IMAGE EVALUATION TEST TARGET (MT-3) 4iJ 1.0 I.I Mi 1^ 1.8 1.25 1-4 IIIIII.6 V] <^ /i v: ^'^ -V ^M^ V *> y M iV «v Lt>' \\ i'^^ <*>. ^ <». V ^r<[» # CIHM/ICMH Microfiche Series. CIHM/ICMH Collection de microfiches. Canadian Institute for Historical Microreproductions Institut Canadian de microreproductions historiques 1980 Technical Notes / Notes techniques The institute has attempted to obtain the best original copy available for filming. Physical features of this copy which may alter any of the images in the reproduction are checked below. □ Coloured covers/ Couvertures de couleur Coloured maps/ Cartes gdographiques en couleur L'Institut a microfilm6 le meilleur exemplaire qu'il lui a dt6 possible de se procurer. 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The following diagrams illustrate the method: Les cartes ou les planches trop grandes pour dtre reproduites en un seul clich6 sont filmdes d partir de Tangle sup^rieure gauche, de gauche d droite et de haut en bas, en prenant le nombre d'images ndcessaire. Le diagramme suivant illustre la m^thode : 1 2 3 1 2 3 4 5 6 THE HUMAN VISCERA. ^\ f "AH OUNOE or PK EVEHTION 18 VO BTH A POUND 01 OU&R" THE • AMILY PHYSICIAI; OB, EVERY MAN HIS OWN DOCTOR, gin %yxt}s\ov^'i>\^ of Pt^^Wui?, , , CONTAINING KNOWLEDGE THAT WILL TOMOTE HEALTH, CURE DISEASE AND PROLONG LIFE DESCRIBING ALL DISEASES, AND TEACHING HOW TO CURE THEM BY THE SIMPLEST MEDICINES. ALSO, N ANALYSIS OF EVERYTHING RELATING TO COURTSHIP, MARRIAGE, AND THE PRODUCTION, MANAGEMENT, AND REARING OF HEALTHY FAMILIES, TOGETHER WITH 'AFTER ON THE PREPARATION OF MEDICINES, GIVING PRESCRIPTIONS AND VALUABLE RECEIPTS, FULL AND ACCURATE DIRECTIONS FOR TREATING WOUNDS, INJURIES, POISONS, ETC. COMPILED BY LEADING CANADIAN MEDICAL MEN. TH NUMEROUS EXPLANATORY ILLUSTRATIONS, AND A COMPLETE INDEX. PRICE #1.S5, ROSE PUBLISHING COMPANY, 1889. pass c , 3l. Entered according to the Act of the Parliament of Canada, in the year one thousand eight hundred and eighty-nine, by the Rose Publishing Company, at the Depart- ment of Agriculture. THE PUBLISHERS' PREFACE. Believing in the sound principle that " an ounce of prevention is worth a pound of cure," the publishers confidently present this volume to the public, in the hope it will fill a long felt want in the community. The purpose of the work is to fully inform every man and woman what are the real causes of sickness and what are the most approved methods of treatment. And moreover it is especially intended as an aid to home or domestic treatment in the thousand cases where a physician cannot readily be reached, and when, if ordinary common sense is used, his services are not required. The compilers, all leading medical men in Canada, wish this work to make an honored mark in the Dominion frjm its merits, and its method and arrangement, and, above all, from the circum- stances that it comprises all that is valuable in every other popu- lar medical guide, added to many new principles and new methods — modes of cure that have been tried in every day prac- tice, and have seldom been known to fail. Toronto, June, 1889. .i t t % TABLE OF CONTENTS. ( » CHAPTER I. The Sick Room and the Nurse, - - CHAPTER II. Diseases of the Air Passages, CHAPTER III. i Diseases of the Blood and Blood Passage, ^ ' CHAPTER IV. [Diseases of the Eye and Ear, CHAPTER V. {Diseases of the Skin, CHAPTER VI. [Fevers and Other Diseases, - CHAPTER VII. )iseases of the Nervous System, - CHAPTER VIII. [Accidents, Injuries and Surgical Diseased CHAPTER IX. [Diseases of the Urinary and Genital Organs, PAOK I II 33 34 43 63 84 -no - 146 : \ vJfi CONTENTS. CHAPTER X. PAGE Poisons, Bites and Stings, 162 CHAPTER XI. Diseases of Women, 168 CHAPTER Xn. Diseases of Children, 202 CHAPTER Xni. Favorite Prescriptions, 238 CHAPTER XIV. Dietetic Receipts for the Sick Room, .... 268 CHAPTER XV. Medical Receipts for the Sick Room, .... 283 CHAPTER XVI. . New, Simple, and Efficient Preparations, - - . - 307 CHAPTER XVII. General Op.servations Regarding the Youth of Both Sexes, AND THE Duty of Parents and Guardians, • - - 314 Weights and Measures, - * - - - ... 336 Index 339 il( THE FAMILY PHYSICIAN. I=>^I^T I. CHAPTER I, THE SICK ROOM AND THE NURSE. Choice of the Sick Room — Its furniture — Air and ventilation — HintH in re^'ard to its warmth— How it shoiih^ liortment of those nursin;,' the sick Personal atttnitionti required by the sick — Man- agement of those recovering from kickness— Household remedies— Family ther- mometry. , Choice of the Sick Room. The room in which a person is con- fincLi to bed with a serious and protracted ailment should be large, lofty, ai;d well ventilated ; the window sashes ought to lower from the top as well as rai^e from below, and work with as little noise as possible. VValls painted in oil are belter than those in plaster or paper. The door must, 1)0 noiseless, witli a ventilator over it or made in one of the panels. A painted or polished tloor is better than a carpeteci one. It sliould be [swept, or at the most lightly wiped, but not Irequt.-ntly washed, as the slow evaporation Irom the wet boards renders the room injuriously Idamp. The room should be a li:;lit one, CNj)oscd to the direct rays of the I morning and mid-day sun. lilinds and shades should be piovided, for jnioditying the light when desirable. Warmth of the Sick Room. As we have said, a thermometer I should always be in the invalid's room, and by it the temperature umst he regulated. The best temperature is that of 60'. If, however, the [patient leels chilly at this temi)erature, it may be raised three or four de- grees. In fevers and diseases of the nervous system a lower temperature is preferable, about 50" ; while in consumption and other affections of [the chest an atmosphe-e of 65" is the most agreeable to the inflamed air- passages. ^ ' < 1^^ It: f if r ?: I ; L 1 F i m 2 THE FAMILY PTIYSTCTAN. In the early morning hours a sick person is apt to be chilly, which is just the time when the room is usually the coolest — a fact that must be borne in mind, and precautions taken, lest the patient suffer serious in- jury from this cause. A low-down grate is much the best way of warming the sick room. Furniture of the Sick Room. All unnecessary furniture must be banished from the room. There is no need of any wardrobe, bureau, trunks, or bandboxes. Two tables, at least, are wanted ; one of them should be small, and on casters, so as to roll easily to the side of the bed, for the immediate use of the j)atient ; the other, a larger f)ne, for the re- ception of medicine bottles, s])are glasses, cui)s, sj)oons, and other articles in constant use. In the drawer of the latter tal ' ' there should be con- stantly kept a sponge, a bundle of soft old linen, i)air of large, and an- other of small scissors, a full pin-cushion, needles and thread, a piece of adhesive plaster, and oiled silk ior covering poultices. A third table, if there be room for it, is useful as a dressing tal)le, on which to place the brush, comb, and other toilet articles. Over it a looking-glass may be hung, but never in such a position as to permit of the invalid seeing himself in it as he lies in bed. A movable washstaiid, on casters, so ihat it can be readily shoved to the side of the bed,, is very useful. An ample supply of clean towels should be constantly on hand. There ought not to be more than three chairs^ of which one should, if possible, be an easy or reclining chair. A lounge or sofa is of great utility, partic- ularly during recovery, when the sitting posture cannot be long main- tained ; it is of service, also, for the patient to recline upon, when his strength permits, while his bed is being made. The bedstead should not be too wide. A greater width than three and a half feet renders it often difficult to reach and move the patient. Two bedsteads are much better than one. Each should be provided with its own sheets and cover. The patient passing hah' the lime in one, permits the entire bedding of the other to be thoroughly aired out of the room, a very import- ant measure in prolonged illness. The bedstead must be low, so as to permit of the patient getting in and out easily, and of his being lifted and moved with facility. Iron bedsteads are much to be preferred to wooden ones. The bed should be without curtains, and l)laced with its head to the wall, so as to admit of access on each side. It is best placed between two windows, or at the side of a window. The bed dotJmigxiWx^'i be light. Heavy cotton counterpanes and Marseilles coverlets must be discarded from the sick bed, and only good light blan- kets employed. The pillow-cases and sheets are better of cotton than of linen, and should be frequently changed ; daily, in the case of infectious fevers. The pillows must be firm and elastic, and arranged so as to sup- port the back, and not piled up in such a manner as to thrust the head forward upon the chest, and so increase the difficulty of breathing. The bed should be level and not too hard. Curtains and heavy drapery of THE SICK ROOM AND THE NliRSE. all descriptions arc objectionable in a sick room, as they harbor dust and contat^ious matter. Besides these main piece- of furniture, there are a number of articles of use in every sick room. Among these we may mention the loUowing, vi/.. : a tJicrtiioiucter (one so constructed that it can be put in water to get the heat of a bath) should hang on the wall, at the height of the bed ; a foot warDier^ which may be made of a com- mon bottle filled with hot water, or of a rubber bottle or cushion, or an earthenware bottle sold for the purpose, should be at hand when wanted ; a stomach 7vannc>\ made of an India-rubber bottle or bag filled with hot water, IS often of use ; air and water ciishwfis, or a cushion in the shape of a ring, filled with bran, are serviceable in warding off pressure from prominent parts, giving support, etc. ; a pillow rest^ made of a bag of ihe same width, but twice the lei'^gth, of a pillow-case, stuffed with hay, straw, or oat-chaff, in such a manner as to make it taper down like a wtitin:; desk, from back to front, is an excellent thing for propping up jjillows ; a cradle, to support the bed-clothes, and jjrevent them pressing u[)on a painlul part, is useful in many ailments ; foldiii}:^ rests for the /eji^% made in the shape of an open book, and covered by a blanket, give com- fort to the weary limbs ; a medicine glass, marked so as to measure ex- actly a tcaspoonful, a desertspoonlul, and a tablespoonlul, enables medi- cine to be given with much greater exactitude than can be done with sjx-ons, which vary in size; a medicine spoon, which can be obtained at most druggists', permits of medicines being administered to very weak and partially unconscious patients, as it is covered, and has an opening near the end, so as to avoid all spilling: Si feeder, consisting of a half- I covered vessel furnished with a spout, for giving soups, teas, and other [duids, is c;onvenient lor administering drinks to ihe patient when lying jin bed ; a bed-side pocket, to be pinned at the side of the bed, makes a convenient place for keeping the pocket-handkerchief, a bottle cf scent, etc., within the reach of the invalid; ^ sich. tray, consisting of a board hollowed out in front to fit the body, and supported on four short legs, to he 1 (laced on the bed before the patient, is olten much more convcn- jient than an ordinary waiter on the knees or a table at the side [of the bed ; a bed-chair is often of service ; a bed-pan, or siipper, is necessary lor those too weak to rise from the bed ; two baskets, with di- vibions or compartments, are useful for medicine bottles, one containing (medicines for internal use, the other, of another color and form, contain- jing external applications ; and two baskets for cups and dishes, one for ■those needing washing, which are to be t^uickly sent out of the room and joxchanged lor the other basket with its clean ware. The following ar- jiicles must not be kept in the sick room, viz. : dirty linen, implements of jcooking, prepared food, medicines discontinued by the physician, soiled jcups or glasses, slop basins or pails. Air of the Sick Room- Fortunately the prejudice against admitt- ling hesh, pure air into the chambers of the sick, particularly of fever I, THE FAMILY PHYSICIAN. patients, is to a great extent a thing of the past. The custom of almost hermeticilly sealing the rooms of patients in fever was very prevalent among nearly all classes, some forty or fifty years ago. ]3r. James Gregory, of Fxlinburgh, the celebrated professor of medicine, used to mention in his lectures, that as no argument was of avail in procuring the admission of fresh air into the sick rooms of the poor, he generally pushed his cane through the panes of the windows. This, however, was not always ade- quate to insure the intended effect, as he often lound the broken panes pasted over with paper on his next visit. No such forcible measures are now, usually, re(iuired. People generally err from carelessness rather than ignorance or prejudice, as few can be unaware of the fact, the sub- ject having been so widely discussed, that foul air is poisonous for sick and well. In many cases, it is useful, once or twice a day, to cover the patient well in bed and protect him from drafts, and then open wide all the doors and windows, so as to wash out the room with fresh air. An excellent test for foul air is the nose ; pure air is tasteless nnd tree from all smell. The air of the room should never be permitted to become too dry, as is the tendency in heated rooms in winter. A basin of boiling water occasionally brought into the room, and replaced by another when it becomes cold, will usually give sufficient moisture. A constant supply of pure air is important lor others in the sick cham- ber as well as lor the patient, as it lessens their '■'...: ^ of contracting the disease. Tiie confuiement of a contagious [ ■!!.'' in a close room increases its force ; the more poisonous emauationi .e diluted by ad- mixture with Iresh air the less dangerous they bee i. Hence certain diseases are more u-eciucntly jiropagated in v.-inter, en doors and win- dows are kept shut, than in summer, when the outside air is freely ad- mitted. While keeping the air that the sick breathe fresh and pure, by ventila- tion, care must be taken not to chill the patient. There is little danger, however, with ordinary i)recautions, of taking cold when lying in bed. Sick people usually catch their colds by rising lor a moment Irom a warm bed without throwing any wrap around them, or by sitting up in bed without a covering over the shoulders. Of course, no air is pure which contains smoke from a badly made fire, or from the chimney of an oil lamp. Not only smoke, but gas, fre- quently escapes Irom a stove, and proves a source of trouble to the sick, particularly those affected with chest ailments. Of all the sources of contamination of the air of the sick chamber, one of the worst is the chamber utensil. On this subject, Florence NiGHT- INCALE, v/ith her usual good sense and thoroughness writes : "The use of any chamber utensil witlumt a //^/should be utterly abolished, whether among sick or well. You can easily convince yourself of the necessity of this absolute rule, by taking one w.'th a lid, and examining the under THE SICK ROOM AND THE NURSE. 5 side of that lid. It will be found always covered, whenever the utensil is not empty, by condensed offensive moisture. Where does that go when there is no lid? But never, never should the possession of this indispensable lid confirm you in the abominable practice of letting the chamber utensil remain in a patient's room unetnpticd, except once in twenty-four hours. Yes, impossil)le as it may appear, 1 have known the [Ijest raid most attentive nurses guilty of this. Earthenware, or if there is any wood, highly polished and varnished wood, are the only materials i'lt for patient's utensils. A slop pail should never be brought into a sick room. It should be a rule invariable, that the utensil should be carried directly to the water-closet, emptied there, rinsed there, and brought i)ack. There should always be water and a cock in every water-closet for rinsing. But even if there is not, you must carry water there to rinse with. I have actually seen, in the private sick room, the utensils emptied into the loot pan and put back under the bed. I can haidly say which is most abominable, whether to do this or rinse the utensil in the sick room. In the best hospitals, it is now a rule that no slop-pail shall eves be brought into the wards, but that the utensils shall be carried direct, to be emptied and rinsed at the proper place. I would it were so in the private house." In typhoid fever, dysentery, and other sinu'Iar affections in which the infectious principle ol the disease resides in the discharges, the chamber utensil, so soon as it is cleaned, which should be at once after use, should have poured into it about half a tumblerful of a strong solution of sul- I)hate of iron, kept on hand for the puriiose in a large bottle or jug, and made by dissolving a pound of copperas in a gallon of water. Directly atier ihe vessel is used, and before its contents are emptied, about a tumblerful of the same solution should be poured in, to destroy the fetor [ and lessen the liability of infection. Light of the Sick Room. The sick require plenty of light as well as an abundance of air. It is only in the beginning and violent stages of certain diseases, and in some nervous affections, that it is advisable to partially darken the room. "^ '-■ ' It is a fact in regard to which there can be no doubt, that the sick dc better and recover more quickly in a sunlit room, than in one into which the rays cannot enter, or from which they are always excluded. An agreeable view from the window is also desirable, especially during con- valescence, to relieve the tired eye, and gratify the craving, nearly always experienced, for looking out of the window. The night light must be so placed as not to throw a shadow on the [ceiling over the patient, or on the wall in front of him. Shadows of things or persons in the room olten assume, to the fearful gaze of the weakened patient, forms of terror, and may excite delirimn or even con- vulsions. If oil be burned, care must be taken that the lamp does not smoke nor smell ; if gvis, that the gas does not escape. I HfiBbABiMaiiaaHCBra \ i 6 • ■ THE* FAMILY PHYSICIAN. Cleanliness of the Sick Room. Cleanliness and order are im- portant in the chamber in which the sick lie, but the dust and noise made in sweeping and arranging the room are frequently a source of great annoyance to the silent sufferer. As after a night's rest the patient is best able to bear a little bustle, the morning should be selected for putting the room to rights. If there be a carpet on the floor, it is to be sprinkled with moist tea-leaves before being lightly swept with a hand- brush and dust-jian. The furniture, the bed and bedding, the floor and walls, and every ar- ticle in the sick room, should be always clean. No vessel or implement used by the patient should be suffered to remain in the apartment, but be at once taken out, to be returned as soon as cleaned. Every glass, cup or plate in which food is administered, must be taken immediately out of the room and washed. Neither ought any glass or spoon in which medicine is eiven be suffered to remain with the small portion which is always left in it ; it must be instantly and well cleansed. Duties and Deportment of those Nursing the Sick. Those women make the best nurses for the sick w^ho are between the ages of twenty-five and fifty-five, active and vigorous, in good health, of hajipy, cheerful disposition, with kind feelings, and a temper not easily ruffled, and of orderly, clean and neat habits. The nurse should cook nothing in the sick room ; move about with- out noise, fidget, hurry or bustle ; keep the room in order, sweet and clean; take out of the. room instantly all evacuations of the patient, slops, soiled linen and wet towels ; avoid eating anything that gives a bad smell to the breath ; order food so as to have it ready promptly at the time for giving it ; observe minutely the orders received for admin- istering food and medicine ; see that the patient's mouth and nostrils remain uncovered during sleep : never express a doubt in regard to the propriety or efficacy of the treatment employed ; always look confidently for recovery; make no comparisons with other cases ; say nothing to dis- courage or alarm the invalid ; never whisper ; give no prohibited food, and permit of no forbidden indulgencies ; see that there is a supply of fresh air, and that the patient is kept out of all drafts ; [)reserve a proper uniform temperature by means of the thermometer. She should also keep in writing, jotting down at the moment, the ex- act time, by the watch, of all the imijortant events in the day, such as the taking of food and medicine, the coming on of sleep, or delirium, or restlessness, the dejections of the patient, any remarkable change in the symptoms, and other matters of interest bearing upon the progress of the ailment and the condition of the patient. Fortunate is he who has a j wife, daughter, mother or sister who can fulfil these recjuirements ; and| sensible is the woman who tries to fit herself, by thought, reading and observation, to take care in a proper manner of those dear to her, in their | hours of pain and weakness, under the shadow of death. THE SICK ROOM AND THE NURSE. 7 The dress of the attendant on the sick is dtjserving of attention. It should be neat and clean, of a soft, warm color, and of a material which will wash. Black is always nasty to the delicate sense of smell of the sick. A dress that rustles must never be worn in the sick room. Creak- ing shoes or slippers are of course ini[)roper. In many cases of illness, [)articularly if the room be not carpeted, it is well to have a pair of large loose slippers outside the door, to be slipped on over their shoes by those entering, not excepting the doctor. Personal Attention Required by the Sick. When there is a tendency, which exists in many diseases, to coolness of the surface of the body, heat should be kept up by means of hot water bottles, warm bricks, or tin cans filled with hot water, etc., applied externally. The skin of the patient must be kept clean by sponging with tepid water, to which a little whiskey or vinegar may be added. Care must be taken while thus cleansing the skin not to expose i'h- person to a draft, and not to uncover the body more than is necessary at one time. This sponging of the entire person may be repeated, in most cases with ad- vantage, every day. In any event, the feet at least twice a week. Re- covery is retarded in cases in which the disease is assisted by the pres- ence of dirt. The bed should be tidied and put straight every day, and the sheet upon which the patient lies should be kept smooth and free from crumbs. • The boily linen must be changed at least once a week, in most cases oftener. The following rules in regard to changing are useful : — 1. Do not begin to change until all that is likely to be needed is ready. 2. See that there is no draft from an open window or door. 3. Have the fresh linen well aired and warmed beforehand. 4. Avoid moving or uncovering the patient more than is absolutely necessary. 5. Do not call upon the patient for too much help. Delirious patients must, of course, never be roughly dealt with, neither must they be argued with or contradicted in their assertions. It is best to appear interested in their conversation, while watching over and con- trolling with gentleness but firmness all their actions likely to do them injury. Such patients should never be left alone, nor should one person be in attendance without being able to call for immediate assistance at a moment's notice. For rules in regard to cooking for the sick, and for special receipts for the invalid's table, see Chapter IX, commencing on page 320. For directions in regard to giving baths, and applying blisters, cups, leeches, poultices, etc., see Chapter X, page 332. Management of those Recovering from sickness. Quiet and rest are essential ia every recovery from sickness. The mind as well as s THE FAMILY PHYSICIAN. the body demands repose after suffering. Any prolonged or violent ex- ertion or mental excitement is, for a long time alter recovery has set in, injurious, and may occasion a relapse. After every illness, as soon as the invalid becomes strong enough, a change of air and scene are of the uip.k st service, 'i'o those living in the city, a visit to the country is specially useful. 'J'he sick must not, how- ever, be de|)rived of home care and comforts too soon. A journey, how- ever short, is al\va)s f;itiguing to the feeble, and a removal to a new abode, always a source of cxcilemcnt and some discomfort to those not long from a bed of sickness When the proper time arrives, the return of health is greatly lacilitatcd by a judicious change of residence for a while. Household Remedies. The articles which are used to restore the sick to health are olten and conveniently divided into " household reme- dies " and " drugs." JJy the former, those articles are understood which are found in every grocery store and household, which arc bought and kept for use in health, but possess medical properties, sometimes very valuable ones. Such, for example, are salt, mustard, vinegar, oil, spices, ginger, etc. An ac([uaintance with their virtues as medicines, and their proper use in curing disease, is an acqui<;ition which every one ought to make. Often such simple articles answer the ])urpose much better, with more promptness, and at less cost, than the more unknown products of the apothecary shop. In the latter, the numerous bottles and drawers, with their labels in large letters, presenting strange words and mysterious abbreviations, be- wilder the ordinary visitor. He is deeply impressed with the difficulties in the study of physic ; and the danger of meddling with what he knows is often j)oisonous is present to his mind. These sentiments are just, for many of these drugs are dangerous, others are rare and cost'y, others difficult to pre{)are and administer. It is not wise for any one who has not seriously studied medicine to tamper with them, and hence, in such a manual of domestic practice as this, it would be inexcusable to recom- mend them. Fortunately, it is not necessary. Although there are so many hundred drugs in every pharmacy, their multiijlication is a matter of trade rather than necessity. The most learned and successful physicians do not use very many remedies. Probably the essential parts of a hundred pre- scriptions from their hands would, in ninety cases, be found in less than ten different drugs. We propose, in this work, to take advantage of the same principle of selection, and shall make the reader familiar with a limited number of drugs of wide application, and which have the further advantages of be- ing not costly, not dangerous, and of decided virtues. They can be used in many different complaints, and in the forms which we shall recom- mend are peculiarly suitable for those to use who have not studied the THE SICK ROOM AND THE NURSE. 9 details of the druggist's trade ?.nd physician's calling. They will be often referred to, and when they are once provided in the family, we shall en- deavour to render them suflicient for the treatment of nearly all ordinary diseases, supplemented, as we shall presume them to be, with those " houscliold remedies " to which we have already referred. It would be advisable, therefore, for every one who intends to made practical use of this book to obtain these remedies, a list of which we shall presently give. They should be carefully put up and kcj)t in a locked chest or box, where children cannot get at them. All the articles can be had of any druggist, though, as some of them are often adulter- atcJ, and others s{)oil if kept too long, care should be exercised in their purchase and preservation. Sometimes, when several drugs are mingled, they act differently and more successfully than either of them (c> any other substance) when taken alone. This is why, in most i)rescri|.>tions or reci{)cs, one sees three or four or more articles mentioned. Another advantage, and a very great one in children and delicate persons, is that it gives the chance to conceal the taste of a disagreeable drug, and olten to render it quite palatable. Many of these firms keep on hand medicine chests containing a select assortment of such drugs as arc most conmionly used l)y emigrants, mis- sionaries, shipca])tains, and others remote from apothecary stores. The number of these offers a wide choice, as not all are selected with reference to the great jirinciples which should govern the selection of medical agents for po[)ular use, which we take to be (i), that they are j efficient ; (2) that they are not dangerous ; (3) that they do not readily isjjoil by time and change of temperature ; (4) that they are not distress- lingly unpalatable ; (5) that they are not too bulky ; (6) that they are not very cosdy. Of the " family medical chests" which have come under notice, we like, as well as any, and in some respects better than any, that which has been sold by the "Medical Commission Agency," in Phila- delphia (115 South Seventh Street). It is called die "Traveller's Medi- cal Kit," and having been carefully selected with a view to the above re- quirements, may serve as a sample of them. Its contents have been more or less changed, from time to time, as imi)rovements in the manu- Ifacture of drugs seemed to suggest. Lists can be obtained from the [Agency, giving their prices and contents. At the end of this work a number of selected receipts will be given [whi1.1i will answer the above requirements, and which will be freely re- ferred to under the treatment of diseases. Any of these can be obtained jfrom the apothecary store, and if used according to directions, will [answer a good i)uri)ose. A number of them might be prepared and [kept on hand ready for use. Others, which will be spoken of, are the [following : — lo THE FAMILY PltYSIClAN. Ammonia, or Hartshorn. The i)rci)arnlions of ammonia which will be relened lo are, liisL, the "aronuUic s[)irits of ammonia,' a valu- at)le sliinulant, serving in place of alcoholic lluids. 'J'he dose of it, for an adult, is twenty drops, in a tablespoonful of water, repeated when necessary. Se "ond, the solution of the acetate of ammonia. A table- spoonful of this, in a wineglass of water, is the ([uantity for an adult, ll acts nn the skin and kidney, and is very cooling in levers, and similar conditions. Bromides. These are the bromide of potassium or of sodium. I'hey are given to allay pain and nervousness, in doses of 20 or 30 grams. Iodine. Tincture of Iodine, which is iodine dissolved in alcohol, is frecpiently used as an external .'i[)[)lication, to cause gentle counter-irrita- tion, and remove swollen glands, chilblains, stiffness of joints, slow rheu- matism, etc. The iodide, of pot.issiiDii^ dose ten grains, and syup of ioiiide of ifo/i^ '.lo^c half a teas]j(ionlul, are very valuable "alteratives," that is, they "alter " the general conditions o\ the body. Opium, one grain of which is an adult's dose, is generally given as laudanuiii^ which is opium dissolved in alcohol, one grain in twenty drops ; or morpltia^ which is a chemical extract of oi)ium, one quarter of a grain of which equals one grain of opium ; or J)an\qoric^ which contains one grain of opium to an ounce ; or as Dover^s po7vder^ which has one grain of opium in each ten. All these must be used with caution. A Tiiermometer is useful, not only to maintain the air of a sick room at a proper temi)eraturc, and to test the heat of warm baths, foot laths, and the like, but in the hands of a judicious ) crson, is a great aid in deciding the severity of a case cf disease, by ascertaining the tempera- ture of the patient. For this purpose, the instrument is so made that its bulb can be placed under the tongue or in the arm-pit. Hold it there three or four minutes, and you have the temj ature of the skin and blood of the patient. This should not be above 99", nor below 97*^. Any material variation from these limits indicates danger, although the symptoms in other res{iects do not api)ear threatening. " Family 'I'liermo- meters " have been devised, with a zero, showing the animal heat in health, so that any deviation from it is perceptible by the most inexperi- enced hand. » iiionia which unia,' a valu- *"i'/. •> V 1 ,*•■ CHAPTER II. DISEASES OF THE AIK I'ASSAGli". Cold in the I lead— Catarrh of the Throat— nronchitis—Diphtluria — AsJiiiui — rk-urisy — Inllamiiiation of the Lungs — Consinnptioii — Inlhicii/ca— (Jiiiiisy — Ulcerated Sore'l'hroat. Cold in the Head. Symptoms.- — ^The patient's eyes and nose lun freely ; at first, however, the eyes are suffused and watery, but the nose dry, swollen rnd irrital)le ; the air will not readily pass through it, the smell is lost, and constant efforts arc involuntarily made to clear the passage. Sneezing occurs on every access of cold air. The distress ex- tends up to the forehead — there are pain, headache, rhiJlness and slight fever. As Hie cold seems to break, a free, watery discharge commences to flow from the nose, which may be enormous in (quantity. H(nv Treated.'— 'Yhc attack is generally readily broken up by a mus- tard foot bath, warm drinks and ten grains of Dover's powder at bed time. When the fever is high, the solution of the acetate of ammonia, two tablespoonfuls in a tumbler of water at bed-time will usually relieve this symptom. Many persons abort such an attack l)y one large dose of quinine, or by a hot lemonade at bed-time and sweating it off. Catarrh of the Throat. By catarrh we understand an injiamnia- tion ; the blood vessels of the part mcrease in size, there is an increas- ed flow of liquid and sooner or later there is a casting off of some part of the membrane itself, causing a thick ropy discharge. This is the history of catarrh, no matter where it appears — that is, no matter what mucous membrane be affected. The liability to catarrh varies extremely among different persons ; a slight exposure to cold, or rapid transition from one temperature to another, is quite sufficient to excite a catarrhal inflamma- tion somewhere in many individuals, while other persons exi)osed to the same influences suffer from no such inconvenience. Then, too, among those who are liable to catarrh there is considerable diversity as to the part most easily affected ; in some exposure to cold is followed by dis- charge from the nose ; in others bronchitis and cough occur ; while still others are apt to suffer from inflammation of the lungs or of the kidneys. All these things may result from "taking cold," though the catarrh in- flammation more frequently affects the mucous membranes situated near- est the surface, among them that of the larynx. We may say in general that poorly nourished people are more prone to a catarrh as a result of exposure to cold than healthy and robust individuals ; and those who are constantly exposed to the weather in the performance of their usual avocations are less easily affected than those whose pursuits are scdcn- II f(l ■iMaaiittMiMiM 12 THE FAMILY PHYSICIAN. tary. Another factor is important in determining the liability to catarrh ; namely, that after re[)eatcd attacks a mucous membrane becomes more readily affected ; it is a weak spot, and yields most readily to any influ- ences tending to derange the individual's health. Among the causes ot catarrh arc the breathing of very cold air or dust ; excessive eff^>rts al singing, shouting, screaming and violent coughing. JUit, in addition, agents which do not affect the throat direcily, may also cause a catarrh of this organ ; thus, chilHng of the skin, especially that of the feet, is frecpiently the direct cause ot the catarrh. Beside these various causes which may induce a catarrh in any indi- vidual, there are certain other factors which frequently induce the dis- ease. Some very obstinate cases of catarrh are due to constitutional taints, such as syphilis ; and fmally there are numerous instances of the disease in which ihe cause is to be found in the growth ot a tumor in the throat. Symptoms. — Acute catarrh docs not usually cause serious constitutional symptoms ; though in some instances siight shiverings mark the outset, and some lever accompanies the disease The patient complains of a sensation in the throat, which he describes usually as tickling, or in more severe cases, as burning or soreness; this sensation is aggravated by coughing or speaking. At the same time the voice is changed in char- acter, grows dee])er, lioarsc, perha[)s cracked, and fmally may be lost al- together. This change in lhe»voi;-e indicates that the mucous niembnine covering the vocal chords is in a slate of intlammation (w calarrh. An- other constant sym])iom is a violent cough, due to the irnialion in the inilamed mucous membrane. Treatmc it. — Since the acute attnck usually subsides spontaneously within a week, treatment with medicines is usually unnecessary. It will suffice to direct the patient to remain so far as possible in a uniform tem- perature, and not expose himself to sudden changes of atmosphere ; he should avoid the effort tojtalk, so far as possible, and should especially resist the inclination to cough. He will of cou se say that he can't help it, but he timst help it. The irritation of the throat, and hence the ten- dency to cough, can be much diminished by one of the following pres- ' criptions : Hydrocyanic acid (dilute), - Sulphate of morphia, - - . - Syrup of tolu, - . . . . Water, Mix and take a teaspoonful every two hours. Or relief may be obtained from the following : Syrup of wild cherry, - - - - Syrup of squills, - . . . Camphor water, . - . . Mix and take a teaspoonful every two hours. H.ilf a drachm. Haifa grain. One ounce. One ounce. One ounce. One ounce. One ounce. DISEASES OF THE AIR PASSAGES. 13 Should the disease become chronic the throat should be gargled thor- oughly twice daily with a solution of salt and water (2 or 3 teaspoonfuls to the pint) and the patient should take besides the following mixture highly recommended by the famous Dr. Da Costa : Acetate of potash ... - One ounce. Muriated tincture of iron ... One ounce. Dilute acetic acid . . . . One-half ounce. Simple elixir . . . . . One ounce. Water to make six ounces. Take a teaspoonful four times a day. Bronchitis. This is an inflammation affecting the lining membrane of the bronchial tubes — that is the tubes which form the continuation of the windpipe. Symptoms. — Acute inflammation of the bronchial tube usually be- gins with a cold in the head ; that is, a catarrh of the nose. Thence it extends down the throat and larynx to the bronchial tubes. Thus a variahle period, from a few hours to two or three days, may elapse from the beginning of the catarrh in the nasal passages to the establishment of the bronchitis. The inflam.mation in the bronchial tubes begins with a sense of tightness across the chest, accompanied with a feeling of raw- ness or soreness. These sensations are aggravated by every act of coughing ; there is at the same time a certain amount of fever, usually slight. The constitutional disturbance may be so considerable as to prevent the patient from attending to his usual vocation, or may be almost imperceptible. The cough is at first dry, but very little mucus being ex- pectorated. During, and especially at the end of, each act of coughing a painful sensation is felt under the breast bone ; this is also the case upon breatliing cold air, or upon drawing a long breath. After some days the cough becomes '* looser ; *' the expectoration be- comes easier, more profuse and less painful ; the matter expectorated be- ing frothy, viscid, and often streaked with blood. After three or four days it becomes thick and yellow, or green. ]3y this time most of the disagreeable symptoms have si .bsided ; the patient is troubled by no other sym[)loms than the necessity for frequent, sometimes violent, coughing. The usual duration of the attack is twelve to fourteen days, though this period is often prolonged by carelessness or neglect on the part of the patient. Treat Dmit. — It is often possible to cut short a " cold on the chest " within twenty-four hours, by takmg, at bed-time, a hot foot-bath, a glass of hot tocldy or lemuiiade, and ten grains of Dover's powder. This at- tempt will, however, be unsuccessful unless made after the first indica- tion that the individual has taken cold — that is, before the sense of tightness in the chest occurs. If this measure be omitted, a brisk saline cathartic, such as the citrate of magnesia, should be given. The pain 14 THE FAMILY PITYSICIAN. and soreness in the chest will be relieved by a light mustard-plaster over the breast-bone ; the cough may be " loosened" by taking a half-spoon- ful of the compound syrup of sciuills every two hours. If this remedy l)rovoke nausea, it may be replaced by the following : ' Tartar etnetic, - - - Two grains. Syrup of wild cherry, - Water, . . . - I^arh three ounces. Mix ; take a teaspoonful every two hours. So soon a« expectoration becomes easier, the removal of the mucus from the bronchial tubes may be promoted by giving a quarter of a teaspoonful of th.e syrup of ipecac every hour ; or, if the cough be some- what violent, the following prescription : Nitrate of potash, - - Two drachms. Syrup of scpiills, - - Two ounces, 'i'incturc of digitalis, - • Half a drachm. Sugar, .... (lum arable, - - - Each two drachms. ' Water enough to make six ounces. A teasjDoonful of this may be put in a wincglasslul of water and sipped every ttn or filteen minutes. Should the disease become chronic, croton oil, tmcture of iodine, plas ters of hemlock or pitch may be ap])lied lo the chest, while tonics, stimulating expectorants and alteratives are used. In these cases, pure fresh air is valuable, and can do no harm, though this is generally pro hibitcd, lest they should take fresh cold. Jiow rnvcuu'd.— Coki in the chest may be prevented by keeping the chest and arms well protected in cold weather, and the feet from damp- ness. Cod-liver oil and syrup of the iodide of iron ( ontinued fora long lime will strengthen the system of one predisposed to this affection, and secure immunity from repeated attacks. Diphtheria. Symptoms. — Prior to the appearance of the peculiar symptoms of the disease, there are languor, uneasiness, sore throat, and swelling of the glands of the ihroat. Fever sets in, headache, etc., and difficulty of swallowing. Exa/iiining the throat shows the parts swollen, red and purple, followed, in a day or two, by a coating of dirty or yellow white, like wc buckskin. At the end of eight or nine days, this begins to loosen, cleans off, and recovery commences. In the severe cases, all these symptoms are aggravated ; in children, the membrane causes a croupy cough, and the most energetic efforts to obtain breath, the patient becoming livid, and evidently strangling. In what is known as the ma- lignant form, the first onset is with intense pain in the headj high fever, nausea and vomit-ing, nnd even bleeding from the mucous surfaces. The coating is very dark, ash-colored, leathery, and exhales an offensive odor. Prostration rapidly ensues, followed by stupor and death. DISEASES OF THE AIR PASSAGES. 15 Tteatmcnt. — Dr. A. Ikondcl writes, in the Bulktin Ghural dc T/u'ra- \ peuli(/ lie oi "^ovcxwhcx 15th, 1886, concernint,' the treatment of di|)iitheria by i)enzoate of sodium, and asserts that of two hundred conseeutive cases he has not lost a single one. He admits tiie possibility of a mis- token diagnosis in some instances, hut even excluding f''"*-v per cent, on this account he has still one hundred cases without a deatii. His method is as follows : Every hour the jjatient takes a teaspoonful of a solution of hcn/oate of sodium, fifteen grains to the ounce, and at the same time one sixth of a grain of sulphide of calcium in syrup or granule. In ad- dition to this the throat is thoroughly sprayed every hall-hour with a ten percent, solution of ben/.oate of sodium. Tins is done religiously at the regular intervals, day and night, but no other local treatment is employ- ed : no attempt is made to dislodge the lalse membrane, and no i)encil- ling nor painting of the fauces is resorted to Nourishment consists of beef-juice, tender rare meat, milk, etc., but bread and all other articles which may cause irritation of the throat are forbidden The sick room is kei>t filled with steam from a vessel containing carbolic acid, turpen- tine and oil of eucalyptus in water. Asthma. Asthma occurs in paroxysms, at irregular intervals. The paroxysm seems to be brought on both by certain conditions of the patient himself and by certain conditions of the atmos[)here. The attack may begin witliout warning, though those individuals who have long sufrered from the disease can usually predict some hours in advance the approach of the paroxysm. The attack may come on slowly, recpiiring, that is, two or three hours for its development ; or it may attain its full intensity in a few minutes. The paroxysm usually occurs at night, or early in the morning. Treat )uc)it. — The treatment of asthma consists of two parts : The management of the patient during the paroxysms, and the treatment during the intervals After he has been j^laced in a large airy room, one of the quickest remedies to afford him relief is stramonium taken in the sha])e of cigarettes, cr the leaves muy be burned and the smoke inhaled. If no stramonium leaves can be ohtu'ned, the same effect may be pro- duced by tobacco leaves or cigars, though this means is lar less reliable. Next to stramonium in efficacy is the nitrate of potassium or nittc. I'ieces of paper which have been soaked in a solution of nitre may be burned, and the smoke inhaled ; or, if preferred, they may be made into cigar- ette? and smoked. A remedy that may be easily procured and always used without dan- ger is the following : — . , ' Tinct. of Lobelia, ■- - - - " - i oz. Iodide of Ammonia, - - - - - 2 dr. Bromide of Ammonia, . - . - 3 dr. Syrup of Tolu, - - - - - - 3 oz. A teaspoonful every one, two, three, f)r four hours. JJr. Roberts Bartholow. i6 THE FAMILY niYSICIAN. :; t Of this prescription Dr. Bartliolow says, " It gives relief in a few minutes." In the intervals, keep the system in good order, build up, if necessary ; give bromide of potassium, in (juite full doses, say filtcen to thirty grains, three times a day, for many wci-ks. Where practicable, change ot climate is, perhaps, the surest remedy, and olten relieves permanently. Pleurisy. By this wc mean an inflammation of the membrane, lining the inner chest wall and covering the lungs. Symptoms. — First a chill some time after exposure, then a sharp pain in the chest, with fever and a short cough, ^\'hcn fluid begins to collect in the chest the pain diminishes, but the difficulty of breathing increases. Tre \tinent. — Ivarly in the disea-ie, restrain the inllammnlion and lessen the pain by lo grains of Dover's ^)owder, repeated if necessary in 4 or 5 hours. \Vhen the fluid has collected the following is an excellent remedy : ^^ Powdered S([uills, - - Powdered Digitalis, - - Each 30 grains, lilue Mass, - - - - 20 grains. Mix and divide into 30 pills ; take one three times a day. The side may be painted with iodine and a linseed poultice applied or a Spanish fly blister may be used if necessary when the case is obsti- nate. Acute Pleurisy. At the onset of the attack : — Tincture of Aconite Root, - - - - 20 drops. Camphorated Tinct. of Opium, ... i^ ounce. Nitrous Spirits of l^'.ther, . . . _ 1/; ounce. Solution of Acetate of Ammonia. - - - 5 ounces. Mix. — A tablespoonful every three hours. /. //. Ripley. Inflammation of the Lungs. Symptoms. — It usually begins with a chill and lever, followed by a dull pain in the chest, and more or less cou;ih. 'i he spittle is mixed with blood and hence looks rusty. This rusty sjjittle is a sure sign of the disease, 'J'he height of the disease is reached about die ninth day, when, in favorable cases the patient begins to recover, l)ut if unfavorable, the change for the worse now takes place. Tfcatmcnt : — • Muriate of Ammonia, - Tartar Emetic, - . . Sulphate of Mori)hia, - Syrup of Lici^"ice, Mix. — A tea5:poonful every two hours. » i - 3 drachms. - 2 grains. - 3 grains. - 4 ounces. D)\ N. S, Davis. DISEASES OF THE AIR PASSAGES. 17 - 6 grains. - 6 grains. - 3 grains. - 30 grains. Calomel, Powdered Ipecac.,- . - . - Powdered ()[)iuni, White Sugar, --.--- Divide into six powders. Take one powder every four hours alternately with the jjreccding [>re- scription. At the same time cover the chest with emollient poultices. * Dr. N. S. J)avis. At the end of twenty-four hours he omits the powders, and if the huwcls have not been moved he gives a mild laxative. It the sym[)toms are not favorably modilied in j or 4 days, a blister is [)!aced on the side of the chest most affected. Should the pulse become soft and frec^uent, the breathing abdominal and the lips of a leaden hue. Quinine, -2 grains. Carbonate of Ammonia, 4 grains. Mix. — Take at a dose. K delirium becomes troublesome add 10 niiiiiins of chloroform to the ammonia mixture. If there is indication (jf malarial influence, (piininc may be given during the remissions. Consumption. In this disease every effort should be made to build u[) the system generally by the use of tonics, and a liberal nourishing diet I Stimulants, such as whiskey (in the form of eggnog) ipay be used, but only to a limited extent. Plenty of fresh air is of first importance. Let the patient be warmly dressed and then remain out of doors the most of the time. The fear of "catching cold" in this disease often keeps the |])ai cut in over-heated rooms, ancl thus in reality hastens the end. Cod bivcr Oil or its preparations should be taken regularly. I'eyond this, the [disagreeable symptoms of the disease should be treated as they arise. These symptoms are night-sweats, slee[)lessness, diarrhoea, bleeding from jthe lungs, and cough and pain in the chest. The iVight Su'eats of consumption may be (juite profuse and exhaust- ling, even before the later stages of the disease are reached. They are best and soonest relieved by improving the patient's strength and vigor, since the night sweats are merely indications of the general debility and exhaustion induced by the dir \n.se. It may be possible, also, to materi- lally reduce this perspiration and its ill effects, either by using some as- tringent wash externally, or a preparation of bellad'>nna as a medicine. For the former purpose, alum may be dissolved in aicohol, and the pa- tient lightly sponged with this, before retiring ; at the same time minute quantities of atropia — one one-hundredth of a grain — may be given as a Ipill, at night. Or the following mixture .,iay be given : Aromatic sulphuric acid, - . - Three v ..ohms. Sulphate of quinine, - - - - Fifteen grains. B ii ■K vntmmmmmm'uma \ I \ • I II THE FAMILY PllVSICIAN. grains. grain. grain. Water to make two ounces. Mix, and give a teaspoonful in water at night. The Pai/is in //v Chest are often so troublesome as to disturb the pa- tient's rest extremely. These can usually be relieved by the use of bella- donna i)laster applied to the painful si)ot, or friction with chloroform liniment or a light mustard plaster may also prove beneficial. I^or the Sleeplessness : — Bromide of Potash, - - - 6 drachms. ' Water to 6 ounces. Take 3 teaspoonsful at bed time with a little wine and water. Di\ Brown-Se^^uard. For the Diarrhd'a \ — ■ Kesin turpentine, - - - - Nitrate of silver, - . . . Opium, ------ Make one pill. Take when needed. This formula is used in these cases at Ivno'-ievelt Hospital with uni- form good results, the diet being milk boiled with mutton suet until it is as thick as cream. For the hieediii^:^ front the Ltut'^s :-— Acetate of lead, . _ . - 40 grains. I'owdcrcd ,1 )igitalis, - - - 20 Powdered Opium, - - . - Mix and make into 20 pills. Take one every 4 hours. Dr. Roberts Bartholouu For the Cough : — Dilute hydrocyanic acid, - - - Haifa drachm. Sulphate of morphia, - - - Half a grain. Syrup of tolu, water, - - - Ea'h one ounce. Mix, and take half r teasi)Oonful every hour. Influenza. It has lately been very much the fashion to call any kind of cold which is acconipanied by catarrhal symptoms. Influenza; but this, in nine cases out of ten, is a misnomer. The true disease sel- dom occurs, except as an epidemic, attacking many persons at once. It comes on quite suddenly. Symptoms. — Its symptoms are those of a general fever. There is great prostration of strength, generally showing loss of appetite, heat and thirst, cough and difficulty of breathing, owing to the air valves and bronchial passages being clogged with nuu^js ; there is also running at the nose and eyes, weiglit across the brow with throbbing pain and great depres- sion of spirits. The febrile symptoms do not commonly last more than fcur.or live days, sometimes but one or two, but the cough generally re- grains. 10 grains. DISEASES OF THE AIR PASSAGES. 19 in water at fs BartJwlow, mains for a considerable time, varying according to circumstances, such as exposure to cold or wet, predisposition to cough, &c. Treatment. — With the strong and healthy this is not a dangerous dis- ease, but aged or weakly persons are frequently carried off by it. In the former case but little medical treatment is reiiuired. Keep the patient in bed, and let the tem])eratureof the room be warm and ecjuable ; open the bowels with a gentle aperient, such as rhubarb and magnesia, or senna mixture, and follow this up with weak-wine whey, or some warm diUicnt drink, in a pint of which a grain of tarter emetic and a drachm of nitrate of potash has been dissolved ; give a v^^ineglasslul of this about every four hours. It is not generally safe to practice much depletion ; but where there is great difiiculty of breathing, and irritation of the throat, a few leeches may be ai)pl!cd above the breast bone, in the hol- low of the neck. Stimulating liniments r>.ay also be applied to the chest, and mustard poultices, but blisters are scarcely to be recommend- ed. Ht fomentations may also be useful, and medicated inhalations, sudi as a scruple of powdered hemlock or henbane, sprinkled in the 1 /oiling water, Irom which tr.e stream ascends into the throat. The fresh leaves of the above plants may be used, or a drachm of the tinc- ture, if these cannot be procured. When the fever is subdued, if there is still cough and restlessness, a five-grain Dover's powder may begiven at bedtime, or one-eighth of a grain of acetate of mor[)hinc. with a five-grain S([uill pill, for the cough if required. If there is great feebleness, tonics must be administered ; infusion of calumbia, cascarilla, or gentian, with carl)onate of ammonia ;oneounccof theformerwith five grains of the latter, three times a day, with a mildly nutritious diet, — broths, arrowroot, sago, and a small (pianlity of wine. Such is anoutline of the course to be taken in most cases of inlluen/a which reall)rci|uire medical treatment atall ; generally warmth, rest, and good nursing, will do all the business. Should the cough be very obstinate, and resist all efforts to remove it, change of air will generally prove effectual, and this is beneficial in most cases. Quinsy. An inflammation of the throat, principally occupying the glands. This kind of inllammatory sOre throat generally commences with cold chills, and other febrile symptoms. There is fulness, heat, and drynes.s of the throat, with a hoarse voice, difticulty of swallowing, and shooting pains towards the ear. When examined, tlie throat is full of florid red color, deeper over the tonsils, which are swollen and cover- ed with mucus. As the disease progresses, the tonsils become more and more swollen, the swallowing becomes more painful and difficult, until liciuids return through the nose, and the viscid saliva is discharged irom the mouth. Very commonly the fever increases also, and there is acute pain of the back and limbs. Causes. — Exposure to cold, wearing damp clothes, sitting in wet rooms, getting wet feet, coming out suddenly of a crowded and heated room into the open :ind cold air. It may also be brought on by violent exer- tion of the voice, and by suppressed evacutions. 20 THE FAMILY PHYSICIAN. '• ii Treatvient. — \Vlien the case is not severe, it ma)' be treated, in the early stages, like catarrh ; but, when it is, more active measures will Le retjuired. An emetic, followed by a strong purgative; a blister outsid>: the throat, and warm bran or linseed poultices ; a cooling regimen, with acid drinks, or pieces of rough ice put into the moutii and allowed to dissolve ; leeches at the side of the throat if it swells much ; inhaling the steam of hot water through a teapot or an inverted funnel ; and the con- tinuation, every four hours or so, of a saline apcrieni. These will be the proper measures to ado[)t. When the abscess has burst, and the in- llammatory symptoms have subsided, a generous diet will be necessary, with tonic medicines. If the tonsils continue swollen, they should be rubbed outside twice a day with stimulating liniments. Turpentine and opodeldoc, equal (quantities, will be as good as any ; and the throat gar- gled with salt and water, a tcaspoonful of the former put into a tumbler full of the latter. When there is chronic soreness of the throat, with hoarseness and cough, there is commonly also a relaxed and elongated uvula, which closes the passage when the patient lies down, and causes a sensation of choking. In this case, a gargle made with salt and ('ayenne pepper (about a tables])oonful of the former and a teaspooniul of the latter, in a pint of boiling water) should be tried ; the throat should be kejjt un- covered, and sponged with vinegar twice a day. If these means are un- successful, it may be necessary to have part of the uvula cut cfr. This must be done by a surgeon. Also, the a])])lication of caustic must some- times be made when the throat has a granulated a[)pearance. Ulcerated, or Putrid Sore Throat. This sort of sore throat shows itself by white specks, covering ulcers, appearing in the thioat, together with great debility, and an eruption on the skin. Cduses, — (Contagion (infection") ; from a humid state of the atmos- phere, it becomes epidemical, and will sometimes rage through families. villages, or towns ; and is also produced by similar^ causes to typhus, or malignant fevers, to which it seems akin in its nature. Syviptoms. — It commences with cold shiverings, anxiety, nausea, and vomiting, succeeded by h.eat, thirst, restlessness, and debility ; also, much oppression at the chest; the face looks flushed, the eyes are led, a stiffness is perceived in the neck, with a humid breathing, hoarseness of the voice, and soreness in the throat. After a short time the breath becomes offensive, the tongue is covered with a thick brown fur, and the inside of the lips is beset with vesicles, containing an acrid matter ; upon inspection of the throat, a number of sloughs, between a light ash and a dark brown color, are to be seen. From the first attack of the complaint, there is a considerable degree of fever, with a small ir- regular pulse, and the fever increases towards the evening. About the second or third day, large patches make their appearance about the face and neck, which by degrees become disposed over every pait of the \ \ DISEASES OF THE AIR PASSAGES. 21 body. As the sloughs in the throat spread, they generally hecome of a darker coloi^ and the whole throat is soon covered with thick sloughs, wiiich, when they fall off, discover deep-seated ulcers. Treatment — The bowels should be opened with a dose of RochcUe salts or sulphate of magnesia. To cleanse the tnroat, use the following •Tiro'lc ■ — Honey of Roses, . . . . Tincture of Myrrh, - - - - Vinegar, Decoction of I'arley, Mix and use frequently. Or the following I ounce. ]/z ounce. I ounce, lo ounces. Muriatic Acid, Compound Tincture of Cinnamon, Tincture of Aiyrrh, - Decoction of Peruvian Bark, Mix and use frequently. Iheathe the steam of hot vinegar and water into the throat. The following is a good astringent draught : — ■ . I drachm. Yz ounce. I ounce. 6 ounces. Aromatic Confection, Tincture of Catechu, Laudanum, Chalk Mixture, Cinnamon Water I drachm. 1 drachm. 30 drops. 2 ounces, 2^ ounces. Mix. Take two tablespoonsful every four hours. Shake well always before taking. Sometimes bleeding trom the mouth, nose or ears, takes ])lace in the latter stages of the disease : and, becoming alarming, use the following as a wash : — Sulphate of Copper, Alum, - - - Rectified Spirit of Wine, Pure Water, ij^ drachms. Yz drachm. I ounce. 7 ounces. Mix, and apply internally with a tent, or on linen cloths. The diet must be light and nourishing — tapioca, sago, rice, and the like : the drinks must be acidulated 3 free air, but not cold ; the room sprinkled with vinegar, and generally as is laid in acute or typhus fever, use the fol- lowing in the room, as a purifying anti-infectious gas : — Take a pound of common salt, put it into an earthen dish, occasion- ally pour a tablespoonful of sulphuric acid (oil of vitriol) ; stir up with a stick, avoid breathing over it when the fumes are rising. Do this four or six times a day, whenever infectious diseases are raging. It is a great jjreventivQ. CHAPTER III. i -i/ \ H \ nil DISEASI'.S OF THF, KOOT) AND IILOOD TASSAilE. Muniirs — Ulcc^mtcd sore lliniat — Dyspepsia or indigestion— liiliousnoss — Heartburn — List ol foods 1 )ianiin'a- Dyscnti-ry-Constipation — Colic — Inflanunation of the liow- f'ls — 'rainworm -] )roiisy—Jaiindico— Piles — The heart— Xouralgia of the Heart. Mumps. This is an inflnmnuilion of one of the glands which secrete saHva — \.\\c paroiid i^hfid, situated at the angle of the ja^v, just below and in front of tiic ear. Treatment. — 1 he only treatment rcfjuircd is the palliation of the pain, whicii is olten very severe. The application of cloths wrung out in hot water, or of linseed poultices, fretjuenlly changed, will usually relieve the severity of the pain. If the painful feeling be felt especially in the ear, it may be well to syringe the ear gently with warm water three or four times a day, yet there is no danger that the ear itself is involved in the inllammation. The use of mild lic^uid diet — milk and soupb — completes the care necessary during the disease. Ulcerated Sore Throat. Treatment. — When ulcers form in the throat, a solution of Lunar Caustic 40 grains, water i ounce, should be made, and with a camel's hair brush dipped in this solution the ulcers should be touched once a day. At the same time tonics should be given. Dyspepsia or Indigestion, with its accompanying train of discom- forts, is the result of haste or carelessness in eating, not chewing the food, excess or deficiency of food, fatigue, excitement, study, the use of tobacco, or of ardent spirits, and last, but not least, the ignorant use of medicine. Symptoms. — The most prominent symptom is a feeling of uneasiness, not exactly pain, at the stomach. Pain would be indicative of ulceration. Nausea, and even vomiting, occasionally occur. I'here is a clammy feeling in the mouth, with a bitterness or sourness. The skin is gene- rally sallow. The bowels are generally costive, but this may be alter- nated by diarrhfea. When biliousness is present, the stools are apt to be scanty, and of light clay color. The following symptoms appear from time to time : water-brash, a running of tasteless fluid from the mouth, heart- burn, caused by the presence of acid in the stomach, and extending up the (esophagus; palpitation of the heart; headache, depression of spirits, melancholy, or the occurrence of foolish ideas ; disorders of taste, vision, •etc. ; more or less vertigo in every case. Dyspepsia is always an obstinate affection, but can scarcely be regarded as dangerous. DISEASES OF THE FOOD AND BLOOD PASSAGES. 23 Tieatmcnt. — Medicine is less important than the regulation of the quantity and (luality of food, and the hours for its ingestion. Plain, easily digested food, is re(iuircd. The stomach should never be loaded ; the meals should not be at too long or too short intervals. Beef, mutton, fowl, oysters, roasted, stewed, or panned, never fried, wilii bread raliier stale ; crackers, kiln dried ; rice ; stewed or fresh fruit ; and milk, as a beverage, will be the proper diet for the dys]tcptic, and will give a sut'ticient vai'iety. Pastry must be scrupulously avoided. Some prefer, and may have, milk tea, or milk and warm water, as a drink with the meals. Some seem to require a slight stimulant with dinner, and here, ginger and water, or cider, or sherry wine and water may be allowed in small quantities. Where the digestion is greatly impaired, the food may be given in very small (quantities, at short intervals. 'I'o use the remark of a distinguished authority, "sixty meals a day." Of course, this is only to be enforced until the stomach will bear a larger ciuantity at a time, when the plan should be abandoned. Daily exercise, in the open air, and bathing, are very important, as well as rest at meal time. Never eat under an excitement. At a meal, the family chat aids the digestion ; hence the better appetite while travelling; the mind is relieved of cares, etc. As regards medicine in this disease, the bowels should be kept free by magnesia, rhubarb, senna, or some such mild laxative ; to aid diges- tion the following is excellent : Dilute Hydrocianic acid, Subnitrate of P)ismuth, Syrup of Orange, Infusion of Gentian to 25 drops. Yz drachm. I ounce. 8 ounces. Take a teaspoonful 3 times a day before meals. Di\ Farqnharson. Biliousness. Symptoms. — Varial)le appetite, dizziness, bad taste in the mouth, a feeling of weariness, especially in the morning, and some- times a pain between the shoulders. The patient's tongue is coated and he feels "sick." Treatment. — At bedtime take 5 grains of blue moss, and the following morning, enough magnesia to move the bowels. After the bowels have moved begin to take the following, : Dilute Nitro-Muriatic Acid, Licjuor Strychnia, Compound Tincture of Gentian, Syrup of Orange, Water to eight ounces, Take a tablespoonful 3 times a day before meals. Six drachms, ij^ dr.ichm.s. One ounce. One ounce. 24 THE FAMILY PHYSICIAN. I 1 Heartburn. Tliis is best relieved by taking ten grams of bicar- bonate of soda in water before meals. Remember this symutom often depends upon the presence of dyspepsia, which must jc cured before the heartburn will disappear. In order to afford some assistance in the selection of diet for dys. peptic patients, the following table, adapted from Hartshorne, is added ; Easy of Digestion. Mode) ately Digvstible. Hard to Digest. Mutton, lieef, Pork, Venison, Lamb, Veal, Chicken, Rabbit, Goose, Turkey, Duck, Salt meats. Hare, Pigeon, Sausages, . Lecf tea, Snipe, Salt fish, Mutton broth. Soui)s, Lobster, Milk, Eggs, Herring, Most fresh fish, Raw oysters, Salmon, 'J'urbot, Stewed oysters. Shrimi)S, Sole, Potatoes, Oils, Haddock, Beets, Cheese, • Roasted oysters. Turnips, Fresh bread, Rice, Cabbage, Toast, * Tapioca, Lettuce, Pastry, Sago, Celery, Cakes, ' Arrowroot, Apples, Nuts, Asparagus, Ras])berries, Pears, Cauliflower, Bread, Plums, / Baked ap])les. Puddings, Cherries, Oranges, Rhubarb, Cucumbers, * (irapes, Chocolate, Onions, Strawberries, Coffee, , Carrots, Peaches, "^ Porter. Parsnips, Ale. Pickles. Diarrhoea. The acute form of this disease is frequently due to un- digested or improper food, or to exposure to cold, and usually subsides of itself after a dose of castor oil has been given to carry away the irritat- ing substance. After two days, should the discharge still continue, the following will be found useful : Prepared Chalk, Powdered Acacia, - White Sugar, - Tincture of Opium, Water, . - - - Take a teaspoonful every hour. lYz drachm. I drachm. I drachm, % ID drops. 3 ounces. Dr> Dewees^ |/*8WW«»' i DISEASES OF THE FOOD AND BLOOD PASSAGES. 25 Or Tincture of Opium, Tincture of Capsicum, - Aromatic Tinct. of Rhubarb, - Sijirits of Peppermint, Spirits of Camphor, Take from 20 to 40 drops as required. An equal quantity of each. Dr. Ruschenhers.er. Dysentery, or bloody flux, or bloody stools, is an inflammation of the large bowel, the colon, hence it is also called colitis. Cause. — This disease appears to occur most frequently about the last of August and September, and is due to the use of unripe fruit, improper food, exposure to cold aud damp after the heat of the day, impure water, etc. It often prevails in a locality as an epidemic, attacking the majority of thosfe exposed to it. Symptoms. — It is characterized by pain in the lower part of the abdo- men ; tenderness on motion and on pressure ; frequent desire to evacuate the bowels ; small, bloody, mucous passages ; great tendency to strain or bear down, which is called *' tenesmus ; " griping, called " tormina," and moderate fever. There may be debility, generally not at first ; ulcer- ation, and purulent, shreddy discharges may occur later. Treatment. — Where the strength will bear it, and the inflammation is great, leeches may be usefully applied, at first, to the abdomen, at the seat of the greatest soreness, followed by warm poultices of flaxseed, hops, Indian meak A tablespoonful of castor oil, with fifteen to twenty drops of laudanum, is the usual dose before anything else, and this is generally very useful. A large injection of warm water is often of great service. When the disease has become fully established the following prescrip- tions have been found to be eminently successful. Powdered Catechu, Powdered Acacia, Water, .... Take a tablespoonful every two hours. 2 drachms. y^ ounce. 6 ounces. Also Sulphate of Copper, Sulphate of Magnesia, • ] )ilute Sulphuric Acid, - AVater, . . . . . Take a tablespoonful every four hours. Dr. Nieim'ycr, Yi grain. I ounce. I drachm. 4 ounces. Dr. BarihoUnv. Of course, great care should be paid to the diet, which should be main- ly of rice, arrowroot, chicken or beef tea ; and for thirst, iced drinks^ as slippery elm water, ^^um arabic water, etci /! I i rH 26 THE FAMILY PHYSICIAN. With great debility, quinine may be given, or other tonics and even stimulants, if there is great weakness. Constipation or Costiveness. Treatmetit. — The first thing to be done is to establish the habit of trying to evacuate the bowels every day at a certain hour ; the best time for most people is just after break- fast. It matters not if the bowels do not act ; the practice of attempting should be persisted in, and in time it will break up the confined state f;f the bowels. Adopt a diet free from all astringents, taking care especially that there is no alum in the bread, and using a coarser kind. Let the food consist of a due admixture of meat and vegetables for dinner ; the beverage water. For breakfast, stale bread or dry toast, with a moderate quantity of butter, honey, fish, or bacon ; cocoa, perhaps, is preferable to tea or coffee ; and porridge made with Scotch oatmeal, i)robably bet- ter still. Regular exercise, either by walking or on horseback, should be taken. Roasted or boiled apples, pears, stewed prunes, raisins, gruel with currants, broths with spinach, leeks and other soft pot-herbs, are excellent laxatives. If the above mode of living fail to relax the bowels, inject warm water by means of enema It is a great mistake in this disease to use powerful medicine. The milder the better. One of the best remedies for habitual constipation is the following : Senna leaves. Liquorice root, Sulphur, Fennel seed. White sugar. Pulverize thoroughly and mix. spoon, either dry or in water. This powder has the advantage that it can be used for a considerable time without weakening the bowels, and thus creating a demand for more powerful 'axatives. Another prescription which will be found beneficial in constipation re- sulting from indigestion, is the following : Powdered rhubarb, Podophylline, - . . . Extract of nux vomica, Mix and make 24 pills. Take one at night. Another formula which has been much used is the so-called " safbty pill:" Extract ot hyoscyamus, - - -10 grains. Extract of nux vomica, - - - 6 " Extract of aloes, - - - - 30 Powdered ipecac, - - - - 2 Mix and make 20 pills Take one at night. - Three ounces. - Two - One ounce and a half. - Six ounces. Take from a teaspoon ful to a table 12 grams. 4 " 8 " « <( DISEASES OF THE FOOD AND BLOOD PASSAGES. 27 ics find even icine. The The last prescription we will mention in this connection is also perhaps Ithc best : . Fined extract of cascara sagrada, - - 4 ounces. Take a teaspoonful at bedtime, and repeat if necessary next morning. Colic — Wind Colic. ^Vind colic is a severe and distressing pain I in the bowels, sometimes a stoppage, and swelling about the pit of the stomach and the navel. The complaint may be caused by weakness in |the digestive organs, by indigestible food, unripe fruit, or costiveness. Treatment. — It the p^in is caused by having eaten anything indigesti- ble, an emetic should be immediately taken. It this does not bring re- hief a dose of salts, or sweet tincture of rhubarb, may. If there is no sickness at the stomach, a little essence of peppermint in water, or hrandy, or gin, in hot water, may be suliticient to expel tlie wind and give relief. If there be costiveness, and continued pain, a stimulating injec- tion should be given. ,. , Bilious Colic Bilious colic is a dangerous disease. There is griping, twisting, tearing pain about the navel, or sometimes over the whole belly. Causes. — It is caused by irritating articles taken into the stomach, vititated bile, long exposure to cold, torpid liver and skin^ great unnatural heat, &c. '■,:•*, SyinptojHS, — It comes and goes by paroxysms. Sometimes the abdo- men is drawn in, at other times swelled out, and stretched like a drum- head. At first the pain is relieved by pressure, but after a time the belly grows tender to the touch. There is thirst and heat, and a discharge of bilious matter from the stomach. In the worst cases, the pulse is small, the face pale,* the features shrunk, and the whole body covered with a c:)ld sweat. Treatment. — Administer an active purgative injection immediately. Give a mixture of pulverized camphor, four grains ; cayenne, twelve grains ; white sugar, one scruple. This, divided into four powders, and given once in fifteen minutes, will relieve the pain, — at the sami time a mustard-Doultice should be laid upon the belly. The sickness of stomach may be ailayed by hot fomentations over the stomach, in which are a few drops of laudanum ; also on the feet. Inflammation of the Bowels. Symptoms. — There is usually great pain and tenderness of the abdomen, accompanied with fever, and a fre- quent, small, hard pulse. Sometimes at first, the pain is confined to one spot ; but it generally soon extends over the whole of the abdomen. It is very severe, and much increased by any motion, even coughing, sneezing, or drawing a long breath. Even the weight of the bed-clothes is sometimes unbearable. It is acute and cutting, and sometimes occurs in paroxysms ; and the patient usually lies on his back with his knees / 28 THE FAMILY PHYSICIAN. I'! drawn up. The bowels are usually constipated, but sometimes the re- verse ; and conmionly there are present nausea, vomiting and hiccough. Tnatment. — The most inijjortant agent in the treatment of this dis- ease is opiioii. As llic i)atient usually vomits, the drug must be given cither by injection into the rectum or by insertion under the skin. 'J'lic patient can usually endure, without danger, an amount of opium which could not safely be administered to a hcalthly [)erson ; thus half a grain to a grain of opium can be given every three or four hours, according to the severity ot the pain ; the general plan is to administer the drug until the pain is subdued. Hot ai)plications should also be made to the ab- domen ; these may consist of light mustard poultices, or of cloths wrung out in hot water ; the latter may be sprinkled with turpentine. It should be remembered that the bowels must not be disturbed during peritonitis; even though the patient have no evacuation ior several days or a week, it is advisable to avoid the use of carthartics. Whenever it becomes nec- essary to secure a passage of the bowels, this may be done by a rectal injection of hot water. Tape Worm. Symptoms. — There are no signs by which"the exist* ence of a tape worm can be positively asserted. Numerous symptoms are supposed to indicate the presence of the animal — dizziness, ringing in the ears, impairment of vision, flow of saliva, itching about the nose, impairment of appetite and digestion, colicky pains in the abdomen and emaciation. Tiiese, however, may all exist from other causes in cases wlKre no tape worm is present ; while on the other hand the worm may be discovered in individuals who consider themselves perfectly well. The only positive proof of the existence of a tape worm is tlic passage of some ol its joints Irom the intestine. If the worm have attained con- sideral)le size, such fragments are passed daily, or at least at short in- tervals. Ircaimcnt. — One of the commonest, and certainly a very efificient, means for expelling the worm is turpentine. This is given in quantities varying irom one to two tablespoonfuls for aduits, usually mixed with the same (quantity of castor oil, and taken floating on milk. This dose may be re[)cated every second or third day, until the fragments of the worm (ease to ai)pear. The objection to the use of turpentine is that it some- times causes difficulty in passing water, and it may induce a state of intox- ication in some cases. Another populai remedy is the o'\ of maiefer7i. This may be given in doses of one or two teaspoontuls, either in mucilage or acacia. Two hours after this dose the patient may take a teaspoonful of Turpentine in tablespoonful of castor oil. A still more familiar remedy is made of pumi)kin seeds. I'wo ounces of the seeds are pounded in a mortar with six ounces of water, and the mixture strained. Half of this may be taken in the morning and half in the evening. It will probably be necessary to repeat this treatment for several days. t)lSEASES OF THE FOOt) AND BLOOt) PASSAGES. to imes the rc- id hiccougl). of this dis- ist be given skin. The lium which half a grain ccording to drug until c to the ah- loths wrung It should peritonitis; or a week, it iconics ncr- ; by a rectal ch'the exist* is symptoms less, ringing ut the nose, [jdomen and iscs in cases e worm may tly well. I the passage ttained con- at short in- ;ry efficient, n quantities xed with the is dose may 3f the worm hat it some- tate of intox- \y be given :acia. Two " Turpentine y is made of mortar with lay be taken 3e necessary Whatever remedy may be selected, it is important tiiat certain prc- laraiory treatment should be adojjled before the worm remedy itself is nvcn. 'I'his treatment consists in abstinence from food for several liours, or a day ; or the patient may employ light diet, such as broth and ir.ilk, for two or three days i)revious to the use of the remedy. Dropsy. Drojisy consists of an unnatural accdmulation of serous or ^valery lluid, in various parts of the body. Persons of all ages are liable ,0 it. It is divided into five kinds, according to the part affected : first, [dropsy of the skin, generally called anaaarca ; second, dropsy of the belly, called ascites ; third, droj)sy of the chest, called hvdrotliorax ; fourth, Jrojisy of the head, or water in the brain, called liydrocephalus ; [fifth, scortal bag, called hydrocek. Causes. — Excessive and long-continued evacuations, weakening the Isysteni ; a free use of fermented spirituous li([uors ; confirmed and in- jcuiable indigestion ; diseases of the liver, spleen, pancreas, mesentery, or others of the viscera ; jtrcceding diseases, as astiima, scarlet fever, i\:c. ; anything debilitating the digestive organs ; sometimes from family predisposition. Svinpiains. — This disease generally commences with swelling of the feet and ankles toward night, which for a time (lisa[)pears in the morning. The swelling, when pressed will pit ; it gradually ascends till the whole body is swelled, in the first sort, and the belly in the second sort ; the urine scanty, thick ind high-colored ; thirst is great, breathing difficult, I'sjiccially in the third sort, and a troublesome cough ; the flesh wastes, and the patient weakens ; in the fourth sort, pains on the top of the head, and often convulsion or apolexy ; in the fifth sort, the scrotal bag is much enlarged, and much pain in consecpience. . Trcattnent. — The diet must be of a dry heating nature, using pungent vo,m.'tables, as garlic, mustard, onions, cresses, horseradish, shalols, tVc, and the fiesh of wild animals. Avoid drinks as much as [possible ; ([ucnch the thirst with acid liquors, mustard whey, and the like; and take some of the following : — Cream of Tartar, Sulphate of Potass, Rhubard in Powder, I drachm, lo grains. 5 grains. Take in pumpkin-seed two or three times a day Or use the follow- ing Powder of dried Squill-Root, Blue Pill, Opium. - _ - 2 grains. 5 grains. Yz grain. ^[ake into a pill and take one at bedtime for 4 or 5 nights followed by the above powder the morning after. V, y \ ^ 'I ^o vftt / I j I ; ! I .■) THE FAMILY PHYSICIAN. \/, Another excellent remedy in general Dropsy, is the following : — Infusion of Digitalis, - - - - 3 \'incgar of S(iuills, - . - Take a tablespoonful 2 or 3 times a day. ounces. I |ij ounce. Dr. lUirthrow. Jaundice. A disease arising from obstruction to the passage ol the bile into the intestines, from disorders of the liver. Tnadnciit. — The diet should be cool, light and diluting — consistitij,' chielly of ripe fruit and mild vegetables; the drink, barley water or lin- seed lea, sweetened with li([ourice ; the bowels must be kept gently o[)en. When the disease has abated, constant doses of Peruvian bark should be given, with good port wine: plenty of exercise taken, and a mustard poultice occasionally placed over the liver. The following has been of great benefit : Remain in a warm bath, of one hundred degrees, for twenty minutes. Take, every other nigjit, five grains of blue pill, and live grains ol compound aloe pill on those nights when the olue pill is not ordered. Piles- 7"/-6Y//Wd7//.— Keep the bowels well oi)ened by a mild aperient such as castor oil, or senna tea, and ap[)ly to the part one of the following ointments : Hemlock bark finely powdered. Fresh Dard, Mix and apply. Powdered nut gall, C'am{)hor, . . . Melted wax. Tincture of Opium, Mix and apply. I ounce 6 ounces. 2 drachms. I drachm. 1 ounce. 2 drachms. Should the ])iles be internal, the bowels should be kept lax, and after each motion one ounce Pond's IvMract should be gently injected into the bowel, the patient lying dov/nfor half an-hour-afterwards. DISEASES OF THE FOOD AND ULOOb PASSAGES. 31 Heart Valve. .r i Front View of the Heart, with the Walls of the Riyjht and Left Ventricles removed. a, b, Riijht and left walls nf thi- vcntiiclos. c, Septum veiitrirtilonmi. d. Cavity of tlie rij^lit VL-iUiick; *•, C"avily of the left ventricle;. /, \'alves of the riijlil ventricle. ;'■, \'alves of the left ventricle. //, linlrance of the pulmonary artery. /', Kutnuice of the aorta. /, 111, Upper and lower vena cave. «, jHilmonary artery, o, Aorta, y, Heart case or pericardium. The Heart. Pali)ilation of the heart is an increase in the force or frequency of the heari's action. It is fretiucntly jDroduced ny physical action or mental emotion, and is sometimes the result of disease. Some- times the palpitations are loud and clear and regular ; at others they are faint and intermittent ; now, a distinct throb or several and then, a tremulous flutter. Usually these symi)toms merely indicate functional derangement of the heart and not organic change. Causes. — A disordered stomach may be the cause, although there may be no other symptoms of this. We have known cases in which a very slight irregularity in the mode of living has produced palp, ition of the heart, and that, too, in an otherwise healthy person. In some, almost any strong nervous stimulant will produce it, and we recollect one in- 32 THE FAMILY PHYSICIAN. Ill lli^ hi Mi stance in which it ahvays came on after a cup of tea, and was never troublesome when this beverage was not taken. AV^e mention this to show that palpitation is not always, nor indeed commonly, symptomatic of heart disease ; and need therefore cause no unnecessary alarm, although its frecjuent recurrence should set the pa- tient incjuiring as to what is the real cause. Young women with whom there is derangement of the menstrual functions, in whom the blood is watery nnd [, /or, wanting the red corpuscules ; the listless, the pallid, the hysterical, in these we meet with [)alpitation in its most aggravated forms ; as also in the indolent, the susceptible, and the delicate; those who dwell on morbid fancies, and excite the imagination with sensual thoughts, or horrible pictures. To such every beat of the pulse seems like 1 call from the world of spirits, every flutter and palpitation like a brush from the wings of the angel of death, or the whispering voice of an accusing conscience. 'freatmcrit. — In these cases the only treatment likely to be of service must be directed towards rc;novingthe predisposing and exciting causes, and establishing a more healthy nervous condition : gentle exercises, tonics, change of aii a^id scene, an endeavour to occupy the mind in some uselul and moral pursuit ; a well regulated and generally frugal, al- though sulhciently nourishing diet; and a strict avoidance of all that can excite or stimulate eiti er mind or body. By this means palpitations not connected with organic disease, may generally be got rid of. If the patient is of a full habit, and has a tolerably strong pulse, a course of general purgatives may be necessary. They should not be salines, but of a cordial nature, something like this : — rill of Aloes and Myrrh, Compound Calbanum Pill, - Divide into twelve pills, and take one at bedtime. Yz drachm. V2, drachm. 3 ounces. 3 ounces. 1 drachm. 2 drachms. V2 ounce. Compound Infusion of Senna, 1 )ecoction of Aloes, . . . . Spirits of Sal Volatile, - - - - Comjjound Tincture of Cardamums, Tartrate of Potash, . - . . Mix and take two tablespoonsful occasionally. Neuralgia of the Heart {Angina Pectoris). commonly connected with ossification, or other morbid affections of the heart. Symptoms. — It is characterized by a sudden and most violent pain across the chest, which extends down the arms, and seems to threaten immediate dissolution. It sometimes comes on during rest, but most usually after violent exertion. The paroxysm does not commonly last long, but it has been known to continue lor an hour or more. A disease which is DISEASES OF THE FOOD AND BLOOD PASSAGES. 33 ras never )r indeed cause no t the i^a- th whom : blood is he palhd, gravated te; those 1 sensual Ise seems on Hke a voice of Df service ig causes, exercises, mind in frugal, al- 1 that can itions not f. If the course of lines, but Treatment. — An anodyne combined with ammonia has sometimes been found very effectual in relieving the spasm. The following is a good formula : — Fetid Spirits of Ammonia, - ' V^ ounce. > Solution of Morphine, - - - 3 drachms; Camphor Mixture, - - - 6 ounces. Take a tablcspoonful every half hour until relieved. If the paroxysm is very violent, a little hot brandy and water may also be taken ; or a teaspoonful of sal volatile or ether in water, and repeated at intervals. If the pain continue, frictions and mustard j;lasters applied to the chest, soles of the feet, and calves of the legs. Where there is extreme faint- ness, the horizontal posture should be adopted. Persons subject to these attacks would do well to provide themselves with the following, as a medicine in case of need : — Half an ounce each of suli)huric ether, s[)irits of ammonia, and sal volatile ; two drachms of tincture of opium. Mix, and take a teaspoonful in water ; and rejicat at the end of an hour if relief be not afforded. which is ans of the t \ Jent pain ) threaten but most lonly last ?l 1 l|r I Hi CHAPTER IV. DISEASES 01'" THE EYE AND EAR. Squinting- -Inflamnialion of tlic Eye— Short Sight- -Long Sight— Old Sight— Weak Eyes— Ingrowing Eydaslics - Bhndncss— Cataract— Inflammation of the Eydids— Styes— Ear- ache— Wax in the Ear— Runnings from the Ear— General Cautions regarding the Ear. THE EYE Longitudinal Section of the Globe of the V.ye. J marks tlic course of tlio ouivv tunic, called tin; sclerotic, wliich invests four-fifths of the glol)e, and gives it its peculiar form. It is a dense fibrous memijrane, thicker be- hind Uian ill front, when; it presents a bevel- led edge, into wliich tits like a watcli-ghiss the roriicn (2), which invests tlie projei'ting portion of liic globe, and is eonqiosed of four layers, viz., the ronjiivctiva ox com ca pro- pria, consisting of thin lamellEe, or scales, connected by extremely line areolar tissue ; the cornea clasfica — an clastic and exces- sively transparent membrane, wliich lini;s the inU'T surface of the last ; ;ind the liiiiii;^ vicmhranc of this front vestibule of the ICyo ball, whose second tunic is formcul bv tiie The J'Lycball divested of its first tunic. T, part of the outer tunic, the sclerotic; 2, the optic nerve, communicating with the ball at the back ; 3 3, distinguish the outline of the choroid coat ; 4, the ciliary ligament, a dense wiiiie structure which surrounds, like a broad ring, the circumference of the iris (5). This ligament serves as a bond of union Ixuween the external and middle tunics of the I'A'eball, aiulservesto connect the cornea and sclerotica at their Iin(>s of junction with the iris and external layer of the choroid ; 6 6, mark the vena: Tw-//twvr.- and 7 7, the choroid (3), represented by the dark line ; the trunks of these veins 'at the point where they ciliary lii:(nnciit\J[), wliich develops from its have jiicrced the sclerotica ; 8 8, the jioster- inner surface the ciiiury />ri'( rs.ws, and the io« ciliary veins, whi'h enter the Isycoall in //7,» (6), of wiiii'h the opening at 7 icpn sents comiiany with tin- posterior ciliary arteries, the pupil. We shall go nn^re into details bv piercing the scieroiica at 9. The course presently as to the nature of tlu-se several of one of die long ciliary ner\es, accompan- constituents of the tunics and other ])arts of ied by a vein, is marked by 10. the Eye ; at present we will keep to general outlines, ns represented in the diagram. ' 'Ihe third tunic then, is the rrliiia (R), which is carried forward to the Uiis (i-:), by the zoiiitla ci liars, a prolongation of its vascular layers passing along the front of the Canal J\-/i( (9), which entirely surrounds the lends. In the space niarke(i 10. is contained the ai/ncoit.s humor \ 11 i-s the posterior chamber ; 12 the lens more convex behind thaii before and enclosed in its proper capsule ; 13 ntarks the inner DISEASES OF THE EYE AND EAR. 35 area of the globe filled with a thin membrane called the hyaloid wnA containing the vitreous humor ; 14 is the tubular sheath of the membrane, through which passes an artery con- nected with the capsule of the lens, and, at the back of the eye, with the optic nerve, as re- presented at 16. Of this nerve, 1^ marks the neurikuina, or sheath. Squinting*. Squinling is, in the vast majority of cases, the result of defective formation of the eyes. It may result either from an undue depth or an undue flatness of the eyes — that is, from myopia or from hypermetropia. If the child be short-sighted, he is apt to liave that form of squint in which one eye turns outward ; if, on the other hand, he he far-sighted in a high degree he is prone to the common form of squint in which one eye turns inward. Treatment. — The remedy for squinting lies, during its early stages, in the use of glasses. It is olten possible to correct a squint entirely, be- fore it has existed more than two or three years, by the judicious em- ployment of spectacles. 'I'he glasses act, of course, by correcting the near-sightedness or far-sightedness upon which the squint depends. After the individual has been in the habit of scjuinting lor several years, it is rarely possible to correct the deformity entirely by the use of glasses. Yet there should be no hesitation whatsoever in submitting the eye to an operation whereby it can be straightened ; since, even thcnigh the sight of the eye be somewhat impaired, the vision can often be re- stored, at least so as to make the eye practically valuable. Eye-Appendages. Meibomian Glands. I, thejM//<*-/Vror upper tarsal carfila;:ri,/ue has its bony or- j^s a tcaspoonful of Rochelle SaltS Or ij,nn — the jjoint ofw hicn is inaiked by the little r . 1 ■. . r ^ \ square knob. The other lour muscles are ^^ l^^ Citrate 01 potasi). called Recti, strai!,du ; the Superior Rectus, The CyCS ma}' bc bathcd CVCry sometimes called ihc Levator Oculi,iiXi,c\ov J^our Or tWO with onC of the follow- er the eyes, and sometimes o///>m^/^.v, because . , ■. , . . , its action gives an expression of pride ; its "Ig lotlOns, care being taiCCn tO al- opposite, 13, the ////ivvV)/- /vV/7«-, sometiiues low alitlle of the sciution tO flow cMcd Deprimu oculi, depressor of the eye, ;„.„ j.Up „ „„ „,. p^p^v ntmlintion • and Ilumulus, as giving an expression of ^"'° ''"^ ^^^^ ^^ ^^^^> '^PPi'Cailon . Inunility ; 10, the Rectus Intcrnus, sometimes called Adductor Ocuii, from its drawing the I''yeball toward the nose, and Bibitorius, a sort of punning name, in allusion to the cup, or orbit, towards which it directs the glance ; II and 12, Rectus Externus, the one showing its two heads of origin, and the other its ter- mination ; the intervening portion of muscle [having been removed] has the name of Ab- ductor Oculi, because it turns the ball out- wards; /udifinabuudw; is another name for it, as giving an expression of scorn. In our Alum, - - - Ten grains. ^^'ater, - - - Two ounces. If the case be severe the following lotion may be employed : Alum, - - - Eight grains. Sulphate of zinc. Two grains. Water, - - - Two ounces. In the intervals between the ap- diagram, the internal rectus passes behind plication of the lotion the eye may the optic nerve, which partlv conceals it ; 14. ^g washed with water tO securc tliC the //////(vz (///'/;•(;//?