gratified in a community where the female sex greatly
preponderates, numerically, over the male. When we consider how
powerful within a woman's breast the conflict often is between the
impulse of passion and the dictates of duty, and how strongly this
conflict must react upon the sexual organs, and especially upon the
ovaries, the centre of the sexual system, we can easily see in how
many cases they may become inflamed.

Another cause of this disease ia suppression of the men . The
engorged and crowded state of the vessels of the womb, of the ute-
rine neck, and ot the ovaries, not finding vent in the accustomed flow,
inflammation in any one of these organs is a very natural result.

The inflammation of these ovarian bbdies is a frequent result, too,
of a similar condition, previously existing in the neck of the womb.
In passing from the uterine neck to the ovarian bodies, the inflamma-
tory cofidition often fastens itself upon the broad ligament, the fallo-
pian tubes, and their fimbriated extreu^^ties. The whole, it will be

1 -

392

FEMALR DISEASES.

seen, prusenlH an amount of diHeane which it in painful to contem-
plate.

The womb l)eing turned over, and pressini^ ai;^in8t one of the
ovaries, may cauHO it to inflame by mechanical irritation. Pessaries,
injudiciously used, may do the same tiling.

Symptoms. — The first and most obvious symptom is a pain a little
to the right or left of the womb. This pain is almost always increased
by walking, riding, or by external pressure. It is especially aug-
mented by straightening the thigh, by which the parts over the in-
flammation are put upon the stretch. When standing up, ladies
suffering from this disease are generally compelled to rest the foot
on a stool, so as to bend the thigh, and relax the muscles. The pains
radiate from the ovaries, and go down* to the loins and thiglis, and
sometimes to the fundament. They are of a dull, dragging, heavy
nature.

Sometimes the ovarian bodies become very much enlarged, and
dropping down somewhat, press upon the lower bowel, causing con-
stipation, or upon the neck of the bladder, creating a frequent desire
to urinate, and an inability to pass the water freely.

Treatment. — As inflammation of the ovaries is always increased
during the .nenstrual flow, it is not proper to meddle with it at these
monthly periods, lest the trouble be aggravated. Immediately after
one of the turns has passed, from six to eight leeches should be aj)-
plied over the diseased ovary. When the bites are healed, a blister
may be used in the same place. The scarf-skin should not be re-
moved, and the irritated surface must be healed as soon as possible.
The blister should be camphorated to prevent strangulation. The
part should next be rubbed for a few minutes, night and morning,
with an alterative and anodyne ointment (169).

After the next menstruation, the same things should he repeated,
and again after the next, and so on, for five or six monvii.^-, or even
longer, if need be. The already bloodless condition of the patient
may require, however, that the leeches should not be applied more
than once, or, at most, twice.

The bowels should occasionally be opened by some simple cathartic,
for the purpose of removing all hard substances which may press
against and fret the inflamed ovaries. The purgatives employed
should be of the most cooling kind, such as salts or oil ; while aloes,
and all harsh cathartics must be avoided.

Injections of tincture of belladonna and hyoscyamus are useful for
quieting neighboring parts, and warding off external disturbances.
They act like soft substances thrown upon the pavement in front of a
sick man's house. A piece of flannel soaked in hot laudanum, laid
over the ovary and covered with dry flannel, will give great relief and
enable the patient to sleep.

The patient should be kept, as much as possible, in the recumbent

""^si

FRMALR niSEASES.

398

1 to contem-

; one of the
. Pessaries,

a pain a little
ays increased
pecially aug-
over the in-
g up, ladies
'est the foot
. The pains
. thiglis, and
?ging, heavy

iilarged, and
causing con-
squent desire

lys increased
th it at these
jdiately after
lould be ai>
led, a blister
i not be re-
as possible,
lation. The
nd morning,

hs repeated,
tivii.^-, or even
f the patient
ipplied more

pie cathartic,

sh may press

es employed

while aloes,

,re useful for
disturbances,
t in front of a
idanum, laid
3at relief and

le recumbent

position, lying upon tlio l)ed or the lounge, and should only bo i)er-
luitted to move about to such extent as will nou irritate the inflamed
parts.

Whites. — Leucorrhwa. — Fluor Albtia.

Leucorbhcea is from two greek words, Xivxoi' and /»«(», and^^uor
albus from two Latin words, alhut and Jluo, having jjrecisely the
same meaning as the Greek, namely, a white discharge. Flence, in
popular language, the disease is called the " whites "; it is also called
'■'■female weakness."

These terms are well enough, perhaps, if we have in mind that
they convey to us only the idea of a symptom of disease. They all
mean, with the exception of the last, a white discharge from the
female genital organs. They are slightly inaccurate, as the discharge
is sometimes yellow, or green, ur otherwise variant from whit«i. Any
discharge from the female genital organs which is not bloody, comes
under the term " whites."

A 5ymptom Only. — As the name of a disease, the term whites has
no specific meaning. It does not designate any particular complaint.
It is a symptom, just as the matter expectorated and raised in lung
diseiises is a symptom ; and as such only should it be regarded.
When persons cough and raise a great deal, they do not, on consult-
ing a physician, say they have got the expectoration ; but they say
they fear they have some disease of the lungs, because they expecto-
nite. They look upon the expectomtion as the sign or symptom of
disease.

So females, and phyBicians too, must learn to look upon the whites,
not as a disease, but as the sign or symptom of disease, which sign
they should become skilled in interpreting.

There is no reason why the discharge from the genital organs
should not be as well interpreted as the expectoration or discharge
from the throat. The parts from which it comes may be about aa,
easily and as well inspected.

No Female Ailments so Common. — There are no female troubles
to wliich the attention of the physician is so often called as these
annoying and debilitating symptoms called whites ; and there is no
department of medical practice in which the really able as well as
conscientious and painstaking physician is so well tested. If, re-
garding these discharges as they are, simply as signs, he searches
faithfully for their cause, he will be led to a treatment which in a
great majority of cases will be successful. And surely no success in
life can be more prized by a right-minded physician. It procures
health, the highest earthly boon, for suffering woman, and gratitude,
the most prized of all rewards, for himself

There are Four Kinds of Discharges from tiie female genital or-
gans, — mucus, pus, mucus and pus combined, and the watery. The

i i

394

FEMALK niBRASIS.

firet, inucuH, (Iooh not in itAelf imply diHeaHt; ; but when puH iH iHn-
(shargnd, wo know tlmt inflammation exiHtH, IxHiauHe huuIi a (;auH(;
alonu can produce it.

Seat of the Diseaae. — Ttie cuiue which produces the whites nmy
have itH seat either in the vagina, or in the neck of tlie womb ; and
in practice it iH of courue quite important to know where its location
ia. The character of the discharge generally settles this point. If it
be thin and watery, or thick and cream-like, it is from the vagina or
passage which leads to the womb ; if ropy, gluey or albuminous, like
white of egg, it is from the cavity of the uterine neck.

Treatment. — Some physicians always prescribe the same remedy
for the whites. They might as well liave but one proscription for
expectoration. The remedy must have reference to tlie cause of the
discharge ; until the cause be searched out, every prescription is a
mere trial at guessing, — a sort of practice well enough adapt^ed to
quacks, but not becoming scientific men.

When a case of whites is brought before a physician who under-
stands his business, he makes no prescription until he has discovered
what the disease is. Having determined this point, his remedies have
an intelligent bearing upon the case.

If the discharge be of a ropy, tenacious character, one of the best
remedies is a strong solution of nitrate of silver, used as an injection
with a female syringe, once a day (254). Of this, not more than two
teaspoonfuls should be used at a time ; and great care should be ob-
served not to stain the underclothes with it. When the discharge is
either yellow and thick, or lighter colored and watery, some one of
the following: (200), (202), (208), (207), (209), (220), (230),
(282), (248), (244), may be used with advantage as an injection,
twice a day. An infusion of the white pond-lily, one ounce to the
pint of water, makes a very excellent injection, which may be used
twice a day. A very simple injection, and sometimes quite effectual,
is a strong infusion of green tea.

Some one of the above remedies will generally afford some relief;
but if whites exist in a somewhat aggravated form, they furnish evi-
dence of some serious disease in the vagina or neck of the womb,
and the case ought to be submitted to a competent physician.

Absence of the Menses. — Amenorrhoea,

The absence of the menses is divided into two kinds, — retention
and mppreseian. It is retention when the montlily flow has never
appeared ; suppression, when, having been established, it is, by one
caxise or another, stopped.

Retention Explained. — The ovaries, as we have before said, are
the centre of the female sexual system. It is the swelling or ripening

FKMALR niSK/lSKS.

395

II pus \H iVlH-
itUcil U CllUHO

le whituH liiiiy
3 womb ; and
'6 its lucatiun
I point. I f it
the vagina or
uminouH, like

same remedy
ascription for
a came of the
scription is a
h adapted to

1 who under-
1H8 discovered
remedies have

16 of the best

a an injection

more than two

should be ob-

le discharge is

r, some one of

;220), (230),

an injection,

ounce to the

may be used

[uite effectual,

d some relief ;
3y furnish evi-
of the womb,
rsician.

hoea.

is, — retention
low has never
I, it is, by one

efore said, are
ing or ripening

of an ovum or egg, everv four weeks, which causes the large flow of
blood to the parts, and e consequent menstrual discharge.

But it Hometime.s happens that the ovaries are not dev«lo[)ed at the
usual time of life. The monthly evacuation does not then appear.
There is retention. There may be retention, too, from other causes,
lifter the ovaries are matured. Costiveness may sometimes occasion
it; so may a degenerated and low state of the blood.

There may be mechanical causes of retention. The mouth of the
womb may be entirely closed, or the neck may Im so constricted as
to close the passage through it, leaving no outlet for the montlily ac-
cumulation. The hymen, also, may have no opening through it.
When these mechanical obstructions exist, there are sometimes large
collections of fluid in the womb, which cause enlargenient of the body,
and in some instances, painful suspicions that the sufferer has com-
mitted imprudences, and is in the family way. Physicians should be
on their guard ogainst falling into such errors, and lending the sanc-
tion of their name to these oiasting mistakes.

Suppression Explained. — Suppression — a stoppage after flow
has been once established — may be caused by inflammation of the
ovaries, the blood, in this diseased condition, being drawn so entirely
to these swelling and genuinating bodies, that the accustomed flow
from the womb does not take place.

Inflammation in the neck of the womb may also cause a stoppage.
So may a fright, as from a fire occurring in the neighborhood, or a
cold taken by being raught in a shower. Girls sometimes, in their
utter thoughtlessness or ignorance, dip their feet in cold water, when
their courses are upon them, and bring on a suppression of a most
dangerous character. The most lovely and innocent girls have done
this for the purpose of attending a party ; and, in some instances, the
stoppage induced has ended in death within a few hours. The pro-
found ignorance of their own mechanism, and of the laws which gov-
ern it, in which girls are kept who are just budding into life, is a
serious reproach both to parents and physicians.

Suppression may be induced by whatever reduces the quantity or
quality of the blood, as consumption, or by great depression of spirits.
With somj rare exceptions, women have not their turns while in the
family way.

Treatment. — Before anything can be done in the way of treat-
ment, the case must be thoroughly investigated, and the specific cause
of the disease searched out.

If it prove to be retention, and arises from a bloodless condition
and an undeveloped state of the ovaries, iron is the proper remedy
(61), (73), (74), (76), with a generous diet and exercise out of
doors. If caused by an inflammatory state of the uterine neck or ova-
ries, the proper treatment has been already indicated. If from cos-
tiveness, relief may generally be found from prescriptions (5), (9).

li.

I ''

i, y

f :

i ^

896

FEMALE DISEASES.

The mechanical causes alluded to above, when found to exist, must
be removed by gently dilating the mouth of the womb or the uterine
neck, with bougies, beginning with the smallest, and increasing the
size, or by puncturing the hymen, as the case may require. Per-
manganate of potash, in capsules of 2 grains each, after meals, is
one of the best remedies.

In Treating Suppression* it should be borne in mind that at a cer-
tain time each month nature makes an attempt to restore the lost
function. Even when she is not successful, probably an ovum is ma-
tured and in some way disposed of. The intelligent physician will of
course avail himself of this favorable moment, to try his skill in bring-
ing about the desired regularity. When this time arrives, he should
order three or four leeches applied to each groin at night. The next
night, he should direct the use of a pungent foot-bath (242) ; also
(16) as a cathartic.

When suppression exists, it is not always proper to try in this
direct way to bring on the turns. There may be no blood to spare ;
and this may be the sole reason why the courses do not appear.
When this is the case, nothing is to be done but to build up the
health as rapidly as possible, and when this is sufficiently established,
the courses will be all right,

Profuse Menstruation. — Menorrhagia.

Menstrttation may. continue too long, or occur too often, or be too
profuse while it lasts; or all these irregularities may be experienced
by the same person. Any one of them will prove a serious irritation,
and a drain upon the constitution ; the whole together, if not arrested,
will undermine and destroy it.

Tlie Cause of tliis, like the source of all other female diseases, is,
in a great rr^jority of cases, overlooked.

It is not to be attributed, as so many suppose, to a congested state
of the womb ; but is rather the result, in a great many instances, of
the inflammatory or ulcerated condition of the uterine neck.

In still another large number of cases, it arises from a succession
of ovarian abortions. When the blood has Tvr. low, and nutrition is
defective, as in the consumptive habit, the ovarian vesicles fail to
reach maturity. Like other products of the economy, they become
blighted, and abort. And as these blights occur often, nature is busy
every two or three weeks casting them off. Hence, the menses
appear often. They come and go without order, because they spring
from a process which is a contraversion of nature's laws.

Profuse menstruation, like scanty menstruation, is a sjrmptom of
a variety of diseases. The quantity may be increased only on one or
more days, or be so great as to cause death from hemorrhage. At all
events, the amount of blood lost is often so great as to cause aneemia

^ w

FEMALK DISEASES.

897

exist, must
the uterine
reasing the
[uire. Per-
)r meals, is

hat at a cer-
•re the lost
»vum is ma-
ician will of
dll in bring-
s, he should
The next
^242); also

try in this
)d to spare ;
aot appear,
lild up the
established,

n, or be too
experienced
s irritation,
lot arrested,

diseases, is,

nested state
nstances, of
ok.

succession
nutrition is
cles fail to
hey become
ture is busy
the menses
they spring

lymptom of
y on one or
age. At all
use aneemia

and impaired health for a long time. This is, however, usually the
result of continued free bleeding extending through a number of
months.

The local causes of uterine hemorrhage are fibroid tumor of the
womb ; inflammation of the wcmb, or metritis ; inflammation of the
lining membrane, or endometritis ; uterine congestions from any
source ; cancer of the womb in its early stages ; retroversion, or tip-
ping over backward of the womb onto the rectum ; polypus ; enlarge-
ment of the womb following labor or abortion ; the retention of pla-
cental tissue, etc., etc. These also are among the local causes of hem-
orrhage. But not infrequently the excess of flow is due to impaired
general health. Wasting diseases like phthisis or consumption caus*^
the blood to be so thin as to render it unable to form a clot, thuc
facilitating the easy or profuse hemorrhage often seen in young girls
in the earlier stages of consumption ; later, amenorrhoea ensues from
utter lack of blood. This flowing often attends acute fevers, pur-
pura, Bright's disease, jaundice, heart-disease and debility. This
last cause is often seen in the case of young girls who have grown
rapidly since puberty and pursued a vigorous course of study with
little or no out-door exercise. The strain on the nervous system in
these girls is kept up constantly by sharp competition, and no heed
is paid to nature's demand for rest and relaxation at the menstrual
time. The claims of society on the young girl add no small share in
the production of this evil.

Explanation. -7- It is not easy to explain how inflammation and
ulceration of the uterine neck should in one case produce suppression,
and in another profuse menstruation. Yet it is a settled truth that
such opposite results do come from one and the same apparent cause.
Probably the explanation is to be found in the difl'erent degrees of
inflammatory action, in the varieties of
constitution, and in the variant degrees
of tenacity with which the vessels hold
the blood.

Bleeding from the female genital or-
gans may be produced by a variety of
causes which have nothing to do with
menstruation. Such bleedings are prop-
erly uterine or vaginal hemorrhc^es, and
not profuse menstruation. They are the
result of inflammations, or tumors within
the uterine neck (Fig. 140), or weak-
ness. The womb may bleed for days, or even months, from pure
debility.

Treatment. '■ — As profuse menstruation and uterine hemorrhage
spring from a variety of causes, so the remedies are various. Here
again we are confronted with the same lute necessity to investi-

.FlO. 140.

f ,

I ■

■5

f "^

i I

398

FEMALE DISEASES.

gate accurately the true nature of the complaint before we venture
a single prescription. All the cases present one general feature.
There is too great a loss of blood; and the first thoughu is that
astringent medicines are necessary to arrest it. But if the bleeding
be occasioned by a polypus, or by inflammatory ulceration, astringents
would not arrest it, and might do great mischief.

When the immoderate flowing is caused by a general breakdown
of the nutritive powers, and by ovarian abortions, the great aim must
be to rally the vital powers by iron, quinine, porter, wine, a generous
diet, exercise on horseback and on foot, and warm and cold bathing.
When produced by local diseases of the ovaries and neck of the
womb, the treatment is to be local, — such as has been described. If
a polypus or other tumor be the cause, the remedy must be sought
for under the appropriate head. If the womb has become relaxed,
and bleeds from pure debility, — as it may, — something must be
found, if possible, which will condense its substance, making it
harder, smaller, and more solid. For this purpose, cold bathing, as-
tringent injections into the fi-ont passage, and acid drinks are useful.
But one of the best remedies is the wine of spurred rye (267). One
teaspoon ful should be taken three times a day. This article, by
causing the womb to contract, solidifies and condenses it, thus arrest-
ing the blood which oozes from its relaxed tissues. Of course, the
object of all treatment is twofold : the one to stop the hemorrhage
for the time being, the other to remove the cause. The physician
may have tb be called, and resort had to tampons in the vagina ; the
uterus itself might have to be packed with gauze ; hot douches of
115° to 120° F. will frequently quiet a stubborn hemorrhage, espe-
cially if rest in bed with the hips elevated be strictly enjoined. The
hot douche should be repeated every three hours. Besides the giving
of ergot, hydi'astis, hamamelis and atropia are also quite useful, as,
for instance : Fluid extract ei'got, fluid extract hydrastis, fluid extract
hamamelis, of each twenty drops, in water every three hours, with
the addition of jj^ graii of atropia at the same time.

Sedatives, like the bromide of soda, in ten-grain doses every hour
or two, will be of service if the hemorrhage be caused by fright, grief,
or injury. The treatment of the intervals must depend on the cause,
but generally some systemic tonics like iron or quinine are of great
service ; rest in bed is, par excellence, the ti "batmen t in most cases at
some stage of the flowing, generally during the flow itself ; but rest
from excitement and freedom from overv/crk are ^oiial?y important
when the hemorrhage is due to this cause. Out-*.":' jv exarcise, fresh
air and good food are none the less important for vvbary brains and
tired nerves.

Hemorrhage between the periods, or menorrhagia. — When hem-
orrhage from the womb occurs between the periods, it is called men-
orrhagia, and is more apt to occur in women past thirty years of age,
or, at all events, in married women. It is of more significance usually

1^1:

FEBIALE DISEASES.

399

we venture
3ral feature,
iighi, is that
the bleeding
I, astringents

[ breakdown
;at aim must
J, a generous
jold bathing,
neck of the
[escribed. If
st be sought
jme relaxed,
ing must be
}, making it
L bathing, as-
£8 are useful.
(267). One
lis article, by
t, thus arrest-
f course, the
) hemorrhage
'he physician
B vagina ; the
)t douches of
jrrhage, espe-
joined. The
ies the giving
te useful, as,
, fluid extract
a hours, with

es every hour
T fright, grief,
on the cause,
! are of great
most cases at
self ; but rest
Ty important
sxsrcise, fresh
,ry brains and

-When hem-
is called men-
years of age,
icance usually

than profuse menstruation, and almost alway8 proceeds from the womb
itself. This bleeding comes on often after the menopause, or "change
of life." The causes are quite similar to those just considered, but
local causes are oftener found. Some sloughing surface, as from
cancer, fibroid, erosion of the lining membrane, exists in half the cases.
Abortion, and the retention of small pieces of afterbirth, are frequent
causes of this kind of flowing.

This trouble demands the immediate attention of the family phy-
sician or the specialist, who will examine the uterus and ascertain the
cause ; and, as not infrequently, the cause consists in something to be
removed, a brief mention of the methods employed will not be out of
place.

The size, shape, position and firmness of the uterus and ovaries are
made out by the examining fingers of the left hand being pressed
into the abdominal walls above the bladder, while the fingers of the
right hand, with the knees drawn well up, are introduced into the
vagina and pressed against the neck of the womb. An endeavor is
then made to bring the womb between the two sets of fingers, which
maps out its locality, position, etc. The ovaries and ligaments are
likewise located. Any erosion of the mouth of the womb, foreign
growth there, malposition, excessive size, etc., can thus be readily
detected. To explore the inside, one of the various specula before
described are used, and the uterus dilated either with tents, so-called,
or more commonly with a steel dilator. If, then, there is found
aught to be removed, a sharp, spoon-like instruntent, called a curette,
is used to scrape away all diseased tissue or foreign growth, and the
womb then washed out with some antiseptic solution. The womb is
then often packed with gauze to still further disinfect its interior and
afford a means of draining away all oozing blood or forming mucus.

This operation called curetting is now frequently done as a regfular
means of treatment to do away with the causes of hemorrhage and to
restore the normal bulk and character of the womb, instead of resort-
ing to the slow, tedious, and less successful methods of former times.
It is, to be sure, a regular operation; but when done under so-called
aseptic methods, to be described later, is a perfectly safe and trust-
worthy treatment, far in advance of old-fashioned methods, which
8eem less heroic.

It necessitates rest in bed, nursing, and the disadvantages of sick-
ness; but on the other hand, it saves lives, stops disease, and renders
useful what otherwise might become useless and dangerous to life and
health.

Painful Menstruation. — Dysmenorrhoea.

Dysmenoerhcea is from three Greek words Sw, /a^ *^d pim which
mean, literally, a difficult monthly flow. These words do not pre-
cisely describe the complaint; for it consists not so much in a diffir
cult, as in a painful flow.

400

FEMALE DISEASES.

Symptoms. — This affection is always marked by more or less pain
while the courses are on, — especially during the first day or two.
The pain sometimes begins two or three days in advance of the evac-
uation. It extends over the whole lower part of the belly, running
down, at timea, to the thighs, and causing great distress in the back.
It is frequently so violent as to resemble the pains of labor, compel-
ling the sufferer to take the bed, and drawing from her tears and
groans, and occasionally throwing her into Rpasms most painful to
witness. So terrible are the monthly suffeimgs which some women
experience from this cause, that the anticipation of it destroys much
of their peace, even during the intervals of respite.

The Causes of this complaint are very numerous. There is,
doubtless, such a thing as pain in the womb from rheumatism, and
especially from neuralgia, though these are much rarer forms of the
complaint than many suppose.

Pains at the monthly periods are often induced by a displacement
of the womb. If the organ fall over backward or forward, its nerves
are pressed upon in an unnatural way, and when the parts are crowded
with blood, it is very natural for painful sensations to be excited.
In these cases, the neck of the organ is bent at right angles, and the
canal which passes through it is, of course, atrictured, so that the
evacuations are necessarily made with difficulty.

And this leads me to remark, that the passage through the uterine
neck becomes, occasionally, from inllammation or other cause, almost
closed. The result is, much difficulty and great paiu in passing the
monthly secretion.

There are no causes which excite painful menstruation more often
than inflammation in the uterine neck and the ovaries. An increased
flow of blood to an inflamed part always causes pain. An inflamed
foot or leg has to be laid up in a chair, because it aches when put
down. The reason is, that when hanging down it is more full of
blood, and the seutsitive nerves are painfully compressed. When the
finger is hot with inflammation, we assuage the pain by holding it up
for the blood to run down. For the same reason, the inflamed ovaries
and uterine neck ache when the blood flows to them in large quanti-
ties, at the menstrual period.

Congestion of the lining membrane of the womb itself is a frequent
cause of painful menses. It is a condition of the membrairxe of the
womb similar to thai, of the larynx in membranous croup. There is the
same pouring out of what physicians call coagulable lymph, which
forms itself into a membrane. This membrane the womb strives by
strenuous conti-actions to throw off, and linally succeeds in expelling
it, not whole and entire, but in shreds and patches'. These shreds,
which women sometimes call skinny substances, are characteristic of
the disease. The efforts to expel them cause pains very much like
those of natural lalwr, and sometimes almost as severe.

Treatment. — Painful menstruation, excited by the falling over of

- yfU f-" ' i-f i> Ifiiilt i*iVitFili mUhiWii rrfi'<>-ic

FEMALK DISEASES,

401

or less pain
day or two.
of the evac-
lly, running
in the back,
bor, compel-
er tears and
b painful to
lome women
istroys much

There is,
matism, and
iorms of the

iisplacement
I'd, its nerves
1 are crowded
» be excited,
gles, and the
, so that the

h. the uterine
3au8e, almost
1 passing the

n more often
An increased
An inflamed
les when put
more full of
. When the
holding it up
amed ovaries
large quanti-

is a frequent
nbrmie of the

There is the
Lymph, which
mb strives by
J in expelling
rhese shreds,
iracteristic of
iry much like

ailing over of

the womb, backward or forwaic, is cured, of course, by putting the
organ back into its proper position.

Pains caused by stricture of the canal through the uterine neck,
are cured only by enlarging the passage. This is effected by intro-
ducing at first a very small bougie, and then a larger and a larger,
until the passage is of the usual size. It is a delicate operation,
quite successful in careful and skillful hands, but liable to produce
mischief when improperly conducted.

In all the forms of this disease, the treatment should aim, not
merely at palliation, but at a cure. And generally, I am happy to
say, a cure is attainable. Yet how many women suffer for years
until health has fled, and life has become a burden, receiving from
their medical attendant the assurance that palliation only is possible 1

It is necessary at each monthly turn to do something, in these
cases, to quiet the pain. For this purpose, twenty drops of spirits
ether in a wineglass of tepid water, thrown into the bowel, will be
liighly serviceable. For a like purpose, one pill (116) may be taken
twice a day, beginning one day before the menstrual flow. A bella-
donna ointment (170) maybe rubbed upon the neck of the womb
with great advantage, and a teaspoonf ul of viburnum compound taken
each hour.

In the congestive form of this disease, — that in which the membrane
is formed on the internal surface of the womb, and thrown off in f raff-
ments, — ■ the liquid acetate of ammonia, or spirits of Mindererus, is
a very valuable remedy taken in two-teaspoonful doses, in a table-
spoonful of cold water, three or four times a day, while the pain lasts.

Medicines almost innumerable have been put on the market for
this complaint, of which Hayden's viburnum, liquor sedans, diovi-
bumum, and a host of others, are examples. These are usually
harmless, and may be used. Gin, in goodly doses, is often service-
able by stimulating the circulation. Turpentine cloths, the hot-water
bottle, rest in bed, etc., also help amazingly. But whatever remedy
may be used at the time, even though the pain be severe enough to
require an anodyne, the cause must be sought and treated.

Chlorosis. — Green Sickness.

Before the age of puberty, the girl is only i child. She has
witiiin her only the elements of a woman. The change to which she
is destined brings with it a wonderful development both of body
and mind.

To effect this development, and bring out the new being iu the
perfection designed by the Creator, a large amount of hidden nerve-
power is required. She requires to have been born with a well-vital-
ized constitution, and to have been physically trained in a way to
harden and energize it. Without these antecedents, her development
at puberty will be feebly and imperfectly made. Her development

":il

FEMALE DISEASES.

and evolution of germs will be so defective as to cause her menstrua-
tion to be only partially established, or to fail altogether.

Symptoms. — Where the inherent powers of the system are just
sufficient to bring about a first menstruation, it often happens that
they seem to be spent by the effort, and that the evacuation fails to
appear again for several months. Indeed, the whole organization
may break down at this point, and become blasted, as it were, like a
blade of wheat which has grown well for a time, but which fails to
develop the kernel.

The blood at this period may become impoverished, and fail to
distribute adequate nourishment and development to the various
tissues. When this occurs, it loses a part of its red globules, and
increases its watery portion. As a result, the skin becomes pale, and
sometimes of a yellowish hue,* the bowels become torpid and con-
fined ; the nervous system sensitive and weak ; the digestion is
impaired ; the appetite is either lost, or perverted, — longing for un-
natural food ; the tongue is white ; the heart palpitates ; the spirits
are depressed ; the temples and ears throb ; the head occasionally
aches and whirls with dizziness ; the sleep is disturbed and abbrevi-
ated, and hysterics are now and then superadded to close the cata-
logue of ills.

This is Chlorosis, briefly depicted in its origin and its symptoms.
The word is from the Greek x^<"P<'«» which means green and pale.
By nurses it is called the " green sickness."

Its Causes are quite numerous, among which may be reckoned
impoverished diet, damp atmosphere, sedentary habits, long confine-
ment indoors, overworking the mind in childhood, constipation of the
bowels, and an inherited feeble constitution. This disease is very
frequently met with in domestics emigrating to this country from
Ireland, Sweden, and the Provinces, and depends on the failure of
Nature to accustom herself to the new climate. These cases, how-
ever, all respond well to treatment, but when left alone, lapse into
consumption, Bright's and similar diseases.

Treatment. — Chlorosis, as a general thing, is connected either
with retention or suppression of the menses ; and in treating it,
physicians are too much in the habit of resorting indiscriminately to
forcing-medicines, called emmenagogues. From such practice great
injury often results.

It is not always sufficiently considered that a woman fails to men-
struate, or ceases to do so, because she is sick ; and if we would cause
her courses to return, we must restore her health. To do this, should
generally be the great object of treatment. Let the health be restored,
and the menses will come back. The only philosophical treatment is
that Avhich will invigorate the system.

In chlorosis, the vital powers are in a state of dilapidation. How
can they be roused? By exercise on horseback and on foot; by

(ti^W' r':iJXi%Mf\AniL>uuMJij^\M^u^, kr^..

FEMALB DISEABB8.

403

ler menstruii-
r.

stem are just
happens that
lation fails to
organization
it were, like a
i'hich fails to

i, and fail to
3 the various
globules, and
>mes pale, and
rpid and con-
; digestion is
inging for un-
js ; the spirits
1 occasionally
I and abbrevi-
close the cata-

its symptoms.
'een and pale.

' be reckoned

long confine-

tipation of the

iisease is very

country from

the failure of

3se cases, how-

»ne, lapse into

(ineSled either

ill treating it,

jcriminately to

practice great

n fails to men-
re would cause
do this, should
Ith be restored,
al treatment is

idation. How
d on foot; by

wearing clothing enough to keep warm; by a tepid bath two or
three times a week, and brisk rubbing with a coai-se towel ; and by
a generous diet, composed of tender meats, animal broths, etc.

This treatment, however, should be preceded by unloading the
bowels with prescription (35) or (40), according to choice. One
pill should be taken at night. When the liver is considerably de-
ranged, perscription (40) will be particularly serviceable. Half a
pint of tepid water thrown into the bowel, night and morning, will
help relieve costiveness.

The bowels having been well opened, give a tablespoonful of pre-
scription (59), two or three times a day; or of prescription (60), a
teaspoonful, the same number of times each day.

In the treatment of this disease, iron, in some form, is almost
always needed. Prescriptions (61), (71), (73), (74), (76), (80)
and (316), are suitable preparations. Among the more recent
remedies for building up the blood in chlorosis, perhaps none is more
successful than the combined pill of iron and manganese, called
Bland's modified pill, or, if preferred in liquid form, the same remedy
may be obtained in still milder and more physiological form in the
preparation known as Gude's Peptomangan. The peptonate of iron
is also one of the best modem remedies.

A girl suffering from this disease should always be taken out of
school. The mind should be divided between rest and recreation.

Cessation of the Menses. — Turn of Life.

There is probably no period in woman's earthly existence which
she approaches with so much anxiety as that which she is in the
habit of calling " the turn of life." The aniiety is not without some
reasonable ground for its existence. She has been accustomed, for
thirty years or more, to lose, every four weeks, a certain amount of
blood. When this evacuation stops, disturbancep of the system may
well be expected. So well is this understood, that this climacteric
has come by general consent, to be called the " critical period " in
female lif^

If it be well and safely passed, the health is generally better than
before, and a " green old age " is likely to follow. But if the seeds
of disease are in the system, — if there be a tendency to cancer or
other malignant disease, which has been held in check by the monthly
fiow, it now takes up its destructive work, and shows itself ; or, if
there be a predisposition to apoplexy or congestion of any organ, it
is more likely to become active, now that the accustomed waste-gate
is closed. A distinguished writer has said that about half the deaths
among women, about the age of forty-four, are from cancer.

Nervous Complications It is the duty of the physician to look

carefully after those females who come under his care at this critical
time. For, in addition to the organic and malignant diseases which

404

n5MALR RISEASKS.

attivck her at this time, she in exposed to a host of nervous irritations,
which, if neglected or badly managed, make her life a cions and a
burden. The symptoms of these irritations are in number, legion.

Age at which the turn of life come«. — As a general rule, tlie
turn of life comes between the ages of forty and fifty ; but oycasion-
ally occurs at other periods, varying from thirty to seventy. If tlie
menses appear early in life, they terminate early.

Symptoms. • — When there is a tendency to corpulency at this
period, the symptoms are headache, dizziness, and a sense of suffocja-
tion. It is common, when the period of cessation approaches, for
deviations from regularity to occur. At one time the menstrual dis-
charge will be profuse ; at another, scanty. It will now disappear
for a time, and be replaced by the whites. Then it will appear for a
few times with considerable regularity. Next will come a suspension
for several months, to be followed by a flow of such profusion as to
amount almost to flooding.

Mixed up with these irregularities will be palpitations of the
heart, constipation of the bowels, a variable appetite, and broken
sleep, weakness and inquietude, timidity, a dread of impending evil,
irritability of temper, hysterical attacks, bad feelings in the head,
with sounds in the ears, as of the rolling of carriages, sparks before
the eyes, and an unsteady gait.

Treatment. — If there be, at this period, fulness of habit, with
dizziness, headache, sparks before the eyes, a sense of suffocation,
etc., there is a plain indication that the brain is oppressed with too
much blood. I am not much in favor of bleeding, but this is a case
in which from a gill to a half-pint of blood may, if ever, be drawn
from the arm with positive advantage. Cups applied to the back of
the neck will also be useful. Give at night, also, three of the com-
pound cathartic pills, and then keep the bowels regular with pre-
scription (18), — a wineglassful to be taken occasionally. The diet
should be spare, and strictly vegetable : to which should be added
much daily exercise.

For the flushes and sweats to which women are subject at this
time of life, ergot often answers admirably, in teaspoonful doses
every few hours. Atropia in -j^grain doses not infrequently helps
the sweating.

Purging should not, in any case, be carried too far. If nervous
affections show themselves, with disturbance of the digestion, and
general debility, even leeches would be improper, and physic should
be swallowed very sparingly.

When serious organic disease is suspected, as cancer, it is the duty
of the physician to inT stigate the case very thoroughly, and to give
the patient the advantage of the most prompt and decided treatment.
That treatment is spoken of in the proper place.

FEMALE DISEASES.

405

rous irritations,
! a ciosH and ii
mber, legion.

meral rule, the
; but occiwion-
sventy. If the

lulency at this
ense of suffoca-
approaches, for
} menstrual dis-

now disappear
rill appear for a
me a suspension

profusion as to

itations of the
te, and broken
impending evil,
fs in the head,
IB, sparks before

of habit, with
of suffocation,
)re88ed with too
it this is a case
ever, be drawn
1 to the back of
iree of the cora-
igular with pre-
lally. The diet
hould be added

subject at this
laspoonful doses
frequently helps

far. If nervous
e digestion, and
id physic should

er, it is the duty
[hly, and to give
cided treatment.

Hysterics. — Hysteria.

The name of this complaint is from a Greek word signifying the
womb. It took this name from the belief that this organ is the scat
of the irritation which produces the hysteric disturbance.

This belief is correct, if we include with the womb the ovaries
and the other sexual organs. The sexual system is doubtless the
centre of the reflex nervous derangement called hysteria.

It has been sufficiently demonstrated that hysterics are dependent
for their existence either upon organic disease, or upon simple irrita-
tion of the sexual organs. Sir Benjamin Brodie mentions cases of
the hysteric paroxysm, produced by pressing upon an inflamed and
tender ovary.

Symptoms. — An attack of hysterics is generally preceded by de-
pression of spirits, restlessness, and a frequent desire to pass water.
It is sometimes marked by convulsions, or fits ; at other times, it is
not. At times, the attacks are local, and are manifested by spasms
of the throat at the top of the windpipe, or in the bronchial tubes ;
the patient feels a ball rise up in her throat (globus hystericus), her
heart beats violently, and she laughs and cries by turns.

When the disease is more general, the muscles of the lim^js are
thrown into spasms ; the patient struggles violently ; rising up in a
sitting posture, and then throwing herself back ; twisting the body
from side to side, clenching the hands, and throwing the arms about,
so that she is with difficulty held by persons much stronger than
herself. Soon after these paroxysms, the patient generally passes a
large quantity of very pale urine.

The Causes of this complaint are as numerous as the causes of
female diseases, for in truth there is no female complaint which may
not produce it. Whatever develops and excites the sexual system,
and at the same time weakens the constitution, lays the foundation
of this malady. Nervous women are much inclined to it. In large
cities there is more of it than in the country, because there is more
excitement and luxury, and more of their consequences, — nervous
and female diseases.

Treatment. — To treat this complaint successfully, it is necessaiy
to search out its cause, and remove that. Like the whites, it is not
so much a disease in itself as a symptom.

The first inquiry to be made should have reference to the real
origin of the complaint. Is it dependent upon inflammation of the
f^varies or the womb, or to displacement of this latter organ ? or does
it arise from the low state of the blood, and the weakened condition
of the nerves, acted upon by some irritation or heightened sensibility
of the sexual organs ?

If dependent vpon inflammatory disease, that is to be treated ac-
cording to directions elsewhere ; if upon falling of the womb, no

""Tmi.,^

406

FEMALE DISSABES.

remedies will avail until t*>at is put in its proper place. If diluted
blood and weakened nerves be the cause, iron and quinine art! tin;
remedies. When the complaint arises from deficient menstruation,
iron and aloes (47) will be serviceable. The nervous spasni can
sometimes be broken up by pouring cold water upon the head, or
face, or limbs of the patient.

The Hysienlc and Moral Treatment are of great consequence.
The complaint is very much under the control of the will. Whatever
tones the moral nature and strengthens the will, tends to subject this
disorder to the control of the patient. Plain, wholesome diet, exer-
cise, bathing, and the enforcing, as far as possible, of a rugged, self-
reliant habit, generally go far towards breaking its force.

Polypus of the Womb.

This is simply a foreign body, or tumor, growing either within the
womb, or in the vagina, and attached to the uterine neck. It is
rather a serious affection.

These tumors vary in weight from half an ounce and less to many
pounds. They are, in color, whitish, red, brown, and even black.
They have almost every consistence, — being soft, spongy, gfristly,
and hard.

The Symptoms of poljrpus are various, resembling those of almost
every other womb-complaint. It is often mistaken for displacement
of the womb, for dropsy of this organ, and for pregnancy.

These tumors are apt to give rise to dangerous bleeding from the
womb, and other discharges which greatly weaken and derange the
system. They are liable to terminate in cancer. In pregnancy, they
may produce miscarriage. When they are suspected, therefore, the
utmost scrutiny should be employed to search them out. This is
especially desirable, since the fallen or inverted womb may carelessly
be taken for a polypus, and be operated on as such.

Treatment — This is of two kinds, medical and surgical. The
first consists in means of supporting the strength of the patient, and
checking the discharges by means of injections, rest, etc., and in en-
deavoring to cause the removal of the tumor by absorption.

This last object is sometimes effected by an unstimulating diet ;
and by the use of iodine (101) for some time. This treatnc^ent does
not often succeed, however, and cannot be relied upon. ■

If the polypus be within the womb, of course it cannot be reached.
The only thing to be done, in such case, is to cause its expulsion.
This is sometimes effected by causing the womb to contract by the
use of spurred rye (267), or by the use of the electro-magnetic
machine. This latter remedy can do no harm, and had better be
tried first.

When the polypus is outside the womb, the methods of removing

se. If diluted
iiiiiine are tin;
menstnmtioii,
)118 HpuNiii uaii
n the head, or

: consequence.
11. Whatever
to subject this
)me diet, exer-
a rugged, self-

ther within the
e neck. It is

d less to many
id even black,
pongy, gristly,

:hose of almost
r displacement
acy.

ding from the
d derange the
regnancy, they
, therefore, the
out. This is
may carelessly

jurgical. The
le patient, and
3tc., and in en-
)tion.

nulating diet;
breatn^ent does

lot be reached,
its expulsion,
ontract by the
ectro-magnetic
had better be

i i

i I

FEMALE DISEASES.

407

it are various. Tt is HometimeH done by cauterization, or burning it
i)(T by bot ii'oM or ciiUNtiu. This iH a baixb inetbod, and not leHorted
to by Mkillt'ul HurgoonH. Another method iH that of crushing the tumor
with an inHtnmiont. Another still in that of torsion, or twisting it
off. And still another, that of applying a ligature, or tying a string
around the neck of the tumor, and strangling it by preventing the
blood from going to it. By this means it falls off in a few days.
There is one other method, that of cutting the tumor away with a
knife, or with a pair of curved scissoi-s. These three last methods
are the chief ones now used by skillful surgeons.

Uterine Hydatids.

This name is given to a bladder-liko substance, occasionally found
growing in the womb. It is filled with a white or yellowish fluid.
Sometimes a bundle of them grow together, like a bunch of grapes.
Some are elongated, like a bean, and have a sort of claw, by which
they are nttached; others are shaped like an egg.

Those with a claw are generally .supi)osed to be living beings, like
worms in the bowels. When expelled from the womb, they move
about if placed in warm water.

The Causes which produce these singular growths are obscure.
Probably whatever improperly excites or irritates the uterine organs
may produce these vesicular bodies.

The Symptoms may be easily mistaken for those either of preg-
nancy, or of water or inflammation in the womb.

From the growth of these bodies, the bowels may enlarge, the
breasts swell, and the menses stop. If to these symptoms be added
sickness at the stomach, the woman, if married, feels confident she is
in the family way. There is no certain method of correcting this
mistake, until the collection of bladder-like bodies is expelled from
the womb.

It is rare that these bodies appear in the virgin woman. They are
supposed to be connected, in some way, with imperfect conception.

Treatment. — We can seldom say absolutely that hydatids exist,
until we see them expelled. Whatever will produce contractions of
the womb, will cause their expulsion ; but it will not do to give these
remedies indiscreetly, lest the cause be one of real pregnancy instead
of hydatids. When once reasonably assured that hydatids do exist,
the only logical treatment consists in their removal. This is best
effected by the dilatation of the womb and a thorough curetting or
scraping as described under hemorrhages. Ergot often causes suflB-
cient contraction of the womb to drive out these masses, and may be
judiciously tried before resorting to the curette. It should be given
in teaspoonful doses every four hours till pains ensue.

iiliiMiki

408

FEMALE DISEASES.

■^ I

t 1

Inflammation of the Womb. — Metritis.

This disease very often follows delivery, and is connected with
child-bed fever.

Various Causes also produce it in the unimpregnated state. Im
flammation of the ovaries, or of the uterine neck, may extend to the
womb. Falling of the womb may caure it to be irritated by being
placed in a new position, and thus bring on inflammation. In some
temperaments, marriage may produce this disease ; in others, single-
ness. It may also be biought on by painful menstruation, by forcing
medicines, by constipation, by tight corsets, by solitary vices, and by
excited sexual feeling.

This is the most common variety of inflammation found in the
pelvis. It is often limited to the neck of the womb, and is then called
endocervicitis ; it may be limited to the lining membrane of the womb,
and is then called endo-nietritig, but practically it is all one and the same
disease, and sooner or later involves not only the mucous m • Torane
of the interior, but also the muscular structure of the womb itself.
It is now considered a germ-disease and rarely results in spontaneoxis
cure. It proceeds from the entrance of germs into the uterus either
at the time of labor or miscarriage, or from the entrance of the germ
of gonorrhoea ; germs, however, from the vagina, which are normal to
that region, may ofteu be carried into the cervix and there set up a
trouble.

Symptoms: — Pain in the back, nape of the neck, the right or left
iliac region ; leucorrhcea ; painful menses ; hemorrhage from the
womb; symptoms from neighboring organs (bladder, rectum) ; and
symptoms from distant organs, as stomach, heart, nerves, etc.

Ino disease gives rise to so many and so complex symptoms. Nau-
sea and vomiting, flatulence, constipation, palpitation, headaches,
cough, nervousness, loss of appetite, etc., are frequent symptoms of
the various forms of metritis. On examination a- hard, congested
womb is felt, with perhaps enlargement either of the neck or the en-
tire organ, erosions, ulcerations, eversion of the lips from a tear may
be found, while issuing from the mouth of the womb is seen a plug of
mucus which is either white, translucent and ropy, or yellow and
more pus-like. The womb is tender to touch, and this tenderness
may be transmitted to the appendages (tubes and ovaries).

Trea.ment. — This varies with the variety and the length of time
the disease has existed. If there is inside the uterus any retained
product of c inception, placental tissue or granulating surfaces, they
must be curetted out as descnbec' in a previous article. This process
is practically an operation and must be done thoroughly and under
ether. If there is active inflammation going on in the tubes or ova-
ries, this procedure must be postponed and milder measures used for

PEMALE DISEASES.

409

iritis.
onnected with

ted state. Ixv-
extend to the
tated by being
ion. In some
others, single-
ion, by forcing
J vices, and by

found in the
i is then called
6 of the womb,
le and the same
ous m • ibrane
16 womb itself.
in spontaneous
e uterus either
ce of the germ
1 are normal to
there set up a

[le right or left
lage from the

rectum) ; and
,res, etc.
nptoms. Nau-
lon, headaches,
t symptoms of
lard, congested
neck or the eii-
rom a tear may
3 seen a plug of

or yellow and
this tenderness
tries).

length of time

15 any retained
r surfaces, they
. This process
rhly and under

16 tubes or ova-
lasures used for

the time being, such as painting the vagina and neck of the womb with
iodine and similar remedies.

Tampons of wool wet with glycerine are frequently used to de-
plete the engorged womb, applications of creosote and iodine will
often heal over simple erosions, while hard cicatricial masses are often
absorbed by applications of iron. Tampons are to be worn from
twelve to forty-eight hours, but should be removed whenever pain is
produced. Leeches applied to the neck of the womb often relieve a
congested state. The womb is to be thoroughly scraped and washed
out, and a good drainage kept for the escape of forming secretions
whenever there is severe inflammation oi' the body of the organ.
Lacerations of the neck, when extensive, are to be sewn up, but when
only moderate may be successfully treated with strong styptic iron.
Hot douches lot only serve a good purpose in reducing congestion
and inflammation, but are often very soothing. They are to be taken
in the recumbent position ; the water to be hot as can be borne —
110° to 112° F. — and as much as six quarts are to be used. One
should purchase for this purpose a large fountain syringe, or a tin pail,
and hang it two feet above the head ; it is to be used twice daily, and
may be used every three or four hours. Patients suffering with this
and similar diseases must not dance or take long walks, nor should
they use the sewing-machine ; neither should tliey stand long at a
time, but should have light exercise in the open air and general sys-
temic medicine ; they should' lie down every day from two to four
hours, and in severe cases must retain the recumbent position. The
bowels must be kept relaxed with cascara-sagrada or some morning
saline ; a teaspoonful of the aromatic cascara at night, or a half-glass
of Hunyadi Janos water on rising, are excellent for this purpose.
If the woman is pale, a prescription of some iron tonic will be useful,
such as the/owr chiorides or Aikevk% tonic pill,

Faliing of the Womb. — Prolapsus Uteri,

The womb is often found out of its natural and proper place.
There are certain ligaments and muscles intended to act as stayB,
and hold it up in its position. These, from various causes, become
relaxed. It then, losing its support, drops dovm into the vagina, be-
tween the bladder in front and the large bowel called the rectum,
behind. It is then said to be fallen or prolapsed.

The womb of a married woman is more apt to become prolapsed
than that of the unmarried, because it i-^j r^ore liable to have its weight
increased by congestions, enlarges, t, toin perineum, etc.

The Symptoms are dull pain in the small of the back, a dragging
sensation in the groin, and a feeling of fullness around tlie funda-
ment; dragging pain in the nape of the neck; headache, constipation,
etc.

. Treatment. — The complaint is easily cured if the remedies oe

wmmmmmmm

I i

•f

|, ^«;

410

FEMALE DISEASES.

applied early. If the prolapse be due to relaxed, weakened supports,
tonic constitutional remedies must be employed. The diet must be
full and easy of assimilation , exercise taken in the open air, proper rest
secured, and electricity be used.

If the womb be* tipped over, some support must for a while be used
in the shape of pessaries. If by i-eason of its increased size and weight
the womb hang too low down in the pelvic cavity, then it must be
made smaller and lighter by treating the coexisting inflammation and
subinvolution. If the floor of the vagina has been torn during labor,
thus allovnng the womb to sag, this must be sewn up and a new floor
formed.

In complete prolapse of the aged, the uterus often protrudes from
the vagfina. This condition in the middle-aged is best met by ampu-
tation ; while in the very aged a support may be adjusted after hav-
ing replaced the organ.

Falling Over of the Womb.

Anteversion. — The womb sometimes falls over forward upon the
bladder, towards € o pubes. This is called anteversion. The top is
turned forward to the bladder; the mouth, back towards the large
bowel. (Fig. 141, 6.)

a be

Retroversion. — When the womb falls over JatfAfwarof, between the
rectum and the vagina, it is said tc be retroverted (i). This is just
the opposite of being anteverted. In this displacement, the mouth is
turned forward, the top backward.

This displacement may occur suddenly or gradually. If the former,
there is generally great distress, and the organ should be immediately
put back in its place; if the latter, the pain will be less intense, and
the replacement must be e£fected by pessaries, — particularly with the
ring pessary, made of India rubber.

mi- m

FEMALE DISEASES.

411

tied supports,
iiet must be
r, proper rest

tvhile be used
56 and weight
a it must be
mmation and
during labor,
d a new floor

otrudes from
net by ampu-
»d after hav-

ard upon the

The top is

ds the large

, between the
This is just
the mouth is

;f the former,

immediately

intense, and

arly with the

Anteflexion and Retroflexion. — When these occur, the womb is
dovhled upon itself, the mouth of the organ not being tilted up before
or behind, but retaining its natural position. These flexions are rep-
resented by a, tf, and e.

Besides these more common displacements of the womb, there are
several slighter deviations which it is scarcely necessary to describe.
There is the obliquity of the womb, which is simply a leaning of the
organ backward or forward, or to one side.

There are still other more serious troubles, which are so very rare
as not to require me to dwell upon them, such as the inversion of
the womb, or turning it wrong side out, like the finger of a glove ;
and the hernia of the womb (hysterocele), which is like that of the
bowel.

/^essaries. — Much might be said about pessaries : they are at
times of the greatest assistance in keeping a badly placed uterus in
its proper position ; on the other hand, they are serious hindrances
to health. By their pressure they often cause inflammation of the
ovaries and tubes and light up afresh old, quiescent chronic inflam-
mations. They often stretch unduly the uterine ligaments and
make a relaxed vagina. But it must be said that often, too, they
keep in place a simply misplaced womb with no trouble and little
expense to the wearer, thus avoiding long treatment and perhaps an
operation. TBey should always fit accurately and nicely and should
never cause pain or make the wearer conscious that she wears such a
thing. The soft rubber variety, or at least those made of wire and
covered with rubber, are the least likely to cause trouble ; but they
need, on the other hand, more frequent •inspection and cleansing.
The hard rubber are more easily kept clean, but are more dangerous.
Whenever a pessary is worn, it should be under the surveillance of
the family doctor, lest ulceration of tl^ vagina and undue pressure
on the internal parts ensue. Pessaries no doubt are very use-
ful in keeping in place a womb that has been replaced and in
warding off an operation otherwise indicated. They are of all
shapes and designs, so that a description of them seems superfluous
here.

Displacements. — The various displacements of the womb are
such common occurrences among womankind that they have always
received considerable attention by the gynaecologist. They result
from falls in young girls, from enlargement of the organ, from weak
uterine supports and poor health, from torn muscles of the vagina
during labor, and irom new growths in the womb.

The symptoms of a misplaced womb are from nothing to an amaz-
ing amount of trouble. Many a woman goes tlirough life with a
badly torn vaginal floor and retroflexed worab without the slightest
ill-effect, while her neighbor suffers intensely from a much less de-
gree of displacement.

warn

wmwukM i .M. .i. .unJMii ^^ ": ■",:.'!. ' ' u:.; ,

FEMALE DISEASES.

Operative Treatment. — When for any reason a pessary cannot
or ought not to be worn, and there is much inconvenience from the
misplacement, resort must be had to packing the vagina and reducing
the size of the womb, and allaying inflammation and pain before again
trying a pessary, or else some of the several operations must be per-
formed. Of these latter there are at the present day three principal
methods in vogue, viz. : —

Alexander's operation consists in cutting down on the little holes
in the lower abdomen, near the pubic bones, called the hernial rings,
through which in the male the cord and vessels of the testes run,
where hernia or rupture occurs, and through which in the female the
the round ligament of the womb runs. This ligament is a small
round cord attached to the anterior and top part of the uterus, acting
as a stay. This ligament is dissected out and pulled up taut on
either side (there are two, one on each side of the womb) till the
womb is brought up into its normal position and there fastened.
This operation is a very ingenious one, and answera well in simple
uncomplicated cases.

Ventral Fixation is a second method of fastening the womb in
place, and consists in opening the abdomen, lifting up the womb and
fastening it to the under side of the abdominal wall. This method
is tolerably free from danger, like the preceding, but has the advan-
tage of parting adhesions which may bind down the uterus and pre-
vent its rising, and of permitting the operator to see and correct any
existing disease of the tubes and ovaries which so commonly accom-
pany bad cases.

Vaginal Fixation is a third method, whereby the uterus is likewise
fixed, but this time to the vagina in front of the bladder. This last
method is at present receiving considerable attention ; but it may be
said that no one method is the best for all cases, the surgeon being
the best judge of the situatio». These operations are safe and effi-
cient, and forever do away with pessaries and the existing disease.
Women go on to term in labor quite generally after these operations.

Tumors of the Womb.

The womb is especially prone to be the location of foreign growths.
These occur mostly in middle life, and ai* commonly either of a
fibroid or cancerous nature.

The fibroid is a firm, hard mass of fibrous tissue, growing either on
the inside waU and suspended like a polypus, or developing in the
uterine muscle itself, or on the outside of the womb in the abdominal
cavity. They attain oftentimes huge proportions and weigh many
pounds. They are not necessarily fatal to life or detrimental to
health, but usually give rise to a train of symptoms which may be
annoying and fatal. Hemorrhage and profuse menstruation to such
an extent that the patient is rendered pale and almost blanched are

3sary cannot
ce from the
nd reducing
tefore again
nust be per-
'ee principal

little holes
emial rings,
3 testes run,
d female the
b is a small
terus, acting
up taut on
mb) till the
re fastened,
11 in simple

16 womb in
e womb and
^his method
8 the advan-
rus and pre-
correct any
lonly accom-

s is likewise
■. This last
at it may be
rgeou being
ife and effi-
;ing disease,
e operations.

gn growths,
either of a

ng either on
ping in the
e abdominal
iveigh many
brimental to
lich may be
tion to such
ilauched are

FEMALB DISEASES.

413

not infrequent. Pressure on the bladder and surrounding organs
often causes serious disturbance to urination and defecation; di-
gestion is interfered with, and pain is frequently present. When
these tumors, which are of slow growth, are small, painless and free
from trouble, they may be let alone ; but when large, bleeding freely,
and causing symptoms of. pressure, they must be dealt with. Many
gynaecologists of the present day claim that every fibroid should be
removed; but as this means the enucleation of the womb and ovaries
(hysterectomy), — a very severe operation, — we cannot endorse this
view, especially as hundreds of women go through life unscathed
even with large tumors.

The menopause, or " change of life," has a twofold effect on them :
some begin to atrophy and g^row small after the blood ceases to come
to these parts in regular mon- hly congestion, and they may even dis-
appear entirely : others are increased in size and even change their
structure into malignant gfrowths. Hence it will be seen that these
tumors require the supervision of the family doctor or specialist, that
their growth may be watched. It remains to be added that many
advocate the use of strong galvanic currents, applied according to
the method of Apostoli, a noted French savant, to diminish the size
of these tumors. Many cures are claimed, and at one time it seemed
as though this method was destined to supersede all others ; but now,
after a few years' trial all over the world, it is generelly conceded
that only certain varieties are amenable to this treatment, and that
the tumor does not entirely disappear. This method, however, ob-
viates the necessity for operating, and is in many cases an admirable
way of reducing and keeping in check what otherwise might threaten
life. It is still a much used, though often abused, method of treating
them, and appeals to tlia timid and obdurate.

Cancer of the Womb.

This is another but more dangerous growth of the womb, and oc-
curs mostly in women near middle life, especially in cases which have
a family predisposition to cancer, and when the neck of the womb
has been badly lacerated from labor or miscarriage. It usually be-
gins in the neck of the womb like a little bunch, which bleeds easily
on touch, and extends rapidly into the neck and finally up into the
body of the uterus. Its entire life-dumtion may not exceed one or
two years before death claims the sufferer. Hemorrhage and foul
leucorrhoea are often the only signs which attract the patient's notice.
Pain finally sets in, with breaking down of the cancerous tissue, and
then a very foul and peculiar odor commences. This odor is very
penetrating and is characteristic of the disease. Emaciation, loss of
appetite and strength, painful days and nights supervene, and finally
death comes to relieve the sufferer of one of the worst diseases to
which womankind is liable.

1 1

414

FEMALE DISEASES.

Treatment. — The only treatment, consists in the early detection
of the disease and the enucleation of the entire uterus by the vagina.
If it has been discovered early, before the cancer-cells have got out-
side of the womb, it may be successfully treated at least for a num-
ber of years. I can not better advise M^omen than by warning them
to consult a physician at once on the occurrence of any unusual
hemorrhage near the change of life. So many ascribe these slight
hemorrhages and aches to this broad mantle of ignorance, that pre-
cious time has been wasted and the golden opportunity passed for
curing the dread disease. Do not waste time and money, either on
nostrums or other quackish methods, nor listen to what Mrs. So-and-
So did, but proceed at once to the best authority you have at your
disposal. So much is being successfully done now for the relief
and cure of these growths, women owe it to themselves and their
families to take advantage of modern skill and knowledge. The
microscope will detect it earlier than the eye or finger, and th-is a
suspicion may be corroborated or a fear dispelled by timely advice.

Of palliative treatment, the application of styptics and the curette
cause a delay of the growth and a cessation of hemorrhage ; while
anodynes like morphine or opium in some of its forms will allay pain
and anguish.

Ovarian Tumors.

Ovarian tumors are rather frequent growths, occurring for the
most part as cysts and attaining a huge size ; not infrequently they
grow to such an extent that their weight far exceeds that of the en-
tire body. They are filled with a clear light-yellow fluid. Their
treatment consists in their removal through the abdomen (ovari-
otomy), and should be operated upon as soon as detected. The rate
of mortality following these' growths is not large. It was this oper-
ation, began in America in the forties, that was the beginning of a
new era for surgery of the abdomen. Only when neglected does one
now-a-days meet with these enormous growths.

When for any reason an operation is inadAasable, they may be
tapped and comfort received for a long time. '

The ovary is likewise the seat of otiier growths both benign and
malignant.

Inflammation of tlie Fallopian Tubes.

To speak of this disease means to review the growth of gynsecolo
gical science within the last fifteen years.

The operation of laparotomy, or opening the abdomen, is now per-
formed so successfully by almost every surgeon, that it has taken its
place among the every-day mea-sures for relief, and frequent oppor-
tunities have of course been presented to the profession, of corrobo-
rating or refuting some old-time theories. Many a notion of inflam-
matiou of the bowels, or peritonitis, has become a thing of the past ;

: J .yjMKfwemK'V

iKu. »i#Mffffj hr" rfHrifcrtlito.iUiH

PEMALK DISEASES.

415

rly detection
Y the vagina,
lave got out-
t for a num-
arning them
any unusual

these slight
ce, that pre-
;y passed for
ey, either on

Mrs. So-and-
have at your
or the relief
'68 and their
rledge. The
, and tLv.s a
lely advice,
d the curette
rhage; while
nil allay pain

rring for the
jquently they
lat of the en-
fluid. Their
omen (ovari-
The rate
as this oper-
^inning of a
sted does one

they may be

benign and

bes.

I of gynsecolo-

1, IS now per-
has taken its
quent oppor-
a, of corroho-
Lon of inflam-
of the past ;

many an unexplained death has been made clear, and many, many
lives have been saved by a timely recognition of the true state of
affairs within the pelvis.

Many cases of what formerly was regarded as peritonitis are now
known to have been either salpingitis, ovarian abscess, appendicitis,
etc. Of these diseases the most prolific of trouble, as well as the
most common, is salpingitis, or inflammation of the tubes which con-
duct the ovum to the interior of the womb, where it is f-uctificd by
the male germ.

These tubes are lined with a mucous membrane like that of the
interior of the womb, and continuous with it, so that whenever in-
flammation from whatever source is present in the cavity of the
womb, it is extremely liable to travel up the tubes, even to the ova-
ries and peritoneum. This inflammation may be merely catarrhal,
and only become bothersome by its chroaicity, or it maj' become
purulent and suddenly cause violent illness.

The catarrhal form begins very slowly and gradually from some
old neglected uterine disorder, or it may follow a labor where there
was some septicsemia or blood-poisoning; it may spring from venereal
disease, either contracted by the woman illicitly or given her by her
husband ; and it may come in several ways not of general interest to
the reader. At all events, it is essentially a germ-disease, and when
anyways severe has a tendency to spread and become worse.

Symptoms. — These little tubes, which are normally about the
size of a slate-pencil, become swollen, and very painful and tender,
causing inability on the woman's part to do a full day's work, and
even confining her to bed. The temperature is raised, the belly
bloated, the urine often being frequently passed ; the bowels are
constipated, appetite poor, and digestion bad; sleep is disturbed and
the nei-ves weakened.

On examination, the trained finger in the vagina feels a large,
swollen, tender tube on the affected side, and often a bulging of the
roof of the vagina.

Treatment. — Rest in bed, hot douches, painting the side with
tincture of iodine, and the using in the vagina, every night and
morning, of a suppository of five grains of ichthyol, with laxatives
and nerve sedatives, will do much toward reducing a slight and even
moderate attack. The disease, however, does not usually exist alone,
and therefore much time is generally necessary in eradicating it.

When the catarrhal form, however, gets worse, and pus forms, we
then have the so-called purulent salpingitis, or pus-tvbe. Pus gathers
here as elsewhere, stretching the tube more and more ; finally the
pus-germs work through the tube and out of the end, where they set
up an active inflammation, and new tissue forms about the tube,
shutting it off from the general cavity. Everj'thing in the neigh-
borhood becomes glued together, fixing the womb in an immovable

SBTiiBE&l

•'••Jiif^: -

416

FEMALE DIBKA8ES.

position. The tube goes on stretcliing more and more, till finally it
becomes one large abscess-cavity. It may then, at times, be punc-
tured through the vagina and thus drained ; but generally an opera-
. tiou is required, either to remove the womb auu its appendages
through the vagina, or else to open the abdomen and take away the
large msiss of exudation, in the centre of which is the pus-cavity.
When matters Imve reached this stage, the patient is of course in a
very grave condition. There is a high fever, with sweats and perhaps
chills, loss of appetite, pallor, pain, and all the evidences of Imng
extremely sick. The patient either dies shortly or becomes bed-rid-
den, unless an operation can relieve her. This latter variety of the
disease is calle pyoaalpinx.

Acute Salpingitis is best treated by rest in bed, douches, saline
purgatives, and a liquid diet. It gradually subsides without serious
results.

Chronio Salpinitgis is the more common variety, is very protracted
iii its course, and rarely ends in spontaneous recovery. It requires
great patience on the part of both physician and patient, and often
can only be cured by the removal of the offending organ by lapar-
otomy.

It must be remembered that all these various forms of tubal dis-
ease are produced by one foi-m or another of bacteria or disease-germs,
and that in their treatment strict cleansing of the vagina by antisep-
tics is necessary.

Salpingitis is always preceded by some form of metritis or endo-
metritis, as, for instance, the gonorrhoeal metritis, that caused by
septicsQmia or blood-poisoning, tiie metritis following labor, etc.

Inflammation of the Vagina.

This may be produced by many of the same causes which induce
inflammation of the uterine neck. It may follow t-edious child-bear-
ing, especially if instruments have been used. Marriage is not an
infrequent cause of it, — so may a pessary be, if an improper one.

The Symptoms are pain in the groins, a feeling of heat and tight-
ness in the passage, and a difficulty in passing water. In a few days
a discharge, like gum-water, begins to flow, which gradually becomes
tliicker, like cream, and is green or yellow. Sometimes the disease
gets well in a few days ; at other times it degenerates into the chronic
forms, and lasts a long time. It should be cured as soon as possible,
lest the inflammation cause the walls of the passage to grow together,
and make a stricture, as in Fig. 142.

In this Figure, b represents the mouth of the womb; a is the
lower entrance to a narrow passage in the vagina, called a stricture.
It is caused by inflammation, which so thickens the walls of the
vagina as to bring their inner surfaces near together. In examining
a case of this sort, a practitioner needs to be on his guard lest he

FKHALE DISEASES.

417

, till finally it
rnes, be yunc-
ftUy ail opera-
« appendages
take away the
he pus-cavity,
if course in a
ts and perhaps
nces of lieing
somes bed-rid-
variety of the

ouches, saline
rithout serious

ery protracted
•. It requires
ent, and often
rgan by lapar-

j of tubal dis-
disease-germs,
ina by antisep-

tritis or endo-
hat caused by
labor, etc.

i which induce
ious child-bear-
iage is not an
iproper one.

heat and tight-
In a few days
iually becomes
les the disease
nto the chronic
)on as possible,
grow together,

omb; a is the

led a stricture.

e walls of the

In examining

guard lest he

mistake the entrance to the stricture, a, for the mouth of the womb,
A, — a mistake wliich might lead to evil consequences as well as seri-
ously damage his professional character.

FIO. 143.

Treatment. — The diet should be light and unirritating. The
bowels should be kept open. A cooling wash (207), (218), should
be used several times a day, until the discharge becomes thick; then
employ injections (232), (202), (244), (243), of a more astringent
nature. Let the marriage-bed be abandoned till the recovery is com-
plete.

When the discharge arises from small granular elevations upon
the inner surface of the vagina, the whole diseased surface should
be painted over with a solution of nitrate of silver, twenty grains to
the ounce of water, — the disease being brought to view by the use
of a speculum. This may be done every other day,

Itching: of the External Parts,— Prurigo of the Vulva.

This complaint is apt to attack females about the cessation of the
menses, though they are liable to it at other periods. It is a most
annoying and distressing affection. So terrible and tormenting at
times is the itching of the external genitals, that the woman is una-
ble to avoid rubbing and scratching, and she is occasionally compelled
to absent herself from all society. She feels, as she says, as though
she could tear herself to pieces.

Sometimes this irritation of the sexual organs excites venereal
thoughts so dominant and controlling as to constitute a real mania,
called nymphomania, from the name of a part involved.

This complaint generally indicates some disease of the womb, or
its appendages, or of the bladder. When this is the case, of course
it cannot be cured without seeking out and removing the disease of
which it is a symptom.

Treatment. — To alleviate the local suffering, the lotion (228),
or the ointment (171), maybe applied to the parts several times a
day. I prefer the lotion. A weak solution of nitrate of silver (211)

iii

418

FBMALK DISEASES.

r ^

t :

'«S3

will sometimes do well. A four per-cent solution of cocaine is the
best application.

When the disease is brought on by masturbation, as it sometimes
is, this habit must, of course, be broken off before a cure can ha
effected. In this cohc, also, moderately cold water must be applit-d
to the parts several times a day ; some of the preparations of iron
should be taken, and some active employment be engaged in, which
will absorb the energies of mind and body.

Tubal Pres:nancy.

Tubal or ectopic pregnancy is mentioned here in connection with
womb diseases, because it assumes the symptoms of certain uterine
affections, and must be so treated.

When, for any reason, the ovum cannot pass through the Fallo-
pian tube into the womb, where it is normally impregnated by the
male germ, but is arrested in the tube, it not infrequently happens
that the spermatozoon of the male travels upward through the womb
into the Fallopian tube, and there meets the impeded ovum. Fecun-
dation takes place, the ovum swells and grows, the tube stretches
more and more till it bursts, and then a hemorrhage occurs into the
abdominal cavity, from the leaking tube. A large clot of blood is
formed, which generally arrests further hemorrhage and causes the
death of the embryo, but not necessarily ; aftor a time, another
hemorrhage occurs, with pain, fainting, and even collapse, depend-
ing on the severity of the hemorrhage. If allowed to follow its
natural course, the hemorrhage finally causes the patient's death.
She dies suddenly, as if she were bleeding from a ruptured artery.
The cause of all this mischief lies in the diseased tube in which the
obstruction occurred. The Fallopian tubes are lined with a beauti-
fully constructed mucous membrar.e: on the ends of the cells are
small rod-like processes, which look (qnder the microscope) like a
field of grain swaying with the wind ; they move in one direction,
from an erect position toward the uterus, and then relax and straighten
up again to repeat the process ; thus the ovum which has been grasped
by the fimbriated ends of the tube from off the outside of the ovary
(see Fig. 136) is carried down into the interior of the womb, where
nature meant it should be impregnated. Now, when these tubes be-
come diseased by catarrhal, and especially by purulent inflammation
(see Salpingitis), the little rod-like extremities of the cells are de-
stroyed, and the ovum finds no ready way of getting into the womb.
An unusually active spermatazoon climbs up into the tube, because
it has the power of motion so long as it lives ; and thus the trouble
begins.

Symptoms. — A woman misses her menstruation, and goes on a
month ; possibly missing a second or even a third menstruation,
without many of the usual accompp.nying symptoms, till suddenly

FEMALE DISEASES.

419

cocaine is the

} it Bometimes
I cure can ixj
list be applied
•ations of iron
iged in, whicli

snnection with
;ertain uterine

igh the Fallo-
ignated by tlie
lendy happens
)Ugh the womb
)vum. Fecun-
tube stretches
occurs into the
lot of blood is
and causes the

time, another
Uapse, depend-
i to follow its
jatient's death,
jptured artery.
be in which the
I with a beauti-
if the cells are
roscope) like a
1 one direction,
c and straighten
las been grasped
le of the ovary
le womb, where

these tubes be-
lt inflammation
;he cells are de-
into the womb,
le tube, because
thus the trouble

I, and goes on a
I menstruation,
IS, till suddenly

she is seized with cramp-like pains in the lower bowel, and takes her
h«^(l ; she may get up from this first shock of pain (due to hemorr-
liiige), till a second, or even a third still severer attack ensues, when
the doctor is culled. If he is thoughtful, he at once examines and
li; 'Is a bunch in the pelvis, on the side of the pain. This bunch is
tilt! clot, and the contained sac with the foetus. Not every case is
taken alike, but many are crippled at the first onset of pain a
hemorrhage ; inflammation ensues, and sickness in bed attracts the
attention. Usually, there is some slight hemorrhage of blood
escaping tlirough the tube into the womb and out into the vagina.

Treatment. — This disease, like appendicitis, belongs to modem
surgery, as only recently has it been recognized, and treatment on
a sound basis been formulated. Death is sure, unless surgical aid
comes to the rescue. Laparotomy, or opening of the abdomen, must
he performed at once, the clots washed out of the abdomen, of which,
usually, there are a quart or more, the sac containing the embryo
removed, and the tube tied off. The successes are brilliant, and
lives are daily saved. I'le operation is a grave one, but not as much
so as many^ others performed on the abdomen.

Sterility or Barrenness.

It has doubtless occurred to every person who has thought upon
the subject, that there must be some special reasons why so many
women do not and cannot bear children. These reasons I propose
now to explain as simply and as plainly as the nature of the subject
admits. To tliis explanation I shall add some remarks upon treat-
ment ; for, in nine cases out of ten, barrenness is completely curable.

Reproduction. — Throughout nature, life is perpetuated by repro-
duction. The vegetable and the animal die; but before death comes,
they reproduce the germ of a new thing, or being, which lives after
them. The law of reproduction, throughout the realm of nature, is
one, and but one. All living things have male and female structures.
Every new being is evolved from an Qgg, the product of an antece-
dent parent.

Reproduction consists in the growth of an egg, or germ, in con-
nection with some living part, until it is capable of independent exist-
ence. This germ or egg is the product of the female parent, and will
abort or perish unless brought into connection with a fructifying ele-
ment from the male. Thus, two palm-trees, growing about forty miles
from each other, the one with stamens (the male organs), the other
with pistils (the female organs), bore no seed for many years; but
when they had risen in height above all intervening and obstructing
objects, ihe winds bore the pollen from the stamens of one to the
pistillate flowers of the other, which immediately began to produce
fruit. A knowledge of tliis great law, as applicable to all living

HOB

wsiamf

420

FKMALU DISEA8RS.

' I

'Si

f I I

things, enableH horticulturiBtA to raise Hiich varieties of fruit an tliey
wish, by shaking the blooming iniile branch, which liiis stumenH, uvor
the female flowers, supplied with pistils. Sometimes the male and
female flowers are upon the same plant, at other times, upon differ-
ent ones. The strawl^erry is of the latter kind, — the pollen being
found only on the plants which have the largest flowers, — the pistil-
late flowers Iwing only on the smaller plants. The pollen, or dust,
is carried from the male to the female plant, on the feet of honey-
bees, as they fly from flower to flower. It has been discovered that
the reason why many beds are unfruitful (strawberry beds, I mean),
is that the large maUvplants are allowed to monopolize the beds to the
exclusion of the smaller female plants. The plants with large flowers
should be thinned out, leaving only a few to furnish pollen for the
females, which are the real bearers.

A N TV Branch of Industry. — It is only comparatively recently
that tiiiB law has been understood in its wide applicability. How
wise and merciful an arrange Jient of Providence that an unseen
hand should turn for man the mystic leaves of knowledge at the very
time when he is most in need of the instruction imparted ! At this
very moment, the more complete knowledge of this great hiw is open-
ing a new branch of industry, and a new supply of food, and is thus
helping the solution of the great problem of how the increasing in-
habitants of civilized countries are to be worked and fed. I refer to
the propagation and culture of fish.

A <3ommittee appointed by the leg^lature of Massachusetts, re-
ported very ably upon this subject. The eggs of the fish may be
fecundated almost as easily ao the pistillate flowers of the plant. It
is only necessary, when the eggs of the female are mature, to hold
her over a basin of water, and make gentle pressure upon the belly,
when the eggs will pass freely into the water; then to pass the milt
of the male into the same water, and shake them thoroughly together.
By this means, the eggs are impregfnated, and fish may be raised to
any extent.

The egg of the higher animals is more difficult to fecundate, and
that of the human female most difiicult of all ; for in nature, as in
art, the more perfect structures are begun and reared with less ease.

Propriety of Impartins: this Knowledge. — Men are naturally
curious, and love to understand the myst«ry of their own origin ;
and yet there is scarcely any subject upon which they have so little
reliable information. It has been held that this is a kind of informa-
tion which it is not proper to impart to the multitude; that, the curi-
osity which seeks this knowledge is based upon improper feelings ; and
that to gratify it by imparting what is sought, would lead to imrao^
ality.

I do not believe it. Such ideas are based upon a shallow philoso-
phy. They overlook the fact that nothing excites the imagination

;

IMAGE EVALUATION
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FEMALE DISEASES.

421

like that which is covered with mystery. It is because the immensely
important subject of the procreation of the race is so carefully hidden
from the public eye ; because it is purposely buried so deep in obscu-
rity, that any allusion to it excites improper thoughts. If the subject
be properly viewed, it is no more indelicate to explain the mode of
reproducing a human being than to explain that of propagating a
plant or a fish. Both are effected in the same way, under precisely
the same natural law.

True, the propagation of the human being involves moral laws
likewise ; but these relate only to the social relations in which it may
take place, and do not affect in any way the propriety of making it
xmderstood by the people.

The Qerm Furnished only at Certain Periods. — These general
remarks bring me to the immediate subject in hand. Throughout
animated nature, the female furnishes the mature germ or egg only
at certain periods. The healthy
human female, — as I have al-
ready explained, — matures a
germ once in four weeks. These
germs or eggs are constantly
advancing, in succession, from
the rudest beginning to a state
of ripeness or maturity. Every
' person must have seen the eggs
taken from a hen when killed
in the laying season. Fig. 143
furnishes a good illustration.
They are in all stages of progress,
from the invisible germ up to
the nearly mature egg.

Such is the progress of the
human egg, — only that it does
not attain to any such size.' So
far as the maturing is concerned,
it occurs in the same gradual way,

Conception or Impregnation can take place only when a germ or
egg is ripe ; and as an egg ripens, bursts, and passes into the Fallopian
tubes and thence to the womb only at the time of menstruation, it is
plain that conception must happen somewhere in the neighborhood
of this period. Intercourse with the male may take place at interme-
diate times ; but, except in some rare instfiuces, conception will not
occur, because there is no mature egg to be impregnated.

Now, as every healthy woman brings to maturity a germ or egg at
the time of every monthly flow, and as every ripened egg is capable,
under favorable circumstances, of being fecundated, it follows that
every woman who menstruates, and is well, can, under certain cir-

FlO. 143.

'-.Vii

422

FEMALK DISEASES.

i'^

cuinstanccs, Ito iniprcgnated. 'I'o effect it, it is only necessary that
the vivifying portion of llic male semen, ealled spermatozoa, come
into union with the ripened egg.

Tliis union (for, that men and women may have a ehanee to know
as much about themselves as they do about fishes and plants, I i)ro-
pose to make tlie whole subject plain) takes place in the following
way. In the act of copulation, the male organ penetrates the vagina,
and deposits the sperm, spermatic fluid, semen, or, as the scriptures
call it, the " seed," directly at tlie mouth of the uterine neck. Some
suppose that when the sensation of the female is at its height, the
womb opens to receive the injected semen. But this is uncertain.
This spermatic fluid is composed, in large part, of mucus. A
smaller ])ortion of it is secreted by the testi-
cles, and is the true semen, or life-giving prin-
ciple. Tills last portion is composed, almost
entirely, of fertilizing filaments or vesicles,
which look like small animals (Fig. 144), and
for a long time were supposed to be animal-
cules. They are generally called spermatozoa.
By some mysterious law of their nature, they
are endowed with the power of motion; and
when deposited near the mouth of the womb,
they immediately begin to move, as if by in-
a ripened egg.

FIO. 144.

stinct, in search of
Passing through the uterine neck, they
enter the womb. If an egg be found,
in its ripened condition, they imme-
diately embrace it, and, in some mys-
terious way, mingling their own con-
tents with the contents of the egg,
they impregnate or fertilize it. Fig.
145 shows the womb divided length-
wise. A, is the internal mouth (os in-
ternum), or point where the canal
through the uterine neck entei-s the
body of the womb ; B, is the external
mouth (os externum) ; the space be-
tween A and B, the passage through
the neck; and C, C, the points where
tlie Fallopian tubes begin. By looking
back now, and examining Fig. 136, the
whole thing will be undei-stood.

This is a very brief and simple ac-
count of impregnation. It is supposed
to be capable of taking place either a
little before or a little after the monthly
flow, and not at intermediate times, for the reason already stated.

—

I 1

-1

i-=-

no. 14S.

FEMALK DISEASES.

423

ecessaiy that
iitozoii, (;oiiie

nice to know
plants, I i)ro-
he following
3S the vagina,
le scriptures
neck. Some
B height, the

uncertain,
mucus. A

by the testi-
!-giving prin-
josed, almost

or vesicles,
ig. 144), and
;o be animal-

spermatozoa.

nature, they
motion; and
>f the womb,

as if by in-

ready stated.

There are some reasons for believing that the same egg or germ, if
fertilized just before the courses, will grow to be a male, while, if
fecundated after tlie tui-ns, it will be a female. One reason for this
su[)position is, that plants may be made to bear male or female
flowers by simply subjecting them to different degrees of heat. If
tliere be more heat than light, male flowers are produced ; if more
liglit tlian heat, female flowers are the result. The heat of the female
generative organs is raised to its highest degree about the time the
egg bursts its covering, wliich is just before the beginning of the flow.
It has been thought that the right ovary produces males, and the
left ovai y females ; but tills theory is not supported by any facts, and
is probably not true.

Causes of Sterility. — From what has been said, it would appear
that to ensure cliild-bearing it is only necessary that semen or seed,
containing spermatozoa, come in contact with a germ-vesicle or egg,
at the right time ; that there be no hindering disease ; and that the
parties cohabiting be adapted to each other.

It is evident enough that a want of adaptation between the parties,
physical or mor.al, or both, is often an absolute bar to conception.
A lack of moral adaptation was probably the obstacle in the case of
Napoleon and Josephine, — her marriage with a previous husband,
and his with a subsequent wife having both been fruitful.

It is certain that indifference on the part of the wife to.wards the
husband, and especially repugnance, may prove an obstacle. A mere
lack of sexual feeling does not necessarily prove a bar, though it
probably lessens the chances of a fruitful union.

Conception may fail to take place from the diminutivoness of the
male organ, — the semen not being deposited in the right place ; or,
from its excessive largeness, — penetration of the vagina being impos-
sible. In some rare cases, the womb is absent. The inflammation
of the ovaries often prevents the ripening of eggs. The Fallopian
tubes occasionally get diseased and plugged up, so that no egg can
pass to the womb. Inflammation in the cavity of the uterine neck
is probably the most frequent of all the causes of sterility. The
viscid, gluey matter which is secreted in inflammatory conditions of
this part, plugs up the passage, so that no spermatozoa can pass up
in search of the egg. The acrid discharges in most of the cases of
whites destroy the fertilizing spermatozoa, and render conception im-
possible. All the displacements of the womb may act as bars to
impregnation. If it fall over backward or forward, the mouth is
tilted up before, or down behind, and is not in the right position to
receive the semen. One of the most general causes is trying to avoid
pregnancy in early years of married life.

Treatment. — Judicious treatment will, in most cases, remove
sterility, and open that " well-spring of pleasure," which the poet
has so felicitously described as — "a baby in the house."

424

FEMALK DISEASES.

The obstacles to conception, stated above, are chiefly those diseanes
which have been previously described. To cure those diseases is [,0
remove tlie obstacles. When it is dependent on the causes whicJi
produce j)aiiiful menstruation, or profuse menstruation, or a suppres
sion of menstruation, the remedies are the same as are pointed out
for those complaints. If inflammation of the ovaries be the cause, a
cure may be effected, provided the inflamed condition be removed
before the bundle of eggs be destroyed. If inflammation or ulcera-
tion of the neck of the womb be the obstacle, the remedy may be
found in the treatment recommended for those affections.

Sterility depending on the causes just mentioned, I have had the
pleasure of curing many times. When dependent on a lack of phys-
ical or moral adaptation between the parties, it does not, of course,
admit of relief. It is a misfortune to be borne in silence. It has
happened, perhaps, through a lack of judgment or care in selecting
a partner, and is one of the mistakes of a lifetime which a lifetime
cannot repair. When this want of adaptation is not complete, a rem-
edy may frequently be found.

Unfortunately, many females do not regard sterility as an evil to
be deplored, but rather as a blessing to be desired. Life, to them,
has no high aims or duties, — it is a round of fashion and pleasure.
To bear and rear children interrupts their frivolities, and they seek to
escape such abridgement of their pleasures. This is wrong. Life is
a great theatre, in which all should strive to act some worthy part,
and feel that, upon retiring, it would be wrong to leave their garments
upon the vacant stage, with none to put them on, and continue the
drama.

Midwifery.

A STOPPAGE of her courses is most commonly the first notice a
woman has of her being in the family way. This is perceived about
tk'.-ee weeks after conception, when she begins to experience other
feolings peculiar to the situation. These feelings are nausea and vom-
iting^ or a decided languor, in the morning ; swelled and sometimes
painful breasts ; the areolae, or colored rings around the nipples, darker
than usual ; pain in the lower part of the back ; and, occasionally, a
good deal of spitting of a frothy, cotton-like substance.

These symptoms are more or less severe in different cases, and
under different circumstances, according to the state of the patient's
bowels and her habits of exercise. Ordinarily, she suffers most dur-
ing the second and third months, on account of

Sinking Down of the Womb, which, from soon after the period of
conception, is gradually increasing in size and weight. As it grows
larger and heavier, it sinks lower in the cavity of th« pelvis, until
about the fourth month, when, becoming so large that it cannot longer
be accommodated within the narrow limits of this unyielding box cf

X\,

litwHlri' .-^J'-rii

'■•^' --fitilt-ftiiii II II III

J^*

FEMALE DISEASES.

425

those (liseiwes
disen-sesj is U)
causes which
or a suppres
! pointed out
e the cause, a
I be removed
ion or ulcera-
medy may be

18.

have had the

lack of phys-

ot, of course,

ence. It has

> in selecting
ch a lifetime
raplete, a rem-

as an evil to
Life, to them,
and pleasure,
i they seek to
'ong. Life is

> worthy part,
heir garments

continue the

first notice a
irceived about
)erience other
lusea and vom-
nd sometimes
lipples, darker
)ccasionally, a

3nt cases, and
: the patient's
Eers most dur-

the period of

As it grows

R pelvis, until

cannot longer

ielding box cf

honest, it is obliged to mount higher to find room in the ampler and
more distensible belly. This low position of the womb in the early
iiionthi of pregnancy occasions many disagreeble sensations, — iis
pain in the lower part of the back and sickness at the stomach.

The Costiveness, too, from which women suffer so much at this
time, is often caused, in part at least, by the pressure of the enlarged
womb upon the lower bowel. Costiveness, thus induced, at length
becomes itself a cause of serious mischief. The lower bowel, filled
and enlarged with its hardened contents, reacts upon the womb,
crowding it still lower in its narrow quarters, and greatly increasing
its excitability. The enlarged bowel and womb combined make
constant pressure, sometimes upon the urethra, or water-pipe, causing
pain and difficulty in making water, and always upon the ascending
veins, checking the return of blood, and producing congestion in the
lower bowel, manifested by troublesome piles.

Treatment of Pregnancy. — When the pregnant woman first rec-
ognizes her situation, she should determine to " observe moderation
in all things." Let her avoid violent and sudden exertion, and move
about more calmly and evenly than usual. By this is not meant that
she should give up her customary occupation ; but that she should
pursue it with becoming carefulness, resolved in no case to hazard
over-exertion, and rather leaning to the side of indolence. This
would not be real indolence, for she is doing a great work internalli/,
and should not unduly withdraw her energies to external affairs.

Let her not be too much in the erect position. If of delicate
constitution, and not in vigorous health, she should make it a point
to lie down several times during the day. The standing position,
continued for a long time, especially if it be under circumstances
to induce fatigue, greatly favors the descent of the womb, — while
a frequent rest in a horizontal position may enable it to keep its
place.

An Objection. — It may be objected by some, that a large majority
of the mothers in the world are wo'-king women, and obliged to con-
tribute by their industry to the support of their families ; and that
they cannot afford, therefore, to lie still, and mind directions.

To this it may be answered, that it is a great advantage to under-
stand the best way, so as to have the privilege of at least aiming at
it. Much is accomplished, in all circumstiinces, by aiming at doing
the best thing ; and few women are so situated that they could not
so favor themselves as to obey the laws of health a little more per-
fectly, if they thoroughly understood them. All can better afford to
avoid sickness, than to be sick. Many occupations, also, unless
money tempt to excessive application, become, when steadily fol-
lowed, comparatively easy and unexciting. Thus, most people can
go through their usual round of duties, because they have got v^ed
to it. Indeed, there is nothing but indolence itself, to which we may

'1 '■>(

426

FEMALE DISEASES.

not become accustomed. The difference between the laboring and
the privileged classes is more imaginary than real. All mujt work.
None can escape the primeval decree — " In the sweat of thy face
ahalt thou eat bread."

Many women, when they find themselves in the family way, will
observe no caution, but work all the harder, and even use other
means for the purpose of bringing on abortion, and preventing an
increase of children. This unnatural and wicked, but too prevalent,
disposition, results sometimes from a fear of the pains of cliild-birth,
sometimes from a desire to avoid the necessaiy care and confinement
connected with raising children, but most often from a wish to escape
the expenses which the prevailing fasliions and customs of society
connect with a large family. The cost of a shattered nervous sys-
tem, and of a body weakened and poisoned by powerful drugs, is not
considered, because not understood! Hence the success of those
quack advertisements, impudently professing to cure female diseases,
but whose chief object is disclosed by the insertion of the hypocritical
caution — " Be careful not to take this medicine during pregnancy, as
it will be sure to produce abortion."

It seems as if the world would never learn that God loves children,
although since Abraham's day he has said so much about them in
his Word, although His Son, sent into the world on purpose to
show the disposition of the Father, took them up in his arms, and
blessed thera, and although He has implanted a most wonderful
love of them in the soul of man.

Costiveness and Piles. — Let the pregnant woman use all proper
means to keep her bowels in order. She will thus greatly diminish
the distressing nausea, and may entirely prevent the accession of
piles. To accomplish this object, the saline aperients (7), (5), or, oc-
casionally, other mild cathartics (10), (12), (14), maybe used. But
more important than either or all of these is the frequent use of a
good self-injecting family syringe. An injection of half a pint of
cold water every morning will do much towards regulating the
bowels, and preventing or curing piles.

Nausea. — If, as sometimes happens, there should be persistent
nausea after the first three months, it will need to be combated by
mild tonics and stimulants, as chamomile tea, or clove tea (58),
(114), and by seeking a kind of diet which will be agreeable both to
the palate and the stomach. Ten grains of ingluvin after each meal,
and on arising, oftentimes prevent vomiting. Stretching the neck
of the womb moderately, and replacing a retroverted womb, are fore-
most in importance of treatment when structural causes demand such
interference.

The Nipplej. — During the last month, particular attention should
be paid to the nipples. Untold misery often results to the young
mother from sore nipples; and it is well worth her while to use every

FEMALE DISKASES.

427

I laboring and
.11 mujt work,
sat of thy face

mily way, will

ven use other

preventing an

too prevalent,

of cliild-birth,

id confinement

wish to escape

oras of society

i nervous sys-

al drugs, is not

ccess of those

emale diseases,

he hypocritical

J pregnancy, as

loves children,
about tliem in
on purpose to
his arms, and
lost wonderful

L use all proper
reatly diminish
le accession of
(7),(5),or,oc-

be used. But
[juent use of a

half a pint of
regulating the

i be persistent
)e combated by
;love tea (58),
;reeable both to
iftereach meal,
ching the neck
womb, are forc-
es demand such

.ttention should
s to the young
lie to use every

precaution against them. The nipples are, of course, in an excitable
state during the whole period of gestation, and at length frequently
become irritable and tender. Let them be daily bathed, for three or
four weeks before confinement, with some astringent and cooling
lotion, as oak-bark decoction, borax water, alum-water, or a solution
of tannin (200), (201), (202), (203).

The object of treatment, in this case, is to toughen them and ren-
der them less susceptible, so that they may not be made tender by the
subsequent application of the child's lips.

When a woman is peculiarly liable to this trouble, the further pre-
caution of having them gently drawn by some friend, every day,
during this last month, would be of great service.

At all events, let no pains be spared to guard against this evil ; for
sore nipples make sore breasts, and sore breasts make broken breasts;
and broken breasts are terrible things. They make the mother sick ;
and if the mother is sick, the child is sure to be sick ; and all hands
soon get sick and worried, and the whole business of having children,
and taking care of them, is deprived of its peculiar joys and consola-
tions, and brought into undeserved disrepute. Whereas, under wise
and prudent management, there is something delightful to the young
mother in yielding sustenance to her dependent offspring. For, when
her nipples and breasts are in a healthy state, she can say with the
poet, as

" The starting beverage meets its thirsty lip,
'Tis joy to yield it, as 't is joy to sip."

Swathing:. — In advanced pregnancy, much assistance in supporting
the burden is sometimes derived from swathing the bowels. Healthy
and vigorous women, however, need no such assistance ; it is chiefly
appUcable to cases of debility, either constitutional, or resulting from
neglect, or from over-exertion during former pregnancies.

■ Cramp In the Stomach is sometimes very severe, and if allowed to
continue, may kill the child. The best remedies are warm carmina-
tives (114), (115), or anodynes, et \ (121), (122), or antispasmodics
(90), (94). : ;

Headaches. — These maybe relieved by antispasmodics, etc. (90),
(94), or anodynes (121).

Palpitation of the Heart may prove very distressing to delicate
women. The remedies are the antispasmodics, with rest. Some-
times tonics are useful, such as the muriated tincture of iron (73).
The bowels should be carefully regxilated.

Fainting, which occurs before or at the time of quickening, is some-
times very troublesome. The proper treatment is the avoidance of
fatigue, and, during the fainting fit, the recumbent posture, cool air,
application of cold water to the face, and ammonia to the nose.

Cough is sometimes present. It is caused by the upward pressure

428

FEMALE DISEASES.

of the diaphragm against the lungs, hy which they are irrita':ed and
convulsed. The remedies may be selected from tlie cough prepara-
tions among the prescriptions.

Varicose Veins. — These cannot be removed during pregnancy;
but they may be relieved by great care of the bowels, and by wearing
tight bandages, or elastic stockings.

Swelling of Lower Limbs is caused by pressure of the enlarged
womb upon the veins ; and may be relieved by care of tlio bowels,
and diuretics (130).

Itching of tlie Oentials may be much relieved by lx)rax, camphor,
etc. A four-per-cent solution of cocaine, painted on, gives most
relief, and is mobt curative.

Miscarriage. — Abor'ion.

When a woman in the family way throws off the contents of her
womb, or loses her child, during the first six months, the accident is
a miscarriage, or abortion ; when the same thing happens during tlie
last three months of her term, it is a premature labor. -

Symptoms. — If abortion occur during the first month after con-
ception, the symptoms may not attract much attention or, L.ay be
regarded only as an irregularity of menstruation. Occurring at later
periods, it is frequently indicated by some feverishness, coldness of
the feet and legs, a puffed-up condition of the eye-lids with purplisli
discolorations, shooting pains in the breasts, which become soft, pains
in the back, bearing-down pains in the lower part of the bowels,
which come and go, and at length take the character of real labor
pains. As these pains increase, blood begins to appear, and, sooner
or later, the bag of water breaks, and the faatus is thrown off.

Causes. — These are very numerous. Some of the principal are,
displacement of the womb ; ulceration of its neck ; syphilitic disease
of the foetus received from the parent ; too much exercise ; heavy
lifting ; falls, particularly when the woman comes down upon the
feet, and is heavily jarred ; emetics ; powerful purges ; and too much
nuptial indulgence.

Treatment. — Where the symptoms are but slight, nothing may
be required more than a little caution for a few days, and rest in the
horizontal posture, using cold drinks, and taking for two or three
nights, at bedtime, perhaps, a pill composed of one grain of camphor
and two grains of sugar of lead. Besides these remedies, it may be
well to put a mustard-poultice low down upon the back.

If, notwithstanding, flooding comes on, and the symptoms of mis-
carriage increase, a napkin wetted with cold water, or vinegar and
water, or a bladder partly filled with ice, should be laid upon the ex-

ii'w'»Tiffiii'ilil1 "frtril IT

H i il ^ 1 i h i iiJWl i m w fj "

Lijtf rt U>-*<.«w jiit lifM ili< HW ,il

y'yp i w

»iw.

iim-it i ii i iir i - , 7Tm'»rnrTTff°fi'i'

■■ijiSy-'^

FEMALE DISEASES.

429

e irrit8':ed and
lOUgh prepara-

ig pregnancy;
nd by wearing

f tlie enlarged
of tlio bowels,

oiax, camphor,
n, gives most

ontents of her
the accident is
BUS during the

)nth after con-
)n or, L.ay be
urring at later
88, coldness of
with purplish
)me soft, pains
af the bowels,
' of real labor
ir, and, sooner
iwn off.

principal are,
ihilitic disease
ercise ; heavy
own upon the
and too much

nothing may
nd rest in the

two or three
in of camphor
lies, it may be
k.

ptoms of mis-
' vinegar and
1 upon the ex-

ternal genitals, and pulverized alum, mixed up with a little honey,
must 1h) given internally, every half hour ; and if the flooding still
increase, it may be proper in some cases to resort to the tampon or
Itlug. To do this, take either lint, or absorbent cotton, or a piece of
line sponge, and having soaked it full of a strong solution of alum,
or tannin, or, still better, Monsel's pei-salt of iron, one part to six
parts of water, fill the vagina full, and then place a fold of linen
in the genital fissure, and apply a bandage. This will generally stop
the flow; but the, plug must be removed in from five to ten hours.

If the abortion cannot be prevented, — especially in the lattei-
niontlis of gestation, — then the case is to be permitted to go on,
and to be treated the same as a natural labor. ■

Abortion (Criminal).

Many married people who consider the bearing of children a bur-
den, and those who suffer from a lapse of virtue, are tempted to
commit abortion.

I wish it were possible for me to express to them the sin and folly
of such a course. The sufferings ahd evils that almost always follow
are far worse than any care or shame which come from letting nature
take its course. Any crime against nature is sure to be punished.
In this case, consumption, nervous prostration, and various womb
complaints are the usual accompaniments, ruining the future life or
usefulness of. the woman, until finally life becomes a burden to her-
self and friends ; it usually being impossible to obtain a cure, though
she seek it carefully and with tears. No conscientious physician will
commit abortion. She will be obliged to trust herself in the hands
of quacks and rascals, who commit the crime either with medicine
or instruments, in one case ruining the digestion, in the other the
womb. Nature has not provided any way in which it can be done
with safety, and it is justifiable in no case except when it will save
the life of the mother.

Prevention of Pregnancy.

There are many cases in which, on account of some contagious
or hereditary disease, it is not advisable for the wife to become preg-
nant. It is not always advisable for a wife to have children too fast,
the constitution not being strong enough to stand the strain of bear-
ing children, or the care of bringing them up. In such cases, while
it would' be wrong to commit abortion, it would be desirable to avoid
pregnancy. I do not agree with many of the fashionable women of
this age wh( . consider the bearing of children a burden, and who do
not know the joy of a baby in the house. How little they realize
that the happiness and pleasure of a family of children is far greater
than the care. That love makes labor light. It is hard for the
young to realize the lonesomeness of childless old age.

430

KKMALR DIBKASRB.

While it may not be l)e8t to have children too fast when yoinig,
they must realize that if protective measures are carried on too Umjr
it will be impossible for the woman to become pregnant. Nature
has provided a reasonable way ; if there is no coition for ten days
after the courses, or three days before, the chances of pregnancy an;
much diminished. Douching with warm or tepid water (never on any
condition use cold water), immediately after coition, is perhaps the most
commonly used method to prevent conception. The addition of
carbolic acid (one tcaspoonful to the pint of water) is an extra safe-
guard. Two quarts of water is none too much to use, although a
pint might bo suHicient. The safest, least harmful method to the
woman with which I am acquainted, consists in the insertion into the
vagina, as high as possible, of a tampon of wool. This piece of wool
must first Ik; moistened with glycerine and ''ater, or vaseline, and
bound by a small string to its centre. It should be i.bout two inches
square, possibly a bit smaller for some women. It '"• most easily
iuserted by the woman when lying on her back. .After coition, tliis
wool is withdrawn by means of the string, and a warm douche taken.
This procedure is not only certain to prevent conception, but is abso-
lutely devoid of danger.

There are condoms made of fine rubber, which can be bought of
druggists, which are absolutely safe ; before use they should be wet
with soap-suds or vaseline. This is not a healthy habit, and I would
not advise its use, except where there is danger of a contagious dis-
ease, or where it would endanger the life of the woman by becoming
pregnant.

In conclusion, I would say, the nearer a couple live to nature, the
better and happier they will be.

Labor. — Delivery.

The expulsion, at full term, of the child, the after-birth, the mem-
branes, and the fluids, constitutes labor, or delivery. It is supposed
to occur about two hundred and eighty days after the last menstrua-
tion ; but authors reckon it differently ; in truth, it is not possible to
fix it exactly, for it evidently varies in different cases.

When the time of her lying-in arrives, let every woman meet it
with calmness and undoubting confidence. There is every reason to
encourage this state of mind. Think of the vast multitudes of peo-
ple in the world. Each once existed in the womb of a mother, and
had to pass through itn narrow portals to be admitted to the light.
Successful delivery is the rule, the worla over ; and it should be the
rule to confidently expect it.

In the midst of the pains of labor, nothing does more to bring to
favorable result than courage and patience. Patience is able calmly
to survey all the difficulties before her, because she never attempts to
encounter but one at a time. There is much philosophy in the story

■Irt.li'iaJi^ftttTlii'ridi'iitfwi

■i,dJit«tBiaa*Mki,ii. 'nfc.iW ;■>■>*« w-

FKMALK 1)IHKA8K».

431

when younjj,
)d on too long
lant. Nature

for ten dajK
pregnancy arn

(never on any
rhai)8 the nioHt
e addition of

an extra safe-
ise, although ii
method to the
lertion into the
1 piece of wool
r vaseline, and
3Ut two inches
'' most easily
er coition, this

douche taken,
in, but is abso-

1 be bought of
should be wet
it, and I would
contagious dis-
\,n by becoming

} to nature, the

birth, the mem-
It is 8uppose«l
last menstrua-
not possible to

yoman meet it
every reason to
Ititudes of peo-
a mother, and
d to the light,
t should be the

lore to bring to
3 is able calmly
ver attempts to
jhy in the story

of the ^^digcontented pendulum" wlu(;h got discouraged, one morning,
from reflecting how many millions of tiihes it would have t(> swing
during succeeding yrai-s, but became reius.sured upon con.sidering that
a single stroke cost but a very triHing (iffort, and that it really had
to make but one at a time. So it is with labor; it« pains, which are
really severe and agonizing, will become comparatively tolerable, if
the whole attention of the woman Ih' confined to present sutfering,
and her whole stock of courage and patience be brought to l)ear upon
OTie pang at a time.

Lot her ri!sist the temptivtion to a feeling of haste. Nature will
often proceed more eveidy and more speedily if allowed to take her
own time. A hurry to get through is a great obstacle to successful
delivery; it always puts things back.

Symptoms; — One of the Hrat indications that lal)or is about to
iHjgin is, that the woman finds herself umaller, — the child having
sunk down lower in the abdomen, and she accordingly breathes
easier. The genital organs become relaxed and moist, and mucus
escapes, which is called " the shows." The woman finds herself dis-
posed to be nervous and fidgety, and perhaps a little depressed in
spirits.

When labor has fully set in, it is marked by lowness of spirits,
ttiishes of heat and cold, a great desire to empty the bowels and to
make water, and grinding, cutting pains, which grow stronger aud
more continuous, with intervals of ttju or fifteen minutes' ease be-
tween. Vomiting in the early sttiges of labor often occurs, and may
be regarded m favorable, — indicating the softening and opening of
the mouth of the womb.

Treatment of Labor. — When labor liegins, the attention should
be directed to the state of the bowels and bladder. The child's head
l)egins early to press upon t' -^ bladder and lower bowel, causing the-
desire to make water, etc. ; and these should be immediately emptied
to make room for the head to pass more easily. The bowel may be
freed by a dose of castor-oil (10), if there is time for it to operate, —
but more surely, and more satisfactorily, by an injection. Relief in
the bladder ma^ , perhaps, be obtained by a different position of the
woman in the act of making water. ■ It is the pressure of the child's
head upon the water-pi[)e which causes the trouble ; and to relieve it,
the woman shouh^ get upon her hands and knees, with her shoulders
lower than the hips, so as to throw the child upward and forward
towards the cavity of the abdomen. Thus situated, she may often
find it easy to make water, when in the ordinary position it would be
impossible. If, howevei-, this mantwuvre does not succeed, and the
bladder becomes greatly distended, the catheter must be used.

The B*^d and Habiliments. — In the next place, fix the bed and

the patient's ha' nents. Reject feather beds; use the mattress.
Cover this with rubber cloth, i.' convenient, and then with folded

432

FEMALE DISEASES.

sheets to absorb the discharges, and protect the bed. Let the woman
be arrayed in the same garments she expects to wear after the com-
pletion of the labor, and let these be well tucked up under her anus,
and let the lower portion of her body, from the waist downwards, be
enveloped in a sheet. This sheet can be easily removed, and the
clean clothes pulled down without greatly disturoing the patient when
in the exhausted state which follows labor, and when it would subject
her to great iatigue to be obliged to sit up in bed to have her clothes
changed. Let her lie upon her Ifeft side, with her body shortened by
bending forward^ so that the muscles may be relaxed ; let her head
be placed in the middle of the bed, and her feet press against the
right foot-post. Around this post a shawl or towel may be faatened,
upon which she may be allowed to pull during the pains.

Antiseptic Dressings.

In one essential particular, the case of the modem woman differs
■widely from that of our grandmothers. Childbed-fever, blood-poison-
ing, and other similar germ-diseases, have been from time immemo-
rial the hSte noire of the lying-in chamber, and the odium of the
medical profession. Since the discovery by Sir Joseph Lister, of
England, that these diseases were caused by the introduction of
germ bacilli into the living tissue, and that to prevent them it is
only necessary to kill these germs on all things which in any way
come in contact with the motlier's private parte, these diseases have
become very much less frequent in occurrence, and much less fatal.
We know now that the skin and vagina even normally contain living
germs which act as scavengers of dirt, and exert a beneficial influence
on health, so long as they remain in their natural abodes ; let them,
however, be introduced into the system through raw surfaces, tears
and excoriations consequent on labor, and the group of symptoms
generated by this poison is truly frightful to think of.

To avert such catastrophes, it must be the aim of the physician
and nurse, and even the patient, to use scrupulous care in keeping
away from the patient anything which has not first been rendered
absolutely clean or germ-free.

It thus becomes evident that, first of all, as soon as labor sete in,
the thighs and privates should be thoroughly washed with soap and
some antiseptic, as, for instance, a five per-cent solution of carbolic-
acid, or better, sulpho-naphthol solution, which may be made by adding
one-half teaspoonf ul of sulpho-naphthol, or " oil of milk," to a quart of
water ; l)etter still is a solution of corrosive sublimate of the strength
of one part in two or three thousand parts of water. This poison-
ous drug is best bought in tablet form, so that by adding one tablet
to two quarts of water, we have the required solution. During labor,
and even after, all napkins and cloths used to protect or wipe the
woman, must be wet in one of these solutions, or otherwise disin-

rSMALG DISEASES.

433

et the woman
if ter the coni-
ider her arms,
ownwards, be
oved, and the
5 patient when
would subject
ive her clothes
J shortened by
let her head
38 against the
ly be fastened,
ns.

•woman differs
r, blood-poison-
time immemo-
odium of the
seph Lister, of
ntroduction of
ent them it is
ch in anyway
e diseases have
nuch less fatal.
J contain living
eficial influence
)des; let them,
r surfaces, tears
p of symptoms

i the physician

sare in keeping

been rendered

is labor sets in,
with soap and
ion of carbolic-
made by adding
k," to a quart of
! of the strength
r. This poison-
Iding one tablet
During labor,
;ect or wipe the
otherwise disin-

fected. Every examination by the physician or nurse must be made
only after thorough scrubbing of the hands with soap and some dis-
infectant. The napkins used may either be wrung out of these colu-
tions, or steamed an hour before using.

By such precautions we may expect to avoid blood-poisoning. The
nurse must always wash and disinfect her hands before giving a
douche or handling the patient's private parts. The douche is always
a source of vexation to nurses, a'.id the matter may here be thus
stated : unless there has been given an order hy the phjrsician to the
contrary, never use a douche after the baby is born.

Remember the principle of always keeping surgically clean, i. e.
germ-free, all objects which come in contact with the lying-in woman.

The Presentation. — An examination with the finger is to be made
to learn the presentation, — that is, to learn which part of the child
"omes first into the mouth of the womb.

Head Presentation If the head present, the labor will probably

go on without the need of medical aid. But in all labors there is a
liability to dangers from unforseen accidents, which renders the at-
tendance of an intelligent physician highly prudential.

Breech or Feet Presentation. — If the feet or breech present, it is
desirable to have the first part of the labor proceed slowly, so that
the passage may become well dilated, and prepared for a more rapid
delivery of the head. If the breech present, do not pull down the
feet ; let the child come double ; it will make more room for the head.
If the feet present, let there be no pulling upon them to hasten the
birth of the breech.

After the feet and breech have fully cleared the external orifice,
the delivery may be judiciously hastened for the purpose of prevent-
ing the death of the child from pressure on the umbilical cord, before
its head is brought to the air, and the act of breathing thus permitted.
For after the pulsations of the cord cease, the child must either
breathe or die.

In this kind of presentation, therefore, the child's life is in great
danger. After the birth of the lower half of the body, the cord ex-
periences severe pressure, gufficient to interrupt if not wholly prevent
its pulsations. It then becomes necessaiy to hasten the birth of the
upper extremities and head by ali prudent means. Violence is never
in order in midwifery ; but considerable force, skillfully directed, may
sometimes be safely used. After the shoulders are delivered, the pas-
sage of the head may be facilitated by carefully pulling down the
arms. Then, as soon as possible, introduce the finger into the mouth
of the child. Tins will serve the double purpose, perhaps, of per-
mitting a little air to make its way into the child's lungs, and of fur-
nishing a hold by which its head may be gently dmwn along into the
world.

If there is much delay at this juncture, perhaps in some cr.ses the

434

FEMALE DISEASES.

child's life may be preserved by inserting into its mouth one end of a
male catheter, — thus furnishing an open tube for the passage of air,
until more vigorous pains shall introduce it into the full liberty of the
atmosphere. While the head is yet undelivered, great care should be
used to keep the child's body warm by covering it with flannel, and
also to keep it in a correct relative position with the head. If the
body be incautiously turned round, of course the neck will be twisted ;
and the child's subsequent delivery with a broken neck will be the
miserable result, bringing confusion to the medical attendant, and
uuhappiness to all concerned.

Arm or Shoulder Presentation. — If the arm or shoulder present,
the child will probably have to be turned. In case this cannot be
effected, its chest must be opened and emptied of its contents, that
there may be room to bring down the head. It is barely possible to
avoid a resort to art in this presentation.

Flooding or Hemorrhage, occurring to an alarming extent, is hap-
pily one of the rare incidents or consequences of labor. But when it
does occur, it demands the most serious and prompt attention.

Profuse bleeding from the womb is most commonly owing to a
partial separation of the placenta, or afterbirth, from its attachment
to the internal cavity; and it has been observed that the flow
proceeds more rapidly from the detached portion of the afterbirth
than from the corresponding exposed surface of the womb. A knowl-
edge of this fact has an important practical bearing ; for if, in severe
cases of flooding, the partially detached afterbirth can be entirely
separated, the bleeding will often be speedily arrested.

The most dangerous floodings occur in cases of placenta previa,
when the aftt^rbirth is over the mouth of the womb. In such cases,
when the labor commences, and the womb begins to open itself, the
afterbirth of course must be partially separated. These cases, unless
promptly relieved by art, may prove fatal in a few minutes. Yet
there is ordinarily sufficient time, if it be improved, calmly to choose
and pursue the proper treatment. If the flooding be immediately
dangerous to life, the child must be turned and delivered, or the
tampon or plug be applied, as directed under the head of abortion.
This expedient is used when, through rigidity of the mouth of the
womb, the delivery is inadmissible.

Before Delivery In all cases of flooding, we prescribe quiet, the

recumbent posture, cold applications to the abdomen and the external
genitals, and the internal administration of astringents and anodynes
(151).

After Delivery, our object is to promote contraction of the womb
by cold applications and frictions externally, or, if necessary, by the
introduction of the hand into the womb, for the purpose of removing
the afterbirth, clearing out clots, or stimulating it to shut itself up for

'■TatiUliiitiitliiiitiMii'<n^^^^

FEMALE DISEASES.

435

tth one end of a
5 passage of air,
nil liberty of the
t care should be
tritli flannel, and
e head. If the
; will be twisted ;
leck will be the
1 attendant, and

boulder present,

this cannot be

ts contents, that

arely possible to

ig extent, is hap-
or. But when it

attention,
only owing to a
1 its attachment
jd that the flow
jf the afterbirth
vomb. A knowl-
; for if, in severe

can be entirely
id.

• placenta previa,
In such cases,
) open itself, the
lese cases, unless
y minutes. Yet
calmly to choose

be immediately
delivered, or the
lead of abortion.
16 mouth of the

■escribe quiet, the
1 and the external
nts and anodynes

Lion of the womb
necessary, by the
rpose of removing
I shut itself up for

the expulsion of the offending substance. Until this contraction is
secured, the plug should not be used, lest internal bleeding into the
enlarged and expanded womb should be profuse, and fatally exhaust
the patient.

After the Child is Born, our first duty is, if possible, to see that it
breathes. In the vast majority of cases, the well-known cry which
salutes the ear gives proof that the duty is unnecessary. But some-
times we do not hear the welcome sound. The umbilical cord may
be once or repeatedly wound around the child's neck, and must be
immediately removed to prevent strangulation ; or, the child's mouth
may be filL with phlegm, or some sticky mucus, which must be
poked out with the ringer, and its exit favored by turning the face
downward; or, after tedious labors, the child may be bom in a very
feeble state, and may need the stimulus of cold water thrown sud-
denly, in small quantities, upon its chest and body, with considerable
rubbing, and perhaps the inflation of its lungs with air blown into its
mouth.

Tying the Cord When breathing is established, a piece of narrow

tape or common twine is to be tied tight around the navel-string,
about two inches from the child's navel, and the cord is then to be
cut off, with a pair of sharp scissors, from half to three quarters of
an inch outside the place where it is tied. The child is then to be
delivered to the nurse.

Washing the Child. — The child is now, while the physician is at-
tending to the mother, to be washed and dressed by the nurse. Its
skin is at this time covered with a suet>-like substance, called the
verniz caseosa. To remove this, it should be washed all over gently
with warm water and castile soap. It is not material that this coat-
ing should be absolutely all removed at the first washing ; but the
soap and water should be again gently applied in eight or ten hours
from their first use. It is improper to use spirits for this cleansing.
All rough rubbing must be avoided as injurious to the delicate skin
of so tender an infant. Washing with cold water would lower the
temperature to a dangerous degree, and should in no case be allowed.

Removal of the After-Birth. — The woman having rested fifteen
or twenty minutes, a little gentle soliciting or pressure on the womb
will generally bring away the after-birth. If, however, any serious
obstacle prevent its expulsion, it may be slowly and cautiously taken
away by the hand introduced.

Cleansing the Bed, and Applying the Swathe. — Upon the re-
moval of thu afterbirth, a disinfected napkin is immediately applied
to the external organs, a drink of water or tea administered, and
another rest of an hour or more allowed. The swathe may consist
of a towel pinned snugly around the body, or of a cloth, cut and
fitted exactly for the purpose. Its object is to afford a fii-m and
steady aupport to the contracting womb.

436

FEMALE DISEASE&

The DressiniTS for the Child's Navel should be so fixed that the
navelHString or cord will not be left in contact with the healthy skin.
To effect this, make a hole large enough to admit the cord in the
centre of a piece of linen cloth four inches square ; pull the cord
through this hole, leaving the cloth lying flat upon the child's belly;
then, having bandaged the cord down to the belly, fold the cloth over
it, and appTj' the belly-band. The interposition of these dressings
will thus keep the cord, which is dead and in process of decomposi-
tion, from irritating, and perhaps excoriating the living flesh, with
which it must otherwise be in close contact. To wrap the stump of
the cord in fresh absorbent cotton is another neat, dry, and practical
method of treating it.

Nourishment of the Child, etc. — After being dressed, the child
should be kept next the body of the mother or nurse, that it may
receive the natural warmth thus to be derived. Its nourishment
shoi'ld be obtained exclusively from the mother's breast. If it is
hungry, be cure and keep it so. There is nothing more appropriate
than a hungry child all ready to take hold and exhaust the full and
almost bursting breast on the third day, when the milk has come.
Alas I How many children have been fed on sweetened water, and
on milk and water, till they have lost all instinctive idea of, and all
appetite for, nursing ! and how many bowel complaints and broken
breasts have been the miserable consequence ! But meddlesome
f^iend^ are afraid the " little dears " will starve ; and therefore thoy
must.i. st be made sick by unnatural diet, and then for their cure be
treated that filthy, harsh, and indecent substitute for medicine,
ehamber-c^ and molasses !

But it may be asked, "must not the child be fed at all, if it is hun-
gry, and cries a great deal, and there is nothing in the mother's breast
for it ? " Such cases will be exceedingly rare, if the breasts have
been properly solicited from the first by a hungry child. When they
do occur, being themselves exceptions, their treatment must be ex-
ceptional; but, even then, only so far as is absolutely necessary. If
fed at all, the child should not be fed to satiety, but as little as the
circumstances will possibly permit. The great rule remains : keep
the child as hungry as possible till the milk comes. When it has to
be fed, imitate the mother's milk as nearly as possible in the prepar
ration of the artificial diet. A little sweet cream, warm water and
sugar, should be so mingled, that in warmth, richness, and sweetness,
the mixture may closely resemble human milk. (See page 447.)

Diet of the Mother. — For the first few days after confinement, the
most appropriate diet for the mother is gruel, cocoa, rice-water, crust
coffee, or some similar liquid nourishment. Different constitutions,
however, need somewhat different management.

A woman naturally robust, and of full habit, should confine herself
more strictly, and for a longer time, to this light diet, than one whu

Miiinu'wwiwmjittoi ft »!■■

wmm n

FEMALK DISEASES.

437

10 fixed that the
the healthy skin,
the cord in the
! ; pull the cord
the child's belly;
>ld the cloth over
these dressings
188 of decomposi-
iving flesh, with
rap the stump of
ry, and practical

Lressed, the child
irse, that it may
Its nourishment
breast. If it is
more appropriate
lUst the full and
I milk has come,
stened water, and
e idea of, and all
aints and broken
But meddlesome
id therefore thoy
I for their cure be
ute for medicine,

at all, if it is hun-
he mother's breast
the breasts have
hild. When they
nent must be ex-
ely necessary. If
it as little as the
lie remains: keep
When it has to
,ble in the prepa-
, warm water and
iss, and sweetness,
See page 447.)

ir confinement, the
a, rice-water, crust
:ent constitutions,

lid confine herself
iiet, than one who

is more slender and feeble. In some cases, weakly women require
the juice of meat, and even wine or ale, as early as the second or third
day. If she be subject to canker, or nursing-sore mouth, a generous
diet is particularly serviceable. After the first week, she may gradu-
ally i-eturn to her customary diet.

Costiveness may be treated with the usual remedies. It was an
old rule to give a dose of castor-oil on the third day, when there is a
little increa.se of excitement in the system, from the filling of the
breasts. This is not always necessary, and in most cases an injection
would be far better. The mother should stay in bed from three to
four weeks, according to the state of her general health. A little
time now is a great gain later.

The Perpendicular Position During the first month, let the

woman avoid being often or long on her feet. This is a very essential
caution to avoid prolapsus, or falling of the womb, with all its atten-
dant weaknesses and pains, and to ensure a good " getting up," with
a sound womb, in the right place, and subsequent months of health
and enjoyment.

Milk Leg. — Phlegmasia Dolens. — Crural Phlebitis,

The Pv pular idea is, that in this disease the woman's milk has
fallen into her leg, which has inflamed. This is of course absurd.
As to the real nature of the complaint, there are various opinions, —
some holding it to consist in inflammation along the sciatic, crural,
and pubic nerves ; others, that it is an inflammation of the lympha-
tics of the groin which causes it ; others, that it is an inflammation
of the crural veins. The fact of the matter is that tliis disease is one
of the many evidences of septic matter entering the circulation and
setting up local trouble where it is deposited. It is, in other words,
a mild form of pre-existing blood-poisoning.

Symptoms. — The disease begins in from two to seven weeks after
delivery, with pain in the lower bowel, groin, or thigh. The pain is
more violent when the thigh is extended. In a day or two, the pain
diminishes, and the limb begins to swell, frequently in the calf of the
leg first, thence extending upward ; but generally in the groin, and
extending gradually down. The skin becomes entirely white, smooth,
and glossy, does not pit when pressed, is painful to the touch, and is
hotter than the skin upon the other limb. In connection with this
local disease, there is general fever, with small and rapid pulse, thirst,
etc.

Treatment. — The patient must lie flat upon her biick, with the
swelled limb placed upon pillows, or a bolster, raised so that the foot
shall be a little higher than the hip, and then charged not to put her
foot down upon the floor until she is very nearly well.

Apply a narrow blister along the course of the crural vein. When

i.'-^

438

FEMALE DISEASES.

this is removed, take a large piece of flannel, — Dr. Meigs says an old
flannel petticoat, with the hem and the gathei-s cut oft', — and dip it
in vinegar and hot water, equal parfo. ; wring it out, and t;ovei- the
whole limb with it. I*ut a piec!^ of blanket or oiled silk over it to
keep it from wetting the bed. Repeat this and keep it up for six
hourd. When it becomes tedious to the patient, remove it, and bathe
the limb witli warm sweet-oil, two parts, and laudanum, one part, and
cover it with flannel. In two or three houi-s, return to the first appli-
cation of hot water and vinegar. Continue this for five or six hours,
and then take warm sweet-oil and laudanum : and thus pass front
one to the otiier until the inflammation is subdued, or, as Dr. Meigs
says, till the calf of the leg can be shaken.

If the bowels are confined, let them be gently moved by some
mild physic (13), (14), (18), (25), (27), (41).

In many cases, diuretics and cathartics combined will be proper
(302), or diuretics only (128), (130).

While the inflammation lasts, and there is fever, the tincture of
veratrum viride must not l)e forgotten.

If recovery does not take place after the active inflammation has
subsided, the limb should be bandaged from the toes to the groin.

Wrap up the leg in wet flannels, covered air-tight with rubber
cloth, and great quantities of water will exude from the leg.

Child-Bed Fever.

— Puerperal Fever. — Septiccemia.
Blood- Poisoning.

Few complaints more justly excite the dread of the practitioner
than this. It cuts down woman at a time when she can least of all
be spared by her young offspring, and at a moment when she most
excites the love and sympathy of her whole family. It is a terrible
disease.

Until after the discovery of the germ character of many diseases,
this feai'ful scourge was only suspected by medical men to be con-
tagious. It has, however, long since been found to be highly conta-
gious and propagated by the ordinary routes of travel by physician,
nurse, friend, etc., who come in contact with women about to be
confined or with people who have open wounds.

We know that when a woman is confined the germs which natur-
ally belong on the skin and in the vagina, if introduced into the
little lacerations and wounds which are liable to ensue during labor,
set up a violent form of blood-poisoning, which, for its severity,
rapidity of development, and direful consequences, surpasses all other
infectious diseases. Child-bed fever is purely and simply a germ-
disease, caused by unclean hands, unclean instruments, unclean nap-
kins, or, in fact, anything which contains germs, being brought in
contact with the mother. For a further understanding of this cau-
sation, see articles on Asepsis, Antisepsis, etc.

■iiMMWMteiWMMn

■■f*»S»r«iS*l*

— ■

FRMALE DISEASES.

489

says an old
- and dip it
d (!OV«r I he
t over it to
, up for six
it, and batlu;
me part, and
lie first appli-
or six hours,
18 pa«8 from
18 Dr. Meigs

^ed by some

11 be proper

3 tincture of

mmation has
the groin,
with rubber
3 leg.

ticcemia. —

3 practitioner
,n least of all
len she most
is a terrible

[lany diseases,
to be con-
highly conta-
by physician,
about to be

which natur-
uced into the
during labor,

its severity,
asses all other
mply a germ-
unclean nap-
y brought in

of this cau-

Tt becomes quite necessary for a woman to regard liei-self as about
1<) undergo a surgical operation when she is to be .ioniined, for the
simple reason that she should be pn^parcd for the labor just as the
piitient is for tlie operation, that she nia^ have all the advantivges of
skilled nui'sing and the many little antiseptic precautions which ren-
der not only operations but labor itself safe.

Symptoms. — The train of symptoms Iwlonging to this dreadful
iiiidady are too well known to many to repeat them in much detail.
Tlie first that one carefully observant of the sick one notices, is a
slijrlit rise of temperature, then perhai)s follows a chill, sweating and
liuiidache ; discharges begin to smell badly, the bowels enlarge from
the formation of gas ; the stomach is upset, and finally, if the diseiise
is not checked, the infection spreads to the tulxis and ovaries and
into the general abdominal cavity, when death soon steps in to end
tlie frightful scene.

Treatment. — The nurse should always be on the alert to discover
the least rise in temperature or any beginning odor ; it is just here
that valuable time is often lost. The womb has become infected,
but as yet the septic inflammation is only on the inside of the organ.
At this point vigorous measures must be at once inaugurated and
tlie womb thoroughly irrigated with some disinfectant solution, like
thecorroiive sublimate solution, with carbolic acid solution or sul-
pho-naphLlu)l solution. If this measure, rejjeated every eight to twelve
hours, doei not speedily correct the odor, lower the tempeiature and
improve afifairs at once, a thorough curetting of the entire lining of
the womb must bs made, as described under womb-diseases (page
399) and the organ daily irrigated or packed with iodoform gauze.

In many cases the womb and its l)elonging8 may have to be re-
moved entirely. Blood tonics must be employed from the first, and
the infection thoroughly removed lest subsequent womb troubles
'insue.

The chief preventive of this disease is extreme cleanliness and care
in warding off its causes.

Puerperal Convulsions. — Eclampsia.

During the latter part of pregnancy, and even during the lying-in
period, a pregnant woman may be suddenly seized with a convulsion
from which she may never recover consciousness. These fits gener-
ally last a few minutes, and complete consciousness follows with a
terrific headache ; from one to a hundred more attacks may ensue.
The urine usually is found heavily loaded with albumen, and contains
all the evidences of serious kidney disease.

Causes. — These disorders are supposed to be due to the pressure
on the kidneys and its vessels by the increasing growth of the child.
Some cases, however, remain still unsatisfactorily explained.

I III' I
I

440

FEMALE DISEASES.

the womb must be immediately
pressure thus moved from the kidneys.

To avoid any such sudden nurprisea women should have their
urine examined every week or two in the luttyr part of pregnancy.

Symptoms. — The disease is usually ushered in by some slight
frontal hoadache, by swelling of the feet, ankles and eyelids ; these
are symptoms of impending trouble, and precautions should at once
be taken to ward off tue consequent disease. The urine becomes
scanty, thick and smoky ; the face or eyelids twitch, and soon the
fit comes on, superinduced by the large amount of urea retained in
the blood in consequence of the crippled condition of the kidneys,
which normally throw off these poisonous products.

Treatment. — In most cases
emptied of the child and

which are stimulated to secrete freely. The fits are for the time
being controlled by tlio inhalation of ether or chloroform. Bleeding,
the free use of veratrum viride, and the use of chloral or even mor-
phine will materially aid the case toward recovery.

It is a very fatal disorder if left to itself, the patient not infre-
quently dying in tlie first convulsion, after prolonged unconsciousness.

Here again the early discovery of the disease will often be sufficient
to tui-n the tide in a favorable direction.

Flooding and Hemorrhage. — Placenta Praevia.

Sometimes during the latter months of pregnancy quite a little
hemorrhage starts up from the fact that the afterbirth, which normally
is attached to the side of the womb, becomes engrafted into the lower
segment so as to cover the opening into the womb. This latter is
often separated from its moorings and considerable hemorrhage en-
sues, which may vary from a small to an extremely large and fatal
amount. The physician should be summoned immediately and labor
induced at once, if this condition is really found to exist.

Flooding after labor is due to a relaxed womb or some open blood-
vessel. The womb is to be seized and squeezed together into a small
mass, driving out clots; one teaspoonful of ergot in a little hot water
is to be taken, and the foot of the bed elevated till the arrival of the
doctor.

Nursing Sore Mouth.

NxTRSiNG women sometimes suffer terribly with this complaint. It
begins with a scalding sensation upon the tongue, a pink color in the
roof of the mouth, and a hot, watery discharge from the mouth.
After a few days, small ulcers appear on the tongue, and in the
throat. Costiveness is generally present ; but when the ulceration
extends to the bowels, diarrhoea occurs. It comes to an end upon
weaning the child.

Treatment. — To relieve costiveness, give some gentle cathartic
(12), (15), (25), (84), (36).

FKMALE DISEASES.

441

Id have their
i pregnancy.

)y some slight
eyelids ; these
ihould at once
urine becomes
and soon the
ea retained in
f the kidneys,

8 immediately
n the kidneys,
e for the time
:m. Bleeding,
i\ or even mor-

ient not infre-
nconsciousness.
^n be sufficient

I Praevia.

y quite a little
which normally
I into the lower
This latter is
hemorrhage en-
large and fatal
[lately and labor
xist.

[)me open blood-
ther into a small
, little hot water
ae arrival of the

B complaint. It
)ink color in the
rom the mouth,
gue, and in the
1 the ulceration
to an end upon

gentle cathartic

Iron in some of iU forms and combinations is hiehlv necessary
((il), (71), (73), (849).

Gargles will frequently do much good (227), (229), (230), (236),
(243), (244), (347), (350). ^ ^ '^ ^

The diet must l>e simple, nourishing, and dit 'istible, consisting of
stale bread, tender beefsteak, broths, etc.

Inflammation of the Breast. — Broken Breast.—

Mammary Abscess.

The mammary gland, or gland which secretes milk in the human
breast, coiisists of a number of ducts, passing inward from their tei>
mination in the nipple, and then spreading around
like the roots of a tree, and terminating in minute
glands. The mammillary tubes are straight ducta,
ten or twelve in number, having their mouths at
the centre of the nipple, dilating at ita biuso into
larger reservoirs, which extend some distance into
the gland. (Fig. 146.)

When milk is first formed, after confinement,
these tubes and reservoirs sometimes get so full
and hard that they crowd and compress each other,
making it difficult to remove the milk, and under
these circumstances, the breast will inflame.

Symptoms The inflammation generally begins with a chill, fol-
lowed by fever, and pain of a shooting kind, which is much increased
by pressure. An examination will generally reveal a circumscribed,
hard, and painful tumor, even before there is any redness on the sur-
face. After a time, the swelling spreads, the skin becomes of a dusky
red, is hot and shining, will frequently pit a little on pressure, and
soon gives a sense of fluctuation. TTpon the formation of matter, the
breast is enlarged, and there is local tenderness and throbbing pain.

This complaint may be caused by taking cold, irregularities in
diet, or by mental emotion ; but more commonly it is caused by ac-
cumulation of milk within the ducts ; still more commonly by septic
matter from the uterus entering the circulation and causing a local-
ized blood-poisoning.

Treatment. — These afflictions may generally be prevented by
keeping the breasts well drawn. It is the duty of a nurse to look
well after this matter, and see that the breasts do not get l\rd and
distended with milk.

But when the inflammation has fairly set in, the first aim should
be to prevent, if possible, the formation of matter.

Active purging should be resorted to at once (29), (32). Sweating
should be encouraged by the tincture of veratrum viride. If the ob-
ject be to prevent the formation of matter, cold lotions, or cold water
compresses should be used freely j but if two or three days have passed

FIO. 140.

•iji;

lit

442

FKMALR DISEASES.

before active treatment, tlie Hiippuration will go on, and it is better to
UHO warm upplicutioMt;. Dewees nays wann vinegar is the most liene-
ficial as woll as the most comforting. Poultices and warm fomentji-
tions are much used. Some apply Htimulating linimentH, made of
essential oils, etc. (195), (198). Leeches are often used with advan-
Uige. They should he applied, not upon the breast, hut just l)elow it.

Ddriug the 2)rogre8s of the disease, especially after the alwc'ss is
opened, the breast should be supported, and prevented fiom hanging
down, by long strips of adliesive plaster carried below and around it.
liy this means a gentle pressure is kept up by which the matter is
more easily evacuated.

The breast should be opened with a lancet as soon as the abscess
points, or fluctuation is discovered. Should the ulcer not heal, an
astringent wash, such as a weak solution of nitrate of silver (211),
may be applied to it once or twice a day.

During the discharge of matter, the system of the patient should
be supported by a nourishing diet, wine, tonics, etc. To lift up the
breasts, and at the same time gently compress them with a gauze or
thin flaimel bandage, is one of the best methods of treatment.

Sore Nipples.

Women suffering from excoriated nipples are apt to keep the infant
chiefly to the healthy breast, and only to apply it to the tender side
for the purpose of obtaining present ease from the pain of over-dis-
tension. In this way the ducts remain alwa}^ full, and are apt to
get inflamed. Sore nipples, therefore, are to be attended to as much
on account of the evils to which they lead, as of the suffering they
directly occasion.

The excoriation of the nipples begines as a chap. This shows no
tendency to heal; and the child's mouth being often applied, rubs
off the skin around the crack, and this naked surface soon becomes
an ulcer. These ulcers are sometimes only on the surface ; at other
times they are profound, going deep into the substance of the nipple.

Treatment. — These excoriations and ulcers might be easily healed,
were it not that the newly-formed skin is apt to be continually rubbed
off by the child's mouth in the act of nursing. Two things are there-
fore to be done, — to favor the healing, and to protect the tender part
from renewed injury.

For the first object, a strong infusion of green tea or port wine may
answer very well in ordinary cases. A little alum or borax, dissolved
in rosewater, or water (201), (202), is often used. A weak solution
of sulphate of zinc, or sulphate of copper, or nitrate of silver (209),
(211). But one of the very best articles is composed of glycerine
and tannin (306).

To protect the nipple from injury in the act of sucking, use a shield
made of India-rubber. When the infant is not at the breast, the
nipple should be covered by a shield.

t is better to
e most bene-
irin fomentii-
iitH, luiulu of
I with lulvivn-
just ImjIow it.
lie ul)H(""S8 is
lom hanging
ml around it.
the matter is

18 the abscess

not heal, an

silver (211),

atient should
I'o lift up the
til a gauze or
tmeut.

eep the infant
le tender side
n of over-dis-
ind are apt to
ed to as much
iufiering they

rhis shows no

applied, rubs

soon becomes

face ; at other

of the nipple.

e easily healed,
inually rubbed
lings are there-
bhe tender part

port wine may
QFdx, dissolved
L weak solution
if silver (209),
jd of glycerine

ng, use a shield
the breast, the

MARRIED LADIES' PERPETUAL CALENDAR.

TiiK utility of those tablcH. servinp us n faithful and conflrtentinl friend in
matters <if urgent interent, cannot fail of lieing perceived. The young and
newly-married might be spared an unpieaHant amount of embarrasHment by
consulling the Calendar as to the time of conttnement, which, in nclconing
the full period of gestation "280 days from conception, may be very nearly ap-
l)roximated; or, in tiio event of the time of conception l)eing uncertain, from
the period of quickening, whicli she can usually note, she may reclton 140
(lays. It will be perceived that the Calendar luus three colunuis of Hgures, de-
noting tlie days of the months noted at the head of each. The first column
;^ive9 the date of conception; the second, that of the period of quickening;
and the third, that of delivery. Thus, if a lady dates the period of conception
.lanuary 1, 189((, quickening will occur May 20, and confinement about the 8th
of October following; or, if she is ignorant of the time of conception, by con-
sulting the middle column as to the time of quickening, if it occurs May 20,
she may expect her confinement to occur about the 8th of October following,
or 140 days afti^r tlie period of <|uickening. The date in the first column is
that of Cvfuception; the corresponding date in the second column is that of
quickening; and the corresponding date in tho third column that of contine-
ment.

Jastjaey.

Pkbruart.

March.

April.

Vonetp-

^uut-

Jkliv-

Conetp-

Quiek-

Veliv-

Concep-

Quick-

Deliv.

CoKCtp-

Quick-

Deliv-

tim.

eninQ.

try.

tion.

ening.

try.

tion.

ming.

try.

titm.

ning.

try.

•Tan.

May

Oct.

Feb.

June

Nov.

March

July

•Dec.

April

^?f

Jan.

6 .

.30

July

June

i:<

Aug.

Sept.

■

25 .

Dec.

Nov.

Jan.

Feb.

l(i

■m.

MAKKIKD LADIR8' PEBI'KTUAL CALKNUAK.

Oaiictp-
Him

M«y

3
3
4

1)
10
11
12
13
14

16
16
17
18
19
20
21
22
23
24

2fi
26
27
28
29
30
31

Mat.

tning.
Sent.

2(i

•n

28
29

:io

Oct.
1
2
3
4
5
6
7
8
9
10

11
12
13
14
10
16
17

Othr-
try.

Fob.

9
10
11
12
13
14
IS
16
17
IH

19
20
21
22
23
24
20
20
27
28
March

JUNB.

Jdlt.

AUODIT

Cotiffih

Quick-

Dtliv-

Coticrp-

Qairt-

Otlir-

Conetp-

(JHiell-

DtHr.

ti.m

minff.

try.

lion.

mlng.

try.

lian.

thinf.

'•y.

June

Oct.

Marnh

July

Nov.

April

Aug.

Deo.

May

1»

2»i

;«)

2f»

31
Nov.

30
Deo.

31
Jan.

1ft

\li

2ft

;«)

31
April

■M
May

31
June

2fi

'A)

■M

Skptkmbier.

:.\

Conetp-
tion.

Sept.

2
3
4

6
7
8

12
13
14

15
16
17
18
19
20
21
22
23

24
26

20
27
28
29
30

Quick-
ning.

Jan.

Feb.
1
2
3
4
6
6
7
8
9

10
11
12
13
14
15

ir>

Dtlif.
try.

June
8
9
10
11
12
13
14
10
16
17
18
19
20
21

July

3
4

T)CTOBKR.

Conetp-
lion.

Oct.

9
10
11
12

13
14
15

16
17
18
19
20
21
22
23
24

25
2()
27

29
30
31

Quick-
ening.

Feb.
17
18
19
20
21
22
23
24
26
26
27
28
March

9
10
U
12

13
14
15
16
17
18
19

Dtliv-
ery.

July

9
10
11
12
13
14
10
16
17
18
19

20
21
22
23
!k
2-5
2(5
27
28
29

;«

31
Aug.
1
2

3
4

NOVKMBBR.

Conetp- Quick-
lion, tning.

Nov. March
20

2
3
4

13
14
10
16
17
18
19
20
21
22
23
24

26
27
28
29
30

21
22
23
24
20
26
27
28
29
.30
31
April

9
10
11
12

13
14
15
16
17
18

Velir-
try.

Aug.

12
13
14
10
16
17
18
19

20
21
22
23
24
25
26
27
28
29
30
31
Sept.

2
3
4
5
6

Drcembbr.

Conctp-
lion,

Dec.

9
10
11
12

13
14
16
16
17
18
19
20
21
22
AS
24

25
2(i
27
28
29
30
31

Quid-
<nif.(;.

April
19
20
21
22
23
24
20
26
27
28
29
30
May

9
10
11
12

13
14
15
16
17
18
19

Driir-
try.

Sept.

9
10
11
12
13
14
16
16
17
18

19
20
21
22
23
24
25
26
27
28
29
30
Oct
1
2

3
4

6
7

a mm m amt t mim^ smsaiissnits

Avovwt.

etp-

OMift-

tUtir-

an.

aiiint.

fy.

UK-

Dec.

May

•ifi

31
Jan.

Ifi

;»

31
June

:»

Drcembbr.

nrep-

Qiiirl-

Driiv-

ion.

enihg.

*ry.

)eo.

A)rll
9

Sept.

30
May

1!)

'*•»

■J.'<

30
Oct

2ri

;»

CAKE OP CHILDREN AND THEIR
DISEASES.

Pure Air. — The first want of a child is a plenty of fresh air; and
this want never ceases to the end of life. Impure air kills thousands
of infants. Out of 7,660 born in the lying-in hospital of Dublin,
2,944 were destroyed by impure air within two weeks after birth.

Children should be kept in the open air as muoh as possible, and
ill well-ventilated rooms when indooi-s. It is wrong, when infants are
sleeping, to cover their faces with bedclothes, or draw curtains around
their cots, or to envelop their heads in blankets and shawls when
curried in the open air.

The Skin. — The health of infanta requires that their skin should
ba kept clean. Unless this is done they are liable to suffer much
from cutaneous and other diseases. The skin of a new-bom child
is cover: with a white, unctuous matter, called the vernix caseosa.
It is injurious to let this remain for any length of time after birth.
To remove tliis, Dr. Dewees recommends that the child be smeared
with hog's lard, and then washed with soap and water. Dr. Eberlp
says, smear with yolk of egg, and then wash with simple warm
water.

The young child should be washed every day with warm water, —
then, after a time, with tepid water, then with temperate, and finally,
after it is some months old, with cold water. This, if persevered in
through childhood and youth, will ward off a thousand ills and sick-
nesses to which the young are liable.

The Clothing: of Children should be so adjusted as to give their
limbs ample play, and should be thick enough to keep them warm.
They ought to have flannel next the skin in winter, and cotton in
summer. At the risk of wounding some nice people's feelings, I
must add that the fashion of a child's clothes is not important.

The Food. — The natural and proper food of a young child is its
mother's milk. To this it should be confined, unless prohibited W
imperative circumstances, until a portion of the teeth are cut. WL ..
the mother cannot nurse her child, the breast of a suitable nurse
should, if possibio, be supplied. If the infant need any more food

445

StSSSS^^

446

CAUE OF CHILDREN AND THEIR DISEASES.

than is supplied by the breast, give cow's milk and water, sweetened
with a little loaf sugar. The nursing bottle, if used, must never U
permitted to get sour.

Health of a Nursing Woman. — During nursing the greatest at-
tention to health is required by the mother or the nurse. A woman
of a consumptive constitution should never nurse an infant. Nour-
ished at the breast of such a mother, the child, who has inherited her
constitution, will be the more likely to fall a victim to her disease.

Passions of a Nursing Woman. — Let the woman who nurses a
young child be careful of iier passions. An irritable disposition, giv-
ing rise to gusts of violent passion, may so alter the character of thu
milk as to throw the child into convulsions. Grief, envy, hatred, fear,
jealousy, and peevishness, unfit the milk for nourishing the child, and
often cause the child's stomach to be much disordered.

Tlie Diet of the Nurse shouhl receive strict attention. It should
be plain and wholesome, and the amount should never be excessive.
Her drink should be simply water and non-stimulating and nourisli-
ing drinks such as the various preparations of cocoa, etc. She should
take gentle daily exercise in the open air.

Wet Nurses. — If for any reason it should be necessary to wean
the baby, or the mother cannot nurse the child, then we must select
a food the most like that of the mother.

Wet-nurses formerly were quite popular among the well-to-do t«
supply this food ; but as in her selection there are so many exacting
requirements, she is fast becoming obsolete. There are three requi-
sites for a good wet-nurse : she must be of good health, of good moral
character, and be able to supply plenty of good healthy milk.

If she has any tubercular, scrofulous, syphilitic, insane or osseous
history; if she is menstruating, or pregnant, or is in anywise below par
in health, she is necessarily disqualified as a nurse for any child ;
only your phjreician may be able to detect these evidences and per-
haps not even he. If, on the other hand, she is occasionally given
to blues, has a violent temper, is jealous, or fretful, or worries about
har own child, or goes into dangerous^ company when away fi'om the
house, then you have added a second disqualification. Again, her
supply of milk must be good as shown by an analysis and the healtli
and growth of her own child. A nurse may pass muster to-day in
reference to this third requisite, but perhaps not in- a week from to-
day.

Seeing that the average wet-nurse comes from a lower stratum of
society, even if not from the criminal class, that she is in consequenci;
more liable to fcquired disease and contagion, that she is more than
likely to bring trouble into the household rather than to relieve the
household of it, it will be extremely difficult for you to find such a
person as can furnish all the required conditions of a safe wet-nurse.

mmtMimtm-mimeim

-t^S;::a;'uj-^Jt.^->i^4-,.^„

ESS.

water, sweetened
d, must never be

[ the greatest at-
lurse. A woman
m infant. Nour-
has inherited her
I to her disease.

lan who nurses a
ie disposition, giv-
e character of the
envy, hatred, fear,
ling the child, and
fed, I ^

ntion. It should
iver be excessive.
ting and nourisli-
,, etc. She should

necessary to wean
3n we must select

T the weil-to-do to
so many exacting
re are three requi-
alth, of good moral
althy milk.
, insane or osseous
anywise below par
rse for any child;
jvidences and per-
occasionally given
il, or worries about
hen away from the
ation. Again, her
ysis and the health
3 muster to-day in
in- a week from to-

a lower stratum of
le is in consequence
it she is more than
than to relieve the
you to find such a
jf a safe wet-nurse.

CARE OF CHILDREN AND THEIR DISEASES.

447

It has been found, therefore, that artificial feeding gives better satis-
faction and is quite as safe.

Nursing Bottles. — There are nursing bottles innumerable, few of
which are of practical value. A simple bottle with plain black nij)-
ple is all that is requi8\te for successful feeding cA the ' hands of a
careful and cleanly mo^Jier or nm-se. The] • should be several bottles
and several nipples, the latter to be kept in soda water or other sim-
ple alkaline solution when not in use. A pinch of soda to a cup of
water is of sufBcient strength. After a bottle lias been used it should
be thoroughly scalded with hat water and soda and finally set away
tilled to the brim with thi,3 sam'^ solution, till later in the day.
Meanwhile, a fresh bottle and /esh nipple is used, they having
tirst been cleansed with the above solution. The best bottle, how-
evei, for nursing in those cases, where for want of time and means
the bottle cannot be held by mother or nurse, is one called " The
Best." See Figs. 147 and 148, This bottle, like many others, al-

Fia. 148.

FlO. 147.

lows of its resting on the bed; but, unlike many others, it ic very
readily cleansed, is of easy suction and has a nipple which does not
collapse. The » jompanying cuts and description are worthy of at-
tention. The pec'iliar feature of the bottle is a valve or air-inlet
in the end admitting air back of the food, thus rendering suction
easy. This valve does not leak and cannot be pulled off by the baby,
but is easily cleansed and adjusted. Whatever else you may do with
the bottle, above all things keep it clean, not only to outward ap-
pearances, but by actually scalding and soaking in soda solution up
to the very time of its use.

Food for Infants. — It has been found that mother's milk, which
of course is the best food for babies, is composed on the average of
the following ingredients: water 87, fat, 4, casein 1, sugar 7, ash 1,
and slightly alkaline in reaction.

Now, c'dinary cow's milk has the following composition : water
87, fat H. r, casein 2.9, sugar 4.9, ash .4 ; it is slightly acid.

*6^,

teiiiSwSES

448

CARE OF CHILDREN AND THEIK DISEASES.

We car therefore see that if we take cow's milk and dilute it with
water sufficiently, we diminish the amount of caaein to that of
mother's milk, and by the addition of cream, milk, sugar and lime-
water, we raise these constituents to the standard found in human
milk. This mixture, known among medical men as the "Meigs'
Cream Mixture," is the basis of all modern compouiuls for artificial
feeding.

Milk, as ordinarily received from the milkman, swarms with bac-
teria and germ-life which, under favorable conditions, quickly changes
the milk and renders it unfit for easy and proper digestion. Milk
from the mother is devoid of these germs, or, as medical men say,
it is sterile. This attribute then is in reality quite as important as
the proper constituency of milk. The process of making cow's milk
sterile is called sterilization^ of which we will speak shortly.

Temperature of Milk. — Mother's milk is of the same heat as the
body, or nearly so ; hence common sense dictates that the artificial
food must be of that degree of heat, or, about 98° Farenheit.

Quantity and Interval of Feedings. — The capacity of a baby's
stomach and the length of time food remains in it are matters of ex-
perience. Herewith is appended a table covering the general rules
of feeding infants and especially adapted to milk and cream mixture
of which we will now speak.

GENEEAL RULES

FOE FEEDING.

aob.

Inte*val.
Hours.

Feedings in
24 Hours.

Amount at

each Feeding.

Ounces.

Amount in

'2A Hours.

Ounces.

Istweek

Ist to 6th week ....
6th week to 6th month . .

At 6 months

At 10 months

10
8
6
6
5

1
lJto2
3to4

10
12 to Ifi
18 to 24

—Dr. F. M. Eotch, Heating's Cyc. Dis, Children.

Based on the average analysis of mother's milk, i. e., 7 parts
sugar, 4 of fat, and 1 of albuminoids, we must take : cream 1 J ounces,
milk 1 ounce, water 6 ounces, lime-water ^ ounce, sugar of milk 3
to 84 drachms.

The milk-sugar is to be obtained at the druggist's. This gives an
eight-ounce mixture, so that for a baby four weeks old (see table)
we need to take about one-half or three-fourths more of this mixture ;
for a baby six months three times this amount, and so on. For a
child newly born, after the first few days, when only a little should
be -given, only slightly more of these ingredients should be used than
in above formula.

Of course, plain cow's milk one-third part, with boiled wal r twn-
thirds, will answer well for many babies, if the milk is steriliztd and

CAKK OF CHILDREN AND THEIR DISEASES.

440

[id dilute it with
jein to that of
3ugar and linie-
oiind in human
as the "Meigs'
uls for artificial

warms with bac-
quickly changes
iigestion. Milk
nedical men say,
as important as
iking cow's milk
shortly.

same heat as the
lat the artificial
arenheit.

icity of a baby's
re matters of ex-
he general rules
d cream mixture

nnt at

Amonnt In

'eeding.

24 Honra.

ICM.

Ouncea.

to 2

12 to Ifi

»4

18 to 24

!yc. Dis. Children.

.k, i. e., 7 parts
cream 1 J ounces,
sugar 01 milk 3

. This gives an
s old (see table)
Bof this mixture;
d so on. For a
ly a little should
>uld be used than

xtiled water twn-
t is sterilizt'd and

a little sugar of milk and lime-water be added just before feeding ;
but tliis simple mixture, while quite sufficient for the average baby,
will not answer for all, nor is it as good for any as the cream mixture
given above. Should the former cause green stools or curdy masses,
the latter must be substituted. This mixture is very easy to prepare,
as the process of making it sterile is very simple, and any woman of
ordinary care and intelligence can successfully carry on this kind of
feeding till the eruption of the second or fouith tooi.h, when plain
cow's milk diluted with an equal quantity of oatmeal jelly and
sweetened, may be substituted. This food should be given at fii-st
once daily ; and later, twice, thrice, and finally it may be fed alto-
gether on mi' 'd oatmeal.

When the <. teeth, or molars, have come through, then, for the
fu-st time, breau, rice, and soft-boiled egg may be added.

Oatmeal jelly may be prepared by boiling a quarter of a pound of
oatmeal, in a quart of water, down to one pint. This mixture is then
to he diluted with an equal quantity of boiled water and strained
through a cloth. Should the oatmeal prove too laxative for the
child, barley jelly may be made in the same way.

Sterilization of Millc. — We have seen how much more important
than the kind of nursing-bottle that may be selected is the kind and
quality of food put into that bottle. To complete our consideration
of the best artificial food, we meat know how to render the milk free
from bacterial life ; this process is called sterilization, and may be
accomplished in a simple way as follows : into as many bottles, which
have been previously scalded and cleansed, as there are to be feed-
ings in the twenty-four hours, pour that quantity of the milk mixture
which is to be given at a feeding; place these bottles, with al)sorbent
cotton in the mouths, into a kettle filled with water up to the level
of the milk in the bottles, and allow the water to rise to 170° Faren-
heit, when the kettle is removed to a warm part of the stove and
covered for about half an hour. The bottles should then be kept in
a cold place till used, when they are to be heated just sufficiently to
correspond to the body heat. These bottles come ready made,
also a rack in which to rest them in the kettle. They should be, in
reality, specially made bottles, and are to be obtained at any drug-
store. They are ready for the baby's use after removing tlie cotton and
attaching the nipple. One may, however, sterilize the entire feeding
of the twenty-four hours, or for twelve hours, as thought best, in any
clean, thin bottle or jar, and pour out the given amount required at
each feeding ; but there is some danger of spoiling the st«rilization by
so much handling. Should it be desirable to prepare milk t4) keep for a
longer time, it will then be necessary to sterilize at a greater heat
(212°), and to repeat the process two or three times. Such milk is
supplied nowada)r8 in the larger cities by companies whn will express
it daily to one's address. By giving the age, quantity and kind of
feeding the baby ueeds, these companies send to you in neat straw

450

CARE OF CHILDREN AND THEIR DISEASES.

baskets the number of bottles the baby will use in the next twenty-
four hours, containing the quantity required, and of the composition
found to agree best with the baby. The Walker-Gordon Laboratory,
203 Clarendon St., Boston, perhaps is the best known of these insti-
tutions, as it sends milk even to remote parts of the country, and in
sufficient quantities to last for a voyage to Europe, and even further
if needed.

To summarize, then, in reference to infant feeding, first in impor-
tance is the mother's milk ; second, the sterilized cream mixture ;
third, the sterilized milk and water; and in later months, the addition
of oatmeal jelly.

Weaning. — At the end of twelve months, the first set of teeth are
generally so far cut that the child can manage most kinds of plain
food ; and it may now be taken from the breast. Should the teeth
appear earlier, and the infant be healthy, it may be weaned even at
the end of the tenth month. Never take the child from the breast in
the midst of summer heat. A disordered state of the bowels, or
cholera infantum, would be likely to be the result. The spring and
the autumn are the proper periods for weaning.

If for some months it has been accustomed to other food besides
the milk of the mother, it may be taken suddenly from the breast.
It must not have any amount of solid food it may crave immediately
after weaning. It should still be kept, for some time, upon a simple,
bland, half-fluid aliment, taken in moderate quantities, and at proper
intervals. At first, the food should be bread and milk, boiled rice and
milk, soft-boiled eggs, oatmeal gruel, plain rice-pudding, preparations
of arrowroot, tapioca and sago, simple meat-broths, mixed with
crumbs of bread or grated crackers, or in which rice or barley has been
well boiled. From this it may pass gi-adually to a more solid diet ;
though, until the age of puberty, the principal part of the diet should
be milk, the farinaceous articles, and vegetables. Sugar has been
thought to be injurious to children. It is not so. If taken moder-
ately, at meal-times, it is wholesome. Lately a new form of choco-
late has come into use, called Kraft-chocolate, made in Germany. It
is prepared with cocoa-butter and comes in small cakes, is easily di-
gested, nourishing, and supplies sweets in a very acceptable and
strengthening form.

Whatever be the food allowed to children, it should never be taken
in excess ; and to prevent this, they ought not to take their meals
alone ; for they have very keen appetites, and if permitted to do so,
they will generally form habits of gluttony. Three or four light
meals a day is enough.

Their drink should be water simply, — nothing else.

If parents would observe these rules, and enforce them strictly, they
would confer blessings upon their children greater than riches. They
would send them into the world with health and good constitutions,
and would save them from untold misery and an early death. Such

•mm

i l l l Hl l 1 l l«i ,! l)».»W l W

H!Hiiim.iii'iii<l»»tliHiW»illM>IHiiii

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CARE OF CHILDRRN AND THEIR DISEASES.

4r.i

! next twenty-
le composition
on Laboratory,
of these insti-
)untry, and iu
[I even further

first in impor-
eam mixture;
18, the addition

set of teeth are
kinds of plain
)uld the teeth
eaned even at
m the breast in
bhe bowels, or
"he spring and

r food besides
)m the breast,
^e immediately
upon a simple,
, and at proper
boiled rice and
g, preparations
J, mixed with
)arley has been
3re solid diet;
the diet should
ugar has been

taken moder-
"orm of choco-

Germany. It
3S, is easily di-
icceptable and

never be taken
ke their meals
litted to do so,
I or four light

m strictly, they
I riches. They
1 constitutions,
y death. Such

a course would evince more love for their children than those weak
concessions which allow tea and coffee, and all sorts of food, in quan-
tities to suit, which occasion early disorders of the stomach and
bowels, and bring later derangements of the nervous system, with
all its regrets and horrora.

Sleep of Children. — During the first period of its existence, an
infant sleeps a large portion of the time. This is a wise provision of
nature. It withdraws the young child, for a time, from those outward
exciting agents, which would too nmch disturb the nervous system
of so tender a being. Whenever a young infant is restless or wakeful
much of the time, we may feel sure it has had too much food, or is
in some way disturbed by it, or by tight clothes, or that some other
cause is giving it uneasy sensations. Do not make the mistake of
thinking the child is hungry because it cries.

Its sleep should be the promptings of nature, and should never,
except iu rare instances, be brought about by opiates. It is wrong
and sinful for a mother or nui-se to put an infant to sleep with an
opiate, merely that she may gain time for pleasure, or even for other
duties.

The Infant should be kept Warm while Sleeping. — During the
fii-st few weeks it should '^leep with its mother, especially if the
weather be cold. After that, it may be in a cradle or cot. The
covering should be warm, but light, so as not to press heavily upon
its tender limbs. If laid upon its back, the fluid of its mouth and
throat may get into the windpipe, and obstruct the breathing, or
produce coughing. It is better, therefore, to lay the infant upon its
side, — taking care not to produce distortion of the spine or limbs
by always laying it upon the same side.

Children should not be allowed to sleen either with the aged, or
with siok persons. It is not healthful for them to breathe the exhala-
tions from the bodies of such. For a somewhat similar reason, some
kinds of plants, and flowers generally, should be excluded from their
sleeping-rooms. Their beds should be so placed as to turn their
faces away both from the sunlight which comes in at the windows,
and from the artificial light in the room.

They should be taught to retire early at night, and to rise imme-
diately after waking in the morning. This habit will be worth much
to them through life. Do not form the habit of rocking the child to
sleep. After the meconeum has passed, the bowels of an infant
should be opened from two to four times in twenty-four hours. If
the stools are less frequent than twice a day, or, if they are lumpy,
some gentle cathartic is called for. From one-quarter to one-half
teaspoonful of castoria, or a dessert-spoonful of mixture (24), an-
swers a good purpose. During childhood, the bowels should lie
moved once or twice a day. When a cathartic is required, a table-
spoonful- of mixture (25), or a teaspoonful of (17), will be found
excellent.

452

CARK OF CTIILPRFN ANP TIIF.IIl DISEASKS.

Exercise. — During tho first few weeks of an infiuit's lifd it i'0(iiiircH
but little exeroist; ; indeed its organization is not sufficiently suttlod
and compacted to j)ermit much without injury. A little gentle rul>-
bing with the hand over the whole body is about all it needs or will
bear. To dandle and toss it about, and especially to set it upright,
is injurious and wrong. Its bones arc all soft, and will not endure
to be much twisted about, and its spine is not stiff enough to bear
up the weight of its head.

After a few months, riding in a carriage, by a careful and trusty
nurse, is both a healthful and pleasurable exercise for children.

Learning to Walk. — At the end of the ninth or tenth month, a
child may begin to learn to walk. It is not safe to teach it this
exercise much earlier than this, as the bones, being soft, may be
bent by the weight of the body, and the limbs be permanently
deformed.

As soon as the child has learned to walk alone, it should be allowed
perfect freedom of exercise. Thenceforward, the open air is its proper
place during the day ; and such an unrestrained use of its limbs as
its own instincts may dictate, is its proper calling. For five yeara
after it has learned to walk, it should do little else than to use its
limbs out of doors, as it pleases. The books and the school-room
will be in season after that. First compact the body, then bring out
the mind. The mind is of no use without the body, — the body must
be developed first, or never.

Moral Treatment. — We charge upon nature many of the bad
passions which we ourselves implant in children. The moral treat-
ment of children is generally bad. We are apt to begin by either
making them our masters or our slaves. Sometimes we do both, —
allowing them to govern us for a time, and then, getting into a pas-
sion, or a mood for playing the tyrant, we turn upon, and govern
them as if we were autocrats. We submit to their whims until we
grow irritable, and then, by way of retaliation, we compel them to
submit to ours.

This is all wrong. Children should be governed always, but with
an even, a gentle, and a loving hand. They should early be sulv
jected to habits of self-control, and of regularity in eating and sleep-
ing ; and should be taught absolute and continued obedience. All
this can be brought about only by firmness, self-control, and great
gentleness on the part of the parents.. If they would- make a child
cheerful and happy in its disposition, they must themselves be cheer-
ful, and never let it see anger, passion, and fretfulness, marring their
conduct. Nothing is more injurious to the health of a child than a
peevish, complaining, and soured disposition ; and these vices are
seldom acquired, unless seen in the lives of parents.

nmmrn

■

CARE OF CHILDREN AND THEIR DISEASES.

463

life it ro(|niioK
ciently sotthid
tie gentle riil>-
; needs or will
set it upright,
ill not endiue
nongh to bear

ul and trusty
shildren.

x;nth month, a
) teach it this
; soft, may be
i permanently

uld be allowed
air is its proper
of its limbs as
For five yeai-s
;han to use its
lie school-room
then bring out
- the body must

my of the bad
he moral treats
)egin by either
we do both, —
ting into a paa-
on, and govern
vhims until we
ompel them to

Iways, but with
i early be suli-
iiting and sleep-
jbedience. All
itrol, and great
Id- make a child
selves be cheer-
9, marring their
E a child than a
these vices are

How to Nurse Sick Children.

As the education of the young, whether religious, moral, or intel-
lectual, is more important than that of adults, so is the care of their
physical life of more importance. Death aims to " out-Herod Herod,"
and seeks the life of all infants, male and female, and in fact destroys
one-half of all below the age of five years.

But few know how to train and take care of children. It is a still
more rai-e gift to know how to nurse them when sick. No person
can properly nurse sick children who is in feeble health, or has a
fretful temper, or is low-spirited: for she can neither endure the
fatigue, nor bear the trials, nor hear the prattle which such a respon-
sibility would bring. Som^ will manage a well child very well, who
are not fit to have the care of a sick one ; for there is a great differ-
ence between a child when well, and the same child when sick.
When well, and full of fun and frolic and life, laughing and jump-
ing and shouting aloud for very joy at being alive, it is an easy thing
for a person of even a morose temper to attend upon them. But
when sickness comes, and the child's playfulness is all laid aside ;
when it becomes so fretful that nothing goes right with it ; when it
cries to be laid down, and then cries to be taken up ; stretches out its
hand for drink, and pushes away the cup when it is presented, —
apparently made more angry. by your attempts to serve it; — when
these things are repeated day and night, until the nurse is weary and
exhausted, and even a change of disease and amendment only brings
a cross and fractious temper, it is only by possessing peculiar qualifica-
tions that the nurse can maintain an even and unruffled disposition.

While passing through such scenes, it is hard for the nurse to re-
member that sickness does not destroy the little loving heart, but only
hides its affection for a short time.

Signs of Disease in Cliildren. — It is important that the nurse of
sick children should know what to observe, and the meaning of the
signs of disease. A baby has only cries to express its sick feelings.
To one person, these cries mean no more than that the baby has some
sort of illness. To another, with more experience and better powers
of observation, they point to the head, or chest, or stomach as the dis-
order. A baby with the stomach-ache utters long, loud, and passion-
ate cries, and sheds tears plentifully. Suddenly it stops for a moment,
and then begins again, drawing up its legs to the stomach, and as the
pain passes off, stretching them out again, and with many sobs, pass-
ing off into a gentle sleep.

If there be inflammation in the chest, it neither cries loud, nor sheds
tears, but after every long breath or hacking cough, it utters a short
cry, which is cut off before it is half finished, — apparently because
crying is painful.

If the disease be in the head, the cries will be sharp, piercing shrieks^

454

OARK OV CHILDREN AND THEIR DISEASES.

with low monnit and tvaih between. Or, there will lie (juiet dozing',
inten'upted by stiirtliiig jmuiih.

When a child is Uiken ill, whatever the diHoiuso which is impending,
there is always a change of some sort, whicii soon attnicts attention.
It eitlu'i" loses its apj)etitc, or is fretful, or soon tired, or sleepy, or
restless, or thii-sty, or has a hot skin, or, rather, has a number of i\\v.w
symptoms. It vomits, or is purged or lx>und in its bowels. It loses
its merry laugh and cheerful look ; it no longer watches its mother's
or its nuree's eye, as before, but clings to her more closely, and will
not be out of her arms a moment. If lulled to sleep in her arms, it
wakes immediately on being placed in its cot.

Such symptoms often continue a day or two before it can be de-
termined what disease is impending. An intelligent nurse may do
much towards 8olving*the question. It is frequently proper at such
times to place the child in a warm bath. When stripped for IIk;
bath, it should be carefully examined to see if there is any rash upon
its body. If it be a rash from which it is about to suffer, the bath
•will help bring it out. The rash should be looked for at least every
twelve hours, until the nature of the disease is determined.

The Appearance of the Different Rashes may be distinguished
with a little care and experience. Measles has a number of (lark-red
spots, in many places running into each other, and is generally seen
first about the face and on the forehead, near the roots of the hair,
and is preceded by running at the eyes and nose, and all the signs of
a severe cold. Scarlet fever does not show separate 3pots, but pre-
sents a general bright red color of the skin, much like a boiled lobster.
At first there is more of it about the neck and chest than on the face,
and it is preceded by a sore tlu-oat. Chicken-pox is .attended by
fever, but not so much running at the nose and eyes as in meaales,
nor is there so much cough. The spots, too, ar. smaller, and are not
so much run together ; and they come out more over the whole body.
They appear a few hours earlier on the body than elsewhere ; and in
a day or two they are found to be enlarged, and turn into little blad-
ders of water as big aa the head of a shawl-pin. (See table of com-
parison of these diseases.)

And now a few Words as to what should be Done in the sick-
room of a child. The room should be kept cool^ and its temperature
should be measured by a tliermometer. This instrument, when hung
away from the fire, should show a temperature of about 60°. That
is about the right degree of warmth. Sick-rooms are generally kept
too hot. The room should be darkened ; not made totally dark, but
its light shaded down by closing the outside blinds, or by dropping
the curtains, so as to give a kind of twilight ; and the cot should
always be so placed as to turn the little one's face away from the
light. The room should be kept quiet; and this requires attention
in the whole house, as well as among the persons in the room. Those

WHiHJ.IUI'1

CARB OP CHILDREN AND THETR lUSEASKa

455

e quiet doziiip,

h is impending,
nicttt iittciition.
d, or sleepy, or
lumber of these
)wel8. It loHeH
lies it8 mother's
losely, and will
) in her arms, it

re it can be de-
t nurse may do
• proper at siuli
itripped for the
i any rash upon
suffer, the biitli
)r at least every
tuined.

le distinguished
iber of <lark-red
8 generally seen
lots of the hair,
[ all the signs of
I jpots, but pre-
I a boiled lobster.
;han on the face,

is .attended by
es as in measles,
Her, and are not

the whole body,
lewhere ; and in

into little blatl-
lee table of coni-

one in the sick-
its temperature
lent, when hung
bout 60°. That
•e generally kept
totally dark, but
, or by dropping
the cot should
e away from the
equires attention
the room. Those

present should never whisper, but speak in low and gentle tones, —
.sliDiild not walk on .tip-toe, !)ut move about carefully. There is a
fi(»Hi/ ({uietnens wliich disturbs the sick far more than noise. The
child must be spoken to, and roused from its slumbers, and turned
from side to side, and raised for its food or medicine, with a soothing
lenderness, and a delicacy which never forgets itself.

In applying leeches or cold to a child, judgment is needed to suc-
ceed well. The leeches should be put either behind the ear or on top
of the head, so that the child cannot see them. Cold is best applied
by means of a couple of ice-lmgs, half filled with powdered ice, and
wrapped in two large napkins ; one of them should be placed under
the child's head, the corner of the na{)kin being pinned to the pillow-
case to prevent its being disturbed, while the other is allowed to rest
upon tlie head, with the corner of the napkin again pinned to the
pillow, to take off the greater part of its weight. In this way the child
will not be wetttid, or irritated, as by the changing of wet cloths,
nor will the cold applications get displaced by its movements.

A word should be said respecting the nurping of children in cases
of lung-inflammation, — an affection from which they often suffer.
The lungs are much like two large sponges, and the air enters them
tlirough the windpipe ; and passing through smaller and yet smaller
tul)es, it comes at last into tiny cells, so small that they can only be
seen by a magnifying glass. When the lungs are inflamed, some of
the tubes become stopped up; and the very small cells are pressed
on by the flow of more blood than natural to the part ; and so the
air enters less easily, and in smaller quantities, than it should. If
now you let the child lie flat, it is not only less able to draw a deep
breath, and fill the lungs, but the blood also flowing to the inflamed
portion of the lung, returns less easily than if the child were propped
up in bed. When a whitlow is on the finger, if the hand be hung
down, the inflamed finger will become redder, and will beat and
throb so as hardly to be endured, while, if the hand be raised, the
pain will abate. The same increase of pain does not foUov," an accu-
mulation of blood in an inflamed lung, because the lung is not as
sensitive as the finger ; but the consequences are very serious. The
air-cells being more and more pressed upon, the admission of air is
more and more difficult, until, at length, a large part of the lungs is
rendered useless, and the child dies.

In this disease, the temperature of the room needs attention. The
air should not be quite so cool as in other diseases. From 60° to 65"
is about rig'nt.

Of course crying will irritate inflamed lungs, and it is all important
that a child sick with this disease should be soothed and quieted as
much as possible. Every good nurse knows how to do this better
than any rules can teach her.

Sometimes sickness and vomiting, from which a child may suffer,
are increased by want of judgment in giving food and drink. When

i'i

466

CARE OF CIianRKN AND THEIR DIHRASER.

there in niuisea, the HtomiK^h will licnr only very Hiinll qitaiititioH of
food at a time, while cold drinks are alnioHt always lK>rn(! niU(;h IhiI-
ter than warm. When there is nausea, it is In^st, for an hour or two,
not to attempt to give any food or drink. After the Htomach has iHtuu
thus completely rested, give a single teaspoonful of cold water. If
this is not thrown up, it may Ik<^ succeeded, in ten or fifteen minutes,
by n second or a third. If this is Imrne, give a little water thickened
with isinglass, or cold barley-water, or cold milk and water; and
then, with the same precautions, and in very small quantities, beef
tea, or chicken broth, or whatever else the doctor in attendance nmy
direct. The small ness of quantity, the coldness of the articles, and
the giving it without moving or disturbing the child, if possible, are
the important points to he attended to.

It is of great consequence that children suffering from diarrlia;a
should have their skin kept very clean. The pores should Ikj kept
well open, so that the fluid matter which is passing off by the bowels,
and through the mucous membrane or inner skin, may be diverted to
the outer skin. In this disease, the skin of children is apt to become
irritable, or even sore. In these cases, soap and water are quite apt
to increase the soreness, while a little starch, made as for use upon
clean clothes, though much thinner, will, if used in place of soap,
very much soothe the inflamed skin.

A child much exhausted by diarrhoea, or other disease, should Iw
moved or lifted out of its cot or cradle as little as possible. Sud-
denly, moving it when very weak may cause fainting, or even con-
vulsions. Let it bo sponged and cleaned by merely turning it, with
great gentleness, from side to side.

In such cases, too, the child should be supported with proper nour-
ishment. When worn down by diarrhoea, its desire for food may l)e
nearly lost. Though at one time it cried much, ar 1 seemed to suffer,
it will, in this condition, grow quieter, and doze, and even sleep on
for hours, appearing fretful only when roused. If, in such canes, the
child be allowed to go without food because it does not seek it, or
declines it when offered, it will sink into a deeper and deeper sleep,
and finally into a stupor which will end in death. To give a little
arrow-root, or broth, may now require trouble and perseverance ; but
it must be done, for upon it depends the child's life. The effort to
administer food must not be abandoned because once or twice, or
several times unsuccessful, for the food which is refused one minute
may be accepted five minutes after.

In the various rashes from which children suffer, there is a very
general fear of washing the surface lest the rash be driven in. There
is no ground for this fear, unless it be in measles ; and even in this
complaint there is no danger if lukewarm water be used. If only a
small part of the body be sponged at a time, there is nothing to fear
even from frequent washing ; and the passing of a wet sponge fre-
quently over the surface is a great comfort when the skin is burning

wmawjawaw iiiwMi'>iy<Muua

OARR OF CHII.nRRN AND TIlRIIl niHRARK8.

487

quiuititicH of
rn! nuu!h 1h;1-

lutur or twn,
iDich hiis been
>ld water. If
teen tninuteH,
iter thickeiu;(l
d water; and
lantities, Ix'of
tendance may
9 articles, and
f possible, are

;rom diarrhoea
lould he kept
by the Ixiwels,
be diverted to
apt to become
• are quite apt
for use upon
place of soap,

lase, should be
jossible. Sud-
, or even con-
uming it, with

;h proper nour-
)r food may be
emed to suffer,
even sleep on
such caitcs, the
not seek it, or
1 deeper sleep,
give a little
severance ; but
The effort to
ce or twice, or
jed one minute

there is a very
riven in. There
id even in this
led. If only a
nothing to fear
vet sponge fre-
skin is burning

willi fever. Tlu) sanio remark applies to the changing of tlm linen.
■|"ht' Hiimt' kind of objoction, and witli no lHitt4T reason, is ofU'n urged
against cohl water in feveix, tliough it is nioht refresliing, and if
taken in small <juantities, and often, never does harm, Init often much
good.

The Warm Bath. — The In^st method of giving a child a warm
liiitli is a nuitter of importance. There should Iw as little parade
iilK)ut it as possible. If the child sees the batl< prepared, is taken out
of k'd, undressed and put into it smoking l)efore its eyes, it may Im)
imich alarmed, and cry so passionately as to bo really injured by it.
Tlio bath should be prepared out of its sight, and brought to tlie bed-
side with a blanket spread over it to liide the steam. The child
should then be laid upon the blanket, and gently let down into tlio
water, and then set to play witli a couple of corks with feathera stuck
in them.

Inflammation of the Mouth. — Ery thematic Stomatitis.

This is a simple inflammation of the mucous membrane of the
mouth, and is very common during infancy. It may l)e confined to
the tongue, or spread over the whole mouth. It is sometimes very
severe, going down into the gullet and stomach, and into the wind-
pipe. It occasions redness and pain in the mouth and fretfulness of
the infant, causing it to quit the nipple suddenly when nui-sing. A
frequent result of tliis inflammation is the secretion and exudation
upon the surface of a white, matter-like curd. It appears in small
points and patches. This is the thrush, or what nurses call children's
sore mouth. It is commonly confined to the period of suckling.

Treatment. — For the simple inflammation of the mouth, a wash
made by infusing the inner bark of slippery elm in water answers a
good pui-pose ; and .n more severe caDos, a wash made of sugar of
lead (227) will hp found useful.

In some mild cases of curdy exudation, this last wash will do well,
if united with the daily use of the warm Imth, and i)roper care of the
diet. But in the more severe cases, a little pulverized borax and
white sugar or honey (274), (275), placed occasionally on the in-
fant's tongue, will do good service. A decoction of equal parts of
hlue cohosh and golden seal is a good remedy. When the curdy
patches are large, touch them with a mixture of hydrochloric acid
and honey (276). If the exudation have a look as if mortification
were taking place, use a wash of chloride of lime (228), or chloride
of soda, etc. (229), or creosote and mucilage (230), or alcohol and
vinegar (231), or nitrate of silver (211). When diarrhoea is present,
with acidity, give (26). In tl. ~ more severe cases, when appearances
of mortification are seen, quinine (69) should be administered.

468

CARK OF CiilLUKKN AND THKIK DIHKAMKH.

Follicular Inflammation of the Mouth. — Aptlmr.

This diHoiwe iittiickH tlio little glantlH of the mouth, eiilleil I'oUich'H,
and nppeai-s alK)Ut the time of cutting teeth. Small white HpeclcH, a
little elevated, lirat show themselves on the lip8, iiwides of the cheek.s,
and under side of the tongue, etc. The specks enlarge, a whitish,
curdy matter flows out from their centre, and ulcers are formed, witli
elevated edges, surrounded hy a red, inflamed circle. Sometiiiics,
instead of curdy matter, a bloody exudation takes place, and dark-
colored crusts are formed which are mistaken for mortiflcation. In
bad cases, there is great restleHHiiesH, with hot mouth, dry skin, thirst,
and diarrhcea, with green stools, and sometimes salivation.

Treatment. — The milder forms of this disease are treated like
simple inflammation of the mouth. If there is thirst, give several
times a day, a spoonful of cold water, with a little gum arable dis-
solved in it. If the child Iw weaned at this time, its food sliould Im
barley or rice-water, sweetened with white sugar. An occasioniil
dose of magnesia, with or without a little rhubarb, will remove the
acid wluch alxjunds in the bowels. After ulceration has taken place,
l)orax (274) wi'' do well. When watery discharges from the bowels
and griping pains appear, preparation (28) should be used. If the
strength be reduced, give (69).

Inflammation of the Qums. — Gengivitis.

During the cutting of teeth, the gums are apt to be inflamed, red
or livid, swelled and painful. The child is languid, with a hot and
dry skin, small and quick pulse, little appetite, much thirst, and a
tongue covered with a thick, yellowish fur. When ulceration takes
place, and is allowed to go on, the teeth become loose, black, and
rotten, and often soft and pulpy; a flow of fetid spittle takes place,
the breath of the child becomes offensive, and its countenance pale
and callow. The gums bleed under the least pressure, and a profuse
diarrhoea fills up the list of ills.

Treatment. — In the first stages, mild washes to the gums, such as
(^227), will do well. Clear out the bowels at once with magnesia and
rlmbarb (26). After ulceration has taken place, use oak-bark (232),
or chloride of lime (227), or diluted hydrochloric acid (233). A
daily tepid bath. If the strength be reduced, use an infusion of
Peruvian bark, or quinine (69).

Qcngrene of the Mouth. — Canker. — Cancrum Oris.

This disease attacks weakly childi-en, of a lymphatic temperament,
and having inflamed gums. It often follows intermittent, reiriittent,
or bilious fever, and is also frequently connected with disease of the
stomach and bowels.

,;?fes;»Lia»iK-*»»,(Sfft%;it?A>w-.j%«i(n.i^^

■.IVi I I

CAUK OF CIIILDRKN AND THKIK DIHKASKH.

460

I. — Aptlini\

called foUic'li'K,
white HptickH, a
i of the cheeks,
trge, a whitish,
10 formed, with
0. SometimcH,
lace, and dark-
irtiflcution. la
dry skin, thinit,
,tion.

tre treated like
8t, give several
fum arabi(! dis-
tood sliould liu
Au occaHional
will rwmove the
las taken place,
rom the bowels
9 UBed. If the

Symptoms. — It is attended with languor, listleHsncHS, indispoHition
to play or move alH)ut, thirHt, 1oh8 of apiMJtito, peevishncHH, and ina-
hility to Hleep. The countenance Ih pale and Hunken, and there in a
peculiar puckering of the checks about the corneni of the mouth.
The breath is bad, the gums have the app(;amnce of Halivation, the
teeth jjccome loose and fall from their sockets, or, if they remain, they
h(M:ome covered witli a thick coating of a dirty white o. ash coloi-.
A few ash-colored water-pimples apjxMir upon the gums, whifsh en-
large, »un together, and finally break, presenting a black appearance
of mortification. The gangrene, sooner or later, goes to the lips and
cheeks.

Treatment. — When bowel complaints exist, the re to lie treated
with *ho usual -emedies, such as (70) or (16(J). If there be active
inflammation Ci the gums, at first, leeches may l>e applied, after
which, the inflammation being subdued, a wash of oak-bark (232)
will be in place, with quinine given internally (Olt) to ward off the
mortification. As a wash, too, a strong solution of sulphate of cop-
per (284) is excellent; so is white vitiiol (285), and nitrate of sil-
ver (219), and creosote (28(5).

The diet should bo beef-tea, plain beef or mutton broth, with rice,
milk and rice, tapioca, sago, and the like.

xgwitis.

be inflamed, red
with a hot and
3h thirst, and a
ulceration takes
oose, black, and
tie takes place,
(untenance pale
a, and a profuse

e gums, such as
h magnesia and
oak-bark (232),
acid (233). A
an infusion of

"Hancrum Oris.

ic temperament,
ttent, reiTiittent,
h disease of the

Difficult Teetli-Cutting.

Tbeth<!U f TING generally begins between the ages of five and
seven months. It is indicated by redness, heat, and tenderness of
the gums, an increase ol oaliva, and, occasionally, redness of the
cheeks, watering of the eyes, thirst and fever, with fretfulness, dis-
turbed sleep, and more frequent motions of the bowels, a little more
fluid than usual, and sometimes of a greenish hue. As the tooth
comes near the surface, the child holds its fingers in its mouth and
presses the gums harder upon the nipple when nursing. Beside
these milder symptoms, there are sometimes ulceration of the mouth,
gangrene, extensive and long-continued diseases of the bowels, and
even disorders of the brain, convulsions, and palsy.

Treatment. — Watch the gums, and the moment they are swollen
by the teeth pushing them up, lance them at the elevated points, cub-
ting entirely down to the advancing teeth, — so that no tough mem-
brane shall cause pain by impeding their growth. These incisions
often prevent fatal disease of the brain, and sometimes almost in-
stantly relieve the most threatening symptoms. Before the teeth
are far enough advanced for lancing, some soothing wash may be
applied to the gums, or a leech or two to the angle of the jaw. For
obstinate diarrhoea, with watery .'itools and griping, use prescription
(157). If the child be drowsy and starts from sleep, .and has heat
and redness, with enlargement of the blood-vessels about the head,

■Hri

460

CAKE OF CHILDREN AND THEIR DISEASES.

put three or four leeches behind the ears, and make cold applications
to the head. At the same time, open the bowels with castor-oil (17).
When there is difficulty of passing the water, give flax-seed tea ; and
if the pain be considerable, a sedative (351) ; one half teaspoonful
in as much water, every hour till quiet.

Croup.

This is one of the scourges of childhood. Croup is an inflamma-
tion of the mutious membrane of the laiyug. and windpipe. It causes
a peculiar fluid to flow out upon the surface of the membrane, which
stiffens into a membrane, or skin-like substance and adheres to the
inner surface of the windpipe, and sometimes extends through the
whole of the bronchial tubes. This is membranoua croup, — the worst
and most fatal form ot the disease. The ordinary form of croup con-
sists in a congestion of the vocal chords with oedema and swelling, so
that the voice is very husky and the cough very much like a hoarse,
tight bark. This form is the result of cold, and is usually quickly
amenable to treatment, although it is really quite frightful for
parents to hear.

The Symptoms of croup are, difficulty of breathing, hoarseness,
and a peculiarly loud and ringing cough, with fever. In. the mem-
branous and worst form of the disease, the breathing is not, at first,
so laborious, and the symptoms generally not so violent and alarm-
ing as in the less fatal but more inflammatory type. This latter kind,
though generally causing great alarm, like a highway robber, by the
sudden fierceness with which they seize the throat, are yet much
less fatal, and of course less to be feared, than the membranous form.
The disease is pretty much confined to children between the ages of
^ one and eight years.

Treatment — The mild and ordinary form of croup, so frequently
experienced by young children at night time, is usually much allevi-
ated by small, oft-repeated doses either of the syrup or of the wine
of ipecac, say five drops (for a >hild two years old) every fifteen
minutes, till nausea, and even vomiting ensue, then much less often.
The inhalation of steam, and of many of the medicated vapors, is an
excellent method of treatment for the older children. One tea-
spoonful of the compound tincture of benzoin in a bowl of boiling
water inhaled through a tin funnel is a very simple thing and a very
efficacious one; this is to be repeated every twenty minutes. In
cases which do not yield to this treatment at once, the employment
of turpeth mineral, in one-half to one-grain doses every half-honr till
the child vomits,.will clear up almost any severe case. The accom-
panying bronchitis which often follows is to be treated as laid down
for that disease. Membranous croup is in reality diphtheria, and is
to be so treated, the exudation being in the windpipe rather than m

"'^'^?a''^'i''?i5f'VS-'^'Si#'i-'-^iti^'j'^^

-^mt

CARE OF CHILDUEN AND THEIR DISEASES.

4t>l

old applications
castor-oil (17).
x-«eed tea ; and
lalf teaspoonful

is an inflamma-
pipe. It causes
lembrane, which
adheres to the
ds through the
>up, — the worst
•m of croup con-
and swelling, so
jh like a hoarse,
usually quickly
» frightful for

ling, hoarseness,
. In. the niem-
g is not, at first,
)lent and alarm-
rhis latter kind,
y robber, by the
t, are yet much
3mbranous form,
iveen the ages of

ip, so frequently
illy much allevi-
3 or of the wine
id) every fifteen
much less often,
ted vapors, is an
dren. One tea-
, bowl of boiling
thing and a very
ity minutes. In
the employment
ery half-hour till
se. The accom-
ited as laid down
iphtheria, and is
pe rather than in

the throat. As soon as the case is diagnosed, the child is to be quar-
antined in a room by itself, and all the precautions taken against
spreading the disease that would be employed in diphtheria proper.
The newly-discovered antitoxin, with which the world has now been
blessed for a year or two, has already saved hundreds and thousands
of lives by its timely use. Nothing is simpler, nothing more effica-
cious, and nothing less deleterious. (See Diphtheria, pagb 485.)

The inhalation of the vapor of water-slacked lime softens the
membrane and causes the little one to breathe with more ease.
Place a bucket under a tent made with a sheet spread over the crib,
into this bucket put a piece of lime the size of a turnip, and gradu-
ally add a Uttle water. The fumes produced are not hard to bear,
but an adult should also get under the tent, so that the little one
will not be frightened. Keep the room warm, with plenty of moisture
in the air. Liquid diet which is very concentrated, like beef-extracts,
milk and egg, etc., with stimulants, should be given every two houi-s.
Support the strength and heart by simple tonics like quinine, one-
half grain in powdered sugar, or in a tiny pill, every two hours.

Spasm of the Glottis. — Laryngismus Stridulus.

This disease consists in a sudden shutting up of the glottis, or
passage to the windpipe, which creates a feeling of strangulation,
/ind a difficulty of breathing- so great that the drawing in of the
breath causes a peculiar crowing sound. There is no fever. The
child, upon taking food or drink, or upon being irritated or teased, is
taken suddenly with an impossibility of drawing in its breath. After
struggling convulsively for a time, its head thrown back, its nostrils
dilated, its mouth open, its eyes rolled up, its face pale, its legs and
arms stiff, it begins to breathe with a shrill crowing sound. The
disease is sometimes mistaken for croup, and for hoopmg-cough. It
is strictly spasmodic in its nature.

Treatment. — During the paroxysm, set the child in an upright
posture, with the head leaning foi-ward, exposed to a full draft of
cool, fresh air, and sprinkle cool water upon the face. Let nothing
be tight about the neck. Slap the child slightly on the lt?-ck, and
apply friction along the spine. If these means do not succeed, place
it in a warm bath ; while in the bath, sprinkle cold water on the face.

When the fit is over, examine the gums. If they are swollen, lance
them down to the coming teeth. The bowels should be moved daily
with some gentle physic, but not irritated by severe purging. If the
stools are light-co:..jd, use the following prescription: Podophyllin,
one-half grain, alcohol, one ounce, elixir, one ounce, and take a tea-
spoonful in a teaspoonful of water, three times daily.

mamssssBoassm

tssisssms^memmsiimmi

462

CARE OF CHILDREN AND THEIR DISEASES.

^ Whooping Cough. — Purtussis.

This is a contagious disease, peculiar to childhood, and occurring
but once in the same individual. It is characterized by a convulsive,
paroxysmal cough, which is attended by long-continued hissing, con-
vulsive breathing, with rattling in the windpipe, which is succeeded
by several short efforts to expel the breath, following each other in
quick succession. The long, convulsive breathing, attended by the
whooping sound, is immediately repeated ; and these paroxysms con-
tinue unJl a quantity of thick, slimy, ropy mucous is thrown up, by
expectoration or vomiting, when the breathing is again free. These
paroxysms have all the appearance of impending suffocation, redness
of the face, shedding of teara, sweating about the head and forehead,
and such agitation of tlie whole body that the child lays hold of
something for support. Blood sometimes stjirts from the nostrils,
and the child involuntarily passes water or evacuates the bowels. In
spring and autumn the disease most prevails. It is not generally
dangerous.

Treatment. — First give an emetic, — say, two drams of wine of
ipecac. Afterwards, give small doses of ipecac and sulphur (277).
From six to fifteen grains of sulphur alone, three times a day, is an
excellent remedy, A liniment of olive oil, oil of amber, etc. (193),
applied to the spine, is useful. Belladonna (278) is a good remedy.
Prussic acid (96) is strongly recommended by many, and is worthy
of a trial. Lobelia (106) is a valuable remedy. Alum (279) is well
recommended. Sulphuric ether, a little being spilled in the nurse's
hand and held to the child's nose, generally shortens the paroxysm,
and frequently abridges the disease. A solution of nitric acid in
water, as strong as lemon-juice, and sweetened, is a very valuable
remedy, breaking up the disease in two or three weeks; The
child may drink it freely, a little further reduced with water. In-
halations of cresoline are the most useful to abridge aftd soften the
paroxysms.

There are remedies by the legion that have from time to time been
used against whooping cough, but few of them have survived their
infancy. Among the more modern drugs bromoform still holds a
prominent place. Given in one to six-drop doses in a tablespcwnful
of water, three times a day, and gradually increased to five and ten
drops, respectively, the drug exerts a marked impression on the
duration and severity of the disease. Antipyrin, in five- to ten-gi-ain
doses, according to age of child, given three or four times daily,
mitigates the paroxysm and shortens the disease. The burning of
cresoline, a coal-tar product obtainable at all drug-stores, is a most
valuable means of cutting short the; disease. This liquid should l)e
put in a tin box-cover and set over a lamp with very small blaze, —
just sufficient, in fact, to evaporate the cresoline. A lamp for the

CAKE OF CHILUUKN AND TIIEIK UISKASES.

463

and occuriinp
r a convulsive,
i hissing, cnn-
h is succeeded
each oilier in
tended hy the
laroxysms con-
thrown up, hi-
ll free. These
ication, redness

I and forehead,
id lays hold of

II the nostrils,
;he bowrels. In

not generally

anis of wine of
sulphur (277).
nes a day, is an
ber, etc. (193),
a good remedy.
r, and is worthy
m (279) is well
I in the nurse's
s the paroxysm,
f nitric acid in
a very valuable
le weekSi The
ath water. In-
i and soften the

me to time been
e survived their
rni still holds a

a tablespoonful
to five and ten

)ression on the
five- to ten-grain
our times daily,

The burning of
jtores, is a most
liquid should he.
Y small blaze, —

A lamp for the

purpose comes with the cresoline, but any ordinary lamp with ser-
rated lamp-chimney may just as conveniently be used. The odor
is strongly tarry. The vapor should be confined in the sleeping
chamber at night, but may also be burned both night and day.

Looseness of the Bowels. — Diarrhea.

Infants and children are more liable to diarrlupa than adults, and
this is the reason for speaking of the disease here as well as else-
where. It may be caused by inflammation of the stomach and
bowels, by irritation produced by too much or improper food, by cold
and damp weather, or by teething. The discharges from the bowels
may be more or less thin, of a dirty white color, of a curdled appear-
ance and acid smell, or they may be watery, yellow or green in color,
and often mixed with blood. Sometimes they are mixed with por-
tions of undigested food, are very acid, and when the looseness has
been caused by unripe vegetables and fruit, in a state of fermentation,
like yeast. At other times, especially while teething, they are a kind
of thick mucus, like jelly.

If pressure on the bowels causes pain, the diarrhoea is the result of
inflammation. When the disease has become chronic, the skin is dry,
harsh, and discolored, the face wrinkled, looking yellowish, dirty,
and old.

Treatment. — First, regulate the diet. This is very important.
In the case of older children, take away every kind of solid food, as
well as pastry, confectionery, sweetmeats, and fresh vegetables. Give
plain boiled rice and milk, — sometimes boiled milk, — water gruel,
crackers and milk, tapioca, etc. At the beginning of the attack, give
some mild physic, as ct.. "^or oil, or syrup of rhubarb. A warm bath
at this period is excellent. If the discharges are very sour, dissolve
a teaspoonful of bicarbonate of soda in half a tifmbler of water, and
give a teaspoonful every hour, or the same amount of lime-water,
mixed with an equal quantity of new milk, or prepared chalk and
ipHcac (158), some slight astringent being used also (159). But
better than all other astringents for this complaint is a decoction of
tlie eranesbill or spotted geranium with milk, or of the bark from
the root of the common blackberry, which is armed with strong
prickles.

The Summer Complaint of Infants. — Cholera Infantum.

This is confined to the North American continent. It occurs in
large cities during the hot season. Its subjects are infants between
the ages of four and twenty months, — occurring most frequently
about the time of cutting the fii-st teeth. It is one of the most fatal
diseases of infants.

Symptoms. — It begins with a profuse dian'ha>a, — the stools being

MMIMBMBii BMfhmgiafiii«»w . 1f-W«BSS«

464

CABE OF CHILDREN AND THEIR DISEASES.

green or yellow, or more often light colored, and very thin. The
stomach soon becomes very imtable,T- rejecting everything with
violence. In some cases, vomiting and purging set in, — the dis-
charges from the bowels being without color or smell. The infant
rapidly loses flesh, and is soon reduced to great languor and prostra-
tion. The pulse in the beginning is quick, small, and often tense.
The tongue is covered with a white, slimy mucus. The skin is dry
and harsh. The head and belly are hot. The feet and hands are
either of the natural temperature, or cold. There is great thirst, and
towards evening, fever. The belly is .-iten a little swollen, and
tender to the touch. Occasionally there is delirium, as indicated by
wild and bloodshot eyes, violent tossing of the head, and attempts to
bite and scratch the nurse.

Treatment. — If possible, remove the child at once from the im-
pure and heated air of the city to the cooler and purer air of the
country. Or better, take it to the seashore or a short trip on the salt
water. This will often give immediate relief. Be careful the child
does not take cold. If this cannot be done, keep it in as large and
dry a room as can be had, and take it often into the open air in clear
weather. Confine the infant entirely to the breast, or, if weaned, let
its food be tapioca, pure arrow-root, rice flour and milk, and put it
daily in a warm or tepid bath, according as the skin is hot or cold.
Give it gum-water, or rennet whey, with a little gum-arabic added
to it.

These measures, if used early, will often cure the disease, without
medicine. If the vomiting be obstinate, camphor and sulphuric
ether (280) will generally give relief. When everything else fails,
in relieving the sickness, sugar of lead (160) is generally successful.
When the vomiting is stopped, the most prompt remedy for the dis-
ordered bowels is the compound syrup of rhubarb and potassa.
When the disease has become chronic, treat it the same as children's
diarrhoea. But if the discharges are sour, offensive and dark colored,
pulverized charcoal (42), with tartrate of ivon (71), will be suitable
remedies. Rhubarb, lept ^diin, etc. (28), will often answer a good
purpose. 4

Colic.

Infants are very much subject to colic, from over-feeding and
consequent acidity of the stomach, from giving them solid food at
too tender an age, and from some improper thing eaten or drunk by
the mother or nurse. They often suffer intensely from these pains,
tossing their legs up and down, and screaming vehemently. When
it arises from costiveness, the bowels are often hard and swollen.

Treatment. — When it arises from costiveness, give an injection
of a tablespoonful of castor-oil, and a half-ounce of warm infusion of
peppermint or spearmint. At the same time, administer internally
an infusion of one of the same herbs, with a small portion of bicar-

S8.

CAKE OF CHILDREN AND THEIR DISEASES.

406

very thin. The
Dverything with
et in, — the dis-
lell. The infant
juor and prostra-
and often tense.
The skin is dry
it and hands are
great thirst, and
tie swollen, and
, as indicated by
, and attempts to

bonate of soda dissolved in it, and sweetened with loaf sugar. Or,
if the bowels need to be acted upon, the syrup of rhubsirb, ir the
sweet tincture of rhubarb, with a little soda in it, will do well. Para-
goric generally brings relief, but should not be used, if simple car-
minatives will answer tlie purpose. Children are often relieved by
covering them with a hot flannel, laying them upon the belly on the
knee, and trotting them, at the same time tapping them gently upon
the back. This should be done cautiously ; for if unsuccessful, it
might increase the suffering ; and the infant has no language but
screams to tell its distress. Five drops of aromatic spirits of ammo-
nia, with same amount of spirits of lavender, in warm water, relieve,
if often repeated, most cases.

nee from the im-

purer air of the
rt trip on the salt

careful the child
t in as large and

open air in clear
or, if weaned, let

milk, and put it
in is hot or cold,
jum-arabic added

e disease, without
)r and sulphuric
rything else fails,
lerally successful,
smedy for the dis-
arb and potassa.
same as children's
and dark colored,
), will be suitable
en answer a good

over-feeding and
bhem solid food at
saten or drunk by
from these pains,
hemently. When
d and swollen.
, give an injection

warm infusion of
ninister internally
11 portion of bicar-

Falling of the Bowel. — Prolapsis Ani.

In cases of long-continued looseness, the lower bowel of children
sometimes gets so weakened that it drops down, and projects through
the fundament. Occasionally, only the mucous membrane which
lines it comes down, in the shape of a small tumor, causing a sense
of bearing down and smarting. These fallings-down occur when the
child goes to stool. Whether it be the bowel or the lining membrane
which has come down, if it be allowed to remain long down, inflam-
mation will take place, and to return it will then be very diflicult.

Treatment. — Place the child upon his back, and, having smeared
the thumbs, or forefingers, with lard or sweet oil, press them gently
upon the tumor in such direction as shall t(Mid to return it within the
body. If this does not succeed, push the forefinger into the gut, so
as to relax the circular muscle which contracts upon and holds it. If
the falling is caused by straining at stool, made necessary by costive-
ness, some ripe fruit stewed in molasses, or rye hast3'-pudding and
molasses, should be given to the cliild daily, and it should be caused
to empty the bowels while standing up. To strengthen the bowel,
few things are better than cold water, applied to the fundament
several times a day. An astringent wash of oak-bark (232 ) is also
valuable. Should the bowel become so much relaxed that these
means fail, a tight bandage must be applied to support the funda-
ment. Be careful that some ignorant pretender does not — as has
happened — apply the ligature or the knife, and cut off the tumor,
instead of returning it into the body. Feed upon the simplest of
liquid food.

Qastric Fever of Infancy.

The inflammatory affections of the bowels, which happen after
teeth-cutting, are frequently accompanied by remittent fever, — the
fever showing itself very distinctly towai'ds evening, and subsiding,
or nearly disappearing, in the morning. It is a sympathetic fever,

466

CARK OK t!llll,l)KKN ANI» THKIk DISKASES.

and is generally the result of a reaction produced by inflammation of
the stomach, or ileum, or colon. The attack is sometimes siifkleii,
though generally gradual.

Symptoms. — For several days, the child will be languid and
fretful, with loss of appetite, increased thirst, and some heat of skin.
Towards night these symptoms are more intense ; the skin is more
hot, the thirst and restlessness ai"e greater, the pulse more rapid. In
the morning, the skin is more moist and cool, and the child falls into
a short, disturbed sleep. Early in the attack, the bowels are consti-
pated, — though there is sometimes diarrhtea, or a frequent desire to
go to stool without mucli being passed. The evacuations are always
umiatural and very offensive. They are dark-colored, or clay-like, or
of the consistency of tar, — sometimes mixed with mucus, and occa-
sionally with blood. There is tenderness of the belly, and pressure
upon it causes pain. It is also hot to the touch, while the feet aie
cold. The face is flushed, and the breath has a decidedly sickly
smell. The stomach is irritable, and vomiting is frequent. The
tongue, after a time, becomes coated, diy, and pointed.

In the chronic form of the disease, there is, frequently, diarrhea,
the passages being unhealthy and fetid ; the tongue is covered with
a brownish-yellow mucus, the gums with sores ; the lips are parched
and cracked ; the urine is scanty and high-colored, with a white sedi-
ment; the skin, dry, harsh, and dirty-looking; the countenance con-
tracted and wrinkled ; and there is, frequently, a dry, hacking cough.

Treatment. — Regulate the diet. This is important. In recent
and acute cases, withhold all food, except some cold mucilaginous
fluid to drink, as rice-water, gum-water, infusion of slippery-elm bark,
or milk diluted with baiiey-water. Give a warm or tepid bath daily.
Purgatives should be used iparingly. The bowels, when costive, had
better, generally, be opened by injections of tepid water, or thin
gruel. If any laxative be used, let it be the compound rhubarh
powder, or either of the following (28), (281). When the discharges
have become healthy, and the tongue clean and moist, some light
bitter, as the infusion of Peruvian bark, or calumba, in combination
with diluted sulphuric or hydrochloric acid, may be given. These,
carefully given, with the daily tepid bath, and exercise in the open
air will soon restore the strength.

Mesenteric Disease.

This attacks scrofulous children between the ages of three and
ten years. Its symptoms are a prominent belly and loss of flesh, —
particularly upon the arms and legs. To be able to feel the enlaigi'l
and hardened glands through the walls of the belly is the surest
sign of this disease. When the complaint is long-continued, the
child loses all its flesh, and dies in almost a complete skeleton state.

DARK OF CHILDREN ANP THEIR DISEASES.

467

nflammatiDii of
letimes sudden,

be languid and
me heat of skin.
he skin is more
more rapid. In
5 cliild falls into
jwels are consti-
■equent desire to
itions are always
id, or clay-like, or
mucus, and occur
Uy, and pressure
vhile the feet are
decidedly sickly
I frequent. The

,ed.

uently, diarrhoea,
.e is covered with
B lips are parched
with a white sedi-
countenance con-
i-y, hacking cough.

prtant. In recent
3old mucilaginous
slippery-elm bark,
r tepid bath daily,
when costive, hiui
id water, or thin
ompound rhubarb
len the discharges
moist, some hght
ba, in combination
)e given. These,
ercise in the open

ages of three and
md loss of flesh, —
to feel the enlargv-'l

belly is the surest
long-continued, the
ilete skeleton state.

