Class ■ •'-. Book - * : DOMESTIC MEDICINE Jl6>£ A TREATISE PRACTICE OE MEDICINE, ADAPTED TO THE REFORMED SYSTEM, COMPRISING A MATERIA MEDIC A, It WITH NUMEROUS ILLUSTRATIONS. BY J. KOST, M. D., Formerly Professor of Materia Medica, Therapeutics and Botany, in the Medical College of Worcester, Mass.; and of the same in the P. M. College of Ohio, American Medical College of Cincinnati ; and of Mat. Med. and Thera- peutics in the Medical College of Macon, Ga.; Author of "Materia Medica and Therapeutics;" "The Principles and Practice of Med- icine ;" First Vice-President of the Ec. National Medical Asso- ciation, and Member of various State Medical Societies. "" CINCINNATI: MELICK & BUNN, PUBLISHERS. 1868. • Entered according to Act of Congress, in the year 1851, By JOHN KOST, M. D., !d the Clerk's Office of the District Court of the United States, for tb* District of Ohio. C. JAMES, STEREOTYPIC 187 Walnut St, Cincinnati. PUBLISHER'S NOTICE. The time when the three great professions were committed en- tirely to the hands of the Priest, Lawyer and Doctor, is now hap- pily passing by. Keligion comes now, like the rain from the clouds, and the sunlight, to all; and although men still go into court by counsel, yet their own judgment upon the law, is now the arbiter of their legal course. In Medicine, the people now begin to act for themselves in a great measure. Indeed, this is done to a much greater extent than appears at first thought. Persons now rarely send for a physician at first ailment, but wait a little to see if it be really necessary; and in the meantime resort to such remedies as they judge proper under the circumstances. They still continue the exercise of their judgment in the selection of a Doctor, and also as to how long they will submit to his treat- ment or take his medicines. In view of the great responsibility thus assumed by people gen- erally, a responsibility that determines very largely the results of the ailment, a responsibility, too, that is universally practiced (and properly so, too; for who is so much interested in the results as the patient?) the reader of this notice is candidly asked whether the people should not be informed on medical matters — on the nature and appearance of disease, the properties and preparation of medicines, and the use and effects of those agents provided by the great Creator, in the vegetable and mineral kingdom? By means of such a work as this, prepared by an eminent prac- titioner of great scientific attainments, written plainly, any person of ordinary intelligence and common education, may become ac- quainted with the conditions necessary to health, and thus avoid disease ; since our author has not only given the plainest possible description of the inroads of all forms of disease, but has also given such apt hints and directions for maintaining health, in the vi publisher's notice. various parte of this work, as must prove an inestimable blessing to the possessor. It is but simple justice to the public, and all concerned in thif matter, to state that this work has passed through seventeen edi- tions — 100,000 copies having been printed and sold, mostly to families and physicians. The work has also been extensively used as a text book in medical colleges. Since the publication and sale above referred to, the author has had the opportunity of extended observations in the hospitals of our own country and those of Europe, and it is no small com- mendation of the work to observe that be has seen no cause to make a single change in, or addition to, the work. PREFACE. In preparing the following volume, the author had in view more especially the benefit of the people, and hence it appeared necessary to crowd in more subjects, and consequently to treat each more briefly, than would be desirable if the work were designed exclusively for the profession. The part on Practice contains a larger list of diseases than is generally found in works of the kind ; it has, therefore, been a constant object to avoid unnecessary details and useless comments, to make space for the more important matters, as the symptoms, diagnosis, prognosis, and special treatment of diseases. The sub- jects of fever and inflammation, as well as cholera, have been treated of at greater length than others, as the for- mer are more important, and the latter more interesting at the present time while the disease is so prevalent. The plan of treatment is always elementary and thor- ough. When convenience could be consulted with safety this was considered desirable, but where danger might be involved the treatment is most prompt and thorough. The Materia Medica is very judiciously arranged. All the articles are classified according to their Thera- peutic properties and value. The virtues of each plant may be known at once by the class it occupies, and its comparative value, in most cases, by its position in point of priority. The active principles of plants are generally pointed out and the method of preparation briefly noticed Most of the more important medical plants are so well illustrated that it is supposed there will be little diffi- culty in recognizing them. There has been much done to put the people in pos- session of a knowledge of the means of preserving their health, — many excellent treatises have been dedicated to them, and numerous journals and medical papers have been issued for their information, and it is grati- fying to see how much good there has been done — how much suffering has been avoided and expense saved. Still there are some in the profession who are opposed to the plan of committing a knowledge of medicine to the people. They seem to think that it will lower the character and dignity of our profession, and that con- sequently our usefulness will be measurably destroyed. But the results are far otherwise. Real and important knowledge has no such tendency — it elevates rather than lowers the confidence and respect of its possessor. It has been supposed too that mischiefs would result from an attempt on the part of the people to prescribe for themselves. But they ever have prescribed more or less for themselves, and it must be supposed that they ever will do so ; and it is difficult to see how a knowl- edge to do properly, what will be done at all events, will give rise to mischief. Novelty is the food of fancy, and so long as any matter, the existence of which is known, remains in mystery, the human mind will never cease to pry into it. Let the mind once fully grasp a thing and its novelty is gone. So far as responsibility and danger is concerned, the whole rests with the people at any rate. They form their own habits, whether they be conducive to health or otherwise— they select their own regimen, and when sick they take the responsibility upon themselves of determining upon what plan they will be treated, and accordingly send for a physician of their own choice Of his skill they judge for themselves — if they are sat- isfied the physician continues ; if dissatisfied they take the responsibility of discharging him. If the medicine suits them they take it ; if not, they refuse it. Thus the responsibility rests almost entirely upon them, and why should they not be informed upon this important subject? One thing is remarkable in reference to safe medica- tion, — that the people are in advance of the profession. They seem to be less heroic in the use of poisons than the latter, and when they prescribe for themselves they usually employ very simple and harmless agents, and hence occasion much less mischief than might be appre- hended. They have an opportunity also of observing the peculiarities of their own habits, susceptibilities and necessities ; and when informed on the subject of med- icine as much as they are on other subjects generally, they will in many instances prescribe more successfully for themselves than physicians who have less chance to know their cases. The author has thus attempted what he has considered a duty, and he must leave the consequences with the experiment. One thing, however, he must urge in extenuation of fault, if there be any here, — that he has labored much more in this way for the profession than he has for the people. INTRODUCTION. In presenting to the people a work contemplating the cure of all diseases by safe remedies, it may be proper to make some remarks upon the popular error that " all substances are more or less poisonous ! " A mis- apprehension of the proper definition or meaning of the term poison alone could originate an error so gross and yet so popular. Medical authors commonly designate a poison to be any substance which, when introduced in any way to the system, will prove hurtful, or tend to do injury. This is true, but is not sufficiently definite, and leaves the subject open for controversy. The true meaning of the term poison, is any substance, which, when introduced, in any way, to the system, has an intrinsic tendency to prove hurtful or to do injury. The adjective intrinsic ends the controversy, for with this definition the attendant circumstances are not in ques- tion. It is always important to give words their proper meaning. If the idea of a poison does not refer to a property intrinsically possessed by the agent, we have no use for it at all, for, properly speaking, there could then no poison exist. To illustrate this clearly, it is only necessary to advert to a few of the arguments of those who advo- cate the error that " all things are more or less poisonous.'''' . They say that poisons are only relative agents — the relation is to the circumstances and extent of their use. Thus it is contended that even our food, which is most innocent in proper quantities, becomes poisonous in excessive portions ; while on the other hand, the mos 12 INTRODUCTION. virulent poisons, when taken in sufficiently small quan- tities will be perfectly innocent. But the absurdity of making the definition of a poison contingent upon extrinsic circumstances is apparent when it is seen that these must, on this principle, con- stitute mechanical agencies poisons; thus circumstances will make an axe, a knife, or any other instrument mis- chievous and destructive of life ! Are then all these agents poisons ? If the circumstances or excessive use make food or medicines poisonous, then the same must make the simple mechanical agents so. Is it not plain here that the circumstances are the cause of the mischief, and not the instrument ? It does not, therefore, argue, that because the circumstances make food or medicines mischievous that they are poisonous ! But it is said again that our food certainly is poison- ous, because substances are prepared from it which evidently are so ; i. c., alcohol is made of grain, potatoes fruits &.c. Here is only another error; the alcchol does not exist in the grain, &c, as such — the latter only serve as materials to act on in generating the spirit, just as sugar is employed as a substance to act on in instituting the acetous fermentation to make vinegar ; the vinegar was not in the sugar, and the latter was only used as an agent capable of fermentation. The error which contemplates all poisons to be per- fectly innocent when taken in sufficiently small doses, is alike obvious. This supposes that to alter or dimin- ish the dose will really change the nature of the agent; e. g., if you take a grain of mercury and divide it into two portions of a half grain each, according to this doc- trine, then it is no more mercury, but is something else ! This, in effect, is what such reasoning will lead to. But, the reader will say again, three or four grains of arsenic are a fatal dose, while half a grain presents no INTRODUCTION. 13 other than a gentle tonic effect, and are we not therefore justified in the opinion that when the dose of any pois- onous agent is diminished to a certain extent its poison ous nature is destroyed ? The answer here is unequiv- ocally in the negative. There is a conservative power in the living animal body which tends to resist or remove hurtful agents or mischievous influences, and whenever the offending cause is not too violent, the vital power will subvert or overcome it, so that its effects are not discovered : yet we know in all reason that although we cannot trace the effects of small por- tions of poisons, yet the poisonous power is neverthe- less expended against the vital force; and it is just as reasonable to say that the sun does not shine after he sinks below our horizon, — since we cannot trace his direct effects, — as it is to say that a poison is not such when taken in quantities so small as that its effects are not appreciated by our external senses. A poison proper, — that is, a substance which is intrinsically poisonous, — is most assuredly mischievous in any quantity, although the extent of its effects is modified by the quantity taken, and may in small por- tions be so slight as not to be detected. But still we may be assured that although we may not have any present demonstrations of the effects of small doses of poisons, owing to the resistance of nature, yet as "con- tinued dropping wears a stone" so. will the constant, though sparing, use of some poisons ultimately ruin the constitution. Some may still be dissatisfied with this definition of a poison, and may urge that the latter are not all such intrinsically, but are dependent, in some instances at least, upon extrinsic circumstances: thus carbonic acid gas is perfectly innocent when taken into the Btomach, but when respired or taken into the lungs 14 INTRODUCTION. it is almost immediately fatal, and it is, moreover, sup- posed that even the poison of the rattlesnake is inno- cent in the stomach, while its fatal effects are well known when it is introduced into the circulation. The question may now be pressed, Do not the circum- stances here alone make these agents poisonous, as they appear to have no bad effects when taken in one way, and are so very fatal when applied in another ? It may, however, be answered here, that although the extrinsic circumstances may be indispensable to the development of the effects of the poison, yet they have nothing to do in forming their nature or inherent char- acter. The carbonic acid gas, and the animal poison spoken of, are of the same nature, whether they be in the stomach, lungs, or blood, and the only difference is, that in one case they have not the chance to prove their nature or show their poisonous effects, while in the other they have. It must, then, be admitted that any article which is perfectly innocent in its nature cannot be made poison- ous by an increase of quantity or excess of dose. Mis- chief may, indeed, be done by the improper use of any agent, but then this mischief is not the effect of a poison : it is the result of imprudence or error — it is in the conduct or verb, and not in the substantive. Another erroneous idea has been advanced, which it may be proper to notice here : it is contended by some that poisons act only in virtue of their power to over- stimulate, or stimulate in excess. This absurdity implies that all substances acting on the body are stimulants. It is true that the term stimulant is little more defined than that of poisons, and any one has the just right to employ the word to represent any effect which raises action of any kind in the body. But do all articles raise action ? Are there no substances which specific- INTRODUCTION. 15 ally depress action? What must be thought of the long list of sedatives which are so much employed by old school physicians ? Are they mock-remedies, intro- duced merely to deceive the profession, as well as the people? Prof. A. T. Thompson, of the University of London, says that " sedatives are substances which directly depress the energy of the nervous system, diminishing motion in animal bodies without inducing previous excitement ;"* " and this they effect by depressing the nervous power, and by diminishing the energy of the brain and that of the spinal marrow." Prof. Dunglison, of Jefferson Col- lege, Philadelphia, says, " sedatives are medicines which directly depress the vital forces." This is about the doctrine maintained by all the most popular authors of Europe and America. But it is only necessary to observe the effects of some of the most deadly sedatives, as Cyanogen in its combination with Hydrogen — Hy- drocyanic acid; Potassium — Cyanide of Potassium; and of Sulphur in its combinations with Hydrogen — Sulphuretted Hydrogen, Sulphuret of Ammonia ; and of Carbon when combined with Oxygen in the form of Carbonic Acid Gas ; or of some vegetable products, as Laurel, Bitter Almonds, the empyreumatic oil of To- bacco, &c. ; and there can be no doubt of a direct and deadly depressing power. A single drop of the anhydrous hydrocyanic acid will extinguish vitality in an instant. It is alika deadly to all animals from the worm to man, and is also little less destructive to vegetables. The author first quoted above says that it will " destroy the animal as instan- taneously as the most powerful shock of an electric battery, or the stroke of lightning ;" and by experiment- ing with the poison in a diluted state we find that this * Elements of Materia Medica and Therapeutics, London, 1835 16 INTRODUCTION. deadly power is absolutely of a sedative character When given in this way it prostrates the energy of the brain, spinal marrow and general nervous system, as is evinced in the sinking of the pulse, loss of sense and motion, and depression of the mental powers, stupor and general prostration that supervene. It seems also that the contractility and irritability of the muscular fibre is destroyed in like manner. DOMESTIC MEDICINE, OF FEVER. — ITS GENERAL PATHOLOGY. Whatever other objects of interest or importance may be found in the pathway of the medical inquirer, there is none in the province of pathology, that holds a higher claim to our careful, thorough, and candid inves- tigation, than the subject of fever; and this holds good, whether we consider the subject in reference to its own intrinsic importance, or the fact that it is comparatively so little understood. The history of all ages, proves it to have held the highest rank of all pathological questions. Hippocrates, Erasistratus, Asclepiades, Athenaeus, Galen, and Avi- cenna, among the ancients, and Van Helmont, Stahl, Hoffman, Boerhaave, Cullen, Brown ; and Broussais, among the moderns, have been the most prominent of the authors, who have founded their systems of medi- cine upon their views of fever. The ancient Romans, who supposed that diseases were sent by their deities, as rewards for their follies, were accustomed ever to enter the Temple of Fanum in fear and awe, when they directed their supplications against fever. Horace calls all the emanations from Pandora's box, simply fevers. . " If we except," says Van Swieten, " those who perish by a violent death, and such as are extinguished by mere old age, and which are indeed few, almost all the rest die either of fever, or of diseases accompanied with fever." But, however important and labored this subject has been, still the true essence of fever, or, to speak more' professionally, its etiology, has not been so satisfactorily certained, or so clearly demonstrated, as to meet the 2 18 DOMESTIC MEDICINE. views of all. On this head, our countryman, Professor J. Eberle, very deploringly remarks : " The history of practical medicine, consists of little else than a review of the doctrines which have successively risen and sunk again, concerning the nature and treatment of fever. * * * From a retrospective glance over the history of our science, we are forced to acknowledge that there is, perhaps, no subject which is more emi- nently calculated to humble the pride of human reason, than this one. In relation to this subject, pathology has been in a continued state of revolution and instability. The human mind has been engaged' with it for near three thousand years. Theories have risen and sunk again in a continued and rapid series of succession, each has had its hour to ' strut upon the stage,' and its votaries to yield it faith ; but the stream of time has hitherto overturned all these unsubstantial, though often highly wrought fabrics." Alas, the truth of these remarks are but too apparent! as will be perceived by a glance over the theories of the most prominent authors on medicine Thus the fate of genius in the past history, would now give but poor encouragement to enter upon the farther prosecution of this important, and seemingly, almost unfathomable subject, were it not that the hu- man mind is so constituted, that our interest in any subject increases in the same ratio that its intricacy deepens. But, it may be asked, has the mind made no real advancement in relation to the pathology of fever? Are our views now, no more correct and rational than were those of the ancients? and are we still destined to wander only in the dark mazes of speculation and hypothesis, on this important subject? Far from it; the human mind is continually verging toward truth, and few efforts are made on this subject, which do not contribute in some degree, to open th^ pathway to the great discovery : and however much error there may exist in any theory, there is generally some truth also ; and as the former is unprofitable, it i& generally rejected as soon as detected, while the latter is treasured up from one author to another, until our knowledge has now so advanced, that the honor of producing a perfect FEVER. ITS GENERAL PATHOLOGY. 19 theory on this subject, cannot be claimed by any one individual. What is fever ? Like many other things that are at once obvious to our senses, and concerning the presence of which almost any one can readily decide, fever does not admit of a strictly correct and unobjectionable defi- nition, as there is not a single one of its symptoms which is invariably present, and which can be consid- ered as absolutely essential to its existence.* But the modification of the symptoms is only circumstantial, and the following may be considered among the most common indicating its presence: a sense of chilliness, attended by thirst, and which is succeeded first by hot flushes, and then a diffused heat throughout the body; quick, hard, and throbbing pulse ; hurried respiration ; obstruction of the secretions and excretions ; headache, restlessness, soreness of the flesh, aching of the bones, husky dryness of the skin ; sickness at the stomach, loss of appetite, and furred tongue. The proximate cause of fever, as already hinted, has ever been an object of labored inquiry, and it would be gratifying if those labors had been equally well rewarded in the record of practical facts. In the early ages of medicine, the proximate cause of fever was supposed to be found in the humors of the body. These were supposed to be either altered in their consistence, or obstructed and deranged in their circula- tion. But then it remained to be shown how these de- rangements were produced. It is easy to say that obstruction is the cause of fever, but this is only beg- ging the question ; what is the cause of the obstruction? If the obstruction is referred to the remote causes, then the former must be of a definite or identical character. This point has been assumed, and it has been variously * Boerhaave collected together, from a great number of authors, all the symptoms which had been observed in fevers. He then struck from this list all those which do not appear in every form of fever, retaining such only, as, by the common admission of authors, and his own observations, were found to be present in all cases ; and the consequence was, that only three symptoms were remaining, namely: a quick and frequent pulse, preternatural heat of the sur- face of the body, and a sense of cold and chilliness in the com- mencement ; and it has been remarked that he might have gone further, and struck these also from his list. 20 DOMESTIC MEDICINE. claimed to be obstruction of the circulation and of the perspiration. But if this be the proximate cause, how are the most marked symptoms, as the excessive heat, the increased activity of the circulation, and the chills, produced ? The proximate cause must always account for the production of the symptoms, else it cannot be called the proximate cause. Again, it has been claimed, in more modern times, that fever is simply an excessive vital action, and with this view, the sedatives and debilitants have been em- ployed as its antidotes. But if the proximate cause is excessive vital action, then the remote causes must be excessive stimuli, or a redundancy of the inherent vital principle, which latter supposes an absurdity ; and if the former be the remote cause of lever, why is it that the fever is not discon- tinued on removing stimulating causes ? and how could we explain the result of fever from strictly sedative causes, as cold, exhaustion, and sedative drugs ? But these questions were not intended in this brief article, and the design of the work will by no means admit of a full disquisition of the many points of interest, that crowd upon us in the contemplation of this important subject. A few condensed remarks, comprising the author's own views of the pathology of fever, is all that can here be admitted. To detect any cause of disease, we should always refer to the physiological state, in order that we may appreciate justly the extent of the pathological state for disease, literally, is only a deviation from the stan dard of health. The physiological functions are dependent, in part, upon chemical and mechanical, as well as vital laws ; and as all laws are capable of infringement, these are all liable to be disturbed in the order of their institution. It must be assumed, however, that the vital law main- tains the supremacy, in the mutual influences of the several laws of our constitution. Then if it be further granted that the vital influence* is capable of modifica- * As the terms vital power, vital force, vital integrity, &c, are fre- quently employed, it may be proper to qualify the sense in which FEVER. ITS GENERAL PATHOLOGY. 21 tion in its manifestation, or in other words, that the integrity of the vital principle may be interrupted, or its energy diminished, it is easy to discover that other forces, which are in the order of our economy regulated by this principle, and which have a tendency to tran- scend the normal limits of their action, as they are less restrained, may evince their native tendencies according as the circumstances will admit. Thus the chemical laws which are subservient to the vital purposes, and are essential to digestion, calorifica- tion, metamorphosis, and most other vital functions, may nevertheless be a cause of mischief. The chemical action of oxygen upon the materials of the circulation, is the cause of the animal heat; but if the action of oxygen is not properly directed or sufficiently restrained by the vital power, as the circumstances may demand, this chemical action may become excessive, and thus a preternatural amount of heat will be produced; this heat is called fever heat. The avidity with which oxygen combines with carbon and hydrogen, two of the chief constituents of the blood, is very great. Under certain circumstances the ele- ments unite with a flame of fire, as is well knowm. When venous or dark blood, rendered so by the pres- ence of carbonic acid, is agitated with oxygen gas, it is changed into the vermilion-colored arterial blood, just as occurs in the process of common respiration. This is due to the absorption of oxygen by the blood, and they are used here, since there has been so much affected ridicule bestowed upon them. And first, it is here assumed that the em- ployment of the terms, cannot justly render any one liable to the charge of supposing a superior intelligence or divinity in the living organism, as has been asserted. That there are peculiar manifestations of a conservative power, no one can dispute, in the face of such an array of facts as crowd upon us ; the inherent reparative processes are positive and unmis- ta able, even if the conservative power be denied. It does not matter whether this be called a law of organized matter, physical instinct, or whether it be called the vital principle. Nor does it mat- ter, as to the fact of its existence, what its peculiar identity is, or what its existence may be more specially associated with. Whether it be the nervous power, electricity, or magnetism, it is not neces- sary here to decide. Nevertheless the conjecture may be ventured, that, in the superior animals, this power stands very nearly associated with the nervous system. 22 DOMESTIC MEDICINE. the escape of carbonic acid gas. The chemical combi nation of oxygen and carbon is always free and active, unless restrained by other forces ; and the influence of the oxygen afforded by respiration, will thus always be excessive when the integrity of the laws regulating it (the vital laws) is impaired, or in other words, when the vital power is deficient. The deficiency of vital resistance is, however, not necessarily of the positive kind, it may be comparative only, and this fact should be distinctly noted.* It has been objected to former theories on fever, that the proximate cause does not account for all the essen- tial phenomena involved. This objection, it is thought, is here obviated. The proximate cause being referred here to the chem- ical action of oxygen, the same as oar modern physiolo- gists do in accounting for the production of animal heat,f and the proposition that more combustion produces more heat being self-evident, it remains only to be shown such excessive oxydation may take place, in the order of the animal economy. In the first place, it may be observed that the vital economy is, to some extent, subject to all the physical influences with which we may be brought in contact, and but for the conservative power inherent to our living bodies, our physical organism would be the pas- sive sport of the play of governing affinities of matter, as is eminently proven by the decay of our dead bodies. Bat further, the vital protection is of a limited char- acter. Our bodies are by no means protected from certain degrees of mechanical or chemical violence ; we may be crushed to atoms, or be burnt to ashes. While ever the functions of respiration and circu- lation are sustained, there is a liability to excessive * In the common combined and comparatively neutral state of the chemical agents, as we find them in the atmosphere, water, &c, oxygen, being already combined, is less forcible in its action upon the system ; in order to its excessive action, therefore, a positive deficiency of the conservative force is necessary to the rise of fever ; but when the chemical force is free, the full vital resistance is insuf- ficient to prevent its influence. This must then be considered a« deficient vital resistance, in the comparative degree. f Hee Liebig's An. Chem., p. 17. FEVER. ITS GENERAL PATHOLOGY. 23 oxydation and consequent fever, as there are so many remote causes which affect or modify the conservative power. All sedatives, exhaustion, deficient or improper nourishment, poisons, as malaria or miasmata, &c, are examples of these. An interesting example of excessive oxydation, and of the invasion of fever without a positive deficiency of vital force, is found in the respiration of air more highly, charged with oxygen, or of pure oxygen itself; and here we have a full illustration of the proximate cause and symptoms of fever, according to the theory here given. When pure oxygen is respired, we soon discover the effects of a powerful excitant; the respiration, though at first natural, is soon increased and becomes exces- sively rapid, as in common synocha; the circulation is also quickened in a corresponding degree, until the pulse throbs with great violence; the general system is in a state of great excitement and heat, and manifests all the symptoms of common inflammatory fever. If the process is continued, the delirium gives place to a deep stupor, the vital power sinks, and death closes the scene. The thirst, dryness of the mouth and skin, and the obstruction of the general secretions, together with all the other symptoms common to fever, are mostclearly evinced in this case, proving beyond a doubt the part that oxygen takes in the production of fever. The varieties of fever and their various grades of violence, are always dependent upon the remote causes, and upon the idiosyncrasy and habits of the patients. Thu3 an exposure to ma? sh-miasmata, is likely to result in intermittents and remittents ; sudden exposures to cold and wet, are most likely to occasion inflammatory fever ; and fatigue, and other long-continued depressing causes, give rise to continued fevers ; while the specific remote causes or contagions, as those of scarletina, rubeola and variola, give rise to the fevers bearing their names. But still the proximate cause is the same in all, for the remote cause only opens the way for the former, and gives to it its distinctive character. That theory which explains the greatest number of facts with the fewest assumptions, must ever be pre- ferred ; in this, the present has the advantage. It has 24 DOMESTIC MEDICINE. already been stated that the preternatural oxydatioir explains all the symptoms common to fever. The premonitory symptoms of intermittents, remit- tents, and continued fevers, characterized by a sense of languor, listlessness, drowsiness, stupor, yawning, stretching, and depression of spirits, which are so gen- erally noticed by authors, could only be expected as legitimate consequences of a diminished state of the vital energies, brought on by the remote causes, as already stated. The chill which succeeds or accompanies the state of languor, is dependent upon a morbid sensation of the nervous system, common to a want of vital integrity, a3 is illustrated by the sedative effects of cold. Cold, as is well known, has no inherent power to produce a shake as in ague; for we find that in such parts of the body where the nervous circulation is obstructed by ligatures, the peculiar effect here referred to does not take place. Many different sedative agents are capable of produ- cing this sensation or effect upon the nerves. Thus the effects of the various passions, as joy, anger, grief, fear, &c, present the same phenomena, when the exciting power of the passion is over. Intense pain, likewise, is capable of modifying sensa- tion. Thus in the passage of biliary or urinary calculi, and the formation of pus, as well as in painful surgical operations, or even in toothache, we often find that the effect upon the nerves is the same, and the sense of chill, rigors, and even shakes, are produced. It is certain that the sense of chill and the shake of ague, is not, in this instance, occasioned by cold, as we find the heat of the body is about the same as in the natural state. Nor will heating the body remove the chill. The author has frequently seen patients shake most violently in the vapor bath of the highest endurable temperature.* The excessive oxydation which is con- sidered as the proximate cause of fever, and which we know, from the acknowledged laws of our constitution and the physical elements, must of necessity be liable to take place in this exposed condition of the system, is * The fact that tonics are better remedies for agues or chills than simple stimulaDts, goes far to establish the above position. FEVER. ITS GENERAL PATHOLOGY. 25 fully equal to the production of the hot stage of fever. The extra heat produced by the excessive chemical ac- tion of oxygen, excites an increased action of the heart and arteries, and by consequence, the respiration is quickened, and thus in turn an increased supply of oxy- gen is furnished, to raise more heat and fever. Irritation of the blood-vessels, and particularly of the arteries and capillaries, has ever been known to be attended by a corresponding sluggishness of glandular action ; and on this principle the dryness of the skin and mouth, and the general obstruction of the secretions, is easily accounted for. Oxygen acts as an irritant and excitant, and when present in the circulation in a proper proportion, it is sufficient only to maintain the normal action of the heart and arteries ; but when it is present in excessive quantity, it produces too much irritation, and thus arrests the action of the glandular organs. The periodicity of action in intermittents and remit- tents, is dependent upon peculiarities of the remote cause — the marsh -miasmata — which suppresses rather than destroys the vital action, and thus, upon the inter- mission of its force, the recuperative powers are mani- fested in producing the apyrexia. It is highly probable, moreover, that the vital power, or vis medicatrix natures, may do much in breaking up the paroxysm of fever; a rallying of the vital energies at the time when the remote febrific cause ceases, (in virtue of its own pecu- liar mode of action,) may modify or discontinue its violence, and must doubtless be sufficient to produce the intermission. The sweating stage of fever, is but the natural effect of the re-establishment of the functions of secretion. Perspiration is a secreted fluid, as is implied in the foregoing pages, and hence is dependent upon the laws of secretion. After the functions of the secretion in the skin have been obstructed for a while, and are then again restored to their normal, or perhaps, even an increased action, it is plain that so marked an evidence of their active state should be evinced, as we observe in the copious sweat that succeeds the hot stage of fever. It must moreover be supposed, that when the irritation of the blood-vessels is modified by the suspension of the remote cause of the fever, and the system becomes 26 DOMESTIC MEDICOVE. relaxed, such an effect as diaphoresis is favored by the momentum of the circulation, which continues for some time after the febrile excitement abates. The critical discharges attending fevers, are the obvi- ous results of the phenomena already explained. The precipitation in the urine, as an instance, is the effect of the chemical changes upon the substance of the tissues, by the oxygen,* and this process also occasions Jhe emaciation. Haemorrhages are produced by the arte- rial excitement. Diarrhoea is often incidental, but it may be accounted for as a critical discharge, on the same principle to which the increased activity of the cuticular emunctories is referred. Thus it is evident that the essence of fever is not in- compatible with the vital economy ; nay, it is certain that it is identical with some of the most important phenomena of animal life. The oxydation of the Mood, the metamorphosis of the tissues, &c, are indispensable to the physiological state. Fever is only mischievous, therefore, in the extent of its developments, and not in its essence. f From the foregoing considerations, the remedies for fevers are very obvious. They should be directed to the support of nature or the vital force, and should consist of relaxants, proper evacuants, and tonics, together with various mechanical or hygienic means, as cold effu- sions, hot vapors, &c, according as the circumstances or different stages of the fever may indicate. Those remedies which are exhibited on the principle that fever is an excess of vital action, should be avoided. Fever is excessive action, but not strictly excessive vital action — it is excessive chemical action. This subject is already extended beyond the limits designed for it in the present work, and the reader is therefore referred, for further illustration of this theory, to the extended treatise on fever by the author, in his larger work on the principles and practice of medicine, designed for the profession. For the various modifications and symptoms of fever, see the respective articles on the specific forms of fever, which immediately succeed. * It is equivalent to the ashes of common combustion. + See what is said, on this «*»"»ject, in the article on inflammation. INTERMITTENT FEVER. 27 INTERMITTENT FEVER. — (Febris Intermittens.) AGUE. FEVER AND AGUE. Intermittent fever, as the name denotes, occurs in the form of successive paroxysms. These come on at vari- ous regular intervals, the length of which mark the distinctions in the forms of the disease : thus, when a paroxysm occurs as frequent as once in twenty-four hours, the intermittent is called quotidian ; when it comes on every forty-eight hours, it is denominated tertian, which is the most common form of the disease ; when the return is suspended for seventy-two hours, it is called quartan. These are the most common forms in which the ague appears, but instances nevertheless occur, in which re- duplications of these take place, as double and triple tertians, &c. The former of these may, however, be mis- taken for quotidians, a paroxysm occurring every day, but varying in intensity, time of access, duration,&c, still every other paroxysm will be similar. The triple tertian is marked by the occurrence of two paroxysms every other day, and a single one on the intermediate day. Very rare instances occur of the appearance of regu- lar paroxysms at long intervals, as one or two weeks. Symptoms. — The incipient or forming stage of an intermittent paroxysm, is attended with symptoms which do not differ much from those of other forms of fever. There is generally a sense of lassitude, frequent yawning and stretching, and an uncomfortable sense of weariness of the entire body, attended with slight pains, and aching in the loins and extremities. Cold Stage* — Sooner or later, after the appearance of the foregoing symptoms, the patient begins to experi- ence slight and transient sensations of cold, along the back ; the nails and lips turn blue, and the skin pale. * Called so from the sensation, as from cold, which the subject experiences. 28 DOMESTIC MEDICINE. The chilly sensation now pervades the whole body ; the patient becomes restless and irritable in his feelings ; his ideas pass his mind unusually rapid, and being im- patient, he crumps himself down in a chair, or goes to bed, shivering and shaking with the sensation of cold. The shaking or rigors, in some instances become so se- vere as to resemble convulsions, and not unfrequently alarm those unacquainted with this distressing com- plaint. During the chills, the sensibility of the suiface becomes benumbed ; the skin is unusually pale, shrunken and rough, presenting to the touch those small prom- inences that have given rise to the name goose-skin. which are caused by the prominence of the bulbs of the hair owing to the departure or recession of the fluids from the skin. During the chills, as well as the follow- ing stage, the breathing is remarkably quick, and some- what laborious, vomiting also occurs in many instances ; the matter ejected is generally bilious and foul. The duration of this stage is variable, but usually lasts from fifteen minutes to one or two hours. The chills are not always as severe as above noticed, and it sometimes happens in some persons, that only a slight sense of coldness is felt. Small children seldom shake ; they, however, exhibit marked signs of chilliness. Hot Stage. — The cold stage is rapidly succeeded by the hot or feverish state, which is premonished by sick- ness at the stomach, thirst, and dryness of the tongue. As the sensation of cold subsides, the color of the skin changes, and becomes red ; the countenance is flushed, tongue dry, and thirst intense. The pulse, which in the cold stage is contracted and weak, now becomes full, hard and frequent. The fever runs high, and is attended with intense headache, generally in the fore- head. The temperature of the blood generally rises from two to four degrees Fahrenheit. The hot stage usually lasts considerably longer than the cold. Sweating Stage. — This stage, which is commonly re- garded as the effect of vital reaction, constitutes the last in the paroxysm. The perspiration appears first on the face and breast, but soon occurs on the entire body and is, in some instances, so considerable as to wet the INTERMITTENT FEVER. 29 clothes about the patient. The headache is now gone, and likewise the thirst; the pulse becomes softer and less frequent ; the breathing easy and free, and the heat subsides rapidly. The urine, if voided now, is free, and deposits a pale red sediment, but in the preceding stage is scanty, and has no sediment. The perspiration con- tinues until the patient is entirely free and comfortable, enjoying the condition of apyrexia, or convalescence. Cause. — Koino-miasmata, or poisonous effluvia, arising from marshes and stagnant waters containing decaying vegetables, is the general remote cause of intermittent fever ; nevertheless, instances of this disease have been said to occur from other causes, such as sudden suppres- sion of accustomed evacuations, &c. The time neces- sary for the development of the disease, after the expo- sure, is generally from one day to two weeks. Dr. Macculloch has stated that it never takes more than twenty-four hours from the exposure ; but he was most certainly mistaken in the matter. Agues generally occur in autumn, and are most prev- alent in warm and dry weather. The distance that this poison is carried by the atmosphere from the place whence it emanates, in quantities sufficient to bring on the disease, varies very much, as it is much governed by the direction of the wind, altitude of the ground, &c. But it is evidently, in some instances, carried several miles. Intermittents are seldom fatal in their termination ; but if badly managed, or suffered to run too long, they often bring on other diseases, such as dropsies, enlarge- ments of the spleen and liver, dyspepsia, &c, which are sometimes difficult to cure. If the two first stages, or either of them, become milder or shorter in their duration ; if the paroxysms come on at a later hour, or should miss occasionally altogether, and if the strength and appetite keep up good ; or when a scabby erup- tion about the mouth and nose breaks out, and the nat- ural discharges, suppressed by the ague, reappear, the signs are favorable. But if the duration of the cold and hot stages increases; and if the fever and headache should be very severe, especially if attended with delir- ium or coma ; if the abdomen should grow tense, the 30 DOMESTIC MEDICINE. tonsils swell up, or the urine become bloody ; or should the intermittent change into a severe remittent, or typhus, the signs are unfavorable. But the latter seldom occur, except in warm countries, and as the result of bad treatment. Treatment. — Tonics have proved to be the proper remedies for intermittent fever. But it must be observed, as the author has elsewhere stated, (see Therapeutics, page 401.) that all tonics are not efficient alike, in the cure of intermittents. Gentian, columba, and most other tonics in common use for simple debility, are far inferior to certain other articles of the same class of agents, as cinchona, cornus, euonymus, salix, &c. It must be observed, moreover, that all diseases ot periodic occurrence are very apt to relapse, after being arrested. Hence medicines employed for their cure must never be entirely discontinued, as soon as the symptoms disappear. The question has been mooted whether evacuants may be safely omitted, while intermittents are treated with tonics. But experience has now cleared this point beyond cavil with many. The importance of evacu- ants is always dependent upon the state of the secre- tions. If these are much deranged, they are necessary. When there is nausea and oppression at the stomach, attended with loss of appetite and headache during the intervals of the paroxysms, an emetic, consisting of equal parts of sanguinaria and lobelia, should precede the tonic remedies. The following formula gives one of the most simple and best compounds of the tonic class for agues : $r Quinine, I -^ , . Ext. Cornus Fior. (Alcoholic,) \ Mual parts * Let the extract be of proper consistence for pill- making, and make up the materials into pills of the usual size ; give two of these three times a day, until the paroxysms cease, then give the following : # Ext. Sanguinaria C. (Alcoholic,) ) -,-, , mmm . Ext. Euonymus. \ E( l ual P arts " Make into pills, and give one every morning and even- ing for three days. REMITTENT FEVER. 31 Should there be any signs of bilious derangement, a cathartic may now be given, composed of two parts of the alcoholic extract of apocynum A., and one of podo- phyllin, in the form of pills. The use of the quinine pills should always be resumed in from three to six days after their first employment, to prevent a relapse, which is so common in all intermit- tent diseases. Three or four doses of the pills at this 'time, are sufficient to insure the cure : whereas, if this precaution were not observed, it would frequently be necessary afterward, to renew the entire treatment. Convalescents from intermittent fever should avoid laborious exercise, as this is entirely incompatible with a sure recovery. In the treatment of this as in many other diseases, we often find some eccentricities to prevail; occasionally there will a case occur, which will not yield to the usu- ally successful remedies. Thus, after cinchona or all its preparations have failed, a single dose of the san- guinaria, eupatorium, podophyllum, aristolochia, aloes, or even black pepper, will prove successful. The fact should never be overlooked, that astringents very much promote the power of simple tonics, in the cure of intermittents as well as other diseases. REMITTENT FEVER.— (Febris Remittens.) BILIOUS FEVER. This form of periodical fever, is scarcely less common than the foregoing. It differs from it in being more vio- lent in its attack, as well as in having its first and last stages less distinct, and its middle or hot stage of much longer continuance, so that the intermission or apyrexia is very short, and in some cases scarcely observable. Symptoms. — In remittents we witness the usual pre- monitories of fever, a sense of languor or debility, and 32 DOMESTIC MEDICINE. relaxation, attended with lassitude and peevishnesss, or irritableness of temper. Generally there is a remark- ably increased sensitiveness to cold, and shortly before the febrile paroxysms set in, there is a distressing ten- derness of the skin, so that the slightest touch causes pain ; even combing the hair in a contrary direction, causes a feeling of soreness, as if the skin were blis tered. At times, transient chills, alternated with slight flashes of heat, are experienced at this stage. These symptoms continue, longer or shorter, until finally the fever is fully established. The sufferings of the patient are now much enhanced by intense pains in the head, eyes, back, and limbs, particularly in the bones of the legs. There is also an intolerable soreness of the flesh, lasting for many days. The secretions and excretions (except the bile,) are checked, and hence the skin is dry, and the mouth and eyes also lack moisture ; the urine is scanty, and the bowels costive. The bile is an im- pure alkaline product of combustion, corresponding to the ashes of common combustion in open fires, and is, in this fever, very abundant, being absorbed into the circulation and diffused throughout the entire system, staining the eyes and skin yellow. The tongue is cov- ered with a thick brownish-yellow fur, and the thirst intolerable. There is, sometimes, considerable disturb- ance of the stomach, attended with nausea, and vom- iting of bilious matter. A sense of fullness is also some- times felt in the region of the stomach and liver. These symptoms, accompanied with a high fever, run on for a longer or shorter period, when they moderate down somewhat, or give way entirely, for a short time, to a slight perspiration. This remission generally occurs in the morning, and lasts only an hour or two, when another paroxysm, perhaps much more severe, sets in, which again yields, like the former, and thus the parox- ysms continue to succeed one after another, until the disease ends in death, or is either overcome by the vital force, or removed by medicine, or perhaps yields to an intermittent, or typhus, according to the extent of vital resistance. It is to be remarked that the above description only applies to the milder forms of remittents, and that the malignant character is much worse than this, in every REMITTENT FEVER. 33 way. Remittents sometimes seem to prevail as epi- demics. Marsh-miasma is considered the general remote cause of remittent as well as intermittent fever. Thus it is mostly confined to low grounds or marshy districts, and places bordering on sluggish streams. The disease is more common in southern latitudes, and occurs mostly in Autumn. Remittent is distinguished from intermittent fever, by the longer duration of its paroxysms, and from all the varieties of continued fever by the remissions of this. Among the favorable symptoms of remittent fever, may be considered : the protraction of the remissions, free perspiration, the free discharge of urine depositing a red or brownish sediment, and every sign of its change into an intermittent, the most prominent of which are, a comparative mildness of the symptoms every second day. But should the strength of the patient fail rapidly, and the remissions grow shorter and less marked, and should the pulse sink and the patient incline to stupor or delirium, danger may justly be apprehended. Treatment. — If we commence our treatment in the heat of a paroxysm, and the pulse is hard, full and quick, the first thing to be done for the comfort of the patient is to cool the surface, either by a cold shower bath, wet sheets, or sponging, as the strength of the patient, or other circumstances, may indicate. The effect of this will be admirable ; if the patient be delir- ious this will compose him; and if restless and nervous, it will quiet him. The paroxysm is usually broken up by this means, and a free perspiration and refreshing- sleep will often ensue. The bathing should be con- tinued until the desired effect is produced. After the bath, the surface must be dried by a soft towel, and then rubbed briskly with coarse linen, or the flesh brush may be employed in its stead. An emetic composed of equal parts of lobelia and sanguinaria may now be given, and its operation promoted by liberal draughts of boneset tea. If, after the operation of the emetic, the pulse be soft and, in the adult age, not over seventy-five or eighty to 3 34 DOMESTIC MEDICINE. the minute, and the skin is moist, it may only be neces* sary to follow up by the use of some sudorific or dia- phoretic drink, as the infusion of boneset, or the acetate of ammonia. On the following day, a cathartic should be given : R Podophillin, ) v , Ext. Eupatorium Per.} E( * ual P arts - Form into pills, and give two, three hours apart. Should the fever set in again at any time after the cathartic has done its duty, the patient should be envel- oped with a wet sheet, either cold or hot, according to the temperament of the patient — the sanguine and bilious temperaments requiring cold, while the nervous and lymphatic may indicate warm water for the pur- pose. The patient after being enveloped by the wet sheet, must be placed in bed and covered well with warm clothes, so as to promote perspiration. The latter may be favored also by means of sudorific drinks, or even by copious draughts of cold water. If there be difficulty in procuring diaphoresis, a tea spoonful of the acetate of ammonia may be given once an hour, until the effect is produced, when it may be given in smaller and less frequent doses. Conjoined with, or in lieu of this, under doses of lobelia and the extract of eupatorium perfoliatum may be employed. In difficult cases the emetic must be repeated, and the interium well supplied with relaxants and dia- phoretics. The bowels must be kept free by the use of the eupatorium extract As soon as an intermission is produced, and in cases where there is no delirium or tendency to congestion to the head, the best anti-intermittent tonics, as quinine, or the pills in the first formula recommended for intermit- tent fever, should be used in proper doses, say three to five grains three times per day. When there is much headache or delirium, a mustard plaster applied to the ankles and nape of the neck, will be serviceable. The pain in the extremities which often becomes intolerable, may be relieved by the following : CONTINUED FEVER. 35 ]jfc Tincture of Lobelia, 4 oz., Oil Cajeput, ^ " Oil Sassafras, ^ " Shake well, and apply with the hand. Some practitioners are in the habit of treating this fever by the free use of nauseants, composed principally of lobelia; others depend upon the vapor bath, in con- junction with emetics ; while some again contend, that no treatment is so good as the tonic or quinine treat- ment, from the commencement. These several plans have their preference, only according as the circum- stances or indications of the case may be. The tonics must never be discontinued, until the patient is well advanced in convalescence. CONTINUED FEVER. — (Febris Continua ; Synochus.) SIMPLE CONTINUED FEVER. The term continued fever, is only relative, as it is an occurrence remarkably rare, if indeed it ever happens, that a fever runs its entire course, without an intermis- sion of seme character. The name is therefore only given to distinguish those fevers which have no well marked intermissions or remissions, from those already described, which have such marked intervals of relief. To this class belong synocha or simple inflammatory fever, synochus, typhus, typhoid, and the plague. But it is thought best to treat all these separately, for there is no one of them that does not possess such peculiarities as are well calculated to distinguish them. It is therefore designed to treat synochus alone, under this head, as it best answers to the name ; it likewise being that form of fever most generally known through the country, as simple continued fever. This grade of fever, is that most generally met in common practice ; it occurs in all seasons, climates and places, and among all classes of people. 36 DGMESTIC MEDICINE. Symptoms. — This, like some other forms of fever, admits of such a variety of modifications, that, it is diffi- cult to give such a history of the symptoms, as will enable those unacquainted with it, readily to recognize it in all its modifications. The affection is sometimes so slight, that medicine does not become necessary ; and again, it occurs in a form so violent, that it admits of cure with difficulty. Before the fever rises, the patient generally complains of considerable debility; corpoial and mental languor, which is succeeded by chills, that are soon attended alternately with flashes of heat, that continue until finally the fever sets in. In more aggra- vated cases, the fever is ushered in by a distinct cold stage, characterized by great lassitude, restlessness, a feeling of tension and confusion in the brain, oppressed and anxious breathing, feebleness and quickness of pulse, a clammy tongue, disgust for food, flatulency, frequent nausea, retching and vomiting. The fever now sets in; the pulse becomes full and frequent, about 112 to tlie minute ; the face flushed, and the carotid and temporal arteries are observed to throb considerably. The patient suffers much from headache and thirst, and becomes very restless and peevish. The tongue is at first white, but soon becomes covered by a darkish- brown fur; the skin is hot and dry, the urine is gener- ally high-colored and without sediment, the bowels are torpid, and the discharges assume a clay-colored appear- ance. Intolerance of light and sound is also complained of, even from the beginning, and now the patient is often delirious through the night, but is generally easier in the morning, when sometimes a little sleep is obtained. These symptoms generally continue from six to ten days, with little variation, only that sometimes a short interval of ease is enjoyed in the morning. About this time a change may be looked for ; the disease from this usually declines, or the patient either dies, or sinks into a low state from which recovery is doubtful. Cause. — This fever is generally brought on by expo- sure to cold, and fatigue from hard labor, or other exer- cise. Any cause, in short, that is calculated to diminish suddenly the vital force, may bring on continued fever Sudden changes of the weather from hot to cold, the CONTINUED FEVER. 37 wearing of damp or wet clothes, cooling suddenly when in a perspiration, drinking copiously of cold water while the body is heated by exercise, intemperance, ex- cessive venery, and violent passions, are all capable of bringing on the disease, but cold is by far the most fruitful cause. By careful attention to the description of the symp- toms, simple continued fever may generally be distin- guished from all others ; but as already hinted, the modifications of this grade of fever are quite various, and therefore, some difficulty in the diagnosis may some- times be experienced. But happily the treatment of this, and those other forms of fever with which it is most likely to be confounded, varies but little. Ordinary fevers of this kind, are not generally dan- gerous, but the more difficult cases need care. If the strength of the patient keeps up well, and the skin, instead of remaining dry and husky, should occa- sionally break into a moisture, and should the tongue clean off from the centre, and the taste and appetite improve, the signs are good. But should the patient sink rapidly, his breathing become hurried, the pupils of his eyes dilate, the pulse become small and sharp ; and should the delirium increase, and subsultus set in, and the patient become imbecile, restless, dissatisfied of his state, and be con- stantly insisting to he removed, u to go home" as he expresses it; and especially should the evacuations become involuntary and the senses dull, much danger may justly be apprehended. Treatment. — Tn mild cases of continued fever a good sweat, with herb teas, may be sufficient. But in more severe cases, when the fever is high and there is much pain in the head, and delirium, the patient should be treated with cold affusion or wet cloths, as recom- mended for remittent fever. The cold applications must first be made to the forehead, and, as soon as the head ]s cooled, to the entire body. The cloths must be renewed as often as they become dry, until the pulse softens and a perspiration sets in, when they may be removed, and the surface dried and rubbed by means of coarse towels. While the wet cloths are applied, the 38 DOMESTIC MEDICINE. patient should take some diaphoretics, or sudorifics, to promote diaphoresis. If the means here proposed do not produce diapho- resis, an emetic of lobelia, aided by an infusion of pennyroyal or some other diaphoretic drinks, must be given. After the emetic has done its duty, and the stomach is composed, some suitable food — as corn gruel, por- ridge, or panada — may be taken and, in an hour afterward, two pills, composed of equal parts of podo- phyllin, extract sanguinaria and capsicum, should be given. If these do not operate in six hours, give another of the same. If the first emetic does not cleanse the stomach well, which may be known by the continued oppression and sense of uneasiness in this organ, as well as by the tainted or foul breath, dull headache, slimy appearance of the tongue and bad taste, another emetic, composed of lobelia and extract of bayberry, ten grains of each, must be given the following day. This precaution is the more necessary, as there is a great tendency in this fever to derangement of this organ, and while the stomach is in a bad state, it is almost impossible to effect an improvement in the symptoms. In order to keep up a perspiration, the emetic should be followed up with the free use of the sudorific powders, or thoroughw^ort extract. The body and limbs should be well bathed with the rubefacient solu- tion, or what is better, the bathing drops ; and the bowels should be kept open, with the use of enemas, composed of an infusion of thoroughwort, adding man- drake root, and tincture of myrrh, a tea spoonful of each, to every injection. The main object in the cure of all fevers, is to keep the stomach and bowels in good order, and the skin moist ; and if this is done, all will be safe. As soon as the skin is well relaxed, and the excretions well restored, the use of tonics may be commenced, and perhaps the tonic powder, in tea spoonful doses, three times a day, will be as good as any other. It should be remarked, that if there is any subsultus tendinum or muscular twitching, the nervine tonic must be used. If the skin is not too much bound or con- INFLAMMATORY FEVER. 39 tracted, the diaphoretic powders may be employed alternately with the sudorific powders. If at any time through the treatment, it should become difficult to keep the surface moist, the vapor bath must be used, and the emetic repeated, if neces- sary. The diet should be spare and well regulated. INFLAMMATORY FEVER. —(Synocha.) This variety of fever, in contradistinction to others, is denominated inflammatory, as it is characterized by the highest grade of febrile excitement. It rises sud- denly, with great irritation and vascular action, and furnishes the best example for the illustration of the theory of fever given in this work. Symptoms. — The fever sometimes rises suddenly, without the usual premonitories that precede other fevers ; but generally there is a sense of chilliness, attended with lassitude, and some signs of debility. The premonitory stage is always short, and followed by a diffused heat of the body and headache, often attended with delirium. The pulse is full and vigorous, and about one hundred and twelve to the minute. The face becomes flushed and turgid ; the eyes suffused, sparkling, and unusually sensitive to the light; the temples and carotids throb ; the breathing is hurried but laborious ; the mouth and throat very dry, and the thirst for cold water intolerable. The skin is very hot, dry, harsh, and suffused with a blush. The tongue is covered with a white fur in the centre, and presents a red margin. Sometimes there is a humming noise in the ears, and there is always a sensitiveness to harsh sounds and noise. The bowels are torpid, and the urine scanty and high-colored. Inflammatory fever, though strictly of a continued character, is nevertheless characterized by occasional 40 DOMESTIC MEDICINE. modifications of its symptoms. The patient generally feels better in the morning, and worse in the evening and fore part of the night. Inflammatory fever is usually of short continuance, when compared to others, seldom running over nine days, and often only five or six, when it terminates under some critical evacuations, as perspiration, or the free discharge of urine with a lateritious sediment. Persons of a sanguine temperament are most liable to this fever; and those with a rugged constitution, when attacked, suffer most with it, as with these the fever generally runs higher, and the tendency to deli- rium is greater. Causes. — Atmospheric vicissitudes, high solar heat, ardent spirits, hard labor, especially when performed in hot weather, copious draughts of cold water when the body is heated by exercise, violent passions, mechanical injuries, etc., are among the most fruitful causes of inflammatory fever. But cold stands pre-eminent in the list of causes, and hence it is that during the winter season, or more especially in the changeable months of spring and autumn, the disease is so apt to occur. Treatment. — Cold water is one of the most important means in the treatment of this fever. In mild cases, it may be sufficient to apply cloths wet with cold or ice-water to the forehead and temples, and renewing them as they become warm : and wetting the hair and sponging the body with cold soft water. In more severe cases, however, the entire body should be enveloped in cold wet sheets, which must be renewed as often as they get warm, until the heat is abated and the pulse is moderated. During this part of the process the covering should be light, but as soon as the fever subsides more clothes must be put on, so as to promote perspiration. After the patient has lain one or two hours in a perspiration, the wet clothes may be removed and the body rubbed with dry towels, and then sup- plied with other clothes. Cold water may be freely drank by the patient throughout the treatment, but especially during the foregoing part. Diaphoretic herb teas may be taken, likewise, with good effect. INFLAMMATORY FEVER. 