(;, or white tunic, formed r 1 i- 1 by the expansion of the tendons of the four escape of the discharge ; the paticnt Recti muscles. will derive much comfort from the application of a cloth, such as a soft handkerchief, soaked in cold M-ater and allowed to rest upon the eye. In making such a[)i)lications to the eyes, only thin cloth should be used, and not more than three thicknesses should be applied to the eye, since otherwise the heat produced may aggravate the pain. If there be much swelling and puffiness of the conjuctiva the following solution may be prepared ; DISEASES OF THE EYE AND EAR. 37 itc at the >-ior lt prove applied, applied case is L blister, lis : — s. h much 1 be the id, after the pro- ittention t of the in each ache, no and may 3d: — ichm. chm. ices, t. d, or ac- cracking cnt. In I instru- ounccs, lole pas- a hand- 1 syringe put into wool or p ounces case, as the parts. There is generally redness and swelling of the passages of the meatus, and inflammation of the surrounding skin. This may arise from an inflamed state of the membrane which lines the passages, or from an abscess formed beneath it, or between the cells of tiie bones of the mas- toid process. The discharge may be caused by some foreign substance thrust in the ear. Treatment. — For the purulent discharge from the ear, which is induced by this or any other cause, a lotion made with two drachms of solution of chlorinated soda to six ounces of rose, or elder-flower water, should be injected, but not with any force. The best method is to let it flow into the ear, held so as to receive it fairly, from a small sponge saturated with the lotion. (Jounter-irritation will sometimes have a good effect on purulrnt dis- charges from scrofula or other causes. A small blister behind the ear is the best application, but it should not be kept open for any length of time, or it will weaken the system too much. When the discharge is the result of active inflammation, and is attended by febrile symptoms, a spare diet and aperients must be the treatment ; but weakly, scrofulous systems require a generous diet and tonic medicines. General Cautions. — From the outer ear there is a tube or canal, the auditory canal^ leading to the middle ear. At the bottom is a tightly- stretched membrane, which makes the outer wall of the middle ear, or the head of the drum. The auditory canal is about an inch and a (juar- ter long, and slightly curved upon itself, so as to be higher in the centre than at either end. It carries in, just as an ear-trumpet does, the waves or undulations of the air, collected by the outer ear, to the middle ear. The hairs at the entrance of this canal, and the wax which keeps it^oft, are for the purpose of excluding dust, injects and other substances. Children frequently fall into the habit of picking the ear with the finger, thus irritating it, and exciting inflammation and running. Many adults, also, cannot let their ears alone, but are constantly thrusting toothpicks, pins and needles into them, to clean them out. This habit often leads to permanent injury, and not unfrequently, by an accident, punctures the drum of the ear, and destroys the hearing. The practice which some people have of stopping up this tube with pieces of wool, " to keep out the cold," is absurd and hurtful ; absurd, because if nature intended the car to be thus shut up, she would have done it herself; hurtful, as it heats the ear, makes it very sensitive and liable to take cold and become inflamed. 1' liii''. ire liable rst often t pain in 'i\ I CHAPTER V. DISEASES OF THE SKIN. Pimples or Acne— Dandruff— Itch— HarlxT's Itch— Salt Rheum or Eczema— Chilblains— Ualdness— Erysipelas- Nettle- Hash or Hives— I'rickly Heat or Lichen— Irritation or Itchinfj—Freciiles— Lice— Mother's Marias- Other External Diseases— Hang Nails- Ingrown Nails— Blood Blisters — Boils or Eeruncles— Bunions— Carbuncles— Corns— - Eelon or Whitlow— Goitre— Sores and Ulcers— Eetid or Foul Feet — Warts— King- worm — Diet in Skin Diseases. Pores and Papillne of the Skin. On the left is a magnificent View of the Ridges of tlie ("utide, as seen in tlie Pa'ni of the Hand, with the openings of the Pores in their Furrows. CJn the ighi, tile Cuticle lias been removed, leaving cor- •esponding rows of rapilUe. Diagram of the Structure of the Skin. a, l\pi(lerniis ; /> b, Pores ; c c, Layers of t-piderniis and rete nui- cosuni ; /, Inhalent vessels ; ir t^^ Pa|)illie of the skin ; // //, (,'oriuui or true skin ; l>. Dandruff. Trci. ,it. — For the removal of dandruff it is necessary not only to keep the scales brushed out of the hair, but also to correct, if [)0ssiblc, the unhealthy action of the sebaceous glands. The hair may be gently brushed with a solt brush, and then washed with a little soaji and water. After this, the yolks of two eggs may be applied to and thoroughly rubbed into the scalp. The repetition of this process daily is often of itself suflicicnt to remove the difficulty. If the scales still form, there may be substituted for the eggs the following prescription ; Tannic acid, . . . . - i drachm. Simple ointment, . _ . - i ounce. Mix and rub thoroughly into the scalp. 44 I DISEASES OF THE SKIN. 4S lilblains— litation or ng Nails — — Corns — rts— king- Kin. e Ridges of land, uitii ws. CJn the aving cor- lecessary :orrect, if lair may illc soap 1 to and :css daily ales still iplion : Another valjablc remedy is the following : Hydrate of chloral, .... 2 drachms. Water, 4 ounces. If there be much oily matter in th(? hair, the following prescription may be used : Aromatic spirits of ammonia, - - 4 drachms, (ilycerine, - - - - - }4 ounce. Rosemary water, - ... 4 ounces. Pimples or Acne. This is the most common of skin diseases, and is usually due to some disorder of digestion. Treatment. — (luard against constipation by the use of citrate of magnesia and oc- casionally 4 grains of Blue pill. Avoid all articles of diet which are found to be followed by pim|)les, such as alcohol, pastry, buckwheat cakes, etc. Numerous lotions and ointments are re- commended and sold for the cure of acne ; yet none of these can be relied upon, unless proper measures arc taken to remove the condition of the stomach, bowels, liver, etc., upon which the difficulty dejiends. Among the best of these are the follow- ing : Flowers of sulphur, - Tincture of camphor, (ilycerine, - . - - Rose water, - - - This may be applied over the affected spots, and may be rubbed gently on those parts of the skin affected with the disease two or three times daily. 2 drachms. 3 drachms. I ounce. 4 ounces. Vertical Section of the Skin Largely Magnified. //, Sweat Gland; ?', a Hair enclosed in its Follicles, and showing its pair of Sebaceous Glands ; /, a Scliaceous Gland. Borax, i drachm. Carbonate of soda, - i drachm, ('ilycerine, - - - - Tincture of cami)hor, Distilled water, - - 4 drachms. I ounce. To make 6 ozs. This may be applied in the same way. Precipitated sulphur. Carbonate of potash. Glycerine, ... - Sulphuric ether, Alcohol, . - - « - Half an ounce. - Four drrchnis. - Two ounces. - One ounce. - One ounce. T' i 46 THE FAMILY PHYSICIAN. t This mixture should be carefully applied to the pimples and to those parts of the skin that seem liable to exhibit an eruption. In all these cases no more friction should be employed than is necessary to apply the lotion. In all cases success can be hoped for only after persevering use of the remedies, both those for application to the skin and those which are de- signed to iiiiprove the condition of the digestive organs. Cases are found which seem to resist almost all measures of treatment ; such individuals have at least the consolation that the affection will yield to time, even if all medicines prove unavailing. Itch. Symptoms. — The most r ominent symptom of this disease is a constant and intolerable itching, it never comes on of itself ; but is always the result of contact with an affected person. It first shows itself in an eruption of small bladders or vesicles filled with a clear watery fluid, occurring principally on the hand and wrist, and in those parts most exposed to friction, such as the spaces between the fingers, and the flexures of the joints, etc. ; after a time it extends to the legs, arms, and trunk, but it rarely appears on the face. Treatment. — The itch is never got rid of without medical treatment ; l)ut to that it will always yield, provided proper cleanliness be observed. Sulphur is the grand specific for it ; it may be applied in the form ot ointment, prepared as follows : Flowers of Sulphur, - - - 2 ounces. Carbonate of Potash, • - - 2 drachms Lard, ---..- 4 ounces. To be rubbed well in, whenever the cru|)tion appears, every night and morning — washing it off with soap and (lannel be.' ore each Ircsh op[)li cation. The most effectual plan is to anoint the whole body, Irom the nape of the neck to the soles cf the Icet. and out to the ends of the fingers ; put on socks, drawers, flannel wrapper, and gloves, and so remain in bed (or thirty-six hours, repeating anointing operation twice during that time ; then take a warm bath, and wash the whole person with soap and flannel. In mild cases, a sulphureous vapor bath taken twice in twenty-four hours, with warm soap and water washing, will generally be suflicient. Barbers' Itch is the development of pimples and pustules in the beard and whiskers. Each pimple, if examined, will be found to have a hair passing through it There is hut one way to set about curing this troublesome and disfiguring disease, and that is as follows : Remove the crusts by oil and poultices. Cut the beard short with scissors. Then pull out every hair that is seen to come from a yellow point or jjimple. A small forceiis should be used for this. When this is completed, rub thoroughly with the following ointment : :o those ill these to apply e of the I are de- •c found iividuals ne, even ease is a ; but is 3WS itself ir watery )se parts , and the rms, and ^atment ; )bserved. i form ot niglu and jsh appli Irom the ds of the so remain :e durinjj; with soap /enty-four "licient. Ics in the to have a irin}^ this -move the s. Then r pimple, eted, rub DISEASES OF THE SKIN. 4; Flowers of Sulphur, White Precipitate of Mercury, Carbolic acid, pure, Fresh Lard, . - - Mix well. I scruple. 1 scruple. 10 drops. I ounce. Repeat this treatment, plucking out the hairs, as directed, and con- tinue as long as there arc any yellow points. Do not shave for at least six months after the disease has left. Salt Rheum, {Eczema). This is one of the commonest, most troublesome and hence most important of all the diseases of the skin. In adults, eczema occurs in almost all parts of the body ; the forehead, ' the cheeks, the eyelids, the nose, the lips are very often affected. When the disease occurs in the face, especially around the mouth, it is apt to prove obstinate, in consequence of the constant movement of these parts. In men, too, the presence of the beard is an additional cbstacle to the cure of the affeclion, since, if the beard be allowed to grow, it is im- ])ossible to reach the disease satisfactorily, while if the face be closely sh.iven, the ec/.cma is often thereby aggravated. In women eczema is very common around the nipples and on the genitals. Many of the affections of the nipples during nursing are simi)- ly cases of eczema. Very many women who are afflicted with diseases of the womb, or of the vagina, suffer constantly from eczema on the neigiiboring skin, as the result of irritating discharges. In some cases, too, eczema frequently appears periodically during the menstrual flow. Eczema is also frecjucntly found in adults on the leg, especially just above the ancle. This is especially often the case with those who are troubled with enlarged' or " varicose " veins. In this location the eczema is very obstinate and is apt to proceed in the course of time to the for- mation of ulcers. Treatment. — In those cases in which the disease is traceable to ex- ternal irritation, the source of this irritation should beof course removed. In some instances thii- is, under the circumstances, impossible, since the patient is unable to abandon his employment ; thus the most obstinate cases occur in women who are compelled to have their hands constantly in water. In such instances much good can be derived from the use of rubber gloves. So, too, if the eczema dei)ends upon an irritating dis- charge from the vagina, it will be necessary to adopt such treatment as will stop this discharge before the eczema can be cured. In general in the treatment of eczema in which there is considerable watery discharge and the formation of (Musts, the surface should be softened by oiling the skin thoroughly, or by the use of a light flax-seed [)qultice. After this is ac(^omi)lished i nd the crusts removed, one of the following ointments may be applied : — Oxide of Zinc, - - - - 2 drachms. Lead Water, - 2 drachms. 11 i 48 tHE FAMILY PHYSICIAN. Glycerine, - ..--.,.- 4 drachms. Lime Water, - - - - To make 8 oz. This may be appHed to the surface by means of a soft cloth, such as an old handkerchief, which should be saturated with the lotion and laid upon the raw surface. If there should be much burning and itching, one of the following remedies may be used : — Carbolic Acid, - - - - | ounce. Water, - - - - i pint. This may be applied frequently on soft cloths. The following quotation shows how this disease is managed in Vienna, the headquarters of the world for the treatment of skin diseases : — " In eczema of the scalp or of the ears, the crusts are to be removed by inunctions with oil, which are to be made twice a day, about three ounces of oil being used each time. The crusts are thus removed, and raw places are covered with flannel. If the skin be not much thickened, the salves which have been mentioned above can be applied at once. If the skin be found red and ' weeping,' 1, -vill be necessary to apply recti- fied spirits rc]:)eatedly. When the swelling subsides, if the skin continues to secrete freely, tar may be applied in the case of adults ; this agent should not, however, be used for children, because their skin is much more sensitive, and swelling, perhaps even suppuration, of the glands in the neck can be induced very easily. If the eczema extends into the ear, one may use injections or stringents ; but in order to bring the salve into contact with the entire surface of tlije ear, a piece of sponge, properly shaped and covered with lint, should be smeared over with the salve and inserted into the car. If the eczema, extends high into the nostril, we may use suppositories. Each of these may contain : Cocoa Butter, - - . - 8 grains. Oxide of Zinc, - - • . 5 grains. This should be inserted into the nostril. " A child suffering from eczema of the face should have a piece of linen smeared with diachyolon ointment laid upon the raw place; this may be fastened with a flannel bandage and renewed constantly until the crusts have been removed." — Neumann. Chilblains. To prevent this annoyance, avoid cold or wet feet. Sleeping with the stockings on is also liable to produce them. A nightly foot bath of cold or tepid salt and water with plenty of rubbing with a rough towel, and exercise during the day will be most likely to prevent chilblains. Treatment — Should they come — as sometimes they will — in spite of all precautions, let them be gently rutibed every night with some stimu- lant application ; alcohol, spirits of turpentine, or camphorated spirits of wine, are all good for this purpose : but the application which we have ")' JJiSLAsLb Ot TaE.aKlN. 49 ^ct feet. nightly with a prevent found most efficacious is a lotion made of alum and sulphate of zinc — 2 drachms of each to lialf a pint of water, rubbed in warm ; it may be made more stimulating by the addition of one ounce of camphorated spirits. Baldness Treatment. — Take of Pure (Ilycerinc, ... - 3 drachms. Lime Water, - - - - 4 ounces. To be applied to the scalp, night and morning, with a soft tooth brush, after the head has been cleaned by gently washing with Castile or Sulphur soaj) and warm water. This is an excellent treatment to commence with for slight scurfiness of the head, and falling of Ihe hair, and baldness. Alter several weeks' use the preparation may be changed to the follow- ing :— 'J ake of Tincture of Cantharides, - - - \ ounce. Pure (ilycerine, - - - - 3 drachms. Lime Water, - - - - 4 ounces. To be rubbed into the skin, briskly, twice a day. The following hair tonic is also otten of service for scurf and com- mencing baldness : — ■ Take of ' Rock Salt, - - - As much as will dissolve. Pure Cllyccrine, - - A tablespoonful. Flour of Sulphur. - - A tablespoonful. > Old \Vhi.,kcy, . - A tumblerful. Mix. Hrysipelas. This disease has been popularly known as the Rose, from its red color ; and as St. Anthony's Fire, partly from its burning heat, and partly because the saint whose name it bore was supposed to have the power of curing it wUh a touch. There are several species of this disease ; but withotit going into the j)art" uilar characteristics of each, it will be sufficient for us to state what are the general symptoms of ery- sipelatous inflammation, and best remedial measures. Symptoms. — Chill, headache, furred tongues, (juick pulse and olten disordered stomach for a day or two i)rcviously, then a tingling burning sensation with stillness and pain at some particular [)art followed by a discoloration of the skin ; the red or purplish tint is at first confined to qne part, but soon extends itself sometimes over the whole part affected, lrc(]uently this is the head which, with the face becomes much swollen and tender ; the eyelids puff out and close the eyes, and the lips swell. Treatment. — The treatment must always be adapted to the patient ; and the constitutional treatment is, therefore, of lar more consequence than the application of remedies to the inflamed skin. Mi 50 THE FAMILY PHYSICIAN. If the individual be at the beginning of the attack somewhat debili- tated, or if he be evidently much exhausted by the onset of the disease, it is extremely important that his strength should be sustained in every possible way. For this purpose we rely upon iron and quinine. The following prescription may be given : Tincture of the chloride of iron Sulphate of quinine Tincture of nux vomica. Syrup of orange peel. Water, One ounce One drachm Half an ounce. Two ounces. To make four ounces. Mix, and take a tcaspoonful in water every four hours. Sometimes the pain is so intense that it becomes necessary to adminis- ter opium. Twenty drops of laudanum may be given every three or four hours until the pain is somewhat allayed. For application to the skin itself one of the best remedies is the fol- lowing. Tincture of opium, - - - Liquor plumb sub acetatis (lead waterr) One ounce. Five ounces. Mix and apply by saturating soft clothes with the lotion and laying them upon the inflamed skin. In the early stage of the inflammation, the application of cloths wrung out in ice water, or of the ice itself, will often be grateful to the patient, though it has probably no influence in arresting the disease ; after the first day or two, cloths wrung out in hot water will usually be found more agreeable to the patient than the ice. ^ . Nettie-Rash or Hives. Nettle-rash appears in the shape of elevated patches, or " wheals," which are of irregular shape, flat upon the top, hard and usually of a pale red color ; in some cases, however, the elevated portion of the skin is whiter than that which surrounds it. It occurs most frequently in women and children. It is often the re- sult of some indiscretion in diet. Oysters, fish, pickles, honey and strawberries are among the articles which seem especially apt to induce an attact of urticaria. Certain medicines also occasion nettle-rash in some individuals. Thus it has been known to follow the use of turpen- tine, copaiba, chloral and morphine. Some individuals learn by experi- ence to avoid certain articles of food and certain drugs, knowing the in- dulgence in them is followed by an outbreak of nettle-rash. Treatment. — An emetic should be first administered, if the eruption is caused by anything recently taken into the stomach ; it should be followed by a saline aperient — senna mixture, with salts, is perhaps best, and this repeated until the bowels are freely moved ; if the febrile sym- ptoms do not subside, a mixture composed of sweet spirits of nitre, 2 drachms ; liquor of acetate of ammonia, i ounce ; and camphor mixture, DISEASES OF THE SKIN. 51 5 ounces should be given, two lablespoonsful every four hours. In the chronic form, a simple diet, active exercise, an avoidence of any articles of diet likely to excite the eruption ; keeping thebowles regular by gentle aperients, combined with ami acids ; a five grain rhubarb pill an hour before dinner, or a small piece of the root chewed, are good remedial means ; the tepid bath should be occasionally used, or sponging, to keep the skin in a healthy state ; to allay the irritations, dust starch powder over the irruptions, or use a lotion made of rose or elder- (lower water in half a pint of which has been dissolved i drachm of carbonate of ammonia, and Yz a drachm of sugar of lead. Prickly Heat or Lichen, is a disease caused by intense and long-continued heat ; but it may be excited by the same causes which produce the nettle-rash, when the system is prepared for it. It is one of the most annoying plagues of a tropical climate. Treatineiit. — For the relief of the itching and burning sensation atten- dant on prickly heat, which in tropical countries are often absolutely unbearable, the best remedy is cold water-- • ing caution when the pat- ient is perspiring. Live sparingly and take a .ew doses of Powdered Aloes - - - - 2 drachms Powdered rhubarb - • • - i drachm Powdered Jalap - - - - 2 drachms. Powdered Cream of Tartar, - - • 4 drachms. Magnesia, - - - - - i drachm. Best Honey, - • - - i ounce. Mix and divide into 120 pills, take 2, 3 or 4 on going to bed. Irritation, Itching. A papulous affection of the skin, attended with troublesome itching. Sometimes it is attended with a sensation as of ants or other insects creeping over and stinging the skin, or of hot needles piercing it. This disease, although not dangerous, is a cause of great discomfort, and sometimes even misery ; it attacks persons of all ages, and is not easily got rid of, sometimes lasting for months, or even vears. Treatment. — Wrish well, every evening before going to bed, with Cas- tile soap, and allow it to dry in. Brandy or alcoliol may be used in the same manner. An ounce of lemon juice in a pint of water, or vinegar used in the same proportion, will be found useful ; also, water and spirits of camphor. The diet should be carefully rf gulated, and all stimulants avoided. This disease often affects the private parts, especially in pregnant females. In this case one of the following lotions will be useful : — Hyposulphite of Soda, - • - 4 drachms. Glycerine, • • * - 2 drachms. Distilled Water, • -. - -6 ounces. Apply as a lotion. Dr. Fox, \f .1 6 grains. I ounce. A wineglassfull. One pint. A few drops. 52 THE FAMILY rilYSIClAN. Or, Carbolic Acid, - - . - Water, • - . - . Apply as a lotion. Freckles. To remove freckles use one of the following : — Fresh Lemon Juice, Rain VVater, Altar of Roses, Mix, and put in a well corked bottle. Wash the face and head with this several times daily, letting it dry into the skin. Dr. Wilsoti^ London. Or, Juice of cucumber pressed from the fruit. IJoil over a quick fire, cool rapidly and bottle. '• Apply a tablespoonful diluted with two tablespoonsful of water, night and morning. Dr. Cheevy. Or, Juice of Horse-radish, - - - - | pint. Cider Vinegar, -• - - - i pint. Mix, and apply night and morning. Lice. These disgusting insects are easily transferred from one per- son to another, and give rise to much iiritaiion and even eruption of the skin Sometimes they breed with inconceivable rapidity, especially on diriy or broken-down subjects 'I he treatment is simple. The clothes should be baked, for washing alone will not kill the insects ; a warm bath should be taken, and the skin anointed with stavesacre ointment (one drachm to one ounce). Flannel should be discontinued next the skin until the eruption is well. A strong tea of tobacco, and mercurial ointment also destroy them. The louse wliich frecjuents the hair differs from that found in the clothing. It can be destroyed by the same measures. The crab-louse occurs in the hair on the trunk, under the arm-pits, etc. He is exceedingly tenacious of hfe. Mercurial ointment, or calomel lubbed in, is generally sufficient, however. Mother's Marks. Treatment. — Rthylate cK Sodium painted over the part, night and morning, for a time, will produce a scab, which must be removed, and the medicine re-applied until the mark has disap- peared. ' ^ 4 DISEASES OF THE SKIN. 53 OTHER EXTERNAL DISEASES. Hang-nails. The loose fragments of nails which bear this name should always be carefully removed, as they may, by their irritation, pro- duce felons, and other inflammatory troubles. Ingrown Nails. These usually are found on the toes, cspeciall the big toe. They are very painful and obstinate. To heal them, the middle of the nail should be scraped with a piece of glass until it is quite thin. Then the edge which has grown under the flesh should be gently but firmly pressed upward by inserting under it a roll of lint or solt cot- ton. The raw edge of the flesh should be fastened down, away from the nail, with narrow strips of adhesive plaster, and a loose shoe be worn. Perseverance in this plan will affect a cure. Blood Blisters rise on the skin when one of the small skin blood- vessels is broken. If not the result of an accident, they are often the s^^n of bad health, and point to the necessity of a good diet, tonics, cod- Ifver oil, and change of air. Boils or Furuncles. These are great pests to some people, and many ways are suggested to " backen " them. The best is to apply heat as soon as there is any sign of one. Hot water, long continued, will often succeed. When matter has once formed, warm poultices should be ap- plied, and the boil opened with a sharp knife, so that the core can loosen. When a person has crop after crop of boils, it is a sign of enfeebled health. Peruvian bark or quinine should be taken with iron. For a bli7id boil, which is a dull, obstinate sore, opening with a knife, and poulticing, is the proper treatment. Bunions are hard, tender swellings, which appear on the ball, the outer portion of the second joint of the big toe, or on the insteps. Tight or short shoes produce them. A loose, but well-fitting and flexible shoe must be worn, and the swelling painted, several times a week, with tinc- ture of iodine or a weak solution of carbolic acid. Carbuncle.This is a large and malignant boil, very painful, and eveii dangerous, as it indicates a low state of health. It is flat and firm, with a crust with several imperfect openings, from which the matter passes out. This, and its size, and the intense pain accompanying, distinguishes it from a common boil. At times it is infectious, induced by the recep- tion of an animal poison (from cattle) into the system. This is called a " malignant pustule." Treatment. — The only efficient plan of treating a carbuncle is to de- vide it crosswise, with a sharp surgical knife, early in its course, and then poultice it steadily. The system should be kept up with tonics, and strong, nourishing food, with ale or porter. \ '. 54 THE FAMILY PHYSICIAN. Corns. The cure of these common annoyances is easy, but trouble- some. The foot should be thoroughly soaked in warm water, and all of the corn removed with a dull penknilCjbut no pain should be produced. When this is felt, it is a sign that the knife is going too far. Then the little cavity should be surrounded with Hat rings of wash leather, or felt, or corn plaster, leaving a hollow centre. A drop or two of sweet oil should be placed in this, and the foot clothed in a soft stocking, and a loose easy shoe. This process, repeated twice or three times a week, for a month or two, will cin-e a corn ; but it will return if tight, ill-fitting shoes are resumed. Felon, or Whitlow This is a very painful inllammation of the finger, arising from a bruise, from the cnlrnnce of a needle or si)linter, a hang-nail, or other irritant. ^Vhen milder, it is called a " fiesh felon ; " when severe, affecting the bone, a "bone felon." The former begins generally at one side of the root of the nail, or in the bulb of the finger end, with redness, swelling, and a throbbing, burning pain, shooting up the hand and arm. These symptoms are very much increased in severity in the second variety. Tiie patient holds his hand up, as the pain is more acute when it is dropped. The appetite su-llers, and sleep is disturbed or [)reventcd. At the outset, a felon may be backened, at limes, by holding the hand for a halt-hour in water as hot as may be borne, and then wrappmg it in a large hot poultice. After this is done, leeches may be applied, so as to draw blood freely from the part. These measures failing, the next measure, which should not be delayed, is to open freely the swelling, with a sharp knife, cutting, in a bone felon, fully to the bone. This, alone, will prevent the danger of having a stiff, mutilated, and useless finger for a lifetime. After the incision, poultices and warm water dressing will complete the cure. A great (icrman authority says : — Boils and felons may be often aborted by the free use of nitrate of mercury ointment, if su|)puration have not commenced. It does not cause i):iin, but after about twelve hours, a drawing sensation is felt, after which all sensation ceases. The writer covers the entire finger with a coating of the ointment about j4 inch thick and covers with strong slicking plaster. The dressing is al- lowed to remain on for six hours, after which no further ireairr.ent is necessary. , Goitre, Derbyshire neck, or swelled throat, is a deformity common m mountainous countries. Its cause is not ascertained. The swelling is in front and at the base of the neck. It is painless, but is unsightly, and may become troublesome by pressure on the windpipe and large blood-vessels. When of many years' s'anding, it cannot be cured ; but when comparatively recent, rubbing with the following ointment, three times a week for several months, will cause it to disappear. « DISEASES OF THE SKIN. 55 Take of Iodide of Cadmium, - - - i drachm. Fresh Lard - - - - - i ounce. Mix. Rub in a portion the size of a small pea. Goitre is liable to return, however, unless a change of residence is ad opted. Sores and Ulcers. Cold sore, leg sore, or indolent ulcer. These are names given to those obstinate sores, or issues, that come on the legs of persons, especially those in advanced life, whose systems are below par, and who have suffered from swollen veins, rheumatism, frosted feet, and similar troubles. They are not very painful, but are foul, debilitat- ing, and difficult to heal. The treatment is local and internal, (lood hygiene, great cleanliness, pure air, nourishing, simple diet, and iron or cod-liver oil, daily, are es- sential. Then locally apply the carbonate of ammonia ointment, given below, taking care to wash the sore by a stream of warm suds from castile soap. This done, cut long strijis of sticking plaster about a half inch wide, and long enough to go once and a half round the limb. Ap- plying the middle of one of these to the opposite side of the limb from the ulcer, the two ends are brought forward across this with a firm pres- sure, so as to bring together, as much as may be, the edges of the sore. A number of straps, so applied (leaving i)laces lor the matter to escai)e), completes the dressing. This should be repeated once or twice a week. This method of bandaging a leg is shown elsewhere. Cariwnatc of Aiiunonia Ointvient. — Take of Carbonate of Ammonia, - - J a drachm. 1 ,ard, - - - • . ■^ an ounce. Mix. A useful application to slucgish, scrofulous sores. Sweating, excessive. Persons of a stout habit occasionally suffer from excessive perspiration, which, though it may not be irfjurious, is disagreeable. It may be diminished by avoiding warm baths, changing the underclothing frequently, and sponging the body with a lotion con- sisting of two teaspoonfuls of dilute sulphuric acid, in a (piart of water. The skin, when dried, should be powdered with starch or pulverized asbestos. . . , • Fetid, or Foul Feet, from excessive sweating, are a great annoy- ance to some. Benefit in such cases will be derived from bathing the feet, night and morning, with a mixture of half an ounce of tannic acid in a pint of cologne water, drying, and powdering with starch or dry tannic acid. Warts. These ugly excrescences are best dispersed by rubbing them night and morning, with a piece of muriate of ammonia (salammonic), moistened with water. 5^ THE FAMILY PITYSTCIAN Ringworm. Treatment. — Ringworm on parts of the skin which are not covered with hair is usually cured very easily. The {jrinciplc of" treatment consists simply in the application of some material which destroys the vegetable parasite ; so soon as the plant is killed the irri- tation subsides, the crust is thrown off, the skin resumes its natural condition. A considerable number of agents have i)cen used for this purpose ; among household remedies may be mentioned kerosene oil and a solu- tion ot borax, as follows : Borax, . . . . _ Half an ounce. Water, _ _ . . . Half a pint. Some of the borax remains undissolved at the bottom of the vessel, but this is useful in order to keep the solution at full strength. AVhile these remedies are usually effectual, yet many people object to the application of kerosene, which is moreover irritating as well as unpleasant, and is apt to cause some swelling and pain of the skin around the diseased spot. For these reasons various other remedies are to be preferred in tlie treatment of ringworm. Among those most employed by physicians are the following : Hyposulphite of soda, ... One ounce. Dilute sulphurous acid, - - . Two drachms. Glycerine, - ... One ounce. Water, ----- Four ounces. This should be applied to the diseased patches by means of a stiff brush or a coarse cloth, which is to be dipped in the lotion. Saturated solution of sulphurous acid, - One ounce- Water, - . - . . Three ounces. The removal of the parasites is hastened by the use of a remedy in solid font!, which can, therefore, be kept in contact with the skin con- stantly, and not simply applied at intervals, as is necessary when liquids are used. If the disease be located on the face, an ointment can be applied at night and allowed to remain till morning ; for this purpose any one of several ointments may be used, as follows : Ammoniated mercury, - - - Twenty grains. . Red oxide of mercury^ powdered, - Twenty grains. Simple ointment, . - - One ounce. Mix thoroughly and apply directly to the skin, rubbing the salve vigor- ously into the pores of the skin. The simple ointment of viercury will also be found efficient. In n.ost cases, too, the ordinary sulphur ointment can be successfully used for destroying the parasite. This affection is entirely a local disease of the skin, and requires no intprnni tn>i'm'nt. DISEASES OF THE SKIN. 57 Ringivorvi of the scalp is a far more troublesome and obstinate affection to cure, not because the parasite is any more difficult to destroy, but because it is extremely difficult to introduce the remedy into the follicles of the hair, which are a continual brcedint; place tor these or^^^nisms. It will often happen that by a few apt)lications of one of the remetiics above given the disease will entirely disappear from the scalp, and the patient will consider himself cured ; but in a few days or weeks it becomes evident that the ringworm has started again in the same ])lace. It is, therefore, necessary to take especial pains to introtluce the vari- ous agents used for killing the parasites into the hair follieles. I'or this purpose the first re(|uisite is to shave the head closely, so as to remove all the hairs from the diseased patch and from its immediate vicinity. After this has been done, there may be rubbed into the scalp daily one ointments : of the following One drachm. One ounce. Hyposulphite of sodium, Vaseline, ... - Or, Salycycle acid, ... Vaseline, • - - . In some cases good results ma)' be (obtained Ijy brushing the surface thoroughly with strong tincture of iodine. Twenty grains. One ounce. DIET IN DISEASES OF THE SKIN. The physician is constantly asked by patients suffering from skin dis- eases, what they shall eat and what they shall not eat. Probably no other class of patients is so deeply impressed with the idea that their diseases are due to impurities of the blood, and that extreme care should be taken to avoid the use of certain articles of food. Most of these patients have theories and hobbies as to the diet which it is proper for them to take and to avoid-; and most of them seem to believe that dieting consists in the avoidance of food so far as possible. It is true that the diet can be made to exercise considerable influence upon diseases of the skin as well as upon diseases of the internal organs ; but it is not especially necessary to regulate the food in diseases of the skin, with certain exceptions to be presently mentioned. In every case it should be remembered that the plan of dieting does not mean to reduce the patient to the verge of starvation, but simply to grant him such articles of food and in such quantities as will, in the opinion of the physician, tend to restore his bodily functions to their natural condition. In most cases the patient needs to be built up rather than torn dotvn ; for most diseases of the skin, even those of local origin, such as ringworm, indicate that the patient is in a more or less debili- tated condition, since these diseases do not ordinarily occur in persons of the most robust habits. S8 THE FAMILY PHYSICIAN. There arc certain affections of the skin which arc provoked and aggra- vated by indulgence in particular articles of diet ; the patient soon learns to discriminate for himself upon this point ; he soon discovers what articles of food are especially apt to provoke the outbreak of his com- plaint. Thus the sufferer from nettle rash early ascertains that he has an attack of the disease whenever he eats strawberries, or oysters, or shellfish, or whatever his particular weakness may be. Aside from these personal peculiarities, there are certain principles wliich apply to patients affected with chronic diseases of the skin. In most cases the appetite is a leliable guide, though it sometimes needs direction. To begin with, it must be remarked that much of the difficulty from error of diet arises not so much Irom the nature of the substances eaten, as from the imperfect and careless way in which ihey are eaten In our country especially, rapid eating and hurried chewing are prevalent habits, which are responsible for many difficulties of other organs than the stomach. For digestion really begins in the mouth ; here the food is not simply divided into small particles, so that it can be acted upon by the juices of the alimentary canal, but it is also mixed with the saliva, which effects certain changes in it. If the chewing be imperfectly per- formed, or if the saliva be but slightly mixed with the food, there will result first derangement of the stomach, and subseijuently derangements of other organs, h'or the ill effects are not limited to the stom ich alone. If this do its work but imperfectly, additional labor is required of other organs to piece out the work of the stomach ; while at the same time these other organs are supplied with imperfect blood, since the stomach does not digest and take up the focd in a natural way. It is evident, therefore, that one of the first requisites for the diet of a patient affected with skin disease is that the food shall be easily digested. The patient's own sensations will usually indicate to him when he has indulged in indigestible food. As to the quantity of food which should be taken, it may be said that but very few of the skin diseases are caused or aggravated by excessive indulgence in food. Patients with acne are perhaps the only ones whose complaint is aggravated by simple over-indulgence. Such patients should avoid hot drinks and soups, since these provoke flushing of the face and favor the development of the rash. It is well for them to avoid desserts, since these are usually just so much more than the incKvidual requires or really desires. A prevalent habit, which probably contributes largely to the preval- ence of indigestion, is the liabitual use of large quantities of liquids with the meals. Aside from the injuiy which may result from alcohol or tea or coffee in excess, it is not desirable to fill the stomach with any licjuid, however harmless, during the process of digestion ; since the stomach juices are thereby diluted and weakened and the process of digestion is. DISEASES OF THE SKIN. 59 to say the least, rotardfd. This is especially true if the liciuids taken he cold, since the effect of chilling the stomach is also to arrest tlic diges- tive process. Patients with eczema are apt to dislike and avoid fatty food. It has been ascertained that the use of fats in the food generally exerci^.cs a good influence upon the course of the disease ; hence it is desirable that such patients take a moderate amount of fat with their food, even though they do not crave it. These patients with eczema are apt to eal vege- table food by preference, especially the starchy substances, such as rice, arrowroot, and oatmeal. It is well for them to bear in mind the poi)U- lar idea that " oatmeal is heating," since there seems to be some foun- dation for Ihis idea in fact. One of the most frequent causes and one of the most constant means in prolonging the various diseases of the skin, is indulgence in lerment- ed litpiids. 'J'hese generally exercise a decided influence in originating and in prolonging diseases of the skin. A patient suffering from such disease should, therefore, abstain from the use of beer, ale, wine, whisky, cider, etc., unless his condition is so debilitated as to require some of these liquids to increase and support his strength. Especial care must be taken in the food of infants who are afflicted with diseases of the skin. The great bane of infancy among skin affec- tions is eczema. This is doubtless often caused by a poor (jualily of lood, whether this food be artificial nourishment or the mill: from a debilitated mother. In every case of eczema in an infant, the attention should be directed to the matter and manner of nourishment of the child; the mother should scrutinize carefully her own condition ; should see that she eats only suitable food and avoids articles which she knows to be harmful, even though she have a craving for them. She should also endeavor to avoid any mental disturbances, excitement or emotion of any sort, undue sexual indulgence, and she should secure sufficient rest by retiring in due season at night. Another habit which may assist in the development of eczema is the practice of giving the child the breast too fre(juently. The custom is almost uni'-ersal of using the breast to soothe a crying infant ; this is usually a successful device, but it exerts a most injurious influence upon the child's digestion and promotes the development of several skin ^dis- eases, especially eczema. As will be observed under the ap[)ropriate heading, the child should not have the breast, even in the early weeks of life, oftener than once in two hours ; and as time passes this interval should be lengthened, in the interests of the child as well as the mother. Doubtless another factor in the production of eczema in nursing in- fants is the use of fermented liquors by the mother. It is well ascer- tained that the use of such liquors promotes the occurrence of eczema in adults and in infants through the mother's milk; hence, unless tlie 6o THE FAMILY PHYSICIAN. mother's general condition is such as "to absolutely require the support which can be given only by fermented liquors, it is advisable that she avoid these, in spite of the counsels and remonstrances of friends. Eczema is especially frequent among artificially nourished or "bottle- fed " infants. It is often imi)Ossible to relieve an infant from eczema until its diet be radically changed. Directions for the feeding of infants will be found in the section on " diseases of women and children." It is scarcely necessary to remark, that the habit of feeding suckling infants with scraps from the table, pieces of cake " which don't do him any harm," sips of tea and coffee and the like, should be avoided even when the child is perfectly healthy, in the hope of keeping him so. It is all the more necessary when the infant is afflicted with a disease of the skin. Much might be said also as to the hygiene of the skin during the ex- istence of ailments affecting it. The popular idea that bathing is always desirable in all diseases of the skin, is a mistaken one ; some of these diseases, especially eczema, are greatly aggravated and prolonged by fre- quent contacts of the skin with water. Yet certain diseases, especially psoriasis, are certainly benafited by fretjuent bathing, especially at the sea shore. In fact everything which tends to increase the activity of the skin — muscular exercise in the open air, sunlight, iresh air in the bed- room, etc. — is highly desirable and important in the treatment of chronic diseases of the skin. Dr. Fox gives the following directions as to diet in skin diseases : First. — A distinction must be made between the diet < f the private and the hospital patient. The latter often requires to be well fed and his disease then speedily goes ; the former, on the other hand, oiten needs to have a check put on the quantity and fjuality of his food. Second. — In children, skin diseases may arise directly from defective alimentation, as in the case of eczema ; and it is frequently the case that the child who is the subject of eczema has not a sufficient supply of milk, either from excessive dilution or otherwise. lliird. — The regulation of the diet, setting aside the (jucsticn of quantity or quality, is as a rule needed not so much to directly influence skin disease as certain states of the general health, which modify the par,ticular disease .present ; for instance, to meet especially dyspeptic, gouty and rheumatic conditions, but particularly the former. In dyspepsia, in connection with eczema, acne, or congestion of the face, it is advisable, especially if the urine be very acid, to avoid sugar, tea, coffee, alcoholics, beer, raw vegetable matter, unripe or uncooked fruit, veal, pork, seasoned dishes, pastry and the coarser kinds of veg- etables, but especially all articles whose use is followed by heat or flush- ing of the face, and by flatulence and the like. Milk, the common meats, light kind of bread and some very light wine should be the diet of dyspeptic patients whose skins are at all in a state of irritation. In DISEASES OF THE SKIN. 6i very many cases the stomach is at fault at the outset, and a careful regu- lation of the diet is of the utmost importance as an aid to the other means adopted to correct faults in other parts of the system. In gouty subjects much the same line of treatment is to be pursued. As regards stimulants, hock, a good light claret, or whiskey and water are the best beverages. In scrofulous patients the diet should consist of as much f'ttty matter as possible. Fourth. — In children who suffer from ringworm it is desirable to give plenty of fatty food by means of milk, cream, eggs, and fat meat, if they can be persuaded to eat it. Fifth. — In syphilis the greatest care should be taken to avoid every- thing beyond the most moderate use of stimulants ; their abuse in this disease is a source of the greatest aggravation. Sixth. — In all cases in which the onset or early stage of a skin dis- ease is accompanied by fever, however slight, stimulants should be avoided, and the plainest and simplest diet ordered. In marked cases of this kind a milk diet for a while is often found to be very beneficial. Seventh. — In some cases in which the disease is accompanied by flushing of the skin, this condition is much increased by the consump tion of food, especially if dyspepsia exist, in consequence of the sym- pathy existing between the stomach and the skin of the part affected. This state of things is especially marked in such diseases s acne, con- gestion of the face, and sycosis (barber's itch). Stimulants must be avoided, unless they be diluted with some alkaline water. The use of a diet appropriate to the dyspepsia must be rigorously enforced. Eighth. — In all cases where a skin disease has become chronic, and where there is debility, the patients hould be allowed a full unstimulat- ing diet. At the well known hospital for diseases of the skin, Illackfiiars, Lon- don, the following directions rrf» issued, to be observed by patients : Remove flannel from next the skin affected, or line it with soft linen. Wash with warm water, and, as regards diseased skin, not more fre- quently than cleanliness requires. Avoid using soap of any kind to the oTected parts. To cleanse the diseased skin, substitute instead of soap a paste or gruel made of bran, oatmeal, linseed meal, arrowroot, or starch and warm water. Rinse off with warm water or warm milk and water ; and employ yolk of an egg and warm water to cleanse the scalp. Dry the skin with soft linen, and smear it lightly with the ointments or liniments, or dress wounds wit'^ ♦^hc same spread thin upon lint or linen. Afterward apply the bandages evenly should they be required. Bathe the affected part by means of a sponge or rag with the lotions or embrocations, or paint them over with a camel's hair brush, not more frequently than directed by the physician. 62 THE FAMILY PHYSICIAN. Rinse the mouth with water, and brush the teeth after taking the medicines, and observe that neither more nor less than the dose ordered is taken. At the same institution the following rules of diet for patients are observed : For breakfast — Bread and milk, ric^, milk or porridge instead of much tea, coffee or cocoa — with or without eggs^ and bread and butter, or a little animal food. For dinner — Plain roast or boiled fresh meats, fish or poultry plainly cooked, egg or farinaceous (starchy) puddings, potatoes, and few other vegetables, plain boiled rice. For supper — Milk and water, or gruel or other farinaceous food, with bread and butter, a little cream, cheese or poached eggs. Beverages — Barley water, toast and water, thin gruel, beef tea, soda, potash or seltzer water. N. B. — To be avoided — Salt meats, soups, sweets, acids, fruits, pastry and raw vegetables. No malt liquors, wine or spirits are to be taken without the sanction of the medical officers of the hospital. the red are ich r a nly her ith da, itry ion CHArXER VI. FEVERS AND OTHER DISEASES. Small-pox or Variola — Scarlet Fever or Scarlatina — Measles — Typhoid Fever — Typhus Fever— Inteniiittent or Malarial Fever (Fever and Ague) — Bilious or Remittent Fever — Acute Articular Klieumatism— Chronic Rheumatism — Muscular Rheumatism— Gout — Sciatica. Small-Pox ( Variola). This, like scarlet fever and measles, belongs to the class of eruptive fevers ; it attacks persons of all ages, but the young are the most liable to it. At no particular season of the year is it more prevalent than at any other, nor does climate appear to be influential in modifying its visitations. Symptoms. — When it occurrs naturally, the premonitory symptoms arc those of other fevers of its class ; there are usually cold chills, pains in the back and loins, loss of appetite, prostration of strength, nausea, and sometimes vomiting : with young children, there are sometimes convul- sions. About forty-eight hours after those symptoms set in, an eruption of hard red pimples begins to overspread the face and neck, gradually extending downward over the trunk and extreinities. Each pimple is surrounded by the peculiar dull red margin termed areola, and has a central depression on the top, containing lymph ; at this period the eruption is decidedly vesicular, but it becomes afterward pustular; this change takes place on about the fifth day of its appearance, when the central depression disai:)pears, suppuration takes place, and the vessels are filled with matter, which shortly after oozes out and dries into a scab. In about ten days this falls off, and leaves a pale purple stain like a blotch, which gradually fades, unless the disease has penetrated so deeply as to destroy the true skin, in which case a pit, or, as it is usually called a " pock-mark," remains for life. Small-pox may be either distinct or confluent. In the former case, the pustules are perfectly distinct from each other, in the latter, they run into each other ; this latter is the most dangerous form of the disease, the fever being more intense ind rapid, and having no intermission ; it goes on increasing from the first, and frequently by its violence, in nine or ten days, so exhausts the system that coma, delirium, and death en- sue, preceded by convulsions, hemorrhages, bloody stools, dysentery, and all the train of symptoms which indicate that a virulent and fatal poison has entered into the circulation. Treatment. — As soon as the premonitory fever comes on, an emetic should be administered, and followed by a purgative of a tolerably active nature ; then keep on spare diet (certainly no meat), and give plenty of 63 I 64 THE FAMILY PHYSICIAN. warm diluent drinks ; keep the bowels moderately open by means of saline aperients ; let the patient have plenty of fresh air, and sponge the skin with cool or tepid water, as may be most agreeable, to diminish the heat of the body. Sometimes there is not energy in the system to de- velop to pustules with sufficient rapidity; in this case nourishment and stimulants should be gi'.en in the form of broths, wine, whey, etc. ; warm or mustard foot-baths should also be resorted to : and, to allay irrita- bility, a ten-grain Dover's powder may be administered at bed time, or a ^ ot a grain ofmorjihine, in camphor mixture. A good nourishing diet will be rctjuired in the secondary stage of the fever ; and if it assumes a typhoid character, the treatment should be the same as that of typhus fever. Freciuently the face is much swelled, and the eyelids closed ; in this case rub the latter with oliye oil, and bathe the whole with poppy fomentation. If the throat is sore, use a gargle i.x honey and vinegar, i tablespoonful of the former, 2 of the latter, added to a h pint of water or sage tea. If much affected, a blister should be applied to the neck. If there is much headache, cut the hair close, apply mustard poultices to the feet, and a spirit lotion to the head ; to reduce itching, apply to the eruptions a liniment composed of lime water and linseed oil, equal quan- tities, or smear the pustules with cold cream ; to check diarrhea, give chalk mixture, with 5 drops of laudanum in each dose ; if perspirations are too copious when the eruptive fever has subsided, take acidulated drinks. Smearing the eruption with mercurial ointment, or puncturing each pus- tule, and absorbing the pus with wool or cotton, has been recommended to prevent the deep pittmg which is so great a disfigurement to the face. Painting the face once or twice a day with glyceiine is said to effectually prevent pitting. There is no disease more certainly and decidedly contagious than this; after imbibing the poison, a period of twelve days generally elapses before the commencement of the fever, and during this time no inconvenience may be experienced. Besides breathing the effluvia arising from a per- son attacked, small-pox may be communicated by inoculation with the matter of its pustules, and, the resulting disease being of a milder char- acter, this method was formerly much practised to guard persons from a spontaneous attack ; since, however, the introduction of vaccination by Dr. Jenner this practice has been abandoned. This disease is frequently epidemic, and the statistics of its different visitations show that the mor- tah'iy of those attacked who have not been vaccinated is one in four ; whilst of those who have, it is not one in four hundred and fifty ; a strong argument this for vaccination where the disease prevails. A Certain Cure. Wm. (irandy, of Detroit, communicated the fol- lowing item of Mr. Hines' to the Detroit Tribune^ which he had seen in the Toronto Weekly Globe^ with these remarks : " Small pox being so fatal and so much dreaded, an unfailing remedy like the following, so simple and s6 safe, once discovered, ought to be brought to the knowledge of the masses without liesitation or delay." FEVER AND OTHER DISEASES. ^5 r; "I am willing," says Edward Hines, "to risk my reputation as a public man if the worst case of small i)ox cannot be cured in three days simply by cream of tartar. This is the sure and never-failing remedy : Cream of tartar, i oz., dissolved in boiling water, i pt. ; to be drank when cold, at short intervals. It can be taken at any tmie and is a pre- ventative as well as a curative. It is known to have cured tb.ousands of cases without fail. I have myself restored hundreds by this means. It never leaves a matk, never causes blindness, and always prevents tedious hngering. Scarlet Fever or Scarlatina, Is a contagious febrile disease, al- most always attended during a part of its course by a rash and by sore throat. Sometimes only one ot these fealuics is well marked, sometimes both. Though persons jf all ages are susceptible of it, it is eminently a disease of children. Like small pox or measles, it rarely attacks a per- son more than once. Thysicians distinguish three different varieties of scarlatina — namely, scarki/ina siiiip/c\^ in wiiich there is a florid rash and little or no affection of the throat ; scarUxtiiui mii^iiwsa^ in which both the skin and throat are decidedly implicated ; and scariatina maii^na^ in which the distress of the disease falls upon the throat. Syuiptonis. — So plainly are the symptoms marked that it is scarcely possible to mistake this eruptive fever for any other ; almost invariably we have first sore throat, with shivering, headache, and loss of appetite ; probably there may be sickness and vomiting, with heat of skin, quick pulse, and great thirst. In about forty-eight hours from the commence- ment of the attack, we have an eruption of red spots upc^n the arms and chest ; these gradually i)ecome more thickly [)lanted and widely spread, until they pervade the whole of the body, making the skin appear of one uniform scarlet tint, that is over the body generally ; in the extremities it is more in patches, the skin being [)erceptibly rough to the touch. On the second day, generally, the tongue presents the appearance ot being covered with a white film, through which the papuke project as bright red spots, as we see the seeds on a white strawberry ; then the white creamy-looking film comes away gradually and leaves the tongue preter- naturally clean and red. On the fourth or fifth day the eruption begins to fide, and by the seventh or eighth has entirely disappeared, and with it, the lebrile symptoms. Then commences the peeling off of the cuticle or scarf skin, which comes away in scales from the face and body, and in large flakes from the extremities. It is during this process that the greatest danger of contagion is to be api)rehended, and, until it is com- pleted, the patient should be kept apart from the rest of the family : it may be hastened by tepid bathing and rubbing. Sometimes with scarlet fever, there is little real illness ; the patient leels pretty well, and, in a few days would like to leave the sick chamber ; but it is always neces- sary to bo cautious in gratifying such a wish, both for the sake of the invalid and of others j after an attack of this lever, as after measles, the '; M s. \: .1 66 THE FAMILY PIIYSICIAN. system is peculiarly susceptible of morbific influences, and a chill taken at such a time may cause the most alarming results. Sometimes we have a great aggravation of the symptoms above des- cribed ; the throat gives the first warning of the attack ; there is stiff neck, swelling of the glands, and the lining ot the mouth and fauces becomes at once of an intense crimson color ; there are ash-colored spots about the tonsils ; the general eruption is of a deeper color, and spreads more rapidly than in the simple kind. Then again we have the mnlignant form, with the rash in irregular patches of a dusky hue, which sometimes recedes and apjiears again. There is intense inflammation of the throat at the \»ery outset, with gen- eral enlargement of the salivary glands; the neck sometimes swells to a great size ; there is a sloughy ulceration of the throat, from which, and the nostrils — through whicli it is dillicult to breathe— there comes an acrid discharge, causing excoriation of the nose and li[)s, and sometimes extending to the larynx and trachea, as well as to the intestinal canal, causing croup, vomiting and purging. The i)oisonous secretion enters into the circulation and vitiates the blood ; sometimes the sense of hear- ing, as well as of smelling, is entirely destroyed by the acrid matter com- ing in contact with and inflaming the mucous membrane. With this form of the disease it is extremely difficult to deal, and the patient often sinks beneath it in spite of the best medical advice and assistance. Scar- let fever may be distinguished from measles by the following character- istics : In scarlet fever the eruption appears on the second day, accompanied with sore throat, but no running of the nose. In measles the eruption comes out on the third or fourth day, with running from the nose, and other catarrhal symptoms. The eruptions of measles are like flea bites, slightly elevated from the surface, in patches the shape of a half moon ; whereas the rash of scarlet fever is smooth to the touch, spreads over the whole body, and is of a brighter color than the measles. Treatment. — At first mild ajierients only should be given, with diluted drinks, as flaxseed tea, and a ;:pare diet ; the patient should have plenty of fresh air ; the head should be kept cool, the hair being cut close off or shaved. The following is a good febrifuge mixture : Carbonate of Ammonia Solution of Acetate of Ammonia Water or Camphor Mixture 1 drachm. 2 ounces. 6 ounces. A tablespoonful to be taken every four hours — that is for an adult ; a dessertspoonful will be sufficient for a child. The whole body should be sponged with cool water as often as it becomes hot and dry. If the throat swells much externally, and there are headaches, apply a blister or hot bran poultice, and soak the feet and hands in hot water, with a little mustard or Cayenne pepper stirred in. To gargle the throat, dis- ■■W/ lie the ter a iis- FEVER AND OTHER DISEASES. 67 solve I drachm of common salt in ^^^ a pint of water ; with children who cannot gargle, this may be injected against the fauces or up the nostrils, by means of a syringe or elastic gum bottle. When the inflammatory ac- tion has ceased and the skin is peeling off, it is necessary to take good stimulant and nutritious food, with tonics such as iron and (juinine, un- less they cause bad head symptoms, in which case these must be discon- tinued and the diet chiefly depended on. When the system seems to be overwhelmed with the strength of the poison, a liberal administration of wine and bark will be required to sustain the flagging powers until the deadly agency has in some measure passed away. As gargles for the throat, a weak solution of chloride of soda, or of nitrate of silver is very useful. A solution f chloride of potash in water (a drachm to a pint) is recommended as a drink in this disease. The bowels also re(iuire to be carefully watched. It is of the utmost importance that the throat should be carefully treated. Jf neglected, the inflammation is liable to enter into the middle ear and cause life-long deafness, and perhaps ulceration of the ear, with ciischarges. With regard to the more malajnant form, but little is to be done ;* the depressing effect of the contagious poison upon the whole body, and upon the nervous system especially, is so great as to defy all active treat- ment. To assist the action of the skin, use the following : 1 scruple. Yz an ounce. 20 drops. 2 ounces. Pulverized Gum Arabic, Sweet Spirits of Nitre, Tincture of Veratum Viride, Water, soft, ... Mix : give half a tcaspoonful every half hour. Measles is known also as rubeola, French measles, black measles, morbili, and may be confounded with resoela or rose rash. The latter has no fever or throat symptoms. Symptoms. — The attack is ushered in by all the evidences of a cold. The nose runs, the eyes are red and watery, sneezing is frequent, and there is more or less cough. Along with this is more or less fever and debility. About the fourth ,day the eruption appears, first on the face, then on the chest and upper extremities, finally covering the whole body. It is of a dark red color, not fine pointed, and arranged in ])atches of a crescent shape. The fever soon declines, and the eruption fades after three days, being followed by slight scaling of the skin. There is also a soreness of the throat, though generally of a mild form. French or German measles is also called " riitheln." It appears like a mixture of measles and scarlet fever. On one part, the erui)tion strong- ly resembles the one, while on another, it resembles the other. Some regard this as an entirely separate disease, and claim that it does not afford any safety against an attack of either measles or scaVlet fever. ia 'I I 4 \\ li :;! 6S THE FAMILY PHYSICIAN. f^ V 'I Black measles is that form when typhoid symptoms occur, and the attack is .complicated with hemorrhages, etc., and generally ]iroves fatal- Tnaiment. — The bowels should be acted on gently by some cooling saline, such as — Cream of Tartar, Carbonate of Soda, Water, 3 drachms. 3 drachms. I tumblerful. Tut the whole in a stone ji.g or bottle and fasten the cork. To be taken in the morning before eating. 'J'hen the solution of acetate of ammonia may be given freely with cooling drinks such asjcmonade, etc. And if the cough,;ind chest sym- toms are severe ^ teaspoonful ipecac syrup as well. In very many cases nothing is rec^uired but good nursing and care. In debilitated cases quinine stimulants and nourishing food are rccjuired. Table exhibiting the difference between small pox, scarlet fever and measles. MEASLES. SCARLET FEVER. 8UALL-P0X. The pt-riod wliich cl.i])ses The pcri(j(l bctwocn expo- Tlic period hetwocn ex- bt'txseeii exposure to f.ont.i- sure tocont;i.i(ion and tlie he- posure to contagion unci Uie gion and the V)eginning of giiming of tliechsease is vari- fx-ginning of the disease may the disease is usually jffe;// to able, often three \.o j/.v days, vary from five to twenty tlays, jourtecn days. but maybe several weeks. and usually about A// days. Fever is moderate ; it does Fever is intense ; eontinues The lever is usually high ; not decrease, but often in- without interruption after the it subdues when the rash ap- creases when the eruption eruption npp'ars. pears, appears. The eruption make* its The rash makes its appear- The eruption makes its ap- nppearancc on the/fl7^/7// day ance on the .wwwr/ rA/y, first pearance on the ihirii or hist on the/<7ars as cresccnt-sliaped palihcs, the in- tervening skin being healthy. The rash lasts7?7r days, at the end of which time the skin peels off in very Jinc scales. The tongue is coated and red at the edges. The rasii s]ireads uniform- The rash consists at first of />' over the skin, without in- ///;///f.v whicli become a d.ay tervening jjatches of healthy later watery hlislrrs, ]• inally skin. these blisters become white, and are drawn in at the centre The eruption lasts six or — ninbilicated. sc-i'cn days, when it begin* to peal off in lan^ejlakes. 'I'he tongue is covered with The tongue is heavily coat- numerous hue red points, ed and often swollen, which give it the name " strawberrv tongue. " Kunniii;^ of the eves and 'I'here is rarely any notice- There is no running at the y/iw and bronchitis are usu- n\>\c bronchitis otrunnini^^ of eyes or noi,o, and not often aWy /resent. the eyes and nose. bronchitis. FEVER AND OTHER DISEASES. 69 MEASLES. Sore throat is very rare* The mihtiis net affected. There is no secondary fever ; that is, afti-r the first fever has subsided, which happens during the s«"cond or third day after the appearance of the rash, no further fever occurs. SCARLET FEVER. Sore throat is always pre- sent. The mind is usually affect- 8MALL-F0X. Sore throat isoftcn present, l)Ut not so ruarltofNs. — The cold stage commences with a sense of languor and de- bility, and slowness of motion ; fre(iuent stretching and yawning ; pain in the head and loins ; sometimes sickness and vomiting ; ])ulse small, frequent, and irregular ; urine pale ; to this succeeds a violent shivering and shaking, the patient feels very cold, and the breathing small, frecjuent and anxious, sensibility is much impaired. After a time these symptoms abate, and the second stage commences with an increase of heat and fever all over the body, redness of the face, dryness of the skin, thirst, pain in the Iwad, throbbing temples, the tongue iurrcd, the pulse be- comes dry, hard, full, and regular ; when these have continued some time, a moisture breaks out on the forehead, which by degrees becomes a general sweat a'll over the body, the fever abates ; the water deposits a sediment ; the breathing and pulse are free, and the fit is over, but leaves the patient in a weak state. Tieatment. — In the cold stage, give warm diluent drinks, such as barley water, weak tea, or weak wine and water. Apply external warmth by means of extra clothing, hot bottles to the feet, mustard fool-baths, bags of heated bran, baked salt, osure, or similar to ague. Symptoms. — l-'requent flushings and shiverings, with vomiting, bilious phlegm, and sometimes purging, same as bilious diarrhoea. Tieatment. — Cleanse llie stomach witii the following : Emetic tartar, one grain ; powdered ipecacuenha, fifteen grains ; water, three table- spoonsful ; mix and take ; drinking warm camomile tea till it operates ; and the bowels with this : ICpsom salts, six drachms ; glauber salts, three drachms ; infusion of senna, seven ounces ; tincture of jalap, half an ounce ; compound tincture of cardamoms, one ounce ; mix, and take twotablespoonsful every four hours, till it operates freely. Then take for a day or two the following : Subcarbonate of potash, four drachms ; purified nitre, one drachm ; syrup of saffron, six drachms ; cami)hor mixture, twelve ounces ; mix, take two tablespooiisful every four hours, with one of the following powders each time in the dose : citric acid or tartaric acid, half an ounce ; divide into twelve powders, mix in the draught, and drink whilst effervescing. When the fever has subsided take for a week or two the following ])ills : Sulphate of quinine, two drachms ; extract of gentian, three drachms ; mix well ; divide into sixty pills, and take one every four hours. Then use the following excellent drink : Take well-crushed pale malt, three lbs. ; dried wormwood, dried century, dried hoarhound, dried li i ■ 74 THE FAMILY .PHYSICIAN. buckbean, dried bctony, dried camomile, dried ground ivy, of each one ounce (but if fresh two ounces), gentian root, sHced, one ounce ; Virginia snake root, sHced, one ounce ; infuse all in two gallons of hot water, in a warm place, two hours, then boil together fifteen minutes, then strain off (he herbs, etc., squeeze as dry as possible, put in two pounds of sugar, and boil again ten minutes ; when cool enough, put in some fresh yeast; work it well for two days, then bottle in sound bottles, putting two table- spoonsful of brandy to each (juart. This is remarkably good for weak- ness, eic. Take three tablespoonsful three times a day, with a teasp»on- ful of the compound tincture of bark in each dose. Rheumatism. Several distinct affections are popularly included under this term, rheumatism. First, an acute inflammatory affection of the joints, called in medicine acute atticular rheumatism. Second, the disease, or perhaps series of diseases, called chronic rheumatism. And third, muscular rheumatism. Indeed this term is popularly applied with considerable license to almost any painful affection in which there are no local signs of disease. Acute Articular Rheumatism. This disease affects the joints, as the name implies. It is indeed an inflammation of a smooth mem- brane which lines the joints, called the symwial membrane. At the same time it may extend to other parts of the body containing this same mem- brane, especially the heart. So long as the disease is confined to the joints it is not immediate'v dangerous ; the peril of life consists in the possibility that the inflammation may extend to the heart, in which case there often results serious difficulty, which may cause immediate death, or may result in permanent disease of the heart. Perhaps the majority of cases of so-called organic heart-disease originate in attacks of acute rheumatism. Symptoms. — Acute rheumatism usually begins with a sudden attack, which may occur in the night. In some cases the manifestation of local difficulty — that is, pain in the joints — may be prec ded for a few hours or days by more or less fever. In most instanu . ., however, the fever and the local pain oegin at about the same time ; it may indeed happen that soreness in the joints is felt for some time before the fever begins. The commencement of the disease consists in a painful swelling in one or more joints, the skin around which is red and tender, the inten- sity of the pain varies, but in most cases it is quite severe, and becomes agonizing upon movements of the inflamed joints. Perfect quiet ?s therefore requisite as one of the essentials tor diminishing pain. Pres- sure, too, over the joints is extremely ppinful, so thcii even the weight o* the bed clothes is at times unsupportable. Those joints which are not covered by the muscles — the knee, wrist, elbow and ankle fo; example — exhibit considerable swelling \ while others, such as the shoulder and >.,^«. i; i! FEVER AND OTHER DISEASES. 75 hip, may be equally affected and equally painful, but show only slight swelling. In some cases several joints become inflamed at the same time, or in rapid succession, in others the inflammation usually remains limited to one joint tor some time before spreading to others ; it rarely happens that the inflanmiation is permanently limited to a single joint, since several joints are successively attacked, and various ones may be suffering from the inflammation at the same time ; in severe cases it seems as if nearly all the joints of the body were invaded by the disease during its course. It is a singular feature in the disease that the corresponding joints on the two sides of the body, both knees or botli elbows for instance, are simultaneously affected. The relative liability of the different joints to the disease appears to be, first the knee, then the ankle, wrist, shoulder, elbow, hip and fingers. Acute rheumatism is always associated with more or less fever, and is hence often called rheumatic fever. The appetite is impaired or lost, there is great thirst, the tongue is thickly cOi ted, the bowels usually con- stipated. A special feature is the profuse sweating which occurs, espe- cially at night ; tlie i)erspiration evolves a sour odor. 'I'he mind is usually not impaired, unless the membranes of the brain become in- volved in the inflammation. The patient's strength is usually well preserved, his chief suffering consisting in the pain in the joints. Although the local inflammation in the joints may result in some permanent stiffness or deformity, yet the chief danger from the disease occurs, as has been stated, from the possible complication in the heart, for the heart is lined with a membrane quite similar to that of the joints, and is covered over with another such membrane ; cither one or both of these may become the seat of the inflammatory process, a complication which may occur at any time in the course of the disease, though most frequently in its first half. Another unpleasant feature in the disease is its liability to recom- mence when apparently about concluded ; that is to say, the patient will sometimes, alter weeks of illness, become quite free from fever and pain, the joints are no V nger swollen nor tendf^r, and complete recovery seems to be at hand, when suddenl;' the disease b'^gins again affecting perhaps the same joints as before, and manifesting the same mtensity. Treatment. — Until a few years ago, the treatment of acute rheumatism was not entirely satisfactory, as was proven by the fact that many meth- ods were in use. The best results have been obtained by the use of alkalies, with or without cokhecum. A formula frequently used was the following : « - . Each two and a-half drachms. Carbonate of p()tassi.mi,\ Nitrate of potassium, / Water, eight ounces. Dissolve and take a tablespoonful three times a day. 11 J!i!''! jilftJ \ lil! 11 . MHBfSI X^B 76 THE FAMILY PHYSICIAN. Much value has been obtained also from the use of lemon juice in water, say a tablespoonful every three hours. Yet, since 1876, there has been but little resort to those measures, because means have been found by which the disease can be promptly and effectually checked. Under the use of the alkalies and lemon-juice, the patient was usually ill for two or three weeks at least, and ran the risk of complications in the heart, which might prolong the disease indefinitely. At present, how- ever, we are enabled to cut short acute rheumatism usually within three days, sometimes within twenty-four hours ; and not the least valuable feature of this treatment is the avoidance of the heart complications, which often prove the most serious feature of the entire illness. The measure employed for this purpose is the use of salicylic acid, or some of its compounds. The best form for general use will be the compound of the acid known as the salicylate of sodium, which is less disagreeable and reore easily administered than the acid- itself. Perhaps the best way to take it is in powder, ten grains of which may be taken every two hours until six doses have been swallowed. It may then be desirable to dis- continue the drug lor six hujrs. . If, at the end of this time, the symp- toms of the disease have not materially subsided, the powder may be administered in the same way and quantity for another twelve hours. In the majority of instances the remedy works like a charm, especially if it be administered early in the disease, before complications have arisen in other structures than the joints. The fever s'.bsides, the joints are less sore and not at all painful, the appetite returns, and not infrecjuently the l)aticnt who a day previously was writhing in agony upon the slightest movement, (lushed and feverish, arises from his bed and walks without jxiin. It must be said that this result cannot always be depended upon. If the case has already lasted one or two weeks, the drug does not always act so promptly nor so efficiently, though even then it is usually the best treatment that can be employed. Then again, there are cases in which the disease is not very acute nor painful, in which the swelling of the joints is moderate and the fever slight. These cases are apt to be es- [)ecially Dbstinate, and to resist the action of salicylic acid. It is impos- sible to say in advance which of the cases will yield, and which will resist this drug, although one may leci sure in the cases in which the fever is high, and be somewhat doubtful in regard to those in which the fever is very moderate. \'et, in every case we sr.ould begin the treatment — and the earlier the letter — with thesalicylic acid. If this drug be efficient in controlling the case, the fact will be evident within three days, at the outside, in the rapid diminution of the pain, swelling and fever. If, a. the end of three days, there be no evidence of improvement, it will be wise to resort to the alkalies, as in the formula above given, and the lemon juice. Local treatment may also be used for the swollen joints ; these may be enveloped in llannel or cotton wool, which may be surrounded with oiled ■ FEVER AND OTHER DISEASES. 77 silk. Or the swollen joints may be wrapped up in cloth saturated with chloroform liniment, as it is obtained in the drug store. Much benefit is derived in some cases by gentle friction of the joints with the dry hand or with chloroform liniment. The choice of measures may be left large- ly to the selection of the patient, since some individuals will prefer one and some another of these local applications. In employing the friction, the pressure must be at first, of course, extremely light, to avoid giving pain ; though many times the force employed can be gradually increased with comfort to the patient until the attendant may use as much pressure as he can conveniently employ. A method which has been recently much employed consists in the application of fly blisters' to the affected joints permitting them to remain until some blistering occurs. This plan doubtless relieves temporarily the pain in the particular joint which is blistered, but seems to have no effect upon the progress or course of the disease. On the whole it is an undesirable measure, since the blisters may subsequently give trouble. The following is much used in Uellevue Hospital, New York. Salicylic Acid, - - - - i6o grains. Acetate of Potash, - - - - 320 grains. Glycerine, - - - - i ounce. Water, to make - - - - 4 ounces. Take a teaspoonful every 3 or 4 hours. Chronic Rheumatism. This name should, according to all medical usage, represent a coniinuation of an acute rheumatism in a less violent and painful form, and such cases are actually found under the name chronic rheumatism. Yet this name, as ordinarily employed, designates several affections all of which are characterized by pains in the joints or in the muscles, which have a tendency to persist indefinite- ly. There is a form of chronic rheumatism which affects the patient like the acute disease, except that the symptoms are less marked : there may be no fever, the pain and soreness are less intense, the tenderness on pressure is comparatively slight, and the swelling of the joints may be scarcely noticeable. As in the acute variety, various joints are affected successiviily ; the disease may finally become concentrated and remain fixed in a single joint. In this disease there is but little disturbance of the general health, insufficient, indeed, to disturb the patient's avocation. Yet there are instances in which movements of the affected j)art cause considerable pain, and patients may be even confined to the bed. After long continuance of the disease the affected joints may present irregular enlargements and stiffenings, while the muscles of these limbs become small from lack of use. In many cases of acute rheumatism the severity of the pain varies extremely with the weather ; so that such individuals are usually able to foretell, by a few hours, the occurrence of cold and moist weather. There IM 78 TtlE FAMILY PHYSICIAN. I is a variety of rheumatism, so-called, in which the pain is felt chicHy along the leg bones, the "shins," and occurs especially at night. Tliis affection is often due to a syphilitic taint, and will be discussed in speak- ing of syphilis. Treatment. — One of the most important features of treatment of chronic rheumatism, is care in wearing tlanncl next to the skin through- out the year. The administration of dru<'s is bv no means certain to produce beneficial results. Some cases are materially benefited by the regular employment of the hot air, or hot vapor bath, the Turkish bath, etc. The fact is, that the treatment of each case of chronic rheumatism is largely an experiment which can be successfiilly accomplished after considerable time has been spent in trials of drugs and remedial mea- sures. Among the medicines which are most frecjuentl^ useful, are the iodide of potassium, guiac, and cod liver oil. The following formula may be given : Iodide of potassium, Tincture of guiac. l''ive drachms. 'F\vo ounces. Two ounces. Water, Mix, and take a tcaspoonful four times a day. Othercaseswill.be benefited by using colchicum with the alkalies. An example of such mixture is the following : One (Irnchm Three drachms. Three drachms. Four ounces. Wine of colchicum root, - IMcarbonate of potassimn. - Rochellc salts. Peppermint water. Take a tablespoonful three limes a da)-. Muscul.ir Rheumatism. .Mthough this affeciion is designated rheumatism, there is every reason (or beheving that its cause is (]uite dif Jerent from that of the disease just described. It seems to be of the same nature as neuralgia, and might properly be so described, though it is convenient to follow the usual designation as already given. Symptoms.' The disease is usually developed gradually. A dull pain is felt in certain muscles, gradually increasing until it becomes ([uite severe. The pain is usually increased upon movement, sometimes becoming convulsive and cramp-like, causing the i)atient to groan, or even cry aloud. The.se movements, and the consequent i).iin, .may occur during sleep and awaken the patient. The muscles thus affected are somewhat tender upon pressure, but present no other signs of dis- ease, such as swelling or redness. The constitutional condition is other- wise good, and no interference occurs in the bodily functions except such as are consequent upon the painful movements. The duration of this disease may vary from a day to a week or may last, in less severe form, indefinitely. The muscles hiost apt to be af- FEVER AND OTHER DISEASES. 79 or fected are those of the forehead and of the temples. Another familiar example is in the neck, resulting in what is popularly termed " wry-neck." The pain may also be located in the muscles of the back and loins, con- stituting the affection known as hmibago It occurs not infrec^uently in the muscles of the chest, where it may for days render deep breathing impossible without pain. Wherever it may occur, the characteristic feature of muscular rheum- atism is the occurrence of" cramp-like pain, aggravated by the movement of the part. In this particular it is distinguished from neuralgia, which is a constant pain, affecting perhaps the same localities. This form pf rheumatism is undoubtedly promoted by exposure to cold, and seems often to result from getting the feet wet. The treatment should consist ill. improving the general condition by such measures as will invigorate the health. In the acute cases benefit can also be derived from the use of liniments and of gentle friction. Gout. Gout is closely related to articular rheumatism ; indeed, by some the two diseases arc regarded as essentially identical. However, they arc so distinct in their symptoms and course as to be generally re- cognized and described as distinct diseases. They may be regarded as allied, just as typhoid and typhus fever are allied, (iout occurs both as an acute and a chronic disease. Sy))iptonis. — In describing the symptoms, it becomes necessary to dis- tinguish between the transient acute cases, and those of long duration, called chronic. The acute attack usually occurs suddenly, often during the night. In many cases the patient has retired in his usual health, though in others there may be certain premonitory symptoms, such as pain in the region of the heart, belching of gas from tlie stomach, and mental dei)rcssion or irritability. These symptoms so frecjuently pre- cede an attack of gout that many who have already experienced one at- tack, recognize in the symptoms the onset of another. The attack itself begins by extreme pain in one of the joints, usually that between the great toe and the foot. This pain is variously described by patients as like that of the gnawing of an animal, the dislocation of the bone, or like tearing the flesh with pincers. A feeling of throbbing accompanies the pain, and there is usually considerable fever, sometimes preceded by a chill. These features continue for several hours before subsiding ; at the end of this time the patient is reasonably comfortable, and usually falls asleep. This attack is usually followed on succeeding nights by re[)ctiMons of a similar nature; either during these repetitions, or jierhap.s during the first attack, the painful joint becomes swollen, reddened and exvpiisiiely tender. The local affection may be limited to the joint origitially af- fected, but often attacks also the corresponding joint of the other foot, or spreads to the instej) and hollow of the foot. Indeed, in individuals who have repeatedly suffered from this disease, numerous joints in differ- ;!« liiiii ! h; Ik 'mjB^SBk UMriMHtMHitMMI te| £f/. 8o THE FAMILY PHYSICIAN. ent parts of the body, even of the hands, may become similarly affected. In many cases the pain lasts but a few hours, and returns again on the following night. There are instances, however, in which the pain mere- ly decreases in intensity during the day without entirely ceasing. Cramp may affect the muscles of the legs, the thigh, and even other parts of the body, though this is a somewhat unusual symptom. These attacks may return nightly for a week or for several weeks. These long continued attacks arc usually less severe than the brief ones ; the result may be entire recovery or continuation as the chronic form of the disease. CItronic gout may be the result of a series of acute attacks of gout, or may begin in a very mild manner. In either case the symptoms which characterize the acute affection are present in but slight degree. The disorder is rather a constitutional one, that is to say, the symptoms manifested in the foot are so slight that,attention is directed to the con- stitutional derangement. There are usually disorders of indigestion — dyspepsia, pain in the stomach, derangement of the bowels. In many cases these derangements have caused serious impairment of the general health. Sooner or later there occurs in the chronic cases of gout a condition quite characteristic of this affection : masses resembling chalk are formed in and around the small joints, and, indeed, some of the large ones ; the joint of the great toe is especially apt to exhibit this appear- ance. As a result, the joints become deibrmed, stiffened and even in- capable of any movement. Sometimes collections of this chalk-like matter can be felt just under the skin, and if opened this matter can be pressed out. Sometimes matter forms around these masses and makes its way through the skin, resulting in the formation of openings, called fisttthc. The result of all these changes is that both hands and feet be- come strangely deformed, presenting appearances which have been likened to a bunch of parsni[)s. Similar formations of chalk-like matter have been known to occur in various parts of the skin, on the eyelids and in the ear. There has long been an impression among medical men, which has become a po) ular belief among the people, that gout may be mani- fested, not merely in the joints, but also in the internal organs, such as the stomach, heart nn.i brain. Disorders which iiffcct these organs dur- ing an attack of gout are supposed to be due to the gouty influence ; the gout has "struck in." This expression is particularly applicable to those attacks of gout during which the affection ot the joints suddenly ceases, and symptoms indicating some derangement of some internal organ follow. There is, doubtless, some connection between the local attack and the affection of the internal organs. This is amply shown in tlu,' fact that remedies addressed to the gout relieve these symptoms. Those who have long been subject to gout usually present certain dis- orders which constitute the dangers of the disease ; for the local affection FEVER AND OTHER DISEASES. 