Treatment. — If there is inflammation or other disorder in tlie
Htomach or bowels, attend to this fii-st. Tlicn put the patient on a
generous diet,«ach as meat-broths, etc. Give bicarbonate of potassa,
dissolved in the infusion of calumba or (luivssia, and when there is
costiveness, add rhubarb to the preparation. For tlio enlargement
of the glands, apply, externally, an ointment (1^-^) of the iodide of
lead, or of the iodide of potsissium (185). Give an ioduretted bath,
daily, which is formed by adding one grain of iodine and two grains
of iodide of potassium to each gallon of warm water.

The syrup of iodide of iron should be given, internally, three times
a day, in a little water, or the iodide of p()t4is8ium, and compound
infusion of gentian. Daily sponging the body in salt and water, and
exercisL in the open air, are important.

Rickets.

This is also a disease of scrofulous children. By some defective
process of nutrition in such children, there does not enter into the
hones enough phosphate of lime to harden them, and the weight of
the body, or the pulling of the muscles, o\ the pressure of the
clothing, bends and distorts them in all manner of ways. The heads
of the thigh-bones are pushed nearer together, making the lower belly
narrow; the backbone is so. curved as to lessen the height; the
slioulder-blades stand up like wings when flying is contemplated j
and the shoulders are so lifted up that the head seems only a little
higher than the elevations on each side.

Treatment. — A good, generous, wholesome diet, properly regu-
lated ; out-door exercise ; the tepid or cold salt-water sponge-bath,
with friction, and but little medicine. The hypophosphite of lime,
in two-grain doses, given in a little sweetened water, three times a
day, or the syrup of the hypophosphites, in half-teaspoonful doses,
three times a day, may be given with advantage. The pyrophosphate
of iron, combined with the lime, makes a good tonic for scrofulous
cliildren.

The Blue Disease. — Cyanosis.

This disease is known by a blue, purple, or leaden tinge over the
whole body. The warmth of the body is reduced, there is difficult
breathing, which is increased by quick motion or by crying. The
disease is generally fatal. The blueness is occasioned either by the
passage between the right and left side of the heart remaining open
after birth, so as to let the blue, venous blood run through and mix
with the red arterial blood, thus making the whole blue, or by the
obstruction of the pulmonary artery, which withholds the blood from
the lungs, and does not allow it to be arterialized and reddened. This
latter opinion is the more general one now.

468

CARK OF ClIlLnKKN AND THEIU PIRKASES.

Treatment. — Keep the patient, as muoh as jioHHible, in a Htatt' of
rest, HO that the circuhition may not Ik; hniried. Allovv pure, frcsl.
air, easily-digested food, and protect the bn.ly fron. c^old and damp-
ness. Hold the infant near the fire, and apply gentle friction over
the head and body with a warm, soft cloth.

Fits.

Most persons have seen a baby in fits; anr^. it is a sad sight,— its
little face all distorted and livid, its eyes rolling and squinting fright
fully ; its hands clenched, arras bent, legs drawn up, body arched
backward, and limbs twitching violently, — itself insensible and un-
able to see or swallow or move. After a time, tlie fit cetvses, some-
times by degrees, at other times suddenly, the child fetching a deep
siffh, and then lying quiet and pale, as if it had fainted. From this
state it passes into a sleep, and, on waking, some hours after, seems

quite well. , „ • i -i

Fits may attack a child which is apparently well, occurring daily,
or even several times a day, and it may linger on for weeks. A
child may have fits from a great variety of causes ; they theretore,
have a different meamng in different cases. But they ahvayB show
that the brain has in some way been disturbed.

Treatment. — As fits are not a disease in themselves, but only a
Bymptom of some disease, the treatment must have reference to the
cause. Sometimes, while the fit lasts, it is wise to do nothing. But,
if a fit come suddenly, in the case of a child previously healthy, it is
aenerally safe to place it in a hot bath, and at the same time to dash
cold water on its face, or to pour cold water on its head, or hold on
it a large sponge dipped in cold water. The hot bath will draw the
blood to the skin, and away from the overloaded brain. It will quiet
the disturbance of the system, and if scarlet-fever or measles are
about to appear, it will bring them out.

cs.

ble, in a Htatt' of

lUow pure, fresli

cold and dainp-

itle friction over

a sad sight, — its
squinting fright-
up, body arclied
isensible and un-
fit ceases, some-
i fetching a deep
nted. From this
lours after, seems

, occurring daily,
n for weeks. A
I ; they therefore,
they always show

selves, but only a
reference to the
lo nothing. But,
usly healthy, it is
same time to dash
. head, or hold on
)ath will draw the
vin. It will quiet
Br or measles are

DISEASES OP THE GENERAL SYSTEM

AND MISCELLANEOUS DISEASES.

Having now treated of those disorders which affect the skin, the
brain and nerves, the throat, the lungs and their appendages, the
lieart and its covering, the abdominal cavity and its lining membrane,
the sexual organs, and those complaints peculiar to females and chil-
dren, it remains to speak of those others — fewer in number — which
are not specially developed in any particular part, but disturb the
whole system.

Fever.

Fever is a disease which affects the system generally, and is char-
acterized by more or less excitement of the circulation, increased
heat, diminished strength, and, oftentimes, unnatural thirst. The de-
gree of excitement is measured by the state of the pulse. Of this
state, there are two characteristic indications : namely, frequency and
hardness. A pulse is frequent when its rapidity exceeds that of
health ; it is hard when its stroke resists the pressure of the finger
with unusual force.

In health, the pulse of an adult beats from sixty to eighty times in
a minute ; that of children is more frequent. The pulsations of the
heart of the unborn infant, as heard through the body of the mother,
are one hundred and fifty in a minute. After birth, the pulse varies
from one hundred and forty down to the standard of adult age. To
appreciate hardness of pulse, experience is absolutely necessary.

The great activity of the circulation, in fever, is intimately con-
nected with the heat and thirst, and tends directly to waste the ener-
gies and consume the strength of the patient. The heat of fever
lessens or dries up the secretions, or different fluids of the body,
which, in a state of health, are separated from the blood for various
purposes. This is the cause of the dry skin, scanty urine, etc.

A crisis of fever is that period in its course when unfavorable
symptoms give place to those of returning health.

A course of fever, or, in common language, a run of fevr, is dis-
tinguished by a great variety of symptoms, which. will be more par-
ticularly spoken of in the pages which follow.

469

470

I»I8KA8K8 OK THK QFNRKAL 8YSTKM.

Typhoid Fever.

Ok tho (liffon^nt kiiKls of ftivcr, tliia is oiu) ot t!"' most coiuiunii
and widely prevahait. Tho niuno fi//>hoii/ is from two Greek words
which iiR'iin like ti/phuM,or similar to typhim. Tlio word ti//>hus, fmiii
a Greek word signifying ntupor, moans stupiil^ dull or line ; :uid, when
applied to a fever, imi)lieH that is /ow, or characterized by great neri'-
oua depreanihn.

Tyjjlius and typhoid fevers, if not identical, are ho siniiLir in IiIh-
tory and treatment as to make unnecessiiry their consideration under
separate heads. The following is one of the differences claimed to
exist between the two : namely, in typhus fever, the belly is flat ;
there is no marked disease of the bowels, and gcncjrally no diarrhd'ii
until the second or third week. In typhoid fever, on tiio coiitniiy,
some small glands, called y'eyer'* ^^a7trf«, situated i;; the lower part
of the small intestines, are always inflamed, and sometimes ulcer-
ated ; and consequently, among the symptoms most frequently no-
ticed, are diarrhoea, and drum-like swelling of the 'jelly, called tym-
panites.

Symptoms. — The disease often lias precursory symptoms. For
several days before its actual beginning, tlie patient droops. He may
attend to liis various duties, but does not seem well ; he is low-8j)ir-
ited and Lmguid ; is indisposed to any exertion of body or mind ; has
pains in the head, back, and extremities ; loses his ajjpetito ; and
although dull and perhaps drowsy in the daytime, his sleep is inter-
rupted and unrefreshing at night. The immediate harbinger of the
fever is a chill, often so marked as to cause violent shiveri ig.

The history of the first week shows increased heat of the surface ;
frequent pulse ranging from eighty to one Inmdred a'ld twenty;
furred tongue ; restlessness and sleeplessness ; headache and pain in
the back; sometimes diarrhoea and swelling of the belly ;oid some-
times nausea and vomiting.

The second week is frequently distinguished by an eruption of
small, rose-colored spots upon the belly, and by a crop of little watery
pimples upon the neck and chest, having the appearance of minute
di'ops of sweat standing on the skin, and hence called sudamina, or
sweat-drops ; the tongue is dry and black, or red p.nd sore, the teeth
are foul ; there may be delirium and dullness of hearing ; and the
symptoms generally aie more serious than during the first week.
Occasionally, at this period, the bowels are perforated or eaten
through by ulceration, and the patient suddenly sinks.

If the disease proceeds unfavorably into the third week, there is
low muttering and delirium; great exhaustion; sliding down of the
patient towards the foot of the bed ; twitching of the muscles ; bleed-
ing from the bowels ; and red or purple spots upon the skin.

If, on the other hand, recovery takes place, the countenance briglit-

DI8EA8ES OF THF, OENRIIAL 8YHTKM.

471

mOHt UUUlllKlll

(> Greek wnnls
nl ti/}ihis, fi'iiii

I by great iien'-

1 similar in liis-
ndenition under
iiicert clanued to
10 belly i» flat;
[illy no diiirrlui'ii
on the contnuy,
the lower part
ionietiines uleer-
^t frequently iio-
H-Uy, called tyiii-

symptoms. For
, droops. He may
I; he is low-Bpir-
Kjdy or mind ; has
Ins appetite ; ami
bis sleep is inter-

barbinger of tlie
shiveri ig.
at of the surface ;
.red a'ld twenty;
kdaclie and pain in

belly; 01' dsome-

jy an eruption of
[op of little watery
karance of minute
filled sudamina, or
]nd sore, the teeth
bearing; and the
g the first week,
[rforated or eaten
Mks.

lird week, there is
Jiding down of the
[be muscles ; bleed-
t the skin,
fountenancc bright-

cuh; th(! pulse nioderatcH ; tlie tongue cleans, and the (lischargcH
iisNunie the apjM'uraniM^ they have in health.

Treatment. — (iiv(^ tiie patient good air, and frequent s[)ongingM
with water, cohl or tepid, as Hhall Im! most agreeable to his feelings.
Keep the IkjwcIh in order; h\ which is meant, Ik) more afmid of
diarrliu'a than of costiveness. Diarrhwa should Ih) restrained by a
little lirimdy.

For costiveness, give injections, or the mildest aperients (7),
(10), (12).

To lessen the frequency of the pulse, reduce the fever, and pro-
duce perspiration, give from three- to ten-tlrop doses of the tincture or
fluid extract of veratrum virido every hour. This remedy has great
power in fever.

(Jreat wind-swelling of the bowels may he relieved by fomentii-
tiuns, or hot, steaming ap})lications. Sometimes the wind may be
let off by introducing into the bowels a long India-rubber tulxi, —
thus reducing the swelling, and greatly promoting the patient's com-
fort.

If pain in the head be severe and constant, let the hair be cut
short, and the head l)e frequently bathed with cold water.

Let the strength 1h) supported by light nourishment ; and in case
of bleeding fiom the bowels, or great debility, by broth and wine.

For foul mouth, the weakest possible infusion of old hyson tea is
valuable. Good nursing is eminently desirable.

If the fever runs a low course, the patient being much prostrated,
quinine, even in large doses, may be given from the beginning.

Be very sure the patient has absolutely no solid food during the
fever and for five days after. There is nothing so good as milk for
typlioid fever, — a glassful every two to three hours will be all the
food required.

Bilious Remittent Fever.

There are three principal varieties of periodical fever, which,
though varying considerably from each other in several particulars,
are yet essentially, in their substance, but one disease. These are
Bilious Remittent Fever, Pernicious Intermittent or Conyestive Fever,
aiul IrUermittent Fever or Fever and Ague. According to the custom
of most writers, I shall treat them separately, beginning with Bilious
Remittent Fever.

Symptoms. — The attack is generally sudden and well marked.
Some writers say it has no premonitory symptoms ; others that it
lias. The more general understanding is, that for a day or two, or
even longer, liefore the onset, there is a sense of languor and debility,
slight headache, lack of appetite, furred tongue, bitter taste in the
mouth in the morning, pains in the joints, and general uneasiness.

The formal onset is nearly always marked by a distinct chill or

472

DI8EABKB OP THK OF.NBRAL 8Y8TRM.

rigor, — HoraetimoH Hlight hikI lu'iof; at othjr timeH Hev(!ru iind |irn-
longed. The chill may begin at tho f«et, or al)out the Hhniildci-
bludeH, ur in the buck, and thoncc run liko hiiiuII Mtruums of cdid
water poured in every direction through the whole lM)dy. There is
(jcnerally but one well-marked chill, the niturns of the paroxyHins (if
fever being Meldom, after the linit, precieded by the cold Htage.

At certain periodH of the day there is an increased intensity in the
Hymptoms of the disease, occasionally i)receded, though generally
not, by the cliill. Between this period of severity in the feverish
symptoms, and a similar period which follows it, there is generally a
decrease in tlie violence of the symptoms, during which the fjivtr
moderates, but does not, as in fever and ague, entirely go off ; hius
distinct remisaions, but not complete intermianionf.

During the liot stage, the pulse is up to one hundred and twenty,
or one hundred and thirty. There are pains in the head, back, and
liml)B, of a most distressing kind.

The tongue is generally covered with a yellowish or a dirty-white
fur ; and in bad cases in the advanced stage is frequently parched,
brown or nearly black in the centre, and red at the edges. There is
no appetite for food, and generally nausea and vomiting ; and usu-
ally there is pain and tenderness in the epigastrium. The bowels are
at first costive, but afterwards become loose, and there are frequent
evacuations of dark, offensive matter.

Causes. — This disease is produced by malarial exhalations from
the decomposition of vegetable matter. It is most prevalent in hot
climates, and in the summer and autumn.

Treatment. — If the fever be in the formative stage, and have not
fully developed itself, give an emetic (1), (2), and follow it with a
mild cathartic (7), (18).

If the disease be already developed, sponge the body all over sev-
eral times a day, with cold or tepid water, according to the feelings
of the patient^ and give cooling drinks (132), (133), (298), (299).
To moderate the fever, give three- to ten-drop doses of tincture, or
fluid extract of veratrum viride. The compound powder of ipecac and
opium is a valuable preparation for the same purpose. Give cold
water as drink if desired by the patient, or let him eat ice.

When fhe headache is very severe, let wet cups be applied upon
the temples or behind the ears ; and the same remedy to the pit of
the stomach, when there is great tenderness, is often desirable ; though
a mustard poultice will sometimes do better.

During the remissions of the fever, quinine and other tonics are to
be given, as in fever and ague. Quinine, in large doses, acts almost
as a specific for these diseases.

gevore and jiro-
it the Hhouldci-
Htrtiums of colli
Ixxly. Thero in
he piiroxyHiiiH of •
old Htage.
1 intensity in llic
hougli generally

in the fevisrisli
ire is genei'iilly a
which the fnvor
irely go off ; has

Ired and twenty,
head, hack, and

I or a dirty-whito
quently parched,
edges. There is
niting; and nsu-
, The bowela are
here are frequent

exhalations from
, prevalent in hot

age, and have not
1 follow it with a

3ody all over sev-
ig to the feelings
8), (298), (299).
les of tincture, or
vder of ipecac and
rpose. Give cold
eat ice.

9 be applied upon
tnedy to the pit of
desirable ; though

sther tonics are to
doses, acts almost

DT8KA8ER OF THK ORNKRAL HY8TKM. 478

Malarial or Cons:estive Fever.

This is the jxjrniciouH or malignant form of malarial fever. It is
marked, either in the earlier or later stage, by a rush of blood towards
one or more organs, by which they are crowded full and conyented, —
lience its title of congestive fever.

Symptoms. — It may l)e intermittent or remittent, — more com-
monly, it is the former. It may assume any of the types of period-
ical fever, but it is most frequently quotidian or tertian.

The first attack does not differ very materially from a common
attiick of simple intermittent. The first paroxysm is simple, exciting
l)iit little attention. The second is always severe, producing great
coldness, and a death-like hue of the face and extremities. The ad-
vancement of the disease brings dry, husky, parched, and pungency
hot skin, followed, after a time, by a cold clammy sensation. Tise
eyes are dull, watery and sometimes glassy ; the countenance dull,
sleepy, distressed ; the tongue, at first white, changes to brown or
l)laok, and in usually tremulous; the breathing is hurried and diffi-
cult. Pressure over the liver, stomach or bowels produces pain.
The mind is often disturbed, and falls into lethargy and stupor, or is
delirious.

Treatment. — This should be very much like the treatment of the
bilious remittent fever.

While getting up from the fever, the diet must be light and nutri-
tious at first, but may be increased in quantity as the strength re-
turns. Exercise out of doora must not be omitted. If recovery be
slow, some mild tonic, or a little wine, or ale, or brandy may be taken
two or thi'ee times a dsvy. Ten grains of quinine, taken four hours
before the expected chill, will put a stop to these attacks like magic.
After a day or two the dose may be diminished.

Fever and Ag^ue. — Intermittent Fever.

This is a kind of fever in which there is a succession of attacks
with equal intervals and intermissions that are complete but unequal,
on account of the uncertain duration of each fit.

An interval is the period of time between the beginning of one fit
and the beginning of the next.

An intermission is the period of time between the close of one fit
and the beginning of the next.

The different varieties of ague take their designation from the
length of the interval in each case.

The interval of a quotidian, or daily ague, is twenty-four hours.

The interval of a tertian, or third-day ague, is forty-eight hours.

The interval of a quartan, ov fourth-day ague, is seventy-two hours.

_ ^aWtHnssrsKr.

474

DISEASES OF THE GENERAL SYSTEM.

Symptoms. — The disease first develops itself by an ague-fit. This
luis three stages, the .cold, the hot, and the sweating. The cold
stage is very marked. The patient has a sense of debility, yawns,
stretches, has no appetite, and does not wish to move. The face and
extremities become pale, the skin shrinks, causing universal horripi-
lation, or goose-flesh ; the patient shakes, and his teeth chatter.

After a time, these symptoms decline, and the hot stage comes on,
which is characterized by high fever, with its various uncomfortable
sensations.

When this fever passes off, it is followed by the sweating stage,
during which a moisture breaks out, which increases, frequently, to a
profuse sweat ; the body returns to its natural temperature, the pains
and aches disappear, and a feeling of health comes back.

During the cold stage, the ''ood is driven inward from the sur-
face, and particularly oppresses the spleen, which, in cases of long
standing, becomes swelled and permanently enlarged. This swelling
may be plainly felt, and is often quite pei*ceptible to the eye. It is
called ague-cake.

Ague-fits begin at different hours of the day, and generally termi-
nate in the evening.

A quotidian usually begins in the morning; a tertian at noon ; and
a quartan in the afternoon.

The cold stag a is shortest in the quotidian, and longest in the
quartan.

Thus the longest fit has the shortest interval, and the shortest cold
stage ; while the shortest fit has the longest interval, and the longest
cold stage.

There are also double tertians and double quartans, wherein the
fits repeat themselves, — sometimes the same day, at other times on
alternate days.

To these varieties, the terms postponing and anticipating are ap-
plied, according as the intervals are growing longer or shorter.
When a person is recovering from ague, the interval may gradually
grow longer, the attack being put off, or postponed. But if the dis-
ease be increasing in severity, the attack may anticipate its usual pe-
riod, making the interval shorter.

Tertians are more common than either qilotidians or quartans.

Agues are more prevalent in spring and autumn. Fall agues are
most severe and dangerous.

Causes. — Exhalations from the soil, called malaria, arising from
decomposition of vegetable matter in new countries, or from low and
marshy districts in which tlie land is alternately covered with water,
and again left dry and exposed to the sun.

In districts where it prevails, high hills are exempt, and even the
upper stories of houses are more healthy than the lower.

Treatment. — Frnt clear the bowels with the fluid extract of

DI8KA8E8 OF THR Qr>EBAL SYSTEM.

475

II ague-fit. Tliis
ng. The cold
lebility, yawns,
The face and
ihereal horripi-

chatter,
stage comes on,

uncomfortable

sweating stage,
frequently, to a
uture, the pains
ck.

■ from the sur-

I cases of long

This swelling

the eye. It is

generally terrai-

m at noon ; and

longest in the

;he shortest cold
and the longest

ns, wherein the
p other tinjes on

Icipating are ap-
yer or shorter,
may gradually
But if the dis-
ate its usual pe-

or quartans.
Fall agues are

•ia, arising from
or from low and
red with water,

pt, and even the
ver.

fluid extract of

senna (15), or the preparation (21). Then, in the cold stage, give
hot, and in some cases, stimulating drinks. Administer hot foot-
baths, and putting the patient in bed, apply bottles filled with hot
water to the feet, sides, and back, and in every way try to excite
warmth and comfort.

In the hot stage, give cooling drinks, and camphor (117), (118)
in decided doses; or, what is better, quinine (67) in two-teaspoon-
ful doses every half hour, at tiie same time giving five-drop doses of
tincture or fluid extract of veratrum viride every hour.

During the sweating stage, stop the veratrum, and rub the patient
with dry towels.

In the intermission, give quinine (62), in three-grain doses once in
three or four hours, and continue it, gradually decreasing the dose, a
fortnight after the cessation of the attacks. The following is a good
preparation : quinine, one scruple ; elixir of vitriol, one dram ; dis-
solve the quinine in the elixir, and add tincture of black cohosh,
fourteen drams. Twenty drops aie to be given, in a little water, o^ce
an hour.

Quinine is the one medicine which surely relieves and cures this
disease.

It is important, in fever and ague districts, to avoid the hot sun,
and the damp evening and morning air.

Yellow Fever.

This disease belongs to warm climates, being most prevalent in
Southern cities. It makes its appearance chiefly in the latter part of
summer, and disappears upon the approach of frosty weather.

Symptoms. — The complaint begins, generally, with a chill, which
is sometimes severe, though commonly moderate, of short duration,
and rcvrely repeated.

Following this chiU, there is moderate fever and a little heat of
surface ; but this rarely rises to any considerable height, and only
continues to the second or third day, when, in fatal cases, it gfives
place to coldness of surface, etc. In many cases there is sweating.

The pulse is peculiar, — not easily described, — generally not rising
above one hundred in a minute, — a kind of bubble under the finger,
which breaks and vanishes before it can be fairly felt.

The tonguf is moist and white in the first and second days, but
red, smooth, shining, and dry, as the disease advances towards the
closp having a d^y, black streak in the middle.

The most st iking symptoms are nausea and vomiting. The
vomiting, in fatal cases, is generally very persistent, and towards the
termination, the yellowish o: greenish matters thrown up give place to
a thin and black fluid, having a sediment looking like coffee grounds.
This is called the black vomit.

The bowels are generally costive, with frequent epigastric tender-

DISEASES OF THE GENERAL SYSTEM.

ness and distress. There is generally severe headache, and a peculiar
expression of countenance, in which the lips smile, but the rest of the
face is fixed and sad, sometimes wild. The patient continues wake-
ful night and day. There are discharges of blood, often, from tlie
nose, the gums, the ears, the stomach, the bowels, and the urinary
passages.

Treatment. — First, move the bowels with some mild physic (40),
(18), (19), (41), (37). , ^ .

During the chill, put the feet in.a mustard bath (242), give warm
cordial drinks, and apply hot bottles, etc., externally.

Cups may be applied to the back of the neck, or over the stomach,
according to circumstances.

During the second stage, or %tage of calm, nothing is to be done
but give some light stimulants, and to promote sweating by warm
drinks and tincture of veratrum viride; and also quinine (62).

The third and severest stage is to be met by stimulants, as bfandy,
freely given, with a continuartce of the quinine.

During the fever stage, and for the vomiting, give creosote, twenty
drops to six ounces of spirits of Mindererus, and alcohol enough to
dissolve the creosote. The dose is half an ounce every two hours.
Said to be excellent for putting a stop to the retching and vomiting.
Cleanliness, temperance, and cheerfulness are essential in warding
off the disease when one is exposed to its causes.

Rheumatism.

This is an inflammation of a peculiar character, being caused by
acid or poisonous matter in the blood, and having for its seat the
fihrou% tissue, or that thready texture which enters largely into the
composition of the cords and muscles of the human body. The
synovial, or lining membrane of joints, is also peculiarly subject
to rheumatic inflammation. Hence the terms, muscular rheumatism,
and synovial rheumatism. There are also acute and chrome rheu-
matism.

Acute Rheumatism

Is a very painful affection. It is most frequently brought on by
exposure to wet and cold after violent and fatiguing exercise of the
muscles.

Symptoms. — Its principal characteristics are, high fever, with a
full, bounding pulse; furred tongue; profuse sweat, which has a
sour smell, and seems to increase the weakness without relieving the
pain; scanty and high-colored urine, with brick-dust settlings; and
swelling of the joints, with slight redness, great tenderness, and
severe pain, which is particularly agonizing when the patient attempts
to move.

DISEASES OF THE GENERAL SYSTEM.

477

3, and a peculiar
t the rest of the
jontinues wake-
often, from the
md the urinary

ild physic (40),

!42), give warm

irer tho stomach,

ig is to be done
eating by warm
nine (62).
lants, as bfandy,

creosote, twenty
cohol enough to
ivery two hours.
[g and vomiting,
ntial in warding

being caused by
for its seat the
largely into the
man body. The
eculiarly subject
"ular rheumatism^
tid chronic rheu-

y brought on by
I exercise of the

igh fever, with a
3at, which has a
LOUt relieving the
ist settlings; and
tenderness, and
3 patient attempts

This affection often changes suddenly from one part of the body to
another, or from one set of joints to another. This sudden shifting,
termed metaataaig, is peculiarly dangerous ; for sometimes the inflam-
mation, seeming to regard the constantly moving heart as a large
central point, suddenly seizes upon its lining membrane and occasion-
ally proves speedily fatal.

Treatment. — It is well first to open the bowels freely with the
oompound powder of leptandrin, or the compound powder jalap.
Tlien give tincture of black cohosh and tincture of veratrum viride
(124), and push the preparation to the extent of producing sweating.
This, if no evil effects seem to result from it, that is, no prostration
or bad feelings in the head, may be kept up till the violence of the
disease abates.

Sometimes opium, nitrate of potash, etc. (127), administered one
or more times, will have a g^^od effect.

The tincture of black cohosh root, two parts, and the tincture of
colchicum root, one part, and given in dbsos of forty drops, is a valu-
able remedy.

For articular rheumatism, some form of the salicylates must be
used and continued till all pain and soreness have entirely ceased for
several days. Omit all sweets, condiments, and much meat from the
diet.

It is a valuable treatment, -after clearing the bowels with salts and
senna, to give equal parts of wine of colchicum and spirits of turpen-
tine in doses of ten drops every two or three hours; and after a day
or two to give, in connection with the above, at intervals of five
hours, tincture of chloride of iron, ten drops, with ten to twenty drops
of laudanum.

Fomentations of hops and cicuta, or stramonium leaves, placed
upon the inflamed and swollen joints, will have a good effect in re-
lieving the pain. The recent leaves of stramonium pounded, mixed
with a little water, and laid upon the joints, are said to act very
favorably.

Salicylic acid and its salts, or salicin, the active principle of the
willow bark, when given at the commencement qf an attack, often-
times arrests the course of the malady as effectually as quinine
arrests the intermittent fever, or as opium and ipecacuanha arrest
dysentery. It exerts such a beneficial influence that it is recognized
by the profession as a specific. From ten to fifteen grains of salicylic
acid, or the salicylate of soda should be given every two hours until
relief is obtained. This usually takes place in from twelve to thirty-
six hours. In most cases the fever and swelling will abate within
the above time. If not entirely arrested, the disease is very much
shortened.

When the specitic effect is produced on the sysleui, it causes ver-
tigo, headache, ringing in the ears. These symptoms indicate that

,-*iW"'

478

DISEASES OF THE GENERAL SYSTEM.

the medicine should Vie given in smaller doses and with longer intor-
vals. For chronic rheumatism, Seawright's Lithia Water, drunk
in large quantities, is one of the best remedies.

Chronic Rheumatism.

The chronic form of rheumatism may follow the acute as its con-
sequence, but is more often an independent disease. It is seldom
attended by fever, and in this differs from the acute rheumatism.
It often lasts a long time, and causes much suffering.

Symptoms. — These are various, but are generally understood,
even by the common people, to consist of pain, lameness, stiffness,
etc., in the joints and other parts. The joints are often swollen, but
not as much as in the acute disease. It is peculiar to this form of
the complaint, that when the patient remains at rest for a time, he
will have pain and stiffness in the affected part on beginning to move,
but as he grows warm both will disappear.

Treatment. — This complaint is often palliated, and sometimes
cured, by passing a current of electro-magnetism through the affected
part. The diet is all-important; no sweets nor fats should be allowed,
nor spices and other rich condiments are to be taken ; meat is to be
eaten but once a day.

The tincture or the fluid extract of black cohosh, taken in full
doses, is one of the best remedies. It may be taken alone or mixed
with the tincture of poke-berries, and a tincture of prickly-ash bark,
if convenient.

Opium and nitre (127) form a valuable remedy. Colchicum is
much used, and has a deservedly high reputation (292), (301) .

Liniments often have a good effect (190), (195), (196), 198). It
is well to wear a piece of oiled silk over the affected pait. It keeps
up a gentle perspiration from the rheumatic surface, and materially
hastens a cure. Iodide of potash in ten- to thirty-grain doses, with
one-third glass of water, after food, three times daily, is an old hut
very efficacious lemedy. The salicylates in this form are not without
their special value, but are not so useful as in the acute form. The
" Wonderful Wintergreen," lodia, Tongalin, are a few of the well-
known reliable preparations that may be found on the market, each
of which well deserve a trial in chronic rheumatism. .

To bathe the affected joint at bed-time with hot sweet oil, and
then envelop it in cotton batting, to be kept on through the night,
will often give much relief. Oil of cajeput relieves a largo propor-
tion of cases.

The bowels must be kept regular, and all exposure to wet feet or
clothes, and to currents of cool air whe i sweating, must be carefully
shunned.

DISEASES OF THE CJENEKAL SYSTEM.

479

th longer iiiter-
Water, drunk

icute as its con-
B. It is seldom
lite rheumatism.

ally understood,
meness, stiffness,
'ten swollen, but
,r to this form of
t for a time, he
ginning to move,

, and sometimes
3Ugh the affected
lould be allowed,
n; meat is to be

sh, taken in full
n alone or mixed
prickly-ash bark,

Colchicum is

92), (301).

(196), 198). It

part. It keeps

e, and materially

Train doses, with

y, is an old but

n are not without

cute form. The

ew of the well-

the market, each

ot sweet oil, and
irough the night,
!S a largo propor-

ire to wet feet or
must be carefully

Qout

Gout is rheumatism's cousin ; the parentage of l)oth belong to the
brotherhood of the acids.

A very acid state of the biood, or a state favorable to the forma-
tion t f acid, is supposed to be tlie cause of the inflammation peculiar
to both these disorders. In rheumatism, an acid wliich exists i:i sour
milk, and in cider, called lactic acid, is thought to be the disturbing
element. In gout, lithic or uric acid is known to be uncommonly
abundant, and to form a principal ingredient of those concretions
found in gouty joints and familiarly called chalk-atones.

The larger joints are most often affected by rheumatism ; while
gout prefers the smaller ones. In rheumatism, the pain is excrur
dating ; in gout, it is intolerable. There is truth in the hiimorous
Frenchman's description of the pains of these two complaints, whicli
is, in substance, as follows : Place your joint in a vice ; turn the
screw till you can bear it no longer ; that gives you an idea of rheu-
matism ; now give the instrument one more turn, and you have gout.

Symptoms. — A fit of the gout, as it is called, generally makes its
attack in the night. Its unsuspecting victim is first awakened, per-
haps an hour or two after midnight, by an intensely burning, wrench-
ing pain in the ball of the great toe, or some other small joint. This
pain, with its accompanying" symptoms of fever, continues with little
abatement for twenty-four hours. There is then a distinct remission,
when the sufferer may get some sleep. He has a similar experience
during several succeeding days and nights, when the disease, which
has been growing milder, leaves him.

After a considerable interval, there is likely to be another similar
visitation. The length of this interval is inversely as the number of
attacks, — that is, it diminishes in length as the attacks increase in
number ; in yet plainer and more homely terms, the attacks come
" thicker and faster " ; the space between them gradually shrinking
from three or four years to one or two months.

Recovery fron he first attack may be complete, — the skin peeling
off from the red and swollen joint, and leaving it strong and supple
iis ever. But, after several repetitions of the in-
flammation, the joint becomes stiff, its motions
being obstructed by the deposit of lithic acid con-
cretions, or chalk-stones, the limbs are sometimes
actually frosted over with crystals of urate of soda
(Fig. 149). Tliis form of urate of soda crysbvls
differs very materially from Fig. 124. Wlien these
cryst}\ls appear upon the surface, and deposits are
made in the joints, uric acid is not secreted as
usual by the kidneys, but accumulates in the blood.

But gout is a disease by no means entirely local in its character.

FIO. 149.

4«0

D18KA8KS OK TIIK GENERAL SYSTEM.

i^ll

It vitiates the blood, affects the system generally, and is often lic-
trayed by general symptoms long before the loiuil mischief is indi-
cated by one of the attacks. Irritability of temper, unpleasant
sensations in the stomach and head, and various ur.comfortable feel-
ings of body and mind, have been considered iis premonitory of this
disorder. Many other organs also, besides joints, are subject te tlie
gouty inflammation. The stomach, heart, lungs, head, and even the
eyes, are known to have been thus affected.

Causes. — Luxury and indolence — particularly the former — are
regarded .as the principal causes of gout. But poverty and activity
will not always kec-> the disease away. Probably an improper diet
has more to do with the creation of gout than all else. Starchy fofxl,
sweets, etc., which cause an acid fermentation, are most likely to set
up the trouble.

Treatment. — Colchicum is the remedy for gout. It removes tlie
disease by exciting the kidneys to action, so that the poison is con-
veyed away in the urine. Perhaps it acts in some other unexplained
way as an antidote to the disease. One teaspoonful of the wine of
colchicum may be taken two or three times a day, until relief is ex-
perienced. It should then be continued, in ten-drop doses, for a few-
days longer, to prevent a relapse. The colchicum may be taken in
the form of prescription (301).

Coffee, d-unk freely every day, is said to be a sovereign remedy
for gout.

The bowels must be kept in order, but not actually purged (34),
(40). The diet must be simple and unstiraulating.

Let the inflamed joint be bathed often in a saturated solution of
bicarbonate of soda in soft, warm water. Cold applications should
not be made, as there is danger of provoking a sudden change of the
inflammation to some internal organ.

A regulation of the diet and open air exercise are the best meth-
ods of fighting the disease.

Scrofula. — King's Evil.

This disease was once thought to be peculiar to swine, and hence
derived its name from acrofu, a sow. It shows itself in various forms,
— as hip-disease, white swelling, rickets, salt-rheum, etc. Pei-sons
affected by it are subject to swelling of the glands, particularly those
of the neck.

Symptoms. — In the beginning of the disease, small, hard, movable
kernels appear about the neck, just undf the skin. These are lym-
phatic glands, and the swelling generally takes place long before there
is any soreness, or perceptible redness. They may be felt under the
skin, and, ,in the course of six months or a year, may grow to the
size of a filbert, or even a hen's egg. Sometimes they are much

IF"

DISEASES OF THE OENEUAL SYSTEM.

481

mil is often bo
niachief is indi-
per, unpleiusaiit
omfortable feel-
iionitory of this
3 subject to tlic
kd, and even the

he former — are
rty and activity
n improper diet
!. Starchy food.
lost likely to set

It removes the
,e poison is con-
ther unexplained
,1 of the wine of
in til relief is ex-
p doses, for a few-
may be taken in

sovereign remedy

ally purged (34),

rated solution of
(plications should
den change of the

re the best meth-

swine, and hence

in various forms,

am, etc. Pereons

particularly those

nail, hard, movable
These are lym-

e long before there
be felt under the
may grow to the

les they are much

larger even than this, and very hard. They may appear in many
other parts besides the neck.

After a time, though very slowly, they come to a head and break,
— discharging a watery fluid, or a mixture like whey and curd.
They are seldom very sore. When they heal, they are apt to leave
a puckered condition of the skin, and ugly scars.

The scrofulous humor may sometimes affect the eyes, when the
lids will become red and thick, and discharge mucus and water ; —
the under lid sometimes turning out, and presenting a shocking
spectacle.

The scrofulous condition is generally supposed to be indicated by
a white, delicate skin, thick lips, light hair, and a delicate constitu-
tion ; but these signs are not worthy of much confidence.

Tlie disease often attacks the cellular tissue, causing numerous
suppurations and abscesses. It also affects the bones, producing
caries, necrosis, and other affections. It shows itself in certain in-
flammations of the eyes, in the formation of running sores in the
ears, and in various other ways.

Causes. — It is contended by some that scrofula is in all cases
inherited ; that we receive it from our progenitors, as we do their
other constitutional peculiarities ; that the disease is everywhere, and
in all time, one and the same, which shows it to come from within,
and not from without ; that w«re it dependent on external causes for
its existence, it would be greatly modified by temperature, climate,
and the peculiarities of the races affected by it.

They assert that though the causes which are usually assigned
for scrofula, such as living in cold, damp, and impure air, and the
lack of sufficient food, connected with filthy habits, often have a
powerful effect in developing scrofula already existing in the con-
stitution, and of aggravating it when already developed ; it never
produces it.

How far these statements are to be received, I will not undertake
to judge. It is certain that the disease is often inherited ; and if we
admit that the other causes named have some share in its production,
it is possible we may not go entirely astray. Yet my own strong
suspicion that scrofula arises from the animal poison of syphilis, fil-
tered through the blood of many generations, inclines me to the adop-
tion of the above views.

Treatment. — In olden times of superstition, this disease was be-
lieved to be cured by the patient coming into the presence of the
king, and being touched by his royal hand. The ceremony was
called the "sacred touch," It was from this that the disease took
its name of " king's evil." This superstition reached its height in
the reign of Charles II. After the Restoration, the numbers who
flocked to Whitehall and Windsor to receive the " touch," are said to
have been immense, — no less than ninety-two thousand in twelve

r«.^

482

DISEASES OF THE OENKEAL 8Y8TKM.

years ; and the writers of that day declare tlmt none failed to receiv<!
benefit.

In modern times, believing that the ceremony of the touch was
best adapted to the period when kings were thought to have Hiicied
persons, we rely for the cure of this disease upon rational medicine
and hygiene.

The medical treatment of it is constitutional and local.

Iodine is the great remedy for scrofula. Dissolve one scruple of
iodine and two scruples of iodide of potassium in seven teaspoonfuls
oi water. Of this, give ten drops three times a day, in a little water,
gradually increasing the dose to one aud a half or twice that amount.
The iodide of potassium, as in prescription (101), is a good remedy.

Where there is considerable debility, the iodide of iron, in doses
of twenty-five or thirty drops, i?' water, three times a day, is a good
preparation. The syrup of the iodide is the most agreeable fomi.

The compound syrup of yellow-dock root, and the compound
syrup of stillingia, taken sometimes alone, and at other times with
two to five grains of iodide of potassium in each dose, are both ex-
cellent medicines for scrofula.

The bowels must be kept open by laxative food, or in the failure
of this, by some gentle physic (12).

Medicinal springs, particularly those containing iodine, are ex-
cellent. Cod-liver oil benefits most scrofulous people.

Before the tumors become very sore, let them be bathed several
times a day with a solution of muriate of lime, or ammonia, or soda,
two drams to the ounce of water. When they are inflamed, apply
poultices of ground slippery-elm and powdered bayberry, equal parts.
Powdered poke-root, or blue-flag may be substituted for the bayberry.
If these things are not at hand, use white bread and milk, or flax-seed
poultices.

When the tumors have opened, and ulcers have formed, the ulcers
must be washed out with soapsuds, and dressed with salve made of
beeswax and swtet-oil ; or, when the ulcers are indolent, with the
red iodide of mercury ointment. Let the dressing be changed two
or three times a day.

Great attention should be paid to the improvement of the general
health. The diet must be ample and nourishing, — consisting of
fi-esh meat, poultry, broths, soups, milk, and wholesome vegettvbles in
such variety as the season allows.

The skin must be washed daily with cool water and spirit, or water
and saleratus ; and rubbed to redness with a coarse towel or flesh-
brush. Either flannel or silk should be worn next the skin, summer
and winter.

Exercise must be regular, and cheerfully performed, in the open
air. If the residence be in a damp and unhealthy air, it should lie
changed at once, if possible. In any case, a change of residence, from
time to time, when travelling is not possible, is much to be desired.

DISEASES OF THE GENKKAL SYSTEM.

488

1 failed to rcceivt!

if the touch was
b to have Hiicved
•ational medicine

local.

one scruple of
3ven teaspoonfuls
, in a little water,
ivice that amount,
is a good remedy,

1 of iron, in doses
!8 a day, is a good
igreeable form,
id the compound
, other times witli
dose, are both ex-

, or in the failure

ig iodine, are ex-

o\)\e.

be bathed several
ammonia, or soda,

ire inflamed, apply

yl)erry, equal parts.

id for the bayherry.
d milk, or flax-seed

formed, the ulcers

ivith salve made of

indolent, with the

g be changed two

nent of the general
ig, — consisting of
3Some vegettibles in

and spirit, or water
irse towel or flesh-
ct the skin, summer

brmed, in the open
hy air, it should be
re of residence, from
auch to be desired.

Scurvy. — Scorbutus.

Owing to a better knowledge of this disease, and of itiii proper
treatment, it is much less common than in former years. It chiefly
affects seamen who make long voyages ; but is not entirely unknown
on land.

Symptoms. — Languor, loss of strength, and great depression of
mind, are among the first signs of scurvy. To one about being at-
tiieked, work and play are > ike burdensome. There is no heart even
to move. The face and th., whole skin look pale and bloated, and
the breath has a fetid smell. The gums are swelled, soft, red, and
spongy ; and they bleed upon the slightest touch, — sometimes the
blood oozes from them spontaneously. The teeth get loose, and
often fall out. The skin becomes covered with bluish or purple
.spots, — looking precisely like bruises. These spread and run into
each other, forming large patches of discoloration.

These spots appear to be formed by the bursting of the small capil-
laries Ox the veins and arteries, which have grown too weak and rot-
ten to hold their contents, and the infiltration of dissolved blood into
the cellular substance under the skin.

Ulcerous sores break out in various parts of the body, which smell
badly, and discharge a thin matter. These ulcers are covered with a
crust. Various parts of the body, the bones included, are twinged
with pains. The pulse is weak and soft. All the secretions, includ-
ing the urine, have an offensive smell, — as though the whole bocy
were approaching putridity. In truth, the whole man seems to be
disintegrating, decaying ; the flesh becomes soft, and dwindles ; and
the bones break easily, — being afflicted with a decay approaching to
rottenness.

In bad cases, blood is discharged from the bladder, bowels, womb,
nose, and mouth ; and the smallest exertion is followed by fainting,
and in many cases, by sudden death.

Causes. — The disease is owing to the use of food and drink begin-
ning to be decomposed, and to living long at sea without vegetables
eoutiiining certain acids. Its attacks are likewise encouraged by
whatever weakens and depresses the nervous system, as long expos-
ure to a moist, damp aii", part" larly when this is connected with
confinement on board a ship, unclean linens, occasional loss of the
usual rest, and great fatigue, as in storms. The force of these ^auses
is increased by the loneliness, the sadness, and the despondency of
the sailor's life.

Treatment. — Sailors are very much protected from the disease
now, by frequent returns to land, during long voyages, to procure
fresh meats, vegetables, and water. This practice is very generally
adopted, paiticularly by whale-ships, which make long voyages;

!' ih

484

DIBKASES OF THE GKNEKAL HY8TKM.

and Ihu reuult iH, very littl» muirvy, and genural noaltli iiiiion^'
the men.

One of the best inedtcint'8 for tlie diHcoHo is ({uinine; it iiiiiy Im;
given in from one to two-grain doses twice or thiee times a diiv.
Gentian and qiniBsia are also Huitahle remedies ; so is the muriiitic
tincture of iron ^73).

But the best of all remedies are fresh and succulent vegetables, und
also fruits. Spinach, lettuce, dandelion, sorrel, cresses, and the like,
are among the very best things when they can be had. Lemon or
lime-juice produces the happiest effects. Potatoes are among tlio
very best remedies, — particularly if scraped and eaten raw. They are
also valuable when cooked. Spruce beer is a good antidote ; luid
may be made at sea from the essence. Many kinds of beer may bo
brewed at sea, which are valuable.

When the bowels are costive, cream of tartar, dissolved in water,
and drunk freely, will be found the best remedy. If there be loose-
ness of the bowels, morphine, laudanum, a tea made of logwood, or
geranium, or the tincture of catechu, will be suitable.

For the spongy gums, a solution of alum applied to them will Ik;
proper, or a mixture of equal parts of tincture of myrrh, catechu,
and Peruvian bark ; and ulcers may be washed with the same.

Vinegfar, which is an excellent preventive in this disease, may be
made at sea from molasses and Avater exposed to the sun. Two
ounces of nitre dissolved in a quart of vinegar, and given in table-
spoonful doses, three times a day, is said to be an excellent remedy.

Every ship, on going to sea, should be supplied with dried fruit, as
raisins, currants, whortleberries, prunes, etc. ; and should have peas,
beans, rice, flour, sugar and molasses. Beside these, ships should
have essence of spruce and lemon, and dried balm, sage, pennyroyal,
and other herbs.

Seamen, when dowi. with this disease, should be moved with care,
as the spark of life ma} he easily extinguished.

Purple Disease. — Purpura Hemorrhagica.

This has been sometimes ranked as an affection of the skin ; hut
it is not such ; it is rather a disease of the general system.

Symptoms. — The complaint is known by the appearance upon the
skin of two kinds of spots ; the one kind are small, round, bright-red
points even with the surface, and changing in a day or two to a pur-
ple or livid color, which are yellowish brown when about to disap
pear. This variety of the purples is quite simple, attacking, gener-
ally, young persons, and in warm weather. It is sometimes tedious in
its course, but never dangerous. It requires little treatment — pure
air, wholesome diet, with quinia and the mineral acids, make up the
chief part of it. It may be known by the spots not disappearing
when pressed upon by the finger.

DISEASES OF THE r.RNKRAI. SYSTEM.

485

Health aiwm^

line ; it miiy Ui
iO times ii diiy.
is the niuriiitii!

, vegetables, and
lea, and the like,
lad. Lemon or
are among the
^mw. They are
d antidote ; ami
1 of beer may Iw

jsolved ill watei\
i there be loose-
e of logwood, or

le.

to them will be
: myrrh, cateclni,
1 the same.
is disease, may be
D the sun. Two
id given in table-
xcellent remedy,
rith dried fruit, as
ihould have peas,
lese, ships should

sage, pennyroyal,

moved with care,

rhagica.

of the skin ; but
system.

peanvnce upon the
round, bright-red
y or two to a pur-
n about to disap
. attacking, gener-
netimes tedious in
treatment — p"i'«
icids, make up the
not disappearing

Tho otlirr and more dangerous variety of the disease is attended,
generally, by faintneHS, wandering pains, great debility, and the ap-
jiearance upon the legs, arms, and l>ody, it' dark-red spotM, and irreg-
ular, livid patches, looking just like the marks of re(!ent bruises.
These marks ai'e caused by tho effusion of blood in patches under the
skin ; and in this respect they are just like bruises, only they are
produced by different causes.

In the rapid progress of tho disease, (link venous blood frequently
oozes from the tongue, mucous nienibraiie of the mouth, nose,
breathing tubes, ears, vagina, wond), stoniacdi, etc. The other symp-
toms vary in different cases very much, but generally indicate great
disturbance of the system.

It often runs a very rapid course, but sometimc^s remains f(»r
months. The disease, as seen in this country, is oftentimes jussoci-
ated with rheumatism, it not infrequently being the forerunner of a
long and tedious rheumatic outbreak.

Treatment. — The Ix^wels are to be kept regular by gentle physjc
(26), (21), (12), (15).

Iron is a valuable remedy (73).

Astringents generally have a good effect (156), (159), (279),
(305). The best astringent in this complaint is gallic acid, taken
in tive-grain doses every three or four houi-s.

The sponge bath, twice a day, with tepid or cool water, and fol-
lowed with gentle rubbing with a coarse towel, will do much to
restore and equalize the circulation in the skin.

During the active stage of the disease, the diet should be very
light, — simple toast-water, rice and arrow-root gruel, and either alum
or wine whey.

While gettirig well, the patient may have a more nourishing diet,
consisting of tender fresh meat, brotlis, etc. ; and must tsike gentle
exercise in the the open air.

When associated with rheumatism, the latter disease should be
treated on the same lines laid down elsewhere for rheumatism.

Iron usually is the mainstay for building up the blood, and should
be given in some mild, unstimulating form, such as Bland's pills, or
pepto-maugau, peptouate or albuminate of iron, etc.

Diphtheria.

Diphtheria is an acute, contagious and infectious disease, whose
characteristic feature is the formation of a pseudo-membrane upon
a mucous surface. It is a comparatively recent disease in this
country, and only lately well understood as to its origin and pathol-
ogy. The excessive mortality of this diser^^e within the last fifty
years has been so gieat as to justly frighten all parents at its ap-
proach, and lead them to regard it as the most terrible of all modern
scourges. In New York city alone, over fifty thousand deaths have

486

mSRASKS OF TIIK fiRNERAL 8Y8TKM.

occurred in twenty-llvo v<'<i'n- It ih oho of tlio nioHt fatal, as well us
Olio of tlu^ (■oiiiinoncHt of children's (liHiiiiscH. It is iniposHiltlc to khv
at the outhiit wheUicr tlu; typi; will prove to Im) a mild or kcvch'
one. A cius«! coinnieiKMng with Hudden, soveni conHtitntional .wmp-
toins and liij^h fever may jjo on to recovery; whiht ono with slow,
gradual development, and little Hystemic disturbanee, may proprcsH
gradua'.ly and end in death. Nor Ih theamonntof mcinlmmu present
in any case a guide as to the final outeomo of the ease. Many very
mild cases may not at first Ih) recognized as diphtheria until later,
when some })ost-<li[)htheritic paralysis or other complication ensues.
These mild cases are equally conuigious, and often the origin of a
severe and most malignant epidemic.

Cause. — True diphtheria is caused by a germ known as the
Klelw-Lieftler i)aeillus, either alone or in company with other germs;
it is originally u local disease, becoming general as the poisons ema-
nating from these germs are alworbed into the system.

Thisbifcillus is always present in diphtheria, and found only at the
site of the local infection, and when injected into animals prochutes
all the characteristic symptoms of the disease.

In doubtful cases, recourse is now had to the finding of these germs
by cultures made from little particles taken from the suspected mem-
brane.

There is, besides the true diphtheria, a pseudo-membranous inflam-
mation which runs a mild course, but which cannot be distinguished
clinically from the real disease, except by making these cultures in
the laboratory ; in the latter disease, the Klebs-Luiffler bacillus is
always absent. On the other hand, there are often seen cases of true
dij)htheria so mild in character, and showing so little membrane, as to
pass unnoticed, but which on bacteriological examination prove to
be the dreaded disease ; hence in all doubtful cases arises the neces-
sity, in these modern times of refinement in diagnosis and treatment
of disease, of having an examination made that the exact disease may
be properly diagnosed, and the appropriate treatment be speedily in-
stituted. The development of bacteriological science within the last
few years renders this a very practical and sure test of the presence
of the disease. Accepting the proven origin of the disease to be
microbic, still there are many circumstances influencing the develop-
ment or arrest of the germs when once introduced into the throat,
since it is one of the most variable and uncertain of the contagious
diseases. It is said that a normal throat wli. not be attacked by the
bacillus, while one with some slight abmsion, inflammation, or other
lesion, ceilainly offers a fertile field for its development. It is essen-
tially a disease of childhood, although it occurs at all ages. Cold
and dampness, and all unsanitary conditions, are knov,'n to favor the
germ development.

It occurs mostly in cold weather, as at this time catarrhal con-
ditions are present, favoring the rooting of the germ.

niHKAHKS OF TUB QKNKUAh HYSTKM.

487

vtiil, as well ns
|i()Ssil»U' to Hiiy
iiild or huvere
utional Kyiiip-
)no with hIow,
, may pro^nesH
ubrane pn'seiit
a. Many very
iria until later,
icatiou eiiHiu's.
till) origin of a

known aa the
Lh other gernirt ;
he poisonH uaia-

lund only at the

iiiraals proiluoes

,g of these germs
suspected mem- *

nbranous inflam-
be distinguished
ihese cultures in
iiffler bacillus is
leen cases of true
membrane, as to
lination prove to
arises the neces-
|is and treatment
xact disease may
t be speedily in-
■e within the last
v)f the presence
[he disease to be
ling the develop-
into the thioat,
(f the contagious
attacked by the
iraation, or otlier
lent. It is essen-
, all ages. Cold
lovm to favor the

le catarrhal con-

Propajfatlon. — The gorms aro introdncod for th(( moflt part by
till' air, iilthdiigh food may contain tliese bat illi. Domcstir animals
have been known to friMiuently convey the poison. All articles of
fiiriiitur*', clothing, the hands of attcndantM, etc., arc common carriers
(if till) di[)htlu'ritic germ, which is very tenacious of life, unless pre-
viously disinfected, hence the alwolnte necessity of the greatest caro
in tlioronghly cleansing everything which ha« come in contact with
a (hphtlieritic patient. The writer once had the diseasn. The mat-
tress on which he :dept was put away, after a simple cleaning, in the
attic for two years, luul when later on it was brought down to accom-
modate his two little brothers on one occasion, the disease wiut com-
municated to them and they both died.

Incubation Period. — This is quite uncertain in the ordinary case
of air inoculation, depending on the condition of the throat, but
probably it varies from one to twenty days. In the case of inoculo-
ti'"'. of the bacillus into the tissues of animals the period is only from
OHO to three days.

Location of Disease. — The tonsils, uvula, pharynx, nasal pas-
sages and the larynx are the ordinary locations where the membrane
is formed, but it may be found less commonly on the conjunctivae,
border of the anus, vagina, and respiratory tract.

All the internal organs may eventually become involved through
the absorption of the germ poisons, and at the autopsy show marked
lieiuorrhages, inflammations, congestions or fatty degeneration of their
tissues.

Symptoms and Diagnosis. — The characteristic feature is the
membrane, which is apt to be of a dull gray color, firmly adherent to
the tonsil or throat, spreading gradually and becoming thicker. To
distinguish it from simple follicular tonsilitis, which is so common,
is often difficult and frequently impossible without a bacteriological
examination. The membrane of simple tonsilitis is white, begin-
ning aa little white specks like the curd of milk, and is usually easily
removed without bleeding. The membrane of diphtheria spreads and
attacks the uvula and back of the throat, the adjacent tissues become
swollen, the neck increases in size, breathing becomes more difficult,
tlie pulse more r<ii)id and smaller, and prostration with drowsiness, as
a rule, more and more marked.

In simple cases, there is usually not much fever, but in severe
cases the temperature may run high, with great prostration and
languor; delirium and restlessness accompany the severe cases of
great absorption of poison. The heart usually is rapid, with feeble
pulse, but many severe cases have a very slow pulse, which ordinarily
is a bad symptom. The heart in diphtheria is always the uncertain
element, many cases dying suddenly and unexpectedly from heart
paralysis. Albumen often appears in the urine, and is usually an
evideuce of the involvement of the kidneys; this uephritis uiay

488

DISEASES OF THE GENERAL SYSTEM.

become chronic iiiul i^eraist long after the convalescence from (lio
original disease, and may even j)rove fatal. When the membrane is
deposited in the nares, the breathing is more labored, and bloody
mucus may be seen in the nostrils, which hardens, forming crusts,
or may run down on to tlie lip and cause sore places. As the tonsils
grow larger and the nose becomes plugged, sleep is more and more
disturbed by snoring and inability to properly inspire the air, so that
the child tosses from one side of the bed to the other every few
minutes. Add to this an encroachment by the membrane on the
vocal chords or the larynx, and one sees a truly terrible malady, dis-
tressing in the extreme. The encroachment into the larynx is
suspected when the voice becomes husky and hoarse ; it finally may
be reduced to a whisper. The membrane may be limited to the larynx
alone, as in the so-called membranous croup, which is no more or less
than diphtheria of this region. The symptoms of this affection are at
first local, and 'is the disease progresses, become more and more
marked and distressing till death ensues from suffocation. The face
becomes blue, the chest heaves with the deep, labored respirations,
the nostrils dilate, and the little spaces below the collar-bones more
and more depressed and drawn in.

The severity of the case depends much on the amount of absorp-
tion from the throat, nose, or pharynx, of the toxines produced by the
growth of the germs on the one hand, and the ability of nature on
the other hand to resist the invasion.

The odor of the breath in diphtheria is characteristic, and when
once experienced is never forgotten.

Sequelae. — Besides the chronic catarrh which is left at the origi-
nal site of the membrane, and the anaemia (or paleness consequent
on the impoverished blood), the most frequent, and the most charac-
teristic sequel of diphtheria is paralysis, which comes on in from one
to five weeks after convalescence. This paralysis lasts from two to
six weeks, though it may last for months, and even for a lifetime.
It is in no wise, apparently, proportionate to the severity of the dis-
ease. It is seen in all parts of the body, particularly the throat and
nose, causing a nasal twang to the voice, and the regurgitation of
food through the nose. It may affect the muscles of deglutition and
speech, may attack the legs, arms, diaphragm, and the sphincter
muscles of the bladder and rectum.

Prognosis. — The prognosis varioa according to the age and
health of the patient, the severity of the aymptoras, place of attack,
and the character of the epidemic prevailing ; nasal and laryngeal
complications, as well as the large area of mucous membrane in-
volved, increase the risks of the patient. The mildest cases may termi-
nate fatally from relapse. The heart may give out at any time, and
death may be close at hand when apparently all is going well. Un-
favoaablc symptoms are pallor, prostration, vomiting, and inability to

DISEASKS OF THE GENRRAL SYSTEM.

489

jcence from llm
the membrane is
red, and bloody
, forming crusts,
. As the tonsils
1 more and more
■e the air, so that

other every few
lembrane on the
ible malady, dis-
n the larynx is
e ; it finally may
Ited to the larynx
s no more or less
is affection are at

more and more
jation. The face
)red respirations,
joUar-bones more

mount of absorp-
s produced by the
lity of nature on

eristic, and when

i left at the origi-
eness consequent
I the most charac-
es on in from one
lasts from two to
ren for a lifetime,
verity of the dis-
rly the throat and
) regurgitation of
of deglutition and
nd the sphincter

to the age and
8, place of attack,
isal and laryngeal
0U3 membrane in-
jt cases may termi-
t at any time, and

going well. Un-
ig, and inability to

take much nourishment, weakness of pulse witli great rapidity or
slowness, hemorrhages into the skin, restlessness and delirium.

Prophylaxis. —The complete isolation of the i)atient in a room of
the top story, supplied with as little furniture as possible, is requisite.
All utensils and dishes should be thoroughly disinfected before taken
out ot the room. All discharges received into a vessel containing
corrosive sublimate. All clothing should be boiled when possible.

During the disease, some volatile oil, like eucalyptus, turpentine,
carbolic acid, etc., should be vaporized through the rooni. The
. nuree in charge should not be in communication with other members
of the household, nor children of the family allowed to play with
others in the neighborhood, although hey should be kept out of
dooi^ hbemlly, but carefully fed and .u every way protected from
catarrhal disorders. The patient after convalescence should be
thoroughly bathed with soap and water, and finally with corrosive
sublimate so ution, including the hair. As much as possible of the
uimture and other equipmenta that cannot be thorougldy cleansed
by boiling water, steam or corrosive sublimate, should be destroyed;
hnally the room and its contents should be fumigated with sulphur
fumes by burning three pounds of sulphur to every thousand cubic
leet of air space.

Members of the family should be kept from school and church and
other public places, and their. mouths and nostrils daily washed with
some disinfectant like carbolic-acid gargle. Only thin, washable
clothing should be worn in the sick room.

Treatment. —From the first the treatment should be supportive,
tonic, and stimulating. The temperature of the room should be kept
at abotit seventy degrees, and plenty of fresh air and sunlight ad-
imtted. The clothing and bedding should be changed frequently,
and the recumbent position without exertion be insisted on. The
diet should be liquid, and given every two to four hours, in definite
quantity, not exceeding what the child can easily digest. Beef-tea
milk and lime-watei-, egg and milk, Bovox or Bovinine in milk or
water, are samples of the class of foods to be administered. Alcohol
in the fonn of brandy, whiskey, champagne, etc., should be given
ireely ; there is more danger of giving too little than too much. The
more septic or poisoned the patient, the more the alcohol will be
tolerated and required. Very large amounts are taken in this dis-
ease, as well as in all sererely septic diseases. A five-year-old child
will easily take from two to fifteen ounces of whiskey a day. Other
valuable stimulant* are strychnine, digitalis, ammonia, camphor, etc.

h«.i,'''^'A n u " ^'^? ^^''''^^ ^ ^"^y^*^ ^y ''Old sponging or the cool
„,n ; 1. : ^«™?"'^g«S' diarrhoea, or other exhausting complications
must be stopped. Of internal treatment, perhaps none has stood the '
test ot time better than that recommended years ago by Dr. Jacobi
of New York, of which the following is an illustration : L

490

niSKASK8 OF THK GWNERAI, SYSTEM.

Corrosive sublimate, one-lialf grain ; wine of pepsin, four ounces.
Tetispoonful every two lioni-s, for a child five yeara old. This is an
antiseptic to tlie intestinal tract, and helps disinfect the system.
Locally, the throat is to be sprayed with a solution of peroxide of
hydrogen. If this smarts or excoriates the mouth, it may be diluted
even to equal parts with lime water. This solution may be injected
through the nose. It must be used freely and often.

To desti'oy the bacilli, a one part to one thousand solution of
corrosive sublimate in the form of spray may be used after the
cleansing with the peroxide of oxygen solution, or what has recently
been introduced as the Lceffler diphtheria spray, which consists of
several antiseptics.

The use of papoid, papayotin and other solvents of membranes, is
frequently very beneficial: they may be sprayed or swabbed on to the
throat. The sequelae are to be treated on general tonic principles;
the catarrh is to be treated by the application of mild nitrate of silver
solutions, and the paralysis by stxychnia, massage, electricity, and
general tonics.

These measures constitute the main essential points in treatment
in those cases which for any reason do not receive the modern
antitoxin treatment.

Since the better understanding of the Klebs-Loeffler bacillus, at-
tempts have constantly been made to produce an antidote to the
diphtheria poison, and it would now seem as if bacteriology had at
last revolutionized the entire treatment of diplitheria, for of late a
remedy called antitoxin has been found and successfully tested. The
death-rate of diphtheria has been reduced nearly one half ; apparently,
one of the greatest boons ever sent to humanity has been realized in
antitoxin.

For some time it has been known i '«,. the serum of animals immune
from diphtheria, when injected into susceptible animals, would prevent
the infection of cultures made from the Klebs-Loeffler bacillus ; and at
last the essential elements, or the antitoxin., has been isolated.

Not only has it been found *;hat the injection of a given amount of
antitoxin into the human subject would iill out the diphtheria, but
also that, when injected into ijhildren not yet taken down with the
disease, but who have been subjected to it, this antitoxin would
actually pr.ivent the occuirence of the disease in them, or, technically
speaking, reiider them immune.

For over a year now this modern blessing has been enjoyed by
thousands of I'-opl^ a); over the world. Reports are everywhere
published bypubi.--. institutions and private practitioners, speaking
in figures more convincing than any statement could be, of the
greatest advance in medicine that the last half centuiy has witnessed.
It is to diphtheria what Listerism was to surgery.

The essential features of this treatment consist in the injection into
some convenient part of the lx)dy, like the back, loins, or thigh, of a
certain amount of this liquid proportionate to the age of the patient,

-r-»,

DISEASES OF THE OENEUAL SYSTEM.

491

the severity of the disease, and the time elapsed since the outset of
the symptoms.

The dosage varies with all these conditions, and the particular
variety of antitoxin employed. The repetition of the dose depends on
the amount of improvement in the membrane. At first a reddening
about the diphtheritic patch is seen, then a thinning out of the mem-
brane and a general amelioration of the symptoms. To prevent the
occurrence of the disease, only quite a small amount ia required, and
it needs to be injected but once. The great advantage of this treat-
ment, outside of its favorable statistics, is the comfort derived by the
patient in not being so frequently disturbed by other auxiliary
treatment, as nothing else is required -to be done when the case is
seen early. As a matter of fact, cases are often seen so late, and the
poison has so successfully invaded the system as to render the anti-
toxin treatment less potent, that medical men employ local measures
to help out the antitoxin. The earlier the treatment is begun, the
less antitoxin will be required, and the surer the successful issue.

Like all great advances in medicine and surgery, this method is
not without its enemies, who will tell of the ill effects to the blood
experienced later in life. The only ill effects are certain rashes
resembling hives, or urticaria, situated generally near the site of the
punctures and due to local irritation. These all pass off in a few
days, and are only annoying at the very worst. Should abscesses
occur they may be put down as the result of an unclean syi'inge, or
ascribed to the neglect of proper aseptic precautions on the part of
the physician.

This antitoxin serum, taken from horses after repeated inoculation,
may now be obtained from local boards of health, and other similar
authorities, thus enabling the poor to be able to procure free of cost
this antidote against the most ravenous of diseases.

Canker. — Aptha Communis.

Vert few, if any, standard medical writers have treated of canker.
In truth, it is only a symptom of various complaints, and not itself a
disease. It has accordingly been shut out from medical books. It
afflicts — yes, »orely afflicts, numerous persons, who, though doubt-
less affected by some constitutional disturbance as its cause, are not
conscious of any complaint except this single manifestation — canker.
You find not only the disease, therefore, but complaints respecting it,
in almost everybody's mouth; "What shall I do for the canker?"
meets us at almost every turn. " I am sorely aiflicted with the
canker," says one. " I am literally sick with the canker," says
another. And a third says, " I can neither eat, nor converse, nor
take rest, I am in such pain from canker in my mouth." And these
complaints are not unnatural, for the sufferings occasioned by this
affection are indeed terrible.

492

DI8KASE8 OF THE GENERAL SYSTEM.

Canker begfins in the form of small blisters, generally upon the
tongue, or inside of the cheeks or lips, or stomach, which, after a
time, break and form little ulcers, which are oftentimes very sore
and painful. These ulcers will, at times, not only multiply, but
spread themselves to large dimensions, going deep into the flesh, and
becoming painful almost beyond endurance. In many cases, tlu;
parts swell, and become so sensitive and tender that it is almost im-
possible to swallow the blandest food. The mouth will frequently
become fiUod with saliva, which runs involuntarily out, to the great
annoyance of the patient. ,

Treatment. — Canker is frequently dependent on a deranged state
of the stomach and bowels. When this is the case the treatment
may begin with a dose of gentle physic (12), (15), (19), (26). If
the stomach be quite permanently deranged, let this be followed with
a somewhat prolonged use of preSvription (28) or (37), or of the
neutralizing cordial. If the mouth be veiy sore, use a tea of slippery
elm bark, or flax-seed, or a solution of gum-arabic ; and as the in-
flammation subsides, touch the ulcerated patches with the stick
nitrate of silver (lunar caustic) ; or use gargle (201), (202), (203),
(205), (208), (209), (232), (243), r244), or sulphate of copper,
eight grains dissolved in two ounces of water. A tea made of rasp-
berry leaves, or blackberry roots, may be freely used as a drink.

One of the best remedies is hamamelis. Of this a dessertspoon-
ful, may be held for a few moments in the mouth and then spit out.
A teaspoonful may be taken internally, once an hour until relieved.
Receipe 205 is not only useful as a gargle, but may be reduced by
adding one pint of water, and may then be swallowed four or five
times a day, in doses of two tablespoonfuls at a time.

The diet should always be carefully regulated, arid only the more
simple food taken, and at regular meals.

To rapidly heal a canker spot, touch it with a wooden tooth-pick
which has been dipped in a strong solution of carbolic acid. The
ulcer turns white, and in a few days is completely healed.

merally upon the
ih, which, after a
mtimes very sore
ily multiply, but
nto tlie flesh, and

many cases, tlu;
it it is almost iiii-
h will frequently

out, to the great

1 a deranged state
Lse the treatment
,(19), (26). If

be followed with
r (37), or of the
i a tea of slippery

; and as the in-
i with the stick
1), (202), (203),
phate of copper,
tea made of rasp-
d as a drink.
\ a dessertrspoon-
,nd then spit out.
ur until relieved,
ly be reduced by
wed four or five
e.
.rid only the more

/^ooden tooth-pick
rbolic acid. The
liealed.

DISEASES PECULIAE TO MODERN

TIMES.

In so short a space as we liave at our command the mere outlining
of this chapter is all that can be expected ; whole volumes might be
written, and that, too, much to the reader's profit and interest

Within the last fifty years diseases have assumed different aspects,
while many actually new or heretofore unrecognized diseases swell
the list of ailments. The "diathesis " of disease is the type of con-
stitution inherited from the parents. From time immemorial, almost,
there have been recognized five such types : the strumous, the ner-
vous, the bilious, the lymphatic, and the gouty. Diseases of modern
times tend greatly to the nervous type ; not only this, but individual
cliaracteristics are at times so pronounced as to form what are pro-
fessionally known as "idiosyncrasies." These idiosyncrasip con-
tinually increase, — so much so that what may be "food for one is
poison to another." The causes of this change of tendency in disease
are most numerous and espocially noticeable in young countries.

Born of busy, hard-working parents, whose lot in life has been to
struggle hard in new lands, or cast among neighbors whose life has
been one of hurry and excitement, the child receives a nervous im-
petus at an early age, and his precociousness is considered to be due
to an inheritance of unusual mental strength rather than to an over-
strained nervous system of the parents and a consequent nerve-debility
of the child. The child's early training is a rapid one, and at the
early age of five or six the youth begins a course of school instruc-
tion calculated to make a man or woman within a given time. The
already frail nervous system is overtaxed ; when he branches out into
business life, he already shows signs of mental feebleness, which
should be the concomitant of long years of hard labor only. Society,
too, claims so much of young people as unfits them for anything else
but its own exactions. Too long waking hours and too short sleep-
ing hours waste the surplus energy and call on the nervous system to
whip up the tired body. The wear and tear of business life, with its
constantly increasing complications and confinement to indoor work,
only add to the strain induced at dentition and puberty. In modern
times, when every business in rapidly growing towns and cities is
being more and more "cut up," and when, consequently, greater

493

;v^PSBRMn

494

DISEASES PECULIAR TO MOUEKN TIMES.

struggling for existence occui-s, greater speed and anxiety, and more
frequent disappointments are necessarily incurred. We rush tlu-ough
life nowadays. Advancing civilization is the cause of much of lliis
extra speed. The press, telegraph, telephone, and steam appliances
enable us to live faster, know and see more in a given time than ever
before. The temptation is too great, and we rush on, regardless of
tired bodies and exhausted brains, of overtaxed stomaclis and sleej)-
less nights, to keep up with the times. Climates which are dry, with
extremes of heat and cold, also cause much waste of nerve-force.
The upbuilding of a new country has much to do with our discuses.
At present the West exhibits that feverish eagerness for success in
life once exhibited in the East. Europe has passed that stage of
barometrical change in disease, due to advancing civilization, while
the United States is passing through it. The faults of Europe lie
in the direction of pleasure-excesses ; ours is an overworked nervous
system. Our American liberty, and freedom of personal ambition to
rise from the lowest station in life to the highest, from poverty to
riches, and from ignorance to intelligence and honor, will always act
as an excitant to the nervous system, and is the one cause of our
excessive activity. We must huny less ; give more time for Dame
Nature to repair the waste of the system and to store up potential
energy. We must divide more evenly our periods of sleep, recrea-
tion, and work, that our children may become the possessors of more
vital energy. We neglect too much old-fashioned methods of strength-
ening our bodies, as outdoor gymnastics and walks. Even our sports
tinge t<io much of speed and undue excitement, and partake too much
of "professional " knowledge. Let us have fewer " finely-cut " men,
and more robust ones.

Thus it is we inherit a greater diathesis to nerve disetises. This
diathesis means a greater susceptibility to stimulants and narcotics,
social evils and greater risks. The changes peculiar to this diathesis,
or those much increased by it, are the early and rapid decay of teetli,
neuralgia, premature baldness, and hay fever; nervous dyspepsia,
sick headaches, short-sightedness, St. Vitus's dance, sleeplessness,
hypochondria, hysteria ; cerebral, spinal, digestive, and sexual ex-
cesses ; inebriety, epilepsy and insanity.

The first signs of ascension or declension in the health of a nation
are seen in woman. The American woman of to-day offers a striking
contrast to the original female inhabitant of this continent. The
difference in the mental, moral, and social types m.ay be well worth
the cost, but we have sacrificed too much of the physical and nervous
strength to have gained the most out of our three hundred years or so
of existence. Womb troubles are almost the birthright of every
woman, — so much so that necessity has developed in America a
science for their relief, in a short space of time, as wonderful aw the
telegraph or telephone. The physician of to-day feels he must have
at least a knowledge of gynaecology, whatever else he may or may
not know.

DISEASES PECULIAR TO MODERN TIMES.

495

mxiety, and more

We rush through
B of much of this

steam appliances
en time than ever
I on, regardless of
omaclis and 8lee[)-
diich are dry, with
te of nerve-force,
with our diseiises.
less for success in
ised that stage of
civilization, while
iilts of Euro[)e lie
erworked nervous
rsonal aiuhition to
;, from poverty to
)r, will always act

one cause of our
>re time for Dame
store up potential
is of sleep, recrea-
possessors of more
ethods of strength-
Even our sports

partake too much
" finely-cut " men,

fe diseases. This
nts and narcotics,
ir to this diathesis,
pid decay of teeth,
lervous dyspepsia,
nee, sleeplessness,
e, and sexual ex-
health of a nation
ly offers a striking
s continent. The
nxay be well worth
ysical and nervous
lundred years or so
irthright of every
ped in America a
,s wonderful as the
feels he must have
se he may or may

The terms nervous exhaustion, nervous prostration, neurasthenia,
etc., are of modern invention. Ancients knew little of the continual
noises of factories and teams, electric and steam appliances ; tlieir
wearied bodies were lulled to sleep by gentle sighing of the trees,
and refreshed by sweet air. The evident cure for these increasing
evils lies in a change in our national habits. We must cultivate the
restful out-door recreation of the Indians ; we must go through life
more slowly, eat less rapidly, and sleep longer. Cultivate the desire
to enjoy nature and art more. Do business only in business hours
and on business days. Indulge more in cool baths, rides, walks, and
natural sports. Learn to do less in amount, but better in quality.

OLD AGE AND ITS DISEASES.

Life, like the natural day, has its morning, its noon, and its even-
ing. Eacli period has its sunshine and its clouds ; its light and it«
darkness ; its fair weather and its storms ; its joys and its sorrows.
The old do not feel the exhilarating brightness of the morning of life,
nor the fervid strength of its noon ; but they often experience what
is better : a calm, quiet stillness, and peaceful repose, in its evening.

There is, perhaps, no one thing — certainly not many things —
which impress the reflective mind and tender heart with more sadness,
than to see an old man, bending low with years, with little or no self-
restraint ; the passions all untamed, except so far as age has quenched
their fires ; fretful, peevish, jealous, complaining ; distrustful of the
ways of Providence ; doubting the integrity of any human being ;
surrounded by clouds and dsirkness ; and stepping down gradually
and reluctiintly, amid a cold, drizzly, sleety, moral rain, into a dark,
uncheered, and unillumined grave.

On the other hand, how unspeakably pleasant it is to see the silver-
haired pilgrim, in the evening-time of life, cheerful, happy, trustful
in God and hopeful of men ; the winds and storms of life bringing
little or no disturbance of his peace ; baring the head reverently and
bowing it meekly in the presence of great afflictions, and lifting it
up rejoicingly when blessings fall upon it ; converting, by the soft,
subdued, and beautiful sunshine which he spreads around him, the
very unpromising elements of the latest autumn into the finest Indian
summer of life ; and finally sinking down peacefully to his rest amid
the golden evening sunlight, and leaving the sky, long after, tinted
with colorings more beautiful than artists ever conceived.

"Why weep ye, then, for him who, having won
The bound of man's appointed years, at last, —
Life's blessings all enjoyed, life's labors done,—

Serenely to his final rest has passed :
While the soft memory of his virtues yet
Lingers like twilight hues when the bright sun is set ? "

Besides these general reflections, it is proper in this chapter to
contemplate the old from several points of view.

They are experienced persons, and we may learn much from them.
To be sure, they have, in most cases, lost the acuteness of thoir
senses. They do not hear, or see, or taste as sharply as the young,

OLD AGR AKD ITS DIflRASES.

497

.8ES.

)on, and its oven-
its light and its
and its sorrows,
le morning of life,
1 experience what
se, in its evening.
t many things —
vith more sadness,
th little or no self-
i age has quenched
distrustful of the
my human being;
ig down gradually
rain, into a dark,

is to see the silver-
•ul, happy, trustful
ns of life bringing
lead reverently and
ions, and lifting it
[erting, by the soft,
Is around him, the
[to the finest Indian
illy to his rest ainid
r, long after, tinted
iiceived.

|un is set ? "
in this chapter to

rn much from tliera.
[acuteness of thoir
(arply as the young,

or even always think as quickly ; yet their judgments are founded
on r large experience ; their decisions, though not as prompt, or
emphacic, or brilliant as those of younger persons, are more safe and
reliable. They are worthy, therefore, of our respectful confidence.
We may seek their counsel and advice, and in most cases follow it
with safety. True, they are apt to be conservative, and to distrust
new things and ideas ; but these new things and ideas are matters in
which they have had no experience — matters which belong to an
age subsequent to their time — matters, therefore, which lie outside
the sweep of their active life, and respecting which they should not
be expected to judge. It is no disparagement to them to say that
they are not fitted to judge of those new thoughts and discoveries
which have swarmed upon the world since the sun of their life has
been sinking low in the western sky. But in all those staple max-
ims and ideas which underlie human duties, in all ages, the old may
safely be taken as our counsellors.

Depositories of Family History. — They are the frail depositories
and keeper's of a vast deal of valuable family history, anecdote, and
reminiscences of events fast fading from human recollection. Few
errors of my own early life have been so much regretted by me as the
neglect to learn from my aged relatir es, when I had the opportunity,
some of the more important points in the history of my family. My
grandfather, Col. Gideon Warren, — a first cousin of Gen. Joseph
Warren, and a personal friend of Ethan Allen, — lived in some of the
towns of southern Vermont, and finally spent his last days and died
in Hampton, N.Y. There stands his tombstone to this day, with the
following beautiful words from Young's " Night Thoughts " engraved
upon it : —

<'An angel's arm can't snatch me from the grave;
Legions of angels can't confine me there."

These few facts are about the substance of what I know of his his-
tory. In what town his father settled, who was one of three brothers
who emigrated to this country, or who were his brothers and sisters,
or what became of them, I have not been informed, simply because I
did not obtain the information, now so much desired by me, as I
might ^easily have done, between thirty and forty years ago, while
spending a year in Hampton fitting for college. An uncle of mine,
Caleb Warren, was then living in Hampton, an old man. He had
learned from my grandfather the full history of the family; and
from him I might have derived knowledge which I should now value
above price — knowledge which I intend yet to acquire, if the pres-
sure of professional business shall ever be so lifted from me tliat I
can command time for the investigation. But I shall never cease to
remeihber the fact, or to lament my misimprovement of it, that from
this venerable relative I might have learned facts and put them on
record in one hour, which it will cost me weeks and months of cor-
respondence, travel, and the searching of records to acquire. I say

:,:

^rWil

498

OLD AOK AND ITS PTflRASKS.

to all young persons, value very highly the knowledge of your family
history, which you may easily learn from your parents, grandparent,
uncles, aunts, etc., and esteem those very highly who are able to
impart it to you. Soon these living records will 1x3 suddenly Wotted
by the hand of death ; and then no regret for past negligence will
enahle you to repair your loss, if you have not improved your oppor-
tunity.

The Fathers of our Race and the Founders of our Institutions.—

The aged people who yet linger among us are our fathers. We have
our existence, through God, from them, and from others who have
preceded them to the silent land. They educated the present race.
All that is valuable in the moral principle and mental culture of the
men and women of this genenition, has been derived from them.
Much of their lives was spent in training us, mentally and morally,
and fitting us for usefulness.

Not only the fine moral and intellectual characters which are found
everywhere, acting like salt and leaven in human society, are the
work of their hands ; but society, and government itself, have been
handed down to us by them, with much valuable instruction as to
the means of their preservation. We can scarcely conceive the
amount of obligation our fathers have laid upon us in giving us
these vast blessings. The men who have been the means of bringing
us into life ; who have educated and trained us ; who have preserved
our government and passed it into our hands unbroken ; who have
built and enlarged our colleges, established and improved our un-
equalled common schools ; have founded and endowed our charitable
institutions, and thus made our land famous throughout the world,
are certainly worthy — those of them who are yet among us — of our
constant regard and veneration.

Loneliness of the Aged. — The old are left, in some sense, alone
in the world. The age in which they have had their active being
has gone by. The world has slid from under them ; and they stand
far out, as it were, on a narrow neck of land between this world and
the next, from which they hear strange sounds doming to them from
the moving mass of beings of whom they are soon to take leave.
Most of the companions with whom they started in the journey of
life have, one by one, dropped away from their side, and the younger
and stirring multitude vho have come after them are moved by new,
and to them strange thoughts and aspirations. The throng of younger
men is driven forward by impulses which they never felt, and in paths
which they never trod. Manners, speech, dress, modes of doing busi-
ness — all have changed. The old-fashioned fire-place, the stage-
coach, the boy's bow and the girl's coui-tesy to strangers in the street,
these all — some of them useful and some of no further value —
have disappeared, never more to be enjoyed by thocv who so much
prized them in their day.

OLD ACE AND ITS DIBEAaES.

490

(Ige of your family
ents, grandparents,
y who are able to
K) suddenly blotted
a«t negligence will
proved your oppor-

)ur Institutions.—

fathei-s. We have
tn others who have
)d the present race.
ental culture of the
ierived from them,
mtally and morally,

ters which are found
nan society, are tlie
snt itself, have been
(le instruction as to
arcely conceive the
on us in giving us
le means of bringing
who have preserved
inbroken ; who have
d improved our un-
iowed our charitable
iroughout the world,
it among us — of our

in some sense, alone
id their active being
hem ; and they stand
tween this world and
Coming to them from

soon to take ^ leave.
,ed in the journey of
side, and the younger
m are moved by new,
rhe throng of younger
ever felt, and in paths
(, modes of doing busi-

fire-place, the stage-
strangers in the street,
I no f"rt.her value —
jy thoi^v who so much

What wonder if at times a sense of loneliness and desolation should
Kleal into the minds of tho aged? It is not without cause that they
often yield to nufluncholy reflections. The young have their com-
panioas and their sports. Tho companions of the old have mostly
gone ; and for sports they have no agility. Cut off from the present,
they are llirowu upon the past, and too often look gloomily to the
future. They should be sympathized with and encouraged. We
Hhould sit by their side, and tjvlk with them of the manners and
events of other days. Their convei-sation is often instructive as well
iw amusing. Would we engage in it with right feelings towards the
old, it would be to us a source both of profit and pleasure. To a
right-minded person, few things are more pleasurable than, to sit by
intelligent aged persons, cozily seated in a large armed-chair, and
listen to their tales of personal adventure and experience. They
enter upon such narratives with so much animatior and live over
tiie past with such evident satisfaction, that the benevolent person
would find pleasure in engaging them in that conversation for this
reiifion alone.

Helpless Dependence of the Aged. — No one thing should tendmore
to excite our pity, compassion, and kindly feelings for old people, than
tiieir helplessness and dependence. It is one of the best indications
of humanity to deal gently with the weak. The old are in their
second childhood. In their day, they have been strong and vigorous
— laboring, many of them, in season and out of season, to support
their families and gain a competence. They have felled the primitive
forests, and brought the soil under the dominion of the plough and
hoe; they have constructed turnpikes and built bridges; made ships
and sailed them over stormy seas, whitened every harbor with the
emblems of commerce ; filled every city with the beautiful creations
of art, and the useful productions of mechanical handicraft ; created
systems of education and philanthropy ; framed strong governments
and worked them, — in a word, have carried the world upon their
shoulders, without bending or giving tokens of exhaustion. But a
multitude of yeara have robbed them of the strength which did all
these things. They now totter like a young child. The brain which
conceived and the arm which executed are alike feeble. How proper
that much which is kindly should now be done for those who have
done so much for us and for the world ! Oh, let the old have a
warm place in the affections I Supply, as far as possible, all their
wants. Go with them, in spirit, into the shadows of evening, within
which they are retiring, and there hold them up. Be a staff to them
in their weakness ; and, if it be possible, when the shades deepen
around them, lift the curtains of the future and let in upon them,
though it be never so few, some raj^ of light from the heavenly world.

From these general remarks, I pass to consider —

^vi i. ^,(;,JiMi , 'h: i i'K!j i tiJir ';i . \\-,»KiU'si i

OLD AOR AND ITS DI8KA8E8

The Changes occurring In Advanced Life.

Growth, maturity, and decline are tho threw periods which divide
and measure human life.

During growth, the deposit of new matter takes place more rap-
idly than the decay or waste which is also going on.

During healthy maturity, waste and increase are exactly equal,
the one taking place just as rapidly as the other.

The decline of old age reverses the order of growth, and waste
outstrips addition. The newly deposited matter comes, but not ho
rapidly as the old is cast away.

Declining Age may be said to extend frorn fifty to sixty.
Incipient Old Age from sixty to seventy. ■ ^

Ripe Old Age i'om seventy to eighty.

Decrepitude or 3econd Infancy from eighty to the end of life.
During all these periods, particularly during the latter, important
structural and other changes are occurring in the human system,
Piles, apoplexy, paralysis, diseases of the liver, kidneys, and bladder,
with organic changes of the heart, dropsy, chronic affections of the
breathing organs, gout, etc., frequently appear.

No fear of Death. — It is a wise and merciful provision of Provi-
dence, tlmt as old age advances, and the natural end of life draws
near, the dread of death diminishes. As the aged gradually lose
their hold upon life, they do so with less and less reluctance, until
finally they let go willingly, and part from it even with ]oy. Persons
passing from life at the age of eighty or upwards, generally look
forward to death with more of pleasure than of fear. It is one good
reason why it is desirable to live to great age, that life may come to
a close without those harassing fears which so many dread.

Preservation of Old People's Health.

It is proper here to speak of the hygiene of old age, or the means of

^Til'^tufaftS^desfre atontinuance of life; and except in the case
of the extremely old, there is a geneial wish for its prolongation.
Those who are born of parents who have lived long, are more likely
to attain length of days than those who have descended from short.
lived ancestors ; yet the influence of correct habits may add quite as
many years to their lives.

Reeular Habits. — The old feel the evil influence of irregular
habits much more than the young. It is seldom that any changed
habit, long indulge s well borne by the aged. So true is this, tha
the attempt to correct some habits of evil tendency is sometimes

OLD AOE AND ITS DI8EAHE8.

r.oi

need Life.

leriods which divide

es place more ta,\)-
on.
are exactly equal,

growth, and waate
comes, but not so

y to sixty.

the end of life.

he latter, important
the human system,
idneys, and bladder,
ic affections of the

provision of Provi-

1 end of life draws
aged gradually lose
ess reluctance, until
1 with joy. Persons
ards, generally look
fear. It is one good
lat life may come to
lauy dread.

Health.

1 age, or the means of

,nd except in the case
for its prolongation,
long, are more likely
escended from shortr
aits may add quite as

nfluence of irregular

m that any change of

So true is this, that

indency is sometimes

(langermis to tho old, ho mnoh have tlioy lost tho power of adapting
ihcnmclvcH to clmngt^ Tlio diHcontinuaiicc of tliu hahilual uhi; of
spirit, or tobacco, or opium, l>y an old ptnHoii, tiiougli the itse of
eitiuT is of acknowledged evil tendency, will frucpK^ntly prove fatal.
It is ahiKMt necessary that the habits of the aged should remain as
they are. What an impressive lesson this fact gives the young on
the necessity of forming good habits in early life !

Even the hours of taking meals should not be changed in the
decline of life. Kemoving to new (tlimates, and forming new social
relations by those advanced in years, is not favorable to length of
days. Old trees do not often take root and live long when trans-
ferred to a new soil.

Diet. — The food of old people should of courae Iks easy of diges-
tion. It is often the case that they bear made di.shes such as " hash,"
so called, better than plain boiled or roasted meat. This can only be
explained on the ground that the meat is ohopped line, and is more
thoroughly cooked.

node ot Cooking fleatA. — Tliis leads me to speak of the best
methods of cooking meats so that they may be tender.

The flesh of all warm-blooded animals is identical in composition
with that of human beings. That the flesh of animals used as food,
therefore, may form flesh in the human body in the easiest manner,
none of its essential constituents or parts should l)e taken from it
during the process of cooking. If any one of its constituents is
extracted, it will no longer be like human flesh ; and that lost part
will have to be resupplied before it can become a part of the frame
of man.

Flesh is composed of two parts — that which can be dissolved, and
that which cannot. The separation between these two parts is more
or less completely effected in boiling, according to the amount of
water used and the length of time employed in the process.

In making soup, we have no objection to a separation between the
hard and juicy parts of the meat, because the latter passes ink) the
water and helps form the eoup. Hence the proper way is to put the
meat into cold water when it is put over the fire, and let it come to
the boiling point very gradually ; during which time the juicy part
lias a chance to dissolve out, and, uniting with the water, make lich
soup.

But when the meat is to be boiled simply, and eaten as boiled meat,
we should aim to retain the juice within it, that we may retain the
whole of it. To do this, we must put the meat into water which is
briskly boiling over the fire. The juice of the meat contains a large
quantity of albumen, a substance just like the white of egg; and
putting the meat suddenly into boiling water almost instantly hardens
this albumen all around the surface, just as boiling water hardens
white of Qgg, and this prevents all the juice of the inner portion of

--m^ssss^s^isiT^smsm^sm^s^m^?

502 OLD AGE ANT) ITS PISEASES.

the meat from running out into the water and being lost. Keep the
meat in the briskly-boiling water a few minutes, then pour in a little
cold water to reduce the temperature slightly, and keep it in thi.s
somewhat reduced temperature until it is done through.

Broiling and roiisting are pretty generally undentood, and are
done well enough where persons are disposed to take pains. Frying
is an abomination, and shoiUd be banished from all civilized house-
holds.

Milk is an excellent article of diet for old persons. Except in some
few cases where it disagrees with the stomach, it is among the very
best. Sometimes, when it disagreed with a weak £,tomach, a little
lime-water added to it will make all right. Artificial ass's milk, which
will generally sit well on aged people's stomachs, may be made by
dissolving one ounce of pulverized sugar of milk in one pint of
skimmed cow's milk.

Potatoes, beets, carrots, parsnips, and asparagus are healthful;
peas, beans, cabbages, etc., had better not be largely indulged in.

Ripe Fruits, taken in modeiation, are useful; but should be eaten
at meal-time, not between meals. Among these, ripe apples, pears,
peaches, plums, strawberries, currants, and grapes are luxuries in
which not even the oldest persons need fear to indulge to a reason-
able extent.

Plain Puddings and Pies are not entirely objectionable ; but all
rich and high-seasoned articles of pastry should be strictly rejected
by the old, as they should, in fact, by all classes.

Wine, etc. — If any persons in the a\ arid may indulge in a little
wine for their stomach's sake, it is the old. But even they, if they
have not been accustomed to its use, often get along very well with-
out it ; and when they can do so it is better, for various reasons,
especially that their example may have a good influence with others.
When the feeble vitality of the aged seems to require it, especially if
they have been in the habit of leaning upon it, they should be en-
couraged to use it. And if they chance to be poor, and cannot pro-
cure it themselves, for friends to withhold it from them on the ground
of economy,. or from the feeling of grudging stinginess, is nothing
less than inhumanity and cruelty.

To these remarks upon diet, I add : the old should never eat to
excess or repletion. They should eat slowly, and' chew their food
very thoroughly.

Susceptibility to Cold. — Aged people suffer very much from cold
hands and feet, and, indeed, from languid circulation and low tem-
peratui^ generally. The heart, like all their other muscles, has
become feeble, and sends the blood very lazily along the arteries.
The clothing of the old should be thicker and warmer than that of
younger people. We must prevent the escape of what little animal

OLD AGE AND ITS DISEASES.

-.03

g lost. Keep the
311 pour in ta little

I keep it in this
.ugh.

leiftood, and are
ce pains. Frying

II civilized house-

Except in some

among the very

stomach, a little

I ass's milk, which

may be made by

k in one pint of

us are healthful;
J indulged in.

it should be eaten
dpe apples, pears,
s are luxuries in
ulge to a reason-

ctionable ; but all
e strictly rejected

indulge in a little
jven they, if they
ig very well with-
r various reasons,
aence with others,
lire it, especially if
hey should be en-
r, and cannot pro-
hem on the ground
iginess, is nothing

ould never eat to
dchew their food

sry much from cold
tion and low tem-
ther muscles, has
ilong the arteries,
rmer than that of
what little animal

heat there is by flannel worn next to the skin, and by woollen clothes
(((norally — they being bad conductors of heat. Unless very fleshy,
tliey seldom suffer from heat, even when their flannels are continued
tlu'ough the summer.

It is during winter nights that the old arc apt to suffer most from
cold. On going to bed, therefore, they should be warm ; and on very
cold nights should have a hot-water bag at their feet. The commu-
nication of animal heat, particularly from the young, is better even
than this to support the vital energies of age; and some writers have
recommended that the vital warmth of the old should be kept up by
letting the young of our own species sleep with them. The human-
ity of this suggestion is very questionable The aged would doubt-
less be benefited by such a proceeding; but the young would be
injured. Whatever vitality should be gained by one would be lost
by the other. While a few might be added to the limited days of
the aged, many would be quite as likely to be subtracted from those
of the young. I would much sooner recommend that old people
attach to themselves, and take to their bed, au affectionate, clean, and
silken-haired English terrier dog. Such an animal, usually as clean
as a child, would impart warmth and vitality at night, and be a +- ae,
affectionate, and amusing companion during many a lonely hour of
the day. Whatever may be said against this recommendation, — and
of course some over-nice people will object, — I insist that it is in
every sense far more proper than the expedient adopted with King
David, when he " was old and stricken in years," and after " they
covered him with clothes, but he gat no heat." (1 Kings i, 1.)

Mortality in Cold Weather. — Far more of the old people die in
wmter than in summer, or, indeed, in any other season. For this
r-^ason, old people should be very careful how they expose themselves
auiing the coldest days of the winter.

If there be any change which the old are likely to bear with im-
punity or advantage, it is from a cold to a warm climate in their lat-
ter yeara. The wealthy Romans, when they grew old, were taken
to Naples.

Care of the Skin. — Attention to the skin, always important to
health, is very essentially so in the latter years of life. The scarf-
skin of the old tends to become dry, and peel off. This may be pre-
vented in a great measure by regular washing with tepid water, and
iiibb'< g. If the bath cannot be endured, not even the sponge-bath,
let friction alone be employed. For friction, either the naked hand,
a piece o* flar -il, or the flesh-brusl may be used. In rubbir- the
belly, the land should follow the course of the large bowel; t
m the region of the stomach pass across from right to left, dow m
the left, across on the lower parts of the bowels, up on the right, etc.
oy this method, constipation and a windy condition of the stomach
and bowels may frequently be removed, or rendered less distressing.

504

OLD AOB AND ITS DISEASES.

Exercise. — Always important, in all periods of life, exercise does
not lose its advantages in old age. But the aged should always exer-
cise with moderation. The violence used in youth would break the
bones, and do various kinds of mischief were it indulged by the old.
Carriage exercise is very suitable for old people, but the more active
exercise of horseback riding, walking, and even working in the gar-
den, should not be omi*ted — bearing always in mind that great
fatigue is injurious.

Sleep. — Aged people should get about as much sleep as nature asks
for. They should retire early, and not be in haste to rise with the
dawn. They require more sleep than persons in middle life. Eight
or ten hours in the twenty-four is not too much.

Sleeplessness. — Though the old require a good deal of sleep, it is
unfortunate that many of them can sleep but little. A large propor-
tion of persons far advanced in life, complain of inability to sleep.
Many old people deceive themselves, and really sleep much more
than they are aware. Yet they often persist that they sleep none at
all, night after night. Their case is illustrated by an old lady whose
doctor entered her room arid found her sleeping very soundly and
comfortably. The noise of a person entering the room awoke her
soon after, when, rubbing her eyes, she turned to the doctor, and said
all she wanted was sleep, that she had slept none for a month ; and
unless he could give her something to bring sleep, she must die.

Medical art, I am sorry to say, frequently fails to bring relief, when
there is real want of sleep. Narcotics should always be avoided if
possible. They do too much mischief ; yet it is necessary, sometimes,
to resort to them. Much may be done sometimes by taking an earlier
or a lighter supper. Early rising, and exercise in the open air, will
often bring sleep at night. Occasionally a glass of wine, or a little
spirit of any kind, taken just before retiring, will bring the needed
sleep.

Electricity. — In connection with sleep, the disturbing and the
tranquillizing influence of electricity and magnetism has received some
attention within a few years. A German philosopher contends that
terrestrial magnetism exerts on perf .is of a sensitive organization a
very soothing influence, when placed in proper relations with its cur-
rents, and a disturbing impression when otherwise situated. He
cit«s cases to show that lying from east to west is so intolerable that
persons of delicacy cannot endure it ; while the horizontal position
from north to south, with the head south, is more agreeable ; and most
agreeable and tranquilizing with the head to the north. A German
surgeon is mentioned in Reichen back's Memoirs, who always woke
early in the morning, and turning his head where his feet had been,
invariably fell into a sound slumber, which was more refreshing than
that of the night. When he chanced to omit this, he felt ill all day.
Observing that the head of his bed was directed to the south, Reich-

ife, exercise does
ould always exer-
would break the
iilged by the old.
t the more active
rking in the gar-
mind that great

jep as nature asks
B to rise with the
iddle life. Eight

deal of sleep, it is
A large proper-
inability to sleep.
sleep much more
hey sleep none at
an old lady whose
very soundly and
room awoke her
le doctor, and said
tor a month ; and
she must die.
bring relief, when
lys be avoided if
essary, sometimes,
y taking an earlier
the open air, will
f wine, or a little
bring the needed

isturbing and the
has received some
)her contends that
live organization a
itions with its cur-
'ise situated. He
80 intolerable that
horizontal position
^reeable; and mosJ
lorth. A German
who always woke
his feet had been,
)re refreshing than
, he felt ill all day.
the south, Reich-

OLD AGE AND ITS DISEASES.

505

enback persuaded him to turn it to the north ; and ever after he slept
soundly till the proper time to rise in the mo/ning.

Without pronouncing upon the correctness of this theory, I will
simply say that in my winter residence in town, the head of my bed
is to the south. I sleep toUrahly well ; but not m well as at my
summer residence a little out of town, where the head of my bed is
towards the north. How much the stillness of the country and the
greater purity of its atmosphere may contribute to this difference, I
will not pretend to decide.

Medical Treatment of the Old.

In prescribing medicine for old people, we should bear in mind the
difference between the sexes. Women in advanced life are less ex-
citable, and enjoy better health, frequently, than in early life. Old
men, on the contrary, are more nervous, in their latter years, and
consequently more easily affected.

The physician cannot rely on the reaction ot the system in old age.
He must do more by his remedies, and depend less upon nature to
help him out of straits.

The small power of rallying in the systems of the old, puts all
blood-letting, severe purging, etc., entirely out of the question. The
man is near enough to insanity who, except in some very rare case,
bleeds the young. He who takes a drop of blood from the old, should
be put in a straights-jacket and sent to the insane hospital.

Larger Doses. — The torpid condition of the system in old age
frequently requires larger doses of medicine to make an impression.

Fluid Medicines. — Pills and powders sometimes pass through the
stomach and bowels in the same state in which they entered. Fluids
are more readily appropriated — especially when the more active me-
dicinal ingredient is mixed with wine, or some stimulating tincture,
or aromatic water. These things rouse up the torpid stomach and
bowels, and cause the medicine to take effect.

Medicine by Rectum. — When the disease is situated in the imme-
diate neighborhood of the lower bowel, as the bladder, etc., it is
sometimes better to administer the medicine by injection inu) the
rectum.

Suitable Medicines for the Old The acids, the alkalies, and the

neutral salts are unsuitable to be administered much to old people.
All metallic medicines must be given sparingly, and with caution.
Iodine and iodide of potassium are not very well borne. Narcotics
must sometimes be used to some extent. Harsh and drastic purga-
tives are out of the question, except in some few instances in which
they may be given sparingly in connection with compound tincture
of gentian, or some other stimulating tonic. Sulphur is a valuable

MMMMM

506 OLD AGE AND ITS DISEASES.

remedy for aged people. So are the stimulant tonics, bitters, astrin-
gents, gum-resins, balsams, etc., together with the various carmina-
tives, as anise, coriander, fennel, uascarilla, ginger, etc.

Surgical Operations. — Some of the smaller operations in surgery
need not be forbidden in the case of the old ; but great operations are
not to be thought of. There is not recuperative power enough to
bear them.

Diseases of the Old.

Most of the diseases which afflict aged people are of course much
the same as those which come upon people at all periods of life.
These having all been treated of in the previous pages of this book,
do not require to be gone over particularly again. There are a few
complaints, however, which are peculiar to the old, of which I must
briefly speak.

Bronchial Flux. — Bronchorrhoea.

A MORE than usual amount of mucous expectoration, accompanied
with cough, is very common with old people — so common that in
many cases they think very little of it, even when the expectoration
becomes very profuse. This discharge, however, from the mucous
surface of the bronchial tubes, is very apt to be attended by shortness
of breath on making even very slight exertion ; and the whole trouble
is aggravated in damp weather, and by constipation, and the stoppage
of leucorrhoea in females, or the interruption of insensible perspiration
through the skin.

Slow progress. — This complaint makes very slow progress, as a
general rule, often continuing many years without doing any great
mischief. It is apt, however, to degenerate into a mischievous con-
dition in the end ; and should, therefore, as a general thing, receive
some attention.

Treatment. — Attend carefully to the skin. Keep it in as healthy
a condition as possible, by regular and faithful bathing and friction.
This is of prime importance.

Care must be had not to suppress the discharge too suddenly. It
may be necessary, at times, to use some expectorant (see expectorants
among the prescriptions) to make the raising easier. But when it is
thoroughly loosened up, we should begin to suppress it by astringent
inhalations. For this purpose Inhalant No. 4 is excellent. It might
be well, however, to begin with the Inhalant No. 6, which is slightly

styptic. ,,11 1

'if ulcers on the legs have recently healed, they should be opened,

or blisters applied in their vicinity.

Removal to a dry climat« is a valuable i-emedy, provided tlxe ch-
mate is not too hot, and is healthful in every other respect.

wumf i ia ii

,-s

OLD AGE AND ITS DISEASES,

507

s, bitters, astrin-
irarious carmina-
tc.

itions in surgery
sat operations are
ower enough to

I of course much
[ periods of life,
ges of this book,
There are a few
of which I must

oea,

ion, accompanied
common that in
the expectoration
Tom the mucous
ided by shortness
the whole trouble
and the stoppage
isible perspiration

ow progress, as a
doing any great
mischievous con-

ral thing, receive

ep it in as healthy
liing and friction.

too suddenly. It
(see expectorants
r. But when it is
3S it by astringent
cellent. It might
, which is slightly

should be openetl,

, provided tlxe cU-
• respect.

Other Diseases. -— The other diseases with which old persons are
afflicted are so common to all ages, that I do little more than name
them, adding a few general remarks. .

Asthma. — The asthma, or intermittent difficulty of breathing of
the old, is connected with various other troubles, as chronic inflamma-
tion of the bronchial tubes, air in the lung-tissue, swelling of the
lungs, enlargement and dilatation of the heart, and diseases of its
valves, etc. It is also dependent on impurities of the blood, and is
connected with torpid action of the kidneys. It is impossible, some-
times, to say which of these conditions it is dependent upon. As far
as may be, however, the cause must be searched out; and then, while
the general remedies for asthma must be employed, the particular
tiling with which it is connected must also receive attention, especially
if it be connected with derangement of the kidneys.

Asthmatic old people are almost always dyspeptics. The stomach
and bowels, therefore, require particular attention. The warm pur-
gatives, combined with alkalies, are generally useful : aa rhubarb and
soda, equal parts, or Mettauer's Aperient, with a little tincture of
ginger or tincture of cayenne in it. A very valuable preparation is
compound tincture of gentian and tincture of calumba, two ounces
each, one-half ounce of tincture of ginger, and half an ounce of bi-
carbonate of soda. Mix, and take a teaspoonful as occasion may
require.

Apoplexy and Paralysis. — The nervous system being weakehed
iu aged people, the way is opened for greater frequency of attack
from apoplexy and paralysis. The exciting cause may be hypersemia,
too much blood ; or anaemia, too little blood. It may be general
debility, or gout, or a poisoned state of the blood.

The treatment is to be conducted much on the same principles as
when these diseases occur in younger subjects.

I pass over numerous complaints which may be said to be somewhat
more common in advanced life than at earlier periods. They are so
fully treated in previous pages of this book, that it is deemed needless
even to name them here. There is, however, one other class of dis-
eases occurring so very often in old age, and in so many cases mak-
ing advanced life a burden, that I cannot pass them wholly in silence.
I refer to

Diseases of the Urinary Organs^ — These afflict the old, not only
very commonly, but very severely. A man who reaches the age of
seventy or eighty without experiencing some serious trouble from
deranged kidneys, diseased bladder or prostate gland, or gall-stones,
or giavel, or unliealthy urinary deposits of some s.ort, may think him-
self greatly favored.

Treatment. — It is not necessary here to go over the whole ground
of treatment. That is done in other parts of the book. I will say,

[

508

OLD AGE AND ITS DISEASES.

however, that a surgical operation for stone in the bladder is not often
to be thought of in the ca^e of old people. Other remedies must be
sought And among these, none hold out so good a chance of rehef
as the free drinking of the alkaline bicarbonates dissolved in water
This will frequently dissolve stones formed of unc acid, urate of
ammonal and\riple phosphates. Poland water in large quantities
is good. _ - ;

1 •■

'■■> ' ' < ll| - | t i |II T >| „ ..

adder is not often
remedies must l)e
a chance of relief
issolved in water,
ic acid, urate of
large quantities

ACCIDENTS.

Apparent Death from Noxious Vapors.

When persons become insensible from breathing foul air in a deep
well or other place where it collects, let them be immediately exposed
to the open air, cold water be sprinkled upon the face and head,
and strong vinegar be rubbed about the nostrils. As soon as there is
ability to swallow, give some drinks, as lemonade, or a few drops of
aromatic sulphuric acid, dropped into a tumblerful of water, and
slightly sweetened. A stimulating injection (246) may be given.

Apparent Death from Burning Charcoal.

Some persons very thoughtlessly attempt to warm their sleeping or
sitting rooms with a portable furnace, or open pan filled with burning
charcoal, or live coals from a wood fire. This is very wrong, as such
coals while burning throw off large quantities of carbonic acid gas, a
deadly poiaon. This being heavier than atmospheric air, falb to the
bottom of the room, and for a tim« may do no damage ; but, if there
be no chimney-draught, or open door or window, it will rise above
the heads of those in the room, and bring on asphyxia and death.

Let such cases be treated the same as the preceding, with the ad-
ditional measure of attempting to excite breathing, as in the case of
persons apparently dead from drowning.

To Recover Persons Apparently Drowned.

Of all the sad accidents that may often be avoided jby a knowledge
of their prevention, drowning seems the most lamentable. Its oc-
currence, too, is the most frequent. A knowledge, then, of how to
restore the drowning to life, and to renew the suspended animation,
is equally important to people as a knowledge of how to swim.

Drowning persons die by what is called asphyxia. The air being
sluit off from the lungs, breathing stops, and the immediate accumu-
lation of carbonic acid in the blood paralyzes the nervous system, and
insensibility immediately follows. The heart continues to beat, how-
ever, from five to twenty minutes after the occurrence of insensibility
and apparent death.

' „.-■■■ 509 . ■ -•.■■.^:

MMIAiMIH^rJili.

510

ACCIDENTS.

Recoveiy may take place at any time before the heart ceaaes to
beat, and has been brought about in some casea even after this organ
has become still. It has taken place, ir. some few instances, as late
as an hour after Ixiing under water, but it can scarcely be expected,
even under the best treatment, later than twenty minutes from i\w
time of submersion ; and even as late as this, the chances are nnich
against restoration.

Several main facts should never be lost sight of : remember, fii-st.
to empty the water out of the person's stomach and lungs ; second,
to remove the patient as little away from the spot where rescued as
possible ; third, to go to work at once, unless the atmosphere of winter
prevent ; remember, finally, to keep at work long after hope seems
gone, to many, of restoring the person to life.

PlO. 160.

Roll the patient over on to his stomach, with a parcel of clothing
(see Fig. 150), a barrel or box under him, and press firmly on his
back, while au assistant pulls forward the tongue and clears the
mouth of mucus. Repeat the pressure once or twice, and then roll
the patient on to his back (Fig. 151) with the clothes rolled up
resting under his lowest ribs. Loosen all clothing about the neck,

chest, and waist. c x, x. a

Let the assistant extend the arms in the direction of the body
above the head, bringing them as near together as possible, while
you blow into the patient's mouth. Now, straddling the body, re-
place the arms and press firmly with your own weight upon the
sides and front of the lower chest, as if to press out something from

ACCIDENTS.

511

»e heart ceaaea to
m after this organ
T instances, as late
rcely be expected,
minutes from i\w,
chances are nuK^li

E: remember, fii-st,
ad lungs ; second,

where rescued as
[iiosphere of winter

after hope seems

a parcel of clothing
press firmly on his
gue and clears the
;wice, and then roll
e. clothes rolled up
ng about the neck,

rection of the body
ir as possible, while
ddling the body, re-
m weight upon the
out something from

the lungs ; suddenly let go. Repeat these motions of the arms and
uhest peraeveringly, ten or fifteen times a minute.

While thus engaged, assistants should remove the wet clothing,
wipe the body dry, and, by vigorous friction of the skin, endeavor
to restore warmth to the surface. Hot-water bottles, if they can be
[iiocured, are very serviceable in securing this result. Neither the
weather nor place may allow of this warmth. When, however, the
iwphyxia has been relieved, warmth should be abundantly supplied
and light stimulants given. Avoid the warm bath. Rubbing with
coarse cloths answers well in the absence of hot-water bottles.

Ito. iM.

As soon as the patient can swallow, give warm milk, beef tea, or
coffee with a tablespoonful of some spirit. Volatile stimulants like
ammonia, held before the nose, are very serviceable, even before the
patient breathes.

Sleep should now be encouraged, but a watch must be kept, in
cases of prolonged asphyxia, lest a relapse occur.

How long a person may be under water and yet recover, is not
definitely known, although the duration depends on the amount of
air confined in the chest just prior to the immersion.

Unlesi you are well acquainted with heart or lung action, you
may be deceived as to the existence of life ; persevere, therefore, in
the worst oases, fully an hour, sinoo the heart may beat so feebly as
to escape your notice, and yet, finally, rally.

It is doubtful if a heart that has actually stopped for five minutes
can be resuscitated.

512 AccmKNTS.

Apparent Death from Lightning.

A axnoKK of lightning will frequently produce asphyxia by par-
alyzing the muscles of respimtion. In such ca e, the same nicaiis
for locovery should be used as in apparent death from drowning. Or,
the apparently dead penson may be placed in a current of fresh air,
and cold water dashed upon the face, neck, and breast, and warm
frictiou be ai)pliod if the body is cold.

Apparent Death from Hanging.

Persons found hanging, who have committed suicide, are to ho nit
down instantly, and the same means employed to re-establisli Inoath-
ing as in cases of drowning. It may help to restore the breathin<r. to
bathe the forehead and face with vinegar, or tincture of camphor, and
to pass hartshorn frequently uuder the nostrils.

Clothes Catching Fire.

It is perhaps unreasonable to look for presence of mind when tliis
frightful accident occure, yet it is never more needed than at such a

tiine. '

The instant a lady perceives her clothes to be on fire, and in a bme,
she should seize the nearest large rug, cloak, blanket, coverlet, or any
equivalent article, and, wrapping it tight around her, throw heitielf
flat upon the floor, taking care to keep the protecting covenng dom
to her until the fire is completely smothered. If she does this with
energy, and effectually, she will put out the fire instantly.

If she continue on her feet, the blaze will rapidly ascend, and burn
her vital parts. If she run to seek relief from others not present, the
motion of the air will fan the flame into a swifter work of destruc-
tion.

If it be a child that is on fire, let any person present treat it as
above. If it be badly burned before the fire is extinguished, put it
instantly into a tub of cold water, or dash cold water upon it, to
prevent the burn from becoming deep.

■•'it- ;

r Accidents on the Water.

Ip upset in a boat, or otherwise thrown into the water, ftnd not
able to swim, draw the breath in well, and keep the mouth shut tight.
Do not struggle and throw the arms up ; but yield quietly to the
water, hold the head well up, and stretch out the hands only below
"the water. To throw the hands or the feet up, will pitch the head
down, and cause the whole person to go immediately under water.
Keep the head above, and everything else under water.

W' ,.^..^ - ir BirJUi'iifHi'iirtitiiii

AOOIDENT&

613

tning.

;e asphyxia by par-
e, tliri siiniu iiicans
OTi (Irowninf?. Or,
iirrt'iit of frosli iiir,
. broaat, and warm

ging.

luicido, are to ho rut

re-establisli broatli-

ire the breathiii<,', to

ure of camphor, and

) of nrinrt when tliis
sded than at such a

n fire, and in a blaze,
iket, coverlet, or any
I her, throw hei'HeU'
cting covering done
I she does this with
instantly.

lly ascend, and burn
hers not present, the
«r work of destruc-

present treat it as
extinguished, put it
Ld water upon it, to

I r'

) the water, ftnd not
;he mouth shut tight.
yield quietly to the
he hands only helm
will pit<}h the head
idiately under water.
water.

Poisoning Accidents. — Antidotes of Poisons.

AcciDENTH from poiaons are of such common occurrence, that
every person should know the proper remedies, and not be obliged to
wait the arrival of a physician before the proper corrective is applied.
The most common remedies, with aq methods of applying themi
will i)e given under the proper heaud bfc.'ow.

Poisons may be claasified under two hmc'ji : viz., mineral and vetre-
tahle. **

In the treatment, three objects are to be kept in view : first, to get
rid of the poison ; second, to stop ita action ; and third, to avert its
tendency to death.

The first indication is accomplished by the administration of eme-
ticH to cause vomiting, or by the use of a stomach pump. The
simplest way to provoke vomiting is to give large draughts of luke-
warm water, and to thrust a finger down the throat.

A teaspoonful or two of mustard in warm water is oftentimes an
effectual emetic. Some of the emetics are ipecacuanha, tartar emetic,
sulphate of zinc, and sulphate of copper. Sulphate of zinc in twenty-
grain doses is about the best.

The second indication is to use an antidote. The third ' ^dication
IS fulfiUdd by palliating the symptoms, and neutralizing U after-
effects on the constitution.

After copious vomiting, soothing liquids should be given, such as
oil, milk, beaten-up raw eggs. These are useful when the poison
has been of an irritating character.

If the patient be much depressed in mind or body, the hands and
feet cold, the lips blue, the face pale, a cold perspiration oi. the fore-
head and about the mouth, some stimulant may be administered,
strong, hot tea is the best, because it is a chemical antidote to many
poisons. Strong coffee is a good stimulant. Brandy and other
spints are sometimes necessary. Sometimes when the powers of life
are much depressed, artificial heat also is necessary.

; Mineral Poisons.

Poisoning by Ammonia.

Water of ammonia, or hartshorn, if taken in an undiluted state,
acts as a violent poison.

When this accident happens, give vineffar instantly, mixed with a
little water. Vinegar is an acid, and ammonia is an alkali ; acids and
alkalies neutralize each other.

Poisoning by Antimony.

Tartar emetic, and wine of antimony, are sometimes taken by
accident in large doses, so as to act as poisons, and cause dangerous
vomiting and prostration.

MWaaiMM

j. ' j<i.n i jnwiij^un i n) i» u T u »i | ii . j ff i Kmmj .i .n.n i I

muiuMitmMmm

514 ACCIDENTS.

nlsd

Give a tea of slippery elm, flax-Heed, marshmallow, etc
syrup of poppies, paregoric, or laudanum in twenty-drop doses. To
neutralize the poison, give a strong solution of tannin, or an infusion
of oak-bark, or nutgalls.

Poisoning by Arsenic.

Use the 8tv'>mach-pump instiintly, if onb is to be had ; if not, give
twenty grains of sulphate of zinc (white vitriol) in a little warm
water; and pron tte'the vomiting by tilling the stomach with liiige
di-aughts of warm or cold milk, sweetened water, or flax-seed tea.
Or, vomiting may be induced still more quickly, by giving a large
tablespoonful of strong ground mustard, mixed with a teacupful of

water.

but the best antidote for arsenic is hydrated sesquioxide of iron.
Mix a Ublespoonful of this with water, and give this amount every
five or ten minutes, until half a dozen doses are taken.

Treat the inflammation of the stomach which follows, by blisters,
a bland liquid diet, mucilaginous drinks, etc.

Poisoning by Verdigris, or Acetate of Copper.

Cooking utensils made of copper never ought to be tolemted;
yet they are used ; and it is from the verdigris which forms upon
them that most of the casjs of poisoning by copper happen.

Give an emetic instantly, and then two teaspoonfuls of carbonate
of soda (baking soda) in a tumblerful of water, to be repeated in ten
minutes. White of eggs diffused in wat«r, and mucilaginous dnnks,
are proper.

Poisoning by Corrosive Sublimate.

This is the common bed-bug poison, and is often taken by

mistake. e u

Mix up quickly the whites of a dozen eggs, with two pints ot cold
water, and give a glassful of the mixture every two minutes till the
stomach can contain no more. If there are not eggs enough at hand,
take what there are, and make up the deficiency with milk. Wheat
flour, mixed with water, is a good remedy. Use the stomach-pump,
if it is at hand. Treat the resulting inflammation with leeches and
fomentations.

Poisoning by Sugar of Lead, or Acetate of Lead.
Give a ground-mustard or a sulphate of zinc emetic; then give
diluted sulphuric acid, or either epsom or glauber's salts.

Poisoning by Strong Lye.

Strong lye is sometimes swallowed by children. The remedy is
vinegar, or oil. Vinegar will convert the lye into acetate of potash,
and any of the oils will unite with it and form soap ; and neither
the acetate of potash nor soap will materially injure the stomach.

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Photographic

Sciences
Corporation

23 WEST MAIN STREET

WEBSTER, N.Y. 14580

(716) 872-4503

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CIHM/ICMH

Microfiche

Series.

CIHM/ICMH
Collection de
microfiches.

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ACCIDENTS.

515

Poisoning by Nitric, Muriatic, or Sulphuric Acid.

When either one of these acids is swallowed, not a moment of
time is to be lost. Fill the patient /m« of calcined magnesia stirred
up in water. This is the best remedy ; but if it is not to be had,
give half an ounce of soap in a pint of water. If neither are at
hand, give chalk, or whiting, in water, or even pound fine some of
the plastering of the room, and give it in water.

Poisoning by Nitrate of Potash, called Nitre, or Saltpetre.

Induce vomiting by lukewarm water, and by tickling the throat
with a feather : but avoid irritating the stomach with the ordinary
emetics.

Poisoning by White Vitriol.

Provoke vomiting by warm drinks, and by tickling the throat,
and give freely carbonate of soda, in water.

Poisoning by Oxalic Acid.

This resembles epsom salts, and is liable to be taken for salts by
mistake. The two can always be distinguished by touching a little
to the tongue. Epsom salts taste bitter; oxalic acid, very sour.

In cases of poison from oxalic acid, give magnesia in water as
quickly as possible. When this is not at hand, give chalk, or lime,
or saleratus. Use the stomach-pump, if it is ta be had.

Vegetable and Other Poisons.

The vegetable poisons are quite numerous, and many of them
quite as virulent and rapid as any in the mineral kingdom.

Poisoning by Aconite.
Give an emetic of ground-mustard or sulphate of zinc, or use the
stomach-pump instantly, and then give stimulants, as brandy, gin,
whiskey, rum, etc.

Poisoning by Opium, Morphine, and laudanum.

Use the stomach-pump, if at hand ; if not, a powerful emetic of
sulphate of zinc, or sulphate of copper ; or, if these are not at hand,
a tablespoonful of ground mustard in a teacupful of warm water.
If vomiting is not induced at once, tickle the throat with a feather,
or with the finger. If sleep is impending, take the patient into the
open air, and keep him walking; dash water upon his face. etc. If
he still falls into sleep, and appears to be near dying, apply means
for artificial breathing as for persons apparently daad from drowning.

Poisoning from Belladonna, Hyoscyamus, Stramonium, and Conium.
These are all narcotics, and when accidentally taken in poisonous
doses, the treatment is to be the same as for poisoning by opium.
Strong coffee is said to counteract the effect of these articles.

aavi

5ie ACCIDENTS.

I-

f'.

Poisoning by Dogwood, Ivy, etc.
Give some of the salts as a cathartic, and apply to the skin a solution
of sugar of lead, or still better, a decoction of witchhazel-haik or
lime-water.

Poisoning by Prussic Acid.

This is the most deadly of all known poisons. One drop of the
pure acid will cause immediate death. Give water of ammonia or
hartshorn, one part dUuted with six parts of water, freely.

Poisoning by Strychnine.

The same treatment as for poisoning by opium, excepting that
sweet milk should be freely admini.iered. This has been recom-
mended by one respectable physician, at least, who says he has found
it to be a specific. Camphor, two ounces dissolved in a quart ot
whiskey, and given freely, is also said to be an antidote.
Poisoning by Spanish Flies.

Give large draughts of sweet oil, sugar and water, milk, or flax-
seed tea. For the inflammation of the bladder which is produced
by it, apply leeches, and a liniment composed of camphor and sweet
oil. To relieve the strangury or scalding of the water, give camphor
internally.

skill a solution
bhazel-bark or

ne drop of the
if ammonia or
jely.

excepting that
18 been recom-
s he has found
in a quart of

te.

', milk, or flax-
3h is produced
phor and sweet
r, give camphor

SUBGICAL DISEASES.

Modern Surgery.

To one educated in surgery a quarter of a century ago, the cus-
toms and theories of to-day must seem very odd, and the results of
to-day's surgical science must seem truly miraculous. Formerly pus
formation in a healing wound was regarded not only as unavoidable,
but really beneficial. Pus, or matter, was known as laudable or good
pus, and diseased, or bad pus. Wounds only occasionally healed by
primary union or first intention, — that is to say, skin growing to skin
and muscle to muscle as sewn, but they rather healed by a long, slow
process of granulation attended with pus-formation, called second in-
tention. The various surgical epidemics of contagious diseases were
extremely common in the very best hospitals under the guidance of
the very best men ; tliey wfere thought unavoidable. Hospital gan-
grene, erysipelas, and the various forms of blood-poison diseases, were
so common and spread so rapidly as often to render it necessary to close
a hospital. Major operations were attended by a mortality that now-
adays seems almost incredible. To amputate a leg, except under
the most favorable circumstances, meant almost sure death. The
late Dr. Pasteur of France first made known to the world that there
were such things as germs, or microscopic life, capable of transmitting
themselves and their spores almost ei-'dlessly. These germs were
soon found to be the outcome of dirt and disease, and that possibly
in their extermination lay a great future for surgery. It was Sir
Joseph Lister, of England, who first discovered the fact that certain
medicines, like carbolic acid, would kill these germs, and that in so
doing wounds would uu'te by first intention in the majority of cases.
This was the first great step toward the realization of the dreams of
our forefathers.

The study of bacteriology was then commenced, and it has pro-
gressed rapidly ever since, till to-day it has become a marvelous
science unfolding the life, nature and propagation of all sorts of
bacteria.

We now know that on the living skin there exist normally certain
germs whose function apparently is to use up the waste products of
the economy, but which, when introduced into the flesh, produce most
deleterious effects.

517 ' .

'wm

518

SURGICAL DISEASES.

Germ-lifc is found everywhere, — on our hands and clothes, in tlu-
dust of tlu! air and in the water we drink. So long as the;/ keep to
their natural abodes no mischief is done. It is this germ-life wliicli
causes wounds to suppurate, erysipelas, blood-poisoning and gangrene
to occur. It is the annihilation of these germs about all wounds,
and on all objects which come in contact with wounds, that (Hstin-
guishes the newer from the older surgery. To-day the mortality
figures are revised as regards all important operations. Regions of
the body are invaded which fifteen or twenty years ago w ere thought
to be inviolate to the scalpel. Thousands of lives are now saved and
thousands of people rescued from becoming invalids.

The methods of treating germs have changed very materially since
Sir Joseph Lister first announced his antiseptic treatment and showed
the way to a new ei-a in surgeiy ; but the principles are much the

same.

Some germs have been found to be innocuous, even on wounded
surfaces ; others are deadly poisons. Some germs cause one kind of
disease, some another ; some are even antagonistic to others. They
are all endowed with great resistance to ordinary medicines and are
capable of propagation under adverse circumstances ; they are con-
tagious and infectious, and when carried from one person to another
cause their specific disease to start up. The so-called blood-poison
is a general name for many distinct varieties of germ-disease.

It matters not whether a simple wound is to be dressed, a leg am-
putated or a woman delivered, the one essential thing above all else
which protects life and allows the wounded surface to heal is to
make a clean field, to render the surfaces aeeptic.

Aseptic. Septic. — These are two terms which are daily becoming
the common property of the laity : the former means without poison,
germ-frei, or surgically clean ; the latter means poisonous, germ-laden,
surgica] iy dirtg. Let it not be supposed that the flesh looks to the eye
differently in these two conditions, — it is not so necessarily. These
bacteria are so minute that if a single rod-bacillus were enlarged fif-
teen hundred times it would then only reach across the head of a
pin. Nor is their virulence in proportion to their apparent numbers,
for in twenty-four hours a single germ may multiply to sixteen and
one-half millions 1

Surgical cleanliness is surgical morality, and consists not merely ni
washing off the rough, visible, outside dirt, but in rendering every-
thing which can possibly touch the wound, directly or indirectly,
germ-free. This condition is called asepsis; when, however, germs
have entered the wound and the consequent changes due to germ
life have developed, then the condition is called sepsis.

Antiseptics. — The important and practical question then is, ho^y
are these germs killed and how is the wound rendered aseptic?
Lister discovered in carbolic acid a germicide of no mean power, and

■

SURCICAI, DISKASES.

51fl

I cloihos, ill tlic
118 thtr',' kct']) to
gerni-lifi! wliicli
ig and gangrene
DUt all wounds,
(ids, that distin-
yr the mortalitj'
[IS. Regions of
go w ere thought
B now saved and

materially since
neat and showed
s are much the

ven on wounded
Yuse one kind of
o others. They
edicines and are
8 ; they are con-
erson to another
led blood-poison
n -disease,
ressed, a leg am-
ig above all else
,ce to heal is to

B daily becoming
18 without poison,
inou8, germ-laden,
1 looks to the eye
jessarily. These
/ere enlarged fif-
is the head of a
jparent numbers,
y to sixteen and

sts not merely in
rendering every-
,ly or indirectly,
, how over, germs
ret, due to germ
sis.

tion then is, how
endered aseptic?
mean power, and

oven lo-diiy this acid is most (^xfensivtdy used for the clcanHing of
wouikIs and instruments. 'I'his pnxiess of killing germ-life is called
stcrUiztttion.

After carbolic acid came numberless other ilrugs, such as corrosive
sublimate, phenyl, sulpho-naphthol, etc. Of this group corrosive
sublimate is by far the most potent : it may be used in very weak
solutions as one part to three, five, or even ten thousand of water.

Heat. — By far the sim.plest, safest, and most economical method
of sterilization is by means of heat, either in the form of lioiling
water, dry oven-heat, or steam. Whatever can be baked lor an hour
at 140° of heat, or whatever can be steamed for an hour, and what-
ever can be boiled five minutes without impairing the integrity of
the object sterilized, can be rendered absolutely sterile. Germs and
their spores, which latter are more tenacious of life than the former,
yield readily to boiling water in a few minutes; while some germs
of the most virulent type may soak for houi-s in a tolerably strong
solution of the chemical sterilizers without being killed. The ten-
dency of the present is to substitute these natural means of steriliza-
tion for the chemical germicides.

Preparation for Operation. — Nothing withstands boiling; but
as the flesh cannot be baked, boiled, or steamed, it is the custom be-
fore an operation to make free use of green soap and a brush to scrub
off the external superficial- dirt and then to give the skin a good
scrubbing and soaking in corrosive sublimate, in the strength of
aljout one part to two thousand. This prepares the skin antiseptically
for the operation. The instruments and apparatus likely to touch
the flesh are boiled ; the hands and arms of the surgeon, assistant
and nurse are rendered sterile by repeated scrubbing with soap and
brush and some one of the several antiseptic processes in vogue.
This requires fifteen to twenty minutes. All dressings such as gauze,
cotton, etc., are steamed and neatly done up air-free and germ-free
ready for use. Sponges, generally made of gauze, have been sterilized
by steaming previous to the operation. Sutures, etc., have been boiled'
or steamed or soaked in some suitable disinfectant. The neighbor-
hood of the wound is covered with steamed towels or sheets, the
clothes of the operator covered with some sterilized coat, and in fact
everything and everybody that is likely to approach the wound is
fir.st thoroughly rendered aseptic.

In the subsequent dressing of a wound, and for all time till the
wound is healed, similar precautions are taken. Thus it is that by
shutting out all germ-life one succeeds in securing primary union, a
quick convalescence and a freedom from the risks of septicaemia and
other blood-poisoned diseases.

The change from the old-fashioned soap-and-water cleanliness to
the new antiseptic cleanliness has wrought marvellous results.
Brains are exposed, gall-bladders incised and stones removed, kidneys

11 HW

, ■•*

"^ssiti-

wmmm

mmd

520 SUROICAL DISEASES.

removed, wombs and ovaries and huge tumors taken out witli a small
mortality rate. These same operations were but dreams in the pro
Listerian days.

. Inflammation.

On this pathological basis much of surgical disease rests. Surgical
inflammation is due in a great mecasure to tlie introduction into tlu'
tissues of germs which there multiply with great activity, forniiuir
as a result certain poisonous products called toxines. These toxines
are deadly poisonous to the system, and when absorbed cauae high
fever, chills and sweats, loss of appetite and strength, and generally
undermine the strength. It is as if so much mineral or vegetable
poison had been introduced into the stomach. Their activity is
astonishingly rapid when they are situated in tissues favorable to
their development, like the peritoneum and other serous membranes,
richly supplied with lymphatic vessels to convey the poison from one
point to another.

There are several conditions favorable to the development of germs
when introduced into the body, chief among wluch is moisture ; hence
to keep the wound dry and well drained is the constant aim of the
surgeon. When bacteria are introduced into the system through a
wound, they begin at once to put on their activity, and the produc-
tion of toxines commences. Nature rushes, so to speak, to the field
of the enemy, and a great fight at once occui-s. She throws out a
mass of lymph about the invaded portion of the flesh to surround the
enemy and cut off his base of supplies. She forms out of her ovi
blood antitoxines., so called. It soon becomes a question of which is
the stronger form, — the toxines of the germs, or the antitoxines of
the serum. This battle results in a thickened, congested, painfully
swollen and reddened area, which, if nature conquers, softens and
melts away, but which, if the enemy is victorious, breaks down and
forms pus. The result depends largely on the location of the strug-
gle, the strength of the patient, and the virulence of the germ. If
it be in a part poorly supplied with lymphatic vessels and soft struc-
tures, nature has the advantage, because the enemy cannot find easy
access to structures beyond the field of battle; but if the neighbor-
hood of the invasion is in soft structures, the enemy quickly seizes
on some short route to a neighboring lymphatic station and there
deposits its poison and thus extends its field till nature is over-
whelmed. The ability of nature to manufacture antitoxines quickly
and mobilize her forces to the rescue on the one hand, and the viru-
lence of the germ or its capability to develop its poison quickly, on
the other, are always deciding elements in the preservation or de-
struction of the part attacked. Much is now being accomplished
toward eradicating germ-diseases and germ-inflammation by the cul-
tivation of this natural antitoxine. Its special victory is seen j in the
diphtheritic antitoxine with which that disease is now so succeisfully

S W . -v^itffrt . M :\ ■ ^-tif flfe^iw . t i vw l. \

SURGICAL DI8EA8KS.

521

out with a smiiU
iams in the pro

rests. Surgical
luction into the
ictivity, foiiuiuLf
These toxines
rbed cauae liigh
h, and generally
ral or vegetabh;
'heir activity is
les favorable to
"ous membranes,
poison from one

jpment of germs
moisture ; hence
jtant aim of the
?^stem through a
md the produc-
»eak, to the field
le throws out a
to surround the
out of her ovi
ition of which is
e antitoxines of
yested, painfully
3rs, softens and
reaks down and
ion of the strug-
f the germ. If
s and soft struc-
cannot find easy
if the neighbor-
ly quickly seizes
ation and there
nature is over-
itoxines quickly
d, and the viru-
ison quickly, on
servation or de-
ig accomplished
ition by the cul-
ry is seenun the
f so 8ucce| sfully

fought. This antitoxine wliich naturt; throws out is cultivated in
iiorses till such an amount is stored up that against it diphtheria no
longer has any influence ; this serum, so ricli in antitoxine, is then
introduced into the human subject as an antidote to the forming
toxines of the diphtheria.

And so it is with lockjaw, labies, and many other germ-diseases.
This therapeutic agency is yet in itw infancy, but much may be ex-
pected of it in the future.

But not all inflammation is necessarily of bacterial origin, at least
HO far as is yet proven.

Every part of the body which lias vessels and nerves is liable to
inflammation. Where there are no nerves, it cannot exist. Many
diseases are caused by it. Mechanical injuries, such m cuts, bruises,
and fractures, produce it. And many other disorders, not caused by
or causing it in the beginning, become entangled with it in their
progress. It is very important, therefore, to understand the nature
and management of inflammation. It is not always to l)e looked upon
iiH a disease ; it is frequently a simple process of repair, whereby
nature restores injured parts to health, in wliich there is no germ-life
present.

The Signs of Inflammation are redness, pain, heat, swelling and
loss of function, though in some cases these do not all appear.

Acute Inflammation. — When the redness, the pain, the heat, and
the swelling are clearly marked, and the infl'iramation is so rapid
that it either subsides in a few days, or quicklj^ brings on suppuration,
or ulceration, or mortification, it is said to be acute.

Chronic Inflammation. — When it is less painful, and flower in
its progress, beginning very gradually, and lingering a long time, it
is then chronic.

Common, or Simple, or Healthy Inflammation, is that which is
not mixed up with any disease, but is established by nature for some
salutary purpose, and is generally germ-free.

Unhealthy Inflammation is that which has been caused by some
other disease, like the poison from germ life, and is under its control.

Specific Inflammation is that which seems to vary from all ordi-
nary cases, being dependent on a particular state of the system, on an
animal poison, or a principle of contagion or infection, and a power
of propagation from one person to another, such as all germ-poisons.

Some of these produce such permanent effects, that those having
them are not liable to a second attack.

Inflammation is Primary, or, as the doctors say, idiopathic, when
it is the original disease.

Inflammation is Secondary, or Sympathetic, when it is tho re-
sult of some other disorder, which goes before, and produces it.

'rrr

522

8UR01CAL 1)I8EA9K8.

It haH lieen explained clsewlicre that tlie different pails of tlic
body are connected l)y little threads or nervous strings which run
from one to the other. If one jjart of the body iKieonie injured or
disordered, it u os these nervous threads as telegraphic wires, to k'il
other, part-s of its misfortune ; and it sometimes happens that when the
intelligence conveyed is of a 8ad and alarming character, the part re-
ceiving the news is so excited and distressecl as to become inflamcii
Nothing can be more proper than to call this aympathetic inflannmi-
tion.

When the inflammation is violent, and is seated upon some impor-
tsint part, the sympathetic action is so great as to disturb the wliolu
(!onstitution ; and this general disturbance is sympathetic or symptom-
atic inflammatory fever On the other hand, it more frequently hap-
pens, especially in the light of modern surgical pathology, that the
lymphatic system, which is in reality a delicate railroad system for
ihe economy, leading toward the great citadel A life, the heart,
carries over its tracks to the nearest station some of these germs or
germ-poison from the primary wound or inflamed spot, thus spread-
ing the contagion to whatever lymphatic station the vessel happens
to run.

The Symptoms are quick and strong pulse, dryness and heat of
skin, parched mouth, great thii-st, scanty and high-colored urine, cos-
tiveness, disordered nervous system, loss of appetite, anxiety, restless-
ness, sleeplessness, headache, wandering and confusion of mind, and
sometimes delirium. This fever John Hunter called a univeraal
sympathy of the body with the disturbed condition of a part of it.

It is only by inflammation that a wound is healed, or a broken bone
repaired.

Upon the surface of a wound nature pours out a fluid called plas-
tic lymph. This is composed of fibrin, — the material of which flesh
is made, — united with a little of the watery part of the blood, chiefly
albumen. The watery part disappeai-s soon after it is poured out,
and the fibrin hardens into a kind of membrane. Through this,
nature sends small nerves, arteries, and veins, which she uses as
threads to sew up the womid. Fibrin being the chief material with
which nature constructs our bodies, she of course uses it to repair
them when wounded, just as a carpenter, who constructs a floor with
planks, uses planks to mend it when it is broken through. ,

Buffy Coat of the Blood. — The effects of inflammation extend to
the blood. This fluid, when draw n from the veins of a person suffer-
ing from an inflammation active enough to disturb the constitution,
forms a clot in the basin more slowly than usual, but the clot is
harder ; and a layer of fibrin is left upon the surface, of a yellowish
buff-color, looking like size or glue, and called the buffy coat. The
clot is also scooped out in the centre, and the blood is said to be
cupped. . •

•^aaiaaMlWaK

' ^1

SUIUilCAIi MSKAHKS.

523

•ent parts of I he
triiij^s \vlii(^li run
oonio iiijiinMl or
i)liic. wiroH, to k'll
ens that when the
icter, the part rc-
hecomo inflamed,
mthetic inflamiiia-

ipon some impor-
iisturb the whoh;
thetl<y or »ymptom-
e frequently hap-
thology, that tlie
ilroad system for
f life, the heart,
if these germs or
ipot, thus spread-
le vessel happens

yrness and heat of
!olored urine, cos-
, anxiety, restless-
iion of mind, and
ailed a univeraal
of a part of it.
, or a broken bone

I fluid called pla»-

ial of which flesh

the blood, chiefly

it is poured out,

3. Through this,

hich she uses as

ief material with

uses it to repair

tracts a floor with

irough. ,

(imation extend to
of a person suffer-
b the constitution,
al, but the clot is
ace, of a yellowisli
e buffy coat. The
>lood is said to be

Coin Discs. — It is another i)eculiarity of inflamed blood, that if a
(hop of it 1)6 examined under a powerful microscope, it« globules, or
(lisi's, which are very numerous, will be found .standing on their
edges, and leaning against each other, like a row of copper or silver
coins. (F'ig. 152.)

Inflammation may end in one of four different ways.

I. By Resolution. — Suppose a large splinter of wood be ptuck into
Iho liand of a healthy man. It causes rcidness, lieat, swelling, and
j)ain ; and these combined are inflammation. The splinter is pulled
out, and the hand well done up with a disinfectant dressing, and
[)roperly cared for. The redness fades, the heat declines, the swelling
subsides, and the pain disappeai-s ; the inflammation is ended, and the
hand is well. Coming to a fortunate end in this way, iuflammatiou
is said to be resolved., or terminated by resolution.

O O

q o «

FlO. 1B2.

FIO. 163.

II. By Suppuration. — It does not always end so happily. The
splinter may be broken off below the skin, and not pulled out ; or, even
if removed, germs may have been introduced from the splint or from
ill! skin of the hand; these germinate rapidly and form pus, and
i!i lead of the inflammation abating, it will increase, and the centre
of the injured part will begin to rise up to a point, and grow white
oil the top. This shows that there is matter formed underneath,
wliich is lifting up the scarf-skin, and seeking to come through. Fig.
153 is a microscopic view of pus ooipuscles.

The pain is now very throbbing and pulsating — keeping time with
the beats of the heart. When the scarf-«kin can hold out no longer,
it breaks, and yellow, cream-like fluid runs out, ^v^hich we call pus.
The redness, pain, etc., now subside. This process we call suppuror
lion.

At this time, if the wound have been a severe one, attended by
sympathetic fever, and the discharge of pus be now large, there may
be a change in the fever, marked by frequent shiverings and chilli-
ness, followed by flushes of heat, which ends in sweating. We call
this heatie fever.

III. By Ulceration, or the formation of open, running sores.

iiil

mM»

D24

8UK0ICAI. DIHKAHKH.

IV. By Mortification. — If tho wounded part have l)eon bo mnoh
injured m gradually to destroy its vitality, it dies. The vivid red
of the inflammation changes to a purplish, or livid, or hlaek hiu'.
The strained condition of tho skin ceases, a bloody fluid liftH up tiu-
cuticle, the pain and feeling are all gone, — tho part is dead and
putrid, and gives out a peculiarly offensive smell. This process is
called mortification.

The mortified and dead part is called a dowjh; and it is seijarated
from the living parts l)y a peculiar vital i)rocess whi'jh has the name
of ulceration.

Treatment of Inflammation. — Though inflammation sometinies
ends kindly by resolution, and though it is often a salutary process,
yet it is frequently very destructive, ending in suppuration, uhsem-
tion, and mortification, thickening, hardening, soi'tening, and en-
larging parts affected by it; and doing these things in textures of
great delicacy, and of vital importance in tho economy of life. It
calls, therefore, for judicious, and, often, for very active treatment.

There are tliree principal things to be done, — to remove the cause,
if it be still active, to take the blood away from the inflamed part,
and to render the part aseptic, if possible.

If a bullet be lodged in the flesh, or a thorn, or a splint of wood,
or a piece of glass, it is the exciting cause of the inflammation whuli
follows, and little can be done to advantage till the offending sul)-
stance is extracted. If inflammation be excited in the bladder by
the irrittvting presence of urine which cannot be passed, this must be
drawn off with the catheter before relief can be had. If thestomacli
be inflamed by improper food, or too much of it, the diet nuist
cease to follow appetite, and ttike reason for its master. If ladies
have excited -nflammation in the bowels, or any of the internal or-
gans, by a dragging weight of skirts, they must either put off the
burden, or hang it upon tlie shoulders with straps.

The blood is removed from the inflamed part in two ways : —

Cupping and Leeching. — It is done directly by cupping and leech-
ing. These methods take the blood out of the small vessels, which
are so full and crowded as to produce pain. Cold water, ice, etc.,
applied to the part cause these little vessels to contract, and squeeze
the blood out of themselves. These are very useful applications;
and they are to be pursued as long as there is any hope of breaking
up the inflammation, or causing it to end by resolution. But when
this is no longer to be expected, and it is found that it will go on to
suppuration, then apply warm fomentations and poultices. These
will mollify and soften the parts, and cause the suppurating to go on
more rapidly and with less pain.

Counter-Irritation. — The other method of removing the blood
from the inflamed part is by what is called counter-irritation.

People are apt to think it very absurd that inflammation fhould be

. ^.,.iij.ji.ji;.;iL»'-i^:a.-..J.:^.', . — j:aa._a^..iA.^ — —f^^ — ^-^

- . r^'

wo l)een ho mnrli
Tho vivid rcil
id, or black hiK;.
fliiitl lifts up tJH'
part is dead uiul
Thia piocetw is

iiid it is separated
lich has tho name

■nation sometimes
I salutary j)rocoHs,
ppuration, uUieni-
nttoning, and eii-
igs in textures of
noniy of life. It
ctive treatment,
remove the cause,
bhe inflamed part,

a splint of wood,
iflamraation whiili
ihe offending sub-
n the bladder by
issed, this must be
I. If theBtomach

it, the diet must
master. If ladies
of the internal or-
either put off the

two ways : —

Rupping and leech-
lall vessels, which
Id water, ice, etc.,
tract, and squeeze
eful applications;
hope of breaking
ution. But when
at it will go on to
poultices. These
)purating to go on

moving the blood
-irritation,
amation phould be

8UUUI0AL DIHKAHKS.

625

induced in one place to relieve or cure it in another. But it is not
iibsurd. It relieveH or cures on the principle of synipathy, wiiicli 1
have already explained. Wo put croton oil, or tartar emetic, or
Spanish flies, or cayenne jjep/ier, or mustard, tipon tlie surface of the
bowt'l.s wlien tho internal ps rts are dangerously inflamed, and what
is the result? Why, the terrible smarting >..ul pain alarms nature,
mid she ruslies up to the surface with a large amount of the blood
iiroiind the inflamed parts, and there, for hours, perhaps for days,
struggles to l)eat down tlio new mischief at the surface ; and, in tho
mean time tho internal partw, relieved by the removal to the surface
of so largo a quantity of hot blood, make a long stride towards re-
covery.

A popular orator is speaking to a multitude in a hall, which is
thronged to excess, and a few feeble persons faint, and are lik(dy to
be suffocated and trodden ui)on in the dense mass. A person at the
door, seeing what luis happened, cries "/re." The crowd rush out ;
the fainting persons get breath, and are saved. So, when the thou-
sand streams of blood rush througli their channelH upon an inflamed
and fainting internal organ, crowding and oppressing it, we set the
skin on fire wi*^h some inflammatory sul)stance ; the blood rushes to
tho now point of excitement, and the oppressed and fainting organ
recovers.

Cupping and leeching, which are often necessary, are not to be re-
Hoi'tefl to in very debilitiited constitutions. In some persons, leeching
produces erysipelas.

Costiveness is always produced by the symptomatic fever which
often results from inflamnuition. This should be removed by saline
purgatives, such as Rochelle, Ejwom or Glauber's salts, salts of tar-
tiir, tartrate of potassa, and the tartrate of soda (9), (7), (12), (14),
(18), (20), (25), (27), (41). So: itimes more active purgatives
are required, and then the compound extract of colocynth, etc. (29),
will Ije excellent, or two compound cathartic pills, at night, followed
by (299) may be used.

As a drink, cream of tartar (298) will be found cooling and re-
freshing. In all inflammations, the diet must be light and unstimu-
lating.

To allay the excessive fever and pain of inflammation, some of the
coal-tar products may h3 used, like ammonol or phenacetine, in ten-
grain doses, every two to four houra ; but it must be remembered
that inflammation is the result of poisons and not the cause of them,
hence these remedies are but temporary and palliative, and must be
used while the real cause is being fought by removal of the original
source of the trouble.

The third method of treating inflammation is the most important,
because generalu it str" i home. Inasmuch as most inflammation
which comes from outs j causes is the result of the introduction of
bacteria into the body, che most natunl thing to do is to disinfect

526

SURGICAL DISEASES.

at once the injured or diseased part. The bruised finger, the hole
made by the bullet, or the cut by the knife, all need to be bathed in
some antiseptic solution to kill all germ-life and arrest the develop-
ment of their poisons, which inevitably cause inflammation. Such
solutions should be injected into the vs^ound or freely bathed over
the surface. They are legion in number, but only a few may be
mentioned, such as corrosive sublimate, wliich one can buy in tablet
form of the druggist, and of which one is taken dissolved in two
quarts of water; strong carbolic acid is another disinfectant, and
may be used in strength of one teaspooiiful of the ninety-five \m-
cent acid to a pint of water. Sulpho-naphthol or oil of milk, is still
a third disinfectant, and is used in strength of one-half teaspoonful
to a quart of water ; this latter turns the water milk-color. Carbolic
acid on standing long or being exposed to the light turns reddish,
but is not impaired in efficacy. The sulpho-naphthol is the least
expensive, and may be used for sinks, drains, etc. It is perhaps the
safest and best to have in the house.

Suppuration and Abscess.

An abscess is the 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 said to be suppuration ; when it collects in a tissue,
it is an abscess. When the matter collecting in some organ conies
towards the surface, and a place in the centre rises above the sur-
rounding skin, and turns white, the abscess is said to point. Some
abscesses point and break in a week ; others of a more chronic char-
acter vi'ill linger on for months.

Fluctuation. — Before an abscess points, a fluctuation may gener-
ally be felt in the swelling, which is one of tiie surest signs that it
contains pus. Sometimes this fluctuation may be felt even when the
matter lies very deep in the flesh. And when it is so deep that tt
cannot be felt, if a sudden cessation of the symptomatic fever should
occur, and shiverin^s or rigors should come on, attended by coldness
in the affected part, we may reasonably suspect that pus is formed.
It is not easy, at times, to say whether matter is really present ; and
great care should be used not to plunge in a lancet where none
exists. Chills and fever due to pus formation are caused by the
absorption into the system of the poisons of ptomaines, which are the
result of germ-life, and their propagation.

Treatment. — When the abscess is completely formed, and there
is no longer any doubt of the presence of matter, it should be opened
at once. To let out the confined pus alleviates the pain and lessens
the inflammation. If the matter lie close to a bone, the openiiit,'
should be made without delay. The opening should lie large enough
to let the matter out freely. It is a rule to keep the incision open

TTil:

SURGICAL DISEASES.

627

[ finger, the hole
d to be bathed in
■rest the develoi)-
immation. Such
eely bathed over
ly a few may be
jan buy in tablet
dissolved in two
disinfectant^ and
e ninety-five per
il of milk, is still
-half teaspoonful
c-color. Carbolic
ht turns reddish,
ithol is the least
It is perhaps the

the substance of
}d out from some
ollects in a tissue,
ome organ conies
}S above the sur-

to point. Some
lore chronic char-

uation may gener-
jrest signs that it
3lt even when the
is so deep that \i
natic fever should
nded by coldness
at pus is formed,
ally present ; and
incet where none
ire caused by the
les, which are the

ornied, and there
should be opened
i pain and lessens
)one, the openiiit,'
\ lie large enough
the incision open

till the cavity of the abscess is so far filled up that another collection
of pus is not likely to occur.

If the matter do not readily get to the surface through the opening,
it may burrovr itself in the flesh, in a long narrow channel called a
sinm. To relieve this, the opening must be extended in such a way
as to give vent to the new collection.

An abscess is sometimes indisposed to heal at the bottom, and pus
continues to be formed a long time, pud is discharged through an
opening smaller than the sack whicn contains it. This is a fistula,
and tlie opening to it should be enlarged so as to let out the matter
more fre ly. A little soft lint may then be gently pressed into the
wound to prevent its healing before tlie cavity below. The cavity
should be freely scraped out to remove all germ-life, and then thor-
oughly disinfected and kept clean and aseptic by aseptic gauze pack-
ings, and in this way nature is bound to heal the wound.

Au abscess from acute inflammation requires to be poulticed for a
time after it has been opened. When the swelling and inflammation
are gone, the poultices are to be laid aside, and a bandage put on.
When the inflammation is gone, let the diet be improved; and if the
lUscharge of matter be large, give wine and tonics.

Mortification.

The complete death of a part of the body, and its change into a
black, stinking, cold, and insensible mass, with which the other parts
of the system have discontinued all organic connection, is what we
call mortification. That form of it which is most common is said to
be humid, on account of the moisture of the dead pai-ts. It is the
result of nature having walled oft" by her antitoxin the scene of the
battle, and while she has lost the original battle and the original
field, has nevertheless succeeded in keeping out the enemy from the
remainder of the system. The enemy feeds on the dead tissue, set-
ting up a putrid, stinking cesspool of filth.

Gangrene. — Before the mortified part is completely dead, and,
consequently, while its recovery is supposed to be possible, the con-
dition of the part is called gangrene.

Sphacelus is the name given to it after its entire death.

Sloughing is the process of separating the dead matter, and the
susbtance separated is a slough.

The causes of mortification are quite numerous. The most com-
mon are, stoppage of the circulation by inflammation, by mechanical
causes which obstruct the passage of the blood, by chemical agents
and poisons, and by local or general debility.

In a bad constitution, which l)ears diseiuse poorly, mortification is
vei-i/ dangerous.

528

SURGICAL DISEASES.

Treatment. — In treating mortification, three things are to be aimed
at, — to stop its progress, to promote the separation of the dead from
the living parts, and to heal tlie ulcer which is left after the separa-
tion.

To stop the progress of mortification, we must remove its cause.
If it be inflammation, treat that according to the principles laid down,
though leeching, purgatives, etc., should be used sparingly, as mor-
tification reduces the constitution so rapidly that it does not bear
reducing well, and sometimes not at all. As soon cas the inflamma-
tion has subsided, particularly if the system be weakened, tonic bit-
ters and a nourishing diet must be had. When there is fever, with
great excitement of the nervous system, delirium, picking of the
bed-clothes, etc., the patient should have anodynes (1^1) and anti-
spasmodics (87), (91), (90), drafts upon the feet, and such other
local remedies as the case may require. Here opium and stimulants
are of paramount importance.

It is of little use to pat anything upon the mortified part, except
with a view of lessening the stench. For this purpose, lay upon the
part lint soaked in a solution of chloride of lime or soda, or a solution
of pyroligneous acid, or of creosote.

Very little can be done to hasten the separation of the dead part
from the living ; but while it is taking place, a common flax-seed
poultice, mixed with a little powdered charcoal, may be kept on it.

The ulcer left after the separation is to be treated like other
ulcers. A dressing of bovinine and five per cent solution of carbolic
acid, equal parts, will be found to hasten the granulation.

Pyaemia.

This frightful afPection has been called the bane of surgery. It
is caused by a peculiar poison, resulting from the fermentation and
disintegration of the tissues of a wound, which is taken into the
system either by the veins or absorbents, and is usually accompanied
by the formation of collections of pus in the various tissues and
organs of the body. It follows very trifling as well as severe injuries,
and it is a frequent sequela of surgical operations, oftentimes of a
very slight character. The only tenable theory which can explain
the different phenomena of this diseah'e is, that the pysemic condition
is caused by the absorption of septic material, sometimes in a fluid,
sometimes in a gaseous state, which unfits the blood for the processes
of healthy nutrition, induces capillary stagnation and its conse-
quences, low forms of inflammation in different parts of the body, as
in the joints and serous cavities, and may finally produce those sec-
ondary deposits of pus, in any or all parts or organs of the body,
called metastatic abscesses.

When an internal organ is involved, the result is generally fatal.
When suppuration attacks the integuments or the extremities, there
is a fair chance of recovery.

SURGICAL DISEASES.

629

are to be aimed

the dead from

ter the separa-

love its cause.

pies laid down,

.ringly, as mov-

does not bear

the inflamma-

ened, tonic bit-

J is fever, with

picking of the

;^l£t) and anti-

md such other

and stimulants

ed part, except
se, lay upon the
da, or a solution

I the dead part
mmon flax-seed
be kept on it.
ated like other
ution of carboUc
Eition.

of surgery. It
jrmentation and

taken into the
lly accompanied
LOUS tissues and
,s severe injuries,

oftentimes of a
lich can explain
ysemic condition
Avaes in a fluid,
for the processes
and its conse-
s of the body, as
oduce those sec-
ins of the body,

generally fatal,
ixtremities, there

Thence the disease ntvs been divided into two classes : the internal
or acute, the external or clironic pyaemia. When pyaemia involves
the internal organs the coui-se is usually rapid and fatal. When it
attacks the external parts, it is slow in its course and may be recov-
ered from.

Duration of the Disease. — Sometimes its course is so rapid that
the patient may die in two or three days after the appearance of the
Hymi)toms. As a rule, however, bad cases terminate during the
second week. Some go on for six or seven weeks. In cases which
recover, the patient jjoes through a long illness and may be left per-
manently crippi. by secondary affections of the joints. As a rule,
tlie longer a patient lives the better the hopes of a successful ending.

Pyaimic symptoms generally make their ai)pearance after the fourth
day. The first symptom is a chill ; this is repeated at irregular
intervals, and is followed by profuse and exhausting sweats.

The hot stage which characterizes the malarial paroxysms of inter-
mittent fever is usually absent or but slightly marked. During the
course of the attack, the temperature of the body, which is naturally
98^° Fahrenheit, may rise six or eight degrees, and in ordinary cases
its fall is, as a rule, gradual. The greatest elevation of temperature
corresponds witli the period of rigor. During the sweating stage the
temperature falls again. Should the fall be sudden, a general break-
down of the powers of the patient is indicated. The pulse rate varies,
according to the violence of the attack, from ninety to one hundred
and thirty. The respiration is usually rapid, from forty to fifty a
minute, and in many cases a hay-like odor of the breath is present,
which is considered pathognomonic of the disease. The countenance
is flushed, the skin dusky, sallow, sometimes jaundiced and marked
with sudamina.

The tongue is coated, and there is a complete loss of appetite, and
often nausea and vomiting. The urine is frequently albuminous.
When the brain is involved there will be sleeplessness, or delirium
of a low, muttering kind ; some unconsciousness, from which the
patient can be aroused only to relapse.

Intense pain usually attends the secondary complications, though
it is sometimes remarkable how slight the symptoms often are when
severe local disease exists.

The wound becomes sauious, serous, and fetid ; sometimes the
secretions are arrested and the surface becomes dry and glazed;
sometimes absolute sloughing occurs. Union, if progressing, will
become disunion, and all reparative action ceases. As the disease
progresses, the symptoms become profoundly typhoidal, and the
patient may die comatose or from exhaustion.

The exciting causes of pyaemia are very obscure. It attacks the
healthy as well as the feeble, those surrounded by perfect hygienic
influences as well as those who are exposed to deleterious influences.
It is found not only in hospitals but in private practice; but it is

l-l:: ^

M -H)

530

SURGICAL DISEASES.

more prevalent in unhealthy places, in the overcrowded wards, and
in those spots where ventilation and drainage is bad. It lurks among
the poorly housed and poorly fed and clad, and wherever those in-
fluences exist which are depressing to the vital powers.

The general treatment in these cases is of paramount importance.
It is the duty of the surgeon to see that the patient's room is well
ventilated, and that it ii5 frequently purified by cleansing and tUsin-
fectants.

Tlie wound is to be kept clean and well -drained.
The dressings should be changed as often as four times a day, and
saturated with disinfectant lotions.

When sloughing exists the charcoal poultice should be applied, and
every measure pursued which will insure the utmost cleanliness of
the patient and his surroundings.

The curative treatment is to be conducted on the same principles
which guide the surgeon in the management of all cases of atyphoid-
al character.

The bowels if constipated are to be opened hy a gentle laxative,
and the different secretory organs restored to a healthy action as far
as possible.

The vital energies of the patient are to be maintained or stimu-
lated, and everything that tends to lower them must be warded off.
Quinine is the most valuable remedy we have for the treatment of
pyaemia. Some su'geons give it in large doses and speak highly of
its effects. It is valuable in doses of four or five grains every three
or four hours. It may be combined with iron advantageously in
some cases. Tl ^lest combination is with the citrate of iron. Four
grains of each are lo be given four or five times a day.

Stimulants are also of great importance to maintain the powers of
life. In some cases it is necessary to employ them freely to keep up
the waning strength.

The diet should be as nutritious as the patient's assimilative powers
will bear. Milk and the animal broths are the best.

When the stomach rejects nourishment it must be given by the
rectum, enema of beef-tea and milk with brandy being administered
every four houre.

When the nervous system is disturbed by pain and want of rest
and sleep, some of the forms of opiates or anodynes are to be given,
small doses frequently repeated being better than large.

Should diarrhoea exist it is to be kept under control. It should
not be checked suddenly, as it appears to have an eliminative ten-
dency in cases of blood-poison.

Carbonate of ammonia in ten-grain doses five or six times a day
is a valuable remedy when other tonics cannot be tolerated.

When secondary 'abscesses fonn, they should be opened and kept
cleansed by some disinfectant fluid, such as carbolic acid or the solu-
tion of the chlorinate of soda, in their proper strength.

irhV''lirtitii(iiViirf"i''lr '

wded wards, and
It lurks among
lerever those in-
ers.

aunt importance,
snt's room is well
insing and tlisin-

times a day, and

Id be applied, and
)st cleanliness of

e same principles
iases of a typhoid-

a gentle laxative,
Ithy action as far

atained or stimu-
)t be warded off.
[" the treatment of
i speak highly of
rrains every three
.dvantageously in
ite of iron. Four
lay.

;ain the powers of
freely to keep up

ssimilative powers

; be given by the

eing administered

and want of rest
38 are to be given,
large.

ontrol. It should
n eliminative ten-

r six times a day
tolerated,
opened and kept
c acid or the solu-
igth.

SURGICAL DISEASES. 581

Ulcerations and Ulcers.

When the small particles composing tlie body have been used
a while, they wear out, and become useless. Over the whole body
are distributed a multitude of small vessels, called absorbents, whose
business it is to pick up these worn and loosened particles, aiid carry
them away.

There is another class of small vessels, having just the opposite
duty, — namely, to bring new particles of matter, and put in the
places of those taken away. These are arteries. They are the natu-
ral artisans, who construct oar bodies. The absorbents ara the
demolishers who pull them down. Under these two forces, our
existence is, for a time, a drawn game between life and death. The
absorbents, like myriads of hungry insects, eat us up, — the con-
structing arteries, like faithful builders, reconstruct us. The work
of the absorbents, is called absorption ; that of the constructing arte-
ries nutrition.

When nutrition partially ceases, and absorption continues una-
bated, we grow thin, or lose flesh. This happens in consumption.
If nutrition should stop altogether, absorption going on sii* usual, our
bodies would be quickly destroyed. We should be wholly devoured
by these little absorbent vessels. This would be ulceration applied to
the whole body. But it does not appear in so gensral a form. It
confines itself to particular parts.

When nutrition entirely ceases in any portion of the body, the
absorbents devour all the skin, flesh, and vessels of the part, — leaving
an open cavity. The process of taking away the flesh, etc., is ulcer-
ation, — the cavity left is an ulcer or sore.

Natural Surgery. — Ulceration sometimes acts the part of a nat-
ural surgeon. When a part dies from mortification, it is necessary
to have it removed ; so nature sets up, directly around it, an acute
inflammation, in which all nutrition stops, and absorption goes on
rapidly. In this way, a complete dike is in a short time made around
the dead mass, and it is as handsomely amputated, or cut off, as any
surgeon could do it.

When the ulceration is going on, and the blood-vessels are b3ing
cut off by it, the blood coagulates or curdles in them for a short
distance back from the breach, which prevents bleeding. This is as
good as tying the arteries.

Some textures ulcerate more easily than others, — the skin and
mucous membranes most easily of all.

Ulcers are divided into healthy., unhealthy, and specific.

A Healthy ulcer i.s a simple sore, not showing any bad symptoms,
but rather a kindly disposition to heal. It is generally small in size,
of a florid-red color, and has upon its surface little elevations, pointed

532 SUKGICAL DISEASES.

like cones, i;iille<l (franulations, vvliioh are not so apt as in the ciuto of
unhealthy ulcers, to rise above the level of the surrounding skin.

Unhealthy Ulcers comprise those called irritable, indolent, pha-
gedenic, etc.

Indolent Ulcers are m iierous. The edges of the skin around
them are generally thick, prominent, and rounded. The granulatioiiH
are pale, smooth, large, and flabby, with a peculiar gloss upon tliem.
These ulcers form most often on the leg ; and the nearer they are to
the ankle, the harder they are to cure.

Phagedenic Ulcers are those which look as thcagh they literally
eat away the parts. Their surface has a livid appearance. The
matter formed is small in quantity, and is frequently tinged with
blood.

Specific Ulcers embrace scrofulous, cancerous, venereal, scarhutic,
and others. They are called specific because they are produced by
particular diseases and states of the system. ,

Treatment. — The first thing to be done is to remove the exciting
cause. A venereal, or a scrofulous, or a scorbutic ulcer, cannot be
cured, unless we first lessen the force of the disease in the general
system. If the continuance of a sore depends on bad digestion, we
cannot expect to cure it till we put the stomach right.

Healthy ulcers need no treatment, except some simple dressing,
such as oxide of zinc ointment. It is well, in some cases, to touch
the granulations near the surface with lunar caustic.

Ulcers upon the legs and ankles do not heal well if the patient
walks about much, or even allows the legs to hang down a great
deal. The patient must be put to bed and the leg bandaged, especially
if the ulcers are the result of the breaking down of varicose veins,
which are so common a cause of leg-ulcers.

Indolent ulcers are to be touched by lunar caustic, or by diluted
nitric acid. The diluted ointment of the nitrate of mercury is also
often used with benefit. So is the compound tincture of benzoin, the
basilicon ointment, etc. Or, apply a bread-and-milk poultice to the
ulcer, and keep the patient twenty-four hours in bed. Then apply
the lunar caustic to the whole sore, and to the skin around it. After-
wards cover the ulcer with sticking plaster, and a bandage.

The following is the best plan. Lay upon the sore a number of
pieces of lint, soaked in the nitric-acid lotion (314), xand cover them
with a bread-and-milk poultice. Change these applications twice a
day, and continue them till the discharge looks healthy, and the gran-
ulations begin to appear.

If there is inflammation about tlie sore, give some of the prepara-
tions of salts to purge the bowels, and confine the patient to bed.
When the parts begin to look healthy, lay some pieces of lint upon
the sore, wet with nitric-acid lotion (214), or zinc lotion (216); and

SUUGICAL DISEASES.

533

as in the ciwi- of
ounding skin.

W«, indolent, phor

the skin around
The granulatioiiH
gloss upon tlieni.
learer they are to

agh they Uterally
ippearance. The
sntly tinged with

wnereal, scorbutic,
are produced by

move the exciting

ulcer, cannot be

le in the general

bad digestion, we

:ht.

simple drcvssing,
e cases, to touch

■»
.>•

ell if the patient
ing down a great
idaged, especially
of varicose veins,

itic, or by diluted
if mercury is also
ire of benzoin, the
k poultice to the
)ed. Then apply
iround it. After-
jandage.

ore a number of
, xand cover them
ilications twice a
thy, and the gran-

e of the prepara-
i patient to bed.
ices of lint upon
otion (215); and

then apply strips of adhesive plaster, one and one-half inches wide,
two-thirds round tlie limb, and extending an inch below the ulcer
and an inch above it, — at the same time drawing the edges of the
sore together with a gentle fonu;, and retaining them there with the
plaster. Put a compress of soft linen over tlie plaster, and ai)ply a
bandage over the whole, making it tighter below and a iittle looser
above, and extending to tlie knee. {Vig, 164.)

Surgeons frequently snip out little pieces of healthy skin from
some adjacent part and graft onto the ulcer, thus shortening the pro-
cess of healing. A dressing of bovinine and water in equal parts
hastens the growth of the flesh part. Whenever the fleslx is even
with the skin it should be kept at this level by some mild caustic, as
stated above. Then comes the time for transplanting skin. The
varicosities of the veins must be cured, or at least improved before
the ulcera will remain healed. Avoid the use of pork or lard.

Boils. — Ferunculus.

Underneath the skin is a layer of tissue composed chiefly of cells.
From this tissue there are small elevations, in the shape of cones,
which rise up into the substance of the true skin. Like those papillae
of the skin which become inflamed and produce copis, these eleva-
tions are subject to an inflammation, which causes boils.

At first, a tender knot or hardness is felt just under the skin, which
soon begins to look red. A painful tumor now begins to show itself,
of a dusky red or purple color, which acquires the size of a pea, a
hazel-nut or a walnut. Some time between the fourth and eighth
day it becomes pointed and white at the top, when the scarf-skin
gives way, and lets out a" little pus mixed with blood, and exposes to
view a mass of dead matter, called a core, which is too large for the
opening, and is not ready to come away, if it were not. This core is
a mass of mortified or dead flesh ; and nature is cutting a space
around it, that it may be thrown off. In two or three more days, it
comes away, leaving a cup-like cavity, which gradually fills up, and
the boil is over.

Some constitutions yield boils in successive crops. When this hap-
pens they are a terrible affliction. There are not many Jobs who can
bear them with patience. »

534 BURGIOAL DISEASES.

Treatment. — A boil will generally run its course. A five-priiin
blue-pill, tiikim at bed-time, wliun tbe boil is (irHt .sbowiiig itHoit', is
about the only tbing I know tbat will bliust it. And yet, my unwil-
lingness to encourage a general use of mercurials makes me iiesitile
to rev'ommend it. One pill, not to be repeated, can do no harm, how-
ever, and may safely be tsiken.

Boils may sonietimes be stopped by touching them with lunar
caustic. Water-tlressing, if used early, and persevered in, will some-
times prevent their growing larger than a pea. After the boil luus
oi)ened, apply poultices for a day or two, then some simple, stimula-
ting ointment, as Ixisilicon salve, or Turner's cerate, or nitric acid
lotion (814). If boils continue to come out in successive crops, give
alterative medicines, or sulphurous mineral waters, or liquor potassas
or bicarbonate of soda. General tonic treatment, with iron, quinine,
etc., is usually required (65), (75). A cupful of Indian meal soaked
in a quart of water for four hours, and the water drunk freely, will
often stop a boil if taken when it firat starts, and if continued will
prevent their returning. I would advise its trial, as it is often suc-
cessful.

Carbuncle. — Anthrax.

This is like a boil, only much larger and more painful. Instead
of one of the little cellular elevations being inflamed, as in the case
of the boil, the carbuncle begins with the inflammation of several.
Its surface is more flat than that of a boil ; its inflammation more
violent; and the constitutional symptoms excited more severe. It
has the breadth, sometimes, of the top of a quart bowl. Like the
boil, it appears most often upon the neck, the shoulders, the back, the
buttocks, the thighs, etc. It goes through the same process as a boil,
and ends in the same way, only discharging a vastly larger core.

Carbuncles most often appear in persons above middle age, and
indicate an impaired and broken constitution. They occasion great
suffering, and sometimes prove fatal. Upon the head or neck, they
are more dangerous than in other situations. They are now con-
sidered to be of bacterial origin.

Treatment. — Apply, constantly, during the formation of the car-
buncle, either fomentations and poultices, or cold-water dressing. I
prefer the latter. To stop both the local and the constitutional dis-
order, make two incisions in the form of a cross, cutting entirely
through the dead mass. Then apply a fermenting poultice, or one of
oatmeal, for two or three days, after which use the basilicon salve, or
apply daily a weak solution of lunar caustic, or the nitric-acid lotion
(314). During recovery, tonics are useful, such as quinine, tincture
of Peruvian bark, and sulphuric acid ; and morphine to procure rest,
at every stage when it is required. A piece of caustic potash the
size of a pea, dropped into the middle of the cross-cut, hastens the
suppumtion and subsequent healing of the wound.

BBilNBMiW ^MI Iil l I . mmrvn'WKmn mMaietism'tJ^ti ii W <i H i nmjJl^jfl|jaiJ

c. A five-pniin
lowing itHolf, is
I yet, my uiiwil-
ikes mo iicsitjvto
o no harm, liow-

lem with lunar
id in, will 801110-
ter tlw boil luus
simple, stimiilii-
i, or nitric m'ul
ssive crops, give
• liquor potassa),
th iron, quinine,
ian meal soaked
•unk freely, will
' continued will
9 it is often sue-

ainful. Instead
, as in the ciise
tion of several,
ammation more
lore severe. It
)owl. Like the
IS, the back, the
»roces8 as a boil,
larger core,
[niddle age, and
r occasion great
i or neck, they
sy are now con-
ation of the car-
ter dressing. I
nstitutional dis-
autting entirely
lultice, or one of
isilicon salve, or
litric-acid lotion
[uinine, tincture
to procure rest,
istic potash the
cut, hastens the

SURGICAL DISEASES. 635

Malignant Pustule.

Tnia is one of the five diseases which man may take from animals.
The other four are the <;ow-pox, hydrophobia, (flandera, and vmlignant
carbuncle. This hist is what the French call nharbon, — pronounced
gharbo. My own mother and an elder brother came nb.>r losing their
lives by it, — having taken it by handling the flesh and tallow of a
dead cow.

Malignant pustule begins with a water-pimple, not bigger than a
millet seed. Underneath it is a hard point, surrounded with redness,
hke a flea-bite. This hardneas is soon attacked by mortification,
which spreads on all sides, and kills everything as it goes. Next, in
fatal eases, come great restlessness, faintings, sunken countenance,
dry skin, dry brown tongue, despondency, delirium, and death. It is
su[)i)08ed generally not to arise from constitutional causes, but to be
produced by a specific poison or bacterium applied to the skin, or by
eating the flesh of cattle which die of gangrenous diseases. The dit
order is probably the same as the malignant carbuncle.

Treatment. — Deep incisions, and the application of the most pow-
erful caustics, as the caustic potash, etc., and tincture of peruvian
hark, quinine, aromatic sulphuric acid, wine, ether and opium. Prob-
ably the best treatment is to surround the pustule with a thick layer
of ointment ; then to fasten mme lint to the end of a stick, wet it
with nitric acid, and press it upon the pustule. Now apply cloths,
wet with cold water, and when the slough comes off, dress with sim-
ple ointment, or touch occasionally with weak solution of nitrate of
silver (211). When once opened it should be thoroughly irrigated
with disinfectants like corrosive sublimate, in strength of 1 part to
2000 solution.

Chemical Injuries.

These are of two kinds, produced by causes of an exactly opposite
nature. The flret are

Burns and Scalds.

A bum is the effect of concentrated heat acting upon living tissues.
The effects are inflammation, and sometimes complete disorganization
and destruction of the parts.

A scald is an injury produced by applying hot water or other flui .1,
to the skin or mucous membrane. The natural temperature of the
human body is ninetj^-eight degrees ; that of boiling water, two hun-
dred and tv/elve degrees. Bringing the skin in contact with a fluid
heated so far above it, produces redness and pain ; and when nothing
is done instantly to ward off the injury, the scarf-skin is raised from
the true skin in the form of a blister, filled with water.

-'-«^5(51gS^

■^■tt

586

SUKQICAL DISEASES.

The degree of danger from a burn or Hcald (htpcnds upon tlio ex-
tent oi the injured Hurfaee, and also u])on the depth ol the injury, aw
extensive scahl or hum may prove fatal in a few hours, — the padini
never i-allying from the first prostration. These injuries are most
dangerous when upon the head, neck, chest and belly. Old persons,
and those who are feeble and have shattered constitutions, will sink
under burns and scalds from which robust pereons will suft'er but
little.

Treatment. — For slight burns and scalds, make cold applications.
Put the injured part in very cold water, or lay upon it piecies of linen,
or lint, wet with vinegar and water, or rose-water and sugar of lead
(288), or diluted solution of acetate of ammonia. When these are
not to ])e quickly had, lay on scraped raw potatoes, which is one of
the best remedies to give immediate relief. The object is to reduce
the inflammation, and to prevent blistering. They must, therefore
be put on very soon. If the scald be extensive, and on the body,—
producing shivering, faintness, paleness and coldness of the skin,
and a small j)ulse, — cold applications are not propor. In such case
we may use warm fomentations, or, in the case of a child, the warm
bath. A liniment of spirits of turpentine, linseed oil, etc. (194),
makes an excellent application. Also (371).

Raw cotton, spread out thin, and laid upon a burn, is a good dress^
ing, and one which is much used. So is flour sprinkled upon the in-
jured surface with a dredger. For loosening the flour when it is to
be taken off, poultices are useful.

Keep the air from the wound as much as possible. With this
view, do not remove the dressing often, and when a cold lotion is
used, merely pour it upon the rags, letting them remain undisturl)ed.
Stimidate and narcotize the patient if exhausted by the shock of the
burn. Nothing is more generally used than carron oil, which is com-
posed of equal parts of linseed oil and lime-water. It soothes, heals
and promotes granulation.

Effects of Cold.— Frost-Blte.

Cold is a relative term. The same temperature may be called hot
or cold, according as it is compared with a hotter or colder tempera-
ture. If we warm one hand by a fire, while we lay the other upon
ice, and then plunge them both into cold water, the water will feel
cold to the one which has been by the fire, and warm to the one taken
from the ice.

The warmth of the body being ninety-eight degrees, any tempera-
ture below this may be said, in a certain sense, to be cold. Yet a
temperature much lower than this, namely, from sixty to seventy, is
the most agreeable and invigorating, because it takes away the heat
just about as fast as it is produced in a healthy body.

The first effect of cold applied to the body is to weaken the circu-

■MMMta

WMMIIIMM

^^^

SURniCAL PISEASKB.

687

lends upon the ex-
of tho injury. .An
DUrH, — the piiliiiiL
injuries uro iiuxst
tUy. Old persons,
titutions, will sink
ins will suffer Imt

) eold applications.
I it pieces of linen,

aiul sugar of lend
When these are
9, which is oiu) of
object is to reduce
ley must, therefore
md on the body, —
Iness of the skin,
por. In such case

a child, the warm
ed oil, etc. (194),

rn, is a good dress^
nkled upon the in-
flour when it is to

(ssible. With this
n a cold lotion is
smain undisturlwd.
)y the shock of the
1 oil, which is com-
It soothes, beak

ite.

may be called hot
or colder tenipera-

ly the other upon
the water will feel
m to the one taken

yrees, any tempera-
lO be cold. Yet a
uxty to seventy, is
akes away the beat
)dy.
weaken the circu-

lation in the small l)lood-ves8el8 of the skin. When applied with
Hoino intctnsity, tlu; Ix^art and arteries in general an; weakened; .'.le
Iddod is delayed in tlio vessels near tlie Hiirface, and not In-in^L,' changed
to a red color in the lungs tis ftust us it should be, the lingei's, cans,
etc., l)ccomu blue or livid; and, if the cold Ih) continued sufficiently
long, the circulation stops in these parts ; heiit ceases to In; evolved,
and inortiiication or death is the consequence. Parts killed in this
way are said to he froat-bitteii.

A free circulation of red blood is essential to tlie continuance of
sen.sibility. Hence, when the circulation is seriously impeded by cold,
the body becomes nuniV), — it loses its feeling; the muscles act feebly;
a languor and torpor follows ; drowsiness comes on, followed by sleep,
from which there is no waking. Drowsiness, during exposure to ex-
treme cold, indicates great danger.

Treatment* — It is a great principle in restoring frost-bitten parts,
and pei-sons benumbed with cold, to coninmnieate heat in the most
gradual manner. It has been said that the degree of external heat
should be in proportion to the quantity of life. When life is
weakened and nearly destroyed by frost, therefore, the warmth must
he small, and rise no faster than life returns.

To rectore a frozen limb or part, rub it with snow, or place it in
cold water for some time. When feeling begins to return, still keep
it in cold water and let heat be added in a very gradual manner, by
pouring in, now and then, a very small quantity of warm water.

If a person be nduced by cold to insensibility, and apparently
frozen to death, take his clothes off, and cover him all over with snow,
except the mouth and nostrils. If snow is not to be had, put him in
water as cold as ice, and let him lie for some minutes. Then rub
him with cloths wet with cold water. When the body is thus thawed
by degrees, and the muscles begin to relax, dry the body, and placing
it in a cold bed, rub with the warm hands, only under the clotlies.
Continue this for houra. If signs of life appear, give a small injec-
tion of camphor and water, and put a drop of spirits of camphor on
the tongue. After a time, rub with spirit and water, and finally
with spii'it, and give tea, or coffee, or brandy and water,

Chilblains.

These are caused by exposure to cold, and affect the fingers, toes,
and particularly the heels, with a painful inflammatory swelling, of
a red, purple, or bluish color. The skin may be red in patches, and
slightly swelled, with itching, tingling, pain, and lameness ; or there
may be blisters, around which the skin is blue or purple ; or, worse
yet, there may be ulceration and sloughing.

Treatment- — Stimulating Imiments are the remedies usually em-
ployed for this complaint. One of the best consists of six parts of

wmd

538

BUKOIOAL DIHRASKH.

floiip linimont, aiul ono piirt of tin.-turo of SpimiHh (Hch ; im»l iiiiollicr
excellent one is prescription J107. If tlioro is ulceration, use Tuiiht's
cerate, or the resin ointment.

Mechanical Injuries.

WouNns are divided into several kinds.

Incised Wounds are very common. Heing made with sharp in-
struments, they are cuts, and have no laceration or tearing about
them.

5tabs, or Punctured Wounds, form another class. They are made
with pointed weapons, as bayonets, lances, swords, and daj^gurs.
They are more dangerous than the former, because they penetrate
to a greater deptli, — injuring blood-vessels, nerves, bowels, and
other organs.

Contused and Lacerated Wounds form still another class. They
embrace gun-shot wounds, and all those produced hy blunt instru-
ments. They tear, and brui»e, and maiih the flesh.

Poisoned Wound* form yet another class. They are such as are
united with the introduction of some venomous p(>ison into tlie in-
cised, or punctured, or contused part. Stings and bites of venomous
insects and snakes are of this class, — also the wounds made hy
poisoned arrows.

Simple Wounds are such as are inflicted on a healthy subject with
a clean, sharp instrument.

Complicated Wounds are those inflicted when the state of the
whole system, or of the wounded part, is such as to make it neces-
sary for the surgeon to deviate from the treatment needed for a sim-
ple wound, — as, for example, when there is bleeding, or nervous
symptoms, or great pain, or locked-jaw, or much contusion, or ery-
sipelas.

Lacerated wounds are more dangerous than ircised ones, because
the parts are stretched and otherwise injured, besides being separated.

A very small wound upon the brain, the spinal marrow, the bowels,
or the heart, will often prove fatal, because the functions of these
parts are intimately connected with life.

Woundb of young persons heal much more rapidly and kindly than
those of old persons.

Septic Wounds.

Whenever a surface has been cut, lacerated, or in any way in-
jured, so that the surface can absorb germ-life from the instrument
inflicting the wound, from the dressings used to cover it up, or from
the diit of the skin itself, we are very apt to get in a few days what
used to be known as sympathetic fever, but which is no more or less

mum

;>H ; iiikI iiiintlicr
■»ti, iiKo Tuiiht's

with Hhar{) iii-
r tearing about

They aro inadt!
1, and daj^gors.
I they penetrate
BB, bowels, and

SUROICAL niBEABRS.

539

than the neptic fever, or the HyHteniio nianifefltation of gorm ubtiorp-
tion. Fever, Iohh of appetit(% hoadache, Hwelling and tunderneHH of
tlio wound, witli perhaps pu« formation, are the natural outcome of
Huch abHorption. Hence it will readily ho seen frotn what has Iwen
previously said alxiut nrpsis, that the lirst indication in all cuts is to
disinfect the area injured witli some one of the germicidal solutioiLs.
None is cheaper than (iorrosive snhlimato in the strength of one part
to two thousand. This, in many cases, is all that need l)o done. If
the cut is to he sewn up, the wound is fust cleaned with corrosive
sublimate or oil of milk solution (a half-teaspoonful to one quart of
water), and then sewn with needle ami thread that iiave been boiled
live minutes. The dressingii or bandage should be disinfecttid with
..jeam before being applied. Druggists nowadays keep in stock I'-sep-
U'^ gauze meant for precisely this class of cases, lacerated wounds, etc.

J ■

ler class. They
)y blunt instru-

■ are such as are
ison into the iii-
tes of venomous
ounds made by

thy subject with

he state of the
a make it neces-
Beded for a sim-
ing, or nervous
antusion, or ery-

ed ones, because
being separated,
row, the bowels,
nctions of these

and kindly than

• in any way m-
1 the instrument
er it up, or from
a few days what
I no more or less

Incised Wounds.

V/hen the flesh is divided with a cutting instrument, the cut edges
separate, and the wound has a gaping a})pearance. This drawing
apart happens in consequence of the elasticity of the skin. It often
happens that vessels of considerable size are cut, so that bleeding is
the principal thing to receive attention.

Treatment of Hemorrhage. — Bleeding is stopped by the tourniquet,
by the ligature, by compression, by the application of cold water and
ice, and by astringents and styptics.

The Tour ^uet. — This instrument consists of a bjind and buckle,
a pad and two brass frames, the
upper of which is furnished with
two small rollers, and the lower
with four, over all of which the
band plays. When the handle is
turned to the right or left, the
band is tightened or relaxed to
just the extent required. (Fig.
155.) The band is buckled round
the limb in such a manner that
the pad is placed exactly over the
artery. When an artery is cut, it
is known by the blood being very
rerf, and spirting out in jets; and
in this case, the instrument must
l)e placed upon the limb above the
wound, or between it and the
heart. *"'o- »»•

The Ligature. — When an artery is divided, the surgeon lays hold
of the end of it with his forceps, and ties a thread tight around it, or

K %

540

SURGICAL DISEASES.

twists the end of the artery. This is called a ligature. By it, tlio
bleeding is instantly stopped, and long before the thread becomes
loose, the opposite sides of the vessel have grown together, and all
danger of a renewal of the bleeding is over. In all these procedures
the careful surgeon uses only disinfected instruments and ligatures.

Application of Water and Ice. — This is done by saturating witli
cold water several folds of linen rags, or lint pads, and applying them
to the wound, remoistening, and reapplying them as fast as they be-
come hot, till the pain and inflammation subside.

Compression. — When the blood does not come from any large
vessel, but from several small ones, compression is sufiicient. It con-
sists in placing the opposite sides of the wound together, if possible,
and then laying compresses over, and applying a bandage with mod-
erate tightness.

Astringents and Styptics. — These are spirits, tinctures of myrrh,
Peruvian bark, diluted mineral acids, solutions of tannin, alum, sul-
phate of copper, decoctions of white-oak bark, etc. These have the
po ^er to stop bleeding from small vessels. Monsel's salt is soid to
have more power than all the above. It is a preparation of iron and
nitric acid, and has been used with great success in stopping violent
bleeding. It is not a caustic or an irritant ; but it acts very power-
fully upon albumen and blood, — producing with the latter a large
clot, absolutely insoluble, which continues to enlarge for several houre
after the application, and becomes quite hard and firm, so that no
blood can get through ; but it leaves the wound filled with clots
which afterward decompose and often give rise to blood-poisoning.
The compress wrung out of some antiseptic solution is always the
best method when practical.

Beside these means, the application of the lunar caustic, potash, and
the hot iron, are used, particularly the first, quite often.

Union by the First Intention.

When the bleeding is stopped, all foreign substances removed, and
the wound properly cleansed, the next thing is to bring the opposite
sides c f the cut evenly together, and to keep them steadily in this
position till they have healed. If this method succeeds, the healing
takes place without the formation of any pus. This is called healini/
by the first intention, or adhesion. The cut surfaces grow together.
For keeping the surfaces together, straps of adhesive plaster are used,
putting them at right angles across the cut, and leaving spaces be-
tween them.

Sutures. — Incised wounds are sometimes seived together by what
is called the interrupted suture. After the bleeding is stopped, a
a curved needle is threaded, and, the liijs of the wound being brought
together, is introduced through ' "le right lip, and then, being directed

■v i« « ii r lw niaiWW>wwKi

mmm

i^-l*V^ ^ — —

•TOKWfJgiBliiV

ure. By it, tlio
thread becomes
)gether, and all
hese procedures
I and ligatures.

saturating witii

1 applying them

fast as they he-

from any large
ficient. It con-
ther, if possible,
dage with mod-

ctures of myrrh,
nnin, alum, sul-
These have the
i salt is soid to
ition of iron and
itopping violent
lets very power-
e latter a large
or several houre
irm, so that no
illed with clots
blood-poisoning.
1 is always the

Stic, potash, and
en.

les removed, and
ing the opposite
steadily in this
eds, the healing
is called hcalimj
3 grow together.
plaster are used,
ving spaces be-

ogether by what
g is stopped, a
d being brought
1, being directed

SURGICAL DISKASRS.

541

across the wound, ia pushed through the left lip, from within out-
ward. It is now cut off, and tied in a bow. These stitches should
Iw at least an ijich from each other. These needles and sutures are,
of course, to be boiled or otherwise rendered aseptic before using, aa
well an the hands of the one doing the sewing. Needles and thread
come all ready i)ut up in glass tubes, Imving been fii-st sterilized, and
kept in alcohol c in a vacuum for any length of time perfectly germ-
free.

The first ]Ai. ;,ers and dressings should remain on the parts at least
three or four days, unless veiy great pain, bleeding, or some other
bad symptom, should call for their removal.

Useful Rules for Examining and Dressing Wounds.

Neveu givo the patient more pain from the mode of handling and
dressing the wound than is necessary for liis present good or future
safety. Never distress him by probing, squeezing, etc., to find things
diat will Ije of no use when learned.

Make all examinations ns soon after the accident as possible ; for
l)efore inflammation and swelling take place, the prol)e or finger in-
flicts nmch less pain.

In changing the dressing of a wound, let all the fresh ont i be ready
before the removing of the old. The sponge, warm water, adhesive
phisUir, lint, ointment, lotions, bandages, etc., should all be at hand,
and not have to be looked after wlien the wound is exposed.

Put the patient in the most easy position, that he may not l)e
needlessly fatigued during the dressing.

If the bandage, plaster, and other dressings, have become hard, and
glued together, and to the skin, by blood or matter, soften them with
warm boiled water, which is to be pressed out of a sponge, — a basin
being held below the part to catch the water as it falls from the
dressing.

The strips of adhesive plaster are to be removed by pulling gently
at one end, and then che other, — each to be drawn towards the
wound, so as not to pull lus lips apart.

In large wounds, take off one, or at most, two strips of plaster
at a time. Cleanse, wipe dry, and again eupport this part of the
wound with new strips of plaster, before any more are taken off.
Tbis will prevent the wound being torn open by the weight of its
parts.

If the wound be large and deep, its sides should be supported by
an assistant while changing the dressings.

If there are several wounds, dress but one at a time, that there
may be no needless exposure to the air.

Pay the utmost attention to cleanliness, asepsis and dryness.

T);a frequency of the dressing must depend (ju the amount and
qi'^.uty of the disclutrge, the situation of the injury, the climate and

i ,t i i> w pi . i i ff ji^i i iii a (t» J i

542

SUKGICAL DISEASES.

season of the year, the effect produced by the dressing, and hy the
feelings of the patient-
Remember that the one great desideratum is to keep away all
germs from the wound and its vicinity.

Antiseptic Dressings.

Antiseptics have lately attracted a great deal of notice in the
treatment of inflammation, especially resulting from wounds.

The article most used at the present time for this purpose is car-
bolic acid. Lister is its chief advocate, and under his authority it
has established a position which deserves attention.

It is based upon the germ-theory of disease, which is founded
upon the observations of Pasteur. The theory supposes that animal
decomposition is due, not to the chemical action of oxygen, or any
other gas, but to the presence of organic germs floating in the atmos-
phere. Carbolic acid is used on account of its known destructive
effects upon low forms of organic life.

These low forms of vegetable organisms, which float in the air in
great abundance as constituents of the dust, are called by naturalists
bacteria, of which there are many varieties. Whenever they find
entrance into the body, there putrefaction is produced. "

These vegetable parasites are capable of a wonderful power of
multiplying their species, — a single germ producing in a few hours
many thour-nds. Once admitted into the body, they find their way
everywhere, — into the muscles, into the blood, into the different
organs of the body, — and they spread destructive fermentation and
putrefaction wherever they go.

In accidental wounds, it is fir»t necessary to kill any septic organ-
isms which may have been introduced from the air or from contact
with foreign bodies. We do this by thoroughly bathing the surfaces
with a solution of carbolic acid, of the strength of one part of the acid
to twenty of water.

When the wounds are made by the surgeon, the germs are de-
stroyed by means of a spray imbued with the acid. This spray is
produced by an atomizer, of which there are many kinds, and is
thrown continually on to the surface of the wound, until the comple-
tion of the operation, including the ligaturing of the vessels and the
final stitching together of its edges.

Lister also recommends the use of carbolized catgut for ligatures,
being of an animal substance and finally absorbed.

When the operation is fully completed, the antiseptic dressings
are applied. Besides these antiseptic precautions, in cases of large
and deep wounds a drainage tube is introduced to allow for the
escape of the serum.

The antiseptic dressings consist of — first, the protector ; second,
the cai'bolized gauze ; third, tlie mackintosh ; and fourth, another

SURGICAL DISEASES

543

jssing, iuul l)y the
to keep away all

il of notice in the
m wounds,
lis purpose is car-
er his authority it
1.

Avhich is founded
pposes that animal
of oxygen, or any
ating in the atmos-
known destructive

I float in the air in
ailed by naturalists
i/'henever they find
uced.'

'onderful power of
cing in a few hours
they find their way
, into the different
e fermentation and

II any septic organ-
lir or from contact
lathing the surfaces
one part of the acid

the germs are de-
Lcid. This spray is
nany kinds, and is
d, until the comple-

the vessels and the

catgut for ligatures,

antiseptic dressings
IS, in cases of large
id to allow for the

protector; second,
iud fourth, another

layer of the gauze, and a bandage of tlie same to keep the whole in
place. For the purpose of protecting the cicatrizing parts from the
irritating effects of the gauze, a layer of oil-silk coated on both sides
with copal varnish, and afterwards brushed over with dextrine, to
eniihle it to become uniformly moistened when dipped into a watery
solution of the acid, is applied directly over the wound, the ends of
the drainage tube protruding about an inch from each extr»'mity of
the incision. The wound is then covered with a layer of ar.tiscptic
gaiixe dipped into a solution of one to forty of the acid. There are
then snperimposed six other layers of dry gauze ; then the mackin-
tosh or a piece of rubber cloth ; then an eighth layer of gauze large
enough to cover i ' the remainder, and finally a bandage of the
same.

When the dressings are renewed, it is to be done under the spray,
great care being taken not to admit any non-carbolized air.

The dressings are not to be changed until the discharge has begun
to soak through and appear below the edge of the rul)l)er cloth.

Tlie antiseptic gauze is made by impregnating cotton doth of open
texture with a mixture of carbolic acid one part, resin five parts,
paraffine seven i>arts. The resin acts as a vehicle for the acid, while
the paraffine is added to prevent inconvenient adhesiveness.

The Way in which Wounds Unite.

When the two surfaces of a wound are brought togethei", they be-
come impervious to the blood, but not to coagulable lymph, or fibrin.
Tliis, — the material of which all flesh is made, — flows out upon the
two surfaces, and becomes a bond of union between them.

Into this layer of fibrin, the small blood-vessels, — arteries and veins,
— which have been cut asunder, push themselves with open mouths,
and, meeting in the centre, they inosculate, or grow together, and the
blood resumes its circulation through them.

By this method, incised wounds of moderate size are often healed
in foity-eight hours. This method of healing by the f rst intention is
always to be brought about, if possible.

Punctured Wounds.

These are produced by swords, daggers, etc.

Great swelling and inflammation, large abscesses, erysipelas, the
wounding of large arteries, and the consequent extravasation of blood,
symptomatic fever, and lock-jaw, are the frequent results of punctured
wounds. They are, therefore, more dangerous and hard to cure than
cuts. ,

Treatment. — For the first twenty-four lioui-s, use superficial dress-
ings of lint, wet with some disinfecting liquid, and a loose bandage.
If, after this, pain and swelling should increase, leeches may be ap-

544

SURGICAI. mSEASKS.

plied to the neighborhood of the wound, and fomentations, or poul-
tices, be applied, placing a small linen rag or gauze, that has first been
soaked in the disinfectant, over the wound. When the pain and in-
flammation are great, saline purgatives (7), (18), (25), (27), and
opiates are often called for.

Contused and Lacerated Wounds.

These are produced by cudgels, stones, bullets, or Avhatever else
of a blunt nature tears asunder the muscular fibres, leaving jagged
and uneven surfaces. They are rarely healed without suppuration,
and are frequently followed by violent inflammation. They suppur-
ate and slough, but they do not bleed much, — not even, sometimes,
when large arteries are torn asunder. Whole limbs are occasionally
torn away without hemorrhage. In warm climates, lock-jaw is a fre-
quent consequence of them.

Treatment. — Draw the edges of the wound loosely together, and
retain them with a few strips of adhesive plaster. Sometimes a su-
ture, here and there, will be proper. If a great deal of inflammation
ensues, take away the adhesive plitster and the stitches, and apply a
poultice, or water-dressing ; and if there be much fever, restlessness,
or delirium, saline purgatives (18), (25), and opium (118), will be
needed ; but especially will it be necessary to again disinfect the
wound, and by every means passible render the field aseptic.

The wound having thrown off its sloughs, suppurated, become
clean, and formed granulations, the poultices are to be taken off, and
simple dressings substituted. These should be adapted to the con-
ditions of the sore, according to the directions for treating ulcers.

When the wound is so severe that extensive mortification will be
sure to follow, the limb must be immediately taken off, to save the
life of the patient. . .

Granulation and Scarification.

Suppurating wounds heal in the same way as ulcers. The
chasm is filled up by the appearance of little soft elevations of new
substance, which originate at all points, and meet at the centre, draw-
ing the sides nearer together, and raising the bottom towards the sui-
face This is called granulation, because these elevations look lilce
grains; and the result is a new tissue, of a peculiar character, wbicli
constitutes the cicatrix, on scar.

Reproduction of Lost Parts,

Among some of the lower animals, whole limbs which have been
destroyed are easily reproduced. It is not so with man ; though cer-
tain parts, when only partially destroyed, are sometimes regenerated.
Thus, portions of skin, of considerable extent, are often reproduceU;

iT-i-iitiiiiri '

8UKGICAL DISEASES.

646

sntations, or pnul-
that has first been
I the pain and in-
, (25), (27), and

inds.

, or Avhiitever else
BS, leaving jagged
liout suppuration,
in. They suppur-
; even, sometimes,
)8 are occasionally
1, lock-jaw is a fre-

)8ely together, and
Sometimes a su-
alof inflamination
tches, and apply a
fever, restlessness,
um (118), will be
gain disinfect the
Id aseptic,
ippurated, become
be taken off, and
iapted to the con-
treating ulcers,
ortification will be
sn off, to save the

ion.

r as ulcers. The
elevations of new
it the centre, draw-
m towards the sui-
ilevations look like
ar character, which

ts.

s Avhich have been
\\ man ; though cer-
etimes regenerated.
I often reproduced ;

and so are the whole of some long bones, when destroyed by necrosis.
Tlie same is true, to some extent, of ligaments. But portions of
brain, and spinal marrow, and muscle, and mucous membrane, when
once removed, are never regenerated.

Gunshot Wounds.

At a time when fire-arras are so mucli carried about the person,
and so often used for purposes of duelling and murder, it is proper
that every peraon should know something of the modes of treating
gunshot wounds.

Treatment. — It is often proper to make a gunshot wound larger
at the orifice. When this is done, it is generally on the side where
the bullet has passed out, if it has gone entirely through. A bullet
is always to be removed, if it can be felt.

The dressings are at first to be superficial, light, unirritating and
aseptic. The common antiseptic dressing, covered with a piece of oiled
silk, is one of the best. Where suppuration occurs, because of the
introduction of germs into the wound, poultices may be called for, but
the douching and cleansing of the wound with hot oil of milk solu-
tion is often demanded and always grateful.

Poisoned Wounds.

To the bites and stings of various creatures man is exposed in
most climates, and in all seasons of the year. These may be divided
into three classes.

Bites of Mosquitoes and Spiders, and Stings of Bees and Wasps.

— For these, the best applications are a solution of common salt, or
water of ammonia, or sugar of lead (239), or laudanum, or tincture
of iodine. If none of these are at hand, at the moment, cover the
part with wet earth. Tincture of arnica (240) is a good application.
(See article on Bites, etc.)

Bites of Venomous Snakes. — Either instantly cut out a. piece
from the bitten part, or apply a dry cup, to prevent the absorption of
the poison. Suction with the mouth will sometimes answer the same
I)urpose. After doing one of these things, touch the part with caustic
potash. Internally, give Fowler's solution, twenty drops, in a little
water, every two hours. Also purgative injections, stopping the ar-
senic when purging is well established ; or drink freely of whiskey.

For the bite of the rattlesnake, the only known remedy is alcoholic
drink, taken in large quantities, and immediately. Gin and whiskey
are believed to be the liest. Fill the system full. When the poison
has begun to take effect, enormous quantities will be borne, before
intoxication can be induced. Keep the whole person saturated until
the symptoms decline.

546

8UE0ICAL DISEASES.

Fractures.

The existence of a fracture is to be known by the symptoms.
TWb are DakT swelling, deformity from the limb bending to one
ride 8om tiCXrteni^gof the limb, or loss of power to use it, and
a crS oTiating sound or sensation from the rubbing of the ends
of tKokenW together. There are several kinds of fi^ctures.

They are

The Trav^etM Fracture, which is directly across the bone.

The Oblique Fracture, which runs from side to side, in an oblique
direction.

!Z%e Longitudinal Fracture, which runs lengthwise of the bone.

A Simple Fracture is one in which the bone is broken simply, with-
out any wound of the flesh with it.

A Compound Fracture consists of a simple fracture, and of an ex-
ternal wZnd in addition, caused by pushing the end of the broken
bone through the flesh.

A Complicated Fracture is one in which, besides tiie breaking of the
bone tS is the dislocation of a joint, the wounding of an artery
tre'xtnslve tearing of the soft parte, or the wounding of the bowels
or some other internal organ.

A G<mminuted Fracture is one in which the bone is broken into
several pieces.

Trentment of Fractures. — When a bone is broken, the first thing
toKrrste get t?e injured person to his home, or to the nearest
ho^e T^do this in a riugh or careless way might add much to

*^inf iSTarm which is broken, let it be placed in a broad sUng.
extending from^he elbow to the fingers. In this condition the pa-
tient!l?\i tolerable health, and the distance - -ot g^f ' -^^ ^"^ ''
easier to walk home, than to bear the jolting of a carnage.
^S'^ lag or the thigh he hroien, then a hurdle of s^me^-^rt ( 1 ,,

soon as possible, and, being
covered with straw, or blan-
kets, or garments, the pa-
tient should be gently lifted
FI0.1B6. upon it by just persons

enough to raise him easily from the ground. This shoidd now b
canried bv four persons, two at each end, moving with great gently
ntr and keeping exact step with each other If these persoM
Shold of tL fnds of two poles, laid under the hurdle^ they J^l
find they can carry it much more easily. If no hurdle be at hand,

by the symptoms.
,b bending to one
ower to use it, and
ubbing of the ends
cinds of fractures.