41 It is important that the head should be kept cool by wetting the hair, and placing cold wet cloths upon the forehead and temples, and renewing them frequently; as when this precaution is not observed, daring the application of the wet sheets to the other parts of the body, congestions to the head may take place when the fever is high. The author has, in many instances, succeeded in breaking up violent attacks of this fever in children by means of a single shower bath, continued until a com- plete chill is produced, and then, after wiping dry, placing the little patient in a warm bed, to sweat for an hour or two, when he would be well, and get up without any return of fever. When the foregoing treatment proves insufficient, it will become necessary to exhibit an emetic of lobelia, after the cold applications are discontinued, and while the means for exciting perspiration are instituted; and if a single emetic, followed by diaphoretics or sudo- rifics, does not accomplish a satisfactory effect, some active cathartic pills may be taken, and their operation promoted by drinking freely of an infusion of thorough wort or sweet alder bark. Blood-letting, which is generally practiced by physi- cians on the old plan, is unnecessary, as the purpose for which this means is employed is much better effected by the use of lobelia in under doses, This article will soften down the pulse, and obviate congestion with remarkable promptitude. Cold affusions, emetics, nauseants, diaphoretics, and cathartics, are our chief agents in the treatment of inflammatory fever, and if promptly used will almost always be successful. Astringents and active stimulants, as capsicum, are improper remedies in this form of fever, especially when the skin is dry and the fever high. The com- mon diaphoretic or composition powders, therefore, should not be indiscriminately used, as is the practice with some. Sinapisms, applied to the extremities and nape of the neck, will be serviceable in relieving the head, when there is much pain or delirium. It is not necessary that they should remain long enough to cause blistering. 42 DOMESTIC MEDICINE. Tonics may be necessary when the fever has cor tinued long and the patient is debilitated. The time for their employment is after the fever is broken up. They will promote the appetite and improve the strength of the patient. The food should be light and easy of digestion. TYPHUS FEVER. — (Febris Typhoides.) It is difficult to define typhus fever in the present unsettled state of its pathology. By some, all low fevers are called typhus ; others define typhus so as to comprise all low fevers which are accompanied by stupor and delirium ; while many regard it to be a specific, well defined, contagious disease. Typhus fever, as now recognized by the most popular authors, is a distinct idiopathic disease, commencing like synochus, and then passing into a low state, which is characterized by a torpid condition of the sensorial powers, with delirium, and great prostration of strength. Symptoms — {Premonitory Stage.) — " A peculiar uneasy sensation in the pit of the'stomach; want of appetite; slight giddiness and nausea; pale, shrunk, and dejected countenance; dull and heavy eyes; often tremor of the hands ; and a general feeling of weariness, debility, and disinclination to mental and corporal action. These premonitory symptoms usually continue from three to six days, terminating in these which mark the stage of invasion, — viz: slight chills, alternating with flushes of heat; an entire disgust for every kind of food; tongue covered with a thick, whitish fur; considerable nausea, and sometimes vomiting ; a quick, small, and irregular pulse; a confused and heavy sensation in the head, and increased mental and physical depression. This stage generally occupies from six to twelve hours, and termi- nates in the stage of excitement. The febrile heat now increases considerably; the face is slightly flushed; the TYPHUS FEVER. 43 pulse rises in strength and fullness; the skin becomes dry, and the lips parehed ; there is a considerable thirst for cool drinks; the tongue becomes more furred and slimy; the bowels are usually torpid; the mind is more confused, the patient fretful, restless and watchful, with an anxious expression of the countenance ; the urine is small in quantity, and reddish; the head feels heavy, much confused, and vertiginous; during the first two days of this stage, occasional manifestations of slight delirium occur during the night. About the end of the second or during the third day of this stage, slight catarrhal symptoms usually supervene, such as suffused and injected eyes, moderately inflamed fauces, some- what painful deglutition, more or less oppression in the chest attended generally with a short, dry cough. There is often some tension and tenderness in the hypo- chondrium, especially the right one. " Pains in the back, loins, and extremities, are rarely absent in this stage, and in most cases a general sore- ness is experienced throughout the whole body. To- ward the close of the third day of the stage of excite- ment, there is usualty much giddiness and sensorial obtuseness [dullness] present ; the patient appearing, even at this early period of the disease, as if under the influence of some narcotic. The cerebral functions now become more and more disturbed, hearing becomes obtuse, delirium more frequent and considerable, and the general torpor gradually increases. Hildebrand asserts that a peculiar milliary exanthema [eruption] occurs on the surface about the fourth day of this stage, which he considers essential to the perfect and regular development of the disease. The same observation is made by Hartman. One of the most striking charac- teristic phenomena in typhus, is the almost insurmount- able aversion to corporeal and intellectual exertion manifested throughout nearly the whole course of the disease The patient moves slowly, and seemingly with great reluctance, and his answers to questions are hesitating, short and peevish. The stage of excitement generally continues about six or seven days, before it terminates in the stage of co'lapse, though this sinking stage sometimes supervenes at a much earlier period and occasionally comes on a few days later." — (Eberle.\ 44 DOMESTIC MEDICINE. The patient now becomes very feeble and prostrated, The tongue is thickly covered with a brown and, finally, black coat ; the teeth incrusted with black sordes : there is, generally, much subsultus tendinum or twitching of the muscles. There is, also, a very peculiar biting heat of the skin, and sometimes the latter turns purple or black in spots. The discharges from the bowels, which often become thin and watery, are exceedingly offen- sive; and as the disease advances, the patient becomes indifferent to all surrounding objects; will not often even notice his most intimate friends whom he may not have seen for a long time; when spoken to, his answers are short and unintelligent, and are generally ended with a low, muttering delirium. The voice becomes peculiarly strange and sepulchral. As the patient gets lower, the coma or stupor becomes more constant and complete, and it is now with difficulty that the patient is aroused at all; and even when he is made to speak, it will only be a word or two, w r hen he will again fall back into a deep state of stupor. The easiest time the patient has, is, generally, in the morning. Before dis- solution, the poor sufferer usually experiences a respite, lasting longer or shorter, but generally several hours, in which he possesses his senses and mental faculties nearly as well as in health. This is certainly a great blessing; the dying man may know his danger, and his friends and relatives may enjoy the great satisfaction of conversing with a friend whom they shall shortly see no more on earth. This relief is well calculated to deceive many, who are flattered thereby to expect a speedy recovery, whereas it is only the precursor of death. After this respite, the patient again sinks rapidly into the former condition, and continues growing worse until he dies. Cause. — The cause of typhus fever is by some referred entirely to a specific contagion, and it is obvious that under some circumstances it may be communicated in this way. in densely populated cities, where the air must of necessity be more or less contaminated with putrid effluvia arising from the decomposition of animal matter; and in camps, hospitals, jails, and in the mise- rable hovels of some of the poor where due cleanliness TYPHUS FEVER. 45 is not observed, this disease is always found to be much more prevalent. It is stated, that during the campaigns of the French against Russia, the typhus contagion, which was generated in the hospitals and houses crowded with prisoners and the sick, was communicated to the inhabitants along the road by which the soldiers returned; and that the disease from this, afterward, spread gradually into the adjacent districts, until it became very common. The route of the army, return- ing from Poland through Germany, could be readily traced by the desolating train of the disease that fol- lowed. The difference between the malaria that generate typhus and remittent or intermittent fevers, is, that the latter arises from the decomposition of vegetables, while the former is caused by the decomposition of animal matter. But whatever the character of the contagion may be, it is certain that unless there be a want of vital resistance, which thus subjects the system to its influ- ence, those exposed to the contagion will pass with impunity. Every cause of debility, such as blood- letting, the use of poisonous minerals, drastic purges, cold, fatigue, &c, must be carefully avoided. The prevalence of the disease is much enhanced by a cer- tain train of circumstances that are generally to be witnessed in all families which this disease has invaded. Such is the dread entertained for it, that as soon as a member of a family is taken down with it, all hearts fail, despondency impairs the conservative power, the appe- tite declines, sleep flees away, and a permanent debility sets in. This state of things illy qualifies persons to go through the hardships and fatigues brought upon the friends of the sick, by their solicitude and anxiety. If now the chamber or sick room is neglected, and not sufficiently ventilated and cleansed, those thus exposed are almost certain to contract the affection. But all this need not happen, if proper precaution be observed and it is remembered that collateral circumstances alone make this disease contagious. Abatement of the heat and thirst, moisture of the surface, and cleansing of the tongue, but especially the subsidence of the delirium and stupor, may be regarded as favorable symptoms. 46 DOMESTIC MEDICINE. The unfavorable symptoms are, — Violent delirium, unusually small intermitting and fluttering pulse, loss of vision, difficulty of deglutition or swallowing, invol- untary stools and urine, distortion of the muscles of the face, unusual staring, and change of the countenance, &c. Treatment. — In the very onset, the patient should be carried through a course of the vapor bath and lobelia emetic, which is to be followed with a dose of the anti- bilious pills; during the operation of the emetic, as well as the pills, the strength of the patient should be sus- tained by nourishing broths or porridge. The baths and emetics must be repeated, if the symptoms do not yield to the other means that may be employed. From the commencement, capsicum should be freely and perse- veringly employed, both internally and externally; and the compound tincture of myrrh should be occasionally used. Enemas, composed of an infusion of the astrin- gent tonic and as much compound tincture of myrrh as the patient can bear, should be administered three or four times in the course of twenty-four hours. But should the bowels not be kept open by these means, this end must be accomplished by an occasional dose of rhubarb; for if the bowels are not protected from mor- bid accumulation, the delirium and danger will always be greater. But the precaution not to use any unne- cessary physic or any other means calculated to reduce the strength of the patient rapidly, is very important. The nervine tonic should be freely used to calm the ner- vous system. Common pepper sauce is a very good article to be used in typhus fever; and when there are strong symp- toms of putridity, charcoal, properly prepared, should be freely given; for this purpose, yeast is also highly recommended by some. Frictions and Rubefacients. — There is no disease in which these means are more important, than in typhus fever. The surface should be frequently washed off by the use of the rubefacient wash, and afterward well bathed with bathing drops; but should they not prove sufficiently active, the rubefacient oil must be used. TYPHOID FEVER. 47 Ventilation. — Great care should be taken to keep the patient's room well ventilated, and a vessel containing some chlorinated lime should be kept in the room. Tonics. — The use of active tonics, in this complaint, is very important. Quinine, dogwood, columba, or any other good tonic, should be early used. The diet, also, must be nourishing and well regulated. TYPHOID FEVER. — (Dothinenteria.) This affection, as already noticed, has generally been confounded with typhus fever, and the English physi- cians are still reluctant about admitting typhoid fever as worthy of consideration, separate from typhus. But in our country and France, it is pretty generally recog- nized as a different affection. The disease, anatomi- cally considered, seems more particularly to implicate the bowels and brain. Post mortem examinations have discovered extensive affections of the mucous membrane of the lower part of the small, and upper part of the large intestines, and particularly the glands of Peyer, and sometimes those of Brunner, (so named after their discoverers.) Opposite those patches, the glands of the mesentery are in a diseased and en- larged state. The spleen, moreover, in nearly all cases, is softened and enlarged ; in some cases, it is found four or five times its natural size. Symptoms. — The symptoms of typhoid fever are, most of them, nearly the same as typhus. Those of the first four or five days, need not here be repeated, as they can seldom, in the main, be distinguished from those attending typhus in the corresponding stage. About this time, or perhaps sooner, a diarrhoea sets in, which is an almost constant attendant, and about the sixth day a peculiar eruption breaks out over the breast and abdomen, called rose patches. The bowels bloat 48 DOMESTIC MEDICINE. considerably, and the abdomen becomes tense, and the spleen often swells so as to be distinctly felt externally under the edge of the ribs. Like typhus, this fever is characterized by great stupor, and generally, more or less delirium. The tongue is usually much coated, dry, and glossy along the edges, often cracked and bleeding ; the countenance is red or purplish, and suffused ; the expression sunken, vacant, or wild, and spasms of the lips and muscles of the jaws, are not unfrequent. The pulse, which at first is not generally much accelerated, in the more advanced stage grows more frequent and tense. Bleeding at the nose, and from the bowels, is not unfre- quently an attendant. Typhoid fever is not generally considered contagious. Cause. — Among the various agents that give rise to this affection, might be named all those that produce typhus, excepting the contagion. It would seem that in connection with the common febrific agencies of this affection, there is found a collateral or concurrent one, that determines the morbid influence to the bowels and inferior glands. Now the cause of typhoid fever is well illustrated, if a profile of the common causes of con- tinued fevers, and those of dysenteries, are viewed to- gether ; and as typhoid affections are generally the most prevalent in the same season in which dysenteries are most common, this view of the matter is entitled to much credit. Typhoid fever may be distinguished from typhus, by the diarrhoea, headache, bloated condition of the bowels, rose spots, and the enlargement of the spleen, common to this. The crisis of this disease seldom forms in less than three, and sometimes not under five weeks. Among the favorable signs may be reckoned, the sub- sidence of the stupor and headache, return of memory, free perspiration, copious discharge of urine, and nat- ural appearance of the stools. But it is always discouraging to see the delirium and headache continue, the pulse frequent and low, purple cheeks, involuntary discharges in bed, retention of urine, irregular breathing, rigidity of the muscles, convulsive movements, cold extremities with the nails turning to a TYPHOID FEVER. 49 purplish-black, loss of vision and hearing, and distortions of the countenance. Treatment. — In this disease, the first object to be accomplished, is to get up an action in the surface ; this may be done in the following way : apply the vapor bath until the patient perspires freely, then wipe off and apply the rubefacient oil or bathing drops, after this a good dose of the neutralizing mixture should be given, and followed up with additional doses, every hour or two, until the bowels are well cleansed. This will carry off an astonishing amount of filth from the bowels. If the patient is not relieved by this, he must have another course of the vapor, and as soon as through with this, he should have a dose of lobelia, to be repeated every ten or fifteen minutes, until copious vomiting is pro- duced, which must be followed up with the free use of the sudorific, diaphoretic, or Thomson's composition powders. The use of the syringe must not be neglected in this affection, as the bowels need the application of the infusion of astringent tonics, with a little of Thom- son's No. 6, in it. The bowels should be kept open with the use of the neutralizing mixture, administered every other day, in doses large enough to move them. Howard's cholera syrup is excellent in this disease, and may be freely used when the bowels are cleansed. To insure success in the treatment, the skin must be Kept moist constantly, by the use of diaphoretics and liniments, or other appropriate means. The ner- vine tonic, should there be much nervous irritation, must be used in proper doses several times a day, to calm the nervous system, and the use of the bitter tonics must be early instituted. Fomentations applied externally, are sometimes of signal benefit to the bowels. Diet. — The diet should be light and nourishing, but must always be used in moderate quantities. Over- eating in this disease, is always attended by serious consequences. Slippery elm water affords a very good drink. 50 DOMESTIC MEDICINE. YELLOW FEVER. — (Febris Icterodes.) This is a disease common to warm climates, raging more in the tropics than elsewhere, especially in the West Indies. But in warm seasons it has been known to visit with violence, places as far north as Boston, Massachusetts. Medical men are much divided in rela- tion to the cause and character of this form of fever. Some consider it a species of the indigenous remittent fever of this country, and that it is brought on by the same general cause ; while others consider it a distinct disease, which is propagated by a specific contagion, that originated in the East Indies, and from thence con- veyed to the West Indies, and thence to the continent of North America. Sauvages says, that it was imported into Martinique in the year 1686, from Siam, by a ship called Oriflame. It first appeared in this country in the autumn of 1699,* in Philadelphia, and it is stated that it appeared the same season in Charleston, South Caro- lina. In 1702 it occurred in New York, and in 1703 it re- appeared in Charleston, and it appears from Dr. Lining, that it also prevailed in this city, in the years 1732, 1739, 1745, and 1748 ; and from Dr. Harris, it would seem that it was again known there in 1792, but per- haps he means 1794. It is certain, however, that it had appeared there also in 1761. It reappeared in Phila- delphia in the year 1741, and prevailed also in 1747 and 1762. It also reappeared in New York in 1748, after which it was not known again in this country until the year 1793, when it prevailed again in Philadelphia with dreadful mortality, and the following year Charleston was again visited. New York suffered from it again, the year after it occurred this time at Charleston, since which time it has been of very frequent occurrence in those, as well as many other places on the sea-coast, from Maine to Louisiana, and indeed, not only on the * It appears, however, from Hutchinson's History of New England, that a lever similar in character, was imported into Boston, from Martinique, by the fleet of Sir Francis Wheeler, in the year 1693. YELLOW FEVER. 51 sea-coast, but far in the interior of some of the South- ern states. Symptoms. — Yellow fever usually commences sud- denly, with a sense of giddiness and headache, accom- panied by chills, shivering, and pain in the limbs and back. This is succeeded, generally, in from a few to twelve hours, by the fever, which is marked by a flushed countenance, red eyes, extreme headache, great thirst, and throbbing of the arteries. The tongue, though sometimes clean, is generally a little coated with white; there is usually a want of appetite* and a sensation of weight and oppression, and not unfrequently, pain at the stomach ; and in the course of twelve to twenty- four hours after the fever sets in, the patient becomes harassed with distressing nausea and vomiting, which is aggravated by drinks. The matter thrown up, con- sists at first of such fluids as are drank, but this is often followed by a considerable bilious matter, very acrid to the taste. The violence of the fever now increases, the patient becomes restless and anxious, " the countenance assumes an indescribable expression of distress and hopelessness." These symptoms generally increase for thirty-six hours, and then give way or decrease for a similar length of time, when the patient either recovers, or enjoys a short respite or remission, only to prepare for another attack of still greater severity than the first paroxysm. The poor sufferer in a few hours becomes distressed with a severe burning and painful sensation at the stomach, accompanied with almost constant sick- ness and straining to vomit; the matter thrown up at this stage, consists of a greenish watery mass, of the consistence of mucilage, containing many minute flakes floating through it. The thirst for cold water is intense, but all drinks serve only to aggravate the nausea and vomiting. The eyes are yellow, and the skin about the neck and breast also become considerably stained by the diffusion of bile. At this period also, sometimes the yellow appearance extends over the. body and limbs, forming a dirty yellow color of the entire body, whence * It has been observed that, in some cases, there is an urgent hunger experienced by the patient, at the subsidence of the first paroxysm. 52 DOMESTIC MEDICINE. the name of the disease ; but if this diffusion into the capillaries does not occur at a period so early, the yel- lowness of the skin will not generally become very prominent. This second stage generally continues about as long as the first, during which time many die ; but those who survive, either mend from this period, or shortly pass into the third stage, which differs considerably from either of the first two. The pulse now sinks rapidly, the tongue is coated with a brown or black fur, the vomiting is almost continuous and exceedingly severe, and the matter now ejected is of a dark brown or black, resembling coffee grounds, (called the black vomit,) sus- pended in a glary or yellowish-brown liquid; the burn- ing in the stomach becomes intolerable, the discharges from the bowels are green or black, and frightful haem- orrhages often ensue. The extremities grow cold, and hiccough and violent convulsions close the scene, or the patient may sink away from the loss of blood. Delirium often sets in before death. Cause. — As already hinted, there has been much dif- ference of opinion among physicians, as to the cause of this disease ; but it is now pretty generally conceded, that it is most commonly of miasmatic origin, but it is not dependent on the putrid effluvia arising from the decomposition of vegetable matter alone, as it may, and does frequently arise and prevail alarmingly, from idio- miasmata, or the putrid effluvia arising from the decom- position of animal matter. Dr. Thomson considered that the principle in the in- fected atmosphere, which is the cause of this disease, is a nitrous gas* which is very poisonous, and which from its known properties or character, is entirely adequate to the production of this disease. He states that when it arises from marshes or the decomposition of vegetables containing nitrogen, it, from its specific gravity, (being a little greater than that of the atmosphere,) is confined to low places, and hence the more frequent occurrence of this, and other miasmatic diseases, in low grounds * Deutoxide of nitrogen. YELLOW FEVER. 53 and along streams, on the surface of which, he says, this poison is carried in great density. The protoxide of nitrogen is of a specific gravity a little less than that of the atmosphere, and if Dr. Thomson's views are correct, this combination of nitrogen may account for the occasional appearance of miasmatic diseases on high grounds. The suddenness of the attack, the extreme nausea and irritability of the stomach, the black vomit, and the yellowness of the skin, are the principal characteristics of this complaint. But these peculiarities are chiefly confined to the more violent cases of the disease. "When the attack is more mild, the symptoms very much resemble the common remittent fever, only it is consid- erably more attended by irritability of the stomach. Yellow fever may justly be considered a dangerous disease, sometimes proving rapidly fatal, even in a few hours. Its duration is generally from five to seven days. The unfavorable signs are the black vomit, de- lirium, and convulsions. Treatment. — Dr. Thompson gives the following: — " This disease should be treated with the most rigorous course of medicine, [i. e. vapor baths, lobelia emetics, and enemas,'] and a continued perspiration must be kept up. The surface should often be bathed with a strong alka- line wash, made of hard wood ashes put into water and allowed to settle, and then mixed with whiskey or West India rum, to clear the glutinous substance from the pores, and prevent an absorption of the morbid matter that has worked out by perspiration. Baths should be used daily, and the temperature of the system generally, should be kept as regular and as near that of health, as artificial means will effect it. Soups and gruels highly seasoned should be taken as food, and strong tonic mixtures, such as bitters, syrup, &c, to strengthen, should be used as soon as the state of the stomach will admit of such treatment. The saline properties of the blood become much reduced by this disease, by which means the system becomes very pu- trid, therefore pepper and salt should be used in great profusion in the nourishment, after thorough courses of medicine." The Doctor's object maybe effected in the 54 DOMESTIC MEDICINE. following way : in severe attacks, the patient, after taking a few doses of capsicum, should be immediately placed over a vapor bath, which should be raised grad- ually until free perspiration appears, when the body may be wiped with a dry towel, and the following wash applied : — # Common Salt, 2 table spoonfuls, Capsicum, 1^ " Pour on half a pint of boiling water ; then stir it until the salt is dissolved. This should be prepared while the patient is in the bath, so as to have it ready when it is needed. As soon as the patient is thus bathed, he must have an active lobelia emetic, and an enema composed of an infusion of thoroughwort, to which should be added a tea spoon- ful of brown lobelia, and one tea spoonful of the tinc- ture of myrrh. During the operation of the emetic, the patient should drink freely of an infusion of thorough- wort and nervine tonic, and must also be well supported by nourishing broths. Prepared charcoal, if taken after the operation of the emetic, in table spoonful doses, will generally quiet the stomach. The bowels must be kept free with the use of enemas. Should this first course not break up the disease, it must be repeated until the urgent symptoms yield ; the lobelia need not, perhaps, be employed in such large quantities in the subsequent courses ; nevertheless, if the disease should still prove obstinate, it must be treated as at first. Mild cases of this disease may be treated in the same way recommended for remittent fever. As soon as the skin becomes permanently relaxed, the use of active tonics should, in this disease, always De instituted. The apartment of the sick must be well ventilated, and cleanliness be strictly observed. Chloride of lime may be used to correct the effluvia ; — see this article by reference to the Index. SCARLET FEVER. 55 SCARLET FEVER. — (Scarlatina.) Tins disease, like most others, is susceptible of variations in its violence, and hence has generally been divided by authors, into several grades. The three fol- lowing, however, alone are worthy of consideration in the present case, namely : scarlatina si?nplex, scarlatina anginosa, and scarlatina maligna. The first of the vari- eties consists of a mild attack of the disease, in which the fever seldom runs high, but there is an eruption or efflorescence on the surface, giving to the skin quite a scarlet appearance, which generally sets in in the course of from two to three days after the appearance of the usual premonitories of the fever, such as lassi- tude, stretching, drowsiness, and chills. This variety of the disease generally passes off in the course of a few days ; the eruption by desquamation. The second, scarlatina anginosa, is characterized by a very high fever,* and a more regular or complete erup- tion, attended, moreover, with inflammation of the fauces and throat. The fever is early accompanied with a kind of stiffness and dull pain in the muscles of the neck, and under the ears and angles of the jaw. Deglutition now becomes difficult and painful, and the fauces, on examination, will be found to be of a scarlet appearance, like the surface, and to be enlarged. In bad cases, the inflammation in these parts runs very high, and in many cases results in suppuration. The scarlet eruption, in this variety, does not appear as early in the disease as it does in the simple variety, and although it is most generally more complete when it does appear, yet it frequently recedes the second day after its appearance, and is not observed again for a number of days, when it is again developed. It may be regarded as a general rule, that as many days as the eruption disappears, so long will the crisis of the disease be protracted, as the patient does not generally improve during this time. * Currie and Wilson have found the temperature even of the surface, as high as 108 to 112 degrees Fahrenheit. 56 DOMESTIC MEDICINE. If the fever declines as early as the fourth or fifth day, the inflammation of the throat will be likely to pass off with the fever and eruption, and suppuration may not ensue. But should the fever run very high, and continue beyond this period, and should the swell- ing and inflammation in the throat be considerable, ulceration may be expected. The third variety, scarlatina maligna, presents a series of phenomena still more to be dreaded ; but it is indeed probable that in a large majority of these cases, the ma- lignancy is much dependent upon bad management in the treatment. It is deeply to be deplored that the fash- ionable practice of medical treatment in many cases of disease, is more injurious than beneficial. The most active poisons known, constitute many of the articles most depended upon, by many physicians, in the cure of disease ! " Although this form of the disease usually com- mences like the preceding variety, it soon betrays its violent and dangerous character. The eruption comes out at uncertain periods from the second to the fourth day, and is usually pale when it first makes its appear- ance, acquiring, in most instances, a dark or livid hue in the progress of the disease. It is also very irregular in its duration, and often suddenly disappears soon after it comes out, and reappears on some other parts of the body two or three days afterward. The temperature of the skin is variable and not generally very high ; and the pulse, though in the commencement active, becomes small and feeble in the course of the second day. De- lirium generally occurs at an early period, and often continues, with occasional intermissions and exacerba- tions, throughout the subsequent course of the disease. In nearly all cases, the sensorial functions suffer very considerable disturbance ; and in aggravated instances the eyes are dull and inflamed, and the cheeks suffused with a livid flush. The tongue is dry and covered with a brown or dark fur, the breath foetid. On examining the fauces, clay-colored sloughs are seen on the soft palates and tonsils, which acquire a brown, and at last a dark color. The disease, however, sometimes termi- nates fatally under symptoms of cerebral oppression, before the ulcers become extensive, or acquire a very SCARLET FEVER. 57 lad appearance. 'In general,' says Dr. Armstrong, 'it is only when the fever is protracted beyond the fourth day, that the ulcers are converted into ill-conditioned, black, and foetid sloughs.' There is generally a large quantity of very viscid mucus secreted and lodged in the fauces, giving rise to difficult respiration, and a rat- tling noise in the throat. When the sloughs are foul and excessive, a thin acrid fluid is generally discharged from the nose, occasioning irritation and excoriation of the parts with which it comes in contact. In cases of a particularly violent character, collapse supervenes toward the middle or end of the second week of the disease. When this occurs the heat of the surface sinks, the pulse becomes very frequent and feeble, the tongue dark-brown or black, the animal powers greatly prostrated, painful diarrhoea often ensues, and in some instances petechia? and haemorrhages from various parts occur, toward the fatal termination of the disease. The fever and ulcerous affection of the throat fre- quently exist, without an eruption at any period of the disease. Death sometimes takes place as early as the second or the third day, and Bateman observes, that occasionally the symptoms continue to be moderate until an advanced period, when they suddenly assume a malignant and rapidly fatal character." — (Ebcrle.) Cause. — Scarlatina is generally regarded as depend- ent for its cause on a specific contagion. Measles and miliary fever, are the only diseases with which scarlatina is likely to be confounded. Dur- ing the first or second day, and indeed, during the entire course of the milder grades of this disease, the diagnosis is made out with difficulty. Eberle states that " there is not a single symptom that can be regarded as abso- lutely peculiar and characteristic of scarlet fever." It is true that when the disease is fully developed the diffi- culty will be less, but it often happens that the eruption is wholly or nearly absent, or it may be much diffused and blended; again, it may appear in blotches. The following circumstances, however, will generally enable us to distinguish scarlet fever from measles. The erup- tion in the former generally comes out earlier, usually within the first forty- eight hours of the existence of the 58 " DOMESTIC MEDICINE. fever; while in measles, the rash rarely appears before the third day, and most commonly not until the fourth; and in this, the eruption also differs in character from that of scarlatina. In the latter it is more diffused and blended, giving the appearance of a deep blush of the skin, and the eruption is very little elevated above the common surface ; whereas in measles, the eruption is elevated somewhat above the surrounding parts, and consists of numerous small circular dots, like flea bites, being of a deeper red in their centre, and paler on the circumference, so that even though the redness of the spots may coalesce, yet the skin will nevertheless pre- sent a speckled appearance. The color of the eruption in measles is likewise much darker than that of the other, but perhaps the catarrhal symptoms of measles, are the most prominent distinguishing symptoms be- tween the two diseases. The eyes also are inflamed, and tears flow profusely ; there is more or less sneezing and cough ; while in scarlatina these symptoms do not appear, or are so slight that they are generally over- looked. The sudamina, or miliary eruption that attends vari- ous affections, especially typhoid fever, puerperal fever, &c, which has by some been considered a separate af- fection, and called miliary fever,) slightly resembles the eruption of scarlatina ; but on examination, it will be found that the miliary eruption in scarlet fever only ap- pears in scarlet blotches, whereas in the eruption attend- ing other fevers, the miliary appearance may be ob- served to arise from parts of the skin possessing its natural color. Scarlet fever terminates variously ; — a variety of other diseases may follow : dropsies, are, however, by far the most general sequelae of this disease Abscesses of the tonsils, head and ears, enlargement of the parotid glands, gutta serena, (loss of sight,) deafness, loss of hair, hysteria, asthma, epilepsy, cutaneous diseases, and many other affections have been known to follow the disease. A regular abatement of fever, attended with free per- spiration, and softness of the skin, lateritious sediment in the urine, soft, but full and regular pulse, bright color of the eruption ; desquamation or peeling off* of the SCARLET FEVER. 59 cutis or outer skin, continuation of strength and return of appetite, may in general all be regarded as favorable signs. But if the strength should fail rapidly, the pulse sink, and symptoms of putrefaction supervene ; or if violent delirium sets in, attended by a glassy appearance of the eyes, and above all, if gangrene of the fauces should occur, the danger will be imminent. Treatment. — The indications of cure will be readily inferred from the character of the affection. It is evi- dent that the urgency of the case generally corresponds with the deficiency in the development of the eruptive phenomena, for the case is generally comparatively mild when the eruption comes out early and continues complete. To bring about all the conditions necessary to the successful removal of the contagion or specific virus from the system, is among the first things to be done in the cure. The capillaries seem to be implica- ted more than any other part of the vascular system, and if obstructions here are the cause of the irregular development of the eruption, it is well to give attention here. Rubefacients, or what is better, the vapor bath, if it be convenient, must be used early in the treatment. The common bathing drops, or even the rubefacient solution, will be found very serviceable in bringing out the eruption, as well as to let down the fever. In the meantime, if the case be a bad one, an emetic of lobelia should be prepared and administered after the bathing, which should in turn be followed with small but fre- quent doses of the sudorific powders. The bathing and sudorific powders should be continued, until a favorable crisis is formed. Local Treatment. — The local symptoms must receive such attention as the circumstances of the case may require. The rubefacient oil should be applied exter- nally to the throat and angles of the jaws, and when ulceration takes place, the astringent gargle will be found of eminent service. Capsicum,. — With regard to the utility of capsicum in sore throat, there is now but little dispute. Dr bU DOMESTIC MEDICINE. Eberle speaks of it as follows : — " The capsicum appears to be a particularly valuable exciting remedy in this [malignant] variety of the disease." This article was first employed in malignant scarlatina, by Dr. Stephens, in a very fatal epidemic which prevailed at St. Christo- pher's, (West Indies,) in 1787, and it has since received the decided approbation of many eminent practitioners. The manner of employing it is as follows : take two table spoonfuls of small red pepper, or three tea spoon- fuls of common cayenne pepper, and two table spoon- fuls of fine salt ; beat them into a paste, and pour upon them half a pint of boiling water ; this is to be strained, and half a pint of good vinegar added to it. Of this liquor, when cold, a table spoonful is to be taken every half hour by an adult, and the throat should be fre- quently gargled with it. Stephens asserts that he em- ployed this remedy in about four hundred cases, and with surprising success. The ulcers in the fauces soon cast off their sloughs and commenced to heal, a genial pleasant warmth was diffused throughout the whole system, and the vital powers speedily resumed a more active condition." The compound tincture of myrrh, or Thomson's No. 6, is also very good in putrid sore throat. OF INFLAMMATION. The general principles involved in the foregoing doctrines of fever, are the fundamentals, also, of the present theory of inflammation. The essential phenomena of fever and inflammation differ none in their primary manifestations, excepting that the one is local and the other general in its action. The term infl-ammation is derived from in, within, and flamma, flame, fire, combustion ; because of the burning pain attending it, and the appearance of the parts affected therewith, the chief characteristics being heat, redness, pain, excitement, and swelling. OF INFLAMMATION. 61 111 inflammation, as in fever, the proximate cause, evidently, is oxydation: in the latter, the circulation chiefly furnishes the elements supporting the process, while in the former, the elements of the tissues them- selves are also acted upon. It is unnecessary here to treat of the circumstances necessary to the phenomena of oxydation in the living animal body, as these have been presented in the article on fever, to which the reader is referred. The remote and exciting causes may therefore at once be presented, in connection with the essential phe- nomena of inflammation, as they commonly occur. We will suppose, therefore, that a lesion of any structure occurs by accident, as by a cut, bruise, punc- ture, burn, or any other mechanical or chemical vio- lence ; irritation sufficient to excite a large influx of blood must necessarily ensue. It is here said this must ensue, because of the peculiar endowment of all the sensible tissues of the body, i. e. the endowment of irritability. No law of our constitution is better known than this, that wherever irritation is excited there will be an increased flow of blood. Though the doctrine ubi irri- tatio ibi affluxus has been disputed by some, on the ground that it is inconsistent with the laws of hy- draulics — they assuming that the arterial circulation is strictly mechanical, and altogether dependent upon the action of the heart, and therefore it would be impossible that any part of the body should receive a quantity of blood disproportioned to the circulation in other parts. But the experiments of Dr. Phillip seem to demon- strate that the blood-vessels have a power of action independent of either the nerves or heart, and that the blood will circulate in parts when the heart is extracted. (See Philosophical Trans., 1815.) Analogies to this occur in animals which have no heart. This action is most probably due, to some extent, at least, to the vitality of the blood itself. The fact is now estab lished, at least, that the arteries possess an inherent power of contraction, like the heart itself, and this power acts simultaneously with the latter. The evident fact alluded to above, that there is an increased flow of blood to irritated paits, therefore admits an explanation. 62 DOMESTIC MEDICINE. The modern views on physiology go to show that the entire circulation is dependent upon the principle, irri- tability, and the state of its activity always governs the state of the circulation. Thus, any injury or agent, whose effects are inimi- cal to the quiet state of the principle, irritability, will produce irritation, and thus increase the flow of blood to any part. The consequence is, that an extra amount of oxygen is supplied in the part, and if the latter should lack sufficient vital resistance to regulate the action of oxygen, it is plain that excessive oxyda- tion, or, in other words, inflammation, must take place. Irritation is the active state of the principle, irrita- bility, and although it be necessary to the rise of inflammation, yet it does not necessarily produce it. We have a beautiful illustration of this fact in the transient exposure of any part, as the cheek, for in- stance, in a frosty morning. The cold irritates the part — the blood flows in freely — the part becomes red, tumid, and hot, showing that more oxydation goes on in the part than in the natural state ; but as the vitality of the part is not deficient, the phenomena of oxydation and calorification are no greater than the circumstances demand; the cold exhausts the heat rapidly, and hence the oxydation necessarily is more rapid thus to supply the exhaustion of the temperature. Now, if the exposure were continued sufficiently long, or if the cold were intense enough to impair the vitality, inflammation would be the consequence. The symptoms of inflammation are readily explained by this theory. The following is the chain of causes and effects: First, the exciting cause, as an injury or obstruction of any part occurs, irritation is immedi- ately produced,* which excites an extra influx of blood, bearing oxygen sufficient to produce the inflammation, above stated. * The primary impression is commonly supposed to be conveyed by the nerves to the brain, and thence a force reflected which directs the greater influx of the blood. But, as has already been stated, the irritability itself seems to control the circulation, and thus the circulation has been known to go on in parts cut off from the influence of the nerves, and even the heart OP INFLAMMATION. 63 The swelling, redness and pain are effects of a crowded or compacted state of the vessels, by the extra influx of blood. The more delicate arterial ramifica- tions usually contain white fluids, but in a state of congestion the red blood is forced into them, and thus the redness is occasioned, and the parts become turgid, or swollen, by the compaction. The pain is referred by some to the injury the nerves sustain by the com- pacted state of the vessels — being compressed, stretched and otherwise disturbed; while others refer it at once to the irritation. In the foregoing brief remarks on the proximate cause of inflammation, as related to the several exci- ting causes, it will be observed that the essential phe- nomena involved are identical with the vital pro- cesses, just as was said of fever. Inflammation is not, therefore, necessarily, a pathological condition, circum- stances only make it such, and in many instances, as in the reparation of injuries, some of the most re- markable sanative effects are produced by some of its processes. Our surgeons now well know the importance of these natural processes; they are well aware that all that is effected in surgery, by what is called "first inten- tion" is the result of inflammation. The healing of wounds ; the restoration of fractures ; and the cure of bruises or contusions, are all alike dependent on inflam- mation. By its agencjr, extraneous substances are removed from every part of the body. Of this we have a very good example in the removal of pus from the liver. This may be effected by ulceration through the parietes, and it be thus discharged externally, or the parts may contract adhesions with the intestines, they become perforated by ulceration, and the matter may in this way be removed ; or the liver may form adhesions with the pulmonary organs through the medium of the dia- phragm, and by ulceration, the matter may peneti ate the bronchia, and thus be removed by expectoration. Again, when the location of the pus is in such a part as renders either of these modes of escape imprac- ticable, we find that a cist will be formed around the matter, so as to protect the parts, when the pus will be taken up and carried into the circulation, and thus 64 DOMESTIC MEDICINE. be ultimately removed by the cutaneous exhalents Finally, we find that when a solid substance is forced into the soft parts, as, for instance, the obtrusion of a splinter or thorn, the surrounding parts will soon take on inflammation, and ulcerate, and thus carry off the substance in a flood of pus. On this subject, Dr. Marshall Hall remarks as follows : "Some of the provisions of nature — or rather of the Creator of all things — accomplished through the me- dium of the action and processes of inflammation, are quite wonderful. An abscess may form in the liver; the pus may be expectorated through the bronchial tubes ; and the patient may survive. An intestine may be strangulated by being intussuscepted into another portion of intestine ; it may separate and pass per anum, leaving the original canal free and entire ; and this patient, like the former one, may survive. If we experiment on a dog, draw out a portion of the small intestine, and tie a ligature firmly around it, so as entirely to obstruct its course, the adjacent portions of the intestine reunite, the ligature is separated into its canal, this canal itself remains pervious as before, and the animal survives the dangers of this fearful operation." Terminations. — Among the most common termina- tions, as they are called, of inflammation, are resolu- tion, effusion, suppuration, induration, and gangrene. These depend upon the nature of the physical changes occurring in the structures under the influence of oxygen and the vital principle. Resolution. — Resolution takes place when the exci ting cause of the inflammation is withdrawn or over come before any considerable lesion occurs in the struc tures. In resolution, the pain gradually ceases, the redness disappears, and the swelling subsides, leaving the parts in their natural condition. Effusion. — When the swelling assumes an oedematic (doughy) character, and seems to incline toward the more dependent parts of the organs affected, and if, moreover, the pain moderates and the redness incline to OF INFLAMMATION. 65 more of a pale or yellowish appearance, we may con- clude that more or less effusion is going on. The matter effused is generally serum and lymph. Serum is frequently thrown, and sometimes in great abundance, on serous surfaces of the organ's — that is, on the lungs, pleura, diaphragm, Sfc. — and into the cellular tissues, of which we have examples in dropsies. Lymph is also thrown out on inflamed serous surfaces, which is apt to coagulate, and thus often forms a union of con- tiguous surfaces. It is the effusion of lymph into lace- rated wounds, that causes them to heal up. The matter effused in inflammation separates from the blood and the substance of the organs, by the collateral agency of oxygen and the vis medicatrix naturce. Suppuration. — This is a very common termination of inflammation. The general premonitories, if the action be^extensive, are chills, rigors and anxiety. The local symptoms are a sense of a dull, heavy weight in the affected part, attended with more lancinating pains and with a circumscribed appearance of the redness and swelling. In the centre of the swelling, if it be in the outer parts, may now be discovered a point more ele- vated and soft to the touch, where the pus is collected. The integuments, also, become more and more thin, and assume a whitish or yellowish color, and at length lose their firmness, and give vent to the pus. The pus is, however, not always found in a collected form ; for in some tissues it may lack the cist formation, and hence it may become infiltrated through the neighboring cel- lular portions. Infiltration is very common in the lungs, where abscesses are comparatively rare. Suppuration may also be diffused; thus, it sometimes covers large surfaces, as that of the archnoid, the pleura, the pericar- dium me peritoneum, &c. Induration. — The parts often increase in consistence or grow hard, as the inflammation subsides. This ter- mination may occur in any tissue of the body; but is by far the most common among the glandular parts, espe- cially in the spleen, the liver, the lymphatic ganglions, and subcutaneous cellular substance. 5 jQ DOMESTIC MEDICINE. Gangrene. — In very violent cases of inflammation, in which the vitality of the part is much diminished, the inflammatory action may end in the death or mortifica- tion of so much of the part as the conservative powers are not able successfully to defend. The general symptoms which foretell the approach of gangrene, are, — a collapsed state of the system; paleness; a cold, clammy sweat; sunken features ; a peculiar cadaveric look; tremor; and a feeble, thread- like pulse. The part affected assumes a livid or pur- plish hue ; its tension and elasticity diminish and yield to a doughy state like a cist containing thick fluids. The symptoms that give evidence of the immediate approach of sphacelus, are a loss of sensibility and heat, and a discoloration of the part. Inflammation modified by textures. — The character and terminations of inflammation, are much modified by the character or kind of texture implicated. Inflammation of the serous membranes, is character- ized by effusion, first of serum, and afterward of coagu- lable lymph and albumino-febrine, which is sometimes considerably mixed with blood. Adhesions are apt to form in cases of inflammation of these membranes; and thus it happens that the pleura is so often found attached to the surface of the ribs and lungs. The following cut from Baillie, showing an adhesion of the pleura to the ribs, well illustrates these adhe- sions. Inflammation of the serous membranes sel- dom end in ulceration. In inflammation of the mucous membranes, the reverse obtains. In this case the effusion consists of mucus, at first considerably trans- parent, but afterward becoming more opaque and puriform. Instan- ces sometimes occur, in which the mucus is tinged, or even deeply stained with OF INFLAMMATION. 67 Dlood, as is evinced in bronchitis, and pretty generally in dysentery or bloody flux* It is rarely the case that we observe the exudation of coagulable lymph, in inflammations of this texture. Nevertheless, it occurs sometimes, as is seen in cases of cynanche trachealis or croup, and in the bowels and vagina, in which it is called false-membrane. \ This disposition of the textures is a very happy and important circumstance, for if the reverse should occur, if the mucus surfaces should exude coagulable lymph, and the serous surfaces mucus or pus, we would find that in inflammations of the oesophagus, bowels, urethra, vagina, &c, that they would contract adhesions and close up their passages, while the pleura, pericardium, peritoneum, &c, would be subject, on the occurrence of inflammation to ulcerations, and thus be attended with consequences almost certain to prove immediately fatal. It seems that when inflammations implicate parts constituted of various textures, that these, severally, evince their common characteristics. Thus the mucous textures throw out mucus and pus, while the serous in turn line their surfaces with lymph and serum. Ac- cordingly we find that in typhoid fever, in cases even of perforations, that while the internal surface is slough- ing off, the outside is contracting adhesions to contigu- ous surfaces, forming in this way a protection to the abdominal cavity against extravasation, which would necessarily prove fatal by the violent peritoneal inflam- mation that it would occasion. " The parenchymatous substance of organs, is apt to be softened by acute, and indurated by chronic inflamma- tions. Softening, induration, and abscess, are frequently seen in the brain, abscess in the liver, gangrene in the lungs." — {Hall) The arteries are not much disposed to inflammation from injuries ; when they are wounded, the margins of the wound may take on inflammation, a coagulum form, * When the inflammation subsides, or the mucus becomes more cool, it reassumes its transparency. •j- This is what Dr. S. Thomson denominated canker. DOMESTIC MEDICINE. and the wound heal. When an artery is divided, the ends will contract, and a stopper- like clot of blood form in each ; ad- hesive inflammation now closes up the artery, as represented in the annexed cut, which is given by Dr. Jones, and is designed to show the femoral artery of a dog, nine days after it was divided. It will be seen that the ends are considerably retracted as well as contracted, and that the coagulum is neatly healed into the ends or stumps of the vessel, and assuming a firm texture like the artery itself, is sufficient to resist the force of the circulation, and thus prevent the haemorrhage that would other- wise take place, and thus immediately destroy the subject. The circulation is now sustained through these parts, by the anastamosis of their branches, as represented below. By this cut it is designed to show the healing of a large ar- tery, to which a ligature was applied, and the circulation car- ried on by the anastamosis of the branches in the neighbor- ing parts. The veins manifest a disposi- tion different from the arteries. In these we observe diffused ef- fusion of albumino-fibrine, but adhesive inflammation is not so likely to occur. When a vein is divided, we do not find the same readiness of the vessels to heal up. It is true, that coagulable lymph may be thrown out by the surrounding textures, but the ulcerative process, is most likely to occur. Diffusive phlebitis is by no means an uncommon occurrence, anci this may run along the vein even to the heart, and thus prove speedily fatal. It is very common to observe OF INFLAMMATION. 69 mischiefs of no small magnitude to follow even the small puncture of the lancet, in the practice of blood- letting. If there were no more disposition to heal in the arteries than is found in the veins, we might expect fatal haemorrhages universally to accompany wounds or ruptures of these vessels, for although ligatures might be applied, the parts not healing* would in many in- stances rot away, and renew the difficulty. Inflammation of the lymphatic vessels is, like phlebitis, apt to be diffused. The morbid action extends along their course toward the thoracic duct and the heart, and would probably prove as fatal in its results as phlebitis, if it did not meet with a barrier in the glands of the system, situated in the neck, the axilla, the groin, &c. These glands guard the inlets into the great cavities ; they frequently suppurate, and what havoc would en- sue, were they within, instead of being without — Pou- part's ligament for example ? Inflammation of the absorbents generally terminates by resolution. In one instance, however, it passed on to suppuration, and many abscesses formed in the course of the lymphatic vessels, as they ascended from the heel (which was the seat of ulcer from chilblain, the cause of the inflamma- tion,) upward along the thigh. — {Hall.) Ulceration of the lymphatic glands frequently occurs from the morbid accumulations which arise from ulcers, &c, in the extremities, and are carried by the lymph- atic vessels into these glands. The glands of the neck, axilla, and groin, are often found thus affected. As to the Jibrous tissues, tendon may slough, cartilage and ligament ulcerate ; but they, as well as the muscles, are more apt to end their inflammations in the exuda- tions of serum and gelatinous fluids, or the deposition of earthy matter. But by far the most frequent termi- nation in these tissues is by resolution. Inflammation of the osseous tissue is apt to terminate in necrosis, and caries. f Finally, we find in the termination of inflammation in the cutaneous tissues, the evidences of a mixture of * It is true that veins that are tied do heal up many times, yet all surgeons know how difficult the process is. f Caries may be considered to correspond to ulceration, and necrosis to mortification. 70 DOMESTIC MEDICINE. textures. The ulcerations occurring here are very anal- agous to those of the mucous linings of the intestinal canal. Erysipelas exhibits an imperfect development of suppuration, sloughing, and gangrene. In the variolous pustule, we have an example of the different phenomena that attend inflammation of this structure. In the first place, a sebaceous gland will manifest the usual symptoms of inflammation, that is, redness, tumor, &c. ; on the third or fourth day, we have the effusion of serum, in a vesicle with its centre tied down by the duct of the gland ; on the fifth day, we observe the deposition of pus around this central point ; on the seventh or eighth day, the serum is en- tirely replaced by pus ; and probably on the ninth, the central duct has been absorbed or has sloughed away, and the pustule assumes an orbicular form. Effusion of lymph may also be observed, which occurrence is shown by the cicatrix that marks the part after healing. It will be observed moreover, during the process of the inflammation, that sloughing of the cutis vera occurs about the time that the pustule is in its maturity. INFLAMMATION OF THE BLADDER. {Cystitis.) This affection is of rare occurrence, and when it does take place, it is generally the result of injuries to the part. It may, however, arise from the irritation of a calculus or stone in the bladder, from suppression of urine, the use of cantharides or Spanish flies, &c. Symptoms. — Tension or hardness, tenesmus, fever, hard pulse, and pain in the parts, frequent desire to urinate, with difficulty to void it; or sometimes a total suppression of urine, are among the most prominent symptoms of this disease. Treatment. — Enemas of the infusion of lobelia and thoroughwort, frequently administered, together with the use of the rubefacient oil or wash, over the region INFLAMMATION OF THE BLADDER. 71 of the bladder, and the usual means of equalizing the circulation, will generally be all that is required. When there is suppression of the urine, it may be necessary to draw it off by means of a catheter. In very severe cases the water should be drawn off, and leaving the catheter remain, an infusion, made by scalding a tea spoonful of lobelia in a pint of thick slippery elm tea, stirring it till it cools, and then strain- ing through a cloth, should be injected (once in a few hours, in portions of a tea cupful,) into the bladder through the catheter, by means of a syringe having a point that will enter the catheter. This application with the other parts of the treatment, will generally give relief with considerable promptness, even in the worst of cases. Cold water injected into the bladder in this way, when the inflammation runs very high, will sometimes be serviceable. INFLAMMATION OF THE BOWELS. (Enteritis.) Inflammation of the bowels manifests itself by pain in the abdomen, particularly in the umbilical region, which is accompanied with eructations, sickness at the stomach, a vomiting of bilious matter, obstinate cos- tiveness, thirst, heat, great anxiety, and a quick and hard pulse. As the disease progresses, the pain grows more severe, the bowels seem spasmodically drawn together, and the abdomen becomes much distended, and very painful to pressure ; the constipation becomes more dis- tressing, and the urine scanty or completely obstructed. Dissections in this disease, show that when these symptoms appear, the diseased action chiefly impli- cates the external or peritoneal coats of the intestines; and that when the inner or mucous coat is principally affected, the usual symptoms of dysentery prevail. The affection sometimes involves only a small por- tion of the intestinal tube, but more generally pervades them to a very considerable extent. 72 DOMESTIC MEDICINE. The inflammation commonly terminates by resolu- tion, but effusion and adhesion to contiguous parts sometimes occur, or ulcerations may take place, or gangrene set in. Treatment. — In the treatment of this severe, and fre- quently dangerous affection, the main object should be to equalize the circulation, and direct the determining powers to the surface. For this purpose, no means is better adapted than the vapor bath, which should be ap- plied alternately with the rubefacient wash or bathing drops. The next object should be to open the bowels, which must be effected with the use of appropriate medicines, by means of injection. For this purpose the following is very good : # Gum Arabic, or Slippery Elm Powder, \ oz., Lobelia, (fine,) 1 drachm. Put the ingredients into a pint of cold water, and agitate it well. This should be used at one injection, and a like portion administered every hour, until the bowels evacuate. Should the inflammatory symptoms run very high, cold water, by injection, will sometimes be found very useful. The stomach in this complaint is usually very irritable, and hence, generally, requires attention. An infusion of spearmint or peppermint may be used to obviate the nausea, and should this prove unsuccessful, a handful of the mint herb may be scalded and applied to the stomach externally, or the oil may be applied in its stead. Emetics. — Lobelia emetics, besides their beneficial effects in cleansing the stomach, are eminently service- able for their relaxing powers, and tendency to equalize the circulation. Diaphoretics. — A free perspiration should be kept up, but this must be done, as much as possible, by exter- nal means, as by keeping a steaming stone to the feet, the use of the vapor bath and the rubefacients. The milder diaphoretics, such as the white root and penny- royal, may however be used, in the form of a tea. The use of the acetate of ammonia is here suggested to the mind of the author, but as he has never tried it, he cannot vouch for its utility. INFLAMMATION OF THE BRAIN. 