8l :led. of the feet, or of the hands, however painful and unsightly, contains no element of danger to the patient. One of the most serious complica- tions occurring in gouty persons is a disordered action of the heart. I'his disorder occasions not only palpitation, shortness of breath, sense of suffocation and pain in the region of the heart, but may even cause sudden death, in consequence of the sudden stoppage of the heart's action. Various affections of the lungs also are popularly, and doubt- less properly, attributed to the gout. Among these are persistent cough, bronchitis and asthma. The explanation of many an intractable case of asthma has been found in the gouty condition of the patient, and relief from the asthma has followed remedies addressed to the gout. So, too, various pains designated as neuralgia, — particularly neuralgia of the face and of the hip (sciatica) — periodical headache and even hysteria, seem to be promoted by the gouty condition of the patient. Another most serious compHcation of the gout is a disease of the kidney, one form of the so-called " Ikight's disease." This disease is so common among those affected with gout that the small, hard kidneys characteristic of this affection are called "gouty kidneys." This form of liright's disease is not indi( ted by the symptoms characteristic of the ordinary acute lUight's disease ; there is no dropsy, no fever, in fact none of the usual signs. The most characteristic feature, at least the one most readily recognized by the non-professional observer, is the fact that the patient i)asses an 'musually large quantity of urine. These pa- tients are almost alv.; • -"need in years. " Trcatmoit. — One of . m t imiiortant measures in the treatment of gout consists in the regulation of the diet ; the avoidance of excesses at the table and in the use of liquors is an evident necessity. Among the remedies used during the attack, reliance is chiefly placed upon co/chicum and aikalics. Instead of the latter, various mineral waters have been highly recommended by different authors ; pcrhajjs the most noted and universally used of these is the so-called " Lithia Water," which may be obtained at the druggist's. This is in reality, not a natural mineral water, bat an artificial solution made by dissolving the citrate of lithia. If this be not procurable, a sokition of magnesia and colchicum may be employed as follows : One drachm. One drachm. Four ounces. Wine of colchicum root, Magnesia, ----- Peppermint water. Mix ; take a tablespoonful three times a day. It may be necessary also to protect the inflamed joint ; this may be accomplished by the means prescrilx-d in treating of rheumatism— by enveloping the joint in cotton, or by wrapping it with cloths which have been saturated with the tincture of belladonna or with the tincture of aconite. The chloroform liniment will also be found advantageous for F 1 1 < !II|! H II fl S3SE It 82 THE FAMILY PHYSICIAN. local use in this affection. During the paroxysms it may be necessary to relieve pain by the use of ojjiatcs; for this purpose twenty drops of laudanum, or ten grains of I )over's powder may i)e employed. If the opiate cause unpleasant effects, such as nausea and headache, we may substitute ten drops of the tnirture of belladonna, which may be repeated in two or three hours. In the intervals between the attacks the diet must also be restricted — should embrace no wines or malt liquors, and but little, if any, meat ; a simple, unstimulating diet of milk, eggs, fish and vegetables will materially assist in preventing the return of the at- tack. So, too, the remedies uselul in treating the paroxysm — especially the colchicum — may be continued during the intervals between the attacks. If the indications, such as dyspejitic symptoms, render the pa- tient suspicious of an approaching attack, it will be well to employ the colchicum and the alkalies in advance. For there ir> reason to believe that impending attacks can be in thi'^ . ay warded off. The local affections of the joints may sometimes require attention after the severity of the paroxysm nas subsided, for, as already said, the joints are often rendered permanently stiff and deformed by the deposit in and around them of chalk-like masses. This stiffness can be some- times partially relieved by systematic gentle friction, and by the arrange- ment of the shoes so as to afford the parts ample room. The swelling can be sometimes diminished before the deposit of chalk is ap| vrent by the use of repeated blisters, not allowed to remain long enough to pro- duce excessive blistering. After this chalk-like matter has been de- posited in abundance no measures can be successfully applied for its removal. With reference to the use of mineral waters, Dr. Garrod, the most eminent authority on this subject, says : " They should be altogether prohibited when there is considerable structural disease in any important organs, especially in the heart or kidneys ; and even when the organic mischief is slight, the greatest caution is necessary in their use. They should be avoided when acute attack is cither present or threatening. " The waters should be selected according to the nature of the case. When the patient is robust and of a full habit, the alkaline-saline springs ; when torpidity of the bowels predominates, the purgative waters ; when there is a want of vascular action, the saline water ; when the skin is in- active, the sulphur springs ; lastly, when debility prevails, then the more simple warm waters should be chosen. In all cases the use of the waters should be cautiously commenced, and care taken not to oppress the stomach by giving too much liquid, nor to induce debility or any other injurious effects by allowing a too long sojourn in the bath." Sciatica. This is a painful rheumatic affection, confined to the hip- joint and lower extremities, and affecting the large nerve (called the sci- atic nerve) of the leg. g t c r a b s c i FEVER AND OTHER DISEASES. «3 Treatment. — Apply a small blister on the spine at the bottom of the loins, and when it is removed sprinkle the surface with one-third of a grain of acetate of morphia, mixed in a little starch-powder. Or, apply to the part affected a bran poultice, to be followed twice or three times a day by an embrocation composed of one part of tur[)enline, and two parts of soap and opium liniment. A couple of drachms of this should be rubbed in for ten minutes at a time. Meanwhile, cleanse the bowels by a purgative, and if there is no tendency to fever, take drachm doses of car- bonate of iron, three times in twenty-four houis. When the pain is very severe, accompanied with general fever, leeches should be applied, and cooling purgatives taken. It will also be advisable to employ the hot bath at a temperature of 105 degrees, and to remain in it from fifteen to twenty-five minutes. This should be repeated two or three times a week. I 1 a^ CHAPTER VII. DISEASES OF THE NERVOUS SYSTEM. Falling Sickness or I''.pilc|vsy— Hysterics or Hysteria — St. Vitus' Danco or C'liorea — Neu- ralj^ia - I ieadaclie- Lock -Jaw — VN'akcfiilness- Sunstroi^e - WlioojiiiigC oiigh Apoplexy — Convulsions or I'its in Adults — iJi/zincss— Delirium Tremens — I'aralysis — Writer's Cramps- Nervous Ivvliausiiou. Falling Sickness. This is known as epilepsy. It is an attack of convulsions, with unconsciousness, and which recurs from time to time, without ?ny regularity. Cause. — This may, and often does, result from parentage, intemperance, or excesses of any kind ; injuries to the head, or Iright. * Sy//i/>/<>//is. — In many instances an attack is ushered in by a headache, vertigo, a sudden feeling of terror, or what is called the aura ; a feeling as though something was creeping up a limb, or a wind blowing on it. This extends slowly upward, and then the patient screams, starts, and falls suddenly, convulsed, foaming, grinding the teeth ; the face is flush- ed, the eyes roll wildly, respiration is performed with ditlfkulty, and there may be vomiting and involuntary passages This lasts usually five or ten minutes, the fit passes off, the patient goes into a sleep, or a drowsy state, or may arise bewildered, and stagger on his way, with more or less headache, weakness, or even delirium and frenzy, wliich impels to attack those aiound. A fresh attack may occur in a few minutes, or hours; or even months may elapse before a renewal. Treatment. — During the fit but little can be usefully attempted. The patient should be cared for, and placed so that no injury may result fiom striking his limbs or head as he tosses about. The clothing should be loosened, and he should be allowed plenty of fresh air. If prolonged, ether, chloioform, or nitrate of amyl may be given by inhalation, to ar- rest its continuance. The special effort will be to prevent a recurrence, and for this purpose, many and diverse remedie- have been proposed. Perhaps the best results have been obtained from the valerianate of zinc, one grain, two or three times a day ; the bromide of potassium, in full doses, and continued for a long time, say 15 to 30 grains, ttiree times a day, for months. Jhnv Pt evented. — This indication will be met by the careful avoidance of the causes ; by living temperately, yet using nutritious diet, keeping away from all excesses, avoiding all bad habits, and taking regular exer- cise in the open air. Tobacco, especially, should be avoided, as highly detrimental. The bowels should be kept as regular as possible. 84 DISEASES OF THE NERVOUS SYSTEM. 85 The following is the famous 15rown-St'quard mixture which, if taken faithfully for six or nine months, is most successful in this disease : > r>romide of Soda, IJromide of Potash, IJroinidc of Ammonia, Iodide of Potash, Iodide of Ammonia, - Carbonate of Ammonia, Tincture ot Calumba, Water to make 8 ounces. 3 drachms. .3 drachms. 3 drachms. 1^2 drachms. jj4 drachms. I drachm. ly^ ounces. The full dose is i^ teaspoonfuls before each meal and 3 teaspoonfuls at bedtime. jDr, Bro7vn-Sc(]ttard. Hysterics {Hysteria). — This is a nervous affection seen sometimes in males, but usually in females suffering from uterine irregularities. Single women, and the married who do not bear children, are the most subject to it, although it sometimes occurs at the early period of preg- nancy and immediately after childbirth. Persons of studious and seden- tary habits, and of scrofulous and weakly constitutions, are especially likely to be the subjects of hysteria, as are indolent and plethoric persons, and those debilitated by disease or excesses of any kind. It may be excited by excessive evacuations, suppression of the natural secretions, strong mental emotions, or sym[)athy with others so affected. It is a curious circumstance connected with this affection that it sinm- lates almost every disease to which humanity is liable. Symptoms. — An attack generally comes on with a sensation of choking. It seems as if a ball were rising in the throat, and threatening to stop the passage of the air ; then the trunk and limbs become convulsed, so much so that an apparently feeble woman will require three or (our strong per- sons to restrain her from injuring herself; then follows the hysterical sobbing and crying, with alternate fits of laughter. Generally the head is thrown back, the face is flushed, the eyelids closed and tremuluus ; the nostrils distended, and the mouth firmly shut. There is a strong movement in the \t, which is projected forward, and a wild throwing about of the arms ana hands, with sometimes a tearing of the hair, rend- ing of the clothes, catching at the throat, and attempts to bite those who impose a necessary restraint. A fit of hysteria may last for a few minutes only, or for several hours, or even days ; persons have died under such an affliction. It may gene- rally be distinguished from epilepsy by the absence of foaming at the mouth, which is nearly always present in that disease, and also by the peculiar twinkling of the eyelids, which is a distinguishing symptom of great value, and a sign of safety. In epilepsy, too, there is complete in- sensibility, not so in hysteria \ the patient retains partial consciousness ; fi masA m^m ^ <>^^> V] ^ y W IMAGE EVALUATION TEST TARGET (MT-3) 1.0 !P^ I.I 1.25 1^ 1^ 1^ |M 2.0 1.8 1-4 III 1.6 // // 4is <>- Li/ioi(snes.'; There is usually impairment ot the appetite, an uneasy feeling in the region of the stomach, a bitter taste in the mouth ; the tongue becomes coated and the breath may be offensive. There is pain in Iront of the head especially, and a general indisposition for exertion. In other cases sick headache appears to be a form of neuralgia ; it , occurs without perceptible cause, and seems to run in families. In some cases the attack occurs, as has been said, without any per- ceptible cause. At other times it is the direct result of excessive emotion, bodily fatigue, exhaustion, the consumption of indigestible food, exposure to cold and over-heating. Treatfncnt.~—\Jn\.\\ the cause and seat of the difficuUy can be accurate- ly located, attempts at treatment must be necessarily somewhat experi- mental in character. There are numerous remedies which have l)een used to relieve this affection, and it is (^uite certain that many individuals can be completely cured of the difficulty. Yet it is impossil)le to say in advance just what plan of treatment will be adapted to a particular case. We shall, therefore, mention several plans, which may be tried in succession. In many instances, particularly those associated with biliousness, a mercurial laxative will secure relief. For this pur[)ose, take : — Calomel, 5 grains. Bicarbonate of sodium, ... 10 grains. W^here there is no evident disturbance of digestion to account for the difficulty, and where the individual is "nervous," the following prescrip- tion may be given : — Extract of guarana, - . . . 40 grains. Extract of cannabis indica, - - - 30 grains. Citrate of caffeine, .... 60 grains. Mix, and make forty pills ; take one pill, and repeat the dose after two hours, if not relieved. In many cases, thirty or forty grains of the bromide of i)Otassium, taken in half a glass of water, will secure relief In other cases, three grains of the monobromated camphor^ in the shape of a pill, will be efficient. One to two teaspoonfuls of ihc fluid extract of guarana have occasion- ally relieved sick headache after other measures had failed. One or two grains of the citrate of caffeine may- be placed upon the tongue dry, and swallowed. This has proven efficient in many cases where the ordinary remedies had been used without success. Lock-jaw {Tetanus'. — This is a spasmodic seizure of a dreadful and generally fatal character. By this disease, not only are the muscles ■i! ! i |! ! 92 THE FAMILY PHYSICIAN. of the jaws, but those also of the whole body, thrown more or less into spasm, often so violent as to break the teeth or bones. Causes. — The cause of tetanus is frequently exposure to cold and damp, or it may be some local injury, such as a cut, puncture, or lacera- tion. It more commonly results from citi er of these in warm climates, although intense cold alone has not unlrctjuently produced it. It oltcn affects a large number of the wounded on a field of batUe, who are ex- posed to the vicissitudes of the weather. Lock-jaw, which is produced by a wound, will sometimes show itself in four days ; sometimes not lor two or three weeks after the wound has been received. Syniptoins. — The most common form of this fearful malady is that in which the muscles of the neck and throat are chiefly affected. It gen- erally comes on in a gradual manner : there is a slight stiffness in the back of the neck, which extends to the root of the tongue, causing great difficulty in swallowing; then the wl:ole muscles of the face probably become implicated ; there is soon tightness of the chest, and the spas- modic pain extends to the back ; while the teeth become so closely and firmly set together that no lood of any kind can pass them. If the spasm extends further than this, the muscles of the trunk, and lastly of the extremities, become involved, contracting and drawing the body to the side, or backward, as the case may be, so as to form an arch, resiing on the head and heels. The suffering caused by the tetanic spasm is frightful to contemplate. The lace is pale, the bones contracted, the skin covering the forehead wrinkled, the eyes fixed and prominent, some- times suffused with tears, the nostrils dilated, the corners ol the mouth drawn in, the teeth exposed, and the features fixed in a sort of grin. The breathing is performed with difficulty and anguish ; there is great thirst, and the sufferings are greatly increased by attempts to swallow; the pulse is feeble and frequent ; the skin is covered with perspiration ; and yet, with all this torture, the intellect remains clear and unaffected. I )eath at length closes the scene, being due partly to suffocation, and partly to exhaustion. Trcatmctit. — It seems to be well established that tetanus can often be controlled and cured by the use of calabar hcaii^ given in frequently re- peated doses, if treatment be begun sufficiently early, (lood results have also been obtained by the use of curare. But these remedies are too ])owerful and too dangerous to be used by any one except a phy- sician. Other measures to be api)lied are opium, a grain of which may be given every two hours ; chloral, twenty grains of which have been employed in the same way ; bromide of potassium, and stimulants, espe- cially brandy and whteky. If the services of a physician cannot be at once procured, the follow- ing mode of treatment should be adopted until a medical man can arrive : Ice should be applied to the spine, wrapped up in soft, thin cloths. DISEASES OF THE NERVOUS SYSTEM. 93 A grain of opium ma/ l)e given in a tablespoon fill of brandy or whisky, nixed with the same (quantity of milk, every two hours. The violence of the spasms maybe controlled by permitting the patient to inhale chloroform. The great ditificulty attending success in the treatment of tetanus arises from the fact that t^e disease is not recognized until some time alter its appearance, because the early symptoms of lock-jaw are not distinguished from the stiffness and soreness of the neck, such as occurs alter simply exposure to cold. It should be remembered that if the patient has been wounded or injured in any way, if even his skin has been bruised, the possibility of tetanus must not be forgotten ; and the ai)pearanre ot stiff ness in the jaws and of difficulty in swallowing must be regarded as the possible evidences of the onset of this disease. Wakefulness. Known as insomnia, morbid vigilance. Cause. -'Ihis symptom, for it cannot be regarded as a disease, marks the presence of some form of disease of the brain ; or is the result of strong mental excitement, or mental labor ; or is caused by excessive pain, or the inordinate use of articles, as strong tea, coffee, tobacco, etc. Syniptonis. — When not the result of acute pain, the patient finds him- self, at the hour for retiring, wide awake, and is unal)le by any of his usual methods to compose himself to slumber. 'I'he history of the case will enable the physician to decide as to whether it is the result of excite- ment, over-work, the use of stimulants, etc., or a symptom of hidden brain affection. When no other cause can be assigned, the gravest fears may be felt lest it result in insanity, inflammation of the brain, or soft ening, etc. Treat incnt.~X\\Q. treatment will depertd solely upon the cause. What- ever this may be, it must be removed, if removable. The patient should be made fully to understand the danger he is in, and to lend his entire concurrence in the efforts for his relief. Mental labor should be given up ; overwork of any kind must be abandoned : articles liable to keep up the trouble must be forbidden, such as tobacco, coffee and tea. If general debility be present, the system must be brought to a natural standard by tonics and a proper diet. If there are symptoms of a ful- ness of the brain, this must be relieved by cups, or leeches to the nape of the neck, t. ' ' ' ■iji| i iJi.i.' 't". i il" !' l ' jffi ' !^'l j? l 94 THE FAMILY PHYSICIAN. ings, as to whether any cause exists, such as improper position in bed ; the best is always where the head and shoilders are above the level. For the relief of this symptom, excej)! where it is the result of pain, medicines should be employed with caution. It is always best to obtain sleep with the mildest means first. A glass of beer, at bed-time, a hop pillow, or the ')reparations of hops, hyoscyamus, la(;*tucarium, bromide of potassium cr of sodium, will generally relieve, and preferably in the order given. Some observers have found that opium or morphia, added to the l)romides, appear to correct the unpleasant action of the opium, and aid its effects. The best remedy of all is the chloral. This should be employed in positive doses, say fifteen or twenty grains, repeated, when necessary, in one, two or three hours. A variety of other remedies have been proposed, but those quoted will answer the purposes. 1 )r. iirown-Seciuard recommends the following : Jiromide of potash, ... 6 drachms. Water, - - - - - 5 ounces. Take 3 teaspoonsful before dinner, and 4 at bedtime, with a little wine and water. Sunstroke, This is a common accident in the intense heat of Ame- rican summer. It does not always need the sun to bring it on ; a great heat in the shade may cause it. Before it comes there is pain in the head, wandering of the thoughts, irritable temper, nervousness and general illfeeling. "Sun-headache" and " sun-pain" show that there is unusual danger from this source. Ifow prevented. — During the hot weather all alcoholic drinks must be avoided. A bath should be taken daily. Abundant cool, but not ice- cold, water should be taken. The head should be well protected by a tall straw hat, with a damp newspaper or sponge, a wet handkerchief or a handful of green leaves, in the crown. When the heat is felt unpleas- antly, exposure to it should cease. Treatment. — The person attacked should at once be carried to a cool, airy s])ot, in the shadow of a wall, or to a large room in a house with a bare floor ; or, what is often better, if there is no sun, he should be placed in a back yard, on the pavement. The clothing should be at once gently removed, and the patient placed on his back, with the head raised a couple of inches by a folded gar- ment. Then the entire body, particularly the head and chest, dashed with cold water in profusion. While preparations are being made for this, a messenger should be despatched for a good supply of ice. A large fragment should be placed in a towel, and struck a few times against the side of the house, to reduce it rapidly to small pieces. These pieces, mixed by the hand into a bucket of water, will promptly supply ice-water. Two buckets can be used, each half full of the small ice, and as soon as the water of one is used for dashing against the DISEASES OF THE NERVOUS SYSTEM. 95 patient, another will be ready for the same purpose. The ice-water must not be j/>7>//{.'/6'^ over the person, but ^/^rv/ztv/ aL;ainst him in large bowl- fuls, particularly against the head and cliest. Wliilc one person makes the ice water, and another uses it, a third should, in the same manner, with a towel, break some ice in tVagmenls not larger than almonds. A double handful, at least, of tliese bits should l)e placed in a thin, coarse towel, the ends gathered up and fastened with a string, as you would a pudding. Then holding to the t'-xl portion of the collection of ice, the entire surface of the body should be rai)idly rubbed. These measures are to reduce the heat of the body. When the decline in the heat is noticed, the cold applications should be abandoned, the patient carefully removed to a dry spot, and the entiie surface of the body dried off wiih towels. Should a tendency to a return of the high temperature be seen, as sometimes hap[)ens, even after consciousness is restored, itnmst be met by a renewal of the cold application. Artificial respiration, until the natural returns, must be resorted to as soon as the heated condition of the body is overcome. The dashing of cold water over the chest and face is a useful means of encouraging a re- turn of the life force. This plan of treatment is only to be used in those cases of sunstroke where the skin is hot, face Hushed, pulse strong and bounding. There is another form of sunstroke where the face is pale, skin cool and pulse feeble. In these cases the clothing should be loosened, especially from the neck ; the patient's head should be kept lo.v, tiie air allowed to circulate around the body ; half a tablespoonful of whisky or brandy may be ad- ministered every fifteen minutes until six doses have been taken ; hart- shorn should be applied to the nostrils. If there be any vomiting, the whisky or brandy may be administered as an injection into the rectum. In this case, an ounce (two tablespoonsful) may be given for each dose. It is highly important that such a patient be not moved nor agitated ; he should not, therefore, be taken home nor to a hospital, unless the distance be short, but should be treated at once at the nearest convenient place. Whooping-cough. This affection is by many classed among ner- vous diseases, notwithstanding the apparently infectious nature of the com[)laint. The symptoms of whooping-cough are so familiar that no description is necessary. Treatment. — The paroxysms can usually be shortened by the use of emetics, which not only provoke vomiting, but also loosen the phlegm. For this purpose, we may give a full dose of ipecac or squills. Aside from this measure, but little treatment seems beneficial. In fact the mild cases do best without medicine, if care be taken to avoid exposure to the cold and to wrap the body well in flannel under- clothing. 96 THK 1 AMIT.Y IMIVSiriAN. To cut short the disease, a t^icnt many remedies have been adminis- tered ; the fact that these remedies arc so numerous, indicates that no one otlhem can he reUed upon for all cases, (lood results have been reported from the use of belladonna. The following mixture will be found of servii:e : One grain. Two ounces. I'Atract of belladonna, - - - Mucilage of gum arabic, - (live twenty or thirty dr()|)s of this every three hours. We may also use to advantage the following piescription : I'luid extract of hyoscyamus, - - Haifa drachm. Orange (lower water, - - - I'our ounces. Mix and give a tablesjioonful every ..irec hours. This dose is suited to a child ot i 2 years, and must be correbi)ondingly reduced for a younger child. Apoplexy. This is the deprivation of life or motion by a sudden stroke or blow ; it is one of the most awful and api)aling modes of sud- den death ; in an instant a healthful and vigorous man is smitten down — one who has exhibited no signs of decay or disease- who has perhaps received no premonitory warning, lies before us motionless and stark. Apoplexy may be either cerebral- proceeding from congestion or rup- ture of the brain — or {lulmonary— proceeding from hemorrhage into the ])arenchyma of the lungs. The first is the more common form, and this may be s|)oken of under four heids ; first, when it is sudden and violent at once; second, when it is comparatively slight at the commencement, and progressively increases in severity ; third, when it commences in apoi)lexy and terminates in paralysis ; fourth, when it commences in the latter, and ternu'nates in the former. Ca/isvs. — 'l"i e causes of apoplexy are cither ])redisposii"!g or exciting ; among the first may be named, first: Sex- men are more liable to it than women, because they are more subject to its exciting causes, of which which we shall jiresently speak ; second : Age — it is very rare in child- hood, rare also in youth, most common between the ages of forty and seventy--rare much beyond the latter age ; third : ]>odily Conformation — the man of sanguine and plethoric temperament, with large head, short neck, and full chest, is most liable to its attack, although one of the op- posite state and condition of system is sometimes smitlen down with it ; fourth : Mode of Life — persons of sedentary habits, who live luxuriously, are its frequent victims ; fifth : Suppression of evacuations or eruptior.j — as the piles, i)erspiration, healing ot the scton or wound ; sixth : Mental Anxiety — such as a long contin^iance of harassing fears, business per- plexities, grief, or any violent emotion or passions. All these are pre- disposing causes of apoplexy, to which it has been said that the studious are more liable than others ; but this is an error, as the history of lawyers, DISEASES OF THE NERVOUS SYSTEM. 97 Fir,. 21. \h Dksckii'TION of Fir;. 2T.— I. FrontnlLnnchofthc'lifth ncrvcof tlic; brain wliidi Iv^tows sen.Siilion alone. II. Superior maxillary, or that branch of the lifth nerve wliieli supplies the upper jaw, and whieii, like the last, ari.sinj^ from th-; sensative root, bestow:; .senbati".— -A[)ople\)' may be known by the pal'ent falling down in a state of insensil>i!ity or stupor, out of which it is impossible to rouse him by any of the ordinary means ; the face is generally llushed, the breath- ing difticult and stertorous ; the upper lip-maigin is [troiecled at each expiration; the veins of the head anil tcp ; ' ])!otriide as thcMigh o\er- lllled, the skin is covered with persijir; m, ,i id the eyes are fixed and blood-shot ; sometimes, iiowever, iIk luce and dejection ; and the pulse, instead of and intermitting. Treat iiic lit. — This, of course, must var\ c:onsiderably in accordance with the pathological condition of the brain (jf the [)erson attacked, and with other circumstances which only those nccusto^ned to the treatment of disease can judge of. 'I'he immediate nuMsures to be adopted when a fit of ajioplexy comes on are the following ; Mace the [)aticnt in a sit- ting position, with the legs de])ending ; remove ever\ thing about his neck, and let the air be freely aduntied ; apply cold wet cltjths to the liead and neck, and nuistard plasters to the soles c;i the leet ; if the pati- ent be old and llie pulse weak and feeble, the skin bloodless, and the countenance pinched, warm llannel and hot bricks s'.iould be used, and cold water should be dashed in the face, strong si)irits of annnonia ap- plied to the .nostrils, tlie leet put into a waiin bath with a little nuistard, and every means taken to arouse the patieiU from his state (jf lethargy. As soon as this is so far effected that he can swallow, giw. jj drachm of aromatic sjjirils of ammonia in i;j oimces of campiior mixture, as a stinuilant draught, but it is only when the pulse is feeble and lluttering that the stimulant may be administered ; that is the e\cei)tional case in ii[)oplexy — most couunoiii)' the t;ymptoins are those first described. ale, with a look of misery :mg lull and hard, is weak DISEASES OF THE NERVOUS SYSTEM. 99 in lul u lllCU unci iicnl lieu sit- his the iUti- Ihe and a ap- tan.1, m of as a Cling case ibcd. Purgatives must be got down a-s soon as possible ; lo grains of calomel placed on the tongue, and washed down with a black draught, or 2 or 3 drops of croton oil may be rubbed on the back of tlie tongue, and an injection composed of 2 tablespoonsful of common salt, with a little oil or butter, and a pint of warm water ; or a tablespoonful of soft soaj) mixed with the same quantity of water ; or an ounce of spirits of turpen- tine, rubbed down with the yoke of an egg, and a pint of thin gruel ; one of triese should be repealed every two hours until some decided effect is produced. Other means of relieving the system may be taken should these fail, such as blisters behind the ears, to the nape of the neck, or calves of the legs ; should the head be very hot let it be shaved, and a cold lotion be api)lied to it — water and vinegar or acid water will do best. Should the attack be soon after a full meal, administer an emetic — a scruple of sulphate of zinc with a grain or two of tartar emetic; something like this should always be given when apo[)lexy arises from the effects of opium or spirits. In all cases after the crisis of the dist'ase is over, and when the patient has become convalescent, it behooves him to be very careful, as a slight indiscretion may bring on a fresh attack. We have said that apoplexy comes without warning, but this is not strictly true. However sudden the attack itself may be, there are cer- tain premonitory symi)toms which no prudent man will disregard. Among those may be named a sense of fulness in the veins of the head, and a feeling of pressure in the head itself, with occasional darting [>ains, giddiness, vertigo, partial loss of memory, and the powers of vision and of speech ; numbness of tiie extremities, drowsiness, and a dread of fall- ing down ; irregularity in the action of the bowels, and involuntary pas- sage of the urine. These all indicate that some internal miscliiefis going on, and if their warning is attended to the threatened attack may, per- haps, be avoided. Persons whose full habit of body and modes of life predispose them to this disease should, when such warnings reach them, live sparingly, avoid stimulants, es})ccially fermented and sjiirituous lic^uors, take regular and moderate exercise, sleep on a firm pillow with the head elevated, and nothing round the n'^ck to impede the act of brenthing ; the mind should be in a cheerf'jl condition, and free from excitement ; sexual indulgence should rarely be resorted to ; late sup- l)ers must be avoided, and a hard liiii mattrass used for slee[)ing on. Keep the bowels regulated by an occasional dose of saline purgatives. Those of a spare habit should take light, although nourishing diet, a lil^tle beer or wine, if they liftve l)cen accustomed to it, and it does not affect the head ; si)iriluous litjuors and hot s[)ices sholild be avoided, and great bodily fatigue or nervous excitement of any kind. Convulsions, or Fits Involuntary contractions of the muscles of a part or the whole of the body —generally with corresponding relaxa- tions, but sometimes with rigidity «and tension ; in the former case they are called clonic sj)asms, as hysteria ; in the latter tonic spasms, as lock- A-i^ 100 « THE FAMILY PHYSICIAN. jaw ; when the convulsions are slight and rapid the.)' are called tremors. They are universal, affecting all the limbs more or less, and the muscles of the face and those of respiration, as in epilepsy, md the convul- sions of children ; and partial, when they only affect some of the muscles irregularly, as in chorea or St. \'iius' dance. Treatment. — In adults^convulsions may be apoi)lectic, epileptic, hysterical, or puerperal, as the case may be. Some narcotic poisons pro- duce them, such as opium, prussic acid, some kind of fungi, ardent si)ir- its, and indigestible substances. In all these cases, emetics would be the fust remedies, and the stomach-pump ; then volatilcs and stimulants — as ammonia, valerian, and a stream of cold water poured ujion the head from a considerable height. Convulsions may be caused by ex- cessive mental emotion, and sometimes by long continued diseases, such as dropsy, jaundice and fever. When a person is taken with a fit, proceed thus : Loosen any part of the dress which may appear tight, 'jspecially about the neck and chest ; if a female, cut the stay-lace, as tight lacing otten causes fits; sprinkle cold water on the face, and ai)ply volatile stimulants to the nostrils ; rub the temples with cau de cologne, ether, or strong spirits of some kind, and blow upon them ; and as the patient can swallow, give 30 drops of sal volatile in water, or the same of ether, or, if neither are at hand, a little cold brandy and water. When the fit is over, a gentle aperient should be taken, to be followed by cold bathing, exercise, and, if possible, by a change of air. Dizziness. Many persons are subject to a fulness and rush of blood to the head, either with or without «ny excitement. It is a symiv tom of a deranged system, and it may be a synijjtom of a tendency to apoplexy. Causes. — This condition may be caused by heart disease, by debility arising from hemorrhages, indigestion, constipation or excessive mental labor. Treatment. — What has been said on congestion of the brain applies to this affection ; a dose of some gentle purgative should be taken, as cas- tor oil, salts, or salts and senna, at night, and the following in the morn- ing : Rochelle salts, - - - - 2 drachms. ]>icarbonate of Soda, - - - 2 scruples. Water, - - - - " /^ P''"'^- • Mix. To this mixture add 35 grains of tartaric acid. Take the whole while foaming. Delirium Tremens. Delirium ebriositatis, or mania a-potu, is a disease of the brain, usually caused by an abuse of spirituous liquors, but sometimes also by great mental anxiety and loss of slecj); or it may re- sult from bodily injuries or accidents, loss of blood, etc. Delirium some- DISEASES OF THE NERVOUS SYSTEM. lOI a to times makes its appearance in consequence of a single debauch ; but more frequently it is Uie result of protracted or long-continued intemper- ance. It usually supervenes on a fit of intoxication ; but it not unfre- quently occurs, also, when the habitual drunkard omits his accustomed draught. Symptoms. — The approach of an attack is almost invariably j)rccedcd by the patient being remarkably irritable, with fretfulness of mind and mobility of body. He becomes very nervous and uneasy ; is startled by a sudden noise, the opening ot a door or the entrance of a visitor ; is restless ; the hands and tongue are tremulous ; he complains of inability to sleep, and if he dozes for a moment, he is awakened by frightful dreams. Soon delirium manifests itself; if questioned, the patient often answers rightly enough ; but if left to himself, h'^ begins to talk or mut- ter ; he is surrounded by frightful or loathsome animals ; is pursued by some one who has a design iMon his life ; has terrible and ghastly vis- ions. Though most commonly of a frightful or territying character, the delirium is not always so ; occasionally the appearances are dull and ludicrous, and the patient seems ■ amused by them ; at other times it turns on some matter of business, as settling of accounts or, telling of money, and the patient is in perpetual bustle, and his hands are con- stantly full of business. The predominant emotion with the delirious ])atient is fear, and in his efforts to escape from an imaginary enemy, he may be guilty of murderous assault, or, as is more frequently the case, may take his own life ; and hence he re(iuires to be very carefully watch- ed. " The strong features of this complaint," says Watson, "are sleep- lessness, a busy but not angry delirium, constant chattering, a trembling of the hands, and an eager and fidgety employment of them. The tongue is moist and creamy ; the pulse, though frequent, is soft ; the skin is perspiring, and most commonly the patient is drenched in sweat." The delirium continues until the patient sinks into a sleep, from which he awakes comparatively rational, or dies from exhaustion. In such cases death is often sudden * the patient rising for some trivial purpose, and falling in a faint, from which he never recovers ; or at length, after pass- ing many nights without sleep, he sinks into a state of coma, which termin- ates in death. This disease, however, is rarely fatal, unless where the strength of the patient has been seriously impaired by long-continued excesses. Treatment. — The chief object in the treatment of delirium tremens is to induce sleep. For this purpose he must be carefully protected from the inciuisitive gaze and questioning of friends and acquaintances. It is also ' necc'ssary that he be confined in such a way as lo prevent him from harm- ing himself. In some cases it will be necessary only for a friend to stay in the room with him, and to judiciously soothe and quiet him during the more violent parts of his delirium ; in other cases it will be neces- sary to put him in a straight jacket^ or in a padded room. In general I02 THE FAMILY rilYSICIAN. rfl no more violence should be used ihan is absolutely necessary to control him. The following prescription may be ordered : ]5roniide of potassium, Ilydraie of chloral, Syruj) of orange peel, "W'aicr, - 2 ounces. 1 ounce. 2 ounces. 2 ounces. Give a teasjioonful in water every two hours, until four tloses have been taken, unless ihe patient becomes ([uiet. In using this mixture certain caution must be observed, especially after three or tour doses have l)een given. It will l)e advisable not to give ojMum or any of its preparations, which are apt to aggravate the patient's mental condition. So soon as the vio- lence of the attack is over, measures should be taken to tone up the patient's nervous system. For this purpose the following mixture may l)e used : Tincture of nux vomica, Tincture of digitalic. - Tincture of gentian, - Wine of pepsin to make four ounces. 6 drachms. G drachms. () drachms. Afix, and fake a teaspoonful l)efore meals. Much good has been observed from the aj)])lication of a small mustard jilastcr over the jiitof the stomach, especially those cases in which obsti- nate vomitmg occurs. One of the most important items in the treatment of delirium tremens is the employment of nutritious food in an easily digestible form. For this |)urpose, milk and eggs are the staple articles ; they may be supple- mented by soups and beef tea. These should be gi\-en in small ouanti- ties, at intervals of two or three hours. It must be remembered that delirium tremens is a disease of exhaus tion ; notwithstanding the patient's frenzy and fre([uent exhibition of strength, his nervous system is profoundly prostrated ; hence all mca sures employed in the treatment of the disease should tend to build up the patient's exhausted powers. Paralysis, l^y paralysis we ordinarily understand a loss of the power of movement. The term, however, is used in medicine also to em- brace a loss of the sensibility of a part. In this discussion we shall em- ploy the word in the po[)ular sense, namely, as designating an impair- ment in the power of motion. In order to understand the conditions which cause paralysis, we must remember the conditions which must exist in order that a part of the body can be moved at will. Movement is, of course, performed by the DISEASES OF THE NERVOUS SYSTEM. 10? contraction of muscle ; but this muscle does not contract of itself. Under natural conditions a contraction of the voluntary muscles occurs only under the influence of nervous force. This originates in the nerve cen- tres — especially in the brain and s[iinal cord — and is conducted along the nerve, just as electricity i)asscs along the wire. Wh.en this nervous force reaches th.c muscle, contraction occurs and the part is moved. In order, therefore, that a voluntary movement shall occur, it is necessary that the nervous force shall be manufactured ; that is, that the brain or spinal cord must be in a healthy condition. Secondly, it is essential that the nerve leading from the brain to the muscle shall be sound ; if this be injured in any way, the force which is produced in the brain is interrupted in its passage along the nerve, just as the electric current is interrupted if the conducting wire be cut ; artd Anally, the muscle itself must be in a contlition to respond to the influence of this nervous force. It is evident, therefore, that paralysis- that is, loss of motion — may result from any one of three causes : fn-st, disease or injury of the brain or spinal cord ; second, disease or injury of the nerve; third, disease or injury of the muscle. In various diseases we have illustrations of these different causes of jjaralysis ; thus, in apoplexy a portion of the l)rain is destroyed and a portion of the patient's body is paralyzed, though the muscles and the nerves of the paralyzed ])art remain iminjured. In certain cases a nerve of the arm for instance is cut or injured by a wound, i)aralysis of the muscles to which this nerve runs is a consecpicnce, althougli the brain and the muscle itself are miinjured. Then, again, the muscle itself sometimes becomes incapable of contracting, as in the disease known as wasting palsy. In this case there is paralysis, although the brain and the nerve remain intact. Whenever, therefore, a ])alient is paralyzed, it becomes necessary to ascertain what part of the apparatus is at fault ; whether the paralysis results from disease of the brain, so that no nervous force is generated; or whether the nerve goin;: to the part is injured, so that the nervous force cannot be convcjed to the muscle ; or whether fmally the muscle itself is diseased, so that it fails to respond to the nervous intluence. Paralysis therefore is a Syniptoiii of a disease rather than a disease itself. As to the paralysis of Sensation^ it will not be necessary to enter into any detailed discussion. Sensation, like moti(jn, may be lost in any one of three ways : injury to the brain, injury to the nerve, injury to the skin of the part affected. In many cases sensation and motion are trans- mitted by different nerves; that is to say, there may be paralysis of mo- tion in consequence of injury to a given nerve, while the sensibility of the part remains unimpaired ; in the same way the sensibility may be lost while the part can be moved without difficulty. Paralysis receives different names according to the part of the body which is paralyzed and according to the nerve which is injured. It i-irTii»a»iWflfc^ 104 THE FAMILY niYSICIAN. sometimes happens that an entire half of tl>e body — one side of the face one arm, one side of the l)ody, and one leg— will be paralysed, while the other side remains intact. Writers' Cramp is a form of paralysis usually limited to certain muscles of the hand. As the name indicates, the affection is especially con.mon among those whose occupation compels them to hold the pen many hours a day. It may be indicated by actual paralysis^ so that the finger and thumb cannot be brought together with the usual power ; in other cases, the muscles controlling the fingers are firmly contracted, so that the thumb and fingers cannot be moved or are moved irregularly. Unlike most of the forms of paralysis, this affection can usually be cured by rest and treatment. Persons engaged in other occupations than writing, who are compelled to use the same muscles constantly for many hours daily, are often simi- larly affected. Taylors and sewing-girls, for example, may lose the power of holding and guiding the needle; and women who are compelled to work a sewing machine may have a similar affeclion of the feet and legs. Treatment of Para/ysis. — In every case the first object is to ascertain the cause. In many cases careful investigation will show that the cause can be removed and the ])aralysis relieved. Thus paralysis affecting various parts of the body, even an entire half, as in hemii)lcgia, may be due to syphilis^ for an individual who has had this disease is liable to inOammalions in the brain which may paralyze his muscles. These are the most favourable cases for treatment, since, if taken early, they may be readily cured by the following prescrijition : Iodine, Iodide of potassium,- . . - Syrup of sarsaparilla, Mix, and take a teaspoonful after mcnl'^ ; the dose may Uc gradually in- creased to two or even three teaspoons ul In other cases paralysis results from slow poisoning of some of the metals, such as lead and mercury. These forms of paralysis are, of course, found with especial frccjuency in those who are compelled to handle and work with these metals. Lead poisoning may occur, too, among women who apply cosmetics containing the article, and from the use of drinking waters which pass through imperfectly constructed pipes. In these cases relief may be obtained by the use of the following in con- nection with the measures to be piesently mentioned : - Five drachms. Right grains. Ten drachms. Eitiht ounces. |W Iodide of potassium, Water, - Four ounces. Take a teaspoonful four times a day. • , , In addition to this the sulphate of magnesia may be given in doses sufficient to keep the bowels active ; for this purpose it may be necessary to give from a teaspoonful to a tablespoonful of this laxative every day. DISEASES OF THE NERVOUS SYSTEM. 105 in- the of I to 3es. ^on- It would be impossible to follow out in detail all the diflerent mea- sures which may be at times useful in the treatment of paralysis ; for every case must be studied and treated separately ; it has been already stated that [)aralysis is a symptom and not a disease. VcL there are certain measures which will l)e found i'seful in almost all cases, and which may be iherefore mentioniid here. Prominent among these is elcciricity. I'hysicians have come to rely >i|)on this aijent as furnishinif excellent results, though it must not be e.\[)ecied that a cure can always be effected. When, for e.-ami)le, paralysis results from an inlhunmation or hemorrhage in the brain, the application of electricity to the arm or to the leg can be of no service. Another most valuable agent is iMassat^c. This process, which is now extensively employed by physicians, is [)erformed as follows : the patient is stri[)ped, or at least as much of the body is laid bare as is re- quired for treatment.; an attendant then kneads, pinches, pulls and rubs the flesh until a gentle glow and feeling of warmth are excited. This process may seem at first somewhat rough, and may leave a slight sore- ness, but in a short time these symptoms no longer occur and evident benefit results. Considerable practice is recjuired for the skilful perfor- mance of massage, but much benefit can be conferred even by an inex- perienced person who will persevere in the effort. It is higlily important that those alllicted with ]}aralysis should have the benefit of fresh air and of such exercise as they are capable of taking ; for this jnnpose it may be necessary to furnish them with the assistance of perambulators, easy chairs, and other mechanical contrivances. Among the remedies which may be em[)loyed with advantage in cer- tain cases of paralysis, are strychnine and [)hosphorus. The former may be given in the following prescription : Sulphate of strychina, ... Haifa grain. Reduced iron, - ... Thirty grains. Extract of belladonna, - - - Eight grains. Mix and make thirty pills. Take one morning and niglit. Phosphorus can be beat given dissolved in almond oil ; one-fourth of a grain of phosphorus may be dissolved in two ounces of the oil, and a teas]:)Oonful of this may be taken morning and night. Nervous Exhaustion. This term designrtes a condition which is known by physicians as ucicrnsiJicnia. It may be defined in short as a lack of nervous force. It often exists in pallid, bloodless peojjle, and disappears when the patient's general condition is so improved that the blood-producing organs again perform their functions properly, and tlic individual acquires again the ruddy glow of health. Yet it often hap- pens that nervous exhaustion exists in individuals whose gen- eral apjiearance would not lead any one to suspect any serious dis- ease J the person may be stout and, of full habit, may have a good ap- w I < It I06 THE FAMILY PHYSICIAN. petite and digest the food well, and yet may be and feel quite incapable of performing those diilies v.hich he had previously fuhllled without difficulty. The affection seems usually to proceed from an improper degree of activity of some part of the nervous system, more especially in the ex- ercise of the mental faculties. It seems also to be subject to certain hereditary inlluences ; the children of parents who have suffered from chronic diseases of the nervous system, such as epilepsy, hysteria and insanity, are especially prone to the manifestatifjn of nervous exhaustion. Physicians, especially those who practice in large cities, are often con- sulted by individuals who, although manifesting no well-defmed disease, are evidently not in good health. It is i)ossible that these cases do not receive as mucli attention from friends of the person, or even from the physician himself, as they deserve ; for the tendency to complain, to ex- aggerate slight indisposition, is so common, that unless there is some dcllnite and tangible derangement of the body, the tendency is to ignore and make light of the symptoms presented. In nervous exhaustion, moreover, the indications of the difficulty are of a subjective rather than of an objective character ; that is, they are symptoms which the patient can himself feel, but which no one else can perceive. The subjects of nervous exhaustion complain of lassitude, a want of buoyant feeling, an indisnosition for exertion, mental depression, and sometimes wandering pains and aches lelt in various parts of the body. Such individuals are wakeful at nitjfht, and cT-'Se with a slmisc of fati^aie and a feeling that their sleep has not refreshed them. When stimulated by some unusual excitement they are capable of the usual exertion, but when the excitement has subsided they feel exhausted. Such paiients usually fancy that they have some serious disease, and otten become melancholy at the thought that their jjowers are being undermined and that they are "inadechne." Spinal Irritation is a manifestation of nervous exhaustion which af- flicts many of those engaged in active mental effort, and is especiallv common among women who are subject to diseases of the womb. In this conditif)n there is extreme tenderness along the spine ; there are usually flying pains, especially in the chest and abdomen; and the occurrence of hysteria as well as of convulsive spasms of the limbs is a frequent symptom. This condition of spinal irritation is usually periodical, and is especi- ally apt to occur after over-exertion or excessive emotion. In nervous women it oceurs particularly during the period of menstruation. There are also conditions which seem essentially the same as spinal irritation, though there is no tenderness on pressure along the back bone. The condition is manifested by unj)leasant and annoying sen- sations in different parts of the body. Some individuals suffer from neuralgic jj)ains in the limbs i others have throbbing sensations in the DISEASES OF THE NERVOUS SYSTEM. 107 chest and in the head. Anoilier symptom is itching, which may occur in any part of the body without apparent cause, and maybe (iuile in- tense and persistent. One of the most distressing symptoms is the wakefulness of such pa- tients. Tiiey he awake and tf).ss about for hours and [)erhaps fall into a heavy slec[) toward morning, from whifh they awake without feeling much refreshed. This condition is obstinate and may not yield even to the bromide of potassiumorto chloral, unless taken in excessive doses. Another manifestation of nervous exhaustion, is dysj)epsia, which is rarely so distressing as those forms of dyspepsia which result fron. organic disease of the stomach, but is nevertheless a source of much annoyance and uneasiness to the patient. The special senses are also liable to derangements. Among tiie most common of these are s[)ecks before the eyes, which appear especially when the individual feels exhausted. Another occurrence is noise in the ears, which sometimes take^ the form of a continual humming, and sometimes appears as sudden and loud noise. One of the sym|)toms of nervous exhaustion, which is brought to the notice of the ])h)sician with cspetMal frecjuency, is derangement of the sexual fun<-tions. This may take the form ot ifiipotc)ici\ ])artial or com- plete. This is often manifested by a loss of sexual [)Ower before the ap[)etitedisai)pears. Under these citcumstances the patient is extremely depressed and desjiondent, as a result of which the symptoms are ag- gravated. Sometimes this sexual weakness takds the form of senn'nal emissions. These are of course natural and in i)erfect accord with health and those who are continent ; but in conditions of nervous e.\- hnnistion the emissions are apt to occur with far more frequency than in health. These emissions when excessive are of themselves somewhat exhausting, but tiiey are especially important as indications of nervous prostration. The i)opular idea ascribes to seminal losses the symptoms which occur in the individual at the time ; in other words the emissions are assumed to be the cause of the patient's prostration. As a matter of fact they are a result rather than the cause of the condition, and the l)atient's despondency should be relieved by the assurance that when his general health shall be im[)roved, this symj)tom will disappear, pro- vided there be no organic disease of sexual organs. In females nervous exhaustion is manifested by pain and unusual prostration at the time of the menstrual epochs. Here also the men- trual disorders are the result rather than the cause of the nervous pros- tration accompanying them. There may be in various parts of the body derangements of motion and of sensation which are 10 be explained simply by the general con- dition of the patient, and not by any local disease Thus it mav happen that certain portions of the skin become ([uite numb, and remain so for hours and days at a time \ in other cases certain parts, such as a linger io8 THE FAMILY PHYSICIAN. or toe, an arm or a leg, become extremely sensitive both to pain and to chauL^cs of temperature. At times too there may occur what seems to be a i^tnuinc jjaralysis ; the latient loses control of fingers, of thumbs, or even of the entire hand or lore-arm. In other instances twitchings of the muscles are constantly observed ; this is especially frecjuent in the muscles of the eyelids. Such patients are annoyed by the consciousness that they are constantly winking, and yet they are unable to control the eyelid. Occasionally such patients are troubled also with unusual diffidence, and even timidity, which sometimes manifests itself by an aversion to society ; this is particularly apt to occur in tliose whose nervous exhaus- tion lakes the form of scxtual incajjacity. 'JVca/i/ic/iL — Nervous exiiauslion usually recjuires, first of all, complete relief from care, anxiety and exertion. It is not desirable that the i)a- tiint should entirely reiintjuish his occupation ; but a respite for a cer- tain [leriod seems absolutely necessary. Not less important is the avoidance of errors in the habits of life. 'I'he inordinate use of stimulants, excesses of any kind, etc., are of course to be avoided. The best sanitary reg"'ations also should be observed, and one of the most efficient remedies, that can be employed is a course of sea bathing. It this cannot be procured, the cold bath in the morn- ing at least, or morning and night if the patient can bear it, is a good substitute. The diet should be' generous and varied, even though the patient nay already. seem to have an abundance of flesh. Among the remedies to be emplojed, two are es[>ecially valuable — electricity and massage. Ivx- ercise should l)e [provided for, but not taken in excess, since exercise of the body re(|uires exertion on the part of the nervous s) stem. In some cases severe measures have beenempl-yed to relieve spinal irritation; small blisters and even the white-hot iron have been applied along the spine. Such measures must, of course, be used only under the advice of the physician, since in every case it is the pci/Zc/// and not the disease that is under treatment, The drugs that are to be used vary in different cases. In most cases strychnine, arsenic and ciuinine, with or without iron, will be useful. These may be given in the loUowing prescription : Forty grains. One third of a grain. Twenty grains. , Four grains. Five grains. I Sulphate of (juinine, Arsenious acid, Reduced iron, Extract of nux vomica. Extract of cannabis indica, Mix, and make twenty pills. Take one before meals. If there be symptoms of dyspepsia it will be advisable to use in ad- dition to the above pepsin and extract of malt, as in the following des- cription, ; DISEASES or THE NERVOUS SYSTEM. tCQ Extract of malt, ... 'I'hrcc ounces. ^Vinc of pepsin, ... Tlircc ounces. Mix, and lake a teaspoonful after meals. If the patient i)e troubled wii.. sleei)lessncss, the follcnvinL,' niay be adminiblercd at nif^ht : Itromide of jiotassium, Hydrate of choral, Syrup of orange peel, ^Vater, 'I'wo ounces. One ounce 'I'wo ounces. Four ounces. Mix, and take a teaspoonful before retiring. The dose may be repeated in an hour if needed. I I CHAITER VIII. ACCIDENTS, INJUKIllS AND SUUCICAF, DISKASliS. "F I! . h f 1 IG ij8. IIiiw to ha ml. !,!.;(■ Hui-n.-^ and Scalds- ( iiiiccr ot llu; 'ron^nic iMilargwl 'loii.'^il:,— I 'L'crs of the 1,1'j;— ('liokinj; — Frnslbite — (ioiliX! 1 lousrinaid's Knee -Wounds, Incised, I .airral- cd, (.Jonlusi'd, I'liiuttircd Hla.'diii,i; or II(iuoriliaj(c — lUi-cdin^ from the Nose — Hlccdiii^ from tlic I?o\vcls — Faint in,L,'-l''racturi-s, Varieties of--l''raetiire of Fini^cr — Of Dones of Jl.iiid - Of Foreariu— Of llunierus or Upper Arm— Of Siioulder lllade Of (.'ollar iSonc — ()» Kiljs— Of Le-j— Ofl'liigh— iJislocationofLowerJaw -Of Collar Hone- -OfSlioiildur — Of I'llbow— Of Fingers or Toes — Of Wrist - Of Hip-joint Of Knee-pan — kupluru or llermia — Sprains — 'Footh-aclic — Drowning — Foreign Ilodies in the Fly e — In the Ear — In the Nose, How to Bandage. There is not a more important art connected with liouscliokl surgery than that of bandaging. To do it well reiinireii much [practice and no little judgment. The material em[)lo) ed in band- aging is usually stout unbleaclied cotton, Iroiu two or three to nine or ten inches wide, and from six to twelve }ards long : the former length and breadth will do best for the leg. If commenced at the ball of the foot, and evenly ajjplied so that each fold over- la[)s the other about one-third, it will reach to the knee. l''ig 9S will best sliow the mode of ap[)lication. 'I'he bandage having been first tightly rolled up, is taken in the right hand of the operator; the end is passed under the toot, and held there by the left hand until it is secured by one turn of the bandage over it ; an upward directi::)n is then taken, so that a couple of folds bring the bandage up to the Iront of the leg, over the inste[) ; the next turn will naturally pass above the heet behind ; and then, if pro- per care be obseived, it will go on, fold above fold, each over-lai)ping the other slightly, all up the leg. The bandage is passed from the right to the left hand each time it goes round the leg, and great care should be taken to hold it firmly, and e(|ualize the pressure, as well as 10 smooth out any wrinkles that may occur in the process of binding. A firm and even support is thus afforded to the limb, which is not likely to crease, or get displaced by the motion which may be ai'terwaids netx'ssary ; it may be made fast above the calf by a couple of pins, or a needle and thread. (Ireat care should be taken in this, as in all similar operations, to get the bandage rolled up tightly and smoothly, before commencing ; no ACCIDENTS, TNJURTKS AND SURCICAI, DISKASKS. Ill nine or !<;. (/^. it may thus I>c L^raspcd in the hand, and Icpi well under the roniniand of the operator, who should on no aceount let ^o his hold ol the bandage, so as to relax the pressure. The arm does not re'iuire so long or broad a bandage as the leg ; about two inehes, by three or four yards, being the average size : this limb is rather more diflicult to manage, half turns being necessary to effect a i)roper envelo[) mcpt liow this is cfferted may be seen in l".g. 99. Tiie bandage is folded back upon Itself, so as to take a different di- rection, and cover die si)ace which would be left exposed by the ordinary melliod of folding ; those half turns, unless they are dcjne tightly and evenly, will be a[)t to slip and derange the whole binding. Some oper- ators avoid half turns, by letting the roller take its natural course, and then coming back to cover the cxi)oscd parts ; but this method, besides reipiiring a larger bandage, does not effect the rehor water, Twenty grains. One ounce. Five ounces. . This may be used to swah the throat. For this purpose a piece of sponge as large as a hickory nut may be tied firmly unto the end of a jjiece of wood or wlialebone. The sj^onge is moistened with the solution, and then rubbed thoroughly over the surface of the tonsils and the neighbor- ing part of the throat. It will generally be necessary to hold the tongue down with the handle of a spoon during this ])rocess. Care must be always taken to fasten the sjjonge firmly M])on the handle, in order to l)revent the possibility of its slii)[)ing^ off into the throat. Ulcers of the Leg". One of the most common and troublesome affections, among poor people especially, is ulcer of the leg, i)articularly on the part of the leg just above the ankle. In most cases of severe ulceration of the leg in which the individual has not had syphilis, the veins of the leg and thigh will bq found to be ACCIDENTS, INJURIES AND SURGICAL DISEASES. 117 enlarged, constituting the condition known as " varicose veins." These ulcers occur almost always in middle or advanced life, though they may be found in children who are poorly nourished. Treatment. — The healing of the ulcers will he promoted by improve- ment of the general health. In most cases, however, the sufferers arc unable to enjoy the recrtation, air and exercise which form such im[)or- tant elements in improving the health. Yet what can be done in the way of food and personal care should not be neglected, since such mea- sures will have a marked effect in hastening the healing of the ulcers. The treatment consists chiefly of local applications. Sometimes the ulcers can be healed by the constant ap[)lication of astringent ointments, of ivhich the following is a good example : Diachylon ointment, Vaseline, - One ounce. One ounce. Mix. Apply the ointment spread upon soft cloths, which should be bound over the ulcer by means of a bandage. The healing of the ulcer will be [)romoted by measures which tend to keep the blood out of the leg. For this purpose the leg may be enclosed in a bandage of soft flannel which is applied from the foot to the knee. Muslin bandages should be avoided, since it requires considerable prac- tice and skill to apply these evenly and firmly. As they are ordinarily put ui)on the leg, they do injury rather than good ; for they are generally arranged so as to make deep impressions in the skin, and even to cut or abrade the surface. The healing of the ulcers will be hastened by keeping the foot ele- vated as many hours in the day as possible. This can be best accom- plished by having the patient lie down, or at least by supporting the foot upon a chair. Yet, as a matter of fact, it is practically impossible to persuade a person to remain in bed or on a chair all day and night, even though he have the o[)portunity ; and for most individuals the opportu- nity is lacking. It was, therefore; a godsend for persons afflicted with ulcers of the leg when Dr. Martin introduced to the profession the rubber bandages, which he had himself employetl in his private practice for twenty live years. These bandages are simply made of pure rubber, of varying widths and lengths, according to the needs of the patient. The bandage is api)lied directly to the skin without interjiosing any dressings or oint- ments over the ulcer. It should be put on in the morning before tHe patient leaves the bed, or even puts his foot out of the bed. It is ap- plied to the foot first, and then wound snugly around the ankle and leg some distance above the site of the ulcer. The patient can then rise and attend to his. usual duties. The bandage is (juite warm, and causes profuse perspiration of the limb ; there is apt to be also an increased dis- charge from the surface of the ulcer. Yet these elements do not inter- P I ' I '1 ii8 THE FAMILY rilVSlClAN. lere at all with the beneficial effect o( the Ininda^^c ; in fnrt the hcnefit seems to dei)t.nd lai;:i;ely 'i()on the nioistu-e and wanntli secured by llu.' bandaL^c as well as b)- the supjjort to the .eins of the skin. At night the bandage is removed and cleansed with warm wa'.er, aftv:r which it may be hung i![) to dry until morning. 'I'he limb bliinikri;e also bathed and cleansed, and the ointment above mentioned may be ai)plied during the night. The success obtained in the treatment of ulcers of the leg by the use of this bandage astonished every jihysician who employed it. The most obstinate ulcers, even those w'.iich had resisted ordinary measures lor years, were healed in a few months or even a few weeks by the < onstant use of this bandage; and the patient had moreover the pleasure and profit of i)ursuing his usual avocation instead of being compelled to sit or recline during the day. • Choking. This accident, caused by substances getting into the gul- let, or stoj)i)ed between the mouth and the stomach, is extremely dan- gerous, and generally the effect of carelessness. Treatin.iit. — Slap the back smartly, but nfit too heavily, .ind in the meantime let the person swallow some cru'nbs of bread, and drink a draught of water. Or, press a finger immediately down the throat as lar as posL-ible. Or, take large draughts of water, and make great efforts to swallow. 'J'he ([uantity of water distends the gullet above the lodged food, alters its j)osition, and both water and food pass into the stomach with a sudden jerk. If the foregoing efforts fail, ir.ake a hook with a strong iron wire or a thin and narrow fiat ])iece ot iron, stifficiently long not to sli[) out of the opeiator's hand. The hook should be covered by sewing over it a piece of wash leather or ta[)e. This is to be introduced into the throat, and by that mean^ the obstruction removed. A strong emetic will sometimes effect the i)ur[);)se when other means fail ; mus- tard mixed with warm water is as efficacious as an)'. Frost Bite. Lengthened exposure tf) the cold is apt to render [)arts of the body numl) and inanimate. The rmgers, toes, li[)-;, no.se anil ears, are especially liable to be affected. Trcainu'iit.' -'\\) restore the natural warmth of the |>:iit gradually must be the UJiin o!)jet"t ; and on no acc(Mint must a (•onsidL';al)le degree ot heat be ai)[)lied suddenly, as it would eitlier kill the part outright, or cause violent inllammation to result. Friction with s low or cold water merely should be used, until a circulation is somewhat restored, and equal parts of brandy or some other spirit mixed with cold water ma*- be applied, until the restoration is completed. I''rost-l)ites are apt to leave troublesome sores, which are difficult to heal. The red precipitate oint- ment is the best application j and, if much infiamcd, they should be poulticed. • ACCIDENTS, INJURIES AND SURGICAL DISEASES. II9 Goitre, or Big Neck. Treatment. — An important item of treat- ment is the removal of the patient from those influences, whatever they may be, which induce the disease ; hence, a change of residence is al- most essential. No medicines can be relied upon to check the growth of the tumor, though much good seems to have resulted in many cases from the use of iodine. This should be applied to the skin in the fol- lowing form : Tincture of iodine, Glycerine, - One ounce. - Two ounces. This may be painted over the enlarged gland every day or two ; if the skin show much evidence of irritation, the painting process may be per- formed less frequently. At the same time the patient may take iodine internally in the form of iodide of potassium. The following prescription may be ad- ministered : Iodine, Iodide of potassium, Syrup of sarsaparilla. - Four grains. - Four drachms. - Four ounces. A teaspoonful of this may be taken three times a day after meals. Housemaid's Knee. This affection consists of a swelling on the front of the knee, or rather on the upper part of the leg just below the knee. It consists of an enlargement of a little sac which naturally ex- ists over the knee-pan. This sac becomes filled and dilated with watery fluid, constituting a soft fluctuating tumor. The swelling may vary in size from that of a hazel-nut to the dimensions of a walnnt. The swell- ing is at first painless, and remains so until irritated by mechanical violence ; it may then become acutely inflamed and occasion much pain. This affection is termed housemaid's knee, because it occurs with especial frequency in servant girls, presumably in consefjuence of kneel- ing upon hard, damp floors. So long as it remains painless it need not be interferred with, unless it attains such a size as to inconvenience the patient. In this case it may be punctured with a fine needle, and the fluid allowed to escape. If it becomes inflamed, the patient suffers great pain and high fever ; the knee swells so that walking is impossible. Treatment. — During an inflammation of such a tumor the patient should lie quietly in bed. Hot cloths must be wound around the knee and frequently changed, in order to keep up a constant warmth and moisture. In two or three days the pain and swelling usuully subside, and the patient's condition remains as before. In other cases matter forms, and it becomes necessary to open the swelling with the knife. 5 |i 120 Till'. FAMILY I'lIYSICIAN. The tumor can usually be made to disappear by pnspinp; a scion through it : this consists in inserting a needle armed with clean silk into and through the sac, the silk bemg peruiiUed to remain. This causes some inlkunmation, as a result of which the sac gradually dries up. Several other plans of treatment are in use, but can be practised only by the surgeon. Wounds. Wounds are citlicr incised, lacerated, contused, or punc- tured. They are called incised wounds when they are made with a sharp cutting instrument, as when a shoemaker cuts himself with his knife, or a carpenter with his chisel. They are called lacerated when the llesh is torn, either by machinery, hooks, or otlier blunt instruments. Wounds are said to be contused when there is an irregular breach of surface, accomijanied by injury and a bruised conduion of the surround- ing parts; they are generally produced by falls or blows of dull instru- ments. I'uncturcd wounds are produced by the fort.ible entry of shar}) instruments, such as bayonets, swords, scissors, hooks, or the pointed ends of broken bones. Incised Wounds. It has been observed before, that incised wounds consist of a mechanical division of the parts by a cutting instrument ; all, therefore, that is necessary to be done, is to bring the edges of the wound nicely together, and maintain them in that position until union takes place. This is effected, if the wound be trilling, by means of straps of sticking-plaster, which should ha so applied as to preserve the edges of the wound in apposition. Collodion answers admirably. If the wound be of considerable extent, and bleeds freely, the first thing to be done will be to arrest the hemorrhage ; this will be effected, if the bleeding vessels be small, by making pressure with a sponge for some consider- able time. All extraneous matter should be cleared off, and the lips brought together ; a piece of lint should be dipped in the blood and placed over its edges. This is found to be an excellent application, as the blood in drying, in consequence of its adhesive qualities, seems to maintain the union of the edges of the wound. In the course of four or five day?, the parts will be found to be united, unless some accidental circumstance, such as too great a degree of inflammation or an untimely meddling with the dressings, should occur. The strappings or dressings should on no account be disturbed before the fourth, fifth, or sixth day, unless the parts should be in great pain or much swollen. If the incis- ion takes place about the cheeks or lips, or other i)arts which are unsup- ported, and where sticking plaster could not be applied, it will be nec- essary to put in two or three sutures, according to the extent of the wound. Should the parts swell, a cooling lotion may be applied, such as Cioulard-wuc "■, and the bowels should be kept in a free state. Fre- quently the edges of the wound must be maintained in apposition by means of sutures. ACCIDENTS, INJURIES AND SURGICAL DISEASES. I ill FIIJ. 128. ■^ Sutures are for the purpose of holding together the edges of a wound in soft, fleshy parts that ore loose and movable, where sticking- plaster would not, of itself, hold sunicicntly secure. They consist of stitches, from half tothrce-cjuarters of an inch apart, between which strips of plaster are placed, and arc not drawn out for several days if they do not irritate the part much ; hut if they do, then they must only be continued one or two days. The needle should be threaded with silk or hemp thread well waxed and flattened. It should always be borne in mind that the edges of wounds are never to be drawn to- gether with any degree of strain or force to the parts, as then the process of healing will not take place. In what is tech- nically called the interrupted suture, a stitch ift taken straight through the edges of the wound, as in ordinary sewing, and then kncjtted. In the twisted suture fine steel needle:;, with flattened points, are passed through the edges of the wound ; then silk is twisted in the figure of eight around them, as a boy twists his kite twine on a slick. It is better not to cut the silk, but continue e ich end down to the next iieedle, and so on ; secure the ends with a small knob of wax. I'ig. i jS shows the mode of making and tying suturea. Lacerated Wounds. Lacerated wounds, in consequence of the great injury done to the parts, and from the fact of their not bleeding nmch, are very subject to active inflammation. If the wound be con- siderable and the part-s much injured, the patient should enjoy pertect rest ; the parts should be covered with cooling lotions, all dirt and ex- traneous substances being previously washed off; the bowels should l)e opened by the common black draught. If inflamm»Uion run high, leeches should be applied, and the bleeding encouraged by the appli- cation of hot water ; the cold lotion should now give way to fomenta- tions and poultices ; the patient should live low. When the inflamma- tion has subsided, the wound may be dressed with basilicon or Tur- ner's cerate. Krysi])elas freiiuenily follows lacerated wcninds of the scalp; in this case the parts should be iVeely fomented with hot water, and the patient should take a fever mixture. Tetanus, lockjaw, and spasm, often arise from lacerated wounds ; in such case;; opium should be administered in doses suited lo the age anel ciicumsiances of the pa- tient. One grain might be given every three or lour hours until relived. Contused W^OUnds. Contused w^ounds will require the same treat- ment as that already described. Cold applications in the first instance, and if inflau>mation sets in, leeches and hot fomentations. They gener- ally terminate in suppuration and sloughing, or moi tiflcalion of the [)arts, according to the extent of the injury. In order to expedite these pro- cesses, poultices of bread and water, or linseed-meal, should be applied 122 THE FAMILY rilYSICIAN. three or four times a day, and when the abscess opens or the slough is thrown off, they arc to be treated as common ulcers with basihcon or some otlicr stimulating ointment, for the purpose of promoting healthy granulations, and thus healing them. During the active stage of intlam- malion, the i)aticnt should live sparingly ; but tonics, such as (luinine, and a generous diet should be allowed under the stage of suppuration or sloughing. Punctured Wounds. Punctured wounds arc extremely dangerous — • much more so than the others already described. A punctured wound Irom a nail, hook, or any other pointed instrument, gives rise to inflam- mation of the absorl)ents (a set of vessels running from the wou. d into the neighboring glands), and is manifested by red lines taking the course of these vessels. Abscesse?; of the inlands, and of other parts of the body, in their coin-se, h-ecjuently ensue ; and if the matter be deep seated, such a degree of irritative fever is produced as to cause death. Lock-jaw (tetanus) and frightful convulsions are often the result of tendons or sinews receiving punctured wounds. In the first instance the i)uncturc should be laid open with the lancet, cold lotions should then be applied, and if inflammation sets in, the parts should be covered with leerhes according to the age and strength of the patient ; the diet should be sparing, fomentations and poultices should be constantly ap- |)lied, and the limb should be supported on an inclined plane, in order to favor the gravitation of the blood towards the body. All stimulating drink should be cut off. The bowels should be kept freely open, and the patient should observe perfect rest. As soon as matter has formed, it should be let out by free incisions with the lancet, after which the parts should be poulticed three or four times a day. In order to allay irritation and pain, and to procure sleep, great advantage will be derived from the administration of ten grains of Dover's powder, at bedtime. Bleeding, or Hemorrhage. This always accompanies wounds, Mul is generally most alarming to bystanders. There is no occasion for fright, as people do not bleed to death very quickly. Retain your presence ot mind, and remember that three things are to be done, all of which you can do at once. Take time to notice the color of the blood. IJlood from the arteries is a bright red color, and bursts out in spurts, while venous blood is a purple red, and flows in a steady stream. The three steps you can take to stop the blood are : I. Pressure. — Should an artery or 5ranch have been divided (indicat- ed by a spurting of a spray of bright blood at each beat of the heart), the firm pressure of the fingor for some time, to the point of division, should be used, to diminish the size of the vessel at that point, until a clot is formed there. Sometimes, pressure to the supposed seat of the injured vessel does not reach the artery. In such a case the pressure must be used to some ACCIDENTS, INJURIES AND SURGICAL DISEASES. 1 23 known trunk between the original supjily of the blood and the injured branch. Thus, if tiie finder or the toe is the seal of the arterial hcuior- rhaj^e, firm j)rcssuie applied each side of the hnger, close to the hand, or toe, close to the foot, coni[*rcsses the arteries passing along to be dis- tributed to the extremity. If the hand or foot is the seat of the injury, pressure on the wrist, over the point where the artery is felt for the " pulse," or at the inside of the ankle, will materially retard the i)assage of I he blood beyond these points. 2. Position, — Tiie part from wliich the blocjd comes should be raised above the rest of the body, and if the patient become faint he should not be roused immediately, sin(-e faintness acts as nature's remedy by less- ening the force and activity of the tlow of blood. 3. The Application of Cold, — This plan answers best when the bleed- ing is from several points scattered over a large sinface ; it is convenient- ly applied by letting cold watei drij) from a sponge upon the bleeding points, or by the application of ice in a rubber bag, or bladder. When these immediate measures have been used, there is time enough to use what physicians call hemostatics, to stop the blood. Ciallic acid is a cheap and convenient one. Still more handy is alinn. ICilher may be dusted on the part in jjowder, or i)oured over in solution. Or the woimd may be touched with nitrate ot silver, or tinctiue of iron. lUit these measures are needless in ordinary cases. Sometimes, when a tooth is drawn, and the blood will not cease running, a piece of cotton, damp- ened witli alum water, or s[)rinkled with alum powder, and ai)[)lied, will check it promptly. Bleeding from the Nose. This is seldom serious, and may gen- erally be controlled by the application of a little cold water. The patient sliould be kept upright with his head thrown back, and his hands raised above his head. Ice to the back of the neck is useful. If very obstin- ate, throw into the nose with a syringe, ice water or a solution of (lallic acid, or pure vinegar. If these fail, the nostrils should be plugged with lint dipped in a strong solution of sulphate of coi)per, or the lint first moistened and then dipped in finely powdered charcoal. When the bleeding has sto[)i)ed there should be no haste to remove the clotted blood from the nostrils. Let it come away of itself; do not blow the nose violwitly, nor take stimulants, unless there be excessive faintness, in which case a little cold brandy and waier may be taken. Where there is full habit of body, cooling medicines and low diet may be safely advised. Bleeding from the Bowels. When blood escapes from the bowels the patient is usually afilicted with hemorrhoids, or " piles." i>Ieeding from this source need occasion no alarm ; indeed the patient's sufferings are usually alleviated by it. In other cases an escape of blood from the bowels is a symptom of disease higher up in the intestine. The affection which is most frequent- t24 TliF. FAMILY rilVSirtAN. ly accompanied by hemorrhage from the bowels is typhoid fever. In this disease severe bleeding sometimes occurs ; and in some cases but little blood escapes fiom the body, so that the i)atient may even die horn unsuspected loss of blood into the bowel. Wc can usually distinguish blood which escapes from some point liigli up in the bowel from tliat which comes from piles by the color ; blood which issues from piles is usually of a bright red cohjr, while that which i)ro( ecds Irom the ujjpcr i)art of the intestine is generally very daik, or even black; its true nature may in fact escape detection, since it looks very much like pilcii. 'Ircoimcnt. — JUceding Irom the bowels should be treated by giving' half a teaspoonful ol the sjiirits of turpentine in a tablcs[)oonful ot mi.k and by the ajjplication of cold cloths to the abdomen. It these measures do not suffice, ice-water may be injected into the rectum, or i)ieces of ice wrapped in soft cloth may be inserted into the bowel. In these cases the tincture of ergot is a valuable remedy ; half a teaspoonful ot this may be given, and a similar amount taken at the eNi)iration of fifteen or twenty minutes. The patient should of course lie perfectly (iuiet, and resist, so far as })Ossible, the inclination to e\acuate the bowel. Fainting. {Syncope.^ — This is a stale of total or i)arlial unconscious- ness caused i)y diminished action of the heart causing less rapid circu- lation of blood through the brain. Causes. — The causes of it are various and sometimes very i)eculiar, such as a particular smell ; that of a rose, lor instaiMc, has Jjcen known to cause it ; certain objects presented to the sight ; surprise, joy, fear, or any sudden emotion ; loss of blood or anytb.ing which tends to debilitate the system by diminishing the vital energy. Sy/iip/onis. — The first sensation of fainting to the patient himself is generally a singing in the ears ; then the sight becomes confused, and all the senses deadened ; a clanuny sweat breaks out over the person, the countenance becomes deadly pale, and the limbs refuse to supjjort the weight of the body, which sinks to the earth as hcl|)less and moiioH- less as a corpse ; indeed the condition scmIhscIv lesembles thai of death, that it is difficult to distinguisli it therefmui. 'I'liis is a com|)lete faint ; frct[uently the fits are (Jiily partial, and very limited in duration. 7>-fW////« ■///.— Place the ])atient in a hon/ontai jjosition ; free the face, neck, and upper part of the chest from all incumbrances ; let the fiesh air play freely upon them, and sprinkle the lormer with cold water ; holding to the nostrils from time to time some volatile stimulant, such as hartshorn or ammonia ; as soon as swallowing can be accomplished, administer about thirty drops of wine, or sal volatile in water. The after- treatment will of course depend on the cause. As the first stage of some forms of apoplexy and paralysis is one of faintn<^ss, a little discrimination should be used in the administration of ACCIDENTS, INJURIKS AND SURdlCAL DlSi.ASI S. 125 Stimulants. Where the seizure, too, is in consequence of loss of blood, no violent efforts at restoration slioukl for a time he made, as this state is necessary for the patient's safety. Persons subject to fainting should be careful in frecjuentinj; crowded rooms, or goini; anywhere where the air is bad. 'Tii^ht dresses should be avoided ; and no excitement i>e allowed. ;\ well-rej;iilaled diet, cold bathing, and vegetable tonics, will usually mire this distressing inhrmity. Bones, Broken or Fractured. Splints is the name surgeons give to the apparatus used to i)la(e along the broken Iragnu'nts, to keep them in jiosition. They are made of wood, rubbqr, leather, binders' board, tin, and many otht-r materials. j''f)r general use those manufactured ol stilV tell are the best. They come in sets, and arc readily moulded, when hot, to any limb, and are firm and soft when cool. In instances of suspected fractiue or dislocation of the thigh or leg, the injured i)aits should be placed in a comfortable position, and as well su[tporled as possible, to j)revent the /ic/U'/u'/^i^s of the leg from the si)as- mcjelic action of the muscles of the injured extremity. If necessary to remove the i)atient to his home or the hospital, from the spot where the accident hapijcned, the arrangement of tlie limb should be made after he has been placed on the stretcher or substitute. If found necessary to carry the injured person some distance, and a litter for the purpose cannot be had, the arrangement of the fractured limb against the other, and ke[)t there by handkerchiets, is often of great comfort to th.e sufferer. l»y a little ingenuity a comfortable litter can be made by fastening four stout poles together, and tying a blanket securely to them. We shall now describe particular fractures which may be either Simple, Compound, or Comminuted. Sini/>le. — When a bone is broken in one place without any external wound. Contpound. — When a bone is broken in one place, and there is an ex- ternal wound leading down to the broken bone. Coiniitinuted. — When a bone is broken in two or more places, as when a splinter of bone is broken off. l^ractute of Skull — Put the patient in bed, and let his head be shaved for some distance round the seat of injury, and wet lint with, gutta percha tissue ajjplied over it. Fracture of Lower Jaw. — In this fracture the parts of the l)onc should be rei)laced in their natural position, the mouth closed, and the face bandaged so as to retain the fragments in place. The patient should be fed by a tube, which can be inserted where he has lost a tooth. Proth and milk must be his diet until the bones knit. A dentist can easily make a splint of rubber to fit inside the mouth, and thus hold the parts in position at less discomfort. . - 126 THE FAMILY PHYSICIAN. FIG. Fracture of the Finger, — After employing extension, and thus bringing the ends of the hone together, ^ylace a small smooth piece of wood, or of gutta-percha, on the under, and another on the upper side, and proceed to bandage somewhat tightly, so as to keep the finger extended ; put the arm in a sling, and keep it so for a month. If the injured ])art swells and becomes painful, the bandage must be loosened, and a cold lotion applied ; this is generally by no means a difficult case to treat. Fracture of the Bo7ics of tJie Hand or Finger. — These bones, which intervene between the wrist and the fingers, should be treated in the fol- lowing manner : place in the palm of the hand, a soft, but firm, spherical body, and clasping the fingers and thumb over it, in a grasping position, keep them so with a bandage ; by this means the natural arch is preserved, which it will not be if Hat sjjlints are applied. In this case, too, the arm had better be slung, and Irom a month to five weeks will be the time re- quired to effect a union. Fracture of t]ie Forearm. — Fracture of the forearm may be either of the ulna or the radius, or of both : the former is the inner and thicker bone of the two (see Fig. f i6), and the fracture of this does not much disturb the general outline of the arm ; it may be Ijroken at any part of its length or at the elbow process, called olecranon (3), or at (4). In the first place the plan will be to bend the elbow, and bring the hand into such a position that the thumb points upwards ; use extension until no unevenness can be discovered in the course of the bone, and then apply two splints, the inner one reaching from the elbow to the tips of the fingers, and f H ^ '^1^ ^^^^ outer from, a litile beyond the elbow to the middle of 111 kill ^'^"^ back of the hand, which should be raised well towards the chest so as to make a sharp angle and draw the ulna from the radius. When the fracture is in this latter bone (2) the same method must be adopted, only that the hand must be depressed instead of raised, in order to keep the two bones apart. When these are both fractured, the set- ting is, of course, more difficult, and much time has'often to be sjjcnt in extension aud manipulation, before the four broken ends can be brought proj^erly together. 'J'he splints should be put on as above directed, bandaging the hand firmly to the longer one, and placing it so that it is neither raised nor depressed, but in a right line with the axis of the ami. When there is a fracture of the o/ecration there is little or no power of extension in the elbow be- hind which a bony lump may be felt. A true osseous union in this case is scarcely to be looked for ; but the injury will probably be repaired by a band of ligament. There is commonly inflammation and swelling, which must be reduced before pressure can be applied ; the arm should S ':m The Fore-Arm. ACCIDENTS, INJURIES AND SURGICAL DISEASES. 12/ be kept straight, and wet with cold lotion ; and apply a splint as soon as it can be borne ; let it be a long one, reaching on the inside from the shoulder to the hand. Inindage the arm in a straight position, i)cgin- ning from the top, and making, as you go, extension downwards, so as to get the broken bone in its place ; it is long ere the limb is in a service- able condition after a fracture like this. Wlien the coronoid process is broken, the matter is more easily managed. The forearm must be ban- daged iij a bent position and kept so. In ai)OUt a month, slight exertion of the limb may be allowed, and there must be great care taken that it is not too violent. Fracture of the Humerus. Fracture of the humerus or upper arm-bone, very commonly takes place in the shaft, or any jjart of it within an inch and a half of the extremities. It is easily detected by the mobility of the limb at the r.eat of the injury, and the patient's incapability of rais- ing the elbow ; the broken ends of the bone, too, may readily be felt, and the crepitation heard, when they are rubbed together. In this case two wooden splints will be required — one to go before and the other behind; or, if the arm is very muscular, four may be necessary to embrace it properly ; they should be padded with tow, wadding, or lint, as here re- presented, and furnished with tapes to bucki ^ or tie, as may be most convenient. The padding should be Fig. nS. placed upon a soft piece of cotton or linen, a little longer than the splint at each end, and three times as broad ; turn in the ends and sides, so that the pad may be a little larger than the splint in every way, and about half an inch thick, and make all fast by tacking ; place the turned-in ends of the cotton next the wood, so that there is a smooth surface presented to the skin. The tapes, three in number, are put on to the splints double, so that there is a loop at one end (i), through which, after it has encircled the limb, the other end is passed (2), then drawn tight and tied to the remaining end (3) with a bow-knot, as shown in Fig. 118. A bandage, very easily loosened, may be made in this way of a strip of cotton or broad tape. The setting of the bone is not difficult in this case ; the ends are easily brought together, and being so, the splints may be placed, and made firm by means of loose tapes ; these should not, at first, be drawn tighter than is recpn'red to keep the splints right, and prevent movement of the arm. After the first few days, when the swelhng has subsided, a more permanent investment of the limb may be made. Place two sj)lints, one on each side, of stout pasteboard, gutta percha or leather, cut so that they will come down and m4 B«I|P 128 Fig. 119. Fk;. 120. TTIE FAMILY PHYSICIAN. cover part of the forcnrm, as represented by the clotted Inics in Fig. 119. The si)lints sliould have been pre- viously shaped, or moulded, to the sound arm. and should be well fixed by more bandage, which, as it is rolled, ahould be brushed over with starch to prevent it sli[)ping. Sometimes, where there is not much muscle, the starch bandage alone is used ; but in this case, the whole of it must be well saturated with strong ^''^M starch, paste, gum, or white of egg, with strips of brown paper stuck down across the folds here and there, (.'are must be taken not to move the arm until all this J""""^ is dry and firmly set. .The hand and wrist must l)C supported with a sling, but the elbow had belter hang free, as its weight will tend to keep the bone straight and the muscles extended. Fracture of the Neck of the Humerus. Fracture of ihe neck of the humerus is that which takes i)lace when the upper extremity, or head is broken off. The symptoms here are very much like those which attend dislocation of the shoulder, and the treatment must be much the same. Draw down the shaft of the bone, and push up the head by means of a pad in the armpit ; then bringing the arm close to the body, with the lower part at right angles with the upj)er, fix it to the chest b)' a splint en its outside, and a long bandage encircling it and the whole body, fiijr iis shown in Fig. 120. Fracture of the Condyles. This is when the lower i)art of the humerus is the seat of the injury, the condyles being the rounded eminences which fit into the socket-like hollows at the head of the ulna to form the elbow joint. 7>r<;//-'/^///.