38 the bone,
side, in an oblique

rise of the bone,
roken simply, with-

ture, and of an ex-
end of the broken

i the breaking of the
nding of an artery,
inding of the bowels

bone is broken into

roken, the first thing
me, or to the nearest
might add much to

ed in a broad sling,
lis condition the pa-
lot great, will find it
a carriage.
Ueof some sort (Fig.
must be obtained as
i possible, and, being

with straw, or blan-
r garments, the pa-
lould be gently lifted
it by just persons

This should now be
ag with great gentle-
r. If these persons

the hurdle, they will
hurdle be at hand,

SURGICAL DISEASES.

let four poles, two long ones, and two short ones, be laid across each
other at right angles, and fasten together with nails or strings. Then
lay u})on these an old door, or some loose boards ; and the injured
person may be easily carried upon this temporary structure. A
blanket fastened upon four poles, in the manner of a cot-bed, will
answer a good purpose.

Having placed the patient upon the hand-carriage, bring the sound
limb and the broken one snug together, and tie them to each other
with two or three pocket handkerchiefs ; this will support the broken
limb, and prevent its being shaken about and injured by motion. In
doing this, the limb should be laid as near as possible in the natural
position, so that the bones may not get out of place, and their ends
get pushed through the flesh.

The Reduction, or Setting of the Fracture, is the first thing to be
done. By this is meant the bringing of the ends of the broken bone
together, and adjusting them to each other in their natural position.
This is done by what surgeons call extension, counter-extension and

coaptation.

Extension means taking hold of the limb below the fracture and
pulling from the body.

Counter-Extension is pulling above the fracture towards the body.
These opposite puUings are done at the same time to overcome the
force of the muscles, which contract, and draw the ends of the bone
by each other and shorten the limb.

Sometimes no extension or counter-extension is necessary, the ends
of the broken bone not being pulled out of their place. When the
pulling is necessary, it should be gentle and steady.

Modern surgery has developed two simple mechanical means of
making extension and counter-extension for the purpose of overcom-
ing muscular spasm which rarely fail. One is by the use of elastic
rubber bands, and the other by the attachment to the limb of a cord
running over a pulley at the foot of the bed and sustaining a suitable
weight. The method of employing these will be given in detail in
connection with special fractures.

Coaptation means adjusting the ends of the bone to each other.

The next thing is to provide for keeping the ends of the broken
bone steadily in contact, so that nature may have a fair chance to
unite them.

To secure this object, mechanical contrivances are used, which are
simple, and may always be had without difficulty.

They consist of linen bandages, about the breadth of four fingers,
and from four to ten yards long ; and pads, made of old woollen cloth
or blankets lightly quilted together, or pillow-cases filled with tow, or
chaff, or cut straw, or even leaves ; and of splints, made of clapboards,
or thick shingles, four fingers wide, and in length corresponcUng with

pa NT

548

SURGICAL DISKASKS.

that of the broken limb; or wheat straw laid sidn bysi(l(!, and (inilit-il
into a piece of ch)th to prevent them niovinjif alMiut. A very useful
splint may l)e made from the fresh hark of tree.s.

The pads are to Ikj placed under the splints, to prevent injuries to
the skin; and the bandages to bo bound over the whole.

A great point is to have the splints accunttely adapted in each case,
and the ability to affect this is an important element of success in tliis
branch of surgery. Wood may be generally cut into suitable shape,
but it is perhaps easier to use moulded splints of leather, felt, gutUi-
percha, or shellac cloth. Tlie starched or plaster bandage or guinined
paper may be effectively used ; and with a proper pair of shears,
sheets of tin or zinc may l)e cut into splints, which will answer ad-
mimbly. Woven iron wire splints are highly recommended.

For some hours after a limb is broken, the parts continue to swell,
and if bound up immediately with the pads, splints, etc., niiich
needless pain will be occasioned. It is best, therefore, not to put
these on under two or three days, but merely to lay the limb in a
natural position, and perhaps lightly bind one splint to it. Broken
ribs and collar-bones are exceptions, and should be bound up imme-
diately.

A broken arm lies easiest half bent, upon a pillow ; the thigh or
leg, upon the outside, with the knee bent.

When the apparatus is once adjusted, the less it is meddled with
the better.

In fractures of the shoulder or arm, u sling is a contrivance of great
importance. This, if well made and adjusted, keeps the broken bone
in its place, and at the same time allows the patient to take some
exercise by walking about.

Besides the above contrivances, there is the double inclined plane

FIO. 167.

(Fig. 157) for giving the leg the advantage of a bent position. There
are 2^so fracture-boxes (Fig. \b^)^waA fracture-cradles, — the latter to
keep the bed-clothes lifted away from the painful limb. Fracture-
beds are now brought to great perfection, and one should, if possible,
be procured when the patient is likely to be confined a long time
wiUi a compound fracture. The fracture-box represented by Fig.

SURGICAL DISEASES.

640

Hi(l(!, ami (jiiilii'il
A very usi'fiil

event injuries to
liole.

)ted in each case,
of success in this
to suitable sha[iu,
lather, felt, gutUi-
idage or gunuued
jr pair of shcare,
h will answer ad-
mtnended.
continue to swell,
dints, etc., much
refore, not to put
lay the limb in a
it to it. Broken
) bound up imme-

ow; the thigh or

; is meddled with

)ntrivance of great
)8 the broken bone
ent to take some

uble inclined plane

nt position. There
dies,— the latter to
il limb. Fracture-
should, if possible,
ifined a long time
epresented by Fig.

LIS, may Iw made from thin ImmimIs, l)y any r!arj)Pnter. It 1ms a
Iiirif(i; at the knt-r to enahlo it to i'liilil tlic double purpose ot a dnublu-
inolined plane and a fracture-lnix.

ma. 16M.

The Way in which Broken Bones Unite.

The union of broken bones is much slower than that of severed
flesh. The ends of the bone l)eing kept steadily together, they soon
become surrounded by a swelling of the soft parts, which change to
a sort of osseous substance, making a kind of bony hoop, to act as a
splint or support, — nature not being willing to trust the surgeon to
keep the fragments exactly in their place. This is called a provi-
sional callus, because it only has a temporary use.

This First Stage lasts about ten days. At the end of this time, a
spongy sul)stance appeal's between the ends of the bone. This sub-
stiince is not bone, but in the swelling around the fracture specks of
bone begin to be deposited; the fibrin here poured out becoming
first cartilage, and then receiving into itself phosphate of lime, it be-
comes bone. A similar work is going on within, in the part called
the medullary membrane.

Tliis Second Statue lasts from the tenth to the twenty-fifth day.

Tiien begins the Third Stage, which goes to the end of the sixth
or eighth week. During this period the external swelling, and the
internal medullary membrane, become completely ossified and firm ;
though the ends of the bone are not yet grown together.

Tlie Fourth Stage goes to the end of the fifth or sixth month. Dur-
ing this time, the external swelling, or provisional callus, becomes cov-
ered with a periosteum, and the ends of the Itones themselves are fas-
tened together by a bony union.

The Fifth Stage extends from the fifth or sixth to the twelfth month.
During this time, the ends of the bone become grown together so
strongly that the bony ring, or provisional callus, is no longer Avanted,
and it becomes absorbed, and disappeais ; in other words, having no
further use for it, Nature takes off her splint. The place where the
fracture was is now as strong as any other part.

til

dkMiM*

:.50

ftUROICAL T)IHEA8R8.

Union in Compound Fractures.

Thk wnion of cuinpouiKl friiclurcs taki's pliu'i; in ii (lift'crent way
from that of a siinpli; fracture, jiistdem-riljed. 'IMit* Ix U(!h rotnaiii din-
united Heveral weeks, and tliere m no proviHioiial cal'iUH *^ornied; but
after some weeks tlie eiids of the Inme niiften and </ rami I ate, and tliCHe
granulatiouH are gradually changed into lK)ne.

In notliing have the benefits of antise|Mis been shown so vividly as
in the treatment of compound fractures. Twenty years ago a larji^c
percentage of all compound fractures either suppumted or caused the
death of the patient ; but now suppuration and high mortality are not
seen. The wound is treated exactly like any other wound, on ascptii'
principles, the Ixines being lield in phice as usiuil. Union thus resiiltH
without suppuration, and a cure is completed in one-half the time, with
over fifty per cent less moi-tality than was the case previous to the
introduction of aseptic and antiseptic surgery.

The first thing in event of a compound fmcture is to render the
parts aseptic as soon and lus completely as possible. This may Ik; done
by a thorough scrubbing with tincture green soap and water for live
or ten minutes, and then, after washing off the soap with alcohol, to
thoroughly scrub the skin adjoining the wound with sonie one of the
disinfectants mentioned under the heading of Sei^is and Asepsis ; as,
for instance, corrosive sublimate, one part to two thousand parts of
water. The wound is to be dressed precisely as any wound, and is
to be so arranged that access may be had to it for future dressings.
When skin and flesh are much torn they may be sewn together with
a needle and thread or silk which htvs l)een boiled five minutes. The
stitches are to be removed from the fourth to seventh day. The bones
are to be approximated just as in simple fractures, and splintu
applied.

Formerly the mortality of compound fractures was ve. - high, owing
to the invasion of the tissues by germ-life, but since the introduction of
antiseptic measures in surgery, the death rate has fallen so markedly
as to be a matter of great pride to surgeons and tlie world at large.

In cases where the wound does not allow of good coaptation, and
much mangling of the- tissues has occurre«l, it may be well not to sutine
the parts, but to dress them with some antiseptic gauze drainage, and
do them up like an open wound.

Time Required for Uniting Different Bones.

rRACTTTRKS of the arms unite sooner than those of the legs.

The ribs and collar-bone unite with tolerable firmness in about a
month ; those of the arm in six weeks ; of the thigh and leg in eiglit
weeks. I only mean the firmness derived from the provisional callus.

A broken bone will unite much sooner in a healthy person than in
an unhealthy one ; much sooner in a young than in an old person.

it^m^m

liURniCAL niSRAHR.S.

661

15.

ii (liffovent way
i« lUiH reimiin tlis-
liiH 'orineil ; hut
nulaie, aiitl tlit'HH

iwn so vividly as
ears ayo a larj^c
ted or cauKt'(l the
mortality are not
vound, oil aKcptii'
nioii thiiH results
alf the time, with
previous to tiie

is to render the
This may Ik; done
,nd water for five
) with alcohol, to
li some one of the
1 and Asepsis ; as,
thousand parts of
iiy wound, and is
future dressings,
wn together with
ive minutes. The
hday. The bones
ures, and splints

8 ve.y high, owing
le introduction of

alien so markedly

e world at large.

)d coaptation, and
well not to suture

auze drainage, and

fit Bones.

I of the legs,
mness in about a
;h and leg in eight
provisional callus.
thy person than in
n an old person.

As II goniT.il rule. I he apparatus shou'l 1h' kept on tliiriy days in
the I'iisf of I'liihlnii : forty (hiys in that of adults; and much hnigor
in that of aged pei'sons.

False Joint.

Thk union of a l)rokon Ikiiio is sometimes prevented by a frequent
n\i>ving of the liinh. The ends of tht- lK)ne, having faile(l to grow to-
gether, will sometimes t)econie nmnded and smoothed, uniting only
hy a kind of ligament, and aequire the habit of sliding U[)on each
other, and thus form what is called n false or artijinal joint, — the
limb IxMug permanently cajmble of landing to some extent, at the
place of the fracture.

Fractures of the Skull.

TnF.SE are always dangerous in tiieir nature, and the aid to be de-
rived from surgery is much less than in other fractures. If a fracture
of the skull produce deep sleep and snoring, and the patient does
not show any symptoms of pain when pinched, etc., we are to infer
that a piece of l)one is pressed down upon or into the brain.

In this civse, if the position of the iilow Im known, a cut is to be
made through the skin, two or three inches long, down to tlie bone.
If arteries bleed, they nuiirt Ik? taken liold of with a pair of forceps,
aiui tied with a silk thread, the ends of which are to be cut off. The
hone being well exposed by one or two incisions, the piece which is
l)ressed down upon the brain is to be raised with a clusel, or some
similar instrument, to a level with the other bones. The surface
nmst then be cleansed antiseptically, the hair around shaved off, the
.skin brought together, and the cut edg«;s reunited by sticking plaster.

When the inflammation ajjpeara, twenty-four hours after, it is to be
kept down by doses of from five to ten drops of tincture of vcratrum
viride, given every one or two houra.

Fractures '>f the Bones of the Nose.

In.tukies of this kind may generally be rectified by passing a strong
prol)e up the nostril, and pressing out the bones to their natural place,
at the same time using the fingei-s on the outside to prevent their
being pressed out too far. Inflammation must be kept down by cloths
wet in cold water and laid on, and by light diet.

Fracture of the Lower Jaw.

Tht8 usually takes place near the chin. It may occur also near
the angles of the jaw. It may be simple or compound, and is known
by the pain, the swelling, the inability to move the jaw, the indenta-
tion felt by the finger, the irregularity of the teeth, and the grating
sensation felt while moving the ja; • with the hand placed on the back
fragment.

r>52

HUROICAL I)t8KA8E8.

Treatment. — T.^'ionc orltotli tInimliH Ih> int.ro<hico«l into the moiiili,
With lliuric, ku()p thu iKi)'l< |)iii'( ol' llir jiiw Htatitniiiiy, iiii<l pull Im-

wiinl tlu! fnn; purl with thi* tlii^ciH on thii
oiitHid*!. In thiH way the fnirlnr, cuii smiii
lit- put ri^ht. 'I'liis dom-, hIiuI thu nioiitli
lirnily, tuul piaci* a thick cnniprttHH of lint
ovor th(! l>rok(Mi part; ovctr tluH put a piwe
of paHtt>l)<)ai-(l, wetted ho aH to bend casilv
to the partH, and over tluH a Htronj^ band-
age of muHlin, two and a half in(;huH wide,
with a Hniall ba^r to fit and hoUl the chin;
all which is reprcHented in Fi^. 169.
For fi fortnij>ht tlie patient niust feed on gruel, broth, arrow-root
and milk, that the jaw may not be diuplacud by chewing.

Via. iBO.

Fracture of the Collar-Bone, or Clavicle.

This accident generally occurs about the middle of the lK)ne, and
is generally caused by falls on the arm and shoulder.

FlO. 160.

FIO. 161.

Symptoms. — Ptain and tenderness at the place of the injury, and
inability to lift the arm ; a small bunch or prominence at the point of
the fracture ; the distance from the pohit of the shoulder to the
breiiHtrlx)ne shorter than on the other side ; and the dropping down-
wards, forwards, and inwards of the shoulder. To make the case
sure, compare the two bones, and see whether they agree.

Treatment. — Place the knee between the shoulder-blades, and
gi'asping the round ends of the shoulders with the two hands, draw
them gently back till the ends of the bone come t<i their proper place;
or place the elbow of the patient close to the body, and a little for-
ward, and then push it upward.

SUItOICAL DIRRASRH.

663

1(1 into lliA mouili,
a'y, an<l pnll I'ln-
,li(^ lin^tTH on till!

fllirtliri Clin sniiii

I, hIiuI thu nioiitli
citniprnHH of lint

!!• tlllH put !l pilHL'

iiH to bond t'tiHily
lis II Htronjj hiimi-
liiilf indiuH wide,
lid hold the chin;
in Ki^. 159.
broth, arrow-root
iwiug.

Clavicle.

I of the lione, and
jr.

FlO. 161.

of the injury, and
ence at the point of
le shoulder to the
he dropping down-
To make the case
\f agree.

loulder-blades, and

le two hands, draw

their proper place;

dy, and a little for-

To retain the fihouldfiH in tliis npwiird and l)iickwiird position for
::onu! wcekH, piiHM a llaniicl bundiigc. four inches wide, arnuiid tint
front of one Hhouldcr, under the iirni-jtit, acroHs the back, over th«
opposite Hhonldcr, under the other arm-pit, and a^ain acrosH the liaek,
in the form of the lif,'nre oo. 'i'o prevent the bandaj,'e from cutting
the Hkin, put pads under the arms. (Kigs. 160 and Itil.)

Fracture of the Shoulder-Blade.

When this accident happeiiH, the body of the l)one is generally
broken acrosH by some great direct violence. In a few in^ttances, the
end next to the collar-bone is broken. *

Symptoms. — Great i)ain in moving the shoulder, "d the ffratiruj
Hensiition wiiicdi may Ihj felt by placing one hand on upper end

of the l)one, and int ving the lower portion with the otiier.

Treatment. — A bandage must be passed round the chest, and a
few turns Iks made around the nj)per arm, so as to fasten it to the
side, and prevent all motion. Purging, low diet, and the tincture of
veratrum viride will be required to keep down inflammation.

Fracture of the Acromion, or the end of the scapula which unites
with the collar-lx)ne, may l)e known by the flattening of the shouhler,
— the l)roken part l)eing drawn down by the action of the deltoid
muscle.

Treatment. — It must be supported by the same bandages m are
used for a fracturi of the collar-lxme ; and the elbow must Im well
raised, so that the head of the upper-arm bone may l)e lifted against
the upper portion of thescapul", and act as a prop to keep it in place.
No pfld should be put in the arm-pit, for this would push the broken
part too much outward. Gentle motion of the arm may be begun
about the sixth week.

Fracture of the Upper-Arm Bone.

Thk bone of the upper-arm is most frequently broken near the
centie, though it may be fractured' near the ends. It may be known
by taking hold of the arm above and below the suspected fracture,
and attempting to move the ends of the upper and lower fragments
upon each other. If there be a fracture, the grating of the broken
ends against each other will either be heard or felt. The arm will
also be bent and helpless ; and if the ends of the bone be slipped by
each other, it will be shortened.

Treatment. — Let a powerful man take hold of the arm and pull
gently and gradually, but with considerable force, till the arm is
brought to its natural length, another man taking hold of the body
of the patient, and pulling in an opposite direction. In the mean
time, the surgeon is to adjust the ends of the bone to each other, and

554

SURGICAL DISEASES.

Fio. 162.

apply a bandage, but not very tightly, from the elbow to the shoulder,
and over this, four splints, with pads under them ; one in front, roiuli-
ing from the shoulder to the bend of the elbow,
with a few turns of the bandage over it ; another
behind, reaching from the shoulder to the point
of the elbow, with a few turns of the bandage
around it also ; another on the inside, extending
from the arm-pit to the inner projection of the
bone at the elbow, also secured by a few turns of
the bandage ; and the fourth one on the outside,
reaching from thy shoulder to the outside knob
at the elbow. The whole is now to be secured
either by a bandage or tape. (Fig. 162.) The arm is to be confined
to the side, and the hand and fore-arm placed in a sling. In from
seven to ten days, the drest-ug should be taken off to see if all is
right.

Fracture of the Elbow.

This may be known by the patient being able to bend the arm,
but not straighten it, and by the grating which may be heard or felt
when the urm is moved back and forth by the operator, and also by
the severe pain felt in the fractured part.

Treatment. — First apply leeches and evaporating lotions to re-
duce the inflammation. When this is effected, straighten the limb,
and apply a bandage snugly from the fingers to the elbow. The
broken end of the bone must now be brought to its place, and the
bandage continued over it, and for a few inches above it. Secure it
here, and bring it back, — carrying it above and below the elbow for
several times ; and then extend it up to the shoulder. A splint
must now be applied to the inner side of the arm to prevent its being
bent, extending from the hand nearly to the shoulder, and another,
of similar shape, to the outside. The joint should be kept quiet for
four or five weeks, during which time the splints may be taken
off three or four times, to see if there is any chafing of the skin, or
any disturbance of the bones. *

Fractures between the Elbow and Wrist.

The part of the arm between the elbow and wrist, called the /ore-
arm, has two bones, — one extending from the elbow on the inside
to the wrist at the root of the little finger, called the ulna, and the
other on the side next the thumb, a shorter and a smaller bone, and
called the radius.

When both these bones are broken at the same time, the fracture
may be easily discovered ; when only one, the sound bone keeps the
other iu place, and the injury is not so easily made out.

SURGICAL DISEASES.

555

y to the shoulder,
ine in front, niiuh-
snd of the elbow,
1 over it ; another
ilder to the point
I of the bandage
inside, extending
projection of the
by a few turns of
le on the outside,
the outside knob
ow to be secured
1 is to be confined
a sling. In from
)fip to see if all is

to bend the arm,
ly be heard or felt
jrator, and also by

ting lotions to re-
raighten the limb,

the elbow. The
its place, and the
)ove it. Secure it
ilow the elbow for
loulder. A splint
) prevent its being
ilder, and another,

be kept quiet for
its may be taken
ng of the skin, or

tid Wrist.

ist, called the /ore-
bow on the inside
. the ulna, and the
smaller bone, and

! time, the fracture
nd bone keeps the
e out.

Treatment. — Relax the muscles by bending the elbow, and then,
by extension and counter-extension, put the ends of the bones in
proper place ; then place two splints, thickly padded in the centre,
one upon the front of the hand and forearm, and the other upon the
back of the hand and forearm, — ti;e palm of the hand beir\g turned,
not towards the chei t, but downwards. They are to be covered with
a bandage from the lingers to the elbow. The whole arm and hand
should be placed in a sling, and remain in this position four or five
weeks.

Fractures of the Wrist, Hands, and Fingers.

The setting of fractured bones in these parts is to be done by ex-
tension and counter-extension, as in the case of other bones.

If the wrist be broken, a splint should be applied in front and one
behind, and a bandage bound tightly from the hand half way to the
elbow.

In fracture of the bones of the hand, a pad or compress must be
put upon the palm of the hand, and a splint placed over this, with a
bandage extending from the wrist to near the ends of the fingers.

If one finger only be broken, apply narrow pasteboard splints on
four sides, and cover them with a narrow bandage ; and then bandage
the whole hand.

In all these fractures, place the hand in a sling. About three
weeks will be required for the bones to unite properly, and several
weeks more for the parts to acquire their natural usefulness.

Fracture of the Ribs.

This accident occurs either by blows, or by being crushed between
two opposing forces. One, two, or more ribs may be broken at a
time, according to circumstances.

Symptoms. — A fixed, piercing pain, made worse by breathing,
coughing, or any other motion, and also a grating sensation during
the taking of a long breath, the hand being laid upon the injured
part at the time.

Treatment. — The ribs are to be held steadily in their place by
pressure. To effect this, request the patient to draw in a long bieath,
and hold it. While the ribs are swelled out in this way, and the
broken ends are thus brought to their proper place, pass a woollen
bandage, five or six inches wide, several times tightly around the
chest, from the arm-j .' '.^ to the pit of the stomach. This will confine
the muscles of the chest, and the breathing will have to be done with
the muscles of the belly, and the ribs will thus be kept still, and
have a chance to grow together.

If the pleura he wounded, and inflammation follow from this or
other cause, the patient must be confined in bed, kept on a low diet,

556

SURGICAL DISEASES.

and his pulse be kept down by tincture of veratrum viride. The
bowels should be emptied by recipes 18, or 10, or 27, or 41, both to
subdue inflammation, and to give the diaphragm a chance to drop
down freely.

Fracture of the Breast-Bone.

Symptoms. — Thd injured part is frequently either sunk down or
raised up ; there is difficult breathing, cough, spitting of blood, pain,
inability to lie on the back, and a grating noise caused by breathing.

Treatment. — The same as that for broken ribs. Should the broken
part be pressed down upon the lung, so as to cause serious difficulty
of breathing, an incision may be made, and the broken piece raised
up with a chisel, or stiff case-knife, or some similar instrument.

Fracture of the Hatinch-Bones, or Pelvis.

These fractures are dangerous, — being often connected with some
other injury, as tearing of the bladder, lower bowel, or great veins or
arteries. Fortunately, however, they are only caused by some great
violence, and do not often occur.

Treatment. — Place the patient in the easiest possible position, and
keep him entirely at rest. Generally a catheter should be kept in the
bladder, that the water may pass off easily ; and the whole hips
should be bound round tightly with a flannel or calico bandage, and
made as firm and fixed as possible, to keep the broken bones together.
The most perfect rest must be ordered for six weeks or two months.

If the extreme lower end of the sacrum, the os eoccygU (Figs. 8— 3)
be broken, the separated portion must be put in its place by introduc-
ing the finger into the rectum ; and the bowels must be kept loose by
gentle physic, that the broken bone may not be pushed from its place
by tlie pressure against it of hard stools.

Fracture of the Thigh-Bone.

The points where this bone are broken are at its upper portion or
neck, and near its middle. The break at this latter place may be
straight across, or oblique, — partially lengthwise. When oblique,
the point of the bone may stick into one of the large muscles, and be
made fast by it.

Symptoms. — The fracture in the middle of the bone, if it be trans-
verse, may be known by some swelling or irregularity discovered by
running the hand along the thigh, and grasping it here and there ;
and if it be oblique, the ends of the lx)ne will be drawn by each other,
and the limb will be shortened.

Treatment. — Place the patient on his back, and let two strong
men use extension, — one taking hold near the hip, and the other

SURGICAL DISEASES.

557

rum viride. The
27, or 41, both to
a chance to drop

le.

her sunk down or
ng of biood, pain,
xsed by breathing.

Should the broken
! serious difficulty
oken piece raised
r instrument.

or Pelvis.

nnected with some
I, or great veins or
sed by some great

ssible position, and
)uld be kept in the
id the whole hips
alico bandage, and
ten bones together,
jks or two months.
occygia (Figs. 8— 3)
1 place by introduc-
st be kept loose by
shed from its place

ne.

ts upper portion or
atter place may be
e. When oblique,
rge muscles, and be

! bone, if it be trans-
iarity discovered by
it here and there ;
rawn by each other,

and let two strong
hip, and the other

grasping the limb at the knee and pulling steadily and strongly till
the limb is of the proper length, and the ends of the bone are in their
place. The man who takes hold of the upper end of the limb may
hold it more firmly and with less fatigue by passing a folded sheet
around the groin.

The extending force being still continued, the operator is now to
apply the splints, which are to be four in number, — one in front,
reaching from the knee-pan to the groin ; one behind ; one on the
inside, from the upper part of the thigh to the inside of the knee ;
and a fourth one, about four inches wide, reaching from the arm-pit
to a distance of two or three inches beyond the sole of tlie foot. Cot-
ton must be placed under these splints to prevent their injuring the
skin, and they must be of a width to nearly, but not quite, touch
each other. These being properly adjusted, and the extension still
continued if the fracture is oblique, the bandage is now to be firmly
applied from the foot to the upper part of the thigh, and then passed
a few times around the body. This fracture is sometimes treated
without splints, as represented in (Fig. 163).

Fio. 184.

Six or seven weeks will be required for the bones to grow together,
during which time the patient will need to lie upon his back. But the
dressing may now and then be biken off and put on again.

Sometimes only a single long splint is used; sometimes no splint;
ni still other cases, four splints, — the outside one being short, and
the limb resting on a double inclined plane.

558

SURGICAL DISEASES.

Fracture at the Neck of the Bone. — When the bone is broken at
the neck, close to the hip-joint, the injury is known by the knee and
foot turning outward, and by the limb being an inch or two shorter
than the other (Fig. 164). This is an accident to which old persons
are particularly liable. When the bone is broken here, it seldom
grows together again. The union which is formed is generally by a
ligament.

Treatment. — This requires a very Jong splint, reaching from the
armpit to beyond the sole of the foot, and bound firmly with a band-
age, as in fracture in the middle of the thigh. The limb should be
kept extended, and the injured one must be bound to the other by a
bandage, keeping both legs straight and immovable. A broad leather
strap, bound firmly round the hips and thighs will be serviceable.

Two or three months will be required for the injury to become re-
paired, so that the limb may be used. The patient must get up cau-
tiously, and be careful not to use the limb much so long as pain is
produced.

• Fracture of the Knee- Pan.

The knee-pan (patella) may be broken up and down, or across ; —
the latter fracture is the more common. It is a troublesome fracture,
and is very apt to leave a stiff knee.

Symptoms. — When the bone is broken across, the patient cannot
stand upon the limb ; the leg may be flexed or crooked, but cannot
be straightened , the upper part of the knee-pan is drawn up away
from the lower portion, leaving a wide gap, into which the fingers
may be laid, — at the top and bottom of which the rough edges of
the movable bones may be felt.

Treatment. — First, reduce the inflammation by tincture of arnica,
leeches, etc. Then straighten the limb, and put a well-paddgd splint
beliind, to keep the knee motionless ; place the patient's body in a
half-sitting posture, and raise the foot considerably above a level.
Put ^ bandage over the splint, beginning half way up the thigh, and
extending down to the knee-p -i, and being made very tight just
above the broken bone, so that it cannot easily slip under it. The
broken bones must now be brought together, and the bandage be
passed below and again above the knee several times in the form of
a figure 8, to keep the bones from parting.

The bandage, generally, may not be removed for a fortnight. After
this period, if everything has gone on well, the limb may be carefully
bent a little every day, to avoid a stiff knee.

Fracture of the Bones of the Leg.

The leg is that part of the limb between the knee and ankle,
has two bones ; the smaller on the outside, called the fibula ;
larger on the inner and front side, called the tibia, or shin-bone.

tlie

bone is broken at
by the knee and
h or two shorter
ivhich old persons
1 here, it seldom
is generally by a

reaching from the
rmly with a hand-
le limb should be
to the other by a
. A broad leather
be serviceable,
jury to become re-
i must get up cau-

loug as pain is

own, or across ; —
ublesome fracture,

the patient cannot
•ooked, but cannot
is drawn up away
which the fingers
16 rough edges of

T tincture of arnica,
well-paddsd splint
patient's body in a
bly above a level.

1 up the thigh, and
,de very tight just
Lip under it. The
id the bandage be
nes in the form of

a fortnight. After
lb may be carefully

e Leg.

nee and ankle. It
led the fibula; the
(, or shin-bone.

SURGICAL DISEASES.

659

Fig. 186.

One or both of these may be bioken at the same time. If both
are broken, it is impossible to walk upon the limb ; there is a change
in its shape ; it may be bent ; and the grating of the broken ends oi
the bones may be felt or heard.

Treatment. — First, adjust the bones by means of extension and
counter-extension, as in other fractures.
Then apply two splints, one on the out-
side from the knee to the solo of the foot;
the other u])on tlie inside. Over these a
bandage is to l)e firmly applied, reaching
from the toes to the knee. The leg may
rest upon the side or the back, as the com-
fort of the patient may require. Upon
the side is generally the easiest position,
with tlie knee a little bent (Fig, 165).

The dressing may be removed in six or seven days, to see that the
bones are in their proper place. Five or six weeks will be required
for recovery ; and at the end of this time, the dressing may be laid
aside. But the patient must use his leg very gradually.

In the treatment of fractures of the shafts of the bones of the
lower extremities, three indications should be fulfilled : Fii-st, coap-
tation and fixation of the fragments ; second, moderate extension ;
third, gentle compression and support. Provided these requirements
are carried out, it matters little what apparatus may be employed ;
bnt that which can be applied with the least disturbance of the
fractured bone, and is most comfortable to the feeling of the patient,
should be preferred.

The best mode of extension and counter-extension now in use is
by raising the foot of the bedstead about eight inches, by a block of
wood placed under each fore-leg. Tins makes an inclined plane, and
the body consequently tends to incline towards the head of the bed ;
this is the counter-extension.

Then extension is made as follows : A strong piece of adhesive
plaster, about two and one half inches wide and about three feet long,
is applied to the sides of the leg, extending from a little below the
knee, leaving a loop under the foot four or five inches long. This
is secured firmly in place by a bandage to the whole length of the
leg. A piece of cord is fastened to the loop and passed over a pul-
ley, which is fixed to the foot-board of the bed. To the other end of
this cord is attached a weight. This need not exceed ten or twelve
pounds.

In this way we get our counter-extension and extension : the body
IS drawir.g one way and the weight is pulling the other all the time.

Tliis is a simple and comfortable way of treating fractures of the
shafts of tlie bones of the lower extremities wliich require extension.
It may be applied to the different fractures of the neck of the thigh
bone, to fractures of the shaft, and also to fractures in the shafts of
the bones of the leg.

:i:^. r'.TFi it' -^^u.j. •:;»jr:.rjt'- tt--

560

SURGICAL DISEASES.

It is the best and most effectual way of preventing undue short-
ening that we have in use, and what is of as great importance to the
patient, a most comfortable way of keeping the painful limb in the
proper shape.

Fractures of the Bones of the Foot.

These are to be treated in the same manner with fractures of the
hand. They are often attended with much other mischief, as lacei-a-
tion of the flesh, ligaments, etc. Hence, cutting off the foot, or a
part of it, is often necessary. Pasteboard splints are frequently used
in these fractures. If matter forms, it must be let out by opening
the parts.

Compound Fractures.

When, in connection with a broken bone, there is a wound of the
flesh, which leads to, and communicates with the space between the
broken ends of the bone, the whole injury is called a compound frac-
ture. The wound in the flesh may be caused by the same force
which breaks the bone, as a bullet from a gun, or a cart-wheel, or
some machinery in which the limb is entangled. Quite often the
flesh wound is caused by one of the ends of the bone being forced
through the flesh and skin.

But, however caused, a compound fracture is of a much more
serious nature than a simple one ; and it is particularly dangerous
when a joint is involved. It is more serious above the knee and
elbow than below, and more to be dreaded in the lower limbs than
in the upper.

Treatment. — An attempt should always be made to preserve the
limb ; it should not be cut off, unless the compound fracture is of
the worst kind. But if there be no hope of saving the limb, the
amputation should be performed at once, while the constitution is
tranquil, and before it has been shocked and injured by suppuration,
abscesses, and sepsis, which sometimes follow such grave injuries.

But, suppose it be determined not to cut the limb off, — as it gen-
erally should be, — the first thing is, after the bone is set, to close the
wound against all entrance of air, and to cause it to heal by the first
intention, that is, without suppuration. To do this, one method is to
cover the wound with lint dipped in blood ; but the more usual mode
is, to bring the sides of the wound together, and secure them very
carefully by strips of adhesive plaster, in the same way as in common
cuts. The bandage should be kept wet with cold water, by squeez-
ing a sponge over it, or by sprinkling cold water upon it as fast as it
l)ecomes dry.

It will be necessary, in this case, to keep the l)ed-clothes away from
the limb while it is thus wet, which may be done by cutting a barrel
hoop in two, and nailing it to two pieces of lath. There should be

ntrr-rr ■'"--'-■—^■°--'

8UROI0AL DISKASES.

661

y undue short-
portance to the
ul limb in the

Foot.

fractures of the
achief, as lacera-
S. the foot, or a
, frequently used
out by opening

g a wound of the
)ace between the
a compound frac-
y the same force
r a cart-wheel, or
Quite often ihe
)one being forced

of a much more
icularly dangerous
ove the knee and

lower limbs than

ide to preserve the
und fracture is of
ving the limb, the
the constitution is
•ed by suppui-ation,
h grave injuries,
mb off,— as it gen-
B is set, to close the

to heal by the first
lis, one method is to
he more usual mode
I secure them verj-
e way as in common
Id water, by squeez-

upon it as fast as it

Hl-clothes away from

,, by cutting a
There should be

air circulating under the sheet, that the heat of the inflammation may
not keep the limb in a steam bath.

Should the wound heal by the first intention, the danger will soon
be over, and the treatment may be the same as for simple fracture.
But this, unfortunately, does not always occur.

It occasionally happens, that after three or four days, the patient
grows restless, has very short and disturbed sleep, is hot and thirsty,
has headache and shivering fits, is more ill towards evening, wanders
in his mind, or becomes delirious, and perhaps dies in ten days or a
fortnight from the sepsis or blood-poisoning that has taken place.
If the symptoms are a little less severe, the wound will at first dis-
charge a small quantity of dirty, bloody matter, which, if everything
goes well, \v'ill, by degrees, change to healthy matter, without smell,
of a straw-coi ^r, and about as thick as cream.

The fever, and other bad symptoms, will now subside ; the sleep
and appetite come back, and a new process begins, that of healing by
granulation, or the formation of new flesh to fill up the gap made by
the wound.

For old persons, or those whose health has been broken, this stage
is full of danger, and is apt to result in death, if the lower limb be
the injured part.

li the constitution proves unable to bear up against this stage of
the injury, alternate heat and sweating set in, the face is flushed with
a pink color, the pulse becomes weak and quick, the body wastes, the
appetite disappear, the tongue becomes diy and brown, restlessness,
wandering, and delirium follow in quick succession, and all are
speedily terminated by death. With the setting in of these symp-
toms, the wound stops discharging, or throws out only a thin, wateiy
and stinking matter. Quite often the skin and other parts mortify,
and if there be strength enough to throw off the dead parts, the
broken ends of the bone stick out, looking dead and white.

When the constitutional symptoms begin, open and thoroughly
disinfect the wound and provide for free drainage ; a poultice may
also be used if much pain be present. The poultice must be
contiimed till the wound is filled with new flesh nearly to the
surface.

It must be said in justice to modem surgery, that, if antiseptics
are used at the first dressing of the wound, we expect union by first
intention, and the avoidance of pus formation with all the dangers
this entails. The wound is to be treated just like other fresh
wounds, aseptically ; the limb may then be done up like a simple
fracture, but the dressings should be so arranged as to allow of sub-
sequent inspection. (See article on Asepsis, etc., p. 618.)

Dislocations. — Luxations.

The surfaces where two bones meet and glide upon each other for
the purposes of a joint, are called articular surfaces, and the union is

662

SURQIOAL DISEASES.

said to be an articulation. These surfaces are covered hy a smooth
cartilage, to render their play upon each other easy.

The joints are held together by cartilaginous straps and ligaments,
which serve as pullies ; by the aid of these, the joints turn back and
forth, as a door opens and shuts upon its hinges.

When by some external violence, or the weakening of these liga-
ments, these surfaces are suddenly separated, or forced apart, there
is said to be dinlocation or luxation.

Joints are divided into two kinds, the ball-and-socket (orbicular),
which has a rotatory motion, as the shoulder, hip, thumb, — and the
angular, or pump-handle (ginglymoid), as the elbow and knee.

The ball-and-socket joints have a greater diversity of motion, and
are more exposed to dislocation. They are likewise more easily put
in their place.

In a Primary Dislocation, the bone is thrown at once into the
place where the surgeon finds it.

The Secondary Dislocation is one in which the muscles pull the
head of the bone still further from its natural place than it was
thrown by the first shock of violence.

A Dislocation is Simple when there is no wound penetrating the
synovial membrane.

it is Compound when attended by such a wound.

A Dislocation is Complete' when the articular surfaces are entirely
separated.

It is Incomplete when the separation is only partial.

Recent Dislocations are rectified with comparative ease.

Old Dislocations are hard to be repaired, and sometimes cannot be
reduced at all.

The Symptoms of Dislocation are, inability to use the joint ; the
head of the bone being felt in an unnatural place ; the limb shortened,
lengthened, or distorted ; a change in the shape of the joint, etc.

Simple dislocations are generally trivial. Compound dislocations
often render amputation necessary, and are always perilous.

Aged persons are less liable to dislocations than the young.

When a dislocation and a fracture occur at the same time, the
dislocation is to receive attention first.

A dislocation is to be reduced by a gradual and continuous extend-
ing force. The reduction is known by the limb recovering its natural
length, shape and direction, and by its being able to perform certain
motions which are not possible while in a dislocated state. The pain
is immediately reduced upon reduction taking place. In shoulder
and hip dislocations, the head of the bone makes a loud noise when
it slips into its place.

.i»»'..,ii«»iw.TK*-mSr •-,»,;*;.- !a«aht(itaB«PWiiM«iw<i«gaMiiiiBa<a^^

BUROIOAL DISBASBS.

563

rered by a smooth

Y-

•aps and ligaments,

ints turn back and

ling of these liga-
Porced apart, there

socket (orbicular),
thumb, — and the
)w and knee,
ity of motion, and
se more easily put

at once into the

I muscles pull the
place than it was

id penetrating the

irfaces are entirely

irtial.
Ave ease,
tmetimes cannot be

use the joint ; the
the limb shortened,
' the joint, etc.
)ound dislocations

perilous.

the young.
16 same time, the

continuous extend-
overing its natural
to perform certain
i state. The pain
ace. In shoulder
k loud noise when

Dislocation of the Lower Jaw.

Gaping very wide is the usual cause of this. It hac been known
to result from a mere yawn. One or both sides may be disjointed.

Symptoms. — If but one side is dislocated, the chin is twisted to
one side, and immovable, and the jaws are partially open ; if both
sides, the mouth is wide open, the chin projects, there is a hollow in
fiont of each ear, great pain, inability to speak, and dribbling of
spittle from the mouth.

Treatment. — To effect a reduction, cover the thumbs with a towel
or a piece of wash-leather to prevent their being injured by a sudden
snapping together of the jaws, and then, standing in front of the
patient, introduce them into the mouth, press them upon the crown
of the back lower teeth, at the same time lifting the chin with the
fingei-s.

After the jaw is set, it should be kept bandaged for a few days, —
the bandage being merely passed once or twice over the top of the
head, and under the chin. No solid food requiring chewing should
be taken for a short time.

Dislocation of the Collar-Bone.

This may take place by the end attached to the breast-bone slip-
ping over or under that bone, or by the other end slipping above or be-
low the bone to which it is attached. "When the firat named end of
the bone slips over the breast-bone, it is said to be a forward disloca-
tion ; when it slips under the breast-bone, it is backward. In this
latter form of dislocation, the end of the collar-bone sometimes presses
upon the gullet, and prevents swallowing.

Symptoms. — In the forward dislocation of the inner end of the
bone, a bunch may be felt by the hand at the top of the breast-bone ;
in the backward dislocation, a depression or hollow. The upward dis-
location of the outer end of the collar-bone may be known by the
flattened and sunken condition of the shoulder.

Treatment. — To put the bone in its place in the first of these ac-
cidents, draw the shoulders back, by which means the collar-bone (clav-
icle) is drawn away from the breast-bone (sternum), and easily slips
into its place. To reduce the dislocation at the other end of the
bone, place the knee between the patient's shoulder-blades (scapulae),
and draw his shouldere backwards and upwards. After the reduction,
support the arm in a sling.

Dislocation of the Shoulder- Joint.

The head of the long bone of the arm (humerus) may be displaced
in three different directions, — dowmoard, into the arm-pit (axilla) ;

664

BURGIOAL DISEASES.

fil

forward, under the muscles of tho breiist; and backward, uimhi ilu;
back of tlie Hhoulder-blivdc.

It is rccogniznd by the shoulder losing its roundners, iind becoming
flat; by the lengthening of the arm; by the head of the Ixme bring
felt in the arm-pit ; and by severe pain.

To effect the reduction in the fii-st form of displacement, put tlie
patient on a bed, or upon the floor. Put one heel in the arm-pit,
agfainst the head of the l)one. Then, taking hold of the arm alK»ve
the elbow, or at the wrist, pull steadily, and push with the li(;t'l.
(Fig. 166.) The extension may \re more steady and powerful by a
double towel arouud the surgeon's ueck.

Fio. tM.

If the reduction cannot be effected, relax the muscles by a warm
bath or by etherization.

A simpler method often succeeds and is the only one require*', in
certain forms of shoulder dislocation. Bend the elbow at right an-
gles and place it at the side of the body. Next rotate the fore-arm
outward as far as possible ; then carry the elbow, still flexed, inward
and upward onto the chest, and then allow the elbow to fall. The
head of the humerus often slips into place with the greatest of ease.

After the reduction, a sling will be required, and three weeks' or a
month's rest.

Dislocations of the Elbow-Joint.

Op these there are six varieties. In the first, both bones of the
fore-arm (radius and ulna) are thrown backwards ; in the second, both
are drawn backwards and inwards; in the third, both are thrown
backwards and outwards ; in the fourth, the vlna alone is forced back-
wards ; in the fifth, the radius is forced forwards ; and in the sixth,
the radius is thrown backwards.

In general, these dislocations are all easily set. In the first four,

;'/ :■

BUROICAL niHKABKB.

Sfif)

akteard, iipoii llie

gi'«, ivnd lie(;()niiii^
•f the Ikiiu! being

laconieiit, put the
1 in thu arm-pit,
)f the arm alM)ve
(h with tlie li(;t'l.
id powerful by a

inscles by a wa nn

y one require'', in
ilbow at rigiit aii-
)tate the fore-arm
till flexed, inward
bow to fall. The
3 greatest of ease,
thiee weeks' or a

int.

)oth bones of the
n the second, both

both are thrown
lone is 'forced back-

and in the sixth,

In the first four,

FtO. 167.

the knpo la to }^o. planed at the l)ond of the elbow, and the foro-ami
bout upon it, i\ui siirguon ^niHpiii^ the upper arm with one liaiid,
and tilt; fore-arm with the oUu^r. In tho (iiHlocatiuuH ol' tlu; rudiiiH,
tliu upper arm is to Ihj put in a foced condition, wiiiiu the Hur^i>oii
takes hold of the hand and pulls, at tho same time throwing the lM)iie
forward. If the luxation Ih» iNickwards, there must l)o tho same ex-
tension and couuter^jxtension, whde the fore-arm is bent.

Treatment. — The fore-arm must Ix) placed in n half-l)ent position,
and a splint should be bandaged npon the front of tlu; whole lind),
compresses being placed upon the head of the houvH opposiU- the di-
rection of the dislocation. This confinement must bo continued three
weeks.

Dislocations of tlie Wrist.

These are caused by falls upon the hand. Both the radius and
ulna may be thrown back-
wards or forwards upon
the wrist, causing a pro-
jection either in front or
behind. (Fig. 167.) The
bones are to be set by
pulling in opposite direc-
tions upon the hand and the forearm, and pressing laterally, if the
displacement be at the side of the wrist.

Treatment. — Put a straight splint on the front, and another on the
back of the fore-arm and hand, with compresses on both sides of the
wrist, and a Iwindage over the whole. Support the fore-arm in a sling,
and keep down inflammation by cold water, cooling lotions, etc.

Dislocatiokis of the Bones of the Hand.

Some one of the carpal bones may be pushed up out of its place,
80 as to form a projection on the back of the hand. To put it in its
place, press upon it simply, and then put compresses on the front anil
back.; with straight splints upon these and a bandage over all. Put
the hand in a sling.

Dislocations of the finger-joints may generally lie replaced by bend-
ing the displaced phalanx over the head of the bone from which it
has been disjoined. Sometimes a good deal of extension and counter-
extension are required, for which purpose a piece of cord may be
wound around the finger, — the skin being protected by covering it
with a piece of wetted buck-skin.

Dislocations of the Hip-Joint.

These are four in number, — upwards, downwards, bachvards and
upwards, forwards and upwards.

560

StJRQICAL UISKASCfl.

To niduco tlu'HO, a jjroatcr amount of powoi- Ih needed iliiui in the
dislocations of any other lM)iie, — owin^ to the greater |)ower of the
niiiHclos wliieh are to \)f overcome.

DislocatioiiH of this joint are often (confounded with fracture of tliu
head and neck of tlie thigh bone. This hitter may he diHtinguishiil
from the luxation hy the grating sound t-) Iw he:ud, by the possiljility
of pulling the limb out to itH natural length, and by its Ixnng slmrt-
ened u]) again by the action of the muscles the moment the pulling'
is given up.

The Upward DiAlocatlon of the head of this l)one upon the lituk
of the haunch-lM»ne is known by the mliorteninif of the limb, and liy
the knee and foot turning inward, — the foot lapping over the oppo
jjite foot, and the great toe resting upon the other instep. (Fig. ItiH.)

The Dislocation Downward is known by the lenc/theniru/ of tliu
limb, the projection of the knee, the turniiui of the foot and knee out-
ward, and the bending of the body forward. (Fig. 1H9.)

FlO. 108.

FIO. 169.

The Dislocation Backward and Upward is distinguished by the
inclining of the foot and knee inward, the drawing up of the heel, and
the resting of the great toe against the ball of the great toe of the
other foot. (Fig. 170.)

The Dislocation Upward and Forward is known by the shorten-

J: ^4.

!C(l«ll lllllll ill tlic
iifT poWtT ol tlu'

th fracture (»f tlic
' Ih! ili8tinfj;uishcil
by tlio ixmsilnlity
y itH being sluirl-
ineiit the imHin^'

)no iijton the Uuik

the limb, iiiul by

ijT over the oppo-

nBtep. (Fig. ItiH.)

leru/thenin(/ of llu'
foot and knee out-

r:it>9.)

FIO. 169.

distinguished by the
y up of the heel, and
he great toe of the

own by the shorten-

BUIKilOAL lilHEASEH.

667

iiig of tho limb, and the turninq of the foot and knee outward. (Fig.
171.)

For replatiing tho l)one, put tho patient upon a tJible, on hiH Uvck.
Driiw a sheet l)et\veen iiis thiirlis, and extending it uj) by the side of
his lK)dy, let it Int fastent'd fo u Htiplc. I'ut a padded l)elt. with rings
uttuched, around the injured liml). jiiHt alxtvu tht* knee. To these

FlO. 170.

FlO. 171.

rmgs, fasten one block of a pulley, and attach the other to a post,
giving the pulley-rope to an assistant. The surgeon now, standing
on the injured side, directs gradual extension to be made, while he,
by his hands, or by a l)and passing around the injured thigh and over
his own shoulders, lifts the head of the bone, and guides it iuto its
socket. Etherization is not infrequently required.

Treatment. — Keep the patient in bed for two weeks or more, with
his knees tied together by a strip of muslin, and a broad belt around
his hips.

Dislocations of the Knee- Pan or Patella.

This bone may be thrown outward, causing a great projection on
the outside, and an inability to bend the knee.

It may be thrown inward, causing the same impossibility to bend
the knee, and a projection on the inside.

To restore the bone to its place, put the heel of the patient upon

■■■■

568

SURGICAL DISEASES.

the shouLler of an assistant; then press down the edge of the knee-
pan which is farthest from the centre of tiie joint, thus tilting U[) the
other edge of the bone, when the muscles, aided by a lateral pressure,
will draw it to its place.

Treatment. — Put a straight splint upon the back of the limb,
and make moderate pressure upon the knee by a bandage. Cold
water, or cooling washes, should generally be applied. Keep the pa-
tient in bed two weeks.

Dislocations of the Knee-Joint.

There are four of these, — forward^ backward, inward and out-
ward.

They are readily corrected by extemion and counter-extension from
.he ankle and thigh, and pressure upon the head of the displaced
bone.

Treatment much the same as for displacement of the knee-pan.

Dislocations of the Ankle.

These may occur in a forward, backward, outward, and inward
direction. (Figs. 172 andl73.)

PlO. 172.

PlO. 173.

To rectify it, bend the limb, so as to relax the muscles on the back
of the leg; then, \7hile extension and counter-extension are made
upon the foot and thigh, press firmly on the dislocated bone, and thus
force it to its place. •

Treatment. — Confine the foot and leg in splints made of thick

SURGICAL DISEASED.

669

ge of the knee-
is tilting up the
lateral pressure,

ick of the liml),
bandage. Cold
I. Keep the pa-

nt.

inward and out-

ir-extension from
of the displaced

the kneu-pan.

ard, and inward

iscles on the back
tension are made
ed bone, and thus

ts made of thick

pastelward, soaked in hot water and moulded to tlie shape of the
liinh, with a foot-pioce at right angles. Keep the patient in bed five
or six we«^ks, and when he begins to walk, support tlie ankle with a
roller bandage, or a laced gaiter.

Contusions. — Bruises.

When any blunt, hard substance comes in violent collision with
the soft parts of the l .y, without breaking the skin, the injury re-
ceived is called a bruise. One of these accidents generally ruptures
a great number of the very smallest blood-vessels, which let out
blood under the skin, producing '^ black and blue" or livid spots
(ecchymosis). What fist-fighters call a Mack eye is an example.

Treatment. — Cold applications at first to prevent the blood run-
ning out of the small vessels under the skin. After the inflammation
has subsided, stimulating applications, as vinegar and water, alcohol,
camphorated liniment, ammonia and alnohol, equal parts, and some-
times bandages.

Sprains.

A SPRAIN is a forcible wrenching and twisting of a joint to such a
degree as to stretch and more or less lacerate the ligaments of the
part, and sometimes to break a tendon, but without entirely displac-
ing a bone. Its symptoms- are, violent pain, swelling, and discolora-
tion of the parts from the blood running into the cells under the skin.
In elderly persons, the effects of sprains are very tedious, disabling
them for many weeks, or even months.

Treatment. — Elevate the limb, keep the joint perfectly quiet,
and apply cold lotions or fomentations. When the inflammation is
all past, apply stimulating liniments, and bandages, or shower the
part with cold water.

When first done, put the part, if possible, into as hot water as can
be borne and maintain it there for half an hour, then strap the part
moderately tight with plaster. An ice-bag applied over a joint when
the hot water cannot be obtained, or is inapplicable, is nearly as effica-
cious.

Ruptures of Tendons.

These accidents are known by a sudden snap, followed by pain,
loss of motion in the part, and swelling and discoloration.

Treatn.ent. — Ph. 3 the part in such a position as to relax the
broken tendon, the ends of which must be brought together, and re-
tained in contact till they grov together. They are to be sewn
aseptically and the wound treateu like any closed wound.

570

SURGICAL DISEASES.

Diseases of the Bones.

The bones are supplied with blood-vessels and nerves ; and as they
live and grow like other parts of the body, so they become diseased
and die in like manner.

Ulceration of tlie Bones. — Caries.

Bones, like the soft parts, when attacked by violent inflammation,
may ulcerate, discharge matter, and heal by granulation ; or, having
lost a portion of their substance, may sink under entire disorganiza-
tion and death. ' This disease passes, in some parts of the country,
under the name of "fever sore." It is generally the result of poor
blood, scrofula and like disease, and. hence needs tonic, constitutional
as well as local treatment, cod-oil, iron, etc.

Treatment. — Apply splints, and keep the part in a state of abso-
lute rest. Subdue the local inflammation by the usual means. If
the disease arise from scrofula or syphilis, use the remedies for those
diseases.

Death of the Bones. — Necrosis.

This is like mortification of the soft parts. It occurs from injuries
and inflammation of the periosteum.

It is known by dull, deep-seated— sometimes acute— pain; and is
followed by increase of size, from the formation of new bone around
the old, — the old being gradually broken into pieces, and discharged
through external openings.

Treatment. — Poultices and quieting fomentations. Resort will
generally be made to surgery.

Unnatural Growth of Bones. — Exostosis.

This disease consists either of a tumor of a bony nature, growing
upon and arising from a bone, or an enlargement of a bone. It
springs from the periosteum, or from the surface of a bone, or from
its spongy texture. The enlargement or the tumor may be white
and hard, like ivory, or dark-colored and spongy, or a mixture of the

two. , , . ,

At first, a tumor of this kind is not attended with pain or incon-
venience. It comes on slowly, and sometimes remains nearly sta-
tionary for several years.

Treatment. — If the tumor be large and inconvenient, remove it
with the knife. If not, use local pressure with pads and bandages;
also leech, blister, and restrict the patient to a spare diet.

■ftm^

SURGICAL DISEASES.

571

rves ; and as they
become diseased

Diseases of the Joints.

Some of these diseases begin in the cartilages, some in the synovial
membrane, and others in the heads of the bones.

anes.

ent inflammation,
ation ; or, having
ntire disorganiza-
3 of the country,
he result of poor
[lie, constitutional

in a state of abso-
usual means. If
remedies for those

osis.

3curs from injuries

ite — pain; and is

new bone around

es, and discharged

ions. Resort will

Exostosis.

ly nature, growing
mt of a bone. It
>f a bone, or from
mor may be white
>r a mixture of the

ith pain or incon-
emains nearly sta-

Lvenient, remove it
ids and bandages;
ire diet.

Disease of the Hip-Joint. — Coxalgia.

This generally consists in inflammation of the synovisil membrane
and capsular ligament of the hip-joint, ending frequently in ulceration
and destruction of the head and neck of the thigh bone.

The symptoms are fullness in the groin ; pain, which is increased
by motion ; aggnivated when the limb hangs without touching the
ground ; is more felt in the knee than in the hip itself ; and shoots
down along the inside of the leg, as far as the instep. The thigh
inclines forward, and the limb has the appearance of being longer
than the other, — though in the latter stages, it is really shorter.

Treatment. — Before suppuration takes place, apply leeches and
blisters, and enjoin perfect rest. After suppuration, keep the patient
upon his back, on a mattress, and mould to the parts thick paste-
board splints, with pads, and give tonics. Keep the bowels open with
senna and bicarbonate of potash, and rub the parts with iodide of
potassium ointment, or with preparations (282), (283), (195). The
disease being scrofulous, the iodide of potassium (140) may be taken
with advantage internally. The disease occurs for the most part in
children. They should be put on a long splint from the very first
and the joint kept immobilized.

White Swelling.— Synovial Degenerations.

There are several diseases of the knee-joint, characterized by swell-
ing and white color from tension of the skin, which have passed
under the common name of white-swelling. The diseases are not
strictly the same, but as they all affect the knee, and have symptoms
to some extent in common, it is well enough to group them under
the same title, — especially as one treatment is adapted to all.

One is a pulpy disease of the synovial membrane. It begins with
a trifling stiffness, and a slight swelling. The swelling increases by
degrees, and on touching the part there is a sensation as if it con-
tained fluid. By and by the caitilages ulcerate. The disease is in-
curable, as the synovial membrane is finally converted into a pulpy
substance, and the limb has to be amputated.

Another of these is inflammation of the synovial membrane, be-
ginning with ulceration of the cartilages. It Ixigins with pain in the
joint, which is severe at one point, and attains its height in a week.
In a day or two, the joint is swollen from a collection of water.

Treatment.— Splints and entire rest) as in all chronic diseases of

572

SUUGICAL DISEASKS.

the joints. Also a generous diet, and whatever is calculated to huild
up the health. For the tubercular variety an injection of iodoform
dissolved in glycerine is most commonly used.

Bunions.

This is an inflammation, enlargement, and hardening on the inside
of the ball of the great toe. It is frequently connected with a distor-
tion of the toe, which seems partially out of joint. The projection
of the joint exposes it to great irritation from the shoe, and to re-
peated attacks of inflammation. It occasions great suffering.

Treatment. — Remove the pressure from the part, and when there
is inflammation, keep the foot quiet and elevated upon a chair, apply-
ing leeches, poultices, etc. Another method is to cover the bunion

with soap-plaster, spread on
thick, soft leather, or, put the
toe in a separate compartment
of the stocking, like the finger
of a glove. Then enclose it
in a separate part of the shoe,
which is contrived by fixing
a piece of firm sole-leather in the bottom of the shoe, so as to make
a separate compartment for the toe. By this means the pressure
against the side is removed. Sticking plaster may be spread on
wash-leather, and a piece cut out the size of the bunion. This will
take off a portion of the pressure of the shoe, and will hasten the
cure.

Fig. 174 represents a ganglion or tumor formed upon the syno-
vial sheath of the tendon which bends the finger.

FlO. 174

Whitlow. — Felon.— Paronychia.

This is an abscess of the fingers, of which there are three kinds,—
the first situated upon the surface of the skin, the secdnd under the
skin, the third within the sheath which contains the tendons of the
fingers, and sometimes involving the covering of the bone.

The latter form of the disease is the most terrible, and begins with
redness, swelling, and a deep-«eated and throbbing pain, which grad-
ually becomes so excruciating as to banish all sleep,, and nearly drive
the patient to distraction. Finally matter form>' and burrows in the
deeper parts of the finger, and at lengtli fina an opening, which
brings relief.

Treatment. — Carry the hand in a sling ; apply a leech or two,
and use poultices. A poultice made of equal parts of powdered slip-
pery-elm bark, poke-root, ground flax-seed aad lobelia^eeds, mixed
with hot ley, and changed twice a day, is an admirable application.

iii^iasE,

:iit:;;".

fs'^&£ism:mi

fi lift

iloulatecl to build
bion of iodoform

SURGICAL DISEASES.

573

When these methods fail to stop the progress of the abscess, the
finger should be laid open with the scalpel, cutting down to the bone.
This will give vent to the matter, and the wound may be dressed
with poultices, until the inflammation is subdued, and the healing
process is well established* when some simple salve may be applied.

ling on the inside
ted with a distor-
The projection
shoe, and to re-
suffering.

t, and when there
ion a chair, apply-
cover the bunion
aster, spread on
ather, or, put the
rate compartment
ng, like the finger
Then enclose it
I part of the shoe,
atrived by fixing
oe, so as to make
lans the pressure
ay be spread on
anion. This will
i will hasten the

i upon the syno-

via.

ire three kinds, —
secdnd under the
le tendons of the
le bone.

e, and begins with
pain, which grad-
»,.and nearly drive
id burrows in the
n opening, which

y a leech or two,
of powdered slip-
belia-seeds, mixed
able application.

Stiff Joint. — Anchylosis.

Tras is of two kinds, complete and incomplete, — complete when the
bones of the joint have become firmly united by bony matter, and
incomplete when the motions of the joint are very much interrupted,
hut not entirely destroyed. The first is the result of ulcerations of
the cartilages of the joints, and of the heads of the bones ; the latter,
of fractures, sprains, bruises, thickening of the synovial membrane,
and weakening of the muscles.

Treatment. — No treatment is of much use in the first-named form
of the disease. By sawing through the bone, piid then daily moving
the limb back and forth, a false joint may be made, but it is apt to
grow together again, and finally defeat the purpose of the surgeon.
When, however, stiffness arises from the weakening of the muscles,
and some other causes involving the ligaments and tendons, something
may be done by daily frictions with stimulating liniments, champooing,
and warm fomentations ; and by gently bending the joint back and
forth, several times every. day, as much as can be done without pain.

Tumors.

A TUMOR is a swelling which consists of a new production, not
constituting any portion of the original structure of the body. There
are several kinds of tumors ; but it is sufficient for my purpose to
follow Mr. Ferguson, and divide them into the malignant and non-
malignant.

Cancer.

This belongs to tl - class of malignant tumors. It has two stages.
The first is that oi induration or seirrhus, during which it has,
under the finger, the feeling of stony hardness. The second stage is
that of ulceration or open cancer.

Cancer most often attacks the female breast, tlie skin, the mucous
membranes, the tongue, the stomach, the neck of the womb, the lips,
etc. It rarely occui-s in subjects under thirty years of age, and not
often in persons under forty-five.

The Symptoms of Cancer, when it appeai-s in the breast, are, a "
puckered condition, and dull, leaden color of the skin ; a hard, knotty,
and uneven feel ; and occasionally sharp pains. When it attacks
the skin and mucous membranes, there is a hard, warty lump, which

674

SURGICAL DISKASE8.

ulcerates, after a time, producing an open sore, with a hard base.

(Fig. 175.)

The sore of a cancer discharges an
irritating, excoriating matter, which has
a peculiarly fetid odor, so offensive and
so different from any other smell, that it
is seldom forgotten. The bones of a
cancerous person break with great ea«i!.
Unmarried females are much more liable
to the disease than the married. Tlie
cancerous growth is composed, in part,
of cells, rounded or caudate, containing,
as seen under the microscope, nuclei,
(Fig. 176.)

FlO. 175.

younger cells, and granules.

FIO. 178.

FIO. 177.

Fia. V9.

The difference between these cells and those of common pu8-glol>-
ules may be seen by comparing Fig. 176 with 177, — the latter being
pus-corpuscles highly magnified by a powerful microscope. Fig. 178
represents pus-globules not so much magnified.

Treatment. — There are but two methods of treatment which
promise any success. The first is to extirpate the tumor by a surgical
operation before the disease has so far invaded the constitution as to
be sure of returning. The other is that adopt' I by Dr. J. W. Fell,
an American physician, who was permitted tu try his remedies in
one of the English hospitals, and who drew from the surgeons in
, charge of it a favorable report of the results.

Dr. Fell's remedies are mainly blood-root and chloride of zinc (336)
made into a paste. The skin over the tumor is first destroyed, and
this paste, spread upon strips of linen, is applied. This causes an
eschar, into which incisions are made, half an inch apart, taking care
to avoid the living tissue. The same paste spread in a like manner
is then daily inserted into the furrows. By tbis means, which is
original with Dr. Fell, the effect of the cans to penetrates through
all parts of the tumor, causing the whole diseiised mass to fall off,
and leave a healthy, granulating surface.

In incipient cancer, where the disease has not made much progress,

SURGICAL DISEASES.

575

dth a hard base.

er discharges an
natter, which has
so offensive and
ther smell, that it
The bones of a
; with great ease.
much more liable
le married. The
omposed, in part,
udate, containing,
icroscope, nuclei,

no. ITS.

common pus-glol)-
, — the latter being
uoscope. Fig. 178

f treatment which
tumor by a surgical
e constitution as to
by Dr. J. W. Fell,
try his remedies in
>m the surgeons in

iloride of zinc (336)
first destroyed, and
d. This causes an
sh apart, taking care
id in a like manner
Ills means, which is
penetrates through
id mass to fall oS,

nade much progress,

Dr. Fell uses the above, which he calls a brown ointment (886), and
in connection with it an ointment of the iodide of lead (337), using
each twelve hours. With these, he claims that he cures incipient
cancers with great readiness. He also employs, internally, half-grain
doses of pulverized'blood-root (143), with arsenic and cicuta.

Dr. Fell claims that with these preparations, he has often cured
lupus, and has been very successful with them in treating indolent
ulcers. Of late a new treatment has sprung up — namely, the injec-
tion of anti-cancer serum, but as yet a definite opinion cannot be
given as to its results.

Soft Cancer. — Bleeding Cancer.

Medullary Cancer. — Encephaloid Tumor. — Fungus Hematodes.

This varies in size from that of a nutmeg to a child's head. Its
color varies from white to deep red. At times it is soft and elastic at
first ; at other times, it is firm and tense. The patient is wan and
pale from the beginning. The parts do not ulcerate, as in scirrhus ;
but after the skin is broken, a spongy, bleeding tumor protrudes.

Treatment. — Dr. Fell's method.

) f

Black Cancer. — Melanosis.

This is an organic disease, in which the tissue of the disordered
part is converted into a black, hard substance, which is converted
into ulcerous cavities. This often appears in the lungs, and is met
with in the liver and other parts.

Its symptoms are, a sallow complexion, great debility, and dropsi-
cal swelling of the limbs before the termination.

Treatment. — When it appears externally, Dr. Fell's treatment is
worth a trial. When in the lungs, the inhalation of tincture of blood-
root and solution of chloride of soda (241) should be used. Two
teaspoonfuls may be put in a Vapor Inhaler, — the instrument being
filled half full of hot water, — and inhaled ten minutes, three times
a day; the blood-root pills (143) being taken at the same time.

Fatty Tumor. — Adipous Sarcoma.

This is the most common of all the forms of tumor. These bodies
generally have a soft and doughy feel, or as if filled with wool.
They are the least inclined to become malignant, and consequently
the least dangerous, of all the tumors. Whatever pain there is, is
caused by their size, weight, and pressure. They are occasionally
found a little below the point of the shoulder, in the deltoid muscle
of females, and are caused by the unreasonable pressure of the dress
at that point. - '

576

BTTROICAL DISEASES.

Trsatment. — They should be removed by an operation, wliicli is
easily performed, as they separate very readily from surrouuding
parts.

Polypus.

The polypi constitute a cl^s of tumors growing from mucous
membranes. They are of two kinds, — the toft, jellyAike polyjjus,
and Hiejlesht/ ox fibrous polypus.

The Soft Polypus, which grows from the nose, has not mucli feel-
ing, and is not particularly disposed to bleed.

The Fleshy Polypus is firmer and harder than the preceding, and
most generally connects itself with tlie womb.

Treatment. — Both kinds of polypi are either twisted off with a
pair of forceps, or strangled by puti'ng a string, called a ligature,
around their neck, which will cause them to fall off in a short time.

Piles, — Hemorrhoids,

Thesb venous swellings often cause so much pain and trouble, are
so often chronic and unyielding to medical treatment, that surgical
interference becomes now and then a necessity. The operation for
their relief and cure is an extremely common one, and nowadays is
limited to a very few different methods.

The carbolio acid treatment which has found favor with many
consists in the injection into the pile of a small amount of carbolic
acid dissolved in glycerine or water. The process is simple and
almost painless, especially if done after numbing the parts with a three
per cent cocaine solution. The carbolic coagulates the blood and al-
bumen of the tissues and causes a death of the parts with a subsequent
sloughing and puckering. The advantage of this procedure lies in
the ability of the patient to be up and about. The danger lies in
the risk of setting free a clot in the circulation, causing most serious
consequences and even death. It should be used only in selected
cases and then not too freely.

A second method, and by far the oldest, is to encircle the pile with
a ligature and allow it to eat through, thus destroying the pile and
causing it to heal behind the ligatures. This method is painful, re-
quires ether and necessitates rest in bed. A third way is to burr.
off the pile by means of a cavtery and clamp. It is far preferable to
the ligature, requiring but a few days' stay in bed, and is less painful.
A fourth, and the most scientific method, is one just coming into
prominence, and consists in distecting out the pile area and sewing the
flaps of mucous membrane and skin together.

Numerous washes, ointments, and lotions have been used to tem-
porize, but the only sure and thorough way to treat obstinate piles
which remain after continued and unsuccessful attempts to remove

SURGICAL DISEASES.

577

operation, wliicli is
from BurrouucLug

iwing from mucous
1{, jelly-like polji)us,

I, has not much feel-

1 the preceding, and

r twisted off with a

g, called a ligature,

off in a short time.

pain and trouble, are

itment, that surgical

The operation for

ne, and nowadays is

•

id favor with many
I amount of carbolic
:ocess is simple and
the parts with a three
ites the blood and al-
i,rts with a subsequent
his procedure lies in
The danger lies in
causing most serious
used oiSy in selected

encircle the pile with
jtroying the pile and
nethod is painful, re-
third way is to burr.
It is far preferable to
led, and is less painful,
one just coming into
le area and sewing the

ve been used to tern-
) treat obstinate piles
il attempts to remove

i\w, original cause, is to remove them once for all. The following
salve will be found useful: cocaine, eight grains; gall ointment,
half an ounce ; mix. Smear well over the jules i.nd then push them up
into the bowel. Piles should always l)e returned into the bowel
when po.s8ible ; this of itself, when practicable, oftentinies constitutes
a cure.

Whenever a small, round, hard pile is seen on the outside and is
very painful, it shouhl be incised, after numbing with a cocaine so-
lution, and the clot turned out. This simple and painless procedure
works gieat relief and often a cure.

The bowels are to l)e kept open daily by a solution of tlie citrate
of magnesia (one-half bottle^ which keeps the bowels loose and
causes no pain in defecation.

Wens. — Encysted Tumors.

The most common situation of these is under the skin of the head.
A wen is simply a sac full of various mattei-s, which, when examined
with a microscope, are found to be oil-globules, epithelial cells, and
crystals of stearine. These contents are secreted by the internal
surface of the sac. They sometimes look like curd or riQe, sometimes
like suet, and sometimes like honey. In other instances, they are
mere water, and they have been known to consist of hair or horn.
Those tumors are round, elastic, and movable, and are without pain.
They grow slowly, but steadily.

Treatment. — The attempt to excite inflammation and conse-
quently absorption, by punctures, setons, or injections, are danger-
ous, and ought not to be resorted to. If the tumor is small, its
opening, indicated by a small black spot, may be found, a probe be
introduced into it, and the contents of the sac be squeezed out ; and
this may be repeated as often as necessary. But the proper and only
real remedy for these tumors is their removal by a surgical operation,
which, under aseptic rules, is painless, easy and sure.

Fia. 179.

Aneurisms.

An aneurism is a tumor formed by arterial blood, and communi-
cating with an artery. A true aneurism is formed by the coats of aa

-■•jf"

678

SURGICAL DI8RA8E8.

artery getting weakened by some cause, and swelling out so a« to
form a pouch or sac. (Fig. 179.) There are o^her kinds of aneu-
risms, which need not be described.

Symptoms. — An aneurism may be felt as a tumor somewlicre
along the coui-He of an artery, and it beats under the tiiiger liku tlie
pulse. The beating is caused by a fresh quantity of blood Ix-iiip
{)Ushed into this sac with every stroke of the heart. If it Ihj Hniull,
I)res8ure on the artery alx)ve it will so far shut off the blood from it,
that it will feel flaccid or soft. The patient will often say that the
tumor began to appear after some violent strain, when something
appeared to give way. In the chest, aneurism will produce an un-
natural pulsation felt by the patient. In the belly, it may generally
be felt as a tumor through the abdominal walls.

Distinction. — Tumors which lie directly over arteries are lifted
up every time the blood is driven along under them, and hence they
pulsate like aneurisms ; but they do not pulsate when small, whereiiH
aneurisms do from the begiiming of their growth. Aneurisms are
soft at first, and hard afterwards; whereas tumors are generally hard
at first, and finally soft.

Treatment. — In some few fortunate csvses, aneurisms get well
spontaneously. If the flow of blood through them can be stopped, tlmt
which is within them will coagulate, forming a hard tumor, wl;icli
will gradually waste away. To cure them, therefore, we must stop
the circulation through them ; and this may be done, in some cases,
by compression. The pressure upon the arteiy must of course he
above the tumor, and should not be so great as to stop the blood
altogether, but only very materially to diminish its flow. The pres-
sure is applied by an instrument having two pads, an arc of steel, a
joint in the middle, and a screw by which the padded extremities are
pressed together. (Fig. 180.)

When this mode of treatment is not practicable, the artery must
be tied between the aneurism and the heart. The patient should be
placed in bed, with the limb wrapped up to preserve its temperature,
and placed in an easy position. Nothing cold should be applied to it.

The force of the circulation should be reduced by the tincture of
veratrum. ,- , .. i.

Bronchocele. — Derbyshire Neck. — Goitre.

Bronchocele is what is called an endemic disease ; which means,
a disease which prevails in certain localities. This complaint is preva-
lent in Nottingham and Derbyshire. England, among the Alps, and
especially in the Tyrol and valley of the Rhone. It is thought to be
produced by the use of melted snow, and water impregnated with
lime and earthy matter. ,

• Symptoms. — A prominent, soft, elastic tumor, occupying the front

SUKOICAL DI8KA8K8.

579

ling out 8o as to
er kindB o£ uneu-

tumor somewliere
he finger like the
ty of blood k'ing
t. If it Ik) Hniivll,
the blood from it,
often say that the
1, when sometliing
11 produce an un-
>r, it may generally

arteries are lifted

m, and hence they

hen 8malU whereas

ti. Aneurisms are

are generally hard

ineurisms get well
can be stopped, that
hard tumor, which
fore, we must stop
one, in some cases,
must of coui-se be
to stop the blood
its flow. The pres-
9, an arc of steel, a
Ided extremities are

ble, the artery nnist
le patient should be
irve its temperature,
uld be applied to it.
i by the tincture of

k. — Goitre.

sease ; which means,
3 complaint is preva-
mong the Alps, and
It is thought to be
jr impregixated with

•, occupying the front

of the throAt, in the situation of the thyroi<l gland, and like it in shape.
It is not tender, and the skin is not discolored. In old cases, the
tumor Incomes hard. In Fig. 181 the tumor is so large as to have
pushed the gullet to one side.

FIO. IHO.

Treatment. — The usual and perhaps the best remedy for this dis-
ease is iodine. It may be given m iodide of potassium, with a bitter
or some other article (188), (145), (101). An iodine ointment may
l)e applied to the tumor (185).

'Jlie patient should move away from the infected district, and re-
side, if possible, upon the sea-coast.

Water in the Scrotum. — Hydrocele.

As the name shows, this is a collection of water in the scrotum or
bag which holds the testicles.

Symptoms. — It presents a swelling, shaped like a pear, smooth
on its surface, fluctuating if pressed, without pain, but causing a little
uneasiness by its weight. On placing a lighted candle on one side
of the scrotum, the light may be seen through it.

Distinction. — This complaint may be distinguished from a solid
enlargement of the testicle by its not being so heavy, solid, or pain-
ful, and by its fluctuating and being transparent ; from lupture, by
its forming slowly instead of suddenly, by the swelling beginning at
the lower part of the scrotum instead of the upper, and by the en-
largement not being increased by coughing as it is in rupture.

Treatment. — In children, strong scattering washes (353) are some-
times successful. But most commonly a number of punctures are
made with a larffe needle, to cause :\e fluid to escape into the cull
tissue of the scrotum, whence it is removed by absorption.

To effect a radical cure in grown persons, the surgeon is to grasp

B80

BUItnlCAL DISEASRS.

the tumor Iw-hiiid, iiiid introduoe iv trorur iind canula into tlio hiio, —
iMtiii^ riiritful to [toiiit tlic iiiHti'iiiiutiit iiitWiudH, so uh not to wniiiiil
tin; tt!Hti(do. Tlu! trowir is tlnMi withdnuvii, — lliu (suiulii hriii;,' al
tliu Hiinit! tiniu ptiHlicHt veil into tliu auc, ho that nonu of tlio tlnid may
get into tlie cell-tisHUo outside the «ac. Tlic lluid runs oil' linnii^li
tlu! (;auul<i. When this Iihh nil cHuaped, Home Htiiiudiitiii^r tluid, -i^
conunou liuie-water, or, still l)elti;r, tincture of iodine, is to In* injirUd
through tlie 'lanula into the emptied sac. After retaining tliis fidiii
two to (ive minutes, it is permitted to flow out. In'Hiimmaliou I'ol-
lows, wiiieh breaks up the secretion of water, and etTectM a cure in
two or three weeks. The amount of fluid thrown in should he aliout
one or two teaspoonfulsof a mixture of one part of tini^ture of iodine
and two j)artfl of water. If tim lirst operation does not efTeet a com-
pleto cure, it may be repeated. The most successful of all troatinentH,
however, is to open the scrotum and disstict out the greater i)ait of
the tiasue which coverti the teatidu uud which seuruteu the fluid.

Blood In the Scrotum. — Ilaematorele.

This is a collection of blood in the scrotum, from some injury.

Treatment. — If the quantity of blood effused be small, cold \\\y
plications may cause it to be ab8orl)ed. If it be large, make a punc-
ture, and apply a poultice for the blood to ooze into.

Acute Inflammation of Veins. — Phlebitis.

The veins are subject to attacks of acute inflammation, which con-
stitutes a very dangerous, and often fattvl, disejise.

Symptoms. — F'its of shivering, or perhaps fainting, a rapid pulse,
anxiety of countenance, lowness of spirits, catching (lains about tiie
heart, and xivelUng, redness, tenderness and hardness along the course of
the affected veins. Sometimes the tongue is furred brown or black,
the skin is sallow, there is bilious vomiting, low delirium, and death.
In ciises less rapid, there are great swelling and redness over the dis-
eivsed veins, and abscesses form, which, when opened, reveal clots of
blood mixed with pus. Or, the patient, while remaining low, with a
sallow countenance, and a yellow tongue, will complain suddeulv of
intense pain in some joint, as the knee or shoulder, — in which tliere
will be a rapid formation of pus ; a similar suppumtion will follow
in other joints, as well as in the lungs, etc., unt" the patient sinks,
and dies of exhaustion.

Treatment. — Apply leeches freely over the inflamed veins, — also
fomentations. Every abscess should be opened early. Keep the
bowels moderately open with some preparation of salts, and allay
pain and restlessness by morphia. Support the strength by beef-tea,
etc. ; and, if the pulse be feeble, give wine or quinine.

8UKU1UAL OmKAHKS.

581

la into tlm n;xt\ —
as not to Wdiiiiil
I) ciiiiulii Ix^iii;,' iit
II! of tlio lliiiil may
niiiH olT tliniii^li
inuilatiii^r tliiid, iw
le, iH to lit! injfi ti'd
b'taiiiint^ tliis fnun
liitlaiMinatioii I'ol-
effecUK n cuin in
in should he ahout
f tinctun' of iodine
!H not effect a coiii-
il of all troatnitMiK
he j^ieater part uf
ruteu the fluid.

latorele,

)m some injury.

1 he small, eold a]>
aige, make a puuc-
tto.

- Phlebitis.
imation, which con-

iting, a rapid pidse,
\g pains ahout the
« along the course of
3d brown or hlack,
lelirium, and death.
ednesa over the dis-
ned, reveal clots of
naining low, with a
raplain suddeidv of
■r, — in which there
>ui-ation will follow
' the patient sinks,

flamed veins, — also
I early. Keep the
of salts, and allay
itrength by beef-tea,
iuine.

The suppuration may ho (dieoked, in thi« as in other complaints,

liy drinking freely of chamomile tea. The power to control suppum-

ion haa recently txjfn discovered as belonging to chamomile flowers.

Chronic Phlebitis.

This is a far less serious disease than the preceding. It generally
aft'ects the veins of the legs.

Symptoms. — Tenderness and hardness of the affected vein, with

swelling around it, and of the part* IhjIow; a general painfulness of

he limb. After tlie inflammation has sulwided, the vein feels hard,

like a cord, because the inflammation causes the blood within to co-

acrulate, and harden, so that notliing can pass through the vessel.

Treatment. — Leeches, fomentations or cold lotions, as the patient
may choose, purgatives and rest, with the limb elevated. Subse-
quently, when the inflammation seems completely subdued, friotiou
with camphorated oil and bandages.

Enlarged or Varicose Veh^s. — Varix.

The veins which lie near the surface, especially those of the legs,
are apt, by exhausting labor upon the feet, and by strains, to get
weakened, so that their valves lose their tone, and the r sides stretch
and give way in certain places, letting the blood bulge out, and form
purple bunches. These bags of blood, lying along upon the surface
of the limb, form knotty tumors, looking like blood-boils. They oc-
casion a kind of distress, but no sharp pain.

Persons of weak, soft and relaxed muscles and blood-vessels are
particularly liable to this complaint. It often attacks women in the
family way.

Treatment. — Where only a few veins are affected, it may be
sufficient, in some cases, to apply firmly over them a few strips of
leather, spread with soap-plaster. But generally it is better to sup-
port the whole limb with a good woolen bandage, or with a laced
stocking, which should be applied in the morning before the patient
is up. It is generally well, also, to use friction, with some liniment,
or iodine ointment. Lead-water, or alum-water, or an infusion of
white-oak bark, may be used with advantage. Burdock and plantain
leaves, bound upon the skin, and removed before they are dry, are
useful. Showering with cold water strengthens the veins. An elas-
tic silk stocking made for the limb is the best general measure.

Rupture. — Hernia.

Hernia signifies a protrusion of any internal organ from the cavity
where it belongs ; but the term is generally restricted so as to mean
no more than a protrusion of the bowel through the walla of the belly.

582

SURGICAL DISEASES.

When the abdominal walls are weak, from any cause, no matter
what, — lifting, straining, or making violent muscular exertion of any
kind, will then often cause the bowel to force itself through at the
most debilitated spot ; and pushing the lining of the belly, the peri-
toneum, along before it, a bag or sac is formed, in which the project-
ing bowel is enclosed, forming an external tumor.

Divisions of Hernia. — Rupture may occur in several different
places, and has accordingly received different names.

Umbilicai Hernia is a protrusion of the bowel at the umbilicus or
navel. This is most common in children soon after birth; and
women who are often pregnant are liable to it.

Ventral Hernia is that which occurs at any part of the belly where
other forms of rupture do not appear.

Inguinal Hernia is that in which the bowel protrudes at the groins,
or through the abdominal rings.

Scrotal Hernia is that in which the bowel descends into the bag
or scrotum.

Femoral Hernia is the dropping down of the bowel behind what
is called Poupart's ligament, and appearing as a tumor at the upper
part of the thigh.

Reducible Hernia. — Rupture is said to be rediieible, when the
bowel may be put back into the cavity from which it came.

Irreducible Hernia. — Hernia is called irreducibh .vhen the pro-
truding bowel cannot be returned into the belly.

Strangulated Hernia is that form of the complaint in which the
bowel is so pressed upon at the point where it passes through the
walls of the belly that it is strangled or constricted so that its contents
cannot pass through. ■ . - . % .,

Symptoms of Hernia. — A soft tumor, which may be compressed,
appears somewhere about the belly ; and is increased in size when
the patient stands up. It also swells when he coughs, or makes any
exertion; and grows smaller, or entirely disappears, when he lies
down.

Treatment. — In a case of reducible hernia, the first thing to be
done is to put the bowel back in its place, which is accorapUshed by
gently pressing and kneading the tumor; and swaying it back and
forth, — b'^ing careful to use no violence, — until it can be pushed
within the abdominal walls. It is then to be kept in its place by the
use of a truss, made expressly to fit the case. This instrument should
be constantly worn by day, and by night, too, if not too irksome ; but
if worn by day only, it should always be applied before rising in the
morning.

SURGICAL DISEASES.

583

jT cause, no matter
liar exertion of any
slf through at the
the belly, the peri-
which the projectr

n several different
les.

at the umbilicus or
1 after birth; and

t of the belly where

trudes at the groins,

jcends into the bag

bowel behind what
tumor at the upper

redrmhle, when the

ch it came.

leihU A^hen the pro-

aplaint in which the

passes through the

I so that its contents

. may be compressed,
greased in size when
oughs, or makes any
►pears, when he lies

he first thing to be
1 is accomplished by
waying it back and
bil it can be pushed
pt in its place by the
is instrument should
not too irksome ; but
I before rising in the

Irreducible Hernia may be palliated by wearing a truss with a hol-
low pad, whicli will so evenly and firmly embrace the tumor as neither
to irritate it, nor permit any further protrusion or enlargement.

Stranguiated Hernia. — If a person has worn a truss for some
time, and suddenly leaving it off, makes some violent exertion, either
the bowel or omentum is liable to be suddenly forced through a nar-
row aperture, and to become strangled. In such case, the patient
has flatulence, colicky pains, a sense of tightness across the belly, and
a desire to go to stool, but no ability to pass anything. Then follows
vomiting, first the contents of the stomach, then mucus and bile,
and, lastly, the fecal matters from the bowels, which are not per-
mitted to pass on to their natural outlet. The neck of the hernial
sac now becomes swelled, tender and pain ' , the countenance is anx-
ious, and the pulse small, hard and wiry ; and, after a time, the tu-
mor begins to mortify, the patient expresses himself free from all
pain, and soon after dies.

In the treatment, the bowel is to be returned if possible, lo do
this, the bladder should fii-st be emptied with a catheter, and the
patient should lie down with his shouldei-s raised, and both his thighs
bent towards the belly, and placed close to each other, so as to relax
all the ligaments and muscles of the ' jUy. The surgeon may now
work gently for half an hour, if necessary, trying to put the bowel
back, but must be very careful not to excite inflammation by any
violence.

If he does not succeed, efforts are next to be made still further to
relax the muscles, as well as to reduce the force of the heart's action,
and to diminish the size of the tumor. With the tincture or fluid
extract of veratrum viride, the heart's action and force of the circula-
tion may be reduced to any desirable extent.

To reduce the tumor, apply pounded ice in a bag, or a freezing
mixture (354.) If the pain be acute give large doses of opium or
morphia. Ether is generally required to reduce a hernia.

If all these remedies fail, there is then no hope but in relieving the
stricture by a surgical operation, which must not be deferred too long.

General DirectionA. — Rupture is an exceedingly common affec-
tion. Perhaps every third or fourth person suffei-s from it more or
less. Females, from motives of delicacy, are apt to conceal the mis-
fortune, and not seek advice. This exposes them to danger. Queen
Caroline, wife of George II, lost her life by such concealment.

A swelling coming on suddenly in the groin cr at the navel, after
considerable exertion, may be taken to be a rupture without nmch
fear of mistake.

The complaint being discovered, the bowel should be put back in
its place, and a truss be put on at once. In the case of young per-
sons, a truss may frequently effect a cure ; but, that it may do this, it
should not be taken off, night or day, except to cleanse it, and then
only when the — arer is in bed.

584

SURGICAL DISEASES.

Those who can afford it should have two trusses of the same size
iuid strength, so that if one get out of order, the other may take its
place while it is being repaired ; for an hour's absence of the truss
might occasion a mischief which it would require months to repaii.

Persons having a rupture must be very careful to keep costiveness
at a distance ; for straining at stool is highly injurious.

Varicocele. — Cirsocele.

This is an enlargement or varicose state of the spermatic veins
and may be mistaken for hernia, inasmuch as standing and coughing
increase it. But it feels like a bag of worms ; and by this peculiar-
ity may be distinguished from rupture.

Treatment. — Wear a suspensory bandage. Have an operation
done if this fails to relieve. i

Deformities and Irritations of tlie Spine.

Lateral Curvature. — There are several varieties of curvature of
the spine. Some of them are caused by the destruction of some por-
tion of the spinal column by disease. It will not be necessary for me
to treat of these forms of curvature, as they can only be investigated
and treated by the most skilful surgeons. Those who will use this
book chiefly, would hardly think of meddling with them.

The curvature which arises from debility of the bones, ligaments,,
and muscles, and which is very common among females, has the tol-
lowing

cymotoms. — At first there is a projection of one collar-bone, or
' *^ one side of the chest, or one shoulder is

considerably el«^^ated, and is popularly
thought to be y,omng out" On exami-
nation, the right shoulder and the right
side of the chest will be found, generally,
to be rounded and lifted up, while the
other is sank down p.nd concave. At the
same tim-:, the left 'lip sticks out, and the
loins on the right side have an inward
curve. The spinal column will have a
curve, as in Fig. 182.

Causes. — This affection is caused by
occupations which keep the body in a
laterally distorted position, and tax one
bide 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. The muscles,
no. 182. too, get so weakened in many females of

SURGICAL DISEASES.

685

of the same size
;her may take its
ance of the truss
aonths to repair.
) keep costiveiiess

LOUS.

,e spermatic veins
ling and coughing
I by this pecuUar-

lave an operation

he Spine.

es of curvature of
iction of some por-
e necessary for me
ily be investigated
J who will use this
I them.

! bones, ligaments,
males, has the fol-

one collar-bone, or
)r one shoulder is
and is popularly
out." On exami-
der and the right
e found, generally,
'ted up, while the
I concave. At the
sticks out, and the
e have an inward
)lumn will have a

ction is caused by
jp the body in a
ition, and tax one
re than the other,
lildren who study
)1 with one elbow
isk. The muscles,
n many females of

luxurious, .sedentary and indolent habits, that they cannot hold tlie
hoiiy frame of the body in an upright position, and (ho jointed
(•(liiiiiin of bones, called the spine, sags down to one .side, iiiul" draws
tlic whole skeleton of the trunk out of shape.

Treatment. — The first thing to be done is to learn what particu-
lar attitude of the body has occasioned the distortion. This discov-
ered, every possible effort is to be niade to break up the habit, what-
ever it may be. If it be standing on one foot, or sleeping on one
side, or reading or writing with the elbow high, keep a constant
watch and strict rule over the patient.

Exercise in the open air should be free, and taken daily. The use
of the dumb-bells is excellent for both sexes }■ but girls should, in
addition, have all the variety of elegant exercise furnished by calis-
thenics. Wealthy parents, whose daughtera are tenderly bred, should
never let them grow up without the invigoration which these exer-
cises impart.

When the curvature is marked, and the debility considerable, these
vigoroiis exercises should be taken for a time with moderation, and
the patient should lie down and rest immediately after taking them.

In many cases considerable benefit is derived from the mechanical
sujjport afforded by supporters of various kinds. These are now con-
structed and adapted to the body, with considerable skill, by those
who make their construction a study and a business.

Spinal Irritation. — The spinal column is liable, at certain points,
to become congested, and consequently sore and irritable.

Sympto»n£. - The symptoms of this state of things are very varia-
ble and numerous, as all sorts of sensations of the skin, from utter
numbness and insensibility up to the most acute sensitiveness, de-
scribed as creeping, shooting, coldness, tingling and the crawling of
^ ants. There may be neuralgic pains, spasm, cramp, trembling or
palsy of the voluntary muscles ; or a fixed pain and tenderness in
some joint or other part ; or palpitation of the heart, ^jjtziness and
wind and pain in the stomach.

When any of these symptoms appear, and cannot be traced to any
other cause, we are to suspect some irritability of the spinal column,
and to search, accordingly, in that direction. The proper method of
search is, to make firm pressure on each of the projections of the
spine, and to pass over the projections a sponge wrung out of hot
water. If there be trouble here, the patient will now be likely to
complain of severe pain at some one point. Or, the tender place
will generally be found sooner, by tapping with the ends of the fin-
gem, with quick and sharp strokes along upon the projecting bones
of the spine. The patient will be pretty sure to wince when the ten-
der point is reached.

Treatment. — Apply leeches, and follow them with a blister, or
stimulating liniment, or some strong, slightly irritating plaster, and
the tenderness will be very likely to disappear, as if by magic.

086

SURGICAL DISEASES.

Wry Neck. — Caput Obstipum.

In this complaint, the head is drawn over towards one of the shoul-
ders, with the face generally turned towards the opposite side. This
is caused by the rigid contraction of a particular muscle. In some in-
stances, however, other muscles are affected, and the head may be
drawn in other directions, or be twitched about in various ways.

I had a singular case from New Hampshire, which, though not
exactly wry neck, was a kindred disease, and is worthy of being men-
tioned. The subject of it was a young lady of good physical develop-
ment, but inclined to nervous complaints. Her head was chiefly.
drawn over backwards, sometimes so as to lie for a short time flat
upon the back, with no power to raise it. She was obliged, ordinar-
ily, to let her head lean a little to one side, and rest upon the hand,
in order to keep it steady. When walkin j, with the head erect, with-
out this support, it was every few moments jerked over backward
and a little to one side, the chin being thrown up in a most unseemly
way. The case partook of the nature of chorea.

Treatment. — For the genuine wry neck, where the muscle wliich
draws the head to one side is rigid and inflamed, the treatment should
consist of leeches, poultices, purgatives, blisters and alteratives. When
the muscles causing the distortion are not rigid, electro-magnetism, or
the shower-bath may have a good effect. In some cases, strychnine
will do well.

The peculiar case mentioned above completely recovered, under
the use of the extract of St. Ignatius' bean (95), one pill three
times a day, and gradually increased to nine pills a day. She also
took iron, and was put upon a most energetic system of out-door ex-
ercise. Considering the stubborn and severe nature of the complaint,
her complete recovery was as unexpected to her friends as it was
gratifying. As the majority of wry neck cases are due to muscular
contrdction%f a rheumatic type, the remedies employed for that dis-
ease should be used here. In all cases the hot applications should
not be lost sight of.

Foreign Bodies in the Eye.

When a person complains of some substance in the eye, the inside
of the lower eyelid and lower portion of the ball should first be ex-
amined, the person being directed at the same time to look up. H
nothing be discovered there, the patient is then to be directed to look
downward. This will expose to view the upper part of the globe.
At the same time, the eyelashes should be taken between the thumb
and finger, and the lid turned upward over some round smooth thing,
as a pencil, which will turn the lid wrong side out, and bring to view
whatever is on the inner surface. Any foreign body discovered may

SURGICAL DISEASES.

587

B one of the shoul-
)po8ite side. This
luscle. Ill some iii-
the head may be
various ways,
which, though not
»rthy of being nien-
1 physical develop-

• head was chiefly

• a short time flat
IS obliged, ordinar-
jst upon the hand,
he head erect, witli-
:ed over backward
in a most unseemly

e the muscle wliich
le treatment should
1 alteratives. When
ectro-magnetism, or
le cases, strychnine

ly recovered, under
95), one pill three
is a day. She also
}tem of out-door ex-
re of the complaint,
sr friends as it was
re due to muscular
iployed for that dis-
applications should

n the eye, the inside
1 should first be ex-
me to look up. H
) be directed to look
r part of the globe.
between the thumb
round smooth thing,
It, and bring to view
body discovered may

be removed by wiping it off with the head of a pin, having a silk
hai archief turned over it. If this fails to detach it, it may be
carefully picked up by running under it the point of a wet tooth-pick.

Stye. — Hordeolum.

A STYE is nothing more nor less than a small, painful boil at the
edge of the eyelid.

Treatment. — In severe cases, apply a poultice ; and open it as
soon as it begins to point. After it has discharged all it is likely to,
apply, on going to bed, for two or three nights, a little diluted nitrate
of mercury ointment. Tonics and alteratives are frequently required
to break up the formation of styes.

Inflammation of the Edge of the Eyelids.

Ophthalmia Tarsi.

This inflammation often involves the Meibomian glands, which
then secrete a sticky mucus, which, not being wiped away during
sleep, glues the lids together, so that, on waking in the morning, the
patient cannot get his eyes open. The complaint is generally chronic
and obstinate, lasting a long time. Weakly persons, with disordered
digestion, are most subject to it. In some cases the lids ulcerate, and
the lashes fall out. Generally the lids are considerably inflamed for
a few days, and then, the inflammation subsiding, branny sca^ s,
which may be brushed off, form along the borders of the lids, at the
roots of the lashes.

Treatment. — The health being generally disordered, needs first to
be improved by all possible means, as by alteratives, tonics, bathing,
exercise in the open air, travelling if practicable, and a generous diet.

While the lids are inflamed, they should be bathed by a wash com-
posed of sulphate of zinc, twelve grains ; laudanum, two drams ; and
soft water, twelve ounces. The redness and heat having subsided,
and the bowels being opened by a gentle dose of physic, an astrin-
gent wash should be applied once or twice during the day (208),
(209), and a small piece of the diluted nitrate of mercury ointment
be rubbed along the borders of the lid, with a pencil-brush at night.
This will generally effect an immediate improvement, and in time
will bring about a cure. .

Disorder of the Lashes.

Trichiasis. — This signifies a growing inward of the eyelashes.

Dystrichiasis. — This is a double row of eyelashes, one of which
grows inward.

Treatment. — Pull out the misplaced hairs, and continue to do so
as fast as they appear.

v*S!

588

SUKGICAL DISEASES.

IHosis.

This is a falling down of the upper eyelid, from palsy of the tliiid
nerve. It is sometimes attended with headache and dizziness, and
may be the forerunner of apoplexy.

Treatment. — Begin the treatment with purgatives, and then us(>
every means to improve the health, especially exercise out of doors.

Chronic Inflammation of the Lachrymal Sac.

When the mucous lining of the nasal duct gets thickened and
obstructed, the patient complains of great weakness of the eye, Avhich
is constantly weeping,— the nostril on the same side having a cones-
ponding drynesi. The tears not passing down through the obstructed
duct, collect in the lachrymal sac, and form a small tumor by the side
of the nose. By pressing the finger upon this, the tears may l)e
squeezed out through the upward passage, and glairy mucus along
with them. There is generally tenderness of the sac, and sometimes
redness of the skin. There is commonly inflammation of the mucous
membrane lining the eyelids, etc.

Treatment. — The acute inflammation of the sac must be treated
by leeches, purgatives, and cold washes.

Chronic inflammation of the sac requires a special attention to the
general health. The diet should be carefully regulated, and the alka-
line sponge-bath used every day, with brisk rubbing after it. When
the sac gets very full, the patient should try gently to force the con-
tents down into the nose by pressing upon the upper side of the
tumor ; and he may promote the same object by strongly drawing m
his breath often with his mouth and nostrils both tightly shut. Hie
so-called citrine ointment, fuU strength, may be applied to the eye-
lids at bed-time, and a little of prescription r211) may be dropped
once during the day into the inner corner of the eye.

Purulent Ophthalmia. —Egyptian Ophthalmia.

Owing to the glaring sunshine, and the particles of sand witli
which the air is loaded, this disease is endemic in Egypt. Hence its
name Egyptian ophthalmia.

Symptoms. — It begins with stiffness, itching, and watering d
the eyes, and a feeling as if there were dast in them. The lids are a
little swelled, and become glued together during sleep. The mucous
mambrane which lines the Hds and covers the ball is intensely red
and swollen, and discharges a copious quantity of pus. There is a
severe burning pain extending to the cheek and temple, with hea.l-
ache and fever. The eyes cannot be opened. It is both contagious
^d infectious.

SURGIOAL DISEASES.

589

1 palsy of the tliiid
and dizziness, and

tives, and then use
rcise out of doors.

tirytnal Sac.

jets thickened and
58 of the eye, which
ide having a corius-
3Ugh the obstructed
1 tumor by the side
I the tears may be
glairy mucus along
sac, and sometimes
ation of the mucous

sac must be treated

cial attention to the
iilated, and the alka-
ing after it. When
tly to force the con-
) upper side of the
strongly drawing in
I tightly shut. The
applied to the eye-
1) maybe dropped
eye.

I Ophthalmia.

rticles of sand witli
1 Egypt. Hence its

ig, and watering (if
lem. The lids are a
sleep. The mucous
ball is intensely red
of pus. There is a
1 temple, with head-
It is both contagious

Treatment. — At the very beginning, apply a nitrate of silver wash
(211) twice a day. With this application, a low diet, and five to
ten-drop doses of fluid extract or tincture of veratrum viride, every
hour, tliis terrible complaint may often be broken up.

If the disease have reached its height, and there is great fever and
lieadache, the patient may be freely purged (81), and the pain bo
allayed by cocaine applied with a camel's hair brush.

The patient must he kept in bed, in a dark room, with the head
elevated.

The eyes should be frequently washed out gently with warm water,
or a decoction of poppies, containing one grain of alum to an ounce.
This must be done with a piece of fine sponge, or with a small
syringe. Once or twice a day, a few drops of solution of nitrate of
silver, two grains to the ounce of soft water, may be dropped in
the eyes from a camel's-hair pencil. As soon us the disease begins
to give way, the alum in the poppy decoction may be increased a
little.

Purulent Ophthalmia of Children.

This always begins within a short time after birth, — generally
on the third day.

Symptoms. — The edges of the lids at first become red, and glued
together, and the membrane lining them is red and rough. The eye
remains closed. The conjunctiva or membrane wliich covers the
globe, next becomes intensely scarlet, and so much swelled, at times,
that the lids turn out ; and it discharges a thick purulent matter.
The child is feverish and restless.

Causes. — Exposure to cold and damp, bad nursiug, omitting to
wash away from the eyes the cheesy secretions of the skin, and the
contact of gonorrl:oeal and leucorrhoeal secretions of the vagina at
birth.

Treatment. — Wash out the eye frequently, and gently, with a
weak astringent wash (207), (203), or put between the lids once a
day, a large drop, with a camel's-hair pencil, of prescription (208).
When the disease is declining, apply to the lids, with a camel's-hair
pencil, the ordinary citrine ointment of the druggist.

Catarrhal Ophthalmia.

Symptoms. — In this complaint, the white of the eye becomes in-
flamed and very red, the redness being superficial, so that the vessel
can be moved by pulling the eyelids ; generally there is a thin mu-
cous discharge, which, in sevei-e cases, becomes thick and purulent.
It is caused by cold and damp.

Treatment* — If there be considerable pain and headache, give
purgatives (31), (19), and continue them, once a day, till the symp-

ifimiiM

'itimatoSRni

■iniUM**

690

BUKUIUAL DIHKASKS.

toms of active inflainniatiou subside. Ai)ply to the eyes a poultice
of slippery elm, and bathe them frequently with a decoction of pitppy
leaves, lukewarm or cold, according to the choice of the patiuiit.
Smear the edges of the lids at night with fresh lard ; and when the
inflammation begins to decline, use diluted nitrate of mercury oint-
ment instead. Keep tlie eyes well protected from the light with a
shade. A large drop of a solution of jiitrate of silver, two to four
grains to the ounce of water, may be \)\it into the eye two or tiirco
times a day. Sometimes sulphate of zinc, four grains to the ounce
of water, will do well, or cocaine solution, 4 per cent.

When the disease reaches the chronic stage, — the pain and head-
ache having passed off, — some astringent applications will 1h^ re-
quired, as a very weak solution of nitrate of silver (208), or a drum
each of powdered witchhazel hmves and golden seal, steeped for ten
minutes in a gill of boiling water, and strained when cold.

Scrofulous Ophthalmia.

This disease is chiefly confined to childi-en under eight yeai-s of
age-
Symptoms* — Entire inability to bear light ; the lids are spasmoiU-
cally closed, and the head constantly turnel away from the light.
The blood-vessels of the conjunctiva are not particularly injected,
with the exception of one or two large ones which run towards the
cornea, and terminate in one or more small opaque pimples. The
cornea frequently ulcerates, and the complaint is very obstinate, —
being liable often to recur.

Treatment. — As in all scrofulous complaints, it is important in
this to look after the general health. No more physic is required
than to keep the bowels open ; and even this, if costiveness exist,
had better be done by bread made from unbolted wheat flour, by
injections of cool or tepid -water, and by exercise. The health must
be supported by iron, sarsaparilla, stillingia, and quinine.

The eye is to be strengthened by cold water applied to the lids,
the forehead, and the temples. The eyes may be bathed likewise with
a warm decoction of poppies, or of chamomile flowers or cocaine.

But one of the best applications. is a solution of nitrate of silver,
one or two grains to the ounce of water, a few drops being put into
the eye once or twice a day. Occasionally a solution of sulphate of
copper, of the same strength, may be used with decided advantage.

Both eyes should be protected by a shade.

Inflammation of the Cornea. — Comeitis.

Symptoms. — The cornea is rough, red, opaque, and generally
prominent. There is some pain and inability to bear light, but not
great. The pulse is frequent, and the skin dry.

SURGICAL DISEASES.

691

B eyes a poult i(;e
ecoction of poppy
e of the piiliiMit.
(1 ; and when the
I of mercury oint-
the light with a
ilvcr, two to four
eye two or tlueo
ains to the ounce
int.

he pain and head-
iations will l)e re-
• (208), or a dram
al, steeped for ten
len cold.

der eight years of

e lids are spasmodi-
a,y from the light,
rticularly injected,
h run towards the
(jue pimples. The
very obstinate, —

it is important in
! physic is required
f costiveness exist,
jed wheat flour, by
The health must
quinine.

ipplied to the lids,
jathed likewise with
wers or cocaine,
jf nitrate of silver,
rops being put into
ition of sulphate of
lecided advantage.

- Corneitis.

ique, and generally
) bear light, but not

Treatment. — If the inflammation be acute, use leeches, purgatives,
tincture of veratrum. Apply fomentations, and smear belladonna
ointmert on the eyebrows.

For ti.j chronic form, give quinine and other bitters, and put blis-
tei-s upon the nape of the neck, and behind the eara. The wine of
opium, and the diluted nitrate of mercury ointment, must be applied
to the lids, or cocaine.

Inflammation of the Iris. — Iritis.

Thk iris is covered with a serous membrane, and is very liable to
adhesive inflammation.

Symptoms. — In the first stage, the iris changes its color, and the
pup 1 is contracted. In the next stage, lymph is poured out upon the
surface in a thin layer, sometimes, which looks rusty, and sometimes
in larger quantities, filling the whole cavity of the aqueous humor.

Causes. — Injuries, or overworking the eye, but more frequently
a taint of the system from gout or syphilis.

Treatment. — If there be considerable inflammation, apply leeches
to the temples, and keep down the circulation by tincture of vera-
trum. To relieve pain, if any, paiiit with cocaine or morphia.
The strength is generally to be suppcvted by quinine ; and in many
instances, iodide of potassium is to be given as an alterative. A little
solution of atropia, one grain to the ounce of water, is to be dropped
into the eye once or twice a day, and a warm infusion of slippery-
elm bark, or of marshmallow, to be used as a wash. The bowels to
be kept open by gentle physic.

Weakness of Sight. — Muscw VoUtantes.

This is an affection to which persons of weakly constitution are
liable, and those who write much, or examine very small objects.

Symptoms. — Dimness of sight; uneasiness on exposure to a strong
light ; and specks floating before the eyes, — often looking like flies.

Treatment. — The complaint depends on debility, natural or ac-
quired; and tonics, as quinine and iron, and the shower or sponge
bath, and out-door exercise, are the proper remedies.

Imperfect Vision. — Amaurosis.

The complaint here referred to is dependent on some change in
the optic nerve or the brain, — most commonly the former.

Symptoms. — In some cases the sight becomes suddenly dim, and
is perhaps soon lost altogether; but more often it is impaired by slow
degrees, — being only defective at intervals, as when the stomach is

)^'mafmmmmtf9^im'imaMtimmm0iimt

692

BUROIOAL DIBEABKS.

out of order, or the eyes have been fatigued. At one timo, it will
begin with objects appearing dim; at another, with their hcinp
double; at still another, with the ability to see only one Imlf of
objects. In some instances, the complaint begins with a crooked
or disfigured or discolored appearance of things looked at. AEraiii
it will begin as near-sightedness, or far-sightedness ; or the patient
cannot measure distances, and will miss his aim in pouring water
into a glass, or in putting a match to the wick of a lamp. The llamo
of a lamp will appear split. At times the eye does not l)ear lijjlit;
at other times it longs for it, and objects do not appear illuminated
enough.

Distinction. — Amaurosis may be distinguished from cataract hy
there being no opaque body to be seen behind the pupil ; and by the
light of a candle appearing discolored, split, or lengthened, or irides-
cent ; whereas in cataract vision m only clouded, and a lighted candle
looks as if surrounded with a mist.

Chances of Cure. — These are generally not very favorable, unless
the remedies employed very soon produce good effects.

Treatment. — Electro galvanism is one of the most promising reme-
dies. Bayberry root, dried and reduced to an impalpable powder, and
taken as a snuff, is occasionally useful. Cayenne, steeped in water,
one grain to one ounce of water, and a little of it dropped into the
eye, may stimulate the palsied nerve, and in some cases restore siglit.

Blisters may be applied behind the ears, or a seton may be tried
upon the back of the neck, with some promise of success.

But probably nothing will do better than cold bathing, — a shower
bath if it can be borne, — outnioor exercise vigorously pursued, and
an adherence for a long time — perhaps a year — to a strictly vege-
table diet, at the same time using nervine tonics, etc. (316).

Short and Long 5ight.

Short 5ight, called myopia, depends on too great a convexity of the
cornea, or crystaline lens, or vitreous humor, — one or all, — and tiie
consequent formation of the image of the object inspected a little in
front of the optic nerve, or retina, — as at a (Fig. 183), instead of ati,

Fig. 183.

where it should be formed. The rays of light are brought to n focus
before they reach the retina.

S.-.^J!L-.

SUWilCAL DISKASKH.

5D3

it one timo, it will
witli their being
5 only one liiilf of
18 with a crooked
looked at. Ap;ain
38.S ; or the patient
I in pouring water
I lamp. The tlame
068 not bear liglit;
appear illuminated

hI from cataract by
9 pupil ; and by the
iigthened, or irides-
kud a lighted candle

ary favorable, unless
ffects.

nost promising rcnie-
ialpable powder, and
le, steeped in water,
it dropped into the
3 oases restore sight.
seton may be tried
[ success.

bathing, — a shower
)rou3ly pursued, and
— to a strictly vege-
1, etc. (316).

eat a convexity of the

one or all, — and the

t inspected a little in

183), instead of at 6,

riiildrcn aro either l)orn with this defect, or it is brought on by too
clo.so study, or by long apidioation of the eyes to minute objects.

It may lie remedied frequently by exercising the eyes in looking at
distant objcc^ta. Children alllictcd in this way sliould liave their
studies abridged, and their exercise in the open air increased. Wiiilo
studying they should have some apparatus applied to them which
shall kv!ep the chin elevated, so that the head cannot be dropped too
low, and the eyes brought too near the book. And the book slould
each day be jilaced a very little further from the eyes.

Glasses worn by peraons having this defect of vision should Ims
concave, as at c.

Long Sight, or presbyopia, depends on the humora of the eye not

heiiiji convex enough. In this case, the image of the inspected object
, is formed beyond the optic nerve, as at d (Fig. 184). This is one of
tho earliest signs of advancing age.

ire brought to a focus

Ho. 184.

This defect is to be remedied by glasses which are convex, e. Per-
sons iu the early autumn of life must not resort to glasses too hastily,
or, indeed, until they are Compelled to, nor should they change those
fii-st used too soon. Ghisses should make objects look distinct and
bright, but not larger than natural.

Squinting. — Strabismus.

Ix strabismus, the eyes arie not parallel in their i)osition and mo-
tion.

It is supposed that one eye may become weaker tiian the other, or
that the visual axis of the two may not be adjusted alike, so that one
eye — perhaps the more defective one — turns aside to escape the
distorted vision, or possibly the injury to itself which would follow
the attempt to make eyes of unequal power work evenly together.
The opposing muscles lose their counterbalancing force, and the in-
ternal rectus, gaining the preponderance, draws the eye inward, — for
the squint is more often convergent than divergent; that is, the eye
turns in more often than out. Both eyes sometimes squint.

Treatment. — In recent cases there is some chance of curing this
coniplrtint without a surgical operation. The patient should not be
lu the society of other squinting pei-sons, so as to learn it by imitation.

Iu the first place care should be taken that the bowels are kept in

,i.-,a..:'ai.,^

•AiiinMiatalMi^aiimHn--

I ' JW WM u" tiJuiwi g wrm i '

504

HUltiilCAL DI8RA8F.H.

good condition, iind that the frunonil health is well fortified hy IhiUi-
iiig, tonics, and excrciMo. The patient Hhould be made to Htand
before a gliiHH, and while he cIohcs the Hound eye, look steadily at
Home ol)ject with the H(|uiiiting eye. Lot him do this till the eyn is a
little tired; then let him open Uie sound eye, when theHiiuintingone
will turn anide. But by compelling it, in this way, Hcvenil tim-M u
day, to wo'k in a Htraight line, it may, perhaps, be taught to remain
parallel with the other.

Nervine tonics, as strychnine (86), (94), (05), (816), will noimc-
times do good service ; and electro-gidvanism has l)een found iiscful
in many cases.

But in old and ol)stinate ciises, the only cure is found in diviiHiiir
the muscle which j)ulls the eye to one side, — the internal rectus, if
the eye is drawn in, — the external rectus, i£ it is drawn out.

Affet:tlons of the Ear.

Thehk are so common, that, in almost every family, they re(piiio
attention, at one time or another. And deafness, which so often
results from these disorders, is so serious a misfortune that every
affection of the ear should receive early attention.

Examination of tlie Meatus. — For examining the meatus, or ex-
ternal passage of the ear, there is perhaps no better instrument than

a simple silver or glass tube, of the size
and shape represented in Fig. 186.

To make the examination properly,
place the patient either in a sitting,
kneeling, or standing posture, as may \k
Fio. 186. ^ " most convenient, with the ear directly
under a good stream of gas- or lamp- or
sun-light. Then take hold of the ear with the thumb and finger, and
gently draw it outward and backward, and with the other hand in-
troduce the small end of the tube or speculum, and cany it forward
as far as it will go without producing pain. Then by gently swaying
the largo end of the tube back and forth, a stream of light may k'
made to illuminate all sides of the passage. If the lining of this
passage is smooth, dry, pearly-white, and shining, and is without wax,
it may be regarded as healthy. At the close of the passage, tiie
tympanum may be seen, and should be semi-transparent, dry, and
grayish-white. "Within this may be seen the handle of the malleus.
coLiing from above downward and forward. This bone runs about half
way across the tympanum, and divides it into an upper front, and
a lower back part. This lower back portion, when viewed through
the speculum, is more glistening than the upper and front part, ami
a bright spot of light is seen on its most rounded portion, which is
just below and Ixjhind the i)()int of the malleus. Inflammation causes
this innermost part of th( leatus to become thickened, vascular, or

8URUICAL IIIBRA8E8.

r)9r>

I fortified by biitli-
JO inudo to sUiiul
e, look Bteadily at
lluH till thi) eyo Ih a
I the stiuiiitinjj one
ly, Heveml tiinvs a
) tiuight to remain

, (816), will Hoiiie-
l)een found u«oful

found ill dividing
I internal rectus, if
I drawn out.

'amily, they require
388, which so often
jfortune that t'veiy

g the meatus, or ex-
,ter instrument than
438 tube, of the size
in Fig. 185.
imination properly,
ither in a sitting,

posture, as may l)e

,h the ear directly

of gas- or lamp- or

lumb and finger, and

the other hand in-
and carry it forward
;n by gently swaying
sam of light may be
[f the lining of tliis
, and is without wax,

of the passage, the
transparent, dry, and
indie of the malleus.
8 bone runs about half

an upper front, and
vhen Ariewed through
r and front part, and
ded portion, whioh is

Inflammation causes
hickened, vascular, or

granular, — like the conjunctiva of the cy«^ when it is inflamed: it
uIho cauHeM it to Hocrutu and diHchargc matter.

Inflammation of the Meatus. — Olorrhn'a.

This is quite a common complaint among delicate children ; and
may occur a8 the result of Hcarlet fever, or be excited by curreutti of
cold air, by rotten teeth, or by deranged stomach and lH)welH.

Symptoms. — Fever, headache, intense pain in the ear, and swell-
ing of the glands of the neck. After a time, a reddish, watery dis-
charge comes on, which soon grows thicker and mattery. The fever
disappears with the appearance of the thick matter. An examination
with the speculum shows the whole meatus to he swollen, vascular,
and covered with a slimy matter.

Unless great attention be given to cleanliness, the discharge be-
comes very abundant and fetid, and lasts for a long time ; and if
neglected, will be likely to lead to very serious consecpiences, even
the decay of some of the bones of the head.

Treatment. — While the inflammation is acute, and there is fever
and pain, the diet should be confined to mere liquids, — as rice-watei-,
gruel, etc., and the bowels should be opened with some preparation of
salts, the ear being gently syringed, occasionally, with warm water
or decoction of poppies, and being covered with a warm poultice of
flax-seed or bread and milk. In place of a poultice, a soft linen bag,
lilled with bran, and dipped in hot water, may be kept on the ear.
If tliere be great pain and headache, put leeches behind the ear.

The pain and fever being gone, and the mattery discharge having
come on, the case is to be treated like other chronic diseases of mu-
cous membranes in scrofulous constitutions, by tonics, alteratives,
warm baths, and out-door exercise.

The ear may now be gently syringed out with castile soap and
water, and immediately after with a weak solution of alum, or sul-
phate of zinc, one grain to a dram. This may be done twice a day.
Or, a little of a mixture of two drams of solution of sugar of lead
and half a pint of water may be dropped into the meatus, and, after
remaining two or three minuies, be allowed to run out. If the dis-
charge be very fetid, two drams of solution of chloride of lime, with
half a pint of wat«r, will make a suitable wr^h with which to syringe
it, applying, once a day, a solution of nitrate of silver, five grains
to the ounce of water.

Should the discharge stop at any time, and pain and fever come
on, lay aside these astringent applications, and go back at once to the
leeches, purgatives, poultices and fomentations.

ti^:-

j3T

596

SUBOIOAL DISEASES.

Wax In the Ear.

The oar sometime.s becomes completely filled with wiix, mixed
with hairs and flakes of scarf-skin, impeding greatly the sense of
hearincr.

Treatment. — Let the ear be gently syringed each morning witli
warjn soapsuds, so as to thoroughly clear out the whole mass of
matter, after having dropped into the ear the night before four oi' iive
drops of oil. The water may be quite warm, and a little cotton sliould
be loosely inserted after the syringing.

Earache. — Otalgia.

Symptoms. — This is simply neuralgia of the ear, and comes on in
fiita of excruciating pain, which shoots over the head and face. It
may be distinguished from inflammation of the ear by the sudden-
ness and intensity of the pain ; by its not throbbing, not increasing
in intensity, not being attended by fever, and not coming and going
without apparent cause.

Treatment. — Fill or remove all rotten teeth, which may be sus-
pected as the cause of the suffering. Give iron, particularly the
citrate combined with strychnine (316). The core of an onion after
being baked, applied to the ear as hot as it ca:i be borne, will often
give relief. The onion is to be baked whole. The core then is taken
out while hot and inserted in the ear.

Inflammation of the Tympanum. — Deafness.

„ .,.,;^ :,,. , t,„...v. Otitis. .^. ^^■ •:"•."''.: '■?-.■ •';''-,.

Symptums. — In the acute form of the disease, there is violent
pain, ringing noises in the ear, and delirium. When the suppuration
takes place, there is a chill, and a heavy, tensive pain.

' In the chronic form of the complaint, the lining membrane of the
tympanic cavity has its vessels a little enlarged, with blood sorae-
tim6s effused into its substance, or lymph upon its surface, or the
membrane is thickened, and sometimes covered with tuberculous
Qoncretions, or there are fibrous bands occupying nearly the whole
of the cavity.

Symptoms. - These are slight, — the first perceptible change being
generally deafness in one or both eaic. There may be a woolly sen-
sation, with noises or ringing, and slight aching pains.

Treatmenr — As the deafness in these cases generally depends on a
chrc lie inflammation of the tympanic membrane, the best remedies are
those which improve the condition of the digestive organs and gen-
eral health, as regular diet, bathing, pure air, and exercise, with tonics

>"„■-.

SURQICAL DISEASES.

507

with wax, mixed
atly the sense of

ach morning witli

le whole msiss of

hefore four or live

little cotton sliould

r, and comes on in
ead and face. It
ar by the sudden-
ng, not increasing
coming and going

jvhich may be sus-
1, particularly the
B of an onion after
e borne, will often
i core then is taken

- Deafness.

e, there is violent

en the suppuration

)ain.

f membrane of the

with blood some-
its surface, or the

with tuberculous
r .nearly the whole

ptible change being
ly be a woolly sen-
ains.

lerally depends on a
le best remedies are
i^e organs and gen-
ixercise, with tonics

and alteratives. Occasionally, a leech or two, or a blister behind the
ear will be serviceable. But generally dry cupping behind and in
front of the ear will answer the purpose for calling the blood away
from the thickened membrane.

If the inflammation be acute, it must be combatted with purging
blisters, poultices and fomentations.

When deafness is caused by inflammation in the Eustachian tubes,
or from enlargement of the tonsils, etc., the tonsils mu3t be cut off,
and a solution of nitrate of silver, twenty grains to the ounce, must
Le thrown upon the mouths of the tubes with a shower syringe.

Bleeding from the Nose. — Epidaxis.

Treatment. — In full-blooded persons, with redness of face, and
subject to headache and dizziness, bleeding from the nose may be
salutary, and necessary to ward off apoplexy, and should not be too
suddenly stopped.

When the bleeding is such as to require to have it arrested, plug
the nostrils with the scraping from a fur hat, or with lint, dipped in
a strong solution of alum or tannin or Monsel's persalt of iron, one
part to ten parts of water. To give immediate relief, press up undor
the upper lips or apply something cold to the back of the neck.

Ingrowing Toe-Nail.

To most persons, the above words will suggest some unpleasant
associations, for there are few bat have had some painful experience
with this affection. It is usually^ like corns and some other trouble-
some things, the penalty inflicted for wearing tight shoes. It gener-
ally appears upon the great toe. The constant
pressure of a narrow boot or shoe against the side
of the toe, causes the edge of the nail to sink into
the flesh, producing inflammation and pain, and
finally ulceration. Nature, attempting to repair
the mischief, sends out granulations, which, being
perpetually irritated, shoot up into unhealthy
growths, called proud Jlesh. Thenceforward, the
sufferings of the patient become incessant ; and he
cannot now even compromise, as he would be glad |
to do, ^^ putting on shoes of ample dimensions, but'
is obliged to negotiate a peace by putting away the
shoe altogp+bcr, or by cutting a hole through it to
take off tn^ pressure. At the risk of giving the reader a few d: '
twinges every time he looks upon this page, we place here, in
186, a good representation of this tormenting disorder, as a sale-
able warning against the folly of giving the toes narrow quarters.

Treatment. — Make a lye by putting half a pint of hard-wood

Fia. 186.

BMtti

598

SURGICAL DISEASES.

I^f^

ashes into a quart of hot water ; bathe the toe in this, while warm,
twenty minutes, every day. Immediately after each bathing apply u
poultice made of ground slippery elm and weak lye, changing tlie
[)Oultice twice a day. As fast as the inflammation is subdued by
♦this, press a little fine lint gently under the edge of the nail. At each
subsequent dressing, cut off as much of the nail as is raised out of the
tender flesh, with the keen poiit of a penknife. Continue to do this
till the whole offending portion is cut away.

If the above treatment does not reduce the inflammation and great
tenderness, spread some extract of belladonna upon lint, — lay this
upon the diseased part, and put a poultice over it.

When the disorder begins to make its appearance, it is a good plan
to scrape the nail very thin on top ; this will cause it to grow upon
the upper surface, and to give way at the tender part, so as to obvi-
ate, sometimes, the necessity of any other treatment.

The following is the best treatment. Wash the toe in warm water,
and m^ke the parts dry with cotton wool. Then gently press cotton
wool in between the toe-nail and the tender projecting flesh, and ex-
tend it along the groove back between the skin and nail. Next, wet
the end of a piece of nitrate of silver, and rub it thoroughly upon the
nail, close to the cotton, not allowing it to touch the tender flesh;
then put on a thin layer of cotton wool, and, in two or three hours,
a poultice around the toe.

In two dajrs, the nail will be perfectly black, and, aa far as the ni-
trate was we:l applied, will be separated from the parts underneath,
and may be taken off without pain.

If the nail is very thick., scrap off the black and deadened pai-t in
two days, and apply the nitrate again. This treatment is a vast im-
provement on the old and cruel practice of tearing off the live nail.

Chafing and Excoriation.

When the neck, arm-pits, thighs, etc., of children, get chafed or
excoriated, a remedy may be found by keeping the parts clean, and
by dusting them with powdered slippery elm, starch or talcum pow-
der. If this does not effect a cure, api'^y Turner's cerate, or wash
the parts with a solution of sulphate of zinc, or nitrate of silver, five
grains to the ounce of soft water.

Grown persons may treat these troubles very much in the same
way, ox by wearing cotton between the parts wliich rub together.

Foreign Substances in the Nose.

When any foreign substance gets lodged in the nose, close the
mouth and Uie opposite nostril, and then blow forcibly through the
obstructed side. If this is not successful, press the thumb against the
nose above the obstructing body, and then make a hook of a piece of

SURGICAL DISEASES.

599

this, wliile ■warm,
ch bathing apply a

lye, changing tlie
ion is subdued by
: the nail. At each
is raised out of the
Ilontinue to do this

mmation and great
)on lint, — lay this

Be, it is a good plan
56 it to grow upon
part, 80 as to obvi-
snt.

toe in warm water,
gently press cotton
icting flesh, and ex-
nd nail. Next, wet
horoughly upon the
h the tender flesh;
wo or three hours,

nd, as far as the ni-
B parts underneath,

id deadened part in
),tinent is a vast im-
ig off the live nail.

dren, get chafed or
the parts clean, and
irch or talcum pow-
aer's cerate, or wash
aitrate of silver, five

T much in the same
ich rub together.

Nose.

the nose, close the
forcibly through the
le thumb against the
a hook of a piece of

wire or knitting needle, and pressing it up over the offending sub-
stance, pull it down.

Foreign Substances in the Ear.

If flies and other insects get into the ear, fill the ear with sweet
oil, and then syringe it out with warm water. Sometimes it will be
sufficient to hold the head down on one side, and have the ear filled
with water, — remaining quiet in this position for a short time, when
the insect will rise to the surface. If any hard substance be got into
the ear, lie down quietly upon the affected side, and send for a phy-
sician.

Foreign Substances in the Outlet.

If the substance have not gone beyond the reach of the thumb and
finger, thiust them down as far as possible, and try to pull it out; or,
a small curved pair of forceps will reach still lower than the fingers.
Or, tliis failing, let some one place one hand firmly on the chest of
the choking person, and give him a smart blow or two between the
shoulders with the other hand. If the substance be down some way
in the gullet, it may be pushed along into the stomach by some
smooth, blunt instrument.

Foreign Bodies in the Windpipe.

Sometimes foreign bodies will remain a long time in the windpipe,
and will only create some inflammation and cough, but not any im-
mediately dangerous symptoms. When the body has gone entirely
below the epiglottis, l)ut little can be done, except to give a pinch of
snuff to cause sneezing, and to direct the patient to expel the air ex-
plosively from the lungs by a few energetic and sudden coughs. This
may drive the offending body out.

Bleeding from Wounds.

If bleeding occur from any part where a bone lies near the surface,
as the head or' face, it may generally be stopped by pressing firmly
against the bone with a finger, or a piece of cork, or by binding on
tightly a hard pad. If this does not succeed, lift up each edge of the
wound, and examine carefully to see if any small stream of blood is
spouting out in jets. If so, an artery is wounded, and the point of
small forceps or tweezers must be dipped in where the jets come
from; the spouting mouth taken hold of and drawn out; and a
strong silk thread passed aro'ind it, and tied below the forceps. The
white and gaping mouth of the vessel may then be seen.

If the bleeding be profuse from an arm, the whole current of blood
to that limb must be cut off, which may be done by some person
pressing a thumb firmly into the neck behind the middle of the col-

:^jtd.*^\£^: . '.■.-^.^^'^^^..-Si^.^ . ■^..^^.^■^.^■^t.^-.-r.-. -^.^i.^..: j^:.t'^. • .:•::.. :..^f^-:..J:^.-

600

SURGICAL DISEASES.

lar-bone. This will clam ap the blood in the great artery of the arm,
as it conies out of the chest. The handle of a door-key, wrapped in
several folds of linen, may be pressed upon this place for a long time
until medical assistance can be had.

Dangerous bleeding from the thigh or leg may often be stopped by
pressing the great artery just below tlie crease of the groin.

If the bleeding be below the middle of the upper arm, or middle
of the thigh, pass a handkerchief once or twice around the limb, as
far above the wound as possible, and tie it tightly. Slip a stiff stick
under thi^, and turn it round, like the handle of an auger, until tlie
handkerchief becomes so tight as to stop the bleeding. This arrange-
ment is called a stick-tourniquet, and is intended to answer the same
purpose as the instrument represented by Fig. 155.

One of the best methods now in use, of arresting hemorrhage in
cases of accidental injuries ol the large arteries of the extremities, is
by surrounding the limb above with two turns of a piece of rubber
tubing about three-fourths of an inch ia diameter, and tying it tiglit.
This safely and effectually controls all bleeding.

Advantage is taken of this elastic property of rubber in controlling
hemorrhage, in performing what is called bloodless operations of sur-
gery. It is called Esmarch's method, from the name of the origitiii-
tor. It may be resorted to in all operations on the extremities, whether
of amputations, che removal of tumors, or in the minor operations of
removing needles, and whenever the bleeding interferes with the per-
formance of the operation.

It is applied as follows : The limb should first be tightly bandaged
with an elastic rubber bandage about three inches wide, from below
upwards, and then surrounded at the highest 'point with a band or
tube of rubber in the place of a tourniquet. The bandage is then to
be removed, when the operation may be performed in temporarily
bloodless tissues.

An amputation of the thigh may be thus performed without loss of
any blood of consequence.

Anaesthetics.

In these days when so much wonderful surgery is done and when
everybody desires to have the advantage of all modern methods being
employed in the treatment of their case, a little knowledge of anses-
thesia will be of service to the reader. Before the discovery of ether
an operation meant torture to the patient. If you should visit some
of the old operating-rooms you would find rings in the floor to which
ropes tised to be attached in order to hold down the patient. Ether
is the most commonly employed anaesthetic, and is safe to inhale, sure
in its action and gives the least mortality. Something like one per-
son in 50,000 dies from the inhalation of ether against one in 15,000
to 30,000 when inhaling other anaesthetics. It is not over pleasaut

SURGICAL DISEASES.

601

artery of the arm,
)r-kt:y, wrapped in
,ce for a long time

[ten be stopped by
,he groin,
er arm, or middle
round the limh, as
Slip a stiff stick
in auger, until the
ing. This arrange-
io answer the same
t.

ing hemorrhage in
the extremities, is
a piece of rubber
and tying it tight.

bber in controlling
s operations of sur-
ime of the origina-
xtremities, whether
minor operations of
rferes with the per-

be tightly bandaged
!8 wide, from below
»int with a band or
1 bandage is then to
ned in temporarily

•med without loss of

y is done and when
>dern methods being
knowledge of anses-
le discovery of ether
)U should visit some
in the floor to which
the patient. Ether
9 safe to inhale, sure
lething like one per-
gainst one in 15,000
is uot over pleasant

to inhale, as it is somewhat pungent and choky to breathe when first
inhaled. Tliis sensation soon passes off. A longer time is required
to produce anaesthesia with ether than with chloroform, but its greater
sjifoty overbalances this slight disadvantage. Vomiting more fre-
quently occurs after ether than after chloroform.

Chloroform is the next most commonly employed anaesthetic. It
is agreeable, quick in its action, and very little is required. It is
the common angesthetic in European practice, yet its greater mortality,
the sudden change in heart and lung action, render its usefulness
much more limited in this country than that of ether. It is employed
especially in cases complicated by lung and kidney disease in the
young and very old.

The A. C. E, mixture, so-called, is still a third anaesthetic, and is
composed of a mixture of alcohol, chloroform and ether, and is fre-
^acntly given to start a case with, as its inhalation is pleasant and
its anaesthetic properties quick. Its mortality rate lies between that
of ether and chloroform. Some people take these anaesthetics with
perfect comfort; others, being timid, require a larger amount and
give in to its soporific effects very slowly.

Of late Cocaine has been introduced into medical practice as a
means of rendering the flesh numb and painless when injected under
the skin about the site of the part to be operated on. It has the great
advantage of maintaining the senses other than that of sensation and
pain perfectly intact. By its use large operations may be done, and,
in the case of minor operations, time and money are saved and bad
after-effects are avoided. Sometimes a temporary faintness occurs
from the use of a too strong solution, but this can always be avoided
by weaker solutions and overcome at the time by a little stimulant.

There is a popular feeling that ether and chloroform leave their
traces in the system for a long time afterward ; such is not the case,
however, and fear need never be entertained that the system will be
left the weaker for it.

In the use of anaesthetics proper, certain rules are to be observed.
Nothing solid is to be eaten for a number of houi-s previous to the in-
halation. All artificial teeth must be removed and all waist-bands
and tight clothing should be loosened if not removed.

A little strong coffee or a little brandy and hot water may be given
by mouth to prevent the subsequent vomiting and nausea.

Care of the Teeth.

Decay and loss of the teeth is common even among the young.
Few persons at the age of twenty have sound teeth, and the ten-
dency to decay is no doubt to some extent inherited; but with care-
ful attention they may be preserved in good condition till late in life.
Parents should inculcate in their children the habit of cleanliness of
the teeth.

Sf...;

» i r i,*h - * Uf . nt i

i^i

602

SURGICAL PT£)EASE8.

Rotting of the Teeth.— Cams.

This is not confined to any age, temperament, or condition of

^° The 'teeth become diseased, die, and drop away, while all the other
orcans are sound and active.

The Creator doubtless intended that all the members of the same
body should be equally durable ; but certain laws of nature, violated
by us habitually, turn upon us, as it were, in anger, and smite us full
in the face, breaking. our teeth, and robbing us of the means of pre-
serving the health which we do not appear to prize.

When rotting begins in the teeth, its progress is more or less rapid
and their destruction is certain, unless it is arrested by artificial

™ Tlfe" enamel is nature's fortification to protect the teeth against ex-
ternal injuries. When this is broke., or worn away, the bone of the
tooth becomes exposed, and rotting begins immediately. Whateve
has a tendency to crack, break up, or destroy the enamel, therefore, is
to be carefully avoided. ' ^

Hot Drinks, or hot food, coming suddenly in contact with the en-
amel, are liable to crack it, and expose the bony substance of the
tooth. The enamel is exceedingly brittle, much like glass in its
structure, and is easily cracked when exposed to sudden transitions
from heat to cold, and from cold to heat.

Luxurious Living often deranges the general health, and causes
acid and unhealthy secretions in the mouth, which act injuriously
upon the enamel.

Acids are injurious to the enamel; and when taken sb medicine,
should be well diluted, and in some cases, drunk through a tube, so
as not to come in contact with the teeth. Sugar is not directly inju-
rious to the teeth, as many suppose ; but i.f allowed to ^e^ about
and between them, it may generate an acid which is destructive to
the enamel.

A Crowded Condition of the teeth in the mouth causes the enamel
to wear away, and leads to rotting; in which case, early attention
and advice from a dentist is quite important.

Food Lodged Between the Teeth, and in their depressions, is a
cause of extensive decay. Animal and vegetable ."patter, j^hen ex-
nosed to warmth and moisture, soon generate an acid which corrooes
the enamel. The teeth, consequently, often begin to decay in parte
where one presses upon another, and in depressions, where food lodge^
and remains. This shows the necessity of cleausiug the mouth and
teeth often, — particularly after meals.

SURGICAL DISEASES.

603

nes.

t, or condition of

while all the other

mbers of the same
of nature, violated

r, and smite us full
the means of pie-

;e.

} more or less rapid,

rested by artificial

he teeth against ex-
i^ay, the bone of the
iiately. Whatever
3namel, therefore, is

jontact with the en-

ly substance of the

;h like glass in its

sudden transitions

L health, and causes
lich act injuriously

taken as medicine,
: through a tube, so
• is not directly inju-
ved to remain about
ah is destructive to

th causes the enamel
case, early attention

Bir depressions, is a
jle matter, when ex-
acid which corrodes
rin to decay in parts
ris, where food lodges
isiug the mouth and

Mercury, when taken to the extent of salivation, — whether it be
calomel, corrosive sublimate, blue pill, or any other form of it, —
causes inflammation of the membranes about the teeth, and indirectly
produces ctries.

Acidity of the stomach, the contact of decaying teeth and dead
stumps with sound ones, diseased and ulcerated gums, and, above
all, a filthy, unclean and unwholesome condition of the mouth, are
active causes of diseased teeth.

improper Tooth-Powders, us those containing gritty particles, are
to be avoided.

Tobacco, by deranging the general health, may be indirectly inju-
rious to the teeth. Smoking blackens the teeth ; and though chewing
may be useful in deadening the sensibility of the nerve of a decaying
tooth, this alone is not a sufficient reason for so uncleanly and disa-
greeable a habit, while so many agents may be found to produce the
same effect.

Tartar. — This is derived from the saliva, and is found, when ex-
amined by the microscope, to be composed of myriads of living
animals. When first deposited around the teeth, it is in a soft state ;
but, when not brushed away, it soon hardens, and changes from a
yellow to a brown, and sometimes to a black color ; and often in
children it becomes a dark green. It destroys the beauty of the
teeth, giving them a filthy and revolting look ; the setting of the
teeth in their sockets is weakened ; their appearance is elongated ;
the periosteum or covering of the fang becomes inflamed and tender ;
and, if the proper remedy be not applied, the teeth will become loos-
ened, and finally fall from their sockets. It causes the gums to be-
come inflamed, swollen, tender, and ulcerated, and loads the breath
with a disagreeable fetor. Its direct influence on the teeth is not
great ; but it vitiates all the secretions of the mouth, and is thus a
very efficient, though an indirect cause of decaying teeth. In all
cases, it should be immediately and carefully removed, and some
astringent wash, made from Peruvian or oak bark, be applied to
reduce the inflammation and swelling of the gums.

Tooth-Ache.

This is generally caused by an exposure of the nerve which fills
the internal cavity of the tooth. This exposure is caused by a frac-
ture, or, more commonly, by the rotting away of a part of the tooth.
This nerve is extremely sensitive ; and, by coming in contact with
the air and acrid substances, inflammation is excited, and tooth-
ache is the consequence.

Teeth sometimes ache when they are, to all appearance, perfr^ctl)-
sound. This may be caused by bony enlargements of the ends of

. I

■:vi'

604

8'JBaiOAL PI8KA8E8

y-A

the fangs, inflammation of the periosteum, a peculiar irritability and
ague of the face, which excite neuralgia, etc.

Pain of a sound tooth is sometimes caused by sympathy with a
decajdng one, by a disordered stomach, or by scurvy, pregnancy, tar-
tar, or whatever excites painful sympathetic action in the nerves of
the face.

Treatment Tooth-ache may bo quieted by placing a drop of oil

of cloves, or cajeput, or a drop of creosote upon a piece of cotton,
and inserting it into the cavity of the tooth, and. bringing it into con-
tact with the exposed nerve. A few drops of a five per cent solution
of cocaine placed in the tooth by means of absorbent cotton, or even
wiped around the gum, acts very beneficially and usually quiets the
worst tooth-ache. Chloroform likewise is often good.

Pains of the face and jaw, when not the consequence of rotten
teeth, may be relievul by holding brandy, or whiskey, or rum, or
diluted tincture of cayenne, or hot water, in the mouth, and by ex-
ternal applications of laudanum, Oliver's plaster, a mustard plaster,
or ho[)s steeped in alcohol, or a blister behind the ear. But for teeth
too much decayed to bo saved by filling, there is no remedy so proper
as extraction.

Filling Teeth.

There is no operation of the dentist of more real and lasting
benefit to the patient than that of filling rotten teeth.

A tooth that is well filled before its nef vp is exposed, is as service-
able as a sound one, and nearly as durable. Its preservation for
many years is perfect and complete.

It is necessary, in the performance of this operation, to remove
very carefully all rotten and foreign matter lodged in the cavity ; to
make the cavity of a dovetail shape, so as to retain the filling ; to wipe
it perfectly dry; and to press the gold in so as to make the cavity
perfectly water and air tight. A tooth filled in this way may be
preserved many years, and in many cases during life.

When decay has gone so far as to expose the nerve and render a
tooth' painful, the nerve, in all cases, should be destroyed before the
cavity is filled ; otherwise there may be soreness, and sometimes ex-
treme pain making the extraction of the tooth absolutely necessary.

A tooth filled after the nerve is destroyed is not as good as if filled
before the nerve was exposed ; the walls of the cavity are thinner and
weaker, and consequently are more liable to break and crumble away
when brought into contact with hard substances ; and the filling will
be more likely to be loosened. There is likewise some danger of ulcer-
ation and absorption at the root of a tooth, when filled in this condition,
which makes it very important that teeth should be filled early.

Gold foil is preferable to all other substances for filling teeth. H
it is properly dressed and polished, it will remain in the mouth for
many years without any sensible loss of its substance.

SUUOIOAIi DIHKASKS

605

,ar irritability and

' sympathy with a
y, pregnancy, tar-
in the nerves of

icing a drop of oil
a piece of cotton,
inging it iiitocou-
) per cent solution
nt cotton, or even
usually quiets the
lod.

leqnence of rotten
liskey, or rum, or
mouth, and by ex-
1 mustard plaster,
jar. But for teeth
) remedy so proper

B real and lasting

5th.

josed, is as service-

3 preservation for

eration, to remove
i in the cavity ; to
the filling; to wipe
a make the cavity

this way may be
ife.

lerve and render a
stroyed before the
and sometimes ex-
isolutely necessary,
as good as if filled
ity are thinner and
and crumble away
and the filling will
ntie danger of ulcer-
ed in this condition,
m filled early.
)r filling teeth. If

in the mouth for
buce.

The First Teeth.

It is an imperative duty of parents to see that their children's teeth
have early and careful attention.

The health and durability of the permanent teeth depend materi-
ally on the healthy condition, regularity and durability of the tempo-
rary ones. It may seem strange that diseases of the first set of teeth
should influence the set which is to follow ; but wlien we consider
that the rudiments of the second set already exist when the first are
cut, it is not unreasonable to suppose they may inherit disease from
their predecessors.

Cleaning the Teeth.

The most important rule to be observed in the preservation of the
teeth is to keep them perfectly clean, and never to allow any foreign
substance to remain on or about them. A decaying tooth should
never be allowed to remain in the mouth ; it causes others to decay.

If tartar has been allowed to collect, have it removed immediately.
The teeth should be carefully and thoroughly brushed daily with
warm water, and the occasional use of a dentifrice that is impalpably
fine, and that contains no acid.

A Brush has no bad effect upon the teeth, as some suppose, for
the parts of the teeth most exposed to the friction of a brush are
never the first to begin to decay. This beginning of decay takes
place in their depressed surfaces, and where they touch each other.
A soft brush is better for the teeth than a stiff one, because the lat-
ter is apt to fret the gums, and cause them to recede, which gives
the teeth a lengthened appearance.

Teeth in a crowded condition should never be filed, unless they
begin to decay.

Tooth-Picks, made of quill, or wood, or ivory, should be used after
meals, and all particles of food lodged between the teeth should be
removed.

In Sickness., the rules for cleanliness of the teeth should be more
rigidly enforced than at any other time, as then they are more ex-
posed to destructive agents, and are liable to participate in the gen-
eral debility and disease of the system.

Influence of Diseased Teeth upon the Health.

The bad effects of a diseased and unclean mouth upon the general
health are of more serious consequence than most people are aware,
in twenty-four houi-s, we breathe twenty thousand times ; and what
must be the effect upon the delicate structure of the lungs, when,
for days, months and years, the air we breathe is drawn through a

iVfTSftfjuram^—

njAiiiim

606

SUKOIOAI, D'SEASES.

depository of filth, and is poisoned by being mixed with effluvia
arising from decayed and diseased matter in the mouth.

The intermittent fevers of the West are caused by the eflla.iii
arising from the decaying matter of low grounds and marslies, which
can hardly be more pernicious than the effluvia from the impuiity
and corruption generated in an unclean mouth, filled with decayiii),'
teeth. Dr. Hays says " no species of animal matter is sc offensive to
the health and vitality of the adjoining substance, whether nerve, or
membrane, or any part or portion of the living body, as decaying
bone."

Dr, Ira Warren's Paracentesic Instrument.

PtTNOTDRiNO the chest for drawing off water in extensive pleuritic
effusion, as practised of late, has proved one of the most valuable
operations in modern surgery. Like most new operations, however,
it has been embarrassed by imperfect instruments.

The annexed cut represents an improved instrument which I have
just invented, by which this operation is made extremely simple and
easy. At the right hand is the puncturing instrument, including the

FIO. 187.

external canula, and the trochar inserted -in it. At the letter i is a
sliding guard which moves back and forth, and may be set at the
point of desired depth to which it is desirable to puncture, and made
fast by a screw. By this arrangement it may be driven home to the
desired depth, without any fear of going too far, or of falling short
of the mark. The guard also serves in a measure to keep the instru-
ment steady during the operation, and to prevent inflicting pain by
having it oscillate about. At 6 is a tubular attachment opening into

•Wf

8lTR(iICAL IiIBEABES.

607

ixed with effluvia
louth.

ed by the efllu.irt
Did marshes, wliich
from the impurity
lied with decaying
31- is so offensive to
, whether nerve, or
body, afl decaying

strutnent.

extensive pleuritic

the most valuable

perations, however,

iment which I have
tremely simple and
ment, including the

the canula ; to this an india-rubber hose is attached, which connects,
lit the other end, with tlie cock a, upon the exhausted receiver o.
To a cock, c, on the other side of the receiver, another rubber hose is
fastened, which connects at the other end with an air-pump.

The mode of operating is exceedingly simple. First, exhaust tlie
receiver; then quickly, yet gently, plunge iu the instrument, and,
leaving the canula, withdraw the trocar till the point passes the con-
necting tul)e at b, when the water will ' mediately flow, in a full
stream, into the exhausted receiver o. lue working of the appara-
tus is extremely beautiful. Five pints of water may be taken away
with it in five minutes, — an amount which cannot be got with the
old instrument in much less than half an hour. If the patient can-
not bear to have it drawn so rapidly, the stream may be wholly or
partially arrested, at any moment, by entirely or partly closing the
cock a.

The reader will see that the apparatus is so arranged that the ad-
mission of air into the chest is entirely impossible.

The artist, in making the drawing for me, has inserted the instru-
ment much farther forward than the point usually selected.

My apparatus has a second puncturing instrument, a little larger
in size, for the purpose of operating in ascites, or dropsy of the belly.

This, or similar instruments, can be bought of any good dealer in
surgical instruments.

. At the letter i is a
i may be set at the
I puncture, and made
B driven home to the
r, or of falling short
re to keep the instrii-
nt inflicting pain by
ichment opening into

A BRIEF TREATISE ON THE

HOM(EOPATHIC TREATMENT OF

DISEASES.

BY A. E. SMALL, M.D.,
Pbmidint or tkb Hahnkm ann Mbdioal Collmb, OmoAoo.

'in

In the following pages will be found a reliable guide in the ad-
ministration of homeopathic remedies for the various ills known to
occur in almost every-day life. Nearly every disease incident to the
human family is briefly considered, and the corresponding treatment
explicitly stated. It must be borne in mind that homceopatliic
remedies are addressed to vital forces, whose derangement may be
seen in the manifold forms of disease. But, in order to obtain the
desired effect from the administration of any remedy for a given case,
a certain principle must be observed in its selection. This princi-
ple is believed to be a competent guide in affiliating remedies to dis-
eased conditions. The discovery of a universal law of cure, which
points out the direct relationship between all diseases and their
remedies, is ascribed to Hahnemann, the founder of the homoeopathic
system of medicine. By numerous experiments with drugs upon
healthy individuals, he ascertained that diseases are curable by such
medicines as are capable of producing similai- characteristics : as, for
instance, chamomile will produce a colic, and will cure a similar one
from some morbific cause; hence, the formula, "«SV7ni7ia gimilibvs cu-
rantur," is the principle that guides in the administration of remedies.
Every medicine has a specific range of action in the body : one will
act on one set of organs, and another on another set ; some will direct
their energies so as to affect one locality, and others to another.
The only way, therefore, of ascertaining how a remedy will direct
its action to any local or general disease is by trying it first upon
healthy persons in order to ascertain its range of action. As disease
manifests its action by symptoms, so remedies show their action by
symptoms, in a similar manner ; and, when a disease presents itself
for treatment, a remedy must be selected whose pathogenetic effects
upon those in health resemble the phenomena of the disease. The
homoeopathic materia medica is made up of a collection oi remedies
that have been thus tried. Those employed in this treatise are of
this character, and are comprised in the following

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HOMffiOPATHIC TREATMENT OF DISEASES.

600

. Acouite. 3.
, Aloea. 6.
, Alumina. 6.

Ammonium carb. 6.
, Antimonium crud. 6.
. Apis mellifica. 6.
, Arnica montana. 3.

Arseiiicum album. 6.

Aurum metallicum. 6.

Anacardium. 3.

Baptisia. 1.

Belladonna. 3.
. Bismutli subnit. 3.

B; yonla alba. 3.

Calcarea carb. 6.

Calendula. 1.

Camphora. 3.

Capsicum. 3.

Cantharis. 3.

Cannabis sat. 3.

(Jarbo animalis. 6.

Carbo veg. 6.

Causticum. 6.

Chamomilla. 3.

China, o.

Ciitilidonium maj. 3.

Ciraicifu^a racem. 1.

Cicuta virosa. 3.

Cina. 3.

Cocculus indicus. 3.

Coffea cruda. 6.

Colchicum. 3.

Colocynthis. 3.

Conium mac. 3.

Crocus sativa. 3.

Cuprum acet. 6.

♦ LIST OF EEMEDIES.

37. Digitalis. 3.
t38. Dioscorea villosa. 2.

oO. Drosera rotundifolia. 3.

40. Dulcamara. 3.
t41. Elaterium. 3.

42. Euphorbium. 3.

43. Euphrasia. 3.
144. Ferrum redact. 3.

45. Gambogia. 3.

46. Gelsemium. 1.
t47. Graphites. 6.

48. Olonoinum. 6.

49. Holleborus nig. 6.
ISO. Ilepar sulpli. 6.

61. Hyoscyamus nig. 3.

62. Hamamelis. 1.

63. Ignatia amara. 3.

64. lodium. 6.

66. Ipecacuanha. 3.

66. Iris versicolor. 3.
t67. Kali carb. 6.
t68. Kali bichromicum. 3.

69. Lachesis trig. 6.

60. Ledum palustre. 3.

61. Laurocerasus. 3.
t62. Leptandria. 3.

t63. Lycopodium clav. 6.

64. Lobelia inilata. 3.

66. Mercurius corrosivus. 6.
t66. Mercurius vivus. 6.
t67. Mercurius iod. 3.
t68. Mercurius biniod. 3.

69. Mercurius sol. 6.

70. Mezerium. 3.

71. Moschus. 6.

72. Natrum muriat. 6.

73. Nitrum. 6.

74. Nitric acid. 6.
76. Nux vomica. 6.

76. Nux moschata. 6.

77. Opium. 3.

78. Oleander. 3.

79. Petroleum. 6.

80. Phosphorus. 6.

81. Phosphoric acid. 6.
t82. Platina. 6.

83. Phytolacca decandra. 1.

84. Pulsatilla. 6.

85. Podophyllum pelt. 3.

86. Rhus tox. 3.

87. Ruta graveolons. 3.

88. Sabina. 3.

89. Sambucus nig. 3.

90. Sanguinaria. 3.

91. Secale cornutum. 3.

92. Senega. 3.

93. Sepia succus. 6.
194. Sillcea. 6.

96. Spigelia. 3.

96. Spongia. 3.

t97. Stannum. 6.

98. Staphysagria. 3.

99. Stramonium. 3.
tlOO. Sulphur. 6.

101. Sulphuric acid. 6.

102. Tartar emet. 6.

103. Uva ursi. 1.

104. Urtica urens. 3.
106. Veratrum album. 3.
106. Veratrum viride. 1.

tl07. Zincum met. 6.

TINOTUEES FOR EXTERNAL USE.

1. Aconite.

2. Arnica.

3. Baptisia.

4. Calendula.

6. Cantharis.

6. Conium.

7. Causticum.

8. Hypericum.

9. Ruta gra-eolens,

10. Staphysagria.

11. Urtaoa urens.

I.. V

RULES FOR THE ADMINISTRATION OF REMEDIES.

As specific dirsctions will be found in the treatment of each dis-
ease treated of in this work, only a few general rules are necessary.

1. In acute cases, the chosen remedy may be repeated every hour
or two hours, until a change occurs ; then it is prudent to wait awhile
for the result.

2. Tf there is no favorable reaction within a few liours, or in very
acute pain, within half an hour, select another remedy according to
the indications ; and, should no favorable reactign follow the adminis-
tration of this, select another, and so on.

3. When convalescence follows the administration of a remedy, it
need not be repeated unless the recuperation reaches a certain point
and then ceases ; in which event, select a remedy according to indi-
cations.

•The remedies marked t should bo bought as triturations. Ask the pharmacist to pre-
pare them all on the decimal scale, and so, also, the dilutions. The triturations may be
liiven dry on the tongue, a small powder the size of a pea ; or the same amount or more
dissolved in half a tumblerful of water, a teaspoouful at one dose, when it is desirable to
repeat the medicine at short intervals.

■M

610

HOMfEOPATHIC TRKATMENT OF DISEASES.

4. The same remedy may be repeated in case of continued con-
valescence becoming interrupted, provided there is no change other
than amelioration of symptoms.

5. A change of remedies is admissible in obstinate cases, when one
has been employed for some time without the desired effect. In
chronic cases, it is well to try the remedy at least a week before

changing.

6. In chronic diseases, the remedies need not be repeated oitener
than once or twice in twenty-four hours, and even at longer intervals.

FORMS OF MEDICINES FOR ADMIKISTRATION.

There are four forms in which homoeopatliic medicines are pre-
pared for rse : 1. Mother tinctures prepared from fresh plants; 2.
Triturations prepared from metals, salts, earths, and herbs ; 3. Dilu-
tions prepared from the tinctures;* and, 4. Globules medicated with
the solutions. The last two are generally employed, and the first
two occasionally, in household practice. When water is employed
as a medium for the administration of either form, five drops of the
tincture or dilution, or ten globules (use size No. 30), or three or
four grains of the trituration, may be thoroughly mixed in half a
tumbler of water, and a dessertspoonful of this mixture will suffice
for a dose. The tumbler containing the medicine should be care-
fully covered, and kept away from the light and from any cor-
rupting odor; and all other medicines, teas, tonics, and stimulants
are strictly prohibited during its administration ; and all medicated
poultices, lotions, and the like, must be avoided, because of their
interference with the medicinal action of the remedy.

KULES FOR PRESERVING THE PURITY OF MEDICINES.

1. The medicines should be kept in a small box or chest, exclu-
sively for this use, carefully closed, and in a cool place. Examine
the corks often to see that they are perfectly tight.

2. Be careful to keep the vials corked always with the same cork,
or one that has never been used for any other purpose ; and be par-
ticularly careful not to misplace the corks, or fail to replace the
identical one each time when a vial is uncorked for use.

3. Never put medicine into a vial that has been alieady used for
one of a different kind, unless it be thoroughly washed and baked.

4. Every vial should be labelled, to prevent mistakes ; and every
glass, spoon, or cup should be carefully cleansed before using it in
the preparation of a remedy.

6. Never use the same spoon in giving medicines of a different
kind to different persons sick in the same house.

• Dilations »re recommended to be prepared on the decimal «cafe.

Ilfl!

' 1

DISEASES.

I case of continued con-
there is no change other

obstinate cases, when one

, the desired effect. In

at least a week before

not be repeated oftenor
even at longer intervals.

IINI8TRATI0N.

latliic medicines are pre-
jd from fresh plants; 2.
rths, and herbs ; 3. Dilu-

Globules medicated with
J employed, and the first
When water is employed
jr form, five d'-ops of the
size No. 30), or three or
roughly mixed in half a

this mixture will suffice
medicine should be care-
light and from any cor-
as, tonics, and stimulants
ation; and all medicated
avoided, because of their
le remedy.

TY OP MEDICINES.

mall box or chest, exclu-
ti a cool place. Examine
ly tight.

Lways with the same cork,
her purpose ; and be par-
es, or fail to replace the
jrked for use.
has been already used for
whly washed and baked,
vent mistakes ; and every
sansed before using it in

r medicines of a different
house.

t on the itdmal fcale.

HOMCEOPATHIC TKEATMENT OF DISEASES. 611

ANTIDOTES TO MEDICINES.

In some exceeding impressible conditions, the remedy chosen may
produce intense aggravation of suffering, which may be relieved by
the administration of a drop of Spirits of camphor. If Belladonna
should provoke an aggravation. Aconite will antidote its effect, and so
will Camphor ; and this latter is regarded as the general antidote of
homoeopathic remedies, two of which should seldom be given in alter-
nation, because of the liability of their neutralizing the effects of
each other. For the same reason it will not do to change from one
remedy to another suddenly. A period of from four to six hours
should intervene in acute cases, except in emergencies of great pain,
and from one to two days in chronic affections.

EXTERNAL APPLICATIONS.

Compresses wet with cold water, covered with a dry bandage, are
always a convenient and successful resort for bruises, sprains, and
injuries in general. Tepid applications, or cold when agreeable, in
the same way, may be applied to local inflammatory affections. Warm
poultices, to hot and inflamed surfaces, will often exert a salutary
influence. The tinctures named for external use may at times be
employed in full strength ; but lotions made of a teaspoonful of any
one of them, to a cupful of cold water, is the usual form of applying
them. Mustard poultices may be employed, either in full strength,
or tempered by adding to the ground mustard a due proportion of
meal. Sintple cerate, cold cream, and healing salves may be em-
ployed when needed ; but any strongly medicated poultice, plaster,
salve, or ointment must not be used when taking homoeopathic reme-
dies.

BATHING.

Persons of debilitated constitutions should not bathe too frequently;
for those of robust constitutions, this luxury may be indulged in to
almost any extent. Bathing in very cold water is not recommended.
Tepid baths are the most beneficial, and should be taken regularly
throughout the year. Kot baths are weakening and relaxing. They
may be employed for children in convulsions, and to overcome rigid-
ity of the skin, or for a cold. Sulphur baths are sometimes recom-
mended for rheumatism; but they should be taken with caution ; and
this remark is applicable to all vapor-baths. Sea-bathing is good for
dyspepsia, and those inclined to biliary derangements. Consump-
tives derive but little benefit from any kind of bathing aside from
necessary ablutions. Tlie addition of salt to the water is recom-
mended in cases of debility.

I- If

612

HOMOEOPATHIC TKEATMENT OK DISEASES.

DIET AND REGIMEN.

But little need be said about diet here, as that which is appropriate
is pointed out in the following pages, as a part of the treatment for
each individual case. It may be remarked simply that no medicinal
condiment or food, no stimulant or other medicinal beverage, can be
employed when taking homceopathic remedies ; and, further, all pa-
tients must be placed in the best possible condition for recovery.
They must have clean and well-ventilated apartments, and plenty of
fresh air. They must have clean and well-aired bedding. They
must have proper clothes and food to correspond with the appetite
and wants of the system. An experienced nurse is of great impor-
tance, especially in fevers.

For description of diseases, see first part of this book. It is unneces-
sary to duplicate the descriptions and symptoms, as they are the same
for any school of medicine, the remedies and manner of treatment
only differing.

DISEASES.

;hat which is appropriate
art of the treatment for
imply that no medicinal
dicinal beverage, can be
es ; and, further, all pa-
condition for recovery,
partments, and plenty of
ll-aired bedding. They
spond with the appetite
nurse is of great impor-

this book. It is unneces-
)m8, as they are the same
id manner of treatment

DISEASES OP THE HEAD.

Headache. — Cephalalgia.

This affection is usually attendant on other difficulties, and must
Iw treated with reference to the cause. If from cold, affecting the
entire system, and accompanied by pains in the back, give Niix
vomica. If from heat, or determination of blood to the head, Bella-
donna. If from chilliness, Arsenicum. For rheumatic headache in
cold, damp weather, Bryonia. For that produced by constipation,
Nux vomica. Bilious, Merc. viv. Sick-headache, Iris versicolor, Sepia,
Pulsatilla, or Sulphur: Nervous headache, Coffea. For headache
caused by suppressed eruption, Calcarea or Sulphur. From sup-
pression of the menses, Pulsatilla. From a fall, or fatigue. Arnica.
From simple cold in the head. Aconite. A dose of four globules, of
any remedy selected, may be repeated every four hours until relieved.

Vertigo, Swimming of the Head.

This uncomfortable feeling consists in a sensation of the head
whirling around, causing one to stagger, and sometimes to fall. If
from a deranged stomach, Nux vomica. If from a cold, G-elsemium
or Arsenicum. From derangement of the biliary system, Aconite,
Pulsatilla, or Bryonia. Vertigo produced by rush of blood to the
head. Aconite or Belladonna. The remedy indicated may be repeated
in the usual dose every two hours. For vertigo from riding in a
carriage, Oocculus. From a shock or fall, Arnica. Dose and ad-
ministration as above.

1 "r

•tr ii

Ringworm of the Scalp.

This IS a pustular eruption, that begins at one or more points upon
the hairy scalp, and spreads sometimes so as to involve much of the
surface. When there are a number, they spread until they coalesce
and form a continuous eruption, from which exudes a greenish or
sanious matter, that mats the hair, and renders the whole appearance
of the head disgusting. Great care is required to keep the surface
clean ; and, for this purpose, no soap should be used. Water, softened

613

f j t

014

mSKASES OF THE HEAD.

by tlie white of a raw egg, is a better wasli. Calcarea may be ad-
miiiistered in the usual dose every morning and evening. If this
remedy does not prove ellicient, give Sulphur in the same way, and
also ffepar mlph., or Lycopodium. The head may be, at the same
time, washed once or twice a day with a lotion made of twenty drops
of the tincture of Sulphur in a half-tumbler of water.

Scald-head. — Tinea Capitis.

This is also an eruption upon the scalp, that may be dry or humid.
•For the dry scald-head, Natrum muriaticum or Sulphur may be ad-
ministered twice or three times a day. For the humid scald-head,
Lycopodium, Arsenicum, Conium, or Graphites may be given twice a
day. The same restriction as to the use of soap must be observed,
and the same measures for cleansing may be recommended, as in the
case of pustular ringworm of the scalp.

• Ulcers of the Scalp.

In scrofulous children, these ulcers sometimes occur in the form
of small furunculi, or boils, exceedingly sore and painful. The best
remedies are Arsenicum, ffepar sulph.. Nitric acid, and Silicea. They
may be given as required in daily doses of four globules. The ulcers
may be wet with Hamamelis Virginica, after having been pricked with
the lancet.

Baldness.

When the hair falls from the head by reason of debility, the reme-
dies to be given are China and Ferrum ; when in consequence of
perepiration, Mercurius ; from the use of quinine, Belladonna, or
Pulsatilla; if from the abuse of mercury, Carbo. vegeta. ; if from
grief or trouble, Phos. acid. If baldness occurs after protracted
inflainmatory diseases, and nervous and typhoid fevers, give Calcarea
in daily doses, or ffepar sulph. and Silicea. For dandruff, give Ly-
copodium.

Ii. Calcarea may he ad-
y and evening. If this
ur in the same way, and
sad may be, at the same
in made of twenty drops
of water.

Capitis.

at may be dry or humid,
or Sulphur may be aJ-
f the humid scald-head,
?« may be given twice a
soap must be observed,
recommended, as in the

Ip.

imes occur in the form
I and painful. The best
acid, and Silicea. They
ir globules. The ulceis
aving been pricked with

on of debility, the reme-
i^hen in consequence of
quinine. Belladonna, or
Oarbo. vegeta. ; if from
occurs after protracted
oid fevers, give Calcarea
For dandruff, give Ly-

DISEASES OP THE BRAIN AND NEBVE8.

Brain Fever.

This disease comes on with more or less pain in the head, attended
with heat and delirium ; the eyes also exhibit a red or fiery appear-
ance : and this pain, heat and delirium are sometimes followed by drow-
siness and inclination to vomit. The pulse is usually rapid and feeble.
In brain fever, there is loss of appetite, great restlessness, short, com-
atose naps, and frequent inclination to cry out with pain. Aconite is
useful to commence with, and this may be followed with Belladonna.
If respiration is hurried and labored, give Arsenicum. If brain fever
is brought on by a fall, or a blow upon the head, give Arnica ; and if
no relief follows in . twenty-four hours, Glonoin. If from trouble or
grief, Ignatia. If from intoxicating drinks, Kux vom. If at the men-
strual period, Pulsatilla. If from intense study, or close application
to business, Sulphur and Nux vomica.

Rush of Blood to the Head.

The signs of this occurrence are intense headache or vertigo at
first, which is followed by fainting, and of'^en with loss of conscious-
ness ; at times there will be twitching and spasms. The difficulty
may occur from various causes, and is common with females and
those of nervous temperament. Aconite, in solution, may be put iu
the mouth of the patient, and also the head may be wet with cold
water. The head should be laid a little lower than the body ; the
lower extremities should be rubbed, and friction should be applied to
the arms and hands. Belladonna may be given after Aco lite, or, in
grave cases, Glonoin. If the rush of blood has been caused by run-
ning and getting heated, give Arnica, and bathe the temples with a
solution of twenty or thirty drops in half a tumbler of water. If at
the menstrual period, give Pulsatilla. In plethoric persons, exposed
to the heat of the sun, give Nux vomica, and apply friction to the ex-
tremities. If in consequence of having drunk stimulating beverages,
Arsenicum and Nux vomica. If from indigestion, Pulsatilla. If from
fright, Aconite. If from exposure to winter cold, Camphora. The

616

|ttV|

'Ik

^ IP

■ f

'Jf:

1 ;

H'-\

jfiiii

:«

■l '

^ii

616

PI8KA8E8 OF THE BRAIN AND NKHVES.

dose of any of the remedies selected may bo repeated every fifteen
minutes until the patient is better.

Sunstroke. — Coup de Soleil.

Protracted exposure to the heat of the sun will sometimes pro-
duce a sudden prostration of the nerves, and an intense headache,
causing blindness, vertigo, and extreme sensitiveness to the glare of
light, and sometimes a sudden chilliness and shuddering, extremely
alarming. This is termed sunstroke, and frequently is so intense as
to prove fatal in a few hours. The remedies that have been found
the most useful are Glonoin^ Belladonna, Phosphorus. These may be
given singly, and repeated, until relief is obtained, every thirty min-
utes. As soon as the patient recovers consciousness, give China, in
thf usual dose, several times a day ; or, if there be disturbance of di-
gestion and feeble voice, or entire loss of voice, Antimonium cnulum.
The patient, when convalescent, should be kept out of the sun, and
away from strong light. After one has suffered from sunstroke, it
may be several weeks before he really recovera. When it occurs in
summer, his system will be exceedingly impressible to the sun's rays
until cold weather, or until his nerves regain their normal vigor.
Great care should be exercised in reference to the diet. For after
treatment, Laohesis or Nitrio add often indicated.

Apoplexy. — Apoplexia.

This alarming disorder is the result of a sudden determination of
the blood to the head, which produces a rupture of some one or more
of the blood-vessels of the brain, and a hemorrhage in the nervous
centre. When only the left side of the brain sustains this injuiy,
the right, upper, and lower extremities are liable to paralysis. When
the right is similarly effected, the left side usually becomes paralyzed.
When both hemispheres of the brain become implicated in the hem-
orrhage, there usually occurs general paralysis, and the patient falls
entirely senseless. There are premonitory symptoms of this disorder,
which, if carefully heeded, may suggest a treatment that will ward
off the difficulty. These symptoms are vertigo, fullness, and dull
headache, and sometimes nose-bleed. When one feels an uncomfort-
able fullness of the head, under which he walks with an unsteady
gait, he may find relief by one or two doses of Aconite ; or if he finds
this uncomfortable fullness takes the form of a dull, stupefying head-
ache. Belladonna may be preferable, and is the leading remedy. If
there is vertigo and fullness, with prostration, Nux vomica is indicated.
In case of nose-bleed, give Aconite, Bryonia or Pulsatilla. These pre-
liminary symptoms may be made to disappear with these remedies,
when otherwise they might augment until an apoplectic attack set
in. Then is the period of danger. But few cases of sanguinary

v„_

NKKVE8.
)o repeated every fifteen

! Soleil.

sun will sometimes pro-
nd an intense headache,
jitiveness to the glare of
d shuddering, extremely
equently is so intense as
38 that have been found
osphorus. These may be
tjiined, every thirty miii-
ciousness, give China, in
lere be disturbance of di-
ice, Antimonium cnidum.
:ept out of the sun, and
fered from sunstroke, it
ers. When it occurs in
ressible to the sun's rays
^in their normal vigor.

to the diet. For after
cated.

oda.

sudden determination of
ture of some one or more
lorrhage in the nervous
ain sustains this injuiy,
ible to paralysis. When
ually becomes paralyzed.
i implicated in the hem-
lis, and the patient falls
mptoms of this disorder,
reatment that will ward
irtigo, fullness, and dull

one feels an uncomfort-
Bvalks with an unfeteady
)f Aconite ; or if he finds

a dull, stupefying head-
;he leading remedy. If

Nux vomica is indicated,
tr PuUatilla. These pre-
ar with these remedies,
.n apoplectic attack set
:ew cases of sanguinary

DLSKASKti OK THE BKAIN AND NEKVES.

617

iipoplcxy arc cured ; and yet some do recover. When the clot pres-
sing upon the brain is of snuill si/,e, and ihe hemorrhage comparatively
light, an alworption of (he dot may take place, and the patient re-
cover; but, when the clot is loo largis to be disposed of by the pro-
cess of absorption, it becomes an obstacle in the way of recovery:
and yet active measures should in all cases be called into requisition.
Aconite Bho\x\il be placed in the mouth, and the face should be bathed
with it. The bowels should be moved l)y an enema, and cold appli-
cations, or rather applications of tejiid water, should bo made to the
liead. Friction should be applied to the surface of the entire body
and the extremities. Belladonna is also a remedy that may be ad-
ministered, if possible, and repeated every half-hour or hour. Ignatia,
m persons of lymphatic temperament, may be given in the same way.
Arnica may be administered internally and externally. The skin
may be rublxnl with it ; the usual doses may be given every hour, by
placing the globules in the month. If the attack follows the nose-
bleed, anil there is heavy or labored bieathijig, Arsenicum or Puhatilla
may be used. It is important to get an action on the bowels as soon
as possible.

Epilepsy, Fits.

This disease is termed the falling sickness, as, without warning,
the patient loses consciousness, and falls insensible to the ground or
floor, with convulsive motion of the limbs, distortion of the muscles
of the face, frothing at the moutli ; and sometimes the mouth, lips
and jaws are spasmodically closed, the hands clinched, and a general
rigidity of the muscles of the entire body. After a time, the rigidity
passes off, and all the muscles become relaxed ; the patient then aj>
pears to be in a deep slumber, and remains so for a longer or shorter
period, and then awakes to consciousness, feeling wearied, but totally
unaware of anything unusual having occurred. Confirmed epilepsy
is rarely, if ever, cured. When the disease is not congenital, the in-
cipient stage may be overcome. Sulphur, or Calcarea carb., may be
given when the first signs of the difficulty occur ; and this may be
followed with Belladonna, Hyoscyanms or Ignatia. When epilepsy is
brought on by intemperance, its first signs may be attacked with Nux
vomica, and the sooner the patient can be brought into a state of total
abstinence the better. Cuprum met. may be given to this class of
patients when there is pain in the head, and nausea, attending the
incipient stage. Opium, when there is inclination to sopor, may be
given every two hours. Stramonium, also, when there ij deep sleep
and loss of consciousness. When there is loss of memory following
one of these falling or unconscious fits, give Sulphur, China, Ferrum
and Nux vomica, — all are required to effect a cure ; the only hope
for which is in preserving the patient in a condition for the curative
action of the remedies. In all cases, between the attacks, no fat
food should be eaten ; but a simple, nutritious, and spare diet should
be adhered to.

Vi.'f,

■ q(^» .«■■■'■■-' -■•^'■■'■■^-''.■i'<'-r.'^i''*\<'^j-f>'~.

618

niHEASKH OK TlIK BltAIN ANIi NKIIVKS.

Acute Inflammation of the Spinal Cord.— Myeletis.

This is denoted by pain in th(! IkvcU, along the couim(! of the Hpinc.
which also effects the Mpinai nerves, and results in general sutt'eriiiir
of the trunk. When the cervical or neck portion of the cord is im-
plicated, there is pain and stiffness of the neck, and pain in the hack
pai't of the head ; and sometimes the accessory nerves become so af-
fected as to produce derangement of the organs of speech and deglu-
tition. Aconite is one of the remedies that must be employed to re-
move the inflammation when in this location. Hypericum is another;
and this may be used internally and externally three times a day.
Verat. viride is considered by some a speciflc remedy. When the
dorsal portion of the spinal cord is beset with inilammation, th'^-e is
shortness of breath, dyspncua, or fainting, and a sense of suffocation.

There is, at the sime time, i)ain in the back and chest, and rapid ac-
tion of the heart. The spinal accessory nerves, that supply the in-
tercostal muscles, partaking of the difficulty, renders the function of
lungs, diaphragm and heart, severtilly, impaired. Aconite, for the in-
flammation in this locality, may be given at first, and repeated every
hour; and a lotion of twenty drops of the tincture in half a tumbler
of water may be applied to the spine. Belladonna may Ik; given
when there is intense pain between the shoulder-blades. Bryonia is
quite essential when every motion of the patient aggravates the suf-
fering ; Oonium, when the pain is not so marked, but the respiration
is difficult ; Cocculus, also, when the pain in the biick affects the stom-
ach, producing nausea and prostration ; Pulsatilla, when this occurs
in young women and children, or in those of lymphatic temperament.
The patient should take but little exercise, if any. If only the lower
portion of the spinal column is affected, there will be pain in the
small of the back. The secretion of the kidneys may be diminished
or increased ; the bladder, also, may be implicated. The womb may
be subject to neuralgic pains ; the nerves accessory may implicate the
abdomen, and cause severe pains. Nux vomica, when the pain is the
most prominent in the small of the back, and when there is pain in
the bowels, and constipation. When the bladder is implicated, or
spasmodically closed, Hyoscyamus is the remedy. When there is too
great secretion of the urine, Nur vom. and Sulphvr will obviate tlie
difficulty. When this portion of the spinal co d is affected, the
womb may become subject to neuralgic pains. Belladonna, Cicuta,
Ignatia and Nux vom. are all valuable remedies. Conium, to remove
the inflammation of the cord, may be given every three hours, unti)
the pain ceases. If spasms attend the difficulty, j^ive Hyoscyamns
every two hours, as long a3 they last, or else Ignatia or Belladonna.
If the inflammation is brought on by a fall, or shock upon the nerves,
give Hypericum every two hours, and bathe the back with a lotion of
the tincture, — forty drops in hulf a tumbler of water. Bryonia is

^OMMTOPWrall-

'HF

NKUVKH.

lal Cord. — Myeletis.

r tilt' courso of the spine,
lilts ill gmioml suffuriiij,'
)rtion of the cord is im-
ck, and pain in the hack
loiy iiervea become ho ut-
aiiH of speech and deghi-
niust l)e enn)loyed to re-
llypericum ia aiiotht'r;
nally three times a day.
ific remedy. Wlien the
ih inlhimmation, th'u-o is
id a Sense of HufTocation.
k and cliest, and rapid ac-
ives, that supply the iii-
r, renders the function of
ired. Aconite, for the in-
first, and repeated every
incture in half a tumbler
iflladonna may l)e given
ulder-blades. Bryonia is
atient aggravates the suf-
uked, but the respiration
the biick affects the stoni-
Isatilla, when this occurs
f lymphatic temperament,
if any. If only the lower
;here will be pain in the
idneys may be diminisheil
)licated. The womb may
cessory may implicate the
nica, when the pain is the
nd when there is pain in
bladder is implicated, or
fiedy. When there is too
Sulphvr will obviate tlie
inal CO d is affected, the
linfi, IfelladomM, Cicuta,
idles. Conium, to remove
L every three hours, unti)
ficulty, rrive Hyoacyamxii
le Ignatia or Belladonna.
jr shock upon the nerves,
the back with a lotion of
ler of water. Bryonia is

niSEAHKU OK TIIK IIKAm AND NKRVEH.

fil9

idso goo<l for inflammation of the cord in the Inmlwir region, and es-
pocially when motion augments the suffering. The diet for all per-
sons having the nervous centr«'8 implicated must bo simple and nu-
tritious.

Paralysis, Palsy.

Wrkn the whole muscular system becomes so feeble and trembling
Its to 1)6 no longer controlled by the will, it is a ciwe of palsy; and
tliia is brought on by some trouble in the nervous centres. It attends
apoplexy, epilepsy and other affections incident to the nervous cen-
tres. Inflammation of the spinal cord will often produce the affec-
tion. The palsy may affect only one hand or one cheek ; or it may
l)e more general, and all the muscles may Ixj smitten with paralytic
weakness. Belladonna is often indicated for rightrsided paralysis,
and is, perhaps, the l^est remedy, in the majority of cases. Pulsatilla
is one of the best remedies for this disorder : give a dose of it three
times a d\y. If this does not cure, give Ooc<ntliis, in the same way, or
Niix vomica, China or Ignatia. For palsy of the tongue, give Calcarea ;
for palsy of the ittce, Pulsatilla ; for palsy of the arms and legs, give
Mercurius viv., Nux vomica, Pulsatilla and Bryonia. If the palsy is the
result of a shock or fall, give Arnica. If great weakness and slow
fever, give Rhus iox. Strong tea and coffee are not advisable Ixjver-
ages for those threatened with palsy. Water, milk and black tea of
moderate strength may be allowed.

Lockjaw, Trismus.

One of the most painful affections that can assail human nature is
the shock upon the nervous system ^ oduced by a wound. Loclgaw
is a rigid stiffness of the muscles of the jaws, by some irritation from
a wound Injing first sent to the brain, and thence, by some nervous
channel, to the muscles that control the jaws ; causing them to as-
sume a painfully rigid ' ardness, closing them beyond the possibility
of opening them. Pain oftentimes is felt in other muscles, at the
same time causing them to be rigid. One of the common resorts to
control traumatic fever, or the fever produced by a wound, is brandy
or whiskey. It is said that large drafts of either will have no intoxi-
cating effect when this fever is present. Tincture of Opium, Black Drop
and Opium itself, have been given to antidote it, and sometimes with
success. One of the best remedies for traumatic fever, or that pro-
duced by a wound, is Arnica. It may be given every hour or two
hours, internally ; or applied, in the full strength of the tincture, to
the wound. TYr^e can "^^ no other remedy more likely to produce
pleasant results, unless, .n actual injuiy of some nerve, Hypericum
is rnade to take the plhiie of Arnica. If the patient is nourished
tlirough a quill, and the circulation is made vigorous by stimulants,
and the intensity of the pain is kept under by anodynes, the remedial

"^aWnDWfStfc*-.

620

IJISEASKS OF THE BKAIN AND NERVES.

Lachesis has benefited

effects of Arnica and Hypericum may cure,
some cases.

Tetanus.

This is the general disease of which the foregoing is a part. A
wound either in the ball of the foot or palm of the hand may so for-
cibly transfer its irrit .bility to the brain, that the brain distributes
the effect to the whole system, producing that most painful of all mor-
tal sufferings, — the lockjaw or general tetanus. Belladonna, Nm
von.Ln, Ignatia, Mercurius viv. and Sulphur may be employed in the
general form of the disease, in addition to the treatment for lockjaw.

Delirium Tremens.

This disease is the sequel of persistent inebriation. When a man
forgets the extremity to which his appetite may lead, and keeps his
nervous system excited even to intoxication, after a while liis stomacli
will lose its tone, and become extremely irritablo ; his system conse-
quently gains but little support from food: and, what is still worse,
his strength leaves him ; his mind, operated upon by his weakened
nerves, is filled with fancies, and he is unable to sleep. Even before
he becomes delirious he has what in conmion parlance is termed " the
horrors," which seem to be a wretched, nervous agitation and fearful
foreboding of trouble. Finally, the mind becomes so unsettled as to
be totally deranged. Illusory pictures present themselves continu-
ally ; such as serpents and other reptiles, with other hideous sights
too numerous to particularize. Unless some remedial measures are
made available in procuring sleep, his life in this world will soon ter-
minate. Bryonia once cured a case of delirium tremens in an army
officer, who, in delirium, had passed eight successive nights without
sleep. Nnx vomica will often quiet the nerves, and bring about a cure.
Opium is a valuable remedy, and, in large doses, has been employed
for many years. Arsenicum is a valuable remedy to allay the irrita-
bility of the stomach ; Ignatia, also, when there is much inclination
to weep. The dose of any of the remedies may be four globules, or
from one to five drops of the dilution in a spoonful of water ; re-
peated at intervals of one or two hours. As soon as the patient can
eat, give him the lightest kind of food, gradually increasing its
strength until he is able to take full meals.

Neuralgia.

This disease is a simple pain in the nerves, and manifests itself in
various parts of the body, — most frequently in the face ; and may
be caused by decayed teeth, or any weakening influence, such as loss
of blood, diarrhffia or dysentery. A torpid liver or feeble digestion
may be the source of the pain. It is usually a stubborn disease, and

was«HMn***«

NERVES.

Lachesis has benefited

foregoing is .a part. A
of the hand may so for-
at the brain distributes
most painful of all mor-
anus. Belladonna, Nnx
nay be employed in the
e treatment for lockjaw.

DISEASES OF THE BKAIN ANI» NERVES.

621

ibriation. When a man
nay lead, and keeps his
iter a while his stomacli
;able ; his system conse-
and, what is still worse,

upon by his weakened
3 to sleep. Even before
parlance is termed "the
>us agitation and fearful
jomes so unsettled as to
snt themselves continu-
;h other hideous sights

remedial measures are
this world will soon ter-
um tremens in an army
ccessive nights without
and bring about a cure,
ses, has been employed
ledy to allay the irrita-
ire is much inclination
nay be four globules, or
spoonful of water ; re-
soon as the patient can
radually increasing its

, and manifests itself in
in the face ; and may
y influence, such as loss
ver or feeble digestion
a stubborn disease, and

proves in some cases an agony of suffering for years. It accompanies
.spinal irritation. It often follows miscarriages in females, and is too
frequently an accompaniment of other female diseases. When diseased
teeth are evidently the cause, Arsenicum or Belladonna may afford re-
lief ; or else let the tooth or teeth be extnacted. If from extreme de-
bility, Ohina and Arsenicum. Chamomilla, when there is a flushed
face and much restlessness and extreme inquietude. Coniiim, when
it accompanies spinal irritation. Sepif and Oalcarea, when depen-
dent upon uterine derangement. For neuralgia of the stomach and
bowels, give Cocculus, Ignatia or Pulsatilla. • That which occui-s after
miscarriage, dysentery or diarrhoea, requires China, Ferrum, Nitric
add or Sulphur. Avoid rich foods. Live on a plain, nourishing diet
and keep out of doors as much as possible.

St. Vitus's Dance, Chorea.

A DEBILITATED condition of the nervous system may show itself
in involuntary twitchings of the muscles of the face, extreme rest-
lessness of the limbs, involuntary movements of the hands, arms, and
the entire body. Nux vomica, Ignatia and Cocculus are remedies that
will cure a majority of cases. China is best for debilitated pei-sons ;
Belladonna, for those of nervous temperament ; Sulphur, when there
has been suppressed eruption. One remedy should be selected pnd
tried firat, and repeated every three hours until the patient is better ;
or, in caae of no change, select another, and so on. Children afflicted
with chorea should not be confined in school or be tasked with
studies.

Stammering.

This is but another form of chorea, affecting the organs of speech.
Belladonna, Sulphur, Hyoscyamus and Causticum have been employed
against this difficulty and with success. The training of young boys
or girls addicted to stammering, to be deliberate in their efforts to
express themselves, will often accomplish more than remedies. It is
remarked that stammerers can sing or utter any sentence in song.
This would indicate the propriety of enjoining upon all thus affected
to practise slow and delibei-ate speech. Cuprum met. is a remedy that
has cured many cases ; and so has Ferrum, Ignatia and Belladonna.
Employ each remedy singly and repeat eve*;y three hours.

Loss of Memory.

FoRGETPULNESS may be the result of nervous disease, as well as
of heedlessness. Great and debilitating losses often impair the mem-
ory; so does a resort to Opium to destroy pain. Excesses of any
kind may result in this difficulty. The remedies that have Ikhmi em-
ployed are Phosphoric acid, Sulphur, Nux vomica and Ignatia. Of
the remedy selected, prepare twenty drops in half a tumbler of w aoer
and give a tablespoonful twice a day.

■%!

DISEASES OP THE EYE AND LIDS.

stye.

This is a small tumor on the lid, about the size of a pea, which is
quite painfuL Aconite will often cure in a day ; Pulsatilla, also, af-
fords speedy relief ; Belladonna, when the inflammation of the stye
causes redness of the eyeballs; Staph, prevents their recurrence,
taken once daily for a while.

Inflammation of the Eyelids.

When the entire lids become involved in acute inflammation,
Aconite, in the usual dose, may be given every two hours until re-
lieved ; Puis., the same way, when there is burning, with flow of
tears. If the lids become congested, red and swollen, give Bella-
donna. If the inflammation is -chronic, give Calcarea once a day,
or else Sulphur or Hepar sulph. If dependent upon gastric or
bilious derangement, give Nux vomica or Mercurius every two hours
until relieved, the latter especially when there are cutting pains,
worse nights.

Iritis, Inflammation of the Iris.

The little circle in the front of the eyeball, which we call the iris,
is subject to inflammation. It may result from a cold, or from in-
jury, or from some impurity of the blood. When from a cold, Aco-
nite speedily affords relief. If very painful. Belladonna. If from
injury. Arnica or Aconite. The patient must be kept in a dark room
until the inflammation passes off. To relieve acute pain, resort has
been had to Morphine, in one-eighth of grain doses, repeated every
four hours if necessary. It is doubtful if any external applications
in iritis ever prove beneficial. If any are used, none are better than
water in which six grains of Opium to a gill has been boiled.

Scrofulous Sore Eyes.

In persons of a strumous constitution, a cold, or any undue ex-
posure of the eyes, may cause them to be the seat of scrofulous in-

E AND LIDS.

DISEASES OF THE EYE AND LIDS.

623

flammation; in which event, there will be a redness of the eyeballs,
and swelling and ulceration of the lids, and a greater or less accumu-
lation of matter beneath the lids. This disease is often very painful,
and destructive to the coats of the eye ; and, what is worse, it be-
comes the fruitful source of cataract and blindness. When the eyes
fii-st become inflamed and burning, Arsenicum may be given ; when
tlie lids are implicated, give Calcarea ; when the inflammation passes
off, leaving white spots on the cornea, give Sulphur^ Hepar sulph.
or Conium. Daily doses of the remedy selected will be suflBcient.

the size of a pea, which is
I day ; Pulsatilla, also, af-
inflammation of the stye
>revent8 their recurrence,

Eyelids.

I in acute inflammation,
every two hours until re-
is burning, with flow of
and swollen, give Bella-
ive Calcarea once a day,
jpendent upon gastric or
fercurius every two hours
there are cutting pains,

f the Iris.

lall, which we call the iris,

from a cold, or from in-

When from a cold, Aco-

ful. Belladonna. If from

ist be kept in a dark room

eve acute pain, resort has

rain doses, repeated every

any external applications

used, none are better than

II has been boiled.

Eyes.

a cold, or any undue ex-
the seat of scrofulous iu-

Syphilitic Sore Eyes.

SoMETiMKS syphilis will affect the eyes and threaten the destruc-
tion of sight. The lids will inflame ; the cornea will be congested,
and of a bluish red ; the conjunctiva will become the seat of inflam-
mation, and sometimes of ulceration. Mercurius iod. may be given
first, while the patient is kept in a quiet and dimly illuminated room,
two doses daily. If the patient has already been treated with Mer-
curius, give Nitric acid or Repar sulph. If considei-able matter ex-
udes from under the lids, give Aurum once a day ; and if the eyes
itch continually, give Sulphur.

Cataract.

This film that obstructs the sight of the eye is undoubtedly the
sequel of scrofulous inflammation or injury of the crystalline lens.
It is simply an abnormal growth of a film over the pupil of the eye,
partially if not wholly obstructing the sight. Oonium mac, given
twice a day. Mere. iod. is also a good remedy ; Phosphorus, Causti-
oum or Sulphur may be indicated. Either may be repeated twice a
day when selected.

Rlieumatic Sore Eyes.

Rheumatism of an inflammatory character may fall with great
force upon the eyes, and produce severe pain and temporary blind-
ness. Nux vom.. Belladonna, Bryonia and Aconite are remedies that
may be consulted. Bryonia may be given three times a day, when
every effort to open the eyes is attended with pain; Belladonna,
when the pain is such as to give the sensation of the eyeball being
too large for the socket; and also when there is a feeling as if the
eyeball would buret. Sulphur, for dull pain in the eyeballs, and the
sight impaired. Ilhus when the eyes are pink and lame on moving
them.

Qonorrhceal Sore Eyes.

When the eyes become inoculated with gonorrhoeal matter, there
will he smarting, and then inflammation and swelling of the lids, and

624

DISEASES OF TUB EYE AND L1D8.

such serious infiltration as to close the eyes; and, in a very brief
period, a perfect disorganization of the texture of the eye w?ii take
place. As soon as the character of the inflammation becomes known,
It is well to make some compresses of linen a half-inch thick, and
bind them tightly over the eyes, and then give Cannabi% every three
hours for two or three days; afterwards, give CanfAan's in the same
way ; and, after the smarting pain begins to cease, carefully remove
the compress, keep the patient in a dark room, and Sulphur, in daily
doses, may complete the cure.

Specks on the Cornea.

Little opaque spots on the cornea may be U;ft after scrofuloi^ in-
flammation has passed away. These may be removed by daily doses
of Sulphur or Euphrasia.

Watery Eyes.

When the eyes are watery, or prone to become so, from slight ex-
posure to wind or cold, the difficulty may be obviated with daUy
doses of Pulsatilla, Mercurius vivus or Lachesis. Blood-shot eyes
will be relieved by daily doses of Euphrasia.

Squinting, Strabismus.

What is tern -d cross-eyed in persons is usually the sequel of some
cerebral disturbai 'S that have deranged the normal action of the
little muscles thai gulate the position of the eyeballs, and give
them an abnormal or squinting appearance. Sometimes daily doses
of Hyoscyamus or Belladonna will entirely remedy the difficulty.
Short-sightedness may be remedied by daily doses of Sulphur,
Lyoqpodium or Pulsatilla,

^'^■ ' liliiMIWi

Hl i ai lll 4 M»i < * W. «li^ i i..*» .W <..^-' <W »WIIII..I* W iWfcl.

'i> miit iii

I i i '« 'n i m< i n«> «8 inai>*»

.-uiJafc-

) LIDS.

res; and, in a very brief
,ure of the eye will take
iimation becomes known,
3n a half-inch thick, and
ive Cannabis every three
ve Cantharis in the same
cease, carefully remove
jm, and Sulphur, in daily

DISEASES OP THE EAE.

rnea.

36 U;ft after scrofulous in-
)e removed by daily doses

become so, from slight ex-
y be obviated with daily
achesia. Blood-shot eyes
a.

smus.

usually the sequel of some
the normal action of the
of the eyeballs, and give
). Sometimes daily doses
sly remedy the difficulty.
r daily doses of Sulphur,

Inflammation of the Ear.

When there is inflammation and swelling of the external ear, and
it has a red and fiery appearance, Pulsatilla may be administered
twice a day. If the swelling and inflammation extend within, so as
to close the external orifice, give Belladonna twice a day until the
difficulty passes away. If suppuration threaten, Hepar sulph.

Earache.

This may result from cold, or from gatherings within the ear ; or
it may possibly be neuralgia, or proceed from decayed teeth ; or, in
children, from teething. When from cold, give Chamomilla or Dul-
camara three times a day ; if from injury, Hypericum or Arnica; if
from gatherings, Hepar sulph. or Calcarea ; if from decayed teeth,
Mercurius viv. ; if in teething children, Pulsatilla, two doses a day;
if the pain is neuralgic, give Niix vomica or Belladonna. The core of
an onion baked, applied to the ear as hot as it can be borne, will often
give relief.

Running of the Ears. — Otorrhoea.

Otorbhcea may be occasioned by a cold, when there are no sores.
For this, give Pulsatilla; when from sores in the ears, Calcarea. If
this should fail to cure, try, in succession. Sulphur, Mercurius viv.
and Silieea.

Deafness, Hardness of Hearing.

To remedy this difficulty when produced by a cold, give iVkr vom-
ica eveiy night until relieved. For that which occurs after scarlet
fever, Calcarea, and for that after measles, give Pulsatilla ; from
hardened wax. Sulphur ; if from rush of blood to the head, or con-
gestion. Aconite or Belladonna ; Causticum, if these fail. The reme-
dies may be repeated every four hours until relieved.

626

{*T?

nM rr HM I Hl l il aiaaaWiilBil,

626

DISEASES OF THE EAR.

Nervous Deafness.

When the nerves of the ear lose their vitality, and deafness re-
sults as the consequence, Photphorio add may be given, in drop
doses, twice a day ; or SiUphur maj^ be given every night, or Nux
vomica or Caiieticum, in like manner. When deafness occurs from
Rheumatism, Pulsatilla may be given three timed a day. Arsenicum^
Nitrie acid, Calcarea and Mercuriua viv. may likewise be consulted.
If deafness occurs from suppressed eruption, the remedies are Sul
phur, Calcarea, Graphites or Causticum in daily doses. If deafness
is the sequel of malarious fevers, Phosphorus or Phosphoric acid, in
daily doses ; if from sudden check of nose-bleed, or discharges from
the nose or ears, Hepar sulphur or Lachesis ; if from enlargement of
the tonsils, Nitric acid, Mercurius or Aurum,

^(~-»«

{..

v 9K t*vf* r'^n m i ' ^mm \ . \ i, xs ui."m ' mjf i u m na m

MtlMMI— UWI llWilnniliB

itality, and deafness re-
may be given, in drop
en every night, or Nux
n deafness occurs from
inies a day. Arsenieum,,
' Hkewise be consulted.
, the remedies are Sul-
aily doses. If deafness
t« or Phosphoric acid, m
ieed, or discharges from
if from enlargement of

DISORDERS OP THE NOSE.

Nose-bleed. — Epastaxis,

This trouble arises from various causes and must be treated ac-
cordingly. When it arises from arterial excitement, Aconite; from
an injury, Arnica ; from rush of blood to the head. Belladonna ; if
from inflammation of the lungs, Bryonia ; in typhoid fever, Rhu»
tax. ; if caused by worms, Qina or Spigelia; if from weakness or de-
biUty, China or Carbo veg. ; if from cold or coryza, Nux vomica. Dose,
three times a day. To give immediate relief press up under the up-
per lip or apply something cold to back of ueck.

Obstruction of the Nose. — Ozcma.

OzfENA is an entire obstruction of the nasal ducts, from thickening
of the mucous membrane or other causes. If from accumulation of
the mucus, Pulsatilla ; if from suppressed eruption. Sulphur, Lyco-
podium and Oalcarea ; if from scorbutic tendency, Bryonia ; if with
diy crusts, Aurum. The usual dose, three times a day.

Polypus of the Nose.

Not infrequently a morbid growth attached to the mucous mem-
brane of the nose will fill the entire nostril. This is termed a poly-
pus and is perfectly curable. Oalcarea, when the disease appears in
scrofulous subjects ; Sanguinaria, when a cold has been the exciting
cause ; Sepia, when there is a pain in the head and nausea ; and Star
physagria, when it is the sequel of other disorders. The medicines
may be given in the usual dose and repeated every four horn's.

627

DISEASES OF THE RESPIRATORY

ORGANS.

The organs of respiration embrace the nose, larynx, trachea, bron-
chia, lungs, pleura, heart and their appendages. We will, therefore,
consider the diseases that affect them in their order.

Coryza, Cold in the Head.

When, from exposure to cold, the nose becomes stopped, and there
is an inclination to sneeze, and the eyes become more or less affected,
the following remedies, as indicated, will prove useful : Nux vomica at
night, should the coryza be more apparent in the afternoon or even-
ing, and particularly if it is attended with cold affecting the entire
system. Stibium^ or Tart, em., is a good remedy to lubricate the
stoppage of the nasal passages ; Hepar sulph. also, when this stop-
page is painfully disagreeable ; Arsenicum or Euphrasia, when there
is a thin, acrid discharge from the nose. Pulsatilla is best for chil-
dren and ladies when suffering from nasal catarrh. Coryza is syn-
onymous with acute catarrh, as both affect the mucous membrane
that lines the cavities of the nose.

Chronic Catarrh is much like the acute, only all the symptoms
have become persistent. Acute catarrh is often cured in a few days
by Mercurials, Nux vomica. Belladonna, Pulsatilla, Tart, em., Hepar
sulphuris and Sulphur; Mercurius, for stupefying headache with ca-
tarrh; iVki; vomica, when tlie catarrh occasions nausea; Belladonna,
when there accompanies the difficulty pain over and in the eyes;
Pulsatilla, when there is depression of spirits ; Tart, em., Hepar
sulph. and Sulphur, to remove obstructions in the nasal ducts, and
to subdue irritation and soreness of the external orifices of the ducts.
Doses as usual, repeated three times a day.

In the treatment of chronic catarrh, other remedies are called into
requisition. Aurum metallicum, if there is a heavy yellow discharge
from the nose, or crusts form- at night; Mercurius iodatus, in scrofu-
lous persons ; Aurum muriaticum, if there is any affection of the
vomer or partition of the nose ; Sulphvr and Hepar sulph. are both
valuable remedies, as are Arsenicum and Lachesis, when the peculiar
symptoms are such as to indicate their affiliation. The remedies for

628

^m^m

riREABES OF THE BESPIKATOKY OROANS.

629

8PIRAT0RY

(se, larynx, trachea, bron-
zes. We will, therefore,
ir order.

Head.

comes stopped, and there
me more or less affected,
ve useful : Nux vomica at
[1 the afternoon or even-
old affecting the entire
remedy to lubricate the
ph. also, when this stop-
r Euphrasia^ when there
uhatilla is best for cliil-
catarrh. Coryza is syn-
b the mucous membrane

5, only all the symptoms
ften cured in a few days
Isatilla, Tart, em., Mepar
jfying headache with ca-
sus nausea ; Belladonna,
1 over and in the eyes;
lirits ; Tart, em., Mepar
in the nasal ducts, and
rnal orifices of the ducts.

' remedies are called into
I heavy yellow discharge
'ourius iodatus, in scrofu-
is any affection of the
d Hepar sulph. are both
cheats, when the peculiar
ition. The remedies for

the chronic form need not bt> repeated so often ; once in twenty-four
lioura, in the usual dose, is sufficient.

Inflammation of the Larynx.

The upper part of the windpipe or trachea is termeu :he "laryn^t" ;
and, when inflamed, it is said to be affected with lar}'iigitis : and this
may be acute or chronic.

Acute Laryngitis, or Infiammation of the Larynx. — This trouble
is denoted by cough, hoaraeness and sore throat, affecting the voice,
and rendering respiration somewhat difficult and conversation fa-
tiguing or painful. It comes on from a cold and may be the continua-
tion of a nasal catarrh. With the cough there is usually some expec-
toration, or else a dry, uncomfortable sensation and inclination to be
clearing the throat. If the pulse is febril or full, give Aconite in the
first stage ; and, if there is painful soreness of the larynx, give £eP-
donna. Aconite will remove the fever, and Belladonna the congestion
of the capillary vessels of the mucous membrane, which causes tlie
soreness. Mercurius viv. often follows Belladonna well. If, after the
employment of these remedies, expectoration of mucus occurs from
coughing, give Phosphorus or Sanguinaria. If the cough is tight, as
if the laiynx was closing up, give Sambucus. The remedies, in the
usual doses, may be repeated every two hours. The diet should be
simple, but nutritious.

Chronic Laryngitis, or Inflammation of the Larynx. — The

symptoms of this form of the disease are similar to those of the acute
variety, only the cough and irritation are constant and the expecto-
ration sometimes great. The disease becomes chronic from the
weakening of the organ after one or more acute attacks of the dis-
ease. It sometimes mitigates in warm weather, and returns again
in winter. Argentum metallieum is a good remedy for the chronic
form when characterized by soreness of the throat. Belladonna is al-
ways useful when the difficulty is aggravated by a cold ; Phosphorus,
when there is considerable collection of mucus, and Hepar sulph.
when there are excessive drjrness and hoarseness. Causticum is par-
ticularly useful when the inflammation is persistent, and the cough
constantly excited, and when it resembles a croupy cough, and comes
on spasmodically or in paroxysms. When chronic laryngitis is not
kept in check or cured, it soon runs into that formidable disease
known as laryngeal consumption or becomes attended vnth hectic
fever. In such a case, give Stannum or perhaps Sulphur ; but in no
case more than one dose a day. The patient should be warmly clothed
and should always provide for tempering cold air before it is inhaled
into the lungs. The diet must be nutritious, aad strictly non-medi-
oinul.