73 Cathartics. — In this disease cathartics are not advi- sable, because of the irritation they are apt to excite in the bowels. It may, however, be proper sometimes to use a dose of olive, almond, or castor oil, as they are emollient, and less irritating than cathartics in general. Fomentations. — Fomentations of hops, camomile and rue, with a few pepper pods stewed in vinegar, and applied to the bowels externally, are sometimes of sig- nal service. Slippery elm water, or the mucilage of gum arabic, should be drank pretty freely, with a view to their emollient effects on the bowels. INFLAMMATION OF THE BRAIN. (Phrenitis.) Phrensy, as the disease is sometimes called, is char- acterized by a considerable fever, violent headache, redness of the face and eyes, intolerance of light and noise, watchfulness and delirium. The disease comes on with a sense of fullness and heat in the head, flushing of the countenance, redness of the eyes, and a full pulse. The stomach and bowels soon become disturbed by sympathy, and hence there is, sometimes, more or less vomiting, and pain in the bowels. The pain in the head is not always severe ; when the morbid action affects the substance of the brain alone, there is seldom much pain, as this tissue is not very sensitive, but when the meninges or mem- branes are implicated, which is generally the case, the pain is distressing. As the disease advances, the fever increases, and the delirium sets in ; the patient looks wildly, talks inco- herently, grits his teeth, and becomes very restless. At the highest stage of the disease, the headache some- times becomes intolerable, and the delirium rises to a raving pitch. 74 DOMESTIC MEDICINE. Treatment. — In the treatment of this violent affec- tion, no time should be lost in applying the most prompt means. The first object should be to equalize the circulation ; and for this purpose, enemas made of thoroughwort tea, containing a tea spoonful of capsi- cum, and as much lobelia in each, must be immedi- ately administered, and continued on at suitable inter- vals, until relief is obtained. Mustard plasters, or at least a hot steaming stone, should be applied to the feet. The patient must be kept sick with nauseating doses of lobelia, but until the pressure to the head is relieved, it should not be pushed so far as to produce vomiting. A sinapism to the nape of the neck, will relieve the headache. Cathartics. — These agents are of great importance in the treatment of this disease. A cathartic powder composed of equal parts of jalap, senna and pepper- mint plant, finely pulverized and mixed, will be an excellent preparation. The dose is a large tea spoon- ful, divided, and given thirty minutes apart. Castor oil is likewise quick in its action, and may be used. Podophyllin is good, but rather slow in its action. Diaphoretics. — The acetate of ammonia in tea spoon- ful doses, is an important medicine ; it should be repeated every two hours, till perspiration is produced. Local Means. — Sulphuric ether, or cold water, should constantly be applied to the head. INFLAMMATION OF THE EYES. (Ophthalmia.') Inflammation of the eyes may be confined to the lids and external membranes of the eyes, or it may also implicate even the whole globe. The symptoms in this affection are redness of the eyes, with pain and heat over their surface, and sore- ness of the lids ; there is also generally a profuse effu- sion of tears, and an intolerance of light. INFLAMMATION OF THE KIDNEYS. 75 Causae. — Exposure to wind or dust, working before a very hot fire, the obtrusion of extraneous substances, excessive weeping or crying, cold, external violence, eruptive diseases, syphilis, &c, are among the most common causes of this complaint. Treatment. — The treatment will depend much on the character of the disease. In acute inflammation, cold water will be one of the best remedies. In the chronic variety, the following is excellent : 5r Crocus of Iron, 2 drachms, Sulphate of zinc, 1 drachm. Pulverize, and dissolve in a pint of rain water. The medicine may be applied three or four times a day, until the cure is effected Infusions of lobelia and hydrastus are very good. A solution of acetate of lead, is a remedy highly prized by some. In cases of long standing, small doses of podophyllin should be given for some days, until the bowels become loose, and then followed by an alterative medicine. Astringent vegetable infusions are sometimes indi- cated. INFLAMMATION OF THE KIDNEYS. {Nephritis.') Symptoms. — Acute pain in the region of the kidneys, extending downward along the course of the ureters ; a frequent desire to pass urine, attended with difficulty in voiding it ; a hot skin and constipation of the bowels, are the principal symptoms. If only one of the kidneys is affected, the patient will have a disposition to lie mostly on the side affected. Treatment. — Diaphoretics, relaxants and such other means as are calculated to equalize the circulation, and direct the determining powers to the surface, are indicated in this disease. Enemas of thoroughwort, 76 DOMESTIC MEDICINE. with a small portion of lobelia and the extract of man drake, (3 to 5 grains,) should be administered, not only with a view of keeping the bowels open, but in order, by these means, to control the diseased action in the kidneys, by a revulsive effect. Rubefacients. — The rubefacient oil or stimulating liniment, should be applied to the small of the back with friction, and after this, a steaming stone should be laid against the part, the patient being in bed. Revulsives. — An irritating plaster applied to the small of the back, will frequently be found of great Diuretics. — Queen of the meadow, or the Indian fvemp, must be used in strong infusion, and continued until it produces a sensible diuretic effect, and then be followed with a decoction or infusion of dried peach leaves, till health is restored. INFLAMMATION OF THE LIVER. (Hepatitis.') Authors, in treating of this affection, generally regard it as consisting of two varieties, the acute and the chronic. The acute variety comes on with a pain in the right side, usually extending up to the shoulder, which is much increased by pressure on the parts. The tongue is mostly coated, and there is often nausea and sickness at the stomach, with occasional vomiting of bilious matter. The urine is deeply stained with bile, and the eyes and skin are also of a yellowish color. The patient usually inclines to lie on his right or affected side. There is generally considerable fever, especially if the attack is severe. In the chronic variety the same symptoms are gener- ally present, but are not so prominently marked. The patient will perhaps be able to be up, but w r ill be complaining more or less of pain in his side, want of INFLAMMATION OF THE LIVER. 77 appetite, indigestion, flatulency, and a feverish state of the body. The pain in either variety, though sometimes quite acute, is more usually of an obtuse or dull character ; indeed the disease, owing to the absence of pain, often progresses considerably before it is detected. Instances have occurred in which no hepatic derangement was at all suspected, and yet by examination after death, it was found that the liver was very extensively ulcerated. In this affection, especially in the chronic variety, tubercles in the liver are of very frequent occurrence. These are sometimes of considerable size, but more generally they are small, and many in number. The liver when in an inflammatory condition, some- times varies very much in its color; the author saw one in the hospital at Cincinnati, that was taken from a patient that died in the wards, the color of which was such as could not be distinguished from that of the lungs. Besides the change of color, it is often found that changes of its size occur; it sometimes becomes enormously swelled. Treatment. — Liver affections are sometimes very difficult to cure, for, as above stated, the diseased habit generally becomes much confirmed before it is de- tected; but by the use of proper means and perse- verance, this affection may generally be cured as well as others. Emetics. — In the treatment of liver affections, emet- ics render important service in relaxing the diseased organ, and stimulating it to a healthy action. Their power in equalizing the circulation, is also as efficient as any other agency in the resources of our materia medica. The mechanical pressure and agitation of the liver, during the operation of emetics, is moreover very beneficial. In this complaint as well as in most others, the lobelia inflata is entirely the best article of the emetic class. It should be administered in small, but frequent doses, so as to keep up a continued nausea for several hours, when the doses must be increased so as to pro- duce active emesis. The vapor bath is eminently cal- culated to promote the good effects of the lobelia, and 78 DOMESTIC MEDICINE. will also do much to equalize the circulation, and to remove the bilious obstruction in the circulatory system. Cathartics. — After the system is well relaxed, a dose of podophyllin* must be given, and until the operation of this, a flesh-brush or coarse trembling and feeling of restlessness in the extremities ; an anxious feeling in the precordial region ; restlessness and starting during sleep ; loss of the power of distinct articulation ; complete temporary deafness and drowsi- ness. In some instances there is a manifest change in the moral disposition a short time before the accession of the attack. Sullen gloominess, with an irritable temper, is manifested by some patients. In some cases, the mind falls into a kind of reverie from which it can- not be drawn, which terminates often speedily in a total insensibility. Some epileptics evince an unusual timid 158 DOMESTIC MEDICINE. disposition ; others are spiteful, resentful and mis- chievous, shortly before the accession of the paroxysm. Occasionally, spasmodic twitches of particular muscles, especially in those of the face, precede the attack. Richter states, that painful sensations in certain parts of the body, particularly spasmodic pains in the stomach, with a rumbling noise in the bowels, occur as the precursor of the epileptic paroxysm." When the paroxysm comes on, the patient falls sud- denly with convulsions accompanied by temporary loss of consciousness, sense and voluntary motion. The face is frightfully distorted, the breathing hurried and laborious, the tongue protruded, and there is a frothing at the mouth. The eyes roll about wildly in their sockets, though sometimes at length become permanently fixed. The countenance is usually of a dark purple color, but is sometimes pale. The paroxysm may consist of a single fit; but more usually there is a succession of fits with alternate relaxations, sometimes to the number of a dozen, or even twenty or more. After the final fit, the patient generally soon becomes conscious, and sometimes has not the least recollection of his suffer- ings, or of anything that passed during the paroxysm. Some patients, however, often lay in a stupid or coma- tose state for hours after the convulsions have subsided. The disease is caused by blows, fractures, and other injuries of the head by external violence ; hyperaema, or fullness of the vessels of the brain, arising from obstruc- tion in the circulation; water in the brain; tumors, concretions and polypus among the membranes of the brain ; malformation of the head ; and sudden frights, violent passions, drunkenness, intense pain, worms, teething, poisons, obstruction of accustomed evacua- tions, and hereditary predisposition, may also give rise to epilepsy. Treatment. — The convulsions will yield, with singular promptness, to the effects of the anti-spasmodic tinc- ture. This should be given in tea spoonful doses every five or ten minutes until relief be obtained. In the meantime, friction, with the use of some stimulating preparation, such as the rubefacient solution, or the bathing drops, should be applied to the extremities. FAINTING 159 Various preparations have been used to prevent the recurrence of the disease, among the best of which, are pills composed of equal parts of lobelia seed, cypripe- dium, and capsicum. Of these, the patient should take as many, once a day, as the stomach will bear without sickening too much. The pulverized seeds of the thorn- apple, in one grain doses twice a day, has gained great popularity as a remedy in epilepsy; but the medicine is not a safe one, being possessed of narcotic properties of a very active character. The leaves of this plant are milder, and when digested in vinegar, may be em- ployed pretty safely in small doses. The following makes a very good compound for com- mon use by epileptics : ~fy Paeony, .... 1 ounce, Skull-cap, .... 1 Valerian, (English,) 1 Assafoetida, . . . ^ Lobelia, . . . * ^ Stramonium leaves, \ Pulverize, and digest in three pints of good wine. The patient may take a table spoonful from one to three times a day. The practitioner should always inquire into the cause of the complaint, and if this can be discovered, it must be obviated, if possible; for no treatment will be suc- cessful while the exciting cause of the disease is con- tinued. Care as to diet is also necessary. FAINTING. {Syncope.) This affection is characterized by a partial or total cessation of the functions of the lungs and heart; thus the pulse is either very weak or entirely imperceptible, the respiration indistinct, the countenance pale, and the extremities cold. Fainting is generally brought on by loss of blood, or irregularities of its circulation, by which the brain is deprived of its usual and necessary stimulus, 160 DOMESTIC MEDICINE. and hence sudden and violent emotions of the mind fright, intense pain, &c, by suspending the functions of the heart, may also give rise to it. Treatment. — In many instances, the patient is relieved immediately by being placed in a recumbent position. Sometimes a sudden dash of cold water into the face will give relief. Stimulating the nostrils with volatile excitants, such as some of the preparations of ammonia, &c, are pretty certain to prove beneficial. In urgent cases of fainting, permanent stimulants are required, suc*h as capsicum, ginger, and carbonate of ammonia. Frictions with stimulating liniments are also sometimes of great service. FALLING OF THE RECTUM. {Prolapsus Ani.) This difficulty consists of a descent of the lower por- tion of the large intestine, so as to expose the bowel externally. When thus exposed, the parts become irri- table and painful, and often swell considerably. The difficulty arises from a relaxed condition of the parts, brought on, most generally, by the use of purges that spend their stimulating and relaxing influence exces- sively on this portion of the intestine. Aloes, in par- ticular, is very apt to bring on this difficulty. The most of the pills that are sold throughout the country, are also calculated to do mischief in this way. The people cannot be too careful about the use of public nostrums. The constitutions of thousands have been ruined for- ever by their use, while many others, for their impru- dence, have paid the forfeiture with their lives Treatment. — The parts sometimes return without assistance; but when this becomes necessary, it may be easily rendered by applying the fingers, previously oiled, to the protruding intestine, and gently pressing it back. Injections, made of such astringent articles as will not FELON. 161 irritate the bowels, should now be used to contract and stay the part. For this purpose, cranesbill, white pond- lily, witch-hazel, or raspberry, is very good. An infu- sion of these articles may also be applied externally by means of a sponge. Falling of the womb, (prolapsus uteri,) is also treated with the use of astringent injections to the parts, by means of a syringe for the purpose, which may be obtained at any drug-store. FELON. {Paronychia.) Abscesses of the fingers are variously called, accord- ing to their situation in the part affected, as to their depth from the surface. When they are situated in the dermis or true skin near the nail, they are commonly called runround, (tourniole ;) when in the cellular tissue, whitlow; and when in, or under the periosteum or mem- brane covering the bone, they are called felon. The abscess when thus situated in the finger, is in its essen- tial character, just the same as when affecting the tissues in other parts of the body; the attending pain and slowness of its course being caused by the firm- ness of the tissues implicated, which do not yield much to the swelling, nor yet so readily to the suppurating process. Treatment. — Various plans of treatment have been adopted for this painful disease. Some are of opinion that the least painful and quickest method, is to lay the finger open to the bone at once, in any stage of the disease after inflammation has fairly set in, and then treating it with poultices and salves till healed. Others employ various cataplasms, or soft and moist applica- tions, as slippery elm and ginger, or bread and milk, and other poultices, from the commencement, without the operation. These applications are sometimes alter- 11 162 DOMESTIC MEDICINE. nated with stimulating ones, as the dregs of myrrh, capsicum, lobelia, &c. But perhaps the best treatment is as follows : — Im- merse the finger in weak lye, contained in a vessel so as to admit of being heated. Let the lye be heated gradually, and let the finger be held in it as long as it can be borne, then apply the following: ]£ Common yellow clay, l£ ounces, Camphor, .... ^ ounce, Alcohol £ pint. Dry the clay perfectly and pulverize very finely, and adding a small quantity of the alcohol to the camphor, pulverize this also, and mix the two intimately; then add sufficient alcohol, and form into a paste of the consistence of common mortar. This is to be spread on a cloth, and tied around the finger closely. It will soon become dry, and will need to be frequently wet with the alcohol. This is to be kept on wet for several days, though it will give relief in less than an hour. After this there will be no more trouble with the felon. If the treatment is commenced previous to suppuration taking place, it will arrest the disease at once. If mat- ter is formed, it will be discharged with comparatively little pain, and the sore, by the application of some common healing salve, will soon heal. Steaming the hand over a decoction of wormwood, tansy, hops, and dog-fennel, will ease the intolerable pain of this and similar affections, in a short time. The part should be confined over the vapor. FLUX. {Dysentery.) Dysentery is a distressing disease affecting the bowels, and is characterized by frequent slimy or bloody discharges, griping pains, and distressing tenes- mus. The disease occurs generally during the latter part of the summer and autumn. FLUX. 163 Symptoms. — Dysentery usually sets in with a sense of lassitude, want of appetite, nausea, bad taste in the mouth, depressed pulse, slight chills alternating with flushes of heat, thirst, dry skin, and transient pains in the bowels. " Sometimes the disease comes on sud- denly with griping, mucous and bloody stools and tenes- mus, without any premonitory symptoms ; and this is most apt to be the case, when it arises from causes that act immediately on the mucous membrane of the intes- tines. In general the fever is developed before the proper dysenteric symptoms show themselves ; some- times more or less diarrhoea, with tormina, [severe pain,] precede the occurrence of the febrile irritation ; and occasionally mucous and bloody stools with tenes- mus, [ineffectual straining at stool,] are the first symp- toms. From the commencement of the disease, through- out its whole course, little or no faeces [natural stools] are discharged spontaneously ; the stools consisting entirely of intestinal mucus, mixed with more or less blood. Tenesmus is one of the most constant and characteristic attendants on this affection ; and the vio- lence of this painful symptom, affords us a pretty accu- rate measure of the violence and degree of danger of the disease. There is often considerable pain and dif- ficulty experienced in voiding urine. The tormina are extremely violent and distressing, particularly just be- fore the urgent calls to stool are experienced ; and a constant soreness is felt in the abdomen. Sometimes the stools consist almost entirely of intestinal mucus, very little or no blood being mixed with it. In most instances, however, a considerable portion of blood is discharged with the mucus, and in some cases the evacuations consist almost wholly of blood. These dysenteric discharges usually have a very peculiar dis- agreeable smell, but no fetor in the beginning of the disease ; but in the advanced period of violent and dangerous cases, they frequently possess a pungent and cadaverous smell ; and often acquire a corroding and sanious character." — (Eberle.) Treatment. — The author has had much experience in the treatment of dysenteries, and consequently fa- vorable opportunities of testing all the most popular 164 DOMESTIC MEDICINE. plans that have been proposed; but the following, in his hands, has proved decidedly the most successful : — Give to an adult a large tea spoonful of the neutral- izing mixture, once in every two hours, until the bowels are well cleansed, which may be known by the change of the stools, and the relief the patient gains from the effects of the medicine ; then give the following : ft Extract Bayberry, } Camphor, > Equal parts. Carbonate Ammonia, ) Pulverize finely and mix. Dose, five grains repeated every time the bowels move. When this is not at hand, let the patient drink freely of a strong infusion, made by scalding either two ounces of astringent tonic, bayberry, or cranesbill, in a quart of soft water, adding (after straining it) four table spoonfuls of white sugar, a gill of brandy, and an ounce of compound tincture of myrrh. This preparation, if taken in wine glassful doses every two hours, after the neutralizing mixture has done its work, will in most instances soon relieve the looseness. As soon as the bowels are relieved, tonic cordials, or even the cholera syrup, should be used until the patient is entirely restored. Enemas. — Astringent injections are of incalculable advantage in the treatment of dysenteries, and should never be neglected in the more difficult cases ; they restrain the blood, and adstringe the inner coats of the bowels, so as to prevent the escape of the fluids into the intestines. By the use of these means in dysen- tery, the medicine is applied more directly to the parta suffering most, and hence it may be expected that it will do more good than if used in another way. Diaphoretics. — In this disease the cutaneous exha- lents are very inactive, the matter usually passing off in this way, is now discharged through the bowels, by the laws of vicarious action. To restore the excretions of the skin, therefore, becomes a great desideratum. The common diaphoretic powders here answer an ex- cellent purpose, and should be used freely. Rubefa- IRACTURES. 165 cients are also very beneficial, they detract the deter- mining powers to the surface. Stimulating fomentations to the bowels are indicated, when the dysenteric inflammation runs high. FRACTURES. Fracture, in surgery, means a division or broken condition of a bone, arising from violence. " Fractures are either simple or compound : according as they are accompanied with an external wound, com- municating with the ends of the bones, or otherwise. " If the bone is broken in two or more pieces, and there is not an external wound communicating with the fractured edges of the bone, the fracture is still called simple; and, on the other hand, if the bone is broken in but one place, and there is an outward wound, the accident is called a compound fracture." — {Castle.) External wounds occurring with fractures, although they may be extensive, do not make the fracture a compound one. unless the injuries are connected. When fractures are attended with diseases or acci- dents, which render the indications in the treatment more numerous ; that is, when the treatment neces- sarily becomes complicated, requiring various opera- tions or different remedies, the accident is called compli- cated fracture. Symptoms. — In the long bones, the existence of frac- ture is sometimes known at once, by the position in which the limb is found, as this is often distorted or out of its natural shape between the joints, so as to make the diagnosis clear. The crepitus or cracking noise in moving the parts ; the change in their form and length ; and when the bone is superficial, the inequalities or unevenness of its surface are all pretty sure signs of fracture. The ina- bility to use the parts, and the deep-seated pain and swelling, may result from dislocation. Dislocations 166 DOMESTIC MEDICINE. also, sometimes cause quite a crepitation when the parts are moved, owing to the changed condition of the synovial fluid. Treatment. — The most important things to be done in the treatment of fractures, are to adjust the parts properly, and then to keep them so, long enough for the reunion of the bones. The first thing to be done, is to relax the muscles of the parts concerned. This may be done either by the use of frequent doses of lobelia, or the antispasmodic tincture, or by means of the vapor bath. But the best plan is to employ those means conjointly. If the vapor bath cannot be conveniently applied, the entire limb or part should be enveloped in sheets or large cloths wrung out of hot water, which must be renewed as often as they cool off, until the muscles are completely relaxed. This being done, the limb must be put in such a position as will slacken the muscles alike on every side, and then the bone should be replaced into its natural position. To effect this, a little extension is generally necessary.* When the bone is properly adjusted, the next object is to keep it in that position. For this purpose, splints, wrappings, or bandages, &c, are necessary. In the line of splints, an infinite number and varieties of pat- terns have been proposed, and it is now hardly known whose invention answers the best purpose. When the fracture is situated near the middle of any of the long bones, a few simple pieces of shingle, or even strips of stiff pasteboard, will answer very well in the ab- sence of anything better. The edges of the splints must, however, be smoothly trimmed off, or the parts well protected by wrappings, so as to prevent injury to the soft parts by the swelling that may take place after the application. A very good apparatus of the splint kind, may be made of some strips of woolen cloth, by applying to * The force applied in extension, and counterextension, by some of our surgeons who are unacquainted with the relaxing power of steam and lobelia, is a disgrace to the profession. The author has a knowledge of a number of instances, in which irreparable injury was done thereby. FRACTURES. 167 them some gum shellac dissolved in alcohol. These strips, although made very hard and stiff by the shellac, may be rendered quite pliable by holding it a few mo- ments before a fire, or by placing it in hot water for an instant. While in this state, these strips may be ap- plied to the parts, and very neatly molded to the shape of the limb, and as soon as the gum in the cloth gets cold, it will be firm and unyielding as before it •Was exposed to the heat, and hence if two or three of them are well applied in this manner around the frac- tured limb, they will keep it secure. After the splints are applied, the only remaining particular in the treatment will be, to secure undis- turbed rest to the injured part, until it shall have had time enough to recover sufficient strength to support itself. Should there be much heat and fever about the frac- ture, after the splints are applied, it may be relieved by the application of cold water or vinegar. Treatment of Compound Fractures. — The bones in compound fractures are often forced into the ground, and thus in reducing them make it necessary to clean them carefully, before they are returned. For this purpose a sponge with warm water should be used. In reducing compound fractures, the greatest care must be taken not to let any foreign substance remain in the wound among the bones, as it will become a source of protracted irritation and ulceration. All loose splinters and small pieces of bone should be carefully removed with a suitable pair of forceps. After the bones are properly adjusted and secured, the wound in the soft parts should be treated, in the main, like any other fresh wound. The medical treatment in fractures, in addition to the relaxing means, consists in the use of such articles as are calculated to sustain an equal and uninterrupted circulation, and to keep up the vital powers. The dia- phoretic powders are a very good medicine to be used as an occasional drink. The bowels should be kept regular, but the patient must not be purged. The muscles must be kept in a quiet state by the use of the nervine tonic, but if this should not calm the 168 DOMESTIC MEDICINE. twitching that sometimes comes on, the lobelia, or blue cohosh should be used in proper doses, in connection with the nervine tonic. The natural phenomena in the restoration of frac- tures, is strikingly illustrative of instinctive vital action In these accidents the contiguous parts are always more or less lacerated ; the medulla, (mari-ow,) medul- lary membrane, periosteum, {membranous covering of the bone,) cellular tissue, and muscles, are always injured to some extent. Bleeding from the ruptured vessels ensues, which surrounds the fragments, passes into the cavities of the bones ; and permeates the surrounding cellular tissues ; whereupon inflammation takes place in all the parts, which may be considered the first step toward a cure. The cellular tissue that immediately surrounds the bone, now becomes very vascular, is somewhat thickened, loses its elasticity, and acquires a considerable degree of consistence. A number of irreg- ular processes are sent out from this to the surround- ing muscles, which adapt themselves to the design, and in common with the periosteum, (which is also very much thickened and very vascular,) join in the formation of a kind of provisional callus or envelop, around and exterior to the fractured ends of the bone. The me- dullary membrane, (if the bone be hollow,) forms a process of cartilaginous, or rather a fibro-cartilaginous substance, which fills up the whole cavity of the in- tended new bone, from above till below the fracture. Between these two walls of provisional callus, is now deposited a viscous or gelatinous fluid, which gradu- ally assumes a reddish or rose-colored appearance, and adheres by its margins to this mold or provisional callus. From the twentieth to the fortieth day, (de- pending on age and other circumstances,) this gelatinous substance, thrown out between the ends of the bones, begins to ossify, (turn to bone.) Before this time, how- ever, the extravasated blood is absorbed, and the mus- cles surrounding the external callus, have also become considerably liberated, and as the new part of the bone acquires solidity, the provisional callus becomes ab- sorbed, thus leaving the parts in their original condition FRENCH MEASLES. GOITRE. 169 FRENCH MEASLES. {Roseola.) This complaint, which is sometimes called false measles, is characterized by rose-colored spots of various forms unattended by swelling or pimples, but occasion- ally preceded or accompanied by fever. These efflo- rescences may occur over the whole surface of the body, but are commonly confined to one or more parts. The complaint generally runs its course in from two to eight days. The affections with which this is most likely to be confounded are measles and scarlet fever. This may, however, be distinguished from measles, by the size and appearance of its eruptions, which are much larger than those of that disease; and, what is more, the catarrhal symptoms are not generally so prominent in this, as in measles. It may be distinguished from scar- let fever, by the irregularly diffused raspberry efflores- cence and tumefaction that characterize the latter French measles is not generally considered contagious. Treatment. — Mild aperients, such as the man root, narrow dock root, and white root, given in the form of teas for several days, will generally be all that is required in this, comparatively, mild affection. Rest and appropriate diet will also favor the cure. GOITRE. (Bronchocele.) This affection is characterized by an enlargement of ae thyroid gland, and is commonly called the big neck. :he swelling commences on both sides of the larynx . ind trachea, with the appearance of a spongy tumor, ./hich increases at first very slowly or imperceptibly, >, ut, after a number of years, sometimes becomes t lormously large. 170 DOMESTIC MEDICINE. Bronchocele is seldom attended with pain, or any other inconvenience except its bulk, unless it gets very large, when there is often not only the attendance of pain, but there is also a considerable difficulty of respi- ration in some cases. Females are more subject to the disease than males Treatment. — A compound made of equal parts of the soft extract of yellow willow, stimulating liniment, and pulverized salt, if applied with friction three times a day, will generally remove the difficulty. The iodine ointment, however, is perhaps entitled to as much con- fidence as any other single article, in the treatment of bronchocele. It should be applied in small quantities, with friction, once a day. In the treatment of this affection, perseverance is necessary. GOUT. (Arthritis.) Gout is an inflammatory affection of the fibrous and ligamentous parts of the joints. It usually first attacks the great toe, and from this it passes to the other toes, the joints of the fingers, and sometimes to the larger articulations. This is a very distressing disease, being attended with severe pain, which gives rise to numerous sympa- thetic affections. The stomach is most apt to become affected with sympathy, and hence gout is attended with indigestion and its accompanying symptoms. The disease usually comes on by paroxysms, lasting, sometimes, for a number of weeks, with but: little abate- ment in its violence. It is supposed that the inflamma- tory action, in some instances, also involves the muscles and internal organs, that sympathize with the affected articulations, and hence the disease is variously called, retrograde gout, misplaced gout, anomalous gout, &c, according to the location or shifting of the pain. GRAVEL AND STONE. 171 Chalk-like formations occur in those joints long affected by the gout, and it has been supposed that this is the essential peculiarity of the disease. Treatment. — Inflammatory affections of the ligaments and other parts about the articulations, are generally pretty hard to relieve, being so remotely situated from the general circulation. Thorough courses of the vapor baths and emetics, administered every day, or every second day, as the urgency of the case may require, are the only means that have yet been found to give relief with anything like promptness. Iji Guiacum resin, . 1 drachm, Botrophin, . . 5 grains. Pulverize and mix. Ten grains of this, taken every two hours till it purges, proves serviceable in many cases. Local Means. — A slippery elm poultice, with some pulverized lobelia seed and capsicum, sprinkled over the surface, and applied to the affected parts, will gen- erally be beneficial. For this purpose, the rubefacient oil is very good, and its use should, therefore, not be neglected. Bathing the feet in a strong decoction of the black cohosh, as hot as it can be borne, will be found very serviceable, especially when the disease is located ir the feet. GRAVEL AND STONE. ( Calculus.) We understand by gravel, small sand-like concretions, which form in the kidneys, and pass through the ureters into the bladder, and thence from the system with the urine. The stone is a collection of the same substance into a larger bulk. These sometimes pass off in large sizes, and thus produce extreme pain and suffering When too large to pass through the erethra, they will 172 DOMESTIC MEDICINE. lay in the neck of the bladder, and thus produce great irritation of the parts, by obstructing the urine. As the water accumulates in the bladder, the patient becomes pressed with a distressing inclination to urinate; but this can be voided only in small quantities — sometimes only drop by drop. It is thought by some, that the disposition of the sys- tem to form gravel or the sand-like concretions, is not favorable to the formation of stone ; that is, those who discharge gravel are seldom troubled with the stone or larger formations. Treatment. — Alkaline preparations are mostly de- pended on in the treatment of gravelly complaints, and they are, in general, useful. The disposition of the urine to favor these formations, is, in the majority of instances, dependent on the agency of Uthic acid. The alkalies may, therefore, do much to obviate the chemi- cal phenomena producing these morbid concretions. There is, however, one variety of these concretions, in which earthy phosphates seem to constitute the material. In the treatment of this variety, the alkalies will not only prove useless, but may, indeed, ultimately enhance the difficulty. The diagnosis or symptoms distinguishing between these varieties of gravel, although very important, are somewhat obscure. The sediment or deposits in the urine, afford us the principal means of gaining a know- ledge on this point; when they are colored, that is, if they are red, yellowish, or brown, they are caused by the predominance of acid ; but when they are pale, or white, they consist chiefly of earthy phosphates. When there is a discharge of the sand-like material, or of a calculus, our diagnostics are still better. All the red, brown and yellowish appearing concre- tions, as a general rule, demand in their treatment the use of alkalies. In earthy phosphate concretions, or those of a pale or whitish color resembling chalk both in appearance and consistence, are managed best by the use of diluted muriatic acid. Perhaps the best way to take the acid, is to first drop it into a glass with some slippery elm water : the dose is from ten to fifteen drops three or four times a day. GRAVEL AND STONE. 173 Soda and subcarbonate of potash, are the alkalies generally used in the treatment of gravelly complaints: they may be given in tea spoonful doses, two or three times a day. Diuretics. — This class of agents is also of value in the treatment of gravelly affections ; for, while diuretics tavor the escape of the concretions, they also attenuate or weaken the chemical agencies causing them, by the increase of fresh and unimpregnated urinary secretions that they produce. The queen of the meadow, (Eup. Pur.,) in the hands of the author, has given the most encouraging evidence of its utility in these affections. The medicine should be freely used in strong decoction. The juice of the garden radish has gained some popu- larity for its supposed power of dissolving stone in the bladder. The mode of its use is by injection through a catheter. Injections. — Fourcroy introduced a practice (which has now, however, fallen somewhat into disrepute) of injecting lithontriptics into the bladder, by means of a catheter and suitable syringe. The agents, in this case, consist of acids and alkalies, soda, saleratus, and the muriatic and nitric acids. They are administered according to the indications above named. The blad- der is first to be emptied, and then the preparation, about as strong as can be held in the mouth or swal- lowed, is to be injected in suitable quantities. The recent juice of the convulvulus panduratus, injected into the bladder, is said to dissolve the stone in the bladder. Tonics and Diet. — These concretions are not formed according to the physiological laws, but are the result of a morbific influence. Whatever, therefore, can be done to tone up and strengthen the system, will be of paramount importance in these cases. Columba root, peach leaves, poplar bark, &c, are all good, and should be used, especially in cases attended with much debility. The food and drink, which alone afford the materials constituting these morbid concretions, ought to be selected with reference to ' this circumstance. People 174 DOMESTIC MEDICINE. that are troubled with gravelly complaints, should endeavor to discover in what particulars their food differs from that of others, and in every deviation a change ought to be made. HEADACHE. ( Cephalalgia.) Pain in the head is seldom found to exist independ- ently of some other derangement of the system. It is a usual attendant of all febrile diseases, foul or disor- dered condition of the stomach, and constipation of the bowels. Headache is also brought on by over-eating, drinking spirits, colds, intense solar heat, hard study, &c. When the headache is very severe and protracted, and attended by sickness at the stomach, with vomiting, the affection is called sick-headache. Treatment. — The pain will generally yield to the means employed to remove those affections or diseases that give rise to the headache; but when it becomes necessary to do something directly for the relief of the head, a cloth wet with ether or cold water should be tied around the forehead, while th« feet, after being bathed with the rubefacient wash, must be placed in a pail of water as hot as can be borne. The heat of the water should be kept up by adding boiling water to it as it may be needed. By these means, the head will be relieved from the mechanical pressure of the circula- tion, and thus ease may be obtained. Sinapisms applied to the feet and ankles, and left tc remain until considerable irritation is produced, will mostly afford relief. EmeticS. — In severe cases, the patient must take a lobelia emetic, as this usually affords prompt relief. This is effected through the remarkable sympathy there is between the stomach and the head. When the head- ache is caused by over-eating or a foul stomach, an HEARTBURN. 175 emetic is indispensable. Nauseating doses of lobelia will frequently relieve headache. Liniment. — In that variety called nervous headache, the stimulating liniment will generally afford relief: the good effects of the liniment may be promoted by drinking a tea of the nervine tonic. Cathartics. — Medicines of this class will generally alleviate the headache; but it is not a good plan to use them much for this purpose, as the relief is obtained at too great a sacrifice. When the pain arises as an effect of constipation, the bowels should be relieved by the use of enemas, instead of cathartics. Nevertheless, it is sometimes the case that the latter are indicated: when there is much biliary derangement connected with obstinate constipation, one grain of the extract of mandrake should be taken every two hours, until three grains are taken : should it not operate within twelve hours, one or two more doses must be taken. The common cathartic pills are usually taken for this pur- pose, but are not quite so good. HEARTBURN. {Ardor Ventriculi.) The difficulty known by this name, consists of a burn- ing and gnawing pain in the stomach, accompanied with sour eructations and occasional nausea. It depends upon the souring or fermentation of the food in the stomach, and hence is a common symptom of dyspepsia. Treatment. — Alkalies, such as soda, saleratus, and particularly magnesia, will generally give immediate relief. But these means must be considered only as palliatives ; for, as the difficulty arises from a debilitated condition of the stomach, permanent relief can, in rea- son, only be expected in the use of such means as are 176 DOMESTIC MEDICINE. calculated to strengthen the stomach and thus promote digestion. Capsicum, taken with the food in small quantities, will be found very good for this purpose. The spiced bitters should also be taken once a day. Regimen. — The proper treatment of heartburn con- sists mostly of negative means. The patient should be careful to avoid the use of all kinds of food that are hard of digestion, and that disagree with the stomach: he should be very particular not to eat too much at a time, of any kind of food, as this practice is very ruinous to the stomach. The food should always be well mas- ticated, and eaten slowly. Small quantities of lean animal food, such as beefsteak and mutton, will gener- ally agree with persons troubled with heartburn. HYSTERICS. {Hysteria.') The disease called hysteria, chiefly implicates the ner- vous system, but has received its name from the idea of its arising from an affection of the uterus. Females are most subject to it, but well marked cases are some- times met with among males. " The complaint appears under such a variety of shapes, imitates so many other diseases, and is attended with such a variety of symptoms, which denote the animal and vital functions to be considerably disordered, that it is difficult to give a just character or definition of it; and it is only by taking an assemblage of all its appearances, that Ave can convey a proper idea of it to others. The disease attacks in paroxysms or fits. These are sometimes preceded by dejection of spirits ; anxiety at the stomach, and palpitation at the heart ; but it more usually happens, that a pain is felt in the left side, about the flexion of the colon, with a sense of distension advancing upward, till it gets into the stomach ; and removing from thence into the throat, it occasions, by its pressure, a sensation as if a ball was HYSTERICS. 177 lodged there, which by authors has been called globus hystericus. The disease having arrived at this hight, the patient appears to be threatened with suffocation, becomes faint, and is affected with stupor and insensi- bility ; while, at the same time, the trunk of the body is turned to and fro, the limbs are variously agitated; wild and irregular actions take place in alternate fits of laughter, crying and screaming; incoherent expressions are uttered ; a temporary delirium prevails, and a frothy saliva is discharged from the mouth. The spasms at length abating, a quantity of wind is evacuated upward, with frequent sighing and sobbing, and the patient recovers the exercise of sense and motion [sometimes] without any recollection of what has taken place during the fit — feeling, however, a severe pain in the head, and a soreness over the whole body. In some cases, there is little or no convulsive motion, and the person lies seemingly in a state of profound sleep, without either sense or motion. Hiccough is a symptom which likewise attends, in some instances, on hysteria; and now and then it happens that a fit of hysteria consists of this alone. In some cases of this nature, it has been known to continue for two or three days, during which it frequently seems as if it would suffocate the patient, and proceeds, gradually weakening the consti- tution, till it either goes off, or else occasions death by suffocation; but this last is extremely rare. Besides hiccough; other spasmodic affections sometimes wholly form a fit of hysterics, which perhaps continue for a day or two, and then either go off of themselves, or are removed by the aid of medicine. In some cases, the patient is attacked with violent pains in the back, which extend from the spine to the sternum, and at length become fixed upon the region of the stomach, being evidently of a spasmodic nature, and often pre- vailing in so high a degree as to cause clammy sweats; a pale, cadaverous look, coldness of the extremities, and a pulse hardly perceptible." With these symptoms there is frequently quite a disturbed state of the mind, and extravagant ideas of various dreadful diseases affecting the body, harass the patient. Hysteric fits are, however, sometimes mild in their attack, the patient often experiencing only a slight 12 178 DOMESTIC MEDICINE. oppression at the stomach, attended with anxiety of mind and a sense of heat in the body. Persons of weak and nervous habits are most subject to hysterics ; and in those, the attacks are excited or brought on, frequently, by sudden emotions of the mind, as by sudden joy, grief, fear, &c, and from this circum- stance the poor sufferer is often treated with neglect, and the most uncivil indifference, from the idea that the patient brings on the disease unnecessarily, that is, that it might have been avoided by a proper exercise of the mind. This has associated such an abhorrence with the name, that many are offended to be considered sub- jects of the disease. There are, however, many cases of hysterics, in which the disease is so intimately asso- ciated with a morbid predisposition of the organism, that the strongest mind is insufficient successfully to repel it — nay, when, in addition to this, medicine some- times fails. Treatment. — The treatment, in the paroxysm, must be commenced by the use of two or three doses of the an ti- spasmodic tincture, which, after the spasms are relieved, should be followed up with a strong tea of the nervine tonic. The following tincture is an excellent medicine for this complaint : ]jfc English Valerian, 1 ounce, Assafoetida, . . 1 " Skull-cap, . . £ " Alcohol, ... 1 pint. Pulverize, and digest in the alcohol for ten days, and strain ; or, for immediate use, the powders may be boiled in alcohol for ten minutes, and strained when it is fit for use. The dose is from a tea spoonful to a table spoonful. A tea spoonful will do well when the use of the medi- cine is first commenced; but as the patient becomes accustomed to it, the dose must be Increased. This is so excellent a medicine for this complaint, that hyster- ical patients, when they once become accustomed to it, will never be without it. INDIGESTION. 179 INDIGESTION. {Dyspepsia.) Dyspepsia, strictly speaking, is only a symptom of disease, as it only implies difficulty of digestion, which is an attendant or effect of nearly all diseases. The stomach, which is the principal organ of digestion, is, as it were, the centre of sympathies, and thus may be reached by a great variety of morbific influences. In chronic inflammation of the mucous surface of the stomach and upper part of the intestines, we witness a train of symptoms that come the nearest filling the description generally given of dyspepsia. There is a pain and burning in the stomach, with nausea and occasional vomiting; nidorus eructations; raising of sour food and fluids of a disagreeable acrid taste; heartburn ; waterbrash ; constipation of the bowels ; clamminess of the mouth ; foulness of the tongue ; flatulency; palpitation; epigastric pulsation; general debility; dizziness, and sometimes fainting; lassitude and low spirits. The appetite is generally poor, but sometimes voracious. A full meal, and even some- times a very small one, will lay heavily on the stom- ach, especially if the things eaten are hard of diges- tion, such as warm, heavy bread, fat meats, and certain kinds of vegetables. When the disease extends through the upper part of the intestines, there is generally considerable derange- ment among the hepatic and biliary organs. It must be observed that the mucous surfaces, from the nature of their use, cannot be favored with the pro- tection of an epidermis, as is nearly every other sur- face of the entire system ; but the nerves and vessels with which these organs are so abundantly supplied, are invested only with a membrane of the most delicate structure. When, in view of this extreme delicacy, it is considered that the human stomach is the devoted receptacle of all that is called for by our depraved ap- petites, which are only governed by the capriciousness of an imagination stimulated by the corrupt fashions of our day ; and what is worse, fashion, by its magic in- 180 DOMESTIC MEDICINE. fluence, has led us to impose upon our stomachs ser- vices so unnatural and incongruous, as to make of them a kind of portable apothecary's shop, or dispensary, where drugs of every kind are kept, even without bottles or envelops, for distribution ; it will then not seem strange that inflammation of the mucous mem- brane of this organ should be of such frequent occur- rence. There can be but little doubt that dyspepsia, in the large majority of cases, is produced by inflammation of the gastro- enteric mucous melnbrane. Dr. Eberle remarks:* — "The worst forms of dyspepsia, and all that host of inveterate gastric and bilious disorders of which so much is heard, and the true nature of which is so often misunderstood, are, in nine cases out of ten, the consequences of a chronic inflammatory condition of the lining membrane of the stomach. The slow and insidious progress of this grade of gastric inflam- mation during its early period, is indeed well calculated to elude observation, and to lead to a misapprehension of its true character." Dunglison writes to the same import; and Dr. Stokes in his lectures,! speaking of chronic gastritis, makes it the chief cause of dyspepsia; he remarks; — It [chronic gastritis] is commonly called dyspepsia, and this term, loose and unlimited in its acceptation, often proves a stumbling-block to the stu- dent in medicine. Dyspepsia, you know, [speaking to his class,] means difficult digestion, a circumstance which may depend on many causes, but perhaps on none more frequently than upon chronic gastritis. * * Long continued functional lesion will event- ually produce more or less organic disease ; and you will find that in most cases of old dyspepsia, there is more or less gastritis. But let us go further, and in- quire whether those views are borne out by the ordi- nary treatment of dyspeptic cases. When you open a book on the practice of physic, and turn to the article dyspepsia, one of the first things which strikes you, is the vast number of cures for indigestion. The more incurable a disease is, and the less we know of its * Practice, vol. I, page 218. i Stokes and Bell's Practice, second edition, vol. I, page 125. INDIGESTION. 181 treatment, the more numerous is the list of remedies, and the more empirical is its treatment. Now the cir- cumstance of having a great variety of "cures" for a disease, is a strong proof, either that there is no real remedy for it, or that its nature is very little under- stood. A patient afflicted with dyspepsia will gener- ally run through a variety of treatment ; he will be ordered bark by one practitioner, mercury by another, purgatives by a third ; in fact, he will be subjected to every form of treatment. Now all this is proof posi- tive that the disease is not sufficiently understood. What does pathology teach in such cases ? In almost every instance where patients have died with symp- toms of dyspepsia, pathological anatomy proves the stomach to be in a state of demonstrable disease. It appears, therefore, that whether we look at the uncer- tainty and vacillations of treatment, or the results of anatomical examinations, the case is still the same ; and that, where dyspepsia has been of considerable duration, the chance is that there is more or less or- ganic disease, and that, if we prescribe for dyspepsia, neglecting this, we are very likely to do mischief." Whatever may be the extent of the inflammation of the mucous membrane of the stomach and bowels, it will be invariably found to be attended with a corres- ponding suspension of the function of digestion. When the inflammation runs high, it generally happens that if food be taken, however agreeable in character, it is thrown up immediately from the stomach by vomiting, or it will pass into the bowels and be finally discharged without any signs of digestion. When the inflamma- tion is less active, i. e., chronic gastro-enteritis, we have all the varieties of symptoms and grades of indiges- tion, from the most distressing dyspepsia, down to the slightest and most transient want of appetite. Cause. — Although dyspepsia may result from almost any cause of disease, yet, as already shown, it is most frequently brought on by the common causes of inflam- mation of the mucous coat of the stomach ; as by ex- cesses in eating and drinking ; unwholesome food , intense mental application; sedentary habits, &c. 182 DOMESTIC MEDICINE. But one of the most deplorable sources of gastric difficulties, is the use of poisonous drugs as medicine, which are now given for the slightest derangements of the system. Treatment. — The first thing to be done in the treat- ment of dyspepsia, is to discover, if possible, by what irregularity of habit or circumstances of exposure the difficulty was brought on, and then efforts should be made to remove at once, if practicable, the cause or causes of the disease. The second indication is, to cleanse the system ; and here it is to be observed, that to operate on the stomach alone, is not sufficient, although the primary affection may be here, for when the disease is once established in the stomach, the functions of all the other organs will be more or less impaired. We find that there is not only want of action in the stomach, but that the bowels move slowly, or at least very irregularly; that chylific absorption and the circulation are very lan- guid; nor are the excretions more rapid. Obstructions so universal, need a general process of cleansing. For this purpose, a course of emetics, baths, frictions, and enemas, is most eminently adapted. This part of the treatment, if the case be difficult, should be commenced, first by the use of the diaplwretic powders for a few hours, while the preparations for a bath are progressing. As soon as the skin becomes moist, a lobelia emetic should be administered and sus- tained during its operation, by stimulants, relaxents, astringents, or alkalies, as the case may require. When the emetic is done operating, the patient, after eating a little of some appropriate food, should be well rubbed with a towel wrung out of cold water, and have an enema, composed of a strong decoction of thorough- wort and poplar bark, or of the laxative bitter tonic, with a small portion of capsicum, or of the compound tincture of myrrh. This course should be practised every second, third, or fourth day, according to the urgency of the symp- toms, using laxatives, diaphoretics, tonics, and rubefa- cients, in the intervals, until the disease is broken up. In less obstinate cases, the several parts of this course INDIGESTION. 183 may be used separately or alone, ana* repeated as occa- sion may require ; observing also the plan of using an appropriate intermediate treatment. As soon as the disease is found to yield, the use of tonics should be instituted ; for this purpose the cascar- illa is an excellent article, but if this is not at hand, any of the restorative preparations recommended among the compounds or the simple tonics in the Materia Medica, will answer very well. During the course of the treatment, the various inci- dental and local symptoms should have appropriate attention ; thus the acidity of the stomach may be ob- viated by the use of a little carbonate of soda or sub- carbonate of potassa (saleralus.) Colic pains may be relieved by carminatives, stimulants, and anod} nes. Fine charcoal, taken in table spoonful doses several times a day, is very good, not only to keep the bowels open, but to prevent acidity of the stomach ; it may be prepared by scalding it in milk. Capsicum. — This is an excellent article in dyspep- sia, and should be u^sed in half tea spoonful doses, three times a day, or oftener. This medicine is a pure excitant, and will stimulate the living organs to the performance of their natural functions. Made into pills with equal parts of beef's gall, dried sufficiently to form into pills, and taken in the quantity of a com- mon sized pill every evening, will not only be of eminent service to the stomach, but will keep the bowels regular. 184 DOMESTIC MEDICINE. INVAGINATION OP THE INTESTINES. (Intussusceptio.) Intussusception is a disease of the intestines, in which one portion of the tube is introduced into another, as represented in the following cut: All parts of the bowels are sub- ject to this derangement, but the small intestines, particularly the ileum, are found most prone to it. The length of the intestine thus invaginated, is usually only a few inches ; but cases are recorded, in which several feet were involved. The number of these invagina- tions in a single case, is generally but one; but it happens some- times, that in the course of the intestine, as. many as two, three, or even half a dozen, occur at a time. The part thus incarcerated, if not relieved by the force of the muscular fibres of the surrounding por- tion of the intestine, some fortunate motion of the body, or the effects of medicine, may contract adhesions to the surrounding portion, and remain in this way, or it may die and separate from the living portion, and pass off from the system. This must, however, be consid- ered a very dangerous accident, as many suffering from it, die in the course of from eight to twelve days. The symptoms of this disease resemble those of inflamma- tion of the bowels or peritoneum so much, that it is hard to distinguish it from them ; but when these symptoms prove unusually obstinate, intussusception may generally be suspected. The greatest distinguish- ing mark that we have, is that this disease is not pre- ceded by the usual premonitory symptoms of those other affections, the pain coming on suddenly, and being soon followed with rumbling of the bowels. Small children are most subject to many of the intestinal diseases, and it is supposed that nine-tenths INVAGINATION OF THE INTESTINES. 195 of the cases that occur of this kind, are found among them. The cause of the difficulty is supposed to be irregular or spasmodic contractions of the intestines, in which one portion contracts while the adjoining part is re- laxed, and thus receives it. It may be proper to remark, that while this explana- tion of the manner in which the derangement takes place seems very reasonable, it is altogether probable that the irritation produced by unnatural and poison- ous medicines, may, in many instances, give rise to these irregular or spasmodic contractions, and thus be the primary cause of this terrible disease. Treatment. — Injections of lobelia and capsicum tea, of proper strength, promise more in this affection than any other means. The injections must be repeated until the system is completely relaxed ; and after this, if relief is not obtained, the next plan will be to crowd the bowels as much as possible, with thick slippery elm mucilage. With a view to the best effects of this means, the patient must endeavor to retain as much of the injected material as possible. The anus may also be secured by an assistant, or by means of bandages. For the purpose of carrying up the injected material as far as possible, it may be advisable to use a bogie, which may be introduced as far as the sigmoid flexure at least, and then the material may be injected through it. Injecting or forcing wind into the bowels, has also been recommended by some writers. This may be effected by the use of a common bellows, the point of which may be introduced into the rectum, or it may be forced into the bogie, and the wind thus blown into the bowels. 186 DOMESTIC MEDICINE. JAUNDICE. {Icterus.) Jaundice is occasioned by an obstruction of the course of the bile, which is consequently taken up by absorp- tion, and thus carried into the circulation; and hence, by its diffusion into the capillary vessels, stains the skin, eyes, mouth, throat, urine, &c, (being the only places in which it can be seen, although affecting the whole body just as much,) with a deep yellow. This obstruction of the bile may arise from the pres- ence of calculi in the gall-bladder, from inflammation of its duct or even the liver itself. The obstruction may also be produced by constipation of the bowels, external injuries, and mental emotions. The attending symptoms are loss of appetite, dys- pepsia, vertigo, nausea and perhaps vomiting, flatu- lency, and great dejection of spirits. Treatment. — The treatment, in this complaint, should be commenced by taking a pill composed of equal parts of podophyllin and the extract of dandelion, every two hours until a cathartic effect is produced. This com- pound seems to have a specific action on the glandular system, and will generally reach the liver, stimulating it to a healthy action. If the stomach is much disturbed, an emetic of lobelia may be necessary. As soon as the intestinal canal is cleansed, and the functions of the biliary system are restored, it will be necessary to remove the bilious mat- ter from the circulatory and capillary systems. This may now be done, by the use of diaphoretics, aided, if necessary, by the vapor bath. "When the system is well cleansed, the organs may be toned up by the use of tonics, such as the yellow parilla, cascarilla, colomba, &c. The laxative bitters is an invaluable medicine in this disease, and should be used freely. The yelk of eggs has been highly esteemed as a remedy in jaundice. It is to be taken raw, on an empty stomach. LEPROSY. 187 The extract of dogwood bark is also highly prized in this disease. LEPROSY. {Lepra.) There are several varieties of leprosy, some of which are common to this country. "What are called, by authors, lepra vulgaris, lepra alphos, and lepra nigricans, are scaly affections of the skin, which, although divided into three varieties, consist essentially of the same disease. The leprosy of our country makes its appearance in circular scaly eruptions, usually on the elbows and knees, but spreads afterward over the other parts of the body. The first variety (lepra vulgaris) consists of round patches of scales, that accumulate in thick crusts, which, if removed, will be quickly reproduced. The disease, commencing at the knees and elbows, passes from those parts to the body, where it may spread over a large surface. The second variety (lepra alphos) does not spread so extensively as the first, and it differs, also, somewhat, in the face of the eruption: in this, the cen- tre of the patches is depressed, and as the patches enlarge, it (the centre) will frequently heal up, and thus recover the natural appearance. The third variety (lepra nigricans) is distinguished from the other varieties by the color of the patches, and the facility with which the scales may be removed. The color of the scales is dark or purple ; they are easily removed ; and as the skin under them comes to view, it is likewise found of a dark color: it remains bare much longer than in the other varieties, and is covered with a thin coat of bloody lymph. The scaly leprosy seldom makes its appearance on the face, but is sometimes known to occupy the hairy scalp, and to affect even the nails of the fingers and toes, which become spongy, as it were, and assume a narrow and roundish shape not unlike the claws of a fowl. 188 DOMESTIC MEDICINE. EGYPTIAN OR GRECIAN LEPROSY. The leprosy of the ancients, and which still appears in the oriental countries and Africa, is a disease much more dreadful than the leprosy of our country. This affection, which, from the appearance of the skin, is called elephantiasis, consists of a horrible tubercular erup- tion, that commonly makes its appearance on the face but as the disease advances, the skin of the entire body may become affected with it. This disease is exceeding obstinate in its character, and was believed, in ancient times, to be absolutely incurable ; and from the idea of its being contagious, or perhaps more from the obscene appearance of the affected person, the unhappy sufferer was banished from society to die in obscurity.