—r)end the elbow to a considerable angle, and keei) it so by means of bent splints of gutta-|)ercha, or millboard, moulded to the shape, the first being softened by heat, the -last l)y moisture, liandage, and keep all nuiet until adhesion of the bone takes place, then put the ami in a sling, and let it remain thus supported lor a month or six weeks. Fracture of the Shoulder- Blade. This commonly happens near the neck, and is very likely to be conloi.nded with dislocaticjn of the shoulder, or fracture of the neck of the humerus, like which it should be treated, only that the arm, instead of being drawn down, must be sup- ported. ACCIDENTS, INJURIES AND SURGICAL DISEASES. c dotted iccn pie- irm. and 1, as It is ) prevent Dt much ut in this ih strong of brown nd there, til all this t nuist lie :,nter hanc; le straight f the neck )lace when )rokcn off. like those )ulder, and lie. 1 >ri^w msh up the [iipit ; then y, with the )j)er, fix it ide, and a hole body, lis is when the seat of rounded of the ulna keep it so dcd to the r.andage, icn put the onth or six appens near ition of the it should l)e lust be sup- Fracture of the Collar-Bone. This is, perhaps, one of the com- monest accidents of the kind that ran h:\\)\^cn, and one of the most easily detected. It is generally occasioned by a blow on the shoulder. IIG, 121. which falls forward, pushing the ends o( the broken bone one over the other. The main object in the treatment must therefore be, to keep the shoulder back until the bone has united, and become suf- ficiently firm to do this without artificial aid. This end is accomplished by various means, but the following plan is the most simple and successful for unprofessional adoption (sec Fig. i2i). A wedge-shaped pad of any solt material — a pair of old stockings, for instance — is made, an(i jiut in the middle of a small shawl or a large handkerchief; it is then placed well under the arm, but on the injur- ed side(i); the ends of the envelope arc brought, bac:k and Iront over the opposite shoulder, then crossed, and tied beneath the sound arm (2); another broad bandage of some kind is then passed several times round the body and injured arm (3), so as to bind the lat- ter closely to the former in such a manner that the i)ad beneath the arm- pit acts as a fulcrum, and allows tlie outer end of the broken cohar-bo#e to be pulled backward and outward during the process of binding, which, when completed, sets it fast in the right position. ^Ve have then only to envelope the whole of the fore-arm in a sling, and the apparatus is complete ; it should be worn a month at least. Sometimes the collar-bone is broken externally, near the point of at- tachment to the coracid process. In this case there is scarcely any dis- placement of the fractured ends, and little need be done beyond keep- ing the patient (|uiet, and slinging the arm. In any fracture withinside of this point, the arm falls down, and is drawn inwards, and the above should be the plan of treatment. Fractures of the Ribs. Fractures of the ribs are not of unfreciuent occurrence. They commonly result from a fall or blow, and may be complete or only i)artial, involving one or more of the bones. S]7///>/('///s. — A sharp pain is felt at the injured spot, especially in breathing and coughing; irregularity to the touch; and distinct crepita- tion. Treatment. — The chief risk involved is injury to the lungs, from the sharp ends of the bone and consequent indammation. Leeches are some- times applied to the seat of i)ain, and hot bran bags. A band of stout cotton or tlannel, from eight to ten inches wide, should be passed round the chest several times, beginning close under the armpits and going down to the end of the ribs. It should be drawn so tightly as to keep l?,0 THE FAMILY niYSICIAN. FICJ, 122. the ribs from falling in the act of respiration. If inflammation follow, the pulse must l)c (juicted by five to eight drops of tincture of viratrum viride, every one or two hours. 'J"he patient should be kept perfectly quiet, and on low diet, for a fortnight at least, assuming the position which is found most easy, which will probably be a half-sitting one sup- ported by pillows. Fracture of the Leg between the Knee and the Ankle- joints. The leg is com])osed of two bones, an inner larger (the tibia), an outer smaller bone (tlie fibula). One or both may be broken. The tibia is more fre(iuently broken about two-thirds of the way down. It is detected without much difficulty by i)assing the hand down the line of the shin, although the displacement may not be great. It is not easy to detect a fracture of the fibula, nor is it ')f great importance to do so. ^"reatinent, — Extension mu.';t be made as in the other fractures, and sufficiently so to bring the broken sur- faces together. The old-fashioned straight splint would probably be the most readily available in domestic treatment. It is shaped as siiown in Fig. 122, and should be sufficiently long to extend from a little above the knee to four inches beyond the sole of the loot. It may je (juickly made out of half-nich board, planed smooth ; the b^padth should be aWout four inches ; this must be padded throughout its whole length, except the matched end, which is to project beyond the foot, with tow, lint, or other soft material, taking care to have the pad thicker at the lower i)art, t© suit the diminution in the size of the leg. This splint must be carefully i)laccd against that side of the limb from which the foot exhibits a tendency to turn. We will suppose that a stout cotton bandage, about two and a half inches wide, and twelve feet long, has been provided. With ihis, be- ginning at the foot, and bringing it down from the instep between the notches at the bottom of the splint, envelope the limb evenly, fold over fold, up nearly to the knee, just below which a broad piece of tape should be passed, with the ends through the holes in the top of the splint, which ends are to be firmly tied at the moment when extension of '^hc limb is made by an assistant; the bandage is then to be carried on over the head of the splint, and made secure. In Fig. 123 we see tlie It m b?\pa'. I'IG. 124. Mi ACCIDENTS, INJURIES AND SURGICAL DISEASES. 131 limb, before this process is completed. When both bones arc broken, it is generally necessary to apply the angular spliiU adapted to the ankle, of which Fig. i 24 exhibits the outer and inner sides. Fracture of the Knee-Pan. Fracture of the knee-i)an sometimes happens from the more muscular exertion of kicking or throwing out the leg violently. It may b^ at once detected by the depression of die bony plate and separation of the broken fragments ; these cann(jt be ke[)t in close apposition, and the injury is made good by a ligamentous band, which connects them. To facilitate this i)rocess, the leg should be kept in a straight position, above the level ot the hip, so that the muscles of the thigh, which are attached to the upper edge of the knee-pan, may be relaxed. A long splint, bound beneath the leg from the thigh to the foot, will effect this object. Over the broken jjatclla a piece of cotton is bound, and the knee is bandaged tightly above and l)elow this, so as to bring the broken pieces as closely together as possible, and to keej) them so. The bandage will have to remain on probably for two months, as a fracture of this kind unites very slowly. 'i'he knee is generally weak after, and it is best to support it with an elastic kneecap. Fracture of the Thigh. This is a very serious accident. The bone may be broken just above the knee, in the shaft, or near the neck. In the first of these cases the nature of the injury is sufficiently obvious, "^s the broken bone can be felt beneath the skin. This also is the case with the second, in which, as in the third, there is shortening of the limb, and generally turning out of the foot. This accident may be leadily distinguished from dislocation of the hip, by the mobility of the hip- joint. Treatment. — There is always much difficulty in keeping the ends of the bone in api)osition here, in consequence of the power exerted by the muscles of the thigh, which are constantly pulling lengthways and caus- ing the ends to overlap, or, as we say, " ride " upon each other 3 this is especially the case if the fracture is oblique. It is best to use the straight splint first iu either of these cases, and put it on with a light bandaging, gradually tightening it, to accustom the limb to the pressure. The si)lint must be made in the same way as that shown in l''ig. 122, but much longer, reaching from the hip to beyond the toes. \Vhen in- flammation has subsided, and the presi^urc can be borne, the case had better be treated in this way : let the patient lie on a hard mattress, with the leg extended and uncovered ; then place the splint, previously well padded, in its place, and make it fast with rollers to the loot, ankle, and leg, taking care that the former is in the position which it is to occui 'O' ipy- that is, pointing straight upwards ; next, take a silk handkerchief, in the middle cf" which some wool has been rolled up, to make it a considerable thickness, and pass it between the le;/^, bringing one end up behind, and one before ; these ends pass throuj^n the holes at the top of the long !^ .•-^'l.k^rJ^>/^.!l£>'.'Jiu''^.:r.i'.l.kA':lkv''.!^0 :bi£iJtimA}JiSii^dA 132 THE FAMILY PHYSICIAN. splint, and tie tlicm as tightly as possible, without displacing the fracture. Then after confining the splint to the waist, with a bandage, insert a short stick between the loop of the handkerchief, and give two or three turns; this will have the effect of shortening the handkerchief, and pulling down the splint, which will carry with it the part of the limb attached to it below, {)roducinj^^ the necessary extension. Keep on at this until you find that the injured leg is as long as the sound one ; and when this is the case, lay a well padded short splint along the inside of the thigh, and bandage tightly and smoothly, from the knee to the hip. When it is FIG laiuB '^^^'Sifei^-r completed, the patient will appear as in Fig. 125. The extension must be kept up for about six weeks, at the end of which time the fracture may be sufticiently united to bear the strain of the muscles upon it. I'fachtrc of the Pelvis. — Fracture of the pelvis sometimes occurs in falls from great heights, or in being run over, or having some crushing weight thrown on the body. When it occurs there is generally serious injury to the viscera of the abdomen and pelvis, indicated by the passage of blood horn the bladder and bowels. The nature of the mischief m this case is not easily detected, and little can be done beyond enjoining perfect rest and a lowering diet, unless there are symptoms of collapse, in which cabc stimulants must be given. ConipoiDtd Fnicturcs. — The term coiiipouud is applied to a fracture in which the skin is broken or lorn, the wound of which communicates with the broken bone. This case is more serious and much more tedious than of common fractures, especially when the wound is large ; but be it ever so small, it proves great violence and injury done to the soft parts, muscles, &c. Some weeks after the injury elapse before the bone be- gins to unite, in consccjuence of the large formation of matter that gener- ally takes place, and the process of union of the bone does not begin unul this action has ceased. During this stage the patient often becomes seriously ill, and his vital powers are exhausted by the large (quantity of matter poured out around and among the injured parts. In young and healthy persons, in whom the injury to the muscles, (S:c., is not very fracture, insert a or three I pulling iched to intil you n this is ugh, and [len it is ision must e fracture ou it. occurs in crushing illy serious jic passage ischiet in enjoining f collapse, fracture in licatcs with ne tedious \; but be it |sott parts, bone l)e- ^hat gcner- not begin In becomes Quantity of /oung and lis not very ACCIDENTS, INJURIES AND SURGICAL DISEASES. 1 33 great, these stages are not very strongly marked, and the cure proceeds more rapidly. Treatment. — The wound must be healed, if possible, the edges being brought together by adhesive plaster. The splints, wliatever bone may - be affected, should be applied as in simple fracture, care being taken, however, not to press on the wound if possible, and this may be avoided by dividing the pad that lies over the wound, into two parts, leaving a space for the wound, which should be untouched ; the pad should be very thick. A better method than this, however, is to divide the splint and to connect the two parts by means of an arch of iron, so that the wound may be dressed without difficulty. This is called an interrupted splint. If the wound does not heal at once, the plaster may be removed, and a linseed-meal poultice substituted. During the stage of formation of matter (suppuration), the patient will require tonic medicines, as bark, porter, »ly:c., and small doses of opium at night, and nourishing diet, if the stomach will bear it ; but this treat- ment must not be carried too far. Strong purgatives are injurious. The case will continue to progress very slowly for some weeks ; abscesses may form ; and should matter collect under the skin so as to be felt on examination, or the skin become red and th'n, the part should be punc- tured, and great relief will be afforded by its escape. The splints should be removed as often as the matter renders the pads foul, or the wound appears to suffer from their presence ; perhaps this may be required every other day, or even oftener. When the suppura- tive stage has passed, which may occupy from one month to two, the wound will look florid and healthy ; and as soon as it begins to heal, the bone will begin to unite, but not till then. A month or five weeks will still be required before the union is complete, and two or three weeks yet longer before the patient is enabled to use the limb. The above periods refer to compound fracture of the thigh-bone. Compound fractures of other bones pass through these stages more readily. Injuries to Achilles' Tendon. This is the great tendon which passes from the muscles of the calf down to the heel, upon which it acts with the whole force of those muscles. It sometimes happens that by a sudden jerk, or violent exertion, the tendon gets torn across, or rup- tured, and great pain or lameness is the consequence. Treatment. — ^^On the first occurrence of the accident, if swelling and inflammation ensues, apply three or four leeches, and encourage the bleeding for some time with warm fomentations, or a linseed poultice. Afterwards resort to cooling lotions, such as the following : Liquor or acetate of lead and tincture of opium, of each two drachms; common vinegar, one ounce ; distilled water, fifteen ounces ; keep lint or linen rag wet with this lotion constantly applied. When the inflammation has subsided, if there be still swelling and stiffness, rub in, night and morning, this liniment : strong liquor of ammonia and tincture of opiumj 134 TIIF- FAMILY niYSICIAN. 1 1(.. m of each one drachm ; spirits of turpentine and sonn liniment, of each one ounce. If it is merely a strain of the tendon, a little rest and the above remedial measures will scjon afford a cure ; l)Ut if a [)Ositive rupture, there may be much difficulty in L^cttini,' the parts to unite. To ac- complish this end, it is best to use a slipi)er with a strap attached to the heel, which passing up and en- circling the thigh, may be drawn tight and kept so, as in l'"ig. 125. During the process of uniting, if the jjatient walk at all, it should be with a crutch ; and after the cure has been effected, a high-heeled laced boot should be worn to [)rotcct the part. Dislocations, l^y this term, we understand a displacement by violence, of one part of a joint from its natural connection to the other, lly a knowledge of the structure of the joint, we are enabled to lay down rules by which the displaced bone may be returned or reduced. The ligaments wliicli have been torn asunder re-unilc, and the joint re- gains its healthy structure. 'I'he sooner this is done the better, ami die easier will it Ijc effected ; but the attempt may be made even after the expiration of three or four weeks, if in the larger joints. After this, period, the displaced bone adheres to the part it is in contact with, and the attempt should not be made but by an experienced surgeon. After the reduction, inflammation of a mild character may follow, which the application of a few leeches will suffice to remove. The joint may be bound up lightly with a wet band, and cold water, or vinegar and water, applied. Dislocation of the Lower Jaw. Symptoms. — The mouth, is fixed o[jen, pain in front of the ear, and extending up to the temj)les. This state of jaw occurs suddenly,, while gaping, eating or talking, while the jaw is in motion, and is apt to recur. Treat uient. — Place the patient on a low seat, cover the two thumbs with a silk pocket-handkerchief, pass the thumbs into the mouth, and ])ress with force, slowly applied, on the last four lower teeth, and at the same time raise the chin, pushing the jaw backwards. Considerable pressure is required by the thumbs; two pieces of wood maybe employ- ed as a substitute for the thumbs. Disloca':ion of the End of the Collar-Bone. Either end of the collar-bone may be dislocated by a blow or a fall, indicated by a swell- ing over the joints which the bone forms either with the breast-bone or shoulder-blade, and by the suddenness of its occurrence. The treat- ment is very much like that of the fracture of the collar-bone, to which reference must be made. A pad of lint should be put on the swelling, and the arm raised high in a sling. This accident will req^uire three weeks' res^ ACCIDENTS, INJURIES AND SURGICAL DISEASES. 1 35 111:. m. Dislocation of the Shoulder. 5vw//^///j.— Flatness of the shoulder, compared with the roundness of the sound side ; inabiHty to move the arm ; the elbow placed at from two to three inches from the side ; the attempt to press it to the side occasioning', j^nin in the shoulder. If the fingers be passed up under the arm to the armpit, the head of the bone will be felt out of the socket, and may be revolved to make it per- ceptible. Treatment. — A round or Jack towel, through which the arm should be drawn ; the towel carried u[) to the arm[)it and twisted over the shoulder, •AW^X the two ends thus twisted passed over the back of the neck, and fixed into a staple by a rope, or other- wise. Wash-leather, or other soft material to ho. wound around the ^rm, just above the elbow ; a close hitch-knot of good (juarter-inch line made upon it. The patient to be placed in a chair and held firm, or to lie down on a bed, and ixed. The arm may be drawn slowly and steadily, at an angle half way between the horizontal and vertical, and the extension to be continued for ten minutes to a quarter of an hour, — during which, frequently, the surgeon or su|)erin- tendcnt should raise the arm, near the upper or dislocated end, up- wards, with his two hands, with some force ; the head will return into the socket with a sound, or slight shock. If the head of the bone be thrown forward on the chest, the extension to be carried a little backward ; if backwards, a little forward. After reduction, a sling and three weeks' to a month's rest. The reduction may also be effected by laying the patient on the ground on his back, while the operator [)laceshis left heel in the left armpit (as in Fig. iii), if the dislocation occur on the left side, and his right heel in the right armpit, if it occur on the right side, and makes a powerful extension on the affected arm by both hands. A person who has repeatedly dislocated his shoulder, may, if he have courage to bear a little pain for a few minutes, even manage himself to reduce it, if the accident should happen while he is out in the fields, and if there be a five-barred gate at hand. All he has to do is to get his arm over the top rail and then, having grasped the lowest rail he can reach, hold fast, and let the whole weight of his body hang on the other side of the gate ; and then if he make some little attempt to change the posi- tion of his body, still, however, letting its weight rest on the top of the gate, the bone will probably slip into its place. Dislocation of the Elbow Joint The elbow-joint consists of three bones — the bone of t^he arm spreading out across the joint, and I 13^ THE FAMILY PHYSICIAN. lie. 1 I'J the radius outside, the ulna inside. The most common dislocation is when both radius and ulna arc thrown backwards. Sym/>i(>nis. — The joint motionless, a little bent ; skin tiijht in lYont of the joint ; a projection behind formed by the elbow, which, with its tendon is ])ushed back. The joint can neither be bent nor straightened. Tfi'ainioit. — 'I'wo men will be sufifi- cient generally, unless the j^atient be ^1^ very muscular. Kxtension to be made /^ in a straight direction by both. 'J"he force required is not generally very great, .jhI the reduction takes [jlace commwnly with a snap. Both bones I. Tli(> Iluincius.or tipiicr Imno of tlic uiay be forced forward— when this ac- arm. 2. The Ulna. 3. 'Ilu- kad'.us :— tin so cident occurs, the elbow (oh'cra}wii)\ joint will l.)e readily observed when a shaft. 4 marks the insertion of tin- extcr- comparison is made with the oppo- nal lateral ligament, wnicli passes Innealh ... ^ '■ i.ito the orbicular litjanients, of which the ^'^^ JOint. liinder p.irt (6) is spread out at its inser- McdtlctioH Simple extension, aS tion into the Ulna. 7 n'aiks the situation ^^j-^j ^^^^ ^^i^^.,^ reduced, the joint ot the anterior ligament, scarcely seen in , , ' , ' . , ' , , -' this view; and 8 is thc posterior ligament, should be placed Straight, and bound thrown into folds by the extension of the on tO a splint. 'i'his accident will rc- joinis. There are other ligaments not • r r . • ...ppU^ Othpr shown here; nor arc the nuiscles bv which 4"'r<- irom live lO six WCCKS. Winer the complicated movements of the joint accidents of this kind OCCUr tO the are etlectcd. elbow joint, but they may all be treated on the same principle, namely, forcing the bones back to their natural position, which may be ascertained on comparison with the opposite sound limb, or the limb of another person. Dislocation of the fingers and Toes. Dislocation of the fingers and toes is of rare occurrence ; and, when it does happen, it is gener- ally between the first and second joint. They may be easily known by the projection of the dislocated bones, ■, and reduced without much difficulty, i;\ if done soon after the accident. Treatment. — Fig. 113 will show the method of reduction ; the clove-hitch, made with a piece of stout tape, may be u.^cd if there is much difficulty ; the wrist during the operation should ha\e a slight forward inclination given to it. This will relax the flexor muscles. Dislocation of the Wrisl-Joint. The hand may be forced back- FIG. 113. ACCIDENTS, INJURIES AND SURGICAL DISEASES. 1 37 wards or forwards, but this accident is very uncommon. The nature of the case will be apparent to the sli^'htest observation. Treatment. — 'J"he hand should be grasped firmly by a powerful man, and drawn straight. If the liJind slips, a bandage may be applied around it to aid the application of the extending force : but all that is refjuired is full extension, by which the hand may be drawn straight. The same observation will apply to dislocation of the fingers. Dislocation of the Hip-Joint. These dislocations are very im- portant and very numerous being not less than four in number. The liip-joint consists of the head of thigh-bone and the socket formed by the pelvis, or continuation of the haunclvbone, towards the middle of the body. These accidents generally arise from a fall from a height, or a very severe blow, and are attended with severe injury to the structure of the joint and surrounchng parts, although the consecjuences are not generally so severe as fracture of the neck of the thigh, detailed above. The head may be thrown from the socket in four directions : J""irst — upwards and backwards. Second — backwards. Third — downwards and inwards, i'ourth — upwards and inwards. The most frequent is the first — upwards and backwards. Symptoms. — Shortening of the leg to the extent of about two inches. 'I'he foot is turned in, and lies over the opposite foot ; the ball of the great toe towards the opposite instep ; the leg can not be turned out, nor the attem[)t made without pain. On examining the side of the buttock where the head is thrown, it will be felt on the bone, with the great pro- jection formed by the end of the shaft of the bone placed in front of it. If the leg is rotated, the head and the great process, or prominence (trochanter), will be felt to revolve also. The line of the thigh is alto- gether too far outwards. Treatment. — A round or jack towel should be applied, as in the case of the dislocation of the shoulder, and drawn up around the thigh as high as possible, and twisted over the hip-bone somewhat tightly, and fixed behind into a staple. Wash-leather, or a soft towel, to be wound around the thigh, above the knee, and around this the cord or line with two clove-hitches, one on each side of the thigh. The aid of six men will be required, who must draw very slowly and very cautiously. The patient should be placed nearly on the sound side, and the limb should be drawn a little across the other limb ; and after it has begun to des- cend, yet a little more across the opposite leg. When the thigh is fully extended it will generally reduce itself, and may be heard to return to the socket with a snap. Should it not do so, the superintendent should take the thigh high up towards the trunk in his hands, and raise it, and use a round towel, passed under the limb and over his neck, and raise it, t^visting it out'ivards at the same time. Dislocation Backwards. Symptoms. — The symptoms are nearly the same, except that the shortening is less, and the turning in of t^'e I3S TIIK FAMILY niYSICIAN. foot less also ; hut both the symptoms exist in a deforce. The head of the hone lies lower down, and is less ai)i)arent to the hand when press- in;^ on it. Tieatmcnt. — 'The reduction is effected by the apj)lication of nearly the same means. The limh should, however, he drawn rather more over the opj)osite limh. When fully extended, it should ho turned outwards, when the head will slip into the socket. Dislocation Downwards and Inwards. Symptoms. — The leg is a little lengthened, and is drawn forwards on the trunk; or, if placed straight downwards on the ground, the trunk will he hcnt forwards as in a stooping jjosture ; the toe points a little outwards. The line of the ihigh, when compared with its fellow, is directed too nuich inwards to- wards tlie middle of the body, and also too far backwards. The thigh should he moved in all directions slightly, t(j ascertain that it is fi.\ed in this position. Treatmod. — Apparatus apj^licd as before, patient lying on his back; extension to he maile doiinnvard wwA outward, and when brought down, after some minutes' extension, the thigh should he forced in its upper end, outwards, by the hand, or the towel being ])laced between thC thighs and drawn in the direction opposite to that of the dislocation, namely, upwards and outwards. Dislocation upwards and Inwards. This is the most formid- able of all these dislocations. Symptoms. — The leg is shortened, and, like the last dislocation, drawn forwards on the body, as though in the act of stepping to walk, lioih these last symptoms are more strongly marked than in the former. A swelling, caused l)y the head of the bone, is ap[)arcnt at the groin, and the hone is firmly fixed. Treatmetit. — The same means as before, and nearly the same direction as the last accident, except that the liml) should be drawn outwards and more /'ac/i- ^- These two last dislocations may he reduced in the sitting P' -f the patient, and in that position drawn around a bcd- yiost ith's rest is retjuired, or even more. L nation of the Knee-Pan. The knee-pan {patdJd) may be forcea off the end of the thigh-hone either outwards or inwards ; but the latter is very rare. Displacement outward is generally caused by sudden and violent action of the muscles of the thigh. Symptoms. — The appearance of the bone on the outside of the knee- joint, instead of in front, attended with pain, stiffness of the knee, and inability to walk without much pain. Treatment. — The leg must be bent forwards on trunk, and the knee straightened as much as possible ; the hone is then to be forced back by the pressure of the hand. When it is returned, the knee should he very slightly bent, and placed over a pillow. From three weeks to a W\onth will be required. ACCIDENTS, INJURIES AND SURCrCAL DISEASES. 1 39 Ruptures or Hernia. 'I'his is a comr.ion weakness. It is caused by a portion of tlie bowels or tlieir revering slipping out of their natural position in the cavity of the abdomen. If happening' afterbirth, a rup- ture shows itself as a swelHng suddeidy ni)pearing in the yroin after viol- ent exertion ; remaining distin("t while the person stands upright, disap- j)caring when he lies down, and returning again when he gets up. It also usually fdlsout when he coughs. H let alone it cc^ntinues increas- ing in size, so that instead of the l)Owels being contained, as they should be, in the belly, the greater part drop into the swelling, which mny be- come of an enormous size. The proper treatment for a rupture -is the wearing of a well-fitting truss. It should never be laid aside for a day. 'I'hc bowels should never be allowed to become costive. When through neglect of precaution the !)owcl *' comes down" and will not return, the rupture is said to be "strangulated." 'I'his is a dangerous condition, and one should be able to recogni/e it. When a person has been costive two or three days, and he becomes violently and froiiuently s-ick, at first throwing up stuff like coffee-grounds, and after some hours like slo(/.s, and very offensive ; if there be a feeling of a cord tied round the midriff, constant feeling of sickness, nuuh uneasiness and anxiety, there is great reason for supposing that this is something to do with a rupture. The incjuiry should be made, and if there is a rui)ture, and it has fallen down, immediate treatment is recpiired. The j)atient m;iy be i)Ut into a warm bath up to his neck, and ke[)t there till he feel very faint ; he may then attemjjt, according to his own usual method, to put the rupture up, by pressing it gently, if it be in the groin, or by lifting it up if in the purse, and gently s([ueezing it toward the belly, but no violence must be used, or the gut will burst. If this do not su('ceed, cold may be applied (n-er the swelling, by fil- ling a bladder with pounded ice and a handful oJ salt, or with a freezing mixture consisting of (Dauber salt and salammoniac, to whii^h some water must be added. Either of these, after being kept on some hours, will occasionally cause the return of a rupture, but they recjuire to be used with some caution, as if the skin become frosted it may mortify. If neither ice nor the materials for the freezing mixluic can be obtained, a wet rag may be put on the part, and evaporation encouraged by a con- tinued stream of air from a pair of bellows, repeatedly wetting the cloth as it dries ; by these means almost as great a degree of cold can be pro- duced as by ice. Some surgeons have of late strongly recommended attempting re duction of a rupture by reversing the position of the body ; in other words by holding the patient head downwards, or nearly so, and they state that in many instances this method has succeeded. Sprains. A sprain is a wrenching of a joint, whereby some of the ligaments— the bands which unite the bones — are torn or severely stretched. In many cases there occurs also an injury to the bonq^ ni 1: i I40 THE FAMILY PHYSICIAN. ... The severity of the injury varies extremely. A severe sprain, while containing no element of danger to the life of the patient, is neverthe- less a serious injury, which may result in the permanent impairment of the functions of the joint, Treatment. — The first item in the treatment of a sprain is perect rest of the limb. In many cases it is advisable to apply a splint in order to prevent any unconscious movement of the part. The splints are essen- tially the same as those which have been described in treating of frac- tures. A most valuable feature for reducing the swelling and pain consists in wrapping the joints with cloths saturated with water as hot as can be com- fortably endured. "hese fomentations should be continued for three or four hours. So soon as the pain and swelling have somewhat sub- sided an elastic bandage or cap should be placed around the joint. Care should be taken in avoiding any violent movements of the af- fected joint for some weeks after the injury. Some stiffness may occur, which can be overcome by having the joint moved regularly every day by an assistant. The restoration of the motions can also be furthered by the use of some stimulating liniment, such as the ammonia liniment. In some cases serious diseases of the bone follow a sprain. This is the result of the original accident and cannot be averted by treatment. Toothache. The most frequent causes of toothache are : First. — Decay of the tooth cNcending to the nerve contained in the pulp of the tooth. Second. — Inflammation of the membrane surroundfng the root of the tooth. This usually causes a swelling of the gum, and the formation of an abscess or a "gum boil." , Third. — The general condition of the body, which predisposes to neu- ralgia. Treatment. — The treatment depends upon the source of ihe p-iin. There is no one remedy which can be relied upon to cure toothache in general. If the tooth be decayed, a dentist should be consulted and his opinion sought as to the advisability of removing the tooth. In many cases it is possible for him to devitalize the pulp of the tooth, fill the cavity, and retain a useful member. Until the services of a dentist can be procured the pain must be alle- viated by the application of oil of cloves, creosote, chloroform, laudanunij or Jamaica ginger. The cavity of the tooth should be cleaned with a little cotton ; a few drops of one of the substances named is then placed upon a small wad of cotton, which is then gently inserted into the cavity of the tooth. If the toothache be caused by inflammation at the root of the tooth, it can sometimes be quieted by painting the gum with a mixture of tinc- ture of aconite and tincture of iodine in ec^ual parts. Sooner qr later^ ri ACCIDENTS, INJURIES AND SURGICAL DISEASES. I41 , while iverthe- nent of 'ect resf )rder tc- I essen- of (rac- nsists in be com- Dr three lat sub- int. »f the af- ly occur, very day urthcred liniment, lis is the ment. id in the )t of the lation of :s to neu- he pain, lache in 1 opinion le tooth, be alle- lidanunii with a placed le cavity |e tooth, of tinc- lor later. however, matter will form at the root of the tooth ; the a])scess should be opened at once. Such teeth are usually of no service, and may be extracted. Toothache which originates not in any local difficulty around the tooth, but in a constitutional condition, must be treated by internal remedies. In many cajes advantage will be derived from the internal use of quinine, two grains of which may be taken three times a day. Toothache is sometimes of malarial origin ; it may come on every second day, just like the chills and fever of ague. In such cases it must be treated by quinine. Drowning. This frequent accident every one should learn how to treat. The body should be recovered as soon as [)ossihle from the water ; the face turned downward for a moment, and the fore finger of a bystander thrust back into the mouth to depress the tongue, to favor the escape of any mucous or water that may be obstructing the throat. The practice of rolling a person over a barrel, or hanging him head downward, to permit the escape of water from the lungs, is of no use. The body should be conveyed to the nearest house, a messenger having been previously dispatched to make the arrangements involved in the following : — As soon as the body arrives it should be stripped of the clothing, rapidly dried, placed on a bed previously warmed, the head, neck, and shoulders raised a vc -y little, if any ; frictions with the dry hands used to the extremities, and heated flannels kept applied to the rest of the body^ If artificial breathing can now be carried out for some time, it may be that the natural respiration can take place. Two methods are usually employed for the purpose, the first known as " Sylvester's Ready Method." This consists, after the above suggestions have been carried out, in pulling the tongue forward, which better favors the passage of air along the base of the tongue into the trachea (windpipe), and then drawing the aruis away from the sides of the body and upward, so as to meet over the head, by means of which the ribs are raised (expansion of the chest) by the muscles (pectoral) running from them to the arms near the shoulder. A vacuum is thus created in the lungs, the air rushes in, and the blood then is purified by the ])assage of the impure gases in the bloo^ vessels to tlie air, and by the giving up by the air of a portion of oxygen to the blood. The arms are now brought down to the sides, and the elbows made to almost meet over what is called the "pit of the stomach." This produces contraction of the walls of the chest, and ex- pulsion of the impure air from the lungs. These two movements constitute an act of respiration, and should be [icrsisted in, without interruption, at the rate of about sixteen to the minute. In other words, each complete movement should occupy about four seconds, which is about the natural rate of respiration in hcallh. 1 1 Is ; 1 145 tilE FAMILY PliYSiCiAN. The second " Ready Method," as it is called, is that of Marshall Hall. Tiic person whose i>reathinL; is to he restored is ]-)laced flat on the face, gentle })ressure is tiien made on the back, the pressute removed, the body turned on its side, or a little l)eyond that. The body is then turned again on its face, gentle i)ressure again used to the back, then turned on the side. This should be done about sixteen times in a minut^'. <♦ Bot'i of these methods have the same object in view ; either may be exclusively used, or one may be alternated with liie other. Most [)hy- sicians express preference for the first described (" Ready Method of Silvester)''. IJoth of the procedures might be [)ractised in advance by the reader, because such practice might be more easily remembered than a concise rule. In speaking of the restoration of persons drowned,, it is often said that he was a good swimmer, and must have been attacked with "cramp." This is a spasmodic ( ontraction of the muscles bcNond the control of the individual, and c, 'irs alter exhaustion of the muscles iroui over- exertion. Persons suffering from debility, especially the debility pecu- liarly affecting the neivous s\slcm, should never be induced to go be- yond doptii in the water, or out ot reach of immediate assistance. There IS no warning in adwance ot the soi/uie, and the ])cr3on sinks at once. Many lives are hjst each season, in shallow as well as in deep water, from these seizures, which could have been avoided had the bather, perhaps just recovering from an attack of sickness, or even ot indisposition, not neglected the precautions stated. Recovery from drowning can scarcely be ex[)ccted to take place after an immersion of five or six minutes, alih(jugh there are well authenticated cases where re-toration has taken place alter an immersion of as much as twenty minutes. Tlie efforts our it to be made, niul persisted in, for at least a couple of hours. As soon as returning \iiality permits, a few drops of brandy, in a hltle water, may begivgn ; and as the stiength of the i^erson is usually conijilelely exhausted, from nuiscular effoits of the most violent and continued character, to save himself hom drownini- some i;eef tea, or other easily digested nourishment, should be given. Tiie accident of di owning is to lre(iuent tiiat we go still further into the treatment of it, and co[n' into our [jages the detailed rul'^s ])ubli^hed by the Life Saving Society, of New Vor^. At the risk o; repetition, we show their method. T/nee steps are to be taken : I. Remove all obstructions to breathing. Instantly loosen or cut apart all neck and waist bands ; turn the ])atient on his face, with his head down hill ; stand astride the hips with your i;ice toward his head, and locking your lingers together under his belly, raise the body as high as you can without lifting the forehead off the ground, and give the body a smart jerk to remove mucus from the throat, and water from the wind- w, lISi Si \c. so or tac e)-c usi ACCIDENTS, INJURIES AND SURGICAL DISEASES. I43 pipe ; hold the body suspended loiii; enough to count one, two, three, four, five, repeating the jerk more gently two or three limes. 2. Place the patient on the ground, face downward, and maintaining all the while your position astride the body, gras]) the i)oints of the shoulders by the <:lothing, or, if the body is naked, thrust your fmgers into the armpits, clasping; your thumbs over the points of the shoulders, and raise tiie chest as high, as you can, without lilting the head (piile off the ground, and hold it long enough to slowly count one. two, three. Re- j)lace iiim on the ground, and his forehead on his tlexed arm, the neck straightened out, and the mouth and nose free. Place your elbows against your knees, and your hands upon the sides of his chest, over the lower ribs, and press downward and inward with increasing force, long enough to slowly coimt one, two. 'Ihcn suddenly let go, grasp the shoulders as before, and raise the chest ; and press upon the ribs, etc. These alternate movements should be repeated ten or fifteen times a minute lor an hour at least, unless breathing is restored sooner. Use the same regularity as in natural breathing. 3. After breathing has commenced, restore the an'mal heat. ^VraI) him in warm blankets, apply bottles of hot water, hot bricks, oranythinL; to restore heat. Warm the head nearly as fast as the body, lest convul sions come on. Rubbing the body with warm cloths or the hand, and slap- l)ing the fleshy parts, may assist to restore warmth, and the I.Mcathing also. If the patient can surely swallow, give hot coffee, tea, milk, or a little hot sling. dive spirits sparingly, lest they produce de[)ression. i*lace the patient in a warm bed, and give him i)lenty of Iresh air ; keep him (juiet. Things in the Eye. A great deal of pain is often suffered from various sul)stances getting in the eye The best way to remove them is by holding a knitting needle over the upper lid, close to and just under the edge of the orbit, then, holding it firm- ly, seize the lashes of that lid by the lingers of the disengaged hand, and gently turn the lid upward and bat k- ward o\er the needle, or lAibstitiUe used. Movement of the eyeball by the sufferer, in a strong light, usually re- veals lhe|)resence ol the intruding body, so that by means of a corner of a silk "^^'"'"^^''(f' N^ or cambric handkerchief, it can be de- ''/MiMis i • lached and ren\OVed. Ki-mnvini; an C)l.j.-ct from tlie I'.y,-. Should the foreign !)ody be imljcdded in the membrane covering tlie cyehall or the eyelid, a steady hand and a sharp-pointed instrument will usually lilt it out. in; 144 THE FAMILY PHYSICIAN. ' 31- « The foreign body often cannot be seen, but the person assures us he feels it. Often he docs not really feel the presence of the body, as much as the roughness left by it. In such a case, or even if the body has been seen and removed, a soothing application to the injury is as useful as the same thing applied to a wound of the hand. Take a s])oon or cup, heat it, and pour in a few drops of laudanum. It will soon become dense and jelly-like. A few drops of water added will dissolve this gummy material, and the liquid thus formed may be applied by the fin- gers to the "inside of the eye," as they say. 'J'he laudanum is opium dissolved in alcohol. The alcohol is somewhat irritating, but is easily evaporated by the gentle heat, leaving an extract of opium, which is dis- solved by the water afterwards added. After an injury of this kind to the eye, or any other which causes pain and inflammation, this precious organ should be bandaged, and exclud- ed from the light. Things in the Ear. Insects sometimes get into the ear, and cause much inconvenience, even if they do not sting and produce further mis- chief. The best mode of proceeding, in such case, is to fill the car with sweet oil, which will kill the animal by stopping up its breathing pores, and generally floats it out. But if it be not thus dislodged, it must be washed out with a syringe and warm water. When peas, beans, pebbles, or such like are found in the ears of chil- dren, attempts should never be made to get them out with a knitting- needle, or a stick. The rounded end of a hair-pin may sometimes be used. But the safest is to employ a syringe with a narrow nozzle, which will throw a good stream of water behind the object, and thus force it out. The eat^vig is a small winged insect, which has its name from the frequency with which it has been the cause of trouble by entering the ear. Pouring in oil will soon destroy it. In cases where this means is not at hand, as in hunting, blowing tobacco smoke in the ear will kill or stupify it and similar intruders. Things in the Nose. Cliildren sometimes amuse themselves with poking things with which they are at play into their noses. If peas, beans, or any other seed or substance be thrust in, which swell as they moisten, no time should be lost in getting them out, otherwise as they enlarge, they become more lirmly fixed, and more difificultto be removed, are attended with great pain and suffering, and may even cause danger- ous consequences. Hard substances, as shells, which remain un- changed in bulk by moisture, are of less consequence, and may remain some days without causing much inconvenience, and often drop out of themselves. If the pea or shell be in the nostril, the child should be made to draw bis breath in deeply, and then stopping the other nostril with the finger, is he nuch yr has .iscful on or :come ; this he fin- opiuni , easily is dis- cs pain cxclud- d cause iier mis- car wilh ,g pores, must be s of chil- knitting- ilimes be Ic, which Is force it ACCIDENTS, INJURIES AND SURGICAL DISEASES. I45 and closing the mouth firmly, to snort forcibly throui;h that side of the nose in which the substance is lodged. If this be done soon after the accident, two or three efforts usually shoot the unwelcome lodger out. But if this does not succeed, the nose must be lightly ni[)ped with the finger and thumb above the pea or shell, so as to prevent it getting further in, and then the eyed end of a bodkin or probe, having been a little bent, must be gently insinuated between the l)ottom of the nose and the sub- stance, and wlien introduced sufficiently far, must be gently used as a hook, to bring it down. iv,- '' )■. Ifrom the kning the means is till kill or elves with , If peas, l\\ as they [e as they 1 removed, Ise danger- ^main un- lay remain [lop out of Ic to draw Ithe finger, liHMiH CHAPTER IX. DISEASES OF THE URINARY AND GENITAL ORGANS. Acute Inflammation of the Kidneys— Diabetes— Gravel— Stone in the Bladder— Inconti- nency of Urine— Suppression of Urine — Inflammation of the Bladder — The Generative Organs, Male and Female — The Perineum — Bloody Urine— Cloudy, Thick, or Dark- colored Urine— Gonorrhoea — Inflanmiation of the Testicle— Phymosis—Chordee— Bubo —Syphilis or Pox— Chancre — Gleet — Impotence — Nocturnal Emissions. ! The Urinary Bladder, showing its fibres. muscular Section of the Kidney. 8, I^ft Ureter. 9, Left por- tion of Seminal Vesicles. II, II, L.Ueral Lobes of the Pro- tateCjland. 14, Urethra, tied with a cord. Acute Inflammation of the Kidneys. The existence of this disease may be known by a sense of heat and sharp pains about the loins, and a dull, benumbed feeling down the thigh. Treatment. — Get the skin and bowels to act as soon as possible. For this purpose give the patient a hot bath, and after drying, wrap him in hot blankets and give him the following powder : Jalap, - - - - 5 grains. Cream of Tartar, • - i teaspooniul. Repeat this mari>ih^«and evening. 146 DISEASES OF THE URINARY AND C.ENITAL ORGANS. I47 -Tnconti- ineraiive 3r Dark- e— Bu\)0 (Iney. :e of this Ibout the Iblc. For Ip him in In order to promote the excretion of the urea and other poisonous materials, the patient should be permitted the free use of water, lemonade and" other bland liquids for which he may express a desire. It is quite im])ortant that the diet be judiciously selected during the disease, especially since the stomach is apt to be irritable. By employ- ing chielly milk and eggs we can, to a certain extent at 1st, diminish the work required by the kidneys. In addition to these measures, the celebrated Dr. Grainger Stewart recommends early in the disease the lollowing : — Infusion of Digitates, - - i^ ounces. Spirits of Nitrous Ether, - - 6 drachms. Simple Syrup, - - " /^ ounce. Water to - - - - 6 ounces. Take a tablcspoonful three times daily. Later on in the disease he gives : — Tinct. of the Perchloride of iron, Spirits of Nitrous Ether, Infusion of (Hiassia to - 2 drachms. 4 drachms. 6 ounces. Take a tablespoonful three times daily. Diabetes, or an immoderate flow of urine, may be sugary diabetes, or simple diabetes. Cause. — This disease is caused by injuries to the head ; the abuse of alcoholic liquors ; exposure to cold and dampness ; sudden checking of the perspiration ; emotion ; fevers ; diseases of the bram and spine ; and in the sugary form, the inordinate use of food containing sugar. Symptoms. — The simple form, or diabetes insipidus, generally comes on suddenly, and the patient finds himself constantly passing his water, and on each occasion a large quantity, amounting to many ciuarts each day. The thirst is intense, and the patient drinks immoderately, both day and night, being compelled to rise frecjuenlly to urinate, and also to (quench his thirst. He becomes weak and thin, with a harsh, dry skin. The sugary form, or diabetes niellitus, usually comes on more slowly, and is attended with general languor, uneasiness, emaciation ; gradually the desire to i)ass the urine becomes very frequent, and the amount be- comes alarming, accompanied with great thirst, and often with a vora- cious appetite The symptoms are similar to the other form, the general powers fail, hectic sets in, dropsy of the limbs, diarrhcea, the lungs be- come involved, and death closes the scene. Treatment — The treatment of this affection is yet, to a great degree, a matter of uncertainty. It is believed that the absolute prohibition of sugar in the diet, or of articles prone to form sugar, will aid greatly in checking this disease. Hence, the diet must be composed of meats eggs, butter, bran-bred, cabbage, onions, celery, lettuce, spinach ; and 148 THE FAMILY I'lIVSICIAN. *ii these must 1)C varied 1)y turns, lest distaste occur, and thus an additional cause of del)ility be induced. 'I'he forbidden fruits would l)e, all fruits, wheat bread, potatoes, beets, milk, liver, sweet breads, etc. Li([uors must only be allowed in case of great debility, and then only in small quantities, preferring whiskey, or sherry or claret wine. A great variety of medicines have been proposed, but few seem es- pecially useful. Cod-liver oil, both by the mouth and inunction, may l)revent the rapid progress of the debility. TcrhaiJS the best results ob- tained have followed the " skhn-milk treatment." The i)atient is restricted to the milk carefully skimmed for a month at least, and then allowed in addition two to four pints of curd made by the use of rennets, gradually. As im[)rovenient occurs, lean meat, and green vegetables aie given ; then eggs, fish, fowl, etc. There is always a loss of weight for the first few weeks after which improvement com- mences. Gravel. A disease depending on the formation of stony matter in the kidney. Ticatntoit. — The general treatment should consist in a hot bath and warm fomentations ; a dose of castor oil should be administered, and when the bowels have acted, if there be much [)ain, the following may be given : Solution of acetate of morphine, one drachm ; spirit of hydro- clTloric ether, two drachms; syiup of roses, half an ounce ; camphor Uiixture, four ounces. One-fovjih part to be taken at bed-time. Lin- seed tea or barley water should be drunk freely. 'J he following may be also used with good results : Infusion of buchu, seven ounces ; tincture of musk seeds, one ounce;, sal volatile, two drachms. Mix ; dose, two tablespoonsful once or twice a day. Or this : Essential oil of spruce, one scruple ; spirit oi nitric ether, one ounce ; mix; dose, a teaspoonful two or three times a day, in a teasi)oonrul of the decoction of marsh- mallow root. Or the following may be used : Rectified oil of turpentine, sweet spirit of nitre, oil of juniper, balsam of sulphur, of each half an ounce ; mix ; dose, fifteen or sixteen drops in a wineglassful ot water three times a day. Or this: Alicant soap, eight ounces ; fresh lime, finely powdered, one ounce ; oil of tartar, one drachm ; mix with a suf- ficient (piantity of water for a mass, and divide into five grain pills, from three to four of which should be taken daily. The following remedy has been highly recommended for this com[)laint : Parsley lUakcstonc (of the herbalist), ten cents worth, stewed down in a pint of water to half a pint ; when cool, add a wineglassful of gin. Take a wineglassful of the mixture every morning, until relief is afforded. Stone, or calculus in the bladder, would be indicated by sudden stop- page of the stream in urinating ; pain in the bladder, more or less acute ; init could only be positively known by the use of a sound passed into the bladder and striking the foreign body. A prominent symptom, es- n ol th cl cxP h([ vel DISEASES OF THE URINARY AND CENITAL OUCANS. 1 49 onal uits, luors .mall m es- may s ob- Aionth \dc by t, and always t com- xtter in lib and ■cd, and >; may be f by'dro- pampbor e. Lin- may be tincture ose, two f spruce, spoonful t marsb- rpenline, I halt" an ot ^vatcr esb bmc, ith a suf- IpiUs, from mcdy bas stone (of to bait a ful of tbe Idden stop- [less acute ; Lssed into tptom, es- pecially in children, is itchinij; or pain at the end of the [)cnis, causini; the child to be constantly pulHng at or rubbini^ the origan. This some- times causes an elongation of the foreskin, and great annoyance by the collection of the secretions in this i)art. Treatment. — The removal of the stone by an operation, either culling or crushing, is ahrost all that can be done. A vegetable diet should be preferred, and the bowels and kidneys kept in prompt action. Inc#ntinency of Urine. This is rather a troublesome than a dan- gerous complaint ; young children and aged persons arc most liable thereto. Causes. — Most generally from a relaxation of the governing si)hincter muscle of the bladder, from weakness or paralytic affeclion, but some- times it is caused by some irritating substance in the bladder; in child- ren, some say, from sleeping on their backs. Symptoiiis. — The water comes away in drops, sometimes involuntarily. lyeat/iieiit. — Dash cold water on the loins and genitals ; a blister on the si)ine is useful, and the following are useful : Stimulant tonic drops : Tmcture of steel, six drachms ; tincture of rantharidcs, two drachms ; tincture of henbane, one drachm ; mix, take thirty drops, three times a day, in water. Or the following may be used with good effect : Suljjhate of zinc, one drachm ; powdered rhubarb; one drachm ; Venice turpentine, two drachms ; mix, divide into sixty pills, take one three times a day, and therewith a wineglassful of the decoction of leaves of bear's whortle, or bilberry. Suppression of Urine. If there is a frequent desire of making water, attended with much difficulty of voiding it, it is called strangury. If none is made, suppression of urine. Causes. — Inflammation of the uretlira or passage, or sores, or severe inilammation about those parts ; a lodgment o! hard matter in the last gut or rectum, spasm at the neck of the bladder, exposure to cold, taking to excess cantharides, or blistering back, excess in drinking, stone in the kidneys or bladder, and enlargement of prostate glands. Symptoms. -A. constant desire, or feeling of necessity to make water and cannot, or if jxirted with, much pain and difficulty in passing it ; much enlargement (;f the bladder. If stone in tiie kitlney be the cause, often nausea, vomiting and acute pain in the loins ; if from stone in the bladder, the stream of water will be divided into two, or suddenly checked. Treatment. — If much indammation and irritation exist, all straining to expel the urine should be avoided, and it let off by a cathetar every six hours, or, as it is commonly called, drawn. The following will be found very useful remedies. Anodyne diuretic draught: Mucilage of gum acacia, six ounces ; olive oil, one and a lialf ounces 3 mix well in a marble mortar, then add six 150 TtlE FAMILY iMiYStClAN. drarhms of .spirits of sweet iiilrc; laudanum, one and a half drachms ; Icnncl water, three ounces ; mix, and take three tablesi)oonslul every three hours ; or this : Demulcent diuretic draught : Acetate of potash, two drachms ; laud- anum, one and a half drachms ; syrup of marsh mallows, one and a half ounces ; fennel water, eight ounces ; mix, take three tahlespwonsful every three h )urs. The bowels must in all cases be kept free by using the fallowing often : I'^mollicnt clyster : Balsam copivi, two drachms ; yolk of an egg; rub this and the balsam together ; then add castor oil, half ounce ; laudan- um, one drachm ; compound decoction of marsh mallows (that is well boiled), eleven ounces ; mix, inject up the rectum ; this foments and soothes the parts. Inflammation of the Bladder. Causes. — It is seldom a primary disease, but is in consecjucncc of inflammation in the neighboring j)arls; it is, however, sometimes caused by retention ot the urine, and cinseed tea and new milk, each half a pint; laudanum, forty drops ; m'x and inject ; this foments the internal parts. The bowels may be ke[)t o[)en by this mild aperient draught : Tartrate of potash, three drachms ; tincture of senna, one drachm ; manna, half an ounce ; warm water, one and a half ounces ; mix and take at once. Generative Organs. — In the human race, as throughout the greater part of the animal kingdom, generation is accomplisb.ed by fecundation, or the effect of the vivifying fluid provided by one class of organs upon the germ contained in the seed or ovum formed by another class, in the opposite sex. This germ, when fecundated, is termed the embryo. The process consists of impregnation in the male — conception in the female. The organs of generation in the male are i. The testes and their envelopes, namely, the scrotum, or cutaneous envelope ; the dartos, which corrugates or ridges the scrotum ; and the fibrous or vaginal tunics ; we must also here include the epidermas, above the testes ; the vas deferens, or excretory duct, and the spermatic chord. 2. Vesiculae .seminales, forming a canal situated beneath the bladder. 3. The pro- state gland surrounding the neck of the bladder and the commence- ment of the urethra. 4. Cowper's glands, a pair situated below the prostate. 5. The ejaculatory ducts. 6. The penis, which consists of the corpus cavernosum, the urethra, the corpus spongiosum, which ter- pai it. col anj Io\ DISEASES OF THE URINARY AND GENITAL ORGANS. 151 ms ; ivcry laud- ilialf mslul ^wing ; rub udan- 5 well s and rimary pails ; i-(jnsc- laclder. sire to ot it ; ; in all luin ar- ry bad, a pint ; 1 parts. Tartrate na, half once. I greater nciation, IS i'pt>n in the vo. The Icmale. nd their dartos, vaginal tes • the Vesicular The pro- mmence- clow the ansists ot" hich ter- minates in the glans [)cnis ; then there are the vessels, nerves, and a cutaneous investment, which l)y its prolongation forms ihc prepuce. 'Ihe female organs are : i. The vulva or pudendum, the external parts, comprehending the labia .pudcndi (lips), clitoris, situated at the middle and superior part of the pudendum ; the nymplne or al;e minorus ; the urethra, which terminates in the meatus urinarius, opening into the vagina, which is occupied by the hymen, a semilunar fold, or the carun- cute myrtiformis, its lacerated remains after the first act of copulation. 2. 'I'he uterus, whose appendages are — the ligamcnta lata (the broad ligaments), and the round ligaments, commencing innnediately before and below the Fallopian tubes, which extend to the ovaria. Thk Perin.kum — The space between the anus and the external parts of the generative organs. The operation of cutting for stone in males is usually [)erformed here, and here it is that serious injury some- times occurs, when persons fall with their legs astride of any ol)ject, or get a bruise in that position, as on horseback ; bloody urine, or com- plete stoppage may be the consefpicncc, arising from intlammation of the bladder or urethra. Rest and warm fomentations, with leeches, and the use of the catheter, if necessary, must in this case be resorted to ; with low diet, a[)erienls, and cooling medicines, to kce[) down any ten- dency to fever there may be. We abstain from giving cuts of these parts and organs for sufficient- ly obvious reasons ; in a book intended for family use they would be al- touether objectionable. With regard to the diseases which more im- mediately affect them, a few simple remarks will be made under their several heads ; but we would here impress upon our readers the neces- sity of at once seeking medical advice for all affections of the genital or- gans. It is in the treatment of this peculiar class of diseases that ad- vertising empirics reap their richest harvest, entailing the greatest [iresent sufferings, and most fearful after-consequences upon their too credulous dupes. Bleeding from the Bladder — Bloody Urine. Causes.— Y:i\\s, blows, bruises, or some violent exertion, such as jumping or the like ; sometimes from small stones in the kidneys, ureter, or bladder, which wound those parti Symptojiis. — The blood parted with is somewhat coagulated, and de- posits a dark brown sediment resembling coffee grounds. When the blood is from the kidney or ureter it is commonly attended by acute pain, and sense of weight in the back, and some difficulty in parting with it. When the blood is from the bladder immediately, it is upually ac- companied by 4 sense of heat, and pain at the lower part of the body, and the blood is not so much coagulated. Treatment. — Empty the bowels with cooling purges, and take the fol- lowing astringent tonic mixture : — m 152 THE FAMILY I'lIYSlCIAN. 'I'liroc (Irnclims. Six omiccs. Tincture of slccl, Infusion of rejscs, Mix, take two tablcspoonsfu! every three hours ; and ])hysirians f^encr- ally recommend that the drink should hC thick barley water, solution of gum arabic, or decoction of mallows sweetened with honey. Mild ai)erient draii;j;lu : — Tartrate of I'otash, Tincture of senna, Manna, Warm water, - - - Mix, and take at (mk e. Clouded, Thick or Dark-Colored Urine, Take the following antacid diuretic mixture : — Three drachms. One drachm. Half ounce, i}^ ounces. Liquor potash, Tincture of cubcbs, - Infusion of buchu leaves, 'I'wo drachms. Two ounces. Thirteen ounces. Mix, take two tablespoonsful four times a day. The following will usually eTfect a cure : — Two drachms, l-'our drachms. Eight ounces. day ; or take half a tea- Dilute nitric acid, Syrup of lemon. Water, . . - Mix, take one tablcspoonful three times spoonful of citric acid in water four times a day. Gonorrhoea or Clap. Treatment. — In the mild form of this dis- ease, and in the first stage when the discharge is fully developed, and the inflammation confined to the first inch and a half of the urethra, the first thing to be done is to open the bowels briskly. This may be effectually accomplished by administering the following powder : Powdered Jalap, - - - - 20 grains. Calomel - - - - - 4 grains. Mix. To be given in something thick at bcd-timo. Animal food, all stimulating drinks, such as ale, spirits, and wine should be carefully abstained from. Great cleanliness should be oljserved, the penis should be bathed several times a day in hot water, allowing it to soak for a few minutes each time, and taking care to wash off all discharge which might be collected between the foreskin and glans of the penis. The patient should rest as much as possible, and he should wear a suspensory band- age to keep the penis out of the way of all friction. His diet should consist of light farinaceous food, such as arrow-root, sago, or bread pud- dings ; and for his ordinary drink, barley water or toast and water. Broths of an unstimulating character', such as mutton and chicken might and vent infla nios sweJ DISEASES OF THE DklNAkV AND (IKNITAL OIUIANS. 1 53 cr- of a tca- his dis- id, and .ra, ibc ay be l\ food, larefuUy should )r a few |h might patient Yy band- should |:ad pud- water. he both allowed occasionally, lie should then take the following [)ow- der three limes a day : Cubebs Powder, - - - - i draclnn. I'owdercd Ouni Arabic, - - - i scruple. Carbonate of Soda, - - - - 10 grains. Make a mixture, 'i'o be taken in a little milk or water This treatnunt should bo continued for a lew days, after which the doses of cubcijs nn'ght 1)0 increasctl to two drachms three times a day. Should the dis- charge still continue after persevering in this plan for eight or ten days, and when the active stage of the inllammation has subsided, the follow- ing mixture may be administered with advantage : JJalsam Copiaba ... - j drachm. Sweet S[)irit of Nitre, - - - 4 drachms. Tincture of French Flies, - - -2 ilrachms. Water, ilra< hms. Mix, shake up, and take one teaspoonful three or four times a dr.y, in a wineglassful of water. Fater on in the disease the following injection should be used : Sulphate of zinc, Subacetate of lead (of each), - • 16 grains. Water, - 4 ounces. Inject one ounce once or twice daily. If this injection causes i)ain, dilute it with an equal quantity of water. Dr. Sfurgts. One of tlie most painful and sometimes most troublesome conse- (]uences of gonorrhea is InHanunation of the Testicle. 'Fhis affection, usually termed " swelled testicle," may occur at any period ot the dis- ease ; and although its occurrence may be favored by im|)roper treat- ment or mode of living, is in most cases independent of such causes. It arises from extension of the inllammation from the tuethra down the spermatic canals to one or both testicles, but usually attacks only one at a time. It is best to be aNoiLJed by careful attention to regular living and quiet during the inflammatory stage of the gonorrhea. It com- mences sometimes with pain in the lestii:le itself, and sometimes the ])ain is felt first in tiic groin, in the situation of the s[)ermatic cord. If its approach is thus i)erceived, the a[)[)lication of numerous leeches in the groin, or of cupping to the loins, with rest in the recumbent posture, and suspension of the scrotum in a proper bandage, will frccpicntly pre- vent the extension of the inllammation to the testicle itself. Should the inllamniation, however, have reached that organ or commenced in it, the most immediate relief will be obtained by carefully surroundmg the swelled testicle with narrow strips of adhesive plaster, together with per- 154 THE FAMILY PHYSICIAN. r feet rest, the testicle being further supported in a bandage ; and should the pain extend to the groin, the api)lication of leeches in that situation will usually put a stcJp to the disease in a few days. As many, however, will be unable to apply the strapjiing in a proper manner, and it is only applicable in the early stage of the affection, it may be as well to say that usually the inflammation will subside spontaneously in a few days, if the patient will keep quietly lying on his back with the testicles sup- ported in a proper bandage, and fomented either with hot water, or with cold water, as his feelings may dictate. The bowels should be kept open by saline purgatives, such as Epsom salts, etc., and the diet should be low. If there is much pain in the groin, flank and back, leeches should be applied in the former situation, or cujjping in the latter, and a full dose of Dover's powder should be taken at bed-time. In extremely painful cases, great relief will be experienced by the application of a tobacco poultice to the scrotum. This may be made by mixing equal parts of tobacco and meal together, and moistened with hot water. Mercury is never recjuisite in this affection, and l';ec!ies should never be applied to the scrotum itself The swelling of the testicle in most cases leaves hard swelling on the back of the gland, which is gradually removed in process of time; but during its existence, care should be taken to keep the testicles well supported in a suspensory bandage, as relapses under neglect of this precaution are not unfrequent. In I'hymosis, the glans of the penis frequently become excoriated from the irritation of the matter from the urethra, and warty excrescences grow between the glans and the foreskin. In order to prevent such effects, great cleanhness should be observed, the foreskin should be drawn back as far as possible and the matter washed off, and warm water should be thrown under the foreskin several times a day by means of a syringe. If excoriation or warts exist, black wash will be of the greatest service — it should be used in a similar manner to the warm water. Black wash is made by mixing thirty grains of calomel with two ounces of lime water — to be well shaken when used. The bowels should be kept gently open by means of the common black draught. Treatment of Chordee. — We have observed before that chordee con- sists in a painful erection of the penis, produced by the non-extension of the spongy cellular body surrounding the urethra, while all the other parts of the penis are distended with blood. This want of harmony be- tween the parts occasions the penis to be bent downward, and also the pain which is experienced by the patient during an erection. In order to obviate this the penis should be rubbed with strong solutions of opium, such as the tincture; or pledgets of linen, wet with the tincture of opium, should be constantly applied, taking care to exchange them as often as they become warm ; or it may be rubbed with the following application, which is found of great service in this affection : Extract of Belladonna, .... 2 drachms. Camphox; 10 grains. DISEASES OF THE URINARY AND GENITAL ORGANS. 1 55 be con- ision of [e oihcr jny bc- llso the In order ] opium, I opium, j)ftcn as lication, Rub up the camphor into a fine powder, having previously dropped on it a few drops of spirits of wine, then add the belladonna ; about the size of a pea of this, rubljcd along under the surface of the penis, and upon the fnTinum and bridle, quickly brings down and reHeves pain. All la'^civious ideas should be dismissed from rlie mind. The bowels should be kept open by a mild aperient. As the erection generally comes on more frequently when the patient becomes hot in bed, the best means of teni^iorarily relieving it will l)e to bend the penis downward with the hand, and to apply cold ; hut the most certain means of preventing it will be to administer at bed-time the following draught : Tincture of 0[)ium, - - - - 20 drops Camphor Mixture, - - - - i}4 ounces. Mix. This draught to be taken at bed-time, and to be repeated in three or four hours, if not asleep or if in pain. In the treatment of sympathetic ]>uboes accompanying gonorrhea, lit- tle will be required to be done, as they depend on the amount of inflam- mation in the urethra, and will increase and diminish in size according as the original disease becomes worse or better ; however, as they some- times enlarge very much and become very painful, it may be found necessary to apply leeches once or twice a week. The patient should rest as much as possible, and pledgets of linen wetted in Goulard water should be constantly applied. The boweK hould be kept freely open. If they should not yield to this treatment, but should proceed to sup- puration, poultices should be constantly applied until matter is formed, when it may be evacuated by the lancet. In cases of retention of urine following gonorrhea the patient should be placed in a warm bath, and a large dose of laudanum administered. If this treatment does not succeed in relieving the bladder, the catheter should be introduced. Syphilis, or Fix, is usually accompanied by three distinct charac- ters of sores or uicers ; first, the common primary venereal sore ; second- ly, the phagedenic or sloughing sore ; and thirdly, the true syphilitic or Hunterian chancre. The common venereal sore usually appears in three or four days after connectioii ; the patient feels an itching about the tip of the penis, finds either a postule or an ulcer, situated either upon the prepuce externally or internally, at its junction with the glans or on the glans itself, or at the orifice of the urethra at its union with the bridle or Ira^num. The form of this ulcer is generally round or circular, and is hollowed out, presenting a dirt '^rown, hard, lardaceous surface, which secretes a puriform matter. When this ulcer is situated on the prepuce, it be- comes raised, particularly at its edges ; when in the fossa, or at the root of the glans of the penis, it is ragged ; and when on the glans, it is exca- vated. Its progress is first destructive, and then healing ; and, if not in- 156 THE FAMILY PIIVSICIAN. tcrfered with in favorable cases, usually runs its course in about twenty days — the destructive or ulcerative stage lasting about ten days, and the granulating or healing stage lasting the remaining ten. This sore is un- ac(ionipanicd by any thickening or hardened base in the first stage, unless interfered with by mal-treatment, dissipation, or the abuse of caustic. This sore is fre([uently productive of swelling and inflammation in the groin, and is followed by warts and growths of an unhealthy character situated between the buttocks. Treatment. — In the first stage — that is, before the crust falls off, C)r where the ulcer is very small — the sore should be touched with lunar caustic ; this frecjucntly stops the ulcerative stage, and causes it to take on a new action by which it heals ; the same a^jplication, but weaker, will be necessary if the sore becomes indolent. During the ulcerative stage, or that stage in which the ulcer increases instead of diminishes, great attention must be paid to cleanliness \ the sore should l)e washed three or four times a day with warm water ; a piece of lint or fine linen, covered with spermaceti ointment, or wetted with black wash, should be applied to it after washing. 'J'he bowels should be kept open, and '^Wii grains of blue pill, or five grains of Plummer s pill, administered night and morning, taking care not to produce salivation. ^Vhen the sore as- sumes an indolent character, great benefit will be derived from the apj^li- cation of the following wash : I/Unar caustic, Distilled water, 5 grains, ounces. 1):.' Mix. A piece of lint or linen, wetted in this lotion, to be a[)plied to the sore three or four times a day. l)lack wash is the best a[){)lication for those warts and growths which spring up about the anus and buttocks. The swelling in the groin, aris- ing from the connnon venereal sore, seldom recpuresany treatment ; but if it should prove troublesome and painful, leeches may be api)lied, followed by fomentations and poultices. 'I'he patient should rest as much as possible, and make use ot a plain, unstinuilating diet. In the treatment of phagedenic or sloughing ulcer, no specific rules can be laid down, the sores at one time rc(|iuiing a stinuilaling and at another time a soothing method of treatment. This sore usually com- mences from an excoriation, or a jjustule, as in the c;i.se of common vene- real sore, or it may follow that form of the disease. It is known by that process of extension by which its edges appear to melt away; "the action is chiefly confined to the margin, which the destruc- tive process having undermined, overlaps with an irregular and raggeil edge." In this form of ulcer, the reparatory action commences as soon as the destructive is exhausted, so that the two processes advance together at opposite edges, the sore ulcerating at one part and healing at another at the same time. In the commencement, the sore may be DISEASES OF THE URINARY AND GENITAL ORGANS 1 57 m •enly J the 3 un- nlcss ustic. n the racter Dff, or lunar take caker, ;rativc lishcs, rashctl linen, •uld be nd five 1 night jore as- e appli- 1 to the which n, aris- nt ; l)Ul pplied, rest as ic rules i and at ly coni- n\ vene- known to melt destruc- 1 ragged as soon advance healing may be touched with nitric acid, or diluted nitric acid, upon two or three occa- sions, and if found not to agree, the stimulating treatment should be laid aside, and the soothing substituted. It may now be washed with warm water, and various applications tried, as it is impassible to say what form of wash will answer best. Those in most repute are the black wash, yellow wash (yellow wash is made by addmg six grains of corrosive sub- limate to four ounces of lime water), diluted nitric acid, Peruvian balsam, and solutions of the nitrate of silver. For the treatment of the true syphilitic or Hunterian chancre, mercury is the sheet anchor, and must be employed either internally or externally, or, where circumstances require it, by both means. This sore, unlike the preceding, seldom appears before a week or ten days, and is some- times not detected for four or five weeks after connection. It appears in the form of a red, raw, superficial ulceration, placed on a circum- scribed elevated, hardened base. This base is firm, incompressible, and inelastic, and is as hard as cartilage ; it is destitute of pain and very slow in its progress. This form of the disease is generally accompanied by true bubo — ^that is inflammation of one or two glands in th.e groin, dis- tinct and circumscribed in their outline, and totally dissimilar to those swellings in the groin arising from gonnorhea or the common venereal sore. As soon as the sore is detected, the patient should commence taking five grains of blue pill, and a quarter of a grain of opium, made into a pill, night and morning ; and he may, at the same time, in order to bring the constitution as soon as possible under the influence of mercury, rub in, twice a day, along the inside of the thigh, about the size of a nut, an ointment composed of blu or mercurial ointment and camphor. The following is the formula : Rub down twenty grains of camphor on a slate with a spatula, having previously saturated it with spirits of wine, and then mix it uj) with mercurial ointment. This treatment should be con- tinued only until the mouth and gums become slightly affected, when it should be left off lor a short time. The patient should be kept under the influence of the medicine for three or lour weeks, and then the de- coction of sarsaparilla and the hydriodate of potash administered. Five grains of the latter, in a common-sized tumblertul of the former, may be taken three times a day, and continued for a month, according to circumstances. The sore, in the meantime, should be kept clean, and such a[)plications employed as may happen to agree with it best ; these consist of washes of nitrate of silver, black wash, and spermaceti oint- ment. When the ulcer cicatrizes, or heals, and any hardness remains, mer- cury should be given to promote its absorption, and the skin destroyed by the direct application of the nitrate of silver. When the disease has been neglected, or a sufficient quantity of mer- cury has not been given, the constitution becomxxio7'i'. — Treat as for belladonna. Twenty or thirty drops of aromatic s[)irits of ammonia, in water, will aid in restoring the strength of the heart. Henbane. JJyoscyamus. — T*- * Ps given above for belladonna. Iodine. 'I'he conimon tinci. iodine, used for external applica- tion, is the usual form of this j jison. Staich, in water, may be freely given until vomiting is secured by an emetic. Iron, Sulphate of. Copperas or Green Vitriol. — This is an irritant poison. Alter vomiting, let the patient take carbonate of soda (baking hoda). as recommended for cop[)er poisoning. Lead. 'l"he form from which poisoning by this substance usually takes place is the a^-ctate of lead (sugar of lead). The carbonate of lead, the " while lead "' ot the [)ainters, and the red oxide (red lead), are also sometimes swallowed in poisonous doses. They all act as irritant poisons. The treatment of such cases consists in giving, as an antidote, water acidulated to about the strength of lemonade, with sulphuric acid (oil of vitriol). Sulphate of magnesia (epsom-salts), or the sulphate of soda ((llauber's salt), in water, are also reputed antidotes. After the antidote has been given, in poisoning by lead, an emetic should be given. J.ead poisoning, in the forms of painters' colic, and lead i)alsy, follow from nmch exposure to the metal. Cosmetics containing whue lead, and hair color restorers, containing sugar of lead, water which is contaminatetl ))y lead pil'ing, and eating food preserved in leaden cans, may cause them. The free use of milk will olten prevent these bad effects. Mushrooms. \\'hen poisoning from eating niushrooms takes place, the contents oi" the stomach should at once be evacuated by an emetic. After vomiting has commenced, it should be promoted by dfaughts of warm water, barley water, but particularly by drmking copiously of nvarm milk and water, to which sugar has been added. Nitrate of Potash. Saltpetre. — In large doses, say half an ounce or more, taken internally, is followed by poisoness symptoms. There is pain, with heat in the stomach, \omiting, and purging of blood with great ])rostration, and other symptoms denoting the action of an irritant poison. • ,.,.,. POISONS, BITES AND STINP.S. I&. iber's l)cen Llacc, luelic. jits of luarm )uncc lerc is wiili hitant No antidote is known. The treatment consists in rai)idly evacuating the contents of the stomach hy an emetic, and the free athninistralion vi nuicilaginous drinks, with some paregoric, every Httle while. Nitrate of Silver. Lunar caustic. — Used in hair dyes and indchblc ink. 'I'he antidote for this violent poison is common salt, wliich acts promptly and etiiciently. A strong brine should he swallowed as soon as possilile. Opium. /Mitdtvium, M()r/>hi(jy Soot/tin;^ Syrup. — This is the most frecjuently used poisonous agent. The first step is to give an active emetic, like ground mustard, salt and water, or ijiecac. The narcotic effects upon the brain, at the same time, as far as possible must be attended to. If the respiration is yielding to the jKiison, thai is, falling much below the standard of about twenty to the minute, it must be sustained by assistance. 'i'he exposed body of the patient should be dashed with cold water, not neglecting the head, face, and chest. After the cold water has been sufficiently used in this way, the body should be dried, removed to a dry spot, and hot applications made to the extremities and other parts. This is necessary, owing to the heat- producing power of the body being impaired by the suspended or diminished respiration. If the respiration is not suspended, but is going on at a diminished rate, say six or eight to the minute, artificial resfjiration is not reciuired, unless the number of respiratory movements of the chest falls below that ; but the other measures may be used. In addition to these, a strong stimulant, in the sb.ape of twenty or thirty drops of aromatic spirits of ammonia in a tablespoonful of water, may be given three or four times, at intervals of a couple or more minutes. It is better than I;randy, or anything alcoholic, because the mode of the action of brandy is much the same upon the brain as opium, and it might be rather adding to in- stead of taking from the poison that is at work. The aromatic spirits of ammonia will give the advantage, without the disadvantage. A few tablespoonsful of very strong freshly niade coffee is a useful thing to give in such cases. Among measures to keep in activity the circulation and respiration, as well as to promote the elimination (casting out) from the blood of the poison acting as a narcotic, there are few things more useful than mus- cular exercise. The patient should be walked or run up and down the room constantly. Oxalic Acid. Often taken by mistake for epsom salts — a dangerous mistake. Give at once po . red chalk, calcined and powdered mag- nesia, or strong lime-water. After these have been administered for a time an emetic will empty the stomach. Poison Vine. Poison Oak., Poison Sumac. — These are species of Khus^ and abound in many parts of the United States, The juice, or i66 THE FAMILY PHYSICIAN. even the touch of the leaf when the dew is on it, brings about in many persons redness, itching, sweUing, and bhsters. The person so affected should take a dose of o[)soni salts or cream of tartar, to empty the bowels, and bathe the parts with lead wash. A wash of a teasi)0()iiful of baking soda in a tumbler of water immediately after exposure will prevent the eruption. When the latter has appeared, painting the parts with tincture of iron will usually check it. A solution of blue vitriol or sulphate of copper, a teaspoonlul to the pint of water, is also an efficient lotion. Prussic Acid. This substance is so rapidly fatal that little can be done to avert death. If possible, give an emetic of mustard, and follow with stimulants. Phosphorus. .Sometimes taken in rat and roach poison, and in matches. There is no antidote known. Some calcined magnesia may be given in plenty of water, to be rapidly followed by an emetic, and then an abundance of n"kucilaginous drinks. Savine, Oil of. This substance in large doses inflames the stomach and bowels. (Jive olive oil in tablcspoonful doses, and empty the stom- ach with emetics. Stramonium. Usually known as thorn apple, or jimson weed ; be- longs to the same natural order in botany as belladonna, and when taken inlernally in improi)er (juantities, i:; to be treated by similar general means. Children olten gather the seeds and eat them. Strychnine. Nux Vomica. — This dangerous substance destroys life quickly, with severe convulsions. The patient should be made to vomit without delay. Chloroform should then be given in teaspoonful doses, in water, every quarter of an hour. Artificial res[)iration may be tried if apparent death has set in. Tobacco. The oil of tobacco is a violent poison, and the leaf when swallowed causes nausea and vomiting. 'I'his should be encouraged with warm water, after which twenty-drop doses of auunonia, in a tablespoon- lul of water, will be of benefit. Laying Out the Dead. When a person dies, the eyes should be closed by gentle pressure with tlie fingers for a few minutes, or a small weight— a penny or similar coin — may be used to keep up the pressure. rhe limbs should be straightened out carefully, and a bandage applieu under the lower jaw, to sup[)ort it; the arms should be placed by the side, and the lower extremities kei)t in position by means of a bandage connecting the great toes. The clothes should then all be removed, and after the body has been thoroughly washed, be replaced by a clean bed-gown. Bites and Stings of Insects. — The most frequent wounds of this kind are those made by bees or wasps. These are not of course dangerous, unless many be intlicted at; the same time, or unless the sufferer be a ^i POISONS, BITES AND STINGS. 167 young child. Sinj,'le stings are, however, (luite painful, and occasion much swelling if inllicted round the eyes or in the mouth. When a large number of bees attack an animal, they inflirt injuries which are usually fatal. Men, as well as horses, have been rei)ealedly stung to death by an infuriated swarm of bees. In some parts of the country there are found certain other small ani- mals which indict painful and severe wounds. In the southern and western i)arts jf our country individuals frequently suffer from the bite of a large spider called the tarautiiia. \\\ the northern i)art of the coun- try there is a small black spider which is often found in the neighbor- hood of old logs and trunks of trees, and which intlicts a painful wound. Treatment. — The bites of spiders and the stings of bees and wasps usually re([uire no other treatment than measures to allay the pain. There are various j)opular remeilies employed for this purpose. Some- times hartshorn is applied to the skin in the vicinity of tlie wound ; some people consider a cabbage leaf the best possible application. 'I'he fact is, that anything which serves to cool the surface diminishes the irrita- tion and pain. (Moths wet with cold water, or a mixture of ecjual i)artsof water and hartshorn, are usually very grateful to the sufferer ; or a solu- tion of ordinary baking soda, a teaspoonful of which is stirred up in a glass of water, will make a cooling and pleasant ai)[)Ucation. If a person be slung in the mouth or throat, the swelling which re- sults is apt to be so great as to embarrass the breathing. Jn such a case the patient should even before the parts are much swollen, employ faith- fully gargles of hot water containing a little borax. A i)opular remedy is a mixture of vinegar and water, which is heated and used as a gargle. The swelling is sometimes so great as to render surgical interference necessary in order to prevent suffocation. The tongue may be punc- tured with a sharp ])caknite in several places, and the use of the gargles should be continued. In many of these cases the pain is so great that opium must be given to alleviate it. l""or this pur{)ose twenty drops of laudanum may be taken every two hours until three or four doses have been administered. n : CHAPTER XI. DISEASES OF WOMEN. Menstruation — Dolaycd or Obstructed — Suppressed and painful — Profuse— Ctjsation of — The Womb — Fallint^ of — Inllainniation of— Ulcerntion of — Flooding of— Polypus of— Cancer of — Tlie Ovaries InHanuiiation of^ — Whites — Pregnancy — Signs of — Duration of — Management of Mother during — Diet during — Dress and J^xercise during — Moral Influences during — The Breast during — Morning Sickness of — ConslipoDon of— Heart- burn of — Incontinence of Urine during — Cougii of — V^aricosc Vi'ins of— Itching of Pri\ate Parts during — Restlessness of -Melancholy during — False Picgnancy — The Breast and its Diseases — Intlanimation of — Abscess of — Sore Nipples — Milk Fever — Confinement — Abortion or Miscarriage — Anaemia — Barrerness — Green Sickness — Puer- peral or Childbed Fever — Puerjjeral Mania -White Leg or Milk Leg — Itching of tlie External tJenital Organs -Lactation and the Si'xual Fimctions — Marriage. W^omen, in addition to the diseases incidental to both sexcj, are sub- ject, from their peculiar organization, to a number of distressing com- plaints; and in many instances, through a mistaken sense of delicacy, their lives are shrouded in sadness and pain, from a want of proper in- formation lelaiing to their peculiar ailments. To woman is entrusted a most sacred charge — the germ of a new being, whose position and use- fulness in life will be greatly influenced by her prudence or indiscretion. We shall treat under their various heads the principal forms o( disease and suffering that commonly affect the women of civilized life. Menstruation : its Physiology and Functions. The func- tions of the uterus, by which the menstrual, catamen»il, or monthly dis- charges take place, generally commence between the fourteenth and six- teenth years of age, although we have known them to begin as early as eleven or twelve. A considerable period mav elapse between the a})- pearance of the first and second menstrual ^charge ; but, when they are properly established, their recurrence at regular periods may be cal- culated on with great cf^rtainty, unless some functional or other derange- ment of the system interferes with them. Ordinarily, a lunar month of twenty-eight days is the intervening period ; but with some women the discharge occurs every third week. The fluid discharged resembles blood in color, but it does not coagulate. The (quantity is from three to five oub:es, and the process occu|)ies from three to seven days. The cause of this monthly flow is the ripening and expulsion of the egg from the ovaries. We quote from Professor C. D. Meig.., of Phila- delphia, a reliable and competent authority on these matters : — " * 0^/ine vivurn ex ovo^ (every living thing comes from an egg, or germ), is the universal law of reproduction. This can be shown as well in the l68 being 1 ill DISEASES OF WOMEN. 169 ic- lis- o.s cy of llie les to he lla- Ibe vegetable as in the animal kingdom. The sturdy oak from the acorn, the ear of corn from the grain [slanted by the farmer, the robin and the> elephant, all springing from germs, go to prove the truthfulness of this law. Hvcry seed, every egg, contains a germ, wlu'ch, when brougiit un- der proper influences, will produce of its own kind. Thus far all is plain enough, but where do these germs originate? It has been ascer- tained that each aniuial, as well as each plant, is [)rovidcd with an organ for the i)rodurt.ion and throwing off of these cells or germs. In th female, this orgnn is the ovary. The ovaries are two in number — small oval bodies, nbout one inch in length, a little more than half an inch in breadth, and a third of an inch in thickness. This measurement will differ in some cases, but will be found generally correct. l''.acli ovary is attached to an angle of the womb, about one inch from its upj)er por- tion, by a ligament. The whole physiological function or dut)- of the Ovary, is to mature and deposit its ova or eggs every twenty-eighth day, from the age of fifteen to that (.f forty-five, or for about thirty years. This function is susi)ended only during pregnancy and nursing, but sometimes not even then. There are numerous cases on record where the woman has had her courses regularly during the time she was pregnant, and there arc many with whom lactation does not at all interfere. 