K if

c:)0

Dlf RABEH OF TJIK ItKsMHATORY ORGANS.

Croup.

Crofp is of two kinds, spasmodic and membranous. The spiis-
medic is the result of a cold ; and it comes on with a hoarse, rouph
cough which is often Hpasmodic and suffocating. The catarrhal or
membmnous comes on like a cold, and then supervenes a crowing
cough and copious collection of mucus ; and sometimes an exudation
of a membranous character fills the larynx and upper portion of the
trachea. For spiwmodic croup, Tartar emetic is undoubtedly the best
remedy; Aconite, -when there is fever; Belladonna, xi the throat is
sore ; Ipecac, if the breathing is asthmatic. In membranous croup,
a resort must bo had to Aconite at first, to induce perspiration; if
this fails, give Bryonia, and then Spongia, Iodine, Bromine and Hepar
mlph., in the order mentioned. The usual doses may be given every
fifteen or twenty minutes when the symptoms are alarming. Croup
goes under the technical name of Cynanche Trachealis, because it im-
plicates both the larynx and windpipe.

Inflammation of the Windpipe. —Tracheitis.

There is some resemblance of this disease to croup ; and yet it
may occur and not manifest that peculiar character. It is denoted
by cough, sometimes exceedingly tight, at others looser, greater or less
obstruction of the breathing, and some pain and soreness of the throat
above and a tickling, raw feeling below, towards the bronchial tubes.
Aconite is essential in the treatment of this difficulty, and also Bella-
donna, Bryonia, Phosphorus, Causticum, Hepar, Sanguinaria and Span-
gia. It is to be observed, however, that only one of these remedies
must be given at a time ; five drops in half a tumbler of water and a
teaspoonful every thirty minutes. Diet simple and non-medicinal.

Acute Bronchial Inflammation. — Bronchitis.

As the name implies, the bronchial tubes become highly inflamed
in this disease, or rather, the mucous membrane that lines them.
There is much cough and expectoration. This disease is called ca-
tarrhal fever in its acute form ; and, when the substance of the lungs
becomes affected, it amounts to pneumonia. Acute bronchitis re-
quires, for the reduction of fever. Aconite or Bryonia ; Belladonna
may follow ; and when copious expectoration commences, give Phoir-
phorua ; and, some time after, give Hyoacyamua, especially for the
cough at night, and also Calcarea carb. for the soreness and cough
that may be created. Repeat the medicines, in the usual doses, three
times a day. Diet as in all febrile diseases. Barley or flaxseed tea
for drink and a light diet of toast is best.

'W»TMM Ww aB M P«tt'gatiiii*» j aB W i

a vm ^ Ktv^ itrnv sn. j Sf.)gg»*

i ORGANS.

DlilEAHEH OF THK KKHPIKATORY UUUANH.

631

Tieinbranotis. The flpiw-
on with a hoarse, rough
,tiiig. The catarrhal or
n supervenes a crowing
sometimes an exudation
ml upper portion of tlie
r is undoubtedly the best
\adonna, if the throat is
In membranous croup,
induce perspiration; if
line. Bromine and Hepar
loses may be given every
IB are alurming. Croup
rrachealis, because it im-

Chronic Inflammation of the Bronchia.

LiKR the acute form of the disease it has ito seat in the mucous
membrane that lines the bronchial tubes, and it is believed t^) l)e the
sequel of acute bronchitis. It is always accompanied by a cough, and
more or less expectoration ; now and then a paroxysm of fever. It
is a tedious and troublesome disease ; and, when not cured, is always
better in warm weather, and much aggravated in cold ; and this
would point to a perpetual warm climate as its cure. When there
are paroxysms of fever, give Aconite; if there is pain in the chest,
Belladonna ; profuse expectoration. Phosphorus or Lycopod.; hectic
fever, Stannum ; when the throat is sore, give Cnuatitmm. Great care
must be taken in the treatment of this malady, if a cure is expected,
or otherwise it will terminate in a lingering consumption. The most
generous living the patient's appetite will admit of must be supplied,
but free from medicinal condiments.

Ipe. — Tracheitis.

se to croup; and yet it
haracter. It is denoted
icrs looser, greater or less
nd soreness of the throat
ards the bronchial tubes,
iifficulty, and also Bella-
!r, Sangainaria and Spon-
y one of these remedies
I tumbler of water and a
pie and non-medicinal.

on. — Bronchitis.

become highly inflamed
nbrane that lines them,
'his disease is called ca-
le substance of the lungs
Acute bronchitis re-
or Bryonia; Belladonna
n commences, give Phos-
amu8, especially for the
the soreness and cough
in the usual doses, three
Barley or flaxseed tea

Lung Fever. — Pneumonia.

Lung fever is indicated by pain in the chest cough, flushed face,
quick pulse, rusty expectoration, headache, lo.s8 of appetite and op-
pressed breathing. Aconite or Bryonia may be given, in the usual
dose, every hour until the skin becomes moist ; Belladonna, if the
pain continues in the chest, every hour until relief or a change is
necessary ; Bryonia may follow Belladonna, if heat in the chest is a
prominent symptom ; and Phosphorus may follow Bryonia, provided
the expectoration has changed and a more plentiful secretion of mucus
is thrown off. Each medicine may be given in hourly doses when
called for.

This disease becomes typhoid pneumonia when the fever accom-
panying the inflammation is typhoid ; in which event Bryonia may
be given in the first stage and Belladonna if there is a manifest in-
clination to sleep. When the patient begins to cough up mucus
tinged with blood, give Phosphorus ; and, if very much prostrated,
give Mhus tox. As to diet in pneumonia, give the patient any light,
nourishing and soothing drinks, as jelly-water, barley-water, rice-water,
etc. Application of warm compresses to the chest is recommended.

Whooping Cough. — Tussis Spasmodica.

This disease often comes on like an ordinary cold and the victims
are observed to have frequent coughing fits ; and when there is no
fever or loss of appetite and the fits of coughing continue to be re-
peated, it may fairly be inferred that wliooping cough is progressing.
Soon the child or patient will begin to whoop and to experience fre-
quent paroxysms, and draw in a long breath or whoop, which is fol-
lowed by numerous short expirations. Drosera will mitigate the

k;::W:

W^W^^'^

632

niSKAHKH OK TIIK KKHPIUATORY OROANH.

HC'Vority of tlio i)iiroxyHniH, jind ho will Hj/oitni^amux, CoralUa ruhra,
Sanguinaria mid t'aiiHticum ; Chelidoniiiin, if thero are Hytn[)toiiiH of
pulmonary (;oii}((!Htion; but there it* no remedy known that will hn-ak
it up at once. Give a dose of the selected remedy immediately after
each paroxyBm.

Pleuritls. — Pleurisy.

Inflammation of the pleura Ih denoted hy sharj), shooting pains
in the sideH of the chest that interfere with respiration ; quick pulse,
ilushed face, great heat over the chest, etc. Aconite, in the usual
dose, may l)o given every twenty minutes, and a cloth compress of
warm water may be applied to the region of the pain. Avonite miiy
be followed with Phosphonm, given eveiy hour until relieved. Bryo-
nia is good.

Asthma.

DiFPiouLT and laborious breathing may be hereditary or be brought
on by a cold, overexertion or exposure of some kind. It comed on
in paroxysms tliat sometimes interfere with the respiration to so great
a degree us to oblige the patient to sit or stand in order to get breath.
Many cases are entirely curable with Ipecac, Arsenicum, Apis melli-
fica, Apocynum, Lobelia and Tart, emetic. When one remedy fails, try
the next until a fair waifare with the disease has been encountered.

Bleeding from the Lungs.

This trouble is occasioned by the rupture of some of the blood-
vessels in the bronchial tube, caused either by mechanical injury or
tubercles. If from the former, Arnica is the remedy ; if from the
latter, ffamamelis. In case of pain and inflammation, give Phospho-
rus ; and if motion aggravates, give Bryonia. Let the patient sit up,
if able, in an easy-chair until the bleeding ceases. If fever and ex-
citement of the circulation exist, give Aconite often. Once in a half
hour at first. To give temporary relief give strong salt and water.

Consumption.

This formidable disease may be hereditary or result from acci-
dental causes. When hereditary, it may not develop itself until adult
age ; and one of the first signs is extreme sensitiveness to cold, a
slight cough, defective nutrition and extreme emaciation ; night-
sweats come on subsequently, with hectic fever; and, at a later stage,
there may be diarrhoea, which resists remedial measures and exhausts
the life of the patient. That kind brought on as the sequel of pri-
mary affections usually supervenes upon bronchitis or some other
exhaustive disease that proves destructive to nutrition. In the first
stage, or wheu chilliness, debility and loss of flesh become apparent,

OKOANH.

DISKASKS OK THE KKHI'IUATOUY OIUtANS.

033

^cifamxH, Cornllia ruhnt,
■ thertj me Hymptoiim ot
y known Unit will brciik
smedy immediately after

by shari), shooting pains
•cHpiration ; quick pulse,
. Aconite., in the usual
,n(l a cloth compress of
the pain. Aconite may
lur until relieved. Bryo-

I hereditary or be brought
ome kind. It comea on
lie respiration to so great
id in order to get breath.
;., Arsenicum.^ Apis melli-
hen one remedy fails, try
le has beep, encountered.

much l)enofit can Imi obtained from the use of good old Hnurbon or
rye V/'hiskey: from iialf to a whole winuglassful may Iks taken twit:e
11 day. The introduction of carlH)n into tiie syNtem in this way has
often pntved of great sorvit^e. When there is deei>-Heat(!(l pain in the
lungH, cHpecially in the upper i)urtion, Lycupodium ; tiio usual dose
may Ui given every day and continued as long as any benetit is per-
ceived. Lyeopoilium may bo followed by tStannum or iSulphur, pro-
vided there is any hectic fever; by t'arho animalitt when there are
night-sweats. If the cough becomes troublesome and the expectora-
tion nmco-purulent, J'hoH/ihonis in the usual <lo.s(? may be given
twice a day. If occasional hemorrhage, BeUaihmna may be given, if
tli-re is pain; Ipecac, if there is asthmatic breathing; and Hamame-
lis ir., if there is bleeding from the lungs without nnuih pain. For
thi- !. 4t stage of l)ronchial consumption, see the treatment directed
for bronchitis. After tubercles Income manifest, the same remedies
may be indicated as for the hereditary disease. The diet for (!on-
sum^^t'ves should be fish, game, beef, mutton and vegetables such as
potatoes, beans and egg-plant ; butter and (!ream, witli toast, are also
allowable. Let the diet be as generous us the patient cau take. And,
if possible, live iu the open air.

Lungs.

re of some of the blood-
by mechanical injury or
the remedy; if from the
lammation, give Fhospho-
!. Let the patient sit up,
leases. If fever and ex-
lite of ton. Once in a half
re strong salt and water.

itary or result from acci-
t develop itself until adult
le sensitiveness to cold, a
ireme emaciation ; night-
ever; and, at a later stage,
lial measures and exhausts
t on as the sequel of pri-
bronchitis or some other
to nutrition. In the first
of flesh become apparent,

. ?3i

DISEASES OP THE URINARY ORGANS.

The urinary apparatus includes the bladder and kidneys, and their
appendages, all of which are subject to inflammation.

Inflammation of the Bladder, — Cystitis.

- /hen urination becomes painful and difficult, and the orifice of
the bladder seems to be insufficient for voiding the urine, we have
Stations of inflammation of the bladder; and also when there is
frequent inclination to urinate, with ability to pass but little at a
tSie. Aconite maybe given at first if fever attend the difficulty;
Belladonna might follow Aconite if there should be any congestion;
CaXris, howUr, is one of the best remedies, if there is tenesmus
or straining. Cannabis sativa, also, is a good remedy, and with old
people, Arfenieum is often beneficial. It is well to drink mucilagi-
nous drinks, and subsist mostly on gruel, until the severe symptoms
ZZde. All this trouble may pass from the acute to the chronic
?ot; of the disease, and be an'entailed cUfficulty. The best way to
prevent it is to have the first acute stage well attended to. Ihe tre-
^uent desire to urinate, which we sometimes And - aged pejus
may be due to chronic inflammation of the neck of the bladder
Sulphur, given every night, may mitigate the disease materiaUy; and
so ato aTcided benefit ma/be gained from the use of Comum
ZaTatum. The same diet found beneficial for the acute form of
this disease will be found beneficial for the chronic.

Strangury.

This affection consists in being unable to void the urine, and is
believed to be the result of inflammation of the ne«\ of the bkdd^^^^
or some mechanical pressuro upon the urethra It often F^ves Jo
be quite painful, and attended with fever. ^<^omte m^y he guen
eve?y hou? when the skin is hot, dry, and feverish, ovSpints of Cam-
phor in drop doses every twenty minutes until relieved. ^W«!^« ^
if the stoppage appears to be ""Attended with i^ever;/7«»«A«nMt
there is an ineffectual urging to urinate ; and Cannabis, also, when

-. 634

38t i<^9i Wi i r r.-

DISEASES OF THE URINARY ORGANS.

635

ARY ORGANS.

ler and kidneys, and their
immation.

Jer. — Cystitis.

fficult, and the orifice of
iding the urine, we have
; and also when there is
ty to pass but little at a
irer attend the diificulty;
hould be any congestion;
jdies, if there is tenesmus
)od remedy, and with old
IS well to drink mucilagi-
antil the severe symptonis

the acute to the chronic
ficulty. The best way to
roll attended to. The fre-
nes find in aged persons,
the neck of the bladder,
he disease materially; and

from the use of Conium
cial for the acute form of
3 chronic.

e to void the urine, and is
of the neck of the bladder,
rethra. It often proves to
3r. Aconite may be given
feverish, or Spirits of Cam-
atil relieved. Hyoscyarmis.
d with fever ; Cantharis, if
; and Cannabis, also, when

there is inability to evacuate the bladder. Dose and administration,
four globules every hour.

Stone.

When one is voiding urine, and some obstacle to its passage sud-
denly interferes, and the stream is cut short, we may infer that a
stone has interposed at the orifice of the bladder. The symptoms
lire like those of strangury. Oftentimes there is pain in passing
mine, inclination to pass it often, and straining to keep the stream
flowing. Against the ill effects of stone in the bladder, Cantharis or
Cannabis are among the prominent remedies. Li/copodium, Calcarea^
nd Phosphorus are also good remed*' The two remedies first
iiamed may be given in drop doses every hour, and the three last
only three times a day. The patient should drink soft water, Poland
water in large quantities, if possible, and live upon a moderate non-
medicinal diet, avoiding malt and distilled liquors as a beverage.

Qravel.

This is indicated by violent, cutting, intermittent pains in the re-
gion of one or the other hip and kidney and extending down the
ureter to the groin or down the thigh, frequent but sea ity urine,
fever, and nausea. The most useful remedies, in the order of their
importance, are Uva ursi. Belladonna^ Chamomilla. and Nitrum, re-
peated often.

Retention of Urine.

This difficulty results from fever or some local irritation, and con-
sists simply in disinclination to evacuate the bladder, not from ina-
bility on account of inflammation, or some obstruction, but because
there is an irresistible proneness to retain tlie urinary secretion,
either from nervous weakness or spasm of the neck of the bladder.
The remedies found n 3t useful are Cina, Spigelia, Hyoscyamus, Bel-
ladonna, and Rhus tax. ^ither of these may be given and repeated
until the patient is relieved. Hyoscyamus and Gina are preferable.
With old people, Arsenieum or Secale.

Suppression of Urine.

In some fevers the kidneys do not perform their office, and the uri-
nary secretion is suppressed and thrown back upon the system ; and,
as a consequence, the blood fails of being defecated, and the result, in
a short time, must prove quite disastrous. A dose of Sulphur may
sometimes overcome this difficulty, and set the organs of secretion at
work. Baptisia, Nitrum, Pulsatilla, Bryonia, Rhus, Cantharis, and
nny of the remedies that act specifically upon the renal region, will
be likely to afford relief. The remedies may be repeated every two

'ti

^sa w "

£■

636

DISEASES OF THE URINARY ORGANS.

hours, and the diet should be mucilaginous drinks. Poland water
taken in large quantities is good in all cases of urinary diseases.

Incontinence of Urine.

Some persons cannot help urinating at once as soon as the bladder
fills. Their incontinence Ijecomes manifest when no opportunity
offers for immediate resort to the water-closet, and in many instances
becomes painfully mortifying, and renders the victim an object of
sympathy. Mercurius vivus may be given in the usual dose, three
times a day. If, after a trial of a few days, the patient is not im-
proved, give either Opium, China, Oalcarea, Caustimm, or Sulphur
in the same way.

Wetting the bed. — Nocturnal Enuresis.

Children addicted to this habit from some diseased condition may
be cured by daily doses of Sulphur or Carlo animalis, or perhaps
Silicea, or Caustioum. But some children get the habit and become
confirmed in it from no physical cause whatever ; and, if no measures
are taken to reform them, they will grow up under the impression
that they cannot help it. The best way to treat such is to impress
upon them that they can and must banish the habit. Let them be
impressed even to shame and a threat of chastisement if they keep
up the practice • and in most cases, this is all that is necessary.

Diabetes. — Immoderate Flow of Sweet Urine.

There is no disease that resists more stubbornly the action of
remedies than diabetes. It consists in a copious secretion of sweet
urine, that contains many grains of solid material passing away from
the tissues every twenty-four hours. This disease will emaciate a
fleshy subject in six week i, and give him a pale and sickly look. The
disease has been palliated, but never cured permanently that we find
any record of ; and yet Phosphoric acid, given three times a day, has
diminished the amount of the secretion from twelve to two quarts in
twenty-four hours ; and apparently this remedy, with Nitrate of ura-
nium, has effected temporary cures. Muriatic acid, Sulphur, and Kali
carb. have also been esteemed as valuable remedies, all of which may
be given in the usual doses, three times a day. I would also recom-
mend Poland water in large quantities.

Bloody Urine.

As gravel is believed to be one of the causes of this difficulty, and
inflammation of the bladder is believed to be another, the same reme-
dies applicable to the one will serve for the other. Arsenicum may,
however, be added to the remedies, particularly if there is any burn-
ing at the neck of the bladder and tenesmus.

::ismi«e!msmmm^-''

DEUANS.

DISEASES OF THE URINAllY ORGANS. 637

} drinks. Poland water
of urinary diseases.

*ine.

36 as soon as the bladder
t when no opportunity
it, and in many instances
the victim an object of
in the usual dose, three
I, the patient is not ira-
i, Causticum, or Sulphur

rnal Enuresis.

5 diseased condition may
rbo animalis, or perhaps
et the habit and become
iver ; and, if no measures
up under the impression
treat such is to impress
the habit. Let them he
lastisement if they keep
11 that is necessary.

)/ Sweet Urine.

itubbornly the action of
jpious secretion of sweet
iterial passing away from
disease will emaciate a
3ale and sickly look. The
permanently that we find
3n three times a day, has
1 twelve to two quarts in
ledy, with Nitrate of ura-
te acid, Sulphur, and Kali
smedies, all of which ma}-
ay. I would also recom-

Inflammation of the Kidneys.

When there is pain in the back, and increased flow of urine, and a
desire to urinate frequently, and sometimes severe pain in the hip and
side, nausea, vomiting, and fever, there is undoubtedly inflammation
of the kidneys. In the treatment of this painful difficulty, we find
Arnica the best remedy if the inflammation has been produced by a
mechanical injury. If from a cold, Rhu^ tax. or Nux vomica. If
there is much fever. Aconite ; chilliness down the spine, Belladonna.
When there is obstinate vomiting. Bismuth. The patient should lie
in bed, and not try ercise much till the inflammation passes off.

The medicine shoul given every hour or two houre, according to
the severity of the innammation. Use Poland water in large quan-
tities.

ises of this difficulty, and
e another, the same reme-
! other. Arsenicum may,
arly if there is any buni-

-TiEW»

^■W

DISEASES OP THE ORGANS OP
GENERATION.

The organs of generation in the male are the penis, testes, and
their appendages. Those of the female are the vulva, vagina, womb,
ovaries, and their appendages.

Inflammation of the Urethra.

The urethra is the common passage through which the urine passes
from the bladder, and the semen from the testes. When it becomes
inflamed from cold, or as the sequel of some acute disease, PuUatilla,
Cannabis, Mereuriua viv., or Sulphur may cure the difficulty by being
given every two or three hours. One remedy only must be given ;
if this fails, try another; but if the disease is the result of impure
connection, and is the gonorrhoea (or clap), give Cantharia, and after-
wards Cannabis. If there is painful smarting, give these remedies
every hour in alternation until the discharge ceases. Give Pulsatilla,
also, every hour, if the other remedies fail, and use a solution of
Hamamelii in water as an injection.

Syphilis.

Nearly allied to gonorrhoea is syphilis ; only the latter is a more
formidable result of impure connection, which inoculates the blood.
It becomes manifest iu discharge from the urethra, chancres, buboes,
etc. When there is a purulent discharge from the urethra, Mercu-
riu8 viv. may be given persistently for eeveral days, and this may
arrest the further progress of the disease; but should it not, and
chancres make their appearance on the prepuce or foreskin, or on the
glans, burn them with Nitric acid, full strength of the stores, and
then give Mercurius corrosivua every six hours for several days;
dressing the sores with lint wet with cold water and Calendula. If
the chancres heal, it is well and good, if they do not, give Mercurius
iodatus three times a day. Let the patient avoid drinking any in-
toxicating beverage whatever, and abstain from all medicinal articles
of diet.

638

DISEASES OF THE ORGANS OF GENEUATION.

639

IGMS OP

e the penis, testes, and
tie vulva, vagina, womb,

rrethra.

1 which the urine passes
stes. When it becomes
icute disease, Pulsatilla,
e the difficulty by being
dy only must be given ;
is the result of impure
ive Cantharia, and after-
ng, give these remedies
(eases. Give Pulsatilla,
, and use a solution of

nly the latter is a more
!h inoculates the blood,
rethra, chancres, buboes,
•om the urethra, Mercu-
jral days, and this may
but should it not, and
loe or foreskin, or on the
ngth of the stores, and
lours for several days ;
ater and Calendula. If
y do not, give Mercurivs
avoid drinking any in-
om all medicinal articles

Inflammation of the Testicles.

Sometimes a suppression of gonorrhoea will cause inflammation and
swelling of tlie testicles. Both may be implicated, and become ex-
ceedingly painful and enormously swollen. For the first stage be-
fore the swelling, Aconite may be given every two hours to reduce
the general febrile condition of the system. Afterwards Arnica may
he given to lemove the soreness, and Pulsatilla to remove the swell-
ing. Either of these remedies may be given every day, three times,
until the object for which they are given is accomplished. Let the
patient lie in bed, and apply warm compresses to the part. Let him
subsist upon a spare diet, and drink no exciting drinks. Let him
wait with patience for a subsidence of the swelling and inflamma-
tion.

Dropsy of the Scrotum. — Hydrocele.

Sometimes inflammation of the testes will result in hydrocele, and
the scrotum will become filled with water. Helleborus nig.. Apis mel.,
and Arsenicum are remedies that have been employed to cure the
difficulty ; but sometimes remedies prove unavailing, and the water
has to be drawn off by a trochar, in which event consult an experi-
enced surgeon. But try the remediis first, and give each named in
succession (provided the first or second does not prove effectual),
every three hours during the day.

Inflammation of the Vulva.

This hiay occur from acrid leucorrhoea, or cold, or from gonorrhoea;
and, from whatever cause, it requires the application of warm water
and compresses, and a dose of Aconite or Belladonna every hour until
relieved.

Inflammation of the Vagina.

The vagina is lined by a mucous membrane, which sometimes
becomes inflamed ; and when from a cold, producing an ordinary
catarrh, give Nux vomica or Sulphur, night and morning, until better.
If from chronic irritation of the membrane there is a leucorrhoeal
discharge from the vagina, give Sepia night and morning. If this
fails, give Calcarea carh.; and if this fails, give Sulphur in the same
way. Leucorrhoea may be occasioned by falling of the womb, which
irritates the mucous membrane of the vagina, in which event Sepia or
Nux may be given every night, with full prospect of a cure.

Inflammation of the Womb.

This painful malady is often the result of protracted labor, and is
known by great thirst, pain over the region of the womb, and great

s-tsr

,sS«*

S-aiUP!

— TSP-

wam^

640

DISEASES OF THK ORGANS OK GENERATION.

tenderness of the touch. Arsenicum, given every three hours at first,
and followed by Belladonna, generally proves successful ; but Brij-
onia and Rhus tox. or Verat. viride may be resorted to, and repeated
every three hours, if found necessary. Inflammation of the womb is
a painful difficulty and a dangerous one, and should be treated with
great care. Warm bran poultices, if the patient can bear them, may
be applied while giving the remedies. Injections of hot water, 110
degrees, taken at night, will often give great relief. Would recom-
mend patient to consult a physician.

Falling of the Womb.

The womb is said to fall, when from debility, or a relaxed condi-
tion of its ligaments, it sinks down into the vagina; and this is indi-
cated by pain in the back, and a dragging sensation over the hips,
and bearing-down pains. These are often attended with headaches
and other derangements, which must be considered. Nux vomica,
every night, is one of the most valuable remedies for prolapsus uteri.
Sulphur sometimes does well. Sepia every morning has often cured
and relieved the headache, nausea, and other concomitant symptoms.
Calcarea has relieved when the pain is most prominent about the hii)8;
Ignatia, when the difficulty has been brought on by grief. Patients
of this description should not drink coffee or strong green tea. Black
tea, cocoa, and milk may be allowed, with a moderately generous diet.

Inflammation of the Ovaries.

This difficulty is denoted by sharp pains, either in the right or left
side, or both, just front of the upper edge of the hip-bone. It some-
times is very painful, and requires rest and the best treatment and
nursing to subdue it. Conium, in daily doses, has relieved some ; so
has Pulsatilla, Belladonna, and Ignatia. Some remedies relieve for
a time, such as Bryonia and Rhv^s tox. Belladonna will cure when
the inflammation is attended with headache and considerable neu-
ralgic pain in the region of the glands ; if much fever attends the
affection, give Aconite three or four times a day. Now, as all these
affections disturb the nervous system, and give rise to various forms
of nervous complaints, such remedies as Pulsatilla, Ignatia, Hyoncy-
amus, Nux vomica, Moschus, and Oaulophyllin will be constantly
needed, and stimulants need to be taken with great caution. Cold
compresses in acute attacks. A piece of flannel soaked in hot
laudanum laid over the ovary, covered with a dry flannel, will give
relief and enable the patient to sleep.

Ulceration of the Womb.

Anything that irritates the mouth of the womb may occasion, first,
inflammation of the os tincae, and then ulceration. Frequent mis-

lliiM^»l.< .>

' GENERATION.

1 every three hours at first,
•oves successful; but Bry-
B resorted to, and repeated
iflammation of the womb is
md should be treated with
patient can bear them, may
njections of hot water, 110
■reat relief. Would recom-

Vomb.

lebility, or a relaxed condi-
he vagina; and this is indi-
ig sensation over the hips,
n attended with headaches
» considered. Nux vomica,
emedies for prolapsus uteri.
ry morning has often cured
:her concomitant symptoms.
3t prominent about the hii»s:
aght on by grief. Patients
I or strong green tea. Black
a moderately generous diet.

e Ovaries.

18, either in the right or left
e of the hip-bone. It some-
and the best treatment and
doses, has relieved some ; so
Some remedies relieve for
Belladonna will cure when
ache and considerable neu-
; if much fever attends the
}8 a day. Now, as all these
id give rise to various forms
» Pulsatilla, Ignatia, ffyoscy-
>phyllin will be constantly
n with great caution. Cold
5 of flannel soaked in hot
with a dry flannel, will give

DISEASES OK THE OKOAN8 OF OENEKATION.

641

carriages will so weaken the organ, and especially its ligaments, as
to admit of its being easily misplaced, or turned backwards or for-
wards. These misplacements are often the cause of ulcerations, and
almost always the source of weakening leucorrhoea. The medical
treatment of this difficulty is of the first importance. Sulphur every
night may commence the treatment. If, after using the Sulphur for
a week, the purulent discharge becomes less, and there is less pain
and soreness in the region, and still considerable pain remaining in
the back, give Nux vomica every night for a week. If these two
remedies fail of bringing about a cure, then drop twenty drops of the
tincture of Calendula (Marigold flowers) in half a tumbler of water
and inject it into the vagina every day, and at the same time take a
dose of Sepia every morning. Continue this treatment as long as
useful. Culcarea, taken every night, sometimes has a good effect.
Local applications to the ulcers are sometimes made, but this is the
business of the surgeon.

Leucorrhoea. — Whites.

When the mucous membrane lining the womb and vagina becomes
irritated or inflamed, it undergoes solution, and there is a white dis-
charge. This is of frequent occurrence, and in some instances is such
a drain upon the system as to weaken the function and tone of the
nutritive organs. Any treatment that will strengthen the whole
system will generally cure the derangement. China, Ferrum, and
Aurum are remedies that may be employed, either of which, in daily
doses, will prove sufficient. In the mean time, let the patient refrain
from over-exertion. A more aggravated form of leucorrhoea attends
falling of the womb, and this perhaps is the cause of the difficulty.
The remedies which will best meet this difficulty are Sepia and Cal-
earea earh. ; the former may be given every morning, and the latter
every evening ; or perhaps Nux vomica may be given in the evening,
and Oalcarea in the morning. If there is sick headache attending
this form of leucorrhoea, Sepia is still the remedy. If other biliary
derangements Nux vomica is equally applicable. Ladies afflicted
with any of these uterine difficulties must not drink strong tea or
coffee; but mild black tea, cocoa, and milk should be the chief
beverages, and. if the appetite permit, a moderately generous, but
non-medicinal diet may be added.

J Womb.

the womb may occasion, first,
ulceration. Frequent mis-

DISEASES OP THE SKIN.

Boils. — Furunculi.

These are small, circumscribed, and painful tumore,. which hepin
in the form of a pimple, and then grow until they acquire the wize
of acorns. They are several days in coming to maturity; and some-
times their painfulness excites fever and chilliness, loss of appetite,
and other derangements. When suppurating, the pain in them is
intense and pulsating just before the crisis. As soon as they break,
the pain diminishes, and very soon the injury is repaired. Aconite
may be given two or three times a day to subdue any fever that may
be present. Belladonna also will remove the pain of congestion ; and
this may be given several times during the day. Arnica tincture may
be applied externally to remove the soreness, and with great advan-
tage it may be taken internally ; and in the same way Hamameli% Vir-
ginica may be employed. Wet a compress, and apply directly over
the boils, and renew several times a day, and the pain will be very
greatly diminished. Poultices, in case of very large boils, may prove
of pervice, — bread and milk or flaxseed ; and, when employed, give
at the same time Hepar sulpk, four globules, and repeat twice a day.
Amenicum often prevents their recurrence. When the uoil first ap-
pears drink quantities of Indian-meal water. It will usually blast the
boil and prevent others coming.

Carbuncle. — Anthrax.

The difference between a boil and a carbuncle is this : a boil is
circumscribed, but a carbuncle travels, or moves along the subcu-
taneous tissue ; and, when it breaks, it seems to have several open-
ings instead of one as in the case of the boil. Anthrax is a trouble-
some disorder; sometimes it is attended with active inflammatory
fever and sometimes with low fever. It is far more common among
old than young people and sometimes very diflficult of cure. A car-
buncle upon the back of the neck, accompanied by fever, requires
Aconite during the time of its development and afterwards Hepar
mlphuris. The effect of this latter remedy is to hasten suppuration.
Phosphorus is also employed to promote the same end. Bread and milk

64a

mtna 'riifr'i

DISEASES OK THE SKIN.

643

S SKIN.

li.

riful tumors,. which hepiii
itil they acquire the size
g to maturity; and sonie-
liilliness, loss of appetite,
ting, the pain in them is
. As soon as they break,
jury is repaired. Aconite
abdue any fever that may
le pain of congestion ; and
lay. Arnica tincture may
js, and with great advan-
same way Haviamelis Vir-
i, and apply directly over
nd the pain will be very
ery large boils, may prove
ind, when employed, give
IS, and repeat twice a day.
When the ooil first ap-
, It will usually blast the

hrax.

irbuncle is this t a boil is
■ moves along the subou-
ms to have several open-
»il. Anthrax is a trouble-
with active inflammatory
far more common among
difficult of cure. A car-
ipanied by fever, requires
mt and afterwards Mepar
(T is to hasten suppuration,
same end. Bread and milk

poultices may be employed; and a dressing of adhesive plaster, witli
ii[)erture8 for the pus to discharge, may Ixj applied after tlio poultice.
The sore should bo dressed every day ; and, if very painful, compresses
wet with llamameliH may be lesorttnl to. To remove great soreness,
Arnica may be used in the same way. Sometimes in aged people a
carbuncle becomes gangrenous ; and then Armenicum should be em-
ployed, a dose every three houra. When the disease, or carbuncle,
comes on the back, either to the right or left of the spine, it is liable
to make its way downwards; and, in order to prevent its doing* so to
any extent, compresses bound tightly beneath may keep them where
tliey begin. In all cases where there is active fever accompanying
carbuncle. Aconite may be necessary ; for so long as there is great
art«rial excitement, it will tend towards the carbuncle and greatly
augment its severity. Slow fever, or a lassitude and stupor, attends
the discrasia, give Bryonia and repeat every three hours ; or perhaps
Rhus tax.; Arsenicum, if the pus is of an offensive smell. Carbuncles
are supposed to originate from low conditions of the circulation, and
therefore a generous diet is suggested. Avoid medicinal food and
condiments, except salt. Animal food is most commended for a diet.

Abscesses.

Abscesses generally form in the subcutaneous tissue, but manifest
themselves through the skin. Generally there is some protuberance
or swelling upon the surface ; sometimes there is none. Frequently
there will be some redness to indicate that an inflammatory process
is going on ; and, at other times, there will be no indication of the
kind. An abscess, then, is simply a circumscribed collection of pus,
formed from broken-down tissues or blood corpuscles. They are sub-
ject to medical treatment. Calcarea, for abscesses in scrofulous per-
sons, may be given every day, and especially in cases of scrofulous
children. Accesses upon the arms or hands may be cured by the
use of Pulsatilla or Nux. Abscesses on the face require Bryonia and
Oalcarea ; abscesses from the bone require Silicea. Abscesses should
be relieved of their pus by the lancet as soon as sufficiently ripe.
They may bfe washed with Calendula tincture. Persons prone to
suffer from abscesses should sulwist upon a spare diet, and should
avoid rich gravies or great quantities of buuter. Bread, potatoes,
beans and peas, beef and mutton may constitate about the range of
diet ; and coffee, ale, cider and distilled spirits must not be touched.

Corns.

The feet appear to be the only locality affected by corns ; and they
occur frequently upon the toes. A com is simply hardened cuticle or
skin, rendered so by some pressure or irritation upon the surface, such
as a tight boot or shoe. Those who subject the feet to such treat-

~SM9M^^^^^^'

044

D18RASRB OF TIIR SKIN.

ment in U8t suffer tin- conHoquetices. Tlio lx?8t treatment for ii hi>ri'
onrii 18 to shave off tlie liimi Hkin and apply tlie tinctun* of Aniira
or perhaps the tincture of CaiiMaum. It is naid, however, that (h-K-
jthitt'K^ Silicea^ Sulphur and Aiitimonium cruii. are remodiert that may
Im) taken internally to cue corns. Either of the remed'es may Iw
taken in daily doseH. A .-orn-Malve is soinetimeH applied, made of
pine-pitch or diachylon. Any plastt'r that will protect the teudt-r
and irritated spot from the pressure of the hoot will \>e found useful.

Ulcers.

Ulcers are included among skin-affections hecatwe they break the
continuity of the skin and manifest themselves upon the surface. An
ulcer is formed generally hy the disorganizing influence of inflainniii-
tion which affects the membranes and skin. Ulceration of the sol't
parts and ulceration of the stomach and intestines are of frequent oc-
currence: and an ulcer is slow to heal and constantly discharges pus.
Ulcers of the legs, toes, feet, hands and arms are met with exlcii-
sively. Ulcers of the lower extremities or legs and feet can be cured
by a daily dose of Silicea or of Sulphur. Ulcers of tlie upper extrem-
ities, or the arras and hands, can be cured by daily doses of Calearea
and Oraphites. Ulcers of the soft parts require Phosphorus or China.
Ulceration of the stomach requires Coniurn or Phosphorus. Ulceration
of the bowels requires Arsenicum. Each of these remedies may Ih;
given in daily doses, and continued as long Jis observation teacht's
their utility. Ulcerations are supposed to result from low states of the
blood; and, therefore, stimulants must be employed to tone up the
system. A generous diet is generally to be commended. There is no
use in trying to heal over the surface of an ulcer ; for, in so doing, it
may work out deeper mischief in the economy. The only safe way Ih
to build up the most healthy stsite of the system, and let tue ulcer dis-
charge itself and heal from the bottom. Persons subject to ulcei-s are
evidently scrofulous or the victims of some i/ther tiiint. If scrofu-
lous, Arsenicum, Silicea or Calearea may benefit the condition. Ulcers
arise also from hereditary syphilitic taint. Mercurius viv., Mercurim
iodatua and Mereunus corr. are competent to eradicate this taint
from the constitution; so Ls Hepar sulph. or Nitric acid. If the ul-
cers arise from this taint, alcoholic stimulants must be avoided and
the most generous moat diet must take their place. Whatever l»e
the predisposing cause of ulceration known in a family, it should' be
carefully watched. Avoid eating pork and lard in any form.

Chilblains.

Frosted feet, as this complaint is termed, occurs mostly in cold
weather, and most frequently in persons susceptible from some con-
stitutional taint. It has been observed that chilblains will assume the

Till

»OHt treatment for ii hcrt-
y tilt) tincture of ^\rtiii\i
said* howevrr, tlmt <fra-
if. are remodicH tlmt may
of the reined 't'« may Iw
letimcH applied, made of
will protect the tender
K)ot will Im3 found useful.

18 hecaUHe they break the
es upon the surface. A»
ii{r influence of intlanniui-
Ulceration of the soil
stines are of frequent oc-
onstantly discharges [ms.
rnus are met with exten-
gs and feet can be cuied
cers of tlie upper extrcm-
»y daily doses of Calcarea
lire PhoHj>hoTru» or China.
\r PhonphoruH. I'lceration
if these remedies may he
g as observation teaches
iult from low states of the
employed to tone up the
commended. There is no
ulcer ; for, in so doing, it
uy. The only safe way is
item, and let tne ulcer dls-
srsons subject to ulcere are
3 crtber tJiint. If scrofu-
efit the condition. Ulcers
Mereurius viv., Mercvrim
t to eradicate this taint
r Nitric acid. If the ul-
its must be avoided and
leir place. Whatever Iw
I in a family, it should be
lard in any form.

3d, occurs mostly in cold
sceptible from some con-
chilblains will assume the

DISEASES Of THK SKUf.

645

(;)iaracter of painful sores in those known to be of a scrofulous habit.
The feet l)eing very suHceptible to cold, l)ecomu ohilled, and after-
wards the heels, and sonietinies the toes, become painfully tender.
Croton tig. or Araenicum, in the usual dose, may be administered
twice a day when there is burning heat and swelling ; Nux vomica^
ill the same way, wh^in attended with rheumatic pains. Pulmtilla is
a better remedy for females of delicate constitution and subject to
colds. Wher the chilblains iWHunie a bluish appearance, PhuHphoruii
and Sulphur may be given ; either of which, in the usual dose, may
lie given twice a day. Externally the tincture of Arnica may be aj)-
l)lied to remove soreness. Tincture of Cantharig, if there is an incli-
nation to blititer; Jihus tox.., if they are red and inflamed. A solution
ot glue, in warm water, has been found a good palliative us a foot-
bath.

Whitlow.

This is an inflammation and suppuration around the nails of the
fingers ; sometimes slight and at other times exceedingly jMiinful.
Hepar aulph. taken internally will hasten to a crisis ; Graphites or
MercuriuH is sometimes used for the same purpose; Silieea will has-
ten suppuration and a cure. Rhu» or Lachesin, if the sjrstem is in a
low condition. Either remedy may be administered twice in twenty-
four hours.

Itch. — Scabies.

This cutaneous eruption consists of small pimples, or piistules,
which make their appearance in clusters upon the skin and itch and
burn continually. They are believed to result from the acarus or
itch-mite imbedded in the cuticle. These pimples usually break out
between the fingers, on the hands and wrists, and over the body. StU-
phur has ever been found * salutary remedy, taken internally, and ap-
pHed as an ointment dp'.iy. In many cases, Calcarea, Hepar sulph.,
Mercuritig and Rhus have been found useful. For what is termed the
j)rairie itch, which is very stubborn, Mercurius viv., taken internally,
and an ointment of the red oxide of mercury, used with care, exter-
nally, has proved effectual. Sulphur ointment has been in general
use, and is of great service if used sparingly and with caution.

Itching of the Skin.— fV-Mn^ro.

Sometimes there will be intense itching of the skin, without any
apparent eruption. Scratching or rubbing does not relieve ; every
attempt to relieve in this way aggravates the difficulty. There is no
disease of the skin apparently more superficial, nor yet more annoy-
ing. As there is no prominent syi^^ torn but itching, we would nat-
umlly suppose that some simple remedy would antidote it. But not
tio. In bilious temperaments, Mercurius is the best remedy. In sau-

"S^^'^^f^fr T '^"Jl^^!'^:-'

'i46

DI8KA8KS OK TIIK 8KIN.

guiue teinperamentii, Nux vontUa, or |)erhfti« Sulphur. In tin- ner-
vous, PulmtiUiu J'/natia, Sepia, i'alrnrea and Conium. TIk ronicdy
selected to meet tlio case may Us fr'ivvn twice a day until relievtMJ,
unless there in found a necessity for change.

RlnSfWOrtn. — Herpes Circinnatus.

This troublesome disorder usually manifests itself upon the face,
and is, at first, a small circular eruption that enlarges in the form of
a ring. The cause is believed to be a minute itcli-mite which lives
in the skin and commits its circuitous mischief. Sometimes (tiily
one ring appears ; at other times there are several, each enlarging its
area until the face l)e<iome8 nearly covered. A frequent cause of
their appearing is by being shaved with a razor that communicates
the infection. A strong tincture of Uyo»cyamui» applied to the sur-
face, will generally extinguish them ; but there must be some consti-
tutional predisposition that favoi-s them; and therefore internal reme-
dies must be employed. In case of syphilitic taint, daily doses of
Mereurim viv. will be required. In those of strumous constitutions,
Calcarea, Arsenieum an \ Sepia. In those constitutionally inclined to
erysipelas, Rhus tax.., Duleamara, Hepar mlph. and Bryonia will be
found of use. Two or three doses of the remedy selected may l)e
administered every day; and, at the same time, the Hyoscyamu*
tincture may be applied externally. This treatment has been found
efficacious in most cases. A dilute tincture of Oantharis, applied
locally, is a specific.

Hives.

Small red blotches upon the skin, that bum, itch and sting, are
usually called hives. They are believed to result from some de-
rangement of nutrition, caused by certain articles of diet. But lit-
tle danger attends the difficulty, unless, by exposure to cold, the
eruption is made to recede, and it falls upon the bowels : this, some-
times, in children, results in diarrhoea. Pulsatilla may be given in
the usual dose, three or four times a day. In young children, who
may be teething, Chamomilla will be found useful. If there is any
nausea, give Bryonia or Ipecac^ and the derangement will be cor-
rected very soon, Vroton tig. is a fine general specific.

Varicose Veins.

The external veins upon the lower limbs sometimes become con-
gested and enlarged, and are termed "varicose." Inflammation
sometimes attends this difficulty, and terminates in varicose ulcers.
The best remedy known for simple varicose veins is Hamamelis Virg.
Pulsatilla is believed to be useful, and also Lachesis. Either of these
remedies may be administered three times a day. The Hamamelis

IN.

|)H Sulphur. In tliH ner-
11(1 Coniuni. TIk n'tncdy
w\ce 11 (lay until I'uliuvtMl,
}.

'Jircinnatus.

feats itself upon the face,
ut enlarges in the form of
nute itch-mite which lives
liHchief. Sometimes only
Hevenil, each enlarging iU
id. A frequent cause of
razor that communicatcH
yamuD applied to the sur-
ihere must be some con.sti-
id therefore internal reiiie-
ilitic taint, daily doses of
of strumous constitutionH,
[Jonstitutionally inclined to
Iph. and Bryonia will be
3 remedy selected may Ixj
me time, the Hyoscyamm
treatment has been found
bure of Cantharis, applied

burn, itch and sting, are
[ to result from some de-
articles of diet. But lit-
by exposure to cold, the
on the bowels : this, some-
*ul8atilla may be given in
In young children, who
d useful. If there is any
derangement will be cor-
leral specifict

IS.

bs sometimes become con-
• varicose." Inflammation
minates in varicose ulcers.
le veins is Hamamelis Virg.
) Lachesis. Either of these
38 a day. The Hamamelis

niHKAHKS OK TIIK .SKIN.

647

may 1)0 ftp[)lied oxteriially wImmi adniinistorcd inUrniilly For vari-
cose ul(;ei-s, Arnlcii may Im* given in {\\v. inlliunniatoiy stiigc, and
/lipitr tiulph.idU'r: wlnsn ulctMiilion lakes |»liice, /Irc.'^/iv/w and (Mr-
III! lU'ifetabUin may Ihj calhtd inti> \im\ A dose every day will hasten
a cure.

Felons.

Fklonr commence at the l)one, lieneath the periosteum or mem-
brune that surrounds it. They are very painful, and most commonly
make their appearance on the lingers or thumbs ; at first a prickling
sensation is experienced, as from a splinter, and then a sensation of
heat attended with intense pain, depriving the suff 'er of rest or
sleep. The skin becomes changed in color at the sur ts and there
is painful tinobbing and swelling. The most speedy cure for a felon
is to thrust in the 1 inoet to the bone, and give vent to the matter
jjeneath tiie membrane ; and, afterwa'ds, an application of warm flax-
seed poultices will keep the sore discharging. Previous to lancing,
resort has sometimes Injen had to soaking the part in hot water to
which Ammonia has been added, to ripen and prepare the way for
the matter to come to the surface. Hepar nulph., ttiken internally,
exerts a benelieial influence in hastening suppuration. After a resoit
to the lancet is had, Silicea is a valuable remedy to hasten a cure.
For the constitutional disturbance which felons excite, Aconite may
be given to reduce arterial excitement ; Arnica, to remove soreness ;
Niix vomica, to al '.ay an irritable condition of the stomach ; and Sul-
phur, to fortify the system against the recurrence of the difficulty.
It is always well to keep the l^-^iid at rest until the pain and inllam-
maticu has subsided.

Tetter. Salt Rheum.— Herpes.

Tetter is an inflammatory disease of the skin, which, for the most
part, appears upon exposed surfaces, — the hands and the face, —
though sometimes it comes on the arms and legs. It is a red, scaly
or burning eruption, very stubborn in its character, and painful. It
sometimes becomes complicated with constitutional erysipelas and
causes swelling and infiltration of the cellular tissues around the
eyes ; affects the ears and nose ; breaks out on the backs of the
hands and arms, and in the bend of the elbow-joint, causing the skin
to crack and become exceedingly soro. Sometimes the tetter is dry,
sometimes humid ; and at others scaly. For dry, burning tetter, Ar-
mnicum is a valuable remedy. If there is feverish heat in the skin
generally, Aconite and a lotion of tincture of Aconite may be a^)-
plied externally. When the skin cracks and is dry, it may be
anointed with the glycerole of Aloe». The burning may be some-
what allayed by applying, with a down-brush, a little rye-flour. Sepia,
Qalearea and Dulcamara are also valuable remedies for diy tetter.

ismssmM.^^^^^w^^^'^^mf^f^

648

DISEASES OF THE SKIN.

The remedies, when selected, must be used persistently, two or three
doses a day. For humid tetter, Bhux tor., Conimn and Sulphur may
be employed. The Rhus tox. may be given at first and repeated
every six hours. A lotion of twenty drops of the tincture in half a
tumbler of water may be applied externally ; and a similar prepara-
tion of Conium may be used externally when this remedy is adminis-
tered internally. When humid tetter smarts, and the skin is broken,
cold cream may also be applied. For the scaly tetter, Calcarea carb.
may be given persistently three times a day ; if this fails. Sepia, es-
pecially if the face is implicated. When the eyes or ears are affected
and swollen Mhus tox. and Belladonna may be given alternately every
three hours until better. In all caaes of tetter of the furfuraceous
type, Natrum muriaticum may be found of service when other reme-
dies fail. Cantharis is account( ^ a general specific. All persons af-
flicted with the disease should refrain from the use of salt provisions,
pork, rich gravies and the like ; for these articles of diet heat the
blood and augment the suffering.

Scrofula.

This disease shows itself in swelling of the glands and sores upon
the face, neck and extremities. To rid the blood of this discrasia,
Arsenieum may be given when there are sores or ulcers affecting the
soft parts. Sores around the mouth and upon the faces of scrofulous
children may be cured with Pulsatilla or Bryonia. For swelling of
the glands, give Mercurius three times a day ; and, if there is a ten-
dency to suppuration, give Hepar mlph. In some children of scrofu-
lous taint, vaccination will bring out sores on the face, hands and
arms. This has been ascribed to impure vaccine matter ; but this is
not usually the case, as the best virus ever used will often be fol-
lowed with this result ; and, when it is, Calcarea carb. or Silicm may
l)e given in daily doses till the humor disappears. Ointments that
simply drive these humors from the surface are pernicious and often
result in producing worse forms of the dist ase. Great care in refer-
ence to diet is necessary when these sores break out upon children.
They should be fed mostly upon farinaceous food. Avoid pork in
all its forms.

Eczema. *

This is a disease of the skin, that may be brought on by working
in smelting-furnaces, where the victims are all the time exposed to
much heat, and are obliged to work among cinders and steam. The
appearance of this skin-disease is that of red and inflamed spots cover-
ing the entire body. The biliary system seems to be much deranged,
and nutritive system impaired. Persons thus affected become very
much prostrated, and suffer intensely from the burning and smarting
of the eruption. Almost any severe exercise that heats the blood of

DISEASES OF THE SKIN.

649

rsistently, two or three
7iiutn and Sulphur may
1 at first and repeated
f the tincture in half a
and a similar prepara-
this remedy is adminis-
and the skin is broken,
y tetter, Calcarea carb.
if this fails, Sepia, es-
lyes or ears are affected
given alternately every
er of the furfuraceous
rvice when other reme-
[)ecific. All persons af-
e use of salt provisions,
-tides of diet heat the

I glands and sores upon
blood of this discrasia,
1 or ulcers affecting the

the faces of scrofulous
onia. Fof swelling of
; and, if there is a ten-
lome children of scrofu-
)n the face, hands and
iine matter ; but this is
used will often be fol-
rea carb. or Silicm may
pears. Ointments that
re pemiciious and often
e. Great care in refer-
eak out upon children.

food. Avoid pork in

brought on by working
11 the time exposed to
inders and steam. The
id inflamed spots cover-
is to be much deranged,
.8 affected become very
e burning and smarting
that heats the blood of

those usually forced to live upon an indifferent diet of unwholesome
food will become subject to eczema. To treat this difficulty success-
fully is, first to regulate the biliary system by three or four doses of
Nux vomica or Mereurius viv., for several days ; and then follow with
Arsenicum, Tartar emetic, Petroleum or Antimonium crudum, three or
four doses every day ; and, as soon as the appetite and stomach will
permit, furnish the patient with a generous diet, and let him change
liis employment for one of less exposure.

Liver Spots. — Maculce, Moss.

This affection consists of discolored spota upon the skin of the
face, sometimes covering the surface of the forehead with dark dis-
colorations of the skin. Derangements of the liver are believed to be
the cause ; and, although these discolorations are not painful (except
to the mind), they often mar the countenance and annoy those smit-
ten with these marks. They can be removed with appropriate reme-
dies. Sepia is one of the most prominent. Chelidonium, given the
same, is useful. A dose should be given morning and evening per-
sistently, until the color fades and the spots disappear. To facilitate
this, let the patient a^^oid coffee, milk, eggs and all oily food. An
animal diet, of the lean of well-fed beef and mutton, is preferable,
with bread. Potatoes, and esculents of every kind, may be allowed ;
but gravy and mutjh butter are pernicious ; as are stimulants, such
as malt liquors and highly seasoned soups.

Scurvy.

Persons so situated as to be obliged to subsist upon salt provi-
sions are liable to become affected by a disease termed " scurvy." It
manifests itself in scorbutic eruptions upon the skin, and by an in-
flamed and sore condition of the gums, which sometimes become so
much affected as to cause the teeth to become loose. The want of
fresh vegetables or lemons, oranges and other fruits, is believed to be
sufficient to cause the difficulty. To cure the disorder, a wholesome
diet must be provided, with plenty of fruit, fresh provisions and vege-
tables. The only remedy necessary to carry off the difficulty, after
providing the proper diet is Natrum muriatieum, three doses a day,
— morning, noon and night. Mercuriu9 viv.. Nitric acid and Muri-
atic add are also remedies that have been employed.

B&rber's Itch. — Sycosis Mentagra.

This is exclusively a disease of the male sex and occurs about the
time the beard begins to grow thick and hard. The disease is sup-
posed to be contracted by using bad soap upon the face, when shav-
ing or washing the beard. A dull razor, that pulls and irritates the

;

650

DISEASES OF THE SKIN.

skin, may form the nucleus of the difficulty. In laboring people, ex-
posed to dust, especially of tobacco, and where there is not particulai
pains in washing out the dust frequently, the disease is likely to be
generated. The disease resembles, in some degree, the herpes of the
lips, makes its fii-st appearance on the chin in small clusters of red
pimples, or tubercles, each of which is perforated with a hair. These
pimples increase in size and disgusting appearance, though not pain-
ful, until arrested by some remedial means. Graphites, in daily
doses, has often cured. Mtrie acid, also, twice a day, has proved ef-
ficient. Aurum muriaticum, alone, will cure cases in those having
psoric or syphilitic taint. Silicea, Carbo animalia, Hyoseyamus tinc-
ture (externally), are also good remedies. Nitric acid may be ap-
plied in a diluted form, externally, and also Sulphur ointment. A
solution of Iodide of Potass., two grains to an ounce of water, applied
several times daily, cures stubborn cases.

I '

In laboring people, ex-
B there is not particular
! disease is likely to be
legree, the herpes of lh(
n small clusters of red
ited with a hair. These
irance, though not pain-
Graphites, in daily
ce a day, has proved ef-
i cases in those having
maliB, Hyoscyamua tine-
Nitric acid may be ap-

Sulphur ointment. A
ounce of water, applied

DISEASES OP THE ORGANS OF
CIKCDLATION.

The heart, its appendages and valves ; the pericardium or mem-
brane that covers the heart ; the nerves that are distributed to the or-
gan, as well as the arteries and veins, — are embraced in the organs
of circulation.

Inflammation of the Heart. — Endocarditis.

When a sharp pain is sometimes felt in the region of the fifth rib,
with quick pulse, flushed face, and hurried respiration, there are in-
dications of endocarditis. Aconite in the usual dose may be given
every hour until the frequency of the pulse is diminished ; Verat.
viride, if Aconite fails to reduce the pulse in twenty-four houre. If
the disease has been brought on by a shock or injury, Arnica ; if from
excessive grief, Ignatia ; if from cold, Arsenicum ; if it is the sequel
of inflammatory rheumatism, Pulsatilla ; if the disease terminates in
dropsy of the pericardium or chest. Apis mellifica. Let the diet be
simple and easy of digestion.

Inflammation of the Pericardium. — Pericarditis.

AoiTTB inflammation of the pericardium is denoted by symptoms
much the same as those attendant on endocarditis, and may be
brought on by a cold, a sudden check of perspiration, or simultanb-
ously with a sudden attack of inflammatory rheumatism. Aconite re-
peated every hour. Pulsatilla or Bryonia may follow in the usual
dose, and be repeated every hour until a change occurs. The peri-
cardium, being a serous membrane, is liable to a profuse collection of
serum about the heart. Apis mellifica in the usual dose every two
hours will be likely to give relief; Apocynum and Helleborus niif. are
also remedies that may be employed in curing this trouble. If the
heart palpitates severely, give Pulsatilla or Digitalis. Diet simple
and nutritious and free from any exciting stimulants.

Chronic Inflammation of tlie Pericardium has similar symptoms,
but not so severe. It often attends the gout, and is treated with the
same remedies. Colchicum is a valuable remedy, and may be given
three times a day, in usual doses. Sulphur is often useful.

661

652

DISEASES OF THE ORGANS OF CIRCULATtON.

Chronic Perlcardltia may sometimes be cured by Calcarea or Ly-
copodium. Aurum muriaticum and Spigelia are called into requisi-
tion when there is irregulatity of the heart's action, Arsenicum when
there is a burning sensation accompanying the pain. Diet, if the
stomach will bear it, may be quite generous.

Dilatation of the Cavities of the Heart.

This trouble is manifest from a more perceptible action of the
heart than is normal; its motion being more violen; Lachesis when
there is a disposition to sigh ; Belladonna if there is a tendency of
blood to the head ; Digitalis if there is a quick, full pulse ; or Verat.
viride; Aconite if there is fever ; Pulsatilla if there is rheumatism of
the joints at the same time.

Imperfect Action of the Valves of the Heart.

A DIFFICULTY such as this is not denoted by any one set of symp-
toms, but it may give rise to various sufferings, such as fainting,
rush of blood to the head, apoplexy and convulsions. Fainting re-
quires Pulsatilla, China, Bryonia and Rhus. Rush of blood to the
head, Belladonna ; apoplexy. Aconite, Belladonna and cold applica-
tions to the head ; convulsions require Chamomilla, Belladonna, Hyos-
cyamus and Digitalis. Whichever remedy is selected may be given
every half-hour until relief is obtained, or change. Spasmodic pains
about the heart from some sudden excitement, Qelsemium.

Aneurism of the Aorta.

Thts 18 a rupture of some of the coats of the great artery, and
which so weakens the rest that they lose their tenacity, and bulge
out so as to impair its function. It often is very painful and pulsates
in a frightful manner. Aconite, Bryonia, Digitalis, Zinc, Lachesis
and Ehus tox. are remedies that may be consulted. Either will re-
lieve, under certain eonditions. Tl^d usual dose may be repeated
every two hours.

Inflammation of tlie Arteries may be relieved by the persistent
use of Aconite, and inflammation of the veins by Phosphorus, Rama-
melis or Rhus tox. Arteritis and phlebitis are both formidable dis-
eases, and require the attendance or care of a physician.

3ULAT!0N.

red by Calcarea or Ly-
ire called into requisi-
iction, Arsenicum when
the pain. Diet, if the

f the Heart.

rceptible action of the
dolen ; Lachesis when
there is a tendency of
t, full pulse ; or Verat.
there is rheumatism of

> of the Heart.

by any one set of symp-
ings, such as fainting,
ivulsions. Fainting re-
Rush of blood to the
onna and cold applica-
milla, Belladonna, Hyos-
selected may be given
mge. Spasmodic pains
b, Q-elsemium.

trta.

if the great artery, and
leir tenacity, and bulge
ery painful and pulsates
Digitalis, 2jinc, Lachesis
isulted. Either will re-
dose may be repeated

Lieved by the persistent
8 by Phosphorus, Hama-
re both formidable dis-
i physician.

DISEASES INVOLVING THE VAEI0U8

ORGANS.

Simple Fever.

This disease is a simple accelemtion of the pulse, with flushes of
heat ; and when brought on by fatigue, give four globules of Ami-
i-a ; if from cold. Aconite; if from grief, Ignatia ; if from indiges-
tion. Belladonna ; if from dampness and chill, Oelsemium or Rhus
tax.

Inflammatory Fever.

In most cases this disease commences with pain in the head and
full pulse, more or less thirst, loss of appetite, constipation of the
bowels and dry, hot skin. One drop of the dilution, or four globules,
of Aconite may be given in the first stage, every hour, until the skin
becomes moist, and the pulse somewhat reduced. Belladonna may
follpw Aconite, and be given in the same doses and intervals, until
there is a mitigation of the pain in the head ; or if the patient becomes
weak and subject to aggravation of suffering from the slightest
motion, give a drop, or four globules, of Bryonia, every hour,
until there is a change ; with restlessness and when from checked
perspiration, Mhus tox., same dose as Bryonia. In the case of uri-
nary obstruction give four globules of Cantharis; or of flatulent colic,
four globules of Ohamomilla. The diet should be farinaceous gruel
or toast.

Typhoid Fever.

In general, the commencement of this disease is denoted by lassi-
tude, headache and considerable acceleration of the pulse. Then fol-
low stupor or delirium, coldness of the surface and great prostration.
Four globules, or one drop, of Aconite may be given at first, every
two hours ; to reduce the pulse and moisten the skin (by many Bap-
tisia, in drop doses, hourly, of the tincture, is preferred to Aconite'),
Bryonia may be used after Aconite, a dose every three hours. If the
patient becomes drowsy, give Rhus tox. ; cleanse the surface of the
patient daily with a towel wet with tepid water ; and, if he will take
any nourishment, give him beef-tea or mutton-broth ; milk is allow-
able, and rice gruel. When convalescent, allow some light wine

653

654

DISEASES INVOLVING THE VARIOUS ORGANS.

three times a ilay. For the diarrhoea of typhoid, Arsenicum^ four
globules, after each discharge, is good.

Bilious Remittent Fever.

This disease is so named because it comes on by considerable gan-
tric derangement, headache and fever, which appears to be subject to
elevations and depressions, without any distinct intermissions. In
the firat or inflammatory stage, pive four globules, or a drop, of the
dilution of Aconite, and follow it with a like dose of Ipecacuanha, and
repeat every hour, until the nausea and vomiting are bette/. If the
bowels are constipated, give Nux vomica at night, — a single dose of
four globules. If there is colic, give Colocynth. If there is vomit-
ing of greenish bilious matter, give Bryonia or Pulsatilla. Diet
same as in inflammatory fever.

Intermittent Fever.

The symptoms by which this fever is distinguished are yawning,
stretching, shuddering and chilliness, followed by heat, pain in the
back, limbs, head, etc.; and afterwards a copious perspiration, and
then an interim of complete intermission. Arsenicum, where the
chilliness and heat are simultaneous, and where, during the cold
stage, there is intense thirst for cold drinks ; Arnica, where there is
soreness of the flesh, as if bruised; Belladonna, where headache and
chilliness down the back ; China, where there is ringing in the ears ;
Sulphur, in cases of long standing, where much Quinine has been
given; Bryonia, where there are glairy vomitings during the chill
and fever, and where all the sufferings are aggravated by motion.
Apis, attacks chronic, and preceded by nettle-rash, — followed well
by Nat. mur., either to be given three times daily. All the medi-
cines may be administered in drop doses of the dilutions, or four
globules ; and repeated every two hours between the paroxysms.

Yellow Fever.

Common to the Southern States during the warm season. Nearly
all the symptoms of an ordinary bilious fever, in an aggravated form,
characterize this disease ; and the victims become so sallow, and the
surface so yellow, as to give rise to the name " yellow fever." When
the stage of febrile excitement exists, give Aconite. When the nose
bleeds, give Belladonna. When vomiting of black or dark bilious
matters occurs, give Arsenicum. For the prostration or diarrhoea,
give Carbo vegetabilis, and when the most offensive odor comes from
the breath, give Baptisia. Arsenicum and Carlo vegetabilis are the
most prominent remedies. The usual drop or four globule doses
may be repeated every two hours, and sometimes every hour. Diet,
— barley-water and gruel.

iHlW It'r'iMlflBHBlfctr'^

i ORGANS.

phoid, Arsenicum, four

5ver.

jn by considerable gas-
tppears to be subject to
inct intermissions. In
mles, or a drop, of the
ose of Ipecacuanha, and
;ing are better. If the
ght, — a single dose of
ih. If there is vomit-
ia or Pulsatilla. Diet

it.

nguished are yawning,
3d by heat, pain in the
(pious perspiration, and

Arsenicum, where the
vheve, during the cold
; Arnica, where there is
na, where headache and
e is ringing in the ears ;
nuch Quinine has been
litings during the chill

aggravated by motion,
le-rasb, — followed well
s daily. All the medi-
f the dilutions, or four
wreeu the paroxysms.

le warm season. Nearly
r, in an aggravated form,
scome so sallow, and the
e "yellow fever." When
icdnite. When the nose
of black or dark bilious
prostration or diarrhoea,
ffensive odor comes from
Oarbo vegetabilis are the
p or four globule doses
times every hour. Diet,

UISEASKS INVOLVING THE VARIOUS OUUANS. 656

Eruptive Fevers.

Nettle*Rash is a pale-red, stinging eruption, that sometimes is at-
tended with vomiting, and sometimes with some other derangement
of the stomach. Ipecac, and Nux vomica are indicated for the vom-
iting, and Apis mellifica, Rhus tox. and Sulphur for the burning, itch-
ing and stinging ; Croton tiff, cures nearly all cases, a favorite remedy
with physicians. Doses as usual, and repeated every hour or two
hours until relieved.

Scarlet-Rfish is the roseola, or red eruption, and is much like the
nettle-rash, only less annoying. Bryonia, Pulsatilla, are the ordinary
remedies ; and either may be given in doses of four globules every
two hours ; A jon., if wakeful and restless.

Scarlet-Fever usually begins with vomiting, quick pulse, sore
throat, headache and great restlessness. Belladonna, when there is
a bright, scarlet eruption ; Galcarea carhonica, when the child is of a
scrofulous habit ; Arsenicum, when there is great prostration ; Helle-
horus, when there are dropsical symptoms ; Bryonia, when the erup-
tion is slow coming out. Repeat the medicines in the usual doses
every hour. Diet, — nourishing drinks, toast and tea.

Measles come on with cough, pain in the head, sneezing, redness of
the eyes, and sometimes attended with nausea and vomiting. Bryo-
nia will hasten the appearance of the eruption ; Ipecac, should it
disappear too suddenly, with consequent increase of cough or vomit-
ing ; Phosphorus will obviate the inflammatory effect upon the lungs ;
and Drosera will cure the entailed cough. Diet, simple and light.

Erysipelas, either vesicular or phlegmonous, is denoted by a red,
Imrning and fiory appearance of the face, and sometimes by a bullar
eruption, resembling fly-blisters. Rhus tox.. Belladonna and Bryonia
are prominent remedies, — Belladonna, vfh.QXi the head and face are
most implicated; Rhus tox., when there is eruption on the extremities
and great weakness ; and Bryonia, when the suffering seems greatly
aggiavated by motion; Arsenicum, should there be great prostration,
thiist and restlessness, — one of the best remedies in severe cases.
Any of these remedies may be repeated every hour. Diet, — barley-
gruel, rice-water, beef-tea, mutton-broth, toast and tea.

Chicken-Pox. — A pustular eruption, attended with slight fever
and gastric derangement. One or two doses of Pulsatilla will gen-
erally remove all the suffering attendant on this disease.

Varioloid is another pustular disease, more severe, as it comes on
witli pain in the head and back, as if the latter would break ; and, be-
ing a near relation to small-pox, both may be considered under the
same head.

666

DISEASES INYOLVIKO THE VARIOUS ORGANS.

Small-Poz, of which varioloid in a modification, comes on with in-
tense fever, spitting, pain in the head and back and lower extremi-
ties. All the sufferings are intense. Nux vomica will remove tlic
pain in the back ; Bryonia will hasten the eruption ; Pulmtilla will
aid in carrying it off. As soon as the appetite returns, feed the pa-
tient quite generously. In the small-pox delirium, you can give
Stramonium ; and to prevent pitting, break the pustules, and cover
them with Styptic Collodion.

Rheumatic Fevers.

Inflammatory l^heumatism is accompanied by pain in the limlw
inflammation of the joints, swelling of the same, and great pain and
difficulty in moving about. Aconite reduces the fever ; Bryonia re-
lieves the pain in moving about ; Pulsatilla^ the inflammation of the
knee-joints ; Colocynth, that of the hip-joints ; Nux vomica, the pain
and rheumatism of the back ; and Sulphur and Rhus, the stiffness
that ensues during convalescence ; Rhus is indicated if the cause be
check of perspiration or exposure to wet. Diet, — bread and butter,
steak and other meats in moderation. '

Chronic Rheumatism is more confined to the muscles than tlie
joints, and is oft«n the sequel of the acute form. Sulphur is one of
the remedies much relied upon in curing this disease. Nux vomica
may be given after Sulphur, when there is pain in the back or sciatic
nerve, and Rhu^ tax. when there is a general stiffness of the limbs.
The medicines, in the usual doses, may be repeated every two hours.

Lumbago is simply rheumatism of the back, in the lumbar region,
and so stiffens one that he cannot stand erect. Sulphur, four glob-
ules at night, and Pulsatilla, four globules in the morning, will gen-
erally cure this trouble. Cimidfuga is a very valuable remedy, given
hourly, in water.

Sciatica is simply neuralgia of the sciatic nerve and may be cured
in a short time by a galvanic battery. Rhus is often useful. Bella-
donna, or its active principle, Atropin, is a valuable remedy to ad-
minister internally. The diet in all forms of rheumatism, whether
acute or chronic, may be generous.

Toothache.

When caused by a cold, Nua; vomica ; when from caries of the
tooth, Mereurius viv. ; at the menstrual period, Pulsatilla ; neuralgic,
Belladonna or Ohamomilla ; Aconite when there is heat in the gums.
Dose as Tisual, repeated every hour.

-* -^- Mitiii I '<ifiiinii

itA'^ft-*\'-

as ORQANS.

•fttion, comes on with in-
ack and lower extremi-
vomica will remove the
iruption ; Puhatilla will
ite returns, feed the pii-
delirium, you can give
the pustules, and cover

PS.

led by pain in the limhs
}ame, and great pain and
I the fever ; Bryonia re-
, the inflammation of the
bs ; Nux vomica^ the pain
and Rhus^ the stiffness
indicated if the cause be
[)iet, — bread and butter,

to the muscles than the
form. Sulphur is one of
hia di8easi\ Nux vomica
>ain in the back or sciatic
ral stiffness of the limbs,
epeated every two hours.

ick, in the lumbar region,
ect. Sulphur, four glob-
in the morning, will gen-
ry valuable remedy, given

B nerve and may be cured
%s is often useful. Bella-
I valuable remedy to ad-
I of rheumatism, whether

DISEASES INVOLVING TUK VAKI0U8 ORGANS.

657

when from caries of the
iod, Puhatilla ; neuralgic,
there is heat in the gums.

Diseases of the Alimentary Canal.

Inflammation of the Ton«ils is the result of a cold which affects
this locality, and causes a swelling and sometimes a suppuration of
these parts. When they fii-st begin to inflame, give Aconite, and fol-
low with Belladonna; repeat every two hours. Mercurius viv.,
Lachesia and Mercurius iodatus are also good remedies.

Quinsy is the same as tonsillitis, and requires the same treatment.

Putrid Sore Throat comes on by little vesicles making their aj)-
pearance in the mouth and fauces, or throat, wliich soon, by reiwon
of a low constitutional fever, change color, run together, and consti-
tute the offensive sore mouth which we denominate putrid. Arseni-
cum, Mercurius vivus. Nitric acid and Sulphur or Sulph. acid, will gen-
erally cure. Dose and repetition as before.

Canker of the Mouth.

This troublesome disorder is caused by a disordered condition of
the stomach, and requires Arsenicum when the breath is foul, the
throat diy, and attended with much thirst ; Carbo vegetabilis, when
the system is in a low condition, and there is much coldness on the
surface of the body ; Dulcamara, when produced by a cold ; Hepar
sulph., when the canker seems indolent and slow in coming to a cri-
sis ; Natrum muriaticum, when it assumes the character of scurvy, or
Mercurius viv.

Dose and A^dministration. — Dissolve fiom two to five drops of the
dilution in half a tumbler of water, and give a teaspoonful every two
hours. Diet, — • avoid salt provisions ; use meat-broths, toast and tea.

Inflammation of the Tongue.

The first indications of this difficulty are soreness and difficulty
in using the tongue in deglutition or eating. When caused by me-
chanical injury, or from accidental biting with the teeth, give Arnica,
four globules, and wash the mouth with a dilution of ten drops of
tmcture of Arnica in half a tumbler of water. If from other causes,
give Aconite or Belladonna in the same way. When inflammation
*j^*he tongue takes the form of ulcere, give Arsenicum; of blisters,
Mercurius or Lachesis ; when the tongue inflames and cracks, give
Nitric or Sulphuric acid.

Pharyngeal Sore Throat.

This is an inflammation of the pharynx or of the opening into the
upper portion of the passage from the mouth into the stomach. It is
sometimes quite serious, and is usually termed « quinsy sore throat."

^^^^^l^^^n»^^^^^^^^^!iSS^S^^^4^S^?^^S^^^!?^t^^^^^^^

058

DISEASES INV(iI,VIN(! TIIK VAKIOUH OROANH.

Aeonite may be given at first, and thin may Ik) ff)llowe(l hy Belladovvu,
and this again by Mercuriun viv. Should it lx3come ovident that 8U|)-
puration mnst take place, give ffepar mlph. Whichevei rem»;dy ig
given, let it be repeated every hour until amelioration or change.
Baryta carb. is often the specific.

Dyspepsia, Indigestion.

Difficult digestion, whatever form it assumes, is termed dyspep-
sia, and must be treated in accordance with the symptoms, and the
cause that has produced them. Dyspepsia brought on by intemper-
ance in drinking intoxicating liquors requires Nvx vom. ; if from a
cold, and the patient is chilly and feverish. Belladonna, or perhaps
Bryonia ; if from eating fat meat or rich food, Pulsatilla ; if from
grief, Ignatia. Dose, one drop, or four globules, repeated evety three
or six hours, according to the degree of suffering.

Heartburn, or Waterbrash. — A burning at the pit of the stomach,
and a constant inclination to regurgitJite sour, acrid or bilious matter,
is termed waterbrash, and is but a form of dyspepsia, and indicates
Mercurius, Nux vomica, Pulsatilla, Arsenicum, Cimieifuga, etc., given
as above.

Cardialgia, or Qastralgia, is nearly allied to the above, only at-
tended with pain in the stomach, as well as burning, sour or acrid
risings. Arsenicum, Nux vomica, Bryonia, Calcarea, Ohamomilla,
Coffea, Oolocynth, and Pulsatilla are remedies indicated in this diffi-
culty ; and each may be gfiven and repeated every hour, iu the usual
doses, until relieved.

Dyspeptic Headache is simply a sympathetic action of the stoma.:h
upon the head, causing considerable pain. Bryonia, Belladonna. (Joe-
cuius, Nux vomica and Arsenicum constitute the group of remedies to
give relief or cure. When cold water, taken into tjie stomach, is
found to disagree with the stomach, either Nux vomica, Arsenicum,
Pulsatilla or China will afford relief. When any kind of food disa-
grees with the stomach, causing distress and headache, give either
Ferrum, Camphor, Chamomilla, Pulsatilla or Sulphur, in the usual
dose of one drop cr four globules. If caused by beer, Colocynth ; by
milk, Calcarea, Pulsatilla, Nux vomica. When animal food proves
difficult of digestion, or fat meat, gravies, or drawn butter, Pulsatilla,
lynatia, Nux vomica, Cocculus, etc. Dyspepsia is so common a dis-
ease, and afflicts so great a variety of temperaments and habits, we
will be explicit in pointing to specific treatment. For hypochondria-
cal persons. Sulphur, Nux vomica, Ignatia ; for hysterical persons.
Sepia, Pulsatilla, Hyoscyamux and Lachesis ; for those of a sanguine
temperament, Nux vomica ; for the 8ymj)athetic, Pulsatilla ; for the
bilious, MercuritiM viv.; and for the melancholic, Nitric and Fhoii-
phoriv acid, Aurum metallicum, etc. When those of a nervous tem-

OUH OROANS.

followed by Belladnvmu
become oviuent that Hup-
h. Whichevex reintuly is
L amelioration or change.

jtion.

ssumes, is termed dyspep-
h the symptoms, and the
broujifht on by intemper-
ires Nux vom. ; if from a
,h, Belladonna, or perhaps
food, Pulsatilla ; if from
jules, repeated every three
ffering.

ig at the pit of the stomacli,
ur, acrid or bilioud matter,
if dyspepsia, and indicates
-wm, Vimidfuga^ etc., given

lied to the above, only at-
as burning, sour or acrid
iia, Calcarea, Ohamomilla,
iies indicated in this diffi-
}d every hour, in the usual

uhetic action of the stoma ih
Bryonia, Belladonna. Hoc-
be the group of remedies to
taken into tjie stomach, is
ler Nux vomica, Arsenicum,
hen any kind of food disa-
and headache, give either
I or Sulphur, in the usual
ised by beer, Colocynth ; by
When animal food proves
or, drawn butter, PulmtHU.
Depsia is so common a dis-
mperaments and habits, we
atment. For hypochondria-
tia ; for hysterical persons.
«8 ; for those of a sanguine
:>athetic, Pulsatilla ; for the
slancholic. Nitric and Pho»-
len those of a nervous tero-

mSKASES INVOLVINC TIIK VARIorK OHOaNS.

(ir>9

peniniont are afHictcd with dyspcpsiii, we find I'nlcrian, /fi/osrifamun,
Pulmtilln, lynatia and Moschus good n^mcdies ; tliose of a Hcrofuhms
habit require Calcarea, Arsenicum and Sulphur; students atllictrd
with dyspepsia require Nux vomica, China and Ferrum. Dose and
repetition at} before.

5ea-5ickness.

There is no remedy that will prevent sea-sickness and no condi-
tion of health capable of always resisting it. Hut the effects of the
sickness, which are often distressing, (fan he removed by Coceulus,
Nux vomica and Ignatia. If there remains an inclination to retch
after the sickness has passed, give Ipecac, Petroleum is often taken
as a preventive with success.

Mucous Vomiting.

This is simply sickness at the stomach, which may arise from its
irritable condition, and result in vomiting of slime or mucus. The
remedies that will obviate the difficulty are Ipecac, Rheum, Pulsa-
tilla and Veratrum. ^ Usual dose and repetition.

Vomiting of Blood.

This may be caused by mechanical injury of the stomach, and re-
quires Arnica; if caused by pregnancy, Arsenicum ; if from retained
menses, Phosph. or Pulsatilla ; if from acrid humore, Arsenicum or
Ipecac. ; if from suppressed eruption, Sulphur,

Gastritis, or Inflammation of the Stomach.

This is indicated by severe pain in the stomach, continuous vom-
iting, heat over the region of the stomach, quick and feeble pulse,
cold feet and pain in the head. The remedies for gastritis are Acon-
ite, Bism. subnit., Arsenicum, Belladonna, Ipecac, Tart, emetic, Vera-
trum, Lobelia and Cocculus, and sometimes Nux vomica. Dose and
repetition as usual.

Qastrodynia, or Cramps in the Stomach.

A PAIN in the stomach, with cramp, is very distressing and can-
not be mistaken ; for the cramp is a sudden spasmodic action of the
muscles of the stomach, which seems like taking the breath out of
one. Pulsatilla, Nux vomica and Colocynth are the remedies. Any
one of them will be likely to afford prompt relief. Dioscorca is use-
ful.

■

T ^ri^ sjg a fc-i agBKSfeaMej ai te ''

G60

DISBABr.8 INVOLVINO THE VAKIOUh OltOANR.

Inflammation of the Bowels.

A SEVERE pain in the bowels, with diatention, and euch soront-ss
to the touch that weight or pressure cannot Im) borne, hetokenH in-
flaramation. Anonite may be given in the usual doHe, every half-
hour at firet. If perHpiration occurs and the vomiting continucM, jrive
Bryonia in the same way. If there is tympanitis, or distensiun, mi
that percussion upon the bowels causes them to sound like a dniin,
Terebinthe, Araenvrum and MercuriuH must be coiwulted. If the dis-
charges from the l)owels, while the inflammation lasts, are acrid, give
Arsenicuyn, and follow with 'Bryonia. If there is strangury, or in-
ability to pass urine, Canthari». It would be better, in treatinj^ so
formidable a disease as this, to drop ten drops of the selected remedy
into half a tumbler of water, and give a teaspoonfui every half-liour,
or hour, until amelioration or change. Compresses on the aklonien
are indicated.

Chronic Inflammation of the BoweU.

Acute inflammation of the bowels sometimes passes off, leaving
them susceptible to entailed inflammation from trivial causes; the
mucous coat may have l)een left in a semi-ulcerated condition, fioiii
which there will be occasional vomiting and muco-purulent diarrlm-a.
The remedies *or this disease are Nitric and Sulphuric acid., Argeni-
cum. Sulphur and PhosphoruH. The doses may Ikj as usuP/l ; but the
remedy may not be repeated more than twice a day,

Inflammation of the Peritoneum.

Peritoneal inflammation is often considered in connection with
inflammation of the bowels, and requires nearly the same remedial
treatment. The disease is known by the extreme sensitiveness of the
abdomen to touch ; and the tenderness is so great as to be unable to
bear the weight of bed-clothes. Aconite given in the usual doses
every half-hour, until the skin becomes moist, and then Belladonna
or Verat. viride. If there is thxv^t., Arsenicum ; Pulsatilla; ii in fe-
males. Nux vomica, if the bowels are constipated. If dropsy of the
abdomen follow, give Hellehorus nig. or Apis mellifica. Diet, — a
very light gruel of corn-starch or farina.

Diarrhoea.

A looseness of the bowels, which may be watery, bilious, pappy,
painless or Mrith pain. A merely relaxed condition of the bowels
may be cured by a single dose of four globules of Pulsatilla ; or, if
not arrested by this, give Mercurius. A watery diarrhoea may be ar-
rested with Chamomilla, Nux vomica or Veratrum ; a bilious diarrhoja,

I..

ova UliOAMH.

DISEASES INVOLVINQ THE VAJtIOUS 0K0AN8.

661

Bowels.

lention, and euch Korcrn'Ms
ot Ihj bonie, hctokfiis in-
e usual dose, every lialf-
j vomiting continues, give
npunitis, or diHtensiun, so
m to sound like a drum,
be consulted. If the dis-
lation lii8t«, are acrid, give
there is strangury, or in-
be better, in treating so
ips of the selected remedy
ispoonfui every half-hour,
mpresses on the uklomen

the Bowels.

letimes passes off, leaving
I from trivial causes; the
-ulcerated condition, from
i muco-piuulent diarrho'a.
id Sulphur h acid, Arseni-
may Ikj as usual ; but the
ice a day.

eritoneum.

idered in connection with
nearly the same remedial
ctreme sensitiveness of the
jO great as to be unable to
given in the usual doses
loist, and then Belladonna
dcum ; Pulsatilla, ii in fe-
stipated. If dropsy of the
Apis mellifica. Diet, — a

' be watery, bilious, pappy,
i condition of the bowels
Dbules of Pulsatilla; or, if
ivatery diarrhoea may be ar-
ratrum ; a bilious diarrhoea,

with Arsenicum and Mercurius ; a painless and involuntary diarrhcea,
with Phosphoric acid. Diarrhcea with colic requires Chamomilla and
Colocynth ; tinged with blood, Ipecac. ; with undigested food, Pulsa-
tilla. From fruit, often China. The dose and administration must
accord with the case. Either of the remedies may Ihj given in water,
a teaspoonful every hour ; five drops of the dilution, or ten globules
in half a tumbler of water, may be the mode of preparation. The
diet for persons uffering from diarrhoja may be mutton-broth, beef-
teu, boiled milk, or tuuut uud tuu, uu the [mtiuut may alect.

Dysentery.

One of the most formidable and prostrating diseases is dysentery.
It usually begins with a diarrhoea, though occasionally with constipa-
tion, after a season of lassitude, and increases until mucous discharges
from the bowels follow. The disease is characterized by much strain-
ing when trying to evacuate the bowels. This straining is involun-
tary and painful. Just before there is an inclination for a stool, there
is usually a sharp pain in the lower portion of the abdomen. Dysen-
teric discharges are mucus mixed with blood, or pure blood, or no
blood at all. For dysentery with no blood in the stools, and yet
mu(!h tenesmus. Gamboge ; when the tenesmus is low down. Aloes ;
when the mucus is tinged with blood, Mercurius corrosivus, the leading
remedy, especially if the tenesmus is painful. To aiTest a dysentery
where the discharges are pure blood, and very painful straining and
thirst, Arsenicum. For much tenesmus, and discharge of mucus
mixed with blood. Ipecac. Whichever remedy is administered, let
the usual dose be given immediately after each stool, until relieved.
The diet in this disease is somewhat important. Water cannot be al-
lowed in great quantities, but small bits of ice may be held in the
mouth of the patient; barley-water, flavored with lemon, may be al-
lowed as a drink ; rice-water ; and, if the patient has any appetite,
he may be allowed mutton-soup, beef-tea and lamb-broth ; but chicken-
broth must be entirely prohibited. Enemaa of cold water or rice-water,
after each diacharge, are beneficial.

Chronic Dysentery.

Symptoms much like those of the acute, but occurs frequently as
a weakness left after a protracted attack of the acute form. Sulphur,
Nulph. acid, Calcarea carb., Ferrum and Carbo vegetabilis are remedies
employed to overcome the difficulty. Sulphur may bo given in daily
doses for a while, and then Nitric acid or Sulph. acid or Calcarea, un-
til a cure is completed. Diet in chronic dysentery should be very
sustaining, and wine may sometimes be allowed.

mmm!^mim«j^fsm»:^i mi>f^ ' f«'m !f!!^^

662

DISEASES INVOLVING THE VARIOUS ORGANS.

i:^^

Cholera Morbus.

This disease begins with severe pain in the stomach and bowels,
and then severe vomiting and purging, until seemingly there is noth-
ing left to be discharged from the system. Arsenicum and Verat.
alb. are the leading remedies ; Nux vomica may be given to stop the
vomiting; Ipecac, Tart, emetic, Podophyllum are severally good rem-
edies, and any one of them may complete the cure ; four globules
may be given every fifteen minutes until relief is obtained.

Asiatic Cholera.

MOBK formidable than cholera morbus is asiatic cholera, as its at-
jks are insidious : first, by painless uiarrhoea, which seems to indi-
cate that all the contents of the alimentary canal are in a soluble
condition. Floods of rice-water discharges pass from the bowels and
the same matter is vomited profusely. After a time, the lower ex-
tremities begin to cramp, and then the cramps come in the abdomen ;
and, if the disease is not arrested, the patient soon passes into collapse,
and then to the grave. The treatment of this disease in the early
stage is very important. Very few cases need to prove fatal, if timely
resort to the proper treatment is had. As soon as the patient is at-
tacked with diarrhoea, let him go to bed, and take Veratrum alb. If he
has great thiret, let him take Arsenicum. If without pain, Phospho-
ric acid. If with vomiting and purging and great prostration, Iris
versicolor. Other remedies, such as Materum, Secale comutum. Cam-
phor and Mercurius viv. may be consulted. Cuprum acet., if with
violent cramps. The medicines may be administered every thirty
minutes. In the collapse stage, give Muriatic acid, — ten drops in
half a tumbler of water, a teaspoonful every *-wenty minutes. But
little time can run to waste at any stage of the disease ; every mo-
ment requires vigilance and attention. Should the disease pass over,
and the patient is left, he must fii-st have a stimulating diet, and then
more and more generous, as he can bear it.

Constipation (Costiveness).

A CONFINED condition of the bowels is scarcely a disease by itself,
but a symptom that attends many maladies. In a torpid state of the
liver, it is generally manifest, and requires a treatment tending pri-
marily to affect this organ, and thence the bowels. When there is a
sense of fullness in the rectum, Bryonia ; when a tedious constipa-
tion, that indicates ^vesA. torpidity of the bowels, Lycopodium ; a
constipation following a diarrhoea requires Mercurius viv. or Sulphur ;
a constipation resulting from a collection of hardened faeces requires
Sulphur and Nux vomica, or Silicea. Two doses a day, of any of the
remedies, will be sufficient. A diet for those addicted to habitual

(> •

us ORGANS.

niSEASES INVOLVING THE VAPIf.tUS ORGANS.

663

he stomaoh and bowels,
seemingly there is noth-
. Arsenicum and Verat.
lay be given to stop the
I are severally good reni-
the cure ; four globules
ief is obtained.

asiatic cholera, as its at-
na, which seems to indi-
y canal are in a soluble
pass from the bowels and
er a time, the lower ex-
ps come in the abdomen ;
soon passes into collapse,
bhis disease in the early
1 to prove fatal, if timely
joon as the patient is at-
take Veratrumalb. If he
f without pain, Phospho-
id great prostration, Iris
m, Secale comutum, Cam-
[. Cuprum acet., if with
.dministered every thirty
atic acid, — ten drops in
ry <-wenty minutes. But
f the disease ; every mo-
uld the disease pass over,
stimulating diet, and then

^eness).

carcely a disease by itself,
, In a torpid state of the
a treatment tending pri-
bowels. When there is a
when a tedious constipa-
bowels, Lycopodium; a
^ercuriu% viv. or Sulphur ;
f hardened fseces requires
doses a day, of any of the
liose addicted to habitual

constipation is iniportiint : corn-meal mush, i)rown-bread or bran-
bread, prunes, apples and other kinds of fruit are recommended.
Give the new remedies now being used, such as Alonin,

In vermi nation ( Worms).

This trouble is indicated by the child picking its nose, and by vo-
racious appetite, restlessness at night, colic and sometimes diarrhoea
an pale expression of the face. The remedies for this difficulty are
Santonin, Cina, Spigelia, China and Sulphur. Santonin will suit bet-
ter for the long round worms, and Cina, Calcarea and Nux vomica
for the pin-worms. Dose and administration as usual, three times a
day.

Protrusion of the Intestine.

Falling of tlie bowels, as the protrusion is usually termed, is
caused by protracted diarrhoea, and stT.Ining at stool, while the intes-
tine is weak and relaxed. Podophyllum, Merciirius viv., Ignatia and
Aloes are remedies that will cure the difficulty. Either may be given
three times a day.

Inflammation of the Liver {Hepatitis) Acute or Chronic.

Denjted by pain in the right side, below the ribs, sometimes se-
vere and at others dull. If there is fever, give Aconite or Verat. vir-
ide, and follow with Mix vomica in acute hepatitis, and repeat every
hour until relief or change. If much thirst, give Arsenicum. In the
chronic form, a daily dose of Sulphur or Sepia, Mercurius viv., Nux
vomica, Pulsatilla or Podophyllin, will do as much for the patient as
any treatment in the world.

Jaundice.

When the gall-duct of the liver becomes obstructed, and the bile
is prevented from passing oif in the usual way, it seeks an escape
through the skin, and gives it a yellow color. This is jaundice.
Podophyllin, Chelidonium, Mercurius, Dulcamara, Leptandrin and
Nux vomica axe competent to cure the severest cases. Carbo vegetor
hilis, in a crude foim, may be given in massive doses when an offen-
sive odor comes frcm the mouth or breath. The {)atient, having no
appetite, must be supplied with some farina or rice, cooked in the
most delicwte way.

Inflammation of the 5pleen.

The spleen, being an associate purificatory organ with the liv^r, is
liable to similar alfections. When inflamed, it is manifest by pain in
the left side, below the ribs. The same remedies that affect the liver

.iiiBIKSlBSSW^^'"^"'-

-'^'gg,^?5a8s»gra» fli a «tf ? i'^ e^gg^ss

664

DISEASES INVOLVING THE VARIOUS 0BGAN8.

will also affect the spleen. For congestion of the spleen caused by
running, immoderate laughter, etc., Chinos a single ordinary dose,
will answer.

Painter's Colic.

The effects of lead upon the alimentary canal are sometimes disas-
trous ; and painters who work much in mixing the various prepara-
tions of white lead are liable to imbibe sufficient of its poisonous
quality to give them a most distressing colic : hence its name. The
remedies employed in antidoting the effects of the lead are Opiun>
and Alumina, or Oolocynth. Should the first-named remedy fail to
afford relief, try the next, and 30 on, in doses of three drops of tie
dilution in a spoonful of water. Olive oil, a wineglassful every three
hours, is good.

Piles {Hemorrhoids).

There occurs in the rectum a class of small tumors, caused by
congestion of the hemorrhoidal veins; and these sometimes become
so swollen as to protrude from the anus. Sometimes these protrud-
ing tumora are numerous, and resemble a bunch of grapes. They are
exceedingly painful, and destructive of comfort. To cure them is of
the utmost importance. Constipation being often one of the proxi-
mate causes, such remedies as overcome this condition must be called
into use. Nux vomica, taken at night, has often proved salutary.
Sulphur, when the tumors are painful and sting and burn so as to be
almost unbearable. For bleeding piles, Hamamelis Virginica is par-
ticularly recommended. For excessively burning piles, Arsenicum ;
and for those of a blue color, Oonium or Muriatic acid. Each of
these remedies may be employed in the liquid form, and three drops
of the dilution may be taken in a spoonful of water every night.
The tincture of Podophyllum is also a valuable remedy, and may be
administered as above ; and so also is Collinsonia. Hamamelis sup-
positories should be used in all cases. An injection of moderately
cold water will often give relief and cure the most obstinate cases.
Inject a quart, night and morning. Commence with a small amount
at first and gradually increase ; should be used with caution until it
is found to agree with the patient. To designate an appropriate diet
for one afflicted with piles requires a little care. Salt provisions
must generally be avoided. The free use of stimulating drinks is
pernicious. Bran-bread and fruits are commendable. Meats, not
highly seasoned, are allowable, and most kinds of vegetables.

Itching of the Anus, which sometimes is a concomitant of piles
and sometimes of worms, is cured in the first instance with Sulphur
and in the latter with Oina. The usual dose should be given night
and morning. j

rs OKGANS.

)f the spleen caused by
a single ordinary dose,

,nal are sometimes disas-
ing the various prepani-
fficient of its poisonous
: hence its name. The
of the lead are Opim>
jfr-named remedy fail to
s of three drops of tie
wineglassful every three

small tumors, caused by
these sometimes become
lometimes these protrud-
nch of grapes. They are
fort. To cure them is of
; often one of the proxi-

condition must be called
s often proved salutary,
ting and burn so as to be
mamelis Virginica is par-
urning piles, Araenieum;
Muriatio acid. Each of
lid form, and three drops
ul of water every night,
able remedy, and may be
limonia. Hamamelis sup-
1 injection of moderately
the most obstinate cases.
lence with a small amount
used with caution until it
ignate an appropriate diet
tie care. Salt provisions

of stimulating drinks is
)mmendable. Meats, not
inds of vegetables.

is a concomitant of piles
irst instance with Sulphur
lose should be given night

DISEASES OP VARIOUS ORGANS
AND REGIONS.

Passage of Qall-5tones.

The passage of gall-stones is attended by severe pain in the region
of the stomach, obliging one to writhe in agony, and roll from side to
side. The strongest men become subdued when suffering from the
passage of these concretions. The pain resembles an intense colic ;
and sometimes the agony produced by biliary calculi goes under the
name of bilious colic. In addition to the pain occasioned by the con-
cretions, there may be vomiting, headache, cold extremities and sal-
low complexion. To relieve the suffering, resort has been had to
Morphine and Opium ; but these sedatives only prolong the difficulty.
They afford only temporary relief from pain and the use of them must
be discouraged. Cathartics, on the whole, have failed of accomplish-
ing the purpose, and only weaken the patient. Homoeopathic reme-
dies have sometimes afforded prompt relief ; but, as a general thing,
the success attending the most perfect affiliations of indicated reme-
dies has not been great. The most modern treatment for biliary cal-
culi is to administer to the patient from two to four ounces of pure
Olive oil, the laxative effect of which has gently moved the bowels,
and brought from the gall-duct large numbers of the concretions,
sometimes a dozen or more ; after which, the blackness of the coun-
tenance will begin to disappear, the indurations found in the region
of the liver become lessened, and the appetite returns. When attacks
of bilious colic occur, it is not always certain that the gall-duct is ob-
structed with stones. Therefore, Colocynth, in the usual dose, may
afford prompt relief ; even when gall-stones have been present, and
the suffering and agony are indescribably gfreat, Pulsatilla has cured.
When there is severe pain and induration in the region of the liver,
a dark, sallow countenance and black circles around the eyes, much
relief has been obtained by the use of Arsenieum. When there re-
main black spots or discolorations upon the face. Sepia, When there
is much vomiting during an attack. Ipecac. External applications
sometimes prove useful. Emollient poultices applied to the region
of the pain have proved beneficial. The pain attending the passage
of biliary concretions has sometimes been mistaken for chronic in-
flammation of the stomach ; and, on this account the remedies have

tJSWWiVSS?'

■MiaMi tfiO W tfttCa^ ia^iBfcgltBJl^waiBtWwWt^^ ^iimffx^r-

666

DISEASES OP VARIOUS ORGANS AND REGIONS.

failed to control the suffering. Very many persons suffering from
chronic liver-complaint become victims to the suffering produced by
gall-stones, and should restrict themselves to a simple but nutritious
diet. After an attack, the olive oil should be taken for at least six
months, a tablespoonful on retiring, each night.

Cancer of the Liver. — Schirrm.

In the event of a constant suffering in the right side, with apparent
hard protuberances, while, at the same time, there are dark circles
around the orbits of the eyes, and when there are shooting or lancin-
ating pains darting from the indurated protuberances, a cancer may
be suspected. If not too far advanced, it may be cured by the use
of Arsenicum^ when there is much thirst and dryness of the mouth, a
white coating upon the tongue, and considerable prostration. Conium
maculatum nay be given three times a day when there is pain in the
right side, as if constricted by a band, or tearing and stretching in
the region of the liver, and colicky, abdominal spasms.

Cancer of the Stomach.

This formidable disease often comes on insidiously and the victim
supposes himself to be a sufferer from an aggravated form of dyspep-
sia. Severe anxiety and trouble are supposed to have a serious in-
fluence in the production of the disease. A constant irritation of the
mucous lining of the stomach may terminate in the difficulty. The
chief symptoms denoting the presence of cancer in the stomach are
great depression of spirits, a downcast countentance, a pinched ap-
pearance of the nose, with the corners of the mouth drawn down, and
also a constant inclination to retch and vomit dark matter, somewhat
resembling coffee-grounds, and also severe cutting or shooting pains
in the stomach, with intense thirst. Nux vomica has sometimes cured
cancer of the stomach. The indications for its use are intensely bit-
ter eructations, and spitting up of dark matter ; and also when the
eructations are followed by vomiting of sanious or bloody matter.
When the patient has suffered greatly from anxiety and d3rspepsia,
l^natia may be given, instead of Nux vomica. When the tumor can
be diagnosed or discovered by external manipulation, Arsenicum and
also Oonium may be given twice a day. Oocculus also may be given
when the nausea and vomiting are similar to that '-roduced by riding
in a carriage, or sea-sickness. When one has su ^ered many yeara
from dyspepsia, and then begins to emaciate and spit up this dark
matter, Nux vomica given persistently is most likely to be of service.
The patient should subsist upon broths, beef-tea and the most deli-
cate farinaceous diet. .

b "

• ^BK flsK-iaiB^.iV.

Jt.-'. - -.-

1 REGIONS.

[)er8on8 suffering from
suffering produced by

i simple but nutritious
taken for at least six

Schirrus.

ight side, with apparent
there are dark circles
are shooting or lancin-
berances, a cancer may
ly be cured by the use
dryness of the mouth, a
le prostration. Oonium
hen there is pain in the
iring and stretching in
il spasms.

lach.

aidiously and the victim
fravated form of dyspep-
d to have a serious in-
ionstant irritation of the
3 in the difficulty. The
icer in the stomach are
itentance, a pinched ap-
mouth drawn down, and
b dark matter, somewhat
itting or shooting pains
lica has sometimes cured
its use are intensely bit-
ktter ; and also when the
mious or bloody matter.
L anxiety and dyspepsia,
I. When the tumor can
ipulation, Arsenicum and
ecultis also may be given
( that produced by riding
has su ered many yeai-s
;e and spit up this dark
St likely to be of service,
if-tea and the most deli-

DI8EA8E8 OF VAKIOUS 0B0AN8 AND RKGI0N8. GfiT

Cancer of the Intestines.

The symptoms which denote the presenlBfe of cancer of the intes-
tines are constant pain in the bowe) "'^ acrid discharges of black-
ish stools, a very black or dark appearance of the countenance, down-
cast expression, a constant inclination to relieve the pain by pressure
of the hands and arms. This affection generally terminates fatally,

the result being perforation of the bowels. When autopsy, or

post-mortem examination reveals the fact, it is then called to mind
that the victim has worn the expression and complained for a long
time in a w.iy that might have excited suspicion of the trouble. To
note these symptoms when they first occur may suggest a treatment
that possibly might avert a fatal termination. Arsenicum may be
given when the patient has thirst, burning pain in the bowels, and
hot, acrid stools ; Oonium, when the pains appear to be of a neural-
gic character, and persistent ; Belladonna, when there is painful dis-
tention of the abdomen. The diet should be tlie same as that directed
for cancer of the stomach.

Cancer of the 5kin.

When inflammation of the skin, or any persistent irritation, ter-
minates in cancer, there is a rough, hard tumor of a bluish appear-
ance, at first about the size of a common wart. It sometimes grows
into the shape of a tumor, and is the seat of sharp, shooting pains.
The remedy that has apparently cured this affection is Silicea, in
daily doses. It is particularly indicated when there is painful sore-
ness or sensitiveness of the skin, and an itching of the whole body ;
and also when there is stinging in the sore. To prevent cutaneous
ulcers of the skin from becoming cancerous, the same remedy may
be used. To prevent horny excrescences from assuming a cancerous
character, Oonium or Oausticum may be given in daily doses. Almost
any persistent irritation may assume the character of a cancer. Icho-
rous ulcers, fetid sor . malignant boils or ulcers, should be carefully
treated and cured, oi otherwise they may take on a settled or consti-
tutional schirrous character. The skin should be kept clean ; a flesh-
brush should be frequently used, and exercise in the open air is com-
mended. Diet free from condiments, but nutritious.

Fig-Warts.

These are excrescences upon the skin in the shape of a fig, and
hence their name. Nitric acid and Thuja are remedies for these ex-
crescences. Thuja is more particularly indicated when they bleed ;
Nitric acid, when they are flat; Nux vomica, when they are dry.
When they suppurate, or are humid. Thuja ; when they split or
crack, Nitric acid. Of the remedy selected, give a dose every day.

...^

r*wsa^ttWtsS««*^sini^pi^^

668

DISEASES OF VARIOUS ORGANS AND RKGI0N8.

For Common Warts, Thuja is also the chief remedy, and should be
given every two or three days.

Qangrene.

When one has been so long sick as to acquire bed-sores, and these
become black and fetid and deathlike, they are said to be gangrenous.
They indicate a low condition of the system, and generally indicate
the employment of Amenicum in daily doses, or else Lachem. For
dry gangrene, give Arsenicum. For that which is humid, give Ohina.
For that which emits an oflFensive odor, give Secale cornutum. This
last remedy may be given for j. angrenous blisters. The patient, if
he take it, should have a generous diet.

Zona, or Shingles.

In some cases, there is a zone or belt of vesicles, four or six inches
in width, that extends half way round the body, on the right side,
over the region or the liver. These vesicles appear to be filled with
lymph, and are prone to burn and itch to almost an unbearable ex-
tent. It is believed to be a concomitant of chronic liver complaint,
and indicates an exceedingly low condition of the blood. Rhu% tox.,
in daily doses, will generally cure the disease. Graphites may be
given after Rhus tox. When there is pain in the right side and a
sallow complexion, give Merourius. Bryonia will eliminate the
eruption, and aid materially in the invigoration of the system. If
there is much headache, give Belladonna. If the patient is scrofu-
lous, give Arsenicum or Galcarea. The diet of the patient, if his ap-
petite will permit, should be quite generous. A little wine every
day is recommended. Beef or mutton without condiments, and the
usual vegetables, are allowed.

Nasal Polypus.

This fungous growth in one or both nostrils someumes proves a
serious obstruction to respiration through the nose, and can be cured,
in most instances, with well-chosen remedies. When both nostrils
are affected, give a dose of Calcarea every twenty-four hours. When
the polypus is in the right nostril, give Pulsatilla ; when in the left,
give Sanguinaria. If the nostril seems plugged, give Sepia or Silicea.

Warts on the Nose.

Warts on the nose are sometimes quite annoying, as they not only
are inconvenient, but often painful. It is diflScult to iet one of these
excrescences alone ; and, by constant irritation, it may become can-
cerous ; therefore, prompt treatment when they make their appear-
ance is requisite. Caustieum, given at first, will soon relieve the
nose of this appendage.

REGIONS,
remedy, and should Ik;

re bed-sores, and these
said to be gangrenous,
ind generally indicate
or else Lachesis. For
is humid, give China,
'ecale cornutum. This
sters. ' The patient, if

cles, four or six inches
dy, on the right side,
ppear to be filled with
lost an unbearable ex-
uonic liver complaint,
the blood. Bhtts tox.,
le. Graphites may be
1 the right side and a
,ia will eliminate the
on of the system. If
the patient is scrofu-
f the patient, if his ap-
A little wine every
it condiments, and the

ils some limes proves a
nose, and can be cured.
When both nostrils
mty-four hours. When
tilla ; when in the left,
i, give Sepia or Silicea.

loying, aa they not only
cult to let one of these
)n, it may become can-
ley make their appear-
, will soon relieve the

DISEASES OF VAUIOUS ORGANS AND REGIONS. 669

Warts on the Hands.

When warts on the hands are prone to grow thick and large, and
appear to be seedy, Thuja in the form of lotion may be applied exter-
nally, while the usual dose of the same may be taken internally. Cu-
prum asceticum also may be taken internally, and a wash of Cuprum
sulph., one dram to half a pint of water, may be applied externally.

Inflammation of Glands under the Arms.

A SOBE upon the back of the thumbs, and sometimes an irritable
sore upon the backs of the fingers and hands, may cause soreness and
inflammation of the glands in the arm-pits ; that is, the inflammation
may be transferred to this locality from the thumb, fingers or hands.
At first, a slight soreness is felt under the shoulder in the arm-pit,
and the glands will swell and become sore to the touch ; more or less
fever will manifest itself at the time ; and not infrequently pain,
throbbing and suppuration supervenes upon the inflammation. Aco-
nite may be given to subdue the fever and inflammation ; ffepar sul-
phuris may be given to promote suppuration ; Belladonna or Bryonia
to prevent it. Phytolacca, also, is a most useful specific, given every
three hours until relieved.

Inflammation of the Qroin, Inguinal Glands.

The inguinal glands are situated in the groin; and sometimes
sores of an irritable character upon the toes may operate so as to
transfer these influences to this region, causing swelling and suppur-
ation. If taken in time, this soreness may amount to nothing more
than an uncomfortable lameness, rendering it difficult to walk. If
not arrested, the inflammation will pass into suppuration. Sores or
chancres upon the integuments of the penis may also cause inflamma-
tion, swelling, and even suppuration, of the inguinal glands. When
caused by sores on the toes, poultices of bread and milk may be ap-
plied to them, to draw the inflammation from the groin ; and Nux
vomica may be given internally, to aid in curing the difficulty. When
this inflammation occurs in scrofulous persons, Arsenicum may be
given twice a day. When the inflammation proceeds from a chancre,
give Merc. iod. three times a day ; when from suppressed gonorrhoea,
give Sulphur. Mercurial ointment may be applied to the sores, when
of syphilitic origin. If they occur from syphilis, Merc. iod. may be
given internally three times a day.

Milk Leg. — Phlegmasia Dolens.

This affection frequently occurs one week after delivery. It con-
sists in a swelled condition of the thigh and leg of either the right

670

niHEASKW OK VAKI0U8 OKliANS ANU KKOIONH.

or left side. The skin Ixjcomes tense, sore to the toucli, cBdemalous
or dropsical, and very sensitive. It rarely affects botli limbs at tlio
same time, although in some instances such is the case. It inay
sometimes be arrested in the incipient stage by a single dose of Aco-
nite. In a more advanced stage, Belladonna will have a curative ac-
tion ; and, wiien there is great sensitiveness of the skin, Jthun tii.v.
When the victims of milk leg have been aflUcted with dropsy before
confinement, Arseaieum may be given. In cases where women aie
suffering from rheumatic pains in the knees, or where there is sup-
pressed lochia, Pulratilla. When the bowels are constipated, Lyco-
podium may be given, and not repeated for several days.

j:;

Stone Bruise.

By a stone bruise is understood an injury upon the plantar, or un-
der surface of the foot, which becomes inflamed, painful and siiji-
purative. It mostly occurs with boys and girls who run barefooti'd
thrdugh the warm weather ; and it is believed to be the result of stej)-
ping forcibly upon pebbles or other hard substances. Arnica given
once or twice internally, and a lotion of the same applied externally,
will often remove the pain speedily ; but, after suppuration has taken
place, the sooner the matter is let out with a lancet the better.

Bunions.

These protuberances upon the joint of the great toe, or upon the
side of the foot immediately back of the little toe, frequently grow
so large as to interfere with the wearing of a shoe or a boot, and so
painful ivs to interfere with the comfort of the patient. In order to
derive any benetit from treatment, all mechanical interference must
be removed, the boot or slioe must be shaped to favor the tumor, and
then wet the tumor a number of times during the day with Amirn.
Antimonium crud. may be gi\en internally, or else Calcarea, Sepia or
Sulphur. Give but a single dose of each remedy ; after which, wait
with patience. If the bunion is very painful, give Calcarea; and af-
ter two days, give Nitric acid. If the pains are stinging, Lycopodium,
Silicea or Sulphur. Give a single dose of either remedy, and wait
forty-eight hours. A weak solution of Nitric acid will often moder-
ate the severe pain of a bunion in dry weather ; Bryonia will do the
same in cold, damp weather. Silicea or Rhus tax. will afford great
relief when every change of weather aggravates the pain and suffer-
ing. In case of bunions becoming the seat of neuralgic pain, Bella-
donna may be given ; and when they aie made sore by chilblains, as
in scrofulous persons, Arsenicum must be given. The patient must
not walk much, but keep the feet dressed and warm until the soreness
disappears.. A ])oultice of bread aud milk will softeu and mollify tlie
aching during a sturni.

ii^

IV UEOIONH.

,o the touch, (fidematnus
Efects botli limbs at tho
h ia the case. It may
by a single dose of Aco-

will have a curative ac-
8 of tho skin, Khux tor.
icted with dropsy before

cases where women aie
)8, or where there is suii-
is are constipated, Lyco-
ieveral days.

upon the plantar, or uii-
iamed, painful and sup-
'irls who run barefooted
I to be the result of step-
ibstances. Arnica given

same applied externally,
er suppuration has taken
a lancet the better.

he great toe, or upon the
ttle toe, frequently grow
a shoe or a boot, and so
the j)atient. In order to
lanical interference must
d to favor the tumor, and
ing the day with Amim.
or else Calcarea, Sepia or
jmedy ; after which, wait
il, give Calcarea ; and af-
are stinging, Lycopodium,
■ either remedy, and wait
rie acid will often moder-
iher ; Bryonia will do the
lhu8 tox. will afford great
v^ates the pain and suffer-
, of neuralgic pain, Bella-
lade sore by chilblains, as
fiven. The patient must
id warm until the soreness
vill soften and mollify the

mSKASKS UV VAlilUUS OUGAMti AMD KEUIUNU.

671

Hectic Fever.

The importance of this fever is so great, that, instead of elabora-
ting upon it under the head of " fevers," it is introduced here, be-
cause it should riot be confounded with other febrile diseases. There
is a common impression that hectic fever and consumption are one
and the same thing ; but this impression will be corrected when we
consider briefly the origin of this fever. It is sometimes intermit-
tent, and sometimes remittent. Often a slight chilliness is felt some
time during the day; and this is 'oHowed by a febrile reaction, more
or less severe, and of a prostrating character. Extreme debility may
cause a fever of this kind to spring into existence ; and, under such
circumstances, it may take the form of a low nervous fever, very slow,
and wearing upon the nutritive system. But hectic fevers show
themselves where there are local chronic inflammations and suppura-
tions, as in the case of abscesses, carbuncles, etc. They are some-
times caused by grief, or emotions of any kind. They are caused by
the loss of nimal fluids ; or they may supervene upon any pros-
trated condition brought on by acute disease. They result also from
scrofula and syphilis, and from the poisonous influences of Quinia or
mercurial medicines. It is probable, therefore, that hectic fever, taken
in time, is curable, provided the organic lesions on which it depends
are not of a fatal or incurable kind. That which usually accompanies
pulmonary tubercles* can only be overcome by curing the tuberculo-
sis of the lungs. We will proceed to specify the treatment according
to particular indications. Those springing from debility, and with a
slow nervous fever, require the use of China and Ansenicum. Give
the China every time the fever remits or intermits, — a single dose,
(jive Arsenicum in the same way when there is extreme prostration
and thii-st. Give Phosphoric acid when there is diarrhoea. When the
fever attends local inflammation, Arsenicum may be given, when there
is great emaciation and debil'ty, with palpitation of the heart, hot,
dry skin, and night-sweats; Calcarea, when there is constant heat
and little thirst, frequent flushes of heat, especially in the evening,
with red cheeks. Calcarea is also indicated when there is loss of ap-
petite, great debility and emaciation, and also paroxysms of anguish.
China is indicated when there is great paleness, sunken cheeks and
eyes, great listlessness, dry and flaci skin, great hunger or else loss
of appetite, and a tendency to diarrhoea. For hectic fever brought
on by emotions or grief, give Phosphoric acid, followed by Capsict n
wlien there is painless diarrhoea, sad, oppressed mood, febrile heat in
the evening and sweat towards morning. Give Ignatia when the pa-
tient weeps during the fever, and has much heat in the palms of the
hands. Give Graphites when the patient is pale and the heart is
prone to palpitate. If the fever is produced by debilitating losses,
give China wher from hemorrhage ; give Nux vomica when from sex-

•I

i uii. ' . i |i,n,Hjma» ' i

f.72

DIHKAHKS OK VARIOUS ORGANS AND UKC.IONH.

ual oxcesscH ; Phosphoric asid wlien from diarrhoeii, .\n<l there in hc
celerated |)u1ho, anguish, and HweutM in tlie morning. When the fever
comes on after dysentery or typhus fever or cholera, give Araenieiitn,
if there are dysenteric discharges, and if the patient is greatly eniu-
oiated, and has laborious breathing, witli debility and palpitation and
thirst, obliging him to drink frequently. Give Oocculua when hectic
fever sets in after typlius, when there is great debility, and trembling
after the least exertion, blue margins around the eyes, dry mouth,
and loss of appetite, oppression of the chest, and with greiit sadness
and anguish. Give Veratriim album when hectic comes on aftei'
cholera, if there is great weakness, or cramps, or pain in the btick dI'
the head during the fever. When syphilis is attended with hectic
fever, and if the imtient has taken much Merctiry, give Aurum viur.
or iStannum^ when there is great emaciation, and pains in the bones,
and loss of appetite. Nitric acid may be given when the hectic fever
has been brought on by mercurial medicines, and when there is great
dryness of the throat and varices of the tongue. In many cases of
hectic fever, springing up like those named above, a careful selection
of the remedy, and corresponding adaptation of diet and regimen, will
bring about a large proportion of cures. Persons suffering from any
form of hectic fever should be kept in an atmosphere of uniform tem-
perature, — from 68° to 70° Fahrenheit, and should be supplied witli
generous food when the appetite will take it, and in some cases the
best of grape wine.

Night-Sweats.

If nightrsweats break out in particular diseases, they do not require
any special consideration, unless it happens to be one of the most
prominent symptoms ; in which case, it may constitute an important
indication for the selection of a remedy. A profuse perspiration of
this kind which affords no relief indicates Mereurius or China. Ex-
hausting night-sweats in the case of peraons that have become weak-
ened by disease or other causes, point to Carbo. vegetdbilis., Veratrum
album. Sulphur. But there are individuals, who appea^" to be well
enough otherwise, who perspire copiously every night, and sometimes
so profusely as to wet the bed-clothing. It would seem that sleep
induced some kind of labor that wrought the system up to this pitch
of perspiration. It is said to be most common with corpulent per-
sons. Such cases as only exhibit the one symptom of sweating for
consideration, must be treated as follows : When one begins to sweat
as soon as he lies down to rest at night, Arsenicum, may be adminis-
tered. When he fails to sweat so long as he keeps awake, give Hepar,
if he is corpulent ; or Oalcarea if he finds the sweats to diminish his
strength. If exercise of mind sets him to perspiring after gettin}?
into bed, give Niix vomica, if there is a sanguine temperament. If
the person is a good feeder, and eats heartily, and has these prostrat-
ing sweats at night, let him eat less, and take Pulsatilla. Exhausting

n — ' ' ^

I) IlKlilUNM.

irrlKBa, .ind thero is ac-
)rniiig. When the fever
L'holera, give Ar»enieum,
I patient is greatly enia-
ility and palpitation and
ve Oocculus when hectii:
b debility, and trembling
id the eyes, dry nioutli,

and with great sadness
1 hectic comes on afU-r
8, or pain in the back nf

is attended with hectic
injury, give Aurum mm:

and pains in the bones,
en when the hectic fever
, and when there is great
rigue. In many cases of
vbove, a careful selection
of diet and regimen, will
rsons suffering from any
nosphere of uniform t«;ni-
. should be supplied with
b, and in some cases the

eases, they do not require
1 to be one of the most
/ constitute an important
k profuse perspiration of
Mercurius or China. Ex-
j that have become weak-
irbo. vegetahilii, Veratrum
J, who appeal- to be well
irery night, and sometimes
It would seem that sleep
le system up to this pitch
mon with corpulent per-
symptom of sweating for
iVhen one begins to sweat
rsenicum may be adminis-

keeps awake, give Hepar,
he sweats to diminish his

perspiring after getting
nguine temperament. If
ly, and has these prostrat-
le PuUatilla. Exhausting

DIHKAHKB 09 VAItlOllS OIUiANS AND KKOIONS.

678

night^tweats that occur after fatigue require Arnica and China. If
after severe mental lal)or, give Cocculua or Nux vomica. If from no
cause that can be determined, Carbo. animalit. When no fever pre-
cedes one of thjse exhausting sweats, and there is great debility
after, China, Ferrum, and Oraphiten are appropriate remedies. For
the exhausting night^weats that occur after masturbation, China is
also the remedy. If there is uncomfortable feeling alwut the head, —
a (hill feeling, — give Phonphoric acid. Those nightrsweata that occur
aftt^r excessive sexual indulgence require China., Arsenicum, and
Qraphitea. For niorlud sweats in general, Arsenicvm., Arnica, Bry-
onia, China, Ferrum, Graphites, Helleborus niij., Hyoscyamus, Ignatia,
Mercurius, Nux vomica, and Sulphur may be consulted.

Pulmonary Consumption.

There is reason for a distinct monograph upon this disease. Much
that can be done to ward off the disease by domestic treatment should
be done ; and, therefore, to point out a plain description and treat-
ment of the incipient stage is at least desirable. The cause of con-
sumption may be hereditivry taint or overpowering influences that
break down the strongest constitutions. When hereditary, it fre-
quently exists as a predisponent in the system until aroused by some
exciting cause. It is therefore of the fii-st importance to become
familiar with the rrieans of protecting one thus disposed from sur-
rounding influences that may develop the hereditary taint. When a
child of consumptive parents appeare to thrive well and grow, be-
traying no signs of disease, it is well to keep him suriounded by such
atmosphere, food, and clothing, as contribute to his healthy develop-
ment, until the age of puberty. It is at this period that changes
occur, more or less fraught with danger. With the male, there is
danger of arousing any latent tendency to pulmonary tubercles ; with
the female, there is danger of the menstrual function becoming so
feebly developed, that it acts as an excitant upon any latent discrasia
of the blood. Treatment is therefore required at this period, not
only to ob\iate any derangement consequent upon its occurrence, but
to aid a burthened system in bringing about this physiological change,
so as to answer all the demands upon it. Separate beds should be
insisted upon.

For males at the age of puberty, children of scrofulous parents,
give a dose of Calc. carb. tvdce a week, and restrict them to a strictly
nutritious diet, free from fat or gravy. In case of their being chil-
dren of parents who had tubercular disease of the lungs, give them
Lycopodium twice a week, or perhaps Graphites, and direct for them
a good diet of aniiral and vegetal ^^ food; let them avoid exposure
to extremes of temperature ; . let them sleep in well-ventilated apart-
ments : and any hereditary tendency to consumption can be overcome.
Should a cough ensue upon the period of pubescence, give Lyco-

!.)

674

DIHEA8K8 OF VARIOUS OKCiANH ANU RKGI0N8.

podium or Calcarea ; if a short, htvckiiig cough, give Photphonm ; if
a tickling oough, give Pulmtilla or Sepia. By thus watcliiiig tlm
first development of cough, and by giving the appropriate remedy at
once, the same can be cured. In funialus, when there is great debility
of the chest, and sometinios a slight bleeding occasionecl by a trifling
cough, give Sauro cerasus. Thus, by noting the slightest (l«vel()|>.
nient of cough at this period, and by being prompt in selecting the
appropriate remedy, this incipient form of consumption can be cured,
and sound health be established, and will remain until some otliur
revolution occurs to unsettle the system. Any exccHSos on the part
of the male must be avoided. Whatever weakens or deteriorates any
of the functions may prove an exciting cause, so long as there is any
predisposing influence in the system. On the part of females, there
is danger at the period of the first pregnancy. This revohition will
either make further improvements in the direction of sound health,
or it will arouse unfavorable influences that depress and ruin it. Thus
it may seem plain that consumption may be successfully treated in
its incipient stage, whether it shows itself early or late in lift;. If
there is indication of its approach after a fever, give China ; if after
excessive fatigue, give Lycopodium or Stannum. If excessive venery
causes a development of consumptive symptoms, give Arsenicum or
China ; if the shock of labor produces depressing effects, give Arnica,
China, and ArBenicum / and if cough ensues, give Bryonia or Pho»-
phorus, and a well-regulated diet. It is believed, that, in a majority
of instances, hereditary consumption can be erased from the family
record by carefully waging a warfare upon the fitst approach of the
enemy.

But a different aspect presents itself in that form of consumption
which comes on by reason of a good constitution having been over-
taxed and worn out. A cold, badly treated, may leave behind a per-
manent irritation even upon the most naturally healthy constitutions.
A cough from a cold is not to be trifled with; therefore, attend to
the slightest cough. Nux vomica may remove a cough brought on hy
a cold, if given at once ; a dry, hollow, or hoarse cough may be cured
with ffepar sulph. ; a cough with heat of the chest and soreness of
the lungs may be cured with Bryonia. Long exposure to cold that
chills the whole system may be followed by a violent fever that fixt :
itself upon the lungs, producing violent inflammation ; and this, if
improperly treated, may end in consumption. Almost any acute dis-
ease, badly treated, m.ay terminate in fatal consuii^^ption ; therefore,
when any interruption occurs in the function of respiration, it is
more or less dangerous. The slighter the interruption the better,
and the more easily can it be removed. But it must not be neglected.
An exceedingly slight capillary congestion, if neglected, may become
chronic, and end in tuberculous consumption ; a slight bronchial dis-
turbance, not properly treated, may terminate in bronchial consumj)-
tion: in short, any of the ailments of a trivial character, which can

II m i^iitkitmiu

11) UKOIONS.

jph, give PhotphoruH; if
Ily thus watching Uui

10 appropriate remedy at
leti there is great duhility
^ oc(;asi()nt'(l by a triiling
ig the blightcHt (leveloj)-

prom[)t in selecting tho
Dusuniption can he cun^l,
remain until some otlier
Any excesses on the part
lakens or deteriorates any
je, so long as there is any
the part of females, there
cy. This revolution will
Lirection of sound health,
depress and ruin it. Thus
je successfully treated in
early or late in life. If
'ever, give China ; if after
iium. If excessive venery
ptoms, give Arsenicum or
essing effects, give Arnica^
es, give Bryonia or Pho»-
lieved, that, in a majority
bo erased from the family

the fitst approach of the

that form of consumption
itution having been over-
jd, may leave behind a per-
rally healthy constitutions,
with; therefore, attend to
lOve a cough brought on hy
hoarse cough may !« cured
the chest and soreness of
jong exposure to cold that
)y a violent fever that fixt ;
inflammation; and this, if
on. Almost any acute dis-
al consu.i.ption ; therefore,
nction of respiration, it is
de interruption the better,
ut it must not be neglected,
n, if neglected, may become
tion ; a slight bronchial dis-
inate in bronchial consump-
trivial character, which can

DISEASES OK VAKIOUH 0KQAN8 AND KEOIONB.

675

bo made worse by neglect, may demand the most careful treatment,
otherwise they may terminate in consumption.

Influenza, or Qrlppe, comes on like a cold, with sneezing or snivel-
ling, pain in tho chest, and a g((neral appearance of catarrh. Too
froijuently it hiw been neglectecl in tho firat stage, and it hiw run into
tho chronic form of bronchitis, and thence into consumption. Sn<;h
l)eing the known tendency, it is well to seek the best of treatment
f(»r this disease at once. ArHenitmrn,'n\ the incipient stage, will re-
Hcvo some of the symptoms : it will relieve the thin discliarge from
the nose and eyes, the pain in the liml)s, and general aching in tho
bonus. Euphraxia relieves many cases in the beginning wliich re-
semble Arseniruni. MercuriuH viv. is also a tine remedy for tho stop-
page of the nose, eyes, and general restlessness of the whole system.
Intluonza has been reckoned among the causes of consumption, be-
cause, in many instances, it has been the means of calling into action
certain latent tendencies that have been dormant until set ui)on
by tl.io exciting cause. Influenza is but an acute form of bronchitis,
and as such it must be treated. Aconite ma; be given if there is a
quick, full pulse. After Aconite has softened the pulse, and pro-
duced moisture upon the skin, if the head continues to ache, give
Belladonna; if there is soreness of the throat, give Merc, viv.; if
much thirat, Ar»eni('um ; if pains in the back and loins, Nux vomica.
In females, Puhatilla may remedy many of the derangements which
influenza produces; If a sudden check of menstruation su[)ervene8
u[)on an attack of this disease, give Aconite^ and follow with Puhor
tilla ; and, finally, if influenza shows itself in an epidemic form, and
almost every man, woman and child become victims. Aconite^ Bella-
doHiia, Merourius, and Nux vom., or else Arsenicum, Apia met., Bry-
onia, Calcarea carb.. Phosphorus, and Sulphur, may constitute the
group from which is to be selected a remedy, according to symptoms.
It is an old saying, with regard to diet, " to starve a fever, and stuff a
cold;" but all proverbs are not true. There is, in every cold, some
degree of fever that must be heeded, because a too generous diet
would be likely to do harm. A moderate diet of black tea, rice,
barley, toast, and fruit, is best. Thus, by judicious medication and
an appropriate diet, there need be no sequel that causes the patient
to sink rapidly into the grave. If otherwise, it will arouse some con-
stitutional diathesis, and this will render the joint action formidable
in the extreme. As in tubercular consumption, or rather in that
which is hereditary, a constant vigilance is required to put in action
certain antagonistic influences to overpower the disease, so in bron-
chial consumption, or that which is generated by a succession of
ailments that implicate, in a lesser or greater degree, the mucous
membrane that lines the bronchial tubes, an effort must be made to
bring any and every assault upon the bronchia to a successful termi-
nation, — whether a common cold, a trivial cough, a slight soreness
upon the air-passages, or even pneumonia: let each be treated per-

676

DISEASES OF VARIOUS ORGANS AND REGIONS.

sistently, acicordiiig to symptcns, until perfectly cured, so as to leave
no entailment in the form of a sequel, to prey upon the conatitution.
Hygienic ^treatment must correspond with the administration of
remedies. Well-ventilated apartments, sufficient clothing, and good,
nourishing food, cannot fail of putting the system in a favorable con-
dition for recovery. Regular sleep, regular meals, and a well-regu-
lated temperature, are things indispensable.

Weakness of the Sight. — Amblyopia.

The term amblyopia signifies a weakness or morbid alteration of
sight ; and there is every grade, from mere dimness of vision to com-
plete blindness. A sense so important au that of sight is entitled to
a distinct consideration, inasmuch as a variety of causes may operate
to impair it. The difficulty may be attended with many morbid con-
ditions of the organism, and a variety of remedies may be required to
tr<3at the affection. We will therefore point out the treatment for
the various grades, in order. For Simple Weakness op Sight in
plethoric persons, give Belladonna ; for scrofulous individuals, Cal-
carea ; for weak or debilitated individuals, China ; for nervous per-
sons, Hyoicyamua. For those whose sight is impaired from biliary
derangement, Sepia or Sulphur. For Incipient Amaurosis, Aurum,
Sepia, Sulphur. For Complete Amaurosis, not incurable, give
Belladonna to persons of full habit; Calcarea to persons who have a
scrofulous tendency ; Mercurius, for those suffering from hepatic de-
rangement; Phosphorus, for those suffering from catarrhal affections;
and for those subject to sick headache, Sepia. For Torpid Weak-
ness OP Sight, Phosphoric acid. For weakness of sight brought on
by fine work, give Belladonna or Ituta. For that which occurs from
old age, give Baryta curb., Opium or Secale comutum. Where weak-
ness of vision occurs after suppression of the menses, or hemorrhoids,
give Pulsatilla or Lycopodium. For that occasioned by suppression
of measles, Causticum, Stramonium or Sulphur. For that supervening
upon rheumatism, give Belladonna, Pulsatilla or Bhus tox. For that
attendant on gout, give Nux vom. or Colchicum. For that caused by
the abuse of mercury, give Nitric acid. For that caused by worms,
give Cina. For that occasioned by diarrhoea, give Merc. viv. For
that brought on by loss of blood, China. For that produced by scrof-
ula, give Arsenicum, Calcarea or Nitric acid. When produced by cold
in the eyes. Dulcamara or Niix vomica. That produced by blows or
concussions requires Arnica, Ruta, Euphrasia. The remedies chosen
must not be repeated oftener than once a day. When weakness of
sight is attended with nervous headache, give Aurum, Belladonna,
Bryonia, Sepia or Sulphur. If by congestion of blood to the head,
give Belladonna, China and Phosphorus. For that attendant on
deafness or noises, give Ciouta, Nitric acid or Pulsatilla. The reme-
dies need not be repeated more frequently than once or twice in

ND REGIONS.

DISEASES OF VARIOUS ORGANS AND REGIONS.

677

ictly cured, so as to leave
ey upon the conatitutioii.
li the adiniuistratioii of
icient clothing, and good,
ystem in a favorable coii-
• meals, and a well-regu-

— Amblyopia.

or morbid alteration of
dimness of vision to com-
hat of sight is entitled to
ety of causes may operate
d with many morbid con-
aedies may be required to
nt out the treatment for
Weakness of Sight in
I'ofulous individuals, Calr
China; for nervous per-
is impaired from biliary
lENT Amaubosis, Avrum,
osis, not incurable, give
rea to persons who have a
suffering from hepatic de-
from catarrhal affections;
m. For Torpid Weak-
ikness of sight brought on
or that which occurs from
g comutum. Where weak-
le menses, or hemorrhoids,
occasioned by suppression
hur. For that supervening
ilia or JRhva tox. For that
icum. For that caused by
'or that caused hy worms,
•hoea, give Merc. viv. For
i'or that produced by scrof-
. When produced by cold
hat produced by blows or
sia. The remedies chosen
day. When weakness of
give Aumm, Belladonna,
tion of blood to the head,
For that attendant on
or Pulsatilla. The reme-
tly than once or twice in

twenty-four hours. If weakness of vision is attended by gastric or
abdominal ailments, give Cocoulun, Nux vom., Ignatia or Pulsatilla.
If attended by derangements of the womb, give Calcarea or Sepia.
If by pulmonary complaints, give Phosphorus, Lycopndium, Calearea
and Sulphur. If by disease of the heart, Laehesis, Phosphorus, Pul-
satilla, Sepia and Spiijelia. If by epilepsy, spasm or hysteria, Ht/os-
cyamiis. Opium, Stramonium or Sulphur. The remedy may be re-
peated, if necessary, every twenty-foift" houi'S.

The particular indications for several of the remedies may be stated
as follows : Aurum, for black spots or scintillations, or half-sighted-
ness, or tensive pain in the eyes, or in case of sudden attack after
scarlet fever, or during confinement after delivery. Belladonna for
dilated pupils or insensible pupils, spasmodi' ^witching of the lids, or
mist befora the eyes, aching and distensiv pains in the orbits and
forehead, and red face. Calcarea, for mistiness of sight, as if gauze
were before the eyes, especially when reading; for dilated pupils, and
for pressure or feeling of coldness in the eyes. Causticum, for sud-
den and frequent loss of sight, with sensation as if something wert
stretched over the eyes, or for dimrsiffhtedness, as if looking through
a veil or mist. China, for weak sight : the patient only sees the out-
lines of things near him; letters look pale, and appear to be sur-
rounded by white borders ; dilated and not very sensitive pupils ;
dimness of the cornea, as if the eyes were filled with smoke or black
motes. The eyes feel better after sleeping. Cicuta is indicated
when the sight frequently vanishes, and when there is vertigo or
absent-mindedness, or aching pains in the orbits. Cina, for dimness
of sight improved by wiping the eyes, and for pressure in the eyes
when reading, as if sand had got in. Cimicifuga, when there is ach-
ing pain in the centre of both eyeballs, and black specks before the
eyes. Drosera, for frequent vanishing of sight, or when the eyes are
dazzled with the glare of light or of fii-e. Gelsemium, when there is
a thirst for light after apoplexy or congestion of the brain. Hyoscy-
amus, for squinting, illusory sight and stupefying pains over the
eyes. Merourius, for paroxysms of momentary blindness, sensitive-
ness of the eyes to light or the glare of fire. Nux vomica, for red
face and sensitiveness of the eyes to light only in the morning.
Phosphorus, for paroxysms of sensations as if things are covered
with a gray veil. Pulsatilla, for paleness of the face, and disposition
to vomit, and a sensation as if dimness of sight could be removed hy
wiping; for frequent and copious flow of tears, and contraction of
the pupils. Buta, for mistiness of sight, and boring pains in the or-
bits, and the filling of the eyes with water in the open air. Sepia,
for dimness of sight when at work, stripes before the eyes and aching
pains in the eyel^lls, with sick headache. Silicea, paroxysms of sud-
den obscuration of sight, as if a colored veil were before the eyes.
Sulphur, for general mistiness of sight, as if looking through feather-
dust or black gauze ; great dryness of the eyes. Veratrum album.

II <mtmm *)m 'r m 'mt ^

678

DISEASES OF VARIOUS ORGANS AND REGIONS.

for profuse shedding of tears, or the copious filling of the eyes with
water. Verntrum viride, when walking brings on blindness, with
fainting vertigo iind dilated pupils. When any one of the remedies
is indicated, let the dose be repeated only once in twenty-four hours.
In all affections of the sight, the patient should avoid hearty meals
or excessive overloading of the stomach; he should l)e regular in his
habits, and free as possible froiji mental anxiety ; and, above all, his
habits should be strictly temperate, and late hours should Ih) avoided.
In most cases of defective sight, the eyes require rest. An atteniiit
to exercise them in reading in any defective light is pernicious ; ami
so is prolonged reading in any light.

Paralysis of the Eyelids, — Blepharoplegia.

This affection sometimes occurs in children, but very rarely in
adults, and requires remedial treatment. The best remedies are Bel-
ladonna^ Spigelia, Sepia and Stramonium. Belladonna, if there is red-
ness of the face; Spigelia, if there is any sign of spasms ; Sepia, if it
follows severe headache and sickness of the stomach ; Stramonium,
if there is pale face, and inclination to sleep. Gavsticum for chronic
cases.

Whooping-Cough. — Tussis Spasmodica.

Among the diseases of children, we find this malady quite com-
mon. The cause is only conjectured. As it is a disease much
dreaded by parents, we shall not only be particular in describing the
disease, but also in pointing out the remedies for the various stages
and complications. The cough begins in the form of an ordinary
catarrh arising from a cold. The child has f^ryza and coughs; the
mother or nurse may be aware that the di.^ jtvoo commences in this
way, and their fears may be that it will turn out whooping-cougli.
The catarrhal stage may last ten days or two weeks, and then a dif-
ferent and characteristic cough sets in. This co'Jgh comes on in
paroxysms, in which a number of rapid expirations lollow each other,
as in the act of coughing, and with m'ach violence, and without any
intervening inspiration, till the patient turns black in the face, and
seems on tlie point of being suffocated; then one long-dn;.wn act of
inspiration takes piace, attended with that peculiar rough, crowing
noise, which is denouiinated a whoop, and gives the disease its name.
Immediately after this long-drawn inspiration, a series of short expir-
atory coughs, repeated 'ii the breath is almost exhausted; and
then a second whoop, unti: ?<■ white, glary mucus is thrown up, and
this ends the paroxysm. After a lapse of some little time, the par-
oxysm will be repeated. During the urgency of some of these par-
oxysms, the face becomes red and swollen, the nose bleeds, the eyes
start from the sockets, the little sufferer stiimps with impatience, and
clings to some object near him ; and tliis frenzy continues till vomit-

ND REGIONS.

DISEASES OF VARIOUS ORGANS AND REGIONS.

679

1 filling of the eyes with
ings on blindness, with
any one of the remedies
ice in twenty-four hours,
ould avoid hearty meals

should 1)6 regular iu his
iety ; and, above all, his
liours should l)e avoided.
quire rest. An attempt

light is pernicious ; and

Blepharoplegia.

dren, but very rarely in
he best remedies are Bel-
'elladonna, if there is red-
^n of spasms ; Sepia, if it
e stomach ; Stramonium,
Cauaticum for chronic

s Spasmodica.

I this malady quite com-
Ls it is a disease much
,rticular in describing the
es for the various stages
the form of an ordinary

pnryza and coughs; the
. jtvoj commences in this
urn out whooping-cougli.
wo weeks, and then a dif-
This co'igh comes on in
rations loUow each other,
.riulenca, and without any
IS black in the face, and
len one long-dn:.wn act of
, peculiar rough, crowing
[ives the disease its name.
)n, a series of short expir-

almost exhausted ; and
nucus is thrown up, and
some little time, the par-
ficy of some of these par-
the nose bleeds, the eyes
imps with impatience, and
enzy continues till vomit-

ing or expectoration ends the paroxysm. The victim pants a little
wiiile, and appears quite well again, and begin.s to have a craving for
food. The number of paroxysms that occur every twenty-four hours
varies in different subjects. Children are very susceptible to the dis-
ease, and it spreads by contagion. The ordinary duration of the dis-
ease! is from six weeks to three months ; but it may run its couree in
thi*ee weeks, and sometimes not for four or five months.

As long as this disease is uncomplicated, — unmixed with inflam-
mation, and therefore without fever, or with that slight inflammatory
condition proper to a mild catarrh, — it is not a dangerous disease.
Iu all probability, it will run its course under the most favorable cir-
cumstances. How much it can be abridged by appropriate remedies
is yet a question, but the violence of tliC disease may be moderated,
its sequel may be guarded against, and its complications may be tem-
pered, by the right use of remedies. The most favorable season for
the disease to rage is in the spring, when the weather is becoming
warmer. The most unfavorable is late in the fall, when the weather
is augmenting in coldness. Cold or damp weather is thought to pro-
tract the disease, and warm weather to abridge it. We have thus
been somewhat particular in describing this malady, in order to facil-
itate its treatment by mothers and nurses. We will now proceed to
direct the use of appropriate remedies. In the catarrhal stage, give
Aconite. If there is fullness of the nose, and headache, give Bella-
donna. In case of asthmatic breathing, give Ipecac. Aconite is the
remedy for a dry, wheezing cough, with fever or burning pain in the
larynx or windpipe. Belladonna is the remedy for severe paroxysms,
with coDgoation of blood to the head, expectoration of blood, and
bleeding from the nose, the eyes appear congested, involuntary stool
and urine, and also when the paroxysm is announced with crying,
which arises from pain in the stomach, but not accompanied by vom-
iting. Also, in the first stage, Carbo veg. may be given when the
cough is convulsive, especially in the evening, and when there is
great exhaustion after each coughing-spell. Dulcamara is a good
remedy when the cough is moist from the commencement. Ipecac.
for the incipient stage, when the child has coughing-spells so rapid
as not to be able to get his breath, and when the open air is requisite
to relieve him. Pulsatilla is useful when the cough is loose from
the beginning, and worse towards evening. In the second stage,
after whooping sets in, with vomiting, and bleeding from the nose
and mouth, give Caulophyllum. If without bleeding at the nose, give
Drosera. If the children suddenly become rigid, give Cina. This
remedy is specific when children are affected with the usual worm
symptoms, and the paroxysm is followed by a gurgling noise from
the abdomen. Corallia rubrum is believed to be a sure remedy for
violent spasmodic cough ; short, barking cough all day, and towards
evening becoming violent and spasmodic. Cuprum is indicated when
every paroxysm is attended with cataleptic fits, so that in most every

;

680

DISEASES OF VARIOUS ORGANS AND REGIONS.

paroxysm the child appeai« as dead. Veratrum is very suitable after
Cuprum. Droaera is the remedy when the paroxysms come on at
midnight, and cease before noon, and are very severe and suffocating,
Veratrum album is indicated, after Droaera and Cuprum have been
employed, when the patient is very feeble, quick pulse, and with a
sort of hectic fever, and cold sweat upon the forehead, and great
thirst ; and also when the coughing causes an emission of urine, and
pain in the chest and loins, and when the patient, between the par-
oxysms, is in a comp,tose state, and cares not either to move or con-
verse ; and also when there is excessive weakness of the neck, so that
the victim is scarcely able to keep the head erect ; and also wlien
there is rash over the body, or face and hands. For the most severe
or convulsive stage of whooping-cough, give Belladonna^ when there
is pain in the head, or convulsions ; give Bryonia when the child
coughs immediately after eating or drinking, and vomits what he has
eaten, and returns immediately to finish hi^ meal, and then coughs
and vomits again ; give Chamomilla when the cough and vomiting are
more frequent during a meal, fretful disposition, and worse at night ;
give Caustieum when the cough is better, and when it is dry and hol-
low ; give Hyoicyamus when the patient is worse lying down, and bet-
ter on sitting up ; give Arnica when the patient feels sore from
coughing. After the cough subsides, and there is any sequel left
behind, give whatever remedy is indicated, as Aconite for fever, Nux
vom. for constipation. Phosphorus for catarrh, China for extreme weak-
ness, etc. If there is no loss of appetite, allow a substantial diet in
all the stages of the disease. Change of air is very beneficial, even if
but a short journey from home, especially to the searshore.

Diphtheria.

An exudative inflammation of the throat, during the progress of
which a dirty, grayish membrane is exuded upon the tonsils, and
often upon the pharynx and posterior nares. The disease is com-
monly ushered in by the following symptoms : chilliness, headache,
pains in the back and limbs, excessive prostration, fever, some diffi-
culty in swallowing, though not always, and offensive breath. Later
appear acrid lainning from the nostrils, or bleeding, as rather an un-
favorable indication ; swelling of the external throat ; and sometimes,
in very severe cases, vomiting or hoarseness, and other indications
that the disease is invading the larynx or trachea.

This disease is now almost universally considered in some degree
contagious, and for this reason the patient should be, so far as possi-
ble, isolated from those who are not in charge of the case. All his
excreta should be disinfected with a strong solution of Sulphate of
Iron at once. The room should be well aired constantly. The throat
should be gargled, to prevent decomposition, with glycerine and
water mixed, one part of glycerine to seven of water, to be used

ND REGIONS.

um is very suitable aftt'r
paroxysms come on at
y severe and suffocating'.
and Cuprum have betMi
quick pulse, and with a
the forehead, and great
m emission of urine, and
)atient, between the par-
fa either to move or con-
cness of the neck, so that
id erect ; and also when
is. For the most severe
> Belladonna, when there
Bryonia when the child
•;. and vomits what he has
;• meal, and then coughs
3 cough and vomiting are
tion, and worse at night ;
id when it is dry and hol-
i-orse lying down, and bet-
patient feels sore from
there is any sequel left
as Aconite for fever, Nux
, China for extreme weak-
llow a substantial diet in
is very beneficial, even if
o the seashore.

it, during the progress of
ed upon the tonsils, and
es. The di&eaae is com-
)m8 : chilliness, headache,
(stration, fever, some diffi-
d offensive breath. Later
bleeding, as rather an un-
lal throat ; and sometimes,
jss, and other indications
rachea.

onsidered in some degree
should be, so far as possi-
rge of the case. All his
g solution of Sulphate of
id constantly. The throat
tion, with glycerine and
ven of water, to be used

DISEASES OF VARIOUS ORGANS AND REGIONS.

681

ever *^wo hours, or oftener in severe cases. Small pieces of ice al-
loweu to dissolve in the mouth have a favorable influenci;. The pa-
tient's strength should he sustained by nourishing liquid food, such
as broth of beef, lamb, mutton or fowl; milk, or milk and raw egg;
oatmeal gruel; oystere, in cold weather, are allowable. Stimulant^j
are not recommended, except as a gargle, as much as formerly ;
though in severe cases, with alarming sinking of vitality, brandy in
small doses may do good, when repeated often.

Dangerous symptoms have resulted fi-om the patient being allowed
to sit up too soon. The membrane should begin to disappear on or
before the fifth day, else grave symptoms may be apprehended, such
as delirium, epistaxis, vomiting, croup, or paralysis of the heart. The
urine should be watched carefully, as albuminuria is generally pres-
ent in a mild form, and sometimes complicates convalescence, induc-
ing dropsical swellings, etc.

In severe cases the patient should exercise care against a relapse
for at least three months.

Be sure that your house is properly drained. Local filth is the
most common exciting cause of this dread and fatal disease.

For the benefit of those who cannot secure the advice of a compe-
tent physician in this grave disease, the following brief but trust-
worthy indications for its treatment are given : —

For the premonitory symptoms, such as chilliness, flushed face,
headache, backache and fever, Gehemium, ten drops in half a tum-
blerful of water, a teaspoonful every half-hour until the fever uub-
sides. Should there be no improvement in twelve hours, give Cimi-
cifuga in the same way. This remedy has proved of great service in
the hands of physicians of both schools. For the throat symptoms,
the most frequently indicated remedies are the several preparations
of Mercuriua, the Mercurius hiniod. taking preference, in water, and
repeated hourly. This, or the Mercurius cyanuretum, may be alter-
nated with Cimicifuga or Gehemium, or, later, in obstinate continu-
ance of the membranous exudate, with Phytolacca decandra. When
the breath is very putrid early in the attack, and the membrane of-
fensive, with fever, darkly flushed face, delirium, Baptisia is better
than Gehemium or any other remedy. Should the tonsils swell rap-
idly, and the throat and external face have a puffy appearance. Apis
mel. is indicated, in place of the mercurial preparations. It should
be given in water, hourly. Should croupous symptoms begin, indi-
cated by hoarseness, whistling breathing, dusky complexion or doughy
pallor, croupy cough, Spongia or lodium will be the main reliance,
together with the inhalations of the vapor of boiling water. Lache-
sis has saved cases of a grave type, which have resisted the before-
mentioned remedies. When bleeding from the nose becomes trouble-
some and alarming, the best remedy is Carbo veg., together with a
free local use of ice. The remedies should not be changed oftener
than once in twelve houra, as it is a disease slow to show improve-
ment.

-'•^«---»«r'.B«fK^- ^tm^ t i f .ttrnMi*

(Ks*r— (^""^

682

DISEASES OF VAKI0U8 OHGANS AND KEGIONB.

Homoeopathic Treatment of Diphtheria.

Two views have been taken with regard to the intimate nature
and cause of diphtheria. Most physicians regard it as an essential
fever, and are of the opinion that the local affections of the throat
and air passages are secondary, and are but local manifestations of
the special condition of the system, and that they have the same ic-
lation that the local affections of the skin and mucous menibiiuics
have to the eruptive fevers. They, however, admit that the general
disorder is increased and intensified by the absorption of the septic
mattera of the local disorder, thereby producing the blood-poisoning
of septicaemia.

The other view is what is called the germ theory. According to
this view, the disease is caused by a vegetable organization, whiili
naturalists call sphero-bacteria or micrococci, which, finding access to
the throat through the nostrils and the mouth, fasten upon the mu-
cous membranes of the tonsils and fauces, and produce an infiani-
mation which is characterized by the effusion of a fibrinous exu-
dation called diphtherite. This is not all : under the conditions
favorable for their life and growth they possess an enormous power
of reproduction. From this centre of infection these germs find
their way into the different tissues of the body, and acting as fer-
ments, give rise to deleterious chemical products which destroy life.
These vegetable parasites, according to this theory, are as inseparable
from the diphtheritic process as the bacteria of decomposition are
from putrefaction and decay. Without bacteria there can be no
diphtheria. In grave cases, these parasites are found everywhere, in
the smallest patches of membrane, and in immense numbers in the
different tissues of the body. They are the cause of embolism, of
metastatic abscess, and the intensity of the disease increases with
their number. These are the theories of diphtheria.

The duration of the disease depends upon its severity. The period
of incubation occupies from two to eight days. In mild cases the
membrane commences to be shed on the fourth day ; in severe cases
not before the tenth or twelfth day, and it may take four or more
days to finish it.

The membrane is detached in the same way as any sloi\gh or ne-
crotic tissue, by the process of suppuration. Whatever theory is
adopted, the local treatment is of primary and equal importance ; for
the mucous membrane of the throat, if it is the avenue through which
germs find entrance to the body, is also the generator of those irritant
poisons, the absorption of which contaminates the system and de-
stroys life. The object of the treatment is, fij:st, to put a stop to the
spread of the disease, and to bring about a retrogression of the in-
flammatory process, with the removal of the membrane ; secondly, by
the most perfect disinfection and antiseptic cleansing of the moutli

D UKGI0N8.

DISEASES OF VARIOUS ORGANS AND REGIONS.

683

f Diphtheria.

to the intimate nature
egard it as an essential
affections of the throat

local manifestations of
t they have the same ic-
and mucous membranes
', admit that the general
absorption of the septic
cing the blood-poisoning

a theory. According to
able organization, which
, which, finding access U>
th, fasten upon the mu-
and produce an inflani-
sion of a fibrinous exu-
l: under the conditions
sess an enormous power
fection these germs find
body, and acting as fer-
ducts which destroy life,
theory, are as inseparable
ria of decomposition are
)acteria there can be no
are found everywhere, in
immense numbers in the
he cause of embolism, of
le disease increases with
phtheria.

I its severity. The period
days. In mild cases the
arth day ; in severe cases
t may take four or more

(vay as any slough or ne-
lon. Whatever theory is
,nd equal importance ; for
the avenue through which
generator of those irritant
nates the system and de-
, first, to put a stop to the
a, retrogression of the iu-
B membrane ; secondly, by
c cleansing of the mouth

and throat, to prevent the absorption of injurious products of decom-
position from the surfaces of the diseased tissues.

In order to accomplish the above results, the local treatment by
the application of disinfectant and antiseptic remedies is now in vogue.

Cauterizing substances are considered hurtful and but seldom used.
I'lie most common remedies now resorted to are carbolic acid, sali-
cylic acid, permanganate of potash, chloral hydrate, sulphite of soda,
benzoate of soda and chlorate of potash. These various substances
iiave be(!n applied in solutions by means of a sponge or a brush, in
the foiin of spray, and in the form of a powder, taken dry into the
mouth combined with sugar.

I think that the best way to treat the throat is by the frequent in-
halation of a liot steam, applied in hourly sittings of about fifteen
minutes' duration. These may be medicated with chloride of sodium,
or the chlorate of potash, about twenty grains to the ounce. Such
fluids, steadily flowing over the surfaces of the mucous membranes,
wash away masses of mucus, remnants of food and other products of
decomposition. They assist nature's work of promoting suppuration,
which is the legitimate way in which these pseudo-membranes are
shed ; and by combining this treatment with the use of strong gar-
gles, composed of the solution of any of the above disinfecting sul>-
stances, we more completely prevent septic absorption than by any
other treatment ever used. The steam may be generated in any or-
dinary kettle, and conducted to the patient's mouth through any
suitable tube. Being careful not to have it too hot, an atomizer is
much better. The general treatment of the patient is, aa in every
other infectious disease, to be sustaining.

Tonics, sucli ?is sulphate of quinine and the tincture of the muriate
of iron, are also always indicated.

It has been claimed tliat alcohol conjoined with quinine, given
freely from the firet, is an effective curative agent. Alimentation is
an essential part of the treatment. The diet should be highly nutri-
tious ; milk and animal broths are of this class.

Patients affected with this disease should be at once isolated.
Thorough disinfection of the dejections, and of all articles which
have have been in contact with patients, and of the apartments which
they have occupied, is to be recommended, and all defects of drain-
age must be remedied.

In case of an attack of diphtheria no time should be lost, but a
physician should be called at once. In first stages I would advise a
trial of the Anti-Toxine treatment.

DROPSIES, HYDROPSIES.

A GENERAL swelling of the whole exterior snviace of the hody,
and a sensation of weakness, is termed general dropsy, because the
water infiltrates into the cellular or subcutjineous tissue all over tlie
body. Local dropsies' may affect the chest, abdomen, head, womb
and testes.

General Dropsy, Anasarca.

This is caused by cellulitis and infiltration of water into the areo-
lar tissue, causing one to swell all over the body. There is generally
some thirst and fever that ushers in general dropsy. Arsenicum m
the usual dose may cure the disease when it seems to arise trom a
low state of the system. When it is the sequel of scarlatina or ery-
sipelas, give Hellehorm nig. three times a day. If after a bilious
fever, give Mercunm viv. Following scarlet fever, Apu or Terebinth.

Dropsy of the Belly. — Ascites.
When inflammation of the peritoneum terminates in dropsy of the
abdomen. Apis mellifica may be given, (3very three or four hours, for
several days. If it fails of effecting a cure, Apocynum may be given
in the same way, and in like manner, Bryonia, Hellehorus mg. and
Arsenicum. Tapping is sometimes necessary, when the peritoneal
sack is filled with water, and does not yield to remedies.

Dropsy of the Chest, or Hydrothorax.

The cause of this affection is intlammation of the pleura, causing
an accumulation of serum in the pleural cavity. Apis mellifica in the
usual doses, repeated at intervals of three or four hours, will otteu
effect a radical cure, and so will Apocynum. If these fail, use ^ui-
phur.

Dropsy of the Heart.

This is an accumulation of water around the heart, in the cavity
of the pericardium. Spigelia or Apis mellifica will generally cure.
Sulphur is efficient in many cases. Bryonia, if from pericarditis or

rheumatism.

681

-O

DROPSY, IIYbKOPS.

685

PSIES.

IT surface of the body,
sral dropsy, because the
leous tissue all over the
;, abdomen, head, womb

sarca.

n of water into the areo-
ody. There is generally
L dropsy. Arsenicum in
b seems to arise from a
[uel of scarlatina or ery-
day. If after a bilious
fever, Apia or Terebinth.

— Ascites,

rminates in dropsy of the
' three or four hours, for

Apocynum may be given
mia, Hellehorus nig. and
,ry, when the peritoneal

to remedies.

iydrothorax.

)n of the pleura, causing
ity. Api% melUfica in the
or four hours, will often
. If these fail, use Sul-

art.

[ the heart, in the cavity
lifica will generally cure.
a, if from pericarditis or

Dropsy of the ^tsAn.— Hydrocephalus.

Inflammation of the brain may terminate in an effusion of serum
in the arachnoid cavity, and is often fatal, ffi/ogci/amua in the usual
dose, repeated four or five times a day, may prove beneficial. Apin
mellifiea has been employed in the same way, also Hellehorm.

Dropsy of the \Womh,—Hydrometra.

Inflammation of the womb often terminates in this affection.
Belladonna, Apis mellifiea., Arsevicum and Hellehorus nig. have been
eipployed against it.

Dropsy of the SctoiMm.^ Hydrocele.

This consists in the scrotum becoming filled with serum or water,
after inflammation and swelling of the testes. It may be caused by
gonorrhoea or it may be the sequel of scarlet fever. The same reme-
dies employed in other local dropsies may be employed ; or, these
failing, the water may be drawn off, and a weak solution of iodine
may be injected into the sack by a surgeon.

Ovarian Dropsy.

Inflammation of the ovaries is the cause of this diflficulty. Ar-
senicum yiSS. generally have a good effect, and so will Gonium and
also Apis melUfica and Pulsatilla ; either remedy in the usual dose
may be administered every three tours, with the prospect of relief.

"■ aMHMimJ t-'a».g""a -''

"_!■■

1/ •',■:""

INSIDIOUS DISEASES.

Malignant Pustule.

There is sometimes a low and vi Jated state of the blood, and so
powerfully predisposed to take a malignant, if not a fatal tendency,
that a very slight exciting cause will arouse a disturbance not easily
quelled. Such is believed to be the origin of what is iisually termed
" the Malignant Pustule, a small pimple upon the face, regarded of
little account by the person, who, unconscious of the vitiated condi-
tion of his blood, pinches it and irritates it. It begins to inflame ; a
determination of all the subtle impurities of the fluid takes place at
this spot ; and a malignant and disorganizing fever pervades the en-
tire economy, and, if not arrested, it runs a rapid course, and termi-
nates fatally often in a single day, or before any remedial agent can
be brought to bear to arrest the process. Pimples upon the face
should never be pinched or squeezed, for fear of inviting inflamma-
tion to the spot, that might react in calling up or setting fire to a
discrasia of a malignant quality. Individuals apparently well in the
morning have gone to business, and, ere another morning came round,
have found themselves fatally prostrated by this disorder. As soon
as suspected give Arsenicum every hour for three or four hours, and
then follow with Nitric acid ; and, if there is any indication of change
for the better, well ; if not, give Muriatie acid, or Lachesis. Just as
soon as any pustule upon the face begins to inflame like a boil, and
there are chilly rigors running down the back, retire to bed, take
Arsenicum, and a chp.nge in the febrile condition may take place for
the better, and the life of the patient may be saved. When the face
begins to swell and there is delirium, give Belladonna every half-
hour to hold in check, if possible, the tendency to the brain. After
Belladonna, give Ithus tax. Very many cases of "Malignant
Pustule " have been cured by a timely resort to proper remedies.
But celerity of action is required ; one moment's unnecessary delay
may be too hazardous for the patient. It is believed that the brain
and nervous centres elsewhere are most liable to speedy implication.
A resort to such remedies as will guard against these will undou^*
edly furnish the best protection. Consult Arsemcu/my Apis iruv.,
Bell., Graphites, Merc, Gonium, and Sidphur.

68fi

>aic>.iSK

INSIDIOUS DISKAUKS.

687

18E8.

le.

ate of the blood, and bo
if not a fatal tendency,
I a disturbance not easily
oi what is usually termed
)on the face, regarded of
lus of the vitiated condi-
It begins to inflame ; a
f the fluid takes place at
ig fever pervades the en-
rapid course, and termi-
I any remedial agent can
Pimples upon the face
ar of inviting inflamma-
ig up or setting fire to a
vis apparently well in the
ther morning came round,
r this disorder. As soon
three or four hours, and
1 any indication of change
cid, or Lachem. Just as
inflame like a boil, and
back, retire to bed, take
dition may take place for
36 saved. When the face
fe Belladonna every half-
lency to the brain. After
ly cases of " Malignant
esort to proper remedies.
»ment's unnecessary delay
is believed that the brain
ible to speedy implication,
gainst these will undou^^*
lit Arsenictm^ Apis tn^i'-,
ur.

Spotted Fever. — Fehris Petechialis,

This fever usually begins with great lassitude ; the patient feels
fatigued, and unable to l)e about ; and then a headache ensues, without
much fever ; the pulse is not much accelerated, the tongue is coated
with a dark or brown coating, nutrition becomes interrupted, and
rapid emaciation takes place. After a while, the patient begins to
Buffer from intense pain in the back and limbs; a cold chill comes
over him, and a febrile reaction, that is cliamcterieed usually by great
thirst, entire loss of appetite, and inclination to vomit. During the
fel.ile excitement, the skin becomes discolored, and red or purple
8i)ois appear in great numbers upon the surface of the body. This
is believed to be the crisis, and affords an indication of the malignant
character of the disease. For the most part, the patient lies in stu-
por, or perhaps at times evinces a low, muttering delir \m, and
inclination to pick the bed-clothes. The cause of this fever is sup-
posed to be some malaiious poison acting upon the blood. The prog-
nosis, or prospect of the result, is by no means favorable ; yet many
such cases recover under proper treatment. In the first stiage, when
the patient is complaining of great weariness and lassitude, give Arnica
every three hours. When the head begins to ache, give Belladonna,
and especially if there is any twitching of the muscles, or redness of
the eyes. If there is any derangement of the kidneys, following
checked perspiration, give Rhus tox. For the intense pain in the
back, give Belladonna, and follow with Verat. viride. When the cold
chill ensues, and the countenance looks pallid and sunken, give Carbo
vegetahilis. When the fever appears, and there is thirst, and incli-
nation to vomit, give Arsenicum, or perhaps Veratrum album, and
repeat the remedy every three hours. When the low, muttering de-
lirium shows itself, give Stramonium. Let the surface of the body
be rubbed gently with a crash or Turkish towel, and wet with tepid
water. If the patient becomes quiet, and the spots gradually begin
to disappear, and the coating upon the tongue begins to break up,
and a normal secretion upon the tongue begins to show itself, —
these are signs of convalescence ; and then it is well to give China,
and supply the patient with beef-tea or broth in moderate quantities,
and then with something more substantial, as he can bear it.

Cold Fever.

In some parts of the country, there has prevailed endemically a
kind of fever which at first makes its appearance with general pros-
tration and coldness of the surface of the entire body. The face ap-
pears as cold as marble, the nose pinched, the eyes sunken in their
sockets, the tongue covered with a thiijk white coating, no appetite,
Itut intense thirst. This cold stage lasts for a longer or shorter
period; and then it is followed by a febrile reaction, and the entire

r>88

INfliniOUS DIBRASRS.

h(»(ly becomes intensely heated, the pulae becomes quick and feeble,
the head and back bticomu the seat of pain for a while; and then all
these symptoms disappear, and another cold, sunken condition of the
system ensues, and sometimes the body is covered with a cold perspira-
tion, which lasts for an indefinite period, and then a more fierce febrile
reaction conies on again, and elevates the pulse and temperature of
the skin, giving a flushed appearance of the countenance, redness of
the eyes, and heat of the head; when a warm perspiration terminattis
the febrile heat, and then there gradually appears the coldness of the
surface again. These alternations of the extremes of temperature
upon the surface go on until a crisis occurs that terminates the life
of the patient, or the disease begins to wane. But, to mitigate the sev-
erity of the disease by treatment, in the cold stiige, give Carho. ve(/.
every four hours until the reaction commences, and then give Bryonia
or Rhus ; and these remedies raay moderate the reaction. If, in the cold
stage, the patient is stupid, y\\Q Belladonna ; after Carlo veff., and
and for the cold perspiration, ^rive Carbo animalia. At the recurrence
of the fever upon the surface, give Arsenicum and Bryonia. If the
patient has much heat in the liead, and is delirious, give Belladonna ;
and, until the coating upon the tongue begins to disappear, do not
thrust any food other than light gruel upon the patient, but as soon
as the natural secretion of saliva appears upon the tongue, give beef-
tea or good mutton soup, a little wine, and other nutritious stimu-
lants ; and as the appetite returns, increase the strength of the diet.
The same process of rubbing must be employed as in the Spotted
Fever. If the urine is turbid, give iVkc vom. If the feet swell dur-
ing the convalescence, give Artenioum, Apia met,, or Eellebore.

Putrid Fever.

This fever, as its name implies, emits an unpleasant or fetid odor.
It comes on much like those just described, only the breath appeal's
to be tainted with something of a putrid character, and very often
there are patrid discharges from the bowels. The urine has a putrid
odor ; and when there is any perspiration upon the surface, it has the
same smell. The disease comes on unobserved, and is attended with
lassitude and inappetency. There is seldom any noticeable cold
stage, and yet there is very little if any heat upon the surface.
The tongue becomes coated with a dark brown coating, and sordes
collects upon the teeth in large quantities. The pulse is feeble and
quick , the skin, for the most part, is dry and of low vitality. There
is often more or less pain in the bowels, and a distension of the ab-
domen. The urine is thick and high colored, and of an offensive
odor. The patient rejects all kinds of food and drink, except water ;
and this uniformly has to him a disagreeable taste. His nose is dry
and sore, and his lips become dt md cracked ; and sometimes a black
or dark-colored saliva runs out ux the corners of his mouth, which dis-

-i^AMftMUitaMi^

iNflimons msKA8E&

689

ecomes quick and feeble,
for a while ; and then all
, sunken condition of the
irered with a cold perspini-
[ then a more fierce febrile
julse and temperature of
i countenance, redness of
m perspiration terminattts
)pear8 the coldnes-s of the
extremes of temperature
that terminates the life
But, to mitigate the sev-
)ld stiige, give Carho. veij.
jes, and then give Bryonia
)he reaction. If, in the cold
%a ; after Carho veg., and
umalis. At the recurrence
rum and Bryonia. If tlu;
ielirious, give Belladonna ;
egins to disappear, do not
n the patient, but as soon
pon the tongue, give beef-
id other nutritious stimu-
the strength of the diet,
ployed as in the Spotted
»m. If the feet swell dur-
it's mel,^ or Sellehore,

a unpleasant or fetid odor,
id, only the breath appeai-s
character, and very often
Is. The urine has a putriel
ipon the surface, it has the
3rved, and is attended with
idom any noticeable cold
ly heat upon the surface.
brown coating, and sordes
i. The pulse is feeble and
md of low vitality. There
md a distension of the ab-
)lored, and of an offensive
)d and drink, except water;
ble taste. His nose is dry
ced ; and sometimes a black
ers of his mouth, which dis-

colors them, and gives to his pale and sunken countenance a distress-
'"K appearance. The progress of this fever is slow and low, and
often terminates in ulceration of the bowels. There is from the first
a labored respiration and a putrid breath. For the conuuencing
stage give Arnica ; if this fails to relieve the symptoms in twenty-four
hours, give Baptisia ; when the mouth becomes dry and the lips
(tracked, and the sordos collects upon the teeth, give Nitric acid, and
follow with Argenicum ; when the patient complains of pain in the
bowels, and there are putrescent discharges from them, give Phos-
phorus ; if there is involunttvry and painless diarrha-a, give Phos-
phoric acid ; in case of great prostration, give Arsenicum, followed in
twelve hours, if no relief, by Muriatic acid. Putrid fevers are often
fatal, and especially where a putrid diarrhoea is kept up by the fever.
For the distension of the abdomen, give Nux ; for the thick and of-
fensive urine, Sulphur, Carbo vet/., or Arsenicum ; should the putrid
stiige pass off, leaving the patient prostrate, give China, wine, egg-
nog, and even a little brandy to keep up the vitality of the system.
The sooner any one recovering from this fever can take light, solid
aliments, tho better.

-.,-»::. ij^-i: ..'TtOf

MISCELLANEOUS DISEASES.

Relapsing Fever.

A FEVER has lately made its appearance in some of our large
cities, having all the characteristics of a common typhoid tha. appar-
ently passes through all its stages, and then reproduces itself,
and the same round occurs again. 7 ach siege lasts about se. 'en
davs Several of these in succession make the condition ot the pa-
tient precarious, and the prognosis unfavorable. The treatment is
with stimulants, and the usual remedies for low fevers, such as Ars.,
Carbo vegetabilis, Bryonia, and Rhus tox. Doses as usual, and repe-
tition of the remedy selected, every three hours. A stimulating diet
always required.

Black Tongue.

In warm climates and in a low country, there are biliary derange-
ments, accompanied with low fever, and a black coating upon the
tongue. This is what is termed the Black Tongue. Carho veg. has
been given freely, even the crude powder, a teaspoonful at a dose.

Black Vomit.

This is another bilious disease, that results from superabundance
of carbon in the blood, and a wretched derangement of the liver and
stomach, which causes copious vomitings of black bile. ArBmicum,
given every hour, has remedied this difficulty. After the vomiting is
arrested by the use of Arsenicum, give Carbo veg., China, Khm, or
Bryonia. Whichever remedy is selected by the indications should
be repeated every hour or two hours, until complete recovery takes
placef As soon as the patient can take nourishment, give beet-tea
and other nourishing soups, and then more solid aliments.

Nightmare. — Incubus.

The characteristic symptoms of this distressing condition are semi-
consciousness, and a sense of inability to extricate one s sell trom
some imaginary weighs, or seizure. It may be caused by some detect

690

MISCELLANEOUS DISEASES.

691

8EASE8.

ce in some of our large
imon typhoid, that appar-
then reproduces itself,
siege lasts about se^'en
! the condition of the pa-
rable. The treatment is
low fevers, such as Ars.,
Doses as usual, and repe-
ours. A stimulating diet

there are biliary derange-
, black coating upon the

Tongue. Carbo veg. has
J, teaspoonful at a dose.

lilts from superabundance
angemen\; of the liver and
f black bile. ArsHnicim,
ty. After the vomiting is
hrbo veg., China, Rhus, or
by the indications should
1 complete recovery takes
[lourishment, give beef-tea
3 solid aliments.

cuhus.

ressing condition are semi-
extricate one's self from
y be caused by some det'ei;l

in the circulation or indigestion. The sufferer is generally supposed
to be asleep ; but in some cases, he knows when persons are about
him, and yet, unless he is spoken to or moved, or by effort himself
can voluntarily move his foot or hand, he is liable to remain spell-
bound, under a sense of weight or oppression. To relieve one when
thus affected, turn or shake him. The remedies that may be em-
ployed to prevent nightmare are Aconite, when there is a feverish
condition of the system ; Nux vomica, when there is indigestion ; and
also Pulsatilla and Sulphur,

Hysteria.

This is a name applied to a great variety of nervous derangements,
that for the most part are dependent upon nervous debility. It may
manifest itself in an irresistible inclination to weep or laugh ; some-
l/iraes in fainting and spasms, shortness of breath, screeching and a
sensation of choking. Aconite will sometimes quiet the nerves ; Ig-
natia, if there is an inclination to weep ; Hyo»cyamu», if inclined to
laugh ; Pulsatilla, if connected with the menstrual period. For hys-
teric mania, Hyoscyamus, Stramonium or Belladonna. Either of the
remedies may be given in the usual dose, and repeated every two Ox
three houi-s until relief is obtained ; and it is also recommended that
such persons ride out in the open air and seek change of scene.

Hydrophobia. — Babies.

The bite of rabid dogs is productive of this disease. The poison
communicated by the bite may remain in the system for an indefinite
period ; and then all at once, the sight of water or some polished
meta^ will throw the victim into indescribable distress and madness,
which are apt to increase and terminate in death. A dread of water
is an unmistakable sign of the disease. When one is bitten by a rab-
id animal, the effect may be extinguished by an immediate resort
to cauterization. A heated poker brought as near to the wound as
possible without contact is l^lieved to be effectual in destroying the
poison ; or the application of Nitrate of Silver immediately may also
have the same effect. Hydrophobia has been cured by the persistent
use of Belladonna in the usual dose, repeated every hour or two
hours for several days ; Hyoscyamus may also be employed in the
same wp" ; Cantharis has been recommended as an antidote to rabies.
Lachesis, and even copious draughts of whiskey, have been found
useful. Nothing however, has been found more salutary as an im-
mediate resc. t than dry or radiating heat, unless the patient is
immediately under the Pasteur treatment, which operates on
theory that rabies is a germ-disease, and has proved very successfi..
Tliere is a special hospital for the Pasteur treatment in New York
City

(

AFFECTIONS OF THE MIND.

It is well known to physiologists, that soundness of mind, as well
as entire soundness of body, indicates a condition of perfect health.
The two are so intimately blended, that one can hardly exist without
the other, and vice versa. An unsound condition of the physical sys-
tem is often attended with manifest unsoundness of mind. It is not
intended to include the mental phenomena frequently attendant on
acute fevers, as in nervous, scarlet and other fevers, but such only as
appear to exist as the chief symptom of disturbance in the entire sys-
tem ; and we will begin with simple

Mental Derangement.

What is understood by mental derangement is a disordered mind,
which may have been occasioned by one or more of a variety of causes.
It is indicated by irrational expressions of illusory notions, incoherent
ideas, strange fancies, and not infrequently by vicious inclinations.
There is, nevertheless, some specific cause for every case of mental
alienation that occurs ; and the treatment has to be adapted with
reference to the cause, when there is a chain of circumstances that
indicates it. Nevertheless, the cause is not always apparent, and
therefore particular symptoms must be our guide in affiliating reme-
dies. When insanity takes the form of rage, and the patient appears
to be governed by angry and revengeful feelings, and is inclined to
utter imprecations and threats towards his best friends, give Aconite
in daily doses. If his face appeai-s flushed, an^ his eyes suffused, and
exhibit a fiery red appearance, give Belladonna. If in a scrofulous
subject, give Caloarea. If strange fancies seem to beset the patient,
or complaints are made of illusory sights, give Hyo%cyamu». If the
patient is inclined to run away from home, or hide in soi-ic secret
place, give a dose of Sulphur, and follow with a few doses of Stra-
moniwm every three or four hours. If the patient seems depressed,
and sighs frequently, give Laehesis. If much distress is evinced,
and there is defective nutrition, give Nux vomica. For violent rage,
followed by soporific sleep, give Opium. If the patient laughs and
talks continually, give Hyoscyamus ; or if given to crying, sobbing or
constant weeping, give Ignatia. If the patient is subject to cold

692

.1^,:',

AFFECTIONS OF THE MIND.

693

[E MIND.

undness of mind, as well
dition of perfect health,
can hardly exist without
ition of the physical sys-
iness of mind. It is not
frequently attendant on
r fevers, but such only as
irbance in the entire sys-

lent.

lent is a disordered mind,
lOre of a variety of causes,
lusory notions, incoherent
r by vicious inclinations,
for every case of mental
has to be adapted with
lin of circumstances that
lot always apparent, and
guide in affiliating renie-
B, and the patient appears
jlings, and is inclined to
best friends, give Aconite
m^ his eyes suffused, and
m,na. If in a scrofulous
seem to beset the patient,
rive Hyo%cyamu8. If the
I, or hide in sOiie secret
ith a few doses of iitra-
patient seems depressed,
luch distress is evinced,
omica. For violent rage,
f the patient laughs and
iven to crying, sobbing or
atieut is subject to cold

sweats, give Veratrum. If thirsty, give Arsenicum. If there is great
weakness and prostration, give China. If, during p-iroxysms of rage,
there is intense perspiration, give Mercurius. Disposition to suicide,
Aurum. None of the medicines need be repeated oftener than twice
a day. Great care should be taken to keep the stomach of the pa-
tient at ease, by furnishing for it light but nutritious food.

Mania ProduceU by Depression of Spirits.

Protracted Qrief. — Extreme mortification or chagrin, or intense
anger, may end in mental derangement. When grief wears out the
^ind, and strange fancies begin to show themselves, give Ignatia.
When great mortification on account of some exposure to censure or
on account of some humbling of family pride, give Pho». acid. When
disappointment unsettles the mind, and chagrin gives rise to insane
imaginings, give Pulsatilla ; or, if there is a manifest inclination to
hide away from friends, give Sulphur, and follow, in four or six
hours, with a dose of Hyoscyamus. If the face is red, and the temples
beat and throb, give Belladonna. When excessive anger and general
moroseness of spirit ensue, with general antipathy towards every one,
give Sulphur^ and, in six hours, follow with a few doses of Nux vomica.

Mania from Excited Emotions. .

The mind is often beset with emotions of one kind or another, that
often tend to unsettle and derange it. Anguish or foreboding often
has this disastrous effect, and one of the principal remedies is Aconite.
If there is an attending inclination to weep, give Ignatia. If there is
dullness or stupor, give Opium, or if in females, give Pulsatilla. If
mania is produced by fright, give Aconite, Coffea or Nux vom. When
fear unsettles the mind, give Lachesis, Hyoscyamus, Gelsemium, Opium
or Pulsatilla. When excessive joy produces derangement of the men-
tal faculties, and gpives rise to strange fancies, give Coffea, Opium or
Punatilla. When homesickness unsettles the mind, give Phos.
acid. When fancied neglect of friends distracts the imagination,
give Causticum or Capsicum. For unhappy love, and the derange-
ment of mind consequent thereon, give Hyoscyamus, Ignatia or Pho»^
phoric acid, or, perhaps, Coffea or Nux vom.

If disappointed affection or any cause produces the mania of sui-
cide, give Aurum. If excessive jealousy ends in mania, give Hyos-
cyamus. If rage ensues upon insults, give Veratrum alb.. Belladonna
or Chamomilla ; if upon contradiction, give Aconite, and afterwards
Ignatia or Nux vom. For thj concomitant symptoms of insanity
from excited emotions, give Aconite when there is headache, feverish
heat or tendency of the blood to the head. Give Belladonna when
there is loss of consciousness, or constant anxiety, with fear, weeping,
howling and malice (in children), and also when Aconite and Opium

694

AFFECTI0K8 OF THB MIND.

had proved insufficient for the consequences of flight Gi^ 3 Bryonin
when there is chilliness and shuddering over tlie whole body, gieat
tendency to vehement anger, loss of appetite, nausea, vo iting und
bilious state in consequence of anger. Give Cajmeum fo- sleepless-
ness caused by homesickness, with heat and redness of iie cheeks.
Give Chamomilla when anger produces bitter taste of lae mouth,
nausea, disposition to start, and vomiting of bilious mati;er. Give
Coffea when there is much nervous excitement after great joy. Give
Ooloeynth when chagrin or mortification produces spasmo^nc colic or
cramps. Should this condition persist, give Causticum. » Hve Hyo»-
cyamui when fear produces stupefaction or convulsions, :' nvoluntaiy
laughter during sleep, or a desire to run away. Give Ignatia for
grief, disappointment, or unhappy love, when there is deep, gnawing,
irresistible grief, vomiting, headache, vertigo, pale face, convulsions
or epilepsy, and in children when they occur from the sho'k of fright
or fear. When homesickness, fright or mortification is atl '. nded with
great anguish, restlessness and trembling, or sudden stii ting from
sleep, or accelerated circulation on the least exertion, si aplessness
and inability to bear the warmth of the bed, great ner /ousness, a
disposition to be quarrelsome, and to complain of everyl ody as being
hateful, and the patient takes a dislike to his own family, and wishes
to leave them, and also when there is shivering and night-sweats,
give Mercurius. Give Nux vomica, when, after an angry fit, there is
chilliness'without heat. Give Opium when diarrhoea follows exces-
sive joy or fear, or when a sudden start or fright produces sudden
and involuntary diarrhoea, with heaviness of the abdomen. For
chronic diarrhoea from fright, Oehemium. Give Phosphoric acid in
all cases after deep grief, homesickness, or unhappy lov<^. when the
patient is taciturn, dull or listless, and has a constant de^ .le to sleep,
and has night-sweats towards morning, after hectic fever sa the even-
ing. Give Pulsatilla when fear produces cold hands and feet. Give
Veratrum album when any emotional excitement produces diarrhoea
or involuntary evacuations from the bowels, with coldness of the
whole abd.omen.

Morbid Emotions.

A CELKBRATED writer on insanity considers all morbid emotions
under this head, £.nd for this reason : that all morbid states of the
mind may become so augmented as to result in complete mania or
monomania. It is, therefore, well to understand the best method of
bringing remedial action to bear upon the first departure from sound
health of any faculty or emotion of mind. For anguish or anxiety,
no remedy seems better adapted than Arsenicum, to be given morn-
ing and evening, or perhaps, Pulsatilla for females at the menstrual
period, or Veratrum album for very weak and exhausted persons.
For apprehension or fear, give Aconite morning and evening, espe-
cially if the ^ufEerer is a plethoric, full-blooded person. Give Bdlor

IND.

AFFECTIONS OF THE MIND.

695

of fright. Gi\ iBryoin'ii
er the whole body, git'at
te, nausea, vo iting iiiid
e Capsurum fo- sleepless-
d redness of tie cheeks,
tter taste of me mouth,
of bilious maioer. Give
ent after great joy. Give
)duces spasmo'-ic colic or

Causticum. < Hve Hyos-

convulsions, involuntary

away. Give Ignatia for

m there is deci), gnawing,

JO, pale face, convulsions

r from the sho'k of fright

tification ia ati'. nded with

or sudden stii ting from

ist exertion, si oplessness

bed, great ner .'ousness, a

ain of everyl^ody as being

is own family, and wishes

ivering and inght-sweats,

after an angry fit, there is

diarrhoea follows exces-
r fright produces sudden

of the abdomen. For

Give Phosp^tric acid in
[• unhappy lov -. when the
a constant de .ve to sleep,
r hectic fever va the even-
sold hands and feet. Give
ioment produces diarrhea
els, with coklness of the

IS.

iders all morbid emotions
; all morbid states of the
ult in complete mania or
rstand the best method of
first departure from sound
, For anguish or anxiety,
miavm, to be given mom-
' females at the menstrual
k and exhausted persons,
orning and evening, espe-
oded person. Give Bfll<tr

donna to one who suffers much from ht-adache, or rush of blood to
the head ; or Bryonia if there is anxiety, with heat of the chest and
difficult respiration ; or Hyoscyamus for anxiety about one's safety, or
religious anxiety; or Opium for a kind of anguish and depression of
spirits that confuses one's ideas, and is attended by a stupidity and
headache. When one is constantly vexed and irritable, it may be in-
ferred that a corresponding physical condition requires Arsenicum
once or twice a day, or perhaps Nux vomica. Jynatia is suitiible when
there is a tendency to be vexed, and to Aveep on account of trifles.
For one always in hiiste to get angry without reason, give Aurum or
Sulphur. When one is morbidly suspicious and distrustful, and, in
fact, is a hater of his fellow-men, and wishes to avoid every one, and
to spend his time in seclusion, give Arsenicum^ Hyoscyamus, Pulsa-
tilla or Rhus tox. For nervous excitement, which may lead to men-
tpl derangement, give Aconite or Pulsatilla; and especially if there
is great tendency to start. For a morbidly malicious disposition,
give Belladonna^ Hyoscyamus and Lachesis. For a disposition to kill
somebody, or to commit acts of violence, give Stramonium, Bella-
donna or Veratrum alburn^ morning and evening until a change. For
a morbid disposition to be audacious or impertinent, give Ignatia,

Opium or Sulphur. For headstrong obstinacy and disposition to be
quarrelsome, give Belladonna, Nux vomica, Ignatia, Lachesis and

Veratrum. For an artful disposition or an involuntary disposition
to practise deception with no definable motive, give Lachesis and
Nux vomica. When the mind is either beset with fancies or fixed
ideas, give Belladonna, Cocculus, Stramonium or Sulphur. For sad
and melancholic fancies and forebodings, give Calcarea, China or
Pulsatilla, and Petroleum. For a morbidly serious, silent and un-
talkative disposition, give Belladonna, Hyoscyamua and Pulsatilla.
For morbid indifference and apathy, give Arsenicum morning and
evening, or else Phosphoric acid. Sepia and Sulphur, in daily doses.
Moaning and lamenting without any special cause indicates a degree
of insanity that demands prompt attention ; and Hyoscyamus may be
given three times a day, or else Chamomilla, Coffea or Ignatia. De-
spondency, despair and being tired of life, as well aa an inclination
to suicide, are severally affections of the mind that are subject to
medical treatment. Arsenicum may be given morning and evening
for despair. Lachesis for despondency, especially where there is sigh-
ing, as if something awful was weighing upon the mind. For incli-
nation to commit suicide, give Aurum and Arsenicum, especially if
there is great anguish, melancholy and morbid disgust of life. For
one simply tired of life, and anxious to get out of this world by natu-
ral death, give China., Lachesis or Nitric acid. For illusions and illu-
sory notions, showing mental difficulties, give Lachesis, China or Pul-
satilla. Many of these mentjvl difficulties are the result of selfishness
or mortified self-love, and can be overcome by strong determination
of the will and moral training, which, of couree, involves more or
less of self-denial.

696

AFFECTIONS OF TllK MIND.

Religious Mania.

Tms mental affection is simply a morbid excitation of religious
sentiment and feelings, producing strange and fanciful ideas of God,
heaven and the importance of certain missions to which the victims
believe themselves specially called. Religious mania is characterized
by morbid inclination to be always singing, praying, preaching and
performing religious rites, out of time and place, and in a discon-
nected and incoherent manner. The cause of this mental affection
may be excitement upon religious t-opics, or during what is ordinarily
tenned religious revivals. The effect of anything of the kind is to
unsettle the healthy condition of the nerves and that of the nutritive
system. For religious mania in general, give Hyoscyamus or Stra-
monium ; for that which is attended with indigestion, give Nux vom-
ica; for that which is accompanied by torpidity of the liver and mel-
ancholic temper, give Arsenicum, Mercuriv%, Podophyllin and Ignatia.
Let the patient avoid all surroundings calculated to unsettle the mind
or emotions.

Hypochondria. — Hypochondriasis.

Pixel classes hypochondria among the various forms of insanity,
as it is characterized by morbid imaginings concerning one's health.
Sometimes the victim imagines himself void of strength, or sadly dis-
eased at the heart ; he fancies he sees death staring him in the face,
and believes himself often in a dying condition, when, in fact, there
is not the slightest reason for such apprehension. In the future, all
is darkness : the next hour, the next day, week or year, is believed by
him to be pregnant with something awful. He never enjoys a laugh,
for everjrthing is 'clothed in gloom. If the subject is of a bilious
temperament, and has black hair and eyes, give Mcrcurius ; if of a
lymphatic temperament, and inclined to obesity, give Pulsatilla ; if
of a sanguine temperament, and has red hair and blue eyes, g^ive Nux
vom. ; if addicted to the use of intoxicating liquors, give Arsenicum
or Nuz vom. ; if of a downcast countenance, and subject to indiges-
tion, give Ifux vomicoj Lycopodium or Petroleum. If caused by sex-
ual abuse, give China or- Sulphur ; when caused by sedentary habits,
Nux vomica and Sulphur, or if by derangement of the abdominal func-
tions and constipation, give Calcarea, Lachesis or Lycopodium ; for
one suffering from languor, mental dullness, or mental distress and
discouragement, give China. If the victim has the fixed idea that
he is unhappy and has no friends, and imagines himself surrounded
by enemies, China is also the remedy. For a hypochondriac troubled
with weak digestion and distension of the abdomen, ill-humor and
indolence after eating, give China ; when he laments on account of
the future, and desires to be alone, give Natrum muriaticum ; when
he is beset with ill-humor, despondency and aversion to life, give Nux

AFFECTIONS OF THK MIND.

697

excitation of religious
i fanciful ideas of God,
18 to which the victims
I mania is characterized
praying, preaching and
place, and in a discon-
►f this mental affection
aring what is ordinarily
thing of the kind is to
nd that of the nutritive
ve Hyo»cyamu8 or Stra-
ligestion, give Nux vom-
ity of the liver and mel-
°odopkyllin and Ignatia.
«d to unsettle the mind

ondriasis.

nous forms of insanity,
loncerning one's health,
of strength, or sadly dis-
staring him in the face,
ion, when, in fact, there
sion. In the future, all
k or year, is believed by
le never enjoys a laugh,

subject is of a bilious
^ive Mereurius ; if of a
38ity, give Pulsatilla; if

and blue eyes, give Nux

liquors, give Arsenicum
!, and subject to indiges-
\eum. If caused by sex-
ised by sedentary habits,
it of the abdominal func-
e%is or Lycopodium ; for
, or mental distress and

has the fixed idea that
ines himself surrounded
k hypochondriac troubled

abdomen, ill-humor and
3 lamfents on account of
itrum muriatioum ; when
aversion to life, give iVkr

vomica ; when with painful anxiety of mind and lowness of spirits.
Sulphur ; when he has great dread of death, and is in restless, whin-
ing mood, give Aurum; if indifferent about his business or his own
family, give Sepia. Any of the remedies named may be given three
times a day.

Weak Memory.

There are many conditions of the physical system that may oper-
ate to impair the memory ; the most prominent of which are those
that produce debility, — such as loss of blood and other animal fluids,
and intense application of the mind. When occasioned by the former,
give China, Nux vom. and Sulphur, in daily doses ; when by the lat-
ter, Nux vom., Pulsatilla or Sulphur; if caused by external injuries.
Arnica or Rhus; if by inebriation, Arsenicum, Opium or Nux vom.;
if caused by violent emotions, as fright, grief or anger, give
Aconite, Opium, Phos. acid ; if caused by dampness, give Oarbo vc;/.,
Rhus, Veratrum album; if by rush of blood to the head, give Bella-
donna. In nearly all instances of weakness of the memory, it is con-
nected with some form of debility. That following epileptiform dis-
ease requires Sulphur; that following childbirth requires China; and
also weakness of memory following an acute fever, or any other
prostrating disease, requires China, Ignatia, Nux vom, and Arsenicum.
Give the remedy selected twice a day.

Hysteric Derangement.

The ordinary forms of hysteria sometimes degenerate into insan-
ity. The nervous system becomes shattered, and such patients be-
come tormented with all kinds of fancies, — sometimes sexual, frivo-
lous and even foolish. For hysteric insanity in general, give Ignatia,
Phosphorus or Platina ; or, if attended with uterine derangement,
give Aurum, Crocus or Sepia; for those tormented with excessive
sexual fancies, give Phosphorus, Pulsatilla or Platina ; if the patient
acts foolishly, with much frivolity and levity, give Apis mel.; if fitful,
laughing at one time and crying at another, give Crocus or Stramo-
nium; if there are marked heavings of the chest, give Phosphorus;
and if the bowels are constipated, persistant and tedious, give Lyco-
podium; if in any way connected with the menstrual function, give
Pulsatilla ; if the patients are prone to lie and deceive, give Veror
trum- album; wlien they evince an insane paasion for work, give
Lachesis and Hyoscyamus ; when full of suspicion and distrust, give
Hyosnyamus, Mereurius and Pulsatilla ; if excited excessively in body
and mind, give Aconite and then Nux vomica, after which give Phos-
phorus or Lachesis ; if disposed to be imperious, and exliibit a passion
to order their friends about, give Lycopodium or Cuprum; if they
betray a tricky and malicious disposition, give Nux vom. ; if there is
great obstinacy, give Belladonna, Ignatia ; if disposed to hide or be

698

AFFECTIONS OF THK MIND.

alone, give Calcarea ; if on the contrary there is a mania for company,
and a dread of being alone, give Arsenieum^ Lycopodium, Phoaphorun
and Belladonna ; for great loquacity, give Stramonium; if excessive
mirthfulness, give Hyoscyamus ; if there is a disposition to obscenity,
and a great want of modesty, give HyoHeyamus, Phosphorun or Vera-
trum; if there is a great disposition to sing, warble or whistle, give
Belladonna or Stramonium ; if there is a disposition to make faces
and cut antics, give Cuprum or Stramonium ; if there is a disposition
to scold or swear, give Lycopodium ; if given to self-importance and
pride, give Cuprum to men and Platina to women. Let whatever
remedy is selected be administered twice a day. Diet should be
moderate, and easy of digestion.

Imbecility.

Loss of mind, as well ais the derangement of its faculties, comes
under the head of mental difficulties. There are several causes that
may operate to destroy the intellect. Epileptic fits will in time ren-
der the brain an unfit organ for the mind, and consequently there can
be but little power or force in the mental manifestation. A soften-
ing of the brain that may supervene upon inflammation is also at-
tended with imbecility. Self-pollution is also a fruitful source of
mental weakness. Congenital idiocy results from causes not possible
to describe ; but many a bright child has become the victim of idioiy
by the mal-treatment it has had in tlie nursery. To quiet crying
children resort has been had to a variety of sedatives, instead of ex-
ercising patience, to initiate them into sleep and quietness. How of-
ten do nurses give poppy or lettuce-tea, to put a crying infant to
sleep, little dreaming that they inflict a permanent injury upon the
mind of the child. The effect of paregoric, soothing-sirup and poppy-
cordial is often disastrous, and the source of spasms, fits or convul-
sions that impair the tender textures of the brain so much, that, even
if the children live, they are apt to be the victims of imbecility.
Fear and fright also are causes of imbecility. If epilepsy is the cause,
give Cuprum or Sulphur in daily doses, or else Belladonna^ Ifelleborus,
Lachesis, Hyoscyamus or Opium. If caused by a softening of the
brain, there is not much hope of the patient deriving much benefit
from remedies. There is only a bare possibility that the difficulty
may be arrested. Hyoscyamus, Sulphur and Apis mel. may do some-
thing to ward off total and hopeless idiocy. When imbecility is
caused by onanism, give Arsenicum or China twice .a day ; when by
sexual excesses, give Nux vomica every evening, and Sidphur every
morning ; when from the effects of opium, a persistent coui-se of I'e-
storative treatment must be decided upon. Give Coffea, in usual
doses, every three hours ; give also Sulphur, in the full strength of
the tincture, in drop doses ; also, give Ammonia curb., and when from
the use of other narcotics, give J^ux vomica or Jgnatia,

ND.

3 is a mania for compiiny,

Lycopodium, Phosphorus

Stramonium; if excessive

i disposition to obscenity,

mu8, Phosphorus or Vera-

T, warble or whistle, give

lisposition to make faces

; if there is a disposition

en to self-importance and

o women. Let whatever

a day. Diet should be

nt of its faculties, comes
sre are several causes that
eptic fits will in time ren-
id consequently there can
manifestiition. A softeu-
. inflammation is also at-
also a fruitful source of
3 from causes not possible
jcome the victim of idiocy
lursery. To quiet crying
f sedatives, instead of ex-
p and quietness. How ol-
io put a crying infant to
jrmanent injury upon the
soothing-sirup and poppy-
of spasms, fits or convul-
) brain so much, that, even
the victims of imbecility.
y. If epilepsy is the cause,
ihe Belladonna^ ffelleborus,
jed by a softening of the
int deriving much benefit
isibility that the difficulty
id Apis mel. may do sorae-
ocy. When imbecility is
ina twice .a day ; when by
/ening, and Sidphur every
, a persistent coui-se of re-
on. Give Coffea, in usual
Mr, in the full strength of
monia curb., and when from
?a or Jgnatia,

AFKKCTI0N3 OK TIIK MIND.

Monomania.

699

This term signifies insanity upon a single matter, when in every
other respect the mind is sound. ♦When a single idea seizes the mind,
and morbidly dwells there, however erroneous, it is difficult to dis-
lodge it. Sometimes a most singulaf and absurd idea will be cher-
ished ; as that one is dead. Dr. William Rush once had a patient in
Pennsylvania hospital, who claimed to be dead ; and, after exhaust-
ing his ingenuity to convince him of the contrary, he told him ab-
ruptly that he was dead, and should be buried ; for he would not
have his stinking remains there to pollute the room any longer. This
had the tendency to fire up the anger of the pretended dead man ;
and, on cooling down, this singular illusion left him. The treatment
of monomania is for the most part moral. It. is never prudent to con-
tradict the patient, or to show disfavor to any absurd idea that may
be besetting him, but rather to indulge him in it. A celebrated
French writer on this malady says of a case at the Mnison des Inva-
lides, that he fancied that if he urinated, it would cause a flood ;
and, after finding that the patient must die unless there was an evac-
uation of the bladder, the attendant hit upon the idea of crying
" Fire ! " and exclaiming at the top of his voice that the city was on
fire, and wanting in water to extinguish it, said to the patient, " to
let the flood come " ; it was wanted to save the city from ruins ; and
this appeal had the desired effect. For a mania to kill some one per-
son, under the idea that it must be done, Arsenicum has apparently
proved to be a remedy. In a case quite similar, Lachesis proved of
great service. For some of the fixed ideas in monomania, remedies
may have a good effect. When one has the idea of being great above
all created beings, give Aconite or Conium. When orte has an idea
that he is hated, and his mind appears sound in other respects, give
Aurum or Ignatia. When he is tormented with the idea that his
family or friends are all conniving against him, and appears sane on
other subjects, give Sulphur and then Nux vom. If he seems right
on all questions, except that his mind is cogitating theft, so that he
has an irresistible inclination to steal when occasion offers, give Sul-
phur^ Pulsatilla.

SURGICAL DISEASES.

Concussion of the Brain.

This is the result of a fall or blow, and may be relieved by Arnim,
usual dose, and repeated if necessary. Should stupor and uiability
to retain food persist, try Glonoin.

Concussion of the Chest.

This may be produced bysome sudden mechanical injury. If there
is fever, give Aconite every three hours. If from having been com-
pressed mechanically, Arsenicum may prove serviceable ; and so may
Arnica, PuUatilla, and Nux vomica, Bryonia, and Ohma. Any ot the
remedies selected may be given in the usual dose every three houi-s.
In all cases let the diet be simple, and use friction externally; and
when there has been a blow upon the head causing the concussion,
pour a stream of cold water from a small pitcher or cofiee-pot tor
thirty or forty seconds.

Sprains.

A SPRAIN may be more or less severe. Sometimes it may impli-
cate only the muscles, and at others the ligaments, involving the ap-
paratus of the joints. A sprain of the wrist requires Arnica, inter-
nally and externally at first, and then a compress of tepid water,
covered with a dry bandage. A sprain of the hip-joint or shoulder-
joint requires Ledum, with a lotion of the same of twenty drops to
half a tumbler of water, applied by means of wetting with it a com-
press, covered with a dry bandage. A sprain of the knee-joint should
be treated with Arnica, externally and internally, as above, and also
with Pulsatilla after. Sprains of the ankles are soonest cured by
applying compresses of cold wat«r, and dry bandages over them, and
by the administration of Ledum internally. Should this fail, use
Bryonia.

Injury of a Nerve.

The place which Arnica has in surgery in the treatment of ordinary
bruises and sprains is of no greater importance than that of Hypen-

700

8UKOICAL DI8KASE8.

701

ASE8.

Brain.

nay be relieved by Arnim,
luld stupor and inability

Chest.

lechanical injury. If there
[f from having been coni-
3 serviceable ; and so may
I, and China. Any of the
x\ dose every three hours.

friction externally; and
,d causing the concussion,

pitcher or coffee-pot for

Sometimes it may impli-
jaments, involving the ap-
ist requires Arnica, inter-
compress of tepid water,
the hip-joint or shoulder-
same of twenty drops to
of wetting with it a com-
m of the knee-joint should
ernally, as above, and also
ties are soonest cured by
■f bandages over them, and
ly. Should this fail, use

rve.

a the treatment of ordinary
bance than that of Hyperi-

sionlf'f '''"'t? ''PP^''^ ^"'^""^^y ^ ^"J""«« involving the nerves
Shocks upon the nervous system, injuries to the sninf, or fronTex

ruTdCandluor ^ ^^^^^'-^ ^"^-"^ -^ «--4"in the

Wounds.

WotjNDs are of various kinds ; such as incised, lacerated Duno-
tured, gun-shot wounds, etc. A simple incised wound Ss on Ivtht
sides pressed together, and compressed with a strirT adhes ve
planter. The application of Calendula externally will^acilitate he

T^T ^\"^.r'r^ ^'"""l^« ^'^^"'^^ «"^«f"l adjusLent and dressing
and then let the Iressing be wet frequently with a dilute tinctuTof
Oalefula; and where it is supposed the trunks of ne^es are -mP"
cated use Ilypencum. Any of these remedies may be used intemX
in the usual dose, three times a day. Contused wounds reSe com

cZZ^^^i'"'-'^' ^""^ ^m^ca/ while Arnica, Muta, ^TLpZ-
cum may be administered in the usual form internally. ^^

Hemorrhage from Wounds.

nJ^/^J^^I protracted hemorrhage from wounds, give Amicd or
(7afeni«/a internally, and, with a lotion of forty dr^p^ of eiTher L
half a tumbler of water, wet compresses, and apply externally

Hernia, or Rupture.

There are two kinds of rupture met with among peraons One is
termed the femoral, and is near the groin; and fnSr i^ termed
umbilical, and is near the navel. There is a third kind whme the
Trnif T.^ into the scrotum; and it is temed scrSl or tig^^^^^^^
hernia When either has been of long standing, well-adjusted trusses
must be worn or else for scrotal hernia, a susp;nsoiy £kg^
recent inclination to rupture. Aconite will subdue any inflammato^
symptoms. Arnica, if caused by a strain ; Nux vomica TZl.?f
constipation of the bowels. The^emedies ^sSca ed i; be^ven
m the usual dose three or four times a day. For stranguTted hSZ
iVk...m every half-hour; and if this affords no relif,^^^^^
same. Lycopodzum and Sulphur follow these well, given thfeeTiiZ
daily. Ihe patient should be in a recumbent post^fe uporflhe Zt.

Luxations, or Dislocations.

These consist in the removal of the head of the bone from its cor-

a th?i?"^ "t'J'/'i"". *^" ^''^'- ^f*- dislocatToilsT
duced, the joint may be bathed with a lotion of forty drops of the

tincture oi Aconite in half a tumbler of water, whi Jfour^gloUes

may be used internally to allay any febrile excitement. " Arnica lotion

' '.iiafe«ajfi!««*se'«-

».*•,-»•-'■■—■

702

SURGICAL DIHKASES.

prepared and used in the same way will relieve the soreness. The
usual dose of this remedy may be administered internally, and re-
peated two or three times a day. To remove the pain and suffering
of luxations in general, Arnica, Aconite, and Rhus tox. may be given
- as required.

Fractures.

When there is a separation of bony fibres, either simple or com-
plicated, and the fracture has lieeu properly reduced and bandaged,
and splints have been culled into requisition to aid the system in re-
covery from the shock, give two or three doses a day of Arnica in-
ternally, and wet the bandages with a lotion of the same. If there is
fever, give Acoriite or Bryonia.

Bums and 5calds. ,

By a bum is understood a sore or blister caused by dry heat. By
scald is understood that produced by some heated fluid, as water,
spirits or oil. The former is soonest relieved by the application of
cotton, provided the skin is not broken. The latter by cotton dipped
in lime-water. If the skin is broken, it will be necessary to use, in
each instance, a salve made of lard and finely preiwired carbonate of
lime. In all cases of burns or scalds, internal remedies are required;
Aconite, in case of much fever ; Arsenicum, or Qantharia, if there is
much burning, smarting, and thirst; Apis mel., if there is swelling,
and inflammation following as a sequel.