* We are informed by the Moravian missionaries in Africa, that the natives there have at this da}' a large plain enclosed with a very high wall, within which all that are found affected with the disease are confined, never to be released, but there to support themselves by raising their own provisions. Treatment. — As leprosy is, without doubt, dependent on a depraved condition of the nutritive functions, its proper treatment involves especial attention to this matter. A thorough cleansing process is first required ; the condition of the stomach must be improved by the use of emetics, that of the bowels Ly proper cathartics and enemas, while the skin is relieved and restored to its healthy condition by the use of diaphoretics, baths, and other proper external applications. After the main channels or vascular organs have been restored into a healthy condition, the system should be put under a course of depuratives and alteratives, as recommended for scrofula, while the attention is then * It is more than probable that the leprosy spoken of in the sacred scriptures, differed somewhat from the disease now called elephan- tiasis. This latter is characterized by a dark, rough appearance, whereas, that seems to have been of a light or white color. It ia certain, however, that the leprosy spoken of in the Bible, was fully as obstinate as the elephantiasis seems to be, and hence the miracu* leus cures by the Saviouk were the more striking in character. LOCKED JAW. 189 main!}" directed to the skin or more extensively affected parts. The diseased parts should be covered with a mucilage of slippery elm, thickened with finely pulverized lobelia seed. The parts must then be enveloped with a thin, soft skin, or oiled silk, to exclude the air. This appli- cation should be left to remain only some twenty-four hours, when it must be renewed. The vapor bath, should be applied, at the renewing of the external appli- cations, as often as two or three times a week. In these obstinate diseases, perseverance in the treat- ment is all important ; and when, from some peculiari- ties of the symptoms, the above applications will not be found the best adapted, they may be changed, and the oleaginous liniments and ointments may be used in their stead, or alternately with them, washing the sur- face with soapsuds at the changes. The stramonium ointment will be found very good. It may be mixed with the extract or powder of blood-root, and applied to the parts affected. Linseed oil has also been found serviceable. LOCKED JAW. {Trismus.) In common usage, the term locked jaw has comprised all the different forms of tetanus; but in systematic classifications we have : 1, opisthotonos, in which the body is thrown backward by the contraction of the mus- cles of the back ; 2, emprosthotonos, when the body is bent forward; and 8, trismus, or locked jaw, in which the muscles of the neck and jaw are chiefly affected. Tetanic affections often come on with great violence, but more usually they appear more gradually. In loekee jaw, a slight stiffness is at first perceived in the back part of the neck, which, after a short time, becomes considerably increased, and at length renders the motion of the head both difficult and painful. An uneasy sen- sation is now experienced at the root of the tongue, 190 DOMESTIC MEDICINE. together with some difficulty in swallowing, and a tight- ness in the breast. There is also a pain at the extremity of the breast bone, shooting into the back. At this stage, a stiffness will be experienced in the jaws, which increases until the jaws will become so firmly set that they cannot at all be opened, and hence the name lacked jaw. This affection is occasioned by irritation of the nerves, brought on by the effects of cold, particularly when con- joined with wetness, — by local injuries, such as punc- tures, incisions, lacerations, bruises, and burns or scalds. Lacerated or punctured wounds, in tendinous parts, are very apt to bring on the disease. Treatment. — The most prompt and certain remedy for this as well as most other spasmodic diseases, is the anti-spasmodic tincture. This must be poured into the mouth, between the cheeks and teeth, and should also be administered (diluted with a tea of the nervine tonic) by injection. In the meantime, an assistant should apply the stimulating liniment, with rapid friction, around the jaws, neck, and along the spine. When the spasm is broken up, the patient must continue to use the nervine tonic in proper doses. It may be pre- pared in a strong tea, sweetened, and drank freely for several days. The blue cohosh, swamp cabbage, and assafoetida, are also good in this disease. MADNESS — CANINE. {Hydrophobia.') The term hydrophobia signifies a dread of water, which is one of the characteristic symptoms of the disease resulting from the bite of rabid animals. But this symptom is not peculiar to this affection, as it some- times attends other disorders, as hysteria, and various febrile and other affections attended with an excitable, MADNESS CANINE. 191 irregular nervous impressibility. Nevertheless, as a dread of liquids is so much more pressing and constant in this disease than any other, the name is still retained by most writers. It seems, however, that this singular dread is not confined to the sight and noise of liquids, only, but may be produced by the sight of polished bodies and of mirrors. " Dr. James observes, that this peculiar affection prop- erly belongs to the canine genus, viz : dogs, foxes and wolves ; in which animals only it seems to be innate and natural, scarcely ever appearing in any others, except when communicated from these. When a dog is affected with madness, he becomes dull, solitary, and endeavors to hide himself, seldom barking, but making a murmuring noise, and refusing all kinds of meat and drink. He flies at strangers; but, in this stage, he remembers and respects his master; his head and tail hang down ; he walks as if overpowered by sleep ; and a bite, at this period, though dangerous, is not so apt to bring on the disease in the animal bitten as one inflicted at a later period. The dog at length begins to pant; he breathes quickly and heavily; his tongue hangs out; his mouth is continually open, and discharges a large quantity of froth. Sometimes he walks slowly, as if half asleep, and then runs suddenly, but not always directly forward. At last he forgets his master; his eyes have a dull, watery, red appearance ; he grows thin and weak, often falls down, gets up and attempts to fly at everything, becoming very soon quite furious. The animal seldom lives in the latter state longer than thirty hours ; and it is said, that his bites at the end of his existence are the most dangerous. The throat of a person suffering hydrophobia is always much affected; and,, it is asserted, the nearer the bite to this part, the more perilous." It appears that the disease can be communicated to man by rabid animals that are not of the canine spe- cies, provided that they have the genuine disease. So far as yet known, however, it would seem that a person cannot communicate the disease to his own species; yet prudence would dictate that caution should be observed in this matter, as it appears that hydrophobia has been produced in dogs by inoculation from the human subject. 192 DOMESTIC MEDICINE. The appearance of the affection, after the bite, is at an uncertain period; sometimes within a fortnight, a month, or, according to some, it may not come on for a year, and even then appear. The bitten part may heal up without any signs of the hydrophobic symptoms, and yet the disease come on afterward. Hydrophobia may take place without the appearance of any local symptoms; but more usually the individual feels a slight pain in the bitten part, which somewhat resembles rheumatism. From this, the pain will be felt to wander through the body, while a universal uneasi- ness and heaviness will be experienced ; there will be disturbed sleep, frightful dreams, sudden startings and spasms ; the patient evinces a disposition of anxiety, sighing, and a desire of solitude. The symptoms now become more severe daily; pains are felt to shoot from the wound toward the throat, which are soon followed with a sensation of choking, and a horror and dread at the sight or noise of water. The patient is, however, able to swallow other substances with tolerable ease; but as he endeavors to resist or overcome the dread of liquids, the mental and physical effort is singularly dis- tressing and horrific: every muscle of the face is thrown into violent agitation, and those of the throat and trunk contract so forcibly and convulsively as to threaten suf- focation. These agitations or paroxysms, at first, are only of a moment's duration ; but subsequently they become more prolonged and still more violent. In the majority of instances, the patient retains his reason, and will sometimes warn by-standers to keep away, lest he should bite or otherwise injure them. At last the patient becomes exceedingly agitated and furious ; his eyes sparkle ; his face is red ; he froths at the mouth; his countenance bears an expression of the deepest agony; and being convulsed in every part of the body, becomes a frightful object to behold. Vomit- ing finally ensues; a clammy sweat breaks out over his face and body; the pulse becomes small and intermit- tent, respiration difficult, and the poor sufferer sinks in the midst of the most awful sufferings. Treatment. — Numerous remedies have been recom- mended for the cure of this terrible disease, many of MADNESS CANINE. 193 which have been regarded as specifics. The chickweed, {alsine media,) water plantain, (alisma plantago*.) scarlet pimperel, (anagallis arvensis\ ,) the ash-colored ground liverwort, (lichen caninusX,) skull-cap, valerian, camphor, and carbonate of ammonia, have all been highly extolled for their virtues in the cure of hydrophobia. Besides these, a number of poisonous articles have also been recommended, the most prominent of which are the following: mercury||, arsenic, copper filings, strych- nine, {mix vomica}) nightshade, jimson-weed, poke-root, tobacco, Spanish flies, &c. But with all these boasted remedies, it has been declared by very many, that nothing but the knife or the actual cauter}^ {burning, or cutting out the wound}) will promise any certainty of cure; while, on the other hand, some have affirmed that even excision or ampu- tation is unsafe to be relied upon. Now, the truth may be found just between those notions : it is certain that excision or cauterization, though very severe and unne- cessary operations, would, if well practised immediately on the occurrence of the bite, be pretty certain to be effectual; while it is equally certain, that if the bite is not cut out until after the poison has become diffused through the system, it will do no good whatever. " When we take," says Howard, " a survey of the empirical, contradictory, extravagant and pernicious means which have been used or recommended in the treatment of this terrible malady, we are forcibly driven to the reflection that the popular practice of medicine, as taught in the schools, was nothing more than a chaos of confusion — a tissue of error, and of dangerous and unprofitable experiment ; for, of all the various and contradictory modes of treatment, recommended by dif- ferent authors, whether of stimulating or depleting, of relaxing or exciting, of burning or cutting, of warm * This article, as a prophylactic against hydrophobia, gained great popularity in Russia. f This is one of the oldest remedies for this disease ; both Galen and ^tius recommended it. I The celebrated Dr. Mead asserts, that in more than one hun- dred instances he prevented the disease by the use of this remedy. || The noted remedy of Dr. Merchant, consisted principally of the eubsulphate of mercury and the chickweed. 13 194 DOMESTIC MEDICINE. bathing or cold bathing, nothing as yet is known to the learned authors of medicine, which can be relied upon as a certain cure. As Dr. Good observes, 'our curative practice is still unfortunately all afloat, and we have neither helm to steer by, nor compass to direct our course. There is, indeed,' continues he, 'no disease for which so many ltemedies have been devised, and none in which the mortifying character of vanity of vanities has been so strikingly written upon all of them.' " A new era has, however, taken place in the annals of medical science ; the practice of medicine has become established upon new and correct principles ; the means of cure have been investigated and improved; while, at the same time, the powers of the physician to control disease have become augmented and multiplied. There is good reason to believe that the lobelia inflata will be found a certain remedy for this terrific disease, as the few trials which have been made of it,* give strong proofs of its powers, and high promise of its future use- fulness." Vapor Bath. — It is stated that the great utility of the vapor bath in the cure of hydrophobia, was discovered in France by the following singular incident : Dr. Buisson, having pressing symptoms of hydrophobia, and despairing of a cure, selected the vapor bath as the easiest means of his death. The vapor was raised to a heat of one hundred and twenty-six degrees Fahrenheit: the doctor, taking leave of friends and all earthly objects, went into the bath to take his final exit; but, to his astonishment, instead of bringing on suffocation and death, it relieved his hydrophobic symptoms with sin- gular rapidity. Dr. Buisson, in the communication of his case to the Academy of Arts and Sciences at Paris, says that by the same means he had cured upward of eighty patients of hydrophobia, and intended to try it in cholera, plague, yellow fever and gout. The vapor bath has since fully established its char- acter as a prophylactic against this disease. It should be applied once every other day for two weeks, and, after this, for two weeks more, every second day. The * It has since been thoroughly tried in numerous instances. MADNESS CANINE. 195 lobelia must be used in emetic doses immediately on coming out of the bath, as the relaxation produced by the vapor will much insure the good effects of this valuable medicine. Local Treatment. — In this disease the local treatment is a very important part : as soon as possible after the bite, the wound should be well washed out with the sour tincture of lobelia; and then a poultice made of equal parts of lobelia seed well pulverized, and slippery elm flour, mixed up with vinegar, must be applied and worn (replacing it by a fresh one every day,) on the wound until it is healed up. Nauseants. — The lobelia should be given once in two or three hours, in broken doses ; that is, in doses large enough to keep the stomach somewhat nauseated. The condition favorable to hydrophobia is entirely incompatible with the nausea of lobelia. Nervine Tonics. — The skull-cap and valerian should be taken in a tea, two or three times a day, with a view to defend the nerves against the morbific influence, which is very important, as the disease chiefly impli- cates the nervous system. The author cured two cases of the disease in 1845, simply with the sour* tincture of lobelia, given inter- nally, in nauseating doses, once in two or three hours, and applying it freely externally — using, at the same time, a strong tea of skull-cap and valerian. * It is important to observe the precaution of preparing the lobelia for this use, with vinegar instead of spirits, as the vinegar itself is a powerful prophylactic against this disease. In favor of its good effects in hydrophobia, we have the authority of Rhazes, among the ancients, and Werlhot, Bucholz, and Rust, among the moderns. 196 DOMESTIC MEDICINE. MEASLES. (Rubeola.) This is a disease that is very common among chil- dren, prevailing some seasons in the character of an epidemic. Symptoms. — In the commencement, there is suffusion and running of water from the eyes and nostrils; sneezing, cough, and swelling of the eyes and face; with occasional shivering, cold in the back, and drowsi- ness. "An eruption first appears behind the ears, on the third or fourth day, spreading downward to the neck and forward to the chin, mouth, or forehead, but seldom shows itself on the body until a day or two after. The eruption speckles the skin somewhat like the bites of fleas, and is of a crimson color and not scarlet, as in scarlet fever. The crimson specks of measles arrange themselves in groups of irregular circles or crescents, and leave the skin between them of its natural color, which never occurs in scarlet fever. The great danger in measles does not arise from the abundance of the eruption, the severity of the fever, the oppressed breathing, nor the violence of the cough ; but almost wholly from the secondary inflammation that comes on, or, rather, after the fever or eruption have gone off, which usually happens in nine or ten days. Many children have this secondary stage pro- duced or increased, by cramming them with too strong- food when they are beginning to recover, with the false notion of strengthening them. It is no less absurd to dose the little patients, after measles, with purgatives, when their bowels are in proper order." — Abcrnclhy. The cause of measles evidently is contagion, although rare instances occur in which the disease arises without any chance of the agency of contagion. The disease which this resembles most, is scarlatina and here the diagnosis is sometimes difficult. The following table is given in Marshall Hall's Prac tice, showing the difference between the symptoms of scarlet fever and measles : 197 1 . The prevailing epidemic. Rubeola, [measles.'] | Scarlatina, [scarlet fever!] 2. The latent period. From 10 to 14 days. From 1 to 6 days. 3. Symptoms. Febrile catarrh, coryza, [running at the nose,] oph- thalmia, [inflammation of the eyes!] 4. Appearance of the eruption On the fourth day. Febrile sore throat, great heat and tumidity of sur- face, nausea or vomiting. On the second day in S. simplex; third, in S. angi- nosa ; and later still, in S. maligna. 5. Form of the eruption. Circular dots ; crescentic I Diffused. arcs, [growing circles.] 6. The Indoles, [disposition or character!] Mostly inflammatory. ! Often typhoid, and espe- I dally in S. maligna. 7. Principal complications. Affections of the ante- rior nares, the larynx, tra- chea, lungs, &c. 8. Principal sequela Thoracic disease. Affections of the poste- rior nares, fauces, &c. Inflammatory anasarca ; meningitis, [inflammation of the membranes of the brain.] Measles are not generally attended with much danger, except when complicated with other diseases, or when the affection results in other complaints that are of a fatal tendency. Symptoms of disease in the breast and head, may be regarded as being at least tedious to manage. The same individual is liable to the affection but once. Treatment. — In mild cases of the disease, it is seldom necessary to use much medicine. Some gentle diapho- retic, such as chamomile, pennyroyal, thoroughwort, or the diaphoretic powders, may be used to keep out the eruption. In more difficult cases, it may become neces- sary to use more active means. Should there be much 198 DOMESTIC MEDICINE. fever and pain, and the eruption not appear, or appear imperfectly, the patient must take some permanently stimulant and relaxant medicines, such as the following: # Lobelia herb, . } Thoroughwort, . > Equal parts. Seneca Snake-root, ) Pulverize and mix. It may be taken in molasses or some preserves, or it may be stirred into some hot water and sweetened, and then taken in suitable doses. This, with friction on the surface, will generally bring the determining powers to the surface, and fully develop the eruption.* Should the stomach be much out of order, an emetic may become necessary ; and if the bowels be consti- pated, they must be relieved by the use of enemas, as it is not best to employ much cathartic medicine in measles. When other diseases supervene, they must be treated according to the symptoms' that attend them. MELANCHOLY. {Hypochondriasis.') This is a very singular and distressing disease, affect- ing both the body and mind. It consists, essentially, of a deranged condition of the digestive organs and func- tions of nutrition ; thus giving rise to depression of the animal spirits, and a disturbed condition of the intel- lectual faculties. Hypochondria comes on with a sense of languor, listlessness, or want of resolution and activity with res- pect to any undertakings. The patient feels serious,, * The country people have a remedy that they call sheep saffron, by the use of which, they bring out the eruption with great success. Indeed, with this remedy, an old woman will treat more patients, and lose a less number, than the best physicians practicing after the old plan. But a remedy so filthy and disgusting, it is not designed here to recommend. A compound of carbonate of ammonia and the bitter snake-root, in equal parts, taken in proper doses, will answer perhaps equally well. MELANCHOLY. 1 99 sad and timid; he is ever pondering on the ills and misfortunes of life; and, on the slightest grounds, he suspects evil, and from the most trivial events he takes alarm. He is particularly attentive to the state of his own health; and the smallest changes of feeling are regarded as indications of constitutional unsoundness. Any unusual sensation, however slight, he considers a premonitory symptom of approaching disease, if not the immediate forerunner of death. Sometimes he imagines that he is dying, or that he is actually dead ; and so strong and fixed is his notion, that he will not be per- suaded out of it, however great the pains taken. Treatment. — The medical treatment of patients affected with low spirits, should consist of such means as are calculated to improve the condition of the diges- tive organs. The various means, therefore, that are recommended for dyspepsia, under page 182, should be instituted. Frequent cold bathing is particularly advantageous in this affection. Occasional emetics, tonics, and laxa- tive bitters, are always required. The grand object is to keep the system free of obstruction, and the organs in good tone. Moral means. — It is always a matter of the greatest importance for the practitioner to secure the full and entire confidence of the patient. Every effort should be made to get the patient to believe that the means Used will cure him; and with a view to this, some important remedy — a celebrated arcanum — must be talked of; desires to get it must be frequently expressed in his presence, and, at the same time, doubts as to the possibility of procuring it may be evinced. Finally, however, the great desideratum is gained — the medi- cine is procured, and hence the cure will be certain. Together with other good and prompt treatment, some mild remedy, whose specific action is certain and well known, must now be given. The patient must be made to anticipate certain effects, and to be assured that if they take place, all will be well. This important remedy, for instance, may be a safe but active diuretic, or any innocent article that will stain the urine, or that 200 DOMESTIC MEDICINE. will produce some other prominent or remarkable effect that may be safely predicted by the physician. Sometimes a cure may be effected by instituting some interesting, engrossing and absorbing scheme, as some mining speculation, or some important expedition, and thus isolating the attention and thoughts of the patient. Traveling is very beneficial to some. Moral and religious conversation is very beneficial, and if the patient's mind can thus be engaged and engrossed, it is entirely the best plan of treatment. Some very singular and amusing means have oc- casionally proved successful. The author heard ai instance related, of a hypochondriac patient, who livee. in this country at the time of its early settlements, and who, withal, had a most horrible dread of the Indians. The chief affliction of this individual, was his belief that his legs were glass. He never suffered himself to be moved, and his legs were even not to be handled, lest, by accident, they might be broken ! After keeping his room for a year or longer, he was at length pre- vailed on to take a visit to a neighboring house, with the assurance that the care he would have would insure the safety of the enterprise. A carriage was procured, the man with "glass legs" was carefully placed into it, when the driver proceeded with the greatest care. When about a mile from his home, a sham conversation with reference to some late depredations by the Indians, was introduced. The fears of the hypochondriac were soon aroused, so that he entirely forgot his glass legs. Soon they were to pass through a strip of woods, and as they drew near, the fears of the distressed man evi- dently became more and more pressing. The carriage had no sooner entered the woods, when five men, {pre- pared for the design,) in Indian habits, with rifles and tomahawks in hand, rushed from the hill-side with tre- mendous war-whoops, yells, and firing of their guns. One of the men in the carriage, who had risen up to make his escape, fell as dead to the ground, when the man with the glass legs leaped from the carriage and "took to his heels" and the Indians after him. But the stiff-legged man left them far in the rear; he was soon at his house, in a fine perspiration. — The means were successful. MELANCHOLY. 201 The following, from Ewell's Medical Companion, are cases that are not without interest : "Some hypochondriacs have fancied themselves mis- erably afflicted in one way, and some in another — some have insisted that they were tea pots, and some that they were town clocks — this, that he had a big belly, and that his legs were glass — one, that he was extremely ill; and another, that he was actually dying. But 1 have never heard of any of this blue-devil class, whose extravagance ever yet came up to the following, which was related to me by my noble-hearted old friend, Dr. Stevenson, of Baltimore, whose very name always sounds in my ears as the summary of every manly virtue. " This hypochondriac, who, by the by, was a patient df Dr. Stevenson, after ringing the change on every mad conceit that ever tormented a crazy brain, would have it at last that he was dead, actually dead. Dr. Stevenson having been sent for one morning in great haste, by the wife of his patient, hastened to his bed- side, where he found him stretched out at full length, his hands across his breast, his great toes in contact, his eyes and mouth closely shut, and his looks cadaverous. " ' Well, sir, how do you do ? how do you do this morning?' asked Dr. Stevenson, in his blustering jocu- lar way, approaching his bed. ' How do I do ? ' replied the hypochondriac, faintly — 'a pretty question to ask a dead man.' 'Dead!' replied the Doctor. 'Yes, sir, dead, quite dead; I died last night about twelve o'clock.' " Quick as lightning, Dr. Stevenson caught his cue, which was to strike him on the string of his character; on which, the Doctor happily recollected, he was very tender. Having gently put his hand on the forehead of the hypochondriac, as if to ascertain whether it was cold, and also felt his pulse, he exclaimed, in doleful note, 'Yes, the poor man is dead enough — it is all over with him, and now the sooner he can be buried the setter ' Then stepping up to his wife, and whispering her not to be frightened at the measures he was about to take, he called to the servant, ' My poor boy, your poor master is dead, and the sooner he can be put in the ground the better. Run to Mr. C m, for I know he always keeps New England coffins by him, ready made; and, do you hear, bring a coffin of the largest 'ZWZ DOMESTIC MEDICINE. size, for your master makes a stout corpse, and having died last night, and the weather warm, he will soon begin to smell.' Away went the servant, and soon returned with a proper coffin. The wife and family having got their lesson from the Doctor, gathered around him, and howled no little, while they were putting the body in the coffin. Presently, the pall-bearers, who were quickly provided and let into the secret, started with the hypochondriac for the church -yard. They had not gone far before they were met by one of the towns- people, who, having been properly drilled by the face- tious Stevenson, cried out, ' Ah, Doctor ! what poor soul have you got there?' '"Poor Mr. B ,' sighed the Doctor, 'left us last night.' " ' Great pity he had not left us twenty years ago,' replied the other, 'for he was a bad man.' " Presently another of the townsmen met them with the same question, ' And what poor soul have you got there, Doctor?' '"Poor Mr. B ,' answered the Doctor again, 'is dead.' " ' Ah ! indeed ! ' said the other. ' And so the devil has got his own at last.' " ' Oh, villain ! ' exclaimed the man in the coffin, ' if 1 was not dead, how I would pay you for that.' " Soon after this, while the pall- bearers were resting themselves near the church-yard, another one stepped up with the old question again, 'What poor soul have you got there, Doctor ? ' " ' Poor Mr. B ,' he replied, ' is gone.' " ' Yes, and to h- 11,' said the other, ' fcr if he is not gone there, I see not what use there is for such a place.' " Here the dead man, bursting off the lid of the coffin, which had been purposely left loose, leaped out, exclaim ing, ' Oh, you villain ! I am gone to h— 11, am I ? \A~ell, I have come back again to pay such ungrateful rascals as you are.' A race was immediately commenced between the dead man and the living, to the petrifying consternation of many of the spectators, at sight of a corpse bursting from the coffin, and in all the horrors of the winding- MELANCHOLY. 203 sheet, racing through the streets. After having exer- cised himself into a copious perspiration by this fantastic chase, the hypochondriac was brought home by Dr. Ste- venson, freed of all his complaints. And by strength- ening food, generous wine, cheerful company, and moderate exercise, was soon restored to perfect health. " To demonstrate further, the happy effects of posses- sing quick wit, 'to shoot folly as it flies,' I will cite another case of Hypochondriasm, which came under the care of that philanthropic and learned physician, the late Dr. Crawford, of Baltimore, who, in everything that was amiable and good, was not unlike his intimate friend, Dr. Stevenson. " A certain hypochondriac, who, for a long time, fan- cied himself dying of a liver complaint, was advised by Dr. Crawford to make a journey to the state of Ohio. After an excursion of three months, he returned home, apparently in good health ; but upon receiving informa- tion of the death of a twin brother, who had actually died of a scirrhus liver, he immediately took the stag- gers, and, falling down, roared out that he was dead, and had, as he always expected, died of a liver com- plaint. Dr. Crawford being sent for, immediately attended, and asked the hypochondriac how he could be dead, seeing he could talk. But still he would have it that he was actually dead. Whereupon, the sagacious doctor exclaimed, ' Oh, yes, the gentleman is certainly dead, and it is more than probable that his liver was the death of him. However, to ascertain the fact, I will hasten to cut him open before putrefaction takes place.' And thereupon, getting a carving knife, and whetting it as a butcher would to open a dead calf, he stepped up to him and began to open his waistcoat, when the hypo- chondriac, horribly frightened, leaped up with the agility of a rabbit, and crying out, ' Murder ! murder ! murder ! ' ran ofT with a speed that would have defied a score of doctors to catch him. After running a considerable distance, until he was almost exhausted, he halted; and not finding the doctor at his heels, soon became com- posed. From that period, this gentleman was never known to complain of his liver; nor had he, for bettei than twenty years afterward, any symptom of thia disease " DOMESTIC MEDICINE. MILK SICKNESS. In some sections of Kentucky, Ohio, Indiana, and Illinois, an affection prevails, which from its cause and symptoms, is variously named, milk sickness, puking complaint, and trembles. The disease is caused indi- rectly by a poisonous plant, which being eaten by cattle, thus communicates its poison to the milk, as well as to the flesh of the animal, which when eaten by the people, gives rise to the disease. Symptoms. — " Milk sickness usually comes on with lassitude and weariness, with a sense of great exhaus- tion, and trembling from slight exertions ; the breath is very offensive, having a peculiar and disagreeable smell. Obstinate costiveness either accompanies or succeeds these symptoms, which is soon followed by sickness at the stomach, and vomiting; and great dis- tress, with a burning sensation at the stomach." If the disease is not checked, it will soon bring on great debility, which is generally attended with a singular trembling. Treatment. — The symptoms readily suggest the treat- ment most appropriate in this affection. Thorough emetics are particularly indicated. The anti-spasmodic tincture, or the lobelia in powder with the nervine tonic, in equal portions, will be better in this disease than the lobelia alone. When the stomach is well cleansed, the next object should be to relieve the bowels from the pressing constipation, that is always attendant on the disease. For this purpose, injections are necessary. Among the best preparations for this use, is the following : ]£ Soft soap, 1 table spoonful, Common cathartic, 1 tea spoonful, Lobelia, £ " Capsicum, ^ " Scald in a pint of water, and administer at once while warm. The injections must be repeated at short inter- vals, until the desired effect is produced. In the mean- MORTIFICATION. 205 time, a dose of some safe but active cathartic should be given. Charcoal. — In this disease, prepared charcoal is one of the best remedies, and should be used in proper doses, once in three or four hours during the entire treatment, after the lobelia has done its duty. External Applications. — The oil of spearmint or peppermint, applied over the region of the stomach, will be very good to quiet the irritation of this organ. If the oil of" the mints is not at hand, the herb, bruised and scalded, may be applied, first sprinkling the surface with some capsicum. Tonics. — As soon as the symptoms give way, the use of tonics must be commenced, and continued until the strength is again restored. The bitter and nervine tonics may be used, in equal portions, three times a day, in tea spoonful doses. MORTIFICATION. Mortification is usually divided by writers into two stages, gangrene and sphacelus* It is generally calcu- lated that gangrene is within the reach of medicine, while the parts affected with sphacelus are absolutely beyond the control of all remedies. Mortification simply means the death of a part, and may take place in any part of the body. When it im- plicates the bones, it is usually called necrosis or caries. When mortification is about to take place in a part, the affected structure loses its sensibility, it becomes cold, the blood ceases to circulate, and absorption is suspended. The process by which these changes are * " When any part of the body loses all motion, sensibility, and natural heat, and becomes of a brown livid or black color, it is said to be affected with sphacelus. When the part becomes a cold, black, fibrous, senseless substance, it is termed a slough. As long as any sensibility, motion, and warmth, continue, the state of the disorder ia eaid to be gangrene." 206 DOMESTIC MEDICINE. accomplished, is usually progressive, but is much gov- erned by the soundness of the constitution, the violence of the exciting causes, and still more by the nature or structure of the affected part. Thus mortification, in some parts, takes place in a few hours, whilst, in others, it does not make its appearance for several weeks, or even months, after the parts have first be- come diseased, and active inflammation has set in. "The cellular, cutaneous, and mucous, may be enu- merated as the textures which are more frequently seized with mortification than any other ; and it is worthy of remark that these are parts that are ex- tremely well supplied with blood, especially the two latter. Nevertheless in the skin and cellular substance, this event takes place most frequently in situations which are remote from the central organ of the circu- lation, as on the hands, feet, and posterior portions of the trunk. In the mucous system, the parts most liable to mortification are the gums, the inside of the cheeks, the tonsils, the colon, the inferior third of the ileum, the urinary bladder, and the lining membrane of the vulva. The serous membranes, muscles, ligaments, tendons, aponeuroses, and cartilages, are rarely affected in this way ; and the same remark holds good in refer- ence to the arteries, veins, and absorbents. The three latter of these' structures, indeed, seem to possess a most astonishing conservative power, and hence it is not uncommon to find them retain their integrity in the midst of the sphacelated part. In malignant scar- let fever, attended with mortification of the tonsils and upper part of the neck, I have several times seen the carotid go on in the performance of its function, and the individual recover, notwithstanding the detachment. of immense sloughs of the skin and cellular substance; and similar phenomena have often been witnessed in mortification of the inferior extremities." — Gross. Mortification is almost universally preceded by in- flammation ; and the hight of the inflammatory action will sometimes furnish us with a pretty certain index to the nearness of its approach. " Hiccough," says Sir Astley Cooper, " is the characteristic sign of gan- grene, in whatever part of the body it is situated. The fact is, when gangrene arises from a diseased stale of MORTIFICATION. 20? the constitution, the stomach is extremefy deranged, and this derangement is followed by a spasmodic con- traction of the diaphragm, producing hiccough." Any cause which prevents the entrance of arterial blood, will give rise to mortification. This fact is ex- emplified in the occurrence of strangulated hernia, in the application of ligatures, &c. Poisons, excessive lacerations, extreme cold or heat, great pressure, and paralysis in debilitated habits, are frequent causes of the death of parts. Treatment. — The most important indication in the general treatment, is to maintain the free circulation of the blood, as it is upon this fluid that the vitality of ever}'" part is dependent. Capsicum, compound tincture of myrrh, or any other of the permanent stimulants, must be taken in large and frequent doses. Stimula- ting liniments with lively friction, should be applied to the entire body. Should this treatment not increase the volume and frequency of the pulse, the vapor bath must be applied two or three times a day, in addition to the other means. Local Treatment. — When the affected parts are situ- ated externally, a poultice, made of the dregs of myrrh, sprinkled over with capsicum, must be immediately applied, and renewed every three hours, or its use should be alternated with that of a poultice made of the diaphoretic powders, with wheat or rye flour enough to give it adhesiveness. Before this is applied, its surface should likewise be sprinkled with capsicum, or pulverized cloves or cinnamon. At each renewal or change of the poultices, the parts should be saturated with the an ti- spasmodic tincture, or the compound tinc- ture of myrrh. The pyroligneous acid, is perhaps the most active antiseptic that we possess, and if it is at hand, should always be preferred to our less active agents. The acid should be freely applied three or four times a day, by means of a feather, cloth, or sponge. A cataplasm of charcoal and yeast, is excellent in mortification. When mortification is threatened in the internal organs, as in the bowels and stomach, the same medi- 208 DOMESTIC MEDICINE. cines may be taken internally, as per stomach, and by injection. The pyroligneous acid, which is very anal- ogous to vinegar and equally safe to take, should be used, of proper strength, three or four times a day. Charcoal, compound tincture of myrrh, and capsicum, must likewise be freely used. MUMPS. {Parotitis.) This is an affection of the parotid glands, which are situated below the ears and immediately behind the angles of the jaws. The disease is contagious, and is sometimes known to prevail epidemically. Mumps usually occurs but once in the same indi- vidual ; but it sometimes happens that only the gland on one side is affected, which will not prevent the oc- currence of the affection on the other side, at some future period. Children and young persons, are most liable to this disease. The mumps is not a dangerous disease, though by taking cold a feverish state of the system may be pro- duced, and the affection may become translated to other glands of the body ; thus in the male it may attack the testes, and in the female, the mamae or breasts. When this takes place, the case may require special and careful attention. The glands affected usually swell very much, but the skin is not discolored. The swelling, in ordinary cases, continues increasing until about the fourth or fifth day, when it will again gradually subside. Treatment. — It is seldom the case that much medi- cine is necessary in this affection. The parls should, however, be kept warm, by wearing flannels around them, and some mild diaphoretic teas may be drank. But should the disease prove severe, such remedies as are applicable in other inflammatory affections, should be used. The feet may be bathed in a pail of warm water. A strong tea of prickly- ash bark and wild NIGHTMARE. 209 marjoram should be drank freely, while the bowels are kept open by the use of laxatives. The local means to be used, are also about the same as for other inflammatory affections. A poultice made by scalding equal parts of fine slippery elm bark and flour, with a sufficient quantity of water to form the poultice of a proper consistence, is very good. When the pain is severe, a little fine camphor and lobelia herb, maybe sprinkled on the surface of the cataplasm. Liniments made of lobelia, camphor, and ammonia, as strong as the affected parts will bear, are also good. NIGHTMARE. {Incubus.') This is an affection that only comes on during sleep ; and consists of an interrupted condition of the func- tions of respiration and the circulation. The brain being thus disturbed, gives rise to frightful dreaming. The difficulty of breathing, and the smothering at the heart, will generally occasion the presentment of dan- ger from violence, as from the intrusion of an assassin, a furious wild beast, or perhaps some demoniac influ- ence. The difficulty generally arises from indigestion, which causes distension of the stomach and bowels, by the gases or wind that is eliminated by the attending fer- mentation, and which thus pressing against the dia- phragm, crowds the viscera of the chest, so as to produce the oppression already named. A diseased condition of the liver and spleen, and constipation of the bowels, will also sometimes occasion the night- mare. In persons predisposed to the affection, an attack is almost sure to be brought on by taking a heavy meal immediately on going to bed. Nervous irritability, great anxiety of mind, grief, despondency, intense thought, and late hours, are also favorable to it. The attack generally comes on gradually, and lasts usually for several hours ; the patient lies, often with- out the power of motion or of speaking, groaning and smothering, and evinces the greatest agony. 14 210 DOMESTIC MEDICINE. Treatment. — To overcome the attack or paroxysm, it is generally only necessary to awaken the individual out of his sleep, when he will soon be entirely relieved. But to prevent the return of the complaint, attention to the digestive organs will be necessary. If the stom- ach is much out of order, an emetic will become neces- sary. The bowels should be kept free with laxative bitters. The shower bath, taken two or three times a week, is an excellent remedy. The nervine tonic, cas- carilla, and various other simple articles, will be found useful. OBSTRUCTED MENSTRUATION. (Amenorrhea.) Treatment. — The various emenagogues, found in materia medica, will all be found useful ; some individ- uals will find more benefit from one article, and some from another. Among the most useful and certain emenagogues is the black cohosh, which should be well dried and used in a tea, as much as the patient can take without producing headache and dizziness. The emenagogue infusion, if taken freely at the proper time, will be found an excellent preparation for this difficulty. While using it, the feet should be well bathed in warm water, before a hot fire, the patient being surrounded with a blanket, and drinking some tincture of myrrh or some other warming medi- cine to promote perspiration. Stimulating bitters are clearly indicated, and as a remedy of this kind, the following is a good example : R Motherwort, 2 ounces, Cascarilla, or Poplar bark,. 1 ounce, Wild Ginger, 2 ounces, Black Cohosh, 2 " Capsicum, 1 ounce. Pulverize and mix. For use, one ounce should be scalded in a pint of boiling water, strained and sweet- ened, and drank through the course of a day. The various oxides of iron are very good for this disease. The common iron rust or iron filings may be taken in molasses in half tea spoonful doses. PALPITATION OF THE HEART. 211 PALPITATION OF THE HEART. " An irregular beating and fluttering motion of the heart, very frequently attends dyspepsia, sick-headache, neuralgia, asthma, consumption, hysteria, gout, consti- tutional debility, and in persons of nervous tempera- ment, it is frequently occasioned by any slight derange- ment of the system. The use of strong coffee, tobacco, an oppressed condition of the stomach from food that is hard of digestion, grief, anxiety, or any sudden emo- tion of the mind, will, in some, occasion irregular throbbing and fluttering motions of the heart." The beating of the heart is sometimes so violent, that it may readily be perceived by the eye or even the ear of a by-stander. The affection is usually attended with a difficulty of breathing, paleness of the coun- tenance, and a purple color of the lips. These symptoms are, however, not always the effects of functional derangement ; but may result from or- ganic disease of the heart or its large vessels. When this is the case, it is generally very difficult to cure. Treatment. — When the palpitation is symptomatic of some other affection, it will generally give way to the means appropriate to those affections. When there seems to be little other disturbance of the body, the difficulty may generally be relieved by one or two good doses of the nervine tincture, or of the tincture of assafoetida. The stomach and bowels in this affection, must always be kept in good order by appropriate means ; and should any irregularities in the circulation occur, these must also receive prompt attention. The symp- toms must point out the means that should be used, whether they ought to be relaxants, stimulants, or evacuants. The use of capsicum, with an occasional dose of the nervine tincture, will be found very good to prevent palpitation of the heart. The nervine preparation recommended for hysterics, will also be found quite useful in this complaint. 212 DOMESTIC MEDICINE. PALSY. (Paralysis.) When the sensation, or voluntary motion of a part of the body is impaired or lost, the part is said to be palsied. In rare cases, the sensation and the power of motion are both destroyed at the same time. Palsy usually attacks only one side of the body, and often only a portion of this, as a limb, shoulder, or hip. Sometimes, however, parts of both sides may be attacked together. When palsy occurs in the whole of one side of the body, it is called hemiplegia; if both the inferior ex- tremities, from the hips downward, are paralyzed, it is called paraplegia; and when only some one particular part is affected, it is usually called paralysis partialis, by authors. The disease usually comes on suddenly, with the immediate loss of sensation or motion, or both ; but in some instances this is preceded by a numbness, cold- ness, and paleness, and sometimes by slight convulsive twitches. When the head is much affected, the eye and mouth are occasionally drawn to one side, the memory and other mental functions are impaired, and the speech is indistinct and incoherent. When the extremities are affected, and the disease is of long du- ration, there is often considerable flacidity and wasting of the muscles of the limbs. Palsy is caused by injuries or affections of the brain, spinal marrow, or of the nerves themselves. Hemi- plegia is generally produced by affections of the brain ; paraplegia, by those of the spinal marrow; and paral- ysis partialis, by disease or injuries of the nerves of the part. Treatment. — Immediately on the attack of palsy, the body should be well bathed with the stimulating lini- ment, which ought to be applied with considerable fric- tion ; then the patient, after taking a dose or two of a strong tea of capsicum, should be placed in the vapor bath. The heat of the bath must be gradually raised, PILES. 213 until it is as high as is comfortable for the patient.* After a free perspiration is produced, the patient must be taken out, and after being well rubbed and dried with a coarse towel, he should have another bathing of the liniment, and then be placed in bed, with a hot stone to the feet. A strong tea, made of equal parts of capsicum, valerian, and skullcap, should now be drank freely, so as to produce a general perspiration. The affected parts should now be well bathed with the stimulating liniment or the bathing drops, as often as once in four or five hours ; and once a day, some of the rubefacient oil, mixed with an equal quantity of the extract of Peruvian bark, or of quinine, should be applied to the paralyzed parts, and the tract of the nerves leading to them. This course of treatment should be renewed every day, until permanent relief is obtained. It is well to keep the parts warm between the bathings, by means of flannels. Rubbing the parts well along the course of the nerves, and also the spine, will sometimes prove very beneficial. In cases of partial paralysis, a cure may generally be effected by the simple use of the liniments, and stimulating nervine teas. PILES. (Hemorrhoids.) The pile is a very common affection of the veins of the rectum, which occurs in both sexes, and in all classes of society. The patient first experiences a singular itching and uneasiness about the parts, which is soon followed by an enlargement of the veins, causing tumors that are filled with dark blood. These tumors, which are some- * Care must be taken during the use of the bath, so as not to raise the heat too high, as the patient will sometimes not be able to judge the temperature, from the loss of sensation ; and this remark will also apply to the use of hot stones, or other hot applications to the diseased parts. 214 DOMESTIC MEDICINE. times from three to six in number, are extremely pain- ful, particularly on going to stool. When the bowels are in a constipated state, it is often very difficult to procure a passage, owing to the obstruction produced by the tumors ; but the attendant irritation brings on tenesmus and bearing down, which forces down the hardened passages, often bringing •with them the tumors when they are situated low in the bowel. If they are large, they will usually remain without, and thus prove a source of great annoyance. But the tumors frequently burst, and thus will bleed sometimes very profusely. When the piles bleed, they are called open or bleeding piles, and when they do not, they receive the name of blind piles. When the tumors are situated high up in the rectum or bowel, they are called internal piles, while those that are pushed down without, are called external piles. Piles are occasioned by a relaxed condition of the parts, which may arise from the use of drastic purga- tives, particularly those that spend their influence chiefly on the lower part of the intestines, such as aloes, and the most of the pills now offered to the public. Habitual costiveness, sedentary habits, and heavy lifting, may also bring them on. Piles are seldom dangerous, unless they become so from the excessive loss of blood that they sometimes occasion. Treatment. — Recent cases of piles may soon be relieved by the use of astringent injections. The bowels must, however, always be kept regular by the use of proper diet, or by means of the laxative bitters. Old and confirmed cases of piles are sometimes con- siderably difficult to cure. In the treatment of these, it is necessary, in the first place, to get the bowels into a good condition by the use of laxatives, and laxative enemas. The use of astringent injections must then be commenced, and continued three or four times a day. In the meantime the pile ointment must be applied by smearing it on a rag or bit of linen, which should then be introduced into the bowel, and left to remain until the syringe is used, when it should be renewed. PLAGUE. 215 Sometimes the tumors grow hard and very irritable, and in this state will not readily yield to the foregoing treatment. When this is the case, it is sometimes best to touch them slightly with some moistened caustic potash, two or three times a day, for a day or two, and then, after washing them off with an astringent preparation, heal them up with the stramonium, or pile ointment. PLAGUE. (Pestis.) The plague is an oriental disease, infesting the east- ern borders of the Mediterranean ; but it seems not to be confined to these parts, as we have in history some deplorable accounts of its ravages at Marseilles, Mos- cow, London, and elsewhere. Egypt, Asia Minor and Greece seem to have suffered most from this dreadful disease. In the days of Hypocrates, it made dreadful ravages at Athens, and the unprecedented success of that individual, in the management of this epidemic, did much in gaining for him his immortal character. It appears that the plague possesses many of the characteristics of a typhus affection. But some late writers class it among the exanthematous diseases ; yet even this does not argue much against its being typhus, as typhus fever, as well as typhoid, are often attended with considerable eruption. The eruption of this dis- ease consists of pustules, carbuncles, and buboes of a white, livid, or even black color.* The disease is usually ushered in with a sense of lan- guor, lassitude and chills, but is soon followed with an * A grade of continued fever occurs in this country, commonly ca.led cold plague, congestive fever, &c, which has been associated with this disease by some physicians, but without just reason. The treatment of congestive fever differs little from that of the malignant grade of remittent, with which it is identical. The local hyperemia, or congestions, may, however, need special attention, and may gen- erally be obviated by equalizing the circulation, together with the use of counter-irritants. 216 DOMESTIC MEDICINE. intolerable heat, almost consuming to the entrails. There is intense headache, which is most severe in the temples ; the tongue is usually much swollen, (which is by some considered a marked symptom of the plague,) and is covered with a white fur, glistening in the centre. A remarkable staggering generally sets in, in the early part of the disease, and ofttimes the patient is seized with violent delirium, which sometimes sets in soon after the attack commences. There is considerable pain in the region of the heart and stomach ; vomiting is likewise a very common symptom, which is attended with a sense of faintness and sinking. The countenance becomes haggard, and the features distorted, presenting a hideous appearance. The skin is dry and harsh, and the pulse accelerated, but small and contracted, and ranges from 115 to 130 to the minute. Respiration is laborious, and the speech indistinct and tremulous. Darting pains are experienced in various parts of the body, but especially in the axilla and groins, producing in those parts carbuncles and buboes, according to the tissues that become affected. The strength generally declines with terrible rapidity, and the patient sinks with the deepest anguish and despair into the arms of death. Treatment. — Awful as this disease is, it nevertheless admits of successful medication. After raging through Egypt, Lybia, Persia, Syria, Cyprus, Lemnos, and other isles of the great sea, the plague seemed to pour with tremendous fury into Greece, and to threaten the entire depopulation of Athens. The eloquent Robinson describes the suffering of the inhabitants thus : " The diseased were first smitten in the head ; from this, the malady passed down through the whole body, leaving in one shapeless, ruined mass, that noble form divine. But the sufferers seldom waited for this terrible .'atas- trophe ; but, in the beginning, in the fury of distraction, plunged into wells, rivers, and the sea, to quench the consuming fire which devoured within them ! " And yet, at this dreadful juncture of ruin, Athens was deliv- ered by a single man — the immortal Hippocrates, who, as with Egyptian magic, stayed at once the traveling besom. POISONING. 217 The proper treatment of plague varies little from that for yellow fever, but should always be prompt and vig- orous. Bathing, above all other means, seems to have been of the most benefit in the treatment of this dread- ful malady. Hippocrates depended chiefly on this, and the free use of stimulants. It is said, that by an ele- vated temperature the morbific contagion causing the disease may be destroyed ; and does this not give some useful hints in favor of hot bathing? This doctrine is well corroborated by the conduct of that chief of physi- cians already mentioned, in staying the progress of this malady at Athens ; he built large fires in all the streets and alleys in the city, evidently thus to heat and purify the air; and this, together with the use of the baths, stimulants and tonics, were, indeed, the principal means employed on this occasion. But if the treatment recommended for yellow or typhus fever be persever- ingly instituted in the management of plague, reason- able success may well be expected. POISONING. Poisoning may happen from accident or design, and may be produced by a great variety of agents found in the mineral, vegetable and animal kingdoms. Poisons are generally divided into six classes, viz: 1, the corro- sive or escharotic ; 2, the astringent ; 3, the acrid; 4, the narcotic and stupefying ; 5, the narcotico - acrid ; and 6, the septic or putrescent. As there are some important peculiarities attendant on a number of the most prominent poisons, it is best to consider those separately. Mercury and its preparations. — Dr. Pareira, of Lon- don, who has treated on the poisonous effects of mer- cury at length, states : " When large doses of some of the soluble salts of mercury have been swallowed, gastro-enteritis [inflammation of the stomach and bowels'] is produced. The patient complains of an acrid styptic taste in the mouth, and a feeling of burning and tight- ness in the throat ; the face is usually flushed and some- times swelled; violent vomiting and purging (frequently 218 DOMESTIC MEDICINE. of bloody matters) soon come on, the vomiting being increased by everything taken into the stomach ; often- times there is irritation of the urinary passages, and sometimes even suppression of the urine; the pulse is small, frequent and contracted; the respiration difficult; the extremities cold. In some cases, salivation is pro- duced : this seldom comes on during the first twenty- four hours, and is not often delayed beyond the fourth day. Toward the termination of the case, some indi- cations of disorder of the cercbro- spinal system comes on, such as slight drowsiness and stupor, or even coma; tremors and twitchings of the muscles, and sometimes even violent convulsions ; in some cases, paraplegia. These symptoms terminate in death. Post-mortem examination discovers inflammation (and its conse- quences) of the gastro-intestinal membrane." The following description of poisoning by the muriate of mercury is given by Dr. Wood in the United States' Dispensatory : " Swallowed in poisonous doses, it pro duces burning heat in the throat, excruciating pain in the stomach and bowels, excessive thirst, anxiety, nau- sea, and frequent retching with vomiting of bloody mucus, diarrhoea, and sometimes bloody stools, small and frequent pulse, cold sweats, general debility, diffi- cult respiration, cramps in the extremities, faintings, insensibility, convulsions, and death. The mucous membrane of the stomach exhibits, on dissection, all the signs which mark the action of a violent corrosive poison." Salivation. — Mercury frequently exhibits its most vio- lent effects on the mouth and throat, in producing what is technically called ptyalism. "The first observable effects of mercury in inducing ptyalism are a coppery taste in the mouth, a slight soreness of the gums, and an unpleasant sensation in the sockets of the teeth when the jaws are firmly closed. Shortly afterward the gums begin to swell, a line of whitish matter is seen along their edges, and the breath is affected with a peculiar and very disagreeable smell, called the mer- curial fetor. The saliva, at the same time, begins to flow; and if the affection proceeds, the gums, tongue, throat and face are much swollen; ulcerations attack POISONING. 219 the lining membrane of the mouth and fauces ; the jaws become excessively painful; the tongue is coated with a thick, whitish fur; and the saliva flows in streams from the mouth. It occasionally happens, that the affection thus induced in the mouth proceeds to a dan- gerous extent, inducing extensive ulcerations, gangrene, and even haemorrhage." A case of salivation came under the notice of the author, in which the entire cheek was mortified, being almost perfectly black from the nose to the ear, and from the prominence of the malarum to the angle of the jaw. The sides of the neck were also black, as well as several places on the body. In this situation, the child lived several days and nights in the greatest agony. Cases of very extensive sloughing of various parts of the mouth and throat, are not of unfrequent occurrence. The author assisted, a short time since, in a plastic operation for a new cheek, where the soft parts of one side of the face, from the prominence of the cheek down to the neck, had been entirely sloughed away from the effects of mercury. The sloughing and ulceration of the mouth and throat often continue until the bones become im- plicated ; the teeth loosen and fall out ; the gums decay, and the bones of the face rot away; and thus sometimes there is produced the most hideous de- formity. " A very frequent consequence," says Dr. Pareira, " of excessive mercurial salivation, and the attendant ulceration and sloughing, is contraction of the mucous membrane in the neighborhood of the anterior arches of the palate, whereby the patient is prevented from opening the mouth, except to a very slight extent. I have met with several such cases. In one, (that of a female,) it followed the use of a few grains of blue pill, administered for a liver complaint. The patient remains unable to open her mouth wider than half an inch. Several operations have been performed by dif- ferent surgeons, and the contracted parts freely divided, but the relief was only temporary. In another instance, (that of a child four years of age,) it was produced by a few grains of calomel. Though several years have elapsed since, the patient is obliged to suck his food ■ 220 DOMESTIC MEDICINE. through the spaces left between the jaws by the loss of the alveolar process." Ercthismus. — This affection, which is commonly called mercurial disease, is not an uncommon attendant of the use of mercury even in common practice. It comes on with great depression of strength; a sense of anxiety about the praecordia; irregular action of the heart ; frequent sighing ; trembling ; a small, quick, and sometimes intermitting pulse; occasional vomiting; a pale, contracted countenance, and a sense of coldness and languor. The system is extremely irritable, and morbidly sensitive. These symptoms continue on increasing in severity, until the patient sinks in death. Neuralgia from the effects of Mercury. — Various pain- ful affections of the nerves, are found to follow the use of mercury. The pains wander through the system, giving rise to extreme restlessness and suffering, which is always increased on any change of the weather or the state of the atmosphere. It is very common to hear people complain of mercurial rheumatism and pains in the bones. Many people, from these sufferings, have a thousand times wished themselves dead, to be out of their misery. Shaking palsy is also a result of the injurious effects of mercury on the nerves. Enlargements of the Glands. — Glandular enlargements, particularly of the liver, spleen, mesenteric glands, pan- creas, &c, are occasional results of the poisonous effects of mercury. Chronic diseases and enlargements of the liver, are now infinitely more common than they were before the great "regulator of the secretions'''' was so much in use. Authors also furnish us with detailed accounts of mercurial purging, mercurial bloating, mercurial fever, mercurial erysipelas, mercurial leprosy, mercurial exan- themous, • and miliary eruptions, mercurial sore eyes, mercurial paralysis, mercurial epilepsy, mercurial apo- plexy, mercurial asthmas, mercurial cancers, mercurial dyspepsia, mercurial hypochondriasis, mercurial con- sumption, mercurial dropsies, mercurial affections c POISONING. 