1 )uring the maturation or ri])ening, and discharging of the ovum into the canal or tube which conveys it into the womb, the generative organs become very much congested, looking almost as if inflamed. This congestion at last reaches such a height that it overflows, as it were, and produces a dis- charge of bloody fluid h-om the genitalia, or birth-place. As soon as-the flow commences, the heat and aching in the region of the ovaries, and the weight and dragging sensation diminish and gradually disappear. Thus you will see tliat menstruation consists merely in the rii)ening and dist;hargc of an ovum or egg, which, when not im[)regnated, is washed away by the menstrual fluid, or blood, poured out from the vessels on the inner surface of the womi). It will also be seen that a woman can become i)regnant only at or near the time of her menses. The marvel- lous re'uilarity of menstruation lias always e\(.ited great wonder, but why should it ? Whe'T we look around, we see that both animal and vege- table life have stated and regular times at which germ production takes place. Fruits and vegetables ripen, and animals produce their young at certain i>eriods. It is a law of nature, and why should r.ot woman obey it in her monthly term ? Nt)w since we have shown that menstru- atiim consists in the ripening aiul regular dei)osit of an egg -the flow heing but the outward visible sign of such an act — it is possible that a wonian may menstruate regularly without having any show, 'i'o prove this, there are many -^ases on record where a woman has married, and become i)regnant witiioul having had tlie least show, which would be im- possible if she did not menstruate. Again, a woman who has always been regular may have several children, without in the meantime having r I/O THE FAMILY PHYSICIAN. had any sign. This may be explained by her becoming pregnant dur- ing the time she was nursing her first child, carrying it to the full term, again Ijecoming pregnant, and so on, until being no longer impregnated, her courses return, and are regular thereafter. " Menstruation commences at about tiie age of fourteen or fifteen in this country. In warmer climates it appears earlier, and in colder ones later. Menstruation, menses, courses, catamenia, monthly periods, and "being unwell," arc some of the terms by which this function is desig- nated. Those who are brought up and live luxuriously, and whose moral and physical training has been such as to make their nervous systems more susceptible, have their courses at a much earlier period than those who have been accustomed to coarse food and laborious employment. The appearance of the menses before the fourteenth year is regarded as unfortunate, indicating a premature development of the organs ; while their postponement until after the sixteenth year is generally an evidence of weakness, or of some disorder of the generative apparatus. If, how- ever, the person has good health, and all her other functions are regular, if her spirits ar^ not clouded, nor her mind dull and weak, it should not be considered necessary to interfere to bring them on, for irreparable injury may be done. The first appearance of the menses is generally i:'receded by the following symptoms : Headache, lieaviness, languor, pains in the back, loins, and down the thighs, and an indisposition to exertion. There is a peculiar dark tint of the countenance, particularly under the eyes, and occasionally uneasiness and a sense of constriction in the throat. The perspiration has often a faint and sickly odor, and the smell of the breath is peculiar. The breasts are enlarged and ten- der. The appetite is fastidious and capricious, and digestion is im- paired. These symptoms continue one, two, or three days, and subside as the menses appear. The menses continue three, five, or seven days, according to the peculiar constitution of the woman. The quantity dis- charged varies in different individuals. Some are obliged to make but one change during the period, but they generally average from ten to fifteen. " It is during the menstrual period that the system, especially of young persons, is more i..usceptible to both mental and physical influences. Very much depends upon the regular and healthy action of the discharge, for to it woman owes her beauty and perfection. Great care should therefore be used to guard against the influences that may tend to derange the menses. A sudden suppression is always dangerous ; and among the causes which may produce it may be men*;ioned sudden frights, fits of anger, great anxiety, and powerful mental emotions. Ex- cessive exertions of every kind, long walks or rides, especially over rough roads, dancing, frequent running up and down stairs, have a tendency not only to increase the discharge, but also to produce falling of the womb." ~r DISEASES OF WOMEN. 171 The quantity and duration of the emission varies greatly in different women, and unless the former is either very scanty or excessive, these do not appear important particulars ; but the regular recurrence of the issue is important to health. This should be borne in mind, and due care taken not to suppress the discharge by exposure to cold or wet, or by violent exertions of any kind about the time when it may be expected. It is desirable that young females sliould be properly informed by their mothers, or those under whose care they are placed, of what may be ex- pected at a certain age, or they may be alarmed at the first appearance of the menses, taking it to be some indication of a dangerous disease or injury, and, perhaps, by mental agitation, or a resort to strong medicines, do mischief to themselves. DISEASES OF THE MENSTRUAL FUNCTION. urge, Ihould Ind to and idden Ex- 1 rough ley >omb. not Delayed or Obstructed Menstruation. If the menses do not appear at the usual age, or for some years after, no alnrm need be felt, provided there is no constitutional derangements which can be attributed to this cause. If the girl has not developed about the hips and breast, and feels not the changes peculiar to this period, it would be very in- jurious to attempt to force nature. If, however, she is fully developed, and her general heali'.h suffers, a course of treatment will be necessary. Causes. — An undeveloped state of the germ-jjroducing organs ; an impoverished condition ol the blood ; habitual costivcness ; or the womb may be closed, or iiymen be imperforate. Symptoms. — Discharges of blood will sometimes occur from the nose, mouth and gums, or from the stomach and bowels. Nearly always there will be unnatural heats and flushings, headache, tendency to faint, and hysterical symptoms. Treatment. — The patient must be very attentive to her diet and regi- men. Much exercise should be taken in the open air. Avoid late hours, rich food, and exciting pursuits. If the retention proceeded from costiveness or bad condition of the system, use the means as directed under the several heads. If from a mechanical cause a physician must be consulted. When it results from defective action of the ovaries, give the following : Carbonate of Iron, - - - - i drachm. Extract of Gentian, - - - - i drachm. Mix, and make into thirty pills. Dose, one pill two or three times a day. Suppressed Menstruation {Amenorrhea). — Suppression is the stoppage of the menses after they have been once established. It may be either acute or chronic. il II 1 '* 172 THE FAMILY PHYSICIAN. i! 'I ' t: ^1 ■ Causes. — Sudden cold, wet feet during the flow, fear, strong emotions, anxiety, or any cause that affects the general health. Chronic suppres- sion may result Irom the acute, or from defective nutrition of the organs; from the early determination of menstrual functions, or from the weak- ness occasioned by a profuse discharge of whites from the uterus. Symptoms — The symptoms usually present in a well developed body are all those mentioned in delayed menstruation, in a more aggra- vated form. In chronic sujjpression, failure of the general health, loss of appetite, pains in the head, back, and side, and constipation are the usual symptoms. At the regular periods when the menses ought to ap- pear, there will be great excitability, and an aggravation of the above symptoms. With those of full habit, there will be a strong, bounding pulse, with acute pain in the head, back, and limbs ; with the feeble and sickly, extreme langour, tremblings, shiverings, and pale visages. Treatment. — Care must be taken that pregnancy is not the cause of the stoi)pagc, or the health may be seriously injured by treatment for their restoration. \Vhere the flow has sto[)ped suddenly from exposure, the [lalient must take warm diluted drinks, saline aperients, till the bowels are freely oi)ened ; have hot bran poultices ai)plied to the lower part ot the abdomen ; immerse the feet and legs in hot water, rendered stimulant by the addition of mustard. If the pain is extreme, take an opiate draught every four hours, and have an injection, with one drachm of turpentine and half a drachm of tincture of opium thrown up. The pr\tient must be kept as ^uiet as possible. If it can not be brought on, wait till the next period, and use the hip-bath a few days before the period. I'^very other night the bath should be made more stimulant by the addition of a little mustard ; and on every occasion, active friction with dry coarse towels should be used. A lavement containing two drachms of spirits of turpentine may also be usetul ; and a leech or two applied to eacli thigh, on the upper part, as near to the situation of the uterus as may be. Also give the following, which seldom fails if i)er- sisted in : IJarbadoes Aloes, - - - - i drachm. Sulphate of Iron, - - - - i drachm. Powdered Cayenne, - - " /^ drachm. Iv.tiact of Ccnlinn, - - - >i, drachm. Simple Syrup, sulhcient (juantily. Mix, and make into sixty pills. Dose, one pill night and morning. The warm hip-bath sUiuld be used about the proper })eriod of men- struation . aud it would be well to give some uterine stimulant, such as a mixture composed of sjjirits of turpentine, made into an emulsion with a yolk of an egg, sugar, and essence ot juniper, about six drachms of the first and the last, in a six-ounce mixture. One ounce to be taken three timeo a day. Attempts to ^jromotc the discharj^e in any case n\ust totSEAS£S OF WOMEN struation, followed In ^ '"■'\^^'" P^^'^^bly be he n ' nT •''"' ''' ^'^^^^ P'lin at the I of7nn. . u'''^/'^'-^ cliscliarge only ° -] 1 ' ''^ns of men- before acce bn "f ?k '^" ^^^'^' ^'^^^'go, iWerh f"^"^!"!^''^"'^^ by acute cessation or VF '^^ '"^"^^•^' ^-^"d elderl n^;. ^"^'^^ >'°""- ^^0"ien, Gainful Menstruation / /i 'ntercourse. Tnrw y'l^iTeV'''=,4°" '^ '^'^'^^^^^^^^^ ''= '"^ ™'^ -•'" cesses, and but >„rthn„ ^'""'^"'" '' "■• l>ut one or n,t f^' •'""='"' the whole procp 'r rl ™'""'« "" '" l«roxy.,n?" or r„° r" 'if ""^ 1"«- tf stron. „,en,:,| .i^^Z^T"! :"?^'- ^ ''as been observed I- Tincture of Aconite leaves - test hp.nts of nitre - '. " " - ^ drachnis l^^^'^f''^ ---.■■- I ounce. J^iniple syrup . . ' - - 3 grains. Jan- Jody. !i Jl» ! i N B I' 174 THK FAMILY PHYSICIAN. Causes. — This k in consefiuencc ot irritability of the uterine system, probably produced by over-exertion, luxurious living with insufficient exercise, or excesses oi' nny kind ; too rapid child-bearing, frecjuent mis- carriages, or protracted lactation. The habitual use of tea and coffee will also produce it. Symptoms. — It is generally accompanied by pain across the loins, great languor and debility, throbbing of the temples, headache, and vertigo. \Vhen there is much hemorrhage, there is an aggravation of these symptoms, sometimes followed by dropsy of the cellular tissue. Treatment. — In persons of full habit, where the menses are not bloody, the following may be taken : Sulphate of iron, -..-.- Dilute Sul[)huric Acid, Sulphate of Magnesia, - - - - - (Jinnamon Water, . . . . - Mix. Take two tablespoonsful three times a day. 12 grams. I drachm. 6 drachms. 12 ounces. If there is much pain, add tincture of henbane, two drachms ; or compounded infusion of roses may be taken, with sul})hate of magnesia ; or ten or fifteen drops of the muriatcd tincture of iron in water, with or without the salts, as the bowels may rciiuirc, two or three times a day. Sponge the loins and pudenda with vinegar and water, use the hip-bath, but let it be cold water, with a little salt in it, to strengthen the system as much as possi- ble, and avoid all enervating influences. If there is blood in the dis- charge, use cold vaginal injections, with alum and oi)ium in them, or the latter with gallic acid, about a drachm of each to a tpiait of water. Apply hot bran poultices to the breasts ; keep the feet warm, but let the loins be ligluly covered ; take gentle exercise, bitter ale, and tonics, especially iron. Cession of Menstruation. As the accession of the menses shows when the womb is in a fit state for con' o•^^ /a ^ V <^ I So THE FAMILY PHYSICIAN. i If i 1 II 1 8 - 1 t' ■ H ^i ' ■W' or a half drachm of quinine with one drachm dilute sulphuric acid, in six ounces of gentian or cascarilla ; a tablespoonful to be taken two or three times a day. Should there be proluse menstruation, nothing is so likely to be effectual as the iron and acid mixture, with or without the sulphate of magnesia, according to the stale of the bowels. Mustard poultices to the lower part of the back or stimulant liniments, rubbed well in every night, for a time, will often prove useful. Women who are likely to have leucorrha>a should avoid all predispos- ing causes of the disease, such as wines and other stimulants and hot tea and other slops taken in large quantities ; luxurious living, and sensual indulgence of all kinds, esjjecially much sexual intercourse, and anything that has a tendency to enervate and enfeeble the frame. Early rising and regular open-air exercise, warm and comfortable clothing, good food and tonic medicine, with use of the shower-bath and bathing, — these will prove the best preventives. Herbal or Electric Treatment for Womb Diseases. For the whites care must be taken not to arrest the discharge too soon, or bad consequences may ensue. Use every means to improve the general health. Avoid hot rooms, excessive exertion, and strong tea and coffee. A decoction of the roots of comfrey-root, boiled in milk, is highly recom- mended. Take a teaspoonful three or four times a day. Injections of alum-water or decoction of oak-bark, are very good. A preparation of one ounce of aloes and two drachms muriated tincture of iron well mixed, and forty drops taken three times a day in a little water, has been found of great advantage. lor falling of the womb, an infusion of white-oak bark, or an infusion of ecjual parts of peach-leaves, Solomon's seal, and hoi:)s, as an injection, will produce excellent results. Where heat and difficulty in making water exists, give a drink of infusion of marsh-mallow and spearmint. Pregnancy and its Disorders. Utero-gestation, or the period of child-bearing, — that is, from the time of conception to that of deli- very, — extends over a period of forty weeks, or two hundred and eighty days. It is commonly set down as nine calender months, but this would make only two hundred and seventy-five days ; or, if February be in- cluded, two hundred and seventy-two days ; that is, thirty-nine weeks only, instead of forty, or nine calendar months and a week. In making the necessary provision for the coming on of labor, it is best to calculate from midway between the last occurrence of menstruation and the one which would have followed if conception had not taken place, and allow nine calendar months from that time. Thus, if menstruation had taken place on the first of January, labor might be expected some time about the middle of October. The Signs of Pregnancy. The chief signs of pregnancy are as follows : — W ii DlSfiASfeS OF WOMEN. l8l if m- kks :ing llate lone |\lo\v jkcn jout re as t. The cessation of the menses, — although this is by no means an un- faihng sign, for sometimes this discharge will cease from other causes, and sometimes it will continue after conception has taken place. 2. Morning sickness, which generally commences about the fourth or fifth week, and lasts to about the fourth month. With some this is but slight, and causes but little inconvenience ; but with others it is more continuous and serious, sometimes causing the rejection of nearly all the food for a very considerable period. This symptom, again, can not be taken as a proof of pregnancy ; it is merely a suspicious circumstance, to be watched in connection with others. 3. Enlargement of the breasts, which generally increase in size about two months after conception. They also become tender and sore ; they throb and burn, and, when pressed by the hand, have a hard knotty feel, in consequence of the swelling of the glands by which the lacteal fluid is secreted. The nipple also becomes more prominent, and increases in diameter, while the areola around it assumes a purplish tinge, and has on it several little raised pimples of a yellowish-white color. 4. Enlargement of the womb and abdomen, which, in the fourth month, becomes rery perceptible, — the womb, which may now be felt in a firm rounded body, having ascended above the bone of the pubes, and pushed the bowels up into the abdomen. 5. A tendency to flatulent distension of the stomach, towards evening especially, rendering insupportable a pressure of stays, etc., which in the morning could be easily borne. 6. " Quickening," which is the mother's first perception of the second life within her. There is at first, probably, a very slight tremulous mo- tion, like a mere pulsation. This day by day grows stronger, until it becomes quite distinct, often painfully so. It is as though the child, to use a scripture phrase, " leaped in the womb." These movements can be distinctly felt by the hand placed upon the abdomen. There are other and less obvious signs, which only the professional man would be likely to detect. All may notice, however, the change which generally takes place in the countenance. The mouth and eyes seem to enlarge, and the nose becomes what is generally termed more or less "pinched up." There is an alteration, too, in the color of the eyes, which becomes somewhat paler, — especially is this perceptible if they are blue eyes. Then the patient is generally fidgety, peevish, and restless, exhibiting a high degree of nervous irritation ; she has odd fancies, and longings after out-of-the-way things and articles of diet, which should be procured for her if possible. At such a time she requires soothing and humoring ; harsh and unkind treatment will be likely to have a most in- jurious effect, both upon her and her offspring. Management and Conduct of Mothers during Pregnancy. A pregnant woman should be made aware that the advantages obtained by well-regulated habits are by no means exclusively conferred upon her, i' ' u I 1 82 THE FAMILY niYSICIAN. l)ut that others c(iually iinportant arc hkewise conferred on the child, for whom a larger supply of nutrition, and of a better (juality, will thus be provided ; and so, being nourished by sound and healthy fluids, will commence its career of life strong, vigorous, and less liable to those mor- bid debilities and derangements which affect the children of the indolent, the pampered, or the debauched. From the moment, therefore, that conception has taken place, a new and most sacred duty involves upon the female. She is bound by all ties of maternal sentiment, of humanity, and of moral and religious ob- ligations, to iM'otect the nascent being in her womb against every circum- stance, under her control, which might have an unfavorable influence on its delicate organization. 'i'he state of pregnancy is one peculiarly liable to disease and injury ; and we daily witness much suffering and danger incurred both to the mother and tlie child, from the inlluencc of causes which, with i)roper rare, might have been avoided altogether, or, at least, rendered inof- lensive. Diet during Pregnancy. The peculiar tendency to febrile irrita- lion and general plethora, in pregnancy, renders it es[)ccially proper to a\oid undue excitement and nourishment during this period. Not that the pregnant female is to be dieted like a valetudinarian ; but that moderation and simplicity of food is especially proper in her case. As the appetite is frecjucntly very craving during this period, an inor- dinate indulgence in rich and high seasoned food is among the most common errors ; and this mistake is the more readily fallen into from the erroneous idea which many entertain, that, as the Actus draws its nourishment from the maternal system, a greater (juantity of aliment is required in pregnancy. The exercise of caution in the selection of 'proi)er food, appears to be particularly important towards the termination of gestation. When the stomach is in a weak and irritable state, rice, barley, arrow-root, oatmeal, the lean pait of mutton, tender beef, soft- boiled eggs, and slewed apples constitute ai)i)ro])riate articles of nourish- ment. Jlut it is always to be recollected, that the temperate use of food is of more consecjuenre than any very cautious selection as to its kind. Coffee and tea may be moderately used ; but all vinous or alcoholic drinks should be studiously avoid^^ed. The temjjtation to indulging in small portions of cordial, or brandy, in the early months of gestation, is often very strong ; but it ought to be firmly checked, or the dei)lorable habit of solitary dram-drinking may be the result of indulgence in these potent stimuli. The ai:)petitive sensibilities of the stomach, in some instances, undergo extraordinary derangement, especially in weak and delicate females. Articles ot food which, previous to i)regnancy, were very grateful and congenial, become highly disagreeable, and an almost irresistible craving for singular and even disgusting substances, is experienced. This re- DISEASES OF WOMEN. 183 its icnt ^ of iOft- rish- Ifood ind lolic hg in In, is ible ithcsc bergo lales. Il and laving lis re- markable irregularity of the appetite is usually called a lon^s;ing. If the substances longed for be not evidently of an injurious character, they should not be withheld ; in some instances these longings may be re- garded as instinctive calls of the stomach for articles favorable to the health of the individual. Thus, when a strong desire for eating chalk, charcoal, or clay, is manifested, we are 'admonished that the digestive powers are feeble and that there is a tendency to acidity in the stomach. In such cases the means of relief are alkalines, mild laxatives, and tonic vegetable bitters, with a suitable regimen. Dress and Exercise. The custom of wearing tightly laced cor- sets during gestation can not be too severely censured. It gives rise to functional disorder of the stomach and liver, as well as to uterine hemor- rhage and abortion in the mother ; it likewise impedes the regular nourishment of the ftetus in the womb. The clothing should always be sufficient to protect the body against the injurious influence of cold and atmospheric vicissitudes ; the abdomen and feet especially should be guarded against injury from these causes. In winter, or cold and damp seasons, the use of a llannel l)andage or roller around the abdomen will be found very beneficial and comfortable. All kinds of agitating exer- cise, such as riding in carriages rapidly over rough roads, dancing, lifting or carrying heavy loads,— in short, all masculine and fatiguing employ- ments — whatever ought to be avoided by pregnant women ; and the more so as gestation approaches the term of its regular completion. During the eighth and ninth months of pregnancy unusual exertion or fatigue is particularly apt to excite premature labor. It is to be observed, however, that if injury is apt to result from too much exercise, injurious consequences may also arise from too much indolence and inactivity. Riding in an easy carriage on even roads, or moderate walking, may be enjoyed with great proi)riely, and usually with obvious advantage during gestation. Sexual intercourse should be avoided after conception : it is useless to reproduction, and is interdicted by moralists and physicians, as prejudicial to the parents and their offspring. Moral Influences. Tranquillity and cheerfulness of mind are of l)rime importance during pregnancy. Convulsions, severe hysteria, spasms, syncope, hemorrhage, and abortion, may be produced by violent anger, terror, or jealousy, during pregnancy. Intense grief will occasion debility, indigestion, jaundice, and various other functional disorders. A strong excitement of the imagination is supposed by some to be capable of producing impressions on the fcetus in the womb. The Breasts. The breasts and nipples should be particularly at- tended to during the latter months of gestation, in order to prepare them for suckling the infant. For some weeks before the expected termina- tion of gestation, the nipples should be daily washed in lukewarm water, then dried by exposing them to the free air, and afterwards gently rub- i i I 184 THE FAMILY PHYSICIAN. bed for five or six minutes with a soft piece of flannel, or with the extre- mities of the fingers. When the skin of the nipples is very delicate and sensitive, they may be washed with brandy and water, or a wash com- posed of two drachms of the tincture of myrrh, one drachm of laudanum, and two ounces of water. In using this, the nipples should first be bathed with lukewarm water, and dried and rubbed as before directed, and then washed witii the lotion. Compression of the breasts by corsets, or any other artificial means, is carefully to be avoided. When the nipples are very small, or sunk in the breasts, they should be drawn out by means of a suction pump with a common clay tobacco-pipe. This process should be repeated several times daily, until they have acquired a suffi cient degree of prominency. DISEASES OF PREGNANCY. Morning Sickness. This complaint is sometimes very trouble- some and obstini'.te. Treatment. — The j)atient should have breakfast in bed, and remain in a recumbent position for some time after. Small lumps of ice put into the mouth and allowed to dissolve will sometimes give relief. Give if the sickness is troublesome, three times a day, a mixture composed of one scruple of bicarbonate of potash or soda, dissolved in a wineglass of water. Take while effervescing, with a tablespoonful of lemon juice. Constipation. During the latter months of pregnancy, constipation is nearly always present, the pressure upon the lower bowel being the eause. Neither aloes nor any violent cathartic should be taken. A moderate dose of castor oil may be administered about every other day, or as often as necessary ; but if the stomach nauseates at repeated doses of this, try the following mixture : Sulphate of Magnesia, Infusion of Roses, - Cinnamon Water, - 1 ounce. 6 ounces. 2 ounces. Dose, a wineglass every morning early. If, as is sometimes the case, diarrhcea supervenes, give the following : — Chalk Mixture, - - - 6 drachms. Aromatic Confection, - - - 2 drachms. Tincture of Opium, - - ■ ^ drachm. Dose, a tablespoonful every three or four hours. Heartburn. This may be removed by moving the bowels with a little magnesia, and taking a winegio?>sful of lime-water in milk two or three times a day ; or carbonate of potash and magnesia, of each ten grains, in cinnamon water, with one drachm of tincture of gentian. DISEASES OF WOMEN. 185 ion the lay, )ses use. th a or ten Incontinence of Urine. The frc(iuent desire to make water, aris- ing from irritation of the bladder, should be attended to, as long reten- tion of urine may cause retroversion of the ^Yomb and aijortion. An ab- dominal belt will be found of great service in the renal affections of pregnancy. Effervescing draughts, with ten grains of nitrate of potash and the same of magnesia, will also be found serviceable ; and iJ there is much pain, add five grains of laudanum, and ai)ply hot fomentations or use the hip-bath. Cough. If there is cough, which frequently attends pregnancy, give any soothing pectoral mixture. If the cough is attended wiih pains in the chest, or headache, apply in the former case mustard-poultices over the sternum. Varicose Veins. For cramps and pains in the legs, with swelling and varicose veins, sponge the legs with co'd vinegar and water, and put on roller bandages or clastic stockings, and rest in a recumbent po- sition. Itching of the Private Parts. Itching about the vagina, with gleety discharges, call for the use of the hip-bath, and a slightly astrin- gent injection, such as Goulard water, a weak solution of alum, or an in- fusion of green tea. Restlessness at Nights. For dreams and restless nights, extract of hemlock, or henbane, five grains at bedtime, with strict attention to the condition of the bowels. Melancholy, Despondency, &c. Despondency frequently seizes upon those who are about to become mothers ; but generally, if the health be pretty good, it is shaken off as the great trial approaches. There are some women who are never so well and cheerful as during the time of pregnane/, but many there are to whom it is indeed a period of trial and suffering ; and especially is this the case with those who arc about to become mothers for the first time. False Pregnancy. It is necessary to the com[)leteness of our sub- ject that we say a few words here about false or spurious pregnancy, a condition of the female system of a remarkable kind, most frequently observed about the turn of life, when the catamenia becoming irregular, previous to their final cessation, are suppressed for a few periods ; and, at the same time, the stomach being out of order, nausea or vomiting is experienced, the breasts enlarge, become sensitive or even slightly pain- ful, and sometimes a serous or acrolactescent fluid exudes from the nip- ples and orifices of the areolar tubercles ; the abdomen grows fuller and more prominent, especially in women of full habit and constitutionally disposed to embonpoint^ and the abdominal enlargement progressively in- creases, partly from deposition of fat in the integuments and in the omentum, but still more from distension of the intestines by flatus. 1 t I 1 86 THE FAMILY PHYSICIAN. FIG. 94. which, passing from one part to another, communirates a sensation hke that produced by tiie motion of a f(etus ; the nervous system is gener- ally much disturbed, and the woman feels convinced that she is preg- nant, an idea which, at the time of life alluded to, is cherished by the sex with an extraordinary devotion, and relin([uished with proportionate reluctance ; and not unfrecpiently at the end of the supposed gestation, the delusion is rendered complete, and almost assumes the character of a reality, by the occurence of periodical pains strongly resembling labor. The Breast and its Diseases. We use this term in its restricted sense, as a[)[)lied to the llcshy i)rotubcrance common lo women, in whicii is situated the mammary glands, for the secretion of the milk by which the infant is nourished. Its full development depends greatly upon habit and constitution, being in some much more early in advancing womanhood, of which it is one of the most remarkable signs, and promi- nent in full maturity, dian in others. In the earlier stages of pregnancy, its fullest development commences : the breast swells, and the nipple en- larges, and by, or near the tmie of delivery it is filled with lacteal Huid, which passes readily, on suction, into the mouth of the child. Too fre- quently the j)rui)er enlargement of the breast, and increase of the nipple, is retarded by tight lacing. The consequences, sometimes, are hardened and congested states of the tissues, an insuf- ficient supply of milk, or afailure of it altogether; or a nipple so flattened and pressed into the chest that it cannot be taken hold of by the mouth of the infant. Abscess, cancer, and other evil consequences may also ensue from undue [pressure upon such tender parts. Inflammation of the Breast. This af- ;7J^rr^ fcction is common, and frequently results in ab- ^''^*l^M^^ scess. Various causes may produce it, such as ^^ a blow, exposure to cold or wet, great mental excitement, unnatural distention by an accumu- lation of milk, or too much pressure by corsets. It may occur at any period between early and advanced womanhood, but most commonly it does occur within a week or two of childbirth, and is the result of some obstruction in the flow of the milk, or change in its normal character. Such a change will be sure to occur if the milk is suf- Section of Mammary fered to remain long in the breast ; therefore, Gland. should the infant be unable to relieve it at all, , Ti . or insufificiently, artificial means must be taken 1, I. GiilivctcpnorousUucls. •" 3, a, Lobuli. tO dO SO. DISEASES OF WOMEN. 187 FIG. 95. ito the the and from lis af- in ab- ucli as mental cumu- orsets. y and only it th, and ofthe Such is suf- ^refore, at all, 2 taken •'''>':JU Origin of the Duct?. ITG. 96. Milk A simple and cheap form of breast-pump is • made with a stout clastic bag with a glass mouthpiece, a wide-mouthed bottle sufficiently capacious to hold two quarts. This is dipped in hot water, and the mouth immediately ap- I)lied to the breast ; the heat will have rarefied the air within, which, as it cools, contracts and leaves a vacuum, causing suction, which draws the milk into ti.e bottle. Some nurses have the art of drawing the breast with the mouth ; and it is well to let them do so, as no instrument can effect the object so thoroughly. Abscess in the Breast. When there is an inflamed state of the tissues ofthe breast, there are shooting pains, and often febrile sym[)toms The i)art will become hard and exhibit knotty protuberances, indicating the formation of an abscess. Tiiese symptoms will be succeeded Ultimate Follicles of the by throbbing and a sensation of weight,— the Mammary (Hands. skin gradually assuming a thin and red appear- (7, a, the secreting Cells. /', ance, and becoming thinner until it finally />, the Nuclei. breaks, and allows the escape of the matter. Treatment. — When the premonitory symptoms of mammary abscess are observed, recourse should at once be had to remedial measures. Let the breast be well yet gently rubbed with a soft hand, into the palm of which is poured fresh olive or almond oil ; the friction should be con- tinued for about ten minutes, and repeated every four hours or so. Cioose-grease and other fatty substances are recommended, but simple oil is best, the friction being the principal agent for good. Between the intervals of this the breast should be kept covered with a tepid-water dressing — having over it oiled silk to prevent evaporation. Caie must be taken during this treatment to keep the bowels gently open, and to keep under the febrile symptoms.. A mammary abscess will frecjuently continue discharging for a considerable 1 eriod, and, during this time, the patient should be supported by a nourishing, although light diet. A warm bread-poultice is best for the abscess ; it should be changed about every four hours, and covered with oiled silk. When the dis- charge has nearly ceased, simpFe tepid-water dressings may be substitut- ed. The breast, durim; n'l this time, should be supported by a solt handkerchief tied round th icck An application of collodion all over the part has sometimes been used ; it forms a thin coat which, contract- i ng as it dries, affords the necessary support, if the breast is not very large and heavy. If seme amount of pressure is required, strips of strapping crossing each other will effect this object. After all danger of inflammation is over, a more generous diet may be allowed. Should the I m THE FAMILY fllYSIClAN. breast remain liaid, friction with soap liniment should be resorted to. A drachm of compound tincture of iodine to each ounce will render it more effectual. Sore Nipples. Very painful and distressing cases of sore nipples frequently occur after childbirth. Sometimes they cannot be avoided, but frequently they arise from too great an anxiety on the part of the mother, who is constantly meddling with them, applying the mouth of the child, and resorting to all sorts of expedients to diaw them out. Nipple-shields, with Indian-rubber teats, may be readily procured, and should be used when the nipples are too sore and tender to bear the ap- plication of the infant's mouth. In this case the milk must be drawn trom the breast by one of the contrivances above mentioned, and given to the child in a feeding-bottle. Glycerine has been found a good application for chapped or otherwise sore nipples. It must be applied with a camel-hair brush, first wiping this dry with a soft piece of linen. If obtained pure, there will be little or no smell in it to annoy either mother or child. Collodion is also useful, but it causes considerable smarting, If, as is sometimes the case, there be suppuration, warm bread-poultices must be applied, and after them tepid-water dressing. Infants, a few days alter birth, sometimes have the breasts distended with a thick, milky-looking fluid ; youths just arriving at the age of puberty have hard and painful swellings about the nipples. In both cases warm fomentations only are required ; the parts should not be pressed or rubbed ; lor the child, a little cold creair or simple ointment, after fomenting, is desirable. When the nipples are cracked or abraded the following is one of the best applications, and may be obtained at the drug store : Tannic Acid, Glycerine, Simple Cirate, 3 grams. I drachm. I ounce. This may be applied to the nipple and into the fissures three or four times a day, care being taken to remove it and cleanse the nipple before the child is applied to the breast. Milk Fever. An aggravated form of the excitement which takes place at the onset of lactation. Causes. — The cause m.ay be a cold, or over-heating the apartment, too stimulating a diet, or any obstruction to the flow of milk from the b»reast. Symptoms. — Its first symptoms are increased heat of the system, pre- ceded by shivering, and sometimes accompanied with vertigo and slight delirium. These are followed by severe headache, thirst, dry tongue, quick pulse, throbbing of the temples, and intolerance of light. Treatment. — Spare diet, perfect tranquillity, subdued light, cooling drinks, and saline aperient medicines ; the head should be kept some- DISEASES OF WOMEN. 189 takes tment, ^m the M pre- slight )ngue, [ooling 1 some- what elevated, and bathed with cold water or evaporating lotions. If the symptoms should become worse in spite of this, apply half-a dozen or more leeches to the head, and put the feet in a warm mustard bath. Most lying-in women have more or less of this fever, which is no doubt an effort of nature to rouse the hitherto dormant mammary organs to se- crete a proper quantity of milk. If, however, it is not checked, the ar- terial action runs too high, and no milk at all is secreted. Confinement. {Parturition). — Every prudent woman, who has the power of doing so, will maice all necessary preparations for an approach- ing accouchnient^ as the French term childbirth, or delivery. Few women, who are near their confinement, are sutificiently cautious of exposing themselves to unnecessary fatigue and atmospheric changes. They will " keep about until the last," and it is well for them to do so, provided they take only gentle exercise, and avoid getting wet or chilled, or heated in crowded assemblies, and the like. Miscarriages, difficult labors, and fretjuent lasting injury to mother and child, if not death of one or both, is not unfrecjuently the result of imprudence at this critical period. Therefore we would impress upon all our readers who are likely to become mothers, the duty which they owe to themselves, their friends, and their future offspring, of refraining, when enceinte^ as much as pos- sible from the more exciting pleasures and laborious occupations of life, and of preparing for the pains and cares which will shortly come upon them. Let all the preparations for the little stranger be made in good time, and the services of an experienced nurse engaged. Let the mother or some female, very near and dear, be at hand to aid and counsel, and, above all, to cheer and encourage the often sinking heart, not only at the actual period of labor, but for some time previously. And let the mother in expectancy be treated with all possible love and gentleness. She may be fidgeity and whimsical, — what of that ! — provided they do not run into outrageous extremes, let her very whims be indulged. She is frequently in a state of great nervous excitement, — her body may be racked with pain, and her mind unhinged. Let her be soothed and tenderly dealt with. She has that to go through, at which the strongest man might well tremble, and shrink aghast. We will suppose that the inevitable hour has come, and that the labor- pains are regular, and that the work of delivery proceeds properly, al- though perhaps slowly. In due time — it may be in two hours, or four, or six, or even, in the case of a first child, twenty-four hours — the infant is born, and treated according to the directions given for the manage- ment of in'ants. But we are getting on too fast, and must go back to explain what has been, or should have been done to bring about the de- sired consummation -of a safe delivery, and what is yet of more conse- quence, the safely of the mother and child, and the gradual recovery of the former from the shock which, under the most favorable circumstances, lOO THE FAMILY niYSICIAN. her system will receive. If she he a strong, healthy woman, and no un- usual complications arise to disturb the natural process, but little aid or interference may be re(iuired. There will be the usual warning symp- toms; intermitting pains in the hack, slight at first, but increasing in in- tensity. There will probably be a slight discharge of mucus, stained with blood, and perhaps also a considerable discharge of a clear fluid, popularly called " the waters." This is an albuminous litjuid filling up the membrane in which the fcjctus floats, and so preventing pressure. It sometimes does not escape until labor has actually commenced by the falling down of the child into the pelvis. When this takes place, the re- cumbent positions should be assumed. Previous to this, it is best for the patient to sit upright or walk gently about, and to assist the action of the uterus. When the labor-pains be( ne very great, the patient should be placed on the bed, previously guarded by some waterproof material on her left side, and not far irom the edge, so that needful assistance can be easily rendered. She should have a tightly rolled pillow placed between her knees. If there is no unnatural ol)struction to the delivery, it is best left to nature Should the patient in the strugiile become very faint and weak, a little brandy and water may be administered at short intervals, but this must be stopped as soon as the labor is over, or inflammatory action may ensue. As soon as the child is born, and the umbilical cord, — or, as it is commonly called the navel string, — by which it is attached to the womb, has been tied and cut, a broad bandage or towel should be passed round the body of the mother, so as to cover the hips, drawn tightly, and pinned or tied, so as to sustain a pressure upon the womb, and stim- ulate the vessels to return to their normal condition. Before this is done, however, it will be best to pull that part of the above-named cord which remains attached to the uterus very gently, and by this means to accom- plis.i if possible the removal of the placenta, commonly called after-birth, which sometimes comes away with the child, or immediately after, and is sometimes only removed with great difficulty. If, at the expiration of a couple of hours or so, this still remains in the womb, where it will cause irritation, the hand of the nurse or medical man, previously well oiled, must be carefully passed in, so as to grasp, and without breaking it, detach it gently from its adhesion, and bring it away, waiting to com- plete the process until an after-pain comes on. Generally the natural ex- pulsion, or the artificial removal, of the placenta is attended with hemor- rhage, sometimes to a frightful extent. For directions ho vto proceed in this case, see article on F/ooding. For at least six hours after labor, the patient should be disturbed as little as may be. We have seen fussy nurses very desirous of making "missus" comfortable, and begin to put things to rights about her, when she, poor soul ! only wants perfect rest and quiet. Let her have it. And DISEASES OF WOMEN. 191 ed as aking when And if the pulse is thin and fcel)le, and the cheeks are colorless, and the breathing scarcely noticeable, so that life seems almost ei)bing away, put a little a very ii.Je, brandy ;ind water, warm and sweet, between her lips now and then ; but st')[) instantly if it produces tlushinL,' or rest- lessness ; and do not give it at all unless there seems urgent necessity for a stimulant. At the e.\i)iration of the above time, if a revival has taken place, soiled bed-clothes and body-linen may be changed ; but all this should be done very carefully and gently, or the (atigue may occa- sion a relapse. If the after-i).iins continue severe at the expiration of the above time, an anodyne drauglit may be given. It may be composed of from twenty to thirty grains of tincture of opium, or a quarter of a grain ... of morphine, in an ounce of plain or spearmint wnter. l''or eight or more days after labor, the recun mt position should be strictly maintained ; and the same rule holds good after a miscarriagt-. Some women feel so well and stro^^g in a day or two, that they will sit up, and sometimes even get out of b-id, and make themselves useful in the house. We have seen a woman at the wash-tub three days after she had been conhncd ; and we.h;i\e heard of lemales under^oinir the pains of labor under a hedge by the roadside, and in a few hours pro- ceeding on their journey with their babies at their breasts. But these women were semi or entire barbarians ; they had not been delicately nurtured. W^ith the immense advantages, we must also take some of the disadvantages of civilization, and those who give birth to children surrounded by all its comforts and luxuries, must not attempt to emulate the Indian squaw. If they do, they will inevitably suffer for their temer- ity. Getting about too early after childbirth is, perhaps, the most fruit- ful of all sources of uterine disease. The consequences may or may not show themselves at once, but whether or no, bad consequences there most likely will be ; therefore we warn all mothers to keep their beds long enough ; but little exertion should be made until the end of the first fortnight. If there is a necessity for getting about earlier, of course it must be done, for necessity has no law ; but unless there is, the risk should not be run. 1 )elicate women especially do wrong to attempt it, and the strong will be likely to render themselves weak by the practice. Abortion, or Miscarriage, the premature expulsion of the foetus from the womb, — that is, before the seventh month. After that period, if delivery occurs before the ninth month, it is called premature labor. Causes. — A sudden shock to the system by a fall or a fright ; straining, or over-reaching ; the administration of strong purgatives or emetics^; excessive indulgence in venery, or ought which may tend to debilitate , the system ; malformation of the generative organs ; fevers and severe inflammation ; syphilis or constitutional disease of any kind ; the growth of polypi or tumors in the cavity of the uterus, or adhesion to the sur- rounding viscera ; too great contractibility of the uterine fibres and blood- vessels. Most frequently, perhaps, it is a diseased condition of the fuetus m 192 THE FAMILY PHYSICIAN. itself, which, wanting the elements of growth and vitality, is rejected as a useless and troublesome incumbrance. Two classes of females, very different in constitution and appearance are more than commonly liable to abortion, namely, those of a voluptuous and plethoric habit, and those of a weak and irritable frame, 'i hose who continue to suckle after con- ception has again laken place render themselves liable to it, because a certain amount of nutriment re(iuired by the fcclus goes to the formation of tlie lacteal lluid. Miscarriage is generally attended with much pain. It weakens the system, and often severely tries the constitution of the sufferer, whose liability to the accident increases with each occurrence. The periods at which it is most likely to take place are said to be about a month after conception, again in twelve weeks, and again in the seventh month — the liability increasing in those stages which correspond with the periods of menstruation. Some people mvariabiy miscarry at a certain stage ; and thus, altliough often in the way to become mothers, are never blessed with offspring. By this it will be sufficiently plain that pregnant women ought to avoid all violent exercises ot the body, strong mental excitement, over- indulgence of sensual appetites, exposure to wet, or any extremes of weather, or aught which may tend to constitutional derangement of what- ever kind ; and those who have once aborted should be doubly careful, on account of their greater liabili^- Symptoms. — These vary cor ^erat iy, according to the more or less advanced stage of pregnancy, anu .te and condition of the patient ; but usually she feels at first slight pr i in the loins, and parts about the womb. There is a sense of bea, ^ down, a frequent desire to make water, or to evacuate the bowels, .-nd a feverish state of the system gen- erally. A discharge of blood commonly follows, sometimes in clots, at others in gushes, at longer or shorter intervals ; and this will continue until the Itetus is expelled. As the patient can not be considered out of danger until relieved of the ovum, the discharge ought to be carefully watched, and preserved lor the examination of the medical man, should he not be present during its progress, which is much to be preferred. Treatment. — The first object, when the premonitory symptoms above mentioned set in, is, if possible, to f revolt abortion. To this end, the patient should at once assume a recumbent position, and on no account be suffered to move moie tlian may be absolutely necessary. For a few days, use only cold drinks, and at bedtime take a pill tpmposed of one grain of opium and two grains of sugar of lead. If there is much heat in the abdomen, cloths wet with vinegar and water, in ecjual portions, should be applied thereto, and removed as often as they get warm. When the hemorrhage becomes at all profuse, all hopes of prevention are at an end, and die efforts should be directed to relieve pain, prevent utter exhaustion ot strength, and finally to remove, siyUBBaatastMaaMa DISEASES OF WOMEN. 193 of ly all to as quickly as may be, the ovum from the womb. To effect the latter ob- ject, mechanical means are sometimes resorted to, but only one thorout^h- ly acquainted with the anatomy of the parts should attempt this. As the flooding proceeds, the patient should be kept as cool as possible ; she should be exposed to, and suffered to breathe, cold air : acidulated drinks should be administered ; if ice can be obtained, let it be used to lower their tem))erature. Should fainting ensue f'om loss of blood, cor- dials may be given, but not hastily, or frequently, a teaspoontul of brandy, or fifteen drops of aromatic spirits of ammonia, in half a wineglassful of cold water, is the best stimulant for the purpose. When the discharge . is very profuse, lint, wadding, or a piece of sponge, dipped in a solution of alum, and then in olive-oil, may be introduced into the vagina, or an injection of the same gently thrown up by means of a syringe ; or a de- coction of oak-bark may be used for the same purpose. Should these means fail to check the hemorrhage, make up eighteen grains of sugar of lead into twelve {nils, with crumb of bread, and give one every two hours, with a draught of vinegar and water, or dilute sul- phuric acid, fifteen drops in half a wineglasst'ul of water being a sut"ticient dose. Opiates may be given with advantage when the pain is very severe, especially before the flooding comes on, or aftei it has continued too long. Suppositories, consisting of about a grain of powdered opium, made up into a softish mass, with a few grains of powdered gum, or ex- tract of henbane, are also useful. These latter may be introduced when miscarriage is likely to ensue. With rest and proper care, they will sometimes prevent it. The best preventives of miscarriage are the frequent use of the cold hip-bath, and sponging the lower part of the belly with cold vinegar and water; strict attention to diet, and avoiding all violent purging medicines; moderate gentle exercise, and entire abstinence from sexual intercourse during the first month of pregnancy. We can say nothing here about abortions vohmtniily produced except to warn women of the folly and danger of resorting to unprincijjled emi^ii ics, or the use of powerful drugs, to hide the consequences of an unlawful gratification of the passion... Death has frequently resulted Irom the employment of such means as are necessary to i)roduce abor- tion, and far t)etter is it to bear the shame and disgrace of being the mother of illegitimate offspring than to incur the risk and sin of being possibly the destroyer' of self, as well as of the embryro of a human being over which the parental instinct alone ought to stimulate a tender care and watchfulness. Ansemia, This is a condition of the constitution in whirh there is a deficiency of the red globules, or coloring matter, in the blood. It is marked by extreme pallor in those parts, such as the lips, which are generally suffused ; and is not uncommon in young females of a weak or scrofulous habit. It appears to aribe from a deficiency of vital energy M 194 THE FAMILY rilYSICIAN. in the system, cither constitutional or brought on by want of nourish- ment, brcathiiiL; impure air, or great loss of blood. In any case a cure may be ciTeclcd by good generous diet, pure air, moderate exercise, and strengthening medicines. Treatment. — Any of the various preparations of iron may be taken in comI)ination, if the appetite be bad, with some bitter tonic, such as in- fusion of gentian, with a little ([uinine vShould there be emaciation, cod liver oil, taken in orange wine, will be of service. The pores of the skin should be kept open by tepid sponging, and the bowels moderately so by a rhubarb or colocynth pill now and then. Strong purgatives should be avoided, and especially salines. In young females the absence of the monthly discharge need cause no uneasiness ; with returning strength, that will most likely retuyi. Should it hot do so, however, when this treatment lias been persisted in for a lime, and should the pallor, languor, sleei)lessncss, headache, confined bowels, swelling of the feet, -Sic, which generally distinguish annc^mia, continue, a medical man ought to be consulted, as it is likely there may be consumption, or other organic disease, at the spot of the mischief. Barrenness is the defect of power in the female to produce off- spring. Causes. — It is caused sometimes by want of tone or strength in the system ; nervous debility ; sometime* the result of malformation of struc- ture in sonic part of the generative organs ; and sometimes of functional disorders from local or constitutional causes. Syi/i/^tonis. — Want of issue j and, in married women, frec|uently con- tinued ill-health. IWat.ini'iif. — Cold batliing, or dashing cold water on the loins daily ; general tonics, or strengilieners to the system ; electricity or galvanism applied locally. A milk and vegetable diet is recommended, and absti- nence from sexual intercourse for a time. Take plenty of exercise early in the morning in the open air, and take the following ; — Compound Aloetic Pill, •• - 2 scruples. Com[)ound Rhubarb Pill, - - 2 Sulphate of Iron, - - - 2 Extract of Henbane, - - - 2 Mix, and dividt- into thirty-two pills. Take one every night, and the following in the daytime : — Compound Tincture of Valerian, - - ^^ Comi)ound Tincture of Lavender, Aromatic Spirits of Anmionia, Mix, and take a teaspoonful twice a day in two tablespoonsful of in- fusion of cascarilla. , . (I (C / - 1 ounce. DISEASES OF WOMEN. 195 Green Sickness. This disease has obtained its name from the pale and greenish cast of the skin of the patient. It is one of the forms of anaemia, and chiefly affects young girls, although adult and even mar- ried women, and young delicate males, are subject to it. Causes. — The disease appears to rise from a defect in the blood of red particles, and other solid constituents, and this is caused by defective assimilation. Those young persons of sedentary habits, or who work in crowded factories or shops, or who live in underground kitchens, and like places, are particularly subject to it. Symptoms. — In addition to the i)allor of the skin, which is common to all the forms of anaemia, this has some peculiar symptoms, such as hys- terical paroxysms, and extreme nervousness, pain in the side, swtjlling of the ankles, headache recurring at certain periods ; there is also frecjucnt. ly depraved ap[)etite and a disinclination for wholesome food altogethcr- If the case is long neglected, the symptoms become greatly exaggerated, the secretions are i iliealthy in character, and deficient in (juantity ; the limbs swell, the pains in the head and face are more severe, and so weak is the patient that every exertion, even the slightest, is laborious ; tthe depraved ap{)etite becomes more remarkable — cinders, chalk, slate-pen- cil, and articles efjually unfit for eating, are eagerly sought for, and mas- ticated with avidity. Treatinoit. — Change of air, tonics, and the course of treatment pre- scribed under the head of Aiiuvniay is the best in such cases. Exercise, fresh air, and nourishing diet, are the grand restoratives. Iron is the best tonic, alone, or in combination with (luiniue. It should be given in the least nauseous form, and at least one hour before meals. Puerperal Fever. {Childbed Fever). — This is one of the most fatal diseases which attack lying-in-women. It is a fever of a very high character, arising from inllamniation of the serous membrane, and often of the womb itself, and of its veins and absorbents. It runs a very rapid course, and is commonly fatal. It assumes the character of an epidemic, and frec[uently causes great mortality in lying-in hos[)itals. Whether it is really contagious or not is yet an open cjuestion The mere probabil- ity that it may be should render persons extremely cautious in their in- tercourse with those who are suffering under it. Symptoms. — There is usually an anxious countenance, sickness, hurried res[)iration, a furred tongue, and a stoppage of the secretions, especially of the milk. When these symptoms occur soon after childbirth, no attempt should be made at domestic treatment. Let the medical man be summoned immediately, if he be not already in attendance. Puerperal Mania, or Nervousness. This disease frequently attacks women either a little l)efore, during, or shortly after childbirth, and sometimes durmg nursinj?. Symptoms. — Great nervous irritation ; the face is commonly pallid, the 196 THE FAMILY PHYSICIAN. eye troubled, the tongue white, and skin hot ; the mind wanders, and conduct very irregular. Treatment. — Give a purge of senna and salts, and keep the bowels regular by the compound rhubarb pill. Keep the room darkened, and let the patient be kept quiet, and free from the interruption of friends. If she is restless at night, give her an anodyne, such as twenty drops of hartshorn, or one grain of opium in a solid pill. White Legj or Milk Leg. This troublesome disorder is apt to follow childbirth in some constitutions, and is of long duration. Symptoms. — It may commence two or three days after delivery, or it may not for some weeks. There is a little fever, and the parts about the thigh and groin feel hot, stiff and painful ; swelling commences, which extends over tha whole limb, which does not, however, change color, ex- cept it be paler or whiter than natural. At this time the pain is usually very severe, after a time the symptoms abate a little, but the limb re- mains for a long time swollen and comparatively useless. Treatvioit. — Cooling purgatives, such as magnesia, and salts and senna, and warm fomentations and poultices. Judicious bandaging will be of great service. Itching of the External Genital Organs. The delicate internal lining o( tlie external organs of generation sometimes becomes the seat of a most distressing itching, to relieve which, the parts may be so irri- tated by friction as to become violently inflamed. Leeches have been used sometimes with benefit : so has the application of cold, such as ice- water, or even lumps of ice introduced into the vagina. When there is an eruption like that in the sore mouth of children, injections of a strong solution of borax have been very useful ; thick starch water, with a solu- tion of lead, injected into the vagina, and retained for an hour or two, have been also of great utility in a few cases under our care. This irri- tation sometimes arises from disease of the womb, pregnancy, the presence of a stone in the bladder, or worms in the bowels. The original affec- tion must first be attended to in these cases, as elsewhere directed. In every instance, except where there is considerable abrasion of the skin from scratching or other cause, one of the following lotions may be applied on cloths to the skin : Sugar of Lead, - - • - i drachm. Carbolic A.cid, - - - - 10 drops. Laudanum, - - - - i ounce. Water, - - - - - i pint. Mix, and apply as directed. Borax, - - - - - i ounce. 1 Morphine, - - - - - 5 grains. Water, - - - - ' V2 pi"t. DISEASES OF WOMEN. 197 ■■ Duration of Pregnancy. For ordinary purposes it is sufficient to accept the popular idea as to the duration of pregnancy, namely : that it occupies a period of nine calendar months. To he accurate, however, it must be remarked that the average of a large number of cases ob- served with considerable accuracy is 280 days or ten lunar months — a period, therefore, equivalent on the average to nine calendar months plus one week. The important thing to '.>c borne in mind is, however, that this process, pregnancy, is not limited by iron regulations ; that a certain amount of variations from the average period, whether greater or less, is the rule. In fact the term 280 days is given as the average, not because it is the actual time in the majority of cases, but because the average time of those periods, greater and less, is about 280 days. A convenient rule for reckoning the probable time of confinement is as follows : — Count three months back from the time of the last menstrua- tion and to this add seven days and the result will approach very nearly the date of confinement (of course in the following year). As an ex- ample, suppose a woman to have menstruated last on the ist of May, 1888 ; counting three months back from this date and we get February ist ; to this add seven days and this gives us February 8th, which will" be the probable date of confinement in 1889. The Relation Between Lactation and the Sexual Functions. Since the nourishment of the child by the secretion of the breast is a part of the reproductive process — and one, too, which abundantly taxes the physical powers of the woman — we would expect to find what we know to be the case, namely, that the other reproductive organs, the womb and ovaries, usually remain in a quiescent state until lactation is completed ; hence it is that conception rarely occurs until the child is weaned. But it should be remembered tliat this intimate sympathy be- tween the breasts and the sexual organs is one which may react ui)on the former as well as upon the latter ; and that undue sexual excitement is apt to be followed by itijurious influence upon the secretion of milk. For this, among other reasons, it is a matter of the utmost importance, that during the early period of lactation there may be a total abstinence from intercourse, which should be allowed not earlier than the third month after delivery. Another most important reason for such abstinence is the fact that a failure to observe it often interferes seriously with the involution of the uterus, which is not always completed within two months after confine- ment. If the period of nursing be not unduly prolonged, if the child be weaned between the tenth and twelfth month, menstruation is usually deferred so long as lactation continues. Yet exceptions to this rule do occur ; either because of undue sexual excitement, or for some undeter- mined reason, menstruation occasionally begins five or six months after delivery. In such cases the woman is often urged to discontinue nur- sing for th^ sake of hqr child. In regard to this wq would aimply say 198 THE FAMILY PHYSICIAN. that the appearance of the menstrual discharge does not necessarily de- mand the discontinuance of lactation ; the decision must rest entirely upon the health of the child. If this be evidently impaired from the time when menstruation began, it is always advisable that the infant be weaned, otherwise not. It is observed that in die majority of cases, when menstruation begins so late as the fifth or sixth month, lactation may be prolonged without interference during the usual period. Quite otherwise is it, however, if conception occur while the mother is still nursing. For in this case her energies, unequal to the increased demand made by the attempt to perform both functions, will be devoted to the child in the womb to such an extent as to interfere seriously with her nursing. This does not necessarily imply that the mil : will be dried up, since the contrary is oflen observed, but the effect upon the child is always evident. The milk plainly suffers such a change in (juality as to render it injurious to the infant, and in every case the child should be weaned just so soon as the fact of conception is apparent. In some cases, indeed, it has been observed that a previously healthy child thriv' insr upon tlie milk of a healthy mother, becomes suddenly and unac- countably ill. Obstinate derangements of digestion, resisting all remed- ies, either in the shape of drugs or in attention to the mother's diet, transform the previously rosy babe into a deathly caricature of its former self. The mystery has been only explained a few months later by the evident pregnancy of the mother. Marriage. In selecting a partner for life many factors, religious, social, mental and moral, perhaps I should say also pecuniary, enter into consideration, which it is not the province of the medical adviser to dis- cuss ; yet there are certain facts bearing upon the physical basis of mar- riage which it is the physician's duty to impart, and which may therefore be properly presented here. First. — It should be remembered that marriage implies as its natural result the production of offspring ; and that a due regard for the welfare of such possible and probable offspring should be taken into consider- ation as a by no means unimportant element. It is, therefore, evident that marriage can be complete only when the parties to the contract are physically competent to fulfil the sexual relation, and, more than that, when the woman is capable of maternity. Now, while the girl is fre- quently capable, even in the earlier years of puberty, of becoming a mother, yet it is a fact patent even to the unprofessional mind, and well established by medical observation, that the girl is physically unfit for maternity, and that the disastrous results of premature motherhood are often visited, not only on the youthful mother as physical injuries; but are also apparent in the puny bodies and limited intellect of her offspring. The girl, in other words, is not made a woman by Jier first menstruation, for in the years to follow there must occur not only the development of her sexual organs, but also the increase in size and change of form of her (M ;: DISEASES OF WOMEN. 199 (^ whole frame, particularly the part included between her hips — the />eh>is — whereby the germ of a new Hfe may be fitly and fully developed within her body, and at the proper time permitted to pass through the pelvis to the outer world. For the too youthful wife marriage often proves a pain, not a pleasure ; a grief, and not a joy. The imperfectly developed womb and ovaries, which might well have attained perfection if permitted to re- main unmolested, unable to meet the demands of matrimony, are goaded into a state of irritation and disease. Her nervous system is often there- by enfeebled and she is pror.e to general prostration, as well as to those diseases peculiar to women. If she become a mother, she experiences more risk of injury during and subsequent to her connnement ; and when called upon to nourish her infant as well as her own still growing body, it is not surprising that she often breaks down entirely. It has been found that in our latitude and climate women usually con- tinue to grow and develop up to the age of 20 years ; though there are, of course, numerous exceptions in which maternity occurs earlier as well as later than this period. On the other hand, there are certain physical disadvantages accompanying over-maturity in the bride ; for it is a well- established fact that women who experience the first confinement at an age exceeding 28 or 30 years furnish a larger mortality from child-birth than those who become mothers between 20 and 30 years of age. I'Vom the physical standpoint alone, therefore, matrimony seems most advis- able as a rule between 20 and 25 years— an age, too, previous to which the mental development is not usually such as to demand marriage. In the choice of a husband no adviser can infiuence the dictates of a woman's heart ; and it is not our purpose either to usurp the duty of the parents in suggesting ordinary discretions and previous acquaintance with the mental and moral, as well as the physical, characteristics of the suitor ; nor to pad our pages with romantic, sentimental, and utterly ab- surd advice, so interesting to imaginative young ladies, as to just how tall and heavy and graceful and manly he should be ; as to what should be the color of his eyes, etc. It should be, however, remarked that certain physical characteristics ought, in the interest of the girl herself, to con- stitute insuperable obstacles to matrimony : It cannot be too emphatic- ally insisted upon, that a man and a woman presenting the Sifime heredi- tary taints, suffering from the same constitutional disease, or tendency to disease, should not, as they value their own happiness and that of their possible children, marry. In our land thisisparticularlytrue in regard to consumption and insanity. Were our laws made with the same rigid regard for physical health as prevailed in ancient times, we would doubtless for- bid marriage to all suffering or likely to suffer from consumption ; and while we are in these days more humane ; while we take into considera- tion, in the estimation of conjugal happiness, the mental and moral as well as the physical welfare of the participants, yet we must remember that consumption is an eminently hereditary disease, and that the child's qhances of becoming a victim to it are greater if both parents be bora of I 200 THE FAMILY PHYSICIAN. tainted stock than if one at least be healthy. The same remark may be applied to insanity, epilepsy and other diseases of the nervous system ; for we may be sure that while children may escape if the tainted be mixed with healthy blood, yet the most aggravated and numerous cases of ob- stinate nervous diseases are found in families where both parents exhibit a tenden'iy to the disease. In this general fact, too, we have a solution of that much discussed (juestion, whether relatives, particularly cousins, should be allowed to marry. With reference to this, we may say that the simple fact of relationship — when not nearer than that indicated — constitutes no physical impediment to marriage, yet there usually exists in the'ie cases a physical objection ; for the physical imperfection, if any exist- hereditary taints and tendencies to disease — will probably be found in both members of the family, and these defects and taints would in all proi)ability be condensed and aggravated in their children ; and while we may say there is no phyL>ical objection to the inter- marriage of cousins as such, provided both be healthy, yet there will usually be found upon closer scrutiny a family tendency, the aggravation of which by inter-mar- riage, would be disastrous to happiness. It need scarcely be remarked that closer and repeated inter-marriage among relatives is, from the physical point of view, undesirable. It is a law, true of man as of other animals, that the most vigorous qualities of a given stock are best maintained by an admixture of foreign blood ; and it isa fact of observation, that niTriages between Americans^ — ^those whose ancestors have lived in this country for several generations — are less pro- ductive in at least the number of children than marriages between a na- tive American and a European : though it must be admitted that since tlie size of the family is influenced by many other circumstances than simple fertility of the parents, we are not justified in drawing the same conclusions from the fact just stated as might follow such observation upon animals. It is specially interesting in this connection to note the peculiarity of the Jews ; they, as is well known, marry, as a rule, only members of the same race, and yet are remarkable for both physical and mental vigor of their numerous progeny. The peculiar traits, mental and physical, we may indeed say moral, are retained and perpetuated by inter-marriage, and yet a sufficient latitude of choice is allowed to secure a proper admixture of stock. It must, however, be remembered that the religious tenets of Israel provide not only for the health of the soul, but contain also admirable regulations for the health of the body ; to which perhaps their fertility and general health are to be in part attrib- uted. In selecting the time for marriage, certain physical facts should not be lost sight of amid social considerations. The health of the wife and of her possible offspring is furthered by consummation of the marriage rite in the spring or in the fai'; for entrance upon this new life is beset with physical and mental trials, which are certainly all the more trying annid th^e h,eat; of sunimer or th^ cqoI of y«int,Qi:. One i.nx^ " il DISEASES OF WOMEN. 201 " IS e portant consideration gives spring an advantage over autumn ; that if a child be born within a year its chances will be far better for surviving the trying period of teething, since the most critical part of the process will then occur in cool weather, and not in the heat of summer. The wed- ding should occur about the middle of the interval between two men strual periods. Although custom ordains that Ihc newly-married pair shall start at once upon a wedding tour, yet it is generally understood that this tour need not be extended a greater distance than suffices to remove them from the immediate and critical observation of their friends ; indeed, it is a hopeful sign to observe that the wedding tour is no longer so impera- tively required by society as formerly. From a physical point of view, certainly nothing could be more objectionable than u long journey im- mediately subsequent to the marriage ceremony. When, in addition to the annoyances inseparable from travelling, the bride is subjected to the trials incident to initiation into her new life, it becomes apparent that the girl is, during the ordinary bridal trip, subjected to a severe and in large part unnecessary physical strain, and that, too, at a time most critical and important for the security of her future happiness, as well at that of her husband. They are, it is true, withdrawn to a certain extent from the rude realities of life into an atmospiiere of affection and senti- ment ; yet it must be remembered that this affection and sentiment, how- ever sincere and hearty, has a physical basis — a foundation which would be much better and more securely laid if both, especially the bride, were re- lieved from all unnecessary fatigue and annoyance, for at this time she has supreme need of physical perfection and at the same time of the greatest tact and discretion ; sometimes, too, she must be prepared for disap- pointment, for probably every man, however sensible and rational in other matters, is positively silly during the courtship and engagement ; invests his fiance with perfections of body and mind which are actually never clothed in mortal shape ; in fact he marries an ideal creature of his own imagination, and during the first week of married life must learn ^. to substitute the actual for the idea. Hence it often happens that a" certain revulsion of feeling is felt by many men, who nevertheless have sincere affection for their wives — a revulsion of feeling for which the bride is not responsible, and yet which she must anticipate and be pre- pared to meet. There can be little doubt, though it is a matter of course which scarcely permits of actual demonstration, that the seeds of much unnecessary discord and unhappines*? are sown during the honeymoon by ignorance and lack of tact. It is therefore extremely desirable that all useless troubles and fatigues, such as those attendant upon travelling, be postponed until the wedded life be fairly begun. And it is hardly necessary to add that it is desirable to avoid the inquisitive eyes of friends and acquaintances, while on the other hand it is just as undesirable to forget and forsake the world entirely during this time ; the boy who eatjj jam wit,hout bread will surely have dyspepsia * 1, . i CHAPTER XIL DISEASES OF CHILDREN. CfirR of the Infiint — Fond — Tcothinp — Weaning — Worms — Croup— Child-Crowing — Sminics St. Vitiis's I);inro— Scarlatina — Measles — Smallpox — Chiekon-pox — Infantile Remittent l'\;ver — Worm I'Vver — Scronila-kickets— Convulsions ur Fits — Night 'I'ernjrs — l''rysipelas— Thrush — Ulceration of tlie Mouth — Summer Complaint Falling of the Howel — Constipation — Diarrho.'a — Colic — Hed-vvetting or Incontinence of Urine — Weanir.g Brash— Milk Crust or Infantile Salt Rheum or Infantile Eczima — Rupture or Hernia — Cancer— Swelling of the Glands of the Neck. Care of the Infant. Before birth the child is but a portion of the mother's body, enjoying the advantages of the protection and nourish- ment which she provides for herself. At birth the infant is deprived of these favoring inlluences and compelled to conduct an existence indc' pendent, to a large extent, of assistance from others, it is not surprising that the experiment is in man cases a failure ; that the tender little crea- ture, deprived of the warmth and shelter of the maternal body, and tiirown upon its own resources, compelled to eat, digest and breathe for itself, instead of having food and air furnished it as before, should suc- cumb to the unaccustomed influences, notwithstanding the most assidu- ous attention. The mortality among infants is accordingly large — one of ev.ly ten dies during the first month, and fifteen of every loo during the fust year. Many of those which have survived the first difficulties of life with the assistance of the mother's breast, die when they are com- pelled to surrender this aid and masticate their own food. Hence it happens that at the end of four years there remain alive but three out of every four infants born. Yet even without these figures it v.-ould be self- evident thai the new-born infant demands especial and intelligent care and attention. In the course of a few days after birth the navel-string, which has been at delivery enclosed under a flannel bandage, withers and falls off. If, before this happens, there be a decided odor of putrefaction, it is neces- sary to cleanse and dress the string somewhat frequently. It sometimes occurs that after the stump has dropped off the navel remains unhealed, raw, perhaps even ulcerated. If this occur, the matter should be brought at once to the attention of a physician, since the result may be serious injury to the child. For some weeks after birth this spot in the abdcm- inal wall remains weak, and may easily be made to protrude when the child strains, especially if the infant be addicted to violent crying and screaming. In such cases there may result a rupture, or hernia — a source of serious annoyance and even danger in subsequent years. To guard 202 h' t^iiL^i'tliJlj.' DISEASES OF CHILDREN. 203 jard against this, it is advisable in every case to place a soft pad over the navel and keep it bound on by means of a flannel bandage or adiiesive plaster. While the clothing of the child is to be regulated to a certain extent by the climate and seasoi., yet it will be fount! advantageous to place flannel next to its skin all the year round. The advantages comjjrise not only the maintenance of an eciuitabk; temperature, but also the ab- sorption of the secretions of the skin, which might otherwise be a source of irritation. The regulation acquires double im[)ortance in the case of those infants prematurely born, and, therefore, less capable of maintain- ing an independent temperature. A most important element in securing the well-being of the infant is strict cleanliness ; and in nothing else is the difference between an atten- tive and careless nurse more evident than in the m:uiagement of the nap- kms and in the protection of the child's skin from its own discharges. It may be, in general, stated that soreness and rawness about the child's thighs indicate neglect of cleanliness either of the infatu itself or of the napkins. So far as the child is concerned, there siiould be, and is usually, no difticulty, since the warm bath is everywhere procurable. It is, liow- ever, to be borne in mind, that the infant can be bathed to excess ; dur- ing the first weeks of its existence the child should not be put into the bath more than once a day, nor remain there more than two or three minutes ; feeble children must be bathed with still more caution, since the warm bath is (juite exhausting. Yet many infants which are regul- arly and carefully cleansed suffer, nevertheless, from soreness of the skin ; and many a mother applies industriously, but unsuccessfully, a variety of baby powders, and is puzzled to know why the child's skin remains sore. There is just one slovenly habit which is apparently responsible for much of the trouble of this sort : many mothers, namely, seem to consider that the napkins require washing only after being soiled ; and that if only wet they may be reapplied after drying by the stove. This idea, is, of course, a mistake, since the urine contains a number of sul> stanccs which are extremely irritating when applied to thc'skin; the napkins should be washed in one case as well as in the other. After the first ten or twelve days the child may be carried out thor- oughly wrapped up if the weather be properly warm (70° F.) ; and unless the inclemency of the season absolutely forbid it, the infant should re- ceive a daily airing and sunning as regularly as plants. Food. — It need hardly be repeated that the most appropriate and de- sirable nourishment for the new-born child is derived from the mother's breast ; yet it may with propriety be remarked that this nourishment is of itself amply SM^cient for a// the needs of the infant ; and that sugar and water, and a dozen other mixtures which are poured into the help- less child during the first few days of its life, may do harm, but can do no good. If the secretion of milk be delayed beyond the usual time 204 TIIK FAMILY PHYSICIAN. nothing should be given the child except a little water simply stained witli cream. So soon as the secretion is cstal)lishod there should be no further administration ot artificial food, 'llic best assurance of health to the child duriii;^ the (irst seven months of its existence, is an ample sup- ply of motlier's milk. In a considerable minority of cases, however, it becomes necessary, on account of some of the causes already indicated, that artificial food should be substituted entirely or in part for the breast. These are the cases which furnish so much sickness or mortality, es[)ecially in our larger cities. It must not be understood that artificial feeding implies in itself anything injurious to the child, but as ordinarily implied it is such a poor substitute for the natural food that the results are, as a rule, very unsatis- factory. With care and attention a bottle-fed infant may and often does enjoy the most robust health ; and there are certain combinations of artificial food which give, as a rule, excellent results as a substitute for mother's milk. Vet while physicians are accustomed to rely upon these substi- tutes, they are ec^ually well aware that there must be an adaptation of means to meet the lefiuiremcnts of individual cases ; that the effects upon the child, as indicated by the condition of his digestive organs, must be carefully observed, as an index to possible modifical'ions of diet, A food which may meet the requirement in four successive cases may re(iuire modification in the fifth ; and it is extremely important for moth- ers to realize the fact thai there is no such thing as a universal infants' food ; that the nourisjmient of infancy must vary, not only according to age and season, but also with individual peculiarities ; and that her vigilance may not be relaxed, so soon as she has obtained from a friend or physician a formula for preparing infants' food. The I ^est plan in every case in which difficulty is experienced is to place the matter in the hands of a physician, ^'et a few directions for the composition of food, which will in many cases answer all requirements, are appended : The simplest substitute for mother's milk is obtained by diluting cow's milk. The milk of the cow differs from that of woman in two essential details : It is considerably richer in solid constituents but contains less sugar. To approximate it to human milk it is merely necessary then to add a certain amount of water and sugar, preferably "milk sugar." The amount of dilution varies with the age of the infant ; since mother's milk is less rich in the early months of nursing than it subsequently becomes, a correspondingly greater amount of water must be added to the cow's milk to secure the proper consistence. The milk, as obtained from the cow should be mixed with its own bulk of water for a child one or two months old ; if the milk be obtained from a dealer it will rarely be neces- sary to add more than half its bulk of water ; the mixture may be sweet- ened with table sugar, or better with sugar, of milk. This preparation Qft.en atxswers admirably as a substitute for the mother's breast, especi. ally i the n DISEASES OF CHILDREN. 205 .g to cows :ntial less en to The milk ally in the country ; in large cities the plan is less often successful, since the milk cannot be obtained so fresh, and in warm weather at least, has always undergone fermentation whereby irritating compounds are formed. Yet it is oftentimes possible to obviate, to a certain extent, these disad- vantages by previously boiling the milk. Yet if it be impossible to secure fresh and pure cow's milk, it will be best to resort to one of several other modes of preparing artificial food. A very popular mixture, and one which has rendered valuable service, is an attem[)ted imitation of the natural composition of milk — a popular and ready form of Liebig's food. The ingredients required are : Malt, Flour, Skimmed milk, Bicarbonate ot potassium, Water, Ja ounce. Yz ounce. 6 ounces. 7 grains. I ounce. Malt should be crushed or ground in a coffee mill. All the ingredients may be mixed, i)ut into a clean pan, boiled for eight or ten minutes and constantly stirred ; then strained through an ordinary piece of muslin ; if the child must be fed from the very first, it will be desirable to increase the quantity of water in the above mixture to six ounces. After the first two or three weeks the (quantity named will be insufficient, as the child requires two or three teacupslul. The mixture tastes quite sweet ; no sugar should be employed. The disadvantage of this food is the neces- sity for this somewhat complicated preparation every twelve or twenty- four hours. A most satisfactory and generally applicable food can be obtained from arrow root and cream. Dr. Meigs, ot rhiladelphia, gives the following directions : " A scruple of gelatine (or a piece two inches square of the flat cake in which it is sold) is soaked for a short time in cold water and then boiled in half a pint of water until it dissolves — about ten or fifteen minutes. To this is added, with constant stirring, and just at the ter- mination of the boiling, the milk and arrow root, the latter being pre- viously mixed into a paste with a little cold water. After the addition of the milk and arrow root, and just before the removal from the fire, the cream is poured in and a moderate quantity of loaf sugar added. The proportions of milk cream and arrow root must depend on the age and digestive powers of the child. For a healthy infant less than a month old, I usually direct fror three to four ounces of milk, half an ounce to an ounce of cream, and a teaspoont'ul of arrowroot to half a pint of water. For older children, the quantity of milk and cream should be gradually increased to half or two-thirds milk and from one to two ounces of cream. I se.Jom increase the quantity of gelantine or arrow root." A still simpler food may prepared simply from arrow root and cream. Two teaspoonsful of arrow root are added to half a pint of water, 206 ttlE FAMILY PttYSICIAN. Stirred over the fire until pasty, and then strained ; a tablespoonful oi cream is then added and given warm. The most important feature in the success of artificial feeding is per- fect cleanUness of the bottles and tubes employed ; and only such bottles and tubes should be used which can be readily taken to pieces and thoroughly cleansed, from the point of the rubber nipple to the bottom of the bottle. A failure to observe this simple precaution will certainly vitiate any and all attempts at artificial feeding, whatever material be employed ; for there occurs fermentation in the milk and other matters collected at the joints and in the crevices of the feeding bottle ; and these I'l.'rmcntod matters passing into the child's stomach with the next instalment of food, must derange its digestion. For cleansing the bottles and tubes, warm water containing a little borax may be used. The success of the attempt to substitute artificial food will be ultimately measured by the welfare of the infant ; yet careful observation mav early indicate the imperlcctions of the method in use before the child's, xiealth has been seriously impaired. Perhaps the most important indications of lailure in the character of food are to be observed in the appearance of the infant's discharges, which should be always carefully inspected by the mother herself and not left entirely to the chance observation of the nurse. Indeed, it may be said as a general truth, that serious disorders of infancy — which are, in a majority ol cases, derangements of digestion and their consetjuences — might be often avoided if the appearance of un- natural stools were always regarded as a demand lor a careful supervision to the diet ; and this applies to children at the breast, as well as those ar- tificially nourished. In this way it would be often possible to avoid that scourge of infancy — summer complaint ; tiie first indications of this af- fection should be met not so much by medicines as by a regulation of the child's food and general management. Whether sustained by the breast or by arlificia! means, the infant will usually, in six or seven months, be able to digest other food also ; yet a mistake is often made in permitting the child to have such food at a ♦^^oo early date ; not infrequently a four months' bat)e is supplied with crackers and similar articles, while the mother wonders why the child is not well. As a rule, nothing should be given aside from the regular diet until the coini)ietion of the sixth or seventh month, and then it may not feed promiscuously upon whatever chances to be in its way, but must be gradually accustomed to the digestion of solid food. As a preparation, it may be well to give the child, even as early as the fourth or fifth month, some of the artificial food already mentioned, without, however, discon- tinuing the breast ; later, soups and broths — containing but little fat — may be administered in small quantities. The general principle should not be forgotten, that until the child has some teeth it cannot properly dispose of anything solid ; the attempt will almost certainly result in dis- aster to its alimentary organs. DISEASES OF CHILDREN. 