•

5nakc Bites.

These are to be treated somewhat after the manner of the bites
of rabid animals : that is by dry or radiating heat at first, and then
by cauterization ; internally, Lacheais, Apis mellifica and Hyoscyamus.
Either may be given every two hours ; at the same time, there is
good authority for drinking copiously of whiskey or other alcoholic
spirits. Several drops of tincture of Iodine, repeated every fifteen
minutes, have saved some cases.

Stings of Insects.

Aconite, Belladonna, Merc, viv., are remedies for internal adminis-
tration, either of which may be given three times a day ; Arnica lo-
tion, weak solution of Nitric acid, or Lemon juice, may be applied
externally. Dilute Aqua ammonia is a good antidote iis a lotion.

The Removal of Tumors.

Nearly all tumors require removal with the knife. It is not our
purpose to specify tne nature of the operation, but rather to point out

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WEBSTER, N.Y. 14580

(716) 872-4503

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i^_^

SURGICAL DISEASES.

703

a treatment to be pursued after their removal. When cancerous
tumors are removed, Arsenicum should be persistently given, every
three or four hours, with the view of preventing the cancerous dia-
thesis, or condition from reproducing the same. Where fibrous tu-
mors are cut out, give Calendula three or four times a day, and apply
it to the wound. Adipose tumors require, after their removal, Pul-
satilla, three or four times a day. Fungous tumors require, after re-
moval, Oaioarea. The fungoid or medullary tumors are mainly
subject to medical treatment, and various remedies may aid in curing
them. Oonium, Arsenicum, Sulphur, Cuprum met, and Calcarea may
be consulted. Encysted tumors are embedded in the skin, and re-
quire dermic treatment. Nitrum, Natrum muriaticum, and Natrum
carh. may be employed, internally and externally. Scrofulous tu-
mors require Arsenieum, Graphites, Juglans regia, and Calendula,
The two last named may be used internally and externally. Scrof-
ulous tumors require Arsenicum, Graphites, and Calendula. The
two last named may be used internally and externally, several times
a day.

Lumbar Abscess.

A VERY malignant sore, that discharges a cheesy matter, and from
which very few recover. Calendula, Hepar sulph. and Mereurius
may be given internally, and Calendula, Baptisia, and Arnica may
be used in the form of lotions, to apply externally.

Ulceration of the Bone.

Fob bone ulcers, Aurum met., Silicea, and Calcarea may be g^ven in
daily doses, — one remedy only at a time: Aurum met, for bone
ulcers caused by syphilis ; Silicea, if from injury ; Calcarea, if from
scrofula. For idceration of the hip-joint, Arsenicum, three times a
day ; of the knee-joint. Sulphur, or perhaps Pulsatilla, twice a day.

Rickets. — Rachitis.

DisOBDEB of the nutritive functions may end in distortion of various
parts of the S3r8tem, and give rise to various deformities of the head,
trunk, and extremities. Remedies directed to the digestive system
must first be employed, in order that a healthy nutrition may be es-
tablished. Nux vomica, Pulsatilla, Ferrum and China, either of which
may be given in the usual dose three times a day ; after which, Cal-
carea carh. may be given in daily doses peioiatently, followed by
Silicea Good animal food may be allowed ?a a diet. Frequent
bathing with s<alt water, and friction, are also to be commended.

White Swelling.

This is a form of scrofula, and requires the same remedies used in
other scrofulous complaints. Arseniown, Jodium, Calcarea and Sul-

704

SURGICAL DISEASES.

phur may be employed ; and whichever remedy is selected may be
gfiven twice in twenty-four hours. Pulsatilla, Bryonia and Nux vom.,
in like manner, may be gfiven, one at a time, and repeated every four
hours, when there is any pain in the affected joints.

Dropsy of the Joints.

Friction externally, and some kind of soap liniment, and then the
application of compresses. Apia meUifica may be given internally,
every four hours, or else Pulsatilla, Arsenicum, Bryonia or Conium,

5tiff Joints. — Anchylosis.

This diffioully involves the tendons, ligaments, and bones, which
in some instances become united at their extremities. These joints
may be showered with cold water, rubbed with a stiff brush, bathed
witili soap liniment ; while Sulphur, in daily doses, may be given in-
ternally, or else Aurum mur.. Nitric acid, or Jodium.

Aneurism.

Aneitbisms are pulsating tumors formed of arterial blood. Aconite
is a good remedy to administer, three or four times a day ; Digitals,
also, in the same way ; Valerian, in the usual dose, when the tumor
appears to be in the abdomen. For Vabicosb Aneurism, bandaging
is required, while Samamelis virg. may l^e administered internally.

Varicose Veins.

When lihe entire lower extremities are involved, bandaging with
a roller, or lace stocking, must be employed, while Hamamelis Virg.
is administered several times a day, internally. Pulsatilla, for preg-
nant women thus affected, and follow with Lycopodium, after three
weeks.

Qoitre. — Bronchocele.

This is an enlargement of the thyroid gland, and causes a swelling
of the neck. Jodium, externally and internally, is said to be a sure
remedy. Kali hydriodicum, the usual dose three or four times a day,
may also be used. Spongia is also a valuable remedy, and so also are
Merc, tod., Merc, hiniod. The remedies must be used persistently
until the goitre disappears.

Wry Seek. — Torticollis.

Tma is owing to the contraction of some of the cervical muscles.
Stimulating liniments may be employed externally, while Nux vom,,
Rhus, Sulphur, Bryonia^ or PuttatiUa may be administered inter-
nally.

^sEa

r remedy is selected may be
satiUa, Bryonia and Nuz vom.^
time, and repeated every four
:eoted joints.

Joints.

)f soap liniment, and then the
fica may be given internally,
aenioum, Bryonia or Conium.

inchylosis.

, ligaments, and bones, which
sir extremities. These joints
jed with a stiff brush, bathed
daily doses, may be given in-
d, or Jodium.

aed of arterial blood. Aconite
r four times a day ; JDigitalk,
i usual dose, when the tumor
BI0O8E Aneurism, bandaging
\>e administered internally.

eins.

are involved, bandaging with
iloyed, while Hamamelis Virg.
emally. Fulaatilla, for preg-
Mrith Lyoopodium, after three

ichocele.

d gland, and causes a swelling
internally, is said to be a sure
dose three or four times a day,
luable remedy, and so also are
3S must be used persistently

SURGICAL DISEASES.

Fistula in Ano.

705

This difficuliy requires Silicea, Calcarea, or Sulphur, in daily
doses. If an operation has been performed, and the Sphincter ani
has been divided, Arnica may be given three or four times a day, or
perhaps Calendula ; after whioh, consult Pulsatilla and Niix vom.

'^orticollis.

some of the cervical muscles.
1 externally, while Nux vom^
I may be administered inter-

:. Iri

DISEASES OP INFANTS.

Crying.

When a youtiff infant is inclined to cry continually, and sleeps
but little, give it one or two globules of Uoffea or Chamomtlla and
repeat every four hours.

Colic.

FoK infantile colic, which maybe caused by flatulence, give Cham-
omilla; put one or two globules upon its tongue. If this does not
relieve, give a globule of Nux ; if restless, and throws up its food,
after th^ Nux, give a globule of Coffea. (Terat album is an excellent
remedy for infantile colic, and Dio^corea has a great reputation.

Infantile Diarrhoea.

There will generally be a diarrhoea after an infant has nursed the
first-fruits of the breast. If excessive, give one or two globules of
Puluatilla; if attended with colic, give the same of ChamomtUa ; it
the diarrhoea is acrid or scalding, give Arsenicum, one or two glo-
bules ; if with excessive vomiting, give Ipecac.

infantile Dysentery.

When young infants are observed to strain, and have frequent
stools, and sometimes pass mucus and blood, give Ipecac., one globule,
or else Mercurius. If they cry out after each stool, and the intestine
protrudes, give one or two globules of Ignatia If they refuse the
Ct, giy! Aconite. In case of heat in the head, give Belladonna.

Inability to take the Breast.

Some infants are congenitally opposed to nursing the breast; and
all the coaxing and trying which a patient perseverance can supply
avails but Uttle. Such infants require to l^ fed; and to devise toi
them a good and wholesome nourishment is sometimes ditticu t.
The nursing-bottle must taKe the place of the breast, and the child

706

DISEASES OF INFANTS.

707

IPANTS.

cry continually, and sleeps
Ooffea or (Jhamomilla and

jd by flatulence, give Clmmr

tongue. If this does not

38, and throws up its food,

V'erat. album is an excellent

has a great reputation.

'hcea.

fter an infant has nursed the
rive one or two globules of
the same of Chamomilla ; if
Arsenicum^ one or two glo-
Ipecac.

itery.

o strain, and have frequent

lod, give Ipecac., one globule,

each stool, and the intestine

Ignatia. If they refuse the

the head, give Belladonna.

he Breast.

d to nursing the breast ; and
!nt perseverance can supply
bo l>e fed ; and to devise foi
went is sometimes difficult,
of th3 breast, and the child

must be nourished by it. One of the best preparations of food for
young infants is a thin gruel made of a tiible-spoonfiil of unbolted
flour to a quart of water, to he boiled half an hour, and then strained
through a tine strainer, sweetened, and put into a nursing-bottle suf-
ficiently thin to flow through the tube. This food may be enriched
with a little good milk, as the child requires it. Nothing has so uni-
formly answered as a substitute for the breast, though many of
the so-called Infants' Foods are good, such as Mellin's or Nestl^'s. It
is often necessary to try several before one is found that will per-
fectly agree with the infant.

Infantile Jaundice.

Young infants sometimes become yellow, and their skin affords
evident signs of jaundice. One or two globules of Mercurim viv.,
followed by one or two of Pulsatilla, will change this condition. If
frequent discharges from the bowels occur after these remedies, give
one or two globules of Arsenicum.

Snuffles.

In cold weather, young infants are prone to take cold easily, from
the slightest change ; and they will show it by sneezing and snuff-
ling : occasionally there will be indications of fever, and heat in the
head. One or two globules of Aconite may be given tirst, and then
one or two of Nux vomica. If there is thin discharge from the nose,
give a globule or two of Arsenicum. Sambucus, twice daily, is a good
remedy.

Sore Mouth. — Aphthae.

Considerable uneasiness is manifest in young children from a per-
ceptible inflammation of the mucous membrane of the mouth. It
will look red and inflamed, and there will be perceptible some little
points or pimples of a whitish character. Give one or two globules
of Mercurius or Bryonia, and wash the mouth with warm tea, or
milk and water. Some have introduced into their mouths a little
powdered Borax. This difficulty is generally of brief duration, and
is but a trifling malady.

Thrush.

This is also a sore mouth to which infants are subject, and a little
more serious in its character. The child first has fever, and then
refuses to take its food. On examining the mouth, it is found to
contain a number of white blisters that have a sore and inflamed
appearance. One or two globules of Phosphorus will often cure the
trouble. Bryonia has also been used. Mercurius viv. may also be
used. A decoction of black tea may constitute a wash ; also a weak

if!; : H

708

mSKASlS OF INFANTS,

solution of Borax. Good nursing, and care to prevent taking cold,
are essential. If with this kind of sore mouth there is diarrhoea, give
one or two globules of Arsenicum. If the child cries much from
colic, one or two globules of Ooloeynth may afford relief.

Red Qum.

When an infant is one or two days, or a week old, there occurs
an eruption all over the body of a bright red appearance, that prob-
ably itches, and causes the child some suffering. A couple of glob-
ules of Pii/satt'^^a night and morning will suffice to cure the difficulty.

Retention of Urine in Young Infants.

This difficulty occasionally is observed, and is attended with much
restlessness and inquietude. An infant should urinate eight or ten
times in twenty-four hours ; and, when there is a failure in this le-
spect, give one or two globules of Hyoscyamus, and repeat every three
or four hours until the derangement is obviated. When Hyo»cyamu%
fails, give a globule or two of PuhatiUa or AconiU.

Teettiing, Dentition.

Whxn an infant has attained the age of four or six months, the
period of teething commences. The child begins to drool, and is rest-
less and uneasy, and frequently cries out with pain. At times the
cheeks will be red, and the head will be hot ; or else there will be
diarrhoea, and the food will pass the bowels undigested. The child
is geuiBrally fretful and uneasy. The most effectual remedy for the
restlessness and irritative fever is Chamomilla. Two or three glob-
ules may be given three times a day. When the head is hot, and
the child thrusts its fingers into its mouth, give it two globules of
Belladonna ; when the food passes undigested, give two globules of
PuhatiUa. When there is a general heat of the body, and demnged
condition of the stomach, give two globules of Aconite ; if this fails
to relieve in twenty-four hours, give Qimicifuga every hour.

Summer Complaint, Cholera infantum.

During the heat of the summer, teething children are proue to be
affected with a prostrating diarrhoea, sometimes watery, at others
dysenteric, when the stools are tinged with blood. In the first stage,
when there is considerable fever and watery discharges from the
bowels, two or three globules of Aconite may arrest the difficulty, fol-
lowed by Tartar emetic ; if the discharges are profuse and frequent,
Veratrum album ; if there is much thirst, Arsenicum. For discharge
of mucus, gfive Mercurius; when tinged with blood, give Ipecac.
The dose of either is two globules. When there is coldness of the face

DISEASES OF INFAKTS.

709

and extremitieB, give Carlo veg. If, in spite of these remedial meas-
ures, the disease nonti»iues, let t.ho child be taken into the open air, or
into the country, or better, to the seanshore. A trip upon salt water in
a steamboat has frequently resulted in a favorable change in the con-
dition of the child. The diet, aside from nursing, should be mutton-
broth and beef'tea, or perhaps arrowroot or farina gruel.

Marasmus, Extreme Emaciation.

FKOMthe combined effects of teething and interrupted nutrition, and
aleo from diarrhoea, the child will lose its flesh in a remarkable degree,
and nearly all the adipose or fatty tissues will soon disappear. The
bones of the face will become prominent ; the eyes will sink into their
sockets ; the skin will be shrivelled and loose over the entire body, and
very marked upon the upper and lower extremities. The most
prominent feature of the disease is interrupted nutrition ; and often
the cnild's stomach rejects the simplest kind of food. When there
is continual retching, give Ipecac.., to allay the irritable condition of
the stomach ; and then give Calcarea ; or if, at first, there is no nau-
sea, but thirst, give Aneniemn. Svlphur is a valuable remedy, and
also Ferram. When either beef-tea, or barley-gruel, or any other
kind of light soup or g^el, fails of being retained upon the stomach,
a gruel made of the flour of the yelk of a hard-boiled Qgg has supplied
the want of nourishment, and promoted the recovery of marasmus
pctients. When the child is old enough to feed himself, the yelk,
boiled hard, may be broken in a saucer, and seasoned with a little
salt ; and the child will pick it up a little at a time and eat it. But
if otherwise, to a pint of boiling water add a half-pint of fresh milk
and the flour of one yelk, seasoned with salt, and sweetened. This
makes a gruel that will flow through a nursing tube.

Hiccous^h. — Singultus.

This annoying difficulty reisults from the irritation of the dia-
phragm and the oesophagus, or passage from the mouth to the stomach.
Nux vomica. Ipecac, Pulsatilla, and Sambueus, have been employed
as remedies. A single dose of two globules of either may be admin-
istered when infanta are so affected.

Convulsions, Fits.

Thebe may be various causes of these convulsions in infants. A
fever, an irritable stomach, teething, or cold, may produce them ;
when from fever, give two globules of Aconite, and in two hours fol-
low with a dose of two globules of Belladonna. When from an ill-
conditioned stomach, give Ohamomilla, Ipecac., or Ignatia ; when from

710

DISEASES OP INFANTS.

colli, Nux vomica, or Sulplmr. When tho convulsion comea on with
vomiting, Ipecac. ; when from colir, Puhatilla or Colocynth ; wlien
with inclination t(> sleep, Opium,o perhaps Stramonium : when from
the sudden disappearance of any rush or eruption. Cuprum.

Excoriations.

The tender and delicate skin of infants is liable to become excori-
ated from the slightest causes. To relieve the pain and suffering
attendant upon it, give two globules of Chamomilla, Menrurius viv.,
or Pulsatilla internally, and wash them with a weak solution of Arn-
ica or Uamamelit externally. Should this condition persist, give
Sulph daily.

Soreness behind the Ears.

When a chil(^ is teething, and there is considerable of the fever of
dentition, an eruption is liable to show itself behind the ears ; and,
although this eruption is believed to be effectual in preventing more
serious disease of the head, it is, nevertheless, an uunecessary disease.
Graphites may be given to remedy the difficulty, a single dose in
twenty-four hours; and, in like manner, Arsenicum^ Calearea, and
Baryta Carb.^ may be employed.

Prickly Heat.

DURIKG intensely hot weather, children are liable to break out
with prickly heat. The stomach at first seems slightly deranged,
and the eruption upon the surface appears to be an elimination of
some internal disorder. There is sometimes much fever and head-
ache ; for this, give two globules of Aconite. If the child is teething,
give Chamomilla. If the surface becomes red and inflamed give Ehu»
tax. If burning and smarting, give Arsenicum. In case of severe itch-
ing, give Sulphur. When children are taken out by their nurses on a
hot day, they must not be exposed to the heat of the sun : shade
should be sought for them, where, if any air is stirring, they can get
the benefit of it.

Millc-Crust. — Porrigo.

This is a scabious eruption upon the scalp of nursing infants, which
at first appears to be a hurtiid scurf. It collects as a slight humor,
and begins to enlarge, involving more and more of the surface, until
that of the scalp is entirely covered. It is a source of annoyance to
mothers and nurses. There appears to be great difficulty in keeping
the affected surface clean, and consequently a hasty resort to some
drying wash has wrought disastrous effects. When milk-crust is
suppressed, the irritation is apt to fall upon internal organs, and
produce worse affections. The tar and sulphur ointments, which

DI8EASE8 OF INFANTS.

711

have l)een too frequent a reaoi-t, have had the effect, in some measure,
to diHsipate the eruption ; but the usual sequel to this are convul-
sions, or fatal brain diseases. It is, therefore, recommended as the
most prudent course, to depend upon the internal administration of
riMnedies such as eliminate the humor, and keep it upon the surface.
The purer the blood can be kept, the sooner will the disease disap-
pear. If no attention is paid to the use of external agents, the en-
tire difficulty will be eliminated and dissipated in the course of a few
months. Two globules of Aconite may be given when there is fever,
and this may be followed for a while with daily doses of Mhux tox.
and Bryonia. In scrofulous cliildren, give Calcarea, Arsenicum, or
Sulphur. In debilitated constitutions, give Oraphites, Ferrum, Hepar
sulph. and China. Lycopodium, three times daily, has cured most
obstinate cases. All oily food should be withheld. Butter is not
allowable. After children have been weaned, and still tlie milk-crust
remains, a farinaceous food is best.

Scurf of the Head.

This is an accumulation upon the scalp, of an oily and dirty
appearance, which, in many cases, is the result of not being particu-
lar in washing and wiping the head dry. Soap should never be used
upoa the scalp, and strong alkaline solutionf, are injurious. Water
softened with corn or rye meal will answer all the purposes for cleanli-
ness. As the difficulty does not penetrate below the external skin,
Rhi» tox., Pulsatilla, Calcarea, and Silicea are remedies, either of
which, in daily doses, will be all that is required.

Scrofulous Swelling: of the Salivary Glands.

This is a disease somewhat common to children of scrofulous par-
ents ; and it is of the utmost importance to understand well its charac-
ter and treatment. When these child).-en take cold, the glands are
apt to become excited, and there is a perpetual flow of saliva from
the mouth ; at the same time there will be soreness of the throat, stiff-
ness of the neck, and swelling of the glands externally. Sometimes
children will carry their heads to the right or left shoulder, when
laboring under the difficulty ; and, in spite of the best efforts to re-
lieve them of suffering, they will continue indisposed a long time.
Two or three globules of Aconite will subdue the initial fever. Mer-
eurius viv. may then be given two or three times a day. If this fail
to arrest the salivation, give Nitric acid for a day, at intervals of six
houra. Belladonna also may be given to remove any congestion of
the throat. Silicea may be given afterwards to aid in softening the
glands. Also, Nuz vomica and Sulphur may prove to be useful rem-
edies. The children should be kept in a room of moderate tempera-
ture, and not be allowed at any time to be exposed to extremes of
heat and cold until they have fully recovered.

■I 1

712

DISEASES OF INFANTS.

Sleeplessness of Infants.

Infants are sometimes Hinitteii with inability to sleep, as well as
adults. The cause is not always known. It is believed, however,
to be the result of some disorder acting upon thdir delicate nerves ;
suck as indigestion, excoriation, or overloading their stomachs. If
from an irritable stomach, give them Chamomilla or Coffea every
night. If from any excoriated surface, that burns and smarts, give
two globules of Arsenicum, and then "apply to the excoriated surface
a little rye-flour, or Lyeopodium powder, aud soothe them to sleep in
a quiet and noiseless room. If the sleeplessness is produced by re-
tention of urine, give Hyo»cyamu»; if by worms, Cina. If the head
is hot, give Belladonna. If the sleeplessness is from feeding the
child too much, give two globules of Pulsatilla, if from constipa-
tion of the bowels, give Nux vomica or Lycopodium at night. Tf
these remedies fail, a tepid bath will often consummate the desired
result.

DISEASES OP WOMEN.

Deratig:enient of the Function of Menstruation.

From the age of puberty until the change of life, the health of
the female system depends upon regular menstruation, varying in
intervals from twenty-six to twenty-nine days. With this standard
in view, the irregularities as to time are easily noted. By the period
of puberty is understood the age capable of bearing children, which
is denoted by menstruation taking place.

Ailments at the Ag:e of Puberty.

Immediately preceding the first menstmal period the breasts
inci-ease in size, the voice is changed, the system becomes rapidly
developed and the wind matured. There may be headache, dullness
of the eyes, pains in the lower abdomen, lassitude, capricious appe-
tite, and, not unfrequently, a premonitory leucorrhoea. To relieve
these ailments. Aconite ; four globules may be given first ; Puha-
tilla may be given after Aconite, to remove the pains in the abdomen,
and to promote menstruation. If there is much pair and the func-
tion is tardy in making its appearance, give Calcarea or Sulphur, and
then follow with Puhatilla every four or six hours until the period
commences. In case of considerable leucorrhoea, give Sepia, or per-
haps Qraphites. When the periods become established they should
last from three to five days. If scanty at first, give Ferrum, and
follow with Puhatilla ; if there is intense headache give Belladonna ;
if there is hysteria and much agitation and suffering, give Hyoscya-
mu8 ; and during the interim let the youag lady take strengthening
food until signs of the recurrence of another period. If it comes on
normally, it is well ; but if tardy or painful, resort again to Puha-
tilla, Hyoioyamus, Belladonna and Graphites, as they may be indi-
cated ; and continue this treatment from time to time until regularity
is established. If tardy, with pains in the back, Kali carb.

Interrupted Mens'' nation.

This may be caused by cold, fright, fovers, diarrhoea and dysen-
tery, and by pregnancy. When by cold or getting the feet; wet^

713

■"fF-

714

DISEASES OF .WOMEN.

Aconite, at first, to remove any febrile excitement or neadache, and
then Pulsatilla. If this fail to remove the obstruction, give Calcarm,
and follow with Nux mosehata ; should this fail, try Sulphur.
When menstruation is interrupted by fright, and there is intense
headache, give Aconite, and follow with Belladonna or Ignatia, and
finally with Pulsatilla. When fevers weaken and depress the system,
so as to interrupt the function, first .educe the fever, and then, by
properly nourishing the patient, the period may return. The same
rule may be observed ia treating the interruption caused by diar-
rhcea or dysentery. These diseases should be treated and cured by
appropriate remedies, and the period will be likely to return sponta-
neously. If otherwise, resort may be had to Pulsatilla, Belladonna,
Sepia, Oalearea, and other remedies, according to indications.

Excessive Menstruation.

When the flow is excessive or weakening. Ipecac, and China may
be employed, — the first to regulate, the last to strengthen the sys-
tem ; and this treatment will be found necessary at each period, until
duly regulated. Calcarea should be given once daily between the
periods.

Menorrhagia, or Profuse Bleeding from tlie Womb.

This indicates a want of tone in the uterus, if not a state of dis-
ease, and is usually attended with fainting, pain in the back, nausea,
and hysteria. When from a want of tone, or debility, China or
Ferrum may arrest the diificulty; if from disease or inflammation,
Belladonna or Arsenicum ; when there is fainting and nausea. Ipecac.;
pain in the back, Nuz vomica, Nux moschata, or Ignatia, especially if
the flow is dark or almost black, with fainting and drowsiness ; for
hysteria give Hyoscyamus. The patient should lie in bed until
relieved, and should begin sitting up with great caution. A generous
diet, easy of digestion, should be supplied patients of this description.
When the strength will permit, this class of patients should seek
fresh air, and should avoid warm baths. Bathing with tepid water
is far better.

Painful Menstruation. — Dysmenorrhoea.

Some ladies suffer intensely at every menstrual period. They
have chills, headache, fever, colic, and most excruciating pains in the
womb. Aconite must be given for the fever. Belladonna for the
chills ?ud headache, Colocynth for the colic, and for the pains in the
uterus, Hyoscyamus, Pulsatilla, Oimieifuga, or Rhus.

Ailments attending Change of Life.

This occurs about the forty-fifth year of life, and is denoted by
irregularities, -— profuse menstrual periods, great irregularities, pain

' I

DISEASES OF WOMEN.

716

in the head, melancholy, mania, loss of memory, and great nervous
depression. For profuse menstruation at this period, give Arnica or
Lachem; for headache. Belladonna or Sepia; for intense pains in the
womb, Arsenicum and Conium ; for Melancholy, Lachem, or per-
haps Petroleum; for mania, /Stramonium; for loss of memory,
Sulphur, China, or Qalcarea.

Ailments during Pregnancy.

Some ladies are troubled much with morning sickness in the early
stage of pregnancy, and this is often cured with Oooculu% or Nvx
vomica; if- with heartburn, Oimicifuga or MercuriouB viv. ; if with
water-brash of a hot or acrid nature, Arsenicum. Sometimes these
derangements are so stubborn that no remedies seem to relieve.
pimple syrup, by the wineglassful, has been taken by some, chamr
pagne wine by others, ,i,ard cider by others. The simple resort will
sometimes relieve ; and at others nothing seems to afford relief.
Discharge of blood from the uterus may be cured with China.
Leucorrhcea, very profuse and debilitating, requires Sepia twice a
day; corroding discharges, Calcarea twice a day; for rheumatic
pains, Caulophyllum ; for paiinful breasts, bathe with Phytolacca;
for threatened miscarriage. Ipecac., Sabina, China, Arsenicum, and
Belladonna; for sleeplessness, Nux vomica or Ars., and a light diet
at night ; for nose-bleed, Carho veg.. Aconite, Belladonna, Lacheaia^
and Mercurim, a dose of any one of them twice a day.

■■■I

LABOR, PARTURITION.

False Pains.

These is a kind of pain that afflicts parturient women, thai?
simply aggravates and unsettles the nerves. Cimieifuga or Cavlo-
phyllum will usually control this. When true labor pains commence,
they may be regarded as normal if they come at regular intervals,
and increase in force and frequency as the labor progfresses. No
medicine is needed ; and waiting, with patient labor, will accomplish
the object. After the child is born, a dose of Fuhatilla will aid in
expelling the placenta. If there is hemorrhage, elevate the hips and
depress the head, and give a dose of Secale comutum ; if anything
more complicated occurs, call on an experienced midwife.

Milk Fever.

About the third day after labor, there is a struggle in the system
to fill the breasts with milk, attended with fever. Give Bryonia or
PulaatUla ; if the milk is tardy in coming, give Oaloarea.

Difficult Urination.

After labor, there may be a difficulty in passing u-ine, which
Arsenicum or Hyoscyarmis will usually relieve, if aided with cloths
wrung out of warm water applied to the region of the bladder ; or
else Aconite may be used instead of Hyosoyamus, and sometimes
PiUaatilla, or Oantharis.

Soreness after Delivery.

A PAINFUL soreness of the muscles after delivery may be relieved
by the internal administration of drop doses of Amiea in a spoonful
of water, while at the same time a towel wet with Arnica tincture
may be applied to the abdomen. If there is soreness of the vagina,
forty drops of the tincture of Calendula, in half a pint of tepid water,
may be used as an injection.

716

..M?

LABOR, PARTURITION.

717

Constipation of the Bowels.

This condition after labor may be removed by one or two doses of
Nvs vomica, or perhaps by the use of Lycopodium ; if they fail, the
bowels should be moved by an enema of warm salt water.

Excoriated Nipples.

Soon after the breasts fill with milk, and the child begins to nurse,
tlie nipples are apt to become r^'itive, and sometimes exceedingly
sore. For a little sensitivent^s, or slight irritation, bathing the
breasts with a solution of Arnica will help them ; or perhaps a solu-
tion of powdered Borax will do as well. If the soreness amounts
to a decided inflammation, and the exterior of the nipples crack and
bleed, a more careful and efficient treatment is needed. When put-
ting the child to the breast excites great pain in the gland, and
severe after-pains at the same time, the internal administration of
Belladonna is necessary, — two or three doses during twenty-four
hours ,■ and, at the same time, wet a compress with Amida tincture^
and apply to the nipple. Arnica also may be given internally.
When Belladonna faik, Bryonia, when the pains are worse in damp,
cold weather. As an external application, a decoction of Oak-bark
has been found useful, and also the same of the Apple-tree root. A
solution of Alum, Tannin, or Sulphate of zinc, has been employed ;
but if the skin is cracked, and blood oozes out every time the child
nurses, it is of little service. A weak solution of Mtric acid is
better, two drops to an ounce of water. The best external applica-
tion for healing the cracks is the CHycerole of aloes, which is made
by dissolving one ounce Aloe» in four .ounces of Glycerine. This is
the best preparation known to heal an inflamed and cracked surface
on any part of the body. At the same time, Sulphur, Hepar mi-
phuris, Oalcarea, and Nitric acid may be administered internally. It
is hardly necessary to add, that whatever lotion is used externally
must be carefully washed off with ^arm milk before the child is al-
lowed to nurse.

Suppression of the Milk.

After the breasts have once filled with milk, and it disappears, a
return may be promoted by the internal use ol Oalcarea carhonica,
followed with Ptdeatilla, or Phytolacca, while the patient is required
to drink chocolate, or table-bee m.

Induration of the Breasts.

When the breasts cake, or portions of them seem hard, like a po-
tato, rub them well with lard, and give mtemally Oarbo aninuUi*.

718

LABOR, PARTURITION.

In a majority of instances, these hard cakes will disappear if care-
fully attended to. When lard fails to soften, try dry rubbing with
the hand. If the breasts ache, give Belladonna ; if there is fever,
Aconite^ or Phytolacca. If inflammation sets in, and cannot be scat-
tered, give Hepar mlph. to hasten it to a crisis. Poultices of flax-
seed meal may also be applied to hasten suppuration. If it is found
necessary to lance the abscess, let it be done with an opening in the
direction of the milk-ducts, and not across them ; for, when once
severed, the parts never unite perfectly again. After the matter
has discharged, some emollient calve spread on chamois skin may be
applied, for the double purpose of protecting the breasts and healing
the sore.

Suppression of the Lochia.

The flowing after delivery is termed " lochia," and should con-
tinue for ten days or two weeks. If, through any unfavorable influ-
ences, the flow is suppressed, 'he whole system will be more oi less
disturbed. If simply arrested, Pulsatilla may be given every two
hours, for.at least a day ; and, if there is no return, give Secale cor-
nutum. If stiil the suppression seems stubborn, and the head begins
to feel light, and the nerves become unstrung, give ffyoseyamus, and
repeat every three houra until better, or there is indication of a
change. Sulphur will sometimes remove the difficulty. If the light-
headedness be very marked and maniacal, and there is no inclination
to sleep, a decided advantage mv > be found in the use of Belladonna,
If the lochia should finally ret. rn, and be of offensive odor, give
Rhvx tox. ; if much thirst and dr} ss of the throat, Arsenicum ; in
case of diarrhoea, Arsenicum and Jh.. ourius viv., repeated every two
hours. The application of tepid cloths to the abdomen is recom-
mended, until the lochia returns. Should the lochia continue too
long, — that is, beyond the seventeenth day, — Bhu*.

Child-bed Fever.

A LOW form of fever frequently sets in about the fourth or fifth
day after confinement, sometimes severe enough to prostrate the pa-
tient for weeks. Every day she will suffer from pain in the head
and copious perspiration ; the hair falls out. This fever sometimes
continues until a diarrhoea sets in, and the patient sinks into a typhus
and expires. Therefore, at the first manifestation of this fever,
Bryonia should be given every three hours ; and this may be fol-
lowed with Rhus tox.,, in the same manner. In case of diarrhoea and
prostration, give Arsenicum or Veratrum album. If there is sallow-
ness of the complexion, give Mercurius viv. A very light mutton-
broth may be given for nourishment. Should there be a general
pain, and aching of the whole body, give Phosphorus two or three
times, and especially if the diarrhoea should be dark and watery. If

^P W ' H wi ^a — n iw

'••••••••••^^^'''iiiii'i'iiiiiiiiii^immmmmmmmmmmmmmmmm

LABOR, PARTURITION.

719

the fever should be subdued and convalescence established, allow the
patient a little wine and water, beef-tea, and a gradual ajjproach to
more substantial, aliments. Should the above remedies fail, and ty-
phoid symptoms present themselves, Baptisia, hourly.

Leucorrhoea after Confinement.

A FLTTX of this kind may result from general debility, and requires
for its removal a good nourishing diet. China may be given three
or four times a day at first, and afterwards Sepia or Calcarea.

Falling of the Womb.

In some cases, after child-birth, there will be falling of the womb.
This may be the result of a weakened condition of the muscles that
retain the womb in its place. When this trouble is of an aggravated
form, and is attended with copious leucorrhoea, Niix vomica may be
given every evening. The patient should allow herself to be as little
upon the feet as possible, — rest being one of the essential conditions
for gaining strength and for obviating the diflBculty.

Hemorrhoids, or Piles.

Fob the piles consequent upon a tedious labor, Amioa may be
given every morning and evening, or perhaps ffamamelis, if they are
inclined to bleed; also Ntix vomica and Sulphur, when there is severe
constipation and hemorrhage at every stool. Sulphur in the morn-
ing, and Nux vomica in the evening. In all cases use ffamamelis
suppositories. Stewed prunes, Graham toast, and chicken soup, may
enter into the diet.

i 4j

SPECIFIC INDICATIONS FOB BEMEDIES

IN FEVERS.

Tn giving speoiflo indications for the selection of remedies in
fevers, a large ground is covered, inasmuch as nearly all the dis-
eases to which flesh is heir are attended by some specifically charac-
terized fever, which calls for the proper remedy. It is therefore
deemed important to state, in connection with the names of the im-
portant remedies, the particular characteristic symptoms that they
represent.

Aconite is indicated for violent heat and chill, heat about the head
and face ; and red cheeks, palpitation of the heart, pleuritic stitches,
anguish, sadness or ill-humor, despondency, and dread of death, bodily
restlessness.

Antlmonium is indicated when there is little thirst, yellow ooat^
ing upon the tongue, bitter taste in the mouth, eructations, nausea,
loathing, vomiting, and other gastric derangements ; constipation or
diarrhoea.

Arnica is indicated when there is thirst before the chill, and when
the chill comes on in the evening after considerable aching of the
bones ; and also when there is constant desire to change one's posi-
tion during the fever ; for apathy, and pains in the stomach ; for
want of appetite, and aversion to meat when the fever has gone off.
It is particularly indicated when there is weariness, listlessness, yel-
low color of the skin, and bitter taste, and following a blow or con-
cussion.

Arsenicum album is called for when the chill and heat set in
simultaneously, or when they rapidly alternate with each other, or
when there is internal chilliness and external heat, and vice versa;
also for burning heat, as if boiling water was flowing through the
veins ; no sweat until the commencement of sleep, oppression of the
chest, anguish and uneasiness, pressure in the head, vertigo, pains in
the liver and spleen, great debility, burning pain in the stomach, and
disposition to vomit, great uneasiness and anguish in the region of
the heart, violent psdns and lameness of the extremities, and tendency
to dropsy.

790

BPEOIFIO INDICATIONS FOR REMEDIES IN FEVERS.

721

Belladonna, when the fever comes on with violent headache with
stupefaction, marked chilliness and slight heat or the opposite ; red-
ness of the face, with heat and throbbing of the temporal arteries and
carotids ; entire absence of thirst, or the reverse ; and also when the
patient is irritable and in a whining mood.

Bryonia, for coldness, chill with red cheeks, heat about the head,
and yawning ; or when the heat prevails with subsequent chilliness,
heat of the chest with slight pains indicating pleurisy ; or when there
is a coated tongue, or headache and vertigo during the heat, nausea
and faintness on sitting up.

Calcarea carbon ica, for heat in the face, then chills; or with cold
hands, heaviness of the head and limbs, pains in the small of the back,
and restlessness ; cold, sour-smelling sweat on the head.

Capsicum, when there is thirst during the chill and fever, and
much mucus in the mouth, throat and stomach ; also when there is
diarrhoea with slimy and burning evacuations ; and when the patient
in irritable, anxious and oppressed during the chill, and when the
chill begins in the back.

Carbo veg., when the chill occurs in the evening or at night; thirst
during the chill only, which is foUov/^ed with fever and copious sweat
and chilliness ; afterwards rheumatic pains in the teeth and limbs
before or during the fever ; and when there is vertigo, nausea and
red face during the heat.

Chamomilla, when there is pressure in the pit of the stomach, hot
sweat on the forehead, despair, tossing about or bilious vomiting,
diarrhoea and colic, — the thirst, heat, and sweat prevailing, frequent
urination.

China is indicated when there is nausea, canfne hunger, headache, an-
guish, palpitation of the heart, or other ailment previous to the parox-
ysm; when there is thirst generally before or after the chill and heat,
or during the sweat; when there is no thirst, but tendency of blood to
the head, headache, red face, uneasy sleep and yellow complexion.
China is also indicated when there is drowsiness, pains in the liver and
spleen, bilious or dropsical symptoMS, or enlargement of the liver
and spleen.

Cina, for vomiting and canine hunger, both before and after the
paroxysm of fever ; the face is pale during the fever, and a tendency
to emaciation exists, and dilated pupils.

Ferrum is indicated when the fever comes on with chill and
thirst, headache and tendency to congestion of various orgfans ; swell-
ing of the external veins, swelling of the face, especially around the
eyes ; great debility, vomiting of the food when partially digested,
and laborious breathing.

722

SPECIFIC INDICATIOKR VOK KKMKDIE8 IN FEVRKS.

Isnatia, when there is thirst only during the chill, and when tluM
is moderated by external heat, or when there is external heat with
partial internal shuddering ; nauseu and vomiting, pale color of the
skin, and pains in the back during the chill ; and also when there is
no thirst, with headache, vertigo and delirium, and particularly when
there is paleness of the face, or else alternately pale and red, or only
one cheek red during the heat ; great lang"or, deep sleep, with snor-
ing ; after or during the fever, eruption ou the lips and in the comers
of tiie mouth. This remedy is also indicated for the fever attending
nettle rash and other eruptions of the skin.

Ipecacuanha is indicated for a fever of much chilliness and little
heat, or vice versa, and when the chill is increased by external heat,
or when there is little or no thirat during the chill, and great thirst
during the heat ; and also when there is nausea and vomiting, and
other gastric symptoms, previous to, or during and between, the
paroxysms of fever; and when there is a coated tongue and an
oppression of the chest.

Lachesis is particularly indicated when chills occur after a meal
in the latter part of the day, with violent pains in the limbs, and
pleuritic stitches, oppression of the chest, and • convulsive motions ;
and when there is violent headache during the heat , delirium, burn-
ing thirst, red face, restlessness, internal shudderings during the
heat, livid complexion, debility, prostration between the paroxysms,
heat especially at night, sweat after the heat, and when the fever is
easily excited by eating lemons or other sour things.

riercurius is indicated when heat and sweat appear together, and
when there is violent thirst, pains in the right side, acid stomach, and
regurgitation of sour or bilious matter from the stomach , and when
there are pains in the bones, and an aching of the limbs.

Nux Vomica is suitable for a fever that comes on with great debil-
ity, then chill and heat ; constant desire to be covered, even during
the heat and sweat j and when, during the chill, the skin, hands,
feet and face are blue ; and when there are pains in the chest and
abdomen, back, and particularly in the small of the back, or drawing
in the limbs , and when there is headache, buzzing in the ears, dis-
tress in the chest, heat about the face, red cheeks and thirst during
the chill and heat ; and also when there are gastric or bilious symp-
toms, vertigo, anguish, and constipation.

Opium is called for when there is sleep during the heat, and even
during the chill, with snoring respiration with the mouth open ; con-
vulsive twitchings, warm sweat, suppression of the secretions. This
remedy is suitable for old people and children.

Pulsatilla is wanted when there is no thirst during the fever, or
thirst only during the heat, and when there is an aggravation in the
afternoon or evening, with headache, anguish, and oppression during

\A'

SPECIFIC mriOATlONS FOR RKMEPIKB IN FEVKHB.

723

hen this
5at with
r of the
there is
rly when
, or only
ith snor-
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attending

•

ind little
nal heat,
eat thirst
ting, and
veen, the
) and an

«r a meal
Lmbs, and
motions ;
um, burn-
uring the
aroxysms,
e fever is

ether, and
tnach, and
and when

reat debil-
en during
in, hands,
chest and
)r drawing
B ears, dis-
rst during
ious symp-

and even
open ; con-
Dns. This

le fever, or
tion in the
ion during

the entire period of the fever ; and when there is a rod and bloated
face, sweat in the f^'-e, 'i:iti bliuclderinE' aa soon .in the palieiil recov-
ers himself; and also when there are gastric or bilious symptoms,
bitter taste in the mouth, bilious, slimy, or sour vomitings, or
diarrhoea, alternating with constipation, oppression of th3 chest, moist
cough, or headache. Puhatilla is frequently suitable after Lachesia,
or when the fever comes on ^gain after overloading the stomach in
any way. Often beneficial after the abuse of Quinine.

Rhus tox. is suitable for an evening or night fever, when the
chilliness and heat both make their appearance simultaneously, and
a copious sweat comes on after midnight or towards morning; and
when, during the chill, there are pains in the limbs, headache, vertigo,
or toothache ; or when, between the paroxysms, there are convulsive
twitchings of the limbs, nettle-rash, colic, diarrhoea, and gastric de-
rangement; or when there is jaundice, sleeplessness, and tossing
about, thirst at night, palpitation of the heart, with anguish and
pressure in the pit of the stomach.

Veratrum, when there are external chill and cold 8wer\ or inter-
nal heat, with dark-red urine, delirium, and flushed face ; or when
there is chill, with nausea, vertigo, pains in the small of the back and
back ; or when there is chill alternating with heat, constipation, or
vomiting with diarrhoea ; and when there is thirst during the chill
and heat

With the above remedies, or any of them, the following remedies
maybe employed: as CantJiaris, when the urinary passages are in-
volved ; or Goceulus, when the patient is nervous and threatened
with spasms, cardialgia,and constipation. When the fever for which
any of the remedies are indicated is in sensitive persons, made rest-
less by great nervousness, give Coffea ; and especially when there is
sweat with thirst, soft stools, or diarrhoea. Give Droaera, when there
is violent chilliness with cpld face, icy cold hands and feet, nausea
and bilious vomiting, headache and spasmodic cough during the heat,
and gastric symptoms between the paroxysms. Give Jlepar, when
the patient has coryza, cough, or distress in the chest, or chill and
thirst, preceded by bitter taste, followed by heat and sleep. Give
Hyo»cyamu9^ when the fever is atteided by cough at night, or even
epileptic attacks. Mercurius, sour and fetid sweat, with palpitation
of the heart. Sulphur, when the fever is from suppressed Itch, with
chilis every evening, heat and sweat towards morning, fever with
palpitation of the heart, and violent thirst even before the chill.

In case of any fever occurring with symptoms described as being
particular indications for the employment of any one remedy, always
select that remedy ; and, iu all probability, but few doses will be re-
quired to effect a cure, provided the patient is placed in the most
favorable condition for recovery ; for this is as essential as the em-
ployment of remedies.

724

SPECIFIC INDICATIONS FOK REMEDIES IN FEVERS.

In many instances, only a single symptom may present itself, while
in other respectx the patient may lie well. A brief oonsideration of
some of these may be useful ; as, —

Aversion to Food. — Anwexia.

When this exists as a mere symptom, or dislike for food, give
Tart, emetic. If after gastric affections, give China. For aversion
to food, accompanied with hunger, give Bryonia or Rhu9 tox., or elsu
Ignatia or Nnx vomica. For complete loathing of food* give Ipecac.
or Pulaatilla.

. Loss of Smell. — Anosmia.

This S3rmptom may show itself independently, and consists in a
mere insusceptibility of the olfactory nerves, which may be quickened
by one or two doses of Belladonna, Calcarea, or Sanguinaria. If
from paralysis of the olfactory nerves, give Nux vomica or Sepia. If
from catarrh, give Calcarea, Separ, Silicea, or Sulphur.

Loss of Taste. — Agustia.

Fob the absense of this sense, independently of other affections,
give Natrum mur. and Silicea. For loss of taste from purely nervous
causes, such as paralysis of the gustatory nerves, give Hyo»cyamu»,
Nux vom., or Sepia. For the same attended with catarrh, coryza,
and other effects of cold, give Pulsatilla or Sulphur, or else Hepar or
Sepia. Give the usual dose, and repeat twice a day as long as is
necessary.

For alterations of taste, viewed as mere symptoms, the following
remedies may be employed ; Aconite, Arsenicum, Belladonna, Bry-
onia, Mercurius, Rhua, Pulsatilla, etc. For bitter taste, g^ve Aconite,
Bryonia, Mercurius, or Nux vomica. For the taste of blood, give
Ipecac, or Sulphur. For the taste of i^us, Pulsatilla. For clayey
taste, China, Hepar, Pulsatilla. For flat, watery taste, or insipid,
give Bryonia or China. For the taste of bad eggs, cheese, etc., give
Arnica, Rhus, or Sulphur. For greasy taste, Caustieum. For metal-
lic taste, give Calc, Lachesis, Nux vomica, or Rhus. For clammy or
slimy taste, Arnica or Belladonna. For rancid taste, give Bryonia
or Ipecac. For salt taste, Arsenicum, Carho veg., or Sulphur. For
sour taste, give Calc, China, Nux vomica, or Sulphur. For other
forms of illusory or bad taste in general, give Nux, Pulsatilla, or
Sepia. For sweetish taste, give Belladonna, Bryonia, China, Merc,
or Pulaatilla. When food tastes bitter, give Colocynth. For bitter
taste after eating and drinking, Bryonia, China, Pulsatilla. When
food has a salty taste, give Carho veg. When it tastes sour, give
Calc. or China. When there is a sour taste after eating, Nux vom. or
Pulsatilla. Sour taste after drinking. Sulphur. If after drinking

'mrmnnmn^

BPKOIFIC INDICATIONS rOK RKMEDIEB IN FEVERS.

milk, Nux vomica. When bread tastes sweet, give Mercuriiia, When
those w'lo use tobacco imagine that it has an acid taste, Staphytagria.
VVhen there is an illusory taste of sweetness of h^fur, Pul»atilla.
For nauseous taste, Ipecac. A single dose of the remedy indicated
for illusions of taste will generally correct the disorder. Nearly all
these departures i-ora the normal condition of the sense mey be indic-
ative of some peculiar derangement of the animal or organio func-
tions, that the chosen remedy may avert or correct. The value of
th. } isolated symptoms in pointing to remedies that may be used
as timely preventives of more serious derangements can hardly be
appreciated. As, for instance, a bitter taste may forebode a serious
biliary derangement, that Aconite may prevent. And so with all the
other varieties of illusory taste : what might follow, if neglected, no
one can tell. It is better to prevent than to cure a malady : and
when the sentinels of taste and smell stand ready to guard against
the approach of diseases, it is always best to give need to their
admonitions.

POISONS MD THEIK ANTIDOTES.

SUBSTANOES which derange the vital functions, and produce death
by an action not mechanical, are denominated poisons; and distin-
guished writers have noted three classes of these substances, which
may be noted as follows : - -

Ist. Irritant Poisons, or those which produce irritation or inflam-
mation, as mfneral acids, Arsenic, Copper, etc.

2d. Narcotic Poisons, or those which produce stupor or delirium,
and other affections of the brain and nervous system, as Opium,
Prussia acid, etc.

8d. Narcotic-acrid Poisons, or those which sometimes produce irri-
tation, and sometimes narcotism ; sometimes both together. These
are all derived from the vegetable kingdom ; as Strychnia, Nux vom-
ica, etc.

As almost everybody is obliged to be so situated, that, through mis-
take or accident, poison of one or another of these classes may be
taken into the system, it seems desirable to be well instructed in the
use of antidotes, and the treatment of the supervening irritation or
inflammation.

If, through mistake or accident, either sulphuric, nitric, or hydro-
chloric add is taken into the stomach in poisonous doses, give Chalk
or Magnesia ; or, if this is not at hand, beat down the plaster from the
wall, and make into a thin paste with water, and give this. Soap-suds is
another antidote. Drink freely of any mild fluid, or milk, both before
and after the antidote is administered. For the supervening inflam-
mation, such remedies may be employed as in Gastritis from any
other cause: Aconite, in case of much fever; Bryonia, if glairy
vomitings ; Nux vomica, if there is sense of weight, etc.

In case of Oxalic acid being taken into the stomach by mistake,
as this may occur from its resemblance to Epsom saltu, it will be nec-
essary to excite vomiting at once by tickling the throat with a
feather, or by an emetic ; and, after, to administer Chalk or Magnesia
in large doses suspended in water. These not being at hand, break
off the plaster, and make a paste as before. Alkalies will not answer,
as they would only form neutral salts. For the after-symptoms,
give Aconite dissolved in water, — a tablespoonful after every par-
oxysm of vomiting, until they cease ; and give the victim at the

726

P0IBON8, ANI> THKIK ANTinOTKS.

727

giiine timo, frooly, inuoilagiiioiis drinks, uiid iilmi ('ojfnt iiikI Opium
UN luitidotes.

For /witoniiit/ with Arnenie^ tho lirnt thing ne(!OHHary is to thor-
(»ii|,'lily evacuate tho 8toiimch ; and, for this purport*!, give an onietiu,
mid then follow with iron-runt, or the Senqui-oxld of Iron, hugely dif-
fused in water; and let tho patient drink freely of inucilaginouH,
furiiiaceous, or albuminous drinks, and milk. The suljsequent in-
tlanimation must Iw treate<l with Aaonitf, — a dose every two hours
until the nausea entirely disappears ; Nux vomira, also, for the inflam-
mation and soreness of the gastric region , Bri/onia, if the slightest
motion produces pain ; and Pulmtilla or Nux vom„ if the most deli-
cate kinds of food aggravate the suffering.

For Poiaoniiuj ivith Mennirif, and Corronive Sublimate. — This is
the usuid form oi Mercury employed for committing suicide ; and, as
it is used for hed-^ \ poison, it is liable to be taken through careless-
ness or mistake. It is therefore requisite to point out some antidote
the nearest at hand, (live whiten of egija in abundance, or Oluten if
eggs cannot Iw haa, )r else milk. The most usual form of the sup-
ervenuig irritation is salivation or mercurial fever. For these, give
Nitric acid, Hepar sulph,, and obtain for the patient fresh air and
a nourishing diet as soon as possible.

For Poitoniny with Copper. — The blue vitriol, or Sulphate of
Copper, and Verdigris, are the forms in which this poison is most
common ; and, when tivken into the system, the most ready antidote
is tlie white of eggs. Great care should be taken to exclude vinegar,
for tiiis acid would Kid virulence to the poison. To allay or cure
the remaining irritation, give Sulphur twice a day.

Poisoning with Antimony o, fart, emetic, is liable to occur, as this
suljsUmce is somotimes used in medicine as an emetic. When given
to excess, it produces vomiting, attended with burning pain at the
pit of the stomach, followed by [)urging and colic, stricture of the
throat, and cramps. As an antidote, give large draughts of warm
water, and tickle the throat with a feather to induce vomiting ; also
the decoction of any bark containing tarmin, as oak, hemlock, or
cherry-tree bark. For the subsequent ailments, give Sulphur, China,
Nux vomica, or Opium.

For Poisoning toith Zinc, or white vitriol, which is denominated by
violent vomiting, sunken eyes, and pale face, cold extremities, and
fluttering pulse, give the infusion of any of the substances contain-
ing tannin, and feed the patient with cream, butter, and chalk quite
freely.

For Poisoning with Lead. — Red lead and white lead, aa well as
sugar of lead, are liable to be taken by mistake ; and their poisonous
effects are denoted by obstinate colic, spasms of the muscles, and
sometimes apoplexy. As an antidote, give water of ammonia, or
hartshorn, or pearlash-water, or any of the earthy sulphates, as lime,
etc. For lead paralysis, give Sulphur, and afterwards Nux vomica.
For colic. Opium.

■iri

728

POISONS, AND THEIR ANTIDOTES.

^or Poisoning with Cantharides, which is denoted by intense burn-
ing in the pit of the stomach, and pain in the lower abdomen, feeble
voice, laborious breathing, strangury, and tenesmus of the bladder,
headache, and delirium. To remove the Cantharis from the stomach,
excite vomiting in the quickest and most speedy way, — by tickling
the throat with a feather, or drinking a strong mustard-tea, or by
taking snuff upon the tongue. Give Aconite to allay the fever ; give
Nux vomica and Pulsatilla to allay the irritability of the stomach, and
Arnica to relieve the tenesmus, or straining; or else spirits of Camphor.
This is believed to be the best antidote.

For Poisoning with Morphine, which is denoted by giddiness and
stupor, the person becomes motionless, and insensible to external im-
pressions, breathes slowly, and -lies quite still, with the eyes shut and
the pupils contracted, the whole expression of the countenance being
that of perfect repose. As the poison advances, the features become
ghastly, the pulse feeble and imperceptible, the muscles excessively
relaxed ; and, unless assistance is speedily called, death soon ensues.
The first thing necessary is to remove the poison from the stomach,
which is by inducing vomiting If soon after taking the morphine,
give mustard-wate^ freely, or injaot in the stomach some Sulphate of
Zinc, if the patient is too insensible to take it otherwise. After
vomiting is induced, arouse the victim, make him walk up and down
the room for hours, until the in<ilination to sleep is superseded by
nausea, headache, and vomiting, and then give him strong coffee ; and
afterwards to remove the entailed symptoms, give Nux vomica.

For Poisoning with Prussic Aeid, when not fatal, resort to cold
shower-bath, and inhalation of diluted water-of-ammonia vapor ; give,
also, solution of Carbonate of potash.

For Poisoning with Charcoal 0-as, as from the fumes of burning
charcop.l m a close room, resort to cold affusion, and give Aconite, in
drop doses, in a spoonful of water. The same treatment may be
resorted to in case of poisoning with any of the poisonous gases, as
svlphureted hydrogen and carbonic add.

Poisoning by Strychnia, or Nux vomica, is denoted by convulsions,
with much anxiety and agitation during the fits. The whole body
is stiffened or straightened ; the legs pushed out and forced wide
apart; no pulse or breathing can be perceived; the face and hands
livid, and the muscles violently convulsed. Nux vomica, or Strychnia,
in poisonous dosee, generally proves fatal, in spite of treatment. If
emetics are given, and the stomach is made to disgorge its contents
sufficiently early, and the patient is not attacked with convulsions in
two hours, he will generally be safe.

In treating any case of poisoning, two things are required : 1st, re-
moval of the exciting cause ; 2d, treatment of the effects that remain.
The removal of the poison should be done, if possible, with little vio-
lence, and by the simplest and most innocent method, either with the
finger, or in case the poison has been a long time swallowed, excite

i.i.'Wi;»a.' i ' ii

POISONS, AND TUEIK ANTIDOTES.

729

vomitir^ or stool by the simplest means. Copious administration of
tepid water, irritating the fauces by means of a leather, or something
similar, or by salt, mustard, and snuff, or injections of tobacco-smoke;
and neutralize the poisons by means of albumen, vinegar, lemonrjuice,
coffee, camphor, milk, oil, soap, mucilaginous drinks, tea, wine, sugar,
or, as it has been seen, with ammoniacal gax, ironrrust, charcoal,
kitchen salt, Epsom salt, potash, and starch.

It is well to be familiar with these antidotes of poisons, and to
bear in mind the particular indications, or poisonous substances that
call for them, as follows : —

Albumen, or whites of eggs, antidotes such metallic substances as
quicksilver, ' orrosive sublimate, verdigris, tin, lead %nd Sulphuric
acid, when 1 victim complains of violent pains in tie stomach, with
tenesmus, or diarrhoea, and pains at the anus.

Vinegar antidotes alkaline poisons, and obviates the ill effects of
aconite, opium, poisonous mushrooms, belladonna, etc.

Coffee. — Strong black coffee, made of the berry lightly roasted,
and drunk hot, is an antidote to opium, nux vomica, belladonna, nar-
cotics, mushrooms, poisonous sumac, bitter almonds, and all those
substances containing prussic acid. It must be borne in mind, how-
ever, that the cause must be removed, if possible, first.

(7ampAor antidotes the ill effects of poisonous insects, and especially
cantharis, whether administered internally or externally. Camphor
also antidotes the toxical effects of phosphorus, spigelia, and santonin.
It is also useful for the after-effects' of acids, salts, metals, etc., after
the poisonous substance itself has been removed from the stomach by
means of vomiting, etc.

Milk is frequently alluded to as an antidote for poisons ; but it has
no real merit. Mucilaginous substances are better, and much to be
preferred.

Olive Oil ranks with milk, and is much less useful than is believed.
It is useless in metallic poisons, and even hurtful in poisoning with
arsenic. It is of some service, however, in case of poisoning either
with Nitric, Sulphuric, or Phospho' j add. Olive oil and vinegar,
administered in alternation, has proved lerviceable in cases of poison-
ing with alkalies.

Soap. — Castile soap, dissolved in four times its bulk of hot water,
and drunk, will antidote many cases of poisoning with Corrosive sub-
limate and also with arsenic, or with any of the numerous forms of
lead. Soapsuds is likewise a valuable antidote for poisoning with
Sulphuric and Nitric acid. Soap is hurtful in cases of poisoning with
alkalies.

Sugar, or sugar-water, is quite as good as any of the antidotes, and
much to be preferred in cases of poisoning with paint, verdigfris, cop-
per, sulphate of copper, alum, etc. In cases of corrosive sublimate,
in solution, being taken into the stomach by mistake, as it has been,
8ugar*water iu^y be given before the white of an egg. Sugar is also

730

POISONS, AND THEIR ANTIDOTKS.

an excellent antidote in cases of poisoning with Arsenie. The other
antidotes are, —

Ammoniacal gas, or the volatile odor of spirits of hartshorn, for
poisoning with alcohol, bitter almonds, or prussic acid.

Iron-rust, or the sesqui-oxide of iron, for poisoning with arsenic,
freshly-prepared.

Epsom salt, for the various alkaline poisons.

dharooal, for poisoning with putrid fish, meat, mushrooms, or
mussels.

Kitchen salt, for poisoning with nitrate of silver, and poisonous
wounr .

Magnesia, for poisoning with any of the mineral acids.

Potash and Sweet Almond oil are also good antidotes for acids.

Starch, in solution, is the best antidote for poisoning with iodine.

Strong tea is a good antidote for poisoning with honey ; and so is

Wine, for noxious vapors and poisonous mushrooms.

And here it may be repeated, that the first thing we have to do,
in treating cases of poisoning, is to remove the poison by vomiting,
and then to administer the suitable antidotes. In case we should
not be able to ascertain what kind of poison has been swallowed, we
should first administer the white of egg ; and in case there should be
stupor, give coffee, quite strong, made of the lightly-roasted kernel.
But if we should know the poison to be mineral or metallic, the first
resort may be to white of Q^g, sugar-water, soap-water, or soap-suds,
and for the remaining effects Hve Sulphur, which has been ascer-
tained to be a real antidote to tae effects of metallic poisons. If it
should be kuown that acids or corrosive substances have been taken,
give Castile soap mixed with four times its bulk in warm water, or
magnesia dissolved in water, or powdered chalk stirred up in water,
or a solution of saleratus, pearlash, or super-carbonate of soda, in
spoonful doses, after each paroxysm of vomiring, as long as it con-
tinues; and afterwards give mucilagino'is drinks, and, alternately,
coffee and opium, in the form of homoeopathic remedies ; and for the
remaining ailments, give Pulsatilla. After the antidotes have been
administered, give Pulsatilla for sulphuric acid, Bryonia for muriatic
acid, and Aconite for other acids, and especially for crab-apple vin-
egar. In case it should be known that alkaline substances have been
swallowed in poisonous quantities, vinegar and water may be given
in large quantities, and also lemon-juice or cranberry-sauce, without
sugar, or sour milk ; and for the secondary effects of poisoning with
potash, give Ooffea or Oarho veg. If the poisoning is known to be
the effects of spirits of hartshorn, give ffepar sulph. ; if it should be
known the patient had been inhaling noxious vapors, bathe the
patient freely with vinegar and water, and let him inhale the vapor
of a solution of hydrochloric acid; and, after a return to full con-
sciousness, give a strong decoction of partially-charred coffee, or a few
doses of Opium or Belladonna.

■Twr — ; — •^SFT

POISONS, AND THEIB ANTIDOTES.

781

The vapors of coal, when having a poisonous effect, may be anti-
doted by copious draughts of vinegar and water ; and for poisoning
by any substance not mentioned, first follow the rule of removing the
poison from the stomach by vomiting, and, for the irritation or in-
flammation left behind, affiliate any homoeopathic remedy that may
meet the case. If there is much fever or arterial excitement, give
Aconite, every hour ; if severe burning at the stomach, and thirst,
give Arsenicum or Mercurius ; if there is great soreness of the mus-
cles, give Arnica, and let the patient be bathed with a lotion of the
same; if it is known that any of the animal poisons have been taken
into the stomach, give a teaspoonful of powdered charcoal in half a
tumbler of water at a dose, and i ^ after each vomiting until the
stomach becomes quiet ; and if jison of this kind fias come in
contact with the eyes, give Aconite; and, finally, to guard against the
infection of poisonous wounds, when torched with the fingers or
hand, let them be held in strong heat, as strong as it can be borne,
for ten or fifteen minutes, and afterwards wash them with soap.

lU:'

jmmm

^F^

PB0CE88E8 OP THE HYDEOPATHIC
TREATMENT.

Fob the description of the hydropathic appliances contained in the
following pages, I am indebted, in substance, to the " Hydropathic
Family Physician," by Joel Shew, M. D., author of several popular
works upon the principles and practice of hydropathy. I have not
uniformly adopted his exact language, which is not always the best
he might have chosen to express his thoughts.

Priessnitz is admitted to have been the originator of the hydro-
pathic modes of treating diseases. He was an unlearned man, though
he had origina,l powers of mind ; and, imperfect as the treatment is,
he benefited his race by conferring it upon the worid.

At first, and for some time, baths were made too cold, and were
continued too long ; the result was much injury to the patient in
many cases. Time and experience have brought a better adaptation
of the temperature and continuance of the water appliances to the
symptoms, constitution, and temperament of each patient. Formerly,
weak, exhausted, and nervous persons, not less than the full-blooded
and strong, were put into the wetsheet pack, and reduced near to
death's door; and there is reason to believe that in some cases where
the practice is in ignorant hands, this barbarity is not wholly discon-
tinued. The practice, however, is now mainly in better hands ; and
although I by no means admit its sufficiency as a system of remedial
agencies, I am persuaded it is doing some good. Used in connection
with the ancient system of regular medicine, which is the joint prod-
uct of time, science, and experience, the water treatment, moulded
and modified to the circumstances and strength of the patient, is an
auxiliary of no mean power. As such, I accept it. As such, it is re-
ceived by hundreds and thousands of regrular practitioners through-
out the world. Further than this, it never can or will be generally
received. By pushing it beyond this, its rightful and honored sphere,
its friends only limit its progress and injure its influence.

. Division of Baths.

On no one subject connected with hydropathy has there been more
"confusion of tongues," than concerning the temperature of baths.

73a

L5iB»^..j a.=.^VAj^:L^4^<■i:^^*jittf^ir^ ' o^^;£j.^'l>:^tfaMa i k;'aK

PR0CE88K8 OP THE HYDROPATHIC TREATMENT.

733

Both in books and in popular language, among physicians as well as
laymen, have, words been used, sometimes confusedly, and at other
times without any meaning whatever. Orthodox medical works, as
well as the unorthodox, come under the same category of error. A
few simple explanations on this head, properly made, will be sufficient
for all practical as well as scientific purposes.

The simplest and most natural division of baths is into cold, tepid,
warm, and hot. These are all terms of every-day life, and are fully
sufficient to guide us in the selection of any and aU the multiform
uses of water which hydropathy teaches. I admit, however, that
when we wish to be especially explicit, the actual thermometrical
temperature should be mentioned. Sot baths, I maintain, have no
proper place in hydropathic practice. He who resorts to them either
does not at all understand the true principles of the Water-Cure, or
is guided merely by the whims or caprices of those who employ him.

But whatever words we use to designate the different baths, there
is one objection, which is, that all such terms are necessarily arbitraiy
in a greater or less degree. What appears to one person cold, may
to another appear tepid, or warm, or even hot. Thus it is said that
on a road over the Andes, at about half way between the foot and
the summit, there is a cottage in which the ascending and descending
travelleis meet. The former, who have just quitted the sultry val-
leys at the base, are so relaxed, that the sudden diminution of tem-
perature produces in them a feeling. of intense cold ; while the latter,
who left the frozen summit of the mountain are overcome by dis-
tressing sensations of extreme heat. If on a cold winter's morning
we go from a warm bed to a bath of sixty to seventy degrees Fahr.,
the water appears cold. If we then plunge immediately into water
which is at about the freezing point, and then return again to the
water at sixty to seventy degrees Fahr., it appears warm. When the
temperature of the atmosphere is at fifty-five degrees Fahr., in No-
vember or October, in this latitude, and the body of a comfortable
degree-of warmth, and we take three basins of water at sixty, seventy,
and eighty degrees Fahr., placing one hand in the water at sixty de-
grees, the other in that at eighty degrees, letting them remain thii-ty
seconds in each, and then immerse them both in the water at seventy
degrees, it appears to one cold, to the other warm.

But we can arrive at rules which approximate so nearly to the ac-
tual truth, that they will serve us, as before remarked, for guides in
all practical and scientific purposes.

The Cold-Bath. — With a majority of persons, and at most seasons
of the year, water at from seventy to eighty degfrees Fahr. downward,
gives, when immersed in it, a sensation of coldness. The spring-
water of all countries furnishes what may therefore be called a cold-
bath, although there will be a i-ange of many degrees variation in
what we term oold.

734

l'liOCE88E8 OF MIK HYUKOPATHIO TKEATMENT.

The Tepid Bath. — The word tepid is from the Latin tepeo, to be
warm. The true English meaning of the term, however, is, according
to Mr. Webster, moderately warm, or lukewarm; in other words,
water which, when a person is immersed in it, gives a kind of inde-
fini ' ^1 sensation, o^ie which, coming properly under the term neither
eol "arm, is said to be tepid. This temperature will be found

to 1. at from eighty to ninety-two degrees Fahr.

The ^arm Bath. — The term warm is generally well understood.
It means that temperature of water which is peculiarly agreeable to
the sensations. Fresh-drawn milk or blood we say are warm. The
temperature of water which will cause this sensation varies from
ninety-two to ninety-eight degrees Fahr.

The Vapor Bath. — The temperature of the vapor of simple water
varies from about ninety degrees Fahr. upward, according to the heat
of the water, and the space through which the vapor passes.

The Hot Bath. — The term hot is also expressive of ifs proper
meaning. If the body is immersed in water above blood-heat, it
causes an uncomfortable sensation, which we designate as hot. Hot
water is a disturber of the vital functions, particularly if the whole
body is immersed in it. Hot baths, therefore, should be used, if ever,
only in a most urgent necessity. Hot water, iu no form whatever,
entered into any part of Priessnitz's treatment.

Having thus explained the temperatures of the different divisions

of the bath, it is proper to state them in a tabular form, the better to

aid the memory. They are as follows : —

Oold-bath, from freezing point, . . 32 to 85° F.

Tepid " 80 to 92°

Warm " 92 to 98°

Vapor " 90° and upward.

Hot " above 98°.

I now propose to explain somewhat minutely, and at the same time
with a due regard to the needs of the non-professional reader, the
physiological effects of each of the several kinds of bath, and I here
respectfully premise that any one who attempts to practise the water
treatment without having in his mind clear notions upon this subject
is, to say the least, as much a "groper in the dark " as he who attempts
the practice of drugs of which he knows nothing, upon the living
body of which he knows less. How can a man be trusted in water
treatment if he cannot tell beforehand what effect a bath is to have;
and this he cannot, if he does not fully understand the meaning of
the terms which I have here explained.

Effects of the Cold Bath. — The effects of the cold bath are properly
spoken of under two heads, the primary and the secondary. The
terms are sufficiently expressive of their meaning. The first are
those which take place at the time of the immersion ; the second,
those that occur later, constituting what we understand by the term
reaction.

L.'jAV.-JiiS3t'.'.;5i^.^-

i ■^^M^M^fMB*mtti*\itLj^'ih9,x-A^*\'t\\*s^'.^:iii^^ Y .

J(*3fc*.'h- Mil^alU!Mi;fAt;lBjic>«w.^

PK00E8SE8 OF THK HYDROPATHIC TKKATMKNT.

735

Immediately on immersion in cold water, the bather experiences
some acceleration of respiration and the heart's action, .although the
pulse becomes at the same time smaller and weaker. Very soon,
liowever, the panting^ if I may so call it, passes off ; the temperature
of the body is found diminiahed, tlie surface paler tlian natural, tlie
skill taking on that form of appearance known as "goose-flesh."

The first effect of cold water applied to the l>ody, generally, is to
abstract a certain amount of heat from the surface, to constringe the
capillary vessels, and to force the blood inward. Now, as the living
body possesses the remarkable property of maintaining its tempera-
ture at very nearly the same point, whether it is in a colder or hotter
medium than itself, the vitals at once set to work in restoring the
caloric abstracted by the contact of the water ; and as the functions
of circulation and calorification go necessarily together, the vital
power, acting through the heart and blood-vessels, attempts a return
of the blood that had been forced inward by the coldness of the
water.

This is what we call reaction. If the individual is 8u£Sciently
strong and well stocked with vitality, the blood is quickly returned
to the surface and to the extremities (which are always most liable
to become cold, being farthest from the heart), constituting what is
termed good, or vigorous reaction. But if the surface and extremities
continue to remain unwarmed by this return of the blood to them,
as happens in the case of feeble persons, there is said to be poor, or
imyfficient reaction. It would then be necessaiy to give some warm-
ing medicine to start the blood circulating.

Effects of the Tepid Bath. — The tepid bath, which we have seen
mnges from eighty to ninety-two degrees Fahr., produces effects
analogous to those of the cold bath, only not so lasting and perma-
nent. It is especially useful in the treatment of infants and children,
and in all cases where the reactive energy is feeble. If in any case
we are in doubt as to whether the cold bath is admissible, the tepid
form will be a milder measure, and at the same time serve as a test
in venturing upon the cold. The tepid bath may be continued longer
at a time, which in some cases will be found an advantage.

Effects of the Warm Bath. — There is among hydropathic physi-
cians, if I am not mistaken, too gi-eat a fear of warm applications on
the part of some, while others go to the opposite extreme, Mark, I
speak of warm applications. Hot, as before remarked, have no proper
place in hydropathy, — a rule to which the exceptions are few.

The warm bath, as before remarked, ranges from ninety-two to
ninety-eight degrees Fahr. It is not the most useful of the hydro-
pathic resources, but one of the most useful, aa I shall endeavor here-
after to show.

Among the ancient Romans the warm l)ath was not considered as
a means of luxurious indulgence that tended to weaken the vital

Jf ^i

:;ii

asm

■wi

736

PROOESSKS OF THE HYDROPATHIC TREATMENT.

powers, but a means of refreshment for the wearied traveller, and of
preparing him for the repast and the enjoyment of other rites of
hospitality. -The effect of the warm bath is not one of debility, as
many suppose, but, on the contrary, it is a sedative, lowering the
heart's action and the circulation, and tending to repose rather tbaii
excitement.

Effects of the Hot Bath. — The hot bath, l)efore remaiked, is one
whioh is above the temperature of the blood, ninety-eight deprives
Fahr. It was laid down as a precept by Hippocrat^es, that a bath en-
feebles when the heat exceeds that of the body immersed in it. The
truth of this precept has often been verified in practice.

I do not wish to be understood as aflBVming that hot applications
can never be made with benefit to the body ; on the contrary, heat
applied to a part locally may be of service, although I am inclined to
believe that even in those cases where heat acts in a beneficial way,
some other form of hydi-opathio appliance can be used more bene-
ficially. I make, it will be remembered, a broad distinction between
the terms hot and warm.

Sea-Bath ins;.

As regards temperature, sea-bathing comes under the general head
of cold baths. Sea-water, however, at those seasons of the year when
sea-bathing is resorted to, is of a moderate degree of coldness, vary-
ing in this latitude not much from seventy degrees Fahr.

In order to appreciate fully the effects of sea-bathing upon the sys-
tem, a number of things are to be considered.

Sea-water differs in its effects from common water by its possessing
greater density. This circumstance, however, is not of so great im-
portance as that of the stimulating nature of the minerals it contains.
The saline ingredient is a powerful stimulant and even irritant of the
skin. On account of this property, it is found that an exposure to the
action o' ^alt water is not so liable to cause ill effects as that to fresh.
The sail causing a degree of heat upon the surface somewhat higher
than that of the natural state, the system is for the time shielded
from the action of cold. It does not follow from this, however, that
a pei-son could live longer immersed in sea than in common water,
any more than it follows that because alcohol for a time increases the
animal temperature, life can, under circumstP^ces of great exposure
to cold, be the longer preserved. This it is now well known, is not
the case.

An advantage of sea-bathing in the hot season is, that the air at
the sea-shore is cooler than on land. That our climate in summer \s
too hot for the most favorable development of health is proved by
the great increase of mortality, not only in our cities, but in othei'
parts, during the hot season. The European cities, with all their
numbers of inhabitants, dampness, narrow streets, intemperance,

\u.iiiittJmi£^Li^j.:>Cj&iuiuM.: t niiix.iit.uytbtiiigiuvk,- jkiljil-^

PKO0K88E8 OF THE HYDROPATHIC TBKATMENT.

737

pauperism, etc., would naturally be expected to show a higher range
of mortality than our American cities, but such is not the fact. Even
New York, with all its natural advantages, is as sickly, probably, as
any of the British or European cities. This, it is agreed on all
hands, must be owing in great part to the intense heat of our summer
months.

The manner of taking the salt-water bath has some peculiarities
which are favorable to health. It is, in the first place, in the open
air, which, if the weather is favorable, that is, neither too hot nor too
cold, is always a great advantage. Other things being equal, a bath
in the open air is always attended with a betterreaction and a greater
degree of invigoration than one within doors.

In the second place, sea-bathing is usually and almost necessarily
conn :cted with exercise both before and after the bath, circumstances
which are always highly favorable to the action of cold water. So
beneficial, indeed, is exercise taken in this way, that it would be dif-
ficult to determine which of the two — the exercise or the bathing — .
is the more beneficial. In connection, the two act reciprocally upon
each other, each rendering the other doubly beneficial.

Injections.

The term injection implies the act of throwing a fluid into some
cavity of the body.

In Water-Cure we inject water more frequently into the bowels
than any other cavity. This kind of injection is also called enema^
or clyster.

Most people have so little confidence in simple water, that if a
clyster is administered to them, thay have no idea that it can operate
in so effectual a way as it usually does. Years ago, when the water
treatment was much less known than at the present time, I have
been suspected of having secretly put some cathartic substance in the
water, " for," said the patients, " how is it possible for water to act in
this way?"

A gi-eat variety of injection-instruments have been invented. Some
of these are very convenient and useful ; others are got up on mere
speculation, and are but little worth. Every family, at least, ought
to have a good injection-instrument. A lady's toilet is never com-
plete without it. A gfood article is either manufactured or sold by
most surgical-instrument makers and druggists.

Modus Operandi of Water.

It is often objected to hydropathy, that water, being but one agent,
cannot be made useful in all diseases. I propose here to make some
remarks on the modus operandi of water., in which I shall endeavor to
explain, not only to the scientific scholar, but to the ordinary reader,

788

PR0CK8HKS OF TIIK HYDKOPATIIIC TRKATMENT.

that water is capable of being iiiiulu available iim a remedy, — uiid
that powerfully too, — in a great variety of ways. It then acts: —

1. By its Presence. — Water, as we have seen elsewhere, com-
poses the larger part of the living l)ody, and that without its prcsoiicj
in a large proportion in the living syti'cem, the vital processes cannot
for a moment go on.

2. By its Coldness. — Cold, within proper limits, preserves tmd
ttugmenta life, while heat tends to debility and decay. In propdrtidii
as tlie animal heat is diniiniHhed in the different classes of aiiiiniils,
the less is the want of air felt. If in a puppy the eighth pair of
nerves be divided, producing a closure of the glottis so that no air
can ent«r ita lungs, the animal dies in half an hour, if kept at an or-
dinary temperature. But if the animal is benumbed with cold it
survives the operation for a whole day. Frogs, in the summer, when
the temperature of water is elevated, are obliged to come often to the
surface for air. But in winter, when the water is colder, they live
almost entirely under its surface. A cholem patient in collapse, a
person who has been stifled by foul gases, one in the sinking stage of
a fever, or fainting from loss of blood, or in any way asphyxiated,
desires always coldness rather than heat. It may not be possible in
the present state of science to explain these phenomena; but luide-
niably we have the facts.

3. By Endosmosis and Exosmosis. — Animal membranes have the
power of absorbing liquids, — called enc^osmom, or imbibition^ and of
throwing them out, exosmosis, or transudation.

If we take a portion of the intestine of a chicken, tie one end,
nearly fill it with milk, then tie the other end, and lastly immerae it
in a tumbler or other vessel of pure water, we find that in a sliort
time the milk passes out of the intestine into the water, and the
water inwardly mingling with the milk. This' process goes on till
the fluid within and without the intestine becomes one and the same.
This is a familiar illustration of the principle in question-

4. By Dilution. — Water is the greatest diluent in nature. There
is no substance which is at all comparable to it for penetrating the
myriads upon myriads of capillaries that exist in all parts of the
living structure. When the fluids become thick, viscid, and filled
with impure matters, as is usually the case to a greater or less ex-
tent, in disease, it is an important object to dilute these matters.
For this purpose water is the only available remedy.

6. By its Tonx Effect. — Water is the greatest of all tonics, and
possesses the valuable property, not of wearing out, but of increasing
in its good effects.

0. By its Excitant or Electrical Power. — A man feels dull and
stupid from excessive bodily or mental labor, from excessive alinien-

'M^msSKtiTsmmm

«■

PKOCKH8KW OK THK HYnKOPATHIO TRKATMRNT.

739

ly,— ami
acts: —

lere, com-
lea caimot

srves and
)r<»p(irti()ii
[ animuls,
Lh pair of
liat no air
t at an or-
th cold it
mer, when
f ten to the
, tliey live
collapse, a
ig stage of
phyxiated,
possible in
but unde-

es have the
ion, and of

3 one end,
immerae it
in a short
5r, and the
[oes on till
I the same.

re. There
trating the
arts of the
and filled
or less ex-
je matters.

tonics, and
increasing

lis dull and
jive alimen-

tjiti<tii, or spirit, "P tea and coflfoc drinking, with the blood all crowd-
ing up into bin head. We apply the well-wrung rubbing wet sheet
one, two, or three times, to his surface, according ivs he may need,
and he at once perceives a most wonderful change for the better. Or
a man feels of a morning dull and stupid, with his muscles sore ; he
has the rubbing wet sheet, the plunge, shower, or douclie, and in-
st4intly his troubles vanish. Or he may have a lumbar abscess, which
has run him down so low that when he wakes in the moniing he finds
ho cannot walk. Two or three gallons of cold water are poured over
him, upon which he walks readily. Now these elfecta of water, re-
markable as they are, arise simply from its excitant or electrical
power.

7. By it« Temperature. — In acute disease, in all fevers and in-
flammations, of whatever name or grade, the great power of water to
regulate the temperature of the body is one of the most striking of
all the phenomena cognizable by man. By the use of cold water we
can always vary the heat of the body and the velocity of the heart's
action to any desirable extent.

8. By Purifying tlie Blood. — Water accomplishes one thing which
no drug, no other substance in nature can. It purijies the blood. It
does this because it penetrates every lane and alley of the system,
however minute. No capillary is so delicate that it does not pene-
trate lis smallest possible paii;. It purifies the blood, because as long
as the vital principle lasts, the tendency of nature is to preserve the
vital fluid in a healthy state; and penetrating every tissue of the
body as water does, it assists nature in the purifying process as no
other substance can.

9. By AuKmenting the Vital Pofce. — No fact in science is better
established than that water possesses the power of actually increas-
ing the amount of vitality in the system. This is, in fact, the prime
effect of water. It aids the system in throwing ofic disease in the
same way that inci-easing a merchant's cepital aids him in throwing
of? debt.

The foregoing propositions are sub.aitted as elucidating some of
the leading principles concerned in the action of water upon the liv-
ing body. I do not claim, however, that the whole of the philosophy
of the effects of water is yet understood by any one. Doubtless
those who know most about it have yet much to learn.

Rules for Using: Water.

The Time of Day. — In general, the more powerful applications
should be made in the early part of the day. At this time the calor-
ific powers and the circulation are more vigorous, and, consequently,
the body more able to resist powerful applications of whatever kind.

The Meals. — Ordinarily, no powerful bath shoiUvl be taken within

f/c-'it'i

740

PR00R88ES OF THX RYDHOPATHIO TKRATMKMT.

tihree to foui' Iioufh iiftcr a meal. A full stomnch and cold water do
not at all agree. Hut in certain diseaHed oonditiomi, as feverislinciH,
intlanimatiou, colic, cramp in the Htuniiich, cholera morbus, and utliur
sudden attacks, water appliances are to be commenced without refer-
ence to hours or meals. The syniptoniH then are oiir only guide.

The Lighter Baths. — If there is doubt as to which application to
make, the well-wrung rubbing wet sheet, the tepid shallow bath, or u
warm bath should first be taken.

Reaction. — Within a reasonable time after a bath, the body in all
its parts should become naturally warm. If the feet and hands re-
main cold, and the nails and lips blue, the bath has, to say the least,
done no good. In some cases of fevers and other inflammatory dig-
eases, it is better to keep the body chilly than to allow it to become
too warm.

Ulceration. — If any part of the body, as the extremities, lungs,
bowels, etc., is undergoing any considerable ulceration, veiy cold
baths are inadmissible.

NervousnesA. — With some persons who are highly nervous, and
part^^<".ularly with nervous females, much cold bathing, althougli it
appears to agree well, and to be the best for a time, is in che end
ht^mful, rendering the nervousness and general debility worse.

Exercise. — For the douche, plunge, cold sitz, and foot hatha, and
all others that abstract a lai'ge amount of caloric from the system,
the body should be fully warm, and the circulation somewhat acceler-
ated by exercise. Exercise should also be taken after the bath,
until the heat and circulation are fully restored. But if exercise is
impracticable either before or after the bath, friction should be made
to take its place.

Increased Heat. — Elevation of temperature constitutes no objec-
tion to bathing, provided the body is not excessively fatigued. The
reason why overheated persons sometimes lose their lives by plunging
into or drinking largely of cold water, is, that the vital force has
been too much exhausted. Mere heat is an advantage.

Perspiration. — Neither does this constitute an objection to bath-
ing or water-drinking, if the foregoing rules are observed.

The Air. — Bathing in the open air is always preferable to in-doors,
provided the extremes of heat and cold are avoided.

The Head. — It is well always to wet the head with cold water,
both before and after a bath. Douches and the shower should never
be taken on this part Simple pouring or affusion is the only mechan-
ioal force of water that .should be allowed on the head.

Pregnancy. — This, as abundant experience proves, forms no ob-
jection to bathing, or any form of properly regulated water treat-

KaMadjSj^.;

.-jji8m3i«m!.ja&!KaaMiaa B aaiM

.^ ^-

l>R0OKH8KS or Till HYDROPATHIC TKItATMRNT.

741

1 Wllt«'l lid

/emliiusM,
uiid otlit'i-
iiout refer-
guide.

lication to
Uith, or u

body in all
I hands re-
r the least,
aatory dig-
to become

ties, lungs,
very cold

TV0U8, and
ithough it
in the end
rcTse.

baths, and
;he system,
bat acceler-
the bath,
exercise is
d be made

a no objec-

ued. The

y plunging

force has

)n to bath-

X) in-doors,

jold water,
ould never
ly mechan-

pms no ob-
^ater treat-

ment. Cold Imthing iiiul wat«r-driiiking lire of tlie greatCMt aervice
(luring this period.

The Season. — If the liingH are not extensively disoasod, and if
there is no considerable ulceration going on in any part of the Hys-
teni, the cool and cold seasons are preferable for a coui-se of bathing.
W'itli right luanagemeiit, a patient gains two or three timeH as much
ill a given time during the cold months as he does in the hot.

Days of Reat. — One day in seven water-treatment sliould h& dis-
continued, with the exception of u simple ablution in the morning.
Six days' treatment in the week is worth more than seven, because it
Ih a law of nature that, if a remedy is continued steadily and without
change, it loses much of its good effect. This is as true of water as
of any other agent. Those who do wisely will omit the treatmen
on Sunday, whatever their religions convictions may be.

Internal Use of Water. — The same general rules apply here as in
the external applications. Thirst should for the moijt part be grati-
fied whenever it is experienced. Aa a rule, the less water drank at
meals the better. For the tonie effect, it is to be taken while tlie
stomach is empty, and it is better that exercise should accompany it.
From six to twelve tumblers per diem is a fair allowance for average
patients.

Quality of Water. — For all remedial as well as hygienic purposes
water should be as pure and soft as can be obtained. With proper
care and ingenuity in the construction of cisterns, filters, etc., this
desirable end can be everywhere accomplished. Lead, and lead
pipes, should be avoided, except where the water runs freely and
constantly.

The Swev.tlnir Process. — Formerly it was much in vogue to sweat
patients in the blanket pack, but latterly the practice has quite gone
into disrepute. For several years of the latter part of Priessnitz's
career he was vory averse to using the process. It was a remark of
his, that the cures by sweating were not permanent.

Wet Bandas:es, Compresses, etc.

These, as we have already seen under the head of wounds and in-
juries, are of great value in water treatment. They are used of any
desirable size, upon any part of the body, and produce different effects
accordingly as they are used. Cooling wet compresses are such iis
are changed or rewet frequently, and for the most are left uncovered.
The warming or stimulating are covered and left upon the part until
it becomes as warm or warmer than natural. Warm fomentations are
useful in certain cases, but the hot should, as a rule, be discarded.

The wet girdle is one of the most useful of all medical appliances.
Two and a half or three yards of good toweling, with tapes arranged
at one end, the comers of which have been turned over and sewed so

' V:

ii^ii,^

742

PROCESSES OF THE HYDROPATHIC TREATMENT.

as to form a point, forms a good girdle. It should pass usually three
times about the body, one-half having been wet. This brings two
thicknesses of wet on the abdomen and one upon the back. At
Graefenberg, this application was worn by every patient, and, as a
rule, all of the time. It is useful in a great variety of ailments, both
acute and chronic. The same form of application is also useful for
thd arms, legs, etc., the tapes being used in preference to pins.

The wet jacket, or chest wrapper, is also a valuable resort in dis-
eases of the chest. Oiled silk and other similar articles, as I have
elsewhere observed, are not to be used upon these local applications.

The following is the substance of Dr. Show's description of hydro-
pathic appliances.

The Wet-Sheet Pack.

In this process a coarse linen or.cotton sheet is used, long enough
to reach from the patient's bead to the soles of his feet, and al)out
two yards in width. The bed is stripped of all its covering, one or
two pillows only being left for the head. One or two comforters are
then spread upon it, and over these the same number of woollen
blankets, which are less injured by wet than cotton comfortables.
The sheet having been pretty well wrung out of cold water, — always
pure and soft, if such can be had, — is then spread out smoothly upon
the blanket. The patient being undressed, lays himself upon the
sheet, and, his arms being held up, an assistant laps one side of it
over the body and lower limbs ; when, the arms being dropped at the
side, the other part of the sheet is, in like manner, lapped over. The
blankets are then, one by one, brought over the person in the same
way, and tucked under from head to foot. Comfortables may be added,
if necessary. •

It is always best to place a wet towel, covered with a dry one, on
the patient's head while he is packed. If too much chill is not pro-
duced, the dry one may be left oflP.

This is the ordinary way of taking a pack in chronic disease.

The wet sheet is one of tho most soothing and agreeable of all the
water appliances. Hence it is that it is so often misu'^ed. It is so
delightful, and tends so much to produce slumber, that the patient
never feels ready to get out of it But this slumber, — ■ so profound
and sweet as it often is, — he should remember, may be only an apo-
plectic stupor, which leaves him with a swimming head, attended with
faintness, perhaps, and ending in a severe headache ; giving him, in
short, a congestion of the brain. All this happ)enB in consequence of
robbing the skin too long of the air it should breathe.

There has bden a notion at some of the establishments that the
wet sheet is to be used for sweating ; and to this end, the patient has
been literally stewed hour after hour, in some cases, even four, five,
and sir hours in succession, with the view of sweating him. All
such practice is hurtful. If the patient gets better under it, it is in

,::!-l!Maa!iii!K^,;:,, . —rSaSH

SB S^flSWBi Vi'n i aii i 'iiist i^ea jJtl i M I W

^^^m

PROCESSES OF THE IIYPROPATHIC TREATMENT.

743

consequence of the good effects of water used in other ways, coui>]ed
with the ever-important adjuncts, air, exercise and diet. In later
times, Priessnitz never sweat patients at all, much less in wet sheets.
If a man must sweat, leave off the wet sheet assuredly, as that only
hindere the operation. Use the blanket pack or the vapor bath.

How Long shall the Pack Contiiue? — Here, too, there has been,
and still is, much error in hydropathic practice. "Stay in the pack
till ycu get warm," has been the old doctrine. But some get warm
at firat, and afterward get cold ; — so at least they feel. What is to
1)6 done?

One of Priessnitz's improvements was to give short packs. " Re-
main enveloped for fifteen or twenty minutes only," he said. " If you
are not able to bear the pack in that way, take the rubbing wet sheet
and the lighter processes until you are." In some cases he gave two
or three of these short packs in succession, the patient rising between
each to take an airing, a rubbing wet sheet, or other bath, and then
returning to the pack.

Thus far the wet sheet has been spoken of as used in chronic dis-
eases. In acute attacks it is managed differently, according to the
case. If the object be to abstract caloric from the body, we cover the
sheet but little, — with a single dry sheet, or a blanket or two, or, per-
haps, with none of these.

We know that if we keep a wet towel about a keg of water on a hot
day, the water will be made cooler by evaporation. In the same way,
when a patient is hot and feverish, we keep one, or, still better, two
wet sheets around him, without other covering, and thus bring down
the heat and circulation to any desirable degree. We sprinkle water
upon the sheets, or rewet them as often as is necessary, — in some
extreme cases of fever continuing them a whole week or more. Ex-
perience teaches that the continuous application of the wet linen is,
in such cases, a most serviceable application, and one that tends most
powerfully to induce in the dermoid structure its natural and health-
ful state.

The Wet Sheet Acts by Absorption. — It draws morbific matter
out of the body, as any one may see who applies the sheet for a short
time, and then washes it. Observe, too, wiiat an odor comes from
the sheet when a diseased patient has been packed. At the same
time, it absorbs the pure water into its finest tissues on a large scale,
thus supplying that fluid which of all substances the system, under
such circumstances, most needs. This moist warmth of the sheet also
acts as a most soothing poultice.

The Wet Dress.

A MODIFICATION ©f the wet sheet, and in some respects an improve-
ment, is the "wet dress," so called.
A coarse linen or cotton dress is made with large arms, so that one

"■5

744

PK0CESSE8 OF THE HYDBOPATHIO TREATMENT.

may take the application without help. The dress being wet and ap-
plied, the patient lays himself upon blankets, in which he wraps him-
self just sufficiently to become comfortable. Or, he may have dry
flannel dresses to put on over the wet one, and then lie in a common
bed. In this application, the air is not excluded from the surface to
anything like the same extent as in the common tight pack. Hence,
a patient may remain in it a half, or the whole of the night, if he
choosos, — being careful to becomo neither too warm nor too cold.
Rewetting once or twice in the night will be of service. Often in a
single night a bad cold may be thrown off in this simple way.

The Half Pack.

Many patients have so little reactive energy, that while they can
bear a half pack, so called, the entire sheet woidd abstract so much
caloric from the body as to injure them. In such cases, the sheet is
to be applied so as to extend' only from the arm-pit, or at most, from
the neck to the hips, leaving the lower extremities, as it were, in the
dry pack. Sometimes the sheet is allowed to extend to the ankles,
not including the feet Packing the trunk of the body in wet towels
acts upon the same principle as the partial or half pack, and is, ux
many cases, a valuable preliminary measure. It is well to take these
preparatory steps when a patient who has suffered long from chronic
disease is beginning with the envelopment.

The Folded Wet Sheet.

In domestic practice, a modification of the wet sheet may be had
by folding four-double a common coarse sheet, for enclosing the trunk
from the armpits down. Two thicknesses of this are wet in cold
water to come next the body.

This is a valuable application in a host of ailments, as pleurisy,
inflammation of the lungs, inflammation of the bowels, colic, cholera,
cholera morbus, rheumatism, painful menstruation, after-pains, etc.
This remedy, which can be applied in five minutes, will often soothe
a patient quietly to sleep, whose lot, without it, would be a night of
agony. One advantage of this application is, that if a patient is too
weak to lise, the sheet may be opened in front, so that fresh water
may, when needed, be sprinkled upon it, and wet towels inay be
added under it upon the abdomen, if necessary.

In all the methods of applying the wet sheet, there can be no pos-
sible objection to using warm bricks, bottles, et^j., for the feet when
cold.

Bath after the Pack. — It is the practice generally to take some
form of the bath after the pack. If the patient is too feeble to rise,

-^mMMMSB:: '

i ii ii i i jj i i i .ia. iiii m (> i«Mn| i J ill

PROCESSES OF THE HYDROPATHIC TREATMENT.

746

an ablution is performed while he is in bed. In other cases, a wet-
sheet rubbing, shallow, plunge, towel, or other bath, is resored to,
but not strictly of necessity. It is better however, as a rule, to make
the process a compound one, tliat is to take some form of bath after
the pack. This should also be followed by exercise in the open air,
if it can possibly be taken. A pack, followed by a faithful turn at
work, or by exercise in the open air, is always worth much more
than when followed by rest witiun doors.

The Rubbing Wet Sheet.

The rubbing wet sheet, too little appreciated, and too seldom used,
is one of the most valuable of all the hydropathic resources. There
is probably no other single application of water, in all the multiform
modes of hydropathic medication, that can be made, on the whole, as
useful as this. It is a tonic, a stimul&nt, a sedative, an antispasmodic,
a derivative, or a febrifuge, according to the circumstances under
which it i« applied.

We take a coarse linen sheet, — although cotton answers a very
good purpose, — large enough to throw around the body like an In-
dian's blanket. It is wrung more or less, according to the demands
of the case. Thereupon, it is thrown
quickly around the patient's body, who,'
if strong enough, is in the standing pos-
ture ; and then both patient and assistant
set vigorously to work, rubbing over the
sheet, not with it, as some do, three, four,
or more minutes, until the surface becomes
thoroughly warm (Fig. 188).

If there is fever, less friction is required.
After the ivet sheet, comes a dry one, to be
used in the same manner. Those who have
suflScient reactive energy, — and most have,
— may dry the body simply by fanning it
with the drj'- sheet, the windows at the
same time being open. TTiis sort of air-bath exerts a highly pleasurable
efPect upon the skin. Instead of giving one a cold, it helps greatly
to ward it off. This method of drying the body was one of Priess-
nitz's later improvements.

The rubbing wet sheet, it should be remembered, is not a tingle
application, capable of producing only one effect. It is used in three
different gradations, and to produce very different results. It is well
wrung, or only modemtely wrung, or left quite wet and dripping.
If a person is fatigued, or has a low degree of reactive energy, the
first form is the one to adopt; if there is not much fatigue, and good
reactive energy, the second ; and if the patient is feverish, and the

FlO. 188.

■*M^II<

746

PU0CK88ES OP THE HVUnOPATHIC TREATMENT.

object is to alwtiact heat simply, we use the sheet quite wet and drip-
ping; and we repeat it as many times in succession as the case may
need. One great advantage is, that we give it before or after a wet
pack, when no bath is at hand ; we also give it in connection with
any other bath wo may choose.

See how admimble a remedy the rubbing wet sheet is, when prop-
er V understood! A patient, —a child, perhaps, — is so feeble in the
reactive power, that almost any form of bath we can give it sends
the blood from the surface, making the lips and nails pale or blue, and
the extremities cold, showing congestion of the internal organs.
When a bath produces such effects, it is very apt, to say the 1 t, to
do more harm than good. But we can apply the rubbing wet sheet
in such a way as to cause none of these ill effects ; besides, it may be
repeated many times in the day, so as to give tlie patient the advan-
tage of a strong treatment ; for a light treatment, which can be easily
borne, is made a %tr<yn^ one by the frequency of its repetition.

A wet sheet, well wrung, holds perhaps a pint of water ; or, at
most, a quart. Now, it must appear plain, that a pint or quart of
cold water, spread over so large a surface as the whole skin, must
become very easily warmed by the body's heat. Besides, if there is
ireM delicacy of constitution, we may wring the sheet out of water
at seventy, eighty, or even ninety degrees, gradually lowering it as
the patient can bear it.

The domestic availability/ of this application is also to be spoken
of. In every dwelling, however humble, there is the coarse sheet,
and the bucket of water. How useful, therefore, as a resort, in
home practice!

The rubbing wet sheet appears a tiifling application, — one which
is not capable of producing any great result. But when we remem-
ber the myriads of nerves of animal life, spread over the skin, and
derived from the brain and spinal cord, it need not surprise us that
its application should so invigorate the body, take off bodily and
mental depression, remove languor and fatigue, expel flatus from the
bowels, remove thirst, gfive appetite, and cause a feeling of calmness
and relief which can be appreciated only by those who experience it.
A minister, for example, preaches three times on ^ Sunday, and gets
his brain so excited that he cannot sleep. A cold bath would be too
powerful, and opiates would only act as stimulants, making the mat-
ter worse. Two or three successful applications of the rubbing wet
sheet, with powerful friction, bring the blood so much to the surface,
that his brain becomes relieved, and he very soon falls into a soimd
and refreshing sleep. So, too, when a man has been long wet and
drenched on a rainy day, and comes home, virith the surface and ex-
tremities cold, and the blood pressing hard upon the brain and other
internal organs, — the well-wrung rubbing sheet is applied, with plen-
tiful friction, and at once the oppressed organs are set free.

In using the rubbing wet sheet, as in all other forms of general

PBOCEB8E8 OF THE HYDROPATHIC TBBATMENT.

747

bath, it is well to wwsh the hands and face in cold water, both before
and after it. There is no need of throwing it over the head, as some
have thought it necessary to do. A patient needs to breathe freely
when he takes a bath.

This application is not always the most pleasant one. It does, in
fact, require a good degree of moral courage to enable one to endure
the first shock. The sensations produced by it are worse, if possible,
than those from a plunge into cold water ; I mean the first touch of
the sheet to the body. Nervous ladies sometimes tell us they cannot
take the rubbing wet sheet, when, at the same time, they take the
cold plunge, which is far more powerful, and perhaps too powerful
for their case. This unpleasant feeling does no harm, for it vanishes
in a moment or two after the sheet touches the body.

■ i

■ J

The Douche Bath.

This is the most powerful, but not the most useful of all the
hydropathic appliances. A common douche consists of a stream of
water from one to two inches in diameter, with a fall of five to ten
feet. But douches may be arranged of any desirable size and height.

(Fig. 189.)

This remedy is useful in paralysis, stiff joints, gout, rheumatism,
tumors, and old swellings of various kinds. Those who have weak
limgs, stomach, or other abdominal organs, should not resort to the
douche without the best of medical advice.

The Shower Bath.

This is also one of the more powerful of the hydropathic appli-
ances, and needs judgment in its use. It consists in fact, of a vast
number of small streams or douches, and hence is a powerful refrig-
erant, as well as excitant, to the system. It is useful to commence
this bath, for a time at first, only upon the limbs. It is used by all
gymnasts.

The Cataract Bath.

This also is one of the more powerful of the hydropathic processes,
and is to be classed with the two preceding baths. Like them it may
be said to be stimulant, tonic, and alterative, while it is also highly
sedative as far as animal heat is concerned.

The Hose Bath.

Through the modem improvements in Indiarrubber, gutta-percha,
leather, etc., it is easy, whenever there is a small fall or head of
water, to arrange what is called a hose-bath. It is in principle a

^>i :

■^^

748

PK00ES8ES OF THE HYDKOPATHIO TBEATMENT.

(louche, with the additional advantage that it can be made to act
upon any part of the body," and from whatever direction we choose.
Rightly applied, the hose bath is a valuable remedy. (Fig. 190.)

FlO. 189.

FlO. 190.

The Pail Douche.

The process which passes under this name is taken thus: The
patient seats himself in an empty, shallow, or other bathing-tub, and
crosses his hands over his chest. As many pails of water as are
ordered are then dashed over him suddenly, one after another, before
and behind alternately, — not poured, but thrown with some force,
by first a backward and then a forward motion of the pail.

A better method of using it is, for the patient to stand in an
empty bathing-tub, while an assistant takes two pails of water, one
ten degrees warmer than the other, and empties the warmer half upon
the chest and half upon the back, and then bestows the colder pailful
in the same manner ; and then dries with friction.

The Wave or Sluice Bath.

Tras is taken at the sluice-way of an undershot mill-wheel, or in
any similar place. The patient takes hold of a rope, or something by
which he can maintain his position, and then, lying down, subjecte
his body to the action of the water. This is, on the whole, a pleasant
and agreeable bath, and in its effects somewhat resembles the douche,
being, however, milder and safer.

The Half Bath.

This bath may be used as one of the mildest of the water-cure
processes, or as one of the most powerful. An ordinary bathing-tub
is a very good apparatus for the purpose. A good-sized washing-tub
will answer very well, if there is nothing else at hand. The water
should generally be quite shallow in this bath, — from three to six

PKOOESSES OF THE UYDKOPATHIO TREATMENT.

749

inches. Priessmta's half-baths were made of wood, four or five feet
long, about two and a half feet wide, and twenty inches deep. This
simple contrivance is one of his most powerful remedial means, —
that by which some of his highest triumphs are achieved.

The water is generally used of moderate temperature, at sixty to
• seventy degrees Fahr., and, when long continued, is changed, as it
becomes warm from t\).e heat of the body.

This bath may be used.

First, as a means of cooling the mass of the circulation in the hot
stages of fever, and in inflammatory attacks of every kind.

Secondly, as a revulsive, or means of drawing blood in congestions
or inflammations of the nobler organs, the brain, lungs, stomach,

liver, etc.

Thirdly, as a means of r( suscitation in the shock of serious acci-
dents, sun-stroke, and before, during, or after apoplectic and other
fits. In drunkenness and delirium tremens, the half bath is a sover-
eign remedy.

Fourthly, as a middle means^ and preparatory to the general bath
in weak constitutions.

In the latter of these indications, the bath is generally used but for
a few minutes after the wet sheet, or at other times, as may be de-
sired. In the former, much practical knowledge is necessaiy in order
to proceed always with safety, and to obtain the best results. Thus,
six, or even nine hours may be required, with the greatest persever-
ance, the patient being thoroughly rubbed over the whole surface,
and this to be kept up constantly by relays of assistants, the pa-
tient's head and shoulders, meanwhile, being supported.

The Plunge Bath. .

In sea, river, and lake, as well as by artificial means, and as a
matter of luxury, religious observance, purification, and the preven-
tion and cure of disease, the plunge bath has, in all periods of time,
and in all parts of the world, been a favorite resort. So efficacious,
indeed, has this simple means proved in healing the sick, that not a
little superstition has been mingled with it. Springs and wells have
often been supposed to possess some mysterious power, and for that
reason has been named after some patron saint. In tJiis respect, the
world has loved mystery and inarvellousness rather than the pure and
simple truth.

In hydropathic practice, the plunge is much used; but many pa-
tients are not able to bear it. Those who are not sufficiently strong
for it at first, should practise the lubbing wet sheet, the half-bath,
drinking, exercise, etc., until the pi unge can be borne. It is :i favorite
remedy at 0.II the establishments, to be taken directly on coming from
the wet-sheet pack.

■■■I

■Hi

760

PB00K8UES OP TUB HYDROPATHIC TUKATMENT.

The Head Bath.

FboM time immemorial, oooling applications to the head have been
much depended upon in that violent and dangerouu disease, inflam-
mation of the brain. All other known means failing, certain o))sti-
nate affections of the head have been known to give way to affusion
of cold water upon the part. In headache, drunkenness, delirium
tremens, the delirium of fever, epilepsy, rheumatism of the head, dis-
eases of the eye, earache, deafness, loss of smell and taste, and in
nose-bleed, this highly energetic remedy is brought to bear. In
taking it, the patient lies down, placing the back of his head in a
shallow dish, filled only an inch or two with water. (Fig. 19l.)

no. 193.

no. in.

The Leg Bath.

This is useful in cases of ulcers, swellings, eruptions, gout, rheu-
matism, sprains, wounds, etc., of the leg or thigh. The relief and
strength obtained, often by a single application of this remedy, is
truly wonderful. A variety of apparatus may be contrived for ad-
ministering the leg bath. A common wooden tub, contrived for the
purpose, l&e that represented in Fig. 192, answers a good purpose.
In such a vessel, he covei's the inflimaed limb iutroduoed, and cools
the blosd flowing to it.

The Sitz-Bath.

CoKVENiEKT tubs, woodcu or metallic, are constructed for this
bath, but an ordinary wash-tub answers very well. The vessel should
be la' enough to permit the motion of the arms in rubbing the
abdot^mdn, sides, and hips, first with one hand, and then with the other.
Water enough should generally be used to pretty nearly cover the
belly. The more movement and friction while in this bath the better.
It is more conveniently administered when the tub is elevated two
or three inches from the floor. Some undress the patient completely,
and place a blanket or sheet over the upper part of the body ; but

a^ aSgwgawwttia

PROCESSES OF THK HYDROPATUIO TREATMENT.

751

hftve been
\se, iuflam-
"tain olwti-
to affusion
3, delirium
I head, dis-
te, and in
bear. In
head in a
. 191.)

oftener only those parts are uncovered which are to be exposed to the
water. (Kig. 198.)

In a variety of ailments, this bath is highly valuable. It may be
made one of the most powerful of all the hydropathic modes. Like
uU other powerful applications, it should be taken only when diges-
tion is nearly or quite completed.

As a tonic to the stomach, liver, bowels, womb, spine, etc., this
bath is highly useful. In constipation and other irregularities it is
famous. Those of sedentaiy habits will find its use of rare service.
For the tonic effect, ten, twenty, twenty-five, or thirty minutes. If
continued for some length of time the water is to be changed once or
more, as it would otherwise become too warm.

PlO. US.

ria. iM.

jout, rheu-
relief and
remedy, is
ed for ad-
red for the
1 purpose,
and oools

)d for this
3sel should
ibbing the

the other.

cover the
the better.
vated two
ompletely,
body; but

The Wash-Tub Bath.

Under a great variety of circumstances, the wash-tub bath is an inval-
uable remedy. For example, a patient is feverish ; by setting him in
a wash-tub half filled with water, and at the same time, if we choose,
putting his feet in a pail of water, cold or warm, according to the
case, we may give him any desirable amount of cooling. We cannot,
indeed, too highly pri? e this simple contrivance for using water, — a
means which every family possesses. (Fig. 194.)

The water, as a general rule, should be tepid, ranging from 72° to
90°, and may be prolonged from two to fifteen minutes, according to
the strength of the patient. It should never be carried to the extent
of producing blueness of the nails. The patient should be dried with
towels, or the dry rubbing sheet.

This bath is useful in the treatment of eruptive fevera, bilious
remittents, the hot stage of intermittents, and in hectic and typhoid
fevera. It is often used after the wet sheet pack, in chronic affec-
tions, and may then have a little cooler temperature, or else be fol-
lowed by pouring a pad of cooler water over the shouldera to tone
up the skin.

752

FUUUKUtiKS UK TUK llYUKOl'ATUIO XHKATMKNT.

The Affusion.

The patient stands in a wash-tub, bathine-tub, or other convenient
place, when, by means of a pail, pitcher, or basin, the ansiutant pours
water upon the head, neck, etc., either upon the whole of the bo(])>
or only upon a part. The water is used in quantity and tempenv-
ture according to the necessities of the case. The affusion ii> one of
the best of hydropathic modes.

Fifty years ago Dr. Currie, of England, performed great cures in
fever by the affusion, sometimes tepid, at others cold, according to
the strength and heat of the patient. li' there was great heat, the
water was used cold ; if not, the reverse. In a variety of febrile
diseases, such as typhus fever, scarlet fever, small-pox, measles,
tetanus, convulsions, etc., he used this remedy With remarkable
success.

Towel and Spons:e Bath.

With one or two coarse towels and a quart or two of water we
may take a very good bath almost anywhere, even in a carpeted room,
at a hotel, or wherever we may be, without spilling a drop of the
water. After a person becomes accustomed to this form of ablution,
none but the most indolent will be willing to do without it, unless
they can have some other form of bath. A daily towel ablution,
thoroughly performed, is an excellent prevention against colds, helps
the appetite and digestion, and is a good means of preventing con-
stipation.

Some are in the habit of sitting in a half-bath or a sitz-tub, and
with a large sponge making the water pass freely upon the head,
neck, shoulders, and other parts of the body. At the same time the
bather may pour water from a cup, basin or pitcher, upon the head,
neck, etc. This is a mild affusion, and stronger in effect than the
towel-bath.

Wash-Down.

The process to which this name is given by Dr. Edward Johnson
is practised as follows : " The patient stands in an empty sitting- or
wash-tub, beside which stands a pail of cold water with two coarse
towels soaking in it. The bath attendant, taking his place behind
the patient, lifts one of the towels all loaded with water, and lays it
quickly on the patient's head. The patient immediately seizes it,
removes it from his head, and rubs himself rapidly with it, — his face,
his thioat, shoulders, arms, chest, stomach, bowels, thighf* and legs.
having gone rapidly over the whole body once, he droiw his towel
into the pail again, which the bath-man presses down to the bottom
of the water, then lifts it out, and places it on his head again. As

^^SSE^SSBSSSSS^^^SHMk

Bonvenieni
itant pours
' the boclj
I temperiv-
n is one uf

it cures in
oording to
b heat, thu
■ of febrile
:, measles,
remarkable

water we
letedroom,
"op of the
if ablution,
b it, unless
1 ablution,
iolds, helps
nting con-

bz-tub, and
the head,

8 time the

the head,

than the

Johnson
sitting- or
two coarse
ace behind
nd lays it
y seizes it,
— his face,

and legs.

his towel
le bottom
gain. As

PK00K88KH OK THE HYDROl'ATHIO TBRATMKNT.

753

before, the patient seizes it, and goes all over the same ground onoe
more, and tiien drops it into the water again, when the bath*man
again lifts it and places it on tho head to be a third time removed by
the patient, and applied as before, rapidly, actively and energetically,
all over his body in front. The bath-man is industriously occupied
all the time l)elund in the same manner, from the back of the neck to
the back of the legs, wetting his own towel as often as he wets that
used by the patient, viz., three times. This is called a wash-down of
three towels. The patient is then diied in a dry sheet. It is a more
powerful bath than the common towel-bath, but not in all respeots so
coavenient to take.

The Cold Foot-Bath.

Oms of the first things people who are troubled with cold feet do
is to plimge them into cold water. Nor is the assertion, put forth
in some of the hydropathic works, that the cold foot-bath was pre-
scribed by Priessnitz for the same purpose that the faculty order
warm ones, correct. When the feet are already cold, neither Priess-
nitz nor any one in his sober reason would prescribe cold water, which
can only make the parts colder. To obtain the good effect of the
cold foot-bath, so far as the feet are concerned, they should be warm
whenever it is taken. For a tendency to coldness of the feet, — a
very common symptom in these days of so-called luxury and refine-
ment, and one that indicates a state of things in the system incom-
parably more to be dreaded than the mere coldness of the feet, —
this is the remedy. It may be taken at any convenient time ; just
before the morning walk is a very suitable occasion, the parts being
usually warm early in the day.

At other times, if cold, they should, if at all praotioable, be warmed
oy exercise and friction before subjecting them to the action of cold
water. But in cases of old age, great debility, etc., the warm foot-
bath and other warm applications may be resorted to before the cold.
Thus with cold, exercise and friction, accustoming the feet daily and
frequently to cold water, will beget in them a habit of remaining warm.
In a great variety of ailment^ such as toothache, rush of blood to the
head, headache, earache, inflammation of the eyes, gout, rheumatism,
hemorrhage, etc., the cold foot-bath is a valuable remedy. It is or-
dered deep or shallow, and of duration according to the nature of
the case.

Wadins Foot- Baths.

I HAVB often directed patients to wade in water in some conven-
ient place as a means of hardening the system and of giving tone to
the nerves. Delicate ladies who were not able, as they supposed, to
endure cold water applied to the feet, have by degrees, wetting the
feet but little at first, become so accustomed to the coldest water that

704

rUOUEHHKS or TIIR HYDKOPATHIC TKRATMKNT.

in a few weeks they could bear ud much aa any one would dusiru.
Caution and perseverance should be the mle.

It is partly by Hyini)athy and partly by the abe>traotion of heat, that
foot-lmths and wetting the feet act in ho beneficial or deleteriouH a
manner as we know them to do. The principle of Hympathy is an old
one in the medical art, but none the worse for that.

The Warm Poot-Bath.

I AM aware that some who consider themselves genuinely hydro-
pathic object to the use of this remedy. Having truth for my ubjecl,
tiowever, I care not for such objections so far as I myself am concerned,
and without stopping here to argue the question, I simply remark
that warmth under some oiroumstances is as natural an applicutioti
for the living body as cold under other circumstances. I have already
remarked, under the head of the cold foot-bath, that putting the feot
into warm water is often a good preparatory process to that bath. It
is good also, now and then, for soothing divers aches and pains, and
also for warming the feet of old and weakly people, who cannot
exercise sufficiently. Soaking the feet in hot water for twenty min-
utes, and taking five or six dro|« of spirits of Camphor in a tea-
spoonful of sugar will often break up a cold, if taken in season.

The Nose-Bath.

Ik a variety of ntuKil ailmentc, catarrh, colds in the head, inflam-
mation and ulceration of the nasal passages, nose-bleed, etc., the
no^e-bath is a salutary rempdy. The water is used either tepid or
cold, according to the case. It should be drawn back, if possible,
so that it is ejected by the mouth. Those who have injured the
nasal cavities by much snuff-taking will find advantage from sniffing
water freely into the nostrils. If one is determined to leave off snuff,
as every one addicted to it, if he regards either health or bodily
comf(M-t, ought, he will find it useful oft«u to take cold water in-
stead of the abominable weed.

The Eye and Ear Bath.

"^^ contrivances may be brought to bear in applying water

^ a and ear. Light, ascending douches and showers are

. for various diseases of the parts. There should not be much

oe used in this way. Immersing them also in water is often useful.

The water should not, in general, be very cold, tepid or warm being

often the best.

iH*

PKOCBHHKH OK THK HYUKOPATHIU TREATMENT.

755

mid desire.

f heat, that
ileteriouH u
ly U an old

neli/ hydro-
my object,
I concerned,
ply remark
application
live already
iig the feot
t bath. It
paiiiH, and
rho cannot
iventy min-
r in a te&-
eason.

Mouth, or Oral Bath.

For inflammation of the gumn, mouth, throat, and palate, in slimy
seca'tioiiH from the throat and utomach, in tootlmuhe, cabirrh, coUIh,
and uiironiu hoarsenenH, gargliugs and batlu for the mouth are of
great Hervice. Pauley, a merchant of Vienna, has been thought
HJnguhir for his zeal in recommending this bath. Clergymen and
otliers wlio suffer hoareeueHS bv much speaking will find that hold-
ing very cold water in the mo ith until it l)egin8 to grow warm, and
then ejecting it, and by frequently repeating the process, much
l)enefit will be obtained. Coughs and tightness of the chest may
often be essentially relieved by this bath. In mucous secretions
from the throat and stomach, by ejecting the water a number of
times, it will surprise tho,se who have not v/itnessed file remedy to
see the amount of slimy secretion thrown off.

ad, inilam-
1, etc., the
sr tepid or
if possible,
njured the
ora sniffing
e off snuff,
I or bodily
d water in-

: ^* .P

ying water
lowers are
jt be much
ften useful,
yarm being

\h.\

DOMESTIC MANAGEMENT OP THE SICK

EOOM.

Choice of the Sick-Room. etc.

Sleeping Apartment. — In every case of disease, however slight
its nature, the sleeping apartment of the sick should be airy and well
ventilated; but, when Providence visits any member of a family with
disease of a serious and protracted description, all other considera-
tions giving way to the necessity of the case, an apartment should be
chosen and arranged in a special manner for the reception of the in-
valid. It should be one calculated to administer to his temporary
comfort, as well as to aid his recovery. It is not time, when the
alarm is sounded and the danger is already urgent, to think of such
arrangements; forethought must be put in requisition; every want
anticipated; and whatever is likely to be required should not only
be provif'^d, but so armnged that it can be instantly found when it
is needed.

The sick-room should be large, lofty, and, if possible, with a north-
em aspect, in order to avoid the heat of the mid-day, or the after-
noon sun; the windows should be capable of being opened by
drawing down the uppermost sash? If possible, choose a room with
an open fireplace or a ventilator opening into the chimney in the
upper part of the room. No article of unnecessary furniture should
be permitted to remain in the room; and that which is left in it
should be of a description fitted to administer to the convenience of
the invalid.

Two tables are sufiScient. One of them may be small, to stand
near the bed, for the immediate use of the patient: namely, to hold
his jug of barley-water, or toast-water, or other beverage; --a small
tea-pot, or what is preferable, a half-covered cup with a spout, to
enable fluids to be administered without raising the sufferer in bed;—
his medicines for the day; — and any other thing which he may fre-
quently require.

The other table should be large, for the accommodation of medi-
cines not in immediate use, and also for spare glasses, jugs, cups,
spoons, both large and small, and other necessary articles. This

756

DOMESTIC MANAGEMENT OF THE BJCK-ROOM.

767

5 SICK

ever slight
ry and well
fomily with
considera-
t should be
1 of the in-
temporary
, when the
nk of such
every want
[d not only
nd when it

ith a noiiih-
' the after-
opened by
room with
iney in the
ture should
) left in it
irenience of

1, to stand
ily, to hold
; — ^ a small
i spout, to
r in bed;—
le may f re-

n of medi-
jugs, cups,
;le8. This

table should have one drawer, at least, which ought to be furnished
with the following articles: broad and narrow tape; two or three
half-worn ribbons ; a bundle of old, soft linen ; a sponge ; a few
ounces of lint ; scissors, large and small ; a bone spatula for spread-
ing ointment; a couple of rolls of muslin, and the same quantity of
flannel bandage two inches broad ; a pin-cushion well supplied with
pins; needles and thread; and about half a yard of simple adhesive
plaster.

A Sofa or Reclining Chair. — A sofa, if the apartment be suiB-
ciently large to admit of it, is a very important piece of furniture in
the sick-room; the erect or the sitting posture being injurious in
many diseases ; and, when the sick-bed requires to be made, a sofa
affords the means of removing the patient from the bed with as little
inconvenience to him as possible.

If there is not a space for a sofa, there should be an invalid or re-
clining chair; and, when circumstances will permit, it should be of
that kind which is susceptible of a variety of changes, so as to vary,
at pleasure, the position of the patient. There should not be moi-e
than two other chairs in the room. If there is a looking-glass in the
apartment, in a situation which adm'.cs of the patient seeing himself
in it as he lies in bed, its place should be changed, or it should be
altogether removed from the room. A chest of drawers is essential ;
but none of the drawers should be appropriated for the reception of
dirty linen, which ought never to be allowed to remain a moment in
the sick-room. One drawer should be especially allotted for towels,
of which an ample supply is, in every case, necessary. The washing-
stand will require two additional iMwins ; an additional water-bottle
and a tumbler; and a large water-pitcher, under the table, always
full of water.

No Cookins In Sick-room. — There should be no kettle, nor any
implement of cooking, in the sick-room ; even in winter, and when a
fire is required. In general, a fire in the sick-room is only necessary
for the comfort of the attendants. The lamp termed a Night^urse,
consisting of a water-bath placed over a lamp in a wire-worked cylin-
der; a small tin kettle which enters the top of the cylinder; and a
covered earthenware vessel which fits into the water-bath, are use-
ful for keeping fluids warin, and at the same time for preserving a
light in the room, when an unshaded lamp or a candle would be
hurtful.

In ro itinued fevers, the sense of hearing is often so morbidl;y acute
that o/dinary sounds ^come cau^^es of pain. In this case, if the
floor of the sick-room be not w? jlly carpeted, every precaution to
lessen the intensity of the sound should be taken. One of the most
effectual is to have a couple or more pairs of :irge list shoes outside
the door, into which the feet, even of the doctors, may be advanta-
geously thrust, when their shoes make a creaking noise, or when a

758

DOMESTIC MANAGEMENT OF THE SICK-ROOM.

visitor or muse treads with a heavy foot. On the same account,
when more than one nurse or attendant is required to he in the room
at the same lime, no conversation, although it may be carried on in
a whisper, should be permitted. Whispering, indeed, is apt to ex-
cite delirium, and to augment it when it is already present.

Beds and Bedding. — Beds without curtains are those best adapted
for the sick-room. In every case of disease, indeed, especially when
it is attended by fever, the patient should be kept cool, and the most
perfect freedom be given to the breathing ; the hair mattress should
be used, never a feather bed, and the pillows be firm and elastic.
The coverlets, which are spread upon beds during the day, and often
retained at night, are heavy, and calculated rather to increase than to
subdue fever ; consequently they should be wholly discarded from
the sick-bed. Indeed, when the disease is fever, and when it is
accompanied with great restlessness, owing to the evening exacerba-
tion, if the bedroom be sufficiently large, two beds should be placed
in it; or if two adjoining bedchambers can be obtained, a bed ought
to be put in each, so that the patient can be moved from one bed to
the other every morning and evening. This both aids sleep, and it
also tends greatly to insure the personal cleanliness of the patient.
The Ijedclothes of the bed from which the patient is moved, should,
on his removal, be immediately turned down and fully exposed to the
air ; a precaution which will set aside the necessity of so frequent a
change of linen as would be otherwise required. When there is
only one bed, and when the disease is fever (unless the patient is too
ill to permit his being moved), the sheets which have been used at
night should be replaced by others in the morning, and hung up in
the free air during the day, to be again used at night. But, when it
can conveniently be done, in every case of continued fever, especially
of an infectious kind, the sheets should be changed once in twenty-
four hours ; a practice which is likely to prevent the fumes of in-
fection from being communicated to the blankets, or to any of the
furniture of the room.

Ventilation is always of primary importance ; and that period,
happily, is gone by, in which air was carefully excluded from the
chambers of the sick, even when they were suffering under febrile
disease.

Ventilation is particularly demanded in those fevers in which
miliary eruptions display themselves; under no circumstances is it
so essential as in febrile diseases of an infectious kind. It may, how-
ever, be consolatory to those whose duty it is to attend such cases, to
know that infection communicated through the air rarely extends
above a few feet from the body of the patient ; and even in the most
malignant diseases, with the exception of confluent small-pox, and
malignant scarlet fever of the woiBt kind, its influence does not ex-
ceed a few yards, if the room be well ventilated. On the contrary,

iiiiiiiii

DOMESTIC MANAGEMENT OP THE SICK-ROOM,

769

if ventiliition l)e neglected, the power of infection becomes greatly
augmented from its concentration in coJifined and quiescent air ; it
even settles upon the clothes of the attendants, and on the furniture
of the room ; and these imbibe it most readily when their texture is
wool, fur, or cotton, or any loose or downy substance capable of re-
ceiving and readily retaining the air. Smooth and polished surfaces
do not easily receive or retain infectious matter; consequently the
nurses and attendants, in cases of infectious diseases, should have
glazed gowns, and aprons of oiled silk.

In no infectious diseases are these rules more essentially necessary
than in small-pox and scarlet fever. It is well known that, if the
bedclothes of a patient laboring under either scarlet fever or small-pox
be closely folded up, they will letain the infectious matter, and com-
municate the disease at a great distance of time ; but the influence of
free ventilation is so great, that medical practitioners who are attend-
r.g small-pox patients, and who go from them into the open air, do
not spread the disease. Indeed, all infection is weakened by dilu-
tion with air. The danger of infection is augmented, if, along with
bad ventilation, the atmosphere of the room be moist from any cause.

It is further consolatory to know that the infectious matter, even
of the most virulent description, is not poisonous to everyone who
is placed within the sphere of its influence. A predisposition of the
body to receive the infection must exist before it can be communi-
cated; a condition which is augmented by fatigue and watching,
defective nourishment, mental depression, or anything which can
lower the vital powers. The necessity, therefore, of maintaining
these powers by attention to rest, a sufficient quantity of good and
generous diet, and cheerfulness of mind, need not be insisted upon.

In every case of infectious disease, the attendants, even in the
best ventilated rooms, should stand on the windward, or on that side
of the sick-bed from which the current of air comes ; as, by neglect
of this rule, and by standing in the cunent which has passed over
the patient, the infectious exhalations are blown upon them in a direct
stream from the body of the patient. The attendants should never
lean over the sick, nor should they receive their breath. The health
also of the nurses should always be supported by nutritious and gen-
erous diet ; but not by brandy, nor any other ardent spirit.

The term infection, in its most extensive signification, implies some
deleterious matter, originating from any source, and transmitted
through the air, which is capable of causing diseases in the human
body. When this matter is emanated from the diseased bodies of
men, the term is frequently regarded as synonymous with contagion;
but. in strictness of language, the latter refers only to the communi-
cation of disease by contact. Whatever may be the matter of infec-
tion, it may enter the body through the medium of the lungs, which
is the most ready inlet, or by the saliva, or even through the surface,
if the skin be abraded, or if any ulceration be present. The iuflu-

760

DOMESTIC MANAGEMENT OF THE SIOK-ROOM.

ence of infectious matter is evidently exerted on the nervous system,
displaying itself by debility, inertness, dislike to motion, great sus-
ceptibility of cold, irritability and despondency of mind, and by the
production of a disease similar to that of the person from whom the
infectious matter has proceeded. The infection may be supposed to
have taken effect, and to have produced the actual disease, when the
pei-son who has been exposed to its influence is attacked with giddi-
ness, pain in the head, irregular heat and chills, nausea, and, if the
infectious disease be small-pox, convulsions. These symptoms are
sufficient to denote the necessity for immediate medical advice.

Temperature. — Next to ventilation nothing is of more importance
than the regulation of the temperature of the sick-room, avoiding both
extremes of elevation or of depression ; but much depends on the
nature of the disease.

The best general temperature of a sick-room is 60° (Fahr.) ; and
it is preferable to regulate this rather by the thermometer than by the
sensations of the patients or the attendants. Under some circum-
stances, however, the feelings of the patient, and his susceptibility of
impressions upon the skin, should not be overlooked. Thus if the
temperature be a little above that of summer, and the patient, never-
theless, feel chilly, it should be raised five or six degrees. This chil-
liness is very apt to be felt in a dyspeptic state of the habit, and
more especially when it is accompanied with hypochondriasis. It dif-
fers from that more severe but transient coldness which accompanies
intermittent fevers, and some other periodical affections ; and it
requires an elevated temperature of the air for its removal, whilst the
cold stage of intermittent diseases is best relieved by the warm bath,
either general or local.

So important is the regulation of temperattire, especially in fevers,
that it often does more good than any other remedial measure. I
have seen patients laboring under high delirium in a close, ill-venti-
lated room become rapidly quite collected by merely lowering the
heat of the apartment twelve or fifteen degrees.

In convalescence, as the air of the sick-chamber should be fre-
quently renewed, the temperature in spring and autumn ought to be
maintained as near as possible at 55° to 60° (Fahr.) ; and it should
be very gradually lowered as the invalid acquires strength, so as to
enable him to bear with impunity the varying temperature of these
seasons in the open air. Even then, if the previous disease has been
pulmonary, the air admitted to the lungs should be tempered by the
use of the Respirator, or a muslin handkerchief tied around the mouth.
When the invalid first ventures out of doors, nothing, indee is so •
essential, in a prophylactic point of view, as avoiding extremes and
sudden transitions of temperature.

Cleanliness. — Although cleanline»a in the sick-room is essential,
yet it may be carried so far as to become an annoyance to '>A'.k invalid,

DOMESTIC MANAGEMKNT OP THE 8I0K-UOOM.

761

and consequently to prove injuTious. It is not requisite to sweep
the room daily, nor to dust and arrange the furniture eveiy morning,
provided order be preserved in the room, and nothing but what is
immediately necessary for the comfort and convenience of the invalid
be permitted to remain in it. It is truly distressing to observe the
confusion which prevails in some sick-rooms ; evervthing being out
of place, and to be searched for when it is wanteu.

The period chosen for ' leaning and arranging the sick-room should
be the morning, as after a night's rest the patient is mort able to
bear the little noise and bustle which it always more or less occasions.
The carpet should be sprinkled with moist tea-leaves, or newspaper
torn in small pieces and wet, and lightly swept.

It is scarcely requisite to insist on the necessity of the utmost
attention to the cleanliness of everything in the sick-room. The
moment after any vessel or implement is used by the invalid, it should
be removed from the apartment, and returned as soon as it is cleaned.
Nothing in the form of a slop-basin or slop-pail is admissible ; they
only administer to the laziness of nuiBes.

The necessity of cleanliness in the vessels used for the food of in-
valids is strikingly illustrated in the bad effects arising from the
neglect of it when an infant is brought up by hand. In such a case,
if the feeding-bottle which is employed be not instantly cleansed after
the meal has been given, the small portion of the pap or food which
remains in the vessel becomes sour, and taints the whole of the fresh
food mixed with it, causing colic and convulsions in the infant. The
same risk of injury occui-s in the sick-room, if the vessels used for
administering food to the invalid be not instantly and well cleansed
after every time they are used.

It is too common, also, to use one glass or cup for administering
medicines, and to leave it unrinsed from time to time, — a custom
which may prove as deleterious as a defect of cleanliness in vessels
employed for food. Some medicines, when they are exposed to the
air, rapidly undergo changes which alter their properties ; and this
alteration having been undergone by the small portion which is always
left, in the glass or cup, communicates the disposition to be decom-
posed to that which may be next -loured into the cup. An active
medicine maybe thus rendered i..ort; or one which is mild in its
operation may be so changed as to operate with hazardous energy.
The same precaution, as to cleanliness, is also requisite as to the
minim measure, when medicines are directed to be administered
in a form which requires its employment.

Darkening the Sick-room. — It is a common error to imagine that
a sick-room should always be either partially or wholly darkened. In
some diseases, as, for example, fevers, when the eyes are acutely sen-
sible to lipfht, so that they remain half-closed, and the eyebrows are
contracted, the greatest relief is experienced from darkening the
room. When delirium is present, a certain degree of darkening is in

762

DOMKUIIO MANAI.KMKNT OF THE BICK-UOOM.

some instances serviceablo ; whilst in others, especially when the de-
lirium is accompanied with visual illusions, nothing so readily dispels
these, and consequently abates the delirium, as the admission of the
full daylight into the sick-room. Theie is much difficulty, however,
in determining which state of the apartment is likely to l^e must ser-
viceable in any particular case. Observation of the effects of light
and darkness, in the individual case, must be our guide.

These illusions of the sight are generally the result of former im-
pressions,' renewed at a moment when the brain is in such a disturbed
condition as to set aside the exercise of judgment. In this condition
of the brain, the renewed conceptions are not readily corrected, as in
health, by impressions received from the external world; hence, they
become more vivid in the mind of the invalid when the sick-room is
darkened, and all visible objects are shut out. They are usually dis-
pelled by new impressions on the organ of sense chiefly implicated ;
on which account, those which are connected with sight seldom occur
during the day, when real objects are presented to the eye, unless the
brain be so over-excited as to bring the conceptive faculty into in-
tense exercise, sufficient to awaken those false perceptions wliich
create a belief of the prbscnce of individuals not only not present,
but who have been long dead. This state of the mental organ is
similar to that on which depend the spectral illusions of the insane,
but differing from it in its transient nature. I have frequently wit-
nessed the conversation with one of these spectral beings instantly
terminated, and the whole illusion dispelled, on opening the window
curtains of the room ; whilst the invalid has thus expressed himself :

" Bless me ! I thought I was talking with Mr. , just now ; I

must have been dreaming; for now I recollect he has been dead many
years." A twilight obscurity in the sick-room is often more produc-
tive of these illusions tiian darkness.

Fumigation.

After every contagious disease, like diphtheria, scarlet fever, etc.,
the room, furniture, bed, etc., are to be thoroughly disinfected, to pre-
vent the development and spreading of the germs.

Sulphur fumes have been used for many years for this purpose,
but this method is not secure, agreeable nor efficient. It no doubt
kills many germs exposed any length of time to its fumes, but never
destroys their spores. So much so-called fumigation, as usually prac-
tised, is useless, that it might as well not have been doue, as it
gives a false impression of security. Most virulent germs are capa-
ble of reproduction and dissemination years after their original occu-
pation of a house. Old bedding and clothing, brought out months
after the so-called fumigation, have caused the death of many a little
one, and the dangerous sickness of others.

Sulphur and its allies have been found to be so altogether uncer-
tain and untrustworthy that boards of health are no longer willing
to endorse its usefulness.

■H^i

DOMESTIC MANAGEMENT OF THE 8ICK-K00M.

763

ion tli(! (le-
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sion of the
U however,
le most ser-
ta of light

former im-
a disturbed
s condition
acted, a£i in
hence, they
ick-room is
usually dis-
Lmplicated ;
Idom occur
), unless the
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jted, to pre-

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[t no doubt
J, but never
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DS are capa-
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lany a little

sther uncer-
iger willing

The only reliable, practical measure against the life of contagious
germs is the same as now used in ciujc of surgical diseases. Corro-
sive sublimate, carbolic acid, boiling water, steaming, and baking are
sure aud safe remedies.

Of this xiwashev corrosive sublimate is easily the leader in efficiency.
It u not the dangei'ous drug to use as commonly supposed, since the
quantity necessary to kill cannot be collected in a room subjected to
ite use. Every piece of furniture and all woodwork, even the paper
of the wall, can be safely washed in a solution of this drug, made by
dissolving one tablet in two quarts of water, and fear need not be
enlertahied, either, of its efficacy or its harmfulness. Doors, windows,
and other woodwork should be thoroughly washed with it. Carpets
should be first wet with it from a sprinkler, dried and beaten. The
piper need not be removed, if only it can be wiped with this solution.
Bedding should be steamed, bed-clothing boiled, and all articles not
readily washed may be likewise steamed. A solution of carbolic acid,
1 pait to 40 of water, is likewise efficient. The great danger of
doing poor work in the matter of fumigation lies in the practice of
carrying things out of the room during the illness, before fumigation
has been commenced. The nurse or mother travelling from one
room to another may carry in her clothing germs sufficient to infect
a whole neighborhood. The attendants of such a case should wear
some tliin linen, cotton, cambric, or other washable dress, that may
now and then be put into the boiler, and thus thoroughly cleansed.

The hair of patient and attendaint should be thoroughly washed in
the corrosive wash on leaving the room, before disinfection of same.
Hands are to be scrubbed in soap and water, and then washed in
corrosive solution on leaving the room, and finally the room is to be
thoroughly aired.

K the work is done well and care has been exercised not to have
contaminated other portions of the house except that occupied by
the patient, all will be well. Frequently during the illness sheets
wrung out of the corrosive solution are hung up on one side of the
door to filter the air passing out of the room. It has-also been found
that the evaporation of some mild antiseptic in the room during the
sickness not only modifies the virulence of the germ, but is actually
beneficial in the treatment of these diseases. Of these drugs the
following is an excellent combination, which may be evaporated in a
tin dish-cover placed over a light, a stove, or other heated surface.
It should be burned during the continuance of the disease.

Carbolic Acid, . 1 oz.

Turpentine, 1 oz.

Oil of Eucalyptus, 1 oz.

Alcohol, 1 pint

Let the rate of evapomtion be very slow, and, if much carbolic acid
be used in case of children, see that the drug is not absorbed into the
system to such extent a-s to cause black urine or a'backache.

764

DOMKSTIC MANAGEMENT OF THE SIOK-ROOM.

m Si

Sulphur Fumigation. — This mode of fumigating ohambera after
measles, scarlet fever, and diphtheria is perhaps the most common,
and, while not an ideal method, it is very easy of application, and
quite practical.

Buy two sulphur candles for every room to be fumigfated, and,
having lit them, shut up all windows and doors, and stuff all crevices
in the doors with coi,tcn batting. Allow the fumes to penetrate
every closet and drawer for twenty-four hours. The room may then
be occupic'l.

Nitric Aclfd Fumigation. — Tho efficiency of nitric acid in the form
of gas, in arresting contagion, and in cleansing infected rooms, shiix,
and other places, is well established. To obtain the gaa, pour one
ounce of sulphuric acid upon two ounces of nitrate of potash in a
large tea-cup, — the cup being placed in a basin containing hot water.
The gas or vapor will be immediately disengaged.

This quantity will thoroughly cleanse a small apjirtment, but if
used in a sick-room, should be placed at some distance from the pa-
tient. In a large room two cups will be required ; and if a whole
house is to be fumigated, let several be placed in various apartments,
and the doors and windows be closed for half an hour.

Cliioride of Zinc. — A solution of the chloride of zinc has great
power in arresting contagion, and in cleansing infected places. A
small quantity of it will, in a few minutes, cleanse the most offensive
apartments.

Chloride of Lime. — This is one of the most powerful disinfecting
or cleansing agents known. To prepare it for use, add four gallons
of water to a pound of the chloride of lime ; stir the mixture well,
and after allowing it to settle for a short time, pour off the clear solu-
tion, and keep it in well-corked bottles.

Chloride of Soda. — This, in disinfecting power, is about equal to
the chloride of lime. In order that it may retain its properties, it
must be kept from the light, in a well-stopped glass bottle. When
used, it must be mixed in the proportion of one ounce, or two large
spoonfuls, to the pint of water. It is excellent for cleansing car-
buncles, gangrenous sores, bad ulcers, ulcerated soro throat, and fetid
discharges of every kind. A weak solution should be frequently
applied. [

Uses of Chlorides of Lime and Soda. — These articles almost in-
stantly destroy every bad smell, and all effluvia arising from animal
and vegetable decomposition, and entirely prevent their bad influ-
ence.

While infectious or contagious diseases prevail in large towns or
cities, the rooms should be sprinkled, morning and evening, with
some of one of these solutions. Some of it should be placed in the
different rooms, in shallow dishes, — the small bed-rooms Jbeing par-
ticularly remembered.

DOMESTIC MANAUEMKNT OF THE SICK-ROOM.

765

It must he remembered that whatever can be boiled, like linen
sheets, towels, etc., and whatever can be subjected to prolonged
steaming, or the presence of boiling water, can be made absolutely
clean and germ-free. No fear need be caused after such a disinfec-
tion.

In houses where there are typhoid and putrid fevers, and infectious
complaints, it is highly proper to sprinkle the solution about the
rooms, and occasionally upon the bed-linen ; and the air of the room
should be frequently renewed. A wineglassful added to the cham-
ber-vessel or the bed-pan will remove all smell. The most frequently
used disinfectants for the stools of typhoid patients is carbolic acid,
in the strength of one teaspoonful to the p'lt of water; of this use
half or third of the quantity for each stool.

Before sending the bed and other linen to the wash, let it be im-
mersed, live or six minutes, in one of these solutions, diluted, as mere
washing will not always remove the infection. But the linen should
be immediately rinsed in pure water after the immersion ; to allow it
to dry without such rinsing might injure it.

By pouring a quart of one of these mixtures, added to a pailful of
watp*-, into drains, sewers or cesspools, and repeating the application
as may be required, wil. destroy all their offensive effluvia.

Meat will keep for some time without any taint, and without the
molestation of flies, if immersed in one of these solutions for an in-
stant, and hung up ; and all tainted meat, fish, game, etc., will be
rendered sweet by a little sprinkling of the same.

To purify water in cisterns, and destroy the animalcules in it, add
to every one hundred gallons about a pint of one of the solutions.

The washing of bedsteads with one of the solutions, and putting
it into all the crevices, will destroy bugs.

A room just painted may be slept in safely, if one of the mixtures
be sprinkled about, and left in shallow dishes.

Stables, slaughter-houses, hog-sties, privies, and all places from
which offensive smells arise, may be thoroughly purified by these
mixtures ; or, still better, by the use of sulphur-naphtha, " oil of
milk," which is to be diluted in the proportion of one teaspoonful to a
quart of water, and used very freely. This is one of the most excel-
lent wound dressings now known, but should be used in one-half
strength solutions.

Being guardians of the public health of such wide application, and
of so great utility, it is surprising that they are not more used.

Freezing Mixtures.

In treating wounds, inflammation, etc., it is often quite important
to have ice, where it is not to be obtained without manufacturing it.
Accordingly, I« give here a few directions for its imaiediate produc-
tion.

...'■rtfWi.

ti ^j^idSiSwi^i^* •

766

<0ME8TI0 MAMAOEMKNT OF THE BICK-ROOM.

The salta U8«d should be in a ciystallized state, with as much water
in them as possible without being damp. They should be coamely
pulverized at the time of using, and put into the water oontainvd in
a basin, or other suitable vessel. The water to be frozen should l)e
inclosed in a thin vessel, and immersed in the freezing mixture. To
obtain extreme degrees of cold, the ingredients and the vessel should
be cooled by one mixture before being mixed for another.

To five drams of pulverized hydrochlorate of ammonia, and five
drams of pulverized nitrate of potash (nitre), add two ounces of
water, in a tin, stone-ware, or glass vessel, and you may freeze
water, sea-water, milk, vinegar, or oil of turpentine. It will cause
the thermometer to sink from 60° above zero to 10° above ; that is,
forty degrees.

A mixture of five drams of sulphate of soda, and four drams of
diluted sulphuric acid, will sink the thermometer seven degrees lower
than the above, namely, down to 8° above zero, or twenty-nine degrees
below the freezing point.

If six drams of sulphate of soda, four drams of hydrochlorate of
ammonia, two drams of nitrate of potash, and four drams of diluted
nitric acid be put together, the mixture will lower the thermometer
60° ; that is, to 10° below zero, or 42° below the freezing point.

Besides the above the following combination may be used :

Muriate of ammonia, five ounces ; nitrate of potash, five ounces ;
water, sixteen ounces. Mix.

Nitrate of ammonia, four ounces; crystalized carbonate of soda,
four ounces ; water, four ounces. Mix.

Nitrate of ammonia and water, equal parts. Mix.

Nitrate of ammonia and nitrate of potash, five parts each ; sul-
phate of soda, eight parts ; and water, sixteen parts. Mix.

Phosphate of soda, nine parts ; diluted nitric acid, four parte.
Mix.

Sulphate of soda, eight parts ; muriatic acid, five parts. Mix.

Sulphate of soda, six parts ; nitrate of amiaonia, five parts ; diluted
nitric acid, four parts. Mix.

Freezing Mixtures with ice. — Snow or pounded ice, two parts;
salt, one part. Mix. This will sink the thermometer to 5° below
zero.

Snow or pounded ice, four parts ; salt, two parts ; muriate of am-
monia, one part. In this mixture the thermometer will go down to
12° below zero.

Snow or pounded ice, twenty-four parts ; common salt, ten parts ;
muriate of ammonia, five parts ; nitrate of potassa, five parts. Mix.
Gives 18° below zero.

Snow or pounded ice, twelve parts; common salt, five parte;
nitrate of ammonia, five parts. Mix. Gives 25° below zero.

Snow, eight parts; muriatic acid, five parts. Mix. Gives 27°
below zero.

niSKl !*!'••»'»'■ 11 vTJf»i

DOMESTIC MANAOBMKNT OP THE SICK-UOOM.

767

1()

of soda,

Snow, sev uii parte ; diluted nitric acid, four parte. Mix. Gives
80° below zero.

Snow, four parte ; chloride of calcium, five parte. Mix. Gives
40° below 7A)ro,

Snow, three parte ; potassa, four parte. . Mix. Gives 61 ° below
zero, or 88° below the freezing point.

The NuMe. — When all the arrangemente are completed in the
HJck-room, little l)enefit can 1h! anticipated if a proper nurse be not
obtained to render tlieni available to the invalid. Every female who
wishes to act as a sick-nurse should 1x3 obliged to serve a certain
time as nn assistjuit nui'se in one of the pulilic hospitals, and to re-
ceive a certificate of her efKciency before she leaves the establish-
ment. The advantages which tlie public derive from a body of nurses
ediK ited in this manner must be obvious to every one.

in hiring a sick-nurse, the qualifications which should regulate our
choice refer to a; «, strength, healthy temper, disposition, habits and
education.

Age. — She should not be under twenty-five, nor above fifty-five
years of age. This period is fixed upon on account both of the
physical powers and tlie moral conduct of the individual. Under
twenty-five, the strength of a woman has not reached ite maturity,
and is scarcely adequate for lifting patiente in and out of Led, and
for many other duties which require strength, connected with tlje
office of a nurse ; but the strength and the muscular power in females
begin to fail after fifty-five, when the natural transition from maturity
to decay takes place.

Strength. — The foregoing remarks respecting age render it almost
unnecessary to say that a woman of a naturally delicate frame of
body is unfit for a sick-nurae ; at the same time, a coarse, heavy,
and masculine woman is, for many reasons, objectionable. Whilst
strength is requisite, the fi-ame should be such as to indicate activ-
ity.

Mealth. — None of the qualifications of a sick-nurse are of more
importance than health. An individual who herself requires atten-
tion is iil-calculated to attend upon others. A woman who is asth-
matic, or has any difficulty of breathing, or a habitual cough ; who
is rheumatic or gouty, or has any sptismodic affection ; who is af-
flicted with palpitation ; or suffers from periodical headache, vertigo,
or a tendency to paralysis ; or who is consumptive, or scrofulous ; or
has defective sight or hearing; or anything which causes decrepitude,
18 disqualified for a sick-nurse. It is important, also, to ascertain that
there is no hypochondriacal or hysterical tendency, nor predisposition
to mental depression.

Temper and Disposition. — It is scarcely r [uisite to say that an
attendant upon the sick should possess a happy, cheerful, equal flow

768

DOME8TI0 MAMAUKMKMT OK TUK HIOK-KOOM.

of Bpirite ; a tuinper not easily rufHed ; and kind and Hym|)ntlu>tic
feelings ; but, tit the Hnine time, not hucIi as to intcrfeix) witli linn-
nesB of oharucter. The expi-ession of the countenanue sliould Iw
open and winning, so as to attriict the good-will and confideneu ut'
the invalid : a pleasing and gentle manner being more likely to },'iuii
esteem, and insure obedience to the ordei-H of the physician, than tliu
most persnasive arguments wiiiuh can be addressed to the under-
stiinding of the patieni.

A collected, cheerful expression of the countenance, in the attend-
ant on the sick, is likely to inspire hope, and to aid tlie efforts uf the
physicicji for the recovery of his patient.

The general disposition of a sick-nurse should be obliging. Every
little office, which the invalid may require to be done, should be per-
formed at once, and without the smallest apparent reluctance, even
when the necessity for its immediate performance is not absolute.
There is also an earnestness of manner, which should, if possible, l)e
obtained or acquiesced in by the sick-nurse, as it impresses the idea
that she feels deeply interested in the case ; a circumstance whicli is
always highly appreciated by the patient.

Finally, it is unnecessary to say that a nurse should be honest, as
no description of servant has so much in her power. But the hoiieHty
of the nurse is not to be measured by her respect for property ; she
must be above imposing on the physician, with respect eitlier to
nitedicines or to diet. Iler religion, also, should be sincere, but not
Pharisaical ; and although she may occiisionally persuade her cliarge
" to put hia trust in God, the fountain of hesilth," * yet she must rec-
ollect that preaching is not her province ; and, when mistimed, even
the best advice may prove not only profitless, but injurious; and this
is especially likely to be the result when the doctrines she professes
are of a controversial kind.

With respect to gossiping, it is a detestable habit under any cir-
cumstances; but in a nurse it may be productive of the greatest
danger, produce family feuds, und a thousand other evils.

In her Habits, a sick-nurse should be sober, active, orderly, and
clean, and neat in her person.

The first of these habits — namely, sobriety — is so essential a
qualification in every attendant in the sick-room, that it requires no
comment. Happily, the desire for ardent spirits is now less frequent
than formerly, when women were seldom employed svs nurses until
they were nearly superannuated, and until their liabits, good or bad,
were too firmly rooted to be removed.

The Activity essential for a good nurse does not imply a bustling or
fidgety manner, but a quiet, steady method of proceeding in the per-
formance of her duties, equally devoid of fluster, turbulence or noise.
This activity is generally associated with orderly habits ; a most valua-

♦PuUer.

DCMRSTIO MANAnRMKNT or TUB 8I0K-ROUM.

76'J

mpiithntic
with tiriii-
hIiouUI lit-
fidt'iico of
Ay to },'iiiii
I, than tin;
;he uiider-

'Aie attcnd-
ort« uf the

g. Every
iild be pur-
ance, even
t abBohite.
)0H8ible, Iw
98 the idea
je which is

honeHt, as
he honesty
perty ; she
t either to
re, but not
her charge
B must rec-
imed, even
s; and this

) professes

er any cir-
le greatest

[•derly, and

Bssential a
equires no
)8 frequent
ir8e8 until
od or bad,

justling or
in the per-
e or noise,
nost valua-

ble qualification, and without which the Hick-room IwcnmeH a scene of
confuHion and diHguat. Kvery medical iniin must have witneHHed thJH
Mtiite of disorder with regret, when, on viHiting his patient, he Hnds no
ehair to Hit U| n until Home article of bedding or of clothing he re-
moved from i and the Heat duHted with the apron of the iiurHc; and
when a former prencription, dt anything else, is wanted, he niUHt
wait until the nurxe rummagcH out half a dozen of drawero in search
of it.

Another quality, UHUally conjoined with activity and orderly habitH
in a nurse, is cleanliness in her own person and in that of her charge,
as well as that of the Hick-room. The dress of a nurse should be
Himj)le and nea*^, without vrimmings. Nothing is more out of place
tlian a fine lady attempting to |>erform the duties of a nurse.

Education. — It niay appear a refinement to talk of, the education
of a nurse; but there is not a greater diffei-ence between noon-day
and midnight than Initween an educated and an ignorant nurse. The
former is often an aid to the physician, not only in carrying his op^iers
into effect, but by observing and informing him of symptoms of great
importance which h..ve occurred during his absence; whereas the lat-
ter is a source of constant anxiety, and too often assumes ohe privi-
lege of acting in direct contradiction to his orders, and according to
her own opinion.

Unhired Attendants.

The selection of a good nurse, however eminently qualified she
may be for her duties, does not supersede the attendance of a rela-
tive or friend in the sick-room ; on the contrary, I can conceive no
condition so deplorable as that of an invalid left altogether to the care
and management of a hireling. It is, nevertheless, too true that few
ladies, even those who are wives and mothers, have any acquaintance
with the arrangements of the sick-room, and the management of the
invalid ; they are, consequently, too often forced to be guided by, and
to rely for instruction on, the nurse, instead of being able to superin-
tend her conduct, to ascertain that she performs her duty, and to
correct her failings.

The degree of intelligence which is demanded in a nurse is very
different from that wliich is requisite for a wife or a relative in the sick-
••oom. The intelligence of the nurse is directed to supply the wants
of tl.3 invalid, to administer to his comforts, and to obey the instruc-
tions of the physician ; that of the friend or relative involves the
power of discriminating disposition and temper ; of watching the
progress of the disease, and judging of the propriety of not pursuing
I'ertiiin measures, which, although indicated by the symptoms at the
1 luie of prescribing, yet may require to be altered, and consequently
detailed to the physician, whose presence maybe retjuisite before his
next intended visit. It is of the utnjost importance, also, that rela-

770

DOMESTIC MANAGEMENT OF THE SIOK-KOOM.

tives attending in the sick-room should be able to control their feel-
ings in the presence of the invalid.

Nothing is more essential, in the domestic management of diseases,
than a knowledge of the natural disposition and temper of the inva-
lid. An irritable or a passionate man requires a very different man-
agement from that which is proper for a man of natui-ally mild and
easy disposition. Disease awakens, in an augmented degx ee, the irri-
tability of the former ; he becomes impatient of contradiction ; and
every time his opinions are injudiciously opposed, the turbulent agi-
tation of the nervous s^-stem Which follows either increases the dis-
ease or weakens the influence of the remedial agents. On the other
hand, a mild and gentle disposition often leads to extreme sensitive-
ness, when disease attacks the body ; a word, a look, is sufficient to
touch some sympathetic cord: to unstring the whole nervous system;
and to augment the morbid susceptibility already present in the habit
to a degree that is not always devoid of danger. Much discretion
and judgment, therefore, are requisite in both instances ; in the one
case, to present ebullitions of temper; in the other, to refrain from
anything that might be construed by the invalid into harshness ; and
yet at the same time, in each case, to maintain that influence over
the patient which the treatment of every disease demands in an at-
tendant on the sick.

Prejudice and Antipathies. — In those who are imperfectly or erro-
neously educated, the judgment is apt to be biassed by prejudice and
antipathies ; and, under the influence of these, it is misdirected in a
manner of which the individual is often wholly unconscious ; thence
the necessity of freedom from prejudice in the attendants in the sick
room, and the farther importance of the friends or relatives of the
sick being able to superintend the conduct and the management of
hired nurses. On the other hand, the judgment, even in the well-
educated, is apt to be misled by the affections, the influence of which
is as much opposed to the healthy exercise of discrimination as the
prejudices of the ignorant. Self-control, therefore, is also an essen-
tial qualification of the sick-room.

It is only from knowing that the attendants of the sick are pos-
sessed of intelligence and self-control, that a physician can rely upon
having his orders correctly and duly executed ; when those qualities
are absent, he has to dread, on the one hand, the presumption of
ignorant prejudice ; and on the other, the improper yielding of sensi-
tive indulgence. To the invalid, also, it is important to know that
the directions of his physician are filled by an intelligent person;
for, even in the most severe diseases, as long as the mental faculties
remain unaffected, a sick man is capable of detecting ignorance, or
the effects of prejudice, in his attendants ; and, when he is convinced
of the existence of either, all the influence of the individual, whether
nurse, or friend, or relative, is at an end.

Were the business of the sick-room findependent of the wants and

DOMESTIC MANAfiEMENT OF THE SICK-ROOM.

771

>1 their feel-

i of diseases,
of the inva-
ffereut man-
ly mild and
fi ee, the irri-
liction ; and
irbulent agi-
Eises the dis-
)n the other
ne sensitive-
sufficient to
ous system;
in the habit
h. discretion
; \n the one
refrain from
■shness ; and
fluence over
Is in an afr

sctly or erro-
rejudice and
irected in a
ous; thence
in the sick
tives of the
lagement of
in the well-
ice of which
lation as the
30 an essen-

?ick are pos-
m rely upon
ose qualities
sumption of
ing of sensi-
) know that
:ent person;
tal faculties
gnorance, or
is convinced
ual, whether

le wants and

(•(iniforts of the invalid) confined to the mere observation and collec-
tion of facts — namely, the noting of the symptoms of disease — and
reporting them to the physician, it would be superfluous to urge the
necessity of superior intelligence in its superintendent ; but many of
its duties require not only a well-regulated understanding, but an
equally sound condition of the moral feelings and the benevolent
affections, with a recognition of the authority of conscience in the
whole operations of life. In the period of sickness, under the direc-
tion of the judicious and discreet, an invalid may be led to the in-
vestigation of his moral and religious condition, and to review his
past conduct, with the determination of turning the result to his
future welfare, should he happily recover and re-enter society. Surely
such important duties as these cannot be intrusted to the unqualified,
or the ignorant, or the hireling ; nor can more be requir ^o demon-
strate the importance of adding to the other branches at female edu-
cation a knowledge of the various important duties of the sick-room,
which females, whether as mothers or daughters, or wives or friends,
are likely to be called upon to fulfil.

Prognostics.

In every disease the medical attendant is naturally called upon to
deliver his opinion of the degree of danger which hangs over the
patient : hence, it is unnecessary to enter into any minute details on
the subject of prognostics. But, as in many diseases changes occur,
in the absence of the practitioner, which ought instantly to be ex-
amined into, in order that the danger likely to accrue from them may
be averted, it is important that the friends and ordinary attendants
of the sick should be aware of their presence, so as to obtain the im-
mediate assistance of the medical attendant. Were this information,
also, morft generally diffused, many unnecessary visits would be saved
to the physician, and much unfounded suspicion of danger prevented
from distressing and touturing the minds of the friends of the sick.

In Fevers delirium alone should excite no alarm, unless it be very
high, or of the low, muttering, incoherent kind. In jaundice, and in
diseases of the chest, it is alarming ; and in the latter stages of pul-
monary consumption, its presence always indicates the approach of
death.

Great confusion of thought, loss of recollection of the most recent
occurrence, a restless, wandering eye, and a correspondent vacancy
or confusion of countenance, are always to be dreaded in fevers and
in diseases of the brain. An expression of great anxiety is equally
alarming in all acute diseases ; and a presentiment of death is still
more to be di-eaded.

Hoarseness, with constant spitting, oocui'ring at an early period
in small-pox, is very unfavorable.

772

DOMESTIC MANAGEMENT OF THE 8I0K-R0OM.

Squinting in affections of the head ought to be particulaily noticeu,
and mentioned to the attending practitioner; and the same remark
applies to a greatly contracted^ or a dilated, or an immovable condition
of the pupil of the eye ; or the turning up of the pupils under the
upper eyelids.

Deafness is not an unfavorable occurrence in continued fever; hut
a sudden attack of headache in pulmonary diseases ought instantly
to 1)8 mentioned to the physician.

The Sudden Disappearance of Pain in inflammatory affections of
the bowels is always to be dreaded ; but it does not in every instance
portend the existence of mortification.

Cough, depending on inflammation of the bronchial membrane,
suddenly supervening on a suppressed eruption, is always to be
dreaded.

In Croup, when the breathing is audible, or when there is a crow-
ing sound in inspiration, or a cooing or croaking respiration, danger
is present.

In Whooping-Cough, when the paroxysms suddenly increase in
violence, and the face becomes livid, and the thumbs are drawn
across into the palms of the hands, the appeamnce of convulsions
may be anticipated : hence immediate notice of these symptoms
should be communicated to the medical attendant.

Rigors invariably excite alarm ; but they are only dangerous in
chronic internal diseases, in which they often indicate the formation
of pus, or the existence of suppuration.

Pallidness of the countenance, with a slight degree of lividity,wt
sjonptoms of hazard in inflammation of the lungs.

The Position of the Patient as he lies in bed, especially in fevers,
is of much importance. Constantly lying on his back, with a ten-
dency to sink to the bottom of the bed; a propensity to keep the
arms and the feet out of bed, and to uncover the trunk ; or to pick
the bed-clothes ; tremors ; twitching of the tendons ; grindir.g of the
teeth, and sleeping with the eyelids half open, fcud the white of the
eyes only seen ; are all justly regarded as symptoms of great danger.

Fainting (^Syncope ) is to be considered alarriing in diseases of the
heart, or during profuse bleeding from the nose, or from any other
part: deep sighing, also, under cuch circumstances, is most unfavora-
ble, and often indicates rapid uis^OiUt'.on.

Hiccup, in the advanced stages oi ''ther acute or chronic diseases,
is invariably alarming.

Difficulty of Swallowing, also, in the advanced stages of fever,
palsy, and affections of the head, always indicates extreme danger;

^iiMttiiiiii^^ '"^f ti i iiij ii ii iiii

DOMESTIC MANAGEMENT OF THE SICK-ROOM.

773

Illy noticeu,
Hue remark
le condition
1 under the

i fever ; but
it instantly

iffections of
ery instance

membrane,
ways to be

•e is a crow-
ion, danger

increase in

are drawn

convulsions

) symptoms

mgerous in
e formation

lividity, are

ly in fevers,
with a ten-
» keep the
or to pick
tding of the
irbite of the
:eat danger.

eases of the
n any other
jt unfavora-

lic diseases,

es of fever,
ne danger;

vomitinff, on the contrary, is not unfavorable, unless it be very severe
and protracted; but, if the ejected matters be putrid, or feculent,
then the vomiting is always to be dreaded.

Coma, or an irresistible propensity to sleep, following the sudden
suppression of gout, or the cessation of periodical bleeding in piles,
or the healing of old sores, is always alarming, and requires prompt
medical assistance.

Convulsions without fever or any affection of the head seldom
prove dangerous ; but they are never free from danger when they
are accompanied with stupor or coma. They are also dangerous
when inflammatory fever is present. They are less dangerous in
women than in men, in the young than in advanced age. In infancy,
convulsions aie more to be dreaded in the robust than in the delicate
and irritable child.

Diarrhoea is, under every circumstance, an unfavorable eventf
when it occurs either in fevers, or in the termination of chronic dis-
eases; and the passing of involuntary stools, when scarcely any
diarrhoea exists, is equally to be dreaded.

Retention of the Urine, as well as its involuntary discharge, is
always an unfavorable symptom.

Purple Spots appearing on the skin, livid lips and cheeks, oozing
of blood, svdden flushings followed by pallor, are unfavorable symp-
toms ; and the appearance of oedematous swellings of the legs and
skin in the last stage of organic diseases always indicate approaching
death. When purple spots, also, appear in small-pox, with flattening
of the pustules on the trunk of the body, and a white, pasty aspect
of the eruption in the face ; and if, at the same time, the extremities
' become cold, any hope of recovery can scarcely be entertained.

Great and continued or progressing emaciation in chronic diseases,
and what is termed the fades Hippocratiea, are to be dreaded.

Excoriations on the parts on which the body rests, — for example,
the haunches, or the lower part of the back, — especially if these
become livid and sloughy, always indicate extreme danger.

Great Difficulty of Breathing, even to a feeling of suffocation, is
not necessarily hazardous in asthma; for although few diseases are
so little under control by the interference of the physician, yet
asthma seldom proves fatal, unless it tends to the production of
other diseases.

In Consumption, partial sweating, as of the head, the chest, or the
limbs, is always an unfavorable symptom.

When pregnancy occurs in a woman laboring under consumption,
the disease is arrested until after delivery, as if Providence threw a
shield over the mother for the safety of the offspring.

774

nOMESTIC- MANAfiEMENT OF THE SICK-HOOM.

The Sudden Disappearance of Swellins: of the Legs, in chronic
organic diseases, is indicative of ft,pproaching death.

When a child, instead of rallying after any acute disease, becomes
emaciated, and the belly is large and tympanitic, there is always
much danger.

Bed-Sores.

The danger of bed-sores is often in proportion to the carelessness
of the nurse, although the condition of the patient has much to do
with it. They attack fii-st the skin at the end of the spine, the hip-
joints, knees, elbows and heelp.

Debility from continued fever, from paralysis, old age, continued
pressure, unclean bedding, and the untidy habits of the nurse, are
the immediate cause.

The first appearance of a bed-sore is to be noticed in redness of
the skin ; soon a blister forms, the skin breaks away, leaving the sur-
face raw and moist. Decomposition sets in very qu'ckly if the
symptoms are neglected, and the blister becomes an open sore.

The outcome of the disease depends upon the condition of the
patient, and the removal or non-removal of the cause.

Treatment. — If there is much debility, tonics should be given.
The various places of the body which are likely to become soie
should be rubbed four times a day, from five to ten minutes, with a
stimulating mixture like spirits of camphor or olive-oil and brandy ;
a good liniment is alcohol or weak bay rum. Be careful not to irri-
tate the skin, — simply cleanse and harden. The prominences of bone
may be covered with surgeon-plaster if tliere is sweating of the body.
Unless a blister forms, the part should be relieved of pressure by air-
cushions. Collodion should be applied, and the parts kept dry.

If the blister turns to an open sore, use poultices until it is open
and the matter discharged, then use stimulating cleansing washes of
borax-water or weak carbolic-acid. Peruvian balsam on cotton-
wool is a good remedy.

The best preventive measures are careful nursing, dry, smooth
sheets, air-cushions, frequent changes of position. The bedding and
night-x'obe should be absolutely clean, dry and smooth and frequently
changed.

Ovarian Disease.

Or, as it is usually termed, ovarian dropay^ has hitherto, proved
incurable; but it is relieved by tapping; and, if the powers of life
be sustained by proper food, and carriage exercise in the open air ;
and if all medicines be let alone, except such as are required to
regulate the bowels, life may be sustained for many years.

All diseases not involving organic changes are, with a few ex-
ceptions, more or less under the control of medicines, and are conse-
quently curable. But some diseases, in which no organic changes

^MrfM

DOMESTIC MANAGEMENT OF THE SICK-ROOM.

776

have been discovered, are nevertheless incurable. This is the case
with spasmodic of hma, which haa rarely been cured.

It is true that i .ctional disturbances are not unfrequently as'soci-
ated with orgainc diseases ; but, under such circunistivnces, it is tlie
province of the attending physician to point out to the friends of the
patient the greater or the less degree of danger in these complica-
tioiis.

Diet, etc., in Disease and Convalescence.

In numerous instances, much hazard often exists after disease has
disappeared, and when the patient is declared convalescent ; and as
this period in the removal of diseases is left to the management either
of the patient himself or of his friends, some general remarks re-
specting it, and also in reference to particular diseases, are requisite.

In every recovery from sickness, whether external or internal, be-
fore the salutary advantages obtained from the treatment be confirmed,
the organ or part which has suffered must be either left at rest or be
used, according to the nature of the case. Thus, if any part have
suffered from inflammation, it must not be used for some time after
the inflammation is subdued. If the eyes have suffered, the person
must neither read nor write, nor expose the eyes to the heat of the
fire, nor to a strong light, until some days after every trace of the
disease has disappeared. If the arm has been affected it must be
kept at rest ; and if the leg, not . only should walking be refrained
from, but the limb should be placed mther higher than the trunk of
the body. If the previous disease has affected the brain, every men-
tal exertion must be avoided ; and so on, whatever may be the ergan
which has especially suffered. Even when the exercise of the organ
is resumed, it should not be carried to fatigue, nor, on any account,
should it be such as to produce excitement. At the same time, it
must not be forgotten that, in the treatment of external injuries, when
it has been necessary to keep the limb long in a sling, in one position,
— as, for instance, in fractures, — the muscles which bend the arm
acquire from the habit a contraction which cannot be overcome by
the antagonist muscles, owing to the length of time they have been
on the stretch, weakening their contractile power. The arm, there-
fore, should be frequently taken from the sling, and, being rested upon
the elbow, a moderate weight should be held in the hand, and friction
with oil employed upon the contracted muscles. It is true that sur-
geons usually give directions for this operation, before they quit the
management of the case ; but surgeons, as well as physicians, are
sometimes dismissed b.foi'e the convalescence is complete ; on which
account, arms and limbs have remained contracted for life, from a
want of the knowledge necessaiy to counteract the evil at an early
stage. I say nothing respecting the continuance of remedies during
convalescence from many diseases, except urging the necessity of
regulating the bowels.

776

DOMESTIC MANAGEMENT OF THE SICK-BOOM.

The most important part of the management of convalescence cer-
tainly refers to air, exercise, and diet. The erroi-s daily commitUMJ,
in all these matters, exert the most powerful influence in retarding
complete restoration to health ; and often, indeed, induce evils of a
more formidable kind than the diseases from which the patients have
just emerged.

1. Air. In every convalescence, whatever may have been tlie
nature of the disease, if it has been so severe as to wear down tlie
strength of the invalid, countiy air is essential. The benevolent
Author of our existence has made medicinal the hills, the vales, tlie
groves, and all the harmonies of nature ; and in the repose of these
man finds a balm, not only for a wounded spirit, but for his stricken
body.

In selecting a country residence for a convalescent, care must be
taken to ascertain whether any source of malaria exists in the neigli-
borhood; as, in that case, even if all other circumstances be favorable,
the place is exceptionable.

2. Exercise. In convalescence, much caution is requisite in apnor-
tioning the exercise to the degree of returning strength. When the
convalescent is still too feeble to take sufficient exercise on foot, tlie
best substitute for it is riding horseback; but, as soon as walking
can be borne, it should be preferred to either horse or carriage exer-
cise.

3. Diet, In health, diet may be left, in a great degree, to the in-
clination or the taste, as far as regards the quality of the food ; and,
although diseases occasionally originate from repletion, yet, in gen-
eral, the appetite may be considered as the best regulator of quan-
tity, when the food is simple, and the appetite is not pampered by
high seasoning and rich sauces. In disease, however, a very opi)o-
site rule is to be observed ; the regulation of both the quantity and
the quality of the food is of the utmost importance. The taste is
often so perverted as to desire that which would prove injurious ;
and were appetite to be the guide of quantity, diseases would fre-
quently not only be increased in severity, but life itself would be
brought into .jeopardy.

As soon as solid animal food can be taken with impunity, that
which is most digestible should be selected. An opinion has gener-
ally prevailed that gelatinous matters, and meats which readily yield
jelly, — such, for example, as veal and lamb, — are the most easily
digested, and at the same time are also the mo;t nutritive. This is
a mistake ; for, with the exception of poultry, the flesh of young ani-
mals is stringy and of a lax fibre, and is even less easily digested than
that of too old animals, which presents great density of texture.
The middle-aged animals afford the most digestible food.

Nothing tends to lessen the density of the fibre of eveiy kind of
animal food so much as kee[)ing it for a certain time before it is
cooked. In this case the tenderness is the result of incipient decora-

DOMESTIC MANAGEMKNT OF THE SICK-ROOM.

777

scence cei-

jommitted,

retarding

evils of a

iients have

been the
• down tlie
benevok-nt
! vales, tlie
je of these
is stricken

re must be

the neigli-

) favorable,

je in api)or-
When the
m foot, the
as walking
riage exer-

, to the in-
food; and,
et, in gen-
)r of quan-
mpered by
very op»o
lantity and
?he taste is

injurious ;
would fre-

would be

lunity, that
has gener-
adily yield
nost easily
J. This is
young ani-
jested than
Df texture.

3iy kind of
)efore it is
ent decom-

position or putrefaction ; but the utmost caution is requisite to pre-
vent this from advancing so far as to present the slightest trace of
taint in the food of the convalescent. In the low state of vitality in
convalescence, the change which commencing decomposition (putre-
laction) causes, renders animal food in that condition a source likely
to occasion either a relapse into the disease from which the patient
has recovered, or to form a new disease.

In examining the relative value of other articles of diet adapted
for the sick and convalescent, the first which presents itself to our
notice is

Milk. — As milk is the food of almost all young animals, its diges-
tibility appears at once evident ; and there can be little doubt that it
is very digestible, when it is drunk immediately after it is drawn
from the udder of the cow or the goitt, before its components have
time to separate. When this separation is effected, either spon-
tivneously by time, or by means of rennet or other agents, its prop-
erties are altered, and ita digestibility is lessened.

Cream, when intimately united with the other components of
milk, — namely, the curd, or the caseous part, and the whey, — is
not the same substance as after its separation. In the milk, it is
more easily digested, and is the most nutritive part of the milk. But
in its separate state it is ill adapted either for the sick or convales-
cent except in the form of butter, which is not unwholesome unless it
be eaten in excess or be melted. • Although cream is not as digesti-
ble as milk, yet it is much less liable to turn acid in the stomach ; it
is often beneficial to dyspeptics, either alone or diluted with water.
In the same manner the separate eurd is indigestible ; and whey
itself, although highly nutritive, yet is flatulent ; nevertheless, it is
an excellent demulcent in many cases of diseasfe. But none of the
components of milk are equal to milk itself. It is often necessary,
in convalescence, to dilute it with water.

Eggs. — It is not uncommon to hear that the yolk of a raw egg,
beaten up with water and sugar, with the addition of a small quan-
tity of white wine, is a light and nutritive aliment in convalescence,
and even in some states of disease ; but eggs aro much less digestible
in this form than when they are lightly boiled. In jaundice, however,
arising from viscid mucus obstructing the orifice o^ the common
duct, the yolk of a raw egg beaten up with cold water is serviceable.

Fish, at least the white kind, stimulates much less than the flesh
of land animals; hence it is a proper food for those laboring under
some acute diseases ; and also for convalescents, when a sudden re-
turn to more stimulating food would prove hurtful. But it is not
adapted for convalescents when the object is to bring up rapidly the
strength of debilitated habits.

Raw oysters have been erroneously supposed to be both easy of
digestion and nutritive. The latter opinion is, in some degree, true;

778

DOMKSTIC MANAOKMENT OF THE SICK-ROOM.

but the former U erroneous. Raw oyslurs are less di^'csliMc! than
plainly-cooked oysters. Both are inij»rt)iHM' for the sick iiiid for eariy
convalescents. Lolwters, crabs, prawns, cray-fisli, scallops, and other
shell-fish, are still more objectionable.

If fish of any kind be admissible, it shouhl be simply boiled; fried
fish is even worse for invalids than the outside or tlie brown of roasted
meat.

Vegetables. — In reference to vegetahle diet, it is only the mildest
description of esculent roots that are fitted for the use of the sick.
In preparing all of them for the sick room, they should be well boiled
in two distinct waters, until they are soft and very soluble, and in a
state not to leave undissolved anything which could act as a mechani-
cal irritant on the intestinal canal. When properly cooked, they are
moderately nutritive, and free from any stimulant properties ; and
they are well adapted for the stomach of the sick, unless in cases in
which the torpor of the organ is such as to permit them to run into
acetous fermentation and to prove flatulent.

Fruits. — With respect io fruits, they produce the most diversified
effects ; and, consequently, are more or less proper for invalids, ac-
cording to circumstances, either connected with themselves or with
the condition of the patient at the time. The stone-fruits., with the
exception of the ripe peach, or the nectarine, are to be rejected. The
apple tribe, except very soluble pears, are still less admissible. The
apple, however, when roasted, and when the seeds and the hard cen-
tral parts, as well as the skin, are removed, is less objectionable ; and,
as it possesses laxative properties, the roasted apple is well adapted
for the sick, when food is at all allowable, and wiien the bowels are
torpid. The orange, if fully ripe, is grateful and wholesome to all
invalids, and is only equalled in these qualities by the grape ; but in
using the orange, the pulp should be rejected. The juice of the
grape-fruit is good and refreshing, but care should be taken not to
use any of the pulp, on account of its bitter taste. Care also should
be taken not to swallow either the skin or the seeds of the grape.
Strawberries are a little stimulant, of easy digestion, and more cool-
ing than the other small fruits ; mulberries are also unexception-
able ; but currants and gooseberries, and even raspberries, are not
free from objection for invalids laboring under acute diseases.

With the exception of oat and wheaten hread, especially that
made from Franklin Mills flour (see receipt), all the varieties of
farinaceous aliments may be regarded as modiflcations of starch,
containing little nutritive matter, and therefore well adapted for the
sick-room. It has been supposed that arrow-root, sago, tapioca, and
similar substances, are very nutritive, because they form mucilages
with boiling water; but this is not the fact; and were they very
nutritive, they would be ill adapted for invalids. Rice, in every case
where the stc ^ach is in an acescent state, is preferable to the other
farinacesB, because it is less fermentable.

^^^

nmtmatmtSA

DOMESTIC MANAQKMENT OK THE 8ICK-U00M.

779

The farinaceous food which is ordered in the convalescence of
children from acute diseases, is often made of bread so as to consti-
tute pap. No description of food has a greater tendency than this
to become sour; a ^^nantity only sufficient for a single meal, there-
fore, should be made at a time ; for what remains is always sour
before the next meal ; and even if the quantity be small, and it be
mixed with fresh pap, it communicates its faculty of becoming sour
to the whole mass.

Fluid Aliments.

Water. — The best and the most universal beverage for the sick
is water : but the qualities of water differ, according to the sources
whence it is procured. The fewer foreign ingredients it holds in so-
lution the greater are its diluent properties. Distilled water, or rain
or river water filtei-ed, and that of soft-water springs which filtrate
through silicious strata, are the only kinds proper for the use of the
sick-room. Hard water, under whatever name it is found, whether
as spring water, or pump water, or well water, should be excluded.
The impurities of river and min water are merely held in suspension ;
consequently, they are readily removed by filtration.

Water itself is aliment ; many individuals under certain circum-
stances have lived for a considerable time upon it alone. Those
who live chiefly on animal food require more drink than those who
eat much vegetable matter.

The influence of water on the animal economy may be regarded in
two points of view :

As an article of diet.
As a medicinal agent.

As an article of diet, in health, water is the beverage provided by
nature for all animals, man not excepted. The sensation of thirst is
the natural call for fluids, either to assist digestion, or to allay a dry,
hot condition of the mouth and the gullet. The consequence of not
satisfying this call is fever of a nervous kind; and, if it be long re-
sisted, inflammation of the air-passages. On the other hand, too
nmch fluid is injurious ; for although the vital powers of the stomach
counteract the tendency which it affords, by over-diluting the gastric
fluid, to the fermentation of the aliment in the stomach, yet when it
is in excess, those vital powei"s languish ; hence spontaneous chemi-
cal changes in the contents of the stomach take place, and induce
dyspepsia. For all the purposes of dilution in health, water is ade-
quate, and it is the only truly wholesome beverage.

As a medicinal agent, water is demanded in every disease in which
a dry skin and an elevation of the natural heat of the surface, con-
stituting fever, are present. In this case, the desire is for cold water
or cooling fluids; and it should always be indulged. The degree of
temperature, however, must be regulated by the condition of the in-
valid; but the best medium temperature is between 50° and 60°

tg0

780

DOMESTIC MANAOEMENT OF THE BIOK-KOOM.

Fahr., although even 60° is too low, when the debility ot the fiame
is Gonsidemhle.

The qualities of the various kinds of beverages proper, and gene^
ally employed in the sick-room, should be known.

Toast-water, when properly prepared, which it seldom is, forms a
useful beverage in the sick-room. It is slightly nutritive, owing to
its containing a small portion of gluten, in conjunction with fecula
and sug^r. It is one of the oldest and one of the best diluent de-
mulcents ; diluting at the same time that it softens the acridity of
the secreted juices of the stomach, in febrile diseases.

Qruel, whether made of grroats or of oatmeal, is less mild and de-
mulcent than barley-water ; and it is more likely to undergo the ace-
tous fermentation in the heat of the stomach ; a circumstance which
is greatly favored by the sugar and butter which is sometimes added
to it. Unless gruel be very thin, it can scarcely be regarded as dilu-
ent ; and when thick, it is too heating an aliment for patients labor-
ing under febrile symptoms.

Tea, in the form in which it is usually taken, is too stimulant and
astringent to be a good diluent : and, when it is strong, the narcotic
property which it possesses renders it improper for most invalids,
whatever may be the nature of their diseases. As it is, nevertheless,
agreeable to most palates, and very refreshing, it may be taken in
moderate quantity, provided it be not strong, without any hazard.

Sas^, balm, and mint teas, are often substituted for common tea.
Each of them undoubtedly allays the irritability of the stomach in
some cases ; but, as general beverages in disease, they are less useful
than toast-water. Raspberry vinegar, lemotiade, tamarind tea, apple
tea, and similar compound diluents, should never be administered
without the consent of a physician. If a patient be taking an anti-
monial, they will excite vomiting ; if a mercurial, gi iping ; and they
are equally incompatible with many other medicines, and with many
conditions of the stomach in disease. They are a description of
beveragfe greatly recommerded and largely distribn^ >d by the Lady
Bountifuls in the country, and have frequently been productive of
serious mischief.

Coffee is more heating, aud connequently less ad" issible than tea ;
it may, however, be taken, if it be largely combined ' /ith milk. Cocoa
and chocolate are still more objectionable than eithrr tea or coffee in
the sick-room. Shells i're good and nourishing.

With respect to the Number of Meal?, and ihe periods best
adapted for taking them, it is scarcely requisite x) remark, that,
although in health three moderate meals, at proj ir intervals, are
customary, and well adapted for the support of the irame, yet, under
the changed condition of the system in disease, it would be improper

DOMESTIC MANAGEMENT OF TUB 8I0K-BOOM.

781

to take any regular number of meals, or to observe any stated periods
for takinnj tl^em: hence no general rules can apply.

As a general rule, in the decline of diseases, and on the approach
of convalescence, when the desire for taking food rctuins, the test
time for the principal meal, dinner^ is about two hours after noon.
If the breakfast be taken at nine o'clock, and the evening meal at
seven, the hour of two is the middle period of the day ; so that, when
dinner ia taken at that time, the intervals between breakfast and
flinner, and between dinner and suppei', are not only ecjual, but
neither is too short to limit the complete digestion of the previous
meal, nor too long to injure the powers of the weakened stomach
by protracted fasting.

AH acute d'.^eases require more or less abstinence, especially when
the object of 'he treatment is to lower the system ; and in some
chronic affections, abstinence is almost essential. If this be true, the
necessity of the strictest observance of the directions of the physician
oil this subject must be obvious. It is one, however, which is not
only neglected, but is often combated lx)th by nurses and friends;
and indulgences, which are supposed to be of too trivial a nature to
cause any injury to the sick, have often been followed by fatal effects.

But, although abstinence be requisite during the existence of an
acute disease, yet it is injurious when it is too rigidly maintained
after convalescence is actually established : it often induces a new
train of symptoms, not very nplike those for which it was properly
prescribed and the removal of which it has aided ; namely, accelera-
tion of the pulse, increased impetus of the heart, headache, and even
delirium.

General Diseases.

Happily, in febrile affections, the appetite of the invalid is not in
a condition to desire food ; and no stronger demonstration can be
required of the impropriety of forcing it upon him under such circum-
stances. Simple fluids, such as diluents, are all that he desires, all
that the stomach can bear ; and such alone should be administered in
fever, before that low condition of the system, which demands the
use of wine or other stimulants, supervenes. In these cases, when
the patient desires more nourishment than is usual, animal food
ought not to be given, unless by the direct recommendation of the
physician. Indeed, in general, the inclination of the invalid happily
revolts from animal food, as much as experience condemns its ad-
ministration.

While febrile symptoms are present, farinaceous matters, little
nutritious, such as barley-water, gruel, arrow-root mucilage, or sago,
acidulated with lemon-juice, and sweetened to the taste of the patient,
are most suitable ; but even these should be given in small quantity,
and at considerable intervals. The beverage generally most agree-
able, and also most salutary, to those suffering under fever, is cold
water. *

78S

DOMKHTIO MANAdKMKNT OV THE HICK-K(J(>M.

In the decline of fevera, even, oh I have alreiidy remarked, ftltlioiigli
the severity ruH^Hiutiug diet Hhuiihl be relaxed, yrt much diiiigei may
result from miHtnken kindneHS and over-zeal, in urging aiiinuil uiul
stimulant food at too early a period of the uonvaltMcence. Imlci'd,
the necessity of caution at IIiIm time is greater than during tli" con-
tinuance of the fever; and the more acute tlie disoaae has been, tliu
greater must be the caution in the convah Hcciice, enpecially if the
treatment Iuvh Imjoii of an evacuant and lowering description.

The first change of di(it, in the decline of fevers, should be to an-
other article of the same kind of food which wiw allowed in tlio din-
ease ; for example, from simple arrow-root mncilaye to arrow-root and
milky or to some other of the farinaceous compounds ; whilst, at the
same time, agsee^ milk may l>e given in small quantity in the morn-
ing. Rice, one of the furinacete, is generally supposed to be aHtrin-
gent, but this is a mistake. It forms an excellent diet in all cases of
early but decided convalescence. It should be well-boiled, and mixed
either with bioth and beef-tea, or gravy which has been cooled, and
the fat taken from it. In the transit on to animal food, heef-tea,
chicken-broth, and mutton-broth, and othtr liquid animal decoctions,
should he first resorted to; then ff/»7«jiv'«A, simply cooked ; for, al-
though fish is more digestible than animal food, yet it affords nmcli
less stimulant nourishment; it is therefore betti>r iitted for the early
stage of convalescence. When convalescence is completed, a more
generous diet is admissible.

With respect to beverage, water, toast-water or lemon-peel^ater,
is sufficient, until the medical attendant declares that a little wine is
requisite.

In convalescence from /et>«r, it is an error to permit the patient to
get up too soon. He should not leave his bed until his strength be
considerably advanced. No danger can result from too strict an
observance of this rule ; whereas much risk may be incurred by its
neglect.

If the head has been much affected, every mental exertion should
be refrained from dunng the convalescence ; and, according to the
degree of suffering in any local organ, precautions must be taken to
guard that part of tlie frame against a fresh attack of disease.

Eruptive Fevers require more i)recaution in convalescence than
general fevers, both as regards diet and exposure to sudden alterna-
tions of heat and cold. This is more especially essential after measles
and scarlet fever.

Measles are often followed by a distressing cough, and other sjTnp-
toms of piilmonary inflammation ; or by a harassing diarrhoea, which
wears down the strength ; or by inflamed eyes, catai'rh, or obstinate
toothache. In infants, canker of the mouth occasionally makes its
attack, and pioves fatal. All these affections, aftt^r measles, might
generally be prevented by taking care not to allow too soon a return

nOMKHTIO MANAORMRNT Off THE HICK-ROOM.

788

(1, ivltliougli
liiiigfi nmy
iiiiiiiiil iind
3. Indeed,
rig tiut coil-
S 1)6011, tlio

ially if the
on.

(I 1)0 to ftll-

iii tliu dis-
ow-root ami
lilst, ut the

the niorn-
1)0 astrin-
nil cases of

and mixed
cooled, and
)(1, heef-tea,
decoctions,
3(1 ; for, al-
ords much
)!• the early
ted, a more

\rpeel^water,
ttle wine is

} patient to
itrength l)e
o strict ai<
rred by its

bion should
ling to the
be taken to
sase.

icence than
len alternar
ter measles

(tlier syrap-
;ioea, which
»r obstinate
makes its
sles, might
m a return

to the use of animal food, or too early an cxpoHur« to cold or to night-
iiir. Kvcn in summer, flannel should Ih) worn next the ukin for some
weeks after the disease has disappeared.

Scarlatina is frequently followed by dro{>sical symptoms ; which,
however, might generally ho avoided by tht* same attention to diet
and regimen as after measles.

Small-Pox, when severe, and especially when confluent, is very apt
to awaken into activity the dormant seeds of sciofula, if any lieredi-
tary taint exists in the constitution ; hence al)sces8es, ulcers, and
swelled glands make their appeamnce. These demand the aid of
the physician or tlie surgeon. But if the convalescent be properly
dieted, and recourae he had to a change of air as soon as his strength
will permit, tliese evils may be avoided.

Erysipelas not unfrequently attacks convalescents from small-pox
and other eruptive fevers. When it occurs, independent of any prior
disease, the same attention to diet and regimen is requisite as in other
eruptive fevers.

Convulsions, it is well known, are not unfrequently the result of
errors in diet, in individuals with an irritable condition of the stotn-
ach and bowels. Advice should always be demanded respecting the
diet of those who are liable to, and who suffer from, convulsions ; but
it must not be supposed that when they occur in children and have
l)een subdued, a system of starvation is necessary to prevent their
recurrence. As far as regards convalescence in such cases, it will be
proper to bear in recollection the following rules :

1. When the patient is of a. full habit, has a short neck, and a ten-
dency to diseases of the head, the diet should be spare. The use of
animal food, indeed, in BU(di a habit, should be wholly prohibited in
childhood, and very sparingly employed by adults ; whilst vegetables,
farinaceous matters, milk and weak broths, may be allowed.

2. When the habit of body is spare, and when languor and chilli-
ness are present, the diet, although free from stimulus, yet should be
nourishing, and consist of the lighter kinds of animal food ; namely,
poultry and fish, with a moderate share of vegetable matters.

3. Under all circumstances, and at every period of life, fermented
liquora and wine should be either wholly avoided, or very sparingly
used, in almost all convulsive diseases connected with affections of
the head.

In convalescence from some varieties of convulsive diseases, the
nature of the diet must depend on circumstances which cannot be
judged of by the attendants of the sick-room; hence it should be
referred solely to the medical attendant. In St. Vitus^a Datice
(chorea), for example, although a tonic plan of treatment may have
l)een successfully pursued, yet the diet may be required to be mild,
and wholly free from stimulut}.

^^P^-:

mmm

784

DOMESTIC MANAGEMENT OF Tl'E SICK-BOOM.

Attention to diet in Hysteria is most important. When the disease
is connected with indigestion, the meals should be moderate : and
rest in the horizontal posture should be indulged for an hour after-
wards, and then moderate exercise taken. Fluid food, such as broths
and gruel, are improper ; yet animal food should be eaten only once
a day. Tea and coffee should be very sparingly taken ; and the sim-
plest beverages, even water and toast-water, should be taken in great
moderation after a meal, and should not be drunk during dinner.

In convalescence from hysteria, change of scene and air are abso-
lutely requisite. The mind should be directed to solid studies, and
everything which can cherish morbid sensibility of the nervous system
avoided.

Dropsy. — An opinion was long maintained that fluids are to be
withheld from dropsical patients. No opinion was ever founded on
more erroneous principles. Dropsical patients, indeed, should be
allowed the free use of fluids. With respect to diet, it should, gen-
erally speaking, be light and unstimulating : but much depends on
the causes of dropsy. There is, however, less n*- ^essity for a rigid
adherence to low diet in this than in other inflammatory affections.

In Palsy, abstinence from all stimulating food, solid or fluid, must
be rigidly observed ; and the restriction should not be discontinued
in convalescence. At the same time, change of air and of scene is al-
ways of decided advantage. In every instance, an easy state of mind,
and freedom from every source of irritation, as well as from the anxi-
eties of business, are indispensable.

Qout and Rheumatism. — In no diseases affecting the general
habit are abstinence and repose more essential during the attacks than
in the two which head this paragraph, when they assume an acute
form. When they occur in weakened or in biuken-down habits, it is
too often supposed that the opposite plan of diet is to be pursued,
and that stimulating food and a liberdl supply of wine should be in-
dulged; but nothing is more likely to prove injurious.

When the paroxysm subsides, it is too customary to permit the in-
valid to glide into his usual habits with respect to diet and regimen ;
consequently the plethora which originated the disease gradually re-
turns ; aad the same plan being continued, paroxysm follows after
paroxysm, at shortening intervals, until scarcely any interval occura,
and life is sacrificed on the altar of self-indulgence.

For some weeks after the paroxjram of gout has subsided, in a
young or middle-aged man, animal food should be sparingly taken,
and fermented liquors altogether avoided.

Chlorosis, or Qreen Sic*'nes5, in a state of the habit which seems
to depend on an i'npa.red condition of the blood itself. Its treatment
is well understood, and recourse to medical advice should never be
neglected j otherwise it may terminate either in mental demngement

'^V'i^-\J^'

DOMESTIC MANAGEMENT OF THE BICK-ROOM.

785

or in sudden death. In convalescence from it, the diet should be
mild and light, but nutritious ; the exercise should be much within
the limits of fatigue, and consist of both walking and horse exercise,
dailv, in the open air ; the body, more especially the lower extrem-
ities", should be warmly clothed ; the mind ought to be amused ; all
sedentary occupations thrown aside; and confidence placed in the
honor of the physician, who should be made the repository of any
mental anxiety, especially connected with the tender passion, which
may be preying upon the vital energy of the body.

Affections of the Head.

Whatever may be the cause of Apoplexy, no disease requires more
prompt and energetic treatment : the alarming nature of the symp-
tf 03 is always sufficient to prevent any time from being lost by at-
tempts to relieve the sufferer without medical assistance. Should
the attack not prove fatal at the time, and should it not be followed
by palsy, still the utmost caution is requisite to prevent a recurrence
of the disease. It is scarcely necessary to insist on the strictest ad-
herence to temperance, both as to meat and to drink ; and the impor-
tance of daily exercise, when the attack is over, and indeed for the
remainder of life. Prolonged study and intense thinking must be
given up ; the violent and exciting passions should be subdued ; and
even the pleasurable moderated.

Inflammation of the brain is one of those diseases which require, as
observed respecting apoplexy, the most energetic treatment. When
convalescence has fortunately been established, the attention of the
physician is still requisite, during several weeks, until complete re-
covery be fully confirmed ; for the brain, after suffering from inflam-
mation, is very ap to relapse into the same stats, from the excite-
ment of too full a meal, or over-exercise, or even slight mental exer-
tions or emotions. On this account, the convalescent must be kept
perfectly quiet, and completely free from the smallest excitement,
and the strictest regimen observed. His diet should not only be mild
and unstiraulating, but small in quantity.

Inflammation of the eyes requires the same caution when convales-
cence is secured as other inflammatory affections ; namely, quiet,
great moderation in diet, and avoiding exposure either to much light,
heat or cold, or whatever can stimulate the still highly excitable
organ.

Affections of the Chest.

Inflammation of the Lungs (^Pneumonia). — In convalescence
from this disease, the temperature of the room in which the patient
sits should not exceed 60° F. ; and it should be free from currents of
air ; but at the same time it should not be close. The necessity for
continuing the same elevated position of the siuuildei-s '^hen in bed,

!P jilASBSiiMis:.mmj:^)!..:': ^9rsiem

immmtf-

* '■-.

786

DOMESTIC MANAGEMENT Or THE 8I0K-R00M.

which 18 demanded during the existence of the disease, remains even
when the convalescence is advanced. The patient should be pre-
vented from talking, and from exerting sChy muscular motion that
can accelerate the circulation. The diet should be of that descrip^
tion which will support the strength without exciting or producing
repletion. As the convalescence advances, and exercise is permitted
by the medical attendant, it should be regular, but not hurried nor
violent ; and evening air should be sedulo' sly avoided.

Pleurisy. — Inflammation of the lining membrane of the chest re-
quires the same attention to diet and regimen during convalescence
as the last-mentioned disease, except that a greater strictness with
regard to abstemiousness in food is requisite ; the least deviation
being likely to bring on a renewal of the inflammation. When the
disease assumes a chronic character, and when the object is to remove
fluid effused into the cavity of. the chest, and pressing upon the lungs
so as to circumscribe their action, the same degree of strictness with
respect to diet is not necessary ; but, as in this condition of the habit
the physician must continue his attendance, the regulation of the diet
devolves upon him.

Angina. — In that condition of the habit which is connected with
a predisposition to gout, but in which, instead of a regular paroxysm,
the heart and the pulmonary organs become affected, and the disease
assumes that form which has been denominated diaphragmatic gout
(^Angina pectoris^ the regulation of diet is of vital importance ; and
it should be of as low a standard as the constitutional powers will
admit. It should not be of a description either to nourish much, or
to augment or to cause fullness of habit ; mild animal food, in mod-
erate quantity, may be allowed ; but the staple should be of a farina-
ceous kind: every stimulant, whether solid or fluid, should be
avoided ; and wine and malt liquors regarded as poisons. The in-
valid himself should be made aware that whatever tends to excite
or to hurry the circulation is calculated to bring on a paroxysm ;
nor is it sufficient that he avoids all stimulating viands and beve^
ages ; he should also be instructed that the same deleterious effects
are likely to follow a full meal, even of the most proper and mildest
food.

The same attention to diet, both as regards quantity and quality,
is essential in palpitations depending upon organic disease of the
heart.

Asthma. — In no affection of the chest is attention to diet so im-
portant as in asthma. Sir John Floyer, who himself suffered from
the disease, recommends almost a degree of abstinence; which is
correct in reference to quantity ; but the diet, although of a light,
yet should be of a solid, kind. This is especially necessary when
dyspepsia is present to aggravate and excite the disease of the lungs.

DOMESTIC MANAGEMENT OF THE SICK-ROOM.

787

jmams even
uld be pre-
motion that
hat descripi
r producing
is permitted
hurried nor

ihe chest re-
nvalescence
ictness with
Jt deviation
When the
is to remove
)a the lungs
ictness with
of the habit
n of the diet

nected with
r paroxysm,
[ the disease
Tmatic gout
rtance; and
powers will
jsh much, or
>od, in mod-
I of a farina-
, should be
IS. The in-
Is to excite
, paroxysm;
i and bever-
rious effects
and mildest

and quality,
lease of the

3 diet so im-
iffered from
e; which is
I of a light,
lessary when
of the lungs.

In Whooping-cough, the diet, whether the patient be an adult or a
child, should be of the mildest description ; and jjerhaps no nutri-
ment is so well adapted to support the tone of the bod}', v ithout
exciting it, as milk. In infancy, nothing but the breast sliould be
given ; the system of the nurse, at the same time, being kept as cool
as possible by mild diet, and her mind in a tranquil state. If cou-
vulsions occur, these sometimes depend on the nature of the milk :
in which case the nurse should be changed. It is still customary
with non-profe3sional persons to consider change of air essential in
whooping-cough ; but it is only after the malady has run its coui-se,
and convalescence is progressing, when the cough remains as a
kabit, that change of air is really beneficial. It is unnecessary to
combat the absurd opinion, that a change even to a worse air is
salutary.

Affections of the Stomach and Bowels.

Although acute inflammation of the stomach rarely occurs, yet
there is a chronic form of that disease, in which, during its actual
existence, and also in convalescence from it, much of the safety of the
invalid depends upon domestic management. Every source of excite-
ment should be avoided ; the sick-room should be airy, and its tem-
perature that of summer. The food should be of the blandest kind,
given cold, or iced, and in small quantity: even when the
convalescence is established the diet should consist of farinaceous
matters, mixed with small quantities of beef-tea, or weak broths ;
and this severe diet should be pei-sisted ija for a considerable time
after recovery.

Enteritis. — When inflammatory action extends to, or exclusively
exists in, the mucous lining of the bowels, constituting this disease,
the diet, during the early stage of it, should be confined to cold
water, or iced almond-emulsion ; after which, milk and barley-water,
or weak chicken or veal-tea, may be given in small quantities; namely,
two or three tablespoonfuls, at intervals of three or four hours.
Nothing stronger should be ventured upon, unless expressly ordered
by the medical attendant.

Atonic dyspepsia, or simple indigestion. — During the attack, ab-
stinence, to a certain degree, is necessary ; but, if this is not essen-
tial, the diet should be somewhat stimulant, but simple ; namely, a
small cup of moderately strong coffee, with little sugar or milk ; or
beef-tea, with a small quantity of dry toast ; and, as the stomach
begins to regain its tone, a little animal food of easy digestion, such
as mutton or poultry.

During the intervals of the paroxysms of indigestion, attention to
diet is of the first importance. As a general rule, the patient should
be confined to a spare animal diet, with a moderate share of well-
boiled vegetables, and a oonsiderable restriction with respect to the
use of fluids.

■wawiiiiiiii

788

DOMESTIC MANAGEMENT OF THE SICK-ROOM.

Dysentery, which impUes inflammation, acute or chronic, of tlic
same membrane as in enteritis, but confined to the larger and lower
bowels, requires the diet to consist of the mildest farinaceous matters,
strictly avoiding all solid animal food. It should be given in small
quantity at a time, and the whole allowance for the day should be
moderate. The farinaceous food should not be either solid, nor yet
altogether fluid ; the former may prove injurious as a mechanical
irritant ; the latter is liable to excite griping, from the extrication of
much flatus.

Diarrhoea. — Much of the domestic, as well as the medical man-
agement of diarrhoea depends on the nature of the attack, and its
causes ; but too much attention cannot be paid to the regulation of
the diet. It should be both small in quantity, and mild in quality.
In the early stage, and the acute form of the disease, barley-water,
arrow-root made with water, rice or grit-gruel, and light broths, are
proper. In chronic diarrhoea, rice, properly boiled, and mixed with
a small quantity of beef-tea, forms an excellent diet, as it nourishes
moderately, and leaves scarcely any feculent matter behind it.

In Cholera, convalescence is often tedious ; and nothing is so hkely
to cause relapse as even slight irregularities of diet. For weeks after
the feverish symptoms have disappeared, the diet should consist of a
very moderate quantity of vegetable matter only. The feet should
be kept especially warm and the whole body clothed in flannel, to
prevent that irregular distribution of blood which so strongly charac-
terizes the disease.

After inflammation of the lining membrane of the cavity of the
belly (peritonitis) has been subdued, the invalid should still observe
the strictest diet and regimen. He should return very gradually to
the use of animal food and wine. The bowels should be moderately
and daily opened, the feet kept warm, and the skin maintained in a
healthy condition by wearing flannel next to it, for a very considera-
ble time after every trace of the disease has disappeared.

Diseases of the Liver. — In all cases of recovery from these dis-
eases, whether inflammatory or otherwise, every precaution should
be taken to guard against the deleterious influence of alternations of
temperature, and also of damp, by clothing in flannel next the skin.
Errors in diet should be avoided ; and fermented liquors and stimu-
lating '>everages of every kind refrained from. When pains of the
side continue, after all the other symptoms of the disease have dis-
appeared, the introduction of a seton, if prescribed, should not he
objected to ; as the greatest benefit has often followed that mode of
counter irritation.

■Mi

nr -mminssuammmB,

onic, of tilt'
r and lower
0U8 matters,
veil in small
y should be
alid, nor yet
mechanical
xtrication of

ledical man-
ack, and its
3gulation of
[ in quality.
)arley-water,
. broths, are
mixed with
it nourishes
nd it.