221 the bones, periosteum, joints, heart, kidneys, brain, spinal marrow, &c., &c. Arsenic. — This is one of the most fatal corrosive poisons, and is the article generally used for criminal purposes or self-destruction. " The symptoms it pro- duces are an austere taste ; foetid state of the mouth ; frequent ptyalism; continual hawking; constrictions of the pharynx and oesophagus ; the sensation of the teeth being on edge; hiccough; nausea; anxiety; frequent sinkings ; burning pain in the praecordia ; inflammation of the lips, tongue, palate, throat, and oesophagus ; irri- table stomach, so as not to be able to support the blandest drinks; vomiting of matters, sometimes brown, at other times bloody; black, horribly foetid stools; small, frequent, concentrated and irregular pulse, but occa- sionally slow and unequal ; palpitations ; syncope ; insatiable thirst ; burning heat over the whole body, or a sensation of icy coldness ; difficult respiration ; cold sweats ; scanty, red and bloody urine ; change in the countenance; a livid circle around the eyelids; swelling and itching of the body ; livid spots over the surface, and occasionally a miliary eruption ; prostration of strength ; loss of feeling, especially in the feet and hands ; delirium ; convulsions, often accompanied with insupportable priaprism ; falling off of the hair ; detach- ment of the cuticle, &c. Sometimes there exists inflam- mation and burning pain in the urino-genital organs. It is very rare to observe all these symptoms in the same individual. In some cases, indeed, they are nearly all wanting, death taking place without any pain or prominent symptom. After death, the morbid appear- ances are various. In some cases, no vestige of lesion can be discovered, The appearances, however, in the generality of cases, are the following : The mouth, stomach and intestines are inflamed; the stomach and duodenum exhibit spots resembling eschars, and perfo- rations of all their coats ; and the villous coat of the former is in a manner destroyed, and reduced to the consistence of a reddish brown pulp. " Dr. Christison divides the poisonous effects of arse- nous acid into three orders of cases, according to the character and violence of the symptoms. In the first 222 DOMESTIC MEDICINE. order, the poison produces symptoms of irritation and inflammation along the course of the alimentary canal, and commonly kills in from one to three days. In the second, the signs of inflammation are moderate, or even altogether wanting, and death occurs in five or six hours, at a period too early for inflammation to be always fully developed. In the third order of cases, two stages occur, one in which inflammatory symptoms are devel- oped, as in the first order ; the other, marked by symp- toms referable to nervous irritation, such as imperfect palsy of the arms or legs, epilepsy, tetanus, hysterical affections, mania, and coma. It is a general character of this poison to induce inflammation of the stomach in almost all instances, provided death does not take place immediately, whatever be the part to which it is applied. Thus the poison, when applied to afresh wound, will give rise to the same morbid appearances in the stomach and intestines, as when it is swallowed. In some cases noted by Drs. Mall and Bailie, the rectum was much inflamed, while the colon and small intestines escaped.'' Antimony. — The symptoms of poisoning by antimony and its preparations, do not differ in many respects from those that characterize poisoning by most other active corrosive articles. There is usually a metallic taste; nausea; copious vomiting; frequent hiccough; burning pain in the stomach; colic; violent purging, attendant with griping pains; fainting; small, con- tracted, and sometimes accelerated pulse; difficult res- piration; difficulty of swallowing; coldness of the skin; convulsive movements; painful cramps, particularly in the legs; prostration; insensibility, and death. The tartrate of antimony and potassa, or tartar emetic, is the most common form in which the poison is taken. The other mineral corrosive and escharotic poisons such as bismuth, copper, lead, zinc, tin, nitre, and theii preparations, produce symptoms so near like those attending poisoning by mercury, arsenic and antimony, that it is not necessary here to give a separate descrip- tion of them. Acids. — When acids are taken in poisonous doses, the symptoms differ, in some respects, from those of the POISONING. 223 metallic corrosives and escharotics. The patient will generally experience a sour, acrid taste; burning in the throat, which is increased by pressure, swallowing or coughing ; pain in the stomach, accompanied with eructations; vomiting; a corroded condition of the membranes of the mouth, throat and stomach. The countenance is glazed, and the skin cold. The matter thrown up effervesces with lime and soda. Nitric acid occasions yellow stains, and sulphuric acid, black. Alkalies. — The alkaline poisons, such as carbonate of potash, ammonia, &c, produce "violent caustic, acrid taste ; great heat in the throat, with destruction of the lining membrane; difficult and painful deglutition; vomiting of bloody matter, which turns the yellow of tumeric brown; acute pain in the stomach; cold sweats; weakness ; hiccough ; violent colic pains, with purging of bloody stools and membranous flakes ; and death." The materials thrown up, will effervesce with vinegar and the other acids. Alcohol. — When alcohol is taken in excessive doses, it is frequently followed with violent symptoms, and occasionally by death. The symptoms are violent intoxication ; delirium ; irritability of the stomach ; vomiting ; apoplexy ; paralysis ; and sometimes con- vulsions. The breath generally smells of the liquor, by which the case may usually be distinguished from other affections. Gases. — Carbonic acid gas, when respired, produces spasms of the glottis ; great difficulty of breathing ; dimness of sight ; loss of strength ; and, finally, insen- sibility, apoplexy, and speedy death. It is this gas that is called damps, in wells and caverns. It is also pro- duced by the burning of charcoal; and thus, by care- lessness, or a want of knowledge of its fatal effects in close rooms, many persons are destroyed by it. Chlorine, when inhaled, produces violent irritation of the organs of respiration ; cough, with a raising of blood ; and permanent pulmonary diseases. 224 DOMESTIC MEDICINE. Narcotics. — The narcotic poisons, such as the deadly nightshade, opium, jimson, foxglove, hemlock, &c. ; when taken into the system, give rise to symptoms dif fering considerably from those attending all the other poisons. Soon after the poison is taken, the subject will feel a sense of heaviness in the head, stupor, and a peculiar numbness ; there is a disposition to vomit, which soon becomes pressing. A kind of intoxication will take place; the pupils of the eyes will dilate, and the patient falls into a deadly sleep, or perhaps becomes affected with mirthful delirium, or, on the other hand, a furious craziness ; there is great anxiety and dejection ; the pulse is variable, but at first full and strong. Con- vulsions of various parts of the body, and palsy of the limb", often set in, and, if not relieved, the patient soon sinks in death. Animal Poisons. — The poisons communicated to the body by the bites or stings of serpents and insects, pre- sent a train of symptoms that are somewhat peculiar. The bite of a venomous serpent, as from the copper- head, moccasin, viper, rattlesnake, &c, is immediately followed with a sharp and intolerable pain, that soon extends to the surrounding parts. The bitten parts soon swell considerably, and in some instances the entire body becomes very much swollen ; the color of the skin is various, at first pale, then reddish, yellow or greenish, and livid. Faintings, vomiting, and some- times convulsions, set in ; the pulse is frequent and irregular ; the breathing difficult, and the mental facul- ties sometimes very much deranged. The inflammation of the bitten parts generally ends in resolution ; but not unfrequently in ulceration, and even sometimes in mortification. The stings of insects are not generally followed with much inconvenience, except the intolerable pain and the swelling that usually attend them. Treatment. — The treatment of poisoning varies very much, — depending entirely on the nature of the cause or agency by which the affection is instituted. The first thing to be done, when any of the metallic corrosive or escharotic poisons are taken into the sys- POISONING. 225 tern, is to excite vomiting as quick as possible. This may sometimes be done best by tickling the fauces or throat with a feather. But if this does not readily excite free or copious vomiting, a full dose of lobelia should at once be taken, and repeated once in four or five minutes, until the stomach is well cleansed. Should the lobelia (owing to the blunted condition of the nerves) not operate promptly, a dose of equal parts of ipecac, blood-root, capsicum and bayberry must be given as soon as possible. This being done, the patient should take some of the white of eggs, beat in a bowl or other vessel, in half tea cupful doses, once in from half an hour to an hour, until three or four doses are taken. For this purpose, the mucilages of slippery elm, flaxseed, or comfre}' - , may be used, but they are not so good as the albumen of eggs. Sweet milk is also recommended by authors for this purpose. After the poison is evacuated, and the urgent symp- toms are removed, the patient should continue to drink, occasionally, some mucilaginous preparations, with a view to soothe and heal the stomach. The remaining treatment must be regulated according to the symp- toms. In cases of salivation and ulceration of the mouth, a strong tea of the astringent tonic should be used to wash the parts, which may be done by means of a swab. To correct the intolerable fetor, a solution of the chloride of lime or of soda should be used. Two drachms of the chloride may be added to a pint of water, and the parts washed with it three or four times a day. The healing process may now be commenced with the use of the compound tincture of myrrh, which should at first be diluted with water, and applied to the affected parts freely. The compound recommended for aphtha or thrush, should be employed freely as a wash. Sugar of lead seems to possess a chemical control over the disease, and may be used in a mild solution occasion- ally after the other medicines have been applied. The internal remedies should consist of alteratives, stimulants and tonics. The tincture of myrrh, sarsa- parilla, and narrow dock root, are all good. 15 226 DOMESTIC MEDICINE. The alterative syrup, given by Dr. Beach, is a very good medicine in the treatment of mercurial diseases; it is made as follows : J£ American or foreign Sarsaparilla, 6 ounces, Guaiacum shavings, .... 3 " Sassafras-root bark, .... 2 " Elder flowers 2 " Burdock root, 2 " Add of cheap spirits and water, each one gallon ; boil, and pour off the liquid; then add water repeatedly, and boil till the strength is obtained ; strain, and reduce to sixteen porter bottles full ; then add twenty-five pounds of clarified sugar. Let it stand twenty-four hours to settle; pour off, and bottle for use. The dose is a wine glassful, three times a day. A plaster made of Venice turpentine and sulphur, may be applied to the parts externally, by means of strips of cloth suited to the locations of the disease. When the concentrated acids are swallowed, it is not advisable to give an emetic. The inconvenience of their use in these cases, is, that they will not operate promptly, and, what is more, the acids are likely to augment the mischief by being thus agitated in the stomach, and carried up again through the oesophagus and mouth. The acids may be effectually neutralized by the agency of the alkalies. For poisoning by the sulphuric, muriatic, citric and acetic acids, the carbonates of soda, potash, lime and magnesia, may be taken indiscriminately. But for the nitric and oxalic, carbonates of magnesia, and lime, can alone be employed with safety It is very important, when sulphuric acid is taken internally, or applied to the surface, to observe the pre- caution not to take or apply water, as this, with the acid, will produce a very considerable heat, and thus materially enhance the mischief. The acids, in turn, are the proper antidotes for poi- soning by the alkalies. The vegetable acids are always to be preferred. Vinegar, lemon juice, or citric or tar- taric acid in solution, should be taken freely until relief is obtained. The fixed oils, such as castor, linseed, almond, and olive, form soaps with the free alkalies, and thereby destroy their caustic effects. POISONING. 227 Poisoning by alcohol, requires active emetics of lobelia. When the medicine cannot be given per stomach, it must be administered by injection. When the patient is feverish, the shower bath is very useful. The lobelia should be continued, in broken or emetic doses, as the case may require. Cold effusions to the head, are very good in cases of poisoning by the gases. Stimulating liniments and rubefacients are required when the heat of the surface is low. When the vital energies are much exhausted, the vapor baths and active stimulants, such as capsicum and the tincture of myrrh, must be used. When any of the narcotic or stupefying poisons are taken, the patient must immediately have an emetic of ipecac and lobelia in equal parts. The bowels must also be well evacuated, by means of stimulating and laxative enemas. As soon as the alimentary canal is cleared of the poison, the patient should take vinegar freely, as strong as it can be drank ; and this article, diluted, ought also to be administered by injection. The entire surface should be bathed once every hour or two, with a preparation made by scalding a table spoonful of capsicum in a pint of good vinegar. The vapor bath is also an excellent means in poison- ing from narcotics ; the vapor should be applied to the whole body, keeping the head cool by means of cloths dipped into cold vinegar. Poisonous bites must be treated with applications made by bruising or pounding into a pulp, equal parts of lobelia and the large plaintain taken in the green state, or if dry, they must be moistened with warm water. This poultice should be renewed every two hours, until the pain ceases and the inflammatory symp- toms subside. The blue or wild violet, bruised and applied to the wound, is said, by high authority, to cure a snake bite in a very short time ; and it is said that this is a plant that some of the Indian tribes employed for this purpose. Broken doses of lobelia should also be taken inter- nally ; and if there is much sickness, the portions must be increased so as to procure vomiting. Other attend- C*-8 DOMESTIC MEDICINE. ing symptoms must be treated according to their char acter and urgency. The stings of insects seldom require medical treat- ment; but if there is much swelling, the application recommended for poisonous bites, will be found useful. The anti-spasmodic tincture, and also the sour tincture of lobelia, are very good to bathe the parts with. RHEUMATISM. (Kheumatismus.) This is an inflammatory affection of the fibrous tissues, and is chiefly confined to the articulations, par- ticularly the large ones, as the knees, ankles, hips, shoulders, and elbows. The inflammatory symptoms exhibit various degrees in their violence and duration, and hence the disease has been divided into two vari- eties, the acute and the chronic. The disease has also been named after some of its principal locations, thus we have lumbago, when it occupies the articulations in the loins ; sciatica, when it affects the hip ; arthrodynia w r hen situated in the other joints. Symptoms. — Rheumatism comes on with severe pain, which in a day or two is followed with swelling of the joints. There is usually considerable stiffness, or want of mobility. In the chronic variety the skin is never discolored, but in the acute it is generally a little red. The pain is very apt to shift from one joint to another, and sometimes it runs along the course of the muscles connected with the affected joints. The disease may arise at any time of the year when there are frequent vicissitudes of the weather from heat to cold, but the spring and autumn are the seasons in which it is most common. Young persons are more subject to the acute variety, while in older people the reverse obtains. Rheumatism is occasioned by cold, and is brought on most generally by wearing wet or damp clothes, work- ing in cold and wet places, &c. RHEUMATISM. 229 People who are much affected with rheumatism, are very sensitive to the approach of wet weather, as they will be affected with wandering and aching pains through their limbs. Treatment. — Most old school writers are of the opinion, that rheumatism is but little susceptible of control by medication, and that when it sets in, it gen- erally runs its course, which is from three to six weeks. " One set of physicians," says Dr. Macintosh, " depend entirely upon blood-letting ; another upon purging ; another upon exciting long-continued profuse perspira- tions ; a fourth upon the exhibition of bark alone; and a fifth upon a course of mercury to produce salivation. It is no wonder, therefore, under such empirical treat- ment, that an attack of the disease used formerly to continue violent for such a long period of time. For- merly an attack of acute rheumatism, with its conse- quences, generally confined the patient for twelve months, that is to say, before he regained his ordinary state of health, and few got off with less than six months' confinement to bed." But in the reformed practice, it is seldom the case that more than from three to ten days are required to effect a complete cure. Ordinary cases of rheumatism may be successfully treated by the use of a powder composed of two pro- portions of gum guaiacum, and one of the extract of black cohosh, in fine powder, taken in doses of five grains three or four times a day, and to be accompanied with the use of the bathing drops applied to the affected parts frequently, with lively and long continued friction. In more obstinate cases, it may be necessar}^ to use in connection with this treatment, the vapor bath, and lobelia, in broken but frequent doses. In the most difficult cases, it is necessary to employ the lobelia in emetic doses, and when given in this way, the practi- tioner should always endeavor to manage so as to bring to bear the full relaxing powers of the medicine. It should be preceded with the vapor bath, and then given in nauseating doses for several hours before emesis is produced. The use of the vapor bath and lobelia emetics, should be practised every day or every second day, 230 DOMESTIC MEDICINE. according to the severity of the symptoms, and this course must be continued, until the disease is broken up. It has already been suggested that the use of the bathing drops and the guaiacum powders, should be continued throughout the entire treatment. The bowels must be kept open by the use of the laxative bitters. During convalescence, the patient may take two or three doses of the spiced bitters, daily. RICKETS. (Rachitis.) This is a very distressing disease of children, and seldom occurring before the ninth, and after the twenty- fourth month of their age. The disease is character- ized by softening and distortion of the bones of the back in the loins. The muscles become flaccid, the head enlarges, the carotids are distended, the limbs waste away, the abdomen swells and grows tense ; the stools are frequent and loose, a slow fever succeeds, with cough and difficulty of breathing, and the nervous system becoming more and more affected, the poor little sufferer finally sinks in death. On dissection, the liver, spleen, and other glands, have been found enlarged and in a scirrhous state. Treatment. — The general treatment in rickets, should differ little from that recommended for scrofula, but it must be perseveringly used, as this disease is extremely difficult to cure. The alterative syrup, comfrey, and Solomon's seal, are good articles in rickets. The bowels should be kept open with the use of small doses of the extract of mandrake, taken every evening, or every second evening, as the case may require. Cold bathing should be practised once every day or two, and the patient ought to be rubbed freely with a coarse towel, or the flesh brush should be used im- mediately after the cold bath. The stimulating lin- iment, or bathing drops, should be applied freely all RUPTURE. 231 over the body, soon after the friction with the towel or brush. Mechanical Support. — Physicians of the old school, depend mostly on mechanical means, for relief in rickets. Those means consist chiefly of stays to the small of the back, by means of pads and springs, as well as bandages. It is, however, very obvious, that mechanical means can promise but little toward a final cure, in cases in which the constitutional rickety dia- thesis is not obviated. Plasters. — Strengthening plasters will sometimes be found very useful in rickets. After sprinkling a very small quantity of capsicum (if this should prove too irritating, ginger will do) on the surface of the small of the back, a pitch plaster of large size may be laid over it, and worn as long as it will stick. The irrita- ting plaster will generally be found better, however. Tonics. — Tonics are very important remedies, and should always be used. A tonic cordial may be em- ployed, or the spiced bitters, cascarilla, or any other pleasant bitter or tonic medicine, may be taken three or four times a day. Regimen. — In this affection, attention to the diet, and exercise, is of paramount importance. The child should not be fed with any food that .is hard of diges- tion ; fat meats, cheese, butter, &c, should not be allowed. Nor should it be suffered to exercise too much in an upright position ; nevertheless, it must be taken out, so as to get the fresh and circulating air. RUPTURE. {Hernia.) This affection consists of a breach or rupture of the muscular wall of the abdomen, and the protrusion of some of the viscera of the belly. The parts that are thus forced out, are generally a part of the omentum, 232 DOMESTIC MEDICINE. or of the intestines, or both. But instances have occurred, in which the stomach, the spleen, uterus; ovaries, and bladder, have been forced through the openings. The protrusion consists of a kind of a sack composed of a portion of peritoneum, that is pushed out before the intestine or other organ that may be protruded. The rupture may take place at various parts of the anterior walls of the belly, but it occurs most com- monly in the groin, at the upper part of the thigh, and at the navel. When the hernial contents lie passively in the sack, and admit of being readily put back into the abdomen, it is termed a reducible hernia; and when they cannot be readily put back, but yet the passage in the intes- tine remains free, it is called irreducible. In cases of irreducible hernia, in which also the passage in the intestine is obstructed, the difficulty is called strangu- lated or incarcerated hernia. Again we have congenital hernia, and which, indeed, is of very common occur- rence. In this case the extruded viscera are not sur- rounded with the peritoneum, but descend nakedly through the tunica vaginalis into the scrotum. Hernia is also variously named, according to the extent and situation of the extruded part ; thus, if only a part of the circumference of the intestine forms the tumor, it is called entcrocele ; if a piece of the omen- tum only, it is named epiplocele ; and if both the intes- tine and omentum contribute in the formation of the tumor, it is called cntero-epiplocele. When the contents of the hernia are protruded at the abdominal ring, but only pass as low as the groin, or labium pudendi, the case receives the name of bubonocele, or ingual hernia ; when the parts descend into the scrotum, it is called an oscheocele or scrotal hernia. When the parts protrude below Poupart's ligament, it is called femoral or crural; when at the navel, exomphalos or umbilical ; and when it occurs at any other or promiscuous part of the front of the abdomen, it is called ventral hernia. Treatment. — As soon as a rupture is discovered, gentle efforts should be made to return the protruded parts, which may generally be done with the fingers, RUPTURE. 233 in such a way as readily suggests itself to every indi- vidual of common judgment. To facilitate the opera- tion, the patient should lie on the opposite side, with his knees drawn up a little, and his head somewhat raised, so as to relax or slacken the muscles of the abdomen. When the parts are returned, the patient should wear a compress or truss, so as to prevent the parts from returning again. When the parts cannot be readily returned, the system must be well relaxed with lobelia and steam, after which the operation will generally be found more successful. In cases of strangulation, the patient should be im- mediately placed over the bath, and should take nau- seating doses of lobelia while being vaporized ; and on leaving the bath a large dose of lobelia should be given so as to sicken considerably, when by proper manage- ment, the difficulty may generally be overcome. But should this method be unsuccessful, the patient should be placed in bed, and be surrounded with some steam- ing stones, and should have two or three injections of a weak tea of lobelia, in order thus still to extend the relaxation. While this is going on, the practitioner should be engaged very carefully to put back the ex- truded part. The author has found an application of finely pulverized lobelia seed, moistened with slippery elm mucilage, very excellent as a relaxing means. If the hernia cannot be thus reduced, an operation must be performed with the knife. The operation consists simply in enlarging the opening, so that the extruded parts may be returned, and then closing it again by making a few stitches. This operation, though not very dangerous, should only be entrusted to surgeons or persons of experience. The rupture may sometimes be healed up without an operation, especially when of recent standing, or when in a young subject, by wearing over it a plaster of the extract of oak bark. 234 DOMESTIC MEDICINE. SCROFULA. Scrofula, or king's-evil, as it is sometimes called, is a constitutional disease, which, however, chiefly affects the glandular system, especially the conglobate glands. The disease is most common among children, and rarely makes its appearance for the first time, after the body has attained its full growth. It is supposed that the disease is chiefly hereditary, and is first developed by a depraved condition of the nutritive functions, that the disease of the glands is a secondary effect, and that it is therefore not exclusively entitled to the name scrofula. Under this impression, physicians consider a great variety of chronic and difficult diseases, such as cancer, pulmonary tubercles, white- swelling, &c, as being more or less influenced by a scrofulous taint of the system. The symptoms which are usually considered to indi- cate the presence of scrofula, are the following: — Slight inflammation and swelling of the wings or outer cartilages of the nose ; swelling of the glands of the neck, which increase gradually, and at length become hard, painful, and of an irregular shape. The color of the skin over the glands is scarcely changed, but the protuberance or swelling is sometimes so great, as to constitute considerable deformity, and to interfere with the movement of the head, and with swallowing, or even to prevent opening the mouth. After having remained in this situation for an uncertain period, the tumors may disappear. Such, at least, is usually the case in the grown subject, and it is the most favorable termination ; but in young children they more fre- quently proceed to suppuration. The tumors soften, are painful, and fluctuation is perceptible ; the skin covering them becomes red and bluish, and ultimately opens, giving issue to a puriform fluid, which is usually of a thinner kind than that from phlegmonous ab- scesses ; and is mixed with pieces of white substances, resembling curds. The irregular wound, resulting from the spontaneous opening of the abscess, heals with difficulty, and the resulting cicatrix often constitutes an unsightly deformity. "Where the scrofulous vice tine- SCROFULA. 235 tures the organism deeply, the scrofulous inflammation first affects one gland and then another, and ultimately the individual may die of consumption, or mesenteric disease. — {Rostan.) In determining as to the existence of scrofula, the practitioner must bear in mind that simple tumefaction of the glands in the neck or any other part of the body, considered alone, is not sufficient evidence of the disease. These may become inflamed and enlarge in healthy constitutions, from the ordinary causes of in- flammation. Moreover, there are several other specific diseases, that give rise to swelling in the conglobate glands. We have an example of this character in mumps, {parotitis) and in the presence of ulcers or injuries in the extremities, the glands situated between them and the trunk of the body, soon become inflamed and enlarged. Evident symptoms of constitutional de- rangement, connected with the local symptoms, can alone be considered true diagnostics of the disease. Treatment. — In the treatment of scrofula, such a course must be adopted as is calculated to effect a permanent change in the condition of the nutritive and secretive functions. For this purpose the general sys- tem must be well relaxed and thoroughly cleansed. The stomach must be kept in order by the use of lobelia emetics ; the capillary system, by the use of sudorifics, or diaphoretics, and the baths ; the bowels, glandular and lymphatic systems, by the use of mandrake ex- tract, alterative syrup, laxatives, and other depuratives and detergents. The emetics and baths must be administered once, twice, or three times a week, as the obstinacy of the case may require, In the meantime the patient should fake the alterative syrup three times a day, in doses large enough to keep the bowels loose. Should there be difficulty in keeping the bowels in this condition, the common cathartic powders, pills, or mandrake extract may be taken, occasionally, with the syrup. Local Treatment. — The tumor in the indolent state, may often be discussed by accompanying the general treatment with local applications. An ointment, made 236 DOMESTIC MEDICINE. by mixing together equal parts of the stramonium and iodine ointments, should be laid on the tumor, and a plaster of it laid over the whole of the swelled gland. This application should be alternated with a stimula- ting and relaxant poultice, to be applied four hours every second day. But if the tumor, in spite of this treatment should proceed to suppuration, it must be treated after this, in the same manner that is proper for an occult or open scrofulous tumor. When the tumor is open, it must be well washed out, first with soapsuds, and then with a strong astringent tea, made of bayberry, cranesbill, pond-lily, and sumac bark. After this, the ointment for scrofula should be applied, and worn over the sore, renewing it morning and evening, until it is healed. At the dressings, the sore must always be well cleansed with astringent or alkaline washes, as the case may require. The solu- tion of chloride of soda or lime, should occasionally be used as a wash, especially if the sore is very foul. When the sore is very indolent and difficult to heal, a powder of equal parts of capsicum and mandrake root may occasionally be sprinkled on it. For this purpose the tincture of myrrh is also very good. Regimen. — Nothing is more important in the treat- ment of scrofula, than proper attention to the diet and general habits of the individual. Fat meats, gravies, rich pies, &c, should never be eaten by a patient of scrofulous habits. Pork is particularly injurious, being peculiarly calculated to favor the scrofulous diathesis. Indeed, it is supposed by many that the disease, in the majority of instances, is brought on by the use of swine flesh, either directly, or indirectly through the parent. It is even true that the name of the disease comes from scrofa, the Latin name of the hog ; but this is in consequence of the disease having so near a resemblance to the common throat disease of that animal. Vegetables constitute the best food for patients of scrofulous habits. Free exercise in the open air, is also very important. Alcoholic drinks must be sedulously avoided. 237 SCURVY. (Scorbutus.) The scurvy is a very distressing disease that is char- acterized by extreme debility ; emaciation ; pale and bloated countenance; spongy gums; livid spots on the skin ; offensive breath ; oedomatous swellings in the legs ; haemorrhages ; foul ulcers ; foetid urine, and ex- tremely offensive stools. The scurvy is a disease of a putrid nature, much more prevalent in cold climates than in warm ones-, and which chiefly affects sailors, and such as are shut up in besieged places, owing, as is supposed, to their being deprived of fresh provisions, and due quantity of acescent food, assisted by the prevalence of cold and moisture, and by such other causes as depress the nervous energy, as indolence, confinement, want of exercise, neglect of cleanliness, much labor and fatigue, sadness, despondency, &c. These several debilitating causes, with the concurrence of a diet consisting principally of salted or putrescent food, will be very apt to produce this disease. It seems, however, to depend more on a defect of nourishment, than on its vitiated state; and the reason that salted provisions are so productive of the scurvy is, most probably, because they are drained of their nutritious juices, which are extracted and run off in brine. As the disease is apt to become pretty general among the crew of a ship when it has once made its appearance, it has been supposed by many, to be of a contagious nature; but the conjecture seems by no means well founded. " A preternatural saline state of the blood has been assigned as its proximate cause. It has been contended by some physicians, that the primary morbid affection in this disease is a debilitated state of the solids, arising principally from the want of aliment. The scurvy comes on gradually, with heaviness, weariness, and unwillingness to move about, together with dejection of spirits, considerable loss of strength, and debility." As it advances in its progress, the countenance becomes sallow and bloated, respiration is hurried on the least motion, the teeth become loose, the gums are spongy, 238 DOMESTIC MEDICINE. the breath is very offensive, and livid or black spots appear on different parts of the body. These are some- times quite small, and circular, appearing sometimes in groups. In some places, these discolorations look like bruises or contusions. Old wounds which have been long healed up break out afresh; severe wandering pains are felt, particularly by night; the skin is dry; the urine small in quantity, turning blue vegetable infu- sions of a green color; and the pulse is small, frequent, and, toward the last, intermitting ; but the intellects are, for the most part, clear and distinct. By an aggrava- tion of the symptoms, the disease, in its last stage, exhibits a most wretched appearance. The joints become swelled and stiff; the tendons of the legs are rigid and contracted ; general emaciation ensues ; haemorrhages break out from different parts ; foetid evacuations are discharged by stool ; and a diarrhoea or dysentery arises, which soon terminates in death. "What is called land scurvy, or that form of the disease that occurs on the shore, or where the individual is not subject to the various remote causes, as above enume- rated, the disease is always more mild. Blotches with scaly eruptions on different portions of the body, a sponginess of the gums, and debility, are among the most prominent symptoms observed in these cases. But occasionally a case occurs in which the purple or black spots and spongy gums appear the same as in sea scurvy. Treatment. — The cause of scurvy very clearly indi- cates the course that should be adopted in the treatment. In the first place, the patient should be placed in an airy and comfortably warm apartment. This bein^ done, the entire surface ought to be well washed of? with a wash made by boiling an ounce of the best cap- sicum in a pint of good vinegar. In the meantime, the following preparation, which is an excellent stimulating and astringent tonic, should be taken : B; Capsicum, . Bay berry, Golden-seal, 1 ounce, . 2 ounces, . 2 White sugar, . 16 " Vinegar, Water, . . . 1 pint, . 1 " scurvy. 239 Pulverize and boil the first three articles in the water and vinegar for ten or fifteen minutes; strain, and add the sugar. The dose is a table spoonful once in two hours. The bathing with the vinegar and pepper, should be practised once every day. The bowels must be well cleansed and regulated by the use of astringent enemas, as the case may require. The tincture of myrrh is an excellent article in scurvy, and should be used in connection with the other means. Charcoal has been found especially advan- tageous in cases in which strong symptoms of putridity prevail. But for this purpose, the pyroligneous acid is better than any other article that can be used. This article should be freely employed throughout the treat- ment. When the gums are very spongy and sore, it is a good plan for the patient to hold an infusion in the mouth for a few minutes, three or four times a day, made by scalding some sumac berries in water. For this pur- pose, the tincture of myrrh, tincture of capsicum, and a tea of the astringent tonic, are also very useful. Oranges and lemons are excellent in this disease, and should be freely eaten. When haemorrhages occur, they must be restrained by the use of astringents, as in other cases of the kind. Regimen. — In no disease is the success of the treat- ment more dependent on the diet than it is in scurvy. Salted meats and oily substances, must be entirely aban- doned; and the patient should make up his meals, as much as possible, of vegetables ; or, if meat is used, it must be fresh and Jean. Vegetables of the cruciferous tribe, as mustard, cresses, radishes, horse-radish, cab- bages and turnips, used as food and medicine, seem particularly indicated in this disease. The scurvy-grass has always held a high character for its virtues in the cure of the scurvy. Potatoes, tomatoes, ripe fruits, &c, are all good, and may be used as food, in proper quantities. 240 DOMESTIC MEDICINE. SMALL-POX. (Variola.) " Small- pox, like the measles, is an eruptive fever propagated by contagion, running a definite course, and, as a general rule, — to which, indeed, the excep- tions are extremely rare, — affecting persons but once in the course of life. Its origin is lost in antiquity, and the common opinion is, that in these days, it never arises except by contagion ; yet there is reason to believe, that under an exceedingly unfrequent catena- tion of causes, it may be engendered. It must have originated in the first instance, from common causes, and it would be very strange if the circumstances that gave rise to it then can never now recur." The disease is divided into two distinct varieties, viz : the distinct and confluent. In the former, distinct, ele- vated, distended, and circular pustules are scattered over the surface of the body; and in the latter, the pustules are exceedingly numerous, depressed, irregu- larly circumscribed, and confluent or joined. But as there exists no essential difference between these vari- eties, the division is altogether arbitrary. We find that in the same case, on some parts, the pustules are dis- tinct, while on others, perhaps the face or breast, they are quite confluent. Symptoms. — In from seven to twenty days after the exposure, the patient experiences a sense of languor, weariness, aching pains in the back and lower extrem- ities, slight creeping chills, with flushes of heat, and pain in the forehead, when more or less nausea and vomiting, thirst, tenderness of the stomach, and soreness of the fauces rapidly supervene. The eruption now makes its appearance, first on the face, neck, and breast, then, on the following day, it is seen on the other parts of the body. On the Jirst and second days of the erup tion, being about the few th or fifth of the fever, the inflamed points are papular, smali, hard, globular, red, painful, separate and distinct from each other, the inter- stices being of the natural color and appearance. On SMALL-POX. 241 the third, fourth, and fifth days, they become vesicular, containing a little yellowish fluid, and the interstices become red. " During the sixth and seventh days the variola assumes a very peculiar character; it consists of concentric rings, of which the exterior and interior are opaque and pustular ; the intermediate one vesicular, and still trans- parent; it may therefore be denominated vesicular-pus- tular. It is further distinguished by a central indentation, and a surrounding areola of rose- colored inflammation, which frequently coalesces with those of adjacent pus- tules, when the eruption is numerous." About the eighth day, the eruption is. perfectly pustu- lar, and the central indentation remains. On the ninth and tenth, the pustules become orbicular, and are filled; and finally, on the eleventh, twelfth, and thirteenth, the pustules break or burst, and scabs are formed. This description applies to the distinct variety ; the confluent is more severe, and the appearance of the pustules is different, according to their number ; when very numer- ous, they give a uniform appearance of redness to the surface between the heads of the pustules. The fever generally runs pretty high as the eruption is developed, and in the confluent variety, there is some- times much delirium, or coma. The febrile symptoms, in the latter variety, not unfre- quently assume a typhoid character, and a horrible putrefaction may follow. The sequelae of small-pox are various, and sometimes very distressing. Chronic cutaneous affections, pro- tracted ulcers, necrosis ; inflammations of the eyes, mouth, throat, ears, head, and lungs ; dropsies, epilepsy, mania, paralysis, and many other distressing evils, sometimes result from small-pox. The diagnosis of small-pox, after the eruption appears, is not difficult; and before this, it matters not, as the treatment does not vary from that of the same symp- toms in other affections. When the fever is mild, and the strength of the patient keeps up, and if, moreover, the color of the eruption keeps of a bright red, there is not much danger. But if the fever runs very high, and there is much delirium, the danger is considerable. When there is a dispos''- 16 242 DOMESTIC MEDICINE. tion of a typhus character, and the pustules turn dark or black, and the strength fails suddenly, the case is almost certain to terminate in death. Prevention. — Vaccination seems to be an effectual prophylactic against the small-pox, provided that the vaccine matter be genuine, and produces its constitu- tional impression on the subject. Vaccination, although known before, was introduced to popular favor, by Dr. Jenner, and he, like the authors of other valuable dis- coveries, met with the usual opposition and persecution attending all innovations on old and established doc- trines and practice. Vaccina, or cow-pox, as it is called, seems to be at- tended with the various characteristics of small-pox, only that it is incomparably more mild. The number of pustules is not generally any greater than that of the insertions of the matter, although rare instances have occurred, in which a number, or even a consider- able crop has been produced. The vaccine matter, as the name {cow-pox) indicates, is derived from the cow. The virus of small-pox is inserted into the udder of this animal, and after the pustules have filled and dried, the scab is preserved for vaccinating purposes. Varioloides — Modified Small-pox. — "Soon after the general introduction of vaccination, exanthematous affections closely resembling small-pox, were occasion- ally observed in individuals who had previously under- gone the vaccine disease in a regular and satisfactory manner. These varioloid affections became more and more common ; and within the last fifteen years, they have appeared in various countries, in frpquent and extensive epidemics. In the early periods of vaccina- tion, these eruptions were generally regarded a* chicken,' pox; but subsequent inquiries lead to the opinion with many, that they are the product of & peculiar contagion, acting on systems, but partially protected against small- pox by previous vaccination ; and this appears now to be the general opinion. " From the earliest times of small-pox, of which we have any records, this disease has been noticed under various modifications, as remarkable and apparently as SMALL- POX. 243 distinct as the form we now call varioloid. We find various irregular forms of the disease described by the early writers under the names of the vesicular, pustular, and spurious small-pox ; swine-pox, sheep-pox, stone- pox horn-pox, &c, all of which were regarded as having but one origin, namely, variolous contagion. After small-pox inoculation was introduced, spurious variola was by no means uncommon ; and it has always been observed that genuine and spurious small-pox have in the same epidemics come in and gone out to- gether, in the same manner as they have been uniformly observed to do since vaccination has been introduced. " It appears, therefore, that various circumstances, either of a constitutional or accidental character, may modify small-pox in a variety of ways ; and as such modifications were abundantly observed before vaccina- tion was practised, we need not be surprised that they should be so frequent now, when a new and very ex- tensive modifying cause exists in the influence of the vaccine disease. That the present varioloid disease is in fact nothing but a modified form of small-pox, may be regarded as established by an abundance of direct and conclusive evidence." — (Eberlc.) The disease has many of the symptoms common to the genuine small-pox, but they are invariably more mild. Varioloides usually occurs but once during lite. The following particulars may be regarded as among its most prominent characteristics : 1. The eruption appears in clusters, occurring usually from the second to the fifth day. 2. Unlike the genuine small-pox, the eruption seldom or never enters into complete suppuration. 3. Excepting in very violent cases, the eruption is seldom attended with much fever, and the desiccation or scabbing, invariably occurs much earlier than in real small-pox, and instead of inclining to leave pits or depressions, the scabs leave rather an elevated disk or tubercle of a red appearance. Treatment. — On the proper treatment of small-pox, the profession has for many years been much divided. The great question has always been on the comparative merits of the stimulating and the anti-phlogistic plan. 244 DOMESTIC MEDICINE. But it is unnecessary here to give a detail of the vari- ous arguments that have been adduced on either side It is sufficient to know that we may expect to be suc- cessful in our remedial applications, only when we operate in concert with the vital powers, for when these give way, the " chance is over" and all medicine is use- less. To sustain and promote vitality, then, is the only rational plan of treatment in any case. When the fever runs high and the skin is dry and husky, (a condition unfavorable to the natural develop- ment of the eruption,) the body should be sponged with cold water, while the other usual means applied in fevers are instituted. Lobelia, thoroughwort, saffron, Seneca snakeroot, and black cohosh, are all valuable here. Should it be needed, the lobelia may be pushed to the extent of emesis. It is always comfortable in fevers, to have the air rather cool and the skin moist, and this seems especially favorable in small-pox. The patient's room should not only be kept cool, but well ventilated, and his surface should be daily sponged with tepid or cool alkaline washes, or lime-water. The skin should be kept relaxed, and the determining powers to the surface. In confluent small-pox, when the patient inclines to a typhus condition, stimulants and tonics must be freely used, such as capsicum, ginger, compound tincture of myrrh, brandy, wine, columba, gentian, and poplar bark. About the time that the pustules are filling, the cir- culation should be well sustained with light nourishing food and stimulating medicine, thus to prevent the pit- ting or pock-mark ; and with a view to this, the patient should be well guarded against picking and scratching the pustules, which all have a disposition to do, owing to the intolerable itching that attends the drying up of the pustules. If the face be oiled, or covered with oiled silk so as to shield it from the air, it will serve to pre- vent the pitting. The black cohosh {botrophis racemose) has of late proved itself of great utility in small-pox, and should be constantly used throughout the treatment. Indeed, it is thought by some that this article is a complete preventive to this disease. ST. Anthony's fire. 245 SPRAIN. (SuUuxatio.) Sprains result from accidents, and usually occur about the joints, especially at the ankles and wrists. They are attended with considerable pain, swelling, redness, and sometimes a yellow or dark green color of the skin. The ligaments of the joints are sometimes considerably injured; and when this is the case the parts are gen erally slow to recover. Treatment. — Some physicians recommend the appli- cation of cold water, by pouring it from a considerable hight on the injured part. If this course is taken, the skin, after the application, should be dried and well rubbed with a towel, and then a coat of the stimulating liniment, or the bathing drops, or opodeldoc ought to be freely applied. If the part is very painful, it may be steamed over a pot of bitter herbs, applying or laying the hot herbs over the sprain, while the hot water is regularly poured over them. An application of bruised poppy, or jimson leaves, will be found very excellent to assuage the pain. The fomentations and liniments should be applied frequently, or as the case may require. Sometimes a relaxing poultice made of lobelia, slip- pery elm, and capsicum will be found very advantageous. ST. ANTHONY'S FIRE. (Erysipelas.) Erysipelas is a febrile affection, attended with diffu- sive cutaneous inflammation on some part of the body, characterized by redness, burning, heat, swelling, and vesication. Symptoms. — Previously to the development of the local symptoms, there is almost universally more or less 246 DOMESTIC MEDICINE. morbid movement in the general system. The digestive organs are usually impaired; there is loss of appetite, a furred tongue, sometimes nausea and headache, and often a considerable oppression in the region of the stomach- After these symptoms have appeared for an indefinite length of time, the eruption will make its appearance, sometimes preceded with a paroxysm of fever. The inflammatory eruption comes out in the form of an irregular stain or diffused red blotch, which has a disposition to enlarge rapidly. Some vesicles general' appear about the third day, which are filled with , yellowish serum. The eruption, however, sometimes assumes a latent form, and seems to become chronic. There is usually more or less swelling of the parts ; and this often becomes considerable. When the disease attacks the face, the eyes are often closed by the swell- ing, and the entire countenance becomes so disfigured by the tumefaction, that it cannot be recognized. Although the dermoid texture (the skin) is most sub- ject to erysipelas, yet the inflammation is known some- times to penetrate deeply into the body, or even to affect the surfaces of internal organs. Erysipelas assumes various degrees of violence, and presents different characteristics, which are, however, all owing to the idiosyncrasy of the patient — the condition of the atmosphere — the state of the system at the time of the attack, or the character of the treatment. These varieties have been severally called the erratic, the suppurative, the cedomatous, and the gangrenous ery- sipelas, according to the character and termination of the disease. Among the various circumstances and causes that tend to produce erysipelatous inflammations, the follow- ing might be named : 1, sudden transition from warm to cold atmosphere ; 2, local irritants ; 3, general depraved and corrupt condition of the humors ; 4, maltreatment of other diseases; 5, constitutional predisposition. It is not very difficult to distinguish this, from other forms of disease. The local symptoms are generally the most unequivocal diagnostics. The redness and swelling of erysipelas, is generally attended with an intolerable itching and burning. The eruption differs from that ST. Anthony's fire. 247 of scarlet fever, in its more marked phlegmonous char- acter, and from that of measles, by its diffusion, and the abruptness of its margins. When the disease is of the erratic or wandering char- acter, it is comparatively mild and without danger. When the redness disappears, and is followed by the natural color of the skin, and the fever subsides, the disease may be expected to terminate by resolution ; and even when it terminates by suppuration, it is not con- sidered dangerous, although it is very distressing ; but when the skin in the oedematic or any other variety, turns purple or dark, and the swelling becomes soft, gangrene is apt to supervene, and carry off the unfor- tunate sufferer. Treatment. — The indications in the treatment of ery- sipelatous inflammation, are about the same as in other violent inflammations ; prompt relaxation, evacuations, and tonics are required. In former years the author was in the practice, in severe cases, to put the system under the influence of nauseants, and applying a liniment made of lime-water and linseed oil to the affected parts This latter some- times was alternated with a cataplasm of lobelia, slippery elm, and the common diaphoretic powders, in equal parts, — adding sufficient rye or wheaten flour to render it adhesive. When putrescent symptoms appeared, an application was made, composed of the dregs remaining in the preparation of the compound tincture of myrrh; Peruvian bark, and bayberry, in equal portions, — adding sufficient water and gum arabic to form a cataplasm. These means were generally quite successful. But in milder cases the first named liniment was often alone sufficient. The application of fresh blood or flesh to the affected parts was formerly considered the best external remedy, and though this is somewhat inconvenient, it is certainly an effectual means. A plan of treatment, at this moment suggests itself to the mind of the author, which is very excellent in other cases of inflammation, and why not in this? It is to apply the acetate of ammonia freely to the parts 248 DOMESTIC MEDICIHJ. affected, and then enveloping them in cloths kept wet with cold water. Emetics of lobelia are important in all bad cases, and should never be neglected. They tend to obviate the general inflammatory diathesis, by equalizing the cir- culation and regulating the nervous action. Cathartics are proper, but should never be of an irritating character, lest they might occasion metastasis of the disease, and thus endanger the bowels. Diaphoretics of the relaxant and non-stimulant kind, as thoroughwort, acetate of ammonia, &c, are service- able when there is much fever. Tonics are important in low cases, especially when there is danger of gangrene. ST. VITUS' DANCE. ( Chorea.) This singular disease consists of an affection of the nerves, giving rise to irregular and uncontrollable jerk- ing or twitching of the muscles of parts, or even, in rare cases, the entire body. "It has been called St. Vitus' dance, because some devotees of St. Vitus exer- cised themselves so long in dancing, that their intellects were disordered, and could only be restored by dancing again at the anniversary of St. Vitus." The disease most commonly affects only one side at a time, particu- larly the arm and leg. When chorea affects the muscles of the face, it gives rise to quite a variety of the most strange and fantas- tical grimaces and contortions. When any motion is attempted to be made, various fibres of other muscles act which ought not; and thus an effect contrary to that intended, is produced. The disease is chiefly incident to children and young persons of both sexes, seldom occurring, for the first time, after the age of puberty. The intellectual faculties are seldom affected in this disease ; but it has been stated, that when the affection is very severe and of long standing, more or less injury of the mind has been experienced. ST. VITUS' DANCE. 249 Chorea may arise in debilitated habits, from any cause that produces protracted nervous irritation. The irritation occasioned by the presence of worms, and that attending teething, &c, may be named among the exciting causes of the disease. Treatment. — The cure of chorea may generally be effected by taking, in connection with a strong tea of the nervine tonic, three or four times a day, the follow- ing preparation : ]£ Black Cohosh, . 2 ounces, Skull-cap, . . 1 ounce, Assafetida, . . ^ " Pulverize and digest in a pint of alcohol for six days, and pour off the tincture carefully. The dose is a tea spoonful once in three hours. The good effects of the above are made more sure by taking some pills, made by rolling equal parts of lobelia and skunk cabbage root, in fine powder, with the extract of blue cohosh or of lady's slipper. The dose of these is from one to three, two or three times a day. Bathing. — The shower bath is an excellent auxiliary to the other means in this disease. The patient should take a showering at least once a week, but would do much better to take one every day. After the bath, the skin must always be well dried and freely rubbed with a coarse towel. Cathartics. — Cathartics have been found of consid- erable utility in this disease ; but the articles used of this class must be mild and unirritating. Usually, how- ever, it is only necessary to keep the bowels open by the use of laxatives. 250 DOMESTIC MEDICINE. SUSPENDED ANIMATION. (Asphyxia.) It is known that when oxygen, the supporter of phy- siological as well as common combustion,* is excluded from the lungs, that all the vital functions will cease. This condition of the body is now called asphyxia. Formerly, the term was restricted to diseases of the heart ; or, rather, it was used to designate those affec- tions that were characterized by suppression or want of pulse. Asphyxia may be caused by anything that will obstruct the passage of atmospheric air to the lungs. The common " causes of the difficulty are drowning, strangling or hanging, irrespirable gases, &c. These will receive a short notice separately. Drowning. — When a person is submerged, or falls into water, the instinctive motions of respiration are continued; but as the irrespirable fluid is drawn into the windpipe, the irritation produced by its presence gives rise to spasm in the muscles of the glottis, and thus the passage is instantly closed up ; and in this way we may account for the fact that water is never found in the lungs of persons recently drowned. It is, how- ever, generally the case that a frothy mucus is found in the air cells or bronchial tubes, which, by most patholo- gists, is supposed to be dependent on the presence of water. It is not improbable, that although the trachea is very sensitive to the irritation of water or any other foreign substance; yet during the first few inspirations more or less may be drawn even into the lungs, and then, by the coughing excited, the most of it be forcibly expelled, while the spasmodic contraction at the glottis, which by this time has become permanent, prevents the further admission of the fluid. It is remarkable, that it is also seldom the case that water is found in the stomachs of those recently drowned. * The term "physiological combustion " is here used to express that phenomenon that is evinced in the union of oxygen with the elements of the blood. SUSPENDED ANIMATION. 251 It is very certain, that unless the submersion is attended with violence, as contusion, &c, sufficient to occasion death more quickly than it would take place in consequence simply of submersion, that the death is alwav« occasioned by the absence of the atmospheric air or oxygen from the lungs. Strangling or Hanging. — It has been supposed that in cases of asphyxia from this cause, the mischief is occasioned by the obstruction produced to the circulation in the large vessels of the neck, — that from engorge- ment in the venous system, a fullness or hyperaemia in the brain is occasioned, which, giving rise to apoplexy, in this way brings on death. But this is a mistaken idea; for, although the venous circulation through the jugulars and other superficial vessels in the neck, is totally obstructed, and notwithstanding a considerable hyperaemia of the vessels of the brain is produced, yet it is certain, from the results of observation and experi- ment, that this is not generally the cause of the death, in strangulation. In this, as in other cases of asphyxia, this event follows as the common result of the exclusion of the atmospheric air or oxygen from the lungs. Asphyxia by Irrespirable Gases. — These gases pro- duce death negatively by their want of support to respiration, or by their occasioning a spasmodic clo- sure 6f the glottis, and thus preventing the entrance of the atmosphere or oxygen, the only supporter of respi- ration. The gases that are especially mischievous in this respect, are not very many ; among the most promi- nent, are carbonic acid gas, ammoniacal gas, muriatic acid gas, deutoxide of nitrogen, and chlorine. Among the less frequent causes of asphyxia, are mechanical hindrance to the expansion of the chest, as in tight lacing, &c, smothering, tumors in the chest, and the congenital causes. General Symptoms, Sfc — The symptoms attending asphyxia, although about the same, whatever be the character of the mechanical cause, must nevertheless be expected to vary according as the supply of oxygen 252 DOMESTIC MEDICINE. is diminished or totally withheld. But the following description by Dunglison, will hold good in the gene- rality of cases : " When the access of oxygen is in a manner pre- vented, a few seconds elapse before any uneasiness is experienced ; but after this, a marked feeling of disti ess indicates the necessity fur satisfying one of the most imperious wants — that of respiring — the besoin de res- pirn-. This feeling soon becomes insupportable ; the animal gasps and yawns repeatedly, and makes use of every effort to obtain a supply of the indispensable fluid. The whole body is agitated. The limbs quiver, and are convulsed, or thrown into tetanic spasms. Almost instantaneously, especially if respiration has been slightly practicable, and the supervention of asphyxia therefore gradual, the feeling of distress is attended by vertigo and stupor ; the face becomes livid, especially the lips and the orifices of the mucous membranes; and, at times, the whole surface becomes of the same hue. The sensorial functions are suspended in a few moments, and almost simultaneously the muscles lose their power of contraction, so that the individual falls. In this state of apparent death, an obscure circulation alone exists in the great vessels, while the functions of the capillary system continue. The precordial region pre- sents, at times, a dullness on percussion, which extends as far as two inches to the right of the sternum, and three inches above the space usually occupied by the right heart. This dullness is owing to the engorgement of the right cavities. — (Piorry.) Soon the circulation ceases, first of all in the larger vessels, and afterward in the capillaries; and, with this cessation, the functions of secretion, nutrition and calorification are arrested The asphyxia has now become positive death. " Examination of the body after death, exhibits gen- eral lividity of the surface, and the face more especially. The parenchyma of the different organs is filled with fluid, especially that of the liver — which is sometimes quite purple — of the spleen, kidneys, and lungs. The whole capillary system, indeed, is surcharged with blood of a dark color, which is described by some writers as always fluid; — {Addon;) but to this there are many exceptions. — (Bc?ard.) The blood appears to be wholly SUSPENDED ANIMATION. 253 collected in the pulmonary artery, the right side of the heart, and the venous system generally, while the pul- monary veins, the left cavities of the heart, and the arteries, are empty, or contain but a small quantity of fluid. The appearances, however, differ somewhat, according as the respiration is at once obstructed, or has taken place, although imperfectly, for a time. In the former case, death ensues more promptly, and there is less suffering ; and, on examination, the cutaneous capillaries and the various organs are less charged with blood, and the fluid is less exclusively collected in the venous system." The cause of the livid or dark appearance of the countenance and other parts of the body, and the dis- tortion of the features, will not always insure these phenomena for any considerable time after death. For it is often, if not generally the case, that the counte- nance assumes its natural appearance; and it is even said, that not unfrequently there is quite a placidity of expression — a "rapture of repose" giving a singular contrast with the previous appearance. Nevertheless, in some cases, especially when there is mechanical obstruction in the superficial vessels, as in hanging, that all the ' horrible appearances attending asphyxia are continued long after death. This condition of the dead body is graphically described in Shakspeare's lines on the frightful physiognomy of Duke Humphrey : " But see ! his face is black and full of blood ; His eye-balls further out than when he lived, Staring full ghastly like a strangled man ; His hair uprear'd ; his nostrils stretch'd with struggling ; His hands abroad displayed, as one that grasp'd And tugg'd for life, and was by strength subdued." Treatment. — In the treatment of cases of suspended animation, the great object should be to bring about that, condition of the body most favorable to the per- formance of the physiological or vital functions, as respiration, circulation, calorification, &c. The first thing, therefore, that should be done, is to remove the subject from the influence of the cause or causes of the asphyxia. This being done, the body, if wet, should be immediately, dried with the use of a towel or dry cloth, and then a course of the most lively friction must 254 DOMESTIC MEDICINE. be instituted with the use of the rubefacient oil, bathing drops, tincture of capsicum ; or, if none of these are convenient, the dry hand should be used. In the mean time, efforts must be made to get down some permanent diffusive stimulant, as the anti-spasmodic tincture, tinc- ture of capsicum or myrrh, &c. Enemas, as warm as could be borne by a healthy subject, composed of the same permanent and diffusive stimulants, must also be frequently administered. By this time the preparations for a vapor bath may have been instituted, so that the patient may now be surrounded by a vapor of moderate heat. The precau- tion must, however, be observed, not to deprive the face of fresh and circulating air. The vapor should, for a few moments, be kept at a temperature of only about sixty or seventy degrees, or about that of the surface of a healthy man; and then it may be gradually raised as the circumstances may seem to require. Artificial inflation of the lungs, has ever been regarded as a very important means of resuscitation. The infla- tion is generally made by forcing the air into the mouth through a tube, or by means of a common bellows, while the nostrils are held close, to prevent the return of the air through them. The air must, however, be forced in very moderately, and time should be given for it to pass out alternately with the inflations. The pro- cess may also be favored by placing the band on the breast or abdomen, and gently pressing alternately with the inspirations. Galvanism has of late been found very useful in those cases, and if a battery is at hand, it is advisable to use the means. TIC DOULOUREUX. {Neuralgia.) Tins is one of the most painful affections that are incident to man. It essentially consists of an intermit tent pain that is seated in a nerve, and shoots along its? course and ramifications. TIC DOULOUREUX. 