207* Teething. This term is applied to the period at whicli the growth of the teeth causes their penetration through the covering of tiie gums. It IS understood, of course, that their develoinnent has begun at a period previous to birth, but their growth appears to have no particular influence on the general condition of the child until the commencement of the irritation caused by the protrusion of the teeth through the membrane covering the gums. This irritation is doubtless often the cause of troubles manifested in other parts of the body ; yet there is a too prevalent dis- position to ascribe all the ills which afflict babyhood during this period, to the process of teething. Any indisposition of the child, whatever its nature or wherever manifested, is often regarded merely as a manifesta- tion of the teething ])rocess, the evil result of which is that affections de- pendent upon other causes which might be detected and removed, are regarded as inevitable becgiuse the child is teething. The fact is, that many a child acquires its iliilk teeth without suffering any a[)preciable disturbance of its general health ; and that the troubles ascribed to teething are oftentimes the result of errors of diet and imi)roper man- agement, which originate quite independently of the teeth, and are mere ly aggravated by the effects of the irritation in the gum. The firsi teeth ordinarily appear during the sixth and seventh month, though there may be variations of several months cither way. In fact, instances are recorded in which some teeth have been cut before birth. If there be any irritation, it is often manifested some weeks before the tooth becomes visible — in which fact lies sometimes the explanation of an unusual fretfulness. It is desirable to know and note the periods at which the teeth appear, since in order to avoid the complication of teeth- ing, the child should be weaned at one of the longer intervals. The teeth ordinarily a[)[)ear in a certain order, and at regular periods, which may be grouped as follows: First, The first to appear are usually the two middle teeth of the lower jaw, technically called incisors ; this ordin- arily happens in the course of the seventh month. Second. After a pause of one or two months the corresponding teeth of the upper jaw appear, usually followed, after a short interval, by two more, one on either side of the two central teeth. Third. There now occurs a pause of six or ten weeks. It is during this pause, while the child is quite free from any irritation of the gums, that weaning is ordinarily advisable. This pause occurs, it will be noticed, during the tenth and eleventh month. Fourth. At the completion of the first year there usually ap- pear the first grinding teeth. Fifth. At about the eighteenth month, the eye-teeth appear, ordinarily* in the upper jaw first. Sixth. The full set of twenty teeth is completed during the early part of the third year, by the appearance of the remaining grinding teeth, or molars. So long as the process of teething proceeds naturally, and causes noth- ing more than restlessness, or perhaps even slight fever, no interference is demanded. The advance of the tooth into and through the gum is, i i I 208 THE FAMILY PHYSICIAN. of necessity, slow, but cannot be hastened by recourse to the lancet. There are cases in which, undoubtedly, the gums should be lanced ; but it is just as certain that the early and frequent use of the lai)cet is undesirable. We may say, in general, that the gum should be lanced, first, when the child is evidently in pain, and the tooth is so nearly through that a slight incision will relieve the tension of the gum ; sec- ond, when the gums are hot, tender, swollen and full of blood, in which case an incision, even if it do not remove an obstacle to the progress of the tooth, will nevertheless relieve the congestion of the part ; third, when the irritation in the gum is so great as to disturb the child's nervous sys- tem, including, perhaps, convulsions. In this case, even though the gums be net obviously swollen, an incision will often relieve the difficulty entirely. Weaning. The separation of the child from the breast is an epoch in its existence which is often attended by more or less constitutional disturbance. The time at which this separation should occur may be fixed by some unforseen conditions which render the mother incapable of providing sufficient and proper nourishment for her offspring. Such circumstances may arise at any time, and imperatively require that wean- ing occur at once. Yet, under ordinary circumstances, considerable latitude is allowed as to the choice of the time at which nursing shall cease. It might be, and by some has been, assumed that the child should be more or less sustained by the mother until it has acquired a complete set of teeth • and it does sometimes happen that nursing is continued for two years. Another inducement for prolonged nursing is the protection ♦hereby afforded to a greater or less extent against concep- tion. This hope has indaced many a mother to prolong lactation be- yond the usual limit. While it is impossible to continue nursing for an indefinite time, yet a variety of considerations indicate that the best per- iod for weaning is usually between the tenth and thirteenth months ; though, as will be presently explained, circumstances may require a cer- tain departure from this rule. The first consideration must be the health of the child and of the mother. Now, as a rule, the infant begins to ta'iie o'Jier food than the breast as early as the seventh or eighth month, and usually becomes largely independent of the mother by the tenth or twelfth month. Uy this time, too, the quality of the milk has usually de- teriorated, so that even though nursing be continued, the mother's milk furnishes but a part — usually a small part — of the infant's nourishment ; at the same time the mother's health is often unequal to the task of fur- nishing so much nutriment in addition to that required for her own body. By the end of the first year, therefore, the child is usually abundantly able to digest its own food, while the mother should be relieved from the additional and no longer essential burden ; and since there occurs during the last two months of this time, an interval of complete freedom from the annoyance of teething, it will be, as a rule, found advisable to DISEASES OF CHILDREN. 209 wean the cliild during the eleventh or twelfth month of its life. Yet this is ijy no means an inviolable rule ; indeed, there are circumstances under which a prolongation of nursing is advisable in the interest of the child. It may be stated, as a general principle, that the child should not be weaned while some of its teeth are cutting through, nor just be- fore the hoi weather of summer. If, therefore, an infant be an excep- tion, m that these months of the first year are employed in teething; or if the child have been born in the early summer it will be advisable, as a rule, to postpone weuning until the objectionable circumstances he re- moved. So, too, it is nec-essary to postpone weaning until any ailment which may hapi)cn to affect the child — even if only an ordinary -.'atarrh — shall subside. If, in conscfjuence of inabilitv on the part of the mother, it become necessary to wean the child during any such circum- stances, it may be desirable to procure a wet-nurse. As to tlie i)rocess of weaning, but litde need be said, except that it should be gradual ; that an interference with the child's health is far less probable by this plan than if nursing be suddenly discontinued. By with- holding the breast altogether at night, and by substituting artificial food on certain occasions during the day, the infant may be accustomed to the new regime without appreciable inconvenience or bodily disturbance. If weaning be postponed until the end of the first year the mother will rarely have any difliculty with the breasts. The gradual decrease in the demand upon them will usually be accompanied by a corresponding do- crease in their activity. The breast-pump should not be used ; it will rarely be necessary to adopt any other measures than simple friction with c.imphorated or sweet oil. Worms. Woinis are parasitical animals which infest the intestinal canal of man. They arc of five different kinds — the Ascarides, or small thread-worms, varying from an eighth of an inch to one and a-half inches in length, and having usually their seat in the rectum, or last gut ; the Lumbricie or long round worms, from two or three to ten or more inches in length, and usually occu[)ying the small intestines, and sometimes the stomach ; the 'iVichuris, or long, hair tailed thread worm, occupying the ciecum ; and the Taenia, or tape worm, of which there arc tv/o kinds, occupying the whole tract of the intestines, and sometimes thirty or forty feet in length. Although adults are subject to this complaint, it is most common in children. Sy?>ipioms. — Fetid breath, grinding of the teeth during sleep, picking the nose, paleness of the face, acid eructations, swelling of a portion of the belly, which is there hard and tender ; gripings, variable appetite, great irritability and itching of the lower parts ot the body ; short, dry cough ; emaciation, slow fever, increasing towards night ; irregular pulse, and liability to convulsions. N * , ■i :i'."'« 210 THE FAMILY PHYSICIAN. f Treatment, — A dose of castor oil, exercise in the open air, wholesome diet, and a strict prohibition of uncooked fruit, and raw and green vege- tables ; salt to be taken with all the food eaten. Any of the following remedies may be used, according to circumstan- ces : Grey powder, - - - - 24 grains. Santouine, - - - -12 grains. Mix and divide into 1 2 powders. Take one each night at bedtime until the worms are passed. Dr. Wylie, Oil of Turpentine, - - - V^ ounce. Castor oil, - - - - i J^ ounces. Take 2 teaspoonsful at bedtime. Wormseed Tea. Take of Fr°sh wormseed leaves, Milk, I ounce. 1 pint. Boil with a little orange peel. Dose, a wineglassful, morning and evening, for the expulsion of worms from the bowels. Croup. This is an inflammation of the larynx and trachea, causing a difficulty of breathing, and a rough, hoarse cough, with a sonorous in- spiration of a very peculiar character, sounding as if the air was passing through a metallic tube. It most usually attacks children of from one to three years of age, to whom it sometimes proves fatul ; very rarely are adults affected by it. Sympioffts. — The symptoms are merely those of a common cold, or catarrh ; then comes on a dry cough, with hoarseness and wheezing ; at night there is restlessness and rattling in the throat, aftendvhich the croupy crow and sound above spoken of gives unmistakable warning of the disease, which goes on increasing in intensity for a day or two, or perhaps several days, before there is a really alarming paroxysm, which mostly occurs about midnight. The child, after tossing restlessly about, endeavoring in vain to sleep, will start up with a flushed face, protruding eyeballs, and a distressing look of terror and anxiety ; there is a quick vibrating pulse, and agitation of the whole frame, which presently be- comes covered with a profuse perspiration. As the struggle for breath proceeds, there is clutching of the throat, as though to force a passage ; the arms are thrown wildly about, the respiration becomes more labored, the rough cough more frequent, and the characteristic croup rings out like an alarm. There is expectoration of viscid matter, but so difficult is it to be got rid of, that the efforts appear to threaten strangulation ; gradually the symptoms become weaker, and eventually the child falls into the sleep of exhaustion. It will probably wake up refreshed, and DISEASES OF CHILDREN. 2IX during the day may appear pretty well ; but at night again, probably there will be a recurrence of the attack with aggravated symptoms, con- vulsions, spasms of the glottis, causing the head to be violently thrown back, in the effort to obtain a passage for the air through the wind-pipe ; there is a fluttering motion in the nostrils, the face is puffed, and of a pale leaden hue ; a film comes over the sunken eyes, the pulse becomes feeble and irregular ; there are more gasping convulsive efforts to con- tinue the struggle, but in vain ; the powers ot life at Icngih succumb, and the patient sinks into a drowsy stupor, which ends in death. Such is the frequent course of this painful disease, and the changes from bad to worse are so rapid that there is little time !or the operation of remedies, that is, when paroxysms have begun. Treatine7it. — Confinement to the house, in case of threatened croup, is always advisable, unless the weather should be very warm and open, and then exposure after sundown should be avoided ; a dose of calomel (about three grains) should be administered, and followed by nauseating doses of tartarized antimony, of which one grain dissolved in an ounce of warm water, and a teaspoonful of the solution given every (juarter of an hour, until the effect is produced. Should the bowels be confined after this, give senna mixture, or scammony powder. Apply mustard and bran, or flaxseed poultices, to the fchroat. Fill the room with the vapor of boiling water — a large kettle on the stove will effect this. Leeches, if the patient is of full habit and the breathing is very labored, and a spare diet, are the other remedial measures. In the paroxysms, the most prompt and vigorous measures must be adopted to give any chance of success ; strong emetics to cause full vom- iting, which often has a most beneficial effect ; Nvarm baths and blisters applied from one ear to the other. Calomel combined with ipecacuanha powder, or tartar emetic, should be given every four hours or so ; and, if the danger is extreme, counter irritation by means of mustard poultices applied to the calves of the legs, c\:c. In leeching for croup, one leech for each year of the child's age is the general rule to be observed, and the best part is over the breast 'bone, where pressure can be applied to stop the bleeding, if required ; over the leech-bites apply a blister, should one appear necessary. If the above powders should cause too violent an act on the bowels, add to them a little chalk and opium. Should the child appear likely to sink from exhaustion, after vomiting has been p'-oduced, stay the emetics, and give liquor of acetate of ammonia twenty drops, with five or ten drops of sal volatile, or the same of brandy in a little water, or camphor mixture, a little white wine whey may also be admin- istered. Of course, the first endeavor in an attack of croup should be to obtain medical assistance ; but if this can not be procured there must be no temporizing : resort at once to the remedies most ready to the hand, using them to the best knowledge and discretion available. Let ]the contagious nature of croup be ever borne in mind, and especial care I ^ 212 THE FAMILY PHYSICIAN. ' 3 I :i hi V II t taken to keep apart those affected with it from any other children in the family or house. Let it also be r membcred that the great agents in producing croup are cold and moisture ; and the greatest of all the east wind, and that those who have once been attacked by it are peculiarly liable to a recurrence of such attack. Croup is most likely to be fatal when inflammation commences in the fauces ; and this, if discovered in time, may be stopi)ed by the applica- tion of a solution of nitrate of silver to the whole surface within sight, and to the larynx. The following is highly recommended even in the worst forms of true croup : Chlorate of Potash, - - - - 2 drachms. Syrup of Lemon, - - - - i ounce. Water, - - - ■ • " 3 ounces. Dose, according to age; if under 2 years, ateaspoonful ; from two to ten, 2 teas})oonsiul ; over ten, a tablespoonful, given every 3 hours, or every half hour in urgent cases. Dr. T. M. Drysdaie. When the child is much exhausted, in addition to the above give Acetic Ether, Camphor, 3 drachms. 10 grains. Mix, and take 10 to 15 drops every quarter of an hour. Dr. Niemeyer, Spasm of the Glottis or Child-Crowing. 1'his exhibits much the same symptoms as the croup. It is not, however, of an inflammatory character, but is symptomatic of some other disease commonly coming on as a result of irritation caused by hydrocephalus, teething, worms, &c. The medical man only can judge of the probable cause, and he will use such remedies as are most applicable to the peculiarity of each case. Treatment. — The following mode of treatment recommended by Dr. Leman, ot Torzan, has, we believe, been found efficacious in many cases of croup. It is simple and easy of application. We give the details as furnished by Dr. Graves : "A sponge, about the size of a large fist, dipped in water as hot as the hand can l^ear, must be gently squeezed half dry, and instantly applied under the little sufferer's chin under the larynx and windpipe ; when the sponge has been thus held for a lew minutes in contact with the skin, its temperature begins t*^ sink ) a sec- ond sponge, heated in the same way, should be used alternately with the first. A perseverance in this plan during ten or twenty minutes, pro- duces a vivid redness over the whole front of the throat, just as if a strong sinapism had been applied ; this redness must not be attended or fol- lowed by vesications. In the meantime the whole system feels the in- DISEASES OF CHILDREN. 213 yer, much iatory )ming ,&c. I use e. Dr. cases Is as e fist, eezcd er the a lew a sec- ith the s, pro- strong or fol- the in- fluence of the topical treatment ; a warm perspiration breaks out, which should be well encouraged by warm drinks, such as wliey, weak tea, &:c., and a notable diminution takes place in the frequency and time of the cough, while the hoarseness almost disappears, and the rough ringing sound of the voice subsides, along with the difficulty of breathing and restlessness ; in short, all danger is over, and the little patient again falls asleep, and awakes in the morning without any appearance of having suffered from so dangerous an attack. I have repeatedly treated the dis- ease on this plan, and with the most uniform success. It is, however, only applicable to the very onset of the disease ; but it has the advantage of being simple, efficient, and easily put in practice, and its effects are not productive of the least injury to the constitution." Snuffles, or Cold in the Head. Children are very liable to this distressing complaint, caused by inflammation of the lining of the nose. Treatment. — Rubbing the nose with goose-grease, lard or tallow, will generally give relief Keep the bowels open with a little castor-oil ;and, if the stoppage in the nose is obstinate, give warm doses of catnip, penny-royal, or balm tea. St. Vitus' Dance. This is also known as chorea. Cause. — Chorea generally occurs in debilitated children, especially girls from the age of eight to fifteen, or when puberty commences, the oc- currence of which often appears to art as a cure of the trouble. It re- sults frequently from rheumatism in the acute form, from general debility, flight, excitement, fatigue, great mental effort. Symptotns. — It is characterized by incessant movements of the hands, the feet, the face, the tongue, in fact, of the whole body. These are ir- regular,, and appear beyond the control of the patient. They interfere with walking, working, and speech, but cease entirely during sleep. Treatment. — It is well, if possible, to ascertain the cause and remove it. If the disease is due to rheumatism the patient should be put on anti-rheumatic treatment (see Rheumatism). The bowels must be kept freely open, and the child kept as much in the open air as possible, and the general health improved by exercise, good food and, if necessary, tonics. In addition to these measures the most successlul drug to be used is Arsenic, in the form of the Arsenical Solution, beginning with doses of 2 drops three times daily and gradually increasing it to 10 drops. This is the treatment used by Dr. Eustace Smith. Another excellent treatment is : — Bromide of Zinc, - - - i drachm. Simple Syrup, - - - - i ounce. Take 6 drops three times daily, gradually increasmg it. Dr. Hammond. Scarlatina, Measles and Small Pox are diseases not wholly confined to children and have been already described. When they oc- It; ■i .)■•. 2t4 titE f AMILY rilYSlCIAN. cur in children great care .should lie taken when the patient is recovering or the result may be serious. The child should be kept warm in bed until the last trace of the disease has disapp'cared, and only when the child is fully recovered should it be allowed to leave its room ; and even then a close watch should be kci)t that no untoward symptoms arise. The same medicines may be used in the treatment of these diseases in childhood as are used for adults with, of course, smaller doses. For the proper doses for different ages see the section of this book headed "Weights and Measures, etc. ' Chicken Pox. {Varicella). — Chicken pox is a very mild form of eruptive disease, which affects a jierson but once in a life-time, and which can generally be traced to specific contagion or infection ; it is mostly confined to children. Syviptovis. — It is preceded — in most cases, but not in all — by slight fever, which lasts for one or two days before the eruption appears, which at first is in the form of conical pimples with a white head, mostly on the shoulders, breast, and neck, and more sparingly over the face and body generally. These vesicles, on the second day, ai:)pear like little globular blisters, but with little or no surrounding inflammation ; they now become filled with a watery fluid, which is not converted into pus, as in small pox — to the milder kind of which this disease bears some re- semblance — and, about the fifth day, the bladders shrivel up and dry away, leaving only crusts or scales. The main distinctions between chicken pox and small pox are the absence or extreme mildness of the premonitory fever in the former disease, and the form and contents of the vesicles ; those of the latter eruption being filled with dark matter, and having invariably, a depression in the centre. Treatment, — On the first appearance of the eruption, the patient should be put upon spare diet ; this, and a dose or two of some cooling aperient, as rhubarb or magnesia, is generally all that is necessary ; but should the febrile symptoms run high, give a saline draught as the following : Carbonate of Potash, Citric or Tartaric Acid, Essence of Cinnamon, Syrup of Orange Teel, Water, I scruple. 15 grains. Y2, drachm. I drachm. 10 ounces. Shake, and drink while sparkling a wineglassful as a refrigerant. To make it effervescing, add the acid after the draught is poured out. Give plenty of cooling drink, and, if the bowels are at all obstinate, emollient injections. Care must be taken th.at the skin is not irritated by some- thing — as if it is, painful and troublesome sores may be produced — and also that the patient does not take a chill. If these precautions are ob- served, little or no danger is to be apprehended from chicken pox. DISEASES OF CHILDREN. 215 Infantile Remittent Fever. Known Also a■■ mSEASES OF CHILDREN. 219 wer of iwn in is ob- mvcni- The nc arc , being rcssure esultin of the nt care, e, Ircsh jrly pro- )le, and ndency, sunlight 5 in im- ncnt, in id. For se, is the igetables ;raUy ac- /luch de- ed when l^uent ac- In addi- too large curs, and le vicinity er used is se. This t is hoped ^ded, and those who ;ven more :h persons t of^en re- 1 to obtain n the mis- hly known a draught, lly opening a window, and interi>osing a screen, as a cliair wilh a shawl thrown over it, to prevent the direct current of air. Overcrowded ;ii);\rlineiits nuist be strictly interdictetl, whether by night or day, in the dwelling or the workroom. When possible, the patient should i)C removed to a hcallhy locality, an atmosphere of a dry and elevated situation, in the country or at the sea-side. Exercise in the open air must be regular, and never omitted excei^t in the most inclement weather. This may be on horse- back, in an easy carriage, walking, etc. If so arranged as to be comt)ined with pleasant recreation, so as to aid in the development of the muscles, greater benefit will be obtained. Fatigue should not be allow- ed, hence the sports, etc., must be watched and controlled, to prevent excesses. liathing is a valuable adjunct, keeping the skin in ])roper con ition, and thus enabling it to throw off disease. If the i)atient is easily chilled, warm bathing is preferable, and promotes the circulation. Otherwise, the tepid bath may be employed. Sponging, followed by friction with coarse towels, or towels dipped in salt water and allowed to dry, is very useful. When at the sea-shore, bathing must be practised, but its results must be watched, lest a chill follow, and thus undo all the good accom- [)lishcd. Rarely is the cold bath of service. Almost always it is followed by a want of reaction, causing more or less congestion of the more delicate organs, and hence it proves positively hurtful. With some, a cold bath daily, to an infant, is regarded as a means of invigoration, a hardening process, which too often results in the death of its victim. It is pleasant to know that fashion is at last l)ccoming more reason- able, and permits her votaries to dress their children according to the dictates of good sense and propriety. The child should be fuUy pro- tected against chilliness, especially in a climate liable to sudden changes. In summer, the clothing should be light, avoiding cither extreme, as often a child is kept in a state of perspiration in warm weather for want of a little attention. Flannel next the skin, protecting the chest and bowels, should be worn until the warm weather has fully set in, and then should be substituted by some of the finer textures until all danger of sudden changes are past, or these may be continued during the balance of the year. As to medicine, this must be the last resort, and at first should be of the mildest nature. The bowels should be regulated by mild aperients, or, when indicated by clay-colored passages, those which arouse the liver may be employed, such as small doses of rhubarb, magnesia, calomel, blue pill, senna, or jalap. To improve the digest'on, the blood, etc, some form of iron will be of value, and here it will be important to find, by observation, which pre- paration is most appropriate — the syrup of iodide, ten drops, three times a day, the tincture of the chloride, five drops, three times a day, the 220 THE FAMILY PHYSICIAN. it r I potassio tartrate, or tlv"^ pure powder of iron. Either of these may be conibined with quinine, or cinchona, as in its agreeable form of elixir, which is most readily taken by children. Symptoms must be met as they arise. If the bowels are much affected, a special point will be the avoidance of exercise and the upright position ; rest, in bed, is of the utmost value in the treatment of all lorms of diarrhcua. l>ut frictions to the entire surface, once or twice each day, should not be omitted. The appetite may be restored by the use of mild bilier infusions, as chamomile, columba, or cinchona. Animal fats are highly useful in such cases. Hence the value of cod-liver oil ; and if to this we add the syrup of iodide of iron, or some other of the preparations now so happily pre- pared by the skill of the chemist, the results will be still more bene- ficial. Such remedies require many months to obtain their full and last- ing effects. In enlargements of the glands of the abdomen, added to the above treatment should be the application of iodine to the surface ; this may be by the use of the tincture, or of the ointment. The same may be said of enlarged joints, with the addition of perfect rest of the part. Recently a variety of remedies have been introduced, as iodized milk, made by dissolving one part of iodine in ten alcohol, and mixed with ninety of fresh cow's milk. All enlargements of glands may be painted with the tincture of iodine, or coated with the iodine ointment. In inflammation of the bones, an ointment of carbonate of lead, freely applied over the seat of disease, often acts to arrest its progress. Burdock tea is an old and valuable domestic remedy in this complaint. The following will be found of great value in this disease : Sulphide of Calcium, - Water, Take a teaspoonful every hour. I gram, lo ounces. Dr. S. Ringer. Rickets, technically known as Rachitis, is a want of nutrition of the bones and muscles, causing bending or breaking of the bones from slight injuries ; muscular weakness ; crooked limbs ; curvature of the spine ; nervous irritability ; general tenderness, etc. Cause. — Perha[)s the usual cause of this disease is want of food, or food of improper kind. It would also appear to be the result of bad ventilation, and want of sunlight. A distinguished observer declares "that wherever the rachitic child is dependent upon the mother's milk, the mother will be found to have menstruated during lactation, regular- ly, for several months, and the degree of rachitis to be in direct ratio to DISEASES OF CHILDREN. 221 the frequency, duration, and amount of the menstrual flow." In short, the disease is the result of anything which impairs nutrition. Treatment. — Children with a tendency to rickets exhibit in their whole bony structure unmistakable evidences of the disease. The lace is broad and square ; the head is large and flat ; the moulds or openings in the skull do not close until late ; the veins are prominent ; the spine is curved ; the limbs, especially the lower extremities, are bowed, shorten- ing the child so as to give it a squat appearance ; the muscles are feeble ; the child is generally deficient in vigor, mental as well as physical ; the skin is-thick, and of a dirty appearance; the teeth are late in appearing, and the child rarely can walk or even stand, until long after the usual time. The child is spiritless, dull, languid; the appetite is poor; the flesh is flabby ; the passages from the bowels are loose, dirty looking, and offensive ; perspiration occurs at night, and often this is excessive ; the child gains no power over its muscles, and requires help in all its movements, though at first the muscles do not seem wasted, and preserve their contour. As the disease advances, the mental and physical powers retrograde, and a glance at the child, with its deficient mental powers, its crooked limbs, unsightly joints, and the shape of its chest, shows the whole trouble. The glands often become enlarged, as in its congener, scrofula, but are softer, much larger, and not so easily moved as in scrofulous cases. Death occurs from exhaustion, the powers of vitality being unable to carry the system to a favorable termination ; or death may ensue from some complication, as hydrocephalus, diarrhuea, convulsions, incurable changes in the larger glands, as the liver, spleen, etc. Treatment. — With a full knowledge of the causes inducing this affec- tion, and of the nature of its changes, it is easily understood what would be the special line of treatment. In the early stages, when the patient is so fortunate as to come under the proper observation, much may be done to prevent its full development, and ward off the possible compli- cations. The nourishment must be positive and of ea^iy digestion. The greatest care must be observed, to see that food is given at proper inter- vals, and in sufficient quantity, as well as of a proper kind. Too much stress cannot be laid upon the value of pure cow's milk for children, after weaning, or in the event of a failure ot the breast-milk Of course, the mother's milk, or that of a healthy young person, is to be preferred in all cases where it is possible to be obtained. Combined with milk, other articles are valuable, as eggs, in the form of custard, or soft-boiled, rice, farina, corn starch, roasted potatoes, meats, etc. The same observations apply here as in scrofula, as the great point is to remedy the difficulty by properly nourishing the bones, etc. All exhausting discharges, as diarrl.cea, etc.; all complications, as in- digestion, constipation, etc., must be met as they arise, with the appro- f i 222 THE FAMILY PHYSICIAN. priate remedies heretofore indicated. The constitution must be toned up, strengthened, by tepid baths, sea-bathing, fresh air, always that of the country or seashore, if obtainable ; tonics, as the preparations of iron, cod-hvcr oil ; bone itself, as fine filings of fresh bones, in milk, or rice- milk. Chalk mixture will generally relieve the diarrhoea ; and if the stools are offensive, castor oil may be given to cleanse the bowels, and then astringents such as Tincture of Colomba, Deodorated tincture of Opium, - 'ake half a teaspoonful in water before meals. 15 drachms. I drachm. Dr. Bartholow. A valuable aid in changing the character of the evacuations, is the ad- dition of a few drops of the solution of chlorinated soda to each dose of the diarrh(ea mixture. ()uinine, in combination with iron, as the potas- sio-tartrate of iron, in cinchona tea, or the tincture of the chloride of iron, acts as well as a tonic. In many instances, the dilute acids combined with a bitter, act well in toning up the muscular system. Thus, the dil- ute nitro-muriatic acid, two to five drops, in gentian, columba, cascarilla, or cinchona tea, checks the excessive perspiration, strengthens the di- gestion, and, in fact, improves the whole system. Occasionally, when the treatment is commenced at a late period, rest will become necessary, to prevent curvature of the limbs becoming greater, or great deformity of the spine, resulting from the softened con- dition of the sniviU bones comprising the spinal column. This rest must be in a recumbent position, but must be combined with daily excursions into the open air. Or some form of apparatus may be employed to sup- port the part until the bones have acquired sufficient hardness. Thus, when the seat of the affection is at the bones of the neck, the weight of the head may be taken from the bones by means of an anpropriate sling, suspending the head from a bowed piece connected with an apparatus placed around the chest. Each deformity, or tendency thereto, will re- quire its own apparatus, varied to meet the indications. IIoiv Frcvcnted, — A child manifesting a tendency to rickets should be kept from an erect position, or the early use of its feet, until the bones have iissumed a proper degree of hardness. Violent exercise, in older children, should be interdicted. Cleanliness, ventilation, full nutrition, arc the prerequisites for the prevention of this affection, as well as the aids in its cure when it is established. Sunlight deprivation is too often a main exciting cause of this, as well as other diseases of children. Hence, our legislators would show their wisodm by prohibiting the build- ing of houses, as dwellings, in the rear of tall factories, as well as upon streets of such narrowness as to preclude the entrance of the sun's rays, if at all, but for a short period of each clear day, DISEASES OF CHILDREN. 7,21 jned up, t of the ; of iron, or rice- id if the rels, and s. ^holow. is the ad- ti dose of he potas- e of iron, :ombined s, the dil- :ascarilla, IS the di- :riod, rest jecoming ned con- rest must xcursions id to sup- !. Thus, weight of iate shng, apparatus ;o, will re- should be the bones ;, in older nutrition, veil as the too often children, the build- 11 as upon sun's rays, Convulsions, Fits, Spasms. Fits are cerebral, and arise from disease within the head, or from irritation in the stomach and bowels, or from exhaustion ; or they are evidence of, and depend on, some mal- formation or disease of the heart. Treatment. — The treatment must be directed, during a convulsion, to the shortening of it, and care in preventing injury to the head or limbs by the struggles. All tight clothing should be loosened, or better, en- tirely removed. The child should then be placed in a warm bath, to which mustard may be added ; during this time cold should be applied to the head, either by cloths saturated, or by the douche, or by the use of a bladder filled with crushed ice. Should this fail to relieve the spasm, the child should be placed upon a coucii, and a mustard plaster placed the whole length of the spine, extending on either side for an inch or two. Jl^. decided impression must be made before this is removed. If there ji reason to believe that foreign matters in the stomach are acting to prolong the attack, a brisk emetic, ipecacuanha, tartar emetic, sul- phate of zinc, should be given, and its effect encouraged by the use of draughts of hot water with salt or mustard. Injections should be thrown into the bowel, of salt and hot water, castor oil, oil of turpentine, to stim- ulate the action of the bowel, and act as a revulsive to draw the blood from the brain. In obstinate cases, convulsions may be broken up by inhalation of ether or chloroform. In rare cases, with a strong tendency to a return of the convulsions, the effect of the drugs may be continued until all such symptoms disappear. Of course, it would scarcely be necessary to make the artificial sleep very complete, only sufficient to control the convulsion. Chloral, by injection into the bowel, certainly has proved of value in these cases ; a teaspoonful in a pint of water, of which a gill may be thrown up in a child often. In the interval, or after the spasm has gone off, the indication will be to prevent its return and relieve any accompanying symptoms, or treat whatever disease may be thus ushered in. The bowels should be freely moved ; the stomach thoroughly emptied, the teeth lanced, if necessary ; restlessness subdued by narcotics, as, above all, chloral. Worms may be expelled by the appropriate medication ; fever lessened by sponging with tepid water, and cold applications to the head ; the force of the circulation diminished by small drafts of digitalis tea, a teaspoonful of the leaves to a quart of water. If there are marked evidences of a ful- ness of blood in the brain, leeches behind the ears, to the nape of the neck, or temples, will rarely fail to give great relief. In obstinate cases, a blister to the back of the neck, extending up and down, and allowed to draw well, will prove of great benefit. Other complications should be met as they occur, and treated in ac- cordance with the principles laid down. Night Terrors, and excessive nervousness, arc of frerjuent occur- rence in childhood. Frights to children often terminate in convulsions, ■Il1' •MiKummiim^ t 224 THE FAMILY PHYSICIAN. imbecilify, or death. Tliose who have the care of children should he especially on their guard to use every endeavor to prevent frights, and to protect against the loolish habit of working on the fears of a child to make it behave properly. Not only is this very injurious, but it is liable to make children deceivers and liars, and its evil results often cling to them when grown to adult age. On the contrary, children should be kindly encouraged, and made to feel the protecting care of those around thcni. They should be constantly shown the absence of all danger. A child will often sufo)iis. — The child is observed to suffer greatly, and examination reveals the presence of a red tumor at the opening, which is generally easily pushed l)ack. If allowed to remain down long, it becomes stran- gulated, and gorged with blood, inflames, and may even ulcerate or be- come mortined. Trcafnictit. — The reduction should be performed at once, by anoint- ing the parts with sweet oil, lard, etc., and then gently pressing it back, and being sure to see that it is com[)!etely returned, and no portion al- lowed to remnin grasped by the sphincter or lower muscle controlling the opening of the bowel. If it is constantly recurring", an injection may be thrown into the bowel, consisting of bismuth and catechu. In cases where the part is much engorged and difficult to rclu'n, the free use of cold water to the part will relieve it, or a few leeches may be ai)plied be- fore any effort is made to return it. The parts may then be washed fre- quently with astringent lotions, as strong alum water ; a decoction of white oak bark ; or the two may be combined ; or a decoction of galls may be used. The accident must be prevented by keeping the bowels relaxed by proper food, fruit, etc., and by careful attention at the time of having an operation of the bowels. In severe cases, it becomes necessary to retain the bowel in place by a pad or compress held on by a bandage. It is proposed to reduce the size of the opening, and thus retain tfie bowel, by removing a portion of the projecting folds. This has proved successful iit;\ some cases, but of course requires the hand of a competent surgeon. :ss DISEASES OF CHILDREN. 231 Constipation. Torpor of the bowels and consequent costivencss is of frequent occurrence among infants. In some instances the l)owcls always require to be excited by artificial means. In constitutional cos- tiveness, a [jcriod of from two to four days may intervene between stools without the child receiving any great injury, but it is prudent to watch such symi)toms, especially where there is any tendency to convulsive affections. lycatnicnt. — Manna dissolved in warm water to the consistency of a thick syrui) is a good laxative, in teas[)oonful doses. Costivencss from accidental causes is a more serious com[)laint. These causes may be a preternatural determination of the blood to the head, or an undue ex- liibition of opiates, or a rice diet, or unhealthy milk. Cold-pressed castor-oil is an excellent laxative in ordinary cases of this kind ; if acidity be present, magnesia is the appropriate laxative. In moderate cases^ the introduction of a soap suppository into the anus will be of service. Diarrhoea. Diarrhoea is more common during infancy than at any other i)eriod of life; and it is also more apt to assume an unmanageable and dangerous character at this period than at a more advanced stage of childhood or adult a^e. Causes. — The exciting causes of this disease arc extremely various. Irritating, crude, and ina[)pr()priate articles of food or drink, are a fre- quent cause ofdiarrh(ea. Children who arc entirely nourished at the breast are much less liable to this complaint than such as arc partly nour- ished by artificial food. Some infants are in\ariably purged when fed with cow's milk, even when considerably diluted with water ; others again arc purged by arrowroot, although the usual effects of this sub- stance are rather of a constipating character. Inf:ints who are fed with solid food seldom escape suffermg more or less diarrhcea. The practice of allowing them to gorge themselves with potatoes, meat, pastry, dried fruit, and other articles of this kind is particularly injurious, and often produces chronic diarrhoea. In some instances the mother's or nurse's milk gives rise to vomiting and purging. Cold, by suddenly checking perspiration, and determining the blood to the internal p^arts, frequently gives rise to bowel complaint in infants. Cold bathing, or washing ; 'suffering wet diapers, stockings, etc., to remain too long on the infant j setting it down on the grass-plots, floors, steps, etc. ; passing suddenly from a close and warm room into the cold external air ; exposure to cold and moist weather without sufficient clothing, particularly about ''^r abdomen ; — these are the ordinary ways in which diarrhcea, from the . .- fluence 6f cold, is produced in infants ; and cases arising from such causes are generally attended with catarrhal symptoms, more especially with cough. A high atmospheric temperature is frequently concerned in the production of this complaint ; the occurrence of bowel-com- plaints among children is comparably more frequent during the hot months of summer than in the colder seasons of the year. \ -■T 232 THE FAMILY rilYSICIAN. Treatment. — Immediate attention must be paid to the diet. Do not give the child any sohd food, and especially keep from it pastry, sweet- meats, and confectionary. The most appropriate food willbcj^lain boiled rice and milk; in many cases simple boiled milk will arrest the discharges. Crackers and milk, gruel, tapioca, etc., arc also useful. At the com- mencement of the attack give a mild purge of castor-oil or syrup of rhubarb, and use the warm bath. If the stools are sour, dissolve a tea- spoonful of bircarbonatc of soda in half a glass of water, and give a tea- spoonful every hour. An excellent remedy for looseness of the bowels is tea made of ground bayberry. Sweeten it well, and give a half tea- cupful once in two hours, until the child is better. Following are two excellent preparations in the Diarrhcea of children : Infusion of Rhubarb, Bicarbonate of Potash, Tincture of Cinnamon, Simple Syrup, Take a teaspoonful every two hours. 2 ounces. - I drachm. - 2 drachms. - 6 drachms. Dr. Faiquharson. When the l^iarrhuca becomes chronic use Nitrate of Silver, - - - i to J'^ of a grain. Distilled water, • - - i ounce. Simple Syrup, - • • - 5 drachms. Mix, and take a teaspoonful every 3, 4 or 5 hours during the day. Dr. Trousseau. Colic, or Gripes, in children, is a disease of constant occurrence. It is also regarded as a neuralgia of the bowel. Cause. — This affection is the result of indigestion, as brought on by inoroper food, overloaded stomach, etc., or it seems to have an intcr- t tendency, recurring at a certain hour, generally late in the aftcr- ., day after day. Or it may be brought on by cold and dampness to c feet. Olten, carelessness, and want of proper changing of a wet diaper, will cause such an attack. Symptoms. — Generally, there is more or less wind in the bowels, as shown by the distension of the abdomen, and the drum sound on per- cussion. Again, very little wind may be present. The child becomes fretful, draws its knees up to its chest, cries suddenly and becomes quiet. These actions may be repeated at intervals, often very short, sometimes of greater duration, but rarely disappear until wind has passed from the bowels, or perhaps a thin and frothy discharge occurs. All these symp- toms may be exaggerated, the screams are piercing, the contraction of the limbs are almost spasmodic, the face exhibits great suffering, the child is bathed in perspiration, and yet, when the attack passes off, the DISEASES OF CHILDREN. 233 vels, as on per- ecomcs s quiet, limes of om the c symp- :tion of g, the off, the child appears as well as usual. These attacks are often observed in the cases of children otherwise remarkably hcaltiiy. In rare cases, the attack becomes convulsive, almost epileptic, though the intervals are marked by a[)parent health. Treatment. — The [)aroxysm is so distressing that the earnest desire is to give the child inunediate relief. This wish is met by the warm bath, iiot fcjinentations to the abdomen, particularly flannel wrung out of hot mustard water ; i)Oultires of hops ; mustard plasters, not too long con- tinued ; spice poultices, etc. At the sametime may be given by thenujuth, oil of turpentine dropped on sugar, say three to five drops every two or three hours. A favorite and highly useful mixture is chlorototm, one drop, syrup of gum arable and mintwaler or anise water, of each half a teaspoonful, repeated every fifteen minutes, until complete relief is ob- tained. The bowels should be well opened by stimulating enemas, as of castor oil with a few drops of turpentine. A few drops of laudanum, or a half a teaspoonful ot paregoric, may be considered as safe and useful. ( )ther remedies, as bromide of potassium, and chloral, may be employed, both by the mouth and by enemas, as necessity may recpiire. In all rases, constii)ation must be relieved, and acidity corrected, by the ajjpropriate remedies, as heretofore mentioned. In some cases, mustard plasters to the whole length of the spine, or stimulating frictions over it and the stomach, prove of great service. Uow Prevented. — Wy avoiding constipation, and the consequent ac- cumulation of wind in the bowels, much may be done to prevent attacks of colic. Thus, occasional enemas of molasses, salt and milk, or the ad- ministration of magnesia, with belladonna, or hyoscyamus and ipecacu- anha, will generally keep the bowels in a relaxed condition. Then the feet should always be kept dry and warm, and the linen changed when wet, lest its coldness induce an attack. Bed-Wetting', or Incontinence of Urine, is a most annoying affection of children, and, singularly, is most frecpient in colored children. This is often the result of habit ; want of proper teaching; a lack of men- tal capacity ; or it may result from a partial jiaralysis of the retaining mus- cle of the bladder. It most commonly occurs at night, while in bed, and hence its name. Especially is this likely to occur when care is not taken to have the child pass its water before going to bed. It may be the result of the urine containing irritating salts, and thus causing the child so much distress that it iialf consciously allows the urine to escape. In these instances, the child is observed to use the vessel very frequent- ly during the waking hours. Some assert that the discharge of the water only occurs when the child turns on its back, and hence [)roposc and in- sist on the good results of a blister to the back, to prevent the child from assuming that position. Treatment. — When the urine is being constantly passed, its irritating nature may be corrected by daily exercise in the air ;; avoiding exposure 1 1 :t^l 1 234 THE FAMILY niYSlCIAN. M I to cold and damp; alkalies, as lime water and bicarbonate of soda, five grains thrice daily, with mild, bitter tonics, as cinchona tea, keeping the bowels free, improving the digestion, etc. Often, under this plan, the trouble will riuickly disappear, and recovery be permanei;t. In all cases, the child should have a light supper ; be allowed to drink but little of tluids towards night, and empty his bladder the last act be- fore retiring. As a medicine the tincture of cantliaridcs, say three to five or ten dro])s, three times a day, gradually increasuig the dose, will eventually relieve the difficulty. Care should be taken to stop this rem- edy at once if i)ainful and difficult urination is complained of. Eella- donn' in repeated doses long continued, has acquired a great reputa- tion. Two to five dro[)s of the tincture of Ijclladonna should be given in sweetened water every night. Professor S. D, Gross, M.D., treats incontinence of urine in children as follows : Strychnine, Powdered Cantharides, Sul})hate of Morphine, I'owdcred iron, I gram. - 2 grains. - i^ grains. - 2o grains. Mix, and divide in 40 pills ; give one three times a day to a child ten years old. Weaning Brash, or dianluoa, or looseness of the bowels at the time of weaning, most freriuently occurs during the summer, and is often the result of' negligence as to the food. The utmost care is necessary to sec that die milk given the child is pure, fresh, and not loo much, it at all, diluted. Clenerally, the diarrlKua is checked by these attentions, and tlie use of prepared chalk, and calomel, followed by a mild astringent. When protracted, the same principles will apply as given under similar head- ings heretofore. Milk Crust generally occurs during teething, and while the child is yet nursing, hence its name ; and it is connnonly thought to be incu-- able until all the teeth are rut or weaning takes j^lace. It usually appears in children of scrofulous tendency, and is, by its disgusting appearance. a great source of annoyance, Synip/o/ns. — Milk crust is an eruption, upon the face or head, of a number of red blotches, soon covered with pustules ; these, itching and breaking, exude a whitish yellow or greenish discharge, which hardens and forms a thick brown crust, beneath which the discharge continues to ooze, and constantly adds to the crusts. These crusts may appear only on the cheeks or chin, over a small space, or they may cover the whole scalp and face, forming a mask of hideous ajipearance. In the course of three or four weeks the discharge ceases, the crusts fall off, leaving a red, shining surface, very irritable, and liable to renew the pustules and dis- DISEASES OF CHILDREN. 235 soda, five eping the ; plan, the d to drink St act be- \f three to dose, wil' • this rcni- of. Bella- cat re put a- 1 be given in children ain. ains. grains. L!;rains. a child ten ; at the time is often the ssary to sec h, il at all, ons, and the gent. When milar head- the child is to be incu- p-lly appears appearance. head, of a itching and ich hardens continues to a]ipear only r tlic whole the course of ;aving a red, lies and dis- 2 parts./ cc charge as before, This matter seems to act as a source of conveyance of the disease, as, wherever it is brought in contact with the skin, it pro- duces more or less of a similar irritation. Fortunately, the disease leaves no scar or marks after healing. Treatment. — \x\ tlie early stages it will often speedily yield to proper regulations of the diet, mild laxatives, and soothing lotions. Small doses ot magnesia and ipecacuanha, warm baths, pure, fresh air, are invaluable adjuncts in the treatment. In very greatly protracted cases, the solution of the arseniate of potassa, or " Fowler's solution," in two-drop doses three times a day, will generally effect a cure, if persisted in. This disease is aijo known as Infantile Salt Rheum or Infiintile Ecze- ma. The following has been found to be a very successful treatment : Salicylic Acid, - . . . Subnitrate of Bismuth, - - - 3^ Corn Starch, - - - - 20 Ointment of Rose Water, - - - 100 Spread thickly on muslin and cover carefully every portion of inflamed and moist skin. This should not be used on the s(\al[) on account of matting the hair. For the scalp use Oil of Cade and Aimond Oil, ecjual I'arts. If thick crust is present, remove by poulticing and wear an oiled silk skull cap. Dr. G. If. Fox, iVew York. Rupture or Hernia may occur in children from the time of birth, or may be developed at any nge in those prcdis[)Osed, after unusually violent exercise, as leai)ing, wrestling, or riding. Whenever a child is observed to nave a sliglit tumor or swelling at the navel, or in the groin, enlarging on coughing or straining, he should be warned of the risk of violent effort, and the first opportunity embraced to consult a competent surgeon. The permanent cure of a ru[)ture, by means of a projierly fitting truss, is more likely to be brought about in a child than in grown persons. In very young children a rupture at the navel is not uncommon. It may ap[)ear a few days after birth. When a child presents this infirmity, it nuisi he removed by compression. This is accomplished by a well- fitting bandage around the waist, containing a coin or similar body im- mediately over the navel, thus retaining the parts in their natural i)osi- tions. Cancer, although not specially an affection of childhood, is liable to occur at that time, and moreover, as a disease generally hereditary, may he apjiropriately spoken of in this connection. Cancers are of various kinds, and may occur in all parts of the body, and appear at any age. They have been described as hard, soft, open, or bleecling, black, skin and bone cancers. They usually commence with a swelling and ^)ain, 236 THE FAMILY PHYSICIAN. I ! followed by a breaking of the skin, and the formation of an external running sore. The pain is a very vaiable symptom. At the outset it is rarely very severe, and may not be continuous. At times, it is de- scribed to l)e of an aching or rheumatic character ; at others, and more commonly, it is an occasional dart of pain through the pait, as if a needle had suddenly been thrust into it. I,ater in the disease, the suffering be- comes severe and constant, even excruciating, and can only be relieved by heavy doses of opiates. What makes cancers so dangerous, is their tendency to recur after removal, and penetrate into and poison the tissues of all the organs of the body. Hence the only hope is to treat them early, before this has come to pass. Although generally hereditary, they are, in their outbreak, entirely local, and many instances are on record where early and complete removal has saved the patient from any recurrence of the cancerous growth. One of the most common forms of cancer is epithelial, or skin cancer. It is frc^ lently seen on the lips and face. Its surface may be dry and warty, or watery and ulcerating. The edges arc thick and a little ele- vated, and the discharge thin. It is usually slow in progress, lasting for years before causing such serious inconvenience as to lead the sufferer to a surgeon. The treatment of a cancer, whether in a child or in an adult, is always and only by removal^ and the earlier and more completely this is done, the greater safety has the patient for his life. Removal may be accom- plished either by the knife or by caustics. Of the first of these methods, we shall only say that in the majority of cases it is the least painful, the most prompt, and the most ctificacious. Whenever it is possible, the ad- vice of a good surgeon should be sought early, and his intervention so- hcited. ])Ut many people have a great dread of the knife. They prefer to suffer indefinite agonies from strolling quacks who advertise cancer salves, and it is, of these we would speak. Whatever secrets such quacks pre- tend to have, they are all deceptions, and unscrupulous frauds. The caustics which are of use in cancer are all well known to the regular medical profession, and appear in the text-books of surgery. The two ])rincipal ones are the chloride of zinc and arsenic. The former, made into a ])aste with two parts of flour and a small quantity of morphia, is as efficient a cancer salve as any, but it is dangerous and unjustifiable forepersons ignorant of surgery to employ it. Of the internal remedies given to prevent the return of cancer, the best are arsenic in small doses, long continued, and poke root. The latter vegetable preparation, given as a tea or extract, seems to have really valuable properties. Swellings of the Glands of the Neck are often treated at home, without the aid of a physician or surgeon, until they suppurate, and are likely to leave scars. When such domestic management^ however, is pgp DISEASES OF CHILDREN. 237 determined upon, the invalid should be allowed a nutritious animal diet, his bowels kept free by exercise on foot, whilst mild purgatives should be given, and the solution of iodide of iron, in doses of from ten to sixty drops, or the syrup of the iodide, in doses of a teaspoonful (a fluid drachm, which contains three grains of the iodide), should be internally administered, in a glass of water twice a day. The tumors should be treated with fomentations of salt or sea water, and friction employed twice daily, for half an hour each time. If suppuration cannot be ar- rested, under the improved state of health, then surgical advice must not be delayed until the abscess bursts spontaneously, for an ugly scar is likely to be the result j an event always to be regretted, especially in females. the sufferer iT.: ' s 1 1 if*; 1 || il 1 1 . u ' 1 1 i 1 ' m 1 : II L 1 5 tlracliins. 3 ciracliuis. I ounce. 15 u;rains. 12 grains. CHAPTER XIII. FAVORITE PRESCRIPTIONS. Abortion or Miscarriage. To prevent this accident, use : — (i) l"'ki id Extract of Ergot, ] )eodoratcd Tincture of Opium, - Syrup of Lemon, ]\Iix and take a teaspoonful tlirice daily. (2) Tannic Acid, - - . - Powdered Ipecac, - Extract of Opium, - - - 3 grains. Mix and divide into 12 pills. Take one every six hours. Abscess. . In addition to the local treatment (such as poultices, etc.), which has been described, use : — Syrup of Hypophosphitcs, - - (• ouuces. Take a dessertspoonful thrice daily. Acidity of Stomach. (Sour Stontach.) {\) Suhnitrate of lUsmuth, - - - 3 drachms. Carbolic Acid, - - - - 3 grains. Mucilage of Cum Arabic, - - 1 ounce. Peppermint Water, - . . 3 ounces. ^lix and take a tablespoonful 3 or 4 times daily, for an adult. (2) ] bicarbonate of Soda, . - Aromatic Spirits of Ammonia, Tincture of (linger, Compound Infusion of Gentian, to make Mix and take a tablespoonful or two 3 times daily. Acne, or Pimples. Acetate of Potash, Tincture of Nux Vomica, Fluid I'Atract of Yellow Dock, Mix and take a teaspoonful in a wineglass of water half an hour before meals. > 238 2 drachms. 2 drachms. 1 ounce. 8 ounces. 2 scru[)les. 2 drachms. 4 ounces. s'ssm FAVORITE PRESCRIPTIONS. 239 In addition to this apply the following lotion to the pimples : — Sulphur, - ... 1 drachm. Glycerine, - - - . i ounce. Rose Water, - - . - y ounces. Alcoholism or Drunkenness. To overcome the desire use : — (i) Tincture of Capsicum, - - - Jiromide of Potash, Aromatic Spirits of Ammonia, Syrup of Tolu, to make - - . Mix and take a dessertspoonful in walcr 4 or 5 times daily. To overcome the sleeplessness due to alcoholism use : — y^ ounce. y^ ounce. 3 ounces. ounces. (2) Tincture of Nux Vomica. Compound Tincture of Gentian, - S[)irits of Le.i! 1, Spirits of Chloroform, ... Wiii'^r to make - - . - ISIix and take 2 tablespoonsful 3 times daily. AVhen the stomach is disordered by alcohol use ;- (3) Compound Tincture of Gentian, - Comi)ound Tincture of Calumba, - Tincture of Nux Vomica, Mix and take a dessertspoonful before each meal. I drachm. 3 drachms. C dro])S. I drachm. 6 ounces. 2 ounces. 2 uUMces. 80 drops. Dr. Looniis. Amenorrhoea, or Absence of the Menstrual Flow. Aqueous I'lxtract of Aloes, - - i drachm. IJried Sulphate of Iron, - - 2 drachms. Assaftelida, - - - - 4 drachms. Make into 100 pills and take one pill after each meal, gradually in- creased to three. Dr. Coodell. Anaemia or Lack of Blood. 4 dtarhms, 6 (.hachms. 2 drachms. 6 ounces. (i) Tincture of the Chloride of Iron, 1 )ilule rhos[)horic Acid, Spirit of Lemon, Syrup to make Take a dessert spoonful in water after meals. '% • Dr. GoodelL I lllf'l 240 THE FAMILY PHYSICIAN. i ¥m' I (2) Sulphate of Quinine, - • -20 grains. Juried Sulphate of Iron, - - - 40 grains. Sulphate of Strychnia - - - J4 grain. Divide into 20 pills and take one thrice daily. Dr. Bartholow. 2 drachms. 2 drachms. 2 drachms. 2 drachms. 2 drachms. (3) Dried Sulphate of Iron, - Carbonate of Potash, - - . Syrup, a sufficiency. Divide into 48 pills and take one after each meal gradually increased to three. Aphtha or Sore Mouth. Solutions of IJorax and honey, r>oraxand Glycerine or of Chlorate of Potash are excellent gargles. Also the following: Sulphite of Soda, - • - i drachm. Water, - - - - i ounce. Mix, and use as a lotion in the mouth. Sir IV.Jenner. Appetite. To improve the appetite use : Gentian, . - . - Quassia, .... Cinnpmon, .... Put into a pint of boiling water, and when cold strain ; take a wine-glass- ful thrice daily. Asthma. (i) Nitrate of Potash paper, Burn in a close room and inhale the fumes. (2) Bromide of Ammonia, Chloride of Ammonia, Tincture of Lobelia, Compound Spirits of Ether, Syrup of Acacia to make Take a dessertspoonful in water every hour or two till the paroxysm has passed. Dr. Pepper. (3) Tincture of Lobelia, - • - i ounce. Iodide of Ammonia, - • - 2 drachms. Bromide of Ammonia, - - "3 drachms. Syrup of Tolu, - - - - 2 ounces. Take a teaspoonful every i, 2, 3 or 4 hours as required to relieve. Dr. BartJwiaw, One. 160 grains, yo grains. 3 drachms. I ounce.' 4 ounces. FAVORITE PRESCRIPTIONS. 241 lolow. icrcascd lorate of 1. fenner. IS. IS. IS. .vincL-lass- 4: is. Uns. f paroxysm Pepper. ns. Ins. Iclicve. Xrifwluw, (4) Compound Spirits of Ether, - • - i ounce. Suli)hate of Morphia, - - - i grain. Water, - - - - i ounce. Mix, and take a teaspoonful every half hour or hour during the par- oxysm. Biliousness. (i) Fluid Extract of Stillingia, Tincture of Aloes, Tincture of Nux Vomica, - Mix and take 20 drops in water thrice daily. Dr. James. 5 drachms. 2 drachms. I drachm. Dr. Bartholow. 3 grains. (2; Blue Mass, .... Compound Extract of Colocynth, - - 3 grains. Mix and make into 2 pills ; take these at once and follow in a few hours with seidlitz powder. Bladder, Irritability of. Tincture of Belladonna, - - - i ounce. Take 10 drops, every 3 or 4 hours. Boils. Cover the boil with a piece of lint wet in the following : Atrophine, Rose Water, 4 grams. I ounce. Aromatic Sulphuric Acid, - Water to make And take internally : , 6 drachms. 4 ounces. A teaspoonful in a wine glassful of water 3 or 4 times daily. Breath, Fetid or Foul. Chlorate of Lime - - - "3 drachms. Distilled Water, . - - - 2 drachms. Alcohol, - - - - - 2 drachms. Oil of Rose, .... 4 drops. Use a teaspoonful in a glassful of water as a gargle for the mouth. Dr. Bartho/oi:'. Bronchitis, Acute. (i) Solution of Acetate of Ammonnia, - Infusion of Senega - Water, - . . ♦ Take 2 tablespoonsful thrice daily. % drachm. 3 drachms. 6 ounces. Dr. Niemeyer. 1 ;v| ii rirfiiK.'^' I 242 THE FAMILY PHYSICIAN. (2) Wine of Ipecac, - - - Solution of Citrate of Potash, Camphorated Tincture of Opium, Syrup of Acacia. - . - Take a tablespoonful thrice daily. Bronchitis, Chronic. (i) Extract of Eucalyptus, - - Muriate of Ammonia, Extract of Licorice, Syrup of Tolu, - - . Take a tablespoonful 4 or 6 times a day. (2) Compound Spirits of Ether, Syrup of Ipecac, - Camphorated Tincture of Opium, - Water, . . . - Take a teaspoonful as required. Bronchitis in Children. Citrate of Potash, - Wine of Ipecac, Compound Tincture of Camphor, Syrup of Tolu, Water to make 2 drachms. 4 ounces. I ounce. I ounce. Dr. Da Costa, 1 ounce. 2 drachms. 2 ounces. 3 ounces. Dr. Bartholow. I ounce. I ounce. I ounce. I ounce. Prof. Janeivay, 7 ounces. 8 ounces. I drachm. i^z drachms. I drachm. y^ ounce. 3 ounces. Dose, for a child two to four years old, one teaspoonful every hour or two. Dr. Ellis. Burns and Scalds. (i) Linseed Oil, - - - - Lime Water, - . - . Mix, and apply on lint and covered with oiled silk. (2) Carbonate of Soda, - - - 6 ounces. Water, - - - - - 3 pints. Mix, and apply freely for three days on old cloths or lint. Cancer. When the cancer is in the stomach, and there is much pain and vomit- ing, use Subnitrate of Bismuth, - - - 2 drachms. Sulphate of Morphia, - - - i grain. Divide into six powders and take thrice daily in milk. JSaSBMH FAVORITE PRESCRirTIONS. 243 Costa. ns. tholow. ineway. m. ichins, m. ce. es. ry hour or •. Ellis. and vomit- When on the surface of the body use Arsenious Acid, - - - 2 drachms. Mucilage of Gum Araljic, , - - i drachm. Apply as a paste on a canccrou.-5 sore, followed after two or three days by i)read poultices until the slough separates. Catarrh, Acute Nasal. Tincture of Iodine, - " % ounce. Carbolic Acid, - - - . i drachm. Put a small wide- mouthed bottle containing a moistened sponge, in a vessel of hot water ; droi) five or ten dtoi)s of the above solution on the sponge, and as the iodine vapor ascends in the vapor of the water, inhale it. Dr. Bartholow. Catarrh, Chronic Nasal. Carbolic Acid, - - - - 40 drops. Borate of Soda, - - - - 2 drachms. Bicarbonate of Soda, - - - 2 drachms. Glycerine, . . - - 7 drachms. Water to make - ... 8 ounces. Use some of this daily as a spray for the nostrils. Chapped Hands and Lips. (i) Resin, - - . - - White Wax, - - - - Honey, - - - • ~ - Oxide of Zinc, - . . - Mix and apply. (2) Spermaciti, - - Glycerine, . . . - White Wax, .... Oil of Bitter Almond, Chilblains. Tincture of Benzoin, - ^ Linseed Oil, . - . . Yellow Wax, - . - . Glycerine enough to make an ointment. Apply to Cholera Infantum, or Summer Complaint of (i) Carbolic Acid, .... Subnitrate of Bismuth, Mucilage of Gum Arabic, - Peppermint Water, - . - Take a teaspoonful every 2, 3, or 4 hours. Dr, Dobcll. 1 ounce. 2 drachms. 3 ounces. 7 drachms. 1 drachm. 2 drachms. 15 grains. 3 drops. 2 drachms. 4 drachms. 2 drachms. the parts. Children. 4 grains. 2 drachms. I ounce. 3 ounces. li- 244 TITF, FAMILY PHYSICIAN. 4 (2) Sulphate of Co]->pcr, - . . i grain. Deodoratcd 'rincturc of Opium, - - 8 drops. Distilled Water, .... 4 ounces. Take a teaspoonful every 2, 3, or 4 hours for a child of one or two years' old. . /Jr. Bartholoiv. 24 drops. 24 drops, i^ ounces. 6 drachms. T) drachms. 10 drops. 12 grams. 24 grains. I drachm. (3) Carbolic Acid, . " ]jrandy, . . ' . Peppermint Water, ... Mucilage of (Uun Arabic, - Syrui^, - . - . . Deodorated Tincture of Opium, - Give a teaspoonful every 2 hours. Chordee. Towdercd Opium, ... Powdered Camphor, White Sugar, . . . . Divide into 12 powders and take i at bedtime, to be repeated if neces- sary in 2 hours. Dr. Sturgis. Chorea or St. Vitus' Dance. (i) Tincture of the Chloride of Iron, - - i ounce. Solution of Arscnious Acid, - - 2 drachms. Syrup of Lemon, - - - - ^ ounce. Simple Syrup, - - . . i ounce. Water to make - - - - 4 ounces. Take half a teaspoonful three times a day, after meals. (2) Hydrate of Chloral, - - - 4 drachms. Tincture of Hyosciamus, - - - i ounce. Syrup of Lcnion, - - - - i ounce. Cinnamon ^V'ater, - - - 4 ounces. Take a teaspoonful 3 or 4 times a day, according to age. Colic (i) Spirits of Chloroform, . . - Compound Tincture of Cardamoms, Take a teaspoonful in water every half hour. 2 ounces. 2 ounces. (2) Extract of Gentian, Powdered Rhubarb, Dr. Barthfllmv. I drachm. I drachm. Divide into 20 pills and take one or two pills three times a day. FAVORITE PRESCKIPTIONS. 245 (3) rowdcrcd Camphor, Powdered Capsicum, Powdered Ginger, Divide into 12 pills and take one as reciuired. Constipation. (i) Compound Extract of Colocynth, Extract of belladonna, Extract of (ientian, Oil of Caraway, Divide into six pills, and take one at bedtime. (2) Castor oil, ... Glycerine, - - - Tincture of Orange, Tincture of Senega, Cinnamon Water to make half ounce. Take the whole at one dose. (3) Socotrine Aloes, - - Extract of Belladonna, - 2 grains. 2 grains. 2 grains. 12 grams. 2 grains. 6 grains. 3 drops. Dr. Goodell. I drachm. I drachm. 20 drops. 5 drops. Divide into 24 pills, and take one or two as reiiuired. 12 grams. 3 grains. Dr IVaUace. 7 grams. (4) Socotrine Aloes, Powdered Rhubarb - - - 24 grains. Extract of Belladonna, - - - i grain. Divide into 1 2 pills, and take one or two as required. Dr. Da Costa. Convulsions in Children. (i) Hydrate of Chloral, - - - 5 grains. Milk, - - - - I ounce. Inject into the bowel. (2) Bromide of Soda, - - - 8 grains. J>icarbonate of Soda, - - - 8 grains. Hydrate of Chloral, - - - 8 grains. Water, - - - - i ounce. A teaspoonful every hour until relieved, to a child 4 months old or under. Cough. I'or Adults. Spirits of Nitrous Ether, Wine of Ipecac, Deodorated Tincture of Opium, Syrup of Tolu to make Take a teaspoonful 2 or 3 times daily. Dr, Bowditch. 2 drachms. ^2 ounce. 1 drachm. 2 ounces. iiJ If i ll ffff^c 246 tllE FAMILY PHYSICIAN. I I II illi'; ., I , 1 111 m S 1 For children. Comi)ound Licorice Mixture, - - 2 ounces. Syrup of Wild Cherry, - - i ounce. ' Syrup of Tolu, - - - i ounce. Half a tcaspoonful 3 or 4 times a day for infants ; ttaspoonful doses at I or 2 years ; larL^cr doses for older children. nr. rotter. Croup. Powdered lilood root, - • • 20 grains. Powdered Ipecac, - • - 5 grains. Syrup of Ipecac, - - - 2 ounces. Take a tcaspoonful every fjuarter of an hour till vomiting occurs ; then half a tcaspoonful every hour. Dr rotter. Also apply to the throat the following, with a mop or s[)ray. Lactic Acid, - - ■ 3 /^ drachms. Distilled Water, . - - - 10 ounces. London Throat Hospital. Delirium Tremens. Tincture of Capsicum, - - i ounce. Fluid Extract of Hops, - - i ounce. Mucilage of Gum Arabic, - • % ounce. Cinnamon Water, \l > ounces. 1 drachm. 2 drops. I ounce. I ounce. Take a dessertspoonful as required for the wakefulness and excitement. Dentition, or Teething. Bromide of Potash, . - Oil of Anise, .... Mucilage of Gum Arabic, - Peppermint Water, A tcaspoonful every half hour until relieved. Diarrhoea. In adults — when chronic. (i) Sulphate of Zinc, - - - . Powdered Opium, - - - - Powdered Ipecac, - - - - Divide into 1 2 pills, and take one three or four times daily. In Children. (2) Camphorated Tincture of Opium, - - jounce. Aromatic Syrup of Rhubarb, - - )^ ounce. Lime Water, - - - - i ounce. A teaspoonful for children. 12 grams'. 12 grains. 12 grains. FAVORITE PRESCRirTIONS. 24; For Diarrhoea of Teething, (3) Uromidc of Soda, Mucilage of Gum Arabic, - Water to make A teaspoonful every three hours. y^ drachm. 1 ounce. 2 ounces. Dr. A. A. Smith, 1 ounce. I ounce. 4 ounces. Diphtheria. (i) Tincture of the Chloride of Iron, - Syrup of Tolu, .... Solution of the Citrate of Potash, - Take a teaspoonful to a dessertspoonful, according to age, every three hours. Dr. Anderson. (2) Tartaric Acid, - • - -2]^ drachms. Glycerine, • - - - 4 drachms. Peppermint Water, - - 7 drachms. Apply locally to the patches in the throat every 3 hours. (3) Thymol, ----- i drachm. Glycerine, ----- i ounce. Water, - - - - - 3 ounces. Use as a gargle frequently in teaspoonful doses. (4) Sulphite of Soda, - Glycerine, Water to make Apply in teaspoonful doses locally. Dr. Da Costa. 3 drachms. 2 drachms. 4 ounces. Dr. Da Costa, lyi drachms. I ounce. I ounce. (5) Tincture of the Chloride of Iron, - Glycerine, .... Water, ..... Take a teaspoonful of this and the next prescription alternately every half hour. (6) Chlorate of Potash, - - - J^ drachm. Glycerine, • • - - ^ ounce. Lime Water, - - - - 2^ ounces. Take a teaspoonful of this and the preceding prescription alternately every half hour. (7) Muriate of Pilocarpine, - - - ^ grain. ; Pepsin, - - -.."• - 15 grains. Hydrochloric Acid, --•,•: • 2 drops. Distilled Water, - - •* • • • 8 ounces. Take a teaspoonful every hour for a child. M mi II:!? Jb 248 THE FAMILY rilYSICIAN. A Specific for Diphtheria. Dr. Ilccr, Health Commissioner at Ratibor, Clermany, read a paper before the recent Medical Congress at Berhn, in which he gave particulars concerning the use of brewers' yeast in diphtheria. Pie has used the article for 35 years in a large hospital, first in scurvy then in diphtheria. In diphtheria he gives children every hour six to eight grains of fluid yeast and causes their mouths and fauces to be mopped at intervals with the same substance mixed with five times the quantity of water. If this is done promptly and energetically the child is saved. Dr. Hecr maintains that eciually good results follow the use of yeast against all germ diseases. It is efficacious, he says, in pro- venting the disease. So simple a remedy as this should have a fair trial on this continent, where diphtheria attains a prevalence and fatality un- known elsewhere. Dropsy. (i) Bitartrate of Potash, Extract of Taraxacum, - - - Decoction of Taraxacum, Take half a wine glassful two or three times daily. (2) Powdered Sijuills, . . _ Powdered Digitalis, Nitrate of Potash, Divide into thirty pills and take one thrice daily. Dysentery. ( 1 ) Acetate of Lead, - . - Ipecac, .... Powdered Opium, - - - Divide into 12 pills and take one every 2 hours until blood ceases, then one every 3 or 4 hours. Dr. Da Costa. (2) Subnitrate of Bismuth, - - 2 drachms. Aromatic spirits of Ammonia, - - 1 drachm. Tincture of Opium, - - - 16 drops. Simple Syrup, - - - - ^ ounce. Chalk Mixture, - - - - i ^<^ ounces. A- dessertspoonful to a child over one year ; a tablespoonful or more to an adult, every 2 or 3 hours, after emptying the bowels with castor oil. Dismenorrhoea or Painful Menstrual Flow. (i) Extract of ]')elladonna, - - - 4 grains. Extract of Stramonium, - - - 5 grains. Extract of Hyosciamus, - - - 5 grains. Sulphate of Quinine, - - - 40 grains. Divide into 20 pills and take one thrice daily. , I ounce. Yz drachm. 8 ounces. Yz drachm. ]/z drachm. I drachrn. 24 grains. 3 grains. 3 grains. FAVORITE PRESCRIPTIONS. 249 )ner at rcss at s' yeast ospilal, n every 1 f:\uces /e times illy the low the in pro- fair trial ility un- ci ceases, Costa. :s. more to :astor oil. (2) Extract of Opium, - - - 5 grains. Extract of Cannabis Indie us, - - 10 grains. Extract of Hyosciamus, - - - 10 grains. Camphor, - - - - 25 grains. Divide into 10 pills and take one two or three times daily. IJ)t. McLean. Dyspepsia. (i) Dilute Hydrochloric Acid, Tincture of Capsicum, ... Tincture of Calumba, Wine of Pepsin to make Take a dessertspoonful after meals. I drachm. ^2 drachm, i^ ounces. 4 ounces. Z>r. Pancoast. 2 drachms. 2 drachms. I ounce. 8 ounces. (2) Bicarbonate of Soda, Aromatic Spirits of Ammonia, Tincture of Ginger. Compound Infusion of Gentian to make - Take one or two teaspoonsful thrice daily. Eczema or Salt Rheum. Ointment of Zinc Oxide, - - ^ ounce. Ointment of Lead Suba tate, - - ]^ ounce. Chloral, - - - - ■ ^5 grains. Camphor, - - - - 15 grains. Apply to the body as an ointment 2 or 3 times daily after bathing with warm water. Aud take internally the following : Citrate of Iron and Ammonia, Citrate of Potash, Fowler's Solution, . . - Tincture of Nux Vomica, - - . Compound Tincture of Cinchona to make Take a teaspoonful in water after meals. Dr. Gross. 1 drachm. 2 drachms. 1 to 2 drachms. 2 drachms. 4 ounces. Dr. Bulhky. Epilepsy. The famous Brown-Sequard remedy has already been given. The following is also excellent : B lide of Potash, - • - i ounce. Bromide of Iron, - - • • 4 grains. Water, - - - • • 2 ounces. Simple Syiup. - - • • 6 ounces. Take a tablespoonful twice daily. f i i 250 THE FAMILY PHYSICIAN. Erysipelas. Sulphate of Quinine, Dilute Sulphuric Acid, Water, .... Tincture of the Chloride of Iron, - Spirits of Chloroform Glycerine to make Take a teaspoonful in water every 2 hours. 1 drachm, i^ drachm. 2 ounces. Yz ounce. 6 drachms. 4 ounces. Dr. Looviis. 2 drachms. 2 drachms. 4 drachms. 2 drachms. 10 drachms. Also apply locally the following : — Carbolic Acid, . - - . Alcohol, - - - . - * Oil of Turpentine Tincture of Iodine . - . Glycerine, - . - - Brush over the surface every 2 hours and cover with a thin layer of wadding. Or the following : — Acetate of Lead - - - - i drachm. Carbonate of Ammonia, - - - i drachm. Rose Water, ... - 8 ounces. Apply on lint to allay irritation. Dr. Peart. Fever, Simple. (i) Dilute Hydrochloric Acid, - - ^ drachm. Compound Spirit of Ether, - - i J^ drachm. Syrup of Rose, - - - - % ounce. Camphor Water to make, - - - 4 ounces. Take a teaspoonful to a tablcspoonful, according to age every six hours. (2) Acetate of Potash, - ... 2 drachms. Spirits of Nitrous Ether, - - - 4 drachms. Simple Syrup, . . . . 1 ounce. Solution of Acetate of Ammonia, - 2 ounces. • - Camphor ^Vater to make - - - 8 ounces. Take a teaspoonful to a tablcspoonful according to age. Flatulance or Wind. Gum Camphor, - . • . . - i grain. Powdered Ginger, • • - i grain. Powdered Capsicum, - - - i grain. Divide into six pills and take one as required. FAVORITE PRESCRIPTIONS. 251 IS. ,oomis. ms. TIS. lis. [lis. bnis. n layer of im. mi. es. Peart. :hm, chm. ce. es. six hours. Inns. ims. ;e. es. • ■ es. 1. 1. 1. Freckles. Corrosive Sublimate, - - - 6 grains. Dilute Hydrochloric Acid, - - i drachm. Alcohol, ----- 2 ounces. Rose Water, .... 2 ounces. Glycerine, ----- i ounce. Water to make - - - . g ounces. Apply a little to the face at night and wash it off next morning, taking care not to allow any of the wash to enter the eyes or mouth. Gastralgia or Neuralgia of the Stomach. (i) Sulphate of Morphine, - - - Carbolic Acid, - - . - Peppermint Water to make Take a teaspoonful thrice daily. I gram. Yi drachm. 4 ounces. (2) Subnitrate of Bismuth, Carbonate of Magnesia, . . - Dilute Hydrocyanic Acid, Water, ----- Dessertspoonful for child three years old. Gastritis, Chronic, or Chronic Inflammation of the Stomach. Dr. Da Costa. 16 grains. 16 grains. 10 drops. 4 ounces. (i) Oxide of Silver, - - . . Extract of Belladonna, - - Oil of Cloves, . - - - Make into 24 pills, and take one pill twice daily. 12 grams. 3 grains. 20 drops. Dr. DaCosri. i}i drachms. J4 ounce. 8 ounces. (2) Bicarbonate of Soda, - - - Tincture of Orange peel, - - - Infusion of Calumba, to make Take 2 tablespoonsful before each moal. (3) Sulphate of Magnesia, Tartarate of Soda and Potash, Tartaric Acid, .... Dissolve the whole in a glass of water and drink, an hour before break- fast. (4) Alum, - . - - . Extract of Gentian, Divide into 30 pills, and take two pills twice daily. Gastric Ulcer, or Ulceration of the Stomach, (i) Oxide of Silver, .... 10 grains. Extract of Hyoscianus, - - - 10 grains. Divide into 20 pills, and take one thrice daily before meals* I to 2 drachms. ^ to 2 drachms. 20 grains. 2 drachms. % drachm. H iH 252 THE FAMILY PHYSICIAN. (2) Suljcarbonate of Bismuth, - '3 drachms. Sulphate of Morphia, - - - i to 2 grains. Aromatic powder, - - - i drachm. Divide into 1 2 powders, and take one i)owdcr in milk before meals. (3) Nitrate of Silver, - ' ■ ' 5 gf^'^ins. Extract of Opium, - - - 3 grains. Divide into 20 pills and take one thrice daily. Gleet. (i) Powdered Spanish Fly, - - - 3 grains. Oil of Turpentine, - - - i drachm. Divide into 1 2 pills and take one thrice daily, in obstinate gleet, stranguary, stop for a day or two. As an injection use : — (2) Tannic Acid, - - - - 10 grains. Subnitrate of Bismuth, - - - 2 drachms. Rose Water, - ... 5 ounces. Shake, and use a little as an injection thrice daily. Dr. Maury. GonorrhcEa or Clap. For internal use : — (i) Citrate of Potash, Spirits of Lemon, ' - - . Simple Syrup, - - - - Water, . - . - . Take a dessertspoonful, largely diluted, 3 or 4 times daily. Dr. Otis. 3 ounces, i^ ounces. 2 drachms. I ounce. If J^ to I ounce. ^ drachm. 2 ounces. I ounce. (2) Powdered Cubebs, Copaiba, Alum, White Sugar, Magnesia, Oil of Cubebs Oil of Wintergreen, Make into a paste and take a piece the size of a walnut after each meal. i^ drachms. I drachm. I drachm. For injection : — (3) Sulphate of Zinc, • • * Dilute Solution of the Subacctate of Txad, Use a little as injection 2 or 3 times daily. Dr. Otis. 8 grains. 4 ounces. FAVORITE PRESCRIPTIONS. 253 ns. rains. [11. meals. n. :leet. If lis. faury. )unce. m. Otis. I * :es. IS. , ims. tcr each Otis, (4) Chloride of Zinc, ... Rose Water, .... Use a little as injection twice daily. (5) Sulphate of Zinc. . . . Acetate of Lead, Tincture of Opium, Tincture of Catichu, Rose Water to make Inject some occasionally with urethral syringe. (6) Powdered I deform, Carbolic Acid, Glycerine, .... Distilled water to make Use a teaspoonful as an injection twice daily. Gout. (i) Wine of Colchicum Root, Sulphate of Magnesia, Peppermint Water, Take a tablespoonfol every hour until it operates. (2) Acetic Extract of Colochicum, Aqueous Extract of Opium, Iodide of Potash, Acetate of Potash, Distilled Water, White Wine, Take 20 drops thrice daily. Hay Fever. (i) Iodide of Potash, Fowler's Solution, • Cinnamon Water, - - . - Take a teaspoonful every 4 hours. (2) Extract of Hyoscianus, Iodide of Potash, P>icarbonate of Potash, Pure lixtract of Licorice, - Anise water, - - * Take a dessertspoonful every 4 hours until relieved. I gram. 6 to 8 ounces. 8 grains. 15 grains. 2 grains. 1 drachm. 6 ounces. 3^ ounce. 2 drachms. 2 ounces. 8 ounces. I ounce. 1 ounce. 10 ounces. Dr. Satdatnore. 15: grains. It;; Lnains. 4 drachms. 2 drachms. 3 Vz ounces. y.i ounce. Z^r. Lallemand. I ounce. I drachm. 4 ounces. 12 grains 1 drachms. 2 drachms. 4 drachms. 4}4 ounces. Dr. Weber. m r- 254 THE FAMILY niYSICIAN. Headache (Bilious or Sick). Resin of Podophyllin, Tincture of Ginger, Alcohol to make 2 grains. 2 drachms. I ounce. Take a teaspoonful in a wineglass of water every night at bedtime ; or every second, third cy: fourth night as required. , Headache (Congestive or Hot). Spirits of Ammonia, - - - i ounce. Spirits of Camphor, - - - /^ ounce. Put this into a quart of water in which a handful of common salt has been dissolved ; cork tightly and apply to the head on lint or pieces of cloth. Headache (Nervous). (i) Extract of Nux Vomica, Reduced Iron, Sulphate of Quinine, Divide into 12 pills and take one after each meal. (2) Phosphide of Zinc, Extract of Nux Vomica, Confection of Roses, 3 grams. 1 2 grains. 6 grains. Dr. Hammond. 3 grains. 10 grains, a sufficiency. Divide into 20 pills, and take one after each meal. Dr. Fordice Barker. Heart Palpitation. Powdered Digitalis, - - - 20 grains. Powdered Colchicum Seeds, - - 40 grains. Bicarbonate of Soda, - - - 60 grains. Divide into 40 pills, take one at first three or four times daily, grad- ually reduced to one at bedtime. Dr. Doivditch. Hemorrhoids or Piles. (i) Powdered Galls, - - • Powdered Opium, - Ointm<-nt of the Subacetate of Lead, Simple Ointment, 20 grams. 10 grains. 40 grains. I drachm. Make into an ointment, and apply to the piles as necessary. Dr, Easterlin.. FAVORITE rRESCRimONS. 255 TIS. itimc ; or e. ce. nmon salt or pieces »• ns. s. mmond. s. ns. iency. Barker. IS. ns. ns. ally, grad- owditch, ns. Ins. ns. hm. 'asterlin. (2) Powdered Galls, Powdered Opium, - . - Acetate of Lead, - Tar ointment, ... Simple Cerate, Make into an ointment and apply night and morning after bathing the Darts in cold water. 20 grams. 20 grains. 20 grains. Yz ounce. Yz ounce. (3) Extract of Opium, - Powdered Stramonium, Powdered Tobacco, Simple ointment, - - - - Make into an ointment and apply to the piles. Hemoptysis, or Bleeding of the Lungs. (i) Fluid Extract of Ergot, . - - Fluid Extract of Ipecac, - - . Deodorated Tincture of Opiinn Take a teaspoonful every half hour. (2) Acetate of Lead, . - . - Powdered Digitalis, Powdered Opium, * - Make into 10 pills and take one every 4 hours. (3) Alum, - - . , . While Sugar, .... Compound Ipecac Powder, Divide in 6 powders and take one every 2 hours. Herpes, Zoster, or Shingles. (i) Phosphide of Zinc, - - . Extract of Nux Vomica, Divide into 30 pills. Take one every 2 to 4 hours. (2) Solution of Hypochlorite of Soda, Water, - - - , • • Use as a wash for the ulcerated vesicles. 10 grams. 1 drachm. Y2 drachm. Yi ounce. Dr. Shoemaker, \Yz ounce. 2 drachms. 2 drachms. 20 grams. 10 grains. 5 grains. Dr. Barfho/mv. 1 drachm. yi drachm. 20 grains. Dr. Skoda. 10 grains. 10 grains. Dr. Bulkeley. 4 ounces, 2 ounces. . Dr. Fournier. , ii 25<5 THE FAMILY rilYSICIAN. 'U 1 Hiccough. Tincture of Nux Vomica, • Dilute Nitric Acid, Water to make Take a dessert spoonful as required. i}4 drachm. 4 drachms. 4 ounces. Dr. Phillips. Black Pepper in doses of from 2 to lo grains will also arrest hiccough. Dr. Phillips. Hysteria. ( 1 ) Extract of Ergot, - - . Sulphate of Iron, - - - Extract of Nux Vomica, Corrosive Sublimate, Divide into 30 pills, and take one thrice daily. (2) Tincture of Assafoctida, Ammoniated Tincture of Valerian, Tincture of Castor, Camphor Water, - Take a tablespoonful or two every hour. Impotence. (i) Phosphorus, Extract of Nux Vomica, Sacchurated Carbonate of Iron Extract of Gentian Divide into 25 pills and take one, 2 or 3 times (2) Tincture of Sanguinaria, Fluid Extract of Stillingia, - Take 15 to 20 drops in water tiirice daily. Inflammation, (i) Tincture of Aconite, Tincture of Belladonna, Take 3 or 4 drops in water every hour. (2) Tartaric Emetic, Sulphate of Magnesia, Sulphate of Morphia, Aromatic Sulphuric Acid, - Tincture of Veratrum Vivide, Syrup of Ginger, - Distilled Water, Take a tablespoonful every 2, 4, or 6 hours. a day, 1 drachm. ^ drachm. 8 grains. Yz grain. Dr. Bartholcnv. 2 drachms. 2 drachms. 2 drachms. 7 ounces. y^ grain. 6 grains. 40 grains. 30 grains. 3 drachms. 5 drachms. 1 drachm. 2 drachms. Dr. Bartholow. 2^ grains. 2 ounces. i/^ grains. y^ drachm, i^ drachms. 2 ounces. 10 ounces. Dr. Gross, FAVORITE PRESCRIPTIONS. 257 chm. ms. s. 'hillips. hiccough, 'hillips. im. hm. n. -tholoiv. ims. ims. ims. cs. n. IkS. ns. lins. ims. uns. hm. hms. riholow. ains. :es. lains. Ichm. [achms. :es. ices. Gross, 1/ ounce. 1 d tad 1111. 1 1 drachms. 2 drachms. 3 draclims. 1 drachm. 3 draclims. 2 ounces. li ounce. y^ ounce. Influenza. -* (i) Fluid Extract of I[)ecac, - - - 2 drachms. Dcodoralcd Tincture of Opium, - - 4 chachms. Tincture of Aconite, - - - 1 drachm. Take 5 to 10 drops every 2 iiours. (2) Fluid Extract of l>lack Cohosh, ])eodorated 'I'incturc of (Jinum, Syrup of Tolu, . - - . Take a teaspoonful every four hours. Insomnia or Sleeplessness, (i) Hydrate of Chloral, - - . Bromide of Potash, Tincture of Opium, Syrup of Orange Peel, - - - AVater to make - . . . 'I'akc a teaspoonful at bed time, re^jcatcd if necessary. Dr. A'aiic. (2) P.romide of Potash, ' ri - Hydrate of Chloral, ... Syrup o( Wild Clicrry, - - - i ounce, Water to make . - - - 2 ounces. Take a teaspoonful in a wineglass of water ; reitcat, if necessary, in one hour. Intermittent Fever, or Fever and Ague, (i) Sul[)hate of (Juinine, - -, Dilute Sulphuric Acid, Spirits of Nitrous lAher, • Syrup of Tolu, . . - . Water to make I'akc a teaspoonful every 2 or 3 hours till relieved. Dr. Del Costa. (2) Suli»hate of Quinine, - - - 30 grains. Capsicum, - ■ - - - 15 grains. Powdered Opium, - - - - 3 grains. Divide into 30 oills and take from 1 to 5 pills as recjuired. J)r. Piffard. Should the ague become chronic, use the following : (3) Carbonate of Iron Mass (Vallit's Mixture), i drachm. ' Arsenious x\cid, - - - - i grain. Divide into 20 pills. Take one thrice daily. Dr. Barthd ounces. (2) Solution of the Subacelale of Lead, CarboHc Acid, One-fourth of this to be added to a pint of water and used as an in- jection. Malaria Chronic. ^ (i) Arsenious Acid, - . - Carbonate of Iron Mass, Divide into 20 pills and take one thrice daily. (2) Sulphate of (}uinine, . . - Dried Sulphate of Iron, Arsenious Acid, Divide into 20 pills and take one thrice daily. Measles. (1) Carbolic Acid, - - - Acetic Acid. . . . Deodorated 'i'incture of Opium, - Spirits of Chloroform, ... Water to make Take a teaspoonful every 4 hours till fever abates. I gram. I drachm. 40 grams. 20 grains. I grain. 1 drachm. I drachm. I drachm. I drachm. 8 ounces. Dr. Keith. j \\ tni. WW. )S. es. Lwo hours. irkcr. bill, clim. IS. :cs. holow. ncc. uccs. ;d as an in- n. ;hni. ins. lins. n. rAVORITE I'RESCRIPTIONS. 259 (2) Tinrtuic of Tolu, • - -2 draclinis. Syrup of Senega, - - • /^ ounce. Acetic Acid, - • - i^ ounces. Syrui) of Wild Cherry to make - - 4 ounces. Take a teaspoonful as required for cougii after convalescence. Menorrhagia or Excessive Menstrual Discharge. (i) I'luid Extract of Ipecac, - - 2 drachms. l''luid J'Atract ofl'>L;()t, - - • 4 (Jrachms. l'"luid JCxtract ofDii^ilalis, - - 2 drachms. Take half a teaspoonful to a teaspoonful as required, till vomiting occurs. Dr, Jyarilwlow. 12 grains. 5 grains. until relieved. Dr. Keith. (2) Extract of Ergot (S(iuil)l)'s), Extract of Cannabis liidicus, Divide into 12 pills, and take one cvciy hour Nervous Exhaustion. Acetate of Strychnia, Dilute Acetic Acid, Alcoliol, Distilled Water, Take ten drops thrice daily. « Nervousness. Bromide ofl'otash, - - i ounce Fluid Extract of (luarana, - - > ' ' Syrup of Tolu, Water to make Take from a teaspoonful to a dessertspoonful 3 or 4 times daily. Neuralgia, (i) Chloroform, - - - Tincture of Aconite, Soap Liniment, Apply on flannel and cover with oiled silk. Internr.Uy use the following. (2) Phosphorus, . . , Alcohol lugh to dissolve it. Spirits ot I'cppcrmint, Glycerine to make Take a teaspoonful after each meal. 1 gram. 20 drops. 2 ilracluub. 6 ounces. Dr. Marshall Hall ly-z ounces* 3 ounces. 6 ounces. Yz ounce. ^2 ounce. I oance. j4 to I grain. I ounce. 4 ounces. :. «^ Dr. Hamilton. 26o THE FAMILY PHYSICIAN. Nipples, Sore. Jialsani of ]*tru, • - . Oil of Almond, - - . . Miicilai^c of (Juin Arabic, Rose ^Vatcr, .... Apply to the nipples alter eacli nursing. Paralysis. (i) Siili)hatc of Strychnia, Distilled Water, - - . . Inject five drops of this hy[)oderniically. (2) Iodide of Ammonia, Carbonate of Ammonia, Solution of Acciate of Ammonia, - Take a tablespoonful thrice daily. Perspiration in Consumption. (i) (JallicAcid, . . - . Extract of Belladonna, Divide into 10 pills and tukc two at bedtune. (2) Tannic Acid, . . . . Powdered Digitalis. Extract of Cinchona, Divide into 20 pills and take one at bedtime. Pertussis or Whooping Cough. (i) Chloral, llromide of Potash, Syrup of Wild Cherry, \Vater, . . - . . Take a teaspoonful thrice daily for in(anls. (2) Extract of Aconite, Syrup of Ipecac, ... \\'ater of Cherry Laural, - - - Mucilage of Gum Arabic, - 2 drachms. 1 ^2 drachms. 2 drachms. A bufticiency. Dr. riiil/ips. 2 grams. 1 ounce. 1 drachm. 2 drai hms. 6 ounces. Dr, Barllioiinv. 30 grains. 2 grains. Dr. Inirtliolow. 30 grains. 15 grains. A suhiciency. 1 diachm. 2 drachms. I ounce. I ounce. Dr. Dessau. I grain. 45 drops. I drachm. 6'-^ ounces. Take a teaspoonful to a tablespoonful according to age every hour. Dr. Detvieux. FAVORITE PRESCRIPTIONS. 261 Dessau. hs. Im. luces. ly hour. Xctvieux. (3) Carbolic Acid, - - • Chlorate of Potash, - • Glycerine, ... Water to make - - •- Use with a steam atomizer thrice daily. Pt hisis or Consumption. ( 1 ) For the Fever. Sulphate of Quinine, Powdered Digitalis, I'owdcred Opium, Divide into 12 pills. Take one thrice daily. (2) For the Dyspeptic Symptoms. Jensen's Pepsin, Dilute Hydrochloric Acid, (llycerine, - - - - Juice of Lemon, - Water of Orange Flowers to make - Take a dessertspoonful with meals. ^ drachm. 2 drachms. 4 drachms. 6 ounces. Dr. J. Lewis Stnith. 18 grains. 6 grains. 3 grains. Dr. Da Costa. 40 grains. 2'-'^ drachms. 5 drachms. 4 drachms. 4 ounces. Dr. Hu'rhes. 2 drachms. 2 ounces. I grain. 4 ounces. 3 For the Coui^h and R(stkss)iess. Tincture of l!elladonna, Syrup of Squills, - - - . Sulphate of Mori)hia, Syrup of Tolu to make Take a teaspoonful at bedtime and repeat if necessary. Dr. Gibbons. Pleurisy, (i) Acetate of Poiash, - - - i drachm. Infusion of Digitalis to make - - 4 ounces. Take a teaspoonful every 3 hours for a child 4 or 5 years old, in the second stage. (2) Mixture of Iron and Acetate of Ammonia, 6 ounces. Take a teaspoonful to a tablespoon ful according to age, in the second stage. Pneumonia or Inflammation of the Lungs, (i) Tincture of Viratrum Viridis, Spirits of Nitrous Ether, - Solution of the Citrate of Potash, - Syrup of Ginger to make - Take a tablespoonful every three hours in the early stage. Dr. Da Costa, 40 drops. 6 drnchms. 4^^ drachms, 6 ounces. m I i. I m 262 THE FAMILY PHYSICIAN. (2) Iodide of Soda, - - - . Sul[)liate of Morpliia, Simple Elixir, - - - . Take a tcaspoonful thrice daily. (3) Carbonate of Ammonia, - Infusion of Serpentaria, Take a tcaspoonful every 3 hours as a stimulant disease. Pruritus or Itching. (1) Carbolic Acid, - . - . (ilycerine, . . . . ]<.osc water to make - - ° ■ Apply to the itching part on cloth. (2) Dilute Hydrocianic Acid, Inlusion of Marsh Mallow, Apply as a lotion. (3) Cyanide of Potash, Wat ~r of Cherry J .aural, - Apply as a lotion. (4) Prepared Chalk, - Coal Tar, Linseed Oil, Make into an ointment and apply. (5) Dilute Hydrocianic Acid, Borate of Soda, Rose Water, Apply as a lotion. Rheumatism, Acute. (i) Oil c' Wintergreen, Salicylic Acid, Borate of Soda, Syrup of Tar, Anise \Vater, Take a dessertspoonful every 2 hours. 1 j4 drachms. ^ grain. 2 ounces. Dr. Da Costa. 40 grains. 4 ounces. about the crisis of the Dr. Barthoimv. 2 drachms. I oil ace. 8 ounces. ^ to I drachm. 5 to 8 ounces. Dr. Fox. 15 grains. 8 ounces. Dr. Anderson. I ounce. 1 to 2 drachms. zyi ounces. Dr. Biilkky. 2 drachms. I drachm. 8 ounces. Dr. Fox. I drachm. 80 grains. - 1 drachm. 2 ounces. 2 ounces. I FAVORITE PRESCRIPTIONS. 263 (2) Iodide of Potash, - Wine of Colchicum Seeds, Simple Syrup, Peppermint Water, Take a tablespoonful every 4 hours. (3) Salicylic Acid, - - - Bicarl)onate of Soda, Water, .... Take a teaspoonful or two every 2 hours. 2 drachms. 4 drachms. 4 drachms. 5 ounces. Ncmi Orleans Ilospitai. 2 drachms. 1 f'rachm. 2 ounces. Dr. Bartholinv. Rheumatism, Chronic. (i) P^therial Tincture of Guaiacum, - - i ounce. Etheriai Tincture of Colchicum, - - 6 drachms. Etherial 'Mncture of Cannabis Indicus, - 2 drachms. Take 25 to 30 drops on sugar every 4 hours for rheumatic and neural- gic symptoms. Dr. Atiee. 2 drachms. 2 drachms. 2 ounces. Dr. Fothcrgiil. j4 drachm. 3 drachms. 4 drachms. 3 drachms. 4 drachms. 6 ounces. (2) Aconite Liniment, Belladonna Liniment, Glycerine to make, Apply locally over the seat of pain. (3) Oil of Mustard, Oil of Turpentine, - Camphor, Strong Solution of Ammonia, Tincture of Capsicum, Alcohol to make Apply as a liniment. This is the celebrated Russian Spirit Liniment. f oabies or Itch. (i) Corrosive Sublimate, Alcohol, - . . , Chloride of Ammonia, Rose water to make Apply as a lotion. (2) Sublimated Sulphur, Peruvian Balsam, Lard, An ointment for children. 4 gra'"-!. 6 dracnms. Yi drachm. 6 ounces. Dr, Fox. I drachuui. Y2, dracham. I ounce. Dr. Duhring^ -iS 264 THE FAMILY PHYSICIAN. m (3) Sublimated Sulphur, Oil of Cade, Prepared Chalk, Green Soap, Lard, Use as an ointment. 2 drachms. 2 drachms. 2}^ drachms. I ounce. I ounce. Scarlatina. (1) lioric Acid, _ - - Chlorate of Potash, Tincture of the Chloride of Iron, Glycerine, • ^ - Syrup, Water, Give a tcaspoonful every 2 hours to a child of 5 years Dr. Bulkky. y^ drachm. 2 drachms. 2 drachms. I ounce, 1 ounce. 2 ounces. (2) ])oric Acid, . _ . . Glycerine, - _ _ . Add to a pint of water and use as a gargle. (3) Carbolic Acid, - - - . Vaseline, . - . . Use as an ointment to the entire surface of the Spermatorrho&a or Seminal Loss. (i) Ih'omidc of Potash, liicarbonate of Soda, - . - Inhision of l^igitalis, - - . Sulphate of Atropia, . - . One dose to be taken at bedtime. (i) Tincture of Spanish fly, Tincture of the Chloride of Iron, Take 20 drops in water thrice daily. Syphilis. (i) Red Iodide of Mercury, - Iodide of Potash, - - Tincture of Orange Peel, - Syrup of Orange Peel, - - - Water, - - Take a tcaspoonful thrice daily after meals. Dr. Smith. 3 drachms. 4 ounces. Dr. Da Costa. }^ to I drachm. 4 ounces. body. 1 drachm. 15 grains. Yi ounce. Dr. Gross. 2 drachms. 6 drachms. Dr. II. C. ITood. 3 grains. 3 to 6 grains. I ounce. I ounce. 8 ounces. Dr. O'is. FAVORITE PRESCRIPTIONS. 265 (2) Red Iodide of Mercury, - Carbonate of Ammonia, - Iodide of Potash, - - - - Compound Tincture of Gentian to make - Take a teaspoonful in water after meals. Tonics. ( 1 ) Sulphate of Quinine, Dilute Sulphuric Acid — a sufficient quantity. Water, . . . - . Tincture of the Chloride of Iron, - Spirits of Chloroform, ... Clycerine to make . - - Take a teaspoonful after meals. (2) Citrate of Iron and Quinine, (Carbonate of Ammonia, - Compound Tincture of (lentian, - Tincture of Quassia, . . . Syrup, ..... Water to make .... 