J is so likely
' weeks after
consist of a
feet should
a flannel, to
ingly charac-

avity of the
still observe
gradually to
! moderately
itained in a
y considera-

m these dis-
tion should
ernations of
xt the skin.
and stimu-
)ains of the
le have dis-
)uld not he
txat mode of

COOKEEY FOR THE SICK-BOOM.

It was said by the distinguished Dr. Rush, in his lectures before
his class, that a physician ought to spend six months in a kitchen be-
fore beginning practice. A knowledge of dietetic preparations fitted
for the sick, and for those recovering from disease, however ap-
parently unimportant, adds much to a physician's power over his pa-
tient, and to his popularity and usftfulness.

In giving nourishment to the sick, who are suffering from low dis-
ease?, it is an important rule which should never be forgotten, to give
but little at a time, and to repeat that often. In cases of great proGtra-
tion from disease, life may at times bo endangered by a dela.y in giv-
ing nourishment of even a few minutes beyond the proper time.

Barley-Water.

Peakl barley, two ounces ; boiling water, two quarts. Boil to
one-half, and strain. A little lemon-juice and sugar may be added,
if desirable. To be taken freely in inflammatory diseases.

Rice- Water.

Rice, two ounces ; water, two quarts. Boil an hour and a half,
and add sugar and nutmeg.

Rice, when boiled for a considerable time, becomes a kind of jelly,
and, mixed with milk, is a very excellent diet for children. It has in
some measure a constipating property, which may be increased by
boiling the milk

Decoction of Bran.

New wheat bran, one pint ; water, three quarts. Boil down one-
third, strain off the liquor, and add sugar, honey, or molasses, accord-
ing to the taste of the patient. A bran tea may be made by using
Iwiling water, and suffering the mixture to stand in u covered vessel
for three or four hours.

ii|j(jB58«»isiia*!W»*5S~5^'^^'^'i*^^

.r ,< B ' i"Hi'< ' J.

790

COOKKKY FOR THE SICK-ROOM.

Sage Tea.

Dried leaves of sage, half - an ounce ; boiling water, one quart.
Infuse for half an hour, and strain. Add sugar and lemon-juice as
required by the patient. Balm and other teas are made in the same
manner.

The above infusions form agreeable and useful drinks in fevers, and
their diaphoretic powers may be increased by adding a little sweet
spirits of nitre.

Barley Coffee.

Roast one pint of common barley in the same way in which coffee
is roasted. Add two large spoonfuls of this to a quart of boiling
water; boil five minutes. Add a little sugar.

Lemon- Water.

Put two slices of lemon, thinly pared, into a ttrpot, a little bit of
the peel and a bit of sugar. Pour in a pint of boiling water, and
cover it close two hours.

A Refreshing Drink in Fevers.

Put a little sage, two sprigs of balm, and a little sorrel into a stone
jug, having first washed and dried them. Peel thin a small lemon,
slice it, and put in with a small piece of the peel ; then pour in three
pints of boiling water. Sweeten, and cover it close.

Anotlier.

BoHi an ounce and a half of tamarinds, three ounces of cranberries,
and two ounces of stoned raisins, in three pints of water, till the
water is reduced to two pints. Strain, and add a bit of lemon-peel,
which must be removed in an hour, as it gives a bitter taste if left
too long.

A Very Pleasant Drink.

Put a teacupful of cranberries into a cup of water, and mash them.
In the meantime, boil two quarts of water with one large spoonful of
corn or oatmeal and a bit of lemon-peel ; then add the cranberries,
as much fine sugar as shall leave a smart flavor of the fruit, and a
wineglassful of sherry. Boil the whole gently for fifteen minutes,
and strain.

Crust Coffee.

Toast slowly one or two slices of brown or white bread, pour boil-
ing water over it, and drink hot or cold, according to preference.

:ai.V

COOKEHY FOR THK SICK-ROOM.

791

one quart.
on-juice as
n the same

fevers, and
ittle sweet

hich coffee
of boiling

ittle bit of
ivater, and

nto a stone
all lemon,
ur in three

ranberries,
3r, till the
emon-peel,
ste if left

lash them,
poonf ul of
ranberries,
:uit, and a
I minutes,

pour boil-
irence.

Infusion of Malt.

To one pint of ground malt add three pints of scpldiiig water, that
is, water not quite brought to the boiling point; infuse two hours,
and strain. Add sugar or lemon juice as desired. An excellent
preparatiou in inflammatory fevers.

Lemonade.

Fresh lemon-juice, lour ounces ; thin peel of lemon, half an ounce ;
white sugar, four ounces ; boiling wattir, three pints. Let them stand
until cold, and strain. When used in fevers, a little nitrate of potash
or sweet spirits of nitre may be added. It may bfc further diluted to
the tF,8te of the patient.

Water Gruel.

Oat or corn meal, two tablespoonfuls ; wat«r, one quart. Boil for
ten or fifteen minutes, and strain, adding salt, and sugar if desired by
the patient.

Milk for Infants.

Cowe' milk, one part ; water, two parta ; sweeten slightly with loaf
sugar.

It is necessary, when children are to be rained by hand, to di-
lute the milk. The above proportions may be altered ap the child
advances in age.

Rice Qruel.

Grottxd rice, one heaping tablsspoonful ; ground cinnamon, one
teaspoonful; water, one quart. Boil gently for twenty minutes, add-
ing the cinnamon near the conclusion. Strain and sweeten. Wine
may be ?^dded in some cases.

Panada.

Whtte ^read, one ounce; ground cinnamon, one teaspoonful;
water, one pint. Boil them until well mixed, and add a little sugar
and aytmeg. Wine or butter may also be added, if desirable.

Compound 5alep Powders.

Sat^EP,, tragacanth, and sago, each four ounces ; cochineal, half a
dram ; prepared oyster shells, one ounce. Mix, and divide into pow-
ders of one dram each. Stir one of these powdei-s into a pint of milk,
and boil for ten or fifteen minutes. To be drunk freely in diarrhoea
and dysentery.

792

COOKKHY FOR THE SICK-ROOM.

Another.

Gum arable, tragacanth, maranta, sago, tapioca, each two draiim.
Mix them well together, and boil in a pint of milk, flavored with nut-
meg or cinnamon. To be used as a diet in dysentery, diarrhoia, etc.

Sag:o Qruel.

Sago, two tablespoonfuls ; water, one pint. Boil gently until it
thickens, frequently stirring. Wine, sugar, and nutmeg, may Iw
added, according to circumstances.

Arrow- Root Qruel.

Arbow-ROOT, one tablespoonful ; sweet milk, half a pint ; boiling
water, half a pint. To be sweetened with loaf sugar. Excellent
aliment for children when the bowels are irritable.

Tapioca Jelly.

Tapioca, two tablespoonfuls ; water, one pint. Boil gently for
an hour, or until it assumes a jelly-like appearance. Add sugar,
wine, and nutmeg, with lemon-juice to suit the taste of the patient,
and the nature of the case.

Jelly of Irish Moss.

Irish moss, half an ounce ; fresh milk, a pint and a half. Boil
down to a pint. Remove any sediment by straining, and add the
proper quantity of sugar and lemon juice, or peach-water, to give it
an agreeable flavor.

Isinglass Jelly.

Isinglass, one roll. Boil in one pint of water until it is dissolved.
Strain, and add one pint of sweet milk. Put it again over the fire,
and let it just boil up. Sweeten with loaf-sugar, and grate nutmeg
upon it. When properly made, it resembles custard.

This forms an excellent diet for persons recovering from, sickness,
and is well adapted to the bowel-complaints of children.

Apple Water.

Cut two large apples in slices, and pour a quart of boiling water
on them. Or, pour the same amount of water on roasted apples. In
two or three hours, strain and sweeten slightly.

COOKKKV KOK THE SICK-IIOOM.

793

two drams.
d with imt-
irrhcea, etc.

tly until it
3g, may Iw

nt; boiling
Excellent

gently for
!\.dd sugar,
the patient,

half. Boil
id add the
r, to give it

8 dissolved,
^er the fire,
ate nutmeg

ra sickness,

iling water
apples. In

Milk-Porridge.

\Vheat flour, cornmeal, or oatmeal, two tablespoonf uls ; milk,
one pint; water, one pint. Mix tho flour or meal with cold water,
to form a thin paste ; put the milk and water over the fire, and when
they come to the boiling point, add the paate, carefully stirring.

French Milk-Porridge.

Stir some oatmeal and water together ; let the mixture stand to
clear, and pour off the water. Then put more water to the meal,
stir it well, and let it stand till the next day. Strain through a fine
sieve, and boil the water, adding milk while so doing. The propor-
tion of water must be small. With toast, this is a good preparation
for weak pei-sons.

Qround-Rice Milk.

Boil one spoonful of good rice, rubbed down smooth, with a pint
and a half of milk, a little cinnamon, lemon peel, and nutmeg.
Sweeten when nearly done.

Boiled Flour.

Tie up as tight as possible, in a linen cloth, one pound of flour ;
and, after frequently dipping it in cold water, dredge the outside
Avith flour till a crust is formed round it, which will prevent the
water from soaking into it while boiling. Place it in water and boil
it until it becomes a hard, dry mass.

Two or three spoonfuls of this may be grated, and prepared in the
same manner as arrow-root gruel, for which it is an excellent substi-
tute.

Vegetable Soup.

Take one turnip, one potato, and one onion, let them be sliced
and boiled in one quart of water for an hour. Add as much salt as
is agreeable, and pour the whole upon a piece of dry toast.

This forms an agreeable substitute for animal food, and may be
given when the latter is inadmissible.

Beef-Tea.

Lean beef, cut into shreds, one pound ; water, ohe quart. Boil
for twenty minutes, taking off the scum as it rises. When it grows
cold, strain.

Essence of Beef.

Lean beef sliced. Put a sufiicient quantity into a porter-bottle to
fill up its body, cork it loosely^ and place it in a pot of cold water.

•mssmmm^i^y

••Ij^tosfK'/i;

794

COOKERY FOR THE 8I0K-R00M.

attaching the neck, l)y iiiuanH of a string, to the ha lie of the veHHul.
Boil this for an hour and a half or two houre ; t^en pour off the
liquor and skim it.

To this preparation may be added spices, salt, , tie, brandy, etc.,
acoording t(> the taste of the patient, and nature of '':e disease.

Calf S'?eet Jelly.

Take two calf's feet, and add to them one gall(<:. of waiter. Boil
down to one quart. Strain, and when cold, skim ! the fat. Add
to this the white of six or eight eggs well beaten, a pint of wine, half
a pound of loaf sugar, and the juice of four lemonB, and let them be
well mixed. Boil the whole for a few minutes, stirring constantly,
and then pass it through a flannel strainer.

This forms a very nutritious article of diet for the sick, and for
those recovering from disease. The wine may be c»mitted or added
according to choice.

Chicken Water.

Take half a chicken, divested of all fat, and break the boifes ; add
to this half a gallon of water, and boil for half an hour. Season
with salt.

Suet Ptisan.

Sheep's suet, two ounces ; milk, one pint ; starch, half an ounce.
Boil slowly for half an hour. This may be used aa a common drink
in dysentery.

Rennet Whey.

New milk, one quart; rennet, a large spoonful. Heat the milk,
and then add the rennet. Boil until the curd separates, which is to
be taken off. To many persons, this forms an agreeable nutriment.

Vinegar Whey.

Milk, one pint; vinegar, one tablespoonful. Boil for a few
minutes, and separate the curd.

Tartar Whey. '

Milk, one quart ; cream of tartar, one dessert spoonful. . Boil,
and separate the curd.

Mustard Whey.

Bruised mustard^eed, one tablespoonful ; milk, one pint. Boil
together for a few minutes, and separate the curd.

This has been found a useful drink in dropsy. A teacupful may
be taken at a time.

TsnsE-?Hrs^

v'W^'?**^ '

';-^- V

COOKERY FOB THE 8ICK-K00M.

795

Alum Whey.

Alum, one teaspoonful ; milk, one pint. Boil together, and strain,
to Heparata the curd.

Orange Whey.

Milk, one pint ; the juice of an orange with a portion of the peel.
Hoil the milk ; then put the orange to it, and let it r' id till coagu-
lation takes place.. Strain.

Sweet Whey.

Skimmed milk, two quarts; a piece of prepared calf's rennet.
Mix and put in a warm place till coagulation takes place ; then
strain.

Whey with Tamarinds.

Milk, boiling, one pint ; tamarinds, two ounces. Boil them to-
gether till coagulation takes place.

Wine Whey.

Milk, two thirds of a pint ; water, one third of a pint ; Madeira,
or other wine, one gill ; sugar,- one dessert spoonful. Place the
milk and water together in a deep pan on the fire, and at the moment
when it begins to boil, pour in the wine and the sugar, stirring assidu-
ously whilst it boils, for twelve or fifteen minutes. Lastly, strain
through a sieve. This is excellent in all forms of fever, given in
small quantities. It may be drunk either cold or tepid, a wine-
glassful at a time.

Milk and Soda Water.

Heat nearly to boiling a teacupful of milk ; dissolve in it a tea-
spoonful of refined sugar ; put this into a large tumbler and fill with
soda water. This is an excellent mode of taking milk when the
stomach is charged with acid, and is oppressed by milk alone.

Sippets.

On an extremely hot plate, put two or three slices of bread, and
pour over them some of the juices of boiled beef, mutton, or veal.
If there be no butter in the dish, sprinkle over them a little salt.

Restorative.

Take two calf's feet, one quart of water, and one quart of new
milk ; place all in a close-covered jar, and bake three hours and a

796

OOOKKRY FOK THE 8I0K-R00M.

half. When cold, remove the fat. Any deaired flavor may lie given,
by adding lemon-peel, cinnamon or maoe, .while baking. Add sugar
afterwar«ls.

Coffee-nilk.

Boil a dessertHpoonful of ground coffee in nearly a pint of milk,
for a quarter of an hour, then put into it a shaving of isingliws, and
clear it. Let it boil a few minutes, and set it beside the fire to
clarify. Sweeten with loafnsugar.

Nutritive Fluid.

Tare two teaspoonfuls of lump magnesia, one teaspoonful of sal-
eratus, one tcaupoonful of salt, two teaspoonfuls of flour, half a pint
of milk, and one pint of water. Put the milk and water, united,
over the fire, and rub up the flour with a little cold water to make a
thin paste. Just when iho milk and water begin to boil, stir in the
paste. This will make a thin porridge, which should boil about five
minutes. At the end of this time remove from the fire and pour
into a pitcher. Now add the magnesia, pulverized, and mixed with
the salei-atus and salt. Sweeten to suit the taste.

This may be drunk freely, several times a day, so as to produce
two evacuations of the bowels in twenty-four hours, in those cases of
dyspepsia attended by acidity of the stomach, and in many debilitated
conditions of the system in which there is a tendency to loss of flesh.

This is one of the leading fluids used by those who pursue what is
called the " Nutritive Sy%tem " of treating disease, and is really a
valuable preparation, having the effect often to increase the flesh, even
while it acts as a cathartic.

Franldin Mills Bread,

OB GERM-WHEAT BREAD.

One quart milk or water ; one quart white flour ; one-half yeast-
cake ; one-half cup sugar ; one-half teaspoon salt ; one quart Frank-
lin flour.

Put the white flour in the mixing-bowl, then add the milk and
yeast gradually, until smooth. Cover; let it rise in the bowl all
night. In the morning, if light, add sugar, salt and Franklin flour,
R little at a time ; then let it rise again until light. Fill the pans
two-thirds full, and rise. Bake one hour.

Indian-Meal Qruel.

Two tablespoonfuls of commeal to one quart of boiling water;
one teaspoonful of salt. Cook about thirty-five minutes. If too
thick, thin with milk or cream.

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23 WEST MAIN STREET

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(716) 872-4503

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^^^t,.

■^■^

COOKERY FOn THE SICK-ROOM.

797

Oatmeal Qruel.

Take one quart of boiling water, three tablespoonfuls of oatmeal,
one-quarter teaspoon salt ; cook two hours, strain and add milk or
cream.

Floui Qruel.

Take two teaspoonfuls of white flour, one cup of boiling water,
one-half teaspoonful of salt. Make a smooth paste of the flour and
salt before adding to boiling water. Strain and thin with milk or
cream.

Mutton Broth.

Boil one pound of juicy mutton in two cups of cold water. Cook
slowly for half an hour ; strain, and after it is cold, remove the fat,
and serve with boiled rice. The rice should be boiled separately and
added to the broth when it is warming.

Beef Tea.

Take one pound of round steak, remove the fat, and cut fine, and
place the meat in a self-sealing jar without water ; cover closely, heat
gradually in a kettle of water, one hour, or until there is no color in
the moat. Press with a spoon all the juices from the meat. Serve
with salt.

Broiled Beef Essence.

Place one pound of round of steak in the broiler and broil until
the juice begins to flow. Cut into fine pieces and squeeze the juice,
using a lemon squeezer. .Salt to taste.

Flaxseed Lemonade

Take two tablespoonfuls of whole flaxseed, and pour over it one
pint of boiling water. Steep one hour and a half ; add the juice of
one lemon and sweeten to taste. Excellent for colds.

Clam Broth.

^VA8H the clams ; put in kettle with enough water to cover; boil
antil shells open, and serve hot.

Egg-Nog.

Take one tablespoonful of sugar and the yolk of one egg, and
b<iat together ; add one-half oup of milk ; teat the white separately,
and mix in lightly ; add brandy or wine. A little nutmeg is used to
flavor.

I ;•

DIETING IN REGARD TO HEAITH.

How to Grow Fat.

It is often as annoying to many to be thin as it is in others to be
fleshy. Here again the remedy consists in overcoming tlie natural
or per .liar forces at work predisposing to the paucity of fat accumu-
lation, and first of all to grow fat means for the tliin peraon to grow
lazy and good-natured. Worry, cares, much work and short hours
for sleep, must be overcome. Clean skins, clean clothes, clean air
and plenty of sunshine are the sine qua non for thin people to observe.

Little work, long houits of sleep, plenty of rich food well digested,
a merry disposition, i-egular hours for meals, with naps between
times are also i-equisite principles to observe for him who would grow
fat. *

Drink plenty of water, say one or two glasses of pure water on
arising and again on retiring. Do not overload the stomach with
water, but drink all it will comfortably stand. Ride in the open air
often, enjoy the sunshine and fresh air, and bathe in cool water,
especially sea-water when practicable.

It will be found much more difficult for some than for othei-s to
observe all these principles, and again much more difficult for some
to benefit by them than others; yet everybody can add pounds to
their present weight if only they will peraevere in all these instruc-
tions.

Of the food necessary to avoid, the chief articles are acids, spices,
and condiments generally.

Of those most productive of fat are the cereals and starchy food
like potatoes, oatmeal, bread, puddings, etc. Again, fatty meats,
cream, butter, and milk, chocolate, oils, etc., supply fat directly to
the system. Sweets are also conducive to fat formation, like sugar,
beets, custards, etc. Sweet wines and porter are likewise fattening.

It must be borne in mind, however, that these very classes of food
are often the cause of indigestion, which makes people tliin, hence a
gfjod appetite and a good digestion are prerequisites for this sort of
a dietary. It is often a benefit for those with weak stomachs to eat
a little six times a day, say a light breakfast, dinner, and supper, and
a glass of milk in the middle of the forenoon and afternoon.

798

■■''■^'iniiih iMlitf iiii«i<iii»^ii

''irl lif-lT1lli «r>ririll l) VM l l ir i ' i -- |i

ihers to be
he natural
it accumu-
)n to grow
liort hours
i, clean air
to observe.
1 digested,
i8 between
rould grow

3 water on
mach with
16 open air
ool water,

othere to

for some

pounds to

SB instruc-

ids, spices,

archy food
;ty meats,
directly to
ike sugar,

fattening,
jes of food
n, hence a

lis sort of
ichs to eat

upper,

and

DIETING IN KEGAKD TO HEALTH.

To Reduce Flesh,

1S)0

CoiiPULKNCE or obesity is generally more annoying (o most
people than the opposite extreme. Ifc is, however, as natural for
some people to be fat as it is for others to be thin.

To reduce flesh, however, is legitimate within certain limits. The
functions of the body should not be interfered with nor weakened by
any sort of treatment directed to the reduction of flesh. There have
alwcays been kept on the market for sale medicines whose sole aim is
to render people thinner, but most of them are neither trustworthy
nor safe.

Of new medicines the most reliable is Phytolene. The thyroid
gland of the sheep, taken in five-grain doses on retiring, has quite
recently ^leen extolled as a reliable and harmless medicine against
obesity. This medicine has been on the market for only a short
time, but it is known to be perfectly harmless.

Corpulence.

All people are not formed in the same mould, some ai'e as fat as
others are lean. This is owing to a number of causes, namely :
the easy digestion and absorption of food stuffs ; easy dispositions
coupled with easy work and nourishing food ; the preponderance of
fatty, sweet or starchy food in the diet list ; a certain hereditary pre-
disposition, etc., etc. The style of one's diet (starchy), and the
natural tendency in some to put on fat, have probably more to do
with corpulency than any other two factors. This condition ofteur
times is so distressing as to amount to disease. The heart walls and
sac become so infiltrated with fat as to impede the easy action of the
heart-muscle, as to retard slow, deep respirations and render all exer-
tions a labor. One may die quite suddenly of fatty heart. The con-
dition at all events often calls for treatment.

To Reduce Flesh.

The so-called Banting Treatment consists in the abptinence from
all fats, sweets, and starchy food. Banting of England, after having
tried all other procedures, very rationally invented this treatment.
Whatever else may be tried, this plan of dieting stands pre-eminently
in the foreground, and must be persisted in, either alone or as an
adjuvant to other treatments.

The following general rules will serve as a guide in the selection
of proper foods : —

Avoid starchy food, sugar and fat, milk, coarse cereals, pork or
lard in all its forms.

"^•""V^'T^W"^

^ '1' ; ' ii ' .iM''"'" -

I ■

UOO

DIKTING IN KBGAUD TO HEALTH.

Can eat : —

Of So tips : Mutton, chicken and clam broths, beef-tea.

Of Fish : All kinds except salt or fatty, like bluefish and mackerel.

Of Meats : The lean of mutton, beef or chicken in small quantities.

Of Vegetables : All kinds but potatoes, turnips and parsnips.

Eggs, bread, cornmeal, etc. All kinds of fruit and berries.

Weak coffee with little sugar or milk, light wines, and the various
mineral waters. Poland, Vichy, Londonderry, Hunyadi, etc., can
be taken.

Moderate gentle exercise is to be indulged in. The bowels are to
be kept loose with some saline aperient each day, like Carlsbad salts.

Recently cases have been reported of marked success in the use of
the extract of thyroid glands in tablet form ; one each night, at the
same time using Garfield Tea. Iodide of potash in ten-grain doses
taken in one-half a glass of water three times daily, has been for a
long time the favorite remedy in the treatment of this disease. TliLs
dose should be increased every third day till twenty grains are taken
as a dose. If the mouth tastes very badly in the morning, or pimples
on the face or back appear to any very annoying degree, the medicine
may be discontinued for a short time, although these symptoms do
no harm.

a*ita

' ' '

L mackerel.

quantities.

nips.

ies.

;he various

, etc., can

vvels are to
Isbad salts.
the use of
ght, at the
rrain doses
been for a
ase. This
i are taken
or pimples
^ medicine
iptoma do

DIETING IN DISEASE.

In Dyspepsia, great care should be taken not to overload the
stomach. It is better to eat often, and take smaller quantities at a
time, and at regular intervals. Dyspepsia assumes so many different
forms that experience should teach each patient what agrees with
him best. Regularity is of importance, and in no case should a meal
be eaten in a hurry or when the mind is disturbed. It is hjst to
avoid pork in all forms, rich, fatty and highly-seasoned focds or
liquors. Plain foods with few condiments are the best. A little
warm water or milk taken with the food is hetU.r than tea or coffee.
Vichy, Apollinaris, or Poland water are good drinks.

The following is usually a safe diet in ordinary dyspepsias:

Plain soups ; oysters, raw or roasted ; fish, except fatty varieties and
blue-skinned fish. Fish should be boiled or broiled. Lobster, blue-
fish, mackerel and salmon, are the most difficult of digestion.
Meats : mutton, roast or broiled ; chicken, beef, sweet-breads, tripe.
Eggs can generally be taken. The various vegetables, if well
cooked, —with the exception of boiled potatoes. Only stale bread
should be eaten. That made from the Franklin Mills flour is the
best. The various coarse cereals are good. It is best to avoid pud-
dmgs and pies. Fruits of different kinds are good, especially apples
and grapes. It is beneficial in some cases to drink hot water imme-
diately on rising, and in others cold water, — experience is the best
teacher.

Dyspepsia accompanied by much gas and belching of wind is
remedied oftentimes by avoidance of starchy food, such as bread,
potatoes, etc. Dyspepsia of the small bowel, coming on one or two
hours after meals, means less starchy food, and avoidance of heavy
vegetables, fruits, cereals, etc. ; in other words, the patient should
live on an animal diet of meat, eggs, milk, etc.

For Consumptives, and those in an anaemic state, the diet should
be generous and and easily digested ; food should be taken in small
quantities and often. It is best to take some light nourishment
lietween meals and before retiring, such as Mellin's Food and milk,
malted milk and egg-nog. In consumption, oils and fatty foods are
beneficial if they can be digested. Various preparations of cod-liver

801

! , >■

li^; :

i^'

802

DIBTINO IN DI8EA8K.

oil are excellent. The patient should avoid pork in all fornvs, fried
foods, pies and pastry, and all starchy or sweet foods.

Can take soups and broths, oysters, fish and eggs, if not fried, beef,
jjoultry, game and mutton,— , roasted or boiled; fresh vegetables;
coarse cereals and stale bread. Desserts : baked apples, prunes, sago,'
tapioca and custards. Best to avoid strong tea or coffee. Vicliyi
Poland and ozonized waters, milk. Malted milk and koumiss are
good drinks.

In Albuminuria. — Do not eat to excess, or overload the stomach
in any way. Eat the most easily digested food, such as plain soups,
codfish, haddock, clamj and oysters raw. Of meats, chicken and
game, avoiding those that have most blood in them. Vegetables of
all kinds, especially those of green variety. Laxatives, coarse cereals
and stale bread.

Do not take of pastry or rich dishes of any kind, sweets, coffee,
tobacco or liquors. Avoid eggs and an excess of meats. Can take
tea, milk, koumiss and large quantities of water, Poland if possible.

For Qouty and Riieumatic People a generous diet is best. Tbey
should avoid all foods that have a tendency to acidity of the stomach,
such as those of a starchy or sweet nature.

Can take plain soups, broths, beef-tea, fish, — except fatty kinds, —
and oysters ; meats, with the exception of pork, in small quantities ;
fresh vegetables, — onions, cauliflower, celery, lettuce, spinach, peas
and baked potatoes. Also various coarse foods and stale bread.

For desserts avoid all rich puddings and pastry and sweets. Can
eat baked or stewed fruits, lemons, oranges and baked apples.

Should drink plenty of water and milk, rather than tea or coffee.
Vichy, Poland and Lithia water are the best.

For Diabetes. — Take easily-digested food, avoiding as much as
possible sweet and starchy varieties. Avoid the use of sugar
altogether, and substitute saccharin, both in the preparation of foods
and for tea and coffee. Use meats, fats, oils and butter, cream and
water especially, say one pint of cream daily. Use few or no potatoes,
and those baked. Mai/ eat all kinds of soup, and various shell-fish ;
fat meats and fresh vegetables that are not starchy. Various fruits,
nuts, gluten bread, etc. Saja-bean meal contains only one per cent
of starch, and is very well adapted to diabetes, — much better than the
ordinary gluten flour, which, after all, is somewhat starchy.

For beverages : weak tea or coffee without cream or sugar, milk,
koumiss, ales and various mineral waters. It is well to avoid flours,
coarse cereals, fruits and vegetables.

'Kr

orms, fried

fried, beef,
vegetables ;
uiies, sago,
e. Vichy,
Dumiss are

le stomach
lain soups,
licken and
getables of
irse cereals

eta, coffee,
Can take
I possible.

est. Tbey
le stomach,

;y kinds, —

quantities ;

in.ach, peas

bread.

eets. Can

lies.

a, or coffee.

s much as
of sugar
)n of foods
cream and
lo potatoes,
shell-fish ;
ious fruits,
16 per cent
er than the

•

igar, milk,
roid flours,

BATHING,

WITH ESPECIAL REFERENCE TO THE TURKISH AND RUSSIAN BATHS
AND THEIR USE AT HOME.

Bathing, as practised both for pleasure and cleanliness, has been
the instinctive custom of every nation. Records date to the bathing
in the Nile and Ganges. Jews, Greeks, Egyptians, and Assyrians
were all lovers of the bath.

The Romans surpassed all others in the variety and luxury of their
baths, but to an excess of them may be ascribed much of the final
effeminacy and physical degeneration of the Roman people.

The Roman bather first entered the warm-air room or "tepida-
rium," where he sweated with his clothes on ; here he was anointed,
after which he passed into the ".calidarium " or hot room, in one end
of which was a bath ; here he sweated more freely, and afterwards
had plenty of cold water thrown over him from above his head : first
warm, then tepid, and after, cold. Succeeding the bath, he was
scraped and rubbed most briskly and again anointed. The popular-
ity of these baths caused structures to be erected in every part of the
city, and in a style of architecture which surpassed all other art
buildings. The immensity of these buildings may be imagined from
the fact that ruins of the baths of Titus and Caracalla extend one-
fourth mile on each side, while one room of the bath of Diocletiuii
has been "converted into a church of imposing proportions. The
baths of Diocletian contained 3,200 seats for bathers. To such a
pitch of luxury did the Romans reach in their bath-houses, that Sen-
eca said they were dissatisfied unless they trod on gems in their
bath. These structures finally were also equipped for all literary
pursuits, for sports and games.

These facts show how a simple custom of bathing became a national
system of luxurious living. The Roman hour for bathing was one
clock (before dinner), as it was supposed to promote the appetite,
as It does. But these baths which gave such invigoration to the
body, and which were synonyms of the highest art and culture, finally
were one great means of Roman degeneracy.

To such excess did they carry their hot baths, that the nation
finally exchanged its manly vigor for Eastern effeminacy. Un-

808

^11

1::

:=:i

804

TURKISH AND RUSSIAN BATHS.

bounded license in social evils took the place of gynmattic training
and philosoi)hical study. I mention these facts at length to show
how Imthing may he a most healthful practice and a most injurious
custom. Modern baths are more or less the outcome of the old
Roman hath, through the agency of the Mahometans, Turks, Rus-
sians, and Crusadei-s. The Turkish bath is a modified Roman bath,
while the Russian bath, so far as its vapor is concerned, was j)mcticed
among the Indians.

The Russian bath is essentially a vapor bath. In the centre of
tlie building is an open space where one undresses. Around this
space are doors opening into small rooms filled with vapor. In the
centre of efoch room is a series of steps leading nearly to the ceiling.
The bather lies on the lowest one of these steps and gradually ascends
to higher and hotter ones. The first sensation is that of suffocation,
the breathing is difficult, but soon perspiration bursts through the
pores and breathing is ea«y -ind agreeable. These steps vary in heat
from 96° to 110° F., and in olden times the temperature ranged very
much higher than this. Bath attendants then flog the bather with
birchen twigs or coarse towels, lather well with soap, and rinsing the
latter off, the bather is rubbed down and put under a shower bath of
ice-cold water. The shock is great, but the sensation is pleasant
after a few moments. In olden times the bather was made to rush
out, steaming hot, and roll in the snow. Milder customs, of coui-se,
prevail to-day, yet the Russian bath is not to be indulged in by all
people at all times with impunity. When tliere is any tendency to
heart disease, palpitation, vertigo, or fulness of the head, the vapor
bath should be indulged in with caution or not at all.

The Turkish bath differs from the Russian bath in that the atmos-
phere is dry. The Lather first enters the "frigidarium," or cooling
room, where he undresses and passes into the " tepidarium," or warm
room, the temperature of which ranges from 110°tol40°F. The
object of this room is to bring on a gentle perspiration, and to pre-
pare the system for exposure to a still higher temperature. This is
attained in the "calidarium," the temperatuie of which varies from
140° to 200° F. In this room the bather undergoes the operation of
kneading or shampooing. To get the full benefit of this bath this
process should never be omitted ; the hands alone being the sole
means of friction. After sweating, shampooing, and soaping, the
bather passes into the " lavatorium " or wash room. In this room he
begins with a warm shower-bath, which is gradually changed to cool,
and then to cold. This not only washes off perspiration and soap,
but also closes the pores and causes a vigorous reaction.

The feeblest people react readily. The bather then returns to the
cooling-room, where he lounges, wrapped in a sheet, to await the
secondary perspiration.

The Turkish bath is one of the most invigorating and refreshing
institutions we have. It is devoid of danger almost to all, if used

"V^f,

If!

TURKISH AND RUSSIAK BATHS.

805

ic training
h to hIiow
t injuriouN
)f the old
urks, Rim-
)man biitli,
8 practiced

) centre of
round this
r. In the
-he ceiling,
lly ascends
uffocation,
iroiigh the
iry in heat
inged very
lather with
rinsing the
ver bath of
is pleasant
ide to rush
of coui-se,
d in by all
endency to
, the vapor

the atmos-

or cooling

," or warm

° F. The

ind to pre-

i. This is

aries from

peration of

bath this

y the sole

aping, the

is room he

ed to cool,

and soap,

rns to the
await the

refreshing
il, if used

in moderation. Veiy hot^ir rooms, as well as very hot baths, are
uiiiiucessary and dangerous to many, as the heart Ijegins to lul)or and
the blood-vessels rapidly dilate.

Fear is often expressed about passing from the hot-air room to the
cold-water bath. There is absolutely no danger in passing into cold
water while in a state of profuse perspiration. Adverse changes are
brought about through the nervous system of the skin ; when this is
elevated above the normal condition, cold water causes no shock ;
hut when the power of the nei'vous system is depressed by being
ciiilled, weary, or by disease, then it is that ill results are apt to ensue.

Precautions must always be taken in indulging in any bath. Never
take a bath ou a hungry stomach, as did the Romans, nor immediately

Fio. i»6. Method of taking a VaporBath.

after meals ; no more should a bath be taken when one is very weary
or exhausted.

Warm baths simply relax and cleanse ; but after all others, whether
hot air, vapor, or sea bath, a good glow of the skin should follow.

Elderly people should use tepid baths and mild Tuikish baths;
cold bathing chills the skin and depresses the nervous system. Cold
sponge-bathing is a useful adjunct to other health measures in the
young and middle-aged, often being the best preventive against
catching cold.

The duration of a bath may last from fiftepn minutes to two hours.
Too much bathing, especially with soap, deteriorates the skin by de-
priving it of its oily matters. The continued sweating of many
water-cures causes bad eruptions and boils, which are difficult of cure.
These " humors," so called by many hydropathists, are not evidences
that bad blood thus escapes from the body, but that the system .has

• ,

il.

806

TURKISH AND RU8BIAN BATHS.

been much debilitated by too frecjiient bitliing, or too proloiigod
sweating. Part* exposed like the face and hands niUHt be frequoiitly
scmped and bathed, while the rest of the body needs soap and Iwith
mueh less Ireciuently.

Searbathing should not be indulged iu by the very old or yoiuiL';
by those whose circulation is languid; by {)ereon8 who have \mu[
disease, chronic lung disorders, brain trouble or local congestions.

A full reaction and a good glow must ensue, and not much time
spent in the watar. Don't cool off before plunging in the water ; all
the body warrith is needed for a full reaction ; no hesitancy should
be harbored alx)ut plunging in at once, as less heat is thus lost from
the body, and the consequent shock to the nervous system ib thereby
much diminished.

For home use both the Turkish and Russian bath may be mucli
simplified.

The vapor for the Russian Imth may be improvised as follows:
The peraon sits on an open-work chair, preferably a stool made for

Fio. iw.

the purpose, and is surrounded by a water-proof sheet fitting closely
about the neck. Hot water is then poured over heated bricks placed
underneath the chair. For more prolonged steaming, a hose may be
run to the top of a boiler, on the stove, from whose tin cover pro-
jects a tin pipe, to which the hose may be attached. (Fig. 195.)

The shampooing and soaping and cold douche may then be taken.

For Turkish bath, hot air may be obtained by burning an alcohol-
lamp under the chair and using the covering mentioned aibove, or
alcohol may be mixed with salt in a pan. (Fig. 196.)

The shampooing and kneading of the muscles should be done by
an assistant. Rubber tubing attached to the hot and cold-water
faucets of the bath-room will readily furnish the requisite shower-bath
of warm, tepid, and cold water, as one or both of the lubber tubings
are used. The essential features of both baths may thus very easily
be procured by almost every household.

't-

proloiigtMl
frequoiitlv
i) atid Iwth

or young;
havf liead
eHtions.
«uch time
water ; all
icy Khould
i lost from
i'6 thereby

y l)e much

H follows:
made for

ng closely
iks placed
86 may be
lover pro-
195.)
be taken.
II alcohol-
a.bove, or

B done by
old-water
3wer-bath
r tubings
jry easily

PROOFS OP DEATH.

The universal dread of l)eing buried alive leads us to give an
epitomized account of the various signs of death.

AMence of Circulation. — The heart cannot be heard pulsating
by one trained to the proper use of the stethoscope. If a band be
tied around a toe or finger no change results; but if the circulation
still exists, after a few minutes a livid hue will be noticed at the
end of the member.

Absence of Respiration. — A cold miiTor placed against or close
to the lipa does not detect the presence of moisture. A flake of
fine cotton or a feather similarly placed reveals no motion imparted
by exhaled air.

Cooling of the Body. — After death the body temperature falls
rapidly to that of the surrounding media. As a rule the corpse
becomes cold in from, six to twelve hours after death, the viscera,
however, requiring much longer time.

Rigor Mortis. — Post-mortem rigidity is one of the most ^ositive
signs of death, and seldom occurs later than twenty-four hours after
death.

Putrefaction is, of course, absolute proof of death, but it does not
occur early. The abdomen becomes green, a d finally the whole
body assumes this livid green color, with a sickish, putrid odor.
These are the chief signs of death, although several minor ones
might be mentioned. It may be said in general, that burial almost
never takes place until death is sure. The evidences of apparently
suspended animation, of the body turning in its casket, etc., may be
explained otherwise.

807 ■%' ■•■■'■'■'.' ■■'■■■'•, '■

!■

MEDICINES AND THEIR PREPARATIONS.

Materia Medica.

That department of medicine which treats of remedies, their doses,
modes of using, and influence upon the constitution, is called materia
medica. The agents employed in the treatment of disease are taken
from three kingdoms of nature, — the vegetable, the animal, and the
mineral.

The largest portion of medicinal substances are taken from the
vegetable world. They consist of leaves, flowers, seeds, barks, and
roots. These lose much or all of their medicinal powers unless
gathered at the right seasons of the year, and are properly cured.
The different parts of a plant are to be gathered when their peculiar
juices are most abundant in them.

The Roots of Annual Plants are best supplied with their- juices
before they are in flower ; they should be gathered at this time.

The Roots of Biennial Plants should be gathei-ed in the autumn,
after the first year's growth.

The Roots of Perennial Plants should be gathered in the spring,
before vegetation has begun.

Before they are dried, the solid parts of these roots are to be cut
in slices, after being washed, and the small fibres, unless they are the
parts used, are to be thrown away.

Bulbous Roots are to be gathered at the time their leaves decay.
Their outer covering being rejected, they must be sliced, strung upon
threads, and hung in a warm, airy room to dry. After being dried,
roots should be packed in barrels or boxes, and kept as free as possi-
ble from moisture.

Barks, whether of the roots, trunk, or branches, must be gathered
in autumn, or early in the spring, when they peel off most easily, and,
the dead outside and all rotten parts being separated, they must be
dried in the same manner as roots. The most active barks are gen-
erally from young trees.

Leaves are to be gathered when they are full grown, and just be-
fore the fading of the flower.

Those of biennial plants are not to be collected until the second
year. For drying, they should be thinly spread on the floor of a

808

.TI0N8.

their doses,
led materia
e are taken
lal, and the

n from the
barks, and
vers unless
erly cured,
eir peculiar

;heir- juices
i time.

t»e autumn,

the spring,

•e to be cut
bey are the

ives decay,
trung upon
leing dried,
ee as possi-

)e gathered
easily, and,
jyniust be
ks are gen-

nd just be-

the second
floor of a

MEDICINES AND TUEIK PREPARATIONS.

809

room through which a current of air passes. For preservation, they
should be packed in vessels, and kept free from moisture and insects.

Flowers must generally be collected about the time of their open-
ing, — either a little before or just after.

They should be dried as rapidly as possible, but not in the sun, and
may be packed away in the same manner as leaves.

Fruits, Berries, etc., may be spread thinly upon the floor, or hung
up in bunches to dry.

Articles to Accompany a Medicine-Chest.

It is advisable for families who prepare their own medicines to
supply themselves with scales and graduated glasses, as the medi-
cines in this book are prescribed in this way. Still, in many instances,
meaauring with spoons will answer.

The following articles shouid be kept in the medicine-chest : —

1. A spatula for mixing ointments and pills, and for spreading
plasters.

2. A piece of smooth marble on which the above articles may be
mixed, divided, and spread.

3. A glass funnel.

4. A domestic syringe for injection.
6. Adhesive or sticking plaster.

6. Lint. '

7. Scales and weights. -

8. A glass or wedgewood mortar and pestle.

9. A graduated wineglass for measuring teaspoonfuls and table-
spoonfuls of liquids. ".

10. A graduated minim measure.

11. A two-ounce graduated measure.

3 Dram. Minims. 3 Ounce. 3 Dram. ,.\

Fio. 196. Minim Heasurb.

FlO. 198. TWO-OCNCB MBABURB.

The minim measure is represented by Fig. 196, and contains one
fluid dram, or sixty minims, which is divided by twelve lines, — each
line representing five minims. A minim is considered about equal
to one and a half drops.

The two-ounce measure is represented by Pig. 196, and is divided
off from half a dram upward.

^Hiniii'ii ■ )

-laiEsiesiiStifiWiE!,

810 MEDICINES AND THEIR PREPARATIONS.

Doses, Weights, etc.

Apotheoaby's weights, by which all medicinal preparations ought
to be weighed, are divided into pounds, ounces, scruples, drams, and
grains.

The characters marked on weights and graduated measures are
explained as follows : —

§j one ounce,
f f j one fluid ounce.
fss half an ounce.
3j one dram.

f3j one fluid dram.
388 half a dram.
9j one scruple.
9s8 half a scruple.

The grain weights are stamped with punch-marlcs.

60 drops make-one fluid dram.
8 drams make one fluid ounce.
13 ounces make one pint.

20 grains make one scruple.
3 scruples make one dram.
8 drains make one ounce.

By apothecary's weight: —

lb The pound is equal to 12 ounces.
§ The ounce is equal to 8 drams.

By apothecary's measure : —

3 The dram is equal to 3 scruples.
3 The scruple is equal to 20grain8.

The pint is equal to sixteen ounces.

The dram is equal to ninety drops, or sixty minims.

The marks and words used by physicians and apothecaries may be
a httle more fully explained by the following table : —

B; stands for recipe, and means take.
da stand for ana, and mean of each.
lb stands for libra vel librce, and means a pound or pounds.
I stands for uncia vel vncim, and means an ounce or ounces.
3 stands for drachma vel drachmce, and means a dram or drams.
3 stands for scrupulus vel scrupuli, and means a scruple or scruples.
O stands for octarius vel octarii, and means a pint or pints.
f| stands for ftuiduncia vel Jluiduncioe, and means a fluid ounce or
fluid ounces.

f3 stands for fluidrachma vel fluidrachmm, and means a fluid dram

or fluid drams,
m stands for minimum vel minima, and means a minim or minims.
Chart, stands for chartula vel chartulm, and means a small paper or

papers. ^ *^

Coch. stands for cochlear vel cochlearia, and means a spoonful or spoon-
fuls. '^
CoUyr. stands for collyrium, and means an eye- water.
Conflr. stands for conguis vel conguii, and means a gallon or gallons.
Decoct, stands for decoctum, and means a decoction.
Ft. stands tot flat and means make.
Garg. stands for gargarysma, and means a gargle.
G^r. stands for granum vel grana, and meanfi a grain or graiTiB.
Gtt. stands for gutta i)el giUtoe, and means a drop or drops.

MKDICINE8 AND THEIR PREPAKATI0N8.

811

ions ought
irams, and

lasures are

ram.

pie.

lid dram,
iiid ounce,
int.

3 scruples,
o 20 grains.

Hauat. stands for haustua, and means a draught.

Infua. stands for infuaum, and means an infusion.

M. stands for miace, and means mix.

Afass. stands for maaaa, and means a mass.

Mist, stands for miatura, and means a mixture.

Pil. stands for pilula vel pilulce, and means a pill or pills.

Pulv. stands for pulvea vel pulverea, and means a powder or powders.

Q. S. stands for quantum aufficit, and means a Bufflcieut quantity.

S. stands for aigna, and means write.

Sa. stands for aemia, and means a half.

Domestic, or Approximate Measu> . — A tablespoon contains
about four drams ; a teaspoon, one dram ; a dessertspoon, three
drams ; a wineglass, two ounces. Spoons vary so much in size, that
they should not be used as measures in giving powerful medicines.

Spoons can also be used for measuring solid substances, but are
not as accurate, as the solid substances vary very much in weight,
so that I would not advise their use in measuring powerful drugs.

One dram, or 60 grains, to a teaspoonful. •

Four drams, or half an ounce, to a tablespoonful.

The spoon should be level full for solids.

IS.

es may be

ms.
sruples.

[ ounce or

luid dram

aims.

i paper or

or spoon-
iUons.

The Approximate Value of French Decimal

Weights.

One centigramme is equal to J grain.

Two centigrammes " |^ grain.

One demi-decigramme " 1 grain.

One decigramme " 2 grains.

One gramme " 18 grains.

One gramme and three decigrammes is equal to 1 scruple.

Two grammes " | dram.

Four grammes " 1 dram.

One decagramme is equal to 2 drams and 36 grains. '

Three decagrammes and two grammes is equal to 1 ounce.

Demi- kilogramme " 1 pound.

Kilogramme ^ ," 2 pounds.

The following table shows the relative doses for young people of
different ages : —

The dose for a person of middle age being
That of a person from 14 to 21 years will be

" 7 to 14

" 4 to 7

" 4

♦' 3

" 2

*♦ 1

t«
u
«i
M

((
it
((
((
u

1 or 1 dram,
f or 2 scruples.
I or I dram.
} or 1 scruple.
I or 15 grains.
^ or 10 grains.
I or 8 grains.
^ or 5 grains.

In administering medicines, it is always well to begin with the

812

MEDICINES AND THEIR PKEPAKATI0N8.

smallest dose mentioned and gradually increase until the desired in-
fluence is produced.

The dose given should not only vary with the drug, but also with
the condition, age and sex of the person.

In giving medicine to children, care should be taken as to the
amount administered. (See foregoing table.)

It is 01 course necessary in all cases that the strength and con-
dition of the patient should be taken into consideration. Especially
where powerful drugs are used, it will be better to give smaller doses
than mentioned in ti^e table. ^ , .

Tinctures.

Thk preparations called tinctures are made by grinding or bruising
the roots, leaves, or barks used, to a coarse powder, placing it in the
proper amount of either alcohol or diluted alcohol, letting it stand
from seven to fourteen days, — shakiii each day, — and, finally,
filtering through paper. A large proportion of tincture3 are made
by taking one ounce of the medicinal substance to one pint of the
spirit ; and whenever tinctures are spoken of in this Materia Medica,
and the quantities are not named, the above proportions are to be
presumed. When a larger proportion of the medicine is to be used,
I shall simply indicate the proportions in the fewest words, as under
Black Cohosh, — " this tincture, four ounces to the pint of alcohol,"
meaning thereby, that the tincture is made by using four ounces of
the root to the pint of alcohol. Most flui ' extracts have the same
strength, ounce for ounce, with the roots, bai leaves, etc., of which
they are made. Tinctures may therefore be iuade w^th very little
trouble, by substituting, in each case, the same number of ounces of
their fluid extracts to the pint of alcohol, which I name of the gross
substance, or, when no quantity is named, one ounce to the pint. "

Infusions.

These doses are for adults : —

For young people from 15 to 21, give | of dose.
*' children' " 7 to 15, " i »«

" infants, i "

In administering medicines of all kinds the strength and condition
of the patient should be taken into consideration.

Infusions are solutions of vegetable medicines, generally obtained
by pouring boiling water upon the substance, and letting it stand till
it cools. When a more prolonged application of heat is desired, the
vessel may stand for a while by the fire, but must not be permitted
to boil. The vessel should usually be covered.

As in the case oi' tinctures, I have uniformly, while writing this
Materia Medica, briefly named the quantity to be used to the pint,
whenever it varies from one ounce.

MEDICINES AMD TUEIB PKEFAKATIOMS.

813

desired in-

t also with

as to the

h and con-
Especially
aller doses

>r bruising
: it in the
g it stand
d, finally,
are made
int of the
ia Medica,
are to be
o be used,
, as under
^ alcohol,"
ounces of
i the same
, of which
very little
ounces of
the gross
pint. ■

condition

' obtained
stand till
isired, the
permitted

itiug this
the pint,

Acetic Acid. — This is a clear liquid, without color, and has a
strong, sour taste, and an agreeable smell. When held to the nose,
its fine, pungent odor often relieves headache. A piece of cambric
wetted with it and applied to the skin, excites heat and redness, and,
very soon, a blister, — for which this acid may be substituted in in-
flammatory sore throat, and other cases requiring speedy action.
Applied to corns and warts, with a camel's-hair brush, it destroys
them.

Citric Acid. — This acid is extracted from lemon or lime juice ; it
is also present in the cranberry, currant, strawberry, raspberry, tama-
rind, and is very abundant in the red elderberry. It is refrigerant
and antiseptic, and is chiefly employed as a substitute for lemonade.
Nine and a half drams of the crystals, two drops of oil of lemon,
and one pint of water, answers a good purpose in place of lemon-
juice.

Diluted Nitric Acid. — This, in the undiluted state, passes under
the name of aqua-fortis. It is tonic and antiseptic. Largely diluted
with water, it forms a good drink in fevers, especially typhus. Taken
in large doses, it is a powerful poison. One-half dram of this prepai-a-
tion, thirteen ounces of soft water, and one ounce of simple syrup,
make a good drink in fevers, of which half a wineglassful is a dose.
Excellent in cases of whooping-cough. Use with care.

Nitro-Muriatic Acid* — This acid, when properly diluted, has a
tonic and stimulant influence. It is much used as a foot-bath in
affections of the liver, and in deficient secretions of the bile.

Diluted Hydrochloric Acid. — This is known by the name of
diluted muriatic acid. It is tonic, antiseptic, and diuretic, and is
used in typhus, eruptions of the skin, and with other articles, as a
gargle in inflammatory and putrid sore throats. Dose, from five to
twenty drops, in a wineglassful of water. It is given in scarlet and
typhoid fevers, about ten drops being put into a bowl of barley-
water or gruel.

Diluted Hydrocyanic Acid This is commonly known by the

name of prussic acid. It is sedative and antispasmodic, and is useful
in spasmodic coughs,, asthma, whooping cough, nervous affections,
hiccough, palpitation of the heart, initable stomach, and dyspepsia.
Dose, from two to five drops, in a glass of water or tea of Peruvian
bark. It is an active poison, and should only be taken when pre-
scribed by a physician.

Diluted Sulphuric Acid. — This acid, known by the name of
diluted oil of vitriol, is tonic, antiseptic, refrigerant, and astringent.
It is useful in dyspepsia, diabetes, nienorrhagia, haemoptysis, erup-
tions of the skin, hectic, and dianhcea. It is often given Avith some
bitter infusions, as rascarilla, Colombo, Peruvian l)ark, or quassia.
The aromatic sulphuric acid is often used in place of it, being some-

(:i;

814

MEDICINES AND THEIR PKEFABATIONH.

times considered more grateful to the taste. Dose of each, from five
to ten drops.

Tannic Acid. — This is an astringent preparation, and pasHes
under the name of tannin. It is prepared from galls. It is used in
diarrhoea, dysentery, passive hemorihagea, and diabetes. Dose of
the powder, from one to three grains.

Tartaric Acid. — This is refrigerant and antiseptic, and ia used in
inflammatory affections, fevers and scurvy. It is much need in pre-
paring what is called lemon syrup, and forms an agreeable and
healthful drink.

Alcohol. — Alcohol is the result of the fermentation of the juices
of many vegetables. It is the intoxicating constituent in whiskey,
rum, brandy, gin, wines, porter, ale, beer, and cider. Its principal
use in medicine is in the preparation of tinctures, essences, and
extracts. One part of pure alcohol to one part of water forms the
diluted alcohol of the shops.

Almonds. — The Amygdalus communis, or almond tree, grows in
the south of Europe and Asia, and yields the sweet and bitter almond.
The oil of the sweet almond is used as a demulcent, in coughs, etc.
A dose is a teaspoonful. The oil of the bitter almond is poisonous,
and is occasionally used as a valuable sedative. Its taste is like that
of a peach-kernel. Dose, one-quarter of a drop. It owes its poison-
ous properties to hydrocyanic acid. Cakes, etc., are sometimes
flavored with an essence prepared from it. Do not confound the
sweet with the bitter.

Aloes. — This is the hardened juice of the leaves of several species
of the aloe-tree, in North and South Africa, in the south of Europe,
and in the island of Socotra. Aloes is purgative, acting chiefly upon
the rectum, or lower bowel, in which it frequently produces irritation,
and is apt to aggravate and induce piles. It is much used to excite
the flow of the menses, and should never be given to women during
pregnancy. It produces griping of the bowels, which may be dimin-
ished by combining it with carbonate of potash.

Alum (^Alumen^. — The cheminal name of this is sulphate of alu-
mina and potassa. In ordinary doses, alum is astringent and anti-
spasmodic. In large doses, it is purgative and emetic, and is used
both externally and internally. It is often used in solution as a gar-
gle in sore throat, and falling down of the uvula, and as an injection
in leucorrhoea. In doses of twenty or thirty grains, it acts as a pur-
gative, and used in this way is useful in painter's colic. When
exposed to heat in a vessel till it ceases to boil, it becomes dry, and
is then called burnt alum, which, when pulverized, is applied with
advantage to canker spots in the mouth, and to proud flesh.

American Hellebore ( Veratrum Viride). — This plant grows in
many parts of the United States, usually in swamps, wet meadows,

, from five

nd passes

is used in

Dose of

i« used in
Bed. in pre-
;eable and

the juices
1 whiskey,
i principal
ences, and

forms the

3, grows in
;er almond,
oughs, etc.
poisonous,
is like that
its poison-
sometimes
ifound the

feral species
pi Europe,
biefly upon
I irritation,
d to excite
aen during
f be dimin-

late of alu-
b and anti-
md is used
in as a gar-
n injection
6 as a pur-
ic. When
>8 dry, and
plied with

grows m
meadows,

MEDICINES AMD TIIEIK PREPAKATIONS.

815

and on the banks of mountain streamlets. The root is the part used.
It is sUghtly acrid, alterative in a marked degree, very decidedly
and actively e: ^ectorant and diaphoretic, and it is an excellent
nervine, though not narcotic. But its most marked and valuable
quality — that in which it has no rival — is its sedative action upon
the circulation. In suitable doses, it can be relied upon to bring the
pulse down from a hundred and fifty beats in a minutu to forty, or
even to thirty. In fevers, therefore, in some diseases of the heart,
in acute rheumatism, and in many other conditions which involve
an excited state of the circulation, it is an article of exceedingly
greau value, because it is always reliable. Use under physician's
directions only.

Preparatioii,%. — Veratum is used chiefly in the form of tincture,
six ounces to the pint of diluted alcohol, or of fluid extract. The
dose of each of these preparations, for a grown person, is two or
three drops every hour or two, in a little sweetened water, and grad-
ually increased, if necessary, till the pulse comes down to sixty or
seventy. If taken in so large a dose as to produce vomiting, or too
much depression, a dose of morphine or laudanum in a little brandy
or ginger, is a co'iuplete antidote.

Veratrin, the t'ctive principle of veratrum, is also used, iu doses
of one-fourth to one-third of a grain.

American Ipecacuanha (^Euphorbia Ipecac). — This plant is per-
ennial and grows in sandy soils in the Middle and Southern States.
When cut or broken it gives out a milky juice. The root is the
medicinal part. It is emetic, cathartic, and diaphoretic. Dose, as a
cathartic, eight or ten grains; as a diaphoretic, three or four grains,
every three or four hours.

American Ivy (^Ampelopsis QuinquefoUa). — This vine grows in
all parts of the United States. It is known by the names of false
grape and wild woodbine. It is alterative, tonic, astringent, and ex-
pectorant. Used in scrofula a id syphilis.

Water of Ammonia (^Liquor Ammonice). — This preparation, called
hartshorn, or spirits of hartshorn, is formed by the union of water
with ammonia gas. It has a powerful ammoniacal odor, and an alka-
line, caustic taste. Taken internally it is stimulant, sudorific, and
antacid, and applied externally, it is rubefacient. It stimulates par-
ticularly the heart and arteries, without very much exciting the brain.
It is an excellent remedy in heartburn, and for sick headache de-
pendent on sourness of the stomach A dose is from ten to twenty
drops, largely diluted with water. United with oils, or with alcohol
in about equal proportions, and applied externally, it reddens the
skin, and, if the cloth wet with it be covered with oiled silk or with
flannel, to prevent evaporation, it will sometimes quickly raise ablister.
Ill cases of fainting, it is frequently applied to the nostrils, to excite
the brain, and rouse the system. Aromatic spirit of anjijonia is a
better preparation.

i-n\m

mm t l ^^ fv

i^mjiumM ri»irii ifjUn i giaiwii t,wtm laMMhfci'Mi^Ht.iPi'w^iiiM.

ai6

MKUICINES AND TUKIH PUKPAKATIONS.

Carbonate of Ammonia. — This is a white, moderately hard, crj>
talline salt, having a pungent, ammoniaoal smell, and a Kharp,
penetrating tatite. When exposed to the air, it loses some of its
ammonia, becomes a bicarbonate, and falls to powder. It is stimu-
lant, diaphoretic, antispasmcJic, powerfully antacid, and, in liirge
doses, emetic. Internally, it is more often used than water of ammo-
nia, and for similar purposes.. Coarsely bruised, and scented with
oil of lavender, it constitutes the common smelling salts, so much
used in fainting and hysterics. For internal use, the dose is from
five to ten grains, taken in the form of pills, every two, three or four
houre.

Muriate of Ammonia (^Sal Ammoniac.^ — This, also called hydro-
chlorate of ammonia, is a white, translucent, tough, fibrous salt, in
large cakes, about two inches thick, convex on one side, and concave
on the other.

It has a saline, pungent taste, but no smell, dissolves in one part
of boiling water, and three parts of cold. Taken internally, it is
stimulant and alterative. It is a valuable remedy in chronic bron-
chitis, pleurisy, and inflammation of the serous and mucous mem-
branes generally. But it must only be used after the first violence
of these inflammations has abated. Pulverized, and placed over a
spirit lamp in a tin cup, the fumes which arise when it sublimes may
be inhaled five or ten minutes, once or twice a day, with great ad-
vantage in chronic bronchitis, and in chronic inflammations generally
of the air-passages. A solution composed of one ounce of the salt
dissolved in nine fluid ounces of water and one of alcohol, may be
used as a wash for bruises, indolent tumors, and ulcers.

Solution of Acetate of Ammonia (^Liquor Ammonice Acetatis). —
This is known by the common name of spirit of Mindererus. The
taste is saline, and is like that of a mixture of nitre and sugar. It is
a valuable diaphoretic, and is much employed, alone or mixed with
sweet spirit of nitie, two parts to one, in fevers and inflammations.
It is a valuable external application iu mumps, applied hot upon a
piece of flannel. One-half ounce mixed with seven ounces of rose-
water and two drams of laudanum, forms a valuable wash for the
eyes in chronic ophthalmia. The dose is from two to three drams
mixed with sweetened water, every two or three hours.

Aromatic Spirit of Ammonia (^Spiritus Ammonice Aromaticus).-—
Taken internally, this answers the same purpose as other prepara-
tions of ammonia, and is much used on account of it agreeable taste
and smell. It is valuable as an antacid in sick headache. Dose,
from twenty to thirty drops, sufficiently diluted with water.

Anise (^Pimpinella Anisum). — This is a perennial plant, and grows
in Egypt. Its fruit is called anise-seed. It is aromatic and carmi-
native. It is much used to allay nausea, flatulency, and colic, par-
tioularly in children. It is frequently added to other medicines to

hard, crj>
il a sharp,
lome of itH
.t is etimu-
d, in large
iT of ammo-
iented with
ts, so much
lose is from
bree or four

ailed hydro-
'ous salt, la
and concave

iu one part
irnally, it is
lironic hron-
ucous mem-
rst violence
laced over a
ublimes may
ith great ad-
(ns generally
3 of the salt
jhol, may be

Acetatis). —
irerus. The
sugar. It ia

mixed with
flammations.

hot upon a
ices of rose-
vmh for the

three drams

tmatictii)- —
ler prepara-
reeable taste
tche. Dose,
ter.

it, and grows
c and carmi-
d colic, par-
medicines to

■f

' ■tim

;

I J...

9Cmm lu^^i.wUm*

I .1 .1 nwiwa)— ^WM^J^wmnbi

MEDICINK8 AND THEIR PUEPAKATI0N8.

817

make them more agreeable, and to lessen the griping effects of physio.
The oil extracted from the seeds, diusolved in alcohol, an ounce of
thii former to a pint of the latter, forms what is called the essence of
niilHe. Dose of the essence, from thirty drops to a dram in sweetened
water. Anise forms a vry valuable siddition to cough preparations.

Arnica (Arnica Montana.) — This is a perennial plant, growing in
moist, shady places in Silwria, etc. It is often called leopard's bane.
It is much .. jed externally as a. stimulating application to bruises, local
infliimmaticm, etc.

Preparations. — It is chiefly used in the form of tincture, or fluid
extract. Dose, ten to thirty droi»8. Half an ounce of tincture, five
and a half ounces of boiling vinegar, and two drams of carbonate of
ammonia, used warm, make in some cases a valuable fomentation. It
is one of the leading homoeopathic remedies.

Arrowroot. — This is prepared from the Maranta arundinaoea, a
plant of the West Indies. It is chiefly used in forming dietetic pre-
parations, and belongs to the first or saccharine group of food-articles.

Assafoetida. — This is the hardened juice from the root of a Per-
sian plant. It is stimulant, antispasmodic, and expectorant, and is
much used in nervous complaints. A dose of the powder is from
five to ten grains, and of the tincture, made by macerating two ounces
in a pint of diluted alcohol, from thirty to sixty drops.

Balm (Melissa Officinalis'). — This is a perennial plant, growing in
Europe and this country. It is moderately stimulant and diaphoretic.
The warm infusion causes perspiration, and is used to relieve painful
menstruation.

Balm of Qilead {Populus Candicans'). — This is a tree growing in
tlie northern parts of our country. A tincture made from the buds,
in doses of from one to four fluid dmras, is useful in affections of the
kidneys, in scurvy, and rheumatism. Steeped in lard they form a
useful ointment for some purposes.

Balmony (Chelone Glabra). — This is a perennial plant, common
to the United States. It is tonic, cathartic, and vermifuge. It is
used in indigestion, debility, and derangements of the liver. A dose of
the powdered leaves is one dram ; of the tincture, two fluid drams ;
of the decoction, one or two fluid ounces ; of the active principle
called chelonin, one or two grains. A decoction of balmony com-
bined with tincture of assafoetida foims a valuable injection for
worms. An ointment made from the fresh leaves is valuable for
piles, inflamed breasts, tumors, and painful ulcers.

Balsam Copaiba. — This is obtained from a South American tree
called the Copaifera Officinalis. It is a clear yellowish fluid, about
the consistency of honey. It is a stimulating diuretic, and is much
used in chronic gonorrhoea, gleet, irritable conditions of the bladder,

818

MEDICINES AND THEIR PREPARATIONS.

and ohrouio bronchitis. In some penonn it causes an eruption ou the
skin, with itohing, etc.

In large doses, it acts as a cathartic.

Balsam Tola. — This is the juice of the tree Mymtpfrmim Tolui-
ferum, growing in South America. It is soft, U'lmtiiouH, luul of ii
piile brown cok)r; and, like balHam copaiba, is soluble in alcohol,
ether, and volatile oils. It haH Iwun used in asthma, (;ough, broii-
cliitiH, etc. Dose, from ten to thirty grains, in mucilage or syrup.

Barberry (^crAm« Vulgarity). — This shrub gro^s along the At-
lantic coiist, from Canad.i to Virginia. The parts used are the Itark
and berricH. It is tonic and laxative, and, in doses of a teaspoonful,
powdered, is useful in jaundice, chronic diarrhoea, and chronic dyHen-
tery. A decoction of tlie berries forms an agreeable acid drink in
fevers, cholera infantum, etc., and as a gargle it is useful for ulcers
of the mouth, etc., as a wash, for chronic inflammation of the eyes,
and as an injection for leucorrluva.

Bay berry (^Myrica Cerifera, Fig 197). — This is found in danip

places, in many parts of the United States,
and is very abundant in New Jersey. The
bark of the root is the part used. It is astrin-
gent and stimulant. Pulverized, and com-
bined with powdered blood-root, it forms an
excellent application to indolent ulcers. In
the form of poultice, combined with powdered
slippery elm, it is a useful application to
scrofulous tumoi-s or ulcers. The decoction
is a good wash for soie mouth, and spongy,
bleeding gums. It is chiefly used in the form
of tincture, dose, half an ounce ; fluid extract,
dose, one or two drams ; and the active prin-

Fio. m batbekrt. ciple, myricin, dose, two to ten gmins.

Bearberry ( Uva Urn, Fig. 198). — This plant, also called upland
cranberry, has a wide range, being found in the northern parts of Asia,
Europe and America. It flowers from June to Sep-
tember, and ripens its berries in the winter. The
leaves are the only medicinal parts. It is astringent
and tonic, and acts particularly upon the urinary or-
gans, for complaints of which it is generally used. It
is specially valued as an antilithic in gravel, and as a
remedy for chronic inflammation of the kidneys, ul-
ceration of the bladder, etc.

Preparations. — Fluid extract, dose, one-third of a
dram to a dram ; solid extract, dose, five to fifteen j,,^ jgg

grains; tincture, dose, one to two ounces. beabberhy.

Beef's Qalls {Fel Bovinum). — This being dried by evaporation, is

MEDI0INK8 AND TIIRIK HHKPAHATIONS.

819

laon on the

lum Tolui-
, and of a
in alcohol,
ugh, bron-
r Hyrup.

rig the Atr
L' the iMik
iospoonful,
Dnic dyHen-
id drink in
for ulcers
E the eyes,

d in damp
ted States,
rsey. The
It Ib OHtrin-
, and com-
t forms an
ulcere. In
h powdered
ilication to
e decoction
nd spongy,
in the form
lid extract,
votive prin-
lins.

led upland
[•te of Asia,

)omtiou, is

fiomotimeH u«e<1 as a tonio and laxative, in torywr of the livor, jaun-
dice, indigestion, uiid coHtivonesH, in (Iohoh of from one to ten graiuH.
Throe drams of ox-gall, one dram of extract of oonium, two draiuH of
soda soap, and one ounce of sweet oil, make a valuable preparation,
which, when applied externally, has a Kurprisingly rapid etl'cci in
reducing enlargement and hardening of the breasts, glandular tumors,
particularly enlargement of the tonsils, and is useful in hypertrophioH
generally. For application to the tonsils, the gall may Ihj rubbed up
with water to the consisteuce of an ointment, and may be applied with
a caniel's-hair brush.

Benzoin. — This is the hardened jnioe of a tree of Sumatra and
lioriico. It is very brittle, of a reddish brown color, and is soluble in
alcohol and ether. It is ('iefly used for inhalation in chronic laryn-
gitis and bronchitis. Wh n used for this purpose, it may be added
to l)oiling water, and the va^)or iidialed; or it may be burned upon
coals or a hot shovel, the fumes being inhaled.

Benzoic Acid. — This is nrepared by heating benzoin, and causing
it to sublime. It consists of b'.lky, feathery crystals, which are white
and soft. It has been found useful in the phosphatic vaiiety of
gnivfal. A convenient way of giving it is to unite one part of it with
four parts of phosphate of soda, the dose of which is from ten to
twenty grains.

Betliroot (Trillium Pendulum). — A perennial plant, growing in
rich soils, in the Middle and Western States. The root is used, and
is astringent, tonic, and antist.ptic. It is useful in bleeding from the
lungs and kidneys ; also in excessive menstruation, cough, asthma,
and difficult breathing. Boiled in k. .k, it is used, in the western
country in diarrhoea and dysentery.

Preparations. — Fluid extract, dose, one to three drams ; trilliin,
dose, four to eight grains ; infusion, dose, two to four ounces ; decoc-
tion used as a local application to ulcers and sore mouth, and as an
injection in leucorrhoea and gleet. A poultice made from the root
is useful for carbuncles, indolent tumors, buboes, foul ulcers, and for
stings of insects.

Bitter-root (^Apocynum Androscemifolium,
Fig. 199). — An indigenous plant, growing in
rich soils in the United States and Canada. The
root is the part used, and is laxative, tonic,
diaphoretic, and alterative. It is employed in
chronic affections of the liver, syphilis, scrofula,
interraittents, and the low stage of typhoid fe-
vera. Forty to fifty grains will cause vomiting
without much nausea.

Preparations. — Fluid extract, dose, as a
tonic, '»n to twenty drops ; as a diaphoretic,
fifteen co twenty-five drops j as an emetic, half fio. i9b. bittkr-root.

I :

'><<!

820

MEDICINES AND THEIR FBEPARATI0N8.

a dram to « dram. Solid extract, dose, two to eight grains ; apocy-
nin, the active principle of the root, dose, half a grain to two grains ;
tincture, dose, two to three drams ; infusion, dose a wine-glassful,
three times a day.

Bismuth. — The principal preparation of this metal used in medi-
cine, is the trisnitrate of bui.mth, also called nitrate, aubnitrate, and
white oxide of bismuth. It is a white powder, without smell or taste.
It is used for various irritable and painful affections of the stomach,
when there is no acute inflammation. It is particularly useful in
chi'onic diarrhoea, more especially the diarrhoea of the latter stages of
consumption, over which it has more control than any other known
remedy. To show its best effects in this form of diarrhoea, it should
be given in large doses, not less than fifteen to twenty grains, imme-
diately afttjr each meal. The small doses usually given are compara-
tively useless. Given in these full doses, it is also almost a specific
in heartburn and water-brash.

Bittersvv^eet (^Solanum Dulcamara'). — This is common in Europe
and North America. It is a woody vine, the roots and stalks of
which are used in medicine It is slightly narcotic, and has altera-
tive and diaphoretic properties. It is used in scaly and syphilitic
affections of the skin. It is said to have antaphrodisiac properties,
and is serviceable in mania connected with strong venereal propensi-
ties.

Preparations. — Fluid extract, dose, half a dram to a dram ; solid
extract, daie, three to eight grains ; infusion, dose, one to three
ounces, three or four times a day.

Black Alder (^Prinos Verticillatus). — This shrub is common in
the United States , its bark and berries are used. It has been found
useful in jaundice, diarrhoea, intermittent fever and other diseases
connected with debility. Applied locally in the form of a wash or
poultice, and given internally, it is popular in chronic eruptions of
the skin, and in flabby, ill-conditioned ulcers, and mortification.

Preparations. — Fluid extract, do^e, two drams; tincture, dose,
two to four drams.

Two drams of the fluid extract of black alder, one dram of the
fluid extract of golden seal, and one pint of water, mixed, and taken
in doses of four fluid ounces, three or four times a day, are valuable
in dyspepsia.

Blackberry (Rvhus Villosus). — There are many species of this
growing in the United States. The bark of the root is the part used.
It is tonic, and strongly astringent, and is a valuable remedy in diar-
rhoea, dysent3ry, cholera-infantum, relaxed condition of the bowels
of children, and the passive discharge of blood from the stomach,
bowels, and womb.

Preparations. — Fluid extract, dose, half a dram to a dram ; solid
extract, four tp six grains ; tincture, dose, two to four d^ms ; inf u-

•wsrssMmwi^

MEDICINES AND TH£IK I'KEPARATIONS.

821

ms; apocy-
;wo grains ;
ne-glasst'ul,

ed in medi-
nitrate, and
bU or taste,
le stomach,
y useful in
sr stages of
tJier known
a, it should
ains, imme-
re compara-
)t a specific

1 in Europe
d stalks of

has altera-
i syphilitic

properties,
il propensi-

Iram; solid
e to three

ommon in
been found
er diseases
■ a wash or
ruptions of
jation.
iture, dose,

ram of the

and taken

re valuable

ies of this
part used,
jdy in diar-
the bowels
e stomach,

ram ; solid
,ms; iufu-

rio. 900.

Black Cohosh.

sion, dose, one ounce. This last preparation i.s also useful as an injec-
tion in gleet, leucorrhoea, and prolapsus of the rectum and womb.
The syrup of the blackberry-root is also a valuable preparation ; so
also is blackl)erry brandy, so called, which is the juice of the fruit
mixed with brandy. This is excellent in summer complaints.

Black Cohosh ( Cimicifuga Racemo»a, Fig. 200). — This grows in
rich soils throughout the United State-s. The
root is the part used. It is slightly narcotic,
sedative, antispasmodic, antiperiodic, and exerts
a marked influence over the nervous system;
being useful in St. V'tus's dance, epilepsy, ner-
vous excitability, as la, delirium tremens, and
many spasmodic affections. It has an especial
affinity for the uterus.

It reduces the arterial action very materially,
and hence is useful in palpitation of the heart.
It has been used successfully in acute rheuma-
tism, but more particularly in chronic rheuma-
tism.

Preparations. — Fluid extract, dose, half a
di-am to two drams ; solid extract, dose, four to
eight grains ; tincture, four ounces to the pint of
alcohol ; dose, one to three drams ; cimicifugin, the active principle,
dose, one to six grains.

Black Willow (Salix Nigra). — This tree is found in the Northern
States, along the banks of rivers, especially in New York and Penn-
sylvania, and is known by the common name of pussy-willow. It is
a bitter tonic, and is sometimes used in fever and ague. A decoction
made from the buds is said to be a powerful antaphrodisiac, and is
accordingly useful in the treatment spermatorrhea.

Bloodroot (^Saaguinaria Canadensis., Fig. 201). — A perennial
plant, growing in light, ric' soils, in most parts of
the United States. The rv,jt is the part used. It
is emetic, narcotic, expectorant, alterative, escha-
rotic, and errhine. It is used in typhoid pneumonia,
bronchitis, rheumatism, dyspepsia, etc. Three to five
grains stimulates the digestive organs, and accele-
rates the pulse.

Preparations. — Fluid extract, dose, five to fifteen
drops ; solid extract, half a grain to a grain and a
half ; tincture, twenty drops to a dram ; sanguina-
ria, the alkaloid principle, from one-twentieth to one-
tenth of a grain.

Four-grain pills, made of sanguinarin, twelve
grail, s, caulophyllin, twelve grains, solid extract of
cimicifuga, twelve grains, are said to be efficacious
in amenorrhoea, dysmenorrhoea, and other female disorders.

V ;■' ; ^-^

■i^^r

'" ». iOl.
rLoonBooT.

822

MEDICINES AND THEIR PREPARATIONS.

\'-'

Blue Cohosh {Caulophyllum Thalictroidea, Fig. 202) A peren-
nial plant, growing in low, moist grounds in most parts of the United
States. The root is the part used. It is antispasmodic, diuretic,
diaphoretic, alterative, emmeuagogue, anthelmintic, parturient, and
tonic. It is used in rheumatism, dropsy, epilepsy, hysterics, cramps,
amenhorrhoea, dysmenoirhoea, chorea, leuconhoea, hiccough, to hasten
delivery, and to relieve after-pains.

Preparations. — Fluid extract, dose, fifteen to thirty drops ; sohd
extract, dose, one to three grains ; tincture, dose, half a dram to a
dram ; infusion, dose, two to three ounces ; caulophyllin, the active
principle of th*^ '-oot, dose, one-quarter of a grain to a grain.

In cases of protracted labor, occasioned by fatigue or debility, the
infusion is said to be fully equal to ergot in hastening delivery. A
wash made by combining one ftunce of fluid extract with one ounce
of the fluid extract of golden seal, and eight ounces ui water, is very
excellent for apthous sore mouth.

FiQ. 302. Bluk Cohosh.

Fio. 203. BLue Flag.

Blue Flag (Iris Versicolor, Fig. 203). — A perennial plant, grow-
ing in damp places, in most parts of the United States. The root is
the part used for medicinal purposes. It is cathartic, alterative, sia-
lagogue, and diuretic. It acts particularly on the glandular system ;
in large doses, it evacuates and exhausts the system, acting on tlie
liver, and fulfilling the purposes of mercury.

Preparations. — Fluid extract, dose, twenty to forty drops ; solid
extract, one to three grains ; tincture, one to two drams. Iridin, tiie
active and resinous principle, dose, half a grain to three grains.
Equal parts of blue flag, mandrake, and prickly-ash bark, mixed, and
given in five- to ten-grain doses, every two or three hours, will act as
a powerful alterative, and cause free salivation, without making the
breath offensive or injuring the gums. Three grains of iridin, five
grains of leptandrin, an.^l twenty grains of bitartrate of potassa, form
an excellent cathartic in dropsy, producing free watery stools.

MEDICINES AND THEIR PKEPARATIONS.

823

— A peren-
the United
3, diuretic,
urient, and
08, cramps,
1, to hasten

rops; solid
dram to a
, the active
in.

ebility, the

ilivery. A

one ounce

,ter, is very

lant, grow-
The root is
jrative, sia-
ar system ;
iug on tlie

pops;

solid

Iridin, the
ree grains,
mixed, and
will act as
ciaking the
iridin, five
tiissa, fonn
lols.

Blue PHI (^Hydrargyri Piluloe). — This mercurial preparation, gen-
erally known by the common name of blue viaas, or blue pill, is made
by rubbing mercury, confection of roses, and pulverized liquorice-root
together until all the mercurial globules disappear. The mass is di-
vided into pills when wanted. It is the mildest of all the mercurial
preparations, and the least liable to produce salivation or irritivtion
of the system. But even this should be used sparingly, and with
caution, and I do not recommend its use.

The blue mass is alterative and cathartic, and is considerably
given to stimulate the action of the liver, and to produce an altera-
tive effect upon the digestive organs. The leotandra and the podo-
phyllum have become its rivals, and will, 1 si ly hope, finally take
its place.

Boneset (^Bupatorium Perfoliatum, Fig. 204). — An indigenous
plant growing in most parts of the United States. The tops and
leaves are medicinal. It is tonic, diaphoretic, expectorant, and, in
large doses, or when taken as a warm infusion, emetic and aperient.

Preparations^ — Fluid extract, dose, one to two drams ; solid ex-
tract, dose, five to fifteen grains ; tincture, dose, one to one and one-
half ounces ; infusion, dose, one to two ounces. Eupatorin, dose, one
to three grains.

Two soiuples of eupatorin, cne scruple of xanthoxylin, and one
grain of strychnia, mixed, and made into twenty powdere, is excellent
for torpor of the liver or kidneys, and for rheumatism ; one powder
being taken three or four times a day.

I'lQ. 204. BONKSKT.

KlO. a06. BUCBU.

Buchu {Barosma Crenata, Fig. 206). — It grows at the Cape of
Good Hope. The leaves are the medicinal portion ; they are stim-
ulant, diuretic, antispasmodic and tonic. Buchu is chiefly given in
complaints of the urinary organs, attended with increased uric-acid
gravel, chronic inflammation or morbid irritation of the bladder,
urethra, and prostate, and retention or incontinence of urine.

Preparations. — Fluid extract, dose, half a dram to two drams ;
tincture, dose, two to five drams ; infusion, one to five ounces. A
combination of fluid extract of buchu half an ounce, acetate of

IHM

824

MEDICINES AND THEIR PREPARATIONS.

potash two drams, and water eight ounces, taken in doses of four
ounces three or four times a day, is a valuable diuretio.

This combination, however, may be improved by the addition of a
little sweet spirits of nitre.

Buckhorn Brake (^Oamunda Regalia). — This is a ferng^wing in
moist grounds in most parts of the United States. The root, which
is the medicinal part, should be gathered in the latter part of May,
and in August, and very carefully dried, to prevent moulding. It
is mucilaginous and tonic, and is used in coughs, diarrhtjea and
dyBentery, and as a tonic while getting up from exhausting disease.
One root infused in a pint of hot water for half an hour will convert
it into a thick jelly. This mucilage may be sweetened with sugar,
and freely taken.

Buckthorn (Bhamnua Catharticus). — This plant grows in Europe,
where it is much esteemed by practitioners. The berries and juice
are actively medicinal. It is a powerful cathartic, producing large
watery discharges. It is seldom used alone on account of the severity
of its action.

Preparations. — Fluid extract, dose, one dram; syrup of buck-
thorn, made by uniting four ounces of fluid extract with twelve
ounces of simple syrup, dose, two drams.

Bugle weed (^Lycopun Virginicm). — This grows in shady and
wet places throughout a greater part of the United States. The
whole herb is used. It is a mild narcotic, sedative, sub-astringent,
and styptic. It is a valuable remedy in bleeding from the lungs,
incipient consumption and pneumonia. It quiets irritation and
allays cough and nervous excitement.

PreparatioTM. —¥\u\di extract, dose, one to two drams; infusion,
dose, two to four ounces.

Burdock (Lappa Minor"). — A native of Europe, and growing in
the United States. The root is used, which is useful in scurvy,
syphilis, scrofula, gout, leprosy, and disease of the kidneys. It needs
to be used for a long time. It is said io be useful for persons
afflicted with boils, stye, etc. An ointment prepared from it is
serviceable in some diseases of the skin, and obstinate ulcers.

Preparations. — Fluid extract, dose, one dram ; solid extract, dose,
five to fifteen grains ; tincture, dose, half an ounce to an ounce.

Burgundy Pitch. — This is the concrete juice of the Norway pine,
Abies excelsa, growing in Europe and Northern Asia, and of the silver
fir-tree of Europe, Abies picea. It gently excites the skin, and is
used chiefly in the form of plasters, either alone or mixed with other
gums and resins.

Butternut (Juglans Cinerea). — This is a forest tree, growing in
various parts of this continent, known also by the names of oilnut

wes of four
ddition of a

i growing in
root, which
irt of May,
mlding. It
arrhcea and
ing disease,
ivill convert
with sugar,

8 in Europe,
BS and juice
ucing large
the severity

p of buck-
^rith twelve

shady and

bates. The

^astringent,

the lungs,

itation and

3; infusion,

growing in
[ in scurvy,
1. It needs
for persons
from it is
ers.

Ktract, dose,
ounce.

orway pine,
}f the silver
skin, and is
; with other

growing in
}s of oilnut

wgm-

,^u.

MEDICINES AND TUEIK PKEPAKATI0N8.

825

and white walnut. The inner bark of the root is used, and is a mihl
cathartic, being useful in cases of constipation. It is much employed
by families as a domestic remedy, in intermittent and remittent
fevers. It evacuates the bowels without debilitating them.

Preparations. — Fluid extract, dose, one to two drams; solid ex-
tract, dose, five to fifteen giains ; juglandin, the active principle, dose,
one to three grains. A very good pill is made by mixing one and a
quarter drams of the solid extract of butternut, three-quarters of a
dram of the solid extract of jalap, and ten grains of soap, and divid-
ing the whole into sixteen pills. Two or three may be taken for
a dose.

Calcined Deer's Horn (ComM Cervince Ustum). — The horns of
the deer are said to be in velvet between August and December, and
(luring this period those which fall are collected, coarsely rasped, and
[ilaced in an iron vessel, which is tightly covered and placed in an
oven, or elsewhere, and subjected to a heat of 200° F., which is con-
tinued until the rasped horn becomes of the color of roasted coffee.
When cooled, it is reduced to powder by trituration, and preserved
in closely stopped vials. It is a powerful styptic, taken in teaspoonful
doses every half-hour ; or, a teaspoonful added to a gill of hot water,
and a tablespoonful of this taken every five or ten minutes. It has
much efficacy in floodings from the womb, and in excessive menstru-
ation.

Calomel {Hydrargyri Chloridum Mite). — This is prepared from
mercury, sulphuric acid and common salt. It is alterative, antisyphi-
litic, and anthelmintic, and, in large doses, purgative. It is much
used in venereal diseases and chronic affections of the liver, combined
with opium ; in dropsies, combined with squill, foxglove and elate-
rium; and in rheumatism and leprosy, combined with antimonials,
guaiacum, and other sudorifics. In the beginning of fevers and other
complaints, it is often combined with purgatives, as gamboge, scam-
mony, jalap and rhubarb. Given in small doses, not large enough to
purge, it gradually excites salivation. Dose, from one to three
grains.

The tendency of this article to produce salivation, to injure the
gums, loosen the teeth, etc., has given rise to much prejudice against
it in the public mind ; and, indeed, it must be confessed that it has
been used by many, from time immemorial, with great indiscretion.
In the hands of sensible and prudent men, it is very serviceable in
some cases; but the podophyllum and leptandra have so fine an
action upon the liver, that they are fast taking the place of calomel
and other mercurials, and possibly may in time wholly supersede
them. I have not prescribed it in this book, and do not recommend
its use. -< :

•tri

826

MEDICINES AND THEIU PREPAUATI0N8.

Fio. S06. Oamphob Tree.

Camphor (Fig. 206). This is obtained from an evergreen tree,
growing in tho EiiHt Indies, — Launis aim-
phora. It is a white, sliiny, crystiUlino sub-
stance, extnicted from tlit- wood and roots of
the al)ove-nanied tree hy boiling them, and is
subsequently jjurified by sublimation. It lias
a j)enetniting, peculiar diffusible odor, and a
pungent, cooling taste. It is moderately stim-
ulant, diaphoretic, and antaplirodisiac. Dose,
from one to ten grains.

Canada Balsam. — This is the fluid ob-
tained from the fir-balsam, Abies balsamea, of
Canada, Maine, etc. It is a stimulating diu-
retic, and, in large doses, cathartic. A dose is
from ten to fifteen drops, two or three times
a day, in pills, or in emulsion. It forms a part of several ointments
and piasters. It is used to mount objects in microscopic invesii-
gfiitions.

Canada Fleabane (Urigeron Ccenadense). — An annual plant, grow-
ing in the Northern and Middle States. It is diuretic, tonic, and
astringent, and has been found useful in droj)8ical complaints and
diarrhoea. The dose of the powder is from thirty grains to a dram ;
of the infusion, from two to four fluid ounces ; of the solid extract,
from five to eight grains ; to be repeated, in each case, every two or
three hours.

Canella (Canella Alba). — This is the bark of a South American
tree, and is an aromatic stimulant and a gentle tonic, and useful in
debility of the stomach.

Caraway ( Carum Cami). — This biennial plant grows in Europe.
The seeds are the part used, and are aromatic and carminative ; tliey
are used in wind colic, and to improve the flavor of other medicine.
The dose is from t i to sixty grains. The dose of the oil of caraway,
extmcted from the seeds, is from one to five drops.

Cardamom (Alpinia Cardamomum) This plant grows on the

mountains of Malabar. The seeds, which are the medicinal parts,
are aromatic and carminative, and are used to expel wind, and to
flavor medicines. Dose, from ten grains to two drams. The volatile
oil obtained from them has similar properties.

Cascarilla, — This medicine is the bark of the West India shrub,
Croton eleuteria. It has an aromatic odor, and a warm, spicy taste.
It is a pleasant aromatic and tonic, and is used in dyspepsia, chronic
diarrhoea and dysentery, wind colic, and other debilities of the stom-
ach and bowels. It counteracts the tendency of cinchona to produce
nausea.

Preparations Fluid extract, dose, twenty to twenty-five drops ;

,iJii.j>iiUiijmu;.

Tgreen tree,
Launis mm-
Htiillino Kub-
iml rot its of
-hem, jiiid is
ion. It liiiB
odor, mid a
irately stini-
ttiuc. DoHe,

le fluid ob-
balaamea, of
lulating diu-
. A dose is
three times
l1 ointments
opic investi-

plant,grow-
B, tonic, and
iplaints and
i to a dram ;
)lid extract,
ivery two or

|;h Ameiican
id useful in

s in Europe,
ative ; tliev
r medicine,
of caraway,

0W8 on the
cinal pnrtfi,
ind, and to
The volatile

ndia shrub,
spicy taste,
sia, chronic
f the stom-
to produce

•five drops ;

MEDICINES AKD THEIR PREPAKATIONS.

827

tincture, dose, one dram ; infusion, dose, one to two drams. An alka-
line infusion, composed of fluid extract, three ounces ; carbonate of
potiissa, two drams; and water, ten ounces, is excellent in weak
stomach, with acidity. Dose, one dram. .

Castor (Catitorevm'). — A peculiar substance obtained fiom the
beaver. It is antispasmodic and enuneiiagogue. It is used Id
typhus, hysterics, epilepsy , retention of the menses, and in many
other nervous diseases. Dose, from ten to fifteen grains. A medi-
cine of no great value.

Castor Oil ( Oleum Ricini). — This is obtained by expression from
the seeds of the castor-oil bush, Ridnus communin. When exposed
to the air, it becomes rancid and spoils.

As a mild cathartic this oil is extensively used, but may be ren-
dered less offensive by being mixed with a few drops of oil of winter-
green, peppermint oi cinnamon ; and its bad taste may be nearly
destroyed by rubbing it up to a thick batter with carbonate of mag-
nesia. Or, if boiled a few minutes with a little sweet milk, sweet-
ened with loaf sugar, and flavored with essence of cinnamon or
peppermint, it may be easily taken. Dose, for an adult, one io two
tablespoonfuls ; for a child, one, two or three teaspoonfuls, according
to its age.

Catechu. — This is a solid extract, made from the wood of the
Acacia catechu^ a tree growing ■ in Asia. It is in dark, brown, and
brittle pieces, and is soluble in alcohol. It is a powerful astringent,
and is. used in chronic diarrhoea and chronic dysentery. . It makes a
useful gargle in some forms of sore mouth, in elongated uvula,
spongy gums and sore nipples. The dose of the powder is from ten
to twenty grains, and of the tincture, from one to two teaspoonfuls.

Catnip {Nepeta Cataria). — A native of Europe, and widely nat-
uralized in this country. The tops and leaves are the medicinal
part, and are carminative and diaphoretic when drunk as a warm
infusion. It is useful in fevers, in wind colic, nervous headache,
hysterics, and nervous irritability.

Preparations. — Fluid extract, dose two to three drams ; infusion,
dose two to three ounces. Fluid extract of catnip, two ounces ; and
the fluid extract of saffron, one ounce and a half, united, make a
popular remedy for colds, and the rashes of children. In nervous
complaints, a combination of fluid extract of catnip, six drams ; fluid
extract of valerian, four drams ; and fluid extract of scuUcap, four
dmiiis, is a valuable remedy. Dose, one to two drams.

Cayenne Pepper {Capsicum Annuum, Fig. 207). — This plant
grows in hot climates, and is known by the common name of red
pepper. The berry, which is the part used, has an intensely hot and
pungent taste. It is a powerful, diffusible stimulant, and is about the

tmd

828

MKDICINKH AND TIIRIK PHKrAUATIONK.

no. W7. Catkmnb Pkffbr.

only stimulus which the Htomach will bear in certain formH uf dyg.
peptiia. It is useful in all cases uf diminished vital action, and ih fre-
quently united with other medicines, either to promote tluiir action,

or to lessen the severity of their opemtioii. It
is much used in colds, hoarsenesM, etc., iw it
pn)nu)te8 a free discharge of nnumN iiiui
phlegm. Taken in smal! doses, it has a tine
effect upon the mucou.^ membrane of tliu
stomach and bowels, lessening very much the
severity of piles, and sometimes curing them.
li may be sprinkled daily upon the food, or
taken in the form of cayenne lozenges; it \»
frequently useful as a gargle in sore throatH,
scarlet fever, etc. Dose of the powder from
one to eight grains.

Preparatiotis. — Fluid extract, dose, five to
ten drops ; tincture, dose, half a dir.m to a
dram, used in low forms of fever, and gastric
insensibility; infusion, dose, one to two drams. A valuable gargle
in R'^a' lot fever may be made by combining fluid extract of cayenne
one ounce ; common salt, one dram; boiling vinegar, one pint; boil-
ing water, one pint.

Celandine (^Chelidonium Maju%). — This plant is indigenous to
Europe, and is extensively naturalized in the United States. It is a
drastic purge, producing watery stools, and is equal to gamboge ; it is
useful in affections of the liver, and particularly in those of the
spleen. In the form of a poultice it is effective in scrofula, indolent
ulcers, skin diseases, and piles.

Preparations. — Fluid extract, dose, ten to fifteen drops ; solid ex-
tract, dose, five to eight grains ; tincture, dose, half a dram to a dram ;
infusion, dose, two and a half to four drams. A very good hydra-
gogue cathartic is made by compounding two and a half drams of
fluid extract of celandine with half a dram of fluid extract of hen-
bane, one ounce of sulphate of potassa, one grain of tartar emetic,
six ounces of elder-water, and ounce of syrup of squill.

ChaFk. — On account of its gpritty particles, it is unfit for medicinal
use intil it has been levigated, after which it is cnlled prepared chalk.
This is the only form in which it is used in medicine. It is an ex-
cellent antacid, and is admirably adapted to diarrluiea accompanied
with acidity. The most convenient form of administering chalk is
that of t' chalk mixture, which consists of prepared chalk, half an
ounce ; sugar and powdered gum-arabic, two drams each ; cinnamon-
water and water, four fluid ounces each, and rubbed together in a
mortar till they are thoroughly mixed. Dose, a tablespoonful fre-
quently repeated.

-r— T"

ormH of (lyg.
311, and ih Ire.

tluiir action,
npemtioii. It
JHtt, etc., m it

n)ncu8 iind
, it has a fine
)rane of ihu
ery much tliu
curing them.

the food, or
zenges; it in
sore throatH,
powder from

dose, five to
i dir.m to a
, and gastric
uable gaigle
t of cayenne
e pint; boil-

idigenous to
ites. It is a
mboge ; it is
hose of the
ala, indolent

ps ; solid ex-
n to a dram ;
good hydra-
alf drams of
ract of hen-
rtar emetic,

3r medicinal
pared chalk.
[t is an ex-
ocompanied
ng chalk is
alk, half an
; cinnamon-
)gether in a
joonful fre-

MEDIOINRH AMI) THKIK PUKl'AUATIONB.

829

FlO. 908. CHAMOIIILK.

Ca4«la-Bud«. — This spice is a product of China. It consista of
the calyx surrounding the young germ of one or more species of cin-
namon. CaHsia buds have some resemblance to cloves, and are com-
pared to small nails with round heads. They may be used for the
same purposes as the ciiinamon-bark.

Chamomile (Anthemis Nobility Fig. 208) — This perennial plant
grows in Europe, and its flowers, the white:;t of which are best, are
considerably used in medicine. They are
cfently tonic, and are generally used in cold
infusion, in cases of weak stomach, dyspej)-
sia, etc. In large doses, the wai-m infusion
will act as an emetic.

Preparation*. — Fluid, extract, dose, half
a dram to a dram ; solid extract, dose, four
to fifteen grains; infusion, dose, half an
ounce to an ounce. For dyspepsia, wind in
the stomach, etc., thirty pills may be made
by combining one dram of solid extract of
chamomile with five grains of the solid ex-
tract of rhubarb and ten g^rains of assafoe-
tida, and taken, one pill at a time, two or
three times a day, with advantage.

Charcoal {Carbo Ligni). — Prepared charcoal is antiseptic and ab-
sorbent, and is employed with great advantage in certain forms of
dyspepsia, attended with bad breath and putrid eructations ; it has a
good effect in correcting the fetor of the stools in dysentery : it is
considerably used, and with much advantage, as an ingre(Uent in
poultices. Dose, when taken internally, from one to three teiiepoon-
fuls.

Chloroform (^Chloroformum). — This is an anasthetic, used to pro-
duce insensibility during surgical operations. A t^aspoonful or more
is poured upon a handkerchief, which is held tr the patient's nose,
but not so closely as to prevent the admission ct »ir. The numerous
sudden deaths which have occurred from its use prove it to be an
unsafe agent, and it is now seldom employed by careful surgeons.
Taken internally it is sedative and narcotic ; applied externally, com-
bined with other articles, it is useful in painful affections, as nervous
headache, rheumatism, neuralgia, etc. The dose when taken inter-
nally is from ten to twenty drops, in flax-seed tea.

Cinnamon. — This is the bark of trees growing in Ceylon, Mala-
bar, and Sumatra. It is a very grateful aromatic, being warm and
cordial to the stomach ; it is also carminative and astringent.

It is not often prescribed alone, but is chiefly used as an aid to less
pleasant medicines, and enters into a great number of pre'^arations.
It is peculiarly adapted to diarrhcea ; and in treating this complaint

■:1

880

MEDICINK8 AND TIIRIK PREPARATIONS.

it in often joined with chalk and iiHtringenUt. DoHe of the bark, from
ten to fifteen grains. The oil has propertieH Hiniilar to thoue of the
bark.

Cleavers (Galium Aparine). — An annual plant, common to thiH
country and Euroi>e, having an acid, SHtringent taste. The whole
herb i.s UHed in infuHion,aH a cooling diuretic, in Hcalding of the uriiu;,
inflammation of the kidneys and bladder, in gravel, suppression of
the urine, etc.

It is hIho used in fevers and all acute diseaseH. The infusion is
made by adding two ounces of the herb to a pint and a half of warm
water. It should stand three or four bout's, and be drunk freely when
cold. Equal parts of elder-blows, cleavers, and maidan-hair, infused
in warm water, make a refreshing drink in scailut fever and other
eruptive diseases.

Clove« (^Caryophylluit Aromatiem). — The flowew of this tree, a
native of tropical climates, collected before they are fully developed,
form cloves. They are highly stimulant and aromatic, and are used
to give tone to the digestive organs, particularly when flatulency
exists, and to relieve nausea and vomiting. They are more generally
employed to improve the taste and modify the tuition of other medi-
cines. The dot. in powder is from five to eight grains. The oil of
cloves has similar propei+'ei ; dose, one to three Irbps. A little cot-
ton moistened with the oil, and pressed into a decayed tooth, will
frequently relieve the toothache.

Cochineal ( Coccug Cacti). — An insect found in Mexico, inhabit-
ing different species of cactus. They are gathered for use by detach-
ing them from the plant with a blunt knife, and dipping them, en-
closed in a bag, into boiling water. Cochineal is anodyne, and has
been used with advantage in whooping-cough and neuralgia. It is
much used for coloring tinctures and ointments, and the color called
carmine is prepared from it. A tincture is prepared by macerating
two ounces of cochineal in one pint of alcohol for seven days, and
filtering through paper. Dose, from twenty to twenty-five drops,
twice a day.

Cod'LiverOII {Oleum Morrhuoe). — This is obtained from the
livers of codfish, and is nutritive and alterative. It is a popular rem-
.edy in consumption and scrofula, and in those complaints genendly
in which there is impaired digestion, assimilation, and nutrition.
Dose, a tablespoonful three times a day.

Inability to digest this oil, to eat fat meats, or to take fats in any
form, is an unfavorable indication in consumption.

Collodion. — This is gun-cotton diF^solved in ether. It is applied
with a camel's-hair brush, to cuts, burns, wounds, leech-bites, etc.,
over which it forms a thin pellicle or skin, protecting the injured part
from the atmosphere. It should be kept in well stopped bottles, to
prevent its evapomting and becoming iinfit for use.

ria

MEDICINKS AKD THKIR PRKPAKATION8.

831

^ bark, from
those of the

nmon to this
The wholo
f the uriiit!,
•pressioii oi

infusion in
lalf of wiirni

reoly when
mir, iiifuHed

and other

tliis tree, a
developed,

nd are used
flatulency

le generally

other medi-
The oil of

A. little cot-
tooth, will

ico, inhabit-
by detach-
g them, en-
ne, and has
Jgia. It is
color called
macerating
I days, and
■five di'ops,

from the
jpular rem-
I generally

nutrition.

als in any

is applied
bites, etc.,
jured part
bottles, to

Colocynth {^Cucumi» Colocifnthin). — A native of northern Africa.
The part used in medicine is the fruit deprived of itH rind. It in a
powerful drastic, hydragoj^ue cathartic ; causing, by its harsh action,
g.iping, vomiting, and sometimes bloody discharges ; from the severity
of its operations, it is mrely used alone. Useful in dropsy, derange-
ments of the hmin, and for overcoming torpid conditions of the di-
gestive and biliary organs.

I'repamtionit. — Solid extract, dose, two to twenty gi'ains; com-
pound extract, dose, two to twenty grains.

Colombo (CocouluH Palmatuit). — A perennial climbing plant,
growing in East Africa, and cultivated in the Isle of France. It is a
pure, bitter tonic, and is used in dyspepsia, bilious vomitings which
attend pregnancy, and during recovery from exhausting diseases.

Prepnrationtt. — Fluid extract, dose, twenty to thirty drops ; solid
extract, dose, four to eight grains ; tiiicture, lose, one to three drams ;
infusion, dose, three drams to an ounce. A compound infusion made
by uniting one dram of fluid extract, four dnuns of orange-peel, and
one ounce of water, is useful in a weakened state of the bowels,
showing itself in a diarrhcea. Dose, two drams every hour. Fluid
extract of Colombo, one ounc«\ ; fluid extract of ginger, two drams,
and water, one pint, also make a useful compound foithe same pur-
pose. Fluid extract of Colombo, one dram ; fluid extract of rhubiirb,
one dram ; fluid extract of ginger, half a dram ; water, one pint, —
this is useful for a like purpose. The following is also a very good
preparation for a similar use ; fluid extract of Colombo, half an ounce;
fluid extract of cascarilla, two drams ; I'ucture of orange-peel, two
drams ; syrup of cinnamon, one ounce ; water, six ounces. Dose, one
dram every hour.

Coltsfoot (^Tussilago Farfara). — A native of Euro^jb, and natural-
ized in this country, especially in the Northern States. It gprows in
wet places and low meadows. The leaves are principally used.
They are emollient, dci.iulcent, and slightly tonic ; used in coughs,
asthma, and whooping-cough ; and externally in the form of poultice
for scrofulous tumoi-s.

Comfrey {Symphytum Officinale), — A perennial European plant,
cultivjited in 'his country. The root is the part used. It is demul-
cent, and slightly astringent, and is serviceable in diseases of the
mucous tissues, and in scrofulous habits ; also in diarrhoea, dysen-
tery, coughs, bleeding from the lungs, whites, etc. It may be taken
as an infusion, or as a syrup, one ounce to a pint of water ; the dose
being one to three fluid ounces, three to four times a day. The fresh
root bruised forms a valuable apjilication to ulcers, bruises, fresh
wounds, sore breasts, and white swellings-
Common Silk- Weed {Asclepias Syriaca). — This is a perennial
plant, common tliroughout the United States. It gives out a milky

.Ji

mOim

832

MEDICINES AND THEIR PREPARATIONS.

juice upon being wounded, and hence is often called milk-weed.
The loot is diuretic, alterative, emmenagogue, and anodyne; and k
sometimes used in dropsy, retention of urine, suppressed menstrua-
tion, scrofula, and rl. umatisra. Dose of the powder, from eight to
twenty grains ; of the decoction, from one to two fluid ounces.

Copper (C'ttjorwrn). — The following are the principal salts of cop-
per used in medicine : —

Subacetate of Copper (^Cupri Subacetas), — This is known by the
name of verdigris, and is used as a detergent and escharotic ; it is
applied to warts and fungous growths, and to foul ulcers and ring-
worm. When reduced to a fine powder, by trituration in a porcelain
mortar, the finer parts of this are separated, and called prepared 8ul>
acetate of copper; this is the preparation used for the purposes above
named.

Sulphate of Copper (^Cupri Sulphas). — In small doses, the sul-
phate of copper is astringent and tonic ; in large ones a prompt
emetic. It is given in small doses in hysterics, epilepsy, and inter-
mittent fevers ; and in large doses, to produce speedy vomiting in
croup, and to eject poisons from the stomach. A weak solution is
sometimes usecl for syphilitic ulcers, and as an injection in gleet.
Dose, as a tonic, one-quarter of a grain to one grain in pill ; as a
rapid vomit, from two to five grains, in two ounces of water. The
medicines which are incompatible with copper, are alkalies, earths
s»nd their carbonates, borax, salts of lead, acetate of iron, and astrin-
gent vegetable infusions, decoctions, and tinctures.

Corrosive Sublimate. — This, in chemical language, is the bichlo-
ride of mercuiy. It is one of the milder mercuriar preparations,
although when taken in large doses, it is a violent poison, and oper-
ates very quickly It is less apt to salivate than any other mercurial,
except blue pill. It is much used as a remedy in syphilis, particu-
larly in the secondary stage, in which, in many cases, it does much
good. It is also popular in many skin diseases, as leprosy. When
employed for this purpose, it is generally associated with alterative
and diaphoretic medicines, such as the compound decoction or syn o
of sarsaparilla, preparations of yellow dock, etc. In order to avoia
its irritating effects, it is often united with opium, or extract of con-
ium. Dissolved in water, it is valuable as a wash in some skin dis-
eases. It is an ingredient in many of the quack nostrums -which are
extensively advei'tised. It is the most powerful antiseptic known.

Cotton (^Q-os»ypium Herbaceum). — Cotton is chiefly employed in
cases of recent burns and scalds, — an application of it which sur-
geons have learned from popular use. It diminishes the inflamma-
tion, prevents blistering, and hastens the cure. It is applied in thin
and successive layers. The absorbent should be used. The inner
bark of the root is said to be emmenagogue, parturient, and abortive.
It is excellent in chl'^rosis.

Preparatian. — Fluid extract, dose, three drams.

milk-weed.
y»e; ajui iy

d menstrua-
om eight to
ances.

salts of cop.

lown by the
rotic; it is
and ring.

a porcehain
epai-ed sul>
loses above

les, the sul-
8 a prompt

and inter-

omiting in

solution is

in gleet.

pill ; as a
ater. The
ies, earths
and astrin-

the bichlo-
3parations,
I and oper-
mercurial,
s» particu-
oes much
i- When
alterative
I or syn d
to avoiu
it of con-
skin dis"
^ hich are
£nown.

loyed in
lich sur-
iflammfi-
1 in thin
le inner
ibortive.

MEDICINES AND THEIR PREPAKATTONS.

833

KlO. 209. CRAME8BILI..

Cranesbill (^Geranium Maculatum, Fig. 209). — An indigenous
plant, growing in all parts of the United States, in the open woods.
The root is the medicinal part. It is a powerful astringent, similar
to kino and catechu, and a valuable substi-
tute for those articles, because less expensive.
It forms an excellent gargle in sore throat*
and uI(;erations of the mouth, and is valuable
for treating those discharges arising from de-
bility, after the exciting causes are removed.
It has no unpleasant taste, and is therefore
well adapted to infants and persons of deli-
cate stomachs. As an injection, it is used in
gleet and whites.

Preparations. — Fluid extract, dose, half a
dram to a dram ; solid extract, dose, three to
ten grains ; geraniin, the active principle,
dose, one to three grains ; tincture, dose, two
and a half to three drams ; infusion, dose, one
to two ounces. A valuable astringent wash
for sore mouth, etc., and as an injection in leucorrhoea, etc., is made
by uniting fluid extract of cranesbill, half an ounce ; fluid extract of
black cohosh, half an ounce ; fluid extract of golden seal, half an
ounce ; fluid extract of witch-hazel, half an ounce ; and water, one
quart. Geraniin, dioscorein, and caulophyllin, united in equal pai-ts,
and given to an adult in six-gmin doses, every fifteen or twenty min-
utes, have an excellent effect in diarrhoea and cholera-morbus, when
there is much pain and rumbling of the bowels.

Crawley ( Corallorhiza Odontorhiza'). — A perennial plant, growing
on barren hills and hard clay soils in New York. The root is the
part used. It is sedative and diaphoretic, and is used in inflamma-
tory diseases, and in typhoid fever; also in flatulency, cramps, hectic
fever and night-sweats. When the liver requires to be acted upon,
it should be combined with mandrake or Culver's root. The pow-
dered root should be kept in well-stopped vials; its dose is from
twenty to twenty-five grains, in warm water, every hour or two.

Creosote (^Creosotum^. — This is obtained by the distillation of
tar. It is irritant, narcotic, styptic, antiseptic, and moderately escha-
rotic. It has been given in diabetes, epilepsy, hysterics, neuralgia,
bleeding from the lungs, and chronic bronchitis. It is an excellent
remedy for arresting nausea and vomiting, when not dependent on
inflammation. The dose, when given internally, is one or two drops.
It is most easily taken in the form of pill. In some forms of bron-
chitis, the vapor of creosote is inhaled with advantage. It may some-
times be applied with excellent effect, to indolent or ill-conditioned
ulcers, in which case, two, four, or six droj)s may be dissolved in an
ounce of distilled water. In some cases the solution is mixed with

^W.vrraOl^HP ■*

834

MKUICINE8 AND THEIR PREPARATIONS.

poultices. One or two drops of pure creosote, introduced into a hol-
low tooth on a little cotton, is generally a speedy remedy for tooth-
ache, but great care must be taken that it does not come in contact
with the tongue or cheek.

Croton Oil {Oleum Tiglii). — This is obtained from the seeds of
the Croton Tiglium, a plant growing in the East Indies. It is a
powerful cathartic producing watery stools, and is used in torpidity
of the bowels, dropsy, apoplexy, mania, inflammation of the brain,
hydrocephalus, coma, and wherever a powerful revulsive action is
needed to call the blood away from the brain. A drop placed on the
tongue of a pei-son in the comatose state, will generally operate. Two
to six drops, rubbed upon the skin, produce an eruption of pimples
in twelve houi-s. In this way, it is used in diseases of the throat and
chest, and some other affections. If the skin is very sensitive, let it
be combined with an equal quantity of sweet oil. Use only under
the direction of a physician.

Cubebs (Cubeboe). — A climbing perennial plant, growing in the
East Indies. The berries are the medicinal part. They are stimu-
lant, purgative, and diuretic, acting particularly upon the urinary
organs and arresting discharges from the water-pipe, and much used
in the treatment of gonorrhoea and gleet. It should not be used dur-
ing active inflammation. Dose of powdered cubebs, from thirty to
forty grains.

Preparations. — Fluid extract, dose, half a dram to a dram and a
half ; ethereal fluid extract, dose, one to two drams ; solid extract,
dose, two to twenty grains ; tincture, dose, one to two drams. A
compound, made of fluid extract of cubebs, five drams ; fluid extract
of ergot, one and a half drams ; cinnamon water, half a dram ; and
powdered loaf-sugar one dram, may be taken with advantage in
gonorrhoea, gleet, and leucorrhoea ; dose, one dram.

Culver's Root (^Leptandra Virginica.) — A perennial plant growing
throughout the United States in limestone districts, and flowering in
July and August. The root is the medicinal part. It is frequently
called black root. When dried, it is tonic, cholagogue, and laxative,
and is a very valuable remedy in affections of the liver, as it acts
upon this organ with energy, without puigation. It is also useful
in typhoid fevers, and in dyspepsia, diarrhoea, and dysentery. A
powder is made from it, containing its active principle, and called
leptandrin, which has a fine effect in diarrhoea, cholera infantum, ty-
phoid fever, some forms of dyspepsia, and in all diseases connected
with derangements of the liver.

Preparationx. — Fluid extract, dose, one-third of a dram to a dram ;
leptandrin, the active principle, dase, in acute cases, one-fourth of a
grain to one grain ; in chronic cases, one to two grains ; tincture, two
ounces to a pint of alcohol, dose, one dram to one-half ounce.

'■■m'S'ii-xi.'ii

:CA.3;.«^.>.sa..-i'^.W«riase^^

^■A

MEDICINES AND THEIK PREPARATIONS.

835

into a liol-
for tooth-
Ill contact

e seeds of
'• It is a
torpidity
the brain,
5 action is
ced on the
•ate. Two
>f pimples
throat and
tive, let it
nly under

ng in the
ire stimu-
e urinary
luch used
used dur-
thirty to

am and a
extract,
rams. A
id extract
ram ; and
antage in

t growing
wering in
lequently
laxative,
IS it acts
so useful
iteiy. A
ad called
ntum, ty-
onnected

D a dram ;
irtli of a
ture, two

Dandelion (^Taraxacum, Dens Leoms.) — This perennial her!) is
tliuretic, aperient, and tonic, It is generally thought to act especially
upon the liver. Used in dyspepsia, diseases of the liver and spleen,
and in debilitated and irritable conditions of the stomach and bowels.

Preparations. — Fluid extract, dose, one to two drams ; compound
fluid extract, dose, one to two drams ; fluid extract of dandelion and
senna, dose, one to two drams ; solid extract, dose, ten to fifteen
grains; infusion, two ounces to one pint of water, dose, four to five
ounces. In dropsical affections, the following compound infusion
will be found useful : fluid extract of dandelion, six drams ; fluid
extract of rhubarb, one and a half drams ; fluid extract of henbane,
twenty-four drops ; bicarbonate of soda, half a dram ; tartrate of
potassa, three drams ; water, three and a half ounces ; take one-third,
three times a day. For jaundice and diseases of the liver and kid-
neys, the following pills have much elficacy : Solid extract of dande-
lion, one dram; solid extract of bloodrnnt, one dram; leptandrin, one
scruple ; podophyllin, five grains ; oil of peppermint, five minims ; to
be divided into fifty pills, and one or two taken three times a day.

Deadly Nightshade. — (Atropa Belladonna, Fig. 210). — A per-
ennial plant, growing in Europe and this country, and having a faint
odor, and a sweet, nauseous taste. It is narcotic, diaphoretic, and
diuretic ; is a valuable remedy in convulsions, neuralgia, whooping-
cough, rheumatism, gout, paralysis, and many diseases having their
seat in the nervous system. "It has been much praised as a preventive
of scarlet fever, though its powera for this purpose are doubtful.

Preparations. — Fluid extract, dose, five to eight drops ; solid
extract, dose, one quarter to one grain ; tincture, two ounces to a pint
of diluted alcohol; dose, from thirteen to thirty drops. The solid
extract is used, mixed with lard or with other .. dwtances, as a local
application for relieving pain, dilating the pupil of the eye, for re-
moving stricture of the urethra, the anus, rigidity of the mouth of
the womb. etc.

Pio. 210. Deadly Nightshade.

Fio. 211. Dogwood.

Dogwood (ComM* Florida, Fig. 211). — This is a small tree
growing most abundantly in the Middle States. The Kark is used
as a medicine. It is tonic, astringent, antiperiodic and stimulant.-

BBsr

886

MEDICINES AND THEIK PREPARATIONS.

It increases the frequency of the pulse and elevates the teraperatuie
of the body. It has been substitiited for Peruvian bark in intei-
mittent feveis. Dose of the powdered baik, from ten to sixty grains.
Preparadong. — Fluid extmct, dose, half a dram to two di'ams;
solid extract, dose, live to eight grains ; tincture, four ounces to a
pint of alcohol, dose, one to three di-ams ; infusion, two ounces to a
pint of wal dose, half an ounce to two ounces; comin, the active
principle, dose, one to eight grains.

Dwarf Elder (Aralia Hispida). — A perennial under-shrub, grow-
ing from New England to Virginia. The bark of the root is diuretic
and alterative. An infusion made from it is used in gravel, suppres-
sion of the urine, and dropsy; to be taken in wineglassful doses,
three or four times a day.

Elder (Sambucus Canadensiti). — The flowers, berries and inner
bark of the elder are used in medicine. A warm infusion of the
flowei-s is diaphoretic, and gently stimulant. A cold infusion is diu-
retic, alterative and cooling ; used in ei-ysipelas, liver affections of
cliildren, rheumatism, scrofula, and some syphilitic diseases. The
bark, pounded with lard, forms a useful ointment for burns and
scalds, and so»ne diseases of the skin.

Elecampane (Inula Helenium). — This perennial plant is a native
of Europe and Japan, and is cultivated in this country. The root is
stimulant, tonic, diuretic and expectorant, and is used in chronic
affections of the lungs and air-passages. It is said a decoction from
the root forms a good application for the itch and other skin diseases.
Dose of the powdered root, from a scruple to a dr»m; of the infusion,
one fluid ounce

Electro-Magnetism. — Within a few years, electro-magnetism has
been employed extensively as a remedial agent, particularly in the
various forms of nervous disorders. That it is a valuable agent in the
treatment of disease, few thinking physicians doubt ; yet, like most
other new things in medicine, it has had its enthusiastic admirers,
who have claimed for it remedial powers beyond what it realty has,
and who have applied it to purposes beyond its sphere of usciulness.

Feverfew (^Pyrethrum Parthenium) . — In warm infusion, this herb
is valuable in i-ecent colds, flatulency, worms, irregular menstruation,
hysterics, and suppression of the urine. The cold infusion is a
tonic. A poultice made of the leaves soothes and alleviates, pain.

Figwort (Scrophdaria Nodosa). — The leaves and root are diu-
retic, alterative, and anodyne, and in some places are used in liver
complaints, scrofula, dropsy, and diseases of the skin. Applied
externally in the form of ointment, or fomentation, it is said to be
useful in piles, painful tumors, bruises, ringworm, and inflammation
of the breasts. Dose of the infusion, from two to three fluid ounces,
three times a day.

temperature
n'k in iiitei-
iixty grains,
two di-ams;
Junces to a
ounces to a
, the active

hrub, grow-
'tis diuretic
'el, suppres-
ssful doses,

i and inner
ision of the
Lsiou is diu-
ffectious of
iases. The
burns and

' is a native
The root is
in chronic
Dction from
in diseases,
le infusion,

;netism has
arly in the
^ent in the
, like most
a admirers,
really jjag,
us^xulness.

ti, this herb
nstruation,
fusion is a
es pain.

)t are diu-
d in liver
Applied
said to be
lammation
lid ounces,

SS"

MEDICINES AND THEIR PREPABATI0N8.

837

Fio.212. Foxglove.

Flax«eed (Linum Usitatissimum). — This is demulcent and nutri-
tive, and is much used in couglis, bronchial diseases, intlammation of
the urinary organs, bowels and lungs; chiefly taken in the form of
flaxseed tea. The infusion is sometimes used as an injection in dys-
entery and piles. Linseed oil is prepared from flaxseed.

Foxglove (^Digitalis Purpurea, Fig. 212). — A biennial plant, grow-
ing in the temperate parts of Europe. The leaves,
in proper doses, are sedative and diuretic, reducing
the pulse, and increasing the flow of urine. In
large doses, they are a narcotic poison. The medi-
cine has been much used in . inflammatory diseases,
palpitation of the heart, and in dropsy connected
with diseased heart or kidneys. When taken for
some time, it is liable to accumulate in the system,
and suddenly to manifest poisorious and alarming
symptoms, as if a large dose had been taken. The
American hellebore is sometimes used in its place.

Dose of the powdered leaves of foxglove, from
one to three grains ; of the tincture, from eight
to ten drops.

Frost weed (^Helianthemum Canadense). — This
herb, also known by the name of rockrose, is tonic,
astringent, and alterative, and has been considerably used in scrofula;
combined with turkey-corn and queen's-root, itis said to have effected
cures in secondary syphilis. A decoction forms a useful gargle in
ulcerations of the mouth and throat in scarlet fever and other dis-
eases, and as a wash in scrofulous inflammation of the eyes. Dose of
the fluid extract, one to two drams, three or four times a day.

Qalls. — These are the unhealthy excrescences found growing on
the young boughs of the dyer's oak, QuercuB infeotoria, growing in
Asia. They are powerfully astringent. In the form of infusion, or
decoction, made in the proportion of half an ounce to a pint of water,
they are useful as an astringent gargle, wash, or injection ; and finely
powdered galls, one part to eight parts of lard, make a valuable oint-
ment for bleeding piles. Dose of powdered galls, from ten to fif-
teen grains.

Qamboge. — The hardened juice of trees growing in Siam and
Cochin China. This gum-resin is a hydragogue cathartic, acting
severely and harshly upon the bowels, and hence is not often used
alone. On account of the severity of its action, it is improper to use
it during inflammation of the stomach or bowels, piles, pregnancy,
diseased womb, or excessive menstruation. Combined with cream of
tartar and jalap, it is a valuable remedy in dropsy. The dose is one
or two grains.

Qarlic (Allium Sativum). — The bulb is the part used. It is stim-

.^iftic

838

MRDICINKH AND THEIK PREPARATIONS.

ulant, diuretic, oxpoctorant, and mbcfacioiit ; useful in couglis,
hoarsenesH, whooping-oough, and in the iiervuus 8pii.8iuudiu couglhs of
cliildren. Dose, from twenty grains to tliree drams ; dose of the
juice, mixed witli sugar, half a teaspoonful to a teaspoonful.

The bruised bulbs are sometimes usefully applied as a poultice to
the chests of young children having inflammation of the lungs, and
as drafts to the feet in inflammation of the brain, fevers, etc.

Qentian ( Qentiana Lutea). — It grows among the Alps, Apennines,
and Pyrenees. The root is the part used, and is brought to this
countiy from Germany. This medicine has long maintained its rejt-
utation, having, it is said, derived its name from Gentius, king of
lUyria. It is a pure and simple bitter, exciting the appetite and
invigorating the digestive powers. It may be used in all cases
dependent on pure debility. It is much employed in dyspepsia, and
during recovery from exhausting diseases.

Preparations. — Fluid extract, dose, half a dram to a dram ; com-
pound fluid extract, dose, half a dmra to a dram ; solid extract, dose,
three to ten grains ; tincture, four ounces to one pint of diluted
alcohol, dose, two to three drams. A valuable preparation is made
by uniting fluid extract of rhubarb, two ounces ; fluid extract of
gentian, half an ounce ; diluted alcohol, two pints ; dose, half an
ounce to an ounce.

Ginger {Zingiber Officinale'). — This is a native of Hindostan, and
is cultivated in all parts of India. The root is the part used. It is
a grateful stimulant and carminative, and is much used for dyspep-
sia, wind in the stomach, colic, gout, etc. It is an excellent addition
to bitter infusions, and is much used to disguise the taste of nauseous
medicines. Dose, from ten to twenty grains.

Preparations. — Fluid extract, dose, half a dram to a dram ; tincture,
four ounces to one pint of diluted alcohol, dose, two to four drams ;
infusion, dose, one to two ounces ; syrup, dose, one to two drams.

Ginseng (^Panax Quinquefolium, Fig. 213). — A perennianl plant,
growing in the Middle and Southern States. It is
a mild tonic and stimulant, and has some reputa-
tion for improving impaired appetite, and for ner-
vous debility, weak stomach, etc. Some persons
are in the habit of chewing it, and it is consid-
erably used in this way. Dose of the powdered
rr from ten to forty grains ; of the infusion, from
J to three fluid ounces.

Glycerin. — This is the sweet or sugary portion
of oils, and is obtained from them during the man-
ufacture of lead plaster. It is demulcent and an-
Fio. 218. GnrsBNo. tiseptic, and has been recently recommended and
used to some extent in place of cod-liver oil, in
It has been still more used, however, as a soothing

consumption.

MEDICINES AND THEIR PREPARATIONS.

839

in couglis,

ic COUgllN of

dose of tlio
ful.

i poultice to
) lungs, and
etc.

. Apennines,
lUght to this
ined its reih
ius, king of
appetite and
in all cases
spepsia, and

dram ; com-
xtract, dose,
t of diluted
ion is made
: extract of
ose, half an

idostan, and
used. It is
for dyspep-
3nt addition
of nauseous

n; tincture,
four drams ;
o drams.

nianl plant,
bates. It is
ome reputa-
nd for ner-
me persons
b is consid-
3 powdered
'usion, from

ary portion
ig the man-
ent and an-
lended and
iver oil, in
a sootking

and emollient external application in skin-diseases, and also in place
of lard in the preparation of ointments.

Qold. The chief salt of gold used in medicine is the chloride or

muriate of gold and soda. It is diuretic and alterative. It ia used
in scrofula, skin diseases, goitre, scirrhous tumors, ophthalmia, dropsy
and 8yi)hilis. Also in the Keeley cure for inehriates. It will, in
many cases, take away the craving for liquor, hut we think there is
great danger of the patient becoming insane and having a desire to
commit suicide. The dose is from one-thirtieth to one-twelfth of a
grain, and is given dissolved in water, or made into pill with starch
or gum-arabic.

Oolden Seal {Hydrastis Canadensis, Fig. 214). — A perennial plant,
growing throughout the United States, par-
ticularly in the West. The root is the me-
dicinal part. It is a tonic, having especial
action upon diseased mucous tissues, and is
particularly beneficial during recdvery from
exhausting diseases. It is used in dyspepsia,
chronic affections of the nervous coats of the
stomach, erysipelas, and remittent, intermit-
tent and typhoid fevei-s. United with gera-
nium, it has u tine effect in chronic diarrhoea
and dysentery.

Preparations. — Fluid extract, dose, half
a dram to two drams ; solid extract, dose,
two to three grains ; hydrastin (resinoid),
dose, one-half to three grains ; hydrastin
(neutral), dose, two to five grains; hydras-
tina (alkaloid), dose, onfe to three grains ;
tincture, three ounces to one pint of dilut-
ed alcohol, dose, from half an ounce to an
ounce. For varipus forms of sore mouth and ulcerated sore throat,
the following is a useful gargle : fluid extract of golden seal, half
an ounce ; fluid exti-act of blue cohosh, half an ounce ; fluid ex-
tract of witch-hazel, half an ounce ; pulverized alum, one dram ;
honey, three dmms ; water, one pint. As a stimulant for a sluggish
liver, and as a tonic in enfeebled mucous membrane in epidemic dys-
entery, and other complaints, the following powders are valuable :
hydrastin, twenty grains ; leptandrin, twelve grains ; podophyllin,
two grains ; pulverized cayenne, two grains ; sugar of milk, or pul-.
verized loaf-sugar, one dram ; rub together thoroughly in a mortar,
and divide into twenty powders ; give one every two hours.

Ground Ivy (Nepeta Gfhihoma). — A perennial herb, common to
the United States and Europe ; in some places known as gill-over-the
ground. The leaves are the part used, which are stimulant, tonic,

Flo. 814. QOLDEM SEAL.

\im

r;!?

\}^

nut"

840

MKDICINES AND THEIU PRKPAIIATIONH.

mid pectoral ; considered useful in jaundice, iiMthma, and diHeatitiH of
the kidneys and lungs.

Quaiacum. — This medicine is the simvings or chips of the wnoil
of a tree growing in the West Indies, also resin obtained from the
same tree. It is stimulant and alterative, and is used in chronio
rheumatism, diseases of the skin, scrofula, and venereal complaints.
The tincture of the resin is valuable as an emmenagogue. Dose nf
the tincture, from one-half to two teaspoonfuls, to be taken with
milk. The wood is much used att an ingredient in alterative prepar-
ations of sarsaparilla, etc.

Oum-Arabic. — This is the hardened sap of trees growing iii
Egypt, Arabia, and other tropical countries, being several variotieH
of the acacia. It is demulcent, and a combustive nutritive, and '\n
much used in forming mixtui-es for hoaraeness, cough, sore throat,
gonorrhceea, inflammation of the bladder, strangury, bronchitis, and
irritations of raucous membranes generally. Mucilage of gum-arabic
is a preparation made by dissolving four ounces of powdered gum in
a pint of boiling water.

Qum, Hemlock. — This is the hardened juice of the hemlock, Abies
Canadensu, a tree growing in Canada and Maine. This gum is a
mild rul)efacientv and like burgundy pitch, chiefly used to make plas-
ters, etc., for which purpose it is very valuable. A tincture of the
gum is diuretic and stimulant. The oil of hemlock is valuable, in
combination with other oils, in preparing liniments. The bark is
astringent, and is much used in tanning leather.

Hcemastasis. — This word is used to imply the retention of the
venous blood in the limbs by ligatures. A cord or common handker-
chief is tied round the upper part of the arhis, or thighs, and a piece
of wood being slipped under the cord, is twisted round until the cord
is so tightened as to prevent the return of the venous blood, but not
to prevent the outward passage of the arterial blood. In this way,
the blood passing out continually in the arteries, and not returning
by the veins, the vessels of the liml)8 become filled to their utmost
capacity, and a great quantity, for the time being, is withdrawn from
tlie trunk. This process is useful in bleedings from the lungs, stom-
ach and womb, and inflammation of the brain, lungs, bowels, etc.,
and in whatever case it may be thought desirable, for the tipie being,
to lessen the blood in the head or trunk, without debilitating the
patient.

Hair-cap Moss (Polytriehum Juniperum). — An evergreen plant
growing on poor, sandy soils in the Northern States. A strong infu-
sion of it is powerfully diuretic. In dropsical cases, two fluid ounces
of the infusion should be taken every half hour. It is useful in
fevers, iiiflammations, gravel, etc. *

ite

MKDICINKH AND TIIEIK PUKI'AKATIONB.

841

MiseaHWH of

of the wo(Mi
ed from tlie
1 in chroiiio
coHiplaijitH.
-'• DoHe of
taken with
itive prepur-

growing ill
'•ill varioticH
itive, and m
sore throiit,
iicliitis, and
gum-arabic
3red gum in

nlock, Abies
i« gum is a
» make plas-
iture of the
valualile, in
'lie bark is

tion of the
on handker-
and a j)iece
til the cord
od, but not
1 this way,
t retaining
leir utmost
Imwn from
lings, stom-
owels, etc.,
;iqie being,
itating the

reen plant

rong infu-

lid ounces

useful in

tiBrdflBCk (Spint-a Tomentom, Fig. 21')). — Tliirt is a iM-aiitifitl
sliriib, eoniniou in the L'niUtd StutuM. ItM leaves are of a dark green
color above, and white underneath. It is tonic; and im-
triagent, and is muc.ii used in chronic diarrhuta, eholera
infantum, etc. It agrees well with the stomach, and is
deservedly a popular remedy in summer complaints of
children.

A fluid extract of it is the Ixsst preparation ; dose, four
to twenty drops. It is much used in the form of infusion.
The green herb boiled in milk forms a valuable preparation
in clironic diarrhcea, when attended with much debility.

Hardleaf Qolden-Rod (^Solidago Riyida). — A {)eren-
nial plant, growing throughout the United States, espe-
cially on the western prairies. It is tonic, astringent and
styptic, and useful to arrest bleeding from the nose, lungs,
utomach, and bowels. The powder and infusion are used, HAKDHAuk.
both externally and internally.

Helonia« {Helonias Dioica). — This herb is common in the United
States, and is known by the name of faUe unicorn plant. The root,
which is the part used, is tonic, diuretic, and vermifuge. In large
dose's it is emetic, and when used fresh, sialagogue. In five or seven
grain doses, three times a day, it relieves dyspepsia, restores the appe-
tite, expels worms, and relieves colic. It is a valuable womb-tonic,
gradually removing debility of that organ, and curing whites, pain-
ful menstruation, and a tendency to habitual abortion. Dose of the
decoction, from two to four fluid ounces. The decoction is said to
kill insects, bugs, etc.

Preparations. — Fluid extract, dose, one to three drams ; helonin,
the ac'ive principle, dose, one-fourth to one-half a grain.

Hisnbane (^Hyoscyamus Niger, Fig. 216). — This plant grows abund-
antly in Great Britain, and on the continent
of Europe, and is rare in this country. All
the parts are active. It is narcotic, gently ac-
celerating the circulation, increasing the gen-
eral warmth, occasioning a sense of heat in
the throat, and after a time inducing sleep.
It is often used in the place of opium, because
it does not bind the bowels. Used in rheu-
matism, gout, bronchitis, asthma, consump-
tion, whooping-cough, hysterics, and spas-
modic affections generally.

Preparations. — Fluid extract, dose, ten to
fifteen drops ; solid extract, dose, half a grain
to a grain ; tincture, two ounces to one pint
of diluted alcohol, dose, half a dram to a dram ; hyoscyamin, the ac-
tive principle, dose, one-eighth to half a grain. In neui-ulgia, rheum-

FIO. !16. HEKBAKE.

' i!

MKni(;iNK8 ANI» TUKIH I'KKl'AKATIONS.

843

OIK) ])int<)f water, domi, Iwo to throo ouiicus ; lupuliii, dosu, hIx to eiglit
iM'iiiiiH; tinutiirt) of liiiiuUn, two ouiicoh to one pint of iilcohol, doHt;,
olio to two (IniniH, in Hweeteiied water ; fifteen to twenty fjriiiiis of
lii|)uliii, well rubbed up with white Huj^iir in ii inortiv, ia very efficii-
fious in priiipisni, ehonlee, and Hpennatorrho'a.

Horscmint (Monarda Punctata^. — This well-known plant, which
is common to the United States, is stiniidant, carminative, and diu-
retic. A warm infusion maybe used .i flatulence, nausea, and vom-
iting. If the Inxly bo kept cool while takinjj it, it will act lut a din-
nitic. The oil of hoi-semint is used for similar purposes with the
plant. Dose, from two to five droj)s on suj^ar. Dose of the essence,
from ten to twenty drops in sweetened water. The oil is frequently
used as an ingredient in liniments. >

Horseradish (^Coahlearia Armoraoia). — The fresh root of this
well known perennial is stimidant, diuretic, antiscorbutic, and rulx)-
faciont. It is useful in rheumatic, paralytic, scorbutic, dropsical, and
dyspeptic affections. It is said that a warm infusion of the fresh root
in cider, drunk freely every night, will cause perspiration and a free
flow of urine, and will consequently cure dro{)8y. The fresh root
grated in vinegar, and eaten with meat at dinner, strengthens the
stomach and promotes digestion.

houseleek {Sempervivum Trctorum). — The bruihed leaves of this
perennial form a cooling application to burns, stings of insects, ery-
sipelas, and other inflammations ; valuable also for ringworm, shin-
gles, and other skin diseases.

Hydrangea {Hydrangea Arhoreseeng). — This grows abundantly
in the Southern, Middle, and Western States. Its root is medicinal.
It is diuretic, and has been much praised for its power of relieving
the excruciating pain caused by the passage of stone through the
urethra, as well as for infallibly removing such stones from the blad-
der, provided they are not already too large for passage through the
water-pipe. A concentrated decoction or the fluid extract may be
taken in teaspoonf ul doses several times a day, — care being taken
not to push the medicine to the extent of dizziness or oppression of
the chest.

Hyssop (Hyasopus Officinalis.^ — This is a native of the continent
of Europe, and is cultivated in this country. The tops and leaves
are the parts used. They are stimulant, aromatic, carminative, and
tonic. The infusion has been much employed in chronic bronchitis
of old people, and those of debilitivted habits. It makes the raising of
mucus more easy. The infusion may be combined with sage and
alum, and sweetened with honey. The fresh leaves bruised, and
applied externally, relieve the pain and dispense the spots and marks
caused by contusions.

'r\:

844

MEDIOINKS AND THEIlt FKKPAKATIONS.

Iceland floss (^Cetraria Islandica). — This plant is found in the
northern latitudes, both of the old and new world, and is abundant
or the mountains and in the sandy plains of New England. It re-
ceived its name from its prevalence in Iceland, in which country, as
well as in Lapland, it serves, in consequence of the gum and starch
it contains, as food for the inhabitants. It is demulcent, tonic, and
nutritious, and is well fitted to relieve affections of the mucous mem-
branes of the lungs and bowels, connected with debility of the diges-
tive organs; it is given therefore in Tihronic bronchitis and other
affections of the chest, attended with copious expectoration, especially
when the matter :' V'harged is purulent; also in dyspepsia, chronic
dysentery, and r^. n-h.^ea. It is usually employed in the form of de-
coction; and \a Mucii used in the common article of diet called
blanc-mange. ^

Ice'Plant (^Mbnotropa Unifiora). — This perennial plant, found in
various parts of the country, is snow-white, resembling frozen jelly,
and is juicy and tender, dissolving in the hands like ice. The flowers
are in shape like a pipe; hence it is called the pipe-plant. The root
V? the medicinal part, and is tonic, nervine, and antispasmodic. It
' as also been considered sedative and diaphoretic ; and the powder
nas been sometimes used in the place of opium. It is said to be
valuable in epilepsy, chorea, and other spasmodic affections. Dose of
the powdered root, from thirty to sixty grains, two to three times a
day. »

Indian Hemp {Avocynum Cannabinum). — This perennial plant
resembles bitter-root, and grows in similar situations. The root is
powerfully emetic, and in decoction, diuretic and diaphoretic. It
diminishes the frequency of the pulse, and produces drowsiness. It
has great eflficacy in dropsy.

Preparations. — Fluid extract, dose, as a tonic, five to ten drops ;
as an emetic, twenty to twenty-five drops ; solid extract, dose, one
to three grains ; tincture, dose, one to two drams, as a tonic, half an
ounce to an ounce, as an emetic ; infusion, half an ounce to a pint of
water ; dose, half an ounce to an ounce.

Indian Turnip (^Arum Triphyllum) This is a perennial plant,

growing in damp places in North and South America, and known by
the name of dragon-root. The root when chewed is excessively acrid,
producing a biting sensation which may be somewhat relieved by
milk. The fresh root is acrid, expectorant, and diaphoretic, and has
been used in asthma, whooping-cough, chronic bronchitis, chronic rheu-
matism, and colic, and externally in scrofulous tumors, scald head,
and other skin disorders. Dose of the gratsd root, in syrup or muci-
lage, ten grains, three or four times a day.

Iodine {lodinurn). — This is prepared from the ashes of kelp, or
sea-weed, and is in small bluish-black, shining scales. It is alterative,

MEDICINES AND THEIR I'REPARATIONS.

845

3und in the
is abundant
and. It re-
country, as
and starch
t, tonic, and
1UC0U8 mem-
of the diges-
s and other
n, especially
psia, chronib
form of de-
diet called

mt, found in
frozen jelly,
The flowers
t. The root
lasmodic. It
I the powder
is said to be
ins. Dose of
ibree times a

rennial plant

The root is

phoretic. It

owsiness. It

to ten drops ;
act, dose, one
tonic, half an
le to a pint of

rennial plant,
md known by
essively acrid,
,t relieved by
iretic, and has
, chronic rheu-
8, scald head,
lyrup or muci-

les of kelp, or
t is alterative,

tonic, and somewhat diuretic. It has been chiefly emjloyed in dis-
eiises of the absorbent and glandular system, particularly scrofula,
goitre, and glandular tumors generally. Dose, in substance, half a
grain, two or three times a day, in form of pill ; in form of tincture,
thrbe to five drops.

Iodide of Potassium (^Potmsii lodiduni). — This is one of the prep-
arations of iodine, and is sometimes improperly called hydriodate of
potasm. It is formed by decomposing the iodide of iron by carbonate
of potassa. It is used for the same purposes as iodine, but chiefly as
an alterative in tertiary syphilis, for which it is a specific ; also in
some forms of chronic rheumatism, and in leprosy. Dose of the salt,
from two to fifteen grains. It is much combined with bitter tinctures,
and particularly with the compound preparations of sarsaparilla, yel-
low dock, and queen's-root. The acids and metallic salts are incom-
patible with it.

Ipecacuanha. — This is a small perennial plant, growing tr^ moist
woods, in several countries of South America. The ^oct is the part
used. It is a very valuable emetic, in large doses j in smaller doses,
it is sudorific and expectorant. Used to prr iuce vomiting in the
commencement of fevers, inflammatory diseases, swelled testicles, and
before the paroxysms of ague ; and to excite nausea in dysentery,
asthma, whooping-cough, various hemorrhages, and inflammation of
the lungs ; and, combined wdtu opium, to produce diaphoresis in
rheumatism, gout, and febrile complaints. Dose, as an emetic, from
fifteen to thirty grains ; to excite nausea, from one to three grains ;
and to produce diaphoresis, two to six gmins, with one grain of
opium.

Preparations. — Fluid extract, dose, as an expectorant, five to eight
drops ; as an emetic, half a dram to a dram ; tincture, half an ounce
to an ounce ; wine of ipecac, three ounces to one pint of sherry wine,
dose, a quarter to half a di-am, as an expectorant ; two and a half to
three drams as an emetic. The following is a useful expectorant for
young children : fluid extract of ipecac, two drams ; syrup of tolu,
five drams ; mucilage of gum-arabic, one ounce ; sherry wine, three
drams, — mix. Dose, one dram.

Iron (Ferrum). — As this is the most abundant, so is it the most
useful of all the metals. It is widely diffused through the mineral,
the vegetable, and the animal kingdoms. It is an essential constitu-
ent in the blood of man, and as a medicine it has great value, being
a powerful tonic. In most cases wh'^re the blond is thin and reduced,
iron is our best remedy; it raises the pulse, p.omotes the secretions,
and gives color, body, and nutritive qualities to the blood. It is
much used, in some one of its prepared forms, in clironic ana nia, chlor-
osis, hysterics, whites, rickets, chorea, dyspepsia, neuralgia, and par-
ticularly consumption. Care should be taken in using the various
preparations of iron, not to let the remedy touch the teeth. It is

846

MKDICINE^ AND TH"IU PREPAKATI0N8.

well to take them, when not in pill form, through a gliws tube. The
following are most of the chemical preparations of iron used in medi-

cine;

Ammonia-Citrate of Iron (^Ferri Ammonio Citras). — This is in
the form of thin scales, of a beautiful garnet-red color, and has a
slightly acid taste. It is very soluble in water. Its great solubility
gives it some advantage oyer the citrate. The dose is five grams,
three times a day, in solution.

Black Oxide of Iron (Ferri Oxidum Nigrum). — This is a dark,
grayish-black powder, unchangeable in the air, and having magnetic
properties. It is a valuable chalybeate, and may be given in five to
ten-grain doses.

Citrate of Iron (Ferri (7t«ra«). — This is a valuable preparation of
iron. It is soluble in water. Usually given in the form of pill, in
two to three-grain doses, three times a day.

Citrate of Iron and Quinia (Ferri et Quinioe Citras). — In the
form of shining scales, garnet^jolored, and soluble in water. Au ex-
cellent antiperiodic and tonic. Given in intermittents, when the
blood is low, etc. Dose, five to eight grains, two or three times a
day. ' , ,

Citrate of Iron and Strychnia. — It is a valuable preparation, and
combines the properties of iron and strychnia, and has proved an
efficacious remedy in atonic dyspepsia, absence of the menses, St.
Vitus's dance, green-sickness, hysterics, etc. It is a beautiful salt,
looking like citrate of iron, except that it is a little darker. Three
grains of the iron are combined with one-sixteenth of a grain of
strychnia.

Hydrated Oxide of Iron (Ferri Oxidum Hydratum'). — This is in
a reddish-brown, moist mass, not much used in medicine, except as
an antidote to the poison of arsenic, for which it is very valuable. It
should be given in tablespoonful doses, often repeated.

Iodide of Iron (^Ferri lodidum,'). — The iodide of iron is a crystal-
line substance, of a greenish-black color and styptic taste. It has
tonic, alterative, diuretic, and emmenagogue properties. It is em-
ployed chiefly in scrofulous complaints, swelling of the glands of the
neck, chlorosis, absence of the menses, and leucorrhoea. In obstinate
syphilitic ulcers, and in secondary syphilis, occurring in scrofulous
and debilitated subjects, it has been used with success. Dose, three
grains, gradually increased to five. It should never be given in the
form of a pill, but preferably in combination with simple syrup (see
Syrup of Iodide of Iron).

Lactate of Iron (Ferri Xac«a«). — This has the general medicinal
properties of the ferruginous preparations. It increases the appetite
m a marked degree, and has been used with decided benefit in clilo-

MED1CINK8 AND THEIR PREPAKATI0N8.

847

58 tube. The
used in medi-

— This is in
}r, and has a
reat solubility
,8 five grains,

'his is a dark,
fing magnetic
ven in five to

preparation of
jrm of pill, in

'as). — In the
'^ater. An ex-
nts, when the
three times a

■eparation, and
las proved an
le menses, St.
beautiful salt,
iarker. Three
of a grain of

I. — This is in
cine, except as
:y valuable. It

on is a crystal-
taste. It has
ies. It is eni-
e glands of the
. In obstinate
f in scrofulous
J. Dose, three
be given in the
aple syrup (see

leral medicinal
ies the appetite
benefit in clilo-

rosis. Dose, one to two grains, three times a day. The dose may
be gradually increased. Given in the form of solution, pill, or
lozenge.

Phosphate of Iron (Ferri Phosphas). — This is a slate-colored
powder, insoluble in water. It is a valuable remedy in consumption,
cancer, and nervous diseases, accompanied by a low state of the blood.
Dose, one or two grains, three times a day.

Persalt of Iron {MoniseVs Styptic'). — Thui is a most valuable
styptic, and is used with success in restraining violent bleedings. It
produces no irritant effects upon the tissues, and may be used with
safety both in slight and extensive surgical operations. Physicians
should have it by them, and will find it very serviceable in sudden
emergencies of bleeding. It is prepared in solution and in the form
of diy salt. The solution is the most convenient and eligible form,
and may be applied as prepared.

Powder of Iron (^Ferri Pulvis). — This is what is often called iron
by hydrogen, or Qu^venne's iron. It is an impalpable powder, and
of an iron-gray color. If black, it is worthless. It is used in anaemia,
and in all those conditions characterized by deficiency of coloring-
matter in the blood. The best metallic iron for medicinal use. Dose,
from two to five grains, several times a day; to be given in the form
of pill.

Precipitated Carbonate of Iron (Ferri Subcarbonaa.) -— This is a
reddish powder, insoluble in water. It is tonic, alterative, and em-
menagogue, and is used in neuralgia, chorea, chlorosis, anaemia, epi-
lepsy, scrofula, etc. Dose, five to twenty grains, three times a day,
to be taken in a little water.

Protoxide of Iron (Ferri Protoxiduni). — This is of a dark-blue
color, and has a tendency to absorb oxygen from the air, which con-
verts it into the sesquioxide. It is a valuable preparation of iron.
Dose, from two to five grains, tliree times a day. •

Solution of Protoxide of Iron. — The protoxide of iron is more
readily absorbed and assimilated, and agrees better with the stomach
than any other preparation of this metal. It is prepared in the form
of a syrup, of which the dose is from one to two teaspoonf uls , three
times a day.

Solution Protoxide Iron, with Rhubarb and Colombo. — This is
a composition of protoxide of iron with vegetable tonics. As a
remedy in many forms of dyspepsia, it must prove of great value.

Solution Protoxide Iron, with Quinine. — This has become a
remedy of established reputation. Quinine combined with iron, par-
ticularly with the protoxide, must have great advantages as a chaly-
beate tonic. Each tablespoonful contains half a grain of quinine.

848

MEDICINES AND THEIR PREPABATIONS.

Solution Protoxide of Iron, witli Iodide of Potassa. — In this

preparation the valuable alterative propeities of iodide of potassium
are connected with iron. It is therefoi-e alterative and tonic, and
may be used in scrofulous and other weakened conditions of the sys-
tem. It is a remedy of decided merit. Three grains of the iodide
of potassium are contained in each tablespoonful.

Sulpliate of Iron (^Ferri Sulphas). — This is in the form of transpa-
rent crystals, of a pale, bluish-green color, and efflorescent in the air.
It has a styptic taste, and is soluble in about twice its weight of
cold water, but insoluble in alcohol. It is astringent and tonic. In
large doses it produces nausea and griping of the bowels. Useful
in scrofula and as an astringent in passive hemorrhages, sweats, dia-
betes, chronic mucous catarrh, leucorrhcea and gleet. As a tonic it
is useful in dyspepsia.

Syrup of Iodide of Iron (^Syntpus lodidi Fern). — This is an
elegant preparation of iodine and iron, and is given in all debilitated
conditions of the system, when there is a taint of scrofula. Dose,
from twenty to sixty drops, well diluted, at the moment of taking,
with water.

Syrup of iodide Iron and flanganese. — This is of a light straw-
color, prepared from protosulphate of iron, protosulphate of man-
ganese, and iodide of potassium. It is a remedy of unsurpassed
efficacy in anaemic, scrofulous, syphilitic, and cancerous affections.
It is considered superior to the syrup of iodide of iron. Dose, from
ten to thirty drops.

Tartrate of Iron and Potassa (Ferri et Potaasce Tartras. — This
is in the form of beautiful shining scales, of a dark ruby color, of a
slightly chalybeate taste, and very soluble in water. It is one of the
mildest of the salts of iron, and is considerably used in scrofula, weak-
ness of the bowels, general debility, etc. It is much used as a remedy
for syphilis, both externally and internally. The dose is ten to twenty-
five grains in solution.

Tincture of Muriate of Iron (Tinctura Ferri Ghloridi'). — This
has a reddish-brown, yellowish color, a sour and very styptic taste,
and an odor like muriatic ether. It is one of the most active and
certain preparations of iron, generally agreeing with the stomach, and
much employed for purposes for which iron is used. It is useful in
scrofula, gleet, and leucorrhcea ; also in hemorrhages from the womb,
kidneys, and bladder, of a passive character. Dose, from ten to twenty-
five drops, gradually increased to one or two drams, two or three
times a day. It should be given diluted with water.

Valerianate of Iron. — This salt is in the form of a dark-red pow-
der, having a faint odor, and a taste of valerianic acid. It is soluble
in alcohol, and insoluble in water. Given in hysterical affections,
complicated with chlorosis. Dose, one grain, several times a day.

a. — In this
'f potassium
i tonic, and
s of the sys-
f the iodide

a of transpa-
it in the air.
is weight of
i tonic. In
!l8. Useful
sweats, dia-
k.8 a tonic it

This is an

debilitated

ula. Dose,

of taking,

light straw-
te of man-
msurpassed
affections.
Dose, from

•as. — This
color, of a
one of the
f ula, weak-
is a remedy
to twenty-
mo.— This
'ptic taste,
active and
)mach, and
8 useful in
the womb,
to twenty-
J or three

k-red pow-
is soluble
affections,
3 a day.

MEDICINES AND THEIR PREPARATIONS.

849

Isinglass (Ichthyocolla). — A gelatinous sul)8tance, prepared from
the bladder of fishes. It is soluble in alkaline solutions and diluted
acids. In boiling it dissolves and forms a jelly upon cooling, in which
form it is chiefly used as a nutritive diet for the sick.

Jalap (Ipomcea Jalapa). — This is a Mexican plant. Its root is
an active cathartic, producing liquid stools, more or less griping.
United with cream of tartar it becomes a hydragogue, and is useful
ill dropsy. The dose is from fifteen to twenty-five grains.

Preparations Fluid extract, dose, a quarter to one dram ; solid

extract, dose, three to five grains ; tincture, two ounces to the pint of
diluted alcohol, dose, one to two drams ; jalapin, the active principle,
dose, one to two grains.

Juniper {Juniperu Communin). — This evergreen shrub is a native
of Europe, and is naturalized in some parts of this country. The
berries, which are the parts used, are wrinkled, of a dark-purple color,
about the size of a pea. They are gently stimulant and diuretic, and
have been used in scurvy and inflammation of the bladder, chiefly in
connection with more active diuretics. The oil of juniper obtained
from the berries is used for similar purposes. Five minims of the
oil mixed with one fluid dram of sweet spirits of nitre, and given
three times a da}', is valuable in dropsy. Dose of the berries, from
one to two drams ; of tlie oil, from five to ten drops.

Kino. — This is the hardened juice of an East Indian tree, Ptero-
carpus Marmpium. There are several varieties of it. It is a power-
ful and valuable astringent, and is much used in diarrlioea, not
attended with inflammation. Opium is often united with it, and it
is a favorite addition to chalk-mixture. It is also used in chronic
dysentery, leucorrhcea and diabetes. It may be used in the form of
powder, infusion, or tincture. Dose of the powder, ten to twenty
grains ; of the tincture, one or two fluid drams ; the infusion is use-
ful as an injection in leucorrhcea and gonorrhoea. The powder is
sometimes sprinkled with advantage on indolent and flabby ulcers.

Ladies' Slipper (^Cypripedium ^ubescens. Fig.
218). — The fibrous roots are the parts used of this
plant. It is tonic, nervine, and anti-spasmodic, and
is employed in nervous headache, and other ner-
vous affections, as excitability, hysterics, neuralgia,
etc.

Preparations. — Fluid extract, dose, half a di-am
to a dram ; solid extract, dose, five to ten grains ;
tincture, two ounces to a pint of diluted alcohol,
dose, half an ouuce; cypripedin, the active prin-
ciple, dose, two to three grains. The following is
a useful preparation for producing sleep, in wakeful
and excited conditions : fluid extract ladies' slipper, j.,q

one ounce; fluid extract pleurisy root, one ounce ; la»ii!,c'"slippek.

21ft.

850

MBD1CINE8 AND THEIR PRKPARATIONS.

fluid extract skunk-cabbage, one ounce ; fluid extract, scuUcaj), one
ounce ; mix ; dose, half a dmni to a dram, three times a day.

For sick and nervous headache, dependent on an acid stomach,
the following is useful: fluid extract ladies' slipper, half an ounce;
fluid extract catnip, half an ounce ; fluid extract scullcap, half an
ounce ; water, one pint ; mix ; dose, one and a half to three drams.

Lead {Plumbum). — Lead acta upon the system as a sedative and
iwtringent. Internally, it is used for the purpose of reducing tlm
force of the circulation, and for restraining impioper bleeding and
other excessive discharges. Externally, it is employed to sulKlne
inflammation. • It should not be excessively used, for, if taken in-
ternally for a long time, it injures the nervous system, and brings on
apoplexy, palsy, and particularly lead colic. Nature generally gives
notice when it is doing mischief, by drawing a blue line around the
edge of the gum». The preparation of lead chiefly used in medicine
is the following : —

Acetate of Lead {Plumbi Acetas). — This is known by the name
of mgar of lead and is a white salt, crystallized in brilliant needles.
It has first a sweetish, and then an astringent taste. In medicinal
doses, it is a powerful sedative and astringent; in large ones an
irritant poison. It is principally used internally for bleeding from
the lungs, bowels, and womb. The dose is generally two grains,
united with half a grain to a gnain of opium, in the form of pill. Ex-
ternally, it is employed in form of solution and applied to inflamed
surfaces witli cloths. Four grains of sugar of lead and four of pul-
verized opium to the pint of water, make a good lotion for various
purposes.

Lemon (Citrus Limonum). — This is a well-known tropical fruit,
the juice of which has a grateful acid taste, and is much used in
fevers and inflammatory complaints, forming the agreeable drink
called lemonade. The oil of lemon, obtained from the fresh rind of
the fruit, is chiefly used in perfumery, and to render the taste of
medicines more agreeable.

Lettuce (Lactuca Sativa). — The medicinal properties of this
garden-plant are contained in the milk. It is given when opium
disagrees with the patient, to allay cough and irritability. It is one
of the most wholesome vegetables for the table.

Preparations. — Fluid extract, dose, half a dram to two drams;
solid extract, dose, two to five grains. The following is a useful
compotind syrup : fluid extract lettuce, two ounces ; fluid extract
poppy, four ounces; simple syrup, ten ounces; mix; dose, half a
dram to a dram.

Life- Root (Seneeio Aureus). — This is a perennial plant, growing
on the banks of mai-shy creeks in the Northern and Western States,
and sometimes called ragwort. Both the root and herb are diuretic,

MEDICINKB AND THEIR PREPARATIONS.

851

BcuUciiji, one
. (lay.

cid stomach,
If an ounce;
leap, half an
hree drams.

sedative and
reducing ilm
bleeding and
d to suhdne
if taken in-
nd brings on
nerally gives
e around the
I in medicine

by the name
iant needles.
In medicinal
irge ones an
leeding from

two grains,
of pill. Ex-

to inflamed

four of pul-
i for various

ropical fruit,
luch used in
eeable drink
fresh rind of
the taste of

'ties of this
wlien opium
y. It is one

two drams;
; is a useful
fluid extract
dose, half a

mt, growing
stern States,
are diuretic,

pectoral, diaphoretic, and tonic, considerably vabied as a remedy in
gravel and other urinary affections, particularly strangury. It is
useful for promoting menstrual discharges.

PrepiiratioiiH. — Fluid extract, dose, half a dram to a dram ; infu-
sion, dose, one to three ounces; senecin, the active principle, dose,
three to five grains. For chlorosis, accompanied by absence of the
menses, the following is a useful preparation : senecin, aletrin and
sulphate of iron, four grains each. Mix and divide into two-grain
powdera. Six gmins each of senecin and geraniin, mixed and tivken
in doses? of two to four grains, has a good effect in restraining an
immoderate flow of the menses. In painful menstrua 'on, the follow-
ing is a good pill : senecin, two grains ; quinine, six grains ; solid
extract belladonna, three grains ; make into ten pills, and take one
every three hours till the pain is subdued.

Lime (^Calx). — This is one of the alkaline earths, and is an abun-
dant natural production. It is used in several forms in medicine, of
which the following are the chief : —

Chloride c' t-ime ( Calx Chloirnata'). — This is a moist, grayish-
white substsmce, having the odor of chlorine, and possessing powerful
bleaching properties. Externally used, it is disinfectant, and, dis-
solved in water, is applied with advantage to ill-conditioned ulcertf,
burns, chilblains and eruptions of the skin ; also as a gargle in putrid
sore throat, and as a wash for ulcerated gums, and to purify the
breath. It has been used with advantage in dysentery, both by mouth
and injection, to correct the fetor of the stools.

Lime- Water {Aqua Calcis). — This is made by dissolving four
ounces of lime in a gallon of water, and letting the solution stand
in a covered vessel, and pouring off the clear liquor when it is wanted
for use. It is antacid, antilithic, tonic, and astringent, valuable in
all complaints attended with acidity of the stomach. United with
milk, and used as the scile diet, it is sometimes the only remedy for
chronic diarrhoea of long standing. Dose of lime-water, half an
ounce to an ounce.

Liquorice (Glycm'rhiza Q^labra'). — This grows in the south of
Europe and Asia. The root is the pari used. It is demulcent and
expectorant, and is useful in cough, chionic bronchitis, and irritations
of the mucous surfaces generally. The pulverized root "nited with
an equal amount of sulphur and a little molasses, is a \iviaable pre-
paration for coughs. The black extract may be used for the same
purposes as the root.

Liverwort (^Bepatica Americana). — An indigenous plant, growing
in woods, upon the sides of hills and mountains. The leaves with-
stand the cold of winter, and the flowers appear early in the spring.
The whole plant is medicinal. It is a mild demulcent tonic and

MBH

852

MEDICINES AND TIIRIK PRKPARATIONS.

FlO. 219. LOBKLIA

oHtringent, and has been used in fevei-H, liver-complaints, bleeding'
from the lungn, and coiighH.

Pri'parntioHK. — Fluid extract, dose, two to three drams; infuHion,
four ounces to the pint of water, to be taken freely.

Lobelia {Lobelia Infiata^ Fig. 219). — Thib weed grows throughout
the United States ; both its seeds and leaves are used in
medicine. The plant is emetic, expectorant, sedative
and aiitispa^tmodic. As an emetic it is generally
used in combination with other articles for that pur-
pose. It is of great advantage in spasmodic asthma,
as well ivs in bronchitis, croup, whooping-cough, and
other throat and chest affections. Whenever relaxa-
tion is re(]uired to subdue spasm, or for other pur-
poses, lobelia will l)e found useful.

Preparations. — Fluid extmct, dose, as an ex-
pectorant, ten to fifty drops ; as an emetic, one-fourth
of a dnvni to a dram ; tincture, two ounces to a pint
of diluted alcohol, dose, as an expectorant, one to
three drams, as an emetic, half an ounce ; infusion,
dose, an ounce every half hour till vomiting ensues;
lobelin, the active principle, dose, half a grain to a grain and a half.
The following mixture will be found excellent, as an expectorant
and sudorific in spasmodic croup, whooping-cough and asthma, and
for subduing mucous inflammation about the throat and air-passages:
tincture of lobelia, half an ounce ; tincture of bloodroot, two ounces ;
oil of spearmint, half a diam ; empyreumatic syrup, five ounces ;
dose, half a dmm every two hours. A poultice made of lobelia, elm-
bark and weak lye, relieves sprains, bruises, rheumatic pains, erysip-
elatous inflammations and poison from ivy or dogwood.

Logwood (^Hcematoxylon Oampechianum). — This tree is a native
of tropical America. The wood is used in medicine. It is tonic and
astringent, and is used with advantage in diarrhoea, dysentery, and
in the relaxed state of the bowels after cholera infan^vni. Used
freely with other treatment, it also benefits constitutions broken down
by disease or dissipation.

Preparations. — Fluid extract, dose, half a dmm to a dram ; solid
extract, dose» five to twenty grains ; infusion, half an ounce to a pint
of water, dose, four drams every three or four hours, in diarrhoea.

Magnesia (Magnesia Ustd). — Calcined magnesia is obtained from
carlxinate of magnesia, by exposure to a strong heat. It is a white,
inodorous, light powder, of a feeble alkaline taste. It is antacid and
laxative, and is much used in dyspepsia, sick headache, gout, and in
other complaints attended with sour stomach and costiveness ; like-
wise a favorite remedy in complaints of children. Dose, as a laxative,
from thirty to forty grains ; as an antacid or antilithic, ten to twenty-
five grains, once or twice a day.

}

MKDICINES ANP HEIK PRKPAKATIONS.

853

nts, bleeding
■ni8 ; infiiHioii,

vn througliout
/es are u.sed in
rant, sedative
is gejiemily
for that |)ur-
lodic aatluna,
g-cough, luid
never relaxa-
or other pur-

N as an ex-
ic, one-fourth
ices to a pint
Jraiit, one to
ce; infusion,
iling enwues;
n and a half,
expectorant
asthma, and
air-jjassages:
, two ounces ;
five ounces ;
■ lobelia, elm-
pains, erjKip.

i is a native
; is tonic and
sentery, and
it\au. Used
broken down

dram ; solid
ice to a pint
diarihoea.

bteined from
t is a white,
antacid and
fout, and in
eness; like-
8 a laxative,
I to twenty-

Carbonate of Magnesia (Mafln-'nice Carhoruu). — This is prepared
from Hulpliiiti! of magnesia, \)y carbonate of soda. It is antacid, and
when it meets with acid in the stomach and bowels it is laxativo.

Sulphate of Magnesia {Magnetia Sulphas). — Obtained from sea-
water. This is the well-known EpLJm salts and is purgative und
diuietic. Used in all cases which require purgatives. It generally
operates without griping, and, when united with an acidulated infu-
sion of roses, will remain on the stomach when all other things are
rejected. The less it is diluted the better and more easily it oper-
ates, provided a draught of warm water be taken an hour afteinvards.
It may be made to act as a diuretic by keeping the skin cool, and
walking about after it has been taken.

Male Fern (^Anpidium Filix Mas). — This perennial plant is found
in both Europe and America, also in Asia and northern Africa. The
root, which is the medicinal part, should be gathered during summer,
as thu active principle is more abundant at that season than any
other. It is also said to deteriorate by age, and become nearly worth-
less in two years. It is slightly tonic and astringent, but its chief
value consists in its power to destroy and expel the tapeworm.

Preparations. — Solid extract, dose, nine to twelve grains. The
following compound pills are adapted to the destruction of the tape-
worm : solid extract male fern, two scruples ; gamboge, fourteen
grains ; calomel, fourteen grains ; scammony, eighteen grains. Mix,
and divide into twenty pills. ' Dose, two to three pills.

Mandrake (Podophyllum Peltatum, Fig. 220). — This is exclu-
sively an American plant. The root is the

medicinal part. It is cathartic, alterative,
anthelmintic, hydragogue, sialagogue, and,
in large doses, emetic. It stimulates and
quickens the action of the liver and kidneys,
promotes expectoration and determines the
blood to the surface. Combined with cream
of tartar, it produces watery stools and is use-
ful in dropsy. It is used in jaundice, dysen-
tery, diarrhoea, bilious, remittent, and inter-
mittent fevers, puerperal fever, typhoid fever,
and all glandular enlargements. But it has a
more particular action upon the liver, and is ^^°- ^^O- mandrake.
especially useful in derangements of that organ.

The severity of its action seems to be the only objection to its very
extensive use. Its harshness, however, maybe much lessened by its
combination with alkalies, ginger, or caulophyllin.

Preparations Fluid extract, dose, half a dram to a dram ; com-
pound fluid extract, dose, one to two dr.ais ; solid extract, dose, three
to twelve grains ; tincture, three and a half ounces to one pint of al-
cohol, dose, one to three drams ; podophyllin, the active principle,

864

MEDICINEH AND I'HKIK PKKf AUATIONH.

dose, iw un alterative, ono-eighth t4) a (juiirtui' uf a grain ; uh a ciitli-
artic, one to two gruins.

Manna. — Tliis is the concrete juice of the tree called OniuH
Europcea, growing in Sicily, Calabria, and Aj.nlia, as well as of
soveml other species of tree. Manna is a gentle laxative, operating
mildly, though sonietinu's producing wind and pain. It is consider-
ably used as a gentle physic for children and women in the family
way. The usual way of prescribing it is in connection with senna,
rhubai'b, magnesia, or the neutral salts. Being sweet, it conceals the
taste of these remedies in some measure, while it adds to their pur-
gative effect. Dose of manna, for a grown peition, from one to one
and a half ounces ; for a child, from one to four drams, according to
age.

Marsh-Rosemary (^Statice Caroliniana). — This plant grows on
the coast from Maine to Georgia. The root of it is the medicinal
part. A decoction of it is much used in diarrhoea, dysentery, etc.,
also ivs a gargle in ulcenited sore mouth and the throat affection of
scarlet fever, and as an injection in gleet, whites, and falling of the
womb and bowel. Dose of the decoction, one or two tablespoonfuls
every hour or two.

Marshmallow (^Althcea Offieinalis, Fig. 221). — A perennial plant,
growing in salt marshes and other moist places in
Europe. The root is the medicinal part, and its
properties are those of a demulcent. A decoction
of it is used in irritations and inflammations of
mucous membranes, sis in inflammation of the
lungs, stomach, bowels and bladder, and some
affections of the kidneys. The powdered root,
and also the leaves and flowers, are sometimes
employed in the form of poultice.

Mastic. — This is the hardened gum or resin
which flows from incisions in the small tree or
shrub pistacia lentiiscus, growing upon the borders
of the Mediterranean. It is not much used in
medicine, but is chiefly employed in manufactur-
ing a brilliant varnish. I introdu(5e it here principally for the pur-
pose of recommending the following use of it in carious teeth,—
particularly in those new parts of the country where dentistry is not
much known. Dissolve, in a well-stopped bottle, four parts of
mastic in one part of sulphuric ether. Saturate with this solution
a small piece of cotton of the size of the cavity in the tooth, and then,
having cleansed and dried the cavity, gently press the cotton into it.
The ether will soon evaporate and leave the gum to attach itsolf to
the sides of the tooth, and protect its inner surfaces from the action
of the air aud food.

FlO. 831.
HAB8HUALLOW.

mi ; iiH H ciitli-

called Ormm
lus well as of
live, operiiiing
It is coiiHider-
in the fiiinily
m witli seiiim,
t coiieealH the

to their pur-
[)m one to one
I according to

ant grows on
the medicinal
ysentery, etc.,
it affection of
'ailing of the
^blespoonfuls

ronnial plant
loist places in
part, and its
A decoction
immations of
ation of the
er, and some
•wdered root,
fe sometimes

gum or resm
small tree or
n the borders
inch used in
manufactur-
for the par-
ous teeth, —
atistry is not
ur parts of
this solution
th, and then,
3tton into it.
ich ittsolf to
m the action

i31b/mmttm»i^mmtm

MEDICINES AND THEIR PREPARATIONS.

855

Matico (^Piper Angustifolium). — The leaves of this plant are
styptic and somewhat stimulant and tonic. The leaves brought in
contact with a bleeding wound, have considerable power to arrest
the flow of blood.

Preparations. — Fluid extract, dose, half a dram to a dram ; tinc-
ture, four ounces to a pint of diluted alcohol, dose, two drams to one
half ounce ; infusion, half ua ounce to a pint of water, dose, one to
one and a half ounces.

Meadow-Saffron (Colchicum Autumnale, Fig. 222). — This is a
native of the temperate parts of Europe, where it
grows wild in moist meadows. The roots and seeds
are used. Colchicuin is justly regarded as a valuable
remedy in gout and rheumatism, in which it is much
and chiefly used. It is thought, also, to act upon the
nervous system, allaying pain and producing other
sedative effects. When not carried off by the bow-
els, it {)roduces sweating, and is occasionally diuretic
and expectorant. Dose of the dried root, from two
to eight grains.

Preparations. — Fluid extract of root, dose, three fio. 222.

to ten drops ; fluid extract of seeds, dose, five to ten meadow.saffbon.
drojjs ; tincture, four ounces to twelve ounces diluted alcohol, dose,
ten drops to half a dram ; syrup, two ounces to fourteen ounces sim-
ple syrup, dose, one third of a dram to a dram; wine, three ounces
of root to a pint of sherry wine, dose, twenty -five to thirty-five drops.

Monkshood (^Aconite). — This is anodyne, sedative and diapho-
retic. The leaves and roots are generally used separately. It is
useful in inflammatory diseases, neuralgia, epilepsy, paralysis, gout,
and particularly in fevers.

Preparations. — Fluid extract, dose, two to five drops ; solid ex-
tract, dose, one quarter of a grain to a grain ; tincture, eight ounces
of the root to a pint of alcohol, dose, three to five drops.

A preparation composed of one dram of the tincture of aconite-
root, and two ounces of the tincture of black cohosh, and taken in
doses of one teaspoonful every four hours, has great power in reliev-
oig the various forms of neuralgia, and also chronic rheumatic pains,
particularly among old people.

For nervous headache, irritability, restlessness and wakefulness,
the following combination of aconite is useful : —

Solid extract of aconite, half a dram ; solid extract of stramonium,
four grains ; valerianate of quinia, one scruple. Mix and divide into
sixty pills, of which one is to be taken every two, three, or four hours,
according to symptoms.

Motherwort (ieo«ttr«« Oardiaca). — This perennial plant is sup-
posed to be a native of Tartary, and introduced into this country. It
IS considerably used in domestic practice for nervous complaints and

ill

856

MEDICINES AND THEIR PREPARATIONS.

many chronic disorders attended with restlessness, disturbed sleep,
pains of the nerves, and affections of the liver. A warm infusion of
the tops and leaves is useful in restoring menstrual suppression from
colds.

Preparations. — Solid extract, dose, three to five grains. Com-
bined with blue cohosh and skunk-cabbage, the solid extract is a
nervine, antispasmodic and emmenagogue.

Mountain Laurel {Kalmia LatifoUa, Fig. 223). — The laurel is

found in most parts of the United States, on hills

and mountains, flowering in June and July, and is

very ornamental. It is sometimes called big ivy, or

calico-bush. The narrow-leaf laurel, or sheep-laurel,

kalmia angustifolia, is also common, and similarly

medicinal. The leaves of these plants are used in

medicine, and produce, when taken in large doses,

vertigo, dimness of sight, etc. In medicinal doses,

they are sedative and astringent. The saturated

no. 228. tincture is the best form of administration, which

MoTOTAw LAHBEL. ^^^ j^ taken in ten to fifteen-drop doses, every

two or three hours, in syphilis, active hemorrhages, hypertrophy of

the heart and jaundice.

Mullein (^Verbascum Thapsus'). — The leaves and flowers of this
biennial plant are antispasmodic, diuretic and demulcent. The in-
fusion is frequently used in domestic practice, and is useful in colds,
coughs, bronchitis, etc. ; and may be drunk freely. The leaves are
sometimes boiled in milk, sweetened, and taken for bowel com-
plaints. The leaves dipped in hot vinegar and water are very useful
applied as a fomentation in mumps, acute inflammation of the tonsils
and malignant sore throat ; a handful of them may also be placed '"
a teapot with hot water, and the steam be inhaled tlu-ough the spo^c,
in the same complaints.

Mustard. — The seeds of the white mustard, Sinapis alba, were a
few years ago much recommended as a cure for constipation of the
bowels ; and, swallowed whole in teaspoonful, or even, in some obsti
nate cases, in tablespoonful doses, they afford a wholesome stimulus
to the bowels, and accomplish some good. The ground mustftrd is a
valuable condiment to eat in small quantities, at dinner, in dyspeptic
cases. It finds its most important uses, however, as a prompt and
almost instantaneous emetic in cases of poisoning, and also as a valu-
able counter-irritant, when applied extetn?l}y. T'ne ^'jlatile oil of
mustard, one part, and ten pails of sweet oil, nit;- be a^)plied to the
skin instead of the mustard poultice, and with similar results.

Myrrh. — The tree Balsamodendron myrrha, growing in Arabia,
etc., yields a juice which hardens into a gum-resin, called myrrh.
This pleasant, aromatic gum is stimulant, tonic, antiseptic, emmena-

MEDICINES AND THEIR PREPARATIONS.

857

isturbed sleep,
rm infusion of
ppression from

Efrains. Coin-
i extract is a

The laurel is
itates, on hills
I July, and is
led big ivy, or
r sheep-laurel,
and similarly
ts are used in
ti large doses,
dicinal doses,
'he saturated
iration, which
doses, every
•pertrophy of

owers of this
int. The in-
ef ul in colds,
le leaves are
bowel com-
e very useful
of the tonsils
be placed •"
jh the spo^c,

alba, were a
tation of the
I some obsti
me stimulus
mustftrd is a
in dyspeptic
prompt and
30 as a valu-
tlatile oil of
plied to the

lUltB.

X in Arabia,
lied myrrh,
ic, emmeua-

ffogue and expectorant. It is employed in chronic bronchitis, con-
sumption, chlorosis, absence of the menses, etc. It is generally
combined with iron and other tonics, and in amenorrhoea it is fre-
quently combined with aloes. Locally, it is considerably used as a
wash to improve spongy gums, ulcers of the mouth, etc. The dose is
from ten to twenty grains, to be given in pill or in powder suspended
in water. The tincture uf myrrh is a useful external application.

Naphtha. — This belongs to the class of native inflammable sub-
stances, called bitumens. It is a transparent, yellowish white, very
light and inflammable liquid, and is found abundantly in Pereia.
Said to have been used with advantage in Asiatic cholera. It is
composed exclusively of carbon and hydrogen. Dose, from ten to
twenty drops, given in half a glass of wine or mint-water. During
the formation of coal-gas, an artificial naphtha is obtained, which,
when purified, has the property of dissolving India rubber.

Medicinally, it is chiefly used for purposes of inhalation in affec-
tions of the chest.

Naphthalin. — This is obtained from a distillation of coal-tar. Is
is soluble in ether, alcohol, naphtha and oils, but not in water. It it
an excellent expectorant, particularly in cases of impending suffoca-
tion of old persons from chronic bronchitis ; also in asthma and other
pectoral affections. Being stimulating, it is improper in acute bron-
chitis, and pulmonary inflammation. The dose is from ten to twenty-
five grains, given in emulsion, or syrup, every fifteen minutes, until
abundant expectoration takes place. A scruple of naphthalin mixed
with five drams of lard, makes a good ointment for psoriasis, dry
tetter and leprosy.

Nitrate of Silver (^Argenti Nitras). — Nitrate of silver is a solu-
tion of silver in nitric acid, and commonly passes under the name of
lunar caustic. It is both in the form of small cylindrical rods and
of crystals, the latter being more pure than the former.

As an internal remedy, nitrate of silver is tonic and antispasmodic
and is given chiefly in nervous diseases, as epilepsy, St. Vitus's dance
and neuralgia of the heart ; also in some forms of dyspepsia, attended
with pain in the stomach and vomiting. The dose is from one-fourth
to half a grain in the form of pill. It should never be taken regu-
larly as an internal remedy more than two months, as it is apt, after
long use, to change the skin to an indelible slate-blue. Use only
under the direction of a physician.

But nitrate of silver is most used as an external remedy in pharyn-
gitis, laryngitis, tracheitis and other chronic and acute inflammations
of mucous membranes. For reducing these inflammations, it is very
nearly a specific ; certainly, it is altogether the best remedy we have.
It fails in some cases ; but when skilfully used it never does harm.
The solutions to be applied to the throat require to have a strength
of from fifteen to a hundred grains to the ounce of soft water. A

858

MEDICINES AND THEIR PREPARATIONS.

solution containing one to four or more grains to the ounce of water
is often used in inflammations of the eye, gonorrhoea, etc.

Nitre (^Potassa; Nitra%). — Nitre, which also passes under the name
of nitrate of potassa, and saltpetre, is both a natural and artificial pro-
duction. As a medicine, it is refrigerant, diuretic, and diaphoretic,
and is much used in inflammatory diseases. It increases the secretion
of urine and sweat, and lessens the heat of the body and the frequency
of the pulse. United with tartar emetic and calomel, it forms the
well-known nitrous powders, which promote most of the secretions,
particularly those of the liver and skin. One of these powders, con-
stituting a dose, to be given every two or three hours, is composed of
eight grains of nitre, one-eighth of a grain of calomel, and one-eighth
of a grain of tartar emetic. Use with care.

Sweet Spirit of Nitre (Spiritus jM:heris Nitrici). — Sweet spirit
of nitre is diuretic, diaphoretic, and antispasmodic. It is deservedly
much esteemed as a medicine, and is extensively employed in febr- ■
diseases, either alone or in union with taitar emetic, or with spirit of
Mindererus. It is often a grateful stimulus to the stomach, relieving
nausea and vomiting, and promoting sleep. It acts especially upon
the kidneys, augmenting the secretion of urine, and is often given in
conjunction with squills, digitalis, and acetate of potassa. The dose
is a teaspoonful, given in water every two or three hours.

Nutmeg (Myristica Moschatd). — The nutmeg is from a tree grow-
ing in the Molucca Islands. It is stimulant and carminative, and
somewhat used to remove flatulency, as well as to render other med-
icines palatable ; it is most employed, however, to flavor drinks, and
articles of diet. In large doses it is poisonous, producing stupor and
delirium.

Nux Vomica (Strychnog Niix Vofnica, Fig. 224). — The tree which
produces nux vomica grows in Bengal, Malabar,
on the coast of Coromandel, and in other re-
gions. The seeds are the medicinal part.

Nux vomica is an emphatic excitant of the
brain and spinal cord, and in large doses is an
active poison ; frequently repeated in small
doses, it is tonic, diuretic, and slightly laxa-
tive.

Given in full doses, it is apt to produce mus-
cular contraction, as in lockjaw, together witli
frequent starts and twitches, as if from electric
shocks. It is much employed in treatment of paralysis, and is more
beneficial in general than in partial palsy.

Preparations. — Fluid extract, dose, two to seven drops ; solid
extract, dose, half a grain to a grain ; tincture, four ounces to the pint
of alcohol, dose, five to ten drops ; strychnia, commonly called strych-
nin, the active principle, dose, one-sixteenth to one-eighth of a grain.

Fio. 824. Nux Vomica.

aim

MEDICINES AND THEIR PKEPARATIONS.

859

unce of water
Lc.

ider the name
artificial pro-
l diaphoretic,
I the secretion
ihe frequency
it forms the
le secretions,
powders, con-
1 composed of
lid one-eighth

Sweet spirit
is deservedly
l^ed in febr';
with spirit of
ich, relieving
)ecially upon
ften given in
a. The dose
•8.

I a tree grow-
ainative, and
!r other med-
" drinks, and
g stupor and

le tree which
gal, Malabar,
in other re-
lal part,
itant of the
3 doses is an
sd in small
lightly laxa-

)roduce mus-
Jgether witli
from electric
and is more

Irops ; solid
>s to the pint
ailed strych-
h of a grain.

Oil of Cajuput ( Oleum \iuput%). — This oil is obtained from the
leaves of the East Indian je cajuputi. It is diaphoretic and anti-
spasmodic, and a powerful diffusive stimulant. Given in cramps
of the stomach and bowels, colic, flatulency, hysterics, and chronic
rheumatism. It is considerably used as an ingredient in liniments,
to be applied externally in rheumatism and neuralgia. Dose, from
one to three drops, on sugar. .

Oil of Turpentine ( Oleum Terebinthince). — This is generally called
spirits of turpentine, and is obtained by distilling turpentine. As a
medicine it is stimulant, cathartic, diuretic, anthelmintic, and astrin-
gent. In large doses it causes strangury and other unpleasant symp-
toms. The dose is from five to twenty drops, repeated every two or
three hours. Fifteen drops, taken every fifteen minutes or half hour,
powerfully restrains bleeding from the lungs, and is, perhaps, the best
remedy we have for this frightful accident.

It is also very efficacious in checking other hemorrhages. Exter-
nally, it is used considerably as an ingredient in liniments and rube-
facients, in rheumatism, paralysis, etc. Combined with linseed oil,
it is much used for burns and scalds.

Olive Oil ( Oleum Olivce). — This oil, often called meet oil, is ex-
pressed from the fruit of the olive tree, Olea Huropcea. It is nutri-
ent and emollient, and, in doses of one to two fluid ounces, laxa-
tive. It is much employed as a constituent of cerates, liniments, and
plasters.

Onion (^Allium Gepd). — The medicinal properties of the onion are
much like those of garlic. The juice, mixed with sugar, is used to
some extent as a remedy for the coughs and colds of infants. Roasted
onions, applied as a poultice, hasten the suppuration of boils, tumors,
etc. They are also useful, in some cases, applied as drafts to the
feet.

Opium.— This is the hardened juice of the unripe seed of the
poppy, Papaver Somniferum. It is a stimulant narcotic. A moder-
ate dose increases the fulness and frequency of the pulse, augments
the warmth of the skin, invigorates the muscular system, quickens
the senses, animates the spirits, and gives energy to the mental facul-
ties. Its operation is directed with special force to the brain, which
it sometimes excites to intoxication and delirium, which excitement
subsides in a short time, and is followed by a delightful calmness and
placidity of mind, all care and anxiety being banished, and the thoughts
yielded to the control of pleasing fancies. At the end of an hour or
more, this reverie is succeeded by sleep, which, at the end of eight
or ten hours, passes off, and is followed by headache, nausea, tremors,
and other nervous disturbances. Large doses are followed by
shorter periods of exhilaration and excitement, and by more protracted
sleep.

Opium is used in medicine to produce gentle perspiration, relieve

860

MEDICINES AND THEIR PREPAKATIONS.

pain, and lessen nervous excitability in all febrile and inflammatory
diseases ; also as an antispasmodic in hysterics, colic, convulHions,
coughs, etc. It should not be used in cases of constipation of the
bowels. A solution, composed of two grains of opium to one ounce
of water, is sometimes a valuable injection in gonorrhoea and spas-
modic stricture. Dose, as a stimulant, one-quarter to one-half a
grain ; as a narcotic, one to two grains ; in some spasmodic aflfections
it is given in very large doses. Use only under the direction of a
physician.

Morphia, generally called morphine, is one of the alkaloid princi-
ples of opium. It is used under the various forms of sulphate, muri-
ate, acetate, and valerianate of morphia, — all having the general
properties of opium, and are given for similar purposes, in doses of
one^ighth to one-quarter of a grain. One-sixth of a grain is equal
to one grain of opium.

Strong coffee is an excellent antidote to the poisonous effects
both of opium and morphia. A solution of morphia may be made by
adding ten grains of the salt to one fluid ounce and a half of distilled
water, and half an ounce of diluted alcohol, and then adding two
drops of sulphuric acid, if it be the sulphate of morphia, or two drops
of acetic acid, if it be the acetate of morphia, or two drops of muri-
atic acid, if it be the muriate of morphia. The effects of morphia
may be obtained by sprinkling some of it on a blistered surface.

Orange-Peel (Aurantii Cortex). — The orange is the fruit of a
tree belonging to the tropical climates. Orange-juice is a pleasant
refrigerant, useful in fevers, and particularly in scurvy. Siok per-
sons sucking the juice of the orange, should be careful not to swallow
any of the skinny portion, or the peel. The peel of the orange is
chiefly employed to give a pleasant flavor to other medicines, and to
prevent their nauseating properties. It is a mild tonic, carminative,
and stomachic, and improves the bitter infusions and decoctions of
gentian, quassia, Colombo, and Peruvian bark. Orange-peel should
never be given in substance.

Preparations. — Fluid extract, dose, half a dram to two drams ;
tincture, one ounce and three-quarters to a pint of diluted alcohol,
chiefly used as an addition to infusions, etc. ; syrup, two ounces fluid
extract or tincture to a pint of simple syrup, used with water as an
agreeable drink.

Origanum (Origanum Vulgare). — A perennial herb growing in
Europe and this country. The warm infusion of it causes perspirar
tion, and promotes the menstrual discharge, when interrupted by a
cold. The oil of origanum is a very useful ingredient in several
stimulant and rubefacient liniments.

Parsley (Petroselinum Sativum). — The root of this biennial plant
is aperient and diuretic, and is used in dropsy, scarlet fever, and
diseases of the kidneys ; also in retention of the urine, gonorrhoea.

MEDICINES AND THEIK PREPARATIONS.

861

inflammatory
, convulsions,
pation of the

to one ounce
oea and spas-
to one- half a
>dic affections
direction of a

kaloid princi-
ulphate^ muri-
the general
, in doses of
fi-ain is equal

)nous effects
y be made by
If of distilled
adding two
or two drops
ops of muri-
I of morphia
surface.

le fruit of a
8 a pleasant
. Sick per-
)t to swallow
ihe orange is
3ine8, and to
carminative,
ecoctions of
peel should

two drams ;
ted alcohol,
ounces fluid
ivater as an

growing m

es perspira-

'upted by a

in several

mnial plant

fever, and

gonorrhoea,

and strangury. The dose of the infusion is from two to three fluid
ounces, two or three times a day.

The bruised leaves are applied with advantage to contusions,
swelled breasts, and enlarged glands.

Partridge Berry {Mitchella Repem). — This perennial evergreen
creeping herb grows in dry woods and swampy places throughout
the United States, and has white, fragrant flowers in June and July.
It is parturient, diuretic and astringent, and is used in dropsy, sup-
pression of urine, and diarrhcea. It acts as a tonic upon the repro-
ductive organs, giving tone and vigor to the. womb, and making
labor less tedious. Dose of the decoction, from two to tliree fluid
ounces, two or three times a day.

Peach (^Amygdalus Persica). — The leaves of the peach are seda-
tive and slightly laxative, and are used in inflammations of the
stomach and bowels ; likewise in irritable bladder, whooping-cough,
sickness at the stomach, and dysentery. They are used in the form
of cold infusion, a tablespoonful being a dose, to be taken every hour
or two. A good tonic is made by adding four ounces of the bruised
kernels to a quart of honey.

Pennyroyal (ffedeoma Pulegioides, Fig. 225). —Pennyroyal is a
gently stimulant aromatic ; it relieves wind colic
and sick stomach, and qualifies the action of other
medicines. Like most aromatic herbs, it has the
property, when given as a warm infusion, of pro-
moting perspiration and of exciting the menses
when the system is already disposed to the effort.
In cases of recent suppression, it may be given at
bedtime as a warm tea, after bathing the feet in
warm water. The oil of pennyroyal has the prop-
erties of the herb.

Peppermint (^Mentha Piperita). — The pepper-
mint is a native of England, where it is largely
cultivated, as it is to some extent in this country,
for the sake of its essential oil. It is a valuable
herb, having a strong aromatic smell, and a pun-
gent, warming taste. It may be used in the form of tea, which,
when largely drunk, imparts warmth to the system. It is valuable
in colds, flatulent colic, hysterics, spasms, cramps in the stomach,
nausea and vomiting, and to disguise unpleasant medicines.

The peppermint furnishes an essential oil, which, dissolved in al-
cohol, forms the essence of peppermint. The dose of this is fifteen to
twenty drops, on a lump of sugar, or in sweetened water, warm or cold.

Persimmon (^Diospi/ros Virginiand). — Tliis is a tree growing in
the Southern and Middle States. The bark and unripe fruit are used
in medicine, — being astringent and tonic. Pei-sinimon has been
found useful in chronic diarrhoea, chronic dysentery, hemorrhage

f/ \i!'. 'y ) -.

Fio. 225.
Pennvroval.

862

MEDICINES AND THEIR PREPARATIONS.

from the womb, and fever and ague. It is used in the form of infu-
sion and syrup, in doses of a tablespoonful every two or three horn's.
The infusion is also used as a wash and gtvrgle in sore mouth and
thi'oai, and as an injection in whites.

Peruvian Bark (^Cinchona, Fig. 226). — This valuable bark is
derived from several species of the cinchona tree, on the western
coast of South America. The remedy is said to have been first in-
troduced into Europe in 1640, by the Countess of Cinchon, wife of
the Viceroy of Peru, on her return to Spain.

There are three varieties of this bark : the pale, the red, and the
yellow. The pale bark is least liable to
offend the stomach, and is perhaps the best
as a geneml tonic ; but for the treatment
of fever and ague, the red and the yellow
are both preferable to the pale, and the red
is considered better than the yellow.

Cinchona is tonic and antiperiodic, and
is much used, and with great success, in
all periodical diseases, as fever and ague,
remittent fever, neuralgia and epidemic
diseases ; also in chronic diseases attended
with debility, as scrofula, dropsy, and affec-
tions of the skin. Dose of the powdered
bark as a tonic, from ten to fifty grains;
as an antiperiodic, from twenty to seventy-
five grains.

Preparations. — Fluid extract, dose, half a dram to a dram ; com-
pound fluid extract, dose, half a dram to a dram; tincture, four
ounces to one pint diluted alcohol, dose, one to four drams ; infusion,
dose, one to one and a half ounces. A good compound infusion of
cinchona is made by combining one ounce fluid extract with half an
ounce of fluid extract of snakeroot, two drams of fluid extract of
orange-peel, one dram of fluid extract of cloves, one dram of carbon-
ate of potassa and one pint of water. Dose, one to one and a half
ounces. The following is a good nervine and tonic for persons of
nervous temperaments : fluid extract of cinchona, one ounce ; fluid
extract of valerian, one ounce ; essence of cardamom, two drams ;
dose, one dram every tlu-ee hours.

Cinchon ia is a white crystalline substance obtained from the Peru-
vian bark. It is sometimes used as a substitute for quinia, in doses
of from one to three grains, thi-ee times a day.

Sulphate of Quinia is snow white, and in satin-like crystals,
having an exceedingly bitter taste. It is completely soluble in water
or alcohol, by adding a few drops of sulphuric acid. It is the chief
active principle of cinchf m, and has similar properties, namely, feb-
rifuge, tonic and antipe; iodic ; it is, however, less apt to nauseate

Fio. 226. Peruvian Babk.

» form of infu-
or three liouw.
»re mouth and

luable hark is
•n the western
! been first in-
nchon, wife of

i red, and the

RUVIAH BaBK.

I dram ; com-
;incture, four
018 ; infusion,
i infusion of

with half an
id extract of
ini of carbon-
i and a half
)r persons of
ounce ; fluid

two drams;

om the Peru-
nia, in doses

ke crystals,
ble in water
; is the chief
namely, feb-
to nauseate

Peppermint.

L-

MKDIOINES AND THKIK PKKrAKATIONS.

863

ami oppress tlie stomach. In the treatment of intermittent fevei-8, it
liiis ainioft entirely superseded the use of the bark.

Valerianate of Ou In la. — This is a eomhiniition of quinia and
valerianic acid. It is tonic, febrifuge and sedative. It is used for
heailaciio of a periodic cJiaractci, and for nervous iiritahility, wake-
fulness, restlessness, etc. Dose, from half a grain to two grains.

Petroleum or Rock-Oil is a dark brown or greenish liquid found
altnndiintly in the upper strata of the earth in various parts of the
world. Before the discovery of the deep deposits of the oil by arte-
sian wells, the Indians of New York used to collect it where it
oozed from the ground, and sold it jus a family medicine niuler the
name of "Seneca Oil." It has been used externally for chilblains,
chronic rheumatism, iiseases of tlie joints, and skin affections.
Taken internally, it is stimulating, anti-spasmodic, and sudorific, and
liiis lieen recomin.Muled for lung troubles. At present it is used in
various rtiodified forms.

Phosphorus. — This is a semi-tianaparent solid, is flexible, and
lias a waxy lustre. It is extracted from bones by sulphuric acid.
As a medicine in small doses, it acts as a powerful general stimulant ;
in large doses, as a violent, irritant poison. Wlien taken in snl)-
stance it causes irritation of the stomach, and should, therefore,
always be administered in solution ; and even in this form it is ob-
jectionable ; it is better to resort to the phosphates and the hypo-
])hosi)hites. Phosphorus, Ijcrng an element in the composition of the
brain, has l)een given with advantage in the various forms of ner-
vous debility, as consumption, typhus fever, amaurosis, paralysis, and
the general breakdown of the vital powers. Phosphorus b-.mis when
exposed to the air, and should therefore be kept covered with water.

Pink-Root (Spiff elia Marilandica, Fig. 227). — This perennial
herb grows in rich soils in the Middle and Southern
States. The root is the medicinal part. It is a
powerful anthelmintic, and is but little used except
for expelling worms.

Preparation)!. — PTuid extract, dose, half a dram
to a di-am ; compound fluid extract, dose, half a
dram to two drams ; fluid extract of pink-root aiid
senna, dose, half a dram to a dram ; infusion, half
an ounce to a pint of water, dose, two to six
ounces. • •

P\ps,\ssaw a ( Cldmaphila Umhellata, Fig. 228). —
This is a small evergreen plant, growing in the
United States, and in Northern Europe and Asia.
It is known by the name of princes pine. The
whole plant is Conic, diuretic and astringent, and
has proved itself useful in dropsy, general debility,
rheuf ..dm, chronic disorders of the kidneys, bladder, urethra, etc. .■

Fio.227. Pink-Root.

864

MKDIOINKH AND THKIK PKKHAKATIONH.

Preparatiov.». — Fluid extract, dose, one dram ; solid extract, (lose,
ten to fifteen grains; infusio.-j, dose, two ouiiie*.

Plantain (PlatUago M<y'or). — This jicriju-
nial herb grows both in Europe and America.
A strong decoction of the tojw and the roolH Ih
highly spoken of for syphilis and scrofula ; the
dose [mug from two to four fluid ounces, two
or three times a day. But the bruised leaves
are most useful when a]iplied to wounds, ulcere,
bites of ])oisonous insects, erysipelas, etc.

Pleuri«y-Root (^Asclepian Tuberosa, Kijj.
229). — This perennial plant is abundant in
the Southern States. The root, which is the
part used, is carminative, tonic, and diuretic ;
used in pleurisy, bronchitis, inflamruation of
the lungs, acute rheumatism and dysentery. The warm infusion
promotes diaphoresis, without raising the tempeiature of the body.
United with the warm infusion of wild-yam root, "t is excellent for
flatulency and wind colic.

Preparations. — Fluid extract, dose, half a dram to two drams;
tincture, four ounces to a pint of diluted alcohol, dose, three to five
drams; infusion, dose, one to four ounces; asclepidin, dose, one to
five grains. Ascelpidin and dioscorein, united in equal parts, make
a valuable preparation for flatulent and bilious colic ; dose, two to
three grains.

rio. 398. PIPBIBBKWA.

Fia. 339. Pleurist-Boot.

Fia. iSO. Poison Hemlock.

Poison Hemiock (Conium Mamlatnm, Fig. 230). — This biennial
plant is a native of Europe and Asia, and is naturalized in this coun-
try. The leaves and the seeds are used in medicine. Conium is
narcotic, anodyne, antispasmciic and deobstruent; used in neuralgia,
asthma, syphilis, chronic rheumatism, and various other affections.

Preparation. — Fluid extract, Mose, five to fifteen drops ; solid
extract, dose, half a grain to two grains ; tincture, three ounces to a
pint of diluted alcohol, dose thirty drops to a dram ; infusion, half

iii

I M I iii nn Bilfti*

MEDIOINRH Am) THEIR PRKPAKATIONH.

865

i<l extract, dose,
>st!, two ounces.

— 'i'his j)iTL'n.
'•' imd iVnierica.
mid the roots \n
1(1 Hcrofulii ; the
iiid ounces, two

bruiHftd leaves
wounds, ulcere.
)ela8, etc.

Tuberosa, Fip.
is abundant in
t, which JH the
, and diuretic ;
iflanin^ation of
warm infusion
ve of the body,
is excellent for

to two drams;
le, three to five
1, dose, one to
lal parts, make
; dose, two to

liniLooK.

This biennial
in this coun-
. Conium is
I in neuralgia,
r affections,
drops ; solid
e ounces to a
infusion, half

an ounce to a pint of water, mainly used as a wash for malignant
nlvrn, etc. Use with care.

Poison Oak (^Rhu» Tnricodendron). — The leaves are the medicinal
jiiirt of this creeping shrub, which is common in this country. The
lorni of using this mfulicine is that of a saturated tincture, made
from the fresh leaves, and io l)e kejjt in well-corked vials. It has
Iwen found useful in paralysis of the bladder and recituni, in diseases
(»f the eyes and skin, and in chronic rheumatism. Dose of the tinc-
ture, from five to seven drops, three times a day. Large doses should
Iw avoided.

Poke {Phytolacca Perandra, Fig. 281). — A perennial plant,
growing in nearly all parts of the countiy, and
called (target^ pigeon-berry and m'oke. The root
i.s the part used. It is emetic, cathartic, alteia-
live and sligiitly narcotic. It excites the whole
glandular system, and is used in 8y[)hilis, scrof-
ula, rheumatism and affections of the skin.
The root, buried in hot ashes until soft, is
then mashed and api)lied as a poultice for
felons and vaiious tumors. Dose of the pow-
dered root as an emetic, twelve grains to half
a dram; as an alterative, from two to five

grams.

Fio. 281. Poke.

Preparations. — Fluiw extract, dose, ten to
twenty drops ; solid extract, dose, one to
three grains ; tincture, four ounces to a pint
of diluted alcohol, dose, half a dram to a dram ; syiup, two ounces to
fourteen ounces of simple syrup, dose, one to two drams ; phytolaccin,
the active principle, dose, one quarter to one grain. For mercurial
and syphilitic pains in the bones the following pill is useful: solid
extract of poke, two drams ; solid extract of stillingia, one dram ;
solid extract of stramonium, eight grains. Mix, and divide into sixty
pills, of which one pill is to be taken every two or three houra.

Potassa. — This is used in medicine under the name of caustic
liotiissa. It is made by boiling a solution of potassa in a clean iron
vessel until ebullition ceases, and the potassa melts, and then pouring
it into cylindrical moulds ; when cold it is to be kept in well-stopped
bottles. It is a very powerful escharotic, quickly destroying the flesh
which it touches, and extending its action deep under the surface. It
differs in this respejt from nitrate of silver, which only acts upon the
surface, and is not, properly speaking, a caustic.

Caustic potassa is used for forming issues. The method of using
it for this purpose is to cut in a piece of adhesive plaster a hole as
large as the desired issue, and then, having stuck this upon the skin,
to apply the end of the caustic, previously moistened, to the opening.
This application is to be continued till the life of the part is destroyed.

866

MEDICINKS AND THEIh PllEPARATlON,?.

when the caustic must be neutralized b}' vinegar, oj- carefully wiislied
off with a wet sponge.

The following preparations of potassa are used in medicine : —

Acetate of Potassa (^Potassce Acetas). — This is made by the un on
of acetic acid and carbonate of potassa, and in consequence of it«
extreme deliquescence when exposed to the air it is kept in ciosely-
stopped bottles. It is diuretic, deobstrueiit, and mildly catlmrtic.
It is used in febrile diseases, several skin disea^ses, such as psnriiisis,
eczema, and lej>ra, and particularly in dropsical affections. Dose, iis
a diuretic, from ten to twenty grains ; as an aperient from one to two
drams.

Bicarbonate of Potassa {Potassce Bicarbonas). — This is a solu-
tion of carbonate of potassa, saturated with carbonic acid. This acid is
diuretic, antacid, and deobstruent; used in dropsy, acidity of tl.c
stomach, and glandular obstructions. Dose, ten to twenty grains.
Twenty grains dissolved in eight fluid ounces of water, and mixed
with four fluid drams of lemon-juice, forms a good effervescing
draught.

Bitartrate of Potassa (Pota»»ce Bitartras). — This salt is better
known as cream of tartar, undi nupertartrate of potaam. It is formed
from the matter deposited on the bottom and sides of casks, during
the fermentation of sour wines. As a medicine it is diuretic, cathartic,
and refrigerent. In ^■mall doses it acts as a cooling aperient, gently
opening the bowels ; in large ones as a hydragogue cathartic, causing
free, wateiy stools. This property, as well as its power of acting upon
the kidneys, causes it to be much used in dropsical complaints. Dis-
solved in boiling water, allowed to cool, and then sweetened with loaf
sugar, it forms a cooling, pleasant, acid drink. This kind of solution,
with a little fresh lemon-peel added to it, forms the drink called im-
filial. Combined with sulphur, it is often used in skin diseases.
Dose, as an aperient, a dram or two ; as a hydragogue cathartic, half
an ounce to an ounce ; as a diuretic in diopsical complaints, a dram
and a half to two drams several times a day. Cream of tartar, pow-
dered rhatany, and myrrh, mixed in equal propt)rtions, form a good
preparation for cleansing the teeth.

Carbonate of Potassa (Pota%»a> Carho'nai<). — Carbonate of j)otii8sa
is purified pearlanh, and is frequently called mlt of tartar. Carbonate
of potassa has the same medicinal properties with the bicarbonate, and
is used for similai- purposes. •

Chlorate of Potassa. — This is prepared by passing an excess of
chlorine through carbonate of potassa. It is refrigerent and diuretic,
and is given in scurvy, scarlet fever, etc., and as a wash in canker in
the mouth, and varitnis unnealthy ulcers, and as an injection in
leucorrhcea and gleet.