255 The pain generally occurs suddenly; but sometimes a slight sensation of itching or of heat, creeping or numbness is felt in the part, which gradually becomes more and more intense, until the disease is fully estab- lished. Then again the pain is preceded by a feeling of coldness and numbness. When the disease has fully set in, the pain is usually extremely acute and lancina- ting, and the velocity with which it traverses the nerves, •has been compared to an electric shock. The face is more commonly the seat of neuralgia than any other part of the body. " When the pain is at its hight, it seems as if burning needles were thrust into the affected parts. After a time, the agony diminishes, and is alternately replaced by a sense of numbness, which remains until the pain recurs. Exacerbations and remissions of pain take place at intervals, until ultimately the pain becomes endurable, which it scarcely was at the hight of the paroxysm." It is obvious, that a disease so painful could not long exist without affecting the general s} r stem. Sleep is driven away; general restlessness sets in; digestion is poorly performed; and if the patient is not relieved, the system will become worn down, and in the worst cases death not unfrequently occurs in the course of a week or two. Treatment. — The pain may generally be removed by the use of the rubefacient oil. This preparation must be applied to the affected parts with thorough and con- tinued friction. In rubbing it on, the ends of the fingers should be drawn along the course of the pain with considerable pressure. In the meantime, lobelia should be taken in nauseating doses. It is the best plan to form some of the pulverized seed into pills with the lady's slipper extract, and then to give them once in three hours in nauseating doses. The bathing drops will sometimes answer instead of the rubefacient oil; and it happens occasionally, that the pain may be readily relieved by the use of the rube- facient solution. Hot fomentations of bitter and relaxing herbs, have also been found useful. 256 DOMESTIC MEDICINE. The vapor bath should be applied, together with emetic doses of lobelia, if the pain does not yield to the other means recommended ; and these should be repeated daily, in extreme cases, until the disease will yield. The nervine tonic should be used during the entire treatment, whatever may be the other means employed. TOOTHACHE. {Odontalgia.) This very troublesome complaint is very common, and needs no detail of symptoms. The pain commonly called toothache, is not always caused by caries of the teeth. Inflammation of the alvaolo-dental membrane often gives rise to extreme pain, when the teeth may be sound. Ulcerations may occur in the sockets of the teeth from inflammations of this membrane, and the pus be discharged between the gums and the teeth ; and sometimes the matter, not finding vent, will remain and give rise to a carious condition of the bones, and thus keep up a fistulous ulcer. The soft parts within the jaw bones may also become inflamed, and cause what is commonly called the "jaimcke." This latter generally passes off by resolution. However, in the majority of instances, the pain arises from caries of the teeth. The crown of the tooth is most commonly affected, but it sometimes hap- pens that its fangs or roots commence to decay first. In this case the symptoms do not differ much from those that characterize inflammation of the membranes, only that the difficulty lasts longer, or assumes a more chronic form. When the crown or top of the tooth is affected with caries, it seems that the disease com- mences on the outer edge of the bony part, immedi- ately under the enamel. Carious parts are generally discovered by the painful sensation caused by the con- tact of cold or hot drinks, by the touch of sugar or other saccharine matter, before it can readily be seen on examination. The rotting of the tooth generally commences in a small point, and continues thence, until the whole crown is decayed away. The bony ULCERS. 257 part goes first, and afterwards the enamel or remaining shell is broken down either by an effort at extraction, or by chewing hard substances. Treatment. — In cases of inflammation of the mem- branes, which may be known by the absence of caries, by the pain seeming to affect a number of teeth at the same time, by the affected teeth being loose and longer than the rest, by the swelling of the cheeks, and the ulceration of the gums, the external treatment should consist of a course nearly the same as that recom- mended for glossitis, only it may be milder in the com- mencement. The teeth should not be extracted in cases of inflammation of the membranes, unless it be- comes necessary to do it when ulceration takes place, in order to give vent to the pus. In cases of toothache from caries, the pain may be relieved by the introduction of a little oil of cloves, cinnamon, summer savory, or some creosote, which may be done by means of a little bit of cotton or lint. When the pain is relieved, the tooth should be cleaned out, and plugged up with a metallic substance, such as silver, or gold foil. But when the tooth is so far decayed as not to be of much service, it should be extracted. The rubefacient oil or bathing drops, applied with considerable friction, will often give relief in toothache as well as jawache. Some advise destroying the nerve ; and for this purpose, the introduction of a hot wire or caustics, such as the carbonate of potash, &c, if well done, will generally be successful. ULCERS. ( Ulcer a.') Ulcers are open, foetid, chronic sores, which have the following description by Hooper: — A purulent solution of continuity of the soft parts of the animal body, arising from a variety of causes, as all those that produce inflammation, from wounds, specific irritation 17 258 DOMESTIC MEDICINE. of the absorbents, from scurvy, cancer, the venereal or scrofulous virus, &c. The proximate or immediate cause is an increased action of the absorbents, and a specific action of the arteries, by which a fluid is sep- arated from the blood upon the ulcerated surface They are variously denominated ; the following is the most frequent division : 1. The simple ulcer, which takes place generally from a superficial wound. 2. The sinuous, that runs under the integuments, and the orifice of which is narrow, but not callous. 3. The fistulous ulcer or fistula, a deep ulcer with a narrow and callous orifice. 4. The fungous Jeer, the surface of which is covered with fungous flesh. 5. The gangrenous, which is livid, foetid, and gan- grenous. 6. The scorbutic, which depends on a scorbutic acri- mony. 7. The venereal, arising from the venereal disease. 8. The cancerous ulcer, or open cancer. 9. The carious ulcer, depending on a carious bone. 19. The inveterate ulcer, which is of long continu- ance, and resists the ordinary applications. 11. The scrofulous ulcer, known by its having risen from indolent tumors, its discharging a viscid, glaring matter, and ,-+ s indolent nature. The following four great, distinctions between wounds and ulcers, are muJe by Professor Richerand : — 1. A wound arises from the action of an extraneous body; the cause of an ulcer is inherent in the economy. 2. A wound is always idiopathic ; an ulcer is always symptomatic. 3. A wound has essentially a tendency to heal, because the action of its cause has been momentary ; an ulcer, on the contrary, has a tendency to enlarge, because its cause persists. 4. The treat- ment of a w nmd is purely surgical ; that of an ulcer is medical as well. Treatment. — As ulcers, in nearly every instance, are a result of an unhealthy condition of the general sys- tem, it is a very good plan, as a common rule, to com- mence their treatment with such a remedial course as ULCERS. 250 is calculated to obviate the various primary and inci- dental causes that may obtain in the case. To regulate the secretions, equal parts of the extract of yellow parilla and mandrake, formed into pills, may be given in doses of one pill three times a day. For this purpose, the alterative syrup is also very good. Laxative betters are very useful, a& a general remedy m the treatment of ulcers; they should be employed throughout the treatment. Local Treatment. — One of the most important things in the local treatment of ulcers, is to keep the sore clean. It must be frequently washed out with soap- suds and astringent infusions made of the astringent tonic, bayberry, sumac bark, white pond- lily, &c. After the washings, the sore should be wetted occasionally with some pyroligneous acid ; or if this is not at hand, some tincture of myrrh, lobelia, or capsicum, may be dropped into it at the dressings. Poultices. — Great benefit is often found in the use of poultices. The ingredients of which these should be made, must be selected according to the condition of the ulcer, whether they should be astringent, relax- ant, stimulating or emollient. Among the astringent articles, almost any of the simples will be found to answer, but the astringent tonic, bayberry, cranesbill, sumac, and pond-lily root are generally preferred. Among the relaxants, the best are lobelia and thor- oughwort. Of the stimulants, ginger and capsicum, made up with meal, or slippery elm bark, are gener- ally preferred. Slippery elm, comfrey, flaxseed, and mallows, are the best emollients. Salves. — As soon as the ulcer issues healthy pus, or that which is of a thick, yellowish, cream-like consist- ence, the sore will be ready for the healing process. To promote this, salves are of great benefit. Either of the salves recommended among the compounds may be employed. It is sometimes best to change them, first using one, and then another. At the dressings, the sore must always be washed out, first with soapsuds, and then with some i stringent wash. 260 DOMESTIC MEDICINE. If, at any time after the use of the salves is com- menced, the ulcer should become inflamed and painful, the emollient and relaxant poultices should be used. The plaster recommended for the treatment of open cancers, is an invaluable application for old indolent and obstinate ulcers. Jn fistulous and sinuous ulcers, it is necessary to inject the articles used into the opening of the ulcer, by means of a syringe made for the purpose, that can be got at drug stores. In gangrenous ulcers, antisceptic poultices, made as directed for mortification, must be used. When the ulcer is very indolent and slow to heal, it is sometimes very good to sprinkle some capsicum or its oil, or the oil of lobelia into it. When there is fun- gous flesh in it, some fine blood-root, mandrake root, burnt alum, or what is perhaps better than anything else, a little carbonate of potash may be sprinkled on the fungous parts ; and then a poultice should be laid over the whole. VENEREAL DISEASE. (Syphilis.) This is a very contagious disease, propagated by impure sexual intercourse, and prevails considerably among both sexes in some of our large cities, and is not unfrequent in most country places. It is supposed by some to be of ancient origin, yet it did not make its appearance in Europe until 1494 or 1495. The disease consists essentially of a specific poison, which when contracted, gives rise to symptoms that mark two distinct stages of the affection, the primary and the constitutional. The primary or local symptoms are not generally called syphilis, but receive the name of gonorrhoea venerea or clap, chancre, and bubo, according to its different seat or appearance. Gonorrhoea. — Gonorrhoea may take place without the presence of the venereal poison ; but when it fol- lows as an effect of this, it generally sets in, in from a VENEREAL DISEASE. 261 few days to one or two weeks after the exposure, with an uneasiness about the parts of generation, sach as an itching sensation in the glans of the penis, and a soreness and tingling feeling along the whole course of the urethra. Soon after this, a whitish matter will make its appearance, and there will be a degree of pungency or burning in passing the urine. There is considerable pain in the glans, which will extend with greater or less activity, upward along the course of the urethra ; the glans becomes red and swollen, and very tender to the touch. The patient is usually much har- assed with painful erections, particularly when in bed, and when the urine is voided. In many cases, the inflammatory action extends from the mucous mem- brane to the corpus or body of the penis, giving rise to much tenderness and hardness in this part. Attending this, there is usually a very painful symptom called chordee, which consists in strong and protracted erec- tions, whilst from the hard and unyielding condition of the corpus spongiosum, the penis is thrown into a curved form, with the head turned down and the body bent upward. It is not unusual for small quantities of blood to be discharged with the gonorrhoeal flux. Both of the sexes are liable to this affection. In females* however, the symptoms differ in most particulars ; du«. the discharge is of the same character, and is often difficult to be distinguished from that of common leucorrhoea. * Chancres. — These make their appearance at an uncertain period after the venereal poison is con- tracted — first by one or more small pimples, excoria- tions or ulcers, that are situated on some part of the genital organs, preceded usually by an itching in the part. These sores enlarge and assume all the charac- teristics of the most obstinate ulcers, with thick hard- ened borders. Nor is the induration confined to the margins, for the whole excavated surface of the ulcer is hard and unyielding. The true venereal chancre is always of an indolent character, or slow in its pro- gress. Bubo. — The glands situated at the junctions of the fimbs, possess a singular power of absorbing poisons 262 DOMESTIC MEDICINE. carried into the circulation ; and thus from this striking arrangement of things, poisons starting in the extrem- ities, are often prevented from passing into the trunk among the viscera. When these glands have absorbed much poison, they swell considerably, and not unfre- quently suppurate and break. The glands in the groin, are those usually affected with the venereal poison ; but it is very seldom the case, that from this cause, more than one in a side be- comes affected at a time. When a gland thus swells, it is called bubo. The bubo may continue for a time in an inflamma- tory condition, and then pass off by resolution, or it may suppurate, and then assume all the usual charac- teristics of an obstinate ulcer. Syphilis. — The constitutional effects of the venereal poison, are still more horrible than the primary symp- toms. The following description is given by Hooper: " When venereal matter gets into the system, some symptoms of it may often be observed in the course of six or eight weeks, or probably sooner; but in some cases, it will continue in the circulating mass of fluids for many months before any visible signs of its effects are produced. The system being completely contamin- ated, it then occasions many local effects in different parts of the body, and shows itself under a variety of forms, many of which put on the appearance of a dis- tinct disease. We may presume that this appearance depends wholly on the difference of constitution, the different kind of parts affected, and the different state these parts were in at the time the matter or poison was applied. " The first symptoms usually show themselves on the skin, and in the mouth or throat. When on the skin, reddish and brownish spots appear here and there on the surface, and eruptions of a copper color are dis- persed over different parts of the body, on the top of which there soon forms a thick scurf or scale. This scurf falls off after a short time, and is succeeded by another, and the same happening several times, and at length casting off deep scabs, an ulcer is formed which discharges an acrid foetid matter. When the matter VENEREAL DISEASE. 203 is secreted in the glands of the throat and mouth, the tongue will often be affected so as to occasion a thick- ness of speech, and the tonsils, palate, and uvula will become ulcerated so as to produce a soreness and diffi- culty of swallowing, and likewise a hoarseness in the voice. In the venereal ulcer of the tonsil, a portion of it seems as if it was dug out; it is, moreover, very foul, and has a thick, white matter adhering to it, which can- not be washed off. By these characteristic marks it may, in general, readily be distinguished from any other species of ulceration in these parts. " If the disease affects the eyes, obstinate inflamma- tion, and sometimes ulceration, will also attack these organs. The matter sometimes falls on deep-seated parts, such as the tendons, ligaments, and periosteum, and occasions hard, painful swellings to arise, known by the name of nodes. " When the disease is suffered to take its own course, and not counteracted by proper remedies, the patient will in the course of time, be afflicted with severe pains, but more particularly in the night time; his counte- nance will be sallow, his hair will fall off, he will lose his appetite, strength, and flesh ; his rest will be much disturbed by night, and a small fever of the hectic kind will arise. The ulcers in the mouth and throat being likewise suffered to spread, and to occasion a caries of the bones of the palate, an opening will be made from the mouth to the nose; and the cartilages and bones of the nose being at length corroded, this will sink on a level with the face. Some constitutions will bear up for a considerable time against the disease, while others again will soon sink under a general weakness and irritation produced by it. #...#* " The general appearances to be observed on dissec- tion of those who die of lues, are, caries of the bones, but more particularly those of the cranium, often com- municating ulceration to the brain itself, together with enlargements and indurations of the lymphatic glands, scirrhus of several of the organs, particularly the liver and lungs, and exostoses of many of the hardest bones." Cause. - - It has already been stated that the venereal disease is produced by a specific poison. This is com 264 DOMESTIC MEDICINE. municated by those affected with it, to others, by impure sexual intercourse; and thus in large cities where this practice is extensive, the disease spreads very rapidly, as one individual may communicate the poison to an incredible number of others. In rare instances the disease may also be taken by the exposure of any excoriated, wounded, or otherwise unprotected part of the body to the contact of the poison, as by kissing, lying against a person laboring under the disease, &c. It is also supposed, and it seems reasonable, that a child may, by sucking at the breast, receive the poison from a nurse that is affected with syphilis; and on the other hand, that a child affected with it may communi- cate it to the nurse. It has also been stated, that the disease has been communicated by a wound with a lancet, or knife in- fected with the poison. Treatment. — In recent cases, when the first symptoms of gonorrhoea appear, nothing more may be necessary than an active cathartic, composed of equal parts of mandrake and blue flag in powder; and at the same time washing the parts, and injecting them with the following compound : ]£ Tincture of Lobelia, 2 ounces, Tincture of Myrrh, 1 ounce, Balsam of Fir, . . 1 " Shake well in a bottle. A table spoonful of this may be mixed with an equal quantity of the infusion of the astringent tonic, and then used as stated above. The application must be frequently repeated. The solutions of the sulphate of zinc and of acetate of lead have been employed with good success in this case. "When buboes make their appearance, the parts should be poulticed, if this be practicable, with the dregs of myrrh and lobelia, and some fine slippery elm bark. If this cannot be done, a liniment made by mixing together equal parts of the stimulating liniment and stramonium ointment, must be applied to the. parts with gentle friction, three times a day. While this is being done, the system must be kept under the influence of the mandrake and blue flag cathartic powder. VENEREAL DISEASE. 265 When the tumors suppurate and break, they must be treated as is recommended for common ulcers. Chancres and syphilitic ulcers, must be kept clean by washing them frequently with a solution of carbonate of potash. If situated where poultices may be applied, these should be used : they may be made as follows : ]£ Thoroughwort, Narrow dock root. Mandrake root, Bay berry, -. . Slippery elm, . Equal parts. Pulverize and form into a poultice by adding flour, if necessary. This should be laid over the ulcer, and be renewed, or a new one should be applied every morning and evening, washing out the sore at the dressings with a solution of potash, or an astringent tea, as the case may require, until it is ready to heal, when salves may be applied. When the ulcers are very indolent, it is a good plan to drop into them some tincture of myrrh occasionally. The antispasmodic tincture, and the tincture of lobelia, are also beneficially used in this way. When the ulcer presents a dark appearance, or exhib- its other signs of mortification, a poultice of the dregs of myrrh should be applied, and renewed as often as the case may require. The pyroligneous acid is also very good to prevent mortification in these sores. Such parts of the treatment recommended for scro- fulous and common ulcers, as may be indicated here, should also be used. In cases of confirmed syphilis, in which the poison produces its constitutional effects, a more thorough course of treatment is required. The vapor and lobelia may be required once, twice, or three times a week, as the urgency of the case may require. # Stillingia, . 12 ounces, Podophyllum, 4 " Phytolacca, . 4 " Iris vers. . . 4 " Alcohol, . . 4 pints, White sugar, 2 pounds. Bruise the four first ingredients and macerate in the alcohol foi ten days and strain, then add the sugar. 266 DOMESTIC MEDICINE. This is one of the best, among the safe remedies for syphilis, that can be prepared. It is perhaps equally- efficient with mercury, which has been considered a specific for this disease. It should be taken throughout the treatment, in doses sufficiently large to keep the bowels loose. From a tea spoonful to a table spoonful three times a day, will usually be sufficient. Should this medicine disagree too much with the bowels, it may be alternated by the use of the alterative syrup. The balsamic diuretics, are important remedies in the treatment of syphilis. Among the best of these, for this use, are the balsam of copaiva, and balsam of fir. The queen of the meadow root, will also be found very useful. When ulcers in the mouth and elsewhere make their appearance, they must be managed, (in addition to the general treatment,) as nearly as possible, after the plan recommended for ulcers arising from other causes. The use of tonics is indispensable to the proper treat- ment of syphilis. WENS. Wens are roundish, loose, fleshy tumors, that grow superficially, on various parts of the body. They gen- erally are situated in the cellular tissue, immediately under the skin. They are seldom painful, and hardly ever become troublesome, except from the inconvenience arising from their bulk. Treatment. — The wen may, generally, be removed by washing it frequently with salt water. The following preparation will, however, act more promptly in its removal than the simple use of the salt water : Take the yelks of eggs, any quantity, beat them up, add as much pure salt as they will dissolve, and wear this over the wen — changing the application for a fresh one, every twelve hours. The iodine ointment is also a good application for the removal of wens, and WHITE-SWELLING. 267 will sometimes be effectual after the above prepara- tions fail. Wens are easily removed by the knife, as their posi- tion is very superficial. WHITE-SWELLING. (Hydarthrus.) White-swelling is a very inveterate and painful dis- ease, that is usually seated on some of the joints of the body, particularly the hip, knee, ankle, and elbow. The swelling is generally very considerable, sometimes extending the size of the part beyond all proportion. The appearance of the skin, as the name implies, is natural or white, even when the inflammatory symp- toms are at the highest. The disease is usually very painful and distressing,* and the pain is much increased by the motion of the joint. As the affection advances, the limb becomes stiff, and continues in a crooked position. The swelling now becomes very hard ; and if the disease is not arrested, suppuration will take place, — the tumor will break, and discharge large quantities of matter, and not unfrequently some pieces of bones. Suppuration some- times makes its appearance early in the disease ; but more usually it does not come on for several months, and occasionally not for a year or two. Various parts of the joints may be the immediate seat of the disease, as the ligaments or capsules, carti- lages, tendons, periosteum, and even the bones. The ligaments sometimes ulcerate away so much as to let the bones slip out of their places, and thus expose them at the surface. It would hardly be expected that such severe and extensive local disease could long exist without giving rise to more or less constitutional derangement. The general health gradually becomes impaired, the appetite fails, and debility sets in. Considerable emaciation * It happens occasionally, that white-swelling progresses with vrcry little pain ; but this is rarely the case. 268 DOMESTIC MEDICINE. generally supervenes ; and finally, if the disease is not arrested, the bowels become disordered, a diarrhoea sets in, and in some severe cases, the patient continues to sink until released by death. Treatment. — White- swelling, in by far the majority of cases, is connected with a strumous condition of the system; and therefore, in order to its successful man- agement, a general treatment, like that recommended for scrofula, must be adopted. The circulating fluids must be kept in a pure and healthy condition; and for this purpose, general deturgents or depuratives, altera- tives, baths, laxatives, cathartics, occasional emetics, and any other means calculated to promote healthy secretion, and improve the condition of the general system, must be perseveringly used. Among these, the alterative syrup is the most important, and should be used as a constitutional remedy throughout the entire treatment. Local Treatment. — Thp affected part should be fomented every day over a pot of volatile herbs, as pen- nyroyal, horsemint, maijorum, peppermint, &c. Imme- diately after this fomentation, if the case has not yet suppurated, some stimulating liniment must be rubbed on the parts, freely. Stimulating and relaxant poul- tices, are also generally found of considerable advan- tage. Binding on wilted or bruised leaves of the jimson, and changing it for a fresh application daily, will be beneficial, if the parts are previously well rubbed and bathed with the bathing drops. An application, made by beating up some yelks of eggs, and adding as much salt as the mass will dissolve, if constantly worn over the swelling, and renewed by a fresh application every morning and evening, w r ill gen- erally prove an excellent means. If the swelling should not readily yield to the above means, an irritating plaster must be applied, and worn until its specific effects are produced ; and after this, relaxant poultices should be applied to keep up a discharge. When suppuration has taken place, and the sore does not readily heal, but inclines to an ulcerous condition, a WHOOPING COUGH. 269 solution of the carbonate of potash should be injected with a small syringe, designed for the purpose. The sores must also be washed out, at least once a da}^, with a strong astringent tea, by means of a sponge or syringe ; and after this, some tincture of myrrh may be thrown into it, or, instead of it, pyroligneous acid. The sore must then be poulticed with slippery elm, thoroughwort, lobelia, or astringent tonic, as the case may require, until it is ready to heal, when the salves should be used. WHOOPING COUGH. (Pertussis.) The whooping cough is a very distressing disease, chiefly confined to children, and occurring but once in the same individual. It seems to be propagated by a specific contagion. The exciting cause of the cough appears to consist of a collection of viscid phlegm that accumulates in the bonchia, trachea, and fauces, and which adheres so firmly as to be expectorated with great difficulty. As soon as this phlegm becomes collected so as to excite irritation, a fit of coughing will ensue, which will sel- dom cease until the phlegm is removed either by the coughing or by vomiting. The patient will then have relief until the irritation is again produced by a new collection of the phlegm. These paroxysms of cough- ing, which may occur four or five times a day or oftener, are sometimes extremely severe. The patient not unfrequently becomes strangled and turns black in the face, and in some instances he may fall to the ground in a manner senseless. The coughing is attended with a peculiar kind of whooping, — whence the name of the affection. The disease, wherf left to run its course, will generally continue from six weeks to several months or longer. Treatment. — Lobelia seems to be a specific for this disease. It should be used in expectorant or slightly nauseating doses, once in two or three hours. It may be given in 270 DOMESTIC MEDICINE. substance, infusion, or in tincture. Sweetening seems to add to its beneficial effects. The oxymel of lobelia, is the best preparation of the article for this disease, as it is about as prompt in its effects as any other, and, what is more, it is very pleasant and convenient to take. WORMS. (Entozoa.) All animal bodies are supposed to afford habitations for other animals. But the means by which they gain their existence are as yet involved in mystery. There are, however, but two possible modes in which they may be produced in the body. They are either devel- oped from ovula taken in, in some way, from without, or they are produced by spontaneous generation in the body. Many cogent arguments have been advanced on both these views ; but as the matter is not demonstrated on either principle, it will be of but little use to give them here. Parasitic animals are not only found in the alimentary canal, but in the liver, kidneys, lungs, brain, eyes, the flesh, skin, and, indeed, in most if not all other parts. There are principally four kinds of worms which infest the intestinal tube — the lumbricus, tricocephalu^, oxyuris, and tenia. The lumbricus, or, more properly, ascarh lumbricoides, is a long, round or cylindrical worm, from three to WORMS. 271 twelve inches in length, and from an eighth to a quarter of an inch in diameter, tapering at each end, and of a reddish brown or dirty white color. It exists sometimes in great numbers, and is commonly found in the small intestines, and occasionally in the stomach. Hence, sometimes it is vomited up, or even discharged through the nose by its entering the posterior nares. Its pres- ence is indicated by uneasiness in the stomach or bow- els, irritation, and itching of the nostrils ; a paleness and puffed state of the lips; foul breath; choking sen- sation in the throat; bloated abdomen; periodic or occasional paroxysms of fever, &c. But the only sure sign is their appearance in some of the evacuations. TRTCOCEPHALUS DISPAE. This is the long thread- worm found in the caecum or first of the large intestines, but not generally in large numbers. It is from an inch and a half to two inches in length. About two- thirds of its length is quite atten- uated, being scarcely larger than a horse-hair, while the other — the posterior portion — is considerably larger, and terminates in a rounded or blunt extremity, which, in the male, is coiled up and has a trumpet- shaped appendage, with a spike projection supposed to be the organ of generation. In the above cut, Fig. 1 represents the male many times magnified, showing its head at a. Fig. 2 represents the same of natural size; and Fig. 3 the female of natural size. 272 DOMESTIC MEDICINE. OXYURIS, OR ASCARIS VERMICUEARIS. This is the common pin, or maw-worm, which is of small size, and exists in great numbers. It is found in every portion of the intestinal tube, but occasions the most annoyance in the rectum. It is from an eighth to half an inch in length, and quite slender, and is mostly enveloped in the mucus of the intestines, and hence very difficult to be removed. The above cut gives many examples of the largest of the natural size, together with one specimen highly magnified. Many individuals are affected with them in child- hood, but get rid of them as they advance in age. Some, however, are troubled with them during the whole of a long life, although they are generally sup- posed to be less annoying after middle age than before. They often appear periodically, both in children and adults, after intervals -of from three to six weeks. During these intervals they are neither felt, nor seen in the discharges. Their periodical return is announced by a sense of itching and burning at the extremity of the rectum, experienced chiefly in the evening, some- times producing tumefaction and eruption in the neigh- boring skin. This irritation continues to recur every evening for perhaps a week or more; then ceases. During this time the worms are discharged alive and active in every alvine evacuation. Cathartics and in- jections bring away vast numbers of them, but without obviating the annoyance of those left behind. At length they spontaneously cease to appear, and the irritation subsides until another paroxysm of them sets in. 273 TENIA SOLINUM. The tape-worm is a very formidable and troublesome inhabitant of the alimentary canal. It is sometimes of great size, as from thirty to forty feet in length. One of extraordinary size is mentioned by Dr. Sib- bargaarde, of Copenhagen, which measured one hun- dred and fourteen feet. It is flat, and something less than half an inch in width at its broadest part, and is composed of numerous joints or sections about the size, and nearly the shape of a gourd seed. These are often detached, and come away in sections of various length, as from a single joint, to ten or twenty feet of the body. The worm is not of an equal width throughout its length; its head and anterior portion of its body are extremely small. Another species of the tape-worm, the taenia lata, or bothriocephalus, is common in Russia and Switzerland. This is represented below : 274 DOMESTIC MEDICINE. BOTHRIOCEPHALUS. Fig. 1, represents the head and anterior portion of the body, of natural size. Fig. 2, the head magnified. Fig. 3, joints of the body of natural size. The signs of tape-worm are often very obscure, and its existence sometimes is not in the least suspected, until some portions or joints of it are observed in the passages. But generally, if the worm has attained considerable size, there is more or less uneasiness, pain- — sense of weight — and sometimes a feeling of movement or crawling in the stomach, or bowels. The appetite is variable, but generally voracious ; there is often nausea, itching of the anus and nose, and atrophy. H^W^I fm WM liwB fill IHKl^' ^ fM STRONGYLUS GIGAS. One of the largest species of worms is found in the kidneys of man and of various quadrupeds. It is supposed, however, that it never exists, except when the structure of the kidney is destroyed or broken down. But it is uncertain whether they are the cause or conse- quence of the disease. The strongylus gigas in shape is cylindrical, and tapering each way, and sometimes two or three feet in length. Its posterior extremity is terminated by a trumpet-shaped enlargement, from which, in the male, a spicular body supposed to be the organ of genera- tion proceeds. The worm is sometimes discharged in the urine, and occasionally, when young or small, in considerable numbers. 275 FILARIA MEDENSIS, The filaria medensis, or Guinea- worm, is a very troublesome species of entozoa, common in hot cli- mates. It is found under the skin in the cellular and muscular substance of man and beasts. It has a round, smooth, and filiform body, about the thickness of a pigeon's quill, and sometimes from three to four feet in length. Sometimes they occasion but little an- noyance, but at others they cause great pain and inflammation. When they appear at the surface, they may, with great care, be extracted entire. FILARIA BRONCHIALIi A little worm of this denomination is very common in the lungs of inferior animals, and has in very rare instances been found in man. Besides these, there are many other species of worms found in various portions of the body, but they are of less consequence. Among those noticed by authors, are the distoma, cysticus, acephalocyst, (hydatid,) spir- optera, echin, ococus, polystoma, &c. Treatment. — The agents used to expel worms, may properly be said to consist of three kinds: 1, those that destroy the worms; 2, those that remove them by mere mechanical means; and 3, those that have a tendency so to tone up and fortify the system against them as will result, ultimately, in their expulsion. The only intestinal worms of any importance, are the long round worm (ascaris lubricus ;) the pin- worm (ascaris vermicularis ;) the thread- worm (trichocephalus 276 DOMESTIC MEDICINE. dispar;) and the two varieties of tape-worm (tcB7iia.) These may, generally, all be removed by the same means. Nevertheless, some are found to require special remedies, sometimes. The pink-root seems to be one of the best articles to remove the lumbricoides, or long round worm. It is best taken in infusion. Half an ounce may be boiled for two hours in a covered vessel; and then, after using gentle physic and spare diet for a day or two, the infu- sion should be taken, in doses of a table spoonful to the child, and a tea cupful to the adult, three or four times a day, for three days, when it must be followed with an active cathartic of senna, aloes, mandrake, or rhubarb, to cany off the worms. If the use of the pink-root should not prove success- ful, the wormseed oil may be employed in doses of from five to ten drops to a child, and from fifteen to twenty to an adult. The medicine should be given two or three times a day for some three days, and then be followed with a brisk cathartic. It is a very common practice to mix the wormseed oil with some castor oil, thus making a vermifuge that is considerably popular. A formula for the preparation of this vermifuge is given among the compounds. The male fern is also an excellent article for the re- moval of this variety of worms; it is given in powder or ethereal extract. The dose of the powder is from one to three drachms, to be given in the form of electu- ary or emulsion, and repeated morning and evening for one or two days, successively. The medicine should then be followed with a brisk cathartic of castor oil or senna. When it is desired to destroy the animals, the cow- hage will be found an excellent article. The common way of preparing it is to dip the pods into some syrup or molasses, and then to scrape off the spiculae or hairs with the liquid, which, is in a proper state for adminis- tration when it has attained the thickness of honey. The dose of this mixture is a table spoonful for an adult, a tea spoonful for a child three years old, to be given every morning for three days, and then followed by a brisk cathartic. The pin-worm {a>caris vcrmicularis) is much harder to expel than the long round worm. This variety worms. 277 chiefly occupies the rectum or lower part of the large intestines, and is hence not much affected by the anthel- mintics used in the common way. It is best, therefore, not only to use the medicine per stomach, as ordered for the other varieties of worms, but to administer the same articles freely by injection. Aloes seems to answer best as a cathartic, after the proper anthelmin- tics are used, as it inclines to act more powerfully on the lower portion of the intestines. The dose of this medicine for the expulsion of worms, is from ten to twenty grains. It is, perhaps, the best plan to give ten grains morning and evening, until the desired effect is produced, — at the same time giving it by injection. Equal parts of lime-water and milk, given by injec- tion two or three times a day, will sometimes remove the pin-worms in large quantities. Spirits of turpentine with milk, in the proportion of a tea spoonful of the former to a gill of the latter, administered in the same way two or three times a day, will also be found a good remedy. The annoyance from this variety of worms is very apt to be renewed, even in cases in which complete relief had been obtained. Whether the worms renewing the difficulty were cotemporaries with those removed, or whether they are a new generation, it is difficult to tell. Perseverance in the treatment alone, will afford any- thing like permanent relief from the annoyance of these worms. For the expulsion of the tape- worm, the bark of the root of the pomegranate is, perhaps, the best article that we possess. The best way to prepare the medi- cine, is to boil two ounces of the fine bark in two quarts of water, straining, and then boiling it down to one quart. Of this the dose is a wine glassful once in two hours until all is taken, when it should be followed up with a brisk cathartic. The male fern is a remedy of great antiquity. Dios corides, Theophrastus, Galen, and Pliny, speak of it. There is no anthelmintic that has had greater popular- ity than this. In 1775, the King of France purchased of Madame Nouffer, a Swiss lady, the knowledge of a secret cure for the tape-worm, that had gained great popularity. This remedy, which was published by 278 DOMESTIC MEDICINE. order of the king, consisted of nothing more than the root of the male fern. The manner of its use was one large dose of the powdered root, (from one to three drachms,) to be followed in two hours with a brisk cathartic. If this process did not prove successful, it was to be repeated with proper intervals till the worm came away. The medicine is, however, more commonly used in smaller doses for several days, and then followed by the cathartics. All the other varieties of intestinal worms, may be successfully expelled by the means here recommended for those just treated. Of late the medical journals have contained an ac- count of a new remedy for worms, and especially for tape- worm. It is derived from the flowers of the Branera Anthelmintica, (Kousco,) a tree growing in Abyssinia. If this medicine should maintain the favor- able accounts given of it, it is hoped that it will soon be introduced into common use here. Those entozoa that occur in the parenchymatous, muscular and cuticular tissues, are of extremely rare occurrence; but when they do occur, they are removed with difficulty. In the treatment of these cases, a strict attention to regimen is necessary. Cleanliness, above all other things, must be scrupulously observed; the diet, exer- cise, and other habits rrust be so changed and regulated as will favor a condition of the system opposite to that under which the parasites were produced. A syrup, made of meadow fern, narrow dock, burdock, and black pepper, should be prepared and used perseveringly. The body may be exposed to sulphurous vapor. The pomegranate bark should be taken two or three times a week, and an occasional dose of turpentine may be taken. Together with these means, a good constitu- tional or general treatment must also be instituted and persevered in. The digestion must be well sustained, and the secretions be kept pure and regular. The medicines that are commonly used to invigorate and tone up the system, and thus to dispose, protect, and fortify it against the invasion and generation of worms or parasitic animals, are those of the bitter tonic wounds. 279 class. Among the best articles, are poplar bark, worm- wood, the twigs of the peach tree, white walnut bark, &c; but all the bitter tonics are serviceable. WOUNDS. A wound is the solution of continuity in the soft parts of the body. They present many different appearances, as regards their situation ; the parts implicated ; their direction; size; shape; the nature of the instrument or agent by which they are produced; their more or less simple or complex character, duration, &c. The wound is called incised, when made by a cutting instrument; when by a pointed instrument, punctured; when the parts are torn or broken down by the wound- ing body, the injury is called laceration; when, in addi- tion to the wound, there is some venomous or poisonous substance introduced, as by the bite of a serpent, the injury is called a poisoned wound; when the injury is inflicted by an obtuse or blunt body, it is called a contusion; and when caused by a bullet or other body projected from fire-arms, it receives the name of gunshot wound. Wounds also differ with regard to their liability to bleed. Incised wounds generally bleed very consider- ably, especially when large vessels are divided. Lacer- ated and contused wounds are less apt to bleed profusely; and punctured wounds sometimes do not bleed at all. Treatment. — In the proper management of wounds, four important indications are to be fulfilled : these are — 1, to stop the haemorrhage or bleeding; 2, to cleanse the wound of such foreign substances as may have been obtruded into the part and left behind; 3, reduce or close up the wound, and so adjust the parts as will most favor the rapidity of the healing process, and the smallness of the cicatrix; and 4, to secure rest to the parts until they are healed. When the situation and character of the wound will admit of the means of compression, the bleeding may in this way most generally be stopped. But if this fails, the most active styptics must be applied. 280 DOMESTIC MEDICINE. It happens, sometimes, when large arteries are divided, that the haemorrhage cannot in any way be arrested short of a ligature. In those cases the artery must be immediately taken up and tied. As haemorrhage from wounds has been treated under a separate head, it is unnecessary here to add anything further. See accidental bleeding. When the bleeding is arrested, the wound must be well examined by means of a probe, unless it is known from the cause or instrument by which the wound was inflicted, that no foreign substance can remain. But unless it is necessary to disturb the wound to remove extraneous bodies or to sew it up, or in any other way to reduce the orifice, the coagula or clots of blood and albumen effused into the wound should be carefully left to remain. The wound being cleansed from foreign substances, the next thing to be done, is to bring its margins together as near as possible to their original position. This may sometimes be done by bandages, or by means of adhesive straps. But if this is impracticable, a few stitches may be taken through the margins of the wound, and the latter in this way brought together so as to favor the restorative process as much as possible. A few poul- tices of slippery elm may now only be necessary, and then the wound healed up as fast as possible, by the use of proper healing salves and rest. Should there be much inflammation and pain during the treatment, relaxant and emollient poultices and washes will be required. Should ulceration set in, the sore must be treated as recommended for ulcers. URINARY DISEASES. Inflammation of the kidneys and bladder, as well as the gravel, have already been treated of; but there are other morbid conditions of those and the accessory organs, some of which merit notice here. DIABETE Diabetes implies a superabundant secretion of urine This mostly contains a very large proportion of sac- URINARY DISEASES. 281 charine matter, and is hence called diabetes mellitus. Sometimes, however, the urine is not sweet, when the disease is denominated diabetes insipidus; but it has been contended that the term diabetes, should be re- stricted to that form in which the urine is saccharine. The occurrence of this disease is very remarkable indeed, since it is known in some instances to take place, without the least appearance of change in the organs which are concerned in the urinary secretion. In post-mortem examinations the kidneys have been carefully inspected, and in some instances not the least trace of disease could be found, while in none has there been sufficient change discovered to account for this singular phenomenon. Diabetes comes on very insidiously, but the patient usually complains of more or less lassitude and weak- ness, and sometimes pain in the loins. The appetite is generally voracious, and the thirst pressing, but the digestion is poor. As the disease goes on toward a fatal termination, there is a feeling of exhaustion, diffi- culty of breathing, together with dropsical infiltration into the lower extremities, and general rapid emacia- tion takes place. The pulse, which at first is scarcely affected, now becomes quick and weak. The urine is of a straw color and peculiar smell, and is evacuated perhaps six or eight times in the course of twenty-four hours, amounting in all sometimes to ten or twenty pounds daily. The quantity of sugar in diabetic urine is very vari- able, but is usually near about an ounce to the pint. Diabetes, if left to itself, is generally of fatal termi- nation ; but will run its course in very different lengths of time, as from a few weeks to several months, or even years. Treatment. — The vegetable astringents are the prin- cipal agents to be employed in the treatment of dia- betes. The extract of bayberry in three to five grain doses, often repeated, will sometimes alone be success- ful. An occasional emetic of ipecacuanha should be administered in bad cases, and the vapor bath, together with friction to the skin, are also very important ad- juncts to the use of astringents in this disease. The 282 DOMESTIC MEDICINE. skin is dry, and indeed most of the other secretions are deficient during the excessive flow of urine. The ter- mination should therefore be brought to the surface, and no articles are better for this purpose than emetics and the vapor bath. Tonics are also important means in this disease. A compound made of poplar bark, bayberry, and the bark of the root of common sumac, (rhus glabra) in the form of extract or infusion, taken freely, will scarcely ever fail to show its good effects. Animal food is preferable to vegetable, in diabetes. SUPPRESSION OF URINE. The urine is more or less suppressed in all febrile, and many inflammatory diseases, and especially in inflammation of the kidneys ; but it also happens that there is a failure in the secretion of urine, dependent upon simple atony of the kidneys, which is the condi- tion most commonly implied by suppression of urine. In this case there is no inclination of the patient to void the urine, and total or nearly total suppression of this secretion sometimes continues for weeks, months, or even longer, without much disturbance of the gen- eral health. There is usually some nausea, constipa- tion, and an occasional feeling of sinking experienced by the patient. Nevertheless, in some instances, the symptoms are more violent ; thus vomiting, hiccough, restlessness, headache, and pain in the back, are expe- rienced from the commencement. The pulse, also, is sometimes slower, which is said to denote danger. Treatment. — Diuretics are the proper remedies in this disease, but the stronger articles, as turpentine and squills, must never be pushed too much, for they may do mischief sometimes, by producing inflammation of the kidneys and urinary passages. The eupatorium purpurium, clevers, oil of juniper, acetate of potassa, elder bark, melon seeds, parsley, &c, are all proper articles, and may be employed separately or conjoined, according to wish or convenience. URINARY DISEASES. 283 INCONTINENCE OP URINE. Incontinence of urine is caused by a morbid irritation of the neck of the bladder, or paralysis of its sphincter, thereby rendering the individual incapable of retaining his urine. Incontinence of urine is a very common difficulty with children during sleep. In these cases it is very much dependent upon habit, and may usually be reme- died by disposing them to regular habits of discharging the urine. At first the subject should be wakened regularly about once in four hours, and induced to void the urine. Then, after this practice is continued for about a week or more, the interval may be lengthened to five hours, and so on, until the little subject will be able to retain the urine all night, and thus will be cured of a most inconvenient and filthy weakness. But in cases in which there is an irritation arising from an acrid state of the urine, soda or magnesia should be given every evening on going to bed, in doses of from three to five grains. In addition to this, flaxseed or- slippery elm mucilage, will be serviceable. In cases of adults in which there is irritation an i burning in the neck of the bladder, it may be suspected that the urine is of an irritating quality, and should be examined. If alkalies effervesce on being mixed with it, or delicate vegetable greens are changed red by being immersed in it for a time, the urine may be ex- cessively acid, and the irritation may be removed by mild alkalies, as subcarbonate of potassa or soda. It may also be serviceable to employ emollient drinks, as the mucilage of flaxseed or slippery elm. When there is no irritation, burning, or other disa- greeable sensation in the lower part of the abdomen, in the region of the bladder, and when the urine passes off so easily that the patient is scarcely conscious of it, it may be justly presumed that there is paralysis of the sphincter of the bladder. In this case an irritating plaster or sinapism applied to the pubis, scrotum, or perineum, while some permanently irritating substances are taken internally, as mustard, turpentine, &c, will usually relieve the difficulty. In the old practice, can- tharides, taken internally and applied externally, con- '2\ 322 DOMESTIC MEDICINE. The noted Dr. Thomson, from his settled conviction of the deplorable imperfections and dangers of the popular practice, was, in his course of reform, led to guard well against the greater evils of that practice, and as this class of remedies, of all others, has been the most abused, he, in his zeal and enthusiasm, fell into error on the opposite extreme. Having had on his mind the purpose of an entire revolution in medicine, and being necessitated to frame his system without the advantages of even a good education, it is not at all strange that in some points he should deviate some- what from a strictly philosophical course. There are still many in the ranks of reform who are quite ultra in their views on this matter ; some declaring positively that no medicine of this class can ever be used without danger. But the error on the other hand is no less marked ; there are some who, without doubt, do much injury by their indiscriminate use of active, and too often poison- ous cathartics. The vis conscrvatrix is but too often diverted by such interference from the fulfillment of better selected indications of cure ; and thus by artificial intestinal irritation, the conservative powers are called, in numerous instances, from parts much exposed, and which, in consequence, are irreparably injured. Again, much purgation unquestionably produces direct debility of the digestive organs, causing dyspepsia and numer- ous other distressing evils. Instances not unfrequently occur in which the constitutions of patients are irre- trievably destroyed by the improper use of cathartics. But does all this argue that catharsis is not a natural indication of cure ? Does the abuse of an agent prove its uselessness? Catharsis is as certainly a true and natural indication of cure as emesis, diaphoresis, or any other; but it, like them, must be fulfilled in a proper way, and at a proper time. We must not condemn a medical agent, simply because given circumstances attending some of its applications are calculated to develop mischief. The question is, can such agents, un- der proper circumstances, be found useful, or beneficial? To settle this matter in the present instance, two kinds of evidence may be brought to bear ; first, that gained by induction from physiological facts; CATHARTICS. 323 and, secondly, that of our experience in the use of cathartics. First, we. discover that the respective functions of vascular parts of the animal body, are governed by a compound agency or sympathy evinced in the nervous system. We find that the sentient extremities of the nerves of these parts are peculiarly sensitive to certain stimuli ; and thus the stimulus of the blood excites the regular contractions of the heart and arteries, thereby sustaining the circulation ; the lacteals are peculiarly sensitive to the chyle, which excites the fulfillment of the normal functions of these organs. The urinary bladder and uterus answer their design in the economy of nature, by the influence of their 'peculiar exciting stimuli. The intestines, according to the same law, are controlled in their functions on the same principle. The bile in the normal condition seems to sustain the peristaltic motion; but we find it increased by excessive ingesta, by the presence of irritating and offensive sub- stances in the bowels, and various other causes, so as to give rise to diarrhoea. The question now arises, — Is this a physiological, or is it a pathological action ? This query is easily answered ; and although this action is often involved in diseased movement, yet, perhaps in this, as well as in numerous other instances, it can be traced as the legitimate effect of the vis vitcB, in the fulfillment of true and important indications of cure. Thus, we discover that living tissues and organs, are not only supplied with means subservient to their phy- siological uses in the animal economy, but are capable of self-defense ; and, moreover, of removing destructive agents from the system : and it is certain, that among the five grand means of the exit of extraneous matter from the system, viz : diaphoresis, catharsis, emesis, diure- sis, and expectoration, or exhalation from the lungs, catharsis stands second in importance; the first being diaphoresis. Peccant matter, in the diseased condition of the body, passes from the bowels in every evacuation from these organs. The functions of the skin are no sooner disturbed than are the bowels found vicariously to fill the office of the cutaneous emunctories, the perspirable matter being taken up and conveyed directly to the bowels, and from thence expelled. The morbific 324 DOMESTIC MEDICINE. accumulations that occur in the liver, are almost uni- versally carried off by the bowels; and so are those, in many instances, that occur in the lungs. Even the urinary and uteral obstructions are sometimes relieved by increased intestinal action. Catharsis is one of the most common critical evacuations. How often it hap pens that our fevers end in spontaneous alvine evacua- tions. Nor is it less frequent that this indication is spontaneously answered in many other diseases. In their organization, the relation existing between the intestines and the general vascular system, is of the most intimate character. When the bowels are full of nutritious matter, lymphatic absorption is active, and the arteries are .rapidly supplied; but when food is sparingly taken, and the lacteals consequently inactive, we find that cutaneous absorption is much enhanced. When catharsis is instituted, the absorption from serous surfaces is always promoted in a corresponding ratio, and hence its utility in dropsies. 2. The evidence that we gain on any point by- ex- perience, is, however, much more satisfactory than any other kind; and in this is found the strongest argument in favor of the use of cathartic medicines. It happens sometimes in obstinate fevers, that the usual means of relaxing and evacuating the system by the use of nause- ants, emetics, diaphoretics, and vapor baths, fail, and that in spite of* them all the fever continues to rage, even after the exhibition of five or six courses of the medicines ; and it almost seems sometimes as if the disease had gained violence, even from those powerful means themselves. In such cases, the symptoms are often found to yield in a remarkable manner, to the use of proper cathartics. In bilious fevers, it is frequently very difficult to succeed in the treatment without the use of this class of remedies. The author has a knowl- edge of various instances, in which patients have been well treated by the usual courses of emetics and vapor, together with the free use of enemas, and after the patient had been treated for a week or two according to the most rigid plan of application, he, instead of improving, gave evident signs of increasing danger. Under these circumstances, on the exhibition of a few small portions of podophyllum peltatum with capsicum, CATHARTICS. 325 after several evacuations of very foetid and dark stools, the patient began manifestly to improve. In those cases, it is evident that the hepatic derange- ment was alike beyond the reach of the emetics and enemas ; and without doubt, the condition of the small intestines may do much to enhance the obstinacy of such fevers. Indeed, it is almost universally the case, that the obstinacy of these fevers arises in consequence of a local inflammatory action, and which too is fre- quently located in the jejunum and ileum, and thus often alike beyond the reach of emetics and enemas. In dysenteries, cathartics are often of signal service. Astringents, and stimulating tonics, are generally used by those physicians who oppose the use of cathartics. But it is a fact, which is corroborated by the experience of every practitioner, that although the astringent plan is in many cases successful, yet in some it is not suffi- cient; and again in others, astringents alone extensively used are unsafe; for it often happens in these cases, that there may be excessive looseness, and violent tenes- mus in the lower part of the bowels, while at the same time, there is constipation, or obstinate obstruction and consequent inflammation of the upper parts of the same. In such instances, therefore, there may be much injury done by instituting the use of astringents before the bowels are relieved from the constipation ; for these medicines, instead of removing the dysentery in this case, spend their entire force on the parts already ob- structed. Now, if a dose of rhubarb were first given, the astringents might have been used, not only with impunity, but advantage. Nor are the mischievous consequences of the common practice of giving astrin- gents alone in cases of dysentery, confined to those peculiarities already named; for as there is always in dysentery avast accumulation of morbific and offensive matter, it is not best to stop the looseness, and contract the bowels, before cleansing them. This, in many instances, may be done by the use of enemas ; but in some cases, purgatives are indispensable. Even in the extreme debility of typhus fever, instead of cathartics increasing the prostration, in some instances the patient has been known apparently, or in fact, to have gained strength from their continued use. This 326 DOMESTIC MEDICINE. is indeed reasonable when the various conditions neces- sary to the development of animal force are considered. For while the absolute source of force is found in the change of the relation of elementary principles in the organism, this force can only be brought to bear on the muscular arrangement, by the agency of the nervous system. "When therefore the functions of the nervea are obstructed, it is evident that debility must be one of its legitimate results. Thus, when the irritation caused by the characteristic morbific contents of the bowels in typhus is obviated or relieved, the debility will be remedied in a corresponding degree. When poisonous substances are lodged in the intes- tines, it seems that the utility of cathartics can hardly be denied by any one. It is, perhaps, unnecessary to particularize farther on this point. But lest the author should be misunderstood in his arguments in favor of this class of remedies, it may perhaps be necessary to be something more definite as to the extent to which cathartics should be used. It is important to remark, that with these, as in the use of every other active and potent article of the materia medica, particular attention is neccessary to the quan- tity and character of the medicine, as well as to the circumstances that may attend their use. Very active and violent purgation is not only unnecessary, but should ever be regarded as a pernicious practice. Laxatives and mild cathartics are all that may be necessary in this class, to the cure of disease ; and there is perhaps more difference in mildness and efficiency between the numerous articles of this class, than any other. Cathartics are particularly indicated in fevers of the continued and intermittent form, but in the eruptive fevers, they are generally injudicious. Inflammatory diseases also require purgatives, especially those of the gravior form. In jaundice, dysenteries, dropsies, and all cachectic diseases, such as scrofula, cancer, &c, it is very difficult to succeed well without them. Podophtllttm Peltatum, {May-apple). CATHARTICS. 