2 grams. 20 grains. 3 drachms. 4 ounces. Dr. Fox. 30 grains. 2 ounces. Yi ounce. 6 drachms. 4 ounces. Dr. I.oojiiis, 1 drachm. 30 grains. 2 ounces. 2 ounces. i^ ounces. 8 ounces. Take a dessertspoonful thrice daily. Bellevird' Hospital., N. V. (3) Tincture of the Chloride of Iron, - - 10 drops. Tincture of Nux Vomica, Water to make One dose to be taken thrice daily after meals. 10 drops. I drachm. Typhoid Fever. (i) Tartar Emetic, . - - Sulphate of Morphine, Water of Cherry Laural, - Take a teaspoonful every 2, 3 or 4 hours. (2) Sulphurous Acid, . - - Dilute Sulphuric Acid, Deodorated Tincture of Opium, Syrup of Orange, - - - Water to make Take one-sixth of this every 4 hours. BlackivcU^s Asylum. I to r grains, i^ grains. 1 ounce. Dr. Dartholoiv. ' 2 drachms. 2 drachms. 20 drops. 3 drachms. 6 ounces. Dr. WUks. m I 266 THE FAMILY PHYSICIAN. (3) Sulphate of Quinine, - - - 10 grains. Dilute Hydrochloric Acid, - - - Yi ounce. Syrup of Orange, - - - i ounce. Caraway Water to make, - - - 6 ounces. Take a tablespoonlul in an equal amount of water every 3 or 4 hours Dr. Murchison. Ulcers and Sores. (i) Iodoform, ----- 2 drachms, Mucilage of Gum Arabic, - - - 15 drops. Oil of Peppermint, - - - - 2 drops. Glycerine, - - - - - 20 drops, Use on unhealthy ulcers. , Dr. Bronso7i. (2) Corrosive Sublimate, .... 15 grains. Carbolic Acid, - - - -30 drops. Water to make - - - - 4 ounces. Use on syphilitic ulcers, with cotton, and renew once a day. Dr. Fox. Urination, Painful, in Women. Fluid Extract of Belladonna, Fluid Extract of Buchu, - Nitrous Spirits of Ether, Take a teaspoonful 3 or 4 times daily. Vomiting. (1) Dilute Hydrocianic Acid, - - - Water of Cherry Laural, Take a teaspoonful every 2 hours till relieved. (2) Hydrobromic Acid, Take half a teaspoonful in a wineglass of water 4 times daily. Vomiting in Pregnancy. (i; Oxalate of Cereum, - . - Ipecac, - . - - - Creosote, - . - - - Divide into 12 pills, and take one ev«.ry hour. J^ to I drachm. 1 ounce. 2 ounces. 1 drachm. 2 ounces. 2 ounces. 12 grams. 15 grains. 24 grains. (2) .Subnitrate of Bismuth, Oxalate of Cerium, Sulphate of Morphia, Syrup, - . - - Take a teaspoonful every hour till vomiting ceases. Dr. GoodeU. 160 grains. 40 grains. \yz grains. 2 ounces. Dr. Vaji Vaizah. FAVORITE PRESCRIPTIONS. iGy Worms. (i) Fluid Extract of Pink Root, - - i ounce. Fluid Extract of Senna, - - • Yz ounce. Give a teaspoonful to a child betv*rcen 3 and 5 years. Dr. Sviith. (2) Pomegranate-root Bark, - - - 2 ounces. Make a tea of this and take before i t a.m., and after two hours take the following : Castor Oil, .... Turpentine, .... Ethereal Extract of Male Fern, Take at a dose. The above is the adult dose. Yellow Fever. ( I ) Carbonate of Potash, ... Camphorated Tincture of Opium, Water, . - . . . 3 ounces. I (Iraclim. T drachm. Dr. IVi/de, 20 grams. I drachm. 8 ounces, Take 2 tablcspoonsful every hour or two to produce sweating. Dr. J)ickson. (2) Chloroform, . . . Tincture of Camphor, Take 2 drops as required for the vomiting. Yn ounce. Yz ounce. >^-J CHAPTER XIV. DIETETIC RECEIPTS FOR THE SICK ROOM. Importancp of the subject — Rules for preparing and serving food for the sick — Nutrilious, coolirtif, and sootliivi^ drinks : |[Leinonade — I">fft'rvoscing lemonade — Barley water — Lin- seed tea — Arrowroot drink — Milk punch — Wine whey — Egg andslicrry — Ice — Toast and water — Nutritious ^coffee— Milk and Isingla. s — A soothing drink — Milk and cinnamon drink — Caudle — Apple water — Chocolate — Chocolate milk — The Invalid's tea— Rose tea —Sage tea— Oatmeal tea. GrueU : Water gruel — Milk gruel— Flour gruel — Rice gruel — Barley gruel. Broths and soups ; Chicken bi' ih — Mutton broth — Whole beef tea — Quickly-made beef tea — Vegetable soup — Breatl soup — Spinach soup — Beef and hen broth. Meats and Vei^c/ables for Invalids: Table, in order of digestibility, of some ar- ticles of animal food — lioiled pigeon or partridge — Bread sauce — Relish for fish — Minced fowl and egg — Fowl and rice — Stewed oysters — The invalid's cutlet — The invalid's mashed potato — I'otato surprise. Jellies for invalids: Isinglass jelly — Strengthening jelly — Mutton jelly — Bread jelly — Rice blanc-mange — Arrowroot blanc-mange — Sago jelly — Tapioca jelly — Panada — Calves' feet jelly — Currant jelly — Irish moss blanc-mange — Gelatine blanc-mange, Puddings for Invalids: Rice pudding — Bread pudding -Batter pudding — Milk for puddings or stewed fruit — Rice and apple — Vermicelli pudding. In many, if not in all diseases, the choice and the preparation of the articles for the patient's table are of the utmost importance. Food is often the best medicine, and the cook may frequently be of more service than the druggist. But not uncommonly, the dishes served the invalid, like the drugs administered to him, fail of their effect because of their faulty preparation. Those who cook for the sick share the responsibility of treatment with the physician and pharmacist. The character and amount of the food required by the sick vary, of course, with the nature and stage of the illness. Those sick of a fever need to be nourished by frequent supplies of nutritious, easily digested food, in a fluid form, for solid food is, ordinarily, then rejected by the stomach, because of the loathing it excites. The weakest stomach, in such case, will take a small wineglassful of milk or beef-tea, every hour or two. If the milk clot in the stomach, and cheesy lumps be thrown up, this can be readily guarded against by adding a tablespoonful of lime water to each wineglassful of milk. As no regular meals can be taken, they should not be attempted. Small (luantities of fluid food at short intervals, will furnish, dm iiig the twenty-four hours, a large amount of nourishment, which the irritable stomach, when thuL approached, will absorb unconsciously. In inflammatory rheumatism, meat in nny form, solid or fluid, is injurious ; the patient must be put upon preparations of rice, potatoes, bread, arrowroot, gruel, vegetable or meatless soups, and Z6^ DIETETIC RECEIPTS FOR THE SICK ROOM. 269 jellies. In dyspepsia and weak digestion, the invalid recjuires frequent small meals, at which he should drink very sparingly, and not all at the beginning of the repast. Persons subject to hysterics need a generous meat diet, and must avoid all si)irituous or fermented liquors. An ex- cellent drink for them is a mixture of ecjual parts of soda water and milk. For consumptives, milk and suet are excellent articles of diet, but the best of all is cod-liver oil, which is the most readily digested fat of which we have any knowledge. In disease of the heart, a dry diet is most con- ducive to the comfort of the invalid, as liquids are absorbed very slowly by the stomacii ; the table should be generous, from which stimulants, however, are to be excluded, as they readily excite the heart's action. We cannot better preface the varied receipts of this chapter, than by cjuoting the words of one whose eminence in the profession, and whose large and long experience, give them the weight of authority. Professor Gross says : " The diet of the sick room has slain its thousands and tens of thousands. Ikoths, and slops, and jellies, and custards, and ptisans, are usually as disgusting as they are [pernicious. Men worn out by dis- ease and injury must have nutritious and concentrated food. The or- dinary preparations for the sick are, in general, not only not nutritious, but insipid and flatulent. Animal soups are among the most efficient supporters of the exiiaustcd system, and every medical man should know how to give directions for their jireparation. The life of a man is his iy.,od. Solid articles are, of course, withheld in acute diseases, in their •'^'' stages ; but when the patient begins to convalesce, they are fre- luenciy borne with impunity, and greatly promote recovery. All an- imal soups should be made of lean meat ; and their nutritious properties, as well as their flavor, may be much increased by the addition of some vegetable substance, as rice or barley. If the stomach is very weak, they may be diluted, or seasoned with j)e])per." 'Hie following rules must be observed in preparing, cookinj serving food for the sick : — ■ All the utensils employed should be scrupulously clean. Never make a large c^uantity of one thing at a time. Serve everything in as tempting and elegant a form as possible. Put only a small (quantity of an article on a dish at a time. Keep milk and other delicacies on ice in warm weather. Never leave food about a sick room. Never offer beef tea or broth with the smallest particle of fat or grease on it, nor milk that is sour, no meat or soup that is turned, nor an egg that is bad, nor vegetables that are underdone. If and NUTRIIIOUS, COOLING AND SOOTHING DRINKS. Lemonade. Take of :— Sugar, two or three lumps. Lemon, one. \H 270 tllK FAMILY niVSIClAR Well rub the sugar on the rind of the lemon, s(iucezc out the juice, and add to it half a pint or a pint of cold or iced water ; or, better slill, one or two bottles ot soda water. Another Lemonade. I'are the ring of three lemons as thin as possible, add a ([u:ut of boiling water and a (}uarler of an ounce of isin- glass. Let them stand till next day, covered, then sciuee/.e the juice of eight lemons upon haU a pound of lumi) sugar ; when the sugar is dis- solved, pour the lemon and water upon it, mix all well together, strain it, and it is ready lor use. Effervescing Lemonade. S(iuee/.e two large lemons, and add a l)int of sjjring water to the juice, and then four or fwc lumps of wiiile sugar. When recjuired for use, pour half of it into a tumbler, and add half a teaspoonful of baking soda ; stir and drink while foaming. Barley Water. Take of : — Pearl barley, half a quarter of a pound. "N', ash with cold water, lluil for five minutes in some fresh water, and then throw both waters away. Then jjour out two ([uarts of hoiliiv: loatcr, and boil it down to a ([uart. Flavor with thinly-cut icnion rind, and sugar to taste, but do not strain, unless at the sick person's special recjuest. This is an excellent rccei[H for making hard water more digestible. Linseed Tea Take of:— Whole linseed, White .'■ugar, each one oi;nce. 1-icorice root, half an ounce. Lemoti juice, four tablespoonsful. Pour on the materials two pints of l>oinn\; uuilcr, let them stand in a hot place four hours, and then strain off the licjuor. This makes an admirable soothing drink, which acts also upon the kidneys. Arrowroot Drink. Take of : — Arrowroot, two tablespoonsful. Cold water, three tablespoonsful. Mix together and pour in al)oul half a [)inl of boiling water. When well mixed, add, by degrees, half a pint of cold water, stirring all llie time, so as to make it perfectly smooth. It should be about the consist- ance of cream ; if too thick, a little more water may be added. Then pour in two wineglasstuls of sherry, or one of brand)', add sugar to taste, and give it to the invalid in a tumbler. A lump of ice may be added. Milk-Punch. Take of :— Good brandy, two tablespoonsful. Cold, fresh milk, one tumblerful. • Mix with sugar and nutmeg to taste. DIETETIC RECEIPTS FOR THE SICK ROOM. 271 This is a useful drink when a stimulant is recjuircd in conjunction with a nutriment. It is a medicinal drink, and must not be given indiscrim- inately. Wine Whey. Take of :— Fresh milk, one pint. Boil it, and so soon as the boiling [joint is reached add as much good maderia or sherry as will coagulate it. .Strain, and sweeten or iluvor lor use. This preparation, when nicely made, renders great service to the sick in proper cases. Eggs and Sherry. Beat up, with a fork, an cu;g till it froths, add a lum[) of sugar and Lwo tables[)oonsful of water. Mix well. Then pour in a wineglassful of sherry, and serve before it gets llat. Half the ijuan- lity of brandy may be used instead of sherry. This is a valuable {)roparation in cases ot great prostration, when stim- ulants and concentrated nutriment are required. Ice. It has been found by'ex[)criments on the gastric juice that low temperature does not exercise any deleterious inlluence iii)on it, though it is ([uite spoiled by heat. The supply of the juices necessary to diges- tion is arrested by fevcrishncss of the system and in hot weather and in hot rooms. It cannot, therefore, but be Ijcnefieial to the stomach to re- duce the unusual lem[)crature to which it has been brought by the over- heated blood. Hence, ice makes a most valuat)le addition to the tables of both sick and well. It is very injurious during the exhaustion follow- ing violent exercise, or the real cooling attending excessive perspiration. Lake ice is much su[)erior Lo pond ice or snow. Toast and Water. Take of:— JJread, one slice, from a stale loaf. Boiling water, one quart. Toast theslice of stale bread (a pieceof hard crust is belter than anything else for the ])ur[)ose) to a nice brown on each side, but do not allow it to burn or blacken. But it into a jug, jiour the boiling water over it, cover it closely, and let it remain until cold. When strained it will be ready for use. Toast and water should always be made a short time before it is re- quired, to enable it to get cold ; if drank in a tei)id or lukewarm slate, it is an exceedingly disagreeable beverage. It', as is sometimes ihe case, this drink is wanted in a hurry, put tlie toasted bread into a jug, and only just cover it with die boiling water ; when ihis is cool, cold water may be added in the proportion rec^uired, and the toast and water strained. It will then be ready for use, and is more expeditiously pre- pared than by the above method. Nutritious Coffee. Dissolve a little isinglass in water, then put half an ounce of freshly ground coffee into a saucepan, with one pint of 272 THE FAMILY PHYSICIAN. new milk, which should be nearly boiling before the coffee is added. ]>oil holh logelhcr for three minutes. Clear it by i)ourin;4 some of it in a cup and dashing it back again. Add the isinglass and leave it to set- tle before the fire for a few minutes, beat up an egg in a breakfast cup and pour the coffee into it; or, if preferred, drink without the egg. Milk and Isinglass. Take of: — Isinglass, a pinch or two. Milk, a tumblerful. Mix well and boil. Serve with or without sugar, as preferred. A Soothing Drink. Take of: — Isinglass, a pinch. New milk, a tumblerful. Bruised sweet almonds, half a dpzen. Sugar, three lumps. Boil together. Milk and Cinnamon Drink. IJoil, in a pint of new milk, sutii- cient cinnamon to flavor it pleasantly, and sweeten with white sugar. This may be taken cold, with a tcaspoonful of brandy, and is very good in cases of diarrhoea. Children may lake it milk-warm, without the brandy. Caudle. Beat up an egg to a froth, add a wincglassful of sherry, and half a pint of gruel ; flavor with lemon-peel and nuimeg, and sweeten to taste. Apple Water. Slice two or three ripe apples, without paring, into a pitcher, pour out a quart of scalding water, let it stand till cool, and sweeten with sugar. Chocolate. Put milk and water on to boil. Scrape the chocolate fine, one or two squares to a pint, as will best suit the stomach. When the mixture of milk and water boils, take it off the fire, throw the cho- colate into it, mix it well, and serve it up with the froth. The sugar may be mixed with the scraped chocolate, or added afterwards. It should never be made before it is wanted, as heating it again injures the flavor, and causes a separation of the oil. Chocolate Milk. Dissolve an ounce of scrai)ed chocolate in a pint of boiling new milk. The Invalid's Tea. Pour into a small china or earthenware teapot a cup of quite boiling water ; empty it out, and while the teapot is still hot and steaming, put in the tea. Add enough boiling water to wet the tea thoroughly, and set it close to the fire to steam, lor five or six min- utes. Then pour in the quantity of boiling water required, from the kettle, and it is ready for use. DIETETIC RECEIPTS FOR THE SICK ROOM. 273 added. of it ill I lo bcl- fast ciii) Ik, siilll- igar. 1 is very without rry, and ceten to ng, into Do\, and ocolatc When ho cho- e sugar ds. It Lires the n a pint 2 teapot t is still wet the ix min- mm the Rose Tea. Take of :— Red rosebuds (the white heels being taken off), half an ounce. White wine vinegar, three tahlespoonsful. White sugar candy, one ounce. Put them in two j)ints of boiling water, and let them stand near a fire for two hours, then strain. Similar sour chinks may he made of api)le jelly, syrup of gooseberries, etc. A variety is always agreeable. Sage Tea. Take of:— (Ireen sage leaves, plucked from the stalks and washed clean, half an ounce. Sugar, one ounce. Outer rind of lemon-peel, finely pared from the white, (quarter of an ounce. Put them in two pints of boiling water, let them stand near the fire for hall an hour, then strain. When the sage is dried, it must be used in rather less quantity than above mentioned. In the srfnic manner, teas may be made of rosemary, balm, southern wood, etc., and are convenient to prevent a thirsty invalid taking too much tea and coffee when not good for him. Oatmeal Tea. Take of : — Oatmeal, a liandful. * Parley water, a gallon. Mix in a deep vessel. Pet the oatmeal subside, whirh it docs in half an hour, and [)our off the lea. Plard water may be made digestible in this manner. GRURPS. Gruels should be thick, but not too thick ; thin, but not too thin. Served in a tumbler they are more appetizing than when served in a basin or cup and saucer. Water Gruel. Take of : — Fine Oatmeal, a dessertspoonful. Cold water, a tablespoonful. Mix. Add a pint of boiling water, and boil it ten minutes, keeping it stirred. Milk Gruel. Take of:— I'inc oatmeal, four tahlespoonsful. ; ' ; ~ Milk, a quart. ' ' ^: R I I'* m ^^J %. ^'V. ...v IMAGE EVALUATION TEST TARGET (MT-3) 1.0 !?<- la I.I 1.25 ■- IM lllll 2 2 la 1^ ^ 1^ 1.4 2.0 1.6 V] > / /^ fe' m>.. ip- m m ii 274 THE FAMILY PHYSICIAN. i ' Stir the oatmeal smoothly into the milk. Then stir it quickly into a quart of boiling water, and boil up a few minutes, till it is thickened. Sweeten with sugar. Flour Gruel. Take of : — Flour, a tablespoonful. Water, half a tumblerful. Mix smoothly. Set on the fire, in a saucepan, half a tumblerful of new milk, sweeten it and, when it boils, add the (lour and water. Sim- mer and stir them together for a quarter of an hour. Rice Gruel. Take of : — Fine rice, two tablespoonsful. Soak for half an hour in cold water. Pour off the water, and to the rice add a pint, or ratjier more, of new milk. Simmer gently till the rice is tender, then press through a sieve and mix with the milk. Heat over the fire, add a little more milk gradually, pour off to cool, and flavor with salt or sugar. Barley Gruel. Take of : — Pearl barley, two ounces. ^ Port wine, a tumblerful. Rind of lemon, one. Water, one quart and a pint. Sugar to taste. After well washing the barley, boil it in a tumblerful of water for fif- teen minutes. Then pour this water away. Put to the barley the (juart of fresh boiling water, and let it boil until the lifjuid is reduced to half; then strain it off. Add the wine, sugar, and lemon peel. Simmer for five minutes and put it away in a clean jug. It can be warmed from time to time, as required. BROTHS AND SOUPS. I'roths, soups and beef tea should not be kept hot, but heated up as required. Neither should they ever be made in the sick room. Chicken Broth. Skin, and chop up small, a smaU chicken, or half a large fowl, and boil it, bones and all, with a blade of mace or sprig of parsley and a crust of bread, in a quart of water, for an hour, skimming it from time to time. Strain through a coarse colander. Chicken broth, poured on thin pieces of bread laid on the bottom of the dish, makes a good sauce for boiled chicken or partridge, when the invalid is well enough to be allowed solid food. . DIETETIC RECEIPTS FOR THE SICK ROOM. 275 Mutton Broth. Take of :— Lean loin of mutton, one pound, exclusive of bone. Water, three pints. Boil gently till very tender, throwing in a little salt and onion, accord- ing to taste. Tour out the broth into a basin, and when it is cold skim off all the fat. It can be warmed up as wanted. If barley or rice is added, as is desirable during recovery from sick- ness, it must be boiled first, separately, till (j^uite soft, and put in when the broth is heated for use. Whole Beef Tea. The virtue of jjccf tea is to contain all the con- tents and tlavors of lean beef in a licjuid form. Its vices are, to be sticky and strong, and to set in a hard jelly when cold. Take half a pound of fresh-killed beef for every pint of tea required, and remove all fat, sinews, veins and bones. Cut u^) into pieces under half an inch square, and soak for twelve liours, in one-third of the water. Take it out and simmer for two hours in the remaining two-thirds of the water, the quantity lost by evaporation being replaced from time to time. Then pour the boiling water on the cold lic^uor in which the meat was soaked. Dry the solid meat, pound it in a mortar, freed from all stringy parts, and mix with the rest. When the beef tea is made daily, it is convenient to use one day's boiled meat for the next day's tea, and thus it has time to dry and is easier pounded. A wholesome flavoring for beef tea is fresh tomato. A piece of green celery stalk, or a small onion and a few cloves, may also be boiled in it. Leeks give it a fusty flavor, and mushroom ketchup, sometimes intro- duced, is of doubtful composition. While this is cooking, some more hastily prepared, in the following way, may be used; Quickly-made Beef Tea. 'I'ake one pound of raw beef, minced, for each pint of water. Stir up cold and let it stand for one hour. Tlien place the vessel in which they are mixed in a pan of water, and heat for another hour, over a slow fire, being careful not to !)oil, as then the pre- paration becomes gluey, and is not equally nutritious or digestible. Run the tea through a coarse strainer, and tlavor at discretion. Vegetable Soup. Take of butter, half a pound. Put it in a deep stew-pan, place it on a gentle fire till it melts, shake it about, and let it stand till it has done making a noise. Have ready six medium-sized onions, peeled and cut small ; throw them in and shake them about. Take a bunch of celery, cut in pieces about an inch long, a large hand- ful of spinach, cut small, and a little bundle of parsley, chopped fine ; sprinkle these into the pan, and shake them about for a quarter of an hour ; then sprinkle in a little flour and stir it up. Pour into the pan two quarts of boiling water, and add a handful of dry bread crust, broken ill 'Vf: H •I 276 THE FAMILY rilYSICIAN. in pieces, a teaspoonful of pepper, tlirce l)lades of mace, beaten fine ; boil gently another half hour. 'I'hcn beat up the yolks of two eggs, with a teasi)oonful of vinegar, and stir them in, and the soup is ready. The order in which the ingredients are added is very important. Bread Soup. Take tlie crust of a stale roll, cut it in pieces, and boil it well in a pint of water, with a piece of butter as big as a walnut, stirring and beating them till the bread is raised. Season with celery and salt. Spinach Soup. Pick all the stalks from one and a half pounds of fresh s[)inach ; wash it and clip it ; pour it in a three-cjuart stew-pan, with a (juarter of a pound of butter ; stir it over the fire for five minutes : add an ounce of flour, and stir again for three or four minutes, then stir in two ([uarts of chicken broth till it boils. Simmer it on a coal stove for half an hour, and add a small teaspoonful of cream. Serve with it some fried or baked bread. ICndive or lettuce soup may be prei)ared in the same way. Beef and Hen Fruit. Take of: — Lean beef, one pound. Hen, one-half, boned. Pound together in a mortar ; add salt ; put in a stew pan with two and a half pints of water, and stir over the fire till boiling. Then add carrots, onions, Iccks, and celery, cut fine. ISoil for half an hour. Strain and serve. MEATS AND VEGETABLES EOR INVALIDS. TAHLE, IN ORDKR OF DIGESTIIUUTY, OF SOME AUTtCf.ES OF ANIMAL FOOD. * Sweet bread. lloiled chicken. Venison. Lightly boiled eggs, new (onsted cliecse. Roast fowl, turkey, partridge and pheasnnt. Lamb, wild duck. Oysters. Boiled haddock, trout, perch. Roast beef. ])oi]ed i)ecf. Rump Steak. Roast veal. Boiled veal, rabbit. Salmon, mackerel, herring. Hard-boiled and fried eggs. . . . ' , :n fine ; gs, with I' it. es, and walnut, h celery unds of tew-pan, linutes : hen stir al stove ; with it vith two lien add Strain ANIMAI, t»IETETIC RECEIPTS FOR THE SICK ROOM. 277 Wood pigeon, hare. Tame pigeon, tame duck, geese. Fried fish. Roast and boiled pork. Heart, liver, lights and kidneys of ox, swine and sheep. Lobsters. Smoked, dried, salt and pickled fish. Crab. Ripe old cheese. Boiled Pigeon or Partridge. Clean and season, inclose it in a pu'T l)aste, and boil. Serve in its own gravy, sui)plinienled by the liver rubbed up with some stock, and do not forget the bread sauce. Bread Sauce. Take of : — The crumbs of a French roll. Water, a tumblerful. Black pepper, six to eight corns. Onion, a small piece. Salt, to taste. r>oil till smooth ; then add a [)iece of Inillcr about as big as a walnut, and mix for use. It is good, hot, with hot birds, cold, with cold birds, and is an excellent food for the sick. Relish for Fish. Fish is made more digestible, and has its flavor brought out, by a few drops of lemon juice squeezed over it. Minced Fowl and Egg. Take of :— Cold roast fowl, one. Hard-boiled egg, one. New milk or cream, three tables])oonsful. ]Jutter, half an ounce. Flour, one tables^xionful. Salt, pepper, or cayenne, to -taste. Lemon juice, one teaspoonful. Mince the fowl and remove all skin and bones. Put the I)ones, skin and trinmiings inlo a stewpan, with one small onion, if agreeable to the patient, and nearly half a pint of watei'. Let this stir for an hour, then strain the li(|uor, clioi) the egg sniall, mince with the fowl, add salt and l)epper, put in the other ingredients, let the whole just boil, and serve with thin slices of toasted bread. Fowl and Rice. Take of : — Rice, one quarter of a pound. Broth, one pint. ■ Butter, one ounce and a half. Minced fowl, egg and bread crumbs. ■mi V I let m 1 1 I 4 ■■ w i ^'■-'' 1 1 '' ' H r II 278 tllE FAMILY PHYSICIAN. I'ut the rice into the bi olh, let it boil very gently for half an hour, then add the butter, and simmer it until quite dry and solt. Wiien cold, make it into balls, hollow out the inside, and fill ihcm with mince made according to the foregoing receipt, but a little stiffer. Cover with rice, dip the balls into egg, sprinkle with bread crumbs, and fry a nice brown. A little cream stirred into the rice before it cools improves it very much. Stewed Oysters. Take of : — Oysters, half a pint. ])Utter, half an ounce. Cream, one-third of a jMnt. Flour, cayenne and salt, to taste. Scald the oysters in their own liquor. Take them out, beard them, and strain the liquor. Tut the butter into a stewi)an, dredge in sufficient flour to dry it up, add the oyster licjuor, and stir it over a sharp fire with a wooden spoon. When it boils, add the cream, oysleis and seasoning, and simmer for one or two minutes, but not longer, or the oysters will harden. Serve on a hot dish, with thin slices of toasted bread. A rjuarter of a ])int of oysters, the other ingredients being in proportion, makes a dish large enough for one person. The Invalid's Cutlet. Take of :— Nice cutlet, from loin or neck of mutton, one. "Water, two teacupsful. Celery, one very small stick. Pepper and salt, to taste. Have the cutlet cut from a very nice loin or neck of mutton. Take off all the fat, juit it into a stewpan, with the other ingredients ; stew very gently indeed for nearly two hours, and skim off every particle of fat that may rise to the surface from time to time. The celery should be cut into thin slices before it is added to the meat, and care must be taken not to put in too much of this in gredie^t or the dish will not be good. If the water is allowed to boil fast the cutlet will be hard. Time, two hours, very gentle stewing. The Invalid's Mashed Potato. Boil one pound of potatoes with their skins on, till they are tender or brittle. Peel them and rub them through a fine sieve. When cool, add a small teacu[)ful of fresh cream and a little salt, beating up lightly until the whole is quite smooth. Warm up gently for use. Potato Surprise. Scoop out the inside of a sound potato, leaving the skin attached, on one side, to the hole, as a lid. Mince up fine the lean of a juicy mutton chop, with a liitle salt and pepper ; put it in the potato, pin down the lid, and bake or roast. Before serving (in the skin) add a little hot gravy, if the mince seems too dry. DIETETIC RECEIPTS FOR THE SICK ROOM. 279 our, then icn cold, ice made k'ith rice, e brown, s it very rd them, iuliicicnt fire witli lasoning, tcrs will -•ad. A )porlion, Take s ; stew rticle of should must be 1 not be Time, potatoes md rub of fresh smooth. leaving up fine ut it in ; (in the JELT.IES FOR INVALIDS. Isinglass Jelly. Boil an ounce of isinglass and a dozen cloves (if liked), in a (juart of water, down to a pint. Strain, hot, through a Ikui- nel bag on two ounces of sugar candy, and llavor. Strengthening" Jelly. Simmer, in two ([uarts of soft water, one ounce of pearl barley, one ounce of sago, one ounce of rice, till reduced to one quart. Take a teacupful, in milk, morning, noon and night. Mutton Jelly. Take of:— Shanks of mutton, six. Lean beef, half a pound. Water, three pints. Crust of bread, toasted brown. Pepper and salt, to taste. Soak the shanks in water several hours, and scrub thcni well. Put the shanks, the beef and other ingredients into a sauce[)an, with the water, and let them simmer, say, gently, for five hours. Strain it, and when cold, take off the fat. Warm up as much as is wanted at a time. Bread Jelly. Take the crumb of a loaf, break it up, pour boiling water over it, and leave it to soak for three hours. Then strain off the water containing all the noxious matters with which the bread may be adulterated, and add fresh. Place the mixture on the fire and let it boil till it is perfectly smooth. Take it off, and after pouring out the water, llavor with anything agreeable. Put it into a mould, and turn it out when required for use. Rice Blanc-mange. Take of : — Ground rice, one-quarter of a pound. Loaf sugar, two ounces, liutter, one ounce. Milk, one quart. Flavoring, of lemon peel. Mix the rice to a smooth batter, with a little milk, and put the re- mainder into a saucepan, with the butter, sugar and lemon i)eel. Bring the milk to boiling point, stir in the rice. Let it boil for ten minutes, or till it comes away from the saucei)an. Grease a mould with salad oil, pour in the rice^ let it get perfectly cold and turn out. Arrowroot Blanc-mange. Take of : — Arrrowroot, two tablespoonsful. Milk, three-quarters of a pint. Lemon and sugar, to taste. Mix the arrowroot, with a little milk, to a smooth batter ; put the rest of the milk on the fire and let it boil. Sweeten and flavor it, stir- V ■ ■ i M ; ■ ■IT I i i?.« . If' ' 280 THE FAMILY rilYSlCIAN. ring all the time, lill it thickciu; sufficiently to come from the saucepan. Put it into n mould till ciuitc cold. Sago Jelly. Take of — Sago, two tablcspoonsful. Water, one pint. Boil gently, until it thickens, frc(iucntly stirring. Wine, sugar and water may be added, according to circumstances. Tapioca Jelly. Take of : — Tapioca, two tablcspoonsful. Water, one pint. Boil it gently for an hour, or until it assumes a jcMy-like ai)pcarance. Add sugar, wine and nutmeg, with lemon juice to suit the taste of the patient and the character of the ailment. Panada. Take of : — Bread crumbs, one ounce. Mace, one blade. Water, one pint. Boil, without stirring, till they mix and turn snu)oth. Then add a grate of nutmeg, a small piece of butter, sugar according to taste. Calves'-feet Jelly. Take two calves' feet and add to them one gallon of water, and l)oil down to one (juart. Strain, and, when cold, remove all fat. Then add the whites of six or eight eggs, well beaten, (a pint of wine, if desirable), half a pound of loaf sugar, and the juice of four lemons, and mix well. ]>oil for a few minutes, constantly stirring. Then strain through a flannel bag. Currant Jelly. Boil together ec|ual weights of white sugar and the juice of white currants, until the mixture solidiiles by cooling, as shown by dropping a few drops on a cold plate. Remove the scum, and form the jelly in suitable vessels. A tablespoonful of this jelly in a tumbler of cold water makes a de- lightful acid drink, very grateful to many invalids. Irish Moss Blanc-mange. Take of : — Irish moss, half an ounce. Fresh milk, one pint and a half. Boil these down to such a consistency as to retain a form when cold. Remove any sediment by filtering, and then add the recjuisite (juantity of sugar, with lemon juice or peach water, to give an agreeable flavor. The moss, before being used, must be well washed in cold water, to remove its saltish taste. Gelatine Blanc-mange. Boil one ounce of shred gelatine in a quart of milk for ten minutes, stirring constantly. Sweeten to the taste, flavor with peach water or essence of vanilla, and strain into a mould. in a taste, uld. DIETETIC RECEIPTS EOK THE SICK ROOM. PUDDINGS FOR INVAT.IDS. 281 Rice Pudding. Boil two ounces of rice in a pint of milk, assidu- ously stirring till it thickens. Take it off and let it cool. 'I'hen well mix in two ounces of butter, a quarter of a nutmeg, grate(.l, and sugar in moderation, according to taste. Pour it into a buttered dish and bake. Bread Pudding- Pour over a French roll half a pint of boiling milk, cover it close, and let it stand till it has soaked up the milk. Tie it up tightly in a clolli, and let it boil for a (juarter of an hour. Turn it out on a plate and sprinkle a little white sugar over it. The addition of burnt sugar or tincture of saffron, will give it the established yellow color. Batter Pudding. Take of:— Flour, three teaspoonsful. Milk, one pint. Salt, a pinch. Powdered ginger. Nutmeg. Tincture of saffron, each a teaspoonful. Boil. It will be observed in these three rccei[)ts eggs arc a\t)ided, as when baked, or even when boiled, so long as it is necessary to boil puddings, they aretpiite insoluble in a weak stomach. Milk for Puddings or Stewed Fruit. Jioil a strip of lemon and two cloves in a pint ot milk. Mix half a teaspoonful of arrowroot in a little cold milk, and add it to the boiling milk Slir it till about the consistency of cream. Have read)' the yolks of three eggs, beaten u[) well in a little milk. Take the hot milk off the fire, and as it cools, add the eggs and a tablespoonful of orange flower water, stirring in constant- ly till quite cool. Keep it in a very cool place till recjuired for use. Rice and Apple. — J5oil about three tablespoonsful of rice in a pint' and a half of new milk, and simmer, stirring it from time to time, till the rice is quite tender. Have ready some apples, peeled, coied, and stewed to a pulp, and sweetened with a very little loaf sugar. Put the rice round a plate, aud the apple in the middle, and serve with a litUe of the above preparation of milk, if liked. Vermicelli Pudding. Take of: — Vermicell' ♦^wo ounces. Milk, three ) carters ot a pint. Cream, one-tjuarter of a pint. Butter, one ounce and a half. Egt,s, two. Sugar, one ounce and a half. I r n \ ' 1 ■-■1? 282 THE FAMILY PHYSICIAN. Boil the vermicelli in the milk till it. is tender, then stir in the remain- ing ingredients (omitting the cream if that he not obtainable). JJutter a small tart dish, line with puff paste, put in the pudding and bake. We conclude this chapter with the following judicious counsels from the pen of Prof. ChamjjI'.rs, of London : " When a patient cannot be raised in bed without risk of exhaustion, a crockery or glass feeder is a convenience, but the same vessel, or even one of the same appearance, should not be used for food and for medicine. If the patient's mouth be foul, as in small-pox or putrid fever, it should be cleansed when lie is fed. The administration of nutriment should then be so frequent that it is not allowed to become again foul. Food should, as a rule, be as near the natural temperature of the body as possible. But when the febrile heat is very high, or there is much nausea, some of it may be iced, with advantage. When life seems passing away under their eyes, the friends will often shrink from tormenting (as it seems to them) the sick man with food. Let them not despair; many a one has recovered alter ihc doctor has taken his leave with a sad shake of the head, and without making a fresh ap])ointment. And let them also be stimulated by this fact, namely, that the pains of death are aggravated, if not mainly caused, by the failure of nutrition. Even when apparently insensible, the dying suffer much increased distress from want of food, though they cannot express their sufferings." le rcmain- liulter t)ake. isels from :annot be jcdcr is a ipearancc, It's mouth when he [^ucnt that ule, be as when the it may be Lhcir C)es, hem) the recovered lead, and ilimulated ot mainly nscnsible, jugh they CHArnui XV. MEDICAL KECEIl'TS FOR THE SICK KUOM. CATHARTICS OR PURGATIVES. Cathartics or purgatives arc medicines which loosen the bowels. Those which act violently arc called drastics, those which act mildly, ai)erients or laxative* Remarks in rei^ard to their 7/se. The habitual employment of purgatives is a practice productive of great injury, causing dyspepsia and many other troubles of the stomach and bowels. Purgatives should not be given so that their operation will interfere with the regular hours of rest. They should not be taken immediately after a full meal. The action of every purgative is followed by a greater or less amount of coi.tiveness. This is es[)ecially true of rhubarb, least so of castor oil. In cases of great debility cathartics should be avoided. Effervescing Cream of Tartar. Take of : — Cream of tartar. Carbonate of soda, each three drachms. Water, a tumblerful. Put the whole into a stone jug or bottle, and attach the cork firmly. To be taken in the morning, before eating. Magnesia and Rhubarb. Take of : — Magnesia, one ounce. Rhubarb, two drachms and a half. Powdered ginger, two scruples. Mix and divide into eight powders. Take one or two in the evening, at bed-time, to obtain a laxative effect in the morning. Rhubarb and Epsom Salts. Take of : — Powdered rhubarb, one drachm. Epsom salts, one ounce. Spirits of peppermint, two drops. Water, a tumblerful. One or two tablespoonsful will produce a laxative effect, 283 ' 1 ! ! ^: :i 284 THE FAMILY PHYSICIAN. May Apple, or Mandrake. Take of: — Powdcrt '. resin of May ai)i)lc (I'odopliyllin), one grain. Powdciod hyoscyamiis leaves, eight grains. Powdered ginger, twelve grains. Mix and divide into four powders. One or two at bedtime in torpor of the liver and bilious disorders. A much better and safer pill Ihau blu6 mass or other mercurials, so frequently employed indiscriminately in these cases. Jalap and Cream of Tartar. Take of :— Powdered jalai), one drachm. Cream 'f tartar, six drachms. Mix And divide into six powders. I )ose, one, in molasses. Calcined Magnesia. Take of :— Husbands' or Ellis' magnesia, thirty grains. And dissolve it in a little milk or water for one dose. This is an excellent cooling laxative. Its operation is promoted by the drinking of lemonade. Seidlitz Powders. These are to be obtained of any druggist. Two powders arc given together, a white and a l)lue one ; each ot which is to be dissolved se[>arately, in a tumbler one-third full of water, and the two solutions then mixed and drank while foaming, in the morning, before breakfast. This is a very popular, gentle laxative, and well borne by the stomach, when other medicines of the kind disagree. Purgative Mineral Water. Take from a bottle of the solution of the citiate of magnesia, to be had of any druggist, a teacupful every two hours, until it operates. For a child live years old, a wineglassful is the proper dose. This preparation, which tastes like lemonade, is one of the most agreeable of laxatives. CLYSTERS OR INJECTIONS. Clysters or injections are solutions thrown into the lower bowel, in order to act as purgatives, as astringents to check diarrluea, or stop bleeding, or as nutrients to nourish the patient in those exhausted con- ditions when food cannot be given by the moutb. 1 A Purgative Injection. Take of: — Epsom salts, one ounce. Sweet oil, two tablespoonsful. Starch water, one pint. To be given when a purgative is required. C a t:i ol a ing c gram. in torpor pill than riminatcly riiis is an rinking of ist. Two hich is to d the two ig, before no by the 2 solution )(u\ every leglassful de, is one [)owcl, in or slop ited con- MEDICAL RECEIPTS FOR THE SICK ROOM. 285 Common salt and molasses also make an cxrcllont purgative injection ; a tables[)oonful of each in a pint of water, willi or without the addition of a little soap. An Astringent Injection. Take of :— Subnitrate of bismuth, twenty grains. • Tincture of catechu, a teasi)oonful. Milk, a wineglassful. I'^or one injection, to be repeated in twelve hours. Useful in check ing the purging of consumption, fevers, etc. Nutritive Injections. Life can be prolonged, and even, in many cases, preserved, by ihe persistent use of nu'ritive injections when, in ailments like ulceration of the stomach, it is '■ possible to give food by the mouth, as it is at onco rejected by the stomach. Nutritive injections are made of strong beef tea, milk, raw eggs, cod liver oil, and, even in extreme cases, of diluted brandy. COLD, MODE OF APPLYING. Cold has been em[)loyed in the treatment of disease from the earliest times. It is applied in various ways, by cold baths, by streams of cold water, by cold moist sponges and cloths, by bladders filled with ice, and by the evaporation of ether. Cold Application. Take of :— Nitre, half an ounce. Sal ammoniac, two drachms. Vinegar, three tablespoonsful. Water, a pint. Mix. This solution, applied, by means of sponges or cloths, to the head, and elscwliere, where intense cold is desired, produces a more powerful eflect than cold water or pounded ice. Cold Without Moisture. When it is desired to apply a freezing mixture to a small portion of the skin, it may ^c readily done by i)utting a mixture of ice and salt in a bladder, or a tumbler, or a lamj) glass covered with a piece of bladder. Hydropathic Belts. A hydropathic belt consists of a belt, five or six inches wide and long enough to pass two or three times round the body. It is dipped into cold water, carefully wrung out, wound round the trunk, and covered by a wider and longer dry band. About every hour, or as often as it becomes dry, it is to be changed. A bandage may be applied in the same manner upon various parts of the body, and particularly over the joints attacked by rheumatism. An eruption of the skin is usually produced by this application, which is frequently of service. I fi-' 1 ! if 286 THE FAMILY PHYSICIAN. COUNTER-IRRITANTS. Counter-irritants are applications intended to irritate the parts to which they are appHed, and by excitin;,^ artificial congestion or inflam- mation, to modify disease existing in a distant part. hiow this curative power is exerted, it is difficult to say. Professor Stille remark^: " It is a familiar fact that the body is an assemblage of organs, which are con- stantly exerting a reciprocal influence upon one another, so that all are more or less involved in the derangements of each. Examples of symjiathy between remote parts, and exerted through the organ of the mind, are innumerable. Emotions of pleasure or shame suffuse the face with blushes ; while fear and the depressing passions blanch the cheeks, chill the extremities, and bedew the skin with a cold sweat. So, emotions of pity or tenderness make the tears flow ; the odor or sight of agreeable food, or even the thought of it, makes the mouth water ; while disgusting objects turn the stomach, and alarming ones suspend digestion or destroy the appetite. Obstinate constipation has been overcome by causing the patient to stand upon a wet marble pavement ; consumption has often supervened upon the suppression of an issue or other habitual discharge ; and still more frequently, apoplexy and other internal con- gestions have followed the same causes. 'I'he translation of gout and rheumatism to the brain, heart, stomach, etc., when suppressed in the extremities, is familiar to ev- practitioner. The coryzas, and sore throats, and pulmonary c irrhs diarrha:as, and other affections which arise from merely getting .n^ ■' jt wet, are matters of daily experience, whose reality cannot be deni nor explained away. They are neither more nor less intelligible thi he effects of counter-irritation, and both must be accepted because th ; are facts." Shakspeare, whose wonderful acquaintance with the actions of the body has furnished us with more than one illustration, speaks, in " Romeo and Juliet," of the principal of counter-irritants, as follows :— " Tut, ninn, one fire burns out another's burning, One pain is lessened by anotlier's anguish. . . . Take thou some new infeetion to thy eye, And the rank poison of the old will die." Counter-irritation is effected by the application of various substances which redden or blister the skin, Croton-Oil Liniment Take of: — Croton oil, thirty drops. Sweet oil, two tablespconsful. Mix. Produces, when rubbed on, redness and eruption of the skin. A useful application to the chest in ' eginning consumption. MEDICAL RECEIPTS FOR THE SICK ROOM. 287 Iodine Paint. Take of : — Tincture of Iodine, Alcohol, equal parts. To be applied with a camel's-hair brush. Useful in many cases of persistent pains in the joints and limbs (See, also, IJlisters and Cups). CUPPING. Physicians employ two sorts of cups, known as wet cups and dry cups. The former are for the purpose of extracting blood, the latter for counter- irritation by reddening the skin. A dry cup can be readily applied by any one. All that is necessary is a tumbler or wine-glass, and a little piece of cotton or paper, which is to be wet with spirits of wine, set on fire, thrown into the glass, which should then at once be firmly nrcssed down over the skin, when the fire will be (juickly extinguished (without causing any pain), and the skin drawn up forcibly into the glass. The same object may be accomplished by holding the tumbler over a light until the air within is well heated, and then applying it quickly and closely to the skin. Cupping is of benefit in rheumatic ailments, and in many affections of the chest and of the large joints. DISINFECTANTS. Disinfectants are substances which possess the power of destroying poisons capable of producing disease, and of removing disagreeable odors and gases by decomposmg both them and the bodies from which they proceed. The ])rincipal disinfectants are carbolic acid, coal tar, creosote, char- coal, chlorine, permanganate of potash, quicklime, sulphate of iron (cop- peras or green vitriol), sulphur and fresh earth. Carbolic Acid as a Disinfectant. Take of: — Impure carbolic acid, one ounce. Water, one gallon. Mix. Sprinkle over the floors of privies, about sinks, etc. Charcoal as a Disinfectant. Powder some wood charcoal and expose it, in open pans, in the place to be disinfected. It has the ad- vantage over lime preparations, being without odor. Chlorine as a Disinfectant. Chlorine water, to be obtained from any druggist, is a. useful agent for correcting stenches, and, diluted with water, for washing foul sores. Permanganate of Potash. Take of : — Permanganate of potash, a teaspoonful. Water, a quart. ft fff] i- ■' , ' X iHi! 288 THE FAMILY niVSICIAN. Expose, in sanrcrs, in the sick room. Useful for musty closets and foul ccilcrs. It lias no odor itself. Green Vitriol. Sulphate of iron, commonly called green vitriol, or copperas, in i)o\vdcr, alone, or mixed \vith lime, is an excellent disinfect- ant for privy-wells, slaughter-houses, ditches, etc. Fresh Earth. Fine dry earth, sprinkled over offensive matters, is an admirable disinfectant. A knowledge of this fact has led to the con- struction of earth closets. A 1)0\ of dust from the road, and a tin cuj), ke[)t at the side of the closet or chamber vessel, so that the earth may be thrown immediately upon the dejection, will serve as a complete de- odorizer, and answer the purpose almost as well as the elaborately-con- structed patent earth closets now in the market. Sulphur. Take of :— Milk of sulphur, a teaspoonful. Water, one pint. Mix. Sprinkle over clothes to be disinfected, and iron with a hot flat- iron. The fumes of burning sulphur may be employed for disinfecting out- houses, closets, carriages, etc. To Quickly Remove a Bad Smell. An unpleasant odor may be quickly removed from the sick room by burning in it dried lavender or cascarilla bark, with the window open. EMETICS. Emetics are medicines which > luse vomiting, They are used to re- move from the stomach jioisons or crude indigestible matters, to dis- lodge things lodged in the throat or air-passages, and lo excite the ac- tion of the skin and of the liver. They are not, except, of course, in cases of poisoning, to be given when there is disease of the heart, great irritability of the stomach, or much general debility. They are well borne by children, and of much service in many of the ailments of in- fancy and childhood. Their action is promoted by drinking plentifully of warm water, and by tickling the throat with a feather. AVlien the vomiting produced is too violent or too long continued, it may be checked by a few drops of laudanum, or by applying a mustard plaster over the pit of the stomach. Mustard Emetic. I'akc a teaspoonful of mustard in a teacupful of warm water, every ten minutes, until vomiting is produced. This is an efficient, cjuick, and safe emetic. Alum Emetic. Take a teaspoonful of powdered alum in a little honey, syrup, or molasses, every fifteen minutes, until vomiting is pro- duced. osets and ^'itriol, or disinfcct- nattcrs, is the con- \ tin cii[), arth may I pi etc dc- itely-con- L hot flat- :ting out- r may be cnder or ed to rc- to dis- thc ac- )urse, in , great are well ts of in- ntilully icn the lecked )ver the acupful a httle is pro- MEDICAL RECEIPTS FOR THE SiCK ROOM. 2S9 Common Salt Emetic. Add one or two teaspoonsful of salt to a teacupful of warm water. Take every ten or fifteen minutes, till vomit- ing is produced. Salt and Mustard Emetic. Mix a teaspoonful each of salt and mustard in a teacu[)lul of warm water. Repeat every ten minutes, until free vomiting is brought on. EYE-WASHES OR WATERS. Eye-waters, or collyria, as they are called by physicians, are solutions applied directly to the eye or eyelids. Alum Eye-wash. Take of ; — Alum, one grain. Pure watL , two tablespoonsful. Mix. A useful wash, night and morning, for inflamed eyes. Brandy Eye-wash. A teaspoonful of brandy to two tablespoonsful uf water makes a serviceable eye-water when a stimulant is wanted. Arnica Eye-wash. Take of : — Tincture of arnica, five drops. , Pure water, two tablespoonsful. Mix. Often of benefit in weak or sore eyes. Tea Eye-wash. Ordinary tea, when cold, makes a valuable eye- water in many cases. FOMENTATIONS, OR STUPES AND STEAMINGS. Fomentation is the application of warmth and moisture to the surface of the body by means of a flannel or soft cloth. Steaming consists in exposing a part to the vapors arising from a piece of flannel wrung out in boiling water ; it is often employed in affections of the eyes. An Ordinary Fomentation. Immerse a piece of flannel in boil- ing water, remove it and put in a wringer made by attaching stout towel- ing to two rods. The wringer is twisted around the flannel very strongly, till as much as possible of the water is pressed away. The wringer is useful, as the flannel is too hot, when first removed from the boiling water, to be grasped by the hand. When wrung as dry as possible, fo- mentations prepared in this way may be applied very liot, without fear of scalding or blistering the skin. The flannel, when n[)|)lied to the j)art, should be covered with a piece of oiled silk or rul)l)er cloth, and chan'j;ed before it becomes cold. On the removal of the fomentation the skin bhould be at once gently dried and covered with a piece of dry flannel. ■ li 290 THE FAMILY rilYSICIAN. «:: If the prccaulion of covering the fomentation with oiled silk, nuislin, or paper, or a rubber cloth, be neglected, the warm, comforting llanncls will be converted, in a few minutes, into cold, clammy, wet ones, disa- greeable and hurtful to the patient. Turpentine Fomentations. Steep a piece of lint or linen in oil of turpentine, place it over the part, and immcdin';ely apply over it flan- nel, heated as hot as it can be borne. This is, frequently, morj effectual than a mustard plaster. Another Turpentine Fomentation. Sprinkle the flannel, wrung out of hot water in the manner described, with a tablcspoonful of tur- pentine. This will act as a counter irritant, rapidly reddening the skin and re- lieving pain in many cases. Opium Fomentation. Instead of turpentine, employ laudanum, as directed in the preceding receipt. Used to relieve pain. Mustard Fomentation. Add a (juarter of a pound of mustard to a pint of boiling water. AVring the flannel cloth out in this solution, in the manner above directed. This fomentation quickly reddens the skin, and is frequently useful in allaying pain. garc;les. Gargles, to be of benefit, must be frequently repeated, and their use persevered in. Gargle of Brandy. A mixture of equal ])arts of brandy and water makes a useful gargle in some cases of sore throat. Gargle of Alum. Take of : — Alum, two teaspoonsful. Water, a tumblerful. Mix. Used to remove offensive breath depending uj)on inflamed throat. Gargle of Lime-Water. Pour upon a quarter of a pound of fresh unslackened lime two quarts of hot water. After standing several hours careluliy decant the clear liquid, without shaking up the lime. This is a valuable gargle in diphtheria and croup. Gargle of Chlorate of Potash. Take of-.— Chlorate of Potash, a teaspoonlul. Water, a tumblerful. Mix. An excellent gargle for ordinary sore throat. MEDICAL RECEIPTS FOR THE SICK ROOM. 291 , muslin, ; llanncls ics, disa- len in oil :r it flan- el, wrun,^ Lil of tur- 1 and rc- ludanuni, lustard to lution, in useful in icir use Gargle of Sage and Linseed. Take of :— Sage, two ounces. Linseed, one ounce. Boiling water, one pint. Mix. To be used cold in the early stages of inflamed throat. HEAT, MODE OF AlT'lATNG. Moistheatis applied by means of fomentations and poultices, which sec. Dry heat may be applied in various ways. Flannel, iiighly heated in an oven, or before the fire, may be em])loyed, but it cools quickly. Hot sand, though heavy, and, therefore, for many pur[)oses imj^roper, retains its heat for a long time. It should be heated over the fire in an iron pan, and put in a warm linen bag of the proper shape lor the object in view. Chamomile flowers are lighter than sand, but more quickly lose ihcir warmth. They are to be iicated, and placed in a linen bag, in the same manner as the sand. Hot salt, in a bag, is a ready method of ap- plying heat in many cases, as, for instance, to the back of the neck, at night, to relieve headache. A thin piece of flat-tile, when it can be pro- cured, can often be used with advantage. It is lighter than sand, and, when heated in an oven, and wrapped in a flannel, retains its warmth for a considerable time. A heated dmner-[>latc, or a hot brick, wrapi)ed in flannel, may sometimes be employed, as may also bottles of hot water, well corked. LINIMENTS. Ff ^ I md water inflamed I of fresh al hours This is Liniments are used for the double purpose of causing the removal of swellings and for reddenning the skin, and so act as counter-irritants. They are applied by rubbing, either with the bare hand or with the hand covered by a piece of flannel, oiled silk or muslin, or a piece of bladder. Camphor Liniment. Take of : — Camphor, one ounce. Olive oil, four ounces. Rub up the camphor in the oil. Hartshorn and Oil. Take one part of hartshorn to two [)arts of oil ; mix. Useful for stiff neck and lumbago. Opodeldoc Take of :— Hard white soap, three ounces. ' Camphor, one ounce. Put them in a bottle, and add a tumblerful of spirits of wine, or brandy or any other spirit, and as much water. Shake the bottle from day to i 292 THE FAMILY rilYSICIAN. day, till the soap and camphor are dissolved, when the liniment is ready for use. A mixture of two tablcspoonsful of this liniment with a teaspoonful of laudanum, is very valuable to lull violent rheumatic pain. Mustard Liniment, is, for stimulating the surface, one of the best, as it is very manageable, and may be made to act either very slight- ly, or so severely as to take the skin off, according to quantity used and the time the rubi)ing is kept up. The best guide as to the quantity re- c[uired is the feelings of the person rubbed. At first, there is a pleasant sensation of heat, then a little pricking, and next a positive smarting ; when this is produced, leave off, for if the rubbing be continued, it will soon flay the skin, and, as a consequence, prevent its being rubbed again for three or four days. An ounce of fresh flour if mustard put into a bottle with a pint of spirits of turpentine, and shaken daily for two or three days, make this liniment. The mustard will settle to the bottom, and the clear fluid should be then poured off. Do not leave the mustard in and shake the bottle up before using ; if so, it will give Jie skin a coating of mustard, and render the application unnecessarily severe. It is excellent for lumbago and chilblains. Sometimes it is necessary to keep up irritation on the skin for length of time without disturbing the constitution, which some irritants will do. The best ai)plication lor this purpose is — Croton Oil. Of which ten or a dozen drops are to be rubbed in lightly with the fingers, guarded with a jjicce of oiled silk, for two or three nights. Generally on the second day the surface is red and puffy, and on the third day a large crop of little blisters, about the size of hemp seed, cover the skin. When these appear, the rubbing must be stopped. In the course of a few hours, the fluid in the blisters changes to matter, and these pustules begin to tingle and itch furiously. As soon as this happens, prick each wuli the point of a needle, and press out the matter with a handkerchief. In the course of a week the skin has been com- pletely reproduced, and then the croton oil may be used again ; but it does not blister quite so (]uickly as when first applied. The croton may be used for months, and is a most excellent mild irritant. Lime Liniment. Take of :— I.ime water. Flaxseed oil, each a tumblerful. Mix them. Chloroform Liniment. Take of :— Pure chloroform, a wineglassful. Olive oil, two wineglassesful. Mix them. A useful liniment in many painful rheumatic and neuralgic affections. MEDICAL RECEIPTS FOR THE SICK ROOM. 293 Lead Ointment. Take of : — Solution of sugar of lead, two ounces. Olive oil, two wineglasscsful. Mix them. Turpentine Liniment. Take of : Rosin cerate (to be had of the druggist), three-quarters of a pound. Oil of turpentine, a tumblerful. Add the oil to the cerate, previously melted, and mix tiiem. LOTIONS OR WASHES. mi\ Washes are employed either for soothing and cooling inflamed parts, for stimulating sluggish sores to heal, or lor drying and absorbing dis- charges. In applying a cooling ^otion or wash, a single piece of linen should be wet with it and laid on the part, which should not be wra[)pcd up nor covered with the bed clothes. So soon as the cloth dries it should be again dipped in the lotion, or wet by squeezing a spongeful of the wash over it. A stimulating lotion is applied by dipping lint or rag into it, putting it on the sore and confining it by a bandage. Lint, for use for this and so many other purposes, in dressing wounds and sores, is made by unraveling old linen, soft from use and washing. It may be prepared by scraping tightly-stretched linen with a sharp knife. A "patent linl" is sold at all the drug stores, in rolls or sheets, which is more compact than loose lint, one side being fleecy and the other smooth. Charpie is an excellent sort of lint, much employed. It is made as fol- lows : Cut a piece of lint into small pieces, a few inches square, and completely unravel it thread by thread. The coarser kind may be made of old tablecloths. Old linen is much better than new for making charpie. Drying lotions are applied, by means of lint or rag, to cracked skin, and to scalds, burns, and sores which weep or discharge very freely. Cold Water Wash is as good a wash as any, to produce evapor- ation, if care be taken to have the wet linen well exposed to the air ; and it has the further advantage of being almost always at hand. Spirit Wash. Half a quarter of a pint of spirits of wine, or a quar- ter of a pint of brandy, or any other good spirit, added to a pint of water, make this wash. Vinegar Wash is made by mixing one-fourth of vinegar to three- fourths of water. To a pint of either of the former washes half a tablespoonful of lauda- num may be added, if the pain suffered be very severe. r \ ■• THE FAMILY PHYSICIAN. Lead Wash, or Goulard- Water or White Wash, as it is often callctl, lor common iuiri)oses, may be made by disj^olving one (Iraclim of sugar of lead in a pint of soft water. Some i)ersons are very fond of using this wash, with the addition of spirits of wine as an eva- ])orant. LiiiJtC Water Wash. A very simple application ; is one of the best, and very easily made. Take half a pound of unslaked lime, and three-quarters of a pint of water. Put the lime into an earihen pot, and pour a little of the water upon it, and as the lime slakes pour the water on by little and little, and stir up with a stick. The water must be added very slowly, otherwise the water will lly alx)ut in all directions, and the great heat suddenly produced will crack or break the vessel which con- tains it. Alter three or four hours, when the slaked lime has sunk to the bottom, the clear fluid may be poured off, and put in a stoppled ')0ttle, away from the light. Oxide of Zinc Wash is made by putting four drachms of oxide of zinc into a j)int of lime water, which does not, however, di.s,solve, but merely suspends it. It is, therefore, always necessary to shake the bottle well up, so that the linen may entangle the proper quantity of oxide. Sal Ammoniac Wash. Take of : — Sal ammoniac, one drachm. Water, a tuniblerful. Mix, with or without the addition of a teaspoonful of laudanimi. Useful for painful, sluggish sores. Chlorate of Potash Wash. Take of :— Chlorate of potash, a teaspoonful. Water, a tumblerful. A useful application to bad sores, and for chapped and cracked hands. Borax Wash. Take of : — Borax, a teaspoonful. Glycerine, a tablespoonful. Water, a tumblerful. Mix. An agreeable soothing lotion. An Absorbent Wash. Take of :— Oxide of zinc, two drachms. Water, a tumblerful. Mix. Arnica Lotion. Take of :— Tincture of arnica, a tablespoonful. Water, a tumblerful. Mix, A useful lotion for sprains, bruises and burns. -I • ^Ti'T I i ri «■ MEDICAL RECEIPTS FOR THE SICK ROOM. 295 1, as it IS jiving one IS are very IS an eva- Dne of the lime, and n pot, and the water ; be added ?, and the 'hich con- LS sunk to I stoppled s of oxide solve, hut the bottle oxide. lum. ed hands. OINTMENTS OR SALVES. Ointments or salves are usually prepared by rubbing of a medicine with lard. They should not be kept on hand too long, as they become rancid and unfit for use. Sulphur Ointment. Take of :— Flowers of sulphur, lialf a pound. Lard, one pound. Oil of bcrgamot, two teaspoonsful. Mix up together. A curative ointment for itch. Common Ointment. Take of :— Yellow wax, one ounce. Olive oil, four ounces. Lard, one ounce. ' Mix Tannin Ointment. A soothing salve. Take of ;- :ns. Tannin, one drachm. Lard, one ounce. Mix. An excellent astringent salve. Camphor Ointment. Take of :— Cami)hor, ten grains. Spirits of wine, a few drops. Lard, one ounce. Mix. Uselul in some skin diseases. Oxide of Zinc Ointment. Take of : — Oxide of zinc, one drachm. Lard, two ounces. Mix. Useful for chapped skin and sores. PAIN REMOVERS, OR ANODYNES. The boldest doubter, he who, in rude health, is a most defiant and sarcastic skeptic of tbe power of medicine, is forced, by the terror and victory of pain, to confess the beneficence of the substances given us by a merciful Creator for the subduing and the destroying of that pain. " Pain is perfect misery, the worst Of evils, and, excessive, overturns All patience." The most powerful means for relieving pain, such as opium by the mouth, morphia injected under the skin, and chloroform by inhalation, 296 THE FAMILY rilYSICIAN. are such potent agents for evil, as well at good, that their use can only be trusted to those trained to employ them. J]ut there are other means which can be handled, with greater or less success, by non-medical per- sons. Many of them we have mentioned in speaking of painful ailments, but we group, in this place, a number of receipts lor the relief of pain, which are of no little value, and which can l)e employed, with the exer- cise of ordinary care and judgment, without the risk ot doing harm. Quinine Powders. Take of quinine, twenty grains, and divide it into eight powders. One of them twice a day is an excellent remedy in many forms of neuralgia (particularly in that occurring in persons living in districts where chills and fever prevail), and sick headache. Sal Ammoniac. Take of sal ammoniac, twenty grains, for one dose ; in a half tumbler of water. Repeat the dose at the end of every hour, until four doses are taken, when, if no relief is had, the medicine is not appro[)riate to the case, and it is needless to continue. If it affortl relief, as it does frecjuently, in an almost magical manner, in neuralgia of the face, and other parts, it should be taken three times a day, for a week or two, after the attark. Camphor. Half a teaspoonful of the spirits of camphor in water, is an excellent remedy for the pains of colic and diarrh(ea. J*ainful joints are also relieved by the rubbing in over them of spirits of camphor, by itself or mixed with a little laudanum. Chloral. Take of :— Chloral, two drachms. Sweetened water, half a tumblerful. Take a tablespoonful for a dose. Useful to procure case and sleep in many ailments, particularly rheumatic pains and pains arising from burns. Coffee. Squeeze the juice of a lemon in a small cup of strong black coffee. This will often afford immediate relief in neuralgic headache. Tea ordinarily increases neuralgic pain, and ought not to be used by persons affected with it. Iodide of Potassium. Take of : — Iodide of potassium, one drachm. Sweetened water, haif a tumblerful. Mix. Take a tablespoonful three times a day, in pains of the joints and bones that are worse at night. External Applications. Warm and hot baths are admirable remedies for pain. So, also, are poultices and hot fomentations, for which receipts are given under their heads in this chapter. can only er means dical per- ailnicnts. " of pain, the exer- irm. divide it .'medy in ns living for one of evciy nedicinc it afford icuralgia ay, for a water, is 3f sj)irits slc('p in from 'g black ache, ised by )ains of nirable ns, for MEDICAL RECEIPTS FOR THE SICK ROOM. 297 Hygienic Means. Whatever improves the general health, saves and relieves pain. Pure air is, therefore, an anodyne. " \'v, who aniiil this feverish world would wear A body free from pain, of cares a mind, Fly the rank city, shun its turbid air." Light rooms ; warm clothing ; regulated gymnastic exercise, out-door recreation ; pro[)cr amount of sleep ; the avoidance of fatigue of body and mind j and of intenii)erancc in alcohol and tobacco, and in every- thing which impairs the nervous force ; together with change of air and climate as restoratives, are all means by which pain may be escaped or its edge blunted. Many forms of ncurnlaia are relieved by change of air, as well as vari- ous constitutional disorders causing pain. Sea air is particularly useful in numerous iubtances. POULTICES. " Poultices are blessings or curses, as they arc well or ill made," was a saying of the celebrated Dr. Abernethy. They should be spread thick- ly, as a general rule, otherwise they dry quickly, and irritate llie part they are intended to soothe. All i)oultices should be covered over by a piece of oiled silk, muslin, or paper, to retain the heat and moisture. Bread and Water Poultice. Scald out a basin, for, in order to make a good poultice perfectly, l)oiling water is necessary ; then, having put in some hot water, throw in coarsely crumbled bread, and cover it with a plate. When tl>c bread has soaked up as much water as it will imbibe, drain off the remaining water, and there will be left a light pulp. Spread it, a third of an inch thick, on folded linen, and apply it when of the temperature of a warm bath. Or, carefully pare away the hard, brown crust from a slice round the loaf of stale bread, di[) it into hot water, lift it out at once, and apply immediately, if not too hot. Flaxseed Meal Poultice. The celebrated Dr. Abernethy gave the following directions for making this poultice : — " Get some linseed powder, not the common stuff full of grit and sand. Scald out a basin ; pour in some perfectly boiling water ; throw in the powder, stir it round with a stick, till well incorporated ; add a little more water and a litde more meal ; stir again, and when it is about two- thirds the cons/«tence you wish it to be, beat it up with the blade of a knife till all the lumps are removed. If properly made, it is so well worked together, that you might throw it up to the ceiling, and it vvould come down again without falling to pieces ; it is, in fact, like a pan-cake. Then take it out, lay it on a piece of soft linen, spread it the fourth qf i ' ft I 298 THE FAMILY PHYSICIAN. an inch thick, and as wide as will cover the whole inflamed part ; put a l)it of hog's lard in the centre of it, and when it begins to melt, draw the edge of the knife lightly over and grease the surface of the poultice. When made in this way. oh ! it is beautifully smooth ; it is delightfully soft ; it is warm and comfortable to the feelings of the patient." The Bran Poultice is a sort of " entire," or half-and-half, partly ])ouUice, partly fomentation, and is a very good application for setting up and keeping up perspiration on a part; but it rccpiires to be often changed, for it very quickly becomes sour and then has not the most agreeable smell. It merely consists of bran moistened, but not made wet, with hot water ; and enough of it should be put into a flannel bag, sufficiently large to cover the part, to fill it about one-third ; if more bran be put in, Lhe bag becomes unpleasantly heavy. It must then be held before the fire, and the bran turned about again and again, till it is thoroughly heated. Thus warmed, it must be ([uickly ajiplied, and the bran should be gently spread, so as to cover the whole extent of the bag. The mixture is to be heated in a pot, carefully stirred, to prevent burning, and, when sufficiently warm, must be spread on linen, like any other poultice. Starch Poultice. Add a little cold water to the starch, and blend the two into a pap ; then add sufficient boiling water to make a poultice of the required consistence, which must be spread on linen. Useful in skin eruptions attended with much heat and pain, and, in general, when a soothing application is required. Charcoal Poultice. The charcoal may either be mixed with the ingredients of the poultice or sprinkled over the pait and covered with a simple poultice, or the following receipt may be used : Take of: — Wood charcoal, in powder, a tablespoonful. Bread, three or four slices. Flaxseed-meal, three tablespoonsful. Boiling water, one tumblerful. Mix. A useful application to offensive wounds a:*d sores. Carrot Poultice. Boil the carrots till they become quite soft, mash them with a fork, and spread the pulp en linen, in the ordinary way. A turnip poultice may be made in the same manner. Alum Poultice. Composed of the white of two eggs and a tea- spoonful of powdered alum. An excellent astringent. Mush Poultice. Stir Indian-meal, in small quantities, into water kept boiling in a pan, until the whole has acquired the proper degree of thickness.. MEDICAL RECEIPTS FOR THE SICK ROOM. 299 Slippery Elm Poultice. Made by moistening, with hot water, the inner b irk of slii)[)ery elm, ground into a fine powder. Arrowroot Poultice. Add enough boihng water to arrowroot, previously mixed with cold water into a smooth paste, as will make it of the icciuired thickness for spreading. A pleasant soothmg poultice. Onion Poultice. Mash some partially roasted onions, and spread them upon tolds of muslin. Applied to the chest, useful in the croup n!ul catarrh of children ; applied to the arms and legs, useful to prevent the fits of children. Mustard Poultice. For a mustard i)oultice, a sufficient ([uantity of powdered mustard should be taken to make a thin paste the required size. This should be mixed with l.>oiling water, with a small (luanlity of vinegar addetl, if a very strong poultice is recpiired, ands[)readon brown pa[)er, with a i)iece of thin muslin over it. A mustard poultice should generally be kept on from ten to twenty minutes, but some skins will bear it much longer than others. If the skin is very irritable afterwards, a little Hour should be sprinkled over it. 'I'his will remove the burning sensation. Bread and Milk Poultice. Upon the crumbs of stale wheat hread, in a basin, pour boiling milk, stirring with the back of a spoon until the mixture has the thickness of mush. Spread and apply. TONICS. Tonic medicines are those which give strength to the sysl^'m. They act slowly, and must be persevered in to obtain their full effects. K\- cellent results are fre(picnlly obtained by changing from one to another, when the first tried fails, or has ceased to do good. Quinine in Powder. Take of :— Quinine, two scruples. Divide into twenty powders. Take one three times a day, well cover- ed in a little scraped apple. The apple disguises, comijletely, the bitter taste of the medicine. This is an admirable tonic in nervous and other forms of debility, and in loss of appetite. Iron Powder, -ake of : — Reduced iron, two scruples. White sugar, in powder, two teaspoonsful. Mix, and divide into t' .ty powders. I )ose, one powder, in molasses, syrup or preserves^ three times a day. - - ^^t - 300 THE FAMILY niYSICIAN. Reduced iron, which is a tasteless powder of an iron gray color, may be obtained from any druggist, and is one of the very best preparations of iron which can be taken by pale, thin-blooded people. In using this, as well as the other preparations of iron, it is necessary to persevere for several months, to reap the fullest results. Potassio-tartrate of Iron. Take of: — ' Potassio-tartrate of iron, one drachm. Divide into twelve powders. Take one, in syrup or preserves, three times a day. An admirable tonic in dyspepsia, and loss of appetite, and debility. It has the advantage over many other preparations of iron, of not constipating the bowels, and of being rajjidly digested. Half an ounce of the potassio-tartrate ot iron, added to a pint of cherry alter solution, may be used instead of the powders, in tablespoon- ful doses. The best time for taking this, and other preparations of iroi , is with the meals, and not on an empty stomach. The juice in the stomach during digestion readily dissolves the iron, which, if taken while fasting, may cause pain and uneasiness. Columba and Ginger. Take of : — Bruised columba, one ounce, liruiscd ginger, a (quarter of an ounce. IJoiling water, one pint. Mix and strain. A wineglassful four or five times a day is a useful tonic in persistent ^iarrh(oa. RECEIPTS FOR THE HYCilENE OF THE PERSON. Under this head we group a variety of useful receipts for the care of the hair, the skin and the teeth. They are all harmless, as well as ef- ficient, which, too freciuenily, is not the case with the many perilous com- pounds widely advertised, and sold as tooth powders, hair tonics, mouth and skin washes, and lip salves, under high-sounding names. Any druggist can put them up, and at a less price than is asked for the dan- gerous secret preparations they are designed to replace. TOOTH POWDER. . Take of:— Powdered camphor, Powdered orris root, each two drachms. Precipitated chalk, half an ounce. Mix thoroughly. The chalk employed should be the " precipitated," and not the " ^^repared " chalk ot the druggist. color, may reparation's 5 necessary ves, three Jctite, and :>( iron, of a pint of blespoon- , is with : stomach e fasting, ersistent 'N. care of II as cf- )us com- , mouth ;. Any lie dan- MEDICAL RECEIPTS FOR THE SICK ROOM. 3OI Another excellent tooth powder is the following : — Take of : — Freshly-prepared willow charcoal, or Freshly-prepared arcca-nut charcoal, one ounce. Keep it in a tightly-corked-bottle. Another powder especially valuable when the teeth have been stained by taking iron : — Take of: — Tannic acid, quarter of an ounce. Sugar of milk, two ounces. Red lake, half a drachm. Oil of tcabcrry, or cloves, a few drops. Mix with care. The following tooth powder is of benefit when the gums are sore and spongy : — Take of : — Powdered myrrh, quarter of an ounce. Powdered borax, half an ounce. Precipitated chalk, one ounce. Powdered orris root, quarter of an ounce. Mix. The following tooth powder is excellent when the saliva is acrid and the breath sour. Take of : — Bicarbonate of soda. Powdered talc, each half an ounce. Oil of anise, a few drops. Improper tooth powder's are powdered pumice stone, which rapidly wears off the enamel, the protecting cover of the tccih (pumice stone is a frequent ingredient in secret tooth powders), cigar ashes, cream of tartar, or any other acid. MOUTH WASHES. These are useful when the gums are tender, or the breath offensive, or the teeth rapidly decaying. Camphor Mouth Wash. Take of :— Spirits of camphor, half a teaspoonful. • - Milk-warm water, a wineglas.sluL To be used several times a day, and at bedtime. i 302 tHE FAMILY PHYSICIAN. Honey Mouth Wash. Take of — Honey of rose, half a teaspoonful. Milk-warm water, a wincglassful. Mix, and use as above directed. Myrrh and Cinchona Mouth Wash. Take of :— Tincture of myrrh, Compound tincture of cinchona, each half a tcas[)oonful. Milk-warm water, a wincglassful. Mix, and use as above directed. Brandy Mouth Wash. Take of :— Pure French brandy, a teaspoonful. Milk-warm water, a wincglassful. Mix, and use as above directed. 1 vUvL of:— Permanganate of Potash Mouth Wash. Permanganate of ])otash, four grains. Rose water, four lluid ounces. Oil of peppermint, a few chops. This is an excellent mouin wash for foul breath, cnuscd by bad teeth or disordered secretions of the mouth It slightly stains the teeth, but does them no injury ; on the contrary, being an excellent preservative, and a valuable remedy for ])rcvcnting and curing toothache. The dis- coloration may be easi'y taken off by a tooth brush or sponge. Chlorate of Potash Moui;h Wash. Take ot : Chlorate of potash, two or three teaspoonsful. Water, a tumblerlul. Oil of teaberry, a lew drops. To be used several limes a day. When offensive breath comes from a foul stomach, twenty grains of bisulphite of soda, in half a tumbler of water, with a little essence of l)ei)permint, twice a day, is an excellent remedy. Or three grains of chlorinated lime, known also as chloride of lime, in a wincglassful of water, several times a day, may be taken. Charcoal internally, is also of use in such cases. For maskingthescent of onions, and other disagreeable acquired odors, freshly roasted coffee grains are useful, or a small portion of Canada snakeroot, chewed. MEDICAL RECEIPTS FOR THE SICK ROOM. 303 aspoonful. )ad teeth eeih, hut ervative, Tiie dis- trains of sence of rains of issful of is also HAIR TONICS. Bark Hair Tonic. Take of : — Red cinchona tea, a tumblerful. Brandy, a wineglassful. Pure glycerine, a tablespoonful. Mix. Apply, night and morning, for scurf and falling of the hair. Ammonia Hair Tonic. Take of :— Stronger water of ammonia, Castor oil, each one ounce. Old brandy, two ounces. Rose water, six ounces. Mix. This mixture must not be em[)loyed ottener than every uther day. Ointment for Dandruff. Take of :•— Powdered borax, twenty grains. Lead water (diluted solution of subacetate of lead), two drachms. Fresh lard, one ounce. Attar of roses, a few drops. o> Mix. to be rubbed on the scaly patches on the scal[) every morning after the skin Ikis been cleaned by soap and water. Or, the iiame ingredients may be used in a wash as follows : Wash for Dandruff. Take of : — Powdered borax, twenty grains. Lead water, two drachms. • Rain water, half a tumblerful. Pure glycerine, a tablespoonful. Mix. Use once or twice a day. LIP SALVES, LOTIONS, ETC. Lip Salve. Take of :— Oxide of zinc, thirty grains. Spermaceti ointment, half an ounce. Attar of roses, one drop. Mix. To be applied, night and morning, for irritated and cracked lip? "''. n 304 THE FAMILY PHYSICIAN. Lotion for the Hands. Add a tablespoonful of pure glycerine to a pint of water. This well rubbed in, but not wiped off, will soften and whiten the hands, and protect them from the air. Ointment for Fetid Feet. Take of: — Crystalized carljolic acid, five grains. Ointment of oxide of zinc, one ounce. Mix. Apply, , morning and evening, after washing the feet in cold water, with which a few teaspoonsful of alum have been mixed. In such cases, the wearing of a thin sole of felt inside the shoe, which should be removed several times a week, wet in a solution of permanganate of pot- ash (twenty grains to the ounce of water), dried, and reinserted, is of benefit. The stockings should be of wool, and changed once a day, and the same pair of shoes should not be worn on two consecutive days. WASHES FOR THE FACE. Take of :- Powdered borax, half an ounce. Pure glycerine, one ounce. Camphor water, one quart. Mix. Wet the face with this, morning and evening, allow it to remain for several minutes, and wash in rain water. An excellent lotion to pre- vent chapped skin, to remove sunburn, and cleanse the pores of the skin. Take of:— , Fresh lemon juice, a wineglassful. ' '■■■' Rainwater, one pint. Attar of roses, a few drops. Mix, and put in a well-corked bottle. Wash the face and hands with this several times a day (letting it stay on for several nu'nules before dry- ing with the towel). This preparation is highly recommended by the celebrated Dr. Wilson, of London, for clearing the complexion of •' muddiness." Take of :— Juice of the cucumber, pressed from the fruit, a sufficient quantity. Boil it over a quick fire, cool rapidly, and bottle. Apply a tablespoon- ful, diluted with two tablespoonsful of water, night and morning. ThiS' preparation is much employed in France, for clearing the complexion. rel HK MEDICAL RECEIPTS FOR THE SICK ROOM. 305 glycerine will soften ;t in cold In such should be ite of pot- rted, is of I day, and days. o remain n to pro- es of the ids with ore dry- by the xion of ifficient 2spoon- This. XI on. In some parts of England the following wash is much employed for removing sunburn and whitening the skin. Take of : — Fresh horseradish root, one ounce. Cold buttermilk, one pint. Put aside for four hours. Or, take of : — The juice of horseradish, one part. Cidar vinegar, two parts. Mix. Has the same uses as the above receipt, and is also recom- mended for removing freckles. Take of:— Benzoin, two ounces. Pure alcohol, one pint. Mix. A tablespoonful of this, added to a tumbler of water, turns it while, and makes a most agreeable wash for clearing the complexion. Ointment for Sunburn. Take of : — Spermaceti, Oil of almond, each two ounces. Honey, one teaspoonful. Attar of roses (or any scent), a few drops. Melt the spermaceti in a pipkin, then add the oil of almonds, and, when they are thoroughly mixed, stir in the honey. Take the pipkin off ihe fire, and stir, constantly, until it is cool, adding the scent. Apply at night, after washing the skin, and allow it to remain until mornmg. It relieves the irritated burning skin, and lessens the redness. Cold, fresh cream smeared over the affected parts sometimes does good. As lunar caustics and tincture of iodine are medicines in common use, and stain the skin and body linen, the tollowing directions for removing these stains will be found useful : — To Remove Stains of Lunar Caustic (Nitrate of Silver) from the Skin. Wash the parts discolored by handHng a stick of so- lution ot lunar caustic in a solution of iodide of potassium in water. The water will turn the discolorations from brown to dead white. Then wash in a solution of spirits of hartshorn. To Remove Stains of Lunar Caustic from Linen. The best way to remove stains of nitrate of silver from linen is to moisten the stain with a few drops of a solution of one drachm of cyanide of potas- sium in a wineglassful of water, to which a few drops of tincture of iodine has been added immediately before using the solution. The linen should ru iM 'il r^^ 3o6 THE FAMILY PHYSICIAN. then be well rinsed in clear water. This plan removes even the oldest stains of nitra'ie of silver, provided the operation be carried on in a mod- erately lighted room. The cyj.nide of potassium may be obtained of ihe druggist, but is a violent poison, wiiich should be kept and handled with great care. Another Way of Removing Nitrate of Silver Stains from the Fingers. Moisten the part with tincture of iodine ; immediately apply spirits of hartshorn, and wash off. To Remove Iodine Stains from Linen. Dissolve two drachms of the hyposulphite of soda in half a tumbler of water, and soak the stain in the solution, then wash in water. ini the oldest in a mod- ncd of ilic ndlcd with ins from imcdiatcly ) drachms 1 soak the CHAPTRR XVI. PERSONAL HEAUTY. THE TOILET : NEW, SIMPLE, AND EFFICIENT PREPARATIONS. The Hair. A thick, handsome head of hair is generally acknow- ledged to be a good thing to have. Many do possess it, and many oth- ers might, but from sheer neglect in the care ot this " divine ornament." The scalp should be kept clean and free from scurf dandruff, and the- dirty accumulations caused by the use of oily hair preparations, &c. Iwery body knows this, and yet how generally neglected is the care of the hair and scalp. Hair W^ash. An unequalled hair wash for cleansing the scalp and hair Irom all impurities is a tablespoonful of hartshorn in a pint of water. Rub thoroughly into thj hair and over the scalp, and then wash the head with clear water. I'he use of this wash once or twice a week, renders the hair and beard soft and glossy, and greatly promotes its growth. Dandruff. A Oire. — After the scalp and hair have been purified of dirt and dandruff by use of the above wash, future annoyance Irom dan- druff can be prevented by dampening the scalp three or four times p^r week (ottener if necessary) with sulphur-water, made by putting one half ounce of flour of sulphur into a pint of water, shaking occasionally for two days, and then pouring off into a clean bottle. This "cure for dandruff" is new and of great value. The neglect of keeping the scal[) tree from those scaly particles known as dandrulf shows a lack of per- sonal cleanliness not particularly commendable. A lady with her liau- powdered with scurf is not particularly angelic ; and a gentleman with his coat-collar whitened with dandruff is surely not a fascinating object. Hair Preparations. As the hair of but few persons is sufficiently oily of itself to be of desirable ap[)e;irance, and to keep in a proper position, the use of various hair prei)arations is almost universal. A fme article is made as follows : — Strong Alcohol, - » Castor Oil, - - Tincture of Spanish Flies, Oils Eergamot and Lavender, of each 1 pint. 2 ounces. 2 drachms. 10 drops. iiiM 3o8 THE FAMILY TTTYSICIAN. Nothing superior to the above was ever made. It is not too greasy to be objectionable. It renders the hair glossy and silken, and is sutli- ciently stimulating to prevent the hair from falling out, and often in- duces an unusually fine growth, and not the least, it is cheap, and quick- ly made. Glycerine Washes. Glycerine washes, for the hair, are objection- able. They render the hair disagreeably sticky, causing it to "catch dirt"tQ such an extent that the scalp must be waslied every lew days, in order to keep it in a wholesome condition. Pomatums. Tomatums are liable to nearly the same objections, liesides, ihcy arc almcrst without exceplion mnde of lard, which is liable to become rancid and acrid, thus irritating the scalp, and not unfreciuenily causmg sores. Grey Hair. Hair-dyes. — From various causes, generally unknown, the hair turns prematurely grey. Nothing will restore it to its original natural color, but it can be artificially colored so as to be quite of satis- factory appearance. '1 he cpiantity of hair-dye used in this country almost exceeds belief. The very best, because producing an almost periectly natural color, and at one time the most popular, was the well-known sul[)hur and sugar of lead dye. In 1866 it was sold under more than four hundred and sixty names, by actual computation. As one dollar was charged per bottle, and as the entire cost was about five and one half-cents per bottle, includinu; the bottle and wrapper, almost every druggist and barber in the country put up the stuff under some attractive tit e, and proclaimed its virtues in the most positive manner. It was always "not a dye," and it would " restore the hair to its original color.'' Rich iirms advertised it enor- mously, and the result was that for a number of years it seemed as if every third person was using the abominable dye. The odor it gave to the ])erson using it was truly disgusting. The suli)hur and lead were quickly absorbed through the pores of the scalp and the head, and the entire body became stenchful indeed from the foetid, sulphur-laden per- spiration. i'rescntly physicians in every part of the country found that cases of paralysis (formerly an uncommon disease) were becoming alarmingly frequent, and on due investigation it was found that the cause was from the use of the lead and sulphur hair-dye. Dr. G. H. Taylor, who treats a large number of paralytics every year, at his well-known " Movement-cure Institute'' in New York found this class of patients increasing to an unusual extent. Investigation showed that in many recent cases the cause was from the use of the hair-dye in question. An eyelid or one side of the face or neck is usually first para- lyzed, then an arm, finally an entire side, — generally the left. In 1869 a lady was taken to Dr. Taylor for consultation who had used the hair- dye so long and so freely, that her grey hairs had become jet black. The PERSONAL BEAUTY. 309 too greasy id is suffi- oflcn in- nd quick- objection- ch dirt"to i, in order bjections. is liable to Irequcntly unknown, -S original e of satis- ;ds belief. :olor, and 1 sugar of and sixty Dttle, and including country rtues in t won Id it enor- ed as if gave to ad were and the en per- cases of irmingly as from odor from her person was sickening. She was entirely paralyzed — could only move her head, and speak. She died after lingering a few weeks in this condition, at her home in Brooklyn, N.Y. A year or two since an editor in a western city died from the effects of this poisonous dye. The newspapers immediately made a hue and cry ; chemists analyzed and warned ; doctors cautioned their patients ; the result has been that the use of the preparation has decreased largely. Still it is extensively used, and it is to save many from jjossible disease and death that we have given so much space to the notice of this most dangerous article. " J>ut I am not old and my hair is turning grcy,^ — what shall I do ?" Well if you re/// color your hair, use only such dyes as arc known to be harmless — which are the " silver dyes," almost the only kind in the mar- ket. The following simple *' hair stain " has no superior. Put into a per- fectly clean bottle : — Nitrate of Silver, - - - - 75 grains. Ammonia, - - - - - 7 ounces, Alcohol, - - - - - 3 ounces. Water, ..... cj'ounces. Keep the bottle well corked and in a dark place. The hair should be well cleaned with soap and warYn water, and then wiped dry, betore each application. The stain is used by combing the hair thoroughly with a fine comb diyped in the preparation ; no washing is recjuired after the operation. The first application gives a reddish-brown color. The sec- ond a brown, and the third a black color. After each application exi)ose the head to the sunlight for fifteen or twenty minutes, if convenient, then oil and keep well oiled. Oentlemen will find this a most satisfactory article for ol)literating white hairs among their whiskers, and for " touching up " the beard or moustache to any shade desired. To give " hair dye receipts " here, we think, would be sui)erfluous, as numbers of them can be found in any of the one or more " receipt books " that almost every family possesses. Curling the Hair. Preparations are being continualy advertised that are claimed will cause the straightest, stiffest hair to curl in wavy, massive ringlets. A genuine swindle. Nothing but mechanical means — the curling iron, ike, will cause the hair to curl, or crimp, in the slight- est degree. The insane belief of a certain class of young persons, that tlic hair can be curled by the use of " curling fluids," &c., was recently rather expensively illustrated. A western sharper, fully alive to the weakness of young folks on the subject of curly hair, advertised in several papers of large circulation, a '* magnetic curling-comb," warranted to cause the stiffest hair to curl beautifulh' . Iii. ixort time this genius received over m ■i- if 310 THE FAMILY PHYSICIAN. thirteen thousand ordeis at one dollar each — the price of the comb. A common ten cent horn comh, with a hit of copper wire twisted about it, was sent at Inst, but presently nolhinii; whatever. Hair artificially curled is not becoming, while the twistini; process around the wood or iron breaks the fibres of the hair and seriously in- jures it. Bandolines, luindolines for the hair, are preparations entirely free from grease for keeping the hair in place, giving it a glossy appearanc,-, i\:c. One of the best, and most sim|)le, is made by jo'-iiing a teacup of boiling water, on ten or fittcen ([uince-seeds ; strain, pour into a bottle, and add five drops of the oil of cloves or cinnamon. Two Hair-brushes. Every person should be provided with two hair-brushes — an ortlinary brush ot good stiff hair, the other a friction or shampoo-l)rush. of stiff, black uneven hair before dressing the hair in tUe morning, the scal[) should be thoroughly '• pcjlished' with the siiam- poo-brush. Nothing gives such tone and vigor to the scalp, and pre- vents a tendency to fall out. It is an excellent sanitary operation in other respects. A person who of a morning gets up drowsy and unrefreshed, after giving his seal]) a brisk rubbing with the stiff brush, will e\i)er;en(c a surprising change in his feelings lor the better. A brisk friction of the scalp in a like manner will often cure headache. Baldness. IJaldncss, unless caused by fever or a similar cause, is generally incurable. One of the most successful remedies eve used, and wc believe now published for the first time, is prepared as follows: — (ilycerinc, - ... 