I) ft win liW, I rill,-

irefiilly wiished

neilicine : —

deby theun on
equence of its
kept in riosely-
lildly catliiirtic.
jh as psnriiisis.
ions. Dose, as
rem one to two

'his is !i solu-
id. This acid is
acidity of tl;c
twenty grains,
xjr, and mixed
d effervescing

salt is better
It is formed

casks, during
•etic, cathartic,
)erient. gently
hartie, causing
of acting upon
nplaints. Dis-
;ened with loaf
nd of solution,
•ink called im-

skin diseases,
cathartic, half
laints, a dram
>f tartar, pow-

form a good

late of potiissa
ir. Carbonate
iarbonate, and

an excess of
t and diuretic,
ti in canker in

injection in

MEDICINES AND THEIR PREPARATIONS.

867

Citrate of Potassa {Potasscn Citrus) . — A grateful, cooling diapho-
retic, long and much used in fevere, chiefly in the forms of the neutral
mixture, and effervcscinff draught.

Solution of Citrate of Potassa {Liquor Fotassce Gitratis). — This
is prepared by taking half a pint of lemon-juice, and adding bicarbonate
of potassa gradually to it until it is saturated, then filtering. This
passes under the name of neutral mixture, saline mixture, and efferves-
cing dratight. It is a valuable refrigerent diaphoretic, well adapted
to tlie hot stage of remittent and intermittent fevers, and indeed to
almost all cases of fever, with a dry, hot skin. The dose is a table-
spoonful, or half a. fluid ounce, which should be well diluted when
taken, and be repeated every two or three hours, according to the
necessities of the case.

Sol uti. n of Potassa (^Liquor Po«a8«flB).^— This is a transparent,
caustic fluid, which requires to be kept in green bottles, tightly corked.
Jt is antacid, antilithic, and diuretic. It is used in some affections of
the skin, and scrofula, but more particularly for scalding of the ure-
thra, in gonorrhcea ; in this case, it is well to unite a few drops of
laudanum with it. The dose is from fifteen to twenty-five drops, two
or three times a day, in half a tumblerful of water. In dyspeptic
cases, attended with acidity of the stomach, it may be associated with
some simple bitters.

Sulphate of Potassa (Potassoe Sulphas). — This is a mild purga-
tive, operating without irritation or pain. As an aperient, it should
be given in doses of from a scruple to a dram. Ten grains of rhubarb
and one dram of carbonate of potassa, united, and divided into* six
powdei-s, is an excellent alterative cathartic for children having defec-
tive digestion and nutrition, and a tumid state of the abdomen. One
powder may be given at a time, as often as may be necessary to open
the bowels gently.

Tartrate of Potassa (Potassce Tartras). — This often passes under
the name of soluble tartar. It is a mild, cooling purgative, operating,
as most of the neutral salts do, without much pain, and producing
watery stools. It is useful in fevers. Combining it with senna destroys
its tendency to produce griping of the bowels. The dose varies from
a dram to an ounce, according to the effect desired.

Potassium. — This is a soft, bluish- white metal. Its union with
oxygen, in the proportion c ■ one equivalent of each, forms potassa or
potash. The following preparations of it are used in medicine : —

Bromide of Potassium (^li. ssii liromidum}. — This is a perma-
nent, colorless salt, having a pungent, saline taste, a little more acrid
than common salt, yet similar to it. As a medicine it is alterative and
resolvent, and is used occasionally for secondary syphilis, scrofula, and
enlarged spleen. Dose, from three to five grains, three times a day, in
pill or solution. One dram of the bromide of pot£;88ium, rub »ed up

'yg^Xp'^iV^"

868

MEDICINES AND THEIR PREPARATIONS.

with an ounce of lard, luakcH an ointment which has hevu useil witli
some good effect in goitre and Hcrofulous affections.

Cyan u ret of Potassium (Potassii Cyanur,etum). — This is emi-
nently poisonous, acting both as a medicine and as a poison, like
hydrocyanic acid. It has therefore been recommended as a substitute
for that acid. The dose is one-eighth of a grain, dissolved in half a
fluid ounce of water.

Sulphuret of Potassium {Pota%8ii Sulphuretum').—^T\\\& is called
liver of sulyhur, and hepar, being composed of sulphur and potassium.
It has been used in chronic bronchitis, asthma, whooping-cough, and
rheumatism. Half an ounce to an ounce of it, dissolved in several
gallons of warm water, makes a valuable sulphur bath for several
skin diseases, as itch, prurigo, etc.

Prickly Ash (Xanthoxylum Fraxineum). — This shrub grows in
various parts of the United States. The leaves and capsules have
a pleasant, aromatic smell. Its medicinal properties
are in the bark and berries. The bark is stimulant,
tonic, alterative, and sialagogue. It is used to rouse
ar>d excite the system, when in a languid state, and for
derangements of the liver, rheumatism, and chronic
syphilis. It stimulates and strengthens mucous mem-
branes, and is a valuable tonic in low typhoid fever.
Applied externally, it improves indolent and malig-
nant ulcere. Dose of the powdered bark, from ten to
twenty grains, three times a day.

Preparations. — Fluid extract, dose, fifteen to

twenty-five drops ; tincture, four ounces to a pint of

diluted alcohol, dose, half a dram to a dram ; infusion,

half an ounce to a pint of water, dose, half an ounce

to two ounces ; xantioxylin, the active principle, dose,

two to five grains.

For chronic rheumatism the following is a good preparation : xan-

thoxylin, one dram ; cimicif ugin, one dram ; apocynin, one dram ;

diluted alcohol, one pint ; dose, three drams, three times a day.

Prickly Ash Berries are carminative, antispasmodic, and stimulant,
and have a special direction to mucous membranes. The tincture is
excellent in nervous diseases, spasms of the bowels, flatulency, and
diarrhoea ; and, combined with the tincture of poke-berries, is very
serviceable in chronic rheumatism and sjrphilis. It is said to have
been used with great success, in the West, in Asiatic cholera. Dose
of the tincture, from ten drops to a fluid dram, in sweetened water.
Dose of the oil of prickly-ash berries, from two to seven drops, on
sugar.

Prickly Elder (Aralia Spinota). — This is a tree which grows m
the Southern and Western States, and is called Southern prickly ash,
and toothache tree. The bark is stimulant, alterative, and diaphoretic.

FIO. S82.
Pricklt Abh.

•|>iftirfi'flw,i.

MEDICINES AND THEIK PREPARATIONS.

869

t-'t'ii used will,

This is enii-
t poison, like
as a substitute
'Ived in half a

This is called
nd potassium,
ig-cough, and
ed in several
h for several

rub grows in

iapsules have

lal properties

is stimulant,

used to rouse

state, and for

and chronic

mucous mem-

yphoid fever.

Qt and malig-

c, from ten to

, fifteen to
3 to a pint of
•m; infusion,
lalf an ounce
■inciple, dose,

iration : xan-
1 one dram;
3 a day.
d stimulant,
le tincture is
tulency, and
Ties, is very
aid to have
ilera. Dose
tened water,
n drops, on

ih grows m
prickly ash,
diaphoretic.

The fresh bark, emetic and cathartic. The tincture is serviceable in
skin diseases, syphilis, and chronic rheumatism. The bark is siala-
gogue, and in small doses, powdered, is said to relieve the dry and
parched condition. of the throat, in many diseases.

Pumpkin-Seeds — The infusion of pumpkin-seeds, made by plac-
ing them in water without bruising them, is mucilaginous and diu-
retic, and is used in inflammation of thei stomach and bowels, scald-
ing of the urin§, strangury, etc. But this infusion is more particularly
valuable for its power of expelling the tape-worm. It may be drunk
freely. The oil of pumpkin .seeds, obtained by expression, has similar
properties, and may be taken in doses of six to ten drops, several times
a day.

Quassia (^Picroena ExceUa). — This is the wood of a tall tree grow-
ing in Surinam and some of the West India Islands. It is an intensely
bitter tonic, febrifuge, and anthelmintic, possessing in the highest de-
gree the properties of the simple bitters. It invigorates the digestive
organs, without producing much excitement of the circulation. It is
well adapted to dyspepsia, and the debility of the stomach which suc-
ceeds acute disease, and indeed all complaints where simple bitter is
required. Its generic title perpetuates the name of the negro Quassi,
of Surinam, who first discovered its medicinal virtues, about the mid-
dle of the last century, and who became famous for treating malig-
nant fevers with it, as a secret remedy.

Preparations, — Fluid exrtract, dose, half a dram to a dram ; solid
extract, dose, three to five grains ; tincture, dose, four to eight di-ams ;
infusion, two drams to a pint of water, dose, two to three ounces.

Queen of the Meadow (^Uupatorium Purpureum) . — This peren-
nial herb grows in low, swampy places, in many parts of the country.
It is called trumpet weed, and, from its fine medicinal effects in com-
plaints of the urinary organs, gravel-root. It is an excellent diuretic,
tonic, and stimulant. Used in gout, rheumatism, hematuriu, chronic
diseases of the urinary organs, strangury, gravel, and dropsical affec-
tions. The decoction h the form in which it is most used ; the dose
being two to three ounces, two or three times a day.

A preparation called eupurpurin is also extracted from it, which, in
three-grain doses, is a powerful diuretic, occasioning, in some cases, it
is said, an enormous flow of urine.

Queen's Root (^Stillingia Sylvaticd). — This perennial herb grows
in sandy soils in the Southern States. The root is medicinal, being,
in large doses, emetic and cathartic ; in small doses, an alterative of
considerable value in skin diseases, rlieumatism, syphilis, and scrofula,
and in such other complaints as require alteratives.

Preparations. — Fluid extract, dose, five to ten drops ; compound
fluid extract, dose, half a dram to a dram ; tincture, two ounces to a
pint of diluted alcohol, dose, one to three drams ; infusion, dose, one
to one and one-half ounces. In clironic bronchitis and similar com-

MKDICINES AND THKIR PREPARATIONS.

plaints, the following syrup is well recommended : fluid extra<i of
stillingia, two ounces; fluid extract of blootlroot, two ounces; Huid
extract of cherry biiik, two ounces; balsam of tolu, one ounce and a
half; syrup, two and a half pints. Dose, one to two drams.

Red Chickweed {Anagallu Arveu»l%}. — An annual plant, com-
mon in Europe and this country. It has small scarlet flowers in June
and July, it has been used in nervous diseases, as mania, delirium,
epilepsy, and partieulaiiy hydrophobia. Old and ill-conditioned ul-
cers are improved by its use, in the form of poultice.

Red Root ( CeanothuH Americanu»). — This shrubby plant has the
names of New Jersey tea and wild snowball, and is found in all parts
of the United States. Tlie bark is antispasmodic, sedative, astringent,
and expectorant, and tastes and smells like the peach-leaf. A decoc-
tion is useful in dysentery, diarrhoea, whooping-cough, and chronic
bronchitis, in doses of a tablespoonful three times a day. It makes,
likewise, a very good injection in leucorrhoea and gleet, and gargle
for ulcerations of the mouth and thi'oat.

Red Clover (^Trifolmm Pratenxe). —The blossoms of this very
common biennial plant are medicinal, and are highly recommended
in deep, ragged, and cancerous ulcers, as well as in badly condi-
tioned burns. They are soothing and detergent, and promote health-
ful granulation. Taken in large doses for a year or so, it is said to
be good for cancer.

Preparation. — Solid extract, to be used as an external applica-
tion, chiefly in tlie form of ointment, made by uniting four ounces of
it with half a pound of lard.

Red Rose (^Rosa Gallica). — The petals of the rose are slightly
tonic and astringent, and are considerably employed in chronic in-
flammations of the eye. Rose-water, distilled from the petals, is
used for similar purposes.

Red 5aunders (^Pterocarpus Santalinus). — This is a large tree
growing in Ceylon, the wood of which imparts a red color to alcohol,
ether, and alkaline solutions, but not to water. It is almost solely
used for imparting color to tinctures, etc., having little or no medi-
cinal properties.

Rosin. — This is the solid resinous matter which remains after
the distillation of turpentine. It is much used as an ingredient in
ointments and plastei*, but is never taken internally. The vapor
which arises from heating it upon some hot surface is sometimes in-
haled with great advantage in chronic bronchitis, and other chronic-
affections of the air-tulies.

Rhatany (Krameria Triandra). — This is a native of Peru, grow-
ing in dry, sandy places. It is a powerful astringent, and a gentle
tonic. It is given with advantage in excessive menstruation, vom-

MKDICINE8 AND THEIR I'REPAHATIONS.

871

'iiid extra<t, of
' ounces ; fluid
ne ounce and a
drams.

al plant, corn-
flowers in June
lania, delirium,
jonditioned ul-

r plant has the
nd in all {tarts
ive, astringent,
eaf. A decoc-
:h, and chronic
ay. It makes.
Jet, and gargle

of this very
recommended

badly condi-
romote health-
o, it is said to

ernal applica-
Four ounces of

e are slightly
in chronic in-
the petals, is

a large tree
lor to alcohol,
almost solely
e or no medi-

^mains after
ingredient in
The vapor
ometimes in-
ther chronic

: Peru, gro
md a gentle
uation, vom-

iting lit' hlood, chronic diarrluua, Uuicorrh(jea, and inability to retain
the urine ; likewise, as a local Huplication in falling of the l)owel.
It is valuable also for nosebleed, and bleeding gums. Dose of the
powder, for internal use, from ten to twenty-five grains.

Preparations. — Fluid extract, dose, half a dram to a diam ; solid
extract, dose, five to fifteen grains ; tincture, three ounces to a pint
of diluted alcohol, dose, three to five drams ; infusion, two ounces to
a pint of water, dose, half an ounce.

Rhubarb (Rheum Palmatum). — This root is derived from several
species of rheum, and passes under the various names of European.,
Miissian, Chinese, Hast India, and Turkey rhubarb. The variety
called Russian or Turkey rhubarb (for they are the same) is consid-
ered the best. Rhubarb is cathartic, astringent, and tonic. It is
much used in mild cases of diai-rhcea and cholera inf an tum ; likewise,
as a stomachic and j^tntle tonic in dyspepsia, accompanied with a
debilitated state of the digestive organs. It is a valuable remedy in
the complaints of children, and is deservedly much used in treating
them. It acts upon the muscular coat of the bowels, producing thick
rather than watery stools. It is therefore not adapted to the treatment
of dropsical complaints. Its astringency may be increased by roasting
it, or diminished by combination with an alkali.

Preparations. — Fluid extract, dose, half a dram to a dram ; aro-
matic fluid extract, dose, half a dram to a dram ; fluid extract of
rhubarb and senna, dose, half a dram to a dram ; solid extract, dose,
two to eight grains ; tincture, an ounce and a half of fluid extract,
and half an ounce of essence of cardamom, to a pint of diluted alcohol,
dose, half an ounce to an ounce and a half ; infusion, one ounce fluid
extract and two ounces spirit of cinnamon to a pint of water, dose,
one to three ounces ; sjTup, three ounces of fluid extract to fourteen
of syrup, dose, two to five drams.

Rosemary (5o««mannM8 Officinalis).— This evergreen shrub grows
on the borders of the Mediterranean, and is cultivated in Europe and
this country. It is stimulant, antispasmodic, and emmenagogue. It
is not used in this country, however, except to perfume ointments,
tinctures, and syrups.

Round-Leaved Pyrola (^Pyrola Rotundtfolia'). — This perennial
shrub grows in various parts of our country, and beans white flowers
in June. It is called canker-lettuce, pear-leaf wintergreen, etc. Its
medicinal properties are those of a tonic, astringent, antispasmodic,
and diuretic. Used in decoction for epilepsy and other nervous dis-
order's ; also for gravel, and other diseases of the bladder and kid-
neys. The decoction may be used, too, as a wash for ulcerations of
the mouth, indolent ulcers, and chronic ophthalmia. The decoction
may likewise be used in making poultices for painful swellings, boils,
and carbuncles. It may be taken in doses of from one to four
ounces.

872

MEDICINKS AND THEIR PREPARATIONS.

Rue (Ruta Oraveohnft). — Rue luu* the medicinal virtues of the
Hiiti8pa»nic)(lic», authelininticb, and emmenagogucH. In large dusts
it is poisonous. It is useful in wind-colic, worms, hysterics, epile|i,s\,
etc. Dose of the leaves, from ten to fifteen grains ; of the infusion,
from one to two ounces. Use with care.

Saffron (Crocus iS'atiws). — This is a native of Greece and Asia
Minor; it is also cultivated in Fmnce, England, and America, as
well as in other countries. It has been thought to be stimulant and
antispasmodic in small doses, relieving pain, and producing sleep ; in
large doses, giving rise to headache, and producing stupor. In the
general judgment of the profession it is now considered, however, as
having very little activity. It is accordingly not much used, except
in domestic practice, where it has some reputation among nurses for
its power to bring out measles, and other eruptions. It is also thought
to be beneficial in amenorrhcea, dysmenorrhoea, chlorosis, and hys-
teria. It is chiefly used at present to impart flavor and color to
tinctures.

Preparations. — Fluid extract, dose, twenty to forty drops ; tinc-
ture, dose, half a dram to a dnim ; infusion, one dram to a pint of
water, dose, one to two ounces.

Sage (^Salvia Officinalis'). — The tops and leaves of this well known
garden plant are aromatic, astringent, diaphoretic, and slightly tonic.
The infusion is useful in debilitated conditions of the stomach, at-
tended with flatulence ; it frequently relieves nausea ; the cold infu-
sion, checks and sometimes entirely removes the night-sweats of
hectic. The infusion is useful as a gargle in inflammation of the
tiiroat, particularly if united with a little honey and alum. Dose of
the infusion, from one to three fluid ounces.

Sarsaparilla {Smilax Officinalis'). — Grows in swamps and hedges
in the Middle and Southern States. The root has long been held in
esteem as an alterative, diuretic, and demulcent, being used in scrof-
ula, chronic rheumatism, and affections of the skin ; but its most ex-
tensive and useful application has been found to be in the treatment
of secondary and tertiaiy syphilis ; and especially in the broken con-
dition of the system which follows the use of mercury in these
affections.

Preparations. — Fluid extract, dose, one dram ; fluid extract of sar-
saparilla and dandelion, dose, one dram ; solid extract, dose, five to
twenty grains ; infusion, dose, two to three ounces.

Sassafras (Laurus Sassafras). — This tree is common in theUnited
States. The bark of the root, which is the medicinal part, is altera-
tive diuretic, diaphoretic, and a warm aromatic stimulant. It is
mainly used to improve the flavor of other medicines, and also as a
constituent ^f those compounds which are recommended in chronic

MEDICINES AND THEIK PKEI'ARATIONS.

873

virtues of tlic
»i large ilosijs
«ncH, epile|),s;,
the infusioii,

eece and Asia
America, as
stimulant and
cing sleep ; in
jpor. In the
, however, as
used, except
ng nurses foi-
8 also thought
wis, and hys-
and color to

' drops ; tine-
to a pint of

is well known
Jlightly tonic,
stomach, at-
the cold infu-
"ht-sweats of
lation of the
im. Dose of

8 and hedges
been held in
ised in scrof-

its most ex-
he treatment

broken eon-
iry in these

ctract of sar-
iose, five to

n the United
% is alterji-
iant. It is
1 also as a
in chronic

I'lieninatism, syphiloid affections, eruptions of the skin, and
scurvy.

Preparations. — Fluid extract, dose, one to two drams ; tincture,
six ounces to a pint of alcohol, dose, half an ounce to an ounce ; in-
fusion, two ounces to a pint of water, to be drunk as desired.

Savin (Jtmiperua Sabina). — An evergreen shrub, growing in
Europe and North America. The tops and leaves are diuretic, dia-
phoretic, emmenagogue, and anthelmintic. The warm infusion pro-
motes menstruation, and destroys worms. Care should be taken nevor
to administer this medicine during pregnancy, its effects being violent
and dangerous.

Preparations. — Fluid extract, dose, ten to twenty drops; solid
extract, dose, one to three grains ; tincture, four ounces to a pint of
diluted alcohol, dose, half a dram to a dram and a half ; infusion, half
an ounce to a pint of water, dose, half an ounce to an ounce. The
following mixture is useful in anienorrhcea : fluid extract of savin,
iialf a dram ; fluid extract of ginger, one dram ; sulphate of potassa,
two drams. Mix. Dose, half a dram twice a day. The oil of savin
has properties similar to those of the leaves. Dose, from two to five
drops, on sugar.

Scammony (^Convolvulus Scammonia) . — This plant is a native of
Syria and the neighboring countries. The medicinal part is the har-
dened juice of the fresh root. It is an energetic cathartic, producing
griping, and sometimes operating with decided harshness, on which
account it is generally combined with other medicines which lessen
the severity of its action. The dose is from five to fifteen grains.

Scullcap (Scutellaria Lateriflora, Fig. 233). — An indigenous plant,
flowering in July and August. The whole herb is used. It is a valuable

nervine, tonic, and antispasmodic; while it
gives support to the nerves, it imparts both
quietness and strength to the whole system,
and does not, like other nervines, leave the
patient excited and irritable. It finds its use
in the treatment of neuralgia, chorea, con-
vulsions, lockjaw, and most other diseases of
the nervous system.

. Preparations. — Fluid extract, dose, half a
dram to a dram ; compound fluid extract, dose,
half a dram to a dram ; tincture, four ounces to
a pint of diluted alcohol, dose, one to two
drams; infusion, dose, a wineglassful three
times a day ; scutellarin, the active principle,
dose, two to five grains.

Seneka (Polygala Senega^ An indigenous plant, commonly

called snakeroot, the root of which is used in medicine. It is a stim-

Fia.288. SCDLLCAF.

874

MRPICINKS AND TIIEIU I'HEI'AKATTONS.

r.lating di'v retic and exiMU'toiant, anil in large doses an emetic ami
(■atlmrtic. It excites all tlu; sucretions. it is useful in ciinniii'
bi'onchitis, and in other chronic affections of the hreathing-tuln's.

PreparatioriH. — Fluid extract, dose, twenty- to twenty-five drops;
infusion, dose, one ounce to an ounce and a half; syrup, four ounces
of fluid extract to twelve ounces simple syrup, dose, half a dram to
a dram. The following is a very good expectorant cougli prepara-
tion : fluid extract of seneka, three drams ; fluid extract of squill,
half a dram ; syrup of tolu, two drams ; paregoric, two drams ; car-
bonate of ammonia, twenty grains ; water, four and a half ounces.
Mix. Dose, one dram.

Senna ( Cassia Acutifolia.^. — Grows abundantly in Upper Egypt.
The leaves are the medicinal part. It is a mild, active, and certain
cathartic, and is much used in combination with other medicines,
jiarticularly epsom salts. The addition of cloves, ginger, cinnamon,
and oth^T aromatics, removes all its tendency to griping, and makes
it a safe and gentle yet active purgative, calling for an evacuation
of the bowels.

Preparations. — Fluid extract, dose, one to two drams ; fluid extract
of senna and jalap, dose, half a dram t,o a dram ; solid extract, dose,
three to five grains ; tincture, three ounces to thirteen ounces of
diluted alcohol, dose, half an ounce to an ounce ; infusion, two ounces
to a pint of water, dose, half an ounce to an ounce.

Shrubby Trefoil (Ptelea Tr\foliata). — This shrub, which grows
in the West, is called wafer-ash and wmg»eed. Its bark and root
have tonic properties, and are used in intermittent and remittent
fevers, and wherever nature needs a lift in getting up from exhaust-
ing complaints. The medicine, like other tonics, improves the ap-
petite and digestion. Dose of the solid extract, from three to five
grains, three or four times a day ; of the cold infusion, a tablespoon-
ful every two or three hours.

The oleo-resinous principle of the crude bark is called ptelein, and
is a powerful tonic. Dose, one or two grains three or four times a
day.

Skunk-Cabbage {Symplocarpm Fcetidus, Fig. 284). — A peren-
nial plant, growing in moist places thi-oughout the United States ;
sometimes called meadow-cahbage. The root is stimulant, expectorant,
antispasmodic, and slightly narcotic. It is given for pulmonary and
bronchial affections, epilepsy, hysterics, asthma, whooping-cough,
and irritable nerves.

Preparations. — Fluid extract, dose, twenty to fifty drops ; tinc-
ture, three ounces to a pint of alcohol, dose, half a dram to a dram ;
infusion, dose, one to one and a half ounces ; syrup, two ounces of
fluid extract to eight ounces of simple syrup, dose, two to three drams.
For asthma and cough, and to promote expectoration and remove

MED1CINK8 ANlJ TIIKIK PUErARATIONS

875

"1 eiiictic iiiid
f»l in cliioiii,.

thing-tulH'H.

Biity-five (Irups;

lip, four ounces
mif a (iriuii to

cougli prepai-a-

tract of squill,

vo drains; cnr.

a half ouuces.

Upper Egypt.
ve, and certiiiu
;her medicines,
ger, cinnamon,
ng, and makes
an evacuation

i; fluid extract

extract, dose,

Ben ounces of

on, two ounces

which grows
3ai-Jc and root
and remittent
from exhaust-
iroves the ap-
tliree to five
a tablespoon-

d ptelein, and
four times a

• — A peren-
rnited States ;
■, expectorant,
ulmonary and
)oping-cough,

drops ; tinc-
tn to a dram ;
vo ounces of
' three drams.

and remove

tigliinesH across tlie chest, the following is a very good compound
preparation: one ounce each of the fluid extract of skunk-cabbage,
l()l)elia, bloodroot, pleurisy-root, and ginger, one pint of water, anil
tliiee pints of alcohol. Dose, two to three drams.

KIO. 234. SKCNK-CabBAOE.

KlO. ,05. Sl-IPPKKY KLM.

Slippery Elm (^Ulmun Fulva, Fig 236). — The inner bark of
tiiis well-known tree is nutritive, demulcent, emollient, and slightly
expectorant and diuretic. It is valuable as a demulcent drink in in-
flammations of the lungs, stomach, bowels, bladder, and kidneys ;
also for coughs, strangury, dysentery, and the summer complaints of
infants. It makes a valuable poultice for various purposes.

Small 5plkenard (Aralia NudicauHs). — This plant grows
tlnoughout the United States, from Canada to the ('arolinas, in
rocky woods. It is called false sarsaparilla and wild sarsaparilla.
The root is a gentle stimulant, diaphoretic and alterative. It is used
in domestic practice, and by some physicians, in rheumatism, syph-
ilis, and cutaneous diseases. The American spikenard, Aralia raoe-
mom, resembles the small spikenard in medicinal jjroperties. Either
of these roots is valuable in chronic affections of the lungs and air-
tubes.

Soap (Sapo). — Soap is laxative, antacid, and antilithic, and is
much used in combination with cathartics, to lessen the severity of
their action. In mesenteric fever, advantage is derived from rubbing
the tumid belly of children with a strong lather of soap, morning and
evening ; and few things are more effectual in removing hardened
feces from the rectum in cases of obstinate costiveness than an injec-
tion of soapsuds. Soap is now made out of so many kinds of fat
that care should be taken to use as medicine only the best Castile.

Sodium. — This is a soft white mebil. .United with oxygen in
the proportion of one efjuivalent each, it forms the alkali, ioua. The
loUowing are the principal preparations of soda usei^. iu medicine: —

876

MBDIOINES AN!) THEIR PRKPAKATIONS.

Bicarbonate of Soda {Sodce £icarhonan). — This in a wliito, inodor-
ous powder, sometimes called super carbonate of soda. Il is arit<u;icl,
antilithic, and slightly diuretic. It is chiefly used in preparing what
are called soda-powders, and in various preparations of medicine, when
an antacid is required. It is also taken simply dissolved in water,
for acidity of the stomach.

Borate of Soda (Sodcp Boras). — This is everywhere known l)y Iho
name of borax. It exists naturally formed in various parts of the
world, and is likewise manufactured. It is a mild refrigerent and
diuretic ; also emmenagogue, promoting menstniation, facilitating par-
turition, and favoring the expulsion of the after-birth liy its specific
influence upon the womb. It has considerable reputation in the treat-
ment of urinary diseases, particularly those connected with an excess
of uric acid. The dose is from twenty to twenty-five grains in solu-
tion. Combined with rose-water, honey, and various other thingiS,
according to circumstances, borax makes a valuable wash for inflam-
matory affections of the mouth and throat, skin-diseases, etc.

Chloride of Sodium (^Sodii Chloridurn). — This is the chemical
name of muriate of soda or common salt. In small doses, it is tonic,
alterative and anthelmintic. It checks bleeding from the lungs, when
taken in teaspoonful doses. The dose as an alterative is from ten to
sixty grains. As moderately used in food by most civilized people,
it promotes digestion and improves the general health.

Sulphate of Soda (^Sodce Sulphas'). — This has a very pretty
name, but it will not sound half as well to thousands of young per-
sons, when they are told that it is the well-known Glauber's salts.
From half an ounce to an ounce of it dissolved in half a tumblerful
of water acts as a cathartic ; a smaller dose, as a laxative and diu-
retic. Its nauseous and bitter taste may be somewhat concealed by
a little cream of tartar or lemon-juice.

Sulphite of Soda (aS'oc?^? Sulphis'^. — This preparation is in the
form of transparent crystals, and is very soluble in water. In doses
of sixty grains, this is said to have been used with success in frothy
vomitings ; it is also well spoken of as a remedy in acute rheuma-
tisir, and as a wash in thrush and some diseases of the skin.

Tartrate of Potassa and Soda (Sodce et Potasses Tartras). — This
is one of the mildest and most cooling purgatives among the salts.
It is known as Rochelle salt, and generally agrees well with irritable
and delicat* stomachs. Dose, from four drams to two ounces, in a
tumblerful of water. The gentle physic called Seidlitz powders is
composed of two drams of rochelle salt and two scruples of bicarbon-
ate of soda in a blue paper, and thirty-five grains of tartaric acid in a
white paper. The contents of each paper is dissolved in half a tum-
bler of water by itself ; one solution is then poured into the other,
and the whole is drunk during the effervescence.

MEDIOINKH AND THKIU PKKI'ARATIONH.

877

H wliito, iiiodor-
h is antacid,
>i t'lJiiritig wlmt
inutJiciiie,wht'ii
olved in wutt-r,

V 'cnown iiy the
18 parts of the
•efrigerent and
"acilitating par-

'•y its specific
ion in the treat-
with an excess
grains in solu-

other thing.s,
ash for inflam-
38, etc.

the chemical

ses, it is tonic,

he lungs, when

is from ten to

vilized people,

very pretty
of young per-
rlauber's salts.
f a tumblerful
itive and diu-
concealed by

ion is in the
ter. In doses
Jess in frothy
cute rheuma-
skin.

tras). — This
ng the salts.
with irritable
ounces, in a
te powders is
i of bicarbon-
aric acid in a
n half a turn-
to the other,

5olomon's Seal (^Convalaria MuUifiora). — This is one of our own

TK-rennial plant**, and is found in various parts of the country. The
root is tonic, mucilaginous and HMtringeut. It acts especially upon
mucous tissues, and has therefore found its use in chronic dysentery
and piles, and in chronic inflammation of the stomach and bowels.
Dose of the decoction, or infusion, from one to four fluid ounces,
three or four times a day. Large doses purge and vomit. The de-
coction applied locally, relieves the inflammation caused by the p^^'son
ivy.

Solution of Arsenlte of Potassa (^Liquor Potasscp Arsenitis). —
This is known under the names of arsenical solution and Fowler's
solution. It is a tran8{)arent liquid, having the color, taate and
smell of spirits of lavender. It has the general action upon the
human body of the arsenical preparations. It is the preparation
generally resorted to where araenic is given internally, and is used
with considerable success in intermittent fever, leprosy and several
other skin diseases, St. Vitus's dance, periodical headache, and some
other complaints. The dose is from three to five drops, three times
a day, given in water ; generally, it is better not to go beyond five
drops. Sometimes it disturbs the stomach and binds the bowels,
producing headache, dizziness and confusion of mind. When such
effects follow its use, it must be laid aside and a purgative given.
After an interval of two weeks, it may be resumed in smaller doses.
It often requires to be used for several months.

Spanish Flies (^Gantharis Vesicatoria^. — These insects are of a
beautiful, shining, golden-green color. They attach themselves to
such trees, in Franco, Spain and Italy, as the white poplar, elder,
privet and lilac, upon the leaves of which they feed. They make
their appearance in swarms upon these trees in May ar>d June, and
are shaken off in the morning while torpid with the cold. Internally
administered, they are a powerful stimulant, exercising a peculiar
influence over the urinary and genital organs. In large doses, they
excite violent inflammation of the alimentary canal and urinary or-
gans, strangury, irritation of the sexual organs, headache, delirium,
and convulsions ; also painful priapism, vomiting, bloody stools, sali-
vation, fetid breath, hurried breathing, and difficulty of swallowing.
They are given internally for chronic gonorrhoea, leucorrhoea, seminal
weakness, and paralysis of the bladder. Dose of the powder, from
half a grain to a grain ; of the tincture, from twenty to fifty drops.
Solution of potassa given every hour, in thirty-drop doses, is a
remedy for strangury produced by cantharides. Spanish flies are
used externally, in the form of blistering plaster ; also in the form of
tincture, mixed with various solutions, to produce irritation and red-
ness of the skin.

Spearmint (Mentha Vtridis') This has carminative, diuretic

and antispasmodic virtues. The warm infusion of it is much em-

i
1

878

MKDIOINKS AND THBIR PKBPARATIUNB.

ployed in domestic, pmctice to produce perspinitioii after takinjr col,],
Hud while sufforiiiif from feverish symptoiiiH from various cauHi'n.
The oil of spearmint hiw similar properties with the herh, and nmy
be taken in five- to eight-drop doses, on sugar. One ounee of the oil
of spearmint dissolved in a pint of alcohol, constitutes the essence uf
spearmint.

Spermaceti {Cetaceum'). — This is a white crystalline sulistaiice
obttiined froni the head of the spermaceti whale. In househeld prac-
tice, it is considerably used for the coughs 'ind 'iolds of children,
\mng generally simmered with molasses or wUte sugar. It forms a
part of several cerates and ointments.

Spider's Web (^Tela Aranecp). — The web of the black or brown
spider, gathered in barns, cellars, etc., is sometimes given in fivi- or
six-grain doses, in pill form, and it is said with good effect, in peri-
odical headache, hysterics, St. Vitue's dance, asthma, and fever and
ague. It is likewise applied externally to check bleeding. Care
shouh' ''« taken to have it clean and free from dust.

Spirit of Nitric Ether (^Spirittia j^Etheris Nitrici). — The general
reader will know this article better under the name of sweet spirttn of
nitre. It is diuretic, diaphoretic, antispasmodic and stimulant, and
in large doses, a narcotic poison. It is much used in diseases of the
urinary organs, either alone or combined with sedatives, and other
diuretics. Dose, from twenty to thirty drops, to be taken in water,
three or four times a day.

Sponge (^Spongia). — When burned, this is used as an alterative in
scrofula, scrofulous tumors, goitre, and obstinate diseases of the skin.
It is much employed by homoeopathic physicians, though it has much
less remedial power than iodine. Dose, one to two drams, mixed
with honey or syrup.

Spurred Rye (Secale Gomutum). — This is a diseased product of
rye, known by the name of ergot. This article has a peculiar effect upon
the womb, causing it to contract with great energy, when given in full
doses. It should never be given, however, continuously, for a great
length of time, as it has been known, when so used, to produce dry
gangrene, typhus fever, and nervous disorders connected with con-
vulsions. Such were its effects in certain provinces of P^rance, in
consequence of the use of rye bread contaminated with it. It is use-
ful in excessive uterine hemorrhage, which it arrests by causing the
womb to contract, and thus to condense its tissue and close up its
bleeding vessels. It has also been successful in bleeding from the
lungs.

PreparatioiiH. — Fluid extract, dose, half a dram to a dram; tinc-
ture, four ounces to a pint of diluted alcohol, dose, two and a half to
five dmms j infusion, dose, one to two ounces ; wine, five ounces of

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MEDICINES AND THEIK PREPARATIONS.

879

fluid e3:tract to a pint of sherry wine, dose, two to thi-ee drams, in
cases of labor ; for other purposes, one to two drams.

Squill {Seilla Maritima), — A perennial plant growing in coun-
tries on the Mediterranean. In large doses it is emetic and purga-
tive ; i:,! small doses expectorant and diuretic. It is used in pulmonary
affections to increase expectoration, and in dropsical complaints to
augment the secretions of the kidneys. Dose of the dried root, one to
five grains, generally to be united with nitre or ipecac.

Preparations. — Fluid extract, dose, as an expectorant and diuretic,
two to six drops ; as an emetic, twelve to twenty drops; compound
fluid uxtl^ct, dose, ten to twenty drops ; tincture, two ounces to a
pint of diluted alcohol, dose, twenty to thirty drops ; syrup, dose,
a quarter to half a dram.

StarsQrass (^Aletri» Farinom, Fig. 236). — This plant is found in
dry soils throughout most parts of the United
•States, and called uniconirroot^ ague-root, and
crow-corn. The root is an intensely bitter tonic,
and is used to improve the tone of the stonnch,
and for flatulent colic and hysterics. It is said
also to give tone to the female generative organs,
affording a protection against miscarriage. Tlie
Eclectics call it one of their best agents in chlo-
rosis, suppressed menstruation, engorgement and
falling of the womb, and painful menstruation.
Dose of the powdered root, from five to ten
grains, three times a day.

Preparations. — Fluid extract, dose, ten to
twenty drops ; tincture, two ounces to a pint of ^'°- ^^- stah-gkabb.
diluted alcohol, dose, half a dram to a dram ; infusion, two drams to
a pint of water, dose, one or two ounces ; syrup, dose, one to two
drams ; aletiidin, the active principle, dose, one to three grains.

St. Ignalius' Bean (^Faba 3ancH IgnatW). — The seeds are the
part used, and are the product of the Ignatia Amara, — a tree of
middle size, growing in the Philippine Islands, and is a species of the
istrychnoa. These seeds possess a large amount of strychnine, and
consequently, in medicinal doses, are a pov/erful nervine tonic, and
are used for improving the digestive functions, and for rousing and
strengthening the whole system when prostrated by nervous com-
plaints.

Preparations. — Fluid extract, dose, five to ten drops ; solid ex-
tract, dose, half a grain to a grain and a half.

Storax (^Styrax Officinale). — This is the hardened juice of the
storax, a native of the countries along the Mediterranean. It is a
stimulant and expectorant, and is used for chronic bronchitis, laryn-
gitis, and cough. The liquid storax is sometimes employed instead

fii,

'■' >

I ,\ «,l^*MI|ilJ|i| f

8M MEDICINES AND THEIR PREPARATIONS.

of copaiba in gonorrhoea and gleet. The dose is from ten to Pfteen
grains. Storax is a constituent in the compound tincture of benzoin.

Stramonium (Datura Stramonium, Fig. 287).— This annual
plant is most known in this country by the
name of Jamestown iveed ; in England by that
of thomapple. The leaves and seeds are med-
icinal. Stramonium is a powerful narcotic ; it
is also antispasmodic, anodyne, and sedative.
It is used in various nervous affections, as
chorea, epilepsy, palsy, tetanus, and mania.
It is much used for relieving acute ^ains, etc.
Taken in large doses, it is a powerful poison.
Preparations. — Fluid extract, dose, five to
Fio. 237. 8TBAM0NIUM. fif^gn drops ; solid extract, dose, half a grain
to a grain ; tincture, two ounces to a pint of alcohol, dose, half a
dram to a dram, and to be gradually increased. Use w ith care.

Sulphur. — This is considerably used in medicine, being laxative,
diaphoretic, and resolvent. It is chiefly used for piles, chronic rheu-
matism, gout, asthma, and those affections of the breathing organs
not attended with acute inflammation. Externally and internally,
it is much employed in skin-diseases, particularly for itch, for which
it is a specific. In these affections, it is frequently applied in the
form of sulphur baths. The dose of sulphur is from one to three
drams, mixed with syrup, molasses, or milk. When sublimed,
this article is called flowers of sulphur, which is the form in which
it is chiefly used in medicine.

Sumach (^Bhus Glabrum}. — Found in almost all parts of the
United States in old, neglected fields, and by the side of fences. The
bark and berries are astringent, tonic, antiseptic, and diuretic, and
are used in diarrhoea, dysentery, gonorrhoea, whites, hectic fever,
and scrofula. The berries make a valuable gargle in quinsy and
ulcerations of the mouth and throat, and also a useful wash for
ringworm, tetter, and ulcers. The excrescences' which grow upon
the leaves have nearly as much astringency as galls, and when pul-
verized and mixed with lard, have a similarly soothing effect upon
piles.

Preparations — Fluid extract, dose, one to two drams; tincture,
four ounces to thirteen ounces of diluted alcohol, dose, half an ounce
to an ounce.

Sunflower (ffelianthus Annuus) The seeds and leaves of this

plant are expectorant and diuretic, and are useful in several
pulmonary affections. The seeds yield a fixed oil, in which their
\^ ' medicinal virtues are chi(jfl3' found. In doses of t.n or fifteen drops,

this oil acts favorably upon inflamed mucous surfaces, and in doses
twice as large it greetly augments the flow of uriae.

MEDICINES AND THEIR PREPARATIONS.

sai

ten to Pfteen
ire of benzoin.

This annual
juntry by the
gland by that
leeds are med-
il narcotic ; it

and sedative.

affections, a.s
3, and mania,
ute ^ains, etc.
.^erful poison.
I, dose, five to
}, half a grain
, dose, half a
ith care.

•eing laxative,
chronic rheu-
ithing organs
ad internally,
tx;h, for which
pplied in the
I one to three
len sublimed,
oTva in which

parts of the
f fences. The
diuretic, and
hectic fever,
1 quinsy and
ful wash for
sh grow upon
nd when pul-
r effect upon

ms; tincture,
half an ounce

eaves of this

in several

n which their

fifteen drops,

and in doses

Swamp Dogwood (^Gornvs Sericea). — This is found in damp
places, and along the banks of rivers, in various parts of our cotintry,
and is known as red osier,, red willow and rose willow. The bark is
tonic, stimulant and astringent, and has been used for similar pur-
poses with dogwood-bark ; it is well spoken of, also, for dyspepsia,
diarrhoea, malignant fevers, and as an external application to foul
and ill-conditioned ulcers. Dose of the powdered bark, from
twenty to fifty grains; of the infusion, from two to three fluid
ounces.

Swamp Milkweed (Asclepias Incamata). — This is a native of
the United States, and bears red flowers from June to August. It
has the name of white Indian hemp. The root is emetic, cathartic,
and diuretic, and is useful in asthma, bronchitis, rheumatism, syphilis,
and worms.

Preparations. — Fluid extract, dose, twenty to thirty drops ;
solid extract, dose, three to five grains ; tincture, two ounces to a
pint of diluted alcohol, dose, one and a half to three drams ; infu-
sion, dose, three to five drams ; syrup, four ounces fluid extract to
twelve ounces simple syrup, dose, half a dram to a dram.

Sweet Fern (Comptonia Asplenifolia^. — This shrub, growing in
stony pastures in New England and Virginia, is tonic, astringent,
alterative and aromatic, and is used in diarrhoea, dysentery, cholera-
infantum, rheumatism, and debility after fevers. Dose of the decoc-
tion, from one to three fluid ounces, three or four times a day.

Sweet Flag {Acorus Calamus). — Found in damp places, in most
parts of the world. The root is stimulant, tonic, and aromatic;
useful in wind colic, weakened conditions of the stoibach, and dys-
pepsia. Dose of the root, from twenty to sixty grains ; of the infu-
sion, from two to three fluid ounces.

Sweet Gum {Liquidamher Styraciflua'). — This tree grows in the
Middle and Southern States. Being wounded, it yields a yellowish-
white, honey-like balsam, which hardens into a gum. This, melted
with equal parts of lard or tallow, forms an ointment which is used
in some parts of the country for piles, ringworm of the scalp, fever-
sores, and other complaints. Used internally, it has very neany
the same effects as storax.

Tag Alder (Alnus Rubra). — This shrub grows in swamps and
other damp places, in northern United States. The bark is altera-
tive, emetic, and astringent. It is used in scrofula, secondary
syphilis, herpes, impetigo, and other skin-diseases.

Preparations. — Fluid extract, dose, one to two drams ; ' infusion,
two ounces to a pint of water, dose, one to one and a half ounces ;
alnuin, the active principle, dose, one to two grains.

Tansy (^Tanacetum Vvlgare) — Tansy is a perennial herb, having
tonic, emmenagogue, and diaphoretic properties ; the cold infusion

882

MEDICINES AND THEIR PREPARATIONS.

■ :.'^

being tonic, and useful in dyspepsia, wind in the stomach, jaundice,
and worms ; the warm infusion, diaphoretic and emmenagogue.
Dose of the infusion, from one to three fluid ounces, two or three
times a day.

Tar (Pix Liquida). — The medicincil qualities of tar are like those
of turpentine, and it is sometimes used in old chronic coughs and
bronchitis. The vapor of boiling tar was once thought to be very
serviceable in bronchial diseases, when inhaled. Doubtless it is
useful in some cases, but its virtues have been extolled above their
merits. In the form of ointment it has real efficacy in scald head
and tetter.

Thimbleweed (JRudbeckia Laciniata). — The whole of ohis herb
is balsamic, diuretic, and tonic, and in the form of decoction, used
freely, is said to have been found useful in some urinary complaints,
as Bright's disease, strangury, etc.

Tobacco {Nicotiana Tahaoum). — The leaves of tobacco are acrid,
narcotic, and poisonous, and are chiefly used in the form of oint-
ment, in skin diseases, etc. Its poisonous qualities, however, render
it dangerous when much used, even externally. Nervous people
should not smoke. Chewing is not only an unhealthy, but a dis-
gusting habit.

Trailing Arbutus (Upigicea Repens). — This grows in sandy
woods and rocky soils, its flowers appearing in early spring, and ex-
haling a spicy fragrance. The leaves are diuretic and astringent,
and are very useful in gravel, and most diseases of the urinary
organs, being regarded in some cases superior to uva-ursi and buchu.

Preparations — Fluid extract, dose, one to two drams ; infusion,
dose, two to three ounces.

Tapioca (Janipha Manihot, Fig. 238). — This plant grows in the
West Indies and Brazil. It is cultivated
chiefly on account of the root, which is large-
ly used as an article of food, particularly for
the sick, or rather for those recovering from
sickness. The starch which it contains is
separated by washing, scraping, grating, and
grinding, and is in the form of hard, white,
rough grains. It is prepared for use by boil-
ing; ?,nd, in debility and low forms of disease,
may have tte addition of wine, nutmeg, or
other aromatics.

Fio. 888. TAPIOCA.

Tulip Tree (Liriodendron Tulipifera) . —
This is a large and elegant tree growing in
many parts of the country, and called poplar and white poplar.
The bark of the root is aromatic, stimulant, and tonic, and in warm
infusion, diaphoretic. It is used in fever and agra, chronic rheuma,-

MEDICINES AND THEIR PREPARATIONS.

883

lach, jaundice,

iinmeuagogue.

two or three

• are like those
ic coughs and
ht to be veiy
}ubtless it is
jd above their
in scald head

B of chis herb
ecoction, used
ry complaints,

acco are acrid,
form of oint-
Dwever, render
3rvou8 people
hy, but a dis-

)W8 in sandy
pring, and ex-
id astringent,
: the urinary
•si and buchu.
kins ; infusion,

grows in the
is cultivated
vhich is large-
articularly for
overing from
contains is
, grating, and
f hard, white,
)r use by boil-
:ms of disease,
le, nutmeg, or

'hilipifera). —
e growing in
white poplar.
and in warm
ronic rheuma-

tism, and chronic diseases of the stomach and bowels. Dose of the
powdered bark, from a scruple to two drams ; of the infusion, from
one to two fluid ounces.

Turkey Corn {Corydalis Formosa). — This perennial plant is
called wild-turkey pea and »tagger^weed, and grows in rich soils in
the Southern arul Western States. The tuber, which is the medicinal
part, should only be collected when the plant is in flower. It is tonic,
diuretic, and alterative. It is much valued do « remedy in syphilis
and scrofula.

Preparations. — Fluid extract, dose, ten to thirty drops ; tincture,
three ounces to a pint of diluted alcohol, dose, half a dram to two
drams ; corydalin, the active piinciple, dose, half a grain to a grain.
A valuable alterative for syphilis is made by uniting eight grains of
corydalin with ten grains of hydi-astin, and dividing into twelve
powders. Dose, one powder three or four times a day.

Turmeric (CwrcMwa Longa"). — This is a native of the East Indies
and Cochin China. The root is a stimulant aromatic and tonic,
somewhat like ginger, employed in debilitated states of the stom-
ach, etc.

Preparations. — Fluid extract, dose, two or three drams ; tincture,
two ounces to twelve ounces of diluted alcohol, dosf one and a half
to two ounces ; infusion, dose, two to four ounces.

Valerian ( FaZer«a«rt Officinalis). — This is a European plant,
flowering in June or July. The root is tonic, nervine, and antispas-
modic, and is much used in cases of iiregular nervous action, partic-
ularly morbid nervous vigilance, or hypochondria, epilepsy, lowness
of spirits, and nervous headache.

Preparations Fluid extract, dose, half a dram to a dram ; solid

extract, dose, three to eight grains ; tincture, four ounces to a pint
of diluted alcohol, dose, two to tlu-ee drams ; infusion, half an ounce
to a pint of water, dose, two to three ounces ; syrup, four ounces of
fluid extract to \ pint of simple syrup, dose, two to three drams.

Vervain (^Verbena ffastata}. — A perennial plant, common in the
United States. The root is tonic, emetic, expectorant, and sudorific.
It is used in intermittent fevers, colds, and obstructed menstruation,
in the form of warm infusion. The cold infusion is a good tonic in
loss of appetite, debility, etc. Dose of the powdered root, one or two
scruples ; of the infusion, from two to three ounces, three or four
times a day.

Vinegar (Aeetum) This is refrigerant, diuretic, astringent, and

tonic ; used in fevera and inflammatory complaints, likewise in 8cui"vy
and typhus, as an antiseptic. It has been found useful in dysentery
and scarlet fever, saturated with common salt. Externally, it is ap-
plied to bruises, inflammations, sprains, and swellings. It sometimes
hfis a good effect as a gargle in putrid sore throat, etc., and as a
cooling wash in headache during fevers.

884

MKUIOINES AND THKIK I'KKI'AltATIONS.

Virsinia Snake-root (^Arittolochia Serpentaria^ Fig. 289). — Tliis
is a perennial lierb of the Middle and Southern States. The root is
stimulant, tonic, and diaphoretic. It is used in typhoid fevers, when
the system needs support, but cannot bear active stimulation. Com-
bined with Peruvian bark, it is also used in intermittent fevers. The
cold infusion is employed in some forms of dyspepsia ; likewise as a
gargle in malignant sore throat.

Preparations. — Fluid extmct, dose, one-quarter to half a dram ;
tincture, thiae ounces to i pint of diluted alcohol, dose, one to two
drams ; infusion, half an ounce to a pint of water, dose, one to two
ounces, in low forms of fever. The following is a good compound
tincture : half an ounce each of fluid extract of snake-root, fluid ex-
tract of ipecac, fluid extract of saffron, fluid extract of ladies' slipper,
together with half an ounce of camphor, and one and a half pints of
diluted alcohol ; dose, a dram to a dram and a half.

VM. 239. VlKGIMIA SNAKK KOOT.

FlO. 240. Watbh-Hobehounu.

Water-Horehound (Fig. 240). — This article has been described
under Bugle-Weed (Lycopus Virginicus). See Bugle-Weed.

Water-Pepper (^Polggonum Punctaturn). — This annual plant is
called smartr^eed, and grows throughout our country, in low grounds,
and along ditches and brooks. It has a pungent, biting taste, and is
stimulant, diuretic, emmenagogue, antiseptic, and vesicant. It is
used in coughs, colds, gravel, and womb-complaints.

Preparations. — Fluid extract, dose, ten to forty drops ; solid
extract, dose, two to three grains ; tincture, four ounces to a pint of
diluted alcohol, dose, half a dram to two drams ; infusion, half an
ounce to a pint of water, dose, half an ounce to an ounce.

Wahoo (Muonymu^ Atropurpureus). — A small shrub growing
in woods in many parts of the United States. The bark of the root
is a bitter tonic, laxative, alterative, diuretic, and expectorant, and is
advantageously used in pulmonary affections, dropsy, constipation,
torpidity of the liver, dyspepsia, and intermittent fevers.

MKTITClTnilfl AND THKIR PRRPAKATI0N8.

88r.

r. 239).— This
1. The root is
id fevers, when
Illation. Com-
nt fevers. The
; likewise as a

I half a dram;
se, one to two
se, one to two
ood compound
i-root, fluid ex-
' ladies' slipper,
a half pints of

BB-HOBEHOUND.

been described
-Weed.

nnual plant is
in low grounds,
ng taste, and is
/^esicant. It is

J drops ; solid
ces to a pint of
'usion, half an
ince.

shrub growing
ark of the root
lectorant, and is
J, constipation,
srs.

Preparationa. — Fluid extract, dose, one to two drams ; tinctuns
four ounces to twelve ounces of diluted alcohol, dose, half an ounce
to an ounce.

Wax. — The yellow and white wax are chietly used as ingredients
of plastera and ointments.

White Hellebore {Veratru,ii Album). — This is a European
perennial plant, the root of which ia a violent emetic and purgiitive,
and in large doses is poisonous ; not often used, except externally,
in the fonn of ointment or decoction, for the cure of itch and some
other skin-diseases.

White Oak (Quercus Alba'). — The inner hark of the white oak
is astringent, tonic, and antiseptic, and has been used in intermit-
tent fever, chronic diarrhoea, chronic mucous discharges, and passive
hemorrhages. As a wash aj)plied externally it sometimes arrests
night-sweats, and as an astringent gargle and injection its use is com-
mon for relaxed palate, spongy gums, leui.* rrhauv falling of the
bowel, etc.

Preparations. — Fluid extract, dose half a dram to a dram ; solid
extract, dose, ten to fifteen grains; tincture, two ounces to a pint of
diluted alcohol, dose, half an ounce to an ounce.

White Pond-Lily (iV//mpA(Bof Odoratd). — This grows in ponds
and marshes in many parts of our country. The root is demulcent,
anodyne, astringent, and alterative ; used in dysentery, diarrhcea,
gonorrhoea, whites, and scrofula. An infusion is sometimes used as
a gargle in ulcei"s of the mouth and throat, and as an injection in
leucorrhoea. Dose of the infusion, from two to three fluid ounces.

Wild Cherry (Prunus Virginiana). — This tree grows extensively
in the American forests, flourishing wheie tlie soil is fertile and the
climate temperate. The inner bark is tonic and stimulant to the
digestive organs, and -sedative to the nerves and the circulation. It
is much used in consumption, scrofula, and dyspepsia.

Preparations. — Fluid extract, dose, two to three drams, compound
fluid extract, dose, half a dram to a dram ; infusion, half an ounce
to a pint of water, dose, one ounce ; syrup, three ounces of fluid
extract to thirteen ounces of simple syrup, dose, two drams to an
ounce.

Wild Cucumber (^MomordicnMaterium). — This, sometimes called
squirting cucumber^ is a native of the south of Europe, and is culti-
vated in Great Britain. It is a powerful hydragogue cathartic, and
in large doses causes nausea and vomiting. On account of the
watery stools it produces it is much used in dropsical complaints,
though the severity of its action foibids its being used alone. Dose,
a quarter to half a grain, repeated every hour till it operates ; of
elaterin, from a sixteenth to a twentieth of a grain, given in solution.

88fi

MEDICINEH AND THEIR PHEPAUAT10N8.

'■^^N '

Wild Qinger (^Amruiii (^anadeiMP) — This JH known by tho iiivineM
of roUitfoot and Cunaitii xnake-roof, nml is common in all parts of tlif
country. The root is tonic, stimulant, aromatic, expectorant, and
dia|)horotic. It is used in pains of the stomach, colic, etc. Dose of
the powder, half a dram ; of the; tincture, half a dram to two drams.

Wild Indigo (^Bapiuia Tinctnriu, Fig. 241). — This perennial
sliriil) is found in most j)art« of the country.
The hark of the root is purf>;ative, emetic, stimu-
lant, astrinjvent, and antiseptic. It is chiefly
used for its antiseptic [jroperties. For external
ust^ it is viilnahle as a wtush oi' gargle for vaiious
uhjcrs, nien^vuial sore mouth, and scrofulous
and syph'litic ophthalmia.

PrvparatlonH. — Fluid extract, dose, a quarter
to half .'• dram ; tincture, two ounces to a pint of
diluted alcohol, dose, two to four drams ; infu-
sion, (lose, half an ounce; baptisin, the active
Fio. 241. WILD iNwdo. p,.i„eiple, a quarter to half a grain ; gargle, four
ounces of fluid extract tt) "twelve ounces of water, to be used as
occasion requires. . .

Wild Yam {Dioxcorea ViUom). — A perennial vine, Ton nd mostly
at the South. The root is antispasmodic, and is successfully used in
bilious colic. It is said to bring relief in the most violent Ciiscs of
this complaint. It allays nausea and spasms during pregnancy. It
is given in the form of decoction, two or three fluid ounces every
thirty or forty minutes. Dose of the tincture, from a quarter of a
dram to a dram ; of dioscorein, the active princi[)le, one to three
grains.

Willow {iSalLr Alba). — The willow is common in Europe and
America. Its bai-k is tonic and astringent, and is used, occasionally,
as rt substitute for Peruvian bark in intermittent fever. It is also
(Mnployed in the treatment of chronic diarrhoea and dysentery.
Uose of the powdered bark, one dram ; of the decoction, one to two
fluid ounces. Salicin, the active prino'.ple, is given, sometimes, in
place of quinine ; dose, from two to eijht grains.

WIntergreen (OauUheria Prommhenti). — This evergreen grows
in mountsiinous, barren regions, throughout our country. The leaves
are an agreeable stimulan,, aromatic and astringent. Used for
chronic diarrhn;a, and as an emraenapogue. The oil and essence are
useful in flatulent colic ; dose of the oil, from five to eight drops, on
sugar ; of the essence, twenty to thirty drops. Much used to flavor
other medicines.

Witch-Hazel (^HamamellH Virginica, Fig. 242). — This derives its
name from its having fruit and flowers together on the same tree.
It is found in most parts of our country. The bark and leaves are

by tlui iiiunoK
1 partH of the
3ct()i-iint, iiiiii
)tc. Doso ol
o two drams.

lis peronnial
the cou'iitry.

iinctic. Htimu-

It iw chiefly

For extoriial

le for various

1(1 Hcrofulous

ose, a quarter
es tt) a pint of
drams ; infu-
in, the active
; gargle, four
« be used iis

found mostly
sfuUy used in
lent Ciist'8 of
•egnancy. It
ounces every
(juarter of ii
one to three

Europe and
occasionally.
It is also
dysentery.
1, one to two
ometimes, in

rgreen grows

The leaves

Used for

I essence are

ht drops, on

ised to flavor

iLs derives its
same tree,
id leaves are

MEDIOINES AND THKIR PRKPAUATI0N8.

887

tonir, aHtringent and .sedative. It is used in bleeding from the lungs
iinil stomach, and in diarrlxpa, dyst-ntcry,
iiMil excessive mucous discihargos. it is
also used in incipient consumption, and
for Hore mouth, e*';.

PreparntionH. — Fluid extract, dose, one
to two dmms ; infusion, dose, three drams ;
svi'Up. four ounces of lluid extract to twelve
ounces bf simple syrup, dose, one to two
drains.

Wolfsbane (Aeonitum Na/tflliix, Fig.
243). — This haa already been deseiibed
under its other common nuiiie, whieli is
monkshood. See " Monkshood " for its
description.

Wormseed (Ohenopodium AntheJmintunivi) This perennial is

CA\\tidiJeruHalemoak,a.i\(x is found in waste places all over the United
States. An oil is extracted from the seeds, whi?b. in doses of from
three to five drops, morning and evening, for a child, destroys worms.
A strong infusion of the tops has a similar effect. The remedy
should be used four or five days, and be followed by a purge.

FIO. 242. WITCH-HazKL.

Fro. 248. WULFSBANB.

Flo. 244. Wormwood.

Wormwood {Artemisia Absinthium^ Fig. 244). — The tops and
leaves of this perennial are tonic and anthelmintic ; used in inter-
mittent fever, jaundice, and worms. It restores the appetite in a
weakened state of the digestive organ?, and is also useful in amen-
orrhcea. It is excellent applied as a tincture, or in the form of fo-
mentation, to biuises, sprains, and local inflammations.

Preparations. — Fluid extract, dose, one-third to two-thirds of a
dram ; solid extract, dose, three to five grains ; tincture, two ounces
to fourteen ounces of diluted alcohol, dose, two to three drams;

1"*^

888

MEDICINES AND THEIR PKEPARATIONS.

syrup, two ounces fluid extract to six ounces of simple syrap, dose,
one to two drains.

Yarrow (^Achillea Millefolium). — A perennial herb, common to
the Old World and New, and growing in old fields and along fences.
It is tonic, astringent, and alterative, and has been used in intermit-
tent fever, bleeding from the lungs, excessive menstruation, wind
colic, and chronic dysentery. Dose of the infusion, a wineglassful
three or four times a day.

Yeast ( Cerevisice Fermentum). — Yeast is slightly tonic and stim-
ulating, and has been used with advantage in typhoid fever ; also in
scarlet fever, and in all diseases where there is a disposition to
putridity. The dose is from one to two fluid ounces ewery two or
three hours. It makes an excellent antiseptic poultice for imhealthy
and fetid ulcers, especially if combined with powdered slippery ^lm
bark and charcoal. '

Yellow Dock {Rumex Crisjms, Fig. 246). — The root of this
perennial plant is alterative, tonic, diuretic, and deter-
gent, and is regarded as very valuable in the treat-
ment of scrofula, syphilis, leprosy, scurvy, and other
skin diseases.

Preparations. — Fluid exti-act, dose, one to two
drams ; solid extract, dose, four to five grains ; syi'up,
four ounces of fluid extract to twelve ounces of simple
sjrrup, dose, half an ounce to an ounce ; rumin, the
active principle, dose, two to three grains.

Yellow Jessamine ( Qelseminum Sempervirens). —
This abounds in the Southern States, where it is cul-
tivated as an ornamental vine. The root is a power-
ful febrifuge, narcotic and relaxant, conti-oliing and
subduing fever, quieting nervous irritability and ex-
citement, equalizing the circulation, promoting perspiiution, and. recti-
fying the secretions. It is much used by the Eclectics of the West-
ern States, but the general judgment of the profession is that it is
too powerful a remedy to be safe. My own opinion is, that the
American hellebore is equally effective with the yellow jessamine,
and that its general use involves far less danger.

Preparations. — Fluid extract, dose, two to ten drops ; tincture,
four ounces to a pint of alcohol, dose, fifteen to thirty drops, and in-
crease ; gelseminin, the active principle, dose, half a grain to a grain
and a half.

Yellow Ladies' Slipper ( Cypripedium Pubescens'). — This perennial
plant is called American valerian, nerve-root, etc. The fibrous roots
are tonic, nervine, antispasmodic and diaphoretic, and are used in
nervous headache, nervous excitability, hysterics, neuralgia, and St.
Vitus's dance. Dose of the powder, from ten to twenty grains.

Fio. S45.
Yellow Dock.

MEDICINES AND THEIR PREPARATIONS.

889

syrup, dose,

), common to
[ along fences,
i in intermit-
ruation, wind
I wineglassful

)nic and stim-
fever ; also in
disposition to
every- two or
for unhealthy
slippery ^lm

root of this
tic, and deter-
in the treat-
vy, and other

one to two
'rains ; syiup,
ices of simple
; rumin, the

18.

ipermrens). —
here it is cul-
5t is a power-
jntrolimg and
.bility and ex-
tion, andrecti-
of the West-
m is that it is
. is, that the
ow jessamine,

)p8; tincture,
irops, and in-
ain to a grain

rhis perennial
fibrous roots
are used in

algia, and St.

jr grains.

Preparations. — Fluid extract, dose, half a dram to a dram ; solid
extract, dose, five to ten grains ; tincture, two ounces to a pint of
diluted alcohol, dose, half an ounce to an ounce ; syrup, four ounces
of fluid extract to fourteen ounces of simple syrup, dose, two to three
di-ams ; cypripedin, the active principle, dose, two to three grains.

Yellow Parilla (^Menispermum Canadenae). — This is a perennial
plant, grov ing in woods and near streams, throughout the country.
The root has the properties of a tonic, laxative, alterative, and diu-
retic. It is valued in the treatment of scrofula, syphilis, skin dis-
eases, gout, rheumatism, dyspepsia, general debility and chronic
inflammation of the stomach and bowels. Dose of the decoction,
from two to three fluid ounces, three times a day ; of the solid ex-
tract, from two to three grains.

Zinc. — Several preparations of this metal are used in medicine,
as follows: —

Acetate of Zinc (^Zinei Acetas). — This is used as an external
remedy only, generally as an astringent wash for inflammations of the
eye, and as an injection in gonorrhoea, but only after the acute stage
of these diseases has past. The strength of these solutions gen-
erally should be one or two grains to a fluid ounce of soft water.

Chloride of Zinc (Zinci Chloridum). — This is a powerful escharo-
tic, and is epiployed as an external application to cancera and obsti-
nate ulcers. A weak solution of it is occasionally employed in old
chronic gleet, also in whites and purulent discharge from the neck
of the womb.

Iodide of Zinc (^Zinci lodidum). — This is in the form of white
needles, and is tonic and astringent. It is not much used, except
externally, being applied in a solution of twenty grains to a fluid
ounce of water, to enlarged tonsils, by means of a camel's-hair pencil
or a piece of sponge tied to the end of a stick.

Oxide of Zinc (^Zinci Oxidurn). — This is an inodorous white
powder, insoluble in water and alcol il. It is tonic and anti-
spasmodic, and is given in chorea, epilepsy, whooping-cough, and
other similar diseases ; but it is more especially employed to arrest
the night-sweats of consumption, for which purpose we have at
present no other article of equal efficacy. It is sprinkled externally
upon excoriated surfaces, and is used in ointmentM. Dose, from two
to five grains, in the form of pill.

Precipitated Carbonate of Zinc (^Zinci Carbonas Prcecipitas.') —
This is employed for the same purpose as prepared calamine, being
adapted only to external use.

Prepared Calamine (Calamina Prmparata). — This is in the
form of a pinkish or flesh-colored powder, of an earthy appearance.
It is employed only as an external application, being dusted on ez-

illii^"

890

MEDICINES AND THEIK PKEPAKATI0N8.

conations and superficial ulcerations, as a mild astringent. It should
be a very fine powder.

Sulphate of Zinc {Zinei Sulphas). This is a colorless, transpar-
ent salt, crystallizing usually in small four-sided prisms. It is tonic
and astringent, and ui large doses, a prompt emetic. Used as a tonic
in cases of debility attended with irritation. In obstinate intermix
tents, it is sometimes conjoined with sulphate of quinia ; it is chiefly
employed, however, in such spasmodic diseases as epilepsy, chorea
and whooping-cough. As an astringent, it is used externally, being
applied in solution to bleeding surfaces, as a wash in ophthalmia,
and as an injection in whites and chronic gonorrhoea.

Valerianate of Zinc (Zinei Valerianas). — This is in white,
pearly scales, with a faint odor of valerianic acid. It is tonic and
antispasmodic, and is used in the various nervous affections which
accompany chlorosis. Dose, one or two grains, several times a day,
in the form of a pill.

Vaseline {Petrolatum). — This is a transparent, fat-like substance,
obtained in the distillation of crude petroleum. It is very exten-
sively used in the domestic materia medica, in the treatment of colds
and many other ailments. Its eflScacy has been, however, much
overrated, its chief utility being that of a neutral, simple unguent,
and as a vehicle for the application of more active remedies, for
which purpose it is preferable to the animal fats generally employed.

ie~-^

.uiut^'

t. It should

ess, transpar-
It is toniu
led as a tonic
late intermits
; it is chiefly
lepsy, chorea
srnally, being
ophthalmia,

is in white,

is tonic and

ictions which

times a day,

ke substance,
3 very exten-
nent of colds
ivever, much
pie unguent,
•emedies, for
ly employed.

PEEPAKATIONS. - PHARMACY.

The preparation of medicines for use constitutes the art of phar-
macy. It is the peculiar business of the apothecary. It will not be
necessary in these pages to describe liis art, in all particulai-s, but
merely as many of the preparations wliich it is his duty to prepare
as are really needed in the treatment of disease. In doing this, I
shall classify the preparations alphabetically, and begin with

Cerates.

These substances have a degree of hardness midway between
ointmeiitB and plasters. They may be spread iii)C)ii leather or linen,
without the use of heat, and they do not melt and run when applied
to the skin. They are made of wax, or spermaceti, combined with
lard or oil. The articles are melted together by a very gentle heat,
and during the process of cooling the whole should be well stirred.

Calamine Cerate. — Prepared calamine and yellow wax, each
three ounces; lard, one pound. Melt the lard and wax together.
When the mixture begins to thicken, on cooling, gradually stir in the
calamine.

This is called Turner' 8 CeraU, and is useful for burns, excoriations,
superficial ulcers, and sores.

Qoulard's Cerate. — Take of solution of subacetate of lead, two
fluid ounces and a half ; white wax, four ounces ; olive oil, nine fluid
ounces; camphor, half a dram. Mix the wax, previously melted,
with eight fluid ounces of the oil ; remove from the tire, and when
the mixture begins to thicken, gradually pour in the solution of
subacetate of lead, stirring constantly, with a wooden spatula, till it
becomes cool. Then add the camphor, dissolved in the remainder of
the oil.

This is the cerate of subacetate of lead, and is used for excoriations,
inflamed burns, scalds and chilblains, and for eruptions of the skin.
Excellent for blistered surfaces, indisposed to heal.

Half an ounce of this preparation united with half an ounce of
simple cerate, and one dram each of calomel and powdered opium,
makes a very valuable remedy for various eruptions of the skin, of a
local nature.

■■', I

'<M;i' s

892

MKDICINES AND THEIR PRKPARATIONS.

Resin Cerate. — Take of resin, five ounces ; lard, eight ounces ;
yellow wax, two ounces. Melt together with a gentle heat, and stir
till cool.

This is known as hcmlicon ointment, and is used as a gentle stimu-
lant to blistered surfaces, indolent ulcers, burns, scalds ftnd chilblains.

Compound Resin Cerate. — Take of resin, suet, and yellow wax,
each a pound ; turpentine, half a pound ; flax-seed oil, half a pint.
Melt together, strain through linen, and stir till cool.

• This, under the name of Deshler^s salve, is popularly used for sim-
ilar purposes with the resin cerate.

Savin Cerate. — Take powdered savin, two ounces ; resin ce-
rate, a pound. Mix the savin with the cerate, previously softened.
Used as a dressing for perpetual blisters.

Simple Cerate. — Lard, eight ounces ; white wax, four ounces.
Melt together and stir till cool.

Used for dressing blisters, wounds, etc., where it is desirable sim-
ply to preserve the moisture of the part, and to exclude the air.

Spanish Flies Cerate, known as blistering plaster. Take finely
powdered Spanish flies, a pound ; yellow wax and resin, each seven
ounces ; lard, ten oimces. To the wax, resin and lard, previously
melted together and strained, add the Spanish flies, and, by means
of the most gentle heat, keep the mixture in a fluid state for half an
hour, stirring occasionally, then remove the heat and stir till cool.

This can be easily spread without the aid of heat, and is used for
the purpose of drawing blisters. It is now, however, supeiseded in
a great degree by various preparations, composed for the most part
of cantharidin, either dissolved in oil, and applied to the skin by
means of a piece of paper saturated with it, or incorporated with wax
and spread in a very thin layer upon fine waxed cloth, silk, or paper,
constituting the blistering cloth, blistering paper, etc.

Confections, Conserves and Electuaries.

These are soft solids, in which medicinal articles are incorporated
with sugar, syrup, honey, or some other saccharine matter, for the
pui-pose both of preserving the mass, and of rendering the medicine
more palatable and convenient for use.

Aromatic Confection. — Take of aromatic powder, fivp and a half
ounces ; powdered saffron, half an ounce ; syrup of orange-peel, six
ounces ; clarified honey, two ounces. Rub the aromatic powder with
the saffron ; then add the syrup and honey, and beat the whole to-
gether in a mortar till they are thoroughly mixed.

Given in debilitated states of the stomach, as a vehi le for other
medicines. Dose, ten grains.

sight ounces ;
heat, and stir

gentle stimu-
\nd chilblains.

i yellow wax,
, half a pint.

used for sim-

ses ; resin ce-
asly softened.

four ounces.

iesirable sim-
3 the air.

Take finely
n, each seven
d, previously
-nd, by means
te for half an
;ir till cool,
id is used for
superseded in
he most part
I the skin by
ted with wax
iilk, or paper,

ries.

incorporated
atter, for the
the medicine

v^ and a half

mge-peel, six

powder with

the whole to-

le for other

MEDICINES AND THEIR PREPARATIONS.

893

Compound Confection of Catechu. — Take of compound powder
of catechu, five ounces ; simple syrup, five fluid ounces. Add the
syrup gradually to the powder, and mix them well.

To be given in diarrhoea and chronic dysentery, in the dose of half
a dram to a dram.

Confection of Senna, otherwise called lenitive electuary. Take of
senna, eight ounces; coriander seeds, four ounces; bruised liquorice-
root, three ounces; figs, a pound; pulp of prunes, pulp of tamarinds,
pulp of purging cassia, each, half a pound ; refined sugar, two pounds
and a half ; water, four pints. Rub the senna and coriander together
and separate ten ounces of the powder with a sieve. Boil the residue
with the liquorice-root and figs, in the water, to one half ; then press
out the liquor and strain. Evaporate the strained liquor, by the
most gentle heat, to a pint and a half ; then add the sugar and form
a syrup. Lastly, rub the pulps with the syrup, added gradually, and,
having thrown in the sifted powder, beat all together till well mixed.

This is a pleasant and admirable laxative, being well adapted to
the habitual costiveness of pregnant women, and those affected with
piles ; for this latter purpose, it is still better combined with cream
of tartar and sulphur, as described in No. 6 of the prescriptions.

Decoctions.

These are solutions of vegetable medicines, obtained by boiling
them in water. They differ from infusions, in being subjected to a
greater degree of heat, the water during their preparation being kept
up to the boiling point. The process should bb conducted in a
covered vessel, and the boiling must not be continued for a very long
time. ^Medicines whose active principle is volatile are not proper
for decoctions, the active principle being driven off by heat and lost.

The usual proportion of vegetable substances used in making de-
coctions is one ounce to a pint of water, and the dose of the decoction,
from one to three ounces.

Essences.

These are generally prepared by dissolving one ounce of the
essential oils of plants in one pint of alcohol. The oils of lemon,
peppermint, sassafras, etc., are made in this way, and their properties,
of course, are similar to the oils from which they are prepared. They
are generally taken in a little sweetened water, in doses of ten drops
to a teaspoonful.

Extracts.

These are soft solids, obtained by evaporating the tinctures, or
solutions, of vegetable substances. The active principles of dried
vegetables can only be extracted by some liquid ; this, for prepariii;^

804

MSDICINES AND THEIK PUEPAKATIONS.

extracts, is either water or alcohol, or a mixture of the two. Those
obtained by the use of water are called aqueouy or watery extracfs ;
those by means of alcohol, alcoholic extracts ; and those by both
alcohol and water, hydro-alcohol extracts. . '^

Fluid Extracts.

These are concentrations, into a small bulk,Jn liquid form, of
the active principles of medicinal substances. They are a valuable
class of remedies, being in some wuses preferable to tinctures, having
less alcohol : and better than extracts or decoctions, because not ho
often injured by heat in their preparation, and not requiring to be
taken in large doses. Great skill is required in their preparation,
and they should always be obtained from those who have the repu-
tation of making reliable articles.

• : r Fomentations.

Fomentation is a sort of partial or local hot bath, and consists
either in the application of cloths dipped in hot water, or some hot
medicated decoction, and applied to the affected oart, or of bitter or
anodyne herbs steeped in vinegar or water, and tnen, while hot, en-
closed in a muslin bag, and laid upon the diseased place. In either
case, whether the cloths wet in a decoction of the herbs, or the herbs
themselves, slightly steeped, be applied in a bag, the application
should be as hot as can be borne, and not so moist as to wet the bed
or clothes of the patient.

Fomentations act by their warmth and moisture chiefly: and
8lightl3% in some cases, by their medicinal virtues. Their object is
to lessen pain and inflammation, by relaxing the parts, and relieving
tension and spasm. They may be prepared from equal parts of hops,
tansy, and wormwood, or from equal parts of hops, lobelia, and stra-
monium, etc., etc.

, Infusions.

Those made of one article only are sufficiently referred to in pre-
vious pages. It will only be necessary here to insert such compound
infusions as are deemed important.

Compound Infusion of Catechu. — Take of powdered catechu
half an ounce, bruised cinnamon a dram; boiling water a pint; mace-
rate for an hour in a covered vessel, and strain. An elegant mode
of administering catechu. Dose, from one to two fluid ounces three
or four times a day.

Compound Infusion of Qentian. — Take of bruised gentian half
an ounce ; dried oninge-peel and coriander-seeds, bruised, each a dram ;
diluted alcohol, four fluid ounces ; cold water, twelve fluid ounces.

MEDICINES AND THEIR PREPARATIONS.

895

e two. Those
itery extractx ;
hose by both

iqaid form, of
ire a valuable
ictures, having
•ecause not so
squiring to l)e
r i)reparation,
lave the repu-

i, and consists
', or some hot
or of bitter or
while hot, en-
ice. In either
», or the herbs
he application
to wet the bed

chiefly : and

!'heir object is

and relieving

parts of hops,

lelia, and stra-

rred to in pre-
iich compound

iered catechu
ri pint; mace-
elegant mode
i ounces three

i gentian half
I, each a dram ;
fluid ounces.

First pour on the diluted alcohol, then, three hours afterward, the
water. Let the whole stiind twelve houre, and strain. An excel-
lent foi-m for using gentian. Dose, one fluid ounce three or four
times a day.

Compound l.ifusion of Qeranium. — Take of geranium root,
sweet bugle-leaves, golden-seal root, witch-hazel bark, each, in coarse
powder, one ounce ; boiling water, four pints. Mix, and allow all
to stand in a covered vessel two hours, applying a gentle heat;
then strain. Two drams of alum may or may not be added.

Used in chronic diarrhoea and dysentery, in one or two tablespoon-
ful doses, every two or three houra ; also as an injection in gleet,
whites, falling of the bowel, etc. ; and as a gargle in ulcerations of
the mouth and throat.

Compound Infusion of Parsley. — Take of parsley roots and
seeds and subcarbonate of iron, each two ounces ; horseradish-root,
one ounce ; squill, juniper-l>erries, white mustard-seed, mandrake
root, and queen of the meadow root, each half an ounce ; coaraely
bruise these articles, and place them in boiling cider, and expose
them for twenty-four hours to a very gentle heat, in a covered earthen
vessel. The cider should be sparkling and tart. Let the articles
stand in the cider.

Useful in dropsy. Dose, one or two fluid ounces three or four
times a day.

Compound Infusion of 5enna. — Take of senna and manna, each
one ounce ; jalap, <jream of tartar, and caraway seeds, bruised,
each two drams ; boiling water, one pint. Add all the ingredients
to the water, in a covered vessel, and let them stand twelve hours.
Then add four ounces of elixir salutis.

This is a valuable, and not disagreeable, gentle jthysic for various
purposes. Dose, from one to three ounces.

Compound Infusion of Trailing: Arbutus. — Take of queen of
the meadow root, dwarf-elder bark, marshmallow root, and trailing
arbutus, each, coarsely bruised, half an ounce ; add to them one pint
of boiling water and one pint of Holland gin, and steep by the fire
four hours, in a closely covered vessel. Strain, and sweeten with
honey.

Excellent for gi-avel, suppression of urine, scalding of urine, and
various other disorders of the uiinary organs. Dose, from an ounce
to a winegliissful, with more or less frequency, according to the ur-
gency of the case.

Injections. — Chjsters.

These are preparations to be introduced into the lower bowel by
means of a syringe. A sufficient number of them are given among
the recipes. It is not necessary to repeat them here.

896 MBDIOINKti AND THEIR PREPARATIONS.

Liniments.

T7r»*?E are liquid preparations, generally a little thicker than water,
and thinner than oils, intended only to be applied to inflamed, piiin-
ful, 01- swelled parts. They are designed to soothe, or quiet, or
stimulate, or make red the part to which they are applied ; and are
rubbed on with the hand, or a piece of flannel or cotton, and fre-
quently in connection with heat, by sitting or standing before a
fire.

A large number of liniments are given under the head of recipes.
To those I add a few valuable ones here.

Camphor Liniment. — Take six drams of camphor, and dissolve it
in one fluid ounce of chloroform, and add to this one fluid ounce of
olive oil.

For Bpiains, neuralgia, rheumatism, etc.

Compound Camphor Liniment. — Take two ounces and a half
of camphor, a fluid dram of oil of lavender, seventeen fluid ounces
of alcohol, and three fluid ounces of strong solution of ammonia,
dissolve the camphor and oil in the alcohol ; then add the ammonia,
and shake till they are mixed.

To be used as a rubefacient and anodyne for local pains, particu-
larly rheumatism.

Compound Liniment of Ammonia. — Take five fluid ounces of
strong water of ammonia, two fluid ounces of tincture of camphor,
and one fluid ounce of spirit of rosemary. Mix them well together.

This is used as a prompt and powerful rubefacient, or even vesi-
catory, in neuralgia, rheumatism, gout, spasms, and inflammations.

Croton Oil Liniment. — Take one fluid ounce of croton oil and
seven fluid ounces of oil of turpentine. Mix, and shake them well
together.

A good rubefacient and pustulating preparation to apply to the
chest and other parts.

Liniment of Opium. — Take six ounces of Castile soap, an ounce
and a half of opium, three ounces of camphor, six fluid drams of oil
of rosemary, and two pints of alcohol. Macerate the soap and opium
in the spirit for three days ; then filter, and add the oil and camphor,
and shake briskly.

This is a useful anodyne and rubefacient liniment for bruises,
sprains and pains of a rheumatic and gouty nature.

Liniment of Spanish Flies. — Take an ounce of powdered Span-
ish flies, and half a pint of oil of turpentine. Mix, and apply gentle
heat to them, in a covered vessel, for three hours. Then strain.

Employed with advantage externally in the sinking stage of ty-
phoid fevers. If so powerful as to cause blistering, it may be weak-
ened by adding flax-seed or olive oil.

.-:T>i-»r< ?i^<Vf ^■•^"v«*»w»«*»"-y^ Xl^Kl^lGCA

MUDICINKB AMD THKIU PREPARATIONS.

897

jker than water,
inflamed, paiii-
le, or quiet, or
)plied ; and are
Botton, and Tre-
nding before ii

[lead of recipes.

*, and dissolve it
I fluid ounce of

ices and a half
en fluid ounces
on of ammonia,
d the ammonia,

I pains, particu-

fluid ounces of
lire of camphor,
n well together,
it, or even vesi-
inflaramations.

croton oil and
ihake them well

to apply to the

e soap, an ounce
iiid drams of oil
) soap and opium
oil and camphor,

aent for bruises,

powdered Span-
and apply gentle
Then strain,
ing stage of ty-
it may be weak-

Llniment of Turpentine. — Take half a pint of oil of turpentine,
and a pound of resin cerate. Melt the cerate, and add the oil to it,
mixing them well.

This is a valuable remedy for scalds and burns, and should be
applied soon after the accident, and be discontinued when the inflam-
mation excited by the fire < removed. The buined or scalded sur-
face should be covered with lint wet with the liniment. •

Opodeldoc. — Take three ounces of white bai- soap, sliced, an
ounce of ca iphor, a fluid dram each of oil of rosemary and oil of
origanum, and a pint of alcohol. Digest the soap in the alcohol by
means of a gentle heat until it is dissolved ; then add the camphor
and oils, and when they are dissolved pour the whole into broad-
mouthed vials.

This is the camphorated soap liniment, and is used as an anodyne
application to sprains, bruises, painful tumora, ate.

Medicated Waters.

Those preparations consisting of \vater impregnated with some
medicinal substance are called medicated watera. They are pre-
pared from volatile oils by triturating in a mortar a dram of the oil,
more or less, with a small quantity of carbonate of magnesia, and
then very gradually pouring on one quart of water, while the tritura-
tion is continued. At last the preparation is filtered through paper.
The quantity of oil, magnesia, and water, used for each preparation,
is as follows :

Oil of bitter almonds, sixteen minims; carbonate of magnesia, a
dram ; water, one quart.

Oil of cinnamon, half a fluid dram ; carbonate of magnesia, a
dram ; water, one quart.

Twenty minims of oil of roses, a dram of carbonate of magnesia,
and one quart of water.

Oil of fennel, half a fluid dram ; carbonate of magnesia, a dram ;
water, a quart.

Peppermint-water, speai-mint-water, and pennyroyal-watei, are
all prepared from the same quantities of their several oils as cinna-
mon-water.

The dose of these waters is half a fluid ounce to two fluid ounces,
except the bitter almond water, which if one or two fluid drams.

Camphor Water — Take two drams of camphor, forty minims of
alcohol, four drams of carbonate of magnesia, and one quart of
water. Rub the camphor first with the alcohol, afterwards with the
carbonate of magnesia, and lastly with the water, gradually added.
Then filter through paper.

^ ' ii^-ifmii^'mi.ie^& ' .d:.:,^ !^

898

MKUICINES A..D THEIK PKEPAKATI0N8.

Medicated Wines.

Wines are used in making certain preparations, because the al(!o-
hol they contain will extract from plants, etc., some medicinal pioi)-
erties which water will not, and at the same time is less timulutiiig
than the tinctures, etc., made from alcoholic spirit*.

Compound Wine of Comfrey ( Rptstorative Wine bUten). — 'i'like
one ounc(! each, bruised, of comfrey, Solon, n's seal, and spikenard ;
and half an ounce each, bruised, of chamomile flowers, columbo, and
gentian. Cover these with Imiling water, and let them stand twenty-
four houm in a covered vessel. Then add two (piarts of sherry wine.
Macerate fourteen days, express and strain.

Valuable in leucorrhcua and other female complaints. Dose, from
half a fluid ounce to two fluid ounces, three or four times a day.

Compound Wine of Qolden Seal. — Take one dram each, bruised,
of golden seal root, tulip-tree bark, and bitter-root, half a dmm of
pulverized cayenne, and two quarts of sherry wine. Macerate for
fourteen days, with occasional shaking ; then express and strain.

This is a pleasant bitter tonic in dysi)ep8ia, etc. Dose, from half
a fluid ounce to two fluid ounces, three times a day.

Wine of Ipecacuanha. — Take two ounces of bruised ipecai;, and
one quait of sherry wine. Macerate fourteen days, with occasional
shaking. Then express, and filter through paper.

This is a valuable emetic preparation, — especially for children.
Dose, as an emetic, for an adult, one fluid ounce ; as an expectorant,
from ten to thirty minims ; for a child two years old, as an emetic,
one fluid dram, repeated every fifteen minutes till it operates.

Mixtures.

Thesk i>re prepamtions in which medicinal substances whicli
cannot be dissolved in water are suspended in it by means of
some vi8(;id matter, like sugar or gum-arabic. Their object is to
conceal the taste, prevent the sickening effect, and make it more easy
to take disagreeable medicines. To make a perfect mixture requires
skill. Generally, the medicines to be suspended should be tritur-
ated in a mortar with the sugar, gum-aiabic, etc., before the water is
added.

Almond Mixture. — Take half an ounce of sweet almonds, half a
dram of powdered gum-arabic, two drams of sugar, and eight fluid
ounces of water. ' Soak the almonds in the water, and, having re-
moved their external coat, beat them with the gum-arabic and sugar
in a mortar, till they are thoroughly mixed ; then rub the mixture,
gradually adding the water, and lastly, strain.

This i's an agreeable, nutritive demulcent, in bronchial, dysenteric,
an 1 uiinary affections. It must be u*ed freely, the dose being from
two to five fluid ounces.

wwtjMw'wrmn

MRDIC1NK8 AND THBIR PHRPARATTONS.

899

iecHU8» the al(!o-
rnedicinivl pioj)-
le»8 tiinulutiiig

Hhter»}. — Tii\n'
and Hpikeiianl ;
IS, coluinbo, and
Jill stand tweiitv-
8 of sherry wine.

nts. Dose, from
times a day.

[vm each, bruised,
half a dram of
!. Macerate for
38 and strain.
Dose, from half

lised ipecai!, and
with occasioiiiil

dly for children.
< an expectorant,
Id, as an emetic,
; operates.

ubetances which
it by means of
heir object is to
make it more easy
mixture requires
should be tritur-
efore the water is

3t almonds, half a
, and eight fluid
, and, having re-
i-arabic and sugar
rub the mixture,

ichial, dysenteric,
I dose being from

Chalk Mixture. — Take half an oui.je of prepared chalk, two
fh-ams each of refined sugar and pow<lcred gum-arabic, and four
tluid ounces each of cinnamon-water and water. Ri'b then, together
till they are thoroughly mixed.

This is much used in hiosenjrfs of the IniweLs, accompanied with
acidity, particularly among (diildreii. If an incnjase of iu iistrin-
geucy be required, add laudanum, or kino, or catecdiu.

Compound Mixture of Iron. — Take a dram of myrrh, twenty-five
gmins of carlionate of potassa, one scruple of powdered sulphate of
iron, half a fluid ounce of spirit of lavender, one dram of rehned
.sugar, and seven and a half fluid ounces of rose-water. Rub tlie
myrrh in a mortar, gradually adding the rose-water, then mix with
these the opirit of lavender, sugar, and carlninate of potsissa, and
lastly, the sulphate of iron. Pour the whole into a glass bottle, and
keep it well stopped.

This is considerably used in chlorosis, and other affections requir-
ing the use of iron.

Brandy Mixture. — Take four fluid ounces each of brandy and
cinnamon water, the yolks of two eggs, half an ounce of refined
sugar, and three drops of oil of cinnamon. Mix them.

A useful stimulant and nutritive draught, to be used in the sink-
ing stage of low forms of .fever.

Extract of Rhubarb and Potassa (Neutralizing Extract). — Take
two pounds of the best rhul)arb, one pound each of cinnamon and
golden seal. Grind or coai-sely bruise the articles, and mix them;
macerate them for two days in one gallon of the best fourth proof
brandy. Then express the tincture with strong pressure, and add
to it one fluid dram of oil of peppermint, previously dissolved in a
Uttle alcohol. Break up the compressed residue from the press, and
place it in a percolator, and gradually run warm water through it
until the strength is exhausted. Evaporate this solution to four
pints, and while the liquor is still hot, dissolve in it two pounds of
bicarbonate of potassa, and three pounds of refined sugar. Continue
the evaporation, if necessary, until, when added to the tincture fii-st
obtained, it will make a gallon and a half, then mix the two solu-
tions together.

This is a useful preparation for diaiihcea, dysentery, cholera morbus.
Hummer complaints of children, acidity of the stomach, heartburn,
etc. Dose, one fluid dram.

Metauer's Aperient. — Take one ounce and a half of pulverized
aloes, four ounces of bicarbonate of soda, two fluid ounces of com-
[lound spirits of lavender and two quarts of water. Place the whole
in a jar or jug, and let them stand fourteen days, shaking well once
a day. Then pour off from the dregs. It improves by age.

900

MKDICINKS AND THKIR PRKPARATT0K8.

This preparation ih one of the hcHt-known aperienU for coslive-
ness, — particularly wlion conneoted with liiliouH dyHpt;|)8ia. For
that class of hilioiia pcrMoiiH who overeat, and have acid HtomachN, it
hiiN great value. In bilious ciihuh, tho nitro-miiriatic acid, taken
before meals (tho aperient after meals) may Ihj usefully asHociated
with it. In the couHtipation of hysteria and hypoclioiidiiiiHlH, tlie
fluid extract uf valuriun may be added to it. Dose, from two dranm
to an ounce. •

Saline Mixture ( White Liquiii Phytic). — Take half a pound of
sulphate of soda, and one and a half pints of Water. Mix, and dis-
solve the soda ; then add two fluid ounces of nitro-muriati«' acid, and
one dram and eight grains of powdered alum.

Used to allay nausea and vomiting, and as a cooling j • i^ative;
also for colic, diseases of the liver, diarrhoea, dysentery, intermittent
fevers, etc.

This is one of tiie remedies of the Eclectic school of physicians,
and is held by them in high esteem. Dose, a tablespoonful in a gill
of water, to be repeated everj' hour or two until it causes one or two
evacuations from the bowels.

Ointments.

Ointments are composed of fatty substances, about the consistente
of butter, impregnated with medicine. All gritty matter shn.ld be
exc'uded from them. To prevent the rancidity to which they are
liable, a little glycerin is now frequently added.

Ointment of Acetate of Lead. — Take two ounces of white wax
and four ounces of lard ; melt them together, and add two and a half
drams of finely-powdered acetate of lead ; stir constantly till cold.
This is useful for burns, scalds, ulcers and excoriations.

Ointment of Bayberry. — Take half a pound each of tallow,
white turpentine and bayberry, and four ounces of olive-oil ; melt
together and strain.

Good for scrofulous and indolent ulcei-s.

Ointment of Belladonna. — Take a dram of extract of belladonna
and an ounce of lard ; mix them.

A useful anodyne application for painful tumors, neuralgia, etc.

Ointment of Creosote. — Take half a fluid dram of creosote and
an ounce of lard ; mix them.

A useful application for syphilitic, scrofulous and cancerous ulcers.

Compound Ointment of Qalls Take six drams of finely-pow-
dered galls, six ounces of lard, and a dram and a half of pulverized
opium ; rub them together.

A valuable prepai-ation in irritable piles.

entH for coBlivo-
lyspupKin. For
iicid stomacliN, it,
atic iicid, tiikeii

fully aHMOciatt'd
)cli()iidi'i)iHiH, tilt;

from twu di'uiiiH

half a pound of

Mix, and dis-

iui'iati'< acid, and

oling t" native;
ery, intermittent

nl of physiciaiiH,
joonful in a gill
lUHBH one or two

t the consisttnice

natter she uld Ik;

which they are

cefl of white wax
d two and a half
atantly till cold.
)ns.

each of ttillow,
: olive-oil ; melt

let of belladonna

neuralgia, etc.
I of creosote and

jancerous ulcers.

s of finely-pow-
If of pulverized

MEDICINES AND THKIK PKRPARATI0N8.

901

Ointment of Red Iodide of Mercury. — Take one dntni of red
iodide of mercury, and Hcven drams of ointment of white wax ; in-
corporate them thoroughly together by trituration in a mortar.

Used as a dressing for indolent scrofulous ulcers.

Ointment of Nitrate of Mercury. — Take one ounce of mercury,
eleven fluid ounces of nitric acid, nine fluid ounces of fresh neatii-
foot oil, three ounces of lard. Dissolve the mercury in the acid, then
heat the oil and lard together in an earthen vessel to 200° F. ; then
add the mercurial solution, and stir with a wooden spatula, constantly,
as long as effervescence continues, and afterward occasionally till the
ointment stiffens.

Milder Ointment of Nitrate of Mercury. — Take an ounce of oint-
ment of nitrate of mercury, and seven ounces of lard ; rub them
together.

The first of the above two preparations is the citrine ointment, and
is much and advantageously employed as an external application in
porrigo, impetigo, psoriasis and pityriasis. It is nearly a specific for
inflammation of the eyeliuo connected with the formation of scaly
matter about the lashes. The second of these two preparations is
merely a dilution of the first.

Ointment of Oxide of Zinc — Take half an ounce of oxide of
zinc and three ounces of lard ; rub them togetiier.

This is a mild astringent application in chronic ophthalmia, erup-
tions of the skin, sore nipples, and other excoriatioas.

Ointment of Poison Hemlock. — Tpke one dram of extract of
poison hemlock and one ounce of lard ; rub them together.
An anodyne application for painful swellings, ulcers and piles.

Ointment of Poke. — Take a dram of the extract of poke and one
ounce of lard ; mix them.

For malignant ulcers, scaldhead, itch, etc.

Ointment of Stramonium. — Take one dram of the extract of
stramonium leaves, and one ounce of lard ; rub the extract with a
little water till it is uniformly soft, and then with the lard.

Used as an external application in irritable ulcers, painful piles and
skin eruptions.

Simple Ointment. — Take a pound of white wax, and four pounds
of lard ; melt them together with a gentle heat, and stir constantly
till cold.

Ointment of Rose- Water. — Take a fluid ounce of rose-water, two
fluid ounces of oil of almonds, half an ounce of spermaceti, one dram
of white wax ; melt together, by means of rater-bath, the oil, sper-
maceti, and wax ; then add the rose-water, and stir the mixture con-
stantly till cold.

gaaa sw ea agUi fe.

902

MEDICINES AND THEIR PREPARATIONS.

This is the well-known preparatit)n called cold cream, and is used
with much advantage for chapped lips and hands, excoriations, ett;.

Spermaceti Ointment. — Take live ounces of spermaceti, fourteen
of white wax, and a pint of olive-oil ; melt them together over a slow
fire and stir constantly till cold.

A mild dressing for blisters, wounds and excoriated surfaces.

Tar Ointment. — Take a pound each of tar and suet; melt the
suet with a gentle heat, and add the tar to it ; then stir constantly
till they are cold.

A useful stimulating application to various scaly and «^ abby erup-
tions, particularly leprosy and scaldhead.

Ointment of White Hellebore. — Take one ounce of powdered
whit* hellebore root, four ounces of lard, and twelve drops of oil of
lemons ; rub them thoroughly together.

A useful ointment for the cure of itch.

Ointment of Wild Indigo. — Take one pound of powdered wild-
indigo root, moisten it thoroughly with alcohol and let it stand
twenty-four hours; then put it in a percolator and add alcohol as
long as the liquid which passes contains the taste of the root. Distil
the alcohol from this filtered tincture until half a gallon of tincture
is obtained. Melt one pound of fresh butter, without salt, add the
above tincture, and carefully evaporate the rest of the alcohol ; stir
constantly till cold, after the alcohol has nearly passed off.

This is one of the preparations of the Eclectics, and is a cleansing,
detergent, antiseptic and discutient ointment, useful in scrofulous,
erysipelatous and malignant ulcers, eruptions of the skin, etc.

Pile Ointment. — Take three handfuls each of witch-hazel bark,
white-oak bark and sweet-appletree bark ; bruise or grind them, and
add to them three pints of water ; boil down to one pint and strain ;
add to this liquid half a pound of lard, and simmer till the water all
disappears, stirring continually both before and after removing from
the fire till it cools.

This forms a brick-colored anodyne, astringent ointment, admirably
adapted to the cure of pile-tumore.

Compound Lead Ointment. — Take two and a half pounds of
olive-oil, four ounces each of beeswax and unsalted butter, and half
a pound of white turpentine; melt them together, strain, and then
heat to nearly the boiling point ; then gradually add one pound of
red lead, stirring constantly till the mixture becomes black or brown ;
then remove from the fire, and when it is partly cool, add to it a
mixture of twelve ounces of honey and half a pound of powdered
camphor.

This is a very healing ointment, and is much used for ulcers, bums,
wounds, aud skin-diseases.

*atlia*-

% and is used
)nation8, etc.

aceti, fourteen
ler over a slow

surfaces.

met; melt the
stir constAutly

i '^ abby erup-

of powdered
iropa of oil of

lowdered wild-
': let it stand
idd alcohol as
e root. Distil
on of tincture
-J salt, add the
3 alcohol ; stir
off.

is a cleansing,
in sci-of ulcus,
dn, etc.

xjh-hazel bark,
ind them, and
nt and strain ;
1 the water all
emoving from

lent, admirably

lalf pounds of
utter, and half
rain, and then
one pound of
lack or brown;
ol, add to it a
of powdered

r ulcers, burns,

MEDICINES AND THEIR PREPARATIONS.

903

Compound dulphurOintment. — Take one ounce of sulphur, one
(li-am each of ammoniated mercury and benzoic acid, one Huid dram
each of sulphuric acid and oil of bergamot, two drams of nitrate of
potassa and half a pound of lard. Fii-st melt the lard with a gentle
heat, then add the other ingredients, stirring constantly till they are
cold.

A sovereign remedy for itch.

Pills.

Pills ''.re small masses of medicinal substances 'n globular shape,
and of ^ -ize convenient for swallowing. Each pill generally weighs
from four to five grains. Those medicines wliich cannot lie dissolved
in water, and are particulaiiy unpleasant to the taste, are usually given
in the form of pill. Sugar, or gelatine coated, as now very exten-
sively used for every important medicine, and in a great variety of
combinations, they are a very popular form of taking medicine. Phy-
sicians 'cannot do better than to use the pills when made by a reliable
firm.

The method of making pills is as follows : If the substance to be
worked into pills be a solid extract, add a few drops of water to it,
and rub it to the right consistence ; if it be a resin, add to it a few
drops of alcohol ; if it be a soft or liquid substance, rub up with it
some inert substance, or crumb of bread, or wheat flour, or starch, or
pulverized gum-arabic ; if it be a powder, mix it with some soft sub-
stance, as confection, or syrup, molasses, honey, or mucilage of gum-
arabic. The materials must be well mixed and rubbed into a uniform
mass, which should be rolled with a spatula or knife into a cy-
linder of just the same size throughout. This is to be divided
equally into the number of pilL? required, each of which is rolled
into a spherical foini between the thumb and finger, or upon the palm.

So many valuable pills are prescribed among the " Recipes," that
it is not necessary here to add to their number.

Plasters^

Plasters are composed of wax, resins, gums, fats and oils, and
sometimes medicinal substances, and are spread upon linen, muslin,
or leather. When cold they are hard ; but when brought to the
warmth of the human body, they so far soften as to adhere firmly to
the skin, but do not " run "so as to spread outward and soil the
under-clothes. They are intended generally to excite and irritate
the skin; sometimes as mechanical supporters, and sometimes to
affect the system by having their medicinal matters absorbed.

Be'Uxdonna Piaster. — Take three ounces of resin plaster, and an
oun't and a half of extract of belladonna, add the extract to the
plaster previously melted by a gentle heat, and mix.

904 MEDICINES AND THEIR PREPARATIONS.

A useful anodyne application in neuralgia, rheumatic pains, and
dysmenorrhoea. ,

Compound Capsicum Plaster. — Melt together half a pound of
resin and two ounces of beeswax ; to this add one pint of spirit in which
two ounces of powdered cayenne, enclosed loosely in a liuen bag, has
been digested one hour by a gentle heat ; evaporate the spirit by a
moderate heat, and add one ounce of powdered camphor and one
fluid dram and a half of oil of sassafras ; stir constantly till cold.

This may be used whenever a stimulating plaster is required.

Compound Qalbanum Plaster. — Take two ounces of galbanum,
three ounces of burgundy pitch, half an ounce of resin, half an ounce of
yellc" wax, and four ounces of lead plaster ; melt them all together
over a gentle fire.

This is a valuable strengthening plaster, and may be used for
weakness of various parts, as well as for scrofulous enlargement of
glands and joints.

Compound Lead Plaster. — Take one pound of lead plaster; melt
it by a moderate heat, and then add two fluid ounces each of linseed
oil and tincture of opium, six fluid ounces of oil of turpentine, and
two-thirds of a pound of oil of origanum ; stir together till cold.

Used for burns, scalds, chilblains, etc.

Compound Resin Plaster. — Take three pounds of resin, four ounces
each of beeswax and hemlock gum ; melt the articles together, then
remove from the fire, and, whsn nearly cold, add gradually one fluid
ounce each of oil of hemlock, oil of sassafras, and olive oil, with half
an ounce of camphor, dissolved in them, and half a fluid ounce of oil
of turpentine. Pour the whole into cold water, and work in the
hands till cold, forming it into rolls.

This is an excellent strengthening plaster, useful for rheumatism,
enlarged joints, glands, and wherever a weakened part needs gentle
stimulation and support-
Spiced Plaster. — Take one ounce each of powdered ginger, cloves,
cinnamon and black pepper; one di-am of pulverized cayenne; half
a fluid ounce of tincture of ginger, and a sufficient quantity of honey.
Mix the powders, and then add the tincture and honey to form a stiff
poultice.

This is applied with great advantage over the stomach in cases of
nausea and vomiting.

Compound Tar Plaster. — Boil three pounds of tar half an hour,
then add one pound and a half of burgundy pitch, one pound of white
gum turpentine (after having melted them together and strained).
Stir together, then remove from the fire and add ten ounces each of
finely-powdered mandrake-root, bloodroot, poke-root and Indian tur-
nip ; mix thoroughly together.

wmMaimmmmmmmmmmmmmmmmmmmmmmmMimm^'

MEDICINES AND THEIR PKEPABATI0N8.

905

tic pains, and

f a pound of
spirit in which
linen bag, has
tie spirit by a
phor and one
y till cold,
required.

of galbanum,
alf an ounce of
m all together

' be used for
inlargement of

I plaster; melt
lach of linseed
urpentine, and
• till cold.

lin, four ounces
together, then
uaUy one fluid
5 oil, with half
id ounce of oil
work in the

>r rheumatism,
t needs gentle

ginger, cloves,
cayenne; half
utity of honey,
to form a stiff

kch in cases of

half an hour,
jound of white
and strained),
ounces each of
ad Indian tur-

This is an irritant, rubefacient, suppurative plaster, and is con-
siderably used by the Eclectics to i)roduce counter-irritation and re-
vulsion in aeumlgia, rheumatism and other painful affections, as well
as in chronic inflammation of internal organs. To be spread thinly
on soft leather, and renewed daily on the same leather. Four days
are required to produce suppuration. If it produce gi-eat pain or
inflammation, remove it, and apply mutton-tallow or elm-poultice.

Lead Plaster. — Take one pound and a quarter of very finely pow-
dered semivitrified oxide of lead, one quart of olive oil and half a
pint of water. Boil together over a gentle fire, stirring constantly
till the oil and litharge unite and form a plaster. If the water nearly
all evaporates before the process is completed, add a little boiling
water.

A useful plaster for ulcers, bums, excoriated surfaces, etc.

Red Oxide of Lead Plaster. — Melt together one quart of oliveK>il
and one ounce each of beeswax and resin ; heat to the boiling point, and
then add g^dually three-quarters of a pound of powdered red-lead.
Stir constantly, and when the oil has taken up the lead, the mixture
will be brown or shining black ; then remove from the fire, and when
nearly cold add four scruples of powdered camphor, and stir together.
It should not be removed from the fire until it has acquired a proper
consistence for spreading, which may be easily ascertained by allow-
ing a portion of it to cool on a knife.

This is a valuable plaster for scrofulous and sj^hilitic ulcers, also
for bums, scalds, and several skin-diseases.

Poultices. — Cataplasms.

Bread-and- Water Poultice. — Put the needed quantity of boiling
water in a basin ; throw in crumbled Avhite bread, or cracker, and
cover with a plate. When the bread or cracker has soaked up all it
will, drain off the remaining water. Spread one-third of an inch
thick, and apply.

Flaxseed Poultice. — Put boiling water in a basin, and stir in
flaxseed meal to make a thick paste. Spread on linen and apply.

Yeast Poultice. — Mix half a pint of yeast with one pound of
flaxseed-meal. Stir carefully while heating.

Carrot Poultice. — Boil the proper quantity of caiTots till they are
quite soft. Strain off the water, mash them to a pulp, and add a
little lard or sweet oil to prevent them from getting hard, then
spread. A good application for malignant and offensive sores.

Oatmeal Poultice — Place hot water in a basin, and stir in oat-
meal slowly, while it boils, till the poultice is of the right thickness ;
that is, till it will not run on the rag on which it is spread.

..tjpW>4

906 MEDICINES AND THEIR PREPAKATT0N8.

Indian-Meal Poultice Made the same as oatmeal poultice .

Arrow-Root Poultice Mix two or more tablespoonfuls of arrow-
root with a little cold water, in a basin, till it is all united with the
water. Then add boiling water, and stir till the whole becomes a
thick paste.

Slippery Elm Poultice Stir ground slippery-elm bark into hot

water, and let it swell. This is a very soothing poultice for irritable
sores.

Onion Poultice. — Made in the same way as the carrot poultice.
This is quite stimulating, and induces indolent sores to maturate
more freely. It is excellent for slow boils.

Charcoal Poultice Take either the bread-and-milk, or the In-
dian-meal poultice, and stir into it one-quarter its bulk of finely pul-
verized clmrcoal. Excellent for thoroughly cleansing a foul sore or
ulcer.

Anodyne Poultice. — Take half an ounce of the extract either of
foxglove, or henbane, or stramonium, or coniuni, or belladonna, and
mix it with half a pint of tepid water. Then stir in as much flax-
seed meal as will make a poultice of the right thickness. Always
be careful not to apply this poultice where there is much skin off,
lest the extract used be so much absorbed as to produce poisonous
effects. These poultices allay the pain of cancerous and other sores.

Lobelia Poultice. — Powdered lobelia and ground slippery-elm
bark, each, one ounce. Stir these into hot weak lye, to make a poul-
tice. For wounds, fistula, whitlow, boils, erysipelas and stings of
insects.

Poke-Root Poultice Roast a sufficient quantity of fresh poke-
root in hot ashes. When it is quite soft, pound it, and make a poul-
tice. To be applied to tumors to scatter them, or hasten their suppu-
ration. To be removed every four hours.

Mustard Poultice. — Stir up a tablespoonful of ground mustard
with a little water, to the consistence of paste. Spread upon linen
or brown paper, and cover with thin muslin, that the mustard may
not stick to the skin when the poultice is removed. They can now
be bought all prepared, either on paper or cloth, of several different
degrees of strength, and are much better than the home-made.

Powders.

A SINGLE substance used as a powder is called a simple powder ;
two or more united, a compound powder. Under the above head, I
shall describe only compound powders. In preparing compound
powders, the substances, if of different degrees of hardness, should

toultice .

als of arrow-
ted with the
} becomes a

lark into hot
for irritable

rat poultice,
to maturate

t, or the In-
if finely pul-
foul sore or

act either of
adonna, and
much flax-
ss. Always
ch skin off,
se poisonous
other sores.

slippery-elm
nake a poul-
id stings of

fresh poke-
nake a poul-
their suppu-

md mustard
upon linen
lustard may
bey can now
sral different
made.

%ple powder ;
bove head, I
J compound
Iness, should

MEDICINES AND THEIR PREPAKATIONS.

907

generally be pulverized separately. Many powdei-s i-equire to be ex-
cluded from the light, which may be done by covering the bottles in
which they are kept with black varnish.

Aromatic Powder Take two ounces each of cinnamon and gin-
ger, and an ounce each of cardamom deprived of the capsules, and
grated nutmeg. Rub them together into a very fine powder, and
keep in well-stopped bottles.

The powder is stimulant and carminative, and in cases of weak-
ened digestion, may be given in ten to thirty-grain doses.

Compound Powder of Aloea and Canella — Take a pound of aloes
and three ounces of canella. Rub them separately to a fine powder,
and mix them.

This is the preparation known as hiera picra, ov simply picra. It
may be used for anienorrhoea, or generally as a bitter to correct cos-
tiveness, and improve the appetite.

Compound Powder of Catechu — Take two ounces each of catechu
and kino, and half an ounce each of cinnamon and nutmeg. Reduce
all to a fine powder, mix and pass them through a fine sieve.

F^or chronic diarrhoea, dysentery, etc. Dose, from fifteen to thirty
grains.

Compound Powder of Chalk.— Take half a pound of prepared
chalk, four ounces of cinnamon, three ounces each of tornientil and
gum-arabic, and half" an ounce of long pepper. Rub them separately
into a veiy fine powder, and mix.

This powder is warm, stimulant, astringent and antacid, and is
well fitted for diarrhoea not connected with inflammation.

Compound Powder of Chalk with Opium — Take six ounces and
a half of compound powder of chalk, and four scruples of powdered
opium. Mix them.

The opium in this preparation increases the elficacy of the com-
pound powder of chalk in diarrhoea. Dose for an adult, ten to fif-
teen grains, and repeated after each discharge.

Compound Powder of Qolden Seal. — Take two drams each of
powdered golden seal, blue cohosh and helonias, and mix them.

Useful in dyspepsia, chronic inflammation of the mucous mem-
brane of the stomach, etc. Dose, half a teaspoonful to a teaspoonful,
three or four times a day.

Compound Powder of Hydrastin. — Take half a dram each, in
powder, of hydrastin, leptandrin, rhubarb and myricin. Mix thor-
oughly, and divide into thirty-two powders.

This is tonic and laxative, and is useful in dyspepsia, jaundice,
(ihronic inflammation of the bowels, and during recovery I'lom ex-
hausting complaints. One powder may be taken often enough to
produce one movement of the bowels a day.

!■ Li !

' }^

908

MEDICINES AND THEIR PREPARATIONS.

InhaliiiK Powder. — Take one dram of crystals of nitrate of silver,
and two and a half drams of lycopodium. Work the lycopodium
into a very stiff paste, with a little warm water, in which the nitrate
is dissolved. Spread this thin in a shallow dish, cover it so as to shut
out the light, and set it where it will dry ; when thoroughly dry, pul-
verize.

I have used this powder with great advantage in many cases of
bronchitis, by directing three to four grains of it to be inhaled once
a day, in an instrument constructed for that purpose. This is the
only really valuable catarrh muff ever used. A pinch of it taken
once a day (never oftener) for nasal catarrh, will often do excellent
service.

Compound Powder of Ipecacuanha.— Take a dram each of pow-
dered ipecacuanha and opium, and one ounce of sulphate of potassa.
Rub them together into a fine powder.

This is the well known Dover's powder. It is an admirable ano-
dyne and diaphoretic, and is much used in inflammatory complaints,
particularly rheumatism and pneumonia, complicated with low ty-
phoid symptoms. Dose, from five to ten grains.

Compouad Powder of Jalap. — Take half an ounce of pulverized
jalap and senna, one ounce of pulverized bitartrate of potassa, half a
dram of pulverized ginger, and ten grains of pulverized cayenne.
Mix thoroughly.

This is a valuable purgative medicine, and may be used in most
cases where a simple cathartic is required. Dose, half a teaspoonful
to a tablespoonful.

Compound Powder of Kino. — Take fifteen drams of kino, half an
ounce of cinnamon, and a dram of dried opium. Rub them sepa-
rately to a very fine powder, and mix them.

This is anodyne and astringent, and is useful in diaiThoea, etc.

Compound Powder of Rhubarb. — Take four ounces of powdered
rhubarb, one pound of magnesia, and two ounces of finely powdered
ginger. Mix thoroughly, and preserve in well stopped bottles.

An excellent laxative and antacid, and well adapted to the bowel-
complaints of children.

Compound Powder of Rhubarb and Potassa {Neutralizing Pow-
,ier). — Take half an ounce each of powdered rhubarb, bicarbonate
of potassa and peppermint leaves. Mix thoroughly.

Valuable in diarrhoea, cholera morbus, dysentery, summer com-
plaint of children, sour stomach, heartburn, etc.

Worm Powder. — Take one ounce each of powdered white Indian-
hemp root (^Asclepias incamata), mandrake, pink-root, and bitter-root ;
two ounces of powdered balmony, and four scruples of powdered
aloes. Mix thoroughly.

fmsmsmmmm

[>rir('-;:WKMIMMrkai«>swiJnn«iJi .ihpih '

MEDICINES AND THEIK PUEPABATIONS.

909

ate of silver,
lycopodium
b the nitrate
JO as to shut
hly dry, pul-

any cases of

inhaled once

This is the

of it taken

do excellent

each of pow-
Q of potassa.

Imirahle ano-
r complaints,
with low ty-

jf pulverized
itassa, half a
zed cayenne.

ised in most
i teaspoonful

kino, half an
3 them sepa-

hoea, etc.

i of powdered
sly powdei-ed
bottles,
to the bowel-

ralizing Pmo-
), bicarbonate

ummer com-

white Indian-
id bitter-root ;
of powdered

A very good remedy for all kinds of worms. A teaspoonful of
the powder may be mixed with a gill of molasses, and a teaspoonful
of this given to a child every hour or two till it operates. After
this, give a teaspoonful three times a day, for a few days.

Syrups.

A STRONG solution of sugar and water is a simple syrup. When
the water is first charged with some medicinal substance, and sugar
is added to this, we have a medicated syrup. Refined sugar should
always be preferred in preparing medicated syrups.

Simple Syrup. — Take two and a half pounds of refined sugar, and
a pint of water ; dissolve the sugar in the water by heat, remove any
scum that may arise, and strain while hot.

Syrup of Almonds. — Take a pound'of sweet almonds, four ounces
of bitter almonds, three pints of water, and six pounds of refined
sugar. Blanch the almonds, then rub them in a mortar to very fine
paste, and add, during the trituration, three fluid ounces of the water,
and one pound of the sugar. Mix the paste thoroughly with the
remainder of the water. Strain with strong expression, add the
remainder of the sugar to the strained liquor, and dissolve by a
gentle heat. Strain through fine linen, and after it is cool, put it
into bottles, thoroughly stopped, and keep in a c« »! place.

This is demulcent, nutritive and sedative, and is sometimes added
to cough mixtures, etc.

Syrup of Citric Acid Take two drams of powdered citric acid,

four minims of oil of lemons, and two pints of syrup. With one
fluid ounce of the syrup, rub the citric acid and oil of lemons, then
add the remainder of the syrup, and dissolve by a gentle heat.

This is much employed as an agreeable and cooling addition to
drinks, especially to carbonic-acid water. Tartaric acid, being cheaper
than citric acid, is often substituted for it, and the preparation thus
made is much sold under the name of lemon syrup.

Syrup of Garlic. — Take six ounces of fresh garlic, sliced and
bruised, one pint of diluted acetic acid, and two pounds of refined
sugar. Macerate the garlic in ten fluid ounces of the diluted acetic
acid in a glass vessel, four days, and express the liquor. Then mix
the rest with what remains of the acid, and again express, till sufficient
has passed to make the whole when filtered measure a piht. Then
pour the filtered liquor on the sugar in a bottle, and shake till it i?
dissolved.

Excellent in the bronchial affections of children. Dose, a tea-
spoonful, for a child a year old'.

Syrup of Qinger. — Add two fluid ounces of tincture of ginger to
a quart of simple syrup ; evaporate the alcohol by a gentle heat.

> ('

910

MKD10INE8 AND THEIR PREPARATIONS.

This is carminative and stimulant, and gives tone to the debilitated
stomach, removing wind, etc. It is added to other medicines to im-
prove their flavor.

Compound Syrup of Hypophosphites. — Take 266 grains of hypo-
phosphite of lime, 192 grains of hypophosphite of soda, 128 gniiiis
of hypophosphite of potassa, 96 grains of recently precipitated hypo-
phosphite of iron, 240 grains of hypophosphorous acid solution, 12
ounces of white sugar, half an ounce of extract of vanilla, and a
sufficient quantity of water. Dissolve the salts of lime, soda and
potassa, in six ounces of water ; put the iron salt into a mortar and
gradually add solution of hypophosphorous acid till it is dissolved ; to
this add the solution of the other salts, after it has been rendered
slightly acidulous with the sam<3 acid, and then water, till the whole
measures nine fluid ounces. Dissolve this in sugar, with heat, and
flavor with the vanilla. Without flavoring, this syrup is not unpleasant,
being slightly saline, and not at all ferruginous. Any other flavor-
ing may be used, as orange-peel, orange-flower or ginger. It is also
suggested to physicians that glycerine may be used, wholly or par-
tially, in place of sugar, when indicated, six ounces and a half of
glycerine being substituted for twelve ounces of sugar. Dose, a tea-
spoonful, three times a day befoie meals.

Syrup of Ipecacuanha. — Take one ounce of ipecacuanha, in
coarse powder, one pint of dilut<Kl alcohol, two pounds and a half of
sugar, and one pint of water. Macerate the ipecacuanha in the alco-
hol, fourteen days, and filter ; evaporate th3 filtered liquor to six fluid
ounces, filter again, and add water to make the liquor measure a pint ;
then add the sugar, and proceed as directed for syrup.

This is chiefly used in compl- ints of children. Dose, as an emetic,
for an adult, two fluid ounces ; for a child a year or two old, one or
two fluid drams. As an expecto; nt, for an adult, two fluid drams ;
for a child, flve to twenty minims.

Syrup of Lemons. — Take a pint of strained lemon-juice, two
pounds and a half of refined sugar, and two and a half fluid ounces
of rectified spirit ; boil the juice ten minutes, and strain ; then add
the sugar, and dissolve. After the syrup has cooled, mix the spirit
with it.

A cooling and grateful addition to drinks in fevers, and serves to
cover the taste of salts and other purgatives.

Aromatic Syrup of Rhubarb. — Take two ounces and a half of
bruised rhubarb, half an ounce each of bruised cloves and cinnamon,
two drams of bruised nutmeg, two pints of diluted alcohol, and six
pints of syrup. Macerate the rhubarb and aromatics in the alcohol
for fourteen days, and strain ; then, by a gentle heat, evaporate the
liquor to a pint, and, while hot, mix it with the syrup previously
heated.

MEDICINES AND THEIU PKEl'AHATIONS.

911

ho debilitated
iicinsH to im-

mins of hypo-
a, 128 gniiim
pitated liypo-

solution, 12
anilla, and a
me, 8oda and
IV mortar and
[lissolved ; to
een rendered
till the whole
ith heat, and
it unpleasant,

other flavor-

iT. It is also

'holly or par-

and a half of

Dose, a tea-

(cacuanha, in
and a half of
la in the alco-
or to six fluid
ga«ure a pint ;

, as an embtic,

vo old, one or

fluid drains;

iOn-juice, two

fluid ounces

in; then add

nix the spirit

a,nd serves to

and a half of
nd cinnamon,
ohol, and six
in the alcohol
svaporate the
ip previously

This is a warm cordial laxative, admirably fitted for the bowel
complaints of infants. Dose, a fluid dram, lepeated every two hours
till it operates.

Syrup of Seneka. — Take four ounces of fluid extract of seneka,
and one pint of water ; mix, and dissolve in the liquid one pound of
refined sugar, and proceed as directed for syrup.

This is a stimulating expectorant, used in colds, coughs, etc., after
inflammatory symptoms have sulwided. Dose, for an adult, one or
two teaspoonfuls, as often as necessary.

Syrup of 5qulll. — To one pint of vinegar of squill, add two
pounds of refined sugar, and proceed as directed for syi'Up.

It is a useful expectorant for coughs and bronchial affections of
infants and children. Dose, half a dram to a dram.

Syrup of Tolu. — Take two fluid ounces of tincture of tolu, and
one pint of simple syrup ; mix, and gently heat the mixture to evapo-
rate the alcohol.

This is chiefly used to flavor other preparations.

Syrup of Wild-Cherry Bark. — Place two pounds and a half of
coarsely powdered wild-cherry bark in a percolator, and pass through
it one gallon of water. Strain this and dissolve in it by heat sixteen
pounds of refined sugar.

This makes an elegant tonic and sedative preparation, and is mixed
with various other articles in prescribing for dyspepsia, consumption,
etc.

Compound Syrup of Partridge Berry. — Take half a pound of
partridge berry, and two ounces each of helonias, blue cohosh, and
high cranberry bark ; add to them one quart of brandy, and macerate
four days. Press out the brandy ; and place the herbs in three quarts
of boiling water, and boil down to two and a half pints. Strain, add
one pound of sugar, and evaporate to two and a half pints. Remove
from the fire, and when nearly cold, add the brandy previously pressed
out.

This is considerably used by the Eclectic physicians, under the
name of mother's cordial, and may be usefully employed by all
physicians in suppression of the menses, painful menstruation, pro-
fuse menstruation and habitual abortions. Dose, from one to two
ounces, two or three times a day.

Compound Syrup of Phosphates (Chemical Food). — Take ten
drams of protosulphate of iron, twelve drams of phosphate of soda,
twelve drams of phosphate of lime, twenty drams of phosphoric
acid (glacial), two scruples of carbonate of soda, one dram of car-
bonate of potassa, sufficient quantity of muriatic acid, sufficient
quantity of water of ammonia, two drams of powdered cochineal,
sufficient water to make twenty fluid ounces, three pou' '.a of sugar,

:■

912

MBDIOINKS AND THEIR PRKPARATI0N8.

and fifteen drope of oil of orange. Dissolve the sulphate of iron in
two fluid ounneu of boiling wate**, and the phosphate of soda in four
fluid ounces of boiling water. Mix the solutions, and wash the pre-
cipitated phosphate of iron till the washings are tAsteless.

Dissolve the phosphate ol liMie in four fluid ounces of boiling
water, with suflicient muriatic acid to make a clear solution, precij)!-
tatt it with water of ammonia, and wash the precipitate.

I'o the freshly precipitated phosphates, as thus prepared, add tlic
phosphoric acid, previously dissolved in the water. When clear, add
the carbonates of soda and potassa, and aftei'wards sufficient muriatic
acid to dissolve the precipitate.

Now add the cochineal mixed with the sugar, apply heat, and when
the syrup is formed, strain and flavor it.

This is an elegant syrup, agreeable both to the eye and taste, and
has been extensively sold and used as a nutritive tonic, in chronic
debility, in cases of broken down constitution, wasting of the flesh,
etc.

Compound Syrup of Rhubarb and Potassa (^Neutralizing Cor-
dial). — Take half a pound each of powdered rhubtvrb and bicarbonate
potassa, and four ounces each of cinnamon and golden seal ; macerate
for four days in one gallon of best fourth proof brandy. Express
the tincture with strong pressure, and add to it two fluid drams of
oil of peppermint, previously dissolved in a little alcohol. Break up
the cake from the press, place it in a percolator, and gradually pass
through it warm water till the strength is exhausted. Evaporate
this solution to four quarts, and while the liquor is still hot, dissolve
in it six pounds of refined sugar. Continue the evaporation, if neces-
sary, till the addition of the tincture first obtained will make three
gallons. Then add the tincture.

A valuable antacid and laxftive Ln diarrhoja, dysentery, cholera
morbus, and summer complaint of children. Dose, for an adult, a
tablespoooful, to be taken as circumstances require.

Compound Syrup of Sarsaparilla. — Take a pound each of sarsa-
parill^t, yellow parilla, and pipsissewa; an ounce and a half of guaia-
cum ; one ounce each of red roses, senna, and liquorice root ; and
three minims each of oil of sassafras, anise, and partridge berry ; di-
luted alcohol, five pints, and four pounds of refined sugar. Grind
and mix the sarsaparilla, yellow parilla, pipsissewa, guaiacum, roses,
senna, and liquorice, and add to them the alcohol. Let the whole
stand fourteen days, then express and filter. Evaporate by a water-
bath to one quart, and add the sugar. Lastly, rub the oils in a mor-
tar with a little of the syrup, and thoroughly mix with the remainder.

This is a valuable alterative syrup, and is used lor syphilis, scrofula,
diseases of the skin, etc. • It is much improved by adding half an
ounce of the iodide of potassium to each pint of the syrup. Dose, a
tablespoonful.

■

IT:-

MEDICINKS AND TtlEIll PRErAKATTONB.

913

)hate of iron in

of aoda in foiir

d wash the pre-

leas.

nces of boiling

olution, preci[)i-

ate.

(>piired, add tlu-

rVhen clear, add

fficient niiiriatic

^ heat, and when

B and taste, and
X)nic, in chronic
ing of the flesh,

Teutralizing Cor-
) and bicarbonate
1 seal ; macerate
randy. Express
'0 fluid drams of
ohol. Break up
I gradually pass
ted. Evaporate
itill hot, dissolve
oration, if neces-
will make three

rsentery, cholera
for an adult, a

nd each of sarsa-

a half of guaia-

lorice root ; and

tridge berry; di-

sugar. Grind

guaiacum, roses.

Let the whole

orate by a water-

;he oils in a mor-

;h the remainder.

yphilis, scrofula,

adding half an

syrup. Dose, a

Compound Aromatic Syrup of Senna. — Take four ounces of
senna, one ounce and a half of jalap root, half an ounce of rhubarb,
one dram of cinnamon, one dnini of cloves, and half a dram of nut-
meg. Reduce these articles to a coarse powder ; add one quart of
diluted alcohol. Let the whole stand two days iviid percolate. Filter,
dissolve in it one pound of refined sugar, and add one dram of oil of
lemons.

An excellent cordial physic.

Compound Syrup of Stilllngia. — Take a pound each of queen's
root and tnrkey corn ; half a pouml each of pi{)HiHsewa leaves and
elder flowers ; and four ounces eai^li of prickly-ash Iwrries and carda-
mom seeds. Oiind all the articles, mix, and place them in a jar, and
moisten them well with alcohol. Let them stand two days ; then
place them in a percolator, and gmduuUy add hot water till two pints
are obtained, which must be stniined and set aside. Then continue
the percolation so long as there is a sensible taste of the spirit. Re-
serve this also. Then continue the percolation till what is obttiined
is almost tasteless. Boil down this last till the addition of the two *
reserved tinctures will make two gallons of th§ whole. Now add
twelve pounds of refined sugar, and make a syrup.

This is one of the Eclectic medicines ; and is quite an effective
alterative for syphilis, scrofula, etc. Improved by adding iodide of
potassium. Dose, from, a teaspoonful to a tablespoonful.

Compound Syrup of Yellow Dock. — Take two pounds of yellow-
dock root, one pound of the bark of the root of false bittersweet, and
half a pound each of American ivy and flgwort. Make a syrup
according to the directions for compound syrup of stillingia, using
sixteen pounds of sugar, and making two gallons of syrup.

A valuable preparation for scrofula. Improved by iodide of potas-
sium. Dose, a tablespoonful, three or four times a day.

Tinctures.

An ethereal tincture is one which is made with ether as the solvent
instead of alcohol, and an ammoniated tincture, one made with water
of ammonia as the solvent.

Simple tinctures, in which only one medicinal article is used, are
made thus:

Tincture of Aconite. — Take eight ounces of powdered aconite-
root, and one pint of alcohol. Mix, and let them stand for two weeks,
frequently stirring. Then express, and filter through paper.

Given in fovers and inflammatory diseases. Dose, three drops
every hour or two in a little water. •

In the above manner all simple tinctures are made. Some medi-
cines require alcohol to extract their active principle ; some only
diluted alcohol.

I ' ,

t> i

»aawfi-

MK1)IC1NK« AND THEIK FKKPAKATIONS.

One Ounce to the Pint of Alcohol. — In piepariiijf «iniple t;:\iUn(!«
from the following; articles, alcohol ie used, and one oun»Ht only of the
m«dicine is employed to the pint, namely :

Ciistot. Saffron, Leptandria.

One Ounce to the Pint of Diluted Alcohol. — In making tinctures
from the following articles, one ounce is used to the pint of diluted
alcohol:

Iodine, Quabsia.

Two Ounces to a Pint of Alcohol :

Assafffitida, Camphor, Oil of Peppermint, Oil of Spearmint, Ben-
zoin, Colchicum seeds, Lupulin. '

Two Ounces to a Pint of Diluted Alcohol :

Cardamom, Cotton-Bark, Cochineal, Colombo, Colchicum, Ergot,
Galls, Hemlock, CuIhjIw, Foxglove, Black Hellebore, Henbane, Lactu-
carium, Lobelia, Poke, Shrubby Trefoil, Bloodroot, Squill, Valerian,
Bittersweet, Belladonna.
Three Ounces to a Pint of Diluted Alcohol :

Peruvian Bark, Rhatiny, Poison Hemlock, Sheep Laurel, Stramo-
nium, White Hellebore, Yarrow, Prickly Elder, Jalap.

Four Ounces to a Pint of Alcohol :

Nux Vomica, Ginger, Guaiacum, Black Cohosh.

Four Ounces to a Pint of Diluted Alcohol :

Yellow Jessamine, Prickly-ash Berri«i8, Ergot, Matico.

The following tinctures embrace those which vary from the above
proportions among the simple tinctures, and also the compound
tinctures : »

Tincture of Orange-Peel. — Take three and a half ounces of dried
orange-peel and one quart of diluted alcohol. Macerate for seven
days, express and filter.

Tincture of Buchu. — Take five ounces of buchu, and one quart
of diluted alcohol. Digest seven days ; pour off the clear liquor, and
filter.

Tincture of Indian Hemp. — Take of extract of Indian Komp
(Cannabis Indica) one ounce, and one pint of alcohol. Dissolve the
extract in the spirit. Dose, from twenty to thirty drops.

Tincture of Cantharides. — Take an ounce of bruised Spanish
flies, and two pints of diluted alcohol. Macerate for fourteen days,
express and filter through paper.

Dose, from twenty drops to a dram, three or four times a day.

MRDICINK8 AND THKIK HHKl'AKATIONH.

915

iiiiple tinctui'eH
n(!« only of the

aking tiiuttureH
[)int of diluted

pearmint, Ben-

ichicum, Ergot,
lenbane, Lactu-
quill, Valerian,

Laurel, Stramo-

[>•

ICO.

from the above
the compound

ounces of dried
erate for seven

I, and one quart
:;lear liquor, and

[ Indian Komp
I. Dissolve the
rops.

bruised Spanish
r fourteen days,

times a day.

Tincture of Cayenne Pepper. — Tako an ounce of pulverized
cayiMiiit;, and two piiitM of diluted alcohol. Macerate fourtetii (lays,
and filter through paper.

Tincture of Catechu. — Take an ounce and a half of catechu, an
ounce of bruised cinnamon, and one pint of diluted alcohol. Lei
them stand together two weeks, frequently shaking; then express
and filter.

Dose, from thirty drops to a taLlespoonful.

Tincture of Cinnamon. — Take an ounce and a half of powdered
ciiuiamon, and one pint of diluted alcohol. Let them sUind together
for two weeks ; expresH and filter.

Dose, from one to three tcaspoonfuls in sweetened water.

Elixir Vitriol. — Take "f a pint of alcohol; drop into it seven
Huid dmms of sulphuric acid, and let the mixture stand threr days
in a close vessel ; then add two drams of po\\(' <id ginjift'r, and tlnee
drams of powdered cinnamon. Macerate scvcii .ys, and filter.

Useful in diarrhoea, dysentery, etc. Dose, from five to fifteen
drops. To avoid injury to the teeth, it should be taken through u
quill, or glass tul)e, or else the moutli should l)e rinsed immediately
after swallowing it. Use with care.

Tincture of Lobelia. — Take four ounces of lobelia, and one pint
each of distilled vinegar and alcohol. Macerate two weeks, express
and filter.

Dose, as a nauseant or expectorant, from thirty to forty drops.

Tincture of Opium. (Laudanum). — Take two and a half ounces
of opium, and two pinfej of diluted alcohol. Macerate fouiteen days,
e:;^. ess, and filter through paper. Dose, from ten to twenty drops.

Tincture of Tolu — Dissolve one ounce of balsam of tolu in one
pint of alcohol, and filter.

Tincture of Rhubarb. — Take three ounces of bruised rhubarb,
half an ounce of bruised cardamom, and a quart of diluted alcohol.
Macerate two we^ks, express, and filter through paper.

Tincture of Virginia Snake-Root. — Take three ounces of bruised
Virginia snake-root, and one quart of diluted alcohol. Macerate tw^o
weeks, express, and filter through paper.

This is advantageously added to the Infusion of Peruvian bark, in
low states of the system. Dose one to two fluid drams.

Compound Tincture of Aloes. — Take three ounces of powdered
aloes, one ounce of saffron, and two pints of tincture of myrrh.
Macerate fourteen days, and filter.

This is the well-known elixir proprietatis, or more commonly, elixir
pro. It is considerably used in female disorders, connected with sup-
pressed, retained, or deficient menstruation. Dose, one to two fluid
dmms.

916

MEDICINES AND THEIR PREPARATIONS.

Compound Tincture of Assafoetida- — Take half an ounce eacli
of lupulin, assafffitida, in small pieces, bruised stramonium seeds,
powdered valerian root, and one pint and a half of alcohol ; macerate
two weeks, shaking frequently, then express and filter.

This is anodyne and antispasmodic, and is used in epilepsy, St.
Vitus's dance, and hysterics. Dose, a teaspoonful.

Compound Tincture of Benzoin. — Take three ounces of benzoin,
two ounces of purified storax, one ounce of balsam of tolu, half an
ounce of powdered aloes, and two pints of alcohol. Macerate two
weeks and filter.

This is used in chronic diseases of the air-passages. Dose, from
thirty to fifty drops.

Compound Tincture of Cardamom. — Take six drams of bruised
cardamom, two ounces of bruised caraway, five drams of bruised cin-
namon, five ounces of seeded i-aisins, one dram of bruised cochineal,
and two pints and a half of diluted alcohol. Macerate two weeks,
and filter.

This is a very agreeable aromatic ; used as a carminative, and to
improve other preparations. Dose, one or two fluid drams.

Compound Tincture of Catechu. — Take three ounces of catechu,
two ounces of bruised cinnamon, and two pints of diluted alcohol.
Macerate fourteen days, express and filter.

This is frequently added to chalk preparations for diarrhoBa, etc.
Dose, from one to three fluid drams.

Compound Tincture of Cinnamon. — Take one ounce of bruised
cinnamon, half an ounce of bruised cardamom seeds, three drams of
bruised ginger, and two pints of proof spirits. Macerate fourteen
days, express, and filter.

This is a warm, aromatic tincture, useful in spasms and debility
of the stomach. Dose, one to two fluid drams.

Compound Tincture of Black Cohosh. — Take one fluid ounce
of tincture of black cohosh, 'ialf a fl-^id ounce of tincture of blood-
root, and two fluii drams of tincture of poke-root. * Mix.

This is used in uiseases of the lungs, liver, and stomach. Dose,
from twenty to fifty drops, three or four times a day.

Compound Tincture of Blue Cohosh. — Take one ounce of pow-
dered blue-cohosh root, half an ounce each of bruised water-pepper
and ergot, two fluid drams of oil of savin, and twelve fluid ounces of
alcohol ; mix, macerate for a fortnight, and filter.

A uterine tonic, used for suppressed and painful menstruation, etc.
Dose, a teaspoonful, two or three times a day.

Compound Tincture of Colchicum. — Mix one fluid ounce each
of tincture of black cohosh and tincture of colchicum-seed.

Used for inflammatory rheumatism and gout. Dose, ten to fifty
drops.

<.■

NAM

iMtwuTiiariitr'

,n ounce each
ionium seeds,
liol ; macerate

n epilepsy, St.

ces of benzoin,
[ tolu, half an
Macerate two

. Dose, from

ims of bruised
)f bruised cin-
ised cochineal,
te two weeks,

ttative, and to
'ams.

jes of catechu,
luted alcohol.

diarrhoBa, etc.

nee of bruised
;hree drams of
jrate fourteen

8 and debility

le fluid ounce

ture of blood-

[ix.

)mach. Dose,

ounce of pow-

water-pepper

luid ounces of

istruation, etc.

id ounce each

leed.

36, ten to fifty

MEDICINES AND THEIR PREPARATIONS.

917

Compound Tincture of Qentian. — Take two ounces of bruised
gentian, one ounce of orange-peel, half an ounce of bruised carda-
mom seeds, and two pints of diluted alcohol. Macerate fourteen
days, express, and filter.

An elegant bitter, much used in dyspepsia, and as an addition tn
tonic mixtures for a weakened state of the stomach. Dose, one or
two fluid drams.

Compound Tincture of Qolden Seal. — Take one ounce each of
powdered lobelia-seed and golden seal, and one pint of diluted alco-
hol. Macerate two weeks, express, and filter.

This is used as a local application to diseased mucous mesnbranes,
in leucorrhcea, gleet, etc.

Ammonisted Tinctur# of Quaiac. — Take four ounces of pow-
dered guaiac, and a pint and a half of aromatic spirits of au^monia.
Macerate for two weeks, and filter.

This tincture has considerable reputation in the treatment of
chronic rheumatism. Dose, one or two fluid drams.

Compound Tincture of Hemlock (^0-olden T}incture). — Take one
ounce each of powdered balsam of tolu, guaiacum, gum hemlock, and
gum myrrh, one ounce and a half of oil of hemlock, one ounce of oil
of wintergreen, and four pints of alcohol. Mix, let them stand four-
teen days, shaking frequently, then filter.

This is used by the Eclectics for rheumatism, wind colic, water-
brash, soreness of the chest, etc. Dose, a teaspoonf ul in a wineglass-
ful of in'ater.

Compound Tincture of High Cranberry. — Take one ounce of
high cranberry bark, powdered, half an ounce each of powdered
lobelia-seed and bruised skunk-cabbage seed, two drams each of
bruised stramonium-seed, powdered bloodroot and capsicum, and two
pints of alcohol. Macerate two weeks, express, and filter.

This is an Eclectic remedy, and is useful in nervous and spasmodic
complaints, particularly hystaiics, etc. Dose, from twenty drops to
a teaspoonful.

Compound Tincture of Lavender Take three fluid drams of

oil of lavender, one dram and a halv of oil of anise, one ounce of
powdered cloves, three drams of mace, one ounce of raisins, two
ounces of red saunders, and one gallon of Jamaica rum. Mix, and
macerate fourteen days, then express and filter.

This is often used for flatulence, hysterics, and faintness. Dose,
from one to three teaspoonfuls, in water.

Compound Tincture of Lobelia. — Take one ounce each of
coarsely powdered lobelia, bloodroot, skunk-cabbage, wil'l ginger,
and pleurisy root. Place tliem in a vessel, and pour over them one
pint of boiling water or vinegar, and cover tightly. Wher cold, add
three pints of alcohoL Macerate two weeks, then ex^.- i. and filter.

UM.

]

MEDICINES AMD THEIR PREPABATIONS.

A valuable emetic for infants and children, in croup, wlioopiiig-
cough, bronchitis, and convulsions. Used also as an expectomnt, in
coughs, pleurisy, etc. Dose, as an emetic for a child, half a teaspoon-
ful and upwards.

Compound Tincture of Lobelia and Capsicum. — Take one ounce
each of powdered lobelia, capsicum, and skunk-cabbage, and one pint
of diluted alcohol. Mix, macerate fouHeen days, and filter.

A prompt antispasmodic in cramps, spasms, lock-jaw, etc. Dose,
half a dram to a dram.

Compound Tincture of Myrrh {Hot Dropis). — Take four ounces
of bruised myrrh, two ounces of capsicum, and four pints of alcohol.
Mix, macemte a fortnight, and filter.

Applied externally, and occasionally given internally for distress
of stomach, flatulence, etc.

Campiiorated Tincture of Opium. — Take one dram each of pow-
dered opium and benzoic acid, one fluid dram of oil of anise, two
ounces of cl»jified honey, two scruples of camphor, and two pints of
diluted alcohol. Macerate fourteen days, and filter.

This is known to all the world as paregoric elixir. It is an agree-
able anodyne and antispasmodic, and a good deal used among cliil-
dren to allay cough, and to relieve pains, diarrhoea, etc.

Compound Tincture of Peruvian Baric. — Take two ounces of
red bark, powdered, one ounce and a half of bruised orange-peel,
three drams of bruised Virginia snake-root, one dram each of saffron,
cut, and red saunders, rasped, and twenty fluid ounces of diluted
alcohol. Macerate two weeks, express, and filter.

This is ffuxham's tincture. It is an excellent stomach cordial, and
is used with advantage in low forms of fever, etc. Dose, from one
to three fluid drams.

Compound Tincture of Rhubarb (^Sweet Tincture of BkubarV). —
Take two ounces and a half of bruised rhubarb, six drams of bruised
liquorice root, three drams each of bruised ginger and saffron, two
ounces of refined sugar, and one quart of diluted alcohol. Macerate
one week, expi-ess, and filter.

A warm, gentle aperient, well fitted for debilitated states of the
stomach. Dose, from a dram or two to an ounce.

Tincture of Senna and Jalap {Elixir Salutis). — Take three
ounces of senna, one ounce of powdered jalap, half an ounce each of
bruised coriander and caraway seeds, two drams of bruised cardamom
seeds, four ounces of sugar, and three pints of diluted alcohol. Mace-
rate two weeks, express, and filter.

This is a warm cordial purgative, useful in costiveness, and gout
attended with debility. Dose, two fluid drams to an ounce.

Compound Tincture of Tamarac {Boners Bitters). — Take three
ounces each of tamarao-bark and juniper-benies, two ounces of

mp, wlioopiiig-
expectomnt, in
lalf a teaspoon-

Fake one ounce
e, and one pint
filter,
iw, etc. Dose,

ke four ounces
tints of alcohol.

illy for distress

-m each of pow-
il of anise, two
ad two pints of

It is an agree-
id among cliil-

pC.

two ounces of
3d orange-peel,
each of saffron,
ices of diluted

ich cordial, and
Dose, from one

yf Rhvharh). —
rams of bruised
nd saffron, two
hoi. Macerate

d states of the

— Take three
1 ounce each of
lised cardamom
alcohol. Mace-

MEDICINES AND THEIR PREPARATIONS.

919

priokly-ash bark, one ounce and a half eacli of wild-cherry l)ark and
seneca snake-root, and half an ounce of tansy ; powder coaiwely, and
mix ; then add one pint and a half of whiskey, and let them stand
twenty-four hours; then place the whole in a vapor displacement
apparatus, and force through the mixture the vapor of another pint
of whiskey, after which steam from water enough to make the tinc-
ture equal to six quarts. To this add twelve ounces of molasses, and
six ounces of thoroughly dissolved alcoholic extract of mandrake.

This is tonic, diuretic, and aperient. Useful in dyspepsia, etc.
Dose, a tablespoonful three times a day.

Ammoniated Tincture of Valerian. — Take four ounces of
bruised valerian, and one quart of aromatic spirit of ammonia. Mace-
rate two weeks, express, and filter.

This is iised as an antispasmodic in hysterics and other nervous
diseases. Dose, one or two fluid drams, in sweetened water.

Compound Tincture of Virginia Snalce-root (^Sudorific Tincture).
— Take oight scruples each, in coarse powder, of Virginia snake-
root, ipejacu.' nha, saffron, opium, and camphor, and one pint of Hol-
land gin or proof spirit. Mix, macerate two weeks, express, and
filter.

This tincture tends powerfully to induce perspiration, and is used
for such purpose when it is desirable to procure sleep, etc. Dose,
from ten drops to a teaspoonful, every hour or two, in catnip or
balm tea

Vinegars.

Vinegar of Lobelia. — Take two ounces of powdered lobelia-seed,
and one pint of distilled vinegar. Macerate in a close vessel one
week ; then express and filter, and add one fluid ounce of alcohol.
This is useful as an emetic and expectorant ; externally, it is valua-
ble in skin diseases. Dose, one to four teaspoonf uls, as often as
necessary.

Vinegar of Squill. — Take two ounces of sliced squill, and one
pint of distilled vinegar ; macerate in a close glass vessel one week ;
then express, strain, and add one fluid ounce of alcohol.

This is expectorant and diuretic, and is sometimes used for coughs
and diseases of the chest.

{ r

mess, and gout
ounce.

. — Take three
two ounces of

1i!lf

WS^^S^*:

•»"51Fl|B?,iJMikJL'l,'l I.

PRESCRIPTIONS. — RECIPES.

These prescriptions are numbered, and referred to by correspond-
ing numbers in the treatment of the various diseases. This arrange-
ment saves the trouble of writing out each prescription every time it
is wanted under the several disordei-s. When there are several
recipes, each of which is suitable in a certain stage of a complaint,
this plan affords the means of referring to them all in a little space,
by simply giving their numbers. The doses named are always for
grovm persons, unless it is otherwise stated. For young people, from
15 to 21, give § of dose. For childien, from 7 to 15, ^ of dose.
In administering medicines of all kinds, the strength and condition
of the patient should be taken into consideration.

Great pains have been taken in preparing these prescriptions. A
considerable portion of them are the favorite recipes of the most dis-
tinguished physicians, the world over. They have been thoroughly
revised, newly discovered remedies added, and those which time has
proved not as valuable have been omitted.

The classification of these recipes under separate heads is necessa-
rily very imperfect, and has been attempted only to make it more
easy for me to refer to them while writing the book. The classifica-
tion could only be applied to a part of them, however ; the rest are
indiscriminately mixed.

Emetics.

1. Ipecac powder, in 30-grain doses, taken in lukewarm water and
repeated every 20 minutes if needed. Wine or syrup of ipecac is a
more useful and palatable emetic for infants and children : it may be
given in 1 to 2 teaspoonfuls as a dose. Useful in poisoning, overloaded
stomach, croup, etc.

2. Mustard flour is a very prompt emetic and always on band for &a
emergency. Dose, 1 dessertspoonful in J pint of warm water; repeated in
10 minutes if needed.

3. Sulphate zinc is a very prompt emetic producing little irritation ; 80
grains, with thirty of Ipecac, generally suffice, but the dose may be re-
peated.

920

mtimm

mmm

MEDICINES AND THEIR PREPARATIONS.

921

ES.

by correspond-
This arrange-
1 every time it
'e are several
)f a complaint,
a little space,
ire always for
g people, from
15, ^ of dose,
and condition

scriptions. A
• the most dis-
en thoroughly
■hich time has

ids is necessa-
make it more
The classificBr
; the rest are

inn water and
of ipecac is a
en : it may be
ing, overloaded

n band for an
er ; repeated in

i irritation ; SO
jse may be re-

4. Apomorphia, when injected under the skiu in doses of J grain,
produces vomiting in 3 to 10 minutes. It may also be given by the mouth
in dosea of ^ of a grain.

Purges. Cathartics.

5. Precipitated sulphur, 15 grains ; magnesia, 1 scruple. Mix. To be
taken each night at bedtime, for costiveness and bleeding piles.

6. Confection of senna, 2 ozs. ; bream of tartar, 1 oz. ; sylphur, 1 oz. ;
syrup of ginger enough to make a stiff paste. Mix. A piece as large as
a nutmeg is to be taken as often as necessai-y to keep the bowels open.
One of the very best remedies for piles.

7. Rochelle salts, 2 drams ; bicarbonate of soda, 2 scruples ; water, ^
pint. Mix. To this mixture add 35 grains of tartaric acid, and take the
whole foaming. This is the recipe for Seidlitz powders.

8. Calcined magnesia, 1 dram ; water, 2 ozs. Mix. To be taken at a
draught. Husband's magnesia, in powder form, taken in teaspoonful
doses every 2 hours till bowels move, is a excellent mild saline.

9. Sulphate of magnesia (epsom salts), 2 drams; freshly roasted coffee
in coarse powder, 2 scruples ; hot water, 4 ozs. Mix and boil for three
minutes, and strain. This may be sweetened, and taken every morning
for habitual costiveness, or repeated once in three hours, if an immediate
effect is desired.

10. Castor-oil, 1 oz. ; the yolk of one egg; put together, and add
simple syrup, ^ oz. ; peppermint water, 2 ozs. Mix. To be taken at a
draught, after being well stirred or shaken. Equally palatable is a table-
spoonful or two of castor-oil between 2 layers of lemon juice.

11. Sulphur, 1 dram; cream of tartar, 2 drams. Mix. To be taken
in syrup or molasses.

12. Rhubarb, 10 grains; calcined magnesia, J dram. Mix. To be
taken in syrup or molasses.

13. Powdered senna, ^ dram; powdered jalap, 10 grains; powdered
cloves, 10 grains. Mix. To be taken in sweetened water.

14. Compound licorice powder, or so-called German powder, is a
thorough physic in heaping teaspoonful doses. It is a physic very com-
monly used. Best taken in milk, but not bad in water.

15. Garfield tea, bought in packages and steeped per directions, is also
a simple carthartic, and may be continued for a while each night. No
physic proper should be so used for any great length of time.

16. Castor-oil, 1 dessert spoonful to 2 tablespoonfuls.

17. Castoria is a proprietary medicine, yet one which children and in-
fants take readily and without any deleterious effect.

18. Sulphate of magnesia, 1 oz. ; cream of tartar, 1 oz. ; pure water,
1 pint. Mix. A wine-glassful occasionally.

19. Compound extract of colocynth, ^dram; aloin, 2 grains; extract
of belladonna, 2 grains. Mix, and divide into 8 pills. One as required

I'M H

nif

>*i(SEJ»li"

mmm

H^-^

i. Jlji l l

MEnrCINES AND THEIR PREPAKATI0N8.

20. The Boliition of citrate of magncBia, which all dniggiBts keep in
stock in pint bottles, is the most palatable, the simplest, and moat effcca
cious saline we have. The ordinary dose is ^ bottle ; this may be repeated
in 4 hours.

21. Syrup of figs is another proprietary medicine of some value; it con-
tains senna. Dose, 2 to 4 teaspoonfuls. Is agreeable to children.

2'2. Aloin, strychnia and belladonna, in pill form, is sold everywhere
by druggists, and is a suitable mild cathartic. The pill is put up in vary-
ing strengths, but that which contains aloin, ^ grain, is a moderate strength
piU.

J. Sulphur, 1 teaspoonful; cream of tartar, 10 grains; saltpetre, 5
grains. Mix. To be taken at a dose.

24. Manna, 2 drams ; fennel water, 1 oz. Mix. One dessert spoon-
ful, as a cathartic for an infant.

25. Castoria (See No. 17) and aromatic syrup of rhubarb are good laxa-
tives for children.

26. Cascam sagrada is an herb which has become extremely popular
and useful in constipation, as it is a tonic laxative. It is given in various
forms, of which the best are the aromatic preparations of cascara, in tea-
spoonful doses at night, the solid extract in pill form, in doses of J to ^
grain, 1 to 3 three times daily, or Maltine with cascara, in I to 4 teaspoon-
ful doses at bedtime. These preparations may be contined for long inter-
vals if need be.

27. Epsom salts, 2 drams; dissolve in pure water, 1 oz. Then add
sweet spirits of nitre, 2 drams; laudanum, 10 drops. Dose, a tea-
spoonful, to be repeated according to circumstances.

28. Aromatic syrup of rhubarb, in teaspoonful doses to a young child,
or in tablespoonful doses to an older child, is a good corrective.

29. Compound extract of colocynth, ^ dram ; extract of jalap, 15 grains.
Mix. Make 12 pills. Two or three pills will produce active operation of
the bowels. Add ext. belladonna, 2 grs., to prevent gripes.

30. Solution of tiie citrate of magnesia, in wineglass doses, every two
hours, till it operates, or in ^ bottle dose for a single dose.

81. Pulverized gamboge, 12 grs.; pulv. scammony, 12 grs.; elate-
rium, 2 grs. ; croton oil, 8 drops ; ext. of stramonium, 3 grs. Mix. Make
12 pills. One pill is a dose, repeated every hour until it operates.

32. Compound cathartic pills, improved, in doses of two to three pills,
produce in four hours one or two complete and full operations.

83. See Nos. 17, 20, 21, and 25.

84. Leptandrin, ^ grain; podophyllin, ^ gr. ; euonymin, ^ grain; in-
spissated ox-gall, 2 grains, is an admirable liver-pill, taken one to three
times daily.

35. Pulverized rhubarb, 2 scruples; bicarbonate of potassa, 1 scruple;
ext. of nux vomica, 5 grs. Mix. Make 20 pills. One pill twice a day.

86. Leptandrin, | grain; ext. nux vomica, J grain; euooymin, ^ grain;
iridin, ^ grain ; ext. cascara sagrada, J grain, makes also a very good bil-
ious pill ; it may be taken as often as three times a day, if needed.

mssms^msm

iiggiHts keep in
ind moat effcca
may be repeated

ie value ; it con-
children.

sold everywhere
1 put up in vary-
loderate strength

ns; saltpetre, 5

i dessert spoon-

b are good laxa-

ctremely popular
given in various
cascara, in tea-
doses of J to I
I to 4 teaspoou-

id for long inter-

oz. Then add
. Dose, a tea-

» a young child,
ective.

jalap, 15 grains,
itive operation of
)es.

doses, every two
e.

12 grs. ; elate-
;rs. Mix. Make
operates.

wo to three pills.
Lions.

ain, ^ grain; in-
cen one to three

tassa, 1 scruple;
pill twice a day.

joymin, \ grain ;
» a vei'y gooid bil-
if needed.

MEDICINES AND THEIK PKEI'ARATIONS.

87. Sweet tinct. of rhubarb, 4 ozs. ; bicarbonate of soda, 2 drams. Mix.
From a teaspoonful to a tablespoonful, as occasion may require.

38. Pulverized rhubarb, 2 ozs. ; bicarbonate of potassa, 1 oz. Mix. Of
this take enough to produce one movement of the bowels per day.

89. Leptandrin, 30 grs. ; podophyllin, 5 grs. ; pulv. cayenne, 10 grs. ;
ext. nux vomica, 6 grs. ; quinine, 12 grs. Mix. Make 24 pills. One,
two or three times a day.

40. Podophyllin, 2 grs. ; leptandrin, 10 grains ; cream of tartar, 5 scru-
ples. Mix. Divide into 10 powders. One is a dose.

41. Comp. powder of jalap, 1 oz. ; cream of tartar, 1 oz. Mix. One
teaspoonful is a dose, to be taken in sweetened water.

42. Pulverized charcoal, \\ drams; pulv. rhubarb, 2 scruples; pulv.
ipecac, 6 grains; extract of hyoscyamus, 12 grs. Mix. Divide into 12
portions. Give one every three or four hours.

43. Pulverized blood-root, 1 dram ; pulv. rhubarb, 1 dram; caatile soap,
2 scruples. Mix, and divide into 32 pills. Take one morning and night.
Excellent for costiveness.

44. Rochelle, 14 drams; magnesia, 11 drams; powdered charcoal, 8
drams. Mix. Dose, a heaping teaspoonful, in dyspepsia and coftive-
ness, with foul breath, etc.

45. Pulverized rhubarb, 8 grs. ; pulv. guaiacum, 8 grs. ; galbanum, 2
grs. ; pulv. ipecac, 2 grs. Mix. Make 8 pills. Take one or two pills
night and morning. For a weak stomach and a bilious condition.

Tonic and Cathartic.

46. Podophyllin, 4 grs. ; leptandrin, 8 grs. ; quinine, 8 grs. ; ext. nux
vomica, 2 grs. Mix. Make 16 pills. One, two, or three pills at bedtime,
according to the requirements of the case.

47. Sulphate of iron, 1 scruple; ext. cascara, 7 grains. Mix and make
into 20 pills. One pill twice a day. An excellent remedy in chlorosis,
when the bowels are confined.

48. Carbonate of iron, 1 dram ; pulverized rhubarb, \ dram ; aloin, 6
grains; extract of hops, ^ dram. Mix. Make 30 pills. One pill three
times a day.

49. Fluid extract of senna, 1 dram; compound fluid extract of gentian,
\ dram ; fluid extract of ginger, ^ dram ; aromatic spirits of ammonia,
I dram. Mix. To be taken in a wineglassful of sweetened water.

50. Aromatic syrup of rhubarb, 1 oz. ; tincture of Colombo, 1 oz. Mix.
Dose, two teaspoonfuls three times a day.

51. Compound infusion of gentian, 6 ozs. ; epsom salts, 4 drams; di-
luted sulphuric acid, 16 drops. Mix. A tablespoonful every six hours.

52. Tr. aloes, ^ oz. ; pulv. gum-arabic, 5 grs.; magnesia, 1 dram;
white sugar, 5 grs. ; comp. infusion of gentian, 1^ ozs. ; water, 1^ oza. :
tinct. of ginger, 1^ ozs. Mix. From a teaspoonful to a tablespoonful to
be taken night and morning.

m\ '

924

MBDIOINEB AND THEIR PREPAKATIONB.

58. Pulverized Peruvian bark, 1 oz. ; pulv. rhubarb, ^ dram ; pulv. mn-
riate of ammonia, 1 dram. Mix. Divide into eight powders. Take one
three times a day.

54. Oxide of zinc, 2 drams ; magnesia, ^ oz. ; quinine, 1 scruple. Mix.
Divide into 32 powders. Take one four times a day.

55. Spnulel salts, 1 teaspoonful in ^ glass warm water on arising; crab-
orchard water, 1 tablespoonful in ^ glass water on arising; Hunyadi
Janos, ^ glass or more in water; 1 teaspoonful phosphate of sodium in a
glass of hot water on arising ; are all good saline remedies for biliousness.

Carminatives.

56. Manna, 1 oz. ; aniseed, bruised, 1 dram ; ooiling water, ^ pint.
Mix. Let the mixture stand for half an hour, then strain, and add three
drams of carbonate of magnesia, so as to make a perfect mixture. Take
a wineglass full every two or three hours till it operates. For the drum-
head Gtate of the bowels.

57. Thoroughwort, 2 ozs. ; ginger and cloves, each, ^ oz. ; ext. dan-
delion, 4 ozs. ; water, 1^ pints. Boil to one- third, and add sugar, 1^
pounds, and brandy, ^ pint. An excellent cordial cathartic to act upon
the liver.

Tonics.

58. Chamomile flowers, i^ oz. ; cold water, 1 pint. Macerate for one
hour and strain. A wineglassful to be taken several times a day.

59. Sulphate of quinine, 15 grains; diluted sulphuric acid, 15 drops;
compound tincture of cardamom, 3 drams ; tincture of hops, 3 drams ; com-
pound infusion of roses, 6 ozs. Mix. A teaspoonful two or three times a
day, in chlorosis.

60. piluted sulphuric acid, 2 drams ; syrup of orange-peel, 2 ozs. ; cin-
namon-water, 1 oz. Mix. A teaspoonful or two in a wineglass of water
two or three times a day.

61. Bland's iron pill, 3 grains, three times daily. This pill is often
united with strychnia, -^ grain, and arsenious acid, -^g grain, which adds
to its efficiency. If constipation exists, there may also be added ext. cas-
cara, ^ grain, in chlorosis, anaemia, and conditions requiring iron.

62. Sulphate of quinine, 12 grains; aromatic sulphuric acid, 24 drops;
syrup, 1 oz. ; peppermint water, 1 oz. Mix. In intermittent fever, take
one tablespoonful once in three hours. Ordinarily, one teaspoonful is a
sufficient dose. Or quinine, 10 grains, four hours before the expected chill.

63. Compound infusion of gentian, 8 ozs. ; nitro-muriatic acid, 30
drops. Mix. Take one tablespoonful three times a day.

64. Bicarbonate of soda, ^ oz. ; compound infusion of gentian, 4 ozs. ;
tincture of Colombo, 1 oz. ; syrup of orange-peel, ^ oz. Mix. Take a
tablespoonful three times a day.

65. Sulphate of quinine, 1 scruple; alcohol, 4 ozs.; sulphuric acid, 5
drops ; Madeira wine, 1 quart. Mix. Two wineglassfuls a day.

66. Tinct. gentian compound, teaspoonful in wineglass water before
eating.

MEDICINES AND THEIK PREPARATIONS.

925

Iram ; pulv. mil-
lers. Take one

1 scruple. Mix.

n arising ; crab-
sing ; Hiinyadi
of sodium in a
for biliousneas.

water, J pint.

and add three

mixture. Take

For the druni-

oz. ; ext. dan-
add sugar, 1|
tic to act upon

icerate for one
I a day.

Eusid, 15 drops;
3 drams : com-
)r three times a

el, 2 ozs. ; cin-
eglasB of water

s pill is often
in, which adds
idded ext. cas-
iig iron.

cid, 24 drops;
»nt fever, take
easpoonful is a
I expected chill,
riatic acid, 30

;entian, 4 ozs. ;
Mix. Take a

Iphuric acid, 5
a day.

water before

67. Quinine, 1 scruple; alcohol, 4 ozs. ; sulphuric acid, it drops. Mix.
Take a teaspoonfui three times a day, or quinine pills, 2 grs. each, one
three times a day.

68. Arseniate of iron, 3 grains; extract of gentian, 2 drams; pulver<
ized licorice, 1 dram. Mix. Make 20 pills. Take one pill three times
a day. If the eyelids become inflamed, discontinue for a few days, and
then begin again. .

69. Soft water, 3 ozs. ; quinine, 10 grains; diluted sulphuric acid, 10
drops; simple syrup, 1 oz. Mix. A teaspoonfui every two or three
hours.

70. Quinine, 10 grains ; diluted sulphuric acid, 10 drops; white sugar,
4 drams ; cinnamon water, 4 ozs. ; tincture of kino, 2 drams. Mix. One
teaspoonfui every three hours.

71. Tartrate of iron, 40 grains; aoft water, 2 ozs. ; Hyrup of ginger,
i oz. Mix. 20 to 40 drops every three hours.

72. Potassio-tartrate iron, 4 scruples ; quinine, 4 scruples ; alcoholic ext.
of black cohosh, 4 scruples. Mix. Make 48 pills.

73. Pill, citrate of iron, quinine, and strychnia, 2 grains. One pill three
times daily.

74. Precipitated carbonate of iron, 30 drams ; ext. of conium, 15 drams ;
syrup of balsam of tolu, 6 ozs. ; oil of cinnamon, 12 drops; oil of lemon,
12 drops; alcohol, 2 ozs.; water, 1 pint; brandy, ^ pint; loaf-sugar,
4 ozs. Mix. Give from one to three tablespoonfuls three or four times a
day, in insanity.

75. Citrate of iron, 1 dram ; sulphate of quinine, 1 scruple ; ext. of nux
vomica, 8 grs. Mix. Make 32 pills. One pill three times a day.

76. Nitric acid, 1 dram ; hydrochloric acid, J dram ; comp. infusion of
gentian, 1 J ozs. Mix. One teaspoonfui in water is a dose.

77. Sulph. quinine, 1 dram ; tartaric acid, 6 grs. ; water, 1 drop. Mix.
Make 30 pills. Dose, one pill, to be repeated as often as needed.

■ 78. Diluted nitric acid, 4 drams ; diluted muriatic acid, 4 drams ; syrup
of orange-peel, 1 dram ; water, 1^ ozs. Mix. One teaspoonfui in a wine-
glass of water, taken before meals.

General and Nerve Tonics.

79. Valerianate of iron, quinine and zinc, of each 1 grain in pill form,
taken three times daily, is an excellent nervine ; or pill sumbul comp. , one
three times daily.

80. Iron by hydrogren, 48 grs. ; arsenious acid, 1 gr. ; ext. of nux
vomica, 5 grs. Mix. Make 24 pills. For an adult, one pill three times
a day.

81. Valerinate quiuiue, 1 grain; extract valerian, 1 grain; extract of hy-
oscyamus, ^ grain. One pill evpry two or three hours till quiet, then one
every four or six hours.

82. White vitriol, 1 dram ; ext. of nux vomica, 8 grs. Mix. Make 32
pills. One pill three times a day.

ijB»»--

926

MKHIClNKb AND TIIEIK PKKrAUATlONS.

83. Strychnia, 2 ri-b. ; oxt. of aconite, 16 grs. ; ext. of hyoBcyainiis, IC.
gni. ; quinine, ^ dram. Mix. Make .S2 pills. One pill three times a day.

84. Citrate of iron, 1 dram; trisnitrate of bismuth, 1 dram; sulphate of
quinia, 1 scruple ; ext. of nux vomica, (i grs. Mix. Make 32 pills. Take
one pill three tiroes a day.

Nerve-Tonics and Antispasmodics.

85. Strychnine, 2 grs. ; ext. belladonna, i) grs. ; alcoholic extract of
black cohosh, 2 scruples. Mix. Make 40 pills. One pill four times
a day.

86. Strychnine, 2 grs. ; diluted phosphoric acid, 1 oz. ; peppermint
water, 3 pints. Dissolve the strychnine in the acid ; then add the pepper-
mint water. A tahlespoonful to be taken three times a day, in palsy, dyn-
pepsia, neuralgia, and in most states of the nervous system requiring tone.
Also in fever and ague.

87. High-cranberry bark, 1 oz. ; skunii-cabbnge root, ^ oz. ; scullcap,
^ oz. ; cardamom seeds, 2 drams ; pulv. cayenne, 2 drams. Put these to
a pint of wine ; shake well every day for three or four days. A table-
spoonful four times a day.

88. Aconitia, ^^^ grain; antifebrin, 2 grains; quinine, 1 grain; ar-
senic chlorophos., j^ grain; strychnia, yjo grain. One pill. Take one
such pill every two to four hours, according to pain. Used in neuralgia.

89. Extract of valerian, 12 grs.; extract of hyoscyamus, 12 grs.;
oxide of zinc, 24 grs. Mix. Make 12 pills. One pill twice a day.

90. Extract of hyoscyamus, 48 grs. ; extract of valerian, 24 grs. ;
camphor, 24 grs. Divide into 24 pills. Take one every four hours.

9 1 . Extract of hyoscyamus, ^ dram ; aconitia, I gr. ; strychnine, 2
grs. ; pulverized cayenne, ^ dram ; phosphide of zinc, 5 grs. Make 80
pills. Take one four times a day. Excellent in neuralgia.

92. Antikamnia, 60 grs. ; caffein, 24 grs. ; divide into 12 capsules.
Take one every two hours for neuralgia of face. See also 88.

93. Valerianate of iron, valerianate of zinc, valerianate of quinine; of
each, 30 grs., to be divided into 30 pills or capsules. Take one three
times a day for the neuralgic condition.

94. Tincture of veratrum viride, 2 drams; bromide of soda, 4 drams;
elixir of anise, 1 oz. ; syrup of orange, 2 ozs. Take a teaspoonful in
wineglass of water every two to four hours according to nervousness.

95. Strychnine, 1 gr. ; arsenious acid, 1 gr. ; quinine, 20 grs. ; reduced
iron, 20 grs. ; extract cannabis indica, 5 grs. Divide into 30 pills or
capsules. Take one three times daily.

96. Simple syrup, 1 oz. ; prussic acid, 1 drop. Mix. A teaspoonful
morning and evening. If no dizziness or sickness is produced within
forty-eight hours, repeat the done three times a day. This is for a child
six months old ; add one drop more of the acid for each additional year of
the child's age.

97. Phosphide of zinc, 5 grs. ; extract of nux vomica, 7 grs. ; extract
of cannabis indica, 5 grs. Divide into 30 pills or capsules, and take one
three times daily as a nerve tonic.

m^^^Sm^^^^^^mi^iiSSSSi^Sssie^Siiir

r hyoHcyanuiit, lii
bree times a day.

Iratn ; sulphate of
e 32 pills. Take

lies.

Qholic extract of
e pill four times

oz. ; peppermint
1 add the pepper-
ay, in palsy, dys-
m requiring tone.

^ oz. ; Bcullcnp,

ns. Put these to

days. A table-

ne, 1 grain ; iir-
> pill. Take one
led in neuralgia,
yam us, 12 grs. ;
twice a day.

derian, 24 grs. ;
y four hours,
r. ; strychnine, 2
) grs. Make 80
;ia.

ito 12 capsules.
JO 88.

;e of quinine ; of
Take one three

' soda, 4 drams;

a teaspoonful in
nervousness.
20 grs. ; reduced

into 30 pills or

A teaspoonful
produced within
["his is for a child
additional year of

I, 7 grs. ; extract
lies, and take one

MRDIC1NE8 ANU THEIK Pi:RPAKATI0N8.

927

9M. Quinine, 12 grs.; reduced iron, 10 grs.; arsenious acid, ^ gr. ;
phosphide of zinc, 2 grs. Divide into 24 pills. Take one three tini':"
dully for ft child from 8 to 12 years of ago. For St. N'itus's dance. Or,
Fowler's solution, 1 oz. (iive 3 drops to a child of 8 to 12 years in a
little water three times daily, and increase dose by one drop every third
diiy till eyes become puffy or nose waters. Then stop for three days and
begin again, (iive also pepto-mangan, 1 bottle; a teaspoonful three
times daily. This latter is an elegant form of mild iron, and does not
Htuiu the teeth or constipate.

!)!>. Phenacetin, 50 grs.; divide into 6 powders: give one every two
houi « till pain ceases. Or chlorodyne, one dram ; aromatic spirits of
anim..nia, one dram ; elixir simplex, I oz. Mix. One teaspoonful in a
tublespoonful of hot water every 20 minulea till relieved.

100. Extract of high cranberry bark, 1 scr. ; cuocymiu, ^ scr. ; iridin,
J Mcr. ; pulverized cayenne, 1 scr. Mix. Make 20 pills. Take one pill
nil hour after each meal. Simpler yet is a tablesiH>onful of crab-orchard
water in ^ glass plain water once or twice a day.

101. Iodide of potash, peppermint water; ofeach2ozs. Give 10 to 30
drojis in J glass water three times daily on a full stomach ; for secondary
and tertiary syphilis and similar complaints. For a child give 5 to 10
drops.

102. Elixir of the three iodides, 6 ozs. ; one teaspcwnful in water three
times daily.

103. Syrup of iodide of iron, 1 oz. Thirty drops three times a day, in
water. An excellent remedy in chlorosis, and all other low states of the
bloo<1 connected with scrofula. Or, a pill of iodide of iron, 1 gr., three
times daily.

Expectorants and Cough Preparations.

104. Apomorphia, 1 gr. ; chloroform, 10 drops; elixir yerba santa,
2 ozs. Take one teaspo )uf ul every two hours.

105. Infusion of sen'^ga, 4 ozs. ; syrup of ipecac, 1 dram ; syrup of
squills, 3 drams; tartar emetic, 1^ grs. Mix. A teaspoonful every
ten minutes.

106. Wine of ipecac, IJ drams; chloroform, 5 drons; syrup of tolu
suflicient to make 1 oz. Give J teaspoonful every two hours for a child
three years old.

107. Tincture aconite, 20 drops; wine of antimony, 1^ drams; chloro-
form, 10 drops; elixir terpin hydrate, enough to make 2 ozs. Give tea-
spoonful every two hours.

108. Bromoform, 1 oz. Give 5 drops in tablespoonful of water four
times daily to a child eight years old suffering with whooping cough.
This dose is to be well mixed and quickly given, because bromoform does
not mix well with water. It is to be increased by 1 drop every other day
till about 10 drops are given at a dose. Other ages in proportion. Burn
also a cresolene lamp.

109. Tincture bloodroot, 4 J ozs.; wine of ipecac, 2 drams; tincture of
aconite 20 drops; honey, ^ oz. ; McMunn's elixir, IJ drams; elixir yerba
santa to make 3 oze. Take teaspoonful every two hours.

I. ■,

:);.

'5-1,

'<<nps<IW(mi

MKDICINK8 AND THEIK PKKFARATIONS.

110. Wine of ipeonc, 2 drams; chloroform, 1ft drops; liquid Dover's,

1 dram ; linoline, or compound emulsion of flax-seed (omitting the chloral
and morphine) enough to make 3 ozs. One teaspoouful every two hours:
for hard, dry cough.

111. Tincture of lobelia, 2 drams; tincture of bloodroot, 4 drams;
honey, 1 oz. ; dilute hydrocyanic acid, 1^ drams; cherry-laurel water
enough to make 3 ozs. Give one teasi)oonful every two hours.

112. Syrup of tolu, 1 oz. ; syrup of squills, ^ oz. ; wine of ipecac,
2dr>imH; codeia, 2 grs. ; mucilage of gum-arabic, 1^'ozs. Mix. Take
a tenspoonful occasionally.

118. Tincture bloodroot, 2 drams; syrup of tolu, 1 oz. ; mucilage of
gum-arabic, 3 ozs. ; diluted hydrocyanic acid, 40 drops ; codeia, 4 grs.
Mix. Dose, from oue to two teaspoonfuls.

Carminatives.

Aromatic spirits of ammonia, 2 drams ; tincture of cardamom com-
pound, 1 oz. ; tincture of capsicum, 10 drops; chloroform, 15 drops;
spirits of lavender compound enough to make 2 ozs. Give teaspoonful iu
wineglass of hot water every fifteen minutes till relieved.

115. Compound tincture of cardamom, 2 ozs.; compound tincture of
lavender 2 ozs ; Hayden's Viburnum Compound, 2 ozs. Mix. One tea-
spoonful at a time, as occasion may require.

Narcotics and Anodynes.

116. Hayden's viburnum compound, or dioviburnum. One teaspoon-
ful every ^ hour while in pain. Two tablespoonfuls of gin, and even of
brandy in hot water also relieve at times.

117. Powdered camphor, 12 grs.; powdered Castile soap, 12 grs.;
codeia, 4 grs. ; syrup, 2 scrs. Mix. Make into 12 pills. Take oue
every hour till the eflfects of opium are experienced.

118. Laudanum, ^ oz. ; wine of ipecac, ^ oz. ; spirits of nitric ether,
} oz. Mix. One teaspoonful every hour, till narcotic effects are observed.

119. Camphor, 2 drams; chloroform, 1 dram; the yoke of an egg.
Mix, and rub together ; and then add, MoMunn's elixir, 3 drams ; aromat-
ic spirits of ammonia, 1 oz. Mix well. Take one teaspoonful every
hour until it proves anodyne.

120. Camphor, ^ dram ; extract of hyoscyamus, 20 grs. ; mucilage of
gum-arabic, 2 scrs. Make 10 pills.

121. Chloroform, 2 ozs. ; compound sulphuric ether, 2 ozs. ; cardamom,

2 ozs. ; tincture cayenne, 1^ ozs. ; hydrocyanic acid, diluted, ^ oz. Mix.
Dose, half a teaspoonful every three hours till anodyne effects are exper-
ienced.

122. Extract of belladonna, 10 grs.; hydrocyanic acid, 40 drops;
tincture Colombo, 1 oz. ; simple syrup, 1 oz. ; soft water, 2 ozs. Mix.
One teaspoonful three or four times a day. Excellent in gastralgia and
irritable dyspepsia. Also in asthma.

123. Extract of belladonna, 6 grs. ; pulverized ipecac, 10 grs. ; con-
fection of roses, 2 grs. Mix. Make 30 pills. Take 1 pill twice a day.

TTfA.

; liquid Dover's,
litting the chloral
Bvery two hours :

Jroot, 4 drnniH;
Grry-laurel water
liours.

wine of ipecac,
18. Mix. Taice

9Z. ; mucilage of
I ; codeia, 4 grs.

f cardamom com-
'orm, 15 drops;
/e teaspoonful iu

ound tiucture of
Mix. One tea-

One teaepoon-
;in, and even of

soap, 12 grs. ;
pills. Take one

I of nitric ether,
cts are observed.

oke of an egg.

drams ; aromat-

laspoonful every

rs. : mucilage of

)Z8. ; cardamom,
ited, i oz. Mix.
ffects are exper-

acid, 40 drops;
er, 2 OZ8. Mix.
in gastralgia and

c, 10 grs. ; cou-
pill twice a day.

MKUIC1NK8 AND THEIR PREfAKATIONB.

Diaphoretics and Sedatives.

929

124. Tincture of American hellebore, 1 dram; tinctureof blank cohosh,
2 oza. Mix. Take one teaspoonful from three to six times a day.
Excellent for neuralgia.

I2fi. I*idverized gum arabic, 1 scr. ; soft water, 2 ozs. ; sweet spirits
of nitre, ^ oz. ; tincture of veratrum viride, 20 drops. Mix. Give half
a tetispoonful every half hour.

12(>. Phenaoetine, 10 grs. taken on tongue with a glass of hot lemon-
ade ; children in proportion to uge.

127. Dover's powder, 10 grs. on retiring, taken with hot drink.

Diuretics.

Tea-

128. Spirits of Mindererus, 2 02.3. ; sweet spirits of nitre, 1 oz.
spoonful every three hours. 10 to 80 drops, diluted, for children.

12*J. Diuretin, 10 grs, every two hours.

1<)0. Infusion of digitalis, 4 ozs.; acetate of potash, 2 drams; sweet
spirits of nitre, 2 drams; cinnamon water, 1^ ozs. Mix. A tablespoon-
ful every four or five hours.

131. Acetate of potash, 4 drams; lemon juice, 1 oz. ; syrup and water
of each, 1 oz. Teaspoonful iu wineglass of water every two hours.

Refrigerants.

132. Cream of tartar, 2 scrs. ; water, 1 quart. Mix. Flavor to suit.

133. Bicarbonate of soda, 30 grs. ; water, 6 ozs. Mix. To this mix-
ture adi 25 grs. of tarte.ric acid, and take the whole foaming.

Stimulants.

134. Muriate of ammonia, 1 oz. ; soft water, 9 ozs. Mix. Ir.l.e one
tablespoonful three or four times a day.

135. Aromatic spirits of ammonia, 2 drams; ethei, 1 dram; chloro-
dyne, 20 drops ; spirits of camphor, 1 dram. Mix. Half a teaspoonful
as often as required.

Alteratives.

136. Proto-iodide of mercury, 5 grs. ; extract of opium, 5 grs. Mix.
Make 20 pills. Take one pill night and morning. For syphilis.

137. Biniodide of mercury, 5 grs.; extract of conium, 2 scrs. Mix.
Make 20 pills. Take one pill night and morning. For syphilis.

138. Compound infusion of sarsaparilla, 1 pint; iodide of potassium,
i oz. Mix. Take a teaspoonful after each meal.

139. Compound infusion of sursaparilla, 1 pint; corrosive sublimate,
4 grs. Mix. Take a teaspoonful four times a day. For syphilis.

140. Compound infusion of gentian, 4 ozs. ; iodide of potassium, J oz.
Mix. One teaspoonful after each meal, well diluted.

930

MEDICINES AND THEIR PREPARATIONS.

141. Iodide of arsenic, 5 grs. ; soft water, 1 pint. Mix. One tea-
spoonful three times a day.

142. Blue pill, 12 grs. ; pulverized ipecac, 3 grs. ; extract of hy^s-
cyarauB, 4 grs. Mix. Divide into 12 parts, one to be given every three
hours. For syphilis.

143. Pulverized bloodroot, 1 scr. ; iodide of arsenic, 2 grs. ; extract
of cicuta, 2 scrs. Mix. Make 40 pills. One pill three times a day.

144. Iodide of potassium, 1 dram ; water, J oz. Mix. Thirty drops
to a child 7 years old, every hour.

145. Compound syrup of stillingia, 1 pint; iodide of potassium, 1 oz.
Mix. A tablespoonful after each meal.

146. Fluid extract of sarsaparilla, 4 ozs. ; fluid extract of pipsissewa,
1 oz. ; water, 1 quart ; iodide of potassium, 2 ozs. Mix. Take a table-
spoonful three times a day.

147. Bicarbonate of potassa, 3 drams; water, 4 ozs. Mix. Add a
tablespoonful of the solution to the same quantity of lemon juice, pre-
viously mixed with a tablespoonful of water. To be taken foaming,
several times a day.

148. Blue pill, ^ dram; extract of henbane, 1 scr. Make 10 pills.
One pill at night. For syphilis.

149. Mercury with chalk, J dram; extract of conium, 1 scr. Make
into 8 pills. Take one pill night and morning. For syphilis.

150. Corrosive sublimate, 4 grs. ; extract of opium, 5 grs. Mix, and
make into 20 pills. Take one pill night and morning. For syphilis.

151. Iodide of potassium, 1 dram; syrup of sarsaparilla, 4 ozs. Mix.
Take two teaspopnfuls three times a day. For syphilis.

Astringents.

152. Sugar of lead, 2 scrs.; ergotine, 1 scr.; conserve of red roses,
1 scr. Beat into a mo'!S, which is to be divided into 30 pills. Take one
every hour, until beneficial effects are observed.

153. TuUy's powder, J dram; prepared chalk, 1 scr. Mix, and divide
into 12 equal powders.

154. Chalk mixture, 4 ozs. ; tincture of catechu, ^ oz. ; papiue, 3
drams. Mix. Dose, in diarrhoea, two to four teaspoonfuls three times
a day.

155. Oil of turpentine, 1 dram; mucilage of gum arable, 1 dram;
simple syrup, ^ oz. ; cinnamon water, 2 ozs. Mix. To be taken at a
draught.

156. Sugar of lead, 16 grs.; prepared chalk, 1 dram; pulverized ipe-
cac, 4 grs.; pulverized opium, 2 grs. Mix. Divide into 16 portions,
one to be given every three or four hours.

157. Sugar of lead, 8 grs.; vinegar, 8 drops; white sugar, 1 dram;
soft water, 1 oz. Mix. A teaspoonful three or four times a day, until
the discharges are abated.

158. Prepared chalk, ^ dram ; pulverized ipecac, 3 grs. Mix. Make
12 powders. (Jive one, two or three times a day.

MEDICINES AND THEIR PREPARATIONS.

931

Mix. One tea-
extract of hy^a-
given every three

c, 2 grs. ; extnict
;e times a clay.
[ix. Thirty drops

)f potassium, 1 oz.

•act of pipsissewa,
ix. Take a table-

iZ8. Mix. Add a
f lemon juice, pre-
)e taken foaming,

•. Make 10 pills.

um, 1 scr. Make

yphilis.

1, 5 grs. Mix, and

For syphilis,
irilla, 4 ozs. Mix.

jerve of red roses,

pills. Take one

Mix, and divide

^ oz. ; papine, 3
>onfuls three times

1 arable, 1 dram;
To be taken at a

,m; pulverized ipe-
B into 16 portions,

ite sugar, 1 dram;
times a day, until

grs. Mix. Make

159. Pulverized catechu, 2 drams ; bruised cinnamon, ^ dram ; boiling
water, 5 ozs. Steep in a covered vessel for one hour and strain. A tea-
spoonful every two, three, or four hours, according to age, nature of the
case, etc.

160. Soft water, 1 oz. ; sugar of lead, 5 grs.; vinegar, 6 drops; loaf
sugar, 3 drams. Mix. A teaspoonful every hour or two.

161. Tincture of catechu, ^ oz. ; laudanum, 2 drams; spirits of cam-
plior, 2 drams; tincture of myrrbse, 2 drams; tincture of cayenne, 2
drams. Mix. Dose, from half a teaspoonful to a teaspoonful, for
diavrha'a.

162. Syrup of orange-peel, 1 oz. ; tincture of catechu, 2 grs. ; tincture
of cinnamon, 6 drams; tincture of cardamom, 2 drams. Mix. Dose, a
teaspoonful. A valuable remedy in diarrhoea.

. Counter-irritants.

163. T'licture of Spanish flies, 1 oz. ; olive oil, 2 ozs. ; alcohol, 4 pint.
Miv To be applied externally, watching the effect, so as not to produce
a blister.

164. Water of ammonia, 1 dram; olive oil, 1 oz. Mix. Apply to
the skin.

165. Mustard powder, 1 tablespoonful. Mix with a little water to
make a thick paste. Then spread upon a piece of brown paper or cotton
cloth, and cover its surface with a piece of thin muslin to prevent the
mustard from sticking to the flesh. Place it upon the sore or painful part,
and keep it on fifteen or twenty minutes, or till a good degree of redness
is produced.

166. Vinegar of Spanish flies, 1 oz. ; spirits of camphor, 1 oz. Mix.
To be rubbed gently upon the skin. If applied freely, and rubbed
thoroughly in, it may produce a blister.

167. Yellow wax, rosin, lard, each, 6 drams. Melt over a slow fire,
and then stir in slowly, when at a very moderate degree of warmth, 1 j
drams of pulverized Spanish flies, to make an ointment.

168. Water of ammonia, strong, 1 oz. ; alcohol, 1 oz. Mix. Wet a
piece of cotton cloth, and lay it upon the painful part, and cover it with
flannel to prevent evaporation.

Ointments.

169. Mercurial ointment, 1 oz. ; extract of belladonna, 1 oz. ; extract
of henbane, 1 oz. ; camphor, 10 grs. Mix. For external use.

170. Extract of belladonna, J dram; vaseline, ^ oz. Mix. To be
rubbed on the neck of the womb in painful menstruation.

171. Prussic acid, -2 drams; sugar of lead, 1 dram; cocoanut oil, J
oz. ; aseline, ^ oz. Make an ointment.

172. Neapolitan ointment, 2 drams, extract of belladonna, 1 dram.
Mix.

173. Extract of belladonna, 15 grs. ; vaseline, 1 oz. Mix.

i IREi

932

MBmriNRS AND THEIR PREPARATIONS.

174. Sulphuret of lime, 1 dram; camphor, in powder, l.*) grs. ; vaseline,

1 oz. Make an ointment.

175. Elder-flower ointment, 1 oz. ; oxide of zinc, 1 dram. Malce an
ointment.

176. Oxide of zinc, ointment, 1 oz.

177. Naphthaline, 2 scrs. ; vaseline, 1 oz. Make an ointment. To be
spread upon linen, and applied to the diseased skin night and morning.

178. Mild nitrate of mercury ointment, 3 drams; sugar of lead, 16
grs. ; rose-water ointment, 1 oz.

179. Laudanum, ^dram; sulphur, ^dram; oxide of zinc, 1 dram; oil
of almonds, 1 oz. ; vaseline, 3 ozs. Make in ointment.

180. Olive oil, 4 ozs. ; white wax, 2 drams. Melt these together, and
then add honey, 2 drams ; croton oil, 20 drops.

181. Elder-flower ointment, 1 oz. ; pulverized blue vitriol, 1 scr.
Make an ointment.

182. Purified beeves' marrow, or lard, 6 drams; oil of sweet almonds,

2 drams ; pulverized Peruvian bark, 1 dram. Mix.

183. Pulverized sulphate of copper, 10 grs.; extract of Spanish flies,
5 grs. ; vaseline, 1 oz. Mix. Rub into the scalp.

184. Iodide of lead, 1 dram; vaseline, 2 ozs. Mix. To be rubbed
on the surface.

185. Iodide of potassium, 1 dram; vaseline, 2 ozs. Mix.

186. Basilicon ointment, 1 oz. ; red precipitate, 1 dram. Mix.

187. Iodide of potassium, ^ dram ; vaseline, 1 oz. Mix.

188. Veratria, 4 grs. ; vaseline, 5 drams. Mix.

189. Tobacco leaves (fresh and sliced), 10 ozs. ; diluted acetic acid, 4
pints; basilicon ointment, 13 ozs. Boil the tobacco in the acid, strain,
and evaporate the decoction to six ounces. Add this to the basilicon
ointcient, heated, and stir till cold. For gathered breasts.

Liniments.

190. Sweet oil, 1 oz. ; strong water of ammonia, 1 oz. Mix. To be
robbed on with a piece of flannel.

191. Lime-water, 2 ozs. ; flax-seed oil, 2 ozs. Mix. Apply outwardly.

192. Olive-oil, 1 oz. ; solution of potassa, 2 drams; strong mercurial
ointment, 1 dram. Mix.

193. Olive-oil, 4 ozs. ; oil of amber, 2 drams ; oil of rosemary, 2
drams. Mix.

194. Spirits of turpentine, 1 oz. ; linseed oil, 1 oz. ; lime-water, 1 oz.
Mix. For external use.

195. Oil of hemlock, 2 drams; oil of origanum, 1 dram; camphor, 1
dram ; opium, 1 dram ; alcohol, 4 ozs. Mix.

196. Soap liniment, 2 ozs.; chloroform, 1 dram. Mix.

197. Tincture of aconite-root, <^ oz. ; opium liniment, ^ oz. Mix.
For neuralgia, etc. Apply a teaspoonful to tlic ]>ninful part.

'^'iiut^i^^ ■ .vv^^>M. .>.- ^,KMm^^i^mM^<mm^iMYmi^ii!iiM»a 'mismiMSsm<

l/i grs. ; vaseline,
dram. Make an

ointment. To be
t and morning,
ugar of lead, 16

zinc, 1 dram ; oil

ese together, and

? vitriol, 1 scr.

f sweet almonds,

of Spanish flies,

:. To be rubbed

Mix.

.m. Mix.
lix.

ited acetic acid, 4
. the acid, strain,
to the basilicoD
ts.

>z. Mix. To be

Apply outwai-dly.
strong mercurial

I of rosemary, 2

lime-water, 1 oz.

iram ; camphor, 1

iz.

ent, ^ oz. Mix.

part.

MEDICINES AND THEIR PREPARATIONS.

933

198. White soap, 12 ozs. ; camphor, 6 ozs. ; oil of rosemary, 1^ ozs. ;
alcohol, 4 pints ; opium, 3 ozs. Mix and filter. An excellent liniment,
acting at times like a charm in the removal of local pains.

199. Sulphuric acid, 1 dram; spirits of turpentine, 1 dram; olive oil,
3 drams. Mix the oil and spirits of turpentine first, then gradually add
the sulphuric acid. A valuable liniment for chilblains. To be rubbed on
two or three times a day.

Washes, Lotions, Gargles, etc.

200. Bruised white-oak bark, 1 oz. ; water, 1^ pints. Boil down to a
pint, and strain. To be used as a wash.

201. Borate of soda or borax, 2 drams; water, 4 ozs. Mix. To be
used as a lotion.

202. Alum, 2 drams ; water, 4 ozs. Mix. To be used as a lotion.

203. Tannin, 1 ecr. ; water, 4 ozs. Mix. For external use.

204. Biborate of soda, ^ oz. ; rose water, 6 ozs. ; sulphate of morphia, 6
grs. Mix. To be used as a wash in itching of the female privates.

205. Chlorinated soda, 1 oz. ; water, 12 ozs. Mix. Rinse the mouth
with it two or three times a day, but do not swallow.

207. Rose-water, 5 ozs.; sugar of lead, 8 grs.; sulphate of zinc, 8
grs. Mix.

208. Rose-water, 4 J ozs. ; nitrate of silver, 2 grs. Mix.

209. Sulphate of zinc, 8 grs. ; tannin, 1 scr. ; water, 5 ozs. Mix.

210. Chloride of zinc, 6 grs. ; soft water, 2 ozs. Mix.

211. Nitrate of silver, 10 grs. ; soft water, 1 oz. Mix.

212. Corrosive sublimate, 5 grs. ; soft water, 1 pint. Mix.

213. Alcohol, 1 pint; soft soap of potash, 1 pint. Dissolve and filter,
then add oil of citron, 1 oz. Mix. It will answer a good purpose if the
oil of citron be omitted.

214. Nitrate of silver, 2 scr. ; nitric acid, 12 drops; soft water, 1 oz.
Mix. Apply with a piece of lint tied to the end of a stick.

215. Copperas, 1 oz. ; soft water, 1 pint. Mix.

216. Alcoho'., Ij ozs. ; rose-water, 4 ozs. Mix.

217. Corrosive sublimate, 6 grs. ; spirits of rosemary, 1 oz. ; alcohol, 1
oz. ; emulsion of bitter almonds, 6 ozs. Mix.

218. Solution of Buga;r of lead, 12 drops; laudanum, 1 dram; water, 4
ozs. Mix. To be applied exterijally only.

219. Nitrate of silver, 1} drams ; soft water, 1 oz. Mix.

220. White vitriol, 1 dram ; rose-water, 3 ozs. Mix. Apply outwardly.

221. Hydrocyanic acid, 4 drams ; sugar of lead, 15 grs. ; alcohol, 4
drams ; water, 7 ozs. Mix. Apply externally.

222. Corrosive sublimate, 5 grs. : almond mixture, •} pint. Mix. Ap-
ply externally.

223. Rose-water, 4 ozs. ; pulverized borax, } oz. ; sulphate of morphine,
6 grs. Mix. To be applied to the parts many times a day.

a^iiasE

934

MEDICINES AND THEIR PREPARATIONS.

224. Sugar of lead, 2 drams ; laudanum, 1 dram ; soft water, i piut.
Mix. For external use.

225. Corrosive sublimate, 5 grs. ; cologne, 2 ozs. ; soft water, 6 ozs.
Mix. For external use only.

226. Acid nitrate of mercury, 1 dram ; soft water, 4 ozs. Mix. Apply
every second day.

227. Sugar of lead, 3 grs. ; soft water, 1 oz. Mix. As a wash in in-
flammation of the mouth in infants.

228. Mucilage of gum arabic, 1 oz. ; syrup of orange-peel, i oz. ;
chloride of lime, 15 grs. Mix.

229. Decoction of Peruvian bark, 3 ozs. ; syrup of orange-peel, 1 oz. ;
chloride of soda, 1 oz. Mix.

230. Creosote, 4 drops ; mucilage of gum-arabic, i oz. ; camphor-water,
8 ozs. Mix.

231. Vinegar, 1 dram; alcohol, 3 drams; simple syrup, 1 oz. ; water,
8 ozs. Mix.

232. White-oak bark, 1 oz. ; water, 1 pint. Boil away one quarter, and
strain ; then add alum, 1 scr. Apply to the parts with a soft sponge, or
dossil of lint, several times a day.

233. Hydrochloric acid, i dram ; honey, 1 oz. ; rose-water, 1 oz. Mix.
Apply three or four times a day.

234. Sulphate of copper, i dram ; soft water, 1 oz. Mix. To be ap-
plied twice a day to the ulcers in gangrene of the mouth.

235. White vitriol, 1 dram ; soft water, 2 drams. Mix. Then add
honey, 2 drams ; tincture of myrrh, 2 drams. To be applied twice a day
to the ulcers in gangrene of the mouth.

236. Creosote, 1 dram ; alcohol, 1 dram. Mix. To be applied, with a
camel's-liair pencil, to the gangrenous ulcers of the mouth, after running a
lancet through the sloughs, and touch with a little strong carbolic acid till
surface is white. Can repeat next day.

237. Acid nitrate of mercury, i dram ; soft water, 1 oz. Mix. To be
injected into the throat with the shower-syringe, or applied to ulcers with
a camel's-hair pencil.

238. Rose-water, 4 ozs. ; sugar of lead, 2 drams. Mix. For external
use.

239. Rose-water, ?, ozs.; sugar of lead, 1 scruple. Mix. For ex-
ternal use.

240. Tincture of arnica, J oz. ; cold water, 4 ozs. Mix. For external
use.

241. Tincture bloodroot, 2 ozs.; solution chloride of soda, 2 ozs.;
tinct. henbane, 2 ozs. Mix.

2ci!. Bucket of warm water ; cayenne pepper, pulverized, 1 tablespoou-
ful ; ground mustard, 2 tablespoonfuls. Mix. As a foot-bath in sup-
pression, etc.

243. Chlorate of potash, i oz. ; strong hydrochloric acid, 40 drops;
water, 1 pint. Mix. An excellent wash for chronic fetid ulcers, — soon
converting a foul ulcer to a healthy-looking one. A good gargle.

ft water, i pint.

ft water, 6 ozs.

8. Mix. Apply

s a wash in in-

ge-peel, i oz. ;

inge-peel, 1 oz. ;

camphor-water,

p, 1 oz. ; water,

one quarter, and
soft sponge, or

iter, 1 oz. Mix.

lix. To be ap-

lix. Then add
lied twice a day

s applied, with a
, after running a
carbolic acid till

5. Mix. To be
d to ulcers with

I. For external

Mix. For ex-

X. For externiil

f soda, 2 ozs. ;

id, 1 tablespoon-
oot-bath in sup-
acid, 40 drops;
d ulcers, — soon
gargle.

MEDICINES AND THEIR PREPARATIONS.

935

244. Powdered golden seal, 1 dram ; powdered cranesbill, 1 dram ;
powdered witch-hazel bark, 1 dram. Mix. Pour upon these half a pint
of boiling water. Let them stand till cold. To swab an ulcerated throat
in scarlet fever, and for other purposes. Still better, listerine, 1 oz. ; per-
oxide c ' ' "'I'-ogen, 2 ozs. ; water, 1 oz. Use as a gargle.

245. Pulverized cayenne, 1 dram; salt, 1 dram; boiling water, 1 gill.
Mix, and let them stand fifteen minutes. Then add one gill of vinegar.
Let them stand an hour, and strain. Put a teaspoonful in a child's mouth
once an hour, in maliguant scarlet fever.

Injections. ^ "

246. Castor oil, 1 gill; pulv. cayenne, 10 grs. ; molasses, 1 gill; table
salt, 1 teaspoonful ; warm water, 1 pint. Mix.

247. Senna leaves, 2 drams. Steep in a pint of water. Then add one
ounce of epsom salts, and strain. A quarter of this may also be taken as
a brisk purge.

248. Castor oil, 2 ozs. ; tincture prickly-ash bark, J oz. ; comp. tinct.
of Virginia snake-root, 2 drams ; infusion of boneset and senna, equal
parts, J pint. Mix.

249. Castor oil, 1 oz. ; salts of tartar, ^ oz. ; warm water, 1 pint. Mix.

250. Epsom salts, 1 oz. ; senna leaves, ^ oz. ; pulv. cayenne, 10 grs. ;
boiling water, 1 pint. Let the water stand upon the senna and cayenne
fifteen minutes. Then pour it off, and add the salts.

251. Thoroughwort, 1 oz. ; senna, 1 oz. ; lobelia, ^ dram ; cayenne, 10
grs. ; epsom salts, 1 tablespoonf ul ; molasses, J pint ; boiling water, 1
pint. Make a strong decoction of the herbs, and then add the salt and
molasses.

252. Wine of ipecac, 1 oz. ; spirits of turpentine, 1 oz. ; castor oil, 1
oz. ; molasBcs, J pint; warm water, J pint. Mix.

253. Flax-seed tea, i pint; laudanum, 40 drops. Mix.

254. Nitrate of silver Crystals, 10 grains; corrosive sublimate, 5 grs.;
sugar of lead, IJ drams; white vitriol, IJ drams; soft water, 6 ounces.
Mix. An injection for certain forms of whites, etc. Or corrosive sublimate
tablets, 1 to 3 pints of water used night and morning.

255. Bruised galls, J oz. ; two large poppy-heads ; watt " pint. Boil
a quarter of an hour, and strain. For piles.

256. Common salt, 1 oz. ; chamomile flowers, ^oz. ; pulv. aioes, 1 dram.
Boil the chamomile and aloes five minutes, in one pint of water, then strain
and add the salt.

Hair-Oils, Washes, etc.

257. Cologne, 2 ozs. ; tincture of Spanish ilies, 2 drams ; oil of rose-
mary, 10 drops; oil of lavender, 10 drops. Mix. Apply cautiously. If
soreness of the scalp is produced, omit for a short time.

258. Castor oil, 2 J pounds; strongest alcohol, 2 J pints; pulverized
Spanish flies, J oz. ; oil of bergamot, 2^ ozs. ; otto of roses, 20 drops.

936

MEDICINES AND THEIR PKEPARATI0N8.

Mix. Let them stand for a few days, and filter. A superior preparation
for keeping ttie hair from falling, and to prevent dandruff.

259. Tincture benzoin comp., 2 drams; tinct. Spanish flieti, 2 drams;
castor oil, 6 ozs. ; oil bergamot, 1 drtim; oil of cassia or verbena, 15
drops ; strong alcohol, 9^ ozs. Mix. As a hair wash, better even than
the above.