329 SPECIAL CATHARTICS. PODOPHYLLUM PELTATUM. Mandrake, May-Apple. Description. — The root is perrenial, creeping usually several feet in length, jointed, round, brown without and white within, and about the thickness of a pipe-stem; the joints and under side of the root are beset with slender fibres. The stem is erect, round, smooth, about a foot in hight, and the bearing stalks divided at the top, bearing the flower and the fruit in the fork. The branches bear each of them a large peltate, palmate leaf, considerably lobed. The flower is nodding and white. Locality and habits. — The May-apple is indigenous to this country, growing in a rich soil, in the woods, new grounds, and on the road side ; but delighting most in moist and slightly shaded grounds. The flowers, appear in May, whence one of its vulgar names, and the fruit ripens in August Medical properties and uses. — The root, properly pre- pared, is perhaps the best cathartic now known ; being very mild, and although somewhat slow, yet certain in its operation. It is alterative in its effects, and seems to have a considerable tendency to the glandular system, especially to the liver, on which its effects are as thor- ough as dare be claimed for mercury ; and yet it is perfectly safe, and not, like it, calculated to exhaust or pervert the tone of this organ, or of the system. In fevers, especially those of a bilious and intermittent character, and all scrofulous affections and diseases of the skin, it is of incomparable utility. It, unlike most other articles of this class, leaves the bowels in a lax and sol- uble condition, and hence is in many instances, very useful in habitual costiveness. It possesses also in some degree, a diuretic property ; and is an excellent article in the cure of hydrocephalus, hydrothorax, and indeed in all other forms of dropsy. All will readily anticipate 330 DOMESTIC MEDICINE. its usefulness in jaundice, and hypertrophy of the liver and spleen, so common in intermittents. Dr. Bigelow, in speaking of this valuable article, says : " The medical properties of the podophyllum peltatum, are those of. a sure and active cathartic; in which character it deserves a high rank among our indigen- ous productions. We have hardly any native plant which answers better the common purposes of jalap, aloes, and rhubarb." The leaves, stem and fresh shoots of the plant seem to be poisonous ; and indeed the root itself, in its recent or green state, is very violent and dangerous in its effects. But in drying it, these violent properties are all dissipated, and the medicine, when prepared from the solid part of the root, scraped and well dried, and about a year old, is in its proper doses perfectly mild and harmless. The dose is from ten to twenty grains of the powder. But the alcoholic extract, or podo- phyllum as it is usually called, is by far the best prepar- ation of this article : this may be prepared by macera- ting the root in alcohol, filtering, and evaporating the spirit to the consistency of thin syrup, when the resin- ous portion or podophyllin may be precipitated by adding cold water. What falls down is to be washed, re-dried and bottled for use. The alcohol may be saved for future use in its pre- paration, by employing a retort or still in the process ; but the process must be conducted in a water bath, that is, the still must be placed in a kettle or boiler, or in a steam-pipe, to prevent burning the medicine when it is much reduced. In this preparation we have at least the advantage of the smallness of the dose, if nothing more ; but the medicine seems likewise to agree better with the stomach, when prepared in this way. The author had the honor of discovering and introducing this article to his medical class in 1849, and soon had the pleasure of seeing it in very extensive use. Rheum Palmatum. Rheum Emodi. Rheum Compactum. 35 CATHARTICS. 333 RHEUM. (Rhubarb.) Rhubarb has been in use for a long time, and still it has not yet been ascertained by the profession, what species of the rheum yields the officional rhubarb. The remoteness of the country where it is collected, and the jealous care by which the monopoly of the trade of this article is guarded, has been effectual in retaining the secret. There are several species now cultivated in this country. Dr. Pereira mentions thirteen species, viz : Rheum pcdmatum, rheum undulatum, rheum compac- tum, rheum rhaponticum, rheum emodi, rheum crassinervium, rheum capsicum, rheum tataricum, rheum hybridum, rheum confluence, rheum Jischeri, rheum barbandifolium, and rheum bullatum; the specimens of which were in his posses- sion. Besides these we have accounts of several others, such as the rheum australa, rheum lucormzon, rheum web- bianum, rheum spiciforme, and rheum moorcroftianum. There are, however, but few varieties of the article now in common use ; these are articles of commerce, and are bought under the names of 1, Chinese rhubarb; 2, Russian rhubarb; 3, European rhubarb. Of these, the Russian, which is sometimes called Turkey rhu- barb, (owing to the fact that it was formerly derived from the Turkish ports, whither it was brought from Tartary,) is entirely the best, and next to this, is the Chinese. Rhubarb should always be purchased in the root, and that selected which possesses an agreeable aromatic odor, and is heaviest, of a lively color, and which when broken presents a fresh appearance, with red and yel- lowish veins intermingled with white, and which also has a bitter astringent taste, staining the saliva of a deep yellow when chewed. Medical properties and uses. — Rhubarb is one of our most valuable medicines : in it we find a singular com- bination of two properties, which in their effects are oi an opposite character, the cathartic and the astringent. But when the medicine is taken, these properties do not exhibit their several effects at the same time; the 334 DOMESTIC MEDICINE. cathartic power is always exhausted before the other takes a permanent effect. This circumstance is what so emin- ently adapts this medicine to the treatment of dysentery, cholera infantum and cholera morbus. Rhubarb is likewise very good in the diarrhoea that often attends dyspepsia, and the last stages of consumption. It is very mild in its operation as a cathartic, and is not apt to produce watery discharger-, but rather such as are of a faecal character. Rhubarb is recommended by authors in cases of habitual constipation attending dyspepsia; but as will readily appear to any thinking individual, it certainly is illy adapted to such cases, in view of its astringent qualities, which always leave the bowels in a confined condition. It may however be relied upon in all cases in which a medicine of its character is indicated, as it is certain and mild, and unless given in over doses will always be agreeable to the stomach. The medicine yields its properties most readily to water and wine/ When, therefore, it is not given in substance, the infusion should be used. Its propeities are not well adapted to extraction, as the dose of the extract must necessarily be half the size of that of the powders, which latter is from ten to twenty grains, or from one to two tea spoonfuls. JUGLANS CINEREA. Butternut, Oilnut, White Walnut. Description. — The white walnut is an indigenous forest tree of considerable size. The young branches are of a whitish-gray color, whence the name, white walnut; are smooth, and in their situation incline to a horizon- tal position. The leaflets are long, lanceolate, senate and are pinnate, or arranged in pairs seven or eight in number, with a terminal one on the end of the petiole, like the locust. As this is a very common tree, further description is unnecessary. Locality and habits. — This useful tree grows in every part of the United States, and Canadas ; most abundant on rich lands. It flowers in May, and the fruit ripens in September. IjKPTAndria Virgikica, ( Black-root). CATHARTICS. 337 Medical properties and uses. — The extract made from the inner bark of the root and trunk of this tree, is an excellent cathartic, operating without pain or griping, and evacuating the alimentary canal without depletion. It has been used for a long time, and was highly recom- mended by Dr. Rush among the soldiers during the revolutionary war. The extract may be formed into pills with a small portion of capsicum, and used in all cases in which cathartics are indicated. The extract, when of the consistence of molasses, serves well as a material for forming pill mass, from dry articles. The extract is made by boiling the bark in water, straining, and evaporating to the consistence of soft extracts. LEPTANDRA VIRGINICA. Black-root, Bowman-root, Brinton-root, Culver's Physic, <$"C. Description. — Root perennial, long, woody, beset with numerous long slender fibres, of a blackish-brown color without. Stems several, upright, round, slightly pubes- cent, and from two to four feet high. The leaves are long, lanceolate, serrate, and are arranged in whorls around the stem, four to six at a joint; the joints are about a hand's-breadth apart. Flowers white, small, numerous, constituting from three to five terminal racemes. Locality and habits. — The black-root is indigenous to this country, and is found throughout the Western and Middle States, growing on low grounds or moist places, in meadows, along fences, &c. It flowers in the latter part of July and first of August. Medical properties and uses. — This is a pretty good cathartic, and operates with considerable certainty and mildness. It has been in high repute among the abo- rigines of this country, who used it in fevers and disor- ders of the stomach and bowels. As several of its vulgar names indicate, it has been a favorite of several individuals of the profession. It is spoken of in How- ard's Botanic Medicine, as follows : " The. black-root is very highly celebrated by those best acquainted with its virtues and effects, as an 22 338 DOMESTIC MEDICINE. efficient purge, operating with mildness and certainty, without producing that depression of the living powers, so common to other purgative medicines. In typhus and bilious fevers, it removes the black, tarry, morbific matter from the intestines, which it seems so necessary to be carried off by some means or other, and does it in a most natural manner, without weakening the tone of the bowels, or leaving behind it the poisonous sting so often remaining after the use of calomel, the most universal cathartic in fevers. The black-root is also a diaphoretic, antiseptic, and tonic. It may be taken in doses of a heaping tea spoonful, in half a gill of boiling water, sweetened if most agreeable, and repeated in three hours if it does not operate." The extract (ieptandrin) made as recommended for that of podophyllum, is much better than the powdered root. The dose of this is five grains. IPOJVLEA JALAPA. {Jalap.) Description. — Nuttall gives the following description of this article: "The root of this plant is a roundish somewhat pear-shaped tuber, externally blackish, inter nally white, with long fibres proceeding from its lowei part as well as from its upper root-stalks. A tubei produced by Dr. Coxe was, in its third year, between two and three inches in diameter. The stem is round, smooth, much disposed to twist, and rises to a consid- erable hight upon neighboring objects, about which it twines. The leaves are heart-shaped, entire, smooth, pointed ; deeply sinuated at the base, prominently veined on their under surface, and supported upon long footstalks. The lower leaves are nearly hastate, or with diverging angular points. The flowers, which are large and of a lilac-purple color, stand upon peduncles about as long as the petioles. Each peduncle supports two, or more rarely, three flowers." Locality and habits. — This plant is a native of Mex- ico, and derived its name from the city of Xalapa, in the State of Vera Cruz, on the neighboring mountains of which it grows sometimes' at the hight of six thousand feet above the ocean. IponiEA Jalapa, (Jalap). CATHARTICS. 341 Medical properties and uses. — Jalap is an active cathartic, rather too harsh to be used alone, but may- be profitably combined with other more mild articles. It is antibilious and hydragogue in its cathartic effects, and is particularly applicable in bilious fevers, dropsies, jaundice, &c. This is one of the most common arti- cles of this class in use in the fashionable practice ; it is commonly prescribed with calomel — thus "calomel and jalap" is a very fashionable compound. The dose is from twenty to forty grains of the powder, taken in two portions. ALOE. (Aloes.) Description. — The, perfoliate or socotrine aloes is among the most important species, and is described by Lindley as having a woody stem, straight, and naked below, considerably marked with the scars of leaves. Leaves amplexicaul, ascending, ensiform, green, curved inward at the point, convex below, rather concave above, marked with numerous small white marginal serratures — the parenchyma abounding in a bright brownish yellow juice. Raceme cylindrical, unbranched. Flowers scarlet at the base, pale in the middle, green at the point. This is the kind of aloes commonly called socotrine, so designated from the name of an island lying in the Indian Ocean, from which the genuine drug is exported. But it is dhTcult to get the genuine article, as its supe- riority gives occasion to the practice of fraud. It is 'ustly said by Dr. Wood, that much of the aloes sold as socotrine, has never seen the island of Socotra, nor even the Indian seas. It has been customary to affix this title as a mark of superior value to those parcels of the drug, from whatever source they may have been derived, which have been prepared with unusual care, and are supposed to be of the best quality. Thus, both in Spain and the West Indies, the juice which is obtained with- out expression, and inspissated in the sun without arti- ficial heat, has been called socotrine aloes. Besides the aloe perfoliata or socotrina, we have other yielding species; aloe spicata; aloe vulgaris; aloe 342 ALOE. arborescens; aloe commelyni, and aloe multiformis, which are all natives of the Cape of Good Hope, and are commonly called Cafre aloes ; and with these we have still others, viz : the Barbadoes, Indian, Mocha, and the Caballine. The Barbadoes, commonly called hepatic aloes, from its resemblance to the color of the liver, comes to us in large gourd-shells, and is a pretty good kind, and when the socotrine cannot be procured this may be sub- stituted for it. India aloes is, perhaps, only an inferior article of the same kind as the Barbadoes. Of this there are however several varieties: 1, that of Northern India, which is of a dull black color, is brittle, and has but a faint odor j 2, that from Guzerat, which is more gummy in its appear- ance and feel, and is more difficult to fracture; 3, that from Salem, which is distinguished from the other vari- eties by the numerous large air cavities observed in the interior of the mass — its odor is similar to the socotrine ; 4, that from Trichinopli, which resembles the Cafre aloes in bitterness, odor, and color, but is more opaque. The Moclia aloes is a dirty mixture, which is of late imported from Muscat, in chests containing nearly two cwt. each. The Caballina or horse aloes, in appearance resembles the hepatic in color and consistence, but has a very rank and unpleasant smell. It is often sold for hepatic aloes, but is much inferior to it, and is now not much used, except by farriers among horses. In selecting aloes for medical use, that should be taken which has an agreeable aromatic smell, and a regular semi-transparent and shining appearance, and if it be soft it is no matter, but it should' always be clean from foreign impurities. The best is always brought in skins and shells. The socotrine should always be preferred. Medical properties and uses. — Aloes is a very certain but slow cathartic. Its stimulating and tonic proper- ties are well calculated to sustain the system during the operation of the medicine. Like the bile, this article seems to have a specific tendency to excite the peristaltic motion, as it little affects the exhalent vessels ; the discharges it produces being generally not very thin, but consisting chiefly of faecal matter and other materials CATHARTICS. 343 that may be found in the intestines at the time of its exhibition. It seems to act most prominently on the large intestines, sometimes giving rise to some irritation in these parts, and hence, when its use is long contin- ued at a time, it has been known to produce piles. This effect, however, seldom arises from the use of the gen- uine socotrine aloes. A singularity about this medicine is, that an increase of quantity beyond the proper dose, does not seem to be attended with a corresponding increase of its action. Aloes also possesses an emen- agogue power of considerable value. The cases in which this medicine is most strongly indicated, are loss of appetite, dyspepsia, constipation, intermittents, and other fevers, amenorrhosa, intestinal worms, want of biliary secretion, &c. The dose is from three to eight grains, which will generally operate in from twelve to twenty-four hours. Its action can be somewhat quickened by using, with it, other articles of more activity. Owing to its extremely bitter taste, it is best administered in pill form : two pills will gener- ally be sufficient for a dose. RICINUS COMMUNIS. Castor Oil Plant. Description. — This plant, which is sometimes called palma christi, is a native of the Indies, where it grows sometimes to the hight of thirty to forty feet, but it is now cultivated in almost every part of the world. As cultivated in this country, it seldom grows larger than from five to ten feet in hight. That cultivated in this country, will bear the follow- ing description : — The plant is of vigorous growth ; Btem erect, round, hollow, smooth, branching, and something of a purplish hue toward the top, some- what resembling the phytolacca decandra or poke. The leaf is large, peltate, palmate, serrate, smooth, and of a bluish-green color. The flowers are monoecious and destitute of a corolla, constituting a knotty pyramidal terminal raceme. The pod is glucious, and of a round- ish shape, having three projecting sides, and is covered with tough spines. It is divided into three cells, each containing a seed of the size of a grain of coffee, which produces the oil. 314 DOMESTIC MEDICINE. Castor oil is a medicine of great antiquity ; it was used by Hippocrates and others of his day, and it is now one of the most common articles of the cathartic kind in use. Dr. Eberle states: — "Castor oil is very mild, unirritating, but a certain and prompt cathartic, procuring copious faecal evacuations, without appearing to excite the intestinal emunctories, since it hardly ever occasions any very liquid or watery discharges. Where we wish simply to evacuate the contents of the bowels, or avoid costiveness, there is no article belonging to this class of remedies, so well adapted as castor oil, to answer our intentions. Independent of the mildness and completeness of its operation, it is less apt than any other cathartic to leave the bowels in a dry or costive condition."* It is very prompt and sure in its operation, generally operating in an hour, and some- times sooner. The chief use of this article as a medicine, is found in its adaptation to the removal from the intestines, of any irritating or offensive accumulations, or poison that may be taken, as it produces but little disturbance in any other part of the system, and is moreover very active in its effects. It serves as a medical vehicle in the use of the chenopodium anthelminticum or wormseed oil. One of the greatest inconveniences in the use of this article, is the difficulty attending its administration, owing to its nauseous and disagreeable taste and smell, which to some is very disgusting. The best way to obviate this is to take it in a little wine, cider, or coffee. The dose is from a table spoonful to an ounce. CASSIA. Senna. Description. — There are several species of the cassia that contribute in furnishing the drug of commerce. As we find the senna in market, it is named according to the country from whence it is brought; hence we have the Alexandria, the Tripoli, and the India senna. The senna brought from Alexandria embraces some three or four species, the C. acutifolia, C. obovata. C. cynanchum, C. olecefolium, and the C. tephrosia apollinea. * Therapeutics, page 129. Cassia, ( Senna ). + Fig. 1, is a specimen lea^of the ovate leaved Alexandria senna. 2. Specimen of the acute variety of the same. 3. Specimen of the Tephrosia or silver leaved Alexandria senna. 4. Specimen of the India or Trinnevelly senna. 5. Specimen leaf of the Coriaria myrtifolia, — an article with which senna is sometirres adulterated. These are of a grayish-green color, and are tinged with blue. They have three parallel nerves, one prominent one in the centre, and one on each side between this and the edge or margin of the leaf. 6. A specimen leaf of the Cynancum oleaefolium orargel, a variety of the Alexandrian senna. 17 CATHARTICS. 347 The Tripoli senna consists of only one species, the C. JEthiopica. The India senna* consists chiefly of the cassia elon- gata; the leaves of which are much longer than either of the above named. The Alexandria senna, until recently, has been con- sidered the best for medical use. But a finer article of India senna, which is the production of Hindostan, and cultivated at Tinnevelly, is now brought to us, which is considered superior to all others. This article, in Eng- land, is known under the name Tinnevelly senna, and is there very highly esteemed. Medical properties and uses. — Senna is a prompt and efficient cathartic, but is objectionable on the account of its tendency to produce griping and pain in its oper- ation. This may, however, be obviated to some extent, by combining with it some aromatic, such as the fennel seed. It seems that the effects of senna are consid- erably improved by combination with bitters, and as the article is chiefly used among children, this hint may be improved upon by combining with it an equal quantity of peach leaves, whose properties are of known utility. Senna is particularly useful in dropsical diseases, and as an ingredient in cathartic compounds, to quicken their operation. It is very convenient to be mixed with spigelia. The dose is from half a drachm to two drachms. When given by infusion, which is the best way, a half an ounce is scalded with an ounce of manna, and a drachm of fennel seed, to a half-pint of water. Take a third once in four hours, until it operates. IRIS VERSICOLOR. Blue Flag, Snake Lily, <$fc. Description. — Root perennial, horizontal, fleshy, and fibrous. Stem two or three feet high, round on one side, acute on the other, and sometimes branched. Leaves sword- shaped, striated, sheathing at the bottom. Flow- ers from two to six in number, and of a blue color. * This article is produced in Arabia, and derives its name India, onlj from the route by which it reaches us. 348 DOMESTIC MEDICINE. Locality and habits. — This beautiful plant grows all over the United States, in low wet places, in meadows and borders of swamps. It flowers in June. Medical properties and uses. — The blue flag is an active cathartic, and in over doses, is emetic ; it is also diuretic. This medicine is too harsh for common use, but from its adaption to several obstinate diseases, it well merits a place in our materia medica. It is perhaps one of our best remedies in venereal affections ; its action is searching, and powerful on the glandular sys- tem. It enters into and is the basis of Dr. Smith's anti- mercurial syrup, which is held in high estimation, by some, in mercurial and venereal affections. The medicine is also useful in dropsy, and in scrofulous complaints. It is highly recommended in colic, and also in liver complaints. The dose of the powdered root is from eight to fifteen grains ; that of the extract, or iridin, one to three. SAMBUCUS CANADENSIS. Elder, Sweet Elder, Black Elder, fyc. The elder is a very common indigenous shrub, and needs no further description. Medical properties and uses. — The inner bark and young leaf buds are a pretty active cathartic of a hydragogue character ; and being actively diuretic, are very good in dropsy. For this use, a handful is usually infused in a pint of cider, and drank at suitable inter- vals, in wine glassful doses. The bark is also some- times made into an ointment, for cutaneous affections. The flowers are much used in families, for children, and the berries are recommended in rheumatism. APOCYNUM ANDROSiEMIFOLIUM. Bitter Dogsbane, Bitter-root, Wandering Milk-weed, Honey-bloom, Wild Buckwheat, Fly-trap, bH DOMESTIC MEDICINE. then be simmered for a few hours in water at a moder- ate heat ; or it may be reduced to a fine powder, and then digested for three or four days in warm water. This is then to be taken freely. The extract of sarsa- parilla that is found in the shops is not, generally, worth much. When sarsaparilla is selected for use, that should be taken which has the strongest odor, and that which on chewing it leaves an acrid impression on the tongue. The alcoholic extract made with as little heat as pos- sible is best. The dose of this is ten to twenty grains. STILLINGIA. Queen' s-root ; Cock-up-hat; Queen's Delight. Description. — An indigenous, perennial, herbaceous plant. Root large, woody, Stem herbaceous, two or three feet high. Leaves sessile, alternate, oblong or lanceo-oblong, obtuse, serulate, tapering at the base, and accompanied with stipules. Flowers yellow, mo- noecious, and arranged in a spike, the upper flowers of which are the staminate, and the lower the pistillate. When wounded, the plant yields a milky juice. Grows in pine barrens from Virginia to Florida and Louisiana. Medical -properties and uses. — The stillingia is one of the best alteratives that we possess. It is also some- what purgative, but its alterative properties are the most valuable. The medicine is now employed with great success in the treatment of syphilis, and is also considered of much service, even in leprosy, elephan- tiasis, and frambcesia, as well as in other affections of a chronic character, dependent upon a depraved or cachectic habit of the system. It was an ingredient in Swaim's Panacea. It is taken in the form of infusion, decoction, tincture, syrup, or extract, in doses large enough to keep up a cathartic effect. GUAIACUM. The gum-resin and chips of guaiacum are employed, and especially of late, with great success as an altera- tive. It is especially useful in rheumatism, gout, sciatica EUTROPHICS OR ALTERATIVES. 559 and glandular diseases. The dose of the resin in pow- der is from ten to fifteen grains. The chips are em- ployed in alterative syrups. RUMEX CRISPUS. Narrow-leafed Dock. Description. — Root perennial, large, fleshy, branched, spindle-shaped, and of a yellow color. Leaves many, radical, large, lanceolate, entire, crisped, and are sup- ported on long grooved petioles. The stem is upright, smooth, furrowed, with a few bracts as it ascends, and branched at the top. The terminal branches are beset with many small flowers, which are followed by numer- ous small three- sided seeds. Locality and habits. — This is an extremely common indigenous plant, growing about door-yards, in mead- ows, along fences, and in lanes. It flowers in July. Medical properties and uses. — This and nearly all the other docks, especially the broad-leaved and bur-dock are good alteratives, tonics, and detergents. These plants are excellent eutrophics, and as such, may be used with advantage in all scrofulous, strumous, scorbutic, and scirrhous affections. They are partic- ularly useful in cases of chronic diseases of the skin that are dependent on a vitiated state of the humors. ACETATE OF AMMONIA. The acetate of ammonia is prepared by dissolving carbonate of ammonia in acetic acid until the product is perfectly neutral. It is an excellent alterative, and a very effectual counter-poison. It will cure the hives and various other inflammatory skin diseases, such as erysipelas, erythema, tetter, &c. ARALIA NUDICAULIS. False SarsapariUa. Description. — This is a common plant in the Western Country, and is much used under the name of sarsapa- rilla. It has a long, horizontal, perennial root, of about the thickness of a pipe stem, with a grayish bark. The stem is upright, round, smooth, about a foot or more in J>60 DOMESTIC MEDICINE. hight, and divided on the top into three petioles, bear- ing as many quinate, or thrice ternate leaves. The leaflets of these are oblong-oval, acuminate, rounded at the base, smooth on both sides, and serrate. The scape or flower stem is naked, shorter than the leaf, and terminated by three umbils with numerous yellow- ish-green flowers, followed by small round berries. Locality and habits. — This plant is found on uplands or hilly places, growing in woods, new grounds, &c. It is found in most of the Western States. Medical properties and uses. — The false sarsaparilla is used for the same purposes as the genuine sarsapa- rilla, only it is not so good, and must be taken in larger quantities. It is generally taken in decoction, or infu- sion, and drank in portions as large as the stomach will bear. ARALIA RACEMOSA. Spikenard. Description. — The spikenard is a beautiful luxuriant plant, with an aromatic, long, perennial, horizontal, spindle-shaped, and branched root, which has a grayish bark. The stem is round, smooth, branched, and of a purplish-green color. The leaves are large, compound or thrice ternate, with oblong-oval, lanceolate, acumin- ate, smooth, entire, serrated leaflets. The flowers are arranged in umbils; they are followed with round, pur- ple or dark berries. Locality and habits. — Spikenard delights in a rich soil, and is found in ravines, along fences, in the woods, and often selects piles of vegetable mold, as the remains of logs or timbers. It grows in most of the States. Medical properties and uses. — Besides its general ap- plication where alteratives are indicated, it seems, ac- cording to the opinion of some, to be particularly ser- viceable in pectoral or lung affections, and female weakness. The green root forms an excellent poultice. Abulia Racemosa, (Spikenard). 3d Celastrus Scawdens, (Bitter-sweet). Silphium Perfoliatum, (Cup-plant). EUTROPHICS OR ALTERATIVES. 567 CELASTRUS SCANDENS.* Staff Vine ; False Bitter-Sweet. Description. — Root woody, long, with a thick fleshy bark, and beautiful yellow cuticle. The stem is a long vine, with a rough bark, which has a grayish cuticle, but yellow derm. The vine is generally supported by bushes, and trees, around which it binds, sometimes so tightly as to bury itself in the solid wood. It is much branched at the top, and bears, in the fall, numerous clusters of beautiful orange-colored, oblong berries. Locality and habits. — This singular plant is found most plentifully in the rich western bottoms. Medical properties and uses. — The bark of the root of this plant, is considerably alterative in its effects. It is chiefly used in decoction or infusion, for chronic cutane- ous affections. In order to insure its good effects, its use must be persevered in. In some medical books this article is recommended in the form of an ointment, for scrofulous tumors, and other obstinate swellings. But this credit was gained for it, from the popularity of the real bitter-sweet, for which it has been mistaken, as already remarked. SILPHIUM PERFOLIATUM. Cup-plant ; Ragged-cup. Description. — Root perennial, long, crooked, pitted, jointed, with fibres issuing from the joints. Stem up- right, square, about an inch in diameter, branched at the top, and from two to six feet in hight. The leaves are large, ragged, clasping or cupped, opposite, and diminishing in size toward the top. The flowers, are terminal, with a broad disk, and beautiful, yellow, spreading petals. Locality and habits. — The cup-plant is found in the rich bottoms of our western rivers. In some places it grows very plentifully. Medical properties and uses. — The root of this beauti- ful plant, when taken into the mouth, has a strong * This plant, though entirely dissimilar, is often confounded with the solanum dulcamara, or woody nightshade. 568 DOMESTIC MEDICINE. scratching or acrid taste, which is very durable in its effects. It excites the secretions, and operates as a general deobstruent. Its effects are also prominently eutrophic. In all chronic visceral affections, this article wiT prove itself a valuable remedy. As a diaphoretic it is not inferior, and hence the medicine is particularly serviceable in visceral inflammation, such as chronic hepatitis and chronic inflammation of the spleen. It is prepared in strong decoction, and taken in half tea cup- ful doses according to the symptoms. PHYTOLACCA DECANDRIA. Poke-root; Scoke. This is a very common plant, growing in most culti- vated places in our county, and needs no description. As a medicine it is generally regarded too harsh for common use. The dried root forms an excellent top- ical application, however, in the treatment of cancers and other obstinate tumors, and forms one of the chief ingredients in the popular irritating plaster now in use by our profession. It is also of considerable service in some cutaneous affections, as in obstinate cases of tet- ter and porrigo. But its chief use is in the treatment of syphilis. ALNUS SERRULATA. Black Alder, Tag Alder. Description. — This is a shrubby tree or bush, rising from five to fifteen feet in hight. It is much branched at the top, and has a grayish bark. The leaves are large, roundish, or oblong, acuminate, and serrate. The flowers are in aments or tags, like those of the hazel, and appear in autumn. Locality and habits. — The black alder is found in wet lands, along brooks, and in swampy places. It grows in bunches of from six to several dozen in a place. Medical properties and uses. — The bark of the root, the tags, and boughs, are alterative, and detergent. The medicine is generally used in diseases of the skin. It is prepared in strong decoction, and taken freely. The decoction makes a good wash for old foul ulcers. Crocus Satavis, ( Saffron ). EUTROPHICS OR ALTERATIVES. 571 CROCUS SATIVUS. Saffron. The saffron plant is a native of Greece and Asia Minor, but is considerably cultivated in Europe and America, in gardens. It has a depressed bulb or cor- mus from which issue its long linear leaves. Its flow- er is large and of a beautiful lilac color. Its style hangs out through a segment of the corolla, bearing three long, convoluted, and highly odorous stigmas, which are the medical portion of the plant. Medical properties and uses. — Saffron has been much in use as an alterative, stimulant, and antispasmodic, and was considered particularly serviceable in bringing out eruptions upon the skin. It is now chiefly em- ployed by nurses and old women, among children. The dose is ten grains. It is very useful as a coloring material for tinctures and essences. V. ANTISEPTICS AND DISINFECTANTS. Antiseptics are remedies which have a tendency or power to prevent putrefaction or mortification, or of obviating it when it has already taken place. Disin- fectants are agents that are capable of neutralizing morbific and offensive effluvia: they are also antiseptic in their effects. SPECIAL ANTISEPTICS AND DISINFECTANTS. ACIDUM PYROLIGNEUM. Pyroligneous Acid ; Vinegar of Wood. This acid is obtained by the destructive distillation of wood. To prepare it, a furnace should be built, and a strong sheet iron cylinder of any size, with a tight lid, placed in it. To the top of this, an iron tube, about a foot in length, should be fixed : to this there should *>e fixed a worm of a common still, or any other suita- ble tube, long enough to condense the vapor. This worm or tube must pass through a tub or trough of water, to favor the condensation. The apparatus being 572 DOMESTIC MEDICINE. complete, the cylinder may be filled with some solid dry oak, or any other good dry wood, and the lid care- fully luted with clay, so as to make the whole air-tight. A good fire may now be raised and continued until the products cease to come over. The products in the ves- sel, previously prepared to receive it, are an impure pyroligneous acid, which will answer for ordinary ex- ternal use, but for internal use, and for the preservation of meat, &c, it should be purified by redistillation. Medical properties and uses. — This is perhaps the most powerful antiseptic that we possess. The article, of moderate strength, (about one part to two of water,) needs only be applied two or three times to gangrenous parts to restore them. As a cleansing and healing application in the treatment of ill-conditioned ulcers, cancers, and scrofulous sores, it, perhaps, has no rival. The medicine is applicable in all cases in which a powerful antiseptic, and healing medicine is required. Any kind of meat may be preserved by dipping it into this acid a few times, and it will neither injure the meat, nor spoil its flavor, but rather improve the latter, at least for some palates. BAPTISIA TINCTORIA. Indigofera ; Wild Indigo. Description. — Root perennial, irregular, large, woody, blackish outside, yellowish within, and sending off many slender branches or fibres. Stem two or three feet high, round and smooth, of a yellowish-green color, interspersed with black spots. Leaves alternate, obo- vate, small. Flowers of a beautiful yellow color, and are succeeded by a swelled oblong pod of a dark color. Medical properties and uses. — The root of this plant is a powerful antiseptic when topically applied. Bruised and simmered in water, it. makes an excellent solution for washing foul and putrid ulcers ; fried in lard it also makes a good ointment for healing up old, obsti- nate, and putrid ulcers and sores. A poultice of the root or top is excellent as an application to gangrenous parts. It may be employed internally in the form of decoction or infusion, as an antiseptic in cases of threatened gangrene of the stomach, bowels, perito- Paptisu Tinctoria, ( Indigofera ). ANTISEPTICS AND DISINFECTANTS. 575 neum, &c. Half an ounce of the dried root steeped in a pint of hot water, and taken in one or two table spoonfuls once in five or six hours, is the common way in which it is employed. CARBO LIGNI. Charcoal. Charcoal is prepared by burning wood in a smothered state, so that the combustion is carried on by a limited supply of oxygen, and hence nothing farther than the more volatile parts, as the oxygen and hydrogen, are dissipated, while the carbon, in the form of charcoal, is left behind. Medical properties and uses. — Charcoal is actively antiseptic and absorbent. In the form of a poultice with yeast, it is very good to arrest mortification. With the same view it may be taken in large doses, inter- nally, when gangrene of the stomach or bowels is threatened. It is an excellent article, to be used in typhoid fever and dysentery. Meat embedded in fine charcoal is preserved for many months. CALX CHLORINATA. Chlorinated Lime, Chloride of Lime. This is prepared by the manufacturing chemist, by the action of chlorine on hydrate of lime. It may be purchased at the shops much cheaper than it can be made by the practitioner. Good chlorinated lime is a dry or slightly moist, grayish -white, pulverulent substance, possessing an acrid, bitter, pungent, astringent taste, and a feeble odor, resembling that of chlorine. Medical properties and uses. — Chlorinated lime is perhaps the most powerful disinfectant that we possess. It is of eminent service to purify the chambers of the sick. For this purpose it is simply to be put in a dish or saucer, which is then to be placed in some conve- nient situation in the room. A solution of chlorinated lime makes an excellent wash for foul ulcers, burns, chilblains, and cutaneous eruptions. It makes, when of suitable strength, a very good gargle in cases of putrid sore throat, and sore 576 DOMESTIC MEDICINE. mouth and gums. The chlorinated lime constitutes the popular bleaching powder that is so extensively used. CHLORINUM. Chlorine. As a disinfectant for clothing and infected apart- ments, chlorine has long been a popular agent. A mixture that will yield chlorine for three or four days, in a quantity sufficient for all ordinary purposes, may be made by mixing intimately one part of common salt with one part of black oxide of manganese, and then placing this in a shallow earthen dish, pouring on two parts of sulphuric acid, previously diluted with two parts by measure of water, the mixture being stirred with a stick while it is being made. If the vessel, con- taining this mixture, is placed in a room that is infected with a poisonous contagion or effluvia, it will perfectly purify it : or if clothes are held over the fumes rising from the mixture, or even hung in the room containing it, they will be rendered pure. Persons using the chlorine, should be careful not to inhale much of it, as it is injurious to the lungs. It is unnecessary here to notice severally, all the antiseptics that are found among the tonics, astringents, and stimulants. It must suffice to say that the most active articles in all these classes, as, for instance, cin- chona, columba, hydrastis can., geranium, bayberry, white pond lily, capsicum, ginger, black pepper, tine, of myrrh, and even sassafras bark, are all excellent antiseptics. When used, they should be made up with yeast, charcoal, or slippery elm mucilage, and applied to the parts : or, if needed internally, they may be taken down in decoction, infusion, or tincture, in large doses CHAPTER VII. MEDICINES WHOSE EFFECTS ARE PROMINENTLY CHEMICAL. I. ALKALIES OR ANTACIDS. These are remedies which are calculated to obviate acidity in the stomach and elsewhere. This they effect by combining with the acid, and thus neutralizing it. ALKALIES OR ANTACIDS. 577 These agents are not of very extensive application, but in some cases are nevertheless considerably important. Alkalies are chiefly indicated in the burning in the stomach attending dyspepsia; to promote the operation of emetics; in the treatment of poisoning by the inges- tion of the concentrated acids, and in urinary calculi, caused by an excess of uric or some other acid. SPECIAL ANTACIDS, SOJLE CARBONAS. Carbonate of Soda. Carbonate of soda is obtained by the manufacturing chemist, from the ashes of the Chenopodiaceae and Alga- cese families of plants. It is also found in certain parts in Egypt, Hungary, and South America, occurring in a native state. The carbonate of soda, as it occurs in the shops, is in opaque, porous masses, of a white color, and made up of numerous, aggregate, chrystalline grains. The bicarbonate of soda is now rather more in use than the carbonate. It is preferred because it is more pure, and is more pleasant to the taste, as well as to the stomach. Medical properties and uses. — Either of these prepara- tions of soda may be taken in from a half to a whole tea spoonful doses, dissolved in water. A dose of it may occasionally be taken in cases of heartburn, acid eructa- tions, and all other cases in which alkalies are indicated. POTASSA BICARBONAS. Supercarbonate of Potash, Saleratus. The bicarbonate of potash is obtained by lixiviation of wood ashes, evaporating the liquid or lye, and puri- fying the salt. As found in the shops, it consists of a coarse granular white powder, and has a nauseous, alkaline taste. It is very soluble in water, but is insol- uble in alcohol. Medical properties and uses. — Saleratus is a very good alkali, but little inferior to carbonate of soda. It may be employed in all cases in which the latter is found useful. 37 578 DOMESTIC MEDICINE. CARBONATE OP AMMONIA. This is an excellent antacid, and is at the same time considerably stimulant and diaphoretic. It is therefore rather better than either soda or saleratus, in dyspeptic sour stomachs. In typhus fever it is of eminent sei- vice. The dose is five to ten grains. CHAPTER VIII MEDICINES WHOSE ACTION IS PROMINENTLY MECHANICAL. I. DEMULCENTS AND EMOLLIENTS; The class of demulcents, by many writers on thera- peutics, is now considered separate from that of emol- lients ; — the former is now made to comprise such agents as are capable of shielding exposed surfaces from the action of acrid matter, by covering or coating them with their viscid and soft substance ; while the latter embraces articles that not. only do this, but at the same time, so insinuate themselves into the textures, as to render the parts more lax and flexible by their relax- ing power. These agents will, however, here be con- sidered together. They are particularly serviceable in irritation and inflammation of the mucous membrane of the stomach, bowels and urinary passages ; as well as externally in chafes, burns, bruises, and irritable wounds. They should be used in large and frequent doses ; for as they chiefly depend on mechanical principles for their action, this end is sometimes prevented by the digestive pro- cess — changing the character of the agent — when it is taken in small portions. SPECIAL DEMULCENTS AND EMOLLIENTS. ULMUS FULVA. Slippery Elm. This is a very common forest tree, and needs no de scnption Gonvalabia Multiloba., (Solomon's Seal). DEMULCENTS AND EMOLLIENTS. 581 Medical properties and uses. — The mucilage of the slippery elm bark is one of the best demulcents that we possess ; and as it is easily procured and pleasant to take, it is very extensively used in medical practice. It may be employed with the certain prospect of benefit in all cases in which demulcents are indicated. It is particularly serviceable in inflammation of the mucous surface of the alimentary canal, and in the form of a poultice or cataplasm, in cases of burns, chafes, irrita- ble ulcers, wounds, bruises, and bealings. ACACIA. Gum Arabic. The gum arable brought to us, is the product of a number of different trees of the leguminose order, grow- ing in Arabia, Upper and Lower Egypt, Hindostan, and other places. As found in the shops, it consists of roundish or amorphous pieces, or irregular masses of various sizes, more or less transparent, hard, brittle and pulverizable. Its color is usually of a yellowish- white, but frequently presents various shades. Medical properties and uses. — Gum arabic is an excel- lent demulcent, and will be found useful in catarrhal affections, and irritation of the mouth and fauces, as well as in inflammation of the stomach, bowels, kid- neys, bladder, &c. It also serves as a very good vehi- cle for taking less pleasant articles. CONVALLARTA MULTIFLORA. Solomon's Seal. Description. — Root perennial, horizontal, jointed, white, round, with some fibres. Stem terete, and in- clining, or arched. Leaves alternate, clasping, oblong- ovate, lanceolate, and nerved. Flowers white, numer- ous, and pendulous. There is another variety of Solomon's seal that grows more plentifully than this, which, although smaller, is equally valuable. Locality and habits. — These plants are found in most parts of the United States, growing in rich soil, in rocky and mountainous countries 582 DOMESTIC MEDICINE. Medical properties and uses. — Solomon's seal is de- mulcent and tonic, — boiled in milk it forms an excellent medicine in the treatment of irritable piles, and inflam- matory diseases of the bowels generally. It is also quite serviceable in leucorrhaea, and gonorrhoea The medicine is beneficially used in the form of a poultice, in the treatment of inflamed and raw surfaces. The root is the part used. Dose, as much as the stomach will bear. Flax-seed, (Linum Semina.) — Flax-seed tea is an excellent demulcent, and is particularly serviceable in scalding of the urine. It is to be taken freely without any particular reference to quantity. Marsh Mallows, (Althcea Officinalis.) — The root of this plant may be used with advantage in all cases in which demulcents are required. Olive Oil, (Oleum 01 ivaa.) — Sweet oil is an excel- lent emollient, and is exceedingly serviceable as a lini- ment in burns, chafes, and inflamed surfaces generally. It forms an ingredient in many valuable cerates and liniments. Oil of Almonds, (Oleum Amygdalce) — This is a good emollient, and may be used as such in all cases in which the sweet oil is found serviceable. Lard, (Adeps.) — Hogs' lard is a good emollient, and is much used by many physicians instead of sweet oil. In addition to those already noticed, there are a number of articles that are valuable demulcents, and which are at the same time quite nutritious, but cannot here be treated of separately. Among the most import- ant of these are, arrow root, tapioca, sago, barley, oat- meal, Iceland moss, &c. These are all good in cases of inflammation of the mucous membrane of the stom- ach and bowels, and in all cases of irritability of these organs. 583 CHAPTER IX. BATHING. Whether we consider bathing as a hygienic means, or curative agent, it is of paramount importance ; for such is the human organization — such the relation of the external surface to the entire system, that the slightest derangements in its functions produce effects on the constitution of no small magnitude. The perpetual supply and metamorphosis or change of the organic elements of the body, are indispensable to its physiological or healthy condition. Now, all these exhausted elements are found immediately in the capillary vessels, and have no convenient chance of exit from the body, excepting that through the pores of the skin. When, therefore, the emunctories of the skin are obstructed, this vast amount of peccant matter is retained in the body; some of it remaining in the cap- illaries, while much of it is retained in the circulation, and thus, in both instances, giving rise to much irrita- tion and fever. If the obstruction should prove perma- nent, these materials will be retained in the system, and continue to increase their mischief until they make their escape, littles by littles, through the other and" more remote outlets. But this is not the greatest mischief that arises from obstruction of the cutaneous exhalents : the functions of these organs involve the regulation of the tempera- ture of the body. All these changes in the supply, metamorphosis, and waste of the materials, are attended with a corresponding evolution of caloric or heat.* Now, this heat, according to the laws of the economy, is intended to be regulated by the evaporation from the surface. f As there is no evaporation sustained while the pores are closed up, the heat of the body must evi- dently increase at no slow rate. It will thus be seen that in obstruction of the cutaneous exhalents, an evil of a two-fold character is evinced : first, a fever is * This is the source of animal heat. f The disposition of the body to perspire, always corresponds with the amount of its sensible heat. 584 DOMESTIC MEDICINE. generated by the retained perspiration, which, by its irritation, increases the activity of the circulation, and hence the increased supply of oxygen and consequent combustion : secondly, it perpetuates this fever by the extinction of the natural means of its removal, — that is, perspiration. These mischiefs are liable to occur at any time that obstruction of the functions of the skin may take place ; and the magnitude of the evil, will always correspond with the extent of the obstruction. There are still other difficulties that are liable to occur from this cause : besides the bond of union be- tween the different parts of the body, by means of the sanguiferous system of vessels, there is another — the nervous system. Now, the skin is more extensively supplied with nerves than any other part of the body : it must appear, therefore, that from the extensive ner- vous sympathy existing, that there is a great liability to mischief from this circumstance. The nerves are functionaries which superintend all the manifestations of vitality in the body. The morbid excitement, there- fore, that is consequent on obstructions of the skin, must also be communicated to the entire system by this means. Whatever nervous depression or derange- ment there may be, it will always be attended with a corresponding depression of all the energies of the system. There is still another chain of general association, i. e., the lymphatic system. These vessels have their chief origin in the skin ; their functions, therefore, are extremely much influenced by obstructions of this organ. Their secretions may also become contamin- ated by an obstructed state of the skin. Thus the now famishing organs of the entire body, instead of being supplied with fresh and healthy blood, are irritated and oppressed by this impure and noxious mixture. The secondary evils resulting from obstructions of the skin, are also of considerable note. The whole system laboring under such an accumulation of morbific agencies, it is but reasonable to expect that, in addition to the acute attacks implicating the general system, as fevers, there is also a great liability to local inflamma- tions and permanent chronic diseases, especially oi BATHING. 585 those organs that from their construction, position, and use in the economy, are most exposed to the deleterious influences. The lungs are perhaps more exposed to this cause of mischief, than any other of the more important viscera ; for while the blood must all neces- sarily pass through them, they are also liable to partic- ular obstruction from the specific termination of the materials destined for expectoration. Hence irritation, congestions, and inflammation of this organ are so extremely apt to occur; — hence the cough attending our colds, — the oppressive pain, and other inconven- iences, so frequently experienced in the breast. Nor does ulceration and consumption of the lungs occur less commonly from this than any other cause. The intestines are next in point of exposure to this cause of disease. The frequency of derangements here is well known to all observers. The bowels, like the lungs, are compelled to act vicariously in the removal of the obstructed perspiration. Dysenteries, diarrhoea, cholera, &c, are of common occurrence. It is unnecessary farther to particularize on the infin- ite, and endlessly varied forms of diseased action, that may result in the different parts of the system, from this prolific source : it must suffice to say that this is the most fruitful of all the causes of disease. In view of all these facts, it cannot but appear obvi- ous that the best remedy for this grand source of dis- ease is of the greatest importance, and this remedy can- not be expected to be found elsewhere but in attention to the surface. Dr. Ewell remarks on this head, in his lectures on Hygiene: — "The evacuations of the body, from its superfluous, impure, and noxious particles, are no less necessary than is nourishment. The same power which changes and assimilates our food and drink, likewise effects the due and timely evacuations of the secretions. It is an object of the first consequence, that nothing remain in the body which ought to be evacuated ; and that nothing be ejected, which may be of use to its preservation. How many persons do we find who com- plain of bad health, notwithstanding every attention they pay to air, aliment, exercise, and sleep ; while others enjoy a good state of health, though totally 586 DOMESTIC MEDICINE. careless witn regard to these particulars, and all owing to a difference in the state of the evacuations. If these be disordered, the most rigorous observance of dietic rules is insufficient to insure our health ; while on the contrary, most of these rules may be neglected, for some time, without any injurious consequences, if the evac- uations be regular." " The grand discharge, the effusion of the skin, Slowly impair'd, the languid maladies Creep on, and through the sick'ning functions steal; As, when the chilling east invades the spring, The delicate Narcissus pines away In hectic languor ; and slow disease Taints all the family of flowers, condemned To cruel Heav'ns. But why, already prone To fade, should beauty cherish its own bane ! O shame ! O pity ! nipt with pale quadrille, And midnight cares, the bloom of Albion dies." — Armstrong. Bathing stands at the head of all our means of pro- moting the natural and healthy functions of the skin , its importance has been known, to some extent, from the earliest antiquity. The ancient Egyptians wer« particularly fond of the practice. From the throne ti the humblest subject this hygienic rule was observed and though the Nile afforded abundant facilicies fo«- bathing, and was frequented even by Pharaoh's daugh- ter and her attendants, yet extensive baths were erected at public expense. The Hebrew lawgiver enjoined upon the Israelites the strict observance of the ordi- nance of washing and bathing. Among the Greeks and Romans bathing, if possible, was still more popular ; they, particularly the latter, erected baths of the most magnificent character : those of Caracalla were constructed with great taste. They are said to have been embellished with two hundred pillars, and furnished with sixteen hundred seats, and were thus sufficient to accommodate three thousand people at a time. SPECIAL MODES OF BATHING. I. VAPOR BATH. There is no form of bathing so extensively useful as the vapor bath. Heat is the most relaxing and BATHING. 587 stimulating agent that we possess, and whenever appli- cable will seldom fail of the object of its use. The author has elsewhere shown that the vital phenomena are manifested only at particular temperatures, and that at certain points of this the animal functions entirely cease. It will appear then, that the diminution of the animal temperature is identical with disease. In all cases, therefore, in which the heat of the body is found to run low, as in typhus fever, cholera or cholera morbus, palsy, asphyxia, &c, the vapor bath is of incal- culable service. A moist heat seems to be peculiarly congenial to the body ; it generally invigorates and equalizes the circula- tion. This last circumstance makes the vapor bath especially valuable in local inflammation, particularly when implicating the pleura, or lungs. A course of the bath eminently prepares the system for the easy, thorough, and successful operation of emetics, and it is a good plan always to precede the latter with it in difficult cases. So commonly are these two important means used together, by some practi- tioners, that they have inherited the common title of " the course of medicine." If the vapor bath did not fulfill any other indication than the promotion of the cutaneous excretions, it, as a remedial agent, would even then, perhaps, be equal to any other now known, and it is not probable that a more safe, prompt, and efficient means of restoring the excretions of the skin, will ever be discovered. Its value in this respect can only be fully appreciated when the numerous mischiefs already hinted at, as resulting from obstructed perspiration, are properly considered. It is impossible to notice all the particular indications for its use. But as the most prominent of these are pointed out in the part treating on practice ; it is unnecessary to be particular here. Various means of applying vapor to the body have been successfully used, the most common of which is to place the patient on a split-bottomed chair, and sur- round him with a quilt or blanket. A shallow vessel, containing about two quarts of boiling water, is now to be placed under the chair, and hot bricks, or sand- stones, carefully put into it successively as they cool 588 DOMESTIC MEDICINE. off. The good effects of this process are much enhanced by placing the feet of the patient in a vessel of water, as hot as can be borne. When the bath is administered to persons in a carpeted room, or where it is wished to avoid wetting the floor, two narrow boards may be placed over a tub, and the chair set upon them ; then placing the vessel into the tub, and bringing the quilt close around it, the bath may be administered as already directed. Another and still more convenient way of adminis- tering the bath, is to procure some half dozen or more joints of copper or tin tube, say ten inches in length, and from a half to an inch in diameter, — let the joints gradually diminish in size, from one end to the other, so as to make the smaller end of one fit or embrace the larger one of the other, — the size of every subsequent tube diminishing from the two middle ones to either end. The arrangement of the tube is calculated to admit of shoving back all the small ones into the two largest, with a view of more convenience in carrying them. In addition to this, it is necessary to procure a plate of copper or sheet-iron, sufficiently large to cover the opening of a large tea-kettle ; through the centre of this, a hole should be made, large enough to admit of a screw, which should have a ring or flat top, so as to admit of turning it, and a shoulder below it to fit tightly on the plate. This screw should pass through the plate some four inches, and should enter the centre of a piece of iron, which should be half an inch wide, a fourth of an inch thick, and long enough to reach in a horizontal position, diametrically across the tea-kettle, about two inches below the plate through which the screw passes. All that is now necessary to the com- pletion of the apparatus is a small elbow to the tube, and a hole midway between the screw and the edge of the plate, corresponding to the size of the elbow, and another one at any convenient place in the plate, to admit of replenishing the water during the operation of bathing. In order to make the plate rest on the mouth of the tea-kettle so as to confine the steam, it may be best to fasten a piece of woolen cloth to the under side of it, cutting it away around the holes. When a bath is administered with this apparatus, the screw is to be passed through the plate, and made BATHING. 589 to enter the iron below, when the latter is to be put into a tea-kettle, one end first. Now by raising the screw with its fixings, so as to bring both ends of the iron below, against the sides of the tea-kettle, the plate may be tightly screwed down on the kettle. The latter, being half full of hot water, may now be placed on a hot stove or fire, and the tube inserted by its elbow, while the other hole is stopped with a cork. The other end of the tube is made to pass under the chair of the patient, who is to be surrounded with a quilt to confine the vapor. Several very convenient fixings may be added to this tube : a slide, covering a hole in the tube, may be so constructed as to regulate the steam or temperature according to pleasure. A small box may be fixed with a cap on it, and with pieces of tube soldered into it, so as to fit into the main tube, at the junction between the two largest joints. This arrangement will admit of administering medicated vapor baths. Any volatile medicine, such as camphor, ammonia, turpentine, and the essential oils may thus be communicated to the body with the greatest facility, while the skin is so much relaxed, and the circulation active. By the use of a spirit lamp, a still more convenient apparatus may be prepared — a representation of which is here given. In the use of this appa- ratus nothing more is ne- cessary than to place the patient on a chair, and sur- round him with a quilt, in the same way as for bathing with the heated bricks, and then placing the apparatus, fully trimmed, under the chair. To trim or prepare the apparatus for bathing, the lamp, with cotton wicks, must be filled with alcohol, and the cap placed on the lamp-cup — the wick wetted with some of the spirit, and the lamp lit and placed in the furnace under the boiler, which is to be nearly full of boiling water. Medicated baths may be adminis* 590 DOMESTIC MEDICINE. tered with this apparatus, simply by putting the in- tended preparation into the water of the boiler. With this, it is not really necessary to have the oil, or con- centrated form of the articles used, as the boiler is suf- ficiently large to receive the articles in their crude state. But still, the oils, resins, and spirits are much more con- venient, and perhaps nearly as cheap. In administering the vapor bath, the head of the patient should never be covered with the quilts, unless this should be necessary to relieve diseases of the head or face, as it is very unpleasant for the patient to in- hale the hot vapor as long as it is sometimes necessary to continue the bathing. The patient should always take a few drinks of some stimulating or diaphoretic teas before entering, and, sometimes, during the use of the bath, especially if it should be difficult to raise the perspiration. It is always best to raise the heat of the bath gradu ally, so as not to increase the momentum of the circu- lation too rapidly. If at any time the patient should feel faint, his face, neck, and breast may be wiped with a towel wrung out of cold water; or should this not prove sufficient, the heat of the vapor may be let down, either by moving the slide on the tube, if this is used, or by removing the apparatus. It is sometimes only necessary to open the quilts a little, and thus to let out the steam. Should the patient feel very faint, he may be placed in a hori- zontal position, by leaning him backward in his chair into the arms of a bystander. He should then have some cordial, stimulating drink, or tincture of myrrh. In the meantime, the bath should be kept up at a low temperature. It is a rare case that patients grow faint, if the bathing process is properly conducted. But these re- marks are here given, so that when this does occur, the practitioner may know what to do. The length of time that the vapor bath should be continued at a time, is not very definite, — depending entirely on the nature of the disease, the idiosyncrasy of the patient, &c. But it is always advisable to con- tinue it, unless the patient should become too weary, until he sweats freely, or is relieved from the pain or BATHING. 591 uneasiness for which he is vaporized. The practitioner is sometimes deceived in the presence, as well as the extent of the perspiration, by mistaking the condensed vapor on the body for sweat. The surest sign of a free perspiration, is to see it profuse on the face. It is a general practice either to shower the patient as he is taken out of the bath, with a basin of cold water, or to wipe him with a towel wrung out of the same, in order thus to excite a contraction of the skin, which is now unusually relaxed. This is a very good practice, and should generally be pursued, except in cases when it is intended to follow the bath with an emetic, or when the patient feels chilly, or, finally, when it is intended to keep him in a permanently relaxed condition, to promote some particular object in the treatment of his case. The practice of applying cold water or the shower bath so suddenly after the hot vapor, seems objection- able to some persons. But however revolting the prac- tice may seem to them, it is nevertheless safe and phil- osophical. All unacquainted with the practice, may be assured that they are less liable to take cold in this case, than they would be to take the same showering with- out being preceded with the vapor. " Taking cold" 1 ' is a negative expression, and philosophically speaking means losing heat, but in common parlance, it means a diminution of the animal temperature to the extent of producing injury to the system, by checking the excre- tions, &c. But it cannot be reasonable to suppose that an individual would be more likely to .sustain injury from the loss of heat, when he has ten or fifteen de- grees of it to spare, (as is the case after a good bath,) than he would be when the heat is of the natural stand- ard, and there is none to spare. The temperature to which the vapor is necessary to be raised depends on circumstances, but generally from ninety to one hun- dred degrees is proper. 