4 ounces. Tannin, ----- 2 ounces. Tincture of canthai ides, - - - 2 drachms. Oil of capsicum, - - - - 10 drops. Apply to the bald spots morning and evening. Character as Indicated by the Hair. Stiff, straight and abund- ant hair and beard are combined with a character which is straightfor- ward, unyielding, strong, and rather bluff. iMne hair and dark skin, show purity, goodness, and strong mind. Black hair, a dark skin, and bilious temperament are usually found together. There is strength of character and sensuality. Fine brown hair indicates exquisite sensibility, with strong will for what is good and right, if not perverted. If the hair is coarse, black, and sticks up, there is not much talking, and the })erson is apt to be stubborn, sour, and harsh. White hair, as a general rule, indicates a good, easy, lazy fellow. There is animosity in coarse red hair, with unusual firmness of purpose and strength of character. Hasty, impetuous, rash people, have curly and crispy hair. Red hair indicates a fiery temperament, passion and devo- tion. Auburn hair, which is hair of a golden-hue, having a yellowish PERSONAL BEAUTY. 3" tinge, with a florid face, gives purity, and great capacity for enjoyment and suffering. Wavy hair is pliable, yielding, accommodating. The dark-haired races — the Spaniard, the Malay, tiie Mexican, the Indian, and the Negro, have physical strength, endurance, robustness in body. The light-haired races are the thinkers of the world, the poets, and tlie artists. Dark-brown hair combines the two, and is the most desirable. THE SKIN, COMPLEXION, S^c. Pimples, Flesh-worms, or " Blackheads." The skin is a mar- vellous piece of lace-work, liirough the interstices or pores of which there is constantly escaping insensible pers[)iration and an oily secretion. In a torpid condition of the skin there appears on the face, nose, and lower part of the forehead of many persons, what are called " black heads," "flesh worms,' is:c., — often in great numbers, and causing an exceedingly disagreeable ajjpcarance. When the skin is ])ressed with the finger-nails they come out in vermicular lorm, having a black point or head, which gives rise to the name grubs, or flesh-worms, which they arc, being real, living worms, which has been ascertained by microscopi- cal examination. They can generally be i^ermanenlly removed by i)ressing them out with the finger-nails, and then bathing the i)arts with mild salt water. Tiie skin should receive gentle friction daily with a coarse towel. Pimples, Red and Matterated. If these are the result of an in- active liver, disordered digestion, or constipation, proper means must i)e employed to remove these ailments. Nothing will accomplish this more effectually and harmlessly than the use of the following pills : — , Strychnia, - - ... i grain. Quinine, ----- i scruple. Leptandrin, ... . i drachm. Hydrastrin, - - 15 grains. Make into thirty pills, one to be taken immediately after breakfast, daily. rimples are generally the result of an inactive and unhealthy condi- tion of the skin. A cure is generally accomplished by the use of the following : — Corrosive sublimate. Muriate of ammonia, Water, 8 grains. 30 grains. I gill. Uathe the pimples twice daily with this wash, using a bit of soft cotton cloth. Carbolic soap or pine-tar soap, to be bought in almost any drug store, dipped in water and rubbed over the pimply portion of the face, usually proves an effectual cure. Freckles, Brown Spots, Moth Spots. A peculiar chemical ^ I" THE FAMILY PHYSICIAN. combination of iron and oxygen in tlic ijlood of many persons produces that appearance of the skin known as freckles, mollipatches, brown spots, etc. It is no (jucstion of health — those most freckled being gen- erally blessed with most vigorous health. 'I'hose with very light or red hair (which is caused by red-colored oil, more strongly impregnated with iron than others), are most liable to Ireckles, etc. The proper means of removing Ireckles and moth- patches is in the use of those chemicals which will dissolve and dissijiate the existing combmation situated in the second or middle membrane of the skin. As those with freckly faces have very naturally an intense desire for a clear skin, it gives us i)leasure to be able to give here a new and posi- tive cure for freckles, etc. Sulpho-Carbolatc of zinc, - ► 2 parts. Glycerine, - - - - 25 parts. Rose-Water, - - - 25 parts. Alcohol, - • - - 5 parts. Apply twice daily, and let remain from onc-half-hour to one hour. Then wash with cold water. To improve the comi)lexion — Corrosive sublimate, - - - 10 grains. Oxide of zinc, - - - ^ drachm. Muriate of ammonia, - - - ^ drachm. Soft watex, - • - - /4 pint. Use a piece of soft cotton cloth, and apply once or twice, daily, slightly moistening the skin. The above has been extensively used lor the re- moval of trcckles, and other discolorations of the skin. A simple and excellent cosmetic for softening, whitening, and beautifying the com- plexion and hands, is made by mixing four parts of the yellow of an egg and five parts of glycerine, and rubbing them well together with a pes- tle. Apply to the face on going to bed. Rub well into the hands after each washing. It will keep for years, and is an admirable preparation for all bruises of the skin. The use of paints and powders, however harmless they may be of themselves — as powdered starch — clogs the pores of the skin, and it be- comes rough, sallow, and wrinkled, and often pimply ; and a painted or powdered woman is such an unlovely object I The Teeth. Probably less attention is given to the care of the teeth than to any other part of the body. Yet the teeth are of the first importance ! But cc nparatively few rinse the mouth regularly after eat- ing, or use a tooth-pick habitually. And food clogged between the teeUi is such a disgusting sight I It ferments — rots, giving the breath a bad smell, and causing the teeth to decty. Besides the use of a tooth-pick, and rinsing the mouth after eating, the teeth should be thoroughly scrubbed with a good stiff tooth-brush at PERSONAL r.KAUTY. 313 least once a clay — on retiring for the night is the best time, using cold water, 'i'hc teeth of many persons can not be kej)l clean and white with- out the use of a powder. The following is good, chc.ip, and safe : — ■ Prepared chalk, .... 4 ounces. Orris-root (powdered), - - - '2 ounces. Green niyrrli (ijowdercd), - ' j4 ^unce. Oil of cinnamon, - - - 20 droi)s. Keep in a corked bottle. Charcoal irritates the gums, and no preivnration containing it should he used. Soap and s(;a[) preparations g"ve the teeth a ycllowisli appear- ance, and hence are decidedly objectionable. Ill-Smelling Breath. If caused by filthy teeth, or a decaying tooth, the remedy is plainly to clean the teeth, and to have the offending tooth filled or taken out. If the cause is from a disordered stomach, of course the breath will be offensive till the digestion becomes good again, by due attention to diet, and proper medication. Jkit the breath of many persons is ir-smclling from no ajjparent cause. Such persons can render the breath sweet temporarily at any time by chewing a kernel of roasted coffee. Wash your Feet. In cities, facilities for taking a hot bath are so many and convenient, that every respectable person feels himself bemcaned, if he does not occasionally give himself a good scrubbing with soap, brush and hot water. IJut in villages and the country proper, things are different. To attempt a bath in a wasluui) plac:ed in the barn or back kitchen, can not be considered particularly convenient ; and the result is bathing in the country is not the general practice. One con- sequence is a good many feet that give forth exceeding bad smells ! The pores of the soles of the feet are much larger than any on any other parts of the body, and they pour out a large amount of i)erspira- lion, which condenses, mixes with dust and dirt, and forms that hard scaley crust that almost every person has noticed at some time on the soles of their feet. Wearing tight boots or shoes, the perspiration is confined' — there is no " ventilation," and the result is about the feet of many persons, especially men, a most rottensome smell. Soak the feet ten or fifteen minutes, at least once a week, in a pail of lu;t water, well soaped, and then giving them a thorough scraping witli a sliff-bladei knife. This will ]jrevent all danger of bad smells from the feel, and add much to your feclmg of personal comfort, at the same time lessening the liability of taking cold. Those who keep their feet scrupulously clean are much less liable to cold ."-et — have warmer feet in winter — than those who do not. lU'm. The feet can be kept comfortably warm on an exceedingly cold day by wrapping apiece of newspaper nbout the feet over the stockings, and then draw ng on the boots. I chaptp:r XVII. GENERAL OBSERVATIONS REGARDING THE YOUTH OF BOTH SEXES, AND THE DUTY OF PARENTS AND GUARDIANS. When the famous Alexander Pope, of Twickenham, gave utterance to the celebrated aphorism, "The proper study of Mankind is Man,"' lie was doubtless fully cognizant of the fact, that the laconism embraces everything appertaining to the sexes as such, as well as to the human family generally. To a mind so astute and analytical as his, it must have been obvious that most if not all of the defects, mental and phy- sical, peculiar to any generation or people, were attributable solely to the imperfect training of its youth, or to the indulgence of such inharmon- ious and incompatible marriage relations as disfigure the annals of the )3resent day, and as have marked so frequently those of past ages. As in the vegetable kingdom, the selection of proper seed and soil is indisp.onsable to the i)roduction of a perfect plant, so in the animal is the enlightened and judicious blending of the sexes a sine qua ?io/i to the production of a being representing all the excellence of its species. 'I'his is an axiom the most unnssailable ; and hence the vital necessity of ac- cepting it in all its integrity, and of never transgressing it in any respect upon the exalted plane of human existence. The sentiment of love, in its highest and most divine acceptation, can obtain between the sexes only. Although far from antagonistic to that of friendship or affection^ it differs widely from it; inasmuch as it 'las more important ends to attain, and can never exist between individuals of the same sex. I^'riendship or affection for one another may character- ize the intercourse of men, or of women ; but love, in its truest sense, never. This latter is the golden link which unites u': at once to our op- posites and to heaven, and that culminates in that holy and mysterious compact which results in the propagation of our species, and the ac- complishments of our mission in this direction. While in pursuit of the study of this question, however, we must be careful not to confound or confuse the love under consideration with the mere animal passion that so often steals its guise to gratify the cravings of lust, and that so constantly betrays the youth of both sexes in excesses that terminate, on one side, at least, in years of misery or shame. And here we would acl''ress ourselves more especially to the inexperienced maiden whose guileless heart is too often open to the deceitful blandish- ments of some cruel suitor who has but one object to attain, or to the sincere and ardent professions of thoughtless youth, who, without paus- ing to analyze the motives which actuate him or the stability of his in- 314 fit OBSERVATIONS REGARDING YOUTH OF BOTH SEXES. 315 tentions, accomplishes her ruin, and leaves her to learn, alas ! too late, that, save before the altar, no woman is justifiable in placinu; her char- acter and happiness in the keeping of any man. In such instances, de- ceit and sincerity being alike at fault, the only safe course for the maiden who would escai)e the Scylla of the one or the Charybdis of the other, is to keep watch and ward on the battlements of her prudence and virtue, and, no matter how impassioned and sincere the pleadiiij^'s of any indi- vidual upon whom she may have bestowed her affections, preserve both intact, as the only means of retaining his love and respect, should he be a true man, and of keeping herself unsullied in the eyes of society and of the world generally. Although delicate and difficult, the task of whisperino; some truths in- to the ears of a young maiden arrived at the years of discretion, )ct, so necessary to her well-being and ha()j)iness in every possible relation is it that she should be made thoroughly aware of the untoward infiuences which so constantly obtrude themselves into even the purest atmos- phere, we venture, although with some hesitancy, to assume the serious undertaking. And here we may observe, in the first place, that the l)rimary elements of all that makes hie worth a single hour's purchase, are to be found in a thorough recognition of what we owe to the Creator, to ourselves, and to society ; and the possession of a mind free from the taint which disfigures some of the literature of the tlay, and from those low desires and loose ideas, which, with scarce a single exception, result Irom its perusal. Nothing can be more dangerous to the youthful mind than even a passing glance at the works of any of those authors who appeal to the animal passions in a manner so insidious and ruinous and who, before a young maiden is aware of it, destroy all i er sense of delicacy, and often, alas ! betray her into those dreadful excesses which, although kept the profoundest secret from every living soul save herseif, invariably end in the total loss of innocent purity and the utter destruction of all physical beauty. We need r.ot be more explicit upop this subject, but may summon on the wit- ness-stand in i")roofof what we here state, the sallow and lifeless fea- tures, the dim eyes, and desponding gait, which are significant to the astute medical man, and which are to be encountered so frequently in what is termed the very best society. Any violation of the laws of the Creator in tins, as in every other connection, is sure to ht visited upon the aggressor ; and when we come to consider that the first offence in the particular relation now alluded to, leads quickly to another, and yet another, until transgressions crowd upon each other thick and fast, and seize upon the whole being, we shall be able to perceive at once how vital the necessity for every young maiden to eschew with prayerful dili- gence the source of such terrible dangers, and to be in a position to feel within herself, at the period when she may be called upon to give her hand at the altar to some one worthy of all the love and affection that ^: 3i<5 THE FAMILY rilYSICIAN. could be bestowed upon him, that she enters the marriage state as pure in mind and body as the veriest child, and that, in this relation, not a cloud or a regret can obscure the sunshine of her after years. In the observance of the course which is here suggested or implied, lies the corner-stone of all the bliss that attends upon the sacred com- pact into which two young souls enter for life. And here we would ob- serve, that in this direction, a serious and solemn duty devolves upon motliers, to instruct, at the proper moment, their daughters as to the dangers that beset them, both mentally and physically, at a certain age. In this relation there should be no false delicncy felt. 'The truth must be told, and in a manner the most unmistakable. A lile ot l-.appiness or of misery hangs on the issue, and there should be thereiore no min- cing of the matter. The crime of sell-abuse, if we must say it, is not conllned to the sterner sex only. Some ot the most fearful examples of it amongst females are to be met with terrible frequency, and ot a char- acter so hopeless as to embarrass all medical interference, and to senl the doom of those who had so fallen from their natural buthright and high estate. ^ How indispensable, then, the proper education of young girls, and how necessary to surround them with a mental and moral atmosphere the most pure and desirable. Let them begin aright, as children, and learn to think well and soberly as they advance in years, and there is nothing to be feared. Let their minds and dispositions be formed on the models of the virtuous fireside rather than upon those of the gaily decorated and frivolous saloon or drawing-room. Let them be taught to respect their own persons, as a sacred trust from heaven, and to feel that any violation of the laws appeitaining to their physical being, in the sense under consideration, can not fail to be visited with the direst re- sults. This knowledge the judicious mother can impart by degrees, and in her own way. She has at her command various modes and oppor- tunities of approaching the subject successfully, which do not obtain in the case of any other individual whatever. Conseejucntly, she is to a great extent accountable for the future happiness or misery of those who lie nearest her heart in this matter ; for it must be obvious, that she, above all, can influence their conduct and habits of thought before they arrive at that period of life when they are piesumed to think and act for themselves. It is surprising how often children of unusually tender years are led bv bad companionsnip to familiarize themselves with the abominable prac- tice which we need not again pause to particularize. It is within our own knowledge, that not long since, in tne city of New York, a young girl of great prominence, and most respectably connected, became a ho[)cless victim to this awful infatuation. And this was the more la- mentable, as she promised to be as lovely as the day, and was possessed of a for'^ and figure that were of exceptional beauty. At first her mother OBSERVATIONS REGARDING YOUTH OF BOTH SEXES. 317 was unaware of the cause of her gradual transformation ; hut when made sensible of the truth, she found, perhaps too late, that to her own crim- inal neglect the disaster was to be mainly attributed ; for, before her un- fortunate child was eleven years ot age, she had learned to make war upon her mind and body in a manner so effectual that it was pitiable to look upon her when she arrived at the age of thirteen. What has be- come of her since we are unable to say ; but this much we know, it will take a strong hand to rescue her from the most terrible of fates, or to restore her to any degree ot health or strength. To the comi^anionship ot books and children of cjuestionable morals this whole disaster may in reality be attributed, lor the parents of this wretched being were them- selves of morals tlie most irreproachable, but not wise and watchlul in iheir day and generation. The necessity, then, of the strictest caution on the part of mothers in the selection of books or playmates for their children becomes obvious at a glance. The child is the marble from which the woman is sculptured ; and if the youthful block is disfigured, fractured, or broken, where may we find the moral, mental, or physical chisel that shall obliterate or remove the damning deiects ? An eminent physician has justly observed on this head : — " We now approach a part ot our subject which we would gladly omit, did not constant experience admonish us of our duty to speak of it in no uncertam tone. We refer to the disastrous consequences on soul and body to which young girls expose themselves, by exciting and indulging the morbid passions. . Years ago Catherine K. IJeecher sounded a note of warning to the mothers of America on this secret vice, which leads their daughters to the grave, the madhouse, or, worse yet, the brothel. •' (lladly would we believe that her timely admonition had done away with the necessity of its rei3etition. But current medical literature, and our own observation, convince us that the habit of selt-abuse has in- creased lalher than diminished. Surgeons have recently been forced to devise painlul operations to hinder young gids from ruining themselves, aud we must confess that, in its worst form, it is absolutely incurable. " '1 he results of the constant nervous excitement which this habit pro- duces are bodily weakness, loss of memory, low spirits, distressing ner- vousness, a capricious appetite, dislike of company and of study, and, finally, paralysis, imbecility, or insanity. Let it not be supposed that there are many who suffer thus severely ; but, on the other hand, let it be clearly understood that any indulgence whatever in these evil courses is attended with bad effects, especially because they create imj-ture de- sires and thoughts which will prepare the girl to be a willing victim to the arts of i)rolligacy. There is no more solemn duty resting on those who have the charge of young femnles than to protect them against this vice. m \M '■\l 3i8 THE FAMILY PHYSICIAN. " But, it is exclaimed, is it not dangerous to tell them anything about it ? Such a course is unnecessary. Teach them that any handling of the parts, any indecent language, any impure thought, is degrading and hurtful. See that the servants, nurses, and companions with whom they associate, are not debased ; and recommend scrupulous cleanliness. ** If the habit is discovered, do not scold or whip the child. It is of- ten a result of disease, and induced by a disagreeable itching. Some- times this is connected with a disorder of the womb, and very frequently with worms in the bowels. Let the case be submitted to a judicious, skilful medical adviser, and the girl will yet be saved. But do not shut your eyes, and refuse to see this fact when it exists. Mothers are too often unwilling to entertain for a moment the thought that their daughters are addicted to such a vice, when it is only too plain to the physician." We have it on high authority that modesty is the chief quality in the adornment of women ; and in no case is it more grateful and becoming than in that of a young maiden who has arrived at that important and interesting period, when she may be wooed and won and made a wife. What the age of puberty is has been made a careful study by medical men. In the temperate zone, fourteen years and six months is the aver- age period of its first appearance in healthy girls. If it occurs six months earlier or later, then there is probably something wrong. There is some- times a wider deviation for the age here slated than this, and without any serious meaning ; but at no time is such a deviation to be neglected. In a vast majority of cases it is owing to some defect in constitution, health, or formation, and should be seen to and corrected at once, otherwise years of hopeless misery may be the result. " Mothers, teachers," observes the author just quoted, " it is with you this responsibility rests. The thousands of miserable wives who owe their wretchedness to the absence of proper attention at the turning point of their lives, warn you how serious is the responsibility." The foundation of old age, observes a celebrated author, is laid in childhood, but the health of middle life depends upon puberty. This maxim is invaluable. Tijie two years which change the girl into the wo- man, frequently seal forever her happiness or misery in this life. They decide whether she is to become a healthy, cheerful wife and mother, or the reverse, — to whom "marriage is a curse, children an affliction, and life a burden." Both sexes mature more early in hot climates than in tem- perate or cold or.ej. Within the tropics, marriages are usual at twelve or fourteen years of age. Such precocity, however, is the precursor of early decay ; for a short childhood portends a premature old age, and vice versa. It is not a favorable symptom to experience any indication of puberty before the usual average time, as it betokens a weakly and excitable frame. Let us therefore enumerate the principal causes which incline to OBSERVATIONS REGARDING YOUTH OF BOTH SEXES. 319 hasten it unduly. Idleness of body, highly-seasoned food, stimulants, such as beer, wine, liquors, and in some degree, coffee, tea, and irregular habits of sleep. The mental causes arc, however, still more potent in tending to premature development. What stimulates the emotions leads to unnaturally early sexual life. Lale hours, children's parties, sen- sational novels, qu ;stionable pictorial illustrations, love stories, the drama, the ball-room, talks of love and marriage, ^c, all hasten the event which transforms the girl into the woman. This becomes obvious when we compare the average of puberty in large cities and country districts, it being clearly ascertained that the females in the former mature from six to eight months sooner than those in the latter ; and the result may be seen more plainly in the well-preserved farm-wife of thirty when compared with the languid and faded city lady of the same age. During the two short years, then, that transform " the awkward ind angular girl of fourteen " into the graceful maiden of " sweet sixteen,'' the utmost caution is to be observed in every relation, moral and physical. The magic wand of the fairy is at work, and a new creature, as it were, is being released from her chrysalis state, with sentiments and responsi- bilities that must be kept well in hand. The transformation goes on until at last the system acquires the requisite strength, and furnishes itself with reserved forces, when the monthly periods commence. A writer of great judgment and experience on this subject, asserts that one of the most frec^uent causes of disease about the age of puberty is starvation. He avers that many a girl is starved to death, from the fact of food of an improper cjuality being given to her, or from the circum- stance of sustenance being administered to her in insufticient quantities, or at improper hours. Hence, from the want of proper nourishment, the system becomes enfeebled and subject to attacks of disease, and es- pecially to those of consumption. The food at such periods should be abundant, varied, and simply prepared. Good fresh milk should be used daily, while tea and coffee should be thrown aside totally. Fat meats and vegetable oils, so generally disliked by girls at this age, are exactly what they require at this juncture of their lives. All kinds of exercise proper to a young lady, and especially those which lead into the pure o[)en air and sunshine, are also beneficial at this momentous crisis ; and a particular kind is to be recommended for those whose chests are narrow, whose shoulders stoop, and who have 1 hereditary predisposition to consumption. If it is systematically prac- tised along with other means of health, we would guarantee any child, no matter how many relatives have died of this disease, against invasion. It is voluntary inspiration. Nothing is more simple I^et her stand erect, throw the shoulders well back, and the hands behind ; then let her slowly inhale pure air to the full capacity of the lungs, and retain it for a few seconds /^y an increased eQ'ort ; then it may be slowly exhaled. After one or two natural inspirations, let her repeat the act, and so on > M 1:1 i 320 THE FAMILY rilVSICIAN. for ten or fifteen minutes, twice daily. Not only is this simple proced- ure a safeguard against consumption, but, in the opinion of some learned phys'icians, it can even cure it when it has already commenced. At first the monthly loss of blood exhausts the system. Therefore, plenty ot food, plenty of rest, plenty of sleep, are rcfiuired. That ancient |)reju(lice in favor ot early rising should be discarded now, and the girl should retire early, and, if she will, sleep late. Hard study, care, or anxiety, should be sj^arcd her. 'J'his is not the time for rigid discipline. CJloihing is a matter of importance, and, if we were at all sure of at- tention, there is much we would say about it. The thought seriously troubles us, that, so long as Canadian women consent to deform them- selves, and sacrifice their health to false ideas of beauty,, it is almost hopeless to urge their fitness lor, and their right to, a higher life than they now enjoy. With thoroughly healthy girls, what is usually termed the monthly period, continues to recur at regular intervals, from twenty-five to thirty days apart. This is true of something like three out of every four. In others, a long interval, occasionally six months, occurs between the first and second sickness. This latter, // the ^i^enera/ licadh is perfect^ need excite no apprehension ; but, under the slightest mental or physical de- rangement, the case nmst at once receive intelligent treatment. Perfectly healthy young women have, on the other hand, been known to have been unwell for sixteen days, while others again experienced this change every thirty-five or thirty-six days only. This a[)pears not ea.sy ofe.\ planation, and may, i)erhai).s, be attributed to some inherited [)eculiarity of constitution. In this relation, climate seems to [ilay a prouu"nent part ; as travellers tell us, that in Lapland this phase of woman's physical life occurs but three or four times a year. "At this critical jjerind," observed an able physician, "the seeds ot licreditary and constitutional diseases manifest themselves. They draw fresh malignancy from the new ac:tivity of the system. The first syni])- toms ot tubercular consum[)tion, of scrofula, of obstinate and disfiguring skin diseases, of hereditary insanity, of congenital epilepsy, of a hundred terrible maladies, which from birth luive lurked in the child, biding the opi)ortunity of attack, suddenly spring from their lair.s, and hurry her to tne grave or madhouse. If we ask why so many fair girls of eighteen or twenty are followed by weeping friends to an early tomb, the answer is, chiefiy from diseases which have their origin at the period of puberty. It is impossible for us to lehearse here all the minute symptoms, each almost trilling in itself, which warn the practised physician of the ai)proach of one of these fearful foes in time to idlow lum to make a de- fence. We can do little more than iterate the warning, that, whenever at this momentous epoch any disquieting change appears, be it physical or mental, let not a day be lost in summoning skiited, coinpetetit medical advice." OBSERVATIONS REGARDING YOUTH OF P.OTII SEXES. ^.21 From what has been now said, it is impossible for any mother of or- dinary good understanding to mistake for a moment the shoals and quicksands, both moral and physical, liiat surround her daughters, whciiicr as mere girls or grown-up maidens. A careful supervision of the company they keep and the books tliey read — their determined ex- clusion Irom the society of either men or women of lax conversation or morals, and the careful inculcation of self-respect, which can alone be based upon 'proper pride and purity, will go far to obviate the dangers that beset their path, and so grouiid thtm, ultimately, in the prihL.ples of virtue and a correct demeanor, as to put cvii thoughts to llight on their first approach. While a handsome person and excellent accjuirements are always de- sirable on the part of any individual wlio pays his ad(h-esses to a young maiden, yet there are other and more important considerations which ought to overshadow mere physical beauty or mental attainments ; and il.cse aie a higli sense of honov, and a thorough and practical concep- tion of the duly we owe to Ood and man. 'I'hese latter constitute the impel ishable part of our nature when jiroj^erly moulded, and are the staff upon which we can lean with ccnlklence when our mere physical being loses all its brightness, and totters to its fall. Hence the neces- sity of warning 'the young and untutored heart against mere outward ai> l)earance, and directing it towards a recognition of those attributes and features on the part ot the sterner sex, upon which a life of true happi- ness can alone be founded. This is a matter of such paramount importance that we feel the necessity of impressing it, to the utmost of our ability, upon those who have arrived at the years of understanding, and whose hearts may yet be tioe, or partially so; and who may be induced to pause ere they com- mit their ha[)piness tor life to the hands of those who may not only be unworthy of the woman's love, but who seek to obtain it under the false pretences of a comely exterior, or the adventitious matter of dress, while every fibre of their nature may be selfish be)ond measure, and set only upon the momentary gratificatio:! of a passion that wiien once satisfied turns aside from the hapless and unsuspecting object that has inspired it, and .leaves her to n^.ourn in the silence of her lonely chamber, the fate she might have avoided, but that is now beyond repair. How warm soever her feelings and sentiments, every step taken in the paths of courtship by a marriageable maiden should l)e well observed and guardetl. In her conversation or conduct there should be nothing of thoughtless levity, or anything that would warrant a familiaiity on the part ol lier suitor which might not be taken in the presence of some dear friend or relative. To observe a proper and well-considered course in this relation, is to insure the iiicreasing admiration of the being up.on whom she has bestowed her affections, if he be woithy her love. And here we may observe tHat this is no mere speculation, but a fart as firm- U ■ I 322 THE FAMILY PIIVSICIAN. ly estaljlishcd as any in human experience. For although the tide of passion may run hii^h in an un^^uardcd moment, and set in aiiainst heaven and society, yet the terrible and painful ebb follows as surely as effect follows cause, and leaves at least one of the thoughtless culprits stranded lorever on the bleak and barren shore of her earthly existence. There is, therefore, nothing so desirable as hrmness and caution on the part of the young maiden in her intercourse with her accepted lover; and both can be observed without wounding his susceptibilities, or im- pressing him with the idea of either prudery or coldness on her part. Her sentiments in this relation can be conveyed through a thousand dif- ferent channels, and witii such force and effect as to imjjress and influence to the proper extent any individual possessed ol correct leelings, or of the mental and moral requisites to make a wife happy. Let us glance for a moment at the fate of many beautiful and warm- hearted maidens whose happiness lias been wrecked, even in this city, through the fiendish machinations of perfidious suitors. Scarce a house ot ill-lame in our midst but has one or more inmates of this character — poor, thoughtless, and confiding creatures, thvit would sooner had thought an angel of light cai)able of deceit than those who had betrayed and ruined ihcm. I'ut they would not be warned, or had not been ad- vised until the die was ca-^t ; and hence, without a hoi)e, their wretched downward career began apace, until at last, with their ears familiarized to the ribald song and jest, they sought refuge from the upbraidings of conscience in the intoxicating cup, which so completed and rendered hideous the work of debauch that their persons, once beautiful perhaps to intensity, became a loathsome mass, that provoked both horror and disgust in even the coarsest nature. And some of these unfortunates had been raised in the lap of luxury, while others had been the idols of respectable and loving households : but the education of both classes had been neglected, as neither had been brought up Ijy strictly moral parents, who had attended upon their footsteps with pious care while they were yet children, and who, as they approached the period of maidenhood, had not excluded every moral taint from the atmosphere they breathed, or taught them true allegiance to the divine laws and those which sustain our great social fabric. Had their guardians inculcated those moral [)crccptions and principles, without which a woman is the darkest stain on humanity, all would have been well ; and perhaps the false suitor, regenerated, or rather transformed, through the persuasive influence of such goodness and i)iet\- might have been induced to turn from the evil of his ways and have led to the altar a happy and beloved bride, the very being who had opened up the ap- proaches to her total ruin by overstepping the bou-ndaries of prudence or those of modesty, without pausing to consider that a step once taken in this latter direction is never recovered. Although the mental and physical tendencies of mere girls may vary OBSERVATIONS REGARDING YOUTH OK BOTH SEXES. 323 xury, lolds ; had their they taint to the their thoiit been nied, have altar e a^)- ice or eii in in no small degree, we are of the firni belief, that, under even the most unfavorable circumstances, both may, through judicious and proper treatment, be brought to harmoni/e with the great objects of creation. In view of the accomplishment of this vast desideratum, then, the early inculcation of proper religious principles, and the cnsample of healthy conversation and moral excellence in the family circle are of paramount importance. And this is quite compatible with the freedom necessary to the happiness and well-being of even the lightest heart and most joyous disposition. There is not an innocent amusement or pleasure incident to the life of a young girl, that may not be heightened and sanctified, in a measure, through the adroit and loving yuidance of a mother of sound observation and an ordinary well-trained mind. Cruel and unjust as it may be, and is in many cases, the axiom is a safe one, that the animal passions of men lead them into the blindest excesses, and that in the at- tempt to gratily them they too frecjuently lose all sight of the conse- ([uences, and pause only to count the cost when a keen sense of the frailty of their victim i)revents them from making the only possil)le ade- ([uate atonement in relation to one already so fallen in their eyes. This is the true state of the case, and the results already glanced at, are, as we have .seen, the most lamentable. Mothers and guardians should there- fore bestir themselves, if they would do a noble and abiding work in this conneciion ; and never relax their vigilance until those under their charge have attained the nge of maturity and understanding, in the fullest sense. Here the parent plays a most important part, and must, if she would see her daughter a hapi)y wife and mother, train her in all the paths of vir- tue and correct thoiight. The surveillance may be gentle and loving, but it must at the game time be constant and inflexible. Every rock and shoal must be pointed out, and dwelt upon with force and clearness, and the guiding lights of self-respect, purity of speech, and careful demeanor, held constantly aloft and in full view. No other course can possibly succeed, or add, in such cases as now command our attention, to the sum of human happiness. Consequently both mother and daughter should understand each other upon an issue so vital ; the younger and more in- experienced looking, with full confidence, for counsel and advice to her truest friend and rightful preceptor, and forming no acciuaintance or friendship, with a view to matrimony, without her sanction and approval. In this relation the quick wit and keen eye of the sober and thought- ful matron will be seldom at fault. She will be able to determine with something like unerring accuracy, and speedily, the character of the suiter who may seek to win the affections of her child, and who must not be judged on mere external appearance, or be taken at his own esti- mate. Here an honest heart, industrious habits, and a good record, are of the first importance, and more desirable than gold itself In saying so much on this head, however, it is not to be supposed that mere world- ly wealth is to be disregarded, as an element in any compact between 1 324 THE FAMILY PHYSICIAN. li- two hearts th.it would become one, and spend together a life of useful- ness and independence. On the contrary, we hold it indispensable, that no young maiden of sound judgment permit her affections or the solici- tations ot her lover to betray her into the cares and responsil)ilities of matrimony without the possession or prospect of sufficient means to render her home comfortable, and remove her bejond ihe probability ol want. In this, both caution and prudence should be observed ; for to step into i)overty and its consequent domestic embarrassments, is often to step out of love ; and then, alas I for the future of both parties. The vital necessity, then, of worthy male companionship, in the first instance, for any young giil whatever, must be obvious to even the most commonplace intelligence. If those who surround her are pure and good, and the uncompromising enemies of the free-love taint and prin- ciples which are now so rife in certain quarters, her selection of a proper companion for life will be the less difficult, as fewer chances present themselves for bestowing her affections unworthily. She can take no more important step between the cradle and the grave than that which leads her to the altar. It should therefore be well considered and guarded, as once it is taken the die is cast forever. J.et us then hope that all those most deeply concerned will ponder well the facts we liave laid before them on this all important subject, and let no mother relax for a single moment the vigilance that should wall out from her daughters the dangerous books and companionship to which we have made such dislinct reference. In addition, let every young maiden who is approaching the interesting and critical period al- ready named, look well to her footsteps, and beware of allowing her af- fections to be captured by a pleasing exterior only on the part of one ot the opposite sex. However agreeable an attractive face and form, these do not comi.)rise all that is necessary to the most abiding and exalted manhood, and are not unfrequently a delusion and a snare. There is no absolute manliness without manly principles ; and no true happiness without moral rectitude and a proper sense of our duty towards heaven. 'J'hese are the attributes and sentiments that tend to make earth a para- dise, and that survive all mere physical excellence, inasmuch as they be- long to our immortal part. Let them therefore be sought after assid- uously by both mother and daughter in the person of any suiter for the hand of the latter ; and let there be no uncertain sound in the p'emises. Let those desirable features be so prominent in the acts and the de- meanor of the man as to be obvious at a glance, and let them not be simulated on certain occasions. True virtue and uprightness of thought and conduct soon manifest themselves in those possessed of such ines- timable treasures ; and whenever or wherever we see their absence veri- fied either by word or act, we may rest assured that the transgressor is unworthy the love of any woman who values her own happiness, or who hopes to make the marriage state, under heaven, all that it ought to be, both morally and physically. OBSERVATIONS REGARDING YOUTH OF BOTH SEXES. 325 For the Especial Perusal of Youths of Understanding, as well as for that of fathers and (iuakdians. If man is " the noblest work of God," most assuredly every word thought, and act of his, ought to tend towards the elevation of his mental and physical being ; because this implied perfection is to be regarded in a measure as the result of his accjuiescence in all the laws, moral and otherwise, appertaining to his nature. That is, if he would assume and maintain the high position accorded to him, he must not violate any of these divine precepts or rules laid down lor his guidance ; but from the first moment of his responsibility to the last of his earthly existence, walk in the way of godliness, virtue, and truth, and never transgress any of the provisions relative to the true development and important mission of his animal structure. The licence accorded to boys when compared with that allowed to girls of the same age, ought to engender in them a chivalrous respect for the gentler sex, and never urge them into anything savoring of egotism or tyranny. The a])parent superiority is but simply the result of greater physical strength, and the freedom with which the one sex is permitted to move through the world compared with that accorded to the other. There is in reality no mental suj)criority in the one over the other ; for in this respect it has been shown that the impress of man has been left mentally on the age more than that of woman ; because, from some ill- judged laws or rules of society, she has been subject to restrictions which circumscribe to an unwarrantable extent her sphere of action. But while laying it down as an axiom that there is perfect mental equality between the sexes, we can not refuse to entertain the idea that woman is the weaker vessel physically, and that her dependence upon man, and her claims to his love and protection, arise to some extent from this cause, although the sublime mystery of her being appeals to him in a higher and more abiding sense. This taken for granted, then, and perceiving, as even the most unphilosophical can, that both sexes were designed to harmonize with each other in every possible relation, and that the weaker and more beautiful is obviously entitled to greater con- sideration than the more robust, it behooves the latter to look well to his manhood and the perfection of his mental and physical status, for a defect in either is not only destructive of anything like love in the female bosom, but of a character which, with but few exceptions, build up an insurmountable barrier between the man and the woman towards whom he may be attracted. We say mental and physical status here, because the body is seldom injured through excesses of any description, without the mind suffering commensurately. And as the foundations of a healthy physical exist- ence are laid in childhood, we would observe that this fact, in relation to boys, as we are now treating on them more especially, should be ;,< : 326 THE FAMILY PHYSICIAN. recognized to the fullest extent by fathers and guardians, as upon their judgment, affection, and fidelity, the character of the rising male generation must mainly depend. Although, as already observed, a greater latitude is allowed to boys than girls, in almost every relation, yet this latitude must be circumsc-il)- cd and confined to certain well-defmed, healthy bounds. And here we would again dwell upon the vital .iccessity of good couipanionship and good books, where example and precept harmonize with the exalted ends to be attained in after )ears. Of course, the family circle is to be regarded as the true startiuLj point, when(X' the earliest lessons in vice or virtue are derived, and should this prove to be lax in any of its teachings, moral or religious, the very germs ot success are embarrassed or destroyeil at once. It is astonishing how quick young lads, not much more than halfway to their teens, ac(iuire bad habits and i)rinciples from impure associates, or the unguarded c(jnversations which sometimes occur at their own fire- side. l""rom both these sources the worst consequences are to be apprehended, as they gradually undermine every principle of good, and so familiarize the tender ear and understanding with what is most pernicious, because of the almost indelible and fatal im[)ress that is left upon the unreasoning susceptibilities. Whatever may be said to tlie contrary, there are unmistakable traces of the early hearthstone to be found in the lives of most men ; and such being the case, how indispen- sable it is that the atmosphere that surrounds it should be free from taint, and that the greatest caution should be observed that nothing transpires within its sacred limits that might liave the slightest tendency to mar the man in the child, or thwart the beneficial designs of nature regarding him. Jn view, then, of the influences of the family circle, and that of the father upon the son, while yet a mere youth or child, that circle should be made as attractive as j^ossible, and on a plane thoroughly compre- hensil '"^ to the intelligence to which it appeals. If parents would shape their an to the noblest ends, they must gain their confidence and a'"'" .jy becoming children themselves in a measure. They cannot i or teach to any purpose from a reserved or exalted pedestal, or ^ugh the instrumentality of the sober long-faced truths which are applicable to grave years only. The atmosphere of youth is, in the natural order of things, bright and happy ; and if we would influence, by precept or example, those still surrounded by it, we must assume to breathe it ourselves for the time being, and sow our earliest good seeds in its tender light. Once the kind and judicious father has won the heart and confidence of his little son, the road to the fullest success lies wide open ; and feet that under other circumstances would assuredly have turned aside under less benign influence from the paths of rectitude and truth are now easily directed into that glorious upward and onward course which never fails to culminate in happiness here and hereafter. OIJSERVATIONS KICGARUINU YOUTH OF BOTH SEXES. 327 i Some of the most terrible evils that beset the path of so many of the young of the sterner sex resull from association with children of their age who have learned to debauch their own i)ersons, and to indulge in those secret habus which have been Itjng noted as fraught with disaster and death. So early the period at which unsuspectuig little ones are led inio this terrible snare by their seniors of two or three years, that few will be inclined to believe that this first essay in crime has been attempt- ed at the age ot eight, and continued until an actual drain on the young energies and vital lorces of the systen^ commenced. It is, therefore, obvious that the lynx eye of the father or guardian, or of both parents, should at this tender period of youth be brought constantly to Ixirr up- on all the acts and tendencies of their young ward or progeny, and that they should seek to inculcate those pure ideas and aspirations which are the only security against this danger. Let the playmates, the toys, and the rudimentary books of the ( hild be carefully selected, and let there be for him an abiding attraction about his own door and fireside, so that he may not be necessitated to look abroad for any of those in- nocent pastimes or recreations that have such charms for the young. The great error of many parents, in this direction, lies in the dry and solemn homilies, which they conceive ought to be forever mumbled into the ears of their children, or the long religious services to which they regard their subjection as wise and indispensable. 'I'iiis is a fatal mis- take. The medium through which the young are to be taught success- fully their dependence upon heaven and their duty towards (lod and man, should rather consist of the green fields, fruits, and flowers, — of sunlit skies, running brooks and balmy winds, — the song of birds, the changing seasons, and the summer woods. These and the beneficent design of the Creator in calling them into existence lor the benefit of man in a pre-eminent degree, should form the earliest pages presented for the study of the child ; and if each of the beauties and truths they contain be carefully explained upon the basis of that higher information which may be sought througb the " revealed word" as the young stud- ent advances in years, the result will be most happy, and culminate in all the perfection possible of attainment in this earthly sphere. Uut while inculcating these salutary lessons, there must be no false delicacy on the part of the father, relative to pointing out, in the clearest ])Ossible manner, the dangers with which his inexperienced and suscept- ible child is assuredly surrounded. The parent is but ill-versed in his duty, or the prevalence of the crime of self-abuse in the young, who fancies that by keeping his youthful offspring in ignorance, so far as he knows, of the character and manner of this frighttul offence, that the child must necessarily escape its taint. Let there be no misconception on this head ; for it may be accepted as a leading fact, that nineteen boys out of every twenty learn something ot it at a very tender age ; and from sources, too, but badly qualified to warn them of its terrible results. 328 THE FAMILY PHYSICIAN. And be it further remembered, that no matter how innocent and uncon- scious of guilt the first attempt at its commission on the part of a poor unsuspecting young creature, there is something ahnost fatal in tanijK'i- ing with even the undeveloped organs of generation, or in cndeavoriim to excite them to undue or premature action, 'i'his fact must be dwelt upon in the plainest manner, and so impressed upon the you'hful mind as to satisfy it that a single move made in this dirccuon tend i to speedy destruction and death to both body and soul. So soon, then, as the child is capable, in any degree, of comprehending advice and instruction, this subject must be broached in tlie best and most imj.Mcssive manner known to the judicious lather who would acquit himself lully in the sight of God ?' ' man ; for to leave the matter to mere chance, in the hope that esca[)e was possible tm-ough a fortuitous combination of circum- stances, would be to be guilty of a crime tiie most heinous, and scarcely second to that of murder. To the youth of understanding, however, we may address ourselves more directly; assuming thathe may not be altogether free from the taint of this sin. In the first" place, then, let us lay it down as an inex- orable iact, thai so terrific and contaminating this practice in any degree, that it not only tends to destroy every particle of physical beauty and manhood, but, if persisted in, results in absolute idiocy, or a premature and most horril)le death. This is no overdrawn picture, but may be taken as an absolute fart, in connection with tiie (juite as inexorable truth, that the )outh addicted to this prevailing vice is as certain to ren- der himself incapable of propagating his species or consunuuating the holy sacrament of matrimony, as that the sun is in the heavens at mid- day. In the unnatin-al exc-itemcnt which saps his whole being, he may fancy, at the time of self abuse, that this is not so ; but should the crisis ever arrive when a lo\ing and confiding wife is betrayed into liis arms, then comes that terrible humiliation which is worse than death. There is no escape from the consequences of this monstrous offence should it be indulged in to a certain point ; for then it seizes upon the whole be- ing, and like the infiituation of the arsenic eaters, whether continued or abandoned, ends alike in the most appalling mental and physical sui- cide. What youth, then, of the slightest manly feeling, or intelligence, would so make war upon his physical being, as to render him disgusting to the j)ure and good of the op])osite sex, and even to those who had fallen from virtue, and taken refuge in the lowest brothel ? Can it be possible that any individual who sets the slightest store by the love of a beauti- ful woman, or the possession of every manly attribute and sentiment, will, after the perusal of these startling and inexorable facts, approach the edge of this shuddering aljyss, or, if partially engulfed in it, will not struggle to extricate himself at once. There may yet be time to retrace his steps, and escape the awful depths that yawn beneath him j while h OBSERVATIONS RECARDING YOUTH OF BOTH SEXES. 329 the commission of a single offence more may hurl him irrevocably to his dreadful doom. Oh ! could we but depict inadequate language the fear- ful and hideous wrecks that have resulted from this crying sin against nature, each particular hair of the youthlul aggressor would stand on end, like the quills on " the fretful [)orcupine." ]»ut so thickly strewn nround us, under a thousand loathsome forms, are the evidence of this most damning crime, that those who run may read if they only will. And now that we have dwelt at some length on this part of our topic, let us turn for a moment to those youths who have sufficient virtue, man- liness, and strength, to eschew this great evil, and say to them, that al- though they have escaped it, their path is still beset with other snares which lead to discomfort and misery in a lesser degree only. If not j)rostrated at this disgusting shrine, we have known the manh.oodof many to fall a victim to unholy and misguided passion, and who, by giving full rein to their unl)ridled lust, or falling into the snare of some cnsual cir- cumstance, have brought woe to true and unsuspecting hearts that loved "not wisely, but too well." And here we would observe, that when a respect and highest consideration for the opf^osite sex are not entertained by a man whatever his condition, he is unworthy the recognition of society or the favor of heaven. There is something of infinite treachery nnd cowardice on the part of a suitor, sincere or pretended, who steals into the affections ot a young maiden, with ■^. view to betraying her, or who having once gained them on an honorable basis, takes, in an un- guarded moment, advantage of the love she bears him, to humiliate her m her own eyes, if not to accomplish her ruin beyond redem[)tion. No true and chivalrous man or youth who respects the person or the memory of the mother who bore him has ever been guilty of doing such dastardly \iolence to the sex, or of treading ruthlessly beneath his feet what viod has made so confiding and beautiful, and what is in every relation the (ounterpart of his own sister. 'I'here is something here which demands attention, and which should be subjected to the strictest analysis and scrutiny. To the professional profiigate, who knows no law, human or divine, we do not address ourselves. We leave him in the hands of the Living God, who is sure to call him to account when he least expects it. To such, however, as are not vitiated in this relation, and whose inex- [)erience is beset by warm passions and susceptibilities, we would give a few words of caution and advice ; hoping to enlist their sympathies and altcnlion regarding a matter which affects so vitally their interest and happiness, not only in this world but in the world to come. To be succinct, then, when a youth finds himself approaching the threshold of manhood, or that period of life which succeeds his mere hovish days, he in most cases enters upon a new and charming phase of hi.:' existence, which is expressed mainly in a desire for female society, and generally for that of one being beyond all others, who in his admir- ing eyesappearii to be the best and most beautiful ot hqr sex. Now this il 330 THE FAMILY PHYSICIAN. is nothing more nor less than the first dawning of love, and before he would have its partial victim commit himself irrevocably to the over- powering passion of any individual case, we would implore him to pause on the verge of the charmed circle, and ere he become hopelessly en- tangled in its delicious mazes, seek advice from his natural guardian, and analyze for himself all the circumstances surrounding the being who has awakened such strange sensations in his bosom, and the possible result of attempting to unite his destiny to hers forever. To this end, he must endeavor to look upon things as they really exist, and not permit his enthusiasm or admiration to present them in any romantic or fanciful light. As a primary step in this direction, he must measure his own pecuniary circumstances and prospects, and see how lar justified he might be in endeavoring to win the affections of any young maiden with a view to making her his wife. We are, of course, aware that but few inexperienced youths pause thus practically upon the thres- hold of new hopes and aspirations ; but then this does not nullify tiie wisdom and necessity of doing so. No honorable or prudent person will commit "unself to a step so serious as that of marriage, without seeinL,^, to some extent, the road before him ; nor will he tamper with the love or affections of any woman whatever, whom he considers unworthy to become his partner for life. In the fullest manliness on this point there is a chivalry the most noble and exalted. Everything like deceit must be discarded totally, and if it is found that the over-sanguine fair one has misinterpreted any word or act of kindness on the part of him who may regard her as a friend only, she must be undeceived, and at once. . The safest rule to follow in this relation is for the young man to be cautious, and never inspire any hopes or confidences in any of the opposite sex, that he does not wish to exist. There are a thousand channels through which the pleasantest intercourse may fiow securely, without entering upon this vital one; r id these are. familiar to every person of ordinary good understanding. Where there is no intention of awaking in the fe- male bosom a sentiment of love, there should be neither act nor word calculated to provoke it ; and if, as is often the case, one of the softer sex, overstepping the bounds of prudence if not of modesty, makes ad- vances on her part, then the only honorable and correct course of the object of her affections, is to withdraw himself totally from her society. After t)Ccoiriing satisfied iha' he is in a position to s pport a wife, and being free in person from such physical blemishes as have been already alluded to, the first care of the expectant bachelor should be to select from among his acquaintances a maiden of comely looks, industrious habits, and sound and pure morals. These are essentials the most im- portant, and must underlie all the accomplishments which render a wo- man fascinating, if she is ever to become the light of her own household. There can, of course, be no objection to the f ossession of those orna- mental acquirements which render a drawing-room so attractive at times, I might fi OBSERVATIONS REGARDING YOUTH OF BOTH SEXES. 33 1 rse, aware such as music, bright conversational powers, and all the agreeable phases of a poHte education; but these, desirable as they undoubtedly are, must not be accei)ted as the true constituents of happiness ; but rather as the agreeable guise that the more serious and abiding attributes as- sume, until the moment f r ilieir more active agency presents itself again. No man of moderate means has ever dined off a piano solo, or supped off a dish of fashionable gossip ; and hence the ne ;essity of looking for something more substantial in th-i person to whom he might be induced to pay his addresses, with a view to matrimony, and of es- chewing every female, no matter what her attractions, who has not with- in herself the knowledge and elements that constitute a good housewife. The freaks of fortune are often both sad and surprising ; and hence it is of vital importance that parents educate their children in some trade or calling that might stand their friend in the hour of adversity, when they might find themselves deprived of the last shilling. And here we may refer, briefly, to the helpless condition of some of the fashionable youths who are depending solely upon circumstances for a life of ease and plea- sure to which they devote themselves, and who, through a single turn of the wheel of fortune, might be reduced to beggary, from the fact of their having no positive means at the ends of their own fingers of earning their daily bread. On this point we would urge the knowledge of some useful employment on the part of the young of both sexes, no matter what wealth may surround them for the time being; because by its ac- quisition they are, in a measure, secured against fate, and have an inner and more satisfactory sense of independence than flows from the pos- I session of mere perishable riches. But, now presuming that our young suitor is fairly on the carpet, and I that, with the sanction of his parents and guardian, which is indispen- sable, he has determined to win, if possible, the heart of some fair one supposed to be possessed of all the attributes, and the germs of all the qualifications, adverted to, it must be a' parent that his hour of danger and difficulty has arrived, and that, in dealing with it, the greatest cau- tion and prudence ought to be observed. With a view to the fullest success, then, and in furtherance of the great object upon the holiest and highest basis, the moment he perceives a being worthy all his love and affection, she must at once become sacred in his eves, and never he the subject of any familiarity that might shock her ears or her sense of propriety in any degree, or that might tend to lower her in her own estimation. The more chaste and considerate his intercourse with her, to even the most trifling word or whisper, the higher her sense of his nobility, and, consecjuently, the warmer and the more profound her sen- timents of love towards him. It is a mistaken idea that an occasional questionable jest or brilliant doubk-entendre has any charm for the ear of a young maiden of correct perceptions ; for, although the circumstances of her position may often extort a smile from her as a foil for her pain I 332 THE FAMILY PHYSICIAN. and discomfiture, the shadow of the cruel, though unintentional, offencl docs not easily pass away from her, inasmuch as it is calculated to awakei in her chaste Ijosom doubts as to the morality and purity of the beinj whom she may love dearly. Let there be then, on the part of the suitoi a noble consideratio:i lor the woman who has given her whole heart U him ; and let him feel that the bonds which she is willing to assume, cai be only made holy and happy when forged in a sense of true delicac] and the highest moral obligations. One impure, indelicate, or low wor(| uttered in the ear of a truly chaste and virtuous woman may be destruc tive of her true hap})iness for all time to come ; while a single trilling acj savoring of the libertine could not fail to estrange her Irom the trans gressor forever, if faithful to her pride or sex, or else so humiliate her it her own eyes, as to cause her to feel that the love she brings to the altaJ is not so worthy, so fresh, or so sanctified, as it would have been had i( not been soiled and dishonored, in a measure, by him who should hav( guarded it more jealously. The demeanor, then, to be observed by a young man, in relation to the maiden of his choice, must, while open, generous, and warm, be care-] fully studied, elevated, and iree from the slightest taint of immorality.! 'i'he step which he i)remeditaies is the most serious that could i)ossibl)i be undertaken by him, and, as it involves a partnership for lite with a being whom he is to pledge himself before God and man to love and cherish until death, it behoves him to make the compact one of the most chaste and sacred, so that it may never pall upon his sensibilities,! but always, under lieaven, bear the imjjress ot unfadmg youth. And now that we have been so explicit on this point, we must gf farther, and warn the ardent and well-meaning suitor of another precipice! that besets his path Irom the period ol his declaration to his appearance! belore the altar, and that is, the great danger that attends the warml embraces which a lover sometimes bestows upon his affianced, when] alone, without presuming for an instant that his passions may outstrii his reason, and, in a moment of intense excitement, hurry him into an| excess that would destroy the purity and sell-respect of the being whc confined so implicitly in his honor, until she stood before him a guilt)'] and injured woman. This is a matter for most serious consideration for, notwithstanding that the aggressor makes every reparation in his power and still redeems his plighted vows, the memory of this great indiscretion or crime is likely to overshadow all his subsequent marriec life. Let it then be distinctly understood, that even the ordinary] embrace so frequent between two young lovers before they becomt united in marriage, must be indulged in with caution and reserve, whert no eye but that of heaven is upon them. The passions, like tinderJ often take fire from the slightest spark, and it therefore becomes matter of the last importance, that until a man and a woman become Qne according to the laws of society as wqU as those of the Creator, tht OBSERVATIONS REGARDING YOUTH OF BOTH SEXES. 333 stronger vessel must keep his desires in hand with a bit and bridle the most inflexible and stern ; otherwise, all the charm and brightness which properly belong to the marriage state can not fail to be tarnished, or, perhaps, ultimately extinguished in gloom. When entering upon that phase of his life which tends towards matrimony, the young and ardent suitor, once that his heart is truly engaged, should treat the object of his affections with such loving respect and consideration, as could not fail to ennoble him in her eyes, and secure her heart upon a true and abiding basis. Every maiden of modesty and womanly instincts is thoroughly conversant with what is due to her, and alive to every circumstance however trifling, bearing upon the character of her intended. The more profound her love the keener her discrimination, and the more jealous her eye and ear. Not a single expression or act appertaining to his intercourse with her or others but is weighed unconsciously, and subjected to that subtile i)rocess of analysis which is almost instantaneous in its results. It is therefore ungenerous, and as dangerous " 't is unjust and reprehensible, to wound her susceptibilities in any rei.;-;on ; for notwithstanding that she may permit, without actun.1 censure, or apparent chagrin, any slight dereliction of duty to pass in tlijs relacion, she can not fail to feel his unworthiness, and the shock of her esteem and affections which it must necessarily entail. liUt if we have dwelt upon what may be termed the two leading evils which beset the path of youth, there are yet others, scarcely less danger- ous, which re(iuire the most careful consideration ; and one of these is die sin of intemperance. We need not travel out of every day common record for evidence to establish the dread conseciuences of this dire infatuation and its general prevalence. Like most other criminal practices, it steals through the first stages of its progress by slow and imperceptible degrees ; but at each unconscious step, so surely does it eniangle its victim in its meshes, that not unfrequently he passes beyond the final point of redemption before he is thoroughly alive to his lost and hopeless state. And here, again, the influence and habits of the home circle become of the first imi)orl;ance. If unswerving lemperance be the inexorable rule of the household — if the stductive cu[), in even the most, harmless aspect, be banished from it with firmness and [)er.sistency, there is every hope that the dangerous out-door influences wiiich so throng the path ot the inexperienced, may be met and neutrali/cd. But if the household be tainted, to any extent, with the vice — if indul- gent fathers and mothers will tempt their children with an occasional sweet spoonful of the poison, they do neither more nor less than set fire to one end of a slow fuse which is almost sure to result, one day or other, in the most fearful destruction. But as we are speaking, as it were, to a youth of" understanding, we must appeal to his own manhood and sense of right. And he*; wc . I 334 THE FAMILY PHYSICIAN. would observe, that next to the appalh'ng crime of self-abuse, that o habitual intemperance is most destructive of pure love, and of ih_ physical capacity or power to realize from the chaste passion ail that heaven designed it should accord. No woman of correct feeling or judgment has ever bestowed her heart upon a habitual toper, or cnjoyc his society for a moment, not to speak of his maudlin embrace. This isl true beyond question, and to an extent so dreadful, that no inconsider- able portion of the infidelity which a neglected and disgusted wife visits upon her husband to-day may be traced simply to the vice of habitual drunkenness on his part. No matter how warm the affections of the maiden, or how sincere the love of the wife, this curse tramples out both alike ; and hence the necessity of the utmost vigilance on the part of any youth who would win and retain the heart of a pure and beautilul maiden, or preserve his health and manhood intact until both, at a ripe old age, declined in the natural order of things. It may be laid down as an axiom, then, that no true love can exist between a good and pure woman and the man who renders his person disgusting to her, and who in a measure emasculates himself through the constant use ot intoxicating liquors : and when we come to dwell on the fact, that the prostration of his high mission and manhood arises from the indulgence of a loathsome vice, whose inception is to be traced to the first fatal and seductive glass that is thoughtlessly raised to his lips, surely the individual who is yet free from the taint of this curse, or the man who is its jiartial victim only, should, if these lines hajipen to meet his eye, never a[)proach — or dash from him forever — the cup that has been so fraught with some of the direst crimes, heart-aches, and miseries, known to the human family. When, therefore, it is a fact beyond contradiction, that a persistent use of stimulants of any description tends to generate morbid and adventi- tious sexual desires, that are succeeded by a reaction the most depressing, inconvenient and dangeious, and that frequently result in a permanent injury, what shall we say in denunciation of the habitual use of those fiery potations that not only lead to rags and beggary, but corru])t the blood, disfigure the features, and trail the last particle of manhood in the dust? To all within reiich of our warning voice we would then say, beware of the first glass, and those inebriates or thoughtless persons who would tempt you to pollute your lips with it. There is danger in even looking ui)on it or in breathing the atmosphere inhaled by those who have passed its fearful Rubicon, without either the wish or the power to re- trace their steps. Avoid such, and their social meetings or orgies, with all the strength and decision of which you are capable ; lor in this re- lation also " wide is the gale and broad is the way that leadeth to destruction." The vice of intemperance in youth is not unfrequently associated with that of gambling, and is almost invariably wedded to that ot promiscuous OBSERVATIONS REGARDINtG YOUTH OF BOTH SEXES. 335 sexual intercourse ; and here we find another dan<;erous pitfall besetting the paths of the younLi; on their way towards matrimony, and the attain- ment of the fullest and most perfect manhood. Fatal even as the crime of gambling, /"d-r se, may be, it is less tcrii!)le in its effects than the physi- cal and moral destruction which results from the loathsome and con- taminating embraces of the lost and lewd woman who sells her person to every passer by, and so poisons the life blood of Iht unsuspecting young victims as to entail u[)on them a life of disease J misery horri- ble to contemplate. A man may lose his money at the gaming table, and suffer the pangs of remorse and the beggary that it involves, but criminal as the passion for play is, and frightful as have been the domes- tic disasters that have resulted and do still result from it, yet if he have escaped the vice of drink and the taint of impure and loathsome women — if his physical structure and mind is not wholly poisoned and de- bauched — there is hope for him, as a woman's love can survive the one, although it dies out into absolute hatred and disgust under the other. There is little more to be said on this ])art of the subject. ^Ve have touched all its vital points, and trust that the seeds we have endeavored to plant, in all honesty and good will, may be found to bear the sweet and abiding fruit they are so pre eminently calculated to yield. In sum- ming up the whole case, then, we would say to fathers and guardians, form the thoughts and habits of your wards or children by a joyous and virtuous fireside. 1 -et their earliest perceptions of right and wrong; be based on no uncertain foundation. Set them examples of morality, and inculcate that religion in them which is filled with innocent sunshine and which alone is calculated to inspire their tender hearts with sentiments of true love towards their Creator and their fellow men. Warn them, in the plainest possible manner, of the danger of bad company, loose habits, and any and all of the evils and infamous practices that lie in wait for them, and when they grow up to be men, they will bless and appreciate the kindly care bestowed upon them, and be not only a credit to them- selves, but to the human family at large. • I « • WEIGHTS AND MEASURES, &c. APOTHECARY'S WEIGHT. ■20 j;iiiiiis 60 <;r;iins 480 grains 5,760 yrains I scruple I clrachm I ouiicu I pound 20 grains. 3 .scrupU'S. 8 (Irachnis. 12 ounces. The scruple and drachm are discarded in the new weiglils, Meiisurcs ol japacity aie Ubcd for li(|uids in mixing medicines. l''ormerly w ine measure was employed, but now it is the imperial, 'I'he weight of the imperial minim of ualer is 91 grains, and i.-i uuilliplied as follows : , . 60 minims cs 1 fluid drachm = 60 minims. 48b minims as i liuid ounce =: 8 liuid draciuns. g,6oo niiniius = i pint = 20 thiid oimces. 76,8tK> minims 7 i gallon = 8 [)inls. '1 he liuid ounce is the measure of one ounce of water ; the pint, i J^^llis. ; and the gallon, lolbs. In prescriptions the weights and meaiures are generally e.xijressed by signs or sym- bols, with Lalin numerals aflixed. These signs, with the Latin and English words which stand for them, are given below : 1/1 '■>} lb J Oj ss Minim, i-6oth part of a tluid drachm. IScrupulus, a seru[)le. Drachma, a drachm. Fluid drachma, a measured drachm. Uncia, an ounce (437.5 gniin:s. ) fluid imciii, a measured ounce. Libra, a jionnd (7,000 grains). Octarius, a pint. Granum, a grain. Semis, liall, allixed to any of the above signs. riie numerals j., i.j., iij. , iv. v., etc., show the number of grains, ounces |,ountb, etc., Ui be taken ; thus, ///l.\, denotes 60 minims, 5 vii. 7 drachms, and 5 i. i ounce. .ON ADMINISTERING MEDICINES. fn prescribing or administering inedicines, the following circumstances are always kv\)\ in view by medical men, and are of the utmost importance, viz., Age, Sex, Temperament, Habit, Climate, and Condition of the Stomach. Agk.- Sec the table ot proportionate doses given on the following page ; remembering '.hat all uiedicincs containing opituu affect children more powerfully than adults. Si':x. — Women require smaller doses than men ; and arc always more quickly affected by ptirgalivcs. 'iKMi'iCKAMENT. — Stimulants and purgatives more readily affect the florid or sanguine than the pale or phlegmatic ; consequently the former require smaller doses. Habits.- -Persons in the habituaLjise of stimulants and narcotics require larger doses ol such remedies to affect them, when laboring under d..:>case, than others not so accustomed ; orllio>e who have haiiiiu;iied ilicmselves to saline purgatives, such as Epsom Salts, arc more easily affected by such remedies. 33^ Cmm differen doses m consequ CONU persons, nient. doses th; together rapidly same tii tem, and oil accjui caution, Emoii orders of in all cas( extraordi mesmeris eased bo( Ag: For an Ad Under i y 2 vi <■ 3 4 " 7 ' " 14 • " 20 ' Above 2 1 ' " 65 • " 80 ■ In the sa tional parts one eighth For the c proximate c A teacup A winegli A tal.l('.-.p A teaspoc Sixteen la Eight Four 'I'wenty-fi ibci'ing :te(l by .ngLiiiic osi's ul uiiRil ; WEIGHTS AND MEASURES. 337 Climatk. — Mcdicinos act differently on the same person in stimmer and winter, and in different cliiiiales. Narcotics act more powerfully in hot than in cold climates, hence smaller doses must i)c? given in tin; former ; but the reverse iti tiic case with respect to calomel, consequently larger doses are recjuired in hot climates. Condition oi" tiik Stomach. — The least active remedies operate violently on some persons, owing to a peculiarity of stomach or disposition of body connected with tempera- ment. In giving mctlicine, the medical man always so regulates the intervals between doses that llie following dose may be taken Ijefore the effect produced by the former is al- together effaced. l'.y not attending to this rule, the cure is always conunencing, but never rapidly proceeding — it may, indeed, have no effect at all. It is to be borne in mind at the same time, tJiat some medicines, such as mercury, etc., are apt to accunmlate in the sys- tem, and danger may tiience arise if the doses be repealed too f^requently. .Aloes and castor oil acciuire greater activity by use, so that the dose rccjuires to be diminished. With due caution, and a proixT attention to the doses ordered, no untoward circumstances need arise. Emotions .and 1'.\ssions ok the Mind have a most powerful influence upon the dis- orders of tlie body. Hope is a mildly stimulating or tonic feeling, which is most beneficial in all cases. The influence of the imagination on disease has long been known, and the extraordinary cures we constantly hear of as effected by such absurd means as homoeopathy, mesmerism, ( tc, are, in fact, .all referable to the influence of the imagination over a dis- eased body or disordered mind. DOSES PROPER FOR DIFFERENT AGES. Ages. For an Adidt Under i year '' 2 years " 3 " " 4 " <' 7 " " 14 " " 20 " Above 2 1 " " 65 " " 80 " Proportional Doses. Suppose the dose One Will require only i-i2th /s The full dose One Will require only ^ Dose, as I drachm or 60 grains. " 5 grains. " 8 "10 " IS " " I .scruple or 20 grains. " % drachm or 30 " " 2 scruples or 40 " " I drachm. "45 grains. " 2 scniplcsor40grains In the same manner for fluids divide the cjuantKy suited for an adult by the above frac- tional parts. If a child under one year, the dose will be one-twelfth ; under two years, one eighth ; under three years, one-sixth, and so on. APPROXIMATE MEASURE. For the convenience of those who have not accurate measures at hand, we give the ap- proxinmte quantities ; A teacup contains four fluid ounces, or one gill. A wineglass contains two fluid ounces. h lal'U•^poon contains one-half tluid ounce. A tea^i)oon contains one-eighth fluid ounce, or on(r drachm. Sixteen large tablespoonsful make half a pint. Eight " " one gill. I-our " " half gill. Twenty-five drops are equal to one teaspoonful. '*. Its, arc INDEX. -•♦•- PAGE Abortion or Miscarria^o 191, 2;{8 AhHcess 2;W AchilW Tendon, Injuries to IIW Acid, Oxalic 105 " Prusaic KiO Acids 1()'2 ^Vcidity of Stomach 238 Aconite HY.i Acne or Pitnplea 45, 2:)8 Acute Plt-urisy 1(5 Adininigteritic MedicineH 'MU'} Air of the .Sick lloom 3 Alcohol 102 Alcoholism or Drunkenness 239 Ameuorrhoea 171, 239 Ammonia 110, 103 Anjemia 193 Anaemia or Lack of Blood 239 Au(jiJynea 295 Antimony 103 Ajioplcxy , 90 Aphtha, or Sore Mouth 240 Appetite 240 Arnica Lotion 294 Ai senic 103 xVsthraa 15 Asthma 240 Bad Smell, C^'^ckly Remove Baldness 49, Bandage, How to Barber's Itch liarnmness Baryta Bed- wetting Beef and Hen Fruit Belladonna Big Neck Biliousness 23, Bismuth Bites Bites and Stings of Insects Bites, Poisons, and Stings Bitter Sweet Bladder, Irritability of " Inflammation of Blanc-Mange, llice " Arrowroot. . . . . ^ <* u Irish Moss Gelatiue..., 283 310 110 40 194 103 233 270 163 119 241 mi 102 100 102 103 241 150 279 279 280 280 PACE Bleeding, or Hemorrhage 122 " from the N(.He 123 " " Bladder 151 " Bowels 123 Lungs 255 IMisters, Blood 53 Bloody Urine 151 Boils 241 Boils (Fnimrles) 53 Bones, liniken or Fractured 125 Bowel, Falling of the 230 Bread Sauce 277 Breasts, the 183, 186 " Inflammation of 180 " Abscess of 180 Breath, Fetid or Foul 241, 313 Bromides 10 Bronchitis 13 Bronchitis, Af^ute 241 " Chronic 242 in Children 242 Broth, Chicken 274 " Mutton 275 •' 15eef Tea 275 Broths and Soups for the Sick Boom . 274 Burns and Scalds 113, 'JA'2 Bunions 53 Camphor 103 Cancer of Tongue 115 of Stomach 242 " of Womb 178 on Surface of Body 235, 243 Carbuncle 53 Care of the Infant 202 Catarrh U Catarrh, Acute Nasal 243 Chronic 243 Cathartics 283 Chapped Hands and Lips , 243 Character, as Indicated by the Hair. . 310 Chicken Pox 214 Chilblains 48, 243 Child-Crowing 212 Choice of the Sick Room 1 Choking 118 Cholera, Infantum or Summer Comylaiut of Children 243 Chordee 244 Chorea 86, 213, 244 339 ^■P 340 INDEX. PAOE Clap 162, 2iV2 CleanlinpHH of tho Sick Koom ('» <'l()ii(lo(l Urine 152 C'of'ee 271 CoMin tho Mead 11, 2l;J Cold, Mode of Arjilying 285 Colic, Wind and UiliouH 27, 232, 244 Complexion, the V. Ull Conhnement IH'J Couuumption 17, 2i!I " Bleeding from the fiUngH 18 *• Coutih IS " DiarrhiEa IS " Nit,dit Sweats 17 " Pains in theCheHt..,. IS *' l'«irspiration in 2(10 " SletpleHsneHS IS ConBrtjni)tioD, Perrtpiration of 2(>0 Constipation or Costiveness 2(5 2S1, 245 ConvulHions i)'J, 223, 245 Copper 1(53 Cornii 54 Corrtisive Sublimate 104 Costiveness 20, 231, 245 Cough 245 CouMi.er-lrtitaiits 28(5 CuppiuK 2S7 Cutlet, Tnvalid'.s 278 Crami >, Writers 104 Cream of Tartar, Purgative 2S3 Croup 210, 24(i Dandruff 44, 303, 307 Dead, Laying out the l(i(» Delirium Tremens 100, 24(i Delirious Patients 7 Dentition or Teething 24(') Diabetes 147 Diarrhoea 24, 231, 24(; Dietin Skin Disea^ es 57 Digestibility of Animal Food 27G Digitalis, (Vox Glove) 1(54 Diphtheria 14, 247 24S DisinJ'ectant, Carbolic Acid 287 " Charcoal 2S7 •• Chlorine 287 " Permanganate of Potiish 287 ** Green Vitriol 288 " Fresh Earth 288 " Sulphur 2S8 Disini ectants 287 Di«lo(!ation of Hip Joint 137 " of KneePau 138 Dislocations 134 " of Lower Jaw 134 •* " Collar Bone 134 "• •* Shoulder 135 " " Elbow 135 " " Fingers and Toes 130 •' " Wrist 136 " Backwards 137 PACK Dislocations Dowtiwards 138 Upwards 138 Di/./.inesB 100 Drinks 'Ml " Lemonade 209, 270 " Barley Water 270 " Linseed Tea 270 " Arrowroot 270 " Milk-jmnch 270 ♦ Wine Whev 271 " EggM and Sherry 271 " IJoffee 271 '• Milk and Isinglass 272 Soothing 272 " Milk and Cinnamon 272 Caudle 272 Apple Water 272 Cliocolato 272 " Chocolate Milk 272 " Invalid's Tea 272 •• Kose Tea 273 " Sai)Tea 273 " Oatmeal Tea.. 273 Drinks for the Sick Koom 2r,\} Dropsy 20, 248 Drunkoimess 23!) Drowning 141 Duties of those Nursing the Sick, ... (i Dysentery 25, 248 Dy.spepsia 22, 21!> Dysmenoirhma 173, 248 Ear, The 40 " Ache 40 " General Cautions 43 *' Washes 280 " Wax in 42 " Punning of 42 " Things in the 144 Eczema or Salt Rheum 47, 249 Electric Treatment for Diseases of the Womb 180 Emetics 288 Emetic, Mustard •. . . 288 Alum 288 Common Salt 280 'I Salt and Mustard 2fc9 Emissions, Nocturnal 150 Enlarged Tonsils 115 ICpilepsy or Falling Sickness 80, 240 Erysipelas 49, 225, 250 Exliaustion, Nervous 105, 259 External Applications 290 Eye, The.... 35 " Squinting of 35 " Inflammation of 36 " Short Si^'ht and long Sight 37 " Ingrowing Lashes 38 " Blindness of 89 " Cataract of 39 •♦ Weak 38 INDEX. 341 PACK Eye, Inflamed Lnehea 40 " HtyuH of 10 «' TliiriKHin the 1 1.< liye-Wanh, Alum I'H'J Brandy *2«'.i Arnii-a L'8;» <« Tea 2bit (< (< (« ti << <( 4( «( <4 il (1 Ague Face Washes Faintinj,' Falling' <»f the Bowel Falling Sickness 'M Feet, WaHh Feet, Fetid or Foul Felon (Whitlow) Fetid or Foul Feet Fever, Simple find Bilious Intermittent 72, Worm Yellow Kemittent 7^$, of Lactation (Milk Fever) Scarlet Typhoid O'J, Typhus Hay Milk I'ueriicral •••• !'■'. i.'ii;j. Flatulence or Wind Flesh-Worms FlooditiLf Fomentations Fomentt'.tious, Ordinary Turpentine 0()ium Mustard Food for Sick Room Foods, List of Foul Breath Fowl and Egg«, Minced Fowl apd Kice .... Fracture of Skull Fits. It it <( <( it Lower Jaw Finger Hand Forearm llumeius Neck of Humerus. Condyles Shoulder Blade . . . , Collar Bone llib.s Leg Knee-pan Thigh Compound . . . . Fractured or Biukeu Bcues. :m 124 24"J 31.{ f)5 54 55 •251) 72 7;i 257 215 2G7 215 2-)8 05 205 71 2.-);{ 18S 105 245 251) Ml 177 28'.) 2.S<) 2!)0 290 21)0 208 24 241 277 277 125 125 120 120 120 120 12s 128 121; 12i) 12!) VM l.U i:u 132 1.32 125 PAGE FreckloR 52, 251, 311 IVoHt Bite 118 Furuncles 53 Furnituie of the Sick Room 2 (Jargle, Brandy 290 " Alum 290 " Lime Water 2J)0 " Chlorate of I'otahh 200 " Sage and Liubeed 201 (tar-les 21)1) (iastrulgia or Neuralgia of Stom- ach 251 (iastric IHcer 251 DaMtritis iir Intlammation of Stomach 251. (Hands, Swelling of '2'M (fleet 158 252 ( Joitre (swelled neck) 54, 110 liuut 70, 253 (ionon ha-a Clap 152, 252 (iravel 148 (jreen SicknesH 105 (irey llMv 308 Ciipes 232 Gruels for the Sick Boom 273 (.iriie). Water 273 Milk 273 Flour 274 Kice 274 Barley 274 Hair, the 307 Hair Tonics 303 Hangnails .5.3 Hay Fever 253 Headache 00 Headache, Congestive 254 " Nervous * .. 254 " Bilious or Sick 2.51 Heartburn 24 Heart, Palpitation of 31, 254 Neuralgia of 32 Heartshorn 10 Heart, The 31 Heat, Mode of Applying 291 Hemorrhage or J.>leeding 122 Hemorrhoid;! or Piles 30, 254 Hemoptysis or Lieeding from liungs.. 255 Henbane 104 Hen Fruit and I'eef 270 Herbal Treatment for Womb Diseases 180 Hernia 1.30, 235 Hermia or llupturi- 130 Herpes, Zoster, ^ti .--hingles 255 Hiccough 256 Hives (Nettlerash) ■. 6U Hou.sehold lleniedies 8 Housemaids Knee , 119 Hydropathic Belts 285 Hygiene 300 Uyuterics (Hysteria) 85, 256 M MUMiMi 342 INDEX. PAGE Ice 271 Impotence 159, 250 Incontinency of Urine 149, 185, 233 Indigestion 22 Infant, care of the 202 Infantile Remittent Fever 215 Inflamed Eye Lashes 40 Inflammation 256 of Lungs 16, 201 " of Bowels 27 " of Stomach 251 " Acute of Kidneys .... 11 " of Bladder 150 of Testicle 153 • *' of Ovaries 177 of Womb 177 " of Breasts 180 Influenza 18, 257 Ingrown Nails 53 Ingrowing Eye Lashes 38 Injections .... 284 Injuries to Achilles' Tendon 133 Insomnia, or Sleeplessness 93, 257 Iodine 10, 104 Iodine Faint 287 Iron, Sulphate of 104 Irritation 51 Itch 46, 263 " Barber's 40 Itching ^ 51, 196, 262 Jaundice 30 Jellies for Invalids 279 Jelly, Isiinglass 279 '• Strengthening 279 " Mutton 279 " Bread 279 " Sago 280 » Tapioca 280 " Panada 280 ♦' Calves'-feet 280 " Currant 280 Kidneys, Acute Inflammation of 140 Knee, Housemaid's 119 Lack of Blood 239 Lactation, fever of , or Milk fever 258 Laying out the Dead 106 Lead 104 liBucorrha^ft, or Whites 178, 258 Lice 5i^ Lichen 51 Li^ht of the Sick Room 5 Liniment, ( !roton-oil 286, 291 Camphor 291 " Hartshorn and Oil 291 •• Opodeldoc 291 " Mustard 292 " Lime 292 •• Ohioroform 292 PAGE Liniment, Lead 293 Turpentine 293 Liniments 291 Lip Salves, &c 303 Lockjaw 91 Long Sight 37 Lotions or Washes 293, 303 Malaria 72, 258 Malarial Fever 72 Management of those Recovering from Sickness 7 Mania Puerperal 195 Marriage 198 Masturbation, or Self- Abuse 100 Measles 67, 213, 258 Measures 330, 3;)7 Meat for Invalids 276 Menorrhagia 173, 259 Menstruation .... 108 " Delayed or Obstructed 171 " Suppressed 171 " Painful 173 *• Profuse 173 " Cessation of 174 Milk Crust 234 Milk Fever 188, 258 Milk Leg 196 Mineral Water 284 Miscarriage 191, 238 Morning Sickness 184 Mother's Marks 52 Mouth, Sore 240 " Ulceration of the 226 " Washes 301 Mumps 22 Mushrooms 164 Nails, Ingrown 53 Nervous Exhaustion 105, 259 Nervousness 195, 259 Nettlerash 50 Neuralgia 88, 259 iff Stomach 251 Night-Terrors 223 Nipples, Sore 188, 200 Nitrate of Potash (Saltpetre) 104 " of Silver (Lunar Caustic) 105 Nocturnal Emissions 159 Nose, Things in the 144 Nose, Bleeding from 123 Nursing the Sick 6 Ointments or Salves 295 Ointment, Sulphur 295 •' Common 295 " Tannin 295 Camph'jr 295 Oxide of Zinc 295 Opium 10, 166 INDEX. • 343 PAOR Ovaries, Inflammation of 177 Oxalic Acid 1(>5 Oysters, Stewed 278 Pain Removers 295 Paf()itation of Heart '254 Paralysis 102, 2()0 Partiirition 189 Personal Attention required by the Sick 7 Perspiration of Consumption 2(50 Pertussis or Whoopiuy Oough 95, 260 Phosphorus IGG Phthisis 261 Piles 30, 254 Pimples 45, 238 Pimples or Acne 45, 238 Pleurisy 16, 261 Pneumonia or Inflammation of the Lungs 16, 261 Poisons, Bites and Stings 162 Poison Vine 165 Polypus of the Womb 177 Poultices 297 Poultice, Bread and Water 297 *• FlaxseedMeal 297 " Bran 298 «« Starch 298 " Charcoal 298 " Mush 298 " Carrot 298 " Alum 298 " Slippery Elm 299 " Arrowroot 299 «• Onion 299 " Mustard 299 " Bread and Milk 299 Potato, Mashed 278 Surprise 278 Pox 155, 264 PutklingE, for Invalids 281 Pudding, llice 281 Bread.... 281 " Batter 281 ** Apple and Rice 281 " Vermicella. 281 Puerperal Fever 195 '* Mania 195 Purgatives or Cathartics 283 Putrid Sore Throat 28 Pregnancy 180 " Signs of 180 •* Management of 181 " Diet during 182 '• Dreaa an8 Stomach, Neuralgia of 2r)l Stoma<;h, Inflammution of 251 Stomach, Ulceration of 251 Stone in the Bladder 148 Stramonium 100 Strychnine IO(i Stupes 28!) St. Vitus' Dance 86,213,244 Styes ; 40 Summer Complaint of ChiMren, 220, 243 Sunburn 305 Sunstroke 94 Suppression of TTrine 149 Suvine, Oil of 160 Sweating (Excessive) 55 Swellings of the Glands of the Neck.. 230 Syphilis 155, 204 Tape Worm. 28 Tea ; 273 Teeth, The 312 Teething 207, 240 Testicle, Inflammation of 153 Tetanus 91 Thermometer 10 Throat, Catarrh of the 11 Thrush 225 Toast and Water 271 Tobacco 100 Toilet, The 307 Tonsils, Enlarged 115 Tonics 205, 299 " Hair 303 Tonic, Quinine, iu Powder 299 Iron 299 Potassio-tartrate of Iron 300 Columba and Ginger 300 Toothache 140 Tooth-powder 300 Typhoid Fever 09, 205 ■Typhus Fever 71 Ulcerated Sore Throat 20, 22 Ulceration of the Mouth 226 Ulceration of Stomach •.... 251 PAttE Ulcei-ation of Womb 177 Urination, Painful in Women 200 Ulcers 55, L'tWi Ulcers of Leg 1 10 Urine, Incontinency of 149 " Suppression of H9 " Clouded, Thick and Dark Colored 152 Vegetables for Invaliits 270 Vomiting 2(50 " in Pregnancy 206 (i (( (I (t Wakefulness Warmth of the Sick lioom Warts Wash, Cold Water Spirit Water Vinegar Lead. . . Lime Water Borax Absorbent Washes Mouth Face Weaning Weaning-Brash Weights and Measures 330, Whites 178, White Leg Whitlow Whooping Cough 95, Wind Wind Colic Womb, The, and its Diseases " Falling of •' Inflammation of '• Ulceration of Neck " Polypus of " Cancer of Worms 209, Worm Fever Worm, Tape 28, Wounds " Incised " Lacerate 1 " Contused " Punctured Writers' Cramp 93 1 55 2!>3 293 2!»3 254 294 294 294 291 :«)l 304 208 234 337 258 196 54 2»)0 250 27 175 176 177 177 177 178 2(i7 215 207 120 121) 121 121 122 104 Yellow Fever 207 Youth, The, of Both Sexes 314 Zoster , 255 !"W"1P??TS^IP" Si), PAftE . 177 . 2(1(5 L'(;(; ] IT) 14!) HI) 270 2()(! 266 93 . . . f)0 .... 2!).} . .. 2S).S . .. 2!);{ .... 2S'4 294 .... 294 ... 294 . .. 291 ... :ioi . .. 304 ... 208 ... 234 30, 337 78, 258 ... 196 54 95, 260 ...250 ,.. 27 ... 175 ... 170 ... 177 ... 177 ... 177 ... 178 39, 2(J7 ... 215 IS, 207 ... 120 .. 120 ... 121 .. 121 .. 122 .. 104 .. 207 .. 314 .. 255 St'