260. Slaked lime, 2 drams ; bicarbonate of soda, 8 drams ; lard, 2 ozs.
Mix.

261. Slaked lime, 1 oz. ; bicarbonate of potassa, 2 ozs.; charcoal in
powder, 1 dram. Mix. Apply to the parts, and wash off when dry.
Keep in well stopped bottles.

26? Slaked lime, 4 ozs. ; orris powder, IJ ozs. Mix. Apply to the
parts, and wash off when dry.

263. Spanish white, ^ pound ; litharge, ^ pound ; slaked lime, ^ pound.
Mix. Pulverize in a mortar. To be kept dry. When used, mix with
water to a paste the thickness of cream. Spread on the hair and lay over
it a wet cloth over night.

264. Sulphur, 1 oz ; sugar of lead, 1 oz. ; rose-water, 4 ozs. Mix.
Apply to the hair.

266. Nitrate of silver, 1 dram; nitric acid, 1 dram; soft water, 1 pint;
sap green, 8 drams; pulverized gum-arabic, 1 dram. Mix. Keep well
corked.

266. Hydrosulphuret of ammonia, 1 oz. ; liquor potassa, 3 drams; soft
water, 1 oz. Mix. Apply this with a tooth-brush fifteen or twenty minutes.
Then brush the hair over with the following : nitrate of silver, 1 dram ;
soft water, 2 ozs., using ^ clean comb to separate the hair.

niscellaneous.

267. Fluid extract of spurred rye, 2 ozs. Dose, one teaapoonfnl three
times a day. For profuse menstruation from a relaxed state of the womb.

268. Sulphate of iron, 1 dram ; su b- carbonate of potash, 1 dram. Mix,
and make into 38 pills. One pill twice a day, and gradually increasing to
four a day, in chlorosis.

269. Sulphate of iron, 1 dram; extract of hops, 15 grs. ; extract of
poppies, 15 grs. ; oil of cinnamon, 15 drops. Mix, and make into 24
pills. One pill two or three times a day.

270. Oxide of zinc, 2 drams ; extract of cicuta, 2 scruples. Mix. Make
48 piUs.

271. Pulverized savin, 1 scruple; sulphate of copper, 1 scruple. To
be sprinkled on venereal lumps or tumors, called condylomata, on the
female genitals, or elsewhere.

272. Balsam of copaiba, 1 oz. ; oil of cubebs, 2 drams ; laudanum, 1
dram; mucilage of gum arable 2 ozs. ; sweet spirits of nitre, ^ oz. ; com-
pound spirits of lavender, 8 drams ; camphor-water, 4 ozs. ; white sugar,
2 drams ; oil of partridge-berry, 5 drops. Mix. Take a tablespoonful
three or four times a day. For gonorrhoea ; or capsules of copaiba and
cubebs.

i'!smsm^fi<f«fim*

MEDICINES AND THEIR PREPARATIONS.

937

rior preparation

flieii, 2 drams;

or verbena, 15

etter even than

ns ; lard, 2 ozs.

8. ; charcoal in
off when dry.

Apply to the

lime, i pound,
used, mix with
lir and lay over

', 4 ozs. Mix.

t water, 1 pint;
ix. Keep well

, 3 drama ; soft
twenty minutes,
silver, 1 dram;

ispoonful three
e of the womb.
1 dram. Mix,
y increasing to

rs. ; extract of
make into 24

8. Mix. Make

I scruple. To
[omata, on the

; laudanum, 1
•e, ^ oz. ; com-
; white sugar,
. tablespoonful
>f copaiba and

273. Bttlsttui of copaiba, 1 oz. ; pulverized cubebs, 2 ozs. ; essence of
peppermint, 30 drops. Make a thick paste, like dough, or get capsules.

274. Pulverized borax, 1 oz. ; pulverized white sugar, 1 oz. Mix. A
little to be dissolved on the tongue.

275. Pulverized borax, ^ oz. ; honey, 4 ozs. Mix.

276. Hydrochloric acid, 1 dram; honey, 1 oz. Mix. For touching
large curdy patches in sore mouth of children.

277. Pulverized ipecac, 3 grains; precipitated sulphur, 2 scruples;
extract of hyoscyamus, 6 grains. Mix. Divide into 12 parts. One to
be taken every three or four hours.

278. Pulverized belladonna-root, 6 grains ; compound ipecac powder, 10
grains; precipitated sulphur, ^ dram; white sugar, 2 scruples. Mix.
Make 20 powders. One every three hours to a child two years old.

279. Pulverized alum, 25 grains ; extract of cicuta, 12 grains; syrup of
red poppies, 2 drams; spearmint water, 3 ozs. Mix. A dessert-spoonful
every six hours for a child two or three years old.

280. Camphor, 1 dram; sulphuric ether, 1 oz. Mix. Ten drops every
half hour.

281. Pulverized rhubarb, 1 scruple; one half scruple Gray powders;
aromatic powder, 5 grains. Mix. Divide into 10 powders. One every
four or five hours.

282. Pulverized bloodroot, ^ to 1 oz. ; chloride of zinc, J to 2 ozs. ;
water, 2 ozs. Add enough wheat flour to make a paste as thick as mo-
lasses.

283. Sal. volatile, ^ dram ; camphor-water, 1 oz. Mix.

284. Tincture of mix vomica, J oz. ; tinct. aconite, 2 drams ; volatile
tinct. of guaiacum, 2 drams. Mix. Thirty drops every three hours.

285. Tincture of black cohosh, 2 ozs. ; tinct. of digitalis, 2 drams.
Mix. One teaspoonful from two to five times a day.

286. Barberry bark, 1 oz. ; pipsissewa herb, 2 ozs. ; wild cherry bark,
1 oz. ; bitter-root, 1 oz. Mix. Infuse for several hours in 4 pints of
water. One tablespoonful three or four times a day.

287. Horse-radish root, 1 oz. ; bayberry bark, 1 oz. ; barberry bark, 1
oz. ; wild cherry bark, 1 oz. ; prickly-ash bark, 1 oz. Reduce the whole
to a coarse powder, and infuse for several hours in 4 pints of cider. A
tablespoonful three or four times a day.

288. Mercury, 95 parts ; balsam of storax, 48 parts ; diacalon plaster,
312 parts; wax, rosin, turpentine, each, 16 parts; ammonia, bdellium,
each, 5 parts ; olibanum and myrrh, each, 5 parts ; saffron, 3 parts ; spirits
of lavender, 2 parts. Mix, and spread. For external use only.

289. Populin, 20 grs. ; sanguinarin, 10 grs. ; pulv. white sugar, 30 grs.
Rub well together, and divide into 16 powders. Take one four times a
day. At the same time use prescription 73.

290. Ptelein, 24 grs. ; bydrastin, 24 grs. ; extract of belladonna, 3 grs. ;
extract of nux vomica, 2 grs. Mix. Make 24 pills. Take one three
times a day.

291. Strychnia, 2 grs.; pulv. canthandes, 4 grs. ; pulv. arnica-leaves,
1 dram. Mix. Divide into 32 powders. One to be taken three times a
day.

,i I

nwn&ir^ra^iy

988

MEDICINES AND THEIB PREPARATIONS.

292. Wine of colchicum seeds, 1 oz. ; fluid extract of dandelion, 1 oz.
Mix. One teaspoonful three times a day.

293. Willow-bark, 1 oz. ; boiling water, 1 pint. Boil for ten minutes,
and strain. Dose, a wineglassfiil once in three hours.

294. Canada balsam, 1 dram; slaked lime, 1 dram. Mix, to form a
paste. An excellent remedy for toothache, when pressed into the cavity ;
or use a drop or two of a 4 % cocaine solution.

295. Tincture black cohosh, 1 oz. ; iodide of potassium, 2 drams; syrup
of ipecac, 1 oz. ; spring water, 2 ozs. Mix. A teaspoonful three or four
times a day, in rheumatism and cell-dropsy.

296. Tincture black cohosh, 1 oz. ; tinct. myrrh, 6 drams ; camphor, 1
dram ; tinct. cayenne, I dram. Mix. Take 30 or 40 drops four times a
day, for dropsy.

297. Solution chloride of soda, 6 drops; water, 2 ozs. Mix. To be,
taken at a draught. A sure remedy for offensive breath from deranged
stomach.

298. Cream of tartar, J oz. ; fresh lemon-peel, bruised, 4 ozs. ; white
sugar, 4 ozs. ; boiling water, 3 pints. Mix, and after standing a while,
strain.

299. Citric acid, ^dram ; bi-carbonate of potassa, | dram ; lemon syrup,

1 oz. ; soft water, 6 ozs. ; epsom salts, 1 oz. Mix. Two tablespoonfuls,
to be repeated every four hours, if necessary.

300. Hardwood ashes, 1 quart ; common soot, J gill ; water, 6 pints.
Digest, settle, and filter. Take one tablespoonful three times a day, in
acidity of stomach. Milk of magnesia is also a very simple and eflScient
remedy.

301. Peppermint water, IJ ozs. ; wine of colchicum-root, ^ oz. ; iodide
of potash, 3 drs. ; magnesia, 1 scruple. Dose. — One teaspoonful three
or four times a day. Excellent for rheumatism of a chronic or gouty type.
For the acute form of ordinary rheumatism, some form of salicylic acid
must be used, like the following : Salicylate of soda, 4 drs. ; tinct. carda-
mom comp., tinct. gent. comp. of each, 2 oz. Mix, and take one tea-
spoonful in water every two hours, till ears ring, then once in three or four
hours. Tongaline in one-dram doses, every two hours, is an excellent all-
round rheumatic medicine.

302. Cream of tartar, IJ ozs.; sulphate potassa, ^ oz. ; pulv. squills,

2 drs.; tartar emetic, 2 gvs. A teaspoonfulof this mixture to be taken
four or five times a day, in dropsy.

308. Pulv. alum, J dram; white precipitate, 1 grain. Rub these well
together, and place the powder in a bottle; then add IJ drams of glycerin.
Shake the bottle until the mixture is of the consistence of ci'eam, and re-
peat the shaking whenever it is about to be applied to the skin. For ex-
ternal use in erysipelas.

804. Copaiba, 5 drams; yolk of one egg; gum of extract of opium, 1
grain ; water, 7 ounces. Mix. To be used as an injection several times
a day in gonorrhoea.

305. Tannin, 8 grains; extract belladonna, f gr. ; extract conium, 2^
grains ; infusion of senna, 3 ozs. ; fennel-water and syrup of marshmallow,
each H ozs. Mix. A tablespoonful to be taken every two hours, in chronic
bronchitis and other complaints.

i tt g g;.-;A';!ufe ' .

Wmi.'mmmM!is^&ssi^mm!rrim'mi>i

^^^

MEDICINES AND THEIR PREPARATIONS.

939

Idndelion, 1 oz.

or ten minutes,

Mix, to form a
into the cavity ;

2 drams ; syrup
ul three or four

ns; camphor, 1
)B four times a

Mix. To be
from deranged

, 4 ozs. ; white
ending a while,

1 ; lemon syrup,
tablespoonfuls,

ivater, 6 pints,
imes a day, in
tie and efficient

;, ^ oz. ; iodide
ispoonful three
! or gouty type,
f salicylic acid
. ; tinct. carda-
take one tea-
in three or four
in excellent all-

; pulv. squills,
re to be taken

Rub these well
ms of glycerin,
cream, and re-
skin. For ex-

ct of opium, 1
1 several times

ict conium, 2^
' marshmallow,
}urs, in chronic

306. Glycerin, 1 dram ; tnnnin, 1 dram. Dissolve the tannin in the
glycerin. Excellent for sore nipples, and for chaps and excoriations
generally.

807. Collodion, 1 oz. ; Venice turpentine,^ oz. ; castor oil, 2 drams.
Mix. To be applied outwardly, for chilblains and chaps. For cancer,
manganic acid. Not as painful as other caustics.

308. Sulphate of copper, 2 grains ; wine of opium, 1 dram ; soft water,
2 drams. Mix. Apply freely with a soft camel hair brush, three times a
day, for purulent ophthalmia.

309. Pure acetic acid, 2 drams; soft water, 3 ozs.; simple syrup, 3
drams. Mix. A teaspoonful is to be taken every three hours, in scar-
let fever, at the same time using sheet baths with tepid water.

310. Compound tincture of Peruvian bark, 4 ozs. ; citrate of iron, 44
grains ; citric acid, 20 grains. Dissolve the citric acid in the tincture, and
then the citrate of iron. After a few days filter. Dose, one to two tea-
spoonfuls.

311. No. 1. Gallic acid, 10 grains; dissolve in alcohol, 2 drams;
water, 6 drams. No. 2. Crystals of nitrate of silver, ^ dram ; water, ^
oz. Dissolve and add strong liquor of ammonia till it becomes clear ;
then add powdered gum-arabfc, and dilute, if necessary, to 6 drams.
This will color black ; to color brown, reduce it. An excellent hair-dye.
Use the common directions-where there is a No. 1 and No. 2.

312. Epsom salts, 2 drams; magnesia, 1 scruple; syrup of ginger, 1
dram; spearmint water, 11 drams. Mix. To be taken at a draught.
This will be retained .by the stomach when most other things are rejected.

313. Diluted nitro-muriatic acid, 2 drams; sweet spirits of nitre, 2
drams ; simple syrup, ^ oz., water, 7^ ozs. Mix. Two tablespoonfuls
are to be taken three times a day. Excellent in dyspepsia, with foul
tongue and inactive liver.

314. Rose-leaves, 1 scruple; boiling water, 8 ozs. ; diluted nitric acid,
2^ drams. Mix. After standing half an hour, strain, and use as a wash
for ulcers.

315. White vitriol, 1 dram; water, 1 pint. Mix. To be used as a
wash for ulcers, etc.

316. Citrate of iron and strychnine, 1 dram; syrup of orange-peel, 2
ozs. ; soft water, J pint. Mix. Givt jne teaspoonful three times a day
in neuralgia, and in other cases in which a nerve-tonic is needed.

317. Aloes and soap pill, 10 grains. Divide into two pills ; or, com-
pound pill of aloes, 10 grs. Divide into two pills.

318 Compound colocynth pill, 2^ scruples ; castile soap, 9 grs. ; oil
of t. ;e, 2 drops. Mix, and make 12 pills. Two to be taken at bed-
time.

319. Compound tincture of senna, 2 drams; epsom salts, 2 drams;
diluted sulphuric acid, 8 drops ; spirits of nitric ether, J dram ; infusion
of rhubarb, 10 drams. Mix. To be taken at a draught.

320. Sulphate of iron, 2 grs. ; epsom salts, 2 scr. ; diluted sulphuric
acid, 10 drops; compound tincture, 1 dram; syrup of poppies, IJ drams;
pimento water, 9 drams. To be taken at a draught twice a day.

'Ml

j:3«gB>ii*i^sigBTa«E!S!3sr

940

MEDI0IM8S AND THEIK PHBPAKATIOKS.

3'21. Pulverized rhubarb, 12 gra. ; carbonate of inagneBia, 10 grs. ;
aromatic spirit of ammonia, ^ dmni ; Bynip of ginger, 1 dram ; Bpearmint
water, 10 driimfl. Mix. To be taken at a drauglit.

322. Comp. infuBion senna,.') drams; infiiBion rhubarb, r» drams; comp.
tincture cardamon, ^dram; ayrup, 1^ drams. Mix. To be taken at u
draught, by dyspeptic persons.

323. Carbonate of soda, 10 grs; aromatic spirit of ammonia, ^dram;
tincture of orange-peel, 1 dram ; syrup of oronge-peei, 1 dram ; compound
infusion of gentian, 10 drams. Mix. To be taken at a draught twice
a day.

824. Trisnitrate of bismuth, 1 dram; comp. tragacanth powd?r, 2
drams; compound tincture cardamom, ^ ounce; tincture of ginger, ^ oz. ;
spearmint water, 7 ounces. Mix. Two tablespoonfuls to be taken twice
a day, in dyspepsia.

Sio. Solution of acetate of ammonia, J oz. ; tincture of orange-peel, 1
dram; syrup of orange-peel, 1 dram; tincture of cayenne, 20 drops;
comp. infusion of orange-peel, 6 drams. Mix. The whole to be taken to
relieve headache, after intoxication.

326. Magnesia, 15 grs. ; solution of potassse, 15 drops; comp. tincture
of senna, 1 dram ; comp. infusion of senna, 6 drams ; syrup of ginger,
1 dram ; comp. infusion of orange-peel, ^ oz. Mix. Taken at a draught,
as an aperient, in sick and bilious headaches.

327. Aromatic spirits of ammonia, 1 dram ; tincture of Colombo, 1 dram ;
infusion of Colombo, 10 drams; syrup of poppies, 1 dram. Mix. To be
taken itt a draught, three times a day.

328. Diluted sulphuric acid, 15 drops; diluted hydrochloric acid, 10
drops ; tincture of orange-peel, 1 dram ; comp. infusion of gentian, 6 drams ;
syrup of poppies, 1 dram. To be taken at a draught, three times a day,
half an hour before meals.

329. Diluted nitric acid, 12 drops; diluted hydrochloric acid, 8 drops;
infusion of cascarilla, 11 drams; syrup of poppies, 1 dram. Mix. To be
taken at a draught, twice a day.

330. Colocynth co., 6 grs. ; comp. pill of rhubarb, 4 grs. ; ext. hyoscy-
amus, 2 grs. Mix. Make two pills ; 1 pill to be taken at night.

331. Ext. Lyoscyamus, 2J grs. ; pul v. camphor, 2 1 grs. Mix. Make
two pills ; one t,v be taken when the pain is most severe, in nervous head-
ache ; or even better, acetanilid, 8 grs. ; camphor, 2 grs. ; citrate of caf-
feine, 4 grs. Divide in four capsules, one every half-hour, for three or
four times.

332. Comp. tragacanth powder, 8 grs. ; oil of lemon, 3 drops ; camphor-
water, 1 1 drams ; comp. tinct. cardamom, ^ dram ; tincture hyoscyamus,
J dram; chloroform, 15 drops. Mix.

333. Tinct. hyoscyamus, ^ dram ; aromatic spirit of ammonia, ^ dram ;
syrup of orange-peel, ^ dram ; peppermint water, 10 drams. Mix. In
nervous and hysterical cases.

334. Soap liniment, 2^ ozs. ; liquor ammoaia, ^ dram ; laudanum, ^ oz.
Mix. Make a liniment.

MKDIOINBS AND THEIR PREPARATIONS.

941

Bia, 10 gn.;
in ; Bpcariiiint

drams; comp.
be taken at u

onia, ^ dram ;
m ; compoinxl
draught twice

ith powd»r, 2
finger, ^ oz. ;
ie taken twice

orange-peel, 1
le, 20 dropB ;
to be taken to

!omp. tincture
■up of ginger,
1 at a draught,

tmbo, 1 dram ;
Mix. To be

loric acid, 10
bian, 6 drams ;
I times a day,

icid, 8 drops;
Mix. To be

; ext. hyoscy-
light.

Mix. Make
nervous head-
iitrate of caf-

for three or

ps; camphor-
hyoscyamus,

onia, ^ dram ;
B. Mix. In

idanum, ^ oz.

33fi. Comp. pill of colocyuth, 7 grs. ; ext. of colcbicum, 'igra. ; oil of
caraway, 1 drop. Mix, and make two pilla. To be taken at bedtime in
rheumatic headaches.

886. Chloride of zinc, 6 oz. ; pulv. bloodroot, 2 ozb. ; myrtle wax, 1
oz. ; water of extract of opium, 6 drams ; extract of conium, 6 drama.
Mix, and make an ointment.

837. Iodide of lead, 1 scr. ; glycerin, 1 dram; spermaceti ointment, 2
ozs. Make an ointment.

838. Rhubarb pulv., ^ oz. ; spearmint herb, pulv., ^ oz. ; pulv. casca-
rilla, ^ oz. ; pulv. bicarlK)nate of potassa, ^ oz. ; pulv. wild-cherry bark, ^
oz. Mix, and pour on one quart of hot water. Let this stand till cold,
and add half a pint of brandy. Dose, ha'f a wineglassful.

339. Ext. belladonna, 6 grs. ; pulv. ipecac, 10 grs. ; confection of
roses, 2 grs. Mix. Make 30 pills, one pill to be taken twice a day.

340. Dioscorein, 12 grs.; pulv. camphor, 4 grs.; pulv. cayenne, 12
grs. ; white sugar, 1 scr. Mix. Diviue into four powders. Give one
every fifteen minutes.

841. Leptandrin, 12 grs. ; geranium, 12 grs.; myricin, 12 grs. Mix.
Divide into twelve powders, of which one may be given three or four
times a day.

842. Quinine, ^ dram; pulv. catechu, 1 dram; pulv. opium, 15 grs.
Mix. Make 32 pills. Give one pill three times a day.

343. Compound syrup of rhubarb and potassa, 4 ozs. ; tincture of
prickly-ash berries, 1 oz. ; essence of peppermint, 1 dram; paregoric, 4
drams. Mix. A tablespoonful should be given every hour until it oper-
ates gently on the bowels.

344. Pulv. camphor, J dram; pulv. opium, 16 grains; pulv. cayenne,
^ dram. Mix. Make 16 pills; one every hour, in cholera.

345. Rhubarb, 4 ozs. ; black-cohosh root, 2 ozs. ; wild-cherry bark, 2
ozs. ; geranium, 2 ozb. : coarsely powder them, and mix. Add two pints
of brandy and two pinta of water. Let the mixture stand five or six days,
stirring often, and then strain. Add four pints of water 'o the dregs, boil
slowly to two pints, strain, and add to this the previous tincture. Sweeten
with white sugar. Take a tablespoonful every one, two, or three hours.

346. Beth root, 1 oz. ; geranium, 1 oz. ; blackberry-root, 1 oz. ; wild-
cherry bark, 1 oz. ; cinnamon, 1 oz. Powder the whole, and add to them
1^ pints brandy, and IJ pints water. Let them stand several days, stir-
ring frequently. Add sweetening if preferred. Dose, one or two tea-
spoonfuls every two or three hours.

347. Raspberr T leaves, 1 oz. ; geranium, 1 oz. ; blackberry-root, 1 oz. ;
leptandra root, 1 oz. Mix, and make three pints of strong decoction.
Dose, a teaspoonf al e ery hour. Suitable for a gargle.

348. Sugar of lead, 24 grs. ; vinegar, 1 dram; syrup of poppies, 1 oz. ;
rose-water, 3 ozs. ; soft water, 4 ozs. Mix. Dose, one or two table-
spoonfuls.

349. Potassio-tartrate of iron, J oz. ; syrup of orange-peel, 1 oz. ; water,
4 oz. Mix. Take two teaspoonfuls three times a day.

(

"ill

Mfi

n iafeM5bfe.v

MRDI0INE8 AND THEIR PREPARATIONS.

860. Geranium, goldon seal, marHhmallow, wild-indigo root, rosemary,
eacb half an ounce. Mix, and make one pint of utroug iufuHiou. After
straining, add two drams powdered borax aud oue gill of ' ^uey. An
excellent astringent gargle.

tlfil. Bromide of Hoda, 3 dramu ; nyrup of orange, or any other ttyriip,
three ounces. Take one teaspoouful in water as often as needed. Koi-
beadache, nervousness, etc., cau take every half-hour.

862. Wine of ipecac, 10 drops in water every half-hour to croupychilil,
one year old ; 30 drops to vomit the child.

353. Hydrochlornte of ammonia, ^ oz. ; diluted acetic acid, ^ oz. ; al-
cohol, ^ oz. ; camphorated mixture, 15 ozs. Mix. A good scattering
wash for hydrocele, etc.

854. Chloride of soda, nitrate of potash, and hydrochlorate of ammonia,
equal parts, and water ouough to diHsolve them. Mix. Au excellent
freezing mixture.

355. Antipyrin, 3 drams; syrup or water, 2 ozs. Teaspoonful every
hour till fever is less ; or pbcnacetine, 8 grs. , every two hours till fever is
subdued, then once in four hours.

856. Chloral hydrate, 4 drams; syrup acacia and syrup checkerberry, of
each, 1 oz. ; Teaspoonful in water every hour till asleep. If the taste is
very objectionable it may be taken in two teaspoonful doses by rectum in
a little cold starch-water.

357. Bromidia; teaspoonful in water every hour till asleep.

358. Jaborandi, fluid extract, 3 drams ; syrup, 1 oz. Teaspoonful every
hour, to produce sweating.

859. Pill, compound cathartic. Two for a dose.

360. " Green Soap." Riib well in at night and wash off in the morning
with water.

861. Powdered camphor and chloral, equal parts, sufflcieut quantity to
make a liniment, rubbed well together. External use.

362. Wilkinson's Ointment. (See Scabies.)

363. Dilute hydrocyanic acid, 1 dram ; solution acetate of ammonia, 2
ozs. ; tincture digitalis, 3 drams ; rose-water, 5 ozs. For pruritus, itch-
ing, etc.

364. Corrosive sublimate, 2 grs. ; tincture benzoin, ^ dram ; almond
emulsion, 1 oz. Used to destroy the epidermis in cases of freckles, acne,
pimples, etc.

865. Alum, 5 parts ; salicylic acid, 45 parts. Dust on freely.

366. Corrosive sublimate, 4 f,.^. ; dissolved in 1 oz. tincture of myrrh.
Paint on to the part affected by ringworm night and morning.

367. Bromide of soda and ammonia, 20 grs. each, in a cup of valerian
tea four times a day. Increase up to 8 or 10 times a day if former dose
proves insufScieuk. Take also daily oxide of zinc and extract of bella-
donna, of each ^ gr., morning aud night. In bad cases use pill 4 times
daily.

MED10INB8 AND THEIK PRKPARATI0N8.

943

root, rosemary,

iaftmiou. Afu-r

II of ■ iney. An

any other syrup,
as needed. For

r to croupycbild,

c acid, i oz. ; al-
L good scattering

rate of amaiotiia,
c. An exceliout

.168. Fluid extract gelseminuin, ;J drops in water every half hour for
.'lor four times. UHoful in facial neuralgia; or exalgine, 4 grs. every
liour for two or three times.

369. Atropia, yj„ of a gr. One such pill each night for sweating; one
Hiich pill 2 or 3 times a day for acute cold in head, with watery secre-
tions; or pill "coryza," one every half hour for three times, then once an
hour till throat is dry, afterwards once in three or four hours.

370. Sulphate quinine, J gr. ; ext. belladonna, X gr. ; pulv. ipecac, ^
gr. ; comp. ipecac powder, -^ gr. One such pill every two hours, for
chronic bronchitis and emphysema.

371. Carron oil. Made by adding equal parts linseed-oil and lime-water.
For burns, apply freely; also boracic acid, 18 grs., dissolved in 1 dram
hot glycerin and olive-oU, 1 oz.

easpoonful every
lours till fever is

checkerberry, of

If the taste is

ses by rectum in

leep.
easpoonful every

flf in the moruinu;
cient quantity to

i of ammonia, 2
)r pruritus, itch-
dram; almond
f freckles, acne,

freely.

Bture of myrrh,
ing.

cup of valerian
5^ if former dose
xtract of bella-
ise pill 4 times

••m^

PROPRIETARY AND PATENT MEDICINES.

Nothing in the world has given rise to so much superstition and
blind folly as the following of fanatic leaders in the curing of disease.
Since Hippocrates, and even back to Apollo himself, if we may be-
lieve old Grecian and Roman tales, quackery in medicine has reigned
supreme.

It pleases people to follow up what appears miraculous in life.
Results are more important to the minds of many people than the
circumstances effecting results ; hence, if a person by hook or crook
recovers from a disease while using some patent medicine, he as-
cribes to its employment some specific usefulness, irrespective of the
natural course of the malady, or whatever else he may or may not
have done.

In this way ancient amulets and modern patent medicines have
seemed to cure cancer, leprosy, liver and kidney and other diseases ;
and in this way enormous fortunes have been made by advertising in
gorgeous attiie some specific oil or oalsam, the apparent defendei-s of
health and strength. Patent medicines are sold to make money, and
not to cure the public ; their usefulness is generally in inverse ratio
to their labels.

There are, however, some good patent medicines. In some cases
they will prove just the thing the system needs, but the risk is too
great unless recommended by some physician. It is their blind, in-
discriminate use that we condemn. Their formula not being known
is what makes them dangerous. They usually are made up of some
powerful stimulant which makes the patient feel better for a time,
and then leaves the system mor-e relaxed than ever, and hurts the
nerves or digestion. We will point out a few that are useful.

There is another class of medicines which are put up by the
great pharmaceutical houses, which deserve popular use. Their com-
position being known, there is no secrecy about them. They are
prepared in the most scientific manner. These houses have a name
to preserve, and have ample means to procure the services of the best
chemists, and, using such large quantities of drugs, they can procure
the best and most uniform. They do not claim to be cure-alls, but
are compounded for special diseases or conditions, which are plainly
stated, and are only claimed to be a remedy for such diseases or con-

944

wn'imifiiigimmftm

PROPRIETARY AND PATENT MEDICINES.

945

IDIOINES.

iperstition and
riagof disease.
, if we may be-
ine has reigned

sulcus in life.
3ople than the
hook or crook
edicine, he as-
spective of the
ay or may not

aedicines have
3ther diseases ;
advertising in
it defenders of
ke money, and
1 inverse ratio

In some cases
the risk is too
iheir blind, in-
being known
ie up of some
ter for a time,
and hurts the
useful.

at up by the
;. Their cora-
u. They are
have a name
368 of the best
y can procure
cure-alls, but
h are plainly
seases or con-

ditions of the system. They are just what your physician would
prescribe. The difficulty is in rightly choosing from the vast number.

Of late there has sprung up a class of houses who make it a cus-
tom to imitate any well-known medicine which has proved valuable,
and, by selling their imitations cheaper and using some flaring label,
palm off these imitations as being just as good. We would advise
that they be shunned like the plague. If there is anything that
ought to be pure, it is the drugs, stimulants and nourishment that we
take as medicine.

While we do not claim ' to give a list in this chapter of all valu-
able remedies, we recommend several of the best and most valuable,
which have stood the test of use, and can be taken with safety and
benefit. Read ' !^he front part of the book a description of your
trouble, then turn to the department in this chapter corresponding
to it, and choose the remedy. In all cases the directions will be
found on the wrapper of the remedy.

Asthma. — Kola-Koloid (T. Metcalf Co."/. The well-known integrity
of this bouse is a siifflcient guarantee of the value of this remedy. Soden's
Mineral Pastilles are also good.

Thyroid Tablets of 5

Anti-Fat Phytoline is used very extensively.

grains each 3 times a day are very effectual.

Anti-Scrof ulcus. — Succus Alterans (Lilly), anti-syphilitic and al-
terative. This is a purely vegetable medicine and will not hurt the most
delicate stomach. It contains no mercu<-y or iodide of potash. It elim-
inates specific poison from the blood and its tonic power increases the red
corpuscles and enables the system to throw off disease. It attacks the
seat of the disease, which is impure blood. Chapoteant Sol. Iodide Stron-
tium is much used, is easily digested, but is rather expensive.

Also iodia, an alterative and tonic, is much used by the best physicians.
It improves the nutrition and eliminates waste. Is purely vegetable.

Biliousness. — Garfield Tea and Fig Syrup contain no salicylic acid,
minerals or opium. Are purely vegetable remedies, and can be used by
infants, children and adults with safety. India Cholagogue is an old
remedy of worth.

Consumption. — Cod Liver Oil is an old and much-used remedy, not
only for consumption but for all wasting diseases. It nourishes the body
and builds up the tissues. The trouble is to get it pure. The pure, pale
oil, extracted from the fresh, healthy livers of the fish, known as Burnett's,
sold by Theo. Metcalf Co., Boston, is the most desirable. It can be emul-
sionized with an egg-beater. The dose should rarely be over a table-
spoonful and can be combined with coffee, eggs, milk or ice cream well
beaten together to make it more palatable and more easily digested.

Cougha. — King's Consumption Cure is one of the best cough mixtures.
Linonine is composed of flaxseed-oil combined with chloroform, and is
good to soften and allay a common hard cough.

Diabetes. — Gluten Flour (Metcalf) is the best food and is free from

fiv-

• I

,i>-

946

PROPRIETARY AND PATENT MEDICINES.

i
ffll

starch. In making the bread it should be mixed with a spoon with wlieat
bran. The hands should never touch the Gluten Flour. No other biead
should be eaten, or potatoes or other starchy foods. If the patient gets
tired of Gluten Flour alternate with Soga Bean Meal.

Digestive Medicines. — Horsford's Acid Phosphate. It promotes di-
gestion without injury and thereby relieves the diseases caused by indiges-
tion. It is excellent for acidity of the stomach and is a very pleasant and
healthful drink combined with some syrup and soda. " There are so many
different causes of dyspepsia, it is often necessary to try several remedicH.
The following are good : Liquid Lactopeptine, Liquid Pancreaticus more
especially for bowel indigestion. The various preparations of pepsin are
good.

Disinfectants. — Eucaline (T. Metcalf Co.) is used around the house
as a disinfectant during disease as a preventative from contagion. Diluted
it makes a good tooth and mouth wash, a few drops in a tumbler of water.
Is good to sweeten bowls and bath-tubs. Can be used in the water-pan
of furnaces to cleanse the air and in fact where any disinfectant is tised.
Chloride of lime and Bulpho-naphthol are also much used.

Poods, Invalid and Baby. — Mellin's Food is one of the oldest and
best ; it needs no cooking. Mixed with milk it contains all that is neces-
sary to nourish the body. It is the best known baby food and is invalu-
able for those suffering from nervous prostration or non-assimilation of
food. Malted Milk is a good food for all ages but is more particulai-ly
adapted for adult invalids. Bartlett's Food is good for nervous children.
Robinson's Groats and Barley, intended for children, is a laxative food.

Headaches. — The remedies for headaches are numberless. If they
are constant or chronic it is well to leave oflf smoking, tea or coffee drink-
ing for three months and see if that is not the sole cause. If a female-,
have a physician and see if they are not caused by some womb trouble.
For immediate relief a cup of black coffee without sugar or milk is as safe
and good as anythin" Most of the headache powders, pills, etc., are
made up of caffeine, ^ruinides, guarana and the cootar products.

Quinacetine (Metcalf) is one of the best remedies and has the advantage
of leaving no unpleasant effects.

The following are good fov immediate relief : Bromo-Caffeine, Bromo-
Seltzer, Elixir Cuarana, Nev ease and Phenacctine. The last two should
be used sparingly.

Hypnotic and Sleep-Producing Medicines. — Bromidia is much
used. It is composed of chloral and the bromides. Every fluid dram
contains 15 grains each of pure chloral hydrate and purified bro. pot.,
and if grain each of gen. imp. ex. cannabis ind. and hyoscyam. In the
restlessness and delirium of fevers it is invaluable. It is well to take out-
door rzoTise and drink a cupful of Mellin's Food, warm or malted milk
jv St oefore retiring.

lijii Preparations. — Elixir Thi-ee Chlorides is a good blood-maker.
Schlotterbeck's Syrup, Phospho-Chloride of Iron is a good preparation of
liquid u'on and easily digested.

Liquid Beef Preparations Beef Peptonoids, Liquid Beef Pepto-

noids, and Liqaid Peptonoids with Creosote, are pieparations of beef in a

HMIW«^4

PKOPRIETARY AND PATENT MEDICINEa

947

ipoon with wlieat
No other bread
the patient gets

It promotes di-
iiised by indiges-
ery pleasant and
ere are so many
several remedies,
ancreaticus more
ns of pepsin are

iround the house
tagion. Diluted
umbler of water.
in the water-pan
nfectant is used.

)f the oldest and
all that is ueces-
d and is iuvalu-
n-assimilation of
lore particulai'ly
lervous children,
laxative food.

)erless. If they
I or coffee drink-
e. If a female-,
le womb trouble.
>r milk is as safe
, pills, etc., are
^ducts.
as the advantage

Daffeine, Bromo-
i last two should

omidia is much
Ivery fluid dram
urified bro. pot.,
jscyam. In the
well to take out-
1 or malted milk

od blood-maker,
d preparation of

uid Beef Pepto-
lons of beef in a

very digestible form, palatable and very nourishing. Bovox, Bovinine
and Wyeth's Beef Juice are very nourishing and are valuable for travellers
and to take between meals when faint.

Liver and Kidney Medicines. — Garfield Tea is a good family med-
icine, is harmless, contains no minerals and clears the liver and kidney of
effete matter. Buchu and Hyoscyamus Comp. (Tyree's) to soothe an irri-
table bladder. In kidney troubles consult the best- physicians obtainable.

Liquid Malts. — Are chiefly serviceable in inability to digest starchy
foods, and in convalescence. All of the following are good : Tarrant's
and Hoff's Malts, Liquid Bread, Trommer's Malt with Iodides, Trammer's
Citrate of Iron and Quinine, and Trommer's Malt with Pepsin.

Laxative)^. — For chronic constipation there Is nothing more useful
than Rhamnus Fragula (Metcalf ) , made from buckthorn bark. It is a
simple and harmless remedy, the results good and sure, and invigorates the
bowels. — Glycones (Lilly) . Frequently, especially for babies and young
children, it is well to move the bowels without taking medicine internally.
Glycones are the best. They are in two sizes, children's and adults'.
They are invaluable for travellers. They produce prompt, painless and
copious stools. Garfield Tea is mild, harmless and sure. One of the best
and pleasant to take, and has no nauseating effects. For babies, Garfield
Fig Syrup.

Loss of Nervous Energy, and Impotency. — Sterility in both the
male and female. The first thing to do is to break off at once and forever
even the thoughts of what causes impotency and loss of energy. If male,
bathe the parts in cold water night and morning and pay no attention to
various advertisements of free remedies, etc. See chapter on Masturbation
and Impotency. The best remedy for loss of energy and impotency is Kola
(Metcalf). Nothing can compare with Kola Koloid. Its use by the
negro in Africa has extended all over the world. It is well known that
they raise the largest families and their energy in this respect can perhaps
be traced to the use of Kola.

Nerve Tonics. — Coca Wine. As a stimulating tonic there is perhaps
no better remedy known than Metcalf's Coca Wine. It is an invigorator
for the aged, a quick builder for the enfeebled, is a palliation for mental
troubles, and is valuable to tone up the system after a tun of fever.
Chapoteant Sol. Bromide Strontium is a good and agreeable preparation
and is well tolerated by the stomach. Phillips* Phospho. -Muriate Quinine
Compound is a good general tonic. Of the bromides the following are
good : Elixir Potassium Bromide, Elixir Sodium Bromide, Elixir Ammo-
nium Bromide. Coca Wine is the safest and best.

Neuralgia. — Is usually caused by poverty of the blood. See Nerve
Tonics. Quinacetine (Metcalf) is one of the best remedies. Its use is
not followed by any unpleasant effects.

Painful Menstruation and Vaginal Remedies. — Orange Blossoms
(J. A. McGill) come in the form of suppositories and is administered
direct tothe seat of the disease. They are safe and harmless. Have stood
the test of use, can easily be administered by the patient and are a specific
for profuse ineuatruatiou. Wine of American Ash (Metcalf) , made from

948

PROPRIETARY AND PATENT MEDICINES.

the outside bark of the white ash, is used in the treatment of the ions
uterine affections, namely, prolapsus, versions, menstrual irreguiu.ities,
inflammation, leucorrhoea, etc., depending upon chronic enlargement for
their basis. While relief and marked benefit may be obtained by a few
weeks' use it may be as many months before absolute freedom from suffer-
ing may result. lodia is much used. It is a combination of the active
principles obtained from the green roots of stillingia helonias, saxifraga
menispermum and aromatics. Each fluid dram also contains five grains
each iod. potas. and phos. iron. Used especially for leucorrhcea, impaired
vitality, habitual abortion and general uterine debility. The surgical
craze for the treatment of diseases of the pelvic organs has prevented phy-
sicians from studying as carefully as they should the medical treatment.
At least it would be well to see what medicines will do before resorting to
the knife. Antiseptic Vaginal Cones and Boro-Glyceride Suppositories
are also good.

Piles. — Hamamelis Suppositories and Comfort Powder are both good
remedies. See chapi >t on Hemorrhoids.

Plasters. — Their number is legion. Bell-Capsic, Cuticura and Cap-
sicum are all good.

Pain Medicines. — One of the very best of all opium preparations is
Papine and it is efficacious in most cases. Papine is the anodyne or pain-
relieving principle of opium, the narcotic and convulsive elements being
eliminated. One fluid dram is equal in anodyne power to ^ of a grain of
moi'phine.

Prostate QIand Diseases. -

troubles, especially for the aged.

Rheumatic Medicines. — Quinacetine (Metcalf). This remedy is
safe and has no unpleasant or injurious effects. Merrill's Alkaline Elixir
is a pleasant and effective remedy in many varieties of rheumatism.
Tongaline is used in both rheumatism and gout. It is laxative if taken
too often. lodia is a good remedy for chronic rheumatism.

Salves. — Cuticura and Salvacea.

Stimulants. — Coca Wine (Metcalf) is one of the best and most
harmless. Kola Koloid is another excellent preparation. Vin de Cbapo-
teant is a good stimulant on the old beef, iron and wine plan.

Skin Diseases. — The very best remedy we consider is Succus Alter-
ans (Lilly) as it strikes at the root of the trouble — impoverished and im-
pure blood. Skin troubles cured by this remedy are likely to remain so.
Hamamelis for an external application is soothing and cooling. It is ex-
cellent for reducing inflammation.

Syphilis. — lodia is a purely vegetable remedy made from the juices of
the green herbs. Can be taken for a long time without injury to any
organs of the body. It improves the nutrition, purifies the blood and is a
specific for syphilis in all stages. Succus Alterans is another good
remedy. It is a vegetable remedy, anti-syphilitic and alterative. It
builds up the system by purifying and enriching the blood.

Sommetto is used largely for these

PROPRIETARY AND PATENT MEDICINES.

"lift'

nt of the ions
ual irregui...itie8,
! enlargement for
•btained by a few
idom from sufifer-
ion of the active
ilonias, saxifraga
itains five grains
torrhoea, impaired
The surgical
18 prevented phy-
ledical treatment.
sfore resorting to
ide Suppositories

ler are both good

Stomach Tonics. — Horsford'B Acid Phosphate for indigcetion, Tar-
rant's Seltzer Aperient for acidity and belching of wind. For a strict tonic
the following are good : Elixir Calisaya Bark and Bismuth, Elixir Calisaya
and Iron, Elixir Calisaya, Bismuth and Pepsin.

Throat Tablets. — Chloramine Tablets, Wyeth'sRed Gum Lozenges,
and Troches Guaiac are all good.

Vaginal Remedies. — Orange Blossoms are the best for general use.
Antiseptic Vaginal Cones and Boro-Glyceride Suppositories are also largely
used.

Whooping Cough. — Vapo-Cresoline. Is a liquid to be burned over
a night-lamp. It relieves the cough and hastens recovery.

Wounds. — Aristol, Dermatol and Iodoform are used to promote
healing.

uticura and Cap-

n preparations is

anodyne or pain-

5 elements being

1^ of a grain of

irgely for these

This remedy is
Alkaline Elixir
of rheumatism,
axative if taken
a.

best and most
Vin de Chapo-
an.

is Succus Alter-
erished and im-
iy to remain so.
oling. It is ex-

..«-'!**•-■

>m the juices of

It injuiy to any

5 blood and is a

another good

alterative. It

: Jl

"wasKHsaBEs:-.

wwrs-

PHYSICAL CULTURE — GYMNASTICS.

In America the noblest interests of the race have :'eached unpar-
alleled development. In no other country, in no other age, has
mental culture been so complete and universal. It is an era in the
progress of the race. The fruits of labor which in other times and
lands have been wasted upon the abnormal life of the few, have here,
like air and light, the two great repr.isentative gifts of Heaven, found
their way to the normal life of the million.

But in this hour of triumph the national life is jeopardized by
physical exhaustion. While the admiring world looks on, our bodies
upon which as a foundation our higher faculties must rest, crumble
and give way. Precocious brains are borne about by doubtful spines;
brilliant talents are linked with dying bodies.

Men, women, and children should be strong, but it should be the
strength of grace, flexibility, agility, and endurance ; it should not be
the strength of a great lifter. Let me allude to the gymnastics of the
circus. Permit me to call special attention to three features — to the
man who lifts the cannon, to the india-rubber man and to the general
performer. The lifter and the india-rubber man constitute the two mis-
chievous extremes. It is impossible that in either there should be
the highest physiological conditions ; but, in the persoixs of general
performers, is found the model gymnast. They can neither llrt great
weights nor tie themselves into knots, but they occupy a point
between these two extremes. They possess both strength and flexi-
bility, and resemble fine, active, agile, vigorous carriage-horses, which
occupy a point between the slow cart-horse and the long-legged, loose-
jointed animal. The race-hoi-se has a much more vigorous circula-
tion than the cart-horse. It is a fact not unfamiliar to horsemen,
that when a horse is transferred from slow, heavy work to the car-
riage, the surface veins about the neck and legs begin at once to en-
large ; when the change is made from the carriage to the cart, the
reverse is the result.

And when we consider that the principal object -of all physical
training is an elastic, vigorous condition of the nervous system, the
superiority of light gymnastics becomes still more obvious. The
nervous system is the fundamental fact of our earthly life. All other

950

PHYSICAL CULTURE.

951

8TICS.

iched unpar-
lier age, has
m era in tlui
!r times and
(v, have here,
eaven, found

)pardized by
n, our bodies
'est, crumble
btful spines;

lould be the
bould not be
astics of the
res — to the
> the general
the two mis-
e should be
i of general
ler lirt great
ipy a point
th and flexi-
orses, which
jgged, loose-
ous circula-
) horsemen,
to the ear-
once to en-
le cart, tlie

ill physical
system, the
ious. The
All other

parts of the organism exist and work for it. It controla all, and is
the seat of pain and pleasure.

The impressions upon the stomach, for example, resulting in a bet-
ter or worse digestion, must be made through the nerves. This su-
preme control of the nervous system is forcibly illustrated in the
change made by joyful or sad tidings.

Could we have an unbroken succession of good news, we should
all have good digestion without a gymnasium. But in a world of
vexation and disappointment, we are driven to the necessity of muscle
culture, and other hygienic expedients, to give the nervous system
that support and vitality which our fitful surroundings deny.

If we would make our muscle-training contributive in the highest
degi'ee to the healthful elasticity of our nerves, the exercise must be
such as will bring into varied combinations and play all our muscles
and nerves. Those exercises which require great accuracy, skill and
dash are just those which secure this happy and complete intermar-
riage of nerve and muscle.

Another point I take the liberty to urge. Without accuracy in the
performance of the feats, the interest must be transient. This prin-
ciple is strikingly exemplified in military training. Those who have
studied our infantry drill have been struck with its simplicity, and
have wondered that men could go through with its details every day
for years without disgust. If the drill-master permits carelessness,
then authority alone can force the men through the evolutions ; but
if he enforce the greatest precision, they return to their task every
morning for yeare with cheerfulness.

At this point it may be urged that those exercises which hasten the
action of the thoracic viscera to any considerable degree are simply
exhaustive. This is another blunder of the " big-muscle " men. They
seem to think you can determine every man's constitution and health
by the tape-line ; and that all exercises whose results are not deter-
minable by measurement are woi-thless.

I need scarcely say there are certain conditions of brain, muscle,
and of every other tissue, far moie important than size ; but what I
desire to urge more particularly in this connection is the importance,
the great physiological advantages, of just those exercises in which
the lungs and heart are brought into active play. These organs are
no exceptions to the law that exercise is the principal condition of
development. Their vigorous training adds more to the stock of
vitality than that of other organs.

I have said an elastic tone of the nervous system is the physiolog-
ical purpose of all physical training. If one may be allowed such an
analysis, I would add that we exercise our muscles to invigorate the
thoracic and abdominal viscera. These in their turn support and in-
vigorate the nervous system. All exercises which operate more di-
rectly upon these internal organs, as, for example, laughing, deep
breathing, and running, contribute most effectively to the stamina of

SI3ii Bj»W«HMMMAa!WfeijM^

952

PHYSICAL CITLTURK.

the brain and nerves. Tt is only this mania for monstrous arms and
shoulders that could have misled the intelligent gymnast on t'-is
point.

As our artificial training is designed to fit us for the more succiess-
ful performance of the business of life, I suggest that the training
should be, in character, somewhat preparatory for those duties. If
you would train a horse for the carriage, you would not do it by
driving at a slow pace before a heavy load. If you did, the first fust
drive would go hard with him.

Just so with a man. If he is to lift barrels of flour, or kegs of
nails, as a business, he may be trained by heavy lifting ; but if his
business requires the average velocity and free motions of human
occupations, then upon the basis of his heavy slow training, he will
find himself, in actual life, in the condition of the dray-horse, who is
pushed before the light carriage at a high speed.

Is it true that in either intellectual or phjrsical training, bold,
brilliant efforts, under proper conditions and limitations, exhaust the
powers of life? On the contmry, is it not true that we find in vigor-
ous, bold, dashing, brilliant efforts the only source of vigorous, bold,
dashing and brilliant powers ?

In this discussion I have not considered the treatment of invalids.
The principles presentcvi arc applicable to the training of children
and adults of average vitality.

I will rest upon the general statement that all persons of both
sexes, and of every age, who are possessed of average vitality, should,
in the department of physical education, employ light apparatus, and
execute a great variety of feats which require skill, accuracy, cour-
age, dash, presence of mind, quick eye and hand, — in brief, which
demand a vigorous and complete exercise of all the powers and
faculties with which the Creator has endowed us ; while deformed
and diseased persons shoul4 be treated in consonance with the phi-
losophy of the Swedish Movement Cure, in which the movements are
slow and limited.

We rejoice to see that the American people of all classes and both
sexes are taking more and more interest in outdoor sports. The
bicycle, if used in reasonable moderation, will prove a great factor
in the physical development of both sexes ; but the danger is that
the American idea of trjHing to outdo others will cause the young
vidth untried muscles to attempt century runs and generally to overdo ;
while, if they should take reasonable rides, and enjoy the fresh air
and scenery, it would prove a benefit to mind and body.

There are many simple contrivances to use at home, if not conven-
ient to take full gymnastic courses. We give a description of two,
either of -which, if faithfully used, will be of great benefit.

■^i^i^la^i^BM

PHYSICAL CULTURE. ^^'i

trous arms and
^mnaBt on tl'is

e more succtess-
it the training
ose duties. If
1 not (]o it by
id, the first fust

)ur, or kegs of
ing ; but if his
ions of human
raining, he will
.y-horse, who is

training, bold,
ns, exhaust the
^e find in vigor-
vigorous, bold,

ent of invalids,
ing of children

lersons of both
vitality, should,
I apparatus, and
accuracy, cour-
in brief, which
he powers and
irhile deformed
e with the phi-
movements are

lasses and both
sports. The
a great factor
danger is that
,use the young
rally to overdo ;
y the fresh air

if not conven-
ription of two,
lefit.

The Whitely Exerciser.

As this method is introduced with the strictly American idea of
furnishing " the shortest route and fastest time " to health and
strength, you may expect some radical departures from older meth-
ods.

After your regular day's work is ended, you are not aaked to do
another each evening, performing feats of strength which tax your
endurance to the utmost, and leave you " all broke up " the next
day. It has been demonstrated that heavy gymnastics, like numer-
ous other ponderous and unwieldy things of the past, are by no means
the liest. On the contrary, exercises that admit of numerous move-
ments of the muscles without greatly taxing the vital fokces,
produce lai-ger development and better quality. Muscular tissue
built in this way is not ordy strong, but quick and active, while that
developed with heavy weights is hard and slow.

You are not required to waste time in the preliminary study of
an intricate system of movements. For brain-workers, a system that
requires study is directly at variance with one of the prime objects
of musculcr exercise, namely, entire relief from mental strain. But,
if you dcn't have to think, it is because someone has done it for
you ; for the exercises, howbeit simple, are scientifically arranged to
bring into action every muscle in your body.

Dumb-bells and Indian clubs exercise the muscles of the arms and
shoulders but do not reach the muscles that pull the arms down-
ward.

The Whitely Exerciser is at once complete, compact and noiseless ;
requiring no floor-room, no changing of weights, for it adjusts itself
to any degree of resistance ; no buckling of straps or other parapher-
nalia ; can be put up in two minutes without the use of a single tool,
and if desired can be removed from the hooks and put out of sight in
a moment and readjusted for use just as quickly. It imparts an easy,
gliding motion, necessary to successful development.

It is equally adapted to ladies, gentlemen and children.

Directions for Putting up. — The Exerciser will work at any
angle, so select any place in your room that permits an unobstructed
floor space in any direction. Better work toward a window that will
permit of ventilation from above than away from it.

Standing on an ordinary chair, screw two hooks into the door or
window-frame on a level with your nose and from two to six inches
apart as best suits the form of the woodwork ; lower hooks two inches
from the floor, or in the floor if you are short of stature.

Should there be a sill or other obstruction to be avoided, put the
lower hooks in the floor at sufficient distance from the wall to make
the cords clear the obstruction.

The middle pulley is purposely made without a swivel to prevent

954

PHY8I0AL CULTURE.

twisting of the cord when in iiae, so run out dny twist between it
and the pulleys attached to the triangle l)efore putting it on the
hook. The pulleys on the triangle are swiveled that the Exerciser
may adjust itwelf to any movement or work in any direction, and if
the cords twist together between them and the handles a pull on the
latter will untwist them.

The rubl)er cord, or rather cable, is calculated to withstand unlim-
ited use and a much greater tension than required for ordinary exer-
cise, but don't, on that acco; at, abuse it unnecessarily.

Don't use a cord that is too strong for you. If you do you will
be exhausted but not benefited by your exercise. The cords are made
of various strengths, be sure you obtain one adapted to you ; that is,
one that pulls easily when close to the Exerciser. As you grow
stronger, you have only to stand a little further from the Exerciser
to obtain a re^ Istsmce suited to your increasing strength.

It is not how much you pull, but how often, so use no more force
than is agreeable.

If your exercise is too vigorous or too heavy, you will be exhausted
before you can complete it. It is better to exercise all parts of the
body a little than a few much. If you are sick or weak, exercise
very moderately, and stop the moment you feel the least exhausted.
If well and strong, be moderate for the first week or two, or exercise
will make you sore. When a muscle is tired it hurts, and to force
it beyond that point is harmful.

Exercise when you have time for it. Not for an hour after meals,
certainly, unless it be very moderately. After eating, your stomach
needs all your force, and much of your blood, which under exercise
would be drawn to the muscles.

Perhaps the most convenient time to exercise is just before retir-
ing, as it puts the body and brain in condition for refreshing sleep.
Sedentary people should keep the apparatus in the office, if possible,
to exercise when they feel the need of it, — that is when your br.iin
is tired, and your thoughts refuse to flow freely. A little vigorous
exertion will renew the supply of blood in the brain, and with new
blood will come clear thought and new ideas.

A tired feeling is not always due to exhaustion ; it is more fre-
quently due to congestion of the blood in some particular spot, and
is quickly dispelled by exercise. Make the attempt, but if the tired
feeling does not soon disappear, you will understand that it is true
exhaustion for which sleep is the only remedy.

Make up your mind that you will exercise, be it midnight or morn-
ing, when you retire, and you will be repaid for it in the quality of
sleep that follows ; though at such times, unless excited, it is well to
somewhat curtail the amount of each movement, or you will tire be-
fore you finish the list. At such times, also, some regard to the mus-
cles that have beeen used during the day is p .jable ; but when you
have time to exercise each group of muscles completely, this matter

PHYSICAL CULTURE.

955

St between it
ing it on the
ttie Exerciser
ection, and if
a pull on the

hstand iinliin-
ordinary exer-

u do you will
Drds are made
you ; that is,
As you grow
the Exerciser
1.
ao more force

be exhausted
1 parts of the
/eak, exercise
st exhausted,
o, or exercise
and to force

r after meals,
your stomach
nder exercise

; before retir-
reshing sleep.
0, if possible,
en your br.iin
ittle vigorous
md with new

; is more fre-
ilar spot, and
it if the tired
lat it is true

ight or iBorn-
;he quality of
, it is well to
I will tire be-
i to the mus-
jut when you
r. this matter

will regulate itself, for those that have l)een used during the day
will tire sooner than the othera. Nature ])uts a limit to muscular
development, beyond which no amount of exercise will force it, and
it is therefore only necessary to exercise all the muscles regularly, to
eventually bring the entire body to a symmetrical shape, and tlie
liighest stage of development.

If practicable, take your exercise in the condition indicated in tlie
cuts ; for at least once a day the l)0(ly should be free to act without
restraint of clothing, and moreover, fresh air is a tonic to the skin
which lessens your chances of taking cold.

Fresh air is an indispensable adjunct to exercise, but the room
should never be chilly.

Never exercise beyond the ability of the heart to keep pace with
yoij ; palpitation is a sure indication of excess. Exercise only as
vigorously as is agreeable, and in keeping with your strength.

Do not exercise long or h :'d early in the morning, as it is apt to
exhaust you bexore the vital forces are fully aroused, and you do not
recover during the day. If you rise as late as half past eight or nine,
vigorous exercise is not likely to hurt you, unless you Ixdt your
breakfast, and rush off to work immediately following it.

In making the movements, endeavor to forget you are exercising,
and, if possible, imagine you are doing the things the movements in-
dicate.

Exercise No. 1. — Throwing. Suspend the apparatus as in posi-
tion No. 4, grasp the handles with either hand, and make a mo^ e-
ment exactly as though throwing a ball or light stone. Having tired
the muscles on one side, change to the other and repeat the move-
ment until that side is tired, also.

This movement brings into play the muscles in front of the neck,
the large muscles on the front of the chest, the muscles on the front

■^i ' mi-^^-i

966

PHYSICAL CULTUHK.

and side of the abdomen, nearly all the muscles of the legs, and broad-
ens the chest. Draw in the breath as you take the first position, and
blow it out forcibly as you make the movement.

If the tension is not strong enough with one handle, it may be
doubled by taking both in one hand.

Before releasing your hold on the handles relax the tension and
give the cords time to untwist. If oiled the Hwivels will revolve
without assistance.

Exercise No. 2. — Houting. — Take a handle in each hand and
make a movement as though hoisting a bucket of pitch or gravel to
the roof of a high building.

This exercise brings into action the muscles on the sides of the
neck, muscles of the fore-arms, back-arms, muscles of the bac'c that
draw the shoulders together, side muscles, and muscles on front of
thighs. In making this movement, endeavor to send the " bucket "
as high as possible at each sweep of the arm. In doing so, you will
diaw the arm back and around in a way that is necessary to develop
the particular muscles which this movement is intended to reach.

Take in the breath as one hand is drawn down, and as the other
comes down, expel it.

Exercise No. 3 Suspend Exerciser as per cut, and use each hand

alteinately. This exercise strengthens the muscles of the arm,
shoulder and thigh. Another exercise is made by turning the back
to the Exerciser. Putting the cords over the shoulders, hands on
back, then bend foi-ward and back. This movement is particularly
intended to reach the large muscles on the front of the chest and
abdomen.

m^^m^m^mm^mm

knees as you draw the arms down, and as the arms go up, bring them
together. This latter part of the movement exercises the muscles

"f^«Mi>|B««lMMjiiaMIMi

958

PHYSICAL CULTURE.

on the inside of the legs which are much used in swimming. Draw
in the breath as the arms go up, and expel it as you draw them down.
This movement is a good chest-expander.

Exercise No. S.~ Putting the shot. — Shift the apparatus to
position No. 6. Grasp the handle in one hand, and make a move-
ment as though throwing a heavy stone or shot. Draw in the breath
as you begin the movement, expel it as you finish. When the
muscles of one side are tired, change to the other and repeat the
movement.

The exercise expands particularly the upper portion of the chest,
exercises the fore-arm and biceps, or front muscles of the upper arm,
triceps, or back muscles of the upper arm, the upper portion c' the
large muscles on front of the chest, and muscles on side of shoulder ;
also the side muscles of the body, and nearly all the muscles of the
legs and feet

Exercise No. 6. — Romng.

This movement may be made either
sitting or standing, though it is
better made sitting. With a
handle in each hand, make a
movement as you would in
rowing: as the body goes for-
ward spread the knees, as re^
resented in the first cut, and as
you go back, bring them to-
gether as shown in the second.
The breath may be drawn in
either as the body goes forward
or backward, but as a rule, in
any exercise, it is better to take

I ',

PHYSICAL CULTURE.

imming. Draw
raw them clown.

e apparatus to
1 make a move-
iw in the breath
sh. When the
and repeat the

n of the chest,
the upper arm,
■ portion c'^ the
de of shoulder ;
muscles of the

be made either
ttg, though it is
iting. With a

hand, make a
y^ou would in
body goes for-

knees, as re^
first cut, and as
)ring them to-
in the second,
ay be drawn in
y goes forward
t as a rule, in
i better to take

the breath before the exertion. In this movement be careful to draw
tlie arms and shoulders well back ; for rowing, as it is generally per-
formed with the sliding seat, tends
to contract the front of the chest.
The movement made as indicated
in the cuts, or in rowing without
the sliding seat, overcomes that
objection to the sport. In rowing,
we use the muscles of the fore-arm,
biceps, back muscles of the shoul-
ders, nearly all the muscles of the
back, and the muscles of the back
of the neck have considerable to
do. With the sliding seat, the
muscles in front of the legs do
much of the work, but as all the
other movements exercise the legs,
there would be nothing gained in
having the seat for this exercise.
In fact, the development of the
muscles on the inside of the legs, as is done in the way the move-
ment is here described, is much more to the point ; for with the
exception of exercise No. 4, these muscles have had little work.

Exercise No. 7 Lie down on floor. Head to Exerciser. Lift

hands straight over head, touch the floor and sink to hips. Raise
body to sitting position without lifting feet from the floor.

This exercise plaj^s particularly on t^ front muscles of the shonl-
jlers, and some muscles in the back, and is specially designed to
strengthen the abdominal muscles.

"ftaaaJILg

iv ' ;aa:. ' 9g"

f-Jf'/r^'^

> ' .i^- ' .t.>-.M:.

960

PHYSICAL CULTURE.

Inhale the breath fully as the arms ascend, and expel it forcibly as
they descend. ''

Exercise No. 8.— Bowling. — Suspend one handle again as in
position No. 6 ; with the other hand free, make a movement as though

to throw a ball as in bowling. Draw in the breath and expel it in
the forward movement.

This exercise develops the muscles of the arms and legs.

As a finishing touch, this old-fashioned exercise for expanding the
chest is given. From a position with the hands down at the sides,
raise the arms laterally to a position high over your head, keeping

the elbows straight. Inhale all the breath you possibly can as the arms
go up ; bring the arms down again to the position first indicated, but
retain the breath for a moment after you have finished the movement.

•rnism

PPP?^

ni^

pel it forcibly as

le again as in
ment as though

PRONOUNCING DICTIONARY. - GLOSSARY.

md expel it in

legs.

expanding the

n at the sides,

head, keeping

an as the arms
indicated, but
he movement.

Ab-do'&eo. The belly.

A-ce-tab'u-lum. The socket for the
head of the thigh bone.

Ab-dom'i-oal c«v'i-ty. The cavity of
the belly.

Ab-duc'tor. A muscle which draws one
part of the body towards another.

Ab-sor' bents. Qlands and vessels
which absorb or suck up substances
from within or without; also, medicines
which, though nearly or quite inactive
themselves, absorb, or combine with
acid matter in the stomach or bowels,

A-cro'mi-on. That part of the scapula,
or shoulder-blade, which unites with the
collarbone.

Al-bu-gin'e-a. The white of the eye.

Al'ter-a-tives. Medicines which gradu-
ally reestablish health, without sensibly
increasing the circulation, or augment-
ing the perspiration, urine, or other ex-
cretions.

Al' ve-o-lar. Relating to the sockets of
the teeth.

Al'vine (Al'vin) . Relating to the Intes-
tines, as alvine diachargea, — discharges
from the bowels.

A-mor'phou8. Having no regular form.

Am-ni-ot'ic liq'uid. The fluid sur-
rounding the fetus in the womb.

An-jes-the'aia. Suspended sensibility.

An-as'to-mose. The uniting of arteries
and veins by joining their mouths.

An-chy-lo'sis. A stiff or useless joint.

An-i-mal'cu-ls, Animals so small that
they can only be seen with a microscope.

An-ae'mi-a. Privation of blood; a com-
paratively bloodless state.

An'o-dynes. Medicines which diminish
sensibility, abate pain, and induce sleep.
It should always be remembered that
anodynes when frequently, and long
taku, lose their influence in disease.

Ant-a'cids. Preparations which neu-
tralize acidity of the stomach and bowels.

Ant-al'ka-Iies. Agents which neutral-
ize alkalies.

An-ta-phro-ais'i-aca. Agents which les
sen or blunt the sexual propensities.

An-thel-min'tics. Medicines which de-
stroy and expel worms.

An'ti-dotes. Medicines which counter-
act and destroy the effects of poison.

An-ti-pe-ri-od'ics. Medicines which pre-
vent or cure diseases of a periodical char-
acter.

An-ti-pMo-gis'tics. Medicines or diet
which remove or appease inflamma-
tion.

An-ti-spos-mod'ics. Medicines which
prevent or allay spasms, commonly
called cramps.

An-ti-«yph-i-lIt'iC8. Medicines which
cure syphilis.

An-ti-s«p'tic. Whatever checks or
counteracts putrefaction.

An-ti-8cor-bu'tics. Articles which pre-
vent and cure scurvy.

A-pe'ri-«nt8. Medicines wliioh gently
open the tiowels.

A-pho'ni-a. A loss of the voice.

Aph-ro-dis'i-acs. Medicines supposed
to excite and promote the sexual aone-
tlte. '^^

A-pon-eu-ro'sis. The membranous ex-
pansion of tendons and muscles.

A-re-o'la. A colored circle, as the cir-
cle around the nipple.

Ar-o-mat'ic8. Medicines which have a
grateful, spicy smell, and an agreeable,
pungent taste.

As-phyx'i-a. Suspended animation;
apparent death.

As-then'ic. Relating to debility ; or to
disease marked by debility.

As-trin' gents. Medicines which have
the power to constringe or pucker up the
ti8suet» of the body, and thereby check
discharges.

At'ro-phy. A wasted condition ; lean-
ness.

Ax-il'la. The arm-pit.

Atts-cul-ta'tion. The art of detecting
disease by listening to the sounds of the
lungs, heart, etc.

Au-top'sy. Personal inspection, — used
in the sense of a post-mortem examina-
tion.

961

•'nm

962

QLOSSABT

A-zo'te. Nitrogen ; one of the oonatlt-
uents of the atmosphere.

Bron'chi-a. The pipes which convey
the air through the lungs.

Bnr'sae mu-co'sa. Small sacs, situated
under tendons, about the joints, contain-
ing a sticky Quid.

Cal'cu-lus. A solid, unorganized body
formed in the kidneys, or bladder, and
called a stone. The plural is calcuU.

Cap'il-la-ry. Small, resembling a hair.

Cap' sale. A membranous bag, enclos-
ing a part.

Car'ti-lage. Gristle attached to the
ends of the bones.

Car min'a-tives. Medicines which ex-
pel wind from the stomach and bowels,
and allay the pain caused by it.

Ca-thar'tic8. Medicines which purge
the bowels.

Cer'vix. The neck. Oer'vix Vter-i.
The neck of the womb.

Car'di-ac. Belating to the heart.

Car' pal. Belating to the wrist.

Cat-a-me'ni-a. The monthly flow of
females.

Purging.
A tvibe for drawing off the

Ca-thar'sis
Cath'e-ter.
urine.
Cel-la'lar.
Cer'e-bral

Belating to cells.
Belating to the brain.

Cha-Iyb'e-ate. Containing Iron or steel.

Che-mo 'sis. A swelling of the eye, in
which the eye projects, with a depression
in th( centre.

Cho' la-gogne. A medicine which causes
a discharge of bile.

Clo'nic spasms. Spasms which are
rigid and relaxed alternately.

Col-li' qua-tive. This term Is applied to
excessive and exhausting discharges.

Co-los'tnun. The flrstsecretion of milk.

Co' ma. Profound stupor, or sleep.

Con'dyle (kon'dil). A knob; applied
to certain projections of bones at joints.

Con'flu-«nt. Not distinct ; running to-
gether.

Con-gen't-tal. Existing at the time of
birth.

Con-ges'tion. Distention of parts by
an accumulation of blood in them.

Con-janc'ti-va. The membrane which
covers the eye and lines the eyelid.

Con'tra-in'di-ca-ted. Not indicated ;
the opposite implied.

Cord'ials. Medicines which have a
grateful, warming and exhilarating ef-
fect upon the stomach.

Conn'ter-ir'ri-tants. Articles which by
irritating one part, withdraw blood from,
and relieve another.

Cri'sis. The turning point of a disease.

Cn'ti-cla. The epidermis; the seart-
Bkln.

De-cid'n-a. A thin, external membrane,
within the womb, thrown off after child-
bearing.

De-liq'ui-um. Fainting.

De-mul'cents. Medicines of a softening
nature, which correct acrid coudltionB,
and, by their bland effects, soothe in-
flamed and irritated parts.

De-ple'tlon. Diminishing the fullness
of a part or parts, as by purgatives, or
bleeding.

De-sqna-ma'tion. Separation of the
skin in scales; scaling off.

De-ter'gents. Medicines which cleanse.

Di-ag-no'sls. The art of determining
the nature of diseases.

Di-a-pho-ret'ics. Medicines which pro-
mote sweating.

Di-ath'e-sis. Any particular disposi-
tion, state, or habit of body.

Di-u-re'sis. CJopious flow of urine.

Dil'u-ents. Watery drinks, which in-
crease the fluidity of the blood, and ren-
der several of the secretive and excretive
fluids less viscid.

Dis-cu' tients . Medicines which scatter,
resolve, or disperse tumors.

Dis-in-fec'tants. Articles which purify
or cleanse Infected places.

Di-u-ret'ics. Medicines which increase
urinary secretions.

Dras'tics. Strong and violent purga-

tives.
Dysp-noe'a.
E-me'sis.
£-met'ics.

DiflSculty of breathing.
Vomiting.

Medicines which cause the
stomach to reverse Its action, and throw
its contents up through the mouth.

Em-men'a-gogues. Medicines supposed
to have the power of e.\ siting or increas-
ing the menses.

E-mol'lients. Those substances which
have the power of softening or relaxing
the animal fibre, when applied externally.

En-dem'ic dis-eas'es. Diseases pre-
vailing in certain localities or districts.

Ep-i-dem'ic dis-eas'es. Diseases ex-
tending over a large extent of country.

Ep-i-glot'tis. The cartilage, which, in
the act of swallowing, shuts down upon
the top of the wind-pipe, and prevents
food from going into the breath-passage.

£p-ls-pas'tic8. Substances which in-
flame thu skin, and raise the cuticle, and
cause what is called a blister.

Es-cha-rot'ics. Articles which bum,
corrode, disorganize, and destroy the
animal tissues, causing what is called an
eschar, or slough, which Ib dead matter,
and falls off.

Ex-pec' to-rants. Articles which act
upon the system, so as to make the dis-
charge of mucus and other substances
from the air-tubes more easy.

£i\ififi''rfi,iiaMlif^:f*r'ry.-^.jjirr,!f,'^ , , ^ , ,

GLOSSARY.

963

xtemal membrane,
own off after chlld-

tlng.

ciaes of a softening

t acrid conditions,

effects, soothe In-

>arts.

Ishlng the fullness

} by purgatives, or

Separation of
goff.
ines which cleanse,
art of determinlcg
i.

jdlcines which pro-
particular disposl-
f body.

18 flow of urine.
Y drinks, which In-
the blood, and ren-
etlve and excretive

jines which scatter,

iimors.

■tides which purify

aces.

nes which increase

md violent purga-

ilty of breathing.

les which cause the
3 action, and throw
gh the mouth,
iiledicines supposed
Bx<;itlng or Increas-

B substances which
ftening or relaxing
1 applied externally.
B. Diseases pre-
illties or districts.
es. Diseases ex-
extent of country,
cartilage, which, in
, shuts down upon
pipe, and prevents
the breath-passage,
bstances which In-
liee the cuticle, and
i blister.

sides which bum,

and destroy the

>g what is called an

lich is dead matter,

Lrtlcles which act
is to make the dis-
1 other substances
)re easy.

the

Er'rhines. Substances whicli cause
sneezing and a discharge of mucus
from the nose when snuffed.

Es'char. The dead part, killed by
caustic or mortiflcation, which falls off;
a slough.

£x-f o-ll-a 'tion . A sealing off, as a piece
of dead bone.

Fau'ces. The back part of the mouth.

Fe'brile. Belonging to fever.

Fe'ces. The matter discharged from
the bowels.

Feb'ri-fu-ges. Medicines which assuage
or remove fevers.

Fla'tus. Wind, or rather, gas, In the
stomach or bowels.

Fol'li-cle. A little bag or sac.

Fo-ra'men. A hole or opening.

For-mi-ca'tion. A sensation like
creeping of ants.

Fur-fu-ra'ceous. Branny or scaly.

6ang'li-on. An enlargement In
course of a nerve.

Gan'grene. Mortiflcation; partial death.

Gas'tric. Belonging to the stomach.

Ges-ta'tion. The period of pregnancy.

Glot'tis. The opening into the wind-
pipe, covered by the epiglottis.

Gran'tt-lar. Like small grains.

Gran'u-la-ted. CJovered with granula-
tions.

Gran-u-la' tion. The filling up or cover-
ing of a wound or ulcer, with small, red
elevations, looking like grains.

Hae-mop'ty-sis. Baising blood from
the lungs.

Haem'or-ihage.

Haem-or-rba'gic.
bleed.

He-mi-cra'ni-a. Fain on one side of the
bead.

He-pat' ic. Belonging to the liver.

Hy-per-ca-thar'sis. Excessive purg-
ing.

Hy-per'tro-phy. An unnatural enlarge-
ment of an organ, without change of
structure.

Hyp-not'ics. Medicines which cause
sleep.

Ich'or (Ik'or). A thin, watery, and
acrid discharge.

In-ter-cos'tal. Between the ribs.

Lar'ynx. The top of the windpipe;
the cavity which contains the vocal liga-
ments.

Laz'a-tiVes. Medicines which render
the bowels a little more relaxed than
natural, but do not purge.

Lig'ate. To secure with a ligature.

Lig'a-ture. A cord or thread.

Lo~chi-a. The bloody discharge from
the womb for some time after child-
birth.

Lo'chi-al. Belatlng to the lochia.

A flow of blood.
Having a tendency to

Lymph. A whitish fluid contained by
the lymphatic vessels.

Lym-phat'ics. The vessels which carry
lymph.

Hac-er-a'tion. The act of softening or
soaking a thing by letting it stand in
water.

Mac'u-lae. Colored spots; blemishes.

Ma-la' ri-a. Noxious gases from de-
composed matter.

Mam'nut. The female breast.

Man-dib'u-Ur. Relating to the jaw.

Mas-ti-ca'tion. The act of chewing.

Mas-tur-ba'tion. The act of exciting
the genital organs with the hands.

Men'stni-um. Any solvent, or vehicle.

Met-a-car'pus. The hand, between the
wrist and the fingers.

Me-tas'ta-sis. The changing of a dis-
ease from one place to another.

Met-a-tar'sus. That part of the foot
between the ankle and the toes.

Mi-as-mat' ic. Partaking of the nature
of miasm.

Mu'co-pu'ri-form. Composed of both
muciis and pus.

Mu'co-se'ro-lent. Composed of both
mucus and serum.

Nar-cot'ic8. Medicines which relieve
pain and produce sleep.

Nau'se-ants. Medicines which cause
sickness at the stomach, or a disposition
to vomit. They are often used as ex-
pectorants.

Nos-ol'o-gist (Noae-ol'o-giat). One who
explains and classifies diseases.

Ntt'cle-us. A central spot.

Nu-cle-o'lus. A spot within a nucleus.

Or-thop-noe'a. Great difficulty of
breathing.

Os-si-fi-ca'tion. Tlie formation of
bone.

Os u'ter-i. The mouth of the womb.

O'va. Eggs.

O'vum. An egg.

Pa-pil'la. A red, elevated point upon
the tongue, or elsewhere. Certain dis-
eases make these points more promi-
nent.

Par-a-cen-te'sis. The operation of
puncturing the chest, or the abdomen,
for the purpose of drawing off water.

Par-a-phle'gi-a. Paralysis of the lower
half of the body.

Par'ox-ysm. A fit of disease taking
place periodically.

Par-tu'ri-ent. Bringing forth, or giv-
ing birth.

Par-tu'ri-ents. Medicines which pro-
mote child-bed labor, by causing con-
tractions of the womb.

Par-tu-ri'tion. Child-birth.

Pec'to-rals. Medicines Intended (o cure
or relieve diseases of the chest.

■^in

964

GLOSSARY.

Pel'rls. The bony cavity, or basin, at
the lower part of the body, oontalning
the womb, abdomen, rectum, etc.

Per-i-ne'um. The part, or space, be-
tween the anaa and testicles.

Per-i-os'te-um. A thin, hard mem-
brane, covering the bones.

Per-i-os-ti'tis. Inflammation of the
periosteum.

Per-l-to-ne'um. A serous membrane
lining the cavity of the belly, and folded
over most of the organs contained in it.

Pet-e'chi-s. Purple spots which ap-
pear upon the skin In low fevers, looliing
lllie llea-bites ; called also ecchymoses.

Pha-ge-den'ic. Corroding, eating,— ap-
plied to ulcers.

Pha-Un'ges. The bones of the Angers
and toes.

Phar'ynz. The upper part of the
throat.

Phleg-mo'nons in-flam-ma'tion. Inflam-
mation marlied by redness, heat, and
pain, and a tendency to form matter.

Prog-no'sis. The art of foretelling the
termination of diseases.

Pty'a-lism. Salivation.

Pri'a-pism. A continued erection of
the penis from exciting, morbid causes.

Re-friz' er-ants. Medicines which les-
sen the neat of the >>ody.

Re-lax'ants. Medicines which relax
the tension of the muscles.

Re-mis'sion. A lessening or mitiga-
tion of the severity of the symptoms of
s disease.

Res-o-lu'tion. Dispersion of an inflam-
mation before pus is formed.

Re-Yul' sives. Medicines or appliances
which remove a disease by causing a de-
termination to some other part.

Ru-be-fa'cients. Applications which ex-
fllte the skin, causing the blood to flow
to it, and making it red.

Sa'nies. A thin fluid disoharijed from
ulcers, having some of the properties of
pus and blood.

Sed'a-tives. Medicines which dimin-
ish the action of the heart and nerves,
and which are used when we wish to
allay any excited action in the system.

Se'roas. Watery.

Scro'tnm. The bag which contains
the testicles.

Scyb'a-1«. Hard, round lumps in the
feces.

Si'a-la-gogues. Medicines which in-
crease the flow of saliva.

Slough (Sb^ff). Any part of the body
killed by mortiflcation, or caustic, and
cast off.

Sper-mat'ic cords. Two cords, com-
posed of nerves, veins, and arteries, de-
scending, one on each side, from the a1t>-

domen into the scrotum, and suspetiiling
the testicles.

Squa'mous. Scaly ; having scaler.

Sor'des. The dark matter di>|iohited
upon the lips and teeth, in low fu\ tMs.

Ster'num. The breast-bone.

Ster'tor. Noisy breathing, as in apo-
plexy. Snoring.

Ster* tor-ous. Snoring and noisy, as
applied to breathing.

Stim'u-lants. Medicines which in-
crease the activity of the system.

Sto-mach'ic8. Medicines which sup-
port and renovate the stomach, making
its action healthy.

Stru'ma. Scrofula.

Styp'tics. Substances which, when
applied externally, have the power to
constringe or pucker up bleeding ves-
sels, and stop the loss of blood.

Sub-cu-ta' ne-out. Under the skin.

Sub-max' il-Ia-ry. Under the lower
jaw.

Sub-snl'tus ten'di-num. Slight twitch-
Ings of the tendons, which occur in low
forms of fever.

Su-do-rif'ic8. Medicines wliicb cause
a flow of perspiration, rather more free
than that produced by diaphoretics.

Sup-pos'i-to-ries. Solid medicinal sub-
stances, of a conical or cylindrical shape,
which are placed in the rectum for the
purposeof relieving constipation and the
piles, and for removing stricture.

Syn'co-pe. Fainting; swooning.

Te-nes'mus. A painful bearing down
in the lower bowel, and a distressing de-
sire to go to stool.

Ton'ics. Medicines which gradually
give tone and strength to weakened or-
gans, or to the whole system. Some act
upon the nervous system, and some upon
the other tissues, by condensing, hard-
ening, and invigorating them.

Tor'mi-na. Griping pain.

U-re'ters. The tubes wliich convey the
urine from the kidneys to the bladder.

U-re'thra. The canal which conveys
the urine from the bladder out of the
body.

U'ter-ns. The womb.

V«g'i-na {Vadgfi-na). The passage
from the external genital organs to the
womb.

Va'ri-C08« veins. Veins which are
morbidly enlarged, and present along
their course soft, knotty, purplish tu-
mors.

Ver'ti-go. Dizziness; giddiness.

Ve-si-ca'tion. Blistering.

Vi'ms. Poison; contagion.

Vis'cus. A liver, stomach, kidney,
heart, or any organ within one of the
cavities of the body.

1 1 .imjifj,^

, and suspeinling

lavlng scales,
natter deposited
, in low fevers.
3t-bone.
thing, as In ape-

; and noisy, as

lines vhlch in-
he system.
Ines which sup-
stomach, mailing

GENERAL nLEX.

B8 which, when
ve the power to
ap bleeding ves-
)f blood,
ider the skin.
Oder the lower

I. Slight twitch-
ich occur in low

les which cause
'atber more free
liaphoretics.
id medicinal sub-
ylindrlcal shape,

rectum for the
itipationand the
stricture.

Bwooning.
il bearing down
a distressing de-

pihich gradually
to weakened or-
Btem. Some act
I, and some upon
mdensing, hard-
them.
ain.

hlch convey the
o the bladder,
which conveys
Ider out of the

The passage
1 organs to the

ns which are

present along

y, purplish tu-

{iddiness.

'g-

Btlon.

raach, kidney,

hin one of the

Abbreviations and signs,
810.

Abdominal cavity. 122, 291 ;
Diseases of, 291-369.

Abies Canadensis, 840 ; Ex-
celsa, 824 ; Picea, 824.

Abortion, 428.

Abscesses, 626; Of brain,
167.

Absence of menses, 394.

Absorbent vessels, 40.

Abstinence demanded by
anger, 76.

AcacU catechu, 827.

Accidents, 509-616 ; On
water, 512; By poison-
ing. 513.

Acetate of ammonia, 816;.
Of copper, poisoning by,
514; Of lead, poisoning
by, 514; Of lead oint-
ment, 900.

Acetum, 883.

Achillea millefolium, 888.

Acid, acetic, 813 ; Benzoic,
819 ; Citric, 813 ; Diluted
hydrochloric, 813; Di-
luted hydrocyanic, 813;
Diluted nitric, 813; Di-
luted sulphuric, 813 ; Di-
luted nltro - muriatic,
813; Tannic, 814; Tar-
taric, 814.

Acids, poisoning by, 515.

Acne, spotted, 166.

Aconite, 856 ; Poisoning by,
515 ; Tincture of, 91S.

Aconitum napellus, 887.

Acorus calamus, 881.

Adenoid growths, 212.

Adipose tissue, 18.

Adipous sarcoma, 676.

Advanced life, changes in,
500.

ACusion, 752.

Age, influence of, 126.

Ague, brow, 204 ; Fever and,
473.

Ague-cake, 474.

Ague-root, 879.

Air, supply of, 115; In
chest, 260 ; Swellings,
321 ; And ventilation,
112.

Air-cells or vesicles, 36;
Enlargement of, 258.

Albinos, 164.

Albumen, 16.

Albuminous foods, 69.

Albuminuria, 338 ; Dieting
in, 802.

Alcohol, 814.

Alder, Ug, 881.

Aletris farinosa, 879.

Alexander's operation, 412.

Alimentary tube, 32.

Aliments, fluid, 779.

Allium cepa, 859 ; Sativum,
837.

Almond mixture, 898.

Almonds, 814; Syrup of,
009.

Alnus rubra, 881.

Aloes, 814 ; Gomp. tinct. of,
915 ; And canella, comp.
powder of, 907.

Alpinia cardamomum, 826.

Alterative inhalant. 243.

Alteratives, 926, 929.

Althaea officinalis, 854.

Alum, 814 ; Whey, 795.

Amaurosis, 691.

Amenorrhcea, 394.

American hellebore, 814 ;
Ipecacuanha, 815; Ivy,
815 ; Valerian, 888.

Ammonia, aromatic spirit
of, 816; Carbonate of,
816; Comp. liniment of,
896; Muriate of, 816;
Poisoning by, 613 ; Solu-
tion of acetate of, 816;
Water of, 816.

Amount of food to be taken,
83.

Ampelopsis quinquefolia,
815.

Amusements, 118; Oames
for, 119; SelecMon of,
119; Want of, li.x.

Amygdalus communis, 814 ;

Pdrsica, 861.
Ansmia, 288.
Anaesthetics, 600.
Anagallis arvensis, 870.
Anasarca, 358.
Anatomy, 14 ; Of the bones,

18.
Anchylosis, 573.
Aneurismal tumors of heart,

280.
Aneurisms, 577.
Anger demands abstinence,

76.
Angina pectoris, 2S'j ; Diet

in, 786.
Anidrosis, 154.
Animal food, 84.
Anise, 816.

Ankle, dislocation of, 568.
Annual plants, when to

gather, 808.
Anodyne poultice, 906.
Anodynes, 928.
Anteflexion of womb, 411.
Anteversion of womb, 410.
Anthemis nobilis, 829.
Anthrax, 534.
Antidotes of poisons, 513.
Antihemorrhagic inhalants,

244.
Antimony, poisoning by,

613.
Antipathies, 770.
Antiseptic dressings, 433,

642; Inhalant, 244.
Antiseptics, 518.
Antispasmodics, 926.
Aorta, 37, 38.
Aperient, Metauer's, 899.
Apocrnum, 819 ; Audrosee-

miiolium, 819 ; Canna-

blum, 844.
Apoplexy, 177 ; Of the old,

607; Diet iu, 785; Pul-

monary, 259.
Apothecaries' weights, 810.
Apparent death from va-
rious causes, 509-512.
Appendicitis, 816.

966

'W^lfM'

-A

966

GENEKAL INDEX.

Apple-water, 792.

Approximate measures, 811.

Aptha coinuiuuiB, 491.

Apthae, 468.

Aqua oalcis, 861.

Arachnitis, 165.

Arachnoid, 46; Inflamma-
tion of, 166.

Aralia hlspida, 836; Nudl-
caulis, 876; Bacemosa,
876 ; Spinosa, 868.

Arbutus, trailing, 882;
Comp. infusion of, 896.

Argenti nitras, 867.

Aristolochia serpentarla,
884.

Arm, fractures of, 663-564.

Arnica, 617.

Aromatic confection, 892;
Powder, 907; Spirit of
ammonia, 816.

Arrowroot, 817 ; Gruel, 792 ;
Poultice, 906.

Arsenic, poisoning by, 514.

Arsenical solution, 877.

Artemisia absinthium, 887.

Arteries, 37, 38; Pulmo-
nary, 37, 38.

Articles for a medicine-
chest, 809.

Arum triphyllum, 844.

Asarum canadeuse, 886.

Ascaris (pin-worm), 332.

Asclepias, iucamata, 881 ;
Syriaca, 831 ; Tuberosa,
864.

Asclepidin, 864.

Ascites, 366.

Asepsin, 249.

Aseptic and septic, 518.

Asiatic cholera, 329.

Asphyxia, 609.

Aspidum fllix mas, 853.

Assafcetida, 817 ; Comp.
tlnct. of, 916.

Asthma, 270 ; of the aged,
607 ; diet in, 786.

Astringent inhalant, 244.

Astringents, 640, 930.

Atmosphere, pressure of,
112. I

Atmospheric inhalation, '
260. I

Atropa belladonna, 835. I

Atrophy, of brain, 173 ; of
heart, 281.

Attendants, unhired, 769.

Aurantii cortex, 860.

Auricles, 37, 274.

Auscultation, 280.

Bacteria, cause inflamma-
tion, 525.
Baldness, 163.
Balm, 817 ; of Gllead, 817.

Balmony, 817.

Balsam, copaiba, 817 ; Tolu,
818.

Balsamodendron myrrha,
85C.

Bandages, wot, 741.

Banting treatment for cor-
pulence, 799.

Baptisia tinctoria, 886.

Barberry, 818.

Barber's itch, 166.

Bark, when to gather, 808.

Barley, 80; -coffee, 790;
-water, 789.

Barosma orenata^ 823.

Barrenness, 419.

Base-ball, 94.

Basilicon ointment, 892.

Bath, cataract, 747; Cold,
733 ; Effects of cold, 734 ;
Cold foot, 763 ; Douche,
747; Eye and ear, 764;
Half, 748; Head, 760;
Hose, 747; Hot, 734;
Effects of hot, 736 ; Leg,
750; Mouth or oral,
755; Uose, 754; Pall
douche, 748 ; Plunge,
749; Bestoration of de-
sirable, 111; Shower,
747; «liz, 750; Tepid,
734; Effects of tepid,
736; Towel and spongo,
762 ; Vapor, 734 ; Warm,
734; Effects of warm,
736; Wading foot, 753;
Warm foot, 754 ; Wash-
tub, 751 ; Wave or sluice,
748.

Bathing and cleanliness,
106; sea, 736; with ref-
erence to Turkish and
BuBsian baths, 803.

Baths of the ancients, 107 ;
Cold, 109, 733; Division
of, 732 ; Names of, 108 ;
Neglect of, 108; Beac-
tion after. 111 ; Shower,
806; Sponge, 109; Vap-
or, 804; Warm, 805;
Warm for children, 467.

Bayberry, 818; ointment,
900.

Bean, St. Ignatius', 879.

Beans, 73, 82.

Bearberry. 818.

Beds and bedding, 758.

Bedbugs, 160.

Bed-sores, 774.

Beef, Essence of, 793, 797 ;
-galls, 818; -tea, 793, 797.

Beets, 82.

Belladonna atropa, 835 ;
Ointment, 900; Plaster,
903 ; Poisoning by, 616.

Belly, dropsy of, 356;
Symptoms affecting, V2h.

BeUy-«che, 320.

Benzoic acid. 819.

Benzoin, 880; Comp. tine
ture of, 916.

Berberis vulgaris, 818.

Bethroot, 819.

Bichloride of gold, 839 ; of
Mercury, 832.

Biennial plants, when to
gather, 808.

Big ivy, 856.

Bile In stomach, 67.

Biliary calculi, 299.

Bilious colic, 321; Head-
ache, 203, 206; Beinit-
tent fever, 471.

Binary compounds, 14.

Bismuth, 820.

Bites of insects and snakes,
645.

Bitter-root, 819.

Bittersweet, 820.

Black alder, 820.

Black cohosh, 821 ; Comp.
tincture of, 916.

Black root, 821.

Black willow, 821.

Blackberry, 82U.

Black vomit, 475.

Bladder, 35 ; Acute inflam-
mation of, 335; Chronic
inflammation of, 336.

Bleeding from kidneys,
341 ; Nose, 597 ; Wounds,
699.

Blenorrhagia, 369.

Blistering plaster, 892.

Blood, buffy coat of, 52J;
Composition of humau,
247; in Scrotum, 580;
Need of a good supply
of, 69, 61; Poisoning,
438.

Bloodroot, 821.

Bloody flux, 330.

Blue cohosh, 822; Comp.
tincture or, 916.

Blue disease, 467.

Blue flag, 822.

Blue pill, 823.

Body, structure of, 14 ;
Chemical properties of.
14; Lice, 159; Physical
properties of, 16; Tem-
perature of, 132 ; Vital
properties of, 18.

Boiled flour, 793.

Boils, 633.

Bone's bitters, 918.

Bones and muscles, 122;
Anatomy of, 18 ; Broken,
how they unite, 649;
Diseases of, 670; Death

GKNKUAL INDKX.

967

tl ropey of, 356;
oms affectiDg, lan.
le, 320.
icid. 819.

880; Comp. tluc-
r, 916.

vulgaris, 818.
,819.

le of gold, 839 ; of
ry. 832.

plants, wheu to
•. 808.
856.

bomach, 67.
alculi, 299.
solic, 321; Head-
203, 206; Remit-
iver, 471.
^mpouods, 14.
,820.
nstictB and snakes,

»t, 819.

eet, 820.

ler, 820.

hosh, 821; Oonip,

re of, 916.

)t, 821.

How, 821.

ry, 820.

mit, 475.

35 ; Acute intlani-

1 of, 335; Chronic

mation of, 336.

from kidneys,
fose, 597 ; Wounds,

Bigia, 369.
SpUster, 892.
uffy coat of, 522;
sition of humau,
n Scrotum, 580 ;
of a good supply
, 61 ; Polsoniug,

t, 821.
ux, 330.

osh, 822; C!omp.
•e of, 916.
ase, 467.
,822.
823.

trueture of, 14 ;
jal properties of.
5e, 159; Piiysical
Lies of, 16; Tern-
re of, 132; Vital
ties of, 18.
ur, 793.
t.

tters, 918.
id muscles, 122 ;
ay of, 18 ; Broken,
hey unite, 549 ;
BS of, 570 ; Dentil

of, 670 ; of Head, 20 ; of
Trunk, 21; of Upper
extremltiee, 23 ; of Low-
er extremities, 24 ; Time
required for uniting,
550; Unnatural growth
of, 570; Ulceration of,
570 ; Uses of, 27.

Boneset, 823.

Bony formations In heart,
281.

Borax, 876.

Bowel, falling of, 465.

Bowels, affections of, 787 ;
Acute inilammatiou of,
314; Chronic inflamma-
tion of, 315; Looseness
of, 327 ; Looseness of, in
Infants, 463.

Brachial plexus, 48.

Brain, 45, 122, 164 ; Abscess
of, 167 ; Diet in affections
of, 785 ; Dropsy of, 175 ;
Enlargement of, 173 ;
Exercise of, 60, 61 ;
Fever, 165; Health of,
59 ; Induration of, 167 ;
Inflammation of, 165 ;
And nerves, diseases of,
164-207; Need of a
healthy, 59; Need of
exercise for, 60 ; Old
people's, 61; Ovei-work-
iug, 61; Shrinking of,
173; Softening of, 166;
Tumors of, 167.

Bran, decoction of, 789.

Brandy mixture, 899.

Bread, Franklin Mills, 796.

Bread-and-water poultice,
905.

Breast, broken, 441 ; In-
flammation of, 441.

Breastbone, fracture of, 656.

Breathing murmurs, 232;
Objects of, 113; Phi-
losophy of, 112 ; Symp-
toms alTecting, 129.

Bright's disease of kidneys,
338.

Broiled beef essence, 797.

Broken bones, 546-661 ;
Breast, 441.

Bronchial consumption,
237; Flux, 506; Tubes,
36.

Bronchitis, 209 ; Acute,
255 ; Chronic, 257.

Broncbocele, 678.

Broncho-pneumonia, 269.

Bronchorrhoea, 506.

Broth, 'lam, 797 ; Mutton,
797.

Brow-ague, 204.

Bruises, 669.

Babo, 361-369.

Buchp, 823 ; Tlnct. of, 914.

Buckhorn brake, 824.

Buckthorn, 824.

Buckthorn bark,

Buckwheat, 81.

Buffy coat of blood, 622.

Bugleweed, 824.

Bulbous roots, when to

gather, 608.
Bunions, 161.
Burdock, 824.
Burgundy pitch, 824.
Burns and scalds, 535.
Butternut, 824.

Cabbage, 82.

Calamine cerate, 891 ; Pre-
pared, 889.

Calcined deer's horn, 826.

Calculus, 299-354.

Calendar for married ladies,
443.

Calf'8-feet-jelly, 794.

Calico bush, 856.

Calomel, 825.

CalTities, 167.

Calx, 861 ; Ohlorinata, 851.

Camphor, 826; Liniment,
890 ; Water, 897.

Camphorated soap liniment,
897.

Canada balsam, 826 ; Flea-
bane, 826 ;Snakeroot,886.

Canal, alimentary, 32.

Canals, semicircular, 63.

Cancer, 673 ; Of intestines,
317 ; Of womb, 413.

Canella, 826.

Canker, 491; Lettuce, 871;
Of mouth (cancrum oris),
458.

Cannabis indica, tlnct. of,
914.

Cantharides, tinct. of, 914.

Cantharis vesicatoria, 877.

Capillaries, 38.

Capsicum annum, 827 ; Plas-
ter, comp., 904.

Capsules, supra-venal, dis-
eases of, 337.

Caput obstipum, 686.

Caraway, 826.

Carbo ligni, 829.

Carbonate of ammonia, 816.

Carbuncle, 634 ; malignant,
635.

Cardialgia, 308.

Cardamom, 826 ; Compound
tiact. of, 916.

Carditis, 283.

Care of children, and their
diseases, 445-468; Teeth,
601; Of the sick, 67; Of
the skin, 503.

Caries, 570; Of teeth, 602.
Carminatives, 924, 928.
Carriage-riding as exercise,

97.
Carrots, 82 ; Poultice of, 906.
Cartilage, 26 ; Arytenoid,

42 ; Cricoid, 42 ; Thyroid

cartilaginous tissue, 17;

Productions in heart,281.
Carum carui, 826.
Caryophyllus aromaticus,

830.
Cascarilla, 826.
Casein, 16.
Cassia acutlfoila, 874 ;

Buds, 829.
Castor, 827.
Castor-oil, 827.
Castoreum, 827.
Catalepsy, 186.
Cataplasms, 905.
Cataract bath, 747.
Catarrh, nasal, 209; Of

bladder, 336.
Catarrhal ophthalmia, 589.
Catechu, 827 ; Confection of,

893; Comp. infusion of,

894; Tinct. of,915 ; Comp.

tlnct. of, 916; Comp.

powder of, 907.
Cathartics, 921.
Catnip, 915.
Caulophyllum thalictroides,

822.
Caulophyllin, 822.
Caustic potassa, 865.
Cayenne pepper, 827 ; Tinct.

of, 915.
Ceanothus Americanus, 870.
Celandyne, 828.
Cellular tissue, 16.
Cerates, 891.
Cerebellum, 46.
Cerebrum, 46.
Cerevisae fermentum, 888.
Cessation of menses, 403.
Cetaceum, 878.
Cetraria islandlca, 844.
Chafing, 598.
Chalk, 828; Mixture, 899;

Comp. powder of, 907.
Chalk-stones, 479.
Chamomile, 829.
Chancre, 361.
Change of circumstances,

badf effect of, 60.
Changes occurring in ad-
vanced life, 600.
Charbon, 636.
Charcoal, 829 ; Apparent

death from burning, 509 ;

Poultice, 906.
Chelidonium majus, 828.
Chelone glabra, 817.
Chemical Food, 911 ; In-

968

OENKRAL INDEX.

juriOB, 636 ; PropertieB of
tho body, 14.

Chenopodium antbolmlntl-
cum, 887.

Cherry, cordial, pulmonic,
249 ; Wild, 885.

Cheat, affectlonB of, 786;
Air In, 260 ; Diseases of,
229-273 ; Sounds, philoso-
phy of, 232; Bymptoms,
affecting, 128 ; Water in,
261.

Chtcken-poz, 141.

Chicken-water, 794.

Chlckweed, red, 870.

ChilbUina, 537.

ChUd-bed fever, 438.

Children, care and diseases
of, 446-468 ; Clothing of,
445; Food of, 446; Nurs-
ing sick, 453 ; Weaning
of, 460.

Children's sore mouth, 457.

Chimaphila umbellata, 863.

Chloride of zinc, 889.

Chloroform (chloroform-
um), 601, 829.

Chloroais, 401; Diet In, 784.

Choice of sick-room, 766.

Cholera. Asiatic, 329 ; Diet
in, 788; Infantum, 463;
Morbus, 328.

Chorea, 187 ; Chronic, 188.

Choroid coat, 50.

ChromidrosiB, 164.

Chyle, 67.

Chyme, 66.

Ciliary processes, 51.

Cimicifvga racemosa, 821.

Cimicifnsin, 821.

Cinchona, 862.

Cinchonia, 862.

Cinnamon, 829; Tinct. of,
916 ; Gomp. tinct. of, 916.

Circulation, organs of, 37-
39.

CirrhOBiB of liver, 296.

CiTBOcele, 684.

Citrate of potassa, 867.

Citric acid, 813; Syrup of,
909.

Citrine ointment, 901.

Citrus llmonum, 860.

Clam- broth, 797.

Clap, 369.

Clavicle, fracture of, 662.

Cleaning the teeth, 606.

CleanlinesB, 106; In sick-
room, 760.

Cleavers, 830.

Clergymen's sore throat,
212.

Climate, 74, 126.

Clothing, 101 ; As con-
ductors of ' heat, 102 ;

Catching lire, 512; Color
of, 104; Cotton, 102
Hair as, 103 ; Linen, 102
Should bo porous, 104
Silk, 103; Tight, 105
Woollen, 103.

Clover, red, 870.

Cloves, 830.

ClOVUB, 162.

Clystere, 896.

Coaptation, 547.

Coats of the eye, 60.

Coca Wine,

Cocaine, 601.

CocculuB palmatus, S.'il.

Coccus cacti, 830.

Cochineal, 830.

Cochlea, 63.

Cochlearia armoracia, 843.

Cod-liver-oil, 830, 946.

Coffee, 88, 780 ; Barley, 790 ;
Crust, 790 ; Milk, 796.

Cohosh, black, 821; Blue,
822 ; Tincture of, 916.

Colchicnm autumnale, 866 ;
Coinp. tinct. of, 916.

Cold, effects of, 536 ; Baths,
109; Crodm, 901; Foot-
bath, 763; Water at
meals, 66.

Colds, 224.

CoUc, 464 ; Bilious, 321 ; Of
infants, 464; Painters',
322 ; Wind, 320.

Colitis, 330.

Collar-bone, fracture of,
562 ; Dislocation of, 663.

Collodion, 830.

Colocynth, 831.

Colombo, 831.

Colon, 33, 291.

Color of clothing, 104 ; Of
skin, disorders affect-
ing, 163.

Colored patches on skin,
163.

Coltsfoot, 831, 886.

Coma, an alarming symp-
tom, 773.

Comedones, 156.

Comfrey, 831; Compound
wine of, 898.

Common silk-weed, 831.

Comptonia asplenifolla,881.

Compound fractures, 550.

Compound infusion of cate-
chu, 894; Of gentian,
894; Of geranium, r95;
Of parsley, 895 ; Of senna,
896 ; Of trailing arbutus,
896 ; Besin cerate, 892.

Compresses, 741.

Compression, 540.

Conception, 421.

Condoms, 430.

Confections, 892 ; Aronrnttc,
892; Of catHohu, coni-
pound, 893 ; Or senna,
893.

Congestive fever, 473 ;
Headaches, 205 ; lullam-
raation of sklu, 135.

Conium niaoulatum, 864;
Poisoning by, 615.

Conjunctiva, 62.

Conservative leaders, 11.

Conserves. H92.

Constipation, 324.

Constitution, 122, 124; Idio-
syncrasy of, 125.

Constitutional differonces,
238; Treatment, 245.

Constriction of bowel, 318.

Consumption, 229-254; A
general disease, 241 ; Of
the bowels, 313; Bron-
chial, 237; Causes of,
235,239; Dieting lu, 801 ;
Sweating In, 773 ; Tuber-
cular, 233.

Contused wounds, 644.

Contusions, 669.

Convalaria multlflora, 877.

Convolvulus scaninionia,
873.

Convulsions, 773; Diet in,
783.

Cookery for sick-room, 789-
797.

Copaifera offlcinalls, 817.

Copper, 832; Subacetate of,
832 ; Sulphate of, 832.

Corallorhiza odontorhiza,
833.

Corn, Indian, 81.

Cornea, 60 ; luHaiuniation
of (comeltis), 690.

Corns, 161.

Cornu cervlnee ustum, 826.

Cornus Florida, 835 ; Seri-
cea, 881.

Corpulence, diet for, 799.

Corrosive sublimate, 83-2;
Poisoning by, 514.

Corydalis formosa, 883.

Coryza, 136.

Cost of foods, 77, 79, 80.

Costiveness, 324; During
pregnancy, 425, 42C.

Cotton, 832 ; Clothing, 102.

Cough, during pregnancy,
427 ; Symptoms indicated
by, 130, 772 ; Whooping,
462 ; Preparations, 927.

Counter extension, 547 ; Ir-
ritation, 624; IrriUnte,
931.

Cow-pox, 141.

Cozalgia, 671.

Cramp-bark, 842.

B.-

'~^.

ii,892; Aroiimtic,
f <'atec'lui, coil,.
893 ; Of senna,

» fever, 473 ;
lies, ao5 ; lutlani-
of 8kln, 135.
iiaoulatiini, 864;
ig by, 515.
'a, 52.

Ive leaders, 11.
892.
on, 324.

111,122, 124; Idio-
y of. 125.
)nal ill (Terences,
eatuieut, 245.
in of bowel, 318.
on, 229-254; A
disease, 241 ; Of
fels, 313; Brou-
137; Causes of,
i Dieting in, 801 ;
g in, 773 ; Tuber-
}3.

vounds, 644.
I, 569.

I multlflora, 877.
IB scaniDionia,

18, 773; Diet In,

" sick-room, 789-

Jfflcinalis, 817.
J; Subacetateof,
phate of, 832.
a odontorhlza,

an, 81.

; luflarumation

Bitis), 690.

inae uetum, 825.
»rida, 835 ; Seri-

, diet for, 799.
sublimate, 832;
g by, 514.
ormosa, 883.

is, 77, 79, 80.
I, 324; During
(y, 425, 42C.
;.Clotlilng,102.
■Ing pregnancy,
ptonis indicated
72; Whooping,
paratlons, 927.
enslon, 547 ; Ir-
524; Irritants,

il.
1.
,842.

Cramps, 188; In stomach,

309, 497.
CranesbiU, 833.
Cranial neryes, 46, 47.
Crawley, 833.
Cream, 777.
Cream of tartar, 8fl6.
Creosote (creosotum), 248,

833 ; Ointment, 900.
Cricoid cartilage
Crocus sativus, b a
Croton cleuteria, 826 ; Oil,

834; Oil iiuiment, 896;

Tiglium, 834.
Croup, 460 ; Dangerous

symptoms in, 772.
Crow-corn, 879.
Crural phlebitis. 437.
Crust-coffee, 790.
Crusted tetter. 148.
Cubebs (cubebflB), 834.
Cucumber, wild, 885.
Cucumus colocynthla, 831.
Cultivating trees, 115.
Culver's root, 834.
Cupping and leeching, 524.
Cupri Bubacetas, 832 ; Sul-
phas, 832.
Cuprum, 832.
Curcuma longa, 883.
Cyanosis, 467.
Cypripedin, 849, 889.
Cypripedium pubescens,

849, 888.
Cystine deposits in urine,

353.
Cystirrhcea, 336.
Cystitis, 336.

Dancing, 95.

Dandelion, 836.

Dandruff, 162.

Darkening of sick-room,
761.

Datura stramonium, 880.

Deadly nightshade, 836 ;
Poisoning by, 616.

Deafness, 596 ; Not an un-
favorable symptom, 772.

Death, apparent, from nox-
ious vapors, 509 ; Proofs
of, 807 ; Of bones, 670.

Decoction of bran, 789.

Decoctions, 893.

Deformities of spine, 684.

Delivery, 430.

Delirium tremens, 167.

Dementia, 194.

Dens leonis, 836.

Depilatories, 168.

Deposits, phosphatio, 349;
Urinary, 345. 366.

Derangement of mind. 191.

Derbyshire neck. 678.

Dermoid tissue, 17.

(iKNKH.M, INDKX.

Deshler's salve, 892.

DUbetes, 340; Dieting In,
802.

Diaphoretics and sedatives,
020.

DUrrhOBa,'327 ; Diet in, 788 ;
In consumption, 260 ; Of
infants, 463 ;WhenadAU-
gerouH symptom, 773.

Dictionary, 000.

Diet, a complex subject,
71 ; In consumption, 262 ;
For the old, 601 ; During
confinement, 436 ; Of
nursing women, 446 ; In
disease and convales-
cence, 776; In general
diseases, 781.

Dieting in regard to health,
799; In disease, 801.

Difficult teeth-cutting, 469.

Difficulty of breathing, 773;
Of swallowing, 772.

DigestibUlty of foods, 71,

Digestion, 64; Symptoms
relating to, 131 ; Table,
72.

Digestive organs, 31.

Digitalis purpurea, 837.

Dilatation of ven ' <icles,278.

DioscorM villosa, 'H6.

Diospyros Vlrginiu-a, 861.

Diphtheria, 219, 486.

Diseases, general, 469-492;
Of children, 445-468 ; Of
the old, 496-608 ; Of the
bones, 570 ; Of the Joints,
671 ; Peculiar to modem
times, 493-49R.

Disinfectants, 7u4.

Dislocations, 561-568; Of
ankle-Jotnt, 668 ; Of
bones of hand, 665; Col-
lar-bone, 563 ; Elbow-
Joint, 664 ; fiip-Jolnt,
666; Knee-pan or patella,
567 ; Knee-joint, 668 ;
Lower jaw, 663; Shoul-
der-Joint, 663 ; Wrist,
666.

Displacement of htort,
290; Womb, 411.

Disturbed sleep, 200.

Diuretics, 929.

Dizziness, 200.

Dock, yellow, 888; Oomp.
syrup of, 913.

Dogwood, 836 ; Poisoning
by, 616 ; Swamp, 881.

Domestic management of
the Blck-i-oom, 756-788.

Domestic measures, 811.

Doses, 810, 811; Frequency
of, 126.

Douche bath, 747 ; Pali
748.

Dover's powder, 908.

Dragon-root, 844.

Dress, wet, 743.

Dresses, tight, 116.

Dressing wounds, rules
for, 641.

Dressings, antiseptic, 642.

Drinks for the sick, 7H0,
790.

Dropsy of l.elly, 356; Of
brain, 175; Of cells,
358 ; Oeneral, 358 ; Diet
in, 784.

Drowning, 609.

Dry pimples, 160,

Drunkard's delirium, 167.

Dumb-bell exercises, 96.

Dura mater, 46 ; lutlamnia-
tlon of, 164.

Dwarf elder, 836.

Dysentery, 330; Diet in,
788 ; Chronic, 331.

Dysmenorroea, 399.

Dyspepsia, 303 ; Causes of,
304; Diet in, 787, 801;
Treatment of, 307 ; Uri-
nary deposits in, 304.

Dyspeptics, 84.

Dystrichiasis, 587.

Ear, affections of, 594-596 ;
Bathe, 764; Drum of,
62; External, 62; For-
eign substances in, 699;
Wax in, 696.

Earache, 696.

Eating, rapid, 64.

Ecletics, 7.

EcsUsy, 186.

Ecthyma, 149.

Eczema, 144.

Effervescing draught, 867.

B|5g», 777 ; Egg-nog, 797.

Egophony, 263.

Egyptian ophthalmia, 588.

Elbow, fractures of, 564;
Joint, dislocation of,
664.

Elder, 836 ; Dwarf, 836. '

Elecampane. 836.

Electricity, 504.

Electro-magnetism, 836.

Electuaries, 892.

Electuary, lenitive, 893.

Elixir proprietatls, 916;
Salutis, 918; Vitriol,
916.

Elm, slippery, 876.

Elongation of uvula, 221.

Emetics, 920.

Emphysema, 268.

Encephalitis, 166.

Eucephaloid tumor, 575

970

Encysted tumor, 677.

Endocarditis, 383.

Endosmosis, 738.

BnUrged veins, 438, 581.

EnUrgement of air-cells,
368; Brain, 173; Neck
of womb, 3H6.

Enteritis, 314; Diet In,
787.

Enuresis, 344.

Epigea repeuB, 8H:i.

Epigastrium, 3t)l.

Epigloitis, inflammation
.f, 387.

Epilepsy, epileptic fits,
1H4.

Epistazis, 6!)7.

Epsom salts, 863.

Ergot, 878.

Erigeron, canadenRc, 836.

Eruptions, scaly, 149, 363 ;
Tubercular, 363 ; Vestou-
lar, 363.

Eruptive fevers, Diet in,
7H'2.

Erysipelas, 141 ; diet in,
783.

Erythema, 144.

Erythematlc stomatitis,
457,

Essence of beef, 793, 797.

Essences, 893.

Eucaline, 000.

Euonymus atropurpureus.
884.

Eupatorln, 823.

Bupatorium perfoliatum,
833; Furpureum, 869.

Euphorbia ipecac, 815.

Eupurpurin, 869.

Eustachian tube, 63.

EzcorUtion, 698; When a
bad symptom, 773.

Exercise, 92-98; Active and
passive, 93, 96; Exces-
sive, 92, 96; In cold
weather, 94; In con-
sumption, 262; In diet-
ing, 73; In-door, 96;
Mental cooperation in,
98; Outdoor, 94-98; Pas-
sive, 96-98 ; Pleasurable,
93, 98; Regular, 92; For
students, 93; For the
aged, 604; When to
take, 93,98; With wands,
94; For young women,
000.

Exerciser , the Whitely, 960.

Exhalants, 41.

Exhaustion. headaches
from, 204.

Exosmosis, 738.

Exostosis, 670.

Extension, 647.

GENERAL INUEX.

Expectorant inhalant, 343.

Expectorants, 937.

Expectoration, symptoms
Indicated by, 130.

External Irritants, 250;
Parts, itching of, 417.

Extracts, 893; Fluid, 894;
Of rhubarb and potassa
(neutralizing), 899.

Eye, 60-63; AIToctlonB of,
586-693; Coats of, 60;
Diseases cause hnad-
aches, 203 ; And ear bath,
764; Foreign bodies In,
686; Globe of, 50; Hu-
mors of, 61.

Eyebrows, 53.

Eyelashes, disorder of, 587.

Eyelids, 62; Inflammation
of, 587.

Faba Sanctl Ignatil, 879.

Face not to be covered
while asleep, 100; Symp-
toms affecting, 127.

Face-ache, 190.

Fainting, 199, 427; An
alarming symptom, 772.

Falling of bowel, 4C6; Sick-
ness, 184; Of womb, 409.

Fallopian tubes, 383; In-
flammation of, 414.

False grape, 815; Joints,
551; Measles, 143; Sarsa-
parilla, 876; Unicorn,
841.

Fat, 15; Hqw to grow, 798.

Fathers of our race, 498.

Fatty degeneration of heart,
281

Fatty foods, 78.

Fatty tumor, 676.

FavUB, 158.

Febrifuge inhalant, 244.

Feeding infants, rules for,
448.

Fel bovinum, 818.

Felon, 572.

Female diseases, 379-442.

Female weaknesses, 393.

Fern, male, 853.

Ferri, ammonio-dtras, 846;
Cltras, 846; lodidum,
846; Lactas, 846; Oxi-
dum hydratum, 846;
Oxldum nigrum, 846;
Phosphas, 847; et Po-
tassee tartras, 848; Pro-
toxidum,847; Pulvl8,847;
et Quiniee cltras, 846;
Subcarbonas, 847; Sul-
phas, 848; Byrupus io-
didl, 848.

Ferrum, 846.

Ferunculus, 533.

Fever, 469; And ague, 473;

Bilious remittent, 471;
Ohlldbed,438 ; OongestI ve,
473; Diet in. 781; Gim-
trio, of infancy, 465; lu-
termlttent, 473; Ludk,
266; Malarial, 473; I'or-
nlcious Intermittent, 47:<;
PrognoHtIca In, 771; Ko-
freshlng drinks In, 790;
Typhoid, 470; Typhoid
lung, 268; Yellow, 476.

Feverfew, 836.

Fibrin, 16.

Fibrous tissue, 17.

Figwort, 836,

FUling teeth, 604.

Fingers, fracttures of, 666.

Fire, clothes catching, 61^;
In sleeping-rooms, 99.

FUh, 777.

Fistula, 527.

Fits, 184; Of children, 468.

Flag, sweet, 881.

Flatulency, 320.

Flaxseed, 837; Lemonade,
797; Poultice, 906.

Flesh, to reduce, 799.

Flies, Spanish, 877.

Flour, boiled, 793; Gruel,
797.

Flowers, when to gather,
809.

Flooding, 434, 440.

Fluctuation, 526.

Fluid ailments, 779; Ex-
tracts, 894; Nutritive,
796.

Fluor albus, 393.

Folded wet sheet, 744.

Follicles, 41.

Follicular inflammation of
mouth, 468.

Folliculitis, solutions for,
220.

Fomentations, 894,

Food, 68; Adapted to dif-
ferent periods, 76 ; Albu-
minous, 69, 77; Amount
of, to be taken, 83 ; And
digestion, 64; Animal
and vegetable, fO, 84;
Articles of, 79-83; Azo-
tlzed and non-azotlzed,
70 ; Choice of, 73; Cost of,
77, 79, 80; Digestibility,
of, 71, 72; Fatty, 78;
in winter, 75; For con-
valescents, 776; For in-
fants, 447; Gelatinous,
69; Heat-generating, 70;
Human structure de-
mands mixed, 85; Na-
ture and destination of,
68; Nutritive, 71 ; Oleag-
inous, 69; In old age.

-•.^

,..^^„^.

IMAGE EVALUATION
TEST TARGET (MT-3)

1.0

I.I

2.5
22

2.0
1.8

L25 111.4 11.6

Photographic

Sdences

Corporation

23 WEST MAIN STREET

WEBSTER, N.Y. 14580

(716) 872-4503

- .ViUBWBKTBWrSW^nWllBHB.

CIHM/ICMH

Microfiche

Series.

CIHM/ICMH
Collection de
microfiches.

Canadian Institute for Historical Microreproductions / Institut Canadian de microreproductions historiques

GENERAL INDEX.

971

76; Organic, 69; Propor-
tions of animal and vege-
table, 86; Saccharine,
69; Starch and sugar,
69, 78; Value of, VO, 71,
72, 79, 80; In youth and
manhood, 76.

Foot, fractures of, 660.

Foot-bath,cold,753; Warm,
754.

Fore-arm, fractures of, 554.

Foreign bodies in ear, 599;
In eye, 586; In gullet,
599; In nose, 598; In
windpipe, 599.

Fowler's solution, 877.

Foxglore, 837.

Fractures, 546-561, Com-
pound,550, 560; Of bones
of foot, 660; Of bones of
no9e,551 ; Of breast-bone,
556; Of collar-bone or
clavicle, 552; Of elbow,
554; Of fore-arm, 554;
Of hand and fingers, 555 ;
Of haunch-bones or pel-
vis, 556; Of knee-pan,
558; Of leg, 558; Of
lower jaw, 551; Reduc-
tion of, 547; Of ribs,
555; Of snoulder-blade,
553; Of skull, 651; Of
thigh-bone, 556; UnlOn
of,549,550; Of upperarm-
bono, 553; Of wrist, 555.

Franklin mills bread, 796.

Freckles, 154, 160.

Freezing miztnres, 765.

French decimal weights,
811.

French milk-porridge, 793.

Frequency of doses, 126.

Frost-bite, 636.

Frostweed, 837.

Fruits, 778.

Fumigants, 764.

Fumigation of infected
places, 763.

Fungus hematoldes, 675.

Galbanum plaster, comp.,
904.

Galium aparine, 830.

Gall-bladder, 34.

GtUjstones, 299.

Gal^, 837; Comp, ointment
of; 900.

Gamboge, 837.

Gangrene, 527; Of mouth,
458.

Gardening as exercise, 96.

Garfield Tea, 000.

Garget, 865.

Gargles, 933.

Garlic, 837; Syrup of, 909.

Gastric fever of infancy.

465; Juice, 64; Not se-
creted without limit, 66;
Nor in sickness, 66 ;
Secretion favored by
cheerfulness, 66.

Gastritis, 301, 302.

Gastrodynia, 309.

Gaultheria procumbens, 886.

Gelatin, 16.

Gelatinous foods, 69.

Gelseminin, 888.

Gelseminum sempervlrens,
888.

Gengivitis, 458.

General diseases, diet in,
781; Symptoms, 126;
And nerve tonics, 925.

General system, diseases
of, 469-492.

GentiAn, 838; Comp. infu-
sion of, 894; Tincture of,
917.

Gentiana lutea, 838.

Geranium maeulatum, 833;
Comp. infusion of, 895.

Geraniin, 833.

Germ or ovum, 382.

Germ-wheat bread, 796.

Gill-over-the-ground, 839.

Ginger, 838; Wild, 886; Syr-
up of, 909.

Ginseng, 838.

Glands, 40, 41, 52.

Glauber's Salts, 876.

Gleet, 371.

Glossary, 000.

Glottis, 43; Spasm of, 461.

Gluten Flour, 000.

Glycerin, 838.

Glycerrhiza glabra, 851.

Glycones, 000.

Goitre, 578.

Gold, 839.

Golden seal, 839; Comp.
powder of, 907; Tinct.
of, 917; Wine of, 898.

Golden tincture, 917.

Gonorrhoea, 369.

Gossypium herbaceum,832.

Goulard's cerate, 891.

Gout, 479; Diet In, 784, 802.

Granulation, 544.

Gravel, 345; Symptoms of,
347; Uric-acid, 347.

Gravel-root, 869.

Green sickness, 401; 3iet
In, 78*4.

Grippe, la, 226.

Ground-ivy, 839.

Ground ric milk, 793.

Grabs or worms, 156.

Gruel, 780; Arrow-root,
792; Flour, 797; Oat-
meal, 797; Bice, 789;
Sago, 792; Water, 791.

Gnaiac, amiuoniated tlnct.

of, 917.
Guaicol, 248.
Guaiacum, 840.
Gullet, the, 32; Foreign

bodies in, 599.
Gum-Arabic, 840.
Gum, hemlock, 840 ; Sweet,

881.
Gums, inflammation of,

458.
Gunshot wounds, 646.
Gymnastics, 948; Treatise

on, 94.

Habits, 125.

Hsmastasis, 840.

Haematocele, 5b0.

Haematoxylon Campechia-
num, 852.

Haematuria, 341.

Haemidrosis, 154.

Hair, as clothing, 103.

Hair and hair-tubes, dis-
orders of, 157.

Hair-cap moss, 840.

Hair-oils and washes, 935.

Half bath, 748; pack, 744.

Hamamelis Yirginica, 886.

Hand, Dislocation of bones
of, 565; Fractures of,
655.

Hanging, apparent death
from, 512.

Hardhack, 841.

Hardleaf golden-rod, 841.

Haunch-bones, fractures of, ■
666.

Hay-asthma (Hay fever),
272.

Head, affections of, 785;
Bath, 750; Face and
neck, symptoms affect-
ing, 127; Water in, 174.

Headaches, 201-207, 427.

Hearing, organs of, 62.

Heart, 37; Diseases, 274-
290; Altered sounds of,
276; Aneurismal tu-
mors of, 280 ; Atrophy of,
281 ; Bone and cartilage
in, 231; Dilatation of
ventricles of, 278, 279;
Displacements of, 290;
Enlargement cf ventri-
cles of, 276 ; Fatty de-
generatloa of, 281 ; Hy-
pertrophy and dilata-
tion of, 279 ; Impulse of,
275 ; Induration of, 280 ;
Inflammation of, 281,
282, 283; Inflammation
of lining of, 283, 284;
Murmurs, 286; Neural-
gia of, 289 ; Palpitations

972

GENERAL INDEX.

of, B88; Percussion of,
276; Polypus of, 298;
Shrinking of, 281; Soft-
, ening of, 280; Sounds
of. 275; Valves of, 274,
285, 287.

Heartburn, 308.

Heart-case, acute Inflam-
mation of, 281; Chronic
Inflammation of, 282;
Water in, 287.

Heat-generating foods, 70;
Incompatible with ex-
citement, 76.

Hectic Fever, 523.

Hedeome pulegiodes, 861.

Heiianthemum Canaidense,
837.

Heliantbus anouus, 880.

Hellebore, American, 814;
White, 886; Ointment,
902.

Helonias, 841.

Helpless dependence of the
aged, 499.

Hemicrania, 190.

Hemiphlegia, 180.

Hemlock, comp. tinci. of,
917 ; Gum, 840 ; Poison,
864.

Hemorrhage,440 ; Huring la-
bor, 434 ; Of wounds, 539.

Hemorrhoids, 325, 576.

Henbane, 841.

Hepar, 868.

Hepatica Americaoa, 861.

Hepatitis, 293.

Herb-teas, 780.

Hernia, 681.

Herpes, 146.

Hiccough, 199 ;When alarm-
ing, 772.

High cranberry, 842; Comp.
tinct. of, 917.

Hip-joint, disease of, 671;
Dislocation of , 565.

Hippuric acid in urine, 353.

Hives (nettle-rash), 1^1,
143.

Hoarseness, unfavorable In
small-pox, 771.

Homoeopathy, 608.

Homoeopathic remedies,
609.

Honey-diseases (honey-
scab), 148.

Hopeful considerations, 63.

Hops, 842.

Hordeolum, 687.

Horehound, 842 ; Water,884.

Horn-pox, 141.

Horse, should be owned, 98.

Horseback-riding as exer-
cise, 97.

Horsemint, 843.

Horseradish, 843.
Horsford's Acid Phoaphate,

946.
Hose-bath, 747.
Hot Drops, 918.
Eouseleek, 813.
Human blood, composition

of, 247.
Humors of the eye, 61.
Humulus lupulus, 842.
Hnxham's tincture, 918.
Hydatids, uterine, 407.
Hydrangea, aborescens,

843.
Hydrargyrichlorldum mite,

825; PillulfiB, 823.
Hydrastin, comi' powder

of, 839, 907.
HyCrastis Canadensis, 839.
Hydriodate potassa, 846.
Hydrocele, 679.
Hydrocephalus, acute, 174 ;

Chronic, 175.
Hydrochloric acid, 813.
Hydrocyanic acid, 813.
Hydropathic treatment,

732-755.
Hydropathy, 6.
Hydropericardium, 287.
Hydrophobia, 182.
Hydrothorax, 261.
Hygiene, 54, 121.
Hyoscyamin, 841.
Hyoscyamns nlger, 841 ;

Poisoning by, 615.
Hypertrophy, of brain, 173 ;

Of heart, 279 ; Of lungs,

259.
Hypochondria, 197.
H3rpochondrium, 292.
Hypogastrium, 292.
Hypophosphites,comp. syr-
up of, 910.
Hyssop, 843.

Hyssopus offlclnalis, 843.
Hysteria, 405.
Hysteric headache, 264.

Ice, for wounds, 640
Ice-plant, 844.
Iceland moss, 844.
IchthyocolU, 849.
Icterus, 298.
Idiocy, 194.
Idiosyncrasy, 125.
Idrosis, 154.
Ignatia amara, 879.
Ileum. 33.
Iliac fossa, 292.
Imperfect vision, 691.
Impetigo, 148.
Impregnation, 421.
Incised wounds, 639.
Incontinence of urine, 344.
Incubus, 200.

Indian com, 81; Hemn,
844 ; White, 881 ; Tinct.
of, 914; Turnip, 894.

Indian-meal poultice, 906.

Indigestion, 303 ; Diet iu,
787; Causes headaches,
203; Headaches from,
206.

Indigo, wild, 886.

Indolent ulcers, 532.

Induration, of brain, 167;
Of heart, 280.

Infants, gastric fever of,
465; Milk for, 447; Moral
treatment of, 452 ; Sum-
mer complaint of, 463;
While sleeping, 461.

Inflammation, 520, 626;
Of the arachnoid or
pia mater, 165 ; Of the
bladder, 335; Of the
bowels, 314, 316; Of
breast, 441 ; Of dura
mater, 164 ; Of epiglottis,
227 ; Of Fallopian tubes,
414; Of heart-case, 281;
282; Of iris, 591; Of
kidneys, 333 ; Of lachry-
mal sac, 588 ; Of larynx,
213; Of liver, 293; Of
mouth, 457, 468 ; Of nock
of womb, 386; Of ova-
ries, 390; Of perito-
neum, 312, 313; Of
pharynx, 212 ; Of spinal
cord, 176; Of spleen,
297; Of stomach, 301,
302; Of tonsils, 222, 223 ;
Of tympanum, 596; Of
vagina, 416; Of veins,
680; Of windpipe, 214;
Of womb, 408.

Inflammatory blush, 144.

Influenza, 224.

Inebriety, 168.

Infusion of malt, 791.

Infusions, 812, 894.

Ingrowing toe-nail, 597.

Inhalants, 243-246; Object
of, 244.

Inhalation, atmospheric,
2C0.

Inhaling, mode of, 246;
Powder, 908.

Injections, ?37, 896, 935.

Injuries, chemical, 635 ;
Mechanical, 638.

Insanity, 191 ; Causes of,
195; Cure of, 196; On
one subject, 193.

Insects, bites of, 545.

Insensible perspiration, 106.

Instruments for throat-
diseases, 216-221.

Interalgia, 320.

I ' ll - lllg l j^ l l'

GKNERAL INDKX.

973

corn, 81 ; Hemn,
White, 881; Tinct.
4; Turnip, 894.
meal poultice, 906.
tion, 303 ; Diet la,
Causes headaches,

Headaches from,

wild, 886.
t ulcers, 632.
ion, of brain, 167:
art, 280.

, gastric fever of,
Hilk for, 447; Moral
nent of, 452 ; Sum-
complaint of, 463;
I sleeping, 451.
tation, 620, 626;
he arachnoid or
later, 165 ; Of the
er, 335; Of the
8, 314, 316; Of
b, 441; Of dura
',164; Of epiglottis,
Of Fallopian tubes,
3f heart-case, 281;
Of iris, 691; Of
ya, 333 ; Of lachry-
10, 588 ; Of larynx.
Of liver, 293; Of
J, 457, 458 ; Of nocli
mb, 386; Of ova-

890; Of perito-

312, 313; Of

ox, 212 ; Of spinal

176; Of spleen,
3f stomach, 301,
'f tonsils, 222, 223 ;
npanum, 596; Of
I, 416; Of veins,
•f windpipe, 214;
nb, 408.

itory blosh, 144.
, 224.
, 168.

of malt, 791.
, 812, 894.
g toe-nail, 697.
I, 243-246; Object

n, atmospheric,

mode of, 246 ;
r, 908.
I, 737, 896, 935.

chemical, 635 ;
ileal, 638.

191; Causes of,
ure of, 196; On
)ject, 193.
ites of, 645.
! perspiration, 106.
Its for throat-
s, 216-221.
,320.

Intermarriages, improper,

59.

Intermittent fever, 473.

Intestinal obstruction, 318.

Intestines, 32, 291 ; Cancer
of, 317.

Introductory remarks, 5.

Inula ht'lenium, 836.

Iodide of potassium, 845;
Of mercury, ointment,
901; Of zinc, 889.

Iodine, 891.

Ipecacuanha, 845 ; Ameri-
can, 815 ; Comp. powder
of, 908; Syrup of, 910;
Wina of 898.

Ipomcea jalapa, 849.

Iridin, 822.

Iris, 60 ; Inflammation of
591 ; Versicolor, 822.

Irish moss, Jelly of, 792.

Iritis, 591.

Iron, 845 ; Ammonlo-citrate
of, 840; Black oxide of,
846; Citrate of, 846;
Citrate of, and quinla,
846; Citrate of, and
strychnia, 846 ; Comp.
mixture of, 899; Hy-
drated. In consumption,
250; Oxide of, 846; Io-
dide of, 846 ; Lactate of,
846; Persalt of, 847;
Phosphate of, 847 ; Pow-
der of, 847; Precipitated
carbonate ot 847; Pro-
toxide of, 847; Solutions
of protoxide of, 847,
848; Suipnate of, 84S;
Syrup of Iodide, 848;
Syrup of Iodide of, and
manganese, 848; Tar-
trate of, and potassa,
848 ; Tincture of muriate
of, 848; Valerianate of,
848.

Irritations of spine, 684.

Irritants, external, 250 ;
Counter, 931.

Ischuria renalis, 342.

Isinglass, 849 ; Jelly, 792.

Itch, 14v ; Barbers', 156.

Itching, 153 ; Of genitals,
417, 428.

Ivy, American, 815 ; Big,
856 ; Ground, 839 ; Poi-
soning oy, 516.

Jackson's itch, 156.
alap, 849 ; Comp. powder
of, 908.
Jamestown weed, 880.
Janipha manihot, 882.
Jaundice, 2^8.
Jaw, fractures of lower.

661 ; Dislocation of lower,
663.
Jejunum, 33.

Jelly, calf'8-feet, 794 ; Irish
moss, 792; Isinglass, 792 ;
Tapioca, 792.
Jerusalem oak, 887.
Jessamine, yellow, 887.
Joints, the, 26 ; Diseases of,
571;False,551; Stiff, 573.
uglandin, 825.
uglans clnerea, 824.
uniper, 849.
uniperus sabina, 873.

Kidi

ted;

Jin

fdi

Calmia angustifolia, 866;
Latifolia, 856.

Kidneys, 36 ; Acute inflam-
^ ation of, 333; Bleed-
ing from, 341 ; firlght's
disease of, 338; Chronic
Inflammation of, 335.

King's evil, 480.

Kino, 849; Comp. powder
of, 908.

Knee, fractures of, 568.

Knee-joint, dislocation of,
668.

Knee-pan, dislocation of,
667.

Kola Koloid. 946.

Krameria trlandra, 870.

Labor, 430.

Labyrinth, B3.

Lacerated wounds, 644.

Lachrymal canals, 62 ;
Gland, 62; Sac, inflam-
mation of, 588.

L&cteals, 33, 67.

Lactuca satlva, 850.

Ladies' slipper, 849.

Lappa minor, 824.

Laryngeal shower-syringe,
216.

Laryngismus stridulus, 461.

Laryngitis, 209; Follicular,

Larynx, 36, 42; Inflamma-
tion of, 213.
Laudanum, 916; Poisoning

by, 516.
Laurel, narrow-lea*, 856;

SLeep, 856.
Laurus, camphoras, 826 ;

Sassafras, 872.
Lavender, comp. tlnct. of,

917.
Laws, physiological, of life

and health, 64.
Lead, 850; Acetete of, 850;

Colic, 322; Ointment,

comp., 902; Palsy, 181;

Pipes, 90; Plaster, 905;

Plaster, comp., 904.

Looseness of bowels, 327.

Leaders, conservative, 11.

Leaves, when to gather,
808.

Leeching, 624.

Leg, fractures of, 658.

leg-bath, 750.

Lemon, 850; Syrup, 910;
Water, 790.

Lemonade, 791; Flaxseed,
797.

Lenitive electuary, 89S.

Leonurus cardlaca, 866.

Leo|)ard's bane, 817.

Leprosy (lepra), 149.

Leplandra Vlrglnica, 834.

Leptandrin, 834.

Lettuce, 850.

Leucorrhoea, 393.

Lice, 159

Lichen, 160.

Life, completeness of, 121;
The Infancy of being, 64.

Life-root, 850.

Ligaments, the, 26.

Ligature, 639.

Lightning, apparent death
from, 512.

Lily, white pond, 886.

Limbs, symptoms affect-
ing, 129.

Lime, 851; Chloride of, 851;
"Water, 851.

Linen clothing, 102.

Liniments, 896, 932.

Linum usitatissimum, 837.

Liquidamber styraciflua,
881.

Liquor ammoniee, 816;
Ammonlae acetatis, 816;
Potassaa, 867; Potassee
arsenltis, 877; Potassie
citras, 867.

Liquorice, 861.

Liriodendrontullplfera, 882.

Liver, 34, 291; Acute In-
flammation of, 293;
Chronic ii'flammatlon of,
294 ; Cirrhosis of, 296;
Congestion of, 295; Com-
plaints, diet in, 788; Of
sulphur, 868.

Liverwort, 851.

Lobelia (inflata) , 852 ; poul-
tices, 906; Tlnct. of, 915;
Comp. tinct. of, 917 ; And
capsicum, comp. tinct.
of, 918; Vinegar of, 919.

Lobelin, 852.

Local palsy, 181.

Locked jaw, 181.

Logwood, 852.

Loneliness of the aged,
498.

Long sight, 692.

SSrer

..J

974

GENERAL INDEX.

11 'i

Looseness of bowels, 327.
Lost parts, reproduction of,

644.
Lotions, 933, 934.
Lower jaw, dislocation of,

663.
Lumbago,8ee Biieumatlsm .
Lumbar plexus, 48.
Lumbar region, 292.
Lumbricus, 332.
Lung fever, 266; Typhoid,

268; Other forms, 270;

Diet in, 785.
Lungs, 36; And heart, 122 ;

Swelliug (hypertrophy)

of, 209; Should be well

filled, 116.
Lupulin, 843.
Lupus, 151.
Luxations, 661.
Lycopus virglnlcus, 824.
Lye, poisoning by, 514.
Lymphatics, 40.
Lypemania, 193.

Macule, 163.

Uagnesia, 852; Carbonate

of, 853; Sulphate of, 853.
Malaria, 473.
Male Fern, 853.
Malignant pustule, 635.
Malt, infusion of, 791.
Mammary abscess, 441.
Mandrake, 883.
Mania, 193; Apotu,167.
Manna, 864.

Maranta arundinacea, 817.
Marks, mother's, 162.
Manied ladies' calendar,443.
Marshmallow, 854.
Marsh-rosemary, 854.
Marubium vulgare, 842.
Mastic, 854.
Ma8turb''.don, 375.
Materia medica, 808-890.
Matico, 865.
Mattery pimples, 148.
Meadow cabbage, 874 ;

Saffron, 855.
Meals, number of, 780.
Measles, 136 ; Diet in, 782 ;

False, 143.
Measures, domestic, 810,

811.
Meat, 80; Americans eat

too much, 85; Majority

of mankind eat no, 86;

Mode of cooking, 501.
Meatus auditorius, 62;

Inflammation of, 695.
Mechanical injuries, 538.
Mediastinum, 36.
Medical knowledge wanted,

13; Treatment of the

old, 605.

Medicated waters, 897;
Wines, 898.

Medicine, progress of, 6-9 ;
Chest, articles for, 809.

Medicines and their prep-
arations, 808-943; Pa-
tent and proprietary,944.

Medulla oblongata, 46.

Medullary cancer, 675.

Megrims, 204.

Melancholy, 193.

Melanosis, 676.

Melissa offlcinalis, 817.

Mellin's Food, 946.

Membrane, synovial, 26.

Menispermjm Canadense,
889.

Menopause (turn of life),
413.

Menorrhagia, 396.

Menses, absence of, 394;
Oessatlon of, 403; Es-
tablishment of, 380.

Menstruation, disturbance
of, 388; Painful, 399;
Profuse, 396.

Mentha piperita, 861 ; Vlr-
ides, 877.

Mercury, bichloride of, 832 ;
Nitrate of, ointment of,
901 ; Red iodide of, oint-
ment, 901.

Mesenteric disease, 466.

Mesentery, 34.

Metastasis, 477.

Metauer's aperient, 899.

Metric weights, 811.

Metritis, 408.

Midwifery, 424.

Milk, 77 ; Coffee, 796 ; Crust,
148; For convalescents,
777; For infants, 447,
491; For old persons,
602; Leg, 437; Mother's,
448; Porridge, 793; Sick-
ness, 311 ; Sterilization
of, 449; And soda-water,
795 ; Sugar of, 247.

Milkweed, swamp, 881.

Mind, derangement of,
191 ; How it gets knowl-
edge, 66; State of in
aieting, 76.

Mindererus, spirit of, 816.

Miscarriage, 428.

Miscellaneous diseases, 469-
492; Prescriptions, 936.

Mitchella repens, 861.

Mitral valves, diseases of,
285.

Mixtures, S98.

Modem diseases, 493 ; Sur-
gery, 617.

Modus operandi of water,
737.

Moles, 154.

Momordica elaterlum, 886.

Monarda punctata, 843.

Monkshood, 855, 887.

Monomania, 193.

Monotropa unlflora, 844.

Monsel's styptic, 847.

Moral treatment of Infants,
452.

Morphia (morphine), 860;
Poisoning by, 515.

Mortality in cold weather,
603.

Mortification, 524, 527.

Mosquitos, bites of, 646.

Mother's cordial, 911;
Marks, 152.

Motherwort, 855.

Mountain laurel, 856.

Mouth, inflammation of,
457- Follicular Inflam-
mation of, 458; Gan-
grene of, 458.

Iffouth-bath, 755.

Mucous tissue, 16.

Mucus, 16.

Mullein, 856.

Mumps, 228.

Muriate of ammonia, 816;
Of soda, 876.

Muriatic acid, poisoning
by, 516.

Murmurs, breathing, 232;
Of heart, 286.

Muscae volltantes, 591.

Muscles, 27 ; Action ot, 29 ;
And bones, 122 ; Number
of, 29 ; Shape of, 28.

Muscular and nervous de
raugements from
wounds, 183; Tissue, 17.

Mustard, 856 ; Poultice,
906; Volatile oil of, 856 ;
Whey, 794.

Mutton broth, 797.

Myopia, 592.

Myrica cerlfera, 818.

Myricin, 818.

Myristica moschata, 858.

Myrospernum toluiferum,
818.

Myrrh, 856; Comp. tinct.
of, 9i8.

Naphtha, 857.
Napthalin, 857.
Narcotics, 928.
Nasal ca' urh, 209 ; Duct,

52 ; Shower syringe, 217.
Natural surgery, 631.
Nausea, during pregnancy,

426.
Week, symptoms affecting,

12'r.
Necrosis, 570.

,154.

rdica elaterlum, 886.

da punctata, 843.

ihood, 855, 887.

lania, 193.

ropa unlflora, 844.

I's styptic, 847.

treatment of infants,

la (morphine), 860;

loning by, 515.

lity in cold weather,

Lcation, 524, 527.

itos, bites of, 546.

r's cordial, 911 ;

kB, 152.

rwort, 855.

ain laurel, 856.

, inflammation of,

: Follicular inflam-

ion of, 458; Gan-

16 of, 458.

-bath, 755.

IS tissue, 16.

1,15.

in, 856.

IS, 228.

te of ammonia, 816;

loda, 876.

tic acid, poisoning

616.

urs, breathing, 232;

leart, 286.

e volltantes, 591.

es, 27 ; Action of, 29 ;

I bones, 122 ; Number

J9 ; Shape of, 28.

liar and nervous de

igements from

mds, 183; Tissue, 17.

,rd, 856 ; Poultice,

; Volatile oil of, 856 ;

ey, 794.

n broth, 797.

ia, 592.

a cerifera, 818.

in, 818.

tica moschata, 858.

ipernum toiuiferum,

I, 856; Comp. tinct.
)i8.

tha, 857.
lalin, 857.
tics, 928.
ca' irrh, 209 ; Duct,
Shower syringe, 217.
al surgery, 531.
la, during pregnancy,

symptoms affecting.

Bis, 670.

Nepeta cataria, 827; Glo-
choma, 839.

Nephritis, 333.

Nerve-root, 888 ; Tonics,
925.

Nerves, cranial, 46, 47;
Diseases of brain and,
164; Optic, 47, 50; Pain
of, 189; Of skin, dis-
ordered, 153; Spinal, 48 ;
Sympathetic, 45.

Nervine and tonics, 862,
925.

Nervous complications in
dyspepsia, 303 ; Derange-
ments from wounds, 183 ;
Diseases, effects of, 62 ;
Headaches, 204, 206;
System, 45, 54 ; System,
sympathetic, 62 ; System,
symptoms affecting, 129 ;
Tissue, 18.

Nettle-rash, 143.

Neuralgia, 189; Of heart,
289.

Neutral mixture, 867.

Neutralizing cordial, 912;
Extract, 899; Powder,
908.

New Jersey tea, 870,

Nicotiana tobacum., 882.

Nightmare, 200.

Night-nurse, 757.

Night-sweats, 250.

Nipples, sore, 426, 442.

Nitrate of mercury oint-
ment, 901; Of potassa,
858; Of potassa, poison-
ing by, 515; Of silver,
857.

Nitre, 858 ; Sweet spirit of,
858.

Nitric acid, 77, 813; Poi-
soning by, 515; Ether,
spirit of. 878.

Nitrogenous foods, 70.

Nitro-murlatic acid, 813.

Nose, bleeding from, 697;
Foreign substances in,
598; Fractures of, 551.

Nose-bath, 754.

Noxious vapors, apparent
death from, 509.

Nurse, activity of, 768;
Age of, 767; Education
of, 769; Habits of, 768;
Health of, 767 ; Strength
of. 767; Temper, etc., of,
767; Wet, 446.

Nursinz bottles, 447 ; Sick
children, 453; Sore
mouth, 440 ; Women,
445.

Nutmeg, 858.

Nutrition table, 70,

GENERAL INDEX.

Nutritive fluid, 796.
Nux vomica, 858.
Nymphaea odorata, 885.
Nymphomania, 417.

Oak, white, 885.
Oatmeal gruel, 797 ; Poul-
tice, 905.
Oats, 80.
Obstruction of intestines,

318.
(Esophagus, 32.
Oil of cajuput, 859; Of
mustard, volatile, 856;
Of turpentine, 869.
Oil-glands, 44; Disordered,

154.
Oil-nut, 824.

Ointments, 900-903, 931.
Old age, and its diseases,
496-508; Diet in, 76;
Preservation of health
in, 600.

Oleaginous foods, 79.

Oleum cajuputi, 859 ; Mor-
rhuas, 830; Ollvae, 869;
Riclni, 827 ; Terebin-
thincB, 869; Tiglii, 834.

Olive-oil, 859.

Omentum, 34.

Onion, 869; Poultice, 906.

Operations, surgical, prep-
arations for, 519.

Ophthalmia, catarrhal,589 ;
Purulent (Egyptian),
588; Of children, 689;
Scrofulous, 690; Tarsi,
587.

Opium, 869; Camphorated
tinct. of, 918 ; Liniment,
896; Poisoning by, 515;
Tinct. of, 915.

Opodeldoc, liniment, 897.

Orange blossoms, 949.

Orange-peel, 86C ; Tinct. of,
914 ; Whey, 795.

Orbits, 52.

Orchitis, 371.

Organized compounda, 16.

Organs, digestive, '31; Of
hearing, 52; Of circula-
tion, 37; Of secretion,
41; Of sight, 50; Respi-
ratory, 36 ; Vocal, 42.

Origanum vuigare, 860.

Omus Europcea, 854.

Osmidrosis, 154.

Osseous tissue, 17.

Otalgia, 696.

Otitis, 596.

Otorrhaea,595.

Ovarian disease, 774; Tu-
mors, 414.

Ovaries, 384 ; Inflamma-
tion of, 390.

975

Ovaritis, 390.
Ovum, 382.

Oxalic acid, poisoning by,
615; Deposits in urine,
351, 359.
Oxide of zinc ointment,

901.
Pack, half, 744 ; Wet sheet,

742.
Pail-douche, 748.
Pain, symptoms indicated
by, 130; Sudden disap-
pearance of, 772.
Painters' colic, 322.
Pallidness, when >- bad

symptom, 772.
Palpitation, of heart, 288,

427.
Palsy, 179; Diet in, 784;
Lead, 181; Local, 181;
Shaking, 181.
Panada, 791.

Panax quinquefoiium, 838.
Pancreas, 34, 291.
Papaver somniferum, 859.
Papillae) 152.
Papulous scall, 149.
Paralysis, 179.
Paraphlegia, 180.
Paregoric elixir, 918.
Parrilla, yellow, 889.
Paronychia, 572.
Parotid gland, 31.
Parotitis, 228.
Parsley, 860; Comp. infu-
sion of, 895.
Parsnips, 82.
Partridge-berry, 861 ; Comp.

syrup of, 911.
Passive congestion of liver,

296.
Patches, colored, on skin,

153.
Patella, dislocation of, 567;

Fracture of, 658.
Patent and proprietary

medicines, 944-949.
Patients, how to examine,

126.
Peach, 861.

Pear-leaf wintergreen, 871.
Pearlash, puriiied, 866.
Peas, 82.

Pectoriloquy, 242.
Pelvis, fractures of, 556.
Pemphigus, 147.
Pennyroyal, 861.
Pepper, red, 827; Water,

884.
Peppermint, 861.
Pepto-maugan, 360.
Perennial plants, when to

gather, 808.
Pericarditis, 281.
Pericardium, S?.

' . ' B i' ti ' .iu ' ilt ' ta'..* ' *" ' ■ * *"

■ M I »MlJ-B ' > ' -au. ' . '» !»t ll U «B ta3ca fcft»«

976

GENEKAL INDEX.

Periods of life, 12b, 126.

Peritoneum, 291; Acute
Intlammatlon of, 312;
- Ch ionic inHammatlon of,
313.

Peritonitis, 312, 313.

Pernicious latermittent fe-
ver, 471.

Perpetual calendar for
marriod iHciios. 443.

Persalt of iron, 847.

Persimmon, 801.

Perspiration, 106; Symp-
toms Indicated by, 132.

Perspiratory tubes, 45, 106.

Peruvian bark, 862 ; Tlnct.
of, 918.

Pessaries, 411.

Petroleum, 863.

Petroselinum sativum, &no.

Phagademc ulcers, 532.

Pharmacy, 891.

Pharyngeal siiower syr-
inge, 917.

Pharyngitis, 208, 212; Fol-
licular, 212.

Pharynx, 32 ; Inflammation
of, 212.

Philosophy of breathing,
112; Of chest sounds,
232.

Phlebitis, 580 ; Chronic,
581.

Phlegmasia dolens, 437.

Phosphate of iron, 847.

Phosphates, comp. syrup
• of, 911.

Phosphatic deposits in ur-
ine, 349, 355.

Phosphorus, 246, 863.

Phrenitis, 165.

Phthisis, 229.

Physical culture, 950-960.

Physiological laws, 64.

Physiologists, 8.

Phytolacca deeandra, 865.

Phytolaccin, 865.

Pia mater, 46; Inflamma-
tion of, 165.

Picra, 907.

Picroena excelsa, 869.

Pigeon-berry, 865.

Pile-ointment, 900, 902.

Piles, C.25. 576; During
pregnancy, 426 ; Oint-
ment for, 902.

Pills, 903.

Pimpinella anisum, 816.

Pimples, dry, 150 ; Mattery,
148 ; Watery, 144.

Pin-worms, 332.

Pink-root, 863.

Pinna, 62.

Piper angustlfolium, 866.

Pipsissewa, 863.

Pittacia lentiscus, 548.

Pityriasis, 150.

Pix liquida, 882.

Plantain (plantago major),
864.

Plants and animals, re-
lation of, 115 ; Medicinal,
when to gather, 808.

Plasters, 903.

Plastic lymph, 622; Diet
in, 786.

Plethoric headaches, 205;
Causes of. 202.

Pleurisy (pleurltis), 262;
Diet in, 786; Root, 864.

Plumbi acetas, 850.

Plumbum, 850.

Plunge-bath, 749.

Pneumonia, 266; Broncho-,
269 ; Typhoid, 268 ; Diet
in, 785.

Pneumothorax, 26C.

Podophyllin, 853.

Podophyllum pelatum, 853.

Poison hemlock, 864 ; Oak,
865 ; Ointment, 901.

Poisoned wounds, 545.

Poisoning accidents, 513.

Poisons, antidotes of, 513 ;
Vegetable, 515.

Poke, 86S ; Ointment, 901.

Poke-root poultice, 906.

Polygala senega, 873.

Polygonum punctatum,884.

Polypus, 576; Of heart,
290 ; Of womb, 406.

Polytrichum juniperum,
840.

Pompholix, 147.

Poplar, 882,

Pores, of skin, should be
kept open, 107.

Porridge, mllk,793.

Porrigo, 157.

Position of patient, impor-
tance of. 772.

Potassa, 866; Acetate of,
866; Bicarbonate of, 866;
Bitartrate of, 866; Car-
bonate of, 866 ; Chlorate
of, 866; Citrate of, 867;
Solution of, 867; Solu-
tion of arsenite of, 577 ;
And soda, tartrate of,
876; Sulphate of, 867;
Tartrate of, 867.

Potassce acetas, 866; Ar-
senitis, liquor, 877; Bi-
carbonas, 866; Blturtras,
866; Carbonas, 866; Ci-
tras, 867 ; Citratls, liquor.
867 ; Liquor, 867; Nitras,
868; Sulphas, 867; Tar-
tras, 867.

PotassU, bromidum, 867;

Oyanuretum, 868; lodl-

dum, 845 ; Sulphuretuiu,

868.
Potassium, 867; Bromide

of, 867 ; Cyanuret of, 868 ;

Suiphuret of, 868.
Potatoes, 82.
Poultices, 905-906.
Powders, 906-908.
Pox, 360.
Pregnancy, bathw during,

740 ; Prevention of, 429 ;

Treatmentof,425; Tubal,

418.
Prejudice and antipathies,

770.
Preparations, of medicines,

808 ;Pnarmaceutical,891.
Prepared calamine, 889;

Chalk, 828.
Presbyopia, 593.
Prescriptions, 920.
Preservation of old people's

health, 500.
Pressure of the atmos-
phere, 112.
Prickly ash, 868; Elder,

868.
Princes' pine, 863.
Prinos verticillatus, 820.
Private organs, symptoms

affecting, 129.
Probang, now superseded,

217.
Prognostics, 771.
Progress of medicine, 9.
Prolapsus ani, 465; Uteri,

409.
Pronouncing dictionary, 969.
Proofs of death, 807.
Prophylaxis, 489.
Propriety of imparting

physiological knowledge,

420.
Protoxide of iron, 847.
Provisional callus, 549.
Prunus Virgiuiana, 885.
Prurigo, 161 ; Of vulva, 417.
Pruritus, 153.
Prussic acid, poisoning by,

516.
Psoriasis, 149.
Pteiea lrifollat,a, 874.
Pterocarpus marsupium,

849 ; Santalinus, 870.
Ptisan, suet, 794.
Ptosis, 588.

Puerile respiration, 233.
Puerperal fever, 438.
Pulmonary apoplexy, 259 ;

Consumption, 233.
Pulmonic cherry cordial,

249.
Pulse, symptoms indicated

by, 131.

etum, 808; lodi-
46 ; Bulphuretum,

n, 867; Bromidi!
Oyanuretof,868,
ret of, 868.
82

, 905-906.
906-908.

y, batha during,
reventlon of, 429 ;
lentof ,425 ; Tubal,

and antipathies,

ions, of medicineg,

larmaceutlcal.SOl.

calamine, 889;

828.
lU, 593.
:ions, 920.
tion of old people's
,500.
of the atmos-

112.

ash, 868; Elder,

pine, 863.
erticlUatus, 820.
organs, symptoms
Dg, 129.
, now superseded,

tics, 771.
of medicine, 9.
IS ani, 465; Uteri,

;ing dictionary, 969.
death, 807.
ixis, 489.

r of imparting
logical knowledge,

e of iron, 847.
lal callus, 549.
/'irginiana, 885.
151; Of vulva, 417.
153.
icid, poisoning by,

1, 149.

■ifollata, 874.
pus marsupium,
iantallnus, 870.
suet, 794.
88

espiration, 233.
I fever, 438.
>ry apoplexy, 259;
mption, 233.
cherry cordial,

^mptoms indicated

Pumpkin seeds, 860.

Punctured woundH, 643.

Purges, 921.

Purple disease (purpura
hemorrhugica), 484;
Spots, 773.

Purtussis, 462.

Purulent ophthalmia, 588;
Of child leu, 589.

Pussy-willow, 821.

Pyaemia, 528.

Pyrethrum parthenlum,
836.

Pyrola rotundifolia (round-
leaved;, 871.

Pyrosis, 309.

Quassia, 8G9.

Queen of the meadow, 869.

Queen's root, 869.

Quercus alba, 885; Infec-

torla, 837.
Quinacetine, 946.
Quinia, sulphate of, 862;

Valerianate of, 863.

Rabies, 182.

RamoUissement, 166.

Rashes on children, 454.

Recipes, 920-943.

Rectum, 33, 291.

Red chickweed, 870; C3o-
ver, 870 ; Iodide of mer-
cury ointment, 901 ; Pep-
per, 827 ; Oxide of lead
plaster, 905 ; Osier, 881 ;
Root, 870; Rose, 870;
Saunders, 870; Willow,
881.

Reduction of fractures,
547.

Refreshing drinks In f»
vers, 790.

Refrigerants, 929.

Rennet whey, 794.

Reproduction of life, 419;
Of lo^t parts, 644.

Resin cerate, 892 ; plaster,
eorap., 904.

Resolution, 623.

Respiratory organs, 36.

Rest aud sleep, 98.

Restorative, 795 ; Wine bit-
ters, 898.

Retention of urine, 343 ; An
unfavorable sign, 773.

Retina, 51.

Retroflexion of womb, 411.

Retroversion of womb, 410.

Rhamnus cathartlcus, S24.

Rhateny, 870.

Rheum palmatum, 871

Rheumatic headaches, 206,
20fi.

Rheumatism, acute, 496;

GENERAL INDEX.

Chronic. 478; Diet in,
784, 802.

Rhubarb, 871 ; Aromatic
syrup of, 910; Comp.
tinct. of, 918; Comp.
powder of, 908; And
potussa, comp. powder
of, 908; Aud potassa,
comp. syrup of, 912;
Tinct. of, 916.

Rhus glabruni, 880; Toxi-
codendron, 866.

Ribc, fracture of, 655.

Rice, 81 ; Water, 789.

Ricinus communis, 827.

Rickets, 467.

Riding, as exercise, 97.

Rigors, 772.

Ringworm, 168.

Rochelle mUs, 876.

Roman baths, 107.

Roots, when to gather, 808.

Rosa gallica, 870.

Rosemarinus ofBcinallB,871.

Rosemary, 871.

Roseola, 143.

Rose-rash, 143; Bed, 870;
Water ointment, 901 ;
Willow, 881.

Rosin, 870.

Rotting of teeth, 602.

Round-leaved pyrola, 871.

Rubbing wet sheet, 745.

Rubeola, 135.

Rubus villosus, 820.

Rudbeckia laciniata, 882.

Rue, 872.

Rules for using water, 739.

Rumex crispus, 888.

Running and leaping, 94.

Rupia, 147.

Rupture, 681.

Ruptures of tendons, 569.

Russian and Turkish baths,
803.

Ruta graveolens, 872.

Rye, 81; Spurred, 878.

Saccharine foods, 79.

Sacral plexus, 48.

Saffron, 872.

Sage, 872; Tea, 790.

Sago-gruel. 792.

Sailing, as exercise, 96.

Saint Ignatius' Bean, 879.

Sal-ammoniac, 816.

Salep powders, comp., 791,
792.

Salicin, 886.

Saline mixture, 900.

Salix alba, 886; Nigra, 821.

Salpingitis, 415.

Salt, common, 876; Qlau-
ber's, 876; Of tartar,
866. • . .

Saltness of the ocean, 91.
Saltpetre, 858; Poisoning

by, 515.
Salt-rheum, 144.
Salvia oftklniillB, 872.
Sambucus Canadensis, 830,
Sanguinatia Cauadenuis,

821.
Sanguinarin, 821.
Sapo, 875.
Sarcoma, 675.
Sarsaparilla, 872; Comp.

syrup of, 912; Falsa

(wild), 875.
Sassafras, 872.
Savin, 873; Cerate, 892.
Scabies, 145.
Scalds, 635.

Scaly eruptions, 149, 363.
Scammony, 873.
Scarification, 544.
Scarlatina, 136; Diet In,

783.
Scarlet fever, 136.
Sciatica, 191.
Scilla maritima, 879.
Sclerotic coat of eye, 50.
Scoke, 865.
Scorbutus, 483.
Scrofula, 480.

Scrofulous ophthalmia, 69C.
Scrophularia nodosa, 836.
Scrotum, blood in, 580;

Water in, 579.
Scullcap, 873.
Scurvy, 483.

Scutellaria lateriflora, 873.
Sea-bathing, 736.
Seasickness, 310.
Secale cornutum, 878.
Secretion, organs of, 41.
Sedatives, 929.
Seidlitz powders, 873.
Self-poUution, 375.
Semen, 422.

Semilunar valves, 37 ; Dis-
ease of, 285.
Sempervivum tectorum,

843.
Senecin, 851.
Senecio aureus, 860.
Seneka, 873; Syrup of, 911.
Senna, 874 ; Confection of,

893; Comp. infusion of,

896 ; Comp. syrup of ,913 ;

And jalap, tinct. of,, 918.
Sensations, 56 ; Agreeable,

57; Kinds of, 56: Moral

uses of, 56; Unpleasant,

68.
Septic and aseptic, 618;

wounds, 538.
Septicaemia, 438.
Sermons, reading of, 216.
Serous tissae, 16.

978

GENERAL INDEX.

Setting of fracturei, 547.

Sex, 126.

Sexual diseases, 360-378;
Prevention of, 374.

Shaking palsy, 181.

Sheep-laurtl, 866.

Shingles, 146.

Shoes, tliln, 104.

Short oight, r)92.

Shoulder-blade, tracturo <>r,
553 ; Joint, dlslouation
of, 563.

Shower-bath, 747.

Shrinking of ihe brain, 173.

Shrubby trefoil, 874.

Sick, care of, 57 ; Clilldron,
nursing, 453 ; Headache,
201-207.

Sick-room, choice of, 756 ;
Beds and beddingu i,
768; CleanllnesB in, 760 ;
Cookery for, 789; Dark-
ening of, 761; Domestic
manageiment of, 756 ;
Fumigation of, 762; No
cooking In, 757; Prej-
udices and antipathies
in, 770; Sofa or reclining
chair in, 757 ; Tempera-
ture of, 760; Unhired at-
tendants in,769; Ventila-
tion of, 114.

Sighing, when a bad symp-
tom, 772.

Sight, organs of, 50; Long
and short, 592; Weak-
ness of, 691.

Signs and abbreviations,
810.

Silk clothing, 103.

Simple ointment, 892, 901;
Syrup, 909.

Slnapis alba, 856.

Singultus, 199.

Sinus, 527. v

Sippets, 795.

Sltz bath, 750,

Skin, 43, 134; Care of, of
the aged, 603; Color of,
disordered, 153 ; Dis-
eases, 134; Nerves of,
disordered, 163; Offlcea
of, 105.

Skull, fractures of, 551.

Skunk-cabbage, 874.

Sleep, 98; Amount of, 101 ;
Disturbed, 200; Natural
position for, 101; Of
children, 451; Prepara-
tion for, 101.

Sleeping apartment, 756 ;
In email room, 113;
Booms, 99; Bedding in,
100; Beds in, 100; Fire
In, 99; Nighlwlress in,

100; Open fireplace in,

99 ; Open windows in,

99; Bmall, 113.
Sleeplessness of the aged,

6U4.
Slei)i;h-riding as exercise,

97.
Slippery elm, H76 ; Poultice,

906.
Sloughing, 627.
Sluice-bath, 748.
Small-pox, 139; Diet in,

783.
Small spikenard, 876.
Smartweed, 884.
Smilax officinalis, 872.
Snake-root, 873 ; Canada,

886 ; Virginia, 884.
Snakes, bites of, 645.
Soap, 875.
Soda, bicarbonate of, 876 ;

Borate, 876; Sulphate of,

876; Sulphite of, 876;

Tartrate of and potassa,

876 ; Soda-water and

milk, 795.
Sodae, bicarbonas, 876 ;

Boras, 876; Et potassie

tartras, 876 ; Sulphas,

876 ; Sulphis, 876.
Sodium, 875; Chloride of,

876.
Soft cancer, 675.
Solanum dulcamara, 820.
Solidago rigida, 841.
Solomon's seal, 877.
Soluble tartar, 867.
Soothing inhalant, 244.
Sore mouth, children's, 457 ;

nursing, 440.
Sore nipples, 426, 442.
Sore throat, clergyman's,

212.
Soup, vegetable, 793.
Spanish flies, 877 ; Cerate,

892; Liniment, 896; Poi-
soning by, 616.
Spasm, of glottis, 461 ; In

stomach, 309.
Spearmint, 877.
Speculuui, 385.
Spermaceti, 878; Ointment,

902.
Spermatozoa, 422.
Spiced plaster, 904.
Spiders, bites of, 545 ; Web,

878.
Spigelia Marllandica, 863.
Spikenard, small, 875.
Spinal cord, 47; Diseases

of, 176; Inflammation of,

176.
Spinal nerves, 48.
Spine, deformities and ir-
ritations of, 584.

Spirit of nitric other, H58
878; Of Ammonia, aro-
matic, 816.

Spireea tomentOKa, 841.

Spleen, 34; Acute inliam-
malion of, 297; Clironlc
Influmniatloii of, 297.

Splenitii, 297.

Sponge, 878.

Sponge-4)aths, 752.

Spotted acne, 155.

Sprains, 669.

Spurred rye, 878.

So-ill, 87^9 ; Syrup of, 911 ;
Vinegar of, 919.

Squinting, 593, 772.

Squirting cucumber, 886.

St. Anthony's fire, 141.

St. Ignatius' bean, 879.

St. Vitus' dance, 187.

Stagger-weed, 883.

Star-grass, 879.

Starch and sugar, 78.

Statice Caroliniana, 854.

Sterility, 419; Causes of,
423.

Sterilization jf milk, 449.

Stethoscopes, 230.

Stiff joint, 573.

Stillingia sylvatlca, 869;
Comp. syrup of, 913.

Stimulants, 929.

Stings of insects, 545.

Stomach, 32 ; Affections of,
787; Bile in, 67; Acute
inflammation of, 301 ;
Chronic inflammation of,
302; Cramp in, 427;
Movement of, 66 ; Spasm
or cramp in, 309, 427.

Stomatitis, erylhematic,
457.

Stone in bladder, 345, 354.

Storax, 879.

Strabismus, 593.

Stramonium, 880 ; Oint-
ment, 901 ; Poisioning by,
515.

Stricture, 371; Of bowel,
318.

Structure of the body, 14.

Strychnine, 858 ; Poisoning
by, 516.

Strychnos nus vomica.
858.

Stye, 587.

Styptics, 540.

Styrax officinale, 879.

Subacetate of lead, cerate
of, 891.

Submaxillary gland, 31.

Succus alterans, 945.

Sudorific tincture, 919.

Suet Ptisan, 794.

Suffocation, 509.

f nitric ether, 858
Of Ammonia, aru-
, 816.

tomentosa, 8(1.
34; A('ut(> Inllam-
n of, 297 ; Clironlc
imatloii of, 2'.)7.
s, 297.

878.
baths, 752.

acne, 155.

, am.
rye, 878.

879 ; Syrup of, 911 j
;ar of, 919.
ng, 593, 772.
ig cucumber, 885.
bony's fire, 141.
itius' bean, 879.
is' dance, 167.
-weed, 883.
iss, 879.
and Bugar, 78.
Carollniana, 854.
y, 419; Causes of,

ation Jt milk, 449.
copes, 230.
nt, 573.

;U sylvatlca, 869;
). syrup of, 913.
ints, 929.
of Insects, 545.
h, 32 ; Affections of,
Bile In, 67; Acute
amatlon of, 301 ;
lie inflammation of.
Cramp in, 427 ;
iment of, 66 ; Spasm
imp in, 309, 427.
itis, erythematlc,

bladder, 345, 354.

879.

mu3, 593.
nium, 880 ; Oint-

901 ; Poisoning by,

■e, 371; Of bowel,

re of the body, 14.

line, 858 ; Poisoning

16.

los nux vomica:

il. '
,540.

ofBcinale, 879.
tate of lead, cerate
I.

:illary gland, 31.
alterans, 945.
ic tincture, 919.
isan, 794.
,tion, 509.

Sugar foods, 78.

Sugar of lead, poisoning by,

514.
Sugar of milk, 247.
Sulphate of zinc, 890.
Sulphur, 880; Ointment,

(■omp.,e03.
Sulphuric acid, 813; Poi-
soning by, 515.
Sumach, b8U.

Summer complaint of in-
fants, 463.
Sunflower, 880.
Sunstroke, 179.
Supercarbonate of soda,

876.
Supertartrate of potasaa,

866.
Suppers, late, 101.
Suppression of urine, 342.
Suppuration, 523, 526; Of

brulu, 167.
Supra-renal capsules, dis-
ease of, 337.
Surgery, natural, 531.
Surgical diseases, 517-607.
Sutures, 540.
Swallowing, difficulty of,

772.
Swamp-dogwood, 881;

Milkweed, 881.
Swathing, 427.
Sweat-glands, 45 ; Dis-
ordered, 154.
Sweating process, 741 ; In

consumption, 773.
Sweet fern, 881 ; Flag, 881 ;
Gum, 881; Oil, 859;
' Spiritsof nitre, 858,878;
Whey, 795.
Swelling, of lunge, 259; Of
lower limbs, 428; Sud-
den disappearance of,
774.
Swinging as exercise, 97.
Sycosis, 156.
Sympathetic nervous sys-

tom, 48-50, 62.
Symphytum officinale, 831.
Symplocarpus foetidus, 874.
Symptoms, 122 ; Table of,

126, 132.
Syncope, 199.
Synovial degenerations,

571; Membrane, 26.
Syphilis, 360.

Syringe, laryngeal shower,
216; Nasal showor, 217;
Pharyngeal sho .\ or, 217 ;
Uterine, 390; Mode of
using, 219.
Syrups, 909, 913.

Table, exhibiting the differ-
ence between smail-pox,

GKNEKAL INDKX.

varioloid, scarlet fever
and measles, 138, 139;
Of foods, 72, 79, 80 ; Of
symptoms of diseases,
126-132.

Tag-alder, 881.

Tamarac, comp. tinct. of,
918.

Tamarinds and whey, 795.

Tannic acid, 814.

Tansy (Tanacotum vul-
gara), 881.

Tape-worm, 332.

Tapioca, 882 ; Jelly, 792.

Tar, 882; Ointment, 912;
Plaster, comp., 904.

Taraxacum, 835.

Tartar on tlie teeth, 603 ;
Soluble, 867.

Tartar-whey, 794.

Tartaric acid, 814.

Tea and coffee, 88 ; Cause
headaches, 202 ; Beef,
793, 797; Garfield, 94 j,
947 ; New Jersey, 870 ;
Sage, 872.

Teeth, 30; Care of, 601;
Cleaning of, 606; Com-
position of, 31 ; Cutting,
difficult, 459; Diseased,
influence of on the
health, 605; Filling, 604;

• First, 605 ; Names of, 30 ;
Number of, 30; Origin
of, 30; Rotting of, 602;
Use of, 31.

Temperance, 87; Good te-
sults of, 87.

Temperaments, 122, 123;
Medication and, 123, 124.

Temperature of the body,
132; Symptoms Indfcated
by, 132.

Tendons, ruptures of, 669.

Tetanus, 184.

Tetter, 145; Crusted, 148.

Thigh-bone, fractures of,
556.

Thimbleweed, 882.

Thomapple, 880.

Thoroughwort, 882.

Throat, symptoms affect*
Ing, 128.

Throat-diseases, 208-228;
Curability of, 224; Worse
at night, 215; Instru-
ments for treatment of,
216-221.

Thyroid cartilage, 42.

Tic douloureux, 190.

Tight dressing, 116.

Tinctures, 812, 913-919.

Tissues, the, 16-18.

Tobacco, 882.

Toe-nail, ingrowing, 697.

979

Tolu, syrup of, 911 ; TInct
of, 015.

Tongue, symptom 4 afTect-
ing, 127.

Tonics, 924; And cathar-
tics, 023.

Tonsilitis, 222, 223.

Tonsils, acute inflammn-
tlon of, 22'J ; Chronic iu-
flaramaiion of, 223.

Toothache, 603.

Toothache tree, 868.

Tourniquet, 539.

Towel and sponge bath.
752.

Towel, coarse, in bathing,
111.

Tracheitis, 209, 214.

Trailing arbutus,882; comp.
infusion of, 895.

Trance, 186.

Traveling, 116; For con-
Bumptrves, 254 ; For the
poor, 118 ; Means of, 117 ;
Seasons for, 117.

Treatise on pliysical cul-
ture, 950-960.

Trees, cultivation of, 116.

Trefoil, shrubby, 874.

Trichiasis, 687.

Tricuspid valves, 274.

Trifolium pratense, 870.

Trillium peuduium, 819.

True physician, the, 12.

Trumpet weed, 869.

Tubal pregnancy, 418.

Tubercular consumption,
233; Eruptions, 363.

Tulip-tree, 882.

Tumors, 573; Encysted,
577; Fatty, 575; Of brain,
167; Of heart, 280; Of
ovaries, 414; Of womb,
412.

Turkey-corn, 883.

Turkish baths, 803.

Turmeric, 883.

Turn of life, 403.

Turner's cerate, 891.

Turnips, 82.

Turpentine liniment, 897.

Tissilago farfara, 831.

Twist in iKJwel, 318.

Tympanitis, 321.

Tympanum, 63 ; Inflamma-
tion of, 596.

Typhoid fever, 470 ; Pneu-
monia (lung-fever), 268.

Ulceration, 623 ; And ulcers,
631 ; Of bones, 570; Of
neck of womb. 386.

Ulmus fulva, 875.

Unbolted wheat floor, 74.

Unhired attendants, 769.

■,

uttkim i

980

Unlcorn-root, 879; False,
841.

Tnion by flrat intention,
540.

Unnatural growth of bones,
570.

Upland Cranberry, 818.

Upper arm-bone, fractures
of. 553.

Urate of ammonia in urine,
352 ; Calculus, 354.

Ureters, 35.

Urethra, 35.

Uric acid calculus, 354.

Urinary deposits, 305 ; Or-
gans, dlsnases of In tho
aged, 507; System, 35.

Urine, characteristics of,
34fi; Cystine deposits in,
353 ; Ex..rainatlon of,346 ;
Hippurlc-acid deposits
in, 332; Inability to hold,
344; Oxalic deposits in,
350; Phosphatlcdeioslts
in, 349; Retention of,
343,773; Sources of, 345 ;
Suppression of, 342 ;
Symptoms indicated by,
131; Urate of ammonia
in. 352.

Urinometer, 346.

Urticaria, 143.

Uterine hydatids, 407.

Uva ursi, 818.

Uvula, elongation of, 221.

Vagina, Inflammation of,

416.
Valerian, 883; American,

888; Ammoniated tlnct.

of. 919.
Valeriana officinalis, 883.
Valerianate of iron, 848 ; Of

quinia, 863; Of zinc. 890.
Value of foods. 70, 71, 72,

79, 80.
Valves, mitral, disease of,

285; Semilunar, disease

of, 285; And tricuspid,

37. 39.
Varicocele, 584.
Varicose veins, 428, 581,

646.
VarioU, 139.
Varioloid, 141.
Varix, 581.
Vaseline, 890.
Vegetable foods, 70, 84,

778; Poisons, 515; Soup,

793.
Veins, 38; Enlarged, 681;

Inflammation of, 580,

581 ; Enlarged or vari-
cose, 581.
Venereal diseases, 360-378.

GENERAL INDEX.

Ventilation, 60; In sick-
room, 114, 758.

Ventricles, 37, 274 ; Dilata-
tion of, 27H; Enlarge-
ment of. 276.

Veratrin, 815.

Varatrum album, 885;
Yirldo, 814.

Verbascum thapsus, 866.

Verbena hastata, HH3.

Verdigris, poisoning by,
514.

Vertigo, 200.

Vervain, 883.

Vesicles, 36.

Vesicular eruptions, 363.

Vessels, absorbent, 40.

Viburnum opulus, 842.

Vinegar, 883 : Whey, 794.

Vinegars, 910.

Virginia snakeroot, 8H4 ;
Comp. Tlnct. of, 919;
Tinct. of, 915.

Vision, Imperfect, 591.

Vital properties of th e body,
18.

Vitreous humor, 51.

Vitriol, elixir, 915; Poison-
ing by, 515.

Vocal cords, 43; Organs,
42.

Vomiting, 310.

Vulva, prurigo of. 417.

Wading foot-baths, 753.

Wafer ash, 874.

Wahoo, 884.

Walking, 93; Of infants.
452.

Warm baths for children,
457; Foot. 754.

Warts and corns, 152.

Wash-down bath, 752 ; Tub,
751.

Washes, 933.

Water, 89-92, 779; Acci-
dents on, 512 ; Ammonia,
815; Brash, 309 ; Chemi-
cal nature of. 89; Ctold,
at meals, 65; Cure, 739;
External use of, 251 ;
Oruel. 791 ; Horehoiind,
884; In chest, 261; In
heart case, 287 ; In the
head, 174; Impurlities
in, 90; Internal use of,
741; Lime, 851; Mwluo
operandi of, 737 ; Of am-
monia. 815 ; Of the ocean,
91 ; Pipes, lead, 90; Prop-
erties of, 90; Pure, es-
sential to health, 89;
Ilain.91 ; Bules for using.
739 ; Salt, 91 ; In scrotum,
579; Supply, 90; Use of.

in consumption, 251 ; For
wounds, 640,

Waters, me(licate<l, 897.

Watery pimples, 144.

Wave or Hlulce bath, 748.

Wax, HH6 ; In tht- oar, 696.

Weakness of sight, 501.

Weaning, 450.

Wens 577.

Weights, 810 ; French deci-
mal, 811.

Wet bandages, 741 ; DrcBs,
743; Nurses, 44(1 ; Khwt,
folded, 744; Sliot't pack,
742; Sheet ruiitiMig, 715.

Wheat, 80; Flour, un-
l)oltP(l, 74.

Whey, alum, 795; Mustard,
794; Grange, 795; Ren-
net, 794; .4weet, 795;
Tartar, 794 ; Vliie^ar,
791; With tamarinds.
795 ; Wine. 795.

White hellebore, S85 ; Oint-
ment, 902; Indian hemp,
881 ; Liquid physic, 900;
Oak, 885; Pond Illy, 885;
Poplar, 882 ; Swelling,
571; Vitriol, poisoning
by. 515 ; Walnut, 824.

Whitely exerciser, 953.

Whites, 393.

Whitlow, 645.

Whooping-cough, 462 ; sud-
den increase of par-
oxysms in, 772 ; Diet in,
787.

Wild cherry. 885; Cherry
bark, syrup of, 911; Cu-
cumber, 885 ; Glngor.
886; Indigo, 886 ; Indigo,
ointment, 902; Sarsapa-
rilla. 875; Snowball, 870;
Turkey pea, 883; Wood-
bine, 815 ; Yam, 886.

Willow, black. 821 ; White,
886.

Wiud-coHc, 320.

Windows In sleeping-
rooms, 99.

Windpipe, 36 ; Foreign
bodies in, 599; Inflam-
mation of, 214.

W'ne for old persons, 502;
Of American ash. 947;
Oi comfrey, comp., 898;
Of golden seal, comp.,
898 ; Of ipecacuanha,89H;
Whey, 795.

Wines, medicated, 898.

Win^seed, 874.

Winter, fatty foods In. 75.

Wlntergreen,886 ; pear-leaf,
871.

Witcb-haxel, 886.

nnaumptlon, 251 ; For
ludn, 640.

1, medicated, 897.
y pimples, 144.
or slulco bath, 748.
885 ; In th»« our, 51)6.
DOS! of sight, 691.
Ing, 450.
,577.

Its, 810 ; French docl-
, 811.

andages, 741 ; DroBB,
; Nuraes, 44t> ; Klioet,
fd, 744; Shft'l iPiick,
; Sheet runti'iig, 715.
t, 80; Flour, un-
,pd, 74.

, alum, 795; Mustard,
; Jrange, 795; Rou-
, 794; Swt'tH, 795;
tar, 794 ; Vliiujjar,
; With tamarinds,
; Wine, 795.
I hellebore, 885 ; Olnt-
it, 902; Indian hemp,
; Liquid physic, 900;
c, 885; Pond lily, 885;
lar, 882 ; Swelling,
; Vitriol, poiaunlug
515 ; Walnut, 824.
9ly exerciser, 953.
!S, 393.
ow, 645.

ping-cough, 462 ; sud-
i increase of par-
sins in, 772; Diet in,

cherry, 885; Cherry
k, syrup of, 911; Cu-
Qber, 885 ; Ginger,
; Indigo, 886 ; Indigo,
tment, 902; Sarsapa-
a, 875; Snowball, 870;
[•key pea, 883; Wood-
e, 815 ; Yam, 886.
w, black, 821 ; White,

-colic, 320.

0W8 In eleeping-
ms, 99.

pipe, 36 ; Foreign
lies in, 699; Inflam-
tlon of, 214.
for old persons, 502;
American ash, 947;
comfrey, comp., 898;
golden seal, uomp.,
; Of lpecacuanba,89Pi
ley, 795.

1, medicated, 898.
seed, 874.

sr, fatty foods in, 75.
irgreen, 886 ; pear-leaf,

i-hasel, 886.

Wolfsbane, 887.

Womb and appendages,
383, 422; Cancer of, 413;
Falling of, 400 ; Falling
over of, 410; Inllamiiia-
tlon of, 40H ; Inllamma-
tion of neck of, 38((;
Polypus of, 406 ; Sinking
down of, 424 ; Tumors of,
412.

Woolen clothing, 103.

Worm-powder, 908.

Worms, 332.

Wormseed, 887.

Wormwood, 887.

Wounds, bleeding from,
639, 699; Contused and
lacerated, 544; Derange-
ments from, 183; Qun-

OENKKAL INDEX.

shot, 545 ; How to unite,
540, 543; Incised, 539;
Of various kinds, 538;
Poisoned, 545 ; Punctur-
ed, 543 r Rules for exam-
ining and dressing, 541.

Wrist, dislocation of, 565;
Fracturi'H of, 6G",

Wry neck, 586.

Xanthoxylln, 868.
Xanthozylum fruxineum,

868.

Yam, wild, 886.
Yarrow. 888.

Yeast, 888; Poultice, 005.
Yellow dock, 888; Comp.
syrup of, 913; Fever,

981

495 ; Jessamine, 888 ;
Ladies' slipper, 888 ;
ParlllH, 889.
Youth, diet in, 76.

Zinc, 889; Acetate of, 889;
Chloride of, 889 ; Iodide
of. 889; Oxide of, 889,
Precipitated carbonate
of, 889; Sulphate of, 890;
In poisoning, 515; Vale-
rianate of, 890.

Zinci, aciotas, 889 ; Car-
bonas prrodpltas, 889;
Clilorlduni, MH9; lodl-
dum, 889; Oxidum, 889;
Sulphas, 890; Valcrianas,
890.

Zingiber omdnale, 838,

ri fei r «ii n iiiaiiit " i A i'iwi i in W l *> ii^ l l *w m * w * > « i w<Uifc« t[i<ni >HimiD i f nm ■iw MW h imini i i i l i

INDEX TO THE HOMOEOPATHIC DEPARTMENT.

A Brief Treatise on Home-
opathic treatment of
diseases, 608.
Abscesses, 643.
Aconite, 720.

Acute inflammation of the
spinal cord, 618; Of the
larynx (laryngitis), 629;
Of the liver, 663; Bron-
chial, 630.

Affections of the mind, 692.

Agustia, 724.

Ailments at the age of pu-
berty, 713 ; Attending
change of life, 714; Dur-
ing pregnancy, 715.

Albumen, for poisoning,
729.

Amblyopia, 676.

Ammoniacal gas, for pel- 1
sonlng, 730. I

Anasarca, 684.

Anchylosis, 704.

Aneurism, 704; Of the
aorta, 652.

Anorexia, 724.

Ancsmia, 724.

Anthrax, 642.

Antidotes to medicines,
611 ; To poisons, 726-731.

Antimonium, 720.

Antimony, poisoning with,
727.

Aphthae, 707.

Apoplexy, 616. ^

Arnica, 720.

Arsenic, poisoning with,
727.

Arsenicum album, 720.

Ascites, 684.

Asiatic cholera, 662.

Asthma, 632.

Aversion to food, 724.

Baldness, 614.
Bathing, 611.
Barbers' itch, 649.
Belladonna, 721.
Bilious remittent fever,654.

Black tongue, 690.
Black vomit, 690.
Bleeding from the lungs,

632.
Bloody urine, 636.
Boils, 642.
Brain fever, 615.
Bronchitis, 630.
Bronchocele, 704.
Bryonia, 721,
Bunions, 670.
Burns and scalds, 702.

Calcarea carbonica, 721.

Camphor, for poisoning,
729.

Cancer of the skin, 667 ; Of
the liver, 666; Of the
intestines, 667; Of the
stomach, 666.

Canker of the mouth, 657.

Cantharides, poisoning by,
728.

Capsicum, 721.

Carbo. veg., 721.

Carbuncle, 642.

Cardialgia, 658.

Cataract, 623.

Cephalalgia, 613.

Chamomilla, 721.

Charcoal, for poisoning,
730.

Charcoal gas, poisoning by,
728.

Chicken-pox, 655.

Chilblains, 644.

Child-bed fever, 718.

China, 721.

Cholera morbus, 662; In-
fantum, 708.

Chorea, 621.

Chronic catarrh, 628 ; Dys-
entery, 661 ; Laryngitis,
629; Pericarditis, 652;
Rheumatism, 656.

Chronic inflammation of
the bowels, 660; Ot the
bronchia, 631; Of the
pericardium, 651.

982

Clna, 721.

Coal, poisoning by the

vapors of, 731.
Coffee, for poisoning, 729.
Cold fever, 687.
Cold in the head, 628.
Colic, 706.
Concussion of the brain,

700; Of the chest, 700.
Constipation, 662; Of the

bowels, 717.
Consumption, 632, 673.
Convulsions, 709.
Copper, poisoning by, 727.
Corns, 643.
Coryza, 628.
Costiveness, 662.
Coup do soleil, 616.
Cramps in the stomach,

659.
Croup, 630.
Crying, 706.
Cystitis, 634.

Deafness, 625.

Delirium, 615.

Delirium tremens, 620.

Dentition, 708.

Derangement of menstrua-
tion, 713.

Diabetes, 636.

Dianhcea, 660.

Diet and regimen, 612.

Difficult urination, 716.

Dilatation of the cavities of
the heart, 652.

Diphtheria, 680.

Diseases of the alimentary
canal, 657 ; Of the brain
and nerves, 615 ; Of the
ear, 625 ; Of the eyj and
lids, 622; Of the head,
613; Of the skin, 642;
Of the organs of circula-
tion, 651 ; Ot the organs
generation, 638 ; Of the
respiratory organs, 628 ;
Of the urinary organs,
634 ; Involving the vari-

MENT.

isoning by the

of, 731.

r poisoning, 729.

r, 687.

le head, 628.

n of the brain,
f the chest, 700.
ion, 662; Of the
717.

lion, 632, 673.
ns, 709.

oisonlng by, 727.
i.
iH.

9S, 662.
oleil, 616.
n the stomach,

)6.
!34.

625.
615.
:remens, 620.

708.

ent of menstrua-
3.
636.

660.

•egimen, 612.
rlnation, 716.

of the cavities of
rt, 652.
I, 680.

if the alimentary
57 ; Of the brain
ves, 615 ; Of the
; Of the eyj and
2; Of the head,

the sliin, 642;
rgans of circula-
I ; Of the organs
ion, 638 ; Of the
ory organs, 628 ;
urinary organs,
i^olving the vari-

ous organs and reglon«4,
653, 666 ; Of women, 713 ;
Of infants, 706.

Dislocations, 701.

Disorders of the nose, 627.

Dropsy of the belly, 684 ;
Of the brain, 685 ; Of the
chest, 684 ; Of the heart,
684 ; Of the joints, 704 ;
Of the scrotum, 639,685 ;
Of the womb, 635 ; Ova-
rian, 685.

Dysentery, 661.

Dysmenorrhoea, 714.

Dyspepsia, 658.

Dyspeptic headache, 658.

Ear, diseases of, 625 ; in-
flammation of, 625.

if-arache, 625.

.vczema, 648.

Endocarditis, 651.

Epastazis, 627.

Epilepsy, 617.

Epsom salts, for poisoning,
730.

Eruptive fevers, 655.

Erysipelas, 655

Excessive menstruation,
714.

Excoriated nipples, 717.

Excoriations, 710.

External applications, 611.

Extreme emaciation, 709.

Falling of the womb, 640,
719.

False pains, 716.

Febris petechialis, 687.

Felons, 647.

Ferrum, 721.

Fever, bilious, 654; Cold,
687; Eruptive, 655; In-
flammatory, 653 ; In-
termittent, 654; Putrid,
688; Remittent, 471, 654;
Rheumatic, 656 ; Scarlet,
655; Simple, 653; Spot-
ted, 687 ; Typhoid, 653 ;
Yellow, 654.

Fig-warts, 667.

Fistula in ano, 705.

Fits, 617, 709.

Forms of medicine for ad-
ministration, 610.

fractures, 702.

Furunculi, 642.

Gall Stones, C65.
Gangrene, 668.
Gastralgia, 658.
Gastritis, 659.
Gastrodynia, 659.
Goitre, 704.
Gonorrhoea! sore eyes, 623.

HOMCEOPATHIO INDEX.

Gravel, 635.

Grippe, 675.

Hardness of hearing, 625.

Headache, 613, 658.

Heartburn, 658.

Hectic fever, 671.

Hemorrhage from wounds,

701.
Hemorrhoids, 664, 719.
Hernia, 701.
Herpes, 6''.7; Circlnnatus,

646.
Hiccough, 709.
Hives, 646.
Hydrocele, 639, 685.
Hydrocephalus, 685.
Hydrometra, 686.
Hydrophobia, 691.
Hydropsies, 684.
Hydrothorax, 684.
Hypochondria, 696.
Hysteria, 691.
Hysteric derangement, 697.

Ignatia, 722.

Imbecility, 698. .

Immoderate flow of sweet
urine, 636.

Imperfect action of the
valves of the heart,
652.

Inability to talce the breast,
706.

Incontinence of urine, 636.

Incubus, 690.

Indigestion, 658.

Induration of the breasts,
717.

Infantile diarrhoea, 706 ;
Dysentery, 706 ; Jaun-
dice, 707.

Inflammation of the ar-
teries, 652; Of the I lad-
der, 634; Of the bowels,
660; Of the ear, 625;
Of the eyeUds, 622 ; Of
the glands under the
arms, 669; Of the heart,
651; Of the inguinal
glands, 669 ; Of the iris,
622 ; Of th& kidneys, 637 ;
Of the larynx, 629; Of
the ovaries, 610; Of the
pericardium, 651 ; Of the
peritoneum, 660 ; Of the
spinal chord, 618; Of
the spleen, 663; Of the
stomach, 659; Of the
testicles, 639; Of the
tongue, 657; Of the ton-
sils, 657 ; Of the urethra,
638; Of the vagina, 639;
Of the vulva, 639; Of the
windpipe, 630; Of the
womb, 639.

983

Inflammatory fever, 653;

Rheumatism, 656.
Influenza, 675.
Injury of a nei-vo, 700.
Insidious diseases, 686.
Intermittent fever, 654.
Interrupted menstruation,

713.
Invermination, 663.
Ipecacuanha, 722.
Iritis, 622.
Iron-rust, for poisoning,

730.
Itch, 645.
Itching of the anus, 664;

Of the sitiu, 645.

Jaundice, 663.

Kidneys, inflammation of,

637.
Kitchen-salt, for poisoning,

730.

Labor, 716.

Lachesis, 722.

Larynx, inflammation of,

629.
Lead, for poisoning by, 727.
Leucorrhoea, 641 ; After

conflnement, 719.
List of remedies, 609.
Liver, inflammation of

663 ; spots, 649.
Lock-jaw, 619.
Loss of memory, 621 ; Of

taste, 724 ; Of smell, 724.
Lumbago, 656.
Lumbar abscess, 703.
Lung fever, 631.
Luxations, 701.

Maculae, 649.

Magnesia, for poisoning,
730.

Malignant pustule, 686.

Mania from excited 'mo-
tions, 693; From df-ores-
slon of spirits, 693. '

Marasmus, 709.

Measles, 655.

Menorrhagia, 714.

Mental derangement, 692.

Mercurius. 722.

Mercury, for poisoning by,
727.

Milk (for poisoning), 729;
Crust, 710; Fever, 716;
Leg, 669.

Miscellaneous diseases,
690.

Monomania, 699.

Morbid emotions, 694.

Morphine, for pc'soning by,
728.

984

HOMCEOPATHIC INDKX.

Hyeletis, 618.
Mucous-vomiting, 659.
Moss, 649.

Nasal polypus, 668.
Nervous deafness, 6Si6.
Nettle-rash, C55.
Neuralgia, 620.
Nightmare, 690.
Night-sweats, 250.
Nocturnal enureeiB, 636.
Nose-bleed, 627.
Kux vomica, 722.

Obstruction of the nose, 627.
Olive-oil, for poisoning, 729.
Opium, 722.
Otorrhcea, 625.
Ovarian dropsy, 685.
Ozcena, 627.

Painful menstruation, 714.

Painter's colic, 664.

Palsy, 619.

Paralysis, 619; Of the eye-
lids, 678.

Parturition, 716.

Passage of gall-stones, 666.

Pericarditis, 651.

Pharyngeal sore throat,
657.

Phlegmasia dolens, 669.

Piles, 664, 719.

Pleurisy, 632.

Pleuritis, 632.

Pneumonia, 631.

Poisons, and their anti-
dotes, 726-731.

Polypus of the nose, 627.

Porrigo, 710.

Potash and sweet almond
oil, for poisoning, 730.

Prickly heat, 710.

Profuse bleeding from the
womb, 714.

Protracted grief, 693,

Protrusion of the intestine,
663.

Prurigo, 645.

Prussia acid, for poisoning
by, 728.

Pulmonary consumption,
632, 673.

PulsatUla, 722.

Putrid fever, 688; Sore
throat, 657.

Quinsy, 657.

Rabies, 691.
Rachitis, 703.
Red gum, 708.
Relapsing fever, 690.

Religious mania, 696.
Remittent fever, 654.
Retention of the urino, 635,

708.
Rheumatic fever, 656 ; Sore

eyes, 623.
Rraas tox., 723.
Rickets, 703.
Ringworm. 646; Of the

sralp, 613.
Rules for the administra-
tion of medicines, 609;

For preserving the purity

of medlciues, 610.
Running at the cars, 625.
Rupture, 701.
Rush of blood to the head,

616.

Salt rheum, 647.
Scabies, 645.
Scald-head, 614.
Scarlet-fever, 665; Bash,

665.
Schirrus, 666.
Sciatica, 666.
Scrofula, 648.
Scrofulous sore eyes, 622;

Swelling of the salivary

glands, 711.
Scurf of the head, 711.
Scurvy, 649.
Sea-sickness, 869.
Shingles, 668.
Simple fever, 653.
Sleeplessness of Infants,

712.
Small-pox, 6r6.
Snake bites, 703.
Snuffles, 707.
Soap, for poisoning, '729.
Sore mouth, 707; Throat

(quinsy), 657.
Soreness after delivery,

716; Behind the ears,

710.
Specific indications for rem-
edies in fevers, 720.
Specks on the cornea, 624.
Spotted fever, 687.
Sprains, 700.
Squinting, 624.
Stammering, 621.
Starch, for poisoning, 730.
Stiff joints, 704.
Stings of i..Bect8, 702.
Stone, 635; Bruise, 670.
Strabismus, 624.
Strangury, 634.
Strong tea, for poisoning,

730.
St. Vitus's dance, 621.
Stye, 622.

Sugar, or sugar-water, for

poisoniuik;, 729.
Summer conipiaiut, 708.
Sunstroke, 610.
Suppression of tlif lochia,

718; Of the milk, 717;

Of the urine, 635.
Surgical diseases, 700
Sweet almonl oil, for iioi-

soning, 730.
Swimming of the head,

613.
Syphilis, 638.
Syphilitic sore eyes, 623.

Teething, 708.
Tetanus, 620.
Tetter, 6^7.
Thrush, 707.
Tinctures, 609.
Tinea capitis, 614.
Toothache, 656.
Torticollis, 704.
Tracheitis, 630.
Trismus, 619.
Tumors, removal of, 702.
Tussis spasmodica, (J31,

678.
Typhoid fever, 653.

Ulcerations of the bone,
703 ; Of the womb, 640.

Ulcers, 644; Of the scalp,
614.

Varicose veins, 646, 704.
Varioloid, 655.
Veratrum, 723.
Vertigo, 613.

Vinegar for poisoning, 729.
Vomiting of blood, 659.

Warts, on the hands, 669 ;

On the nose, 668.
Waterbrash, 658.
Watery eyes, 624.
Weak memory, 697.
Weakness of the sight, 676.
Wetting the bed, 636.
White swelling, 703.
Whites, 641.
Whitlow, 645.
Whooping cough, 631, 678.
Wine, for poisoning, 730.
Worms, 663.
Wounds, 701.
Wry neck, 704.

Yellow fever, 654.

Zinc, or white vitriol, for

poisoning by, 727.
Zona, 668.

ar, or sugar-water, for

)isonin|k;, 729.

imer complaiut, 708.

stroke, 61G.

pression of iho lochia,

L8; Of the milk, 717;

f the urine, 635.

gical diseases, 700

set almonJ oil, for jioi-

>nlng, 730.

mming of the head,

13.

hilis, 638.

hilitio 8ore eyes, 623.

thing, 708.

inus. 620.

:er, 6^7.

ush, 707.

itures, 609.

sa capitis, 614.

thache, 656.

ticoilis, 704.

:heitis, 630.

mus, 619.

lors, removal of, 702.

sis spasmodlca, (iSl,

■8.

hold fever, 653.

rationa of the bone,
3 ; Of the womb, 640.
IS, 644; Of the scalp,
4.

cose veins, 646, 704.

Oloid, 656.

trum, 723.

igo, 613.

!gar for poisoning, 729.

iting of blood, 659.

ts, on the hands, 669 ;

1 the nose, 668.

erbrash, 658.

ery eyes, 624.

k memory, 697.

kness of the sight, 676.

ting the bed, 636.

te swelling, 703.

tes, 641.

blow, 645.

oping cough, 631, 678.

t, for poisoning, 730.

tna, 663.

nds, 701.

neck, 704.

)W fever, 654.

, or white vitriol, for
isonlng by, 727.
\, 668.

Mellins Food

FOR

Infants and Invalids.

Mellin's Food has been before the public
for over Thirty Years, and has become a
household word in every family.

Mellin^s Food fulfils all the requirements of
a perfect food for Infants, and is invaluable
for the Invalid and the Aged.

Mellin's Food prepared as directed (it re-
quires no cooking) is the best food for Infants
and Invalids.

My experience with MELLIN'S FOOD for a number
of years has been of the most satisfactory kind and
though foods have come and gone and the principles
of infant feeding, as laid down in the text books, have
been radically changed several times, MELLIN'S
FOOD has stood the test and seems to fulfil the
indications more nearly in the majority of cases than
any other preparation.

CHAS. GRAEFE, M.D..

March 28, 1806. -- Sandusky, Ohio.

Write to us and we will send our book ''The Care and Feeding of
Infants,'' and a sample bottle of MELLIN'S FOOD free of charge.

DOLIBER-<KX3DALE COMPANY,
BOSTON, MASS.

-^,<*7/A^Z*7,A^^*7^A^\'>7tA-^^ r/Av^»r/A^~»7/Av^t7/AvN t7/A\N»7/ A*.^ tT* A*^»7*A*n *7/ AvT*7/i4^> t^.C

'*. '-.■ >

5f?5^

HorsM's Acid Phosphate.

('mquid. ;

A BRAIN AND NERVE TONIC.

This is not a compounded patent medicine, but a preparat'on
of the phosphates of potash, iron, lime, phosphoric acid, etc., in
solution, and is recommended and prescribed by physicians of all
schools.

Indigestion, Dyspepsia, Eto. Acid Phosphate promotes digestion without
injury, and thereby relieves those diseases caused by indigestion of the food.

Nervousness, Exhaustion, Etc. Acid Phosphate supplies the waste of
phosphates caused by every mental and physical exertion, imparting new
energy, increasing the intellectual and physical power, aud is an agreeable and
teneficial food and tonic for the brain and nerves.

Headache. Acid Phosphate, by its action on the digestion, and as a
nerve food, relieves the headache arising from indigestion and nervousness.

Tired Brain. Acid Phosphate acts as a brain food, increasing the capacity
for mental labor, restoring the tired brain, and imparting new energy to that
organ.

Abuse of Alcohol. Acid Phosphate is of great benefit in the prostration
consequent upon the abuse of alcohol, restoring the nerves to their normal
condition.

Weakened En 'rgy. Acid Phosphate acts as a nutrient to the cerebral
and nervous systems 'ving vigor and renewed strength where there has been
exhaustion.

Ill Effects of Tobacco. Acid Phosphate neutralizes the nicotine, thereby
relieving the immediate ill effects of tobacco.

Sleeplessness. A small dose in water, taken just before retiring, produces
the most refreshing sleep.

Seasickness. Acid Phosphate, taken regularly, materially relieves and
often prevents this dreaded disease.

Night Sweats. Acid Phosphate has commonly given speedy benefit in
night sweats, and is useful in all wasting and debilitating diseases.

A Delicious Drink is made by adding a teaspoonful of Acid Phosphate
to a tumbler of water, and sweetening to the taste. It harmonizes with such
stimulants as may be necessary to take.

FOR SALB BY AIiLi DBALIURS IN MBDICINBS.

Send for descriptive pamphlet. Prepared under the direction of Prof. K. If.
Horsford, by the Rumford Chemloal Worlu, Providence, R. I., U. S. A.* M. D.
ARNOLD, Treaaurer.

BEWMRe OF IKITATIOm.

Lfe '^2

phate.

NIC.

'«/ a preparation
loric acid, etc, in
physicians of all

tes digestion witliout
estion of the food,
ipplies the waste of
ion, imparting new
is an agreeable and

digestion, and as a
md nervousness.
:reasing the capacity
: new energy to that

fit in the prostration
ves to their normal

ient to the cerebral
here there has been

he nicotine, thereby

re retiring, produces

erially relieves and

\ speedy benefit in

seases.

of Acid Phosphate

rmonizes with such

[NES.

ictlon of Prof. B. IT.
• If U. S. Af K. D.

llf Ii*»

iVfii

V "•'