592 DOMESTIC MEDICINE. II. TEPID BATH. The warm bath has been in use both as a hygienic means, and as a remedial agent, from the earliest age of medicine, but it is now almost entirely superseded by the vapor bath, as the latter is more convenient and efficient, and will, moreover, answer all the indications that can be fulfilled with the tepid bath. Nevertheless, at large bathing establishments the warm water is still considerably used. In medical practice, the tepid bath is considerably serviceable in the treatment of many diseases of chil- dren, and in these cases, it is also perhaps more conve nient than the vapor bath. In the use of this bath for children, no fixings are necessary, more than a common wash-tub of suitable size. This is to be about two-thirds full of water, as warm as the child can bear. The patient, after taking some suitable stimulating or diaphoretic drinks, is then to be immersed into this, up to his neck, and continued there, if comfortable, until perspiration appears on the face. During the time the patient remains in the bath, the stimulating drinks should be occasionally repeated. Adults, in the use of this bath, require bathing tubs or other vessels of suitable size, and should likewise have the water as warm as it can be borne. In order to be successful in producing a free perspiration on grown persons, it is necessary to take stimulant and diaphoretic drinks pretty freely. During the use of this bath, it is always very ser- viceable to apply friction to the surface of the body, by the use of the hand. This aids in relaxing the skin, and in bringing the termination to the surface. "When the patient is taken out of the bath, he should be briskly rubbed with a dry towel, thus to give activity to the skin and in other ways promote the good effects of the bath. The general indications to be answered in the use of this, are about the same as for the vapor bath. " Against the rigors of a damp, cold heaven, To fortify their bodies, some frequent The gelid cistern ; and where nought forbids, I praise their dauntless heart. * * * * BATHING 598 With ue, the man of no complaint demands The warm ablution, just enough to clear The sluices of the skin ; enough to keep The body sacred from indecent soil. Still to be pure, ev'n did it not conduce, As much it does, to health, were greatly worth Your daily pains. 'T is this adorns the rich ; The want of this is poverty's worst woe. With this external virtue, age maintains A decent grace ; without it, youth and charms Are loathsome. This the venal graces know ; So, doubtless, do your wives ; for married sires As well as lovers, still pretend to taste ; Nor is it less, all prudent wives can tell, To lose a husband's than a lover's heart." — Armstrong. III. SHOWER BATH. The shower bath is more used as a hygienic means than as a curative agent. But there are man}' circum- stances under which the application of cold Avater in this way, is very serviceable in the cure of disease. In feverish conditions of the body, more especially, show- ering with cold water is often of great utility. It has a tendency to equalize the circulation, and very remark- ably promotes the functions of the skin. It is a very general practice among Reformed physicians, to follow the vapor bath with a cold shower bath, as already stated. The best time for administering this bath is in the morning, when the body is most vigorous. If admin- istered at a later period in the day, it is a good plan to precede it with a dose or two of some stimulating drink. After the bath, the body should be well dried, and briskly rubbed with a coarse towel, in order thus to ex- cite the functions of the skin, and produce a healthy reaction. Apparatus of various forms of construction, have been used for the administration of this bath : but it is unnecessary here to give a description of any of them, as there are but few who will not be able to make or procure one of some form or other. The only principle to be observed in the construction of apparatus for this purpose, is to let the water be distributed in its descent, and to wet the whole body at the same time. This 38 594 DOMESTIC MEDICINE. may be effecte 1 by causing it to pass through a tub or vessel having a perforated bottom. The quantity of water to be used at a time varies according to the na- ture of the case, or the wish of the subject or patient: the amount generally used, is from a quart, to several gallons. The water is also used at various tempera- tures, according to the object to be accomplished; but it is the usual practice to take it at the natural temper- ature of common spring water. In most cases of in- flammation and fever, especially inflammatory fever, the shower bath is among the best means that we pos- sess, if the patient is able to be up to receive it. IV. SPONGING. Sponging with cold water, as a curative means, is of the greatest importance in many cases of disease. In all cases of high fever, and as a local means, in violent inflammation, cold water applied in this manner is of incalculable benefit. It has a tendency to let down the heat very remarkably, and to equalize the circulation. In all cases when there is much heat and dryness of the skin, this potent means should not be neglected: it should be the first thing that is done by the practitioner, who will, in many instances, find it sufficient to break up the most violent paroxysm of fever. In some obstinate cases, it may be necessary to roll the patient up in sheets wet with cold water, and to re- new them as often as they grow warm, until the febrile symptoms give way. So efficient, indeed, is this part of the Reformed medical practice, that a class of prac- titioners have embraced it as an exclusive system, and use it in all cases of disease, and the success attending their treatment is not a little astonishing. The water used for this purpose should be soft, fresh, and cold. COMPOUNDS. 595 COMPOUNDS. In a former edition of this work, an abridged system of pharmacy was given, which gave much satisfaction. But in the present, the part on practice is much ex- tended, and comprises many formulas; so that it is considered unnecessary to put this additional expense upon the book in the present edition. Those, however, who wish something more on this subject, will find it in another work of the author. A few of the more important compounds, and such as are less commonly known, will suffice here. ADHESIVE AND STRENGTHENING PLASTER. Take of the green leaves of burdock and mullein, equal parts ; bruise and put them into a kettle, with a sufficient quantity of water ; boil them well ; then strain off the liquor, pressing the leaves ; boil down to the thickness of molasses, and then add a quantity of rosin equal in weight to that of your syrup, and one- third as much of turpentine ; simmer until the water is all evaporated, when it may be thrown into a basin of cold water, and, as it is cooling, worked into sticks. The consistency of the plaster is regulated by the quan- tity of turpentine ; if too thick or hard, add more of the latter, and vice versa. Use. — This plaster is very good to relieve weakness in the back, breast, and loins. It should be spread on soft leather, and applied to the parts affected. It also answers very well as a common adhesive plaster for dressing wounds. Thomson's healing salve. R- Beeswax, 1 pound, Salt butter, 1 do. Turpentine, 8 ounces, Balsam of fir, 12 do. Simmer together and strain. Use. — Very good to heal fresh wounds, burns, and other sores. BLACK SALVE. R- Flax-seed oil, 1 pint, Sweet oil, 1 do. Red lead, -| pound. Simmer down to a salve, being careful not to burn it. 596 DOMESTIC MEDICINE. Use. — Few articles seem to do better in healing up old soies, and putrid ulcers. This preparation is very analogous to Shepard's salve or Judkins' ointment. Perhaps the better way to prepare this, is to put the oils in a pot, and heat them until they will scorch a feather, when the lead may be stirred in to form the salve. This salve is very highly recommended by Dr. J. Thomson. GREEN SALVE. B; Stramonium ointment, 1 pound, Turpentine, 1 do. Bayberry tallow, 1 do. Melt together, stirring it some, while cooling. If the bayberry tallow cannot be had, take half a pound each of rosin and sweet oil, in its stead. Use. — The same as other healing salves. It is good for piles. IODINE OINTMENT. Br Iodine, \ drachm, Iodide of potassium, 2 drachms, Lard, 2 ounces. Rub the whole together in a wedgewood mortar, so as to form a liniment of a mahogany color. Use. — This is the only certain remedy now known for the cure of bronchoccle or goitre, sometimes called big-neck. It is applied with friction over the part affected. It is also useful in all scrofulous tumors, and ulcers. RUBEFACIENT OIL. B; Oil of capsicum, 1 ounce, Oil of lobelia, 1 do. Spirits of turpentine, 2 ounces, Oil of dittany, 1 ounce, Camphor, fine, 1 do. Shake well together, and apply sparingly. Use. — This preparation is the best rubefacient the author has evei used ; it is permanent in its effects, and may be employed in all cases in which the more active rubefacients or liniments are required. BATHING DROPS OR STIMULATING LINIMENT. B; Best alcoholic tincture of lobelia seed, 1 pint, Tincture of capsicum, best, 1 do. Oil of sassafras 2 ounces, Oil of pennyroyal, 2 do. COMPOUNDS. 597 Oil of wild marjorum, or dittany,. . . 2 ouuces, Gum camphor, 2 do. Castile soap, 2 do. Shave the soap and camphor fine ; put them into a bottle, and add all the remaining ingredients, — shake until the soap and camphor are dissolved, and it is fit for use. Use. — This is one of the best and most convenient of all stimulating liniments, and may be advantageously used in all cases in which articles of this kind are indi- cated, especially in inflammatory swellings, sprains, bruises, rheumatisms, pains in the breast, side, bowels, &c. IRRITATING PLASTER. Take of mandrake-root, blood-root, Indian turnip, and poke-root, finely pulverized, of each half a pound ; cover with alcohol, and let it stand until nearly dry. Melt four pounds of pure or strained Burgundy pitch, and add half a pound of pure Venice turpentine. Then stir in the powdered roots, and incorporate the whole well together. Simmer until formed into a soft plaster. — Beach's Family Physician. Care is necessary in the preparation of this plaster, so that the powders are not burnt by the hot pitch and turpentine. It should be prepared on coals. Use. — This plaster is designed to be applied over the parts, in cases of deep seated chronic affections, such as affections of the liver, lungs, stomach, kidneys, spine, and sciatica or hip-disease. Spread on a piece of leather and applied, it produces a severe itching ; and in the course of a day brings out a crop of small pustules, which dis- charge matter. COMPOSITION DIAPHORETIC POWDERS. ]Jfc Bayberry, 1 pound, Pleurisy-root, 1 do. Ginger, 1 do. Colic-root, 2 ounces, Aralia spinosa, 2 do. Capsicum, 2 do. Pulverize, and mix well by means of a seive. Use. — This is a medicine of great value, and of very extensive application. Its great utility seems to arise from the combination of its stimulant and astringent properties, which, in this instance, are attended with 598 DOMESTIC MEDICINE. effects much more permanent than those following either of these alone. ANTIBILIOUS CATHARTIC POWDER. ~fy Podophyllin, ) v , ,,. Leptandrin, \ Equal parts. Mix. This is a very convenient cathartic for common use in fevers and inflammatory diseases. Dose one to three grains. CATHARTIC PILLS. B; Podophyllin, 1 ounce, Capsicum, % do. Soft extract of boneset, suf. quant. Make into pills. Dose one to two pills. ASTRINGENT TONIC COMPOUND. B £:;'::::::::::!^"* Pulverize and mix. An ounce of this is infused in a pint of boiling water, and the infusion taken in wine glassful doses. Use. — As an astringent for internal use in dysentery, cholera, diabetes, haemorrhage, prolapsus, &c, there is perhaps, no compound superior. If the extracts of these articles are employed, the medicine will be more prompt and powerful. BITTER TONIC COMPOUND. B; Poplar bark, 1 pound, Dogwood bark, 1 do. Bayberry, 1 do. Golden seal, 1 do. Colomba root, 1 do. Cloves, 6 ounces, White sugar, 5 pounds. The whole to be finely pulverized separately, and well mixed. Dose. — A tea spoonful is to be taken in any way the patient wishes, three times a day. Use. — This preparation is intended to tone up and strengthen the system, after the force of the disorder is broken up by the use of the other medicines. The bit- ter tonics are very good to be occasionally used by persons of weak and lax habits, especially in the spring of the year. The bitters generally promote the appetite. compounds. 599 EXPECTORANT POWDER. # Skunk cabbage . l pound, Indian turnip, | do. Blood-root, £ do. Lobelia (brown,) £ do. Pulverize very fine, and mix well. Dose, a tea spoonful in honey or molasses three times a day, or oftener if necessary. Use. — To promote expectoration or the discharge from the lungs in asthma, inflammation of the lungs, pleurisy, whooping cough, croup, consumption, and colds, this is an invaluable remedy. COMPOUND TINCTURE OF MYRRH. # Myrrh, 1 pound Capsicum, , 1 ounce, Brandy (best 4th proofs 1 gallon. Pulverize the myrrh and capsicum, and digest in the brandy for a seven days, and decant or pour off the tincture. Dose, a tea spoonful. This is the popular No. 6. NERVINE AND ANODYNE TINCTURE. Jjfc Alcoholic extract of cypripedium,. ... 1 ounce, Oil of anise, i do. Camphor, 5 do. Tincture of garden lettuce 1 pound. Dissolve the three first ingredients in the tincture and keep in tight bottles. Dose ten to thirty drops. 1 pint, ) 1 do. } 1 do. ) ANTISPASMODIC TINCTURE. B; Lobelia tincture, (prepared from the seed,) Tincture of myrrh, 1 do. ^ Mix. Nervine tincture, '".... Dose, one tea spoonful or more, to be repeated as often as may be necessary. Use. — This is an excellent antispasmodic, very use- ful in all cases of fits or spasms, tetanus, hydrophobia, neuralgia, colic, cholera, delirium tremens, suspended animation, palsy, erysipelas, dropsy, &c. ALTERATIVE SYRUP. Jjfc Sarsaparilla, 3 pounds, Narrow-leafed dock root, 3 do. Dandelion root, 2 do. Black alder bark, ........ 2 do. 600 DOMESTIC MEDICINE. Guiacum shavings, 2 pounds, Burdock root, or seeds, 2 do. Sassafras, bark of the root, 2 do. Mandrake root, 2 do. Boil in equal parts of whiskey and water sufficient to cover the ingredients in the kettle, for two hours ; strain and boil down to half the quantity ; add half a pound of clarified sugar to every pint of syrup ; bottle up and keep in a cool place. Dose. — From a tea spoonful to a table spoonful three times a day. Use. — It is hardly possible to find a better alterative medicine than this, and it is certain that all who observe its effects in venereal diseases, scrofula, con sumption, and many cutaneous diseases, must ad mire it. EXPECTORANT SYRUP. 9? Wild cherry bark 2 pounds, Spignet-root, 1 pound, Pleurisy-root, 1 do. Black cohosh root, \ do. Blood-root, ^ do. Liquorice-root, ^ do. , Elacampane, \ do. Bruise, and boil very slowly in a sufficient quantity oi water and whiskey, (equal parts,) to cover the whole in the kettle, until the strength is extracted, or for about two hours ; strain off the liquid, and boil down to half the quantity, and add to every quart, two ounces of skunk cabbage root, and one ounce of Indian turnip root, all very finely pulverized. Now take to every quart of this, three ounces of good tincture of lobelia, and dissolve in it one ounce of oil of anise, to every pint of the tincture, and add this to as much good sugar- house molasses as there is syrup ; mix to every quart of this molasses, two ounces of balsam of tolu, dissolved in half a pint of hot alcohol. Now add the whole together and mix well. Dose. — From a tea spoonful to a table spoonful, often repeated. Use. — This is one of the best medicines for pulmo- nary diseases that can be made ; it brings on a copious expectoration, and keeps it up. It is likewise very EXTRACTS. 601 healing to the lungs. It is particularly useful in all cases of consumption, pleurisy, bad colds, asthma, whooping cough, &c. EXTRACTS. The simplest way in which extracts are made is by boiling the substance, (crushed or cut fine,) from which the extract is to be prepared, in water, until the strength is extracted, and then straining the decoction and eva- porating it down to the proper consistence. Care must, however, be taken not to burn it when it is reduced low ; and to avoid this the process should always be conducted in a water- bath. A very convenient way to manage it is to put the extract, after it has attained the consistence of thin syrup, in a basin, and then placing this into a kettle or boiler in water, and thus reducing the extract to the proper consistence. When the virtues of the medicines consist in a resin- ous or fixed oily principle, water will not extract them; arid in this case alcohol is required instead of water. When alcohol is employed as the menstruum in pre- paring the extract, the medicine, after being crushed, should be digested in the alcohol, exposed to a hot sun heat, until the strength is extracted, as is done in com- mon tincturing. The tincture, after being filtered or well strained, may then be placed in a common still or retort, and heat applied to carry over the alcohol, while the extract remains behind. The alcohol by this pro- cess is saved for repeated use, The extract should be drawn off from the still before it attains to much consistence, and placed in a basin over a water-bath, and thus reduced. If the virtues consist entirely in a resin or fixed oily substance, this may be precipitated by adding three or four times the quantity, or more, of cold water to the extract, when it attains the thickness of molasses or honey, and is removed from the fire. Some articles require to be precipitated at an earlier stage than others. It may be observed as a general rule, that the earlier the precipitation is made, the fairer will be the product. The author's experiments on this method of prepar- ing extracts, were rewarded, in the summer of 1848, by 602 DOMESTIC MEDICINE. the discovery of the resinoid principle in podophyllum commonly called podophy/lin, and also resinous princi- ples in cypripedium (cypripcdin), leptandria (Icplandrin), myrica cerlfeva, (my ricin), and sanguinaria (sanguinarin.) He communicated his discoveries to his medical class in the Botanico-Medical College of Ohio, in the ses- sion of 1849; and was amused to learn that several of his pupils, and others afterward, claimed the honor of the discovery for themselves. It is important to bear in mind, however, that the plan of precipitating from the alcoholic solution by means of water, is adapted only to the preparation of such articles as are soluble in alcohol, and insoluble in water, and which at the same time are not so volatile as to be dissipated by the heat required in the distillation. Other articles may yield a product by the process, but this may not possess all, nor yet any, of the virtues desired. 20 grains (gr.) 3 scruples . . 8 drachms . . 12 ounces . . TABLE OF WEIGHTS. apothecaries' weight. * make . 1 scruple, 1 drachm, 1 ounce, . 1 pound, . AVOIRDUPOIS WEIGHT. 16 drachms (dr.) . . make . . 1 ounce, 16 ounces. marked marked pound, . scru. dr. oz. lb. TABLE OF MEASURES. APOTHECARIES' OR WINE MEASURE. 4 gills (gls.) . . make . . 1 pint, . . marked . 2 pints "... 1 quart, .... " . 4 quarts ...."... 1 gallon, ...".. . pt. . qt. . gal. WEIGHTS OF FLUID MEASURES. As there is much difference in the sizes of spoons and other utensils in domestic use, which are often used as graduates in administering to the sick, a table * Apothecaries' weight is the same as troy weight, only having different divisions between the grains and ounces : the latter em- bracing the penny weight, which contains twenty-four grains; twenty of which make an ounce. WEIGHTS OF FLUID MEASURES. 603 showing their respective weights may not, therefore, be altogether useless. A tea spoonful is about equal to one fluid drachm, or about sixty drops. A table spoonful is very nearly equal to five fluid drachms. A wine glass will contain about two fluid ounces. A tea cup will contain about four fluid ounces. A pint is very nearly equal to a fluid pound. It will be observed that this last table is made out according to the weight and measure of water, and that many medical fluids may differ somewhat from this, according to their density. This must rather be considered as an example of the average and compar- ative sizes of domestic utensils. GLOSSARY. Abdomen. The belly. Abscess. A tumor containing pus, or a collection of matter. Abnormal. Unnatural; irregular. Absorbent. A vessel that absorbs or takes up fluids. Acetabulum. The socket that receives the head of the os femoris or thigh bone. Acid. Sour ; that which effer- vesces with alkalies. Acrid. Sharp, burning, or pun- gent. Accoucheur. A male midwife, or one that attends in parturition. Acuminate. Taper-pointed ; a narrow or linear point : the point usually inclines to one side. Acute. In botany it means sharp pointed, but less gradually so than acuminate ; in pathology the term is applied to diseases which are of short duration, but attended with violent symp- toms ; it is opposite to chronic. Albumen. A viscid animal or vegetable principle, resembling the white of eggs. Alkali. A substance which is capable of uniting with acids and destroying their acidity : among the most common are potash, soda, &c. Alterative. A medicine capable of changing the condition of the system without producing any sensible increase of the evacuations. Alveola. The sockets for the teeth. Alvine. Belonging to the intes- tines. Ament. Flowers on chaffy scales, and arranged on a slender stalk. Amplexacaulis. The base clasp- ing the stem. Amenorrhcea. An obstruction of the menses. Anasarca. Dropsy of the cel- lular membrane. Anastamose. Joining together. Annual. Yearly. Annulated. Having rings around; as in ferns, &c. Anodyne. That which relieves pain. Antacid. Substances that neu- tralize acids: some of the most common are soda, potash, &c. Antiseptics. Medicines that guard against mortification. Anthelmintics. Medicines which destroy or expel worms. Antilithics. Substances which guard against, or remove urin- ary calculi or gravel. Antispasmodics. Medicines which relieve cramps or spasms. Aperient. That which gently opens the bowels. Apex. The top or summit. Articulated. Jointed. Ardor. Heat. Aroma. Fragrance ; scent. Aromatic. Sweet-scented, fra- grant. Arthroida. A joint movable in every direction. Ascites. Dropsy of the belly. Assimilation. The conversion of food into nutriment. Astringent. That which corrects looseness and debility by ren- dering the solids denser and firmer, known by its pucker- ing effects on the mouth. Atony. A state of inactivity. Atrophy. A wasting, without any sensible discharge. Axillary. Axils; leaves of fruits are said to be axillary when they proceed from the angle formed by the stem and branch, b DOMESTIC MEDICINE. Biennial. In botany, plants are said to be biennial when they are of two years' duration, putting forth leaves the first year only, and bearing blos- soms and seed the second. Bifurcation. The condition of being divided, forked, or parted. Bract. Floral leaf ; a leaf near the flower, which differs from the rest of the same plant., Broncha. The air-cells of the lungs. Cachexia, A general weak, relaxed, and disordered state, without fever. Cadaverous. Deathlike ; hav- ing the appearance of a dead human body ; wan ; ghastly ; pale. Calculi. Small limestones, found in the cavities of the body, as in the urinary and biliary cysts. Callus. Bony matter, found about fractures. g& i ** Calyx. The flower-cup or outer covering of flowers. Campanulate. Bell-form. Canula. A small tube, usually belonging to sharp instruments designed for removing fluids. Capillary. Hair-like ; a term used to designate those small vessels found between the ter- mination of the arteries and the commencement of the veins, and in which the change from arterial to venous blood is effected. Capsule. A little seed vessel that opens when the seed ripens. Carminative. That which ex- pels wind. Cartilage. Gristle; a white semi- bony substance. Catamenia. The monthly evac- uation peculiar to the female sex; the menses. Catheter. A small tube designed for drawing the urine. Caudex. The main root of plants. Cautery. A burning applica- tion. Cellular. Containing cells, or cavities. Cerebellum. The lesser brain. Cerebrum. The brain, or an- terior and larger portion of the soft mass within the skull. Cespitosi. Turf. Chronic. A term applied to diseases which are of long continuance, and usually with- out much fever. Chordee. A morbid contraction and curvature of the corpus ca- vernosum or body of the penis. Cicatrix. The seam, scar 01 mark remaining after the heal- ing of a wound, or ulcer. Coma. ) Strong propensity to Comatose.) sleep. Combustion. Rapid oxydation, or the combination of oxygen with other elementary bodies with a flame. Coagulation. A thickening oi formation of fluids into a more dense or solid condition, as the curdling of milk, &c. Coalesce. To unite, to join into one, to run together. Colliquative. Excessive or weak- ening. Congestion. A preternatural col- lection of blood or other fluids; thus we speak of a congestion in a part when the vessels are much crowded or over dis- tended. Concave. Cup-like, hollowed. Concrete. Collected, united into a solid form. Confluent. Running together, meeting in their course. Congenital. Born together ; a disease or defect is said to be congenital when existing from the time of birth. 607 Conglobate. Round ; collected into a ball or roundish form. Constipation. Costiveness ; a confined state of the bowels. Contagious. Catching ; capable of being communicated. Convalescence. The state or con- dition of recovery. Convoluted. Rolled up in a cylindrical form. Cordate. Heart-shaped. Coriaceous. Resembling leather. Corolla. The most prominent and beautiful part of flowers, usually inclosing the stamens. Corpse. The dead body. Cortex. The bark or skin of a plant or tree. Corymb. A kind of inflorescence in which the flower stalks spring from different hights on the common stem, and form a flat top. Coryza. An increased discharge of mucus from the nose. Crassamentum. The red par- ticles of the blood. Crepitus. A sharp crackling sound. Cutaneous. Belonging to the skin. Cutis. The skin. Cutis vera. The true or inner skin. §3£ }**•*■»*■ Decarbonization. The act of giving off carbon. Deglutition. Swallowing. Dentate. Toothed. Delirium. Alienation of mind; craziness. Demulcents. Soothing, lubricat- ing, and mucilaginous applica- tions. Depletion. The act of emptying, particularly the removal of the blood, as by venesection. Depuration. The act of purifying. Derm. The true skin. Detergent. That which scatters or disperses. Diagnosis. The distinguishing of particular diseases ; the symptoms by which & ly dis- ease is known from all others are called its diagnostics, or diagnostic symptoms. Diaphoresis. Perspiration. Diaphoretic. That which, being taken internally, produces dia- phoresis, or perspiration. Diaphragm. The midriff or mus- cular division between the chest and abdomen. — It as- sists in respiration. Diathesis. Condition of the body, as the inflammatory, &c. Discuss. To scatter. Desquamation. Scaling off. Dichotomous. Forked. Dispncea. Oppressed breathing. Digitate. Like fingers. Dolor. Pain. Duodenum. The first portion of the intestines ; the part in which the food becomes mixed with the bile. Efflorescence. Redness ; in bot- any it means the powder sub- stance found on lichens ; the flowering of plants. Effluvia. Exhalations from bodies in a state of decomposition, as from carcasses, &c. Electuary. A compound made by combining medical sub- stances with saccharine mat- ter, as honey, molasses or treacle. Eliptic. ) Oblong-oval; a defec- Eliplical.\ tive circle by join- ing two fractional sections of a circle. Emaciation. Leanness ; a fall- ing away of the flesh. Ernests. Vomiting. Emetic. A vomit or puke. Emmenagogue. That which tends to promote the menstrual dis- charge. Emollient. That which has a tendency to render parts more soft or pliable, as well as to 608 DOMESTIC MEDICINE. relieve irritation and inflam- mation. Enecia. Continued fever. Enema. An injection. Ensiform. Sword form ; two edged, as in the flag or iris. Enteritis. Inflammation of the bowels. Entozoa. Worms. Epidemic. A disease of general prevalence. Epidermis. The cuticle, scarf or outer skin. Epigastric. From 'epi,' upon, and ' gastricus,' stomach, i. e. upon the stomach; thatdivision of the abdomen immediately before the stomach. Erethismus. Increased sensibil- ity and irritability. Erosion. The act of eating away. Eructation. The ejection or rais- ing of wind from the stomach. Erysipelas. Inflammation of" the skin; St. Anthony's fire. Eschar. The dead substance pro- duced by applying caustic, &c. Evacuants. Medicines that pro- mote the excretions of the body. Exacerbation. An increase in the violence of symptoms or disease. Exanguous. Without blood. Exanthema, i Acute eruptive Exanthemata. \ disease. Excitants. Stimulants. Excoriate. To remove the skin by means of acrid substances: to gall. Excrescence. A preternatural tu- mor growing on the body, as a wart, polypus, &c. Excretion. Matter thrown from the surface ; a collection of matter on the surface. Exotic. Plants are called " ex- otic" when brought irom foreign countries. Exostosis. An unnatural bony extuberance. Expectorant. That which facili- tates discharges from the lungs. Expiration. The act of breath- ing out. Extraneous. Foreign; without; not intrinsic. Extravasation. Effusion; a forc- ing out of the proper vessels. Exude. The act of discharging through the pores of the skin; emitting from the surface. Faces. The alvine excretions ; stool, settings. Fauces. The back of the mouth. Febrile. Pertaining to fever. Febris. Fever. Fetid. ) Having an offensive, Foetid. \ strong or rancid smell. Femoris. _ i Th ^ h Osfemons. £ ° Fibre, ) A thread ; a fine slender Fiber. \ substance which con- stitutes, in the aggregate, the flesh of animals ; a filament or slender thread in plants : in the plural, it means the finer roots of plants. Fibril. A branch of a fibre ; a very small fibre. Fibrin. A peculiar organic ele- ment or compound of animals and vegetables; it chiefly forms the fleshy parts of animals. Fibrous. Having fibres ; in bot- any a root is said to be fibrous when it has many small radi- cals. Fibula. The smaller bone in the leg. Flatulency. Windiness in the stomach. Flatus. Wind. Floret. A little flower . a part of a compound flower. Follicle. A small gland ; a seeo. vessel which opens length- wise on one side only. Foliaceous. Leafy. Fomentation. The act of apply- ing warm liquids to parts by means of flannels, &c. 609 l?ungU». Proud flesh. Fusiform. Spindle-shaped or ta- pering. Ganglion. A knot ; in anatomy the term is applied to certain natural knot-like enlargements, that occur in the nerves. Gangrene. Mortification ; the first stage of mortification. Gastric. 7 Pertaining to the Gastro. £ stomach. Gastritis. Inflammation of the stomach. Gelatin. One of the primary compounds of animal and veg- etable bodies, soluble in water, but not in alcohol. When dissolved in water, it thickens, on cooling, into a well known tremulous elastic substance, called jelly. Glabrous. Smooth ; having an even surface. Glairy. Resembling the white of an egg ; of a viscid, trans- parent appearance. Glaucous. Sea-green ; mealy, and easily rubbed off. Gonorrhoea. A morbid slimy discharge in venereal com- plaints. Gutta Serena. Blindness occa- sioned by a diseased retina. Hastate. Shaped like a halbert ; it differs from arrow-shaped in having its side processes more distant and divergent. Hepatic. Pertaining to the liver. Hepatitis. Inflammation of the liver. Herbaceous. Pertaining to herbs. Hereditary. That which has de- scended from an ancestor. Herpes. Tetter. Hernia. Rupture. Hematuria. The voiding of blood with the urine. Hemoptysis. A spitting of blood; bleeding from the lungs. Haemorrhage. Violent flow of blood Hemorrhoids. Piles. 39 Of the same kind or nature ; consisting of similar parts. Humors. Liquids ; the fluids of the body, as the blood, bile, and humors of the eye. Hydarthus. White-swelling. Hydragogue. A medicine that causes watery discharges. Hydrocardia. Dropsy of the heart. Hydrocele. Dropsy of the scro- tum. Hydrometra. Dropsy of the womb. Hydrocephalis. Dropsy of the brain. Hydrothorax. Dropsy of the chest. Hydrops. Dropsy. Hydrophobia. Rabidness ; mad- ness from the bite of rabid animals. Hygiene. A plan of restoring or preserving health without the use of medicine, as by dieting and proper exercise. Hyperemia. Fullness of the blood-vessels. Hypertrophy. Enlargement. Hypochondriasis. \ Vapors ; low Hypochondria. ) spirits; the blues or horrors. Hypocondrium. That portion of the abdomen that lies on either side of the epigastric region, immediately below the false ribs. Ichor. A sanious matter flowing from ulcers. Icterus. The jaundice. Idio-miasmata. A miasm aris- ing from the human body. Idiopathic. A disease is said to be idiopathic when it has an independent origin, that is, one that is not symptomatic. Idiosyncrasy. Peculiarity of dis- position ; a disposition of the system that may render the person peculiarly liable to cer. tain diseases, which other per 610 DOMESTIC MEDICINE. sons, not having this predis- position, would escape from. Ileum. The last or lower por- tion of the small intestines. Imbricate. Lying over, like scales, or shingles on a roof. Indicate. To point out. Indication. Course pointed out ; an object to be acomplished in the cure of disease ; a course to be pursued in the treatment of a case. Induratea. Hardened. Infection. Contagion ; the prin- ciple or cause of a disease. Inflated. Filled with wind ; in botany the term is applied to capsules or vesicles which are hollow or naturally contain air. Infusion. A tea ; a preparation made by infusing a medical substance in a fluid. Ingesta. The substances receiv- ed into the stomach. Ingestion. The act of receiving into the stomach. Inorganic. Not in an organized state. itis. The termination ' itis' indicates inflammation : whenever, therefore the name of any organ terminates in this way, that organ is to be understood to be in a state of inflammation ; thus the Latin name of the stomach is gastri- cus, and inflammation of the stomach is called gastritis ; — the name of the intestines is entera, and inflammation of the bowels is called enteritis, &c. Jejunum. The second portion of the small intestines, so called because it is usually found empty. Kino miasmata. Vegetable mi- asma. Labiate. Liped. Labia puendi. External lips of the female organs of genera- tion. Laceration. The condition of being torn ; a wound produced by the tearing of the flesh. Lanceolate. Spear-shaped ; nar- row, with both sides gradually terminating to a point. Larynx. The cartilaginous car- ity situated behind the tongue at the commencement of the windpipe. Lateritious. Brick-like ; like the dust of brick. Linear. Long and narrow with both sides parallel, like the blades of grass. Lepra. The leprosy. Lesion. An injury or wound. Ligaments. . Any thing that ties; in anatomy, a strong firm band by which the bones are joined together. Ligate Totieorbind. Ligature. The thread or cord by which any thing is tied. Livid. Black and blue ; lead- colored ; purple. Lobed. Divided into lobes. Lues. A pestilence, poison or plague. Lues venera. The venereal poi- son. Lymph. The pole rose-colored fluid contained in the lymph- atics. Lymphatics. A very delicate set of vessels found in abun- dance in most parts of the body : they absorb and carry the lymph. Mania. Madness, insanity. Meninges. The two membranes that envelop the brain ; the duramater and piamater. Metamorphosis. A change of form, relation or shape ; some- times it means the matter or substance changed. Metastasis. A translation of chansre to otner parts. • Miasmata.) Malaria ; a pestif- Miasma. \ erous vapor aris- ing from marshes or niois* 611 places containing much veg- etable or animal mold. Midrib. The main or middle rib of a leaf, running from the stem to the point or apex. Midriff. The diaphragm or broad muscular partition be- tween the chest and abdomen. Miliary. Of the appearance of millet seed ; a miliary erup- tion is one whose vesicles resemble millet seeds. Mobility. Capacity of being moved ; moving faculty. Morbid. Diseased. Monoecious. A plant is said to be monoecious when it has both pistillate and staminate flowers. Mucus. A viscid fluid secreted by the mucous membrane. Muscles. The organs of motion in animals, being bundles of fibres united and surrounded by cellular membrane ; they constitute the flesh. Nausea. A sickness at the stom- ach, and inclination to vomit, yet not sufficient to effect it ; it is sometimes produced by a disgusting smell, taste, or sight. Nephritis. Inflammation of the kidneys. Neurology. The science of the nerves. Neuralgia. Painful affection of the nerves. Nidorous. Resembling the taste and smell of roasted meat. Normal. Regular; natural. Nosology. A systematic arrange- ment or classification of dis- Nutritive. Having the quality of nourishing. Oblong. Longer than oval, with both sides parallel. Qbovate. Ovate with the nar- row end toward the stem or place of insertion. Obtuse. Blunt; rounded ; not acute. Odor. Smell ; scent ; perfume. OEdema. Swelling ; a soft swell- ing, as by a collection of water. QZdematous. Doughy; pertaining to oedema. Oesophagus. The gullet, or chan- nel leading to the stomach. Omentum. The caul or epip- loon, a membraneous covering that drops or hangs over the front of the entrails. Opaque. Impervous to light; dark; obscure; not transparent. Ophthalmia. A disease of the eye. Ophthalmitis. Inflammation of the eyes. Organic. Pertaining to an or- gan or organization. Os. Bone ; mouth. Ossify. To turn to bone. Oval. > Of the shape of an Ovate. \ egg. Oxydation. The chemical union of any substance with oxygen. Oxygen. A subtile gaseous ele- ment, which is a constituent of the atmosphere, as well as most organic substances : it is the supporter of combustion, and almost the only acidifying prin- ciple: it is this element in the atmosphere that supports respi- ration, and it is upon its union with combustible substances in the body that the latter is dependent for its heat. Palmate. Hand-shaped, so divi- ded as to resemble a hand with the fingers spread. Palpitation. A beating of the heart, particularly a preternat- ural beating, such as is occa- sioned by a fright, or some violent agitation. Pancreas. A long gland situated on the duodenum, or rather be- tween this and the bottom of the stomach : it secretes a fluid that is discharged into the duo- denum, and assists in digestion, 612 DOMESTIC MEDICINE. Panicle. A loose, irregular bunch of flowers, with sub-divided branches, as the oat. Paracentitis. In surgery, the operation called tapping. Paralysis. Palsy ; the loss of the power of muscular motion. Parenchyma. In anatomy, a loose spongy substance ; the spongy cellular tissue that con- nects parts together, particu- larly those of the viscera, as the air-cells and blood-vessels in the lungs, and the absor- bents, arteries and veins in the liver ; in botany, it means nearly the same thing. Paronychia. A whitlow or felon. Parotid. Near the ear, or per- taining to the part of the ear. Paroxysm. An obvious increase or aggravation of the symptoms of disease, which may last longer or shorter and then decline. Pathological. Pertaining to pa- thology. Pathologist. One versed in, or treating on pathology. Pathology. The doctrine or law of diseases ; that which treats on the nature of diseases. Peccant. Morbid ; bad; corrupt ; injurious. Peduncle. A stem bearing flow- ers and fruit. Peltate. Having the petiole at- tached to some part on the under side of the leaf, as in the mandrake. Pendant. ) Drooping; hanging Pendulous. $ down. Penis. The cylindrical male or- gan of generation. Perennial. Lasting more than two years. Perfoliate. Having the stem running through the leaf. Pericardium. The membraneous sack that surrounds the heart. Periosteum. The membrane that invests the bones. Peristaltic motion. The vermic- ular motion of the intestines. Peritoneum. The membrane by which all the viscera of the abdomen are surrounded. Peritonitis. Inflammation of the peritoneum. Permeate. To pass through the pores of anything. S,| The P la ^ Petals. The leaf of the corolla in flowers ; it is usually colored. Petechial. Red or purple spots which resemble a flea bite. Petiolate. Pertaining to petiole. Petiole. The stalk which sup- ports the leaf. Pharmacy That part of med- ical science that treats on the preparation, compounding, and preservation of medical sub- stances ; the business of the apothecary. Phlegm. A thick, white or semi- transparent, tenacious fluid, commonly secreted in the lungs ; in chemistry it means water of distillation. Phlebitis. Inflammation of the veins. Phlegmasia. Inflammation. Inflammatory. Phleymonic . Phlegmonous. Phrenitis. Inflammation of the brain. Phthisis. Consumption of the lungs. Physiology. That science which contemplates the properties and functions of animals and plants ; the science of life. Physiological. Pertaining to physiology. Pinnate. Winged leaves are called pinnate when they are composed of two rows of small leaflets situated on both sides of a common petiole, as in the locusi, rose, &c. Pleura. The membrane which 613 lines the internal surface of the chest, covernig its viscera; it forms a great process, — the mediastinum which divides the thorax into two cavities. Pleuritis. Pleurisy ; inflamma- tion of the pleura. Pneumonia. Inflammation of the lungs. Pollen. Fine flour, as the dust that flies in a mill ; in botany it means the fine dust that is contained in the anthers of flowers. Post mortem. After death. Prcecordia. The region immedi- ately in front of the heart ; but it is frequently applied to the whole of the fore part of the thorax. Priapism. A preternatural or continual erection of the penis. Primary. First in order of time, importance, cause, or effect. Procumbent. Lying down. Prolapsus. A falling down ; de- scent. Prognosis. The foretelling of the event of diseases, by the symptoms and other circum- stances in the case. Prognosticate. To foreshow ; to tell the future events by the present. Prophylactic. Preventive. Prostate. The name of a gland in the male, situated just before the neck of the bladder, and surrounding the beginning of the urethra. Proximate. Nearest ; next : in pathology it is applied to the immediate effects of the exci- ting cause of disease, and hence may be said to be the disease itself. Ptyalism. Salivation ; an in- creased discharge of saliva from the mouth, often brought on by the use of mercury. Pubescent Hairy ; downy ; or woolly. Pubis.) Hair; down; or wool; in Pubes.\ anatomy the shear- bone is called os pubis because the integuments over it are covered with hair in the adult. Pulmonary. Pertaining to the lungs. Pulp. A soft mass; the soft suc- culent part of a plant, or its fruit. Pultaceous. Macerated, soft ; nearly fluid. Pungent. Sharp; acrid; piercing; biting. Puriform. Pus-like. Pus. A yellowish white matter secreted in suppurations and ulcers, and always present in the healing of lesions in the solids. Putrid. In a state of dissolution or disorganization ; corrupt ; iotten. Pyriform. Pear-shaped. R. Recipe ; take of. Raceme. A kind of inflorescence in which the flowers are ar- ranged by simple pedicels on all sides of a common peduncle, as in the currant and grape. Radii. Rays. Radical. Pertaining to the root; growing from the root. Radicle. A minute fibre of a root. Radix. A root; the part of a plant that is in the ground. Reflected. Turned backward ; thrown back ; returned. Resuscitation. The act of revi- ving from apparent death; the state of being revived. Respiration. The function of breathing. Roseola. Measles. Rubefacient. That which produ- ces redness when applied to the body. Rubor. Red ; redness. Rhizoma. A large fleshy or woody part or organ of a root ; analogous to a. stem under 614 DOMESTIC MEDICINE. ground, which is neither a tu- ber nor a bulb. Saccharine. Pertaining to sugar ; sweet. Saliva. The fluid which is se- creted by the salivary glands, and serves to moisten the mouth and tongue, as well as to assist in mastication. Sanative. Healing ; having the power to heal. Sanguiferous. Conveying blood; the sanguiferous vessels are the arteries and veins. Sanguinary. Bloody; a medical plant. Sanguineous. Abounding with blood ; plethoric. Sanies. A thin limpid and green- ish matter discharged from ul- cers. Sanious. Pertaining to sanies. Scabies. The itch. Scape. A stalk that springs from the root, and supports flowers and fruit, but no leaves, as in the dandelion. Scarlatina. Scarlet fever. Sciatica. The hip disease. Scirrhous. Pertaining to scir- rhus. Scirrhus. A hard or indurated tumor, which at first is of the natural color, but the disease is apt to assume a malignant form, when the skin may turn purple or livid, and the surface irregular, and the tumor pro- ■ ceed to ulceration. In this condition the affection general- ly receives the name of cancer. Scorbutic. Pertaining to scor- butus. Scorbutus. Scurvy. Scrofula ) Ki , g . evil . Scrophula.S) ° Scrofulous. Pertaining to scrof- ula. Scrotum. The pendulous pouch containing the testes. Secretion. The act of secerning, or producing specific collec- tions from the general circula- ting mass, as the bile, saliva, mucus, &c. ; the matter secre- ted. Segment. A part or urincipal division of anything, as a leaf, calyx, or corolla. Semina. Seed. Sensorial. Pertaining to the sen- sorium or seat of sense. Serum. The thin or watery part of the blood ; also the same of milk. Serrate. Jagged ; notched like saw-teeth. Sessile. Sitting down ; placed immediately on the main stem without a footstalk. Sialagogue. That which pro- motes salivation. Sinapism. A mustard plaster. Sinuate. A leaf is said to be sinuated when its sides or mar- gins have breaks in them or are hollowed out like a bay. Slough. To separate from the live flesh ; a dead part that ia separating ; a mortified part. Sloughing. Separating in a dead mass. Solution. In pharmacy, it means a liquid containing some sub- stance in a dissolved condi- tion. Sordes. Foul matter ; dregs ; filthy matter. Sordes are apt to collect about the teeth of persons that neglect cleaning them : this term is also equiv- alent with sa?iies and ichor, the offensive matter running out of old ulcers and sores. Sordid. Filthy; dirty; foul. Spasmus. Spasm. Spasmodic. Pertaining to spasm. Spadix. An elongated recepta- cle of flowers. Spathe. A sheathing calyx open- ing lengthwise on one side which may inclose the flower or fruit. Specific. A remedy that has a 615 special effect ; or which cer- tainly cures any particular dis- ease. Sphacelus. Mortified parts ; mor- tification. Spike. A kind of inflorescence in which the flowers are sessile, or nearly so, and thus forming a spiral projection, as in the mullein and plantain. Sputa. Spittle. Stimulants.) Excitants, as pep- Stimuli. $ per, &c. Stipe. The stem of a fern or fungus ; the stem of the down of seeds, as in the dandelion. Stipule. A leafy appendage, sit- uated at the base of leaves or petioles. Stomachics. Medicines that reg- ulate the stomach and set pleasantly. Striated. Marked with fine par- allel lines. Struma. Scrofula ; it is also applied to bronchocele. Strumous. Pertaining to scro- fula ; scrofulous. Stertorous. Snoring. Sub. In anatomy this word is prefixed to others when it is desired to speak of parts that lie under ; it means, therefore, that this lies under the other part whose name it precedes : thus, subscapularis, — under the scapula ; submaxillary, — un- der the maxilla or jaw, &c. In pathology it is used to ex- press an imperfect or feeble state of disease ; as subacute, not acute, less than acute, &c. In botany when shape or any any other character cannot be precisely defined, sub is pre- fixed to the term used ; it then means nearly so, as subrotun- dus, roundish ; subsessile, not quite destitute of footstalk, &c. In chemistry the term is • applied when a salifiable base is predominant in the com- pound, there being a deficiency of the acid, as subcarbonate of potassa, subcarbonate of soda, &c. Subsillus tendium. A twitching of the tendons, arising from convulsive jerking of the mus- cles. Sudamina. Small vesicles that come on suddenly without fe- ver. Sudorifi.es. Medicines which pro- mote sweating. Suppuration. That process by which pus is formed in an in- flamed part. Syncope. .Fainting. Synocha. Inflammatory fever. Synochus. A fever of a subin- flammatory character. Synovia. Joint water. Syphilis. The venereal disease. Temporal. Belonging to the tem- ple. Tenesmus. A continual inclina- tion to go to stool without a discharge. Tendon. The white cord or shining end of muscles; sinews. Terminal. Extreme, situated at the end. Ternate. Three together, as the leaves of the clover. Tetanus. A spasmodic disease. Thorax. The chest, or cavity within the breast. Thyrse. A panicle which is dense. Tissue. Texture; a general name for parts. Tonic. That which strengthens, tones, or braces up. Tonsilitis. Inflammation of the tonsils. Tormina. Severe pains. Trachea. The windpipe. Translucent. Admitting light, but yet not so as to render objects distinctly visible; semi-trans- parent. Transude. To pass through the pores of any thing. 616 DOMESTIC MEDICINE. Triennial. That which is of three years' duration; every third year. Trilobed. Three-lobed. Triple. Three-fold ; three uni- ted ; three times. Tuber. A knot or bulbous limb; a solid fleshy knob. Tubercles. Knots, lumps, or tu- mors. Tumefaction. Swelling. Tunica.) A membrane or cover- Tunic. ) ing. Tunica vaginalis. A sheathing tunic; the tunic embracing the spermatic chord and vessels. Tw-sis. A cough. Typhoid. The term typhoid is now applied to a distinct spe- cies of fever whose primary seat is in the intestines; it has many of the symptoms of ty- phus. Typhus. A species of continued and eruptive fever that is char- acterized by great debility, and a tendency of the fluids to pu- trefaction; the pulse is weak but corded. Umbilical. Pertaining to the navel. Umbilicus. The navel. Umbel. A kind of inflorescence in which the flower stalks di- verge from a centre, like the sticks of an umbrella, as in the parsnip, fennel, &c. Umbeliferous. Pertaining to 01 bearing umbels. fc| One-flowered. Urethra. The membraneous ca- nal that conveys the urine from the bladder. Ureteres. The two membraneous canals that convey the urine from the kidneys into the blad- der. Uticaria. The nettle-rash. Uterus. The womb. Vaccina. The cow-pox. Vagina. The canal leading to the womb. Variola. The small-pox. Varioloides. Modified small-pox. Vermifuge. A medicine that de- stroys or expels worms. Vertigo. Dizziness. Vesication. The formation of vesicles; blistering. Viscid. Glutinous, sticky. Viscera. The entrails ; the or- gans of the chest and abdo- men. Viscus. An organ, as the liver, stomach, &c. Virus. Poison, contagion, foul matter. Villous. Like velvet. Vis vita. Vital force. Vis medicatrix natures. The heal- ing power of nature. Whorls. Flowers and leaves are said to be in whorls when they are situated in circular order around the stem. INDEX Page. Absinthium, 361 Acacia, 581 Accidental bleeding, 101 Acetate of ammonia, 559 Acid, citric 395 poisoning by 222 pyroligneous 571 Acidum pyroligneum, 571 Actea alba, 451 Adeps, 582 Adder's tongue, 314 Adhesive plaster 595 Agrimonia, 555 Ague, 27 Alcohol 223 Aletris 515 Alder, 568 Alkalies, 576 poisoning by 223 Allium cepa, 378 Almonds, oil of, 582 Alnus serrulata, 568 Aloes, 341,456 Alteratives, 556 Alterative syrup, 599 Althea officinalis, 582 Amber, oil of, 445 Ambustum, 109 American centaury, 515 columba, 498 senna, 352 valerian, 421 barberry, 510 Amenorrhoea, 210 Ammonia, carbonate of,. . . 467, 578 carbonas, 467 Amygdalus persica, 351 Anasarca 148 Angelica archangelica, 433 atropurpurea, 434 tree 400 Angina, 92 Animal poisons, , , . . . 224 Animation, suspended, 250 Anise seed, 434 Anisum semiiie, 434 Anodynes, 421 Anodyne tincture, 599 Antacids, 576 Anthelmintics, 355 Anthemis cotula, 408 nobilis, 531 Page, Anthrax 117 Antiseptics, 571 Antibilious cathartic powder, . . 598 Antilithics 394 Antimony, poisoning by, 222 Antispasmodics, 437 Antispasmodic tincture, 599 Apium petroselinum, 393 Apocynumandrosaemifol.,. 348,320 canabinum, 387 Apoplexy, 94 Apothecaries' weight, 602 Aqua calcis, 396 Arabic, gum, 581 Aralia nudicaulis, 559 racemosa, 560 spinosa, 400, 383 Archangel, 433 Ardor urina, 284 ventriculi, 175 Aristo lochia, 516 Arsarum Europium, 378 Arsenic, poisoning by 221 Arthritis, 170 Arum triphyllum, 373 Asarabaca, 378 Asarum canadensis, 456, 380 Ascaris lumbricoids, 270 Asclepias tuberosa, 407, 377 syrica, 393 fibrosa, 392 Ascites, 150 Asphyxia, 250 Asparagus officinalis, 393 Assafoetida 441 Asthma, 99 Astringents, 532 Astringent tonic compound,. . . 598 Avoirdupois weight, 602 Balm, 414 Balmony, 509 Baptisiu tinctoria, 572 Barberry, American, 510 Bath, vapor 586 tepid 592 shower 593 Bathing, 583 drops, 596 Bayberry, 534, 320, 380 Bearberry, 396, 393 Berberries canadensis, 510 Beth-root. 538 618 DOMESTIC MEDICINE. Paoe. Bird pepper, 458 Bites of snakes, 224 Bitter ash, 531 dogsbane, 348, 320 root 348, 320 Bladder, inflammation of 70 Blackberry, 555 Black-root, .337 Black alder, 568 locust, 320 pepper, 463 snake-root, 445, 408 cohosh, 445 salve, 595 elder, 348 Bleeding, 101 from the bowels, 102 from the lungs, 103 from the nose, 105 from piles, 102 from the stomach, 106 from the urinary organs,. . 107 Blood-root, 314 Blooming spurge, 320 Blue bells, 402 cohosh, 438 berry, 438 flag. 347 skullcap, 422 Boils, 108 Boneset, 401 Botanical classification 488 Bothriocephalus, 273 Botrophis racemosa, 445 Bowels, inflammation of 71 Bowman-root, 337 Brain, inflammation of the, ... 73 Brandy, 467 Brinton-root, 337 Bronchitis, 79 Bronchocele, 169 Bubo, 261 Burns and scalds, 109 Butternut 334 Button snake-root, 476 Cachexia scrophulosa, 234 Calculus, 171 Calx chlorinata, 575 Chamomile, 531 Camphora, 464, 437 Cancer, 112 Cancer plaster, 115 Capsicum, 458, 383 Carbuncle, 117 Carbonate of ammonia, 578 of magnesia • • • ■ 395 of soda, 577 of potash, 577 Paoi. Carbo ligni, 575 Carbonas soda? et potassa, 577 Carcinos 112 Cardinal flower, 362 Caryophyllus aromat. (Cloves,) 481 Carolina pink, 355 Cascarilla, 509 Cassia, 344 Marylandica, 352 chamsecrista, 355 Castor oil, 343 Castor, 445 Cathartics 321 Cathartic pills, 598 Catnip, 413 Caulophyllum thalictroides, . . . 438 Cayenne pepper, 458 Celastrus scandens, 567 Centaury americana, 515 Cephalalgia, 174 Cephalis ipecacuanha, 312 Chancre 261 Charcoal, 575 Chelona glabra, 509 Chenopodiumanthelminticum,. 356 Chilblain 119 Chicken-pox, 287 China-root, 475 Chlorine, 576 Chloride of lime, 575 Chloriiium, 576 Cholera, 119 infantum, 128 morbus, 129 Chorea, 248 Cimicifuga racemosa, 445 Cinnamon, 476 Cinchona, 484 Citric acid 395 Clavus, 135 Clevers, 391 Cocklebur, 555 Colic-root, 476 Colomba, American, 498 Compounds 595 Compound tincture of myrrh, . 599 Composition diaphoretic powder, 597 Constipation, 136 Consumption, 130 Continued fever 35 Convalaria multiflora, 581 Convulsions, 138 Convolvulus panduratus, 352 Coptis trifolia, 531 Copaiba officinalis 388 Corns 135 Corn snake-root, 393 Cornus florida, ... . . 494 619 Page. Costiveness, 136 Cotton-weed, 451, 392 Cough, 137 Cowhage, 362 Cowrap, 293 Cramp, 138 Cranesbill, 533 Crocus sativus, 571 Croten eleutheria, 509 Croup, 138 Crowfoot, 533 Crusta lactea, 289 Cucurbita citrullus, 393 Cock-up-hat, 558 Culvers physic, 337 Cunila mariana, 481 Cup-plant, 567 Cutting almond, . . '. 384 Cussander, 352 Cynanchse, 92 trachealis, 138 Cypripedum, 421 humile, 419 pubescens, 421, 416 spectibile, 417 Cystitis, 70 Dandelion, 391 Dartre, 285, 289, 291 Deafness, 140 Delirium tremens, 141 Demulcents, 578 Devil's-bit, 476 Dewberry, 555 Diabetes, 280 Diaphoretics, 396 Diaphoretic powder, 597 Diarrhoea, 143 Dirca palustris, 320 Diseases of the skin,. 285 Disinfectants, 571 Dislocations, 145 Dittany, 481 Diuretics, 383 Dock, 559 Dog-tooth violet, 314 Dog fennel, 408 Dogwood, 494 Dolichos puriens, 362 Dothinenteria, 47 Dropsy, 148 oi the belly, 150 of the chest, 150 of the head, 149 Drowning, 250 Dysentery, 162 Dyspepsia, 179 Dysury, 284 Earache, 156 Page. Eczema, 289 impetiginoides, 289 rubrum, 289 simplex, 289 Elder sweet, 320, 348, 393 Elecampane, 377 Emmenagogues, 445 infusion, 450 Emetics, 303 herb; 307 Emollients, 578 English valerian, 425 Enteritis, 71 Entozoa 270 Epilepsy, 157 Epistaxis, 105 Erythema, 285 papulatum, 285 nodosum, 285 Erythronium Americanum, . . . 314 Errhines, 378 Erysipelas, 245 Eryngium aquaticum, 393 Euonymous, 531 Eupatorium teucrifolium, . . . 531 perfoliatum, 401 purpurium, 383, 395 Euphorbia corollata, 320 ipecacuanha, 313 Eutrophics, 556 Evan-root, 555 Expectorants, 366 Expectorant powder, 599 syrup, 600 Excitants, 457 Extracts, 601 Extract of white walnut, 334 mandrake, 330 dogwood, 494 Fainting 159 Falling of the rectum, 160 of the womb, 1 61 False sarsaparilla/ 559 bittersweet, 567 Favus, 296 Febris, 16 intermittens, 27 remittens, 31 continua, 35 icterodes, •. 50 miliaris, 287 Felon, 161 Fennel-seed, 437 Fernuculus, 108 Ferula assafoetida, 441 Fever, pathology of 17 intermittent, 27 remittent or bilious ...... 31 620 DOMESTIC MEDICINE. Page. Fever, continued, 35 inflammatory, 39 typhus, 42 typhoid, 47 yellow, 50 scarlet, 55 Filaria medinensis, 275 bronchialis, 275 Fits, (See Convulsions,) 138 Flax-seed, 582 Fluid measures, 602 Flux, 162 Fly-trap, 348 Folicular inflam. of the mouth, 83 Fractures, 1 65 Frasera, 498 French measles, 169 Gale, 299 Galium asperula, 391 Gases, poisoning by, 223 Gastritis, 86 chronic, &9 Gentian, 503 Geranium, 533 Geum rivale, 555 Ginger, 462 Ginseng, 433 Glands, enlargement of the, . . . 220 Glossitis, 90 Glossary, 604 Glvcerhiza glabra, 377 Goitre 169 Gold thread, 531 Golden seal, 497 Goose grass, 39 1 foot, 356 Gonorrhoea, 260 Gout, 170 Gravel and stone, 171 Gravel-root, 383, 395 Green salve, 596 Greek valerian 402 Gum 285 acacia, 581 arabic, 581 camphor, 464 guaiacum, 558 myrrh 464 Hamamelis Virginica, 544 Hanging, 251 Hartshorn, 467 Headache, 174 Healing salve, Thomson's, .... 595 Heart-burn, 175 Hedeoma pulageoides, 413 Helonias, 516 Hemlock, 555 Hepatitis, 76 Pag* Hernia 231 Herpes, 291 circinatus, 293 iris, 293 labialis, 292 phlyctenoides 291 preputiales, 292 zoster, 292 Hives 286 Haematemesis 106 Hsematuria, 107 Hsemorrhagia accidentalis, .... 101 Haemorrhoids, 213 Haemoptysis, 103 Honey, 395 bloom, 348 Hops, 531 Horse gentian, 503 mint, 481 Humid tetter, 289 Hydarthus, 267 Hydrastus canadensis, 497 Hydrocephalus, 149 Hydrops, 148 Hydrophobia, 190 Hydrothorax, 150 Hypochondriasis, 198 Hysterics, 176 Hysteria, 176 Icterus, 186 Ictodes foetida, 442 Impetigo, 293 figurata, 293 larvalis, 294 Incontinence of urine, 283 Incubus, 21)9 Indigestion, 179 Indian paint, 314 cup-plant, 567 hemp, 387 pink, 355 sanicle, • 408 tobacco, 307 turnip, 373 Indigofera, 572 Inflammation, 60 of the bladder, , 70 of the bowels, . . 71 of the brain, 73 of the eyes, 74 of the kidneys, 75 of the liver, 76 of the lungs, 78 of the mouth 82 of the peritoneum, 84 of the pleura 85 of the stomach, 86 of the tongue, 90 621 Page. Inflammatory fever, 39 sore throat, 92 Intermittent fever, 27 Intertrigo, 285 Intussusceptio, 184 Inula helenium, 377 Invagination of the intestines, . 1 84 Iodine ointment, 596 Ipecac, 312 Ipomeea jalapa, 338 Iron, 531 Irritating plaster, 597 Iris versicolor, 347 Itch, 299 Itch ointment, 301 Jalap, 338 Jaundice, 186 Jerusalem oak, 356 Juglans cenerea, 334 Juniper, 384 Juniperus communis, 384 Kidneys, inflammation of, 75 king's evil, 234 Lactuca elongata, 426 Lady's slipper, 421 red, 419 white, 417 yellow, 421, 416 f -ard, 582 Laurus cinnamomum, 476 Laurus sassafras, 481 Leatherwood, 320 Leontice thalictroides, 438 I^eontodon taraxacum, 391 Leonurus cardiaca, 452 Leprosy, 187 Egyptian, 188 Leptandra, 337 Leptandrin, 338 Liatris, 476 Lime, chloride of, 575 Lime-water 396 Linum semina, 582 Liniment, stimulating, 596 Liquorice, 377 Liriodendron, 504 Liver, inflammation of the,. ... 76 Lobelia inflata, 307 an antispasmodic, 437 an emetic, 307 an expectorant, 366 an errhine, 380 a sialagogue, 383 tincture, 309 tincture, sour, 309 cardinalis, 362 Locked jaw, 189 Locust, 320 Page. Locust-pant, 352 Lumbricus, 270 Lungs, inflammation of the,. . . 78 Macrotrys racemosa, 445 Madder, 455 Madness, canine, 190 Magnesia carbonas, 395 Male fern, 357 Male shield-fern, 357 Man-in-the-ground, 352 Mandrake, 329 extract of 33C Man-root, 35S Mania a potu, 141 Marubium vulgare, 377 Marsh mallows, 582 Marsh rosemary, 550 Materia medica, 302 Matico, 555 May-apple, 329 May-weed, 408 Mealy star-root, 515 Measles, 196 Measures, 602 Mel 395 Melancholy, 198 Melia azedarach, 362 Mellissa, 414 Menispermum canadense, 523 Mentha veridis, 476 Mentha piperita, 468 Mercury, effects of 217 Miliaria, 287 Miliary fever, 287 Milk sickness, 204 weed, 348 Moonseed, 523 Mortification, 205 Motherwort, 452 Mouth, inflammation of the,. . . 82 Mumps, 208 Musk, 442 Mustard, 476 Myrica cerefera, 534, 380 gale, 475 Myrrh, 464,456 compound tincture of, ... . 599 Myrtle, Dutch, 475 wax, 534 Narcotics, poisoning by, 224 Nicotina tabacum, 379 Narrow-leafed dock, 559 Nepeta cataria, 415 Nephritic plant, 384 Nephritis, 75 Nerviue tonics, 421 Nervine tonic tincture, 599 Nettle rash, 286 622 DOMESTIC MEDICINE. Page. Neuralgia 254 from mercury, 220 Night mare, 209 Nymphse oderata, 538 Obstructed menstruation, 210 Odontalgia, 256 Oil of almonds, 5b2 of amber, 445 of savine, 457 of turpentine, 365 nut, 334 Ointmentfiodine, 596 itch, 301 Oleum amygdala?, 582 olivsea, 582 ricini, 343 succini, 445 Olive oil, 582 Olophlyctide, 291 Onion, 378 Opthalmia, 74 Origanum vulgare, 481 Otalgia 156 Oxymel of lobelia, 309 Palpitation of the heart, 211 Palsy, 212 Panax quinquefolium, 433 Paracusis, 1 40 Paralysis, 212 Parsley, 393 Paronychia, 161 Parotitis, 208 Parthenium, 384 Peach-meats, 531 Peach tree, 351 Pemphigus varioloides, 287 Pennyroyal, 413, 452 Peppermint, 468 Peripneumonia, 80 Periton'eum, inflammation of the, 84 Peritonitis, 84 Pernio 119 Peruvian bark, 484 Pertusis, 269 Pestis, 215 Phrenitis, 73 Phthisis pulmonalis, 130 Phytolacca decautria, 568 Piles, 213 Pills, antibilious, 598 cathartic, 598 Pink-root, 355 Pinus canadensis, 555 Piper angustifolium, 555 nigrum, 463 Plague, 215 Plaster, irritating, 597 Pleurisy, 85 Paq% Pleurisy-root 377 Pleura, inflammation of the,. . . 65 Pleuritis, 85 Pneumonia, 78 Podophyllin, 330 Podophyllum peltatum, 429 Poisoning, 217 by acids, 229 alcohol, 223 animal poisons, 224 akalies, 223 antimony, . 222 arsenic, 221 gases, 223 mercury, 217 narcotics, 224 snake-bites, 224 Poke-root, 568 Polemonion reptans, 402 Polygala senega, 374, 456 Polygonum hydropiperoides, . . 456 Pomegranate, 358 Polypodium felix mass, 357 Poplar, 503 Populus, 503 Porrigo, 296 favosa, 297 scutulata, 297 Potash, carbonate of, 577 Potassa bicarbonas 577 Powder, cathartic 598 diaphoretic, 597 expectorant, 599 Prairie senna, 355 Prickly-ash, 399 southern, 400 Pride of China, 362 Prolapsus ani, 160 Proctorrhagia, 102 Prunica granatum, 358 Prunus Virginiana, 524, 377 Psora, 299 Puke-weed, 307 Pyrolygneous acid, 571 Queen of the meadow, . 383 Quinine, 493 Quinsy, 92 Queen's-delight, 558 root, • 558 Rachitis, 230 Radish, 395 Ragged-cup, 567 Raphanus sativus, 395 Rattle- weed, 445 Red elm, 578 lobelia, 362 puccoon-root, 314 raspberry s 544 G23 Page. Rheum, 333 Rheum compactum 335 emodi 332 palmatum, 332 Rheumatism, 228 Rhubarb, 333 Rhus glabra, 544 Riciuus communis, 343 Rickets, 230 Ringworm, 292 Robinia pseudacacia, 320 Rosemary, 455 Roseola, 169 Rosmarinus officinalis, 455 Rubeola, 196 Rubia tinctorum, 455 Rubus strigosus, 549 trivialis, 555 villosus, 555 Rubefacient oil, 596 Rumex crispus, 559 Running scall, 289 tetter, 293 Rupture, 231 Sabbatia angularis, 515 Saleratus, 577 Salivation, 218 Salt, 320 Salve, Thomson's healing, 595 black 595 green, 596 Sambucus canadensis, 348 Sanguinaria canadensis, 314 Sanicula Marylandica, 408 Sarsaparilla, 556 Sassafras, 481 Saffron, 571 Scabies, 249 Scald-head, 296 Scall, 296 Scalding of the urine, 284 Scailetina, 55 Scoke 568 Scorbutus, 237 Scrofula, 234 Skullcap, 422, 442 Scurvy, 237 Scutelaria lateriflora 422 Senega snake-root, 374, 456 Senna, 344,345 Shingles 292 Shower bath, 593 Sialagogues, 380 Silk- weed 451; 392 Silphium perfoliatum, 567 Sinapis 476 Skin, diseases of, 285 Skunk cabbage, 442 Slippery elm 578 Small-pox, 240 Smart-weed, 456 Snake bites, 224 head, 509 leaf, 314 root, 516 Snow-drop 314 Soda, carbonate of, 394 Soda and saleratus, 394 Sodae carbonas, 394 Sodium chloridum, 320 Solomon's seal, 581 Sore throat, 92 Spasmus 138 Spearmint 476 Spigelia Marylandica, 355 Spiritus vini gallici, 467 Spikenard 560 Spirit lamp vapor bath, 589 Sprain, 245 Sponging, 594 Spurge ipecacuanha, 313 Squaw-root, 445 St. Anthony's fire, 245 St. Vitus' dance, 248 Statice limouium, 550 Star-root, 516 Staff-vine, 567 Stickwort, 555 Stillingia, 558 Stimulants, . . . 457 Stomatitis, 82 Stomach, inflammation of, ... . 86 Strangling or hanging, 251 Strangling by irrespirable gases, 251 Strangury, 284 Strengthening plaster, 595 Strongylus, 274 Subluxatio, 245 Sudamina, 287 Sumach, , 544 Suppression of urine, 282 Suspended animation, - . 250 Swamp cabbage, 442 Sweat-root, 402 Sweet elder, 348 Sweet gate 475 Swallowwort, 407 Swine-pox, 287 Syncope 159 Synocha, 39 Syphilis, 260 Syrup, alterative, 599 Syrup, expectorant 600 Tanacetum vulgare 455 Tag alder, 568 Tansy, 455 624 DOMESTIC MEDICINE. Paoe. Tenia lata, 273 Tenia solinum, 273 Tepid bath, 592 Terebinthiua vulgaris, 388 Tetanus, 189 Tetter, 291 crusted 293 running 293 Thomson's healing salve, 595 Thoronghwort, 401, 319 Thoroughstem 401, 319 Thrush, 83 Tic doloureux, 254 Tincture, antispasmodic 599 lobelia, 309 lobelia, sour, 309 myrrh, 599 nervine, 599 Tinea, 296 Tobacco, 379 Tonics 4b2 Toothache, 256 Toothache-tree, 400 Tooth-rash, 285 Trillium 538 Triosteurn, 503 Trumpet- weed, 426 Trismus, 189 Tulip-tree, 504 Tussis 137 Turtle'bloom, 509 Turpentine, 388 Typhus, 42 Ulcers, 257 Ulmus fulva, 578 Unicorn root, 516 Urinary diseases, 280 Urine, incontinence of, 283 scalding of, 284 suppression of, 282 Uticaria, 286 Uvaeursi, 393,396 Vaccina, 242 Valerian, American, 421, 442 officinalis, 425 Vapor bath, 586 Varicella, 287 Variola, 240 spura, 237 Varioloides, 242 Venereal disease, 260 Verbena, 524 Pagb Vervain, 524, 31S Vinum, 467 Vinegar of wood, 571 Virginia snake-root, 516 Wa-hoo 531 Wake-robin, 373 Wandering milk-weed, 348 Water, cold, 40 Water melon, 393 Wash, in yellow fever, 53, 54 Wax myrtle, 534 Weights, 602 Wens, 266 White baneberry, 451 cohosh, 451 pond-lily, ' 538 root, 407 swelling, 267 walnut, 334 Whooping cough, 269 Wild angelica, 434 chamomile, 408 cherry, 524, 377 cotton, 451 buckwheat, 348 ginger, 426, 300 hoarhound, 531 indigo, 572 lettuce, 426 lily, 538 marjorum, 481 morning glory, 352 potato, 352 senna, 352 turnip, 373 Wine, 467 Witch-hazel, 544 Worms, 270 treatment of, 275 Wormseed, 356 Wormwood, 361 Wounds, 279 Xanthoxylum fraxineum,. .399, 380 Yarn-root, 475 Yellow lady's slipper 421 parilla, 523 puccoen, 497 poplar, 504 root, 497 Zingiber, 462 Zona,.... 292 Zoster,... 213 p?Jl?8 LIBRARY OF CONGRESS •] 022 169 897 6